Journal of clinical and diagnostic research https://www.jcdr.net/back_issues.asp JCDR Elevated Cardiac Troponin (cTnI) Levels Correlate with the Clinical and Echocardiographic Evidences of Severe Myocarditis in Scorpion Sting Envenomation Suresh V Sagarad, Balaram Singh Thakur, S S Reddy, Balasubramanya K, R M Joshi, Sudha Biradar Kerure <b>Objective:</b> This study was to evaluate the predictive value of the cardiac troponins in scorpion sting myocarditis at a tertiary care hospital in Raichur, (Karnataka state) India. <b>Methods:</b> A total of 84 consecutive patients were prospectively studied. The data included the demographics, the time of presentation to the hospital, the clinical features, the cardiac troponin levels and the echocardiographic findings. <b>Results:</b> 12 patients with only local symptoms had troponin levels of less than 0.01µg/L. 12 patients with local and systemic symptoms without an echocardiac evidence of myocarditis had troponin values of 0.01 to 0.11 µg/L. 60 patients with an echocardiographic evidence of myocarditis had troponin levels of above 0.11 µg/L. 6 patients with severe myocarditis who required ventilator support or which led to death had troponin values which were higher than 10 µg/L. <b>Conclusions:</b> High cardiac troponin levels predict myocarditis in scorpion sting envenomation and they can be a useful tool in guiding the therapy early. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1369-1371&id=2361 https://doi.org/10.7860/JCDR/2012/.2361 Multimodal Supervision Programme to Reduce Catheter Associated Urinary Tract Infections and Its Analysis to Enable Focus on Labour and Cost Effective Infection Control Measures in a Tertiary Care Hospital in India Namita Jaggi, Pushpa Sissodia <b>Background:</b> Catheter Associated Urinary Tract Infections (CAUTI) contribute 30%-40% of all the nosocomial infections and they are associated with substantially increased institutional death rates. A multimodal supervision program which incor­porates training of the staff with respect to infection control measures can be effective in reducing the CAUTIs in hospitals. <b>Aim:</b> To assess the impact of a multimodal UTI supervision program on the CAUTI rates over a year, from January 2009 to December 2009, in a tertiary care hospital in India. <b>Setting:</b> A 215 bedded tertiary care private hospital. <b>Materials and Methods:</b> The CAUTI rates were analyzed for the first 6 months (January 2009-June 2009). A UTI supervision program was instituted in the month of July 2009, which included training with respect to the standard protocols for the sample collection and diagnosis, the bundle components of the urinary catheter checklist and hand hygiene practices. The impact was assessed as per the CAUTI rates in the subsequent months. <b>Results:</b> The average CAUTI rate was reduced by 47.1% (from 10.6 to 5.6) after the introduction of the supervision program. This study presented the mean age of the patients with CAUTIs as 54.5 years and it showed an approximately equal contribution of both the sexes (52.94% in males and 47.05% in females). The impact analysis of the supervision program showed a reduction of 8.7% (from 23 days to 21 days) during the average duration of the catheterization. The adherence to the components of the urinary catheter check list was increased by 44.4% (p=0.069) and the hand hygiene compliance was increased by 56.4% (p=0.004) respectively after the interventions. Components like bladder irrigation and practising perineal cleaning were found to show no effect on the CAUTI rates. <b>Conclusion:</b> The most common labour and cost effective infection control measures as revealed by the supervision programme were adherence to the urinary catheter checklist components (indication for catheter insertion and change, asepsis maintenance during and after the catheter insertion and avoiding urine reflux) and hand hygiene practices, whereas bladder irrigation and practising perineal cleaning thrice a day were unnecessary measures. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1372-1376&id=2362 https://doi.org/10.7860/JCDR/2012/.2362 A Ten Year Retrospective Study on Adult Tetanus at the Epidemic Disease (ED) Hospital, Mysore in Southern India: A Review of 512 Cases Vamadeva Giriyapura Marulappa, Renuka Manjunath, Nakul Mahesh, Laxman Maligegowda <b>Background:</b> Tetanus still remains a major public health problem in India like in most other developing countries, with a high morbidity and mortality. <b>Objectives:</b> To study the socio-demographic profile and the clinical profile that they presented with, as well as the outcome of the tetanus patients who were admitted to the E.D Hospital, Mysore in India. <b>Methodology:</b> The data of all the patients of tetanus who were above the age of 15 years, who were