227 research outputs found

    POTENTIAL YIELD OF DEEP SEA SHRIMP RESOURCES IN THE SOUTHERN JAVA OF THE INDIAN OCEAN EEZ WATERS

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    Study on the potential yield of deep sea shrimp in the south off Java waters (lndian Ocean) was carried out based on data collected from the survey conducted between May and June 2005 using Baruna Jaya IV research vessel. This study was basically conducted by applying swept area method

    The alcohol use disorders identification test (AUDIT): validation of a Nepali version for the detection of alcohol use disorders and hazardous drinking in medical settings

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    BACKGROUND: Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse. METHODS: This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females. RESULTS: A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females. CONCLUSION: The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal

    Feasibility of a combined camp approach for vector control together with active case detection of visceral leishmaniasis, post kala-azar dermal leishmaniasis, tuberculosis, leprosy and malaria in Bangladesh, India and Nepal: an exploratory study

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    Background We assessed the feasibility and results of active case detection (ACD) of visceral leishmaniasis (VL), post kala-azar dermal leishmaniasis (PKDL) and other febrile diseases as well as of bednet impregnation for vector control. Methods Fever camps were organized and analyzed in twelve VL endemic villages in Bangladesh, India, and Nepal. VL, PKDL, tuberculosis, malaria and leprosy were screened among the febrile patients attending the camps, and existing bednets were impregnated with a slow release insecticide. Results Among the camp attendees one new VL case and two PKDL cases were detected in Bangladesh and one VL case in Nepal. Among suspected tuberculosis cases two were positive in India but none in the other countries. In India, two leprosy cases were found. No malaria cases were detected. Bednet impregnation coverage during fever camps was more than 80% in the three countries. Bednet impregnation led to a reduction of sandfly densities after 2 weeks by 86% and 32%, and after 4 weeks by 95% and 12% in India and Nepal respectively. The additional costs for the control programmes seem to be reasonable. Conclusion It is feasible to combine ACD camps for VL and PKDL along with other febrile diseases, and vector control with bednet impregnatio

    Linking In Vitro and In Vivo Survival of Clinical Leishmania donovani Strains

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    BACKGROUND: Leishmania donovani is an intracellular protozoan parasite that causes a lethal systemic disease, visceral leishmaniasis (VL), and is transmitted between mammalian hosts by phlebotomine sandflies. Leishmania expertly survives in these 'hostile' environments with a unique redox system protecting against oxidative damage, and host manipulation skills suppressing oxidative outbursts of the mammalian host. Treating patients imposes an additional stress on the parasite and sodium stibogluconate (SSG) was used for over 70 years in the Indian subcontinent. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated whether the survival capacity of clinical L. donovani isolates varies significantly at different stages of their life cycle by comparing proliferation, oxidative stress tolerance and infection capacity of 3 Nepalese L. donovani strains in several in vitro and in vivo models. In general, the two strains that were resistant to SSG, a stress encountered in patients, attained stationary phase at a higher parasite density, contained a higher amount of metacyclic parasites and had a greater capacity to cause in vivo infection in mice compared to the SSG-sensitive strain. CONCLUSIONS/SIGNIFICANCE: The 2 SSG-resistant strains had superior survival skills as promastigotes and as amastigotes compared to the SSG-sensitive strain. These results could indicate that Leishmania parasites adapting successfully to antimonial drug pressure acquire an overall increased fitness, which stands in contrast to what is found for other organisms, where drug resistance is usually linked to a fitness cost. Further validation experiments are under way to verify this hypothesi

    Serum nitrite level and adenosine deaminase activity is altered in visceral leishmaniasis

