Search

Background: Affective states are important aspects of healthy functioning; as such, monitoring and understanding affect is necessary for the assessment and treatment of mood-based disorders. Recent advancements in wearable technologies have increased the use of such tools in detecting and accurately estimating mental states (eg, affect, mood, and stress), offering comprehensive and continuous monitoring of individuals over time., Objective: Previous attempts to model an individual's mental state relied on subjective measurements or the inclusion of only a few objective monitoring modalities (eg, smartphones). This study aims to investigate the capacity of monitoring affect using fully objective measurements. We conducted a comparatively long-term (12-month) study with a holistic sampling of participants' moods, including 20 affective states., Methods: Longitudinal physiological data (eg, sleep and heart rate), as well as daily assessments of affect, were collected using 3 modalities (ie, smartphone, watch, and ring) from 20 college students over a year. We examined the difference between the distributions of data collected from each modality along with the differences between their rates of missingness. Out of the 20 participants, 7 provided us with 200 or more days' worth of data, and we used this for our predictive modeling setup. Distributions of positive affect (PA) and negative affect (NA) among the 7 selected participants were observed. For predictive modeling, we assessed the performance of different machine learning models, including random forests (RFs), support vector machines (SVMs), multilayer perceptron (MLP), and K-nearest neighbor (KNN). We also investigated the capability of each modality in predicting mood and the most important features of PA and NA RF models., Results: RF was the best-performing model in our analysis and performed mood and stress (nervousness) prediction with ~81% and ~72% accuracy, respectively. PA models resulted in better performance compared to NA. The order of the most important modalities in predicting PA and NA was the smart ring, phone, and watch, respectively. SHAP (Shapley Additive Explanations) analysis showed that sleep and activity-related features were the most impactful in predicting PA and NA., Conclusions: Generic machine learning-based affect prediction models, trained with population data, outperform existing methods, which use the individual's historical information. Our findings indicated that our mood prediction method outperformed the existing methods. Additionally, we found that sleep and activity level were the most important features for predicting next-day PA and NA, respectively., (©Salar Jafarlou, Jocelyn Lai, Iman Azimi, Zahra Mousavi, Sina Labbaf, Ramesh C Jain, Nikil Dutt, Jessica L Borelli, Amir Rahmani. Originally published in JMIR Formative Research (https://formative.jmir.org), 15.03.2023.)

Background: Sleep disturbance is a transdiagnostic risk factor that is so prevalent among young adults that it is considered a public health epidemic, which has been exacerbated by the COVID-19 pandemic. Sleep may contribute to mental health via affect dynamics. Prior literature on the contribution of sleep to affect is largely based on correlational studies or experiments that do not generalize to the daily lives of young adults. Furthermore, the literature examining the associations between sleep variability and affect dynamics remains scant., Objective: In an ecologically valid context, using an intensive longitudinal design, we aimed to assess the daily and long-term associations between sleep patterns and affect dynamics among young adults during the COVID-19 pandemic., Methods: College student participants (N=20; female: 13/20, 65%) wore an Oura ring (Ōura Health Ltd) continuously for 3 months to measure sleep patterns, such as average and variability in total sleep time (TST), wake after sleep onset (WASO), sleep efficiency, and sleep onset latency (SOL), resulting in 1173 unique observations. We administered a daily ecological momentary assessment by using a mobile health app to evaluate positive affect (PA), negative affect (NA), and COVID-19 worry once per day., Results: Participants with a higher sleep onset latency (b=-1.09, SE 0.36; P=.006) and TST (b=-0.15, SE 0.05; P=.008) on the prior day had lower PA on the next day. Further, higher average TST across the 3-month period predicted lower average PA (b=-0.36, SE 0.12; P=.009). TST variability predicted higher affect variability across all affect domains. Specifically, higher variability in TST was associated higher PA variability (b=0.09, SE 0.03; P=.007), higher negative affect variability (b=0.12, SE 0.05; P=.03), and higher COVID-19 worry variability (b=0.16, SE 0.07; P=.04)., Conclusions: Fluctuating sleep patterns are associated with affect dynamics at the daily and long-term scales. Low PA and affect variability may be potential pathways through which sleep has implications for mental health., (©Zahra Avah Mousavi, Jocelyn Lai, Katharine Simon, Alexander P Rivera, Asal Yunusova, Sirui Hu, Sina Labbaf, Salar Jafarlou, Nikil D Dutt, Ramesh C Jain, Amir M Rahmani, Jessica L Borelli. Originally published in JMIR Formative Research (https://formative.jmir.org), 05.08.2022.)

