The Role of Pyridoxine in the Prevention and Treatment of Neuropathy and Neurotoxicity Associated with Rifampicin-Resistant Tuberculosis Treatment Regimens: A Topic Review

Rifampicin-resistant tuberculosis (RR-TB) is a global public health problem caused by mycobacterium tuberculosis resistant to Rifampicin. Drug-induced peripheral neuropathy and neurotoxicity are well-known adverse effects of treatment regimens that cause significant morbidity. Pyridoxine is often added to treatment regimens for the prevention and/or treatment of these side effects. The basis and effectiveness of this practice are unclear. We conducted a systematic review to evaluate the effectiveness of pyridoxine in preventing and/or treating neuropathy and neurotoxicity associated with RR-TB treatment. We included studies with patients with RR-TB who experienced neuropathy or neurotoxicity attributed to RR-TB regimens and were given pyridoxine. Our findings showed contradicting evidence on the use of pyridoxine for preventing or treating neurotoxicity due to cycloserine in the treatment of RR-TB. Moreover, pyridoxine did not have a protective effect against neuropathy and/or neurotoxicity caused by other RR-TB regimens that do not contain isoniazid. In conclusion, we found that withdrawing or withholding medications such as linezolid, cycloserine, thioamides, fluoroquinolones, and ethambutol, implicated in causing neuropathy or neurotoxicity was more effective than using pyridoxine to stop the progression of symptoms, and in some instances, led to their reversal over time.

Naringenin protects against isoniazid- and rifampicininduced apoptosis in hepatic injury

AIM To explore the protective effects and mechanisms of naringenin(NRG) on hepatic injury induced by isoniazid(INH) and rifampicin(RIF).METHODS Male mice were randomly divided into four groups and treated for 14 d as follows: normal control group was administered intragastrically with normal saline solution alone; model group was administered intragastrically with INH(100 mg/kg) and RIF(100 mg/kg); lowand high-dosage NRG pretreatment groups were administered intragastrically with different doses of NRG(50 or 100 mg/kg) 2 h before INH and RIF challenge. Mice were killed 16 h after the last dose of drug treatment to determine activity of serum transaminases. Oxidative stress was evaluated by measuring hepatic glutathione(GSH) and superoxide dismutase(SOD) and malondialdehyde(MDA) levels. Histopathological changes in hepatic tissue were observed under the optical microscope. Hepatocyte apoptosis was measured by TUNEL assay and caspase-3 activation. Expression of Bcl-2 and Bax in liver was determined by western blot.RESULTS Both low- and high-dosage NRG pretreatment obviously alleviated serum levels of alanine aminotransferase and aspartate aminotransferase, liver index, hepatic MDA content, and increased hepatic GSH content and SOD activity compared with the INH and RIF-treated group(44.71 ± 8.15 U/L, 38.22 ± 6.64 U/L vs 58.15 ± 10.54 U/L; 98.36 ± 14.78 U/L, 92.41 ± 13.59 U/L vs 133.05 ± 19.36 U/L; 5.34% ± 0.26%, 4.93% ± 0.25% vs 5.71% ± 0.28%; 2.76 ± 0.67 nmol/mgprot, 2.64 ± 0.64 nmol/mgprot vs 4.49 ± 1.12 nmol/mgprot; 5.91 ± 1.31 mg/gprot, 6.42 ± 1.42 mg/gprot vs 3.11 ± 0.73 mg/gprot; 137.31 ± 24.62 U/mgprot, 148.83 ± 26.75 U/mgprot vs 102.34 ± 19.22 U/mgprot; all P < 0.01 or 0.05). Histopathological evaluation showed obvious necrosis and inflammatory cell infiltration in liver of mice administered INH and RIF; however, mice pretreated with NRG showed minor hepatic injury. In addition, INH and RIF resulted in hepatocyte apoptosis, and NRG pretreatment dramatically suppressed INHand RIF-induced hepatocytes apoptosis. Furthermore, NRG-mediated anti-apoptotic effects seemed to be in connection with its regulation of Bax and Bcl-2 protein expression in hepatic tissue.CONCLUSION NRG might attenuate INH- and RIF-induced hepatic injury via suppression of oxidative stress and hepatocyte apoptosis.

