Highlights of ICMR Activities & Achievements

 

Communicable Diseases

 New infrastructure

  • Units of NIV were established at Gorakhpur , Uttar Pradesh and Allapuzzha, Kerala to address arboviral infections especially Japanese Encephalitis (JE).
  • The civil work on BSL-4 facility at MCC is expected to be completed before the end of 2009, and soon the processing of acquiring equipment would start. This adds to capabilities of BSL-3 labs at Pune, Kolkata, Chennai, and Dibrugarh
  • NARI accredited by WHO to carry out anti-retroviral drug resistance testing – (the only one in South East Asia ).
  • NIV designated as H5 reference laboratory for South-East Asia .
  • RMRI, Patna identified as WHO reference center for leishmania parasite and serum bank.

New tools

Diagnostics

  • Dengue antigen capture ELISA in infected and desiccated Ae aegypti mosquitoes evaluated.  Storage at room temperature upto 4 weeks does not affect reactivity.Giemsa staining method was found to be effective and simple alternate to PCR for confirming the presence of Wolbachia spp in mosquitoes.
  • New algorithm for PCR assay for polio virus reduced the period of testing from 28 to 14 days and intratypic differentiation from 14 days to 7 days.
  • An immunodiagnostic assay developed for detection of  P.vivax  antigen.
  • Evaluated rapid diagnostic tests for malaria, resulting in their introduction in the programme.
  • Two step  DNA–IT 52 PCR assay to differentiate the 5 individual sibling species of An. culicifacies developed
  • Development of latex based agglutination technique for detection of leptosprial antibody in acute phase.
  • In collaboration with Serum Institute of India a recombinant hepatitis E vaccine developed and pre-clinical trial in rhesus animal successfully completed
  • Development of Diagnostic assay for Chlamydia trachomatis. Target users- Public/ Private Hospitals, Diagnostic Labs
  • Developed a highly sensitive and species specific PCR for diagnosis of Kala-azar and Post Kala-azar Dermal Leishmaniasis. This test was validated in endemic area in large number of samples. This test was granted US Patent.
  • Developed ELISA and other immunological tests for KA and PKDL diagnosis
  • Identified a novel antigen that has  potential as a diagnostic as well as prognostic agent for KA.

 

Drugs

  • Completed Phase-II expanded safety and acceptability study of vaginal microbicide 1% Tenofovir Gel – 100% retention rate.  Overall safety profile of product was good.
  • Five clinical trials with new artemisinin combinations successfully completed for malaria.
  • Combination therapies for visceral leishmaniasis evaluated (Ambisome, Miltofosine and Paramomycin).
  • Efficacy and safety of 3 and 4 months moxiflox containing regimen for pulmonary TB are underway.
  • Efficacy of combined immunotherapy and chemotherapy in pulmonary tuberculosis is being evaluated

 

Vaccines

  • Two Phase-I studies for HIV vaccines were completed, AAV at NARI, Pune and MVA based vaccine at TRC, Chennai. The vaccines were found to be safe. Based on better immunogenicity, MVA is now being used in Pune and Chennai in a prime-boost approach, where priming is done with a DNA based vaccine.
  • Conducted Phase-III trial of rotavirus vaccine
  • Phase-II trial of bivalent killed whole cell oral cholera vaccine VA 1.3 completed.  Phase-III launched.
  • Phase-I of 3-site measles aerosol vaccine completed, found to be safe and immunogenic.  A pivotal trial for licensing to start in 2Q/3Q of  2009.
  • A recombinant protein-based vaccine for Chandipura developed.  Combination of this vaccine with DPT found to be stable in animal experiments.
  • Development of combined Hep E and B vaccine under progress.  Results so far are encouraging
  • ELISA-based hepatitis A diagnostic technology transferred to BBIL
  • A recombinant protein based, highly specific and sensitive assay for the diagnosis of Hepatitis E developed.

 

Processes, methods and strategies

  • Applied for an Indian patent for a process for preparation of Holey/Lacey Carbon Film (NICED).
  • Established an animal product free culture medium for propagation of leishmania promastigote at RMRI using plants’ extracts.
  • Methodology to assess Health Related Quality of Life of filarial patient for evaluating mobility management developed.
  • Risk map for lymphatic filariasis transmission created for Tamil Nadu on GIS platform for delimitation of areas.
  • Co-administration of albendazole and DEC has been shown that it is operationally feasible, safe for community use and has an edge over DEC alone in terms of reducing new infections of lymphatic filariasis.
  • DEC fortified common salt has been demonstrated to a potential supplementary strategy to MDA for elimination of persistent foci of lymphatic filariasis.
  • Process/technology for production of mosquito larvicide, Bacillus thuringiensis var israelensis was transferred to a commercial manufacturer.
  • SRES – Malathion is three times more effective than DDT spray in vector control.
  • Use of GIS and RS for prediction of kala azar epidemics.

 

New courses

  • The first batch of MPH students admitted at the ICMR School of Public Health, NIE, Chennai.
  • Train the trainers workshop on Forensic Epidemiology at TRC/NIE, Chennai was held.
  • Post graduate diploma in Medical Entomology revived.

 

New Registries Repository

  • Clinical Trial Registry of India launched in July 2007, 150 trials registered.
  • A repository of leishmania isolate started at RMRI, Patna

 

Investigation of outbreaks

  • H5N1 outbreaks occurred in West Bengal, Manipur, Tripura and Assam .  All isolates belonged to Clade-2.2, but were caused by three different introductions.
  • Provided confirmatory diagnostic tests for H1N1 flu viru
  • Acute Encephalitis syndrome in Eastern  Uttar Pradesh, Gorakhpur area, occurred with  JE as a cause in less than 20% of cases.  Enterovirus as causative agent  being investigated.
  • Acute haemorrhagic conjunctivitis outbreak in Mumbai, coxsackie virus A24v was incriminated.
  • Chikungunya outbreaks investigated in several states viz. Kerala, Tamil Nadu, Andaman Islands etc .

