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Biomedical subjects

M V Narasimham

Publications and source records attributed to M V Narasimham.

At least 37 records · Page 2Linked to original sources

Residues of DDT and its metabolite in blood of exposed factory workers and their correlation with ill health symptoms.

The residue levels of DDE, op1--DDT and pp1--DDT of the factory workers exposed to DDT formulations having temporary clinical symptoms and of those without any such symptoms did not show any significant difference in their values suggestive of no direct correlation between insecticide residues and ill health symptoms. The average residue values of DDT (mg/litre) and its metabolite DDE (mg/litre) in exposed workers were 0.8634 +/- 0.1529 and 0.2106 +/- 0.0458 respectively while in unexposed control subjects 0.0826 +/- 0.0238 and 0.0278 +/- 0.0040. Total DDT residue in blood in exposed workers is more than 10 times higher than the same in unexposed control.

Adult↗

Efficacy of a low dose oral quinine therapy in Plasmodium falciparum cases of Assam, Meghalaya and Arunachal Pradesh in India.

A low dose oral quinine schedule with 1050 mg in two divided doses daily for five days was tried for treatment of Plasmodium falciparum cases in Assam, Meghalaya and Arunachal Pradesh, in areas where resistance to chloroquine was confirmed. The drug schedule was found effective in 76.92 per cent cases. The treatment was also found effective in 45.55 per cent of the known chloroquine resistant P. falciparum cases. The drug in this low dose was well tolerated and clinical response was quick.

Administration, Oral↗

Blood Cholinesterase monitoring in spraymen involved in malathion spraying--a health protection measure.

The blood Cholinesterase (ChE) level of malathion in spraymen is continuously monitored through a "built-in warning system" existing under NMEP since the introduction of malathion spraying. The data available from the States of Maharashtra, Punjab and Gujarat revealed that, in spraymen of Punjab, the ChE level in 1988 and 1989 remained normal in about 99.8 per cent spray personnel, and in 1 out of 381 workers, the ChE level fell to 62.5 per cent during 1989. In Gujarat and Maharashtra, the normal level of ChE was maintained in nearly 88 and 98.4 per cent of spray personnel respectively during the spraying period. The ChE level fell to 62.5 per cent in 11.9 per cent of spray staff in Gujarat during 1987 and in 1.5 and 1.6 per cent persons during 1988 and 1989 respectively in Maharashtra. Only in three cases (0.07 per cent) out of 4,100 in Maharashtra showed depression in ChE to 50 per cent in 1988. In none of the above mentioned cases, there was any parasympathetic overstimulation or uneasiness, etc, even then they were withdrawn from spray and were given rest and where needed medical care.

Administration, Inhalation↗

An in vivo chloroquine sensitivity study in relation to low transmission potential and imported malaria in Kerala.

The study highlights the presence of chloroquine resistant Plasmodium falciparum strains in Kerala state, India for the first time. The emergence of chloroquine resistant P. falciparum in a low transmission area is dependent on the imported cases while build up of resistance is mainly due to persistence of resistant parasites which have more opportunities for transmission.

Animals↗

Changing response of Plasmodium falciparum to chloroquine in West Bengal during 1980-1988.

A total of 314 cases of Plasmodium falciparum malaria studied during 1980-88 in nine times monitoring revealed three RIII foci i.e. two in Jalpaiguri and one in Purulia districts. The studies showed a parasite clearance of 40 per cent and 32 per cent of P. falciparum cases within seventh day in Purulia and Jalpaiguri districts respectively, with a dosage of 25 mg per kg body weight, spread over three days in divided doses. Increase in transmission potential and prolonged drug pressure with single drug have been noted in association with development of resistance. Malaria parasite clearance time (MPCT) value of sensitive and resistant cases reach parallelism and malaria parasite recrudescence time (MPRT) value starts declining, giving an indication of stabilisation of genetic change in the parasite.

Animals↗

Vector control through environmental management with special reference to India--approach prospectives.

