BCG skin reaction in Mantoux-negative healthy children

BACKGROUND: Tuberculosis poses a great challenge, especially in children. The response of BCG Test may be different in previously vaccinated children and needs to be considered before interpreting positivity for TB. This study has been carried out to determine the pattern of BCG reaction comparing previously vaccinated with non-vaccinated children. METHODS: The study was conducted in the healthy school children aged 4–6 years. The BCG skin reaction in Mantoux-negative children was compared between children with and without previous BCG scar. After the Mantoux and BCG Test, the analysis of variance was done as per protocol. RESULTS: Out of 50 children previously BCG vaccinated, 39(78%) showed exaggerated BCG test responses while out of another 50 children who were not vaccinated for TB, only 9(18%) showed exaggerated BCG Test response (p-value < 0.00001). Average induration obtained in children who were immunized with BCG at birth was much greater than those who were not immunized. 80% and 76% males and females respectively in Group I showed exaggerated BCG response while 16% and 20% males and females respectively of Group II showed exaggerated BCG response. CONCLUSION: The present study indicates that normal healthy children may have a mild exaggerated BCG Test response i.e. induration up to 8 mm because of prior BCG vaccination. Therefore, BCG Test, though important should not be the only criteria for start of chemotherapy for TB in children as the side effects of drugs may cause much morbidity. An induration up to 8 mm after the BCG Test can be normal in Indian settings due to exposure to Mycobacterium in environment and/or BCG vaccine

Risk of Pseudotumor Cerebri Syndrome (PTCS) with hormonal contraceptive use

Background: Hormonal contraceptives (HC), one of the most prescribed classes of medication in women, have been linked with pseudotumor cerebri syndrome (PTCS). To date, no large epidemiologic study has examined this association.Methods: A case-control study using the IMS LifeLink Pharmetrics Plus database was conducted. Cases had an ICD-9-CM code for benign intracranial hypertension as well as a procedural code for a CT or MRI and a code for lumbar puncture procedure within 15 days of the PTCS code. Controls were selected from the cohort using density-based sampling.Results: From a cohort of 9,053,240 subjects, there were 288 cases of PTCS corresponding to 2,880 controls. The adjusted RRs for two or more prescriptions of oral combined contraceptive was 0.62 (95% confidence interval 0.39-0.99). RRs for overall HC use was 0.91 (95% CI 0.39-2.12) for one prescription of HCs and 0.69 (95% CI 0.45-1.05) for two or more prescriptions. The RRs for one and two or more prescriptions of progestin only HCs were 0.75 (95% CI 0.08-7.46) and 1.06 (95% CI 0.42-2.69), respectively.Conclusions: Overall HC use does not have a significant effect on incidence of PTCS, however harm associated with progestin-only contraceptives cannot be excluded

HO-1 Upregulation Attenuates Adipocyte Dysfunction, Obesity, and Isoprostane Levels in Mice Fed High Fructose Diets

Background. Fructose metabolism is an unregulated metabolic pathway and excessive fructose consumption is known to activate ROS.HO-1 is a potent antioxidant gene that plays a key role in decreasing ROS and isoprostanes.We examinedwhether the fructosemediated increase in adipocyte dysfunction involves an increase in isoprostanes and that pharmacological induction ofHO-1would decrease both isoprostane levels and adipogenesis. Methods and Results. We examined the effect of fructose, on adipogenesis in human MSCs in the presence and absence of CoPP, an inducer of HO-1. Fructose increased adipogenesis and the number of large lipid droplets while decreasing the number of small lipid droplets ( \u3c 0.05). Levels of heme and isoprostane in fructose treated MSC-derived adipocytes were increased. CoPP reversed these effects andmarkedly increasedHO-1 and theWnt signaling pathway. Thehigh fructose diet increased heme levels in adipose tissue and increased circulating isoprostane levels ( \u3c 0.05 versus control). Fructose diets decreasedHO-1 and adiponectin levels in adipose tissue. Induction ofHO-1 by CoPP decreased isoprostane synthesis ( \u3c 0.05 versus fructose). Conclusion. Fructose treatment resulted in increased isoprostane production and adipocyte dysfunction, which was reversed by the increased expression of HO-1

Risk of acute angle closure glaucoma with triptan use in migraine patients : a nested case control study

