Bilateral lacrimal sac mucocele with punctal and canalicular atresia

Congenital absence of lacrimal puncta may be an isolated finding or associated with other developmental abnormality. Nasolacrirnal ducts can be absent thus predisposing to the formation of a congenital lacrimal mucocele. Punctal and canalicular agenesis is very rare. Four percent of new patients attending the lacrimal clinic at Moorfields Eye Hospital, London, UK. from 1981 to 1990 inclusive were diagnosed to have this condition. We describe a case of bilateral congenital absence of lacrimal puncta with lacrimal mucocele. Combined surgery was carried out by Ophthalmologist and Otolaryngologist with successful results.     

Safety of oral iron chelator deferiprone in young thalassaemics

Deferiprone is now widely used for iron chelation in patients with thalassaemia. Studies on its efficacy and safety have largely included older children and adults. OBJECTIVE: To assess the safety of deferiprone in children <6 yr of age. METHODS: The study is based on scrutiny of follow-up data of 44 patients of age <6 yr receiving deferiprone for a variable period of time. Occurrence of various side effects including gastrointestinal, osteoarticular were noticed and complete blood counts were performed every 2-4 wk. RESULTS: Nausea and vomiting were noticed in 12 (27.2%), joint symptoms were reported by four (9.1%) and neutropenia was observed in only two patients (4.5%). None of the patient had agranulocytosis. Thrombocytopenia was observed in 20 patients (45.45%), which occurred 3 months to 1 yr after deferiprone therapy. Interruption of deferiprone for 2-4 wk led to reversal of symptoms in all but two patients. CONCLUSION: Thrombocytopenia is one of the major side effects in young thalassaemics and necessitates frequent close monitoring of blood counts but its resolution after discontinuation and absence of clinical evidence of bleeding does not preclude its use.     

Brainstem auditory evoked responses in coma due to meningoencephalitis

ABSTRACT— Prognosticating the outcome of an unconscious patient continues to pose a serious challenge to the clinicians. BAERs are the latest addition to neurological diagnostic aids for predicting the outcome of coma. The relative value of BAERs in predicting the outcome of 15 comatosed meningoencephalitis patients has been studied. The results points to a rôle of BAERs in the detection of brain stem dysfunction in a large majority of patients. However, when used as a prognostic indicant, the traditional bed-side clinical assessment (GCS and vestibulo-ocular cold caloric response) still holds a slight advantage over advanced technology. BAERs may have a place in assessing brain stem dysfunction in neurologic conditions where an adequate clinical assessment may not be possible.     

A Sublingual Dermoid

Indian Journal of Otolaryngology and Head & Neck Surgery - A case of Sublingual Dermoid in the floor of the mouth is presented which can be mistaken as ranula, cystic hygroma or salivary gland...     

Spinal myelopathy induced by subarachnoid batrachotoxin: Ultrastructure and electrophysiology

A combined structural and electrophysiologic analysis on the effects of subarachnoid injections of batrachotoxin was conducted in rats. Swelling of neuronal perikarya, accompanied by areas of clearing, satellitosis, fatty metamorphosis and central chromatolysis were demonstrated in the spinal anterior horns. Studies on isolated extensor digitorum longus (fast) and soleus (slow) muscles showed membrane depolarization in the extensor 24 h after injection, with progressive augmentation of this phenomenon in animals given multiple injections of the toxin. Differential sensitivity of fast and slow muscles was evident: soleus was only slightly affected. Subarachnoid injections of batrachotoxin, which induced swelling of neuronal perikarya and axonal processes, also caused signs of denervation in the extensor muscle 7 days after injection, while spontaneous transmitter release was still present. Some structural and most electrophysiologic alterations after batrachotoxin injections were reversible.