Overt bleeding in complicated P. falciparum malaria: An experience from east coast of India

Delay in diagnosis of falciparum may result in complicated, life-threatening conditions. Though haematological abnormalities and coagulopathy are common complications that occur in malaria but complications with rare manifestations like overt bleeding do pose challenges for the clinicians worldwide. This study reports the incidence and prognosis of overt bleeding from the east coast of India and makes an attempt to relate it with the pathogenesis of the disease in severe Plasmodium falciparum malaria patients. This study was conducted in Sriram Chandra Bhanj Medical College Hospital, Cuttack, Odisha, India. A total of 120 complicated (multi organ dysfunction) malaria cases were included in this study. Amongst them 54 (45.0%) showed signs of overt bleeding and clinically the bleeding was either from one or multiple sites. Out of the total overt bleeding cases, 79.6% had elongated prothrombin time (PT), activated partial prothrombin time (aPTT) and elevated D-dimer with thrombocytopenia indicating disseminated intravascular coagulopathy (DIC). It was observed that case fatality rate was very high in coagulopathy group than the non coagulopathy group. Our observations highlight that awareness of overt bleeding in P. falcipatum infection is necessary for general practitioners in endemic areas for malaria like in Odisha for effective and timely management of complicated patients.Timely diagnosis and treatment of DIC with appropriate prescribed drugs can prevent and cure the complications of severe falciparum malaria with anti-malarial treatment.

The Prevalence of P. malariae in Odisha, India

Odisha, an eastern Indian state, is known to be highly endemic for malaria. The current national malaria control programme uses rapid diagnostic test (RDT) for early diagnosis and prompt treatment of the cases followed by microscopy for the identification of species. But as per the available literatures and from our own experience it is known that microscopy suffers with underestimation of mixed Plasmodium species infection, especially P. malariae and P. ovale. Since PCR has proven to have more sensitivity and specificity and able to detect multiple infection of Plasmodium species, we have made an attempt to find out the prevalence of species of parasites by PCR and compare the results with light microscopy. During this study 1589 individuals presenting with fever from two malaria endemic blocks namely Badampahar and Ghatgaon were investigated. Amongst them 110 cases were found to be PCR positive while 99 were microscopically positive for malaria. Out of the total PCR positive cases 42 cases (38.2%) had P. falciparum, 35 (31.8%) had P. vivax and 10 (9.1%) had P. malariae mono infections, while 23 (20.9 %) cases had mixed infections. Of the total 23 mixed infections 11(10%) were having P. falciparum plus P. vivax and rest 12 (10.9%) cases were having P. malariae mixed with either P. falciparum and /or P. vivax. However microscopically only 1(1.4%) case was found to have P. malariae mono infection and none of the mixed infections harbor P. malariae. Multiple kind lottery model analysis of PCR positive samples demonstrated that P. malariae is not distributed randomly in population when compared by different age groups, gender and season. The study also has shown that PCR is highly effective in screening the severe and asymptomatic malaria cases than LM. The result of this study warrants newer surveillance strategies for case detection and management by the programme.

Molecular survey in relation to risk factors and haemato-biochemical alteration in Theileria equi infection of equines in Punjab Province, India

Equine piroplasmosis caused by Theileria equi, an apicomplexan intracellular haemoprotozoan parasite effects equids throughout the world. Current investigation is the first detailed epidemiological survey report based on conventional (blood smear) and primary polymerase chain reaction (PCR) for the detection of T. equi on 464 equids (426 horses and 38 donkeys/mules) in Punjab province of India. PCR targeting 18S rRNA gene of T. equi produced high fidelity 709bp amplification products with 100% concordance with blood films. The prevalence of infection was proportional (P≤0.01) to temperature and aridness of the regions, which turned out to be the most important physical factor pertaining to T. equi infection. Spatial distribution analysis revealed an increasing trend of disease prevalence from north-eastern to south-western region of Punjab by both the techniques. Haemato-biochemical analysis revealed significant decrease in total erythrocyte count and haemoglobin; and increase in mean corpuscular haemoglobin, serum globulin, glucose, creatinine, aspartate aminotransferase and bilirubin levels (P≤0.05). This study divulges the endemicity of equine theileriosis in Punjab with the prominence of various odds of infection, emphasising the pathophysiological manifestation associated with latent infection of T. equi detectable by PCR.

Prevalence of gastrointestinal parasitism in small ruminants in western zone of Punjab, India

AIM

The aim of this study was to explore the prevalence of gastrointestinal parasitism in small ruminants in relation to various risk factors in the western zone of Punjab.

