Arsenic in groundwater of the Kolkata Municipal Corporation (KMC), India: Critical review and modes of mitigation.

This study represents the first comprehensive report of groundwater arsenic contamination status in the Kolkata Municipal Corporation (KMC). During the past 23 years, 4210 groundwater samples were analysed from all 141 wards in the KMC: 14.2% and 5.2% samples had arsenic >10 µg/l and >50 µg/l, respectively, representing 77 and 37 wards. The study shows that the number of arsenic contaminated samples (and wards) in the southern part of the KMC exceeds that of other parts of the city. The daily intake of arsenic from drinking water was estimated as 0.95 µg per kg bw and the cancer risk was estimated as 1425/106. Analyses of biological samples (hair, nail and urine) showed elevated concentrations of arsenic indicating the presence of subclinical arsenic poisoning, predicting an enhanced lifetime cancer risk for the population in southern part of the KMC. In the KMC, groundwater is not a sustainable source of freshwater due to arsenic, high iron, hardness and total dissolved solids. Its continued use is impelled by the lack of an adequate infrastructure to treat and supply surface water and in some wards the unaccounted for water (UFW) is even >45% incurred during distribution. The rare imposition of a water tax makes the water supply systems unsustainable and fosters indifference to water conservation. To mitigate the arsenic problem, continuous groundwater monitoring for pollutants, a treated surface water supply with strict policy implications, rainwater harvesting in the urban areas and introduction of water taxes seem to be long-term visible solutions.

Current Perceptions and Practices (KAP) about Leprosy among Leprosy Patients: A Comparative Study between High Prevalent & Low Prevalent Districts of West Bengal.

A cross sectional observational study was conducted to assess knowledge, attitude and practices about leprosy among leprosy patients in six districts of West Bengal. Total patients selected for the study were 300; of them 185 patients were from three high prevalent districts and 115 from three low prevalent districts of West Bengal. 56.33% patients were male and 43.67% were female. Most of the patients (85.67%) belonged to Hindu community and 60% from socially backward group. 64.33% patients lived below poverty line. Thirty five percentage of patients had correct knowledge that leprosy is caused by a bacteria. Patients from high prevalent districts (41.62%) have better knowledge than those from low prevalent areas (26.09%). Difference was found to be statistically significant (p = 0.006). Correct knowledge about spread of leprosy through cough & sneezing, of the patients from high prevalent districts (30.81%) was more than those from low prevalent districts (14.78%) (p = 0.001). 74.05% patients from high prevalent districts could tell one or other forms of clinical presentation of a leprosy patients, while 56.52% from low prevalent areas could mention it correctly (p = 0.01). About infectiousness, duration of treatment, complications, patients from high prevalent districts showed better knowledge that those from low prevalent districts. Similarly, Attitude of the patients towards leprosy was found to be more adverse in low prevalent areas. 90% patients have idea that leprosy was curable, but only 51.67% patients heard about MDT. Place of residence (high prevalent districts) & level of education (secondary & above) attributed to better knowledge score of the patients, whereas Place of residence (high prevalent districts) & age (younger age group) attributed to better attitude score of the patients.

Efficacy and safety of topical nadifloxacin and benzoyl peroxide versus clindamycin and benzoyl peroxide in acne vulgaris: A randomized controlled trial.

BACKGROUND: Topical therapy with comedolytics and antibiotics are often advocated for mild and moderate severity acne vulgaris. Nadifloxacin, a new fluoroquinolone with anti-Propionibacterium acnes activity and additional anti-inflammatory activity, is approved for use in acne. This randomized controlled assessor blind trial compared the clinical effectiveness and safety of eight weeks therapy of nadifloxacin 1% versus clindamycin 1% as add-on therapy to benzoyl peroxide (2.5%) in mild to moderate grade acne. MATERIALS AND METHODS: The efficacy parameters were changes in the total, inflammatory and non-inflammatory lesion counts, Investigator Global Assessment (IGA), and Cardiff Acne Disability Index (CADI) scales from baseline to study end (eight weeks). All treatment emergent dermatological adverse events were evaluated for safety assessment. RESULTS: Out of 84 randomized subjects (43-nadifloxacin arm) and (41-clindamycin) 42 in nadifloxacin group, 37 in clindamycin group completed the study. Reduction from baseline of total, inflammatory and non-inflammatory lesion counts were highly significant in both the groups (P<0.0001), but between group differences were not significant. Significant improvement in CADI and IGA scales were noted in both groups. Between-group comparison showed no significant differences. The safety and tolerability profile of both regimens were good and statistically comparable. CONCLUSIONS: Topical nadifloxacin, a new fluoroquinolone is effective, tolerable, and safe for mild o moderate facial acne. Its clinical effectiveness is comparable to clindamycin when used as add-on therapy to benzoyl peroxide.

