A Study of Malaria in Seven States of India: Jammu and Kashmir; Punjab, Uttar Pradesh; Madhya Pradesh; Assam; Manipur, Arunachal Pradesh

Background: To the best knowledge of the author, there is no available literature on the status of Malaria in the Union Territory (U.T.) of Jammu and Kashmir (J & K), the Punjab state of India, Uttar Pradesh, Madhya Pradesh, Assam, Manipur and Arunachal Pradesh. Hence the preparation of this document. Objectives: To find out the parameters of Malaria in the U.T. of J & K, Punjab state of India, Uttar Pradesh, Madhya Pradesh, Assam, Manipur, and Arunachal Pradesh till as recently as possible. Methods: By studying the documents prepared by the National Vector Borne Disease Control Programme (NVBDCP), an internet search, a study of the website of the National Health Mission, Manipur, and a study of the document titled “National Framework for Malaria Elimination in India 2016-2030” published by the NCVBDC. Results: Rajouri District in the U.T. of J & K had an Annual Parasite Incidence (API) of Malaria during 2017 of 0.12 which decreased to 0.06 in 2018. It is seen that the API of Malaria in Punjab had come down to the very low level of 0.02 in 2018 and that there were only 4 cases of Malaria during 2021 (up to 26 th April 2021). Bareilly district in Uttar Pradesh had a low API of Malaria of 0.06 during 2017 which increased to 7.32 in 2018. Sheopur District of Madhya Pradesh had a very high API of Malaria during 2017 and 2018 of 6.34 and 4.42 respectively. Udalguri district in Assam had an API of Malaria during 2017 of 1.24 which increased to 2.62 in 2018. Manipur reached zero API in 2018. Arunachal Pradesh used to have a high API of Malaria of 4.30 during 2014 which decreased to 0.39 in 2018. Conclusions: If interventions like the treatment of asymptomatic carriers take place, it is expected that the API in the U.T. of J & K, Madhya Pradesh, Assam, and Arunachal Pradesh will come down sooner. Punjab state of India is very close to achieving Malariaelimination goals. A finding from the 2019 Malaria epidemic in Uttar Pradesh was that, out of the 74749 cases of Malaria in the state, 9690 were found to be due to P. falciparum. Although Manipur did not reach zero Malaria cases in 2018, it did reach zero API that year. Therefore, it is a good candidate for being the first state or union territory in the country close to being able to achieve near-elimination goals since no other state or union territory achieved zero API in 2018.

A study of malaria in bordering countries of India: Nepal, Pakistan, and Thailand

Background: Malaria still occurs in Nepal, Pakistan and Thailand which are countries of the South-east Asia region. Material and Methods: For the present study, three countries’ (Nepal, Thailand, and Pakistan) Malaria Prevalence and their strategic elimination programs of were taken into consideration based on all the available online data. These countries were compared by their preventive strategies and stipulated eradication time according to their geographical areas. They were further classified as endemic, non-endemic areas of their country maps and tabulated respectively. Results: During 2021, there were 623 reported confirmed cases of Malaria in Nepal. Of these, 94% were caused by Plasmodium vivax while 5% were due to P. falciparum. During 2021, there were 350,467 reported confirmed cases of Malaria in Pakistan. Of these, 78% were caused by Plasmodium vivax while 21% were due to P. falciparum. During 2021, there were 7420 cases of Malaria in Thailand of which 61% were due to Plasmodium vivax and 23% were due to P. falciparum. Conclusion: The number of imported cases of Malaria from India to Nepal and vice versa would decrease if anti-Malaria measures are stepped up in the respective countries’ border districts. The main species causing Malaria in Pakistan is Plasmodium vivax. This will prove a challenge to eliminate because of the hypnozoites that are difficult to treat which remain latent in the liver and cause recurrent attacks of the disease even if the initial phase is apparently cured. Thailand aims to eliminate Malaria by 2024 using the methods of timely surveillance and quick response.

Treatment of Chloroquine-Resistant Plasmodium vivax Malaria in India

Background: Treatment failure in P. vivax Malaria is a major dilemma that faces health care workers. True drug resistance is one of the causes after ruling out compliance and drug quality issues. The other two causes are re-infection during the treatment period or the release of hypnozoites from the liver. Objectives: To find out what antimalarials can be prescribed in India for treating Chloroquine-resistant P. vivax Malaria. Methods: By reviewing documents prepared by the National Center for Vector-Borne Diseases Control (NCVBDC) and doing a PUBMED search for articles that deal with Chloroquine-resistant P. vivax Malaria treatment. Results: It was found that a fixed-dose combination of oral Artemether and Lumefantrine can be given for Chloroquine-resistant P. vivax Malaria. Conclusions: There is a lack of awareness among health care providers on how to treat Chloroquine-resistant P. vivax Malaria. This paper addresses this concern.

