Sequence analysis of genes associated with resistance to chloroquine and sulphadoxine pyrimethamine in P. falciparum and P. vivax isolates from the Bannu district of Pakistan

AbstractPlasmodium vivax and Plasmodium falciparum are becoming resistant to drugs including antifolates, sulphonamides and chloroquine. This study was focused at sequence analysis of resistant genes of these parasites against sulphadoxine–pyrimethamine and chloroquine, from Bannu, Pakistan. Known mutations were detected at codons 57, 58 and 117 of pvdhfr gene of P. vivax, while none of the isolates had any pvdhps mutation. Similarly P. falciparum isolates exhibited double 59R+108N mutations in pfdhfr, and single 437G in pfdhps thus demonstrating the existance of triple mutant 59R+108N+437G haplotype in this region. The key chloroquine resistance mutation, 76T in pfcrt was observed in 100% of the P. falciparum isolates, with haplotype SVMNT which is also associated with resistance to amodiaquine. Some novel mutations were also observed in pvdhfr and pfdhfr genes

Genetic structure of Plasmodium vivax and Plasmodium falciparum in the Bannu district of Pakistan

<p>Abstract</p> <p>Background</p> <p><it>Plasmodium vivax </it>and <it>Plasmodium falciparum </it>are the major causative agents of malaria. While knowledge of the genetic structure of malaria parasites is useful for understanding the evolution of parasite virulence, designing anti-malarial vaccines and assessing the impact of malaria control measures, there is a paucity of information on genetic diversity of these two malaria parasites in Pakistan. This study sought to shed some light on the genetic structure of <it>P. vivax </it>and <it>P. falciparum </it>in this understudied region.</p> <p>Methods</p> <p>The genetic diversities of <it>P. vivax </it>and <it>P. falciparum </it>populations from the densely populated, malaria-endemic Bannu district of Pakistan were evaluated by analysis of their merozoite surface protein (<it>msp</it>) genes by PCR-RFLP. Specifically, the <it>Pvmsp-3α </it>and <it>Pvmsp-3β </it>genes of <it>P. vivax </it>and the <it>Pfmsp-1 </it>and <it>Pfmsp-2 </it>genes of <it>P. falciparum </it>were analysed.</p> <p>Results</p> <p>In <it>P. vivax</it>, genotyping of <it>Pvmsp-3α </it>and <it>Pvmsp-3β </it>genes showed a high level of diversity at these loci. Four distinct allele groups: A (1.9 kb), B (1.5 kb), C (1.2 kb), and D (0.3 kb) were detected for <it>Pvmsp</it>-<it>3α</it>, type A being the most prevalent (82%). Conversely, amplification of the <it>P. vivax msp</it>-<it>3β </it>locus produced two allele groups: A (1.7-2.2 kb, 62%) and B (1.4-1.5 kb, 33%), with 5% mixed-strain infections. Restriction analysis of <it>Pvmsp-3α </it>and <it>Pvmsp-3β </it>yielded 12 and 8 distinct alleles, respectively, with a combined mixed genotype prevalence of 20%. In <it>P. falciparum</it>, all three known genotypes of <it>Pfmsp-1 </it>and two of <it>Pfmsp-2 </it>were observed, with MAD20 occurring in 67% and 3D7/IC in 65% of the isolates, respectively. Overall, 24% <it>P. falciparum </it>samples exhibited mixed-strain infections.</p> <p>Conclusion</p> <p>These results indicate that both <it>P. vivax </it>and <it>P. falciparum </it>populations in Pakistan are highly diverse.</p

How can health promotion interventions be adapted for minority ethnic communities? Five principles for guiding the development of behavioural interventions.

The term ‘culturally sensitive’ is often used to describe interventions adapted for minority ethnic communities. However, understanding of strategies for adapting behavioural interventions for such communities is limited. The questions addressed in this paper are: What are the main strategies for adapting interventions to reduce coronary heart disease (CHD) for minority ethnic communities? Why have interventions been adapted in these ways? A systematic review was carried out to investigate interventions for preventing CHD, including promoting physical activity, smoking cessation and healthier diets in Pakistani, Chinese and Indian communities in countries where these groups are minorities. International databases and key websites were searched, and 23 477 titles and abstracts were initially identified. Seventeen papers met inclusion and quality criteria. A ‘meta-ethnographic’ approach to data synthesis was employed to identify underlying principles for adapting interventions. The rationale underpinning adaptations is not made explicit in individual studies, limiting generalizability. Five principles for adapting behavioural interventions for minority ethnic communities were identified: (i) use community resources to publicize the intervention and increase accessibility; (ii) identify and address barriers to access and participation; (iii) develop communication strategies which are sensitive to language use and information requirements; (iv) work with cultural or religious values that either promote or hinder behavioural change; and (v) accommodate varying degrees of cultural identification. While the principles require further testing and verification, they have been generated through a systematic approach to study identification, quality appraisal and data synthesis. This represents significant progress in advancing understanding of adapted behavioural interventions for minority ethnic communities

