Pattern of secondary acquired drug resistance to antituberculosis drug in Mumbai, India--1991-1995.

A retrospective observational study was conducted to find out whether secondary acquired drug resistance to isoniazid and ethambutol is high and to rifamycin and pyrazinamide is low, as is commonly believed in India. There were 2033 patients, whose sputum samples (6099) were reviewed from a specimen registry of the microbiology laboratory for the years 1991 to 1995. Of these, 521 (25.6%) patients [335 males and 186 females; age ranged from 11 to 75 years] had sputum positive culture and sensitivity for acid-fast bacilli (AFB). The drug resistance patterns in our study were: isoniazid (H) 15%, rifamycin (R) 66.8%, pyrazinamide (Z) 72.2%, ethambutol (E) 8.4%, streptomycin (S) 53.6%, cycloserine (C) 39.2% kanamycin (K) 25.1% and ethionamide (Eth) 65.3%. The resistance to streptomycin showed a significant fall over a year while there was a rise in resistance to cycloserine and kanamycin which is significant. The rate of secondary acquired resistance of isoniazid and ethambutol was low, and the rate of secondary acquired resistance to rifamycin and pyrazinamide was high, which is contarary to the common belief regarding these drugs in India. This implies that isoniazid is still a valuable drug in the treatment of multidrug resistance in India.

Lung function tests in normal Indian children.

The forced vital capacity, forced expiratory volume in one second, peak expiratory flow, mid-expiratory flow and maximum voluntary ventilation was measured in 632 healthy, normal children from Metropolitan city of Bombay using computerized spirometer. The children were between age range 6 years to 15 years and belong to high or middle and lower socio economic status. The pulmonary function data was separated by sex, and classified on the basis of height and age. The mean and standard deviation for was calculated for every such variable. The lung function variables show a linear positive correlation with height and age. Forced vital capacity and one second forced expiratory volume show a spurt after height 150 cm. Boys show higher values for lung function variables than girls except for mid expiratory flow rates where girls have higher values than boys over height 140 cm and age 9 yrs. Stepwise regression equation was calculated using height, age and weight as independent variables. Height explained the maximum variance in lung function parameters. Use of logarithmic equations for age, weight do not improve the degree of correlation. Hence, for clinical evaluation of child's lung function, height is the most significant independent parameter in comparison to age and weight.