Browsing by Author "Deepak Verma"

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Amphotericin B Deoxycholate Treatment of Post–Kala-Azar Dermal Leishmaniasis in India
(American Society of Tropical Medicine and Hygiene, 2024) Shyam Sundar; Jaya Chakravarty; Jitendra Singh; Deepak Verma; Neha Agrawal; Anju Dinkar
Post–kala-azar dermal leishmaniasis (PKDL) is widely prevalent in the endemic regions of India, but its treatment remains unsatisfactory. The WHO recommends a 12-week treatment with oral miltefosine, but its ocular toxicities are a serious concern. The late 1980s and early 1990s saw the use of sodium stibogluconate and amphotericin B (AmB) for a brief period. Both drugs had frequent adverse events and were expensive, and the duration of treatments was unacceptably long. This retrospective study evaluated, analyzed, and reported the outcomes of PKDL patients treated with a shorter course of AmB, the most effective antileishmanial drug. The hospital records of PKDL patients treated with AmB by 30 alternate-day infusions over 60 days (instead of conventional 60–80 infusions over 100–120 days) between September 2010 and August 2016 were reviewed. Only patients with confirmed parasitological diagnosis were included. Their records were studied for treatment-related adverse events, end-of-treatment parasitological status, and 12-month follow-up results. One hundred two patients were eligible for this study between September 2010 and August 2016. After therapy, 92/102 (90.2%) patients improved; 3 (2.9%) had to cease treatment owing to severe adverse effects, and one died of severe diarrhea unrelated to AmB. Six (5.9%) patients withdrew consent before the treatment was complete. At the 12-month evaluation, 89/102 (87.3%) patients attained a final cure. A 30-infusion regimen of AmB remains highly effective in PKDL. Without a shorter, safer, and more economical regimen for the treatment of PKDL, it should be used until a better regimen is available. Copyright © 2024 American Society of Tropical Medicine and Hygiene.
CUTICLE THICKNESS AND ITS ASSOCIATION WITH INSECTICIDE RESISTANCE IN BACTROCERA CUCURBITAE (DIPTERA : TEPHRITIDAE)
(Connect Journal, 2019) Deepak Verma; Soni Kumari; Dinesh Kumar
Bactrocera cucurbitae is a serious pest of cucurbits. So far, many workers have reported resistance against pyrethroid, spinosad and carbamate in different Bactrocera species. Insects’ cuticle plays key role in the insecticide resistance. Aim of present study was to extend our knowledge about the change in cuticle thickness of Bactrocera cucurbitae with age and its effect on the insecticide resistance. The mean cuticle thickness of ageing insects was 4.63 ± 0.36 μm for day 3, = 6.67 ± 0.13 μm for day 9, 10.36 ± 0.11 μm for 15 day old insects. Parallelly, we isolated the resistant and susceptible population of 10 day old Bactrocera cucurbitae and compared the cuticle thickness. In the present investigation, resistant B. cucurbitae were found to have cuticle thickness 15.84% greater than the susceptible flies. To affirm the role of cuticle thickness in insecticide resistance, we treated thoracic and abdominal segments of Bactrocera cucurbitae with insecticide and noted down the survival percentage. Survival percentage was significantly high in case of thoracic application of deltamethrin than the abdominal application. Higher cuticle thickness is associated with improved insecticide resistance in the same age group of Bactrocera cucurbitae population. However, for ageing insects, it protects the insect to a certain life stage © 2020. All Rights Reserved.
Efficacy and Safety of Amphotericin B Emulsion versus Liposomal Formulation in Indian Patients with Visceral Leishmaniasis: A Randomized, Open-Label Study
(Public Library of Science, 2014) Shyam Sundar; Krishna Pandey; Chandreshwar Prasad Thakur; Tara Kant Jha; Vidya Nand Ravi Das; Neena Verma; Chandra Shekhar Lal; Deepak Verma; Shahnawaz Alam; Pradeep Das
India is home to 60% of the total global visceral leishmaniasis (VL) population. Use of long-term oral (e.g. miltefosine) and parenteral drugs, considered the mainstay for treatment of VL, is now faced with increased resistance, decreased efficacy, low compliance and safety issues. The authors evaluated the efficacy and safety of an alternate treatment option, i.e. single infusion of preformed amphotericin B (AmB) lipid emulsion (ABLE) in comparison with that of liposomal formulation (LAmB).; In this multicentric, open-label study, 500 patients with VL were randomly assigned in a 3∶1 ratio to receive 15 mg/kg single infusion of either ABLE (N = 376) or LAmB (N = 124). Initial cure (Day 30/45), clinical improvement (Day 30) and long term definitive cure (Day 180) were assessed.; A total of 326 (86.7%) patients in the ABLE group and 122 (98.4%) patients in the LAmB group completed the study. Initial cure was achieved by 95.9% of patients in the ABLE group compared to 100% in the LAmB group (p = 0.028; 95% CI: −0.0663, −0.0150). Clinical improvement was comparable between treatments (ABLE: 98.9% vs. LAmB: 98.4%). Definitive cure was achieved in 85.9% with ABLE compared to 98.4% with LAmB. Infusion-related pyrexia (37.2% vs. 32.3%) and chills (18.4% vs. 18.5%) were comparable between ABLE and LAmB, respectively. Treatment-related serious adverse events were fewer in ABLE (0.3%) compared to LAmB (1.6%). Two deaths occurred in the ABLE group, of which one was probably related to the study drug. Nephrotoxicity and hepatotoxicity was not observed in either group.; ABLE 15 mg/kg single infusion had favorable efficacy and was well tolerated. Considering the demographic profile of the population in this region, a single dose treatment offers advantages in terms of compliance, cost and applicability.; Trial Registration: www.clinicaltrials.gov NCT00876824. © 2014 Sundar et al.
Tumor Antigen-/Cytokine-Pulsed dendritic cells in therapy against lymphoma
(Humana Press Inc., 2014) Sumit K. Hira; Deepak Verma; Partha P. Manna
Adoptive cell therapy using dendritic cells (DCs) is a strategy to deliver tumor antigens in cancer immunotherapy. Co-delivery of antigens to DC with essential components like genes encoding cytokines, chemokines, and other molecules or stimulation with recombinant cytokines is a potential method for designing an effective tumor vaccine protocol. Here, we describe the stimulation of purified splenic- or bone marrow-derived DC with recombinant interleukin-15 (IL-15) in the presence of intact soluble antigen from metastatic lymphoma tumor cells in an experimental animal model. © Springer Science+Business Media New York 2014.