In vitro biological activity of cobalt(II) complexes with salicylaldimine ligands in microbial and cancer cells.

Background: More studies using cobalt complexes as drugs are needed. Results: The drug action of two cobalt salicylaldimines was determined. The complexes and amphotericin B (20 mg/ml) inhibited Candida albicans at 9-15 and 21 mm. This concentration of both ligands inhibited Staphylococcus aureus at 10 mm and one ligand inhibited Escherichia coli at 9 mm, but the complexes and ampicillin inhibited four bacteria at 9-20 and 21-26 mm. The ligands were inactive against cancer and normal cells, but the complexes and doxorubicin provided IC50 values of 28.18-54.19 and 9.66 µM against MCF-7 cells and 15.76-20.49 and 36.42 µM against BHK cells. Conclusion: The ligands' activity was much improved by complexation, although they remained substandard.

New iron(III) complexes with 2-formylpyridine thiosemicarbazones: Synthetic aspects, structural and spectral analyses and cytotoxicity screening against MCF-7 human cancer cells.

2-Formylpyridine thiosemicarbazone - iron (III) chelates [ F e L 2 ] C l • 2 H 2 O {L = L1 (C1) [HL 1  = 4-(4-Nitrophenyl)-1-((pyridin-2-yl)methylene)thiosemicarbazide] and L = L2 (C2) [HL 2  = 4-(2,5-Dimethoxyphenyl)-1-((pyridin-2-yl)methylene)thiosemicarbazide]} were prepared. The two ligand anions in each complex resulted in saturation of the iron coordination number and consequently the existence of these complexes as 1:1 electrolytes. As well, the iron in these complexes exhibits low-spin electronic configuration. X-ray crystallography of complex C1 indicated its triclinic crystal system and P 1 ‾ space group. In addition, it proved the ligation through a thiol sulfur atom and two nitrogen atoms of pyridine and azomethine groups. This is while the presence of two water molecules of crystallization in the complex structure was also indicated. The ligand HL 1 was selected for cytotoxicity screening against human MCF-7, A-549, HEPG-2 and HCT-116 cancer cells and the most enhanced activities were detected against the breast cells. Against these cells, the compounds HL 1 , HL 2 , C1 and C2 induced cytotoxicity, respectively, with IC50 values of 52.4, 145.4, 34.3 and 62.0 µM. However, against the healthy BHK cells, HL 1 and HL 2 caused cytotoxicity, respectively, with IC50 values of 54.8 and 110.6 µM and cytotoxicity with percent viabilities of 56.7 and 55.4% of the BHK cells by the complexes (137.4 µM of C1 and 131.9 µM of C2) was determined. These activities against MCF-7 cells are less significant compared with the measured value for doxorubicin. But this standard is more toxic to normal cells than the thiosemicarbazones (IC50 (doxorubicin) = 9.66 µM against MCF-7 cells and 36.42 µM against BHK cells).

First-principles study of thermodynamic stability and the electronic properties of intrinsic vacancy defects in barium hafnate.

The formation of intrinsic vacancy defects in barium hafnate, BaHfO3 and their corresponding electronic structures have been investigated using first-principles calculations. The thermodynamics of pristine and vacancy defects containing barium hafnate have been analyzed. Formation energies for neutral and fully charged Ba, Hf and O vacancies have been evaluated for determining their stability with respect to different chemical environments. From the calculated electronic structure and density of states, it is found that cation deficient barium hafnate is hole-doped, while the incorporation of oxygen vacancy retains the insulating nature of this material. The defect reaction energies for partial and full Schottky reactions are also computed, which controls the properties of non-stoichiometric barium hafnate.

Smokeless tobacco consumption in a multi-ethnic community in Pakistan: a cross-sectional study.

