Arachnoiditis involving optic nerve and the optic chiasm can occur as a complication of tuberculous meningitis (TBM). This study evaluates the clinical features, cerebrospinal fluid (CSF) and laboratory parameters and imaging findings of optochiasmatic arachnoiditis (OCA) and also tried to identify any factors which can predict this complication in patients with TBM. Patients admitted with TBM in the neurology wards of a tertiary care teaching hospital over a period of 6 years formed the material for this study. Student's "t" test and univariate analysis were done to identify any predictors for this complication and the variables found to be significant were further analyzed by multivariate logistic regression analysis. One hundred sixty-three patients with TBM, admitted over a 6-year period, were studied. Twenty-three (14%) patients developed OCA. Eighteen out of 23 (78%) developed this complication while on antituberculous treatment (ATT) and 5/23 (22%) were newly diagnosed cases of TBM. Of those already on treatment, 12/23 (52%) were receiving only ATT, the remaining 6/23 (26%) had received steroids along with ATT in varying doses and duration. The average period from diagnosis of TBM to visual symptoms was 6.4 months. On the multivariate logistic regression analysis, female sex (P < 0.037), age less than 27 (P < 0.008) years and protein content in the CSF > 260 mg% (P < 0.021) were the factors predisposing toward this complication. At 6 months follow-up, on treatment with steroids and ATT, 17% had improvement and no further deterioration was noted in visual acuity in 52%. OCA can develop even while on treatment with ATT. Young women with a high CSF protein content seem to be more prone for this complication.
The usage of probiotics is becoming more common because of the mounting body of research demonstrating its advantages for human health. Of late probiotics have transitioned to a highly promising prophylactic measure that affords colonization resistance against multitude of pathogens. A crucial defence mechanism in the human body against numerous illnesses, especially urogenital ones, is the vaginal microbiota. The present study focuses on screening and isolation of culturable vaginal commensal microbiota from 54 healthy Indian women, and explore its putative probiotic traits such as coaggregation, antagonistic action against uropathogens, ability to form biofilms, antibiotic sensitivity, adhesion properties, etc. In addition, how oestradiol might affect isolated vaginal probiotics in both planktonic and biofilm states were also explored. The purpose of this work was to build a preliminary probiotics topography, specifically a Lactobacilli cartography, from a healthy Indian women cohort, characterize them at the molecular level, and interpret the key activities which were needed for the design and use probiotics as an antimicrobial sparing therapy to curtail UTI infection on the face of rising antimicrobial resistance. Our long-term goal of this work is to develop feminine hygiene product that is incorporated with probiotics to protect against pathogen colonisation without creating dysbiosis and improve women's quality of life.
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