ICMR BULLETIN VOL.6-No.-3-MARCH-1976
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- Title
- ICMR BULLETIN VOL.6-No.-3-MARCH-1976
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Vol. 6 No. 3
KLETIN
226, V Main/ I Block
Korem&ngala
Bangalore-560034
India
March, 1976
FUNCTIONAL SIGNIFICANCE OF GROWTH RETARDATION
DUE TO MALNUTRITION
Protein calorie malnutrition (PCM) in
young growing children is one of the most
widespread nutritional problems in many deve
loping countries, today. In India, 2 to 3% of
preschool
children
belonging
to
poor
communities suffer from the severe forms of
the disease like kwashiorkor and marasmus,
while 60 to 70% suffer from the mild and
moderate forms which manifest themselves as
varying degrees of growth retardation1. Margi
nal forms of PCM, which are diagnosed by
anthropometry, thus, appear to be a far more
serious problem from the public health point
of view.
Measurement of weight and height has been
most commonly
employed for assessing the
growth status of children. The interpretation
of anthropometric measurements requires the
use of standards. There is considerable debate
whether local or international standards are
more appropriate. To evaluate the development
of a given child, it is essential to have
standards which can be accepted to reflect
normal growth.
Standards
established on
children in Western countries have been widely
used for this purpose.
While the use of such
a reference standard may facilitate inter
regional and international comparisons, it is
obviously
essential to
work out
normal
standards for each community in order to
decide the true deviation of a given group
from the normal attainable by it in the light
of the genetic potential.
GROWTH AND DEVELOPMENT OF INDIAN CHILDREN:
The Indian Council of Medical Research
undertook a nationwide study to establish the
]uc i needed reference standard of growth and
eve lopment of Indian children, for the counas a whole, as well as for each of the
States in the country^.
The data, which was of a cross-sectional
nature collected from different parts of the
country revealed regional variations.
Mean
values for heights and weights of children
belonging to different States were found to be
significantly
different from one another.
Children from Punjab and Delhi were found to
be taller and heavier than those from Southern
States. Also, the mean values for heigats and
weights of children belonging to urban areas
were generally higher than those of: children.
from rural areas, throughout the period
of
growth.
However,
these differences were
statistically not significant.
Heights and weights were found to be
significantly influenced by the socio-economic
status: the figures being much higher in both
sexes in children belonging to the well to do
communities,indicating that adequate nutrition
and satisfactory standards of living enjoyed
by this group were responsible for better
growth.
Comparison
of
data
from
different
countries has revealed that the average Indian
child is shorter and lighter
than
it's
counterpart in USA and in Britain.
As the
Indian data are based on measurements of
children belonging to the lower socio-economic
groups, which form the majority of Indian
communities, these values cannot be considered
as representing standard values.
It has, in
the past, been suggested that there may be
racial differences in the genetic potential
for growth. Studies were, therefore,
under
taken to ob tain data on growth and development
of healthy, normal children in whom cons
traints imposed by malnutrition and infection
do not operate.
A cross-sectional study was undertaken by
the National Institute of Nutrition, Hyderabad
on a large number of healthy children attend
ing various public schools in different parts
of the country3.
These schools cater to the
educational needs of the really well-to-do
sections.
The heights and weights of these
children upto the age of 14 years were consi
derable higher than those of children belong
ing to low income groups and essentially simi
lar to those seen in well-nourished American
children. These data suggest, therefore, that
the genetic potential for growth of Indian
children is similar to that of children from
Western countries.
The growth retardation
observed among many Indian children would,
therefore, appear to be due to
environmental
factors, of which nutrition is an important
one.
In addition
to
these cross-sectional
studies, a study was carried out in a group of
well-to-do
boys of the
Hyderabad Public
School'.
Increments in height and weight
over a four year period were found comparable
to those seen in American children. More than
85% of children either maintained the normal
growth pattern
or showed improvement
in
relation to the American percentile values.
These data lend strong support to the earlier
observation that,given a satisfactory environ
ment, Indian children grow as well as those in
developed countries.
