WorldWideScience

Sample records for oral artesunate sold

  1. A stratified random survey of the proportion of poor quality oral artesunate sold at medicine outlets in the Lao PDR – implications for therapeutic failure and drug resistance

    Directory of Open Access Journals (Sweden)

    Vongsack Latsamy

    2009-07-01

    Full Text Available Abstract Background Counterfeit oral artesunate has been a major public health problem in mainland SE Asia, impeding malaria control. A countrywide stratified random survey was performed to determine the availability and quality of oral artesunate in pharmacies and outlets (shops selling medicines in the Lao PDR (Laos. Methods In 2003, 'mystery' shoppers were asked to buy artesunate tablets from 180 outlets in 12 of the 18 Lao provinces. Outlets were selected using stratified random sampling by investigators not involved in sampling. Samples were analysed for packaging characteristics, by the Fast Red Dye test, high-performance liquid chromatography (HPLC, mass spectrometry (MS, X-ray diffractometry and pollen analysis. Results Of 180 outlets sampled, 25 (13.9% sold oral artesunate. Outlets selling artesunate were more commonly found in the more malarious southern Laos. Of the 25 outlets, 22 (88%; 95%CI 68–97% sold counterfeit artesunate, as defined by packaging and chemistry. No artesunate was detected in the counterfeits by any of the chemical analysis techniques and analysis of the packaging demonstrated seven different counterfeit types. There was complete agreement between the Fast Red dye test, HPLC and MS analysis. A wide variety of wrong active ingredients were found by MS. Of great concern, 4/27 (14.8% fakes contained detectable amounts of artemisinin (0.26–115.7 mg/tablet. Conclusion This random survey confirms results from previous convenience surveys that counterfeit artesunate is a severe public health problem. The presence of artemisinin in counterfeits may encourage malaria resistance to artemisinin derivatives. With increasing accessibility of artemisinin-derivative combination therapy (ACT in Laos, the removal of artesunate monotherapy from pharmacies may be an effective intervention.

  2. HISTOLOGICAL STUDIES OF THE EFFECTS OF ORAL ADMINISTRATION OF ARTESUNATE

    Directory of Open Access Journals (Sweden)

    A.O.Eweka

    2008-01-01

    Full Text Available The histological effect of oral administration of artesunate, commonly used for the treatment of Malaria on the medial geniculate body (MGB of adult wistar rat was carefully studied. The rats of both sexes (n=24, average weight of 210g were randomly assigned into three treatment (n=18 and control (n6 groups.The rats in the treatment group 'A' received 4mg/kg body weight of artesunate base dissolved in distilled water for 3 days. The animals in groups 'B' and 'C' received 4mg/kg body weight of artesunate dissolved in distilled water for the first day and thereafter received 2mg/kg body weight daily for six and thirteen day respectively. The control group D, received equal volume of distilled water daily using the Orogastric tube. The rats were fed with grower's mash obtained from Edo Feeds and Flour Mill Ltd, Ewu, Edo State, Nigeria and were given water liberally. The rats were sacrificed on day fourth, eight and fifteenth of the experiment. The medial geniculate body was carefully dissected out and quickly fixed in 10% formal saline for histological studies.The histological findings after H&E method indicated that the treated section of the medial geniculate body showed some decreased cellular population, degenerative changes, cellular hypertrophy, with some vacuolations appearing in the stroma.Varying dosage and long administration of artesunate may have some deleterious effects on the neurons of the Medial geniculate body and this may probably have some adverse effects on auditory sensibilities by its deleterious effects on the cells of the medial geniculate body of adult wistar rats. It is therefore recommended that further studies aimed at corroborating these observations be carried out.

  3. Gametocyte clearance dynamics following oral artesunate treatment of uncomplicated falciparum malaria in Malian children

    Directory of Open Access Journals (Sweden)

    Djimde Abdoulaye A.

    2016-01-01

    Full Text Available Artemisinin-based combination therapies decrease Plasmodium gametocyte carriage. However, the role of artesunate in monotherapy in vivo, the mechanisms involved, and the utility of gametocyte carriage as a potential tool for the surveillance of antimalarial resistance are poorly understood. In 2010–2011, we conducted an open-label, prospective efficacy study of artesunate as monotherapy in children 1–10 years of age with uncomplicated falciparum malaria in Bougoula-Hameau, Mali. Standard oral doses of artesunate were administered for 7 days and patients were followed up for 28 days. The data were compared to a similar study conducted in 2002–2004. Of 100 children enrolled in the 2010–2011 study, 92 were analyzed and compared to 217 children enrolled in the 2002–2004 study. The proportion of gametocyte carriers was unchanged at the end of treatment (23% at baseline vs. 24% on day 7, p = 1.0 and did not significantly decline until day 21 of follow-up (23% vs. 6%, p = 0.003. The mean gametocyte density at inclusion remained unchanged at the end of treatment (12 gametocytes/μL vs. 16 gametocytes/μL, p = 0.6. Overall, 46% of the 71 initial non-carriers had gametocytes detected by day 7. Similar results were found in the 2002–2004 study. In both studies, although gametocyte carriage significantly decreased by the end of the 28-day follow-up, artesunate did not clear mature gametocytes during treatment and did not prevent the appearance of new stage V gametocytes as assessed by light microscopy. Baseline gametocyte carriage was significantly higher 6 years after the deployment of artemisinin-based combination therapies in this setting.

  4. Body and Testicular Weight Changes in Adult Wistar Rats Following Oral Administration of Artesunate

    Directory of Open Access Journals (Sweden)

    al-hassan m. izunya

    2010-05-01

    Full Text Available This experiment was designed to study the effects on the body and testicular weights of adult wistar rats that recieved an oral administration of normal and double normal doses of artesunate. The rats were divided into three groups (A, B and C of five rats each. A and B served as the treatment groups, while C served as the control group. Group A rats were given 4mg.kg-1 b.w of artesunate daily for 3 days followed by 2mg.kg-1 b.w daily for next for 4 days. Group B rats were given 8mg.kg-1 b.w of artesunate daily for 3 days followed by 4mg.kg-1 b.w daily for next 4 days, while group C rats were given only distilled water. The rats were fed with grower's mash purchased from Edo feeds and Flour Mill Ltd, Ewu, Edo state and were given w ater ad libitum. On day eight of the experiment, the rats were weighed and sacrificed. The testes w ere carefully dissected out, freed from adherent tissues and weighed to the nearest 0.001 g. The results showed no changes in body weight of rats in groups A, B and C. There was also no significant change in testicular weight of rats in group A. However a significant increase in testicular weight was observed in group C. Our results suggest that artesunate at normal and double normal doses, has no effect on body weight of rats but may be toxic to the testes at higher doses. It is uncertain however if these changes are reversible. It is recommended therefore, that further studies aimed at corroborating these observations be carried out.

  5. Population pharmacokinetics of artesunate and dihydroartemisinin following single- and multiple-dosing of oral artesunate in healthy subjects

    Science.gov (United States)

    2009-01-01

    Background The population pharmacokinetics of artesunate (AS) and its active metabolite dihydroartemisinin (DHA) were studied in healthy subjects receiving single- or multiple-dosing of AS orally either in combination with pyronaridine (PYR) or as a monotherapy with or without food. Methods Data from 118 concentration-time profiles arising from 91 healthy Korean subjects were pooled from four Phase I clinical studies. Subjects received 2-5 mg/kg of single- and multiple-dosing of oral AS either in combination with PYR or as a monotherapy with or without food. Plasma AS and DHA were measured simultaneously using a validated liquid chromatography- mass spectrometric method with a lower limit of quantification of 1 ng/mL for both AS and DHA. Nonlinear mixed-effect modelling was used to obtain the pharmacokinetic and variability (inter-individual and residual variability) parameter estimates. Results A novel parent-metabolite pharmacokinetic model consisting of a dosing compartment, a central compartment for AS, a central compartment and a peripheral compartment for DHA was developed. AS and DHA data were modelled simultaneously assuming stoichiometric conversion to DHA. AS was rapidly absorbed with a population estimate of absorption rate constant (Ka) of 3.85 h-1. The population estimates of apparent clearance (CL/F) and volume of distribution (V2/F) for AS were 1190 L/h with 36.2% inter-individual variability (IIV) and 1210 L with 57.4% IIV, respectively. For DHA, the population estimates of apparent clearance (CLM/F) and central volume of distribution (V3/F) were 93.7 L/h with 28% IIV and 97.1 L with 30% IIV, respectively. The population estimates of apparent inter-compartmental clearance (Q/F) and peripheral volume of distribution (V4/F) for DHA were 5.74 L/h and 18.5 L, respectively. Intake of high-fat and high-caloric meal prior to the drug administration resulted in 84% reduction in Ka. Body weight impacted CLM/F, such that a unit change in weight resulted in 1

  6. Population pharmacokinetics of artesunate and dihydroartemisinin following single- and multiple-dosing of oral artesunate in healthy subjects

    Directory of Open Access Journals (Sweden)

    Kirsch Lee E

    2009-12-01

    Full Text Available Abstract Background The population pharmacokinetics of artesunate (AS and its active metabolite dihydroartemisinin (DHA were studied in healthy subjects receiving single- or multiple-dosing of AS orally either in combination with pyronaridine (PYR or as a monotherapy with or without food. Methods Data from 118 concentration-time profiles arising from 91 healthy Korean subjects were pooled from four Phase I clinical studies. Subjects received 2-5 mg/kg of single- and multiple-dosing of oral AS either in combination with PYR or as a monotherapy with or without food. Plasma AS and DHA were measured simultaneously using a validated liquid chromatography- mass spectrometric method with a lower limit of quantification of 1 ng/mL for both AS and DHA. Nonlinear mixed-effect modelling was used to obtain the pharmacokinetic and variability (inter-individual and residual variability parameter estimates. Results A novel parent-metabolite pharmacokinetic model consisting of a dosing compartment, a central compartment for AS, a central compartment and a peripheral compartment for DHA was developed. AS and DHA data were modelled simultaneously assuming stoichiometric conversion to DHA. AS was rapidly absorbed with a population estimate of absorption rate constant (Ka of 3.85 h-1. The population estimates of apparent clearance (CL/F and volume of distribution (V2/F for AS were 1190 L/h with 36.2% inter-individual variability (IIV and 1210 L with 57.4% IIV, respectively. For DHA, the population estimates of apparent clearance (CLM/F and central volume of distribution (V3/F were 93.7 L/h with 28% IIV and 97.1 L with 30% IIV, respectively. The population estimates of apparent inter-compartmental clearance (Q/F and peripheral volume of distribution (V4/F for DHA were 5.74 L/h and 18.5 L, respectively. Intake of high-fat and high-caloric meal prior to the drug administration resulted in 84% reduction in Ka. Body weight impacted CLM/F, such that a unit change in

  7. Optimal designs for population pharmacokinetic studies of oral artesunate in patients with uncomplicated falciparum malaria

    Directory of Open Access Journals (Sweden)

    Lindegardh Niklas

    2011-07-01

    Full Text Available Abstract Background Currently, population pharmacokinetic (PK studies of anti-malarial drugs are designed primarily by the logistical and ethical constraints of taking blood samples from patients, and the statistical models that are fitted to the data are not formally considered. This could lead to imprecise estimates of the target PK parameters, and/or designs insufficient to estimate all of the parameters. Optimal design methodology has been developed to determine blood sampling schedules that will yield precise parameter estimates within the practical constraints of sampling the study populations. In this work optimal design methods were used to determine sampling designs for typical future population PK studies of dihydroartemisinin, the principal biologically active metabolite of oral artesunate. Methods Optimal designs were derived using freely available software and were based on appropriate structural PK models from an analysis of data or the literature and key sampling constraints identified in a questionnaire sent to active malaria researchers (3-4 samples per patient, at least 15 minutes between samples. The derived optimal designs were then evaluated via simulation-estimation. Results The derived optimal sampling windows were 17 to 29 minutes, 30 to 57 minutes, 2.5 to 3.7 hours and 5.8 to 6.6 hours for non-pregnant adults; 16 to 29 minutes, 31 minutes to 1 hour, 2.0 to 3.4 hours and 5.5 to 6.6 hours for designs with non-pregnant adults and children and 35 to 59 minutes, 1.2 to 3.4 hours, 3.4 to 4.9 hours and 6.0 to 8.0 hours for pregnant women. The optimal designs resulted in acceptable precision of the PK parameters. Conclusions The proposed sampling designs in this paper are robust and efficient and should be considered in future PK studies of oral artesunate where only three or four blood samples can be collected.

  8. Oral artesunate-amodiaquine and artemether-lumefantrine in the treatment of uncomplicated hyperparasitaemic Plasmodium falciparum malaria in children.

    Science.gov (United States)

    Gbotosho, Grace O; Sowunmi, Akintunde; Okuboyejo, Titilope M; Happi, Christian T

    2012-04-01

    The therapeutic efficacy, changes in haematocrit and declines in parasitaemias were evaluated in 56 children with uncomplicated falciparum hyperparasitaemia after oral artesunate-amodiaquine or artemether-lumefantrine. All children recovered clinically within 2 days and without progression to severe malaria. Falls in haematocrit in the first 3 days after treatment began were similar and <5%. Declines in parasitaemias were monoexponential with both treatments with an estimated half-life of 1 h.

  9. Effect of oral coadministration of artesunate with ferrous sulfate on rat liver mitochondrial membrane permeability transition.

    Science.gov (United States)

    Fafowora, Mosebolatan V; Atanu, Francis; Sanya, Olayinka; Olorunsogo, Olufunso O; Erukainure, Ochuko L

    2011-07-01

    The recent resurgence of interest in the study of mitochondria has been fuelled in large part by the recognition that genetic and/or metabolic alterations in this organelle are causative or contributing factors in a variety of human diseases including cancer. This study hypothesizes that co-administration of artesunate and ferrous sulfate could induce apoptosis which can be targeted on cancerous cells in such a manner, thus providing a novel, viable and perhaps inexpensive way of dealing with the cancer scourge. Artesunate and Ferrous sulfate were co-administered to rats at various doses for seven days. At the end of the treatment, the rats were fasted overnight and sacrificed by cervical dislocation. Low ionic strength mitochondria were isolated from hepatic cells of the rats and assayed for protein content; changes in the absorbance of the liver mitochondria; and mitochondrial swelling. Co-administration of artesunate and ferrous sulfate resulted in a significant increase (Pferrous iron-treated groups were compared with the artesunate only treated group. Results from this study show that co-administration of artesunate and ferrous sulfate can cause an opening in the mitochondrial membrane transition pore. A combined dose of ferrous sulfate and artesunate may prove to be a more potent therapy for targeting cancerous cells.

  10. Review of the clinical pharmacokinetics of artesunate and its active metabolite dihydroartemisinin following intravenous, intramuscular, oral or rectal administration

    Directory of Open Access Journals (Sweden)

    Shin Chang-Sik

    2011-09-01

    Full Text Available Abstract Artesunate (AS is a clinically versatile artemisinin derivative utilized for the treatment of mild to severe malaria infection. Given the therapeutic significance of AS and the necessity of appropriate AS dosing, substantial research has been performed investigating the pharmacokinetics of AS and its active metabolite dihydroartemisinin (DHA. In this article, a comprehensive review is presented of AS clinical pharmacokinetics following administration of AS by the intravenous (IV, intramuscular (IM, oral or rectal routes. Intravenous AS is associated with high initial AS concentrations which subsequently decline rapidly, with typical AS half-life estimates of less than 15 minutes. AS clearance and volume estimates average 2 - 3 L/kg/hr and 0.1 - 0.3 L/kg, respectively. DHA concentrations peak within 25 minutes post-dose, and DHA is eliminated with a half-life of 30 - 60 minutes. DHA clearance and volume average between 0.5 - 1.5 L/kg/hr and 0.5 - 1.0 L/kg, respectively. Compared to IV administration, IM administration produces lower peaks, longer half-life values, and higher volumes of distribution for AS, as well as delayed peaks for DHA; other parameters are generally similar due to the high bioavailability, assessed by exposure to DHA, associated with IM AS administration (> 86%. Similarly high bioavailability of DHA (> 80% is associated with oral administration. Following oral AS, peak AS concentrations (Cmax are achieved within one hour, and AS is eliminated with a half-life of 20 - 45 minutes. DHA Cmax values are observed within two hours post-dose; DHA half-life values average 0.5 - 1.5 hours. AUC values reported for AS are often substantially lower than those reported for DHA following oral AS administration. Rectal AS administration yields pharmacokinetic results similar to those obtained from oral administration, with the exceptions of delayed AS Cmax and longer AS half-life. Drug interaction studies conducted with oral AS

  11. Review of the clinical pharmacokinetics of artesunate and its active metabolite dihydroartemisinin following intravenous, intramuscular, oral or rectal administration.

    Science.gov (United States)

    Morris, Carrie A; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Jung, Donald; Shin, Chang-Sik; Fleckenstein, Lawrence

    2011-09-13

    Artesunate (AS) is a clinically versatile artemisinin derivative utilized for the treatment of mild to severe malaria infection. Given the therapeutic significance of AS and the necessity of appropriate AS dosing, substantial research has been performed investigating the pharmacokinetics of AS and its active metabolite dihydroartemisinin (DHA). In this article, a comprehensive review is presented of AS clinical pharmacokinetics following administration of AS by the intravenous (IV), intramuscular (IM), oral or rectal routes. Intravenous AS is associated with high initial AS concentrations which subsequently decline rapidly, with typical AS half-life estimates of less than 15 minutes. AS clearance and volume estimates average 2 - 3 L/kg/hr and 0.1 - 0.3 L/kg, respectively. DHA concentrations peak within 25 minutes post-dose, and DHA is eliminated with a half-life of 30 - 60 minutes. DHA clearance and volume average between 0.5 - 1.5 L/kg/hr and 0.5 - 1.0 L/kg, respectively. Compared to IV administration, IM administration produces lower peaks, longer half-life values, and higher volumes of distribution for AS, as well as delayed peaks for DHA; other parameters are generally similar due to the high bioavailability, assessed by exposure to DHA, associated with IM AS administration (> 86%). Similarly high bioavailability of DHA (> 80%) is associated with oral administration. Following oral AS, peak AS concentrations (Cmax) are achieved within one hour, and AS is eliminated with a half-life of 20 - 45 minutes. DHA Cmax values are observed within two hours post-dose; DHA half-life values average 0.5 - 1.5 hours. AUC values reported for AS are often substantially lower than those reported for DHA following oral AS administration. Rectal AS administration yields pharmacokinetic results similar to those obtained from oral administration, with the exceptions of delayed AS Cmax and longer AS half-life. Drug interaction studies conducted with oral AS suggest that AS does not

  12. The initial pharmaceutical development of an artesunate/amodiaquine oral formulation for the treatment of malaria: a public-private partnership

    Directory of Open Access Journals (Sweden)

    Gaudin Karen

    2011-05-01

    Full Text Available Abstract Background Artemisinin-based combination therapy is currently recommended worldwide for the treatment of uncomplicated malaria. Fixed-dose combinations are preferred as they favour compliance. This paper reports on the initial phases of the pharmaceutical development of an artesunate-amodiaquine (ASAQ bilayer co-formulation tablet, undertaken following pre-formulation studies by a network of scientists and industrials from institutions of both industrialized and low income countries. Methods Pharmaceutical development was performed by a research laboratory at the University Bordeaux Segalen, School of Pharmacy, for feasibility and early stability studies of various drug formulations, further transferred to a company specialized in pharmaceutical development, and then provided to another company for clinical batch manufacturing. The work was conducted by a regional public-private not-for-profit network (TropiVal within a larger Public Private partnership (the FACT project, set up by WHO/TDR, Médecins Sans Frontières and the Drugs for Neglected Disease initiative (DNDi. Results The main pharmaceutical goal was to combine in a solid oral form two incompatible active principles while preventing artesunate degradation under tropical conditions. Several options were attempted and failed to provide satisfactory stability results: incorporating artesunate in the external phase of the tablets, adding a pH regulator, alcoholic wet granulation, dry granulation, addition of an hydrophobic agent, tablet manufacturing in controlled conditions. However, long-term stability could be achieved, in experimental batches under GMP conditions, by physical separation of artesunate and amodiaquine in a bilayer co-formulation tablet in alu-alu blisters. Conduction of the workplan was monitored by DNDi. Conclusions Collaborations between research and industrial groups greatly accelerated the process of development of the bi-layered ASAQ tablet. Lack of public

  13. Review of the clinical pharmacokinetics of artesunate and its active metabolite dihydroartemisinin following intravenous, intramuscular, oral or rectal administration

    OpenAIRE

    Shin Chang-Sik; Jung Donald; Borghini-Fuhrer Isabelle; Duparc Stephan; Morris Carrie A; Fleckenstein Lawrence

    2011-01-01

    Abstract Artesunate (AS) is a clinically versatile artemisinin derivative utilized for the treatment of mild to severe malaria infection. Given the therapeutic significance of AS and the necessity of appropriate AS dosing, substantial research has been performed investigating the pharmacokinetics of AS and its active metabolite dihydroartemisinin (DHA). In this article, a comprehensive review is presented of AS clinical pharmacokinetics following administration of AS by the intravenous (IV), ...

  14. Effect of mefloquine administered orally at single, multiple, or combined with artemether, artesunate, or praziquantel in treatment of mice infected with Schistosoma japonicum.

    Science.gov (United States)

    Xiao, Shu-hua; Mei, Jing-yan; Jiao, Pei-ying

    2011-02-01

    The purpose of the study is to explore the efficacy of mefloquine administered orally at single, multiple doses, or in combination with artesuante, artemether, or praziquantel in mouse--Schistosoma japonicum model. A total of 205 mice were divided into 4 batches and each batch of mice was infected percutaneously with 40 S. japonicum cercariae for 35 days. The infected mice were treated orally with mefloquine at single doses, multiple daily doses, or combined with artesunate, artemether, or praziquantel, while infected but untreated mice served as control. All treated animals were killed 4 weeks post-treatment for assessment of effect. When infected mice were treated orally with mefloquine at single or multiple daily doses under the same total dose levels, the tendency to decrease the efficacy was seen. Particularly, when a lower single dose of 100 mg/kg was divided equally into five daily doses of 20 mg/kg, the efficacy decreased statistically significant (Pmefloquine or artesuante at a single dose of 100 mg/kg, a moderate effect against schistosomes was observed. No further significant reduction of total and female worm burdens was seen, when the two drugs combined together at the same dose level. On the other hand, administration of mefloquine combined with artesunate at single dose of 50 mg/kg, which exhibited no effect against schistosomes, resulted in significant reduction of total and female worm burdens in comparison with the groups treated with mefloquine and artesunate alone at the same dose level. Similar results were observed in treatment of infected mice with mefloquine in combination with artemether at the smaller dose of 50 mg/kg. The total worm burden was significantly lower than that of control and the female worm burden was also significant lower than that of groups treated with mefloquine and artemether alone. Interestingly, in administration of mefloquine 100 mg/kg combined with artemether 100 mg/kg to the infected mice, all female worms were

  15. Pharmacokinetic Interactions between Primaquine and Pyronaridine-Artesunate in Healthy Adult Thai Subjects

    OpenAIRE

    Jittamala, Podjanee; Pukrittayakamee, Sasithon; Ashley, Elizabeth A.; Nosten, François; Hanboonkunupakarn, Borimas; Lee, Sue J.; Thana, Praiya; Chairat, Kalayanee; Blessborn, Daniel; Panapipat, Salwaluk; White, Nicholas J.; Day, Nicholas P. J.; Tarning, Joel

    2014-01-01

    Pyronaridine-artesunate is a newly introduced artemisinin-based combination treatment which may be deployed together with primaquine. A single-dose, randomized, three-sequence crossover study was conducted in healthy Thai volunteers to characterize potential pharmacokinetic interactions between these drugs. Seventeen healthy adults received a single oral dose of primaquine alone (30 mg base) and were then randomized to receive pyronaridine-artesunate alone (540−180 mg) or pyronaridine-artesun...

  16. Pharmacokinetic interactions between primaquine and pyronaridine-artesunate in healthy adult Thai subjects.

    OpenAIRE

    Jittamala, P.; Pukrittayakamee, S; Ashley, EA; Nosten, F; Hanboonkunupakarn, B; Lee, SJ; Thana, P; Chairat, K; Blessborn, D; Panapipat, S; White, NJ; Day, NP; Tarning, J

    2015-01-01

    Pyronaridine-artesunate is a newly introduced artemisinin-based combination treatment which may be deployed together with primaquine. A single-dose, randomized, three-sequence crossover study was conducted in healthy Thai volunteers to characterize potential pharmacokinetic interactions between these drugs. Seventeen healthy adults received a single oral dose of primaquine alone (30 mg base) and were then randomized to receive pyronaridine-artesunate alone (540-180 mg) or pyronaridine-artesun...

  17. HISTOMORPHOLOGIC ALTERATIONS OF THE CEREBELLUM OF WISTAR RATS FOLLOWING AMODIAQUINE PLUS ARTESUNATE ADMINISTRATION

    Directory of Open Access Journals (Sweden)

    Mr. M. B. Ekong

    2009-07-01

    Full Text Available Amodiaquine and artesunate are two antimalarial drugs sold in combination as Larimal®. This drug is a very effective artemisinin-base combination. This study was to access the effects of amodiaquine and artesunate combination on the histology of the cerebellum. Twenty adult Wistar rats weighing between 150-180g were divided into four groups (A, B, C and D of five animals each. Group A served as the control and the animals received distilled water, while group B received 8.75+2.86mg/kg of amodiaquine and artesunate combination for three days, group C received 8.75+2.86mg/kg of amodiaquine and artesunate combination for six days and group D received 17.50+5.71mg/kg of amodiaquine and artesunate combination for three days. Histological sections showed destruction of the Purkinje cortical layers in group B, with increased destructions in groups C and D compared to the control. These results reveal that amodiaquine and artesunate combination causes histological alterations, which were dose and time dependent and these may result in cerebellar dysfunction.

  18. Study on the developmental toxicity of combined artesunate and mefloquine antimalarial drugs on rats.

    Science.gov (United States)

    Boareto, Ana Cláudia; Müller, Juliane Centeno; de Araujo, Samanta Luiza; Lourenço, Ana Carolina; Lourenço, Emerson Luiz Botelho; Gomes, Caroline; Minatovicz, Bruna; Lombardi, Natália; Paumgartten, Francisco Roma; Dalsenter, Paulo Roberto

    2012-12-01

    Antimalarial drug combinations containing artemisinins (ACTs) have become first choice therapies for Plasmodium falciparum malaria. Data on safety of ACTs in pregnancy are limited and no previous study has been conducted on the developmental toxicity of artesunate-mefloquine combinations on the first trimester of gestation. To evaluate the developmental toxicity of an artesunate/mefloquine combination, pregnant rats were treated orally with artesunate (15 and 40 mg/kg bwt/day), mefloquine (30 and 80 mg/kg bwt/day) and artesunate/mefloquine (15/30 and 40/80 mg/kg bwt/day) on gestation days 9-11. Dams were C-sectioned on day 20, and their uteri and fetuses removed and examined for soft tissue and skeleton abnormalities. Artesunate increased embryolethality and the incidence of limb long bone malformations on the absence of overt maternal toxicity. Mefloquine (80 mg/kg bwt/day) was maternally toxic and enhanced fetal variations. Combination of artesunate and mefloquine did not enhance their toxicity compared to the toxicity observed after its separate administration. Embryotoxicity of artesunate was apparently attenuated when it is co-administered with mefloquine.

  19. Effects of co-administration of artesunate and amodiaquine on some cardiovascular disease indices in rats.

    Science.gov (United States)

    Adebayo, J O; Igunnu, A; Arise, R O; Malomo, S O

    2011-01-01

    The effects of co-administration of artesunate and amodiaquine on some cardiovascular disease indices were investigated in albino rats (Rattus novergicus). The experimental animals were randomly divided into four groups: those administered distilled water (control), those administered artesunate (2 mg/kg body weight), those administered amodiaquine (6.12 mg/kg body weight) and those co-administered artesunate (2 mg/kg body weight) and amodiaquine (6.12 mg/kg body weight). The drugs were orally administered twice daily for three days after which the serum lipid profile, heart MDA content and heart ALP and ACP activities were determined. Artesunate significantly reduced (P0.05) on other parameters compared to controls. Amodiaquine, on the other hand, significantly reduced (Partesunate and amodiaquine significantly reduced (Partesunate and amodiaquine to patients with coronary heart disease should be with caution.

  20. Anti-inlfammatory and antipyretic activities of artesunate in experimental animals

    Institute of Scientific and Technical Information of China (English)

    Ette Ettebong; Emmanuel Etuk; Imaobong Sunday

    2016-01-01

    Objective:To evaluate the anti-inflammatory and antipyretic potentials of artesunate in albino mice and Wistar rats respectively. Methods: For the anti-inflammatory activity, artesunate (5 mg/kg) was administered orally against egg albumin- and xylene-induced inflammation in mice using ibuprofen (50 mg/kg) as standard drug. To assess antipyretic activity, artesunate (5 mg/kg) was administered orally against d-amphetamine- and 2, 4-dinitrophenol-induced pyrexia in rats using ibuprofen (15 mg/kg) as standard drug. Results:The result showed that artesunate significantly (P < 0.001–0.010) reduced inflammation induced by egg albumin and xylene in a time-dependent manner. It also significantly (P < 0.001–0.050) and time-dependently reduced pyrexia induced by d-amphetamine and 2, 4-dinitrophenol. These reductions were similar to those produced by the standard drug ibuprofen, and thereby demonstrating that artesunate possesses anti-inflammatory and antipyretic activities. Conclusions:These results further support the rationale for the use of artesunate in the treatment of malaria, a disease characterized by fever and inflammation and open up possibilities of its usefulness in other inflammatory and feverish diseases.

  1. Pharmacokinetic interactions between primaquine and pyronaridine-artesunate in healthy adult Thai subjects.

    Science.gov (United States)

    Jittamala, Podjanee; Pukrittayakamee, Sasithon; Ashley, Elizabeth A; Nosten, François; Hanboonkunupakarn, Borimas; Lee, Sue J; Thana, Praiya; Chairat, Kalayanee; Blessborn, Daniel; Panapipat, Salwaluk; White, Nicholas J; Day, Nicholas P J; Tarning, Joel

    2015-01-01

    Pyronaridine-artesunate is a newly introduced artemisinin-based combination treatment which may be deployed together with primaquine. A single-dose, randomized, three-sequence crossover study was conducted in healthy Thai volunteers to characterize potential pharmacokinetic interactions between these drugs. Seventeen healthy adults received a single oral dose of primaquine alone (30 mg base) and were then randomized to receive pyronaridine-artesunate alone (540-180 mg) or pyronaridine-artesunate plus primaquine in combination, with intervening washout periods between all treatments. The pharmacokinetic properties of primaquine, its metabolite carboxyprimaquine, artesunate, its metabolite dihydroartemisinin, and pyronaridine were assessed in 15 subjects using a noncompartmental approach followed by a bioequivalence evaluation. All drugs were well tolerated. The single oral dose of primaquine did not result in any clinically relevant pharmacokinetic alterations to pyronaridine, artesunate, or dihydroartemisinin exposures. There were significantly higher primaquine maximum plasma drug concentrations (geometric mean ratio, 30%; 90% confidence interval [CI], 17% to 46%) and total exposures (15%; 6.4% to 24%) during coadministration with pyronaridine-artesunate than when primaquine was given alone. Pyronaridine, like chloroquine and piperaquine, increases plasma primaquine concentrations. (This study has been registered at ClinicalTrials.gov under registration no. NCT01552330.).

  2. Pharmacokinetic Interactions between Primaquine and Pyronaridine-Artesunate in Healthy Adult Thai Subjects

    Science.gov (United States)

    Jittamala, Podjanee; Pukrittayakamee, Sasithon; Ashley, Elizabeth A.; Nosten, François; Hanboonkunupakarn, Borimas; Lee, Sue J.; Thana, Praiya; Chairat, Kalayanee; Blessborn, Daniel; Panapipat, Salwaluk; White, Nicholas J.; Day, Nicholas P. J.

    2014-01-01

    Pyronaridine-artesunate is a newly introduced artemisinin-based combination treatment which may be deployed together with primaquine. A single-dose, randomized, three-sequence crossover study was conducted in healthy Thai volunteers to characterize potential pharmacokinetic interactions between these drugs. Seventeen healthy adults received a single oral dose of primaquine alone (30 mg base) and were then randomized to receive pyronaridine-artesunate alone (540−180 mg) or pyronaridine-artesunate plus primaquine in combination, with intervening washout periods between all treatments. The pharmacokinetic properties of primaquine, its metabolite carboxyprimaquine, artesunate, its metabolite dihydroartemisinin, and pyronaridine were assessed in 15 subjects using a noncompartmental approach followed by a bioequivalence evaluation. All drugs were well tolerated. The single oral dose of primaquine did not result in any clinically relevant pharmacokinetic alterations to pyronaridine, artesunate, or dihydroartemisinin exposures. There were significantly higher primaquine maximum plasma drug concentrations (geometric mean ratio, 30%; 90% confidence interval [CI], 17% to 46%) and total exposures (15%; 6.4% to 24%) during coadministration with pyronaridine-artesunate than when primaquine was given alone. Pyronaridine, like chloroquine and piperaquine, increases plasma primaquine concentrations. (This study has been registered at ClinicalTrials.gov under registration no. NCT01552330.) PMID:25385096

  3. Sodium artesunate-induced diuresis in a patient with malaria

    OpenAIRE

    Syed Ahmed Zaki; Preeti Shanbag; Vijay Lad; Prithi Shenoy

    2011-01-01

    Sodium artesunate is used in the treatment of malaria. We report a case of sodium artesunate induced diuresis and natriuresis in a patient with malaria. Following artesunate administration there was polyuria accompanied by natriuresis that was reversed after discontinuation of artesunate treatment. The diuretic effect of artesunate can modify the course of renal failure in severe malaria. Prescribers should be aware of this effect of artesunate, so that it can be used judiciously and to the a...

  4. Validation and pharmacokinetic application of a high-performance liquid chromatographic technique for determining the concentrations of amodiaquine and its metabolite in plasma of patients treated with oral fixed-dose amodiaquine-artesunate combination in areas of malaria endemicity.

    Science.gov (United States)

    Adedeji, Olumuyiwa N; Bolaji, Oluseye O; Falade, Catherine O; Osonuga, Odusoga A; Ademowo, Olusegun G

    2015-09-01

    Artemisinin-based combination therapies (ACTs) have been adopted by most African countries, including Nigeria, as first-line treatments for uncomplicated falciparum malaria. Fixed-dose combinations of these ACTs, amodiaquine-artesunate (FDC AQAS) and artemether-lumefantrine (AL), were introduced in Nigeria to improve compliance and achieve positive outcomes of malaria treatment. In order to achieve clinical success with AQAS, we developed and validated a simple and sensitive high-performance liquid chromatography (HPLC) method with UV detection for determination of amodiaquine (AQ) and desethylamodiaquine (DAQ) in plasma using liquid-liquid extraction of the drugs with diethyl ether following protein precipitation with acetonitrile. Chromatographic separation was achieved using an Agilent Zorbax C18 column and a mobile phase consisting of distilled water-methanol (80:20 [vol/vol]) with 2% (vol/vol) triethylamine, pH 2.2, at a flow rate of 1 ml/min. Calibration curves in spiked plasma were linear from 100 to 1,000 ng/ml (r > 0.99) for both AQ and DAQ. The limit of detection was 1 ng (sample size, 20 μl). The intra- and interday coefficients of variation at 150, 300, and 900 ng/ml ranged from 1.3 to 4.8%, and the biases were between 6.4 and 9.5%. The mean extraction recoveries of AQ and DAQ were 80.0% and 68.9%, respectively. The results for the pharmacokinetic parameters of DAQ following oral administration of FDC AQAS (612/200 mg) for 3 days in female and male patients with uncomplicated falciparum malaria showed that the maximum plasma concentrations (C max) (740 ± 197 versus 767 ± 185 ng/ml), areas under the plasma concentration-time curve (AUC) (185,080 ± 20,813 versus 184,940 ± 16,370 h · ng/ml), and elimination half-life values (T 1/2) (212 ± 1.14 versus 214 ± 0.84 h) were similar (P > 0.05).

  5. Drug resistant falciparum malaria and the use of artesunate-based combinations : focus on clinical trials sponsored by TDR

    Directory of Open Access Journals (Sweden)

    Walter R.J. Taylor, Jean Rigal & Piero L. Olliaro

    2003-09-01

    Full Text Available Antimalarial drug resistance has now become a serious global challenge and is the principal reasonfor the decline in antimalarial drug efficacy. Malaria endemic countries need inexpensive and efficaciousdrugs. Preserving the life spans of antimalarial drugs is a key part of the strategy for rollingback malaria. Artemisinin-based combinations offer a new and potentially highly effective way tocounter drug resistance. Clinical trials conducted in African children have attested to the good tolerabilityof oral artesunate when combined with standard antimalarial drugs. The cure rates of thedifferent combinations were generally dependent on the degree of resistance to the companiondrug. They were high for amodiaquine-artesunate, variable for sulfadoxine/pyrimethamine-artesunate,and poor for chloroquine-artesunate.

  6. Sodium artesunate-induced diuresis in a patient with malaria

    Directory of Open Access Journals (Sweden)

    Syed Ahmed Zaki

    2011-01-01

    Full Text Available Sodium artesunate is used in the treatment of malaria. We report a case of sodium artesunate induced diuresis and natriuresis in a patient with malaria. Following artesunate administration there was polyuria accompanied by natriuresis that was reversed after discontinuation of artesunate treatment. The diuretic effect of artesunate can modify the course of renal failure in severe malaria. Prescribers should be aware of this effect of artesunate, so that it can be used judiciously and to the advantage of patients with severe malaria.

  7. Role of oxidative stress in therapeutic administration of artesunate ...

    African Journals Online (AJOL)

    Following artesunate pretreatment, groups 3, 4 and 5 rats received vitamin C ... treated with vitamin C. Serum testosterone level was significantly increased (p< ... It was thus concluded that artesunate at therapeutic doses and duration had no ...

  8. General Pharmacology of Artesunate, a Commonly used Antimalarial Drug:Effects on Central Nervous, Cardiovascular, and Respiratory System.

    Science.gov (United States)

    Lee, Hyang-Ae; Kim, Ki-Suk; Kim, Eun-Joo

    2010-09-01

    Artesunate, a semi-synthetic derivative of artemisinin, is used primarily as a treatment for malaria. Its effects on the central nervous system, general behavior, and cardiovascular, respiratory, and other organ systems were studied using mice, rats, guinea pigs, and dogs. Artesunate was administered orally to mice at doses of 125, 250, and 500 mg/kg and to rats and guinea pigs at 100, 200, and 400 mg/kg. In dogs, test drugs were administered orally in gelatin capsules at doses of 50, 100, and 150 mg/kg. Artesunate induced insignificant changes in general pharmacological studies, including general behavior, motor coordination, body temperature, analgesia, convulsion modulation, blood pressure, heart rate (HR) , and electrocardiogram (ECG) in dogs in vivo; respiration in guinea pigs; and gut motility or direct effects on isolated guinea pig ileum, contractile responses, and renal function. On the other hand, artesunate decreased the HR and coronary flow rate (CFR) in the rat in vitro; however, the extent of the changes was small and they were not confirmed in in vivo studies in the dog. Artesunate increased hexobarbital-induced sleeping time in a dose-related manner. Artesunate induced dose-related decreases in the volume of gastric secretions and the total acidity of gastric contents, and induced increases in pH at a dose of 400 mg/kg. However, all of these changes were observed at doses much greater than clinical therapeutic doses (2.4 mg/kg in humans, when used as an anti-malarial) . Thus, it can be concluded that artesunate is safe at clinical therapeutic doses.

  9. Pyronaridine-artesunate granules versus artemether-lumefantrine crushed tablets in children with Plasmodium falciparum malaria: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kayentao Kassoum

    2012-10-01

    Full Text Available Abstract Background Children are most vulnerable to malaria. A pyronaridine-artesunate pediatric granule formulation is being developed for the treatment of uncomplicated Plasmodium falciparum malaria. Methods This phase III, multi-center, comparative, open-label, parallel-group, controlled clinical trial included patients aged ≤12 years, bodyweight ≥5 to P. falciparum malaria. Patients were randomized (2:1 to pyronaridine-artesunate granules (60/20 mg once daily or artemether-lumefantrine crushed tablets (20/120 mg twice daily, both dosed by bodyweight, orally (liquid suspension for three days. Results Of 535 patients randomized, 355 received pyronaridine-artesunate and 180 received artemether-lumefantrine. Day-28 adequate clinical and parasitological response (ACPR, corrected for re-infection using polymerase chain reaction (PCR genotyping (per-protocol population was 97.1% (329/339; 95% CI 94.6, 98.6 for pyronaridine-artesunate; 98.8% (165/167; 95% CI 95.7, 99.9 for artemether-lumefantrine. The primary endpoint was achieved: pyronaridine-artesunate PCR-corrected day-28 ACPR was statistically significantly >90% (P 3 times the upper limit of normal (ULN and peak total bilirubin >2xULN (i.e. within the Hy’s law definition. Conclusions The pyronaridine-artesunate pediatric granule formulation was efficacious and was non-inferior to artemether-lumefantrine. The adverse event profile was similar for the two comparators. Pyronaridine-artesunate should be considered for inclusion in paediatric malaria treatment programmes. Trial registration ClinicalTrials.gov: identifier NCT00541385

  10. Artesunate-induced hemoglobinuria in falciparum malaria

    Directory of Open Access Journals (Sweden)

    Avik Karak

    2016-01-01

    Full Text Available A 26-year-old male got admitted with fever of 103°F with chills and rigor for 6 days. He was diagnosed with Plasmodium falciparum infection by peripheral blood smear examination, later confirmed by polymerase chain reaction analysis. Blood smear showed 2% parasitemia. As the patient was hypotensive, intravenous artesunate was started. Two days later, he reported passing "Coca-Cola"-colored urine. Examination revealed tachycardia, anemia, and mild icterus. Serum free hemoglobin and lactate dehydrogenase was elevated whereas haptoglobin was very low. Urine showed the presence of hemoglobin without red blood cells. Glucose-6-phosphate dehydrogenase assay was normal. Chloroquine, primaquine, and quinine levels in blood were undetectable. There was no evidence of any coinfection. Artesunate was stopped suspecting a causal relationship. Intravenous quinine was started. The urine showed progressive clearance over 3 days, and the patient recovered. The strong temporal association of initiating artesunate and occurrence of hemoglobinuria suggested the possible etiological implication which is not documented before.

  11. Evaluation of a new handheld instrument for the detection of counterfeit artesunate by visual fluorescence comparison.

    Science.gov (United States)

    Ranieri, Nicola; Tabernero, Patricia; Green, Michael D; Verbois, Leigh; Herrington, James; Sampson, Eric; Satzger, R Duane; Phonlavong, Chindaphone; Thao, Khamxay; Newton, Paul N; Witkowski, Mark R

    2014-11-01

    There is an urgent need for accurate and inexpensive handheld instruments for the evaluation of medicine quality in the field. A blinded evaluation of the diagnostic accuracy of the Counterfeit Detection Device 3 (CD-3), developed by the US Food and Drug Administration Forensic Chemistry Center, was conducted in the Lao People's Democratic Republic. Two hundred three samples of the oral antimalarial artesunate were compared with authentic products using the CD-3 by a trainer and two trainees. The specificity (95% confidence interval [95% CI]), sensitivity (95% CI), positive predictive value (95% CI), and negative predictive value (95% CI) of the CD-3 for detecting counterfeit (falsified) artesunate were 100% (93.8-100%), 98.4% (93.8-99.7%), 100% (96.2-100%), and 97.4% (90.2-99.6%), respectively. Interobserver agreement for 203 samples of artesunate was 100%. The CD-3 holds promise as a relatively inexpensive and easy to use instrument for field evaluation of medicines, potentially empowering drug inspectors, customs agents, and pharmacists. © The American Society of Tropical Medicine and Hygiene.

  12. Histopathology of the Liver Following Administration of Artesunate in Adult Wistar Rats

    Directory of Open Access Journals (Sweden)

    Felix Monday Onyije

    2012-02-01

    Full Text Available Summary In must of the developing countries especially in Africa antimalaria drugs are taken regularly either to treat or prevent malaria. The rats were randomly divided into 3 groups of 5 each and tested as follows: - Group O- control (water, Group A – 2mg/kg and Group B - 6mg/kg. The animals were sacrificed after the 7th day. There was no mortality caused by the drug but dizziness in the animals. In the group administered with 2mg/kg of oral artesunate where was no form of distortion in the tissue architecture of the liver, but in the group administered with 6mg/kg of artesunate, artesunate caused sinusoidal congestion, infiltration of inflammatory cells and there was loss of tissue architecture. Drugs are produce to combat illnesses but may turn out be harmful when administered wrongly. In must of the developing countries especially in Africa antimalaria drugs are taken regularly either to treat or prevent malaria. They are taken such that one could even imaging if it is a food supplement. [J Interdiscipl Histopathol 2012; 1(1.000: 26-29

  13. Artesunate and artelinic acid: association of embryotoxicity, reticulocytopenia, and delayed stimulation of hematopoiesis in pregnant rats.

    Science.gov (United States)

    Clark, Robert L; Brannen, Kimberly C; Sanders, James E; Hoberman, Alan M

    2011-02-01

    The artemisinin antimalarials cause embryo death and malformations in animals by killing embryonic erythroblasts. Groups of pregnant rats (N = 4) were administered 35 and 48 µmol/kg artesunate and 17.2, 28.7, 48, 96, and 191 µmol/kg artelinic acid as a single oral dose on gestational day (GD) 12. Litters were examined on GD21. The ED(50) for embryo death with artelinic acid (23.4 µmol/kg) was just slightly lower than that for decreased reticulocyte count at 24 hr postdose (33.5 µmol/kg) and both had similarly steep dose responses (maximal effects of total litter loss and ∼60% decreases in reticulocyte count at 48 µmol/kg). Results with artesunate were similar. The correlation coefficient between embryo death and decreased reticulocyte count was 0.82 (pembryotoxicity and reticulocytopenia is suggestive of a common mechanism-artemisinin-induced mitochondrial damage leading to cell death. At 9 days postdose, treatment with artesunate and artelinic acid also caused increases in counts of reticulocytes, lymphocytes, basophils, and monocytes (up to 3.7 ×, 1.7 ×, 4.7 ×, and 1.7 × control, respectively). This stimulation of hematopoiesis may have been mediated by the direct oxidative conversion of artesunate or artelinic acid to the artemisininyl hydroperoxide within the bone marrow cells or by an indirect increase in reactive oxygen species. The high correlation between embryotoxicity and reticulocytopenia further supports the assertion that therapeutic dosage regimens of artemisinins that cause decreases in reticulocyte count in pregnant women during the putative critical period (approximately postconception wk 3 to 9) are at risk of also causing adverse effects on the embryo.

  14. Population pharmacokinetics of artesunate and dihydroartemisinin following intra-rectal dosing of artesunate in malaria patients.

    Directory of Open Access Journals (Sweden)

    Julie A Simpson

    2006-11-01

    Full Text Available Intra-rectal artesunate has been developed as a potentially life-saving treatment of severe malaria in rural village settings where administration of parenteral antimalarial drugs is not possible. We studied the population pharmacokinetics of intra-rectal artesunate and the relationship with parasitological responses in patients with moderately severe falciparum malaria.Adults and children in Africa and Southeast Asia with moderately severe malaria were recruited in two Phase II studies (12 adults from Southeast Asia and 11 children from Africa with intensive sampling protocols, and three Phase III studies (44 children from Southeast Asia, and 86 children and 26 adults from Africa with sparse sampling. All patients received 10 mg/kg artesunate as a single intra-rectal dose of suppositories. Venous blood samples were taken during a period of 24 h following dosing. Plasma artesunate and dihydroartemisinin (DHA, the main biologically active metabolite concentrations were measured by high-performance liquid chromatography with electrochemical detection. The pharmacokinetic properties of DHA were determined using nonlinear mixed-effects modelling. Artesunate is rapidly hydrolysed in vivo to DHA, and this contributes the majority of antimalarial activity. For DHA, a one-compartment model assuming complete conversion from artesunate and first-order appearance and elimination kinetics gave the best fit to the data. The mean population estimate of apparent clearance (CL/F was 2.64 (l/kg/h with 66% inter-individual variability. The apparent volume of distribution (V/F was 2.75 (l/kg with 96% inter-individual variability. The estimated DHA population mean elimination half-life was 43 min. Gender was associated with increased mean CL/F by 1.14 (95% CI: 0.36-1.92 (l/kg/h for a male compared with a female, and weight was positively associated with V/F. Larger V/Fs were observed for the patients requiring early rescue treatment compared with the remainder

  15. Artesunate plus pyronaridine for treating uncomplicated Plasmodium falciparum malaria

    Science.gov (United States)

    Bukirwa, Hasifa; Unnikrishnan, B; Kramer, Christine V; Sinclair, David; Nair, Suma; Tharyan, Prathap

    2014-01-01

    Background The World Health Organization (WHO) recommends that people with uncomplicated Plasmodium falciparum malaria are treated using Artemisinin-based Combination Therapy (ACT). ACT combines three-days of a short-acting artemisinin derivative with a longer-acting antimalarial which has a different mode of action. Pyronaridine has been reported as an effective antimalarial over two decades of use in parts of Asia, and is currently being evaluated as a partner drug for artesunate. Objectives To evaluate the efficacy and safety of artesunate-pyronaridine compared to alternative ACTs for treating people with uncomplicated P. falciparum malaria. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library; MEDLINE; EMBASE; LILACS; ClinicalTrials.gov; the metaRegister of Controlled Trials (mRCT); and the WHO International Clinical Trials Search Portal up to 16 January 2014. We searched reference lists and conference abstracts, and contacted experts for information about ongoing and unpublished trials. Selection criteria Randomized controlled trials of artesunate-pyronaridine versus other ACTs in adults and children with uncomplicated P. falciparum malaria. For the safety analysis, we also included adverse events data from trials comparing any treatment regimen containing pyronaridine with regimens not containing pyronaridine. Data collection and analysis Two authors independently assessed trial eligibility and risk of bias, and extracted data. We combined dichotomous data using risk ratios (RR) and continuous data using mean differences (MD), and presented all results with a 95% confidence interval (CI). We used the GRADE approach to assess the quality of evidence. Main results We included six randomized controlled trials enrolling 3718 children and adults. Artesunate-pyronaridine versus artemether-lumefantrine In two multicentre trials, enrolling

  16. Characterization of counterfeit artesunate antimalarial tablets from southeast Asia.

    Science.gov (United States)

    Hall, Krystyn Alter; Newton, Paul N; Green, Michael D; De Veij, Marleen; Vandenabeele, Peter; Pizzanelli, David; Mayxay, Mayfong; Dondorp, Arjen; Fernandez, Facundo M

    2006-11-01

    In southeast Asia, the widespread high prevalence of counterfeits tablets of the vital antimalarial artesunate is of great public health concern. To assess the seriousness of this problem, we quantified the amount of active ingredient present in artesunate tablets by liquid chromatography coupled to mass spectrometry. This method, in conjunction with analysis of the packaging, classified tablets as genuine, substandard, or fake and validated results of the colorimetric Fast Red TR test. Eight (35%) of 23 fake artesunate samples contained the wrong active ingredients, which were identified as different erythromycins and paracetamol. Raman spectroscopy identified calcium carbonate as an excipient in 9 (39%) of 23 fake samples. Multivariate unsupervised pattern recognition results indicated two major clusters of artesunate counterfeits, those with counterfeit foil stickers and containing calcium carbonate, erythromycin, and paracetamol, and those with counterfeit holograms and containing starch but without evidence of erythromycin or paracetamol.

  17. Artesunate + amodiaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in the Colombian Pacific region: a noninferiority trial

    Directory of Open Access Journals (Sweden)

    Fernando De la Hoz Restrepo

    2012-12-01

    Full Text Available INTRODUCTION: In Colombia, there are no published studies for the treatment of uncomplicated Plasmodium falciparum malaria comparing artemisinin combination therapies. Hence, it is intended to demonstrate the non-inferior efficacy/safety profiles of artesunate + amodiaquine versus artemether-lumefantrine treatments. METHODS: A randomized, controlled, open-label, noninferiority (Δ≤5% clinical trial was performed in adults with uncomplicated P. falciparum malaria using the 28‑day World Health Organization validated design/definitions. Patients were randomized 1:1 to either oral artesunate + amodiaquine or artemether-lumefantrine. The primary efficacy endpoint: adequate clinical and parasitological response; secondary endpoints: - treatment failures defined per the World Health Organization. Safety: assessed through adverse events. RESULTS: A total of 105 patients was included in each group: zero censored observations. Mean (95%CI - Confidence interval adequate clinical and parasitological response rates: 100% for artesunate + amodiaquine and 99% for artemether-lumefantrine; the noninferiority criteria was met (Δ=1.7%. There was one late parasitological therapeutic failure (1%; artemether-lumefantrine group, typified by polymerase chain reaction as the MAD20 MSP1 allele. The fever clearance time (artesunate + amodiaquine group was significantly shorter (p=0.002. Respectively, abdominal pain for artesunate + amodiaquine and artemether-lumefantrine was 1.9% and 3.8% at baseline (p=0.68 and 1% and 13.3% after treatment (p<0.001. CONCLUSIONS: Uncomplicated P. falciparum malaria treatment with artesunate + amodiaquine is noninferior to the artemether-lumefantrine standard treatment. The efficacy/safety profiles grant further studies in this and similar populations.

  18. Subacute therapeutic dosing of artemether-lumefantrine and artesunate-amodiaquine combination preserves plasma cholesterol, renal antioxidant status, and organ weights in rats.

    Science.gov (United States)

    Otuechere, Chiagoziem A; Edewor, Gloria; Kale, Oluwafemi Ezekiel; Ekor, Martins

    2012-01-01

    Recent instances of breakdowns of malaria control programs and the constant emergence of drug-resistant parasites to monotherapies have shored up the use of artemisinin-based combination therapy (ACT) as the malaria therapy of choice. We evaluated a subacute therapeutic dosing of artemether-lumefantrine and artesunate-amodiaquine on plasma cholesterol, renal antioxidants, and organ weights in rats. Sixteen albino rats were grouped into three. Group A (n = 5) served as the control. Groups B (n = 6) and C (n = 5) were administered, twice daily, oral therapeutic doses of artemether-lumefantrine (1.14/6.86 mg/kg/d) and artesunate-amodiaquine (2.86/8.58 mg/kg/d), respectively, for seven days. From our results, ACTs did not significantly (P > 0.05) alter catalase, superoxide dismutase, glutathione S-transferase, myeloperoxidase, and total glutathione levels when compared with the control. Plasma total cholesterol levels also decreased insignificantly (P > 0.05). Organ-system weights were not significantly (P > 0.05) different from control rats. Artesunate-amodiaquine, but not artemether-lumefantrine, significantly increased (P artesunate-amodiaquine and artemether-lumefantrine may preserve renal antioxidants and organ weights in vivo. However, caution is required above therapeutic indications or in chronic doses as this may predispose to renal oxidative stress.

  19. Treatment of severe falciparum malaria: quinine versus artesunate

    Directory of Open Access Journals (Sweden)

    Dipesh Patel

    2013-02-01

    Full Text Available Background: Malaria is the most important disease of human being. More than 40% of the world’s population is considered to be at risk of exposure of this disease. Malaria infection has been increasing over recent years due to combination of factors including increasing resistance of malarial parasite. Most of the strains of P. falciparum are now resistance to conventional drugs like chloroquine in many areas. The objective of this study was to compare the efficacy and safety of quinine and artesunate in treatment of P. falciparum malaria. Methods: This is hospital based prospective study, conducted amongst 35 randomly selected patients of severe P. falciparum malaria. Patients with any contraindications of either drug were excluded to avoid bias. Standard statistical tests were applied for qualitative as well as quantitative data. Results: As per the study end point results of difference of mortality in patients receiving either drug was not significant (p > 0.75, but difference in clinical parameters like fever clearance time (p <0.01, parasite clearance time (p < 0.001 and coma resolution time (p < 0.001 were significant among patients receiving artesunate. There were no any significant differences in adverse effects of both the drugs. Mortality was same in both arms taking either drug. Conclusions: Artesunate is as good as quinine in mortality aspect but artesunate is superior in fever clearance time (FCT & parasite clearance time (PCT. Coma resolution time is faster with quinine as compared to artesunate. There are no significant adverse effects of either drug. So artesunate is equivalent or superior for treatment for severe falciparum malaria. [Int J Basic Clin Pharmacol 2013; 2(1.000: 30-36

  20. Intravenous artesunate for severe malaria in travelers, Europe

    DEFF Research Database (Denmark)

    Zoller, Thomas; Junghanss, Thomas; Kapaun, Annette

    2011-01-01

    Multicenter trials in Southeast Asia have shown better survival rates among patients with severe malaria, particularly those with high parasitemia levels, treated with intravenous (IV) artesunate than among those treated with quinine. In Europe, quinine is still the primary treatment for severe...... malaria. We conducted a retrospective analysis for 25 travelers with severe malaria who returned from malaria-endemic regions and were treated at 7 centers in Europe. All patients survived. Treatment with IV artesunate rapidly reduced parasitemia levels. In 6 patients at 5 treatment centers, a self...... of malaria patients in Europe. Patients should be monitored for signs of hemolysis, especially after parasitologic cure....

  1. [Study on preparation process of artesunate polylactic acid microspheres].

    Science.gov (United States)

    Pan, Xu-Wang; Wang, Wei; Fang, Hong-Ying; Wang, Fu-Gen; Cai, Zhao-Bin

    2013-12-01

    This study aims to investigate the preparation process and in vitro release behavior of artesunate polylactic acid microspheres, in order to prepare an artesunate polylactic acid (PLA) administration method suitable for hepatic arterial embolization. With PLA as the material and polyvinyl alcohol (PVA) as the emulsifier, O/W emulsion/solvent evaporation method was adopted to prepare artesunate polylactic acid microspheres, and optimize the preparation process. With drug loading capacity, encapsulation efficiency and particle size as indexes, a single factor analysis was made on PLA concentration, PVA concentration, drug loading ratio and stirring velocity. Through an orthogonal experiment, the optimal processing conditions were determined as follows: PLA concentration was 9. 0% , PVA concentration was 0. 9% , drug loading ratio was 1:2 and stirring velocity was 1 000 r x min(-1). According to the verification of the optimal process, microsphere size, drug loading and entrapment rate of artesunate polylactic acid microspheres were (101.7 +/- 0.37) microm, (30.8 +/- 0.84)%, (53.6 +/- 0.62)%, respectively. The results showed that the optimal process was so reasonable and stable that it could lay foundation for further studies.

  2. Pharmacokinetics of artesunate alone and in combination with sulfadoxine/pyrimethamine in healthy Sudanese volunteers.

    Science.gov (United States)

    Matar, Kamal M; Awad, Abdelmoneim I; Elamin, Sakina B

    2014-06-01

    Artesunate (AS) in combination with sulfadoxine/pyrimethamine (SP) is the first-line therapy for management of uncomplicated Plasmodium falciparum malaria in Sudan. The objective of this study was to assess the potential impact of SP on the pharmacokinetics of AS and its active metabolite, dihydroartemisinin (DHA), in healthy adults. A single-dose, randomized, open-label, crossover study design with a washout period of three weeks was performed with 16 volunteers. After oral administration of AS alone or in combination with SP, Tmax values of AS and DHA were significantly prolonged in the combination group (P 0.05). The t1/2 values of AS and DHA were significantly higher in females than in males (P < 0.05). The present findings suggest that co-administration of SP with AS has no clinically relevant impact on the pharmacokinetics of AS or DHA in healthy persons.

  3. Ultrastructural changes in the tegument and gut of adult Fasciola hepatica following in vivo treatment with artesunate.

    Science.gov (United States)

    O'Neill, J F; Johnston, R C; Halferty, L; Brennan, G P; Fairweather, I

    2015-07-01

    An in vivo study in the laboratory rat model has been carried out to monitor changes to the tegument and gut of adult Fasciola hepatica following treatment with artesunate. Rats infected with the triclabendazole-resistant Oberon isolate were dosed orally with artesunate at a concentration of 200 mg/kg and flukes recovered 24, 48, 72 and 96 h post-treatment (pt). The flukes were processed for scanning and transmission electron microscope examination. Changes to the external surface were limited to swelling and blebbing of the interspinal tegument. There was one exception, a specimen recovered 72 h pt, which had completely lost the syncytium over the posterior region of the fluke. Internal changes to the tegumental syncytium and cell bodies were more severe and were apparent from 48 h pt onwards. Increased numbers of secretory bodies were present in the apical region of the syncytium, the basal infolds were swollen and sloughing of the apical plasma membrane was seen at 96 h pt. In the cell bodies, there was swelling and vesiculation of the cisternae of the granular endoplasmic reticulum (ger), swelling of the mitochondria and a decrease in secretory body production. Changes to the gastrodermal cells were evident from 24 h onwards. They comprised swelling and vesiculation of the ger cisternae, swelling and lysis of the mitochondria and accumulation of autophagic vacuoles and lipid droplets. The nuclei of the cells were karyopyknotic by 96 h pt. The gut was consistently more severely affected than the tegument at all time points pt, pointing to an oral route of uptake for artesunate. This study has provided information on the primary subcellular targets for drug action in the fluke.

  4. Embryotoxicity and toxicokinetics of the antimalarial artesunate in rats.

    Science.gov (United States)

    Chung, Moon-Koo; Yu, Wook-Joon; Lee, Jin-Soo; Lee, Jong-Hwa

    2013-03-01

    This study was conducted to investigate the potential embryo-fetal toxicity and toxicokinetics of the antimalarial agent artesunate (ARTS) in Sprague-Dawley rats. Pregnant rats were administered ARTS daily from gestational day 6~15 via oral gavage, at test doses of 0, 2, 4, or 8 mg/kg (22 females per group). The fetuses were examined for external, visceral, and skeletal abnormalities on gestational day 20. With regard to the dams, there were no deaths, treatment-related clinical signs, changes in body weight, or food intake in any of the treatment groups. There were no treatment-related gross findings at necropsy in any treatment group. In the 8 mg/kg group, there was a decrease in gravid uterine weight and in the weight of female fetuses. There was also an increase in fetal deaths (primarily late resorptions) and an increase in post-implantation losses (37%) at 8 mg/kg. An increase in the incidence of visceral and skeletal variations at 4 and 8 mg/kg was observed. These defects included minor changes in the appearance of the kidney and thymus, as well as absent ribs or thoracic vertebrae. Toxicokinetics were assessed in a parallel study, using 4 mated females per group. Using liquid chromatography-mass spectrometry (LC-MS) analysis, the concentration of ARTS and its metabolite dihydroartemisinin (DHA) were quantified in plasma from rats on gestational days 5, 6, 10, and 15. Amniotic fluid was assayed for ARTS and DHA on gestational day 15. There was evidence of rapid conversion of ARTS to the metabolite DHA in maternal plasma, since ARTS could not be consistently detected in plasma at the three doses tested. ARTS and DHA were not detected in amniotic fluid at gestational day 15, indicating limited placental transfer of the two agents. The embryofetal no-observable-adverse-effect level (NOAEL) of the test item was considered to be 8 mg/kg/day for dams, and 2 mg/kg/day for embryo-fetal development.

  5. Artesunate-amodiaquine versus artesunate-sulfadoxine-pyrimethamine for uncomplicated falciparum malaria in children

    Directory of Open Access Journals (Sweden)

    Novie H. Rampengan

    2014-01-01

    Full Text Available Background Malaria is a major cause of morbidity and mortality in children, especially in developing countries. Artemisinin combination therapy (ACT has higher rates of parasite clearance and inhibition of anti-malarial drugs resistance than non-ACT. Hence, we compared the efficacies of artesunate-amodiaquine (AS-AQ versus artesunate-sulfadoxine pyrimethamine (AS-SP combination therapies in children with uncomplicated falciparum malaria. Objective To compare the fever clearance time, parasite clearance time, and length of hospital stay in uncomplicated falciparum malaria patients treated with AS-AQ and AS-SP. Methods We reviewed the medical records of children aged 1-14 years with uncomplicated falciparum malaria admitted to Prof. Dr. R. D. Kandou Hospital between January 2002 – June 2010. Treatment efficacy was evaluated by fever clearance time, parasite clearance time, and length of hospital stay. The differences of treatment efficacy between the two groups of therapy were analyzed by independent T-test. Results We identified 185 children with uncomplicated falciparum malaria, 104 cases were treated with AS-AQ while the other 81 received AS-SP. Parasite clearance time was shorter in AS-AQ group than in AS-SP group at 1.38 (SD 0.69 versus 1.91 (SD 0.93 days, respectively (95%CI of differences 0.30 to 0.76, P<0.05. The length of hospital stay was shorter in AS-AQ group than in the AS-SP group, at 5.01 (SD 1.22 versus 6.04 (SD 0.98 days, respectively (95%CI of differences 0.71 to 1.35, P<0.05. However, there was no statistically significant difference in fever clearance time between the groups. Conclusion AS-AQ combination therapy reduces parasite clearance time and length of hospital stay compared to AS-SP combination therapy in children with uncomplicated falciparum malaria. [Paediatr Indones. 2014;54:46-51.].

  6. Therapeutic efficacy of artesunate-amodiaquine combinations and the plasma and saliva concentrations of desethylamodiaquine in children with acute uncomplicated Plasmodium falciparum malaria.

    Science.gov (United States)

    Sowunmi, Akintunde; Gbotosho, Grace O; Happi, Christian T; Okuboyejo, Titilope M; Sijuade, Abayomi O; Michael, Obaro S; Adewoye, Elsie O; Folarin, Onikepe

    2013-01-01

    The treatment efficacy of artesunate-amodiaquine (AQ) coformulated or copackaged, and the plasma and saliva concentrations of desethylamodiaquine (DEAQ), the active metabolite of AQ, were evaluated in 120 and 7 children, respectively, with uncomplicated Plasmodium falciparum malaria treated with oral daily doses of the 2 formulations for 3 days. All children recovered clinically. Fever clearance (1.1 ± 0.2 vs 1.0 ± 0 days) and parasite clearance times (21.1 ± 10.2 vs 19.0 ± 7.0 hours) in artesunate-AQ coformulated and artesunate-AQ copackaged treated children, respectively, were similar. All children remained aparasitemic for at least 28 days. Blood and saliva samples were collected over 35 days and DEAQ in plasma and saliva was determined by high-performance liquid chromatography. DEAQ was detectable in plasma and saliva within 40 minutes of oral administration of artesunate-AQ. DEAQ concentrations 7 days after the start of therapy were 247.8 and 125.1 ng/mL in plasma and saliva, respectively. The concentration-time curves of plasma and saliva in declining phases were approximately parallel giving a similar half-life of 169.1 ± 16.4 and 142.8 ± 6.5 hours in plasma and saliva, respectively. Clearance from plasma and saliva was also similar (335.6 and 443.4 mL·h·kg, respectively). Area under concentration-time curves (AUC0-35d) for plasma and saliva were 94,744.9 and 74,004.2 ng·mL·h, respectively. In general, Saliva-plasma concentration ratio was 0.25-0.4. DEAQ concentrations in saliva may be useful for monitoring therapy and for the evaluation of the disposition of AQ in children with falciparum malaria treated with AQ-based combination.

  7. Artesunate plus pyronaridine for treating uncomplicated Plasmodium falciparum malaria

    OpenAIRE

    Bukirwa, Hasifa; Unnikrishnan, B; Kramer, Christine V; Sinclair, David; Nair, Suma; Tharyan, Prathap

    2014-01-01

    Background The World Health Organization (WHO) recommends that people with uncomplicated Plasmodium falciparum malaria are treated using Artemisinin-based Combination Therapy (ACT). ACT combines three-days of a short-acting artemisinin derivative with a longer-acting antimalarial which has a different mode of action. Pyronaridine has been reported as an effective antimalarial over two decades of use in parts of Asia, and is currently being evaluated as a partner drug for artesunate. Objective...

  8. Assessment of the Effect of Artesunate on the Developing Bones of Wistar Rat Animal Model of Malaria Treatment

    Directory of Open Access Journals (Sweden)

    Sunday Samuel Adebisi

    2010-02-01

    Full Text Available AIM: Among its contemporaries, artesunate, a semisynthetic artemisinin antimalarial is presently being esteemed above others as a ready combatant against the malaria menace plaguing most parts of the tropics; one, for being less or non-resisted by the parasite and two, less allergy-provoking to the users. However, recent clinical observations and experimental studies had implicated this drug to be embryo-fetal toxic and this had since generated research interests such as this, to ascertain the extent of the effects of artesunate on the morphology, weights and dimensions of the developing Wistar rat bones METHOD: Oral doses of 2mg/kg and 4mg/kg body weight were administered to each experimental pregnant Wistar rat from the 9th to the 11th day of gestation–being the active osteogenic period in this animal. Two rats were sacrificed each day from days 12 to 21 and foetuses retrieved and the following assessed on the skeleton: wet weights, dry weights, ash weights, fat free weights and total body weights, plus dimensions of long bones and pelvic bones. RESULTS: Compared to the control, all the parameters assessed were negatively affected in the treated groups, being more severe in the 4mg/kg rats. CONCLUSION: Artesunate, even at relatively low dosages appears to be hazardous to the structural integrity of bones particularly when administered at critical period of development, a point to note in the global quest to combat malaria cum polio, the presently well acknowledged ravaging twin menace in the tropics. [TAF Prev Med Bull 2010; 9(1.000: 23-28

  9. Intravenous artesunate reduces parasite clearance time, duration of intensive care, and hospital treatment in patients with severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu;

    2015-01-01

    Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive...

  10. Population pharmacokinetics of artesunate and amodiaquine in African children

    Directory of Open Access Journals (Sweden)

    Ouedraogo Alphonse

    2009-08-01

    Full Text Available Abstract Background Pharmacokinetic (PK data on amodiaquine (AQ and artesunate (AS are limited in children, an important risk group for malaria. The aim of this study was to evaluate the PK properties of a newly developed and registered fixed dose combination (FDC of artesunate and amodiaquine. Methods A prospective population pharmacokinetic study of AS and AQ was conducted in children aged six months to five years. Participants were randomized to receive the new artesunate and amodiaquine FDC or the same drugs given in separate tablets. Children were divided into two groups of 70 (35 in each treatment arm to evaluate the pharmacokinetic properties of AS and AQ, respectively. Population pharmacokinetic models for dihydroartemisinin (DHA and desethylamodiaquine (DeAq, the principal pharmacologically active metabolites of AS and AQ, respectively, and total artemisinin anti-malarial activity, defined as the sum of the molar equivalent plasma concentrations of DHA and artesunate, were constructed using the non-linear mixed effects approach. Relative bioavailability between products was compared by estimating the ratios (and 95% CI between the areas under the plasma concentration-time curves (AUC. Results The two regimens had similar PK properties in young children with acute malaria. The ratio of loose formulation to fixed co-formulation AUCs, was estimated as 1.043 (95% CI: 0.956 to 1.138 for DeAq. For DHA and total anti-malarial activity AUCs were estimated to be the same. Artesunate was rapidly absorbed, hydrolysed to DHA, and eliminated. Plasma concentrations were significantly higher following the first dose, when patients were acutely ill, than after subsequent doses when patients were usually afebrile and clinically improved. Amodiaquine was converted rapidly to DeAq, which was then eliminated with an estimated median (range elimination half-life of 9 (7 to 12 days. Efficacy was similar in the two treatments groups, with cure rates of 0

  11. Comparison of chloroquine with artesunate in the treatment of cerebral malaria in Ghanaian children

    DEFF Research Database (Denmark)

    Goka, B Q; Adabayeri, V; Ofori-Adjei, E;

    2001-01-01

    and neurological deficits were documented. There was no difference in mortality rates (chloroquine, 16.7 per cent; artesunate, 21.7 per cent; p = 0.6), neurological deficit at day 14 (chloroquine, 0 per cent; artesunate, 4.3 per cent; p = 0.3), resolution of fever (p = 0.55), and coma recovery time (p = 0...

  12. Study on Invasion of Artesunate on Inhibiting Human Colon Cancer Cell SW620

    Directory of Open Access Journals (Sweden)

    Yu Fan

    2013-09-01

    Full Text Available Objective: To observe the invasive effect of Chinese extraction artesunate on human colon cancer cell SW620 and explore its possible mechanisms. Methods: Colon cancer cell SW620 was managed by different concentrations of artesunate, and soft agar colony-cultivating trial was applied to detect anchorage independent proliferation of cancer cells, Boyden chamber model method to detect the invasive capability of cancer cells and Western blot method to detect the change of intercellular adhesion molecule-1 (ICAM-1 proteins. Results: Artesunate can effectively inhibit malignant proliferation and invasive capability of colon cancer cell SW620, and was dose-dependent (P < 0.01. Artesunate can effectively inhibit the expression of cancer cell ICAM-1 gene proteins, and was time- and concentration-dependant (P <0.01. Conclusion: Artesunate can significantly inhibit the invasion of colon cancer cell SW620, which can be related to down-regulation of ICAM-1 protein level.

  13. Subacute Therapeutic Dosing of Artemether-Lumefantrine and Artesunate-Amodiaquine Combination Preserves Plasma Cholesterol, Renal Antioxidant Status, and Organ Weights in Rats

    Directory of Open Access Journals (Sweden)

    Chiagoziem A. Otuechere

    2012-01-01

    Full Text Available Recent instances of breakdowns of malaria control programs and the constant emergence of drug-resistant parasites to monotherapies have shored up the use of artemisinin-based combination therapy (ACT as the malaria therapy of choice. We evaluated a subacute therapeutic dosing of artemether-lumefantrine and artesunate-amodiaquine on plasma cholesterol, renal antioxidants, and organ weights in rats. Sixteen albino rats were grouped into three. Group A (n=5 served as the control. Groups B (n=6 and C (n=5 were administered, twice daily, oral therapeutic doses of artemether-lumefantrine (1.14/6.86 mg/kg/d and artesunate-amodiaquine (2.86/8.58 mg/kg/d, respectively, for seven days. From our results, ACTs did not significantly (P>0.05 alter catalase, superoxide dismutase, glutathione S-transferase, myeloperoxidase, and total glutathione levels when compared with the control. Plasma total cholesterol levels also decreased insignificantly (P>0.05. Organ-system weights were not significantly (P>0.05 different from control rats. Artesunate-amodiaquine, but not artemether-lumefantrine, significantly increased (P<0.05 lactate dehydrogenase activity and also afforded a 27.2% decrease in heart weight when compared with control. Also, both ACTs increased (P<0.05 lipid peroxidation. Overall, artesunate-amodiaquine and artemether-lumefantrine may preserve renal antioxidants and organ weights in vivo. However, caution is required above therapeutic indications or in chronic doses as this may predispose to renal oxidative stress.

  14. Comparative study of efficacy of artesunate plus cotrimoxazole and artesunate plus chloroquine in the treatment of malaria in Nigerian children: a preliminary report

    Directory of Open Access Journals (Sweden)

    F.A. Fehintola, S.T. Balogun

    2010-09-01

    Full Text Available Background & objectives: The study was undertaken to evaluate the efficacy of cotrimoxazole plusartesunate and to compare the efficacy of this combination with that of artesunate plus chloroquinein the treatment of acute uncomplicated falciparum malaria in children.Methods: Children aged between 0.5 and 12 yr with clinical and parasitological evidence ofPlasmodium falciparum malaria were randomized to receive either artesunate plus cotrimoxazoleor artesunate plus chloroquine. They were followed-up with clinical and parasitological assessmentfor a period of 14 days.Results: In all, 57 out of 81 (31 in the artesunate plus cotrimoxazole group and 26 in artesunateplus chloroquine group completed the study as per protocol and were evaluated. Pre-treatmentclinical and parasitological parameters were similar in the two treatment groups. The time to clearfever and other symptoms were similar in the two groups 1.0 + 0 vs 1.14 + 0.38 (p > 0.05.Parasite clearance times were also similar; 1.65 + 0.49 days vs 1.58 + 0.67 days respectively forartesunate plus cotrimoxazole and artesunate plus chloroquine (p > 0.05. The cure rates on Day14 were 100% for both artesunate plus cotrimoxazole and artesunate plus chloroquine groups.Both drug combinations were well-tolerated in the small population of children.Conclusion: These results indicate that artesunate plus cotrimoxazole has similar efficacy toartesunate plus chloroquine in the treatment of acute uncomplicated P. falciparum malaria inchildren resident in an endemic area of south-west Nigeria.

  15. Pharmacokinetic Interaction between Pyronaridine-Artesunate and Metoprolol

    OpenAIRE

    Morris, Carrie A.; Pokorny, Rolf; Lopez-Lazaro, Luis; Miller, Robert M.; Arbe-Barnes, Sarah; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Shin, Jang-Sik; Fleckenstein, Lawrence

    2014-01-01

    The objectives of this study were to characterize any drug-drug interaction between the antimalarial Pyramax (pyronaridine-artesunate [PA]) and the CYP2D6 probe substrate metoprolol and to assess the safety of 60-day or 90-day PA redosing, particularly with regard to liver biochemistry parameters. Healthy adult subjects were randomized to arm A (n = 26) or arm B (n = 30), with the arm A subjects administered 100 mg metoprolol tartrate in the first period, 100 mg metoprolol tartrate with the t...

