ICMR BULLETIN VOL. 27-No.-8-AUGUST-1997
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- ICMR BULLETIN VOL. 27-No.-8-AUGUST-1997
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ISSN 0377-4910
BULLETIN
August, 1997
Vol. 27, No. 8
DECREASING SPERM COUNTS - FACT OR FICTION
Recent years have seen numerous reports in the pub
lication of a variety of specialities including medicine,
chemical engineering and environmental sciences regard
ing a precipitous drop in sperm quality. These reports
have also been given extensive coverage in the lay press
fanning the fires of a full scale controversy. However, the
retrospective nature of the data, varying methods of analy
sis and lack of quality control have all contributed to the
truth not being clear. Given the sensitive nature of the
issue it has become mandatory to understand whether
this phenomenon is fact or fiction.
Historical Aspects
The issue was raised in 1992 by the controversial
study of Carlsen et al) who performed an extensive lin
ear regression analysis on 61 different sets of data between
1938 - 1990, reporting a decrease in mean sperm concen
tration of more than 40 per cent (from 113 x 106/ml to
66 x 106/ml). This was following McCleod’s2 10 year
study in USA published in 1979 which had reported no
such change. Carlsen’s paper1 received extensive cover
age in both, the international press and audio visual media
and the issue captured popular imagination. This paper
was followed by numerous papers both for and against
this thesis. Emphasis was placed on not only declining
sperm count1,3*9 but also in decrease in seminal volume1
and increase in abnormal forms8,10. These data were used
to extrapolate regarding the fertility status of the genera
tion after the late nineteen fifties.
Trends Over Time and Place
Available reports were predominantly from European
(England, France, Denmark, Scotland and Finland) coun
tries6, ,I*15. In addition, reports about geographical
variations within countries and regions16,17 were published.
During the same period several reports appeared which
denied any such decline13,18. Others in the field without
quoting actual data, criticis.ed the “pro-decrease” papers
on statistical grounds19 and criticised the use of the linear
regression model. They recommended that the quadratic
and spline-fit models would fit the data better. These
models show either no change or even a slight increase in
the sperm count. The studies were also criticised over
methodological issues such as varying methodology for
semen analysis, poor quality control, variation in sexual
abstinence, varying methods of semen collection, all of
which prove confounding5,11,20. Others have attributed this
change to selection bias with the variability of study
group with respect to geography, race and seeming “nor
mality”16,19,21*24. Further statistical problems in the form of
lower reference values11 use of mean and not median5,11.
Doubts were also raised for the validity and reliability of
the early data19,25. Various studies have reported a decline
in various aspects of male reproductive function. These
Division of Publication & Infor mation, 1CMR, New Delhi - 1 10 029
include decrease in sperm counts3'9, decrease in seminal
volume’, increase in abnormal forms4,10,12 and decrease in
fertility4,12.
Etiological Theories
Different theories have been put forward as a pos
sible explanation of this phenomenon. Some authorities
have reported an increase in testicular cancers in differ
ent industrialised countries concurrent with decrease in
sperm quality. There was a birth cohort pattern observed
for data after the mid fifties. This is attributed to etiologi
cal factors of testicular cancer by 3-4 times, operating
early in life probably in utero26'30. Secular trend in the
incidence of testicular cancer in selected areas is given in
Table I31. Simultaneous reports of an increase in the
Reduced fertility was also attributed to foetal Sertoli cell
damage35. Underlying all these varying factors was an
increased estrogenic influence. The final common path
way of estrogenic influence led investigators to postulate
whether the fall in sperm count could be attributed to a
change in estrogenic influences over the last half century
(Fig.l). The sources of these estrogens have been
Table I: Secular trend in the incidence of testicular cancer in
selected areas (annual rate per 100 000)31
Country
1960-63 1964-68 1969-71 1973-77 1978-82 1983-87
Denmark
3.8
4.5
4.9
6.7
7.8
8.4
Finland
1.2
0.8
1.1
1.7
1.5
1.8
UK (South
2.1
Western Region)
2.4
2.6
-
3.8
5.0
Germany
(Hamburg)
2.6
4.0
4.7
5.4
5.7
-
USA (Los Angeles, white men)
-
-
3.6
4.7
5.8
Puerto Rico
0.3
0.7
-
0.5
1.0
1.2
Japan (Miyagi)
0.6
0.4
0.8
0.8
1.0
1.3
Superscript number is the serial no. in the reference list.
incidence of cryptorchidism and hypospadias with de
creased semen volumes and-sperm count were reported
in the sons of women treated with synthetic estrogen
diethylstilbestrol (DES) between 1945 and 197132,33. The
prevalence of hypospadias at birth is given in Table II34.
