Research on lottery winners suggests there is a negative correlation between winning the lottery and happiness. Many winners felt like losers. How do you account for this effect? Given this research, if you won the lottery, what would you do to ensure a positive outcome?
Malaria is a life-threatening disease and is widespread in the tropical and subtropical regions mainly around the equator. Malaria is a protozoan disease and transmitted through infected female anopheles mosquitoes. There are five Plasmodium species which can infect human beings namely Plasmodium falciparum (Pf), Plasmodium vivax (Pv), Plasmodium malariae (Pm), Plasmodium ovale (Po) and Plasmodium knowlesi (Pk). In India, Pf and Pv are equally contributing to the malaria burden in the country, but a gradual increase in Pf cases is observed since last five years. According to NVBDCP, around 0.88 million malaria cases were reported in India and amongst them 0.46 million are Pf cases as it is more virulent (NVBDCP 2013). The highest number of malaria cases reported in India were from Odisha (25.6%) followed by Chhattisgarh (13.3%), Jharkhand (11.6%), Madhya Pradesh (8.7%), Gujarat (6.7%), Maharashtra (5.2%), other states (14.3%) and North Eastern states, which contributes 8.3% malaria cases in the country (NVBDCP-2013). In the past, chloroquine (CQ) was effective for treating nearly all malaria cases. However, CQ resistance of Pf was first reported in Assam, India in 1973 (Sehgal et al.1973) and number of studies until 1977 indicated widespread presence of CQ resistance Pf in Assam, Arunachal Pradesh, Mizoram and Nagaland. Since then drug resistance has been reported from several other parts of the country (Dua et al; 2003, Baruah et al; 2005, Valecha et al; 2009). Epidemiological studies have also confirmed the association of CQ resistance with a mutation in the transporter gene pfcrt. The amino acid substitution at pfcrt codon 76 (K to T) have shown a determinant association with the resistant phenotype (Lopes et al.1993, Babiker et al. 2001). The transporter for CQ resistance is located in the membrane of the food vacuoles where CQ is suggested to act by binding to hematin, a toxic by-product from the digestion of hemoglobin, thereby preventing synthesis of non-toxic hemozoin (Fitch et al. 1998, Bray et al. 1998). To overcome the problem of CQ drug resistance, sulphadoxine-pyrimethamine (SP) combination was recommended by the National Programme in the country (National antimalarial programme, 1982). SP acts by interfering with two enzymes in the biosynthesis of folate. Sulphadoxine(SDX) is analogous to p-amino benzoic acid and competitively inhibits dihydropteroate synthase (DHPS) while pyrimethamine (PYR) is a competitive inhibitor of dihydrofolate reductase (DHFR). The inhibition of these two key enzymes affects the synthesis of tetrahydrofolate, which is needed in the production of dTTP and amino acids methionine and glycine (Sibley et al. 2001). As a result the parasites get killed because of impaired synthesis of DNA and amino acids. Regretfully, resistance to SP developed rapidly in Southeast Asia even before the wide use of the drug (Wangsrpchanalai et al. 2002). Several factors contributed to the fast development of resistance to SP, one of which is long elimination half life of 10 and 4 days for SDX and PYR respectively. Use of antimalarial treatment for febrile episodes and self-treatment are common in high malaria-endemic areas (Nwanyanwu et al.1996, Mahomva et al. 1996). Irrational treatment practices by the clinicians and also self treatment with antimalarials have been reported in the past (Nsimba et al. 2005). Uncontr>GET ANSWER