A greenhouse research was conducted to monitor lead (Pb) translocation dynamics in spinach (Spinacia oleracea L.) mediated by nickel (Ni) application. Each of the four levels of Pb (0, 100, 150, and 300 mg/kg) and Ni (0, 100, 150, and 300 mg/kg) was applied in different combinations in the pot experiment. A fully matured spinach crop was harvested and divided into biomass samples from the roots and above ground. ICP-OES was used to determine the concentrations of Pb and Ni in the samples. The increase in Pb application rate in soil resulted in a decrease in dry matter yield of plant roots and above-ground biomass, according to the findings. Pb accumulation was also found in significant amounts in roots and above-ground biomass. Pb was accumulated in greater quantities in the spinach roots than in the above-ground biomass. Pb uptake in spinach roots and above-ground biomass decreased when high dose of Ni was applied. The Ni application in spinach crop had a negative impact on various parameters of Pb uptake, including translocation factor, bioconcentration factor, translocation efficiency, and crop removal of Pb. Pb toxicity was reduced when higher doses of Ni (100 to 300 mg/kg) were applied to Pb-contaminated soil. The findings of this study could help researchers better understand how Pb and Ni interact, as well as how to treat soil that has been contaminated by industrial wastewater containing nickel and lead., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Individuals can experience different manifestations of the same psychological disorder. This underscores the need for a personalized model approach in the study of psychopathology. Emerging adulthood is a developmental phase wherein individuals are especially vulnerable to psychopathology. Given their exposure to repeated stressors and disruptions in routine, the emerging adult population is worthy of investigation., Objective: In our prospective study, we aim to conduct multimodal assessments to determine the feasibility of an individualized approach for understanding the contextual factors of changes in daily affect, sleep, physiology, and activity. In other words, we aim to use event mining to predict changes in mental health., Methods: We expect to have a final sample size of 20 participants. Recruited participants will be monitored for a period of time (ie, between 3 and 12 months). Participants will download the Personicle app on their smartphone to track their activities (eg, home events and cycling). They will also be given wearable sensor devices (ie, devices that monitor sleep, physiology, and physical activity), which are to be worn continuously. Participants will be asked to report on their daily moods and provide open-ended text responses on a weekly basis. Participants will be given a battery of questionnaires every 3 months., Results: Our study has been approved by an institutional review board. The study is currently in the data collection phase. Due to the COVID-19 pandemic, the study was adjusted to allow for remote data collection and COVID-19-related stress assessments., Conclusions: Our study will help advance research on individualized approaches to understanding health and well-being through multimodal systems. Our study will also demonstrate the benefit of using individualized approaches to study interrelations among stress, social relationships, technology, and mental health., International Registered Report Identifier (irrid): DERR1-10.2196/25775., (©Asal Yunusova, Jocelyn Lai, Alexander P Rivera, Sirui Hu, Sina Labbaf, Amir M Rahmani, Nikil Dutt, Ramesh C Jain, Jessica L Borelli. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.03.2021.)

