Asian Pacific Journal of Tropical Medicine
Volume ,2025 Issue 9
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- Associations between Plasmodium falciparum merozoite surface variants and drugresistanthaplotypes in Plasmodium falciparum field isolates
- Factors contributing to multidrug-resistant tuberculosis among sputum culturepositivepulmonary tuberculosis patients in Indonesia: A cross-sectional study
- Clinical and laboratory predictors of severe pediatric Crimean-Congo hemorrhagicfever: A retrospective study
- Diphtheria immunogenicity following the administration of pentavalent DTwP- HBHibvaccine at 4- and 8-week intervals: A randomized controlled trial
- Safety and immunogenicity of RAZI Cov Pars (RCP) vaccine in children and adolescents aged 5–17 years: An open-label, single arm trial
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2025(9):383-384, DOI: 10.4103/apjtm.apjtm_674_24
Abstract:
2025(9):385-390, DOI: 10.4103/apjtm.apjtm_249_25
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Objective: To evaluate the effectiveness of DTwP-HB-Hib vaccination dosing intervals at eight weeks versus four weeks on the immunogenicity of the diphtheria component. Methods: This is a randomized, open-label, parallel, controlled trial on healthy two-month-old infants who had not received DTwP-HB-Hib vaccinations. The infants received three doses of the vaccine either at an eight-week or four-week interval. The anti-diphtheria toxoid IgG antibody levels before and after three doses of the vaccination were measured using ELISA. Results: Eighty infants were enrolled in this study, with 64 fulfilling the study requirements and randomized into two groups. All study participants exhibited uncertain protection against diphtheria antibodies (0.01-0.99 IU/mL) at the beginning of the study with an average of (0.023±0.009) IU/mL and (0.026±0.009) IU/mL in eight weeks and four weeks groups. Following three doses of the vaccination, the antibody level rose to an average of (1.320±0.234) IU/mL in the eight-week group and (1.307±0.186) IU/mL in the four-week group, with no statistically significant difference in the antibody levels observed (P=0.814). Conclusions: DTwP-HB-Hib vaccinations can be administered at an eight-week or four-week interval, as they do not significantly affect the level of anti-diphtheria IgG antibodies.
Objective: To evaluate the effectiveness of DTwP-HB-Hib vaccination dosing intervals at eight weeks versus four weeks on the immunogenicity of the diphtheria component. Methods: This is a randomized, open-label, parallel, controlled trial on healthy two-month-old infants who had not received DTwP-HB-Hib vaccinations. The infants received three doses of the vaccine either at an eight-week or four-week interval. The anti-diphtheria toxoid IgG antibody levels before and after three doses of the vaccination were measured using ELISA. Results: Eighty infants were enrolled in this study, with 64 fulfilling the study requirements and randomized into two groups. All study participants exhibited uncertain protection against diphtheria antibodies (0.01-0.99 IU/mL) at the beginning of the study with an average of (0.023±0.009) IU/mL and (0.026±0.009) IU/mL in eight weeks and four weeks groups. Following three doses of the vaccination, the antibody level rose to an average of (1.320±0.234) IU/mL in the eight-week group and (1.307±0.186) IU/mL in the four-week group, with no statistically significant difference in the antibody levels observed (P=0.814). Conclusions: DTwP-HB-Hib vaccinations can be administered at an eight-week or four-week interval, as they do not significantly affect the level of anti-diphtheria IgG antibodies.
2025(9):391-399, DOI: 10.4103/apjtm.apjtm_216_25
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Objective: To identify clinical and laboratory parameters associated with severe disease requiring intensive care among pediatric Crimean-Congo hemorrhagic fever (CCHF) patients. Methods: Twenty-three children with confirmed CCHF were divided into two groups: Pediatric intensive care unit (PICU) patients (n=12) and general ward patients (n=11). Laboratory parameters including platelet count, platelet mass index (PMI), liver enzymes, and inflammatory markers were analyzed at admission through univariate and multivariate logistic regression as well as receiver operating characteristic curve analysis. Results: PICU patients had significant lower platelet counts and PMI (P=0.002 for both), and higher aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and ferritin levels (P<0.01). Univariate analysis identified platelet count (OR 0.99, P=0.026), PMI (OR 0.98, P=0.021), AST (OR 1.03, P=0.025), and alanine aminotransferase (OR 1.03, P=0.050) as significant predictors of PICU admission. Multivariate analysis demonstrated PMI as an independent predictor (adjusted OR 0.98; 95% CI 0.97-0.99, P=0.021). The area under the curve (AUC) was the highest for aspartate aminotransferase (AUC=0.886, 95% CI 0.69-0.98), fol¬lowed by lactate dehydrogenase (AUC=0.879, 95% CI 0.68-0.98), platelet mass index (AUC=0.864, 95% CI 0.66-0.97), platelet count (AUC=0.860, 95% CI 0.65-0.97), ferritin (AUC=0.811, 95% CI 0.59-0.94), and alanine aminotransferase (AUC=0.796, 95% CI 0.58-0.93). Conclusions: PMI showed promising predictive value for intensive care requirement in pediatric CCHF patients, maintaining significance in multivariate analysis. Several laboratory parameters including AST, LDH, and platelet count showed high diagnostic accuracy for identifying severe disease. These readily available parameters can guide early risk stratification and resource allocation in pediatric CCHF management.
Objective: To identify clinical and laboratory parameters associated with severe disease requiring intensive care among pediatric Crimean-Congo hemorrhagic fever (CCHF) patients. Methods: Twenty-three children with confirmed CCHF were divided into two groups: Pediatric intensive care unit (PICU) patients (n=12) and general ward patients (n=11). Laboratory parameters including platelet count, platelet mass index (PMI), liver enzymes, and inflammatory markers were analyzed at admission through univariate and multivariate logistic regression as well as receiver operating characteristic curve analysis. Results: PICU patients had significant lower platelet counts and PMI (P=0.002 for both), and higher aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and ferritin levels (P<0.01). Univariate analysis identified platelet count (OR 0.99, P=0.026), PMI (OR 0.98, P=0.021), AST (OR 1.03, P=0.025), and alanine aminotransferase (OR 1.03, P=0.050) as significant predictors of PICU admission. Multivariate analysis demonstrated PMI as an independent predictor (adjusted OR 0.98; 95% CI 0.97-0.99, P=0.021). The area under the curve (AUC) was the highest for aspartate aminotransferase (AUC=0.886, 95% CI 0.69-0.98), fol¬lowed by lactate dehydrogenase (AUC=0.879, 95% CI 0.68-0.98), platelet mass index (AUC=0.864, 95% CI 0.66-0.97), platelet count (AUC=0.860, 95% CI 0.65-0.97), ferritin (AUC=0.811, 95% CI 0.59-0.94), and alanine aminotransferase (AUC=0.796, 95% CI 0.58-0.93). Conclusions: PMI showed promising predictive value for intensive care requirement in pediatric CCHF patients, maintaining significance in multivariate analysis. Several laboratory parameters including AST, LDH, and platelet count showed high diagnostic accuracy for identifying severe disease. These readily available parameters can guide early risk stratification and resource allocation in pediatric CCHF management.