Smokeless tobacco is commonly used in south Asia. In addition to causing oral and pharyngeal cancers, its harmful effects are comparable to smoking tobacco. A cross-sectional survey with systematic sampling was conducted in 2010-2011 to investigate smokeless tobacco use in a multi-ethnic, semi-urban population in Islamabad, Pakistan (n = 2030). The prevalence of smokeless tobacco use was 16.0% (21.6% among males and 8.8% among females); 51.7% of smokeless tobacco users were also cigarette smokers. The rate of smokeless tobacco use was comparatively high among Pakhtun males (38.2%) and Sindhi females (22.4%). The associations between smokeless tobacco use and ethnicity, age group, income level and cigarette smoking were statistically significant among male smokeless tobacco users. Of the sample 41.4% (840/2030) had inadequate knowledge about the health problems associated with smokeless tobacco. Appropriate interventions are needed to raise awareness of the health risks and to prevent smokeless tobacco use.

Smokeless tobacco consumption in a multi-ethnic community in Pakistan: a cross-sectional study

يشيع استخدام التبغ بدون تدخين في جنوب آسيا. وهو بالإضافة إلى أنه يسبب سرطان الفم والبلعوم، فإن آثاره الضارة يمكن مقارنتها مع تعاطي التبغ بالتدخين. وقد أجرى الباحثون دراسة مستعرضة بأخذ عينات منهجية في العامين 2010 - 2011 لمعرفة مدى استخدام التبغ بدون تدخين في مجموعة سكانية شبه حضرية ومتعددة الإثنيات في إسلام آباد، باكستان، وبلغ عدد العينات 2030 عينة. واتضح للباحثين أن معدل انتشار استخدام التبغ بدون تدخين قد بلغ 16.0% [21.6% بين الذكور و 8.8 % بين الإناث]، كما أن 51.7 % ممن يستخدم التبغ بدون تدخين كانوا يدخنون السجائر. وقد كان معدل استخدام التبغ بدون تدخين مرتفعا لدى ذكور باختون [38.2 %]، ولدى إناث السند [22.4 %]مقارنة مع غيرهم. وقد كان هناك ترابط يعتد به إحصائيا بين استخدام التبغ بدون تدخين وبين الإثنية، والفئة العمرية، ومستوى الدخل، وتدخين السجائر وذلك بين من يستخدم التبغ بدون تدخين من الذكور. وكان 41.4 % من العينة [840 فردا من بين 2030 فردا]لا يمتلكون معارف كافية عن المشكلات الصحية التي تترابط مع استخدام التبغ بدون تدخين. وتمس الحاجة إلى تدخلات ملائمة لرفع مستوى الوعي حول المخاطر الصحية وللوقاية من استخدام التبغ بدون تدخين

ABSTRACT Smokeless tobacco is commonly used in south Asia. In addition to causing oral and pharyngeal cancers, its harmful effects are comparable to smoking tobacco. A cross-sectional survey with systematic sampling was conducted in 2010–2011 to investigate smokeless tobacco use in a multi-ethnic, semi-urban population in Islamabad, Pakistan (n = 2030). The prevalence of smokeless tobacco use was 16.0% (21.6% among males and 8.8% among females); 51.7% of smokeless tobacco users were also cigarette smokers. The rate of smokeless tobacco use was comparatively high among Pakhtun males (38.2%) and Sindhi females (22.4%). The associations between smokeless tobacco use and ethnicity, age group, income level and cigarette smoking were statistically significant among male smokeless tobacco users. Of the sample 41.4% (840/2030) had inadequate knowledge about the health problems associated with smokeless tobacco. Appropriate interventions are needed to raise awareness of the health risks and to prevent smokeless tobacco use.

