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A comparative study for the detection of mycobacteria by bactec MGIT 960, lowenstein jensen media and direct AFB smear examination
Rishi S,Sinha P,Malhotra B,Pal N
Indian Journal of Medical Microbiology , 2007,
Abstract: Purpose: To compare BACTEC MGIT 960 (M960) with conventional culture on Lowenstein Jensen (LJ) media and direct acid fast bacilli (AFB) smear examination for the detection of Mycobacteria in clinical samples obtained from suspected cases of pulmonary and extra pulmonary tuberculosis (TB). Methods: A total of 500 samples were processed for direct AFB smear examination, and culture on M960 and LJ media. Results: Two hundred fifty-eight out of 500 (51.6%) isolates of Mycobacteria were obtained by combined use of the two culture methods. Two hundred and fifty-three (50.6%) were positive in culture by M960 and LJ media and 28% (140/500) by direct AFB smear examination. The positivity rate of M960 system alone was 34.10% (88/258) and of LJ alone was 1.93% (5/258). Average time to detect growth (TTD) was 9.66 days by M960 and 28.81 days by LJ. Conclusions: M960 system is a rapid and sensitive method for early diagnosis of pulmonary and extrapulmonary TB. But for maximum recovery of Mycobacteria , a combination of both M960 and LJ media should be used.
Comparative evaluation of bactec 460tb system and lowenstein-jensen medium for the isolation of M. tuberculosis from cerebrospinal fluid samples of tuberculous meningitis patients  [cached]
Venkataswamy M,Rafi W,Nagarathna S,Ravi V
Indian Journal of Medical Microbiology , 2007,
Abstract: Purpose : To evaluate the role of the radiometric BACTEC 460TB system and the conventional Lowenstein-Jensen (LJ) medium for isolation of M. tuberculosis from cerebrospinal fluid (CSF) samples of tuberculous meningitis (TBM) patients. Methods : CSF specimens (n=2325) from suspected TBM patients were processed for isolation of mycobacteria by inoculating BACTEC 12B medium and the LJ medium. The isolation of mycobacteria in both media was confirmed by microscopy and biochemical identification. Drug sensitivity testing for the anti-TB drugs was carried out by BACTEC radiometric method. Results : Among the total 2325 CSF specimens processed by both methods, M. tuberculosis was isolated from 256 specimens. The isolation rates were 93% and 39% for the BACTEC system and LJ medium respectively. Both the media supported growth in 32% of the culture-positive specimens. BACTEC system alone yielded growth in 61% and LJ alone in 7%, of the culture-positive specimens. Among 205 isolates tested for drug susceptibility 81% were sensitive to all the drugs tested and 19% were resistant. Conclusions : The BACTEC 460TB system provides a highly sensitive and rapid tool for the isolation and drug susceptibility testing of M. tuberculosis , from CSF of TBM patients. Use of a solid medium in conjunction with the BACTEC 12B medium is essential for optimal recovery for M. tuberculosis from CSF specimens.
The Burden of Diabetes in a Developing Country  [PDF]
Mohammad Khajedaluee, Maliheh Dadgarmoghaddam, Reza Saeedi, Zahra Izadi-Mood, Maryam Abrishami
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.44023
Abstract:

Introduction: People with diabetes often develop diverse microvascular, macrovascular, and neuropathic complications. Diabetes named high disease because of its high prevalence, high incidence, chronicity and high costs. Accurate projections of diabetes burden are essential for health planning so the aim of this study was to calculate the burden of diabetes in Razavikhorasan population, in Iran. Methodology: We used Disability Adjusted Life Years (DALYs) index using computer model (DisMod) for assessment of burden of diabetes and complications in Razavikhorasan province in Iran in year 2010-2011. Results: Burden of diabetes in Razavikhorasan population was 64,733 DALY in year 2010-2011. The total Years Life Lost (YLL) from diabetes mellitus was 62,883 (34,216 in men and 28,667 in women) due to premature death and the total Years Life Disability (YLD) was 1850. Conclusion: Diabetes mellitus and lesser forms of glucose intolerance can now be found in almost every population and epidemiological evidences suggest that, without effective prevention and control programs, diabetes will continue to increase and therefore advances in all levels of prevention may help reduce the number of people with diabetes.

