Qualtum cosmics is the qualitative opposite of quantum mechanics. The flip-side of qualtum cosmics is qualtum chaotics, the two governing much of what is seen as inscrutable in medicine. The Ultimate (Last) Tortoise is close to Einsteinean idea of a Unified Theory, a single concept that can explain whatsoever there is in physics, (and in medicine, or what have you).

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Two hundred and seventy nine sera (age group 13-50 years) were tested for antitoxoplasma IgG/IgM antibodies by ELISA techniques; the diagnostic titer for positive test is 10 iu/ml or > 1:100. Sera were obtained from (i) 165 (100 men/65 women) healthy adult voluntary blood donors (HIV, HBsAg, VDRL negative); (ii) 89 consecutive HIV/AIDS patients (82 men/7 women); and (iii) 25 patients (HIV negative: 12 men/13 women) treated for cerebral Tuberculoma or Neurocysticercosis during this study from January 1996-June 1997. The overall seroprevalence was 30.9% (51/165) in the immunocompetent adult (group i) 34% (34/100) men and 26.2% (17/65) in women [range: 10-899 iu/ml; (mean: 376.8)]. In HIV infected hosts the seroprevalence [range: 21-340 iu/ml; (mean; 180)] was 67.8% (56/82 men, 04/07 women). The seroprevalence was 20.5% (8/39), 32.8% (22/67), 34.8% (16/46) and 38.4% (5/13) in the 2nd, 3rd, 4th and 5th decades respectively in healthy adults. In HIV/AIDS patients, 69% (29/42) in the 3rd and 70.6% (24/34) in 4th decade were seropositive. The risk of cerebral Toxoplasmosis (encephalitis-02, granuloma-24) was 43.3% (26/60, mean 250 iu/ml). The seroprevalence was 28% in group iii (range 12-80 iu/ml, mean 21 iu/ml). Anti-toxo IgM was negative in all. Primary Toxoplasma infection appears to be subclinical and prevalent throughout life. T. gondii has emerged as an important opportunistic infection in HIV/AIDS patients in Bombay. Recrudescence of cerebral toxoplasmosis (CTOX) is observed with low IgG response during mid-late stage of the disease, as seen in our patients (mean IgG 250 iu/ml, CD4+ = 283/cmm (range 43-504 in 5 patients). Primary prophylaxis for CTOX seems rationale and can be targeted to asymptomatic HIV/AIDS population at risk who are seropositive for T. gondii (mean IgG 111.5 iu/ml in our study). The very high predictive value of a negative test for TOX remains the best serological parameter for excluding acute episode of TOX.

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Chordoma, a rare malignant tumour of early adulthood, rarely presents in children. We report such a case of rare malignant tumour which was diagnosed in the first decade of life.

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Klebocin typing and antibiotic resistance have been studied for 518 strains of Klebsiella pneumoniae, [106 from intensive care unit (ICU) sites, 182 from ICU staff flora, 192 from patient flora and 38 from clinical specimens]. The overall typability was 71.62%. The most common mnemonic types among various sources were 111, 211, and 112. Of the total strains tested, 28.37% strains were found to be untypable. These strains are labelled as "444". When klebocin typing was used in association with antibiogram, in 86.84% cases of clinical infection probable source of infection could be detected. Thus a combination of two typing methods poses a significant contribution in epidemiological studies.

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This is a report a case with a unilateral single ectopic ureter associated with ipsilateral incomplete duplication of upper third of the ureter, contralateral quadrufid ureter and L3 hemivertebra. These findings provide further evidence of a generalised mesenchymal or epithelial defect, which would explain a defective ureteral bud and metanephric development, besides associated anomalies.

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The frontal sinus is prone to various complications--usually secondary to blockage of the fronto-nasal duct and stagnation of frontal sinus secretions. These pent-up secretions may result in pressure necrosis of the inferior or posterior sinus wall. Involvement of anterior wall is uncommon. We present a case of an anterior wall frontal sinus fistula and discuss its management.

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