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The detection of cervical lymph nodal metastasis and carotid artery invasion by metastatic lymph nodes is an important issue in the management of head and neck malignancies. This study compared the evaluation of metastasis by palpation, ultrasonography (USG) and computed tomography (CT) in patients with known head and neck malignancies. Twenty-five consecutive patients with head and neck malignancy were prospectively evaluated for the presence of cervical lymphadenopathy and carotid artery invasion. All patients underwent clinical examination (palpation), USG and CT examination. A modified CT criteria was employed which yielded acceptable results for the detection of metastatic nodes. Radical neck dissection was performed for 26 neck sides, and the results of pre-operative evaluation were confirmed by the surgical and histopathological findings. Palpation, ultrasound and CT have comparable sensitivity in the determination of metastasis involving cervical lymph nodes. Thus palpation should be employed as the primary method of assessment of secondaries in the neck. However, palpation is less sensitive than CT and USG in the detection of carotid artery involvement, hence the clinical suspicion of arterial invasion should be confirmed by either CT or USG which have similar accuracy in the detection of carotid artery invasion.

Rabies is a communicable disease that is almost always fatal. In its classic form, rabies is well recognized, but cases presenting with a paralytic illness mimic Landre's Guillain-Barre syndrome and in such cases the diagnosis remains in doubt. This problem is further compounded when the history of dogbite is not forthcoming. At autopsy rabies can be diagnosed by subjecting fresh tissue to virologic investigations or examining formalin-fixed paraffin-embedded tissue sections for the presence of characteristic inclusions; that is, the Negri bodies. However, these inclusions are not present in all cases. Hence, the need arises for a better method for diagnosis. The present study utilized immunohistochemistry as a diagnostic tool using both monoclonal and polyclonal antirabies antibodies in 20 cases of rabies encephalomyelitis. The diagnosis of rabies could be confirmed in 17 cases (85%) based on neuropathologic findings alone. In contrast, immunohistochemistry yielded positive results in all cases. Moreover, the amount of rabies viral antigen was much more abundant than could be expected from the histopathologic findings. Thus immunohistochemistry is a rapid, safe, sensitive and specific technique for the diagnosis of rabies.

(Genitourin Med 1995;71:32-34)

BackgroundMalaria extensively leads to mortality and morbidity in endemic regions, and the emergence of drug resistant parasites is alarming. Plant derived synthetic pharmaceutical compounds are found to be a foremost research to obtain diverse range of potent leads. Amongst them, the chalcone scaffold is a functional template for drug discovery. The present study involves synthesis of ten chalcones with various substitution pattern in rings A and B and assessment of their anti-malarial efficacy against chloroquine sensitive and chloroquine resistant strains as well as of their cytotoxicity and effect on haemozoin production.MethodsThe chalcones were synthesized by Claisen-Schmidt condensation between equimolar quantities of substituted acetophenones and aryl benzaldehydes (or indole-3-carboxaldehyde) and were screened for anti-malarial activity by WHO Mark III schizont maturation inhibition assay. The cytotoxicity profile of a HeLa cell line was evaluated through MTT viability assay and the selectivity index (SI) was calculated. Haemozoin inhibition assay was performed to illustrate mode of action on a Plasmodium falciparum strain.ResultsThe IC50 values of all compounds were in the range 0.10–0.40 μg/mL for MRC-2 (a chloroquine sensitive strain) and 0.14–0.55 μg/mL for RKL-9 (a chloroquine resistant strain) of P. falciparum. All the chalcones showed low cellular toxicity with minimal haemolysis. The statistically significant reduction (p < 0.05) in the haemozoin production suggests a similar mechanism than that of chloroquine.ConclusionsOut of ten chalcones, number 7 was found to be a lead compound with the highest potency (IC50 = 0.11 µg/mL), as compared to licochalcone (IC50 = 1.43 µg/mL) and with high selectivity index of 85.05.

A 40-year-old man with alcoholic liver disease was referred to the dermatology clinic for Dermatology, Venereology, and asymptomatic papulonodular lesions over the face of 15 days' duration. Cutaneous Leprology and Pathology, Post examination revealed multiple, dusky red to yellow, follicular as well as perifollicular Graduate Institute of Medical papulonodular lesions, varying in size from 0.5 to 2 cm ( Fig. 1). They were distributed Education and Research, Chandigarh, over the forehead, cheeks, eyelids, nose, chin, beard area, retroauricular area, and neck. IndiaCareful examination revealed well-defined scaly margins on the back of the pinna (Fig. 2). Correspondence KOH examination of a scraping from the neck revealed nonpigmented septate hyphae. Bhushan Kumar, MD, MNAMS Histopathologic examination of the excised nodule revealed epitheloid cell granulomas Department of Dermatology, with neutrophilic microabscesses surrounding the hair follicles. Periodic acid-Schiff stain Venereology, and Leprology was noncontributory. Culture of an excised nodule on Sabouraud's agar showed growth of Post Graduate Institute of Medical Education and Research (PGIMER) Trichophyton rubrum. Considering his liver disease, the patient was initially treated with Chandigarh 160 012 topical terbinafine. Because of a lack of a satisfactory response this was changed to oral India terbinafine 250 mg/day. There was marked regression of the lesions by the sixth day.Unfortunately, the patient succumbed to complications relating to his liver disease.

Giant cell tumour of tendon sheath is a benign soft tissue lesion most commonly found in the flexor aspect of hand and wrist. Being rare in foot and ankle, the unusual presentation of this lesion may sometimes mimic other lesions like lipoma, synovial sarcoma, malignant fibrous histiocytoma, synovial cyst and ganglion. Hence it is important to include this lesion in differential diagnoses especially if the lesion is found to be anchored to any of the surrounding tendons. This article describes the unusual occurrence of giant cell tumour of the tendon sheath of peroneus brevis which is rarely described in literature.