Dina Bisara Lolong, Joko Irianto, Ina Kusrini, Ingan Ukur Tarigan, Alfons Maryono Letelay, Kristina L. Tobing, Maria Holly Herawati, Noer Endah Pracoyo, Siti Isfandari, Raflizar, Doni Lasut, Roy GA Massie, Helper Sahat
Manalu, Dede Anwar Musadad, Made Agus Nurjana
2025(9):400-408, DOI: 10.4103/apjtm.apjtm_80_25
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Objective: To analyze the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) as a first national survey in Indonesia. Methods: This national coverage cross-sectional study was conducted from 2017 to 2018. The study subjects were selected using a multi-stage probability random sampling method. MDR-TB is tuberculosis caused by bacteria resistant to at least isoniazid and rifampicin. The dependent variable was MDR-TB. Independent variables included age, sex, education, employment status, place of residence, history of living with TB patients, and the number of household members. Univariate and multivariate logistic regression models were used to analyze the risk factors associated with MDR-TB. All the data were analyzed using STATA V.14.0 (Stata Corp LLC, College Station, TX). Results: This study found the MDR rate was 109/3 234 (3.4%) among positive pulmonary TB patients. More than twice as many patients had MDR re-treatment (74/3 234, 2.3%), compared to 35/3 234 (1.1%) who had new TB diagnoses or were getting initial treatment. After adjusting for employment status, individuals with a prior history of tuberculosis treatment were found to have significantly higher odds of developing MDR-TB, with an odds ratio of 7.22 (95% CI 3.87-13.44). Conclusions: Increasing attention should be paid to these patients to prevent MDR-TB, and MDR-TB transmission is an urgent challenge for controlling TB worldwide. Early detection of MDR-TB is a critical part of TB control programs.
Objective: To analyze the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) as a first national survey in Indonesia. Methods: This national coverage cross-sectional study was conducted from 2017 to 2018. The study subjects were selected using a multi-stage probability random sampling method. MDR-TB is tuberculosis caused by bacteria resistant to at least isoniazid and rifampicin. The dependent variable was MDR-TB. Independent variables included age, sex, education, employment status, place of residence, history of living with TB patients, and the number of household members. Univariate and multivariate logistic regression models were used to analyze the risk factors associated with MDR-TB. All the data were analyzed using STATA V.14.0 (Stata Corp LLC, College Station, TX). Results: This study found the MDR rate was 109/3 234 (3.4%) among positive pulmonary TB patients. More than twice as many patients had MDR re-treatment (74/3 234, 2.3%), compared to 35/3 234 (1.1%) who had new TB diagnoses or were getting initial treatment. After adjusting for employment status, individuals with a prior history of tuberculosis treatment were found to have significantly higher odds of developing MDR-TB, with an odds ratio of 7.22 (95% CI 3.87-13.44). Conclusions: Increasing attention should be paid to these patients to prevent MDR-TB, and MDR-TB transmission is an urgent challenge for controlling TB worldwide. Early detection of MDR-TB is a critical part of TB control programs.
2025(9):409-414, DOI: 10.4103/apjtm.apjtm_239_25
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Objective: To investigate the associations between Plasmodium falciparum merozoite surface protein allelic families (Pfmsp1, Pfmsp2), infection clonality and drug-resistant haplotypes (Pfcrt, Pfdhfr, Pfdhps, Pfmdr1 and Pfkelch13) in malaria samples collected over 30 years in India. Methods: Infection clonality was assessed using Pfmsp1 (K1, MAD20, RO33) and Pfmsp2 (IC/3D7, FC27) allelic families. Five key drug resistance genes were analysed by PCR and Sanger sequencing. Statistical analyses were performed to evaluate associations between specific Pfmsp allelic families, infection clonality and drug-resistant haplotypes. Results: Significant associations were observed between Pfmsp allelic families, infection clonality and resistant haplotypes across four genes (Pfcrt, Pfdhfr, Pfdhps1 and Pfmdr1). For Pfcrt, K1 (P=0.026) and IC/3D7 (P<0.001) alleles were significantly associated with wild-type CVMNK haplotype, while FC27 allele was linked to SVMNT haplotype (P=0.005). Similarly, Pfmdr1 FC27 allele was significantly associated with NFSND haplotype (P=0.034) and IC/3D7 allele with NYSND haplotype (P<0.001). Analyses revealed that both K1 and RO33 alleles were associated with resistant Pfdhfr and Pfdhps haplotypes, whereas MAD20 was exclusively associated with resistant Pfdhps (P<0.001) haplotypes. Additionally, Pfdhfr and Pfdhps haplotypes exhibited distinct associations with both Pfmsp2 allelic families. Conclusions: The findings suggest potential associations between antigenic diversity markers and drug-resistant haplotypes, and some patterns may reflect shared ancestral origins, though the basis of certain associations remains unclear. Further studies with larger datasets are needed to validate these observations and elucidate the genetic and ecological factors underlying these relationships.
Objective: To investigate the associations between Plasmodium falciparum merozoite surface protein allelic families (Pfmsp1, Pfmsp2), infection clonality and drug-resistant haplotypes (Pfcrt, Pfdhfr, Pfdhps, Pfmdr1 and Pfkelch13) in malaria samples collected over 30 years in India. Methods: Infection clonality was assessed using Pfmsp1 (K1, MAD20, RO33) and Pfmsp2 (IC/3D7, FC27) allelic families. Five key drug resistance genes were analysed by PCR and Sanger sequencing. Statistical analyses were performed to evaluate associations between specific Pfmsp allelic families, infection clonality and drug-resistant haplotypes. Results: Significant associations were observed between Pfmsp allelic families, infection clonality and resistant haplotypes across four genes (Pfcrt, Pfdhfr, Pfdhps1 and Pfmdr1). For Pfcrt, K1 (P=0.026) and IC/3D7 (P<0.001) alleles were significantly associated with wild-type CVMNK haplotype, while FC27 allele was linked to SVMNT haplotype (P=0.005). Similarly, Pfmdr1 FC27 allele was significantly associated with NFSND haplotype (P=0.034) and IC/3D7 allele with NYSND haplotype (P<0.001). Analyses revealed that both K1 and RO33 alleles were associated with resistant Pfdhfr and Pfdhps haplotypes, whereas MAD20 was exclusively associated with resistant Pfdhps (P<0.001) haplotypes. Additionally, Pfdhfr and Pfdhps haplotypes exhibited distinct associations with both Pfmsp2 allelic families. Conclusions: The findings suggest potential associations between antigenic diversity markers and drug-resistant haplotypes, and some patterns may reflect shared ancestral origins, though the basis of certain associations remains unclear. Further studies with larger datasets are needed to validate these observations and elucidate the genetic and ecological factors underlying these relationships.
2025(9):415-420, DOI: 10.4103/apjtm.apjtm_425_25
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Objective:To describe the clinical features and outcomes of arboviral infections in solid organ transplant recipients (SOTRs). Methods: This study included SOTRs identified from a passive surveillance cohort of 1 466 patients with acute undifferentiated febrile illness between 2012 and 2019. Diagnosis of arboviral infection was confirmed using RT-PCR and/or serological testing. Clinical, laboratory, and outcome data were extracted and analyzed descriptively. Results: Eleven SOTRs (10 kidney, 1 heart transplant recipient) were diagnosed with arboviral infections: 8 with dengue (DENV), 2 with chikungunya virus (CHIKV), and 1 with Zika virus (ZIKV) infection. The median time from transplantation to symptom onset was 35.0 days (IQR 28.5-111.0). DENV infection was associated with severe disease, including dengue shock syndrome (50%, 4/8) and dengue hemorrhagic fever (25%, 2/8). Six patients (75%, 6/8) required ICU admission. Common laboratory abnormalities in dengue patients included leukopenia (100%, 8/8), thrombocytopenia (100%, 8/8), elevated transaminases (87.5%, 7/8), and acute kidney injury (50%, 4/8). CHIKV and ZIKV cases presented as mild, self-limiting febrile illnesses without complications. All patients recovered without long-term morbidity. Conclusions:DENV infection in SOTRs is associated with significant morbidity, particularly early post-transplant, and requires heightened clinical vigilance. In contrast, CHIKV and ZIKV infections tend to follow a benign course. Enhanced vector control, early diagnostic testing, supportive management, and consideration of dengue vaccination in appropriate candidates are essential to mitigate the impact of arboviral infections in transplant recipients in endemic areas.
