Clinical, Immunological and Therapeutic Aspects of Lymphatic Filariasis

Lymphatic filariasis is a major health problem in many countries of the world. The disease still takes a heavy toll in terms of social and economic losses. • The commonest clinical forms seen in a large clinic in an endemic area are lymphoedema of the lower limbs, hydrocoele, lymphoedema of the genitalia, chyluria and tropical eosinophilia. • Apart from filarial oedema, the most important clinical manifestation of filariasis is the episodes of adenolymphangitis. The brief duration and episodic nature of ADL makes it the best manifestation of lymphatic filarial disease that can be well studied. • These ADL episodes contribute significantly to the morbidity associated with the disease. Recurrent attacks of lymphangitis lead on to the progression of lymphoedema and development of elephantiasis. • Patients with higher grades of lymphoedema were more predisposed to ADL attacks. Thus, while there were ADL episodes in patients with Grade III oedema, they were only in grade II and in Grade I. This can be explained by the predisposition to fungal infection in limbs with higher grades of oedema. • This study has shown that any factor resulting in injury to the skin of the oedematous limb promotes secondary bacterial infection, which is the most important cause for the ADL episodes. Fungal infection of the affected limb, especially on constant exposure to moisture, is the commonest predisposing factor, followed by minor injuries and infections. • As in the case of the analysis done according to drug groups there was an increase in the number of ADL attacks in the follow up phase when compared to the treatment year. A response in the form of reduction in the episodes of ADL in the treatment groups; oral penicillin group alone, DEC group alone and the combination; as well as the foot care group was significant (p<0.008). This was however statistically significant only for patient with grade III (p<0.025) and grade IV (p<0.009) oedema. • The reductions were greater in the lower grades of oedema as compared with the higher grades although the difference between the groups were not statistically significant. There was an increase in the number of attacks in the follow up year. • The importance of the role of bacteria entering through breaks in the skin and precipitating ADL attacks has been convincingly demonstrated. • Further long-termstudies, which would help to document that the lymphoedema of early filarial oedema can be reversed by using antibiotics and carefully designed limb care programmes. This beneficial effect would help to enhance the success of large-scale control programmes since the perceived benefit by the affected persons would be high. • Advanced Multi modality treatment for the reversal of grade IV lemphedema patient has been performed with nodovenal shunt in order to get best outcome in cosmetic and functional limb. • Helminth infections in the study area were highly prevalent. Geohelminths and filarial infections were seen maximally in the younger years of life. • PPD sensitivity was influenced by the presence of helminth infections. • Clearance of helminth infections may provide better response to a variety of vaccines. • Targeting of these pathways, as well as new treatment regimens involving TLR modulation, could potentially provide new avenues in ameliorating pathology in chronic lymphatic filariasis. In addition, our data also reveal a new link between innate immune responses (in the form of TLR activation) and angiogenic/lymphangiogenic pathways (in the form of elevated growth factors), thereby providing additional insight into the pathways connecting the immune system and normal physiologic processes such as lymphatic circulation. • Alteration of TLR expression and function in filaria- infected individuals with latent TB can have major implications in the control of latent TB infection. In addition, these findings also have significant implications for vaccine efficacy in helminth- endemic countries. Vaccines requiring a pro-inflammatory cytokine response for efficacy and those involving TLR agonists as adjuvants may not function optimally in the presence of helminth coinfection. The reversal of TLR modulation upon treatment of filarial infection suggests that elimination of this helminth infection in endemic areas might have a profound effect in the control of TB infection

PHYTOCHEMICAL AND PHARMACOLOGICAL EVALUATION OF ACALYPHA COMMUNIS MULL. ARG. FOR THEIR HEPATOPROTECTIVE ACTIVITY

Objective: Acalypha communis is a synonym of Ricinocarpus communis (Müll.Arg.) belonging to the family of Euphorbiaceae. A. communis possess awide variety of activities like antimicrobial. Hence, the present study was intended to evaluate ethanolic leaf extract of A. communis for hepatoprotectiveactivities.Methods: The hepatoprotective activity was studied by paracetamol (2 g/kg) and D-galactosamine (400 mg/kg) induced models. Acute toxicity studyand preliminary phytochemical screening were also studied to evaluate the toxicity.Results: No toxicity profile was observed in rats after oral administration of the ethanolic leaf extract at the dose of 5 g/kg body weight. Thedifferent dose of 200 mg/kg and 400 mg/kg administered with the extract of A. communis. There was significant (p&lt;0.001) reduction in biochemicalparameters with respect to control. Phytochemical screening of the plant extract revealed the presence of tannins, alkaloids, flavonoids and saponins,and terpenoids.Conclusion: It can be concluded that the hepatoprotective activity elucidated by A. communis could be mainly due to the presences of high-value classof compound like the phenolic group as the major content in the plants.Keywords: Acalypha communis, Paracetamol, D-galactosamine, Biochemical parameters and histopathological studies