Luciferase reporter phage phAE85 for rapid detection of rifampicin resistance in clinical isolates of Mycobacterium tuberculosis

Objective:To evaluate luciferase reporter phage(LRP)phAE85 in rapid detection of rifampicin resistance in a region where TB is endemic.Methods:One hundred and ninety primary isolates on Lowenstein-Jensen medium were tested.Middlebrook 7H9 complete medium with and without rifampicin at 2μg/mL was inoculated with standard inoculum from suspensions of the clinical isolate.After incubation for 72 h,LRP was added.Following 4 h of further incubation,light output from both control and test was measured as relative light units.Strains exhibiting a reduction of less than 50%relative light units in the drug containing vial compared to control were classified as resistant.Results were compared with the conventional minimum inhibitory concentration method(MIC)of drug susceptibility testing.Results:The two methods showed high level of agreement of 97%(CI 0.94,0.99)and P value was 0.000 1.The sensitivity and specificity of LRP assay for detection of rifampicin resistance were 91%h(CI 0.75,0.98)and 99ct(CI0.95,1.00)respectively.Time to detection of resistance by LRP assay was 3 d in comparison with 28 d by the minimum inhibitory concentration method.Conclusions:LRP assay with phAE85 is 99%specific,91%sensitive and is highly reproducible.Thus the assay offers a simple procedure for drug sensitivity testing,within die scope of semi-automation.

Effect of rifampicin pre-and post-treatment on rotenone-induced dopaminergic neuronal apoptosis and alpha-synuclein expression

BACKGROUND: Rifampicin inhibits the formation of α-synuclein multimer and protects against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyritine (MPTP)-induced PC12 cell apoptosis.OBJECTIVE: To compare the effect of rifampicin pre-and post-treatment on tyrosine hydroxylase and α-synuclein expression in substantia nigra pars compacta in a rat model of Parkinson’s disease.DESIGN,TIME AND SETTING: A randomized,controlled experiment was performed at the Experimental Animal Center of Sun Yat-sen University North Campus (China) from November 2006 to October 2008.MATERIALS: Rifampicin was purchased from MD,USA;rotenone was purchased from Sigma,USA;mouse anti-rat α-synuclein monoclonal antibody was purchased from B&D,USA;and rabbit anti-rat tyrosine hydroxylase monoclonal antibody was purchased from Chemicon,USA.METHODS: A total of 72 male,Sprague Dawley rats,aged 8 weeks,were randomly assigned to 5 groups: blank control (n = 12),rifampicin (n = 12),rotenone (n = 16),rifampicin pre-treatment (n = 16),and rifampicin post-treatment (n = 16).Parkinson’s disease model rats were established via a subcutaneous injection of rotenone (1.5 mg/kg per day) in the three treatment groups,once a day for 3 successive weeks.Rifampicin (30 mg/kg per day) was intragastrically administered in the rifampicin pre-treatment group 3 days prior to rotenone induction and in the rifampicin post-treatment group 7 days after rotenone induction.Rats were treated with a subcutaneous injection of 1 mL/kg per day sunflower oil in the blank control group and an intragastric injection of 30 mg/kg per day rifampicin in the rifampicin group,once a day for 3 successive weeks in total.MAIN OUTCOME MEASURES: Prior to treatment and in the end of the 3rd week after treatment,the rats were evaluated using the modified neurological severity score.The substantia nigra from the rats was extracted for hematoxylin-eosin staining.Western blot analysis was performed to determine tyrosine hydroxylase and α-synuclein expression.RESULTS: Hematoxylin-eosin staining revealed a significant reduction in the number of substantia nigral neurons in the rotenone group,in addition to neurodegradation,hypopigmentation,and pyknosis.In the rifampicin pre-treatment and post-treatment groups,the number of dopaminergic neurons was significantly increased compared with the rotenone group (P < 0.01),with slight neuronal damage.Compared with the rotenone group,substantia nigral tyrosine hydroxylase expres-sion was significantly increased in the rifampicin pre-treatment and post-treatment groups (P < 0.01),but α-synuclein expression and modified neurological severity scores were significantly decreased (P < 0.01).In addition,the effect of rifampicin in the pre-treatment group was superior to the post-treatment group.There was no significant difference in tyrosine hydroxylase and α-synuclein expression,or in the modified neurological severity scores,between the blank control and rifampicin groups (P > 0.05).CONCLUSION: Rifampicin significantly attenuated neuropathological and behavioral motor deficits induced by rotenone.Moreover,rifampicin enhanced tyrosine hydroxylase expression,but inhibited α-synuclein expression.The effect of rifampicin pre-treatment was superior to rifampicin post-treatment.

