Drug resistant Skeletal Tuberculosis in a tertiary care centre in South India.

BACK GROUND: Drug resistant tuberculosis is alarmingly on the rise especially in developing countries. Skeletal tuberculosis accounts up to 10% of all extra pulmonary tuberculosis. World Health Organisation (WHO) has not formulated guidelines for the management of Multi-drug resistant skeletal tuberculosis. RESULTS: A retrospective analysis of patients treated for musculoskeletal tuberculosis was done, to study drug resistance patterns. The outcome was assessed both clinically and radiologically.898 patients were treated for skeletal tuberculosis during the period of 2006-2013 (96 months). 478 (53.2%) patients were treated for tubercular spondylitis and 420 (46.8%) for extra-spinal skeletal tuberculosis. Ninety two patients (10.2%) had documented resistance to the anti-tubercular drugs. There were 42 mono resistant tuberculosis cases (4.7%), 13 poly resistant cases (1.4%), 33 multi-drug resistant cases (MDR TB) (3.7%) and 4 (0.4%) extremely drug resistant tuberculosis cases (XDR). All the patients were treated medically as per drug susceptibility patterns and protocols. Surgery was performed when indicated in 59 (66%) cases. 85% completed their course of treatment and were successfully healed as per pre-set clinical, biochemical and radiological criteria. The remaining were lost to follow up. One patient died as a result of post op respiratory infection. CONCLUSIONS: The prevalence of Multi-drug resistant tuberculosis patients in our centre was 3.7% and that of Extremely drug resistant tuberculosis cases was 0.4%. A Multi-disciplinary approach with drug susceptibility tests, sensitive drugs, and surgery if required is essential. Health education is essential to improve awareness among health care professionals about the danger of drug resistance in tuberculosis.

Antibacterial activity of ovary extract from sea urchin Diadema setosum.

OBJECTIVE: Sea urchin gonad is considered as a highly prized delicacy in several countries. It is also rich in valuable bioactive compounds including polyunsaturated fatty acids (PUFAs) and ß-carotene. This study was undertaken to examine the antimicrobial properties of the ovary extract from sea urchin Diadema setosum against selected Gram-negative and Gram-positive bacteria. MATERIALS AND METHODS: The ovary extract was obtained using two different solvents such as methanol and chloroform. The obtained extract was used to examine its potential antimicrobial properties against the following 11 bacterial species using the disc diffusion method: Gram-negative bacteria (Salmonella typhi, Salmonella typhimurium, Shigella flexneri, Pseudomonas aeruginosa, Aeromonas hydrophila, Acinetobacter sp, Citrobacter freundii and Klebsiella pneumonia) and Gram-positive bacteria (Bacillus subtilis, Staphylococcus epidermidis and Staphylococcus aureus). The activity was measured in terms of zone of inhibition (mm). RESULTS: The methanol extract exhibited a higher zone of inhibition against all the bacteria taken for examination. Whereas, the ovary extract obtained by chloroform did not show any antimicrobial activity against S. typhi, S. epidermidis, C. freundii and K. pneumonia. The results indicated that the ovary extract obtained by methanol extracts are capable of inhibiting the growth of pathogenic microbes taken for analysis. Moreover, the result indicates the presence of antimicrobial agents in sea urchin ovary. CONCLUSIONS: The study suggests that the ovary extract of D. setosum may be a potential source of antimicrobial agent for pathogenic microorganisms.

Proprioceptive changes in the contralateral knee joint following anterior cruciate injury.

Loss of proprioception following an anterior cruciate ligament (ACL) injury has been well documented. We evaluated proprioception in both the injured and the uninjured limb in 25 patients with ACL injury and in 25 healthy controls, as assessed by joint position sense (JPS), the threshold for the detection of passive movement (TDPM) and postural sway during single-limb stance on a force plate. There were significant proprioceptive deficits in both ACL-deficient and uninjured knees compared with control knees, as assessed by the angle reproduction test (on JPS) and postural sway on single limb stance. The degree of loss of proprioception in the ACL-deficient knee and the unaffected contralateral knee joint in the same patient was similar. The TDPM in the injured knee was significantly higher than that of controls at 30° and 70° of flexion. The TDPM of the contralateral knee joint was not significantly different from that in controls. Based on these findings, the effect of proprioceptive training of the contralateral uninjured knee should be explored.