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The pharmacokinetics of primaquine (PQ) and its major carboxylic acid metabolite (PQC) have been studied in seven Indian patients withP. vivax malaria following PQ 15 mg/day p.o. for 14 days. After a single oral dose on Day 1, a mean peak blood concentration of 50.7 ng/ml PQ was attained after 2.3 h, which declined monoexponentially with a half-life of 5.6 h. The mean total body clearance was 37.6 l/h and the volume of distribution was 2921. The mean renal excretion (0–24 h) of the drug was only 0.54% of the dose and renal clearance was 0.189 l/h. Following chronic administration, none of the pharmacokinetic parameters was affected, and a steady state blood concentration of 2.5–4.2 ng/ml PQ was attained. After the first dose of PQ, PQC had a mean area under the blood concentration — time curve 11-fold higher than that of the parent drug. In contrast to the rapid distribution and elimination of PQ, the metabolite showed a longer mean residence time and accumulation in the body. The mean Cmax and AUC of the metabolite on Day 14 were 48 and 40% higher than the corresponding Day 1 values. The metabolite could not be detected in urine at any time in any patient. PQ and its metabolite did not show any accumulation in blood cells.

A method has been developed to estimate primaquine in whole blood and urine by sensitive and selective high-performance liquid chromatography. Using the linear chain analogue of primaquine as the internal standard, a single-step extraction, normal-phase silica column with a basic mobile phase, levels down to 1 ng/ml of primaquine could be measured with good precision. Other anti-malarials like amodiaquine and pyrimethamine did not interfere in the assay. The major carboxylic acid metabolite of primaquine did not elute under the normal-phase chromatographic conditions. The method is suitable for use in clinical pharmacokinetic studies with primaquine.

This is a brief review of the commoner neurological disorders encountered in India. Although large sections of the population subsist on borderline diets, nutritional deficiencies of the nervous system are not commonly seen, except pellagra in Rajasthan and Andhra Pradesh, where the diet of maize and millet respectively has a high leucine content.

We carried out a door-to-door survey to screen for neurologic diseases, including peripheral neuropathy, in a community of 14,010 Parsis living in housing colonies in Bombay, India. The most common neurologic disorder was peripheral neuropathy with 334 cases (2,384 cases/100,000 population). The most common neuropathy was compressive, with diabetes the most common non-compressive etiology. There was no leprosy, and nutritional neuropathies were rare.

We carried out a door-to-door-survey to screen a community of 14,010 people (Parsis living in colonies in Bombay, India) for possible neurologic diseases, and used defined diagnostic criteria to evaluate people who tested positive on the screening survey. There were three clinically definite cases of multiple sclerosis (21/100,000). This is the first prevalence survey for multiple sclerosis in a large developing country.

All eligible adult cases of completed ischemic stroke (N 112) derived from a prevalence survey of the Parsi community in Bombay, India, served as the basis of a case-control study of risk factors. The stroke morbidity rate in this group was similar to that reported for North America. A control subject free of stroke was selected randomly from the same population and matched to each case by age and sex. Information was obtained on various risk factors. Hypertension, both by history (odds ratio 10. 8) and by examination (odds ratio 2. 1), had a statistically significant association with stroke (p < 0. 01). This is one of the first community-based case-control studies of stroke in a large developing country.