Low Doses of Rifampicin Used in New Tuberculosis Patients Correlated to Increased Frequency of Rifampicin-Resistance and Poorer Treatment Outcomes

The prognosis of patients with previously treated tuberculosis (TB) was suggested to be dependent on whether the initial treatment was in compliance with the established guidelines. The aim of this retrospective multicenter study was to determine the proportion of new TB patients who received standard doses of rifampicin in multiple provinces of China, and the relationship between low doses of rifampicin and frequency of rifampicin-resistance as well as treatment outcomes. A total of 713 new TB patients were treated with either once-daily dose of bulk anti-TB drugs (group I) or every other day combination blister packs of anti-TB drugs containing rifampicin (group II) at more than 30 TB treatment centers/hospitals in China. Treatment history, therapeutic doses of rifampicin, and information about patients were extracted from their medical records and analyzed, and rifampicin-resistance of isolates collected from patients following the treatment as well as treatment outcomes were compared between two treatment groups. Among 522 patients in treatment group I, 154 (29.5%) received standard and 363 (69.5%) received low doses of rifampicin;238 (45.6%) isolates were rifampicin-resistant, and 243 (46.6%) were successfully treated. Among 191 patients in treatment group II, 175 (91.6%) received standard and 15 (7.9%) received low doses of rifampicin;72 (37.7%) isolates were rifampicin-resistant, and 105 (55%) were successfully treated. When patients who received low doses of rifampicin were compared to others within the same treatment group, increased rates for rifampicin-resistance and treatment failure were observed. Results from this study showed that most new TB patients in treatment group I (69.5%) received low doses of rifampicin, and their treatment outcomes were worse than those in treatment group II, indicating that low doses of rifampicin used for the initial treatment of new TB patients were correlated to increased frequency of rifampicin-resistance and poorer treatment outcomes.

Rifampicin inhibits apoptosis in rotenone-induced differentiated PC12 cells by ameliorating mitochondrial oxidative stress

BACKGROUND:Previous studies have shown that rifampicin exhibits neuroprotective effects,but the precise mechanisms remain unclear.Rifampicin is thought to exert the neuroprotective effect as a hydroxyl free radical scavenger.OBJECTIVE:To investigate the protective effects of rifampicin pretreatment on rotenone-induced mitochondrial oxidative stress in differentiated PC12 cells.DESIGN,TIME AND SETTING:A repeated measure,cell-based study was performed at the Department of Neurology,Second Affiliated Hospital,Sun Yat-sen University,China between December 2007 and November 2008.MATERIALS:PC12 cells were a kind gift from the Physiology Laboratory of Zhongshan Medical School,Sun Yat-sen University,China.Rotenone and rifampicin were purchased from Sigma,USA.METHODS:PC12 cells were differentiated by culturing with 100 ng/mL 7S nerve growth factor for 9 days in Dulbecco's modified Eagle's medium/Nutrient Mix F12(DMEM/F12) supplemented with 10% fetal bovine serum.The cells were assigned to six groups according to various treatment conditions:control,cultured with normal media;rifampicin group,treated with 300 μmol/L rotenone for 26 hours;rotenone group,treated with 2.5 μmol/L rotenone for 24 hours;rifampicin pretreatment groups,pretreated with 100,200,and 300 μmol/L rifampicin for 2 hours,respectively,followed by 2.5 μmol/L rotenone for 24 hours.MAIN OUTCOME MEASURES:Mitochondrial membrane potential was measured by fluorescence microscopy and flow cytometry,respectively,using rhodamine123 staining.Intracellular reactive oxygen species formation was analyzed by flow cytometry using 2',7'-dichlorofluorescin-diacetate staining,and intracellular reduced glutathione was measured with a microplate reader.Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay.Cell apoptosis was detected by Hoechst 33342 staining and flow cytometry.RESULTS:Increased apoptosis in rotenone-induced,differentiated,PC12 cells was accompanied by the loss of mitochondrial transmembrane potential,the formation of reactive oxygen species,and reduced glutathione depletion(P<0.01).Rotenone-induced mitochondrial dysfunction was blocked in a dose-dependent manner by rifampicin(P<0.05 or P<0.01).CONCLUSION:Pretreatment of differentiated PC12 cells with rifampicin blocked rotenone-induced apoptosis by ameliorating mitochondrial dysfunction and oxidative stress.

