Missed opportunity for standardized diagnosis and treatment among adult Tuberculosis patients in hospitals involved in Public-Private Mix for Directly Observed Treatment Short-Course strategy in Indonesia: a cross-sectional study

Background: The engagement of hospitals in Public-Private Mix (PPM) for Directly Observed Treatment Short-Course (DOTS) strategy has increased rapidly internationally - including in Indonesia. In view of the rapid global scaling-up of hospital engagement, we aimed to estimate the proportion of outpatient adult Tuberculosis patients who received standardized diagnosis and treatment at outpatients units of hospitals involved in the PPM-DOTS strategy. Methods: A cross-sectional study using morbidity reports for outpatients, laboratory registers and Tuberculosis patient registers from 1 January 2005 to 31 December 2005. By quota sampling, 62 hospitals were selected. Post-stratification analysis was conducted to estimate the proportion of Tuberculosis cases receiving standardized management according to the DOTS strategy. Result: Nineteen to 53% of Tuberculosis cases and 4-18% of sputum smear positive Tuberculosis cases in hospitals that participated in the PPM-DOTS strategy were not treated with standardized diagnosis and treatment as in DOTS. Conclusion: This study found that a substantial proportion of TB patients cared for at PPM-DOTS hospitals are not managed under the DOTS strategy. This represents a missed opportunity for standardized diagnoses and treatment. A combination of strong individual commitment of health professionals, organizational supports, leadership, and relevant policy in hospital and National Tuberculosis Programme may be required to strengthen DOTS implementation in hospitals

The effect of immunotherapy with gynandropsis gynandra pollen in atopic asthma patients

Background: Immunotherapy (IT) was first described by Noon and Freeman in 1911. The mechanism underlying successful immunotherapy is however not known. The protection from allergy is achieved long before IgE levels are de-creased, and they are indeed not frequently increased. Continued therapy may decrease IgE and skin reaction, although it may take years. Objective: The evaluation of effect of immunotherapy with specific pollen Gyn-andropsis gynandra. Material & Methods: Clinical subjects like skin test response, symptoms score, drugs intake and total sIgE levels were studied in sixty patients. Results: Both immediate and delayed skin test responses were highly significant. The intensity of symptoms score and medication was reduced and total sIgE levels were inconsistent after the course of IT. Conclusion: The decrease in clinical subjects may be attributed to the beneficial effect of immunotherapy with Gynandropsis gynandra

Invitro immune responses in children following BCG vaccination

Introduction: There is still no consensus on the efficacy of BCG vaccine in the prevention of tuberculosis. This study therefore addressed the question of the magnitude of immunity afforded by BCG, by studying the effector mechanisms of protection in children. The main objectives were to assess the degree of immunity conferred by BCG vaccine in children and to identify the most immunogenic antigen(s) of BCG by conducting in-vitro studies. Materials and methods: Children in the age-group of 1 to 10 years, were categorized: (A) normal, and vaccinated with BCG during the first year, n=45, (B) normal, without scar and with no evident history of vaccination, n=31: and (C) children admitted in the hospital with a confirmed diagnosis of tuberculosis, n=31. Fractions of BCG were obtained by lysis, sonication, separation by gel chromatography, HPLC and confirmed by SDS-PAGE. In lymphoproliferative assays PBMC were cultured and stimulated with either Concanavalin-A or Tuberculin or the fractions of BCG. Stimulation indices (SI) in lymphoproliferation, CD4/CD8 cells, levels of Interferon-γ (IFN- γ) in the culture supernatants were measured by ELISA. Results: The vaccinated children displayed significantly high (P< 0.05) mean values of SI in LTT, CD4/CD8 cell ratio against the unfractionated, 67kDa fraction and BCG-CF Ags. While 100% of the vaccinated children had positive lymphoproliferation indices to BCG-CF, only 8.3% of the unvaccinated children were positive. Conclusion: Some of the components of BCG induced a strong Thl cell response in children. These immunogenic antigens were present in the whole cell lysate. The use of BCG vaccine for tuberculosis is worthwhile till a new vaccine is developed

Profile of food allergens in urticaria patients in Hyderabad

Urticaria is one of the manifestations of a pattern of allergy. The associated disorders are vascular reaction and wheals. The objective of this study was to determine the prevalence of sensitivity to food allergens in Hyderabad in patients suffering from allergy. Four hundred and one patients attending the Allergy Clinic at BMMRC, with a confirmed diagnosis of bronchial asthma, rhinitis or urticaria were skin tested. Total sIgE levels were estimated by ELISA. Positivity to beans (53%) was highest, followed by mustard (41%) and cardamom (40%). Often patients having positive skin tests to food allergens which may have skin reactions to foods prove to be a problem. Foods that produce significant positive skin tests could be avoided in the diet; however, other foods that do not show skin reactions may contribute to the disease

Age-related waning of Interferon-γ levels against r32kDaBCG in BCG vaccinated children-0

<p><b>Copyright information:</b></p><p>Taken from "Age-related waning of Interferon-γ levels against r32kDaBCG in BCG vaccinated children"</p><p>http://www.jibtherapies.com/content/5/1/8</p><p>Journal of Immune Based Therapies and Vaccines 2007;5():8-8.</p><p>Published online 7 Jun 2007</p><p>PMCID:PMC1899498.</p><p></p> 6 years & 9–12 years (3316 ± 718 & 1360 ± 344; p < 0.003). (b) 6–8 years and 9–12 years (2880 ± 733 & 1360 ± 344; p < 0.01). (a