ICMR BULLETIN VOL.19-No.-10-OCTOBER-1989
Item
- Title
- ICMR BULLETIN VOL.19-No.-10-OCTOBER-1989
- extracted text
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t"ag49 Ise990
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COMMUNni *‘
176 V Main, 1 Block
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Vol. 19 No.10
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ISSN 0377-4910
October, 1989
TRAINING OF NON-PSYCHIATRIST PRIMARY CARE
DOCTORS IN PSYCHIATRY
There is a wide gap between the mental health needs
of the community and the available psychiatric services in
India1. The psychiatric morbidity among the patients of
general practitioners.(GPs) is about 36 per cent2 and
about 27 per cent3 among outpatients of general
hospitals. The GPs who ideally can and should shoulder
greater responsibility in psychiatric services in the
community are ironically the least adequately trained,
especially in developing countries like India4. Even
countries like Britain with advanced and extensive health
services acknowledge the role of non-psychiatrist doctors
in extending the psychiatric services to the community^6.
primary care doctors who have had functionally
inadequate undergraduate training in psychiatry. It is
practically impossible in such short programmes to train
a primary care doctor to acquire an expertise in managing
psychiatric patients. A modest effort exposing the doctors
to clinical psychiatry in an introductory manner in order
to stimulate their self-learning interest would definitely be
practicable. Such programmes must be clinically oriented
with case discussions and demonstrations. The
NIMHANS, Bangalore had been attempting to achieve
this objective through programmes ranging from 6 to 20
sessions.
In an effort to overcome this problem the National
Mental Health Programme7 had declared the training of
non-psychiatrist primary health care doctors in
psychiatry as a necessary component of extending
essential psychiatric services to the community. The
Department of Psychiatry at the National Institute of
Mental Health and Neurosciences (NIMHANS),
Bangalore has been experimenting with short training
programmes for primary care doctors, including GPs,
and with methods of evaluation since 1977
(Shamasundar, 1986 unpublished data).
The evaluation of such short training programmes
must necessarily be: (i) simple and capable of
administration in a short time; (ii) clinically biased and
able to assess different levels of knowledge; and (iii) easy
to score with inter-rater reliability and replicability.
Short duration training programmes acquire
significance as the available specialist manpower in our
country is too small as compared to the large number of
To fulfil these criteria the theoretically biased essay
type questions and the multiple choice questions that
suggest their own answers are unsuitable; ‘live’ clinical
examination, on the other hand, are very time consuming
and not easy to assess. Over the years, NIMHANS has
found that use of clinical vignettes along with a set of
simple questions can serve the purpose quite well.
On the basis of the work done at N1M H ANS in this
field, the ICMR .initiated a multi-centre study on
Division of Publication & Information, ICMR, New Delhi - 110 029
“Training Non-Psychiatrist Primary Care Doctors in
Psychiatry”, with NIMH ANS as the coordinator. The
project was carried out in 1982-83 at three centres viz
NIMHANS, Bangalore; Government Hospital for
Mental Care, Hyderabad; and Christian Medical College,
Vellore.
The main objectives of this study were to test the:
(i)
(ii)
efficacy of the short training programme by
assessing the extent to which the doctor became able
to identify (diagnose) common psychiatric
problems, indicate simple lines of management for
the above/suggest suitable advise to patient and
family members; and know when to refer;
replicability of the programme at
collaborating centres; and
their side effects, and management of side effects;
(iii) advise to be given about illness, drugs and work;
(iv) when to refer; and (v) a set of 6 questions on
attitude towards the illness.
A scoring key was used for scoring. The maximum
score per vignette was 18(12 for clinical questions and 6
for attitude questions) and the numerical value of the
score indicated the level of desirable knowledge.
The Efficacy of Vignettes
The three collaborating centres administered the
vignettes to batches of doctors as shown in Table 1.
Table I. Administration of vignettes to different groups of
doctors at 3 centres
the three
(iii) efficacy of the vignettes as a tool of assessment by
ascertaining inter-rater reliability in scoring, the
ability of the vignettes to reflect different levels of
knowledge, and consistency in their performance
with different populations.
Untrained GPs
Set ‘A’
Set B'
Total .number
vignettes
vignettes
of protocol 4
7
10
17
II
16
27
20
20
40
22*
22*
44
60
68
128
(Hyderabad)
Preparatory Exercises
Preparatory exercises were carried out for the
purposes of familiarising all the collaborating
investigators in (i) conducting the training programme in
a fairly uniform manner, (ii) administration and scoring
of the vignettes. and (iii) to establish the inter-rater
reliability and other characteristics of the vignettes.
I.
2.
A week long workshop was held where a small batch
of 9 GPs were trained over a period of 6 days in 12
sessions. Investigators from all the 3 centres jointly
participated in the programme, discussing the
proceedings at the end of each day. This programme
was structured similar to the planned programme.
The vignettes were 12 in number, divided into two
sets ‘A’ and ‘B‘ with 6 vignettes each. The vignettes
were so constructed that each vignette of one set had
a similar one in the other set representing the same
diagnosis. The six diagnoses were: Hysteria,
Depression. Psychogenic somatic condition.
