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Background Placement of a prosthetic mesh is integral to successful totally extraperitoneal (TEP) herniorrhaphy. Available meshes have supported the surgical efforts well but search for an ideal mesh continues. Post-herniorrhaphy pain is an index of patient reported outcomes (PRO). The pain is attributable to balloon dissection, cautery, sutures, tackers and prosthesis. Reducing polypropylene content of the mesh is associated with attenuated inflammatory response by the host and improved compliance and comfort. We report the difference in PROs in TEP herniorrhaphy with either heavy polypropylene (PPM) or light weight mesh (LWM) being used for the repair. Patients and methods From June 2004 to December 2005, consecutive candidates for TEP herniorrhaphy were enrolled for this prospective study with an informed consent and compliance to Ethics guidelines. They were operated under general anesthesia (GA) on a day care basis using either PPM or LWM meshes as per the patient's choice. Operative and postoperative PRO were statistically analyzed by an independent doctor using the Microsoft Office Excel 2003. Results One hundred fourteen (84 PPMs and 30 LWMs) TEP herniorrhaphies were performed under GA on 57 male patients without any exclusion, on a day care basis. There was no technical difficulty, operative complications, conversion or prolonged hospital stay in either group. Patients of LWM reported better outcome in regards to pain, NSAID usage, seroma and recurrence. All patients of LWM reported an earlier return to activity. Conclusion Light weight meshes result in comparatively better "patient reported outcomes" in TEP inguinal herniorrhaphy as compared to heavy polypropylene meshes.

Generous overlap by a well-transfixed mesh is important in laparoscopic ventral hernia repair (LVHR). Mesh is usually introduced through a 10-mm trocar and fixed by tackers or transfixed by sutures. Ten-millimeter trocar sites are more prone to hernia development. Transfixation done using a suture passer inflicts some trauma and the site may become painful. This study reports a mesh insertion technique avoiding a 10-mm myofascial port, double-breasted fascial closure of the hernial defect, and transfixation in a relatively atraumatic manner.This prospective study was conducted by enrolling the patients attending our surgery clinic. They were candidates for LVHR. Informed consent was obtained from each patient before the procedure. The study was approved by the Ethical Review Board of the Hospital and conducted as per good clinical practice (GCP) guidelines.Between April 2004 and June 2006, 29 ventral hernia patients were enrolled without any exclusion. All patients had LVHR performed with this technique. Mean operative time and hospital stay were 65 min and1 day, respectively. There were no perioperative complications, conversion, infection, trocar site or recurrent herniation or mortality. The majority of the patients were operated on as day-care surgery. Patients were followed up telephonically for the first 48 h and then by visiting us regularly. There was no postoperative visible bulge.Mesh insertion by avoiding 10-mm trocar, double-breasted defect closure, and transfixation using atraumatic needles is a technically easy, safe, and patient-friendly procedure.

Complications of open inguinal hernia repair, such as wound infection, hematoma, seroma, and neuralgia, are known to occur. Vascular injuries during inguinal hernia repair are rare and documented as case reports only. Vascular malformations are known to occur after trauma or sharp injuries. Most of the venous malformations are congenital in origin and usually reported in relation to congenital heart disease or in visceral locations. We encountered an iatrogenic venovenous malformation (VVM) in the subcutaneous space of the left inguinal region following an open inguinal hernia repair. This VVM presented as a spontaneous rupture leading to widespread ecchymosis of the thigh. It was managed endoscopically.

Thiazolidinediones (TZDs) are currently the most efficacious class of oral antidiabetics. However, they carry the burden of weight gain and haemodilution, which may lead to cardiovascular complications. The present study was designed to ascertain whether a combination of dipeptidyl peptidase IV (DPP IV) inhibitor with low dose of a thiazolidinedione absolves TZD associated weight gain and oedema without compromising its efficacy. In this study, we examined the efficacy and safety of lower dose (1 mg/kg/day) of rosiglitazone, a thiazolidinedione, in combination with 5 mg/kg/day dose of LAF-237 (vildagliptin), a known DPP IV inhibitor, in aged db/db mice after 14 days of treatment and compared the combination with therapeutic dose (10 mg/kg) of rosiglitazone. The combination therapy showed similar efficacy as that of 10 mg/kg/day rosiglitazone in lowering random blood glucose (53.8%, p

