Queuing Dynamics and Beneficiary Satisfaction in The OPD Of a Tertiary Care Centre in Bankura, West Bengal

Context/Background: Queuing, a major problem faced by beneficiaries availing services in public health care system, may also have influence on the level of satisfaction among beneficiaries. Aims/Objectives: To describe the queuing dynamics in the OPD, to explore different factors influencing the level of satisfaction among the beneficiaries and their perception regarding possible ways to improve the queuing situation. Methodology: A hospital-based analytical study was conducted in an OPD of Bankura Sammilani Medi-cal College and Hospital, West Bengal, among 202 beneficiaries. Data were collected from subjects, se-lected from random queue in total 30 shifts (30 minutes each) on different working days, using prede-signed, pretested, questionnaire.Results: Queuing dynamics revealed utilization factor of 75%, while 25% probability of the system be-ing idle. Only 39.1% of the subjects were satisfied with the service in Paediatric OPD, in context of wait-ing in queue. MLR revealed subjects waiting in queue for a duration ≤ 1 hour and those with > 4 minutes consultation time were found to be more satisfied. Conclusions: Considering variable consultation time, arrival and service rates at the OPDs and re-sources, a well-planned system can minimize the waiting time and thus improve the level of satisfaction among the beneficiaries.

Technology Socialization Process of Pulse Enterprise: The Structural and Functional Analysis

Technology socialization process has operationally been defined as the interactive summation of all possible responses to a technology application process in terms of adoption, rejection, discontinuance and reinvention. Here, this interactive summation is measured against a set of standard practices applied in pulse enterprises and the level of socialization as measured against a “recommended technology”. The following specific objectives are set to intervene the present study. Those are, to generate basic information on socialization of pulse crop in the study area to identify and standardize the variables, dependent and independent, impacting on both socialization of pulse crop in the study area, to elucidate inter and intra level interaction between dependent variables i.e. Socialization with those of selected socio economic and ecological variables, to delineate the micro level policy based on the empirical result on effective socialization process. The study has been carried out in two developed block namely Chakdah and Haringhata of Nadia District in West Bengal. The multistage purposive and random sample techniques were the key to contrast sampling design in the present study. The following variables, gross return, area under pulse cultivation, training received, yield, farmer’s attitude towards pulse cultivation have been found generating significant functional impacts on the predicted character, technology Socialization. The statistical tools like mean, standard deviation and coefficient of variation, coefficient of variation, coefficient of correlation, multiple regression, step down multiple regression and path analysis. The study also responded to the inquiry as to where and how the classical crop production process can be replaced with pulse crop and whereas this replacement will be much rewarding and beneficiary to the common farmer. The determinants like gross return, area under pulse crop, training received, productivity of pulse crop and farmer’s attitude are decisively characterizing the socialization process of pulse crop.

Amount of Waste used for Different Purposes: A Socio-ecological Impact

Waste is a ceaselessly developing issue at worldwide and territorial just as at neighborhood levels. Due to vigorous globalization and product proliferation in recent years, more waste has been produced by the soaring manufacturing activities. The social ecology of waste recycling implies the structural, functional and managerial intervention of waste generation process. The specific objective of the research was to isolate and identify the system variables characterizing and the management of waste recycling process and to estimate intra and inter level of interaction amongst and between the variables for respective, inductive and interactive contribution. The present study takes a look into the approach, process and impact of ongoing waste management process, followed by the both kalyani and jalpaiguri municipalities. A set of agro-ecological, socio-economic and techno managerial factors have been developed by selecting two sets of operating variables: Independent Variables: Age(x1), Education(x2), Family member(x3), Total cost of energy(x4), Household land(x5), Income(x6), Expenditure of family(x7), Volume of waste generation per household(x8), Water consumption per day(x9), Total bio diversity(x10), Impact of waste management on health(x11), Impact of waste management on agriculture(x12), Impact of waste management on livestock(x13), Impact of waste management on water(x14), Impact of waste management on soil(x15), Impact of waste management on micro flora and fauna(x16), Exposure to media(x17),Training received(x18), Participation on waste recycling programmer (x19), Perception on environmental impact of waste management(x20), Waste management at household level with value addition by percentage (x21a), Waste management at household level with value addition by percentage (x21b). Dependent variables: Volume of waste used for different purposes (y1). The following independent variables have come out with stark contribution on this consequent variable. Result suggested that in terms of variable, behavior and responses there have been stark differences between jalapaiguri and kalyani municipal areas. In kalyani, some few variables like perception of environmental impact on waste management, waste management at household level with value addition by percentage, impact of waste management on agriculture have recorded the distinct contribution on volume of waste used for different purposes and in jalpaiguri total household land, volume of waste generation from household, water consumption per day have gone in the determinant way. So, in kalyani and jalpaiguri municipal areas these variables have maximum influence on the dependent variable. Household wastes mostly are bio degradable in nature. It can be converted to organic manure which has a great nutritional value for plants and if these bio wastes can be converted into organic manure then amount of waste will be reduced. Not only bio waste but we can use non bio degradable wastes for energy production also.