admitted from January 2001 to December 2010, were collected, compiled and analyzed from the Medical Records Department of the Hospital. <b>Results:</b> Out of the 512 cases of tetanus, 379 (74%) were males and 133 (26%) were females. Their ages varied from 15 to 81 years, with a mean and a standard deviation respectively of 47.7 and 15.0 years. The overall mortality rate was 42.2%. The most common presenting symptoms were trismus (95.7%), neck stiffness (89.3%), body spasms/stiffness (73%) and dysphagia (38.9%). The ages of the patients and the presence of complications had a statistically significant relationship with respect to the outcome (survival versus death). https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1377-1380&id=2363 https://doi.org/10.7860/JCDR/2012/.2363 White Coats as a Vehicle for Bacterial Dissemination Asima Banu, Mridu Anand, Nagarjun Nagi <b>Introduction</b>: White coats are known to be potential transmitting agents of multi-drug resistant organisms. This study was conducted to determine the level and type of microbial contamination present on the white coats of medical students in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting. <b>Materials and Methods</b>: A cross sectional survey of the bacterial contamination of white coats in a tertiary care hospital. 100 medical students working in various specialties were included in the study. Swabs were taken from 4 different areas of the white coat – collar, pocket, side and lapel and processed in the Microbiology department according to standard procedures. <b>Results</b>: Although most of the white coats had been washed within the past 2 weeks, the sides of the coats were the most highly contaminated areas followed closely by the collar and pockets. Staphylococcus aureus was the most common isolate followed by coagulase negative Staphylococci and Gram negative non fermenters. Most of the Gram positive cocci were resistant to Penicillin, Erythromycin and Clindamycin. <b>Conclusion</b>: White coats have been shown to harbor potential contaminants and may have a role in the nosocomial transmission of pathogenic microorganisms. Thus, a yearly purchase of white coats and the possession of two or more white coats at any point in time should be made compulsory. There is pressing need to promote scrupulous hand washing before and after attending patients and alternatives to white coats, including universal use of protective gowns, should be considered. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1381-1384&id=2364 https://doi.org/10.7860/JCDR/2012/.2364 Central Nervous System Cryptococcosis among a Cohort of HIV Infected Patients from a University Hospital of North India Chaitanya Nigam, Rupam Gahlot, Vikas Kumar, Jaya Chakravarty, Ragini Tilak <b>Background:</b> Cryptococcus neoformans is a ubiquitous encap­sulated yeast that causes significant infections which range from asymptomatic pulmonary colonization to the life threatening meningoencephalitis, especially in immunocompromised indi­viduals. Cryptococcal meningitis is one of the AIDS-defining illnesses. Recent data have indicated that, the incidence of the cryptococcal infection is high in developing countries like India. We conducted this study to find out the incidence of cryptococcosis in this area. <b>Material and Methods:</b> The Cerebrospinal Fluid (CSF) specimens were collected from known HIV positive cases that had a clinical diagnosis of meningitis and they were processed by standard microbiological procedures. The cryptococcal isolates were identified by microscopy, their cultural characteristics, sugar assimilation and by the hydrolysis of urea. <b>Results:</b> The incidence of cryptococcal meningitis was 12.9%. All the strains were susceptible to amphotericin B, fluconazole, itraconazole and voriconazole. <b>Conclusion:</b> The cryptococcal infection should be suspected in all cases of meningitis, especially among HIV infected persons. An early diagnosis and treatment may alter the prognosis of these patients and hence, an examination of the CSF for cryptococcosis should be considered in all the HIV infected persons who have the symptoms of meningitis. