ICMR BULLETIN VOL. 26-No.-1-JANUARY-1996.pdf
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Vol. 26, No. 1
January, 1996
HIGHLIGHTS OF RESEARCH
AT THE TUBERCULOSIS RESEARCH CENTRE, MADRAS
“In the future the battle against this plague of mankind
(tuberculosis) will not just be concerned with an uncertain
something but with a tangible parasite, about whose char
acteristics a great deal is known and can be explored.”
the ICMR, the Government of Tamil Nadu, the British
Medical Research Council and the World Health
Organisation by establishing the Tuberculosis Chemo
therapy Centre (TCC) at Madras in Tamil Nadu.
Robert Koch
The primary research priority of the TCC at the time of
its inception was anti-tuberculosis chemotherapy. Over the
decades, the Centre gradually evolved and an expansion of
its activities to cover all aspects oftuberculosis fully justified
its renaming in 1978 as the Tuberculosis Research Centre
by the ICMR. The Centre has made important contributions
in bacteriology, biochemistry, epidemiology and immunol
ogy of tuberculosis in addition to providing base-line data
in the chemotherapy of tuberculosis.
Though the above statement is more than a century old,
it is of relevance even today. Currently three million people
die from tuberculosis every year. At present the containment
of this disease is out of control in many parts of the devel
oping world. It remains a leading cause of death from any
single infectious disease, accounting for over a quarter of all
avoidable'deaths1. The deadly link between turberculosis
and AIDS has now been clearly established2. People with
this dual infection have a 25 fold increased mortality.
CLINICAL STUDIES
For the treatment of tuberculosis to be successful, con
sistent uninterrupted medication of6 to 8 months is required.
Since available measures for ensuring diagnosis and pa
tients' treatment compliance are inadequate, new drug resis
tant strains oftubercle bacilli are emerging at a rapid pace3.
In such a seemingly bleak scenario it is necessary to
recollect the pioneering contributions and continuing efforts
being made by the Indian Council of Medical Research
(ICMR) and the Tuberculosis Research Centre (TRC),
Madras in tackling this dreaded disease.
A modest but notable beginning in the management of
pulmonary tuberculosis in India was made in the 1950s by
The Madras Study—Efficacy of Home Treatment
The initial impetus for the establishment of this Centre
was to explore the possibility of treating tuberculosis pa
tients at their residence. This was done by a menticulosusly
planned and executed randomised controlled trial which later
became famous as the ‘Madras study’*3. This landmark
study established certain ground truths regarding treatment
of tuberculosis. The conclusions of this study were:
(i)
Tuberculosis can be effectively treated at home with
no need for the patient to be admitted to a sanatorium.
Division of Publication & Information, ICMR, New Delhi - 1 10 (»29
The key to successful chemotherapy is regularity of Extrapulmonary Tuberculosis
drug intake.
The experience and expertise gained during the conduct
(iii) Nutritious diet does not play a role in the treatment. of controlled clinical trials in pulmonary tuberculosis were
utilised to study tuberculosis of the spine, tuberculous
(iv) Contacts of the patient at home do not have a greater
meningitis, tuberculous lymphadenitis, tuberculoma of the
risk of developing the infection.
brain, abdominal and skin tuberculosis.
(v) Most of the patients become non-infective within 2
It was found that -the time of initiation of chemotherapy,
months of regular treatment.
rather than chemotherapy alone had greater relevance in the
'outcome of tuberculous meningitis in children. There was
These findings revolutionised the approach to the treat
better prognosis and fewer sequelae with earlier treat
ment oftuberculosis and laid the foundation for the National
ment16,17.
Tuberculosis Control Programme in India, and in other
(ii)
developing countries. There are several advantages of
domiciliary treatment which include substantial reduction in
capital expenditure, reduction in cost oftreatment per patient
and feasibility of the organisation of mass chemotherapy
programmes. Bed strength in a sanatorium was no longer a
key factor involved in successful treatment. Patients in rural
areas far from sanatoria could also be treated at no extra cost
since the treatment given on an outpatient basis for one year
is less than 10 per cent of the cost of maintaining a bed in
a sanatorium for the same period6-7.
