Design and synthesis of mixed-ligand architectured Zn-based coordination polymers for energy storage.

In this work, a Zn-based 1D coordination polymer [Zn(H2O)(C10H8N2)(C9H4O6)]·2H2O, denoted as Zn-CP, has been designed and synthesized by a slow diffusion mediated multi-ligand approach at room temperature. The Zn-CP material is characterized by single crystal analysis and other spectroscopic methods. A heteronanocomposite (Zn-CP/rGO) is prepared by mixing Zn-CP with conductive rGO nanosheets through ultrasonication and is used as a battery-type material for supercapacitor application. The Zn-CP/rGO hybrid nanostructure material delivers a specific capacity of 188.5 C g-1 (377 F g-1) at a current density of 1 A g-1 with good cycling stability (85% capacity retention upon 6000 charge-discharge cycles at 6 A g-1) and a high coulombic efficiency of 97% while a pure Zn-CP electrode delivers only 135.5 C g-1 (261 F g-1) at the same current density. Furthermore, a hybrid supercapacitor device (Zn-CP/rGO∥AC) is fabricated, which delivers a maximum energy density of 13.3 W h kg-1 and a power density of 7446 W kg-1. The suitable power density and long standing endurance of the hybrid device show promising potential for battery-type supercapacitor application.

Design of ZIF-67 nanoflake derived NiCo-LDH/rGO hybrid nanostructures for aqueous symmetric supercapattery application under alkaline condition.

Well-defined polyhedral ZIF-67 metal-organic frameworks (MOFs) are usually synthesized using methanol as solvent. In this work, methanol is replaced with deionized water as a solvent to synthesize ZIF-67 MOFs with unique nanoflake morphology. The ZIF-67 nanoflakes are synthesized directly byin situmethod on reduced graphene oxide (rGO) to obtain ZIF-67/rGO-xprecursors which are further transformed into NiCo-layered double hydroxide nanocomposites (NiCo-LDH/rGO-x,x = 10, 30, 50 and 90 mg of rGO). The NiCo-LDH/rGO-xnanostructured composites are found to be excellent materials for battery type supercapacitor (supercapattery) applications. Among these samples, the NiCo-LDH/rGO-30 composite gives maximum specific capacity of 829 C g-1(1658 F g-1) at a current density of 1 A g-1and high rate capability. The as fabricated 2-electrode symmetric Swagelok deviceNiCo-LDH/rGO-30NiCo-LDH/rGO-30delivered a high energy density of 49.2 Wh kg-1and a power density of 4511 W kg-1, and enabled us to glow red, blue and white LED bulbs using three coin cells. The device can show good capacity retention even after 3000 continuous charge-discharge cycles. The NiCo-LDH/rGO-30 composite,in situderived from ZIF-67 MOF in combination with optimal amount of rGO, is an excellent material to deliver both high energy density and high power density in supercapattery devices.

Arthrospira sp. mediated bioremediation of gray water in ceramic membrane based photobioreactor: process optimization by response surface methodology.

Direct discharge of raw domestic sewage enriched with nitrogenous and phosphorous compounds into the water bodies causes eutrophication and other environmental hazards with detrimental impacts on public and ecosystem health. The present study focuses on phycoremediation of gray water with Arthrospira sp. using an innovative hydrophobic ceramic membrane-based photobioreactor system integrated with CO2 biofixation and biodiesel production, aiming for green technology development. Surfactant and oil-rich gray water collected from the domestic kitchen was used wherein, chloride, sulfate, and surfactant concentrations were statistically optimized using response surface methodology (RSM), considering maximum microalgal growth rate as a response for the design. Ideal concentrations (mg/L) of working parameters were found to be 7.91 (sulfate), 880.49 (chloride), and 144.02 (surfactant), respectively to achieve optimum growth rate of 0.43 gdwt/L/day. Enhancement of growth rate of targeted microalgae by 150% with suitable CO2 (19.5%) supply and illumination in the photobioreactor affirms its efficient operation. Additionally, harvested microalgal biomass obtained from the process showed a biodiesel content of around 5.33% (dry weight). The microalgal treatment enabled about 96.82, 87.5, and 99.8% reductions in BOD, COD, and TOC, respectively, indicating the potential of the process in pollutant assimilation and recycling of such wastewater along with value-added product generation.