 

Promising leads

 

Drugs and Clinical management

  • Novel drug efflux proteins of M.tuberculosis as potential therapeutic/diagnostic targets
  • New  proteins of M. leprae as potential therapeutic target
  • a DNA chip for identification of genes associated with growth and persistence of M. tuberculosis in granuloma formation for development as  potential therapeutic agents
  • Three tail transfer of tibialis posterior muscle to reconstruct foot-drop
  • New tissue schizontocidal and gametocytocidal drug in the treatment of malaria;
  • Method to quantify embroyogenesis in adult filarial parasites S.digitata can be  need as a tool for drug development.
  • Understanding role of nitric oxide and CD 36 deficiency in pathogenesis of severe falciparum malaria can help to develop an adjunct therapy against severe falciparum.
  • Naphthoquinone analogoues for macrofilaricidal activity.
  • Identification and use of CD2 antigen in combination therapy along with conventional anti-leishmanial drug in VL
  • A process for preparation of Cyclosporin A
  • A process for production of thrombinase, a blood clot dissolving enzyme from Bacillus sp.
  • An in-vitro assay for testing anti-HIV activity of new molecules
  • An indigenously produced  polyherbal microbicide formulation Basant has been found to be effective in prevention of C. trachomatis infection.

 
Diagnostics

  • A novel PCR-RFLP assay for identification of pathogenic mycobacteria
  • Development of electrophysiological parameters for easy diagnosis of nerve damage
  • tbl-standardized methods of isolation of DNA of M. leprae from skin smears
  • Use of RLEP and real time RT-PCR to detect live M. leprae from soil and water
  • A process for the preparation of primers useful for detection of M.tuberculosis
  • Pot method for detection of AF
  • Development of quadriplex PCR to identify different sero-groups of V.cholerae
  • New technique for simultaneous detection of  sporozoite, blood meal and identification of sibling species from a single mosquito to evaluate vector competence of other anophelies in malaria transmission
  • ELlSA based diagnostic technology for rotavirus
  • A process for diagnosis of infective (L3) stage larvae of Wucherereia bancrofti in vector mosquito Culex quinquefasciatu
  • Developed an antigen capture ELISA test of JE
  • Identified few plants’ extract as replacement of fetal calf serum/blood/blood products and animal products free media for the propagation of Leishmania parasites
  • Developed PCR based diagnosis for VL from urine samples; identified cholesterol and triglyceride as nutritional marker related to severity of VL infectio
  • Dot-blot assay found useful tool for detecting leishmanial antigen in naturally infected P. argentipes
  • Promising potential of a chlamydial heat-shock protein (cHSP60) as a marker established for predicting and/or confirming secondary infertility and genital tract infection.

 

Disease Control Interventions

  • A new plant based insecticide for mosquitoes control
  • A new botanical formulation for mosquito control; composition containing herbal Solanum nigrum extract
  • Development of an intervention model for reversal of fluorosis through nutritional intervention and safe drinking water (drinking of traditional wells containing fluoride and  dilution of water with rain water and nutritional supplementation through dietary supplementation of Chakoda Bhaji (Cassia Tora for  calcium, vitamin C and iron)
  • Developed a model of malaria control in Betul using indoor residual spray by synthetic pyrethroids and replacing chloroquine by second line drug (SP+Pyrimethamine) along with intensive surveillance for on spot diagnosis using Rapid Diagnostic Test and use of larvivorous fishes. The intervention helped in significant reduction in malaria cases and was found successful.
  • A cyclic lipopeptide of Bacillus subtilis sp. subtilis (VCRC B471) with potential to kill mosquito stages
  • Controlled release formulation of an indigenous IGR DPE-28; macrofilarcidal activity of the fruit extract of Trachyspermum ammi against adult filarial wor
  • New bacterial culture media for the production of mosquito pathogenic bacilli using industrial wastes
  • Microbial fermentation process using bird feather for the production of biopesticides
  • A process for the production of mosquito oviposition attractant
  • B426 - a bacterial metabolite from Pseudomonas fluoroscens showing pupicidal activity
  • A process for the preparation of mosquito larvicidal formulation from Bacillus thuringiensis var. israelensis
  • A process for the preparation of mosquito larvicide (B.sphaericus
  • Expanded polystyrene (EPS) bead application as an adjunct to the mass drug administration to bring about long-term reduction and sustenance in vector density/transmission rates gravid mosquito-trap; mosquitocidal ovitrap; and multi-angles viewer for easy rotation of specimen.
  • Use of GIS and RS for prediction of kala-azar epidem Vaccines
  • A DNA based multi epitope HIV 1 subtype C vaccine, ready for pre-clinical trials
  • Generation of HIV-1 sub-type C based DNA vaccine candidates and assessment of prime-boost immunization strategy in mouse model
  • LipL45 and Dna J-leptospiral proteins identified as highly immunogenic molecules capable of eliciting long lasting immunological memory
  • Identification of a novel protective antigen (Dssd1) against lymphatic filariasis a potential vaccine candidate antigen
  • Use of chimeric T -helper B cell peptide in JE vaccine development
  • Process for isolating a non toxinogenic V. cholerae strain
  • In collaboration with CDC, Atlanta , 6+2 plasmid-based recombinant virus for the H5N1 strain from Maharashtra has been prepared using reverse genetics technology
  • Identified genes exhibiting stage-specific expression in clinical isolates of Leishmania donovani by AP-PCR and genomic microarrays
  • Generated centrin knockout mutant of L. donovani cell-line as a potential vaccine candidate. This mutant parasite was granted US patent for its vaccine potential.
  • Identified genes (P27, P43, ASS, PSA) involved in differentiation process of the parasite from L.donovani promastigote to amastigote stages. These gene transcripts were demonstrated in human tissue.  Studies ongoing for their functional characterization