Short Course Chemotherapy (SCC)
SCC was very early recognised as the need of the hour
because traditionally the treratment was of 12-24 month
duration which led to a major problem of treatment
adherence (patients' compliance). Serious and intensive
efforts to evolve shorter regimens eventually led to the
development of highly effective regimens of 5, 6, 7 and 8
months duration "which included powerful drugs such as
rifhmpicin, isoniazid, pyrazinamide, streptomycin and
ethambutol810. Among the primary anti-tuberculosis drugs,
the most expensive one is rifampicin. In order to further
reduce the cost oftreatment, the Centre evaluated regimens
without rifampicin and these were found to be equally
efficacious. Chemoprophylaxis with isoniazid was also
studied in very young family contacts.
The value of intermittent chemotherapeutic regimens in
the treatment of pulmonary tuberculosis has also been thor
oughly investigated11,12.
Study of drug resistance has been a major priority for
research and reports ofdrug resistant tubercle bacilli in India
were first documented by the ICMR from this Centre13,14
Alternate regimens have been evolved to treat drug resistant
cases with adequate success15.
2
For spinal tuberculosis, effective ambulatory treatment
regimens of 6 to 9 months duration without resorting to
radical surgery and/or hospitalisation were successfully
developed18. This led to increase in cost effectiveness since
surgery and hospitalisation were avoided.
Short course regimens of 6 to 9 months duration have
also been evolved for tuberculoma of the brain, tuberculous
lymphadenitis and abdominal tuberculosis19'21.
These regimens are considered robust with negligible
relapse rates and treatment failures, and have been accepted
for the treatment of such patients in the National
Tuberculosis Programme (NTP).
The Tuberculosis Control Programme
The TRC has pioneered the introduction of short course
chemotherapy for pumonary tuberculosis under the district
tuberculosis programme in 18 districts in 10 states all over
India (Unpublished data). During this period, several prac
tical constrainst were identi fled and remedial measures were
suggested to the State authorities to improve the efficiency
of the Programme. A programme was developed for data
processing which suggested methods to overcome avoidable
deficiencies22. The benefits accrued from these studies are
evident by the feet that there has been a substantial increase
in the number of sputum examinations and detection ofcases
at the public health institutions (PHIs) along with a reversal
in the trend of more numbers being detected at the District
TB Centres (DTCs). These studies were of invaluable help
in implementing the short course chemotherapeutic regimens
at the national level under the DTP23-26
Operational Research
In operational research studies, the potential role ofdais
(traditional birth attendants) in tuberculosis case finding has
been explored to help in the grass-root operations oftheNTP
in the villages. Valuable results have also emerged from
studies to explore the use of literate tribal youth in NTP
activities in remote tribal areas to establish a link between
the governmental agencies and the community. Health edu
cational materials have been developed to create an aware
ness of tuberculosis in the community. Group educational
activities have been undertaken to ensure better community
participation and commitment of health personnel to the
programme. Collaborative studies in urban, semi-urban and
rural areas have successfully established a system for elic
iting accurate home addresses from out-patients attending
chest clinics. They have also demonstrated the superiority
of a home visit by a health visitor over a routine postal
reminder in retrieving patients who fail to attend the clinic
for collecting drugs. Such studies have been largely respon
sible for defining the reasons for default among rural popu
lations, and for suggesting strategies to motivate defaulters
for continuing chemotherapy27"29.
LABORATORY STUDIES
Many landmark laboratory studies in the diagnosis and
treatment oftuberculosis, in the diagnosis ofdrug resistance
and in investigating the efficancy of newer anti-tuberculosis
drugs have been conducted at the TRC since its inception
in the 1950s.
Sputum Microscopy and Culture
Studies at the Centre established the importance of
sputum microscopy in case finding. It was observed that the
results of2 sputum smear examinations are equivalent to one
bacteriological culture30. The relevance of periodic sputum
smear examination alone in monitoring progress of patients
on treatment was realised. The sputum positive, culture
negative picture was recognised as a phenomenon in the
early phase of SCC31. The effects of storage of sputum
at ambient temperature on smear and culture results have
been studied32. The role ofcetylpyridinium chloride in main
taining viability of tubercle bacilli upto 7 days at room
temperature has been reported33. It was found that culture
positivity could be enhanced in cases of extrapulmonary
tuberculosis by using multiple media including inexpensive
combinations such as Lowenstein-Jensen (LJ) with
Kirchner's medium34,35.