Novel potential for optimization of antitubercular therapy:Pulmonary delivery of rifampicin lipospheres

The aim of the present work is to develop rifampicin loaded phospholipid lipospheres containing sulfphobutyl etherβ-cyclodextrin and Vitamin C for inhalation to test their potential for deep lung delivery.The findings of the solid state characterization revealed the amorphous nature of the lipospheres.These exhibited a better flowability,an aerodynamic diameter in the range of 1.76 to 3.99μm.Moreover,the fine particle fraction and emitted dose was found in the range of 68.84–83.73% and 80–93%,respectively.Moreover,lipospheres exhibited enhanced/equivalent efficacy in vitro in H37Rv strain.Hence,the results show the potential of lipospheres for pulmonary delivery of rifampicin.

Effect of rifampicin on anticoagulation of warfarin:A case report

BACKGROUND The drug interaction between warfarin and rifampicin is widely known,but there are still some difficulties in managing the combination of the two drugs.CASE SUMMARY A patient with brucellosis received strict monitoring from a Chinese pharmacist team during combination of warfarin and rifampicin.The dose of warfarin was increased to 350%in 3 mo before reaching the lower international normalized ratio treatment window.No obvious adverse reaction occurred during the drugadjustment period.This is the first case report of long-term combined use of rifampicin and warfarin in patients with brucellosis and valve replacement in China based on the Chinese lower warfarin dose and international normalized ratio range.CONCLUSION Anticoagulation for valve replacement in Chinese patients differs from that in other races.Establishment of a pharmacist clinic provides vital assistance in warfarin dose adjustment.

Hepatoprotective Activity of Yigan Mingmu Oral Liquid against Isoniazid/Rifampicin-Induced Liver Injuries in Rats

Background: To explore the hepatoprotective effect of Yigan mingmu oral liquid (YGMM) on isoniazid-rifampicin induced liver injury in rats. Methods: Total 38 SD rats were randomly divided into 6 groups including control group, model group, silymarin positive control group, and three YGMM treatment groups. Model group was administered intragastrically with INH (100 mg/kg) and RIF (100 mg/kg) for 14 days. Silymarin group and YGMM treatment groups were administered intragastrically with silymarin (100 mg/kg) and different doses of YGMM (1, 2.5, 5 mg/kg) 2 hours before INH and RIF administration from day 4 to day 14.?Results: Rats were sacrificed 16 hours after the last day treatment to determine the activities of serum alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), as well as total bilirubin (TB) content. Oxidative stress was evaluated by measuring total superoxide dismutase (T-SOD) and malondialdehyde (MDA) levels. Histopathological changes in liver tissues were observed under an optical microscope by using hematoxylin and eosin staining. The mice?in model groups showed significantly (p < 0.05) increased levels in AST, ALT, ALP, TB and MDA compared to their control groups;and showed significantly (p < 0.05) decreased level in T-SOD. These changes were significantly (p < 0.05) reversed by the YGMM treatments in a dose-dependent manner. Hepatic pathological changes were attenuated or even reversed by silymarin or YGMM treatments. Conclusions: YGMM has a good hepatoprotective activity on isoniazid-rifampicin induced liver injuries in rats.