The study elucidated the application of indigenously designed and devised ceramic membranes in an algal photobioreactor for viable production of Arthrospira sp. employing gray water, aided by photosynthetic CO₂ sequestration and microalgal biorefinery. A highly encouraging result was achieved in the microalgal process under optimized culture conditions with >95% removal of organics. It may be stressed here that the process ran effectively without any elaborate arrangement of external aeration, thereby reducing the investment and operating costs to the minimum.

MoO3 thin layers on NiCo2S4 substrate for efficient electrochemical charge storage.

Ternary oxides/sulfides have long been investigated as promising electrode materials for charge storage applications. However, it is important to rationally design nanostructured hybrid composites for superior charge storage performance as electrodes in devices. In this work, MoO3@NiCo2S4 hybrid composites materials are synthesized by the hydrothermal method followed by annealing at different temperatures. The charge storage properties of these materials are tested by cyclic voltammetry, galvanostatic charge-discharge curves and electrochemical impedance spectroscopy. It is found that the structure of the hybrid composite material not only assists electron and charge transportation but also precisely control the volume expansion during redox reactions, contributing to superior electrochemical behavior. Among all the electrodes, the electrode fabricated with MoO3@NiCo2S4 composite material annealed at 400 °C (MoO3@NiCo2S4-400) is the best for charge storage applications. At 400 °C, MoO3 spreads as a thin layer of surface polymeric molybdates on NiCo2S4 as seen in the XRD pattern. Significantly, it delivers the highest capacitance of 1622 F g-1 at 1 A g-1 in 2 M aqueous KOH electrolyte compared to other hybrid composite electrodes, NiCo2S4 (962 F g-1), MoO3@NiCo2S4-500 (1412 F g-1) and MoO3@NiCo2S4-600 (970 F g-1), under the same measurement conditions. Furthermore, the MoO3@NiCo2S4-400 hybrid electrode shows better cyclic stability with 93% capacitance retention after 3000 charge-discharge cycles at 8 A g-1. The synergistic effect of two components and annealing temperature plays important role in enhancing the charge storage performance. This work shows the importance of the synthesis temperature on the functional character of ternary sulfide/oxide composite materials for charge storage applications.

Directed Self-Organization Ensured Enhancement of Charge Carrier Mobilities in a Star-Shaped Organic Semiconductor.

Controlled self-organization of organic semiconductor molecules into specifically desired architectures on substrates of interest is one of the most imperative challenges faced in the fabrication of high-performance organic electronic devices. Herein, we report the self-organization of a star-shaped molecule FDT-8 into a highly favored structure, namely, a vertical stack. Thermal annealing of films of FDT-8 deposited on PEDOT: PSS coated ITO substrates was observed to assist the organization of the molecules into columnar stacks. A significant enhancement in the hole (≈50-fold) and the electron (≈13-fold) carrier mobility was observed in single-carrier devices upon thermal annealing that could be attributed to the aforementioned self-organization. The ability of these molecules to spontaneously self-organize was utilized to fabricate bilayer light-emitting devices.

Control over Kinetic and Thermodynamically Driven Pathways of Crystallization to Yield Cofacial and Slipped-Stack Dimers in Single Crystals.

Control over the molecular packing in the solid state is of utmost importance in regulating the bulk optical properties of organic semiconductors. The electronic coupling between the molecules makes it possible to improve the properties of the bulk materials. This work reports an example of control over the selective formation of polymorphic single crystals of donor-acceptor-type small-molecule compound 25TR by 1) kinetic or 2) thermodynamic course of crystallisation to yield slipped stack (S) and cofacial (C) dimers in the single crystals. The distinct optical characteristics of the C-dimer and S-dimer are summarised. Both forms show significant excitonic interactions in the solid state, and the S-dimeric form has strong yellowish orange fluorescence, whereas the C-dimeric form is non-fluorescent in the crystalline state. DFT calculations and differential scanning calorimetric experiments revealed that the C-dimer polymorph is the thermodynamically stable form with a free energy offset of 0.43 eV in comparison with the S-dimer. Interestingly, the thermodynamically driven non-fluorescent single crystal was found to be convertible to its fluorescent form irreversibly by thermal trigger. The charge-carrier-transport characteristics of these two polymorphs were computed by using the Marcus-Hush formalism. The computations of the charge-carrier-transport behaviour revealed that the S-dimer (25TR(R) ) is ambipolar, whereas the C-dimer (25TR(Y) ) is predominantly n-type.

