Prevalence, incidence and resolution of abscesses and sinuses in patients with tuberculosis of spine: A 5-year results of patients treated with short course chemotherapy with or without surgery in Madras

A controlled clinical study comparing 6 or 9 months of ambulatory chemotherapy alone with radical surgery plus 6 months of chemotherapy was undertaken in patients with spinal tuberculosis in Madras. The prevalence of sinuses and/or clinically evident abscesses was 49(19%) of 253 patients, with significantly higher proportion in patients with lumbar or lumbo-sacral lesions. The incidence of lesions appearing after the start of chemotherapy was 32 (16%) of 204 patients. By five years, all had resolved. The resolution of the lesions was significantly faster and the incidences significantly lower in the radical surgery group than in the two ambulatory series. Mediastinal abscesses were observed on radiographs in 66 (66%) of 100 patients with thoracic or thoraco-lumbar lesions. By five years, the lesions had disappeared in all except two patients and the disappearance was significantly faster in the radical surgery group than in the two ambulatory series. There was no recurrence of these lesions during a period of five years

Short-course chemotherapy for tuberculosis of the spine : A comparison between ambulant treatment and radical surgery - a ten year report.

We perfomed a randomised, controlled clinical trial to compare ambulant short-course chemotherapy with anterior spinal fusion plus short-course chemotherapy for spinal tuberculosis without paraplegia. Patients with active disease of vertebral bodies were randomly allocated to one of three regimens: a) radical anterior resection with bone grafting plus six months of daily isoniazid plus rifampicin (Rad6); b) ambulant chemotherapy for six months with daily isoniazid plus rifampicin (Amb6); or c) similar to b) but with chemotherapy for nine months (Amb9). Ten years from the onset of treatment, 90% of 78 Rad6, 94% of 78 Amb6 and 99% of 79 Amb9 patients had a favourable status. Ambulant chemotherapy for a period of six months with daily isoniazid plus rifampicin (Amb6) was an effective treatment for spinal tuberculosis except in patients aged less than 15 years with an initial angle of kyphosis of more than 30° whose kyphosis increased substantially

Immune response & modulation of immune response induced in the guineapigs by Mycobacterium avium complex (MAC) & M. fortuitum complex isolates from different sources in the south Indian BCG trial area

A total of 139 guineapigs were used to study the immune response and its modulation induced by Mycobacterium avium complex (MAC) and M. fortuitum complex strains obtained from different sources in the south Indian BCG trial area. The guineapigs were divided into groups and some were directly sensitised/immunised with different MAC strains, M. fortuitum complex strain or BCG and others were sensitised with MAC or M. fortuitum complex and then immunised with BCG. The resulting delayed type hypersensitivity (DTH) response in the different groups of guineapigs was studied by skin tests using PPD-RT23 and PPD-B, and protective response was studied by challenging the guineapigs with a south Indian low virulent strain of M. tuberculosis and enumerating the bacilli in spleen at different points of time. The 3 strains of MAC induced similar low levels of DTH to PPD-RT23 but much higher and varying levels of DTH to PPD-B. MAC strains from soil and sputum induced different levels of immune modulation during subsequent immunisation with BCG on the DTH response to PPD-RT23 and PPD-B. At 2 wk after challenge, 23.8, 81 and 90.5 per cent protection was induced by the standard strain, soil isolate and sputum isolate of MAC, respectively, while 33.3 per cent protection was induced by the M. fortuitum complex strain compared to the protection induced by BCG alone. Prior exposure to MAC or M. fortuitum complex did not have any modulatory effect on the protective immunity due to BCG at this time point. However, at 6 wk after challenge, while the guineapigs immunised with BCG were protected, modulation of the protective response resulting from BCG was observed in the guineapigs sensitised with MAC and M. fortuitum from soil

Knowledge of tuberculosis in a south Indian rural community initially and after health education

A study was undertaken in a south Indian rural community to assess the initial level of knowledge of tuberculosis (TB) and again after providing health education on TB, to evaluate the effectiveness of health education, after 2 years. A total of 466 respondents from 24 randomly selected villages in Sriperumpudur taluk, Tamilnadu were interviewed. The community was then educated about the important aspects of tuberculosis by means of pamphlets, film shows, exhibitions, role plays and group discussions. After 2 years, the respondents were revisited and interviewed using the same interview schedule. There was an overall increase of knowledge on various aspects of TB, ranging from 18% to 58%

Evaluation of Procedures for Isolation of Nontuberculous Mycobacteria from Soil and Water

Six methods of decontamination each for the isolation of mycobacteria from soil and water were compared. On the basis of the results obtained. three of the six methods for soil and two of the six methods for water were further evaluated. For both soil and water samples, the method using 3% sodium lauryl sulfate in combination with 1% NaOH yielded more positives than the other methods

Prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus and its correlation with coronary artery disease (CAD)

Background: Non-alcoholic fatty liver disease (NAFLD) is a common association of Type 2 diabetes mellitus and diabetes mellitus is a leading risk factor for coronary artery disease (CAD). This study aims at estimating the prevalence of NAFLD by ultrasonography and to correlate NAFLD with CAD in a group of patients with Type 2 DM.Methods: Consecutive patients of Type 2 diabetes fulfilling the inclusion criteria were recruited. Clinical and biochemical parameters were recorded. NAFLD was diagnosed by ultrasonography.Results: The prevalence of NAFLD was 41.2% in the study group (n=114) and was higher in females. Prevalence of NAFLD in the younger age group was significantly higher than that in the older age group. Elevated liver enzymes, elevated HbA1C, duration of diabetes, obesity, acanthosis nigricans and metabolic syndrome were all significantly associated with NAFLD. CAD was significantly higher in the NAFLD subgroup (72.46%) compared to the non-NAFLD subgroup (52.63%) (p=0.001). Using binary logistic regression analysis, it was found that NAFLD is an independent predictor of CAD (p=0.002).Conclusions: NAFLD is extremely common in people with Type 2 diabetes and is associated with a higher prevalence of CAD.NAFLD is an independent risk factor for development of CAD. Thus, identification of NAFLD in diabetics might help in predicting the risk of CAD and to adopt the necessary preventive strategy.

Lymphocytotoxic antibodies & immunity in pulmonary tuberculosis

To understand whether the presence of cold reactive lymphocytotoxic antibodies (LCA) (reactive at 15°C) in the system has any effect on immunity to tuberculosis lymphocytotoxic antibodies to adherent cells (enriched-B ceils) and non-adherent cells were studied in active-TB (n=42) and inactive-TB (cured) patients (n=49) and healthy controls (n=32). The plasma samples of inactive-TB patients showed higher percentage of positivity for lymphocytotoxic antibodies (36.7%) than the active-TB patients (21.4%) and control subjects (18.8%). No significant difference on antibody and lymphocyte response against Mycobacterium tuberculosis culture filtrate antigens was observed between LCA positive and LCA negative active-TB patients and normal healthy controls. Further, determinationof HLA-DR phenotype of the patients and control subjects showed that individuals positive for lymphocytotoxic antibodies were more among HLA-DR2 positive and DR7 positive active-TB patients and control subjects than non-DR2 and non-DR7 subjects. The present study suggests that the cold reactive lymphocytotoxic antibodies may be against B-lymphocytes and persistent for a longer time. HLA-DR2 and -DR7 may be associated with the occurrence of LCA activity. Further, the presence of LCA has no immunoregulatory role on immunity to tuberculosis