Rifampicin for COVID-19

Vaccinations for coronavirus disease-2019(COVID-19)have begun more than a year before,yet without specific treatments available.Rifampicin,critically important for human medicine(World Health Organization’s list of essential medicines),may prove pharmacologically effective for treatment and chemoprophylaxis of healthcare personnel and those at higher risk.It has been known since 1969 that rifampicin has a direct selective antiviral effect on viruses which have their own RNA polymerase(severe acute respiratory syndrome coronavirus 2),like the main mechanism of action of remdesivir.This involves inhibition of late viral protein synthesis,the virion assembly,and the viral polymerase itself.This antiviral effect is dependent on the administration route,with local application resulting in higher drug concentrations at the site of viral replication.This would suggest also trying lung administration of rifampicin by nebulization to increase the drug’s concentration at infection sites while minimizing systemic side effects.Recent in silico studies with a computer-aided approach,found rifampicin among the most promising existing drugs that could be repurposed for the treatment of COVID-19.

Cellular toxicity of isoniazid together with rifampicin and the metabolites of isoniazid on QSG-7701 hepatocytes

Objective:To investigate the cellular toxicity of isoniazid together with rifampicin and the metabolites of isoniazid on cultured QSG-7701 cells lines.Methods:Isoniazid,rifampicin, mixture of rifampicin and isoniazid,acetylhydrazine,hydrazine were added in cultural media of QSG-7701 cells and cultured for 48 hours.The survival rate of cells was determined by MTT method.The cultural media and cells were collected and the activity of lactate dehydrogenase was detected by chromatometry.Results:Compared with control group,the survival rate decreased significantly and the lactate dehydrogenase released from cell increased significantly in cells treated with isoniazid,rifampicin,acetylhydrazine,hydrazine.Hydrazine,the metabolite of isoniazid produced significant damage on hepatocytes in low concentration.Conclusions: Rifampicin together with rifampicin and metabolites of isoniazid produce cellular toxic effects and hydrazine may be the most toxiferous metabolite.

Effects of intraocular rifampicin on retinal ganglion cell structure:a stereological and histopathological study

AIM:To determine the histopathological changes of rifampicin applied intravitreally on retinal ganglion cells by means of stereological and histopathological methods.METHODS:For this study twenty-four New Zealand adult rabbits were divided into four groups(n=6 for each group).50μg/0.1mL(group 1),100μg/0.1mL(group 2),150μg/0.1mL(group 3) and 200μg/0.1mL(group 4),rifampicin were injected into the vitreous of the right eyes of animals,their left eyes were used as control(group 5).After the 28thday of application,animals were anesthetised with xylazine(8mg/kg,IM) and then their eyes were enucleated immediately.Patterns were taken away and eyes were prepared for both stereological and electromicroscopic observation.RESULTS:Depending on the high dose of rifampicin,some histopathological changes such as cytoplasmic dilatation and damaged membrane were observed on the electromicroscopic level.Using quantitative examination,which was done at the light microscopic level,it was shown that the number of neurons decreased linearly as rifampicin dose increased when compared with the control group.CONCLUSION:Based on these findings,low-dose rifampicin(50μg/0.1mL) may be useful for treatment of the ocular diseases.

SLCO1B1, NAT2 Polymorphisms and Pharmacokinetic Variability of Rifampicin and Isoniazid in Tuberculosis Patients from Sub-Saharan Africa

SLCO1B1 and NAT2 polymorphisms have been associated with the variability of Rifampicin and Isoniazid pharmacokinetic (PK). The objective of this study was to identify in African patients with tuberculosis (TB) or TB/HIV co-infection, the SLCO1B1 and NAT2 polymorphisms, associated with the variability of Rifampicin and Isoniazid pharmacokinetic. TB or TB/HIV co-infected patients from Benin, Guinea, Senegal, and South Africa were included in this study. The blood samples collected were stored at -80&#730C until DNA extractions. The DNA extracts were then frozen at -80&#730C after quality control. Double stranded DNA of the samples were quantified using a fluorimetric method to select suitable samples for the preparation of 96-well microplates, containing 100 μl of DNA extract per well at the concentration of 20 ng/μl. Illumina HumanOmniExpress-24 v1.2 microarray genotyping was performed by an external vendor. The genotyping data were analyzed and the polymorphisms with a call rate < 95% or presenting a departure from the Hardy-Weinberg Equilibrium (HWE) were excluded. The correlation between significant genetic polymorphisms, the clearance, and the AUC were tested by a multiple linear regression model using the PLINK2 software. Out of 385 samples, five (05) were excluded after quality controls. After the frequency test, 384,586 SNPs failed the Hardy-Weinberg Equilibrium. Finally, 378 samples and 318,751 SNPs were included in the genetic analyses. The SLCO1B1 and NAT2 polymorphisms were associated with the variability of Rifampicin and Isoniazid PK parameters. There are SLCO1B1 and NAT2 polymorphisms carriers among TB and TB/HIV co-infected patients from Sub-Saharan Africa.

