Long term lung retention studies of 125Sb aerosols in humans

This paper describes the retention of 125Sb oxide aerosols in human lungs based on the data obtained from a group of seven accidental inhalation exposure cases. Long-term follow-up studies for periods of time ranging from 1 to 3 d post intake to 199 to 2,422 d post intake have indicated the biological lung clearance half-time of this material ranging from about 600 to 1,100 d for non-smokers and 1,700 to 3,700 d for smokers. The retention in the lungs after 180 d in all the seven cases is found to be much more than 51% of the estimated initial alveolar deposit, which is consistent with the present ICRP criteria of assignment to the lung absorption Type S. There is little previously reported human data on this radionuclide compound. In these studies reliable information on actual time of intake, the likely type of material, and the amount of retained body/lung activity in initial days after the incident was also available, which adds to the importance of these data. The results of these studies provide a basis for firm classification and suggest that oxides of antimony need to be removed from absorption Type M (earlier class W) where these are presently listed by ICRP and be placed in absorption Type S (earlier class Y). The range of measured retained lung activities after the initial rapid clearance phase (7 d post exposure) was about 3 to 14 kBq, which was sufficient for long-term follow up studies using the whole body counters.

A new focus of cutaneous leishmaniasis in Himachal Pradesh (India)

This paper highlights a new focus of cutaneous leishmaniasis (CL) in the temperate area of Himachal Pradesh (India), a previously non-endemic area. In this hospital-based study, 38 new cases of CL, acquired indigenously have been detected from 1988-2000. Of these, 26 were from Kinnaur district and 12 from adjoining areas of bordering districts situated along the river: Satluj. There were 18 males and 20 females. They were between 4-75 years of age and had the disease for one month to 2 years at the time of presentation. Face involvement was seen in majority of the patients. Nodulo-ulcerative plaque was the commonest lesion. Muco-cutaneous lesions were seen in four cases. Tissue smears and biopsies were positive for LD bodies in 61.7% and 29.4% cases respectively. Intralesional sodium stibogluconate produced a consistent therapeutic response. The possible mode of its introduction in the region is postulated. The reservoir of infection, identity of the vector at this altitude (9,002,900 meters above sea level) and the strain of leishmania, remain to be identified.

Spontaneously improving Michelin tire baby syndrome

Michelin tire syndrome is described in a 22-month-old girl of Indian origin who had generalized folding of the skin, esotropia, epicanthic folds, and delayed speech. Histopathology showed diffuse lipomatous hypertrophy. The skin changes showed partial improvement on follow-up. We report this case because of its rarity. Furthermore, the spontaneous improvement is significant, unlike the persistent course of other congenital nevi.

A computational study of the urinary excretion rates for 339Pu using new ICRP internal dosimetry models

A computational study of the urinary excretion rates for 239Pu has been carried out using a methodology which involved the solution of a complete compartmental model describing the biokinetic behaviour of inhaled plutonium aerosols in the human body. The methodology, after proper validation, was applied to investigate the dependence of urinary excretion rates for 239Pu on the transfer rates given in the complete compartmental model. For this purpose, the default values of the transfer/absorption rates were modified by factors of 2 and 4 and urinary excretion rates were computed on 1, 10, 100, 1000 and 10,000 d post-intake. The percentage variations in the urinary excretion rates as a result of the modified transfer rates were computed for exposures to Type M and S aerosols of 239Pu. These results facilitated the identification of parameters significantly affecting the short-term and long-term urinary excretion rates. In addition, time variations of the predicted ratios of 239Pu activity in daily urine to that in blood (excretion ratios) were studied for the three biokinetic models of plutonium: the ICRP 67 model, the modified ICRP 67 model with the compartment STI to urinary bladder removed and Luciani and Polig's model. All the computational results are presented and discussed in this paper.

Validation of biokinetic models of Cs and I using their daily dietary intakes and organ contents in an adult Indian population

The daily dietary intakes and total contents of Cs and I in skeletal muscle and thyroid, respectively, for an average Indian adult were estimated by determining their concentrations in the total cooked diet and tissue samples using instrumental neutron activation analysis. These data were then used to predict the biological half-lives of Cs and I and their radioactive counterparts for the Reference Indian Man. The predicted biological half-lives of Cs and I for Reference Indian Man were found to be comparable with the reported values for the ICRP Reference Man.

