Community Psychiatry Clinics at Sundarban: a clinical and cultural experience.

A series of Community Psychiatric Clinics were conducted in different blocks of Sundarban region of West Bengal. One of the primary objectives of this was to collect clinical epidemiological data on psychiatric morbidity in the region. A total of 26 clinics were conducted in Sagar, Kakdwip, Canning and Gosaba block of the Sundarban region during the period from end 1998 to end 2000. A total of 451 psychiatric cases with diagnostic categories (male 239, female 212) and 215 non-psychiatric cases (male 107 and female 108) were seen in these clinics. Diagnostic Interview Schedules (SCID) and Clinical rating scales like Hamilton Depression Rating Scale and Brief Psychiatric Rating Scales were used to ascertain clinical diagnosis quantitatively. Special emphasis was given on common psychiatric disorders.

Epidemiology of tuberculosis: current status in India.

India is classified along with the sub-Saharan African countries to be among those with a high burden and the least prospects of a favourable time trend of the disease as of now (Group IV countries). The average prevalence of all forms of tuberculosis in India is estimated to be 5.05 per thousand, prevalence of smear-positive cases 2.27 per thousand and average annual incidence of smear-positive cases at 84 per 1,00,000 annually. The credibility and use of the estimates are discussed in detail. Reports on recent studies on the time trend of the disease from some areas in India, e.g., Chingleput in Tamil Nadu are discussed. They confirm the slow downward trend over a fairly long period of observation, as in the rural areas around Bangalore. It also outlines the serious escalation of disease burden in a tribal population group in Car Nicobar over a period 1986-2002, and highlights the nature and extent of the emerging threats. Some epidemiologists forecast a rise of 20 per cent in incidence in the next 20 yr, for India, with a cumulative rise of 46 million cases of tuberculosis during that period, largely as a consequence of HIV epidemic. The Governmental efforts at intervention through Revised National Tuberculosis Control Programme (RNTCP) and at monitoring the epidemiology of intervention through organising routine reporting are highlighted, and data are presented and evaluated on these. RNTCP needs to be used as an effective instrument to bring a change in epidemiological situation, through fast expansion and achievement of global target. The present review describes the global tuberculosis situation, and views it in the context of the goal of the antituberculosis intervention activities. It presents the epidemiological situation in India, comments on the current trend and discusses the efforts taken towards making projections on the likely burden of disease in India over time.

Spectral studies on the interaction of iodine and anthracene sulfonate with bacterial phospholipids from different mutants of Salmonella minnesota.

Using spectrophotometric and spectrofluorometric techniques, the interaction of iodine and 2-anthracene sulfonate (ANS) with the phospholipids (PL) isolated from four genetically correlated Salmonella minnesota isolates viz., a smooth form (S), a deeply rough mutant (Rc) and two intermediate forms (Ra and Rb) were studied. Appearance of an isosbestic point and a new band in absorption spectra indicated charge-transfer (C-T) interaction of iodine with the PL through the formation of 1:1 complex. Stern-Volmer type fluorescence quenching of PL was observed with the addition of iodine to PL, while PL enhanced the fluorescence of anionic dye ANS. The values of the binding constants between iodine/PL and ANS/PL, measured by using suitable equations, showed a systematic gradation in the molecular properties of the PL in the membrane structure in smooth (S) and rough (Ra, Rb and Rc) mutants of Salmonella minnesota.

Spectrophotometric and spectrofluorometric studies on interaction of cationic dyes with bacterial capsular polysaccharide.

Interaction of Klebsiella K14 capsular polysaccharide with cationic dyes pinacyanol chloride, acridine orange and phenosafranin has been studied by spectrophotometric and spectrofluorometric techniques. The polymer containing both glucuronic acid and pyruvic acid in its repeating unit behaved as a unique polyelectrolyte. It induced blue shift of the absorption band of pinacyanol chloride indicating strong metachromasy. Stoichiometry of the polyanion and the dye cations in the polymer-dye compound (1:2) indicated that both glucuronic acid and pyruvic acid acted as potential anionic sites for interaction with the cationic dye molecules. The stoichiometry of anionic site (of polyanion): cationic site (of dye) in the polymer dye compound was calculated as 1:1. Interaction of the polymer with acridine orange and phenosafranin dyes studied by fluorescence measurements demonstrated Stern-Volmer type of quenching. Equivalent weight of the polymer was determined by spectrophotometric and spectrofluorometric titrations. From the present studies chromotropic property of the polymer was established.

Dr. P. C. Sen Memorial Award Paper. A study of HIV infection in thalassaemia patients of rural Bengal.

Thalassaemia patients receiving repeated blood transfusions are vulnerable to transfusion related infections. HIV infection is the most life threatening of them all. Blood being the most efficient mode of transmission of HIV, increases the risk of infection even further. Although the National AIDS Control programme has laid down stringent rules regarding blood safety, it remained to be seen whether they were being followed meticulously especially in rural areas. The present study was conducted to identify the HIV status of multi-transfused thalassaemia patients attending hospital blood banks of rural Bengal. Only 3 (0.9%) of the 330 thalassaemia patients examined were found to be HIV positive. Although the situation has not reached alarming proportions, yet appropriate control measures must be adopted on a mass scale to prevent further spread of the world wide pandemic.