ASSESSMENT OF MALNUTRITION IN A COMMUNITY:
A variety of anthropometric indices based
on weight and height are currently in use to
quantitate
malnutrition
in a
community.
Weight for age, height for age, weight for
height, weight for height for age, and weight/
height^ have all been used as parameters of
growth status. Of these, two indices, namely,
weight for height and weight/height^ have been
shown to be age independent and are, there
fore, useful where ages of children are not
known with certainty.
The quantum of malnutrition in different
communities is often compared,though different
anthropometric indices are used to assess the
extent of malnutrition.
Such comparisons may
not be yalid, since the extent of malnutrition
2
computed by these various indices has now been
shown to vary widely.
In a study carried out
at Hyderabad, assessment based on weight for
age, indicated that almost all the children in
the community were malnourished5,while assess
ment using weight for height as the criterion
suggested that only 75% of the group were mal
nourished. It may, however, be pointed
out
that these criteria have been devised. with
different objectives in view.
For example,
the use of deficit in weight for age is pri
marily intended for assessing the magnitude of
the problem in a general way, while the cri
teria based on both, weight and height is
meant, in addition, to identify the severity
and duration of malnutrition.
Another important factor which signi
ficantly modifies the quantum of malnutrition
is the fixation of levels that
separate
normals from the malnourished.
These are
often
arbitrary
and by
shifting
these
levels even slightly, estimates can alter
considerably.
When 80% of the
standard
was used as the line of demarcation, the
prevalence rates of malnutrition were found to
be 5%, 83% and 27% respectively based on defi
cits in height for age, weight for age and
weight for height and when 90% of the standard
was used,the prevalence rates came down consi
derably. It is clear, therefore, that there
is an urgent need to develop me thods which can
be employed for the assessment of the true
extent of malnutrition in a community.
FUNCTIONAL SIGNIFICANCE OF GROWTH RETARDATION:
One of the rational methods of de termin
ing whether children showing growth re tar
da tion due to inadequate food intake are
really malnourished is to determine whether
they are in any way functionally handicapped.
Since body
size and
function
need not
necessarily always run parallel,
studies of
the relationship between physical size and
■physiological functions may be expected to
provide data on the meaning of various grades
of growth retardation. Recently, such studies
have been carried out at the National Insti
tute of Nutrition. Two functions - intestinal
absorption of nutrients and immunocompetence,
were measured.
Growth standards of the ICMR, were used
for classifying children into three groups
based on deficit in weight for age. Using the
50th
percentile
of the ICMR,
value as
representing the standard weight for age, the
observed weight was expressed as percentage of
the standard weight.
Apparently
healthy
children who had weights equal to or more than
80% of the standard were considered as normal
and those whose weights were between 60 and
80% of standard were classified as suffering
from mild-moderate PCM. Children with weights
below 60% of the standard were considered to
be suffering from severe PCM.
This group of
children invariably had clinical signs - they
were suffering from either kwashiorkor or
marasmus.
INTESTINAL FUNCTION:
It is
generally believed that under
nourished children suffer from varying degrees
of malabsorption and that this factor may be
important
in
aggravating
existing
mal
nutrition.
Intestinal function was, there
fore, assessed by studying absorption of two
specific nutrients - dietary fat and vitamin
B]2
and a substance which measures nonspecific absorption capacity - xylose.
All
children suffering from the two severe forms
of PCM showed
defective
absorption - the
extent of malabsorption showing considerable
variation between individuals.
However, in
none of the children with mild-moderate PCM,
was intestinal
function impaired?.
These
observations are contrary to what has been
believed so far and suggest that malabsorption
may not be an important factor in aggravating
PCM in children.
The public health signi
ficance of this observation, relating as it
does to the great majority of growth retarded
children, is obvious.
IMMUNOCOMPETENCE:
The interaction between malnutrition and
resistance to infection is well known. A num
ber of clinical, epidemiological and labo
ratory studies have shown that severe mal
nutrition increases
suscaptibility to in
fection.