Assessing skull burdens of actinides using a mathematical phantom: a Monte Carlo approach

In vivo monitoring techniques are needed to estimate the amount of an actinide in the skeleton in addition to that in the lungs and liver. Skull counting with external detectors has been a standard procedure for this purpose. Realistic skull phantoms are normally used to calibrate the counting systems. However, the fabrication of realistic phantoms is extremely difficult and expensive. Therefore, a theoretical approach based on Monte Carlo methods in conjunction with a Cristy mathematical phantom has been examined for assessing skull burdens of actinides. A computer program that generates surface sources of actinides on the skull and simulates low-energy photon transport in the heterogeneous media of the head region of the Cristy phantom was developed for this purpose. The program determines the observable pulse height spectrum of the detector and the corresponding calibration factors for different counting geometries. The computer program was used to generate the pulse height spectra and the corresponding calibration factors of 20 cm and 15 cm diameter phoswich detectors, each positioned on the left and right sides and on the top of the head region of the Cristy phantom, whose skull surfaces were assumed to have a uniform distribution of 241Am. The computed calibration factor for a counting geometry consisting of three phoswich detectors (15 cm diameter each) surrounding the phantom's skull was found to be in excellent agreement with the experimental results obtained for the same geometry using a realistic physical skull phantom. This provided a validation of the realistic design of the skull in the Cristy phantom, implying that the results reported in this paper could be used for in vivo measurements of skull burdens of 241Am for the stated counting geometry.

Feasibility studies for assessing internal exposure to 233U

The potential internal occupational exposure encountered as a consequence of the 232Th-233U fuel cycle are likely to arise predominantly from the inhalation of 232Th, 233U and (232Th + 233U) compounds of absorption Types M and S. In the past, although direct and indirect methods for assessments of internal exposure to 232Th and its daughters were developed, standardised and employed, no such attempts have been made with regard to 233U and 233U + 232Th. Therefore, feasibility studies for assessing internal exposure to 233U have been conducted using three methods: urine bioassay, in vivo counting and measurement of thoron gas in the exhaled breath of a worker. This paper describes details of these studies and discusses the results obtained.

Evaluation of the potential of laser-induced breakdown spectroscopy for detection of trace element in liquid

The analytical figure of merit of the potential of laser-induced breakdown spectroscopy (LIBS) has been evaluated for detection of trace element in liquid. LIBS data of Mg, Cr, Mn, and Re were studied. Various optical geometries, which produce the laser spark in and at the liquid sample, were tested. The calibration curves for Mg, Cr, Mn, and Re were obtained at the optimized experimental conditions with bulk liquid and in liquid jet. It was found that measurements using a liquid jet provide better detection limits than bulk liquid measurements. The limits of detection (LOD) of Mg, Cr, Mn, and Re in the present liquid jet measurement are found to be 0.1, 0.4, 0.7, and 8 ppm, respectively. The LOD of Mg using Mg 279.55 nm was compared with the values found in other liquid work.

Persistence of dengue-3 virus through transovarial transmission passage in successive generations of Aedes aegypti mosquitoes

Progeny of Aedes aegypti mosquitoes infected intrathoracically with dengue-3 virus was reared to subsequent generations. In each generation, blood-fed females were confined individually and the eggs obtained from the transovarially infected females were pooled. The seventh generation obtained from the infected parental mosquitoes showed that virus could persist in mosquitoes in successive generations through transovarial passage. The rate of vertical transmission initially increased in the few generations (F1-F2), but in subsequent generations it was found to be steady. Parental mosquitoes inoculated with virus showed higher mortality than the diluent-inoculated controls. There was an increase in the larval duration of transovarially infected batches at the seventh generation when compared with uninfected control mosquitoes. The fecundity and fertility of the transovarially infected batches of mosquitoes was also affected when compared with the controls. This is the first report demonstrating persistence of dengue virus in the successive generations of mosquitoes infected through vertical transmission. These observations, which have great epidemiologic importance, suggest that vector mosquitoes may play an important role in the maintenance of virus in nature, and that mosquitoes may act as reservoirs of these viruses.