The Revised National Tuberculosis Control Programme (RNTCP), which incorporated the WHO DOTS strategy was introduced in India in the mid-1990s. An operational research project was conducted between 1996 and 1998 to assess the needs and perspectives of patients and providers in two chest clinics in Delhi, Moti Nagar and Nehru Nagar, during the introduction of the new strategy. This paper reports on the findings of the project, concentrating on information collected from 40 in-depth interviews with patient defaulters and from non-participant observations in clinics and directly observed treatment centres. In Moti Nagar chest clinic, 117 of 1786 (6.5%) patients and 195 of 1890 (10%) patients in Nehru Nagar left care before their treatment was complete. It was argued that the reasons for default stem from a poor correlation between patient and programme needs and priorities, and from particular characteristics of the disease and its treatment. Patient needs that were not met by the health system included convenient clinic timings, arrangements for the provision for treatment in the event of a family emergency and provision for complicated cases like alcoholics. The problems facing the provider were poor interpersonal communication with the health staff, lack of attention and support at the clinic, difficulty for patients to re-enter the system if they missed treatment and, in certain areas, long distances to the clinic. Problems related to diseases were inability of the staff to deal with drug side-effects, and patients' conception of equating well-being with cure. Simple, practical measures could improve the provision of tuberculosis (TB) treatment: more flexible hours, allowances for poor patients to reach the clinics and training health care staff for respectful communication and monitoring drug side-effects. The findings indicate a need to rethink the label of 'defaulter' often given to the patients. The important areas for future operational research is also highlighted.

The Revised National Tuberculosis Control Programme (RNTCP), based on the World Health Organization's DOTS strategy,* was introduced in India in the mid-1990s. This paper reports the findings from operational research studies in two pilot sites in New Delhi from 1996 to 1998. A variety of operational research methods were used, including semi-structured interviews, focus group discussions, non-participant observations and collection of data from the tuberculosis registers. The cure rates for the clinics were 71 and 75% with a default rate of 6 and 11%, respectively. An important finding was that health workers screened patients to determine their ability to conform to the direct observation of treatment element of the RNTCP. If the health worker was confident that the patient would comply and/or be easy to trace in the community in the event of 'default', they were provided with short-course treatment under the RNTCP. Other patients, largely those who were in absolute poverty, socially marginalized, itinerant labourers, poorly integrated in the city, were put on standard tuberculosis (TB) treatment as for the previous National TB Programme. The programme was evidently excluding the most vulnerable from the best available care. These findings demonstrate the potential dangers of target-driven programmes where there is an absence of support to both frontline health workers and patients. The paper also highlights the importance of operations research in helping to identify problems within TB programmes.

In continuation of their studies on Biodegradation of cellulosic waste materials, the authors have presented their experimental data on biodegradation on waste paper pulp. Greater efficiency in the cow dung and M3 culture experimental setups have been pointed out and discussed. Necessity of detailed data evaluation of temperature, pH, dry weight, cellulose, protein, carbohydrate, Nitrate, Phosphate & Potassium levels is suggested. Derivation of %, absolute and increase/decrease % of BOO, COD and VS have been pointed out for the first time in solid waste Biodegradation. Further data evaluation and derivation of critical reaction rate kinetics have been recommended for further studies in solid waste-degradation to achieve quicker Bioconversion of cellulosic wastes into compost.

Cold reactive lymphocytotoxic antibodies (LCA) are more reactive in cold than at 37 degrees C and occur following infection, immunization or vaccination and in various autoimmune diseases. In the present study, LCA activity against T and B-lymphocytes has been investigated in patients with pulmonary tuberculosis (PTB), their various clinical sub-groups and consanguineous relatives. Further, the relevance of HLA factors in LCA activity was analyzed. The sera from 144 PTB patients, 52 family contacts and 52 healthy individuals were tested for presence of LCAs by a modified two-stage NIH microlymphocytotoxicity assay. A significant increase in LCA activity against both T (32.6% vs 5.7%, P < 0.0001) and B (59.7% vs 13.4%, P < 0.0000001) cells was observed in PTB patients as compared to healthy controls. There was no correlation between serum LCA activity and sputum acid-fast bacilli status. However, only B cell LCAs revealed significant increase in parallel to disease advancement as assessed by X-ray chest examination. Further, LCA activity was more pronounced in drug responders than drug failure group of patients. No significant difference in the distribution of HLA class I and class II antigens was observed between LCA positive and LCA negative patients. However, panel cells carrying HLA-A1, -A11 and -DR3 were often found reactive in LCA positive patient sera. In household family contacts, LCAs were significantly increased only against B cells as compared to healthy controls (38.4% vs 13.4%, P < 0.01). This study suggests that Mycobacterium tuberculosis infection/exposure could account for the occurrence of LCAs in pulmonary tuberculosis and the strength of these antibodies is related to disease severity and the extent of lung involvement.

