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1997| October-December | Volume 43 | Issue 4
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A prospective study of seroprevalence of Toxoplasmosis in general population, and in HIV/AIDS patients in Bombay, India.
YV Meisheri, S Mehta, U Patel
October-December 1997, 43(4):93-7
Two hundred and seventy nine sera (age group 13-50 years) were tested for antitoxoplasma IgG/IgM antibodies by ELISA techniques; the diagnostic titer for positive test is 10 iu/ml or > 1:100. Sera were obtained from (i) 165 (100 men/65 women) healthy adult voluntary blood donors (HIV, HBsAg, VDRL negative); (ii) 89 consecutive HIV/AIDS patients (82 men/7 women); and (iii) 25 patients (HIV negative: 12 men/13 women) treated for cerebral Tuberculoma or Neurocysticercosis during this study from January 1996-June 1997. The overall seroprevalence was 30.9% (51/165) in the immunocompetent adult (group i) 34% (34/100) men and 26.2% (17/65) in women [range: 10-899 iu/ml; (mean: 376.8)]. In HIV infected hosts the seroprevalence [range: 21-340 iu/ml; (mean; 180)] was 67.8% (56/82 men, 04/07 women). The seroprevalence was 20.5% (8/39), 32.8% (22/67), 34.8% (16/46) and 38.4% (5/13) in the 2nd, 3rd, 4th and 5th decades respectively in healthy adults. In HIV/AIDS patients, 69% (29/42) in the 3rd and 70.6% (24/34) in 4th decade were seropositive. The risk of cerebral Toxoplasmosis (encephalitis-02, granuloma-24) was 43.3% (26/60, mean 250 iu/ml). The seroprevalence was 28% in group iii (range 12-80 iu/ml, mean 21 iu/ml). Anti-toxo IgM was negative in all. Primary Toxoplasma infection appears to be subclinical and prevalent throughout life. T. gondii has emerged as an important opportunistic infection in HIV/AIDS patients in Bombay. Recrudescence of cerebral toxoplasmosis (CTOX) is observed with low IgG response during mid-late stage of the disease, as seen in our patients (mean IgG 250 iu/ml, CD4+ = 283/cmm (range 43-504 in 5 patients). Primary prophylaxis for CTOX seems rationale and can be targeted to asymptomatic HIV/AIDS population at risk who are seropositive for T. gondii (mean IgG 111.5 iu/ml in our study). The very high predictive value of a negative test for TOX remains the best serological parameter for excluding acute episode of TOX.
Single unilateral ectopic bifid ureter with contralateral orthotopic quadrufid ureter--a rare combination.
AD Bhandarkar, AM Raju, MS Rao
October-December 1997, 43(4):104-5
This is a report a case with a unilateral single ectopic ureter associated with ipsilateral incomplete duplication of upper third of the ureter, contralateral quadrufid ureter and L3 hemivertebra. These findings provide further evidence of a generalised mesenchymal or epithelial defect, which would explain a defective ureteral bud and metanephric development, besides associated anomalies.
Qualtum cosmics-and-chaotics--the ultimate tortoise in physics and modern medicine.
MV Kothari, LA Mehta
October-December 1997, 43(4):85-92
Qualtum cosmics is the qualitative opposite of quantum mechanics. The flip-side of qualtum cosmics is qualtum chaotics, the two governing much of what is seen as inscrutable in medicine. The Ultimate (Last) Tortoise is close to Einsteinean idea of a Unified Theory, a single concept that can explain whatsoever there is in physics, (and in medicine, or what have you).
Persistent frontal fistula.
HK Marfatia, SN Muranjan, MM Navalakhe, MV Kirtane
October-December 1997, 43(4):102-3
The frontal sinus is prone to various complications--usually secondary to blockage of the fronto-nasal duct and stagnation of frontal sinus secretions. These pent-up secretions may result in pressure necrosis of the inferior or posterior sinus wall. Involvement of anterior wall is uncommon. We present a case of an anterior wall frontal sinus fistula and discuss its management.
Sacral chordoma--a case report.
KP Khambekar, UB Nadkarni, J Menon, SC Karande, MK Jain
October-December 1997, 43(4):106-8
Chordoma, a rare malignant tumour of early adulthood, rarely presents in children. We report such a case of rare malignant tumour which was diagnosed in the first decade of life.
Klebocin typing of Klebsiella species isolated from nosocomial infection in intensive care unit.
RB Pal, JS Rebello, DD Banker, PK Jain
October-December 1997, 43(4):98-101
Klebocin typing and antibiotic resistance have been studied for 518 strains of Klebsiella pneumoniae, [106 from intensive care unit (ICU) sites, 182 from ICU staff flora, 192 from patient flora and 38 from clinical specimens]. The overall typability was 71.62%. The most common mnemonic types among various sources were 111, 211, and 112. Of the total strains tested, 28.37% strains were found to be untypable. These strains are labelled as "444". When klebocin typing was used in association with antibiogram, in 86.84% cases of clinical infection probable source of infection could be detected. Thus a combination of two typing methods poses a significant contribution in epidemiological studies.
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