Correlating Pregnancy Outcomes Between Early and Late Antenatal Bookings in Labasa Hospital – A Retrospective Cohort Study

Background@#Many benefits are associated with early antenatal booking which include but are not limited to accurate dating, early detection of medical and obstetrical disorders that could make the pregnancy a high-risk pregnancy and affect its outcome, and objective assessment of maternal baselines such as identifying pre-existing risk factors, taking weight, blood pressure, blood sugar level and urinalysis. If done early, it may provide a picture of the pre-pregnancy condition of the woman. @*Aim@#In the time period and setting looked at in this research, it was found that majority of the mothers booked late, however reasons for booking late were not sought as this was only a quantitative retrospective cohort study. From the outcomes measured, it was seen that anaemia was the most significant outcome associated with late bookers. PPH was also found to be significant amongst late bookers however other statistical analysis deemed it insignificant.@*Results@#The results of this study found that majority of the women (76,58%) booked late. Of these, women who booked late fell in the 15 to 25 age range, were of I-taukei ethnicity, were married, did domestic duties, attended secondary level of education and were multiparous. The most significant pregnancy outcome that was associated with late booking was found to be anaemia. The remaining outcomes were found to be insignificant.

Non-pathologic components are associated with reduced visual acuity in myopes after spectacle correction

Purpose: To find the association between reduced best?corrected visual acuity and non?pathologic components after optical correction in individuals with low to high myopia. Methods: Myopic children under 16 years of age were reviewed using electronic medical records and the following data were extracted and recorded: participant’s age, gender, uncorrected visual acuity (UCVA), manifest refraction, and best corrected visual acuity (BCVA). Spherical equivalent and cylinder were classified into low, moderate, and high categories based on the magnitude range. Similarly, astigmatism was defined into with?the?rule, against?the?rule, and oblique based on the location of the steepest meridian. Reduced BCVA was defined when the decimal visual acuity was less than 0.66 (equivalent to Snellen’s acuity of 6/9 or 20/30). Logistic regression was performed to test the factors associated with reduced visual acuity after optical correction in the absence of myopic pathologic changes. Statistical significance was considered if P < 0.05. Results: Overall 44.9% (N = 242/538) of myopes had reduced best?corrected visual acuity (BCVA) and none of the patients had pathologic myopic lesions. Using logistic regression, we found that high spherical refraction (OR 27.98, 95% CI 14.43–54.25, P < 0.001) and moderate spherical refraction (OR 5.52, 95% CI 2.56–11.91, P < 0.001) were significantly associated with reduced best corrected visual acuity despite any pathological lesions. Additionally, oblique and ATR astigmatism were associated with reduced visual acuity in myopic children with (OR 2.05, 95% CI 0.77–5.42) and (OR 1.59, 95% CI 0.82–3.08). Conclusion: Higher magnitude of refractive error components causes reduced visual acuity in the absence of pathologic changes.

Knowledge, attitude, and practice of childhood myopia among Indian optometrists: A questionnaire-based study

Purpose: To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India. Methods: An online survey was distributed to Indian optometrists. A pre?validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self?reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results: A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open?angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non?cycloplegic refractive measures. The most common approaches to management were single?vision distance despite most optometrists identifying orthokeratology and low?dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops. Conclusion: Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence

Clinical Comparative Evaluation of Bupivacaine with Fentanyl and Ropivacaine with Fentanyl in Upper Limb Surgery Under Supraclavicular Brachial Plexus Block

Introduction: A lot of surgeries are now performed to reduce a number of physical ailments. Although these surgeries are done to reduce the sufferings these inevitably lead to a lot of pain for the patient. Material and Methods: Our study comprises of 60 patients who had undergone elective upper limb surgery in a tertiary care centre of central India. Patients of both genders, in age group 18-60 years with American Society of Anaesthesiology (ASA) grade I or II were included in our study and divided in two groups of 30 each. Results: Data was entered into MS-Excel sheet and analysed by SPSS version 20. Quantitative data was compared by using student t-test and qualitative data by using chi-square test and Fisher exact test, as applicable. P<0.05 was considered as statistically significant. Both the groups were similar in demographic and surgical characteristics. However, we found that the group given bupivacaine and fentanyl had longer duration of sensory and motor block and post-operative analgesia than ropivacaine and fentanyl group (p<0.001). Conclusion: Combination of bupivacaine with fentanyl provides longer duration of sensory block, motor block and postoperative analgesia without any major side effects than combination of ropivacaine with fentanyl with comparable haemodynamic in both groups.