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1385-1387&id=2365 https://doi.org/10.7860/JCDR/2012/.2365 Distal Radius Fractures: Does a Radiologically Acceptable Reduction Really Change The Result? Niraj Ranjeet, Emmanuel P. Estrella <b>Introduction:</b> Distal radius fractures are common fractures which are treated by orthopaedic surgeons. However, they are complex injuries with a variable prognosis and if they are not treated optimally, they can be associated with various complications. <b>Methods and Materials:</b> We studied 80 cases of closed distal radius fractures. These patients were treated and their X-rays were evaluated to determine whether the reduction was radiologically acceptable or not. These patients were then followed up at 1.5 and 3 months to evaluate them both radiologically as well as functionally by using the Modified Mayo Scoring System and the Gartland and Werley’s Functional Scoring System. <b>Results:</b> In our study, 68 patients had an acceptable reduction and 12 patients had an unacceptable reduction. All the fractures healed by the end of the study. The radiological parameters improved from the pre-operative to the immediate post-operative X-ray and all the parameters remained the same till 3 months of follow up. The grip strength improved during the 1.5 to the 3 months follow up. We observed that the trend of the final X-ray score correlated with the pre-treatment X-ray score: however, the functional outcome did not correlate with the X-ray scores. <b>Conclusion:</b> We could not find any correlation between an acceptable reduction to a better functional outcome according to the G and W and the MM scores. We believe that a longer follow up will give us the true functional outcome of these patients and thus a true picture of the correlation between them. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1388-1392&id=2366 https://doi.org/10.7860/JCDR/2012/.2366 Anti-Cyclic Citrullinated Peptide Antibody: An Early Diagnostic and Prognostic Biomarker of Rheumatoid Arthritis D. Manivelavan, Vijayasamundeeswari c.k. <b>Objectives:</b> To evaluate the role of Anti-Cyclic Citrullinated Peptide (anti-CCP) antibody and Rheumatoid Factor (RF) in Rheumatoid Arthritis (RA) patients. <b>Methods:</b> The present study comprised of 60 clinically diagnosed rheumatoid arthritis patients and 30 apparently healthy subjects as controls. Among 60 RA patients, 30 were <2 years duration and 30 were 3 to15 years duration. Anti-CCP and RF levels were analyed by ELISA and immunoturbidimetric assay respectively. Disease activity was assessed by disease duration, duration of morning stiffness, hand deformity and radiological findings. Anti-CCP and rheumatoid factor were measured. <b>Result:</b> A valid comparison showed that autoantibodies directed to citrullinated antigen–anti-CCP superior to RF for the detection of RA. Anti-CCP antibodies have an independent role in predicting radiological damage and progression in RA patients. <b>Conclusion:</b> With their excellent specificity, anti-CCP antibodies used as serological marker in establishing the diagnosis of RA. Anti-CCP antibodies discriminated accurately between erosive and nonerosive RA making them a potentially good prognostic marker for the disease. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1393-1396&id=2367 https://doi.org/10.7860/JCDR/2012/.2367 Study of the Fingertip Pattern as a Tool for the Identification of the Dermatoglyphic Trait in Bronchial Asthma Sandeep V. Pakhale, Bharat S. Borole, Megha A. Doshi, Vijay P. More <b>Introduction:</b> Bronchial Asthma is one of the most extensively studied respiratory diseases and its genetic basis is well established. Dermatoglyphic traits are formed under genetic control early in development but may be affected by environmental factors during first trimester of pregnancy. These patterns may represent the genetic makeup of an individual and therefore his/her predisposition to certain diseases. Patterns of dermatoglyphics have been studied in various congenital disorders like Down’s syndrome, Klinefelter’s syndrome and also in chronic diseases like Hypertension, Diabetes Mellitus etc. Epidermal ridge patterns of finger tips in bronchial asthma patients were studied to find out fingertip pattern as Dermatoglyphic features in patients of Bronchial Asthma; it’s comparison and association if exists between normal and bronchial asthma patients and also to find use of fingertip pattern in early childhood as non-invasive anatomical marker for bronchial asthma in adulthood. <b>Methods:</b> The study was conducted on clinically diagnosed all bronchial asthma patients attending OPD of Dr Ulhas Patil Medical College, Jalgaon. Matched controls were selected without any respiratory problem or any symptoms related to asthma from medical students, staff members and paramedical staff of hospital after taking the informed consent and permission from the institutional ethical committee. Data collection and fingertip prints were taken by ink and rolling finger method. Prints taken were analysed and tabulated; data was analysed by using statistical tests. <b>Results:</b> Study shows that decrease in number of arches, increase in AFRC in patients as compared with controls. Also there were increased ulnar loops in male patients and increased Whorls and radial loops in female patients. Conclusion: The fingerprints can represent a non-invasive anatomical marker of bronchial asthma risk and facilitate early detection and effective management which is vital for selecting appropriate agents for treating infections. