A randomized comparison of branded sodium stibogluconate and generic sodium stibogluconate for the treatment of visceral leishmaniasis under field conditions in Sudan.

OBJECTIVE: To compare the outcome of treatment of Sudanese kala-azar patients treated under field conditions with either branded sodium stibogluconate (SSG) (Pentostam GlaxoWellcome) or generic SSG (Albert David Ltd, Calcutta, supplied by International Dispensary Association, Amsterdam). METHOD: Randomised comparison. 271 patients were treated with Pentostam and 245 with generic SSG. RESULTS: No statistically significant differences in cure rate or mortality were detected between Pentostam and generic SSG. No differences in side-effects between the two drugs were noted. The initial cure rate at the time of discharge was 93.7 and 97.6%, respectively; the death rate during treatment 5.9 and 2.4%. Six months follow up was achieved in 88.5% of the discharged patients. Two patients had died in the Pentostam group and two had died in the generic SSG group, giving a final death rate of 7.5 and 3.7%. The number of relapses in the Pentostam and generic SSG groups were 3 and 1, respectively. The final cure rates, calculated at 6 months after discharge, were 91.3% and 95.9%. CONCLUSION: No difference was observed in the performance of generic SSG compared to Pentostam for the treatment of visceral leishmaniasis in Sudan. Generic SSG can be routinely and safely used for the treatment of kala-azar. Generic SSG costs only 1/14 of the price of Pentostam. The use of generic SSG may make treatment of kala-azar affordable for national governments in Africa

Comparison of Generic and Proprietary Sodium Stibogluconate for the Treatment of Visceral Leishmaniasis in Kenya.

OBJECTIVE: To compare the use of generic and proprietary sodium stibogluconate for the treatment of visceral leishmaniasis (kala-azar). METHODS: A total of 102 patients with confirmed kala-azar were treated in a mission hospital in West Pokot region, Kenya, with sodium stibogluconate (20 mg/kg/day for 30 days)--either as Pentostam (PSM) or generic sodium stibogluconate (SSG); 51 patients were allocated alternately to each treatment group. FINDINGS: There were no significant differences in baseline demographic characteristics or disease severity, or in events during treatment. There were 3 deaths in the PSM group and 1 in the SSG group; 2 patients defaulted in each group. Only 1 out of 80 test-of-cure splenic aspirates was positive for Leishmania spp.; this patient was in the SSG group. Follow-up after > or = 6 months showed that 6 out of 58 patients had relapsed, 5 in the SSG group and 1 in the PSM group. No outcome variable was significantly different between the two groups. CONCLUSION: The availability of cheaper generic sodium stibogluconate, subject to rigid quality controls, now makes it possible for the health authorities in kala-azar endemic areas to provide treatment to many more patients in Africa

Directional quantum dot emission by soft-stamping on silicon Mie resonators

We present a soft-stamping method to selectively print a homogenous layer of CdSeTe/ZnS core–shell quantum dots (QDs) on top of an array of Si nanocylinders with Mie-type resonant modes. Using this new method, we gain accurate control of the quantum dot's angular emission through engineered coupling of the QDs to these resonant modes. Using numerical simulations we show that the emission into or away from the Si substrate can be precisely controlled by the QD position on the nanocylinder. QDs centered on a 400 nm diameter nanocylinder surface show 98% emission directionality into the Si substrate. Alternatively, for homogenous ensembles placed over the nanocylinder top-surface, the upward emission is enhanced 10-fold for 150 nm diameter cylinders. Experimental PL intensity measurements corroborate the simulated trends with cylinder diameter. PL lifetime measurements reflect well the variations of the local density of states at the QD position due to coupling to the resonant cylinders. These results demonstrate that the soft imprint technique provides a unique manner to directly integrate optical emitters with a wide range of nanophotonic geometries, with potential applications in LEDs, luminescent solar concentrators, and up- and down-conversion schemes for improved photovoltaics

Burden of visceral leishmaniasis in villages of eastern gedaref state, Sudan: an exhaustive cross-sectional survey.

Since December 2009, Médecins Sans Frontières has diagnosed and treated patients with visceral leishmaniasis (VL) in Tabarak Allah Hospital, eastern Gedaref State, one of the main endemic foci of VL in Sudan. A survey was conducted to estimate the VL incidence in villages around Tabarak Allah

Quantifying the burden of rhodesiense sleeping sickness in Urambo district, Tanzania

Sleeping sickness (human African trypanosomiasis - HAT) is a disease transmitted by tsetse flies and is always fatal if left untreated. The disease occurs in foci affecting poor communities with limited access to health service provision and as such the disease is often left undiagnosed, mistaken for more common afflictions. Even if diagnosed, sleeping sickness is costly to treat, both for health services and patients and their families in terms of costs of diagnosis, transport, hospital care, and the prolonged period of convalescence. Here we estimate the health burden of the acute form T. b. rhodesiense sleeping sickness in Urambo District, Tanzania in terms of Disability Adjusted Life Years (DALYs), the yardstick commonly used by policy makers to prioritize disease management practices, representing a year of healthy life lost to disease. In this single district, the burden of the disease over one year was estimated at 979 DALYs and the estimated monetary costs to health services for the 143 treated patients at US$11,841 and to the patients themselves at US$ 3,673 for direct medical costs and US$ 9,781 for indirect non-medical costs. Sleeping sickness thus places a considerable burden on the affected rural communities and health services