  16. Nevirapine-Based Antiretroviral Therapy Impacts Artesunate and Dihydroartemisinin Disposition in HIV-Infected Nigerian Adults

    Directory of Open Access Journals (Sweden)

    Fatai A. Fehintola

    2012-01-01

    Full Text Available Background. Nevirapine- (NVP- based antiretroviral therapy (ART and artesunate-amodiaquine are frequently coprescribed in areas of HIV and malaria endemicity. We explored the impact of this practice on artesunate and dihydroartemisinin pharmacokinetics. Methods. We conducted a parallel-group pharmacokinetic comparison between HIV-infected patients receiving NVP-based ART (n=10 and ART-naive controls (n=11. Artesunate-amodiaquine 200/600 mg was given daily for three days. Measurement of drug concentrations occurred between 0 and 96 hours after the final dose. Pharmacokinetic parameters were determined using noncompartmental analysis. Results. Comparing the NVP group to controls, clearance of artesunate was reduced 50% (1950 versus 2995 L/h; P=0.03, resulting in a 45% increase in the AUC0-96 (105 versus 69 ug∗hr/L; P=0.02. The half-life of dihydroartemisinin was shorter in the NVP group (1.6 versuss 3.2 h; P=0.004, but other dihydroartemisinin pharmacokinetic parameters were unchanged. A lower conversion of artesunate to dihydroartemisinin was observed in the NVP group (dihydroartemisinin: artesunate AUC0-96=5.6 versuss 8.5 in NVP and control groups, respectively, P=0.008. Conclusion. Although NVP-containing ART impacted some pharmacokinetic parameters of artesunate and dihydroartemisinin, overall exposure was similar or better in the NVP group.

  17. Effects of the combined artesunate and mefloquine antimalarial drugs on rat embryos.

    Science.gov (United States)

    Boareto, A C; Müller, J C; Lourenço, E L B; Lombardi, N; Lourenço, A C; Rabitto, I; de Morais, R N; Rios, F S; Dalsenter, P R

    2013-09-01

    Artemisinins combination therapy (ACT) is the first choice therapy for falciparum malaria. Data on the safety of ACTs in pregnancy are limited and controversial and the use is not recommended on the first trimester. To evaluate the effects of isolated and combined artesunate (AS)/mefloquine (MQ) on embryo rats, pregnant rats were treated orally with AS (15 and 40 mg/kg body weight (bwt)/day), MQ (30 and 80 mg/kg bwt/day) and AS/MQ (15/30 and 40/80 mg/kg bwt/day) on days 9-11 post coitum (pc). The dams were euthanized on day 12 pc and gestational and embryos histological parameters were evaluated. Embryolethality and histopathological anomalies were significant when AS was given alone or combined with MQ. Combination of AS and MQ did not enhance their toxicity compared to their separate administrations; on the other side, there was a reduction in the toxic effects of the AS when combined with MQ. Isolated MQ did not induce developmental toxicity.

  18. Study on Invasion of Artesunate on Inhibiting Human Colon Cancer Cell SW620

    Institute of Scientific and Technical Information of China (English)

    Fan Yu; Zhang Youli; Yao Guangtao; Li Yikui

    2013-01-01

    Objective:To observe the invasive effect of Chinese extraction artesunate on human colon cancer cell SW620 and explore its possible mechanisms. Methods:Colon cancer cell SW620 was managed by different concentrations of artesunate, and soft agar colony-cultivating trial was applied to detect anchorage independent proliferation of cancer cells, Boyden chamber model method to detect the invasive capability of cancer cells and Western blot method to detect the change of intercellular adhesion molecule-1 (ICAM-1) proteins. Results:Artesunate can effectively inhibit malignant proliferation and invasive capability of colon cancer cell SW620, and was dose-dependent (P Conclusion:Artesunate can signiifcantly inhibit the invasion of colon cancer cell SW620, which can be related to down-regulation of ICAM-1 protein level.

  19. Drug-Drug Interaction Analysis of Pyronaridine/Artesunate and Ritonavir in Healthy Volunteers

    OpenAIRE

    Morris, Carrie A.; Lopez-Lazaro, Luis; Jung, Donald; Methaneethorn, Janthima; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Pokorny, Rolf; Shin, Chang-Sik; Fleckenstein, Lawrence

    2012-01-01

    A multiple dose, parallel group study was conducted to assess for a drug-drug interaction between the pyronaridine/artesunate (PA) combination antimalarial and ritonavir. Thirty-four healthy adults were randomized (1:1) to receive PA for 3 days or PA with ritonavir (100 mg twice daily for 17 days, PA administered on Days 8–10). Pharmacokinetic parameters for pyronaridine, artesunate, and its active metabolite dihydroartemisinin (DHA) were obtained after the last PA dose and for ritonavir on D...

  20. Anti-malarial efficacy of pyronaridine and artesunate in combination in vitro and in vivo.

    Science.gov (United States)

    Vivas, Livia; Rattray, Lauren; Stewart, Lindsay; Bongard, Emily; Robinson, Brian L; Peters, Wallace; Croft, Simon L

    2008-03-01

    Pyronaridine is a Mannich base anti-malarial with demonstrated efficacy against drug resistant Plasmodium falciparum, P. vivax, P. ovale and P. malariae. However, resistance to pyronaridine can develop quickly when it is used alone but can be considerably delayed when it is administered with artesunate in rodent malaria models. The aim of this study was to evaluate the efficacy of pyronaridine in combination with artesunate against P. falciparum in vitro and in rodent malaria models in vivo to support its clinical application. Pyronaridine showed consistently high levels of in vitro activity against a panel of six P. falciparum drug-sensitive and resistant strains (Geometric Mean IC50=2.24 nM, 95% CI=1.20-3.27). In vitro interactions between pyronaridine and artesunate showed a slight antagonistic trend, but in vivo compared to pyronaridine and artesunate administered alone, the 3:1 ratio of the combination, reduced the ED90 of artesunate by approximately 15.6-fold in a pyronaridine-resistant P. berghei line and by approximately 200-fold in an artesunate-resistant line of P. berghei. Complete cure rates were achieved with doses of the combination above or equal to 8 mg/kg per day against P. chabaudi AS. These results indicate that the combination had an enhanced effect over monotherapy and lower daily doses of artesunate could be used to obtain a curative effect. The data suggest that the combination of pyronaridine and artesunate should have potential in areas of multi-drug resistant malaria.

  1. Reduced susceptibility of Plasmodium falciparum to artesunate in southern Myanmar.

    Directory of Open Access Journals (Sweden)

    Myat P Kyaw

    Full Text Available BACKGROUND: Plasmodium falciparum resistance to artemisinins, the first line treatment for malaria worldwide, has been reported in western Cambodia. Resistance is characterized by significantly delayed clearance of parasites following artemisinin treatment. Artemisinin resistance has not previously been reported in Myanmar, which has the highest falciparum malaria burden among Southeast Asian countries. METHODS: A non-randomized, single-arm, open-label clinical trial of artesunate monotherapy (4 mg/kg daily for seven days was conducted in adults with acute blood-smear positive P. falciparum malaria in Kawthaung, southern Myanmar. Parasite density was measured every 12 hours until two consecutive negative smears were obtained. Participants were followed weekly at the study clinic for three additional weeks. Co-primary endpoints included parasite clearance time (the time required for complete clearance of initial parasitemia, parasite clearance half-life (the time required for parasitemia to decrease by 50% based on the linear portion of the parasite clearance slope, and detectable parasitemia 72 hours after commencement of artesunate treatment. Drug pharmacokinetics were measured to rule out delayed clearance due to suboptimal drug levels. RESULTS: The median (range parasite clearance half-life and time were 4.8 (2.1-9.7 and 60 (24-96 hours, respectively. The frequency distributions of parasite clearance half-life and time were bimodal, with very slow parasite clearance characteristic of the slowest-clearing Cambodian parasites (half-life longer than 6.2 hours in approximately 1/3 of infections. Fourteen of 52 participants (26.9% had a measurable parasitemia 72 hours after initiating artesunate treatment. Parasite clearance was not associated with drug pharmacokinetics. CONCLUSIONS: A subset of P. falciparum infections in southern Myanmar displayed markedly delayed clearance following artemisinin treatment, suggesting either emergence of

  2. Reduced Susceptibility of Plasmodium falciparum to Artesunate in Southern Myanmar

    Science.gov (United States)

    Kyaw, Myat P.; Nyunt, Myat H.; Chit, Khin; Aye, Moe M.; Aye, Kyin H.; Aye, Moe M.; Tarning, Joel; Imwong, Mallika; Jacob, Christopher G.; Rasmussen, Charlotte; Perin, Jamie; Ringwald, Pascal; Nyunt, Myaing M.

    2013-01-01

    Background Plasmodium falciparum resistance to artemisinins, the first line treatment for malaria worldwide, has been reported in western Cambodia. Resistance is characterized by significantly delayed clearance of parasites following artemisinin treatment. Artemisinin resistance has not previously been reported in Myanmar, which has the highest falciparum malaria burden among Southeast Asian countries. Methods A non-randomized, single-arm, open-label clinical trial of artesunate monotherapy (4 mg/kg daily for seven days) was conducted in adults with acute blood-smear positive P. falciparum malaria in Kawthaung, southern Myanmar. Parasite density was measured every 12 hours until two consecutive negative smears were obtained. Participants were followed weekly at the study clinic for three additional weeks. Co-primary endpoints included parasite clearance time (the time required for complete clearance of initial parasitemia), parasite clearance half-life (the time required for parasitemia to decrease by 50% based on the linear portion of the parasite clearance slope), and detectable parasitemia 72 hours after commencement of artesunate treatment. Drug pharmacokinetics were measured to rule out delayed clearance due to suboptimal drug levels. Results The median (range) parasite clearance half-life and time were 4.8 (2.1–9.7) and 60 (24–96) hours, respectively. The frequency distributions of parasite clearance half-life and time were bimodal, with very slow parasite clearance characteristic of the slowest-clearing Cambodian parasites (half-life longer than 6.2 hours) in approximately 1/3 of infections. Fourteen of 52 participants (26.9%) had a measurable parasitemia 72 hours after initiating artesunate treatment. Parasite clearance was not associated with drug pharmacokinetics. Conclusions A subset of P. falciparum infections in southern Myanmar displayed markedly delayed clearance following artemisinin treatment, suggesting either emergence of artemisinin

  3. Pre-referral rectal artesunate in severe malaria: flawed trial

    Directory of Open Access Journals (Sweden)

    Premji Zulfiqarali G

    2011-08-01

    Full Text Available Abstract Background Immediate injectable treatment is essential for severe malaria. Otherwise, the afflicted risk lifelong impairment or death. In rural areas of Africa and Asia, appropriate care is often miles away. In 2009, Melba Gomes and her colleagues published the findings of a randomized, placebo-controlled trial of rectal artesunate for suspected severe malaria in such remote areas. Enrolling nearly 18,000 cases, the aim was to evaluate whether, as patients were in transit to a health facility, a pre-referral artesunate suppository blocked disease progression sufficiently to reduce these risks. The affirmative findings of this, the only trial on the issue thus far, have led the WHO to endorse rectal artesunate as a pre-referral treatment for severe malaria. In the light of its public health importance and because its scientific quality has not been assessed for a systematic review, our paper provides a detailed evaluation of the design, conduct, analysis, reporting, and practical features of this trial. Results We performed a checklist-based and an in-depth evaluation of the trial. The evaluation criteria were based on the CONSORT statement for reporting clinical trials, the clinical trial methodology literature, and practice in malaria research. Our main findings are: The inclusion and exclusion criteria and the sample size justification are not stated. Many clearly ineligible subjects were enrolled. The training of the recruiters does not appear to have been satisfactory. There was excessive between center heterogeneity in design and conduct. Outcome evaluation schedule was not defined, and in practice, became too wide. Large gaps in the collection of key data were evident. Primary endpoints were inconsistently utilized and reported; an overall analysis of the outcomes was not done; analyses of time to event data had major flaws; the stated intent-to-treat analysis excluded a third of the randomized subjects; the design

  4. Effects of Artesunate on Tracheal Smooth Muscle from the Guinea—pig

    Institute of Scientific and Technical Information of China (English)

    Mao-ShengYang; Jian-ChuXiao

    1997-01-01

    Artesunae is a derivative of qinghaosu,with a sesquiterpene structure.The specific action and the clinical uses of artesunate are on the preliminary stage,on the one hand ,artesunate has specific action of both antiinflammation and antivirus,and also has protective effect on the pulmonary alveolar macrophages,whuich may be advantageous to the treatment of the airway non-specific inflammation of asthma,.On the other hand,qinghaousu has the activities to relax vascular smooth muscle and to cause hypotension.The expectorant action,the antitussive action and the antuiasthmatic action of qinghaosu were preported.Artesunate may also have antiasthmatic activity,because the antimalarial potency of artesunate is stronger than that of qinghaosu,and Artesunate can block Ca2+ influx by inhibiting calcium-dependent chloride current.The main aims of this paper are to investigate the site,the mode,and the mechanism of artesunate action on isolated tracheal smooth muscle from the guinea-pig.

  5. Nrf2 inhibition reverses the resistance of cisplatin-resistant head and neck cancer cells to artesunate-induced ferroptosis

    Directory of Open Access Journals (Sweden)

    Jong-Lyel Roh

    2017-04-01

    Condensed abstract: Our results show the effectiveness and molecular mechanism of artesunate treatment on head and neck cancer (HNC. Artesunate selectively killed HNC cells but not normal cells by inducing an iron-dependent, ROS-accumulated ferroptosis. However, this effect may be suboptimal in some cisplatin-resistant HNCs because of Nrf2–antioxidant response element (ARE pathway activation. Inhibition of the Nrf2–ARE pathway increased artesunate sensitivity and reversed the ferroptosis resistance in resistant HNC cells.

  6. Artesunate induces AIF-dependent apoptosis in A549 cells

    Science.gov (United States)

    Zhou, Chen-juan; Chen, Tong-Sheng

    2012-03-01

    Artesunate (ART), a semi-synthetic derivative of the sesquiterpene artemisinin extracted from the Chinese herb Artemisia annua, exerts a broad spectrum of clinical activity against human cancers. It has been shown that ART induces cancer cells death through apoptosis pathway. This study investigated whether ART treatment induced reactive oxygen species (ROS)-dependent cell death in the apoptosis fashion in human lung adenocarconoma A549 cell line and the proapoptotic protein apoptosis inducing factor (AIF) is involved in ART-induced apoptosis. Cells treated with ART exhibited typical apoptotic morphology as chromatin condensation, margination and shrunken nucleus. ART treatment also induced a loss of mitochondrial membrane potential and AIF release from mitochondria. Silencing AIF can remarkable attenuated ART-induced apoptosis. Collectively, ART induces apoptosis by caspase-independent intrinsic pathway in A549 cells.

  7. Artesunate prevents rats from the clozapine-induced hepatic steatosis and elevation in plasma triglycerides

    Directory of Open Access Journals (Sweden)

    Li Y

    2017-09-01

    Full Text Available Yanmei Li,1,2 Ruibing Su,3 Shuqin Xu,2 Qingjun Huang,1 Haiyun Xu1,2 1The Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, People’s Republic of China; 2Department of Anatomy, Shantou University Medical College, Shantou, Guangdong Province, People’s Republic of China; 3Department of Forensics and Pathology, Shantou University Medical College, Shantou, Guangdong Province, People’s Republic of China Abstract: Clozapine is an atypical antipsychotic with therapeutic efficacy in treatment-resistant schizophrenia patients and low incidence of extrapyramidal side effects. However, the use of clozapine has been limited by its adverse effects on metabolism. Artesunate is a semisynthetic derivative of artemisinin and was shown to decrease the plasma cholesterol and triglyceride in rabbits and rats in recent studies. The aim of this study was to examine possible effects of artesunate on the clozapine-induced metabolic alterations in rats given saline, clozapine, artesunate, or clozapine plus artesunate for 6 weeks. The clozapine group showed significantly high plasma levels of triglyceride, hepatic steatosis, and fibrosis along with high levels of C-reactive protein, alanine aminotransferase, and aspartate aminotransferase compared to the saline group. But the treatment had no effect on weight gain and caused no hyperglycemia, hyperinsulinemia, and behavioral changes in the rats. More significantly, these clozapine-induced changes were not seen in rats coadministered with clozapine plus artesunate. These results added evidence supporting psychiatrists to try add-on treatment of artesunate in schizophrenia patients to ameliorate clozapine-induced adverse metabolic effects. Keywords: artesunate, clozapine, dyslipidemia, hepatic steatosis, schizophrenia 

  8. Ethics and quality assessment of cowpea grains sold in southern ...

    African Journals Online (AJOL)

    International Journal of Tropical Agriculture and Food Systems ... Specifically, quality status; grades of cowpea grains sold and effect of ethics on sales, quality and price ... The consumers can increase their utility by 25% without an increase in ...

  9. China-made Oil Rigs Well Sold on International Market

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ By the end of July, ChinaPetroleum Technology Development Company (CPTDC), one of CNPC's subsidiaries, has cumulatively sold 26 oil drilling rigs worth more than US$200 million in the past three years.

  10. Sources of Microbial Contamination of Local Herbal Medicines Sold ...

    African Journals Online (AJOL)

    East and Central African Journal of Pharmaceutical Sciences. Vol. ... herbalists, 70 % personally processed the herbal medicines they sold. Most of ... primary health care. Despite ... of infection especially for products used on open wounds and ...

  11. Bacteriological Quality Assessment of some Yoghurt Brands Sold in ...

    African Journals Online (AJOL)

    Bacteriological Quality Assessment of some Yoghurt Brands Sold in Kaduna Metropolis. ... Journal of Research in National Development ... Twenty samples of different brands were purchased and analysed in the laboratory for pH, ...

  12. Antimalarial activity of Ageratum conyzoides in combination with chloroquine and artesunate

    Institute of Scientific and Technical Information of China (English)

    Ukwe Chinwe V; Ekwunife Obinna I; Epueke Ebele A; Ubaka Chukwuemeka M

    2010-01-01

    Objective: To determine the suppressive and curative activity of aqueous leaf extract of Ageratum conyzoides (A. conyzoides) in combination with chloroquine and artesunate, respectively against Plasmodium berghei infection in mice. Methods: Using malaria (Plasmodium berghei) infected albino mice of both sexes, aqueous extracts of A. conyzoides in combination with chloroquine and artesunate were tested for antimalarial activity, respectively. Four-day suppressive test and Rane's curative test were carried out. Results: Suppressive tests showed significant dose dependent reduction in parasitemia level produced by the extract-chloroquine and extract-artesunate combinations. Suppressive activities of both extract-drug combinations were greater than the individual drugs alone. Extract-chloroquine (100:5) produced the highest suppressive effect (98% suppression). Curative tests showed absolute survival in two extract-drug combinations. Two extract-drug combinations produced higher curative effects than the individual drugs alone. The highest dose combinations of extract-chloroquine (100:5) and extract-artesunate (100:5) produced absolute parasitemia clearance (cure) in the infected mice. Conclusions: The study indicated that aqueous extract of A. conyzoides had the ability to potentiate the antimalarial activity of chloroquine and artesunate against induced plasmodiasis in mice. It contributes a lot in the malaria endemic and poverty stricken tropics.

  13. Synergistic Inhibition of Angiogenesis by Artesunate and Captopril In Vitro and In Vivo

    Directory of Open Access Journals (Sweden)

    Benjamin Krusche

    2013-01-01

    Full Text Available Inhibition of angiogenesis represents one major strategy of cancer chemotherapy. In the present investigation, we investigated the synergism of artesunate and captopril to inhibit angiogenesis. Artesunate is an antimalarial derivative of artemisinin from the Chinese medicinal plant, Artemisia annua L., which also reveals profound anticancer activity in vitro and in vivo. Captopril is an angiotensin I-converting (ACE inhibitor, which is well established in Western academic medicine. Both compounds inhibited migration of human umbilical vein endothelial cells (HUVECs in vitro. The combination of both drugs resulted in synergistically inhibited migration. Whereas artesunate inhibited HUVEC growth in the XTT assay, captopril did not, indicating independent modes of action. We established a chorioallantoic membrane (CAM assay of quail embryos (Coturnix coturnix L. and a computer-based evaluation routine for quantitative studies on vascularization processes in vivo. Artesunate and captopril inhibited blood vessel formation and growth. For the first time, we demonstrated that both drugs revealed synergistic effects when combined. These results may also have clinical impact, since cardiovascular diseases and cancer frequently occur together in older cancer patients. Therefore, comorbid patients may take advantage, if they take captopril to treat cardiovascular symptoms and artesunate to treat cancer.

  14. Comparative Efficacy of Quinine and Artesunate in the Treatment of Severe Malaria : A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Nigil Haroon, Kalpesh Amichandwala, Mahesah G. Solu

    2005-01-01

    Full Text Available There is a paucity of head to head studies of quinine and artesunate in Indian patients. A consensus onthe best treatment for severe malaria is lacking. To compare the efficacy of quinine and artesunate insevere falciparum malaria. This is a prospective randomized controlled, opened-labeled trial, conductedin a tertiary care center in western India. Thiry-five patients above the age of 18 years, with asexualforms of plasmodium falciparum in the peripheral smear and satisfying the WHO criteria for severemalaria, formed the study population. On randomization 18 received quinine and 17 artesunate. Theend points of the study were parasite clearance time (PCT, fever clearance time (FCT, coma resolutiontime (CRT, adverse effects of the drugs and death. The FCT (p 0.023 and PCT (p=0.04 were lowerwith artesunate. The CRT was lower with quinine (p 0.03. One patient in each arm succumbed to theillness (p 0.96. There was no side effect warranting a crossover to the other arm. Thus, quinine is asgood as artesunate in the treatment of severe falciparum malaria.

  15. Randomized, multicentre assessment of the efficacy and safety of ASAQ – a fixed-dose artesunate-amodiaquine combination therapy in the treatment of uncomplicated Plasmodium falciparum malaria

    Directory of Open Access Journals (Sweden)

    Diallo Mouctar

    2009-06-01

    Full Text Available Abstract Background The use of artemisinin derivative-based combination therapy (ACT such as artesunate plus amodiaquine is currently recommended for the treatment of uncomplicated Plasmodium falciparum malaria. Fixed-dose combinations are more adapted to patients than regimens involving multiple tablets and improve treatment compliance. A fixed-dose combination of artesunate + amodiaquine (ASAQ was recently developed. To assess the efficacy and safety of this new combination and to define its optimum dosage regimen (once or twice daily in the treatment of uncomplicated P. falciparum malaria, a multicentre clinical study was conducted. Methods A multicentre, randomized, controlled, investigator-blinded, parallel-group study was conducted in five African centers in Cameroon, Madagascar, Mali and Senegal from March to December 2006. Efficacy and safety of ASAQ were assessed compared to those of artemether + lumefantrine (AL. The WHO protocol with a 28-day follow-up for assessing the drug therapeutic efficacy was used. Patients suffering from uncomplicated P. falciparum malaria were randomized to receive ASAQ orally once daily (ASAQ1, ASAQ twice daily (ASAQ2 or AL twice daily (AL for three days. The primary outcome was PCR-corrected parasitological cure rate and clinical response. Results Of 941 patients initially randomized and stratified into two age groups ( Conclusion The non-inferiority of ASAQ compared with AL was demonstrated. The fixed-dose combination artesunate + amodiaquine (ASAQ is safe and efficacious even in young children under 5 years of age. Whilst administration on a twice-a-day basis does not improve the efficacy of ASAQ significantly, a once-a-day intake of this new combination clearly appears as an effective and safe therapy in the treatment of uncomplicated P. falciparum malaria both in adults and children. Implications of such findings are of primary importance in terms of public health especially in African countries. As

  16. Field-adapted sampling of whole blood to determine the levels of amodiaquine and its metabolite in children with uncomplicated malaria treated with amodiaquine plus artesunate combination

    Directory of Open Access Journals (Sweden)

    Gustafsson Lars L

    2009-03-01

    Full Text Available Abstract Background Artemisinin combination therapy (ACT has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, amodiaquine plus artesunate (AQ+AS, is the alternative first-line regimen to Coartem® (artemether + lumefantrine for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Methods Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of amodiaquine and its metabolite in whole blood. Results The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. Conclusion The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of amodiaquine up to 28 days suggested that the method is sensitive enough to monitor amodiaquine utilization in patients. Amodiaquine plus artesunate seems effective for treatment of falciparum malaria.

  17. Artesunate/amodiaquine malaria treatment for Equatorial Guinea (Central Africa).

    Science.gov (United States)

    Charle, Pilar; Berzosa, Pedro; de Lucio, Aida; Raso, José; Nseng Nchama, Gloria; Benito, Agustín

    2013-06-01

    The objectives of this study were: 1) to evaluate the safety and efficacy of combination artesunate (AS)/amodiaquine (AQ) therapy, and 2) to determine the difference between recrudescence and resistance. An in vivo efficacy study was conducted in Equatorial Guinea. A total of 122 children 6-59 months of age from two regional hospitals were randomized and subjected to a 28-day clinical and parasitological follow-up. A blood sample on Whatman paper was taken on Days 0, 7, 14, 21, and 28 or on any day in cases of treatment failure, with the parasite DNA then being extracted for molecular analysis purposes. A total of 4 children were excluded, and 9 cases were lost to follow-up. There were 17 cases of late parasitological failure, 3 cases of late clinical failure, and 89 cases of adequate clinical and parasitological response. The parasitological failure rate was 18.3% (20 of 109) and the success rate 81.70% (95% confidence interval [72.5-87.9%]). After molecular correction, real treatment efficacy stood at 97.3%. Our study showed the good efficacy of combination AS/AQ therapy. This finding enabled this treatment to be recommended to Equatorial Guinea's National Malaria Control Program to change the official treatment policy as of March 2008.

  18. Pharmacokinetics and pharmacodynamics of intravenous artesunate during severe malaria treatment in Ugandan adults

    LENUS (Irish Health Repository)

    Byakika-Kibwika, Pauline

    2012-04-27

    AbstractBackgroundSevere malaria is a medical emergency with high mortality. Prompt achievement of therapeutic concentrations of highly effective anti-malarial drugs reduces the risk of death. The aim of this study was to assess the pharmacokinetics and pharmacodynamics of intravenous artesunate in Ugandan adults with severe malaria.MethodsFourteen adults with severe falciparum malaria requiring parenteral therapy were treated with 2.4 mg\\/kg intravenous artesunate. Blood samples were collected after the initial dose and plasma concentrations of artesunate and dihydroartemisinin measured by solid-phase extraction and liquid chromatography-tandem mass spectrometry. The study was approved by the Makerere University Faculty of Medicine Research and Ethics Committee (Ref2010-015) and Uganda National Council of Science and Technology (HS605) and registered with ClinicalTrials.gov (NCT01122134).ResultsAll study participants achieved prompt resolution of symptoms and complete parasite clearance with median (range) parasite clearance time of 17 (8–24) hours. Median (range) maximal artesunate concentration (Cmax) was 3260 (1020–164000) ng\\/mL, terminal elimination half-life (T1\\/2) was 0.25 (0.1-1.8) hours and total artesunate exposure (AUC) was 727 (290–111256) ng·h\\/mL. Median (range) dihydroartemisinin Cmax was 3140 (1670–9530) ng\\/mL, with Tmax of 0.14 (0.6 – 6.07) hours and T1\\/2 of 1.31 (0.8–2.8) hours. Dihydroartemisinin AUC was 3492 (2183–6338) ng·h\\/mL. None of the participants reported adverse events.ConclusionsPlasma concentrations of artesunate and dihydroartemisinin were achieved rapidly with rapid and complete symptom resolution and parasite clearance with no adverse events.

  19. An artesunate-containing antimalarial treatment regimen did not suppress cytomegalovirus viremia.

    Science.gov (United States)

    Gantt, Soren; Huang, Meei-Li; Magaret, Amalia; Bunts, Lisa; Selke, Stacy; Wald, Anna; Rosenthal, Philip J; Dorsey, Grant; Casper, Corey

    2013-09-01

    Additional drugs are needed for the treatment of cytomegalovirus (CMV) infection. Artesunate is an antimalarial drug that has activity against CMV in vitro and in a rodent model. Only a small number of case reports are available describing the clinical effects of artesunate on CMV infection, and these yielded inconsistent results. To evaluate the effect of artesunate on CMV infection, using blood samples collected from children who participated in malaria treatment trials. Quantitative CMV DNA PCR was performed on dried blood spots collected from 494 Ugandan children, who were randomized either to artesunate plus amodiaquine or sulfadoxine-pyrimethamine plus amodiaquine for acute malaria infection. Poisson regression was used to compare treatment regimens with respect to the change in the frequency and quantity of CMV detected that occurred before and after treatment. CMV was detected in 11.4% of children immediately prior to treatment and 10.7% 3 days later (p=0.70). The average quantity of CMV was 0.30 log10 copies per million cells higher on day 3 than at treatment initiation (95% CI 0.01-0.58, p=0.041). There was no measurable difference in either the frequency or quantity of CMV detected in blood between children randomized to the two treatment arms. A standard 3-day artesunate-containing antimalarial regimen had no detectable effect on CMV viremia in children with malaria. Longer treatment courses and/or higher doses of artesunate than those routinely used for malaria may be required for effective treatment of CMV infection. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Nanoparticle Delivery of Artesunate Enhances the Anti-tumor Efficiency by Activating Mitochondria-Mediated Cell Apoptosis

    Science.gov (United States)

    Liu, Rui; Yu, Xiwei; Su, Chang; Shi, Yijie; Zhao, Liang

    2017-06-01

    Artemisinin and its derivatives were considered to exert a broad spectrum of anti-cancer activities, and they induced significant anti-cancer effects in tumor cells. Artemisinin and its derivatives could be absorbed quickly, and they were widely distributed, selectively killing tumor cells. Since low concentrations of artesunate primarily depended on oncosis to induce cell death in tumor cells, its anti-tumor effects were undesirable and limited. To obtain better anti-tumor effects, in this study, we took advantage of a new nanotechnology to design novel artesunate-loaded bovine serum albumin nanoparticles to achieve the mitochondrial accumulation of artesunate and induce mitochondrial-mediated apoptosis. The results showed that when compared with free artesunate's reliance on oncotic death, artesunate-loaded bovine serum albumin nanoparticles showed higher cytotoxicity and their significant apoptotic effects were induced through the distribution of artesunate in the mitochondria. This finding indicated that artesunate-loaded bovine serum albumin nanoparticles damaged the mitochondrial integrity and activated mitochondrial-mediated cell apoptosis by upregulating apoptosis-related proteins and facilitating the rapid release of cytochrome C.

  1. Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with malaria

    Directory of Open Access Journals (Sweden)

    Bose Carl

    2011-05-01

    Full Text Available Abstract Background The World Health Organization endorses the use of artemisinin-based combination therapy for treatment of acute uncomplicated falciparum malaria in the second and third trimesters of pregnancy. However, the effects of pregnancy on the pharmacokinetics of artemisinin derivatives, such as artesunate (AS, are poorly understood. In this analysis, the population pharmacokinetics of oral AS, and its active metabolite dihydroartemisinin (DHA, were studied in pregnant and non-pregnant women at the Kingasani Maternity Clinic in the DRC. Methods Data were obtained from 26 pregnant women in the second (22 - 26 weeks or the third (32 - 36 weeks trimester of pregnancy and from 25 non-pregnant female controls. All subjects received 200 mg AS. Plasma AS and DHA were measured using a validated LC-MS method. Estimates for pharmacokinetic and variability parameters were obtained through nonlinear mixed effects modelling. Results A simultaneous parent-metabolite model was developed consisting of mixed zero-order, lagged first-order absorption of AS, a one-compartment model for AS, and a one-compartment model for DHA. Complete conversion of AS to DHA was assumed. The model displayed satisfactory goodness-of-fit, stability, and predictive ability. Apparent clearance (CL/F and volume of distribution (V/F estimates, with 95% bootstrap confidence intervals, were as follows: 195 L (139-285 L for AS V/F, 895 L/h (788-1045 L/h for AS CL/F, 91.4 L (78.5-109 L for DHA V/F, and 64.0 L/h (55.1-75.2 L/h for DHA CL/F. The effect of pregnancy on DHA CL/F was determined to be significant, with a pregnancy-associated increase in DHA CL/F of 42.3% (19.7 - 72.3%. Conclusions In this analysis, pharmacokinetic modelling suggests that pregnant women have accelerated DHA clearance compared to non-pregnant women receiving orally administered AS. These findings, in conjunction with a previous non-compartmental analysis of the modelled data, provide further evidence that

  2. Pharmacokinetic interaction between pyronaridine-artesunate and metoprolol.

    Science.gov (United States)

    Morris, Carrie A; Pokorny, Rolf; Lopez-Lazaro, Luis; Miller, Robert M; Arbe-Barnes, Sarah; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Shin, Jang-Sik; Fleckenstein, Lawrence

    2014-10-01

    The objectives of this study were to characterize any drug-drug interaction between the antimalarial Pyramax (pyronaridine-artesunate [PA]) and the CYP2D6 probe substrate metoprolol and to assess the safety of 60-day or 90-day PA redosing, particularly with regard to liver biochemistry parameters. Healthy adult subjects were randomized to arm A (n = 26) or arm B (n = 30), with the arm A subjects administered 100 mg metoprolol tartrate in the first period, 100 mg metoprolol tartrate with the third of three daily doses of PA in the second period, and three daily doses of PA alone in the 90-day redosing period. The arm B subjects received the three-day PA regimen in the first period, with redosing of the regimen after 60 days in the second period. The noncompartmental pharmacokinetic parameters were computed for metoprolol, its metabolite alpha-hydroxymetoprolol, and pyronaridine. The coadministration of metoprolol and PA was associated with an average 47.93% (90% confidence interval [CI], 30.52, 67.66) increase in the maximum concentration of metoprolol and a 25.60% (90% CI, 15.78, 36.25) increase in the metoprolol area under the concentration-time curve from time zero to the last quantifiable concentration obtained (AUC0-t); these increases most likely resulted from pyronaridine-mediated CYP2D6 inhibition. No interaction effect of metoprolol with pyronaridine was apparent. Following dosing with PA, some subjects experienced rises in liver function tests above the upper limit of normal during the first few days following PA administration. All such elevations resolved typically within 10 days, and up to 30 days at most. In subjects who were redosed, the incidences of alanine aminotransferase (ALT) or aspartate transaminase (AST) level elevations were similar on the first and second administrations, with no marked difference between the 60-day and 90-day redosing.

  3. HPTLC determination of artesunate as bulk drug and in pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    Agarwal S

    2007-01-01

    Full Text Available A new, simple, rapid, accurate and precise HPTLC method has been developed for the estimation of artesunate in bulk and pharmaceutical formulations. The study employs silica gel F 254 as stationary phase on aluminium foil and mobile phase comprising toluene: ethyl acetate: acetic acid (2:8:0.2. Vanillin (1% in sulphuric acid (5% in ethanolic solution gave prominent well-resolved pink colour spot for artesunate, which was stable for more than a day. The densitometric analysis was carried out in the absorbance mode at 520 nm and symmetrical, well-resolved, well-defined peaks were obtained. The Rf value for artesunate was found to be 0.44. The linear detector response for artesunate was observed between 100-600 ng per spot and the calibration plots showed good linear relationship with coefficient of regression, r= 0.9989 with respect to peak area. The method was validated for precision, recovery and robustness. The limits of detection and quantitation were 30 ng/spot and 90 ng/spot, respectively. The recovery study was carried out by standard addition method and the recovery was found to be 99.89±1.006. Recovery from tablets was 98.88 (±0.55 and from injection, it was 98.83 (±0.60 of the labeled amount.

  4. Drug-drug interaction analysis of pyronaridine/artesunate and ritonavir in healthy volunteers.

    Science.gov (United States)

    Morris, Carrie A; Lopez-Lazaro, Luis; Jung, Donald; Methaneethorn, Janthima; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Pokorny, Rolf; Shin, Chang-Sik; Fleckenstein, Lawrence

    2012-03-01

    A multiple dose, parallel group study was conducted to assess for a drug-drug interaction between the pyronaridine/artesunate (PA) combination antimalarial and ritonavir. Thirty-four healthy adults were randomized (1:1) to receive PA for 3 days or PA with ritonavir (100 mg twice daily for 17 days, PA administered on Days 8-10). Pharmacokinetic parameters for pyronaridine, artesunate, and its active metabolite dihydroartemisinin (DHA) were obtained after the last PA dose and for ritonavir on Days 1 and 10. Ritonavir coadministration did not markedly change pyronaridine pharmacokinetics but resulted in a 27% increase in artesunate area under the curve (AUC) and a 38% decrease in DHA AUC. Ritonavir exposure was increased 3.2-fold in the presence of PA. The only relevant safety observations were increases in liver enzymes, only reaching a clinically significant grade in the PA + ritonavir arm. It was concluded that coadministered ritonavir and PA interact to alter exposure to artesunate, DHA, and ritonavir itself.

  5. The in vitro antimalarial interaction of 9-hydroxycalabaxanthone and α-mangostin with mefloquine/artesunate.

    Science.gov (United States)

    Chaijaroenkul, Wanna; Na-Bangchang, Kesara

    2014-03-01

    Multidrug resistance Plasmodium falciparum is the major health problem in Thailand. Discovery and development of new antimalarial drugs with novel modes of action is urgently required. The aim of the present study was to investigate the antimalarial interaction of 9-hydroxycalabaxanthone and α-mangostin with the standard antimalarial drugs mefloquine and artesunate in chloroquine sensitive (3D7) and chloroquine resistant (K1) P. falciparum clones in vitro. Median (range) IC50 (drug concentration which produces 50% parasite growth inhibition) values of the 9-hydroxycalabaxanthone, α-mangostin, artesunate and mefloquine for 3D7 vs K1 clones were 1.5 (0.9-2.1) vs 1.2 (1.1-1.6) μM, 17.9 (15.7.0-20.0) vs 9.7 (6.0-14.0) μM, 1.0 (0.4-3.0) vs 1.7 (1.0-2.5) nM, and 13.3 (11.1-13.3) vs 7.1 (6.7-12.2) nM, respectively. Analysis of isobologram and combination index (CI) of 9-hydroxycalabaxanthone with artesunate or mefloquine showed synergistic and indifference antimalarial interaction, respectively. α-mangostin-artesunate combination exhibited a slight antagonistic effect of antimalarial interaction, whereas α-mangostin and mefloquine combination showed indifference interaction in both clones. The combination of 9-hydroxycalabaxanthone with α-mangostin showed the synergistic antimalarial interaction in both clones.

  6. Treatment of imported severe malaria with artesunate instead of quinine--more evidence needed?

    NARCIS (Netherlands)

    Cramer, J.P.; López-Vélez, R.; Burchard, G.D.; Grobusch, M.P.; de Vries, P.J.

    2011-01-01

    Rapid and fast acting anti-malarials are essential to treat severe malaria. Quinine has been the only option for parenteral therapy until recently. While current evidence shows that intravenous artesunate is more effective than quinine in treating severe malaria in endemic countries, some questions

  7. Treatment of imported severe malaria with artesunate instead of quinine--more evidence needed?

    NARCIS (Netherlands)

    Cramer, J.P.; López-Vélez, R.; Burchard, G.D.; Grobusch, M.P.; de Vries, P.J.

    2011-01-01

    Rapid and fast acting anti-malarials are essential to treat severe malaria. Quinine has been the only option for parenteral therapy until recently. While current evidence shows that intravenous artesunate is more effective than quinine in treating severe malaria in endemic countries, some questions

  8. gross behavioral effects of acute doses of artesunate in wistar rats

    African Journals Online (AJOL)

    doses, and two test animals were administered with one of the doses following which they were observed ... significant. Behavioral excitatory effects were observed at lower doses of artesunate in mainly ... aged and old mice and female rats has been .... stimulation of dopamine transmission. ... parasite in continuous culture.

  9. A comparative study on the impact of two artemisinin derivatives, artemether and artesunate, on the female reproductive system of Fasciola hepatica.

    Science.gov (United States)

    O'Neill, J F; Johnston, R C; Halferty, L; Hanna, R E B; Brennan, G P; Fairweather, I

    2015-07-30

    An in vivo study in the laboratory rat model has been carried out to monitor changes to the female reproductive system in adult Fasciola hepatica following treatment with the artemisinins, artemether and artesunate. Rats infected with the triclabendazole (TCBZ)-resistant Sligo isolate were dosed orally with artemether at a concentration of 200mg/kg and flukes recovered at 24, 48 and 72 h post-treatment (pt). Rats infected with the TCBZ-resistant Oberon isolate were dosed orally with artesunate at a concentration of 200mg/kg and flukes recovered 24, 48, 72 and 96 h pt. The flukes were processed for histological and transmission electron microscope (TEM) examination of the uterus, Mehlis' gland, ovary and vitellaria. After treatment with artemether, egg production had become abnormal by 72 h pt, with free vitelline cells and masses of shell protein material within the uterus; spermatozoa were absent. The Mehlis' gland and ovary retained a normal morphology over the 3-day period. A change in the cell population in the vitelline follicles was seen at 48 h pt, with a decline in the number of immature cells. This became more marked by 72 h and the follicles became progressively vacuolated over the 3-day period. At the TEM level, there were changes in the immature vitelline cells at 24h pt, as evidenced by a decrease in shell protein production and the presence of lipid droplets and abnormal mitochondria. Spaces in the follicles separated the cells from each other. The changes became progressively more severe with time, so that, by 72 h pt, the follicles were very disrupted, containing cells in the advanced stages of apoptotic breakdown. In extreme cases, the follicles were scarcely recognisable and had become filled with cellular debris. Fine structural changes to the vitelline cells induced by artesunate treatment were similar to those described for artemether, but generally occurred more quickly and were greater; this was particularly true of the swelling of the ger

  10. In vitro action of antiparasitic drugs, especially artesunate, against Toxoplasma gondii

    Directory of Open Access Journals (Sweden)

    Thaís Cobellis Gomes

    2012-08-01

    Full Text Available INTRODUCTION: Toxoplasmosis is usually a benign infection, except in the event of ocular, central nervous system (CNS, or congenital disease and particularly when the patient is immunocompromised. Treatment consists of drugs that frequently cause adverse effects; thus, newer, more effective drugs are needed. In this study, the possible activity of artesunate, a drug successfully being used for the treatment of malaria, on Toxoplasma gondii growth in cell culture is evaluated and compared with the action of drugs that are already being used against this parasite. METHODS: LLC-MK2 cells were cultivated in RPMI medium, kept in disposable plastic bottles, and incubated at 36ºC with 5% CO2. Tachyzoites of the RH strain were used. The following drugs were tested: artesunate, cotrimoxazole, pentamidine, pyrimethamine, quinine, and trimethoprim. The effects of these drugs on tachyzoites and LLC-MK2 cells were analyzed using nonlinear regression analysis with Prism 3.0 software. RESULTS: Artesunate showed a mean tachyzoite inhibitory concentration (IC50 of 0.075µM and an LLC MK2 toxicity of 2.003µM. Pyrimethamine was effective at an IC50 of 0.482µM and a toxicity of 11.178µM. Trimethoprim alone was effective against the in vitro parasite. Cotrimoxazole also was effective against the parasite but at higher concentrations than those observed for artesunate and pyrimethamine. Pentamidine and quinine had no inhibitory effect over tachyzoites. CONCLUSIONS: Artesunate is proven in vitro to be a useful alternative for the treatment of toxoplasmosis, implying a subsequent in vivo effect and suggesting the mechanism of this drug against the parasite.

  11. In vitro bioequivalence study of nine brands of artesunate tablets marketed in Nigeria

    Directory of Open Access Journals (Sweden)

    C.O. Esimone

    2008-02-01

    Full Text Available Background & objectives: The availability of numerous brands of artesunate in our drug market today places clinicians and pharmacists in a difficult situation of choice of a suitable brand or the possibility of alternative use. The aim of the present study was to predict the bioequivalence of nine brands of artesunate tablets marketed in Nigeria using in vitro tests. Methods: The in vitro dissolution study was carried out on the nine brands of artesunate tablets using the basket method according to US Pharmacopoeia (USP guidelines. Other general quality assessment tests like hardness and disintegration time were also determined.Results: All the brands tested passed the British Pharmacopoeia (BP standard for disintegration time. Only AT2, AT4, AT6 and AT9 passed the standard for hardness. There were significant differences in the dissolution profiles of the nine brands. All the brands except AT1, however, released >70% of artesunate within 30 min. Four of the brands AT5, AT6, AT7 and AT8 exhibited >90% dissolution in <10 min. The other brands AT1, AT2, AT3, AT4 and AT9 (innovator brand have calculated similarity factors of 23.8, 59.8, 50, 54.8 and 100.Interpretation & conclusion: Based on the in vitro tests, AT5, AT6, AT7 and AT8 are considered bioequivalent and interchangeable, while AT2, AT3 and AT4 are considered bioequivalent and interchangeable with the innovator brand (AT9. AT1 has very low dissolution rate, which will likely result in poor bioavailability. The results show the need for constant monitoring of new brands of artesunate introduced into the drug market to ascertain bioequivalence and conformity with pharmacopoeia standards.

  12. Antiviral effects of artesunate on JC polyomavirus replication in COS-7 cells.

    Science.gov (United States)

    Sharma, Biswa Nath; Marschall, Manfred; Rinaldo, Christine Hanssen

    2014-11-01

    The human JC polyomavirus (JCPyV) causes the fatal demyelinating disease progressive multifocal leukoencephalopathy (PML). A growing number of patients with induced or acquired immunosuppression are at risk for infection, and no effective antiviral therapy is presently available. The widely used antimalarial drug artesunate has shown broad antiviral activity in vitro but limited clinical success. The aim of this study was to investigate the effect of artesunate on JCPyV replication in vitro. The permissivity for JCPyV MAD-4 was first compared in four cell lines, and the monkey kidney cell line COS-7 was selected. Artesunate caused a concentration-dependent decrease in the extracellular JCPyV DNA load 96 h postinfection, with a 50% effective concentration (EC50) of 2.9 μM. This effect correlated with a decreased expression of capsid protein VP1 and a reduced release of infectious viral progeny. For concentrations of <20 μM, transient reductions in cellular DNA replication and proliferation were seen, while for higher concentrations, some cytotoxicity was detected. A selective index of 16.6 was found when cytotoxicity was calculated based on cellular DNA replication in the mock-infected cells, but interestingly, cellular DNA replication in the JCPyV-infected cells was more strongly affected. In conclusion, artesunate is efficacious in inhibiting JCPyV replication at micromolar concentrations, which are achievable in plasma. The inhibition at EC50 probably reflects an effect on cellular proteins and involves transient cytostatic effects. Our results, together with the favorable distribution of the active metabolite dihydroartemisinin to the central nervous system, suggest a potential use for artesunate in patients with PML.

  13. Medicinal plants sold at the El Rio Market, Camaguey, Cuba

    NARCIS (Netherlands)

    Godinez-Caraballo, D.; Volpato, G.

    2008-01-01

    Information regarding medicinal plants sold in the El Rio Market, Camaguey, Cuba, revealed 184 species belonging to 69 vascular plant families. The most important family was Fabaceae s.l. with 13 species, followed by Lamiaceae with 12, and Asteraceae with 8. More than 90 general medicinal indication

  14. Medicinal plants sold at the El Rio Market, Camaguey, Cuba

    NARCIS (Netherlands)

    Godinez-Caraballo, D.; Volpato, G.

    2008-01-01

    Information regarding medicinal plants sold in the El Rio Market, Camaguey, Cuba, revealed 184 species belonging to 69 vascular plant families. The most important family was Fabaceae s.l. with 13 species, followed by Lamiaceae with 12, and Asteraceae with 8. More than 90 general medicinal

  15. Assessment of organochlorine pesticides residues in fish sold in ...

    African Journals Online (AJOL)

    African Journal of Food, Agriculture, Nutrition and Development ... the organochlorine pesticide residues in fish sold in markets and fishing sites in Abidjan, ... analyzed, at various concentrations ranging from 0.4 to 14.4 μg.kg-1 of fresh product.

  16. Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi

    Directory of Open Access Journals (Sweden)

    Dismas Baza

    2011-02-01

    Full Text Available Abstract Background Malaria is the leading cause of morbidity and mortality in post-conflict Burundi. To counter the increasing challenge of anti-malarial drug resistance and improve highly effective treatment Burundi adopted artesunate-amodiaquine (AS-AQ as first-line treatment for uncomplicated Plasmodium falciparum malaria and oral quinine as second-line treatment in its national treatment policy in 2003. Uptake of this policy in the public, private and non-governmental (NGO retail market sectors of Burundi is relatively unknown. This study was conducted to evaluate access to national policy recommended anti-malarials. Methods Adapting a standardized methodology developed by Health Action International/World Health Organization (HAI/WHO, a cross-sectional survey of 70 (24 public, 36 private, and 10 NGO medicine outlets was conducted in three regions of Burundi, representing different levels of transmission of malaria. The availability on day of the survey, the median prices, and affordability (in terms of number of days' wages to purchase treatment of AS-AQ, quinine and other anti-malarials were calculated. Results Anti-malarials were stocked in all outlets surveyed. AS-AQ was available in 87.5%, 33.3%, and 90% of public, private, and NGO retail outlets, respectively. Quinine was the most common anti-malarial found in all outlet types. Non-policy recommended anti-malarials were mainly found in the private outlets (38.9% compared to public (4.2% and NGO (0% outlets. The median price of a course of AS-AQ was US$0.16 (200 Burundi Francs, FBu for the public and NGO markets, and 3.5-fold higher in the private sector (US$0.56 or 700 FBu. Quinine tablets were similarly priced in the public (US$1.53 or 1,892.50 FBu, private and NGO sectors (both US$1.61 or 2,000 FBu. Non-policy anti-malarials were priced 50-fold higher than the price of AS-AQ in the public sector. A course of AS-AQ was affordable at 0.4 of a day's wage in the public and NGO sectors

  17. Anti-malarial drug artesunate attenuates experimental allergic asthma via inhibition of the phosphoinositide 3-kinase/Akt pathway.

    Directory of Open Access Journals (Sweden)

    Chang Cheng

    Full Text Available BACKGROUND: Phosphoinositide 3-kinase (PI3K/Akt pathway is linked to the development of asthma. Anti-malarial drug artesunate is a semi-synthetic derivative of artemisinin, the principal active component of a medicinal plant Artemisia annua, and has been shown to inhibit PI3K/Akt activity. We hypothesized that artesunate may attenuate allergic asthma via inhibition of the PI3K/Akt signaling pathway. METHODOLOGY/PRINCIPAL FINDINGS: Female BALB/c mice sensitized and challenged with ovalbumin (OVA developed airway inflammation. Bronchoalveolar lavage fluid was assessed for total and differential cell counts, and cytokine and chemokine levels. Lung tissues were examined for cell infiltration and mucus hypersecretion, and the expression of inflammatory biomarkers. Airway hyperresponsiveness was monitored by direct airway resistance analysis. Artesunate dose-dependently inhibited OVA-induced increases in total and eosinophil counts, IL-4, IL-5, IL-13 and eotaxin levels in bronchoalveolar lavage fluid. It attenuated OVA-induced lung tissue eosinophilia and airway mucus production, mRNA expression of E-selectin, IL-17, IL-33 and Muc5ac in lung tissues, and airway hyperresponsiveness to methacholine. In normal human bronchial epithelial cells, artesunate blocked epidermal growth factor-induced phosphorylation of Akt and its downstream substrates tuberin, p70S6 kinase and 4E-binding protein 1, and transactivation of NF-κB. Similarly, artesunate blocked the phosphorylation of Akt and its downstream substrates in lung tissues from OVA-challenged mice. Anti-inflammatory effect of artesunate was further confirmed in a house dust mite mouse asthma model. CONCLUSION/SIGNIFICANCE: Artesunate ameliorates experimental allergic airway inflammation probably via negative regulation of PI3K/Akt pathway and the downstream NF-κB activity. These findings provide a novel therapeutic value for artesunate in the treatment of allergic asthma.

  18. Histopathological effects of sub-chronic lamivudine-artesunate co-administration on the liver of diseased adult Wistar rats

    Directory of Open Access Journals (Sweden)

    Temidayo Olutoyin Olurishe

    2011-01-01

    Full Text Available Background: Lamivudine and artesunate are sometimes co administered in HIV-malaria co morbidity. Both drugs are used concurrently in presumptive malaria treatment and simultaneous HIV post exposure prophylaxis. Aim: The aim of this study was to investigate the effect of lamivudine-artesunate co administration on the histology of the liver of diseased adult Wistar rats. Materials and Methods: Five groups of rats of both sexes were used for the study and placed on feed and water ad libitum. Disease state consisted of immunosuppression with cyclophosphamide, and infection with Plasmodium berghei. Group 1 animals served as vehicle control, while group 2 were the diseased controls. Group 3 animals received 20 mg/kg lamivudine for three weeks, while group 4 similarly received 20 mg/kg Lamivudine but also received 10 mg/kg artesunate from day 12. Animals in group 5 received 10 mg/kg artesunate from day 12. All drugs were administered intraperitoneally. The animals were treated for twenty-one days, at the end of which they were sacrificed and their livers fixed in 10% formalin for histological studies. Result: Results from the study show the presence of regions of focal necrosis and perivascular cuffing with animals that received artesunate. Hemosiderosis was a common feature in all the parasitized groups, while fatty degeneration was observed in the group that received artesunate alone. Conclusion: Concurrent lamivudine-artesunate administration resulted in some histopathological changes in the liver. This study suggests there may be considerable histological changes with repeated occurrence of malaria and immunosuppression that may warrant intermittent lamivudine-artesunate administration, and may require evaluation as well as monitoring of liver function during such therapeutic interventions.

  19. Medicinal plants sold at traditional markets in southern Ecuador.

    Science.gov (United States)

    Tinitana, Fani; Rios, Montserrat; Romero-Benavides, Juan Carlos; de la Cruz Rot, Marcelino; Pardo-de-Santayana, Manuel

    2016-07-05

    The traditional markets in southern Ecuador and within the Andean region are especially important for plant resource trading among local people, even since before Spanish colonization; therefore, ethnobotanical studies are currently necessary and important. These strategic spaces persist for the traditional medicine cultural value reflected in the higher consumption of medicinal plants, which span all socioeconomic levels of rural and urban people. The purpose of this study includes the following: 1) to create a novel list of medicinal plants sold at 33 traditional markets; 2) to establish medicinal plant use agreement amongst vendors with the Factor of Informant Consensus (FIC); and 3) to determine the most sold medicinal plant species using the Fidelity Level (FL). This study focus on traditional markets ethnobotany utilizes the largest sample of medicinal plants market vendors up to date in Ecuador, interviewing them at 33 traditional markets, located within the Loja province. In order to determine the most sold medicinal plants and their ethnobotanical information, structured questionnaires and personal conversations were conducted with 196 medicinal plant vendors, and voucher specimens were created. Agreement among vendors about the therapeutic use of medicinal plants was measured using the FIC, and the most sold medicinal plant species were assessed with the FL. This research registered 160 medicinal plant species, grouped in 126 genera and 57 families that were sold in 33 traditional markets. The uses of medicinal plants in southern Ecuador are related to a long history of traditional medicine health practices that has persisted until today as well as high plant diversity. The 53 therapeutic uses recorded were grouped into 12 medical categories that were adapted from the World Health Organization. Three medical categories shared the highest value for FIC = 0.92, which showed a high level of agreement of market vendors for 57 medicinal plant species sold

  20. Post-treatment haemolysis in severe imported malaria after intravenous artesunate: case report of three patients with hyperparasitaemia

    Directory of Open Access Journals (Sweden)

    Rolling Thierry

    2012-05-01

    Full Text Available Abstract Parenteral artesunate has been shown to be a superior treatment option compared to parenteral quinine in adults and children with severe malaria. Little evidence, however, is available on long-term safety. Recently, cases of late-onset haemolysis after parenteral treatment with artesunate have been reported in European travellers with imported Plasmodium falciparum malaria. Therefore, an extended follow-up of adult patients treated for severe imported malaria was started in August 2011 at the University Medical Center Hamburg-Eppendorf. Until January 2012, three patients with hyperparasitaemia (range: 14-21% were included for analysis. In all three patients, delayed haemolysis was detected in the second week after the first dose of intravenous artesunate. Reticulocyte production index remained inadequately low in the 7 – 14 days following the first dose of artesunate despite rapid parasite clearance. Post-treatment haemolysis after parenteral artesunate may be of clinical relevance in particular in imported severe malaria characterized by high parasite levels. Extended follow-up of at least 30 days including controls of haematological parameters after artesunate treatment seems to be indicated. Further investigations are needed to assess frequency and pathophysiological background of this complication.

  1. An investigation of the quality of meat sold in Lesotho

    Directory of Open Access Journals (Sweden)

    T.M. Seeiso

    2009-05-01

    Full Text Available Since the closure of the Lesotho abattoir in 2003, only imported meat can be legally sold. However, it was estimated in 2007 that 80 % of the meat sold at butcheries comes from informal slaughter. The aim of this study was to investigate the situation. The number and location of informal butcheries in Lesotho (n = 143 were recorded and mapped using Geographical Information Systems. Observations (photographs of informal slaughter indicated a lack of hygiene, unskilled slaughtermen and illegal disposal of offal with possible environmental pollution. In addition, a cross-sectional study was undertaken to determine the microbiological quality of meat from randomly selected carcasses (n = 237 of cattle, sheep and pigs from a sample of 44 butcheries, 4 of which were associated with registered supermarkets. As a control, samples for microbiological assay were taken from imported meat originating from carcasses (n = 20 slaughtered at a registered abattoir in South Africa. Of the 44 butcheries investigated only the 4 commercial butcheries associated with supermarkets sold imported meat only; 3 butcheries sold meat inspected at government slaughter slabs (n = 3, while the rest (n = 37 sold both imported and informally slaughtered meat. In terms of Lesotho legislation, informally slaughtered meat is only for home consumption. The bacteriological counts from all samples showed a total bacterial plate count exceeding 30 organisms per mℓ in contrast with the controls which all showed a count less than 5 colonies per mℓ. This was found for both imported and informally slaughtered meat sold in Lesotho. In addition, meat samples from butcheries showed the presence of the potential pathogens Salmonella (n = 2, Staphylococcus aureus (n = 12 and Escherichia coli (n=15. During the study, anthrax was confirmed in 9 human patients, 5 of whom died, after consumption of informally slaughtered livestock. Although no cases of animal abuse were detected, it was

  2. Artesunate Exerts a Direct Effect on Endothelial Cell Activation and NF-κB Translocation in a Mechanism Independent of Plasmodium Killing

    Directory of Open Access Journals (Sweden)

    Mariana C. Souza

    2012-01-01

    Full Text Available Artemisinin and its derivates are an important class of antimalarial drug and are described to possess immunomodulatory activities. Few studies have addressed the effect of artesunate in the murine malaria model or its effect on host immune response during malaria infection. Herein, we study the effect of artesunate treatment and describe an auxiliary mechanism of artesunate in modulating the inflammatory response during experimental malaria infection in mice. Treatment with artesunate did not reduce significantly the parasitemia within 12 h, however, reduced BBB breakdown and TNF-α mRNA expression in the brain tissue of artesunate-treated mice. Conversely, mefloquine treatment was not able to alter clinical features. Notably, artesunate pretreatment failed to modulate the expression of LFA-1 in splenocytes stimulated with parasitized red blood cells (pRBCs in vitro; however, it abrogated the expression of ICAM-1 in pRBC-stimulated endothelial cells. Accordingly, a cytoadherence in vitro assay demonstrated that pRBCs did not adhere to artesunate-treated vascular endothelial cells. In addition, NF-κB nuclear translocation in endothelial cells stimulated with pRBCs was impaired by artesunate treatment. Our results suggest that artesunate is able to exert a protective effect against the P. berghei-induced inflammatory response by inhibiting NF-κB nuclear translocation and the subsequent expression of ICAM-1.

  3. Artesunate Exerts a Direct Effect on Endothelial Cell Activation and NF-κB Translocation in a Mechanism Independent of Plasmodium Killing

    Science.gov (United States)

    Souza, Mariana C.; Paixão, Flávio Henrique Marcolino; Ferraris, Fausto K.; Ribeiro, Isabela; Henriques, Maria das Graças M. O.

    2012-01-01

    Artemisinin and its derivates are an important class of antimalarial drug and are described to possess immunomodulatory activities. Few studies have addressed the effect of artesunate in the murine malaria model or its effect on host immune response during malaria infection. Herein, we study the effect of artesunate treatment and describe an auxiliary mechanism of artesunate in modulating the inflammatory response during experimental malaria infection in mice. Treatment with artesunate did not reduce significantly the parasitemia within 12 h, however, reduced BBB breakdown and TNF-α mRNA expression in the brain tissue of artesunate-treated mice. Conversely, mefloquine treatment was not able to alter clinical features. Notably, artesunate pretreatment failed to modulate the expression of LFA-1 in splenocytes stimulated with parasitized red blood cells (pRBCs) in vitro; however, it abrogated the expression of ICAM-1 in pRBC-stimulated endothelial cells. Accordingly, a cytoadherence in vitro assay demonstrated that pRBCs did not adhere to artesunate-treated vascular endothelial cells. In addition, NF-κB nuclear translocation in endothelial cells stimulated with pRBCs was impaired by artesunate treatment. Our results suggest that artesunate is able to exert a protective effect against the P. berghei-induced inflammatory response by inhibiting NF-κB nuclear translocation and the subsequent expression of ICAM-1. PMID:23097741

  4. Alaska NAD 83 – Supplemental Official Lease Diagram (SOLD) Images

    Data.gov (United States)

    Bureau of Ocean Energy Management, Department of the Interior — This data set contains Supplemental Official Lease Diagram (SOLD) images in Adobe pdf format for areas within the BOEM Alaska Region. Each SOLD describes a single...

  5. Products of Security Inspecting Have Been Sold to Tanzania

    Institute of Scientific and Technical Information of China (English)

    LI; Yong; WANG; Qiang; GAO; Qi; TIAN; Li-jun; YANG; Lu; ZHENG; Yu-lai; GUO; Feng-mei

    2013-01-01

    Products of security inspecting of China Institute of Atomic Energy(CIAE)have been applied to many major sports events,such as Olympics hold at Beijing in 2008 and World Expo hold at Shanghai in2010,and other important places such as Great Hall and National Theatre.Passage-type inspection system of radioactive materials(RMS),portable radionuclide spectrometer(PRIS),and walk-through metal and radioactive materials detector(MRMD)have been sold to the user of Tanzania.

  6. Artesunate-related fever and delayed hemolysis in a returning traveler

    Directory of Open Access Journals (Sweden)

    Jacquelyn S. Lahoud, M.D.

    2015-01-01

    Full Text Available Malaria is a serious and sometimes fatal disease caused by an intraerythrocytic parasite, and is commonly seen in developing countries. Approximately 1500 cases of malaria are diagnosed in the United States each year, mostly in travelers and immigrants returning from endemic areas [1]. There are many different regimens used to treat malaria, some of which are not approved in the USA. The side effects of these medications may not be familiar to physicians in the USA. We report a case of a returning traveler from Nigeria presenting with fever and hemolytic anemia caused by a delayed response to artesunate given 3 weeks earlier while in Nigeria. To our knowledge, there are few cases reported in the United States of hemolytic anemia secondary to artesunate therapy [2].

  7. Artesunate-related fever and delayed hemolysis in a returning traveler.

    Science.gov (United States)

    Lahoud, Jacquelyn S; Lahoud, Oscar B; Lin, Yu Shia; Ghitan, Monica; Chapnick, Edward K; Solomon, William B; Kuhn-Basti, Margaret

    2015-01-01

    Malaria is a serious and sometimes fatal disease caused by an intraerythrocytic parasite, and is commonly seen in developing countries. Approximately 1500 cases of malaria are diagnosed in the United States each year, mostly in travelers and immigrants returning from endemic areas [1]. There are many different regimens used to treat malaria, some of which are not approved in the USA. The side effects of these medications may not be familiar to physicians in the USA. We report a case of a returning traveler from Nigeria presenting with fever and hemolytic anemia caused by a delayed response to artesunate given 3 weeks earlier while in Nigeria. To our knowledge, there are few cases reported in the United States of hemolytic anemia secondary to artesunate therapy [2].

  8. Artesunate: investigational drug for the treatment of severe falciparum malaria in Hawai'i.

    Science.gov (United States)

    Callender, David M; Hsue, Gunther

    2011-04-01

    There are hundreds of millions of cases of malaria each year worldwide resulting in a million deaths. These deaths are mostly due to Plasmodium falciparum. The only Federal Drug Administration approved treatment for severe malaria is intravenous quinidine gluconate. Intravenous quinidine is increasingly unavailable in the United States. In 2007, the Center for Disease Control and Prevention implemented an investigational new drug protocol to allow the use of intravenous artesunate for cases of severe malaria in the United States. The authors present such a case treated under this protocol at Tripler Army Medical Center, Hawai'i. A 49-year-old man presented to Tripler Army Medical Center, Hawai'i in February 2009 with a one-month history of fever, chills, and weight loss. He recently travelled to multiple malaria endemic areas. Physical examination was significant for fever and prostration. Laboratory studies revealed anemia, thrombocytopenia, and a high parasite load of Plasmodium falciparum. A strategic network was activated to obtain and administer intravenous artesunate. His condition rapidly improved as his parasitemia cleared. He was discharged after six days with no adverse medication effects and full recovery upon six-month follow-up. Our patient met the criteria for severe Plasmodium falciparum malaria. He was immediately treated with intravenous artesunate and manifested a quick and durable response to therapy. At present, intravenous artesunate is awaiting Federal Drug Administration approval but available via a strategic network controlled by the Centers for Disease Control and Prevention. This case highlights a common delay in diagnosis, importance of optimal prophylaxis, and attention to travel history as they relate to the development of severe malaria.

  9. Artesunate: Investigational Drug for the Treatment of Severe Falciparum Malaria in Hawai‘i

    Science.gov (United States)

    Hsue, Gunther

    2011-01-01

    Introduction There are hundreds of millions of cases of malaria each year worldwide resulting in a million deaths. These deaths are mostly due to Plasmodium falciparum. The only Federal Drug Administration approved treatment for severe malaria is intravenous quinidine gluconate. Intravenous quinidine is increasingly unavailable in the United States. In 2007, the Center for Disease Control and Prevention implemented an investigational new drug protocol to allow the use of intravenous artesunate for cases of severe malaria in the United States. The authors present such a case treated under this protocol at Tripler Army Medical Center, Hawai‘i. Case Report A 49-year-old man presented to Tripler Army Medical Center, Hawai‘i in February 2009 with a one-month history of fever, chills, and weight loss. He recently travelled to multiple malaria endemic areas. Physical examination was significant for fever and prostration. Laboratory studies revealed anemia, thrombocytopenia, and a high parasite load of Plasmodium falciparum. A strategic network was activated to obtain and administer intravenous artesunate. His condition rapidly improved as his parasitemia cleared. He was discharged after six days with no adverse medication effects and full recovery upon six-month follow-up. Discussion Our patient met the criteria for severe Plasmodium falciparum malaria. He was immediately treated with intravenous artesunate and manifested a quick and durable response to therapy. At present, intravenous artesunate is awaiting Federal Drug Administration approval but available via a strategic network controlled by the Centers for Disease Control and Prevention. This case highlights a common delay in diagnosis, importance of optimal prophylaxis, and attention to travel history as they relate to the development of severe malaria. PMID:21785506

  10. Intravenous Artesunate: The New Generation of Lifesaving Treatment for Severe Malaria in the Warfighter

    Science.gov (United States)

    2006-11-01

    Artemether Arteether Artesunate Figure 1. Chemical structure of the Artemisinins Artemisinin, extracted from ‘qinghao’ or sweet wormwood...seeking new treatments for malaria, and was first reported in the medical literature in 1979 (QACG, 1979). The structure of artemisinin was...likely related to a temporary arrest of the basophilic erythroblast stage of the developing red blood cells which results in a brief “hole” in the

  11. A Collaborative Epidemiological Investigation into the Criminal Fake Artesunate Trade in South East Asia

    Science.gov (United States)

    Newton, Paul N; Fernández, Facundo M; Plançon, Aline; Mildenhall, Dallas C; Green, Michael D; Ziyong, Li; Christophel, Eva Maria; Phanouvong, Souly; Howells, Stephen; McIntosh, Eric; Laurin, Paul; Blum, Nancy; Hampton, Christina Y; Faure, Kevin; Nyadong, Leonard; Soong, C. W. Ray; Santoso, Budiono; Zhiguang, Wang; Newton, John; Palmer, Kevin

    2008-01-01

    Background Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered. Methods and Findings With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL) and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75), Cambodia (48), Lao PDR (115), Myanmar (Burma) (137) and the Thai/Myanmar border (16), were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9%) on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to ∼ 50 mg per genuine tablet). Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine (‘ecstasy'). Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures. Conclusions An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation

  12. A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.

    Directory of Open Access Journals (Sweden)

    Paul N Newton

    2008-02-01

    Full Text Available Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered.With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75, Cambodia (48, Lao PDR (115, Myanmar (Burma (137 and the Thai/Myanmar border (16, were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9% on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to approximately 50 mg per genuine tablet. Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine ('ecstasy'. Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures.An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation. International cross

  13. Effect of artesunate on maximal electroshock and pentylenetetrazole-induced seizures in albino mice

    Directory of Open Access Journals (Sweden)

    K Sanjana

    2012-01-01

    Full Text Available Artemisinin-based combination therapies are highly efficacious, and they are now listed as first-line therapies for uncomplicated malaria in most countries where malaria is endemic. Neurotoxicity of artemisinins is a growing concern. However, no studies have reported its antiepileptic or epileptogenesis potential, hence the present study was undertaken to explore the activity of artesunate in experimentally induced seizures in rodent models. Artesunate at doses 36.4 and 72.8 mg/kg respectively significantly reduced the duration of the hind limb extensions (3.033±1.493 and 2.033±1.383, respectively when compared to the control (P<0.0001 in the maximal electroshock-induced seizure model. However, no significant decrease was noted in the duration of clonic convulsions in a pentylenetetrazole-induced seizure model indicating lack of activity in petit mal epilepsy. The results of the present study indicate that artesunate at both the doses employed showed a significant anticonvulsant activity in the maximum electroshock-induced seizure model suggesting its potential utility in the management of generalized tonic-clonic seizures and partial seizures. Further studies regarding its mechanism of action are warranted.

  14. [Sensitivity in vitro of Plasmodium falciparum to chloroquine, pyronaridine, artesunate and piperaquine in south Yunnan].

    Science.gov (United States)

    Yang, H L; Yang, P F; Liu, D Q; Liu, R J; Dong, Y; Zhang, C Y; Cao, D Q; He, H

    1992-01-01

    The sensitivity of P. falciparum to chloroquine, pyronaridine, artesunate and piperaquine (CQ, PD, AT, PQ) was assayed using in vitro microtechnique in south Yunnan in 1990. The resistance rates were 98.7% (75/76), 27.6% (16/58), 13.8% (9/65) and 97.7% (43/44) respectively, and ID50 were 125.0, 19.0, 4.7 and 243.3 nmol/L, respectively. The resistance rate against CQ showed no change as compared to the rates against CQ 5 and 9 years ago; but the ID50 was lower. CQ-resistant P. falciparum showed a marked cross-resistance to PQ, but not to PD and AT. AT-resistant P. falciparum exhibited cross-resistance to the above-mentioned three drugs. PD-resistant P. falciparum showed no cross resistance to AT, but showed cross resistance to CQ and PQ. In comparison with chloroquine-coated plates, the plates coated with pyronaridine, artesunate or piperaquine gave similar results as the former, which were shown by the rise in schizont inhibition rates along with the rise in drug concentration. It indicates that pyronaridine-, artesunate-, and piperaquine-coated plates can be used in the assay of sensitivity of P. falciparum to the three drugs.

  15. Effects of mefloquine and artesunate mefloquine on the emergence, clearance and sex ratio of Plasmodium falciparum gametocytes in malarious children

    Directory of Open Access Journals (Sweden)

    Happi Christian T

    2009-12-01

    Full Text Available Abstract Background The gametocyte sex ratio of Plasmodium falciparum, defined as the proportion of gametocytes that are male, may influence transmission but little is known of the effects of mefloquine or artesunate-mefloquine on gametocyte sex ratio and on the sex ratio of first appearing gametocytes. Methods 350 children with uncomplicated P. falciparum malaria were enrolled in prospective treatment trial of mefloquine or artesunate-mefloquine between 2007 and 2008. Gametocytaemia was quantified, and gametocytes were sexed by morphological appearance, before and following treatment. The area under curve of gametocyte density versus time (AUCgm was calculated by linear trapezoidal method. Results 91% and 96% of all gametocytes appeared by day 7 and day 14, respectively following treatment. The overall rate of gametocytaemia with both treatments was 31%, and was significantly higher in mefloquine than in artesunate-mefloquine treated children if no gametocyte was present a day after treatment began (25.3% v 12.8%, P = 0.01. Gametocyte clearance was significantly faster with artesunate-mefloquine (1.8 ± 0.22 [sem] v 5.6 ± 0.95 d; P = 0.001. AUCgm was significantly lower in the artesunate mefloquine group (P = 0.008. The pre-treatment sex ratio was male-biased, but post-treatment sex ratio or the sex ratio of first appearing gametocytes, was significantly lower and female-biased two or three days after beginning of treatment in children given artesunate-mefloquine. Conclusion Addition of artesunate to mefloquine significantly modified the emergence, clearance, and densities of gametocytes and has short-lived, but significant, sex ratio modifying effects in children from this endemic area.

  16. Efficacy of artesunate-amodiaquine for the treatment of acute uncomplicated falciparum malaria in southern Mauritania.

    Science.gov (United States)

    Ouldabdallahi, Mohamed; Alew, Ismail; Salem, Mohamed Salem Ould Ahmedou; Dit Dialaw Ba, Mamadou; Boukhary, Ali Ould Mohamed Salem; Khairy, Mohamed Lemine Ould; Aziz, Mohamed Boubacar Abdel; Ringwald, Pascal; Basco, Leonardo K; Niang, Saidou Doro; Lebatt, Sid Mohamed

    2014-12-16

    A regular evaluation of therapeutic efficacy in sentinel sites and a system of surveillance are required to establish treatment guidelines and adapt national anti-malarial drug policy to the rapidly changing epidemiology of drug-resistant malaria. The current anti-malarial treatment guideline in Mauritania, officially recommended since 2006, is based on artemisinin-based combination therapy. The aim of the present study was to evaluate clinical efficacy and tolerance of artesunate-amodiaquine, the first-line treatment for acute uncomplicated malaria, in Mauritanian paediatric and adult patients to validate its continued use in the country. Plasmodium falciparum-infected symptomatic patients aged > six months were enrolled in Kobeni and Timbedra in southern Mauritania in September to October 2013. Co-formulated artesunate-amodiaquine was administered at the recommended dose over three days. Patients were followed until day 28. Parasitological and clinical response was classified according to the standard 2009 World Health Organization protocol. A total of 130 patients (65 in Kobeni and 65 in Timbedra) were enrolled in the study. Seventeen patients (13.1%) were either excluded (before PCR correction) or lost to follow-up. Based on the per protocol analysis, artesunate-amodiaquine efficacy (i.e., the proportion of adequate clinical and parasitological response) was 96.6% in Kobeni and 98.2% in Timbedra before PCR correction. Late clinical failure was observed in two patients in Kobeni and one patient in Timbedra. After PCR correction, the efficacy rate in the two study sites was 98.2%. On day 3, all patients were afebrile and had negative smears. Treatment was well tolerated. Artesunate-amodiaquine is well tolerated and highly efficacious for the treatment of uncomplicated P. falciparum malaria. In the majority of patients, fever and parasitaemia were rapidly cleared before day 3. The results support the national anti-malarial drug guideline for a continued use of

  17. Bacteriological study of Indian cheese (paneer sold in Chandigarh

    Directory of Open Access Journals (Sweden)

    Vaishnavi C

    2001-01-01

    Full Text Available A study was conducted to isolate and identify bacterial pathogens/contaminants in paneer samples sold in Chandigarh. Fifty eight samples of paneer bought at random were cultured on several media. Bacterial colony counts were also done. The predominant organisms isolated were Staphylococcus species, aerobic spore bearers, Klebsiella pneumoniae, Campylobacter jejuni, Acinetobacter species and Streptococcus species. The viable bacterial counts obtained ranged from 3 x 102 to 9.7 x 1010 CFU/mL. Contamination of paneer by pathogenic bacteria could be an important factor of gastrointestinal illnesses in the consumers.

  18. Andrographolide: A Novel Antimalarial Diterpene Lactone Compound from Andrographis paniculata and Its Interaction with Curcumin and Artesunate

    Directory of Open Access Journals (Sweden)

    Kirti Mishra

    2011-01-01

    Full Text Available Andrographolide (AND, the diterpene lactone compound, was purified by HPLC from the methanolic fraction of the plant Andrographis paniculata. The compound was found to have potent antiplasmodial activity when tested in isolation and in combination with curcumin and artesunate against the erythrocytic stages of Plasmodium falciparum in vitro and Plasmodium berghei ANKA in vivo. IC50s for artesunate (AS, andrographolide (AND, and curcumin (CUR were found to be 0.05, 9.1 and 17.4 μM, respectively. The compound (AND was found synergistic with curcumin (CUR and addictively interactive with artesunate (AS. In vivo, andrographolide-curcumin exhibited better antimalarial activity, not only by reducing parasitemia (29%, compared to the control (81%, but also by extending the life span by 2-3 folds. Being nontoxic to the in vivo system this agent can be used as template molecule for designing new derivatives with improved antimalarial properties.

