Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections

Background: Plasmodium knowlesi is a cause of symptomatic and potentially fatal infections in humans. There are no studies assessing the detailed parasitological response to treatment of knowlesi malaria infections in man and whether antimalarial resistance occurs. Methods: A prospective observational study of oral chloroquine and primaquine therapy was conducted in consecutive patients admitted to Kapit Hospital, Sarawak, Malaysian Borneo with PCR-confirmed single P. knowlesi infections. These patients were given oral chloroquine for three days, and at 24 hours oral primaquine was administered for two consecutive days, primarily as a gametocidal agent. Clinical and parasitological responses were recorded at 6-hourly intervals during the first 24 hours, daily until discharge and then weekly to day 28. Vivax malaria patients were studied as a comparator group. Results: Of 96 knowlesi malaria patients who met the study criteria, 73 were recruited to an assessment of the acute response to treatment and 60 completed follow-up over 28 days. On admission, the mean parasite stage distributions were 49.5%, 41.5%, 4.0% and 5.6% for early trophozoites, late trophozoites, schizonts and gametocytes respectively. The median fever clearance time was 26.5 [inter-quartile range 16-34] hours. The mean times to 50% (PCT50) and 90% (PCT90) parasite clearance were 3.1 (95% confidence intervals [CI] 2.8-3.4) hours and 10.3 (9.4-11.4) hours. These were more rapid than in a group of 23 patients with vivax malaria 6.3 (5.3-7.8) hours and 20.9 (17.6-25.9) hours; P = 0.02). It was difficult to assess the effect of primaquine on P. knowlesi parasites, due to the rapid anti-malarial properties of chloroquine and since primaquine was administered 24 hours after chloroquine. No P. knowlesi recrudescences or re-infections were detected by PCR. Conclusions: Chloroquine plus primaqine is an inexpensive and highly effective treatment for uncomplicated knowlesi malaria infections in humans and there is no evidence of drug resistance. Further studies using alternative anti-malarial drugs, including artemisinin derivatives, would be desirable to define optimal management strategies for P. knowlesi.Publisher PDFPeer reviewe

Prevalence of beta lactamase producing species of pseudomonas and acinetobacter in pediatric burn patients Prevalence de pseudomonas et acinetobacter secreteurs de blse et metallo-beta lactamases chez les brules pediatriques

Burn wound infection is a major cause of morbidity and mortality in burn victims. Pseudomonas and Acinetobacter species are among the most common organisms complicating burn wounds. Presence of extended spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) genes plays an important role in spreading β-lactam resistant strains of these organisms and is a serious condition in the treatment of the affected patients. As a result, we aimed to determine the prevalence of SHV, TEM, PER and VIM β-lactamases in Pseudomonas and Acinetobacter species isolates from burn wound swabs of children with burn injury. In this descriptive observational study, 107 Pseudomonas and Acinetobacter isolates collected from burn patients were subjected to PCR assay. Using PCR method and DNA sequencing, the existence of SHV-, TEM-, PER- and VIM-type β-lactamase encoding genes were determined. Out of the 107 Pseudomonas and Acinetobacter isolates, 66 (77.6) were ESBL positive, 26.2 were positive for SHV gene, 37.4 were positive for TEM gene, 14 were positive for PER gene and 15.9 of them harbored VIM gene. More than half of the Pseudomonas and Acinetobacter strains in our pediatric burn unit harbor β-lactamase encoding genes that make them resistant to a wide range of β-lactam antibiotics. Consequently, it is suggested to choose an appropriate antibiotic regimen based on the antibiogram pattern of the strains. © 2015, Mediterranean Club for Burns and Fire Disasters. All rights reserved

Sleep hygiene in medical students in Tehran; do they learn to attend to their own health?

Background: Poor sleep quality in medical students may negatively affect their professional training and deteriorate neurocognitive and academic performance. Objectives: In this study, we aim to determine the prevalence and determinants of poor sleep quality and its scales in a group of medical students in Tehran, Iran in 2017. Methods: In this cross-sectional study, Pittsburgh Sleep Quality Index (PSQI) was completed by 154 medical students in Tehran, Iran. Demographic characteristics were also gathered. Global PSQI and scales scores were calculated. Results: Median Global PSQI score was 5. Poor sleep quality was observed in 65 (42) students. Participants scored worst in sleep duration and daytime dysfunction scales, and 84.4 of the total participants reported some degree of daytime dysfunction. More than 90 of the participants reported no use of sleep medication. Neither of the variables sex, age, place of residence, being a freshman or having a history of sleep problems showed any significant association with sleep quality. When evaluating the scales, sleep duration problem was mostly observed in freshmen (P = 0.02), while medication use and daytime dysfunction were more common in second-year students (P = 0.04 and P = 0.01, respectively). Conclusions: The prevalence of poor sleep quality was high in this group of medical students in Tehran. The problem was largely observed in sleep duration and daytime dysfunction subscales of sleep quality. © 2020, Author(s)

Magnetoresistivity in a Tilted Magnetic Field in p-Si/SiGe/Si Heterostructures with an Anisotropic g-Factor: Part II