High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome

Background & objectives: Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed. Methods: Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate <40 ml/min) received melphalan 140-150 mg/m2. Results: Post-transplant, 317 of 349 (90.8%) patients responded; complete [complete response (CR)] ?213 (61%)], very good partial response (VGPR) ?62 (17.8%) and PR in 42 (12%)]. Induction with novel agents, pre-transplant chemosensitive disease, transplant in first remission and serum albumin (?3.5 g/dl) were predictors of significant response. At a median follow up of 73 months, median overall survival (OS) was 90 months [95% confidence interval (CI) 70.8-109.2], and progression-free survival (PFS) was 41 months (95% CI 33.0-49.0). On multivariate analysis, achievement of CR post-transplant, transplant in first remission, ISS Stages I and II (vs. III), absence of extramedullary disease and serum albumin ?3.5 g/dl were predictors of prolonged OS. For PFS, achievement of post-transplant CR and transplant in first remission were predictors of superior outcome. Interpretation & conclusions: Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.

Current status of treatment of latent tuberculosis infection in India

In view of the high burden of latency of tuberculosis (TB) in India, tackling latent TB in the right way is a menace. All latent TB’s infection (LTBI) are treated in countries having low burden such as the United States. However, this approach cannot be implemented in high burden countries like India until concrete evidence or consensus by experts on this subject is made. There are very specific risk groups where these patients are to be treated as far as current evidence-based medicine is concerned. Hence, the need to develop a document was felt, through which the treatment of LTBI becomes homogeneous by each and every physician who is practicing and treating TB. The last attempt to review the topic was made in 2015, after which there have been many changes and update in this subject.

Post-transfusion hepatitis C virus infection among ?-thalassaemic individuals with associated clinical parameters

Background & objectives: Multiple transfusions in ?-thalassaemia patients undergoing regular transfusion regimen are at a risk of developing transfusion transmitted infections, including hepatitis C virus (HCV). The present study was conducted to investigate the association of HCV viraemia and genotype with clinical parameters in HCV seroreactive ?-thalassaemic individuals. Methods: A total of 172 HCV seroreactive ?-thalassaemic individuals aged between 2-35 yr with at least 25 units of blood transfusion were catagorized into four groups (2-12 yr, group 1; 13-19 yr, group 2; 20-29 yr, group 3; 30-35 yr, group 4). Aged matched control samples (n=87; ?-thalassaemics without HCV infection) were also included. HCV RNA was detected by nested reverse transcriptase polymerase chain reaction (RT-PCR) based on 5� UTR of HCV genome, viral load was determined by real-time RT-PCR. Nested RT-PCR amplified partial core region was used for DNA sequencing. Liver function parameters [serum total bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] were also determined. Results: Of the 172 HCV seroreactive individuals, 59.30 per cent (n=102) were HCV RNA positive. HCV viral load ranged from 173 to 32.04�[5] IU/ml; 87.65 per cent were infected with HCV genotype 3. Liver enzymes, such as ALT, AST and serum total bilirubin were significantly elevated in all age groups compared to control groups. Serum ferritin levels were found to be high in all individuals, but 16.27 per cent of HCV-infected individuals with >10,000 IU/ml viral load also showed high ferritin levels (>1500 ?g/l) where the majority of them were infected with HCV genotype 3. Interpretation & conclusions: HCV genotype 3 was the major circulating genotype among ?-thalassaemia patients in this region. Our findings indicated an association between HCV replication and hepatic iron load and also highlighted the need for sensitive quantitative RT-PCR-based detection of HCV RNA in the high risk population

Tricky typhus ticks two: A report of two sisters from North India presenting with acute respiratory distress syndrome due to scrub typhus.