  19. Andrographolide: A Novel Antimalarial Diterpene Lactone Compound from Andrographis paniculata and Its Interaction with Curcumin and Artesunate

    Science.gov (United States)

    Mishra, Kirti; Dash, Aditya P.; Dey, Nrisingha

    2011-01-01

    Andrographolide (AND), the diterpene lactone compound, was purified by HPLC from the methanolic fraction of the plant Andrographis paniculata. The compound was found to have potent antiplasmodial activity when tested in isolation and in combination with curcumin and artesunate against the erythrocytic stages of Plasmodium falciparum in vitro and Plasmodium berghei ANKA in vivo. IC50s for artesunate (AS), andrographolide (AND), and curcumin (CUR) were found to be 0.05, 9.1 and 17.4 μM, respectively. The compound (AND) was found synergistic with curcumin (CUR) and addictively interactive with artesunate (AS). In vivo, andrographolide-curcumin exhibited better antimalarial activity, not only by reducing parasitemia (29%), compared to the control (81%), but also by extending the life span by 2-3 folds. Being nontoxic to the in vivo system this agent can be used as template molecule for designing new derivatives with improved antimalarial properties. PMID:21760808

  20. Rectal artesunates, their utilization, and parental perception in the management of malaria in children from Abeokuta, southwestern Nigeria.

    Science.gov (United States)

    Sam-Wobo, Sammy Olufemi; Agbeyangi, Oludare Alani; Ekpo, Uwemedimo Friday; Akinloye, Oluseyi Adeboye; Mafiana, Chiedu F; Adeleke, Monsuru Adebayo

    2012-02-01

    Utilization, efficacy, perception, and acceptability of rectal artesunates for treatment of malaria were assessed in 264 children below 5 years attending two tertiary health facilities in Abeokuta, Nigeria. The children systematically selected were 136 from State Hospital Ijaye and 128 from Federal Medical Centre (FMC), Idi-Aba. Body weights and vital statistics of the children were measured; and blood samples were collected before and 24 h after administration of the rectal artesunates (Plasmotrim-50/200 mg Artesunate) to evaluate the efficacy of the suppository. The first dose of rectal artesunate suppository was administered at a dose of 5-10 mg/kg of body weight per rectum. Giemsa thin and thick films were employed to determine parasite species, malaria parasite count/μL (MPC/μL), and percentage of parasitized red blood cells (PPRBCs). Data were analyzed using SPSS version 16.0. Plasmodium falciparum was the malaria parasite identified by blood examination, with a pretreatment prevalence of 98.9%. Male children had higher infection rate (55%) than females (45%), and infection among age groups and weight groups varied. Chi-square analysis revealed a significant difference between weight and malaria parasite count (p0.05) among the sexes. Chi-square analysis of pre- and post-treatment revealed a significant difference between MPC/μL and PPRBC at p<0.05. This confirmed the efficacy of rectal artesunate in reducing the parasite density (parasitaemia) within 24 h of treatment. On acceptability, 99.60% of parents accepted to use the suppository. However, 87.1% of parents preferred its usage, as it is easy to administer with no adverse effects when administered on their children. If health officials increase more public knowledge on the use of rectal artesunates, the high mortality now experienced in children under 5 years due to malaria disease would be greatly reduced.

  1. Electrocardiographic study in Ghanaian children with uncomplicated malaria, treated with artesunate-amodiaquine or artemether-lumefantrine

    Directory of Open Access Journals (Sweden)

    Adjei George O

    2012-12-01

    Full Text Available Abstract Background Several anti-malarial drugs are associated with adverse cardiovascular effects. These effects may be exacerbated when different anti-malarials are used in combination. There has been no report yet on the potential cardiac effects of the combination artesunate-amodiaquine. Methods Electrocardiographic (ECG intervals in Ghanaian children with uncomplicated malaria treated with artesunate-amodiaquine (n=47, were compared with that of children treated with artemether-lumefantrine (n=30. The ECG measurements were repeated one, two, three, seven and 28 days after treatment. The ECG intervals of artesunate-amodiaquine treated subjects were correlated with plasma concentrations of desethylamodiaquine (DEAQ, the main metabolite of amodiaquine. Results The mean ECG intervals were similar in both groups before treatment. After treatment (day 3, ECG intervals changed significantly from baseline in all subjects, but there were no differences between the two treatment groups. A significantly higher proportion of children treated with artesunate-amodiaquine developed sinus bradycardia compared with artemether-lumefantrine treated subjects (7/47 vs 0/30; χ2 p=0.03. Subjects who developed bradycardia were significantly older, and had higher DEAQ concentrations than those who did not develop bradycardia. The proportion of subjects with QTc interval prolongations did not differ significantly between the groups, and no relationship between prolonged QTc intervals and DEAQ levels were observed. No clinically significant rhythm disturbances were observed in any of the subjects. Conclusion Artesunate-amodiaquine treatment resulted in a higher incidence of sinus bradycardia than artemether-lumefantrine treatment in children with uncomplicated malaria, but no clinically significant rhythm disturbances were induced by combining artesunate with amodiaquine. These findings, although reassuring, may imply that non-amodiaquine based artemisinin

  2. Electrocardiographic study in Ghanaian children with uncomplicated malaria, treated with artesunate-amodiaquine or artemether-lumefantrine

    DEFF Research Database (Denmark)

    Adjei, George O; Oduro-Boatey, Collins; Rodrigues, Onike P;

    2012-01-01

    Several anti-malarial drugs are associated with adverse cardiovascular effects. These effects may be exacerbated when different anti-malarials are used in combination. There has been no report yet on the potential cardiac effects of the combination artesunate-amodiaquine.......Several anti-malarial drugs are associated with adverse cardiovascular effects. These effects may be exacerbated when different anti-malarials are used in combination. There has been no report yet on the potential cardiac effects of the combination artesunate-amodiaquine....

  3. Assessing parasite clearance during uncomplicated Plasmodium falciparum infection treated with artesunate monotherapy in Suriname

    Directory of Open Access Journals (Sweden)

    Vreden SGS

    2016-11-01

    Full Text Available Stephen GS Vreden,1 Rakesh D Bansie,2 Jeetendra K Jitan,3 Malti R Adhin4 1Foundation for Scientific Research Suriname (SWOS, 2Department of Internal Medicine, Academic Hospital Paramaribo, 3Department of Public Health, Ministry of Health, 4Department of Biochemistry, Anton de Kom University of Suriname, Paramaribo, Suriname Background: Artemisinin resistance in Plasmodium falciparum is suspected when the day 3 parasitemia is >10% when treated with artemisinin-based combination therapy or if >10% of patients treated with artemisinin-based combination therapy or artesunate monotherapy harbored parasites with half-lives ≥5 hours. Hence, a single-arm prospective efficacy trial was conducted in Suriname for uncomplicated P. falciparum infection treated with artesunate-based monotherapy for 3 days assessing day 3 parasitemia, treatment outcome after 28 days, and parasite half-life. Methods: The study was conducted in Paramaribo, the capital of Suriname, from July 2013 until July 2014. Patients with uncomplicated Plasmodium falciparum infection were included and received artesunate mono-therapy for three days. Day 3 parasitaemia, treatment outcome after 28 days and parasite half-life were determined. The latter was assessed with the parasite clearance estimator from the WorldWide Antimalarial Resistance Network (WWARN. Results: Thirty-nine patients were included from July 2013 until July 2014. The day 3 parasitemia was 10%. Eight patients (20.5% could be followed up until day 28 and showed adequate clinical and parasitological response. Parasite half-life could only be determined from ten data series (25.7%. The median parasite half-life was 5.16 hours, and seven of these data series had a half-life ≥5 hours, still comprising 17.9% of the total data series. Conclusion: The low follow-up rate and the limited analyzable data series preclude clear conclusions about the efficacy of artesunate monotherapy in Suriname and the parasite half

  4. Treatment of imported severe malaria with artesunate instead of quinine - more evidence needed?

    Directory of Open Access Journals (Sweden)

    Grobusch Martin P

    2011-09-01

    Full Text Available Abstract Rapid and fast acting anti-malarials are essential to treat severe malaria. Quinine has been the only option for parenteral therapy until recently. While current evidence shows that intravenous artesunate is more effective than quinine in treating severe malaria in endemic countries, some questions remain regarding safety profiles and drug resistance. For imported severe malaria, additional unanswered questions are related to generalizability of the findings from endemic countries and to legal aspects, as there is no Good Manufacturing Practice-conform drug available yet. Here, the implications of existing evidence for the treatment of imported severe malaria are discussed.

  5. Capillary electrophoresis for the assay of fixed-dose combination tablets of artesunate and amodiaquine

    Directory of Open Access Journals (Sweden)

    Amin N’Cho

    2012-05-01

    Full Text Available Abstract Background Quality control of drugs in formulations is still a major challenge in developing countries. For the quality control of artesunate and amodiaquine tablets in fixed-dose combination, only liquid chromatographic methods have been proposed in the literature. There are no capillary electrophoretic methods reported for the determination of these active substances, although this technique presents several advantages over liquid chromatography (long lifetime, low price of the capillary, low volumes of electrolyte consumption in addition to simplicity. In this paper, a reliable capillary electrophoresis method has been developed and validated for the quality control of these drugs in commercial fixed-dose combination tablets. Methods Artesunate and amodiaquine hydrochloride in bilayer tablets were determined by micellar electrokinetic capillary chromatography (MEKC. Analytes were extracted from tablets by sonication with a solvent mixture phosphate buffer pH 7.0-acetonitrile containing benzoic acid as internal standard. Separation was carried out on Beckman capillary electrophoresis system equipped with fused silica capillary, 30 cm long (20 cm to detector × 50 μm internal diameter, using a 25 mM borate buffer pH 9.2 containing 30 mM sodium dodecyl sulfate as background electrolyte, a 500 V cm−1 electric field and a detection wavelength of 214 nm. Results Artesunate, amodiaquine and benzoic acid were separated in 6 min. The method was found to be reliable with respect to specificity,linearity of the calibration line (r2 > 0.995, recovery from synthetic tablets (in the range 98–102%, repeatability (RSD 2–3%, n = 7 analytical procedures. Application to four batches of commercial formulations with different dosages gave content in good agreement with the declared content. Conclusion The MEKC method proposed is reliable for the determination of artesunate and amodiaquine hydrochloride in fixed

  6. Intermittent preventive therapy for malaria: arguments in favour of artesunate and sulphamethoxypyrazine - pyrimethamine combination

    Directory of Open Access Journals (Sweden)

    Jansen Frans

    2011-03-01

    Full Text Available Abstract Recent publications put a serious warning regarding the inefficacy of sulphadoxine-pyrimethamine (SP for the intermittent preventive treatment of malaria in young children (IPTi. Recommendations for other therapies are being made. By using a different and better sulphonamide (sulphamethoxypyrazine, it is possible to manufacture fixed dose combination pills with artesunate and pyrimethamine. This combination permits a full therapy over 24 hours (dosing interval being 12 hours. It is recommended that this combination should be tested in future field studies of IPTi.

  7. A new derivative detected in accelerated ageing of artesunate-amodiaquine fixed dose combination tablets.

    Science.gov (United States)

    Charrier, Cedric; Bertho, Gildas; Petigny, Olivier; Moneton, Philippe; Azerad, Robert

    2013-01-01

    An unknown impurity detected in small amounts during the heat treatment of artesunate-amodiaquine bilayer tablets was purified by semipreparative HPLC and identified by MS and NMR as the tetrahydrofuranyl acetate-rearranged derivative of anhydrodihydroartemisinin. When anhydrodihydroartemisinin was treated with a Fe(II) salt in acetonitrile-water solution, the same product was generated, together with an isomeric 2-deoxy-4α-hydroxy-anhydrodihydroartemisinin derivative, as expected from the usual homolytic radical opening of the endoperoxide bond previously described for other artemisinin derivatives.

  8. A simple dose regimen of artesunate and amodiaquine based on age or body weight range for uncomplicated falciparum malaria in children: comparison of therapeutic efficacy with standard dose regimen of artesunate and amodiaquine and artemether-lumefantrine.

    Science.gov (United States)

    Gbotosho, Grace O; Sowunmi, Akintunde; Okuboyejo, Titilope M; Happi, Christian T; Folarin, Onikepe O; Adewoye, Elsie O

    2012-07-01

    A new dose regimen of artesunate and amodiaquine (NDRAA) based on age or body weight range was compared with standard dose regimen of artesunate and amodiaquine (SDRAA) calculated according to body weight and with fixed-dose artesunate-amodiaquine (FDAA) and artemether-lumefantrine (AL) in 304 children afflicted by malaria aged 15 years or younger. In initial comparison (n = 208), children on NDRAA received 1-3 times amodiaquine per kilogram of body weight and 1-1.5 times of artesunate per kilogram of body weight compared with those receiving SDRAA. Parasite but not fever clearance was significantly faster in children who received NDRAA (19.4 ± 8.4 hours vs. 24.6 ± 15.5 hours, P = 0.003). Polymerase chain reaction-uncorrected cure rates on days 28-42 were also significantly higher in children who received NDRAA (P < 0.02 in all cases). Therapeutic responses in children younger than 5 years (n = 96) treated with NDRAA, FDAA, and AL were similar. Changes in hematocrit values and reported adverse events after commencing therapy were similar in those who received NDRAA and SDRAA. All drug regimens were well tolerated. NDRAA based on age or body weight range is simple, is therapeutically superior to SDRAA calculated according to body weight, and is as efficacious as AL in children younger than 5 years.

  9. An open randomized clinical trial in comparing two artesunate-based combination treatments on Plasmodium falciparum malaria in Nigerian children: artesunate/sulphamethoxypyrazine/pyrimethamine (fixed dose over 24 hours versus artesunate/amodiaquine (fixed dose over 48 hours

    Directory of Open Access Journals (Sweden)

    Sowunmi Akintunde

    2010-12-01

    Full Text Available Abstract Background Several studies have demonstrated the efficacy of artemisinin-combination therapy (ACT across malaria zones of the world. Fixed dose ACT with shorter courses and fewer tablets may be key determinants to ease of administration and compliance. Methods Children aged one year to 13 years presenting with uncomplicated Plasmodium falciparum malaria were recruited in Ibadan, south-western Nigeria. A total of 250 children each were randomly assigned to receive three doses of artesunate/sulphamethoxypyrazine/pyrimethamine (AS + SMP (12 hourly doses over 24 hours or three doses of artesunate/amodiaquine (AS + AQ (daily doses over 48 hours. Efficacy and safety of the two drugs were assessed using a 28-day follow-up and the primary outcome was PCR- corrected parasitological cure rate and clinical response. Results There were two (0.4% early treatment failures, one in each treatment arm. The PCR corrected cure rates for day 28 was 97.9% in the AS + AQ arm and 95.6% in the AS + SMP arm (p = 0.15. The re-infection rate was 1.7% in the AS + AQ arm and 5.7% in the AS + SMP arm (p = 0.021. The fever clearance time was similar in the two treatment groups: 1 - 2 days for both AS + SMP and AS + AQ (p = 0.271. The parasite clearance time was also similar in the two treatment groups with 1 - 7 days for AS + SMP and 1 - 4 days for AS + AQ (p = 0.941. The proportion of children with gametocytes over the follow-up period was similar in both treatment groups. Serious Adverse Events were not reported in any of the patients and in all children, laboratory values (packed cell volume, liver enzymes, bilirubin remained within normal levels during the follow-up period but the packed cell volume was significantly lower in the AS + SMP group. Conclusions This study demonstrates that AS + SMP FDC given as three doses over 24 hours (12-hour intervals has similar efficacy as AS + AQ FDC given as three doses over 48 hours (24-hour interval for the treatment of

  10. Biodegradable Chitosan Magnetic Nanoparticle Carriers for Sub-Cellular Targeting Delivery of Artesunate for Efficient Treatment of Breast Cancer

    Science.gov (United States)

    Subramanian, Natesan; Abimanyu, Sugumaran; Vinoth, Jeevanesan; Sekar, Ponnusamy Chandra

    2010-12-01

    Artesunate is a semi-synthetic derivative of artemisinin, the active principle extracted from Artemisia annua. It possesses good anti-proliferative activity and anti-angiogenic activity with very low toxicity to normal healthy cells. The drawback of most cancer drugs is their inability to accumulate selectively in the cancerous cells. So, large quantities of doses have to be administered to get the required therapeutic concentration in the target site and it resulted in many serious side effects due to the exposure of healthy cells to higher concentrations of cytotoxic drugs. The problem may be solved by selectively and quantitatively accumulating the drug at target site using magnetic nanoparticles guided by an externally applied magnetic field. A modest attempt has been made in this present study, the artesunate magnetic nanoparticle was successfully formulated using two forms of chitosan and evaluated for its in-vitro characteristics like surface morphology, particle size and distribution, zeta potential, magnetic susceptibility, encapsulation efficiency, loading capacity and in-vitro drug release. The synthesized magnetite size was 73 nm and the size of developed magnetic nanoparticles of artesunate was in the range of 90 to 575 nm. Acetic acid soluble chitosan at low concentration exhibit highest encapsulation efficiency and drug loading whereas increase in water soluble chitosan concentration increases the encapsulation efficiency and drug loading in formulations. The developed chitosan magnetic nanoparticles of artesunate shows better release characteristics and may be screened for its in-vivo breast cancer activity.

  11. Effect of artemisinin/artesunate as inhibitors of hepatitis B virus production in an "in vitro" replicative system.

    Science.gov (United States)

    Romero, Marta R; Efferth, Thomas; Serrano, Maria A; Castaño, Beatriz; Macias, Rocio I R; Briz, Oscar; Marin, Jose J G

    2005-11-01

    The antiviral effect against hepatitis B virus (HBV) of artemisinin, its derivative artesunate and other compounds highly purified from traditional Chinese medicine remedies, were investigated. HBV production by permanently transfected HepG2 2.2.15 cells was determined by measuring the release of surface protein (HBsAg) and HBV-DNA after drug exposure (0.01-100 microM) for 21 days. The forms of HBV-DNA released were investigated by Southern-blotting. Neutral Red retention test was used to evaluate drug-induced toxicity on host cells. The compounds were classified according to their potential interest as follows: (i) none: they had no effect on viral production (daidzein, daidzin, isonardosinon, nardofuran, nardosinon, tetrahydronardosinon and quercetin); (ii) low: they were able to markedly reduce viral production, but also induced toxicity on host cells (berberine and tannic acid) or they had no toxic effect on host cells but only had a moderate ability to reduce viral production (curcumin, baicalein, baicalin, bufalin, diallyl disulphide, glycyrrhizic acid and puerarin); (iii) high: they induced strong inhibition of viral production at concentrations at which host cell viability was not affected (artemisinin and artesunate). Moreover, artesunate in conjunction with lamivudine had synergic anti-HBV effects, which warrants further evaluation of artemisinin/artesunate as antiviral agents against HBV infection.

  12. Artesunate – amodiaquine combination therapy for falciparum malaria in young Gabonese children

    Directory of Open Access Journals (Sweden)

    Lell Bertrand

    2007-03-01

    Full Text Available Abstract Background Artesunate-amodiaquine combination for the treatment of childhood malaria is one of the artemisinin combination therapies (ACTs recommended by National authorities in many African countries today. Effectiveness data on this combination in young children is scarce. Methods The effectiveness of three daily doses of artesunate plus amodiaquine combination given unsupervised (n = 32, compared with the efficacy when given under full supervision (n = 29 to children with falciparum malaria were assessed in an unrandomized study. Results 61 patients analysed revealed a PCR-corrected day-28 cure rate of 86 % (25 of 29 patients; CI 69 – 95 % in the supervised group and 63 % (20 of 32 patients; CI 45 – 77 % in the unsupervised group. The difference in outcome between both groups was statistically significant (p = 0.04. No severe adverse events were reported. Conclusion The effectiveness of this short course regimen in young children with falciparum malaria could be augmented by increased adherence and improved formulation.

  13. Investigation of Parasitic Contaminations of Vegetables Sold in Markets in the City of Tabriz in 2014.

    Science.gov (United States)

    Balarak, Davoud; Ebrahimi, Masomeh; Modrek, Mohammad Jafari; Bazrafshan, Edris; Mahvi, Amir Hossein; Mahdavi, Yousef

    2016-10-01

    Parasitic diseases are among the most common problems in developing countries. Various parasitic forms such as cysts, larvae and eggs of the parasite are transmitted orally through the consumption of vegetables. So, the aim of this study was to evaluate parasitic contamination of fresh vegetables consumed in the city of Tabriz. This cross-sectional study was conducted for 3 months in 2014 in Tabriz. In this study, 1620 samples from 10 kinds of vegetables (leeks, basil, mint, chives, radishes, parsley, lettuce, watercress, tarragon and coriander) were collected from 54 vegetable shops. After the washing process, centrifugation, sediment preparation and staining, each sample was examined for parasitic contamination. The parasitic infection was observed in 316 (19.5%) which 141 samples (8.7%) was related to metazoan and 175 samples (10.8%) was related to protozoan. the highest contamination was observed in leeks and the lowest in radish. Most parasitic contaminations were related to Ascaris eggs and E. coli cyst and the lowest parasitic contaminations were related to Heterophyes eggs. It can be concluded that vegetables sold in Tabriz are potential sources of human contamination with parasites. It is suggested that the use of fertilizers of human source in agriculture should be avoided.

  14. 12 CFR 617.7015 - What happens to borrower rights when a loan is sold?

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false What happens to borrower rights when a loan is sold? 617.7015 Section 617.7015 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS General § 617.7015 What happens to borrower rights when a loan is sold? (a) What...

  15. 26 CFR 1.451-7 - Election relating to livestock sold on account of drought.

    Science.gov (United States)

    2010-04-01

    ... annually 400 head of beef cattle but due to qualifying drought conditions 550 head were sold in a given... following example: Example. A, a calendar year taxpayer, normally sells 100 head of beef cattle a year. As... follows: $35,100 (total income from sales of beef cattle)/135 (total number of beef cattle sold)×35...

  16. Internal and External Factors Affecting The Size of Paddy Field Sold

    Directory of Open Access Journals (Sweden)

    Endang Rostiana

    2016-12-01

    Full Text Available This study attempted  to identify internal condition of the farmers who sold their paddy field and analyze the effects of age, education level, number of family members, field productivity, location, and production cost to the total area of paddy field sold. This study used quantitative descriptive method. This research found that age, education level, number of family members, and location of the land had positive relation to the total area of paddy field sold. On the other hand, production cost and field productivity had negative relation to the total area of paddy field sold. Partially, field production and number of family members had no significant effect to the total area of paddy field sold.

  17. An open label, randomised trial of artesunate+amodiaquine, artesunate+chlorproguanil-dapsone and artemether-lumefantrine for the treatment of uncomplicated malaria.

    Directory of Open Access Journals (Sweden)

    Seth Owusu-Agyei

    Full Text Available BACKGROUND: Artesunate+amodiaquine (AS+AQ and artemether-lumefantrine (AL are now the most frequently recommended first line treatments for uncomplicated malaria in Africa. Artesunate+chlorproguanil-dapsone (AS+CD was a potential alternative for treatment of uncomplicated malaria. A comparison of the efficacy and safety of these three drug combinations was necessary to make evidence based drug treatment policies. METHODS: Five hundred and thirty-four, glucose-6-phosphate dehydrogenase (G6PD normal children were randomised in blocks of 15 to the AS+AQ, AL or AS+CD groups. Administration of study drugs was supervised by project staff and the children were followed up at r home on days 1,2,3,7,14 and 28 post treatment. Parasitological and clinical failures and adverse events were compared between the study groups. MAIN FINDINGS: In a per-protocol analysis, the parasitological and clinical failure rate at day 28 post treatment (PCF28 was lower in the AS+AQ group compared to the AL or AS+CD groups (corrected for re-infections: 6.6% vs 13.8% and 13.8% respectively, p = 0.08; uncorrected: 14.6% vs 27.6% and 28.1% respectively, p = 0.005. In the intention to treat analysis, the rate of early treatment failure was high in all three groups (AS+AQ 13.3%; AL 15.2%; and AS+CD 9.3%, p = 0.2 primarily due to vomiting. However, the PCF28 corrected for re-infection was lower, though not significantly, in the AS+AQ group compared to the AL or the AS+CD groups (AS+AQ 18.3%; AL 24.2%; AS+CD 20.8%, p = 0.4 The incidence of adverse events was comparable between the groups. CONCLUSIONS: AS+AQ is an appropriate first line treatment for uncomplicated malaria in Ghana and possibly in the neighbouring countries in West Africa. The effectiveness of AL in routine programme conditions needs to be studied further in West Africa. TRIAL REGISTRATION: ClinicalTrials.gov NCT00119145.

  18. Safety and efficacy of re-treatments with pyronaridine-artesunate in African patients with malaria: a substudy of the WANECAM randomised trial

    OpenAIRE

    Sagara, Issaka; Beavogui, Abdoul Habib; Zongo, Issaka; Soulama, Issiaka; Borghini-Fuhrer, Isabelle; Fofana, Bakary; Camara, Daouda; Somé, Anyirékun F; Coulibaly, Aboubacar S; Traore, Oumar B; Dara, Niawanlou; Kabore, Moïse J T; Thera, Ismaila; Compaore, Yves D; Sylla, Malick Minkael

    2016-01-01

    Summary Background Sparse data on the safety of pyronaridine-artesunate after repeated treatment of malaria episodes restrict its clinical use. We therefore compared the safety of pyronaridine-artesunate after treatment of the first episode of malaria versus re-treatment in a substudy analysis. Methods This planned substudy analysis of the randomised, open-label West African Network for Clinical Trials of Antimalarial Drugs (WANECAM) phase 3b/4 trial was done at six health facilities in Mali,...

  19. Artesunate modulates expression of matrix metalloproteinases and their inhibitors as well as collagen-IV to attenuate pulmonary fibrosis in rats.

    Science.gov (United States)

    Wang, Y; Huang, G; Mo, B; Wang, C

    2016-06-03

    The aim of this study was to determine the effect of artesunate on extracellular matrix (ECM) accumulation and the expression of collagen-IV, matrix metalloproteinase (MMP), and tissue inhibitor of matrix metalloproteinase (TIMP) to understand the pharmacological role of artesunate in pulmonary fibrosis. Eighty Sprague-Dawley rats were randomly assigned to four groups that were administered saline alone, bleomycin (BLM) alone, BLM + artesunate, or artesunate alone for 28 days. Lung tissues from 10 rats in each group were used to obtain lung fibroblast (LF) primary cells, and the rest were used to analyze protein expression. The mRNA expression of collagen-IV, MMP-2, MMP-9, TIMP-1, and TIMP-2 in lung fibroblasts was detected by real-time quantitative reverse transcriptase polymerase chain reaction. The protein levels of collagen-IV, MMP-2, MMP-9, TIMP-1, and TIMP-2 protein in lung tissues were analyzed by western blotting. Artesunate treatment alleviated alveolitis and pulmonary fibrosis induced by bleomycin in rats, as indicated by a decreased lung coefficient and improvement of lung tissue morphology. Artesunate treatment also led to decreased collagen-IV protein levels, which might be a result of its downregulated expression and increased MMP-2 and MMP-9 protein and mRNA levels. Increased TIMP-1 and TIMP- 2 protein and mRNA levels were detected after artesunate treatment in lung tissues and primary lung fibroblast cells and may contribute to enhanced activity of MMP-2 and -9. These findings suggested that artesunate attenuates alveolitis and pulmonary fibrosis by regulating expression of collagen-IV, TIMP-1 and 2, as well as MMP-2 and -9, to reduce ECM accumulation.

  20. A replicate designed bioequivalence study to compare two fixed-dose combination products of artesunate and amodiaquine in healthy chinese volunteers.

    Science.gov (United States)

    Liu, Yun; Hu, Chaoying; Liu, Gangyi; Jia, Jingying; Yu, Chen; Zhu, Jianmin; Zheng, Qingsi; Zhang, Kanyin E

    2014-10-01

    Artesun-Plus is a fixed-dose combination antimalarial agent containing artesunate and amodiaquine. The current study was conducted to compare the pharmacokinetic and safety profiles of Artesun-Plus and the WHO-designated comparator product Artesunate Amodiaquine Winthrop. To overcome the high intrasubject variability of artesunate, the study applied a two-sequence and four-period crossover (2 by 4), replicate study design to assess bioequivalence between the two products in 31 healthy male Chinese volunteers under fasting conditions. The results showed that the values of the geometric mean ratios of maximum concentration of drug in plasma (Cmax) and area under the concentration-time curve from time zero to the last blood sample collection (AUC0-last) for the artesunate component in the test and reference products were 95.9% and 93.9%, respectively, and that the corresponding 90% confidence intervals were 84.5% to 108.7% and 87.2% to 101.1%, while the geometric mean ratios for the amodiaquine component in the test and reference products were 95.0% and 100.0%, respectively, and the corresponding 90% confidence intervals were 86.7% to 104.1% and 93.5% to 107.0%. In conclusion, bioequivalence between the two artesunate and amodiaquine fixed-dose combination products was demonstrated for both components. The study also confirmed high intrasubject variability, especially for artesunate: the coefficients of variation (CV) of Cmax values for the test and reference products were 39.2% and 43.7%, respectively, while those for amodiaquine were 30.6% and 30.2%, respectively.

  1. Mefloquine pharmacokinetics and mefloquine-artesunate effectiveness in Peruvian patients with uncomplicated Plasmodium falciparum malaria

    Directory of Open Access Journals (Sweden)

    Quezada Wilmer

    2009-04-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT is recommended as a means of prolonging the effectiveness of first-line malaria treatment regimens. Different brands of mefloquine (MQ have been reported to be non-bioequivalent; this could result in sub-therapeutic levels of mefloquine with decreased efficacy. In 2002, mefloquine-artesunate (MQ-AS combination therapy was adopted as the first-line treatment for uncomplicated Plasmodium falciparum malaria in the Amazon region of Peru. Although MQ resistance has yet to be reported from the Peruvian Amazon, it has been reported from other countries in the Amazon Region. Therefore, continuous monitoring is warranted to ensure that the first-line therapy remains efficacious. This study examines the in vivo efficacy and pharmacokinetic parameters through Day 56 of three commercial formulations of MQ (Lariam®, Mephaquin®, and Mefloquina-AC® Farma given in combination with artesunate. Methods Thirty-nine non-pregnant adults with P. falciparum mono-infection were randomly assigned to receive artesunate in combination with either (1 Lariam, (2 Mephaquin, or (3 Mefloquina AC. Patients were assessed on Day 0 (with blood samples for pharmacokinetics at 0, 2, 4, and 8 hours, 1, 2, 3, 7, and then weekly until day 56. Clinical and parasitological outcomes were based on the standardized WHO protocol. Whole blood mefloquine concentrations were determined by high-performance liquid chromatography and pharmacokinetic parameters were determined using non-compartmental analysis of concentration versus time data. Results By day 3, all patients had cleared parasitaemia except for one patient in the AC Farma arm; this patient cleared by day 4. No recurrences of parasitaemia were seen in any of the 34 patients. All three MQ formulations had a terminal half-life of 14–15 days and time to maximum plasma concentration of 45–52 hours. The maximal concentration (Cmax and interquartile range was 2,820 ng

  2. Antimalarial Properties of Aqueous Crude Extracts of Gynostemma pentaphyllum and Moringa oleifera Leaves in Combination with Artesunate in Plasmodium berghei-Infected Mice.

    Science.gov (United States)

    Somsak, Voravuth; Borkaew, Preeyanuch; Klubsri, Chokdee; Dondee, Kittiyaporn; Bootprom, Panatda; Saiphet, Butsarat

    2016-01-01

    Due to the emergence and spread of malaria parasite with resistance to antimalarial drugs, discovery and development of new, safe, and affordable antimalarial are urgently needed. In this respect, medicinal plant extracts are targets to optimize antimalarial actions and restore efficacy of standard antimalarial drugs. The present study was aimed at determining the antimalarial activities of Gynostemma pentaphyllum and Moringa oleifera leaf extracts in combination with artesunate against Plasmodium berghei-infected mice. P. berghei ANKA maintained by serial passage in ICR mice were used based on intraperitoneal injection of 1 × 10(7) parasitized erythrocytes and subsequent development of parasitemia. These infected mice were used to investigate the antimalarial activity of artesunate (6 mg/kg) in combination with 500, 1,000, and 2,000 mg/kg of G. pentaphyllum and M. oleifera leaf extracts using 4-day suppressive test. It was found that these extracts showed significant (P pentaphyllum leaf extract and 35, 40, and 50% for M. oleifera leaf extract. Additionally, artesunate combined with these extracts presented higher antimalarial activity, compared to extract treated alone with percentage of suppression of 78, 91, and 96% for G. pentaphyllum leaf extract and 73, 82, and 91% for M. oleifera leaf extract. The results indicated that combination treatment of G. pentaphyllum or M. oleifera leaf extracts with artesunate was able to increase the antimalarial activity by using low dose of artesunate. Hence, these results justified the combination of these extracts and artesunate in antimalarial herbal remedies.

  3. Malaysian made condoms sold locally as well as exported.

    Science.gov (United States)

    1979-01-01

    Malaysia, famous for its natural rubber, is also producing condoms made from local rubber. About 40,000 gross of condoms a month are being produced by a factory with about 30 female workers. 30-40% of the production is exported to Europe, Middle East, Asia, Japan, Singapore and South America. The size of the condoms conform to international standards, 49 mm and 52 mm. As there is a greater demand for the 52 mm. condoms overseas, the company produces more of this than the 49 mm. condoms. In April 1975, the Standard Institution and Industrial Research of Malaysia gave its quality control approval to a condom which can hold 5 gallons of water and with thickness varying from 0.03 mm, 0.06 mm. and 0.05-0.07 mm. A 10% tax/piece and a 5% surtax are imposed on imported condoms to protect the local industry from foreign competition. Local condoms are sold tax-free. Pink and black colored condoms appear to be popular among consumers. Although complaints are few, 1 in 10,000 users may suffer from allergic problems because of the silicone oil treatment of the condoms. Another local condom factory which uses Malaysian rubber for condom manufacture is located in Klang, approximately 24 miles from Kuala Lumpur; the factory has 25 workers producing 12,000 gross of lubricated and non-lubricated condoms for local consumption only. There is increasing evidence that condoms are increasing in popularity in Malaysia and that the average consumer is now being more selective in choosing contraceptive methods.

  4. Microbiological quality of kebabs sold in Palermo and Messina

    Directory of Open Access Journals (Sweden)

    Graziella Ziino

    2013-06-01

    Full Text Available Aim of this study was to evaluate the microbiological quality of kebabs retailed in Palermo and Messina. Twenty raw and 22 cooked kebab samples were analysed to determine the aerobic mesophilic bacteria (AMB, Enterobac - teriaceae, Escherichia coli, sulphite reducing anaerobes, coagulase positive staphylococci, micrococci, Bacillus cereus and the presence of Salmonella spp. and Listeria monocytogenes. In raw kebabs, AMB ranged from 4.00 to 7.34 log cfu/g and Enterobacteriaceae from 1.00 to 7.59 log cfu/g. Escherichia coli and sulphite reducing anaerobe counts were from <1.00 to 6.18 and 4 log cfu/g, respectively. Coagulase positive staphylococci ranged from <1.00 to 3.48 log cfu/g and micrococci from <1.00 to 6.00 log cfu/g. Listeria spp. was found in three raw kebab samples. In cooked kebabs, the AMB values ranged from 1.78 to 6.30 log cfu/g, Enterobacteriaceae from 1.00 to 4.00 log cfu/g and micrococci from <1.00 to 5.30 log cfu/g. Three samples were positive for Escherichia coli (from 1 to 1.30 log cfu/g and one for sulphite reducing anaerobes (2.00 log cfu/g. Coagulase positive staphylococci were found in two samples with loads of 2.30 and 2.78 cfu/g, respectively. Salmonella spp., Listeria monocytogenes and Bacillus cereus were not isolated in raw and cooked samples. The results of this study show that the microbiological quality of kebabs sold in Palermo and Messina is quite variable. The authors stress the importance of selection of raw material of high quality as well as the control of cooking and storage temperatures in order to minimise bacterial potential hazards.

  5. Praziquantel, mefloquine-praziquantel, and mefloquine-artesunate-praziquantel against Schistosoma haematobium: a randomized, exploratory, open-label trial.

    Directory of Open Access Journals (Sweden)

    Jennifer Keiser

    2014-07-01

    Full Text Available Treatment and morbidity control of schistosomiasis relies on a single drug, praziquantel. Hence, there is a pressing need to develop additional therapeutics against schistosomiasis. The antimalarial drug mefloquine shows antischistosomal activity in animal models and clinical trials, which calls for further investigations.We comparatively assessed the efficacy and tolerability of the following treatments against Schistosoma haematobium in school-aged children in Côte d'Ivoire: (i praziquantel (40 mg/kg; standard treatment; (ii mefloquine (25 mg/kg combined with praziquantel (40 mg/kg; and (iii mefloquine-artesunate (3× (100 mg artesunate +250 mg mefloquine combined with praziquantel (40 mg/kg (treatments administered on subsequent days. Two urine samples were collected before, and on days 21-22 and 78-79 after the first dosing.Sixty-one children were present on all examination time points and had complete datasets. No difference in efficacy was observed between the three treatment groups on either follow-up. On the 21-22 day posttreatment follow-up, based on available case analysis, cure rates of 33% (95% confidence interval (CI 11-55%, 29% (95% CI 8-50%, and 26% (95% CI 5-48% were observed for praziquantel, mefloquine-artesunate-praziquantel, and mefloquine-praziquantel, respectively. The corresponding egg reduction rates were 94% and above. On the second follow-up, observed cure rates ranged from 19% (praziquantel to 33% (mefloquine-artesunate-praziquantel, and egg reduction rates were above 90%. Praziquantel monotherapy was the best tolerated treatment. In the mefloquine-artesunate-praziquantel group, adverse events were reported by 91% of the participants, and in the mefloquine-praziquantel group, 95% experienced adverse events. With the exception of abdominal pain at moderate severity, adverse events were mild.The addition of mefloquine or mefloquine-artesunate does not increase the efficacy of praziquantel against chronic S. haematobium

  6. Effect of quinine and artesunate combination therapy on platelet count of children with severe malaria.

    Science.gov (United States)

    Gupta, Parul; Narang, Manish; Gomber, Sunil; Saha, Rumpa

    2017-05-01

    There are several case reports of quinine-induced thrombocytopenia but no clinical trials to ascertain its incidence and significance in severe malaria. The primary objective was to assess the effect of quinine on the platelet count in children with severe malaria and to compare it with artesunate combination therapy (ACT), and the secondary objective was to assess outcome of treatment with quinine and ACT. An open-labelled, randomised, controlled trial was undertaken in 100 children aged 6 months to 12 years who were diagnosed with malaria by microscopy and/or rapid diagnostic test kits with at least one WHO clinical or laboratory criterion for severe malaria. All subjects were commenced on either quinine or ACT. Clindamycin was added to artesunate as a combination drug (ACT). It was also given to patients on quinine to avoid its confounding effect on the results. Platelet counts were undertaken every 24 hours for 7 consecutive days, temperature and coma score (Blantyre coma score ≥3 in children 4 years) was recorded 6-hourly and peripheral smears were taken 12-hourly until two consecutively negative smears were obtained. The primary outcome was a fall in the platelet count by ≥20% from the time of drug initiation until day 7. The secondary outcome was comparison of the efficacy, parasite clearance time, fever clearance time, coma recovery time and adverse effects of quinine vs ACT. 30.4% patients in the quinine group (n = 48) had ≥20% fall in platelet count and 10.8% of patients in the ACT group (n = 46) (P = 0.02). Despite the fall in platelet count, there was no bleeding. The efficacy of ACT was significantly better than quinine but the other treatment outcomes showed insignificant difference. Quinine should be used with caution in patients with severe malaria because of the potential risk of quinine-induced thrombocytopenia.

  7. Pyronaridine-artesunate versus chloroquine in patients with acute Plasmodium vivax malaria: a randomized, double-blind, non-inferiority trial.

    Directory of Open Access Journals (Sweden)

    Yi Poravuth

    Full Text Available BACKGROUND: New antimalarials are needed for P. vivax and P. falciparum malaria. This study compared the efficacy and safety of pyronaridine-artesunate with that of chloroquine for the treatment of uncomplicated P. vivax malaria. METHODS AND FINDINGS: This phase III randomized, double-blind, non-inferiority trial included five centers across Cambodia, Thailand, India, and Indonesia. In a double-dummy design, patients (aged >3-≤ 60 years with microscopically confirmed P. vivax mono-infection were randomized (1:1 to receive pyronaridine-artesunate (target dose 7.2:2.4 mg/kg to 13.8:4.6 mg/kg or chloroquine (standard dose once daily for three days. Each treatment group included 228 randomized patients. Outcomes for the primary endpoint, Day-14 cure rate in the per-protocol population, were 99.5%, (217/218; 95%CI 97.5, 100 with pyronaridine-artesunate and 100% (209/209; 95%CI 98.3, 100 with chloroquine. Pyronaridine was non-inferior to chloroquine: treatment difference -0.5% (95%CI -2.6, 1.4, i.e., the lower limit of the 2-sided 95%CI for the treatment difference was greater than -10%. Pyronaridine-artesunate cure rates were non-inferior to chloroquine for Days 21, 28, 35 and 42. Parasite clearance time was shorter with pyronaridine-artesunate (median 23.0 h versus chloroquine (32.0 h; p<0.0001, as was fever clearance time (median 15.9 h and 23.8 h, respectively; p = 0.0017. Kaplan-Meier estimates of post-baseline P. falciparum infection incidence until Day 42 were 2.5% with pyronaridine-artesunate, 6.1% with chloroquine (p = 0.048, log-rank test. Post-baseline P. vivax or P. falciparum infection incidence until Day 42 was 6.8% and 12.4%, respectively (p = 0.022, log rank test. There were no deaths. Adverse events occurred in 92/228 (40.4% patients with pyronaridine-artesunate and 72/228 (31.6% with chloroquine. Mild and transient increases in hepatic enzymes were observed for pyronaridine-artesunate. CONCLUSION: Pyronaridine-artesunate efficacy

  8. Pyronaridine-Artesunate versus Chloroquine in Patients with Acute Plasmodium vivax Malaria: A Randomized, Double-Blind, Non-Inferiority Trial

    Science.gov (United States)

    Poravuth, Yi; Socheat, Duong; Rueangweerayut, Ronnatrai; Uthaisin, Chirapong; Pyae Phyo, Aung; Valecha, Neena; Rao, B. H. Krishnamoorthy; Tjitra, Emiliana; Purnama, Asep; Borghini-Fuhrer, Isabelle; Duparc, Stephan; Shin, Chang-Sik; Fleckenstein, Lawrence

    2011-01-01

    Background New antimalarials are needed for P. vivax and P. falciparum malaria. This study compared the efficacy and safety of pyronaridine-artesunate with that of chloroquine for the treatment of uncomplicated P. vivax malaria. Methods and Findings This phase III randomized, double-blind, non-inferiority trial included five centers across Cambodia, Thailand, India, and Indonesia. In a double-dummy design, patients (aged >3–≤60 years) with microscopically confirmed P. vivax mono-infection were randomized (1∶1) to receive pyronaridine-artesunate (target dose 7.2∶2.4 mg/kg to 13.8∶4.6 mg/kg) or chloroquine (standard dose) once daily for three days. Each treatment group included 228 randomized patients. Outcomes for the primary endpoint, Day-14 cure rate in the per-protocol population, were 99.5%, (217/218; 95%CI 97.5, 100) with pyronaridine-artesunate and 100% (209/209; 95%CI 98.3, 100) with chloroquine. Pyronaridine was non-inferior to chloroquine: treatment difference −0.5% (95%CI −2.6, 1.4), i.e., the lower limit of the 2-sided 95%CI for the treatment difference was greater than −10%. Pyronaridine-artesunate cure rates were non-inferior to chloroquine for Days 21, 28, 35 and 42. Parasite clearance time was shorter with pyronaridine-artesunate (median 23.0 h) versus chloroquine (32.0 h; pestimates of post-baseline P. falciparum infection incidence until Day 42 were 2.5% with pyronaridine-artesunate, 6.1% with chloroquine (p = 0.048, log-rank test). Post-baseline P. vivax or P. falciparum infection incidence until Day 42 was 6.8% and 12.4%, respectively (p = 0.022, log rank test). There were no deaths. Adverse events occurred in 92/228 (40.4%) patients with pyronaridine-artesunate and 72/228 (31.6%) with chloroquine. Mild and transient increases in hepatic enzymes were observed for pyronaridine-artesunate. Conclusion Pyronaridine-artesunate efficacy in acute uncomplicated P. vivax malaria was at least that of chloroquine. As pyronaridine-artesunate

  9. Host-guest inclusion system of artesunate with β-cyclodextrin and its derivatives: Characterization and antitumor activity

    Science.gov (United States)

    Xie, Hudie; Yang, Bo; Wang, Fen; Zhao, Yulin

    2015-04-01

    Inclusion complexes between artesunate (ATS) and three cyclodextrins, namely β-cyclodextrin (β-CD), hydroxypropyl-β-cyclodextrin (HP-β-CD) and sulfobutyl ether-β-cyclodextrin (SBE-β-CD), were prepared by a suspension method. The complexes in both liquid and solid were characterized by phase-solubility diagram, nuclear magnetic resonance (NMR), powder X-ray diffraction (XRD) and thermoanalysis. The results suggested that artesunate was partly encapsulated within the cyclodextrin cavity to form a 1:1 stoichiometry host-guest compound. Especially in the SBE-β-CD complex, displayed the greatest stability constant. Significant enhancement of water solubility and thermal stability of ATS in present of β-CDs was shown. The calculated IC50 values indicated that the antitumor activities of inclusion complexes were better than that of ATS. Satisfactory aqueous solubility, along with high thermal stability of inclusion complexes will be potentially useful for their application on the formulation design of natural medicine.

  10. Pyronaridine-Artesunate combination for the treatment of acute uncomplicated Plasmodium falciparum malaria in paediatric patients in Gabon

    OpenAIRE

    Schreier, Annette

    2010-01-01

    Artemisinin-based combination therapies (ACTs) are now the recommended first-line drugs for the treatment of acute uncomplicated Plasmodium falciparum malaria in many endemic regions and the development of novel therapy options, especially for the use in children, is a major aim in malaria research. This Phase II study intended to provide first clinical data about the new combination of pyronaridine and artesunate for the use in paediatric patients. 60 children were assigned to the four s...

  11. Artesunate-amodiaquine combination therapy in the absence of malarial parasite infection induces oxidative damage in female rats.

    Science.gov (United States)

    Abolaji, Amos O; Osedeme, Fenose; Olusemire, Oluwatosin

    2014-04-01

    Artesunate-amodiaquine is among the most widely available artemisinin combination therapy used as treatment regimen for uncomplicated Plasmodium falciparum malaria. Our aim was to evaluate clinical routine markers of liver and renal functions, lipid profile levels and lipid peroxidation status in a female mammalian rat model. This was an attempt to simulate a scenario where the drugs are taken without malarial parasite infection, which is a common practice in settings where drug misuse is a common practice. Twenty female Wistar rats were randomly divided into four study groups of five animals each. Group 1 (control) received distilled water, group 2 was exposed to artesunate [2 mg/kg body weight (b.w.)], group 3 was administered with amodiaquine (6.12 mg/kg b.w.) and group 4 was co-administered with artesunate (2 mg/kg b.w.) and amodiaquine (6.12 mg/kg b.w.) for 3 days. At the end of the treatment period, animals were fasted overnight and sacrificed. Markers of liver and renal functions and lipid profile indices were evaluated in the plasma, whereas lipid peroxidation status, GSH concentration and G6PD activity were assessed in the erythrocytes. The results showed that the co-administration of artesunate and amodiaquine altered liver function markers and lipid profile indices. The drugs also induced lipid peroxidation as evidenced by the elevated level of oxidative stress marker malondialdehyde (p < 0.05). We recommend therefore that the drugs should be taken with prescription only with clinical evidence of malarial parasite infection.

  12. Artemether-lumefantrine versus artesunate plus amodiaquine for treating uncomplicated childhood malaria in Nigeria: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Nwachukwu Chukwuemeka

    2006-05-01

    Full Text Available Abstract Background The therapeutic efficacy of artesunate plus amodiaquine and artemether/lumefantrine were assessed in an area of Nigeria with high levels of Plasmodium falciparum resistance to chloroquine and sulphadoxine-pyrimethamine. Participants Children aged 6 to 59 months with uncomplicated P. falciparum infection and parasite density 1,000 to 200,000 parasites/μL enrolled following informed consent by parents. Methods Eligible children were randomly assigned to receive either a 3-day course of artesunate (4 mg/kg plus amodiaquine (10 mg/kg or 6-dose course of artemether/lumefantrine (20/120 mg tablets over three days. Patients were followed up with clinical and laboratory assessments until day 14 using standard WHO in-vivo antimalarial drug test protocol. Results A total 119 eligible children were enrolled but 111 completed the study. Adequate clinical and parasitological response (ACPR was 47 (87.0% and 47 (82.5% for artemether-lumefantrine (AL and artesunate+amodiaquine (AAMQ respectively (OR 0.7, 95% confidence interval 0.22 to 2.22. Early treatment failure (ETF occurred in one participant (1.8% treated with AAQ but in none of those with AL. Two (3.7% patients in the AL group and none in the AAQ group had late clinical failure. Late parasitological failure was observed in 9 (15.8 and 5 (9.3% of patients treated with AAQ and AL respectively. None of participants had a serious adverse event. Conclusion Artemether-lumenfantrine and artesunate plus amodiaquine have high and comparable cure rates and tolerability among under-five children in Calabar, Nigeria.

  13. Artesunate-mefloquine combination therapy in acute Plasmodium falciparum malaria in young children: a field study regarding neurological and neuropsychiatric safety

    Directory of Open Access Journals (Sweden)

    Hatz Christoph

    2010-10-01

    Full Text Available Abstract Background Mefloquine-artesunate combination therapy for uncomplicated falciparum malaria is one of the treatments used in African children. Data concerning neurological safety in adults and children treated with mefloquine and artesunate combination therapy is well documented in Asia. Safety data for neurological and neuropsychiatric side effects of mefloquine and artesunate combination therapy in African children are scarce, although WHO recommends this therapy in Africa. Methods A phase IV, open label, single arm study was conducted among African children between 10 and 20 kg with acute uncomplicated falciparum malaria. They were treated over three consecutive days with a paediatric fixed-dose combination of artesunate (50 mg/d and mefloquine (125 mg/d. Parasitological, clinical and neurological examinations and standardized questions about neuropsychiatric symptoms were carried out on days 0, 4, 7, 28 and 63. The primary objective was to assess the neurological and neuropsychiatric safety of artesunate-mefloquine combination therapy in young children. Results From December 2007 to March 2009, 220 children with uncomplicated Plasmodium falciparum malaria were treated with artesunate and mefloquine. 213 children were analysed according to study protocol. 50 neurological and neuropsychiatric adverse events occurred in 28 patients. Eleven drug-related neurological and neuropsychiatric adverse events occurred in eight patients. Sleeping disorders were present in 2.3%, neurological disorders in 1.4%, neuropsychiatric disorders in 1% and eating disorders in 0.5% of the patients. Adverse events were of mild to moderate intensity and resolved spontaneously. Conclusion African children showed a low percentage of self-limited neurological and neuropsychiatric adverse events, confirming studies on neurological safety in Asian children treated with artesunate and mefloquine. Sleeping disorders were most frequently observed.

  14. Health worker and policy-maker perspectives on use of intramuscular artesunate for pre-referral and definitive treatment of severe malaria at health posts in Ethiopia.

    Science.gov (United States)

    Kefyalew, Takele; Kebede, Zelalem; Getachew, Dawit; Mukanga, David; Awano, Tessema; Tekalegne, Agonafer; Batisso, Esey; Edossa, Wasihun; Mekonnen, Emebet; Tibenderana, James; Baba, Ebenezer Sheshi; Shumba, Constance; Nankabirwa, Joaniter I; Hamade, Prudence

    2016-10-18

    The World Health Organization (WHO) recommends injectable artesunate given either intravenously or by the intramuscular route for definitive treatment for severe malaria and recommends a single intramuscular dose of intramuscular artesunate or intramuscular artemether or intramuscular quinine, in that order of preference as pre-referral treatment when definitive treatment is not possible. Where intramuscular injections are not available, children under 6 years may be administered a single dose of rectal artesunate. Although the current malaria treatment guidelines in Ethiopia recommend intra-rectal artesunate or alternatively intramuscular artemether or intramuscular quinine as pre-referral treatment for severe malaria at the health posts, there are currently no WHO prequalified suppliers of intra-rectal artesunate and when available, its use is limited to children under 6 years of age leaving a gap for the older age groups. Intramuscular artesunate is not part of the drugs recommended for pre-referral treatment in Ethiopia. This study assessed the perspectives of health workers, and policy-makers on the use of intramuscular artesunate as a pre-referral and definitive treatment for severe malaria at the health post level. In-depth interviews were held with 101 individuals including health workers, malaria focal persons, and Regional Health Bureaus from Oromia and southern nations, nationalities, and peoples' region, as well as participants from the Federal Ministry of Health and development partners. An interview guide was used in the data collection and thematic content analysis was employed for analysis. Key findings from this study are: (1) provision of intramuscular artesunate as pre-referral and definitive treatment for severe malaria at health posts could be lifesaving; (2) with adequate training, and provision of facilities including beds, health posts can provide definitive treatment for severe malaria using intramuscular artesunate where referral is

  15. Health worker and policy-maker perspectives on use of intramuscular artesunate for pre-referral and definitive treatment of severe malaria at health posts in Ethiopia

    Directory of Open Access Journals (Sweden)

    Takele Kefyalew

    2016-10-01

    Full Text Available Abstract Background The World Health Organization (WHO recommends injectable artesunate given either intravenously or by the intramuscular route for definitive treatment for severe malaria and recommends a single intramuscular dose of intramuscular artesunate or intramuscular artemether or intramuscular quinine, in that order of preference as pre-referral treatment when definitive treatment is not possible. Where intramuscular injections are not available, children under 6 years may be administered a single dose of rectal artesunate. Although the current malaria treatment guidelines in Ethiopia recommend intra-rectal artesunate or alternatively intramuscular artemether or intramuscular quinine as pre-referral treatment for severe malaria at the health posts, there are currently no WHO prequalified suppliers of intra-rectal artesunate and when available, its use is limited to children under 6 years of age leaving a gap for the older age groups. Intramuscular artesunate is not part of the drugs recommended for pre-referral treatment in Ethiopia. This study assessed the perspectives of health workers, and policy-makers on the use of intramuscular artesunate as a pre-referral and definitive treatment for severe malaria at the health post level. Methods In-depth interviews were held with 101 individuals including health workers, malaria focal persons, and Regional Health Bureaus from Oromia and southern nations, nationalities, and peoples’ region, as well as participants from the Federal Ministry of Health and development partners. An interview guide was used in the data collection and thematic content analysis was employed for analysis. Results Key findings from this study are: (1 provision of intramuscular artesunate as pre-referral and definitive treatment for severe malaria at health posts could be lifesaving; (2 with adequate training, and provision of facilities including beds, health posts can provide definitive treatment for severe

  16. Artesunate-amodiaquine fixed dose combination for the treatment of Plasmodium falciparum malaria in India

    Directory of Open Access Journals (Sweden)

    Anvikar Anupkumar R

    2012-03-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT has been recommended for the treatment of falciparum malaria by the World Health Organization. Though India has already switched to ACT for treating falciparum malaria, there is need to have multiple options of alternative forms of ACT. A randomized trial was conducted to assess the safety and efficacy of the fixed dose combination of artesunate-amodiaquine (ASAQ and amodiaquine (AQ for the treatment of uncomplicated falciparum malaria for the first time in India. The study sites are located in malaria-endemic, chloroquine-resistant areas. Methods This was an open label, randomized trial conducted at two sites in India from January 2007 to January 2008. Patients between six months and 60 years of age having Plasmodium falciparum mono-infection were randomly allocated to ASAQ and AQ arms. The primary endpoint was 28-day PCR-corrected parasitological cure rate. Results Three hundred patients were enrolled at two participating centres, Ranchi, Jharkhand and Rourkela, Odisha. Two patients in AQ arm had early treatment failure while there was no early treatment failure in ASAQ arm. Late treatment failures were seen in 13 and 12 patients in ASAQ and AQ arms, respectively. The PCR-corrected cure rates in intent-to-treat population were 97.51% (94.6-99.1% in ASAQ and 88.65% (81.3-93.9% in AQ arms. In per-protocol population, they were 97.47% (94.2-99.2% and 88.30% (80-94% in ASAQ and AQ arms respectively. Seven serious adverse events (SAEs were reported in five patients, of which two were reported as related to the treatment. All SAEs resolved without sequel. Conclusion The fixed dose combination of ASAQ was found to be efficacious and safe treatment for P. falciparum malaria. Amodiaquine also showed acceptable efficacy, making it a suitable partner of artesunate. The combination could prove to be a viable option in case India opts for fixed dose combination ACT. Clinical trial registry

  17. Artesunate inhibits adipogeneis in 3T3-L1 preadipocytes by reducing the expression and/or phosphorylation levels of C/EBP-α, PPAR-γ, FAS, perilipin A, and STAT-3

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Byeong-Churl, E-mail: jangbc123@gw.kmu.ac.kr

    2016-05-20

    Differentiation of preadipocyte, also called adipogenesis, leads to the phenotype of mature adipocyte. However, excessive adipogenesis is closely linked to the development of obesity. Artesunate, one of artemisinin-type sesquiterpene lactones from Artemisia annua L., is known for anti-malarial and anti-cancerous activities. In this study, we investigated the effect of artesunate on adipogenesis in 3T3-L1 preadipocytes. Artesunate strongly inhibited lipid accumulation and triglyceride (TG) synthesis during the differentiation of 3T3-L1 preadipocytes into adipocytes at 5 μM concentration. Artesunate at 5 μM also reduced not only the expressions of CCAAT/enhancer-binding protein-α (C/EBP-α), peroxisome proliferator-activated receptor-γ (PPAR-γ), fatty acid synthase (FAS), and perilipin A but also the phosphorylation levels of signal transducer and activator of transcription-3 (STAT-3) during adipocyte differentiation. Moreover, artesunate at 5 μM reduced leptin, but not adiponectin, mRNA expression during adipocyte differentiation. Taken together, these findings demonstrate that artesunate inhibits adipogenesis in 3T3-L1 preadipoytes through the reduced expression and/or phosphorylation levels of C/EBP-α, PPAR-γ, FAS, perilipin A, and STAT-3. -- Highlights: •Artesunate, an artemisinin derivative, inhibits adipogenesis. •Artesunate inhibits C/EBP-α, PPAR-γ, FAS, perilipin A, and STAT-3 in 3T3-L1 adipocytes. •Artesunate reduces leptin, but not adiponectin, expression in 3T3-L1 adipocytes. •Artesunate thus may have therapeutic potential against obesity.

  18. In vivo transmission blocking activities of artesunate on the avian malaria parasite Plasmodium gallinaceum.

    Science.gov (United States)

    Kumnuan, Rapeeporn; Pattaradilokrat, Sittiporn; Chumpolbanchorn, Kamlang; Pimnon, Suntorn; Narkpinit, Somphong; Harnyuttanakorn, Pongchai; Saiwichai, Tawee

    2013-11-08

    Infection and transmission of the avian malaria parasite Plasmodium gallinaceum in domestic chickens is associated with high economic burden and presents a major challenge to poultry industry in South East Asia. Development of drugs targeting both asexual blood stage parasites and sexual stages of the avian malarias will be beneficial for malaria treatment and eradication. However, current drugs recommended for treatment of the avian malaria parasites target specifically the asexual blood stage parasites, but have little or no impact to the gametocytes, the major target for development of transmission-blocking strategies. In the present work, we established a simple procedure to evaluate gametocytocidal and transmission blocking activities in a P. gallinaceum-avian model. The assays involved administration of seven consecutive daily doses of test compounds into P. gallinaceum-infected chickens with 10% parasitaemia and 1% gametocytaemia. Our studies indicated that intramuscular injection with seven daily low doses (the minimum effective dose of 10mg/kg) of artesunate blocked the gametocyte production and transmission to the mosquito vector Aedes aegypti. This assay can be further applicable for testing new compounds against P. gallinaceum and for other parasitic protozoa infecting birds.

  19. Efficacy of monotherapies and artesunate-based combination therapies in children with uncomplicated malaria in Somalia.

    Science.gov (United States)

    Warsame, Marian; Atta, Hoda; Klena, John D; Waqar, Butt Ahmed; Elmi, Hussein Haji; Jibril, Ali Mohamed; Hassan, Hassan Mohamed; Hassan, Abdullahi Mohamed

    2009-02-01

    In order to guide the antimalarial treatment policy of Somalia, we conducted therapeutic efficacy studies of routinely used antimalarial monotherapies as well as artemisinin-based combination therapies (ACTs) for uncomplicated malaria in three sentinel sites during 2003-2006. Therapeutic efficacy of chloroquine (CQ), amodiaquine (AQ) and sulfadoxine/pyrimetahmine (SP) monotherapies, and artesunate plus SP (AS+SP) or AQ (AS+AQ) were evaluated in children 6 months to 10 years old with uncomplicated malaria. For the assessment of the monotherapies, 2003 WHO protocol with 14-day follow-up was used while the 2005 WHO protocol with 28-day follow-up was used for testing the ACTs. Of the monotherapies, CQ performed very poorly with treatment failures varying from 76.5% to 88% between the sites. AQ treatment failure was low except for Janale site with treatment failure of 23.4% compared to 2.8% and 8% in Jamame and Jowhar, respectively. For SP, treatment failures from 7.8% to 12.2% were observed. A 28-day test of artemisinin-based combinations, AS+SP and AS+AQ, proved to be highly efficacious with cure rates of 98-100% supporting the choice of AS+SP combination as first line treatment for uncomplicated malaria for Somalia.

  20. Antimalarial Properties of Aqueous Crude Extracts of Gynostemma pentaphyllum and Moringa oleifera Leaves in Combination with Artesunate in Plasmodium berghei-Infected Mice

    Science.gov (United States)

    Borkaew, Preeyanuch; Klubsri, Chokdee; Dondee, Kittiyaporn; Bootprom, Panatda; Saiphet, Butsarat

    2016-01-01

    Due to the emergence and spread of malaria parasite with resistance to antimalarial drugs, discovery and development of new, safe, and affordable antimalarial are urgently needed. In this respect, medicinal plant extracts are targets to optimize antimalarial actions and restore efficacy of standard antimalarial drugs. The present study was aimed at determining the antimalarial activities of Gynostemma pentaphyllum and Moringa oleifera leaf extracts in combination with artesunate against Plasmodium berghei-infected mice. P. berghei ANKA maintained by serial passage in ICR mice were used based on intraperitoneal injection of 1 × 107 parasitized erythrocytes and subsequent development of parasitemia. These infected mice were used to investigate the antimalarial activity of artesunate (6 mg/kg) in combination with 500, 1,000, and 2,000 mg/kg of G. pentaphyllum and M. oleifera leaf extracts using 4-day suppressive test. It was found that these extracts showed significant (P < 0.05) antimalarial activity in dose-dependent manner with percentage of suppression of 45, 50, and 55% for G. pentaphyllum leaf extract and 35, 40, and 50% for M. oleifera leaf extract. Additionally, artesunate combined with these extracts presented higher antimalarial activity, compared to extract treated alone with percentage of suppression of 78, 91, and 96% for G. pentaphyllum leaf extract and 73, 82, and 91% for M. oleifera leaf extract. The results indicated that combination treatment of G. pentaphyllum or M. oleifera leaf extracts with artesunate was able to increase the antimalarial activity by using low dose of artesunate. Hence, these results justified the combination of these extracts and artesunate in antimalarial herbal remedies. PMID:27872647

  1. Antimalarial Properties of Aqueous Crude Extracts of Gynostemma pentaphyllum and Moringa oleifera Leaves in Combination with Artesunate in Plasmodium berghei-Infected Mice

    Directory of Open Access Journals (Sweden)

    Voravuth Somsak

    2016-01-01

    Full Text Available Due to the emergence and spread of malaria parasite with resistance to antimalarial drugs, discovery and development of new, safe, and affordable antimalarial are urgently needed. In this respect, medicinal plant extracts are targets to optimize antimalarial actions and restore efficacy of standard antimalarial drugs. The present study was aimed at determining the antimalarial activities of Gynostemma pentaphyllum and Moringa oleifera leaf extracts in combination with artesunate against Plasmodium berghei-infected mice. P. berghei ANKA maintained by serial passage in ICR mice were used based on intraperitoneal injection of 1 × 107 parasitized erythrocytes and subsequent development of parasitemia. These infected mice were used to investigate the antimalarial activity of artesunate (6 mg/kg in combination with 500, 1,000, and 2,000 mg/kg of G. pentaphyllum and M. oleifera leaf extracts using 4-day suppressive test. It was found that these extracts showed significant (P<0.05 antimalarial activity in dose-dependent manner with percentage of suppression of 45, 50, and 55% for G. pentaphyllum leaf extract and 35, 40, and 50% for M. oleifera leaf extract. Additionally, artesunate combined with these extracts presented higher antimalarial activity, compared to extract treated alone with percentage of suppression of 78, 91, and 96% for G. pentaphyllum leaf extract and 73, 82, and 91% for M. oleifera leaf extract. The results indicated that combination treatment of G. pentaphyllum or M. oleifera leaf extracts with artesunate was able to increase the antimalarial activity by using low dose of artesunate. Hence, these results justified the combination of these extracts and artesunate in antimalarial herbal remedies.

  2. Artesunate Effect on Schistosome Thioredoxin Glutathione Reductase and Cytochrome c Peroxidase as New Molecular Targets in Schistosoma mansoni-infected Mice

    Institute of Scientific and Technical Information of China (English)

    Amany A.Abdin; Dalia S.Ashour; Zeinab S.Shoheib

    2013-01-01

    Objective To investigate the possible effect of artesunate (ART) on schistosome thioredoxin glutathione reductase (TGR) and cytochrome c peroxidase (CcP) in Schistosoma mansoni-infected mice. Methods A total of 200 laboratory bred male Swiss albino mice were divided into 4 groups (50 mice in each group). Group I:infected untreated group (Control group) received a vehicle of 1%sodium carbonyl methylcellulose (CMC-Na); Group II: infected then treated with artesunate; Group III: infected then treated with praziquantel, and group IV:infected then treated with artesunate then praziquantel. Adult S. mansoni worms were collected by Animal Perfusion Method, tissue egg counted, TGR, and CcP mRNA Expression were estimated of in S. mansoni adult worms by semi-quantitative rt-PCR. Results Semi-quantitative rt-PCR values revealed that treatment with artesunate caused significant decrease in expression of schistosome TGR and CcP in comparison to the untreated group. In contrast, the treatment with praziquantel did not cause significant change in expression of these genes. The results showed more reduction in total worm and female worm count in combined ART-PZQ treated group than in monotherapy treated groups by either ART or PZQ. Moreover, complete disappearance (100%) of tissue eggs was recorded in ART-PZQ treated group with a respective reduction rate of 95.9%and 68.4%in ART-and PZQ-treated groups. Conclusion The current study elucidated for the first time that anti-schistosomal mechanisms of artesunate is mediated via reduction in expression of schistosome TGR and CcP. Linking these findings, addition of artesunate to praziquantel could achieve complete cure outcome in treatment of schistosomiasis.

  3. Determination of artesunate in artesunate and amodiaquine hydrochloride tablets by HPLC%HPLC法测定青蒿琥酯阿莫地喹片中青蒿琥酯的含量

    Institute of Scientific and Technical Information of China (English)

    蒋红艳; 曾雪; 陈义娟

    2015-01-01

    Objective To establish an HPLC method for the determination of artesunate in artesunate and amodiaquine hydrochloride tablets. Methods WondaSil C18-WR column was used with mobile phase consisted of acetonitrile:phosphoric acid aqueous solution(adjust pH to 3,gradient elution);wavelength was 210 nm; flow rate was 1 mL/min and the column temperature was 30℃.Results The standard curve was linear in the range of 0.2~3.2 mg/mL(r=0.9997), average recoveries were 99.0%(RSD=1.35%, n=6).Conclusion The method is accurate and sensitive, and it can be used to control the quality of artesunate and amodiaquine hydrochloride tablets.%目的:建立梯度洗脱HPLC法测定青蒿琥酯阿莫地喹片中青蒿琥酯含量。方法色谱柱为Wondasil C18-WR,流动相采用乙腈-磷酸水溶液(pH=3)的二元梯度洗脱,检测波长为210 nm;流速为1 mL/min;柱温为30℃。结果青蒿琥酯在0.2~3.2 mg/mL范围内线性关系良好(r=0.9997),平均加样回收率为99.0%(RSD=1.35%,n=6)。结论该方法准确、灵敏,重现性好,可作为该制剂的质量控制方法。

  4. A simple dose regimen of artesunate and amodiaquine based on arm span- or age range for childhood falciparum malaria: a preliminary evaluation.

    Science.gov (United States)

    Sowunmi, Akintunde; Akinrinola, Ibukun A; Gbotosho, Grace O; Okuboyejo, Titilope M; Happi, Christian T

    2012-08-01

    A dose regimen of artesunate and amodiaquine based on arm span- or age range (DRAAAS), derived from a study of 1674 children, was compared with standard dose regimen of the same drugs calculated according to body weight (SDRAA) in 68 malarious children. Children on DRAAAS received 0.8-1.0 of artesunate/kg and 0.9-1.2 times amodiaquine/kg compared with those receiving SDRAA. Parasite and fever clearance and fall in hematocrit in the first 3 days were similar; both regimens were well tolerated. DRAAAS is simple and is efficacious.

  5. Surveillance of the efficacy of artesunate and mefloquine combination for the treatment of uncomplicated falciparum malaria in Cambodia.

    Science.gov (United States)

    Denis, Mey Bouth; Tsuyuoka, Reiko; Poravuth, Yi; Narann, Top Sophoan; Seila, Suon; Lim, Chim; Incardona, Sandra; Lim, Pharath; Sem, Rithy; Socheat, Duong; Christophel, Eva Maria; Ringwald, Pascal

    2006-09-01

    Artesunate and mefloquine combination treatment has been used since 2000 in Cambodia as the first-line drug for the treatment of uncomplicated falciparum malaria. In order to assess its efficacy and safety, the national malaria control programme conducted 14 therapeutic efficacy studies with the drug combination between 2001 and 2004 at nine sites. In 2001 and 2002, co-blister packs of artesunate and mefloquine were used, whereas in 2003 and 2004, drugs were given individually from a bulk pack at a total dose of 12 mg/kg of artesunate and 25 mg/kg of mefloquine over 3 days. A total of 1025 patients were enrolled over the 4 years and 977 were follow-up during the period of 28 days. The PCR-corrected cure rates ranged from 85.7% to 100% with an overall cure rate of 95.8% (920/960). The studies in 2002 showed also that co-blister packs used on the basis of age and not on the basis of weight could lead to underdosed regimens but without any detectable effect on the treatment outcome. The follow-up period was extended from 28 to 42 days in three sites in 2004. A total of 219 among 255 were follow-up until day 42. The cure rate decreased but not significantly from 90.1% (73/81) with 28 days follow-up to 79.3% (46/58) with 42 days follow-up in Pailin, whereas the cure rate remained at 100% in the two other sites. Side effects were common, especially dizziness, but were mild and transient and patients recovered without any medical intervention.

  6. Clinical trials of artesunate plus sulfadoxine-pyrimethamine for Plasmodium falciparum malaria in Afghanistan: maintained efficacy a decade after introduction.

    Science.gov (United States)

    Awab, Ghulam Rahim; Imwong, Mallika; Pukrittayakamee, Sasithon; Alim, Fazel; Hanpithakpong, Warunee; Tarning, Joel; Dondorp, Arjen M; Day, Nicholas P J; White, Nicholas J; Woodrow, Charles J

    2016-02-25

    Combination therapy with artesunate plus sulfadoxine-pyrimethamine (SP) was adopted as recommended treatment for Plasmodium falciparum infection in Afghanistan in 2003. A series of prospective clinical studies examining the efficacy of artesunate plus sulfadoxine-pyrimethamine (AS + SP) against P. falciparum were undertaken in sentinel sites in Afghanistan from 2007 to 2014, accompanied by relevant molecular studies. The first study was a randomized trial of AS + SP versus dihydroartemisinin-piperaquine, while two subsequent studies were standard therapeutic efficacy studies of AS + SP. Three hundred and three patients were enrolled across four provinces in the north and east of the country. Curative efficacy was high in all the trials, with an adequate clinical and parasitological response (ACPR) of more than 95 % in all groups and trial stages. Genotyping for drug-resistance alleles at dhfr indicated fixation of the S108 N mutation and a prevalence of the C59R mutation of approximately 95 % across all sites. Other mutations in dhfr and dhps remained rare or absent entirely, although five isolates from the first trial carried the dhps triple mutant SGEGA haplotype. In the last study undertaken in 2012-2014 the K13 artemisinin resistance marker was examined; only two of 60 successfully sequenced samples carried a K13-propeller mutation. These data confirm maintained efficacy 10 years after introduction of artesunate plus SP as combination treatment of P. falciparum in Afghanistan. The molecular data indicate that despite a substantial fall in incidence, resistance has not developed to artemisinins, or intensified to the ACT partner drug components. Trial Registration http://www.clinicaltrials.gov/ct NCT00682578, NCT01115439 and NCT01707199.

  7. Current status of artemisinin-resistant falciparum malaria in South Asia: a randomized controlled artesunate monotherapy trial in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Peter Starzengruber

    Full Text Available OBJECTIVE: Recent reports indicate that first cases of genuine artemisinin resistance have already emerged along the Thai-Cambodian border. The main objective of this trial was to track the potential emergence of artemisinin resistance in Bangladesh, which in terms of drug resistance forms a gateway to the Indian subcontinent. METHODS: We conducted an open-label, randomized, controlled 42-day clinical trial in Southeastern Bangladesh to investigate the potential spread of clinical artemisinin resistance from Southeast Asia. A total of 126 uncomplicated falciparum malaria patients were randomized to one of 3 treatment arms (artesunate monotherapy with 2 or 4 mg/kg/day once daily or quinine plus doxycycline TID for 7 days. Only cases fulfilling a stringent set of criteria were considered as being artemisinin-resistant. FINDINGS: The 28-day and 42-day cure rates in the artesunate monotherapy (2 and 4 mg/kg and quinine/doxycyline arms were 97.8% (95% confidence interval, CI: 87.8-99.8%, 100% (95% CI: 91.1-100%, and 100% (95% CI: 83.4-100%, respectively. One case of re-infection was seen in the artesunate high dose arm, and a single case of recrudescence was observed in the low dose group on day 26. No differences in median parasite and fever clearance times were found between the 2 artesunate arms (29.8 h and 17.9 h vs. 29.5 h and 19.1 h. Not a single case fulfilled our criteria of artemisinin resistance. Parasite clearance times were considerably shorter and ex vivo results indicate significantly higher susceptibility (50% inhibitory concentration for dihydroartemisinin was 1.10 nM; 95% CI: 0.95-1.28 nM to artemisinins as compared to SE-Asia. CONCLUSION: There is currently no indication that artemisinin resistance has reached Bangladesh. However, the fact that resistance has recently been reported from nearby Myanmar indicates an urgent need for close monitoring of artemisinin resistance in the region. TRIAL REGISTRATION: ClinicalTrials.gov NCT

  8. Pyronaridine-artesunate granules versus artemether-lumefantrine crushed tablets in children with Plasmodium falciparum malaria: a randomized controlled trial

    OpenAIRE

    Kayentao Kassoum; Doumbo Ogobara K; Pénali Louis K; Offianan André T; Bhatt Kirana M; Kimani Joshua; Tshefu Antoinette K; Kokolomami Jack HT; Ramharter Michael; de Salazar Pablo Martinez; Tiono Alfred B; Ouédraogo Alphonse; Bustos Maria Dorina G; Quicho Frederick; Borghini-Fuhrer Isabelle

    2012-01-01

    Abstract Background Children are most vulnerable to malaria. A pyronaridine-artesunate pediatric granule formulation is being developed for the treatment of uncomplicated Plasmodium falciparum malaria. Methods This phase III, multi-center, comparative, open-label, parallel-group, controlled clinical trial included patients aged ≤12 years, bodyweight ≥5 to 90% (P 3 times the upper limit of normal (ULN) and peak total bilirubin >2xULN (i.e. within the Hy’s law definition). Conclusions The pyron...

  9. Efficacy and Safety of Pyronaridine-Artesunate for Treatment of Uncomplicated Plasmodium falciparum Malaria in Western Cambodia.

