Summary. Trichloroacetic acid extracts of plasma were fractionated on a CG-50 resin column and the 50% acetic acid eluents chromatographed on silicic acid-impregnated glass paper in butanol-acetic acid-water. The specific arginine vasopressin (AVP) zone was eluted and assayed for antidiuretic activity in the diuretic rat. Thioglycolate inactivation was used to confirm AVP activity. Recovery of as little as 4 FLU AVP per ml plasma ranged between 80 and 90%. In normal subjects after an overnight fast, plasma AVP ranged between 2.5 and 10.0 ,U per ml. AVP secretion was inhibited by hemodilution and stimulated with nicotine and hypertonic saline. Plasma AVP was absent in patients with diabetes insipidus even after neurohypophyseal stimulation. Plasma AVP was abnormally elevated during mild dehydration and remained above the normal range despite hemodilution in patients with untreated adrenocortical insufficiency demonstrating a delayed water diuresis. Glucosteroid therapy lowered plasma AVP to normal in dehydrated patients. A normal diuretic response to hydration was accompanied by a fall in plasma AVP to zero in steroid-treated patients. These findings suggest that hypersecretion of AVP may play an important role in the abnormal water metabolism of adrenocortical insufficiency and that the glucosteroids promote normal water diuresis by inhibiting the secretion of AVP from the neurohypophysis. IntroductionIncreased or sustained antidiuretic hormone (ADH) secretion has long been implicated in the abnormal water metabolism of primary and secondary adrenocortical insufficiency. The gluco-

BACKGROUND Japanese Encephalitis is one of the most common causes of Acute Encephalitic Syndrome in Asia. During the period of June to August in 2014 an epidemic occurred in Assam, a northestern state of India. METHODS Patients admitted in the Medicine Department in Gauhati Medical College and Hospital (GMCH), Guwahati, Assam, India, with clinical features of Acute Encephalitic Syndrome (AES) i.e. acute onset fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset seizures (excluding simple febrile seizures) from June to August 2014 underwent ELISA for Japanese Encephalitis Immunoglobulin M in cerebrospinal fluid (CSF) at the time of admission. Clinical features, demographic profile and laboratory investigations were recorded in positive patients. RESULTS 226 AES patients were admitted in 6 different units of Medicine ward in GMCH, out of which 76 patients were diagnosed to be JE positive with CSF IgM ESLIA, coming from 17 districts of Assam. Out of 76 patients, 69 patients were from rural area, only 7 patients were from urban area. 59 (77.63%) patients were farmers or daily labourers by occupation and 23 (30.26%) patients were illiterate. Mean age of patients was 47.7 years and male to female ratio was 1.7:1. Mean duration of fever was 6.5 days, convulsion was found in 13.15% patients, out of which most common was generalised seizure (9.2%). 55.2% patients had meningeal signs, 23.68% patients had focal neurological deficits in the form of hemiparesis and monoparesis and mean GCS score was 9.28. Extra pyramidal features present in patients were rigidity (23.68%), abnormal posturing (15.78%) and abnormal movements (23.68%). 23.68% patients had Leukocytosis and Thrombocytopenia was found in 21 (27.6%) patients. Mean CSF cell count was 34.34 cells/mm 3 with mean 29.67% polymorphs, mean CSF protein and sugar was 56.15 mg/dl and 66.92 mg/dl respectively. Serum bilirubin level was normal however elevated liver enzymes were present in 63.15% of patients. CT scan brain was done in 52 JE positive patients, cerebral oedema was found in 19 (36.52%) patients and hypodensities in thalamus, midbrain and basal ganglia was found in 16 (30.65%) patients. CONCLUSION One of the important findings of the present study is Thrombocytopenia and elevation of liver enzymes in JE patients which were not reported in previous studies except one study in Thailand and another in India in Paediatrics patients. Though the study was small it needs further studies to prove that thrombocytopenia and elevated liver enzymes may be an important complication of Japanese Encephalitis and should not be overlooked.

BACKGROUND An alarming incidence and severity of jaundice in Malaria, especially in the Plasmodium falciparum variety, has been reported from various parts of the world and at times it causes diagnostic dilemma in both endemic and non-endemic areas, even sometimes affecting the outcome adversely. There are reports depicting association of severe jaundice with falciparum malaria masquerading as fulminant hepatic failure. This study is done to clinically evaluate the cases of malaria with hepatitis in terms of its presentations, extent of hepatic involvement and biochemical parameters. MATERIAL AND METHOD This study was done on 100 confirmed cases of malaria with jaundice, who were admitted in Gauhati Medical College and Hospital during a period of 12 months (1 st July 2012 to 30 th June 2013). Patients were admitted due to complications of malaria like jaundice, nausea and vomiting, pain abdomen, respiratory difficulty, oliguria, altered sensorium, etc. Detailed history, clinical examination, biochemical parameters for liver function test and other blood tests were done in all patients. RESULTS Age of the patients ranged from 13-55 years. Among all patients, 96% cases were P. falciparum and 4% cases were P. vivax. Fever and jaundice were present in 100% of cases. Among the cases, 14% had only splenomegaly, 30% had only hepatomegaly whereas 56% had enlargement of both the organs. The mean serum bilirubin level was 8.9 ± 8 mg/dL with predominantly conjugated hyperbilirubinaemia. Majority of the cases had elevated transaminases and alkaline phosphatase levels. Lowering of serum albumin level and derangement of prothrombin time was also noted in more than half of the patients while serum ammonia was elevated in small number of cases. Acute renal failure and cerebral malaria were the other complications noted frequently in cases of Malaria presenting with jaundice.

history was obtained, and thorough clinical examination and laboratory tests were done in each case. RESULTSIn our study, most OP compound poisoning cases were observed in 2 nd and 3 rd decades of life (96%) with a male preponderance (male to female ratio is 3:2). 46 (92%) cases had ingested poison in an attempt to commit suicide. Common clinical manifestations were pupillary constriction (82%), nausea & vomiting (82%), abdominal pain (48%), bradycardia (44%), salivation (44%), breathlessness (32%), headache (30%), and fasciculation (22%). 15 cases had blood sugar more than 140 mg% (6 cases had blood sugar ≥200 mg%) while 4 had less than 60 mg% at admission. 7 cases showed a rise of ALT, 15 cases showed hypokalaemia, 5 cases showed a rise of lipase and 12 cases showed a rise of urea. CONCLUSIONSIn our study, majority of cases belonged to the younger age group. The common symptoms seen were nausea, vomiting, miosis, abdominal pain, bradycardia, salivation, breathlessness, headache, tachypnoea and fasciculation. Common metabolic complications are hyperglycaemia, hypokalaemia, elevated serum urea and aminotransferases.

The study was done to validate the DECAF score for the prediction of prognosis in AECOPD patients.Methodology: 92 AECOPD patients were given scores as per the DECAF system. Patients were monitored during their whole hospital stay. The final results were classified as death and recovery. DECAF score's importance for the prediction of clinical outcomes was analyzed. Result:Out of 92 patients evaluated, 27 had a DECAF score range between 0-1 (low risks), 5-9 had a DECAF score range between 2-4 (intermediate risks), and 6 had a DECAF score range between 5-6 (high risks). The high-risk group experienced a 100% fatality rate. On the other hand, there was no mortality seen in patients with DECAF scores 0-4 & all the patients recovered successfully. Conclusion:DECAF score uses routine parameters to classify AECOPD Patients into clinically relevant risk groups. Doctors are benefitted from this regarding management purposes.