Epilepsy, Schizophrenia. and No psychiatric
diagnosis (NPD or Dymmy'). The purpose of the
two sets of vignettes was to ensure that the same GP
would not get the same vignettes at pre- and posttraining assessments. Each vignette consisted of
brief descriptions of 5 to 7 features characteristic of a
major diagnosis? Each vignette was accompanied by
a set of standard questions about: (i) the diagnosis
(multiple choice): (ii) drugs if any to be used, dosage.
104
Untrained GPs
(Vellore)
Previously trained
GPs (Bangalore)
2nd and 3rd year psychiatry
residents (Bangalore)
Total
* Twenty residents were administered both set ‘A* and set ‘B*.
Twenty six (20%) of the 128 protocols werd
independently scored by the three principal investigators
of the centres for calculating the inter-rater reliability by
correlation co-efficient (r-value). The r-values ranged
from 0.94 to 0.98 confirming a high degree of inter-rater
reliability.
The remaining 102 protocols were randomly divided
into three lots, each being scored at one centre. The mean
scores for different groups of doctors were compared by
one way analysis of Variance (Table II). The scores
confirmed the ability of the vignettes to reflect different
levels of knowledge.
The two sets of vignettes 'A' and 'B' were equivalent
(as shown in Table II). This equivalence was also
Table II. Comparison of mean score by different groups of
doctors by one way analysis of variance (F‘ value).
Maximum score = 108
Set ‘B* vignettes
Set 'A' vignettes
Mean
score
N
%of
max.
score
Mean
score
N
%of
max.
score
Untrained GPs
(Hyderabad)
50.5
7
46.8
51.1
10
47.3
Untrained GPs
(Vellore)
67.3
11
62.3
58.6
16
54.5
Previously trained
GPs (Bangalore)
72.5
20
67.1
70.8
20
65.6
2nd and 3rd year
psychiatry resi
dents (Bangalore)
79.9
22
74.0
78.7
22
72.8
*P value
3.7107
4.9661
P <0.01
P < 0.05
3.56
3.65
Significance
df
and counselling. The contents of the manual were
clinically oriented with the case examples.
The programme comprised 13 afternoon sessions of
two hours each, one or two sessions a week, depending on
the convenience of the investigating centre. Each session
consisted of initial brief lecture based on the contents of
the respective section of the manual followed by open
discussion. In those sessions where clinical syndromes
were covered, there were case demonstrations, followed
by open discussion on clinical material. Major topics like
depression were allotted two sessions, and minor topics
were condensed into single session. A standard set of
slides were duplicated and used by all the 3 centres. Preand post- training assessments were administered in the
first and the last sessions. The post training assessment
also included a set of questions enquiring about the GP
trainee’s own opinion about the programme.
The vignettes-protocols from all the 3 centres were
pooled, coded and randomly divided into 3 batches. Each
batch was scored by a Principal Investigator. The scores
were analysed to assess the efficacy of the programme.
Replicability of the Training Programme
confirmed when the mean scores and SDs for the two sets
of vignettes by the same 20 psychiatry residents were
compared by paired ‘t‘ test for each diagnosis, and the‘t’
values ranged from 0.2944 to 0.8499.
The Main Training Programme
By the use of local Indian Medical Association
(IMA) mailing listsand a questionnaire, 100eligibleGP’s
with MBBS qualification, aged 30 to 50 years were
identified at each centre. By a random sequence, these
GPs were offered a short training course in psychiatry till
about 35 GPs volunteered and registered forthetraining.
The characteristics of the GP populations (eligible,
registered for training and unregistered) were compared
within each centre and across the 3 centres, on,4
parameters (age, sex, number of psyhiatric patients and
epileptic patients referred in last 3 months). Except for
differences in the variables of age and sex across the
centres, the populations were comparable in other
respects.
All the three centres carried out a similar training
programme using the same manual and content
curriculum. At the beginning of the training programme,
a cyclostyled manual of 100 typed pages was given to each
GP trainee. The manual consisted of 13 sections covering
Introduction and classification, Major symptoms and
signs, History taking and interviewing, Six clinical
sections, Psychiatric emergencies, Psychopharmacology
When the mean pre- and post-training scores were
compared, the performance of the 3 centres were similar
for the clinical questions (Table III).
Table III. Comparison of pre- and post-training mean score for
three centres
Bangalore
(N=30)
Hyderabad
(N=33)
Vellore
(N=34)
‘p* value by
one way
analysis of
variance
Pre-training
26.4 ± 10.7
28.6 ± 7.1
24.6 ± 9.9
NS
Post-training
35.6 ± 11.6
36.2 ± 12.7
40.1 ± 12.9
NS
‘p* value by
paired *t* test
<0.001
<0.01
<0.001
Pre-training
29.8 ± 3.1
31.4 ± 3.1
28.0 ± 5.2
<0.01
Post-training
32.1 ± 2.7
32.4 ± 2.9
31.6 ±3.3
NS
‘p* value by
paired 't' test
<0.01
On Clinical questions
max. score=72
On Attitude questions
max. score = 36
NS
<0.001
Values are Mean ± SD
105
These findings indicate that (i) the pre-training level
of knowledge of GPs at the 3 centres were comparable; (ii)
their gain in knowledge by training was also comparable.
