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Biomedical subjects

V Dev

Publications and source records attributed to V Dev.

At least 19 recordsLinked to original sources
PubMed2006

Malaria parasite burden and treatment seeking behavior in ethnic communities of Assam, Northeastern India.

OBJECTIVES: The objectives of the study were to define the infectious reservoir of malaria with particular reference to transmission dynamics of Plasmodium falciparum, and to ascertain the disease trends in view of the existing containment practices and treatment seeking behavior in malaria endemic communities of Assam, India. METHODS: Cross-sectional surveys were conducted in population groups of malaria endemic districts of the state to determine parasite prevalence, and data were analysed retrospectively for the years 1991-2003 to ascertain the disease trends. Structured questionnaire based surveys were conducted to study the treatment seeking behavior and practices of healthcare providers. RESULTS: P. falciparum and P. vivax were the only two parasite species encountered, the former being in the majority (>60%). Malaria transmission was persistent, and a seasonal peak of P. falciparum was consistently observed during the months of heavy rainfall (April to September). Among children (5-15 years) there was a significantly higher malaria parasite rate as compared to the <5 years age group and adults (>15 years). There was a decline in parasite rates for all age groups over the years of the study that could not be attributed to vector control intervention intensities and/or meteorological factors. CONCLUSIONS: The persistence of P. falciparum is attributed to the emergence of drug resistant varieties, inadequate interventions and treatment seeking patterns, and for its containment focused intervention measures are advocated in partnership with the communities.

Adolescent↗
PubMed2003

Therapeutic efficacies of antimalarial drugs in the treatment of uncomplicated, Plasmodium falciparum malaria in Assam, north-eastern India.

In the Indian state of Assam, the current therapeutic efficacies of the drugs commonly used in the area for the treatment of uncomplicated, Plasmodium falciparum malaria were investigated. As is routine in this area, subjects found positive for P. falciparum malaria were initially treated with chloroquine (CQ). They were given sulfadoxine-pyrimethamine (SP) if this treatment failed, and subsequently quinine if the SP failed. The protocol of the World Health Organization's extended in-vivo test was used to follow parasite clearance and clinical cure. Therapeutic response was assessed by comparing the baseline (day-0) level of parasitaemia with that observed on day 3. Many (75.7%) of the 144 evaluable subjects were treatment successes after CQ, but six early (4.2%) and 29 (20.1%) late CQ-treatment failures were observed. Of the 34 CQ-treatment failures followed, 31 (91.2%) responded adequately to SP but the other three were early (one) or late (two) SP-treatment failures. Two (66.7%) of the SP-treatment failures responded adequately to parenteral quinine but the other (a late quinine-treatment failure) had to be given an artemisinin derivative to achieve a clinical cure. The foci in which multidrug-resistant cases of malaria are developing in India need to be identified quickly, so that such cases can be cured before the mutant strains of P. falciparum that are resistant to several drugs have a chance to become more widespread.

Adolescent↗
PubMed2003

Transmission of malaria and its control in the northeastern region of India.

Let alone the eradication, malaria control itself has amounted to be a challenge, and is detrimental to the all round development of the northeastern region of India. Focal outbreaks are frequent taking heavy tool on human lives. Plasmodium falciparum is the predominant parasite species and is solely responsible for increased morbidity and mortality. The region contributes bulk of P. falciparum cases for the rest of India, and its proportions are increasing. Efficient vectors like Anopheles minimus, Anopheles fluviatilis and Anopheles dirus persistently support transmission of malaria. The present review gives a comprehensive account of the factors responsible for transmission of the disease with focus on vector bionomics, its prevention and control.

Animals↗
PubMed2001

Allelic variation in the cg2 gene does not correlate with chloroquine resistance among Indian Plasmodium falciparum isolates.

