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P. falciparumparasites manipulate host metabolic processes during malaria to ensure their survival and progression, causing the host and parasite metabolic pathways to become intertwined. We analyzed metabolites to evaluate their potential as biomarkers for cerebral malaria (CM). Our analysis of CM (with coma) and CM-like (without coma) patients identified 835 metabolites, including lipids, amino acids, xenobiotics, peptides, nucleotides, carbohydrates, cofactors, and vitamins. Principal component analysis revealed clear segregation between CM-like and CM patients. Metabolite-by-metabolite analysis identified 103 differentially abundant metabolites, 26 of which were significantly lower in CM-like patients (primarily lipids), while 71% of those higher in CM patients were amino acids and xenobiotics. The results revealed significant differences in circulating levels of long chain free fatty acids and catecholamine metabolism and identified steroid biosynthesis as the most enriched lipid metabolism pathway, with eight endogenous steroids showing significantly higher levels in CM patients compared to CM-like patients (FC > 2, B-H FDR-adjusted P < 0.05). These steroids include pregnenolone sulfate, pregnenediol sulfate, pregnenetriol sulfate, androsterone monosulfate, 16α-OH-DHEA-S, DHEA-S, cortisol, and cortisone. High levels of pregnenolone and its downstream metabolic derivatives were significantly associated with coma in CM patients. Our findings suggest that monitoring circulating neurosteroid levels in patients could aid in the early identification of those at risk of coma, and may important implications for the clinical management of CM patients.

Durgama Anchalare Malaria Nirakaran (DAMaN) is a multi-component malaria intervention for hard-to-reach villages in Odisha, India. The main component, Malaria Camps (MCs), consists of mass screening, treatment, education, and intensified vector control. We evaluated MC effectiveness using a quasi-experimental cluster-assigned stepped-wedge study with a pretest-posttest control group in 15 villages: six immediate (Arm A), six delayed (Arm B), and three previous interventions (Arm C). The primary outcome was PCR+Plasmodiuminfection prevalence. Across all arms, the odds of PCR+ malaria were 54% lower at the third follow-up compared to baseline. A time (i.e., visit) x study arm interaction revealed significantly lower odds of PCR+ malaria in Arm A versus B at the third follow-up. The cost per person ranged between US$3-8, the cost per tested US$4-7, and the cost per treated US$82-1,614, per camp round. These results suggest that the DAMaN intervention is a promising, financially feasible approach for malaria control.

Brain swelling occurs in cerebral malaria (CM) and may either reverse or result in fatal outcome. It is currently unknown how brain swelling in CM reverses, as brain swelling at the acute stage is difficult to study in humans and animal models with reliable induction of reversible edema are not known. In this study, we show that reversible brain swelling in experimental murine CM can be induced reliably after single vaccination with radiation-attenuated sporozoites as proven by in vivo high-field magnetic resonance imaging. Our results provide evidence that brain swelling results from transcellular blood–brain barrier disruption (BBBD), as revealed by electron microscopy. This mechanism enables reversal of brain swelling but does not prevent persistent focal brain damage, evidenced by microhemorrhages, in areas of most severe BBBD. In adult CM patients magnetic resonance imaging demonstrate microhemorrhages in more than one third of patients with reversible edema, emphasizing similarities of the experimental model and human disease. Our data suggest that targeting transcellular BBBD may represent a promising adjunct therapeutic approach to reduce edema and may improve neurological outcome.

The Center for the Study of Complex Malaria in India (CSCMi) is one of 10 International Centers of Excellence in Malaria Research funded by the National Institutes of Health since 2010. The Center combines innovative research with capacity building and technology transfer to undertake studies with clinical and translational impact that will move malaria control in India toward the ultimate goal of malaria elimination/eradication. A key element of each research site in the four states of India (Tamil Nadu, Gujarat, Odisha, and Meghalaya) has been undertaking community- and clinic-based epidemiology projects to characterize the burden of malaria in the region. Demographic and clinical data and samples collected during these studies have been used in downstream projects on, for example, the widespread use of mosquito repellants, the population genomics of Plasmodium vivax, and the serological responses to P. vivax and Plasmodium falciparum antigens that reflect past or present exposure. A focus has been studying the pathogenesis of severe malaria caused by P. falciparum through magnetic resonance imaging of cerebral malaria patients. Here we provide a snapshot of some of the basic and applied research the CSCMi has undertaken over the past 12 years and indicate the further research and/or clinical and translational impact these studies have had.

The Center for the Study of Complex Malaria in India (CSCMi) was launched in 2010 with the overall goal of addressing major gaps in our understanding of “complex malaria” in India through projects on the epidemiology, transmission, and pathogenesis of the disease. The Center was mandated to adopt an integrated approach to malaria research, including building capacity, developing infrastructure, and nurturing future malaria leaders while conducting relevant and impactful studies to assist India as it moves from control to elimination. Here, we will outline some of the interactions and impacts the Center has had with malaria policy and control counterparts in India, as well as describe emerging needs and new research questions that have become apparent over the past 12 years.