Background: Glaucoma is a chronic, progressive disease that affects over 60 million people worldwide and can lead to either partial or complete vision loss. Similarly, migraines are one of the most prevalent and disabling conditions worldwide. Recent case studies and reports to the Food and Drug Administration have alluded to a link between triptans and an acute angle closure glaucoma (AACG) attack; a true ophthalmic emergency. Given that triptans are a highly prescribed medication, we sought to examine the risk of triptan induced AACG. Methods: We undertook a nested case-control study. We had access to a random sample of 9,053,240 patients from 2006-2016. Cases were identified by their first diagnosis of AACG. A risk-set of controls matched by age, sex, calendar time, and follow-up time were constructed. Our manner of control selection has shown to generate odds ratios that are close approximations of the risk ratios (RR). RRs for a positive control (topiramate) and negative control (ranitidine) were also calculated. Study drug use was defined as those with a prescription within 7 (current), 14 (recent), and 30 days (past) and any use of the drug within 1 year (0-365 days) prior to the index date. Results: There were 1,307 cases and 13,070 controls. The adjusted RR for those with any use of triptans was 1.09 (95%CI: 0.56-1.82). The adjusted RR for current, recent, and past use for triptans was 1.37 (95% CI 0.31-6.09), 1.16 (95% CI 0.35-3.92), and 1.19 (95% CI 0.50-2.81) respectively. The adjusted RR for current, recent, past use, and any use for topiramate was 4.44 (95% CI 0.80-24.64), 12.86 (95% CI 5.10-32.42), 6.52 (95% CI 3.34-12.71), and 3.77 (95% CI 2.29-6.20) respectively. The adjusted RR for current, recent, past use, and any use for ranitidine was 0.66 (95% CI 0.08-5.24), 0.39 (95% CI 0.05-2.91), 0.18 (95% CI 0.02-1.28), and 0.79 (95% CI 0.43-1.44) respectively. Conclusion: Although a significantly increased risk was not found for triptan induced AACG, we cannot exclude the existence of this risk due to presence of wide confidence intervals. Therefore, alerting patients on the risk of AACG with triptan use is not currently indicated.Medicine, Faculty ofExperimental Medicine, Division ofMedicine, Department ofGraduat

Risk of Pseudotumor Cerebri Syndrome (PTCS) with hormonal contraceptive use

Background: Hormonal contraceptives (HC), one of the most prescribed classes of medication in women, have been linked with pseudotumor cerebri syndrome (PTCS). To date, no large epidemiologic study has examined this association.Methods: A case-control study using the IMS LifeLink Pharmetrics Plus database was conducted. Cases had an ICD-9-CM code for benign intracranial hypertension as well as a procedural code for a CT or MRI and a code for lumbar puncture procedure within 15 days of the PTCS code. Controls were selected from the cohort using density-based sampling.Results: From a cohort of 9,053,240 subjects, there were 288 cases of PTCS corresponding to 2,880 controls. The adjusted RRs for two or more prescriptions of oral combined contraceptive was 0.62 (95% confidence interval 0.39-0.99). RRs for overall HC use was 0.91 (95% CI 0.39-2.12) for one prescription of HCs and 0.69 (95% CI 0.45-1.05) for two or more prescriptions. The RRs for one and two or more prescriptions of progestin only HCs were 0.75 (95% CI 0.08-7.46) and 1.06 (95% CI 0.42-2.69), respectively.Conclusions: Overall HC use does not have a significant effect on incidence of PTCS, however harm associated with progestin-only contraceptives cannot be excluded

Antibiotics bioremediation: Perspectives on its ecotoxicity and resistance

Antibiotic is one of the most significant discoveries and have brought a revolution in the field of medicine for human therapy. In addition to the medical uses, antibiotics have broad applications in agriculture and animal husbandry. In developing nations, antibiotics use have helped to increase the life expectancy by lowering the deaths due to bacterial infections, but the risks associated with antibiotics pollution is largely affecting people. Since antibiotics are released partially degraded and undegraded into environment creating antibiotic pollution, and its bioremediation is a challenging task. In the present review, we have discussed the primary antibiotic sources like hospitals, dairy, and agriculture causing antibiotic pollution and their innovative detection methods. The strong commitment towards the resistance prevention and participation, nations through strict policies and their implementations now come to fight against the antibiotic resistance under WHO. The review also deciphers the bacterial evolution based strategies to overcome the effects of antibiotics, so the antibiotic degradation and elimination from the environment and its health benefits. The present review focuses on the environmental sources of antibiotics, it\u27s possible degradation mechanisms, health effects, and bacterial antibiotics resistance mechanisms