MATERIALS AND METHODS

During the study, 603 fecal samples (391 of sheep and 212 of goats) were examined qualitatively by floatation and sedimentation techniques, and quantitatively by McMaster technique.

RESULTS

Out of the 603 fecal (391 sheep and 212 goats) samples examined, 501 were found positive for endoparasitic infection with an overall prevalence of 83.08%, consisting of 85.16% and 79.24% in sheep and goats, respectively. Egg per gram in sheep was apparently more 1441.88±77.72 than goats 1168.57±78.31. The associated risk factors with the prevalence of gastrointestinal tract (GIT) parasites showed that females (85.97%) were significantly more susceptible than males (69.23%). Age wise the adults (>6 months) were significantly more prone to parasitic infection as compared to young ones (<6 months). Seasonal variation was recorded throughout the year and was significantly highest during monsoon (90.10%), followed by winter (83.84%) and summer (78.35%).

CONCLUSION

The study revealed an overall prevalence of 83.08% of GIT parasitic infections in small ruminants constituting 85.16% in sheep and 79.24% in goats in the western zone of Punjab. The most relevant risk factors for the prevalence of gastrointestinal parasitism in ruminants were sex, age, and season.

Critical analysis of vector-borne infections in dogs: Babesia vogeli, Babesia gibsoni, Ehrlichia canis and Hepatozoon canis in Punjab, India

There are few published studies on various vector borne diseases of dogs in India and most depict clinical infection in dogs, diagnosed by observation of the haemopathogens in stained blood smears. This study provides the first report regarding molecular confirmation and ancestral relationship analysis of blood smears positive cases of assorted haemopathogens in Punjab province of India. On blood smear examination, haemopathogens were observed in 124 out of 778 (15.95%, 95% CI: 13.53- 18.68) blood smears. Further polymerase chain reactions (PCR) was used on bloods smear positive cases to validate the results. Out of 778 blood samples, Babesia gibsoni was most common parasite infecting dogs (15.04%, 95% CI: 12.7-17.72), followed by Ehrlichia canis (0.39%, 95% CI: 0.0-1.13), infection of Babesia vogeli and Hepatozoon canis was same (0.26%, 95% CI: 0.0-0.9). Among various risk factors studied (age, sex, season), prevalence of infection was non-significantly higher in 1-2 year of age group (19.88%, 95% CI: 14.45-26.71), regarding sex same prevalence was recorded (15.94%), and chances of infection was highest in pre-monsoon i.e. summer (18.26%, 95% CI: 14.49-22.76). Phylogenetic analysis revealed ancestral background of Ludhiana isolates of B. vogeli, B. gibsoni, H. canis, and E. canis with the isolates of Philippines, Mongolia and Tunisia.

Detection of anthelmintic resistance in sheep and goat against fenbendazole by faecal egg count reduction test

Anthelmintic resistance against commonly used anthelmintic fenbendazole was evaluated by employing faecal egg count reduction test (FECRT) in naturally occurring gastrointestinal (GI) nematodes in the semi organized sheep and goat farms of Ludhiana and Amritsar districts. A total of 80 animals (20 each for sheep and goat in both districts) were randomly selected and their faecal samples were examined by qualitative and quantitative parasitological techniques. Results indicate presence of high level of resistance against fenbendazole in both sheep and goat population of Ludhiana and Amritsar districts. More resistance was observed in the GI nematodes from animals reared in Amritsar district as compared to Ludhiana district. The level of anthelmintic resistance observed was apparently more in sheep than goats.

Pathological observations on clinical Anaplasma marginale infection in cattle

Gross and histopathological changes were recorded in a pregnant cattle died of clinical anaplasmosis, a tick transmitted economically important disease caused by Anaplasma marginale. Grossly emaciated carcass along with pale visible mucous membranes and pale serosal surface, splenomegaly and hepatomegaly was observed. Microscopically, in lungs variable extend of interstitial pneumonia, emphysema along with infiltration of mononuclear cells was seen. Spleen showed extensive increase in red pulp area with massive proliferation of lymphocytes. In liver marked thickening of capsule with fatty changes along with retention of bile was seen. Gall bladder showed congestion, glandular hyperplasia and thickening wall. Myocardium showed degeneration and necrosis.

