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Search Results: 1 - 10 of 23720 matches for " Sumadhya Deepika Fernando "
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Current Evidence on the Use of Antifilarial Agents in the Management of bancroftian Filariasis
Sumadhya Deepika Fernando,Chaturaka Rodrigo,Senaka Rajapakse
Journal of Tropical Medicine , 2011, DOI: 10.1155/2011/175941
Abstract: Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC) remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM) is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB) in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA) are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level. 1. Introduction There are nine filarial nematodes causing disease in humans. According to the location of the parasite and the pathogenesis, the disease can be classified as lymphatic, subcutaneous, and serous cavity filariasis. Two filarial worms, namely, Wuchereria bancrofti and Brugia malayi cause lymphatic filariasis. The World Health Organization (WHO) considers lymphatic filariasis to be a global health problem affecting approximately 120 million people in over 80 countries [1]. One-third of affected individuals are from South Asia and another one third is from Africa [1]. One sixth of the world population is at risk of infection [1]. The adult W. bancrofti worms live within the human lymphatic system. They have a long life span of 4–6 years. Females are viviparous and release thousands of microfilaria into the blood stream of the host after mating. These are taken up by vector mosquitoes during feeding, and the parasite undergoes several moults within the intermediate host to become the L3 larva which is the infective stage. During a feed, this larva enters the human blood stream and migrates to the lymphatics where it moults to become an adult worm [2]. There is a range of clinical manifestations in bancroftian filariasis with asymptomatic microfilaremics being at one end of the spectrum. Symptomatic patients may have acute (lymphangitis, lymphadenitis), chronic (elephantiasis, lymphoedema, hydrocoele, chyluria), or atypical (funiculitis, mastitis) manifestations [3]. Some may suffer from tropical pulmonary eosinophilia (TPE) due to the immunological hyperresponsiveness to the parasite [4].
The 'hidden' burden of malaria: cognitive impairment following infection
Sumadhya D Fernando, Chaturaka Rodrigo, Senaka Rajapakse
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-366
Abstract: PUBMED and SCOPUS were searched for all articles with the key word 'Malaria' in the title field and 'cognitive impairment' in any field. Google Scholar was searched for the same keywords anywhere in the article. The search was restricted to articles published in English within the last 15 years (1995-2010). After filtering of abstracts from the initial search, 44 papers had research evidence on this topic.Cognitive abilities and school performance were shown to be impaired in sub-groups of patients (with either cerebral malaria or uncomplicated malaria) when compared with healthy controls. Studies comparing cognitive functions before and after treatment for acute malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery. Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups. The implications of these findings are discussed.Mortality and morbidity due to malaria is still substantial in many tropical countries. In 2006, 247 million cases of malaria were estimated, resulting in 881,000 deaths [1]. Of the 109 endemic countries, 30 countries in sub-Saharan Africa and five in Asia accounted for 98% of malaria deaths globally [2]. The financial cost to tackle malaria is staggering. The global estimate of direct losses due to malaria (i.e., the personal and public expenditures to prevent and treat the disease) is USD 12 billion annually. Approximately 35.4 million disability adjusted life years (DALYs) are lost in sub-Saharan Africa alone due to the mortality and morbidity of malaria [2]. The estimates of expenditure to tackle malaria globally in 2009 and 2010 are USD 5.335 billion and 6.180 billion, respectively, and include direct costs for diagnosis, treatment and prevention [2].There exists an important hidden burden of malaria, namely, that of cognitive impairment and effects on school performance resulting from malaria infectio
Toxoplasma, Toxocara and Tuberculosis co-infection in a four year old child
Randeewari Guneratne, Devan Mendis, Tharaka Bandara, Sumadhya Fernando
BMC Pediatrics , 2011, DOI: 10.1186/1471-2431-11-44
