A study of the cerebrospinal fluid in atypical presentations of tuberculous meningitis

Atypical clinical and CSF profiles encountered in TBM are highlighted. Acid-fast bacilli (AFB) were isolated from the CSF of 7 patients in spite of the complete absence of any cellular response and also from another 3 patients who had no clinical evidence of meningitis. M. flavescens was cultured from the CSF in 4 patients.     

Clinico-cytopathological spectrum of hepatocellular carcinoma, its correlation with serum alpha-fetoprotein level, and hepatitis B and C viral markers.

Fine-needle aspirationbiopsy (FNAB) is now widely accepted as a diagnostic modality for the treatment of hepatocellular carcinoma (HCC). The most common diagnostic problem in HCC is distinguishing it from a metastatic carcinoma. The literature from India on HCC is scanty. Hence, we studied the cytomorphological features of HCC and metastatic carcinoma. The study included 37 cases of space-occupying lesions (SOLs) of the liver as demonstrated by ultrasound or computed tomography (CT) scan. Cytomorphological features of these SOLs were analyzed in all subsequent to FNAB. Hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody (anti-HCV) and alpha-fetoprotein (AFP) were determined in all the cases by enzyme-linked immunosorbent assay (ELISA). The cytopathological diagnosis was HCC in 22 and metastatic carcinoma of the liver in 15. The individual cytomorphological features and which helped to make a definite diagnosis of HCC were: a high nuclear cytoplasmic ratio (81.8%), predominantly trabecular pattern (63.6%) and atypical naked nuclei (100%). Other features were prominent multiple nucleoli (63.3%), hyperchromasia (100%) and moderate anisonucleosis (59%). AFP was elevated in 81.8% of the cases with a mean of 634.8+812.7 ng/ml. HBsAg by ELISA was found to be positive in 72.7% of cases while only 1 case (4.5%) was positive for anti-HCV. In 1 case (4.5%), there was dual infection due to hepatitis B virus (HBV) and HCV. No viral cause was found in 18.3% of cases.     

Role of Yersinia enterocolitica in childhood diarrhea

A total of 157 infants and preshool children with acute diarrhea were investigated for Yersinia enterocolitica over a six months period. Only one infant with acute diarrhea (0.6%) was found to have Yersinia enterocolitica in the stool as compared to none from the 65 asymptomatic controls. Clinical features of the child with yersinia diarrhea have been described.     

Pseudomonas aeruginosa: isolation from ocular tissues

Fifty strains of Pseudomonas aeruginosa isolated from human eyes were aeruginocin typed by the method of Shriniwas (1974) using ten indicator strains. These belonged to types A₁ (3), B (2), F₁ (1) and 14 (1). Fifteen (30.0%) were nontypable and 28 (56.0%) were unclassifiable presenting twenty inhibition patterns. The strains showed a wide range of antibiotic sensitivities. The highest number of insensitive strains were those obtained from corneal ulcers. Experimental keratitis produced by strains of pseudomonas was either mild, moderate or severe and was unrelated to their source. Mild keratitis was produced by types UC 7^-, UC 79^- and 14 isolated from pre-operative, corneal ulcer and post-operative patients. Lesions of moderate severity were produced by types 189^#x002B; & A₁ whereas the severest pathology was produced by UC 23478^-, B and UC 810^- types. The fact that strain 23478^- always produced severest pathology irrespective of whether originated from group I, II, or IV strongly suggests relationship of pathogenicity with aeruginocin type.     

Cockroaches (Blattella germanica) as carriers of microorganisms of medical importance in hospitals

A study was conducted to isolate and identify microorganisms of medical importance from cockroaches (Blattella germanica) and to ascertain their vector potential in the epidemiology of nosocomial infections. Bacteria, fungi and parasites of medical importance were isolated and identified. Important bacterial pathogens responsible for wound infections, were further studies by antibiograms. One hundred and fifty-eight out of 159 (99.4%) cockroaches collected from hospital (test) and 113 out of 120 (94.2%) cockroaches collected from residential areas (control) were carrying medically important microorganisms (P less than 0.05). significantly higher (P less than 0.001) number of test cockroaches were carrying a higher bacterial load (1 x 10(4) and 1 x 10(5] as compared to control cockroaches. Multiple drug-resistant bacterial were isolated from test cockroaches. The diversity of drug-resistant bacterial species isolated from test cockroaches suggests their involvement in the transmission of drug-resistant bacteria. Various fungi and parasitic cysts of medical importance were also isolated from the test and control cockroaches, but the carriage rates were low. The findings suggest that cockroaches, in hospitals, can act as potential vectors of medically important bacteria/parasites/fungi.     

Contralateral male breast cancer with a positive family history — a case report with review of literature

Male breast cancer is an uncommon disease. The incidence of male breast cancer has been found to be gradually but steadily increasing. However, because of rarity of this disease, it is not exhaustively studied and discussed when compared to the female counterpart. The occurrence of a contralateral breast cancer in a male is much rarer. We are reporting a case of contralateral male breast cancer with a positive family history. This is an uncommonly reported entity. The relevant literature has been reviewed and a brief discussion on the current concepts on male breast cancer has been added.     

Failure to isolate verotoxin producingEscherichia Coli from patients of Haemolytic Uremic Syndrome

Haemolytic Uremic Syndrome (HUS) been defined as the simultaneous occurrence of acute renal failure in children with haemolytic anemia and thrombocytopenia. This clinical condition that has been recognized is an important cause of acute renal failure in children.¹