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Biomedical subjects

N Valecha

Publications and source records attributed to N Valecha.

At least 19 recordsLinked to original sources
PubMed2005

Therapeutic efficacy of antimalarial drugs along the eastern Indo-Nepal border: a cross-border collaborative study.

This collaborative cross-border study was performed to determine the therapeutic efficacy of antimalarial drugs used by the National Programmes for falciparum malaria along the eastern Indo-Nepal border where there is unregulated population movement across the border. The study was conducted at sites in Jhapa District, Nepal and Darjeeling District, India. The study was conducted from August 2003 to February 2004, following the WHO 28 day treatment protocol. The efficacy of chloroquine was tested in India among 91 subjects and of sulfadoxine-pyrimethamine in Nepal among 107 subjects with laboratory-confirmed Plasmodium falciparum malaria. Of the 102 subjects who completed the study in Nepal, there were 21 (20.6%) treatment failures comprising 7 (6.9%) early treatment failures (ETF) and 14 (14.7%) late treatment failures (LTF) (5 late clinical failures [LCF] and 9 late parasitological failures [LPF]). Of the 89 subjects who completed the study in India, there were 46 (51.7%) treatment failures comprising 7 (7.9%) ETFs and 39 (43.8%) LTFs (13 LCFs and 26 LPFs). Based on WHO guidelines both countries need to review their drug policy urgently and make appropriate changes, taking into account aspects of cross-border collaboration in the control of drug-resistant malaria.

Adolescent↗
PubMed2004

Anti-malarial activity of some xanthones isolated from the roots of Andrographis paniculata.

Four xanthones were isolated from the roots of Andrographis paniculata using a combination of column and thin-layer chromatographic methods. They were characterized as (i) 1,8-di-hydroxy-3,7-dimethoxy-xanthone, (ii) 4,8-dihydroxy-2,7-dimethoxy-xanthone, (iii) 1,2-dihydroxy-6,8-dimethoxy-xanthone and (iv) 3,7,8-trimethoxy-1-hydroxy xanthone by IR, MS and NMR spectroscopic methods. In vitro study revealed that compound 1,2-dihydroxy-6,8-dimethoxy-xanthone possessed substantial anti-plasmodial activity against Plasmodium falciparum with its IC(50) value of 4 microg ml(-1). Xanthones bearing hydroxyl group at 2 position demonstrated most potent activity while xanthones with hydroxyl group at 1,4 or 8 position possessed very low activity. In vivo anti-malarial sensitivity test of this compound on Swiss Albino mice with Plasmodium berghei infection using Peters' 4-day test gave substantial reduction (62%) in parasitaemia after treating the mice with 30 mg kg(-1) dose. In vitro cytotoxicity against mammalian cells revealed that 1,2-dihydroxy-6,8-dimethoxy-xanthone is non-cytotoxic with its IC(50) > 32 microg ml(-1).

Andrographis↗
PubMed2003

The hospital- and field-based performances of the OptiMAL test, for malaria diagnosis and treatment monitoring in central India.

The performance of the OptiMAL test, to detect and differentiate Plasmodium falciparum and P. vivax, was evaluated in central India. The subjects were either symptomatic patients, who presented at a referral hospital in urban Jabalpur, or the inhabitants of remote, tribal, forested villages where malaria is a major public-health problem. In each setting, the results of conventional microscopy were used as the 'gold standard'. Under hospital conditions, the test had excellent sensitivity (100%), good specificity (97%), a high positive predictive value (98%) and a high negative predictive value (100%). The corresponding values in the field-based study in the tribal villages (100%, 67%, 84% and 100%, respectively) were almost as good. The results of OptiMAL testing reveal the decline in parasitaemias (of P. falciparum or P. vivax) after drug administration. For monitoring the effectiveness of treatment, the test could therefore be a useful alternative to microscopy, particularly (1) in places where the facilities for microscopy are poor or non-existent and (2) among hospitalized patients with severe, complicated malaria (in whom parasitaemia and drug response need to be followed very carefully). Follow-up (within 28 days of diagnosis) of the 58 malaria cases detected in the field revealed that the OptiMAL test can be used to detect re-infection with a different Plasmodium sp. (sensitivity = 100%; specificity = 100%; J-index = 1) or recrudescence/re-infection with the same Plasmodium sp. (sensitivity = 83%; specificity = 100%; J-index = 0.83) accurately. The ability to use the test to distinguish P. falciparum from P. vivax, and to identify mixed infections of these two species, is of great significance in areas where the preferred and effective therapy for P. falciparum malaria differs from that for P. vivax.

Adult↗
PubMed2002

Isolation and antimalarial activity of peroxydisulfate oxidation products of primaquine.