Bancroftian filariasis in Bagdogra town, district Darjeeling (West Bengal)

Filaria endemicity is probably gradually increasing over the years in Bagdogra town, district Darjeeling (West Bengal). Of 1511 night blood smears examined, 35 were found positive for Wuchereria bancrofti (mf rate 2.32%). The microfilaria (mf) rates for males and females were 2.84% and 1.79 % respectively. The age of these positives ranged from 5-45 years. The mf rate was highest (4.46%) in the age group of 20-29 years. All mf carriers were local residents of Bagdogra and Wuchereria bancrofti was only the infection encountered. Mean microfilaria density was 7.71 per 20 cmm. of blood, whereas Median microfilaria density (MFD50) was 21 per 20 cmm. of blood. Disease and filarial endemicity rates were 0.33% and 2.65% respectively. Ten man hour vector mosquito density ranged from 30 to 65. Out of 49 female Culex quinquefasciatus mosquitoes dissected for the presence of filaria infection, none was found positive for the infection. During 1976 survey in the same town, mf rate was 1.6% and disease rate was nil.

Ocular scrofuloderma with unilateral proptosis

Proptosis due to an extraconal orbital abscess of tubercular origin with lacrimal gland involvement, representing ocular scrofuloderma, is a rare entity. This association has not been reported earlier in the literature. We describe a 7-year-old boy who presented with nodulo-ulcerative lesions of tubercular etiology with discharging sinuses on right side of the face and a similar lesion on the right lower eyelid along with proptosis of 4 months duration. Computerized tomography (CT) scan of the head confirmed the extraconal, intraorbital, hyperdense, homogeneously enhancing mass separated from the lateral rectus muscle and further revealed involvement of lacrimal gland along with erosion of the temporal bone. The patient showed marked improvement of his dermatological and ophthalmological lesions with anti-tubercular treatment. Subsequent ultrasound examinations of the orbit revealed regression in the size of the abscess from 10.7 mm to 5.0 mm and then complete disappearance of the abscess obviating surgical intervention.

Breeding habitats and larval indices of Aedes aegypti (L) in residential areas of Rajahmundry town, Andhra Pradesh

Entomological studies on relative prevalence and distribution of adults and immatures of Aedes aegypti were conducted in Rajahmundry town of Andhra Pradesh from December 1998 to November 1999. Adults and immature stages of Aedes aegypti were found in all the 22 localities viz; posh area (8), mixed area (8) and slum area (6) of the town. Larval indices were found to be higher in slum areas as compared to mixed or posh areas of the town. However, the larval habitats were observed to be similar in all localities. The larval indices were highest during monsoon and post-monsoon months. The breeding preference ratio (BPR) was highest for cement tubs followed by discarded tyres and barrels. The high larval indices of Aedes aegypti in these areas warrant intensification of vector surveillance activities along with source reduction and health education.

Development of an automated shielded chair whole-body monitor

A standard shielded chair whole-body monitor has been developed as a computer controlled, unattended, walk-in-type of whole-body monitor for internal dosimetry of radiation workers. A radiation worker enters his personal computer code through the attached computer terminal and follows a few instructions on the screen. The chair door then opens automatically and after the worker has positioned himself into the counting geometry in the chair, the door closes. At the end of the whole-body monitoring for a pre-set time, the chair door opens again and the worker moves out. The monitoring data acquired on a 4K-MCA is saved in the computer memory automatically and the chair door closes again making it available for monitoring the next worker. The system also gives audio instructions to the worker to occupy the chair and to move out after the counting is over. A system supervisor can come at any convenient time and get a print out of the monitoring report in the standardised format or carry out any detailed analysis if required. The system has the software for calculating intakes and the committed effective doses using the latest ICRP methodologies, from the measured retained activities of the various important fission and activation products like 137Cs, 131I, 60Co, 125Sb etc. This type of system with trained staff is also expected to be of value in case of emergencies as a quick monitoring system.

