ABSTRACT
Purpose: We sought to determine the characteristics and relative frequency of transmission of MDR‑TB in North India and their association with the clinical and epidemiological characteristics of TB‑patients. Materials and Methods: To achieve the objectives PCR‑SSCP, MAS‑PCR and direct DNA sequencing were used against 101 Mycobacterium tuberculosis isolates. Results: Multidrug‑resistant‑TB isolates were found to be significantly higher (P = 0.000) in previously treated patients in comparison to newly diagnosed patients. Further, significant differences (P = 0.003) were observed between different age groups (Mean ± SD, 28.6 ± 11.77) of the TB patients and multidrug resistance. Most frequent mutations were observed at codons 531 and 315 of rpoB and katG genes, respectively, in MDR‑TB isolates. Conclusion: Routine surveillance of resistance to anti‑TB drugs will improve timely recognition of MDR‑TB cases and help prevent further transmission in Northern India.
ABSTRACT
BACKGROUND: Cryptosporidiosis caused by the protozoa Cryptosporidium, is the common cause of diarrhoea in Acquired Immune Deficiency Syndrome (AIDS). AIM: To study the efficacy of short-term azithromycin in the management of cryptosporidiosis. SETTINGS AND DESIGN: Randomised, controlled trial. MATERIAL AND METHODS: All consecutive patients infected with Human Immunodeficiency Virus (HIV), who were positive for cryptosporidial oocysts were taken for this prospective randomised study. RESULT: Short-term azithromycin treatment for cryptosporidial diarrhoea in AIDS patients was associated with good clinical improvement but parasitological benefit was doubtful. All 13 patients, who had symptoms of cryptosporidiosis, symptomatically improved with 5 days of treatment with azithromycin and became asymptomatic after 7 days of antibiotic, but stool sample was positive for cryptosporidium even after 7 days of therapy. After 14 days of treatment with azithromycin in 13 patients, in five patients stool was free of cryptosporidial oocyst. The drug was well tolerated in all the patients. CONCLUSION: Short-term azithromycin can be used as a safe and effective treatment for symptomatic Cryptosporidiosis but not effective in eradicating Cryptosporidial infection.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Adult , Anti-Bacterial Agents/administration & dosage , Azithromycin/administration & dosage , Cryptosporidiosis/diagnosis , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , India , Male , Middle Aged , Reference Values , Treatment OutcomeABSTRACT
The serum adenosine deaminase (ADA) level was estimated in 30 patients with pleural effusion and 18 healthy controls and was found to be significantly elevated in the former (P less than 0.001). The pleural fluid ADA level in tubercular pleural effusion was always above 50 U/L and was significantly higher than in nontubercular effusions (P less than 0.001). Pleural fluid ADA to serum ADA ratio was not helpful in the aetiologic diagnosis of pleural effusions. Thus, estimation of pleural fluid ADA is a safe, simple, reliable and non-invasive test in distinguishing tubercular and non-tubercular pleural effusions.