Sodium artesunate-induced diuresis in a patient with malaria.

Sodium artesunate is used in the treatment of malaria. We report a case of sodium artesunate induced diuresis and natriuresis in a patient with malaria. Following artesunate administration there was polyuria accompanied by natriuresis that was reversed after discontinuation of artesunate treatment.

Acute glomerulonephritis: an unusual manifestation of Plasmodium vivax malaria.

Long considered a benign infection, Plasmodium vivax is now increasingly recognised as a cause of severe and fatal malaria. Various atypical presentations of vivax malaria have been reported. This report highlights the occurrence of acute glomerulonephritis in a 7-year-old girl who presented with fever and vomiting.

Paradoxical response to anti-tubercular treatment.

We report a 5-year-old boy who developed optic neuritis as a paradoxical reaction to anti-tuberculous therapy. Steroids were re-started in the patient with gradual recovery of his vision. The case emphasizes the importance of recognizing paradoxical reactions in patients on anti-tuberculous therapy.

Experience with patients with anti-MUSK antibody positive myasthenia gravis.

The association of muscle tyrosine kinase (Musk) antibody with recurrent bulbar weakness in acetylcholine receptor antibody (Ach-R Ab) negative myasthenia gravis (MG) has been well documented. We describe 2 patients, a middle aged man and a 9-year-old girl, both seronegative for Ach R antibody who had recurrent bulbar weakness and MUSK antibody positivity. Patients made a full recovery from the acute episode with intravenous immunoglobulin (IV Ig) therapy.

Monocular blindness during therapy for cerebral neurocysticercosis.

Neurocysticercosis is endemic in India, cerebral and ocular manifestations being common. A 32 yr old man on treatment with Albendazole for cerebral neurocysticercosis for 10 days presented with 3 days of painful uniocular blindness. He had only light perception in the left eye, left pupil was non-reactive to light and left disc was edematous.

Gitelman's syndrome presenting as recurrent paralytic ileus due to chronic renal tubular K+ wasting.

Gitelman' syndrome, although a relatively frequent cause of chronic hypokalemia in adults, is rarely diagnosed correctly. It is frequently confused with overt diuretic abuse or Bartter's syndrome. We describe a 60 year man with 2 year history of recurrent paralytic ileus attributed to recurrent hypokalemia.

Venous flaps.

One of the earliest postulates concerning the physiological basis of flap survival is attributed to Sushruta, who, in his inimitable style, very succinctly noted in Sanskrit verse the following words: "through continuity survives." Sanskrit being a very telegraphic language, what derives from these words is as follows: Through (the flap's) continuity (with its original location) (it) survives. The principle of continuity has survived through the ages, though continuity has come to imply vascular continuity based on the Harvesian model of circulation.

Instillation of silver nitrate in the treatment of chyluria.

A series of 62 patients with chyluria received instillations of 1% silver nitrate in the renal pelvis over an 8-year period; 51 patients responded well but 11 showed no response to treatment. Follow-up ranged from 2 to 7 years. The treatment was found to be safe, effective and minimally invasive.

Experience of continent urinary diversion with modified Koff's technique.

Continent abdominal neourethrostomy is a procedure in which a bladder flap from the dome is raised, converted into a tube and then brought out on the abdominal wall as a stoma, just below the umbilicus. We have done this procedure on 5 patients of different age groups and for various indications. All our patients are perfectly continent postoperatively during the day as well as night.

Catheter-less suprapubic cystolithotomy in children.

Bladder stones in children are common in developing countries and the procedure of choice for their removal is suprapubic cystolithotomy. It is standard practice to drain the bladder for a few days post-operatively to prevent urinary leakage. We have observed that, if the bladder is closed meticulously in 2 layers, bladder drainage by means of a catheter is not required.

An interesting case of aglossia-adactyly syndrome.

A case of aglossia-adactyly syndrome with a sagittal band between the floor of the mouth and the palate is reported. The literature concerning this case is briefly reviewed. This case is being presented for its extreme rarity.