Ellis-van Creveld Syndrome: a report of two cases

Ellis-van Creveld syndrome (EVC) or chondroectodermal dysplasia, a rare autosomal recessive disorder, is a tetrad of chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital heart disease, of which chondrodystrophy of the tubular bones is the most common feature, while central nervous system (CNS) and urinary tract anomalies are some of its rarer associations. This report describes EVC syndrome in two sisters of Indian origin, ages 8 and 6 years, the products of nonrelated, unaffected parents. The patients had chondrodysplasia of tubular bones resulting in disproportionate dwarfism, polydactyly, severely dystrophic nails, partially absent teeth, and short and bound-down upper lips with multiple frenulae. Other features noted in the girls were syndactyly and mild mitral regurgitation. All four of the classic features of EVC syndrome were present in patient 1 and three in patient 2. Additional findings were ichthyosis and plantar keratoderma in the former and absent clavicles in the latter, which have not been reported previously. The importance of prenatal diagnosis of EVC is stressed and a multidisciplinary approach for the management of these patients is highlighted.

Tuberculosis of the vulva masquerading as a sexually transmitted disease

Tuberculosis of the vulva is a rare condition usually seen by a gynecologist. We report a case of chronic ulcer on the vulva of four months duration, which, on detailed investigation, turned out to be a case of primary inoculation tuberculosis. The patient was subsequently put on antitubercular therapy with a good the therapeutic response. The rarity of this presentation in dermato-venereology is emphasized.

Status of soil transmitted helminthic infections in India--observations on sample surveys using Kato-Katz technique

Results of surveys conducted in eight different ecologically homogenous zones in the country, using WHO sampling design methodologies and Kato-Katz technique are presented in this communication. Hilly and coastal areas had high STH prevalence ranging from 34%-36% with total epg ranging from 53,952-4,67,976. Apart from this, Chitradurga urban area had STH prevalence of 39.6% with epg of 81,792. However, except in few cases, in all these surveyed areas, intensity of STH infection was found to be light. A national programme for control of soil transmitted helminthic infections is advocated.

Porokeratosis of mibelli: Disseminated non actinic form

Two cases of nonactinic - disseminated porokeratosis of Mibelli are reported. Autosomal dominant mode of inheritance was observed in one case.

A suspected case of primary cutaneous actinomycosis on the buttock

Primary cutaneous actinomycosis is rare and can mimic mycetoma, tuberculosis and nocardiosis. The results of cultures (aerobic and anaerobic) are not always positive. A high degree of clinical suspicion should be entertained and a combination regimen of penicillins with sulphonamides should be used for treatment. We report a patient with primary cutaneous actinomycosis over the buttock, who was successfully treated with amoxicillin and sulphonamides.

Linear and whorled nevoid hypermelanosis

Linear and whorled nevoid hypermelanosis (LWNHM) is a reticulate pigmentary disorder with a sporadic occurrence, representing genetic mosaicism. It is characterised by hyperpigmented macules in a reticulate pattern along Blaschko's lines, sparing the mucous membranes and stabilising after one to two years. It may be associated with various neurological abnormalities. The disorder may resemble incontinentia pigmenti, epidermal nevus, or zebra-like hyperpigmentation clinically. We report LWMNHM in a 15-year-old girl with progressively increasing streaks of reticulate hyperpigmented macules arranged in a whorled pattern over the trunk and extremities, which appeared soon after birth. There was no history of any preceding eruption or any associated systemic abnormality. Histopathological examination revealed basal cell hyperpigmentation without any pigmentary incontinence. CT scan of the brain was normal.

Internal dosimetry of plutonium using the late urinary excretion

An attempt has been made to standardize the methodology of internal dose computation from the late urinary excretion data. The methodology was selected keeping in mind the most recent ICRP publications and the results of internal dosimetry intercomparison studies reported in literature. The key element of this methodology is the PC-based computational software LUDEP 2.05, which implements the new model of the human respiratory tract. Late urinary excretion data of three male subjects involved in accidental intakes of plutonium aerosols more than 25 years ago were interpreted in terms of intakes and internal doses with the aid of the standardized methodology. An important implication of this work is that late urinary excretion data of the occupational workers of any plutonium handling facility could be used to show the compliance with the life-time dose limit.

Three unusual siblings with Harlequin icthyosis in an Indian family

Harlequin fetuses occurring as three siblings in an Indian family are described here. All three were preterm, low birth weight, and did not survive. There was no history of consanguinous marriage in the parents or in the family. Thus autosomal recessive inheritance appears to be a remote possibility, although not impossible or, as recently described, these recurrent harlequin fetuses could be the result of new dominant mutations with parental mosaicism.