Abstract: This case report describes a co-infection of Toxoplasma gondii, Toxocara spp and tuberculosis in a child with chronic lymphadenopathy and eosinophilia.The case report highlights two important points. First is the diagnostic challenges that are encountered by clinicians in tropical countries such as Sri Lanka, where lymphadenopathy and eosinophilia with a positive serology commonly point towards a parasitic infection. Secondly the importance of proper history taking and performing the Mantoux test as a first line investigation in a country where the incidence of tuberculosis is low, even in the absence of a positive contact history.Tuberculosis. toxocariasis and toxoplasmosis are among the common infectious causes of lymphadenitis in children [1]. Approximately 250,000 children worldwide develop tuberculosis, a larger proportion being reported from the South East Asian region [2,3]. Extra-pulmonary tuberculosis is more common in children, the most common form being lymphatic disease accounting for about two thirds of the cases of extra-pulmonary tuberculosis [4-6].Toxoplasma gondii and Toxocara spp. infections are cosmopolitan zoonotic diseases which may cause systemic and ocular diseases in humans [7-9]. Few publications exist regarding Toxoplasma and Toxocara co-infection [10,11].This case report describes a child with chronic lymphadenopathy and eosinophilia who was seropositive for both Toxoplasma gondii and Toxocara spp, together with a positive Mantoux test and lymph node histology suggesting tuberculosis.A 4 year-old, previously healthy boy was admitted to the surgical unit of the Colombo South Teaching Hospital, Sri Lanka with an abscess in the left big toe. No fever or local lymphadenopathy was present at initial presentation. The abscess was drained, treated with antibiotics and the child was discharged. Two weeks later the child was re-admitted with an infection at the site of original abscess and left sided inguinal lymphadenopathy. Full blood count (FBC)
Genetic polymorphisms associated with anti-malarial antibody levels in a low and unstable malaria transmission area in southern Sri Lanka
Dewasurendra Rajika L,Suriyaphol Prapat,Fernando Sumadhya D,Carter Richard
Malaria Journal , 2012, DOI: 10.1186/1475-2875-11-281
Abstract: Background The incidence of malaria in Sri Lanka has significantly declined in recent years. Similar trends were seen in Kataragama, a known malaria endemic location within the southern province of the country, over the past five years. This is a descriptive study of anti-malarial antibody levels and selected host genetic mutations in residents of Kataragama, under low malaria transmission conditions. Methods Sera were collected from 1,011 individuals residing in Kataragama and anti-malarial antibodies and total IgE levels were measured by a standardized ELISA technique. Host DNA was extracted and used for genotyping of selected SNPs in known genes associated with malaria. The antibody levels were analysed in relation to the past history of malaria (during past 10 years), age, sex, the location of residence within Kataragama and selected host genetic markers. Results A significant increase in antibodies against Plasmodium falciparum antigens AMA1, MSP2, NANP and Plasmodium vivax antigen MSP1 in individuals with past history of malaria were observed when compared to those who did not. A marked increase of anti-MSP1(Pf) and anti-AMA1(Pv) was also evident in individuals between 45–59 years (when compared to other age groups). Allele frequencies for two SNPs in genes that code for IL-13 and TRIM-5 were found to be significantly different between those who have experienced one or more malaria attacks within past 10 years and those who did not. When antibody levels were classified into a low-high binary trait, significant associations were found with four SNPs for anti-AMA1(Pf); two SNPs for anti-MSP1(Pf); eight SNPs for anti-NANP(Pf); three SNPs for anti-AMA1(Pv); seven SNPs for anti-MSP1(Pv); and nine SNPs for total IgE. Eleven of these SNPs with significant associations with anti-malarial antibody levels were found to be non–synonymous. Conclusions Evidence is suggestive of an age–acquired immunity in this study population in spite of low malaria transmission levels. Several SNPs were in linkage disequilibrium and had a significant association with elevated antibody levels, suggesting that these host genetic mutations might have an individual or collective effect on inducing or/and maintaining high anti–malarial antibody levels.
