Some observations on the effect of Daflon (micronized purified flavonoid fraction of Rutaceae aurantiae) in bancroftian filarial lymphoedema

BACKGROUND: Morbidity management is a core component of the global programme for the elimination of lymphatic filariasis. In a double-blind clinical trial, the tolerability and efficacy of Daflon (500 mg) + DEC (25 mg) or DEC (25 mg) alone, twice daily for 90 days, was studied in 26 patients with bancroftian filarial lymphoedema. RESULTS: None of the patients in either drug group reported any adverse reaction throughout the treatment period (90 days). Haematological and biochemical parameters were within normal limits and there was no significant difference between the pre-treatment (day 0) and post-treatment (day 90) values. The group receiving Daflon showed significant reduction in oedema volume from day 90 (140.6 ± 18.8 ml) to day 360 (71.8 ± 20.7 ml) compared to the pre-treatment (day 0, 198.4 ± 16.5 ml) value. This accounted for a 63.8% reduction in oedema volume by day 360 (considering the pre-treatment (day 0) as 100%). In the DEC group, the changes in oedema volume (between day 1 and day 360) were not significant when compared to the pre-treatment (day 0) value. The percentage reduction at day 360 was only 9%, which was not significant (P > 0.05). CONCLUSION: This study has shown that Daflon (500 mg, twice a day for 90 days) is both safe and efficacious in reducing oedema volume in bancroftian filarial lymphoedema. Further clinical trials are essential for strengthening the evidence base on the role of this drug in the morbidity management of lymphatic filariasis

FOSL1 (FOS-like antigen 1)

Review on FOSL1 (FOS-like antigen 1), with data on DNA, on the protein encoded, and where the gene is implicated

Nitrated fatty acids reverse cigarette smoke-induced alveolar macrophage activation and inhibit protease activity via electrophilic S-alkylation

Nitrated fatty acids (NFAs), endogenous products of nonenzymatic reactions of NO-derived reactive nitrogen species with unsaturated fatty acids, exhibit substantial anti-inflammatory activities. They are both reversible electrophiles and peroxisome proliferator-activated receptor γ (PPARγ) agonists, but the physiological implications of their electrophilic activity are poorly understood. We tested their effects on inflammatory and emphysema-related biomarkers in alveolar macrophages (AMs) of smoke-exposed mice. NFA (10-nitro-oleic acid or 12-nitrolinoleic acid) treatment downregulated expression and activity of the inflammatory transcription factor NF-κB while upregulating those of PPARγ. It also downregulated production of inflammatory cytokines and chemokines and of the protease cathepsin S (Cat S), a key mediator of emphysematous septal destruction. Cat S downregulation was accompanied by decreased AM elastolytic activity, a major mechanism of septal destruction. NFAs downregulated both Cat S expression and activity in AMs of wild-type mice, but only inhibited its activity in AMs of PPARγ knockout mice, pointing to a PPARγ-independent mechanism of enzyme inhibition. We hypothesized that this mechanism was electrophilic S-alkylation of target Cat S cysteines, and found that NFAs bind directly to Cat S following treatment of intact AMs and, as suggested by in silico modeling and calculation of relevant parameters, elicit S-alkylation of Cys25 when incubated with purified Cat S. These results demonstrate that NFAs' electrophilic activity, in addition to their role as PPARγ agonists, underlies their protective effects in chronic obstructive pulmonary disease (COPD) and support their therapeutic potential in this disease

Tolerability and efficacy of single dose albendazole, diethylcarbamazine citrate (DEC) or co-administration of albendazole with DEC in the clearance of Wuchereria bancrofti in asymptomatic microfilaraemic volunteers in Pondicherry, South India: a hospital-based study

BACKGROUND: The tolerability and efficacy of single dose albendazole (400 mg), diethylcarbamazine citrate (DEC) (6 mg/kg bodyweight) or co-administration of albendazole (400 mg) + DEC (6 mg/kg bodyweight) was studied in 54 asymptomatic Wuchereria bancrofti microfilaraemic volunteers in a double blind hospital-based clinical study. RESULTS: There was no significant difference in the overall incidence of adverse reactions between the three drug groups [42.1% (albendazole), 52.9% (DEC) and 61.1% (albendazole + DEC); P > 0.05]. The mean score of adverse reaction intensity did not differ significantly between the DEC and albendazole + DEC groups. However, the values in these two groups were significantly higher compared to that of albendazole alone [1.8 ± 3.0 (albendazole) vs. 5.6 ± 7.1 (DEC), 6.7 ± 6.6 (albendazole + DEC); P < 0.05]. By day 360 post-therapy there was no significant difference between the three drug groups in relation to the clearance of microfilaria [26.3% (albendazole), 17.6% (DEC), 27.8% (albendazole + DEC)], reduction in geometric mean parasite density [94.7% (albendazole), 89.5% (DEC), 95.4% (albendazole + DEC)] or reduction in filarial antigenaemia [83% (albendazole), 87% (DEC), 75% (albendazole + DEC)]. Furthermore, there was a significant decrease in mean geometric parasite density (P < 0.05) as well as antigenaemia optical density values (P < 0.01) between pre-therapy levels and day 360 post-therapy in all three groups. CONCLUSIONS: This study has shown that single dose albendazole (400 mg) has similar efficacy in the clearance of microfilaria as that of DEC or the co-administration of the two drugs. The results strengthen the rationale of using albendazole for mass annual single dose administration for the control of transmission of lymphatic filariasis

