Systemic manifestations in chronic arsenic toxicity in absence of skin lesions in West Bengal.

BACKGROUND & OBJECTIVE: Pigmentation and keratosis are the prerequisites to diagnose arsenicosis. However, many systemic manifestations occur in association with pigmentation and keratosis in people exposed to chronic drinking of arsenic contaminated water. The present study aim to find out whether systemic manifestations occur in significant number of cases in arsenic exposed people in the absence of skin lesions in an affected district in West Bengal, India. METHODS: A cross-sectional study was carried out in South 24 Parganas, an arsenic affected district of West Bengal, India. Both dermatological and systemic manifestations were recorded and water samples collected for arsenic analysis from 7683 participants. A correlation of systemic manifestations in relation to arsenic exposure was carried out in subjects having no arsenical skin lesion. Prevalence odds ratio (POR) was calculated for each outcome comparing those with high arsenic exposure with those with lowest exposure. RESULTS: The frequency of occurrence of various clinical manifestations like weakness, anaemia, diarrhoea, hepatomegaly and lung disease was found to be significantly higher among participants drinking water having arsenic concentration > or = 50 microg/l in comparison to those taking water with arsenic content below this level. Further, there was increased occurrence of these manifestations with increasing concentration of arsenic level in drinking water, and this followed a dose-response relationship. INTERPRETATION & CONCLUSION: It appears that it is worthwhile to include people with systemic manifestations in absence of skin lesions with evidence of arsenic exposure as suspected cases of arsenicosis for case detection and in surveillance programme.

New evidence of non seasonal factors in the menarche rhythm.

The phylogenetic, ontogenetic and seasonal hypotheses on the annual periodicity of menarche were tested. Data from European, Asian (Caucasian, Mongolian and Caucaso-Mongolian people from the northern hemisphere) and Chilean (Caucaso-Amerindian from the southern hemisphere) populations were compared with data from Hungary (Caucaso-Mongolian Europeans from a northern temperature zone) and Madras, India (a complex ethnically originated people from a tropical northern area). Chileans were compared with those Caucaso-Mongolian people because Amerindians belong also to the Mongolian group. Hungarian girls showed peaks of menarche in the month of January (winter), June, July and August (summer), in contradiction with most European Caucasians who showed peaks only in winter months; and in agreement with Finns who showed both peaks. Indian girls had peaks in April, May and June (summer) and more extreme peaks and troughs than the Finnish girls (from a temperature arctic zone). These findings do not agree with the seasonal hypothesis, but they do with the phylogenetic hypothesis. Indian girls had a peak of menarche in the same month of birth and the arrangement of data according to the gestational-menarche coincidence showed a significant heterogeneity for the monthly peaks of menarche; thus, the ontogenetic hypothesis was also supported.

New evidence of non seasonal factors in the menarche rhythm

The phylogenetic, ontogenetic and seasonal hypotheses on the annual periodicity of menarche were tested. Data from European, Asian (Caucasian, Mongolian and Caucaso-Mongolian people from the northern hemisphere) and Chilean (Caucaso-Amerindian from the southern hemisphere) populations were compared with data from Hungary (Caucaso-Mongolian Europeans from a northern temperature zone) and Madras, India (a complex ethnically originated people from a tropical northern area). Chileans were compared with those Caucaso-Mongolian people because Amerindians belong also to the Mongolian group. Hungarian girls showed peaks of menarche in the month of January (winter), June, July and August (summer), in contradiction with most European Caucasians who showed peaks only in winter months; and in agreement with Finns who showed both peaks. Indian girls had peaks in April, May and June (summer) and more extreme peaks and troughs than the Finnish girls (from a temperature arctic zone). These findings do not agree with the seasonal hypothesis, but they do with the phylogenetic hypothesis. Indian girls had a peak of menarche in the same month of birth and the arrangement of data according to the gestational-menarche coincidence showed a significant heterogeneity for the monthly peaks of menarche; thus, the ontogenetic hypothesis was also supported

Immunological status of women with prolonged oral contraceptives and occurrence of giardiasis.

Immunological status of 14 women taking oral contraceptive for prolonged period (more than 6 months, low dose pill) was studied. Phytohaemagglutinin induced lymphocytes stimulation (PILT) was found to be significantly depressed in these subjects though T-lymphocyte subpopulation was found to be normal. Serum IgA and IgG levels in these cases were found to be normal but IgM level was increased. Though incidence of G lamblia infection was reported to be high in immunocompromised subjects, it was found only one out of 14 subjects taking oral contraceptive harboured the protozoa.

PIP: Whether use of oral contraceptives depresses the immune system in Indian women, and whether they affect the prevalence of giardiasis in users, was explored by testing immune function and stools for Giardia lamblia in 14 pill users and 10 controls. The subjects were aged 18-40 and had taken a low dose oral contraceptive for at least 6 months. The immune functions examined were quantitative serum IgG, IgA and IgM levels by radial immunodiffusion, cell-mediated response to phytohemagglutinin, and peripheral T-cell counts. 1 pill user had signs of giardia infection. Immunoglobin levels in the other were not significantly different from controls, except for IgM, which was 415.34 mg/dl in pill users, vs. 251.69 in controls. T-cells were normal in 1 pill user tested. The mean blastogenic index, or lymphocyte transformation index, was significantly depressed at 6.6 in pill users as well as the woman with giardia, compared to 17.6 in controls. The reported incidence of giardiasis in an adult Indian population was 4.4%, thus the incidence in these pill users was not increased. The significance of the immunologic findings was unknown.