 

Non-communicable Diseases

 

Oncology

  • Twenty three population based and five hospital based cancer registries (expanded from previously 11 registries) functioning under the National Cancer Registry Programme (NCRP)
  • Among males, cancers of the prostate, colon, rectum and liver showed a statistically significant increase in incidence rates. Among women, cancers of the breast, corpus uteri, ovary, thyroid, gallbladder and lung have shown a rise. Cancer cervix recorded a decline in incidence rates across all registries
  • A model for screening for cancers of cervix, breast and oral cavity, has been developed for three districts of Himachal Pradesh. The model components include finalization of strategy; development of manuals & health education aids; a baseline survey; infrastructure strengthening; and training of professionals and para-professionals. Intervention is being continued by the State health infrastructure.
  • Cancer management guidelines for chronic myeloid leukaemia and buccal mucosa cancer have been finalized.  Work on 18 other cancers is progressing.

Genetic susceptibility:

  • In prostate cancer role of CAG microsatellite repeats in AR gene, polymorphism/mutations in PSA gene and p53 gene have been studied in risk and progression of cancer. Significant association has been found between CAG repeat length less than 22 and genomic Arg. 72 pro. substitution in p53 gene with cancer prostate compared to healthy controls.
  •  Role of pesticide exposure on causation of cancers screening for GST polymorphisms, Cyp17 T>C polymorphism and p53 Arg72Pro polymorphism in breast cancer showed significant high frequency of GSTM1 and GSTT1 null genotypes in cancer cases while no significant association had been found with Cyp17 and p53 codon 72 polymorphism with cancer.
  • Elucidated  role  of candidate genes mainly BRCA1, BRCA2 and CYP17 in Breast cancer susceptibility in Indian women
  • Established mutation database for BRCA genes in Indian breast cancer patients, potential founder mutation in Indian patients, high frequency of mutations in early onset group.
  • Elucidated the role of detoxifying enzyme genes such as GST in breast cancer in high-incidence regions
  • In vitro culture of tumour cells: A model established to evaluate cytotoxicity of immunomodulator & chemotoxic drugs for application intravesically in an attempt to give individualized treatment to bladder cancer patient with tailoring of dose to individual need.
  • Elucidation of host immune factors (IL2) which could serve as target/gene therapy in superficial Transitional cell carcinoma

 

Cardiovascular diseases

  • Jai Vigyan Mission Mode Project on community control of Rheumatic Fever/ Rheumatic Heart Diseases (RF/RHD) has four arms, epidemiology; molecular typing of rheumatogenic strains; RF/RHD registries; and development of a vaccine against streptococci. A model of surveillance provided by community-based registries by four nodal registries is being replicated in other parts of the country. The Group A Streptococcus (GAS) strains circulating in the community are being subjected to molecular typing. The epidemiological components have been completed at Chandigarh and Vellore . Surveys in school children (5-14 years) under registry component have been undertaken at Chandigarh , Vellore and Kochi and Indore . Satellite registries are functioning at Mumbai, Wayanad, Shimla, Jammu , Jodhpur , and Dibrugarh. The data indicates that the prevalence of RF RHD has declined in these parts of the country. A significant development of the project at Chandigarh has been the up scaling of this project to “Punjab Rheumatic and Congenital Heart Disease Programme” from November, 2008.
  • Genetic susceptibility to essential hypertension: A project on salt sensitivity and candidate gene polymorphisms in essential hypertension in tribal population of Mizoram, tea gardens of Assam and indigenous Assamese population, identified subgroups based on genotype (Del/Del genotype in ACE gene) that are most likely to benefit from targeted environmental changes (like changing salt intake) related to progression of cardiovascular diseases.
  • Use of bedside ECHO for screening for congenital heart disease in newborn can increase the detection rate as compared to clinical criteria alone.

 

Mental health

 

  • High prevalence of psychiatric morbidity was found among all social classes in Delhi , Chennai and Lucknow . The data would be useful in understanding urban mental health problems and needs development of   health service.
  • Mental health service needs and service delivery models in natural disasters
  • Earthquake in Gujarat : The prevalence of psychiatric morbidity was found to be higher in affected group (61.35/1000) as compared to control group (22.29/1000) in Ahmedabad, which was moderately affected. The most prevalent psychiatric morbidity were the depressive disorders and recurrent depressive disorders, followed by anxiety disorders and dissociative (conversion) disorder and somatoform disorders in both (affected and control) groups. Similarly, the prevalence of psychiatric morbidity was higher (67.04/1000) in the affected group as compared to control group (22.93/1000) in Rajkot which was mildly affected. The most prevalent psychiatric morbidity was depressive disorder and recurrent depressive disorder followed by anxiety disorder, dissociative (conversion) disorder and somatoform disorder in both affected and control group. The data from severely affected areas of Bhuj is being analysed.
  • Tsunami disaster in coastal areas of Tamil Nadu: a task force study has been initiated at Chennai and Nagapattinam to find out the long term mental and psychological problems in disaster affected population.