Evaluation ofAnti-tuberculosis Drugs and Susceptibility
Testing
Methods for direct susceptibility testing to isoniazid,
streptomycin and rifampicin have been standardised in
order to reduce the time taken to diagnose multi-drug
resistant tuberculosis (MDR-TB)36. Several in vitro studies
on antimycobacterial sensitivity have been published from
this Centre37,38. These include studies on newer rifamycin
derivatives such as rifabutin and rifapentine, quinolones
such as ciprofloxacin, ofloxacin and lomefloxacin,
aminoglycosides such as capreomycin and tuberactinomycin, and other drugs such as minocycline39. In the
current situation where MDR-TB has assumed greater
relevance and the search for newer antituberculosis drugs
has become ofutmost importance, these studies have yielded
valuable information on tackling MDR-TB at the national
level. Studies cm the early bactericidal activities (EBA) have
shown that divided dosage of anti-tuberculosis drugs taken
daily had a similar response to that of patients taking all
4 drugs (such as rifampicin, isoniazid, pyrazinamide and
ethambutol) together during the early phase of
chemotherapy40. This finding has a logistic importance-to
evolve a strategy to deliver drugs in blister packs to enhance
patients' compliance, a strategy similar to that which was
successfully implemented in leprosy control.
All patients undergoing chemotherapy at the TRC are
carefully monitored for adverse drug reactions using
biochemical parameters41"46. In this process, the existing
methods for estimation of drugs which were earlier
complicated became simplified. Invasive procedures
requiring blood were replaced by non-invasive ones
requiring urine and saliva. Quality control of the drugs
administered to the patients is carefully monitored at the
Centre. During such studies it was observed that cycloserine
rapidly deteriorated under warm and humid conditions. A
syrup preparation of isoniazid was also found to be
ineffective becuase of the inactivation caused by the
excipient47.
Immunological Investigations in Tuberculosis
Using the recent explosion in information and tech
niques pertaining to molecular biology, intensive work is
currently under way at the TRC to develop serological and
molecular biological methods for the early diagnosis of
tuberculosis48,49. Immunological parameters relevant to
tuberculosis are also being investigated both indigenously
and in collaborative studies to elucidate those anti-parasitic
mechanisms which may be important in containment of the
disease50-53. Genetic predispositions which may play an
important role in the development ofpulmonary tuberculosis
are being studied54.
3
The South Indian Variant ofMycobacterium tuberculosis
One of the earliest studies undertaken was to elaborate
the properties of tubercle bacilli. These studies established
that the tubercle bacilli isolated in South India have a unique
phenotype compared to strains obtained from other geo
graphical areas. These include their lower virulence in
guineapigs, enhanced susceptibility, tq thiophen-2-carboxylic acid hydrazide, and peculiar phage susceptibility pat
tern55. Today, the South Indian variant of M tuberculosis
is well established and many studies are in progress both at
the Centre and elsewhere to elucidate the molecular biologi
cal basis of the differences observed in these strains54. An
effort is also being made to develope probes using these
strains for the diagnosis of tuberculosis in this part of the
world57,58
Cardio-puimonary Studies, Post-chemotherapy
Rehabilitation
Pulmonary tuberculosis patients are likely to have im
paired lung function due to fibrosis. In the case of spinal
tuberculosis, spinal deformities could lead to compression of
the thoracic cage thereby compromising lung function. In all
these situations there is a deterioration of the quality of life.
Currently, quality of life measurements on such patients are
being undertaken in the Centre59-60. The outcome of these
studies are of direct relevance in rehabilitating patients
during the post chemotherapeutic phase.
EPIDEMIOLOGY OF TUBERCULOSIS
out to further investigate bacteriological, ecological and
immunological aspects pertinent to this hypothesis. These
studies have shown that bacteria of the Mycobacterium
avium complex are predominant in the water and dust of the
South Indian BCG trial area while organisms of the M.
fortuitum complex are predominant in the soil of this area67.
Animal experiments using guineapigs further showed that
oral immunisation with M. avium complex organisms did
not adversely affect the protective efficacy of BCG63 It was
furhter shown' that while no apparent immunomodulatory
effect was observed in the early stage of infection when
animals had been exposed to M. avium prior to
immunisation with BCG, at the later stages the barrier at the
site of the infection appeared not to be intact since challenge
M. tuberculosis organisms could be detected in the spleen
of such animals compared to their absence in the spleen of
animals which had been immunised with BCG alone64. The
relevance of this finding is currently being further explored
in animal model studies.
Prevalence Studies
An age-wise bias in the distribution of the disease with
its concentration among the population in the productive age
group has been clearly demonstrated in studies conducted by
the Centre65. These pioneering studies carried out by the
ICMR at this Centre in the 1950s provide essential base-line
data to planners in Health Services in India even today.