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1397-1400&id=2368 https://doi.org/10.7860/JCDR/2012/.2368 Height Prediction from Ulnar Length in Females: A Study in Burdwan District of West Bengal (Regression Analysis) Malay Kumar Mondal, Tapan Kumar Jana, Susmita Giri (Jana), Hironmoy Roy <b>Introduction:</b> Stature estimation from the skeletal remains bears immense importance in the forensic sciences. Along with the conventionally used long bones, the humerus, femur, tibia, etc.; the ulna also has been used for the said purpose since 1952. Though studies which had highlighted the stature estimation in Bengalee males were carried on earlier, in females, this has still not been uncovered. <b>Objective:</b> An attempt was made to formulate a linear regression equation for the estimation of the stature of living adult Bengalee females from the lengths of their ulna. <b>Method:</b> This study was conducted in the Burdwan Medical College Hospital on 300 subjects who were chosen from among the patients and their lady attendants in the Gynaecology OPD. The height was measured from the crown to the heel and the length of the ulna was measured from the tip of the olecranon process to the tip of the styloid process. The documented data was calculated by the standard statistical software. <b>Result:</b> The parameters were tabulated and statistically analyzed. The correlation coefficient (r) was found to be 0.82 (p=0.002) for the left ulna with stature and it was 0.67 (p=0.001) for the right ulna with stature. Supportive regression equations and scatter-plot diagrams could successfully interpret the height from the ulnar length in females. <b>Conclusion:</b> The ulna being almost a percutaneous bone, it can be used for the prediction of the height. The ulna length provides an accurate and reliable means in estimating the height of an individual. The regression formulae which were proposed in this study will be useful for clinicians, anatomists, archeologists, anthropologists and forensic scientists when such evidence provides the investigator the only opportunity to gauge that aspect of an individual’s physical description. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1401-1404&id=2369 https://doi.org/10.7860/JCDR/2012/.2369 Body-Painting: A Tool Which Can Be Used to Teach Surface Anatomy Komala Nanjundaiah, Sheshgiri Chowdapurkar <b>Introduction:</b> The primary method of learning the surface anatomy is by making the students mark structures on mummified bodies. The students feel that learning the surface anatomy on mummified cadavers is not interesting. The present project on learning the surface anatomy through the body painting method was undertaken to evoke interest among the students. <b>Materials and Methods:</b> Physiotherapy and dental under­graduate students who volunteered were involved in this study. A few surface anatomy classes were conducted by using the traditional method and a few more by using the body painting exercise. Non toxic body paints of various colours and brushes of different sizes were used for the body painting. <b>Results:</b> A feedback was obtained from the students by using a structured questionnaire. The students opined that the body painting method was advantageous to them in learning the human anatomy. They also felt that they could have more practice sessions in any setting other than in the classroom and that they did not need to rely upon the mummified bodies. They described the body painting method as self explanatory, which gave them the feel of live structures. <b>Conclusion:</b> This project was successful in achieving its objectives as the students felt that the method was exciting, with lots of fun during the learning. The body painting method was well accepted by the students as an effective method for learning the surface and the clinical anatomy. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1405-1408&id=2370 https://doi.org/10.7860/JCDR/2012/.2370 Compensation for Victims of Clinical Trials: A Discussion on How Current Indian Rules and Guidelines are Hurting India Jacob Puliyel https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1367-1368&id=2389 https://doi.org/10.7860/JCDR/2012/.2389 Isolated Gall Bladder Perforation Following a Blunt Injury in the Abdomen Caren D’souza, Bhagavan K.R., Rakesh K. Gall bladder injuries which are caused after a blunt trauma in the abdomen are rare and they have significant mortality and morbidity when the treatment is delayed. They usually go undiagnosed until an exploratory laparotomy is done. We are reporting here a case of isolated gall bladder neck perforation, which is an uncommon finding following a blunt injury in the abdomen. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1409-1410&id=2371 https://doi.org/10.7860/JCDR/2012/.2371 The Senior-Loken syndrome: Two cases from the State of Qatar Muftah Othman, Awad Rashed, Adel Bakr We are describing two sisters with the rare Senior-Loken syndrome, which is a combination of familial juvenile nephronophthisis and retinal dystrophy. The earliest presenting features include an impaired urinary concentrating ability, leading to polyuria and polydipsia and these are associated with visual impairment. The two patients had blindness shortly after their births. They presented to us with evidence of chronic kidney disease (CKD) in their teens, that required the initiation of the renal replacement therapy. We are reporting these two cases, as this was the first occurrence of this condition in the State of Qatar. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1411-1413&id=2372 https://doi.org/10.7860/JCDR/2012/.2372 The Abnormal Origin, Course and the Distribution of the Arteries of the Upper Limb: A Case Report Surekha D Shetty, Satheesha Nayak B,Venu Madhav N, Srinivasa Rao Sirasanagandla, Abhinitha P The knowledge on the arterial variations in the arm is of importance for a clinician, as it is a frequent site of injury and as it is also involved in many surgical and invasive procedures. During the routine dissection classes for medical students, we came across the multiple arterial variations in the right upper limb of an approximately 45-year-old male cadaver. The brachial artery was very short, and it terminated by dividing into the radial and the ulnar arteries in the upper part of the arm. The radial collateral, the middle collateral and the superior ulnar collateral arteries arose from a common trunk. This common trunk originated from the proximal part of the brachial artery. The ulnar artery was the lateral branch and the radial artery was the medial branch of the brachial artery at their point of origin. The radial artery had a tortuous course, and it crossed the ulnar artery from the medial to the lateral side in the middle third of the arm. The ulnar artery gave anterior and posterior interosseous arteries and a common trunk that divided into the anterior and the posterior ulnar recurrent arteries in the cubital fossa. The knowledge on these variations is very useful for radiologists and surgeons. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1414-1416&id=2373 https://doi.org/10.7860/JCDR/2012/.2373 Primary Cerebral Nocardiosis in a Renal Transplant Recipient: A Case Report Ragini Tilak , Arvind Achra, Vijai Tilak Nocardial brain abscess is a rare central nervous system infection. A 50 year old renal transplant recipient developed a nocardial cerebral abscess. It manifested clinically with pyrexia of unknown origin, recurrent episodes of convulsions and a right sided hemiparesis. The purulent material was drained and sent to the Microbiology Laboratory for culture and sensitivity studies. Direct microscopy and culture confirmed the diagnosis of nocardial infection. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1417-1418&id=2374 https://doi.org/10.7860/JCDR/2012/.2374 Pseudocarcinomatous Hyperplasia of the Fallopian Tubes which was Associated with Female Genital Tract Tuberculosis, Histologically Mimicking Tubal Adenocarcinoma: A Diagnostic Challenge Sonam Gupta, Prem Singh, Jyoti Bala, Deeba Mushtaq, Ankita goyal The benign proliferative and reactive processes of the fallopian tubes which are a result of female genital tract tuberculosis can mimick malignant neoplasms, both clinically and pathologically. ‘Pseudocarcinomatous hyperplasia’ is a term which is applied to the florid form of epithelial hyperplasia with atypical features, that mimicks tubal adenocarcinoma.It may be encountered in the tuberculous and the non tuberculous forms of chronic salphingitis. We are reporting a case of a 30 years old female who presented to our institute with complaints of vaginal discharge and fever. She underwent panhysterectomy for uterine fibroids. Both her fallopian tubes revealed features of florid atypical epithelial hyperplasia, along with widespread caseating granulomatas. Ziehl Neelsen (ZN) staining of the lesion for acid fast bacilli (AFB ) was positive. A diagnosis of pseudocarcinomatous hyperplasia of the fallopian tubes which was associated with female genital tract tuberculosis, which histologically mimicked tubal adenocarcinoma was made, which posed a diagnostic dilemma. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1419-1421&id=2375 https://doi.org/10.7860/JCDR/2012/.2375 Pseudosarcomatous Myofibroblastic Tumour of the Urinary Bladder: A Case Report K. Chandramouleeswari, S. Anita, B. Shivali A pseudosarcomatous myofibroblastic proliferation is an unusual and a rare benign lesion which arises from the bladder submucosal stroma and is easily mistaken for a malignant neoplasm, clinically, radiologically and histologically. By definition, the tumour is composed of a dominant spindle cell proliferation with a variable inflammatory component. These spindle cells are now known to be myofibroblasts and this is the reason for the current designation for this disease. The term ‘inflammatory’ may not be applicable to all the tumours, since some investigators have demonstrated the presence of chromosomal abnormalities and have documented cases which showed recurrence, thus supporting the theory that at least some of these tumours were true neoplasms . Non-epithelial tumours account for 2–5% of all the primary urinary bladder neoplasms, with the most common types being rhabdomyosarcoma in patients under the age of 10 years and leiomyosarcoma in adults. A pseudosarcomatous myofibroblastic tumour is a nonepithelial lesion that follows a benign indolent course and a conservative management has been reported as the treatment of choice. Herein, we are reporting a case of a pseudosarcomatous myofibroblastic tumour which was mistaken for a sarcoma clinically and radiologically and which was proved as a pseudosarcomatous inflammatory myofibroblastic tumour by histopathology and immunohistochemistry. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1422-1424&id=2376 https://doi.org/10.7860/JCDR/2012/.2376 Idiopathic Giant Cell Myocarditis: A Case Report Kalpana Kumari M.K., Vijaya V. Mysorekar, Praveen S. Giant-cell myocarditis is a disease of relatively young, predom­inantly healthy adults. The patients usually die of heart failure and ventricular arrhythmia unless a cardiac transplantation is performed. We are reporting here an autopsy case of idiopathic giant cell myocarditis with no symptoms in a 27-year old -worker who died suddenly. The purpose of this report is to emphasize that idiopathic giant cell myocarditis is a rare disease and that it could exist in the absence of any symptomatic heart disease. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1425-1427&id=2377 https://doi.org/10.7860/JCDR/2012/.2377 Isolated Diffuse Hyperplastic Gastric Polyposis: A Rare Case Meenakshisundaram The gastric polyps are rare as compared to the colonic polyps. Multiple gastric polyps are seen in association with other polyposis syndromes like juvenile polyposis, Gardner’s syndrome, the Peutz-Jeghers syndrome and the Cronkhite-Canada syndrome. Diffuse gastric polyposis is a rare entity and only few cases have been reported. The mode of treatment is surgery, either total or near total gastrectomy and a careful followup of the patient is needed due to the risk of colorectal malignancy. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1428-1429&id=2378 https://doi.org/10.7860/JCDR/2012/.2378 Coexistent Extra Adrenal Pheochromocytoma and Extrapulmonary Tuberculosis: A Case Report and Review of Literature Amita K, Vijay Shankar S, Geethalakshmi U Tuberculosis is a major cause of morbidity and mortality in the developing countries, accounting for two billion infected cases and 1.7 million deaths which were attributed to it in 2006, as per the WHO. Cancer was the leading cause of death, next only to coronary artery disease, with 11.3 million new cases and 7.9 million deaths in 2007. The combination of these two deadly diseases poses significant diagnostic and therapeutic challenges to the clinicians and the pathologists. The relationship of tuberculosis and malignancy can be viewed in two ways: tuberculosis can be a risk factor for cancer or tuberculosis and malignancy can coexist in the same biopsy or in the same patient. An early and an accurate diagnosis is a must for planning the appropriate management. We are describing a very rare case of coexistent extra adrenal pheochromocytoma and extrapulmonary tuberculosis in a single patient, which was diagnosed by fine needle aspiration cytology, with a brief review of the literature. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1430-1432&id=2379 https://doi.org/10.7860/JCDR/2012/.2379 Neonatal Salmonella Typhi Meningitis: A Rare Entity Vikram Singhal, Saleem EK, Rajesh SM, Anita Coutinho Salmonella meningitis is rarely seen in neonates and if it is present, it is associated with complications like subdural collections and abscesses. We are presenting a case of Salmonella meningitis in a 28 days old neonate who developed complications like extensive subdural collections and ventriculitis. The child responded well to prolonged systemic antibiotics and other supportive measures. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1433-1434&id=2380 https://doi.org/10.7860/JCDR/2012/.2380 Bilateral Type-I Duane Syndrome with Multiple Anamolies: A Case Report Chaitanya Varma, Shrikiran Aroor, Suneel C Mundkur, Karthick Annamalai The Duane syndrome is a strabismus syndrome which is characterized by congenital non-progressive horizontal ophthalmoplegia which primarily affects the abducens nerve. Approximately 70% of the individuals with the Duane syndrome have an isolated disease. We have described here, a case of bilateral Duane syndrome with associated anamolies. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1435-1436&id=2381 https://doi.org/10.7860/JCDR/2012/.2381 Olfactory Memory Impairment in Neurodegenerative Diseases Biju Bahuleyan, Satendra Singh Olfactory disorders are noted in a majority of neurodegenerative diseases, but they are often misjudged and are rarely rated in the clinical setting. Severe changes in the olfactory tests are observed in Parkinson’s disease. Olfactory deficits are an early feature in Alzheimer’s disease and they worsen with the disease progression. Alterations in the olfactory function are also noted after severe head injuries, temporal lobe epilepsy, multiple sclerosis, and migraine. The purpose of the present review was to discuss the available scientific knowledge on the olfactory memory and to relate its impairment with neurodegenerative diseases. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1437-1441&id=2382 https://doi.org/10.7860/JCDR/2012/.2382 Cytomegalovirus Occurrence in Chronic Periodontitis and in Carcinoma of the Cervix: An Exploratory Study Shivali Surendra Rao Gaekwad, Sheela Kumar Gujjari <b>Aims:</b> To explore the following in a group of carcinoma cervix patients with chronic periodontitis: The possible association of the Human Cytomegalovirus (HCMV) in chronic periodontitis and carcinoma of the cervix by examining the presence of HCMV (human cytomegalovirus) in saliva, gingival crevicular fluid (G.C.F.) and in cervical biopsy samples and by comparing the clinical para­meters among the Human Cytomegalovirus (HCMV) detected and the undetected sites. The possible association of chronic periodontitis and carcinoma of the cervix by assessing the common occurrence of HCMV in saliva, GCF and cervical biopsies. <b>Material and Methods:</b> Sixteen female subjects who were aged 35 to 65 years, who were diagnosed with carcinoma of the cervix were selected. All the subjects underwent a clinical evaluation for their periodontal conditions. Cervical biopsies, saliva and GCF samples were obtained from all the participants and these were subjected to HCMV detection by using the nested PCR method. <b>Results:</b> HCMV has been detected in the cervical biopsies of 68.75 % patients, in the GCF samples of 75 % patients and in the saliva samples of 37.5 % patients. The clinical parameters i.e. probing pocket depth (P<0.008) and the clinical attachment level (P<0.026) were statistically significant in the GCF samples of the sites which were positive for HCMV as compared to those in the sites which were negative for HCMV. In 56% patients, HCMV was detected in both the cervical biopsies and the GCF samples. In 25% patients, HCMV was detected in both the cervical biopsies and the saliva samples. <b>Conclusion:</b> The results are suggestive of a possible association of the HCMV occurrence in chronic periodontitis and a possible association of the HCMV occurrence and carcinoma of the cervix. An association between chronic periodontitis and carcinoma of the cervix cannot be elucidated with the available data, since the values are statistically insignificant. Hence, further research incorporating systemic inflammatory parameters would be necessary. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1442-1447&id=2383 https://doi.org/10.7860/JCDR/2012/.2383 Fine Needle Aspiration Cytology of Adrenal Oncocytic Neoplasm of Uncertain Malignant Potential Hilda Fernandes, Maria Bukelo https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=1448-1449&id=2384 https://doi.org/10.7860/JCDR/2012/.2384 ARTICLE RETRACTIONS Following articles has been retracted on 10th Oct 2012 as there was evidence of plagiarized data. PANDEY A*, RANJAN R** . (ARTICLE RETRACTED).HYPERTENSIVE DISORDERS IN PREGNANCY REQUIRING EMERGENCY (108) TRANSPORTATION IN THE STATE OF GUJARAT (INDIA): AN EPIDEMIOLOGICAL STUDY. . Journal of Clinical and Diagnostic Research [serial online] 2010 February [cited: 2012 Oct 9 ]; 4:2017-2022. Available from http://www.jcdr.net/back_issues.asp? issn=0973-709x&year=2010&month=February&volume=4&issue=1&page=2017-2022&id=2503 PANDEY A*, KHANDEKAR R**. (ARTICLE RETRACTED) EVALUATING THE EFFECTIVENESS OF TELEPHONE TRIAGE FOR PRIORITY EMERGENCY AMBULANCE DISPATCH. Journal of Clinical and Diagnostic Research [serial online] 2009 October [cited: 2012 Oct 9 ]; 3:-. Available from http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2009&month=October&volume=3&issue=4&page=-&id=2505 https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2012&month=October&volume=6&issue=8&page=-&id=2504 https://doi.org/10.7860/JCDR/2012/.2504