ICMR BULLETIN VOL. 27-No.-5-MAY-1997
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- ICMR BULLETIN VOL. 27-No.-5-MAY-1997
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Vol. 27, No. 5
May, 1997
ROLE AND RELEVANCE OF POISON INFORMATION CENTRES IN INDIA
Poisoning due to chemicals, pharmaceuticals, plants
and animal toxins is a world-wide phenomenon and has a
heavy social and economic impact on a country’s health
care system. The poisonings may be intentional, acciden
tal or occupational; acute or chronic. Acute poisonings
present as medical emergencies at all levels of health care
and the personnel involved in health care should be aware
ofthe critical care and management required by such cases.
Mass chemical poisonings have occurred due to acci
dental contamination of food, medicines and consumer
goods. Some well known examples include the Minamata
Bay episode in Japan of mercury poisoning during the
1950s. Extensive episodes of mercury poisoning have also
been reported to be due to contamination of bread made
from cereal grains treated with alkyl-mercury fungicides’.
In Spain, the toxic oil syndrome of 1983 killed 340 people
and caused permanent disability in 20,000 persons2. Large
scale poisoning due to diethylene glycol used in place of
propylene glycol in many pharmaceutical formulations has
been reported from many countries3. Adulteration of il
licit liquor with methanol resulting in mass poisoning is
often reported in India. In Vietnam, baby talc containing
warfarin killed many infants and caused serious sickness
in others2.
A number of industrial disasters have occurred during
the manufacture, storage and transport of chemicals. The
worst chemical disaster occurred at Bhopal where methyl
isocyanate and other reaction products released from the
Union Carbide plant manufacturing carbaryl, caused more
than 2500 deaths and disabled nearly 150,000 people2.
In India, as in other countries, mass poisonings due to
any cause receive a great deal of media coverage, but it is
the individual patients of poisoning seen by physicians
which in reality make up the bulk of poisoning cases.
Though it is mandatory to report all cases of poisoning
due to their medicolegal nature, the official figures often
do not reflect the extent of the problem on account of un
der reporting. Since many cases of poisoning are suicidal
in nature, the relatives often consult private practitioners.
Industrial poisonings though notifiable, are also under re
ported as compensation has to be paid to the workers. Under
these circumstances only the very serious patients go to
the hospitals, and it is mostly through publications of such
case reports that the types of poisonings prevalent in India
are known.
The commonest cause of poisoning in India and other
developing countries is pesticides4,5, the reasons being ag
riculture based economies, poverty and easy availability
of highly toxic pesticides. Occupational poisoning due to
pesticides are also common in developing countries, due
to unsafe practices, illiteracy, ignorance and lack of pro
tective clothing.
In India, organophosphates form the largest bulk of
pesticide poisonings6*8. Since 1985, the problem of alu
minium phosphide poisoning, a grain ftimigant, is reported
Division of Publication & Information,
ICMR, New Delhi - 1 10 029
as the commonest cause of intentional poisonings in north
ern parts of India viz. Haryana, Punjab and Rajasthan9-10.
Pesticide poisoning is associated with high morbidity
and mortality. Education of the pesticide handlers about
safe practices can prevent accidental poisoning to a large
extent. Immediate first-aid can be life saving in most cases
of poisoning and can be carried out at the primary health
care level.
The problem of low dose chronic exposure to chemi
cals is as important as that of acute poisoning. In India, a
great deal of concern is being shown about the harmful
effects of environmental pollution on human health. A
number of legislations have also been enacted or
ammended to exercise stricter controls and contain the
harmful effects of chemicals on human health and envi
ronment.
International Concern About Chemical Safety
In the 1970s, international concern about the dangers
of chemicals led to the United Nations Conference on the
Human Environment in 1972 at Stockholm, Sweden11. In
1977, the World Health Assembly, decided to develop
long-term strategies to control and limit the impact of in
creasing manufacture, use, storage, transport and disposal
of chemicals. The International Labour Organisation (ILO)
and United Nations Environment Programme (UNEP)
joined WHO in setting up the International Programme on
Chemical Safety (IPCS) in 1980. The IPCS provides guide
lines for assessing the risk of chemicals to human health
and gives technical support to different countries to
strengthen their chemical safety programmes. One of the
major thrust areas in chemical safety is the development
and strengthening of Poison Information Centres especially
in developing countries.