Brain swelling occurs in cerebral malaria (CM) and may either reverse or result in fatal outcome. It is currently unknown how brain swelling in CM reverses, as investigations have been hampered by inadequate animal models. In this study, we show that reversible brain swelling in experimental murine cerebral malaria (ECM) can be induced reliably after single vaccination with radiation-attenuated sporozoites as revealed by in vivo high-field (9.4T) magnetic resonance imaging. Our results provide evidence that parenchymal fluid increase and consecutive brain swelling results from transcellular blood-brain barrier disruption (BBBD), as revealed by electron microscopy. This mechanism enables reversal of brain swelling but does not prevent persistent focal brain damage, evidenced by microhemorrhages, in areas of most severe BBBD. In a cohort of 27 pediatric and adult CM patients (n=4 fatal, n=23 non-fatal) two out of four fatal CM patients (50%) and 8 out of 23 non-fatal CM patients (35%) showed microhemorrhages on MRI at clinical field strength of 1.5T, emphasizing the translational potential of the experimental model. Our data suggest that targeting transcellular BBBD may represent a promising adjunct therapeutic approach in cerebral brain swelling to reduce edema and may ultimately lead to a reduced permanent brain damage and a better longtime neurological outcome.Author summaryBrain swelling, which occurs in diseases such as cerebral malaria, is not necessarily fatal, and may reverse. Even upon reversal of brain swelling, neurological sequelae can still occur. The factors contributing to the reversibility of brain edema are not known, and treatment options remain therefore limited. Identifying the mechanisms leading to such reversibility could inform clinical management aimed at decreasing brain swelling and consecutive brain injury. Here we introduce a reproducible and simple animal model that allows comprehensive in vivo studies of reversible brain swelling in cerebral malaria at the peak of disease and upon recovery. We identify a specific type of blood-brain barrier disruption (BBBD) as a mechanism that occurs in brain swelling. We show that BBBD can reverse, but also highlight remaining brain damage in areas of most severe BBBD. As the ECM model introduced here bares crucial similarities to the CM in humans, our findings open strategies to study new therapeutic avenues and point to compounds that specifically target transcellular BBBD to reduce brain edema, and increase survival rates.

An efficient and facile synthesis of novel fluorinated imidazolium-tagged ionic liquids under microwave irradiation is described. Novel prepared ionic liquids was identified and confirmed by spectroscopic and elemental analysis. Synthesized ionic liquids (1-12) was explored for their antiproliferative inhibition potency against three selected human cancer cell lines (MCF-7, HepG-2 and CACO2). Screening results have revealed that some tested ionic liquids exhibited promising activity compared with standard drugs, especially compounds 5 and 6 which consistently produced low IC50 values. Preliminary structure activity relationship (SAR) studies have been performed to identify the relation between molecular structure and activity. in silico Analysis of ionic liquids was carried out based on ADME, Lipinski rule, drug likeness, toxicity profiles and other physico-chemical properties. All compounds were safe in toxicity profile and computed LD50 values were in accepted range (2.55-2.89 mol/kg). in silico Results have shown that Lipinski rule of five was in accept range, except compound 1 and 2.

A series of sixteen new ionic liquids (ILs) bearing imidazolium moiety were designed and synthesized under sustainable and green conditions which were confirmed by analytical and spectral techniques using 1H- & 13C-NMR, FT-IR, mass and elemental analysis. A panel of clinically isolated strains was used for in vitro inhibitory antimicrobial activities screening of synthesized ionic liquids. The results of antimicrobial assay showed that some of synthesized ionic liquids showed moderate to good activity. Among these ILs, ionic liquids 3, 4 and 5 (bearing alkyl chain with a phenyl group) significantly inhibited cell growth of strains. In this regard, these ionic liquids considered as promising antibacterial agents when compared with standard antibiotics. By encouraging in vitro antimicrobial screening, in silico ADMET evaluation has been performed and found excellent pharmacokinetic, bioavailability and toxicity profiles. Synthesized ionic liquids has found to be safe and non-toxic according to calculated in vivo computed LD50 values (2.49-2.80 mg/kg) for rat acute toxicity.

Background Cerebral malaria in adults is associated with brain hypoxic changes on magnetic resonance (MR) images and has a high fatality rate. Findings of neuroimaging studies suggest that brain involvement also occurs in patients with uncomplicated malaria (UM) or severe noncerebral malaria (SNCM) without coma, but such features were never rigorously characterized. Methods Twenty patients with UM and 21 with SNCM underwent MR imaging on admission and 44–72 hours later, as well as plasma analysis. Apparent diffusion coefficient (ADC) maps were generated, with values from 5 healthy individuals serving as controls. Results Patients with SNCM had a wide spectrum of cerebral ADC values, including both decreased and increased values compared with controls. Patients with low ADC values, indicating cytotoxic edema, showed hypoxic patterns similar to cerebral malaria despite the absence of deep coma. Conversely, high ADC values, indicative of mild vasogenic edema, were observed in both patients with SNCM and patients with UM. Brain involvement was confirmed by elevated circulating levels of S100B. Creatinine was negatively correlated with ADC in SNCM, suggesting an association between acute kidney injury and cytotoxic brain changes. Conclusions Brain involvement is common in adults with SNCM and a subgroup of hospitalized patients with UM, which warrants closer neurological follow-up. Increased creatinine in SNCM may render the brain more susceptible to cytotoxic edema.

The Indian state of Odisha has a longstanding battle with forest malaria. Many remote and rural villages have poor access to health care, a problem that is exacerbated during the rainy season when malaria transmission is at its peak. Approximately 62% of the rural population consists of tribal groups who are among the communities most negatively impacted by malaria. To address the persistently high rates of malaria in these remote regions, the Odisha State Malaria Control Program introduced ‘malaria camps’ in 2017 where teams of health workers visit villages to educate the population, enhance vector control methods, and perform village-wide screening and treatment. Malaria rates declined statewide, particularly in forested areas, following the introduction of the malaria camps, but the impact of the intervention is yet to be externally evaluated. This study protocol describes a cluster-assigned quasi-experimental stepped-wedge study with a pretest-posttest control group design that evaluates if malaria camps reduce the prevalence of malaria, compared to control villages which receive the usual malaria control interventions (e.g. IRS, ITNs), as detected by PCR.