Subsequent to these studies it has not been possible to carry
out similar exercises on such a magnitude anywhere else in
the country.
The South Indian BCG Trial
A trial to study the efficacy ofBCG in protecting against
the adult form of pulmonary tuberculosis was undertaken in
the rural population ofthe Chingleput district ofTamil Nadu
in South India under the joint auspices of the ICMR, the
World Health Organisation, and the CDC and the USPHS
(until June 1976) from 1968 to 1980. The results of this
study, to date the largest of its kind in the world, unambigu
ously showed that BCG does not seem to offer any protection
in individuals over 12 years of age61. These findings have
aroused widespread comment and raised pertinent questions
on various aspects of tuberculosis. At the IRC, Madras,
currently many research projects are under way which are
examining some of the questions raised by the findings of
the South Indian BCG trial. The role of environmental
mycobacteria as immunomodulatory agents in the protective
response elicited by BCG has received the most attention.
Several laboratory studies in the Centre have been carried
4
Sample surveys carried out by the Centre have shown
that prevalence of tuberculosis in urban, rural and tribal
areas varied from 4-10 per thousand population66. The
annual risk of infection was found to be between l.Oand 1.5.
During the South Indian BCG trial the prevalence of the
disease among the study population was found to be 404 per
100,00061. In surveys conducted in North Arcot district in
Tamil Nadu and Raichur district in Karnataka in the 1980s,
total bacteriological prevalence of 430 and 1090 per
100,000, respectively, was reported. These studies
demonstrate fluctuations in the prevalence rates within India
with the potential for the occurrence of very high risk of
infection'in some areas.
A study of short course chemotherapy in rural areas
under programme conditions has shown 79 per cent accep
tance. Treatment completion rates were 51 per cent for the
twice weekly regimen and 63 per cent for the daily regimen.
At the end of chemotherapy there were 73 per cent culture
negative of whom 95 per cent remained culture negative at
the end of 18 months of follow up.
A cross-sectional survey of patients treated earlier
showed that 80 per cent of the patients who had 80 per cent
or more ofthe prescribed chemotherapy were quiescent upto
3 years. Even among patients who had taken less than 50
per cent of the prescribed chemotherapy, only 46 per cent
were bacteriologically positive.
To sum up, the intensive efforts of the Centre demon
strated for the first time in the world that domiciliary treat
ment of tuberculosis is possible and can be effectively used
in combating and controlling the disease. The study on
efficacy of BCG in protecting against pulmonary tubercu
losis unambiguously showed that BCG does not seem to
offer any protection in individuals over 12 years of age.
Clinical trials carried out by TRC demonstrated the safety
and efficacy of short course chemotherapy (SCC) in pulmo
nary and extrapulmonary tuberculosis including
tuberculoma of the brain, both in adults and children. Fol
lowing these studies, the SCC was introduced into the
National Tuberculosis Control Programme. Alternative
regimens have been evolved to treat drug resistant cases with
adequate success. Using modem biotechnological/molecular
biological methods the Centre is currently undertaking inten
sive work to develop methods for early diagnosis of tuber
culosis and also trying to identify genetic predisposition to
the disease.
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50.
Selvaraj, P., Venkataprasad, N., Vijayan, V.K., Prabhakar, R.
and Narayanan, P.R. Alveolar macrophages in patients with
pulmonary tuberculosis. Lung India, 6: 71, 1988.
59
Vijayan, V.K., Jawahar, M.S., Reetha, AM and Prabhakar, R.
Persisting alveolitis in miliary tuberculosis despite treatment
with short-course chemotherpay. Indian J Chest Dis Allied Sc,
32: 49, 1990.
51.
Rajiswamy. Macrophage functions in tuberculosis. Trop Med
Parasitol. 41: 327, 1990.
60.
52.
Das, S., Narayanan, S., Paramasivan, C.N., Lowrie, D.B. and
Narayanan, P.R. Human tuberculosis sera show predominant
antibody responses to particulate fractions of Mycobacterium
tuberculosis. J Clin Immunol. 11: 1, 1991.
Vijayan, V.K., Reetha, AM, Jawahar, M.S., Sankaran, K. and
Prabhakar, R. Pulmonary eosinophilia in pulmonary tuberculosis.
Chest 101: 1708, 1992.
61.
Tuberculosa Prevention Trial, Madras. Trial ofBCG vaccines
in South India for tuberculosis preveatwn. Indian J Med Res
72 [Suppl]: 1, 1980.