Objective:To describe the clinical features and outcomes of arboviral infections in solid organ transplant recipients (SOTRs). Methods: This study included SOTRs identified from a passive surveillance cohort of 1 466 patients with acute undifferentiated febrile illness between 2012 and 2019. Diagnosis of arboviral infection was confirmed using RT-PCR and/or serological testing. Clinical, laboratory, and outcome data were extracted and analyzed descriptively. Results: Eleven SOTRs (10 kidney, 1 heart transplant recipient) were diagnosed with arboviral infections: 8 with dengue (DENV), 2 with chikungunya virus (CHIKV), and 1 with Zika virus (ZIKV) infection. The median time from transplantation to symptom onset was 35.0 days (IQR 28.5-111.0). DENV infection was associated with severe disease, including dengue shock syndrome (50%, 4/8) and dengue hemorrhagic fever (25%, 2/8). Six patients (75%, 6/8) required ICU admission. Common laboratory abnormalities in dengue patients included leukopenia (100%, 8/8), thrombocytopenia (100%, 8/8), elevated transaminases (87.5%, 7/8), and acute kidney injury (50%, 4/8). CHIKV and ZIKV cases presented as mild, self-limiting febrile illnesses without complications. All patients recovered without long-term morbidity. Conclusions:DENV infection in SOTRs is associated with significant morbidity, particularly early post-transplant, and requires heightened clinical vigilance. In contrast, CHIKV and ZIKV infections tend to follow a benign course. Enhanced vector control, early diagnostic testing, supportive management, and consideration of dengue vaccination in appropriate candidates are essential to mitigate the impact of arboviral infections in transplant recipients in endemic areas.
Naman Lodha, Angirekula Shekhar, Naresh Kumar Midha, Ananya Panda, Kanishka Chaurasia, Anupama
Bains, Deepak Kumar
2025(9):421-424, DOI: 10.4103/apjtm.apjtm_305_25
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Rationale: Central nervous system (CNS) actinomycosis is rare, spreading hematogenously from distant infections. Cutaneous actinomycosis with skull/meninges spread is especially unusual. Patient concerns: A 57-year-old man presented with complaints of discharge from the back of his scalp for six months, an ataxic gait, and bilateral upper and lower limb weakness and numbness over the past 4-5 months. Diagnosis: CNS actinomycosis. Interventions: Intravenous injection of ceftriaxone followed by oral amoxicillin-clavulanic acid therapy. Outcomes:The patient was able to walk without support, with complete resolution of sinus discharge. Lessons: In patients presenting with discharging sinuses especially when accompanied by CNS symptoms, actinomycosis should be considered as a differential, along with tuberculosis, non-tubercular mycobacterial infection, and aspergillosis. Microbiological confirmation should be attempted wherever possible, for accurate diagnosis and treatment, as clinic-radiological picture alone may not differentiate these infections, as treatment of each is diametrically opposite and patients can be cured with timely and appropriate treatment.
Rationale: Central nervous system (CNS) actinomycosis is rare, spreading hematogenously from distant infections. Cutaneous actinomycosis with skull/meninges spread is especially unusual. Patient concerns: A 57-year-old man presented with complaints of discharge from the back of his scalp for six months, an ataxic gait, and bilateral upper and lower limb weakness and numbness over the past 4-5 months. Diagnosis: CNS actinomycosis. Interventions: Intravenous injection of ceftriaxone followed by oral amoxicillin-clavulanic acid therapy. Outcomes:The patient was able to walk without support, with complete resolution of sinus discharge. Lessons: In patients presenting with discharging sinuses especially when accompanied by CNS symptoms, actinomycosis should be considered as a differential, along with tuberculosis, non-tubercular mycobacterial infection, and aspergillosis. Microbiological confirmation should be attempted wherever possible, for accurate diagnosis and treatment, as clinic-radiological picture alone may not differentiate these infections, as treatment of each is diametrically opposite and patients can be cured with timely and appropriate treatment.
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Available online:February 03, 2020, DOI: 10.4103/1995-7645.277515
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Available online:February 03, 2020, DOI: 10.4103/1995-7645.277516
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(), DOI: 10.4103/1995-7645.277515
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Emrah Sefik Abamor, Adil Allahverdiyev, Ozlem Ayse Tosyali, Melahat Bagirova, Tayfun Acar, Zeynep Mustafaeva, Serap Derman
2019,12(8):353-364, DOI: 10.4103/1995-7645.262564
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Objective: To prepare and characterize poly lactic-co-glycolic acid (PLGA) nanoparticles loaded with soluble leishmanial antigen or autoclaved leishmanial antigen and explore in vitro and in vivo immunogenicity of antigen encapsulated nanoparticles. Methods: Water/oil/water double emulsion technique was employed to synthesize PLGA nanoparticles, and scanning electron microscopy, Fourier transform infrared spectroscopy and Zeta-potential measurements were used to identify the characteristics of nanoparticles. Cytotoxicity of synthetized nanoparticles on J774 macrophage were investigated by MTT assays. To determine the in vitro immunostimulatory efficacies of nanoparticles, griess reaction and ELISA was used to measure the amounts of NO and cytokines. During the in vivo analysis, Balb/c mice were immunized with vaccine formulations, and protective properties of nanoparticles were measured by Leishman Donovan unit in the liver following the infection. Cytokine levels in spleens of mice were determined by ELISA. Results: MTT assay showed that neither soluble leishmanial antigen nor autoclaved leishmanial antigen encapsulated nanoparticles showed cytotoxicity against J774 macrophage cells. Contrary to free antigens, both autoclaved leishmanial antigen-nanoparticle and soluble leishmanial antigen-nanoparticle formulations led to a 10 and 16-fold increase in NO amounts by macrophages, respectively. Leishman Donovan unit calculations revealed that soluble leishmanial antigen-nanoparticles and autoclaved leishmanial antigen-nanoparticles yielded 52% and 64% protection against visceral leishmaniasis in mouse models. Besides, in vitro and in vivo tests demonstrated that by increasing IFN-γand IL-12 levels and inhibiting IL-4 and IL- 10 secretions, autoclaved leishmanial antigen-nanoparticles and soluble leishmanial antigennanoparticles triggered Th1 immune response. Conclusions: Both autoclaved leishmanial antigen-nanoparticles and soluble leishmanial antigen-nanoparticles formulations provide exceptional in vitro and in vivo immunostimulatory activities. Hence, PLGA-based antigen delivery systems are recommended as potential vaccine candidates against visceral leishmaniasis.
Objective: To prepare and characterize poly lactic-co-glycolic acid (PLGA) nanoparticles loaded with soluble leishmanial antigen or autoclaved leishmanial antigen and explore in vitro and in vivo immunogenicity of antigen encapsulated nanoparticles. Methods: Water/oil/water double emulsion technique was employed to synthesize PLGA nanoparticles, and scanning electron microscopy, Fourier transform infrared spectroscopy and Zeta-potential measurements were used to identify the characteristics of nanoparticles. Cytotoxicity of synthetized nanoparticles on J774 macrophage were investigated by MTT assays. To determine the in vitro immunostimulatory efficacies of nanoparticles, griess reaction and ELISA was used to measure the amounts of NO and cytokines. During the in vivo analysis, Balb/c mice were immunized with vaccine formulations, and protective properties of nanoparticles were measured by Leishman Donovan unit in the liver following the infection. Cytokine levels in spleens of mice were determined by ELISA. Results: MTT assay showed that neither soluble leishmanial antigen nor autoclaved leishmanial antigen encapsulated nanoparticles showed cytotoxicity against J774 macrophage cells. Contrary to free antigens, both autoclaved leishmanial antigen-nanoparticle and soluble leishmanial antigen-nanoparticle formulations led to a 10 and 16-fold increase in NO amounts by macrophages, respectively. Leishman Donovan unit calculations revealed that soluble leishmanial antigen-nanoparticles and autoclaved leishmanial antigen-nanoparticles yielded 52% and 64% protection against visceral leishmaniasis in mouse models. Besides, in vitro and in vivo tests demonstrated that by increasing IFN-γand IL-12 levels and inhibiting IL-4 and IL- 10 secretions, autoclaved leishmanial antigen-nanoparticles and soluble leishmanial antigennanoparticles triggered Th1 immune response. Conclusions: Both autoclaved leishmanial antigen-nanoparticles and soluble leishmanial antigen-nanoparticles formulations provide exceptional in vitro and in vivo immunostimulatory activities. Hence, PLGA-based antigen delivery systems are recommended as potential vaccine candidates against visceral leishmaniasis.