    Science.gov (United States)

    Leang, Rithea; Canavati, Sara E; Khim, Nimol; Vestergaard, Lasse S; Borghini Fuhrer, Isabelle; Kim, Saorin; Denis, Mey Bouth; Heng, Pisal; Tol, Bunkea; Huy, Rekol; Duparc, Stephan; Dondorp, Arjen M; Menard, Didier; Ringwald, Pascal

    2016-07-01

    Pyronaridine-artesunate efficacy for the treatment of uncomplicated Plasmodium falciparum malaria was assessed in an area of artemisinin resistance in western Cambodia. This nonrandomized, single-arm, observational study was conducted between 2014 and 2015. Eligible patients were adults or children with microscopically confirmed P. falciparum infection and fever. Patients received pyronaridine-artesunate once daily for 3 days, dosed according to body weight. The primary outcome was an adequate clinical and parasitological response (ACPR) on day 42, estimated by using Kaplan-Meier analysis, PCR adjusted to exclude reinfection. One hundred twenty-three patients were enrolled. Day 42 PCR-crude ACPRs were 87.2% (95% confidence interval [CI], 79.7 to 92.6%) for the overall study, 89.8% (95% CI, 78.8 to 95.3%) for Pursat, and 82.1% (95% CI, 68.4 to 90.2%) for Pailin. Day 42 PCR-adjusted ACPRs were 87.9% (95% CI, 80.6 to 93.2%) for the overall study, 89.8% (95% CI, 78.8 to 95.3%) for Pursat, and 84.0% (95% CI, 70.6 to 91.7%) for Pailin (P = 0.353 by a log rank test). Day 28 PCR-crude and -adjusted ACPRs were 93.2% (95% CI, 82.9 to 97.4%) and 88.1% (95% CI, 75.3 to 94.5%) for Pursat and Pailin, respectively. A significantly lower proportion of patients achieved day 3 parasite clearance in Pailin (56.4% [95% CI, 43.9 to 69.6%]) than in Pursat (86.7% [95% CI, 76.8 to 93.8%]; P = 0.0019). Fever clearance was also extended at Pailin versus Pursat (P < 0.0001). Most patients (95.9% [116/121]) harbored P. falciparum kelch13 C580Y mutant parasites. Pyronaridine-artesunate was well tolerated; mild increases in hepatic transaminase levels were consistent with data from previous reports. Pyronaridine-artesunate efficacy was below the World Health Organization-recommended threshold at day 42 for medicines with a long half-life (90%) for first-line treatment of P. falciparum malaria in western Cambodia despite high efficacy elsewhere in Asia and Africa. (This study has been registered

  10. Open-label comparative clinical study of chlorproguanil-dapsone fixed dose combination (Lapdap alone or with three different doses of artesunate for uncomplicated Plasmodium falciparum malaria.

    Directory of Open Access Journals (Sweden)

    Daniel G Wootton

    Full Text Available UNLABELLED: The objective of this study was to determine the appropriate dose of artesunate for use in a fixed dose combination therapy with chlorproguanil-dapsone (CPG-DDS for the treatment of uncomplicated falciparum malaria. METHODS: Open-label clinical trial comparing CPG-DDS alone or with artesunate 4, 2, or 1 mg/kg at medical centers in Blantyre, Malawi and Farafenni, The Gambia. The trial was conducted between June 2002 and February 2005, including 116 adults (median age 27 years and 107 children (median age 38 months with acute uncomplicated Plasmodium falciparum malaria. Subjects were randomized into 4 groups to receive CPG-DDS alone or plus 4, 2 or 1 mg/kg of artesunate once daily for 3 days. Assessments took place on Days 0-3 in hospital and follow-up on Days 7 and 14 as out-patients. Efficacy was evaluated in the Day 3 per-protocol (PP population using mean time to reduce baseline parasitemia by 90% (PC90. A number of secondary outcomes were also included. Appropriate artesunate dose was determined using a pre-defined decision matrix based on primary and secondary outcomes. Treatment emergent adverse events were recorded from clinical assessments and blood parameters. Safety was evaluated in the intent to treat (ITT population. RESULTS: In the Day 3 PP population for the adult group (N = 85, mean time to PC90 was 19.1 h in the CPG-DDS group, significantly longer than for the +artesunate 1 mg/kg (12.5 h; treatment difference -6.6 h [95%CI -11.8, -1.5], 2 mg/kg (10.7 h; -8.4 h [95%CI -13.6, -3.2] and 4 mg/kg (10.3 h; -8.7 h [95%CI -14.1, -3.2] groups. For children in the Day 3 PP population (N = 92, mean time to PC90 was 21.1 h in the CPG-DDS group, similar to the +artesunate 1 mg/kg group (17.7 h; -3.3 h [95%CI -8.6, 2.0], though the +artesunate 2 mg/kg and 4 mg/kg groups had significantly shorter mean times to PC90 versus CPG-DDS; 14.4 h (treatment difference -6.4 h [95%CI -11.7, -1.0] and 12.8 h (-7.4 h [95%CI -12.9, -1

  11. Bioequivalence of Two Intravenous Artesunate Products with Its Active Metabolite Following Single and Multiple Injections

    Directory of Open Access Journals (Sweden)

    Qigui Li

    2011-01-01

    Full Text Available In animal species and humans, artesunate (AS undergoes extensive and complex biotransformation to an active metabolite, dihydroartemisinin (DHA. The bioequivalence of two intravenous AS pharmaceutical products with 5% NaHCO3 (China Formulation or 0.3 M PBS (WRAIR Formulation was determined in rats in a two-formulation, two-period, and two-sequence crossover experimental design. Following single and multiple intravenous administrations, a series of blood samples was collected by using an automated blood sampler and drug concentrations were analyzed by LC-MS/MS. The 90% CI of the difference between the two intravenous formulations was contained within 80–125% of the geometric mean of pharmacokinetic parameters for AS and DHA in all animals dosed. Hematological effects were studied on days 1 and 3 after the final dosing, and a rapidly reversible hematological toxicity (significant reductions in reticulocyte levels was seen in the peripheral blood of the rats treated with each formulation. The results showed that bioequivalence with the parent compound and active metabolite was fulfilled in the 82.3–117.7% ranges of all parameters (AUC0–t, Cmax, concentration average and degree of fluctuation in the two-period and two-sequence crossover studies following single and repeated intravenous injections. For the metabolite, the equivalence was satisfied in most pharmacokinetic parameters tested due to the variability in the hydrolysis rate of AS to DHA. The WRAIR formulation of AS was considered to be bioequivalent to the Chinese formulation at steady-state according to the total drug exposure, in terms of both parent drug and active metabolite, rapidly reversal in reticulocyte decline, and extension of single and multiple administrations. Therefore, the parent drug and active metabolites should play similar important roles in the determination of efficacy and safety of the drug.

  12. Artesunate induces ROS-mediated apoptosis in doxorubicin-resistant T leukemia cells.

    Directory of Open Access Journals (Sweden)

    Thomas Efferth

    Full Text Available BACKGROUND: A major obstacle for successful cancer treatment often is the development of drug resistance in cancer cells during chemotherapy. Therefore, there is an urgent need for novel drugs with improved efficacy against tumor cells and with less toxicity on normal cells. Artesunate (ART, a powerful anti-malarial herbal compound, has been shown to inhibit growth of various tumor cell lines in vitro and of xenografted Kaposi's sarcoma in mice in vivo. However, the molecular mechanisms by which ART exerts its cytotoxicity have not been elucidated. The ART-class of anti-malarial compounds is attractive due to their activity against multidrug-resistant Plasmodium falciparum and Plasmodium vivax strains. Another salient feature of these compounds is the lack of severe side effects in malaria patients. METHODOLOGY AND PRINCIPAL FINDINGS: In this study, we used T-cell leukemias as a model system to study the molecular mechanisms of ART-induced apoptosis. The most typical anticancer drugs are DNA intercalators such as Doxorubicin. To investigate drug sensitivity and resistance, we chose a Doxorubicin-resistant leukemia cell line and investigated the killing effect of ART on these cells. We show that ART induces apoptosis in leukemic T cells mainly through the mitochondrial pathway via generation of reactive oxygen species (ROS, a mechanism different from Doxorubicin. This is confirmed by the fact that the antioxidant N-Acetyle-Cysteine (NAC could completely block ROS generation and, consequently, inhibited ART-induced apoptosis. Therefore, ART can overcome the Doxorubicin-resistance and induce the Doxorubicin-resistant leukemia cells to undergo apoptosis. We also show that ART can synergize with Doxorubicin to enhance apoptotic cell death in leukemic T cells. This synergistic effect can be largely explained by the fact that ART and Doxorubicin use different killing mechanisms. CONCLUSIONS: Our studies raise the possibility to develop ART in

  13. Determination of the level of some elements in edible oils sold in ...

    African Journals Online (AJOL)

    The human body uses oils and fats in the diet as an energy source, as a structural ... on human health and nutrition have been increasingly studied in recent years. ... In this present study, the levels of some metals were determined in vegetable oils sold ... cadmium, lead, chromium, aluminium, copper, manganese and nikel.

  14. Microbiological and physicochemical characterization of shea butter sold on Benin markets

    NARCIS (Netherlands)

    Honfo, G.F.; Hell, K.; Akissoe, N.H.; Linnemann, A.R.; Coulibaly, O.

    2012-01-01

    Shea butter, a fat from the nuts of shea tree, is of great nutritional and commercial value for local communities of Africa. The sanitary and physicochemical qualities of shea butter sold in Benin markets are unknown. This study assesses the quality characteristics of 54 samples of shea butter colle

  15. The physico-chemical characteristics and some nutritional values of vegetable amaranth sold in Nairobi, Kenya

    NARCIS (Netherlands)

    Onyango, C.; Shibairo, S.I.; Imungi, J.K.; Harbinson, J.

    2008-01-01

    Twenty one major supermarkets and ten independent green grocers in the city of Nairobi were surveyed for types of vegetable amaranths sold and their post harvest handling. The nutrient composition of the vegetables was also analyzed. In addition, information on three other traditional leafy vegetabl

  16. 40 CFR 152.30 - Pesticides that may be transferred, sold, or distributed without registration.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Pesticides that may be transferred... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.30 Pesticides that may be transferred, sold, or distributed without...

  17. 18 CFR 367.53 - Service company property purchased or sold.

    Science.gov (United States)

    2010-04-01

    ...) When service company property is acquired by purchase, merger, consolidation, liquidation, or otherwise...) When service company property is sold, conveyed, or transferred to another by sale, merger... property (§ 367.4212). (e) In connection with the acquisition of service company property...

  18. Exploratory survey of informal vendor-sold fast food in rural South ...

    African Journals Online (AJOL)

    Exploratory survey of informal vendor-sold fast food in rural South Africa. ... to understand access to food better and how this influences food choice in rural ... of the Witwatersrand-Agincourt Health and Socio-Demographic Surveillance System ...

  19. Iodine levels in Edible Salt Sold in Malawi, Kenya and Zambia ...

    African Journals Online (AJOL)

    Iodine levels in Edible Salt Sold in Malawi, Kenya and Zambia. ... Log in or Register to get access to full text downloads. ... on the packets, which indicated that the salt was fortified with sufficient amount of potassium ... On the other hand, 50 % of Malawian samples had levels within the recommended range of 80-100 mg/kg.

  20. 12 CFR 16.9 - Securities offered and sold in holding company dissolution.

    Science.gov (United States)

    2010-01-01

    ... dissolution. 16.9 Section 16.9 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SECURITIES OFFERING DISCLOSURE RULES § 16.9 Securities offered and sold in holding company dissolution. Offers and sales of bank issued securities in connection with the dissolution of the holding company of...

  1. 26 CFR 145.4051-1 - Imposition of tax on heavy trucks and trailers sold at retail.

    Science.gov (United States)

    2010-04-01

    ... sold at retail. 145.4051-1 Section 145.4051-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF... trailers sold at retail. (a) Imposition of tax—(1) In general. Section 4051(a)(1) imposes a tax on the first retail sale (as defined in § 145.4052-1(a)) of the following articles (including in each...

  2. A randomized, placebo-controlled, double-blind trial on sulfadoxine-pyrimethamine alone or combined with artesunate or amodiaquine in uncomplicated malaria.

    NARCIS (Netherlands)

    Mockenhaupt, F.P.; Ehrhardt, S.; Dzisi, S.Y.; Bousema, T.; Wassilew, N.; Schreiber, J.; Anemana, S.D.; Cramer, J.P.; Otchwemah, R.N.; Sauerwein, R.W.; Eggelte, T.A.; Bienzle, U.

    2005-01-01

    The therapeutic efficacy of sulfadoxine-pyrimethamine (SP) alone, SP plus amodiaquine (AQ), and SP plus artesunate (AS) was assessed in a randomized, placebo-controlled, and double-blind trial among 438 children with uncomplicated Plasmodium falciparum malaria in northern Ghana. Clinical and parasit

  3. Efficacy and safety of triple combination therapy with artesunate-amodiaquine-methylene blue for falciparum malaria in children: a randomized controlled trial in burkina faso

    NARCIS (Netherlands)

    Coulibaly, B.; Pritsch, M.; Bountogo, M.; Meissner, P.E.; Nebie, E.; Klose, C.; Kieser, M.; Berens-Riha, N.; Wieser, A.; Sirima, S.B.; Breitkreutz, J.; Schirmer, R.H.; Sie, A.; Mockenhaupt, F.P.; Drakeley, C.; Bousema, T.; Muller, O.

    2015-01-01

    BACKGROUND: Methylene blue (MB) has been shown to be safe and effective against falciparum malaria in Africa and to have pronounced gametocytocidal properties. METHODS: Three days of treatment with artesunate (AS)-amodiaquine (AQ) combined with MB was compared with AS-AQ treatment in a randomized co

  4. Artesunate Reduces Proliferation, Interferes DNA Replication and Cell Cycle and Enhances Apoptosis in Vascular Smooth Muscle Cells

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    This study examined the effect of artesunate (Art) on the proliferation, DNA replication, cell cycles and apoptosis of vascular smooth muscle cells (VSMCs). Primary cultures of VSMCs were established from aortas of mice and artesunate of different concentrations was added into the medium. The number of VSMCs was counted and the curve of cell growth was recorded.The activity of VSMCs was assessed by using MTT method and inhibitory rate was calculated.DNA replication was evaluated by [3 H]-TdR method and apoptosis by DNA laddering and HE staining. Flowmetry was used for simultaneous analysis of cell apoptosis and cell cycles. Compared with the control group, VSMCs proliferation in Art interfering groups were inhibited and [3H]-TdR incorprating rate were decreased as well as cell apoptosis was induced. The progress of cell cycle was blocked in G0/G1 by Art in a dose-dependent manner. It is concluded that Art inhibits VSMCs proliferation by disturbing DNA replication, inducing cell apoptosis and blocking cell cycle in G0/G1 phase.

  5. Reversible binocular visual loss in temporal association with artesunate-amodiaquine treatment in a child on mefloquine chemoprophylaxis.

    Science.gov (United States)

    Adjei, G O; Adabayeri, V M; Annobil, S H

    2012-09-01

    A case of an acute reversible visual loss in a 10-year-old child who was on mefloquine prophylaxis, and was treated with artesunate-amodiaquine for an acute febrile illness diagnosed clinically as uncomplicated malaria, is reported. On admission the patient could not perceive light and had bilateral papilloedema. She was treated with dexamethasone and recovered her sight gradually over a 21-day period. There has been no previous report to our knowledge, of an association between acute visual loss and mefloquine, amodiaquine, or artesunate in the published literature, even though mefloquine is associated with blurring of vision, and antimalarials of the quinoline class have been associated with retinopathy (during long term use). While causality is difficult to ascribe in this case, it may be prudent to avoid the use of quinoline-based antimalarials for treating acute malaria in travelers taking mefloquine prophylaxis, because information on the safety of concurrent use of artemisinin combination therapies and mefloquine, or other recommended prophylactic regimens, is limited.

  6. A Phase III, Randomized, Non-Inferiority Trial to Assess the Efficacy and Safety of Dihydroartemisinin-Piperaquine in Comparison with Artesunate-Mefloquine in Patients with Uncomplicated Plasmodium falciparum Malaria in Southern Laos

    Science.gov (United States)

    Mayxay, Mayfong; Keomany, Sommay; Khanthavong, Maniphone; Souvannasing, Phoutthalavanh; Stepniewska, Kasia; Khomthilath, Tiengthong; Keola, Siamphay; Pongvongsa, Tiengkham; Phompida, Samlane; Ubben, David; Valecha, Neena; White, Nicholas J.; Newton, Paul N.

    2010-01-01

    We conducted an open, randomized clinical trial of oral dihydroartemisinin-piperaquine (DP) versus artesunate-mefloquine (AM) in 300 patients in Laos with uncomplicated Plasmodium falciparum malaria as part of a multicentre study in Asia. Survival analysis and adjustment for re-infection showed that the 63-day cure rates (95% confidence interval [CI]) were 100% for AM and 99.5% (96.4–99.8%) for DP. The 63-day cure rates per protocol were 99% (97 of 98) for AM and 99.5% (196 of 197) for DP (P = 0.55). The difference (AM minus DP) in cure rates (95% CI) was −0.5% (−5.1 to 2.0%), which is within the 5% non-inferiority margin. The median fever and parasite clearance times were also similar for AM and DP. The proportion of patients with at least one recorded potential adverse event was significantly higher in the AM group (38 of 87, 44%) than in the DP group (57 of 182, 31%) (relative risk = 0.6, 95% CI = 0.4–0.9; P = 0.04). Dihydroartemisinin-piperaquine is not inferior to AM in the treatment of uncomplicated P. falciparum malaria in Laos and is associated with fewer adverse effects. The results of this study were similar to those of the larger multicentre study. PMID:21118925

  7. Isolation of pathogenic Escherichia coli from buffalo meat sold in Parbhani city, Maharashtra, India

    OpenAIRE

    2013-01-01

    Aim: Isolation, characterization, in-vitro pathogenicity and antibiogram study of E.coli from buffalo meat sold in Parbhani city. Materials and Methods: Meat samples were collected from buffalo immediately after slaughter. Isolation, identification and enumeration of E. coli were done by following standard methods and protocols. Hemolysin test and Congo red binding assay were used to study in-vitro pathogenicity of E. coli isolates. Disc diffusion method was used to study antibiogram of patho...

  8. Bacteriological safety of packaged drinking water sold in Nigeria: public health implications

    OpenAIRE

    Olumide A. Odeyemi

    2015-01-01

    Background Over the past years, there has been increase in packaged water consumption in Nigeria. Although, there are several studies on microbial safety of sachet packaged drinking water, there is no information on prevailing pathogens. Findings A comprehensive literature search and meta-analysis of peer reviewed primary studies reported from 2005 for microbiological safety of packaged drinking water sold in Nigeria was conducted using “sachet water”, “bottled water” and “packaged water” and...

  9. Assessment of Microbiological Quality of Yogurt Sold By Street Vendors in Onitsha Metropolis, Anambra State, Nigeria

    OpenAIRE

    Ifeanyi V. O.; Ihesiaba E. O.; Muomaife O. M.; Ikenga C.

    2013-01-01

    Four brands of yogurt sold by street vendors in Onitsha Metropolis, Anambra State, Eastern Nigeriia were sampled, the pH was determined and microbiological assessments were conducted in order to ascertain the total heterotrophic bacteria, coliforms and yeast in the samples (A – D) during a seven day period. The results revealed that values of pH monitored varied from 3.69 – 4.50 while a total of five bacteria species belonging to Escherichia coli, Staphylococcus aur...

  10. Parasitic contamination of fresh vegetables sold at central markets in Khartoum state, Sudan

    OpenAIRE

    Mohamed, Mona Ali; Siddig, Emmanuel Edwar; Elaagip, Arwa Hassan; Edris, Ali Mahmoud Mohammed; Nasr, Awad Ahmed

    2016-01-01

    Background Fresh vegetables are considered as vital nutrients of a healthy diet as they supply the body with essential supplements. The consumption of raw vegetables is the main way for transmission of intestinal parasitic organisms. This study was aimed at detecting the parasitic contamination in fresh vegetables sold in two central open-aired markets in Khartoum state, Sudan. Methods In this prospective cross-sectional study, a total of 260 fresh vegetable samples and 50 water samples used ...

  11. Prevalence of soil-transmitted helminthes in vegetables sold in Bali markets, Taraba State, Nigeria

    OpenAIRE

    Ukwubile, Cletus A.; Yohanna, Emohseh

    2015-01-01

    In Nigeria, leafy vegetables form essential part of dietary foods especially in the South-eastern part. This is because of enormous supplements derived from them that affect human health positively. These benefits derived were however reduced drastically by incidence of soil-transmitted helminthes associated ailments in humans who consumed these vegetables on daily basis. This present study was carried out to determine the prevalence of soil transmitted helminthes in vegetables sold in Bali m...

  12. Determination of Microbial Load in Multivitamin and Cough Syrups Sold in Dhaka City

    OpenAIRE

    Abdullah Al Mamun; Tapas Kumar Shaha; Md. Murad Khan; Md. Shahidul Kabir

    2014-01-01

    The production of substandard drugs and use of inappropriate methods in manufacturing medical products in pharmaceutical industries may cause non-therapeutic effect in patients particularly in children. Hence this study was conducted to determine the microbiological quality of multivitamin and cough syrups of different brands sold in local pharmacy in Dhaka city. Microbiological analysis was carried out using spread plate technique on different culture media including nutrient agar, mannitol ...

  13. The Trading Balance Sheet Of Romania - Two Decades With An Annual Adverse Sold

    Directory of Open Access Journals (Sweden)

    Simona Corina GUDEI

    2011-03-01

    Full Text Available The current communication, expressing the entirely special importance that must be granted to the fact that for two decades, year after year, the sold of the trading balance sheet of Romania was adverse. Moreover, it has increased greatly during the decade 2000-2009 towards the previous decade 1990-1999, respectively from 20 milliards dollars to 100 milliards of dollars, with especially serious consequences both on the external and on the internal economic balance.

  14. Wild vegetable mixes sold in the markets of Dalmatia (southern Croatia

    Directory of Open Access Journals (Sweden)

    Łuczaj Łukasz

    2013-01-01

    Full Text Available Abstract Background Dalmatia is an interesting place to study the use of wild greens as it lies at the intersection of influence of Slavs, who do not usually use many species of wild greens, and Mediterranean culinary culture, where the use of multiple wild greens is common. The aim of the study was to document the mixtures of wild green vegetables which are sold in all the vegetable markets of Dalmatia. Methods All vendors (68 in all 11 major markets of the Dalmatian coast were interviewed. The piles of wild vegetables they sold were searched and herbarium specimens taken from them. Results The mean number of species in the mix was 5.7. The most commonly sold wild plants are: Sonchus oleraceus L., Allium ampeloprasum L., Foeniculum vulgare Mill., Urospermum picroides F.W.Schmidt, Papaver rhoeas L., Daucus carota L., Taraxacum sp., Picris echioides L., Silene latifolia Poir. and Crepis spp. Also the cultivated beet (Beta vulgaris L. and a few cultivated Brassicaceae varieties are frequent components. Wild vegetables from the mix are usually boiled for 20–30 minutes and dressed with olive oil and salt. Altogether at least 37 wild taxa and 13 cultivated taxa were recorded. Apart from the mixes, Asparagus acutifolius L. and Tamus communis L. shoots are sold in separate bunches (they are usually eaten with eggs, as well as some Asteraceae species, the latter are eaten raw or briefly boiled. Conclusions The rich tradition of eating many wild greens may result both from strong Venetian and Greek influences and the necessity of using all food resources available in the barren, infertile land in the past. Although the number of wild-collected green vegetables is impressive we hypothesize that it may have decreased over the years, and that further in-depth local ethnobotanical studies are needed in Dalmatia to record the disappearing knowledge of edible plants.

  15. A randomised controlled trial of artemether-lumefantrine versus artesunate for uncomplicated plasmodium falciparum treatment in pregnancy.

    Directory of Open Access Journals (Sweden)

    Rose McGready

    2008-12-01

    Full Text Available BACKGROUND: To date no comparative trials have been done, to our knowledge, of fixed-dose artemisinin combination therapies (ACTs for the treatment of Plasmodium falciparum malaria in pregnancy. Evidence on the safety and efficacy of ACTs in pregnancy is needed as these drugs are being used increasingly throughout the malaria-affected world. The objective of this study was to compare the efficacy, tolerability, and safety of artemether-lumefantrine, the most widely used fixed ACT, with 7 d artesunate monotherapy in the second and third trimesters of pregnancy. METHODS AND FINDINGS: An open-label randomised controlled trial comparing directly observed treatment with artemether-lumefantrine 3 d (AL or artesunate monotherapy 7 d (AS7 was conducted in Karen women in the border area of northwestern Thailand who had uncomplicated P. falciparum malaria in the second and third trimesters of pregnancy. The primary endpoint was efficacy defined as the P. falciparum PCR-adjusted cure rates assessed at delivery or by day 42 if this occurred later than delivery, as estimated by Kaplan-Meier survival analysis. Infants were assessed at birth and followed until 1 y of life. Blood sampling was performed to characterise the pharmacokinetics of lumefantrine in pregnancy. Both regimens were very well tolerated. The cure rates (95% confidence interval for the intention to treat (ITT population were: AS7 89.2% (82.3%-96.1% and AL 82.0% (74.8%-89.3%, p = 0.054 (ITT; and AS7 89.7% (82.6%-96.8% and AL 81.2% (73.6%-88.8%, p = 0.031 (per-protocol population. One-third of the PCR-confirmed recrudescent cases occurred after 42 d of follow-up. Birth outcomes and infant (up to age 1 y outcomes did not differ significantly between the two groups. The pharmacokinetic study indicated that low concentrations of artemether and lumefantrine were the main contributors to the poor efficacy of AL. CONCLUSION: The current standard six-dose artemether-lumefantrine regimen was well

  16. Tratamento da malária com artesunate (retocaps® em crianças da Amazônia brasileira Malaria treatment with artesunate (retocaps® in children of the Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Maria das Graças Costa Alecrim

    2000-04-01

    Full Text Available Avaliamos a resposta clínica e parasitológica à terapêutica com o artesunate retocaps®, em 32 crianças internadas na Fundação de Medicina Tropical do Amazonas, que apresentavam malária com quadro clínico moderado e grave. Destas, 29 tinham a doença por P. falciparum e três, P. vivax. A melhora clínica foi observada após 24 horas do início da terapêutica, com 33,3% de pacientes afebris e, 48 horas após o tratamento, 77,2% das crianças não apresentavam febre. O acompanhamento da parasitemia assexuada, mostrou que no D2 58,6% das crianças com malária falciparum estavam negativas; em D4 todas haviam negativado, tanto na malária pelo P. falciparum como pelo P. vivax. No seguimento prolongado, na malária P. falciparum, encontramos 66,6% de recrudescências. Os resultados nos permitem concluir pela eficácia e praticidade no uso do artesunate retocaps® com rápida redução da parasitemia e melhora clínica. Entretanto, na malária P. falciparum a taxa de recrudescência foi elevada. Não foi observado para-efeito que possa ser imputado ao uso da droga.We evaluated the clinical and therapeutic response to artesunate retocaps® in 32 children admitted to the Fundação de Medicina Tropical do Amazonas (Amazon Foundation of Tropical Medicine with clinical characteristics of moderate and severe malaria. Of these, 29 were infected with P. falciparum and 3 with P. vivax. They improved clinically 24 hours after the beginning of therapy, with 33.3% of patients without fever, and after 48 hours, 77.2% of the children had no fever. The monitoring of asexual forms of the parasites showed that on D2 (day 2 of treatment 58.6% of children with P. falciparum infection had no more parasites in the blood stream, on D4 all children had negative slides both for P. falciparum and for P. vivax infection. In a long-term follow up, we found 66.6% recrudescence in P. falciparum patients. The results enabled the conclusion that artesunate retocaps

  17. Assessing Market-Sold Remedies in Lomé (Togo for Hygienic Quality

    Directory of Open Access Journals (Sweden)

    Comlan de Souza

    2011-01-01

    Full Text Available Traditional concoctions sold in marketplaces are always assumed to be safe and efficient; however, they can be potentially toxic because of poor hygienic practices in plant processing or storage. The present study aimed to assess for the microbial quality of market-sold vegetable drugs in Lomé. Thus, a total of 209 plant remedies were collected in marketplaces and analysed for the presence of total aerobic bacteria, total coliforms, thermotolerant coliforms, Staphylococcus aureus, sulphite reducing bacteria, and yeast and moulds according to the French Association of Normalisation (AFNOR guidelines. The results revealed that all formulations were contaminated by several microorganisms, excepted alcohol-based mixtures. According to AFNOR limits nonconform drugs were according to total aerobic bacteria (86.96% powders, 81.82% capsules, 66.67% tisanes, and 42.11% decoctions; to total coliforms (9.10% capsules, 8.70% powders and 1.75% decoction; to yeasts and moulds (77.78% ointments, 40% calcined powders, 36.36% capsules, and 23.91% powders. The microbiological analysis revealed that the majority of contaminating bacteria were gram positive catalase positive and oxidase positive bacilli. Quality control studies on market-sold remedies are currently needed to evaluate the microbial risk in consuming these products and they may allow the standardisation of plant processing and storage.

  18. Development of NIRS method for quality control of drug combination artesunate-azithromycin for the treatment of severe malaria.

    Science.gov (United States)

    Boyer, Chantal; Gaudin, Karen; Kauss, Tina; Gaubert, Alexandra; Boudis, Abdelhakim; Verschelden, Justine; Franc, Mickaël; Roussille, Julie; Boucher, Jacques; Olliaro, Piero; White, Nicholas J; Millet, Pascal; Dubost, Jean-Pierre

    2012-01-01

    Near infrared spectroscopy (NIRS) methods were developed for the determination of analytical content of an antimalarial-antibiotic (artesunate and azithromycin) co-formulation in hard gelatin capsule (HGC). The NIRS consists of pre-processing treatment of spectra (raw spectra and first-derivation of two spectral zones), a unique principal component analysis model to ensure the specificity and then two partial least-squares regression models for the determination content of each active pharmaceutical ingredient. The NIRS methods were developed and validated with no reference method, since the manufacturing process of HGC is basically mixed excipients with active pharmaceutical ingredients. The accuracy profiles showed β-expectation tolerance limits within the acceptance limits (±5%). The analytical control approach performed by reversed phase (HPLC) required two different methods involving two different preparation and chromatographic methods. NIRS offers advantages in terms of lower costs of equipment and procedures, time saving, environmentally friendly.

  19. Enhancing activity of artesunate against breast cancer cells via induced-apoptosis pathway by loading into lipid carriers.

    Science.gov (United States)

    Tran, Tuan Hiep; Nguyen, Anh Ngoc; Kim, Jong Oh; Yong, Chul Soon; Nguyen, Chien Ngoc

    2016-12-01

    Artesunate-loaded nanostructured lipid carriers (ART-NLCs) were prepared by hot homogenization followed by ultrasonication technique. The optimized ART-NLC demonstrated a particle size of 117.5 ± 6.1 nm, with good stability regarding zeta-potential of  -19.47 ± 0.9 mV and drug entrapment efficiency of 92.93 ± 1.47%. ART-NLC showed good cellular uptake in breast cancer cells, which was confirmed by confocal laser scanning microscopy (CLSM) and flow cytometry analysis. The significantly higher in vitro cytotoxicity of ART-NLCs against human breast cancer MCF-7, MDA-MB-231 cells as compared with the free ART was recorded.  Hoechst 33342 staining indicated that ART-NLC induced higher apoptosis rates in MCF-7 as well as MDA-MB-231cells than free ART.

  20. A longitudinal trial comparing chloroquine as monotherapy or in combination with artesunate, azithromycin or atovaquone-proguanil to treat malaria.

    Directory of Open Access Journals (Sweden)

    Miriam K Laufer

    Full Text Available BACKGROUND: The predominance of chloroquine-susceptible falciparum malaria in Malawi more than a decade after chloroquine's withdrawal permits contemplation of re-introducing chloroquine for targeted uses. We aimed to compare the ability of different partner drugs to preserve chloroquine efficacy and prevent the re-emergence of resistance. METHODOLOGY/PRINCIPAL FINDINGS: Children with uncomplicated malaria were enrolled at a government health center in Blantyre, Malawi. Participants were randomized to receive chloroquine alone or combined with artesunate, azithromycin or atovaquone-proguanil for all episodes of uncomplicated malaria for one year. The primary outcome was incidence of clinical malaria. Secondary endpoints included treatment efficacy, and incidence of the chloroquine resistance marker pfcrt T76 and of anemia. Of the 640 children enrolled, 628 were included in the intention-to-treat analysis. Malaria incidence (95% confidence interval was 0.59 (.46-.74, .61 (.49-.76, .63 (.50-.79 and .68 (.54-.86 episodes/person-year for group randomized to receive chloroquine alone or in combination with artesunate, azithromycin or atovaquone-proguanil respectively and the differences were not statistically significant. Treatment efficacy for first episodes was 100% for chloroquine monotherapy and 97.9% for subsequent episodes of malaria. Similar results were seen in each of the chloroquine combination groups. The incidence of pfcrt T76 in pure form was 0%; mixed infections with both K76 and T76 were found in two out of 911 infections. Young children treated with chloroquine-azithromycin had higher hemoglobin concentrations at the study's end than did those in the chloroquine monotherapy group. CONCLUSION/SIGNIFICANCE: Sustained chloroquine efficacy with repeated treatment supports the eventual re-introduction of chloroquine combinations for targeted uses such as intermittent preventive treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT00379821.

  1. Leveraging corporate social responsibility to improve consumer safety of dietary supplements sold for weight loss and muscle building

    National Research Council Canada - National Science Library

    Kulkarni, Anvita; Huerto, Ryan; Roberto, Christina A; Austin, S Bryn

    The potential dangers associated with dietary supplements sold for weight loss and muscle building are well documented and increasingly garnering the attention of the media, public, and government leaders...

  2. Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

    Directory of Open Access Journals (Sweden)

    James Prah

    2016-01-01

    Full Text Available Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%−104.70% of stated content by manufacturer. The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%–111.87%. Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market.

  3. Intramuscular Artesunate for Severe Malaria in African Children: A Multicenter Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Peter G Kremsner

    2016-01-01

    Full Text Available Current artesunate (ARS regimens for severe malaria are complex. Once daily intramuscular (i.m. injection for 3 d would be simpler and more appropriate for remote health facilities than the current WHO-recommended regimen of five intravenous (i.v. or i.m. injections over 4 d. We compared both a three-dose i.m. and a three-dose i.v. parenteral ARS regimen with the standard five-dose regimen using a non-inferiority design (with non-inferiority margins of 10%.This randomized controlled trial included children (0.5-10 y with severe malaria at seven sites in five African countries to assess whether the efficacy of simplified three-dose regimens is non-inferior to a five-dose regimen. We randomly allocated 1,047 children to receive a total dose of 12 mg/kg ARS as either a control regimen of five i.m. injections of 2.4 mg/kg (at 0, 12, 24, 48, and 72 h (n = 348 or three injections of 4 mg/kg (at 0, 24, and 48 h either i.m. (n = 348 or i.v. (n = 351, both of which were the intervention arms. The primary endpoint was the proportion of children with ≥ 99% reduction in parasitemia at 24 h from admission values, measured by microscopists who were blinded to the group allocations. Primary analysis was performed on the per-protocol population, which was 96% of the intention-to-treat population. Secondary analyses included an analysis of host and parasite genotypes as risks for prolongation of parasite clearance kinetics, measured every 6 h, and a Kaplan-Meier analysis to compare parasite clearance kinetics between treatment groups. A post hoc analysis was performed for delayed anemia, defined as hemoglobin ≤ 7 g/dl 7 d or more after admission. The per-protocol population was 1,002 children (five-dose i.m.: n = 331; three-dose i.m.: n = 338; three-dose i.v.: n = 333; 139 participants were lost to follow-up. In the three-dose i.m. arm, 265/338 (78% children had a ≥ 99% reduction in parasitemia at 24 h compared to 263/331 (79% receiving the five-dose i

  4. Intramuscular Artesunate for Severe Malaria in African Children: A Multicenter Randomized Controlled Trial.

    Science.gov (United States)

    Kremsner, Peter G; Adegnika, Akim A; Hounkpatin, Aurore B; Zinsou, Jeannot F; Taylor, Terrie E; Chimalizeni, Yamikani; Liomba, Alice; Kombila, Maryvonne; Bouyou-Akotet, Marielle K; Mawili Mboumba, Denise P; Agbenyega, Tsiri; Ansong, Daniel; Sylverken, Justice; Ogutu, Bernhards R; Otieno, Godfrey A; Wangwe, Anne; Bojang, Kalifa A; Okomo, Uduak; Sanya-Isijola, Frank; Newton, Charles R; Njuguna, Patricia; Kazungu, Michael; Kerb, Reinhold; Geditz, Mirjam; Schwab, Matthias; Velavan, Thirumalaisamy P; Nguetse, Christian; Köhler, Carsten; Issifou, Saadou; Bolte, Stefanie; Engleitner, Thomas; Mordmüller, Benjamin; Krishna, Sanjeev

    2016-01-01

    Current artesunate (ARS) regimens for severe malaria are complex. Once daily intramuscular (i.m.) injection for 3 d would be simpler and more appropriate for remote health facilities than the current WHO-recommended regimen of five intravenous (i.v.) or i.m. injections over 4 d. We compared both a three-dose i.m. and a three-dose i.v. parenteral ARS regimen with the standard five-dose regimen using a non-inferiority design (with non-inferiority margins of 10%). This randomized controlled trial included children (0.5-10 y) with severe malaria at seven sites in five African countries to assess whether the efficacy of simplified three-dose regimens is non-inferior to a five-dose regimen. We randomly allocated 1,047 children to receive a total dose of 12 mg/kg ARS as either a control regimen of five i.m. injections of 2.4 mg/kg (at 0, 12, 24, 48, and 72 h) (n = 348) or three injections of 4 mg/kg (at 0, 24, and 48 h) either i.m. (n = 348) or i.v. (n = 351), both of which were the intervention arms. The primary endpoint was the proportion of children with ≥ 99% reduction in parasitemia at 24 h from admission values, measured by microscopists who were blinded to the group allocations. Primary analysis was performed on the per-protocol population, which was 96% of the intention-to-treat population. Secondary analyses included an analysis of host and parasite genotypes as risks for prolongation of parasite clearance kinetics, measured every 6 h, and a Kaplan-Meier analysis to compare parasite clearance kinetics between treatment groups. A post hoc analysis was performed for delayed anemia, defined as hemoglobin ≤ 7 g/dl 7 d or more after admission. The per-protocol population was 1,002 children (five-dose i.m.: n = 331; three-dose i.m.: n = 338; three-dose i.v.: n = 333); 139 participants were lost to follow-up. In the three-dose i.m. arm, 265/338 (78%) children had a ≥ 99% reduction in parasitemia at 24 h compared to 263/331 (79%) receiving the five-dose i

  5. Ferroquine and artesunate in African adults and children with Plasmodium falciparum malaria: a phase 2, multicentre, randomised, double-blind, dose-ranging, non-inferiority study.

    Science.gov (United States)

    Held, Jana; Supan, Christian; Salazar, Carmen L O; Tinto, Halidou; Bonkian, Léa N; Nahum, Alain; Moulero, Bancole; Sié, Ali; Coulibaly, Boubacar; Sirima, Sodiomon B; Siribie, Mohamadou; Otsyula, Nekoye; Otieno, Lucas; Abdallah, Ahmed M; Kimutai, Robert; Bouyou-Akotet, Marielle; Kombila, Maryvonne; Koiwai, Kimiko; Cantalloube, Cathy; Din-Bell, Chantal; Djeriou, Elhadj; Waitumbi, John; Mordmüller, Benjamin; Ter-Minassian, Daniel; Lell, Bertrand; Kremsner, Peter G

    2015-12-01

    Artemisinin-based combination therapies (ACTs) are the recommended first-line treatment for uncomplicated Plasmodium falciparum malaria. Ferroquine is a new combination partner for fast-acting ACTs such as artesunate. We aimed to assess different doses of ferroquine in combination with artesunate against uncomplicated P falciparum malaria in a heterogeneous population in Africa. We did a phase 2, multicentre, parallel-group, double-blind, randomised, dose-ranging non-inferiority trial at eight African hospitals (two in Gabon, three in Burkina Faso, one in Benin, and two in Kenya). We recruited patients presenting with acute P falciparum monoinfection (1000-200,000 parasites per μL), and a central body temperature of at least 37·5°C or history of fever in the past 24 h. We assessed patients in two sequential cohorts: cohort 1 contained adults (bodyweight >50 kg) and adolescents (aged ≥14 years, >30 kg), and cohort 2 contained children (aged 2-13 years, 15-30 kg). We randomly assigned patients (1:1:1:1) to receive artesunate 4 mg/kg per day plus ferroquine 2 mg/kg, 4 mg/kg, or 6 mg/kg, given double-blind once per day for 3 days, or ferroquine monotherapy 4 mg/kg per day given single-blind (ie, allocation was only masked from the patient) once per day for 3 days. We did 14 patient visits (screening, 3 treatment days and 48 h post-treatment surveillance, a visit on day 7, then one follow-up visit per week until day 63). The primary endpoint was non-inferiority of treatment in terms of PCR-corrected cure rate against a reference value of 90%, with a 10% non-inferiority margin, assessed in patients treated without major protocol deviations for parasitologically confirmed malaria. We assessed safety in all treated patients. This study is registered with ClinicalTrials.gov, number NCT00988507, and is closed. Between Oct 16, 2009, and Sept 22, 2010, we randomly assigned 326 eligible patients to treatment groups, with last follow-up visit on Dec 1, 2010. 284 patients

  6. Artesunate Plus Amodiaquine (AS+AQ) Versus Artemether -Lumefantrine (AL) for the Treatment of Uncomplicated Plasmodium Falciparum Malaria in Sub-Saharan Africa-A Meta-Analysis

    OpenAIRE

    Bello, Shaibu O; Chika, Aminu; AbdulGafar, Jimoh O

    2010-01-01

    The purpose of this study is to summarize the available data on the efficacy of Artesunate plus Amodiaquine (AS+AQ) versus Artemether -Lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa using uncorrected parasitaemia as a clinically relevant endpoint. Studies and conference abstracts identified through Pubmed, Medline, Embase, Ansinet, AJOL, Bioline, Cochrane Infectious Diseases Group trials register, The Cochrane Controlled Trials Registe...

  7. Pyronaridine-Artesunate versus Chloroquine in Patients with Acute Plasmodium vivax Malaria: A Randomized, Double-Blind, Non-Inferiority Trial

    OpenAIRE

    Yi Poravuth; Duong Socheat; Ronnatrai Rueangweerayut; Chirapong Uthaisin; Aung Pyae Phyo; Neena Valecha; B. H. Krishnamoorthy Rao; Emiliana Tjitra; Asep Purnama; Isabelle Borghini-Fuhrer; Stephan Duparc; Chang-Sik Shin; Lawrence Fleckenstein

    2011-01-01

    BACKGROUND: New antimalarials are needed for P. vivax and P. falciparum malaria. This study compared the efficacy and safety of pyronaridine-artesunate with that of chloroquine for the treatment of uncomplicated P. vivax malaria. METHODS AND FINDINGS: This phase III randomized, double-blind, non-inferiority trial included five centers across Cambodia, Thailand, India, and Indonesia. In a double-dummy design, patients (aged >3-≤ 60 years) with microscopically confirmed P. vivax mono-infection ...

  8. Changes in the treatment responses to artesunate-mefloquine on the northwestern border of Thailand during 13 years of continuous deployment.

    Directory of Open Access Journals (Sweden)

    Verena Ilona Carrara

    Full Text Available BACKGROUND: Artemisinin combination treatments (ACT are recommended as first line treatment for falciparum malaria throughout the malaria affected world. We reviewed the efficacy of a 3-day regimen of mefloquine and artesunate regimen (MAS(3, over a 13 year period of continuous deployment as first-line treatment in camps for displaced persons and in clinics for migrant population along the Thai-Myanmar border. METHODS AND FINDINGS: 3,264 patients were enrolled in prospective treatment trials between 1995 and 2007 and treated with MAS(3. The proportion of patients with parasitaemia persisting on day-2 increased significantly from 4.5% before 2001 to 21.9% since 2002 (p<0.001. Delayed parasite clearance was associated with increased risk of developing gametocytaemia (AOR = 2.29; 95% CI, 2.00-2.69, p = 0.002. Gametocytaemia on admission and carriage also increased over the years (p = 0.001, test for trend, for both. MAS(3 efficacy has declined slightly but significantly (Hazards ratio 1.13; 95% CI, 1.07-1.19, p<0.001, although efficacy in 2007 remained well within acceptable limits: 96.5% (95% CI, 91.0-98.7. The in vitro susceptibility of P. falciparum to artesunate increased significantly until 2002, but thereafter declined to levels close to those of 13 years ago (geometric mean in 2007: 4.2 nM/l; 95% CI, 3.2-5.5. The proportion of infections caused by parasites with increased pfmdr1 copy number rose from 30% (12/40 in 1996 to 53% (24/45 in 2006 (p = 0.012, test for trend. CONCLUSION: Artesunate-mefloquine remains a highly efficacious antimalarial treatment in this area despite 13 years of widespread intense deployment, but there is evidence of a modest increase in resistance. Of particular concern is the slowing of parasitological response to artesunate and the associated increase in gametocyte carriage.

  9. Microbiological evaluation of drinking water sold by roadside vendors of Delhi, India

    Science.gov (United States)

    Chauhan, Abhishek; Goyal, Pankaj; Varma, Ajit; Jindal, Tanu

    2015-07-01

    Delhi has emerged as one of the greenest capital city of the world. Microbiological assessment of drinking water emphasizes estimation of the hygienic quality of the water sold with reference to community health significance. This study was conducted to evaluate the quality of drinking water sold by roadside vendors in east, west, north and south zones of capital of India. A total number of 36 samples (nine from each zone) were collected as per national guidelines and studied for microbiological assessment. All the drinking water samples were collected in gamma-sterilized bottles and were kept in an ice pack to prevent any significant change in the microbial flora of the samples during the transportation. The water samples were transported to the laboratory in vertical position maintaining the temperature 1-4 °C with ice pack enveloped conditions. Samples were analyzed for total MPN coliform per 100 ml and for the presence and absence of common human pathogenic bacteria such as Escherichia coli, Salmonella, Staphylococcus aureus and Pseudomonas aeruginosa. All the samples were found to be contaminated with coliform organisms in the range of 14 to >1600 per 100 ml of sample. Out of 36 water samples, the occurrence of E. coli was 61 %, Salmonella 25 % S. aureus 14 % and P. aeruginosa 53 % as 22, 9, 5 and 19 samples were found contaminated, respectively. The numbers of coliform bacteria and presence of some common pathogenic bacteria suggested that the quality of drinking water sold by roadside vendors is not within the Indian standard and WHO guidelines laid down for drinking water quality. Hence, there is a vital need to study the root cause in terms of hygiene, sanitation of vendors and source of contamination to prevent waterborne diseases.

  10. Microbiological evaluation of drinking water sold by roadside vendors of Delhi, India

    Science.gov (United States)

    Chauhan, Abhishek; Goyal, Pankaj; Varma, Ajit; Jindal, Tanu

    2017-07-01

    Delhi has emerged as one of the greenest capital city of the world. Microbiological assessment of drinking water emphasizes estimation of the hygienic quality of the water sold with reference to community health significance. This study was conducted to evaluate the quality of drinking water sold by roadside vendors in east, west, north and south zones of capital of India. A total number of 36 samples (nine from each zone) were collected as per national guidelines and studied for microbiological assessment. All the drinking water samples were collected in gamma-sterilized bottles and were kept in an ice pack to prevent any significant change in the microbial flora of the samples during the transportation. The water samples were transported to the laboratory in vertical position maintaining the temperature 1-4 °C with ice pack enveloped conditions. Samples were analyzed for total MPN coliform per 100 ml and for the presence and absence of common human pathogenic bacteria such as Escherichia coli, Salmonella, Staphylococcus aureus and Pseudomonas aeruginosa. All the samples were found to be contaminated with coliform organisms in the range of 14 to >1600 per 100 ml of sample. Out of 36 water samples, the occurrence of E. coli was 61 %, Salmonella 25 % S. aureus 14 % and P. aeruginosa 53 % as 22, 9, 5 and 19 samples were found contaminated, respectively. The numbers of coliform bacteria and presence of some common pathogenic bacteria suggested that the quality of drinking water sold by roadside vendors is not within the Indian standard and WHO guidelines laid down for drinking water quality. Hence, there is a vital need to study the root cause in terms of hygiene, sanitation of vendors and source of contamination to prevent waterborne diseases.

  11. Oral Medication

    Science.gov (United States)

    ... Size: A A A Listen En Español Oral Medication The first treatment for type 2 diabetes blood ... new — even over-the-counter items. Explore: Oral Medication How Much Do Oral Medications Cost? Save money ...

  12. Light and scanning electron microscopy study of in vitro effects of artesunate in newly excysted metacercariae of Echinostoma paraensei (Trematoda: Digenea).

    Science.gov (United States)

    Souza, Joyce G R; Lopes Torres, Eduardo J; Garcia, Juberlan S; Gomes, Ana Paula N; Rodrigues-Silva, Rosangela; Maldonado, Arnaldo; Machado-Silva, José Roberto

    2017-03-01

    Chemotherapy of food-borne trematodes relies on two drugs, praziquantel and tricabendazole, and there is growing interest in finding alternative therapies. Plant oil extracts have long been used in traditional Chinese medicine as sources of bioactive compounds with antiparasitic activity. Species of the genus Echinostoma are used as good models to test effective compounds against food-borne trematodes. This study evaluated the anthelmintic activity of crude artesunate extracts in vitro on newly excysted metacercariae of Echinostoma paraensei by light and scanning electron microscopy (SEM). The flukes were incubated with 1 μg/mL, 10 μg/mL, 25 μg/mL, 50 μg/mL and 100 μg/mL of artesunate for 4, 12, 24, 48 and 72 h. When the exposure time and concentration of artesunate increased, there were changes in motor activity, tegument damage and death. Blebs and swelling were the most common damages quantified on the tegument. The in vitro study reproduced results described for other immature flukes incubated with artemisinin derivatives. Excysted metacercariae of E. paraensei constitute a good model to study in vitro drug effects.

  13. Surveillance of the efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated Plasmodium falciparum among children under five in Togo, 2005-2009

    Directory of Open Access Journals (Sweden)

    Dorkenoo Monique A

    2012-10-01

    Full Text Available Abstract Background Malaria remains a major public health problem in Togo. The national malaria control programme in Togo changed the anti-malarial treatment policy from monotherapy to artemisinin combination therapy in 2004. This study reports the results of therapeutic efficacy studies conducted on artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Togo, between 2005 and 2009. Methods Children between 6 and 59 months of age, who were symptomatically infected with P. falciparum, were treated with either artemether-lumefantrine or artesunate-amodiaquine. The primary end-point was the 28-day cure rate, PCR-corrected for reinfection and recrudescence. Studies were conducted according to the standardized WHO protocol for the assessment of the efficacy of anti-malarial treatment. Differences between categorical data were compared using the chi-square test or the Fisher’s exact test where cell counts were ≤ 5. Differences in continuous data were compared using a t-test. Results A total of 16 studies were conducted in five sentinel sites, with 459, 505 and 332 children included in 2005, 2007 and 2009, respectively. The PCR-corrected 28-day cure rates using the per-protocol analysis were between 96%-100% for artemether-lumefantrine and 94%-100% for artesunate-amodiaquine. Conclusions Both formulations of artemisinin-based combination therapy were effective over time and no severe adverse events related to the treatment were reported during the studies.

  14. 青蒿琥酯治疗泰勒焦虫病的研究进展%Advances in Treatment of Theileriosis by Artesunate

    Institute of Scientific and Technical Information of China (English)

    张杰; 张继瑜; 李冰; 周绪正

    2011-01-01

    Artesunate is a derivative of antimalarial drug artemisinin, and was used in the veterinary clinic for the treatment of theileriosis of cattle, sheep and double buds piroplasmosis, the characteristics of pharmacokinetics of artesunate on different animals, the therapeutic effect of the clinical treatment of theileriosis, and the dangers of animal husbandry in China in the past two decades were reviewed.%青蒿琥酯( Artesunate)是抗疟药青蒿素(Artemisinin)的衍生物,在兽医临床上主要用于治疗牛、羊的泰勒焦虫病(Theileriosis)以及双芽焦虫病(Double buds piroplasmosis).作者对近20年来青蒿琥酯在不同动物的药物代谢动力学特征、泰勒焦虫病的临床治疗以及泰勒焦虫病对中国畜牧业的危害进行了总结.

  15. Postmodern Detective Fiction and the Questionning of the Commitment: Edmundo Paz Soldán

    Directory of Open Access Journals (Sweden)

    Nina Pluta

    2010-10-01

    In Spanish America, since the turbulent times of various political and social problems of the second half of the 20th century, writers have developed many ways of depicting the social and political crime scene thanks to modifying diverse literary conventions of the detective story. A good example is the creation of the Bolivian author Edmundo Paz Soldán (1967 who merged the metaphysical detective story with critical perspective: it describes contemporary Bolivians, citizens of the global village who are still preoccupied with the “premodern” social and political issues in their country.

  16. MOLECULAR IDENTIFICATION OF Pseudoterranova azarasi LARVAE IN COD (Gadus sp.) SOLD FOR HUMAN CONSUMPTION IN BRAZIL.

    Science.gov (United States)

    Marigo, Juliana; Taniwaki, Sueli Akemi; Pinto, Pedro Luiz Silva; Soares, Rodrigo Martins; Catão-Dias, José Luiz

    2015-12-01

    Anisakiasis and Pseudoterranovosis are human diseases caused by the ingestion of live Anisakidae larvae in raw, undercooked or lightly marinated fish. Larvae were collected from one salted cod sold for human consumption in a Sao Paulo market in 2013. One section of one brownish larva was used for molecular analyses. The partial COX2 gene sequence from the larva had a nucleotide identity of 99.8 % with Pseudoterranova azarasi, which belongs to the Pseudoterranova decipiens species complex. The risk of allergy when consuming dead larvae in salted fish is not well known and should be considered.

  17. Oral myiasis

    OpenAIRE

    Thalaimalai Saravanan; Mathan A Mohan; Meera Thinakaran; Saneem Ahammed

    2015-01-01

    Myiasis is a pathologic condition in humans occurring because of parasitic infestation. Parasites causing myiasis belong to the order Diptera. Oral myiasis is seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficit. In such cases, neglected oral hygiene and halitosis attracts the flies to lay eggs in oral wounds resulting in oral myiasis. We present a case of oral myiasis in 40-year-old male patient with mental disability ...

  18. KAJIAN TERHADAP BEBERAPA METODE PENYUSUTAN DAN PENGARUHNYA TERHADAP PERHITUNGAN BEBAN POKOK PENJUALAN (COST OF GOOD SOLD

    Directory of Open Access Journals (Sweden)

    Juniady Slamed Setiawan

    2001-01-01

    Full Text Available Every company must generate financial statement, that provide information about income, changes in financial position to whom that concerned. In preparing financial statement, each company has a power to choose the accounting methods and technics that recommended by Financial Accounting Standard. Accounting policies adopted by firm has a substanstial impact in financial statement.Therefore the company that has equal performance will report different result.This article try to present the impact of choosing depreciation method in calculating cost of goods sold. Abstract in Bahasa Indonesia : Setiap perusahaan wajib menerbitkan laporan keuangan, yang memberikan informasi mengenai hasil usaha, perubahan posisi keuangan kepada pihak yang memerlukan. Dalam menyusun laporan keuangan, perusahaan memiliki keleluasaan untuk memilih metode dan teknik sepanjang metode yang dipilih tersebut ada dalam SAK (Standar Akuntansi Keuangan. Pemilihan metode akuntansi memiliki dampak yang sangat besar terhadap laporan keuangan yang dihasilkan. Dengan demikian dimungkinkan perusahaan yang sebenarnya memiliki kinerja yang sama dapat melaporkan hasil yang berbeda. Tulisan ini mencoba untuk mengetengahkan dampak pemilihan metode penyusutan terhadap perhitungan beban pokok penjualan (cost of goods sold. Kata kunci: metode penyusutan, beban penyusutan, aktiva tetap, beban pokok penjualan.

  19. Microbiological Safety Assessment of Apple Fruits (Malus domestica Borkh Sold in Owerri Imo State Nigeria

    Directory of Open Access Journals (Sweden)

    Braide Wesley

    2012-04-01

    Full Text Available This study aimed at assessing the microbial colonizers, of apple fruits sold in Owerri to determine its safety for consumption. Apple fruits are dependable source of vitamins, it is rich in fiber, electrolytes, minerals and antioxidants and it is usually eaten fresh and raw, making the vitamins fully available for the body. The popularity and increased consumption of apple fruits therefore calls for necessary safety checks. Two hundred fresh and apparently healthy apple fruits were obtained from street vendors and shopping malls in major streets, motor parks and higher institutions in Owerri. The fruits were washed-out separately in 10 mL sterile distilled water to obtain suspensions which were assayed for total aerobic plate count, coliform count, and fungal count and for specific pathogens. A count of 3.4×105-4.5×107 cfu/mL was obtained for TAPC, while total coliform and total fungal counts ranges from 2.4×104-2.2×106 and 5.0×102-3.6×105 cfu/mL respectively. Twelve bacterial and seven fungal spp were isolated. The apple fruits sold in major busy spots in Owerri are contaminated, the presence of Shigella spp, S. aureus, Salmonella and B. cereus which are known pathogens calls for concern. Education of fruit vendors on food hygiene, adequate packaging/covering of apple fruits on display for sale and washing of fruits before consumption is advanced.

  20. Iodine content in salt sold in sea coastal province, Thailand:quality reflection

    Institute of Scientific and Technical Information of China (English)

    Sora Yasri; Viroj Wiwanitkit

    2014-01-01

    Objective: To call for attention that the problem of iodine deficiency and low salt quality can still be seen in sea coastal province.Methods:province of Thailand were collected. All samples were passed to the laboratory for the analysis of iodine content. The basic screening tool was I-KIT test (Mahidol University, Thailand), which was the standard test used in previous survey.Results:A total of 225 salt samples from each available marine salt shop in the sea coastal iodine content (100 mg/L). It gave the iodine content failure rate equal to 0%. Of overall 225 samples, there was no sample that could pass the acceptable criteria of Conclusions: Intensive research of the iodine content in salt sold and available in a sea coastal province of Thailand shows that the salt sold in salt shop in this sea coastal province is not locally available from marine salt field but from the dirt salt field from remote provinces because of the higher cost of marine salt. As a result, the control of salt quality in any areas is still needed. The use of iodine fortification should be applied to any areas, sea coastal or non sea coastal.

  1. Evaluation of Parasitic Pollution in Fresh Unwashed Herbs Sold in Izeh City, Iran

    Directory of Open Access Journals (Sweden)

    Valipour Nouroozi

    2015-11-01

    Full Text Available Background Fresh herbs are a crucial part of a good diet. However, they can easily become contaminated with food-borne pathogens. Eating fresh unwashed or improperly washed herbs has a major role in transmission of some important parasitic diseases. Objectives This study was carried out to evaluate parasitic pollution in fresh unwashed herbs sold in Izeh city, Iran. Materials and Methods Four hundred samples of fresh unwashed herbs were purchased from a distributor in Izeh city during January 2014 to April 2015. Detergent solution was added to 240 g of each sample. The mixture was shaken and washed solution was filtered through 0.2 µm bottle-top filter. The filtrate was discarded and filter was placed in a 50 mL conical screw cap tube. Then, the detergent solution was added. Following vortex, filter was discarded. The sediment was examined by light microscope after centrifuge. Finally, data descriptive analyses were carried out. Results Parasitic pollution was detected in 3.5% of the examined samples, including Cryptosporidium spp. oocyst (1.5%, Giardia spp. cyst (1%, Blastocystis spp. cyst (0.5% and Taenia spp. egg (0.5%. Conclusions Parasitic contamination of fresh herbs sold in Izeh may pose a health risk to consumers if eaten as unwashed or improperly washed.

  2. Detection of genetically modified DNA in fresh and processed foods sold in Kuwait.

    Science.gov (United States)

    Al-Salameen, Fadila; Kumar, Vinod; Al-Aqeel, Hamed; Al-Hashash, Hanadi; Hejji, Ahmed Bin

    2012-01-01

    Developments in genetic engineering technology have led to an increase in number of food products that contain genetically engineered crops in the global market. However, due to lack of scientific studies, the presence of genetically modified organisms (GMOs) in the Kuwaiti food market is currently ambiguous. Foods both for human and animal consumption are being imported from countries that are known to produce GM food. Therefore, an attempt has been made to screen foods sold in the Kuwaiti market to detect GMOs in the food. For this purpose, samples collected from various markets in Kuwait have been screened by SYBR green-based real time polymerase chain reaction (RT-PCR) method. Further confirmation and GMO quantification was performed by TaqMan-based RT-PCR. Results indicated that a significant number of food commodities sold in Kuwait were tested positive for the presence of GMO. Interestingly, certain processed foods were tested positive for more than one transgenic events showing complex nature of GMOs in food samples. Results of this study clearly indicate the need for well-defined legislations and regulations on the marketing of approved GM food and its labeling to protect consumer's rights.

  3. 4种药物单用或联用治疗大鼠华支睾吸虫感染的实验研究%Effects of single or multiple doses of intragastrically administered tribendimidine, mebendazole, albendazole, and artesunate on rats infected with Clonorchis sinensis

    Institute of Scientific and Technical Information of China (English)

    施维; 李健; 彭婷; 陶俊宇; 张鸿满; 黄维义

    2012-01-01

    Objective To assess the efficacy of single or combined oral doses of tribendimidine, mebendazole, alben-dazole, or artesunate on Clonorchis sinensis in rats. Methods One hundred and forty rats were infected with 100 C. Sinensis metacercariae and treated with experimental chemotherapy. All drugs were administered intragastrically 5 weeks after infection. Infected rats were randomly divided into drug treatment groups and untreated groups (5 to 10 rats per group). In order to observe the effects of the five drugs on juvenile C. Sinensis, tribendimidine, mebendazole, alben-dazole, and artesunate were used in single or combined oral doses given at relatively high or low doses. All groups except the control groups were given separate doses. Rats were sacrificed 10 days after treatment. Worms were recovered from the bile ducts and the liver tissue of rats, the mean reduction in worm burden was calculated, and the mean worm burden was compared among the groups using one-way ANOVA. Results Rats infected with C. Sinensis and treated with a single 75 mg/kg dose of tribendimidine, mebendazole, or albendazole had a high worm reduction of 98. 04% , 100% , and 86. 67%, respectively, while rats treated with 30 mg/kg dose of artesunate had worm reduction of 87. 25%. However, a single 50 mg/kg dose of tribendimidine, mebendazole, or albendazole resulted in slightly lower worm reduction of 78. 3% , 46. 02% , and 31. 94% , respectively, while a 20 mg/kg dose of artesunate resulted in worm reduction of 62. 07%. Results showed that single doses of drugs were more effective at an increased dosage. Combined treatment of 20 mg/kg artesunate plus 50 mg/kg albendazole or 50 mg/kg mebendazole resulted in worm reduction of 89. 22% and 97. 55%. Combining drugs was significantly more effective than single-dose treatment with 75 mg/kg albendazole or 30mg/kg artesunate but less effective than single-dose treatment with 75 mg/kg mebendazole. Resultssuggested that combining these drugs could both

  4. Deployment of early diagnosis and mefloquine-artesunate treatment of falciparum malaria in Thailand: the Tak Malaria Initiative.

    Directory of Open Access Journals (Sweden)

    Verena Ilona Carrara

    2006-06-01

    Full Text Available BACKGROUND: Early diagnosis and treatment with artesunate-mefloquine combination therapy (MAS have reduced the transmission of falciparum malaria dramatically and halted the progression of mefloquine resistance in camps for displaced persons along the Thai-Burmese border, an area of low and seasonal transmission of multidrug-resistant Plasmodium falciparum. We extended the same combination drug strategy to all other communities (estimated population 450,000 living in five border districts of Tak province in northwestern Thailand. METHODS AND FINDINGS: Existing health structures were reinforced. Village volunteers were trained to use rapid diagnostic tests and to treat positive cases with MAS. Cases of malaria, hospitalizations, and malaria-related deaths were recorded in the 6 y before, during, and after the Tak Malaria Initiative (TMI intervention. Cross-sectional surveys were conducted before and during the TMI period. P. falciparum malaria cases fell by 34% (95% confidence interval [CI], 33.5-34.4 and hospitalisations for falciparum malaria fell by 39% (95% CI, 37.0-39.9 during the TMI period, while hospitalisations for P. vivax malaria remained constant. There were 32 deaths attributed to malaria during, and 22 after the TMI, a 51.5% (95% CI, 39.0-63.9 reduction compared to the average of the previous 3 y. Cross-sectional surveys indicated that P. vivax had become the predominant species in Thai villages, but not in populations living on the Myanmar side of the border. In the displaced persons population, where the original deployment took place 7 y before the TMI, the transmission of P. falciparum continued to be suppressed, the incidence of falciparum malaria remained low, and the in vivo efficacy of the 3-d MAS remained high. CONCLUSIONS: In the remote malarious north western border area of Thailand, the early detection of malaria by trained village volunteers, using rapid diagnostic tests and treatment with mefloquine-artesunate was

  5. Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate

    Directory of Open Access Journals (Sweden)

    Rajahram Giri S

    2012-08-01

    Full Text Available Abstract Background The simian parasite Plasmodium knowlesi is recognized as a common cause of severe and fatal human malaria in Sabah, Malaysia, but is morphologically indistinguishable from and still commonly reported as Plasmodium malariae, despite the paucity of this species in Sabah. Since December 2008 Sabah Department of Health has recommended intravenous artesunate and referral to a general hospital for all severe malaria cases of any species. This paper reviews all malaria deaths in Sabah subsequent to the introduction of these measures. Reporting of malaria deaths in Malaysia is mandatory. Methods Details of reported malaria deaths during 2010-2011 were reviewed to determine the proportion of each Plasmodium species. Demographics, clinical presentations and management of severe malaria caused by each species were compared. Results Fourteen malaria deaths were reported, comprising seven Plasmodium falciparum, six P. knowlesi and one Plasmodium vivax (all PCR-confirmed. Of the six P. knowlesi deaths, five were attributable to knowlesi malaria and one was attributable to P. knowlesi-associated enterobacter sepsis. Patients with directly attributable P. knowlesi deaths (N = 5 were older than those with P. falciparum (median age 51 [IQR 50-65] vs 22 [IQR 9-55] years, p = 0.06. Complications in fatal P. knowlesi included respiratory distress (N = 5, 100%, hypotension (N = 4, 80%, and renal failure (N = 4, 80%. All patients with P. knowlesi were reported as P. malariae by microscopy. Only two of five patients with severe knowlesi malaria on presentation received immediate parenteral anti-malarial treatment. The patient with P. vivax-associated severe illness did not receive parenteral treatment. In contrast six of seven patients with severe falciparum malaria received immediate parenteral treatment. Conclusion Plasmodium knowlesi was responsible, either directly or through gram-negative bacteraemia, for almost half of

  6. Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali

    Directory of Open Access Journals (Sweden)

    Doumbo Ogobara K

    2011-09-01

    Full Text Available Abstract Background Sulphadoxine-pyrimethamine, in combination with artesunate or amodiaquine, is recommended for the treatment of uncomplicated malaria and is being evaluated for intermittent preventive treatment. Yet, limited data is available on pharmacokinetic interactions between these drugs. Methods In a randomized controlled trial, children aged 6-59 months with uncomplicated falciparum malaria, received either one dose of sulphadoxine-pyrimethamine alone (SP, one dose of SP plus three daily doses of amodiaquine (SP+AQ or one dose of SP plus 3 daily doses of artesunate (SP+AS. Exactly 100 μl of capillary blood was collected onto filter paper before drug administration at day 0 and at days 1, 3, 7, 14, 21 and 28 after drug administration for analysis of sulphadoxine and pyrimethamine pharmacokinetic parameters. Results Fourty, 38 and 31 patients in the SP, SP+AQ and SP+AS arms, respectively were included in this study. The concentrations on day 7 (that are associated with therapeutic efficacy were similar between the SP, SP+AQ and SP+AS treatment arms for sulphadoxine (median [IQR] 35.25 [27.38-41.70], 34.95 [28.60-40.85] and 33.40 [24.63-44.05] μg/mL and for pyrimethamine (56.75 [46.40-92.95], 58.75 [43.60-98.60] and 59.60 [42.45-86.63] ng/mL. There were statistically significant differences between the pyrimethamine volumes of distribution (4.65 [3.93-6.40], 4.00 [3.03-5.43] and 5.60 [4.40-7.20] L/kg; p = 0.001 and thus elimination half-life (3.26 [2.74 -3.82], 2.78 [2.24-3.65] and 4.02 [3.05-4.85] days; p . This study confirmed the lower SP concentrations previously reported for young children when compared with adult malaria patients. Conclusion Despite slight differences in pyrimethamine volumes of distribution and elimination half-life, these data show similar exposure to SP over the critical initial seven days of treatment and support the current use of SP in combination with either AQ or AS for uncomplicated falciparum malaria

  7. Leveraging corporate social responsibility to improve consumer safety of dietary supplements sold for weight loss and muscle building.

    Science.gov (United States)

    Kulkarni, Anvita; Huerto, Ryan; Roberto, Christina A; Austin, S Bryn

    2017-03-01

    The potential dangers associated with dietary supplements sold for weight loss and muscle building are well documented and increasingly garnering the attention of the media, public, and government leaders. Public health professionals have an opportunity to improve population health in the context of dietary supplement use by translating scientific evidence into action. In this commentary, we discuss the potential to motivate corporate social responsibility (CSR) among manufacturers and retailers of dietary supplements sold for weight loss and muscle building. We examine levers available to public health professionals for generating voluntary corporate self-regulation by reviewing examples from successful CSR initiatives in other domains of public health and offering recommendations highlighting effective advocacy strategies. We encourage public health professionals to use one or multiple advocacy strategies to improve consumer protections for dietary supplements sold for weight loss and muscle building.

  8. Efficacy and Effectiveness of Mefloquine and Artesunate Combination Therapy for Uncomplicated Plasmodium falciparum Malaria in the Peruvian Amazon

    Science.gov (United States)

    de Oliveira, Alexandre Macedo; Chavez, Jorge; de Leon, Gabriel Ponce; Durand, Salomon; Arrospide, Nancy; Roberts, Jacquelin; Cabezas, Cesar; Marquiño, Wilmer

    2011-01-01

    We evaluated the efficacy and effectiveness of mefloquine (MQ) plus artesunate (AS) to treat patients with uncomplicated malaria in the Peruvian Amazon Basin in April 2005–March 2006. Patients ≥ 1 year of age with fever (axillary temperature ≥ 37.5°C) or history of fever and Plasmodium falciparum monoinfection were included. Patients received antimalarial treatment with MQ (12.5 mg/kg/day for two days) and AS (4.0 mg/kg/day for three days) either by directly observed therapy or without directly observed therapy. After a 28-day follow-up, treatment efficacy and effectiveness were assessed on the basis of clinical and parasitologic outcomes. Ninety-six patients were enrolled in each study group; nine patients were lost to follow-up. All patients, except for one in the observed group, demonstrated adequate clinical and parasitologic response; none had detectable parasitemia on day 3. The efficacy of MQ + AS efficacy was 98.9% (95% confidence interval = 94.1–100.0%) and the effectiveness was 100.0% (95% confidence interval = 95.9–100.0%). Our study shows that MQ + AS is highly efficacious in the Peruvian Amazon. PMID:21896825

  9. Microbiological Characteristics of Some Spices Sold in Tekirdağ Markets

    Directory of Open Access Journals (Sweden)

    F. Coskun

    2010-01-01

    Full Text Available In this study, some microbiological properties of ground black pepper, red pepper, ground red pepper and powdered cinnamon sold in Tekirdag market were investigated. The samples were supplied in packaged, unpackaged and irradiated and packaged forms. As a result of the analysis the total mesophilic aerobic bacteria counts of red pepper and ground red pepper samples are higher than those of the other spice samples. Total mesophilic aerobic spore-forming bacteria was determined in all irradiated samples. However coliform group bacteria, S. aureus and mold were determined in a few samples, E.coli and yeast were not found in none of them. As reported in previous studies, spore-forming bacteria are more resistant to irradiation than vegetative forms. S. aureus counts were higher than the limitation of spice communique in Turkish Food Codex.

  10. HEDONIC ANALYSIS OF CELL PHONES SOLD WITH POST-PAID SERVICE PLANS IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Cláudio R. Lucinda

    2012-07-01

    Full Text Available The aim of this paper is to analyze the determining factors for the pricing of handsets sold with service plans, using the hedonic price method. This was undertaken by building a database comprising 48 handset models, under nine different service plans, over a period of 53 weeks in 2008, and resulted in 27 different attributes and a total number of nearly 300,000 data registers. The results suggest that the value of monthly subscriptions and calling minutes are important to explain the prices of handsets. Furthermore, both the physical volume and number of megapixels of a camera had an effect on the prices. The bigger the handset, the cheaper it becomes, and the more megapixels a camera phone has, the more expensive it becomes. Additionally, it was found that in 2008 Brazilian phone companies were subsidizing enabled data connection handsets.

  11. Screening the antiangiogenic activity of medicinal plants grown and sold in Jordan.

    Science.gov (United States)

    Zihlif, Malek; Afifi, Fatma; Muhtaseb, Ruba; Al-Khatib, Sondos; Abaza, Ismail; Naffa, Randa

    2012-02-01

    Angiogenesis is essential for the growth, invasion, and metastasis of most solid tumors and has become a valuable pharmacological target for cancer prevention and treatment. This study was performed to assess the antiangiogenic activity of 31 medicinal plants grown and sold in Jordan. The antiangiogenic activity was assessed using the rat aortic ring assay. Out of 31 extracts, 15 extracts showed more than 50 % inhibition of the blood vessels outgrowth from the primary tissue explants (p = 0.000). Three of these 15 extracts showed a potential cytotoxic effect on normal fibroblast cells. Four extracts shared antiangiogenic and antiproliferative activity towards MCF7 breast cancer cell lines. Eight extracts demonstrated selective antiangiogenic activity. This is the first report demonstrating the potential antiangiogenic activity of Artemisia judaica, Aloysia citriodora, Salvia egyptiaca, and Calendula arvensis. Some extracts with antiangiogenic activity exhibited selectivity against the endothelial cells proliferation, demonstrating a direct inhibitory activity against the key step in tumor angiogenesis.

  12. Isolation of pathogenic Escherichia coli from buffalo meat sold in Parbhani city, Maharashtra, India

    Directory of Open Access Journals (Sweden)

    M. S. Vaidya

    2013-10-01

    Full Text Available Aim: Isolation, characterization, in-vitro pathogenicity and antibiogram study of E.coli from buffalo meat sold in Parbhani city. Materials and Methods: Meat samples were collected from buffalo immediately after slaughter. Isolation, identification and enumeration of E. coli were done by following standard methods and protocols. Hemolysin test and Congo red binding assay were used to study in-vitro pathogenicity of E. coli isolates. Disc diffusion method was used to study antibiogram of pathogenic E. coli isolates. Results: A total of 250 buffalo meat samples were collected and processed. A total of 22 (8.80 percent E. coli isolates were isolated with average differential count of 1.231 ± 0.136 log cfu/g on EMB agar. All the E. coli isolates were confirmed by 10 Grams staining, biochemical reactions and sugar fermentation and motility tests. A total of 9 (3.6 percent E. coli isolates were found to be pathogenic by in-vitro pathogenicity testing. Antibiogram studies of pathogenic E. coli isolates showed that all 9 isolates were sensitive to gentamycin (20 ± 1.49 mm while 7 isolate showed resistance to enrofloxacin (18.22 ± 3.58 mm and tetracycline (11.44 ± 2.04 mm. Conclusion: Buffalo meat sold in Parbhani city is an important source of E. coli infection to human population. A total of 9 pathogenic E. coli were isolated from buffalo meat immediately after slaughter. All isolates were characterized and confirmed pathogenic by in-vitro pathogenicity tests. Antibiogram studies of all isolates revealed sensitivity to gentamicin and resistance to tetracycline and enrofloxacin. [Vet World 2013; 6(5.000: 277-279

  13. The Nutritional Profile of Baby and Toddler Food Products Sold in Australian Supermarkets.

    Science.gov (United States)

    Dunford, E; Louie, J C Y; Byrne, R; Walker, K Z; Flood, V M

    2015-12-01

    To examine the nutritional profile of baby and toddler foods sold in Australia. Nutrient information for baby and toddler foods available at Australian supermarkets was collected between Auguset and December 2013. Levels of declared energy, total fat, saturated fat, total sugar, sodium and estimated added sugar were examined, as well as the presence of additional micronutrients on the label. The Health Star Rating (HSR) system was used to determine nutritional quality. The range of products on offer was also examined by product type and by the age category for which the product was marketed. Of the 309 products included, 29% were fortified. On a per 100 g basis, these 309 products provided a mean (±SD) of 476 ± 486 kJ, 1.6 ± 2.4 g total fat, 10.7 ± 12.2 g total sugar, 2.7 ± 7.4 g added sugar, and 33.5 ± 66.5 mg sodium. Fruit-based products or products with fruit listed as an ingredient (58%) were the predominant product type. On the nutrition label, 42% displayed at least one additional micronutrient while 37% did not display saturated fat. The most common HSR was four stars (45%) and 6+ months was the most commonly identified targeted age group (36%). The majority of baby and toddler foods sold in Australian supermarkets are ready-made fruit-based products aimed at children under 12 months of age. Baby and toddler foods are overlooked in public policy discussions pertaining to population nutrient intake but their relatively high sugar content deriving from fruits requires close attention to ensure these foods do not replace other more nutrient dense foods, given children have an innate preference for sweet tastes.

  14. Bacteriological safety of plastic-bagged sachet drinking water sold in Amassoma, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Yakubu B Ngwai; Adebukola A Sounyo; Siyeofori M Fiabema; Geoffrey A Agadah; Tamunobelema O Ibeakuzie

    2010-01-01

    Objective:To evaluate the bacteriological safety of sachet water sold in Amassoma, a rural community in Bayelsa State, Nigeria. Methods:Six samples of each of the different sachet drinking water brands were bought at random from shop shelves, markets and street vendors and were studies for microbial indicators of safety and quality. Bacterial counts were analyzed by one-way Analysis of Variance (ANOVA) and significance of differences was tested at 5%probability. Results:Minimum and maximum counts with regard to the sachet water samples investigated were (4.3±1.1)í106 CFU mL-1 and (8.2±1.0)í106 CFU mL-1 for heterotrophic plate counts;(0.9±0.3)í106 CFU mL-1 and (1.2±0.4)í106 CFU mL-1 for aerobic spore-former counts;(1.3±0.5)í103 CFU mL-1 and (2.5±0.8)í103 CFU mL-1 for total coliforms;(1.6±0.9)í103 CFU mL-1 and (9.5±11.2)í103 CFU mL-1 for thermotolerant coliforms. Klebsiella spp but not Escherichia coli was present in all samples of the brands;non-coliform bacteria detected in some samples were Staphylococcus, Pseudomonas and Bacillus species. Conclusions:The brands of sachet water sold (at the time of this study) in Amassoma did not meet the minimum acceptable standard for microbiologically safe drinking water as recommended by the World Health Organization.