Lack of awareness of risk posed to the community by a sputum positive case of Pulmonary Tuberculosis (PTB) is an impediment in the control of Tuberculosis. A study involving 212 newly diagnosed sputum positive patients aged 15 years or more, revealed that only 9% of the patients knew correctly the cause of PTB. Knowledge about mode of spread of the disease was not known to 49% of patients. Awareness regarding the investigations like chest X-ray and sputum examination was high as 70% but utility of sputum examination was known to only 29% of the patients. Awareness of harmful sequelae of inadequate and incomplete treatment was as high as 93% but knowledge per se of adequate duration of treatment was poor in a half (50%) of the subjects. Attitude towards domiciliary treatment was generally positive (88%) Practices regarding safe sputum disposal and preventive measures practised in the families were poor in nearly two third's of patients. Health education efforts need to be strengthened to create better awareness of these important aspects of tuberculosis diagnosis, treatment and control.

Setting: A tuberculosis institute and a general hospital in Delhi, India., Objective: To investigate the awareness of nurses about tuberculosis and to evaluate the differences in awareness, if any, between nurses working in tuberculosis and those in a general hospital., Design: A pretested questionnaire survey was performed on 213 nurses., Results: The present study showed that a substantial number of nurses have inadequate knowledge regarding causative factors, the importance of sputum examination, correct doses of routinely used short-course chemotherapy drugs, the minimum duration of short-course chemotherapy, instructions at discharge, and health education for patients and family members. If responding correctly to 75% of the questions asked is taken as the criterion for satisfactory awareness, only 40.2% of tuberculosis nurses and 10.7% of general hospital nurses had a satisfactory level of awareness. There was no effect of increasing age or years of experience on the level of awareness., Conclusions: There is a general lack of knowledge regarding various aspects of tuberculosis among nurses. Active interventions are required to improve awareness for a better implementation of the revised national tuberculosis control programme in India.

Setting: Random survey of knowledge, attitudes and practices (KAP) for tuberculosis among private practitioners (PPs) in Delhi, India, in 1995., Objective: To investigate the KAP of private practitioners for tuberculosis in Delhi where the Revised National Tuberculosis Programme (RNTP) is being field tested., Design: A pre-tested questionnaire survey was performed among 204 doctors attending updates/seminars on tuberculosis in various parts of Delhi., Results: In a suspected case of tuberculosis, sputum examination was advised by only 12% of the PPs, while 89.5% would recommend chest X-ray. For treating tuberculosis 187 PPs were using 102 different regimens, and only 29.4% PPs were using the regimen recommended by the RNTP; 51.3% PPs were over-treating their patients. Only 23.5% of PPs requested sputum examination before the end of treatment, while 35.5% depended on X-ray clearance with clinical improvement. Only 19.5% of PPs emphasized the importance of regular treatment for their patients., Conclusion: Among PPs there is marked reliance on X-ray; sputum examination is being neglected for initial diagnosis, treatment monitoring and as a criterion for stopping treatment. The majority of PPs are not aware of, or are not prescribing, the treatment regimen recommended by the RNTP, and the majority of patients are being over-treated. There is a lack of emphasis on proper health education. PPs need more training, and more collaborative efforts are required between public health facilities and practising doctors for national control of tuberculosis.