Rendimento da cultura de escarro na compara??o de um sistema de diagnóstico automatizado com o meio de Lowenstein-Jensen para o diagnóstico da tuberculose pulmonar
Almeida, Elisabete Aparecida de;Santos, Manoel Armando Azevedo dos;Afiune, Jorge Barros;Spada, Delurce Tadeu de Araújo;Melo, Fernando Augusto Fiuza de;
Jornal Brasileiro de Pneumologia , 2005, DOI: 10.1590/S1806-37132005000300009
Abstract: background: tuberculosis continues to be a global health problem. objective: to evaluate an automated system designed to diagnose tuberculosis, comparing it to sputum microscopy and culture in l?wenstein-jensen medium. method: a comparative study using 844 sputum samples, collected between september and december of 1999 at a reference center for tuberculosis in s?o paulo, brazil, to draw distinctions between the results obtained through the use of the automated system and those obtained through sputum microscopy and culture in l?wenstein-jensen medium. results: of the 844 samples evaluated, 27.1% tested positive for acid-fast bacilli, and 72.9% tested negative. in l?wenstein-jensen culture, 34.7% were positive and 63% were negative, compared with 37.1% positivity and 56.9% negativity using the automated system. sensitivity was 98.1% for the automated system and 91.9% for l?wenstein-jensen culture. specificity and positive predictive value were 100% for both methods. negative predictive value was 98.9% for the automated system and 95.5% for l?wenstein-jensen culture. the degree of accuracy was 99.3% for the automated system and 97% for l?wenstein-jensen culture, and the kappa was 0.99 for the automated system and 0.94 for l?wenstein-jensen culture. the difference between the mean time to detection of mycobacteria using the automated system (10.5 days) and that found using l?wenstein-jensen culture (34.7 days) was statistically significant. conclusion: the difference between the culture yield obtained using the automated system and that achieved with l?wenstein-jensen culture was statistically significant. mean time to detection of mycobacteria was significantly shorter with the automated system. the higher yield provided by this new system justifies its use in a reference center for tuberculosis in s?o paulo
High Burden of Impetigo and Scabies in a Tropical Country  [PDF]
Andrew C. Steer ,Adam W. J. Jenney,Joseph Kado,Michael R. Batzloff,Sophie La Vincente,Lepani Waqatakirewa,E. Kim Mulholland,Jonathan R. Carapetis
PLOS Neglected Tropical Diseases , 2009, DOI: 10.1371/journal.pntd.0000467
Abstract: Background Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these diseases is poorly understood in many areas, particularly in the Pacific. Methodology/Principal Findings We conducted three epidemiological studies in 2006 and 2007 to determine the burden of disease due to impetigo and scabies in children in Fiji using simple and easily reproducible methodology. Two studies were performed in primary school children (one study was a cross-sectional study and the other a prospective cohort study over ten months) and one study was performed in infants (cross-sectional). The prevalence of active impetigo was 25.6% (95% CI 24.1–27.1) in primary school children and 12.2% (95% CI 9.3–15.6) in infants. The prevalence of scabies was 18.5% (95% CI 17.2–19.8) in primary school children and 14.0% (95% CI 10.8–17.2) in infants. The incidence density of active impetigo, group A streptococcal (GAS) impetigo, Staphylococcus aureus impetigo and scabies was 122, 80, 64 and 51 cases per 100 child-years respectively. Impetigo was strongly associated with scabies infestation (odds ratio, OR, 2.4, 95% CI 1.6–3.7) and was more common in Indigenous Fijian children when compared with children of other ethnicities (OR 3.6, 95% CI 2.7–4.7). The majority of cases of active impetigo in the children in our study were caused by GAS. S. aureus was also a common cause (57.4% in school aged children and 69% in infants). Conclusions/Significance These data suggest that the impetigo and scabies disease burden in children in Fiji has been underestimated, and possibly other tropical developing countries in the Pacific. These diseases are more than benign nuisance diseases and consideration needs to be given to expanded public health initiatives to improve their control.
