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Background: There is a widespread range of diverse typical and atypical manifestations of malaria. The diagnosis of malaria may escape the attention of treating physician due to its unusual and vague presentations.The morbidity and mortality due to malaria is increased due to lack of early diagnosis and right treatment. The Aim of the present study was to examine the changing clinical pattern of malaria with special attention to atypical presentations.Methods: The present study comprised of 630 cases of definitively diagnosed malaria.Diagnostic methods used were conventional thick and thin peripheral smear stained with Leishman stain and rapid malarial antigen test.Results: This study revealed atypical symptoms like lack of taste (1.3%), throat discomfort (13.33%) and cough (24.0%) and vomiting (52.4%) as presenting complaints. These were significantly more in patients with P. vivax infestations.Conclusions: A high degree of suspicion is necessary for early detection and treatment of malaria, especially of unusual presentations.

This study aimed to examine the influence of prebiotics on growth and activity of Lactobacillus plantarum and their effect on adherence of anaerobic pathogens to Caco-2 and HT-29 intestinal cell lines. The specific growth rate of indigenous L. plantarum in lactulose (0.51/hr) was found to be maximum followed by fructooligosaccharide (0.34/hr) and inulin (0.18/hr) which was statistically at par with reference strain. Shortest mean doubling time of indigenous strain was observed with lactulose (1 hr 35 min) followed by fructooligosaccharide (2 hr 3 min), and inulin (3 hr 85 min). Lactic and short-chain fatty acids namely, acetic, propionic, and butyric were the principle metabolites observed after fermentation of prebiotics as detected by ultra-performance liquid chromatography analysis. No significant change in growth and pH of anaerobic pathogens was observed in medium supplemented with different prebiotics. Presence of lactulose showed maximum inhibition in adherence of anaerobic pathogens namely, Peptostreptococcus anaerobius (39 and 37%), Clostridium perfringens (36 and 34%), and Bacteroides fragilis (18 and16%), to Caco-2 and HT-29 intestinal cell lines. Practical applicationsThe ability of certain bacteria to ferment prebiotics selectively is an important probiotic characteristic. According to the results of this study, lactulose was found to be the promising ingredient in combination with indigenous strain that not only supported the growth of lactobacillus strain, but also inhibited the adherence of anaerobic pathogens to intestinal cell lines. The metabolites produced on fermentation of prebiotic such as lactate, acetate, propionate, and butyrate have many reported health benefits in boosting the gut immunity of the host. Negligible growth of anaerobic pathogens in lactulose indicating its safe use without any ill effect to the host. Thus, the lactulose might have a potential for practical use in food industry for the development of future functional and dietary foods to impart health benefits at both colonic and systemic levels.

The adherence of bacteria to epithelial cells and mucosal surfaces is a prerequisite for their colonization in the gut and a key criterion for the selection of probiotics. In this study, the eleven indigenous lactic acid bacterial isolates obtained from traditional fermented foods of Western Himalayas were screened for their adherence potential to intestinal epithelial cell lines. The level of adherence of eleven indigenous isolates to Caco-2 and HT-29 cell lines varied from 2.45 ± 0.5 to 9.55 ± 0.76% and 4.11 ± 0.68 to 12.88 ± 0.63%, respectively. Percent adhesion of indigenous isolates to Caco-2 cells was relatively lower as compared to HT-29 cells. Indigenous isolate AdF10 () was found to be the most adhesive to HT-29 and Caco-2 with corresponding figures of 12.88 ± 0.63 and 9.55 ± 0.76%, respectively. AdF4 () was found to be least adhesive to HT-29 and Caco-2 with respective corresponding figures of 4.11 ± 0.68 and 2.45 ± 0.5%. Based on the percent adhesion values, indigenous isolate AdF10 () was comparable to the reference probiotic strain GG-ATCC-53103 with respective adhesion of 13.5 ± 1.19 and 10.33 ± 0.64% to HT-29 and Caco-2 cell lines. It was closely followed by indigenous isolates AdF5 () and AdF6 (); thus, indicating their potential as a promising probiotic candidates.

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