[Evaluation of the efficacy of antiparasitic drugs in the treatment of concurrent parasitic diseases in patients with HIV infection and in those with pulmonary tuberculosis].

The efficacy of albendazole (400 mg taken once), mebendazole (100 mg taken once), and metronidazole (0.5 g thrice daily for 7 days) was evaluated when treating ascariasis, enterobiosis, and blastocystosis, respectively, in patients with HIV infection and in those with pulmonary tuberculosis. Metronidazole-resistant lambliasis was treated with exdisten (5 mg four times for 10 days) in 30.4% of the patients with HIV infection and in 43.3% of those with tuberculosis. Most HIV infected patients received antiretroviral therapy (ARVT). All the tuberculosis patients took isoniazid, ethambutol, pyrazinamide, rifampicin, and streptomycin. Efficiency was monitored by triple coproscopy at an interval of 5-7 days and by additional examinations using the method of Ritchii et al. There was parasitological cure (decreased infection rate for blastocystosis) and clinical improvement as positive changes in symptoms, such as nausea, weakness, headache, weight loss, and others, in all the patients with concomitant ascariasis, enterobiosis, and lambliasis. ARVT and antituberculosis drugs were observed to be better tolerated in all cases.

[Diagnostic criteria of carbohydrate metabolism disorders in pulmonary tuberculosis complicated by diabetes mellitus in patients with various haptoglobin phenotypes]. / Diagnosticheskie kriterii narusheniia uglevodnogo obmena pri sochetanii tuberkuleza legkikh s sakharnym diabetom u bol'nykh s raznymi fenotipami gaptoglobina.

A total of 180 patients with various haptoglobin (Hp) phenotypes were examined in order to detect specific features of carbohydrate metabolism disorders in pulmonary tuberculosis concomitant with diabetes mellitus. Blood sugar levels, G-6-PDH and LDH, acid-base balance, and 2,3-DPG and HbA1c were evaluated. LDH activity was decreased 1.3-1.7 times in comparison with the norm, G-6-PDH was decreased by 15-45% vs. the norm in 87% patients, acid-base status was imbalanced, HbA1c content was increased 1.5-1.7 times vs. the norm, and 2.3-DPG content was increased 2-3-fold in comparison with the norm in 83% patients. Increased levels of HbA1c and 2,3-DPG in the studied combination of diseases augmented disorders of O2 binding to hemoglobin, which led to hypoxia. The most pronounced shifts in the studied parameters were observed in patients with Hp 2-2 and Hp 1-1. Changes in the studied parameters should be used for the diagnosis of the severity of carbohydrate metabolism disorders in diabetics with pulmonary tuberculosis.

[Manifestations of pulmonary tuberculosis concurrent with diabetes mellitus and various haptoglobin phenotypes]. / Proiavlenie tuberkuleza legkikh pri sochetanii s sakharnym diabetom i raznykh fenotipakh gaptoglobina.

For diagnosis, detection of the specific manifestations of pulmonary tuberculosis (PT) concurrent with diabetes mellitus, 48 patients with insulin-dependent diabetes (IDD) and 132 with noninsulin-dependent diabetes (NIDD), who carry various haptoglobin (Hp) phenotypes were studied. It has been found that PT develops in IDD mainly in 5-10 years and in NIDD in 1-4 years. The gravest course of both types of diabetes is frequently encountered in those having Hp 2-2 phenotypes and slightly less frequently in those with Hp 1-1. The patients having these phenotypes have abnormalities in the levels of glycaric hemoglobin, 2.3-diphosphoglycerol phosphate, in the activity of the enzymes lactate dehydrogenase and glucose-6-phosphate dehydrogenase and acid-alkali imbalance. It is expedient to determine Hp phenotypes to evaluate the severity and prognosis and to choose a treatment policy for comorbidity and the proposed biochemical indices should be more widely used to evaluate carbohydrate metabolic disturbances in PT concurrent with diabetes mellitus.

[Features of disruption of certain components of carbohydrate metabolism in a combination of pulmonary tuberculosis and diabetes mellitus in people with haptoglobin phenotypes]. / Osobennosti narushenii nekotorykh zven'ev uglevodnogo obmena pri sochetanii tuberkuleza legkikh i sakharnogo diabeta u lits s raznymi fenotipami gaptoglobina.

Sugar level in blood, the activity of lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G-6-PDH), 2,3-BPG content, HbA1C and the phenotype of haptoglobin were studied in 180 patients with lung tuberculosis and diabetes mellitus. The increased (2-4.2-fold) blood sugar level was found in 77.2% patients. It was accompanied by decreased activity of LDH (by 1.3-1.7 times), G-6-PDH (by 15-45% in 87% patients). In patients with various haptoglobin phenotypes the content of HbA1C and 2.3-BPG was increased by 1.5-1.7 and 2-3 times, respectively. Clear differences in the studied parameters were found in patients with various phenotypes of haptoglobin (Hp). The most serious impairments of the studied parameters of carbohydrate metabolism were found in untreated patients with homozygote Hp phenotypes 2-2 and 1-1. Alterations found in the present study can be used for evaluating the depth of impairments of the carbohydrate metabolism in patients with combination of lung tuberculosis and diabetes mellitus.