Plasmodium falciparum parasites causing cerebral malaria express specific PfEMP1 proteins (group A+CM) on infected erythrocytes. Group A+CM PfEMP1s allow entry into brain microvascular endothelial cells; this causes cell swelling and drives cerebral malaria pathology by disrupting the blood–brain barrier., Cerebral malaria (CM) is caused by the binding of Plasmodium falciparum–infected erythrocytes (IEs) to the brain microvasculature, leading to inflammation, vessel occlusion, and cerebral swelling. We have previously linked dual intercellular adhesion molecule-1 (ICAM-1)– and endothelial protein C receptor (EPCR)–binding P. falciparum parasites to these symptoms, but the mechanism driving the pathogenesis has not been identified. Here, we used a 3D spheroid model of the blood–brain barrier (BBB) to determine unexpected new features of IEs expressing the dual-receptor binding PfEMP1 parasite proteins. Analysis of multiple parasite lines shows that IEs are taken up by brain endothelial cells in an ICAM-1–dependent manner, resulting in breakdown of the BBB and swelling of the endothelial cells. Via ex vivo analysis of postmortem tissue samples from CM patients, we confirmed the presence of parasites within brain endothelial cells. Importantly, this discovery points to parasite ingress into the brain endothelium as a contributing factor to the pathology of human CM., Graphical Abstract

Background Cerebral malaria is a common presentation of severe Plasmodium falciparum infection and remains an important cause of death in the tropics. Key aspects of its pathogenesis are still incompletely understood, but severe brain swelling identified by magnetic resonance imaging (MRI) was associated with a fatal outcome in African children. In contrast, neuroimaging investigations failed to identify cerebral features associated with fatality in Asian adults. Methods Quantitative MRI with brain volume assessment and apparent diffusion coefficient (ADC) histogram analyses were performed for the first time in 65 patients with cerebral malaria to compare disease signatures between children and adults from the same cohort, as well as between fatal and nonfatal cases. Results We found an age-dependent decrease in brain swelling during acute cerebral malaria, and brain volumes did not differ between fatal and nonfatal cases across both age groups. In nonfatal disease, reversible, hypoxia-induced cytotoxic edema occurred predominantly in the white matter in children, and in the basal ganglia in adults. In fatal cases, quantitative ADC histogram analyses also demonstrated different end-stage patterns between adults and children: Severe hypoxia, evidenced by global ADC decrease and elevated plasma levels of lipocalin-2 and microRNA-150, was associated with a fatal outcome in adults. In fatal pediatric disease, our results corroborate an increase in brain volume, leading to augmented cerebral pressure, brainstem herniation, and death. Conclusions Our findings suggest distinct pathogenic patterns in pediatric and adult cerebral malaria with a stronger cytotoxic component in adults, supporting the development of age-specific adjunct therapies.

Sustainable synthesis of Ni–Al double-layered catalysts by the coprecipitation method is described. Synthesized double-layered catalysts have been characterized by X-ray diffraction, scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared, and thermogravimetric analyses, which confirmed a hydrotalcite-like structure. In addition, the impact of aging time and temperature on the activity of catalyst has been investigated. Furthermore, it has been confirmed by SEM and TEM analyses that the recovered catalyst has retained its structure. It has also been observed that the prepared material has potency to catalyze the reaction without loss in the yield. To explore the reactivity of the material, the catalyst has been examined in the synthesis of N-(2-hydroxyphenyl)benzamide under solvent-free conditions. The overall process afforded the product with high purity and high yields within short time.

A facile and efficient protocol has been developed for mild construction of fused pyrimidines via l-proline-catalyzed reaction of 4-hydroxy coumarins, aldehydes, and 2-aminobenzothiazoles/urea. The reaction has been carried out rapidly and efficiently in water under mild and metal-free conditions. Current etiquette has efficiently synthesized the heterocycles and avoids the use of hazardous solvents over conventional organic solvents. A plausible reaction mechanism has been established in this study. This study represents the first case in which l-proline as a homogeneous catalyst has been explored in the synthesis of fused pyrimidines in water in view of simple procedure and acceptable efficiency. This method gives the target product in excellent yield with ease of workup.

The discovery of a novel series of task-specific fluorinated pyridinium ionic liquids (TsILs) tagged with Schiff bases is reported using ultrasound-assisted and conventional syntheses. The synthesis required the quaternization of the appropriate pyridine Schiff base, followed by the metathesis of the resulting task-specific halogenated pyridinium ILs. The structures of the ILs were established by analytical and spectral data (IR, 1H NMR, 13C NMR, 19F NMR and mass spectrometry). In vitro antimicrobial activities of the synthesized ILs on both gram-positive (Bacillus cereus, Enterococcus faecalis, and Staphylococcus aureus) and gram-negative (Proteus mirabilis, Escherichia coli, and Pseudomonas aeruginosa) bacterial strains and two fungal strains (Candida albicans and Aspergillus brasiliensis) were evaluated. Ionic liquids 8, 18, 19 and 20 appear to be the most active antimicrobials among the synthesized series. Preliminary studies were carried out to understand the relationship between the molecular structures and the inhibition activities of the synthesized ILs. In addition, the results of in silico studies revealed that all compounds exhibited good pharmacokinetic, bioavailability and toxicity profiles. Furthermore, drug likeness analysis suggests that the synthesized ILs might have appropriate oral absorption and brain penetration for application. In vivo computed LD50 values (2.59–2.78 mol/kg) were calculated for rat acute toxicity, and the compounds were found to be non-toxic and in a safe range for further study.