Five compounds formed by peroxydisulfate oxidation of primaquine were isolated using chromatographic methods and evaluated for antimalarial activity in vitro. One compound 6-methoxy-5,8 bis(4'-amino-1'-methylbutylamino)quinoline [P(1)] was found to have good gametocytocidal activity against Plasmodium yoelli infected mice at 10mg kg(-1) dose in vivo.

Animals↗
PubMed2001

Antimalarial t-butylperoxyamines.

Twelve t-butylperoxyamines (6-17) were synthesized as targeted antimalarials and evaluated for antimalarial activity in vivo against Plasmodium berghei in mice and in vitro against both chloroquine sensitive and chloroquine resistant strains of Plasmodium falciparum. Compound 8 was found to have highest potency with activity at 80 and 160mg/kg dose in vivo and compound 11 exhibited highest efficacy in vitro.

Animals↗
PubMed2001

Plasmodium vivax polymorphism in a clinical drug trial.

Data from a double-blind randomized clinical drug trial were analyzed to find the comparative responses of two antirelapse drugs, bulaquine and primaquine, against different relapsing forms of Plasmodium vivax infection. A 1-year follow-up study strongly suggests that the duration of preerythrocytic development of P. vivax is a polymorphic characteristic, exhibited by two strains of hypnozoites responsible for early and late manifestations after primary infection. Short-term relapses were significantly higher in the first half year than long-term relapses, and the reverse was true in the second half year. Clinical drug response data showed that the hypnozoites characterized for short-term relapse were not susceptible to either of the antirelapse drugs in the currently administered dose, whereas hypnozoites characterized for long incubation were significantly susceptible.

Administration, Oral↗
PubMed2001

A multicentric study with arteether in patients of uncomplicated falciparum malaria.

Two hundred and sixty seven patients of uncomplicated P. falciparum malaria completed study in a multicentric phase III clinical trial of Arteether. Arteether was given intramuscularly in a dose of 150 mg daily for three consecutive days. Each patient was followed upto 28 days of alpha, beta arteether therapy. The cure rate was 97% with fever clearance time between 1-7 days (24-168 hours) and parasite clearance time between 1-3 days (24-72 hours). Parasite reappearance rate was found to be 3% and reported at only three of the centres. Following the treatment no adverse effect was observed on haematological, biochemical and vital clinical parameters.

Adolescent↗
PubMed2000

Field evaluation of the ICT malaria P.f/P.v immunochromatographic test for diagnosis of Plasmodium falciparum and P.vivax infection in forest villages of Chhindwara, central India.

A rapid new immunochromatographic test (ICT malaria P.f/P.v) for diagnosis of Plasmodium falciparum and P.vivax was evaluated against thick blood smears in forest villages of Chhindwara, Madhya Pradesh, where both Plasmodium falciparum and P.vivax are prevalent. 344 symptomatic patients (Gond ethnic tribe) in five villages were screened by field staff of the Malaria Research Centre in October 1999. For P.falciparum, the ICT was 97.5% sensitive and 88% specific, with a positive predictive value (PPV) of 87.6% and a negative predictive value (NPV) of 97.6%. For P.vivax the sensitivity was only 72%, the specificity 99%, with a PPV of 92% and an NPV of 96%. Although a negative test result was inadequate to exclude parasitaemia < or = 300/microl for P.falciparum and < or = 1500/microl for P.vivax, the test is potentially useful in remote areas.

Adolescent↗
PubMed2000

Evaluation of a rapid diagnostic test, 'Determine malaria pf', in epidemic-prone, forest villages of central India (Madhya Pradesh).

A rapid, immunochromatographic test for malaria diagnosis, 'Determine malaria pf', was evaluated by a field team in the epidemic-affected, forest setting of Chhindwara district, in Madhya Pradesh, central India. In all, 526 fever cases were screened for Plasmodium falciparum in October or November, 1999. Those found to be infected were treated with sulfadoxine-pyrimethamine and primaquine. Using microscopy as the gold standard, the new test had a sensitivity of 98% and a specificity of 87%. The positive and negative predictive values were 88% and 98%, respectively. Although follow-up of 64 subjects on day 7 post-treatment revealed that 20% of those who then appeared smear-negative were still antigenaemic, 34% of the subjects were still smear-positive, for asexual parasites, at that time. The Determine test was found to be very easy to perform and the results could be read reliably by field workers, without any supervision. The ease of use of the test indicates that it could be useful in the management of malaria, particularly in remote and inaccessible areas, provided that its accuracy can be assured and that it can be made affordable.

Adolescent↗
PubMed1999

Antimalarial activity of 3-hydroxyalkyl-2-methylene-propionic acid derivatives.

Several Baylis-Hillman adducts and their derivatives were synthesized and evaluated as targeted potential anti-malarials. The compounds 4, 7 and 9 were found to have highest potency against P. falciparum in vitro. The in vivo test result of compound 4 and 9 against P. berghei demonstrated activity at 80 mg/Kg dose level.