That is, the effect of the training programme at different
centres have been copsistantly similar; and (iii) the slight
differences in gain at different centres are probably
attributable to minor differences in the manner and style
of the investigator-trainers.
The pre-training performance on attitude questions
was quite high, of the order of about 80 per cent of the
maximum, indicating that at least the urban GPs have
appropriate attitudes indicating redundancy of attitude
questions in assessment of training. Nevertheless, the
gains ranging from 2.8 percent to 10 percent is interesting
because the topic of attitudes was not included in the
training programme. The implication of this is that the
GPs were capable of extracting the corollaries of what is
taught which can be termed “indirect learning”, and
hence, it is not necessary in short courses for
comprehensive details about the subject taught.
The Efficacy of the Training Programme
Table IV. Question-wise mean scores on clinical questions
shown as percentage of maximum for each question. All
diagnoses and all centres combined
1. Diagnosis
2. (a) Drugs
(b) Dosage
(c) Side-effects
(d) Management of
side-effects
3. Advise about:
(a) Illness
(b) Drugs
(c) Work
4. Disposal (when
to refer)
1.
106
Pre-training
Post-training
Even though GPs are moderately knowledgeable
about the drugs to be used (or not used) even before
training, their knowledge on dosage, side-effects and
their management was inadequate.
3.
With respect to the advice to the patients and their
family members , despite gains of the order of 0.1 per
cent to 14.4 per cent, the post-training performance
of the GPs remained comparatively poorer. This is
probably related either to their insufficient
receptivity to these issues or to insufficient emphasis
during training, or perhaps to both.
4.
The very poor performance of the GPs before and
after training on the question of disposal was
traceable to effect of the degree of confidence
acquired by them. When a number of protocols were
randomly examined it was found that: (i) before the
training, majority of GPs wrote: “....will refer to a
psychiatrist”, (ii) after training, majority of GPsg
wrote: “....I will treat the patient myself,”, or “no"
need to refer”.
The GPs Performance on Different Diagnosis
The question-wise performance of all the GPs for all
the diagnosis combined is seen in Table IV. It confirms
that all the criteria of efficacy of the training are satisfied,
though to varying degrees:
Question on
2.
Gain by
training
73.8
55.6
39.1
28.6
27.4
86.2
72.1
63.1
47.0
47.7
12.4
16.5
24.0
18.4
20.3
29.8
22.0
44.5
42.3
36.4
53.6
12.5
14.4
9.1
16.6
26.8
10.2
The high pre-training ability (73.8%) of GPs to
diagnose is probably partly spurious due to the
multiple choice nature of the question on diagnosis.
Open ended question like other questions would
have been desirable.
Table V shows the diagnosis-wise performance of the
GPs at all the 3 centres. The relatively poor performance
and gain in respect of ‘No-psychiatric-diagnosis’ is
probably related to: (i) the difficulty of constructing a'
vignette seemingly representing a pathology but not
amounting to the syndrome, (ii) the natural tendency of
the assessee to make a diagnosis of illness. Inclusion of
vignette of ‘No-psychiatric-diagnosis’ may not be
necessary for assessment.
Table V. Comparison of pre- and post-training mean scores for
diagnosis on clinical questions. Three centres combined.
Max. score = 72, N = 97
e
Pre-training
Mean
Post-training
Mean
No psychiatric diagnosis
31.3
37.1
5.8
Hysteria
17.2
26.9
9.7
Depression
18.7
35.3
16.6
Psychogenic somatic
condition
28.4
36.9
8.5
Epilepsy
40.0
46.1
6.1
Schizophrenia
22.6
42.3
19.7
All diagnosis combined
26.4
37.4
11.0
Mean gain
The maximum gains for depression and
schizophrenia, and least gains for hysteria and
psychogenic somatic condition are perhaps related.to the
concreateness and precision of respective clinical
information taught.
•
The high pre-training score and low gain for epilepsy
indicate that (i) it may not be necessary to include
epilepsy, (ii) probably, the investigator-trainers did not
lay much emphasis on this condition.
It is necessary in subsequent training programmes to
lay more emphasis on those topics and diagnosis in which
the post-training performances and gains were
comparatively poorer.
The GPs Opinion about the Training
The opinion of the 102 doctor-trainees suggests the
following areas for further improvement in the training
programme:- (i) There is a need to study thoroughly the
kind of psychiatric patients who commonly attend GPs
clinics in terms of their presentations and diagnosis; (ii)
Case history examples in the manual as well as the
contents of the lectures are to be formulated on the basis
of the above; and (iii) Demonstrations must form a major
part of such training programmes.