Purpose: Laparoscopic cholecystectomy, the gold standard treatment for symptomatic cholecystolithiasis, is still not absolutely safe. Use of energy sources for routine dissection thought to be a facilitator has unfortunately been a cause of significant morbidity. The purpose of this study was to evaluate the feasibility of performing a safe laparoscopic cholecystectomy without using any energy sources. Patients and Methods: From June 2005 to April 2006, 38 consecutive patients of symptomatic cholecystolithiasis without any exclusion criteria underwent laparoscopic cholecystectomy with this technique. Results: Mean operative time was 33 minutes (25–96). There was no perioperative hemodynamic instability, need for blood transfusion, technical difficulty, need for conversion, or any visceral injury. Majority of patients (34 out of 38) were discharged as day cases. Postoperative follow-up was uneventful. Conclusion: Laparoscopic cholecystectomy can be safely performed without resorting to use of any energy so...

Neuropeptide Y (NPY) has been implicated in the control of ingestive, cardiovascular, and reproductive function. Blood pressure and sexual function were examined in Long-Evans rats receiving 6% ethanol-containing or calorically matched liquid diets, or rat chow ad lib. After 12 weeks of exposure, rats were sacrificed and plasma hormone levels and NPY content of microdissected brain regions were determined. Neither long-term alcohol ingestion nor caloric restriction were associated with major decrements in copulatory behavior. Long-term alcohol ingestion was associated with decrements in erectile function ex copula. Long-term alcohol ingestion was also associated with: (i) a moderate degree of hypertension; (ii) a failure to gain weight; (iii) decrements in circulating levels of LH, testosterone, and ACTH (but not progesterone); and (iv) increased corticosterone levels. Long-term alcohol ingesting and calorically-restricted rats exhibited alterations in daily feeding patterns. These physiological changes in response to long-term alcohol ingestion or caloric restriction were associated with neural site-selective differences in NPY content. Elevated NPY in the paraventricular nucleus was associated with voluntary (as in alcohol ingestion) or involuntary (as in caloric restriction) reductions in food intake. Differences in NPY in the suprachiasmatic and ventromedial nuclei were associated with the differences in feeding patterns. The decrements in hormone levels were associated with higher levels of NPY in the median eminence and in the arcuate nucleus.

Neuroacanthocytoses are neurodegenerative disorders marked by phenotypic and genetic heterogeneity. There are several associated genetic loci, and many defects, including gene deletions and insertions, and missense, nonsense, and splicing mutations, have been found spread over hundreds of kilobases of genomic DNA. In some cases, specific diagnosis is unclear, particularly in the early stages of disease or when there is an atypical presentation. Determination of the precise genetic defect allows assignment of the diagnosis and permits carrier detection and genetic counseling. The objective of this report was to utilize exome sequencing for genetic diagnosis in the neuroacanthocytosis syndromes. Genomic DNA from 2 patients with clinical features of chorea-acanthocytosis was subjected to targeted exon capture. Captured DNA was subjected to ultrahigh throughput next-generation sequencing. Sequencing data were assembled, filtered against known human variant genetic databases, and results were analyzed. Both patients were compound heterozygotes for mutations in the VPS13A gene, the gene associated with chorea-acanthocytosis. Patient 1 had a 4-bp deletion that removes the 5' donor splice site of exon 58 and a nucleotide substitution that disrupts the 5' donor splice site of exon 70. Patient 2 had a dinucleotide deletion in exon 16 and a dinucleotide insertion in exon 33. No mutations were identified in the XK, PANK2, or JPH3 gene loci. Exome sequencing is a valuable diagnostic tool in the neuroacanthocytosis syndromes. These studies may provide a better understanding of the function of the associated proteins and provide insight into the pathogenesis of these disorders.