Effect of Rifapentine and Rifampicin on Anti-Tuberculosis

Objective: To investigate the clinical effect of rifapentine and rifampicin in the treatment of pulmonary tuberculosis. Methods: Seventy-two cases of patients with initial treatment of pulmonary tuberculosis who attended the First Hospital Affiliated to Hebei North University from February 2017 to August 2019 were selected. They were randomly divided into observation group and control group, with 36 cases in each group. The observation group was treated with isoniazid + rifapentine + ethambutol, while the control group was treated with isoniazid + rifampicin + ethambutol. The symptom relief, image absorption and adverse reactions were compared between the two groups. Results: The rate of symptom relief was 86.11% in the observation group and 94.44% in the control group, P < 0.05, which was statistically significant. Rifampin was more helpful than rifapentine in relieving clinical symptoms. The lesion absorption rate was 77.79% in the observation group and 88.89% in the control group, P < 0.05, and the difference was statistically significant. Rifampin was more beneficial to the absorption of TB lesions than rifapentine. The incidence of adverse reactions in the observation group was 16.67% much lower than that in the control group, which was 38.89%, indicating that the adverse reactions of rifapentine were less. Conclusion: Rifampicin is superior to rifapentine in clinical symptom relief and lesion absorption, but the incidence of adverse reactions is high.

Prevalence of Mycobacterium tuberculosis Strains Isolated from Both Pulmonary and Extra Pulmonary Samples and Their Resistance to Rifampicin: A Study from Kolkata and Surrounding Suburbs

Tuberculosis (TB) is one of the major causes of morbidity and mortality worldwide. In India, nearly 1.8 million new cases of TB are reported annually, which accounts for a fifth of new cases in the world—greater than in any other country. Anti-tubercular drugs (ATDs) have been used for decades, and widespread resistance to them is a very serious public health concern in any part of the world. Aim of this study was to determine the prevalence of Rifampicin (the first line Anti-TB drug) resistance among both pulmonary and extra-pulmonary samples tested positive for Mycobacterium tuberculosis and thereby predict the prevalence of Multi-drug resistant (MDR) tuberculosis in Kolkata and its Suburban regions. All 331 randomly collected clinical samples (both Pulmonary and Extra Pulmonary) were initially screened by Zeihl-Neelsen AFB staining followed by culture on BacT/Alert 3D system and on Lowenstein-Jensen medium and the positive samples were subjected to detection of Mycobacterium tuberculosis complex (MTBC) and simultaneous analysis of Rifampicin resistance by Xpert MTB/RIF assay. Out of the 51 (15.40%) culture positive samples, 13.7% of pulmonary samples and 9.09% of extra-pulmonary samples were Rifampicin resistant. The prevalence of Rifampicin resistant TB in our study is high and the possible reasons can be mixing of new as well as retreatment cases and smaller sample size but, yet it can help Government and public health regulatory bodies to formulate adequate strategies to fight against drug resistant tuberculosis, especially in this part of the world.