 
Neurological Sciences

  • A registry of epilepsy in pregnancy at Thiruvananthapuram observed malformations in 11.7% and 3.3% of pregnancies with epilepsy and without epilepsy respectively, with a large percentage of malformations being cardiac. Women with epilepsy who were on AEDs and polytherapy were at higher risk of malformations.
  • Study on contribution of prothrombotic state to the etiology of ischemic stroke in the young, observed that majority of the patients had multiple risk factors with large infarcts in 40.7% of the cases by CT sacn/MRI. The homocysteine levels correlated with vitamin B12 levels.   The stroke subtype was mainly of anterior circulation. Protein S deficiency is the commonest deficiency (37.2%) followed by Protein C deficiency (10%). A prospective longitudinal study of stroke in Kolkata on natural course and outcome of the stroke patients, observed the incidence rate of stroke/100,000 per year to be 143.84 in year 2003 and 91.26 in year 2007.  The 30 day fatality rate was higher in men than in women. Dementia was observed in 12.93% of stroke survivor cases.

 

Diabetes

 

  • Human and animal studies on the effect of camel milk in type 1 diabetes in population of north-west Rajasthan (Raica community) indicated its important role in glycemic control, lipid profile and quality of life. Genetic basis of resistance to Diabetes in Raica community in being explored.
  • Launched Registry of People with Diabetes with Young Age at Onset at eight centres with aim to understand magnitude of problem, disease pattern or types including the geographic variation and incidence and prevalence rate of complications.
  • Project on Genomics of Type 1 Diabetes is ongoing at three centres viz Delhi , Chennai and Kashmir with the aim of undertaking genomic characterization of multiple autoimmune favouring HLA-DR3+ve haplotypes in type 1 diabetes (T1D) in these ethnic groups of India . It also aims to evaluate levels of auto-antibodies present at the age of onset in these population groups.
  • Studies to identify genes related to maturity onset diabetes of the young and early onset diabetes have been started

 

Non-communicable Disease Surveillance

  • In Phase I of the surveys, data on major NCD risk factors has been collected in the urban and rural subjects aged 15-64 years in 7 States of the country.
  • Global NCD risk factor InfoBase has been pilot tested. The shortcomings and suggestions for its improvement have been provided to WHO. The work of updating the InfoBase with newer publications is progressing.
  • A model is being developed for Strengthening of existing health system to address Non Communicable Diseases in India . During its first year household screening questionnaire, manuals for health workers and Medical officers, a risk score card has been prepared for action, including referrals to health facility, assessment of workload on the staff and system.

 

Blood  related disorders

 

Diagnostics

 

  • Successful prenatal diagnosis of b thalassemia major from maternal blood. This study shows that in a large proportion of cases prenatal diagnosis for bthal mutation can be done from mother’s blood without invasive fetal sampling.
  • Development of New simple technique for prenatal diagnosis of haemophilia and thalassemia in 2nd trimester. As many of our patient visit us late this technique was developed as quick, cheap phenotypic diagnosis. Molecular biology expertise is not required for such diagnosis and tbl-standard laboratory with well trained technician will be able to do the diagnosis.
  • Development of a quick mismatched RFLP technique for detecting the founder mutation in haemophilia. This will help in pre natal diagnosis and carrier detection as each patient requires Rs.2.0 lakh/annum for maintenance.
  • Establishment of comparative genomic hybridization technique. This will allow to detect new genetic changes in blood cancers and blood cancer-like diseases.

 

Clinical Management

 

  • Modulation of severity of haemophilia by co inherited thrombophilia gene. This study shows that severe haemophilia patients who inherit thrombophilia genes have milder presentation. This is an extremely important discovery in the biology of congenital bleeding disorder and it has immense implication in giving prognosis in a child with severe haemophilia.
  • Invitro expansion of umbilical cord stem cells. This technique has important application in allogeneic hemopoietic stem cell transplantation
  • First Prenatal diagnosis in India for Pyruvate kinase deficiency in Red Cells.

 

 

Reproductive and Child Health

Women’s Health

Drugs & Devices

 

  • Intra uterine contraceptive device Cu T 380 A  demonstrated its long term   efficacy acceptability and has been  introduced in National Family Welfare   Programme
  • Emergency contraception (LNG 1.5 mg) demonstrated high efficacy and now   available in the country as a second option to prevent undesired pregnancy   (after unprotected coitus). It is suggested as a over-the-counter product based    on the research findings of improved access through  paramedical workers
  • Medical methods (Mefipristone and misoprostol) for safe abortion services  made available in the country for early pregnancy termination
  • Oral Misoprostol 600 mcg demonstrated that it decreases blood loss and thereby an effective method for prevention of post-partum haemorrhage (PPH) made available through skilled birth  attendants (SBA) at the peripheral centres

 

Basic reproductive biology

  • Identification of mannose receptor for CD4 independent receptor binding protein responsible for sexually transmitted HI
  • Identification of 80KDA human sperm antigen for development of contraceptive vaccine for male

 

Infertility

  • Developed a diagnostic kit to detect ovarian autoimmunity in  infertility clinics in the country and appropriate draft legislation has been prepared and placed for public debate
  • ICMR/NAMS developed guidelines for Assisted Reproductive Technologies (ART) for accreditation, supervision and regulation of ART clinics in the country and appropriate draft legislation has been prepared and placed for public debate

 

Child Health

Clinical management

  • Home based management of young infants (60 days) demonstrated that skill transfer to village level worker (shishu- rakshaks) is possible for newborn care  trained and skilled workers are able to identify and treat sepsis     effectively in newborn by oral    antibiotics/Inj Gentamycin
  • Oral Amoxicillin (3 days) v/s oral Co-trimoxazole (5 days) in children for non-severe pneumonia demonstrated that the existing treatment of Upper respiratory tract infections (URI) in the National programme with oral Co-trimoxazole is as effective as Amoxicillin in field conditions

 

Animal facilities for research

  • National Centre for Primate Breeding and Research has been established at Sasunavgar, Mumbai
  • National Animal Resource Facility (large animals) for biomedical research established by ICMR in 100 acres land at Genome Valley ,  Hyderabad

 

   Nutrition

 

Diagnostics & new methods

  • Established a methodology for the determination of vitamins A and E and estimation of Ascorbic acid and Folic acid in Dried Blood Samples collected on filter papers.
  • Established an in vitro method using caco 2 cells to study the zinc and iron bio-availability. These methods help in the biofortification programmes to identify the best forms of micronutrients like zinc and iron.