Parut Suksai, Supakarn Kaewchot, Piya Sereerak, Sirinan Boonnan, Bongkotchamat Phimsin, Taksina Jaruwattananon, Kacharin Raschasin, Mutchamon Kaewparuehaschai, Sorraya Siriphet, Benjaporn Bhusri
2019,12(8):375-379, DOI: 10.4103/1995-7645.262566
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Objective: To survey hemoplasmas infection in free ranging non-human primates from 8 provinces in Thailand. Methods: DNA from ethylenediaminetetraacetic acid blood of 262 free ranging non-human primates were identified as hemoplasmas using PCR and phylogenetic analysis based on 16S rRNA and rnpB genes. Results: A total of 148 non-human primates (56.49%) were determined positive for Candidatus Mycoplasma haemomacaque, including 125 Macaca fascicularis and 23 Macaca mulatta. Hemoplasmas can cause anemia in monkey but all positive samples were healthy. The positive rates in male and female non-human primates were not significantly different. Conclusions: Candidatus Mycoplasma infection is prevalent in free ranging Macaca fascicularis and Macaca mulatta in Thailand.
Objective: To survey hemoplasmas infection in free ranging non-human primates from 8 provinces in Thailand. Methods: DNA from ethylenediaminetetraacetic acid blood of 262 free ranging non-human primates were identified as hemoplasmas using PCR and phylogenetic analysis based on 16S rRNA and rnpB genes. Results: A total of 148 non-human primates (56.49%) were determined positive for Candidatus Mycoplasma haemomacaque, including 125 Macaca fascicularis and 23 Macaca mulatta. Hemoplasmas can cause anemia in monkey but all positive samples were healthy. The positive rates in male and female non-human primates were not significantly different. Conclusions: Candidatus Mycoplasma infection is prevalent in free ranging Macaca fascicularis and Macaca mulatta in Thailand.
Maryam Hakimi Parizi, Iraj Sharifi, Saeedeh Farajzadeh, Abbas Pardakhty, Mohammad Hossein Daie Parizi, Hamid Sharifi, Ali Reza Keyhani, Mahshid Mostafavi, Mehdi Bamorovat, Ahmad Khosravi, Daryoush Ghaffari
2019,12(8):365-374, DOI: 10.4103/1995-7645.262565
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Objective: To explore the antileishmanial effect of tioxolone and its niosomal form against Leishmania tropica. Methods: Tioxolone niosomes were prepared by the hydration method and were evaluated for morphology, size, release study, and encapsulation efficiency. The cytotoxicity of tioxolone and its niosomal form was measured by MTT assay, leishmanicidal activity against promastigote and amastigote by MTT assay, apoptosis by flow cytometry, IL-12, IL-10 and metacaspase gene expression levels by q-PCR. Results: Span/Tween 40 and Span/Tween 60 niosomes had good physical stability as depicted in their size distribution curves and high encapsulation efficiency (>99%). The release profile of the entrapped compounds showed Fickian’s model of tioxolone delivery based on diffusion through lipid bilayers. With the IC50 value for amastigote as (24.5±2.1) μg/mL and selectivity index as 10.5, the Span/Tween 60 niosome (NT2) had a superior effect to other drugs. The CC50 value and IC50 of promastigote value for NT2 were (257.5±24.5) μg/mL and (164.8±20.6) μg/ mL, respectively. The flow cytometric analysis showed that tioxolone and niosomal forms induced apoptosis of Leishmania tropica promastigotes in a dose-dependent manner. NT2 increased the expression level of IL-12 and metacaspase genes and decreased the expression level of the IL-10 gene. Conclusions: Niosomes of tioxolone play an immunomodulatory role in increasing Th1 cytokine profile and inhibiting the Th2 cytokine profile. It could be used for treatment of anthroponotic cutaneous leishmaniasis.
Objective: To explore the antileishmanial effect of tioxolone and its niosomal form against Leishmania tropica. Methods: Tioxolone niosomes were prepared by the hydration method and were evaluated for morphology, size, release study, and encapsulation efficiency. The cytotoxicity of tioxolone and its niosomal form was measured by MTT assay, leishmanicidal activity against promastigote and amastigote by MTT assay, apoptosis by flow cytometry, IL-12, IL-10 and metacaspase gene expression levels by q-PCR. Results: Span/Tween 40 and Span/Tween 60 niosomes had good physical stability as depicted in their size distribution curves and high encapsulation efficiency (>99%). The release profile of the entrapped compounds showed Fickian’s model of tioxolone delivery based on diffusion through lipid bilayers. With the IC50 value for amastigote as (24.5±2.1) μg/mL and selectivity index as 10.5, the Span/Tween 60 niosome (NT2) had a superior effect to other drugs. The CC50 value and IC50 of promastigote value for NT2 were (257.5±24.5) μg/mL and (164.8±20.6) μg/ mL, respectively. The flow cytometric analysis showed that tioxolone and niosomal forms induced apoptosis of Leishmania tropica promastigotes in a dose-dependent manner. NT2 increased the expression level of IL-12 and metacaspase genes and decreased the expression level of the IL-10 gene. Conclusions: Niosomes of tioxolone play an immunomodulatory role in increasing Th1 cytokine profile and inhibiting the Th2 cytokine profile. It could be used for treatment of anthroponotic cutaneous leishmaniasis.
2019,12(6):243-249, DOI: 10.4103/1995-7645.261270
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Schistosomiasis is a neglected tropical disease that affects about 290 million patients worldwide. Children aged between 5 and 14 years represent 45.8% of the affected patients, in addition, schistosomiasis has been reported in Schistosoma-free areas, mostly because of tourism and immigration from endemic countries. Intestinal schistosomiasis caused by Schistosoma mansoni is mainly diagnosed via direct stool examination for egg detection. Immunological methods are favoured for disease monitoring and preliminary checking for communities in areas with low infection rates, and for patients with light and chronic infections where parasitological tests are negative. PCR-based diagnostic techniques are more sensitive, but expensive. Tegument proteins and miRNAs are promising markers for diagnosis of schistosomiasis. Here we review the diagnostic methods for schistosomiasis mansoni aiming to reach a standardized technique for diagnosis of early infection to help better control of the disease.
Schistosomiasis is a neglected tropical disease that affects about 290 million patients worldwide. Children aged between 5 and 14 years represent 45.8% of the affected patients, in addition, schistosomiasis has been reported in Schistosoma-free areas, mostly because of tourism and immigration from endemic countries. Intestinal schistosomiasis caused by Schistosoma mansoni is mainly diagnosed via direct stool examination for egg detection. Immunological methods are favoured for disease monitoring and preliminary checking for communities in areas with low infection rates, and for patients with light and chronic infections where parasitological tests are negative. PCR-based diagnostic techniques are more sensitive, but expensive. Tegument proteins and miRNAs are promising markers for diagnosis of schistosomiasis. Here we review the diagnostic methods for schistosomiasis mansoni aiming to reach a standardized technique for diagnosis of early infection to help better control of the disease.