In utero sensitization modulates IgG isotype, IFN-γ and IL-10 responses of neonates in bancroftian filariasis

In utero exposure has been considered as a risk factor for filarial infection. To evaluate the influence of maternal infection on filarial-specific IgG subclass response in neonates and their correlation with plasma levels IL-10 and interferon-γ, 145 pairs of mothers and their respective cord bloods were examined. Transplacental transfer of circulating filarial antigen (CFA) was observed in 34·8% cord bloods from CFA positive mothers. Filarial-specific IgG1, IgG2 and IgG4 responses of cord bloods were found to be positively correlated with CFA of mothers. In contrast, IgG3 responses negatively correlated with CFA of mothers. The % of similarity of recognition pattern in the cord blood with maternal blood was high for IgG3 response than IgG4 in all three groups. An increased levels of IL-10 and decreased levels of interferon gamma (IFN-γ) were observed in cord blood of infected mothers. Interferon gamma was positively correlated with IgG3 and negatively correlated with IgG4 level. On the other hand, IL-10 was positively correlated with IgG4 and CFA, indicating that cytokines may play a role in modulating the immune responses in cord bloods of sensitized foetus. The findings of the study reveal that in utero tolerance or sensitization may influence the filarial-specific immunity to infection in neonates.

Hydrocele fluid: can it be used for immunodiagnosis of lymphatic filariasis?

BACKGROUND & OBJECTIVES

Diagnosis of lymphatic filariasis using serum has been established but the utility of hydrocele fluid for the purpose is not exactly known. Since, hydrocele is a chronic form of the disease manifestation in a variety of situations and often poses difficulty in diagnosing its origin, we have evaluated the usefulness usage of hydrocele fluid for diagnosis of filarial origin of hydrocele in this study.

METHODS

Paired samples of serum and hydrocele fluid from 51 individuals with hydrocele, living in an endemic area of Wuchereria bancrofti were assessed. Circulating filarial antigen, filarial specific antibody and cytokine assay were performed in both serum and hydrocele fluid of patients.

RESULTS

Og4C3 assay detected circulating filarial antigen (CFA) in serum and corresponding hydrocele fluids. The level of IgG, IFN-γ and IL-10 were found to be high in CFA-negative, while IgM and IgE were high in CFApositive hydrocele fluid and serum samples associated with hydrocele. On the other hand neither CFA-positive nor CFA-negative hydrocele fluid and serum samples associated with hydrocele showed any difference in IgG4 level.

INTERPRETATION & CONCLUSION

This study showed that the filaria related antigens and antibodies found in serum can be detected with equal sensitivity in hydrocele fluid. Therefore, it can be used as an alternative to serum for immunodiagnosis of filariasis, and help monitoring the filarisis elimination programme.

Immuno-epidemiology of bancroftian filariasis: a 14-year follow-up study in Odisha, India

Forty asymptomatic, circulating filarial antigen negative (CFA(-ve)) and ten asymptomatic, circulating filarial antigen positive (CFA(+ve)) individuals were followed up longitudinally over a period of 14 years at intervals of 7 years in order to investigate the immunological, parasitological and clinical changes that took place in an endemic area due to natural process. The clinical status, microfilaremia, circulating filarial antigenemia and immunological responses to filarial antigens (DSSd1 and Sd30) prepared from cattle filarial parasite Setaria digitata, were examined. The observations showed that 19 individuals had developed either antigenemia or filarial symptoms (acute filarial lymphangitis/hydrocele) from CFA(-ve) group. Three individuals had cleared antigenemia and one had developed microfilaremia from CFA(+ve) group after 7 years. Increased IgG and IgM and low IgG2 and IgG4 level responses along with high lymphocyte production were observed in CFA-negative individuals. This was in contrast to observations made in CFA(+ve) subjects. The results of the present study indicated that the changes taking place in the immunological, clinical and CFA status of individuals residing in filaria endemic regions developed different clinical manifestation with course of time.

Clinico-pathological study of 50 cases of tumours of larynx

The larynx serves to protect the lower airways, facilitates respiration and plays a key role in phonation. Based on anatomic location, the larynx is divided into the supraglottic larynx, the glottis or glottic larynx, and the subglottic larynx. The tumours of larynx can be divided into benign or malignant. Laryngeal granulomas, Vocal cord nodules, Vocal cord polyps are tumour-like lesions of larynx. Benign laryngeal tumors include a large number of lesions like papillomas, hemangiomas, fibromas, chondromas, myxomas, and neurofibromas. About 95% of laryngeal carcinomas are typical squamous cell tumours. Rarely adenocarcinomas are seen, presumably arising from mucous glands. The exact cause of laryngeal cancer is still unknown. Diagnosis is based on direct or indirect visualization of the larynx, supplemented by CT scan and confirmed by histopathological examination.

