Fifty patients of either sex, aged between 20 and 60 years undergoing electroconvulsive therapy were included in our study. Each patient was used as his/her own control. We observed the cardiovascular changes without nitroglycerin ointment in the first sitting and in the next sitting with the application of 2 inches of 2% nitroglycerin ointment 45 min before the electroconvulsive therapy. Arterial blood pressure and heart rate increase during electroconvulsive therapy can be effectively attenuated by application of 2 inches of 2% nitroglycerin ointment 45 min before the electroconvulsive therapy (p < 0.001 and p < 0.01 resp.). This may be especially beneficial for patients who are at increased risk of myocardial ischemia and stroke.

The study evaluates breast stimulation and oxytocin infusion as methods for cervical ripening in patients where an obstetric indication for induction of labour exists. Forty patients with a Bishop score of 5 or 6 were randomly selected for either breast stimulation or oxytocin infusion. In a similar group of 20 cases, no method was employed. The Bishop score improved in 41.2% of cases where breast stimulation was used as compared to 75% where an oxytocin infusion was given. Three foetal deaths in the breast stimulation group brought the study to a stop after 17 cases. Cervical ripening with an oxytocin infusion drip appears to be a better method since infusion dosage can be precisely controlled making the technique more predictable and reliable. Though breast stimulation is effective in ripening the cervix, it may be used only in cases of intrauterine foetal death as it may otherwise adversely affect foetal outcome.

Data on 105 solitary thyroid nodules, confirmed at surgery to be solitary, is presented. Six (5.7%) were malignant, 4 papillary and 2 follicular. The sensitivity and the specificity of 131I radionuclide thyroid scan (n = 90) were 100% and 24% respectively. Similarly, the sensitivity and specificity of fine needle aspiration cytology (n = 65) was 75% and 100% respectively. In both instances, the "gold standard" was the histopathology of the surgically removed nodule. In order to avoid unnecessary surgery, without missing malignancy, we would recommend the combination of radionuclide thyroid scan and FNAC for investigation of solitary thyroid nodules.

Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agreement and hysteroscopy revealed more information than curettage in 6 cases. Among the remaining 73 cases with 'negative' hysteroscopic view, an abnormality was detected by tissue sampling in only 2 patients. The specificity and positive predictive value of hysteroscopy is 100%. The sensitivity of hysteroscopy was greater (92%) than that of curettage (76%) and the negative predictive value of hysteroscopy was 2.8%. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of intrauterine pathology.

A study of serum iron and ferritin levels in Indian women with pregnancy induced hypertension (PIH) (mild/severe) and eclampsia compared with controls of similar gestational ages, revealed that mean serum iron was elevated slightly in PIH and significantly in eclampsia as compared to controls. Mean ferritin levels were significantly elevated both in PIH and eclampsia as compared to controls indicating that ferritin measurement in PIH and eclampsia would not reflect iron nutritional status. Lack of significant changes in liver enzymes and in hemoconcentration in PIH and eclampsia indicate that liver damage and altered hemodynamics only play a partial role in causing hyperferritinemia. Possible role of placental ferritin, being released as a result of placental damage in these conditions seems to be an area needing further research.

Polyvinylchloride (PVC) disposable endotracheal suction catheters were successfully used as temporary intravascular shunts in 5 patients of popliteal artery trauma. These simple shunts should be used routinely in such conditions to immediately re-establish blood supply to the ischaemic limb particularly in patients of polytrauma where systemic anticoagulation is contraindicated. This avoids the inherent delay prior to vascular repair and reduces the incidence of irreversible ischemia.

The study was carried out to compare the efficacy of three media namely Modified Thayer Martin medium, McClung's carbon free broth with paraffin bait and paraffin agar in isolating Nocardia species from clinical specimens. Two hundred and seventy six clinical specimens from 245 cases were studied which included cases of bronchopulmonary and systemic infections and cases of mycetoma. Paraffin agar was found to be an inexpensive and selective medium for isolation of Nocardia species when compared with Modified Thayer Martin medium and paraffin bait techniques.

Trichomonas vaginalis is a frequently encountered genital pathogen in both males and females. In females, vaginitis due to this parasite is one of the most common manifestation. The indirect fluorescent technique (IFA) test was carried out to detect antitrichomonal antibodies in 370 female patients using whole cell antigen. Seventy one (19.18%) gave positive reaction for either of the class IgG, IgM and IgA antibodies. The level of the IgG class antibodies was found to be higher i.e. 58 (81.69%) than IgM 11 (15.27%) antibodies, which may be suggestive of past infection or a prolonged manifestation by the organisms.

A rare case of a 10 year old boy presenting with history of lower GI bleeding for one year and acute intestinal obstruction was diagnosed as adenocarcinoma of the colon on exploration. One year follow-up after radical colectomy did not show any recurrence.

A case of neonatal pneumoperitoneum in absence of a bowel perforation or intrathoracic pathology has been reported. The cause of such a rare manifestation remains to be established.

Denver shunt patency can be easily assessed by sequential scintigraphy with a Gamma camera after an intraperitoneal injection of 99mTc sulphur colloid. If the shunt is patent, the tracer will be seen throughout the shunt upto it's opening into the right atrium. The following case report illustrates the application and usefulness of this procedure.

A patient with a huge ovarian cyst weighing 38 kg was operated successfully with utmost care to avoid all possible intra and postoperative complications. The same has been presented and the salient features of management have been discussed.

The fine needle aspiration cytology (FNAC) and ultrasound radiologic features of a solitary retroperitoneal angiofollicular lymph node hyperplasia (AFLNH), hyaline vascular type are described. Based on a combination of the two, this diagnosis can be suggested in the differential diagnosis of a retroperitoneal mass.

Posterior midline cervical cystic hygromas (PMC) are frequently found associated with chromosomal aberrations and usually do not survive. The present report illustrates diagnosis of this condition by sonography in an 18 weeks old fetus and an amniocentesis revealed 45 x0 karyotype and increased concentration of alpha-fetoproteins. Pregnancy was terminated in view of Turner's syndrome. The etiology and natural history of the condition is reviewed.