The influence of the mass administration of diethylcarbamazine,alone or with albendazole,on the prevalence of filarial antigenaemia

The current Indian campaign for the elimination of lymphatic filariasis is largely based on mass drug administration (MDA). As part of this campaign, villagers in the Tirukoilur and Mugaiyur 'blocks' (i.e. revenue units) of Villupuram district, in Tamil Nadu, India, were treated with diethylcarbamazine (DEC), either alone (Mugaiyur) or with albendazole (Tirukoilur), in March 2001. The efficacy of treatment, in each of the two treatment arms, was evaluated by determining the percentages of the subjects who were carrying antigen from adult Wuchereria bancrofti before, 6 months and 12 months after the MDA. In a cross-sectional survey at each time-point, commercial, immunochromatographic tests were used to check 1000-1200, randomly selected, young residents (aged 2-25 years) of 18 index villages for the antigen; at least 300 villagers aged 2-9 years and at least 170 aged 10-25 years from each treatment arm were screened in each survey. Before the MDA, 12.7% of the subjects aged 2-9 years and 23.6% of those aged 10-25 years were found to be positive for the filarial antigen. Although only about 50% of villagers aged 2-9 years were successfully treated, MDA (with DEC alone or DEC plus albendazole) led to a significant (28.7%) reduction in the prevalence of antigenaemia in this age-group 6 months later (P<0.05). Although, the prevalences of antigenaemia among those aged 2-9 years were higher 12 months post-treatment than 6 months post-treatment, they were still lower (by 16%-23%) than those observed pre-treatment. The addition of albendazole to the DEC treatment appeared to offer no additional benefit in terms of the prevalence of antigenaemia in children aged <10 years; in fact, the use of DEC alone produced a slightly greater reduction in the prevalence of antigenaemia than the use of both DEC and albendazole. In the block given MDA based on both DEC and albendazole, the prevalences of antigenaemia among the villagers aged 10-25 years were 19.4% and 16.6% lower 6 and 12 months post-treatment, respectively, than observed pre-treatment. Curiously, in the block given DEC alone, the prevalences in this age-group were higher at both post-treatment follow-ups (by 17.4% at 6 months and 35.1% at 12 months) than observed pre-treatment. In concurrent experimental studies, high drug compliance (90%) among young children (aged 2-5 years) led to a pronounced (62.6%) reduction in the prevalence of antigenaemia after one MDA. In follow-up studies of those found antigen-positive, 40% of those aged 2-9 years but only 23% of those aged 10-25 years cleared their antigenaemias after three (annual) MDA. To maximize the benefits of MDA, greater efforts should be made to increase treatment coverage among young children.     

Recyclable Pd/CuFe2O4 nanowires: a highly active catalyst for C–C couplings and synthesis of benzofuran derivatives

Pd/CuFe₂O₄ nanowire-catalyzed cross coupling transformations are described. Notably, these reactions showed excellent functional group tolerance. Further, the protocol is applied to a one-pot synthesis of benzofurans via a Sonogashira coupling and intramolecular etherification sequence. The catalyst was reused and found to maintain its activity and stability.

Efficient heterogeneous Pd/CuFe₂O₄ nanowires which catalyze cross coupling transformations are described. The protocol is applied to a one-pot synthesis of benzofurans via Sonogashira coupling and an intramolecular etherification sequence.     

Angiographic identification of malpositioned balloon catheters during mitral valvuloplasty

The positioning of balloon catheters for the percutaneous mitral valvuloplasty technique is critical to ensure an adequate result and minimize complications. Passage of two balloon catheters in parallel through a thickened atrial septum and maintenance of satisfactory positioning in the left ventricle can be difficult. We describe unsuspected mal-positioning of the balloons in two patients documented angiographically in our laboratory. Recognizing and avoiding these positions will reduce the potential for serious complications.