Refractory cancer pain in young child at end?of?life: Can we alleviate the suffering?

Pain is a common and highly distressing symptom in children with advanced malignancies and it is often multifactorial at the end?of?life. The prognosis of cancer pain is reported to be worse in those with mixed pain type, high pain severity, daily opioid use, and poor emotional well?being. We describe a case of 13?year?old boy, known case of metastatic Ewing sarcoma right iliac bone, who presented to our palliative care ward with intractable pain and was finally discharged home for terminal care with high doses of morphine, ketamine, and midazolam infusion through elastomeric pump attached to a peripherally inserted central catheter (PICC line). The suffering of imminently dying children should be reduced, and judicious dose escalation of opioids along with adjuvants is appropriate and often necessary.

INVESTIGATING THE IMPACT OF EMPLOYEE GENDER ON FACTORS INFLUENCING RETENTION IN THE PRIVATE CORPORATE SECTOR

The purpose of this research paper is to study the Impact of Employee Gender on factors influencing Retention in the private corporate sector and what can be done in order to retain the employees in an organisation. To analyze what gender diversity challenges are faced and what are the ways to overcome it. Twenty one parameters were considered , they were social services, creativity, moral values, independence, variety, authority, ability utilization, social status, company policies and practices, Supervision- human relations, security, compensation, working conditions, advancement, supervision-technical, co-workers, responsibility, recognition, achievement, activity and general satisfaction. The population of the study consisted of 200 IT professionals (137 male, 63 female).Minnesota Satisfaction Questionnaire by Weiss et al (1967) was used as the main data collection instrument .The mean of various factors influencing retention as per the employee gender varies in different facets, out of twenty one factors, ten showed high difference in mean values of both male and female respondents and factors like security t=.021, supervision-technical t=.009 and variety t=.023. shows a significant difference.Thus the results indicated that overall, there is no significant Impact of Employee Gender on factors influencing retention in the private corporate except in these three facets. However the corporate sector is facing a talent shortage which will keep on growing .The findings of the study will be helpful in creating the right culture with competitive compensation and flexible work options for employees as well as for industries to decrease employee turnover rate.

Phytochemicals targeting NF-κB signaling:Potential anti-cancer interventions / 药物分析学报

Nuclear factor κB(NF-κB)is a ubiquitous regulator of the signalome and is indispensable for various biological cell functions.NF-κB consists of five transcription factors that execute both cytoplasmic and nuclear signaling processes in cells.NF-κB is the only signaling molecule that governs both pro-and anti-apoptotic,and pro-and anti-inflammatory responses.This is due to the canonical and non-canonical components of the NF-κB signaling pathway.Together,these pathways orchestrate cancer-related inflammation,hyperplasia,neoplasia,and metastasis.Non-canonical NF-κB pathways are particularly involved in the chemoresistance of cancer cells.In view of its pivotal role in cancer progression,NF-κB represents a potentially significant therapeutic target for modifying tumor cell behavior.Several phy-tochemicals are known to modulate NF-κB pathways through the stabilization of its inhibitor,IKB,by inhibiting phosphorylation and ubiquitination thereof.Several natural pharmacophores are known to inhibit the nuclear translocation of NF-κB and associated pro-inflammatory responses and cell survival pathways.In view of this and the high degree of specificity exhibited by various phytochemicals for the NF-κB component,we herein present an in-depth overview of these phytochemicals and discuss their mode of interaction with the NF-κB signaling pathways for controlling the fate of tumor cells for cancer-directed interventions.