The actual rate of Exclusive Breast Feeding (EBF) (up to the age of 6 months) is dismally low in urban slums of India. The reasons and determinants of this are debatable. The study was planned to understand the determinants of EBF in the infants in urban slums. A community-based cross sectional study was done in urban slums of Gwalior, India. The data were collected by interviewing the caregivers of 279 infants aged between 6 and 11 months from November 2005 to July 2006. Only 11 (3.8%) mothers knew that EBF should be done till six months and 22 (7.8%) actually practiced EBF. A total of 178 (63.8%) and 212 (76.0%) newborns were given pre- and post-lacteal feeds with 26.2% discarding colostrum. Only 22 (7.8%) practiced EBF. The early breastfeeding (BF) initiation, Ante Natal Clinic (ANC) visits, mothers' education and immunization visits were significantly associated with higher probability of EBF. There were a number of myths and misconceptions about BF in this urban slum population. The correct information about BF was more common amongst the women who had frequent contacts with health facilities due to any reason or during ANC or immunization visit. Similarly, it is the continuum of good health and feeding practices and the mothers who start early BF or get their child immunized regularly are more likely to EBF their children. Considering the widely prevalent myths and low rate of utilization of health services along with high potential benefits of EBF, every opportunity of mothers' interaction with the health facility should be utilized for promoting correct and EBF practices.

Absence of recurrence, seroma, and pain eludes the laparoscopic surgeon managing ventral and incisional hernias. Multifactorial etiology (i.e., obesity, comorbidity, and dyscollagenemia) is a challenge. Surgeons have risen to this challenge by providing laparoscopic ventral hernia repair (LVHR). Stability of mesh in a standard LVHR is attributed to Pascal's Principle (PP). PP, based upon concentration of forces at the point of least resistance, has been classically applied in hydraulic jacks to move large masses. Application of PP in LVHR is thus misplaced where the hernial defect becomes a point of concentration of intra-abdominal forces. This makes the mesh inherently unstable. For a stable mesh aided by PP, benefits of defect closure needed to be explored.Between January 2000 and December 2004, 30 nonsmoker patients with incisional, primary ventral, and recurrent ventral hernias were operated on. Laparoscopic closure of the defect augmented with intraperitoneal onlay mesh (IPOM), as done in standard LVHR, was preformed.Thirty patients with 34 defects of a mean "closed defect" length of 5.7 cm (range, 3-10) were operated on. Mean operative time was 90 minutes (range, 75-110). There were no conversions, visceral injury, postoperative visible bulge, or seroma. No painkiller except Paracetamol was required. There was no recurrence in a mean follow-up of 58 months (range, 26-84). Restored abdominal contour was achieved by all the patients.Closure of hernial defect augmented with IPOM is a safe, patient friendly, and scientific way of doing LVHR.

Bancroftian filariasis caused by Wuchereria bancrofti is endemic in many parts of India. In recent years diagnosis of W. bancrofti infection has been revolutionized with the availability of filarial antigen tests, which is important in monitoring success of chemotherapy. We carried out this study to measure microfilariaemia and antigenemia levels in bancroftian microfilariae (mf) carriers at 1 yr follow up after chemotherapy, in lymphoedema patients and in endemic controls from a filariasis endemic area in Tamil Nadu State using Og(4)C(3) ELISA to identify the best marker to assess success of chemotherapy.Serum samples were collected from 30 bancroftian microfilaremic (Mf) carriers pre-treatment and at sequential intervals (7,30,60,90,180 and 365 days) following treatment with diethylcarbamazine (DEC:6mg/kg body weight, single dose), 30 lymphoedema patients (without treatment) at periodic intervals, and 68 control subjects (24 endemic normal subjects in filariasis endemic area in Tamil Nadu State, 24 non-endemic normal subjects residing in Chandigarh, India; 5 brugian filariasis, 5 endemic control subject in brugian filariasis endemic area and 10 other disease controls). The circulating antigen of W. bancrofti was measured quantitatively using Og(4)C(3) ELISA kit.In Mf carriers, there was no significant difference in microfilariae count in pre- and post-treatment (PT) samples till day 30 while significant differences were observed in pre- and sequentially collected post-treatment (PT) samples day 60 to 180 (P0.001), day 365 (P0.005). However, there was no significant difference in antigenaemia levels between pre-treatment (day 0) and PT samples collected on day 7 onwards till day 365. Though of the 19 patients who could be followed up till 365 days PT, 4 (21%) were amicrofilaraemic, none became antigen negative. No significant difference was found in antigenaemia levels in sequentially collected samples from lymphoedema patients. Significant differences were observed in antigenaemia levels in samples collected at the start of study in mf carriers as compared to lymphoedema patients and endemic normal subjects (P0.001). Subjects (non-endemic control) residing in filariasis free area (24), brugian endemic area (5), B.malayi infected patients (5) and patients with other parasitic diseases (10) were found antigen negative.Annual single dose of DEC therapy alone may not result in complete clearance of infection and detection of antigenaemia rather than microfilaraemia may be taken into consideration as an indicator of successful chemotherapy. The study supports the earlier view that filarial antigenaemia is relatively common in amicrofilaraemic and asymptomatic subjects in endemic areas and further studies are needed to determine the clinical significance, prognosis and effective management of such infections in endemic areas.