The mechanism by which this occurs
is also known.
Since almost all studies in
the human situation have been done in very
severely malnourished children, studies were
carried out to determine the immunocompetence
of children suffering from various degrees of
growth retardation.
A number of parameters
such as phagocytic function of leucocytes,
cell mediated immune response, circulating
levels of immunoglobulins, concentrations of
secretory
immunoglobulins
and
antibody
response to specific bacterial antigens like
typhoid, diphtheria and tetanus were studied7.
In severely malnourished children, all
parameters excep t
circulating
levels
of
immunoglobulins
were impaired.
In mild-
moderate PCM, only the phagocytic function of
leucocytes and the immune
responses were
impaired and
these defects
appeared
at
different planes of altered growth status.
Phagocytic function was found to be impaired
when the weight deficit was 20% or more of the
standard,
while the cell mediated immune
response was altered only when the weight
deficit was at least 30%.
Antibody response
following
antigen
adminis tration
was
unimpaired in all mild-moderate PCM.
Simi
larly, secretory IgA levels remained normal.
These observations suggest that all innnunological functions are not equally sensitive
to altered nutritional
status.
They do,
however,
show that malnourished
children
whose weights are below 80% of the standard
(ICMR) are likely to be at increased risk.
since they surfer from at least one functional
defect which may result in lowered resistance
to infection.
Based upon the poor antibody response to
bacterial antigens seen in children suffering
from kwashiorkor and marasmus, it has some
times been suggested that national immunisa
tion programmas may not have the desired
effect in poor communities, unless coupled
with nutrition programmes.
However,
the
observations made here suggest that even under
existing conditions,
a great majority of
children
would respond
satisfactorily to
active immunization
procedures - an obser
vation of considerable public health impor
tance.
As indicated earlier, estimates of mal
nutrition in a community vary widely depending
upon the diagnostic criteria used.
The main
purpose of such estimates is not only to deli
neate the extent of the problem but also to
suggest
guidelines for action.
If only
anthropometric measurements are employed and
80% of the
weight standard
set up for
well-to-do children is used as the diagnostic
criterion, 75% of rural Indian children would
be classified as
malnourished
and these
children would, therefore, be considered as
needing nutritional intervention.
Not all
these children, however, show incompetence
with respect
to either their
intestinal
ahacrDjive function or their immune status.
Only children who have weights below 80% of
ICMR standard, which is equivalent to 60% of
the standards for well-to-do children, show
altered immunocompetence and may, therefore,
be considered at risk,. This classification
may be considered more appropriate, since it
is
based
upon
a
parameter
reflecting
functional status.
Such children constitute
about 10% of the total child population.
3
It must, however, be pointed out that in
these studies only two functional aspects of
growth retardation have been investigated. It
is essential to obtain information on as many
functions as possible to enable a proper
appreciation of the physiological significance
of growth failure.
Heights & weights of well-nourished Indian
School Children. No.18 page 24.
4.
Vijayaraghavan, K.,
Sastry, J.C.
and
Jindal, I. 1974.
Growth performance of
well-to-do Hyderabad children - A follow
up study. Indian J Med
62: 117.
5.
Sastry, J.G. and Srikantia, S.G.
1976.
Using heights and weights, how close are
our estimates of under-nutrition in a
community? Indian J Med Res. 64: 193.
6.
Reddy, V. and Mannni. 1976.
J Trop Paed
Environ Child HeaZ亡丸.
In press.
7.
Reddy, V., Jagadeesan, V., Raghuramulu,N.,
Bhaskaran, C. and Srikantia, S.G.
1976
Functional significance of Growth retar
dation in malnutrition.
Am J CZin Nutri.
29：工・
REFERENCES：
1.
Gopalan, C. and Vijayaraghavan, K. 1971.
Nutrition Atlas of India. National Insti
tute of Nutrition, Hyderabad.
2.
Vijayaraghavan, K.,
Singh, D.
and
Swaminathan, M.C.
1971.
Indian J Med
Res. 59: 648.
3.
ICMR
Technical
Report
Series.