The resistance of majority ofM. tuberculosis strains to rifampicin a key drug in the tuberculosis therapy, has been cause of major alarm world-wide. Such an association of strain with the drug takes a long time i.e. 2-3 months. We have modified a method for rapid detection of rifampicin resistant strains by screening them through PCR-SSCP.We have identified mutations in rpo, β region of the gene encoding, β sub-unit of RNA polymerase in rifampicin resistant 67 clinical isolates ofM. tuberculosis. Mutations were screened in these isolates by single strand confirmation polymorphism (SSCP). When DNA sequencing data was compared with the result of SSCP analysis, direct PCR sequencing results were more easily interpreted and contatined more sequence dependent information. These findings provide the basis for rapid detection of rifampicin esistance, a marker of multidrug resistance.

HLA class I antigen profile was studied in 153 unrelated patients with pulmonary tuberculosis (PTB), 40 family contacts and 289 healthy individuals by the NIH microlymphocytotoxicity test to find out the role of HLA-A, -B, -C alleles in influencing susceptibility to PTB and its various clinical groups. HLA-A2 was found to be significantly increased in the total patient group as compared to controls (38.6% vs 26.3%, p < 0.01, RR = 1.76). The increase of HLA-A2 was more pronounced in the sputum negative patients (59.4%, pc < 0.001, RR = 4.1) suggesting its possible role in the mediation of CD8+ suppressor T cell activity against Mycobacterium tuberculosis, resulting in the development of limited disease in these patients. Further, HLA-B18 was found to be decreased in patients as compared to controls (2.6% vs 7.3%, p < 0.05, RR = 0.34). None of the class I antigens was associated with the dynamics of chemotherapy or disease severity as assessed by the extent of lung involvement on chest X-ray examination.

Setting: Anti-Ig antibodies are known to have important clinical and biological implications., Objectives: To determine naturally occurring anti-F(ab')2 gamma and anti-Fc gamma antibodies in patients with pulmonary tuberculosis (PTB) in relation to various clinical manifestations and human leukocyte antigen (HLA)., Design: Antibodies to F(ab')2 and Fc portions of IgG were detected in the sera of normal healthy individuals (n = 41), patients with pulmonary tuberculosis (n = 50) and their household family contacts (n = 20) using an enzyme immuno assay (EIA) system., Results: As compared to controls (0.110 +/- 0.01 optical density [OD]), the levels of anti-F(ab')2 gamma were significantly increased in PTB patients (0.998 +/- 0.08 OD, P < 0.0001) and in their contacts (0.486 +/- 0.04 OD, P < 0.001) suggesting that the occurrence of these autoantibodies is related to infection/exposure to Mycobacterium tuberculosis. Anti-F(ab')2 gamma antibodies were significantly increased in both sputum positive and negative patients (P < 0.0001) and no deviation was observed between these two groups. The levels of these antibodies were positively correlated with disease severity assessed by chest X-ray. The drug failure patients had higher activity of anti-F(ab')2 gamma than drug responders and no impact of anti-tuberculosis chemotherapy was observed. A statistically significant increase of anti-F(ab')2 gamma levels (1.25 +/- 0.21 OD) was observed in HLA-DR2 positive patients as compared to the DR2 negative groups (1.02 +/- 0.09 OD), P < 0.01. No deviation was observed in the levels of anti-Fc gamma levels between controls and any group of PTB patients., Conclusion: The present data suggests that the elevated levels of anti-F(ab')2 gamma antibodies in PTB patients represent an anti-idiotypic antibody response to anti-M. tuberculosis antibody caused by an immune imbalance following M. tuberculosis infection.

