Background
Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) remain low globally. Availability of newer drugs has given scope to develop regimens that can be patient-friendly, less toxic, with improved outcomes. We proposed to determine the effectiveness of an entirely oral, short-course regimen with bedaquiline and delamanid in treating MDR-TB with additional resistance to fluoroquinolones (MDR-TBFQ+) or second-line injectable (MDR-TBSLI+).
Methods
We prospectively determined the effectiveness and safety of combining 2 new drugs with 2 repurposed drugs—bedaquiline, delamanid, linezolid, and clofazimine—for 24–36 weeks in adults with pulmonary MDR-TBFQ+ and/or MDR-TBSLI+. The primary outcome was a favorable response at end of treatment, defined as 2 consecutive negative cultures taken 4 weeks apart. The unfavorable outcomes included bacteriologic or clinical failure during the treatment period.
Results
Of the 165 participants enrolled, 158 had MDR-TBFQ+. At the end of treatment, after excluding 12 patients due to baseline drug susceptibility and culture negatives, 139 of 153 patients (91%) had a favorable outcome. Fourteen patients (9%) had unfavorable outcomes: 4 deaths, 7 treatment changes, 2 bacteriological failures, and 1 withdrawal. During treatment, 85 patients (52%) developed myelosuppression, 69 (42%) reported peripheral neuropathy, and none had QTc(F) prolongation >500 ms. At 48 weeks of follow-up, 131 patients showed sustained treatment success with the resolution of adverse events in the majority.
Conclusions
After 24–36 weeks of treatment, this regimen resulted in a satisfactory favorable outcome in pulmonary MDR-TB patients with additional drug resistance. Cardiotoxicity was minimal, and myelosuppression, while common, was detected early and treated successfully.
Clinical Trials Registration. ClinicalTrials Registry of India (CTRI/2019/01/017310).
Glaucoma is a multifactorial optic neuropathy disease characterized by elevated Intra Ocular Pressure (IOP). As the visual loss caused by the disease is irreversible, early detection is essential. Fundus images are used as input and it is preprocessed using histogram equalization. First order features from histogram and second order features from Gray Level Co-occurrence Matrix (GLCM) are extracted from the preprocessed image as textural features reflects physiological changes in the fundus images. Second order textural features are extracted for different quantization levels namely 8, 16, 32, 64, 128 and 256 in four orientations viz 0, 45, 90 and 135° for various distances. Extracted features are selected using Sequential Forward Floating Selection (SFFS) technique.The selected features are fed to Back Propagation Network (BPN) for classification as normal and abnormal images. The proposed computer aided diagnostic system achieved 96% sensitivity, 94% specificity, 95% accuracy and can be used for screening purposes. In this study, the analysis of gray levels have shown their significance in the classification of glaucoma.
Objective:The aim of our study is to determine the normal ranges of the calcaneal parameters in the Indian population, and to compare the results with the data in the literature.Materials and Methods:The study was conducted at Coimbatore Medical College Hospital, Coimbatore on the feet (324 in number) of male and female Indian adults. Lateral view of the ankle was taken using a digital X-ray machine. Two parameters namely Bohler`s and Gissane angles were measured, independently by two radiologists to prevent inter-observer variation.Results:The Bohler`s and Gissane angles for the Indian population are statistically different from those seen in the published data for other population groups, as evidenced by the P value (P < 0.05).Conclusion:Calcaneal parameters specific to the Indian population have to be taken into consideration by the orthopedic surgeon to improve the standard of calcaneal fracture treatment in India.
The present study was designed to investigate the antioxidant and anticancer properties of Ficus carica (FC). The dried coarse powder of F. carica fruits was exhaustively extracted with ethanol and the resulting crude ethanolic extract (FCE) was assayed for antioxidant and anticancer activities, since both are inter-related. The antioxidant activity of FCE was determined by reductive potential in reducing ferric ions and anticancer activity was determined using breast cancer cell lines (MCF7). The extract showed strong antioxidant and anti-cancer activities, which suggest the use of the plant for therapeutic purposes, supporting the traditional claims.
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