Non-Equilibrium Polymerization of Cross-ß Amyloid Peptides for Temporal Control of Electronic Properties.

Hydrophobic collapse plays crucial roles in protein functions, from accessing the complex three-dimensional structures of native enzymes to the dynamic polymerization of non-equilibrium microtubules. However, hydrophobic collapse can also lead to the thermodynamically downhill aggregation of aberrant proteins, which has interestingly led to the development of a unique class of soft nanomaterials. There remain critical gaps in the understanding of the mechanisms of how hydrophobic collapse can regulate such aggregation. Demonstrated herein is a methodology for non-equilibrium amyloid polymerization through mutations of the core sequence of Aß peptides by a thermodynamically activated moiety. An out of equilibrium state is realized because of the negative feedback from the transiently formed cross-ß amyloid networks. Such non-equilibrium amyloid nanostructures were utilized to access temporal control over its electronic properties.

Cross-Sectional Study for the Detection of Mutations in the Beta-Globin Gene Among Patients with Hemoglobinopathies in the Bengali Population.

AIMS: Thalassemia is a common autosomal recessive blood disorder, which is most prevalent in South East Asian and Mediterranean populations. It is considered as a major health burden in the Indian population. The aims of the present study were to investigate the common, as well as uncommon, mutations responsible for thalassemia in the Bengali population. METHODS: The Bengali state was divided into four sampling zones. Mutation detection was done using Sanger sequencing of the HBB gene. RESULTS: A total of 14 different mutations were observed, including rare mutations IVS1-130(G>C), IVS1-129(A>C), -90(T>C), CD16(-C), -30(T>C), CD15(-T), and a novel mutation CD53(C>T). The frequencies of IVS1-5(G>C) and CD26(G>A) mutations were higher than other mutations. There were also some silent polymorphisms found in the studied group, CD3(T>C), CD10(C>A), IVSII-16(G>C), IVSII-74(T>G), -42(C>G). CONCLUSION: The present study is the first attempt to screen for ß-thalassemia-causing mutations by direct sequencing in different districts of West Bengal. The information obtained from the present study may be helpful for thalassemia management and prenatal mutation detection.

Effects of methionine chelate- or yeast proteinate-based supplement of copper, iron, manganese and zinc on broiler growth performance, their distribution in the tibia and excretion into the environment.

A straight-run flock of 1-day-old Cobb 400 chicks (n = 432) was distributed into four treatment groups (9 replicate pens in each group, 12 birds in a pen) for a 38-day feeding trial evaluating the effects of a methionine chelate (Met-TM)- or a yeast proteinate (Yeast-TM)-based supplement of copper (Cu), iron (Fe), manganese (Mn) and zinc (Zn) on growth performance, bone criteria and some metabolic indices in commercial broiler chickens. The diets were either not supplemented with any trace elements at all (negative control, NC) or supplemented with an inorganic (sulphate) trace element premix (inorganic TM (ITM), 1 g/kg feed), the Met-TM (1 g/kg feed) and the Yeast-TM (0.5 g/kg feed). Body weight, feed conversion ratio and dressed meat yield at 38 days were better in the Yeast-TM-supplemented group as compared with the NC, ITM and Met-TM groups (p < 0.01). The birds supplemented with Met-TM and Yeast-TM consumed less feed than the NC and ITM-supplemented group (p < 0.001). Supplementation of trace elements irrespective of source increased the total ash content in the tibia (p < 0.001). However, concentration of Cu was lower in the Met-TM and Yeast-TM groups compared with the NC and the ITM groups (p < 0.05) although that of Fe, Mn and Zn was not affected at all by the dietary treatments. Total protein concentration in serum increased when either Met-TM or Yeast-TM was supplemented (p < 0.05) to the birds. Serum alkaline phosphatase activity, however, increased when the trace elements from either inorganic or organic sources were supplemented (p < 0.05). Compared with the ITM-supplemented group, excretion of Cu, Fe, Mn and Zn was lower in the birds supplemented with Met-TM or Yeast-TM, especially in the latter group (p < 0.05). The present experiment revealed that supplementation of broilers with methionine chelates or yeast proteinate forms of Cu, Fe, Mn and Zn improved body weight and feed conversion ratio (FCR) and markedly reduced excretion of the said trace elements. The study revealed that it may be possible to improve broiler performance and reduce excretion of critical trace elements into the environment by complete replacement of inorganic trace minerals from their dietary regime and replacing the same with methionine chelate or yeast proteinate forms.