Table II: Prevalence of hypospadias at birth (rate per 10000;
World Health Organization, 1991)34
Country
1970
1980
1990
England and Wales
9.5
15
12
Hungary
6
22
17
Sweden
16
20
18
Norway
5
15
17.5
Denmark
8
10
14
Finland
-
4
5
Superscript number is the serial no. in the reference list. -
78
OP -Organophosphorous; PCB Polychorinated biphenyls;
DES - Diethyl stilbestrol
postulated to be both endogenous and exogenous. Endog
enous increases could have resulted from changing diets
which increase the enterohepatic circulation of estrogens
and increase in body fat may also have increased the
bioavailable estrogens by converting other steroids into
estrogens. Synthetic estrogens may have increased through
use of oral contraceptives by women and orally active
anabolic steroids in the live-stock. Increased consump
tion of dairy produce and food substances containing
soya may account for hyper estrogenaemia36 with
changing dietary fads and fashions. In addition to which
many such estrogenic chemicals such as organochlorine
compounds and combustion products present in the food
chain further add to the body store of estrogen. Some
organo compounds like dichloro diphenyl trichloro ethane
and polychlorinated biphenyls (PCBs) are remarkably re
sistant to biodegradation37-38. These factors total upto
influences from occupation, environment, diet, life style
and contraception. Various factors like stress, smoking,
sexually transmitted diseases and food habbits make this
problem more complicated. Sharpe and Skakkebaek37 re
port that humans now live in an environment which is a
virtual sea of estrogens.
What Needs to be Done
This phenomenon of decline in semen quality suffers
from an incomplete description of its essential aspects in
spite of a surfiet of publicity. There are numerous ques
tions which have been partly answered and others not at
all.
The epidemiological aspect of this decreasing trend
in sperm counts has to be studied world-wide. Even within
various'centres there are reports of geographical variations16,17 within regions. The implications of these
geographical variations with regard to etiology are worth
exploring. Someworkers have attributed these variations
to environmental nutrition and other causes16. Others have
attributed it to difference in protocol of analysis and yet
others have stated that these differences may be inherent.
The differences taking into account the race, ethnic back
ground and life style (socio-economic) have not been
clearly done. This forms an important area for research in
fertility. There is a paucity of material from the third
world countries which needs to be addressed. There is
also lack of prospective data on larger populations which
would be most predictive of definitive trends. Prospec
tive studies will also address the lacunae in methodology
which .could invalidate previous studies. These would
include use of standardised analytical methods, unbiased
selection accounting for differences in age, race, socio
economic status, urbanization, ethnicity, medical and
reproductive history, life-style patterns and occupation.
There is a need to evolve stringent quality control with
rigorous record keeping. Prospective studies using
predecided reference values and employing means of prov
ing fertility will greatly add to the reliability and validity
of the data. Possible environmental influences ranging
from environmental factors to dietary changes will have
to be explored.
Most of the etiologies regarding this decline in sperm
counts have remained at the stage of hypothesis. There is
a need to verify numerous postulates. This will include
pharmacokinetic studies in xenobiotics, study of the ef
fects of various synthetic estrogens like hormonal
contraceptives on human and use of anabolic steroids on
the live-stock. Study of dietary estrogenic influences like
obesity, low fibre diet and physoestrogens on fertility
should be undertaken. This will also include a thorough
review of veterinary medicine for the effect of global
environmental factors on animal fertility. The possible
contribution of organophosphorous and organochloride
insecticides and pesticides, PCBs and combustion prod
ucts on impairment of fertility needs urgent investigation.
The Indian Scenario
The Institute for Research in Reproduction (IRR),
Mumbai, has been working in the field of semenology
and human sperm quality for over 15 years. Data on
semen parameters of more than 1500 men from various
parts of the country over the last 10 years are available.
These data represent both normal populations and se
lected population attending the Infertility Clinic at IRR.
The Institute is in a unique position of employing the
same staff and equipment over the entire period of the
study. The study used standardised methodolgy and em
ployed stringent quality control. The preliminary analysis
of the data indicated a definitive trend of decline in se
men quality. There is a decrease in the mean percentage
of normal morphology with less than 30 per cent normal
forms (Fig.2). This corroborates the findings of Mehta
and Anand Kumar39 who have reported a similar decline
in a study of population from Bangalore, India. This
decline in the study from Bangalore is correlated with
changes in various air pollution indices like suspended
particulate matter, sulphur dioxide and lead.