  15. Oral myiasis

    Directory of Open Access Journals (Sweden)

    Thalaimalai Saravanan

    2015-01-01

    Full Text Available Myiasis is a pathologic condition in humans occurring because of parasitic infestation. Parasites causing myiasis belong to the order Diptera. Oral myiasis is seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficit. In such cases, neglected oral hygiene and halitosis attracts the flies to lay eggs in oral wounds resulting in oral myiasis. We present a case of oral myiasis in 40-year-old male patient with mental disability and history of epilepsy.

  16. Oral Thrush

    Science.gov (United States)

    ... feeding mothers In addition to the distinctive white mouth lesions, infants may have trouble feeding or be fussy ... candidiasis (yeast infection) patient information. American Academy of Oral & Maxillofacial Pathology. http://www.aaomp.org/public/oral-candidiasis.php. ...

  17. Oral Dysfunction

    OpenAIRE

    鈴木, 規子; スズキ, ノリコ; Noriko, SUZUKI

    2004-01-01

    The major oral functions can be categorized as mastication, swallowing, speech and respiratory functions. Dysfunction of these results in dysphagia, speech disorders and abnormal respiration (such as Sleep Apnea). These functions relate to dentistry in the occurrence of : (1) oral preparatory and oral phases, (2) articulation disorders and velopharyngeal incompetence (VPI), and (3) mouth breathing, respiratory and blowing disorders. These disorders are related to oral and maxillofacial diseas...

  18. Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies

    Directory of Open Access Journals (Sweden)

    van Overmeir Chantal

    2009-08-01

    Full Text Available Abstract Background Very few data on anti-malarial efficacy are available from the Democratic Republic of Congo (DRC. DRC changed its anti-malarial treatment policy to amodiaquine (AQ and artesunate (AS in 2005. Methods The results of two in vivo efficacy studies, which tested AQ and sulphadoxine-pyrimethamine (SP monotherapies and AS+SP and AS+AQ combinations in Boende (Equatorial province, and AS+SP, AS+AQ and SP in Kabalo (Katanga province, between 2003 and 2004 are presented. The methodology followed the WHO 2003 protocol for assessing the efficacy of anti-malarials in areas of high transmission. Results Out of 394 included patients in Boende, the failure rates on day 28 after PCR-genotyping adjustment of AS+SP and AS+AQ were estimated as 24.6% [95% CI: 16.6–35.5] and 15.1% [95% CI: 8.6–25.7], respectively. For the monotherapies, failure rates were 35.9% [95% CI: 27.0–46.7] for SP and 18.3% [95% CI: 11.6–28.1] for AQ. Out of 207 patients enrolled in Kabalo, the failure rate on day 28 after PCR-genotyping adjustment was 0 [1-sided 95% CI: 5.8] for AS+SP and AS+AQ [1-sided 95% CI: 6.2]. It was 19.6% [95% CI: 11.4–32.7] for SP monotherapy. Conclusion The finding of varying efficacy of the same combinations at two sites in one country highlights one difficulty of implementing a uniform national treatment policy in a large country. The poor efficacy of AS+AQ in Boende should alert the national programme to foci of resistance and emphasizes the need for systems for the prospective monitoring of treatment efficacy at sentinel sites in the country.

  19. New Fixed-Dose Artesunate-Mefloquine Formulation against Multidrug-Resistant Plasmodium falciparum in Adults: a Comparative Phase IIb Safety and Pharmacokinetic Study with Standard-Dose Nonfixed Artesunate plus Mefloquine▿

    Science.gov (United States)

    Krudsood, S.; Looareesuwan, S.; Tangpukdee, N.; Wilairatana, P.; Phumratanaprapin, W.; Leowattana, W.; Chalermrut, K.; Ramanathan, S.; Navaratnam, V.; Olliaro, P.; Vaillant, M.; Kiechel, J. R.; Taylor, W. R. J.

    2010-01-01

    A new fixed-dose artesunate (AS)-mefloquine (MQ) was assessed in adults hospitalized for 28 days with uncomplicated drug-resistant falciparum malaria. The patients (n = 25/arm) were treated with (i) two fixed-dose tablets (AS-MQ arm; 100 mg AS-200 mg MQ/tablet) daily for 3 days (days 0, 1, and 2) or (ii) nonfixed AS (AS-plus-MQ arm; 4 mg/kg of body weight/day for 3 days) plus MQ (15 mg/kg on day 1 and 10 mg/kg on day 2), dosed by weight. Clinical laboratory electrocardiogram (ECG), adverse events (AEs), efficacy, and pharmacokinetic parameters were assessed over 28 days. Both regimens were well tolerated. No AEs were drug related. Two serious AEs of malaria-induced hypotension occurring in the AS-MQ arm necessitated rescue treatment. There were no significant changes in hematology, biochemistry, or PR and QRS intervals. For all patients, mean Fridericia-corrected QT intervals were significantly (P ≤ 0.0027) prolonged on day 3 (407 ms) and day 7 (399 ms) versus day 0 (389 ms), in parallel with significant (P ≤ 0.0003) falls in heart rates (67 [day 3], 73 [day 7], and 83 [day 0] beats/minute). Fixed-nonfixed formulations were bioequivalent for MQ, but not for AS and dihydroartemisinin (DHA). One AS-MQ patient developed a new infection on day 28; his day 28 plasma MQ concentration was 503.8 ng/ml. Fixed-dose AS-MQ was well tolerated, had pharmacokinetic (PK) profiles broadly similar to those of nonfixed AS plus MQ, and is a suitable replacement. PMID:20547795

  20. Plasmodium falciparum isolates from southern Ghana exhibit polymorphisms in the SERCA-type PfATPase6 though sensitive to artesunate in vitro

    Directory of Open Access Journals (Sweden)

    Ofori Michael F

    2011-07-01

    Full Text Available Abstract Background In 2005, Ghana replaced chloroquine with artemisinin-based combination therapy as the first-line treatment for uncomplicated malaria. The aim of this work was to determine for the first time, polymorphisms in the putative pfATPase6 and pftctp, pfmdr1, pfcrt genes in Ghanaian isolates, particularly at a time when there is no report on artemisinin resistance in malaria parasites from Ghana. The sensitivity of parasite isolates to anti-malaria drugs were also evaluated for a possible association with polymorphisms in these genes. Methods The prevalence of point mutations in the above Plasmodium falciparum genes were assessed from filter-paper blood blot samples by DNA sequencing. In vitro drug sensitivity test was carried out on some of the blood samples from volunteers visiting hospitals/clinics in southern Ghana using a modified version of the standard WHO Mark III micro-test. Results All successfully tested parasite isolates were sensitive to artesunate; while 19.4%, 29.0% and 51.6% were resistant to quinine, amodiaquine and chloroquine respectively. The geometric mean of IC50 value for artesunate was 0.73 nM (95% CI, 0.38-1.08, amodiaquine 30.69 nM (95% CI, 14.18-47.20 and chloroquine 58.73 nM (95% CI, 38.08-79.38. Twenty point mutations were observed in pfATPase6 gene, with no L263E and S769N. All mutations found were low in frequency, except D639G which was observed in about half of the isolates but was not associated with artesunate response (p = 0.42. The pftctp gene is highly conserved as no mutation was observed, while CVIET which is chloroquine-resistant genotype at codon 72-76 of the pfcrt gene was identified in about half of the isolates; this was consistent with chloroquine IC50 values (p = 0.001. Mutations were present in pfmdr1 gene but were not associated with artemisinin response (p = 1.00. Conclusion The pfATPase6 gene is highly polymorphic with D639G appearing to be fixed in Ghanaian isolates. These may just

  1. Nutrition Standards for Food Service Guidelines for Foods Served or Sold in Municipal Government Buildings or Worksites, United States, 2014.

    Science.gov (United States)

    Onufrak, Stephen J; Zaganjor, Hatidza; Moore, Latetia V; Carlson, Susan; Kimmons, Joel; Galuska, Deborah

    2016-12-22

    The Institute of Medicine and Centers for Disease Control and Prevention have recommended that government agencies use nutrition standards for foods and beverages sold and provided at their facilities. In this study, we examine written nutrition standards for foods sold or served in local government buildings or worksites among US municipalities. We used data from a 2014 national survey of 1,945 municipal governments serving populations of 1,000 or more to assess the presence of written nutrition standards, the food groups or nutrients addressed by standards, and the populations served by facilities where standards are applied. The prevalence of standards was estimated by municipality population size, rural-urban status, census region, poverty prevalence, education level, and racial/ethnic composition. Overall, 3.2% of US municipalities reported nutrition standards with greater prevalence observed among large municipalities (12.8% of municipalities with ≥50,000 people vs 2.2% of municipalities with beverages, fruits and vegetables, and free drinking water. Most standards applied to facilities serving government employees (67%) or the general public (66%), with fewer serving institutionalized populations (23%). Few municipal governments reported having written nutrition standards for foods and beverages sold in their facilities in 2014. Implementing nutrition standards for foods sold or served by local governments is a strategy for increasing access to healthier foods and beverages among municipal employees and local residents.

  2. SHPPS 2006: School Health Policies and Programs Study--Foods and Beverages Sold Outside of the School Meals Programs

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of foods and beverages sold outside of the school meals program. (Contains 3 tables, 1 figure, and 2…

  3. Characterization and expression analysis of SOLD1, a novel member of the retrotransposon-derived Ly-6 superfamily, in bovine placental villi.

    Directory of Open Access Journals (Sweden)

    Koichi Ushizawa

    Full Text Available BACKGROUND: Ly-6 superfamily members have a conserved Ly-6 domain that is defined by a distinct disulfide bonding pattern between eight or ten cysteine residues. These members are divided into membrane-type and secretory-type proteins. In the present study, we report the identification of a novel Ly-6 domain protein, secreted protein of Ly-6 domain 1 (SOLD1, from bovine placenta. PRINCIPAL FINDINGS: SOLD1 mRNA was expressed in trophoblast mononucleate cells and the protein was secreted into and localized in the extracellular matrix of the mesenchyme in cotyledonary villi. SOLD1 bound mainly with type I collagen telopeptide. We confirmed secretion of SOLD1 from the basolateral surface of a bovine trophoblast cell line (BT-1. It may be related to the organization of the extra-cellular matrix in the mesenchyme of fetal villi. Since trophoblast mononucleate cells are epithelial cells, their polar organization is expected to have a crucial role in the SOLD1 secretion system. We established that SOLD1 is an intronless bovine gene containing the Alu retrotransposon, which was integrated via cytoplasmic reverse transcription. CONCLUSION: We identified a novel retrotransposon-like Ly-6 domain protein in bovine placenta. SOLD1 is a crucial secreted protein that is involved in the organization of the mesenchyme of the cotyledonary villi. Furthermore, the gene encoding SOLD1 has an interesting genomic structure.

  4. Artesunate Activates Mitochondrial Apoptosis in Breast Cancer Cells via Iron-catalyzed Lysosomal Reactive Oxygen Species Production*

    Science.gov (United States)

    Hamacher-Brady, Anne; Stein, Henning A.; Turschner, Simon; Toegel, Ina; Mora, Rodrigo; Jennewein, Nina; Efferth, Thomas; Eils, Roland; Brady, Nathan R.

    2011-01-01

    The antimalarial agent artesunate (ART) activates programmed cell death (PCD) in cancer cells in a manner dependent on the presence of iron and the generation of reactive oxygen species. In malaria parasites, ART cytotoxicity originates from interactions with heme-derived iron within the food vacuole. The analogous digestive compartment of mammalian cells, the lysosome, similarly contains high levels of redox-active iron and in response to specific stimuli can initiate mitochondrial apoptosis. We thus investigated the role of lysosomes in ART-induced PCD and determined that in MCF-7 breast cancer cells ART activates lysosome-dependent mitochondrial outer membrane permeabilization. ART impacted endolysosomal and autophagosomal compartments, inhibiting autophagosome turnover and causing perinuclear clustering of autophagosomes, early and late endosomes, and lysosomes. Lysosomal iron chelation blocked all measured parameters of ART-induced PCD, whereas lysosomal iron loading enhanced death, thus identifying lysosomal iron as the lethal source of reactive oxygen species upstream of mitochondrial outer membrane permeabilization. Moreover, lysosomal inhibitors chloroquine and bafilomycin A1 reduced ART-activated PCD, evidencing a requirement for lysosomal function during PCD signaling. ART killing did not involve activation of the BH3-only protein, Bid, yet ART enhanced TNF-mediated Bid cleavage. We additionally demonstrated the lysosomal PCD pathway in T47D and MDA-MB-231 breast cancer cells. Importantly, non-tumorigenic MCF-10A cells resisted ART-induced PCD. Together, our data suggest that ART triggers PCD via engagement of distinct, interconnected PCD pathways, with hierarchical signaling from lysosomes to mitochondria, suggesting a potential clinical use of ART for targeting lysosomes in cancer treatment. PMID:21149439

  5. Artesunate induces cell death in human cancer cells via enhancing lysosomal function and lysosomal degradation of ferritin.

    Science.gov (United States)

    Yang, Nai-Di; Tan, Shi-Hao; Ng, Shukie; Shi, Yin; Zhou, Jing; Tan, Kevin Shyong Wei; Wong, Wai-Shiu Fred; Shen, Han-Ming

    2014-11-28

    Artesunate (ART) is an anti-malaria drug that has been shown to exhibit anti-tumor activity, and functional lysosomes are reported to be required for ART-induced cancer cell death, whereas the underlying molecular mechanisms remain largely elusive. In this study, we aimed to elucidate the molecular mechanisms underlying ART-induced cell death. We first confirmed that ART induces apoptotic cell death in cancer cells. Interestingly, we found that ART preferably accumulates in the lysosomes and is able to activate lysosomal function via promotion of lysosomal V-ATPase assembly. Furthermore, we found that lysosomes function upstream of mitochondria in reactive oxygen species production. Importantly, we provided evidence showing that lysosomal iron is required for the lysosomal activation and mitochondrial reactive oxygen species production induced by ART. Finally, we showed that ART-induced cell death is mediated by the release of iron in the lysosomes, which results from the lysosomal degradation of ferritin, an iron storage protein. Meanwhile, overexpression of ferritin heavy chain significantly protected cells from ART-induced cell death. In addition, knockdown of nuclear receptor coactivator 4, the adaptor protein for ferritin degradation, was able to block ART-mediated ferritin degradation and rescue the ART-induced cell death. In summary, our study demonstrates that ART treatment activates lysosomal function and then promotes ferritin degradation, subsequently leading to the increase of lysosomal iron that is utilized by ART for its cytotoxic effect on cancer cells. Thus, our data reveal a new mechanistic action underlying ART-induced cell death in cancer cells.

  6. Artesunate Induces Apoptosis of Bladder Cancer Cells by miR-16 Regulation of COX-2 Expression

    Directory of Open Access Journals (Sweden)

    Wei Zuo

    2014-08-01

    Full Text Available Bladder cancer is the most common malignant tumor of the urinary tract and remains one of the major causes of cancer death worldwide. In this study, we investigated the effect and mechanism of Artesunate (ART, a traditional Chinese medicine, on inducing apoptosis of human bladder cancer cells. In vivo antitumor activity was investigated in bladder cancer in rat by subcutaneous injection of different concentration of ART. The effect of ART on growth inhibition and apoptosis of bladder cancer cells was evaluated using dimethylthiazoly-2,5-diphenyltetrazolium bromide (MTT assay and flow cytometry analysis, respectively. Cyclooxygenase-2 (COX-2 and miR-16 expression levels were determined with real-time PCR. The concentrations of prostaglandin E2 (PGE2 in the supernatants of bladder cancer cells were measured with an ELISA kit. The miR-16 inhibitor or mimic were transfected into cells to up- or down-regulate miR-16 expression. ART efficiently inhibited orthotopic tumor growth in the bladder cancer rat, which is accompanied with an increase of miR-16 expression and a decrease of COX-2 expression. In vitro, ART could induce cytotoxicity and apoptosis in bladder cancer cells, but presented a much lighter toxicity effect against normal human urothelial cells. ART significantly increased miR-16 expression and decreased the expression of COX-2 and the production of PGE2. More importantly, down-regulation of miR-16 expression could reverse the effect of ART on apoptosis and COX-2 expression in bladder cells. Moreover, exogenous PGE2 could inhibit apoptosis of bladder cancer cells treated with ART. In conclusion, ART can elicit an anti-tumor effect against bladder cancer by up-regulation of miR-16 expression, which resulted in the decrease of COX-2 expression and PGE2 production. Hence, ART might be an effective drug for the treatment of bladder cancer.

  7. Antioxidant Capacity and Metal Content of Physalis Peruviana L. Fruit Sold in Markets

    Directory of Open Access Journals (Sweden)

    Ayse Eken

    2014-12-01

    Full Text Available Aim: The dietary intake of medicinal food with antioxidant activity and required amounts of trace elements is important to pursue good healthy life. In our study, we aimed to determine the antioxidant capacity and metal content of goldenberry (Physalis peruviana L. fruit sold in markets in Kayseri. Material and Method: The antioxidant capacity of P. peruviana fruit was determined by the 2,2-diphenyl-1-picrylhydrazyl (DPPH free radical scavenging assay. The DPPH radical scavenger capacity of the methanol extract of fruit was compared with known antioxidants such as ascorbic acid, gallic acid, and butylated hydroxytoluene (BHT as references. The metal content of P. peruviana fruit was measured by using atomic absorption spectrometer (AAS. Results: The fruit of P. peruviana was found to possess DPPH free radical scavenging activity but the antioxidant capacity was lower than the standard substances. Inhibitory concentration 50% (IC50 values of P. peruviana, ascorbic acid, gallic acid, and BHT were determined as 32 mg/ml, 3.8 mg/ml, 3.51 mg/ml, and 1.21 mg/ml, respectively. As a result of the analysis by AAS, it was observed that P. peruviana fruit contented plentiful trace elements and the content of heavy metal was small amount or not detected. Discussion: These observations suggest that the fruit of P. peruviana has a potential source of antioxidant and trace elements of natural origin.

  8. Analysis of phthalates in food products and packaging materials sold on the Belgian market.

    Science.gov (United States)

    Fierens, T; Servaes, K; Van Holderbeke, M; Geerts, L; De Henauw, S; Sioen, I; Vanermen, G

    2012-07-01

    Phthalates are organic lipophilic compounds that are principally used as plasticiser to increase the flexibility of plastic polymers. Other applications are a.o. the use of phthalates in printing inks and lacquers. Human exposure to phthalates mainly occurs via food ingestion and can induce adverse health effects. In this study, the presence of eight phthalate compounds--dimethyl phthalate (DMP), diethyl phthalate (DEP), diisobutyl phthalate (DiBP), di-n-butyl phthalate (DnBP), benzylbutyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), dicyclohexyl phthalate (DCHP) and di-n-octyl phthalate (DnOP)--was investigated in 400 food products, divided over eleven groups, and packages sold on the Belgian market. For this purpose, suitable extraction techniques were developed and validated for four different matrices, namely high-fat foods, low-fat food products, aqueous-based beverages and packaging materials. The instrumental analysis was performed by means of gas chromatography-low resolution-mass spectrometry with electron impact ionisation (GC-EI-MS). A wide variety of phthalate concentrations was observed in the different groups. DEHP was found in the highest concentration in almost every group. Moreover, DEHP was the most abundant phthalate compound, followed by DiBP, DnBP and BBP. This survey is part of the PHTAL project, which is the first project that discusses phthalate contamination on the Belgian food market.

  9. Determination of Ethyl Carbamate in Alcoholic Beverages and Fermented Foods Sold in Korea

    Science.gov (United States)

    Ryu, Dayeon; Choi, Bogyoung; Kim, Eunjoo; Park, Seri; Paeng, Hwijin; Kim, Cho-il; Lee, Jee-yeon; Yoon, Hae Jung

    2015-01-01

    Ethyl carbamate (EC) classified as a probable human carcinogen (Group 2A) is naturally formed in alcoholic beverages and fermented foods during fermentation process and/or during storage. The objective of this study was to analyze EC in 34 food items including 14 alcoholic beverages and 20 fermented foods sold in Korea. Each food was collected from 18 supermarkets in 9 metropolitan cities in Korea, and then made into composite. According to food composition and alcohol content, samples were divided into four matrices such as apple juice, milk, Soju (liquor containing about 20% alcohol), and rice porridge. The maximum EC value of 151.06 µg/kg was found in Maesilju (liquor made from Maesil and Soju). Whisky and Bokbunjaju (Korean black raspberry wine) contained 9.90 µg/kg and 6.30 µg/kg, respectively. EC was not detected in other alcoholic beverages. Of 20 fermented foods, Japanese-style soy sauce had highest level of 15.59 µg/kg and traditional one contained 4.18 µg/kg. Soybean paste had 1.18 µg/kg, however, EC was not found in other fermented foods. PMID:26483888

  10. Microbial quality of some vegetables sold in ED DueimTwon, Sudan.

    Science.gov (United States)

    Goja, Arafat Mohammed; Mahmoud, Mohamed Salih Osman

    2013-06-15

    This study was probably the first research carried out to investigate the microbiological quality of some vegetables sold in ED DueimTwon, Sudan. Four species of vegetables were used, Arugula (Eruca sativa), Mloukhia (Corchorus olitorius), Tomato (Lycopersicon esculentum) and Green pepper (Capsicum annuum). The samples were collected and examined according to standardized methods for total viable bacteria, coliforms and fecal coliform count. The average of total viable count ranged from 1.2 x 105-5.6 x 105 CFU mL(-1) for Arugula; 2.1 x 105-2.8 x 107 CFU mL(-1) for Mloukhia; 3.4 x 105-4.8 x 105 for Tomato and 2.3 x 105-8.0 x 106 CFU mL(-1) for Green pepper. However, the maximum level of total and fecal coliform were (93, 21); (28, 11); (75, 15) and (150, 20) MPN 100 mL(-1), respectively. Twelve bacteria belonging to five genera were isolated. Staphylococcus (33%) was the most predominant isolated followed by Enterobacteriaceae (25%), Bacillus (17%) and Streptococcus (17%). Micrococcus (8%) was the least dominant isolated. The results of microbial counts of these vegetable samples in this study indicate that, the agricultural practices, harvesting, hygiene, transporting and selling points are poor and therefore, the higher microbial load could be risked for public health.

  11. Detection of Genetically Modified Maize in Processed Foods Sold Commercially in Iran by Qualitative PCR

    Science.gov (United States)

    Rabiei, Maryam; Mehdizadeh, Mehrangiz; Rastegar, Hossein; Vahidi, Hossein; Alebouyeh, Mahmoud

    2013-01-01

    Detection of genetically modified organisms (GMOs) in food is an important issue for all the subjects involved in food control and customer’s right. Due to the increasing number of GMOs imported to Iran during the past few years, it has become necessary to screen the products in order to determine the identity of the consumed daily foodstuffs. In this study, following the extraction of genomic DNA from processed foods sold commercially in Iran, qualitative PCR was performed to detect genetically modified maize. The recombinant DNA target sequences were detected with primers highly specific for each investigated transgene such as CaMV35s gene, Bt-11, MON810 and Bt-176 separately. Based on the gel electrophoresis results, Bt- 11 and MON810 events were detected in some maize samples, while, in none of them Bt- 176 modified gene was detected. For the first time, the results demonstrate the presence of genetically modified maize in Iranian food products, reinforcing the need for the development of labeling system and valid quantitative methods in routine analyses. PMID:24250568

  12. Children sold for transplants: medical and legal aspects. Amnesty International--Danish Working Group for Children.

    Science.gov (United States)

    Fasting, U; Christensen, J; Glending, S

    1998-11-01

    Over the last few decades there has been a substantially higher percentage of successful organ transplants but also a significant imbalance between the demand for and the supply of organs, creating the basis for a highly profitable black market trade in human organs. Sometimes there are reports that children have been kidnapped, only to reappear later lacking one kidney, or that they simply disappear and are subsequently killed to have all their transplantable organs removed for profit. The European Union feels that there is a need for action and that it has a duty to act in this field, especially for ethical reasons. There is now established close co-operation between the various European transplant organizations. The legal protection of children with regard to organ transplantation is not specifically mentioned in the existing conventions because this issue was not foreseen at the time of their preparation. However, the issue is covered in a broader sense by more general provisions. There are endless rumours surrounding this area. Members of various organizations who travel in the suspected countries say that the trafficking in children who are sold for transplantation is well known, but it is too difficult and very dangerous to catch the people involved. We have to conclude that it has been impossible to prove or disprove the rumours, but they are consistent and we all, especially in the health care professions, have an obligation to be keenly aware of how and where organs are obtained.

  13. Bacteriological quality of sliced fruits sold at road site in Maiduguri, Borno State

    Directory of Open Access Journals (Sweden)

    IA Allamin

    2015-06-01

    Full Text Available The study was conducted to assess the bacteriological quality of sliced fruits, Fresh cut fruits collected from different stationary vendors in Maiduguri metropolis and were analysed to determine their bacteriological quality. All samples examined were contaminated with bacteria load. The Total aerobic plate count (TAPC range from 1.8x105 – 3.4x105 for pawpaw, 1.9x105- 6.8x105 for pineapple and 1.5x105- 5.1x105 for watermelon, Likewise Total coliforms count range from 1.0x104 – 2.0x104 for pawpaw, 1.0x104- 3.8x104 for pineapple and 1.0x105- 4.6x104 for watermelon. The bacterial isolate were identified as Staphylococcus aureus, E.coli, Pseudomonas, Shigella sp. and Salmonella sp. The results obtained shows that sliced fruits sold in Maiduguri metropolis are habited by pathogenic bacteria. Therefore educating our fruit vendors on food hygiene, adequate packaging/covering of fruits on display for sale and washing of fruits before consumption is recommended. DOI: http://dx.doi.org/10.3126/ije.v4i2.12645 International Journal of Environment Vol.4(2 2015: 236-242

  14. Determination of contamination pathways of phthalates in food products sold on the Belgian market.

    Science.gov (United States)

    Van Holderbeke, Mirja; Geerts, Lieve; Vanermen, Guido; Servaes, Kelly; Sioen, Isabelle; De Henauw, Stefaan; Fierens, Tine

    2014-10-01

    As numerous studies have indicated that food ingestion is the most important exposure pathway to several phthalates, this study aimed to determine possible contamination pathways of phthalates in food products sold on the Belgian market. To do this, concentrations of eight phthalates (dimethyl phthalate (DMP), diethyl phthalate (DEP), diisobutyl phthalate (DiBP), di-n-butyl phthalate (DnBP), benzylbutyl phthalate (BBP), dicyclohexyl phthalate (DCHP), di(2-ethylhexyl) phthalate (DEHP) and di-n-octyl phthalate (DnOP)) were determined in 591 foods and 30 packaging materials. In general, the four most prominent phthalates in Belgian food products were DEHP, DiBP, DnBP and BBP. Special attention was given to the origin of these phthalates in bread, since high phthalate concentrations (especially DEHP) were determined in this frequently consumed food product. Phthalates seemed to occur in Belgian bread samples due to the use of contaminated ingredients (i.e. use of contaminated flour) as well as due to migration from phthalate containing contact materials used during production (e.g. coated baking trays). Also the results of the conducted concentration profiles of apple, bread, salami and two cheese types revealed the important role of processing - and not packaging - on phthalate contents in foods.

  15. Optimal Overhaul-Replacement Policies for Repairable Machine Sold with Warranty

    Directory of Open Access Journals (Sweden)

    Kusmaningrum Soemadi

    2014-12-01

    Full Text Available This research deals with an overhaul-replacement policy for a repairable machine sold with Free Replacement Warranty (FRW. The machine will be used for a finite horizon, T (T <, and evaluated at a fixed interval, s (s< T. At each evaluation point, the buyer considers three alternative decisions i.e. Keep the machine, Overhaul it, or Replace it with a new identical one. An overhaul can reduce the machine age virtually, but not to a point that the machine is as good as new. If the machine fails during the warranty period, it is rectified at no cost to the buyer. Any failure occurring before and after the expiry of the warranty is restored by minimal repair. An overhaul-replacement policy is formulated for such machines by using dynamic programming approach to obtain the buyer’s optimal policy. The results show that a significant rejuvenation effect due to overhaul may extend the length of machine life cycle and delay the replacement decision. In contrast, the warranty stimulates early machine replacement and by then increases the replacement frequencies for a certain range of replacement cost. This demonstrates that to minimize the total ownership cost over T the buyer needs to consider the minimal repair cost reduction due to rejuvenation effect of overhaul as well as the warranty benefit due to replacement. Numerical examples are presented for both illustrating the optimal policy and describing the behavior of the optimal solution.

  16. Molecular characterization of Salmonella spp directly from snack and food commonly sold in Lagos, Nigeria.

    Science.gov (United States)

    Smith, Stella; Opere, Bolanle; Fowora, Muinah; Aderohunmu, Abdulrahman; Ibrahim, Rita; Omonigbehin, Emmanuel; Bamidele, Moses; Adeneye, Adeniyi

    2012-05-01

    Food borne Salmonella infection is an important cause of morbidity and mortality. A total of 200 food samples commonly sold in Lagos, Nigeria comprising raw and cooked meat as well as meat products and spoilt meat were analysed for the presence of Salmonella spp using REVEAL serology kit, culture methods employing RPVA (Rappaport Vassiliadis agar), SSA (Salmonella-Shigella agar) and BSA (brilliant sulphite agar) and PCR method for direct detection from samples using primer salm3/4 and ST11/ST15 sets. Using the REVEAL serology kit, 74% of the samples were positive for Salmonella spp, while culture methods showed only 19% to be Salmonella spp. The PCR method revealed that Salmonella spp was present in 62% and 54% of the samples using primer set salm3/4 and ST11/ST15, respectively. However, the primer set ST11/ST15 was more reliable in the identification of Salmonella spp directly from food samples. These tools should prove useful in the continuous monitoring and control strategies especially for ready-to-eat foods, as well as in retail meat outlets, slaughter houses, fast food restaurants for the prevention and reduction of this pathogen that is of significant importance in the food industry.

  17. Preliminary investigation of the contribution of CYP2A6, CYP2B6, and UGT1A9 polymorphisms on artesunate-mefloquine treatment response in Burmese patients with Plasmodium falciparum malaria.

    Science.gov (United States)

    Phompradit, Papichaya; Muhamad, Poonuch; Cheoymang, Anurak; Na-Bangchang, Kesara

    2014-08-01

    CYP2A6, CYP2B6, and UGT1A9 genetic polymorphisms and treatment response after a three-day course of artesunate-mefloquine was investigated in 71 Burmese patients with uncomplicated Plasmodium falciparum malaria. Results provide evidence for the possible link between CYP2A6 and CYP2B6 polymorphisms and plasma concentrations of artesunate/dihydroartemisinin and treatment response. In one patient who had the CYP2A6*1A/*4C genotype (decreased enzyme activity), plasma concentration of artesunate at one hour appeared to be higher, and the concentration of dihydroartemisinin was lower than for those carrying other genotypes (415 versus 320 ng/mL). The proportion of patients with adequate clinical and parasitologic response who had the CYP2B6*9/*9 genotype (mutant genotype) was significantly lower compared with those with late parasitologic failure (14.0% versus 19.0%). Confirmation through a larger study in various malaria-endemic areas is required before a definite conclusion on the role of genetic polymorphisms of these drug-metabolizing enzymes on treatment response after artesunate-based combination therapy can be made. © The American Society of Tropical Medicine and Hygiene.

  18. Artesunate Plus Amodiaquine (AS+AQ) Versus Artemether -Lumefantrine (AL) for the Treatment of Uncomplicated Plasmodium Falciparum Malaria in Sub-Saharan Africa-A Meta-Analysis.

    Science.gov (United States)

    Bello, Shaibu O; Chika, Aminu; Abdulgafar, Jimoh O

    2010-01-01

    The purpose of this study is to summarize the available data on the efficacy of Artesunate plus Amodiaquine (AS+AQ) versus Artemether -Lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa using uncorrected parasitaemia as a clinically relevant endpoint. Studies and conference abstracts identified through Pubmed, Medline, Embase, Ansinet, AJOL, Bioline, Cochrane Infectious Diseases Group trials register, The Cochrane Controlled Trials Register, Science Citation Index, Lilacs, African Index Medicus, Clusty, Google, Yahoo and Microsoft search engines. Randomized controlled clinical trials comparing Artesunate-Amodiaquine versus Artemether-Lumefantrine, in Sub-Saharan Africa from January 2004 to June 2009, and which had at least 30 patients per study arm. The authors independently applied the inclusion criteria, assessed methodological quality and extracted data into a predesigned form. The outcome of interest was uncorrected day 28 parasitological failure. Data were then checked for agreement and double entered into RevMan version 5 for further analyses. Fifteen trials (4265 participants) met the inclusion criteria. Day 28 parasitological failure was lower for AL (286 of 2201 participants or 13.0 % failures) when compared with AS+AQ (446 of 2424 participants or 18.4% failures). The relative risk of parasitological failure with AS+AQ was higher when compared with AL (RR 1.65, 95% CI, 1.18-2.32). There were significant heterogeneity and inconsistencies in the studies. AL appears more effective at avoiding parasitological failure at days 28 than AS+AQ.

  19. Safety, efficacy and population pharmacokinetics of fixed-dose combination of artesunate-mefloquine in the treatment of acute uncomplicated Plasmodium falciparum malaria in India.

    Science.gov (United States)

    Valecha, Neena; Srivastava, Bina; Dubhashi, N G; Rao, B H Krishnamoorthy; Kumar, Ashwani; Ghosh, S K; Singh, Jai Prakash Narayan; Kiechel, J R; Sharma, Bhawna; Jullien, V; Dash, A P; Taylor, W R J; Anvikar, Anupkumar R

    2013-12-01

    India has switched over to artemisinin-based combination therapy (ACT) for the treatment of acute uncomplicated Plasmodium falciparum malaria and the ACT used in the national programme is artesunate + sulphadoxine-pyrimethamine. Since the efficacy of ACT is dependent also on the partner drug, there is a need to evaluate and deploy multiple ACTs. This multicentre, single-arm, open-label clinical trial was carried out to assess the efficacy, safety and population pharmacokinetics of a fixed dose combination (FDC) artesunate mefloquine (ASMQ) in P. falciparum infected, Indian adults at Panjim, Goa, and Mangalore, Karnataka between December 2007 and November 2008. A total of 77 patients (males 74) were screened and enrolled: 42 at Goa and 35 at Mangalore with a median age of 25 yr (range 18-55 yr). One patient failed in treatment on D53, a PCR proven new infection, seven developed recurrent vivax parasitaemia and 11 did not have a parasitological endpoint. By per protocol analysis, the D63 cure rate was 58/59 (98.3; 95% C.I. 90.9-99.9%), and 58/58, with PCR correction. ASMQ was well-tolerated and no serious adverse events were reported. The study showed that the ASMQ FDC was efficacious and well-tolerated for the treatment of acute, uncomplicated P. falciparum malaria in highly endemic, chloroquine resistant areas of Goa and Mangalore. It is a viable option for India.

  20. Health worker perspectives on the possible use of intramuscular artesunate for the treatment of severe malaria at lower-level health facilities in settings with poor access to referral facilities in Nigeria: a qualitative study.

    Science.gov (United States)

    Adesoro, Olatunde; Shumba, Constance; Kpamor, John; Achan, Jane; Kivumbi, Harriet; Dada, John; Maxwell, Kolawole; Tibenderana, James; Marasciulo, Madeline; Hamade, Prudence; Oresanya, Olusola; Nankabirwa, Joanita; Baba, Ebenezer

    2016-10-12

    Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging. The study was to provide insight as a formative step into the conduct of future experimental studies to ascertain the feasibility of the use of intramuscular artesunate for definitive treatment of severe malaria in lower level facilities where access to referral care is limited. This qualitative study was done across three southern States in Nigeria (Oyo, Cross River and Enugu). Key informant interviews were conducted over a period of three months between October and December 2014 among 90 purposively selected health workers with different roles in malaria case management from primary care to policy level. A thematic content analysis was used to analyse data. Overall, most of health workers and other key informant groups thought that the use of intramuscular artesunate for definitive treatment of severe malaria at lower-level facilities was possible. They however reported human resource and infrastructure constraints as factors affecting the feasibility of intramuscular artesunate use as definitive treatment for severe malaria in lower-level facilities.. Specifically identified barriers included limited numbers of skilled health workers available to manage potential complications of severe malaria and poorly equipped facilities for supportive treatment. Intramuscular artesunate was considered easy to administer and the

  1. Oral histoplasmosis

    Directory of Open Access Journals (Sweden)

    Patil Karthikeya

    2009-01-01

    Full Text Available Histoplasmosis is a systemic fungal disease that takes various clinical forms, among which oral lesions are rare. The disseminated form of the disease that usually occurs in association with Human Immunodeficiency Virus (HIV is one of the AIDS-defining diseases. Isolated oral histoplasmosis, without systemic involvement, with underlying immunosuppression due to AIDS is very rare. We report one such case of isolated oral histoplasmosis in a HIV-infected patient.

  2. Quantifying exposure to vero-cytotoxigenic Escherichia coli O157 in milk sold as pasteurized: a model-based approach.

    Science.gov (United States)

    Clough, Helen E; Clancy, Damian; French, Nigel P

    2009-05-31

    Milk sold as pasteurized has historically been implicated in the UK and worldwide as a vehicle for outbreaks of food-borne gastrointestinal disease, with a number of causative pathogenic organisms. One such organism is verocytotoxigenic Escherichia coli, or E. coli, O157 (VTEC O157). We present a quantitative assessment of likely exposure to VTEC O157 via milk sold as pasteurized in the UK. Particular interest in our assessment concerns whether there is any differential risk between milk which is processed in on- and off-farm dairies. We model the milk production chain from the farm through to the point of retail and make a comparison between these two production environments. Our model is an example of the Modular Process Risk Modelling (MPRM) approach and represents uncertainty and variability in input parameters using probability distributions. We conclude that milk processed on farm poses the comparatively greater risk, although that risk is still small.

  3. ITMA ASIA + CITME 2010 Exhibition Space Sold Out Visitors offered convenient online registration and badge printing service

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The reputation of ITMA ASIA+ClTME 2010 as Asia’s premier textile industry platform has been given a further boost following an announcement from the show organizers that all exhibition space has now been sold. Over 1,100 textile and garment machinery manufacturers have applied successfully to exhibit at the second combined show,taking up 100,000 square meters of Shanghai New International Expo Centre.

  4. In Vitro Antioxidant Properties, HIV-1 Reverse Transcriptase and Acetylcholinesterase Inhibitory Effects of Traditional Herbal Preparations Sold in South Africa

    OpenAIRE

    2010-01-01

    The antioxidant potentials for fourteen multipurpose traditional herbal preparations sold in South Africa were determined using the DPPH radical scavenging, ferric reducing power and β-carotene-linoleic acid model system, the anti-HIV-1 reverse transcriptase (RT) enzyme inhibitory effects using an ELISA kit and acetylcholinesterase (AChE) enzyme inhibition using the microtitre plate assay. Nine of the herbal mixtures (Umzimba omubi, Umuthi wekukhwehlela ne zilonda, Mvusa ukunzi, Umpatisa inko...

  5. Salvinorin A content in legal high products of Salvia divinorum sold in Mexico.

    Science.gov (United States)

    Hernández-Bello, Rafael; García-Rodríguez, Rosa Virginia; García-Sosa, Karlina; Peña-Rodríguez, Luis Manuel; Vázquez-Hernández, Maribel; Ramos-Morales, Fernando Rafael; Corcoran, Olivia; Sánchez-Medina, Alberto

    2015-04-01

    Salvia divinorum (Lamiaceae) is a herb native to Mexico where it is used by Mazatec shamans for spiritual and divination purposes. S. divinorum products are easily available to consumers and are used worldwide as legal highs because of the hallucinogenic effects caused mainly by salvinorin A. Highly popular videos and websites on the internet depicting the use of S. divinorum products have contributed to an increase in their consumption. Recent reports have highlighted the potential of these products to induce psychosis in consumers. In Mexico, dried leaf extracts of S. divinorum are sold in different strengths, claiming to correlate with increasing amounts of salvinorin A. In order to determine the variability of salvinorin A content between brands and to investigate possible correlation between brand strengths, this study sought to quantify salvinorin A in commercial products available in Mexico using an HPLC method. The HPLC analytical method showed a correlation coefficient R(2)>0.99, with LOD of 0.44 μg/mL and LOQ of 1.34 μg/mL. The retention time for salvinorin A was 23.09±0.95 min and the measured concentrations ranged between 8.32±0.65 and 56.52±3.77 mg/g dried leaf. The results for brand c did not show an agreement between the declared and the calculated amount of salvinorin A. Additionally, the emergence in Mexico of high strength salvia products (100×), the lack of regulation and the observed variability of salvinorin A content between brands of commercial legal highs products of S. divinorum could result in a health problem for consumers.

  6. Hygienic-sanitary evaluation of sushi and sashimi sold in Messina and Catania, Italy

    Directory of Open Access Journals (Sweden)

    Daniele Muscolino

    2014-06-01

    Full Text Available Sushi and sashimi are traditional Japanese food, mostly consisting of raw seafood alone or in combination with rice. Eating sushi and sashimi has become popular in many countries even outside Japan. This food is not free from health risks such as ingestion of pathogenic bacteria or parasite. The aim of this study was to investigate on hygienic-sanitary quality of sushi and sashimi sold in the cities of Messina and Catania, Southern Italy. Fifty samples (38 sushi and 12 sashimi were analysed to determinate the aerobic mesophilic bacteria (AMB, psycrophilic bacteria (PB, Enterobacteriaceae, specific spoilage organisms (SSOs, Pseudomonas spp., coagulase-positive staphylococci, micrococci, Vibrio spp., Bacillus cereus, Salmonella spp. and Listeria monocytogenes. In sushi, AMB ranged from 5.00 to 8.18 log CFU/g, PB from 4.70 to 7.13 log CFU/g, Enterobacteriaceae from 1.41 to 6.67 log CFU/g, while SSOs and Pseudomonas spp. from 3.49 to 7.72 and from 3.36 to 8.00 log CFU/g, respectively. Micrococci ranged from 3.53 to 5.03 log CFU/g and coagulase positive staphylococci were found in 16 samples (2.00 to 3.60 log CFU/g. Bacillus cereus was found in 3 samples (1.70 to 4.00 log CFU/g, while Vibrio spp. was found in 15 of the sushi samples (1.70 to 3.70 log CFU/g. In sashimi, the AMB, PB and SSOs values were higher than 7.00 log CFU/g, Pseudomonas spp. and Enterobacteriaceae were from 6.00 to 8.00 log CFU/g, while Vibrio spp. were found in six samples with means of 2.00 log CFU/g. No Salmonella spp. and Listeria monocytogenes were detected in all sushi and sashimi samples.

  7. Hygienic-Sanitary Evaluation of Sushi and Sashimi Sold in Messina and Catania, Italy

    Science.gov (United States)

    Muscolino, Daniele; Giarratana, Filippo; Beninati, Chiara; Tornambene, Agata; Panebianco, Antonio

    2014-01-01

    Sushi and sashimi are traditional Japanese food, mostly consisting of raw seafood alone or in combination with rice. Eating sushi and sashimi has become popular in many countries even outside Japan. This food is not free from health risks such as ingestion of pathogenic bacteria or parasite. The aim of this study was to investigate on hygienic-sanitary quality of sushi and sashimi sold in the cities of Messina and Catania, Southern Italy. Fifty samples (38 sushi and 12 sashimi) were analysed to determinate the aerobic mesophilic bacteria (AMB), psycrophilic bacteria (PB), Enterobacteriaceae, specific spoilage organisms (SSOs), Pseudomonas spp., coagulase-positive staphylococci, micrococci, Vibrio spp., Bacillus cereus, Salmonella spp. and Listeria monocytogenes. In sushi, AMB ranged from 5.00 to 8.18 log CFU/g, PB from 4.70 to 7.13 log CFU/g, Enterobacteriaceae from 1.41 to 6.67 log CFU/g, while SSOs and Pseudomonas spp. from 3.49 to 7.72 and from 3.36 to 8.00 log CFU/g, respectively. Micrococci ranged from 3.53 to 5.03 log CFU/g and coagulase positive staphylococci were found in 16 samples (2.00 to 3.60 log CFU/g). Bacillus cereus was found in 3 samples (1.70 to 4.00 log CFU/g), while Vibrio spp. was found in 15 of the sushi samples (1.70 to 3.70 log CFU/g). In sashimi, the AMB, PB and SSOs values were higher than 7.00 log CFU/g, Pseudomonas spp. and Enterobacteriaceae were from 6.00 to 8.00 log CFU/g, while Vibrio spp. were found in six samples with means of 2.00 log CFU/g. No Salmonella spp. and Listeria monocytogenes were detected in all sushi and sashimi samples. PMID:27800343

  8. [Microbiological quality of street sold fruits in San José, Costa Rica].

    Science.gov (United States)

    Monge, R; Arias, M L; Antillón, F; Utzinger, D

    1995-06-01

    The sanitary quality of street sold fruits was analyzed during the period from march 1990 thru march 1993 in San Jose, Costa Rica. It looked for the presence of Salmonella spp. Shigella spp., Escherichia coli as well as fecal coliforms in natural refreshments, fruit salads and the fruits most frecuently expended on streets, either in slices as the pineapple (Ananas comosus), papaya (Carica papaya), non-ripe mangoe (Mangifera indica) and watermelon (Citrullus vulgaris) and those that can be eaten without peeling, like nances (Byrsonima crassifolia) and jocotes (Spondias purpurea). 25 samples of each fruit, 50 natural refreshments and 50 fruit salads were processed according to rinse solution method, and the bacteriological determination was based in the methodology described by Vanderzant & Splittstoesser and the Bacteriological Analytical Manual. In the same way, it was used the Most Probable Number for 5 tubes described in the Standar Methods of Water and Wastewater in orden to analyze 15 samples of ready to use water by the fruit hawker. The nutritional value was studied according to the food composition tables for Costa Rica, Latin America and USA. The results show that more than 30% of fruit samples, 70% of natural refreshments and 96% of fruit salad presented fecal coliforms. Same time, all of them present important contamination indexes with E. coli. Salmonella spp. and Shigella spp. were not isolated. The water analysis revelead that 53% contained fecal coliforms, probably due to the lack of hygiene in the utensils used to collect water. The nutritional evaluation shows that fruit portions (except watermelon) satisfy more than 100% of the diary recommendation of vitamin C (60 mg) and 4-7% of the recommended ingestion of dietetic fiber (30g).

  9. Community coverage of an antimalarial combination of artesunate and amodiaquine in Makamba Province, Burundi, nine months after its introduction

    Directory of Open Access Journals (Sweden)

    Brasher Christopher

    2007-07-01

    Full Text Available Abstract Background In 2003, artesunate-amodiaquine (AS+AQ was introduced as the new first-line treatment for uncomplicated malaria in Burundi. After confirmed diagnosis, treatment was delivered at subsidized prices in public health centres. Nine months after its implementation a study was carried out to assess whether children below five years of age with uncomplicated malaria were actually receiving AS+AQ. Methods A community-based study was conducted in Makamba province. Randomly selected households containing one or more children under five with reported fever onset within fourteen days before the study date were eligible. Case-management information was collected based on caregiver recall. A case definition of symptomatic malaria from observations of children presenting a confirmed malaria episode on the day of the survey was developed. Based on this definition, those children who had probable malaria among those with fever onset in the 14 days prior to the study were identified retrospectively. Treatment coverage with AS+AQ was then estimated among these probable malaria cases. Results Out of 195 children with fever on the day of the study, 92 were confirmed as true malaria cases and 103 tested negative. The combination of 'loss of appetite', 'sweating', 'shivering' and 'intermittent fever' yielded the highest possible positive predictive value, and was chosen as the case definition of malaria. Out of 526 children who had had fever 14 days prior to the survey, 165 (31.4% were defined as probable malaria cases using this definition. Among them, 20 (14.1% had been treated with AS+AQ, 10 with quinine (5%, 68 (41% received non-malaria treatments, and 67 got traditional treatment or nothing (39.9%. Most people sought treatment from public health centres (23/99 followed by private clinics (15/99, 14.1%. The median price paid for AS+AQ was 0.5 US$. Conclusion AS+AQ was the most common treatment for patients with probable malaria at public health

  10. In vivo efficacy of artemether-lumefantrine and artesunate-amodiaquine for uncomplicated Plasmodium falciparum malaria in Malawi, 2014.

    Science.gov (United States)

    Paczkowski, Magdalena; Mwandama, Dyson; Marthey, Daniel; Luka, Madalitso; Makuta, Georgina; Sande, John; Ali, Doreen; Troell, Peter; Mathanga, Don P; Gutman, Julie

    2016-04-26

    Malaria causes significant morbidity in Malawi, with an estimated 5 million cases in 2014. Artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) are the first- and second-line treatments for uncomplicated malaria, respectively, but emerging resistance threatens their efficacy. In order to understand whether AL and ASAQ remain efficacious for the treatment of uncomplicated Plasmodium falciparum malaria in Malawi, a therapeutic efficacy trial was conducted. During March-July 2014, febrile children aged 6-59 months with microscopy-confirmed uncomplicated P. falciparum malaria (1000-200,000 parasites/μL) were enrolled in a 28-day randomized in vivo efficacy trial at three sites: one each in northern (Karonga), central (Nkhotakota) and southern (Machinga) Malawi. The study was powered to estimate site-specific efficacy for AL and overall efficacy for ASAQ, with 3:1 randomization to AL or ASAQ. Blood was collected for malaria microscopy and molecular testing on days 0-3, 7, 14, 21, and 28. Recrudescence and reinfection were differentiated using polymerase chain reaction (PCR) genotyping of merozoite surface protein. The primary outcome was the PCR-corrected day 28 Kaplan-Meier cumulative success rate. A total of 452 children were enrolled; 303/338 (89 %) and 98/114 (86 %) reached a study endpoint in AL and ASAQ arms, respectively. All treatment failures occurred after day 3. The day 28 uncorrected cumulative success rate was 97.1 % (95 % confidence interval [CI]: 93.9-100 %) for ASAQ and 76.8 % (95 % CI 72.1-81.5 %) for AL, with 82.5 % (95 % CI 75.4-89.7 %), 69 % (95 % CI 59.9-78.1 %), and 78.2 % (95 % CI 70.2-86.3 %) success in the northern, central, and southern regions, respectively. The day 28 PCR-corrected cumulative success rate was 99 % (95 % CI 97.2-100 %) in the ASAQ arm and 99.3 % (95 % CI 98.3-100 %) in the AL arm, with 98-100 % efficacy in each site. As evidenced by the day 28 PCR-corrected cumulative success rates, both AL

  11. Intravenous artesunate versus intravenous quinine in the treatment of severe falciparum malaria: a retrospective evaluation from a UK centre

    Science.gov (United States)

    Eder, Marcus; Farne, Hugo; Cargill, Tamsin; Abbara, Aula; Davidson, Robert N

    2012-01-01

    Introduction Despite evidence from developing world trials that intravenous (IV) artesunate (AS) is superior to IV quinine (Q) in severe falciparum malaria (FM), IV AS remains unlicensed in the UK with national guidelines listing it as an acceptable alternative to IV Q as the drug of choice. We retrospectively evaluate the safety and effectiveness of IV AS in returning travellers with severe FM. Methods We identified adults admitted to the Infectious Diseases unit with severe FM and treated with IV Q (1991–2009) or IV AS (2009–2011). Outcomes included adverse events, mortality, length of stay, admission to intensive care and, where data were available, parasite/fever clearance time and hypoglycaemic events. Results Of 167 patients, 24 received IV AS and 143 IV Q. There was one potential AS-associated adverse event, a case of late onset haemolysis. Median length of stay (LOS) was significantly shorter for AS (3.5 versus 5 days, P = 0.017), even after adjusting for African ethnicity (for LOS ⩾3 days, mhor = 0.33, P = 0.027; crude OR = 0.29, P = 0.013). In the AS group, there were no fatalities (versus five in Q group, NS) and fewer intensive care unit (ICU) admissions (NS). Median parasite clearance was significantly faster in AS (65 versus 85 hours in Q, P = 0.0045) with no hypoglycaemic episodes (versus five in Q). Discussion We found IV AS to be safe and effective, with shorter LOS, faster parasite and fever clearance, no fatalities or hypoglycaemic events, and fewer ICU admissions versus IV Q. This corroborates both developing world trials and smaller European case series (although these lacked comparison groups). As well as obvious benefits for patients, there are potential resource savings. A case of late-onset haemolysis may represent an adverse event, particularly as it has been documented elsewhere, warranting further investigation. Nonetheless, our experience suggests IV AS should be first-line for treating severe FM in the UK

  12. High risk of severe anaemia after chlorproguanil-dapsone+artesunate antimalarial treatment in patients with G6PD (A- deficiency.

    Directory of Open Access Journals (Sweden)

    Caterina I Fanello

    Full Text Available BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD deficiency is the most common inherited human enzyme defect. This deficiency provides some protection from clinical malaria, but it can also cause haemolysis after administration of drugs with oxidant properties. METHODS: The safety of chlorproguanil-dapsone+artesunate (CD+A and amodiaquine+sulphadoxine-pyrimethamine (AQ+SP for the treatment of uncomplicated P. falciparum malaria was evaluated according to G6PD deficiency in a secondary analysis of an open-label, randomized clinical trial. 702 children, treated with CD+A or AQ+SP and followed for 28 days after treatment were genotyped for G6PD A- deficiency. FINDINGS: In the first 4 days following CD+A treatment, mean haematocrit declined on average 1.94% (95% CI 1.54 to 2.33 and 1.05% per day (95% CI 0.95 to 1.15 respectively in patients with G6PD deficiency and normal patients; a mean reduction of 1.3% per day was observed among patients who received AQ+SP regardless of G6PD status (95% CI 1.25 to 1.45. Patients with G6PD deficiency recipients of CD+A had significantly lower haematocrit than the other groups until day 7 (p = 0.04. In total, 10 patients had severe post-treatment haemolysis requiring blood transfusion. Patients with G6PD deficiency showed a higher risk of severe anaemia following treatment with CD+A (RR = 10.2; 95% CI 1.8 to 59.3 or AQ+SP (RR = 5.6; 95% CI 1.0 to 32.7. CONCLUSIONS: CD+A showed a poor safety profile in individuals with G6PD deficiency most likely as a result of dapsone induced haemolysis. Screening for G6PD deficiency before drug administration of potentially pro-oxidants drugs, like dapsone-containing combinations, although seldom available, is necessary.

  13. Efficacy of artesunate-amodiaquine for treating uncomplicated falciparum malaria in sub-Saharan Africa: a multi-centre analysis

    Directory of Open Access Journals (Sweden)

    Same-Ekobo Albert

    2009-08-01

    Full Text Available Abstract Background Artesunate and amodiaquine (AS&AQ is at present the world's second most widely used artemisinin-based combination therapy (ACT. It was necessary to evaluate the efficacy of ACT, recently adopted by the World Health Organization (WHO and deployed over 80 countries, in order to make an evidence-based drug policy. Methods An individual patient data (IPD analysis was conducted on efficacy outcomes in 26 clinical studies in sub-Saharan Africa using the WHO protocol with similar primary and secondary endpoints. Results A total of 11,700 patients (75% under 5 years old, from 33 different sites in 16 countries were followed for 28 days. Loss to follow-up was 4.9% (575/11,700. AS&AQ was given to 5,897 patients. Of these, 82% (4,826/5,897 were included in randomized comparative trials with polymerase chain reaction (PCR genotyping results and compared to 5,413 patients (half receiving an ACT. AS&AQ and other ACT comparators resulted in rapid clearance of fever and parasitaemia, superior to non-ACT. Using survival analysis on a modified intent-to-treat population, the Day 28 PCR-adjusted efficacy of AS&AQ was greater than 90% (the WHO cut-off in 11/16 countries. In randomized comparative trials (n = 22, the crude efficacy of AS&AQ was 75.9% (95% CI 74.6–77.1 and the PCR-adjusted efficacy was 93.9% (95% CI 93.2–94.5. The risk (weighted by site of failure PCR-adjusted of AS&AQ was significantly inferior to non-ACT, superior to dihydroartemisinin-piperaquine (DP, in one Ugandan site, and not different from AS+SP or AL (artemether-lumefantrine. The risk of gametocyte appearance and the carriage rate of AS&AQ was only greater in one Ugandan site compared to AL and DP, and lower compared to non-ACT (p = 0.001, for all comparisons. Anaemia recovery was not different than comparator groups, except in one site in Rwanda where the patients in the DP group had a slower recovery. Conclusion AS&AQ compares well to other treatments and meets the

  14. Effect of artesunate supplementation on bacterial translocation and dysbiosis of gut microbiota in rats with liver cirrhosis.

    Science.gov (United States)

    Chen, Yun-Xia; Lai, Li-Na; Zhang, Hui-Ying; Bi, Yang-Hui; Meng, Li; Li, Xu-Jiong; Tian, Xiao-Xia; Wang, Li-Min; Fan, Yi-Min; Zhao, Zhong-Fu; Han, De-Wu; Ji, Cheng

    2016-03-14

    To evaluate the effect of artesunate (AS) supplementation on bacterial translocation (BT) and gut microbiota in a rat model of liver cirrhosis. Fifty-four male Sprague-Dawley rats were randomly divided into a normal control group (N), a liver cirrhosis group (M) and a liver cirrhosis group intervened with AS (MA). Each group was sampled at 4, 6 and 8 wk. Liver cirrhosis was induced by injection of carbon tetrachloride (CCl4), intragastric administration of 10% ethanol, and feeding a high fat diet. Rats in the MA group were intragastrically administered with AS (25 mg/kg body weight, once daily). Injuries of the liver and intestinal mucosa were assessed by hematoxylin-eosin or Masson's trichrome staining. Liver index was calculated as a ratio of the organ weight (g) to body weight (g). The gut microbiota was examined by automated ribosomal intergenic-spacer analysis of fecal DNA. BT was assessed by standard microbiological techniques in the blood, mesenteric lymph nodes (MLNs), liver, spleen, and kidney. Compared to group N, the body weight was reduced significantly in groups M and MA due to the development of liver cirrhosis over the period of 8 wk. The body weight was higher in group MA than in group M. The liver indices were significantly elevated at 4, 6 and 8 wk in groups M and MA compared to group N. AS supplementation partially decreased the liver indices in group MA. Marked histopathologic changes in the liver and small intestinal mucosa in group M were observed, which were alleviated in group MA. Levels of pro-inflammatory interleukin-6 and tumor necrosis factor-α were significantly elevated at 8 wk in ileal homogenates in group M compared to group N, which were decreased after AS supplementation in group MA. The dysbiosis of gut microbiota indicated by the mean diversity (Shannon index) and mean similarity (Sorenson index) was severe as the liver cirrhosis developed, and AS supplementation had an apparent intervention effect on the dysbiosis of gut

  15. Comparative evaluation of efficacy and safety of artesunate-lumefantrine vs. artemether-lumefantrine fixed-dose combination in the treatment of uncomplicated Plasmodium falciparum malaria.

    Science.gov (United States)

    Pareek, Anil; Chandurkar, Nitin; Srivastav, Vipul; Lakhani, Jitendra; Karmakar, Partha S; Basu, Subrata; Ray, Arnab; Pednekar, Sangeeta; Gupta, P B; Suthar, Nilay; Lakhani, Sucheta

    2013-05-01

    To establish efficacy and safety of artesunate/lumefantrine fixed-dose combination (FDC) in comparison with artemether/lumefantrine FDC in treatment of uncomplicated Plasmodium falciparum malaria. Confirmed cases of uncomplicated P. falciparum malaria were randomly assigned to receive artesunate (100 mg)/lumefantrine (480 mg) (ASLF FDC) or artemether (80 mg)/lumefantrine (480 mg) (AMLF FDC) tablets for 3 days. Patients were followed up on Day 7, 14, 21 and 28. Of the 158 enrolled patients, 144 completed the study. Seventy-three patients (94.8%) from the ASLF group and 71 patients (94.7%) from the AMLF group showed parasite clearance within 48 h. The mean parasite clearance time was 25.40 ± 14.82 h in the ASLF group and 24 ± 13.32 h in the AMLF group (P = 0.542). All patients showed gametocyte clearance by Day 7 and remained gametocyte free till Day 28. Sixty-five patients (84.4%) from the ASLF group and 56 patients (74.7%) from the AMLF group were afebrile within 24 h. The mean fever clearance time was 17.38 ± 12.33 h in the ASLF group and 17.2 ± 12.01 h in the AMLF group (P = 0.929). There was one early treatment failure in the AMLF group as per WHO criteria. Improvement in haemoglobin and haematocrit was comparable in both the treatment groups. In the ASLF group, of the 25 (32.47%) patients anaemic at baseline, only seven (9.09%) reported anaemia on Day 28, while in the AMLF group, of the 14 (18.67%) patients anaemic at baseline, only four (5.33%) reported anaemia on Day 28. Both study medications were well tolerated. Artesunate (100 mg)/lumefantrine (480 mg) fixed-dose combination could add one more option to currently available artemisinin combinations in treatment of uncomplicated P. falciparum malaria. © 2013 Blackwell Publishing Ltd.

  16. 青蒿琥酯对人胚肺成纤维细胞Caspase-3表达的影响%Effect of Artesunate on the Expression of Caspase-3 in Human Embryonic Lung Fibroblasts

    Institute of Scientific and Technical Information of China (English)

    王昌明; 黎洪秀; 张孝飞

    2011-01-01

    OBJECTIVE To study the effect of artesunate on the growth of human embryonic lung fibroblast HFL-Ⅰ cells in vitro and provide experimental data for anti-fibrosis activity of artesunate. METHODS CCK-8 assay was used to determine the effect of artesunate on the growth of HFL-Ⅰ cells in vitro. Apoptosis ratio was examined by flow cytometry (FCM). The mRNA level of Caspase-3, one of apoptosis related proteins, were assessed by RT-PCR. The expression of Caspase-3 protein was detected by Western blot. RESULTS Artesunate has a significantly inhibitory effect on the proliferation of HFL-Ⅰ cells in a dose-dependent manner in vitro. Flow cytometry assay demonstrated a higher distribution in G1 phase of HFL-Ⅰ cells with artesunate. And apoptosis rate of HFL-Ⅰ cells was significantly increased in artesunate-treated group compared with control group (P<0.01). RT-PCR analysis showed the levels of Caspase-3 mRNA were significantly increased in artesunate-treated group,compared with control group. Western bloting also showed a significant enhancement of Caspase-3 protein levels in artesunate-treated group, when compared to control group. CONCLUSION Artesunate may exert marked anti-pulmonary fibrosis effect by up-regulating the mRNA and protein level of Caspase-3, which could induce the growth inhibition and apoptosis in HFL-Ⅰ cells.%目的 研究青蒿琥酯对人胚肺成纤维细胞(human embryonic lung fibroblast,HELF)系HFL-Ⅰ细胞体外生长的影响,为青蒿琥酯抗纤维化提供实验依据.方法 采用CCK-8法检测青蒿琥酯对体外培养的HFL-Ⅰ细胞生长的影响,用流式细胞术测定细胞凋亡率;RT-PCR法测定凋亡相关蛋白Caspase-3的mRNA表达水平,Western blot法分析Caspase-3蛋白的表达情况.结果 青蒿琥酯呈浓度依赖性抑制HFL-Ⅰ细胞增殖,HFL-Ⅰ细胞经青蒿琥酯作用后细胞主要停滞于G1期,凋亡率明显增加(P<0.01),Caspase-3 mRNA的表达显著高于对照组,Caspase-3蛋白的表达亦

  17. Oral Histoplasmosis.

    Science.gov (United States)

    Folk, Gillian A; Nelson, Brenda L

    2017-02-20

    A 44-year-old female presented to her general dentist with the chief complaint of a painful mouth sore of 2 weeks duration. Clinical examination revealed an irregularly shaped ulcer of the buccal and lingual attached gingiva of the anterior mandible. A biopsy was performed and microscopic evaluation revealed histoplasmosis. Histoplasmosis, caused by Histoplasma capsulate, is the most common fungal infection in the United States. Oral lesions of histoplasmosis are generally associated with the disseminated form of histoplasmosis and may present as a fungating or ulcerative lesion of the oral mucosa. The histologic findings and differential diagnosis for oral histoplasmosis are discussed.

  18. Oral leukoplakia

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Dabelsteen, Erik

    2016-01-01

    The idea of identifying oral lesions with a precancerous nature, i.e. in the sense of pertaining to a pathologic process with an increased risk for future malignant development, of course is to prevent frank malignancy to occur in the affected area. The most common oral lesion with a precancerous...... nature is oral leukoplakia, and for decades it has been discussed how to treat these lesions. Various treatment modalities, such as systemic therapies and surgical removal, have been suggested. The systemic therapies tested so far include retinoids, extracts of green tea, inhibitors of cyclooxygenase-2...

  19. Supplementary dataset for child and adult exposure and health risk evaluation following the use of metal- and metalloid-containing costume cosmetics sold in the United States

    National Research Council Canada - National Science Library

    Angela L. Perez; Melanie Nembhard; Andrew Monnot; Daniel Bator; Elizabeth Madonick; Shannon H. Gaffney

    2017-01-01

    ... cosmetics sold in the United States" [1]. This article describes the concentration of metals and metalloids contained in various cosmetic products such as body paint, lipstick and eye shadow, the relative percent deviation of two analyses...

  20. PHYSICAL AND CHEMICAL QUALITY OF MARKET MILK SOLD AT TANDOJAM, PAKISTAN

    Directory of Open Access Journals (Sweden)

    S. B. JAVAID, J. A. GADAHI, M. KHASKELI, M. B. BHUTTO, S. KUMBHER AND A. H. PANHWAR

    2009-02-01

    Full Text Available The present study was conducted to evaluate the quality of milk sold at Tandojam, Pakistan. A total of 125 milk samples (25 samples from each source collected from five milk marketing agencies viz direct seller (DS, milk collection center(MCC, milk vendor shop (MVS, hotel (HT and buffalo dairy farm (DF, which served as control. Acidity of milk obtained from DS, MCC, MVS and HT averaged 0.13, 0.15, 0.12 and 0.13, respectively compared to 0.14 for DF milk. The pH values of milk from MVS (6.54 and HT (6.53 were significantly different (P0.05 to that of DF milk i.e. 6.65. Viscosity, specific gravity and freezing point of milk procured from DS (1.48, 1.026 and –0.460, respectively, MCC (1.58, 1.026 and –0.470, respectively, MVS (1.34, 1.026 and –0.440, respectively and HT (1.46, 1.027 and –0.480, respectively were significantly (P<0.001 lower than DF milk (1.86, 1.031 and -0.551, respectively. Chemical quality of milk procured from DS, MCC, MVS and HT compared to DF milk (control averaged 13.45, 14.18, 13.19 and 14.06% vs. 16.30% for TS content, 8.25, 8.81, 8.06 and 8.51% vs. 9.79% for SNF content, 5.20, 5.41, 5.13 and 5.54% vs. 6.51% for fat content, 3.85, 3.96, 3.91 and 4.23% vs. 4.35% for protein content, 2.70, 2.77, 2.56 and 3.20% vs. 3.56% for casein content, 3.65, 4.03, 3.34 and 3.52% vs. 4.53% for lactose content and 0.75, 0.78, 0.74 and 0.76% vs. 0.91% for ash content, respectively. All the attributes of chemical quality of milk supplied through four agencies were significantly lower (P<0.05 than DF milk.

  1. Parasitic contamination of fresh vegetables sold at central markets in Khartoum state, Sudan.

    Science.gov (United States)

    Mohamed, Mona Ali; Siddig, Emmanuel Edwar; Elaagip, Arwa Hassan; Edris, Ali Mahmoud Mohammed; Nasr, Awad Ahmed

    2016-03-11

    Fresh vegetables are considered as vital nutrients of a healthy diet as they supply the body with essential supplements. The consumption of raw vegetables is the main way for transmission of intestinal parasitic organisms. This study was aimed at detecting the parasitic contamination in fresh vegetables sold in two central open-aired markets in Khartoum state, Sudan. In this prospective cross-sectional study, a total of 260 fresh vegetable samples and 50 water samples used to sprinkle vegetable(s) were collected from two central open-aired markets (namely; Elshaabi and Central markets) during November 2011 to May 2012. The samples were microscopically examined for detection of parasitic life forms using standardized parasitological techniques for protozoans and helminthes worms. Of the 260 fresh vegetable samples, 35 (13.5 %) were microscopically positive for intestinal parasites whereas 7/50 (14 %) of water samples used to sprinkle vegetable(s) were found positives. Remarkably, high level of contamination in fresh vegetable samples was recorded in lettuce (Lactuca sativa) 36.4 % (4/11) while cayenne pepper (Capsicum annuum) and cucumber (Cucumis sativus) were not contaminated. The identified protozoans and helminthes were Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis, T. trichiura and hookworms. The most predominant parasite encountered was E. histolytica/dispar (42.9 %) whereas both T. trichiura and A. lumbricoides (2.9 %) were the least detected parasites. None of the fresh vegetables had single parasitic contamination. The highest percentages found in water samples used to sprinkle vegetable(s) was for Strongyloides larvae 60 % (3/5). It is worth-mentioned that the rate of contamination in Elshaabi market was higher compared with Central market. However, there was no significant correlation between the type of vegetables and existence of parasites in both markets and a high significant

  2. Oral pathology.

    Science.gov (United States)

    Niemiec, Brook A

    2008-05-01

    Oral disease is exceedingly common in small animal patients. In addition, there is a very wide variety of pathologies that are encountered within the oral cavity. These conditions often cause significant pain and/or localized and systemic infection; however, the majority of these conditions have little to no obvious clinical signs. Therefore, diagnosis is not typically made until late in the disease course. Knowledge of these diseases will better equip the practitioner to effectively treat them. This article covers the more common forms of oral pathology in the dog and cat, excluding periodontal disease, which is covered in its own chapter. The various pathologies are presented in graphic form, and the etiology, clinical signs, recommended diagnostic tests, and treatment options are discussed. Pathologies that are covered include: persistent deciduous teeth, fractured teeth, intrinsically stained teeth, feline tooth resorption, caries, oral neoplasia, eosinophilic granuloma complex, lymphoplasmacytic gingivostomatitis, enamel hypoplasia, and "missing" teeth.

  3. Herpes - oral

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000606.htm Herpes - oral To use the sharing features on this page, ... 374. Read More Atopic dermatitis Cancer Fever Genital herpes Mouth ulcers Vesicles Review Date 8/14/2015 Updated ...

  4. 青蒿琥酯对人大肠癌 Lovo 细胞侵袭影响的初步研究%Preliminary of research of effect of artesunate on invasion of human colon cancer Lovo cells

    Institute of Scientific and Technical Information of China (English)

    郭颖; 郭建华; 符航; 田芝瑜; 罗强; 刘芳; 张林西

    2016-01-01

    Aim To investigate the effect of artesunate on the invasion of human colon cancer Lovo cells and the possible mechanisms. Methods After Lovo cells were treated with different doses of artesunate(20,80, 160 μmol·L - 1 ), the soft agar colony formation test was adopted to observe the anchorage-independent pro-liferation of Lovo cells. Transwell assay was used to determine the effect of artesunate on the invasion abili-ty of Lovo cells. And the protein expressions of HMGB1 and MMP-2 were investigated by western blot. Results Artesunate could significantly inhibit both proliferation and invasion ability of Lovo cells in a dose-dependent manner(P < 0. 01). The experimental group treated with artesunate significantly down-regula-ted the protein expressions of HMGB1 and MMP-2 compared with control group(P < 0. 05). Conclusion Artesunate could inhibit the invasion of human colon cancer Lovo cells by down-regulating HMGB1 and MMP-2 expressions.%目的:观察青蒿琥酯对大肠癌细胞的侵袭作用,并探讨其作用机制。方法采用不同浓度的青蒿琥酯(20、80、160μmol·L -1)作用于人大肠癌 Lovo 细胞,软琼脂集落形成实验检测青蒿琥酯对 Lovo 细胞锚着不依赖性增殖的影响;Transwell 侵袭实验检测其对 Lovo 细胞侵袭的影响;Western blot 方法分别检测 Lovo 细胞内 HMGB1和 MMP-2蛋白质水平的表达情况。结果青蒿琥酯能有效抑制 Lovo 细胞的增殖和侵袭能力,且呈剂量依赖性(P <0.01)。与对照组相比,不同浓度青蒿琥酯处理组 HMGB1和 MMP-2蛋白表达逐渐减少,差异有统计学意义(P <0.05)。结论青蒿琥酯可明显抑制大肠癌 Lovo 细胞侵袭,其机制可能与抑制HMGB1蛋白,下调 MMP-2表达有关。

  5. Fatal liver and bone marrow toxicity by combination treatment of dichloroacetate and artesunate in a glioblastoma multiforme patient. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Martin Uhl

    2016-10-01

    Full Text Available A 52 year-old male patient was treated with standard radiochemotherapy with temozolomide for glioblastoma multiforme. After worsening of his clinical condition, further tumor specific treatment was unlikely to be successful, and the patient seeked help from an alternative practitioner that administered a combination of dichloroacetate (DCA and artesunate (ART. A few days later, the patient showed clinical and laboratory signs of liver damage and bone marrow toxicity (leukopenia, thrombocytopenia. Beside successful restoration of laboratory parameters upon symptomatic treatment the patient died 10 days after the infusion. DCA bears a well-documented hepatotoxic risk, while ART can be considered as safe concerning hepatotoxicity. Bone marrow toxicity can appear as reduced reticulocyte counts and disturbed erythropoiesis. It can be speculated that the simultaneous use of both drugs caused liver injury and bone marrow toxicity. The compassionate use of DCA/ARTcombination therapy outside of clinical trials cannot be recommended for GBM treatment.

  6. Clinical tolerability of artesunate-amodiaquine versus comparator treatments for uncomplicated falciparum malaria: an individual-patient analysis of eight randomized controlled trials in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Zwang Julien

    2012-08-01

    Full Text Available Abstract Background The widespread use of artesunate-amodiaquine (ASAQ for treating uncomplicated malaria makes it important to gather and analyse information on its tolerability. Methods An individual-patient tolerability analysis was conducted using data from eight randomized controlled clinical trials conducted at 17 sites in nine sub-Saharan countries comparing ASAQ to other anti-malarial treatments. All patients who received at least one dose of the study drug were included in the analysis. Differences in adverse event (AE and treatment emergent adverse event (TEAE were analysed by Day 28. Results Of the 6,179 patients enrolled (74% Conclusion ASAQ was comparatively well-tolerated. Safety information is important, and must be collected and analysed in a standardized way. TEAEs are a more objective measure of treatment-induced toxicity.

  7. Disparities in Oral Health

    Science.gov (United States)

    ... 2020: Oral Health Objectives Site Map Disparities in Oral Health Recommend on Facebook Tweet Share Compartir Oral health ... to get and keep dental insurance. Disparities in Oral Health Some of the oral health disparities that exist ...

  8. Efficacy and tolerability of a new formulation of artesunate-mefloquine for the treatment of uncomplicated malaria in adult in Senegal: open randomized trial

    Directory of Open Access Journals (Sweden)

    CK Tine Roger

    2012-12-01

    Full Text Available Abstract Background Prompt treatment of malaria attacks with arteminisin-based combination therapy (ACT is an essential tool for malaria control. A new co-blister tablet of artesunate-mefloquine (AM with 25 mg/kg mefloquine has been developed for the management of uncomplicated malaria attacks. This non-inferiority randomized trial, was conducted to evaluate the efficacy and safety of the new formulation of AM in comparison to artemether-lumefantrine (AL for the treatment of acute uncomplicated Plasmodium falciparum malaria in adults in Senegal. Methods The study was carried out from September to December 2010 in two health centres in Senegal. The study end points included (i PCR corrected adequate clinical and parasitological response (ACPR at day 28, (ii ACPR at days 42 and 63, (iii parasites and fever clearance time, (iv incidence of adverse events and patients biological profile at day 7 using the WHO 2003 protocol for anti-malarial drug evaluation. Results Overall, 310 patients were randomized to receive either AM (n = 157 or AL (n = 153. PCR corrected ACPR at day 28 was at 95.5% in the AM arm while that in the AL arm was at 96.7% (p = 0.83. Therapeutic efficacy was at 98.5% in the AM arm versus 98.2% in the AL group at day 42 (p = 1. At day 63, ACPR in the AM and AL arms was at 98.2% and 97.7%, respectively (p = 0.32. The two treatments were well tolerated with similar biological profile at day 7. However, dizziness was more frequent in the AM arm. Conclusion Artesunate-mefloquine (25 mg/Kg mefloquine is efficacious and well-tolerated for the treatment of uncomplicated P. falciparum malaria in adult patients.

  9. Cost effectiveness of seasonal intermittent preventive treatment using amodiaquine & artesunate or sulphadoxine-pyrimethamine in Ghanaian children.