Fused pyrimidines composed of alternating heteroatoms and a pyrimidine moiety were synthesized efficiently using readily available starting material 4-hydroxycoumarin, aromatic aldehydes, and urea/thiourea at room temperature. Acid, metal salts, and surfactants were screened for their influence on catalytic activity in three-component reactions and sodium lauryl sulphate (SLS) was used as the best catalyst with different concentrations. Screening results of catalyst loading from our investigation showed that good to excellent yields were obtained with 10 mol%. Our method efficiently synthesized heterocycles and avoided the use of hazardous solvents and conventional organic solvents. Our procedure which involves a surfactant is operationally simple, environmentally benign, has excellent yields, short reaction times, and synthetically is as efficient as conventional procedures using organic solvents.

Synthesis of Cu-Al hydrotalcite by co precipitation method is being described. Synthesized nano catalyst has been characterized by powder X-ray diffraction, scanning electron microscopy, FT-IR and thermogravimetric analyses which confirm hydrotalcite-like structure. Effect of molar concentration, catalyst loading, reaction time and catalytic activity have been investigated in the synthesis of benzoxazoles under solvent free conditions using 2-amino phenol and benzoyl chloride. The influence of the hydrotalcite and their different amounts on reactivity was studied. Catalyst can be recycle and used for further reaction without losing its activity.

Malaria is a highly inflammatory disease caused by Plasmodium infection of host erythrocytes. However, the parasite does not induce inflammatory cytokine responses in macrophages in vitro and the source of inflammation in patients remains unclear. Here, we identify oxidative stress, which is common in malaria, as an effective trigger of the inflammatory activation of macrophages. We observed that extracellular reactive oxygen species (ROS) produced by xanthine oxidase (XO), an enzyme upregulated during malaria, induce a strong inflammatory cytokine response in primary human monocyte‐derived macrophages. In malaria patients, elevated plasma XO activity correlates with high levels of inflammatory cytokines and with the development of cerebral malaria. We found that incubation of macrophages with plasma from these patients can induce a XO‐dependent inflammatory cytokine response, identifying a host factor as a trigger for inflammation in malaria. XO‐produced ROS also increase the synthesis of pro‐IL‐1β, while the parasite activates caspase‐1, providing the two necessary signals for the activation of the NLRP3 inflammasome. We propose that XO‐produced ROS are a key factor for the trigger of inflammation during malaria.

A facile, efficient, and convenient synthesis of 4H-pyrimido[2,1-b]benzothiazole derivatives is described using aromatic aldehydes, ethyl acetoacetate, and 2-amino benzothiazole in the presence of l-proline under solvent-free conditions. Present methodology has advantages such as short reaction time, no side products, and easy to work up. Synthesized library compounds have been evaluated for their antitumor and antimicrobial activity. Further, we have compared the experimental work with theoretical parameters using molecular property analysis to develop new ideas about the preparation of pyrimido benzothiazole derivatives for their possible application against cancer and chronic microbial diseases. It has been concluded that Petra/osiris/molinspiration (POM) analyses might prove to be a suitable method to correlate the structural features of 4H-pyrimido[2,1-b]benzothiazole derivatives with their promising combined antimicrobial/antitumor activity and may contribute to the development of novel antimicrobial and antitumor agents against drug resistance.

One-pot condensation of 4-hydroxy coumarins, aldehydes and urea/thiourea to build C–C and C–N bonds is described. Fused pyrimidines have been synthesized under mild reaction conditions using L-proline. The protocol has been performed rapidly and efficiently in water under metal free conditions. Heterocyclic derivatives have been synthesized using the present methodology and avoid the use of hazardous solvents over conventional organic solvents. A proposed mechanism could be established for three component reactions. The present study reveals the first case in which L-proline has been explored as a homogeneous catalyst in the synthesis of fused pyrimidines in water under microwave irradiation. This synthesis involves simple workup and acceptable efficiency. The most notable feature of this protocol is the ability of the catalyst to influence asymmetric induction in the reaction.

Fused pyrimidines composed of alternating heteroatoms and a pyrimidine moiety were synthesized efficiently using readily available starting material 4-hydroxycoumarin, aromatic aldehydes, and urea/thiourea at room temperature. Acid, metal salts, and surfactants were screened for their influence on catalytic activity in three-component reactions and sodium lauryl sulphate (SLS) was used as the best catalyst with different concentrations. Screening results of catalyst loading from our investigation showed that good to excellent yields were obtained with 10 mol%. Our method efficiently synthesized heterocycles and avoided the use of hazardous solvents and conventional organic solvents. Our procedure which involves a surfactant is operationally simple, environmentally benign, has excellent yields, short reaction times, and synthetically is as efficient as conventional procedures using organic solvents.

Series of curcumin derivatives/analogues were designed and efficient method for synthesis thereof is described. All the synthesized compounds have been screened for their cytotoxicity and evaluated their antioxidant activity. Cytotoxicity effect has been evaluated against three cell lines Hep-G2, HCT-116 and QG-56 by MTT assay method. Structure activity relationship has revealed that particularly, compound 3c, (IC50 value 6.25 μM) has shown better cytotoxicity effect against three cell lines. According to results of SAR study, it was found that 4H-pyrimido[2,1-b]benzothiazole derivatives (2e and 2f), pyrazoles (3a, 3b, 3c and 3d) benzylidenes (4d) exhibited better antioxidant activity than curcumin. A correlation of structure and activities relationship of these compounds with respect to drug score profiles and other physico-chemical properties of drugs are described and verified experimentally.