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    ABSTRACT In this study we sought to determine if there is alteration in nitric oxide (NO) production and adenosine deaminase (ADA) activity among patients with visceral leishmaniasis (VL) and the effect of four weeks of chemotherapy on these levels. Fifty-three VL patients diagnosed clinically and by direct demonstration of the LD bodies in the bone marrow smear were studied. They were treated with Sodium Stibogluconate and sampled at the baseline and four weeks. Forty-three healthy individuals coming from the same endemic area were taken as control. Total nitrite Keywords: NO, ADA, Visceral leishmaniasis INTRODUCTION Intramacrophage infection by Leishmania donovani (LD), an obligate intracellular protozoan, results the potentially fatal visceral leishmaniasis (VL) or kalaazar. The elimination of leishmania parasite by macrophage depends upon the mounting of effective cell-mediated immune response. During leishmaniasis infection, the microbicidal interaction between the parasite and host cells involves the presentation of leishmania antigen by macrophage to T-helper (Th) cell through MHC II molecule along with the co-stimulatory molecules (B7-1/B7-2 and CD40). 1, 2 Activation of Th cell causes proliferation of IFN-γ producing CD4+ Th subset. 3 IFN-γ and TNF-α, the defining cytokines of the Th1 subset in turn activates the macrophage to generate NO which is the most relevant anti-leishmanial oxidant. Contrary results have been found in the NO level during L. donovani infection both in vitro and in vivo experiments. 4, 5 Also studies reported hitherto have generally originated from in vitro culture and animal experiments. However no study has so far been conducted to investigate NO production in patients with visceral leishmaniasis. Therefore we aimed to determine serum nitrite level in VL patients as surrogate marker of NO production and compare it with the healthy subjects. Assessments of NO metabolites may be useful tool in the evaluation of the effector mechanism of macrophage and clinical manifestation of patients. Adenosine deaminase (ADA) is an essential for the proliferation, maturation and function of T lymphocytes. Its activity increases during antigenic and mitogenic responses of lymphocytes and is considered as an important immunoenzyme marker for assessing cell-mediated immunity in diseases characterized by T lymphocytes proliferation and maturation

    О некоторых аспектах проблемы формирования рынка труда в Украине и в Крыму

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    В статье дан анализ современного состояния рынка труда в Украине и в Крыму, выявлены причины и особенности безработицы, определены задачи государства в этой связи, предложены мероприятия по их разрешению.Про деякі аспекти проблеми формування ринку праці в Україні і в Криму. У статті даний аналіз сучасного стану ринку праці в Україні й у Криму, виявлено причини й особливості безробіття, визначені завдання держави в цьому зв'язку, запропоновані заходи щодо їхнього вирішення.In article the analysis of a modern condition of a labour market in Ukraine and in Crimea is given, the reasons and features of unemployment are revealed, problems of the state in this connection are determined, actions under their sanction are offered

    Options for Active Case Detection of Visceral Leishmaniasis in Endemic Districts of India, Nepal and Bangladesh, Comparing Yield, Feasibility and Costs

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    For the elimination of any infectious disease (i.e., reduction of the burden of a serious public health problem to a minor problem which can be managed by the general health services) the right mix of public health tools has to be identified for the early detection and successful treatment of new cases as well as effective vector control (in the case of vector borne diseases) at affordable costs. The paper provides a powerful example of evidence building for cost-effective early case detection in the visceral leishmaniasis elimination initiative of Bangladesh, India and Nepal. It compares the camp approach (mobile teams testing in chronic fever camps for spleen enlargement and rapid diagnostic tests) with the index case approach (screening for new cases in the neighbourhood of reported visceral leishmaniasis patients) and the incentive based approach (where basic health workers receive an allowance for detecting a new case) using subsequent house-to-house screening for the identification of the real number of un-detected cases. By applying a mix of different study methods and an itinerate research process to identify the most effective, feasible and affordable case detection method, under different environmental conditions, recommendations could be developed which help governments in shaping their visceral leishmaniasis elimination strategy

    Visceral Leishmaniasis Clinical Management in Endemic Districts of India, Nepal, and Bangladesh

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    Background. National VL Elimination Programs in India, Nepal and Bangladesh face challenges as home-based Miltefosine treatment is introduced. Objectives. To study constraints of VL management in endemic districts within context of national elimination programs before and after intervention. Methods. Ninety-two and 41 newly diagnosed VL patients were interviewed for clinical and provider experience in 2009 before and in 2010 after intervention (district training and improved supply of diagnostics and drugs). Providers were assessed for adherence to treatment guidelines. Facilities and doctor-patient consultations were observed to assess quality of care. Results. Miltefosine use increased from 33% to 59% except in Nepal where amphotericin was better available. Incorrect dosage and treatment interruptions were rare. Advice on potential side effects was uncommon but improved significantly in 2010. Physicians did not rule out pregnancy prior to starting Miltefosine. Fever measurement or spleen palpation was infrequently done in Bangladesh but improved after intervention (from 23% to 47%). Physician awareness of renal or liver toxicity as Miltefosine side effects was lower in Bangladesh. Bio-chemical monitoring was uncommon. Patient satisfaction with services remained low for ease of access or time provider spent with patient. Health facilities were better stocked with rK39 kits and Miltefosine in 2010
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