Scrub typhus is emerging as an important cause of acute febrile illness in Northern India. This is a report of two sisters presenting concurrently with acute respiratory distress syndrome. A diagnosis of scrub typhus was made in both the patients, and they were successfully treated with doxycycline.

An Exploration of Disaster Risk in Farmer’s Community of Angaria Sub-sub-district in Bangladesh.

Aims: Analysis of risk, farmer’s perceptions on risk and their adaptation practices through exploration of agriculture based farmer’s community perceptions were lack on the perspective of Angaria sub-sub-district of Dumki sub-district of Patuakhali district in Bangladesh. That is why this study was conducted to gain understanding on agriculture farmers' risk profile, its impact and potential risk reduction strategy through community participation. Study Design: A total of 23 Focus Group Discussion’s (FGD) and 04 Key Informant Interviews (KII) were conducted. A well structured pretested questionnaire schedule was developed keeping in mind the objectives and variables under this study. Place and Duration of Study: Angaria sub-sub-district of Dumki sub-district of Patuakhali district in Bangladesh, from January, 2015 to May, 2015. Methodology: Primary data was collected through face to face FGD, KII methods and extensive field visit. Secondary data was collected from different secondary sources. Results: The agriculture sector of the study area is potentially exposed by different primary and secondary risk factors such as cyclone, flood, drought, pest attack etc. which threats to agriculture production and pose the farmers to make their livelihood diversified. But due to the changing trend in risk profiles; increasing its persistence time and frequency and intensity, farmers' adaptation capacities and sustainability are more exposed to vulnerability and adaptive capacity of the farmers are decreasing in the study area. They are transforming from on-farm agriculture practices to nonfarm alternative livelihood options –not as innovative adaptive resilient options. Conclusion: Recurring disasters phenomena threatened and undermined farmers capacity to adaptations, resulted more dependence on alternative nonfarm livelihood options than appropriate on farm adaptive options. Future extensive field based research in these regards will fulfill the required information to get the most efficient small farmers friendly risk management plan which will be beneficiary to the country by establishing climate smart disaster risk management in agriculture sector.

A novel nested reverse-transcriptase polymerase chain reaction method for rapid hepatitis C virus detection and genotyping.

Purpose: Rapid and specific detection of viral nucleic acid is increasingly important in the diagnosis of infectious diseases. The objective was to develop a rapid, efficient process of nucleic acid based detection of hepatitis C virus (HCV) infection for its diagnosis and treatment follow‑up. Materials and Methods: A two‑step nested reverse‑transcriptase polymerase chain reaction (RT‑PCR) has been standardised on a sample set of 125 individuals from different liver clinics in Kolkata. The method utilises a novel fast nested RT‑PCR for HCV detection and genotyping from HCV infected patient plasma with high processivity. Results: The overall time required from ribonucleic acid (RNA) isolation to nested PCR amplified product detection is reduced to 42% when compared with conventional nested RT‑PCR amplification. The method is sensitive as conventional PCR and detected all HCV RNA positive samples. Sequencing, phylogenetic analysis of the PCR amplified product by this method showed concordant genotypes with conventional PCR. Conclusion: Though being a two‑step process, this method is fast, cost‑efficient, reliable and feasible for regular HCV RNA screening and apt even in resource limited settings. This method could be translated to regular nucleic acid screening for other infectious diseases as regular PCR regimen.

Retrospective Study of Gefitinib as a Second Line Treatment in Lung Cancer.