An overview of the experimental result on simultaneous measurement of pre-scission neutron, proton, α-particle and GDR γ-ray multiplicities for the reaction 28Si +175Lu at 159 MeV using the BARC–TIFR Pelletron–LINAC accelerator facility is given. The data were analysed using deformation-dependent particle transmission coefficients, binding energies and level densities which are incorporated in the code JOANNE2 to extract fission time-scales and mean deformation of the saddle-to-scission emitter. The neutron, light charged particle and GDR γ-ray multiplicity data could be explained consistently. The emission of neutrons seems to be favoured towards larger deformation as compared to charged particles. The pre-saddle time-scale is deduced as (0–2) × 10−21 s whereas the saddle-to-scission time-scale is (36–39) × 10 −21 s. The total fission time-scale is deduced as (36–41) × 10 −21 s.

Hemoglobinopathies and thalassemias are the most commonly encountered monogenic disorders of blood in humans, posing a major genetic and public health problem round the globe. Hb S (HBB: c.20A>T)-β-thalassemia (β-thal) is a compound aberrant heterozygosity with inconsistent phenotypic expression, which are poorly described and clinically mapped. Comprehensive genetic characterization of such a population is highly warranted for complete understanding of the clinical heterogeneity, disease prognosis and therapeutic management. In this study, Hb S-β-thal (n = 60) patients, strictly defined by varying degrees of clinical presentations, were selected to evaluate their genotype-phenotype agreement. Furthermore, β-globin (n = 120) and α-globin gene clusters (n = 60) were genetically characterized and statistically correlated with clinical terminologies to explain the clinical heterogeneity. Our results revealed the association of the Arab-Indian haplotypes with nine different frameworks of β-thal together with the modulating role of α-thalassemia (α-thal). The study subjects, including carriers of β-thal haplotype III [- - - - - - -] (8.0%), presented with varying severe patterns of clinical symptoms such as painful crisis, multiple infections and splenomegaly, as an outcome of significantly less Hb F and higher Hb S levels (p

Novel KOH-loaded MgO and hydrotalcite as basic catalysts have been synthesized and were characterized by XRD, SEM and their basicity. The effect of the KOH wt%, reaction time, basicity and catalyst loading have been investigated in three-component reactions of aldehydes, 2-amino benzothiazole and 2-naphthol. The present studies showed the impact of KOH loading and reaction time. The best conversion and yield at 70 °C obtained were 93% and 88%, respectively. Hydrotalcite could be reused four times without a loss of the catalytic efficiency. Present catalytic system requires a short reaction time, is non toxic, easy to workup, has a good catalytic activity and gives a high efficiency.

The pathophysiology and molecular mechanisms underlying cerebral malaria (CM) are still poorly understood. Recent neuroimaging studies demonstrated that brain swelling is a common feature in CM and a major contributor to death in pediatric patients. Consequently, determining the precise mechanisms responsible for this swelling could open new adjunct therapeutic avenues in CM patients. Using an MRI scanner with a higher resolution than the ones used in previous reports, we identified two distinct origins of brain swelling in both adult and pediatric patients from India, occurring in distinct parts of the brain. Our results support the hypothesis that both endothelial dysfunction and microvascular obstruction by Plasmodium falciparum-infected erythrocytes make independent contributions to the pathogenesis of CM, providing opportunities for novel therapeutic interventions., The mechanisms underlying the rapidly reversible brain swelling described in patients with cerebral malaria (CM) are unknown. Using a 1.5-Tesla (T) magnetic resonance imaging (MRI) scanner, we undertook an observational study in Rourkela, India, of 11 Indian patients hospitalized with CM and increased brain volume. Among the 11 cases, there were 5 adults and 6 children. All patients had reduced consciousness and various degrees of cortical swelling at baseline. The latter was predominately posterior in distribution. The findings on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps were consistent with vasogenic edema in all cases. Reversibility after 48 to 72 h was observed in >90% of cases. DWI/ADC mismatch suggested the additional presence of cytotoxic edema in the basal nuclei of 5 patients; all of these had perfusion parameters consistent with vascular engorgement and not with ischemic infarcts. Our results suggest that an impairment of the blood-brain barrier is responsible for the brain swelling in CM. In 5 cases, vasogenic edema occurred in conjunction with changes in the basal nuclei consistent with venous congestion, likely to be caused by the sequestration of Plasmodium falciparum-infected erythrocytes. While both mechanisms have been individually postulated to play an important role in the development of CM, this is the first demonstration of their concurrent involvement in different parts of the brain. The clinical and radiological characteristics observed in the majority of our patients are consistent with posterior reversible encephalopathy syndrome (PRES), and we show for the first time a high frequency of PRES in the context of CM. IMPORTANCE The pathophysiology and molecular mechanisms underlying cerebral malaria (CM) are still poorly understood. Recent neuroimaging studies demonstrated that brain swelling is a common feature in CM and a major contributor to death in pediatric patients. Consequently, determining the precise mechanisms responsible for this swelling could open new adjunct therapeutic avenues in CM patients. Using an MRI scanner with a higher resolution than the ones used in previous reports, we identified two distinct origins of brain swelling in both adult and pediatric patients from India, occurring in distinct parts of the brain. Our results support the hypothesis that both endothelial dysfunction and microvascular obstruction by Plasmodium falciparum-infected erythrocytes make independent contributions to the pathogenesis of CM, providing opportunities for novel therapeutic interventions.