Primaquine in vivax malaria: an update and review on management issues
Deepika Fernando, Chaturaka Rodrigo, Senaka Rajapakse
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-351
Abstract: Primaquine, an 8-aminoquinoline, has been approved for treatment of malaria since 1952 by the Food and Drug Administration (FDA), United States [1]. Six decades after its official licensing, primaquine still holds a unique and unchallenged place in anti-malarial regimens of cure and prophylaxis [2]. It is the only drug proven to be effective, and licensed to eliminate, the hypnozoites of Plasmodium vivax and Plasmodium ovale. Though primaquine is effective, unique and irreplaceable, it is also associated with serious hazards and side effects, such as its ability to precipitate haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals [3]. This prohibits its use in key groups, such as pregnant women [4]. The current uses of primaquine in vivax malaria are threefold: for radical cure of patients with confirmed parasitaemia; for causal prophylaxis; and for terminal prophylaxis [1]. In addition, it is used as a gametocytocidal agent in falciparum malaria.This update and review deals with the current role of primaquine in treatment of vivax malaria. It will explore this topic on several fronts namely: a) evidence of efficacy of primaquine for its current indications; b) potential hazards of its widespread use c) critical analysis of reported resistance against primaquine containing regimens d) evidence for combining primaquine with artemisinins in areas of chloroquine resistance and e) the potential for replacement of primaquine with newer drugs.A MEDLINE search was performed for all articles with the key word 'primaquine' and 'Vivax' in any field. The search was restricted to articles published in all languages within the last two decades (1991-2011). There were 480 abstracts in the original search with these restrictions. The software Endnote X3 (Thomson Reuters, Carlsbad, CA 92011, USA) was used to filter articles. Bibliographies of cited literature were also searched. All abstracts were read independently by the three authors, and key articles were
Review on dermatomycosis: pathogenesis and treatment  [PDF]
Deepika T. Lakshmipathy, Krishnan Kannabiran
Natural Science (NS) , 2010, DOI: 10.4236/ns.2010.27090
Abstract: Dermatophytes, a group of keratinophilic fungi thriving on the keratin substrate are the etio-logical agents responsible for causing cutaneous infections. Dermatophytosis is currently treated with the commercially available topical and oral antifungal agents in spite of the existing side effects. Treatment of these cutaneous infections with secondary metabolites produced by marine microorganisms is considered as a novel approach. For many years these organisms have been explored with the view of developing antibacterial, antifungal, antiviral, anti- cancer and antiparasitic drugs. Exploring the unexplored aspect of actinobacteria for developing antidermatophytic drugs is a novel attempt which needs further investigation.
High Accuracy Arithmetic Average Discretization for Non-Linear Two Point Boundary Value Problems with a Source Function in Integral Form  [PDF]
Ranjan K. Mohanty, Deepika Dhall
Applied Mathematics (AM) , 2011, DOI: 10.4236/am.2011.210173
Abstract: In this article, we report the derivation of high accuracy finite difference method based on arithmetic average discretization for the solution of Un=F(x,u,u´)+∫K(x,s)ds , 0 <x < 1, 0 < s < 1 subject to natural boundary conditions on a non-uniform mesh. The proposed variable mesh approximation is directly applicable to the integro-differential equation with singular coefficients. We need not require any special discretization to obtain the solution near the singular point. The convergence analysis of a difference scheme for the diffusion convection equation is briefly discussed. The presented variable mesh strategy is applicable when the internal grid points of the solution space are both even and odd in number as compared to the method discussed by authors in their previous work in which the internal grid points are strictly odd in number. The advantage of using this new variable mesh strategy is highlighted computationally.
Evolution of Slum Redevelopment Policy  [PDF]
Deepika Andavarapu, David J. Edelman
Current Urban Studies (CUS) , 2013, DOI: 10.4236/cus.2013.14021
Abstract: Slums have been part of the urban landscape since the Victorian Era, and, over the years, policies such as public housing, slum upgrading, tenure security, city wide slum removal and other measures were adopted to improve the quality of life of the slum dwellers. In this paper, the evolution of those policies is explored and evaluated, and key policy strategies that need to be adopted at the donor and recipient levels in order to achieve measurable change in slum improvement across the world are suggested.
Bee-Inspired Routing Protocols for Mobile Ad HOC Network (MANET)
Deepika Chaudhary
Journal of Emerging Technologies in Web Intelligence , 2010, DOI: 10.4304/jetwi.2.2.86-88
Abstract: Mobile AdHoc networks( MANETs) are receiving a significant amount of attention from researchers. This paper provides a high light on a new and very energy efficient algorithm for routing in Manets BeeAdHoc. This algorithm is a reactive source routing algorithm and consumes less energy as compared to other existing state of art routing algorithms because a fewer control packets for routing are sent as compared to other networks.
Reply To Letter Of Reader
Pandhi Deepika
Indian Journal of Dermatology , 2002,
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