Association between Glutathione-S-Transferase and Gastric Carcinoma: A Case Control Study

Gastric carcinoma is the fourth most common cancer type and the second leading cause of cancer deaths worldwide. Every year, around 1 million new cases and 0.7 million deaths are caused due to gastric carcinoma. Gastrointestinal tract is involved in absorption and metabolism of toxic or potentially carcinogenic compounds which may be present in the food we eat. In this context, digestive tract may be considered as a major site of cancer in humans. Glutathione-S-Transferase (GST) is an important metabolizing enzyme, present in the epithelial cells of human GIT. As nearly all reactive, ultimate carcinogenic forms of chemicals are electrophiles, GST is substantially important as a mechanism for carcinogen detoxification. The present study was conducted to evaluate the role of GST in gastric carcinoma and analyse the level of serum GST in patients suffering from gastric carcinoma. METHODSThis is a case control study, conducted among 50 cases of gastric carcinoma and 50 age sex matched controls. Patients included in this study were diagnosed with gastric carcinoma, after clinical and histological examination. Circulating levels of GST were assayed in the in the serum of control group and in patients with gastric carcinoma, using standardized method. RESULTSMean GST activity in serum was significantly higher (p < 0001) in gastric carcinoma patients (8.24 ± 1.94) as compared to control (5.47 ± 0.52). After chemotherapy (12.34 ± 1.05) the activity of GST was significantly higher (p < 0001) than before chemotherapy (10.23 ± 2.12). The generation of free radicals is as reflected by increased GST and GST-π activity in carcinoma cases. CONCLUSIONSSerum GSTs measurement in plasma may be a useful tumour marker in stomach cancer and serum GSTs activity might be helpful in predicting the response of chemotherapy in advanced stages of cancer. GST values are helpful in predicting the radiation response. Overexpression of GST in neoplasia may be causal, allowing replicative advantage, or casual, accompanying clonal expansion. The major limitation to its widespread use is the time needed for doing the assay and until this is overcome it will remain primarily a research tool.

A rare case presentation of large mucinous ovarian cystadenocarcinoma in a young female

Here authors report a case of large ovarian mucinous cystadenocarcinoma in a young female complicating young pregnancy. Ovarian mucinous adenocarcinoma is a rare ovarian tumour that arises from the surface epithelium of the ovary. A 25-year young female, 9 days post-partum presented to the hospital with complain of abdominal distension. USG finding suggesting large solid cystic mass 36 × 14 cm arising from pelvis extending up to epigastrium. MRI pelvis evident of heterogenous hyperintense solid cystic mass lesion giving bunch of grapes appearance with size 24.5 × 25 × 11.5 cms seen in intra peritoneal space extending cranially up to epigastrium and caudally into pelvis giving anterior displacement of uterus.  And posterior displacement of bowel loops. A large part of lesion is cystic with solid component with multiple internal echoes.

Mending aesthetics in anterior region - A case report

Lately esthetic rehabilitation has come to be a demanding treatment as a way to correct malposed as well as missing anterior dentition, the advent of creating an esthetic smile has become a part of routine dental practice. An attractive or appealing smile sincerely enhances the recognition of an individual in our society with the aid of enhancing the initial impact in interpersonal relationships. Any esthetic correction calls for right expertise and knowledge. Such rehabilitation can be achieved successfully with the aid of numerous treatment approaches. Orthodontic treatment is one of the most conservative approach for such cases but it is not an acceptable treatment option for most of the patients due to various reasons like long treatment time, financial constraints, appearance during the therapy, and relapse after the treatment. Alternatively, endodontic approach combined with prosthodontics offers a brief, reliable and economic treatment modality for such cases. Placement of implants has also become a treatment of choice for replacement of teeth in esthetic zone with advantages like preservation of unrestored adjacent teeth and halting the resorption of edentulous spaces to provide support for the prosthesis. This case report illustrates the multidisciplinary approach for rehabilitating aesthetics in anterior region.