The magnetoresistance components $\rho_{xx}$ and $\rho_{xy}$ were measured in two p-Si/SiGe/Si quantum wells that have an anisotropic g-factor in a tilted magnetic field as a function of temperature, field and tilt angle. Activation energy measurements demonstrate the existence of a ferromagnetic-paramagnetic (F-P) transition for a sample with a hole density of $p$=2$\times10^{11}$\,cm$^{-2}$. This transition is due to crossing of the 0$\uparrow$ and 1$\downarrow$ Landau levels. However, in another sample, with $p$=7.2$\times10^{10}$\,cm$^{-2}$, the 0$\uparrow$ and 1$\downarrow$ Landau levels coincide for angles $\Theta$=0-70$^{\text{o}}$. Only for $\Theta$ > 70$^{\text{o}}$ do the levels start to diverge which, in turn, results in the energy gap opening.Comment: 5 pages, 6 figure

Spin instabilities and quantum phase transitions in integral and fractional quantum Hall states

The inter-Landau-level spin excitations of quantum Hall states at filling factors nu=2 and 4/3 are investigated by exact numerical diagonalization for the situation in which the cyclotron (hbar*omega_c) and Zeeman (E_Z) splittings are comparable. The relevant quasiparticles and their interactions are studied, including stable spin wave and skyrmion bound states. For nu=2, a spin instability at a finite value of epsilon=hbar*omega_c-E_Z leads to an abrupt paramagnetic to ferromagnetic transition, in agreement with the mean-field approximation. However, for nu=4/3 a new and unexpected quantum phase transition is found which involves a gradual change from paramagnetic to ferromagnetic occupancy of the partially filled Landau level as epsilon is decreased.Comment: 4 pages, 5 figures, submitted to Phys.Rev.Let

Quantum Hall ferromagnets, cooperative transport anisotropy, and the random field Ising model

We discuss the behaviour of a quantum Hall system when two Landau levels with opposite spin and combined filling factor near unity are brought into energetic coincidence using an in-plane component of magnetic field. We focus on the interpretation of recent experiments under these conditions [Zeitler et al, Phys. Rev. Lett. 86, 866 (2001); Pan et al, Phys. Rev. B 64, 121305 (2001)], in which a large resistance anisotropy develops at low temperatures. Modelling the systems involved as Ising quantum Hall ferromagnets, we suggest that this transport anisotropy reflects domain formation induced by a random field arising from isotropic sample surface roughness.Comment: 4 pages, submitted to Physical Review

Hepatitis C Infection Patterns at a Tertiary Care Center in New York: A Cross-Sectional Study.

Introduction In the United States, 2.7 to 3.9 million patients are infected with the hepatitis C virus (HCV) with 3,500 new cases reported yearly. According to the Centers for Disease Control and Prevention, HCV was the underlying or contributing cause of death of 19,659 patients in 2014. These facts underscore the need for a better understanding of the scope of this disease. Our epidemiologic study aimed at analyzing the pattern of occurrence of HCV infection at Staten Island University Hospital (SIUH) by evaluating the characteristics of newly infected patients with hepatitis C in 2014. The identified features served to better distinguish the targets for preventive health care in our particular population. Methodology A cross-sectional study of all newly diagnosed patients with HCV infections in the year 2014 presenting to SIUH was conducted using International Classification of Disease-9 codes (ICD-9) for hepatitis C. We included all patients with a positive HCV antibody confirmed by polymerase chain reaction testing. Patients were divided into groups according to age to simulate the age groups in the 2013 - 2014 Hepatitis B and C Annual Report of the New York City (NYC) Department of Health and Mental Hygiene published in 2016 (abbreviated to 2014 NYCDOH Report, hereafter). Gender and HCV genotypes were also collected. We compared disease frequency between age groups, gender, and genotype with the results of the 2014 NYCDOH Report. Results A total of 378 newly diagnosed HCV cases were identified; 60.05% were men, and 39.95% were women. The rate of infection with genotype 1a was the highest (36. 5%) followed by 1b (25.9%). In women, genotype 1b was predominant (13.76%) versus genotype 1a as the most common in men. The mean age was 54 years for men and 57 years for women. Most cases fell into the 60 to 69-year age group (32.28%), followed by the 50 to 59-year age group (31.48%). More so, all patients 80 years and older were exclusively women. Conclusions We found most new HCV infections at SIUH were diagnosed in patients aged 60 to 69 years, and the 2014 NYC DOH Report indicates most new HCV infections occur in patients aged 40 to 59 years. Also, all HCV infections detected in patients older than 80 years of age were found in women. These findings provide a better understanding of the patient demographics for appropriate HCV screening policies. Increased awareness and strict adherence to screening policies in baby boomers and high-risk populations are paramount in order to diagnose HCV infection early, offer therapy, and prevent HCV-related mortality and morbidity

Sustainable Environment: Nexus project

Arequipa region is locaed in Southwestern Peru. The Arequipa Nexus Institute for food, energy, water and the environment aims to address the key challenges to a sustainable furture for the people in the region. This roundtable discusses about the sustainable water management, geosaptial analysis and environment sharing, long range sensor network solution for soil health monitoring and data management and sharing in this Nexus project