1972.
，
ABSTRACTS
Some Research Projects completed in 1975
PEDIATRICS
Blood Zead ZeveZs Ln children with pica (19721975)
The aims and objectives of the scheme
were to study the prevalence of high blood
lead levels in children with a history of pica
and to identify sources of abnormal lead
exposure in these children.
Estimation of blood lead was carried out
in groups of children with pica, those using
surma, and those presenting with a variety of
complaints, which could possibly be sympto
matic of lead toxicity, such as encephalo
pathy, mental retardation and abdominal pain.
Children and adults living in a locality
contaminated with battery scrapings (found to
have a high lead content) were checked for
blood lead content. Blood lead estimation was
also done on control groups of children and
adults, presenting with none of the symptoms
known to be associated with lead toxicity. Of
the 199 control children, 5 or 2.5% were found
to have blood lead values of 40 megms per
100 ml or above (a value indicative of in-'
creased lead absorption). Of 71 adults 4.0 or
5. 63% had high blood lead values.
A signi
4
ficantly higher percentage of children in the
following groups had high blood lead values:
Children with pica 29 out of 175 or 16.6%;
children with encephalopathy 8 out of 39 or
20.5 %; children using surma 12 out of 83 or
14.4 %; and adults and children living in Motia
Khan area exposed to battery scraping 7 out of
11 or 63.7%.
Multiple articles of the
environment
tested included water from taps and other
sources, fresh water and after storage in
different containers, spices, soil, surma and
surma rock, battery scrapings from the Motia •
Khan area, articles used in cosmetics such as
kajaL and sW九do。!*, paints, whitewash, alu
minium vessels, kaLaz or tinning material,
petrol, kerosene, samples of pottery and other
miscellaneous articles.
A high concentration
of lead was found only in surma, surma rock
and battery scrapings.
Water had lead levels
well below those recommended as safe by the
WHO (50 mcg/L). Higher levels were found only
when it was stored exclusively in lead pipes.
Taps with a connecting lead pipe in which
water had stood overnight showed lead values
well below the limit of 300 mcg/L, set by WHO
for tap water stored in pipes for 16 hours.
Almost all pottery samples were in the safe
range of 2 ppm leachable lead or less as
recommended by the Indian Standards Institute.
In
conclusion,
environmental
checkshowed surma and battery scrapings to be the
main articles with possible risk of environ
mental lead toxicity.
Dr. Seeta Sinclair
Associate Prof, of Pediatrics
All India Institute
of Medical Sciences
New Delhi.
Dr. N.K. Bhide
Prof. & Head of the
Deptt. of Pharmacology
All India Institute
of Medical Sciences
New Delhi.
Dr. N. Basu
Chemist
Department of Pharmacology
All India Institute
of Medical Sciences
New Delhi.
ICMR/WHO SEMINAR ON STREPTOCOCCAL INFECTIONS AND
THEIR SEQUELAE-NEWER ASPECTS IN LABORATORY
DIAGNOSIS & CONTROL (FEBRUARY 23-27, 1976)
A Seminar on Streptococcal Infections and
their sequelae-newer aspects in laboratory
diagnosis & control-was held in the Department
of Microbiology, Christian Medical College &
Hospital, Vellore from February 23-27, 1976.
The faculty consisted of Dr. J. Rotta, WHO
Consultant> Chief, WHO Streptococcal Labo
ratory
Prague,
Czechoslovakia
and
Dr.
Grace Koshi, Prof, of Microbiology, Christian
Medical College, Vellore.
In addition to 16
participants from laboratories of Southern
India, 5 guest observers attended the seminar.
The seminar considered the bacteriological,
serological and epidemiological aspects of
group A streptococci, including the preser
vation of these organisms by Sand Dessication.
At the conclusion of the seminar it was
felt that, in the not very distant past, there
was little information on the prevalence of
pathogenic
streptococci
and strep tococcal
diseases in the countries of the tropical and
subtropical zones.