Effect of short-term dermal toxicity of fenvalerate on residue, cell architecture and biochemical profiles in broiler chicks.

Effect of fenvalerate on cell architecture, tissue biochemical parameters and its residual concentration was studied in broiler chicks following dermal application at 0.1 and 1% in ethanol once daily for 31 days. It did neither produce loss of body weight nor clinical signs of toxicity. Kidney contained maximal residue followed by heart, fat, liver and brain after 0.1%; and fat contained maximal residue followed by kidney, heart, liver and brain after 1% application. Fenvalerate (0.1%) increased the aspartate aminotransferase (AST) (except brain), alanine aminotransferase (ALT), alkaline phosphatase (AP), acid phosphatase (AcP) (only brain) activities, glycogen level (only liver) in liver, kidney, heart and brain tissues; and 1% increased the AST (except brain), ALT, AcP (except liver and kidney), AP (only heart), glycogen (only liver) and decreased AP (except heart), AcP (only kidney), cholesterol (except liver and heart), and acetylcholinesterase (AChE) (liver and brain) of liver, kidney, heart and brain tissue homogenates respectively. Histopathological examination in general showed aggregation of mononuclear cells in liver, around the kidney tubules and cardiac muscle fibre. In addition, fibrosis in the periportal area of liver, proliferation of ureter and tubular degeneration, and congestion of endocardial vessels were also observed. The intensity of cellular changes was more marked after 1% dermal application.

Undernutrition, vitamin A deficiency and ARI morbidity in underfives.

In a longitudinal study of 200 randomly selected underfives were followed fortnightly for a period of one calendar year (January to December 91) to ascertain the influence of undernutrition and vitamin A deficiency on the ARI incidence. The study revealed that on an average a child suffered from 5.9 episodes of ARI in one year period. Children who were undernourished or showed signs of vitamin A deficiency had significantly greater risk of AIR attacks.

Transferable drug resistance in Salmonella typhi strains isolated from an outbreak at Calcutta in the recent past.

Transferable drug resistance, phage type, biotype and minimum inhibitory concentration to different drugs were studied in 50 Salmonella typhi strains isolated during recent outbreak of enteric fever at Calcutta. The antibiotic sensitivity test showed that 44% strains were sensitive to multiple drugs including chloramphenicol. The minimum inhibitory concentrations of the drugs tested were well above the normal level. The transferable drug resistance test suggested that all the resistant strains were carrying transferable multidrug resistant gene containing ampicillin, chloramphenicol, streptomycin, tetracycline resistance factor. From phage typing it was observed that 30% strains belonging to phage type 51, and among them 80% strains were carrying transferable drug resistant factor containing ampicillin, chloramphenicol, streptomycin and tetracycline.

Community based survey of STD/HIV infection among commercial sex-workers in Calcutta (India). Part-III: Clinical findings of sexually transmitted diseases (STD).

On physical examination of 418 sex workers, 202 (48.32 per cent) were found to have vaginal discharge, which was found to be most common among younger age class. Endocervical pus, genital ulcer, and swelling of inguinal lymph glands were observed in 13.16, 6.22 and 1.91 per cent of the sex workers respectively. Clinically 16.51, 15.31, 11.96 and 4.78 per cent were found to suffer from candidiasis, trichomoniasis, cervicitis and syphilis respectively.

Community based survey of STD/HIV infection among commercial sex workers in Calcutta (India). Part-IV: Sexually transmitted diseases and related risk factors.

Community based survey on a sample of commercial sex workers in one red light area of Calcutta, was carried out to determine prevalence of sexually transmitted diseases (STD) including HIV infection and related risk factors. An alarmingly high prevalence of STDs (80.56 per cent) but low HIV-seropositivity (1.13 per cent) was observed. Candida albicans, Neisseria gonorrhoeae and Trichomonas vaginalis were detected in 23.24, 13.24 and 11.11 per cent of genital specimens respectively. BY TPHA test 62.97 per cent of the sera were reactive for Treponema pallidum. Duration in the profession of sex workers was found to have an association with seropositivity for syphilis. Prevalence of HIV infection might be low at present, but conditions were highly favourable for rapid spread of infection.

Subacute toxicity of fenvalerate in broiler chicks: concentration, cytotoxicity and biochemical profiles.

Subacute toxicity study of fenvalerate was carried out in broiler chicks after oral administration @ 525.6 mg/kg once daily for 28 days. The blood concentration of fenvalerate following 1 day post-administration (pd) was 39.65 +/- 2.67 micrograms/ml and maintained plateau thereafter up to day 21 pd, and then declined (18.46 +/- 1.47 micrograms/ml) on day 28 pd. Intestine contained maximum residue (7.46 +/- 1.96 micrograms/g) followed by fat (5.95 +/- 1.16 micrograms/g), brain (5.06 +/- 0.96 micrograms/g), liver (3.93 +/- 0.51 micrograms/g), kidney (3.79 +/- 0.72 micrograms/g) and heart (1.72 +/- 0.35 micrograms/g). Histopathological examinations showed focal areas of necrosis in liver, proliferation and fibrosis of bile duct, larger size of glomeruli, glomerular and tubular necrosis in treated birds. Fenvalerate significantly increased the cholesterol level in brain, GPT activity in liver and heart, GOT activity in heart, and alkaline phosphatase activity in heart and brain tissue. It significantly decreased the glycogen content in liver and heart, GOT activity in brain and acid phosphatase activity in all the tissues analyzed. It appears that comparatively fowl is resistant to fenvalerate toxicity.