 

New knowledge

  • Enzyme Ferric Reductase activity has been demonstrated in human milk fraction which explains the reason why iron is better absorbed through human milk
  • Demonstrated that Zinc inhibits oxygen induced iron uptake and signaling and thus elicits its cytoprotective effects. This also explains the inhibitive effect of zinc on iron absorption
  • Demonstrated antiamyloidogenic potential of curcumin against trans thyretin related amyloidosis. This relates to the studies published earlier which shows benefits of curcumin in prevention and progression of Alzheimer’s disease which happens to be an amyloid disorder.
  • Metabolic programming of Insulin resistance: Several studies done earlier have shown that maternal micronutrient deficiency can alter the body composition of offspring, resulting in greater amounts of body fat, insulin resistance and effects in glucose and lipid metabolism, leading to a syndrome called metabolic syndrome, a fore runner to chronic diseases like diabetes, hypertension and heart disease.
  • Chronic maternal chromium deficiency increased body fat, especially central adiposity in offspring. It altered adipocyte cytokine levels in circulation. It altered lipid metabolism with increased circulating triglycerides and free fatty acid levels. However, it did not alter gene expression. It caused impaired glucose tolerance and increased insulin secretion. Rehabilitation could partially correct these changes.
  • Vision Research: I) identified some micronutrients that are associated with diabetic retinopathy. II) Identified aldose reductase and sorbitol levels as putative biomarkers for diabetic retinopathy. III) Retinal degeneration in spontaneous obese rat model was discovered. WNIN-Ob rat has opened the unique opportunity of using this novel rat model for investigating molecular basis and role of nutritional factors to attenuate obesity-associated ocular complications. IV) Research on functional foods with respect to ALR2 inhibitors and antiglycating agents has led to the identification of compounds from functional foods as molecular target based adjunct therapies for diabetic complications.

 

Community Studies

  • Studies on relationship between Body Mass Index and percent body fat in urban adults indicated that cut-off levels of BMI to indicate Overweight/Obesity, derived based on 25% body fat among men and 30% among women using ROC (receiver operating characteristic) curves, were found to be similar to the cut-off values for Asian Indians suggested by WHO (BMI> 23kg/m2)
  • Evaluation of bio-effect of ultra-rice on iron status of beneficiaries of mid-day meal programme
  • Rice fortified with iron when given in the mid-day meal to the schoolchildren for over a year, resulted in a significant improvement in their haemoglobin levels and iron store
  • It was also observed that the children in control group who did not receive ultra rice but got supervised meal as per the norms of MDM Programme also showed Hb improvements with no change in iron status.
  • Studies on prevalence of overweight and obesity among school-going adolescents
  • The overall prevalence of overweight was 6% and it was higher in high socio economic group (10%)
  • Prevalence was significantly higher among girls (7.1%) than in boys (4.4%)
  • Significantly higher duration of time spent in TV viewing and lesser time on participation in outdoor games and household chores were the factors associated with prevalence of obesity

 

Food and Drug Toxicology

Safety evaluation of traditional medicines

  • Safety evaluation of a polyherbal drug, AB-FN-02 having potential anti-osteoarthritic activity indicated that it was non-toxic when administered in traditional method with milk and was found toxic when administered as a drug otherwise Safety evaluation of 5 herbo-mineral drugs (Bhasmas) to study the toxicity when administered in therapeutic dose range indicated that they did not exhibit toxicity due to heavy metals used.
  • In vitro chelating potential of thiamine in lead (Pb) Earlier studies indicated that thiamine can chelate and thus reduce the uptake of lead in intestines. This was confirmed using in vitro human intestinal cell lines. Therefore correcting thiamine deficiency itself would reduce the risk of lead toxicity in populations at risk.

Assessment of street foods


  • A study carried out on street foods indicated that 50-70% of samples of poultry foods were found to be contaminated with disease carrying bacteria like Bacillus cereus and Staphylococcus aureus.
  • The vegetable salads were found to be contaminated with Salmonella due to improper handling

 

Nutrition Education and Communication

  • Study on coverage  of nutrition related topics in print media
  • It was observed that the vernacular (Telugu) dailies covered more number of nutrition related articles than the English newspapers and most of these were more on conventional foods rich in nutrients
  • English dailies published more articles on lifestyle foods like chocolates, beverages, ice-creams etc.
  • Nutrition components in school science textbooks
  • The school science textbooks of NCERT and AP State Education Board allocated lesser space for biology in relation to physical sciences in higher classes (VII and above). Nutrition topics were almost absent in high school textbooks.
  • Nutrition component is systematically organized at primary school level (till V Class), but not in high school textbooks. The nutrition topics covered in textbooks beyond class III, deal only with food groups or nutrient deficiency disorders. Important topics such as nutrition and growth, link between childhood malnutrition and non-communicable diseases in adulthood, adolescent nutrition, nutrition for girl child, hidden hunger, lifestyle factors and obesity, unhealthy foods, fortification etc. are not covered in the curricula.
  • Case studies on Institutional approaches to nutrition communication
  • Case studies on approaches taken by various organizations for nutrition communication in different sectors (Government, NGO and R&D) indicated that Nutrition communication activities lack proper planning, monitoring and evaluation components. This makes it difficult to attribute any change in behaviour to a particular communication process.
  • The selection of specific communication approaches is not primarily based on normative value of the approach but purely based on institutional factors and expectations including organisation’s goals, bureaucratic dynamics and budgetary constraints.

