We examined the clinical course after switching disease-modifying therapy (DMT) in patients with relapsing-remitting multiple sclerosis (RRMS). Eighty-five consecutive RRMS patients who received weekly interferon beta-1a (IFN beta-1a) 6 MU i.m. for at least 18 months were enrolled. Baseline annualized relapse rate (ARR) for the 2 years prior to initiating therapy with IFN beta-1a was obtained from charts. All 85 patients received treatment with IFN beta-1a at 6 MU i.m. weekly for 18-24 months (mean 19.7 months). Treatment with IFN beta-1a reduced the mean ARR from 1.41 to 1.23 (P=0.005). All 85 patients were then switched to glatiramer acetate (GA) 20 mg s.c. daily and prospectively followed up for 36-42 months (mean 37.5 months). Patients were switched because of persistent clinical disease activity (n=62) or persistently unacceptable toxicity (n=23) as determined by the treating neurologist. Treatment with GA reduced the mean ARR from 1.23 to 0.53 (P=0.0001). Subgroup analysis showed that in patients who were switched because of lack of efficacy (n=62), the mean ARR was reduced from 1.32 on IFN beta-1a to 0.52 on GA (P=0.0001). In contrast, in patients who switched because of persistent toxicity (n=23), the mean ARR was reduced from 0.61 on IFN beta-1a to 0.47 on GA (P, non-significant). Our observations suggest that clinical observations such as relapse rate and tolerability may be used as criteria for switching DMT in clinical practice. More definitive consensus criteria incorporating magnetic resonance imaging and clinical observations for defining optimal response and tolerability need to be developed for the routine clinical management of RRMS patients receiving DMT.

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The use of IVIG, following corticosteroids, may be useful using the protocol described herein, with sustained pulsed dosing. A larger controlled trial is indicated to confirm these results.

There was a lower proportion of subjects with an on-study relapse in natalizumab-treated patients, particularly in those with a more active disease at study entry. Larger ongoing phase III studies will allow more definitive investigation of these preliminary subgroup findings.

Fourteen consecutive clinically definite relapsing-remitting multiple sclerosis (MS) patients were treated with monthly intravenous cyclophosphomide (CTX) for 6 months. All had experienced severe dinical deterioration during the 12 months prior to treatment with CTX despite treatment with conventional immunomodulating agents and intravenous methylprednisolone. Treatment with CTX led to improvement and neurologic stability within 6 months which was sustained for at least 18 months after the onset of treatment with CTX. Therapy with CTX was well tolerated. CTX may be of benefit in MS patients who experience rapid clinical worsening and are resistant to conventional therapy.

SUGARCANE stem borer, Chilo infuscatellus is the most devastating pest, causing huge economic losses in the sub-tropics and therefore requiring effective management strategies. The current research was conducted to study the biology and management of C. infuscatellus. Moreover, we checked the efficacy of Trichogramma chilonis and granular insecticides against this key pest. Theincubation period for C. infuscatellus was 2.30 days, with a total developing time of 23.30 days for the larvae and 5.90 days for the pupa. Male and female C. infuscatellus had a 36.80-day and 38.00-day total life span, respectively, with the female living longer (4.8 days) than the male (3.90 days). The total female fecundity was 315.90 eggs with a 90.87 egg hatchability rate. The mean percent parasitism (87.01%) and percentage of adult emergence (76.11%) of T. chilonis on C. infuscatellus were both very high, with a total developmental time of 8.74 days in laboratory environment. Additionally, there were notable differences between the findings on the effectiveness of granular pesticides and T. chilonis in the field. The plot treated with Fipronil had the least mean percent infestations (3.58%), followed by Carbofuran (4.26%), and T. chilonis (5.63%). The control plot had the highest mean incidence of infestations (13.34%). Future IPM initiatives should incorporate the introduction of Trichogramma or the utilization of Fipronil @ 16 kg ha-1 for the treatment of C. infuscatellus. This practice will play a critical role in environmental protection and natural resource conservation against insecticides.

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