    Directory of Open Access Journals (Sweden)

    Lesong Conteh

    Full Text Available BACKGROUND: Intermittent preventive treatment for malaria in children (IPTc involves the administration of a full course of an anti-malarial treatment to children under 5 years old at specified time points regardless of whether or not they are known to be infected, in areas where malaria transmission is seasonal. It is important to determine the costs associated with IPTc delivery via community based volunteers and also the potential savings to health care providers and caretakers due to malaria episodes averted as a consequence of IPTc. METHODS: Two thousand four hundred and fifty-one children aged 3-59 months were randomly allocated to four groups to receive: three days of artesunate plus amodiaquine (AS+AQ monthly, three days of AS+AQ bimonthly, one dose of sulphadoxine-pyrimethamine (SP bi-monthly or placebo. This paper focuses on incremental cost effectiveness ratios (ICERs of the three IPTc drug regimens as delivered by community based volunteers (CBV in Hohoe, Ghana compared to current practice, i.e. case management in the absence of IPTc. Financial and economic costs from the publicly funded health system perspective are presented. Treatment costs borne by patients and their caretakers are also estimated to present societal costs. The costs and effects of IPTc during the intervention period were considered with and without a one year follow up. Probabilistic sensitivity analysis was undertaken to account for uncertainty. RESULTS: Economic costs per child receiving at least the first dose of each course of IPTc show SP bimonthly, at US$8.19, is the cheapest to deliver, followed by AS+AQ bimonthly at US$10.67 and then by AS+AQ monthly at US$14.79. Training, drug delivery and supervision accounted for approximately 20-30% each of total unit costs. During the intervention period AS & AQ monthly was the most cost effective IPTc drug regimen at US$67.77 (61.71-74.75, CI 95% per malaria case averted based on intervention costs only, US$64

  10. Household expenditures on dietary supplements sold for weight loss, muscle building, and sexual function: Disproportionate burden by gender and income

    Directory of Open Access Journals (Sweden)

    S. Bryn Austin

    2017-06-01

    Full Text Available Dietary supplements sold for weight loss (WL, muscle building (MB, and sexual function (SF are not medically recommended. They have been shown to be ineffective in many cases and pose serious health risks to consumers due to adulteration with banned substances, prescription pharmaceuticals, and other dangerous chemicals. Yet no prior research has investigated how these products may disproportionately burden individuals and families by gender and socioeconomic position across households. We investigated household (HH cost burden of dietary supplements sold for WL, MB, and SF in a cross-sectional study using data from 60,538 U.S. households (HH in 2012 Nielsen/IRi National Consumer Panel, calculating annual HH expenditures on WL, MB, and SF supplements and expenditures as proportions of total annual HH income. We examined sociodemographic patterns in HH expenditures using Wald tests of mean differences across subgroups. Among HH with any expenditures on WL, MB, or SF supplements, annual HH first and ninth expenditure deciles were, respectively: WL $5.99, $145.36; MB $6.99, $141.93; and SF $4.98, $88.52. Conditional on any purchases of the products, female-male-headed HH spent more on WL supplements and male-headed HH spend more on MB and SF supplements compared to other HH types (p-values < 0.01. High-income ($30,000 < annual income < $100,000, compared to low-income (annual income < $30,000 HH, spent more on all three supplements types (p-values < 0.01; however, proportional to income, low-income HH spent 2–4 times more than high-income HH on WL and MB supplements (p-values < 0.01. Dietary supplements sold for WL, MB, and SF disproportionately burden HH by income and gender.

  11. Characterization of advertisements for puppies sold online: determinants of cost and a comparison with parent club breeders.

    Science.gov (United States)

    Voris, H C; Wittum, T E; Rajala-Schultz, P J; Lord, L K

    2011-07-01

    The Internet is an increasingly common way for consumers to purchase puppies. Yet very little information is available about the types of puppies sold via the Internet. In addition these sales are not subject to United States Depart of Agriculture (USDA) regulation. The objectives of the study were to describe puppies sold via the Internet, to assess the characteristics that contribute to the cost of a puppy, and to compare puppies sold via the Internet with puppies sold by American Kennel Club (AKC) Parent Club breeders. Over 14 weeks in 2008, Yorkshire Terrier, Shih Tzu, English Bulldog, Boxer, and Labrador Retriever puppies for sale on two large-scale online puppy sales sites were categorized based on their Internet advertisements. Data were collected in three categories: puppy characteristics, health characteristics, and policies (such as spay/neuter requirement, health guarantee, and return policy). After the survey was completed, 25 AKC Parent Club breeders and 25 other breeders who advertised via one of the puppy sales websites were randomly selected and interviewed over the phone. Small breed puppies were most frequently advertised with 35.2% (1228/3485) of advertisements for Yorkshire Terriers and 23.0% (802/3485) for Shih Tzus. Almost one quarter of Internet breeders 768/3474 (22.2%) advertised four or more different dog breeds. Champion bloodlines increased the cost of a puppy of all breeds. AKC Parent Club breeders 21/25 (84%) were more likely to mention breed-specific health screening tests when compared to Internet breeders 7/25 (28%). Consumers should apply the same standards for purchasing from a breeder found through a puppy sales site as they would for purchasing from a local breeder. Breeders who advertise at one of the large-scale puppy sales websites are less knowledgeable about breed-specific health issues compared to an AKC Parent Club breeder. Internet breeders are less likely to perform these screening tests on their breeding dogs and may

  12. Trace elements in rock phosphates and P containing mineral and organo-mineral fertilizers sold in Germany

    Energy Technology Data Exchange (ETDEWEB)

    Kratz, Sylvia, E-mail: sylvia.kratz@jki.bund.de; Schick, Judith; Schnug, Ewald

    2016-01-15

    68 rock phosphates and 162 P containing (organo-)mineral fertilizers sold in Germany were evaluated with regard to trace element contents. While Al, As, B, Be, Cd, Cr, Mo, Ni, Pb, Sb, Se, Tl, U, and Zn were higher in sedimentary than in igneous rock phosphates, the opposite was true for Co, Cu, Sn, Mn, Ti, Fe, and Sr. Comparing element concentrations to the currently valid legal limit values defined by the German Fertilizer Ordinance, it was found that some PK and many straight P fertilizers (superphosphate, triple superphosphate, partly acidulated rock phosphates) exceeded the limit of 50 mg Cd/kg P{sub 2}O{sub 5}. Mean values for As, Ni, Pb, and Tl remained below legal limits in almost all cases. While no legal limit has been defined for U in Germany yet, the limit of 50 mg U/kg P{sub 2}O{sub 5} for P containing fertilizers proposed by the German Commission for the Protection of Soils was clearly exceeded by mean values for all fertilizer types analyzed. A large share of the samples evaluated in this work contained essential trace elements at high concentrations, with many of them not being declared as such. Furthermore, trace elements supplied with these fertilizers at a fertilization rate leveling P uptake would exceed trace element uptake by crops. This may become most relevant for B and Fe, since many crops are sensitive to an oversupply of B, and Fe loads exceeding plant uptake may immobilize P supplies for the crops by forming Fe phosphate salts. The sample set included two products made from thermochemically treated sewage sludge ash. The products displayed very high concentrations of Fe and Mn and exceeded the legal limit for Ni, emphasizing the necessity to continue research on heavy metal removal from recycled raw materials and the development of environmentally friendly and agriculturally efficient fertilizer products. - Highlights: • Mineral fertilizers (MF) sold in Germany often exceed legal limits for Cd • MF sold in Germany contain high

  13. Oral candidiasis.

    Science.gov (United States)

    Millsop, Jillian W; Fazel, Nasim

    2016-01-01

    Oral candidiasis (OC) is a common fungal disease encountered in dermatology, most commonly caused by an overgrowth of Candida albicans in the mouth. Although thrush is a well-recognized presentation of OC, it behooves clinicians to be aware of the many other presentations of this disease and how to accurately diagnose and manage these cases. The clinical presentations of OC can be broadly classified as white or erythematous candidiasis, with various subtypes in each category. The treatments include appropriate oral hygiene, topical agents, and systemic medications. This review focuses on the various clinical presentations of OC and treatment options.

  14. Oral myiasis

    Directory of Open Access Journals (Sweden)

    Treville Pereira

    2010-01-01

    Full Text Available Myiasis is a relatively rare condition arising from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies. It is an uncommon clinical condition, being more frequent in underdeveloped countries and hot climate regions, and is associated with poor hygiene, suppurative oral lesions; alcoholism and senility. Its diagnosis is made basically by the presence of larvae. The present article reports a case of oral myiasis involving 20 larvae in a patient with neurological deficiency.

  15. Molecular epidemiology of malaria in Cameroon. XXX. sequence analysis of Plasmodium falciparum ATPase 6, dihydrofolate reductase, and dihydropteroate synthase resistance markers in clinical isolates from children treated with an artesunate-sulfadoxine-pyrimethamine combination.

    Science.gov (United States)

    Menemedengue, Virginie; Sahnouni, Khalifa; Basco, Leonardo; Tahar, Rachida

    2011-07-01

    Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes are reliable molecular markers for antifolate resistance. The P. falciparum ATPase 6 (pfatp6) gene has been proposed to be a potential marker for artemisinin resistance. In our previous clinical study, we showed that artesunate-sulfadoxine-pyrimethamine is highly effective against uncomplicated malaria in Yaoundé, Cameroon. In the present study, dhfr, dhps, and pfatp6 mutations in P. falciparum isolates obtained from children treated with artesunate-sulfadoxine-pyrimethamine were determined. All 61 isolates had wild-type Pfatp6 263, 623, and 769 alleles, and 11 (18%) had a single E431K substitution. Three additional mutations, E643Q, E432K, and E641Q, were detected. The results did not indicate any warning signal of serious concern (i.e., no parasites were seen with quintuple dhfr-dhps, DHFR Ile164Leu, or pfatp6 mutations), as confirmed by the high clinical efficacy of artesunate-sulfadoxine-pyrimethamine. Further studies are required to identify a molecular marker that reliably predicts artemisinin resistance.

  16. Microscopic analysis of "prato", "mussarela" and "mineiro" cheese sold in street markets of the City of S. Paulo, Southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Marlene Correia

    1997-06-01

    Full Text Available INTRODUCTION: Cheese should be produced from ingredients of good quality and processed under hygienic conditions. Further, cheese should be transported, stored and sold in an appropriate manner in order to avoid, among other things, the incorporation of extraneous materials (filth of biological origin or otherwise, in contravention of the relevant food legislation. The aim of the study was to evaluate the hygienic conditions of "prato", "mussarela", and "mineiro" cheeses sold at the street food markets in the city of S. Paulo, Brazil. MATERIALS AND METHOD: Forty-seven samples of each of the three types of cheese were collected during the period from March, 1993 to February, 1994. The Latin square was used as a statistical model for sampling and random selection of the street markets from which to collect the cheese samples. The samples were analysed for the presence of extraneous matters outside for which purpose the samples were washed and filtered and inside, for which the methodology of enzymathic digestion of the sample with pancreatine, followed by filtering,was used. RESULTS AND CONCLUSION: Of the 141 samples analysed, 75.9% exhibited at least one sort of extraneous matters. For the "prato" and "mussarela" cheeses, the high number of contaminated samples was due mainly to extraneous matters present inside the cheese, whereas in the "mineiro" cheese, besides the internal filth, 100% of the samples had external filth.

  17. Microscopic analysis of "prato", "mussarela" and "mineiro" cheese sold in street markets of the City of S. Paulo, Southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Correia Marlene

    1997-01-01

    Full Text Available INTRODUCTION: Cheese should be produced from ingredients of good quality and processed under hygienic conditions. Further, cheese should be transported, stored and sold in an appropriate manner in order to avoid, among other things, the incorporation of extraneous materials (filth of biological origin or otherwise, in contravention of the relevant food legislation. The aim of the study was to evaluate the hygienic conditions of "prato", "mussarela", and "mineiro" cheeses sold at the street food markets in the city of S. Paulo, Brazil. MATERIALS AND METHOD: Forty-seven samples of each of the three types of cheese were collected during the period from March, 1993 to February, 1994. The Latin square was used as a statistical model for sampling and random selection of the street markets from which to collect the cheese samples. The samples were analysed for the presence of extraneous matters outside for which purpose the samples were washed and filtered and inside, for which the methodology of enzymathic digestion of the sample with pancreatine, followed by filtering,was used. RESULTS AND CONCLUSION: Of the 141 samples analysed, 75.9% exhibited at least one sort of extraneous matters. For the "prato" and "mussarela" cheeses, the high number of contaminated samples was due mainly to extraneous matters present inside the cheese, whereas in the "mineiro" cheese, besides the internal filth, 100% of the samples had external filth.

  18. Quality evaluation of commercially sold table water samples in Michael Okpara University of Agriculture, Umudike, Nigeria and surrounding environments

    Directory of Open Access Journals (Sweden)

    D.O. Okorie

    2015-01-01

    Full Text Available In Michael Okpara University of Agriculture, Umudike, Nigeria (MOUAU and surrounding environments, table water of different brands is commercially hawked by vendors. To the best of our knowledge, there is no scientific documentation on the quality of these water samples. Hence this study which evaluated the quality of different brands of water samples commercially sold in MOUAU and surrounding environments. The physicochemical properties (pH, total dissolved solids (TDS, biochemical oxygen demand (BOD, total hardness, dissolved oxygen, Cl, NO3, ammonium nitrogen (NH3N, turbidity, total suspended solids (TSS, Ca, Mg, Na and K of the water samples as indices of their quality were carried out using standard techniques. Results obtained from this study indicated that most of the chemical constituents of these table water samples commercially sold in Umudike environment conformed to the standards given by the Nigerian Industrial Standard (NIS, World Health Organization (WHO and American Public Health Association (APHA, respectively, while values obtained for ammonium nitrogen in these water samples calls for serious checks on methods of their production and delivery to the end users.

  19. Bacteriological And Nutritional Analysis Of Groundnut Cake Sold In An Open Market In Samaru Zaria-Kaduna State

    Directory of Open Access Journals (Sweden)

    Oko

    2015-05-01

    Full Text Available Abstract Bacteriological and nutritional analysis of groundnut cake powder sold in open market at Samaru-Zaria was studied. The samples collected from four zones of the study area were analysed for possible microbiological contamination and its nutritional quality. The results indicated a microbial load of 1.93 x 105 cfug and 1.94 x 105 cfug for zones A and B respectively 1.01 x 105 cfug for zone C and 2.37 x 105 cfug for zone D. The bacterial isolates found to be associated with the groundnut cake powder in this study included Klebsiella oxytoca Staphylococcus aureus Bacillus cereus E. coli P. aeruginosa and Streptococcus feacalis. The nutrients content of the sample included carbohydrates 55.15 moisture 12.65 lipid 15.40 protein 12.60 ash 3.95 and crude fibre 0.25. Groundnut cake sold in the study area is highly contaminated with bacteria except for samples from zone C which is within the Food and Drugs Agency FDA recommendation of 1.0 x 105cfuml as allowable microbial contamination for food. The high level of microbial contamination is a serious cause for concern as it may trigger epidemics. However the product is highly nutritious.

  20. Oral calcitonin

    Directory of Open Access Journals (Sweden)

    Hamdy RC

    2012-09-01

    Full Text Available Ronald C Hamdy,1,2 Dane N Daley11Osteoporosis Center, College of Medicine, East Tennessee State University, 2Veterans Affairs Medical Center, Johnson City, TN, USAAbstract: Calcitonin is a hormone secreted by the C-cells of the thyroid gland in response to elevations of the plasma calcium level. It reduces bone resorption by inhibiting mature active osteoclasts and increases renal calcium excretion. It is used in the management of postmenopausal osteoporosis, Paget's disease of bone, and malignancy-associated hypercalcemia. Synthetic and recombinant calcitonin preparations are available; both have similar pharmacokinetic and pharmacodynamic profiles. As calcitonin is a peptide, the traditional method of administration has been parenteral or intranasal. This hinders its clinical use: adherence with therapy is notoriously low, and withdrawal from clinical trials has been problematic. An oral formulation would be more attractive, practical, and convenient to patients. In addition to its effect on active osteoclasts and renal tubules, calcitonin has an analgesic action, possibly mediated through β-endorphins and the central modulation of pain perception. It also exerts a protective action on cartilage and may be useful in the management of osteoarthritis and possibly rheumatoid arthritis. Oral formulations of calcitonin have been developed using different techniques. The most studied involves drug-delivery carriers such as Eligen® 8-(N-2hydroxy-5-chloro-benzoyl-amino-caprylic acid (5-CNAC (Emisphere Technologies, Cedar Knolls, NJ. Several factors affect the bioavailability and efficacy of orally administered calcitonin, including amount of water used to take the tablet, time of day the tablet is taken, and proximity to intake of a meal. Preliminary results looked promising. Unfortunately, in two Phase III studies, oral calcitonin (0.8 mg with 200 mg 5-CNAC, once a day for postmenopausal osteoporosis and twice a day for osteoarthritis failed to

  1. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Topics > Oral Cancer > Oral Cancer Exam Video Oral Cancer Exam Video This video shows what happens during an oral cancer examination. Quick and painless, the exam can detect ...

  2. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Topics > Oral Cancer > Oral Cancer Exam Video Oral Cancer Exam Video This video shows what happens during an oral cancer examination. Quick and painless, the exam can detect ...

  3. Determination of Artesunate and Amodiaquine Hydrochloride Tablets by RP-HPLC%RP-HPLC法测定青蒿琥酯阿莫地喹片中主药的含量

    Institute of Scientific and Technical Information of China (English)

    胡志强; 蒋锋; 姚忠

    2014-01-01

    A method for the determination of artesunate and amodiaquine hydrochloride tablets by RP-HPLC was established.The agilent C18(4.6 mm×15 cm)column was used,and the detection wavelength of artesunate was 210 nm.The mobile phase of artesunate was acetonitrile and the buffer solution.The detection wavelength of amodiaquine hydrochloride was 224 nm.The mobile phase of amodiaquine hydrochloride was methanol:phosphate buffer.The linear ranges of artesu-nate (0.500 5-2.002 mg/mL)and amodiaquine hydrochloride (25.03-100.1μg/mL)were good (r=0.999)with the average recovery rates of 98.6%and 99.5%.The method is simple and accurate,and it can be used for the determination of artesunate and amodiaquine hydrochloride tablets.%建立RP-HPLC法测定青蒿琥酯阿莫地喹片中主药的含量。色谱柱为安捷伦的C18柱(4.6 mm×15 cm),测定青蒿琥酯的流动相为乙腈-磷酸盐缓冲液,检测波长为210 nm,测定阿莫地喹的流动相为甲醇-磷酸盐缓冲液,检测波长为224 nm。在考察青蒿琥酯(0.5005~2.002 mg/mL)和阿莫地喹(25.03~100.1μg/mL)的质量浓度范围内具有良好的线性关系,r均达到0.999,平均回收率分别为98.6%和99.5%。结果表明,两套分析方法测定主药的含量,结果准确、可靠。

  4. DNA barcoding unveils skate (Chondrichthyes: Rajidae) species diversity in 'ray' products sold across Ireland and the UK.

    Science.gov (United States)

    Griffiths, Andrew Mark; Miller, Dana D; Egan, Aaron; Fox, Jennifer; Greenfield, Adam; Mariani, Stefano

    2013-01-01

    Skates are widely consumed across the globe, but many large species are subject to considerable concern regarding their conservation and management. Within Europe such issues have recently driven policy changes so that, for the first time, reports of skate landings now have to be made under species-specific names. Total allowable catches have also been established for many groups, which have been set to zero for a number of the most vulnerable species (e.g., Dipturus batis, Raja undulata and Rostoraja alba). Whilst accurate species identification has become an important issue for landings, the sale of skates is still usually made under a blanket term of "skate" or "ray". The matter of identifying species of skate is further complicated by their morphologically conservative nature and the fact that they are commercially valued for their wings. Thus, before sale their bodies are usually discarded (i.e., "winged") and often skinned, making morphological identification impossible. For the first time, DNA barcoding (of the mitochondrial COI gene) was applied to samples of skate wings from retail outlets across the British Isles, providing insight into which species are sold for consumption. A total of 98 wing samples were analysed, revealing that six species were sold; blonde ray (Raja brachyura), spotted ray (Raja montagui), thornback ray (Raja clavata), cuckoo ray (Leucoraja naevus) small-eyed ray (Raja microocellata) and shagreen ray (Leucoraja fullonica). Statistical testing demonstrated that there were significant differences in the species sold in the distinct retail groups which suggests complex drivers behind the patterns of sale in skates. The results also indicate that endangered species are not commonly being passed on to consumers. In addition, the practice of selling skate wings under ambiguous labels is highlighted as it makes it extremely difficult for consumers to exercise a right to avoid species of conservation concern. Interestingly, a single retailer

  5. DNA barcoding unveils skate (Chondrichthyes: Rajidae) species diversity in ‘ray’ products sold across Ireland and the UK

    Science.gov (United States)

    Egan, Aaron; Fox, Jennifer; Greenfield, Adam; Mariani, Stefano

    2013-01-01

    Skates are widely consumed across the globe, but many large species are subject to considerable concern regarding their conservation and management. Within Europe such issues have recently driven policy changes so that, for the first time, reports of skate landings now have to be made under species-specific names. Total allowable catches have also been established for many groups, which have been set to zero for a number of the most vulnerable species (e.g., Dipturus batis, Raja undulata and Rostoraja alba). Whilst accurate species identification has become an important issue for landings, the sale of skates is still usually made under a blanket term of “skate” or “ray”. The matter of identifying species of skate is further complicated by their morphologically conservative nature and the fact that they are commercially valued for their wings. Thus, before sale their bodies are usually discarded (i.e., “winged”) and often skinned, making morphological identification impossible. For the first time, DNA barcoding (of the mitochondrial COI gene) was applied to samples of skate wings from retail outlets across the British Isles, providing insight into which species are sold for consumption. A total of 98 wing samples were analysed, revealing that six species were sold; blonde ray (Raja brachyura), spotted ray (Raja montagui), thornback ray (Raja clavata), cuckoo ray (Leucoraja naevus) small-eyed ray (Raja microocellata) and shagreen ray (Leucoraja fullonica). Statistical testing demonstrated that there were significant differences in the species sold in the distinct retail groups which suggests complex drivers behind the patterns of sale in skates. The results also indicate that endangered species are not commonly being passed on to consumers. In addition, the practice of selling skate wings under ambiguous labels is highlighted as it makes it extremely difficult for consumers to exercise a right to avoid species of conservation concern. Interestingly, a

  6. DNA barcoding unveils skate (Chondrichthyes: Rajidae species diversity in ‘ray’ products sold across Ireland and the UK

    Directory of Open Access Journals (Sweden)

    Andrew Mark Griffiths

    2013-08-01

    Full Text Available Skates are widely consumed across the globe, but many large species are subject to considerable concern regarding their conservation and management. Within Europe such issues have recently driven policy changes so that, for the first time, reports of skate landings now have to be made under species-specific names. Total allowable catches have also been established for many groups, which have been set to zero for a number of the most vulnerable species (e.g., Dipturus batis, Raja undulata and Rostoraja alba. Whilst accurate species identification has become an important issue for landings, the sale of skates is still usually made under a blanket term of “skate” or “ray”. The matter of identifying species of skate is further complicated by their morphologically conservative nature and the fact that they are commercially valued for their wings. Thus, before sale their bodies are usually discarded (i.e., “winged” and often skinned, making morphological identification impossible. For the first time, DNA barcoding (of the mitochondrial COI gene was applied to samples of skate wings from retail outlets across the British Isles, providing insight into which species are sold for consumption. A total of 98 wing samples were analysed, revealing that six species were sold; blonde ray (Raja brachyura, spotted ray (Raja montagui, thornback ray (Raja clavata, cuckoo ray (Leucoraja naevus small-eyed ray (Raja microocellata and shagreen ray (Leucoraja fullonica. Statistical testing demonstrated that there were significant differences in the species sold in the distinct retail groups which suggests complex drivers behind the patterns of sale in skates. The results also indicate that endangered species are not commonly being passed on to consumers. In addition, the practice of selling skate wings under ambiguous labels is highlighted as it makes it extremely difficult for consumers to exercise a right to avoid species of conservation concern

  7. Oral dirofilariasis

    Directory of Open Access Journals (Sweden)

    R S Desai

    2015-01-01

    Full Text Available Dirofilaria is parasitic nematodes of domestic and wild animals that can infect humans accidentally via vectors. Its occurrence in the oral cavity is extremely rare. The most frequent presentation of human dirofilariasis is a single submucosal nodule without signs of inflammation. We hereby, report a case of human dirofilariasis affecting the buccal mucosa in a 32-year-old farmer caused by D. repens.

  8. Oral leiomyomas.

    Science.gov (United States)

    Damm, D D; Neville, B W

    1979-04-01

    Oral leiomyomas are considered to be rare neoplasms, but they may be encountered more frequently than generally believed. Three types of leiomyomas are commonly described: solid leiomyomas, angiomyomas, and epithelioid leiomyomas. Three cases of solid leiomyoma are presented, all of which occurred in the anterior mandibular mucobuccal fold. Leiomyomas can be easily confused with other spindle-cell tumors. The necessity of using special stains, especially Mallory's phosphotungstic acid hematoxylin, is discussed.

  9. Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine

    Directory of Open Access Journals (Sweden)

    Corpolongo Angela

    2012-03-01

    Full Text Available Abstract Intravenous (i.v. artesunate is now the recommended first-line treatment of severe falciparum malaria in adults and children by WHO guidelines. Nevertheless, several cases of haemolytic anaemia due to i.v. artesunate treatment have been reported. This paper describes the case of an HIV-infected patient with severe falciparum malaria who was diagnosed with haemolytic anaemia after treatment with oral artemether-lumefantrine. The patient presented with fever, headache, and arthromyalgia after returning from Central African Republic where he had been working. The blood examination revealed acute renal failure, thrombocytopaenia and hypoxia. Blood for malaria parasites indicated hyperparasitaemia (6% and Plasmodium falciparum infection was confirmed by nested-PCR. Severe malaria according to the laboratory WHO criteria was diagnosed. A treatment with quinine and doxycycline for the first 12 hours was initially administered, followed by arthemeter/lumefantrine (Riamet® for a further three days. At day 10, a diagnosis of severe haemolytic anaemia was made (Hb 6.9 g/dl, LDH 2071 U/l. Hereditary and autoimmune disorders and other infections were excluded through bone marrow aspiration, total body TC scan and a wide panel of molecular and serologic assays. The patient was treated by transfusion of six units of packed blood red cell. He was discharged after complete remission at day 25. At present, the patient is in a good clinical condition and there is no evidence of haemolytic anaemia recurrence. This is the first report of haemolytic anaemia probably associated with oral artemether/lumefantrine. Further research is warranted to better define the adverse events occurring during combination therapy with artemisinin derivatives.

  10. Screening of quinolone antibiotic residues in chicken meat and beef sold in the markets of Ankara, Turkey.

    Science.gov (United States)

    Er, Buket; Onurdag, Fatma Kaynak; Demirhan, Burak; Ozgacar, Selda Özgen; Oktem, Aysel Bayhan; Abbasoglu, Ufuk

    2013-08-01

    This study aimed to find the effects of quinolone antibiotics in chicken and beef used in Ankara, Turkey. Total number of 127 chicken and 104 beef meat samples were collected randomly from local markets for analysis. Extraction and determination of quinolones were made by ELISA procedure. One hundred eighteen of 231 (51.1%) examined chicken meat and beef samples were found to contain quinolone antibiotic residue. Among the chicken meat and beef samples, 58 (45.7%) of chicken meat samples and 60 (57.7%) of beef meat samples were positive for quinolones, respectively. The mean levels (±SE) of quinolones were found to be 30.81 ± 0.45 µg/kg and 6.64 ± 1.11 µg/kg in chicken and beef samples, respectively. This study indicated that some chicken and beef meat sold in Ankara contains residues of quinolone antibiotics.

  11. A single period inventory model of a deteriorating item sold from two shops with shortage via genetic algorithm

    Directory of Open Access Journals (Sweden)

    Mondal S.K.

    2007-01-01

    Full Text Available Inventory of differential units of a deteriorating item purchased in a lot and sold separately from two shops under a single management is considered. Here deterioration increases with time and demands are time- and price-dependent for fresh and deteriorated units respectively. For the fresh units, shortages are allowed and later partially-backlogged. For the deteriorated units, there are two scenarios depending upon whether initial rate of replenishment of deteriorated units is less or more than the demand of these items. Under each scenario, five sub-scenarios are depicted depending upon the time periods of the two-shops. For each sub scenarios, profit maximization problem has been formulated and solved for optimum order quantity and corresponding time period using genetic Algorithm (GA with Roulette wheel selection, arithmetic crossover and uniform mutation and Generalized Reduced Gradient method (GRG. All sub-scenarios are illustrated numerically and results from two methods are compared. .

  12. State sales tax rates for soft drinks and snacks sold through grocery stores and vending machines, 2007.

    Science.gov (United States)

    Chriqui, Jamie F; Eidson, Shelby S; Bates, Hannalori; Kowalczyk, Shelly; Chaloupka, Frank J

    2008-07-01

    Junk food consumption is associated with rising obesity rates in the United States. While a "junk food" specific tax is a potential public health intervention, a majority of states already impose sales taxes on certain junk food and soft drinks. This study reviews the state sales tax variance for soft drinks and selected snack products sold through grocery stores and vending machines as of January 2007. Sales taxes vary by state, intended retail location (grocery store vs. vending machine), and product. Vended snacks and soft drinks are taxed at a higher rate than grocery items and other food products, generally, indicative of a "disfavored" tax status attributed to vended items. Soft drinks, candy, and gum are taxed at higher rates than are other items examined. Similar tax schemes in other countries and the potential implications of these findings relative to the relationship between price and consumption are discussed.

  13. Animal-based folk remedies sold in public markets in Crato and Juazeiro do Norte, Ceará, Brazil

    Directory of Open Access Journals (Sweden)

    Almeida Waltécio O

    2009-06-01

    Full Text Available Abstract Background Human communities consistently develop a detailed knowledge of the therapeutical and medicinal properties of the local flora and fauna, and these folk remedies often substitute medicines produced by the pharmaceutical industry. Animals (and their derived products are essential ingredients in the preparation of many traditional remedies. The present work prepared an inventory of the animals sold in public markets in the cities of Crato and Juazeiro do Norte, Ceará State, Brazil. Methods Information was obtained through the use of semi-structured questionnaires in interviews held with 27 merchants of medicinal animals (18 in the municipality of Juazeiro do Norte [11 men and 7 women] and 9 people in the municipality of Crato [6 men and 3 women]. We calculated the Informant Consensus Factor (ICF to determine the consensus over which species are effective for particular ailments, as well as the species Use Value (UV to determine the extent of utilization of each species. Results A total of 31 animal species, distributed among 21 families were identified as being used medicinally. The taxa most represented were: insects (8 species, mammals (7, fish (5, reptiles (5 and birds (4. The animals sold in these markets are used to treat a total of 24 ailments, with rheumatism, asthma, and inflammations having the largest numbers of citations. Three species not previously reported as having medicinal use were encountered: Leporinus steindachneri (utilized for treating cholesterol problems, Gryllus assimilis (utilized in treating urinary infections, and Phrynops tuberosus (used to treat asthma, rheumatism and bruises. Conclusion The composition of the local fauna, the popular culture, and commercial considerations are factors that maintain and drive the market for therapeutic animal products – and the lack of monitoring and regulation of this commerce is worrisome from a conservationist perspective. A detailed knowledge of the fauna

  14. Microbial and physicochemical assays of paracetamol in different brands of analgesic syrups sold in Sana’a City-Yemen

    Directory of Open Access Journals (Sweden)

    Ali G. Al−Kaf

    2015-02-01

    Full Text Available Context: Contamination of pharmaceuticals with microorganisms irrespective whether they are harmful or nonpathogenic can bring about changes in physicochemical characteristics of the drugs. Aims: To assay the microbial and physicochemical characteristics of paracetamol of two hundreds samples of different brands of analgesic syrups sold in Sana’a City, Yemen. Methods: Total viable aerobic count, type of isolated microorganisms, physical properties, and content of active ingredients were identified and evaluated by standard methods and techniques. The SPSS program was used to statistical analysis of variance for results obtained. Results: The total bacterial count of <10 CFU/mL and <100 CFU/mL in 179 (89.5% and 21 (10.5% samples, respectively was recorded, while the total fungal count was ≤10 CFU/mL in all analyzed syrup samples. The isolated bacteria were Bacillus subtilis, Micrococcus fulvum, and Staphylococcus epidermidis while isolated fungi were Aspergillus niger, Aspergillus fumigatus, and Penicillium notatum. Bacillus subtilis and Aspergillus niger were the predominant bacteria and fungi isolated. The color results had a light red liquid with a sweet taste in the analyzed analgesic syrups. The pH values were ranged from 4.44–5.88. However, the density fluctuated from 1.149–1.184 g/mL. The paracetamol concentration as an active ingredient in the analgesic syrup was recorded from 98.19% – 106.53%. Conclusions: This finding showed that all analgesic syrups sold in Sana’a City followed Pharmacopeia specifications on microbial and physicochemical qualities.

  15. CUSP9* treatment protocol for recurrent glioblastoma: aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, ritonavir, sertraline augmenting continuous low dose temozolomide.

    Science.gov (United States)

    Kast, Richard E; Karpel-Massler, Georg; Halatsch, Marc-Eric

    2014-09-30

    CUSP9 treatment protocol for recurrent glioblastoma was published one year ago. We now present a slight modification, designated CUSP9*. CUSP9* drugs--aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, sertraline, ritonavir, are all widely approved by regulatory authorities, marketed for non-cancer indications. Each drug inhibits one or more important growth-enhancing pathways used by glioblastoma. By blocking survival paths, the aim is to render temozolomide, the current standard cytotoxic drug used in primary glioblastoma treatment, more effective. Although esthetically unpleasing to use so many drugs at once, the closely similar drugs of the original CUSP9 used together have been well-tolerated when given on a compassionate-use basis in the cases that have come to our attention so far. We expect similarly good tolerability for CUSP9*. The combined action of this suite of drugs blocks signaling at, or the activity of, AKT phosphorylation, aldehyde dehydrogenase, angiotensin converting enzyme, carbonic anhydrase -2,- 9, -12, cyclooxygenase-1 and -2, cathepsin B, Hedgehog, interleukin-6, 5-lipoxygenase, matrix metalloproteinase -2 and -9, mammalian target of rapamycin, neurokinin-1, p-gp efflux pump, thioredoxin reductase, tissue factor, 20 kDa translationally controlled tumor protein, and vascular endothelial growth factor. We believe that given the current prognosis after a glioblastoma has recurred, a trial of CUSP9* is warranted.

  16. Artesunate has its enhancement on antibacterial activity of β-lactams via increasing the antibiotic accumulation within methicillin-resistant Staphylococcus aureus (MRSA).

    Science.gov (United States)

    Jiang, Weiwei; Li, Bin; Zheng, Xinchuan; Liu, Xin; Pan, Xichun; Qing, Rongxin; Cen, Yanyan; Zheng, Jiang; Zhou, Hong

    2013-06-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has now emerged as a predominant and serious pathogen because of its resistance to a large group of antibiotics, leading to high morbidity and mortality. Therefore, to develop new agents against resistance is urgently required. Previously, artesunate (AS) was found to enhance the antibacterial effect of β-lactams against MRSA. In this study, AS was first found to increase the accumulation of antibiotics (daunorubicin and oxacillin) within MRSA by laser confocal microscopy and liquid chromatography-tandem MS method, suggesting the increased antibiotics accumulation might be related to the enhancement of AS on antibiotics. Furthermore, AS was found not to destroy the cell structure of MRSA by transmission electron microscope. AS was found to inhibit gene expressions of important efflux pumps such as NorA, NorB and NorC, but not MepA, SepA and MdeA. In conclusion, our results showed that AS was capable of enhancing the antibacterial activity of β-lactams via increasing antibiotic accumulations within MRSA through inhibiting gene expressions of efflux pumps such as NorA, NorB and NorC, but did not destroy the cell structure of MRSA. AS could be further investigated as a candidate drug for treatment of MRSA infection.

  17. CUSP9* treatment protocol for recurrent glioblastoma: aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, ritonavir, sertraline augmenting continuous low dose temozolomide

    Science.gov (United States)

    Kast, Richard E.; Karpel-Massler, Georg; Halatsch, Marc-Eric

    2014-01-01

    CUSP9 treatment protocol for recurrent glioblastoma was published one year ago. We now present a slight modification, designated CUSP9*. CUSP9* drugs- aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, sertraline, ritonavir, are all widely approved by regulatory authorities, marketed for non-cancer indications. Each drug inhibits one or more important growth-enhancing pathways used by glioblastoma. By blocking survival paths, the aim is to render temozolomide, the current standard cytotoxic drug used in primary glioblastoma treatment, more effective. Although esthetically unpleasing to use so many drugs at once, the closely similar drugs of the original CUSP9 used together have been well-tolerated when given on a compassionate-use basis in the cases that have come to our attention so far. We expect similarly good tolerability for CUSP9*. The combined action of this suite of drugs blocks signaling at, or the activity of, AKT phosphorylation, aldehyde dehydrogenase, angiotensin converting enzyme, carbonic anhydrase -2,- 9, -12, cyclooxygenase-1 and -2, cathepsin B, Hedgehog, interleukin-6, 5-lipoxygenase, matrix metalloproteinase -2 and -9, mammalian target of rapamycin, neurokinin-1, p-gp efflux pump, thioredoxin reductase, tissue factor, 20 kDa translationally controlled tumor protein, and vascular endothelial growth factor. We believe that given the current prognosis after a glioblastoma has recurred, a trial of CUSP9* is warranted. PMID:25211298

  18. Efficacy of Artesunate + Sulphadoxine-Pyrimethamine (AS + SP and Amodiaquine + Sulphadoxine-Pyrimethamine (AQ + SP for Uncomplicated falciparum Malaria in Equatorial Guinea (Central Africa

    Directory of Open Access Journals (Sweden)

    Pilar Charle

    2009-01-01

    Full Text Available Objectives. The objectives of the study were (i to evaluate the efficacy of combination drugs, such as artesunate + sulphadoxine-pyrimethamine (AS + SP and amodiaquine + sulphadoxine-pyripethamine (AQ + SP in treatment of uncomplicated falciparum malaria (ii to differentiate recrudescence from reinfection by analysing msp-1 and msp-2 genes of Plasmodium falciparum in treatment failure cases. Methods. We carried out an in vivo study in the year 2005 in 206 children between 6 to 59 months age groups. Of the 206, 120 received AQ + SP, and 86 received AS + SP. A clinical and parasitological followup during 14 days was undertaken. Finger-prick blood sample from each patient was taken on Whatman filter paper (no. 3 on days 0, 7, 14 and also the day when the parasite and symptoms reappeared for PCR analysis. Results. Late treatment failure was observed in 3.5% (4/114 with AQ + SP, and 2.5% (2/79 with AS + SP. The success rate was 96.5% with AQ + SP and 97.5% with AS + SP. No deaths and severe reactions were recorded. Out of the 6 treatment failure cases, one was reinfection as observed by PCR analysis of msp-1 and msp-2 genes on day 14. Discussion. Both the combinations found to be efficacious and safe and could be used as a first-line treatment for uncomplicated falciparum malaria in Equatorial Guinea.

  19. Efficacy and safety of artesunate plus amodiaquine in routine use for the treatment of uncomplicated malaria in Casamance, southern Sénégal

    Directory of Open Access Journals (Sweden)

    Vaillant Michel

    2007-11-01

    Full Text Available Abstract Background There are no data on the long term use of an artemisinin combination treatment in moderate or high transmission areas of Africa. Methods and findings Artesunate plus amodiaquine (AS+AQ was used to treat slide-proven Plasmodium falciparum-infected patients of all ages in the Oussouye district, Casamance, Senegal, over a period of six years (2000 to 2005. Efficacy, by Kaplan Meier survival analysis (n = 966, and safety (adverse event rates, n = 752 were determined over 28 days. A weight-based dosing regimen was used for the loose tablets during 2000–2003 (n = 731 and a commercially available co-blister was used during 2004–2005 (n = 235. Annual crude (non PCR corrected rates remained stable over the study period [range 88.5–96.7%; overall 94.6 (95% CI 92.9–95.9]. Nine co-blister treated patients (0.9% withdrew because of drug-related adverse events; seven had gastrointestinal complaints of whom two were hospitalized for vomiting. By Day 28, the mean total bilirubin (n = 72, AST (n = 94 and ALT (n = 95 values decreased. Three patients had Day 28 AST/ALT values > 40 Conclusion AS+AQ in combination was highly efficacious and well-tolerated in this area and justifies the decision to use it as first line treatment. Long-term monitoring of safety and efficacy should continue.

  20. Artesunate ameliorates severe acute pancreatitis (SAP) in rats by inhibiting expression of pro-inflammatory cytokines and Toll-like receptor 4.

    Science.gov (United States)

    Cen, Yanyan; Liu, Chao; Li, Xiaoli; Yan, Zifei; Kuang, Mei; Su, Yujie; Pan, Xichun; Qin, Rongxin; Liu, Xin; Zheng, Jiang; Zhou, Hong

    2016-09-01

    Severe acute pancreatitis (SAP) is a severe clinical condition with significant morbidity and mortality. Multiple organs dysfunction (MOD) is the leading cause of SAP-related death. The over-release of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α is the underlying mechanism of MOD; however, there is no effective agent against the inflammation. Herein, artesunate (AS) was found to increase the survival of SAP rats significantly when injected with 3.5% sodium taurocholate into the biliopancreatic duct in a retrograde direction, improving their pancreatic pathology and decreasing serum amylase and pancreatic lipase activities along with substantially reduced pancreatic IL-1β and IL-6 release. In vitro, AS-pretreatment strongly inhibited IL-1β and IL-6 release and their mRNA expressions in the pancreatic acinar cells treated with lipopolysaccharide (LPS) but exerted little effect on TNF-α release. Additionally, AS reduced the mRNA expressions of Toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) p65 as well as their protein expressions in the pancreatic acinar cells. In conclusion, our results demonstrated that AS could significantly protect SAP rats, and this protection was related to the reduction of digestive enzyme activities and pro-inflammatory cytokine expressions via inhibition of TLR4/NF-κB signaling pathway. Therefore, AS may be considered as a potential therapeutic agent against SAP.

  1. Oral contraceptives.

    Science.gov (United States)

    Maclennan, A H

    1987-12-01

    Over 60 million women use highly efficient and safe modern combined oral contraceptives (OCs) every day. A women who takes the oral contraceptive for 5 years before the age of 30 will actually live 12 days longer, although a woman taking the pill for the 1st time for 5 years after the age of 30 will have her life span reduced on the average by 80 days. OC related morbidity and mortality mostly occur in women over 35 who smoke. Combined low dose OCs are safe for women who do not smoke, at least to 45 years of age and probably to the menopause. The prescription of OCs is also safe to the young adolescent. The pill does not interfere with maturation of the hypothalamic-pituitary ovarian axis and does not increase the incidence of amenorrhoea, oligomenorrhoea or infertility in later life. Patients with contraindications to estrogen therapy are excluded from OC use (history of thromboembolism, major heart disease, liver disease, breast cancer). Low-dose (30-35 mcg estrogen-containing monophasic or triphasic) pills are recommended. Combined oral contraceptives contain either ethinyl estradiol (1.7 to 2 times more potent) or mestranol. After absorption the progestagens, norethisterone acetate, ethynodiol diacetate and lynoestrenol are all metabolized to norethisterone. The progestagen-only pill has about a 2% failure rate and poorer cycle control than the combined pill, but it lacks estrogenic, progestagenic and androgenic side effects. This pill is suitable for the lactating mother, for smokers over 35, for hypertensive patients, and for those with a history of thrombosis. The efficacy of the progestagen-only pill is restored in 3 days of pill taking. Postcoital contraception is an alternative: treatment can be given for at least 72 hours after intercourse. The Yuzpe method calls for the patient to take 2 combined oral contraceptive tablets containing levonorgestrel and ethinyl estradiol (Eugynon or Ovral) followed by a further 2 tablets 12 hours later. This regimen

  2. 40 CFR 1039.655 - What special provisions apply to engines sold in Guam, American Samoa, or the Commonwealth of the...

    Science.gov (United States)

    2010-07-01

    ... engines sold in Guam, American Samoa, or the Commonwealth of the Northern Mariana Islands? 1039.655... Commonwealth of the Northern Mariana Islands? (a) The prohibitions in § 1068.101(a)(1) do not apply to an..., American Samoa, or the Commonwealth of the Northern Mariana Islands. (2) The engine meets the latest...

  3. 7 CFR 205.308 - Agricultural products in other than packaged form at the point of retail sale that are sold...

    Science.gov (United States)

    2010-01-01

    ...) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Labels, Labeling, and Market... sold, labeled, or represented as “100 percent organic” or “organic.” (a) Agricultural products in...

  4. 7 CFR 205.309 - Agricultural products in other than packaged form at the point of retail sale that are sold...

    Science.gov (United States)

    2010-01-01

    ...), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Labels.... (1) Such statement must not list more than three organic ingredients or food groups, and (2) In any... the point of retail sale that are sold, labeled, or represented as âmade with organic...

  5. TITLE: Postmodern detective Fiction and the Questionning of the Commitment: Edmundo Paz Soldán. TÍTULO: La narrativa policial posmoderna y el cuestionamiento del compromiso: el caso de Edmundo Paz Soldán.

    Directory of Open Access Journals (Sweden)

    Nina Pluta

    2010-10-01

    Full Text Available ABSTRACT: The classic detective literary convention had been transformed several times before the detective-fiction genre was created by the end of the 19th century. It presented the adventures of individuals that entwined criminal mysteries. It is undeniable that its prestige in the literary world has risen, especially since the middle of the 20th century, when there appeared such literary genres as the metaphysical detective story that endowed plot elements with a philosophical meaning. In Spanish America, since the turbulent times of various political and social problems of the second half of the 20th century, writers have developed many ways of depicting the social and political crime scene thanks to modifying diverse literary conventions of the detective story. A good example is the creation of the Bolivian author Edmundo Paz Soldán (1967 who merged the metaphysical detective story with critical perspective: it describes contemporary Bolivians, citizens of the global village who are still preoccupied with the “premodern” social and political issues in their country. RESUMEN: El relato detectivesco ha experimentado numerosas transformaciones desde que a finales del siglo XIX se forjara como un género literario. Las narraciones sobre individuos singularmente dotados (perspicaces, valientes que se empeñaban en resolver enigmas criminales fueron al principio consideradas como literatura popular. Es innegable que su prestigio en el mundo literario ha ido en aumento, sobre todo desde mediados del siglo XX, cuando surgieron modalidades tan sofisticadas como el relato detectivesco metafísico, con su tendencia a alegorizar los elementos de la trama e investirlos de significados filosóficos. En Hispanoamérica, desde la época de las trágicas turbulencias políticas y sociales de la segunda mitad del siglo XX, la narrativa ha sabido modificar las diversas convenciones criminales para tratar temas vinculados con la delincuencia en el

  6. Long-term effects of artesunate combined with azithromycin on Plasmodium vivax malaria%青蒿琥酯配伍阿奇霉素治疗间日疟患者远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    毛玮; 黎军; 韦海艳; 林康明; 黄亚铭

    2013-01-01

    目的 探讨青蒿琥酯配伍阿奇霉素根治间日疟原虫效果. 方法 对2例在柬泰边境感染间日疟原虫患者采取青蒿琥酯配伍阿奇霉素进行根治效果观察. 结果 对2例间日疟患者采取青蒿琥酯7d(总量800mg)配伍阿奇霉素7d(总量2 000mg)方法给-治疗后,症状改善,原虫消失.治疗后2个月复发,血检原虫均为阳性,遂给予服用青蒿琥酯7d(总量800mg)、阿奇霉素10d(总量2 750mg),原虫消失.但分别于1个月和4个月后再次复发,给予服用青蒿琥酯7d(总量800mg)、阿奇霉素14d(总量为3 750mg)后,对2位患者进行3~10个月的镜检追踪未见原虫复发,随访12~14个月患者良好. 结论 青蒿琥酯配伍阿奇霉素可根治间日疟患者,但阿奇霉素用药时间较长.%Objective To observe the therapeutic effect of artesunate combined with azithromycin on Plasmodium vivax malaria cases.Methods The radical cure effect of artesunate combined with azithromycin was observed on treating Plasmodium vivax malaria cases from the border of Cambodia and Thailand.Results After finishing the first schedule,combination of 7-day-dose of artesunate (800mg in total)and 7-day-dose of azithromycin (2000mg in total),the patients were cured and plasmodium disappeared.Yet relapse was observed on those 2 patients 2 months after treatment and plasmodium was tested positive once again.Then the second schedule was administered with the combination of 7-day-dose of artesunate (800mg in total) and 10-day-dose of azithromycin (2750mg in total).The plasmodium was cleared.Yet relapse was observed in those 2 patients at the end of the first month and the fourth month after finishing the second schedule.The third schedule was administered with the combination of 7-day-dose of artesunate (800mg in total) and 14-day-dose of azithromycin (3750mg in total).And the plasmodium was tested negative during the followup of 3 and 10 months.No relapse occurred to the patients during the followup of

  7. Oral dirofilariasis

    Directory of Open Access Journals (Sweden)

    Mahija Janardhanan

    2014-01-01

    Full Text Available Filariasis affecting animals can rarely cause infections in human beings through the accidental bite of potential vectors. The resulting infection in man, known as zoonotic filariasis occur worldwide. Human dirofilariasis, the most common zoonotic filariasis, is caused by the filarial worm belonging to the genus Dirofilaria. Dirofilarial worms, which are recognized as pathogenic in man can cause nodular lesions in the lung, subcutaneous tissue, peritoneal cavity or eyes. Oral dirofilariasis is extremely rare and only a few cases have been documented. We report an interesting case of dirofilariasis due to Dirofilaria repens involving buccal mucosa in a patient who presented with a facial swelling. The clinical features, diagnostic issues and treatment aspects are discussed. This paper stresses the importance of considering dirofilariasis as differential diagnosis for subcutaneous swelling of the face, especially in areas where it is endemic.

  8. Oral sex, oral health and orogenital infections

    Directory of Open Access Journals (Sweden)

    Saini Rajiv

    2010-01-01

    Full Text Available Oral sex is commonly practiced by sexually active male-female and same-gender couples of various ages, including adolescents. The various type of oral sex practices are fellatio, cunnilingus and analingus. Oral sex is infrequently examined in research on adolescents; oral sex can transmit oral, respiratory, and genital pathogens. Oral health has a direct impact on the transmission of infection; a cut in your mouth, bleeding gums, lip sores or broken skin increases chances of infection. Although oral sex is considered a low risk activity, it is important to use protection and safer sex precautions. There are various methods of preventing infection during oral sex such as physical barriers, health and medical issues, ethical issues and oral hygiene and dental issues. The lesions or unhealthy periodontal status of oral cavity accelerates the phenomenon of transmission of infections into the circulation. Thus consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.

  9. Oral amyloidosis

    Directory of Open Access Journals (Sweden)

    Isabella Lima Arrais Ribeiro

    Full Text Available A amiloidose é uma doença complexa rara de difícil diagnóstico que ocorre devido à deposição de substância amilóide no meio extracelular. Ao ser diagnosticado na cavidade bucal, deve-se monitorar o paciente a fim de avaliar possíveis complicações sistêmicas da doença. Diante disso, o objetivo do presente estudo é relatar um caso de amiloidose oral em uma paciente do gênero feminino de 72 anos de idade. Baseado nos sinais clínicos observados, a hipótese diagnóstica foi de fibroma traumático. Após realização de biópsia e exame histopatológico, o diagnóstico foi de amiloidose oral, o que foi confirmado com a coloração do espécime com o reagente vermelho congo. Depósitos de amilóide foram encontrados no tecido conjuntivo, na avaliação através da luz polarizada, que apresentou birrefringência. Tal achado foi preocupante, já que a amiloidose geralmente acomete diversos tecidos levando a comprometimentos sistêmicos. Por essa razão a paciente foi encaminhada a procurar atendimento médico. No entanto, houve abandono do tratamento e a mesma veio a óbito 6 meses após o diagnóstico da doença. Lesões orais aparentemente simples podem revelar doenças raras e de difícil tratamento. O diagnóstico preciso e acompanhamentos médicos são fundamentais na sobrevida do paciente.

  10. Comparing the 2000 and 2005 factors affecting the selling price of feeder cattle sold at Arkansas livestock auctions.

    Science.gov (United States)

    Troxel, T R; Barham, B L

    2007-12-01

    The objectives of the study were to determine how factors affecting the selling price of feeder calves changed from 2000 to 2005 and to examine the perception that discounts narrow or even disappear as calf supplies decrease and selling prices increase. Data from weekly Arkansas livestock auctions were collected from January 1 to December 31 in 2000 and 2005. Data included calf sex, breed type, color, muscle score, horn status, frame score, fill, condition, health, and BW. Mean selling prices for 2000 and 2005 were $92.91 +/- 15.05 and $118.32 +/- 15.13 (mean +/- SD; $/45.45 kg), respectively. Individual price observations were subtracted from the respective annual means and became the dependent variable. The selling prices for feeder calves sold in groups of 2 to 5 calves and in groups of >/= 6 calves were greater in 2005 than 2000 (P x Hereford, Angus, Angus x Charolais, and Brahman (P Brahman Cross, Charolais, Charolais x Limousin, Hereford x Limousin, Limousin, Limousin x one-fourth Brahman, Longhorn, Saler and Simmental. Yellow-white face, black-white face, black, and gray feeder calves received an increase in selling price from 2000 to 2005 (P < 0.001). Although fewer horned feeder calves were sold in 2005 (P < 0.01), they received greater discounts in 2005 than 2000 (-$2.86 +/- 0.16 and -$0.51 +/- 0.09; P < 0.001). In 2005, large-framed feeder calves did not receive the premium detected in 2000, but medium-framed feeder calves in 2005 received a greater selling price compared with 2000. Feeder calves with a muscle score of 1 received a greater premium in 2005 compared with 2000 ($2.58 +/- 0.06 and $0.02 +/- 0.09, respectively; P < 0.001). Feeder calves with a muscle score of 2 were discounted in both years, but the discount in 2005 was not as great as in 2000 (P < 0.001). Full and tanked feeder calves received greater discounts in 2005 than in 2000 (P < 0.001). Discounts for fleshy and fat feeder calves were greater in 2005 than in 2000. Most factors

  11. Oral Cancer Exam

    Medline Plus

    Full Text Available ... for signs of oral cancer. For Patients and the Public Oral Cancer Pamphlet that describes the risk factors, signs and symptoms of oral cancer, and the importance of detecting the disease in its early ...

  12. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Programs Careers in Dental Research See All Continuing Education Practical Oral Care for People With Developmental Disabilities – ... detection and treatment of oral cancers. Note: For materials specific to African American men, please see: Oral ...

  13. Oral Lichen Planus

    Science.gov (United States)

    Oral lichen planus Overview By Mayo Clinic Staff Oral lichen planus (LIE-kun PLAY-nus) is an ongoing (chronic) ... that affects mucous membranes inside your mouth. Oral lichen planus may appear as white, lacy patches; red, ...

  14. Oral Health Glossary

    Science.gov (United States)

    ... About | Contact InfoBites Quick Reference Learn more Children's Oral Health Mouth Breathing Can Cause Major Health Problems Over ... news feeds delivered directly to your desktop! more... Oral Health Glossary Article Chapters Oral Health Glossary print full ...

  15. Oral Cancer Exam

    Medline Plus

    Full Text Available ... for signs of oral cancer. For Patients and the Public Oral Cancer Pamphlet that describes the risk factors, signs and symptoms of oral cancer, and the importance of detecting the disease in its early ...

  16. Studies on saturated and trans fatty acids composition of few commercial brands of biscuits sold in Indian market.

    Science.gov (United States)

    Amrutha Kala, A L

    2014-11-01

    Saturated fat and trans fat consumption is linked to cardiovascular disease. Considering the health implications of saturated and trans fats investigation was undertaken with the objective to study the fat compositions in biscuits sold in Indian market. These commercial biscuits were analysed for saturated and trans fatty acids using capillary GC. The results of analysis of 46 biscuit samples showed that the total fat content ranged from 9.5 to 25.0 g/100 g of biscuits. The fatty acid profile showed that, saturated fat content in biscuits ranged from 5.1 to 18.7 g/100 g. The overall range of total trans fat content was found to be 0.1 to 3.2 g/100 g biscuit and cis monounsaturated fatty acid content varied from 0.9 to 8.6 g/100 g of biscuits. The low-level trans fatty acid was mainly by dienes and trienes where as high-level trans was from monoenes of C18. Polyunsaturated fatty acids in biscuits ranged from 0.2 to 3.5 g/100 g. Biscuits of same brand on repeat analysis over a period of one year showed little variation in fat, saturated and trans fat content.

  17. Baseline levels of melamine in food items sold in Canada. II. Egg, soy, vegetable, fish and shrimp products.

    Science.gov (United States)

    Tittlemier, Sheryl A; Lau, Benjamin P-Y; Ménard, Cathie; Corrigan, Catherine; Sparling, Melissa; Gaertner, Dean; Cao, Xu-Liang; Dabeka, Bob; Hilts, Carla

    2010-01-01

    A variety of egg-containing, soy-based, fish, shrimp and vegetable products sold in Canada were analysed for melamine (MEL) using a sensitive solid-phase extraction LC-MS/MS analytical method. MEL was detected above the method quantification limit of 0.004 mg/kg in 98 of the 378 samples analysed. Concentrations in the various food product groups ranged 0.00507-0.247 mg/kg (egg-containing items), 0.00408-0.0479 mg/kg (soy-based meat substitutes), 0.00409-1.10 mg/kg (fish and shrimp products), and 0.00464-0.688 mg/kg (vegetable products). MEL was detected less frequently in egg- and soy-containing products. The presence of MEL in most of the Canadian Total Diet Study shrimp composites collected after 2001 suggested the residues in shrimp were caused by a relatively recent exposure to MEL. All concentrations of MEL reported were lower than the 2.5 mg/kg interim standard established for MEL in items containing milk and milk-derived ingredients and the respective maximum residue limits for cyromazine and its metabolite, melamine, in vegetables set by the Canadian Government (2009; http://www.hc-sc.gc.ca/fn-an/securit/chem-chim/melamine/qa-melamine-qr-eng.php#8 ). The consumption of foods containing these low levels of MEL does not constitute a health risk for consumers.

  18. Seasonal variability of thermophilic Campylobacter spp. in raw milk sold by automatic vending machines in Lombardy Region

    Directory of Open Access Journals (Sweden)

    Barbara Bertasi

    2016-06-01

    Full Text Available In temperate climates, a seasonal trend was observed in the incidence of human campylobacteriosis cases, with peaks reported in spring and autumn in some countries, or in summer in others; a similar trend was observed in Campylobacter spp. dairy cattle faecal shedding, suggesting that cattle may play a role in the seasonal peak of human infection. The objectives of this study were to assess if a seasonal trend in thermophilic Campylobacter spp. contamination of raw milk exists and to evaluate a possible relation between this and the increase of human campylobacteriosis incidence in summer months. The results showed a mean prevalence of 1.6% of milk samples positive for thermophilic Campylobacter spp. with a wide range (0.0-3.1% in different months during the three years considered. The statistical analysis showed a significant difference (PCampylobacter spp. between warmer and cooler months (2.3 vs 0.6%. The evidence of a seasonal trend in thermophilic Campylobacter spp. contamination of raw milk sold for direct consumption, with an increase of the prevalence in warmer months, may represent one of the possible links between seasonal trend in cattle faecal shedding and seasonal trend in human campylobacteriosis.

  19. Public health significance of zoonotic bacterial pathogens from bushmeat sold in urban markets of Gabon, Central Africa.

    Science.gov (United States)

    Bachand, Nicholas; Ravel, André; Onanga, Richard; Arsenault, Julie; Gonzalez, Jean-Paul

    2012-07-01

    Wild animal meat represents an important source of protein for many people in central Africa. Also known as bushmeat, this meat commodity is derived from wild animals hunted under uncontrolled conditions, transported to distant markets under rudimentary or no hygienic methods, and often eviscerated >24 hr after death. Considering the plausible role of wildlife as a reservoir for bacterial zoonotic pathogens, bushmeat may be an important public health risk in Central Africa. This cross-sectional survey served to evaluate the presence of Campylobacter, Salmonella, and Shigella in the muscle tissue of 128 wild animal carcasses from several hunted wildlife species (guenons [Cercopithecus spp.], collared mangabeys [Cercocebus torquatus], gray-cheeked mangabeys [Lophocebus albigena], African crested porcupines [Atherurus africanus], duikers [Cephalophus spp.], and red river hogs [Potamocherus porcus]) sold in two markets of Port-Gentil, Gabon, in July and August 2010. Salmonella was detected from one carcass; no Campylobacter or Shigella was detected. If Campylobacter and Shigella were present, the maximum expected prevalence was estimated at 6% and 1%, respectively. In light of such very low apparent muscle contamination levels, bushmeat likely does not represent a health risk per se with respect to Campylobacter, Salmonella, or Shigella. However, because carcass evisceration and skinning can take place within households prior to consumption, consumers should follow strict hygiene and food safety practices to avoid potential health hazards associated with the handling, preparation, or consumption of bushmeat.

  20. The chemical composition of smokeless tobacco: a survey of products sold in the United States in 2006 and 2007.

    Science.gov (United States)

    Borgerding, M F; Bodnar, J A; Curtin, G M; Swauger, J E

    2012-12-01

    Selected toxicant concentrations and other chemical measures have been determined for 43 U.S. smokeless tobacco products sold in 2006 and 2007. Products evaluated included moist snuff, dry snuff, loose leaf, plug, dissolvable and snus tobacco brands. Reference products available for scientific research purposes and eleven Swedish products were also evaluated and compared to the commercial products studied. Chemical endpoints determined included benzo[a]pyrene (B[a]P), N'-nitrosonornicotine (NNN), N'-nitrosoanatabine (NAT), N'-nitrosoanabasine (NAB), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-Nitrosodimethylamine (NDMA), nitrite, cadmium, lead, arsenic, nickel, chromium, chloride, water, pH and nicotine. Different toxicant profiles were observed for the products studied, with snus tobacco brands generally containing relatively low concentrations of B[a]P and tobacco specific nitrosamines (TSNAs) compared to other moist snuffs. Smokeless tobacco reference product toxicant profiles were similar to corresponding commercial products, with the exception of the TSNA content of the dry snuff reference material. TSNA concentrations observed for all commercial products were lower than historically reported values, likely reflecting changes in product shelf life, tobacco curing practices and, possibly, product blend formulations during the last 20-30 years. The survey results summarized provide a temporal point of comparison with future data anticipated from FDA "harmful and potentially harmful constituents in tobacco products" reporting.

  1. Microbial community assessment of mealworm larvae (Tenebrio molitor) and grasshoppers (Locusta migratoria migratorioides) sold for human consumption.

    Science.gov (United States)

    Stoops, J; Crauwels, S; Waud, M; Claes, J; Lievens, B; Van Campenhout, L

    2016-02-01

    In Western countries, the popularity of edible insects as an alternative animal protein source is increasing. Nevertheless, there is a lack of profound insight into the microbial safety and shelf life of living insects sold for human consumption. The purpose of this study was to characterise the microflora of fresh edible mealworm larvae and grasshoppers in a quantitative and qualitative way. Therefore, culture-dependent analyses (the total viable aerobic count, Enterobacteriaceae, lactic acid bacteria, yeasts and moulds, and bacterial endospores) and next-generation sequencing (454amplicon pyrosequencing) were performed. High microbial counts were obtained for both insect species. Different insect batches resulted in quite similar microbial numbers, except for bacterial endospores. However, the bacterial community composition differed between both insect species. The most abundant operational taxonomic unit in mealworm larvae was Propionibacterium. Also members of the genera Haemophilus, Staphylococcus and Clostridium were found. Grasshoppers were mainly dominated by Weissella, Lactococcus and Yersinia/Rahnella. Overall, a variety of potential spoilage bacteria and food pathogens were characterised. The results of this study suggest that a processing step with a microbiocidal effect is required to avoid or minimize risks involved with the consumption of edible insects.

  2. In vitro antioxidant properties, HIV-1 reverse transcriptase and acetylcholinesterase inhibitory effects of traditional herbal preparations sold in South Africa.

    Science.gov (United States)

    Ndhlala, Ashwell R; Finnie, Jeffrey F; Van Staden, Johannes

    2010-10-08

    The antioxidant potentials for fourteen multipurpose traditional herbal preparations sold in South Africa were determined using the DPPH radical scavenging, ferric reducing power and β-carotene-linoleic acid model system, the anti-HIV-1 reverse transcriptase (RT) enzyme inhibitory effects using an ELISA kit and acetylcholinesterase (AChE) enzyme inhibition using the microtitre plate assay. Nine of the herbal mixtures (Umzimba omubi, Umuthi wekukhwehlela ne zilonda, Mvusa ukunzi, Umpatisa inkosi, Imbiza ephuzwato, Vusa umzimba, Supreme one hundred, Sejeso herbal mixture Ingwe® and Ingwe® special muti) exhibited higher antioxidant potentials, while only four (Imbiza ephuzwato, Ingwe® muthi mixture, Sejeso herbal mixture Ingwe® and African potato extract™ showed potent activity against the RT enzyme. Nine mixtures (Imbiza ephuzwato, Umpatisa inkosi, African potato extract™, Sejeso herbal mixture Ingwe®, Vusa umzimba; Ingwe® muthi mixture, Ibhubezi™, Lion izifozonke Ingwe® and Ingwe® special muti) showed AChE enzyme inhibitory activity greater than 50%. The observed activity exhibited by some of the herbal mixtures gives some credence to the manufacturers' claims and goes part of the way towards validating their use against certain conditions such as oxidative stress, HIV/AIDS proliferation and some mental conditions. It is however, desirable to carry out further studies to determine the effects of mixing plant species/parts in one mixture on the antioxidant potency as well as isolating active constituents from the herbal mixtures.

  3. Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria

    Science.gov (United States)

    Lingscheid, Tilman; Steiner, Florian; Stegemann, Miriam S.; Bélard, Sabine; Menner, Nikolai; Pongratz, Peter; Kim, Johanna; von Bernuth, Horst; Mayer, Beate; Damm, Georg; Seehofer, Daniel; Salama, Abdulgabar; Suttorp, Norbert; Zoller, Thomas

    2016-01-01

    Episodes of delayed hemolysis 2–6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3–2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR −0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia. PMID:27434054

  4. Pharmacokinetic profiles of artesunate following multiple intravenous doses of 2, 4, and 8 mg/kg in healthy volunteers: Phase 1b study

    Directory of Open Access Journals (Sweden)

    Miller Robert

    2012-08-01

    Full Text Available Abstract Background Severe malaria results in over a million deaths every year, most of them in children aged less than five years and living in sub-Saharan Africa. Injectable artesunate (AS was recommended as initial treatment for severe malaria by WHO in 2006. The Walter Reed Army Institute of Research (WRAIR has been developing a novel good manufacturing practice (GMP injection of AS, which was approved by the US FDA for investigational drug use and distribution by the CDC. Methods Tolerability and pharmacokinetics of current GMP intravenous AS, as an anti-malarial agent, were evaluated after ascending multiple doses of 2, 4, and 8 mg/kg daily for three days with 2-minute infusion in 24 healthy subjects (divided into three groups in the Phase 1 clinical trial study. Results Results showed that there were no dose-dependent increases in any adverse events. Drug concentrations showed no accumulation and no decline of the drug during the three days of treatment. After intravenous injection, parent drug rapidly declined and was converted to dihydroartemisinin (DHA with overall mean elimination half-lives ranging 0.15-0.23 hr for AS and 1.23-1.63 hr for DHA, but the peak concentration (Cmax of AS was much higher than that of DHA with a range of 3.08-3.78-folds. In addition, the AUC and Cmax values of AS and DHA were increased proportionally to the AS climbing multiple doses. Discussion The safety of injectable AS, even at the highest dose of 8 mg/kg increases the probability of therapeutic success of the drug even in patients with large variability of parasitaemia.

  5. Efficacy and tolerability of artesunate plus sulfadoxine-pyrimethamine and sulfadoxine-pyrimethamine alone for the treatment of uncomplicated Plasmodium falciparum malaria in Peru.

    Science.gov (United States)

    Marquiño, Wilmer; Ylquimiche, Laura; Hermenegildo, Ygor; Palacios, Ana Maria; Falconí, Eduardo; Cabezas, César; Arróspide, Nancy; Gutierrez, Sonia; Ruebush, Trenton K

    2005-05-01

    To assist the Peruvian Ministry of Health in modifying the malaria treatment policy for their north Pacific coastal region, we conducted an in vivo efficacy trial of sulfadoxine-pyrimethamine (SP) and SP plus artesunate (SP-AS) for the treatment for uncomplicated Plasmodium falciparum infections. A total of 197 patients were randomized to therapy with either SP (25 mg/kg of the sulfadoxine component in a single dose on day 0) or a combination of SP plus AS (4 mg/kg on days 0, 1, and 2) and were followed for 28 days for symptoms and recurrence of parasitemia. No statistically significant differences between the two groups were observed on enrollment with respect to age, sex, history of malaria, or geometric mean parasite density. A total of 185 subjects completed the 28-day follow-up. Of the 91 subjects treated with SP alone, two had recurrences of parasitemia on day 7 and one on day 21. Of the 94 subjects treated with SP-AS, one had a recurrence of parasitemia on day 21. Fever and asexual parasite density decreased significantly more rapidly and the proportion of patients with gametocytemia on days 3-28 was significantly lower in subjects treated with combination therapy than in those who received SP alone. No severe adverse drug reactions were observed; however, self-limited rash and pruritus were significantly more common and an exacerbation of nausea, vomiting, and abdominal pain were observed significantly more frequently among patients who had received SP-AS. These results have contributed to a National Malaria Control Program decision to change to SP-AS combination therapy as the first-line treatment for uncomplicated P. falciparum malaria in northern coastal Peru in November 2001, making Peru the first country in the Americas to recommend this combination therapy.

  6. Adherence to Artesunate-Amodiaquine Therapy for Uncomplicated Malaria in Rural Ghana: A Randomised Trial of Supervised versus Unsupervised Drug Administration

    Directory of Open Access Journals (Sweden)

    Kwaku Poku Asante

    2009-01-01

    Full Text Available Introduction. To enhance effective treatment, african nations including Ghana changed its malaria treatment policy from monotherapy to combination treatment with artesunate-amodiaquine (AS+AQ. The major challenge to its use in loose form is adherence. Objective. The objectives of this study were to investigate adherence and treatment outcome among patients treated with AS+AQ combination therapy for acute uncomplicated malaria. Methodology. The study was conducted in two rural districts located in the middle belt of Ghana using quantitative methods. Patients diagnosed with acute uncomplicated malaria as per the Ghana Ministry of Health malaria case definitions were randomly allocated to one of two groups. All patients in both groups were educated about the dose regimen of AS+AQ therapy and the need for adherence. Treatment with AS+AQ was supervised in one group while the other group was not supervised. Adherence was assessed by direct observation of the blister package of AS+AQ left on day 2. Results. 401 participants were randomized into the supervised (211 and unsupervised (190 groups. Compliance in both supervised (95.7% and unsupervised (92.6% groups were similar (P=.18. The commonest side-effects reported on day 2 among both groups were headaches, and body weakness. Parasite clearance by day 28 was >95% in both groups. Discussion/Conclusions. Administration of AS-AQ in both groups resulted in high levels of adherence to treatment regimen among adolescent and adult population in central Ghana. It appears that high level of adherence to AS-AQ is achievable through a rigorous education programme during routine clinic visits.

  7. Recognition, perceptions and treatment practices for severe malaria in rural Tanzania: implications for accessing rectal artesunate as a pre-referral.

    Directory of Open Access Journals (Sweden)

    Marian Warsame

    Full Text Available OBJECTIVES: Preparatory to a community trial investigating how best to deliver rectal artesunate as pre-referral treatment for severe malaria; local understanding, perceptions of signs/symptoms of severe malaria and treatment-seeking patterns for and barriers to seeking biomedical treatment were investigated. METHODOLOGY/PRINCIPAL FINDINGS: 19 key informant interviews, 12 in-depth interviews and 14 focus group discussions targeting care-givers, opinion leaders, and formal and informal health care providers were conducted. Monthly fever episodes and danger signs or symptoms associated with severe malaria among under-fives were recorded. Respondents recognized convulsions, altered consciousness and coma, and were aware of their risks if not treated. But, these symptoms were perceived to be caused by supernatural forces, and traditional healers were identified as primary care providers. With some delay, mothers eventually visited a health facility when convulsions were part of the illness, despite pressures against this. Although vomiting and failure to eat/suck/drink were associated with malaria, they were not considered as indicators of danger signs unless combined with another more severe symptom. Study communities were familiar with rectal application of medicines. CONCLUSIONS/SIGNIFICANCE: Communities' recognition and awareness of major symptoms of severe malaria could encourage action, but perceptions of their causes and poor discrimination of other danger signs - vomiting and failure to feed - might impede early treatment. An effective health education targeting parents/guardians, decision-makers/advisors, and formal and informal care providers might be a prerequisite for successful introduction of rectal artemisinins as an emergency treatment. Role of traditional healers in delivering such medication to the community should be explored.

  8. A randomized trial on effectiveness of artemether-lumefantrine versus artesunate plus amodiaquine for unsupervised treatment of uncomplicated Plasmodium falciparum malaria in Ghanaian children

    Directory of Open Access Journals (Sweden)

    Hogan Benedikt

    2008-12-01

    Full Text Available Abstract Background Numerous trials have demonstrated high efficacy and safety of artemisinin-based combination therapy (ACT under supervised treatment. In contrast, effectiveness studies comparing different types of ACT applied unsupervised are scarce. The aim of this study was to compare effectiveness, tolerability and acceptance of artesunate plus amodiaquine (ASAQ against that of artemether-lumefantrine (AL in Ghanaian children with uncomplicated Plasmodium falciparum malaria. Methods A randomized open-label trial was conducted at two district hospitals in the Ashanti region, Ghana, an area of intense malaria transmission. A total of 246 children under five years of age were randomly assigned to either ASAQ (Arsucam® or AL (Coartem®. Study participants received their first weight-adjusted dose under supervision. After the parent/guardian was advised of times and mode of administration the respective three-day treatment course was completed unobserved at home. Follow-up visits were performed on days 3, 7, 14 and 28 to evaluate clinical and parasitological outcomes, adverse events, and haematological recovery. Length polymorphisms of variable regions of msp1 and msp2 were determined to differentiate recrudescences from reinfections. Acceptance levels of both treatment regimens were assessed by means of standardized interviews. Results Adequate clinical and parasitological responses after AL and ASAQ treatment were similar (88.3% and 91.7%, respectively. Interestingly, more late clinical failures until day 28 occurred in AL-treated children than in those who received ASAQ (17.5% and 7.3%, respectively; Hazard Ratio 2.41, 95% CI 1.00–5.79, p Haematological recovery and drug tolerability were not found to be significantly different in both study arms. The acceptance of treatment with ASAQ was higher than that with AL (rank-scores 10.6 and 10.3, respectively; p Conclusion Unobserved AL and ASAQ treatment showed high adequate clinical and

  9. Efficacy and safety of fixed-dose artesunate-amodiaquine vs. artemether-lumefantrine for repeated treatment of uncomplicated malaria in Ugandan children.

    Directory of Open Access Journals (Sweden)

    Adoke Yeka

    Full Text Available The safety and efficacy of the two most widely used fixed-dose artemisinin-based combination therapies (ACT, artesunate-amodiaquine (ASAQ and artemether-lumefantrine (AL are well established for single episodes of uncomplicated Plasmodium falciparum malaria, but the effects of repeated, long-term use are not well documented. We conducted a 2-year randomized, open-label, longitudinal, phase IV clinical trial comparing the efficacy and safety of fixed-dose ASAQ and AL for repeated treatment of uncomplicated malaria in children under 5 years at Nagongera Health Centre, Uganda. Participants were randomized to ASAQ or AL and all subsequent malaria episodes were treated with the same regimen. 413 children were enrolled and experienced a total of 6027 malaria episodes (mean 15; range, 1-26. For the first malaria episode, the PCR-corrected-cure rate for ASAQ (97.5% was non-inferior to that for AL (97.0%; 95% CI [-0.028; 0.037]. PCR-corrected cure rates for subsequent malaria episodes that had over 100 cases (episodes 2-18, ranged from 88.1% to 98.9% per episode, with no clear difference between the treatment arms. Parasites were completely cleared by day 3 for all malaria episodes and gametocyte carriage was less than 1% by day 21. Fever clearance was faster in the ASAQ group for the first episode. Treatment compliance for subsequent episodes (only first dose administration observed was close to 100%. Adverse events though common were similar between treatment arms and mostly related to the disease. Serious adverse events were uncommon, comparable between treatment arms and resolved spontaneously. Anemia and neutropenia occurred in <0.5% of cases per episode, abnormal liver function tests occurred in 0.3% to 1.4% of cases. Both regimens were safe and effective for repeated treatment of malaria.Current Controlled Trials NCT00699920.

  10. Dihydroartemisinin-piperaquine versus artesunate-amodiaquine for treatment of malaria infection in pregnancy in Ghana: an open-label, randomised, non-inferiority trial.

