ABSTRACT
INTRODUCTION: Erythema nodosum leprosum (ENL) is an immunological complication of leprosy. ENL results in morbidity and disability and if it is not treated can lead to death. The current treatment consists of thalidomide or high doses of oral corticosteroids for prolonged periods. Thalidomide is not available in many leprosy endemic countries. The use of corticosteroids is associated with morbidity and mortality. Identifying treatment regimens that reduce the use of corticosteroids in ENL is essential. Methotrexate (MTX) is used to treat many inflammatory diseases and has been used successfully to treat patients with ENL not controlled by other drugs, including prednisolone and thalidomide. We present the protocol of the 'MTX and prednisolone study in ENL' (MaPs in ENL) a randomised controlled trial (RCT) designed to test the efficacy of MTX in the management of ENL. METHODS AND ANALYSIS: MaPs in ENL is an international multicentre RCT, which will be conducted in leprosy referral centres in Bangladesh, Brazil, Ethiopia, India, Indonesia and Nepal. Patients diagnosed with ENL who consent to participate will be randomly allocated to receive 48 weeks of weekly oral MTX plus 20 weeks of prednisolone or 48 weeks of placebo plus 20 weeks of prednisolone. Participants will be stratified by type of ENL into those with acute ENL and those with chronic and recurrent ENL. The primary objective is to determine whether MTX reduces the requirement for additional prednisolone. Patients' reported outcome measures will be used to assess the efficacy of MTX. Participants will be closely monitored for adverse events. ETHICS AND DISSEMINATION: Results will be submitted for publication in peer-reviewed journals. Ethical approval was obtained from the Observational/Interventions Research Ethics Committee of the London School of Hygiene & Tropical Medicine (15762); The Leprosy Mission International Bangladesh Institutional Research Board (in process); AHRI-ALERT Ethical Review Committee, Ethiopia; Ethics Committee of the Managing Committee of the Bombay Leprosy Project; and The Leprosy Mission Trust India Ethics Committee; the Nepal Health and Research Council and Health Research Ethics Committee Dr. Soetomo, Indonesia. This study is registered at www.clinicaltrials.gov. This is the first RCT of MTX for ENL and will contribute to the evidence for the management of ENL.Trial registration numberNCT 03775460.
Subject(s)
Erythema Nodosum , Leprosy, Lepromatous , Methotrexate/therapeutic use , Prednisolone/therapeutic use , Bangladesh , Brazil , Erythema Nodosum/drug therapy , Ethiopia , Humans , India , Indonesia , Leprostatic Agents/therapeutic use , Leprosy, Lepromatous/drug therapy , London , NepalABSTRACT
Sunflower cannot produce high yields under water-limiting conditions. The aim of the present study was to prevent the impediments on yield and to develop varieties with high-yield potential under water scarce conditions. For achieving this objective, it is necessary to detect parents with desirable traits that mainly depend on the action of genes controlling the trait under improvement, combining ability, and genetic makeup of the parents. Heterosis can also be used to pool the desirable genes from genetically divergent varieties and these divergent parents could be detected by molecular studies. Ten tolerant and five susceptible tester lines were selected, crossed, and tested for genetic diversity using simple sequence repeat primers. We identified two parents (A-10.8 and G-60) that showed maximum (46.7%) genetic dissimilarity. On an average 3.1 alleles per locus were detected for twenty pair of primers. Evaluation of mean values revealed that under stress conditions the mean performances of the genotypes were reduced for all traits under study. Parent A-10.8 was consistent as a good general combiner for achene yield per plant under both non-stress and stress conditions. Line A-10.8 in the hybrid A-10.8 x G-60 proved to be a good combiner as it showed negative specific combining ability (SCA) effects for plant height and internodal length and positive SCA effects for head weight, achene yield per plant, and membrane stability index. Valuable information on gene action, combining ability, and heterosis was generated, which could be used in further breeding programs.
Subject(s)
Genetic Variation , Helianthus/genetics , Stress, Physiological/genetics , Water/metabolism , Alleles , Breeding , Dehydration/genetics , Genotype , Helianthus/growth & development , Helianthus/metabolism , Microsatellite Repeats/genetics , PhenotypeABSTRACT
Hymenaea martiana Hayne (Fabaceae-Caesalpinioideae) apresenta grande valor na medicina popular em Caetité. A casca, entrecasca do caule e a resina, são utilizadas no tratamento de diversos males. Neste estudo são apresentadas a caracterização anatômica e histoquímica dos órgãos vegetativos. Amostras foram coletadas e processadas segundo técnicas usuais em anatomia vegetal e histoquímica. Todos os órgãos apresentam, em visão transversal, epiderme unisseriada e cavidades secretoras. Cutícula espessa ocorre em todos os órgãos aéreos. A raiz é tetrarca. Colênquima lacunar foi encontrado no caule. Bainha de fibras esclerenquimáticas envolve os feixes vasculares dos órgãos aéreos. Células pétreas ocorrem no pecíolo. Tricomas tectores ocorrem em ambas as faces da folha. A folha é hipoestomática com estômatos paracíticos e o mesofilo é dorsiventral. Cristais de oxalato de cálcio ocorrem no caule, pecíolo e lâmina foliar. Compostos fenólicos ocorrem na raiz, pecíolo e nervura central da folha. Grãos de amido ocorrem na raiz, caule e pecíolo. Lipídios ocorrem em todos os órgãos. Acredita-se que compostos fenólicos e cavidades secretoras de resina podem justificar a utilidade medicinal da espécie pela população de Caetité.
Hymenaea martiana Hayne (Fabaceae-Caesalpinioideae) shows a great value in folk medicine in Caetité. Its bark, stem-bark and resin are used to treat various ailments. In this study, the anatomical and histochemical characterization of vegetative organs is reported. Samples were collected and processed according to usual techniques of plant anatomy and histochemistry. All organs have, by cross-sectional view, uniseriate epidermis and secretory cavities. Thick cuticle occurs in all aerial organs. The root is tetrarch. Lacunar collenchyma was found in the stem. Sclerenchymatic sheath of fibers surrounds the vascular bundles of the aerial organs. Stone cells occur in the petiole. Trichomes occur on both sides of the leaves. The leaf is hypostomatic with paracytic stomata and the mesophyll is dorsiventral. Calcium oxalate crystals occur in the stem, petiole and leaf blade. Phenolic compounds occur in the root, petiole and midrib of the leaf. Starch grains occur in the root, stem and petiole. Lipids occur in all organs. It is believed that phenolic compounds and resin secretory cavities may justify the use of medicinal species by the population of Caetité.