The cg2 gene of Plasmodium falciparum has been proposed to be associated with chloroquine resistance. Here we describe PCR amplification and sequencing of all the four repeat regions (kappa (kappa), gamma (gamma), psi (psi) and omega (omega)) of this gene, from Indian isolates. There were variant forms for each of these repeat regions (two for kappa and gamma, and three for psi and omega) among the 123 Indian isolates of P. falciparum. Among these isolates certain forms of psi and omega repeats were uniquely present while some of the reported forms of the kappa and omega repeats were absent. The pattern of combination of all four repeat regions of cg2 gene (genotype) was analysed from 52 isolates. A total of 11 different genotypes were observed among these cases, of which 10 were unique to Indian isolates. Certain genotypes were more common than others. The nucleotide sequencing of all the four repeat regions revealed that Indian isolates have some unique repeating units within the gamma and omega domains. Altogether, the PCR and sequencing results showed that there was an unrelatedness between cg2 repeats and chloroquine resistance.

Alleles↗
PubMed2001

Malaria-attributable morbidity in Assam, north-eastern India.

Malaria is endemic in the Indian state of Assam and transmission of the causative parasites is perennial and persistent. The available data on malaria-related morbidity and mortality in the state for the years 1991-1999 have been reviewed. Over this period, Plasmodium falciparum was the predominant parasite, causing 58%-68% of the malaria cases; all other cases were attributed to P. vivax. All malaria-related deaths were attributed to P. falciparum infection, and the numbers of such deaths were correlated with the numbers of cases of P. falciparum malaria. The deaths occurred mostly in the rainy season (April-September) and among all age-groups of both sexes. The factors responsible for focal outbreaks of malaria across the state are discussed in relation to the existing health infrastructure.

Adolescent↗
PubMed2001

Multicentric clinical trials for safety and efficacy evaluation of alpha;beta arteether in complicated P. falciparum malaria.

OBJECTIVE: To evaluate efficacy of alpha;beta arteether in patients of P. falciparum malaria presenting with complications was undertaken in a multicentric clinical trial. METHOD: Each patient who consented to undergo clinical trial with parenteral Arteether was treated with a fixed dose schedule of Arteether given intramuscularly in a dose of 150 mg once a day on three consecutive days. Every patient was followed upto 28 days with clinical, haematological and parasitological monitoring every day upto one week and thereafter at 14, 21 and 28 days. The response was assessed in terms of fever clearance time, parasite clearance time, cure rate and parasite reappearance rate. RESULTS: A total of 211 patients of P. falciparum malaria were included in the study from four centres (Bhilai, Guwahati, Jamshedpur and Rourkela). Results of this study showed that fever clearance time ranged between 24-168 hours, parasite clearance time ranged between 24-120 hours and overall mortality ranged between 4-8.5%. Out of 211, only 14 patients expired during the study, of these, 10 patients expired within first two days i.e. before completing the three day schedule of arteether therapy. Tolerability to arteether injection was good in all these patients and no untoward effects were experienced or reported during the study. Overall cure rate observed in these studies was 93%. CONCLUSION: This study shows a rapid parasite and fever clearance in patients of complicated P. falciparum malaria.

Adolescent↗
PubMed2000

Quetiapine: a review of its safety in the management of schizophrenia.

Quetiapine, a dibenzothiazepine derivative, is a atypical antipsychotic which has greater in vitro binding affinity for serotonin 5-HT2 receptors than for dopamine D2 receptors. Quetiapine effectively treats both the positive and the negative symptoms of schizophrenia and is also associated with an incidence of extrapyramidal symptoms no greater than placebo across the entire dose range. In addition, it does not cause persistent hyperprolactinaemia. Quetiapine is associated with high levels of patient acceptability and satisfaction, which may result from its combination of efficacy and relatively benign adverse effect profile. The drug is well tolerated and has a low propensity to cause adverse events both during acute and long term treatment in the adult populations. The adverse effect profile of quetiapine makes the drug advantageous for patient populations who are susceptible to the adverse effects of drugs. Indeed, preliminary data show quetiapine to be very well tolerated in the elderly. Overdoses of quetiapine of up to 20g have been reported; however, with appropriate management in an intensive care setting there have been no reported fatalities. Quetiapine is metabolised by the cytochrome P450 3A4 isoenzyme, and the dose may need to be adjusted if quetiapine is co-administered with drugs which affect the activity of this isoenzyme. Overall, quetiapine has a favourable risk-benefit profile that should make it a valuable first-line agent in the treatment of schizophrenia.