External cephalic version in breech presentations at term: comparison of maternal and perinatal outcome with normal pregnancies

Background: To study the maternal and perinatal outcome after successful external cephalic version in term breech pregnancies and to compare the same with normal deliveries with cephalic presentation.Methods: Singleton term breech pregnancies were included in Group I; in which ECV was attempted. Out of this, pregnancies with successful ECV (Subgroup I) were compared with Group II comprising of two term normal pregnancies delivering in labour room immediately after delivery of every woman who had successful ECV. Maternal, labour and perinatal parameters were compared between Subgroup and Group II. Results: The two groups were comparable with respect to maternal age and gestational age. There were more multigravidae in both groups. There were more labour inductions in Subgroup. 83.3% women in study group and 95.8% women in control group had spontaneous vaginal deliveries. There were no perinatal deaths in either group. No serious maternal complications related to version were noted.Conclusions: This study shows that ECV does not adversely affect the maternal and perinatal outcome; although larger studies are required to confirm this. ECV may be more successful in multigravidae with flexed breech presentations. The procedure should probably be practiced regularly to improve the success rate

From blood zone to school zone an analysis of educational industry restructuring requirement after war-ridden decades

Any attack to normal life is not good for individuals and for nations that derail the activities of development It is not only derailing the developments, it forced the decision makers to rearrange the activities and rectify the damages which need additional requirements such as time, skill and knowledge, capital, technology and materials. When a short time attack itself requires such a huge requirements, a war that too consumed more than two decades need huge requirements and some other aspects such as building confidence in domestic as well in international arena. Particularly in educational service, high dropout rate, few education providers, little options to choose in higher education, higher age groups back to education, motivational factors for bring them back to education are few issues that need to be addressed. As informed by UNESCO (United Nations Educational, Scientific and Cultural Organization) Education helps people to develop the attitudes, skills and knowledge to make informed decisions that will improve individuals and nations, now and in the future. For any post conflict development, education becomes higher priority than immediate material needs which has been considered as priority by affected communities, development authorities and Governments. Because Education can provide physical, cognitive and psychological supports and restore the routine and gives hope for the future. It can also serve as a channel for communicating vital messages for trust building, wound healing and base for sustainable development. After 25 years of conflict, Government of Sri Lanka and educational service providers both from domestic and foreign, consumers and other stakeholders can come closer to provide good education to improve economic situation and business environment for sustainable development in Sri Lanka. This study intends to analyze education system restructuring requirement after the war for sustainable development in Sri Lanka

Perceptual Chasm Between Industry and Academic Leaders on the Quality of Higher Education

In the context of the Information Technology Revolution, Communication Explosion, the Knowledge Economy and Globalization, India’s production of Professionals is phenomenal. With over 300 Universities and 15,600 Colleges spewing out 2.5 million graduates each year, in terms of the volume of production India trails behind only the US and recently China. Each year India produces 350,000 Engineers, twice the number produced by the US. A recent evaluation of Universities and Research Institutes all over the world, conducted by a Shanghai university, has not a single Indian University in the world’s top 300 – China has six

Writing as a Therapeutic Agent for Collective Healing in the Poems of Tensin Tsundue

Almost all people experience trauma in their life. Surviving in the era that has witnessed a lot of trauma, a millennium composed of two world wars and cold wars, has made every human being experience chains of trauma. Traumatic problems affect a person mentally and physically. There is a long history of human associating himself through a way or therapy to find himself out of the Post Traumatic Stress Disorders (PTSD). This paper projects the importance of writing that serves as a therapy, with the backdrop of the Tibetan writer Tensin Tsundue. Tibet at present undergoes the tough situations due to the Chinese invasion and Tibetans are mostly away from their homeland and staying as refugees in other countries. Tensin Tsundue is a Tibetan activist and writer, and his works bring out the reality of the Tibetan struggle, where his poems stand as a placard for the readers to identify the lost identity of Tibetans. This paper brings out the importance of writing as a therapy to overcome the traumatic stress, and it analyses how an individual writing brings the impact of collective healing into action

Postmodern Politics Found in Tamil Modern Poetry

One of the two notable elements of modernist politics that emerged in the West was fundamentalism, and the other was identity politics. Postmodern politics encompasses the inadequacies of modernist politics and alternative political ideas. The three elements of unleashing politics, the politics of remnants, and the politics of difference give rise to a fundamental understanding of postmodern politics. It is also necessary to divide it according to the Tamil context into differential feminist politics, Dalit feminist politics, Dalit politics, rainbow coalition or fusion politics, marginal politics, and Periyarist politics. Based on this, the postmodern politics found in the poems of modern Tamil poets such as Salma, Sukirtharani, Sivakami, Thirumagan, M.T. Muthukumarasamy, and T. Kaverinadan have been explained through this article