Lichen Planus-a Clinico-histopathological

The clinico-histopathological features of 75 patients of lichen planus were studied. The male to female ratio was 1:13. The largest number of patients (30.6%) fell into the 31-40 year age group. Two patients had systemic hypertension. There was no history of lichen planus in the family. All patients presented with severe itching within 1-2 months of onset. Papular lesions were seen in 72% and papules with plaques were seen 16%. Lower limbs were involved in 38% of cases. Mucosal involvement was seen in 24% in addition to skin involvement ; nail involvement hypertrophicus (17.3%). Lichen planopilaris and oral lichen planus were uncommon. Clinico-histopathological discrepancies were observed in 7 patients. Civatte bodies were seen in only 37% of cases.

Transition of pemphigus vulgaris to pemphigus foliaceus

We report a case of pemphigus vulgaris in a 46-year-old woman who presented with scaly and crusted erosions over erythematous base associated with itching and burning mainly over the chest, submammary folds, face, abdomen and the back. Histopathology was consistent with pemphigus foliaceus. The patient responded to oral prednisolone (60 mg/day). The above findings suggest that pemphigus vulgaris showed a transition to the pemphigus foliaceus variant.

A study of filarial transmission in a non-endemic area of Pathankot (Punjab)

A filariasis survey was conducted in July 1998 in Pathankot town of Punjab covering a population of 28, 041. A total of 2136 blood smears were collected from migratory and local inhabitants. Microfilaria (Mf) rate and mean Mf density was 1.19 and 15.05 respectively. Disease rate was nil. All the 20 microfilaria carriers detected were known to hall from filaria endemic areas of different states. Mf rate was highest in 20-49 years age-group, whereas Mf density was high in younger age group. Wuchereria bancrofti was the only infection encountered. 10 Men Hour Density of Culex quinquefasciatus ranged between 343 in the North Command unit to 400 in an engineering unit. A total of 339 female Culex quinquefasciatus were dissected. None was found positive for human microfilaria parasite, thus negating any indigenous filariasis transmission in this town. These findings were compared to earlier surveys in the same area and other non-endemic areas. Non-endemic areas continue to be non-endemic for filariasis despite considerable increase in MF rate among migratory population and vector density.

Trichotillomania and trichophagia leading to trichobezoar

A 14-year-old female presented with the complaints of loss of hair, scalp pruritus, and pain in the abdomen. On careful work-up, she was found to have trichotillomania as well as trichophagia. Investigations also revealed a trichobezoar which completely filled the stomach. Hemogram showed moderate hypochromic anemia. Her detailed psychiatric profile showed a few additional features like obsessive hand washing, knuckle cracking, nose picking and body rocking. Her trichobezoar was removed surgically, and she had an uneventful post-operative recovery. She is being maintained on fluoxetine and is doing well. The role of a multi-disciplinary approach to trichotillomania patients is highlighted.

Chromoblastomycosis in India

BACKGROUND

Four patients with chromoblastomycosis are presented. An additional 30 infected Indian patients are reviewed.

RESULTS

These 34 patients ranged in age from 12 to 80 years with a male to female ratio of 5.8 : 1. Onset before the age of 20 years was seen in 24% of cases which was comparatively high. Culture was positive in 72% of cases and sclerotic bodies were observed in 84% of cases. A relatively higher prevalence (15%) of Fonsecaea compacta was observed. Unusual cutaneous sites afflicted were the penile shaft, vulva, and ala of the nose, and unusual extracutaneous spread was seen in the pleural cavity, ileocecal region, laryngotracheal area, and tonsils. Extracutaneous involvement was seen in 24% of cases. Overlapping infection with another fungus, Geotrichum candidum, was seen in one case.

CONCLUSIONS

Combination therapy with two azoles was attempted with some success for clinical cure.

Linear attenuation coefficients of tissue-equivalent materials of differing compositions for low energy photons

Total linear attenuation coefficients of three tissue equivalent materials differing in their fat contents were experimentally determined for low energy photons in the range 13-51 keV. It is found that their variations with photon energy for each of these materials are describable by two distinct power functions with the validity ranges being (13-23 keV) and (32-51 keV), respectively. Therefore, to adequately represent the variation of total linear attenuation coefficients over the full photon energy range i.e., 13-51 keV, a sum of two power functions is needed. Least squares fitted equations to the entire experimental data are thus included. For muscle, the experimental data show a reasonably good agreement with the theoretically computed values that are available in literature.