An efficient and simple protocol is described for synthesis of coumarin derivatives using Mg–Al-CO 3 and Ca–Al-CO 3 hydrotalcite as an environmental friendly and reusable heterogeneous catalyst under solvent free conditions. The catalysts were characterized by Hammett titration, SEM and XRD data. Present study revealed that catalytic activity and basicity depend on compositions of hydrotalcite. The calcined hydrotalcite with an Mg/Al of 3:1 derived from calcinations at 750 K was found to be suitable catalyst that gives the highest basicity and the best catalytic activity for this reaction. Catalyst allows short reaction time, high catalytic activity, easy to work up and is reusable. Step economy, atom efficiency and solvent free conditions are some important salient features of this protocol.

A series of sixteen curcumin derivatives (CURC-D) were designed and evaluated for their antibacterial/antifungal activity. POM analyses showed that lipophilicity and presence of (X–Y) pharmacophore site (X, Y = O, N) are the major factors that governed the orientation in determining antibacterial and/antifungal activity. Furthermore, it was also found that some of the POM analyzed CURC-derivatives have a closed pharmacophore sites which might be responsible of low bioactivity. To confirm the electronic, steric, and hydrophobic requirements for future modifications, we have also carried out receptor-based electrostatic analysis. Therefore, we conclude that POM analyses may prove to be a suitable method to correlate structural features of CURC-D with their promising combined antibacterial/antifungal activity and may contribute to the development of novel antimicrobial agents against drug-resistant human pathogens.

An efficient method is described for the synthesis of 2-aminobenzothiazolomethyl naphthol derivatives by one-pot three-component reaction of aldehydes, 2-naphthol, and 2-amino benzothiazole using triton X-100 as a catalyst in water with good yield. The synthesized compounds have been characterized by IR, 1H NMR, 13C NMR, and mass spectra. The synthesized compounds were screened for their antibacterial activity against gram-positive and gram-negative bacteria viz. Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella typhi, Escherichia coli, Bacillus cereus, and Providencia rettegeri and fungal activity against fungal strain such as Aspergillus niger, Aspergillus fumigatus, and Aspergillus flavus. Synthesized compounds exhibited MICs value between 3.25 and 12.5 μg/mL against bacterial strains and 6.25 and 12.5 μg/mL against fungal strains as shown in Tables 4 and 5, respectively. Derivatives 5c and 5h were equipotent activity as ciprofloxacin against E. coli and 5k against P. aeruginosa and B. cereus. Derivatives 5e, 5g, and 5k exhibited excellent antifungal activity against all tested fungal strains. Ciprofloxacin and fluconazole have been used as standard drugs for antibacterial and antifungal activity, respectively.

Background: Six‑Minute Walk Test (6MWT) is a simple, objective, reproducible test which correlated well with different spirometric indices, and thus able to predict severity of Chronic Obstructive Pulmonary Disease (COPD) and can replace spirometry in resource poor set‑up. Here, author evaluated the correlation of 6 minute walk distance (6MWD) with spirometric indices in COPD patients and the potential of 6MWT as an alternative to the assessment of severity of COPD.Methods: This cross-sectional observational study included a total of 80 COPD patients, diagnosed by GOLD criteria (Post bronchodilator FEV1/ FVC ratio

An efficient method has been developed for the preparation of 4H-pyrimido[2,1-b]benzothiazole derivatives by the condensation of aldehydes, β-ketoester, and 2-amino benzothiazole under solvent and solvent-free conditions using various catalysts. The reaction uses benzothiazole as a new component, and good yield is obtained at 60–65°C under solvent-free conditions. Atom economies, good yield, environmentally benign, and easy to work-up are some of the important features of this protocol. The present study suggests that acetic acid and metal catalysts follow different mechanism. In acetic acid, 2-amino benzothiazole reacts with benzaldehyde, and resultant intermediate reacts with ethyl acetoacetate to give final product, whereas in the presence of metal catalysts, 2-amino benzothiazole first reacts with ethyl acetoacetate, and resultant intermediate reacts with benzaldehyde to give pyrimido[2,1-b]benzothiazole.

Cerebral malaria is a clinical manifestation of the brain during Plasmodium falciparum infection, which may lead to fatal outcomes if left unattended or delayed in therapeutic management. It is often accompanied by multi-organ complications such as renal failure, respiratory distress, jaundice, severe anemia etc., further raising the degree of mortality. Over the years, the management of severe and cerebral malaria has improved radically but still the mortality rate in severe malaria is worrysome. An extremely uncommon case is demonstrated here, which is a classical illustration of malarial death due to CM and multi-organ dysfunction; complicated due to an episode of Oleander poisoning amidst. Falciparum malaria can have myriads of clinical presentations which may co-exist with other pathologies which is challenging for the clinicians, therefore, a high degree of suspicion followed by early diagnosis of malaria, may be more frequently pronounced in healthcare settings in malaria endemic areas to improve overall outcome and better management of malaria control programs.

A novel, one-pot, simple, efficient procedure for 4H-pyrimido[2,1-b]benzothiazole (4a-h), pyrazole (6a-d) and benzylidene (7a-d) derivatives of curcumin under solvent and solvent free conditions in microwave with good yield is have been synthesized. The synthesized compounds were evaluated for their antibacterial activity against gram-positive and gram-negative bacteria viz. Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella typhi, Escherichia coli, Bacillus cereus and Providencia rettgeri and antifungal activity against fungi viz Aspergillus niger, Aspergillus fumigates, Aspergillus flavus. Detailed mechanistic study shows reaction proceeds through Knoevenagel type intermediate 3a which has been suggested as key intermediate for reaction (Fig. 3).