    Science.gov (United States)

    Osarfo, Joseph; Tagbor, Harry; Cairns, Matthew; Alifrangis, Michael; Magnussen, Pascal

    2017-08-01

    To determine whether dihydroartemisinin-piperaquine (DHA-PPQ) is non-inferior to artesunate-amodiaquine (ASAQ) for treating uncomplicated malaria infection in pregnancy. A total of 417 second/ third trimester pregnant women with confirmed asymptomatic Plasmodium falciparum parasitaemia were randomised to receive DHA-PPQ or ASAQ over 3 days. Women were followed up on days 1, 2, 3, 7, 14, 28 and 42 after treatment start and at delivery for parasitological, haematological, birth outcomes and at 6-week post-partum to ascertain the health status of the babies. Parasitological efficacy (PE) by days 28 and 42 were co-primary outcomes. Analysis was per-protocol (PP) and modified intention-to-treat (ITT). Non-inferiority was declared if the two-sided 95% confidence interval for PE at the endpoints excluded 5% lower efficacy for DHA-PPQ. Secondary outcomes were assessed for superiority. In PP analysis, PE was 91.6% for DHA-PPQ and 89.3% for ASAQ by day 28 and 89.0% and 86.5%, respectively, by day 42. DHA-PPQ was non-inferior to ASAQ with respect to uncorrected PE [adjusted difference by day 28 (DHA-PPQ-ASAQ); 3.5% (95%CI: -1.5, 8.5); and day 42: 3.9% (95%CI: -2.7, 10.4)]. ITT analysis gave similar results. PCR to distinguish recrudescence and reinfection was unsuccessful. DHA-PPQ recipients had fewer adverse events of vomiting, dizziness, and general weakness compared to ASAQ. Both drugs were well-tolerated, and there was no excess of adverse birth outcomes. DHA-PPQ was non-inferior to ASAQ for treatment of malaria infection during pregnancy. No safety concerns were identified. Our findings contribute to growing evidence that DHA-PPQ is useful for control of malaria in pregnancy. © 2017 John Wiley & Sons Ltd.

  11. Compliance, safety, and effectiveness of fixed-dose artesunate-amodiaquine for presumptive treatment of non-severe malaria in the context of home management of malaria in Madagascar.

    Science.gov (United States)

    Ratsimbasoa, Arsène; Ravony, Harintsoa; Vonimpaisomihanta, Jeanne-Aimée; Raherinjafy, Rogelin; Jahevitra, Martial; Rapelanoro, Rabenja; Rakotomanga, Jean De Dieu Marie; Malvy, Denis; Millet, Pascal; Ménard, Didier

    2012-02-01

    Home management of malaria is recommended for prompt, effective antimalarial treatment in children less than five years of age. Compliance, safety, and effectiveness of the new fixed-dose artesunate-amodiaquine regimen used to treat suspected malaria were assessed in febrile children enrolled in a 24-month cohort study in two settings in Madagascar. Children with fever were asked to visit community health workers. Presumptive antimalarial treatment was given and further visits were scheduled for follow-up. The primary endpoint was the risk of clinical/parasitologic treatment failure. Secondary outcomes included fever/parasite clearance, change in hemoglobin levels, and frequency of adverse events. The global clinical cure rate was 98.4% by day 28 and 97.9% by day 42. Reported compliance was 83.4%. No severe adverse effects were observed. This study provides comprehensive data concerning the clinical cure rate obtained with artesunate-amodiaquine and evidence supporting the scaling up of home management of malaria.

  12. Effect of artesunate on acute rejection after small intestine transplantation in rats%青蒿琥酯对大鼠小肠移植急性排斥反应的作用

    Institute of Scientific and Technical Information of China (English)

    于小迪; 王为忠; 焦婕英; 郑建勇; 赵正维

    2014-01-01

    BACKGROUND:As the potent, specific immunosuppressants emerge, the survival rate after intestinal transplantation is improved to some extent. However, the adverse effects of immunosuppressants and expensive treatment costs are not tolerable for many patients. Therefore, it is clinical y meaningful to choose traditional Chinese medicine which presents immunosuppressive effects. Artesunate has immune suppression effect, reduces acute rejection fol owing smal intestine transplantation, and improves the success rate of smal intestine transplantation. OBJECTIVE:To observe the effect and action mechanism of artesunate in acute rejection after smal intestine transplantation in rats. METHODS:Al ogeneic smal intestine transplantation models were established in the closed group of Sprague-Dawley rats and Wistar rats, and then were randomly divided into three groups, syngenic transplantation group (SD→SD), al ogeneic transplantation group (Wistar→SD), and artesunate treatment group (Wistar→SD+artesunate 60 mg/kg per day, intraperitoneal injection). RESULTS AND CONCLUSION:Rats in syngenic transplantation group survived for more than 10 days and they were al kil ed on day 10. The average survival of rats in al ogeneic transplantation group and artesunate treatment group was respectively (6.73±0.58) days and (8.50±0.74) days, with significant differences between the two groups (P0.05), serum interferon-gamma expression level in treatment group was higher than syngenic transplantation group (P  目的:观察青蒿琥酯在大鼠小肠移植急性排斥反应中的作用及其机制。  方法:选用封闭群SD大鼠和Wistar大鼠建立同种异基因小肠移植模型,随机分为3组:①同基因移植组(SD→SD)。②异基因移植组(Wistar→SD)。③异基因移植+青蒿琥酯治疗组(Wistar→SD+青蒿琥酯60 mg/(kg•d),腹腔注射)。  结果与结论:同基因移植组大鼠存活均超过10 d,并于第10天全部处死。异基

  13. Apoptosis and Inhibitory Effects of Artesunate on Different Cell Strains of Acute Leukemia%青蒿琥酯对不同急性白血病细胞株凋亡抑制的实验研究

    Institute of Scientific and Technical Information of China (English)

    陈均法; 沈一平; 郑智茵; 陈小红; 沈建平; 刘永林; 虞荣喜; 周郁鸿

    2011-01-01

    [目的]观察青蒿琥酯对不同急性白血病细胞株的增殖抑制作用及凋亡机制探讨.[方法]应用不同浓度青蒿琥酯作用U937、HL60、Jurkat细胞株,MTT法检测抑制率;细胞形态学、DNA琼脂糖凝胶电泳,流式细胞术检测细胞凋亡;Western-blot法检测细胞凋亡过程中Bcl-2、Bax、Caspase 8和ICAD蛋白表达的变化.[结果]青蒿琥酯能够明显抑制U937、HL60、Jurkat细胞增殖;8μg/ml以上浓度青蒿琥酯作用三种细胞24h、48h、72h抑制率均为Jurkat>HL60>U937(均P<0.01);其增殖抑制作用与诱导细胞凋亡有关;随药物浓度的增高Bc1-2和ICAD蛋白表达量下降,而Bax蛋白表达上调,Caspase8蛋白出现明显的剪切激活带.[结论]青蒿琥酯既能通过线粒体途径又能通过外源性途径诱导急性白血病细胞凋亡,对Jurkat的抑制最强.%[Objective]To investigate the proliferation and inhibitory action of artesunate on different cell strains of acute leukemia as well as its apoptosis mechanism.[Methods]Cell strains of U937, HL60 and Jurkat were treated with different doses of artesunate.Inhibition ratio was detected with MTT method, and apoptosis was detected with cell morphology, DNA agarose gel electrophoresis, and flow cytometry.The changes of the protein expression of Bcl-2, Bax, Caspase 8 and ICAD were detected with Western-blot during apoptosis progress.[Results]Artesunate significantly inhibited cell multiplication of U937, HL60 and Jurkat.The three kinds of cells treated with artesunate with the doses above 8μg/ml had the inhibition ratio as followed: Jurkat>HL60>U937 on 24h, 48h and 72h.Proliferation and inhibitory action had a relationship with inducing apoptosis.With the increase of drug concentration, protein expression of Bc1-2 and ICAD were decreased, while protein expression of Bax was increased, and Caspase8 showed significant shearing activation zone.[Conclusion]Artesunate could induce apoptosis of acute leucemia;acute leukemia

  14. Assessment of radioactivity level in granite stones sold to ornamental and building purposes in Brazilian Amazon region (Belem, PA, Brazil): a cross sectional study

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Y.M.; Santos, R.J.C.; Teixeira, C.E.C., E-mail: cecteixeira@pq.cnpq.br [Universidade da Amazonia (UNAMA), Belem, PA (Brazil). Centro de Ciencias Biologicas e da Saude. Lab. de Radiologia

    2015-07-01

    The aim of this work was evaluate the level of radioactivity in granite sold in the region of Belem (Para, Brazil) using a Geiger-Mueller detector. The results showed that only 5 from 57 samples of 35 types of granite evaluated had count rates above that measured in the background. However, the counting statistics suggests that the measured radiation values in these 5 samples are not due random fluctuations inherent in such measures. (author)

  15. A comparative survey of the prevalence of human parasites found in fresh vegetables sold in supermarkets and open-aired markets in Accra, Ghana

    OpenAIRE

    Duedu, Kwabena O; Yarnie, Elizabeth A; Tetteh-Quarcoo, Patience B; Simon K Attah; Donkor, Eric S; Ayeh-Kumi, Patrick F.

    2014-01-01

    Background Consuming raw vegetables offers essential nutrients that one may not get when such vegetables are usually cooked. However, eating them raw may pose a great risk for transmissions of pathogens. Such risks may be influenced by the sources of the vegetables and washing techniques used. The aim of the study was to compare the prevalence and diversity of parasitic pathogens associated with vegetables sold at the two types of markets in Ghana and compare effectiveness of various washing ...

  16. A botanical, phytochemical and ethnomedicinal review of the genus Mitragyna korth: Implications for products sold as kratom.

    Science.gov (United States)

    Brown, Paula N; Lund, Jensen A; Murch, Susan J

    2017-04-18

    The genus Mitragyna (Rubiacaeae) has been traditionally used in parts of Africa, Asia and Oceania. In recent years, there has been increased interest in species of Mitragyna with the introduction of products to western markets and regulatory uncertainty. This paper reviewed the traditional ethnomedicinal uses of leaves for species belonging to the genus Mitragyna with reference to the botany and known chemistry in order to highlight areas of interest for products currently being sold as kratom. A literature search was conducted using Web of Science, Google Scholar, the Royal Museum for Central Africa, Internet Archive, Hathi Trust, and Biodiversity Heritage Library search engines in the spring of 2015, fall of 2016 and winter of 2017 to document uses of bark, leaf and root material. Leaves of M. speciosa (kratom) had the most common documented ethnomedicinal uses as an opium substitute or remedy for addiction. Other species of Mitragyna were reportedly used for treating pain, however the mode of preparation was most often cited as topical application. Other uses of Mitragyna included treatment of fever, skin infections, and as a mild anxiolytic. Mitragyna species have been used medicinally in various parts of the world and that there is significant traditional evidence of use. Modern products that include formulations as topical application of liniments, balms or tinctures may provide effective alternatives for treatment of certain types of pains. Future research is required to establish safety and toxicology limits, medicinal chemistry parameters and the potential for different physiological responses among varying genetic populations to support regulatory requirements for Mitragyna spp. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. Presence of lead in paint of toys sold in stores of the formal market of Bogotá, Colombia.

    Science.gov (United States)

    Mateus-García, A; Ramos-Bonilla, J P

    2014-01-01

    Lead (Pb) is a non-essential metal. Exposure to lead has been associated with adverse health effects in both children and adults. Lead content in paint used in toys or children's products has been identified as both a potential and preventable source of childhood lead exposure. Twenty-four stores located in Bogotá (Colombia) were selected by cluster sampling to participate in the study. A random sample of 96 toys was purchased at these stores. Since one toy can have different paint colors, a total of 116 paint samples from 96 toys were analyzed for lead content. Paint samples were prepared by microwave digestion and lead was quantified using ICP-OES. For quality control purposes of the analytical method, spike samples and a certified reference material (NIST SRM 2582) were used. The lead content in paint ranged from below the method detection limit (5ppm) to 47,600ppm, with an average Pb concentration of 1024ppm and a median concentration of 5ppm. Eight (8) paint samples removed from five toys had lead concentrations exceeding the US regulatory limit for total lead content (90ppm). Brown paint and toys manufactured in Colombia were significantly associated with high concentrations of lead in paint. Furthermore, a statistically significant interaction between these two variables was also found. The results suggest that there is a potential risk of lead exposure from paint of toys sold in the formal market of Bogotá. Therefore, the implementation of a national surveillance program of lead content in children products is urgently needed. The risk of children's lead exposure identified in this study, which is completely preventable, could be present also in other developing countries.

  18. Trace elements in rock phosphates and P containing mineral and organo-mineral fertilizers sold in Germany.

    Science.gov (United States)

    Kratz, Sylvia; Schick, Judith; Schnug, Ewald

    2016-01-15

    68 rock phosphates and 162 P containing (organo-)mineral fertilizers sold in Germany were evaluated with regard to trace element contents. While Al, As, B, Be, Cd, Cr, Mo, Ni, Pb, Sb, Se, Tl, U, and Zn were higher in sedimentary than in igneous rock phosphates, the opposite was true for Co, Cu, Sn, Mn, Ti, Fe, and Sr. Comparing element concentrations to the currently valid legal limit values defined by the German Fertilizer Ordinance, it was found that some PK and many straight P fertilizers (superphosphate, triple superphosphate, partly acidulated rock phosphates) exceeded the limit of 50 mg Cd/kg P2O5. Mean values for As, Ni, Pb, and Tl remained below legal limits in almost all cases. While no legal limit has been defined for U in Germany yet, the limit of 50 mg U/kg P2O5 for P containing fertilizers proposed by the German Commission for the Protection of Soils was clearly exceeded by mean values for all fertilizer types analyzed. A large share of the samples evaluated in this work contained essential trace elements at high concentrations, with many of them not being declared as such. Furthermore, trace elements supplied with these fertilizers at a fertilization rate leveling P uptake would exceed trace element uptake by crops. This may become most relevant for B and Fe, since many crops are sensitive to an oversupply of B, and Fe loads exceeding plant uptake may immobilize P supplies for the crops by forming Fe phosphate salts. The sample set included two products made from thermochemically treated sewage sludge ash. The products displayed very high concentrations of Fe and Mn and exceeded the legal limit for Ni, emphasizing the necessity to continue research on heavy metal removal from recycled raw materials and the development of environmentally friendly and agriculturally efficient fertilizer products.

  19. First report of Toxoplasma gondii infection in market-sold adult chickens, ducks and pigeons in northwest China

    Directory of Open Access Journals (Sweden)

    Cong Wei

    2012-06-01

    Full Text Available Abstract Background Toxoplasma gondii infection is a global concern, affecting a wide range of warm-blooded animals and humans worldwide, including poultry. Domestic and companion birds are considered to play an important role in the transmission of T. gondii to humans and other animals. However, little information on T. gondii infection in domestic birds in Lanzhou, northwest China was available. Therefore, this study was performed to determine the seroprevalence of T. gondii infection in domestic birds in Lanzhou, northwest China. Methods In the present study, the seroprevalence of T. gondii antibodies in 413 (305 caged and 108 free-range adult chickens, 334 (111 caged and 223 free-range adult ducks and 312 adult pigeons in Lanzhou, northwest China, were examined using the modified agglutination test (MAT. Results 30 (7.26% chickens, 38 (11.38% ducks and 37 (11.86% pigeons were found to be positive for T. gondii antibodies at the cut-off of 1:5. The prevalences in caged and free-range chickens were 6.23% and 10.19% respectively, however, statistical analysis showed that the difference was not significant (P > 0.05. The seroprevalences in caged and free-range ducks were 6.31% and 13.90% respectively, but the difference was not statistically significant (P > 0.05. Conclusions The results of the present survey indicated the presence of T. gondii infection in adult chickens, ducks and pigeons sold for meat in poultry markets in Lanzhou, northwest China, which poses a potential risk for T. gondii infection in humans and other animals in this region. This is the first seroprevalence study of T. gondii infection in domestic birds in this region.

  20. Clostridium perfringens and Clostridium difficile in cooked beef sold in Côte d'Ivoire and their antimicrobial susceptibility.

    Science.gov (United States)

    Kouassi, Kra Athanase; Dadie, Adjéhi Thomas; N'Guessan, Kouadio Florent; Dje, Koffi Marcellin; Loukou, Yao Guillaume

    2014-08-01

    The aim of this study was to evaluate the prevalence of Clostridium difficile and Clostridium perfringens in cooked beef sold in the streets in Côte d'Ivoire and their antimicrobial susceptibility. A total of 395 kidney and flesh samples of cooked beef were collected from vendors at Abidjan and subjected to C. difficile and C. perfringens isolation and identification by using biochemical tests, API 20A system and PCR detection. Subsequently, the antimicrobial susceptibility test was performed for confirmed isolates. Our results showed the prevalence of 12.4% for C. difficile (11.04% in kidney and 13.45% in flesh) and 5.06% for C. perfringens (2.32% in kidney and 7.17% in flesh). Metronidazole and vancomycin remained the most potent antimicrobial agents against C. difficile while metronidazole and penicillin G were the most potent agents against C. perfringens. The resistance rates to tetracycline, doxycycline, chloramphenicol and erythromycin against C. difficile and C. perfringens isolates ranged from 2.05% to 8.16% and from 20% to 50%, respectively. Among all antimicrobial agents tested against C. difficile, percentages of resistance to quinolones ciprofloxacin, norfloxacin and nalidixic acid as well as to gentamicin and cefotaxime were the highest. Eight resistant phenotypes were defined for C. difficile isolates and eleven resistant phenotypes for C. perfringens isolates. Clindamycin/gentamicin/cefotaxime/ciprofloxacin/norfloxacin/nalidixic acid resistance was the most common phenotype for C. difficile (55.10% of isolates) while norfloxacin/nalidixic acid resistance was the most common phenotype for C. perfringens (20% of isolates).

  1. Tick front-of-pack label has a positive nutritional impact on foods sold in New Zealand.

    Science.gov (United States)

    Thomson, Rachel K; McLean, Rachael M; Ning, Sherry X; Mainvil, Louise A

    2016-11-01

    Nutritional impact of the Tick front-of-pack labelling programme was evaluated by investigating nutrient changes to the purchased food supply and the nutritional quality of Tick v. non-Tick products. Factors influencing manufacturers' decisions to develop and license Tick products were also explored. Observational, cross-sectional and change over time data. New Zealand food supply, 2011-2013. Forty-five newly licensed Tick products from five food categories were analysed: Edible Oil Spreads, Yoghurt & Dairy Desserts, Frozen Desserts, Ready Meals and Processed Poultry. Four manufacturers of these products were interviewed. Eligible products (31 % of all Tick products in these categories) removed 4·1 million megajoules of energy, 156·0 tonnes of saturated fat, 15·4 tonnes of trans-fat and 4·0 tonnes of sodium from food products sold in New Zealand over three years. In each food category, these Tick products were, on average, 14-76 % lower in energy, saturated fat, trans-fat and sodium than non-Tick products, indicating healthier options. Participating manufacturers reported that international market trends and consumer demand for tasty, healthy foods primarily influenced Tick product development and sales. Tick was used as part of their marketing strategy as it was perceived as a credible, well-recognised logo for New Zealand consumers. Tick was cited as the primary initiative encouraging saturated fat reduction. The Tick Programme is continuing to encourage manufacturers to make meaningful improvements to the nutritional quality of the New Zealand food supply. Over time, these changes are likely to influence population nutrient intakes and reduce CVD risk factors.

  2. Sweet and salty. An assessment of the snacks and beverages sold in vending machines on US post-secondary institution campuses.

    Science.gov (United States)

    Byrd-Bredbenner, Carol; Johnson, Michelle; Quick, Virginia M; Walsh, Jennifer; Greene, Geoffrey W; Hoerr, Sharon; Colby, Sarah M; Kattelmann, Kendra K; Phillips, Beatrice W; Kidd, Tandalayo; Horacek, Tanya M

    2012-06-01

    This study assessed the nutritional quality of snacks and beverages sold in vending machines. The contents of snack and beverage vending machines in 78 buildings on 11 US post-secondary education campuses were surveyed. Of the 2607 snack machine slots surveyed, the most common snacks vended were salty snacks (e.g., chips, pretzels) and sweets (i.e., candy and candy bars). The 1650 beverage machine slots assessed contained twice as many sugar-sweetened beverages as non-calorie-containing beverages. Only two institutions sold both milk and 100% juice in vending machines. The portion of snacks and beverages sold averaged more than 200 cal. Neither snacks nor beverages were nutrient dense. The majority of snacks were low in fiber and high in calories and fat and almost half were high in sugar. Most beverages were high in calories and sugar. This study's findings suggest that vending machines provide limited healthful choices. Findings from benchmark assessments of components of the food environment, like the vending options reported here, can provide valuable input to campus administrators, health services, food service, and students who want to establish campus policies to promote healthful eating. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Empowering Women: A Feminist Argument for Over-the-Counter Sale of Oral Contraceptives

    OpenAIRE

    Prieto-Gonzalez, Mayelin

    2005-01-01

    The oral contraceptive pill, having been on the market for 45 years, should be sold over-the-counter. There is no longer any valid reason for FDA to maintain the prescription status of the drug. First, numerous studies over the past few decades have shown that the pill is safe for the vast majority of women, with current risk to users estimated to be less than the risks associated with pregnancy. In addition, the pill is effective and easy to use. Studies have shown that the pill also confers...

  4. Effects of artesunate on immune function in mice%青蒿琥酯对小鼠免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    林培英; 冯昭明; 潘竞锵; 张丹; 肖柳英

    1995-01-01

    目的:研究青蒿琥酯对小鼠免疫功能的影响.方法:溶血素含量用分光光度法测定,血清IgG和C3含量用单向免疫扩散法测定,淋巴细胞转化率、巨噬细胞吞噬百分率和吞噬指数镜检计数.结果:青蒿琥酯im 75 mg kg-1 bidfor 5-7 d能降低SRBC致敏小鼠血清溶血素和IgG的含量,抑制抗体生成,但增加疟鼠补体C3的含量.青蒿琥酯能促进PHA诱导的小鼠体内淋巴细胞转化,能提高DNFB所致的迟发型超敏反应,并减少腹腔巨噬细胞的吞噬百分率和吞噬指数.结论:青蒿琥酯对体液免疫有抑制作用,但对细胞免疫有促进作用.%AIM: To study the effects of artesunate (dihydroartemisinine-12-α-succinate, Art) on immune function in mice. METHODS:Hemolysin concentration was determined by colorimetric method. Serum IgG and C3 contents were measured by single immunodiffusion method. Percentage of lymphocyte transformation, phagocytosis percentage and phagocytic index were counted under microscope. RESULTS: Art im 75 mg kg-1 bid× 7d decreased the humolysin-forming capacity and levels of serum IgG of mice sensitized with sheep red blood cell. The serum complement 3 level rose remarkably, when Art was given im to Plasmodium berghei-infected mice. Art enhanced the PHA-induced lymphocyte transformation rate (in vivo) in mice and increased the weight of spleen but reduced that of thymus in mice. Art elevated the DNFB-induced delayed-type hypersensitivity.Art im 75 mg kg-1 bid × 5 d reduced the percentage of phagocytosis of peritoneal macrophages and the phagocytic index.CONCLUSION: Art suppressed the humoralimmune responses but enhanceed the cellmediated immunity.

  5. Chlorproguanil-dapsone-artesunate versus artemether-lumefantrine: a randomized, double-blind phase III trial in African children and adolescents with uncomplicated Plasmodium falciparum malaria.

    Directory of Open Access Journals (Sweden)

    Zul Premji

    Full Text Available BACKGROUND: Chlorproguanil-dapsone-artesunate (CDA was developed as an affordable, simple, fixed-dose artemisinin-based combination therapy for use in Africa. This trial was a randomized parallel-group, double-blind, double-dummy study to compare CDA and artemether-lumefantrine (AL efficacy in uncomplicated Plasmodium falciparum malaria and further define the CDA safety profile, particularly its hematological safety in glucose-6-phosphate dehydrogenase (G6PD -deficient patients. METHODS AND FINDINGS: The trial was conducted at medical centers at 11 sites in five African countries between June 2006 and August 2007. 1372 patients (> or =1 to <15 years old, median age 3 years with acute uncomplicated P. falciparum malaria were randomized (2:1 to receive CDA 2/2.5/4 mg/kg once daily for three days (N = 914 or six-doses of AL over three days (N = 458. Non-inferiority of CDA versus AL for efficacy was evaluated in the Day 28 per-protocol (PP population using parasitological cure (polymerase chain reaction [PCR]-corrected. Cure rates were 94.1% (703/747 for CDA and 97.4% (369/379 for AL (treatment difference -3.3%, 95%CI -5.6, -0.9. CDA was non-inferior to AL, but there was simultaneous superiority of AL (upper 95%CI limit <0. Adequate clinical and parasitological response at Day 28 (uncorrected for reinfection was 79% (604/765 with CDA and 83% (315/381 with AL. In patients with a G6PD-deficient genotype (94/603 [16%] hemizygous males, 22/598 [4%] homozygous females, CDA had the propensity to cause severe and clinically concerning hemoglobin decreases: the mean hemoglobin nadir was 75 g/L (95%CI 71, 79 at Day 7 versus 97 g/L (95%CI 91, 102 for AL. There were three deaths, unrelated to study medication (two with CDA, one with AL. CONCLUSIONS: Although parasitologically effective at Day 28, the hemolytic potential of CDA in G6PD-deficient patients makes it unsuitable for use in a public health setting in Africa. TRIAL REGISTRATION: ClinicalTrials.Gov NCT

  6. Treatment of uncomplicated malaria with artesunate plus sulfadoxine-pyrimethamine is failing in Somalia: evidence from therapeutic efficacy studies and Pfdhfr and Pfdhps mutant alleles.

    Science.gov (United States)

    Warsame, Marian; Hassan, Abdillahi Mohamed; Barrette, Amy; Jibril, Ali Mohamed; Elmi, Husein Haji; Arale, Abdulkadir Mohamed; Mohammady, Hanan El; Nada, Rania A; Amran, Jamal Ghilan Hefzullah; Muse, Abdikarim; Yusuf, Fahmi Essa; Omar, Abdiqani Sheikh

    2015-04-01

    Artesunate plus sulfadoxine-pyrimethamine (AS + SP) has been Somalia's national treatment policy since 2006. Routine monitoring of first-line malaria treatment is needed to ensure appropriate national malaria treatment policy and early detection of drug resistance. For this purpose, we conducted therapeutic efficacy studies of AS + SP for the treatment of uncomplicated malaria in Somalia in 2011. Studies were conducted in three sentinel sites. Eligible patients were evaluated for clinical and parasitological outcomes according to the WHO standard protocol. Molecular surveillance was conducted on resistance conferring mutations in the P.falciparum dihydrofolate reductase (dfhr) and dihydropteroate synthase (dhps) genes. The proportion of PCR-corrected treatment failures was high in Jamame (22%, 95% CI: 13.7-32.8%) and low (<5%) in Janale and Jowhar. All patients cleared parasites by day 3. Molecular markers associated with SP resistance were detected in all three sites. Treatment failure was associated with the presence of the double mutant dhps A437G/K540E (OR = 22.4, 95% CI: 5.1-98.1), quadruple mutant dhfr N51I/S108N+dhps A437G/K540E (OR = 5.5, 95% CI: 2.3-13.6), quintuple mutant dhfr N51I/C59R/S108N+dhps A437G/K540E (OR = 3.5, 95% CI: 1.4-8.8) and younger age (OR=0.86, 95% CI: 0.76-0.96). The high treatment failure rate observed in Jamame, together with the presence of molecular mutations associated with SP resistance, indicates P. falciparum resistance to SP. In Jowhar, high treatment failure rates were absent despite the presence of molecular mutations; signs of resistance in vivo may have been masked by the stronger immunity of the older study population. The study underscores the need to update Somalia's national malaria treatment policy. © 2015 John Wiley & Sons Ltd.

  7. Trends in malaria morbidity following the introduction of artesunate plus amodiaquine combination in M'lomp village dispensary, south-western Senegal

    Directory of Open Access Journals (Sweden)

    Hesran Jean

    2008-10-01

    Full Text Available Abstract Background In Thailand, South Africa and Zanzibar, a decrease in malaria morbidity was observed following the introduction of artemisinin-based combination therapy (ACT. In Senegal, therapeutic trials supervised the in vivo efficacy of artesunate plus amodiaquine from 1999 to 2005 at the M'lomp village dispensary. The trends in malaria morbidity in this village were evaluated from 2000 to 2002. Methods Each year, between July and December inclusive, fevers treated with antimalarials and slide-proven, uncomplicated malaria cases were collected from dispensary health records. Data were also collected in 1998, just prior to ACT introduction. Pearson's chi square tests and Student tests were used to compare two percentages or two means respectively (α = 0.05. Results Between 1998 and 2002, the total number of fevers treated with antimalarials and their repetitiveness progressively decreased: From 2824 to 945 fevers and from 17.6% to 9.7% (RR1998–2002 = 0.55; [0.44–0.69]; p 2000–2002 = 0.51; [0.35–0.72]; p = 0.0001. Conclusion The percentage of uncomplicated malaria cases treated with ACT increased, from 18.9% in 2000 to 64.0% in 2002, making it tempting to conclude an impact on malaria morbidity. Nonetheless, the decline in incidence rate of uncomplicated malaria was slight and a lower recorded rainfall was reported in 2002 which could also explain this decline. The context in which ACT is introduced affects the impact on malaria morbidity. In M'lomp, in contrast to studies in Thailand, South Africa and Zanzibar, ACT coverage of malaria cases was low and no vector control measure was deployed. Moreover, the malaria transmission level is higher. In sub-Saharan countries, in order to optimize the impact on malaria morbidity, ACT deployment must be supported, on the one hand, by a strengthening of public health system to ensure a high ACT coverage and, on the other hand, by others measures, such vector control measures.

  8. Safety and efficacy of methylene blue combined with artesunate or amodiaquine for uncomplicated falciparum malaria: a randomized controlled trial from Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Augustin Zoungrana

    Full Text Available BACKGROUND: Besides existing artemisinin-based combination therapies, alternative safe, effective and affordable drug combinations against falciparum malaria are needed. Methylene blue (MB was the first synthetic antimalarial drug ever used, and recent studies have been promising with regard to its revival in malaria therapy. The objective of this study was to assess the safety and efficacy of two MB-based malaria combination therapies, MB-artesunate (AS and MB-amodiaquine (AQ, compared to the local standard of care, AS-AQ, in Burkina Faso. METHODS AND FINDINGS: Open-label randomised controlled phase II study in 180 children aged 6-10 years with uncomplicated falciparum malaria in Nouna, north-western Burkina Faso. Follow-up was for 28 days and analysis by intention-to-treat. The treatment groups were similar in baseline characteristics and there was only one loss to follow-up. No drug-related serious adverse events and no deaths occurred. MB-containing regimens were associated with mild vomiting and dysuria. No early treatment failures were observed. Parasite clearance time differed significantly among groups and was the shortest with MB-AS. By day 14, the rates of adequate clinical and parasitological response after PCR-based correction for recrudescence were 87% for MB-AS, 100% for MB-AQ (p = 0.004, and 100% for AS-AQ (p = 0.003. By day 28, the respective figure was lowest for MB-AS (62%, intermediate for the standard treatment AS-AQ (82%; p = 0.015, and highest for MB-AQ (95%; p<0.001; p = 0.03. CONCLUSIONS: MB-AQ is a promising alternative drug combination against malaria in Africa. Moreover, MB has the potential to further accelerate the rapid parasite clearance of artemisinin-based combination therapies. More than a century after the antimalarial properties of MB had been described, its role in malaria control deserves closer attention. TRIAL REGISTRATION: ClinicalTrials.gov NCT00354380.

  9. Randomized trial of artesunate+amodiaquine, sulfadoxine-pyrimethamine+amodiaquine, chlorproguanal-dapsone and SP for malaria in pregnancy in Tanzania.

    Directory of Open Access Journals (Sweden)

    Theonest K Mutabingwa

    Full Text Available BACKGROUND: Malaria in pregnancy is serious, and drug resistance in Africa is spreading. Drugs have greater risks in pregnancy and determining the safety and efficacy of drugs in pregnancy is therefore a priority. This study set out to determine the efficacy and safety of several antimalarial drugs and combinations in pregnant women with uncomplicated malaria. METHODS: Pregnant women with non-severe, slide proven, falciparum malaria were randomised to one of 4 regimes: sulfadoxine-pyrimethamine [SP]; chlorproguanil-dapsone [CD]; SP+amodiaquine [SP+AQ] or amodiaquine+artesunate [AQ+AS]. Randomisation was on a 1ratio2ratio2ratio2 ratio. Women were admitted for treatment, and followed at days 7, 14, 21, 28 after the start of treatment, at delivery and 6 weeks after delivery to determine adverse events, clinical and parasitological outcomes. Primary outcome was parasitological failure by day 28. RESULTS: 1433 pregnant women were screened, of whom 272 met entry criteria and were randomised; 28 to SP, 81 to CD, 80 to SP+AQ and 83 to AQ+AS. Follow-up to day 28 post treatment was 251/272 (92%, and to 6 weeks following delivery 91%. By day 28 parasitological failure rates were 4/26 (15%, 95%CI 4-35 in the SP, 18/77 (23%, 95%CI 14-34 in the CD, 1/73 (1% 95%CI 7-0.001 in the SP+AQ and 7/75 (9% 95%CI 4-18 in the AQ+AS arms respectively. After correction by molecular markers for reinfection the parasitological failure rates at day 28 were 18% for CD, 1% for SP+AQ and 4.5% for AQ+AS. There were two maternal deaths during the trial. There was no apparent excess of stillbirths or adverse birth outcomes in any arm. Parasitological responses were strikingly better in pregnant women than in children treated with the same drugs at this site. CONCLUSIONS: Failure rates with monotherapy were unacceptably high. The two combinations tested were efficacious and appeared safe. It should not be assumed that efficacy in pregnancy is the same as in children. TRIAL

  10. The efficacy and safety of a new fixed-dose combination of amodiaquine and artesunate in young African children with acute uncomplicated Plasmodium falciparum

    Directory of Open Access Journals (Sweden)

    Kiechel Jean

    2009-03-01

    Full Text Available Abstract Background Artesunate (AS plus amodiaquine (AQ is one artemisinin-based combination (ACT recommended by the WHO for treating Plasmodium falciparum malaria. Fixed-dose AS/AQ is new, but its safety and efficacy are hitherto untested. Methods A randomized, open-label trial was conducted comparing the efficacy (non-inferiority design and safety of fixed (F dose AS (25 mg/AQ (67.5 mg to loose (L AS (50 mg + AQ (153 mg in 750, P. falciparum-infected children from Burkina Faso aged 6 months to 5 years. Dosing was by age. Primary efficacy endpoint was Day (D 28, PCR-corrected, parasitological cure rate. Recipients of rescue treatment were counted as failures and new infections as cured. Documented, common toxicity criteria (CTC graded adverse events (AEs defined safety. Results Recruited and evaluable children numbered 750 (375/arm and 682 (90.9%, respectively. There were 8 (AS/AQ and 6 (AS+AQ early treatment failures and one D7 failure (AS+AQ. Sixteen (AS/AQ and 12 (AS+AQ patients had recurrent parasitaemia (PCR new infections 10 and 6, respectively. Fourteen patients per arm required rescue treatment for vomiting/spitting out study drugs. Efficacy rates were 92.1% in both arms: AS/AQ = 315/342 (95% CI: 88.7–94.7 vs. AS+AQ = 313/340 (95% CI: 88.6–94.7. Non-inferiority was demonstrated at two-sided α = 0.05: Δ (AS+AQ – AS/AQ = 0.0% (95% CI: -4.1% to 4.0%. D28, Kaplan Meier PCR-corrected cure rates (all randomized children were similar: 93.7% (AS/AQ vs. 93.2% (AS+AQ Δ = -0.5 (95% CI -4.2 to 3.0%. By D2, both arms had rapid parasite (F & L, 97.8% aparasitaemic and fever (97.2% [F], 96.0% [L] afebrile clearances. Both treatments were well tolerated. Drug-induced vomiting numbered 8/375 (2.1% and 6/375 (1.6% in the fixed and loose arms, respectively (p = 0.59. One patient developed asymptomatic, CTC grade 4 hepatitis (AST 1052, ALT 936. Technical difficulties precluded the assessment and risk of neutropaenia for all patients. Conclusion

  11. Artemisinin resistance containment project in Thailand. II: responses to mefloquine-artesunate combination therapy among falciparum malaria patients in provinces bordering Cambodia

    Directory of Open Access Journals (Sweden)

    Satimai Wichai

    2012-08-01

    Full Text Available Abstract Background The area along the Thai-Cambodian border is considered an epicenter of anti-malarial drug resistance. Recently, parasite resistance to artemisinin-based therapies has been reported in the area. The artemisinin resistance containment project was initiated in November 2008, with the aim to limit resistant parasites and eliminate malaria in this region. This study describes the response to artemisinin-based therapy among falciparum malaria patients in the area, using data from the malaria surveillance programmed under the containment project. Methods The study was conducted in seven provinces of Thailand along the Thai-Cambodian border. Data of Plasmodium falciparum-positive patients during January 2009 to December 2011 were obtained from the electronic malaria information system (eMIS Web-based reporting system. All P. falciparum cases were followed for 42 days, as the routine case follow-up protocol. The demographic characteristics of the patients were described. Statistical analysis was performed to determine the cure rate of the current standard anti-malarial drug regimen--mefloquine-artesunate combination therapy (MAS. The proportion of patients who remained parasite-positive at each follow-up day was calculated. In addition, factors related to the delayed parasite clearance on day-3 post-treatment, were explored. Results A total of 1,709 P. falciparum-positive cases were reported during the study period. Almost 70% of falciparum cases received MAS therapy (n = 1,174. The majority of cases were males, aged between 31 and 50 years. The overall MAS cure rate was >90% over the three-year period. Almost all patients were able to clear the parasite within 7 to 14 days post-treatment. Approximately 14% of patients undergoing MAS remained parasite-positive on day-3. Delayed parasite clearance was not significantly associated with patient gender, age, or citizenship. However, delayed parasite clearance varied across the

  12. Detection of shiga-toxin producing E. coli (STEC) in leafy greens sold at local retail markets in Alexandria, Egypt.

    Science.gov (United States)

    Khalil, Rowaida K S; Gomaa, Mohamed A E; Khalil, Mahmoud I M

    2015-03-16

    Leafy green vegetables, a popular and an indispensable ingredient of the daily menus of Egyptians' diets, currently presents a great concern in terms of microbiological hazards. To the best of our knowledge, this is the first report that provides scientific evidence for prevalence of shiga-toxigenic Escherichia coli (STEC) in leafy greens sold at open air local retail markets and superstores in the Egyptian environment. A total of 486 conventional and organic leafy green samples that are eaten raw were collected from different areas in Alexandria, evaluated for total E. coli counts (ECCs), and screened for E. coli O157:H7 using conventional and molecular methods. Recovery of E. coli (≥10(2)CFU/g) from all studied types of leafy greens was indicative of fecal contamination. Total ECCs in conventional samples ranged from 5.47 to 2.56 log CFU/g. Based on their inability to ferment sorbitol on CT-SMAC media, 26 presumptive E. coli O157 isolates were detected in 71.4% (270/378) of the studied conventional samples. From all studied organic samples, only 2 types (organic cabbage and parsley, 16.7%) were contaminated with presumptive E. coli O157. All 28 isolates were further serotyped as E. coli O157 by latex agglutination test, and biochemically confirmed as E. coli. Multiplex PCR assays confirmed the ability of 21.4% (6/28) of the E. coli O157 strains to produce shiga-toxins (Stxs), and their virulence markers were as follows: stx1, 66.6% (4/6); stx2, 50% (3/6); stx1/stx2, 16.7% (1/6); eaeA, 83.3% (5/6); and hlyA, 16.7% (1/6). Only 2 strains recovered from conventional and organic parsley could possibly be classified as E. coli O157:H7 based on the presence of stx-genes (either stx1 or stx2 or both). Results of the present research highlight that high E. coli loads, together with recovery of STEC O157 isolates could pose serious health risks to the produce consumers. This emphasizes the urgent need for health authorities to value and utilize the existing knowledge to

  13. Risk of Salmonellosis from Chicken Parts Prepared from Whole Chickens Sold in Flow Pack Wrappers and Subjected to Temperature Abuse.

    Science.gov (United States)

    Oscar, T P

    2017-09-01

    The flow pack wrapper is a popular packaging choice for retail sale of whole chickens. However, it may provide a favorable environment for growth and spread of Salmonella within the package, leading to an outbreak of salmonellosis. To investigate this possibility, a process risk model was developed that predicted the risk of salmonellosis from chicken parts prepared from whole chickens sold in flow pack wrappers and subjected to proper storage (6 h at 4°C) or improper storage (72 h at 15°C) before preparation. The model had four unit operations (pathogen events): (i) preparation (contamination), (ii) cooking (death), (iii) serving (cross-contamination), and (iv) consumption (dose-response). Data for prevalence, number, and serotype of Salmonella on chicken parts were obtained by whole sample enrichment, real-time PCR. Improper storage increased (P chicken parts from 10.6% (17 of 160) to 41.2% (66 of 160) and incidence of cross-contamination of cooked chicken from 10% (4 of 40) to 52.2% (24 of 46). Improper storage also increased (P chicken part and from 0.048 ± 0.089 to 3.08 ± 1.50 log per cooked chicken part. The predominant serotypes isolated (n = 111) were Typhimurium (34.2%), Typhimurium var 5- (20.7%), Kentucky (12.6%), Enteritidis (11.7%), and Heidelberg (8.1%). When chicken was properly stored before preparation, the model predicted that risk of salmonellosis was low and sporadic with only six cases per 100 simulations of 10(5) chicken parts. However, when 0.1 to 1% of chickens were improperly stored before preparation, the model predicted that salmonellosis would increase (P chicken parts. These results indicated that the flow pack wrapper provided a favorable environment for growth and spread of Salmonella within the package and that even when only a small percentage of packages were subjected to improper storage before preparation, the risk and size of an outbreak of salmonellosis from chicken parts increased significantly.

  14. Evaluation of the use of radiation in microbiological control in tomato (Lycopersicon esculentum mill.) sold in the CEASA, Pernambuco

    Energy Technology Data Exchange (ETDEWEB)

    Vicalvi, Maria Claudia V.; Solidonio, Evelyne G.; Silva, Marcio de Albuquerque; Costa Junior, Carlos Eduardo de Oliveira; Alcantara, Moacir Paulo [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Pos-graduation program in Energetics and Nuclear Tecnologies; Miranda, Rita de Cassia M. de [Universidade Federal de Sergipe (UFS), Aracaju, SE (Brazil). Lab. of Chromatographic Analysis and Flavor; Sena, Kesia Xisto F.R. de [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. of Antibiotics; Colaco, Waldeciro, E-mail: wcolaco@ufpe.com.b [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. of Nuclear Energy

    2011-07-01

    Tomato is one of the most consumed fruits in the world and also one of the agricultural products with most losses due to its high perishability. Nevertheless, there are only a few studies on the post-harvest life of tomatoes and therefore are still many undefined parameters related to the treatment and shelf life of different cultivars of that fruit. Its contamination occurs from the pre-to post-harvest crop. The diseases caused by food borne pathogenic microorganisms are a serious public health problem. The bacteria of the Enterobacteriaceae are responsible for large outbreaks of gastroenteritis in humans that may occur due to bacteria per se or by toxins produced by them. Thus, the development of technologies that make the food safe for human consumption has been growing in recent years. Preservation methods employ physical or chemical processes. Among such methods, irradiation is a preventive treatment for food safety. Irradiation can reduce post-harvest losses by killing insect pests in fruits, grains, spices, or by reducing food spoilage organisms by inhibiting the sprouting of plants and delaying the ripening of fruits. The objective of this research was to evaluate the potential of using different doses of gamma radiation to treat tomatoes sold in CEASA-PE and to perform the overall count of microorganisms in control and irradiated samples. The study used two lots containing 60 tomatoes such that 15 of them were used as the control group and 45 were irradiated with one of 3 different doses (1.0 kGy, 1.5 kGy and 2.0 kGy). For microbiological analysis, the tomatoes were sliced, and weighed (after removal of peel) in order to obtain samples weighing 25g. Each sample was added to an Erlenmeyer containing sterile water by agitation for 15 minutes. Aliquots of the washings were sown for exhaustion in sheep blood agar. After growth, colony counting was performed. The results revealed contamination in all tomato groups analyzed with the control groups exhibiting

  15. Comparison of ochratoxin A and deoxynivalenol in organically and conventionally produced beers sold on the Belgian market.

    Science.gov (United States)

    Anselme, M; Tangni, E K; Pussemier, L; Motte, J-C; Van Hove, F; Schneider, Y-J; Van Peteghem, C; Larondelle, Y

    2006-09-01

    Beer was chosen as a cereal-derived and homogeneous product for a comparison of organic and conventional production methods in terms of mycotoxin contamination levels. Ochratoxin A (OTA, a storage mycotoxin) and deoxynivalenol (DON, a field mycotoxin) were assessed by HPLC in organically and conventionally produced beers sold in Belgium. Immunoaffinity column (OchraTest and DONPrep) purification was used prior to HPLC analysis. For in-house validation, recovery experiments, carried out with the spiked beers in the ranges of 50-200 ng OTA l-1 and 20-100 microg DON l-1, led to the overall averages of 91% (RSD = 10%, n = 9) and 93% (RSD = 5%, n = 27), respectively. Organic beers collected during 2003-2004 were more frequently OTA-contaminated (95%, n = 40) than their conventional counterparts (50%, n = 40). Conventional beers were OTA-contaminated at a mean concentration of 25 ng l-1 (range: 19-198 ng l-1), while organic beers contained a mean level of 182 ng l-1 (range: 18-1134 ng l-1). High OTA contamination above the limit of 200 ng l-1 (up to 1134 ng l-1) occasionally occurred in organically produced beers. A complementary survey performed with the same brands in 2005 did not confirm this accidental presence of excessive OTA loads (range: 3-67 ng l-1 for 10 conventional beers and 19-158 ng l-1 for 10 organic beers). Establishing a maximum of 3 microg OTA kg-1 in malt, the application of the regulation EC No. 466/2001 (entered in force before the last sampling) may be related to the observed improvement. The overall incidence of DON was 67 and 80% in conventional and organic beers, respectively. DON concentrations ranged from 2 to 22 microg DON l-1 (mean = 6 microg DON l-1) in conventional beers, while organic beers ranged from 2 to 14 microg DON l-1 (mean=4 microg DON l-1). Thus, DON in beers does not appear to be a major matter of concern. From the statistical tests, it was concluded that the variation between different batches was significant (P < 0.0001), in

  16. Therapeutic efficacy of artesunate in the treatment of uncomplicated Plasmodium falciparum malaria and anti-malarial, drug-resistance marker polymorphisms in populations near the China-Myanmar border

    Directory of Open Access Journals (Sweden)

    Huang Fang

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to evaluate the clinical outcome after seven-day artesunate monotherapy for uncomplicated Plasmodium falciparum malaria in Yingjiang County along the China-Myanmar border and investigate genetic polymorphisms in the P. falciparum chloroquine-resistance transporter (pfcrt, multidrug resistance 1 (pfmdr1, dihydrofolate reductase (pfdhfr, dihydropteroate synthase (pfdhps and ATPase (pfatp6 genes. Methods Patients ≥ one year of age with fever (axillary temperature ≥37.5°C or history of fever and P. falciparum mono-infection were included. Patients received anti-malarial treatment with artesunate (total dose of 16 mg/kg over seven days by directly observed therapy. After a 28-day follow-up, treatment efficacy and effectiveness were assessed based on clinical and parasitological outcomes. Treatment failure was defined as recrudescence of the original parasite and distinguished with new infection confirmed by PCR. Analysis of gene mutation and amplification were performed by nested polymerase chain reaction. Results Sixty-five patients were enrolled; 10 withdrew from the study, and six were lost to follow-up. All but two patients demonstrated adequate clinical and parasitological response; 12 had detectable parasitaemia on day 3. These two patients were confirmed to be new infection by PCR. The efficacy of artesunate was 95.9%. The pfcrt mutation in codon 76 was found in all isolates (100%, and mutations in codons 71 and 72 were found in 4.8% of parasite isolates. No mutation of pfmdr1 (codons 86 or 1246 was found. Among all samples, 5.1% were wild type for pfdhfr, whereas the other samples had mutations in four codons (51, 59, 108 and 164, and mutations in pfdhps (codons 436, 437, 540 and 581 were found in all isolates. No samples had mutations in pfatp6 codons 623 or 769, but two new mutations (N683K and R756K were found in 4.6% and 9.2% of parasite isolates, respectively. Conclusion Plasmodium

  17. Compliance with a three-day course of artesunate-mefloquine combination and baseline anti-malarial treatment in an area of Thailand with highly multidrug resistant falciparum malaria

    Directory of Open Access Journals (Sweden)

    Na-Bangchang Kesara

    2010-02-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT is presently recommended by the World Health Organization as first-line treatment for uncomplicated Plasmodium falciparum malaria in several countries, as a mean of prolonging the effectiveness of first-line malaria treatment regimens. A three-day course of artesunate-mefloquine (4 mg/kg body weight once daily for three consecutive days, plus 15 and 10 mg/kg body weight mefloquine on the first and second days has been adopted by Malaria Control Programme of Thailand as first-line treatment for uncomplicated falciparum malaria all over the country since 2008. The gametocytocydal anti-malarial drug primaquine is administered at the dose of 30 mg (0.6 mg/kg on the last day. The aim of the present study was to assess patient compliance of this combination regimen when applied to field condition. Methods A total of 240 patients (196 males and 44 females who were attending the malaria clinics in Mae-Sot, Tak Province and presenting with symptomatic acute uncomplicated falciparum malaria, with no reappearance of Plasmodium vivax parasitaemia during follow-up were included into the study. The first dose of the treatment was given to the patients under direct supervision. All patients were given the medication for self-treatment at home and were requested to come back for follow-up on day 3 of the initial treatment. Baseline (day 0 and day 3 whole blood mefloquine and plasma primaquine concentrations were determined by high performance liquid chromatography. Results Two patients had recrudescence on days 28 and 35. The Kaplan-Meier estimate of the 42-day efficacy rate of this combination regimen was 99.2% (238/240. Based on whole blood mefloquine and plasma primaquine concentrations on day 3 of the initial treatment, compliance with mefloquine and primaquine in this three-day artesunate-mefloquine combination regimen were 96.3% (207/215, and 98.5% (197/200, respectively. Baseline mefloquine

  18. 青蒿琥酯联合奎宁马斯治疗疟疾90例临床观察%Clinical Observation on Treating 90 Cases of Malaria with Artesunate and Quinimax Injection

    Institute of Scientific and Technical Information of China (English)

    樊春晖

    2012-01-01

    目的:观察青蒿琥酯联合奎宁马斯治疗疟疾的临床效果.方法:将180例疟疾患者根据入院顺序分为治疗组与对照组各90例,2组均给予奎宁马斯针剂静脉滴注治疗,治疗组同时给予青蒿琥酯针剂静脉滴注.结果:治疗组显效率显著高于对照组(P<0.05),2组总有效率差异无统计学意义(P>O.05).治疗组平均退热时间、平均原虫转阴时间均比对照组短(P<0.05),24小时平均原虫下降率高于对照组(P<0.05);不良反应明显少于对照组(P<0.05).结论:青蒿琥酯联合奎宁马斯治疗疟疾疗效显著,可改善临床症状,且安全性好.%Objective: To explore clinical effects of artesunate and quinimax in treating malaria Method: All 180 patients were divided into treatment group and control group in the order of hospitalization. Both groups received intravenous quinimax injection. Threatment group were given with intravenous artesunate. Result: Effectual rate of treatment group was higher than that of control group(P0.05). Average time of defervescence and mean time of parasite clearance of treatment group were shorter than that of control group (P<0.05), 24 h mean decline rate of parasite of treatment group was higher than that of control group(P<0.05), Adverse reactions were remarkably less than that of control group (P<0.05). Conclusion: Artesunate and quinimax injection are effective and safe in treating malaria and could improve clinical symptoms.

  19. Oral Cancer Exam

    Medline Plus

    Full Text Available ... and Deadlines Grant Application Forms Application Receipt Dates Electronic Submission of Applications Grants 101 (How to Write ... detection and treatment of oral cancers. Note: For materials specific to African American men, please see: Oral ...

  20. Oral Appliances Therapy

    Science.gov (United States)

    ... your sleep doctor may schedule you for a sleep study to verify treatment success. Follow-Up Visits Follow-up visits with your dentist will be needed to ensure the optimal fit of the oral appliance. Effective oral appliances ...

  1. Oral Cancer Exam

    Medline Plus

    Full Text Available ... See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See ... this brochure includes information on symptoms, diagnosis, and treatment of oral cancer, along with definitions of selected ...

  2. Oral Cancer Exam

    Medline Plus

    Full Text Available ... the exam can detect oral cancer early—when it can be treated more successfully. Publications​ For Health ... and the importance of detecting the disease in its early stages. The Oral Cancer Exam Step-by- ...

  3. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See All Order ... Education Practical Oral Care for People With Developmental Disabilities – This booklet presents an overview of physical, mental, ...

  4. Oral Cancer Exam

    Medline Plus

    Full Text Available ... signs of oral cancer. For Patients and the Public Oral Cancer Pamphlet that describes the risk factors, ... not collect any actual information. External Web Site Policy This graphic notice ( ) means that you are leaving ...

  5. Oral Cancer Exam

    Medline Plus

    Full Text Available ... diagnosis, and treatment of oral cancer, along with definitions of selected medical terms and resource information. Oral ... of Dental and Craniofacial Research National Institutes of Health Bethesda, MD 20892-2190 301-496-4261 NIH… ...

  6. Oral Cancer Exam

    Medline Plus

    Full Text Available ... See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See ... this brochure includes information on symptoms, diagnosis, and treatment of oral cancer, along with definitions of selected ...

  7. Oral Cancer Exam

    Medline Plus

    Full Text Available ... and College Students Recent College Graduates Dental and Medical Students See All Careers & Training Opportunities Job Openings ... of oral cancer, along with definitions of selected medical terms and resource information. Oral Cancer A fact ...

  8. Oral Cancer Exam

    Medline Plus

    Full Text Available ... signs of oral cancer. For Patients and the Public Oral Cancer Pamphlet that ... any actual information. External Web Site Policy This graphic notice ( ) means that you are leaving ...

  9. Oral Cancer Exam

    Medline Plus

    Full Text Available ... the exam can detect oral cancer early—when it can be treated more successfully. Publications​ For Health ... and the importance of detecting the disease in its early stages. The Oral Cancer Exam Step-by- ...

  10. HAD Oral History Project

    Science.gov (United States)

    Holbrook, Jarita

    2014-01-01

    The Historical Astronomy Division is the recipient of an American Institute of Physics Neils Bohr Library Grant for Oral History. HAD has assembled a team of volunteers to conduct oral history interviews since May 2013. Each oral history interview varies in length between two and six hours. This presentation is an introduction to the HAD Oral History Project and the activities of the team during the first six months of the grant.

  11. Oral Steroids for Dermatitis.

    Science.gov (United States)

    Fisher, Andrew D; Clarke, Jesse; Williams, Timothy K

    2015-01-01

    Contact/allergic dermatitis is frequently treated inappropriately with lower-than-recommended doses or inadequate duration of treatment with oral and intramuscular glucocorticoids. This article highlights a case of dermatitis in a Ranger Assessment and Selection Program student who was improperly treated over 2 weeks with oral steroids after being bit by Cimex lectularius, commonly known as bed bugs. The article also highlights the pitfalls of improper oral steroid dosing and provides reasoning for longer-duration oral steroid treatment.

  12. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Contents NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See All Order Publications ...

  13. Oral Health and Aging

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Oral Health and Aging Oral Health and Aging Past Issues / Summer 2016 Table of ... years. He spoke with NIH MedlinePlus magazine about oral health issues common in older adults. What has been ...

  14. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Dental and Craniofacial Research (NIDCR) Improving the Nation's Oral Health National Institutes of Health Español Staff Directory A– ... Index Search Text size: Website Contents NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral ...

  15. Oral Health in Rural Communities

    Science.gov (United States)

    ... Guide Rural Health Topics & States Topics View more Oral Health in Rural Communities Adequate access to oral healthcare ... about oral health programs in my area? What oral health disparities are present in rural America? According to ...

  16. Therapeutic efficacy and effects of artemether-lumefantrine and artesunate-amodiaquine coformulated or copackaged on malaria-associated anemia in children with uncomplicated Plasmodium falciparum malaria in Southwest Nigeria.

    Science.gov (United States)

    Gbotosho, Grace O; Sowunmi, Akintunde; Okuboyejo, Titilope M; Happi, Christian T; Folarin, Onikepe A; Michael, Obaro S; Adewoye, Elsie O

    2011-05-01

    The therapeutic efficacy and effects of artemether-lumefantrine (AL) and artesunate-amodiaquine co-formulated (AAcf) or co-packaged (AAcp) on malaria-associated anemia (MAA) were evaluated in 285 children < 12 years of age with uncomplicated Plasmodium falciparum malaria randomized to receive one of the three drug combinations. Fever and parasite clearance times were similar in all treatment groups. Mean drug-attributable fall in hematocrit (DAFH), defined as difference between hematocrit values pre- and 3 d post-initiation of treatment, was low (< 4.5%) and rates of recovery from MAA were similar with all treatments. Mean areas under curve (AUCs) of the plot of deficit in hematocrit levels from 30% versus time in anemic children were similar in all groups. All regimens were well tolerated. AL, AAcf and AAcp cleared fever and parasitemia rapidly and had similar rates of resolution of MAA after treatment in malarious Nigerian children.

  17. Infant oral health and oral habits.

    Science.gov (United States)

    Nowak, A J; Warren, J J

    2000-10-01

    Many oral diseases and conditions, including dental caries (cavities) and malocclusions, have their origins early in life. Prudent anticipatory guidance by the medical and dental professions can help prevent many of the more common oral health problems. This article provides information on the rationale for early dental examination and instructions for pediatric and family practitioners in scheduling and conducting an early oral intervention appointment. In addition, feeding practices, non-nutritive sucking, mouth breathing, and bruxing are discussed, including their effects on orofacial growth and development.

  18. Oral steroid contraception.

    Science.gov (United States)

    Sech, Laura A; Mishell, Daniel R

    2015-11-01

    Oral steroid contraception is a popular method of family planning worldwide. Over the past several decades, this method of contraception has changed significantly by decreasing the estrogen dose, changing the progestin component, and reducing the hormone free interval. Despite the popularity of oral steroid contraception, there has been much criticism regarding the associated risks of venous thromboembolism and stroke. Despite these established, yet uncommon risks, oral steroid contraception has many important health benefits. This review highlights the available formulations of oral contraceptives along with their evidence-based associated risks and benefits. Highlights regarding future directions for development of novel oral contraceptives are also addressed.

  19. Application of an LC-MS/MS method for reliable determination of amodiaquine, N-desethylamodiaquine, artesunate and dihydroartemisinin in human plasma for a bioequivalence study in healthy Indian subjects.

    Science.gov (United States)

    Rathod, Dhiraj M; Patel, Keyur R; Mistri, Hiren N; Jangid, Arvind G; Shrivastav, Pranav S; Sanyal, Mallika

    2016-05-30

    A sensitive and high throughput bioanalytical method has been developed for reliable determination of amodiaquine (AQ), N-desethylamodiaquine (DEAQ), artesunate (AS) and dihydroartemisinin (DHA) in human plasma by LC-MS/MS. The method employs a solid phase extraction procedure without an evaporation step and with optimum use of organic solvents to circumvent degradation of artemisinin derivatives. The analytes and their deuterated internal standards (ISs) were analyzed on Hypersil Gold (100 mm × 4.6mm, 5 μm) column using acetonitrile and 2.0mM ammonium formate (pH 2.50) in 80:20 (v/v) ratio as the mobile phase. A triple quadrupole mass spectrometer equipped with an electrospray ionization interface was used to detect and quantify the analytes. The method was established over the concentration range of 0.250-30.0 ng/mL, 1.50-180 ng/mL, 2.00-600 ng/mL and 5.00-1400 ng/mL for AQ, DEAQ, AS and DHA respectively using 250 μL human plasma. The intra-day and inter-day accuracy and precision (% CV) across quality controls varied from 93.3-105.0% and 1.7-8.3 respectively for all the analytes. The stability was assessed in whole blood as well as in plasma samples under different conditions. All four analytes were stable in whole blood up to 2h on melting ice. The long term stability in plasma was ascertained up to 90 days. IS-normalized matrix factors ranged from 0.988-1.023 for all the analytes. The method was successfully applied to a bioequivalence study using 50mg artesunate and 135 mg amodiaquine fixed dose formulation in 14 healthy subjects.

  20. Supplementary dataset for child and adult exposure and health risk evaluation following the use of metal- and metalloid-containing costume cosmetics sold in the United States.

    Science.gov (United States)

    Perez, Angela L; Nembhard, Melanie; Monnot, Andrew; Bator, Daniel; Madonick, Elizabeth; Gaffney, Shannon H

    2017-08-01

    The data presented in this article are related to the research article entitled "Child and adult exposure and health risk evaluation following the use of metal- and metalloid-containing costume cosmetics sold in the United States" [1]. This article describes the concentration of metals and metalloids contained in various cosmetic products such as body paint, lipstick and eye shadow, the relative percent deviation of two analyses performed on the products and the physico-chemico properties of the metals and metalloids used in the SkinPerm model presented in the aforementioned article.

  1. Supplementary dataset for child and adult exposure and health risk evaluation following the use of metal- and metalloid-containing costume cosmetics sold in the United States

    Directory of Open Access Journals (Sweden)

    Angela L. Perez

    2017-08-01

    Full Text Available The data presented in this article are related to the research article entitled "Child and adult exposure and health risk evaluation following the use of metal- and metalloid-containing costume cosmetics sold in the United States" [1]. This article describes the concentration of metals and metalloids contained in various cosmetic products such as body paint, lipstick and eye shadow, the relative percent deviation of two analyses performed on the products and the physico-chemico properties of the metals and metalloids used in the SkinPerm model presented in the aforementioned article.

  2. Microbiological quality of cooked foods and drinks sold in higher educational institutions around Yala, Pattani, and Narathiwat Provinces, Southern Thailand

    Science.gov (United States)

    Dalee, Abdullah D.; Sali, Khosiya; Hayeeyusoh, Nurainee; Hayeewangoh, Zubaidah; Thadah, Amporn

    2017-08-01

    Quality of cooked foods and drinks water sold within the vicinity of higher institutions located in Yala, Pattani and Narathiwat provinces were randomly sampled and microbiologically evaluated. As to Thai National Food Safety Standard, various food menu and drinks were subjected to conventionally determining the bacterial index; Most Probable Number (MPN) of coliform and fecal coliform as well as the detection of indicator organisms; Escherichia coli, Staphylococcus aureus and Salmonella sp. As for bacterial index, results showed that curry-type likes PSU-stir-fried liver (7.5x106 CFU/g), and and the lowest was PSU-Koleh chicken Roast (1.72x103 CFU/g). The highest and lowest counts of soup-type items were observed in YPH-KaengSom soup (1.9x107 CFU/g), and PSU-Palo soup (0.4x103 CFU/g), respectively. Higher bacterial counts were also found in YPH-spicy stir-fried chicken (7.5 x 106 CFU/g), and YPH-squid salad (2.2x107 CFU/g). For drinks, bacterial count ranged 2.0 x 103 to 8.3 x 103 CFU/g, and NRU-iced grape juice having the highest bacterial count (2.0x106 CFU/g). Overall, foods not complying to the Thai National Food Safety Standard of 1 x 103 CFU/g from higher to lower were those of soup, stir-fried, salad, fried, and curry categories with as much as 4:17 (23.53%), 4:21 (19.05%), 2:11 (18.18%), 2:16 (12.5%) and 1:12 (8.33%), respectively. As for Coliform and fecal coliform, the highest (>1100 MPN/g) and the lowest (0.34 MPN/g),were not much found in all food categories with percentages of 23.53, 24.00, 13.79, 9.10, and 47.37 for curry (4:17), soup (6:15), stir-fried (4:29), fried (2:22), and salad (9:19), respectively. However, indicator organisms were not detected in almost all food samples except PSU-chicken yellowish curry, NRU-chicken TongYam soup, NRU-Long-tail tuna soup, NRU-KaengSom soup, YPE-watery soup, NRU-stir-fried liver, NRU-omelets, NRU-fried chicken, YPE-crispy fish salad, and NRU-salted eggs salad, which showed the presence of E. coli, but not

  3. Oral biopsy: Oral pathologist′s perspective

    Directory of Open Access Journals (Sweden)

    K L Kumaraswamy

    2012-01-01

    Full Text Available Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

  4. RASIONALISASI PENGGUNAAN OBAT SIMPTOMATIK DAN OBAT LAIN YANG DIBERIKAN BERSAMAAN DENGAN OBAT ARTESUNATE-AMODIAKUIN PADA SUBYEK MALARIA DI DELAPAN PUSKESMAS SENTINEL KALIMANTAN DAN SULAWESI

    Directory of Open Access Journals (Sweden)

    Ani Isnawati

    2012-07-01

    Full Text Available Background. Since 2004, Malaria Program in Indonesia has used Artemisinin Combination Therapy (ACT to replace the chloroquine resistance. The recommended ACT is Artesunate dan Amodiaquine (AAQ combination for uncomplicated falciparum malaria. To relieve side effects and clinical complaints of malaria , health workers usually gave  symptomatic and other drugs in addition to antimalarial drugs. Methods. The methodology implemented in this study was a cross-sectional study to evaluate symptomatic and other drugs given together with antimalarial (AAQ to uncomplicated malaria subjects (patients infected by falciparum, vivax and mixed (falciparum dan vivax plasmodium. Data were collected from case report form in 6 months (July to December 2010 from 8 (eight sentinels puskesmas (primary health centers in North Sulawesi, Central Sulawesi, West Kalimantan and East Kalimantan. Results. Total number of cases (89,4% were given symptomatic and other drugs in addition to antimalarial drugs. Symptomatic and other drugs that mostly given were antipyretic/analgesic (90.8% and vitamin-mineral (70%. There seemed to be over-use of vitamin-minerals since the indication to giving those medications were not quite clear. Antibiotics were mostly given to subjects with gastrointestinal complaints such as nausea, vomiting, and abdominal pain. The administration of antibiotic for non-bacterial infection were  irrational. Antihistamines were given to 94,3% subjects without cold and flu, and this cases also be defined as inappropriate use of medicine. In addition, antacids were also given to 12,5 %  subjects  without gastrointestinal complaints to anticipate side effects of antimalarial. AbstrakLatar belakang.Tahun 2004 Program Pemberantasan Malaria mulai menggunakan ACT menggantikan klorokuin yang telah resisten. ACT yang direkomendasikan adalah kombinasi Artesunat dan Amodiakuin (AAq, untuk malaria falsiparum tanpa komplikasi. Untuk mengatasi efek samping obat malaria

  5. A feasibility study of singlet oxygen explicit dosmietry (SOED) of PDT by intercomparison with a singlet oxygen luminescence dosimetry (SOLD) system

    Science.gov (United States)

    Kim, Michele M.; Penjweini, Rozhin; Gemmell, Nathan R.; Veilleux, Israel; McCarthy, Aongus; Buller, Gerald; Hadfield, Robert H.; Wilson, Brian C.; Zhu, Timothy C.

    2016-03-01

    An explicit dosimetry model has been developed to calculate the apparent reacted 1O2 concentration ([1O2]rx) in an in-vivo model. In the model, a macroscopic quantity, g, is introduced to account for oxygen perfusion to the medium during PDT. In this study, the SOED model is extended for PDT treatment in phantom conditions where vasculature is not present; the oxygen perfusion is achieved through the air-phantom interface instead. The solution of the SOED model is obtained by solving the coupled photochemical rate equations incorporating oxygen perfusion through the air-liquid interface. Experiments were performed for two photosensitizers (PS), Rose Bengal (RB) and Photofrin, in solution, using SOED and SOLD measurements to determine both the instantaneous [1O2] as well as cumulative [1O2]rx concentrations, where [1O2=(1/τ▵)•∫[1O2]dt. The PS concentrations varied between 10 and 100 mM for RB and ~200 mM for Photofrin. The resulting magnitudes of [1O2] were compared between SOED and SOLD.

  6. Radiation induced oral mucositis

    Directory of Open Access Journals (Sweden)

    P S Satheesh Kumar

    2009-01-01

    Full Text Available Patients receiving radiotherapy or chemotherapy will receive some degree of oral mucositis The incidence of oral mucositis was especially high in patients: (i With primary tumors in the oral cavity, oropharynx, or nasopharynx; (ii who also received concomitant chemotherapy; (iii who received a total dose over 5,000 cGy; and (iv who were treated with altered fractionation radiation schedules. Radiation-induced oral mucositis affects the quality of life of the patients and the family concerned. The present day management of oral mucositis is mostly palliative and or supportive care. The newer guidelines are suggesting Palifermin, which is the first active mucositis drug as well as Amifostine, for radiation protection and cryotherapy. The current management should focus more on palliative measures, such as pain management, nutritional support, and maintenance, of good oral hygiene

  7. Bimaxillary Oral Focal Mucinosis.

    Science.gov (United States)

    Yadav, Sunil; Malik, Sunita; Mittal, Hitesh Chander; Singh, Gurdarshan; Kamra, Hemlata

    2016-10-01

    Oral focal mucinosis is considered as oral counterpart of cutaneous focal mucinosis. The preoperative diagnosis of mucinosis is almost impossible because of its rarity and clinical similarity to other lesions of various etiologies. The histological diagnosis of oral mucinosis is important to better understand the etiopathogenesis, treatment modalities, and any recurrence of the lesion besides differentiating from the other soft tissue lesions.The purpose of this paper is to report the first case of bimaxillary involvement with dome-shaped elevated, rounded, asymptomatic, normally colored swelling in left posterior palatal mucosa and left mandibular posterior region in a 25-year old woman who was diagnosed as oral focal mucinosis histopathologically.

  8. Chrysomya Bezziana oral myiasis

    Directory of Open Access Journals (Sweden)

    G S Vijay Kumar

    2011-01-01

    Full Text Available Myiasis is an opportunistic infestation of human and vertebrate animals with dipterous larvae. Oral myiasis is a rare condition associated with poor oral hygiene, mental disability, halitosis and other conditions. We present a case report of an adult mentally challenged woman with extensive necrotic oral lesion burrowing into the hard palate through which three live maggots (larvae were seen emerging out. The larvae were removed using forceps and the patient was treated with oral ivermectin. The maggots were identified as larvae of the Chrysomya bezziana fly.

  9. Oral microbiota and cancer

    Directory of Open Access Journals (Sweden)

    Jukka H. Meurman

    2010-08-01

    Full Text Available Inflammation caused by infections may be the most important preventable cause of cancer in general. However, in the oral cavity the role of microbiota in carcinogenesis is not known. Microbial populations on mouth mucosa differ between healthy and malignant sites and certain oral bacterial species have been linked with malignancies but the evidence is still weak in this respect. Nevertheless, oral microorganisms inevitably up-regulate cytokines and other inflammatory mediators that affect the complex metabolic pathways and may thus be involved in carcinogenesis. Poor oral health associates statistically with prevalence of many types of cancer, such as pancreatic and gastrointestinal cancer. Furthermore, several oral micro-organisms are capable of converting alcohol to carcinogenic acetaldehyde which also may partly explain the known association between heavy drinking, smoking, poor oral health and the prevalence of oral and upper gastrointestinal cancer. A different problem is the cancer treatment-caused alterations in oral microbiota which may lead to the emergence of potential pathogens and subsequent other systemic health problems to the patients. Hence clinical guidelines and recommendations have been presented to control oral microbiota in patients with malignant disease, but also in this area the scientific evidence is weak. More controlled studies are needed for further conclusion.

  10. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Receipt Dates Electronic Submission of Applications Grants 101 (How to Write a Grant) ... Continuing Education Practical Oral Care for People With Developmental Disabilities – ...

  11. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Writing Tips Careers & Training Fellowships and Internships ... Oral Care for People With Developmental Disabilities – This booklet presents an overview of physical, mental, ...

  12. Towards understanding oral health.

    Science.gov (United States)

    Zaura, Egija; ten Cate, Jacob M

    2015-01-01

    During the last century, dental research has focused on unraveling the mechanisms behind various oral pathologies, while oral health was typically described as the mere absence of oral diseases. The term 'oral microbial homeostasis' is used to describe the capacity of the oral ecosystem to maintain microbial community stability in health. However, the oral ecosystem itself is not stable: throughout life an individual undergoes multiple physiological changes while progressing through infancy, childhood, adolescence, adulthood and old age. Recent discussions on the definition of general health have led to the proposal that health is the ability of the individual to adapt to physiological changes, a condition known as allostasis. In this paper the allostasis principle is applied to the oral ecosystem. The multidimensionality of the host factors contributing to allostasis in the oral cavity is illustrated with an example on changes occurring in puberty. The complex phenomenon of oral health and the processes that prevent the ecosystem from collapsing during allostatic changes in the entire body are far from being understood. As yet individual components (e.g. hard tissues, microbiome, saliva, host response) have been investigated, while only by consolidating these and assessing their multidimensional interactions should we be able to obtain a comprehensive understanding of the ecosystem, which in turn could serve to develop rational schemes to maintain health. Adapting such a 'system approach' comes with major practical challenges for the entire research field and will require vast resources and large-scale multidisciplinary collaborations.

  13. Impact of rosiglitazone safety alerts on oral antidiabetic sales trends: a countrywide study in Portugal.

    Science.gov (United States)

    Herdeiro, Maria T; Soares, Sara; Silva, Tânia; Roque, Fátima; Figueiras, Adolfo

    2016-10-01

    Pharmacovigilance systems are important to monitor the safety of on-market drugs after approval. The aim of this study was to assess the impact of rosiglitazone safety alerts on trends in the sale of rosiglitazone and other oral antidiabetic drugs. An ecological study was conducted, using temporally aggregated data and linking safety alerts to countrywide sales of all oral antidiabetic drugs in Portugal from January 2002 to December 2012. Sales figures for oral antidiabetic drugs marketed in Portugal were supplied by IMS Health Portugal with a breakdown by active substance and fixed combinations. The number of defined daily doses per 1000 inhabitants per day (DIDs) of each oral antidiabetic drug sold to the estimated diabetic population using oral antidiabetic drugs in Portugal was calculated. Particular attention was paid to the case of rosiglitazone, with the results being adjusted for changes in rosiglitazone reimbursement policies. A total of four safety alerts were issued about rosiglitazone. Rosiglitazone sales registered an increase of 32.9% (0.202 DIDs; P sales fell. Following the January 2006 and January 2008 safety alerts, rosiglitazone sales described a long-term downward trend, with decreases of 3.75% (-0023 DIDs; P > 0.05) and 0.24% (-0.001 DIDs; P > 0.05), respectively. It is important to promote the dissemination and publication of drug safety alerts. © 2016 Société Française de Pharmacologie et de Thérapeutique.

  14. Sarcoidosis: Oral and extra-oral manifestation

    Directory of Open Access Journals (Sweden)

    Sanjay Gupta

    2015-01-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disease, which is usually associated with the formation of noncaseating granulomas in affected tissues and organs. It is mostly present with bilateral hilar lymphadenopathy, pulmonary infiltration, ocular, and cutaneous lesions. Oral manifestations of this disease are relatively rare. The present case report shows a 40-year-old male with lesions in the soft tissue of oral cavity (buccal mucosa, gingiva, and palate and a diagnosis of sarcoidosis was established following hematological, biochemical and pulmonary function tests, chest radiograph, and histopathological investigation.

  15. Artesunate united Primaquine in the treatment of delay or reconnection malaria SUN%青蒿琥酯联用伯氨喹治疗迁延、复燃疟疾的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙卫华; Afel TRAORE

    2011-01-01

    AIM: To approach the clinical therapeutic effects of artesunate united Primaquine in the treatment of delay or recrudescence malaria.METHODS: 82 patients were randomly divided into two groups.Patients of the treatment group(n=41)were given an initial dose of 2.4 mg/kg artesunate i.v., 12 h later,a second dose of 1.2 mg/kg artesunate was given in the same way.For the succeeding 6 days,a daily dose of 1.2 mg/kg artesunate was given in the same manner to each patient in the treatment group;and each of the patients were given Primaquine tables 22.5 mg/d, p.o..The control group(n=41)were given an initial dose of 20 mg of quinimax i.v.,12 h later,a second dose of 10 mg/kg quinimax was given in the same way.Thereafter,10 mg/kg of quinimax was given q.12.h.In the same manner until the patients could take medicines by mouth.Quinimax tablets in a dose of 10 mg/kg were then given q.8.h.The course of treatment was 7 d.RESULTS: After 7 and 28 d,the cure rates in the treatment and control group were 97.5%, 95.1% ;97.5%,90.2% ,respectively.The changes in the treatment and control group were similar(P>0.05).The defervescence time was 28.0 and 51.6 h, and the clearing time of haemoplasmodium was 30.4 and 59.5 h in the treatment and control group, respectively;the differences was significant (P<0.01).CONCLUSION: Artesunate united Primaquine was found to act more quickly in the treatment of pernicious delay or recrudescence malaria, low recurrence rate, with only mild side effects.It is also effective in the treatment of malaria caused by quinine-resistant strains of malaria parasites.It should be the drug of first choice in the treatment of malaria that quinine fails to effect a cure.%目的:探讨青蒿琥酯联用伯氨喹治疗迁延、复燃疟疾的临床疗效.方法:将82例患者随机分成治疗组和对照组各41例.治疗组:给予青蒿琥酯和伯氨喹:青蒿琥酯首剂2.4 mg/kg i.v.,12h后予1.2 mg/kg青蒿琥酯,随后6d每日以1.2 mg/kg青蒿琥酯

  16. Shared Oral Care

    DEFF Research Database (Denmark)

    Hede, Børge; Elmelund Poulsen,, Johan; Christophersen, Rasmus

    2014-01-01

    Shared Oral Care - Forebyggelse af orale sygdomme på plejecentre Introduktion og formål: Mangelfuld mundhygiejne hos plejekrævende ældre er et alment og veldokumenteret sundhedsproblem, der kan føre til massiv udvikling af tandsygdomme, og som yderligere kan være medvirkende årsag til alvorlige...