In 1992, the United Nations Conference on Environ
ment and Development (UNCED), the Earth Summit, held
at Rio de Janeiro, recognised the need for an international
strategy to achieve sound management of chemicals which
led to the Intergovernmental Forum on Chemical Safety
(IFCS). The IFCS provides a mechanism for co-operation
between governments for chemical risk assessment and
environmentally sound management of chemicals. The
IFCS has also identified a number of priority areas includ
ing the establishment and development of Poison Infor
mation Centres world-wide as a means of collecting
harmonized data on a global basis on the impact on
human health of deliberate and accidental exposures to
chemicals12.
44
The IPCS/INTOX project has developed a computer
ised information management package which will help the
Poison Information Centres in harmonized collection and
analysis of toxicological data on a global basis. Thus
multicentric toxicological studies can be undertaken to
evaluate the effectiveness of preventive and therapeutic
interventions. The project involves about 100 toxicologists
from 60 centres based in 45 countries12. Two centres from
India, one at the All India Institute of Medical Sciences
(AIIMS), New Delhi and the other at the National Insti
tute of Occupational Health (NIOH), Ahmedabad are
participating in this project.
Poison Information Centres
The Poison Information Centres are specialized units13
with the objective of—(i) reducing morbidity and mortal
ity from toxic exposures of any kind, be they intentional 4
or accidental; single or multiple; acute or chronic and by
any route of exposure; and (ii) carrying out intervention
programmes for prevention of poisoning.
Reduction of Morbidity and Mortality
Emergency information service
This is the most important activity of a poison infor
mation centre. By accessing a number of information
sources and databases, the centre can quickly identify the
agent involved in any kind of toxic exposures and provide
information on its toxicity and risks. In instances of acute
poisoning, the centre provides immediate advice on firstaid, management, antidotes and investigations needed for
patient care. Personnel at the centre would require train
ing to respond to telephonic enquiries which is the
commonest mode of communication. Since many expo
sures are non-toxic and need only reassurance or minor (
first-aid, unnecessary visits to the already overburdened
emergency departments can be avoided. In developing
countries, the poison information centres may also
provide a range of information on the environmental risks
of chemicals and safe levels of chemicals in food and at
the workplace.
Analytical laboratory investigations
The poison information centres can also provide
laboratory service for analyses of the toxicants and bio
chemical investigations for diagnosis of certain types of
poisoning and for patient management. Simple tests such
as spot tests, immunoassays or thin layer chromatography
may be undertaken by emergency services attached to a
clinical toxicology unit. More detailed analyses using so
phisticated instrumentation for confirmation of screening
results and studies on the kinetics of the toxin can be un
dertaken by reference laboratories.
Clinical toxicology services
In many countries poison information centres are
integrated with clinical units which carry out treatment,
follow up of poisoned patients and evaluation of treatment
efficacies.
Teaching and training ofhealth professionals
These centres being an important source of human
toxicology data, can provide updated information oir new
treatment modalities to health professionals.
Chemical accidents and disasters
Poison information centres make an important contri
bution in the handling of chemical disasters by providing
appropriate information at the time of an accident and by
taking part in contingency planning.
Preparation of information material
This may be specially important for developing coun
tries where communication and transport facilities are not
well developed in the rural areas. Information cards,
brochures on locally prevalent poisonings may be prepared
as quick reference materials for health professionals.
Prevention of Poisonings
Toxicovigilance
This is an active process of identification and
evaluation of toxic risks in the community. All enquiries
addressed to a poison information centre are regularly
analysed to determine the possible toxic agents and
circumstances of poisoning. The regulatory or health
authorities can be alerted to take appropriate preventive
measures, if poisoning related to a new product, improper
packaging or wrong labelling is observed.
