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Based on an earlier report of raised titres of herpes simplex viral antibodies in Obsessive-compulsive disorder subjects, and a propensity for this virus to affect limbic structures, a study was conducted to look for the presence of obsessive-compulsive symptoms in surviving patients of herpes simplex encephalities. Two out of five neurologically stable patients studied had elevated scores on Leyton′s Obsessional Inventory and Yale Brown Obsessive compulsive scale, but none fulfilled criteria for obsessive compulsive disorder. Furthermore tow case reports of patients with herpes simplex encephalitis presenting with obsessive compulsive disorder are reported. The possible models to explain this association between Herpes simplex encephalitis and Obsessive compulsive disorder are shared neurobiological substrates or shared neuropsychological deficits.

Thirteen cases of vacuolar myopathy (6 males, 7 females), with age range of 4 months to 22 years and diagnosed over a period from 1986 to 1999, could be categorized into acid maltase deficiency (AMD) (n=6), carnitine deficiency (CD) (n=5), and mitochondria-lipid-glycogen myopathy (MLGM) (n=2), cases of AMD presented as floppy infants with reparatory infection, while cases of carnitine deficiency presented with progressive motor weakness with normal initial milestones. Delayed motor milestones and proximal muscle weakness was the presenting complaints in MLGM. The diagnosis in all these cases was established based on the morphological findings on muscle biopsy, namely demonstration of PAS positive material within the vacuoles in AMD, ragged red fibers, vacuoles containing neutral fats and abnormal mitochondria in CD. MLGM was characterized by the presence of PAS positive material and neutral fat. The diagnosis was confirmed by identification of abnormal mitochondria under electron microscope. The storage product appears to affect not only the muscle metabolism but also the normal structure function relationship. The study highlights the importance of supplementing routine histopathology with muscle histochemistry and election microscopy to delineate the conditions, which look similar in routine histology.

The pathomorphological features noted in 47 cases of HIV/AIDS studied on autopsy (39 cases) and surgical biopsy material (8 cases) over a period of 8.5 years are described here. The serum samples of all cases and 26/29 CSF samples tested were positive for anti HIV antibodies. Majority of patients were young adult males in the age group 25-35 years. History of high risk behaviour was available in 59.6% cases. 38/39 autopsied cases succumbed to various opportunistic infections. Infection by a single pathogen was noted in 76.3% cases and due to multiple infectious agents in 23.7%. The commonest opportunistic infection was cryptococcosis (59%) followed by toxoplasma encephalities (28.2%) and tuberculous meningitis (25.6%). The others included meningococcal meningitis, herpes simplex, cytomegalovirus and acanthamoeba encephalitis noted in one case each. Features meningococcal meningitis, herpes simplex, cytomegalovirus and acanthamoeba encephalitis noted in one case each. Features of HIV leucoencephalitis was noted in one autopsy and tow brain biopsy specimens. Complete body necropsy carried out in 11/39 cases revealed disseminated cryptococcosis in 5, tuberculosis in 4 and features of HIV related changes of lymphoreticular organs in 3 cases. Pneumocystis carinil pneumonia was noted in 2 patients along with cryptococcosis. Diagnostic lymph node biopsy in 3 patients revealed tuberculous lymphadenitis in 2 and infection by non-tuberculous mycobacteria in one. Evidence of IIIV associated neuropathy was noted in 3 cases. In the present series, the incidence of cryptococcal meningitis was very high compared to neurotuberculosis as reported from other clinical and one autopsy series from other parts of India. Similarly, the incidence of toxoplasma encephalitis was also higher. The type of laboratory support and the experience of the pathologist play a crucial role in accurate identification of the pathogens. Therefore, a high index of clinical suspicion and a proper diagnostic approach to HIV/AIDS patients is required in developing countries to identify various pathological lesions.