Subcutaneous phaeohyphomycosis caused by Cladophialophora boppii

Subcutaneous phaeohyphomycosis is an infection of the skin and subcutaneous tissue, caused by dematiaceous fungi. An adult male presented with a history of multiple reddish nodules over the face and hands. Histopathological examination of the skin biopsies showed a dense granulomatous infiltrate of macrophages, containing intracytoplasmic basophilic bodies throughout the dermis. Gomori methenamine-silver stained sections revealed yeast cells within macrophages. Multiple cultures on Sabouraud's dextrose agar grew Cladophialophora boppii. The patient was treated with oral itraconazole for a year and the response monitored with dermal ultrasound. This is the first case report of subcutaneous phaeohyphomycosis caused by Cl. boppii in India.     

Membrane alterations and fluidity changes in cerebral cortex during acute ammonia intoxication

Acute ammonia intoxication is known to cause alterations in activities of several membrane bound enzymes like Na+ K+ ATPase, acetylcholine esterase and glutamate uptake in brain. The alteration in these membrane associated activities could be a consequence of altered membrane architecture. To probe this, the effect of pathophysiological concentrations of ammonia on lipid composition and fluidity of membranes isolated from cerebral cortex of rats, were investigated in the present study. Administration of acute doses of ammonium acetate caused depletion of membrane sphingomyelin and cholesterol levels thereby reducing cholesterol: phospholipid (C: PL) ratio. Levels of phosphatidylserine increased while those of phosphatidylcholine and phosphatidylethanolamine remain unaltered. Membrane fluidity estimations using 1,6-diphenyl-1,3,5-hexatriene (DPH), 1-[4-(trimethylammonio)phenyl]-6-phenyl-1,3,5-hexatriene (TMA-DPH) indicated no changes in core and surface membrane fluidity following ammonium acetate administration. Acute ammonia toxicity induced no alteration in bulk fluidity but a decrease in annular fluidity of membranes, as determined using pyrene fluorescence. Elevated levels of malondialdehyde and declined level of total thiols in cerebral cortex membranes of rats under acute ammonia intoxication indicated the existence of oxidative stress.     

Dengue infection with multi-organ involvement

Fever, headache, body aches, retro-orbital pain, haemorrhage and shock are well known manifestations of dengue infection. We report the case of a 4-y-old child with dengue who presented with meningo-encephalitis and subsequently developed myelitis, hepatitis, glomerulonephritis and bone marrow suppression. Complete recovery occurred within 3 weeks.     

Correcting myogenic ptosis accompanying extraocular muscle weakness: The “Bobby Pin” procedure

This article evaluates the “Bobby Pin” procedure in the correction of myogenic ptosis accompanying extraocular muscle weakness. We retrospectively reviewed 26 eyelids of 13 patients who underwent “Bobby Pin” procedure for myogenic ptosis accompanying extraocular muscle weakness. We evaluated the patients’ clinical features such as age, etiology of ptosis, symptoms, standard ptosis measurements, associated systemic diseases, additional ophthalmic conditions, complications, and recurrence. Etiology of myogenic ptosis and extraocular muscle weakness was oculopharyngeal dystrophy in 4 (31%) patients, chronic progressive external ophthalmoplegia in 4 (31%) patients, myotonic dystrophy in 2 (23%) patients, and idiopathic in 3 (15%) patients. The mean levator function was approximately 5 mm pre- and post-operatively (range 1 to 12 mm). The mean margin-to-reflex distance 1 increased from –1.1 mm (below the light reflex) pre-operatively to +0.4 mm (above the light reflex) post-operatively. After a mean follow-up of 40 months, only 1 (8%) patient experienced ptosis recurrence. Upper eyelids were symmetric in both contour and height in all patients. Mild superficial keratopathy involving less than 10% of cornea was observed in 4 (31%) patients. The “Bobby Pin” procedure is an effective and long-lasting treatment option for correcting acquired ptosis accompanying extraocular muscle weakness. The procedure is safe, simple, easily learned, time- and cost-effective, and does not require any expensive equipment.     

Performance analysis of different wavelet feature vectors in quantification of oral precancerous condition

This paper presents an automatic method for classification of progressive stages of oral precancerous conditions like oral submucous fibrosis (OSF). The classifier used is a three-layered feed-forward neural network and the feature vector, is formed by calculating the wavelet coefficients. Four wavelet decomposition functions, namely GABOR, HAAR, DB2 and DB4 have been used to extract the feature vector set and their performance has been compared. The samples used are transmission electron microscopic (TEM) images of collagen fibers from oral subepithelial region of normal and OSF patients. The trained network could classify normal fibers from less advanced and advanced stages of OSF successfully.