Success of totally extraperitoneal (TEP) inguinal herniorrhaphy depends upon strengthening of the weakened native tissue by inflammation resulting in mesh–aponeurosis scar tissue (MAST) complex formation. The inflammatory response attributable to polypropylene (PP) content of the mesh is linked to weight of PP and pore size of the mesh. Continuation of the inflammatory process beyond MAST complex formation can entrap contiguous structures, leading to adverse outcome such as groin pain. Reduction of PP content has been shown to be beneficial in animal studies. Paucity of randomized controlled trials (RCTs) on human beings has left choice of mesh to surgeon preference or cost. We carried out a double-blind RCT comparing heavy- and lightweight PP-based meshes in TEP. Consecutive, married, sexually active male candidates for bilateral TEP herniorrhaphy were enrolled without any exclusion, with ethical and informed consent protocol. Standard TEP technique was followed for day-care surgery. Heavy- and lightweight meshes were implanted in each patient, one in either groin after randomization. Surgeon and patient were blinded to side of groin and type of mesh. An independent doctor (AID) evaluated the patients for groin pain, discomfort, sexual dysfunction, and clinical recurrence. A nonmedical secretary/AID transferred prospective data for both sides of groin collected by AID to Microsoft Excel. Twenty-five bilateral TEPs implanting 25 heavy- and 25 lightweight PP meshes, one of each type in each patient, were performed from December 2005 to July 2007 without difficulty or complication. Lightweight PP mesh was associated with significantly better pain scores, patient comfort, and sexual function. There was no infection or recurrence with either type of mesh. Lightweight PP mesh is associated with significantly better outcomes in TEP inguinal herniorrhaphy as compared with heavyweight PP mesh.

Due to the devastating nature of acute retinal necrosis syndrome (ARNS), early diagnosis is essential. 5 cases of clinically diagnosed ARNA were investigated for CMC, herpes simplex and varicella zoster virus (VZV) infections. Of the three VZV IgM positive cases, two were positive in acute blood samples and one in vitreous fluid. Thus VZU can be incriminated as the causative agent of ARNS cases in North India.

Human toxocariasis owing to lodgement of the larvae of Toxocara canis in different organs can result in serious clinical syndromes such as visceral larva migrans or ocular larva migrans. Detection of an antibody response to Toxocara canis excretory-secretory (TES) antigen in serum samples is sensitive and specific for diagnosis and epidemiological surveys. To assess the extent of this problem in northern India, we tested the antibody response to the TES antigen by ELISA technique in subjects residing in a rural area near Chandigarh and in patients attending Nehru hospital, Chandigarh and clinically suspected to have toxocariasis.Serum samples were collected from 94 randomly selected subjects, residents of Kheri village, Ambala district, Haryana; 30 patients clinically suspected to have toxocariasis attending Nehru hospital, Chandigarh; 25 control patients and 15 normal healthy individuals. These were subjected to ELISA technique for detection of an antibody response to TES antigen usinga commercial kit (LMD Laboratories Inc. Ca. USA). All the samples were tested in duplicate and positive samples were tested by a different kit (Melotec Biotechnology, Spain).Of the 94 subjects residing in Kheri village and 30 clinically suspected toxocariasis patients, 6 (6.4%) and 7 (23.3%), respectively, were seropositive for anti-Toxocara antibody response. A history of pica and/or contact with puppies could not be obtained from all the subjects/patients, hence the exact mode of transmission could not be ascertained. However, 3 (3.2%), 2 (2.13%) and 1 (1.06%) seropositive subjects in Kheri village were in the age groups of 1-10, 11-20 and 21-30 years, respectively, while 4 (13.33%) and 3 (10%) seropositive patients who attended Nehru hospital, Chandigarh were in the age groups of 1-10 and 21-30 years, respectively. None of the control patients/healthy individuals were seropositive.A positive antibody response to TES antigen in 6.4% subjects residing in a rural area near Chandigarh and in 23.3% of patients clinically suspected to have toxocariasis indicates that human toxocariasis may be endemic in certain regions of northern India. A detailed epidemiological study is needed to determine the extent of this problem.