The introduction of different types of pollutants like those from industrial effluence, bye-products from petro-chemical industries, pesticidal application, wastages of nuclear power industries, etc. is viewed seriously by the society. For the control of vectors of disease the adoption of environmental management is, therefore, imperative. The physical methods like drainage of excess and waste water, making water unsuitable for vector breeding by adopting various indigenous methods in vogue, the intra and inter-sectrol coordination and community based activities are identified as the basic approaches for achieving this goal. Minimising the potentiality of vector breeding through source reduction and water management is thought to be the simplest, cheapest and most permanent method. For the society having varying types of habitation and varying degree of habitational facilities like planned housing, water supply and disposal, sanitation and organized anti-vector measures, the adoption of environmental management to exercise check over vector population is a promising proposition. The suitability of such an approach has already been demonstrated by MRC, (ICMR), Delhi and V.C.R.C., Pondicherry. The implementation of these methods is to be initiated right from Primary Health Centre and district level onwards and community is to be motivated to the extent that the various methods of environmental management for vector control are adopted in the routine way of life. In the present article these ideas have been touched upon and various methods of environmental management described in brief. In addition what other Governmental agencies are required to do in order to effectively implement environmental management methods are briefly enlisted.

Communicable Disease Control↗

Plasmodium falciparum--chloroquine in vivo test in northeast India: reclassification and extended follow-up till day 14.

In vivo test for the susceptibility of Plasmodium falciparum to chloroquine was carried out in 390 patients. Parasite density was analysed by calculating the mean of each day's parasite count and the value was expressed per microliters of blood. Majority of sensitive and resistant infections attained minimal values on day 4. Further more, this value provides a clear-cut, statistically significant difference between sensitive and RI cases (Z = 2.14, P less than 0.05) RII, RIII cases (Z = 3.86, P less than 0.001). It is proposed that assessment of sensitivity should be based on D-4 parasite density per microliters of blood considering D-0 as base i.e., (proportionate reduction of parasite density on D-4 as compared to that on D-0) utilising the present criterion. In endemic areas, where reinfection is possible, patency on D-14 will nearly always be due to resistance. It is therefore, suggested that a better, more economical and an epidemiologically viable result can be obtained by extension of in vivo test upto D-14.

Animals↗

Success of integrated methods of control of mosquitoes in India--a review.

The integrated methodology for the control of vectors of diseases as well as mosquitoes has become an accepted concept amongst the public health experts. The feasibility of adopting this approach in different situations for mosquito control as per field trials by various institutions has been reviewed in this article. This concept, to some extent, has been in vogue under National Malaria Eradication Programme since long in a practicable way. Satisfactory results have been obtained wherever this approach has been applied carefully. The applicability of the integrated control methodology is not difficult provided various methods to be integrated are chosen and utilized in a rational way. Thorough health education is a prerequisite to awaken the community to accept the methods as part and parcel of routine life.

Animals↗

Efficacy of sulfalene and pyrimethamine combination drugs alone and with quinine in treatment of P. falciparum cases in chloroquine resistant areas of north east India.

Studies were carried out in some areas of Assam, Nagaland, West Bengal and Mizoram where chloroquine resistant strains of Plasmodium falciparum were present during 1983 and 1984, to see the efficacy of treatment of P. falciparum cases with SLP alone or with quinine sulphate. The findings have indicated that SLP in the dosage of sulfalene (1000 mg) + Pyrimethamine (50 mg) is suitable for treatment of P. falciparum cases not responding to chloroquine therapy in N.E. India. Treatment with sulfalene (1500 mg) + Pyrimethamine (75 mg) has no advantage over the SLP (1000 + 50) mg. Combination of quinine (1000 mg x 3 days) + SLP (1000 + 50) mg is better with 100 per cent cure rate. In Karhi Anglong district (Manja PHC) of Assam response to these drug combination is however less.

Adolescent↗

An in-vitro profile of the action of four antimalarials on indigenous cases of Plasmodium falciparum malaria in Karnataka.

In view of the emergence of chloroquine resistant Plasmodium falciparum from more and more geographical areas profiling of the responses to other available antimalarials by in vitro methods have become essential. A preliminary study undertaken in two Primary Health Centres of Karnataka State, India show the presence of strains of P. falciparum resistant to chloroquine and amodiaquine. The response for amodiaquine was poor as compared to chloroquine. The isolates were, however, sensitive to mefloquine and quinine.

Amodiaquine↗

Micro in vitro assessment of Plasmodium falciparum sensitivity to chloroquine and mefloquine in Gujarat.