 

Traditional Medicine Research

 

Medicinal Plants

  • Data-base has been created on about 500 medicinal plants/formulations used by traditional practitioners (Non-codified system), and scientific validation (safety, efficacy, mode of action and clinical trials) of selected leads under a multicentric project at 5 states across the Western Ghats . The database provides detailed information on botanical aspects, ethonomedicinal usages, pharmacological activities, chemical composition etc, of each plant along with references.
  • The information on medicinal plants used for treatment by the traditional practitioners of the Belgaum district has been documented has led to documentation of 115 medicinal plants belonging to 56 families to cure 71 types of diseases.
  • A Garden for Medicinal Plants of Western Ghats has been established. The total number of medicinal plants is about 250 out of which 79 are herbs, 58 shrubs, 33 climbers and 96 species are trees. Each plant is provided with information board regarding scientific name, English name, vernacular names in various languages and ethnomedicinal properties.
  • Established Museum for Ethonommedicinal plants of Western Ghats .  This Museum also has a crude drug depository of various parts of medicinal plants in which 280 such samples are collected and displayed appropriately
  • Review Monographs on Indian Medicinal Plants: 7 volumes have been published. Each monograph includes regional names of the medicinal plant, its Sanskrit synonyms as well as the Ayurvedic description (wherever available), ethnobotanical studies, apart from the habitat and the parts used, properties and uses, details of botanical, pharmacognostical, chemical, pharmacological and clinical data. About 1600 medicinal plants species have been covered.
  • Quality tbl-standards of Indian Medicinal Plants: 7 volumes have been published. Each monograph focuses on the diagnostic features and phytochemical studies, including markers besides having information on Pharmacological, clinical, toxicological aspects along with dosage, adulterants/substitutes etc
  • Medicinal plants monographs on diseases of public health importance: During the year the monograph on Perspectives of Indian Medicinal Plants in the area of Liver Disorders was published. The draft monographs of diabetes mellitus, filariasis and other areas are in different stages of review. These monographs aims at integration of leads/scientific information on diseases (including etiopathogenesis) and plant drugs as given in the ancient texts (ISM) and Allopathic system of medicine and the multidisciplinary research data generated on these plant remedies with focus on pharmacological, toxicological, clinical, phytochemical, and pharmacognostic.

 

 

Health of Tribal Populations

Indian Council of Medical Research (ICMR) has 28 institutes/ centers in different parts of India . The following institutes/centres have been doing considerable amount of work related to health in tribal populations:

  •  Regional Medical Research Center for Tribals (RMRC), Jabalpur ;
  • Regional Medical Research Centre (RMRC), Port Blair;
  • Regional Medical Research Centre (RMRC), Bhubaneshwar;
  • Regional Medical Research Centre (RMRC), Dibrugarh; and National Institute of Nutrition (NIN), Hyderabad

ICMR Headquarters in an extramural mode has also been carrying out/supporting research in tribal belt.

Research being carried out by ICMR is with the objectives to generate health and nutritional data and evaluation of various interventional programmes of Government of India as well as of respective state Governments. Applied basic and clinical research have been done extensively especially for malaria and tuberculosis control. Efforts have also been made to develop various health service delivery models through action oriented research.

  •  Generation of data on Health & Nutrition Profile of tribal population

National Institute of Nutrition (NIN), Hyderabad has been doing extensive work on diet and nutritional status of rural population since 1972. They have also carried out three time point surveys in tribal population of 9 states viz. Kerala, Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, Gujarat, Madhya Pradesh, Orissa and West Bengal :

  • Baseline survey in 1985-87
  • First repeat survey in 1998-99, and
  • Second repeat survey in 2007-08

 Investigations were mainly carried out on Socio-economic and demographic particulars, Anthropometry, Clinical examination and Diet survey. The measurement of Blood Pressure for the assessment of Hypertension in adult males & females (= 20 years) was done during only in survey carried out in 2007-08 in all the 9 states.

 The nutritional deficiency signs in preschool children have shown a decline from 1985-87 to 1998-99 surveys, PEM from 4.0% to 0.5%, Bitot spots from 2.1% to 0.5% and Angular stomatitis from 2.0% to 1.3%. Average consumption (g/CU/day) for food stuffs like milk & milk products, fats & oils, sugar & jaggery were found out to be very low as compared to recommended levels.