To evaluate the relative frequency of other conditions that share a clinical overlap with pneumonia as defined by the WHO case management algorithm and to determine the possibility of refining the antibiotic and bronchodilator prescription on the basis of simple clinical features.Prospective observational.Urban tertiary care center.Two hundred children, between the ages of 6 months to 5 years, presenting with difficult breathing (as defined by WHO algorithm) were prospectively evaluated for the diagnosis and the need for bronchodilator and antibiotic therapy (clinician s diagnosis). An additional independent blinded evaluation of the chest X-rays was done by a radiologist after the study (radiologist-aided diagnosis). On the basis of reliable predictors (sensitivity70% and specificity70%) of antibiotic and bronchodilator prescription, irrespective of the exact diagnostic category, two viable modifications of WHO case management algorithm emerged, which were compared by paired proportion test.Acute asthma was the predominant condition (46% or 54%), pneumonia alone was rare (10%), co-existence of pneumonia with wheeze (bronchospasm) was more frequent (22% or 15%) and often diagnoses not related to the respiratory system were documented (18% or 17%). All the subjects in whom a preceding history of cough was not elicited had non-respiratory illnesses. An audible wheeze was appreciated in only 44 of the 150 cases (29.3%) with an auscultable wheeze. The two alternatives represented a significant (p0.0001) improvement over the WHO algorithm preventing inappropriate usage of both antibiotics and bronchodilators, primarily by restricting over-prescription of the former (14% and 26.5% for proposed algorithms 1 and 2, respectively) and under-utilization of the latter (40%). The performance of the alternative algorithms for the radiologist-aided diagnosis was marginally better for over-prescription of antibiotics (16.2% and 30.9% for proposed algorithms 1 and 2, respectively).It is feasible to amalgamate simple clinical features (history of: (i) previous similar episode of cough and difficult breathing, and (ii) fever) in the WHO case management algorithm to significantly refine the antibiotic (95% CI range 7% to 33%) and bronchodilator (35%; 95% CI 27% to 43%) prescription.

To determine the viral agent involved in cases of acute encephalopathy in children during an outbreak in Northern India.Virological and serological studies using serum and cerebrospinal fluid specimens from patients.Serum and CSF specimens were tested by IgM ELISA for IgM antibodies to variety of viruses like Japanese encephalitis, West Nile, Dengue and Measles. The specimens were inoculated into Vero cell monolayer for virus isolation. The viral strains isolated were identified by indirect immunofluorescence test and qualitative in-vitro neutralization test using polyclonal and monoclonal antibodies to measles. Identity of the isolates was reconfirmed using RT-PCR method.Of the 28 specimens tested, 17 had IgM antibodies to measles. Commercial IgM ELISA kits confirmed the serological findings. Vero cell cultures yielded 4 isolates from CSF and 2 from serum specimens of six different patients. Cytopathic effect was typical of measles. Indirect imunofluorescence using polyclonal and monoclonal antibodies to measles HA protein, confirmed the measles etiology. Neutralization tests reconfirmed the measles strain isolation. RT-PCR amplified product was confirmed as measles.The isolation of measles virus from CSF and serum of children with acute encephalopathy without rash proved the etiological role of measles virus in this outbreak.