Intraoral scanners: A narrative review

Objectives: Accurate impressions are essential in fabricating dental restorations and fixed dental prostheses. During the last decade, digital impression systems have improved substantially. The objective of this narrative review is to discuss the recent research on intraoral scanners with regards to it's technology, accuracy and applications for fabrication of dental restorations and fixed dental prostheses. Materials and methods: A search strategy was performed in MEDLINE/PubMed, Scopus and Google Scholar with keywords - intraoral scanners, accuracy, applications, dentistry. Results: 395 articles were retrieved. After hand search a total of 415 articles were identified. Ultimately, 30 articles were selected and summarized and discussed as they met the selection criteria. Conclusion: Within the scope of this review, reported literature showed that digital intra-oral impressions have presented an achievement in the dental market as they reduce time required and simplify the clinical procedures with better communication with the technician and the patient. The current intraoral scanners (IOS) are sufficiently accurate for capturing impressions for fabrication of prosthetic restorations (inlays/onlays, copings and frameworks, single crowns and fixed partial dentures) on both natural teeth and implants; in addition, they can be used for smile design, and to fabricate posts and cores, removable partial prostheses, obturators, orthodontic aligners and custom made devices. The use of IOS in long-span restorations with natural teeth or implants is still a challenge.

Insights into the gastrointestinal tract microbiomes of Indian population

Trillions of microbes living in the gastrointestinal tract (GIT) of the human body finely tune homeostatic equilibrium in theGIT ecosystem and encode key functionalities that play crucial role in host metabolic functions, synthesis of macro- andmicronutrients, xenobiotics metabolisms, development of innate and adaptive immune systems, tissue and organ developments and resistance against invasion of enteric pathogens. The microbial diversity and richness of GIT ecosystem variesgreatly between individuals and over time. Extent of taxonomic and functional variations in GIT ecosystem is linked withdietary habit, pharmaceuticals usages, age, sex, body mass index, ethnicity, geography, altitude and civilization. Understanding a holistic picture of GIT microbiome of healthy people living across geography and identifying population specific‘keystone’ taxa is of immense importance for identifying microbial species that may provide protection against chronic andmetabolic diseases. Knowledge on geographic or ethnicity specific microbial signatures may also help us to understand thevaried efficacy of different drugs and vaccines in different population. India is the home of more than 1.36 billion peoplebelonging to 2000 human communities residing in well distinct geography. In the present review, we discuss the microbialsignatures in health and diseases of the rural and urban Indians living in sea level and high altitude areas.

BioHPP: Properties and applications in prosthodontics a review

Introduction: The demand for metal free restorations may it be fixed or removable has increased manifold in the recent past. BioHPP is one such material that has been introduced recently in the field of prosthodontics. Aim: The aim of this narrative review is to discuss the properties of BioHPP (Biocompatible High Performance Polymer) material and its applications in the field of prosthodontics Materials and Methods: A search strategy was performed on PubMed and Google Scholar with key words: Modified PEEK, BioHPP, Prosthodontic applications. Results: Seventy nine articles were retrieved. After hand search and along with cross reference a total of 84 articles were identified. Ultimately 18 articles were selected and discussed as they met the selection criteria. Conclusion: Within the scope of this review, reported literature showed that BioHPP has proven to be a boon to the field of prosthodontics as a result of its excellent biocompatibility as well as mechanical properties. BioHPP offers a wide range of applications may it be in removable or fixed prosthodontics. With an increase in the number of clinical trials and long term follow up studies, BioHPP might prove to be a material of choice for a variety of prosthodontic applications.

Endometrial evaluation with methylene blue staining in patients with normal hysteroscopy

Background: Normally, endometrium comprises of non-absorptive epithelium and does not take up stain. Conventional staining with methylene blue is explained on the basis of existence of apoptotic cells in endometrium.Methods: Of 50 patients of unexplained infertility, AUB, recurrent pregnancy loss were randomly selected and included in the study. Those with abnormal ultrasound and history of tuberculosis were excluded. Conventional hysteroscopy was performed using normal saline as distending medium and in those with grossly normal endometrium were subjected to staining with 5% methylene blue instilled trans cervically. After 5 min, irrespective of the size and pattern, focal dark blue stained areas were considered abnormal and randomly biopsied. Incidence of endometritis in both groups was compared after histopathological examination.Results: Of total 50 patients, histopathological report of only one patient with dark blue staining had evidence of endometritis. Rest had no evidence, of which 73.5% had light blue or unstained areas and 26.5% showed dark blue staining. No statistically significant difference was found between histopathological reports and light or dark blue staining (p=0.28). When percentage stained area was considered more than 50% only to be positive, sensitivity was 100%, specificity 94%, PPV 25% and NPV 100%. False positives were 75% and no false negatives were observed. Although p values improved but still statistically insignificant.Conclusions: Present study failed to establish any significant correlation between staining pattern and detection rate of endometritis. With no Indian studies published on chromohysteroscopy so far, role of methylene blue in detection of subtle endometrial changes in modern gynaecology in Indian subpopulation is yet to be established.