 

  • NNMB’s second tribal repeat surveys on diet and nutritional status of tribal population in India – Time trends
  • No significant change in the dietary patterns of tribal population in the last three decades. However, consumption of income-elastic foods like pulses, GLVs, Sugar and Jaggery has marginally gone up
  • Prevalence of severe undernutrition has significantly come down from 10% to 5% among both the rural and tribal communities. However, there was a notable shift from moderate to mild malnutrition indicating betterment of nutritional status
  • Nutritional status of tribes of MP, Maharashtra and Orissa were poor compared to those in the other states

 Applied basic and clinical research

  • Genetic disorders like Sickle cell anaemia & Thalassemia have been studied extensively and different means and methods for effective counseling such as group discussion, interpersonal communication, and education through posters, pamphlets & Audio Visual aids have been demonstrated.
  • A preliminary study on hypertension conducted among the Nicotbl-barese of Car Nicobar showed 50% prevalence. Study carried out in 3 distinct ethnic populations of Mizos, indigenous Assamese and Tea Garden Workers (TGWs) indicated a prevalence of hypertension as 60.8% in TGWs. In indigenous Assamese population, prevalence of hypertension was 33.3% and in Mizos, prevalence was 15.9%. Treatment & Counseling is being provided by the Centers in collaboration with the Health Services. Awareness generation camps and meetings have also been organized from time to time about dietary modification & life style changes
  • RMRC, Jabalpur is a sentinel site by Government of India, one of the seven sites throughout the country for conducting tuberculosis prevalence study. RMRC, Port Blair has developed the facilities for culture & facilities for monitoring MDR & XDR Tuberculosis. Center also organizes awareness programmes periodically highlighting the importance of DOTS programme
  • The centres at Jabalpur and Port Blair are also working towards the treatment and prevention of malaria like replacement of DDT with synthetic pyrethoid for indoor residual spray and prescribing Artesunate Combination Therapy (ACT) as first line of treatment and Sulpha Pyrimethamine as second line of treatment resulted in reduction of prevalence of malaria from 36% in 2004 to 20% in 2008.
  • Other measures like distribution of insecticide impregnated bed nets, monitoring of usage and awareness programmes to encourage the use of these has also been taken by the RMRC, Port Blair. Center at Dibrugarh is engaged in developing newer antimalarial based on folklore & traditional medicine- mainly plant based antimalarial and is also running a malaria clinic. RMRC, Dibrugarh has been declared as Centre of Excellence for training in Malariology by the Govt. of India.
  • In tribal population of Orissa, major problems identified are malaria, hypertension, diarrheal diseases, nutritional deficiencies and access to medical care. RMRC, Bhubaneshwar is coordinating several intervention based activities with Government of Orissa.

 

Action Research in Tribal Population

  • A study to develop capacity building of primitive tribes for health care has been operational in 15 districts of 7 states of the country.  Under the study link persons (one Tribal Welfare Volunteer and one Dai Volunteer) have been identified for every 500 population and trained respectively for treatment of minor ailments and safe delivery. Appropriate kits have also been provided to them. The volunteers are also working for motivating the community to avail nearby health facilities in case of seriously ill patients or high-risk pregnant women. This model has been shown to be quite successful in Tripura where the evaluation results are available.

International Co-operation

Existing bilateral collaboration

  • France                              
  • Germany
  • USA
  • Canada
  • China
  • Myanmar
  • Mozambique
  • Cub
  • Bulgaria
  • Japan
  • Spain

 

Existing tripartite collaborations

  • IAVI-NACO-ICMR
  • India-Brazil-South Africa

 

New initiatives

  • Karolinska Institute, Sweden
  • Medical Research Council , U
  • London School of Hygiene & Tropical Medicine
  • Boston University , USA .

 Joint Working Group / Joint Steering Committee meetings under following agreements held during 2008 -09

  • ICMR-University of Minnesota in October, 2008 in Minnesota , USA
  • ICMR- INSERM in November, 2008 in India
  • ICMR-University of Sydney / George Institute of Australia (through teleconference) in March 2009

 Bilateral meetings / workshops held during 2008-09

  • Indo-US workshop (under Indo-US Statement) in Environmental & Occupational Health -July, 2008 in India
  • Indo-German workshop on Zoonoses and Animal Models of Infectious Diseases (under ICMR- IGSCID Programme) in September, 2008 in Indi
  • Indo-French workshop (under ICMR-INSERM MOU) on Translational Research in November, 2008 in India
  • Indo-German workshop (under ICMR-BMBF arrangement) on Bioethics in Oct/November, 2008 in Germany (8 Indian scientists trained)
  • Indo-German workshop (under ICMR-BMBF arrangement) on Epidemiology of Infectious Diseases in November, 2008 in Indi
  • Indo-Australia workshop (under ICMR – University of Sydney / George Institute MOU) on Diabetes in India in November, 2008
  • Indo-Canada workshop (under ICMR-CIHR MOU) on Childhood Obesity in India in January, 2009
 

International Fellowship Programme

  • For Indian biomedical scientists:  to augment capacity strengthening of institutions involved in basic, applied, epidemiological and clinical sciences. ICMR International Fellowships have been awarded to five Senior & ten Young Indian scientists for the year 2008-09.
  • For scientists from developing countries: for capacity building and human resource development of biomedical scientists working in developing countries by offering them opportunities to work in Indian institutes/laboratories. One scientist each from Nigeria and Sudan has been selected to visit ICMR institutes (NARI, Pune and NIMR, New Delhi respectively) for training under this programme

 

Publications and Information

 

Indian Journal of Medical Research

  • Impact factor of IJMR for 2010 is 1.826
  • Free full text available on the net
  • IJMR Archive in searchable interface since inception (1913) is also now available
  • Online submission and editorial processing commenced w.e.f. 20101.670 in 2007

 

Special Issues & Special sections during last 5 years

 

Special Issues

Diabetes Research
Poverty & Human Development
Nutrition and Bone Health
Metal Toxicity and Health Implications
Human Papilloma Virus
Sleep Medicine
Fifty Years of Discovery of Cholera Toxin

Special Section

Maternal Health & Child Nutrition
Cardio Vascular Disease Research

 

Hindi Publications

  • ICMR Patrika in new format with more advanced features
  • Annual Report (Hindi version as Varshik Prativedan) of ICMR and DHR (2009-10 & 2010-11)
  • Hindi version of Pictorial Identification key of Indian Anophelines prepared as Bhartiya Anopheles Machchron ki Sachitra Pehchan Kunji
  • ICMR Puraskar for Popular Medical Books in Hindi started as a new initiative.