Animals↗
PubMed1998

A rapid immunochromatographic test (ICT) for diagnosis of Plasmodium falciparum.

A field study was conducted to assess the sensitivity and specificity of rapid immunodiagnostic test based on detection of Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) in peripheral blood for diagnosis of P. falciparum infection. Evaluation in 173 patients showed that the assay was 98.59% sensitive and 97.1% specific. There was no cross-reactivity with P. vivax. The test was positive in few patients who were found to be negative by microscopy showing the presence of antigen after curative chemotherapy. The test is a valuable diagnostic tool for falciparum malaria, especially in emergency/field situations requiring rapid diagnosis.

Animals↗
PubMed1998

Studies on malaria during pregnancy in a tribal area of central India (Madhya Pradesh).

In tribal villages of central India where malaria is highly prevalent (mesoendemic), this preliminary study was undertaken to determine the effects of malaria infection in a group of 456 pregnant women with or without fever. Only 96 women were found infected with malaria, of which Plasmodium falciparum accounted for 64% of the detected parasites, while P. vivax for the remaining 36%. There were no instances of cerebral malaria or death however, one abortion and four still births were recorded among 38 primigravid women. Only one neonate was found infected with P. falciparum on day 21 though parasitemia was not high. Anemia was commonly present in most of the women (80%). Failure to clear P. falciparum parasitemia after a chloroquine regimen (25 mg/kg of body weight) was commonly observed. Persistent P. falciparum parasitemia was recorded in 8% cases. Poor response to chloroquine suggests the need to change the drug policy.

Adult↗
PubMed1997

Efficacy of alpha,beta-arteether in acute uncomplicated P. falciparum malaria.

A phase-III clinical trial was conducted in 50 patients (42M + 8F) with acute uncomplicated falciparum malaria from Delhi during the period of September to November 1995. Their mean age was 27.2 years, and the mean parasitaemia on day 0 was 0.65%. Patients were hospitalized and treated with a new ethyl derivative of artemisinin developed at CDRI called alpha, beta-arteether, at the dosage of 150 mg l/M for three consecutive days. Peripheral smears were examined every day for 4 days and then weekly up to 28 days. The results of the study showed that the mean parasite and fever clearance times were respectively 19.94 +/- 6.87 and 37.81 +/- 21.67 hours. Within 48 h, 70% of the cases became afebrile and the peripheral smear was negative in 100% of the cases. The drug was well tolerated. Three cases (6%) had recrudescence within 28 days. It is concluded that alpha, beta-arteether is a safe, effective and rapidly acting antimalarial.

Adolescent↗
PubMed1996

Malaria parasite density in pregnant women of district Jabalpur, Madhya Pradesh.

Twenty-two cases (nineteen Plasmodium falciparum and three P. vivax) of severe malaria among 200 pregnant women from District Jabalpur, M.P. were studied for malaria parasite density. Almost all of them were found anaemic. The patients were treated with quinine/chloroquine intravenously but seventeen Pf cases died within 96 h of admission in hospital. Out of twenty-two, thirteen were primigravidae.

Adolescent↗
PubMed1996

Preliminary evaluation of safety aspects of neem oil in kerosene lamp.

Kerosene lamps containing one per cent neem oil were used for mosquito repellent action in a village near Delhi. The safety aspects of this personal protection method developed by Malaria Research Centre were evaluated by animal studies and clinical examination of population before and after exposure. Single application of neem oil (1%) did not produce skin irritation in rabbits and adverse effect on guinea pigs after exposure to aerosol. Clinical examination of 156 adults and 110 children did not reveal any major adverse effects after one year of exposure to 1% neem oil.

Adult↗
PubMed1996

Bromo-deoxyuridine based assay for detection of parasite and drug sensitivity in Plasmodium falciparum in vitro.

A non-radioactive, thymidine analogue-bromodeoxyuridine (Brdu), derivative of uridine has been used for incorporation in DNA in culture of P. falciparum at various dosages and at different time period. Parasite growth rate and effect of chloroquine in culture were monitored by microscopic observation of stained smears and incorporation of Brdu molecules were visualized by immunofluorescence and measured by enzyme immuno assay using anti-Brdu. Uptaking of Brdu in parasite is slower unlike tumour cells. A positive correlation between parasite growth and Brdu uptake measurement by ELISA has been observed.

Animals↗
PubMed1995

In vitro antimalarial activity of monoterpenic fragment analogues of aplasmomycin.

Synthetic analogues of a monoterpenic fragment of aplasmomycin were tested for their antimalarial activity in Plasmodium falciparum culture in vitro. The antimalarial activities of these agents were evaluated in chloroquine sensitive strains. Parasite growth was inhibited in a dose dependent manner in the presence of the synthetic compounds (3-9).

Animals↗