Clinical Profile and Treatment Outcome of Drug Resistant Tuberculosis Patients of Western Maharashtra, India

BACKGROUND

Drug-resistant tuberculosis (DR-TB) imposes formidable burden on national health systems.

OBJECTIVES

This study aims to evaluate clinical profile and treatment outcome of drug resistant tuberculosis patients at tertiary care centre using a standardised treatment regimen (STR).

METHODS

Retrospective analysis of 146 patients with DR-TB from Solapur district who were treated with STR from period of September 2012 to December 2014 was done. Statistical analysis of treatment outcome data was done to know predictors of treatment success of DR-TB.

RESULTS

Out of total 146 bacteriologically proven cases of DR-TB, 95 were males and 51 females. 41% of patients were residents of Solapur city and the rest from different parts of Solapur district. Out of the 146 patients, 130 (89%) patients achieved sputum culture conversion within three months. Treatment outcome of these patients was as followstreatment success in 84 (58%), 20(14%) died, 28(19%) defaulted and failure in 14(9%) patients. Three predictors were identified for successful treatment outcome of DR-TB that include urban residence, patients with chest x-ray findings of moderately advanced disease and patients whose DR-TB status diagnosed by genexpert technology.

CONCLUSION

In resource-poor settings, well-designed STR under national programme provides satisfactory results.

Outcome of phacoemulsification and intraocular lens implantion in eyes with pseudoexfoliation and weak zonules

PURPOSE

To evaluate the results of phacoemulsification and intraocular lens (IOL) implantation in eyes with pseudoexfoliation (PEX) and zonular weakness.

METHODS

Two hundred and ninety-five patients (295 eyes) were recruited. This study is a retrospective case review of 143 PEX eyes with preoperative (Group 1) and intraoperative (Group 2) signs of zonular weakness, 76 PEX eyes (Group 3) and 76 non-PEX eyes without zonular weakness (Group 4) undergoing phacoemulsification and IOL implantation performed by single surgeon from year 1988 to 2010. Outcome measures included frequency of postoperative pseudophakodonesis, anterior capsule contraction and IOL decentration/dislocation. Postoperative vision, intraocular pressure (IOP) and glaucoma medication requirements were also assessed. A subanalysis on identical postoperative outcomes of capsular tension ring (CTR) implantation was performed. Comparisons were made for 52 PEX eyes with zonular weakness receiving nonsutured CTR implantation (Group A), 91 PEX eyes with zonular weakness not receiving CTR implantation (Group B) and 142 PEX eyes without zonular weakness (Group C).

RESULTS

Mean follow-up was 4.08 ± 0.48 years and maximum was 8.3 years. Both Groups 1 and 2 showed higher incidence of complications than Groups 3 and 4 (p < 0.01). Vision, IOP and glaucoma medication requirements were similar postoperatively for all four groups. Groups A and B had a significantly higher proportion of postoperative complications than Group C (p < 0.01). There was no significant difference in risk of developing these complications between Groups A and B (p = 0.64).

CONCLUSION

Postoperative complication rates are higher in PEX eyes with preoperative and/or intraoperative signs of zonular weakness undergoing phacoemulsification. Nonsutured CTR implantation does not prevent IOL and capsular complications postoperatively.

Characterization of one-dimensional position sensitive detectors with improved efficiency and position resolution for neutron spectrometers

Development and characterization of one-dimentional (1D) position sensitive detectors (PSDs) with improved efficiency and position resolution for neutron scattering applications are reported. The PSDs are characterized for energy resolution, count rate capability, sensitivity, efficiency, position resolution, and uniformity of response over the sensitive length. The studies are carried out to verify the dependence of position resolution on detector geometry, electronic noise, and stopping power of the fill gas. One of the PSDs is mounted on the small angle neutron scattering spectrometer and spectra from CTAB micelle sample are recorded using 5.4 A neutrons. A gain of factors 1.1 and 1.2 is obtained compared to earlier in house made 1D PSD and LND-made 1D PSD, respectively. The diffraction patterns from standard vanadium, nickel, and silicon samples are recorded on a powder diffractometer using newly designed PSDs. Gain in efficiency obtained at shorter wavelength of 0.783 A is by a factor of 1.6. All high pressure PSDs show improvement in the position resolution by 2-3 mm. It is observed that 1D PSD filled with isobutane as stopping gas improves the gamma tolerance and position resolution at lower partial pressures as compared to Kr. It is advantageous to use two or more 36C-type PSDs stacked together. It is economic and gives better efficiency due to scanning more beam height.

To evaluate and compare the effects of first generation anti-histamine (chlorpheniramine maleate) and second generation anti-histamine (loratadine) on isolated trachea of rabbit

OBJECTIVE

The incidence of respiratory allergy has increased gradually over the past several years and current estimates suggest that allergic rhinitis affects approximately 20% of the population. Large scales population surveys indicate that up to 38% of patients with rhinitis have asthma. The allergic response in the airways is an important pathogensis to cause bronchoconstriction owing to increased responsiveness of tracheo bronchial tree to various stimuli and also causes the release of histamine and other chemical mediators from mast cells. Histamine has been shown to be an important mediator of an allergic reaction in both the upper and lower respiratory airways. Chlorpheniramine maleate is a stable, most potent, sedative first generation anti-histamine and is effective in the treatment of allergic disorders. Loratadine is a highly potent, non-sedating, long acting tricyclic, second generation anti-histamine. It is indicated in allergic rhinits, chronic idiopathic urticaria and allergic bronchial asthma. The purpose of study was to evaluate the antagonistic effects of chlorpheniramine maleate and loratadine on histamine induced contractions in isolated trachea of rabbit and also to compare the effects of first generation anti-histamine (chlorpheniramine maleate and second generation anti-histamine loratadine).

METHODS

In this study twenty-four experiments were performed on isolated trachea of rabbit, in the presence of selected standard concentration of histamine dihydrochloride, antagonistic effects of various concentrations of chlorpheniramine maleate (10-18 to 10(-3) gm/ml) and loratadine from concentrations 10(-18) to 10(-3) gm/ml were recorded by Polygraph Model 7B in terms of rate and amplitude.

RESULTS

Chlorpheniramine maleate showed non-significant antagonistic effect from concentrations 10(-18) to 10(-3) gm/ml in case of rate and 10(-18) to 10(-8) gm/ml in case of amplitude. Significant response showed from concentrations 10(-8) to 10(-3) gm/ml in case of rate (P<0.001) and 10(-7) to 10(-3) gm/ml in case of amplitude (P<0.001) while, loratadine showed non-significant response from concentrations 10(-18) to 10(-12) gm/ml in case of rate and from concentration 10(-18) to 10(-14) gm/ml in case of amplitude. Significant response observed from concentrations 10(-11) to 10(-3) gm/ml in case of rate and 10(-13) to 10(-3) gm/ml in case of amplitude.

CONCLUSION

It was concluded that chlorpheniramine maleate antagonized the histamine induced contractions 80.65% at concentration 10(-3) gm/ml in case of amplitude and 11.35% at concentration 10(-3) gm/ml in case of rate and loratadine 76.82% in case of amplitude and 10.59% in case of rate.