OBJECTIVE

The aim of the present study was to study the clinical aspects, histopathological patterns of tumours of the larynx to study the various predisposing factors of laryngeal tumours. The present study was undertaken on 50 patients clinically diagnosed as cases of tumour of larynx. These patients were made to undergo direct laryngoscopy and the biopsy taken from the growth in the larynx was sent to the department of pathology for histopathological examination. Smoking played the main role in benign growths (25%). The main predisposing factor (73.2%) for malignant growths was smoking, tobacco chewing and alcohol abuse. The most common benign tumour of larynx was the vocal polyp. Out of the 30 cases of squamous cell carcinoma, 15 (50%) were well differentiated, 8 (26.6%) were moderately differentiated and 3 (10%) were poorly differentiated. The symptoms of laryngeal tumours can vary from mild hoarseness of voice to life threatening respiratory distress. All available methods of study should be utilized to make the diagnosis as early as possible. Early diagnosis of the lesion can lead to effective management.

Lymphatic filariasis in children: age dependent prevalence in an area of India endemic for Wuchereria bancrofti infection

Lymphatic filariasis has been considered as a disease of adults and most epidemiological surveys have excluded children. The prevalence of infection and clinical manifestations of the disease among children in the age group of 1-15 years was determined in a Wuchereria bancrofti endemic area. The 1383 children from the rural villages of a coastal district (Khurda), State of Orissa, India, were studied. The finger prick blood (50ìl) samples were collected between 20:30 and 23:30 hours for parasitological and immunological evaluation. At the same time clinical examination was also recorded. Circulating Filarial Antigen (CFA) status and antibody (IgG) to filarial antigen was also determined in the study population. The prevalence of asymptomatic microfilaraemic carriers (AS), acute disease (AC), hydrocele (Hyd) cases and cryptic infection (CFA +ve) were 9.9%, 14.6%, 3.8% and 17.1% respectively. It was observed that 45.4% of the children below 15 years of age were either infected or had clinical manifestations of the disease. IgG antibody positivity 75.4%, 84% and 95.8% were observed in 1-5 yr, 6-10 yr and 11-15 years age group respectively. The study suggested that asymptomatic infection and acute form of disease were common occurrence among the children and more than half of the children population were either infected or having clinical manifestations of the diseased by pre-adult stage (11-15 years of age) in the endemic area.

Serological survey of antibodies to Toxoplasma gondii in sheep, cattle, and buffaloes in Punjab, India

Sera from 186 sheep, 83 cattle, and 103 water buffaloes from Punjab, India, were evaluated for antibodies to Toxoplasma gondii using a commercial ELISA kit. This study was planned using a 2-stage random sampling procedure and sampling software 'survey toolbox.' In the first step, villages were selected randomly from a sampling frame of all the villages of Punjab, followed by selection of owners and animals in the second step. Antibodies to T. gondii were found in 7 of 186 sheep, 2 of 83 cattle, and 3 of 103 buffaloes. Results indicate a low prevalence of T. gondii in ruminants tested.

Effect of protein kinase C and protein kinase A inhibitors on contraction of isolated femoral arteries of SHR and Wistar rats

Alterations of calcium handling and other second messenger cascades including protein kinase C (PKC) and A (PKA) were suggested to be responsible for abnormal vascular function in spontaneously hypertensive rats (SHR). However, the relative contribution of these pathways to vasoconstriction is still not completely understood. We investigated the effect of Ro 31-8220 (PKC inhibitor) and H89 (PKA inhibitor) on vasoconstriction induced by 120 mM KCl or by addition of 10 microM noradrenaline (NA) in isolated femoral arteries of control Wistar rats and SHR. Moreover, we investigated these responses in the presence and absence of Ca(2+) ions in the incubation medium in order to assess the role of calcium influx in these contractions. We observed that while the vasoconstriction in the presence of calcium was not different between Wistar and SHR, the difference between constriction elicited by NA addition in the absence and presence of external calcium was larger in SHR. The inhibition of PKC had no effect on constrictions in SHR, but diminished constrictions in Wistar rats. PKA inhibition slightly enhanced constrictions in Wistar rats, but reduced them in the presence of calcium in SHR. We conclude that vasoconstriction elicited by adrenergic stimulation is more dependent on extracellular calcium influx in SHR compared to Wistar rats. Moreover, the activation of PKA contributes to this calcium-dependent vasoconstriction in SHR but not in Wistar. On the other hand, PKC activation seems to play a less important role in vasoconstriction in SHR than in Wistar rats.