RÉSUMÉ La consommation de tabac sans fumée est courante en Asie du Sud. Outre les cancers de la cavité buccale et du pharynx, ses effets nocifs sont comparables à ceux de la consommation de tabac à fumer. Une enquête transversale à partir d'un échantillonnage systématique (n = 2030) a été menée en 2010 et 2011 afin d'évaluer la consommation de tabac sans fumée dans une population semi-urbaine et pluriethnique à Islamabad (Pakistan). La prévalence de la consommation de tabac sans fumée était de 16,0 % (21,6 % chez les hommes et 8,8 % chez les femmes) ; 51,7 % des consommateurs de tabac sans fumée étaient aussi des fumeurs de cigarettes. Le pourcentage de consommation de tabac sans fumée était comparativement élevé chez les hommes pachtounes (38,2 %) et les femmes sindhies (22,4 %). Les associations entre la consommation de tabac sans fumée, le groupe ethnique, la tranche d'âge, le niveau de revenu et la consommation de cigarettes étaient statistiquement significatives chez les consommateurs de tabac sans fumée de sexe masculin. Au sein de l'échantillon, 41,4 % (840/2030) possédaient des connaissances insuffisantes sur les problèmes de santé liés au tabac sans fumée. Des interventions appropriées sont nécessaires pour sensibiliser aux risques sanitaires et prévenir la consommation de tabac sans fumée.

Pregnancy with 15 live fetuses and severe ovarian hyperstimulation syndrome after ovulation induction and intrauterine insemination.

The empirical use of ovulation induction and intrauterine insemination for male factor infertility, unexplained infertility, and anovulatory infertility can be associated with multiple gestation and ovarian hyperstimulation syndrome (OHSS). A 30-year-old lady was referred for fetal reduction of very high-order pregnancy. She became pregnant after ovulation induction and artificial insemination. The stimulation protocol included clomiphene citrate and fixed-dose gonadotropins. Triggering of ovulation was done with 5,000 units of human chorionic gonadotropins (hCG). Cycle monitoring was done with ultrasonography only. The patient was admitted to the hospital due to severe OHSS. Physical examination revealed that the uterus size was equivalent to 28 weeks gestation. Transvaginal ultrasonography (TVUS) and pelvic magnetic resonance imaging (MRI) showed 15 intrauterine gestational sacs with viable eight-week fetuses and 7 cm x 4.5 cm fluid collection. Both ovaries were enlarged. The right ovary was 12 cm x 5 cm and the left ovary was 10 cm x 6.5 cm. The patient had a spontaneous miscarriage of the 15 fetuses.

Incidence and predictors of hematological side effects in chronic HCV Egyptian patients treated with PEGylated interferon and ribavirin.

AIM: The aim of this paper was to study the incidence and predictors of hematological abnormalities during treatment of chronic hepatitis C virus (HCV) patients with interferon and ribavirin. METHODS: One thousand and eighty-one chronic HCV patients who were treated with PEGylated interferon α-2a 180 µg (n = 536) or α-2b 1.5 µg/kg (n = 545) plus ribavirin for 48 weeks were included. Baseline demographic, laboratory, and histopathological data and, during treatment, hematological data were collected and analyzed using univariate and multivariate analyses to identify independent predictors of hematological side effects. RESULTS: During therapy, 168 of 1,018 (15.5 %) had moderate anemia (Hb <10 and ≥8.5 g/dL) and 88 (8.1 %) had severe anemia (Hb <8.5 g/dL). Two hundred and six patients (19.1 %) had moderate neutropenia (absolute neutrophil count (ANC) <750 and ≥500/mm(3)); only 55 (5.1 %) had severe neutropenia (ANC <500/mm(3)). Forty-three patients (4 %) had moderate (platelet <50,000 and ≥25,000/mm(3)) and 5 (1.4 %) had severe thrombocytopenia (platelet <25,000/mm(3)). Fibrosis stage, week 4 Hb level, and week 2 and 4 reduction level in Hb were independent predictors of moderate and severe anemia (p < 0.001). Fibrosis stage and ANC at weeks 2 and 4 were predictors of neutropenia (p < 0.001, 0.001, and 0.004, respectively). Fibrosis stage and platelet count at weeks 2 and 4 were predictors of thrombocytopenia (p < 0.001, <0.001, and 0.005, respectively). There was no association between interferon type and anemia (p = 0.57), neutropenia (p = 0.6), or thrombocytopenia (p = 0.79). CONCLUSIONS: Fibrosis stage and week 2 and 4 hematological parameter reduction levels were independent predictors of hematological side effects, which are not related to interferon type.