Comparative efficacy of a phytogenic feed additive and an antibiotic growth promoter on production performance, caecal microbial population and humoral immune response of broiler chickens inoculated with enteric pathogens.

The aim of this work was to compare the efficacy of a commercially available phytogenic feed additive (PFA) and an antibiotic growth promoter, which was bacitracin methylene disalicylate (BMD), on performance, nutrient retention, caecal colonization of bacteria and humoral immune responses against Newcastle disease in broiler chickens challenged orally with Salmonella enteritidis and Escherichia coli. One-day-old male Cobb 400 broiler chicks (n = 120) were fed with 1) a negative control (NC) diet, which is the basal diet without any added growth promoter, 2) a positive control (PC) diet, the basal diet supplemented with BMD, 500 mg/kg and 3) a diet supplemented with PFA (150 mg/kg) for 39 days and the birds were inoculated with S. enteritidis and E. coli on d 28. Supplementation of PFA improved body weight, feed conversion ratio, retention of N and crude fiber, increased fecal moisture content and decreased digesta transit time as compared with the NC and PC groups (P < 0.01). Both the PC and the PFA was found to be equally effective in controlling the surge in numbers of Salmonella and E. coli following oral inoculation of these bacteria as compared with the NC group (P < 0.05) at 24 h past inoculation. Caecal content analysis on d 39 indicated lower numbers of Salmonella, E. coli and Clostridium in the PC and PFA groups as compared with the NC group (P < 0.05). The number of Lactobacillus in the PFA group was higher than those in the NC and PC groups (P < 0.05). Humoral immune response, measured as hemagglutination inhibition titer against Newcastle disease, was better in the PC and PFA groups compared with the NC group (P < 0.05) at d 21 but the difference did not last till d 39. The heterophil to lymphocyte ratio was narrower (P < 0.001) and alkaline phosphatase activity was higher (P < 0.01) in the PFA group as compared with the NC and PC groups on d 39. It was concluded that the PFA, which is animal, environment and consumer friendly, may be used as an effective replacement for common in-feed antibiotics like BMD to enhance broiler performance especially when the birds are exposed to heavy infections on fields.

Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: implications for population screening.

Hemoglobinopathies are common genetic disorders of hemoglobin, which can be prevented by population screening and offering genetic counseling. In absence of population-based screening for hemoglobinopathies, the hospital-based diagnosis register provide idea about the extent of problem in the community. The present study was undertaken to find out the burden of hemoglobinopathies and spectrum of this disorders among the population who were screened in the hospital-based screening program. A record-basedanalysis of subjects who underwent screening for hemoglobinopathies in Burdwan Medical College and Hospital over a period of 3 years and 4 months revealed that overall 29.3% of subjects were positive for hemoglobinopathies. Beta thalassemia heterozygous was the most commonhemoglobinopathy in this region closely followed by hemoglobin E heterozygous. In view of high prevalence of hemoglobinopathies in this region, a routine premarital screening program is needed for identification and prevention of high-risk marriages.

Animal bite of penis in a neonate and macroscopic repair.

We are reporting a newborn male who had injury of the penis probably due to rat bite. The baby was brought to the hospital within 3 h of the injury. The urethra was completely transected. Macroscopic repair was performed. The patient had an uneventful recovery and was discharged after 2 weeks. The patient is doing well 3 months after the operation.

Assessment of the Efficacy of L-Lysine Sulfate vis-à-vis L-Lysine Hydrochloride as Sources of Supplemental Lysine in Broiler Chickens.