A Study of Malaria in Meghalaya State

The South Garo Hills District of Meghalaya had a high number of 284 Malaria cases out of which 281 were due to Plasmodium falciparum and an Annual Parasite Incidence (API) of 1.69 during 2021. However, if interventions like the treatment of asymptomatic carriers take place, it is expected that the API and the number of Malaria cases will come down further.

Treatment of Artemisinin-Resistant Plasmodium falciparum Malaria in India

Background: Treatment failure in P. falciparum malaria is a major dilemma that faces health care workers throughout the country. True drug resistance is one of the causes after ruling out compliance and drug quality issues. The other cause is re-infection with a new strain of the parasite during the treatment period. Objectives: To find out what are the antimalarials prescribed in India for the treatment of Artemisininresistant P. falciparum malaria. Methods: By reviewing documents published by the National Vector Borne Disease Control Programme. Results: It is found that a combination of oral Quinine and oral Clindamycin can be given for Artemisinin-resistant P. falciparum malaria. Conclusions: There is a lack of awareness among health care providers on how to treat artemisinin-resistant P. falciparum malaria. This paper addresses this concern.

A study of Malaria in the Union Territory (U.T.) of Dadra and Nagar Haveli and Daman and Diu (DNHDD)

One of the districts in the newly reconstituted U. T. of DNHDD had a high Annual Parasite Incidence (API) of Malaria during 2014 which decreased in 2017 and 2018. However, if interventions like the treatment of asymptomatic carriers take place, it is expected that the API will come down sooner there.

A Study of Malaria in Tripura State

A Study of Malaria in Tripura State

A study of Slide Positivity Rate (SPR) in three Districts of the Bastar Region of Chhattisgarh State

In Dantewada and Kanker Districts, the SPR began to rise between the 2019-20 and 2020-21 periods, despite the third phase “Malaria-Mukt Bastar Abhiyan” conducted during December 2020 and January 2021. However, in Narayanpur District, it was seen that the SPR came down following the third phase campaign. It remains to be seen as to what the effect of the Phase 4 campaign on the SPRs of Dantewada, Kanker, and Narayanpur would be. This would be possible once the SPR values for 2021-22 are available for these districts.

Hypoplastic right ventricle with multiple associated anomalies: A challenging case for biventricular repair or univentricular approach? – A case report

Hypoplastic right ventricular is a rare congenital heart disease. A few cases have been reported. We presented a case with hypoplastic right ventricular and multiple associated anomaly (Ventricular septal defect, atrial septal defect and pulmonary stenosis) in whom the main concern was whether biventricular repair or Fontan type surgery would be the optimal management in this patient. Biventricular repair was done successfully using the multimodality cardiac imaging with intraoperative transesophageal echocardiography.

Acardiac twin – A case report

Acardiac twinning is a rare congenital anomaly of monozygotic twin pregnancy which often results from abnormal placental vascular anastomosis. It leads to twin reversal arterial perfusion with complex pathophysiology. Current information on early recognition and treatment for salvation of the normal twin is based on individual case reports in the literature. Mortality of Acardiac twin is 100%. Pump twin though structurally normal suffers due to heart failure and prematurity and has high morbidity and mortality all due to pumping blood to the acardiac twin. The acardiac twin receives all its blood supply from the pump twin through anastomotic channels, the term reversed perfusion is used to describe this condition because blood enters the acephalic twin through umbilical artery and exit through umbilical vein which is opposite to the normal blood supply. The acardiac twin loses direct vascular connection with the placental villi and receives its entire blood supply from the pump twin. Here, we have presented a primigravida of 24-26 weeks of gestation with twin gestation of monochorionic diamniotic type in preterm labor. One of the twin was acardiac acephalous and another a pump twin with hydrops.

In-vitro and in-vivo anti-inflammatory activity of Andrographis serpyllifolia (Rottl. Ex Vahl.) Wt.

The study was aimed to evaluate the analgesic and anti-inflammatory activity (by both in-vitro and in-vivo) of both chloroform and methanol root extracts of Andrographis serpyllifolia (Rottl. Ex Vahl.) Wt. Methods used for the studies were In-vitro 5-Lipoxygenase inhibition assay and In-vivo measurement of rat paw edema and ear edema in rats, acetic acid induced writhing response and hot plate method in albino mice. Chloroform and methanolic extracts of A. serpyllifolia root have shown moderate potency in inhibiting 5-LOX and shown significant anti-inflammatory activity. Despite the IC50 values are little higher, anti-inflammatory efficacy of these extracts possibly due to other mechanisms apart of 5-LOX inhibition. However, In-vivo anti-inflammatory studies revealed that A. serpyllifolia methanolic extract has shown higher degree of efficacy when compared to the chloroform extract. In terms of analgesic activity in writhing test, methanolic extract has shown more efficacy than chloroform extract. Hence, it is important to isolate the active principles for further testing the anti-inflammatory efficacy.

Microbicides in India-present and future.