62.
Kamals, T., Paramasivan, C.N., Herbert, D., Venkatesan, P. and
Prabhakar, R. Isolation and species-level identification, of
mycobacteria in environmental samples from the BCG trial area
of South India. Appl Environ Microbiol 60: 2180, 1994.
63.
Narayanan, S., Paramasivan, C.N., Prabhakar, R. and Narayanan,
P.R. Effect of oral exposure of Mycobacterium avium
intracellulare on the protective immunity induced by BCG. J
Biosc 10: 453, 1986.
64.
Herbert, D., Paramasivan, C.N. and Prabhakar, R. Protective
response in gunieapig exposed to Mycobacterium avium
intracellulare/M. scrofulaceum, BCG and South Indian isolates
of M. tuberculosis. Indian J Med Res 99: 1, 1994.
65.
Indian Council of Medical Research. Tuberculosis in India: A
sample survey 1955-58. Special Report no. 34, 1959.
66.
Mayumath, S., Vallishayee, R.S., Radhamani, M.P. and
Prabhakar, R. Prevalence study of tuberculous infection over
15 years, in a rural population in Chingleput district [South
India]. Indian J Med Res 93: 74, 1991.
53.
Cheng, S.H., WAlker, K.B., Lowrie, D.B., Mitchison,.D.A,
Rajiswamy, Datta, M. and Prabhakar, R. Monocyte
antimycobacterial activity before and after M. Bovis BCG
vaccination in Chingleput, India and London, U.K. InfectImmun
61: 4501, 1993.
54.
Sanjeevi, C.B., Narayanan, P.R., Prabhakar, R., Charles, N.,
Thomas, B.E., Balasubramanian, R., and Olerup, O. No
association or linkage with HLA-DR or -DQ genes in South
India with pulmonary tuberculosis. Tubercle lung Dis.. 73:280,
1992.
55.
56.
Bhatia, A.L., Csillag, A., Mitchison, D.A., Selkon, J.B.,
Somasundaram, P.R. and Subbaiah, T.V. The virulence in the
guinea-pig of tubercle bacilli isolated before treatment from
South Indian patients with pulmonary tuberculosis. 2.
Comparison with virulence of tubercle bacilli from British
patients. Bull WHO 25: 313, 1961.
Venkataraman, *P., Paramasivan, C.N., Hampumam, K.J. and
Prabhakar, R. Intraspecies differentiation of strains of
Mycobacterium tuberculosis obtained from Czechoslovakian,
Mongolian and South Indian patients. Indian JMedRes 88:211,
1988.
This write-up has been contributed by Dr. C.N. Paramasivan,
Officer-in-Charge, Tuberculosis Research Centre, Madras.
85TH ANNIVERSARY CELEBRATIONS OF ICMR
The Indian Council of Medical Research entered 85
years of its existence in November 1995. To mark the
occasion the Council and its various Institutes/Centres
located in different parts of India have planned vinous
scientific programmes spread over a year (till November
1996) with the main aim of disymmaring to scientists, pro
fessionals, planners and policy makers as well as the general
public the contributioos/achievements of the Council.
To facilitate effective dissemination ofinformation, each
month, between November 1995 to October 1996, a specific
topic/subject will be highlighted. Nutrition being one of the
most important areas of research in the Council and the
National Institute ofNutrition, Hyderabad—the oldest and
the most well known Institute, Nutrition was selected as the
theme for the inaugural month ie November 1995.
The National Institute of Nutrition (NIN), Hydera
bad started the celebrations on November 28, 1995.
Dr. G.V. Satyavati, Director-General, ICMR, while inaugu
rating the celebrations at the NIN exhorted the scientists
to strive for a multifaceted, futuristic approach to research.
7
Sh. A.P.V.N. Sanna, Secretary, Medical, Health and Family
Welfare, Government ofAndhra Pradesh, who presided over
the function released a Special Issue of the Indian Journal
ofMedical Research on Nutrition Research. An inter school
painting competition was also organized on the occasion at
the Institute's campus in which nearly 250 students (Junior
and Senior) from 40 schools of Hyderabad participated.
The Malaria Research Centre, Delhi, organized an
exhibition and a lecture on “Malaria and Nutrition” at the
Delhi Public School, R.K. Puram, New Delhi on November
28, 1995.
The National Institute of Cholera and Enteric Diseases,
Calcutta, organized an open house on December 1, 1995
where visitors were informed about the nutritive value of
foods, balanced diets, etc. A nutrition quiz competition was
also organized for students.