In this study the effects of L-lysine hydrochloride (containing 78.8% available lysine as crystalline lysine) and L-lysine sulfate (containing 51% available lysine in bacterial cell mass) as source of supplemental lysine in broiler chickens was assessed. The basal diet was supplemented with either L-lysine hydrochloride or L-lysine sulfate to meet lysine requirement. Lysine supplementation irrespective of source improved (P < .05) live weight and food conversion. Live weight and food conversion ratio of the L-lysine sulfate group was superior (P < .05) to the L-lysine hydrochloride group. Supplementation of lysine to the basal diet improved breast meat yield (P < .05). Meat protein content and protein accretion increased (P < .01) when L-lysine sulfate was supplemented. Nutrient metabolizability, N retention, protein utilization efficiency and live weight gain : lysine intake ratio also improved (P < .01) with L-lysine sulfate. A fasting trial conducted after the completion of the feeding trial indicated that the birds receiving L-lysine sulfate retained more of their live weight than the control and the L-lysine hydrochloride dietary groups (P < .05). It was concluded that due to the retained bacterial cell mass, L-lysine sulfate may be a superior source of supplemental lysine than L-lysine hydrochloride for broiler chickens.

Effects of supplemental exogenous emulsifier on performance, nutrient metabolism, and serum lipid profile in broiler chickens.

The effects of an exogenous emulsifier, glyceryl polyethylene glycol ricinoleate, on performance and carcass traits of broiler chickens were assessed. The emulsifier was added to the diet at dose rates of 0 (control), 1 (E1) and 2 (E2) % of added fat (saturated palm oil). Live weight gain (P < .07) and feed conversion ratio (P < .05) in 39 days were higher in the E1 dietary group. Gain: ME intake and gain: protein intake during the grower phase improved quadratically (P < .05). Gross carcass traits were not affected. Body fat content and fat accretion increased (P < .05) and liver fat content decreased (P < .05) linearly with the level of emulsifier in diet. Fat excretion decreased (P < .001) leading to increased ileal fat digestibility (P < .06) in the E1 group (quadratic response). Metabolizable intake of N (P < .1) and fat (P < .05) increased quadratically due to supplementation of emulsifier in diet. Metabolism of trace elements and serum lipid profiles were not affected. The study revealed that supplementation of exogenous emulsifiers in diets containing moderate quantities of added vegetable fats may substantially improve broiler performance.

Comparative efficacy of an organic Acid blend and bacitracin methylene disalicylate as growth promoters in broiler chickens: effects on performance, gut histology, and small intestinal milieu.

This study evaluated the efficacy of organic acids as a growth promoter for broiler chickens relative to antibiotic growth promoters (AGPs). Broiler chickens were supplemented with graded doses of an organic acid blend (OAB, 1 g and 2 g/kg diet) and bacitracin methylene disalicylate (BMD, 0.5 g and 1 g/kg diet) for 35 days. Supplementation of OAB improved (P < .001) feed conversion ratio (FCR) and increased protein accretion (P < .001). Dietary acidification caused pH of the gizzard to decline linearly (P < .01) with the dose of supplemental OAB. In the lower intestine, pH remained unaffected by dietary treatments. Unlike BMD, supplemental OAB selectively promoted growth of lactobacilli in the small intestine. Moreover, compared to BMD, OAB tended to maintain the villi in the small intestine at a greater height. Although benefits of exceeding the dose of supplemental organic acids more than 1 g/kg diet are not always conspicuous, based on the live weight and feed conversion data, supplementation of 2 g organic acid per kg diet may be recommended for total replacement of AGPs in broiler diet.

Metabolism and tissue distribution of trace elements in broiler chickens' fed diets containing deficient and plethoric levels of copper, manganese, and zinc.