Adolescent↗
PubMed2000

Cytotaxonomic evidence for the presence of Anopheles nivipes in India.

Anopheles philippinensis mosquitoes were collected from 5 states in India: Assam, Meghalaya, Arunachal Pradesh, Manipur, and Nagaland. Half-gravid females were examined for variations in wing venation using the presector dark mark on vein I and polytene chromosomes derived from ovarian nurse cells. Polytene chromosomes were examined for diagnostic inversions, t on chromosome arm 2 and I on arm 5. Based on wing characteristics, both An. philippinensis and An. nivipes were identified. Polytene chromosome examinations revealed that all specimens from these 2 populations had 2t; 51 inversion genotype, a diagnostic character for An. nivipes. The wing character was not diagnostic; therefore, it was concluded that all the specimens examined were actually An. nivipes and not An. philippinensis. Further, the X chromosome was of x+b type, that is, the standard arrangement with reference to the inversion b, reported in the An. nivipes population in Thailand. This is the 1st report that unequivocally establishes the occurrence of An. nivipes in India and also shows that the adult wing character is not reliable in distinguishing An. philippinensis from An. nivipes, as has been observed in Thailand.

Animals↗
PubMed2000

Complicated appendicitis: is there a minimum intravenous antibiotic requirement? A prospective randomized trial.

The proper duration of postoperative intravenous (IV) antibiotics in patients suffering complicated (perforated or gangrenous) appendicitis is debatable. Some advocate a set minimum number of IV antibiotic days whereas others discontinue IV antibiotics depending on the patient's clinical course regardless of the length of therapy. Our objective was to determine whether there are differences in morbidity and resource utilization between the two treatment methodologies. Ninety-four patients with intraoperative findings of complicated appendicitis were included. In all patients IV antibiotics were discontinued on the basis of clinical factors. However, Group 1 patients were given a minimum 5-day IV antibiotic course whereas Group 2 patients had no minimum IV antibiotic requirement. Group 1 patients received more IV antibiotics than Group 2 patients did (5.9 vs 4.3 days; P = 0.014). Infectious complications were not statistically different between the two groups (13.0% in Group 1 and 12.5% in Group 2). Average hospital stay was also not statistically different between the two groups. The data suggest that a protocol with no minimum IV antibiotic requirement in patients with complicated appendicitis does not increase morbidity. Furthermore, the protocol arm with no minimum IV antibiotic requirement led to less IV antibiotic use but did not significantly decrease hospital stay.

Administration, Oral↗
PubMed1999

Juvenile tricuspid stenosis and rheumatic tricuspid valve disease: an echocardiographic study.

Tricuspid valve involvement is not uncommon in patients with rheumatic heart disease and is frequently missed on routine clinical examination. We prospectively studied the echocardiographic profile of tricuspid valve disease in 788 consecutive patients with rheumatic heart disease. Out of these patients 9% (70) had tricuspid valve disease and 55.7% (39) of these were of < or = 20 years of age. Of these 60% were females and 40% were males. Their ages ranged from 9 to 64 years (mean 24.2+/-13.6 years). Of these patients, 50% had tricuspid stenosis with or without tricuspid regurgitation whereas 50% had isolated tricuspid regurgitation. Isolated tricuspid stenosis was present in 7.4% of these cases. All patients had associated mitral stenosis. Severe mitral stenosis was present more commonly in patients with juvenile tricuspid stenosis compared to older patients (94.1% vs. 55.6%, P<0.005). Mitral regurgitation was present more commonly in juvenile age group patients compared to older patients (53.8% vs. 25.8%, P<0.01). A combination of mitral, aortic and tricuspid stenosis was present in five cases and four of these were in the juvenile age group. Left ventricular enlargement and dysfunction were present in 28.6 and 14.3% patients, respectively, and the majority of these patients were in the juvenile age group (P<0.05). We conclude that rheumatic tricuspid valve disease occurs early in the course of the disease and progresses faster in India and is always associated with mitral stenosis. Juvenile tricuspid stenosis is more commonly associated with severe mitral stenosis, mitral regurgitation, left ventricular enlargement and dysfunction as compared with older patients.