Migrant tuberculosis: the extent of transmission in a low burden country
Zaza Kamper-J?rgensen, Aase Andersen, Axel Kok-Jensen, Mads Kamper-J?rgensen, Ib Bygbjerg, Peter Andersen, Vibeke Thomsen, Troels Lillebaek
BMC Infectious Diseases , 2012, DOI: 10.1186/1471-2334-12-60
Abstract: Register study based on IS6110-RFLP results from nationwide genotyping of tuberculosis cases during 1992 through 2004. Cases with 100% identical genotypes were defined as clustered and part of a transmission chain. Origin of clusters involving both Danes and migrants was defined as Danish/migrant/uncertain. Subsequently, the proportion of cases likely infected by the "opposite" ethnic group was estimated.4,631 cases were included, representing 99% of culture confirmed cases during 1992 through 2004. Migrants contributed 61.6% of cases. Up to 7.9% (95% CI 7.0-8.9) of migrants were infected by Danes. The corresponding figure was 5.8% (95% CI 4.8-7.0) for Danes. Thus, transmission from Danes to migrants occurred up to 2.5 (95% CI 1.8-3.5) times more frequent than vice versa (OR = 1). A dominant strain, Cluster-2, was almost exclusively found in Danes, particular younger-middle-aged males.Transmission between Danes and migrants is limited, and risk of being infected by the "opposite" ethnic group is highest for migrants. TB-control efforts should focus on continues micro-epidemics, e.g. with Cluster-2 in Danes, prevention of reactivation TB in high-risk migrants, and outbreaks in socially marginalized migrants, such as Somalis and Greenlanders. Fears that TB in migrants poses a threat for resident Danes seem exaggerated and unjustified. We believe this to be true for other low incidence countries as well.Human migration caused by political unrest, wars and poverty is a major topic in international health. Infectious diseases like tuberculosis (TB) follow their host, with potential impact on both the migrants and the population in the recipient countries. The strict health regulations in relation to migration implemented by some TB low burden countries could imply, that the population in the receiving countries is at high risk of contracting TB from migrants, a perception sometimes promoted by politicians and parts of the media [1]. The present study was conducted in Den
Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010  [PDF]
Alize J. Ferrari ,Fiona J. Charlson,Rosana E. Norman,Scott B. Patten,Greg Freedman,Christopher J.L. Murray,Theo Vos,Harvey A. Whiteford
PLOS Medicine , 2013, DOI: 10.1371/journal.pmed.1001547
Abstract: Background Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease. Methods and Findings Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%–10.8%) of global YLDs and dysthymia for 1.4% (0.9%–2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%–3.2%) of global DALYs and dysthymia for 0.5% (0.3%–0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%–3.8%) to 3.8% (3.0%–4.7%) of global DALYs. Conclusions GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. Please see later in the article for the Editors' Summary
Attitudes and burden in relatives of patients with schizophrenia in a middle income country
Alejandra Caqueo-Urízar, José Gutiérrez-Maldonado, Marta Ferrer-García, Claudia Pe?aloza-Salazar, David Richards-Araya, Alejandro Cuadra-Peralta
BMC Family Practice , 2011, DOI: 10.1186/1471-2296-12-101
Abstract: We assessed attitudes towards schizophrenia (including affective, cognitive and behavioural components) and burden (including subjective distress, rejection and competence) in 41 main caregivers of patients with schizophrenia, all of whom were users of Public Mental Health Services in Arica.Attitude measures differed significantly according to socio-demographic variables, with parents (mainly mothers) exhibiting a more negative attitude towards the environment than the rest of the family (t = 4.04; p = 0.000).This was also the case for caregivers with a low educational level (t = 3.27; p < 0.003), for the oldest caregivers (r = 0.546; p = 0.000) and for those who had spent more time with the patient (r = 0.377; p = 0.015). Although attitudes had significant association with burden, their explanatory power was modest (R2 = .104, F = 4,55; p = .039).Similar to finding developed countries, the current study revealed a positive and significant relationship between the attitudes of caregivers and their burden. These findings emphasize the need to support the families of patients with schizophrenia in this social context.In Chile, with a population of 16 million people, the prevalence of schizophrenia ranges between 1.4-4.6 persons for every hundred thousand people, with the annual incidence rate being 12 new cases for every hundred thousand inhabitants [1]. The prevalence of this disorder is higher in the Arica-Parinacota region and in the capital, Santiago [2]. Further, a National Health Survey carried out in 2004 recorded 917,939 Chileans (5.7% of the population) as being moderately/severely disabled, with 68.71% of these being taken care of by relatives [1].At the beginning of the 1990s, and together with the return to democracy in Chile, mental health reforms began to be implemented and the country witnessed a progressive increase in government investment in the area, the development of psychiatric and mental health service networks, and the creation of user groups.