Primary health care: what is it and what is it not? Views of teaching faculty at an undergraduate medical college in Pakistan.

Over 30 years after the Alma-Ata declaration on primary health care in 1978 there are still misconceptions about the basic concept of primary health care. This study aimed to investigate the knowledge and opinions about various aspects of primary health care and its appropriate implementation among the teaching faculty at Shifa College of Medicine in Islamabad, Pakistan. A structured questionnaire was answered by 70 physicians present at the end of the month seminar. Two-thirds of the doctors (67.1%) believed that primary health care involved only basic health care for common illnesses. Few respondents suggested that community-oriented programmes (4.3%), maternal and child health (2.9%), screening (1.0%) or treatment of noncommunicable diseases (2.9%) should be components of primary care. The concepts to primary health care as defined at Alma-Ata in 1978 were not well understood by teaching faculty from the basic and clinical health sciences in this medical college.

Primary health care: what is it and what is it not? Views of teaching faculty at an undergraduate medical college in Pakistan

Over 30 years after the Alma-Ata declaration on primary health care in 1978 there are still misconceptions about the basic concept of primary health care. This study aimed to investigate the knowledge and opinions about various aspects of primary health care and its appropriate implementation among the teaching faculty at Shifa College of Medicine in Islamabad, Pakistan. A structured questionnaire was answered by 70 physicians present at the end of the month seminar. Two-thirds of the doctors [67.1%] believed that primary health care involved only basic health care for common illnesses. Few respondents suggested that community-oriented programmes [4.3%], maternal and child health [2.9%], screening [1.0%] or treatment of noncommunicable diseases [2.9%] should be components of primary care. The concepts to primary health care as defined at Alma-Ata in 1978 were not well understood by teaching faculty from the basic and clinical health sciences in this medical college

Systematic review of the literature for the use of oesophageal Doppler monitor for fluid replacement in major abdominal surgery.

The use of intra-operative Doppler oesophageal probes provides continuous monitoring of cardiac output. This enables optimisation of intravascular volume and tissue perfusion in major abdominal surgery, which is thought to reduce postoperative complications and shorten hospital stay. Medline and EMBASE were searched using the standard methodology of the Cochrane collaboration for trials that compared oesophageal Doppler monitoring with conventional clinical parameters for fluid replacement in patients undergoing major elective abdominal surgery. Data from randomised controlled trials were entered and analysed in Meta-view in Rev-Man 4.2 (Nordic, Denmark). We included five studies that recruited 420 patients undergoing major abdominal surgery who were randomly allocated to receive either intravenous fluid treatment guided by monitoring ventricular filling using oesophageal Doppler monitor or fluid administration according to conventional parameters. Pooled analysis showed a reduced hospital stay in the intervention group. Overall, there were fewer complications and ICU admissions, and less requirement for inotropes in the intervention group. Return of normal gastro-intestinal function was also significantly faster in the intervention group. Oesophageal Doppler use for monitoring and optimisation of flow-related haemodynamic variables improves short-term outcome in patients undergoing major abdominal surgery.

Preparation of nanosize polyaniline and its utilization for microwave absorber.

