Determination of ethambutol MICs for Mycobacterium tuberculosis and Mycobacterium avium isolates by resazurin microtitre assay

Objectives: To test susceptibilities of Mycobacterium tuberculosis (MTB) isolates to ethambutol by the Lowenstein-Jensen (LJ) proportion method and resazurin microtitre assay (REMA) and to evaluate REMA for the determination of ethambutol MICs for MTB and Mycobacterium avium isolates. Methods: A total of 50 MTB and 20 M. avium isolates were tested to determine the MICs of ethambutol by REMA and agar dilution method. MTB isolates were also tested by the LJ proportion method. Results: REMA provided ethambutol susceptibility results for all the isolates within 8-9 days. For MTB isolates, REMA showed 96.7% sensitivity, 100.0% specificity and 98.0% accuracy when LJ proportion results were taken as 'gold standard'. For both MTB and M. avium isolates, the MICs determined by REMA were lower than those determined in agar medium, indicating that MIC values determined by REMA are closer to the actual MICs for the isolates. Conclusions: REMA can be used as a rapid and inexpensive method for mycobacterial drug susceptibility testing against ethambutol. In comparison with the agar method, the MICs determined by REMA can more accurately be correlated with achievable plasma concentrations of antimycobacterial agents

To Study the Hepatic and Renal Dysfunction in Various Species of Malaria in Mewat Region of Haryana

Introduction: India contributes 80% of Southeast Asia malaria burden. The hepatic and renal injury in Malaria is well known. As our region has a high prevalence of Malaria so the purpose of our study is to evaluate the hepatic and renal insult in all species of Plasmodium prevalent in the region.Materials and Methods: A Case control observational study was done on 90 malaria positive cases in SHKM Medical College and hospital Nuh, Haryana from the month of July 2017 to Dec. 2017. Malaria was confirmed by both Rapid kit method and by Peripheral blood smear. Blood and urine were analyzed for liver function tests and renal dysfunction. A case control observational study analysed using SPSS software.Results: Out of all 90 malaria positive cases, 38 % were P. falciparum, 51 % were P. vivax and 11 % were mixed infection. After doing liver function test, it was determined that 50% of these were of P. vivax and 42% were of P. falciparum. Similarly, with kidney function test, raised creatinine level and urine microprotein level were seen in 42% P. falciparum and 49% P. vivax.Conclusion: With changing spectrum different grades of biochemical and hematological changes generally found to be more severe with P. falciparum, are now frequently seen with P. vivax. P. vivax can no more be considered benign. P. vivax is now considered to be lethal due to dormant stage hypnozoites leading to relapse and greater transmission even at low parasite densities