Study of effect of malaria parasitemia on serum electrolytes in south-east Rajasthan

Background: Malaria is a life threatening disease caused by Plasmodium parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. Aim: To study of effect of malaria parasitemia on serum electrolytes in south east Rajasthan. Materials and methods: It was a hospital based study done on malaria indoor patients from June 2017 to March 2018 in Jhalawar Medical College, Jhalawar in South East Rajasthan. The relevant history, systemic examinations and thick and thin peripheral blood smear, malaria antigen detection rapid card test was performed and serum electrolytes like sodium, potassium and calcium level were done for all patients. All patients were categorized into three groups like P.falciparum, P.vivax and mixed infection (both P.falciparum, P.vivax). Results: We observed that female was out numbered than male. Most common affected age group was 35-45 years and most of the patients came from the rural region. Severe dyselectrolytemia was noted in mixed infection (both P.falciparum and P.vivax) and P.falciparum cases. Conclusion: Serum electrolytes level are influenced by the presence of all types of malaria severely with mixed infection and P.falciparum positive cases so severe dyselectolytemia in malaria infections should be treated timely to prevent grave complications

Platelet count – a diagnostic aid in fever.

Introduction: Vivax Malarial infection. Dengue Viral fever is also emerging as a Febrile conditions to have reduced platelet count. The absence of the normal platelet count on peripheral smear in case of fever is a clue to the presence of Malaria and Dengue fever. Material & Method: Present study we have tried to study the pattern of thrombocytopenia in these febrile conditions and their diagnostic and prognostic implications. The study was conducted at GMERs Medical College, Gandhinagar. This study group consisted of 146 Patients of Fever treated at Pediatric Department, Malaria diagnosed by thick & thin smear examination. The platelet count was done by Abascus Junior B- Blood Cell counter. Dengue Fever was diagnosed by NS1 Antigen Test. The Mean Platelet counts in P. Falciparum are 69852 cells/mm3, P.Vivax 1,15,580 and Dengue Fever 53,100. Statistically the difference between P. Falciparum & Vivax is significant for differentiating Malarial type. Result: Platelet count <20,0000 cells/mm3 was observed in both the types of Malaria and not seen with Dengue Fever. Profound thrombocytopenia still remains the distinguishing, feature of P. Falciparum Malaria. Platelet count more than 1,00,000 cells/mm3 favours the diagnosis of P.Vivax & Moderate reduction in Platelet Count (between 20,000 to 1,00,00) is clue to P. Falciparum and Dengue Fever. In this segment other diagnostic criteria like pFHrp Antigen and N.S.Antigen should be applied to differentiate these two grave conditions. Thrombocytopenia (Platelet count <150000 cells/mm3) can be considered as a predictor of Malaria and in combination with Anemia (Hb<10gm/dl) is a next best parameter. Unlike Malaria, in Dengue fever thrombocytopenia is usually associated with normal Hemoglobin.

Expression of inducible nitric oxide synthase, caspase-3 and production of reactive oxygen intermediate on endothelial cells culture (HUVECs) treated with P. falciparum infected erythrocytes and tumour necrosis factor-α.

Cytoadherence of P. falciparum infected erythrocytes on endothelial cells is a key factor in development of severe malaria. This process may associated with the activation of local immune that was enhanced by tumour necrosis factor-α (TNF-α). This study was conducted to see the influence of P.falciparum infected erythrocytes cytoadherence and TNF-α treatment in inducing endothelial cells activation in vitro. inducible nitric oxide synthase (iNOS) and caspase-3 expression, also reactive oxygen intermediate (ROI) production were used as parameters. An Experimental laboratory study had been done to observe endothelial cells activation (HUVECs) after treatment with TNF-α for 20 hours or P. falciparum infected erythrocytes for 1 hour or both of them. Normal endothelial cells culture had been used as a control. Using immunocytochemistry local immune activation of endothelial cells was determined by iNOS and caspase-3 expression. Nitro Blue Tetrazolium reduction-assay was conducted to see the ROI production semi quantitatively. inducible nitric oxide synthase expression only found on endothelial cells culture treated with P. falciparum infected erythrocytes or both P. falciparum infected erythrocytes and TNF-α. Caspase-3 expression found slightly on normal endothelial cells culture. This expression increased significantly on endothelial cells culture treated with both P.falciparum infected erythrocytes and TNF-α (p=0.000). The normal endothelial cells release low level of ROI in the presence of non-specific trigger, PMA. In the presence of P. falciparum infected erythrocytes or TNF-α or both of them, some cells showed medium to high levels of ROI. Cytoadherence of P. falciparum infected erythrocytes and TNF α treatment on endothelial cells can induce activation of local immune marked by increase inducible nitric oxide synthase and release of free radicals that cause cell damage.

Evaluating in vitro effect of 10 alpha-trifluoro methyl hydroartemisinin in powder and tablet form to P.falciparum

Background: WHO recommends that malaria drug should be used with essential elements which are derivatives of artemisinin (ART) for treatment phase and limit the development of parasite (MIC). Objective: To assess in vitro effect of artemisinin powder and 10 alpha- trifluoro methyl hydroartemisinin (TEMHA) in powder and tablet form to P.falciparum. Subject and Method: 48h in vitro test of Phuc Nguyen Dinh was applied to this study. Results and Conclusions: The results showed that: for T996, IC50 values of ART, 10 alpha- TEMHA powder and 10 alpha- TEMHA pill were as follows: 37.8; 16.4 and 17.6 nM/L, respectively. For K1, IC50 values of ART, 10 alpha- TEMHA powder and 10 alpha- TEMHA pill were: 22.8; 11.4 and 12.2 nM/L, respectively. MIC values of artemisinin powder, 10 alpha- TEMHA powder and pill for T996 were as follows: 100; 40 and 40nM/L, respectively. For K1, MIC values of ART, 10 alpha- TEMHA powder and pill are: 76; 24; 32 nM/L, respectively.

Therapeutic efficacy of artemether 300 mg - diluted powder formulation (Erapas) product of Vietnam for treatment of uncomplicated P.falciparum malaria

The clinical studies were carried-out in the commune Health Center of Quang Tri and Ninh Thuan provinces from June to December, 2003. Recrudescence and re-infection analysises by PCR method were performed at NIMPE`s laboratory. The efficacy of Erapas was evaluated for uncomplicated P.falciparum malaria with 5-day regimens (4mg/kg on the first day, followed by 2mg/kg once a day for 4 days). 109 patients were gathered in a group of Erapas treatment. Of which, 102 patients were followed-up to Day 28. Blood sample PCR analysises of 2 patients having parasite re-appearance at day 21 showed that both 2 cases were P.falciparum re-infection. The median (range) fever clearance time was 1.3 (1-2) day(s). The median (range) parasite clearance time was 2.5 (1-3) day(s). The research results showed that the cure rate by the 28¬th day was 100%. Erapas has high effectiveness for treament of uncomplicates faciparum malaria with high tolerance

Rapid diagnostic test in early detecting P.falciparum and controlling malaria in epidemic prevention

To introduce laboratory or testing techniques in detecting malaria parasite with 4 Plasmodium strains is P.vivax, P.falciparum, P.malariae and P.ovale, includes: Microscopic tests as Peripheral smear; Quantiative Buffy Coat test (QBC test); Detecting malaria pigment in monocytic leukemia or macrophage. Non-microscopic tests as Parasight-F test, Optimal assay, Malaria Immune Chromatography test - P.falciparum, Polymerase Chain Reaction; Detecting antibodies by RIA or ELISA