Animal Studies
The reports of decline in semen quality are not only
limited to humans. Changes in male reproduction and
reproductive capacity in wild life and avian populations
have been linked in many cases with environmental
pollutants. Experimental evidence shows that environ
mental pollutants disturb reproductive function in rhesus
monkeys, hens and in fish eating-birds of North America
and United Kingdom40. A compound called tributyrin
leaching from the marine antifouling paints has been
79
80
Fig. 2. Changes in seminal parameters (mean) from 1986 to 1995
reported to be the cause of pseudohermaphroditism in
marine gastropod species41*43. One is very well aware of
the chemical and oil spills in sea and how they affect the
flora and fauna. For example a chemical spill of pollut
ants (compounds with estrogenic and endocrine disrupting
activities) into lake Apopka, Florida, USA had resulted
in significant decrease in the number of juvenile alliga
tors. These alligators had abnormal testicular architecture
and small phali and low testosterone concentrations44.
Reports of morbidity and reduced male reproductive func
tion (lowered testosterone, reduced gonadal size,
hypothalamopituitary-gonal axis disturbances) have been
reported in male fish living in the effluent waters of
different industries45. The DES data on humans have been
confirmed by the animal studies. These studies have
shown an increased incidence of cryptorchidism, urethral
abnormalities, testicular hypoplacia and infertility. When
other synthetic estrogens were tested similar effects were
seen . The animal studies have indicated that treatment of
pregnant rats with chemicals with known estrogenic
80
effects led to reduction of testicular size in the male
offspring32.
Conclusion
There is a need for a critical comprehensive study of
this phenomenon to establish it as a scientific fact. There
are ethical and emotional issues contingent on the truth
regarding the declining sperm counts as it challenges the
basic survival of the human race. The risk of over react
ing in this case has less serious consequences than ignoring
any threat to male reproductive function. This is one
issue where none of us can afford to do too little too late.
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net, P., Keiding, N., Leffers, H., Me Lachlan, J.A., Meyer, O.,
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er, J. and Skakkebaek, N.E. Male Reproductive Health and
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Lipshultz, L.I. Have sperm counts been reduced 50 percent in
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a biological indicator of global TBT contanination. Mar Pollut
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Bangaloreans: A preliminary report. CurrSci. 72:621, 1997.
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40.
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now? Lancet ii: 791,1989.
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and Rokosh, D.A. Impact of bleached kraft mill effluent on
population characteristics, liver MFO activity and serum steroid
levels of Lake Superior white sucker (Catostomus commersoni)
41.
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This write-up has been contributed by Dr Kamala
Gopalkrishnan, Deputy Director, Institute for Research
in Reproduction, Mumbai.
ABSTRACTS
Some Research Projects Completed Recently
Detection and assessment of molecular markers
associated with multi-drug resistance in high grade
non-Hodgkin’s lymphoma
Lymph node biopsies and fine needle aspirates from
109 patients with high grade non-Hodgkins lymphoma
(NHL) were analysed to study the expression of mdr gene
and mdr gene product-P-glycoprotein in high grade NHL
and correlation of the findings with the clinical mani
festations and course of the disease. Normal lymph nodes
dissected during head and neck surgery were used as
control. Patients with severe disease at presentation, those
with a second malignancy or coming after treatment at
another hospital, and those over the age of 70 years were
excluded from the study. The patients were clinically
followed up for periods ranging from 7 to 34 months
after chemotherapy or until the recurrence of the dis
ease.
Of the 109 patients, 73 remained disease free during
the follow up period and 36 patients showed residual or
recurrent disease. Patients with residual or recurrent
disease underwent a second lymph node biopsy analy
sis. None-of the control lymph nodes and only 5 of the
73 (7%) patients who remained disease free during the
follow up period showed the presence of P-glycoprotein.
However, 26 of the 36 patients (72%) with recurrent/
residual disease expressed P-glycoprotein suggesting a
correlation between the expression of P-glycoprotein and
recurrence of disease.