In conclusion, it can be stated with, confidence, that
the short course of Psychiatry training of 13 sessions, not
only contributed to fair increase in the knowledge of the
GPs, but is replicable on different GP populations.
References:
1.
Neki. J.S. Psychiatry in South-East Asia. Brit J Psychiai 123:
257. 1973.
2.
Krishnamurthy. S.. Shamasundar. C.. Omprakash and
Prabhakar, N. Psychiatric morbidity in general practice—A
preliminary report. Indian J Psychiai 23: 40: 1981.
3.
Murthy# R.S., Kuruvilla, K.. Verghese. A. and Pulimood, B.M.
Psychiatric illness at general hospital medical clinic. J Indian
Med Assoc 66: 6. 1976.
4.
Lin, T.Y. The demands for psychiatrists—Discussion. In: The
Training of Psychiatrists. Eds. G.F.M. Russell and H.J.
Walton. Brit J Psychiai Special Pub I. No.5, 1970.
5.
Editorial. Training the basic doctors. Lancet ii: 1361. 1974.
6.
Editorial. Primary care of mental illness. Lancet ii: 1362. 1974.
7.
DGHS. New Delhi. National Mental Health Programme. 1982.
This write-up. by Dr. C. Shamasundar. Department of Psychiatry
NIMHANS. Bangalore, is based on the Report of the ICMR multi
centric study on “Training Non-Psychiatrist Primary Care Doctors in
Psychiatry” (1982-83).
ABSTRACTS
Some Projects Completed Recently
Urinary inhibitors of calcium oxalate crystallisation in
normal population and in stoneformers.
An assay system involving the measurement of rate
of calcium oxalate monohydrate (COM) seed crystal
growth in a metastable solution of calcium chloride and
sodium oxalate containing traces of ,4C-oxalic acid was
standardised. Low molecular weight inhibitors' viz
pyrophosphate and citrate caused a 50 percent decrease
in crystal growth rate at 1.5XI05M and, 2.85X10"4M
concentration respectively.
Fifty stoneformers and 25 healthy controls were
analysed for lithogenic substances and inhibitory activity
towards"COM crystal growth in urine. The stoneformers
revealed a significant hypercalciurea and hyperuricosuria
as compared to controls with no significant difference in
the excretion of urinary oxalate and inorganic
phosphorus in two groups. A significant negative
correlation observed between urinary inhibitory activity
and uric acid levels in stoneformers indicated that
hyperuricosuria indirectly predisposes to calcium oxalate
lithiasis by decreasing the urinary inhibitory activity.
The circadian biology of lithogenic substances in
urine of stoneformers showed statistically significant
circadian rhythm for organic phosphorus only (T=24h,
A°=OO38) and an ultradian rhythm for calcium excretion
(T=8h, A°=0205). Urinary calcium and oxalate
concentrations showed an almost coinciding acrophase
at 1520h and 1536h respectively, thereby showing high risk
for calcium oxalate precipitation at this time. The
cohorts of stoneformers showed significant mesors with
respect to urinary volume, creatinine, oxalate and uric
acid excretion. However, the cohorts of stoneformers did
not differ significantly from the stoneformers with
respect to calcium and inorganic phosphorus excretion.
Cosinor rhythmometry of urinary citrate excretion
revealed a significant circadian rhythmicity in healthy
107
subjects which was absent in stoneformers. Circannual
variation in 24h urinary excretion of lithogenid
substances showed increased excretion of calcium in
winter (October-March) and a gnificantly decreased
excretion of inorganic phosphorus in summer (JuneSeptember). Increased tendency towards calcium and
uric acid excretion and decreased tendency towards
oxalate excretion was observed after the surgical
procedure amongst stoneformersand non-stoneformers.
S.K. Thind
Department of Biochemistry
Postgraduate Institute of
Medical Education & Research
Chandigarh.
Publications:
1.
Sidhu. H., Gupta. R.. Thind. S.K. and Nath, R. Inhibition of
calcium oxalate monohydrate (COM) crystal growth by pyro
phosphate. citrate and rat urine. Urol Res 14: 299, 1986.
2.
Nath. R.. Thind, S.K. Vaidyanathan. S. and Sidhu, H.
Circadian biology of urinary excretion of calcium, oxalate,
phosphorus and uric acid in renal calculous patients. In:
Paihogenese und Klinik der Harnsteine. Fortschitie der
Urologieand Nephrologie. Eds. W. Vahlensieck and G. Gasser,
Steinkopff Verlag, Dormstadt, p.163, 1987.
3.
Sidhu. H.. Vaidyanathan. S.. Wangoo. D.. Rattan. V.,
Thind. S.K.. Nath, R.. Malakondaiah, G.C. and Tandon, S.P.
Urinary inhibitory activity of calcium oxalate monohydrate
crystal growth in stoneformers and non-stoneformers. Indian J
Med Res 86: 500, 1987.
Immunological studies in experimental hydatid disease
in mice.