The National Institute of Virology, Pune, organized, as
part of an awareness programme on Nutrition, 3 lectures—
one on Nutrition by Prof. Kunda S. Redey (SNDT College),
another on Therapeutic Nutrition by Prof. S R Kukade from
SNDT College, Pune, and the third on Naturopathy: Appli
cation to Viral Diseases by Dr. Jitendra Arya, Nisargashram,
Pune (December 8, f995).
All the Bombay-based ICMR Institutes/Centres viz. die
Institute for Research in Reproduction (IRR), Institute of
Immunohaematology, Enterovirus Research Centre and
ICMR Genetic Research Centre jointly organized an aware
ness programme on Nutrition for the general public at the
IRR campus on November 30, 1995. In the afternoon a
nutrition quiz and screening of video films on Nutrition were
also arranged for school children.
The Rajendra Memorial Research Institute of Medical
Sciences, Patna, organized a symposium on Nutrition on
November 30, 1995. The topics covered in the symposium
included role of vitamins and trace metals, balanced diets,
nutrition for children, etc.
At Madras, the Tuberculosis Research Centre, the In
stitute for Research in Medical Statistics and the CJIL Field
Unit at Avadi jointly organized awareness programmes on
Nutrition. The celebrations were launched on November 28,
1995 at the World Vision India, a NGO involved in the
community development programme in the slums of Ma
dras. Similar nutrition awareness programmes were orga
nized at several places in Madras city and Irulancheri village
of Tiruvallur taluk, Perumalpattu and Tirur villages of
Chengi-MGR district; and Thirumazhisai town of
Sriperumbudur taluk during November 29 to December 11,
1995.
Centre for Research in Medical Entomology, Madurai,
organized symposia on ‘Nutrition’ and ‘AIDS’ on December
21, 1995.
The Regional Medical Research Centre for Tribals,
Jabalpur, organized a public meeting on November 29,1995
which was attended by over 500 individuals (mostly women
and children). The meeting was marked by lectures, video
shows and question-answer session on Nutrition.
The Desert Medicine Research Centre, Jodhpur, orga
nized an awareness programme on Nutrition and Health on
November 29, 1995 which included poster display, group
discussion, and nutrition quiz, debate and essay competition
and drawing contest for school children.
ICMR NEWS
The following meetings of various technical groups/
committees of the Council were held:
PRC on Pharmacology
December 13, 1995
(at New Delhi)
Meetings of the Research Advisory Groups (RAGs)/
Project Review Committees (PRCs)/Scientific Advisory
Committees (SACs)ZTask Forces (TFs) of the Council
held:
SAC or the Centres for Advanced
Research in Enteric Diseases at
Vellore and New Delhi
December 18, 1995
(at New Delhi)
TF on Development of Instruments
for Psychosocial Stress
December 20, 1995
(at New Delhi)
RAG of the ICMR Unit for
Research in HIV/AIDS in North
Eastern States of India
8
December 7, 1995
(at Calcutta)
PRC on Virology
January 9, 1996
(at New Delhi)
Participation of ICMR Scientists in Scientific Events:
Appointments:
Dr. B.N. Nagpal, Senior Research Officer, Malaria
Research Centre, Delhi, participated in the II Neem Aware
ness Workshop at Nairobi (December 3-9, 1995).
Dr. M. Mohan Ram took over as Director of the
National Institute ofNutrition, Hyderabad w.e.f. December
22, 1995.
Dr. S.P. Pam, Deputy Director, Vector Control Research
Centre, Pondicherry, participated in a meeting on cross-site
clinical data analysis related to the WHO multi-country,
multi-centric studies on socio-economic burden oflymphatic
filariasis at Dar-es-Salaam (December 4-15, 1995).
Dr. S.K. Rhattarharya Director, National Institute of
Cholera and Enteric Diseasses, Calcutta, participated in IV
Symposium on International Medical Cooperation at Tokyo
(December 11, 1995).
Lectures/O rations:
Prof. Ranjit Roy Chaudhury, Emeritus Scientist,
National Institute of Immunology, New Delhi, delivered the
Dr. D.N. Prasad Memorial Award Oration of ICMR on
Challenges in Clinical Pharmacological Evaluation of Me
dicinal Plants, at the ICMR Headquarters, New Delhi on
November 21, 1995.