Aluminum trichloride acts as readily available, inexpensive, and efficient catalyst for one-pot three-component condensation reaction of aldehydes, dicarbonyl, and 2-amino benzothiazole under the solvent-free conditions to afford the 4H-pyrimido[2,1-b][1,3]benzothiazole derivatives 4 with good yield. The compounds synthesized in this study were evaluated for their antibacterial activities against gram-positive and gram-negative bacteria, viz., Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella typhi, Escherichia coli, Bacillus cereus, and Providencia rettegeri. Compounds 4c, 4d, 4f, 4g, and 4h showed their good activities against tested bacterial species. Pyrimidine derivatives 4d, 4f, and 4g have shown good antifungal activities against tested fungal strains, such as Aspergillus niger, Aspergillus fumigates, Aspergillus flavus, etc.

A convenient, facile, and efficient synthesis of different nitrogen containing heterocycles is reported.

An efficient method has been developed for the preparation of 4H-pyrimido[2,1-b]benzothiazole derivatives by the condensation of aldehydes, β-ketoester, and 2-amino benzothiazole under solvent and solvent-free conditions using various catalysts. The reaction uses benzothiazole as a new component, and good yield is obtained at 60–65°C under solvent-free conditions. Atom economies, good yield, environmentally benign, and easy to work-up are some of the important features of this protocol. The present study suggests that acetic acid and metal catalysts follow different mechanism. In acetic acid, 2-amino benzothiazole reacts with benzaldehyde, and resultant intermediate reacts with ethyl acetoacetate to give final product, whereas in the presence of metal catalysts, 2-amino benzothiazole first reacts with ethyl acetoacetate, and resultant intermediate reacts with benzaldehyde to give pyrimido[2,1-b]benzothiazole.

Relative quantification ofalgCgene expression was evaluated in the multidrug resistant strainAcinetobacter baumanniiAIIMS 7 biofilm (3 to 96 h, on polystyrene surface) compared to the planktonic counterparts. Comparison revealed differentialalgCexpression pattern with maximum 81.59-fold increase in biofilm cells versus 3.24-fold in planktonic cells (P<0.05). Expression levels strongly correlated with specific biofilm stages (scale of 3 to 96 h), coinciding maximum at initial surface attachment stage (9 h) and biofilm maturation stage (48 h). Cloning, heterologous expression, and bioinformatics analyses indicatedalgCgene product as the bifunctional enzyme phosphomannomutase/phosphoglucomutase (PMM/PGM) of ∼53 kDa size, which augmented biofilms significantly inalgCclones compared to controls (lackingalgCgene), further localized by scanning electron microscopy. Moreover, molecular dynamics analysis on the three-dimensional structure of PMM/PGM (simulated up to 10 ns) revealed enzyme structure as stable and similar to that inP. aeruginosa(synthesis of alginate and lipopolysaccharide core) and involved in constitution of biofilm EPS (extracellular polymeric substances). Our observation on differential expression pattern ofalgChaving strong correlation with important biofilm stages, scanning electron-microscopic evidence of biofilm augmentation taken together with predictive enzyme functions via molecular dynamic (MD) simulation, proposes a new basis ofA. baumanniiAIIMS 7 biofilm development on inanimate surfaces.

Coexistence of thalassemia, hemoglobinopathies and malaria has interested geneticists over many decades. The present study represents such a population from the eastern Indian state of Orissa. Children and their siblings (n = 38) were genotyped for β-thalassemia mutations and genotype-phenotype correlation was determined. The major genotype was IVS 1.5 mutation: 26% homozygous (n = 10) and 37% (n = 14) double heterozygous with other mutations or hemoglobinopathies. Sickle hemoglobin was the major associated hemoglobinopathy (n = 12, 32%). Other mutations found were Cd 8/9, HbE and Cd 41/42. The study population did not contain any IVS 1.1 mutations which is the second major Indo-Asian genotype. Genotype-phenotype correlation revealed that genotypes of IVS 1.5, Cd 8/9 Cd 41/42 alone or in association, exhibit severe, moderate and mild severity of thalassemia, respectively. Identification of the mutation at an early age as a part of new born screening and early intervention may help reduce the thalassemia-related morbidity.

Biofilm formation in Acinetobacter baumannii is a common cause of nosocomial infections in humans. Clinical devices and abiotic surfaces are important sites of colonization leading to formation of biofilms. Such infections are often resistant to multiple antibiotic therapies, and hence there is need for an effective mode of control. Herein, we describe the isolation, characterization of a new lytic bacteriophage of A. baumannii and its effect on biofilm. The phage AB7-IBB2, with a genome size of about 170 kb was identified to be of family Podoviridae as revealed by transmission electron microscopy. It had an isometric head (35 nm) and a short tail (7 nm). It lysed 19/39 (49 %) clinical isolates of A. baumannii. Rapid adsorption (>99 % adsorbed in 4 min), a latency period of 25 min and a burst size 22 PFU/infected cell was observed. The phage could inhibit A. baumannii biofilm formation and disrupt preformed biofilm as well. The phage has promising potential to be considered as a candidate biocontrol agent for A. baumannii infections.