Adolescent↗
PubMed1997

Sustained local drug delivery to the arterial wall via biodegradable microspheres.

This study was designed to evaluate the feasibility of applying locally delivered polylactic acid microspheres for drug delivery to the arterial wall. To study drug persistence, rhodamine-loaded microspheres were infused into one carotid artery of 14 rabbits and plain rhodamine solution into the other by using a porous balloon. To study tissue response, plain microspheres and dexamethasone-loaded microspheres were infused into the carotid arteries of another group of rabbits. To study the antiproliferative effects of locally delivered drug, 20 rabbits were subjected to overstretch balloon injury to both carotid arteries and divided into 4 groups: injury alone, plain microspheres, dexamethasone-loaded microspheres, and microspheres containing colchicine and dexamethasone. Fluorescent microspheres persisted in the vessel wall for 4 wk, whereas rhodamine without microspheres disappeared at 72 h. Histopathologic studies in arteries infused with unloaded microspheres showed inflammatory cell infiltrate with polymorphonuclear cells at 1 wk and macrophages and giant cells at 4 wk. Arteries infused with dexamethasone-loaded microspheres did not show any inflammatory cell infiltrate. Local delivery of dexamethasone or dexamethasone plus colchicine did not result in significant change in the intima-to-media ratio or in residual lumen following balloon injury. Polylactic acid microspheres may be used for prolonged delivery of drugs or other bioactive agents locally to the arterial wall. They induce an inflammatory reaction that is suppressable by dexamethasone in the microspheres. Dexamethasone or dexamethasone and colchicine delivered via this system, however, failed to reduce the degree of intimal hyperplasia after overstretch balloon injury to the rabbit carotid arteries.

Angioplasty, Balloon, Coronary↗
PubMed1996

Subacute thrombosis and vascular injury resulting from slotted-tube nitinol and stainless steel stents in a rabbit carotid artery model.

BACKGROUND: Our objectives were to quantify the thrombogenicity and extent of vascular injury created by slotted-tube geometry stainless steel and nitinol coronary stents in a rabbit carotid artery model. METHODS AND RESULTS: Stents were implanted in rabbit right carotid arteries without antiplatelet therapy. Stainless steel stents were implanted for 4 days while nitinol stents were placed for 4 and 14 days (n = 8, 8, and 6, respectively). Stent thrombosis was assessed by thrombus weight, grading thrombus encroachment of the lumen, and by blood flow in the stented and contralateral arteries. Stainless steel stents at 4 days contained more thrombus than 4- and 14-day nitinol stents (20.0 +/- 5.9 versus 2.5 +/- 0.6 and 2.7 +/- 0.3 mg, respectively; P < .000001). Stainless steel stents were more often occluded by thrombus (6 of 8) or contained more subocclusive thrombus (2 of 8) than nitinol stents (0 of 14, P < .002). Resting blood flow was reduced in arteries with stainless steel stents compared with 4- and 14-day nitinol stents (1.5 +/- 2.8 versus 24.0 +/- 2.0 and 25.5 +/- 1.9 mL/min, respectively, P < .000001). Stainless steel stents were less uniformly expanded, had deeper strut penetration into the vascular wall, and were associated with more extensive medial smooth muscle cell necrosis. There were strong correlations (r = .77 to .95) between variables of thrombosis extent (thrombus weight and grade) and histologically determined vascular injury (strut penetration and medial necrosis). CONCLUSIONS: Slotted-tube stainless steel stents were more thrombogenic and created more extensive vascular injury than nitinol stents in a rabbit carotid artery model. The mechanisms underlying these differences probably are related to metallurgic and design geometry properties of the two stent types.