Setting: The analysis of serum levels of soluble interleukin-2 receptor alpha (sIL-2R-alpha) is an indirect method of studying the in vivo state of immune activation, particularly in patients with pulmonary tuberculosis (PTB) where the disease is associated with cellular immune reactions., Objective: To quantitate the serum sIL-2R-alpha in patients and correlate with disease activity., Design: The levels of sIL-2R-alpha were determined using ELISA in serum samples from untreated patients with PTB (n = 107), 30 of whom were later tested during treatment, household family contacts (n = 38), and healthy controls (n = 22)., Results: Concentrations of sIL-2R-alpha were significantly higher in PTB patients than in controls (2845 +/- 187 vs 1217 +/- 80 pg/mL, P < 0.0001), and were even more pronounced in the sputum positive (3200 +/- 148 pg/mL) and treatment failure (3335 +/- 196 pg/mL) groups of patients. However, in household family contacts, the sIL-2R-alpha levels were found to be similar to those of healthy controls. The sIL-2R-alpha levels correlated positively with disease activity as assessed by roentgenographic findings. In six of the 16 responder patients, the sIL-2R-alpha levels fell from 3228 +/- 144 pg/mL to 1497 +/- 131 pg/mL (P < 0.0001) after 3 months of successful treatment with anti-tuberculosis drugs. However, no significant change was observed in the treatment failure patients even after one year of chemotherapy with second-line drugs., Conclusion: These studies indicate that determination of serum concentrations of sIL-2R-alpha is a sensitive and specific method for monitoring disease activity in terms of T cell activation in pulmonary tuberculosis.

HLA antigens were studied by serology and polymerase chain reaction-based sequence-specific oligonucleotide hybridization techniques in 153 patients with pulmonary tuberculosis (PTB) and 289 healthy controls. HLA-DR2 was present more frequently in PTB patients than in controls (51% vs. 36.3%; corrected P[Pc]=.029, relative risk [RR] = 1.8). The DR2 association was stronger in patients in the drug-failure group (n=56; Pc=.000012, RR=3.7) than in healthy controls and in patients in the drug-responder group. No significant deviation was observed in HLA allelic frequencies in various patient groups, as determined by radiographs of lung lesions. Molecular subtyping of DR2 revealed that the bulk of the allele was DRB1*1501 and DRB1*1502 in patients and controls. There was no skewing of the frequency of these molecular subtypes of DR2 in patients, suggesting that the whole DR2 molecule or its closely linked gene(s) may be involved in governing patient susceptibility to PTB and, particularly, development of the severe drug-resistant form of the disease.

An autochthonous case of epididymal histoplasmosis masquerading as tuberculosis in a 55-year-old male patient is reported from India. It was diagnosed by culture of Histoplasma capsulatum from semen and by demonstration of the fungus upon re-examination of epididymal biopsy sections previously misinterpreted as tuberculous granuloma. The patient's main complaints were painful epididymal swelling, occasional fever and cough. He was treated successfully by excision of epididymis and vas deferens combined with amphotericin B therapy. This is believed to be the first case of epididymal histoplasmosis to be reported outside the American continent and the fourth of its type reported in the English literature. The case is also noteworthy in that H. capsulatum was isolated for the first time from semen, and it underlines the importance of mycological culture of semen specimens for diagnosis of genitourinary infections of obscure etiology.

A total of 130 Vibrio cholerae strains isolated during November 1989 to December 1992 from the rural population of Loni areas--Ahmednagar district of Maharashtra were characterised. Of these isolates, 124 were El tor vibrios serotype Ogawa, and 6 were El tor vibrios serotype Inaba. One hundred twenty two strains belonging to T4 phage, while 8 strains of El tor vibrio serotype Ogawa were untypable. All the strains isolated, showing haemolytic and non-haemolytic colony variants of El tor V. cholerae, and had resistance of one or more antibiotics. Maximum incidence was observed in November-December, the illness had a mild onset and no fatality was reported.