Public education and awareness
Educational programmes either for the whole com
munity or for certain high risk groups eg. on prevention of
poisoning in toddlers, safe use of pesticides for rural work
ers, dangers of self medication in the elderly, prevention
ofexposures to chemicals at work, etc. may be undertaken
through various information material and campaigns.
Poison Information Centres: The International Scenario
Clinical toxicology became a specific branch of medi
cine in the early 1950s in developed countries in response
to the proliferation and use of chemicals in everyday life.
The first poison centres were started in America in the
mid fifties and by the early eighties there were nearly 400
centres some of which were in the emergency departments
of hospitals. The American Association of Poison Control
Centres (AAPCC) established in 1958, has developed stan
dards for the certification of such centres14. The Poison
Prevention Packaging act of 1972 in USA which led to
child resistant packaging and a marked reduction in child
hood poisonings was largely due to the efforts of the
AAPCC.
The organization of Poison Information Centres in
various countries is varied. In the USA, most of the cen
tres provide 24 h information and are not associated with
any diagnostic laboratories or treatment units. In Ireland,
Spain and Netherlands the information centres are inte
grated with diagnostic laboratories. In other countries such
as the UK, France and Germany some poison centres work
in conjunction with acute poisoning treatment units and
diagnostic laboratories. The European data indicate an an
nual incidence of human poisoning of 0.2-2.9/1000 in
habitants15.
The National Taiwan Poison Control Centre reported
an annual incidence of human poisoning ranging between
0.16-0.22 exposures per 1000 population16. Among coun
tries of the Asia Pacific region, Australia, New Zealand,
Indonesia, Singapore, Phillipines, Hongkong, Pakistan, Sri
Lanka, Iran and Turkey have already established poison
information centres. Among Latin American countries,
Brazil has 30 poison control centres, while Uruguay has
one well established centre. Very few countries in the
African continent with the exception of South Africa,
Zimbabwe and Kenya have poison information centre
facilities. Some East European countries have started
developing poison control facilities recently17. In 1993, the
Toxicology Information and Advisory Centre (TIAC) was
created in Moscow and there is a plan to create 20 infor
mation toxicology centres in different regions of Russia
by 1998.
In two of the most populated and rapidly industrializ
ing countries viz. China and India, poison information
centres have yet to make an impact on the health care
system.
45
Present Status of Poison Information Centre Activi
ties in India
Poison information centres should become an integral
part of the health care delivery system and chemical infor
mation services in India. These centres need expertise in a
wide range of areas which include pharmacology, toxicol
ogy, clinical sciences, preventive medicine, occupational
health, environmental sciences, biology and computer
sciences. Special skills in telephonic consultation, data
search and risk assessment are also needed. It is essential,
that before a network of such centres is set up, the
infrastructural needs, human resources and the training
requirements are thoroughly understood. Guidelines for
Poisons Control have been prepared by a group of experts
following a joint meeting of International Programme on
Chemical Safety (IPCS), Commission of the European
Communities (CEC) and the World Federation of Asso
ciations of Clinical Toxicology. Centres and Poison
Control Centers at Geneva in 198513.
The need for poison information centres has been felt
in India for quite some time. Following the Bhopal gas
tragedy, an Inter-ministerial Group on Prevention and Con
trol of Chemical Accidents met in 1986 and strongly sup
ported the idea of setting up poison control centres in
India. In 1991, the existing facilities in India for diagno
sis, management and prevention of poisoning were identi
fied at a workshop organized in New Delhi4. The IPCS/
WHO through jts INTOX project provided technical help
and training to two centres from India (AllMS, New Delhi;
NIOH, Ahmedabad).
Poisonings”. The Centre has also prepared booklets
giving information about “Management of Various
Poisonings” and sources from where the antidotes can be
obtained. A card for “Prevention of Household Poison
ing” has also been publised. Further, the Centre has devel
oped facilities for detection of common poisons.