Dr. M.D. Gupte, Officer-in-Charge, CJIL Field Unit at
Avadi, Madras, visited Geneva to assist the WHO Action
Programme for the Elimination of Leprosy to develop stan
dardized protocols and simplified models (January 3-12,
1996).
Prof. G. Padmanabhan, Director, Indian Institute of
Science, Bangalore, delivered the first Dr. B.R. Ambedkar
Centenary Award Oration of the ICMR on Antimalarials to
Gene Therapy, at the ICMR Headquarters, New Delhi on
December 8, 1995.
Dr. Kamala Krishnaswamy, Deputy Director (Sr.
Grade), National Institute of Nutrition, Hyderabad, partici
pated in the V Expert Panel meeting of the project on Diet
and Cancer of the World Cancer Research Fund at Rome
(January 8-10, 1996).
Prof. Indira Nath, Head, Department of Biotechnology,
All India Institute ofMedical Sciences, New Delhi, delivered
the Basanti Devi Amir Chand Prize Oration of the ICMR
on Leprosy a Paradigm ofHost-Pathogen Interaction, at the
ICMR Headquarters, New Delhi on January 17, 1996.
ICMR AIDED SYMPOSIA/SEMINARS/WORKSHOPS/COURSES/CONFERENCES
Symposium/Seminar/Workrhop/
Course/Conference
Date & Place
Contact Address
Symposium on Casava in Nutrition and Health.
February 10-11, 1996;
(at Thimvanantaptiram)
Dr. K. T. Shenoy, Organising Secretary of the
Symposium, Department of Gastroenterology,
Medical College, Thiruvanantapuram.
National Symposium on Molecular and Cellular Bio
physics.
February 18-21; 1996
(at New Delhi)
Dr. V. Kothekar, Convenor of the Symposium,
Department of Biophysics, AU India Institute
of Medical Sciences, New Delhi.
V National Conference of Biomechanics.
February 22-24, 1996
(at Madras)
Dr. S. Radhakrishna, Organising Secretary of
5NCB, Department of Applied Mechanics,
Indian Institute of Technology, Madras.
Internationl Conference on Current Status and Chall
enges in Medical and Veterinary Microbiological
Research Particiation Third World Countries.
February 26-28; 1996
(at Jabalpur)
Prof S.M Singh, Organising Secretary of the
Conference, Department of Biological Sciences,
R D. University, Jabalpur.
9
COUNCIL’S TRAINING PROGRAMMES FOR 1996-97
Virology
Occupational Health
At the National Institute of Virology, Pune:
At the National Institute of Occupational Health,
Ahmedabad:
•
Diploma in Medical Virology (June 1996-May 1997).
•
At the Institute for Research in Reproduction, Bombay:
•
Orientation Course on Occupational Health for
Industrial Medical Officers (January 15-25, 1996).
Reproductiwe Biology
Training Course on Techniques in Neuroendocrine
Research (February 6-10, 1996).
Medical Entomology
At the Vector Control Research Centre, Pondicherry:
•
M.Sc. in Medical Entomology (from August 1996; for
2 years).
Endocrinology
Laboratory Animal Technology
At the National Institute of Nutrition, Hyderabad:
•
At the National Centre for Laboratory Animal Science,
Annual Training Course on Endocrinological
National Institute of Nutrition, Hyderabad:
Techniques and their Applications (August 1,
1996-September 15, 1996).
•
(June 15-July 31, 1996).
*
Nutrition
Training Course for Laboratory Animal Techniques
Training Course for Laboratory 'Animal Supervisors
(September 1-November 30, 1996.
At the National Institute of Nutrition, Hyderabad:
|
•
M.Sc. in Applied Nutrition (June 1, 1996-February
Biostatistical Techniques
28, 1997).
At the Institutefor Research inMedical Statistics, Madras:
Annual Training Course in Nutrition (December 1,
•
1996-February 28, 1997).
Training Course for Doctors in Biostatistical Techniques
in Controlled Clinical Trials (March 4-15, 1996).
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 mouths before 'the date of commencement of the Seminar/Symposium/Work-
shop, etc.
10
ICMR PUBLICATIONS
Price (Rs.)