Erythroderma in children: a clinico-etiological study

Although there are various published studies on erythroderma from western and Asian countries, most of them have only included patients in the adult age groups. As we have an exclusively pediatric dermatology unit, we thought it would be intriguing to study the clinical, etiological and laboratory parameters of erythroderma in children. Seventeen erythroderma patients of both sexes were inducted into the study between 1993 to 1998. The mean age of onset was 3.3 years and the male:female ratio was 0.89:1. Eight (47%) of the patients were infants; 9 (53%) others belonged to the preschool and school going age group (age range between 1 to 12 years). An acute onset of the disease was seen in 47% of the patients while 53% of the patients had a chronic onset. The main presenting complaints were itching in 41% and burning in 18% of patients. Scalp involvement (71%), nail involvement (18%), and alopecia (6%) were the main cutaneous features observed while fever (53%), tachycardia (53%), pedal edema (12%), lymphadenopathy (18%), and hepatomegaly (12%) were the main systemic features observed in this study. Etiologically, drugs (29%), showed the highest incidence, followed equally (18%) by genodermatoses, psoriasis, and staphylococcal scalded skin syndrome (SSSS). Two (12%) patients had erythroderma due to atopic dermatitis, while one was (5%) due to infantile seborrheic dermatitis coexisting with dermatophytosis. Laboratory parameters contributed little towards diagnosis of the underlying dermatological condition. Thus, though erythroderma is a striking entity, it is yet uncommon in the pediatric age group. Because the drug induced group was the largest in this study, we recommend that drugs should be suspected as important causative factors of erythroderma in children.

Increased incidence of allograft rejection in stable heart transplant recipients after late conversion from mycophenolate mofetil to azathioprine

Mycophenolate mofetil (MMF) is a safe and effective immunosuppressive agent in kidney and liver transplantation. Preliminary studies also support its use in heart transplantation. However, the cost of MMF is substantially greater than azathioprine (AZA), the current alternative. Since the majority of rejection episodes occur within the first few months of transplantation, using MMF early after transplantation and subsequently converting to AZA, after the risk of rejection has diminished, might be cost-effective. In order to evaluate the safety of such a strategy in heart transplant recipients, we reviewed the rejection profiles of a group of patients who were converted from MMF to AZA late after transplantation. Forty-three stable patients on chronic MMF therapy as part of an open-label, long-term safety study were converted to either commercially available MMF (CellCept) or AZA, at the conclusion of the study. Demographic variables, rejection histories before and after conversion, and immunosuppressive regimens were examined. Twenty-three patients were continued on commercial MMF and 20 were converted to AZA therapy. The average duration of MMF therapy prior to conversion was 41 months in each group. Baseline demographics were similar in the two groups. Treated allograft rejection occurred in 10 of 20 patients converting to AZA, as compared to only 1 of 23 patients remaining on MMF; p = 0.002. Additionally, mean scores (1-5 scale) for the three biopsies before and after conversion favored continued MMF therapy (1.5+/-0.6 before and 1.2+/-0.4 after conversion in MMF group vs. 1.3+/-0.5 before and 1.7+/-0.9 after conversion to AZA; p = 0.02). No allograft loss occurred as a result of conversion. These data suggest that conversion from MMF to AZA, even late after transplantation, can be associated with allograft rejection. The costs associated with these rejection episodes (the additional immunosuppressive agents, endomyocardial biopsies, and physician visits) may exceed the potential cost savings of converting stable heart transplant recipients from MMF to AZA.