Poison Information Centre at NIOH, Ahmedabad
This Centre provides expert guidance and treatment
recommendations to medical personnel handling patients
of poisoning. Initially, patients were being referred only
from few hospitals of Ahmedabad city but now private
hospitals, nursing homes, general practitioners of not only
Ahmedabad but from other'parts of Gujarat seek help from
the NIOH Poison Centre. Investigations for identification
of pesticide and metal posonings are also undertaken at
the NIOH. The Centre also carries out market surveys for
common poisons and availability of antidotes. Teaching
in clinical toxicology and toxicovigilance are the other main
activities of the Centre. Based on the types of poisoning
reported to the NIOH centre, poison information cards have
been prepared on pesticides and industrial chemicals to
serve as quick reference material for health personnel
The following are the main observations of the Centre:
1.
Acute poisonings are very common and patients are
admitted to the emergency wards almost daily. The
patients often arrive very late when referred from
rural areas leading to high morbidity and mortality.
2.
Pesticides, both household as well as agricultural, are
the commonest cause of poisoning. Mortality is much
higher with agricultural pesticides. Though
organoposphates are responsible for the bulk of pesti
cide poisonings, other pesticides such as organochlorines, synthetic pyrethroids and herbicides are
frequently encountered. A variety of industrial chemi
cals are also responsible for many instances of
poisoning.
3.
Simple diagnostic tests such as plasma cholinesterase
levels are not done in any of the hospitals. Most pesti
cide poisonings are treated as organophosphate poi
sonings. However, with the establishment of the Poi
son Information Centre at NIOH, physicians avail its
services for the identification of the pesticides and also
request for cholinesterase assays.
4.
Teaching or training in clinical toxicology, both at the
undergraduate as well as at the postgraduate level is
limited in some medical colleges.
Poison Information Centre at AIIMS, New Delhi
The National Poisons Information Centre set up in the
Department of Pharmacology in December 1994, provides
information by telephone and fax, on poisoning by drugs
and chemicals on a 24 h basis, seven days a week, through
out the year, to hospitals, doctors in practise and the gen
eral public in the event of poisoning/suspected poisoning.
The Centre has up-to-date information on toxic substances
(drugs and chemicals). In difficult cases, information from
other countries can be collected and transmitted to the con
cerned hospital/individual. The Centre has also made about
two dozen treatment cards on common acute poisonings
which provide information on prehospital and hospital
management of the poisonings; the doses of various drugs
to be used are also given. The Centre has also published
two monographs on the “Management of Plant Poison
ings” and “Management Guidelines for Pesticide
46
5.
6.
7.
Simple remedies such as syrup of Ipecac and activated
charcoal which is recommended for most ingested poi
sons are not easily available in India. Very few anti
dotes are available even in big cities in India.
Many of the pesticide formulations are sold unlabelled
in the market making it difficult for patient manage
ment. Some of the pesticide containers had incorrect
information about antidotes which led to complica
tions in many patients.
Occupational poisonings are quite common but are not
reported due to various reasons.
In a country as large as India, it may be necessary to
have a number of regional poison information centres.
Many research institutes in India not only have the exper
tise in human toxicology, but also have fully equipped
analytical laboratories. Such facilities could be upgraded
and the institutes encouraged to develop liasion with emer
gency care services. By extending service to the hospital
ized patients, unnecessary duplication of expensive labo
ratory facilities can be avoided and at the same time close
observation and follow up of patients exposed to a variety
of toxicants will encourage research in clinical toxicology
and provide a wealth of knowledge (minimizing animal
experimentation).
5.
Fernando, R. Pesticide poisoning in Asia-Pacific region and.role
of a regional information network. J Toxicol Clin Toxicol 33:677,
1995.
6.
Kamath, P.G., Dagli, A.J. and Patel, B.M. Diazinon poisoning, a
report of 25 cases. J Assoc Physicians India 12: 477, 1964.
7.
Singh, S., Sharma, B.K., Wahi, P.L., Anand, B.S. and Chugh,
K.S. Spectrum of acute poisoning in adults (10 years experience).
J Assoc Physicians India 32: 561, 1984.
8.
Adalkha, A., Philip, P.J. and Dhar, K.L. Organophosphorus and
carbamate poisoning in Punjab. JAssoc Physicians India 36: 210,
1988.
9.