Polyaniline powder in nanosize has been synthesized by chemical oxidative route. XRD, FTIR, and TEM were used to characterize the polyaniline powder. Crytallite size was estimated from XRD profile and also ascertained by TEM in the range of 15 to 20 nm. The composite absorbers have been prepared by mixing different ratios of polyaniline into procured polyurethane (PU) binder. The complex permittivity (epsilon' - jepsilon") and complex permeability (mu' - jmu") were measured in X-band (8.2-12.4 GHz) using Agilent network analyzer (model PNA E8364B) and its software module 85071 (version 'E'). Measured values of these parameters were used to determine the reflection loss at different frequencies and sample thicknesses, based on a model of a single layered plane wave absorber backed by a perfect conductor. An optimized polyaniline/PU ratio of 3:1 has given a minimum reflection loss of -30 dB (99.9% power absorption) at the central frequency 10 GHz and the bandwidth (full width at half minimum) of 4.2 GHz over whole X-band (8.2 to 12.4 GHz) in a sample thickness of 3.0 mm. The prepared composites can be fruitfully utilized for suppression of electromagnetic interference (EMI) and reduction of radar signatures (stealth technology).

Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction.

BACKGROUND: Adhesions are the leading cause of small bowel obstruction. Identification of patients who require surgery is difficult. This review analyses the role of Gastrografin as a diagnostic and therapeutic agent in the management of adhesive small bowel obstruction. METHODS: A systematic search of Medline, Embase and Cochrane databases was performed to identify studies of the use of Gastrografin in adhesive small bowel obstruction. Studies that addressed the diagnostic role of water-soluble contrast agent were appraised, and data presented as sensitivity, specificity, and positive and negative likelihood ratios. Results were pooled and a summary receiver-operator characteristic (ROC) curve was constructed. A meta-analysis of the data from six therapeutic studies was performed using the Mantel-Haenszel test and both fixed- and random-effect models. RESULTS: The appearance of water-soluble contrast agent in the colon on an abdominal radiograph within 24 h of its administration predicted resolution of obstruction with a pooled sensitivity of 97 per cent and specificity of 96 per cent. The area under the summary ROC curve was 0.98. Water-soluble contrast agent did not reduce the need for surgical intervention (odds ratio 0.81, P = 0.300), but it did reduce the length of hospital stay for patients who did not require surgery compared with placebo (weighted mean difference--1.84 days; P < 0.001). CONCLUSION: Published data strongly support the use of water-soluble contrast medium as a predictive test for non-operative resolution of adhesive small bowel obstruction. Although Gastrografin does not reduce the need for operation, it appears to shorten the hospital stay for those who do not require surgery.

Computing knowledge, attitude and skills among healthcare professionals in Aminu Kano Teaching Hospital, Nigeria.

BACKGROUND: Health care professionals can no longer ignore the application of information technology to health care. This study was carried out to assess computing knowledge, attitude and skills among health care professionals and identify associated factors. METHODS: A cross section of 200 health care professionals- consisting of 64 doctors, 90 nurses, 35 laboratory scientists and 11 pharmacists in Aminu Kano Teaching Hospital were interviewed using a pre-tested, structured, closed-ended self-administered questionnaire. RESULTS: Only 181 (90.5%) of the respondents returned the completed questionnaires. Twenty six percent of the respondents had formal computer training whereas 34.8% owned a personal computer. Overall, 84 (46.4%) of the respondents had good knowledge of computing. Specifically, 41(66.0%), 5 (50.0%), 14 (51.0%) and 24 (30.0%) of these were doctors, pharmacists, laboratory scientists and nurses respectively. Computing knowledge was highest among doctors and lowest among nurses. These differences were statistically significant (chi2 = 19.1 df = 3 P < 0.01). Age, gender, computer ownership and formal computer training significantly influenced computing knowledge. Most healthcare professionals 160 (88.4%) had positive attitude towards computing and this was significantly influenced by respondent's age and previous computer training. Only 41 (22.7%) of the health care professionals had good computing skills and this was significantly associated with computer ownership (P < 0.01) and formal computer training (P < 0.01). CONCLUSION: Half of the healthcare professionals had good computing knowledge, majority had a positive attitude while many were quite deficient in computer skills. Computer loans and in-house computing courses were recommended to prepare our healthcare professionals for the challenges of the information technology age.