82
In situ hybridization using a specific C-DNA probe
to the mdr gene gave a positive reaction in 2 of the 5
disease free patients who showed expression of P-glycoprotein but in none of the 68 disease free patients with
no expression of P-glycoprotein. Twenty five of the 36
patients with residual/recurrent disease showed the ex
pression of mdr gene. Western blot analysis showed 30
of the 36 samples from these patients to be positive for
P-glycoprotein, while Southern blot analysis for mdr gene
showed positive reactions in all the 36 samples. None of
the samples from 42 of the 73 disease free patients gave
positive Western blot or Southern blot reaction. Repeat
biopsies from all the 36 patients with residual/recurrent
disease gave positive Western blot and Southern blot re
actions.
Correlation analysis showed significant relationship
between prognosis and the detection of P-glycoprotein
by immunocytochemistry and Western blot and mdr gene
expression by Southern blot. P-glycoprotein analysis there
fore is a prognostic indicator for high grade NHL pro
vided it is accompanied by Western blot and Southern
blot analysis to rule out false negative.
M. Radhakrishna Pillai
Division of Laboratory Medicine and
Tumour Biology,
Regional Cancer Centre
Thiruvanantapuram
Characterization and evaluation of hydatid antigens
with diagnostic potential in early asymptomatic hydatidosis
The study was carried out for identification and
characterization of purified antigens from hydatid cyst
and for identification of immunoreactive hydatid fluid
antigenic fractions by Western blotting which could
ultimately be used for the early diagnosis of hydatidosis
and to study the kinetics of immune response in experi
mentally infected animal model.
presence of multiple immunoreactive antigenic compo
nents ranging from 8 to 200 kDa. Of these, 8 and 45 kDa
antigenic fractions were found to be specific for the
diagnosis of human hydatidosis. Sensitivity and speci
ficity of enzyme linked-immunosorbent assay (ELISA)
for the detection of specific hydatid antibodies in opti
mally diluted (1:1280) serum samples of patients clini
cally suspected to have hydatidosis was found to be 81.8
and 100 per cent respectively.
Hydatid cyst fluid collected from hydatid cysts of
naturally infected sheep was processed for the prepara
tion of crude soluble hydatid fluid antigen by sodium
dodecyl sulphate polyacrylamide gel electrophoresis
(SDS-PAGE). SDS-PAGE analysis revealed multiple
) protein bands of molecular weight ranging from 8 to 200
kDa. Of these, most demonstrable protein fractions
occurred as a thick band in the range of 66-90 kDa.
Experimental infection could be established in mice
by intraperitoneal inoculation of 2000 protoscolices of
hydatid cysts obtained from naturally infected sheep.
Kinetics of immune response to the crude soluble ex
tract antigen revealed positive response by the second
month post infection which persisted till the sixth month
post infection (follow up for six months). Crude soluble
extract antigen was found to be more suitable than the
purified antigenic fraction for assessing immune response
in early hydatidosis.
Western blot analysis of hydatid cyst fluid with se
rum samples from patients of hydatidosis,
neurocys^ticercosis, amoebiasis, intestinal helminthic
infection and normal healthy individuals indicated the
N. Malta
Department of Parasitology,
Postgraduate Institute of Medical
^Education & Research, Chandigarh
ICMR NEWS
Smt. Renuka Chowdhury, Hon'ble Minister of State
for Health and Family Welfare, presented the ICMR
Awards and Prizes for 1995 to outstanding biomedical
scientists on August 22,1997. She also launched the ICMR
celebrations of the 50th year of Independence of
India.
♦♦♦
P
***
*♦*
Dr. G.V. Satyavati, a well known pharmacologist (with
specialization in Medicinal Plants/Indigenous Drugs/Ancient Systems of Medicine) and biomedical information
and communication scientist, who took over as the Di
rector-General, ICMR, on May 7, 1994 retired on Au
gust 24, 1997 (on superannuation) after distinguished
service of over three decades in the ICMR. Dr. Satyavati
had the unique distinction of being the first woman to
head not only the ICMR but any scientific/research agency
in independent India.
***
*♦*
♦♦♦
The following meetings of various technical com
mittees/groups of the Council were held:
Meetings of the Project Review Committee (PRC)ZTask
Force (TF) held in New Delhi:
PRC on Biochemistry and Cellular
July 27, 1997
& Molecular Biology
Combined meeting of the Investigators and Steering Committee of
the TF on monitoring of adverse
drug reactions in India
August 8, 1997
Meetings of the Scientific Advisory Committee (SAC)/
Ethical Committee:
SAC of the Centre for Advanced
Research for Bone Marrow
Transplantation for Thalassaemia,
Vellore
Central Ethical Committee of
ICMR on Human Research
July 31, 1997
(at Vellore)
August 10, 1997
(at New Delhi)
Participation of ICMR Scientists in Scientific Events:
Dr. Bela Shah, Senior Dy. Director-General, ICMR,
participated .in the International Conference on
Preventive Cardiology at Montreal (June 29-July 3,1997).