Evaluation of shoulder kinesthesia in patients with unilateral frozen shoulder

Background: Intact sensory-motor system provides kinesthesia for maintaining joint stability. Joint proprioception or joint kinesthetic sensation is often used alternately to describe a deep sensation of joint motion and joint position sense. Mechanoreceptors located in superficial layer of joint capsule, muscle spindle, golgi tendon organ complex and ligaments around joint provides joint kinesthetic sensation. Frozen shoulder or adhesive capsulitis is one of the common musculoskeletal disorders encountered in Indian population with a prevalence of almost 50% older patients with diabetes and 2-10% in non-diabetic patients. This study assessed joint kinesthetic sensation during shoulder movements in people with frozen shoulder and healthy controls which may be affected due to presence of disease process or pain. Authors hypothesized that pain and alterations in non-contractile tissues (mainly capsule) around shoulder joint due to frozen shoulder may interfere with the joint kinesthetic sensation.Methods: Case group consisted of 41 participants with frozen shoulder and 41 healthy participants without shoulder pathology. Joint kinesthesia was assessed in frozen shoulders and dominant shoulders using angle reproduction test by actively reproducing the target angle placed passively by the therapist during flexion, abduction, medial and lateral rotation movements. The angle reproduced was measured using universal goniometer by the same therapist and 3 readings were recorded.Results: Results indicate significant differences between the mean difference of angle reproduction test during shoulder movements in cases of frozen shoulder and healthy group (p value <0.05).Conclusions: Significant shoulder kinesthetic deficits were observed in patients with unilateral frozen shoulder. Therefore, clinicians should consider rehabilitation of kinesthesia in treatment of patients with frozen shoulder.

Clinical, Cytological and Histopathological Study of Salivary Gland Lesions

Background: A prospective study was conducted in the Department of Pathology, GMC Patiala for two years on 60 patients with swellings of jaw seeking consultation in Rajindra Hospital, Patiala. Methods: Fine Needle Aspiration Cytology (FNAC) was done on all these patients followed by microscopic examination of the prepared slides and relevant clinical information was collected. The data was compiled and analysed statistically. In lesions where surgery followed FNAC, the comparison was done with histopathology and statistical values were calculated. Results: The results of the study were: non-neoplastic cases were 51.7% and neoplastic cases were 48.3%. Maximum cases were of chronic sialadenitis (30%) followed by pleomorphic adenoma (23.3%). Parotid gland was involved in maximum cases (60%). Biopsies or specimens for histopathological examination were received for 30 cases; maximum cases of which were diagnosed as pleomorphic adenoma on histopathology. Among malignant tumors, mucoepidermoid carcinoma was the most common. Conclusion: On correlating the cytological and histopathological nature of salivary gland lesions, sensitivity of FNAC came out to be 75%, specificity 100% and accuracy was calculated as 93.3%.

Clinicopathological Study of 100 Cases of Hysterectomies In A Tertiary Care Centre

ackground: A retrospective study of 100 cases of hysterectomies was conducted in Dept. of Pathology, GovernmentMedical College, Patiala. Methods:Clinical and histopathological data were collected and correlation made. Maximum number of patients who underwent hysterectomy were in the age-group of 41-50 years. Results: The median age came out to be 47 yrs. Abnormal uterine bleeding was the most common complaint (82%). Main indication of hysterectomy was fibroid(63%) followed by prolapse (14%) and adenomyosis (12%). Histopathological correlations were made with the clinical findings. On histopathology, leiomyoma was the most common diagnosis followed by atrophic endometrium and adenomyosis. Conclusion: Correlation between clinical and histopathological diagnosis was very good. But still, histopathology remains the mainstay of establishing the confirmatory diagnosis and for histological subtyping of malignancies.