The backpropagation (BP) algorithm allows multilayer feedforward neural networks to learn input-output mappings from training samples. Due to the nonlinear modeling power of such networks, the learned mapping may interpolate all the training points. When erroneous training data are employed, the learned mapping can oscillate badly between data points. In this paper we derive a robust BP learning algorithm that is resistant to the noise effects and is capable of rejecting gross errors during the approximation process. The spirit of this algorithm comes from the pioneering work in robust statistics by Huber and Hampel. Our work is different from that of M-estimators in two aspects: 1) the shape of the objective function changes with the iteration time; and 2) the parametric form of the functional approximator is a nonlinear cascade of affine transformations. In contrast to the conventional BP algorithm, three advantages of the robust BP algorithm are: 1) it approximates an underlying mapping rather than interpolating training samples; 2) it is robust against gross errors; and 3) its rate of convergence is improved since the influence of incorrect samples is gracefully suppressed.

Nine thousand four hundred thirty three pyrexial cases were screened for the evidence of Malaria and Glucose-6-phosphate dehydrogenase deficiency among the rural tribal population of seven primary health centres in the malarial endemic areas of Udaipur District in Southern Rajasthan. One thousand four hundred five (P. Falciparum 831 and P. Vivax 574) cases were positive for malaria and 170 for G-6PD deficiency. Incidence of G-6PD deficiency in malaria, when compared to the non-malarial cases revealed statistically insignificant alterations (X2 is calculated to 0.1299 which for 1 degree of freedom gives P > 0.05).

Three hundred and fifty three subjects among the rural population of Loni area admitted in the hospital, and 188 medical staff members working in the Rural Medical College and Hospital, Loni, were screened for the presence of HBsAg. Reveresed passive haemagglutination assay was used for screening; it showed an HBsAg positivity rate of 21.8% and 15.8% among hepatitis and non hepatitis cases respectively, and 1.2%, 0% and 4.2% among medical students, doctors and nursing staff respectively. A high HBsAg positivity rate has been observed in the rural population of Loni area.

The alterations in serum/plasma levels of total haemolytic complement activity (CH50), complement components C3 and C3d, and circulating immune complexes (CICs) in patients with pulmonary tuberculosis were analysed in relation to the severity of disease and treatment status. The mean levels of CH50, C3, C3d and CICs were significantly higher in untreated than treated patients and in normal controls. In the untreated group, the level of each of these four parameters except C3d was significantly higher in patients with far advanced disease than in those with moderately advanced disease, whereas the difference between treated patients and normal controls was not statistically significant for any of the four parameters tested. There were statistically significant correlations between levels of CICs and both C3 and C3d in the untreated tuberculosis patients. However, the correlations for the same parameters were not significant when treated patients were considered. The CH50 levels in tuberculosis patients suggest a functional classical complement pathway, which is essential for immune complex solubilisation. High C3d level in untreated patients is indicative of increased complement activation, which in turn shows significant correlation with levels of CICs. It appears that the intact and elevated complement proteins and their proper activation by CICs prevents tuberculosis from becoming a typical immune complex disease.

Electrophoretic study of haemolysates from five hundred and forty-five subjects from the University of Garyounis, Benghazi, was carried out to find out the incidence of abnormal haemoglobins in Libya. Abnormal haemoglobins were encountered in 23 subjects of unrelated families, giving an overall incidence of 4.2 per cent. Sixteen of these subjects had Hb-AS trait (3.0%), Five subjects had Hb-AC trait (0.9%) and two subjects had Hb-AD trait (0.36%). Present study indicates that the incidence of abnormal haemoglobins in the indigenous population of Libya is low.

Addition of cholesterol in the diet of male albino rabbits produced hypercholesterolaemia, increased tissue cholesterol, and atheromatous changes in the aorta. Supplementation of garlic oil along with cholesterol significantly inhibited the hypercholesterolaemia, decreased tissue cholesterol and minimised the atheromatous changes in the aorta. These results show that the active constituent(s) in garlic responsible for its anti-atherogenic action is present in the oily fraction of garlic.