An algorithmic approach to female genital tuberculosis causing infertility.

SETTING: A private infertility care and in vitro fertilisation (IVF) centre in Northern India. OBJECTIVES: To describe the prevalence, clinical spectrum, management strategy and outcome of infertility due to female genital tuberculosis (GTB) diagnosed with the help of a simplified tuberculosis (TB) algorithm. DESIGN: Data from 150 women with infertility (Group I) and 47 women with general gynaecological problems (Group II) were analysed. RESULTS: GTB was diagnosed in 7.2% of Group I and 2.8% of Group II women. Anti-tuberculosis treatment resulted in resolution of symptoms other than infertility in over 90% of cases. Of the total 20 pregnancies in the group, 10 were obtained in 32 IVF treatment patients. CONCLUSIONS: A definitive bacteriological diagnosis was generally difficult to achieve in GTB before administration of anti-tuberculosis treatment. A high index of suspicion and several other morphological and/or laboratory criteria were employed. It is suggested that a step-wise algorithm can help in the management of these cases.     

Domiciliary mechanical ventilation in a patient with severe chronic obstructive lung disease and respiratory failure.

A patient of chronic obstructive pulmonary disease (COPD) with cor-pulmonale and chronic respiratory failure, who was given intermittent positive pressure ventilation at home, is reported. The patient did remarkably well on home mechanical ventilatory support. We believe this to be the first case report of domiciliary mechanical ventilation in a patient of COPD from India.     

Impedance of a goat eye lens

The complex electrical impedance of a goat eye lens is studied in the frequency range 10mHz−10Hz at room temperature, using a computer-controlled AC impedance system. AC impedance software (model 368, version 2.2) is employed to determine the total impedance and capacitance of the eye lens at various frequencies. A Cole-Cole plot of the eye lens material is drawn between the real component of impedance Z′ and the imaginary component Z″ for each excitation frequency that shows a perfect arc of a semicircle, with its centre lying below the abscissa at an angle of 35°. The half-angle ϕ between R₀ and R_∞ is found to be 55°, which mathematically demonstrates the selective permeability of the eye lens. Using graphical analysis of the Cole-Cole plot, characteristic frequency f_c and distribution factor α are observed to be 1Hz and 0.77, respectively. At characteristic frequency, capacitance and total impedance are found to be 1.14μF and 9.08kΩ. The effect of electrode polarisation on capacitance is corrected, based on Fricke's power function. The observed electrical parameters are then used to explain the multiple current path through various tissue compartments. Further, an attempt is made to explain the results on the basis of a possible dipolar model.     

Pancreatoblastoma (infantile pancreatic carcinoma)--a case report

Pancreatoblastoma or infantile pancreatic carcinoma is a rare pancreatic tumor with distinct acinar and squamoid cell differentiation that generally affects infants and young children. Ultrasound and CT scan may be useful but preoperative diagnosis is often quite difficult. The outcome is generally favourable. A such case of 10 years old boy with an abdominal mass is being presented.     

Impedance of goat eye lens at different DC voltages

A computer assisted AC impedance system is used to measure the DC voltage—current (V-I) characteristics and AC impedance of a goat eye lens using a two-probe Ag−AgCl electrode system. The measurement of the V-I characteristics shows that when a DC voltage from 0mV to 30mV is applied, the resultant current decreases from an initial value of 0.58μA to 0.006μA. However, when the voltage is increases beyond 30mV, the current increases and reaches a value of 0.9μA at 100mV. The data on the frequency response (0.01–10 Hz) of the impedance of lens tissue show an inverse relationship with frequency. The effect of various DC voltages, namely 0, 30, 50, 100 and 200 mV, on the impedance of the eye lens is also investigated over a frequency range of 0.01–10 Hz. The measurement results for both V-I characteristics and AC impedance further suggest the presence of a 30 mV voltage compartment in the goat eye lens.     

Diagnosis of aortic occlusive diseases using impedance plethysmography

Impedance plethysmographic observations have been correlated with aortographic observations in 57 patients suspected of aortic occlusive diseases. Aortic occlusions have been characterised by marked decrease in blood flow index and significant increase in differential pulse arrival time at thigh level bilaterally. Atherosclerotic affection of the aorta has been featured by a bilateral decrease in the value of blood flow index as well as differential pulse arrival time at thigh level. Leriche's syndrome, however, has been found to decrease the blood flow index moderately at thigh in both the legs without any significant change in differential pulse arrival time. Aortography in all the patients has confirmed the diagnosis made by impedance plethysmography.     

Mycobacterial cervical lymphadenitis in childhood

A study of 190 children of chronic cervical lymphadenitis showed tuberculous etiology on histopathological examination in 92 (48.4%) and bacteriological evidence of mycobacterial infection (smear and/or culture) in 42 (22.1%). Of these 42, twelve (28.6%) showed histopathological diagnosis of non-specific lymphadenitis. Positive culture for mycobacteria was obtained in 40, of which 30 (75%) were typical M. tuberculosis and 10 (25%) were atypical mycobacteria. The most predominant species of typical mycobacteria was M. scrofulaceum (60%) followed by M. avium intracellulare (40%). There was no remarkable difference in the histopathological pattern of those in which M. tuberculosis was grown and those in which bacterial growth was that of atypical mycobacteria. The diagnosis of chronic cervical lymphadenitis should therefore be taken a step beyond histopathology, up to complete bacteriological examination, especially to confirm the cases of mycobacterial lymphadenitis caused by atypical mycobacteria.