Singh, S., Dilwari, J.B., Vashist, R., Malhotra, H.S. and Sharma,
B.K. Aluminium phosphide ingestion. Br Med J290: 1110,1985.
10.
Siwach, S.B., Yadav, D.R.. Arora, B., Dulal, S. and Jagdish. Acute
aluminium phosphide poisoning—An epidemiological, clinical, and
histopathological study. J Assoc Physicians India 36: 594, 1988.
11.
Pronczuk de Garbino, J. The IPCS, its role in strengthening capa
bilities for chemical safety, particularly in developing countries.
Int J Toxicol Occup Environ Hlth 1: 5, 1992.
12.
Meredith, T. and Haines, J. International data collection and
evidence-based toxicology. J Toxicol Clin Toxicol 34: 647,1996.
13.
Guidelines for Poisons Control, World Health Organization,
Geneva (In press).
14.
Bernstein, J., Kulberg, A.G., Goldfrank, L.R. and Weisman, R.S.
Prevention and the role of the Poison Control Center In:
Goldfrank’s Toxicologic Emergencies. Eds. L.R. Goldfrank, N.E.
Flomenbaum, N.A. Lewin, R.S. Weisman, M.A. Howland and
A.G. Kulberg. Appleton-Century-Crafts, Norwalk, Connecticut,
1986, p. 149.
15.
Jaraczewska, W., Czerczak, S. and Kotwica, M. The National
Poison Information Center in Poland. J Toxicol Clin Toxicol 34:
669, 1996.
16.
Yang, C.C., Wu, J.F., Ong, H.C., Hung, S.C., Kuo, Y.P., Sa, C.H.,
Chen, S.S. and Deng, J.F. Taiwan National Poison Center: Epide
miologic data 1985-1993. J Toxicol Clin Toxicol 34: 651, 1996.
17.
Litvinov, N.N., Ostapenko, Y.N. and Kazachkov, V.I. Informa
tion technologies for clinical toxicology in Russia. J Toxicol Clin
Toxicol 34: 665, 1996.
References
1.
Hammond, P.B. and Beliles, R.P. Metals. In: Casarett and Doull's
Toxicology, The Basic Science of Poisons. Eds. J. Doull, C.D.
Klaassen and M.O. Amdur. Macmillan Publishing Co., Inc. New
York, 1980, p. 422.
2.
Haines, J. A. Global overview and classification of chemical inci
dents. Seventh meeting of the Poisons Centre Working Group for
the IPCS/INTOX Project (INTOX 7). Sao Paulo, 1994.
3.
Wax, P.M. It’s happening again-Another diethylene glycol mass
poisoning. J Toxicol Clin Toxicol 34: 517, 1996.
4.
Seth, S.D. Problem ofPoisoning in India. Proceedings of the WHO/
ARMS’Workshop on Establishment and Strengthening of Poison
Control Centres in India. Printways, New Delhi, 1991, p. 13.
This write-up has been contributed by Dr. A. Dewan, Deputy
Director, National Institute of Occupational Health, Ahmedabad.
ABSTRACTS
Some Research Projects Completed Recently
Evaluation of citrate therapy in the management of
test. Potassium citrate therapy in the management of stone
oxalate lithiasis with special reference to renal tubular
formers with dRTA defect and recurrent calcium oxalate
acidosis
stone formers with hypocitraturic defect, was also evaluated.
A total of 181 (164 male and 17 female) radiologicaly
proven renal stone formers (SF) and 30 normal subjects
with no history of renal disorders were evaluated for total
distal renal tubular acidosis (dRTA) defects by acid
challange (150 mg ammonium chloride/kg body weight)
Nephrolithiasis had occurred for the first time in 120
patients while in 61 it was recurrent. dRTA defect was
found in 3.3 percent normals and in 30.3 percent SF; only
one SF had complete dRTA defect. The prevalence of
dRTA was 28.6 and 47.1 per cent in males and females
respectively. In the first episode SF, dRTA was found in
29.0 per cent males and 61.5 per cent females while in
recurrent SF, dRTA was found only in males (28.1%).
