Ciguatera fish poisoning with elevated muscle enzymes and abnormal spinal MRI

We report three cases of ciguatera fish poisoning. One patient died secondary to respiratory failure. Two patients showed elevated muscle enzymes and one patients had an abnormal cervical spinal MRI. MRI findings have not been previously described. MRI findings explain the mechanism of the L'hermitte phenomenon (a common complaint) among these patients. Respiratory failure is rare in ciguatera fish poisoning. Our findings suggest this could be related to respiratory muscles involvement.     

The elderly chronic schizophrenic inpatient: A study of psychiatric morbidity in ‘elderly graduates’

This study surveyed all chronic schizophrenic patients from 11 long-stay wards of a mental hospital. Patients were assessed on a variety of rating scales to assess clinical psychopathology and behaviour. Patients above the age of 65 years were studied in detail and also compared with those under that age living on the same wards. It was found that all the elderly schizophrenic patients in the sample had severe deficits in the form of residual negative symptoms and thought disorder. They had significantly fewer positive but more negative symptoms as compared to a younger sample on the same wards; there was no differences between the groups for affective symptoms or thought disorder. Although there were more males in the sample, no difference was found on any of the parameters between the two sexes. It was concluded that there are significant clinical differences in the ‘elderly graduates’ as compared to younger patients living in an identical environment; such findings could assist managers and administrators in the development of plans for other patients in this age group who are likely to be relocated from psychiatric hospitals in the near future or are already living in the community.     

Studies on the morphology Of Cotugnia digonopora Pasquale 1890 (Cestoda: Davaineidae)

Summary The present paper, Part V of the series deals with the detailed study of the nervous system of C. digonopora. The nervous system in this cestode is divisible into a central nervous system and a peripheral nervous system. The former includes the anterior rostellary nerve ring, cephalic ganglionic mass, the nerves to the four suckers and the lateral longitudinal nerve cords. The peripheral nervous system includes the branches of the lateral longitudinal nerve cords and the neuromuscular cells which connect the muscle fibres with the lateral nerve cords.With 17 Figures in the Text     

Long scarf injuries

Long scarf (Dopatta) traditionally worn by females in South-East Asia have been described to make the females prone to sustain specific injuries when they ride pillion on the cycle powered rickshaw or motor bike. Two cases of females have been described.     

Surgical treatment of hidradenitis suppurativa: case series and review of the literature

The chronic and relapsing nature of hidradenitis suppurativa leads to physical and psychological damage. The absence of a proven cure further worsens the scenario. Patient 1 was a 28-year-old woman with a 10-year history of abscesses and non healing sinuses with foul-smelling discharge from her axilla, submammary and groin areas. This led to an episode of self-harm due to severe depression. After failed medical therapy, she was referred for surgery with wide excision of the skin and healing by secondary intention. Her wounds were managed by our specialist wound clinic with the use of topical and systemic antibiotics and thus remained free from symptoms. Patient 2 was a 32-year-old woman with a similar history for 15 years. Patient 3 was a 41-year-old man with a 20-year history of discharging sinuses and abscesses. All the patients had endured a long period of medical treatment and subsequently required surgery for a long-term relief of symptoms. This has undoubtedly led to psychological symptoms and a decrease in quality of life.     

Studies on the morphology ofCotugnia digonopora Pasquale 1890 (Cestoda: Davaineidae)

Summary The musculature ofCotugnia digonopora is described in detail. In the scolex there are four muscle systems, very well developed and used for the working of the organs of attachment. The suckers do not show any special muscle systems and possess the typical cestode sucker musculature. The musculature of the strobila consists of transverse, dorsoventral and longitudinal muscles. The longitudinal muscles are present in bundles and are in two layers alternating with a double layer of transverse muscle fibres. These muscles are associated with their respective myoblasts, which are of three types. These myoblasts give rise to the muscles of the strobila. A discussion is provided about the origin of the various muscles in the cestodes.With 14 Figures in the Text     

Studies of the anticancer potential of plants used in Bangladeshi folk medicine

The present study evaluated the anticancer potential of 11 plants used in Bangladeshi folk medicine. The extracts were tested for cytotoxicity using the brine shrimp lethality assay, sea urchin eggs assay, hemolysis assay and MTT assay using tumor cell lines. The extract of Oroxylum indicum showed the highest toxicity on all tumor cell lines tested, with an IC(50) of 19.6 microg/ml for CEM, 14.2 microg/ml for HL-60, 17.2 microg/ml for B-16 and 32.5 microg/ml for HCT-8. On the sea urchin eggs, it inhibited the progression of cell cycle since the frist cleavage (IC(50)=13.5 microg/ml). The extract of Aegle marmelos exhibited toxicity on all used assays, but in a lower potency than Oroxylum indicum. In conclusion, among all tested extracts, only the extracts of Oroxylum indicum, Moringa oleifera and Aegles marmelos could be considered as potential sources of anticancer compounds. Further studies are necessary for chemical characterization of the active principles and more extensive biological evaluations.     

Morbidly adherent placenta: can we limit the aftermath?

Morbidly adherent placenta is a grave complication of pregnancy referring to a pathological adherence of placenta to uterine wall with a reported incidence of 1:2500 deliveries. Women with previous two caesarean sections and placenta previa are at greater risk and also those with previous damage to uterine wall. This commentary discusses the pathophysiology, diagnosis and management of the condition in local perspective.