  17. Visual overview, oral detail

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2015-01-01

    and with the coordinating nurse, who is the main keeper of the whiteboard. On the basis of observations, we find that coordination is accomplished through a highly intertwined process of technologically mediated visual overview combined with orally communicated details. The oral details serve to clarify and elaborate...

  18. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See ... this brochure includes information on symptoms, diagnosis, and treatment of oral cancer, along with definitions of selected medical terms and ...

  19. Oral Microbiology and Immunology

    DEFF Research Database (Denmark)

    Dahlén, Gunnar; Fiehn, Nils-Erik; Olsen, Ingar

    , dental assistants and trainees may find it a useful source of reference. The contents are based on general microbiology and immunology. Oral microbiology is given particular attention, with examples relevant to oral infectious diseases. Each chapter opens with a relatively short pre-reading section...

  20. Epilepsy and oral care.

    Science.gov (United States)

    Fiske, Janice; Boyle, Carole

    2002-05-01

    Epilepsy is a common symptom of an underlying neurological disorder. The seizures can take a variety of forms. Both the condition and its medical management can affect oral health. Prevention of oral disease and carefully planned dental treatment are essential to the well-being of people with epilepsy.

  1. Oral environment and cancer.

    Science.gov (United States)

    Kudo, Yasusei; Tada, Hidesuke; Fujiwara, Natsumi; Tada, Yoshiko; Tsunematsu, Takaaki; Miyake, Yoichiro; Ishimaru, Naozumi

    2016-01-01

    Cancer is now the leading cause of death in Japan. A rapid increase in cancer mortality is expected as Japan is facing a super-aged society. Many causes of cancer are known to be closely linked to life style factors, such as smoking, drinking, and diet. The oral environment is known to be involved in the pathogenesis and development of various diseases such as bronchitis, pneumonia, diabetes, heart disease, and dementia. Because the oral cavity acts as the bodily entrance for air and food, it is constantly exposed to foreign substances, including bacteria and viruses. A large number of bacteria are endemic to the oral cavity, and indigenous oral flora act to prevent the settlement of foreign bacteria. The oral environment is influenced by local factors, including dental plaque, tartar, teeth alignment, occlusion, an incompatible prosthesis, and bad lifestyle habits, and systemic factors, including smoking, consumption of alcohol, irregular lifestyle and eating habits, obesity, stress, hormones, and heredity. It has recently been revealed that the oral environment is associated with cancer. In particular, commensal bacteria in the oral cavity are involved in the development of cancer. Moreover, Candida, human papilloma virus and Epstein-Barr virus as well as commensal bacteria have been reported to be associated with the pathogenesis of cancer. In this review, we introduce recent findings of the correlation between the oral environment and cancer.

  2. Genomics of oral bacteria.

    Science.gov (United States)

    Duncan, Margaret J

    2003-01-01

    Advances in bacterial genetics came with the discovery of the genetic code, followed by the development of recombinant DNA technologies. Now the field is undergoing a new revolution because of investigators' ability to sequence and assemble complete bacterial genomes. Over 200 genome projects have been completed or are in progress, and the oral microbiology research community has benefited through projects for oral bacteria and their non-oral-pathogen relatives. This review describes features of several oral bacterial genomes, and emphasizes the themes of species relationships, comparative genomics, and lateral gene transfer. Genomics is having a broad impact on basic research in microbial pathogenesis, and will lead to new approaches in clinical research and therapeutics. The oral microbiota is a unique community especially suited for new challenges to sequence the metagenomes of microbial consortia, and the genomes of uncultivable bacteria.

  3. Oral syringe use survey.

    Science.gov (United States)

    Baldwin, J N; Wedemeyer, H F

    1980-09-01

    Use of oral syringes at children's and ASHP-accredited residency hospitals in the United States was surveyed. Questionnaires were mailed to 131 hospitals; 117 (89.3%) were returned. Of the responding hospitals, 54.5% of children's hospitals and 67.1% of residency hospitals used oral syringes. There was no definite preference for a particular brand or type (glass vs. plastic) of syringe. Patients who often required liquid dosage forms, including pediatric and geriatric patients and patients with nasogastric tubes, were most frequently included in oral syringe distribution systems. Twenty-six of the 73 hospitals utilizing oral syringes used them for most unit dose liquids in all drug distribution systems. The remainder reported use for specific medications or circumstances. Expiration dating policies varied from 24 hours to one year to the manufacturer's expiration dating. The survey indicates widespread use of oral syringes and identifies a need for evaluation of medication stability in these devices.

  4. [Oral fluid bacteriocidal activity in complex diagnostics of oral disbiosis].

    Science.gov (United States)

    Rabinovich, O F; Abramova, E S

    2012-01-01

    The possibility of examination of oral fluid bacteriocidal activity in complex diagnostics of oral mucosa disbiosis was evaluated. Thirty-seven patients were included in complex clinical and laboratory studies. The patients were divided in two groups: main group (30 patients exhibiting various grades of oral mucosa disbiosis) and control group (7 patients with no signs of oral disbiosis). The oral fluid bacteriocidal activity was examined by means of laser flow cytometry. Study results proved oral fluid bacteriocidal activity increase to correlate with the grade of oral mucosa disbiosis thus confirming the usefulness of the method in complex diagnostics of oral disbiosis.

  5. American Academy of Oral Medicine

    Science.gov (United States)

    ... Statements Newsletters AAOM: Representing the Discipline of Oral Medicine Oral Medicine is the discipline of dentistry concerned with the ... offers credentialing, resources and professional community for oral medicine practitioners. Our membership provides care to thousands. We ...

  6. Literatura Oral Hispanica (Hispanic Oral Literature).

    Science.gov (United States)

    McAlpine, Dave

    As part of a class in Hispanic Oral Literature, students collected pieces of folklore from various Hispanic residents in the region known as "Siouxland" in Iowa. Consisting of some of the folklore recorded from the residents, this paper includes 18 "cuentos y leyendas" (tales and legends), 48 "refranes" (proverbs), 17…

  7. Effects of narasin (Skycis) on live performance and carcass traits of finishing pigs sold in a three-phase marketing system.

    Science.gov (United States)

    Arkfeld, E K; Carr, S N; Rincker, P J; Gruber, S L; Allee, G L; Dilger, A C; Boler, D D

    2015-10-01

    The objective was to evaluate the effect of feeding narasin (Skycis; Elanco Animal Health, Greenfield, IN) on growth performance and carcass characteristics of finishing pigs sold in a 3-phase marketing system. Pigs ( = 1,232) were housed in 56 single-sex pens (22 pigs/pen) divided into 2 even blocks based on initiation of treatment. Each treatment × sex combination was replicated 14 times. Pigs were fed either 0 mg/kg narasin (control) or 15 mg/kg narasin for up to 85 d of finishing (initiated at an average of 52.95 kg BW). In each pen, 18% (4 pigs per pen) of pigs were sold in the first marketing group (Day 64 of dietary treatment), 50% (11 of the original 22) were sold in the second marketing group (Day 78), and 32% (the remaining 7 pigs) were sold in the third marketing group (Day 85). Data were analyzed as a randomized complete block design with pen as the experimental unit. The model included the fixed effects of diet, sex, and their interaction. Block and replicate nested within block were random variables. Carcass data from pigs in marketing group 3 of block 2 was not collected due to inclement weather. Narasin had no effect on growth performance traits ( ≥ 0.15) in phases 1 (Days 1-28) or 2 (Days 29-56), regardless of sex. Barrows fed narasin had a 2.0% greater overall (Day 0-85) ADG than barrows fed the control diet ( < 0.01), but ADG of gilts was not different due to diet ( = 0.69). Regardless of sex, narasin improved ( = 0.03) feed efficiency (G:F) by 1.3% throughout the 85-d feeding period. There were no effects ( ≥ 0.21) of narasin on carcass composition in marketing groups 1 and 2. Narasin-fed barrows in marketing group 3 had 0.9 percentage units lower ( < 0.01) estimated carcass lean compared with barrows fed control diets (51.0 vs. 52.0%); no difference existed in gilts ( = 0.21). This is likely due to narasin-fed barrows of marketing group 3 tending ( = 0.06) to have 7.7% greater fat depth than control barrows of marketing group 3. Pooled

  8. Presence Of Multi Drug Resistant Coliform Bacteria Isolated From Biofilm Of Sachet And Borehole Waters Sold In Abakaliki Metropolis Ebonyi State Nigeria.

    Directory of Open Access Journals (Sweden)

    Okafor Collins Onyebuchi Okeke

    2015-06-01

    Full Text Available ABSTRACT This study investigated the presence of multi drug resistant coliform bacteria from biofilm of sachet and borehole waters sold in Abakaliki metropolis in Ebonyi State Nigeria. Five hundred 500 samples of water comprising 250 each from selected brand of sachet water retailers and borehole water dispensers from seven locations were sampled for the detection of coliform bacteria from biofilm and to determine their antimicrobial susceptibility using commercially prepared antibiotic discs. Results revealed a high faecal contamination level in sachet waters as Gospel 36 72 Aqua Rapha 30 60 and Bejoy 18 36 were the highest among the sachet water brands examined with Nene and Rock Tama sachet water brands having the lowest contamination level of 612 and 1326 respectively. Borehole samples results revealed that Aboffia had 27 76.93 samples contaminated with faecal bacteria while Azugwu 11 28.5 Azuiyiokwu 18 50 Azuiyiudene 2980 Kpirikpiri 24 66.63 PrescoNtezi 1646.15 and Udensi 22 61.54. Escherichia coli Enterobacter spp and Klebsiella spp were the major contaminants of both sachet and borehole water samples. The bacteria isolates from biofilm of sachet and borehole waters were susceptible to only three of the antibiotics used namely nitrofurantoin amoxycilin and ampicillin. The bacteria were completely resistant to ciprofloxacin tetracycline norbactinnorfloxacin ofloxacin cefuroxime and gentamicin. This showed that they exhibit multi-drug resistance pattern which is a common feature of medically important biofilm bacteria. We therefore report the presence of multi-drug resistant coliform bacteria from biofilm of sachet and borehole waters sold in Abakaliki metropolis Ebonyi State Nigeria.

  9. A comparative survey of the prevalence of human parasites found in fresh vegetables sold in supermarkets and open-aired markets in Accra, Ghana.

    Science.gov (United States)

    Duedu, Kwabena O; Yarnie, Elizabeth A; Tetteh-Quarcoo, Patience B; Attah, Simon K; Donkor, Eric S; Ayeh-Kumi, Patrick F

    2014-11-25

    Consuming raw vegetables offers essential nutrients that one may not get when such vegetables are usually cooked. However, eating them raw may pose a great risk for transmissions of pathogens. Such risks may be influenced by the sources of the vegetables and washing techniques used. The aim of the study was to compare the prevalence and diversity of parasitic pathogens associated with vegetables sold at the two types of markets in Ghana and compare effectiveness of various washing techniques. We purchased two batches of samples of cabbage, sweet bell pepper, carrot, lettuce, tomato and onion within a two week interval. The vegetables were washed by three methods and the wash solution was concentrated and analyzed for parasites. The prevalent parasites detected were Strongyloides stercoralis larvae (43%) and Cryptosporidium parvum oocyst (16%). Others present were Hookworm ova, Entamoeba histolytica cysts, Giardia lamblia cysts, Cyclospora cayetanensis oocysts, Entamoeba coli cysts, Trichuris trichiuria ova, Enterobius vermicularis ova, Isospora belli oocysts and Fasciolopsis buski ova. Contamination was highest in lettuce (61%) and cabbage and the least contaminated was tomato (18%). Contamination of vegetables sold at the open-aired markets was about ten-times that of the supermarkets. In Ghana, the large open-aired markets are the most patronized and serve as a supply point for most corner shops and stalls. The results thus highlight the potential of fresh vegetables serving as a major source of food-borne disease outbreaks and the contribution of open-aired markets to their transmission. Urgent public education on handling of fresh vegetables is recommended.

  10. The Correlation between Eating Utensils and Place of Sales in the Contamination of Escherichia coli in Food Sold at Campus Food Stalls

    Directory of Open Access Journals (Sweden)

    Dewi Susanna

    2015-04-01

    Full Text Available Up to now, in general, the safety of food that is sold at any canteens in the campuses, the eating utensils are handled and the food stalls are managed are still uncertain. This research was aimed to understand the correlation between the eating utensils handling and the contamination of Escherichia coli (E. coli in the food sold by the food vendors in the campus. The cross-sectional design research applied on the food stalls in the university campus in Depok with a total number of 173 consumers as respondents. The variables observed as independent variables were the sanitation of the eating utensils and the sanitation of the dining place. The examination method of the Most Probable Number (MPN for E. coli was conducted to assess the food’s hygiene. The data analyzed using the chi-square test and followed by the logistic regression. The result showed that more than half of the food samples (59.54% were contaminated by E. coli. The storage place of the eating utensils was most significantly correlated with the E. coli contamination of the served food with an OR=0.45 (0.21-0.87. Therefore, it is necessary to promote the awareness of this risk and reinforce supervision by the Health Authorities and by the management of the place of sales to provide guidance to the food vendors and to the consumers as well. Further research is recommended to observe the E. coli contamination through clean water, eating utensils, the hands of the consumers and the napkins used to wipe dry the eating utensils.

  11. Examining the association between oral health and oral HPV infection.

    Science.gov (United States)

    Bui, Thanh Cong; Markham, Christine M; Ross, Michael Wallis; Mullen, Patricia Dolan

    2013-09-01

    Oral human papillomavirus (HPV) infection is the cause of 40% to 80% of oropharyngeal cancers; yet, no published study has examined the role of oral health in oral HPV infection, either independently or in conjunction with other risk factors. This study examined the relation between oral health and oral HPV infection and the interactive effects of oral health, smoking, and oral sex on oral HPV infection. Our analyses comprised 3,439 participants ages 30 to 69 years for whom data on oral HPV and oral health were available from the nationally representative 2009-2010 National Health and Nutrition Examination Survey. Results showed that higher unadjusted prevalence of oral HPV infection was associated with four measures of oral health, including self-rated oral health as poor-to-fair [prevalence ratio (PR) = 1.56; 95% confidence interval (CI), 1.25-1.95], indicated the possibility of gum disease (PR = 1.51; 95% CI, 1.13-2.01), reported use of mouthwash to treat dental problems in the past week (PR = 1.28; 95% CI, 1.07-1.52), and higher number of teeth lost (Ptrend = 0.035). In multivariable logistic regression models, oral HPV infection had a statistically significant association with self-rated overall oral health (OR = 1.55; 95% CI, 1.15-2.09), independent of smoking and oral sex. In conclusion, poor oral health was an independent risk factor of oral HPV infection, irrespective of smoking and oral sex practices. Public health interventions may aim to promote oral hygiene and oral health as an additional measure to prevent HPV-related oral cancers.

  12. Oral health and nutrition.

    Science.gov (United States)

    Pla, G W

    1994-03-01

    The relationships between oral health conditions, dietary practices and nutritional status, and general health status in the older American are complex, with many interrelating factors. Just as inadequate nutrition can affect oral health, poor oral health status affects food choices and, thus, nutritional status. It is clearly essential that the primary care practitioner and/or screening health professionals always include an evaluation of oral status in assessment of an elderly person. Effective care for the elderly dental patient requires knowledge about the disease of aging and the impact of those diseases on oral health and nutrition, pharmacology and drug interactions and their impact on oral health status, the biology of aging including sensory changes, the relationship of general medicine and systemic diseases, and psychology and sociology. The attitudes of empathy and understanding, caring and compassion, respect and a positive attitude toward the older patient, and flexibility in treatment planning are also critical elements. The interdisciplinary team of physicians, nurses, nutrition professionals, dentists, and social service professionals must all work together to ensure that good oral health status and adequate nutrition are maintained in older Americans. Recognizing and treating oral health and nutrition problems are important in improving the health and quality of life for the elderly population. Research that can provide more answers to health care problems in this growing group; educating professionals with respect to the relationships between oral health and nutrition; and public policy changes with regard to provision and funding of nutrition services, especially when provided by registered and/or licensed nutrition professionals, contribute to improving the health and quality of life for elders.

  13. Etiology of oral habits.

    Science.gov (United States)

    Bayardo, R E; Mejia, J J; Orozco, S; Montoya, K

    1996-01-01

    The pedodontic admission histories of 1600 Mexican children were analyzed, to determine general epidemiologic factors or oral habits, as well as their relationship with identifiable biopsychosociologic factors. Fifty-six percent of the children gave evidence of an oral habit, with significant predisposition among female patients, single children, subjects in poor physical health (particularly from allergies), as well as children with histories of chronic health problems. Oral habits should be considered a major health hazard because of their high incidence. Successful treatment requires a multidisciplinary approach to the basic cause of the problem.

  14. Microbioma oral humano

    OpenAIRE

    Silva, Joana Pinto Oliveira e

    2016-01-01

    O microbioma oral humano é constituído por um vasto conjunto de microrganismos presentes na cavidade oral. Analisando a cavidade oral podemos verificar que nela existem mais de 700 espécies de bactérias responsáveis pelo domínio de parte do microbioma humano, tornando-a um importante local de estudo. É um dos habitats com maior diversidade no corpo humano onde esses microrganismos se apresentam de forma organizada e estruturada. Estes habitats estão intimamente relacionados ...

  15. Amiloidosis oral nodular Oral nodular amyloidosis

    Directory of Open Access Journals (Sweden)

    P. Martos Díaz

    2008-02-01

    Full Text Available Introducción. La amiloidosis constituye una entidad marcada por el depósito de amiloide en diferentes tejidos. En la cavidad oral se manifiesta habitualmente en forma de macroglosia, y más raramente, como nódulos dispuestos en la superficie. Caso clínico. Varón afecto de Mieloma Múltiple, que comienza con lesiones nodulares en labio inferior y lengua. A raíz de estas lesiones, mediante estudio histológico, es diagnosticado de Amiloidosis Sistémica. Discusión. Los nódulos amiloideos en la cavidad oral, constituyen una manifestación rara de la amiloidosis sistémica. Su aparición conlleva la necesidad de realizar un diagnostico diferencial con otras entidades y el diagnostico de certeza se obtiene mediante el análisis histológico.Introduction. Amyloidosis is a condition characterized by the deposit of amyloid in different tissues. In the oral cavity it is usually manifested as macroglossia and, more rarely, as nodules on the surface. Clinical case. A man had multiple myeloma that began with nodular lesions of the lower lip and tongue. As a result of these lesions, the patient was diagnosed of systemic amyloidosis by histological study. Discussion. Amyloid nodules in the oral cavity are a rare manifestation of systemic amyloidosis. Its appearance entails the necessity to make I diagnose differential with other organizations and I diagnose of certainty is obtained by means of the histological analysis.

  16. Oral sex and oral health: An enigma in itself

    Directory of Open Access Journals (Sweden)

    Tarun Kumar

    2015-01-01

    Full Text Available Oral sex is commonly practiced by sexually active couples of various age groups, including male-female and same-gender adolescents. The various type of oral sex practices are fellatio, cunnilingus, and analingus. Oral sex can transmit oral, respiratory, and genital infections from one site in body to the other. Oral health has a direct correlation on the transmission of infection; a cut in the mouth, bleeding gums, lip sores or broken skin increases chances of life-threatening infections. Although oral sex is considered a low risk activity, it is important to use protection such as physical barriers, health and medical issues, ethical issues, and oral hygiene and dental issues. The ulcerations or unhealthy periodontium in mouth accelerates the phenomenon of transmission of infections into the circulation. Thus, consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.

  17. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Z Index Search Text size: Website Contents NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ ... site’s privacy policy when you follow the link. Home Contact Us Viewers and Players Site Map FOIA ...

  18. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/AIDS See All Order Publications English and Spanish brochures available free ...

  19. Oral Cancer Exam

    Medline Plus

    Full Text Available ... it can be treated more successfully. Publications​ For Health Professionals Detecting Oral Cancer: A Guide for Health Care Professionals A step-by-step, illustrated guide ...

  20. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Submission of Applications Grants 101 (How to Write a Grant) Questions and Answers Grant Writing Tips Careers & ... successfully. Publications​ For Health Professionals Detecting Oral Cancer: A Guide for Health Care Professionals A step-by- ...

  1. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Research Programs (Extramural Research) NIDCR Laboratories (Intramural Research) Science News in Brief Study Takes First Comprehensive Look ... Programs Careers in Dental Research See All Continuing Education Practical Oral Care for People With Developmental Disabilities – ...

  2. Oral Hypersensitivity Reactions

    Science.gov (United States)

    ... food, food additives, drugs, oral hygiene products, and dental materials. Q: Are there any specific foods that are ... dental treatment trigger a hypersensitivity reaction? A: Some dental materials used by the dentist can cause a hypersensitivity ...

  3. Oral Cancer Exam

    Medline Plus

    Full Text Available ... In Skip to Main Content National Institute of Dental and Craniofacial Research (NIDCR) Improving the Nation's Oral ... High School and College Students Recent College Graduates Dental and Medical Students See All Careers & Training Opportunities ...

  4. Oral Cancer Exam

    Medline Plus

    Full Text Available ... it can be treated more successfully. Publications​ For Health Professionals Detecting Oral Cancer: A Guide for Health Care Professionals A step-by-step, illustrated guide ...

  5. Leucoplasia oral: Conceptos actuales

    Directory of Open Access Journals (Sweden)

    M. Escribano-Bermejo

    Full Text Available La leucoplasia es la lesión premaligna más frecuente de la cavidad oral. La Organización Mundial de la Salud la define clínicamente como una lesión predominantemente blanca de la mucosa oral que no puede caracterizarse como ninguna otra lesión conocida y con una elevada tendencia a convertirse en un cáncer oral. El objetivo de esta revisión es hacer un repaso al conocimiento actual acerca de la leucoplasia oral prestando especial atención a su nomenclatura, su etiología, su potencial maligno y su tratamiento.

  6. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Main Content National Institute of Dental and Craniofacial Research (NIDCR) Improving the Nation's Oral Health National Institutes ... Browse Studies by Topic NIDCR-Sponsored Clinical Trials Research NIDCR Strategic Plan Research Results Tools for Researchers ...

  7. Oral Cancer Exam

    Medline Plus

    Full Text Available ... and Medical Students See All Careers & Training Opportunities Job Openings Loan Repayment Programs Careers in Dental Research See All Continuing Education Practical Oral Care for People With Developmental Disabilities – ...

  8. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Diabetes Heart Disease HIV/AIDS See All Order Publications English and Spanish brochures available free of charge. ... early—when it can be treated more successfully. Publications​ For Health Professionals Detecting Oral Cancer: A Guide ...

  9. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Submission of Applications Grants 101 (How to Write a Grant) Questions and Answers Grant Writing Tips Careers & ... successfully. Publications​ For Health Professionals Detecting Oral Cancer: A Guide for Health Care Professionals A step-by- ...

  10. Fostering oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2016-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs bet

  11. Oral Cancer Facts

    Science.gov (United States)

    ... shown to participate in their development. These include lichen planus, an inflammatory disease of the oral soft ... at an uncontrolled rate, is unable to repair DNA damage within itself, or refuses to self destruct ...

  12. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Answers Grant Writing Tips Careers & Training Fellowships and Internships for... High School and College Students Recent College ... signs and symptoms of oral cancer, and the importance of detecting the disease in its early stages. ...

  13. Oral Cancer Exam

    Science.gov (United States)

    ... Answers Grant Writing Tips Careers & Training Fellowships and Internships for... High School and College Students Recent College ... signs and symptoms of oral cancer, and the importance of detecting the disease in its early stages. ...

  14. Probiotics and oral health

    OpenAIRE

    Rastogi, Pavitra; Saini, Himani; Dixit, Jaya; Singhal, Rameshwari

    2011-01-01

    Probiotics utilize the naturally occurring bacteria to confer health benefits. Traditionally, probiotics have been associated with gut health, and are being mainly utilized for prevention or treatment of gastrointestinal infections and disease; however, recently, several studies have suggested the use of probiotics for oral health purposes. The aim of this review is to understand the potential mechanism of action of probiotic bacteria in the oral cavity and summarize their observed effects wi...

  15. Oral Somatosensory Awareness

    OpenAIRE

    De Boer, L. L.

    2014-01-01

    Oral somatosensory awareness refers to the somatic sensations arising within the mouth, and to the information these sensations provide about the state and structure of the mouth itself, and objects in the mouth. Because the oral tissues have a strong somatosensory innervation, they are the locus of some of our most intense and vivid bodily experiences. The salient pain of toothache, or the habit of running one's tongue over one's teeth when someone mentions "dentist", provide two very differ...

  16. Oral and esophageal disorders.

    Science.gov (United States)

    Noyer, C M; Simon, D

    1997-06-01

    This article focused on the approach to oral and esophageal disorders in patients with AIDS. Most of these disorders respond to various therapeutic regimens. Some of the oral complications can be prevented with dental prophylaxis, whereas recurrent esophageal disease in some patients may require long-term suppressive therapy. As patients with AIDS live longer with lower CD4 counts, gastroenterologists need to become familiar with the approach to and management of the more common lesions of the mouth and esophagus.

  17. Oral pigmentation: A review.

    Science.gov (United States)

    Sreeja, C; Ramakrishnan, K; Vijayalakshmi, D; Devi, M; Aesha, I; Vijayabanu, B

    2015-08-01

    Pigmentations are commonly found in the mouth. They represent in various clinical patterns that can range from just physiologic changes to oral manifestations of systemic diseases and malignancies. Color changes in the oral mucosa can be attributed to the deposition of either endogenous or exogenous pigments as a result of various mucosal diseases. The various pigmentations can be in the form of blue/purple vascular lesions, brown melanotic lesions, brown heme-associated lesions, gray/black pigmentations.

  18. ON ORAL CANCER

    Directory of Open Access Journals (Sweden)

    P. V. Svetitsky

    2012-01-01

    Full Text Available The paper analyzes a rise in the incidence of oral cancer in the Rostov Region since the 1990s. The study has indicated that this rise is associated with regional population growth due to the forced migrants after the collapse of the USSR. Financial problems, unbalanced nutrition, poor oral hygiene, and depression in this group of patients have contributed to the higher incidence of precancers and cancers.

  19. Maintaining women's oral health.

    Science.gov (United States)

    McCann, A L; Bonci, L

    2001-07-01

    Women must adopt health-promoting strategies for both general health and the oral cavity, because the health of a woman's body and oral cavity are bidirectional. For general health-maintenance strategies, dental practitioners should actively advise women to minimize alcohol use, abstain from or cease smoking, stay physically active, and choose the right foods to nourish both the body and mind. For oral health-maintenance strategies, dental practitioners should advise women on how to prevent or control oral infections, particularly dental caries and periodontal diseases. Specifically, women need to know how to remove plaque from the teeth mechanically, use appropriate chemotherapeutic agents and dentifrices, use oral irrigation, and control halitosis. Dental practitioners also need to stress the importance of regular maintenance visits for disease prevention. Adolescent women are more prone to gingivitis and aphthous ulcers when they begin their menstrual cycles and need advice about cessation of tobacco use, mouth protection during athletic activities, cleaning orthodontic appliances, developing good dietary habits, and avoiding eating disorders. Women in early to middle adulthood may be pregnant or using oral contraceptives with concomitant changes in oral tissues. Dental practitioners need to advise them how to take care of the oral cavity during these changes and how to promote the health of their infants, including good nutrition. Older women experience the onset of menopause and increased vulnerability to osteoporosis. They may also experience xerostomia and burning mouth syndrome. Dental practitioners need to help women alleviate these symptoms and encourage them to continue good infection control and diet practices.

  20. Oral vs. salivary diagnostics

    Science.gov (United States)

    Marques, Joana; Corby, Patricia M.; Barber, Cheryl A.; Abrams, William R.; Malamud, Daniel

    2015-05-01

    The field of "salivary diagnostics" includes studies utilizing samples obtained from a variety of sources within the oral cavity. These samples include; whole unstimulated saliva, stimulated whole saliva, duct saliva collected directly from the parotid, submandibular/sublingual glands or minor salivary glands, swabs of the buccal mucosa, tongue or tonsils, and gingival crevicular fluid. Many publications state "we collected saliva from subjects" without fully describing the process or source of the oral fluid. Factors that need to be documented in any study include the time of day of the collection, the method used to stimulate and collect the fluid, and how much fluid is being collected and for how long. The handling of the oral fluid during and post-collection is also critical and may include addition of protease or nuclease inhibitors, centrifugation, and cold or frozen storage prior to assay. In an effort to create a standard protocol for determining a biomarker's origin we carried out a pilot study collecting oral fluid from 5 different sites in the mouth and monitoring the concentrations of pro- and anti-inflammatory cytokines detected using MesoScaleDiscovery (MSD) electrochemiluminesence assays. Our data suggested that 3 of the cytokines are primarily derived from the submandibular gland, while 7 of the cytokines come from a source other than the major salivary glands such as the minor salivary glands or cells in the oral mucosae. Here we review the literature on monitoring biomarkers in oral samples and stress the need for determining the blood/saliva ratio when a quantitative determination is needed and suggest that the term oral diagnostic be used if the source of an analyte in the oral cavity is unknown.

  1. Oral and systemic photoprotection.

    Science.gov (United States)

    Chen, Andrew C; Damian, Diona L; Halliday, Gary M

    2014-01-01

    Photoprotection can be provided not only by ultraviolet (UV) blockers but also by oral substances. Epidemiologically identified associations between foods and skin cancer and interventional experiments have discovered mechanisms of UV skin damage. These approaches have identified oral substances that are photoprotective in humans. UV inhibits adenosine triphosphate (ATP) production causing an energy crisis, which prevents optimal skin immunity and DNA repair. Enhancing ATP production with oral nicotinamide protects from UV immunosuppression, enhances DNA repair and reduces skin cancer in humans. Reactive oxygen species also contribute to photodamage. Nontoxic substances consumed in the diet, or available as oral supplements, can protect the skin by multiple potential mechanisms. These substances include polyphenols in fruit, vegetables, wine, tea and caffeine-containing foods. UV-induced prostaglandin E2 (PGE2 ) contributes to photodamage. Nonsteroidal anti-inflammatory drugs and food substances reduce production of this lipid mediator. Fish oils are photoprotective, at least partially by reducing PGE2 . Orally consumed substances, either in the diet or as supplements, can influence cutaneous responses to UV. A current research goal is to develop an oral supplement that could be used in conjunction with other sun protective strategies in order to provide improved protection from sunlight.

  2. Melatonin and oral cavity.

    Science.gov (United States)

    Cengiz, Murat İnanç; Cengiz, Seda; Wang, Hom-Lay

    2012-01-01

    While initially the oral cavity was considered to be mainly a source of various bacteria, their toxins and antigens, recent studies showed that it may also be a location of oxidative stress and periodontal inflammation. Accordingly, this paper focuses on the involvement of melatonin in oxidative stress diseases of oral cavity as well as on potential therapeutic implications of melatonin in dental disorders. Melatonin has immunomodulatory and antioxidant activities, stimulates the proliferation of collagen and osseous tissue, and acts as a protector against cellular degeneration associated with aging and toxin exposure. Arising out of its antioxidant actions, melatonin protects against inflammatory processes and cellular damage caused by the toxic derivates of oxygen. As a result of these actions, melatonin may be useful as a coadjuvant in the treatment of certain conditions of the oral cavity. However, the most important effect of melatonin seems to result from its potent antioxidant, immunomodulatory, protective, and anticancer properties. Thus, melatonin could be used therapeutically for instance, locally, in the oral cavity damage of mechanical, bacterial, fungal, or viral origin, in postsurgical wounds caused by tooth extractions and other oral surgeries. Additionally, it can help bone formation in various autoimmunological disorders such as Sjorgen syndrome, in periodontal diseases, in toxic effects of dental materials, in dental implants, and in oral cancers.

  3. Melatonin and Oral Cavity

    Directory of Open Access Journals (Sweden)

    Murat İnanç Cengiz

    2012-01-01

    Full Text Available While initially the oral cavity was considered to be mainly a source of various bacteria, their toxins and antigens, recent studies showed that it may also be a location of oxidative stress and periodontal inflammation. Accordingly, this paper focuses on the involvement of melatonin in oxidative stress diseases of oral cavity as well as on potential therapeutic implications of melatonin in dental disorders. Melatonin has immunomodulatory and antioxidant activities, stimulates the proliferation of collagen and osseous tissue, and acts as a protector against cellular degeneration associated with aging and toxin exposure. Arising out of its antioxidant actions, melatonin protects against inflammatory processes and cellular damage caused by the toxic derivates of oxygen. As a result of these actions, melatonin may be useful as a coadjuvant in the treatment of certain conditions of the oral cavity. However, the most important effect of melatonin seems to result from its potent antioxidant, immunomodulatory, protective, and anticancer properties. Thus, melatonin could be used therapeutically for instance, locally, in the oral cavity damage of mechanical, bacterial, fungal, or viral origin, in postsurgical wounds caused by tooth extractions and other oral surgeries. Additionally, it can help bone formation in various autoimmunological disorders such as Sjorgen syndrome, in periodontal diseases, in toxic effects of dental materials, in dental implants, and in oral cancers.

  4. Personality and oral health

    Science.gov (United States)

    Thomson, W. Murray; Caspi, Avshalom; Poulton, Richie; Moffitt, Terrie E.; Broadbent, Jonathan M.

    2013-01-01

    We investigated age-26 personality characteristics and age-32 oral health in a prospective study of a complete birth cohort born in Dunedin, New Zealand. Personality was measured using the Multidimensional Personality Questionnaire (MPQ). Oral health was measured using the short-form Oral Health Impact Profile (OHIP-14), a global measure, and dental examinations. Personality profiles were constructed for 916 individuals (50.8% men) using standardized MPQ scores, and multivariate analyses examined their association with oral health. Those reporting 1+ OHIP-14 impacts had higher Negative Emotionality scores (and lower Constraint and Positive Emotionality MPQ superfactor scores) than those who did not. After controlling for gender, clinical status, and the other two MPQ superfactors, those scoring higher on Negative Emotionality had a greater risk of reporting 1+ OHIP-14 impacts, as well as 3+ OHIP-14 impacts and worse-than-average oral health. They also had a greater risk of having lost at least one tooth from caries and of having 3+ decayed surfaces. Personality characteristics appear to shape self-reports of oral health. Personality is also a risk factor for clinical disease status, at least with respect to dental caries and its sequelae. Because the attitudes and values tapped into by personality tests can be altered by brief cognitive interventions, those might be useful in preventive dentistry. PMID:21896053

  5. Multicentre study evaluating the non-inferiority of the new paediatric formulation of artesunate/amodiaquine versus artemether/lumefantrine for the management of uncomplicated Plasmodium falciparum malaria in children in Cameroon, Ivory Coast and Senegal.

    Science.gov (United States)

    Faye, Babacar; Kuété, Thomas; Kiki-Barro, Christiane P; Tine, Roger C; Nkoa, Thérèse; Ndiaye, Jean Louis A; Kakpo, Claude A; Sylla, Khadime; El Menan, Hervé; Gaye, Oumar; Faye, Oumar; Same-Ekobo, Albert; Moussa, Koné

    2012-12-27

    This multicentre study was carried out in Cameroon, Ivory Coast and Senegal to evaluate the non-inferiority of the new paediatric formulation of artesunate/amodiaquine (AS+AQ)(Camoquin-Plus Paediatric®) in suspension form versus artemether/lumefantrine (AL)(Coartem®) in the management of African children with uncomplicated falciparum malaria. It was an open randomized trial including children aged between 7 months and 7 years. The endpoints were Adequate Clinical and Parasitological Response (ACPR) at day 28, the clinical and biological tolerability. Statistical analyses were done in Intention To Treat (ITT) and in Per protocol (PP). At the end of the study 481 patients were enrolled in the three countries (249 in the AS+AQ arm and 232 in the AL arm). ACRP in ITT after PCR correction did not show any statistical difference between the two groups with 97.6% for AS+AQ versus 94.8% for AL. In the PP analysis, the corrected ACRP were respectively 98.7% and 96.9% for the two regimens. The clinical tolerance was good without significant difference. Anaemia was significantly higher at D7 in the two groups compared to D0. This study demonstrates the non-inferiority of AS+AQ versus AL, its efficacy and tolerance in the management of uncomplicated Plasmodium falciparum malaria in African children.

  6. Efficacy and Safety of Artesunate-Amodiaquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium falciparum Malaria in Sentinel Sites across Côte d'Ivoire

    Science.gov (United States)

    Yavo, William; Konaté, Abibatou; Kassi, Fulgence Kondo; Djohan, Vincent; Angora, Etienne Kpongbo; Kiki-Barro, Pulcherie Christiane; Vanga-Bosson, Henriette; Menan, Eby Ignace Hervé

    2015-01-01

    Two years after the introduction of free Artesunate-Amodiaquine (ASAQ) and Artemether-Lumefantrine (AL) for the treatment of uncomplicated malaria in public health facilities in Côte d'Ivoire, we carried out this study to compare their efficacy and tolerability in three surveillance sites. It was a multicentre open randomised clinical trial of 3-day ASAQ treatment against AL for the treatment of 2 parallel groups of patients aged 2 years and above. The endpoints were (1) Adequate Clinical and Parasitological Response (ACPR) at day 28 and (2) the clinical and biological tolerability. Of the 300 patients who were enrolled 289, with 143 (49.5%) and 146 (50.5%) in the ASAQ and AL groups, respectively, correctly followed the WHO 2003 protocol we used. The PCR-corrected ACPR was 99.3% for each group. More than 94% of patients no longer showed signs of fever, 48 hours after treatment. Approximately 78% of the people in the ASAQ group had a parasite clearance time of 48 hours or less compared to 81% in the AL group (p = 0.496). Both drugs were found to be well tolerated by the patients. This study demonstrates the effectiveness and tolerability of ASAQ and AL supporting their continuous use for the treatment of uncomplicated P. falciparum malaria infection in Côte d'Ivoire. PMID:26347849

  7. Efficacy and Safety of Artesunate-Amodiaquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium falciparum Malaria in Sentinel Sites across Côte d’Ivoire

    Directory of Open Access Journals (Sweden)

    William Yavo

    2015-01-01

    Full Text Available Two years after the introduction of free Artesunate-Amodiaquine (ASAQ and Artemether-Lumefantrine (AL for the treatment of uncomplicated malaria in public health facilities in Côte d’Ivoire, we carried out this study to compare their efficacy and tolerability in three surveillance sites. It was a multicentre open randomised clinical trial of 3-day ASAQ treatment against AL for the treatment of 2 parallel groups of patients aged 2 years and above. The endpoints were (1 Adequate Clinical and Parasitological Response (ACPR at day 28 and (2 the clinical and biological tolerability. Of the 300 patients who were enrolled 289, with 143 (49.5% and 146 (50.5% in the ASAQ and AL groups, respectively, correctly followed the WHO 2003 protocol we used. The PCR-corrected ACPR was 99.3% for each group. More than 94% of patients no longer showed signs of fever, 48 hours after treatment. Approximately 78% of the people in the ASAQ group had a parasite clearance time of 48 hours or less compared to 81% in the AL group (p=0.496. Both drugs were found to be well tolerated by the patients. This study demonstrates the effectiveness and tolerability of ASAQ and AL supporting their continuous use for the treatment of uncomplicated P. falciparum malaria infection in Côte d’Ivoire.

  8. Polymorphisms in Plasmodium falciparum chloroquine resistance transporter and multidrug resistance 1 genes: parasite risk factors that affect treatment outcomes for P. falciparum malaria after artemether-lumefantrine and artesunate-amodiaquine.

    Science.gov (United States)

    Venkatesan, Meera; Gadalla, Nahla B; Stepniewska, Kasia; Dahal, Prabin; Nsanzabana, Christian; Moriera, Clarissa; Price, Ric N; Mårtensson, Andreas; Rosenthal, Philip J; Dorsey, Grant; Sutherland, Colin J; Guérin, Philippe; Davis, Timothy M E; Ménard, Didier; Adam, Ishag; Ademowo, George; Arze, Cesar; Baliraine, Frederick N; Berens-Riha, Nicole; Björkman, Anders; Borrmann, Steffen; Checchi, Francesco; Desai, Meghna; Dhorda, Mehul; Djimdé, Abdoulaye A; El-Sayed, Badria B; Eshetu, Teferi; Eyase, Frederick; Falade, Catherine; Faucher, Jean-François; Fröberg, Gabrielle; Grivoyannis, Anastasia; Hamour, Sally; Houzé, Sandrine; Johnson, Jacob; Kamugisha, Erasmus; Kariuki, Simon; Kiechel, Jean-René; Kironde, Fred; Kofoed, Poul-Erik; LeBras, Jacques; Malmberg, Maja; Mwai, Leah; Ngasala, Billy; Nosten, Francois; Nsobya, Samuel L; Nzila, Alexis; Oguike, Mary; Otienoburu, Sabina Dahlström; Ogutu, Bernhards; Ouédraogo, Jean-Bosco; Piola, Patrice; Rombo, Lars; Schramm, Birgit; Somé, A Fabrice; Thwing, Julie; Ursing, Johan; Wong, Rina P M; Zeynudin, Ahmed; Zongo, Issaka; Plowe, Christopher V; Sibley, Carol Hopkins

    2014-10-01

    Adequate clinical and parasitologic cure by artemisinin combination therapies relies on the artemisinin component and the partner drug. Polymorphisms in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) genes are associated with decreased sensitivity to amodiaquine and lumefantrine, but effects of these polymorphisms on therapeutic responses to artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) have not been clearly defined. Individual patient data from 31 clinical trials were harmonized and pooled by using standardized methods from the WorldWide Antimalarial Resistance Network. Data for more than 7,000 patients were analyzed to assess relationships between parasite polymorphisms in pfcrt and pfmdr1 and clinically relevant outcomes after treatment with AL or ASAQ. Presence of the pfmdr1 gene N86 (adjusted hazards ratio = 4.74, 95% confidence interval = 2.29 - 9.78, P < 0.001) and increased pfmdr1 copy number (adjusted hazards ratio = 6.52, 95% confidence interval = 2.36-17.97, P < 0.001 : were significant independent risk factors for recrudescence in patients treated with AL. AL and ASAQ exerted opposing selective effects on single-nucleotide polymorphisms in pfcrt and pfmdr1. Monitoring selection and responding to emerging signs of drug resistance are critical tools for preserving efficacy of artemisinin combination therapies; determination of the prevalence of at least pfcrt K76T and pfmdr1 N86Y should now be routine. © The American Society of Tropical Medicine and Hygiene.

  9. Observation on the clinical effect of artesunate for injection in treatment of malaria%注射用青蒿琥酯治疗疟疾的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄兰智

    2015-01-01

    Objectives To investigate the clinical effect and security of artesunate for injection in treatment of malaria. Methods Total of 66 cases with malaria from June 2013 to April 2014 in our hospital were collected, those patients were divided into two groups by random number table. The 33 cases of the observation group were given artesunate for injection, while 33 cases of the control group were given purely artesunate amodiaquine tablets. The fever clearance time, parasite clearance times and adverse reactions between two groups were compared, respecively. All patients reviewed a month later, and evaluated the clinical efifcacy at the end of the course and when reviewed. Results Twenty-four hours after treatment, the decrease margin of the average number of malaria parasites in blood of the observation group was signiifcant than the control group, and the average fever clearance time, average parasite clearance time were signiifcantly shorter than that in the control group. Seven days after treatment, the effect of the treatment group was not signiifcantly different from the control group (χ2=0.9243, P=0.3382). Twenty-eight days at reviewed, the recovery rate of the observation group was 96.97%, which was signiifcantly higher than the control group (χ2=4.0217, P=0.0351). Adverse reactions in the observation group and the control group were 3.03% and 21.21%, repectively. The incidence of adverse reactions of the observation group was signiifcantly lower than the control group (χ2=5.6241, P=0.0184). Conclusions Artesunate for injection could rapid onset, and have advantages of low recrudescence rate and safety, it is the ifrst choice to treat malaria in domestic and foreign.%目的:观察注射用青蒿琥酯治疗疟疾的疗效和安全性。方法选择本院2013年6月至2014年4月收治的66例疟疾患者,采用数字表随机法分为两组,观察组33例患者给予注射用青蒿琥酯治疗,对照组33例患者单纯口服青蒿琥酯阿莫地喹

  10. Efficacy and Safety of Artesunate-Amodiaquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium falciparum Malaria in Sentinel Sites across Côte d'Ivoire.

    Science.gov (United States)

    Yavo, William; Konaté, Abibatou; Kassi, Fulgence Kondo; Djohan, Vincent; Angora, Etienne Kpongbo; Kiki-Barro, Pulcherie Christiane; Vanga-Bosson, Henriette; Menan, Eby Ignace Hervé

    2015-01-01

    Two years after the introduction of free Artesunate-Amodiaquine (ASAQ) and Artemether-Lumefantrine (AL) for the treatment of uncomplicated malaria in public health facilities in Côte d'Ivoire, we carried out this study to compare their efficacy and tolerability in three surveillance sites. It was a multicentre open randomised clinical trial of 3-day ASAQ treatment against AL for the treatment of 2 parallel groups of patients aged 2 years and above. The endpoints were (1) Adequate Clinical and Parasitological Response (ACPR) at day 28 and (2) the clinical and biological tolerability. Of the 300 patients who were enrolled 289, with 143 (49.5%) and 146 (50.5%) in the ASAQ and AL groups, respectively, correctly followed the WHO 2003 protocol we used. The PCR-corrected ACPR was 99.3% for each group. More than 94% of patients no longer showed signs of fever, 48 hours after treatment. Approximately 78% of the people in the ASAQ group had a parasite clearance time of 48 hours or less compared to 81% in the AL group (p = 0.496). Both drugs were found to be well tolerated by the patients. This study demonstrates the effectiveness and tolerability of ASAQ and AL supporting their continuous use for the treatment of uncomplicated P. falciparum malaria infection in Côte d'Ivoire.

  11. Amodiaquine-Artesunate versus Artemether-Lumefantrine against Uncomplicated Malaria in Children Less Than 14 Years in Ngaoundere, North Cameroon: Efficacy, Safety, and Baseline Drug Resistant Mutations in pfcrt, pfmdr1, and pfdhfr Genes.

    Science.gov (United States)

    Ali, Innocent M; Netongo, Palmer M; Atogho-Tiedeu, Barbara; Ngongang, Eric-Olivier; Ajua, Anthony; Achidi, Eric A; Mbacham, Wilfred F

    2013-01-01

    Background. In Cameroon, both Artesunate-amodiaquine (AS/AQ) and artemether-lumefantrine (AL) are used as first-line treatment against uncomplicated malaria in line with the WHO recommendations. We compared the efficacy and safety of both therapeutic combinations and determined the prevalence of drug resistance conferring mutations in three parasite genes. Methods. One hundred and fifty acute malaria patients between six months and 14 years of age were randomized to receive standard doses of either AS/AQ (73) or AL (77) and followedup for 28 days. Outcome of treatment was according to the standard WHO classification. DNA samples from pretreatment parasite isolates were used to determine the prevalence of resistant mutations in the pfcrt, pfmdr1, and dhfr genes. Results. Both drug combinations induced rapid clearance of parasites and malaria symptoms. PCR-corrected cure rates were 100% and 96.4% for AL. The combinations were well tolerated. Major haplotypes included CVIET (71%), CVMNT (25%) for the pfcrt; SND (100%) for the pfmdr1; IRN (79, 8%), NCS (8.8%), and mixed haplotype (11, 8%) for the dhfr. Conclusion. Both AS/AQ and AL were highly effective and well tolerated for the treatment of uncomplicated falciparum malaria in Ngaoundere, Cameroon. High prevalence of mutant pfcrt alleles confirms earlier observations. Long-term monitoring of safety and efficacy and molecular markers is highly solicited.

  12. Comparing changes in haematologic parameters occurring in patients included in randomized controlled trials of artesunate-amodiaquine vs single and combination treatments of uncomplicated falciparum in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Zwang Julien

    2012-01-01

    Full Text Available Abstract Background Artesunate-amodiaquine (AS&AQ is a widely used artemisinin combination therapy (ACT for falciparum malaria. A comprehensive appreciation of its effects on haematology vs other anti-malarials is needed in view of potential safety liabilities. Methods Individual-patient data analysis conducted on a database from seven randomized controlled trials conducted in sub-Saharan African comparing AS&AQ to reference treatments in uncomplicated falciparum malaria patients of all ages. Haematologic values (white cells total and neutrophil counts, haemoglobin/haematocrit, platelets were analysed as both continuous and categorical variables for their occurrence, (severity grade 1-4 and changes during follow-up. Risks and trends were calculated using multivariate logistic random effect models. Results 4,502 patients (72% p = 0.001. Multivariate analysis showed that the risk of anaemia, thrombocytopaenia, and leucopaenia decreased with follow-up time, while neutropaenia increased; the risk of anaemia and thrombocytopaenia increased with higher baseline parasitaemia and parasitological reappearance. White cells total count was not a good surrogate for neutropaenia. No systematic significant difference between treatments was detected. Older patients were at lower risks. Conclusion The effects of AS&AQ on haematologic parameters were not different from those of other anti-malarial treatments used in sub-Saharan Africa. This analysis provides the basis for a broader evaluation of haematology following anti-malarial treatment. Continuing monitoring of haematologic safety on larger databases is required.

  13. Amodiaquine-Artesunate versus Artemether-Lumefantrine against Uncomplicated Malaria in Children Less Than 14 Years in Ngaoundere, North Cameroon: Efficacy, Safety, and Baseline Drug Resistant Mutations in pfcrt, pfmdr1, and pfdhfr Genes

    Directory of Open Access Journals (Sweden)

    Innocent M. Ali

    2013-01-01

    Full Text Available Background. In Cameroon, both Artesunate-amodiaquine (AS/AQ and artemether-lumefantrine (AL are used as first-line treatment against uncomplicated malaria in line with the WHO recommendations. We compared the efficacy and safety of both therapeutic combinations and determined the prevalence of drug resistance conferring mutations in three parasite genes. Methods. One hundred and fifty acute malaria patients between six months and 14 years of age were randomized to receive standard doses of either AS/AQ (73 or AL (77 and followedup for 28 days. Outcome of treatment was according to the standard WHO classification. DNA samples from pretreatment parasite isolates were used to determine the prevalence of resistant mutations in the pfcrt, pfmdr1, and dhfr genes. Results. Both drug combinations induced rapid clearance of parasites and malaria symptoms. PCR-corrected cure rates were 100% and 96.4% for AL. The combinations were well tolerated. Major haplotypes included CVIET (71%, CVMNT (25% for the pfcrt; SND (100% for the pfmdr1; IRN (79, 8%, NCS (8.8%, and mixed haplotype (11, 8% for the dhfr. Conclusion. Both AS/AQ and AL were highly effective and well tolerated for the treatment of uncomplicated falciparum malaria in Ngaoundere, Cameroon. High prevalence of mutant pfcrt alleles confirms earlier observations. Long-term monitoring of safety and efficacy and molecular markers is highly solicited.

  14. High prevalence of pfdhfr-pfdhps triple mutations associated with anti-malarial drugs resistance in Plasmodium falciparum isolates seven years after the adoption of sulfadoxine-pyrimethamine in combination with artesunate as first-line treatment in Iran.

    Science.gov (United States)

    Rouhani, Maryam; Zakeri, Sedigheh; Pirahmadi, Sakineh; Raeisi, Ahmad; Djadid, Navid Dinparast

    2015-04-01

    The spread of anti-malarial drug resistance will challenge any malaria control and elimination strategies, and routine monitoring of resistance-associated molecular markers of commonly used anti-malarial drugs is very important. Therefore, in the present investigation, the extent of mutations/haplotypes in dhfr and dhps genes of Plasmodium falciparum isolates (n=72) was analyzed seven years after the introduction of sulfadoxine-pyrimethamine (SP) plus artesunate (AS) as first-line anti-malarial treatment in Iran using PCR-RFLP methods. The results showed that the majority of the patients (97.2%) carried both 59R and 108N mutations in pure form with wild-type genotype at positions N51 and I164. Additionally, a significant increase (Pdrug for treatment of falciparum patients in these malaria-endemic areas of Iran. However, no quintuple mutations associated with treatment failure were detected. In conclusion, the present results along with in vivo assays suggest that seven years after the adoption of SP-AS as the first-line treatment in Iran, this drug remains efficacious for treatment of uncomplicated falciparum malaria, as a partner drug with AS in these malaria-endemic areas.

  15. HPV-associated oral warts.

    Science.gov (United States)

    Feller, L; Khammissa, R A G; Wood, N H; Marnewick, J C; Meyerov, R; Lemmer, J

    2011-03-01

    Human papillomavirus (HPV) is strictly epitheliotropic, infecting stratified squamous cutaneous and mucosal epithelial cells. Oral HPV infection may be subclinical or putatively associated with benign or malignant oral neoplasms. The benign HPV-associated oral lesions, focal epithelial hyperplasia (Heck disease), oral squamous cell papilloma, oral verruca vulgaris (common wart) and oral condyloma acuminatum, are collectively referred to as oral warts. Oral warts are usually asymptomatic, may be persistent or uncommonly, may regress spontaneously. HPV-associated oral warts have a prevalence of 0.5% in the general population, occur in up to 5% of HIV-seropositive subjects, and in up to 23% of HIV-seropositive subjects on highly active antiretroviral therapy. This paper is a clinico-pathological review of HPV-associated oral warts.

  16. Strengthening of oral health systems

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care...... is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral...... diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work...

  17. ORAL MYIASIS CONVERTING TO ORAL SQUAMOUS CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Akshay

    2015-10-01

    Full Text Available INTRODUCTION: Oral Myiasis, a condition of infestation of the body by fly larvae (maggots is a rare pathology in humans. It is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis. It is seen frequently in tropical countries and hot climatic regions. The reported cases in literature of oral Myiasis associated with oral cancer are few. The treatment is a mechanical removal of the maggots but a systemic treatment with Ivermectin, a semi - synthetic macrolide antibiotic, has been used successfully for treatment for oral m yiasis. We present a case of 55 yr old male alcoholic patient with oral myiasis with extensive proliferative growth of oral cavity. Our patient was managed with manual debridement and administration of systemic ivermect in along with antibiotic coverage. Incisional biopsy of the proliferative lesion showed well differentiated squamous cell carcinoma. Thus our patient showed presence of oral myiasis in association with oral squamous cell carcinoma.

  18. Proximate Composition, Microbiological Quality and Sensory Attributes of Mahi-mahi (Coryphaena hippurus and Emperor Sea Bream (Lethrinus spp. Fillets Sold on Retail Market

    Directory of Open Access Journals (Sweden)

    Cătălina Nicoleta Boițeanu

    2014-11-01

    Full Text Available Introduction: The variety of seafood on the European market has considerably increased in recent years. This study presents data to the main nutritional values and the sensory properties of two exotic fish species, mahi-mahi (Coryphaena hippurus and emperor sea bream (Lethrinus spp., sold on retail market in Germany. Information on the quality of frozen and glazed fillets is still missing, but is important to characterize these products. This also includes details on the substances added to increase the water-binding ability. Aims: The paper aims to assess the quality of exotic fish fillets sold on the German market, through the evaluation of physical and chemical parameters, microbiological quality and sensory attributes. Materials and methods: 10 samples of each fish species were analysed after homogenisation to determine the following parameters:  pH-value (with a pH meter; water (gravimetrically; ash (in  a muffle furnace at 550 °C; salt (NaCl; by auto-titration; fat (by a modified Smedes method; protein (with a LECO TruSpecN based on the principles of the Dumas combustion method; total phosphorus content (photometrically; total volatile basic nitrogen (TVB-N, using the EU reference method; total viable bacteria count (TVC and specific fish spoiling bacteria (SSO (by decimal dilutions method. The sensory assessments were done with cooked and fried fillets by a panel consisting of 6 specialists, using a descriptive method. Results: Lipid, ash and salt contents of mahi-mahi were comparable to the emperor sea bream values. Due to low lipid content, both species can be classified as lean species. The protein amount of emperor sea bream was significantly higher compared to mahi-mahi and many other common fish species. In mahi-mahi samples, slightly higher values of total phosphates content were found. The pH values of emperor sea bream were in a normal range for fresh fish, whereas in mahi-mahi significantly higher values were determined which

  19. Paracoccidioidomicosis en cavidad oral Oral cavity paracoccidioidomycosis

    OpenAIRE

    D. Antunes Freitas; C.I. Vergara Hernández; A. Díaz Caballero; G. Moreira

    2012-01-01

    La paracoccidioidomicosis (PCM) o blastomicosis suramericana es la micosis sistémica más importante de América latina que es relativamente común en Brasil, Venezuela, Colombia, Ecuador y Argentina. Los casos esporádicos también pueden verse en algunos otros países, la cual es progresiva y con un infrecuente desenlace fatal si no es tratada a tiempo. Se considera como una enfermedad multifocal, con lesiones orales como la característica prominente. Es causada por un hongo dimórfico, Paracoccid...

  20. [MICROFLORA AND ORAL DISEASE].

    Science.gov (United States)

    Khavkin, A I; Ippolitov, Y A; Aleshina, E O; Komarova O N

    2015-01-01

    Acid-producing microorganisms are base etiological agents of lesions of tooth enamel and destruction of dentin. The process start by specific microflora of tooth deposit--Streptococcus mutans, Lactobacteria and Actinomycetis viscosus which ferment food carbogydrate to form acids. High titre of them in oral cavity may be considered like a marker of carbohydrate food. But the pathogenic bacteria don't have aggression to host organism until they will have virulent factors which help to get over protection of host organism. At the same time, microflora of oral cavity is involved to form pellicula. Pellicula is a biofilm which to protect tooth enamel and dentin. Understanding relationships between safety factors of host and pathogenic microflora of oral cavity will give to create effective methods of prevention and treatment.

  1. Oral pregnancy tumor

    Directory of Open Access Journals (Sweden)

    Shailesh M Gondivkar

    2010-01-01

    Full Text Available Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It predominantly occurs in the second decade of life in young females, possibly because of the vascular effects of female hormones. Clinically, oral pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous growth on a pedunculated or sometimes sessile base, which is usually hemorrhagic. Although excisional surgery is the treatment of choice , some other treatment protocols such as the use of Nd:YAG laser, flash lamp pulsed dye laser, cryosurgery, intralesional injection of ethanol or corticosteroids, and sodium tetradecyl sulfate sclerotherapy have been proposed. We present the case of a 25-year-old pregnant woman with large oral pyogenic granuloma.

  2. Oral heparin: status review

    Directory of Open Access Journals (Sweden)

    Gomez-Orellana Isabel

    2006-05-01

    Full Text Available Abstract Unfractionated heparin and low molecular weight heparin are the most commonly used antithrombotic and thromboprophylactic agents in hospital practice. Extended out-of-hospital treatment is inconvenient in that these agents must be administered parenterally. Current research is directed at development of a safe and effective oral antithrombotic agent as an alternative for the effective, yet difficult to use vitamin K antagonists. A novel drug delivery technology that facilitates transport of drugs across the gastrointestinal epithelium has been harnessed to develop an oral dosage form of unfractionated heparin. Combining unfractionated heparin with the carrier molecule, sodium N-(8 [2-hydroxybenzoyl]amino caprylate, or SNAC has markedly increased the gastrointestinal absorption of this drug. Preclinical and clinical studies to-date suggests that oral heparin-SNAC can confer a clinical efficacious effect; further confirmation is sought in planned clinical trials.

  3. Fluoride and Oral Health

    DEFF Research Database (Denmark)

    O'Mullane, D M; Baez, R J; Jones, S

    2016-01-01

    of the original 1994 document, again using the expertise of researchers from the extensive fi elds of knowledge required to successfully implement complex interventions such as the use of fl uorides to improve dental and oral health. Financial support for research into the development of these new fl uoride......The discovery during the fi rst half of the 20th century of the link between natural fl uoride, adjusted fl uoride levels in drinking water and reduced dental caries prevalence proved to be a stimulus for worldwide on-going research into the role of fl uoride in improving oral health...... including salt, milk, tablets, toothpaste, gels and varnishes. In 1993, the World Health Organization convened an Expert Committee to provide authoritative information on the role of fl uorides in the promotion of oral health throughout the world (WHO TRS 846, 1994). This present publication is a revision...

  4. [Oral problems in divers].

    Science.gov (United States)

    Scheper, W A; Lobbezoo, F; Eijkman, M A J

    2005-05-01

    Divers can have several oral problems. Firstly, problems caused by pressure changes. These are barodontalgia and odontocrexis. Barodontalgia is toothache by barotrauma. Odontocrexis is restorations coming lose or breaking or tooth fractures by expansion of air beneath restorations. Other problems can occur by cements used to fix casted restorations, by inflammations in the orofacial region, and by not yet fully healed oral wounds. Secondly, there are problems related to the diver's mouthpiece. To keep the mouthpiece in place, the mandible has to be forced in a forward position. Holding this position often and for long periods of time, may develop or aggravate temporomandibular dysfunction. Insufficient fit of the mouthpiece may induce oral mucosal lesions. Therefore, it is recommended to produce individual diver mouthpieces. It is also recommended to produce individual diver mouthpieces for complete dentures wearing divers and for divers with fixed orthodontic appliances.

  5. Microbial quality of selected sandwiches sold at retail outlets of fast food shops in Dhaka city and Mymensingh town of Bangladesh

    Directory of Open Access Journals (Sweden)

    Nazmul Hoque

    2012-11-01

    Full Text Available the experiment was designed to undertake a study on the sanitary quality of commercial fast foods sold at retail outlets of fast food shops in Dhaka city and Mymensingh town of Bangladesh. One hundred sandwiches were subjected to bacteriological examinations. The mean values of total viable count (TVC, total coliform count (TCC and total staphylococcal count (TSC in wrapped and unwrapped samples of pre-microwave oven and post-microwave oven fast foods were determined. In pre-microwave oven the TVC, TCC and TSC were log 6.36, log 3.42 and log 4.21 respectively. similarly in post-microwave oven the TVC, TCC and TSC were log 4.89, log 2.60 and log 3.03 respectively. The role of packaging and heat treatment prior to sale on the bacterial changes of the fast foods were demonstrated. It was observed that the values of TVC of all fast food samples except post-microwave oven treated McDonald’s; Pizza and Ruma were higher than the maximum microbial limit. In TCC and TSC all values were higher than the maximum limit. The degree of initial contamination in fast food samples which may pose health hazard to public health has been discussed. It was concluded that the hygienically packaged fast foods and microoven treatment prior to sale would retain the best quality attributes required for consumer’s acceptability and safety.  

  6. Physico-Chemical And Microbiological Quality Of Some Consumer Preferred Plain Set Yoghurts Sold In Matara Municipal Area Of Sri Lanka

    Directory of Open Access Journals (Sweden)

    K.K.G.U Hemamali

    2015-08-01

    Full Text Available As yoghurt is a health food assessment of quality of commercialized yoghurt during storage period in refrigerator is needed. Lack of data on quality parameters of yoghurt brands in Sri Lanka is impediment to consumer health. This study is an attempt to fill that gap by providing data on evaluation of the changes of physico-chemical and microbiological parameters of some plain set yoghurt sold in Matara municipal area of Sri Lanka. Five different brands of plain set yoghurt samples were collected on the basis of consumer preference for the present study. From each brand fifteen samples were analyzed by means of their physico-chemical syneresis effect pH titratable acidity total protein content and microbiological composition total plate count total yeast and mould count by using three replicates of each sample at 4 7 14 21 and 28 days intervals from production date under refrigerated condition 4 amp61616C and compared against local and international standards. All microbiological parameters and total protein content of all plain set yoghurt brands were not within the permissible range for local and international standards. Titratable acidity was only in the permissible range of local standards. All the physico-chemical parameters and microbiological parameters of collected samples were significantly affected by storage period. Good quality yoghurt of physico-chemical and microbiological parameters with hygiene conditions during processing and storage should be encouraged for consumption.

  7. A comparative study of the sodium content and calories from sugar in toddler foods sold in low- and high-income New York City supermarkets.

    Science.gov (United States)

    Samuel, Lalitha; Ethan, Danna; Basch, Corey Hannah; Samuel, Benny

    2014-05-07

    Information from the nutrition facts labels of toddler foods marketed in low- and high-income New York City zip codes were analyzed for sodium content, the proportion of sugar-derived calories, and presence of sugar and/or high-fructose corn syrup as an added sweetener in the list of ingredients. Among the 272 toddler foods analyzed, more than a quarter were high in sodium, over one-third derived at least 20% their calories from sugar, and more than 41% of the foods had sugar and/or high-fructose corn syrup listed among the first five ingredients. The proportion of foods with such nutritional characteristics did not significantly differ between the low- and high-income neighborhood supermarkets. Median sodium content was highest among "side dishes" and "meals." The proportion of calories derived from sugar was found to be highest among "snacks and yogurt blends" in both low- and high-income neighborhoods and "breakfast foods and cereals" in low-income neighborhoods. When compared to high-income neighborhoods, more than three times the proportion of total calories in "breakfast foods and cereals" sold in low-income neighborhoods were derived from sugar. Since taste preferences established during childhood can have long-lasting influence on dietary habits, it is imperative to limit the promotion of toddler foods that are high in sodium and sugar as well as educate parents to make nutritionally sound decisions at the point of purchase.

  8. Are campus food environments healthy? A novel perspective for qualitatively evaluating the nutritional quality of food sold at foodservice facilities at a Brazilian university.

    Science.gov (United States)

    Pulz, Isadora Santos; Martins, Paula Andréa; Feldman, Charles; Veiros, Marcela Boro

    2017-03-01

    The purpose of this novel study was to evaluate the food environment at a Brazilian university, encompassing 6 restaurants and 13 snack bars. The investigation uniquely analyses the food environment (barriers, facilitators, type of foods and prices). This was a food-based analysis of the nutritional quality of the products sold on campus. A cross-sectional descriptive design was used, applying the classic Nutrition Environment Measures Survey-Restaurants (NEMS-R) adapted for Brazil and an original methodology to evaluate and classify qualitatively the nutritional quality and characteristics of the food. A census of all campus food environments was applied. The main results show most food and beverage products were made with processed ingredients and had a lower nutritional quality and price when compared with similar products made on premises, that is, processed iced tea compared with fresh tea ( p food ingredients or nutritional information of products available. The overall options for healthy food choices and good nutritional quality on campus were mostly limited by the availability and higher prices of products. These findings could be used to develop new policy perspectives for the offering of healthy food items and to facilitate better food choices among students in a healthier food environment.

  9. [Isolation of coagulase-positive staphylococci from cheese and ice-cream samples sold in Ankara and some biochemical properties of the isolates].

    Science.gov (United States)

    Baştepe, S; Köşker, O

    1981-01-01

    Coagulase-positive staphylococci were isolated from different kinds of cheese and ice-cream sold in Ankara and some biochemical properties of these isolates were determined. 55 cheese, 52 ice-cream (107 samples) were examined for the presence of coagulase-positive staphylococci. Baird Parker Medium was used and 26 samples constituting of 13 cheese and 13 ice-cream were found to be contaminated with coagulase-positive staphylococci and ratio of the contaminated samples to the total was calculated as 24.3%. Highest count was determined to be 176, 166/g in Izmir Tulum Cheese, whereas none of the other tulum cheese samples yielded this bacteria. In general, coagulase-positive staphylococci of cheese samples were higher than ice-cream samples. Among the ice-cream samples highest coagulase-positive staphylococci count was obtained in nutty ice-cream. From the 26 contaminated samples 164 coagulase-positive staphylococci were isolated. Results indicate that an important number of the coagulase forming isolates were also phosphatase positive, forming pigment and haemolysin, able to utilize mannitol. No relation could be observed between the coagulase formation and ability to produce lysin.

  10. Analysis and Design of Tobacco Sold Queuing System%烟叶交售排队系统的分析与设计

    Institute of Scientific and Technical Information of China (English)

    王智坚; 李水平; 包洋; 李金娟; 张莨

    2015-01-01

    介绍了烟叶交售排队系统的研究背景,对所需要解决的问题进行了概述;论文提出了系统的设计目标,对系统进行了详细的需求分析,包括业务需求分析、功能需求分析、数据需求分析;在系统设计中,对系统进行了总体设计与模块设计,详细阐述了设计内容,并使用实体关系E-R图和实体属性对数据库进行了详细设计。%This paper first introduces the research background of the tobacco sold queuing system and summarizes the problems need to be solved.It presents the system design goals of the system carried out a detailed needs analysis, including business require⁃ments analysis, functional requirements analysis, data requirements analysis;in the system design, the overall design of the system and module design were made to elaborate design content, and it makes detail design of the database for using the ER diagram and entity relationship structure.

  11. Evaluation of Biogenic Amines Levels, and Biochemical and Microbiological Characterization of Italian-type Salami Sold in Rio de Janeiro, Brazil

    Science.gov (United States)

    dos Santos, Luiz Felipe Lopes; Mársico, Eliane Teixeira; Lázaro, César Aquiles; Teixeira, Rose; Doro, Laís

    2015-01-01

    The objective of the present study was to evaluate the levels of biogenic amines (cadaverine, putrescine, tyramine, histamine, spermidine and spermine) by high performance liquid chromatography (HPLC) and the physicochemical (moisture, lipids, proteins, pH, water activity and fixed mineral residue) and microbiological (lactic acid bacteria and aerobic heterotrophic mesophilic bacteria count) characteristics of six Italian-type salami brands sold in the city of Niteroi (Rio de Janeiro, Brazil). The salami showed lactic acid bacteria count from 5.7 to 8.6 CFU•mL-1, and heterotrophic mesophilic bacteria count from 5.8 to 8.7 CFU•mL-1. Three brands showed moisture contents above 35% and one brand had protein content below 25%. The mean values obtained for the amines were: 197.43, 143.29, 73.02, 4.52, 90.66 and 36.17 mg•kg-1 for tyramine, putrescine, cadaverine, spermidine, histamine, and spermine respectively. Two brands presented histamine contents above the legal limit established in 100 mg•kg-1. We concluded that the evaluated salami presented a wide variation in the count of the bacterial groups with a predominance of lactic acid bacteria. The moisture contents indicate insufficient drying before commercialization and protein content had values below the minimum limit determined by the Brazilian legislation. Finally, the levels of biogenic amines found could cause adverse reactions in susceptible consumers, depending of the amount and frequency of intake of these products. PMID:27800400

  12. Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania

    Science.gov (United States)

    Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Mengkheang, Khin; Adhikary, Indu; Gueye, Ndèye Yaga Sy; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth

    2016-01-01

    Abstract National legislation and global guidance address labelling of complementary foods to ensure that labels support optimal infant and young child feeding practices. This cross‐sectional study assessed the labels of commercially produced complementary foods (CPCF) sold in Phnom Penh (n = 70), Cambodia; Kathmandu Valley (n = 22), Nepal; Dakar Department (n = 84), Senegal; and Dar es Salaam (n = 26), Tanzania. Between 3.6% and 30% of products did not provide any age recommendation and 8.6−20.2% of products, from all sites, recommended an age of introduction of language encouraging exclusive breastfeeding, and almost none (0.0−2.9%) provided accurate and complete messages regarding the appropriate introduction of complementary foods together with continued breastfeeding. Between 34.3% and 70.2% of CPCF manufacturers also produced breastmilk substitutes and 41.7−78.0% of relevant CPCF products cross‐promoted their breastmilk substitutes products. Labelling practices of CPCF included in this study do not fully comply with international guidance on their promotion and selected aspects of national legislation, and there is a need for more detailed normative guidance on certain promotion practices in order to protect and promote optimal infant and young child feeding. PMID:27061960

  13. Evaluation of biogenic amines levels, and biochemical and microbiological characterization of Italian-type salami sold in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Luiz Felipe Lopes dos Santos

    2015-08-01

    Full Text Available The objective of the present study was to evaluate the levels of biogenic amines (cadaverine, putrescine, tyramine, histamine, spermidine and spermine by high performance liquid chromatography (HPLC and the physicochemical (moisture, lipids, proteins, pH, water activity and fixed mineral residue and microbiological (lactic acid bacteria and aerobic heterotrophic mesophilic bacteria count characteristics of six Italian-type salami brands sold in the city of Niteroi (Rio de Janeiro, Brazil. The salami showed lactic acid bacteria count from 5.7 to 8.6 CFU•mL-1, and heterotrophic mesophilic bacteria count from 5.8 to 8.7 CFU•mL-1. Three brands showed moisture contents above 35% and one brand had protein content below 25%. The mean values obtained for the amines were: 197.43, 143.29, 73.02, 4.52, 90.66 and 36.17 mg•kg-1 for tyramine, putrescine, cadaverine, spermidine, histamine, and spermine respectively. Two brands presented histamine contents above the legal limit established in 100 mg•kg-1. We concluded that the evaluated salami presented a wide variation in the count of the bacterial groups with a predominance of lactic acid bacteria. The moisture contents indicate insufficient drying before commercialization and protein content had values below the minimum limit determined by the Brazilian legislation. Finally, the levels of biogenic amines found could cause adverse reactions in susceptible consumers, depending of the amount and frequency of intake of these products.

  14. Use of diffusion-ordered NMR spectroscopy and HPLC-UV-SPE-NMR to identify undeclared synthetic drugs in medicines illegally sold as phytotherapies.

    Science.gov (United States)

    Silva, Lorena M A; Filho, Elenilson G A; Thomasi, Sérgio S; Silva, Bianca F; Ferreira, Antonio G; Venâncio, Tiago

    2013-09-01

    The informal (and/or illegal) e-commerce of pharmaceutical formulations causes problems that governmental health agencies find hard to control, one of which concerns formulas sold as natural products. The purpose of this work was to explore the advantages and limitations of DOSY and HPLC-UV-SPE-NMR. These techniques were used to identify the components of a formula illegally marketed in Brazil as an herbal medicine possessing anti-inflammatory and analgesic properties. DOSY was able to detect the major components present at higher concentrations. Complete characterization was achieved using HPLC-UV-SPE-NMR, and 1D and 2D NMR analyses enabled the identification of known synthetic drugs. These were ranitidine and a mixture of orphenadrine citrate, piroxicam, and dexamethasone, which are co-formulated in a remedy called Rheumazim that is used to relieve severe pain, but it is prohibited in Brazil because of a lack of sufficient pharmacokinetic and pharmacodynamic information. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Research-to-policy translation for prevention of disordered weight and shape control behaviors: A case example targeting dietary supplements sold for weight loss and muscle building.

    Science.gov (United States)

    Austin, S Bryn; Yu, Kimberly; Tran, Alvin; Mayer, Beth

    2017-04-01

    New approaches to universal eating disorders prevention and interventions targeting macro-environmental change are greatly needed, and research-to-policy translation efforts hold promise for advancing both of these goals. This paper describes as a policy-translation case example an academic-community-government partnership of the Strategic Training Initiative for the Prevention of Eating Disorders, Multi-Service Eating Disorders Association, and the office of Massachusetts Representative Kay Khan, all based in Massachusetts, USA. The partnership's research-to-policy translation project focused on dietary supplements sold for weight loss and muscle building, which have been linked with serious injury and death in consumers. Youth and people of all ages with eating disorders and body dysmorphic disorder may be especially vulnerable to use these products due to deceptive promises of fast and safe weight loss and muscle gain. The research-to-policy translation project was informed by a triggers-to-action framework to establish the evidentiary base of harm to consumers, operationalize policy solutions to mitigate harm through legislation, and generate political will to support action through legislation introduced in the Massachusetts legislature to restrict sales of weight-loss and muscle-building dietary supplements. The paper concludes with lessons learned from this unique policy translation effort for the prevention of disordered weight and shape control behaviors and offers recommendations for next steps for the field to advance research and practice for universal, macro-environmentally targeted prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. [Bacteriological quality and toxigenic Bacillus cereus detection in cooked white rice sold at the metropolitan area of San José, Costa Rica].

    Science.gov (United States)

    Coto, Rodrigo; Chaves, Carolina; Gamboa, María del Mar; Arias, Maria Laura

    2012-09-01

    The wide use of rice is one of the factors that favors its implication in food borne diseases, and one of the most important pathogens associated to it is Bacillus cereus. The aim of this work was to evaluate the microbiological quality of 50 samples of white cooked rice sold in restaurants at the Metropolitan Area of San José, Costa Rica, including the determination of the total aerobic plate count, the Most Probable Number of total and fecal coliforms and Escherichia coli. MPN of Bacillus cereus and the detection of nheA, nheB and nHeC genes, associated to its toxicity, was also performed. Procedures described in the Compendium of Methods for the Microbiological Examination of Foods were followed for the bacteriological analysis, multiplex PCR was used for the detection of genes following the methodology described by Hansen et al, 2001. 46% of the samples analysed were positive for total coliforms, 34% for fecal coliforms, 16% for E. coli and 10% for B. cereus, being 8% toxigenic. These facts suggest that white cooked rice may represent a risk for Pubic Health and that improvements shall be performed in order to offer a safe and high quality product to consumers.

  17. Oral myiasis in children

    Science.gov (United States)

    Reddy, M. H. Raghunath; Das, Nagarajappa; Vivekananda, M. R.

    2012-01-01

    Oral myiasis is a rare condition in humans and is associated with poor oral hygiene, severe halitosis, mouth breathing during sleep, mental handicap, cerebral palsy, epilepsy, anterior open bite, incompetent lips, and other conditions. In this report, a 14 year-old boy who had an orofacial trauma in the maxillary dentoalveolar region,which was neglected, has been described. There