Antigenemia in young children living in Wuchereria bancrofti-endemic areas of Orissa, India

The prevalence of filarial antigenemia (an indicator of adult worm burden) among 610 children, aged 3-15 years, was determined in three endemic villages of Khurda District, Orissa, India, during 2005. Prevalence of antigenemia, detected using Og4C3 circulating filarial antigen ELISA, was 32.6% compared with 10% microfilaraemia. Although the prevalence of antigenemia increased marginally with increase in age, no significant difference was observed among the children of different age groups (28.3% in 3-5 years, 31.5% in 6-10 years and 35.2% in 11-15 years), indicating that the adult worm burdens did not vary much according to the age of the study children. Gender did not influence the prevalence of antigenemia. The study emphasizes the advantage of using the circulating filarial antigen assay for detecting true filarial infection and demonstrates a high prevalence of antigenemia among the 610 children studied.

Age-dependent prevalence of asymptomatic amicrofilaraemic individuals in a Wuchereria bancrofti-endemic region of India

The age-related prevalence of asymptomatic amicrofilaraemics, apparently uninfected individuals, was determined in a Wuchereria bancrofti-endemic region of Orissa, India during 2001. The prevalence of these uninfected individuals was highest in the younger age groups (aged < or = 15 years), decreased rapidly in those aged > 15 to 40 years, and then stabilized in those aged > 40 years.

Parasite antigenaemia and IgG4 antibodies to a filarial protease in an endemic human population in India

Levels of circulating filarial antigen (Og4C3) and IgG4 antibodies to a filarial protease were determined in subjects of Wuchereria bancrofti exposed sera from Orissa, India. In addition to all individuals with antigenaemia (microfilaraemia), IgG4 antibodies were also detected in some individuals without antigenaemia. A 2-year longitudinal follow-up indicated that IgG4 seropositivity in asymptomatic amicrofilaraemics could be a risk factor for acquiring infection (antigenaemia).

Incidence of lymphomas in head and neck region

In the present study 109 cases of Heck swellings were subjectedto F.V.A.C. examination. H vases teere found to he positive for lymphomas with 62.5% eases presenting as cervical lymphade.nopathy. Median age of presentation tints 48 years with preponderance of femulr patients. 57.2% of the patients presented in stage I of the disease.

Antigenemia is associated with low antibody response to carbohydrate determinants of a filarial surface antigen

The IgG response to a filarial surface antigen (DssdI) was evaluated in circulating antigen (Og4C3 test) positive and negative individuals from the Wuchereria bancrofti endemic region of Orissa, India. Circulating filarial antigen (CFA) positive individuals exhibited depressed antibody levels to DssdI and individuals with high antibody levels were invariably CFA negative. Low IgG levels to DssdI are associated with CFA positivity irrespective of microfilaraemia and clinical status. Thus asymptomatic microfilaraemic individuals with antigen positivity exhibited low IgG levels similar to symptomatic (chronic filariasis with elephantiasis, hydrocele) or asymptomatic amicrofilaraemic individuals with antigenemia. Western blot analysis revealed a band of approximately 210 kDa reactive with CFA-negative, but not with CFA-positive sera. DssdI was subjected to mild periodate oxidation to investigate the role of carbohydrate epitopes. The treatment considerably reduced the antigenic recognition of DssdI, stressing the immunodominance of carbohydrate residues of DssdI in infection-free individuals. In contrast, individuals with active infection failed to produce such antibodies to filarial surface carbohydrates.

Antigenemia at 10 years after diethylcarbamazine treatment of asymptomatic microfilaraemic individuals: marginal conversion to infection-free state

A group of asymptomatic microfilaraemic individuals (n = 44, 29 males, 15 females) living in a Wuchereria bancrofti endemic region of Orissa, India, was treated with a standard regimen of diethylcarbamazine (12 days, 6 mg/kg) in 1990. The incidence of microfilaraemia and antigenemia (Og4C3) was determined after a gap of 10 years in 2000. Nineteen individuals reacquired microfilariae (43.2%, 11 males, eight females), five males developed hydrocele, two females became acute filarial patients and 18 subjects (13 males, five females) were asymptomatic amicrofilaraemics. Filarial antigen was detected in 36 individuals (81.2%, 27 male, nine female) comprising microfilaraemics, amicrofilaraemics and diseased. Only eight individuals (18.2%, two males, six females) remained antigen free.

