Antimalarial drug toxicity is viewed differently depending upon whether the clinical indication is for malaria treatment or prophylaxis. In the treatment of Plasmodium falciparum malaria, which has a high mortality if untreated, a greater risk of adverse reactions to antimalarial drugs is inevitable. As chloroquine resistance has become widespread, alternative agents may be used in treatment regimens, however, the toxicity of these antimalarial agents should be considered. Quinine is the mainstay for treating severe malaria due to its rare cardiovascular or CNS toxicity, but its hypoglycemic effect may be problematic. Mefloquine can cause dose-related serious neuropsychiatric toxicity and pyrimethamine-dapsone is associated with agranulocytosis, especially if the recommended dose is exceeded. Pyrimethamine-sulfadoxine and amodiaquine are associated with a relatively high incidence of potentially fatal reactions, and are no longer recommended for prophylaxis. Atovaquone/proguanil is an antimalarial combination with good efficacy and tolerability as prophylaxis and for treatment. The artemisinin derivatives have remarkable efficacy and an excellent safety record. Prescribing in pregnancy is a particular problem for clinicians because the risk-benefit ratio is often very unclear.

Background: The emergence of Plasmodium falciparum resistance to widely used antimalarial drugs such as chloroquine has made malaria control and treatment much more difficult. In Yemen, 60% of the total population live in malarious areas. The problem of chloroquine resistance in Yemen is gradually worsening since the detection of first indigenous cases of P. falciparum resistance to chloroquine in 1989. Methods: In a cross-sectional malariometric parasitic survey, 447 Yemeni children were enrolled from two selected districts (Hethran and Al-mafatch) representing Taiz Governorate. Duplicate thin and thick blood smears were prepared, stained with Giemsa stain and examined microscopically. Fifty-six students satisfied all criteria of the WHO for the assessment of P. falciparum response to chloroquine using a 7-day in vivo test. Results: Out of 447 examined slides, 83 cases (100%) were found with falciparum malaria. The overall malaria parasite rate in Taiz Governorate was 18.6%, a prevalently mesoendemic condition. The obtained results of the 7-day in vivo study revealed that out of 83 P. falciparum cases who completed the study period, 56 cases did not respond to the standard dose of chloroquine, i.e. the overall resistance rate was 16.1%. The prevalence of chloroquine resistance was higher in the Hethran district (19.4%) compared with 10.0% in the Al-mafatch district. The majority had an RI resistance level. Conclusion: Chloroquine resistance of the local strain of P. falciparum was recorded in all studied districts in Taiz Governorate. This calls for an urgent revision of the current malaria treatment policy which still considers chloroquine as the first-line drug for treatment of uncomplicated P. falciparum malaria. To assess the magnitude of the problem, these districts could be the basis of future sentinel posts for continuous monitoring of chloroquine resistance in the whole country.

The present study indicated that increase serum digoxin level when combined with gentamicin should be considered a risk factor for digitalis toxicity.

Introduction: Many herbs and natural food materials have been historically recognized as an effective panacea that can establish a balanced infl ammatory response and promoting healthy immune response as well as have antibacterial and viral effects. The clinical use of some medications can cause serious side effects. We proposed that natural ingredients could serve as a better therapeutic approach. Objective: The study aimed to evaluate the effect of IMMUTONIC capsule in human volunteers with fl u symptoms. Methods: Twenty-four male and female adult volunteers, aged between 21 and 60 years were selected for the study. Study design: The study has a randomized clinical trials for one week. Volunteers were taken IMMUTONIC capsule three times daily after meal for one week. Improving of Flu symptoms were follow up after 3 days and 7 days using improving health scale 0-5. Results: fl u symptoms and appetite were signifi cantly improving after 3 days of follow up at p <0.05 , while after 7 days were highly signifi cant improving health at p < 0.05. Conclusion: The present study indicated that Immutonic capsule improves Flu symptoms via improved immune system and its antibacterial & viral effects as well as increased appetite which lead to good feeding.

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