Hepatoprotective and antioxidant activity of ethanolic extract of Artabotrys odoratissimus stem on rifampicin-induced hepatotoxicity in rats

The area of the existing examination was to explore the cancer prevention agent and hepatoprotective action of ethanolic stem concentrate of Artabotrys odoratissimus in rifampicin caused hepatotoxicity in albino wister rodents.The material was dehydrated in gloom;they were powdered,extricated with ethanol later primer phytochemical tests were finished.The hepatoprotective action of the ethanol extract was evaluated in albino wister rodents.Rifampicin(100 mg/kg)has upgraded the degrees of different biochemical markers of the liver like serum glutamic oxaloacetic transaminase,serum glutamate pyruvate transaminase,aspartate alkaline phosphatase and bilirubin.The different biochemical and histopathological examinations have done were aspartate alkaline phosphatase,aminotransferase,alanine transaminase,bilirubin,cell reinforcement movement by 1,1-diphenyl 2-picryl hydrazyl,nitro blue tetrazolium,hydrogen peroxide,lipid perioxidation,hydroxyl revolutionary and nitric oxide techniques.Treatment of ethanolic concentrate of the stem of Artabotrys odoratissimus(100 mg/kg,200 mg/kg and 400 mg/kg)has brought back the changed degrees of biochemical markers to the close ordinary levels in the portion subordinate way.Our discoveries proposed that Artabotrys odoratissimus ethanol stem extricate had an intense cell reinforcement and hepatoprotective action.

Possible agent for COVID-19 treatment:Rifampicin

Rifampicin is a promising drug for the treatment of coronavirus disease 2019 based on its antiviral properties and recent in silico studies.In silico studies can serve as a foundation for further studies.

Rapid Molecular Detection of Tuberculosis and Rifampicine Resistance in Ecuador

Background: In Ecuador, tuberculosis (TB) remains a serious problem that is complicated by the emergence of multidrug-resistant TB (MDR-TB). To evaluate this problem, this study was carried out at the Social Security Hospital (IESS) in Guayaquil, Ecuador from 2013 to 2015. Methods: The Xpert TB/RIF system was used to detect TB and MDR-TB and a survey was carried out to identify the factors that are potentially causing MDR-TB. Findings: 200 TB patients were confirmed on 5649 suspected patients and 20 (10%) with MDR-TB. It was observed that the annual prevalence of TB and MDR-TB had declining during study period. Trends have been declining but co-infection has doubled since 2009 with 16% of patients co-infected with HIV. Potential resistance factors identified were: disruption in drug supply, lack of resources and lack of credibility of treatment.

Effect of garlic on isoniazid and rifampicin-induced hepatic injury in rats

瞄准：为了在肝损伤上评估大蒜的 hepatoprotective 效果，由异菸肼(ZNH ) 和 rifampicin (RIF ) 导致了。方法：称 150-200 g 的 Wistar 老鼠为 28 d 与 INH 和 RIF 每日的各个的 50 mg/kg 口头上地被对待。为 hepatoprotective 研究， 0.25 g/kg 口头上地每刚准备的大蒜匀浆的天被管理在 INH+RIF 剂量前的半个小时。浆液丙氨酸 aminotransferase (中高音) ， aspartate aminotransferase (著名计算机生产厂商) 和胆红素在 d 上被估计 0， 14， 21，和 28 在所有老鼠。组织学的分析被执行估计损害到肝。每氧化(LPO ) ，作为氧化应力和非蛋白质的一个标记，为抗氧化剂的 thiols (谷胱甘肽) 铺平的类脂化合物在肝匀浆被测量。结果：有 INH+RIF 的老鼠的处理(50 mg/kg 每天每) 在由提高的浆液中高音，著名计算机生产厂商，和胆红素判定了的所有对待的动物的导致的 hepatotoxicity 铺平，焦点的 hepatocytic 坏死(6/8 ) 的存在和门 triaditis (8/8 ) 。同时每天在 0.25 g/kg 的剂量管理的大蒜在 INH+RIF 阻止了组织病理学说的损害的正式就职共同对待的动物除了在 4 个动物，它显示出仅仅中等的门 triaditis。组织学的变化在 INH+RIF 与氧化应力相关对待的动物。作为与 INH+RIF 相比与谷胱甘肽(P【0.05 ) 和 LPO (P【0.05 ) 的底层高级的显示出的 INH+RIF 一起每天大蒜匀浆收到了 0.25 g/kg 的组对待组。结论：刚准备的大蒜匀浆在实验动物模型免于导致 INH+RIF 的肝损伤。