Antihyperglycemic and antinociceptive activity evaluation of ‘Khoyer’ prepared from boiling the wood of Acacia catechu in water

‘Khoyer’ is prepared by boiling the wood of Acacia catechu in water and then evaporating the resultant brew. The resultant hard material is powdered and chewed with betel leaves and lime with or without tobacco by a large number of the people of Bangladesh as an addictive psycho-stimulating and euphoria-inducing formulation. There are folk medicinal claims that khoyer helps in the relief of pain and is also useful to diabetic patients to maintain normal sugar levels. Thus far no scientific studies have evaluated the antihyperglycemic and antinociceptive effects of khoyer. The present study was carried out to evaluate the possible glucose tolerance efficacy of methanolic extracts of khoyer using glucose-induced hyperglycemic mice, and antinociceptive effects with acetic acid-induced gastric pain models in mice. In antihyperglycemic activity tests, the extract at different doses was administered one hour prior to glucose  administration and blood glucose level was measured after two hoursof glucose administration (p.o.) using glucose oxidase method. The statistical data indicated the significant oral hypoglycemic activity on glucose-loaded mice at all doses of the extracts tested. Maximum anti-hyperglycemic activity was shown at 400 mg extract per kg body weight, which was less than that of a standard drug, glibenclamide (10 mg/kg body weight). In antinociceptive activity tests, the extract also demonstrated a dose-dependent significant reduction in the number of writhing induced in mice through intraperitoneal administration of acetic acid. Maximum antinociceptive activity was observed at a dose of 400 mg extract per kg body weight, which was greater than that of a standard antinociceptive drug, aspirin, when administered at a dose of 400 mg per kg body weight. The results validate the folk medicinal use of the plant for reduction of blood sugar in diabetic patients, as well as the folk medicinal use for alleviation of pain.Key words: Acacia catechu, antihyperglycemic, antinociceptive, khoye

Decreasing Physical Activity Levels across Religious Sikh Male South Asian Migrant Population in Kent, UK: A Public Health Concern

Physical activity (PA) plays a crucial role in reducing the risk of non-communicable diseases (NCDs). We investigated intergenerational physical activity level (PAL) among first and second generation Sikh Punjabi male subjects (n = 137), recruited from two Sikh temples in Medway, UK. Employing a crosssectional survey PA was quantified using the validated Global PA Questionnaire (GPAQ). Data were analysed using SPSS 20 and Epi Info software. Ninety-one per cent of the subjects were classified as overweight. Mean PAL range was sedentary to low levels of PA (1.45–1.60). Comparisons between first and second generation Punjabi male subjects showed that the two groups are equally culpable in not engaging in work-related or recreational PA, but for the second generation this is significantly lower. Low PAL is a contributory factor to increased risk and prevalence of NCDs among this population and a public health concern. Efforts to increase PA in this group should continue

Lipid-based nanoparticles as drug delivery carriers for cancer therapy

Cancer is a severe disease that results in death in all countries of the world. A nano-based drug delivery approach is the best alternative, directly targeting cancer tumor cells with improved drug cellular uptake. Different types of nanoparticle-based drug carriers are advanced for the treatment of cancer, and to increase the therapeutic effectiveness and safety of cancer therapy, many substances have been looked into as drug carriers. Lipid-based nanoparticles (LBNPs) have significantly attracted interest recently. These natural biomolecules that alternate to other polymers are frequently recycled in medicine due to their amphipathic properties. Lipid nanoparticles typically provide a variety of benefits, including biocompatibility and biodegradability. This review covers different classes of LBNPs, including their characterization and different synthesis technologies. This review discusses the most significant advancements in lipid nanoparticle technology and their use in medicine administration. Moreover, the review also emphasized the applications of lipid nanoparticles that are used in different cancer treatment types

Approaches to improving breast screening uptake: evidence and experience from Tower Hamlets

This paper reports on an innovative whole-systems approach to improving uptake of breast screening in Tower Hamlets, a deprived borough in the East End of London with a large minority ethnic population. The approach, developed by the public health team at NHS Tower Hamlets, draws on analysis of needs and existing literature about effective interventions to promote breast screening. Social marketing research led to a campaign targeted at Bangladeshi women, together with a range of initiatives to promote breast screening through primary care services and community outreach through local well-known organisations. The breast screening service itself was upgraded and a new service specification is being introduced from April 2009

Evaluation of a service intervention to improve awareness and uptake of bowel cancer screening in ethnically-diverse areas

The Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis receives funding for a research programme from the UK Department of Health Policy Research Programme (grant no. 106/0001). It is a collaboration between researchers from seven institutions (the Queen Mary University of London, the UCL, the King’s College London, the London School of Hygiene and Tropical Medicine, the Hull York Medical School, the Durham University and the Peninsula Medical School)