In vitro correlates of delayed hypersensitivity in tuberculosis

Summary Since the demonstration of the lymphocyte as a mediator of delayed hypersensitivity our understanding of this immune response has advanced tremendously. It is now recognised that the lymphocyte acts as the sensitized cell and the macrophage as the indicator cell. The following mechanism for delayed hypersensitivity has been suggested. Antigen→macrophage super antigen→lymphoblast→sensitized lymphocyte→migration inhibitory factor→macrophage. The anergy to tuberculin testing in active tuberculosis and other states is better understood. It is believed that in active tuberculosis there is an inhibitory factor in the serum. The recognition of thein vitro correlates of delayed hypersensitivity has provided yet another method of detecting this immune response. It is more sensitive than the dermal tests. It is hoped that this will prove useful in the diagnosis and management of tuberculosis, a disease where hypersensitivity plays a large part in the pathological process. From the Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-16.     

Ontogeny and distribution of gonadotropin-releasing hormone (GnRH) neuronal systems in the brain of the cichlid fish Cichlasoma dimerus

Using immunocytochemistry we have described the distribution and ontogeny of three distinct gonadotropin-releasing hormone (GnRH) neural systems, emphasizing the analysis during the period of sex differentiation in the South American cichlid fish Cichlasoma dimerus. In the forebrain a group of neurones immunoreactive to salmon GnRH that formed clusters in the nucleus olfacto retinalis (NOR), was located at the junction of the olfactory bulb and the telencephalon. These neurones differentiated 3 days after fertilization from the olfactory placodes. GnRH immunoreactive neurones along the olfactory nerves through the rostrobasal olfactory bulb were observed on day 4 and at the NOR on day 10. A group of neurones immunoreactive to chicken GnRH II was seen in the dorsal midbrain tegmentum. They originate from the ventricular ependyma between days 5 and 6. These neurones remained close to blood vessels throughout development. Between days 22 and 30 a group of neurones immunoreactive to seabream GnRH was detected in the anterior basal preoptic area. GnRH innervation of the pituitary was detected after the differentiation of preoptic neurones and in coincidence with gonadal differentiation. We hypothesize that the GnRH neural systems have three distinct embryonic origins. Furthermore, we show that the NOR and the midbrain GnRH neurones might have functions other than gonadal development, whereas the preoptic GnRH neurones in C. dimerus might be associated with gonadal sex differentiation.     

Chiari malformation type III treated with primary closure

Chiari malformations represent various clinical and anatomic processes that entail varying degrees of involvement of the rhombencephalon (hindbrain). The type III Chiari malformation is distinctly rare. Chiari described only one case of his type III deformity, which is indicative of its rarity. We report a case of Chiari malformation type III, a female child who presented to us at the age of 1 month with a swelling at the back of the neck since birth. MRI revealed a Chiari type III malformation with a high cervical meningoencephalocele along with herniation of cerebellar tissue through the bony defect in the posterior elements of the C2 vertebra. At surgery, the meningoencephalocele was excised along with the gliotic cerebellar tissue, and a posterior fossa decompression along with augmentation duraplasty was done. The postoperative period was uneventful. The case and relevant literature is reviewed.     

Tyrosinemia type I—Diagnostic issues and prenatal diagnosis

A fifteen-month-old boy, born to consanguineously married couple, presented with asymptomatic hepatomegaly. Investigations revealed midly deranged liver functions, necroinflammatory changes and cirrhosis on liver biopsy, a markedly raised alpha feto protein and tyrosine levels in plasma and a generalized aminoaciduria. His diagnosis of hereditary tyrosinemia was established on findings of raised serum and urine succinylacetone, and a deficient activity of fumaryl acetoacetate hydroxylase enzyme. Prenatal diagnosis of hereditary tyrosinemia was performed in a subsequent pregnancy in this family from India.     

Perforated Gastrointestinal Stromal Tumor of the Meckel’s Diverticulum: a Case Report and Review of Literature

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the GI tract, they have a wide spectrum of clinical manifestations, and a small proportion of them present as an acute abdomen due to obstruction, perforation, or hemoperitoneum. We present a case of a perforated GIST of the Meckel’s diverticulum and review the current literature on perforated GISTs. We ran a search on Pubmed and Google Scholar with the following terms “perforated GIST,” “perforated Meckel’s diverticulum,” “GIST with peritonitis,” and “GIST in Meckel’s diverticulum.” After selecting the relevant articles, we tabulated our results and analyzed the data. Out of the 45 cases, 32 (71.1 %) were male and 13 (28.8 %) were female. Out of the 45 reported cases, 41 (91.1 %) were from the small intestine, 2 (4.44 %) cases from the stomach, and 2 (4.44 %) from the small bowel. In 15 (33.33 %) cases, the site of perforation was the Meckel’s diverticulum (MD). Forty-year-old male, presented with features of peritonitis localized to the right iliac fossa, was diagnosed as acute appendicitis and subjected to a diagnostic laparoscopy. Intraoperatively, a perforated Meckel’s diverticulum was found, which on histopathological examination contained a low-grade GIST. Our literature search revealed that in reported cases of perforated GISTs, there is a slight male preponderance. Small bowel appears to be the most common site for a perforated GIST, and a significant proportion (30.23 %) arise from the Meckel’s diverticulum. And most importantly, the commonest tumor to cause perforation of a Meckel’s diverticulum is a GIST.     

Fatal pyothorax: a rare complication of retropharyngeal abscess

Fatal pyothorax following a massive acute retropharyngeal abscess in an adult is reported. Acute non-tuberculous retropharyngeal abscess usually develops following a penetrating injury due to a foreign body or endoscopy. Microbial isolates are mixed and consists of aerobic and anaerobic organisms. It may lead on to mediastinitis since there is a potential communication between the two spaces. Immediate cervical, pleural and mediastinal surgical drainage along with appropriate antibiotics can be life saving.     

‘Jago Grahak Jago’: A cross-sectional study to assess awareness about food adulteration in an urban slum

Background

Food adulteration includes various forms of practices, including mixing, substituting, concealing the quality of food, etc. One of the main causes for rampant adulteration is ignorance of consumer regarding their right and responsibilities resulting in faulty buying practices. Hence, the present study was done to assess the knowledge about adulteration among consumers in an urban slum.

Atrophic rhinitis — A bacteriological profile

75 cases of atrophic rhinitis were studied bacteriologically. Klebsiella species was the commonest (26.66%) isolate Klebseilla ozaenae and Pseudomonas aeruginosa each were isolate in 17.33% of cases. In 22.66% cases multiple bacteriae were isolated. Klebsiella and pseudomonas in combination were the commonest. The culture was found to be sterile in 7.52% cases.