Prevalence and first-line drug sensitivity trends of Mycobacterium tuberculosis at a tertiary center in North-East India

Setting Tuberculosis (TB) still remains one of the major health problems facing humans. India accounts for almost a quarter of TB cases worldwide. The scenario is worsening owing to multidrug resistant-tuberculosis (MDR-TB). Assessment of local prevalence rates and detection of MDR-TB are important to rationalize therapy and prevent spread of resistant strains in community. Objective The study was undertaken to understand drug sensitivity patterns of tubercle bacillus and assess resistance trends in Meghalaya. Designs Specimens were screened for acid-fast bacilli, decontaminated by N-acetyl cysteine–sodium hydroxide method, and subsequently inoculated onto Lowenstein–Jensen media. Characteristic growth was biochemically identified as TB bacillus. Drug sensitivity assessment to first-line anti-TB drugs was performed by proportion method and sensitivity patterns noted. Results Among 103 specimens received, 23 showed acid-fast bacilli. Male to female ratio was 3 : 2. Fourteen (13.6%) pure isolates of Mycobacterium spp. were obtained. Biochemically 10 isolates were confirmed as M. tuberculosis. Drug sensitivity profile revealed highest mono resistance to isoniazid and streptomycin. Two (20%) isolates were MDR. Conclusion The study gives a brief overview of the menace of TB in Meghalaya. The study results provide valuable information about presence of primary MDR-TB and provide basis for future larger field surveys

The Epidemiology, Presentation, and Outcome of Acute Post-infectious Glomerulonephritis in North East India: A Single Centre Experience: Post-infectious Glomerulonephritis in North East India

Background and Aim: Acute post-infectious glomerulonephritis (PIGN) can occur due tovarious etiologies. Among these, post-streptococcal glomerulonephritis is the common cause.Though the burden has drastically decreased over the years in developed nations, it remains areason for concern in developing countries. This study aimed to document the burden, clinicalpresentation, etiology, and outcome of PIGN referred to a tertiary care center in a developingcountry.Methods: This retrospective study was conducted in a tertiary care teaching hospital innortheast India. All cases diagnosed with acute PIGN were included in the study. Caseswith an alternate diagnosis and cases with incomplete records were excluded from the study.Data on relevant clinical, demographic, and laboratory variables were extracted from thecase records and discharge summary. Simple descriptive statistics, such as frequency andproportion were used.Results: A total of 202 cases of PIGN were included in the study. The Mean±SD annualadmission rate was 22.4±6.1 per year. The Mean±SD age at presentation was 10.0±3.9 yearsand the male to female ratio was 1.2 to 1. The most common clinical features at the time ofpresentation were hypertension in 183 patients (90.59%), edema in 168 (83.16%), history ofoliguria in 146(72.27%), and hematuria in 168 patients (83.2%). Proteinuria was present in 95cases (47.03%). Either clinical or serological evidence of preceding streptococcal infectionwas observed in 160 children (83.2 %). Two cases had scrub typhus and one case had hepatitisB seropositivity. Hypertensive encephalopathy and left ventricular failure were observed in20(9.90%) and 44 children (21.78%), respectively. Admission to the pediatric intensive careunit was required in 28.21%. No mortality was observed.Conclusion: PIGN constitutes a significant burden in this part of India. The incidence ofcomplications was high but the outcome was good with adequate acute care