Clinico-bacteriological study of pyodermas in children

One hundred cases of pyodermas in children were investigated clinically and bacteriologically. Nasal and throat swabs from all cases were subjected to bacteriological examination. Most of the children (42%) were in the 1-4 year age group. The majority (58%) belonged to lower socio-economic groups with poor standards of hygiene. A history of over-crowding was obtained from 87% of cases, 82% were undernourished. Most of the children (68%) reported during the hot and humid months of June, July, August, and September. Primary pyodermas were observed in 72% of the children, and secondary pyodermas in 28%. Impetigo was the commonest primary pyoderma (48.61%); among secondary pyodermas, infected scabies was noted predominantly (42.86%). The face and legs were more commonly involved. Bacteriological cultures from pyoderma lesions revealed a single microorganism in the majority of the patients (84%). Staphylococcus aureus was isolated in pure culture from 48% and pure beta-hemolytic streptococci from 36%. A combination of both was obtained from 16%. No other organism was isolated from any case. A similar pattern was also observed in cultures from the nose and throat. Only 46 out of the 64 strains (84.3%) of Staphylococcus aureus isolated from pyoderma were typable. The majority (39.1%) showed a mixed pattern of phages; the second commonest was the non-allocated phage type (30.4%). Nasal flora had more of the non-allocated phage type (50%); two out of the three strains (66.6%) isolated from the throat showed a mixed pattern. All the strains of beta hemolytic streptococci, isolated either from lesions of pyoderma, nose, or throat belonged to group A. Staphylococcus aureus and showed a high sensitivity to netilmycin (100%), ofloxacin (98.4%), amoxycillin/clavulanic acid (96.9%), ciprofloxacin (89.1%) and gentamycin (84.4%) but a high resistance to penicillin (85.9%). A greater correlation was noted between nasal flora and organisms causing pyodermas. A change in the pattern of organisms causing pyodermas in children and their antibiotic sensitivities in this part of the globe has been observed in this study. The role of endogenous nasal and throat flora in the causation of pyodermas has also been highlighted.

Relationship between lichen planus and hepatitis C virus

The present study was conducted on 75 patients of lichen planus to observe the relationship of hepatitis C virus. Only 2 cases (2.66%) were positive for the hepatitis C virus antibody, which is almost parallel to the prevalence of hepatitis C virus in the general population in India (1.5 to 2.2%).

Early development of acute filariasis in a migrant from non-endemic to hyper endemic area: a case report

A case report of a European woman who contracted filariasis after staying for a few weeks in a filaria endemic area of south India is presented in this paper.

MALARIA CONTROL AMONGST TROOPS INVOLVED IN COUNTER INSURGENCY OPERATION IN RESISTANT PLASMODIUM FALCIPARUM AREAS

Incidence of malaria in troops carrying out counter-insurgency operation in thick jungles in North East region was compared for the year 1995 and 1996. Since troops were on constant move in thick jungles in hostile environment and they have to sleep and rest outdoor, use of mosquito net was not feasible in both years. Counter-insurgency operation lasted for two and half months in both the years from last week of March - 1st week of June. Inspite of troops being on 300mg chloroquine (base) per week as chemoprophylaxis, 40 cases (5%) of malaria were observed in troops in the year 1995. During the year 1996 troops were advised to take 600mg chloroquine (base) per week as chemoprophylaxis. Three cases (0.40%) of malaria were observed during the year 1996. Difference was found to be statistically significant.

Attempted suicide in himachal pradesh

Seventy five cases of attempted suicide were studied over a period of one and half years (from January 1996 to June 1997). The findings revealed that 85.4% cases were in the age group 15-54 years. Females (53.4%) and unmarried (52%) attempted suicide more often. House wives (32%) and students (28%) were the two commonest occupational categories involved. Organophosphorus compounds were consumed by a vast majority (74.7%) of the cases. Psychiatric disorder (46.7%), quarrel with spouse/in-laws (13.4%), quarrel with parents/sibs (12%) and failure in love (10.6%) were the most common causes of attempted suicide while no cause could be determined in 14.7% of the cases. A need to launch suicide preventive measures and restriction in the sale of organophosphorus compounds is stressed.

Familial reactive perforating collagenosis: a case report

Reactive perforating collagenosis is characterised by trans-epidermal elimination of collagen and is hypothesized to be both autosomally dominant and recessive. We report a family in which two brothers and a sister had lesions of reactive perforating collagenosis.

False indications of an actinide lung burden arising from a contaminated finger wound

This paper presents the results of in vivo measurements on a worker from a fuel reprocessing plant who was involved in an actinide intake. The results revealed that false indications of an actinide lung burden could arise from a contaminant present elsewhere in the chest region. Consequently, it is important that lung monitoring programs for occupational workers handling actinides are conducted with this caution in mind and that due consideration is given even in cases of minor cuts/wounds in order to rule out substantial overestimation of internal radiation doses.