In recent years, however, there has been
an increasing inflow of information, purport
ing that haemolytic streptococci are highly
prevalent in these areas and the incidence of
group A streptococcus infection is much higher
than was believed in the past.
In fact, the
carriership of beta haemolytic streptococci in
the upper respiratory tract of the populations
of tropical and subtropical areas of Asia is
of the same order as found in the temperate
zones.
There is sufficient data documenting that
skin infections due to haemolytic streptococci
represent a very important health problem in
the tropical and
subtropical areas.
In
addition, group A streptococci cause respi
ratory infections which are responsible for
the considerable incidence of rheumatic fever
and rheumatic heart disease. Acute glomerulo
nephritis in the tropics
and subtropics,
however, is much more frequently seen after
group A s trep tococ cal skin infection than
after respiratory disease.
More information is urgently needed to
elucidate the real
significance of these
findings.
This can be done through adequate
clinical,
bacteriological,
serological,
epidemiological and histopathological investi~
gations. Pilot studies should be carried out
in
centres
where
prerequisites
can be
established for such research and for the
application of the results to practice.
SUMMARY OF LECTURES DELIVERED AT ICMR, NEW DELHI
FORTIFICATION OF COMMON SALT WITH IRON BY DR.
B.S.
NARASINHA RAO,
DEPUTY
DIRECTOR,
NIN,
HYDERABAD ON 20.2.1976.
Iron deficiency anaemia is one of the
major public health problems of nutritional
origin in India. Fortification of common salt
with iron has been considered a practical and
an effective method of providing additional
iron to the at risk population groups in India
to combat this disease. An important technical
problem in the fortification of salt with iron
is the selection of a suitable iron source.
Four iron sources were investigated as to
5
their suitability for fortifying salt: in
soluble iron
compounds,
ferrous citrate,
ferrus sulphate with stabilizing agents, and
ferric
orthophosphate
with
absorption
promoters.
Two important criteria used in
selecting the iron source were stability of
the fortified salt on storage under high
humidity conditions
and satisfactory bio
availability of iron from it, when given with
a meal.
Insoluble iron salts:
Salt
fortified
with
insoluble iron
compounds like ferric orthophosphate, ferric
pyrophosphate, and sodium iron pyrophosphate
did not
develop any
colour even
after
prolonged storage.
However, absorption of
iron from these compounds was unacceptably
low, particularly when ingested with food.
Ferrous citrate:
Absorption of iron from ferrous citrate
was almost similar to that
from ferrous
sulphate, when given alone or with a meal.
11*s stability, however, when added to common
salt was poor as it developed a yellow colour
on mixing and storage.
Ferrous sulphate with stabilizing agents:
Since an ideal iron compound like ferrous
sulphate develops colour readily when added to
salt, the possibility of using
stabilising
agents to prevent colour change was studied.
Of the several stabilising agents tested, only
Salt fortified with
two were satisfactory.
ferrous sulphate (2500 ppm), sodium hexametaphosphate (2500 ppm) and sodium acid sulphate
(155 ppm) remained without any colour for
several months. However, availability of iron
from this combination was poor as compared to
ferrous sulphate.
The other agent, ortho
phosphoric acid (2500 ppm) wher. added to salt
along with ferrous sulphate (2500 ppm) also
prevented colour change, even after several
months of storage but absorption of iron from
this mixture, although satisfactory initially,
decreased considerably during storage.
Ferric phosphate and absorption promoters:
Four chemical agents viz: ascorbic acid,
cystine,
sodium citrate and
sodium acid
sulphate were
tested for improving
iron
absorption from salt fortified with ferric
orthophosphate. It was observed that only in
the presence of sodium acid sulphate the
fortified salt was stable and iron absorption
6
from FePOq improved significantly.
Salt was therefore, fortified with ferric
phosphate (3500 ppm) and sodium acid sulphate
(5000 ppm).
This fortified salt was stable
and bioavailability of
iron from it was
comparable to ferrous sulphate.
It was found
to be generally acceptable for cooking by
families of different
socio-economic back
grounds .