India continues to wage a battle against the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic. Despite an array of preventive and control efforts directed against the disease, it continues to finds its way from the high risk groups to the general population. Women are more vulnerable to HIV/AIDS because of biological as well as socio-cultural factors. Microbicides appear to provide an attractive option as a means of protection to be used by women. At present, microbicide trials are in study phases I and II in India. The development of an ideal microbicide candidate which would be effective and confirms to user satisfaction poses a major challenge to researchers.

Female feticide in India: issues and concerns.

The preference for a son continues to be a prevalent norm in the traditional Indian household. This is evident from the declining sex ratio which has dropped to alarming levels, especially in the northern states according to Census 2001 reports. The proliferation and abuse of advanced technologies coupled with social factors contributing to the low status of women such as dowry, concerns with family name and looking up to the son as a breadwinner has made the evil practice of female feticide to become common in the middle and higher socioeconomic households, especially in the northern states. Despite the existence of the Prenatal Diagnostic Techniques Act, there is a dire need to strengthen this law since the number of convictions is despairingly low as compared to the burden posed by this crime. Moreover, it is necessary to gear efforts against the cultural, economic and religious roots of this social malady by woman empowerment and intensive Information, Education and Communication campaigns. The medical colleges and professional bodies have a vital role to play by sensitizing medical students who are the doctors of tomorrow.

Comparative role of proteins in transport of HCH-isomers in desert locust, Schistocerca gregaria Forskal and bovines.

The studies on binding of hexachlorocyclohexane (HCH) with carrier proteins were carried out to establish the role of proteins in the transport of insecticides in insects. Sephadex G-200 column chromatography resolved haemolymph of adult male desert locust, Schistocerca gregaria into three major protein peaks. There was significant binding of gamma-HCH with first protein peak (F1). Two classes of binding sites were observed on first protein peak for gamma-HCH. However low level of binding was observed with the third protein peak (F3) of the haemolymph. Bindings of HCH-isomers (alpha, beta and gamma) with bovine serum albumin (BSA) were not related to their water solubilities. Moderate to low affinities (1.4 -1.84 x 10(6) M(-1)) of HCH-isomers for BSA were observed. The present studies showed that more HCH binds to haemolymph lipoprotein of locust as compared to BSA. This indicates a significant role of haemolymph proteins in the transport of insecticides in insects.

Antiallergic/antiasthmatic effect of novel antiallergic hexapeptide-95/220 in various experimental models.

The effects of newly synthesized antiallergic hexapeptide 95/220 was investigated on various allergic and asthmatic test models. This newly developed peptide was found to be more potent than clinically used drug disodium cromoglycate (DSCG). Hexapeptide 95/220 inhibited immediate hypersensitivity reactions such as passive cutaneous anaphylaxis (PCA) and mast cell degranulation in rats, antigen-induced bronchoconstriction in actively sensitized guinea pigs in dose dependent manner like DSCG. Antigen-induced contraction of guinea pig ileum was also markedly inhibited by this newly developed hexapeptide in the same fashion as ketotifen and DSCG did but at comparatively lower dose. Egg albumin-induced histamine release was also blocked by this hexapeptide from chopped lung tissues of sensitized guinea pigs. These results suggest that hexapeptide' 95/220 has potent inhibitory effect on immediate hypersensitivity reactions thereby inhibiting mediator release from mast cell. Moreover, this newly synthesized peptide is orally active and effective at lower doses as compared to standard drugs.

Galaxy of health hazards in various socio-cultural scenario.

The word 'Health' has enjoyed an enormous popularity with writers during the past quarter century. It was only during the second world war, the term 'social medicine' came into wider use. The concept of social medicine has given a new orientation of medicine to the changing needs of man and society. The vast majority of the population of the world still have no access to decent health care.

Insecticide interaction with carrier and neuroproteins.

Binding of alpha-, beta-, gamma-hexachlorocyclohexane, p,p'-DDT and p,p'-DDE with bovine serum albumin (BSA) and locust brain homogenate was studied. Binding affinities of pesticides were higher for the locust brain homogenates than for BSA. Results of uptake by isolated locust brain revealed higher uptake of gamma-HCH than alpha-HCH. gamma-HCH uptake was also higher from locust haemolymph than either from BSA or from buffer.

Isolation and characterization of the haemolymph lipoprotein of desert locust, Schistocerca gregaria Forskal.

A yellow lipoprotein was isolated and purified from haemolymph of desert locust, Schistocerca gregaria Forskal, by precipitation at low ionic concentration and by gel filtration. Sephadex G-200 resolved haemolymph into five protein peaks. First peak was of lipoprotein with molecular weight of 501,000 +/- 7000 (n = 3) and on electrophoresis, it separated into three bands. Maximum lipids from lipoprotein could be extracted with chloroform: methanol solvent system and were 52% by weight.

Massive lymphadenopathy in chronic myelocytic leukemia.

A 50 year old male presented with massive lymphadenopathy and was found to be in extramedullary blast crisis is reported. Lymphadenopathy regressed on busulphan therapy and the overt blast crisis took 15 months to occur after initial presentation.