Nutritive Value of Indian Foods (1985), by C. Gopalan, B.V. Ramasastri and S.C. Balasubramaniam,
Revised and Updated (1989), by B.S. Narasinga Rao, K.C. Pant and Y.G. Deosthale (Reprinted 1995)
23.00
Growth & Physical Development of Indian Infants and Children (1972, Reprinted 1989)
10.00
Studies on Weaning & Supplementary Foods (1974, Reprinted 1986)
6.00
Studies on Pre-school Children (1974, Reprinted 1984)
6.00
A Manual of Nutrition .(Second Edition 1974, Reprinted 1992)
4.50
Low Cost Nutritious Supplements (Second Edition 1975, Reprinted 1994)
4.00
Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for South India
(Third Edition 1977, Reprinted 1991)
4.50
Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for North India
(Second Edition 1977, Reprinted 1994)
4.50
Some Common Indian Recipes and their Nutritive Value (Fourth Edition 1977, Reprinted 1991)
10.00
by Swaran Pasricha & L.M. Rebello
Nutrition for Mother & Child (Third Edition 1978, Reprinted 1991) by P.S. Venkatachalam &
L.M. Rebello
9.00
Japanese Encephalitis in India (Revised Edition 1980)
5.00
Some Therapeutic Diets (Fourth Edition 1988, Reprinted 1995) by Swaran Pasricha
4.50
Nutrient Requirements & Recommended Dietary Allowances for Indians (1990, Reprinted 1995)
16.00
Fruits (1983, Reprinted 1992) by Indira Gopalan & M. Mohan Ram
7.00
Count What You Eat (1989, Reprinted 1991) by Swaran Pasricha
9.00
Diet & Diabetes (Second Edition 1993) by T.C. Raghuram, Swaran Pasricha & R.D. Sharma
18.00
Dietary Tips for the Elderly (1992) by Swaran Pasricha & .B.V.S. Thimmayamma
3.50
Diet and Heart Disease (1994) by Ghafoorunissa and Kamala Krishnaswamy
26.00
*Depressive Disease (1986) by A. Venkoba Rao
58.00
**Medicinal Plants of India Vol.2 (1987)
136.00
**The Anophelines of India (Revised Edition 1984) by T. Ramachandra Rao
150.00
* 10 per cent discount allowed to individuals.
** 25 per cent discount allowed to individuals.
These publications are available on prepayment of cost by cheque, bank draft or postal order (bank and postal charges will be extra) in favour of the Director
*
**
General, Indian Council of Medical Research, New Delhi. Money orders 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.4911, Ansari Nagar, New Delhi-110029 (India).
11
Dr. Som Nath Ghosh
(21 March 1929 - 19 October 1995)
A TRIBUTE
Dr. Som Nath Ghosh, formerly Director Grade Scientist, National Institute of Virology (NTV), Pune, passed
away on 19th October 1995 at the age of 66.
After obtaining the MBBS degree in 1953 from Darbhanga University, Bihar, Dr. Ghosh joined the Indian
Institute of Chemical Biology (IICB) (formerly Indian Institute of Experimental Medicine) Calcutta. He was
awarded a NIH Fellowship in 1961 which enabled him to work for his Ph.D. under the guidance of Dr. George
Gifford at the University of Florida, USA. In 1965 he returned to Calcutta and rejoined the IICB as a Pool Officer.
In 1967 Dr. Ghosh joined the National Institute of Virology, Pune, where he worked till he retired in 1990. During
this span he developed the Division of Immunology at NIV. In India he was a pioneer in the field of Interferons,
and autoimmune neurological disorders. His work on Interferon has been well recognised all over the world and
he was made a member of the International Society for Interferon Research to represent the Indian Chapter. Selfsufficiency in the field of monoclonal antibodies was his aim and under his supervision a battery of monoclonal
antibodies was developed against Japanese encephalitis (JE) virus. These were used to analyse the JE virus envelope
protein. He introduced the concept of molecular immunology by working on synthetic peptide on JE virus which
indicates his scientific enthusiasm even at the time of retirement.
In addition to being a scientist he was an excellent teacher. Fifteen scholars obtained their Doctorate/Masters
Degrees by research under his supervision. Dr. Ghosh was responsible for developing a healthy scientific culture
not only among his students but in the entire NIV. Dr. Ghosh will be fondly remembered in NIV as a genial, soft
spoken person, a true scientist and a revered teacher.
Dr. K. Banerjee
Director
National Institute of Virology, Pune
EDITORIAL BOARD
Dr. G.V. Satyavati
...
Chairperson
Dr.Badri N. Saxena
...
Member
Dr. N. Medappa
...
Editor
Printed and Published by Shri J.N. Mathur for the Indian Council of Medical Research, New Delhi
at the ICMR Offset Press, New Delhi-110029
R.N. 21813/71
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