Objective: To find out response of Gefitinib in terms of overall survival in advanced non small cell carcinoma lung progressed after primary treatment. Methods: It is a retrospective study of clinical data experienced with use of Gefitinib as a second line treatment of advanced non small cell carcinoma lung progressed after primary treatment from period of March 2007 to March 2009 in Burdwan Medical College and Hospital at Department of Radiotherapy (Oncology). Results: Among patients treated with Gefitinib (n – 37) median overall survival was 9.6 months whereas, patients treated with placebo median survival was 5.3 months. There is a significant survival advantage ( p < 0.001) in Gefitinib group. Conclusion: Gefitinib is a well tolerated drug and it has a significant survival advantage in advanced non small cell carcinoma lung progressive after primary treatment.

Pattern of Tobacco Consumption among the Diabetic Patients.

Diabetes Mellitus (DM) is a public health challenge all over the world. Recent evidence suggests that there is a positive association between smoking and the risk of diabetes. This descriptive cross-sectional study was conducted from March to June 2008 at BIRDEM Hospital, Shahbagh, Dhaka to find out pattern of tobacco consumption among diabetic patients. Age of the respondents was >15 years. With purposive sampling total 255 respondents were selected. Data was collected through face-to-face interview with structured questionnaire. Out of 255 respondents, 51.4% consumed deferent type of tobacco. Smoker was 63.36% and smokeless tobacco user was 52.67%. The highest (45.80%) had habit of smoking, 36.64% had habit of smokeless tobacco and 17.56% had habit both types of tobacco consumption. The highest smoking and smokeless tobacco consumption found within 50-60 years age group. Total 60.80% male had smoking habit and 32.82% female were smokeless tobacco consumer but no female was smoker. Twenty nine percent tobacco consumers were primarily educated, 16.08% service holders were tobacco consumer and 13.75% service holders were smoker. Among respondents lung diseases and heart diseases were common (78.54.0% and 49.36%). Respondents who consumed tobacco were suffered (74.36%) more complication than non-tobacco consumer (25.64%). So an effective awareness program is required to discourage the consumption of tobacco to protect diabetic patients.

Effects of Griseofulvin in the Treatment of Lichen Planus -A Study in BSMMU.

Lichen Planus (LP) is an inflammatory disorder of skin, mucous membranes, nails and hair. There are various modalities of treatment but none is curative. This prospective therapeutic trial was done among patients with lichen planus at the outpatient department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between November 2001 and April 2002. Total 20 patients were taken of them 12 were male and 8 were female with male to female ratio 3:2. Age of the patients was between 10 to 50 years. Patients were diagnosed clinically & confirmed histologically. They were treated with griseofulvin 500 mg daily for 6 months. Out of 20 patients, 8 had only oral lesions, of them 2 (25%) showed complete response, 3(37.5%) showed moderate improvement and 4 (37.5%) showed no response. Other 12 patients had lichen planus involving skin without oral mucosa, of them 4 (33.3%) showed moderate improvement, 4 (33.3%) showed no response and 4 (33.3%) patients worsens with treatment. So, success in patients with cutaneous lichen planus is less likely; however, griseofulvin may afford relief in selected patients with oral lesion. This study indicates that further prospective placebo controlled studies are needed to clarify the efficacy of griseofulvin in lichen planus.

Food Security and Anthropometric Failure Among Tribal Children in Bankura, West Bengal.

We conducted a cross-sectional study among 188 tribal children aged 6-59 months using two-stage sampling in Bankura-I Block of Bankura district, West Bengal, India, to assess their nutritional status and its relation with household food security. Weight and height/length were measured and analyzed as per new WHO Growth Standards. Mothers of the study children were interviewed to obtain relevant information. Prevalence of Composite Index of Anthropometric Failure was 69.1% and multiple anthropometric failures were more likely among tribal children aged 24-59 months with irregular utilization of supplementary nutrition and from households with severe grades of food security.

Urinary Bladder Tuberculosis – A Case Report.

Genito-urinary tuberculosis is an infrequent but not uncommon condition in countries with high incidence of tuberculosis like Bangladesh. A female patient of 25 years was admitted into Faridpur Medical college Hospital with acute retention of urine with history of haematuria, dysuria, fever and difficulty in urination for about three years. USG revealed few masses in the urinary bladder, later proved by histopathological examination as granulomatous lesion consistent with tuberculosis. Anti-TB treatment was given and the masses were removed surgically. With this treatment recovery of the patient is satisfactory and symptoms are disappearing. The aim of this study to make internist more efficient to diagnose the disease by strong clinical suspicion and relevant laboratory investigation, otherwise such uncommon disease and its complications may endanger life of such patient.