Effect of pre-treatment processes of organic residues on soil aggregates

Process technologies, such as composting, anaerobic digestion, or lactic acid fermentation, greatly influence the resulting organic amendments (OAs) characteristics even when the same raw material is used. However, it is still unclear how these process technologies indirectly modify the effect of OAs on soil microbial activity and soil aggregation. To determine the effect of OA produced using pre-treatment technologies on the soil microbial activity and soil aggregation, we ran a soil column experiment in which we applied compost, digestate and lactic acid fermentation product made of the same model bio-waste. The results indicated that OAs produced under anaerobic conditions (fermented product and digestate) increased microbial activity, biomass, and soil micro- and macro-aggregation compared to compost and control treatments. Soil microbial activity strongly correlated to C, Ca, Mg, extracellular polymeric substances (EPS), fungal biomass, and macroaggregate formation (rs>0.7, p0.7, p<0.05). This study demonstrated that the effect of an organic substrate on soil properties can be modified towards desired effects using different pre-treatment technologies, suggesting the possibility of “engineer” OAs

Detection of oligoclonal IgG kappa and IgG lambda bands in cerebrospinal fluid and serum with Hevylite™ antibodies. comparison with the free light chain oligoclonal pattern

<p>Abstract</p> <p>Background</p> <p>Oligoclonal IgG bands in cerebrospinal fluid that are absent in serum indicate intrathecal IgG synthesis and are a sensitive marker of CNS inflammatory diseases, in particular multiple sclerosis. It may be of interest to determine whether these bands are predominantly IgGκ or IgGλ.</p> <p>Methods</p> <p>We have used Hevylite™ antibodies and developed a technique for detection of oligoclonal IgGκ and IgGλ bands by means of isoelectric focusing followed by immunoblotting. The same technique was used for oligoclonal free κ and free λ detection. Among several techniques tested, affinity immunoblotting appears to be the most sensitive; it can detect less than 1 ng of IgGκ or IgGλ paraprotein. We compared oligoclonal IgG profiles with those of oligoclonal IgGκ and IgGλ. There was good agreement concerning the presence or absence of intrathecal synthesis. We observed the ratios between oligoclonal IgGκ and IgGλ bands, and they did not always match the ratios between free κ and free λ bands. We were also able to detect antigen-specific CSF-restricted oligoclonal IgGκ and IgGλ bands in neuroborreliosis. It remains to be determined subsequently by a clinically-oriented prospective study, whether predominant IgGκ/IgGλ or free κ/free λ can be observed more frequently in particular diseases with oligoclonal IgG synthesis.</p> <p>Discussion</p> <p>Very sensitive detection of oligoclonal IgGκ and IgGλ bands in cerebrospinal fluid with Hevylite antibodies is feasible; detection of antigen-specific IgGκ or IgGλ is possible as well. In particular situations, e.g. when difficulties arise in distinguishing between oligoclonal and monoclonal pattern, the test may be of considerable clinical value.</p

Distribution of sedimentary rock types through time in a back-arc basin: A case study from the Jurassic of the Greater Caucasus (Northern Neotethys)

Abstract The evolution of sedimentary basins can be explored by analyzing the changes in their lithologies and lithofacies (i.e. predominant lithologies). The Greater Caucasus Basin, which was located at the northern margin of the Neotethys Ocean, represents a complete Sinemurian-Tithonian succession. A quantitative analysis of compiled datasets suggests that principal lithologies and lithofacies are represented by siliciclastics, shale and carbonates. The relative abundance of siliciclastics and shale decreased throughout the Jurassic, whereas that of carbonates increased. Evaporites are known from the Upper Jurassic, while volcaniclastics and volcanics, as well as coals, are known only in the Lower to Middle Jurassic. Siliceous rocks are extremely rare. Lithology and lithofacies proportions change accordingly. The Sinemurian-Bathonian sedimentary complex is siliciclastic-and-shale-dominated, whereas the Callovian-Tithonian sedimentary complex is carbonate-dominated. A major change in the character of sedimentation occurred during the Aalenian-Callovian time interval. Regional transgressions and regressions were more important controls of changes in the sedimentary rock proportions than average basin depth. Landward shoreline shifts were especially favorable for carbonate accumulation, whereas siliciclastics and shale were deposited preferentially in regressive settings. An extended area of the marine basin, its lower average depth, and a sharp bathymetric gradient favored a higher diversity of sedimentation. An orogeny at the Triassic-Jurassic transition was responsible for a large proportion of siliciclastics and extensive conglomerate deposition. An arcarc collision in the Middle Jurassic also enhanced the siliciclastic deposition. Both phases of tectonic activity were linked with an increase in volcanics and volcaniclastics. Volcanism itself might have been an important control on sedimentation. A transition to carbonate-dominated sedimentation occurred in the Late Jurassic, reflecting a tectonically calm period