An animal model of human echinococcosis was
developed in weanling Swiss albino mice of both sexes by
inoculating 2000 protoscolices per animal intraperi
toneally. These protoscolices were obtained asceptically
from liver or lung hydatid cysts of infected patients. The
cysts started developing after 2-3 months post infection
(PI) and the whole abdomen was studded with cysts 6-7
months Pl.
antigen. Forty per cent of animals became seropositive by
2 months and 80 per cent by 3 months PI. Depression in
the number of T lymphocytes was observed with increase
in the period of infection, however, there was no change
in the number of B lymphocytes. Besides, depression in
blast transformation of lymphocytes was observed using
non-specific mitogens like PHA and Con A and specific
hydatid antigen. An increase in T cell cytotoxicity was
observed in the later stages of infection (significant
difference in cytotoxicity activity appeared at 4 months
PI and remained unchanged till 6 months PI), indicating
that it had some protective role. No significant difference
in percentage phagocytic activity was observed during
the early stages of infection which increased during later
stages.
Infected animals were treated with mebendazole
after 2/4 and 6 months of infection. The drug was found
effective in decreasing cyst mass in the early stages of
infection, given in dosage of 200 mg/kg body weight for@
21 days.
A. Wangoo
R.C. Mahajan
Department of Parasitology
Postgraduate Institute of
Medical Education & Research
Chandigarh.
Publications:
I.
Ganguly, N.K., Mahajan, R.C., Wangoo, A., Bose, S.M. and
Dilawari, J.B. Potential experimental model for unilocular
hydatid disease. Indian J Med Res 84: 210, 1986.
2.
Wangoo, A.. Ganguly, N.K. and Mahajan, R.C. Lymphocyte
subpopulations and blast transformation studies in experi
mental hydatidosis. Indian J Med Res 85: 149, 1987.
3.
Wangoo, A., Ganguly, N.K. and Mahajan, R.C. In viv@)
efficacy of drug mebendazole in early stages of hydatid disease
with Echinococcus granulosus. Trans RSoc Trop Med Hvg81:
965, 1987.
4.
Infected animals were checked for the presence of
specific haemagglutinating antibodies using hydatid fluid
Wangoo, A., Ganguly, N.K. and Mahajan, R.C. Specific T cell
cytotoxicity in experimental Echinococcus granulosus infected
mice. Indian J Med Res 86: 588, 1987.
ICMR NEWS
Meetings of the following Task Force (TF)/Expert
Groups (EGs)/Project Review Committees (PRCs)/
Project Advisory Committee (PAC) of the Council were
held at New Delhi during the month:
TF on Collaborative Study on
Indian Childhood Cirrhosis.
108
October 3-5, 1989
EG on Hyperthermia in
Treatment of Cancer
October 9, 1989
EG on Mid-term Appraisal of
Efficacy of Killed Poliomye
litis Vaccine in North Arcot
District of Tamil Nadu.
October 11, 1989
PRC on Monitoring and Evaluation of MCH Programmes with
particular reference to Immu
nization by Involving
Government Medical Colleges.
October 11, 1989
PRC on Urology, Gastroenterology, Cardiovascular
Diseases, and Ophthalmology.
October 24, 1989
PAC on Integrated Approach
to Prevention of Avoidable
Disabilities (IMPACT
Programme).
October 25-26, 1989
***
***
***
The 48th meeting of the Scientific Advisory Board of
the ICMR was held at the ICMR Headquarters, New
Delhi on October 19-20, 1989.
• Participation of ICMR Scientists in Scientific Events:
Dr. K. Banerjee, Director, and Dr. M.A. Sreenivasan,
Dy. Director, National Institute of Virology, Pune
participated in the International Symposium on
Arboviral Infections, at Moscow (October 1-7, 1989).
Dr. M.S. Malhotra and Dr. V.K. Dua, Senior
Research Officersand Dr. R.S. Yadav, Research Officer,
Malaria Research Centre, Delhi, participated in the 3rd
Asian Course in Tropical Epidemiology, at Manila
(October 7-27, 1989).
Dr. C.P. Puri, Asstt. Director, Institute for Research
in Reproduction, Bombay, participated in the WHO
Steering Committee Meeting of the Task Force on Post
ovulatory Methods for Fertility Regulation, at Geneva
(October 9-13, 1989).
Dr. J.R. Parikh, Asstt. Director, National Institute
of Occupational Health, Ahmedabad, participated in the
7th International Symposium on Epidemiology in
Occupational Health, at Tokyo (October 11-13, 1989).
Dr. S.P. Tripathi, Addl. Director-General, ICMR,
participated in the Special Scientific Session on Tropical
Disease Control by 2000 AD, at the Annual Conference
of Tropical Disease Control Programme, at Ward ha
(October 12-13, 1989).
Dr. K.A.V.R. Krishnamachari, Officer-in-Charge,
Regional Medical Research Centre, Jodhpur. participated
in the WHO Advisory Group Meeting on Trace Elements
in Human Nutrition, at Geneva (October 16-20, 1989).
Dr. A.S. Paintai, Director-General, Dr. S.P.