Community based survey of STD/HIV infection among commercial sexworkers in Calcutta (India). Part I. Some social features of commercial sexworkers.

A community based sample survey of sexually transmitted diseases and Human Immuno deficiency Virus infection was carried out among commercial sex workers of a red-light area in Calcutta. In this paper socio-demographic aspects of sex workers are discussed. For the survey, 450 sex workers were selected by random sampling method. Among the sex workers surveyed, 84.89 per cent were in the age group 15-29 years. Lowest age was 13 years and mean age was 23.12 years. Large number of sex workers were from Nepal (15.11 per cent) and Bangladesh (11.78 per cent). About 38 per cent were from three districts of West Bengal bordering Bangladesh. About 84.44 per cent of the sex workers were illiterate. Extreme poverty forced 49.10 per cent to choose this profession and family disturbances led 21.56 per cent to this profession. Almost all sex workers (448) had addiction, alcohol being taken regularly by 81.11 per cent. Number of clients of sex workers varied from 2 to 10, average being 3. About 67.33 per cent gave history of pregnancy, 46 per cent had abortion and 41.11 per cent had living children. About 27.11 per cent took precaution against pregnancy regularly. Use of oral pills was found to be the most common practice against pregnancy (13.65 per cent), followed by ligation (11.56 per cent). Only 1.11 per cent reported that their clients used condom regularly.

Community based survey of STD/HIV infection among commercial sex-workers in Calcutta (India). Part II. Sexual behaviour, knowledge and attitude towards STD.

A community based sample survey of STD/HIV infections was carried out among 450 commercial sex workers, (CSW) of one red light area in Calcutta. In this paper, sexual practices of sex workers, their knowledge about sexually transmitted diseases (STD) and practice of preventive and curative measures against STDs, is described. Vaginal intercourse was the usual sexual practice. But as many as 74.44 per cent also practised oral sex. About 82.67 per cent had the practice of washing external genitalia with antiseptic solution after sexual intercourse. About 69.11 per cent of sex workers were aware of sexually transmitted diseases and 30.67 per cent had knowledge about AIDS. About 70.22 per cent had symptoms related to genital tract during one year preceding the survey and 34 per cent of sex workers took medical treatment during last one month.

A type 1 DNA topoisomerase from the kinetoplast hemoflagellate Leishmania donovani.

A type 1 DNA topoisomerase has been purified from the nuclei of the kinetoplast hemoflagellate Leishmania donovani using polyethylene glycol fractionation and chromatography on hydroxylapatite, phosphocellulose and phenylsepharose column. The relaxation activity is ATP independent. Mg2+ is an essential cofactor for the reaction with an optimum at 10 mM. Mg2+ can be substituted by Mn2+ at 5 mM concentration. The relaxation reaction exhibits a salt optimum at 100 mM KCl. The enzyme can not remove supercoils from positive superhelical DNAs nor can induce supercoiling of relaxed DNAs. The topoisomerase activity is associated with a polypeptide of molecular weight about 67 kDa as shown by sephacryl-S200 gel filtration and by electrophoresis on sodium dodecyl sulphate-polyacrylamide gels.

Leukaemoid reaction in diarrhoeal diseases.

There was an outbreak of diarrhoea/dysentery in Naxalbari, North Bengal in August-September of 1992. Ninety-seven cases were investigated. Bacterial pathogens were isolated from stools of 17 cases and the organisms were Salmonella typhimurium (76%), Salmonella enteritidis (12%) and Shigella dysenteriae type 1(12%). A leukaemoid reaction was observed in 4 cases (24%) amongst all 17 patients and they were all children.

Demonstration of acid-fast bacilli in tissues and evaluation of atypical tuberculous lesions.

A study was conducted with tissue sections of 60 different suspected tuberculous lesions, obtained by biopsy from 60 patients of different age groups. The tissue sections were fixed with formol saline and stained with haematoxylin and eosin and Ziehl-Neelsen stain. Histological picture of tuberculosis and presence of acid-fast bacilli were studied. Out of 60, 39 sections showed typical tuberculous lesions. Remaining 21 sections presented atypical lesions. Of those 39 typical lesions 17(43%) showed presence of acid-fast bacilli. Among atypical lesions 10(47%) showed presence of acid-fast bacilli. Thus it may be stated that diagnosis of tuberculosis is not confirmed unless acid-fast bacilli is demonstrated in the lesions. Tuberculosis in substantial number of cases produces non-granulomatous atypical lesions, so non-specific inflammation and granulation tissue in histology need Ziehl-Neelsen staining and careful search for acid-fast bacilli should be made to exclude tuberculosis where the disease is common.