Hamed Behniafar, Vahideh Moin-Vaziri, Mehdi Mohebali, Seyyed Javad Seyyed Tabaei, Zabih Zarei, Elham Kazemirad, Behnaz Akhoundi, Mohammad Kazem Saharifi-Yazdi, Alireza Zahraei-Ramazani
2019,12(7):306-314, DOI: 10.4103/1995-7645.262074
Abstract:
Objective: To clarify the epidemiological aspects of visceral leishmaniasis in Kaleybar and Khoda-Afarin districts, north-west of Iran. Methods: A total of 1 420 human (children under 12 years) samples, 101 domestic dogs samples (Canis familiaris), and 577 female sand fly samples were collected. Sera of human and dogs were tested using the direct agglutination test, and sand flies were identified at species level using the microscopic method. Furthermore, a structured questionnaire was applied to evaluate the correlation between the potential risk factors and the related clinical signs/ symptoms with the human and dogs' seropositivity. Results: Totally, 2.18% of human samples were positive at titers ≥ 1: 800; among them, 13 cases (41.94%) were above 1:3 200, and clinical symptoms were observed in all of them except for an 11-year old girl. Anti-Leishmania infantum antibodies were found at titer ≥ 1: 320 in 9.90% of dogs' samples, half of them had at least one sign of canine visceral leishmaniasis. Moreover, 10 Phlebotomus species were identified in the study areas, and Phlebotomus (Larroussius) major group was the predominant species. There are significant correlations between the presence of anti-Leishmania infantum antibodies and the fever (P<0.001), anemia (P=0.001) and weight loss (P=0.016) in children. On the other hand, significant correlations were revealed between the Leishmania infection and the shelter (P=0.039), cutaneous lesion (P=0.005), lymphadenopathy (P=0.001) and weight loss (P<0.001) in the infected dogs. Conclusions: Visceral Leishmania infection is prevalent in rural areas of Kaleybar and Khoda- Afar districts located in East-Azerbaijan province, therefore active detection and treatment of visceral leishmaniasis cases should not be neglected.
Objective: To clarify the epidemiological aspects of visceral leishmaniasis in Kaleybar and Khoda-Afarin districts, north-west of Iran. Methods: A total of 1 420 human (children under 12 years) samples, 101 domestic dogs samples (Canis familiaris), and 577 female sand fly samples were collected. Sera of human and dogs were tested using the direct agglutination test, and sand flies were identified at species level using the microscopic method. Furthermore, a structured questionnaire was applied to evaluate the correlation between the potential risk factors and the related clinical signs/ symptoms with the human and dogs' seropositivity. Results: Totally, 2.18% of human samples were positive at titers ≥ 1: 800; among them, 13 cases (41.94%) were above 1:3 200, and clinical symptoms were observed in all of them except for an 11-year old girl. Anti-Leishmania infantum antibodies were found at titer ≥ 1: 320 in 9.90% of dogs' samples, half of them had at least one sign of canine visceral leishmaniasis. Moreover, 10 Phlebotomus species were identified in the study areas, and Phlebotomus (Larroussius) major group was the predominant species. There are significant correlations between the presence of anti-Leishmania infantum antibodies and the fever (P<0.001), anemia (P=0.001) and weight loss (P=0.016) in children. On the other hand, significant correlations were revealed between the Leishmania infection and the shelter (P=0.039), cutaneous lesion (P=0.005), lymphadenopathy (P=0.001) and weight loss (P<0.001) in the infected dogs. Conclusions: Visceral Leishmania infection is prevalent in rural areas of Kaleybar and Khoda- Afar districts located in East-Azerbaijan province, therefore active detection and treatment of visceral leishmaniasis cases should not be neglected.
Subin Varghese Thomas, John Paul, Akhila Hosur Shrungeswara, Subhankar Biswas, AartiAbhishek Shah, Chandrashekar Kodangala Subraya, Yogendra Nayak
2019,12(6):272-282, DOI: 10.4103/1995-7645.261273
Abstract:
Objective: To evaluate the anticancer potentials of Annona muricata fruit by in vitro and in vivo methods. Methods: The ethanolic extract of Annona muricata fruit was prepared by Soxhlet extraction method and further fractionated with petroleum ether, ethyl acetate and chloroform. The fractions were tested for cytotoxicity, apoptosis, scratch wound assay, and cell cycle analysis. IC50, apoptotic index and percentage cell migration were determined using HepG2 cells. For the in vivo studies, hepatocellular carcinoma was induced by administering 0.01% diethylnitrosamine (DEN) in drinking water in Wistar rats. In pre-treatment, rats were co-administered 200 mg/kg of fruit extract with DEN for 14 weeks. In post-treatment, the extract was co-administered after 8-weeks of DEN-induction for 14 weeks. Liver function test, haematological test, oxidative stress markers, relative liver weight, number of cancer nodules and histopathological parameters were determined. Results: Annona muricata fruit extract =significantly lowered cell proliferation counts. The chloroform-fraction possessed higher activity [IC50=(53.7±4.3) μg/mL]. The chloroform fraction inhibited cell migration, which was significant compared to curcumin. Further investigations regarding the mode of anticancer activity revealed that the chloroform fraction induced apoptosis. The cell cycle analysis indicated that cells were being arrested at G0/G1. In the in vivo studies, the DEN-control group showed a significant decrease in body weights with increased mortality rate, hepatic nodules, and impairment of liver function compared to normal rats. The rats pre-treated and post-treated with the extract showed positive results with significant improvement in the parameters that were adversely affected by DEN. In addition, other adverse effects of DEN, such as blood dyscrasias and hepatic endogenous antioxidant, were significantly attenuated by Annona muricata fruit extract. Conclusions: The Annona muricata fruit extract has anticancer activity when tested by in vitro and in vivo hepatocellular cancer models.
Objective: To evaluate the anticancer potentials of Annona muricata fruit by in vitro and in vivo methods. Methods: The ethanolic extract of Annona muricata fruit was prepared by Soxhlet extraction method and further fractionated with petroleum ether, ethyl acetate and chloroform. The fractions were tested for cytotoxicity, apoptosis, scratch wound assay, and cell cycle analysis. IC50, apoptotic index and percentage cell migration were determined using HepG2 cells. For the in vivo studies, hepatocellular carcinoma was induced by administering 0.01% diethylnitrosamine (DEN) in drinking water in Wistar rats. In pre-treatment, rats were co-administered 200 mg/kg of fruit extract with DEN for 14 weeks. In post-treatment, the extract was co-administered after 8-weeks of DEN-induction for 14 weeks. Liver function test, haematological test, oxidative stress markers, relative liver weight, number of cancer nodules and histopathological parameters were determined. Results: Annona muricata fruit extract =significantly lowered cell proliferation counts. The chloroform-fraction possessed higher activity [IC50=(53.7±4.3) μg/mL]. The chloroform fraction inhibited cell migration, which was significant compared to curcumin. Further investigations regarding the mode of anticancer activity revealed that the chloroform fraction induced apoptosis. The cell cycle analysis indicated that cells were being arrested at G0/G1. In the in vivo studies, the DEN-control group showed a significant decrease in body weights with increased mortality rate, hepatic nodules, and impairment of liver function compared to normal rats. The rats pre-treated and post-treated with the extract showed positive results with significant improvement in the parameters that were adversely affected by DEN. In addition, other adverse effects of DEN, such as blood dyscrasias and hepatic endogenous antioxidant, were significantly attenuated by Annona muricata fruit extract. Conclusions: The Annona muricata fruit extract has anticancer activity when tested by in vitro and in vivo hepatocellular cancer models.
Ines Sifaoui, Carmen M Martín-Navarro, Atteneri López-Arencibia, María Reyes-Batlle, Basilio Valladares, José E. Pi?ero, Sutherland K Maciver, Jacob Lorenzo-Morales
2019,12(6):283-287, DOI: 10.4103/1995-7645.261287
Abstract:
Objective: To evaluate the combination of several statins (atorvastatin, fluvastatin and simvastatin) and azoles (voriconazole, posaconazole and itraconazole) against Acanthamoeba spp. Methods: The efficiency of the different drug combinations against the trophozoite stage of different Acanthamoeba strains were evaluated by Alamar Blue assay. Effect on the cyst stage was observed by inverted microscope. Cytotoxicity of combinations of azoles and statins was evaluated by measuring the release of lactate dehydrogenase from a murine macrophage cell line. Results: Combinations of any of the tested statins and voriconazole or posaconazole were more efficient in inhibiting Acanthamoeba compared to statins or azoles individually. The drug combinations at the combined inhibitory concentrations 50% showed lower toxicity compared to that of the compounds alone. Conclusions: The combinations of statins together with voriconazole and posaconazole are more efficient than these drugs alone, and these combinations have lower cytotoxicity in mammalian cell lines.