Tripathi and other senior scientists of ICMR. participated
in the Indo-US Vaccine Action Programme Workshop
on New Development in Vaccinology, at New Delhi
(October 24-26, 1989).
Sh. N.S. Murthy, Asstt. Director, Institute of
Cytology and Preventive Oncology, New Delhi, proceeded
to USSR for 2 weeks under Indo-USSR Agreement in the
field of Medical Sciences and Public Health (Oncology)
(October 24 - November 6, 1989).
Dr. M. Dutta, Asstt. Director, Tuberculosis
Research Centre, Madras, participated in the Inter
national Symposium on Childhood Tuberculosis and
Acute Respiratory Infections in Developing Countries, at
London (October 26, 1989).
ICMR AIDED SYMPOSIA/SEMINARS/WORKSHOPS/COURSES/CONFERENCES
Symposium/Seminar/ Workshop/
Course/ Conference
Date & Place
Contact Address
Continuing Medical Education Programme
in Preventive Cardiology and Cardiovascular
Epidemiology.
October 1. 1989;
New Delhi
Dr. H.S. Wasir. Professor. Department of Cardio
logy. Cardiothoracic Centre. All India Institute of
Medical Sciences, New Delhi.
Seminar on New Trends in Methodology for
Social and Population Research.
October 1-3, 1989;
Tirupati
Prof. K. Mahadevan, department of Population
Studies, S.V. University, Tirupati.
National Workshop on Burns Injuries and
their Sequele.
October 7-8, 1989;
Chandigarh
Dr. C.P. Sawhney, Professor & Head, Department
of Plastic Surgery, Postgraduate Institute of Medi
cal Education and Research, Chandigarh.
XVI Annual Conference of Indian Immuno
logy Society and Symposium on Tropical
Immunology.
October 12-14, 1989;
Sevagram
Dr. B.C. Harinath, Professor & Head, Department
of Biochemistry, Mahatma Gandhi Institute of
Medical Sciences, Sevagram, Wardha.
_
TH GELL
COMMUNITY "
E. oaa
Ban--"
109
Symposium/Seminar/Workshop/
Course/ Conference
Date & Place
Contact Address
Symposium on Reproductive Biology and
Fertility Contrpl.
October 12-14, 1989;
Imphal
Dr. B.K. Omar, Professor & Head, Department of
Anatomy, and Secretary, Anatomical Society of
India, Regional Medical College, Imphal.
Symposium on Nurse and MCH Services.
October 13-14, 1989;
Srinagar
Dr. M. Regu, Department of Nursing Education,
Sher-I-Kashmir Institute of Medical Sciences,
Srinagar.
Seminar on Surgery for Base of Skull.
October 13-14, 1989;
New Delhi
Dr. S. Bahadur, Additional Professor, Department
of Otorhinolaryngology, All India Institute of
Medical Sciences, New Delhi.
Symposium on Respiratory Allergy and
Applied Immunology.
October 14-16, 1989:
Hyderabad
Dr. M. Sundaramma, Professor & Chest Physician,
Osmania College and A.P. Chest Hospital,
Hyderabad.
XXII Annual Convention of the Indian
Dietetic Association.
October 19-20, 1989;
Hyderabad
Dr. Indira Ray, Reader, Home & Social Sciences
Department, Calcutta University, Calcutta.
Seminar on Acute Respiratory Infections
Among Children in the Context of Primary
Health Care.
October 20-22, 1989;
Guwahati
Dr. A. Patowary, Director, Medical Education of
Assam, and Hony. Professor & Head, Department
of Social and Preventive Medicine, Gauhati Medi
cal College, Guwahati.
Brachytherapy Workshop for Cancer Cervix.
November, 1989;
Betul (M.P.)
Dr. Anand Vijay Kumar, Secretary, Paramedical
Section, Christian Medical Association of India,
Smruti Theatre Compound, Nagpur.
National Workshop on Advances in Flexible
Fiberoptic Bronchoscopy.
November 4-5, 1989;
Chandigarh
Dr. S.K. Jindal, Department of Chest Diseases,
Postgraduate Institute of Medical Education and
Research, Chandigarh.
All India Symposium on Biophysics of Cell
Structure and Function.
November 6-8, 1989;
Chandigarh.
Dr; P.C. Mangai, Chairman, Department of BioPhysics, Punjab University, Chandigarh.
International Symposium on Levels of Aware
ness and Conscious Experiences.
November 6-9, 1989;
Visakhapatnam
Prof. P.V. Krishna Rao, Director, Institute for Yoga
& Consciousness, Andhra University, Vijaya nagram
Palace, Visakhapatnam.
Seminar on Zoonoses.
November 9-10, 1989;
Dibrugarh
Dr. L.P. Datta, Director, Regional Medical Research
Centre (ICMR). P.B. No. 105, Dibrugarh.
National Symposium on Social and Legal As
pects for AIDS Prevention and Control.
November 9-11, 1989;
New Delhi
Dr. T.R.C. Sinha, General Secretary, National En
vironmental Sciences Academy, Bettiah.
