Effect of Nutritional Support on Treatment of Multi-Drug Resistant Tuberculosis in Rajshahi Division, Bangladesh

Introduction: Multi-drug resistant tuberculosis (MDR-TB) is a public health crisis throughout the world including Bangladesh particularly due to its complexities in diagnosis, longer treatment regimen, and adverse drug reaction. Nutritional supplementation has significant impact on patient’s weigh gain and optimum weight gain is a biomarker of treatment response. The objective of this study was to measure body mass index (BMI) progress among MDR-TB patients in different phases of treatment. Methodology: A prospective observational study was conducted from March 2010 to July 2015 in Chest Disease Hospital (CDH), Rajshahi and different communities of Rajshahi Division, Bangladesh. A total of 233 confirmed MDR-TB patients were selected from CDH who received treatment and nutritional support from ongoing national TB control program (NTP). They received free diagnosis, follow up tests, treatment and nutritional support as regular diet as well as cash amount Bangladeshi taka (BDT.) 1000 per month in CDH. Along with treatment, they also received only cash amount BDT. 1500 per month as nutritional support at community level. Weight measurement was taken at regular interval from enrollment to completion of treatment. Chi-square, paired t-test and linear regression analysis were used in this study. Results: The baseline prevalence of undernourished (BMI < 18.5 kg/m2) was 82.4%. After two months of treatment, 14.5% underweight patients gained weight and reverted to normal BMI. Regression analysis showed the decreasing tendency of BMI progress with increasing age which was significant among male patients (p < 0.05). We observed reversely that patients gained more BMI in intensive phase than continuation phase of treatment. The cohort results demonstrated that the treatment success rate was lower (<83%) among initially underweight patients than their counterparts (>92%). Conclusion: Nutritional support has synergistic effect on treatment response. Adequate nutritional support with proper treatment would help to get better outcomes particularly at community level. Gender issue should also be addressed at household level.

Ameliorating effects of Raphanus sativus leaves on sodium arsenite-induced perturbation of blood indices in Swiss albino mice

Objective: To evaluate the ameliorating effects of Raphanus sativus leaves(RSL)against sodium arsenite(Sa)-induced adverse effects through mice experiments.Methods: Swiss albino mice were divided into four equal groups: control, Sa, RSL,RSL + Sa. Sa(10 mg/kg body weight/day), and powder form of RSL(50 mg/kg body weight/day) were provided as food supplement orallty. Blood indices were measured using commercially available kits through colorimetric methods.Results: It was observed that lactate dehydrogenase, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase activities were significantly(P < 0.05)higher in Sa-treated mice than those in the control group. RSL significantly reduced Sainduced elevation of the activities of these enzymes in serum significantly(P < 0.05).Serum butyrylcholinesterase activity and high density lipoproteins cholesterol levels in Satreated mice were significantly(P < 0.05) lower than the control group, and the food supplementation of RSL could significantly(P < 0.05) prevent the reduction of Sa-mediated serum butyryl cholinesterase activity and high density lipoproteins cholesterol levels. RSL could also reduce the Sa-induced elevation of serum urea level significantly(P < 0.05).Conclusions: Results of this study suggest the protective or ameliorating effects of RSL on Sa-induced perturbation of blood indices are related to the hepatic, cardiovascular and kidney dysfunction. Therefore, RSL may be useful to reduce arsenic toxicity in human in the future.

In vivo analysis of toxic effect of hydrose used in food preparations in Bangladesh

Objective:To evaluate the toxic effect of hydrose used in the molasses preparation in Bangladesh.Methods:Molasses were collected from open markets in different parts of Bangladesh.The presence of hydrose in selected molasses was detected using commercial kit.To evaluate the toxic effect of hydrose.Swiss albino male mice were divided into four groups.Group Ⅰ was used as control,while Groups Ⅱ,Ⅲ and Ⅳ received hydrose mixing food(5.10 and 25 g/kg food),respectively,and these supplementations were continued to the end of the study(16weeks).Blood was collected from thoracic arteries of the mice under ether anesthesia and then organs were taken.To determine the effect of hydrose on host,blood indices related to liver,heart and kidney dysfunctions were measured.Result:Creatinine and urea levels were significantly(P<0.05) increased in a dose dependent manner in hydrose treated mice,whereas calcium level was significantly decreased in hydrose exposed mice compared to control mice.Histological study of kidney showed the glomeruler inflammation,increased diameter of renal glomeruli and enlargement of proximal tubular lumen of kidneys of mice exposed to hydrose compared to that of control animals.Conclusion:The results of this study indicated that use of hydrose in molasses and other food preparations in Bangladesh may cause kidney impairment.