ABSTRACT
The purpose of this study is to investigate the genotype and allelic frequencies of CYP3A in Bangladeshi Tuberculosis (TB) patients which may help for individualized drug dosing and improved therapeutics. Genotyping was done using the extracted genomic DNA from 90 TB patients followed by amplification of target alleles by Polymerase Chain Reaction (PCR). Amplified alleles were then digested by restriction enzymes followed by gel electrophoresis & sequencing to identify the targeted alleles namely CYP3A4*1B, CYP3A4*2, CYP3A4*4, CY3A4*5, CYP3A4*6, CYP3A4*10, CYP3A4*18, and CYP3A5*3. In TB patients, no samples were positive for CYP3A4*2, CYP3A4*4, CYP3A4*5, CYP3A4*6, CYP3A4*10, and CYP3A4*18 alleles. One sample was found to be heterozygous for CYP3A4*1B (1.11%). The wild homozygous (CYP3A5*1/*1) genotype frequency was 7.78%, the heterozygous (CYP3A5*1/*3) frequency was 42.22% and the homozygous mutant (CYP3A5*3/*3) frequency was 50% in Bangladeshi TB patients. The absence of the common polymorphic gene suggests that there will be no impact of CYP3A drug metabolizing enzymes on antituberculosis drugs.
Subject(s)
Antitubercular Agents/therapeutic use , Cytochrome P-450 CYP3A/drug effects , Cytochrome P-450 CYP3A/genetics , Tuberculosis/drug therapy , Tuberculosis/genetics , Adolescent , Adult , Aged , Bangladesh , Female , Gene Frequency , Genotype , Humans , Male , Middle Aged , Pharmacogenetics , Polymerase Chain Reaction , Polymorphism, Genetic , Sequence Analysis, DNA , Young AdultABSTRACT
Typhoid fever, caused by Salmonella typhi, is an important cause of morbidity and mortality in many developing countries. A rapid and sensitive method for the detection of S. typhi is essential for early diagnosis. This was a study to prospectively evaluate the sensitivity and specificity of nested polymerase chain reaction (PCR) to identify the S. typhi using flagellin gene related primers. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July, 2010 and June, 2011, including 82 individuals of different age and sex. Of them, 62 were clinically suspected cases of typhoid fever and remaining 20 were apparently healthy controls. Cultures as well as PCR of blood specimens were performed for each of the cases. Among the 62 suspected typhoid fever cases, 8(12.9%) were blood culture positive and 55(88.7%) were PCR positive for S. typhi. All culture positive cases were positive by PCR and among 54 culture negative cases, 47(87%) were positive by PCR. Neither of the healthy controls was positive by PCR or blood culture. The sensitivity, specificity, positive predictive value and negative predictive value of PCR using blood culture as gold standard were 88.7%, 100%, 100% and 74% respectively for typhoid fever. In this study, the PCR appears highly specific, very sensitive and superior to blood culture for the early diagnosis of typhoid fever.
Subject(s)
Typhoid Fever/diagnosis , Case-Control Studies , Early Diagnosis , Female , Humans , Male , Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
A deeper level of sedation by an anaesthesiologist is requirement for magnetic resonance imaging (MRI) in paediatric populations and sedation of children is different from sedation of adults. The purpose of the study was to compare the efficacy, safety, tolerability and cost effectiveness of ketamine, diazepam combination to midazolam, fentanyl combination for sedation of children during MRI. One hundred twenty children of both sex, age between 1-10 years, American Society of Anesthesiologist (ASA) physical status I and II were distributed into two groups. Group A (n=60) were sedated with 1.5 mg/kg body weight ketamine and 0.1 mg/kg body weight diazepam intravenously. Group B (n=60) were sedated with midazolam 0.05 mg/kg bodyweight and fentanyl 1 microg/kg body weight intravenously. Both groups showed satisfactory sedating condition for MRI. Incidences of side effects of drug regimens during sedation and recovery were recorded in both groups; those were transient and minor inconveniences. Pulse, blood pressure and respiration were within normal range in both groups. Mean procedure time was almost same in both groups and mean recovery time was more in group A than group B and the difference was statistically significant (p<0.05). Every child of both groups was discharged to home. Sedation regimen of group B found 5 times more costly than group A. Both the regimens were found safe and effective for paediatric sedation during MRI but ketamine, diazepam combination found more cost effective which, is a considerable matter in Bangladesh.