Supplementation of broiler diets with copper, manganese, and zinc at levels higher than that stipulated by the National Research Council 1994 reportedly improved live weight, feed conversion, and cured leg abnormality supposedly caused by inadequate intake of Mn and Zn. The objective of the study was to ascertain the effects of plethoric supplementation of copper (Cu), manganese (Mn), and zinc (Zn) on performance and metabolic responses in broiler chickens. The study also aimed to discriminate the responses of the birds when the mineral elements were supplemented either in an inorganic or in an organic form. Cobb 400 broiler chickens (1-day old, n = 300) were assigned to three dietary treatments each containing nine replicates with ten birds for 39 days. The treatments included a control in which the diet was devoid of supplemental trace elements and treatments supplemented with an inorganic trace element premix (ITM) and supplemented with a combination of the inorganic and an organic trace element premix (OTM). The ITM contained (per kilogram) copper, 15 g; iron, 90 g; manganese, 90 g; zinc, 80 g (all as sulfated salts); iodine (as potassium iodide), 2 g; and selenium (as sodium selenite), 0.3 g. The OTM on the other hand, contained copper, 2.5 g; iron, 15 g; manganese, 15 g; zinc, 13.33 g; and chromium, 0.226 g (all as protein chelates). Plethoric supplementation of trace elements improved live weight gain and feed/gain ratio (p < 0.05). Leg abnormality developed in the 16% of the control group of birds but not in the supplemented group. Metabolizability of dry matter, organic matter, and protein was higher (p < 0.01) in the ITM and OTM groups. Excretion of Cu, Fe, and Zn decreased (p < 0.1) due to supplementation of the trace elements leading to increased apparent absorption of the said mineral elements (p < 0.01). Concentration of the concerned trace elements in serum, liver, and composite muscle samples was higher (p < 0.05) in the ITM and OTM dietary groups indicating an increased deposition of the said mineral elements due to supplementation. Although the study revealed subtle difference between the inorganic and organic mineral premixes with regards to the parameters mentioned above, it became apparent that it is possible to reduce excretion of these trace elements by a judicious escalation in the level of supplementation. The results of the present investigation further revealed that the trace mineral requirement of broiler chickens suggested by the National Research Council may not be optimum to support the maximum growth potential of the high yielding strains, and it is reasonable to consider a review of the current NRC recommendations to meet the needs of the modern birds.

Performance traits and metabolic responses in goats (Capra hircus) supplemented with inorganic trivalent chromium.

The effects of supplemental chromium (Cr) as chromic chloride hexahydrate in incremental dose levels (0, 0.5, 1.0, and 1.5 mg/day for 240 days) on metabolism of nutrients and trace elements were determined in dwarf Bengal goats (Capra hircus, castrated males, average age 3 months, n = 24, initial mean body weight 6.4 +/- 0.22 kg). Live weight increased linearly (p < 0.05) with the level of supplemental Cr. Organic matter and crude protein digestibility, intake of total digestible nutrients, and retention of N (g/g N intake) increased (p < 0.05) in a dose-dependent linear manner. Serum cholesterol and tryacylglycerol concentrations changed inversely with the dose of supplemental Cr (p < 0.01). Supplemental Cr positively influenced retention of copper and iron (p < 0.05) causing linear increase (p < 0.01) in their serum concentrations. It was concluded that Cr supplementation may improve utilization of nutrients including the trace elements and may also elicit a hypolidemic effect in goats. However, further study with regards to optimization of dose is warranted.

Prognostic value of AgNOR in benign and malignant lesions of larynx in a rural medical college hospital, Burdwan, West Bengal.

AgNOR counting is a useful proliferative marker in different malignant lesions and it also acts as a good prognostic indicator in rural hospital. Fifty-three cases of benign and malignant lesions of larynx were examine using AgNOR distribution in routinely processed paraffin embedded histological tissue sections. Significant differences were found between benign lesion, dysplasia (p > 0.10) and carcinoma (p > 0.10). Mean AgNOR count was 2.41% in dysplasia and 3.71% in malignant lesion. This value was high in poorly differentiated squamous cell carcinoma (4.17%) and also in supraglottic type of laryngeal squamous cell carcinoma which associated with lymph node metastasis. Thus proliferative marker AgNOR may be a prognostic factor and might be of clinical value as predictor of lymph node metastasis in supraglottic type of laryngeal squamous cell carcinoma.

Management of malaria in children: update 2008.

JUSTIFICATION: The first guideline on diagnosis and management of malaria in children was formulated by Infectious Diseases Chapter of IAP in 2005. In subsequent year WHO proposed artemisinin based combination therapy in all cases of uncomplicated falciparum malaria. The number of falciparum malaria as well as multidrug resistant falciparum malaria cases are constantly on the rise. So there was need to revise the existing guideline. PROCESS: The first recommendations on the diagnosis and management of malaria in children were formulated in 2005. The same protocol was revised on 12 October 2007 in NIMHANS, Bangalore in the light of various recommendations of WHO, where all the members of the Task Force Committee on Malaria in Children were present. OBJECTIVE: To revise and update treatment guidelines for malaria with special reference to artemisinin based combination therapy. RECOMMENDATIONS: The need for Artemisinin based combination therapy (ACT) is emphasized in chloroquine resistant falciparum malaria. Monotherapy with artesunate will further increase the resistance. Once malaria treatment is initiated it should be completed. In severe malaria the maintenance dose of artesunate is revised.