Stoke in the young: a four-year study, 1968 to 1972.

Twenty-six patients under 20 years of age having cerebrovascular disease were studied from 1968 to 1972. Common risk factors such as hypertension, diabetes mellitus, hyperlipidemia and heart disease were not present. Angiographical study showed a variety of abnormalities. No consistent defect was present. There was a high incidence of pyrexia and convulsions in the early stages of stroke and it appears possible that some form of arteritis might have been important in the production of the cerebral infarction.     

Difficulties in Immunohaematology : The Weak D Antigen

Background

The Rh blood system is one of the most polymorphic and immunogenic systems known to humans. The expression of Rh blood group antigen is complex. The Rh D antigen is the most important of the antigens that constitute the Rh antigen system. In most cases, D antigen can easily be detected. However, due to variability of expression, weak forms antigen are encountered. The reactivity of weak D with antisera is variable and presents as a problem in blood banking.

Methods

A retrospective analysis for a five-year period was done. Blood samples that were negative for Rh D by immediate spin tube method were tested for weak D antigen by additional lab tests.

Result

Of 34932 serial Rh grouping tests done in our Blood Bank, the incidence of weak D Rh antigen was 0.189%. All these were confirmed by the antiglobulin test.

Conclusion

These patients present as a problem for the blood banker and a curiosity to the clinician. Although uncommon, all health care workers should be aware of this entity to avoid anti D alloimmunisation.Key Words: Weak D, Rh Blood Group     

Concurrent coronary,bilateral iliac and left renal artery direct stenting

We describe a patient who underwent percutaneous coronary intervention combined with bilateral iliac and left renal artery angioplasty during the same sitting. Stenting of the coronary and peripheral arteries was performed employing the "direct stenting" technique. No complications occurred. The patient was discharged 2 days after the intervention and remains asymptomatic, leading a fully active life during 1 year of follow-up. To our knowledge, unstaged coronary stenting combined with direct stenting of the renal and both common iliac arteries has not been reported previously in India.     

Mosquito survey in Tripura.

Vector survey carried out in Tripura revealed the presence of 17 species of anophelines with a density of 92.39 per trap night. Major malaria vector encountered was Anopheles philippinensis which formed 30% of the total collection and is exophagic in nature. Another efficient malaria vector An. minimus which formed 5% of the total collection prevails equally both indoors and outdoors. The high parity rate of An. philippinensis (59%) and An. minimus (63.9%) gives a strong indication about their vectorial status in Tripura.     

Percutaneous gastrostomy in a child

A 2-year-old girl with cyanotic congenital heart disease needed to undergo gastrostomy. To avoid the use of general anesthesia, a percutaneous gastrostomy was performed as an interventional radiologic procedure with the patient under sedation and with the use of local anesthesia. The placement of a nasogastrocutaneous guide wire under fluoroscopic guidance provided a stable tract for placement of the gastrostomy tube.