 

Biomedical Informatics Centre

  • Biomedical Informatics Centres of ICMR: Established nine Biomedical Informatics Centres of ICMR at TRC, Chennai; NICED, Kolkata; RMIRMS, Patna; NIN, Hyderabad; NIRRH, Mumbai; AIIMS, New Delhi; PGIMER, Chandigarh; SGPGI, Lukhnow; and a Central Coordinating Unit (CCU) at ICMR Headquarters. The centres were established under task-force Biomedical Informatics Centres of ICMR. Achievements of task-force are:
    • To increase awareness of Biomedical Informatics in medical research, the centres have (i) conducted 52 training programs/workshops which were attended by more than 1000 participants from host institutes as well as regional medical research institutes (ii) helped more than 200 budding researchers in their long and short term projects.
    • To support Biomedical Informatics in medical research, the centres have (i) initiated/completed 122 collaborative research projects with medical researchers from host institute and regional medical research institutes. Some of these projects have been funded by other agencies like DBT, DST etc (ii) provided services to medical researchers from host institute and regional medical research institutes.
    • The centres have developed 47 databases of Biomedical and Clinical information produced at host institute or regional medical research institutes.
    • The centres have published 86 research publications in peer-reviewed journals including some of the highly reputed journals such as PNAS, Blood, Plos one etc.
    • The performance of centres is improving as 31 of total 86 publications were published during 2010 – 2011.
    • Scientific staff from Biomedical Informatics Centres has presented research work in many National and International conferences/ seminars.
  • Management Information System: The Management information System pertaining to the Extramural Research activities of the Council has been upgraded in a major way and is now highly interactive and informative; efforts have been made to automate the entire process so that the Programme Officer has updated information about a project at any given time. Reporting facilities have been considerably enhanced. A feature for updating the scientific publications from ICMR scientists has been developed.
  • Data Repository and Business Intelligence Project : The project has been initiated by the BIC, the mandate of the project is to create a data repository of all data generated by both intramural and extramural research, all data pertaining to completed projects in the past would be uploaded to the repository and the metadata would be available on the web. The relevant data would be loaded into data warehouses for further analysis and Data mining. More than 200 scientists, IT professionals and managers working in the area were consulted for formulation of the project, the approach, the technical specifications, work flow etc.
  • STS portal: The Short Term Studentship (STS) programme has been fully automated, from receipt of applications to publishing of results. The web portal is available at http://icmr.nic.in/shortr.htm.
  • MACE registry: BIC has developed an Indian National Database to track outcomes of patients with acute coronary syndrome, including unstable angina, myocardial infarction (both ST-segment elevation and non ST-segment elevation). The data in this registry is being uploaded by participating hospitals across India.
  • ICMR website: Development and maintenance of the ICMR website is an ongoing process, the software is constantly being upgraded the new evolving technologies also every effort is made to weed out obsolete information and maintain currentness. A file movement and tracking system has been implemented in ICMR headquarters.

  • Drafted the “Knowledge framework policy for Health - Service, education and Research”
  • Video Conferencing: Established Video conferencing facilities between 8 ICMR institutes and the headquarters. The facility also provides access to video conferencing between ICMR institutes and with organizations outside the country.
  • Internet and Intranet Connectivity: The connectivity to each of the locations of ICMR has been significantly enhanced with the establishment of 2X2 Mbps lines. The ICMR intranet has been established and applications are being developed. Installation of the National Knowledge Networks (NKN) line (1 Gbps) at all the institute of the Council, this will greatly enhance the Internet connectivity.

 

Scientometric Studies

  • Number of papers as also coverage in SCI/JCR in 2009 was 449 and 79.61% respectively (Average Impact Factor per Paper : 2.778)

 

Library and Information Sciences

  • JCCC@ICMR: Subscribes to JCCC@ICMR that  Provides one point access to over 1941 journals subscribed currently by all 25 ICMR’s network of library and information centers
  • ICMR E-Consortia – Subscribes to the ICMR E-Consortia with  the four  journals viz., Lancet, Nature, NEJM and  Science that can be accessed through IP address of the Institute libraries
  • ERMED Consortia: Around 2745 e-journals with full text facility can be accessed by ICMR and its institutes.
  • ProQuest Health Full Text Database: The full text e-database ProQuest Health was renewed for 4 sites (ICMR Hqrs., New Delhi; NIOH, Ahmedabad; NIN, Hyderabad; RMRC, Dibrugarh). ProQuest Health and Medical Complete provides full text for 1,916 + journals.

 

Intellectual Property Rights and Technology Transfer

  • Brought out IPR Policy (2003)
    Brought out Guidelines for Sponsored and Collaborative R&D (2007)
    Brought out draft proposal for setting up of Indian Regulatory Authority on  
    Medical Devices
    Brought out a document “Technologies for Commercialization 2011” cataloguing
    Technologies developed by ICMR supported research
    Maintain a portfolio of over 70 Indian and 17 foreign patents.
    Transfers of technologies on Drugs, Diagnostics & Vaccines of National Importance to the industry.
    Sensitizes the scientists on IPR & technology transfer through Workshops,
    Seminars,  etc.
    Undertakes research studies for WTO and globalization issues.
    Provides policy support to Ministry of Health & Family Welfare, Govt.of India.
    Collaborates with National & International research Institutes/Organizations for
    promoting access to health products.

 

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