Long-term results of the anterior Délorme's operation in the management of symptomatic rectocele.

PURPOSE: Although the results of surgery for symptomatic rectocele seem satisfactory initially, there is a trend toward deterioration with time. This study was designed to assess the long-term outcome of Anterior Délorme's operation for rectocele. METHODS: Questionnaires were sent to all females who had Anterior Délorme's operation performed in Auckland between 1990 and 2000. The questionnaires included obstructed defecation symptoms and a validated fecal incontinence severity index questionnaire and fecal incontinence quality of life questionnaire. Preoperative and postoperative obstructed defecation symptoms and incontinence score were compared. RESULTS: A total of 150 females (mean age, 56 (range, 30-83) years) who had an Anterior Délorme's operation for a rectocele were identified. One hundred seven patients (71.5 percent; mean age, 56 years) completed the questionnaire. Median follow-up was four (range, 2-11) years. The number of patients with obstructed defecation reduced from 87 preoperatively to 23 postoperatively using Rome II criteria (P < 0.0001). Postoperatively there was a reduction in the number of patients with each of the symptoms of obstructed defecation from 83 to 27 for straining, 87 to 33 for incomplete emptying, 64 to 14 for feeling of blockage, 41 to 10 for digitation (P < 0.0001 for all). The median incontinence score reduced from 20 of 61 preoperatively to 12 of 61 postoperatively (P = 0.0001). CONCLUSIONS: In patients with symptomatic rectocele, Anterior Délorme's operation provides long-term benefit for patients with obstructed defecation and leads to a significant improvement of incontinence scores.

Antimicrobial effect of water extract of sumac (Rhus coriaria L.) on the growth of some food borne bacteria including pathogens.

The antimicrobial effect of water extracts of sumac (Rhus coriaria L.) at concentrations of 0.1%, 0.5%, 1.0%, 2.5% and 5.0% (w/v), non-neutralized and after neutralization to pH 7.2+/-0.1, was studied on the growth of 12 bacterial strains (six Gram positive strains and six Gram negative strains), mostly food borne including pathogens. It was found to be effective against all the test organisms with Gram positive strains being more sensitive than Gram negative strains. Significant differences (P<0.01) were found among the bacteria and between the non-neutralized and neutralized extracts with non-neutralized being more effective against all the bacteria. The minimal inhibitory concentration (MIC) of the extract for each bacterial strain was studied by a gradient plate method. Among the Gram positive organisms, Bacillus species (Bacillus cereus, Bacillus megaterium, Bacillus subtilis, and Bacillus thuringiensis) were found to be the most sensitive showing MICs of 0.25-0.32% (after 24 h incubation) followed by Staphylococcus aureus (0.49%), while Listeria monocytogenes was found to be the least sensitive demonstrating a MIC of 0.67%. Of the Gram negative organisms, Salmonella enteritidis was found to be the most resistant with a MIC of 0.67% followed by Escherichia coli Type I, E. coli O157:H7, Proteus vulgaris and Hafnia alvei having MICs of 0.63%, 0.60%, 0.55% and 0.45%, respectively; whereas Citrobacter freundii was found to be the least resistant surviving up to 0.42%. Some loss of antimicrobial activity was, however, observed after incubation for 3 days. Bacteriostatic/bactericidal effects of sumac, as studied by enumerating survival by the viable count technique after 1 h direct contact of each microorganism with various concentrations of sumac extract, revealed a 4-5 log cycle reduction in Bacillus spp. and 2-3 log cycle reduction in other bacteria tested with 1.0% sumac extract.

Effect of ketorolac on postoperative pain relief in dental extraction cases--a comparative study with pethidine.

