Hypertonic mannitol solution has been found to be most effec­tive in preventing vitreous loss in cataract surgery due to profound hypotony and detergence of vitreous following intravenous in­fusion. Routine use of mannitol is hence recommended prior to cataract surgery, especially in all one-eyed patients or in cases where there is an increased risk of vitreous disturbances.

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An unusual case of metal hammer-head causing strangulation of penis and retention of urine is reported. The clinical presenta­tion, detailed history and subsequent treatment is discussed. It also includes a review of the literature regarding such cases of strangulation of penis.

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A cell-plant or animal-is proving a bioelectric wonder al­ready boasting of pyro-, piezo-, ferroelectricity, solid state and electretism as eminent exhibits and probable functional mechan­isms. A cell, its parts, and its products owe the bioelectric boon to inherent and universal polarity pregnant with dipolar electro­magnetic moment. The cytologic bipolarity prompts a hypothesis that the cell and its world may be no exception to the working of Yin-Yang, the Taoistic concept o f all-pervading reality. Nuclear, cytoplasmic, gametic and zygotic considerations compellingly suggest that Yin­Yang does prevail, making us and' our cells basically field-effects, thus erasing further the distinction between male and female, animate and inanimate, biomass and bioenergy.

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Our earlier studies have demonstrated a possible pharmaco­kinetic explanation for the rate dependent ototoxicity of furose­mide. The present study was carried out to find out possible role of plasma protein levels and drug protein binding in furosemide pharmnacokinetics and toxicity. Twenty patients with different pro­tein patterns were given furosemide intravenously at different rates and doses. Plasma furosemide levels were fluorimetrically estimated in serial blood samples. The results indicate that dose and rate of administration and extent of binding to plasma proteins alter furosemide pharmacokinetics and the chances of toxicity are greater in hypoproteinemic patients.

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Eosinophilic granuloma is a variety of Histiocytosis-X. Its etio­logy is unknown. When it involves the temporal bone it may mimic chronic otitis media, or a mastoid abscess, very often leading to an erroneous diagnosis. Its X-ray appearance and histopathology are characteristic. Infiltration with eosinophils and histiocytes is a constant feature. Very good results are achieved with surgery accompanied by radiotherapy. In this series of 3 patients, one pa­tient presented with facial paralysis and another one with bilateral post-auricular swellings. The first 2 cases were diagnosed only after surgery and histopathological examination of the tissue removed, while the third case was diagnosed pre-operatively on clinical and radiological findings.

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The enzymes viz. glucose-6-P-dehydrogenase (EC 1.1.1.49), cholesterol esterase (EC 3.1.1.13), aspartate amino transferase (EC 2.6.1.1) and alanine amino transferase (2.6.1.2) are intimately related to lipid metabolism. Hence their activities are bound to be affected by the type of dietary fat and substances like bile salts and cholesterol which also influence the lipid metabolism. This relationship between dietary lipid constituent and enzymes was studied in albino rats maintained on diets containing three Indian Shark Liver Oils viz. Waghbeer, Khada mushi and Pisori supple­mented with or without cholesterol and bile salts, Enzyme activities were studied in liver, heart and serum. It was noted that higher unsaturation of dietary fat increased the activity of glucose-6-P­dehydrogenase enzyme while activities of transaminases and chole­sterol esterase were lowered. Addition of cholesterol and bile salts to these diets decreased the activity of glucose-6-P-dehydrogenase and hydrolytic activity of cholesterol esterase. There was increase in the activities of transaminases and esterifying activity of choles­terol esterase due to supplementation with cholesterol and bile salts.

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A case of a solitary, localized, benign hemangioma of the clavicle with a pathological fracture is presented. There was no evidence of any other blood vessel being affected. The hemangioma did not cause any signs and symptoms. The literature on this subject is briefly reviewed.

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Autopsy incidence of infective endocarditis during the past 50 years was analysed to review the changes in the clinico-pathologic pattern if any. 185 cases were recorded in a total of 39931 autopsies giving an average incidence of 0.46%. The cases were classified into groups I, II & III depending upon whether the endocarditis super­vened on normal hearts, diseased hearts or followed surgery, re­spectively. The fifty year period could be divided into three phases on incidence. First phase (1927-41) represented pre-antibiotic era in which group I cases predominated and causative organisms in 801" o f cases were virulent cocci such as staphylococci, haemolytic streptococci and pneumococci. In the second phase (1948-66) the general incidence was reduced by 50%. Group II cases predominat­ed and the most common etiologic agent was streptococcus viridans (40%). In the third phase (1967-76) the general incidence has reached again to preantibiotic level with coagulase positive staphy­lococci, Gram negative bacilli and fungi accounting for 90% of cases. Group III contributed significantly in this phase. The changes in incidence are primarily due to fall and rise in Group I cases. Incidence of rheumatic heart disease with endocar­ditis which mainly forms Group II is declining steadily in post­antibiotic era. There is no shift in the peak age incidence which remains in the 3rd decade. Males with rheumatic heart disease are more prone to infective endocarditis than similarly affected females. There was no change in frequency of involvement of various valves or sites of embolization.

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A case of renal cell carcinoma with secondaries in the opposite suprarenal is described and the relevant literature reviewed.

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