In normals and SF without dRTA defect a progressive
fall in the urinary pH was seen after acid (ammonium chlo
ride) loading. The initial pH in SF was slightly higher than
in normal subjects. In SF with incomplete dRTA defect,
the pre-acid load pH was higher than in those without
dRTA defect and it did not fall below 5.0 after acid load.
In the only patient with complete dRTA the urine did not
become acidic even after acid load. No differences were
observed in urinary creatinine excretion in normals and
various groups of the SF. However, calcium excretion in
creased after acid load in both groups of subjects; the
calciuric effect of acid load being greater in SF without
dRTA defect. A progressive decrease in the excretion of
citric acid after acid load was observed in normals and SF
without dRTA defect. Comparatively the hypocitraturic
effect was milder in SF with incomplete dRTA defect, and
was negligible in SF with complete dRTA defect. No sig
nificant differences were observed in pre-load ammonium
excretion in normals and different groups of SF. Increas
ing pattern of ammonium excretion after acid load was
observed in all the subjects.
No significant differences were observed in the acid
base status of normals and SF and in patients with the first
and recurrent episodes of nephrolithiasis. The base excess
tended to be lower in recurrent SF. After acid load the
bicarbonate, base status and base excess of extra cellular
fluids reduced in SF with and without dRTA defect.
Potassium citrate therapy for the management of renal
stones was evaluated in 58 stone formers (32 first episode
and 26 recurrent). Urine chemistry (24 h sample) was stud
ied pre-therapy and 1,3,6 and 12 months after therapy.
Urinary pH increased progressively during therapy.
Calcium excretion decreased significantly and reached
normal levels after one year in all hypercalciuric patients.
Hypocitraturia was also corrected in all the stone formers.
Twenty four h urine output, creatinine, magnesium, inor
ganic phosphorus, uric acid and oxalic acid remained
unaltered during this, period. Serum chemistry and acid
base status also remained unaffected. Recurrence of the
disease was not observed in any of the patients during one
year of therpay.
The results of the study thus indicate that dRTA
defect is a significant factor in the etiopathogenesis of uri
nary calculi. Recurrence does not appear to be related to
48
this defect. Potassium citrate therapy was found to be an
effective remedy for aleviating hypercalciuria and
hypocitraturia.
S.K. Rajpurohit
P.P. Singh
Department of Biochemistry,
RNT Medical College,
Udaipur
Publication:
Singh, P.P., Pendse, A.K., Ahmad, A., Ramavataram, D.V.S.S.
and Rajpurohit, S.K. A study of recurrent stone formers with special
reference to renal tubular acidosis. Urol Res 23: 201, 1995.
In situ hybridization studies of Epstein-Barr virus in
Hodgkin’s disease
The study was carried out on 40 patients of Hodgkin’s
disease to demonstrate the presence of Epstein-Barr viral
(EBV) RNA in the malignant cells by a sensitive non-isotopic in situ hybridization and to localize the EBV encoded
latent membrane protein-1 (LMP-1) in the malignant cells.
Efforts were also made to correlate the results of in situ
hybridization with immunohistochemistry for EBV-encoded LMP-1 and analyse the. percentage of positivity in
relation to various subtypes of Hodgkin’s disease.
Of the 40 patients studied, 30 were adults and 10 chil
dren; male: female ratio being 37:3. The most common
histological subtype was nodular sclerosis (24/40; 60%),
followed by mixed cellularity (12), lymphocyte predomi
nance (3) and one case of lymphocyte depletion.
EBER-1 transcripts were identified in 28 of the 40
(70%) patients (18 adults and 10 children). In the positive
cases, EBER-1 positivity was confined to the ReedSternberg and mononuclear Hodgkin’s cells. A higher rate
of EBER-1 positivity was observed in mixed cellularity
(83.33%) and lymphocyte depletion (100%) followed by
nodular sclerosis (70.83%). No positivity was observed in
lymphocyte predominance.
Twenty six of the 28 patients (except one with mixed
cellularity and the only case with lymphocyte depletion)
showing positivity with in situ hybridization, showed
reactivity for EBV encoded LMP-l.