OBJECTIVE: To compare the analgesic efficacy and side effects of ketorolac with pethidine in a day care procedure. STUDY DESIGN: Single dose, double blind, case matched study. METHODS: Sixty patients were divided into group A and group B, who received either ketorolac 30 mg or Pethidine 0.8 mg/kg ( both IN ) respectively at the time of induction of general anaesthesia. Patients were assessed in recovery room for pain according to visual analogue scale and any side effects. Amount of rescue analgesia required by both groups were also recorded. Odds Ratio and and Chi Square test were used for statistical analysis. RESULTS: Statistical analysis showed no significant differences between these two drugs at any time interval, however a significantly decreased incidence of nausea and drowsiness was found in ketorolac group. CONCLUSION: Ketorolac 30 mg intravenously provides similar analgesic effects as Pethidine with much less incidence of nausea and drowsiness.

Silent myocardial ischemia and cardiac autonomic neuropathy in diabetics.

OBJECTIVE: To evaluate the association of silent myocardial ischemia (SMI) with cardiac autonomic neuropathy in asymptomatic diabetic patients. MATERIAL AND METHODS: Two hundred asymptomatic patients of diabetes mellitus were assessed for evidence of cardiac autonomic neuropathy. Of these, 30 (15 males, 15 females; mean age 44.7 +/- 8.8 years) were found to have cardiac autonomic neuropathy. Thirty (30) age and sex matched diabetic patients (mean age 42.4 +/- 7.6 years) who had no evidence autonomic neuropathy were included in the study as control group. Both the groups of patients were evaluated for SMI by 24 hour ambulatory electrocardiographic (ECG) monitoring. RESULTS: Incidence of SMI was significantly higher in patients with autonomic neuropathy 12/30 (40%) compared to those without 3/30 (10%) p < 0.001. Duration of diabetes was more (13 +/- 1.59 years) in patients with autonomic neuropathy compared to the control group (8.66 +/- 1.55 years) p < 0.001. Serum cholesterol and triglyceride levels were significantly higher in patients with autonomic neuropathy in comparison to control group < 0.05 and < 0.01, respectively. There was no difference in the pattern of SMI in the two groups (p = N.S). CONCLUSION: Cardiac autonomic neuropathy predisposes patients with diabetes mellitus to SMI. Twenty four hour ambulatory ECG monitoring provides useful diagnostic information in early detection and evaluation of SMI in asymptomatic diabetic patients.

Prognostic evaluation of cell mediated immunity in leprosy and correlation with clinicopathological status of leprosy patients.

Cell mediated immunity was studied in 50 patients of leprosy and 15 control volunteers, by estimation of peripheral blood lymphocytes (PBL), total rosette forming cells (TRFC) and active rosette forming cell (ARFC) counts in vitro. PBL, TRFC and ARFC counts were slightly but not significantly increased in patients of tuberculoid leprosy (TT) and muculoanaesthetic variant of tuberculoid leprosy as compared to control group. However, gradual decrease in T-cell subsets, occurred in borderline tuberculoid leprosy (BT) as compared to tuberculoid type (TT)-(p < 0.05). Significant decrease in lymphocytes and T-cell subsets was observed in midborderline leprosy (BB), (p < 0.01):borderline lepromatous leprosy (BL), (p < 0.001) and lepromatous subpolar and polar types (LL); (p < 0.001) as compared to control group. Mycobacterium leprae (M.leprae) were positive in BT-(20%); BB-(72.7%); BL-(83.2%) and LL-(100%). Delayed hypersensitivity reactions (DHR) revealed significantly increased lepromin positivity in TT (83.3%) and BT (80%) which decreased in BB (63.6%) and BL (50%). Lepromin test showed anergic state in LL group (28.5% positivity). Dinitrochlorobenzene (DNCB) skin test showed 100% positivity in TT group and controls while gradual significant decrease was observed from BT (p < 0.05) to LL scale (p < 0.001). Leprosy spectrum of Ridley and Jopling scale is directly co-related with inherent cell mediated immune status of the patients which has a significant prognostic role in treatment and long term management.