Meibomian Gland Dysfunction as an Indicator of Hypercholesterolemia: A Case Control Study

Background: Chemical analysis of lipids secreted from meibomian glands shows that it consists of a mixture of non-polar and polar lipids. Systemic dyslipidemia may theoretically affect the meibomian lipid composition and secretion. The purpose of this study was to investigate a possible correlation between Meibomian gland dysfunction (MGD) and hypercholesterolemia and that MGD may become a marker of previously unknown hypercholesterolemia. Methods: After obtaining approval of the Institutional Ethics Committee, a case control study was undertaken in the Department of Ophthalmology, AJ Institute of Medical Sciences and Hospital from August 2016 till January 2017 enrolling 60 MGD cases and 100 controls. Patients satisfying inclusion and exclusion criteria were enrolled and examined using pre-specified clinical criteria. Using statistical analysis serum lipid profile was compared for cases and controls.Results: 60 cases of MGD and 100 controls with average age 48.03±12.05 and 44.61±12.11 years respectively were enrolled. Higher serum triglyceride levels were seen in cases (144.03±55.54 mg/dL) and so were higher low density lipid levels (122.16±39.41 mg/dL). MGD cases had higher levels of high density lipids (42.36±13.16 mg/dL) and controls had 41.38±12.17. Using Fisher’s exact test, gender of the subjects was found to be statistically significant for MGD development (p=0.006). Distribution of serum cholesterol and low density lipids was found to be statistically different across the different categories of MGD; p=0.006 and p=0.037 respectively. Conclusion: This study suggests that MGD can act as a clinical marker for hypercholesterolemia. Larger, multi-centric studies are required to confirm our findings

Antiplasmodial activity of silver nanoparticles: A novel green synthesis approach

Objective: To synthesize silver nanoparticles using silver nitrate by a green technique which involves different compositions of aqueous leaf extracts of Azadirachta indica (neem) and Ocimum sanctum (tulsi). Methods: Their shape and size were determined using transmission electron microscopy and UV-visible spectroscopy. Their antiplasmodial activity was studied using the malarial parasite strain (Plasmodium falciparum, 3D7). The parasite strain (3D7) was collected and revived in vitro using Trager and Jensen method in RPMI 1640 medium for 7-8 cycles. Half maximal effective concentration values were calculated by nonlinear regression analysis. Results: Transmission electron microscopy results confirmed the formation of silver nanoparticles with size ranging from 4.74-39.32 nm and their size differs by varying the concentrations from 20% to 100% of neem extract in neem and tulsi extracts. It was observed that samples B and C showed half maximum effective concentration of about 0.3 μ M. Conclusions: It can be easily established that the aqueous leaf extracts of neem and tulsi in combination can be a good source for synthesis of silver nanoparticles with small size possessing appreciable antiplasmodial activity.

Antiplasmodial activity of silver nanoparticles: A novel green synthesis approach

Objective: To synthesize silver nanoparticles using silver nitrate by a green technique which involves different compositions of aqueous leaf extracts of Azadirachta indica (neem) and Ocimum sanctum (tulsi). Methods: Their shape and size were determined using transmission electron microscopy and UV-visible spectroscopy. Their antiplasmodial activity was studied using the malarial parasite strain (Plasmodium falciparum, 3D7). The parasite strain (3D7) was col ected and revived in vitro using Trager and Jensen method in RPMI 1640 medium for 7-8 cycles. Half maximal effective concentration values were calculated by nonlinear regression analysis. Results: Transmission electron microscopy results confirmed the formation of silver nanoparticles with size ranging from 4.74-39.32 nm and their size differs by varying the concentrationsfrom20％to100％ofneemextractinneemandtulsiextracts.Itwasobservedthat samples B and C showed half maximum effective concentration of about 0.3μM. Conclusions:It can be easily established that the aqueous leaf extracts of neem and tulsi in combination can be a good source for synthesis of silver nanoparticles with smal size possessing appreciable antiplasmodial activity.