Brante in 1949 10 earned out the first complete study of the lipid eomposition of human intraeranial tumors. He analyzed 11 cases of gliomas and found that total lipids aecounted for 15 to 85% of the dry weight, the dry weight being about 15% of the weight of fresh tissue. Phospholipids made up about 10%, total cholesterol 2% (3/4 of which was in the free form), and cerebrosides 2-M%. There were only traces of diglycerides and no difference was found between the several types of gliomas analyzed: only in one case of gliomatous teratoma the percentage of phospholipids decreased to 5%, while that of diglycerides increased to 12%. Brante ascribed this difference to a long period of fixation in formalin, which produces a breakdown of glyeero-phospholipids. Besides the tumors of mesodermaI origin, Brante evaluated the lipid eomposition of six meningeomas. The dry weight was calculated as being between 14% and 17% of the total weight, while the total lipid content was between 15 and 25% of the dry weight. Phospholipids were about 9%, total cholesterol 2% (2/3 in free form), and cerebrosides 1--8%. Brante did not consider the differenee in lipid composition between gliomas and meningiomas to be significant. Neurinomas --8 cases of acoustic neurinoma --had a lower lipid content than the other intraeranial tumors; about 15% of the dry weight. In the only case of haemangioma analyzed, phospholipids were only 6%, while total cholesterol was near 8% (only 1/3 of it in the free form), the same proportion as in serum cholesterol. No traces of cerebrosides were found. The lipid eomposition of one eosinophileous granuloma was found to be very similar to that of the haemangioma.Brante also studied the lipid composition of normal human piaaraehnoidea, which contains 82% lipids, with 8% phospholipids and a large unidentified fraction, supposed to be neutral fat. No traces of eholesteroI and eerebrosides were found.In the normal human adult brain, Brante found the following composition: dry weight 15% of total flesh weight, total lipids 85%, phospholipids 20%, cholesterol 5% (all in the free form) and eerebrosides 4%.

SummaryBromocriptine Parlodel, Sandoz)

We are hereby reporting a case of a 72-year-old Indian man, who, in the absence of a detectable tumor, presented with symptomatic hypoglycemia in the postabsorptive state (3-5 h after meal). His serum levels of insulin and C-peptide were very high. He was not taking any hypoglycemic drug. Hypoglycemic episodes completely subsided after withdrawal of pentoprazole and incorporation of small frequent meals in the dietary plan. Six months after the initial presentation, the subject became free of hypoglycemic episodes. Although insulin autoimmune syndrome (IAS) is the third leading cause of spontaneous hypoglycemia in Japan, it is extremely uncommon in the Western Countries. Till 2009, more than 200 cases from Japan and as many as 58 cases outside Asia have been reported. To the best of our knowledge, this is the first case of IAS reported from India.

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Summary Pituitary apoplexy or spontaneous pituitary necrosis is an ill-understood clinical syndrome. It may occur as a neurological emergency requiring urgent interference in a patient with a known pituitary dysfunction or it may be responsible for drawing attention to an as yet unrecognized pituitary pathology. It has a bizarre clinical profile and an unpredictable neurological and endocrine course. Patients may die at once or may recover with or without endocrine/neurological deficit. Six cases of pituitary apoplexy with varied clinical presentation are cited.

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Background: The most challenging problem associated with patient management in Dengue infection is early diagnosis. Secondary infection with dengue virus is the most accepted risk factor for the development of dengue haemorrhagic fever. Serologic diagnosis of dengue virus infection using ELISA of both IgM and IgG distinguishes primary and secondary infections. Aim: To determine the prevalence of Dengue Fever in Thoothukudi, the coastal district of Tamilnadu by serological tests IgM ELISA and IgG ELISA, to compare the IgM and IgG status of the dengue cases to differentiate between the primary and secondary dengue cases. Methods: A cross sectional comparative study in patients with fever suspicious of dengue, fevers with other causes excluded. Detailed history is obtained and complete clinical examination done. IgM and IgG Elisa test were performed. Results: Out of 50 patients, 28 (56%) were positive for dengue and 22 (44%) were negative. 13 cases had primary Dengue (IgM positive) and 15 had secondary Dengue (IgM and IgG positive and IgG positive). Among the 28 positive cases 16 are paediatric, 10 cases had hemorrhagic manifestations, all were secondary dengue. Conclusion: As this study was conducted during an outbreak in Thoothukudi, unusually high prevalence is seen particularly among the pediatric ages. Higher morbidity is seen in secondary dengue cases. Thus, early discrimination of primary and secondary dengue helps to reduce the morbidity and mortality.