ABSTRACT
Tuberculosis (TB) is one of the main causes of deaths related to antimicrobial resistance and the leading killer of people with HIV. The emergence of strains with multidrug-resistant TB (MDR-TB) has led to a resurgence of TB as a major public health menace worldwide, and MDR-TB has been an area of growing concern in recent years and is posing threat to global efforts for TB control. It has been seen that apart from physical symptoms, TB patients face various problems that are social, economic, and psychological in nature. Therefore, for the assessment of patients’ health status, it is necessary to consider the overall effect of TB on health and patients’ perception of well-being, besides routine clinical, radiological, and bacteriological assessments, so this present cross-sectional study was conducted to explore the burden of MDR-TB on the social, economic, and psychological well-being of the patients residing at Ballari. Methods: There are 79 MDR-TB cases registered at DR-TB center and residing in Ballari district. The data were collected from individual patients by home visits according to TB units, using a pre-designed pre-tested semi-structured questionnaire to measure the social, economic, and psychological burden of MDR-TB using standard tools. The data were entered into Microsoft Excel 2007 spreadsheet. Final analysis was done using SPSS for Windows 20.0 version. Social, economic, and psychological burden was analyzed with 95% confidence interval. Results: 68.3% patients became unemployed because of disease, 62 (78.5%) patients have to depend on others/family member for their daily routine work, and 69 (87.3%) patients are worried or had mental anguish about their disease status. The mean total cost incurred per patient is ₹58,061.99 (approximately US$ 855). The mean total direct cost incurred per patient is ₹21,318.8 (US$ 314). The mean total indirect cost incurred per patient is ₹36,743 (US$ 514). The mean pre-diagnosis and diagnosis cost per patient is ₹11,628 (US$ 171). The mean guardian cost per patient is ₹3,991.3 (US$ 59). The mean direct hospitalization cost incurred per patient is ₹6,315.44 (US$ 93). 14 (35%) patients from upper and middle class (Classes 1, 2, and 3) are shifted to lower socioeconomic classes (Classes 4 and 5). 60 (75.9%) patients have stopped working/doing household work for more than equal to 6 months because of disease. Conclusions: Study finding indicates that there is a significant social, economic, and psychological impact of MDR-TB that has a direct impact on the quality of life of MDR-TB patients and their families. There is a need for psychosocial intervention model (strategies) for MDR-TB patients and their caregivers to mitigate the negative effects of disease.Key words: Burden, multidrug-resistant tuberculosis, socioeconomic burden, tuberculosis
ABSTRACT
Background: Chronic rhino sinusitis is a widely prevalent and significant health problem but still its etiology is not clearly understood. It is a heterogeneous condition with persistent inflammation of the mucosa of the sinuses. The present study was aimed at evaluating the characteristics of the subjects most frequently affected by inflammatory sinunasal disease. Materials and methods: The present comparative study was conducted in department of ENT JSS Medical College and Hospital, Mysore from November 2012 to June 2014. A routine hemogram (HB, TC, DC, BT, CT and Platelet count) and urine examination (albumin, sugar, and microscopy) were done for the patients. All the patients in active stage of the disease were treated with course of suitable antibiotic, systemic antihistamines and local decongestants. All the data obtained was arranged in a tabulated form and analysed using SPSS software. Data was expressed as percentage of total data. Results: There were 15 subjects (30%) that were aged between 18-25 years of age. Majority of subjects were in this age group. There were 18% (n=9) subjects between 26-30 years of age. There were 58% (n=29) males in this study, making the majority. There were 21 (42%) females in the study. Conclusion: From the above study it can be concluded that the majority of subjects that were affected were males and of the age range between 18- 25 years of age.
ABSTRACT
L-Glutaminase, an amidohydrolase enzyme has been a choice of interest in the treatment of lymphoblastic leukaemia. The present study reports production, purification and characterization of extracellular glutaminase enzyme from Actinomycetes. Screening was performed for twenty Actinomycetes isolates from soil; one isolate (Isolate 2) was finally selected based on the activity of glutaminase (32.5 U/ml).The isolate was identified as Streptomyces sp. Effect of physicochemical factors namely temperature, pH, NaCl concentration, and supplementary carbon & nitrogen sources on the production of L-glutaminase from the Streptomyces sp. was carried out. The enzyme production was found to be optimum with glucose as carbon source (33 U/ml), L-glutamine as nitrogen source (33.1 U/ml), at 7 pH (32.8 U/ml), temperature 30oC (32.4 U/ml) and for 0.1% NaCl concentration (32.5 U/ml). The L-glutaminase produced from Streptomyces sp. was purified by ammonium sulphate precipitation, dialysis method and ion exchange chromatography. After the purification of the enzyme by ion exchange chromatography, it has been purified 46-fold from cell-free extract and yield was 3.25%. Characterization of extracellular L-glutaminase showed that the enzyme shown optimal activity at temperature of 30°C, pH 7, at 2% NaCl and for 0.04M substrate and the Km value was calculated to be 2.8mM and Vmax was 7.57 U/ml. The molecular weight of enzyme as determined by sodium dodecyl sulphate polyacrylamide electrophoresis (SDS-PAGE) was found to be 50 kDa.
ABSTRACT
Background: MRI is now the preferred imaging modality and preferred technique to define the activity and extent of infection for patients with suspected spinal tuberculosis. The objective of the study was to describe various radiological features of spinal tuberculosis (TB) on magnetic resonance imaging (MRI) and to assess its role in evaluation of the extent of disease. Methods: MRI images of 40 patients with proven Spinal Tuberculosis were retrospectively analyzed to determine the pattern of occurrence of various pathological lesions and extent of soft tissue involvement. Clinical features of the patients were also noted. Post-operative and follow up cases were excluded from the study. Results: The majority of the 40 patients were males (n=26) in the 31-40 years age group (50%). The most common clinical presentation was backache (77%) with a localized kyphotic deformity followed by fever (62.5%), malaise (47.5%) and weight loss (22.5%). The Thoracic spine was the commonest site of the disease (37.5%) followed by the thoracolumbar region (27.5%). An intervertebral disc involvement, pre and paravertebral collections, subligamental extension of the abscess were commonly seen, with an epidural collection occurring in more than 75 % of the cases. In addition few cases (n=5) also showed intramedullary and intradural involvement. Conclusions: The MRI scan is highly sensitive in the detection of various pathological processes of spinal tuberculosis and their pattern of occurrence. The extent of soft tissue involvement disease is best assessed by MRI which help in guiding the surgical treatment as well as to monitor the response to treatment during follow up.