Quantitation of proteinuria in nephrotic syndrome by spot urine protein creatinine ratio estimation in children.

In Nephrotic Syndrome the amount of protein excretion is a reflection of activity of disease. Quantitative measurement of proteinuria by a 24-hour urine collection has been the accepted method of evaluation. Recent studies have shown that calculation of protein/creatinine ratio in a spot urine sample correlates well with the 24-hour urine protein (24-HUP) excretion. A study was conducted to compare the accuracy of a spot urinary protein/creatinine ratio (P/C ratio) and urinary dipstick with the 24-hour urine protein. Fifty two samples from 26 patients of nephrotic syndrome were collected. This included a 24-hour urine sample followed by the next voided random spot sample. The protein/creatinine ratio was calculated and dipstick was performed on the spot sample. This was compared with the 24-hour urine protein excretion. The correlation between the three samples was statistically highly significant (p<0.001) for all levels of proteinuria. The normal value of protein/creatinine ratio in Indian children was also estimated on 50 normal children admitted in the ward without any renal diseases calculated to be 0.053 (SE of mean +/-0.003).

Dysarthric Bengali speech: a neurolinguistic study.

BACKGROUND AND AIMS: Dysarthria affects linguistic domains such as respiration, phonation, articulation, resonance and prosody due to upper motor neuron, lower motor neuron, cerebellar or extrapyramidal tract lesions. Although Bengali is one of the major languages globally, dysarthric Bengali speech has not been subjected to neurolinguistic analysis. We attempted such an analysis with the goal of identifying the speech defects in native Bengali speakers in various types of dysarthria encountered in neurological disorders. SETTINGS AND DESIGN: A cross-sectional observational study was conducted with 66 dysarthric subjects, predominantly middle-aged males, attending the Neuromedicine OPD of a tertiary care teaching hospital in Kolkata. MATERIALS AND METHODS: After neurological examination, an instrument comprising commonly used Bengali words and a text block covering all Bengali vowels and consonants were used to carry out perceptual analysis of dysarthric speech. From recorded speech, 24 parameters pertaining to five linguistic domains were assessed. The Kruskal-Wallis analysis of variance, Chi-square test and Fisher's exact test were used for analysis. RESULTS: The dysarthria types were spastic (15 subjects), flaccid (10), mixed (12), hypokinetic (12), hyperkinetic (9) and ataxic (8). Of the 24 parameters assessed, 15 were found to occur in one or more types with a prevalence of at least 25%. Imprecise consonant was the most frequently occurring defect in most dysarthrias. The spectrum of defects in each type was identified. Some parameters were capable of distinguishing between types. CONCLUSIONS: This perceptual analysis has defined linguistic defects likely to be encountered in dysarthric Bengali speech in neurological disorders. The speech distortion can be described and distinguished by a limited number of parameters. This may be of importance to the speech therapist and neurologist in planning rehabilitation and further management.

Elimination of iodine deficiency disorders--current status in Purba Medinipur district of West Bengal, India.

BACKGROUND AND OBJECTIVES: Towards sustainable elimination of iodine deficiency disorders (IDD), the existing programme needs to be monitored through recommended methods and indicators. Thus, we conducted the study to assess the current status of IDD in Purba Medinipur district, West Bengal. METHODS: It was a community based cross-sectional study; undertaken from October 2006-April 2007. 2400 school children, aged 8-10 years were selected by '30 cluster' sampling technique. Indicators recommended by the WHO/UNICEF/ICCIDD were used. Subjects were clinically examined by standard palpation technique for goitre, urinary iodine excretion was estimated by wet digestion method and salt samples were tested by spot iodine testing kit. RESULTS: The total goitre rate (TGR) was 19.7% (95% CI = 18.1-21.3 %) with grade I and grade II (visible goitre) being 16.7% and 3% respectively. Goitre prevalence did not differ by age but significant difference was observed in respect of sex. Median urinary iodine excretion level was 11.5 mcg/dL and none had value less than 5 mcg/dL. Only 50.4% of the salt samples tested were adequately iodised (> or = 15 ppm). CONCLUSION: The district is in a phase of transition from iodine deficiency to iodine sufficiency as evident from the high goitre prevalence (19.7%) and median urinary iodine excretion (11.5 mcg/dL) within optimum limit. But, salt iodisation level far below the recommended goal highlights the need for intensified efforts towards successful transition.

Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata.

Well-conducted neuroepidemiological studies for the geriatric population are rare in India. In view of the growing aging population, we planned to determine the prevalence of common neurological disorders among the elderly population in the city of Kolkata. This was a cross-sectional study of a stratified random sample of the city population and carried in two stages through house to house survey. Initially, trained non-medical workers screened the cases with a validated family questionnaire and then a neurologist examined all the screened positive cases. A validated neuropsychological screening test was also applied among the elderly population with cognitive complaints. Results showed prevalence rates (per 1000 elderly population--> or = 60 years) of following disorders in decreasing order: stroke--33.93, essential tremor--13.76, dementia--7.89, Parkinsonism--3.30 and epilepsy--2.57. Sex-specific prevalence showed that stroke was commoner among men and that of other disorders among women. Age-specific prevalence recorded progressive increase in the rates of all disorders among both genders, though not uniformly among women. Overall the crude prevalence of neurological disorders was 60.9 per 1000. The present study shows higher rate of stroke as compared to other neurological disorders among elderly population in India, which needs urgent attention.

Persistently high HIV seroprevalence among adult tuberculosis patients at a tertiary care centre in Delhi.

BACKGROUND & OBJECTIVE: This study was designed to estimate HIV seroprevalence among tuberculosis patients presenting to tertiary care centre in Delhi. METHODS: Cross-sectional prevalence study among all patients presenting to the inpatient and outpatient departments of All India Institute of Medical Sciences (AIIMS), New Delhi, and receiving anti-tuberculosis treatment from May 2003 to April 2005. RESULTS: Of the 448 patients who presented to the TB clinic during the study period, 23 (5.1%) were previously tested HIV-positive. An additional 21 patients (4.6%) refused testing, and 30 (6.7%) were lost to follow up. Of the remaining 374 patients who consented to testing, 31 (8.3%) were found to be HIV-positive. Risk factors for HIV seropositivity included high-risk sexual behaviours (48% in HIV-TB co-infected vs. 6% in TB infected patients, P<0.001) and history of blood transfusion (23% vs. 5%; P=0.002). INTERPRETATION & CONCLUSION: Previous studies from the same hospital published in 2000 and 2003 reported HIV seroprevalence among TB patients to be 0.4 and 9.4 per cent respectively. The current study documents a persistently high seropositivity among TB patients. These results emphasize the acute need for improved detection and treatment for HIV among TB patients in northern India.

Occurrence of non-protein low molecular weight cardiotoxin in Indian King Cobra (Ophiophagus hannah) Cantor 1836, venom.

Pathophysiology due to snakebite is a combined effect of various actions of the complex venom constituents. Importance of protein toxins in snake envenomation is well known. The present investigation reports the existence of nonprotein/nonpetide low molecular weight toxin in Indian King Cobra venom, which plays an important role in envenomation consequences in experimental animal models. A group of non-peptidic toxins (OH-NPT1) was isolated from Indian King Cobra Ophiophagus hannah by thin layer chromatography and silica gel column chromatography. UV, IR, NMR and (ESI) TOF-MS studies characterized the OH-NPT1 as a mixture of aliphatic acids having molecular weights 256, 326 and 340Da. The minimum lethal dose of OH-NPT1 was found to be 2.5 microg/20g (iv) and 4microg/20g (ip) in male albino mice. The cardiotoxic property of OH-NPT1 was established through studies on isolated guinea pig heart and auricle preparations, ECG studies in albino rat and estimation of LDH1/LDH and CPK-MB/CPK ratio in Swiss albino mice. Commercial antiserum failed to neutralize the lethality and cardiotoxicity of the toxin. However, calcium and magnesium effectively neutralized the lethal action.