These studies indicate that sale can be
successfully fortified
with ferric orchophosphate and sodium acid sulphate. An intake
of 15g fortified salt which is the average
salt intake in India would provide 15 mg of
additional iron per adult per day. Since 3-4%
of this iron is absorbed, it would provide
about half the daily requirement.
Forti
fication of salt according to this formula on
a commercial scale and trials to determine
its
effectiveness
in
imp roving
iron
status
under
actual
field
nutritional
conditions are currently under study.
SOME
ASPECTS
OF BCG VACCINATION
BY
DR,
RAJ NARAIN, FORMER PROJECT
DIRECTOR,
TUBER
CULOSIS PREVENTION TRIAL,
BANGALORE, ON 19TH
MARCH, 1976.
A large scale BCG trial in the northern
part of Chingleput District, has been carried
out since 1968.
Some 264,000 persons were
given either 0.1 mg dose or 0.01 mg dose of
BCG vaccine or an injection with a placebo.
At the time of vaccination, the population was
also tested with 5 IU of PPD-S and 10 units of
PPD-B.
This population was kep t under cons
tant supervision with frequent X-ray esti
mations and sputum cultures.
BCG is believed to benefit only persons
in whom the size of reaction to tuberculin is
0-7 mm.
Of the new cases, which developed
during the first 4 years of follow up, 62
(less than 3%) were from among those with an
initial size of reaction of 0-7 mm.
Although
this number is too small for arriving at any
conclusions, it is evident that with 100%
efficacy, BCG could have prevented only about
3% of the total cases in this population, over
a period of 4 years.
It will take some time
before the preventive value of BCG in this
population can be assessed with any degree of
accuracy.
Some other important results of the study
obtained so far were:
i.
BCG vaccination of tuberculosis patients,
as compared with the placebo injected
controls, did not appear to increase the
mortality rate nor did it lead to a
greater breakdown of existing lesions
amongst the patients.
ii.
BCG vaccination rendered the tuberculin
test almost useless. Even 4 years after
vaccination,
it was not possible to
identify the newly infected in the group
vaccinated with the weak dose, although
it was easily done in the
placeboinjected controls.
iii. Post-vaccination allergy waned rapidly in
the population under study and by the end
of 2 1/2 years,the difference in the mean
size of tuberculin allergy between the
vaccinated (0.1 mg dose) and the placeboinjected controls was only 4 mm.
Three
months after vaccination this difference
was 12 mm. The reason for and the signi
ficance of this waning is not known.
A method to calculate mortality due to
tuberculosis in children of the age group 1-4
years was described. This was based upon the
difference in total mortality rates for two
ICMR
JAPANESE LEPROSY MISSION FOUNDATION, AGRA
The leprosy centre at Agra was estab
lished by the Japanese Leprosy Mission Founda
tion, in 196p, with the major objective of
care of leprosy patients in the hospital and
to undertake research on certain aspects of
leprosy. During the last 10 years this insti
tute has done commendable work in establishing
an active centre for care of leprosy patients
and
of late
it has undertaken
certain
research
projects
in
sero-diagnosis
of
leprosy.
It has also established
three
peripheral out-patients units so as to cover a
larger number of leprosy patients.
This
centre is to be taken over by the Ministry of
Health and Family Planning on the 31st of
March, 1976.
The Ministry plans to hand
over the centre to the Indian Council of
Medical Research with a view to its being
developed as a centre for research, training
and service.
studies, one in rural areas and the other in
Madras city.
Children with 12 mm or larger
size induration to the tuberculin test were
The method
regarded as
infected cases.
depends on the basic assumption that the
difference in mortality for infected and non
infected children is entirely due to tuber
culosis .
It was estimated that about 16 per
thousand of infected children in this age
group died as a result of
tuberculosis.
Mortality due to tuberculosis in non-infected
children was 0.17 per thousand per annum in a
rural population and 0.94 per thousand in a
part of Madras city.
Of the total deaths,
less than 5% in the rural population and about
46% in Madras city were due to tuberculosis.