Acute Disease↗
PubMed1996

Anopheles minimus: its bionomics and role in the transmission of malaria in Assam, India.

Indoor, day-resting collections of Anopheles minimus mosquitos from human dwellings in the study area in Assam, India, indicated that these insects were prevalent throughout the year and that their maximum abundance occurred from March to August. A. minimus was identified as a vector of malaria, and sporozoite infections were recorded every month of the year, with the highest rating occurring in October. The mosquito was highly anthropophilic and fed on human hosts (indoor) all through the night, but feeding was more pronounced between 01:00 and 04:00, the person-biting rate was 13.7 per night. Breeding occurred throughout the year in slow-flowing streams with grassy banks. A. fluviatilis was also identified as a vector of malaria in the study area but occurred in low density, and sporozoite infections were only seasonal.

Animals↗
PubMed1996

Malaria survey in Tarajulie tea estate and adjoining hamlets in Sonitpur District, Assam.

Malaria survey in Tarajulie tea estate (TE) and its adjoining hamlets revealed that Pf was the predominant parasite species (79%) and morbidity was alarming. Malaria positive cases were recorded in all age groups including infants. However, morbidity was much pronounced in the hamlets than among garden dwellers. Mostly Anopheles minimus were recorded in the day resting collections from human dwellings (indoor) and in overnight man biting catches in the hamlets. From these collections. An. minimus was incriminated and the sporozoite infection rate was found to be 4.23 per cent. An. minimus were not recorded in the garden premises. Thus morbidity in the garden population was attributed to the movement of labourers to and fro between hamlets and the garden premises. The hamlets served as reservoirs for malaria infection.

Adolescent↗
PubMed1996

Morbidity and mortality due to malaria in Tarajulie Tea Estate, Assam, India.

Beginning 1991, a sudden rise of malaria cases were recorded in Tarajulie TE (Assam) coupled with mortality due to malaria. Deaths were confirmed due to Plasmodium falciparum (Pf) infections and were recorded in all age groups excluding infants. Malaria positives were recorded in all months of the year, however, there was a increased hospital attendance due to fever/malaria positives during May to September. During the years (1991-1993), the slide positive rate was as high as 33.04%, mostly being Pf infections (69%), and the annual parasite index ranged between 6 to 304 per thousand population. Morbidity and mortality due to malaria were attributed to labor movements to and fro from garden premises to adjoining hamlets, the latter being the site of acquisition of the infections.

Adolescent↗
PubMed1995

Kinetics of drug delivery to the arterial wall via polyurethane-coated removable nitinol stent: comparative study of two drugs.

Polymer-coated removable stents were used to deliver 14C-labeled etretinate and 3H-labeled forskolin to the vessel wall in 31 New Zealand White rabbits to study their kinetics. Stents loaded with etretinate (n = 8) and forskolin (n = 14) were implanted in the rabbit carotid arteries, and the animals were euthanized at different time intervals. Drug levels were measured in the media and adventitia of the stented segment, in distant tissues, and in blood. In four rabbits, forskolin-loaded stents were percutaneously retrieved 2 hr after implantation in the carotid artery, and the tissue and blood levels were determined 2 and 24 hr after retrieval. In seven rabbits etretinate-loaded stents were retrieved 72 hr after implantation in abdominal aorta, and drug levels were measured in the tissues and blood immediately after and at 1 and 4 days after retrieval. Levels of etretinate in the vessel wall peaked at 24 hr (250 ng/mg) and remained high up to 72 hr (185 ng/mg) after stent placement. Levels of forskolin peaked within 2 hr of stent placement (135 ng/mg) and rapidly declined to 4.9 ng/mg at 24 hr with the stent in situ. About 50% (1.4 mg) of the original etretinate remained in the stent at 72 hr compared to about 5% (0.08 mg) of forskolin at 24 hr. Ratio of peak drug levels in the vessel wall to those in the blood was 6,000 for etretinate and 780 for forskolin. (ABSTRACT TRUNCATED AT 250 WORDS)

Alloys↗