A total of 6418 samples were received between January 1993 to December 1998 from patients with hepatitis. Blood samples were also collected from 946 apparently healthy subjects. All these samples were tested for Hepatitis B surface antigen (HBsAg) by third generation micro ELISA. The overall HBsAg prevalence rate was 12.8%. The highest prevalence was noted in renal transplant patients (21.7%) followed by patients with acute hepatic disease (15.3%), pregnancy with jaundice (9.4%), chronic renal failure (8.8%), nephrotic syndrome (3.1%), whereas the prevalence rate in control group was 2.4%. The prevalence rate of HBsAg was higher in subjects between 21 to 30 years of age with a male preponderance (Male:Female = 2.8:1).

Cryptosporidium, an important cause of diarrhoea, has been reported worldwide both in immunocompetent and immunocompromised individuals and has emerged as a serious public health problem. This study was undertaken to assess the present status of cryptosporidiosis in children and adults with diarrhoea who attended the Nehru Hospital, Chandigarh which is a tertiary care hospital.Routine stool examination was done using saline and iodine stained preparations for various parasites. Modified Ziehl-Neelsen and rapid safranin-methylene blue techniques were used to detect Cryptosporidium in 2000 stool samples (1645 adults, 355 children) from March to November 1998.Of the 2000 samples, 205 (10.2%) were positive for various parasites. Five (1.4%) children were positive for Cryptosporidium and one child was positive for human immunodeficiency virus. In adults, Cryptosporidium was found in only one patient (0.06%). Giardia lamblia was the commonest parasite detected both in adults (4%) and children (15.2%).The present study highlights the importance of Cryptosporidium as a cause of diarrhoea, especially in children. Thus, there is a need for specific staining techniques to detect Cryptosporidium in routine diagnostic laboratories.

The present study was carried out to ascertain the seroprevalence rate in different geographical areas in Central and Western Regions in Nepal. A total of 1,237 serum samples collected from Nuwakot (217), Kathmandu valley (402) and Chitawan (159) districts in Central Region, and Mustang (143), Surkhet (64) and Banke (252) districts in Western Region in Nepal were included in this study. Toxoplasma antibodies were detected by micro-latex agglutination (MLA) and enzyme linked immunosorbent assay (IgM-ELISA) methods. The seropositive rate in Central and Western Regions were found to be 48% and 49%, respectively; with an overall positive rate of 48 percent. Districtwise, the seropositive rate in Nuwakot, Kathmandu valley, Chitawan, Mustang, Surkhet and Banke districts were 38, 46, 64, 51, 67 and 44%, respectively. Interestingly, the relatively newly inhabited Surkhet district in Western Region and Chitawan district in Central Region showed significantly higher seropositive rate compared with those of two other districts in the respective Regions (p0.05). Ethnically, Tibeto-Burmans showed higher seropositive rates in Central Region (p0.05). In contrast, Indo-Aryans showed higher seropositive rate in Western Region (p0.05). Age related increase in seropositivity was observed only in Central Region. One percent of Toxoplasma antibody positive samples also showed Toxoplasma IgM antibody positivity.

Giardia lamblia infection has been shown to modify the glycosylation process of microvillus membranes in mice intestine. Sialic acid content of the membranes was enhanced 3-fold but there was no change in fucose content of infected animals compared to the controls. The binding of 125I-wheat germ agglutinin was augmented and that of Ulex Europeus agglutinin was unaltered to infected membranes. The binding of 125I-peanut agglutinin to brush borders was however, significantly reduced in Giardia infected mice. Kinetic analysis revealed that the observed binding of peanut agglutinin to the membrane was associated with reduced number of the lectin reactive sites (control = 649 and infected 380 nmole/protein) with no change in the affinity constant (Ka = 95.7 nmole/ml) in Giardia infected mice intestine.

The effect of nifedipine (a calcium channel blocker) on the course of P. berghei infection was examined. It was observed that mice receiving a daily dose of 0.015 mg/kg of nifedipine had significantly shorter prepatent, patent and survival periods as compared to untreated P. berghei-infected animals (p0.001). This shows that the calcium channel blockers, in addition to possessing the property of reversing drug resistance during combined therapy with chloroquine, may also alter the pathophysiology of malaria infection. The decreased resistance of the host to the invading parasite suggests that the effect of CCB on the host-parasite interaction in human malaria needs to be investigated further before CCB can be used in combination with chloroquine for the treatment of chloroquine-resistant malaria or for chemoprophylaxis.