83
Dr. V. Ramesh Bhat, Dy. Director (Senior Grade),
National Institute of Nutrition (NIN), Hyderabad, par
ticipated in the meeting of the FAO/IAEA Consultant on.
Food Contaminants at Vienna (July 14-18, 1997).
Dr. P.K. Das, Director; Dr. K.N. Panicker, Dy.
Director (Senior Grade); and Dr. S.P. Pani, Dy. Director,
Vector Control Research Centre, Pondicherry, participated
in the II International meeting on the Control of Lym
phatic Filariasis at Townsville, Australia (July 18-20,
1997).
Dr. G.B. Nair, Dy. Director, National Institute of
Cholera and Enteric Diseases, Calcutta, participated in
the Executive Board meeting of the International Union
of Microbiological Societies at Sydney (July 25-27,1997).
Dr. A.R. Agarwal, Senior Research Officer, Institute
for Research in Medical Statistics, New Delhi, partici
pated in the III International Conference on Combinato
rics, Information Theory and Statistics at Portland, Or
egon (July 18-20, 1997).
Dr. Kamala Krishnaswamy, Director and Y.
Venkataramana, Research Officer, NIN, Hyderabad, par
ticipated in the XVI International Congress of Nutrition
at Montreal (July 27-August 1, 1997).
Dr. P.K. Meherji, Dy. Director and Dr. Jyotsna Gokral,
Research Officer, Institute for Research in Reproduction,
Mumbai, participated in the XV FIGO World Congress
of Gynaecology and Obstetrics at Copenhagen (August
3-8, 1997).
Dr. S.K. Subbarao, Dy. Director (Senior Grade), Ma
laria Research Centre, Delhi, participated in the WHO
Intercountry Workshop on Insecticide Resistance of Mos
quito Vectors at Salatiga, Indonesia (August 5-8, 1997).
ICMR AIDED SYMPOSIA/SEMINARS/WORKSHOPS/COURSES/CONFERENCES
Contact Address
Symposium/Seminar/Workshop/
Course/Conference
Date & Place
International Symposium on Brain Ageing
August 9, 1997;
(at New Delhi)
Dr. A.B. Dey, Addl. Professor, Department of
Medicine, All India Institute of Medical Sciences,
New Delhi-110029.
Symposium on Gastrointestinal Infection and
Inflammation
August 29-30, 1997;
(at Vellore)
Dr. B.S. Ramakrishna, Organising Secretary of the
Symposium, Department of Gastroenterology,
Christian Medical College, Vellore-632002.
III National Conference of the Alzheimer's and
Related Disorders Society of India.
August 31, 1997;
(at Hyderabad)
Mr. K.R. Gangadharan, Organising Secretary of
the Conference, Alzheimer's and Related Disor
ders Society of India, 7-1-59/4 & 8, Ameerpet,
Hyderabad-500016.
Symposium on Recent Trends in Tropical Disease
Research
September 5-6, 1997;
(at Sevagram)
Dr. M.V.R. Reddy, Organising Secretary of the
Symposium, J.B. Tropical Disease Research Cen
tre and Department of Biochemistry, Mahatma
Gandhi Institute of Medical Sciences, Sevagram,
Wardha-442102.
■National Symposium-cum-Workshop on
Leptospirosis
September 11-13, 1997;
(at Port Blair)
Dr. V.G. Rao, Organising Secretary of the Sym
posium, Regional Medical Research Centre, Port
Blair-744101.
International Symposium on Recent Trends in
Mental Health
September 19-20, 1997;
(at Sevagram)
Dr. Prakash D. Behere, Organising Secretary of
the Symposium, Department of Psychiatry, Maha
tma Gandhi Institute of Medical Sciences, Seva
gram, Wardha-442102.
84
Symposium/Seminar/Workshop/
Course/Conference
Date & Place
Contact Address
Mid Term Conference of the Indian Society for
Clinical Pharmacology and Therapeutics
September 19-20,1997;
(at Mumbai)
Dr. S.R. Shahani, Organising Secretary of the
Conference, Department of Pharmacology, L.T.M.
Medical College, Mumbai-400022.