XVI Biennial Conference of the Indian Asso
ciation of Leprologists.
November 9-12, 1989;
Trichur
Dr. P. Vijay Shanker, Damien Institute,Ayyappankavu, Trichur.
Seminar on Pathology of Cardiomyopathies.
November 11, 1989;
Bhubaneswar
Professor L.N. Mohapatra, Convenor, Indian Asso
ciation of Pathologists and Microbiologists (Orissa
Chapter) and Director, Regional Medical Research
Centre (ICMR), Bhubaneswar.
Seminar on Modern Biology: Genetic Re
combination.
November 19-26, 1989;
Mahabaleshwar
Dr. John Barnabas, Scientist (Director's Grade),
National Chemical Laboratory, Pune.
Conference on Health Care for the Villagers
and Urban Slums.
November 23-25, 1989;
Calcutta
Dr. Ashok Sahani, Professor & Hony. Executive
Director, Indian Society of Health Administrators.
104 (13/37), Cambridge Road Cross, Ulsoor,
Bangalore.
110
Symposium/Seminar/ Workshop/
Course/ Conference
Contact Address
Date & Place
National Seminar on Squint and Amblyopia.
November 25-27, 1989;
New Delhi
Dr. Vimla Menon, Dr. Rajendra Prasad Centre for
Ophthalmic Sciences, All India Institute of Medical
Sciences, New Delhi.
All India Symposium on Reproductive Bio
logy and General Endocrinology.
November 26-28, 1989;
Baroda
Prof. P.M. Ambedkar, Department of Zoology,
M.S. University of Baroda, Baroda.
Workshop on Recent Advances in Intensive
Care.
November 26-30, 1989;
New Delhi
Dr. H.K. Kaul, Professor & Head, Department of
Anaesthesiology. All India Institute of Medical
Sciences,' new Delhi.
International Conference on Structure and
Functions of Biomembranes.
November 28-December 2,1989;
Calcutta
Dr. Parul Chakrabarti, Convenor, Bose Institute,
93/1, APC Road, Calcutta.
Seminar on Biochemistry and Modern Bio
logy.
December 4-14,' 1989;
Lakshadweep
Prof. S.P. Modak, Convenor, Guha Research Con
ference, Department of Zoology. University of
Poona, Pune.
Workshop on Paediatric Urological Re
constructive Surgery.
December 23-25, 1989;
Chandigarh
Dr. S.K. Mitra, Professor & Head, Department of
Paediatric Surgery, Postgraduate Institute of Medi
cal Education and Research, Chandigarh.
Symposia on Cytogenetics; Plant Cell Bio
logy: Mammalian Systems; and Microbial
Systems, and Annual Meeting of the Indian
Society of Cell Biology.
December 27-29, 1989;
Hyderabad
Dr. M.R. Das, Deputy Director, Centre for Cellular
and Molecular Biology, Hyderabad.
XXXIII All India Obstetric and Gynaecologi
cal Congress.
December 28-30, 1989;
Patna
Dr. J. Mishra, Department of Obstetrics and Gynae
cology. Hospital for Women. Patna Medical College.
Patna.
Symposium on Current Advances in Mole
cular Biochemistry: Applications in Health,
Environment, and Agriculture.
December 28-31, 1989;
Lucknow
Dr. G.G. Sanwal, Professor and Head, Department
of Biochemistry, Lucknow University, Lucknow.
Ill International Congress on Traditional
Asian Medicine.
January 4-7, 1990;
Bombay
Dr. K.M. Parikh, Chairman, Organising Committee,
III International Congress on Traditional Asian
Medicine, C/o Zandu Pharmaceutical Works Ltd
Dadar, Bombay.
Seminar on Indian Speech, Language and
Hearing Tests—the proposed IS HA battery.
February 8-9, 1990;
New Delhi
Dr. S.K. Kacker, Professor & Head, Department of
Otorhinolaryngology, All India Institute of Medical
Sciences, New Delhi.
National Symposium on Application of Re
combinant DNA Technology in Disease
Diagnosis.
March 23-25, 1989;
Hyderabad
Prof. P.P. Reddy, Director, Institute of Genetics
and Hospital for Genetic Diseases, Osmania Univer
sity, Hyderabad.
COUNCIL’S TRAINING PROGRAMMES
Virology
Nutrition
At the National Institute of Virology, Pune:
At the National Institute of Nutrition, Hyderabad:
Short-term* Course on Detection and Isolation of
Arboviruses Using Mosquito Inoculation and Mos
quito Cell Culture (October, 1989).
Annual Certificate Course in Nutrition (December
1, 1989 to February 28, 1990).
ill
Occupational Health
At the National Institute of Occupational Health,
Ahmedabad:
Physicians, Chemists, Safety Officers, Hygienists
(November 6-10, 1989).
Laboratory Animal Technology
Refresher Course for Industrial/ESIS Medical Offi
cers (October 9-14, 1989).