Objective: To evaluate the combination of several statins (atorvastatin, fluvastatin and simvastatin) and azoles (voriconazole, posaconazole and itraconazole) against Acanthamoeba spp. Methods: The efficiency of the different drug combinations against the trophozoite stage of different Acanthamoeba strains were evaluated by Alamar Blue assay. Effect on the cyst stage was observed by inverted microscope. Cytotoxicity of combinations of azoles and statins was evaluated by measuring the release of lactate dehydrogenase from a murine macrophage cell line. Results: Combinations of any of the tested statins and voriconazole or posaconazole were more efficient in inhibiting Acanthamoeba compared to statins or azoles individually. The drug combinations at the combined inhibitory concentrations 50% showed lower toxicity compared to that of the compounds alone. Conclusions: The combinations of statins together with voriconazole and posaconazole are more efficient than these drugs alone, and these combinations have lower cytotoxicity in mammalian cell lines.
2020,13(1):1-7, DOI: 10.4103/1995-7645.273567
Abstract:
Artocarpus heterophyllus Lam. (Moraceae) has been traditionally used in treating various diseases such as diabetes, diarrhea, malarial fever, inflammation, wound healing and other diseases. Since various bioactive compounds have been found in this plant, this review focuses on the phytochemical and pharmacological properties of a potent bioactive compound artocarpin. Despite its various functions, a mechanistic review on this compound has not been reviewed specifically. Here, pharmacological studies in vitro and in vivo on artocarpin are discussed thoroughly stressing on anticancer, antimicrobial, anti-tyrosinase, antioxidant and antiinflammatory aspects of artocarpin. This review would be beneficial for future study to show the competency of natural products for their therapeutic characteristics.
Artocarpus heterophyllus Lam. (Moraceae) has been traditionally used in treating various diseases such as diabetes, diarrhea, malarial fever, inflammation, wound healing and other diseases. Since various bioactive compounds have been found in this plant, this review focuses on the phytochemical and pharmacological properties of a potent bioactive compound artocarpin. Despite its various functions, a mechanistic review on this compound has not been reviewed specifically. Here, pharmacological studies in vitro and in vivo on artocarpin are discussed thoroughly stressing on anticancer, antimicrobial, anti-tyrosinase, antioxidant and antiinflammatory aspects of artocarpin. This review would be beneficial for future study to show the competency of natural products for their therapeutic characteristics.
2019,12(7):291-299, DOI: 10.4103/1995-7645.262072
Abstract:
The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas; nevertheless, the increase in the number of travelers and migrants has made this infection more common. The current mass drug treatment produces severe side effects and many strains of helminths are resistant to them. None of the chemotherapeutic drugs meets the ideal requirements of anthelmintics, such as broad spectrum of activity, single dose cure, free from side effect and cost-effectiveness. Today, many researchers are screening the traditional herbal system in search of the anthelmintic herbal constituents which overcome all the problems of synthetic drugs. Several researchers proclaim anthelmintic activity of herbal medicines by using different experimental models. The present review demonstrates natural product drug discovery, outlining potential of herbal constituents from natural sources as natural leads against helminthiasis.
The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas; nevertheless, the increase in the number of travelers and migrants has made this infection more common. The current mass drug treatment produces severe side effects and many strains of helminths are resistant to them. None of the chemotherapeutic drugs meets the ideal requirements of anthelmintics, such as broad spectrum of activity, single dose cure, free from side effect and cost-effectiveness. Today, many researchers are screening the traditional herbal system in search of the anthelmintic herbal constituents which overcome all the problems of synthetic drugs. Several researchers proclaim anthelmintic activity of herbal medicines by using different experimental models. The present review demonstrates natural product drug discovery, outlining potential of herbal constituents from natural sources as natural leads against helminthiasis.
2019,12(9):385-395, DOI: 10.4103/1995-7645.267581
Abstract:
Ebola virus disease (EVD) is associated with haemorrhagic fever in humans and nonhuman primates, with a high rate of fatality (up to 90%). Some outbreaks in human history have proven the lethality of EVD. The recent epidemic of 2014 and 2015 in West Africa was the deadliest of all time (11 284 deaths). To understand the transmission dynamics, we have reviewed the epidemiology of EVD to date. The absence of any licensed vaccines or approved drugs against Ebola virus (EBOV) further highlights the severity and crisis level of EVD. Some organizations (public and private) are making considerable efforts to develop novel therapeutic approaches or vaccines to contain the outbreak of EBOV shortly. Here, we summarized the various potential drugs and vaccines (undergoing multiple phases of clinical trials) that have arisen as an alternative against EBOV, and we highlighted the numerous issues and limitations hindering this process. Alternatively, an increasing focus on strengthening the medical and civic health structure could provide speedy benefits in containing the spread of EVD, as well as offer a resilient foundation for the deployment of novel drugs and vaccines to the affected countries, once such drugs and vaccines become available.
Ebola virus disease (EVD) is associated with haemorrhagic fever in humans and nonhuman primates, with a high rate of fatality (up to 90%). Some outbreaks in human history have proven the lethality of EVD. The recent epidemic of 2014 and 2015 in West Africa was the deadliest of all time (11 284 deaths). To understand the transmission dynamics, we have reviewed the epidemiology of EVD to date. The absence of any licensed vaccines or approved drugs against Ebola virus (EBOV) further highlights the severity and crisis level of EVD. Some organizations (public and private) are making considerable efforts to develop novel therapeutic approaches or vaccines to contain the outbreak of EBOV shortly. Here, we summarized the various potential drugs and vaccines (undergoing multiple phases of clinical trials) that have arisen as an alternative against EBOV, and we highlighted the numerous issues and limitations hindering this process. Alternatively, an increasing focus on strengthening the medical and civic health structure could provide speedy benefits in containing the spread of EVD, as well as offer a resilient foundation for the deployment of novel drugs and vaccines to the affected countries, once such drugs and vaccines become available.
2019,12(7):315-320, DOI: 10.4103/1995-7645.262075
Abstract:
Objective: To determine the prevalence and risk factors of Giardia (G.) lamblia infections among the aboriginal community during the wet and dry seasons. Methods: A total of 473 stool samples from the aborigines in Temerloh, Pahang, Malaysia were collected during wet (n=256) and dry seasons (n=217). Smear of all the PVA-preserved stool samples were subjected to Trichrome staining and microscopic examination under 1 000 × magnification (Nikon eclipse E100) for the detection of G. lamblia. Positivity was recorded based on the presence of G. lamblia in trophozoite and/or cyst forms. Results: The prevalence of giardiasis was 12.10% and 8.29% during the wet and dry season, respectively. Age of less or equal to 15 years old and presence of other family members with G. lamblia infection were found to be the significant risk factors to acquire G. lamblia infections during both seasons. Untreated water supply was the significant risk factor of giardiasis during the dry season. This study highlighted the possibility of anthroponotic transmission of G. lamblia during both seasons and waterborne transmission during the dry season in the aboriginal community. Conclusions: This study suggests that seasonal variation plays an important role in the prevalence and risk factor of G. lamblia infection in the aboriginal community. Therefore, close contact with Giardia-infected family members and water-related activities or usage of untreated water must be avoided to reduce the burden of G. lamblia infection in this community.