The 100 per cent EBER-1 positivity in paediatric
patients strongly support the role of EBV in the etiopatho
genesis of Hodgkin’s disease. The demonstration of
LMP-1 along with the detection of EBER-1 sequences
has important implications since it is one of the latent
gene products which produces B lymphocyte transforma
tion. The data thus strongly support the hypothesis, that
when present, EBV is not merely a silent passenger in
Hodgkin’s disease but contributes directly to the patho
genesis. The results also indicate that the procedures used
in this study can be applied on archival material allowing
retrospective analysis of many neoplasms suspected to be
EBV related.
K. Swaminathan
M. Madhavan
Department of Pathology
Dr. A.L. Mudaliar Postgraduate Institute
of Basic Medical Sciences, Chennai
ICMR NEWS
The following meetings of various technical committees/groups of the Council were held:
Meetings of the Project Review Committee (PRC)/
Project Advisory Committee (PAC) and Annual
Review Meeting held at New Delhi:
Annual Review Meeting of the
National Cancer Registry Progr
amme
April 21,1997
PRC on Oncology and Gastroen
terology
May 5, 1997
PAC on development of a scale
for measuring psychosocial stress
May 9,1997
Brain Storming Session/Meeting of the Scientific
Advisory Committee (SAC):
ICMR-DBT Brain Storming
Session on Research in Haemoglobinopathy
April 19-20,1997
(at Mumbai)
SAC of the Centre for Advanced
Research for Health Consequences
of Earthquake Disaster with special
reference to Mental Health, Pune
May 15-16,1997
(at Pune)
Participation of ICMR Scientists in Scientific Events:
Dr. Rani Balasubramanian, Dy. Director, Tuberculo
sis Research Centre (TRC), Chennai, participated in the
XXIII Middle East Regional Congress of the International
Union against Tuberculosis and Lung Diseases at Tehran
(April 21-24,1997).
Dr. Manjula Datta, Dy. Director, TRC, Chennai, par
ticipated in the meeting of the WHO Steering Committee
on Immunology of Mycobacterial Diseases, Vaccine
Research and Development Unit ofthe Global Programme
for Vaccine and Immunization at Geneva (April 23-25,
1997).
Dr. V. Kumaraswami, Dy. Director, TRC, Chennai,
participated in the meeting of the WHO Task Force on
Community Directed Treatment of Lymphatic Filariasis
and Onchocerciasis at Geneva (April 28-30, 1997).
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.
49
COUNCIL’S TRAINING PROGRAMMES FOR 1997-98
Leprosy
Occupational Health
At the Central JALMA Institutefor 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 Environmental Hygiene Practice
(November 10-14, 1997).
Virology
At the National Institute of Virology, Pune:
•
Diploma in Medical Virology (June 1997-May 1998).
Laboratory Animal Technology
Reproductive Biology
At the National Centre for Laboratory Animal Science,
National Institute ofNutrition, Hyderabad:
At the Institutefor Research in Reproduction, Mumbai:
•
Workshop on Genotoxicity (August 18-29, 1997).
9
Workshop on Basic Molecular Biology for Clinicians
(December 2-11, 1997).
9
Training Course for Laboratory Animal Technicians
(June 16-JuIy 31, 1997).
•
Training Course for Laboratory Animal Supervisors
(September 1-November 29,1997).
Endocrinology
At the National Institute of Nutrition, Hyderabad:
•
Haematology
Annual Certificate Course on Endocrinological Tech
niques and their Applications (August 1-September
15, 1997).
At the Institute of Immunohaematology, Mumbai:
9
Training Course in Transfusion Medicine for Blood
Bank Medical Officers (August 27-October 24,
1997).
9
Training Course in Blood Group Serology and Blood
Bank Methodology for Blood Bank Technicians (Au
gust 27-September 26, 1997).
9
Training Course in Advanced Haematology and
Immunohaematology (October 6-24, 1997).
Nutrition
At the National Institute of Nutrition, Hyderabad:
9
M.Sc. in Applied Nutrition (June 1,1997-February 28,
1998).
•
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 1CMR Offset Press, New Delhi-110 029
R.N. 21813/71
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