The Forest behind the Tree: Phylogenetic Exploration of a Dominant Mycobacterium tuberculosis Strain Lineage from a High Tuberculosis Burden Country  [PDF]
Maranibia Cardoso Oelemann,Harrison M. Gomes,Eve Willery,Lia Possuelo,Karla Valéria Batista Lima,Caroline Allix-Béguec,Camille Locht,Yves-Olivier L. Goguet de la Salmonière,Maria Cristina Gutierrez,Philip Suffys,Philip Supply
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0018256
Abstract: Genotyping of Mycobacterium tuberculosis isolates is a powerful tool for epidemiological control of tuberculosis (TB) and phylogenetic exploration of the pathogen. Standardized PCR-based typing, based on 15 to 24 mycobacterial interspersed repetitive unit-variable number of tandem repeat (MIRU-VNTR) loci combined with spoligotyping, has been shown to have adequate resolution power for tracing TB transmission and to be useful for predicting diverse strain lineages in European settings. Its informative value needs to be tested in high TB-burden countries, where the use of genotyping is often complicated by dominance of geographically specific, genetically homogeneous strain lineages.
CD4+ T-lymphopenia in HIV negative tuberculous patients at King Khalid University Hospital in Riyadh, Saudi Arabia
AI Al-Aska, AR Al-Anazi, SS Al-Subaei, MA Al-Hedaithy, MA Barry, AM Somily, F Buba, U Yusuf, NA Al Anazi
European Journal of Medical Research , 2011, DOI: 10.1186/2047-783x-16-6-285
Abstract: Tuberculosis remains an infectious disease causing significant morbidity and mortality on a global scale. The fifteenth annual report of the World Health Organization [1] gave an estimate of the global burden of the disease caused by TB in 2009 as follows: 9.4 million new cases, prevalent cases of 14 million and deaths of 1.3 million and 0.38 million among HIV-negative and HIV positive people respectively.The natural course of TB infection is basically determined by the ability of the host's immune system resulting in swift eradication, dormancy or failure, which leads to active disease [2]. Protective immunity to TB in humans relies upon both CD4+ and CD8+ T-cells through cell-mediated responses, allowing full eradication or control of infection [3]. The important contribution of CD4+ T- cells is especially obvious in HIV infection which by depletion of these subsets of cells predisposes infected individuals to reactivation of tuberculosis. It had previously been documented that Tb infection itself may cause a CD4 lymphopenia in patients not infected with HIV, sometimes with grave consequences [4]. It had also been demonstrated that the CD4 lymphoenia was potentially reversible with treatment [5]. The aim of this study was to determine CD4 and CD8 values of non-HIV tuberculosis patients at baseline and post treatment periods by flow cytometry.We enrolled a study population of twenty-eight randomly selected non- HIV infected patients with wide spectrum of active tuberculosis seen at the King Khalid University Hospital (KKUH), Riyadh over a one-year period. Eligible patients were enrolled based on compatible symptoms of TB and positive My cobacterium tuberculosis based on Ziel-Nielsen smear and/or culture of relevant specimens as determined by the Bactec system and/or Lowenstein-Jensen culture methods. The first control group of matched healthy controls was not infected with Tb confirmed by absence of history suggestive of tuberculosis, negative tuberculin tests and
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