The role of antigens of Brugia malayi adult worms in induction of histamine release from mast cells was studied. Both peritoneal and lung mast cells were passively sensitized using immune serum collected from Mastomys natelensis on different days after infection with B. malayi. A significant release of histamine both with crude worm and 60-kD antigens was shown. However, the role of the 43-kD antigen in histamine release was comparable to that of control. When the sera were heat inactivated, the histamine release was minimal, thus indicating the heat-labile nature of the antibodies. Furthermore, the responses of peritoneal and lung mast cells to filarial antigens were similar.

When stool samples from 970 subjects belonging to lower socio-economic groups were examined for parasites, a total of 121 subjects (12.5%) i.e., 57 (12.1%) males and 64 (12.9%) females showed positive results. The overall prevalence of parasitic infestation did not correlate with sex, caste or religion and living conditions. However, the prevalence was higher in hospital employees residing in well sanitated area. Giardia lamblia (69.5%), Entamoeba, histolytica (15.7%), Hymenolepis nana (12.4%), Ancylostoma duodenale (10.7%), Ascaris lumbricoides (8.3%) and Taenia (0.8%) were the parasites seen. Mixed infections were seen in 9 subjects. Twenty families of the 196 studied had more than one family member positive for parasites. Asymptomatic positivity was high amongst all groups of subjects, and with all parasites.

Sodium stibogluconate, did not bring about significant increase in the production of IL-1, when both specific leishmanial antigen, or non specific Staphylococcus epidermidis was used as stimulus in normal uninfected animals. However, Staph. epidermidis was found to be a better stimulus as it brought about a significant increase (P less than 0.001) in IL-1 production when compared with leishmania antigen. In BALB/c mice infected with L. donovani there was a significant reduction (P less than 0.001) in IL-1 levels on various post infection days irrespective whether Staph. epidermidis or leishmanial antigen was used as stimulus when compared with controls. IL-1 levels were significantly increased (P less than 0.05) when L. donovani infected animals were treated with SSG, after 14 days post infection, irrespective of the stimuli used.

The capacity of Kupffer cells and blood monocytes to release free oxygen radicals was studied by chemiluminescence (CL) response during hepatic amebiasis in guinea pigs. Guinea pigs infected with Entamoeba histolytica intramesenterically were sacrificed on days 0, 2, 5 and 8 post-infection. Hepatic lesions were graded I-IV. A significant increase in the CL response was observed from day 2 post-infection and it increased with the progress of infection. Maximum increase was observed on the 8th post infection day. Animals with grade III or IV hepatic lesions had significantly elevated CL response. The degree of hepatic lesions correlated well with the CL response (P less than 0.01). It is postulated that tissue damage during hepatic amoebiasis may be mediated through enhanced release of free oxygen radicals by Kupffer cells and blood monocyte.

A serological and cultural investigation on the occurrence of T. gondii amongst slaughter pigs in north India has been carried out. Toxoplasma antibodies were found in the sera of 31.5% of the 178 pigs examined by the indirect haemagglutination test. Seropositivity at titres of 1:128 or more was shown by 11.8% of the animals. Isolation by mouse passage was successful in one out of the 26 tissue samples from 17 pigs. This is the first isolation of T. gondii from pigs in this country.

Preschool children of two villages of Kharar Taluka, Ropar district, Punjab (India) were screened for the prevalence of giardiasis. Cysts of Giardia lamblia were found in 35.1% of the stool samples and other parasites were rarely seen. The incidence of diarrhoea in association with G. lamblia positivity was 16.5% in subjects whose stool examination was positive on one or more than one occasion. No difference in the incidence of giardiasis could be seen in well nourished and undernourished children living in these endemic areas.

A sensitive and specific spectrophotometric method for primaquine estimation has been developed and used to study the plasma kinetics of primaquine in Rhesus monkeys. It was observed that the drug completely disappeared from the plasma in 24 hours after a single oral dose. Its concentration in the plasma reached a peak at 2 hours of administration. The mean absorption and elimination half-lives were 0.36 +/- 0.08 and 3.44 +/- 0.37 hours respectively.