Objective: To determine the prevalence and risk factors of Giardia (G.) lamblia infections among the aboriginal community during the wet and dry seasons. Methods: A total of 473 stool samples from the aborigines in Temerloh, Pahang, Malaysia were collected during wet (n=256) and dry seasons (n=217). Smear of all the PVA-preserved stool samples were subjected to Trichrome staining and microscopic examination under 1 000 × magnification (Nikon eclipse E100) for the detection of G. lamblia. Positivity was recorded based on the presence of G. lamblia in trophozoite and/or cyst forms. Results: The prevalence of giardiasis was 12.10% and 8.29% during the wet and dry season, respectively. Age of less or equal to 15 years old and presence of other family members with G. lamblia infection were found to be the significant risk factors to acquire G. lamblia infections during both seasons. Untreated water supply was the significant risk factor of giardiasis during the dry season. This study highlighted the possibility of anthroponotic transmission of G. lamblia during both seasons and waterborne transmission during the dry season in the aboriginal community. Conclusions: This study suggests that seasonal variation plays an important role in the prevalence and risk factor of G. lamblia infection in the aboriginal community. Therefore, close contact with Giardia-infected family members and water-related activities or usage of untreated water must be avoided to reduce the burden of G. lamblia infection in this community.
Haaris A. Shiwani, Rebabonye B. Pharithi, Barkat Khan, Christian Binoun-A-Egom, Peter Kruzliak, Vincent Maher, Emmanuel Eroume-A Egom
2017,10(1):6-10, DOI: 10.1016/j.apjtm.2016.12.008
Abstract:
The recent Ebola outbreak in Western Africa was the most devastating outbreak witnessed in recent times. There have been remarkable local and international efforts to control the crisis. Ebola Virus Disease is the focus of immense research activity. The progression of events in the region has been evolving swiftly and it is of paramount importance to the medical community to be acquainted with the situation. Over 28 000 people were inflicted with the condition, over 11 000 have died. Novel data has emerged regarding modes of transmission, providing rationale for recent flare-ups. Similarly, studies on survivors are elucidating the later stages of the disease recovery process. Novel techniques for diagnosis are also discussed. Finally, the current research regarding treatment and vaccine development is reviewed, particularly the implementation of rVSV-ZEBOV vaccination programs.
The recent Ebola outbreak in Western Africa was the most devastating outbreak witnessed in recent times. There have been remarkable local and international efforts to control the crisis. Ebola Virus Disease is the focus of immense research activity. The progression of events in the region has been evolving swiftly and it is of paramount importance to the medical community to be acquainted with the situation. Over 28 000 people were inflicted with the condition, over 11 000 have died. Novel data has emerged regarding modes of transmission, providing rationale for recent flare-ups. Similarly, studies on survivors are elucidating the later stages of the disease recovery process. Novel techniques for diagnosis are also discussed. Finally, the current research regarding treatment and vaccine development is reviewed, particularly the implementation of rVSV-ZEBOV vaccination programs.
2019,12(8):339-346, DOI: 10.4103/1995-7645.262562
Abstract:
Malaria remains a major tropical health burden owing to the development of resistance and decreased sensitivity to the frequently used conventional antimalarial drugs. The drug like artemisinin possesses potent antimalarial activities, but has some limitations. Therefore, new strategies are to be implemented for optimal utilization of artemisinin to improve its therapeutic effectiveness and to overcome its limitations. The present review focuses on present scenario of malaria and pharmacological as well as analytical aspects of artemisinin. Data from 2000 to 2018 were collected from NCBI for understanding the various analytical techniques used for estimation of artemisinin. This review will reveal the facts about artemisinin which can be utilized to develop novel drug delivery system either in a combination or as alone for the well being of the patients suffering from malaria.
Malaria remains a major tropical health burden owing to the development of resistance and decreased sensitivity to the frequently used conventional antimalarial drugs. The drug like artemisinin possesses potent antimalarial activities, but has some limitations. Therefore, new strategies are to be implemented for optimal utilization of artemisinin to improve its therapeutic effectiveness and to overcome its limitations. The present review focuses on present scenario of malaria and pharmacological as well as analytical aspects of artemisinin. Data from 2000 to 2018 were collected from NCBI for understanding the various analytical techniques used for estimation of artemisinin. This review will reveal the facts about artemisinin which can be utilized to develop novel drug delivery system either in a combination or as alone for the well being of the patients suffering from malaria.
Raimunda Samia Nogueira Brilhante, Germana Costa Paixao, Jonathas Sales de Oliveira, Vandbergue Santos Pereira, Marcos Fábio Gadelha Rocha, Reginaldo Goncalves de LimaNeto, Débora de Souza Collares Maia Castelo-Branco, Rossana de Aguiar Cordeiro, José Júlio Costa Sidrim
2019,12(8):380-384, DOI: 10.4103/1995-7645.262567
Abstract:
Objective: To report atypical morphological features of Trichophyton (T.) tonsurans strains associated with tinea capitis. Methods: Eighty-two T. tonsurans strains isolated in Ceará, Brazil, were analyzed regarding macro and micromorphological features and nutritional patterns. Results: Fifty-two samples presented abundant chlamydoconidia, which were produced in chains. Macroscopically, these strains developed small glabrous colonies that were firmly attached to the surface of the culture medium, with few or no aerial mycelia and intense rusty yellow pigmentation. Seven strains did not grow with stimulus from thiamine. Samples were heterogeneous regarding urease production and none presented in vitro hair perforation. Conclusions: The observation of T. tonsurans strains with distinct phenotypic features indicates the need to revise the taxonomic criteria for routine identification of this dermatophyte.
Objective: To report atypical morphological features of Trichophyton (T.) tonsurans strains associated with tinea capitis. Methods: Eighty-two T. tonsurans strains isolated in Ceará, Brazil, were analyzed regarding macro and micromorphological features and nutritional patterns. Results: Fifty-two samples presented abundant chlamydoconidia, which were produced in chains. Macroscopically, these strains developed small glabrous colonies that were firmly attached to the surface of the culture medium, with few or no aerial mycelia and intense rusty yellow pigmentation. Seven strains did not grow with stimulus from thiamine. Samples were heterogeneous regarding urease production and none presented in vitro hair perforation. Conclusions: The observation of T. tonsurans strains with distinct phenotypic features indicates the need to revise the taxonomic criteria for routine identification of this dermatophyte.
R Latha, TM Chozhavel Rajanathan, Ameer Khusro, N Chidambaranathan, Paul Agastian, Sankaranarayanan Nagarajan
2019,12(6):264-271, DOI: 10.4103/1995-7645.261273
Abstract:
Objective:To evaluate the effects of methanol root extract of Mahonia leschenaultii and berberine of Mahonia leschenaultii on Dalton’s ascitic lymphoma in Swiss Albino mice. Methods: The methanol root extracts of Mahonia leschenaultia (200 and 400 mg/kg) were given orally, and berberines (10 and 20 mg/kg) were injected intra-peritoneally for 14 successive days in tumor bearing mice. Hematological parameters (white and red blood cells, haemoglobin level, granulocytes, and agranulocytes), lipid parameters (total cholesterol and triglycerides), serum enzymes (serum glutamate pyruvate transaminases, serum glutamate oxaloacetate transaminases, and alkaline phosphatise) and mean survival and solid tumor growth were determined and compared with untreated mice. 5-fluorouracil (20 mg/kg) was used as a reference standard drug. Results: Mahonia leschenaultii and berberine reduced the hematocrit significantly. Furthermore, Mahonia leschenaultii and berberine improved the survival of mice significantly and restored the affected hematological and lipid parameters similar to the normal levels. Conclusions: These observations show a strong anticancer effect of methanol root extract of Mahonia leschenaultii and berberine in suppressing Dalton’s ascitic lymphoma cancer cell growth in a mouse model by controlling haematological, lipid, serum enzymes, and other derived parameters effectively.