Detection of beta-thalassaemia mutations in eastern Indian population by polymerase chain reaction.

We report here the application of a non-radioactive amplification refractory mutation system (ARMS) for the direct detection of beta-thalassaemia using polymerase chain reaction. Seven beta-thalassaemia mutations accounting for 89 per cent (71 of 80) of the alleles in eastern Indian population have been identified and majority (67.5%) were due to IVS-1 nt 5 (G-C) mutation. Interestingly, 9 cases did not reveal any of the 17 common mutations reported so far from Indian population.

Observations on the breeding habitats of Aedes aegypti in Calcutta following an episode of dengue haemorrhagic fever.

A year-long (Nov. 1990-Oct. 1991) search for Ae. aegypti larvae was made of all water containers in and around fixed 100 houses at Bowbazar area in Calcutta following an episode of DHF. Out of 10151 containers searched, 615 (6%) were positive. Masonry tanks were the major (64.2%) and preferred (17%) breeding sites of Ae. aegypti. Indoor containers (6.7%) were more conducive to breeding of the vector species than the outdoor ones (3%). Breteau index showing wide variation (25 in December '90 to '93 in August 1991) proved to be the best for measurement of density of larval population of Ae. aegypti and paralleled the fluctuation in both rainfall and humidity. Role of temperature was not pronounced. It was noted that cases of DHF occurred even with the lowest Breteau index in December.

An echo-cardiographic (M-mode & 2D) analysis of thalassaemia major.

25 cases of thalassaemia major were studied by 2D and M-mode echocardiography. A significantly increased (p less than 0.001) mean value (100.8 +/- 27.37 msec, range 80 to 140 msec) of A2-E (early relaxation period) interval on M-mode was observed in thalassemia in comparison to mean level (82.6 +/- 5.7, range 60 to 100 msec) of control population. No significant differences were noted in FS % (fractional shortening) and EF% (ejection fraction) when compared to corresponding normal values respectively. Mean serum iron concentration (142.2 +/- 29.1 micrograms/dl, range 102 to 192 micrograms/dl) was significantly higher in thalassaemia as compared to normal population (mean 106.3 +/- 11.4 micrograms/dl, range 75 to 120 micrograms/dl). There was also a direct correlation between serum iron concentration and A2-E interval. 11 patients (44%) showed abnormal A2-E interval but only 3 patients (12%) showed abnormal percentage of FS and EF. It is therefore concluded that A2-E interval will help to detect early left ventricular dysfunction much before overt and irreversible heart failure becomes manifest and which will also help to optimise transfusion and chelation therapy.

In vivo distribution of lithium in plasma and brain.

A single administration of LiCl (0.5, 2 and 4 mmol/kg) to adult male albino rats produced a dose dependent increase of Li level in plasma, whole brain and brain regions. The concentration of Li in whole brain and brain regions was much less than that in plasma. Further, it is also found that concentration of Li in plasma reached a peak at 8 hr while that of Li in whole brain and brain regions reached a peak at 12 hr after the administration. The distribution and retention of Li was found to be highest in hypothalamus followed by striatum, pons-medulla, cerebellum and cerebral cortex. Daily administration of LiCl at a dose of 0.5 and 2 mmol/kg/day showed a time and dose dependent increase in plasma Li level up to a period of 21 consecutive days. But at higher dose (4 mmol/kg/day), on the other hand, under similar condition showed a time dependent increase in plasma Li level up to a period of 14 consecutive days and then gradually decreased with prolongation of treatment to 21 consecutive days. In brain there was no such decrease, rather increase in Li level was observed with the prolongation of duration of treatment, highest concentration of Li was found in hypothalamus and striatum than the rest of the brain regions. These results suggest that under short term treatment with LiCl, the clearance rate of Li in brain cell is much slower than that in plasma. Both single and long-term exposure of LiCl produces a dose dependent increase of Li in plasma, whole brain and brain regions.(ABSTRACT TRUNCATED AT 250 WORDS)

Reversal reaction in patients with lepromatous leprosy after transplantation of human fetal thymic grafts.

An attempt has been made to reconstitute impaired cell-mediated immunity in 1 patient with indeterminate, 4 patients with borderline and 2 patients with polar lepromatous leprosy by grafting three thymus glands obtained from human fetuses of 14--19 weeks gestation. Most of these patients had severe ulcerative erythema nodosum leprosum (ENL) and were intolerant to dapsone. After thymus transplantation these patients were followed for 1 1/2 years. During this period, all conventional chemotherapy had been withdrawn. In most cases, there was dramatic improvement of the clinical condition, resolution of skin lesions, subsidence of ENL, clearance of bacteria from skin and reconstitution of several immunologic deficits; but late lepromin reactivity returned in none, which indicated permanent lose of resistance to Mycobacterium leprae.