The reason for this difference in tuberculosis
mortality rates between the city and the rural
areas could be that the protected water supply
and/or other public health measures reduced
the total mortality in Madras city but at the
same time mortality due to tuberculosis was
not affected, in fact was relatively in
creased.
In absolute terms prevalence of tuber
culosis and mortality due to it were also
higher in the city of Madras.
NEWS
A COURSE IN CLINICAL CHEMISTRY & INSTRUMENTA
TION FOR TSS FELLOWS
A course in Clinical Chemistry & Instru
mentation was held at the National Institute
of Nutrition, Hyderabad from March 1-10, 1976.
Twelve fellows attended
the course which
consisted of lectures,
demonstrations and
practicals. Apart from the principles and use
of biochemical instruments and techniques,
emphasis was laid on the practical application
of biochemical methods in modern medicine.
The course included a visit to the clinical
section of the Institute at the
Osmania
Medical College, Hyderabad.
COURSE IN HAEMATOLOGY:
A certificate course in Blood Banking Techno
logy and Haematology for medical officers is
being held by the Council at the Blood Group
Reference Centre, Bombay and
Postgraduate
Institute of Medical Education and Research,
Chandigarh for a period of twelve weeks from
16th February, 1976 to 14th May, 1976.
OBITUARY
Ihe Council announces with deep regret the sad
demise of Prof. Sujoy B. Roy, Head of the
Department of Cardiology, All India Institute
of Medical Sciences, New Delhi.
Prof. Roy
died in New Delhi after a short illness.
He
graduated from the Rangoon Medical College,
Rangoon and after postgraduate studies in
England and the United States joined the
Institute in 1958.
Prof. Roy was associated
with the ICMR for ' over 15 years and in
addition to his studies on Rheumatic Fever
collaborated with the defence services in an
ICMR Project to study the problem of cardioHe was
respiratory systems at high altitude.
Honorary Cardiologist to the President of
India and was awarded the Padma Bhushan in
1975.
COUNCIL'S TRAINING PROGRAMMES FOR 1976-77
(A) EXISTING ANNUAL TRAINING COURSES:
Immunology:
Nutrition & Endocrinology:
At the National Institute of
Hyderabad.
Nutrition,
At 1cMR/WHO Research and Training Centre
in Immunology,Department of Biochemistry,
A.I.I.M.S., New Delhi.
*Annual
(1)
Annual Certificate Course in Mutrition;
(December 1, 1976 to February 28, 1977)
(2)
M.Sc.
(Applied . Nutrition)
Course:
(June 1, 1976 to February 28, 1977)
(3)
Annual Certificate Course in Human Nutri
tion for Teachers in Agricultural Uni
versities :(August - October, 1976)
(4)
Annual Training Course in Endocrinologi
cal Techniques and their Application:
Reproductive Biology and Fertility Control:
At the Institute for Research in
duction, Bombay.
Rep re
(1)
Annual Certificate Course in Reproductive
Biology and Fertility Control: (November
1, 1976 to April 30, 1977)
(2)
Annual Training Course on Hormone Assays:
(February 1, 1977 to March 31, 1977)
(3)
Annual Training Course in Endocrinology
and Fertility Control: (October, 1976)
(4)
Annual Training Course in Cytology
Cytogenetics: (September, 1976)
and
Training
Course
in
Immunology
Animal Technicians Training:
At the Laboratory Animals Information
Service, National Institute of Nutrition,
Hyderabad.
Ninth Annual Animal Technicians Training
Course:(For a period of three nonths from
September 1, 1976)
Biostatistics:
At the National Instituce of
Hyderabad.
Nutrition,
*Third Training Course in 3iosuacistics
for Statisticians and 'lecical Research
Workers.
(B) NEW TRAINING COURSES DURING 1976-77:
Vi rology:
*At the Virus Research Centre,
Diploma course in Virology.
Poona.
Anobiasis:
Haematology:
At the
Bombay.
Blood
Group
Reference
Centre,
Comprehensive programme in Blood Banking
Technology and Basic Haematology: (For a
period of 3 months from February 15,1976)
A
At the
cutta.
