BENIGN COLONIC STRICTURES - A STUDY OF TWENTY CASES

An analysis of twenty cases of benign colonic strictures is presented. Thirteen (65%) had tubercular strictures, 3 (15%) had ulcerative colitis, one each had ischaemic colitis and Crohn''s disease. In 2 cases the cause could not be established. Eleven patients (55%) presented with subacute intestinal obstruction and 7 (35%) with diarrhoea. Specific diagnoses based on histopathology could be made in only 45 per cent of cases. Most of the patients responded to specific medical therapy. Seven patients (35%) required surgical intervention.KEY WORDS: Colonic strictures, Colonoscopy, Colitis, Tuberculosis     

AN EPIDEMIOLOGICAL STUDY OF BLOOD PRESSURE AMONG SCHOOL CHILDREN

Blood pressure was measured in 1170 school children between 5 and 15 years of age. Mean blood pressure was significantly higher in boys than girls in all age groups and a steady increase in blood pressure with age was seen in both the sexes. Mean blood pressure was significantly higher among children with positive family history of cardiovascular morbidity. Children from higher socio-economic strata and overweight children also showed higher blood pressure. Nine (0.77%) children had persistent hypertension. However, the degree of hypertension was mild and all these children were asymptomatic. Baseline investigations failed to detect any underlying pathology or target organ involvement. This study suggests that childhood could be a reasonably profitable time to look for such factors and to selectively screen children belonging to the high risk group for hypertension.KEY WORDS: Hypertension, Blood pressure, Epidemiology     

DRUG RESISTANT TUBERCULOSIS — THE EMERGING SCENARIO

During the period April 1992 to September 1994 a total of 2288 patients of pulmonary tuberculosis were treated at our centre. M. tuberculosis could be isolated from the sputa of 1037 patients (45.3%). All the isolates were subjected to indirect susceptibility testing using drug incorporated Lowenstein-Jensen medium slants. A total of 142 (13.7%) patients showed drug resistance. Single drug resistance was observed in 86 (8.3%) patients whereas resistance to two or more drugs was observed in 56 (5.4%) patients. Patients showing initial drug resistance were more in number (83 cases) than those showing acquired drug resistance (59 cases). Resistance to streptomycin was commonest (8.3% of isolates) followed by isoniazid (5.7%) and rifampicin (5.0%). Multiple drug resistance was mostly acquired (71.4% of drug-resistant isolates).KEY WORDS: Antitubercular agents, Drug resistance microbial, Tuberculosis     

A SIMPLE COLD STAINING METHOD FOR ACID FAST BACILLI

Sputum from 105 cases of pulmonary tuberculosis were studied. Direct and post concentration smears were stained by Ziehl – Neelsen (ZN) and cold staining methods. The cold staining method is simple, because it eliminates heatingof stain. For direct smear, the correlations of cold staining procedure with conventional ZN method was 93% and for post concentration smear it was 100%.KEY WORDS: Acid fast bacilli, Mycobacterial cold staining     

ALVEOLAR PROTEINOSIS (A Case Report)

A case of pulmonary alveolar proteinosis diagnosed by open lung biopsy is being reported and relevant literature is discussed.KEY WORDS: Alveolar proteinosis, Pulmonary alveolar lipoproteinosis     

Ultrasonographic changes in malignant neck nodes during radiotherapy in head and neck squamous carcinoma

Limited information is available about the sonomorphological changes in metastatic neck nodes during radiotherapy. The aim of this study was to evaluate the pattern of sonomorphological changes in metastatic neck nodes with radiotherapy. The study population consisted of 16 consecutive patients planned for radical radiotherapy to the head and neck. All patients were subjected to four ultrasound examinations: before therapy, at 46 Gy, at the conclusion of radiation and at first follow up. A total of 59 ultrasound examinations were performed on 16 patients. The difference between the mean number of nodes detected per patient before (10.6) and after (7.8) radiation was significant (P = 0.05). Sixteen nodes were categorized as malignant at first sonography, half of which reverted back to normal by the end of radiation. Changes in the sonomorphology of malignant cervical lymph nodes occur with radiotherapy with more that half demonstrating reversion to normal pattern. Future studies correlating this with histopathology should be considered.     

FEVER OF UNKNOWN ORIGIN

Forty six patients of fever of unknown origin in Service Hospitals who met the standard criteria were studied between 1989 and 1997. Infectious diseases contributed 21 patients (45.65%) of which 13 (28.26%) were diagnosed to have tuberculosis. Eight patients each (17.39%) of malignancies and collagen vascular diseases were seen, solid tumours were found in 5 patients. One (2.17%) patient had intrabdominal abscess. No diagnosis was made in 4 (8.69%) patients. The pattern and height of fever bore no correlation to aetiology. Serially repeated radiograph of chest was the most contributory investigation giving diagnostic information in 41.3%. Tissue/body fluid biopsy and cytology, serology, ultrasonography, computerised tomography and laparotomy were other useful investigations.KEY WORDS: Fever of unknown origin, Pyrexia     

HIGH ALTITUDE PULMONARY OEDEMA – AN EXPERIENCE IN EASTERN HIMALAYA

Three hundred and five cases of high altitude pulmonary oedema (HAPO) hospitalised in eastern Himalayan region have been analyzed. Incidence of HAPO was 5.5 per cent. Eighty per cent cases occurred during latter half of the year. Fifty six per cent of cases belonged to the third decade of life. HAPO cases occurred most commonly between the height of 2740 m to 5960 m. Eighty three per cent cases developed symptoms within 72 hours of induction to high altitude and 65.9 per cent suffered from the illness despite complete acclimatization. Breathlessness, headache and cough were the commonest symptoms. Tachycardia and tachypnoea was present in all cases. Twenty five per cent cases showed various ECG abnormalities. Mortality rate was 0.98 per cent.KEYWORDS: Altitude, ECG abnormalities, Cerebral oedema, Pulmonary oedema