School tuck shops in South Africa—an ethical appraisal

It can be postulated that schools have an ethical responsibility to protect children from an unhealthy food environment. Against the backdrop of stunting, overweight and micronutrient deficiencies prevalent in South African children, the aim of this scoping study is to review information available on foods sold to school children within an ethical framework. While some schools have a formal tuck shop, at other schools, food vendors sell food either on or outside the school premises. Ten studies, of which two were national, fit the selection criteria for this study. Available data show that mostly unhealthy food options are sold to South African school children; with low-nutrient energy-dense foods (e.g. chips, sweets) and sugar sweetened beverages being the most popular. The Integrated School Health Policy provide a policy framework for achieving healthy school food environments in South Africa, and several guidelines are available in South African to assist school tuck shops to sell healthier options. Children’s preference for unhealthy foods, the cost of healthier food options and a lack of proper facilities may however be barriers for implementing healthy tuck shops. An action stronger than merely providing guidelines may therefore be needed. Cognisance needs to be taken of conflicting value based arguments within ethical perspectives. Given these conflicts, the authors argue that an Ethics of Responsibility contributes to the debate of the best and supports the notion that society at large has a responsibility to protect vulnerable communities of which school children are part. Presently an ethical vacuum exists in terms of rights and responsibilities which this study hopes to address.DHE

Combinatorial Bounds for Conflict-free Coloring on Open Neighborhoods

In an undirected graph $G$, a conflict-free coloring with respect to open neighborhoods (denoted by CFON coloring) is an assignment of colors to the vertices such that every vertex has a uniquely colored vertex in its open neighborhood. The minimum number of colors required for a CFON coloring of $G$ is the CFON chromatic number of $G$, denoted by $\chi_{ON}(G)$. The decision problem that asks whether $\chi_{ON}(G) \leq k$ is NP-complete. We obtain the following results: * Bodlaender, Kolay and Pieterse [WADS 2019] showed the upper bound $\chi_{ON}(G)\leq {\sf fvs}(G)+3$, where ${\sf fvs}(G)$ denotes the size of a minimum feedback vertex set of $G$. We show the improved bound of $\chi_{ON}(G)\leq {\sf fvs}(G)+2$, which is tight, thereby answering an open question in the above paper. * We study the relation between $\chi_{ON}(G)$ and the pathwidth of the graph $G$, denoted ${\sf pw}(G)$. The above paper from WADS 2019 showed the upper bound $\chi_{ON}(G) \leq 2{\sf tw}(G)+1$ where ${\sf tw}(G)$ stands for the treewidth of $G$. This implies an upper bound of $\chi_{ON}(G) \leq 2{\sf pw}(G)+1$. We show an improved bound of $\chi_{ON}(G) \leq \lfloor \frac{5}{3}({\sf pw}(G)+1) \rfloor$. * We prove new bounds for $\chi_{ON}(G)$ with respect to the structural parameters neighborhood diversity and distance to cluster, improving existing results. * We also study the partial coloring variant of the CFON coloring problem, which allows vertices to be left uncolored. Let $\chi^*_{ON}(G)$ denote the minimum number of colors required to color $G$ as per this variant. Abel et. al. [SIDMA 2018] showed that $\chi^*_{ON}(G) \leq 8$ when $G$ is planar. They asked if fewer colors would suffice for planar graphs. We answer this question by showing that $\chi^*_{ON}(G) \leq 5$ for all planar $G$. All our bounds are a result of constructive algorithmic procedures.Comment: 30 page

Fluorodeoxyglucose-positron emission tomography/computed tomography in the staging and evaluation of treatment response in a patient with Castleman's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Castleman's disease is a rare lymphatic polyclonal disorder that is characterised by unicentric or multicentric lymph node hyperplasia and non-specific symptoms and signs including fever, asthenia, weight loss, enlarged liver and abnormally high blood levels of antibodies.</p> <p>Case presentation</p> <p>We present the case of a 74-year-old man with Castleman's disease. The disease was detected with a contrast-enhanced computed tomography (CT) scan and a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT study; diagnosis was made with histopathology. After treatment with surgical excision followed by chemotherapy, the disease response was evaluated using both diagnostic techniques. However, only the PET study was able to identify the spread of the disease to the abdominal lymph nodes, which were both enlarged and normal size, and, after treatment, to evaluate the disease response.</p> <p>Conclusion</p> <p>Based on the results of previous case reports and on those of the present study, it seems that Castleman's disease has a high glucose metabolic activity. Therefore, the use of PET can be considered appropriate in order to stage or restage the disease and to evaluate the response of the disease to treatment.</p

Safe Eye Surgery : Non-technical aspects

Peer reviewedPostprin