School of Tropical Medical,
Cal
Technician's Training Course in the field
of Amoebiasis: (For a period of three
months from April 1, 1976)
graduate Institute of Medical Education
and Research, Chandigarh.
Occupational Health:
At: the National Institute of Occupational
Health, Ahmedabad.
(1) *Pneumoconiosis:
This course, meant for the medical prac
titioners to be organised in co-operation
with Directorate of Mines Safety, Dhanbad.
(2) *Diploma in Occupational Health for the
year 1976-77 under Gujarat University.
Pharmacology and Drug Trials:
(2) *A long-term
training.
course
At the National Institute of
Hyderabad. March 1-10, 1976.
Nutrition,
Cell-Biology and Cyto-Genetics:
At the
Indian Institute of
Bangalore. April 12-21, 1976.
Science,
Principles & Methods in Medical Statistics:
At Dr. U.K. Sheth's Unit, Seth G.S. Medi
cal College, Bombay.
(1) *A short-term
training.
Biochemistry & Instrumentation:
four
for
*At the Tuberculosis Chemotherapy Centre,
Madras.
weeks1
Courses in Immunological Techniques:
course
for
twelve
weeks1
*At the Department of Biochemistry, AIIMS,
New Delhi.
(C) COURSES FOR TALENT SEARCH SCHEME FELLOWS:
Haematological Techniques:
*At the
-I
Department of£ ,,
Haematology,
0*.
Post-
*Dates to be announced later
INDIAN COUNCIL OF MEDICAL RESEARCH
TECHNICAL REPORT SERIES
1.
Research in Medical Education 1970
2.
Research in Health Practices 1970
3.
Acute Encephalopathy Syndrome in
1970.
4.
Technical Review
India 1970
5.
Exfoliative Cytology 1971
6.
Symposium on Nutrition
1971
7.
Developments in
India 1971
8.
Study Group in Urolithiasis 1971
18. Growth and Physical Development of
Infants and Children 1972
Indian
9.
Proceedings of Seminar on Immunity and
Immunoprophylaxis in Cholera 1971
19. Review of Work Done in Rural Water
in India 1972
Supply
on
10. Assessment of the National Filaria Control
Progranme (India 1961-70)
1971
Children
Pneumoconiosis
and
in
11. Diagnosis and Treatment of Pesticide Pois
oning 1971
12. Symposium on
Drugs 1972
13. Techniques in Blood
Heart Disease
Industrial Psychology
in
Evaluation
Clinical
Group
14. Laboratory Methods in
Thyroid Diseases 1972
of new
Serology 1972
Investigation
of
17. Proceedings of the First Annual Meetings
of the Indian Academy of Cytologists 1972
9
20. Genetics and our Health 1972
titis and Study Group
gen, 1971
21. All India Conference on Research in Repro
duction and Fertility 1973
22. A study of Morbidity Patterns and Standard
of Medical
Care
in the Rural Health
Centres of West Bengal 1973
23. Proceedings of the First All-India
shop Conference oh Stroke, 1971
Work
on Australia
25. Atlas of
Histopathology
of
Hepatitis and Cirrhosis, 1974
Liver:
26. Studies on Pre-school Children 1974.
27. Studies on Weaning and Supplementary Foods
1974.
24. Proceedings of Seminar on Infectious Hepa
(Price Rs.4/- each except No.25 = Rs.10/-)
(Available from Division of Publication & In
formation, Indian Council of Medical Research,
Ansari Nagar, New Delhi-110016)
EDITORIAL BOARD
Chairman
Dr. C. Gopalan
Director-General
Edi tor
Dr. S.V. Apte
Anti
Members
Prof. Usha K. Luthra
Dr. Sabita Tejuja
Dr. A.D. Taskar
Dr. G.V. Satyavati
Printed and Published by Shri Prem Chand for the Indian Council of Medical
Research, New Delhi at the ICMR Offset Press, New Delhi.
R.N. 21813/71
Position: 1894 (15 views)