Objective:To evaluate the effects of methanol root extract of Mahonia leschenaultii and berberine of Mahonia leschenaultii on Dalton’s ascitic lymphoma in Swiss Albino mice. Methods: The methanol root extracts of Mahonia leschenaultia (200 and 400 mg/kg) were given orally, and berberines (10 and 20 mg/kg) were injected intra-peritoneally for 14 successive days in tumor bearing mice. Hematological parameters (white and red blood cells, haemoglobin level, granulocytes, and agranulocytes), lipid parameters (total cholesterol and triglycerides), serum enzymes (serum glutamate pyruvate transaminases, serum glutamate oxaloacetate transaminases, and alkaline phosphatise) and mean survival and solid tumor growth were determined and compared with untreated mice. 5-fluorouracil (20 mg/kg) was used as a reference standard drug. Results: Mahonia leschenaultii and berberine reduced the hematocrit significantly. Furthermore, Mahonia leschenaultii and berberine improved the survival of mice significantly and restored the affected hematological and lipid parameters similar to the normal levels. Conclusions: These observations show a strong anticancer effect of methanol root extract of Mahonia leschenaultii and berberine in suppressing Dalton’s ascitic lymphoma cancer cell growth in a mouse model by controlling haematological, lipid, serum enzymes, and other derived parameters effectively.
2019,12(6):258-263, DOI: 10.4103/1995-7645.261272
Abstract:
Objective: To describe the symptoms of dengue at acute and post-infection stage and to identify preventive strategies adopted by the patients in the Western Province, Sri Lanka. Methods: This was a descriptive cross-sectional study conducted in the Western Province of Sri Lanka in November 2017. The study population consisted of 473 confirmed dengue patients aged from 18 to 64 years who were hospitalized between June and August 2017. A stratified random sampling technique was applied to select the participants. Data collection was done by trained interviewers, using a structured, pre-tested interviewer-administered questionnaire. Results: The most common symptoms of dengue fever at the acute stage was body ache (81.81%, n=387), followed by headache (71.67%, n=339), loss of appetite (66.80%, n=316), tiredness (53.06 %, n=251) and vomiting (41.86%, n=198). The most common symptom during the post-infection stage was body ache (48.62%, n=230), followed by fatigue (39.74%, n=188), and loss of appetite (28.75%, n=136). Adding sand to the water in places where water accumulates (41.64%, n=197) was the most common method used to prevent transmission of dengue followed by removing/draining stagnant water regularly (36.15%, n=177). Use of mosquito nets (83.08%, n=393) was the most common method in preventing mosquito bites followed by the use of fans among dengue patients (56.02%, n=265). Conclusions: The study shows a prolonged persistence of clinical symptoms during the postinfection period.
Objective: To describe the symptoms of dengue at acute and post-infection stage and to identify preventive strategies adopted by the patients in the Western Province, Sri Lanka. Methods: This was a descriptive cross-sectional study conducted in the Western Province of Sri Lanka in November 2017. The study population consisted of 473 confirmed dengue patients aged from 18 to 64 years who were hospitalized between June and August 2017. A stratified random sampling technique was applied to select the participants. Data collection was done by trained interviewers, using a structured, pre-tested interviewer-administered questionnaire. Results: The most common symptoms of dengue fever at the acute stage was body ache (81.81%, n=387), followed by headache (71.67%, n=339), loss of appetite (66.80%, n=316), tiredness (53.06 %, n=251) and vomiting (41.86%, n=198). The most common symptom during the post-infection stage was body ache (48.62%, n=230), followed by fatigue (39.74%, n=188), and loss of appetite (28.75%, n=136). Adding sand to the water in places where water accumulates (41.64%, n=197) was the most common method used to prevent transmission of dengue followed by removing/draining stagnant water regularly (36.15%, n=177). Use of mosquito nets (83.08%, n=393) was the most common method in preventing mosquito bites followed by the use of fans among dengue patients (56.02%, n=265). Conclusions: The study shows a prolonged persistence of clinical symptoms during the postinfection period.
2020,13(1):46-48, DOI: 10.4103/1995-7645.273574
Abstract:
Rationale: Cryptococcal infections commonly occur in immunosuppressed patients and are uncommon in immunocompetent persons. Patient concerns: A 32 year old lady, active smoker presented with right chest pain, dry cough and loss of weight. Initial chest radiograph showed a lobulated lung mass in the right lower lobe. She developed headache and right cranial nerve palsy during admission. Various investigations were done including lumbar puncture, brain and chest imaging. Diagnosis: Cryptococcal meningitis with pulmonary cryptococcoma. Interventions: She received five months of effective antifungal treatment; however, the patient did not respond well. Subsequently, removal of pulmonary cryptococcoma was done. Outcomes: Her condition improved and she no longer had any headache. Lessons: Disseminated cryptococcosis is rare in immunocompetent patient. Our case highlights the importance of high index of suspicion and we postulate that lobectomy helped in reducing the cryptococcal burden in her body, thus facilitating better response to antifungal therapy.
Rationale: Cryptococcal infections commonly occur in immunosuppressed patients and are uncommon in immunocompetent persons. Patient concerns: A 32 year old lady, active smoker presented with right chest pain, dry cough and loss of weight. Initial chest radiograph showed a lobulated lung mass in the right lower lobe. She developed headache and right cranial nerve palsy during admission. Various investigations were done including lumbar puncture, brain and chest imaging. Diagnosis: Cryptococcal meningitis with pulmonary cryptococcoma. Interventions: She received five months of effective antifungal treatment; however, the patient did not respond well. Subsequently, removal of pulmonary cryptococcoma was done. Outcomes: Her condition improved and she no longer had any headache. Lessons: Disseminated cryptococcosis is rare in immunocompetent patient. Our case highlights the importance of high index of suspicion and we postulate that lobectomy helped in reducing the cryptococcal burden in her body, thus facilitating better response to antifungal therapy.
2019,12(6):288-290, DOI: 10.4103/1995-7645.261308
Abstract:
Rationale: Acinetobacter radioresistens is a non-fermentative Gram-negative coccobacillus that is environmentally ubiquitous and is an uncommon cause of pneumonia in an immunocompetent patient with no known chronic medical illness. Patient concerns: A middle-aged Asian male with a smoking history presented with fever and cough. Physical examination was unremarkable. Chest imaging was consistent with pulmonary parenchymal infection and blood culture grew Acinetobacter radioresistens. Diagnosis: Community acquired pneumonia with Acinetobacter radioresistens bacteremia. Interventions: The patient received a combination of intravenous and oral ampicillinsulbactam over 2 weeks. Outcomes: Repeat blood cultures showed resolution of bacteremia. Completion of antimicrobial treatment saw resolution of respiratory symptoms and radiological pneumonic changes. Lessons: Acinetobacter radioresistens causing community-acquired pneumonia in an immunocompetent host has never been described before. It may be a novel emerging infectious agent in pulmonary infections. Its clinical course in this immunocompetent patient appears to be relatively benign.
Rationale: Acinetobacter radioresistens is a non-fermentative Gram-negative coccobacillus that is environmentally ubiquitous and is an uncommon cause of pneumonia in an immunocompetent patient with no known chronic medical illness. Patient concerns: A middle-aged Asian male with a smoking history presented with fever and cough. Physical examination was unremarkable. Chest imaging was consistent with pulmonary parenchymal infection and blood culture grew Acinetobacter radioresistens. Diagnosis: Community acquired pneumonia with Acinetobacter radioresistens bacteremia. Interventions: The patient received a combination of intravenous and oral ampicillinsulbactam over 2 weeks. Outcomes: Repeat blood cultures showed resolution of bacteremia. Completion of antimicrobial treatment saw resolution of respiratory symptoms and radiological pneumonic changes. Lessons: Acinetobacter radioresistens causing community-acquired pneumonia in an immunocompetent host has never been described before. It may be a novel emerging infectious agent in pulmonary infections. Its clinical course in this immunocompetent patient appears to be relatively benign.
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