A long-term follow-up of asymptomatic amicrofilaraemic individuals living in a filaria-endemic region of Orissa, India: infection and disease status

A group of asymptomatic amicrofilaraemic individuals (endemic normals) aged > 12 years was identified in 2 filaria-endemic villages of Orissa, India in 1990 (Bajapur village, n = 40) and in 1994 (Olosingh village, n = 47). They were re-examined for microfilaraemia and disease status in the year 2000 after a 10-year and a 6-year period. Studies conducted at both villages yielded a similar pattern in the development of disease. Above 85% of the females remained normal, compared to 54% of males. Remaining individuals had acquired hydrocoele (males) and adenolymphangitis (both males and females). Only 1 individual converted to having asymptomatic microfilariae. No case of elephantiasis was observed. Results indicate that most females remained normal and males faced considerable risk of developing hydrocoele in these Wuchereria bancrofti-endemic areas.

Fibrous histiocytoma of orbit: a case report

A fifty year male (K.S.) presented with protrusion (Proptosis) of left eye which was gradually increasing in size for the last one year. The swelling was accompanied by pain for the last fifteen days. Preoperative X-ray & computed tomography showed erosion of frontal sinus & roof of maxillary sinus. Clinical diagnosis of a malignant tumour of eye was made & enucleation of the left eye, along with the mass was done. The specimen was received in the pathology department on 16.9.98. Grossly, encapsulated mass attached with the intact eye ball was received. The mass measured 5x3x2.5 cms. Microscopic examination revealed a benign spindle cell neoplasm and a diagnosis of fibrous histiocytoma (dermatofibroma) was made.

Myelolipoma of adrenal gland in association with occult malignancy--a case report

Myelolipoma is an unusual lesion of adrenal gland in which ectopic marrow tissue is present. This case is being present because of its rarity.

Incontinentia pigmenti

A case of incontinentia pigmenti, a rare genodermatosis, is being presented.

Chromoblastomycosis

This is an account of twenty eight years of sufferings of a young sikh agriculturist, who ultimately succumbed to chromoblastomycosis- a not so uncommon mycotic infection, despite the use of toxic (amphoterecin-B) and newer antimycotic drugs (ketoconazole). Involvement of face, small and large gut, larynx and trachea are the other highlights of this case.

Male genital tract tumors in Punjab, India

A total of 95,797 tissue specimens were submitted to our laboratory for histopathological examination during the 21-year period from January 1964 to December 1984. Out of 21,281 cases diagnosed as tumors, 9,254 were found in the male population, comprising 6,846 malignant neoplasms and 2,408 benign neoplasms. There were 1,175 tumors of the male genital tract of which 1,118 were malignant and 57 were benign. The incidence of male genital tract cancer represented 16.33% of male malignancies. The relative frequency of malignant tumors of various organs in the male genital tract was penis, 42.49%; prostate, 40.34%; testis, 15.92%; scrotum, 0.71%; epididymis, 0.36%; spermatic cord, 0.09%; and urethra, 0.09%. All these tumors were classified into various histopathological types and their relative frequency was determined. Some of the rare tumors diagnosed included leiomyosarcoma of the penis, transitional cell carcinoma of the prostate gland, orchioblastoma of the testis, and carcinoma of the urethra. A separate study by this department on the pattern of cancer distribution revealed that cancer of the uterine cervix is the most common malignancy in females in this geographic region. We postulate that a common carcinogenic agent, either a virus or a biochemical (smegmatic) factor, may be responsible for the high incidence of carcinoma of the penis in males and carcinoma of the cervix in females. Educating people about the importance of penile hygiene, and, in particular, educating mothers to retract the foreskin of male babies and to wash it with soap and water when bathing them, will hopefully reduce the incidence of these cancers in regions of high prevalence.

The kinetic disposition and dosage regimen for carbenicillin in buffalo calves

The distribution half-life, elimination half-life, apparent volume of distribution and total body clearance of carbenicillin in healthy buffalo calves following a single intravenous administration (50 mg/kg) were 0.057 +/- 0.005 h, 1.688 +/- 0.11 h, 0.185 +/- 0.021 L kg-1 and 75.97 +/- 6.519 ml kg-1 h-1 respectively. A satisfactory dosage regimen for carbenicillin in buffalo calves was calculated to be 56 mg/kg followed by 52 mg/kg body weight repeated at 6 h intervals.