Mechanism of action
Miltefosine primarily acts on Leishmania by affecting the speciess promastigote and amastigote stages. Miltefosine exerts its activity by interacting with lipids, inhibiting cytochrome c oxidase and causing apoptosis-like cell death. This may affect membrane integrity and mitochondrial function of the parasite. History
Cancer
While initially studied as a cancer medication, due to side effects it was never used for this purpose.Phospholipid group alkylphosphocholine were known since the early 1980s, particularly in terms of their binding affinity with cobra venom. In 1987 the phospholipids were found to be potent toxins on leukemic cell culture. Initial in vivo investigation on the antineoplastic activity showed positive result, but then only at high dosage and at high toxicity. At the same time in Germany, Hansjörg Eibl, at the Max Planck Institute for Biophysical Chemistry, and Clemens Unger, at the University of Göttingen, demonstrated that the antineoplastic activity of the phospholipid analogue miltefosine (at the time known as hexadecylphosphocholine) was indeed tumour-specific. It was highly effective against methylnitrosourea-induced mammary carcinoma, but less so on transplantable mammary carcinomas and autochthonous benzo(a)pyrene-induced sarcomas, and relatively inactive on Walker 256 carcinosarcoma and autochthonous acetoxymethylmethylnitrosamine-induced colonic tumors of rats. It was subsequently found that miltefosine was structurally unique among lipids having anticancer property in that it lacks the glycerol group, is highly selective on cell types and acts through different mechanism.
Bagassosis, an interstitial lung disease, is a type of hypersensitivity pneumonitis attributed to exposure to moldy molasses or bagasse dust. Signs and symptoms
Some symptoms and signs of Bagassosis include breathlessness, cough, haemoptysis, slight fever. Acute diffuse bronchiolitis may also occur. An xray may show mottling of lungs or a shadow. Cause
Bagassosis has been shown to be due to a thermophilic actinomycetes for which the name thermoactinomycetes sacchari was suggested. Prevention
The following are precautionary measures that can be taken to avoid the spread of bagassosis:

Dust control-prevention /suppression of dust such as wet process, enclosed apparatus, exhaust ventilation etc. should be used
Personal protection- masks/ respirators
Medical control- initial medical examination & periodical checkups of workers
Bagasse control- keep moisture content above 20% and spray bagasse with 2% propionic acid

History
Bagassosis was first reported in India by Ganguly and Pal in 1955, in a cardboard manufacturing plant near Kolkata. India has a large cane sugar industry. The sugarcane fibre which, until recently, went to waste, is now utilised in the manufacture of cardboard, paper and rayon. References


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