Release of extracellular DNA (eDNA) was observed duringin vitrogrowth of a clinical strain ofAcinetobacter baumannii. Membrane vesicles (MV) of varying diameter (20–200 nm) containing DNA were found to be released by transmission electron microscopy (TEM) and atomic force microscopy (AFM). An assessment of the characteristics of the eDNA with respect to size, digestion pattern by DNase I/restriction enzymes, and PCR-sequencing, indicates a high similarity with genomic DNA. Role of eDNA in static biofilm formed on polystyrene surface was evaluated by biofilm augmentation assay using eDNA available in different preparations, for example, whole cell lysate, cell-free supernatant, MV suspension, and purified eDNA. Biofilm augmentation was seen up to 224.64%, whereas biofilm inhibition was 59.41% after DNase I treatment: confirming that eDNA facilitates biofilm formation inA. baumannii. This is the first paper elucidating the characteristics and role of eDNA inA. baumanniibiofilm, which may provide new insights into its pathogenesis.

Urinothorax is classically described as the formation of urinoma as a result of retroperitoneal leakage and accumulation of urine in the pleural cavity. Since respiratory manifestations could be uncommon or rare and dominated by urological signs, which could be due to secondary or obstructive uropathy; the diagnosis of urinothorax warrants high clinical suspicion. We report such an uncommon case of urinothorax in a patient with chronic kidney disease admitted to a tertiary industrial hospital and treated successfully. Increased awareness among the physicians of such a rare clinical entity may facilitate prompt diagnosis and appropriate clinical management.

The Plasmodium falciparum chloroquine resistance transporter (Pfcrt) K76T mutation and haplotype (amino acids 72-76) were analyzed as markers of chloroquine (CQ) resistance in the blood samples of patients from two sites of different intensities of malaria transmission (high, n=70; low, n=68) in Sundergarh district of Orissa, India and correlated with the in-vivo response. Early treatment failure (ETF) was significantly more frequent in the high endemic area (32.9 vs. 7.4%, P0.001), with children below 5 years suffering more. A high frequency of pfcrt K76T mutation was observed in both the areas (87.1 vs. 79.4%, P=0.22). Patients carrying pfcrt 76T were the most likely to develop ETF (odds ratio 36; 95% CI 3.35-1653.3; P0.001). The ratio of 76T:K76 was 22:9 and 11:14, respectively, in high and low endemic areas (odds ratio 3.1; 95% CI 0.9-11.03; P=0.04), which may be used as a measure of drug pressure. Sequences of pfcrt codons 72-76 showed 16 of the CQ-resistant haplotypes to be SVMNT, 5 CVMNT and 12 CVIET. The CQ-sensitive haplotypes were mostly CVMNK in 10 samples; CVIEK in 2 samples. Both Southeast Asian and South American haplotypes were present, with the latter predominating.

A new green protocol for the efficient surfactant catalyzed synthesis of 2-aminobenzothiazolomethyl naphthols and 5-(2-aminobenzothiazolomethyl)-6-hydroxyquinolines from substituted aromatic aldehydes, 2-aminobenzothiazole and 2-naphthol or 6-hydroxyquinoline at room temperature in water was developed for the first time. The influence of the sodium lauryl sulphate (SLS) micelles and their different concentrations on reactivity of 2-aminobenzothiazolomethyl naphthol was studied. It was found that best yield was obtained with 10 mol% catalyst loading with minimum time as compared to when other surfactants and catalysts were used. The best yield of product was achieved by using 10 mol% of SLS. This procedure resulted in a general and environmentally benign protocol and has the advantages of better reusability of the catalyst system, excellent yield, short reaction time and ease of work up.

A kaolin catalyzed solvent-free synthesis for new heterocyclic compounds is described. A series of heterocyclic compounds can be readily obtained using the three-component reaction of diketones, aldehydes and 2-amino benzothiazole, urea or thiourea. The mechanism of the three component kaolin catalyzed Biginelli (using urea and thiourea) and Biginelli like (using 2-amino benzothiazole) reaction has been investigated. This is the first time that we have isolated and characterized the key intermediates using 1H NMR, 13C NMR and ESI-mass spectral characterization. Imine 3 and Knoevenagel type intermediate 4 were strongly suggested as key intermediates by mechanistic study. The reaction is simple, clean and good yield is obtained within minutes.

A simple, efficient and step-economy synthesis to afford the library of 4H-pyrimido[2,1-b][1,3]benzothiazole derivatives of curcumin (4a–4h) from readily available substrates curcumin (potential biological molecule), 2-amino benzothiazole (biological active) and substituted aromatic aldehydes using novel heterogeneous calcined Mg-Al-CO3 hydrotalcite under solvent free conditions is described. The calcined hydrotalcite with an Mg/Al ratio of 3:1 derived from calcinations at 750 K was found to be a suitable catalyst that gives the highest basicity and the best catalytic activity for this reaction. The catalysts were characterized with XRD and SEM and Hammett titration method. This protocol has several advantages such as easy to work up, high activity of catalyst and reusability.

The synthesis of the 4H-pyrimido[2,1-b][1,3]benzothiazole (1a–1h), 1,2,4-triazoloquinazolines (2a,2b), octahydroquinazolinones (3a,3b) and fused thiazolo[2,3-b]quinazolinone (4a,4b) by multicomponent reactions using aldehydes, dicarbonyl and 2-amino benzothiazole/3-amino-1,2,4-triazole/urea/thiorea has been carried out in the presence of Mg–Al–CO3 and Ca–Al–CO3 hydrotalcite as a heterogeneous catalyst. Hydrotalcites need short reaction times, are non-toxic, easy to work up and reusable under solvent free conditions, hence making this process environment friendly. A detailed mechanistic study shows that the reaction using urea proceeds through imine intermediate 6. In addition, we have isolated and characterized the key intermediate of the reaction by using hydrotalcite.