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Amit Kumar Sharma Neeraj Gupta Dilip Kumar Kala Tarun Patni Ramakant Dixit Satyadeep Verma Arjun Chandran 《The Indian journal of tuberculosis》2018,65(3):233-236
Aims and objectives
To determine the prevalence and pattern of resistance to second line drugs among multi drug resistant (MDR) tuberculosis patients being treated on category IV regimen.Methodology
This study was conducted at Department of Respiratory Medicine, J.L.N. Medical College, Ajmer in collaboration with IRL, STDC, Ajmer. Second line anti tubercular drug sensitivity for 398 multi drug resistant tuberculosis patients (between June-2015 and June-2016) was done to find out prevalence and pattern of resistance to second line drugs. Second line drug sensitivity was performed at accredited laboratory, Microbiology department, S.M.S. Medical College, Jaipur.Results
Among these 398 patients, 136 (34.17%) were resistant to fluoroquinolones (Ofloxacin) (Pre XDR); 18 (4.52%) were resistant to one of the aminoglycosides (Inj. Kanamycin, Capreomycin, Amikacin) (Pre XDR); while 22 (5.53%) patients were resistant to fluoroquinolones as well as aminoglycosides (XDR). 148 (37.18%) patients were found sensitive to both the drugs. Samples of 41 (10.3%) patients were contaminated and no growth was seen in 33 (8.29%) patients.Conclusion
Nearly half of the multi drug resistant (MDR) tuberculosis patients (44.22%) being treated on category IV regimen also have resistance to either fluoroquinolones or aminoglycosides or both i.e. Pre XDR or XDR. This may result in poor outcome of category IV regimen under RNTCP. There is a strong need for provision of culture sensitivity for all first line drugs and at least two second line drugs viz. Fluoroquinolones and aminoglycosides for all the patients registered as smear positive under RNTCP. There is also a need for development of rapid culture technique for sensitivity to second line drugs. 相似文献73.
74.
Iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus: A rare injury
Complications following supracondylar fracture of humerus are well-known. Pre- and post-operative
complications have been documented in the literature. Neurovascular injury due to fracture fragments
following this type of fracture is described. Iatrogenic brachial artery during surgical treatment of this fracture is unknown to the literature. So we report a rare case of iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus and try to create awareness to the surgeons that such injuries can occur with improper operative techniques. 相似文献
75.
Takashi Hato Seth Winfree Rabih Kalakeche Shataakshi Dube Rakesh Kumar Momoko Yoshimoto Zoya Plotkin Pierre C. Dagher 《Journal of the American Society of Nephrology : JASN》2015,26(6):1347-1362
Preconditioning is a preventative approach, whereby minimized insults generate protection against subsequent larger exposures to the same or even different insults. In immune cells, endotoxin preconditioning downregulates the inflammatory response and yet, preserves the ability to contain infections. However, the protective mechanisms of preconditioning at the tissue level in organs such as the kidney remain poorly understood. Here, we show that endotoxin preconditioning confers renal epithelial protection in various models of sepsis in vivo. We also tested the hypothesis that this protection results from direct interactions between the preconditioning dose of endotoxin and the renal tubules. This hypothesis is on the basis of our previous findings that endotoxin toxicity to nonpreconditioned renal tubules was direct and independent of immune cells. Notably, we found that tubular protection after preconditioning has an absolute requirement for CD14-expressing myeloid cells and particularly, macrophages. Additionally, an intact macrophage CD14-TRIF signaling pathway was essential for tubular protection. The preconditioned state was characterized by increased macrophage number and trafficking within the kidney as well as clustering of macrophages around S1 proximal tubules. These macrophages exhibited increased M2 polarization and upregulation of redox and iron-handling molecules. In renal tubules, preconditioning prevented peroxisomal damage and abolished oxidative stress and injury to S2 and S3 tubules. In summary, these data suggest that macrophages are essential mediators of endotoxin preconditioning and required for renal tissue protection. Preconditioning is, therefore, an attractive model to investigate novel protective pathways for the prevention and treatment of sepsis. 相似文献
76.
Gretja Schnell Rakesh Tripathi Jill Beyer Thomas Reisch Preethi Krishnan Liangjun Lu Tatyana Dekhtyar Coleen Hall Regis A. Vilchez Tami Pilot-Matias Christine Collins 《Antimicrobial agents and chemotherapy》2015,59(11):6807-6815
Hepatitis C virus (HCV) genotype 4 (GT4) is genetically diverse, with 17 confirmed subtypes, and comprises approximately 13% of infections worldwide. In this study, we identified GT4 subtypes by phylogenetic analysis, assessed differences in patient demographics across GT4 subtypes, examined baseline sequence variability among subtypes and the potential impact on treatment outcome, and analyzed the development of viral resistance in patients who received a regimen of ombitasvir (nonstructural protein 5A [NS5A] inhibitor) plus ritonavir-boosted paritaprevir (NS3/4A inhibitor) with or without ribavirin (RBV) for the treatment of HCV GT4 infection. Phylogenetic analysis of HCV NS3/4A, NS5A, and NS5B nucleotide sequences identified 7 subtypes (4a, 4b, 4c, 4d, 4f, 4g/4k, and 4o) among 132 patient samples. Subtype prevalence varied by country, and the distributions of patient birth cohort and race were significantly different across GT4 subtypes 4a, 4d, and non-4a/4d. Baseline amino acid variability was detected in NS5A across GT4 subtypes but had no impact on treatment outcome. Three patients experienced virologic failure and were infected with subtype 4d, and the predominant resistance-associated variants at the time of failure were D168V in NS3 and L28V in NS5A. Overall, high response rates were observed among patients infected with 7 HCV GT4 subtypes, with no impact of baseline variants on treatment outcome. GT4 subtype distribution in this study differed based on patient demographics and geography. 相似文献
77.
78.
Varun Kumar Sharma Aanchal Kakkar Rakesh Lodha Vaishali Suri Sushil Kumar Kabra 《Indian journal of pediatrics》2014,81(9):926-928
Dermatomyositis with HIV infection has been very rarely reported. The authors report an 8-y-old boy who presented with skin rashes and edema, muscle weakness and polymicrobial infection along with mild immunosupression. Diagnosis of dermatomyositis was established by raised enzymes, suggestive MRI and muscle biopsy findings. Child responded to systemic steroids and low dose weekly methotrexate. 相似文献
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