Micro in vitro tests conducted in 1987 in Surat district of Gujarat on sensitivity status of P. falciparum to chloroquine and mefloquine revealed that the parasite has developed resistance to chloroquine upto 32 pmol. The ED 99 in Hazira, Gothan and Umra areas of the district was found to be 17.3, 18.5 and 8.7 pmol/well for chloroquine and for mefloquine it was 14.5, 4.8 and 6.8 pmol/well respectively. Monitoring of P. falciparum resistance is indicated under National Malaria Eradication Programme.

Animals↗

Status of Plasmodium falciparum resistance to chloroquine in Gujarat, Rajasthan and Maharashtra states of India.

An extended study from 1978-88 revealed that in the western states of India i.e., Rajasthan, Gujarat and Maharashtra; P. falciparum resistance to chloroquine has a scattered pattern in its distribution. However in Gujarat, R-III level of resistance is established in southern districts showing four fold increase from 1.79% in 1985 to 8.2% in 1988. In this area use of some alternate drug is indicated.

Animals↗

Development of a methodology for malariogenic stratification as a tool for malaria control.

Modified plan of operation (MPO) for malaria control launched in 1977 failed to curb malaria incidence beyond about 2 million cases per annum and thus necessitated development of multipronged malaria control strategies based upon malariogenic stratification. A model for such stratification based upon six most sensitive, but quantifiable, epidemiological parameters for which records are easily available at PHC level, namely, topography, average annual rainfall, vector(s), average annual parasite incidence (API) for the last five years, epidemic potential and vulnerability was developed. This model has been successfully tried in the State of Karnataka and on that basis the whole State has been divided into five strata in order of increasing endemicity. Objectives of malaria control for each of the stratum so defined have been proposed.

Animals↗

Control of bancroftian filariasis by diethylcarbamazine medicated common salt in Karaikal, Pondicherry, India.

A trial of diethylcarbamazine (DEC) mixed in crystal common salt at a concentration of 0.15 to 0.2 per cent was carried out for 46 months (1982 to 1986) in Karaikal town and five commune panchayats of Pondicherry for control of bancroftian filariasis. Comparison of pre and post trial surveys showed 97.6 per cent reduction of microfilaria rate. No microfilaria or disease case was found in less than 5 years age group in the post trial survey. There was about 72 per cent reduction of disease rate. In the post trial substantial reduction of disease manifestation was found in 40 years and below age groups. Vector Culex quinquefasciatus density, filaria infection and infectivity rates were monitored only in Karaikal town. Infective vector mosquitoes were found in 1982 and 1983 only but afterwards no infective mosquito was encountered.

Adolescent↗

A longitudinal study of P. falciparum response to chloroquine in relation to the epidemiology.

An attempt has been made to study the dynamics in the epidemiology of a locality where the local strains of Plasmodium falciparum have developed resistance to the antimalarial chloroquine. Increase in the transmission rate and prolonged drug pressure with chloroquine have been noted in association with the development of resistance. The importance of the study is on the mean parasite clearance time and mean parasite recrudescence time which appear to be related with the process developing resistance of chloroquine.

Animals↗

Filariasis control in rural areas through detection and treatment with diethylcarbamazine.

A pilot study for control of bancroftian filariasis through detection and treatment of microfilaria (mf) carriers and filaria disease cases with Diethylcarbamazine (DEC) undertaken in the rural areas of Srikakulam and Vizianagaram of Andhra Pradesh showed that this chemotherapeutic method of control of filaria in rural areas is feasible and acceptable to society. During first round of detection and treatment 20,300 mf carriers (90.6 per cent of detected) and 6,588 disease persons (86 per cent of detected) in Srikakulam and 7,097 mf carriers (94.8 per cent of detected) and 1,436 disease persons (93.4 per cent of detected) in Vizianagaram were treated with DEC tablets. These areas were again surveyed after five years and detected cases were treated with DEC with coverage of treatment ranging from 82.3 per cent to 95 per cent for both mf & disease cases and decline in mf and disease rate was noted to be 52.4 per cent and 50.9 per cent respectively in Srikakulam and 42.2 per cent for mf rate in Vizianagaram. The mf reduction was appreciably high (50 per cent or more) in 11 PHCs of Srikakulam and 4 PHCs of Vizianagaram. The mf rate reduction was the highest in the age group of 1 to 4 year indicating that the transmission has been cut down significantly. The vector infection rate showed reduction by 50 per cent during second round of detection and treatment as compared to first round, indicating significant reduction in transmission potential.

Animals↗