At the Laboratory Animal Information Service Centre,
National Institute of Nutrition, Hyderabad:
Training Course on Disaster Management of
Hazarduous Chemicals in Industry for Industrial
Training Course for Laboratory Animal Super
visors (September 1 to November 30, 1989).
SOME AVAILABLE ICMR PUBLICATIONS
Price
Rs.
Growth & Physical Development of Indian Infants and Children (1972), Reprinted 1989
10.00
Studies on Weaning & Supplementary Foods (1974), Reprinted 1984
6.00
Studies on Pre-School Children (1974), Reprinted 1984
6.00
A Manual of Nutrition (1973), Second Edition 1974, Reprinted 1984
2.50
Low Cost Nutritious Supplements (1972), Second Edition 1975, Reprinted 1977
1.50
Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for South India
(1959), Third Edition 1977, Reprinted 1984
2.00
Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for North India
(1959), Third Edition 1977, Reprinted 1984
2.00
Some Common Indian Recipes and their Nutritive Value (1964), Fourth Edition 1977,
Reprinted 1984, by Swaran Pasricha and L.M. Rebello
6.00
Nutrition for Mother & Child (1962), Third Edition 1978, Reprinted 1983, by P.S. Venkatachalam
and L.M. Rebello
5.00
Japanese Encephalitis in India (Revised Edition 1980)
5.00
Some Therapeutic Diets (1969), Fourth Edition 1981, Reprinted 1983, Revised 1988,
by Swaran Pasricha
2.00
Recommended Dietary Intakes for Indians (1981), Reprinted 1984
4.60
Lathyrism: A Preventable Paralysis (Revised Edition 1983)
1.50
A Manual of Laboratory Techniques (1983), Edited by N. Raghuramulu, K. Madhavan Nair
and S. Kalyanasundaram
30.00
Fruits (1983), by Indira Gopalan and M. Mohan Ram
2.50
Count What You Eat (1989), by Swaran Pasricha
4.50
The Anophelines of India (Revised Edition 1984), by T. Ramachandra Rao
150.00
Depressive Disease (1986), by A.Venkoba Rao
58.00
Medicinal Plants of India, Vol. 2 (1987)
136.00
112
Unpriced Publications
(for limited distribution)
Collaborative Study on Short-term Sequelae of Induced Abortion (1981)
Proceedings of the Indo-UK Workshop on Leishmaniasis (1983)
Peoples of India—Some Genetic Aspects (1983)
Management of Acute Diarrhoea (1985)
Plague Conquest and Eradication in India (1987) by S.C. Seal
Laboratory Manual for the Diagnosis of Haemophiloid Disorders (1989),
by Manorama Bhargava and Dinesh Jain
These publications are available on prepayment of cost by cheque or postal order (bank and postal charges will be extra) drawn in favour of the
Director-General, Indian Council of Medical Research, New Delhi. Money oruers are not acceptable. All correspondence in this regard should
be addressed to the Chief, Division of Publication and Information, Indian Council of Medical Research, Post Box No.4508, Ansari Nagar,
New Delhi-110029.
Some available publication! of the Institute of Immunohaematology, Bombay
Techniques in Blood Banking, by H.M. Bhatia
Price
Rs.
12.00
Genetic Atlas of the Indian Tribes, by H.M. Bhatia and V.R. Rao
125.00
These publications are avaibble on prepayment of cost by money order or bank draft, from Director, Institute of
Immunohaematology, 13th floor. New Multistoreyed Complex, KEM Hospital Campus, Parel, Bombay-400012.
RADIOIMMUNOASSAY KITS AVAILABLE
The following RIA Kits (prepared under the Matched Reagents and Quality
Control Programme of Reproductive Hormones of the Indian Council of Medical
Research) are available for distribution to scientists in the country:(i) Progesterone
(ii) Estradiol-17B
(iii) Testosterone
Kits contain lyophilized antisera, tracer, standard and dextran coated charcoal
for 100 tube assay.
For further information. Dr. B.N. Saxena, Sr. Deputy Director-General, Indian
Council of Medical Research, Ansari Nagar, New Delhi-110029 may be contacted.
113
ANNOUNCEMENT
The Institute of Immunohaematology, Bombay, offers training for establish
ment of laboratory facilities for HLA typing. Individuals interested in setting up
HLA laboratory for the transplantation programme in their hospitals are requested
to contact Dr. N.M. Contractor for further information before December 30,1989:
Dr. N.M. Contractor
Deputy Director
Institute of Immunohaematology
New Multistoreyed Complex, 13 Floor
K.E.M. Hospital Campus
Parel, Bombay-400012.
EDITORIAL BOARD
Chairman
Dr. A.S. Paintai
Director-General
Chief, Publications
Dr. G.V. Satyavati
Members
Dr. Usha K. Luthra
Dr. Badri N. Saxena
Dr. S.P. Tripathy
Editor
Dr. N. Medappa
Printed and Published by Shri G P. Kulshreshth for the Indian Council of Medical Research, New Delhi
at the ICMR Offset Press, New Delhi
R.N. 21813/71
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