International Symposium on Free Radicals in
Medicine
September 22-24, 1997;
(at Udaipur)
Dr. P.P. Singh, Organising Secretary of the
Symposium, Department of Biochemistry, R.N.T.
Medical College, Udaipur-313001.
IV National Conference of the Society of Bio*
materials and Artificial Organs on New Horizons
in Biomaterials Research
October 3-4,1997:
(at Hyderabad)
Dr. P.R. Chatterjee. Convenor of the Conference,
Indian Institute of Chemical Technology, Hydera
bad-500007.
IX National Congress of Veterinary Parasitology
October 6-8, 1997;
(at Ludhiana)
Dr. H.S. Bali. Organising Secretary of the Cong
ress, Department of Veterinary Parasitology, Col
lege of Veterinary Science, Punjab Agricultural
University, Ludhiana-141004.
Guha Research Conference-1997
October 13-17, 1997;
(at Palampur)
Dr. Amit Ghosh, Co-convenor-GRC*97, Institute
of Microbial Technology, Chandigarh-160014.
Seminar on Current Status of Thalassaemia in
India and National Workshop on Carrier
Detection and Antenatal Diagnosis of
Thalassaemia
November 13 and
14-15, 1997;
(at Lucknow)
Dr. Sarita Agarwal, Organising Secretary, Dep
artment of Medical Genetics, Sanjay Gandhi
Postgraduate Institute of Medical Sciences, Lucknow-226014.
International Conference on Advances in
Reproductive Medicine
November 15-18,1997;
(at Calcutta)
Dr. Sudersan Ghosh Dastidar, Organising Secretary-ICARM’97, Infertility Clinic and I.V.F. Cen
tre, 208, Rash Behari Avenue, Calcutta-700029.
Asia-Pacific Congress on Head and Neck Cancer
December 11-14, 1997;
(at Mumbai)
Dr. Ashok R. Mehta, Chairman of the Congress,
Department of Surgery, Tata Memorial Hospital,
Mumbai-400012.
INDIAN COUNCIL OF MEDICAL RESEARCH
Grant-in-aid for organising Seminars/Symposia/Workshops
The Council provides partial financial assistance for organising Seminars/Symposia/Workshops.
Applications for grant of financial assistance (complete in all respects in the prescribed proforma), will
be considered only if furnished at least four months before the date of commencement of the
Seminar/Symposium/Workshop, etc.
85
COUNCIL’S TRAINING PROGRAMMES FOR 1997-98
Leprosy
Occupational Health
At the Central JALMA Institute for Leprosy, Agra:
At the National Institute of Occupational Health,
Ahmedabad:
•
Training Course on National Leprosy Eradication
Programme for Medical Officers (September 15-26,
1997).
•
Orientation Course on Occupational Health for Indus
trial Medical Officers (September 30-October 11,
1997).
_
•
Training Course on Environntental Hygiene Practice
(November 10--.14' 1997). .
Reproductive Biology
At the Institute for Research in Reproduction, Mumbai:
•
Workshop on Genotoxicity (August 18-29, 1997).
•
Workshop on Basic Molecular Biology for Clinicians
(December 2-11, 1997).
Laboratory Animal Technology
At the National Centre for Laboratory Animal Science,
National Institute ofNutrition, Hyderabad:
•
Endocrinology
Haematology
At the National Institute of Nutrition, Hyderabad:
•
At the Institute of Immunohaematology, Mumbai:
Annual Certi ficate Course on Endocrinological Tech
niques and their Applications (August 1-September
15, 1997).
Nutrition
•
Training Course in Transfusion Medicine for Blood
Bank Medical Officers (August 27-October 24,
1997).
•
Training Course in Blood Group Serology and Blood
Bank Methodology for Blood Bank Technicians (Au
gust 27-September 26, 1997).
•
Training Course in Advanced Haematology and
Immunohaematology (October 6-24, 1997)*.
At the National Institute of Nutrition, Hyderabad:
•
Training Course for Laboratory Animal Supervisors
(September 1-November 29, 1997).
Postgraduate Certificate Course in Nutrition (Decem
ber 1, 1997-February 28, 1998).
EDITORIAL BOARD
Dr. G.V. Satyavati
Dr. Badri N. Saxena
Chairperson
...
Member
Dr. Bela Shah
Member
Dr. N. Medappa
Editor
Printed and Published by Shri J.N. Mathur for the Indian Council of Medical Research, New Delhi
at the ICMR Offset Press, New Delhi-110 029
R.N. 21813/71
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