First-Line Drug Resistance Patterns of Mycobacterium tuberculosis Complex Isolates from Re-Treatment Patients from Sudan

Drug susceptibility testing (DST) plays a pivotal role in TB patients’ management leading to the selection of most effective drugs. This study aimed to determine resistance patterns to first line anti-TB drugs in Mycobacterium tuberculosis isolates from re-treated patients from Sudan. A total of 239 sputum specimens were collected from smear positive re-treatment TB patients during the period from July 2009 to July 2010. Specimens were pre-treated according to Petroff method. The recovered isolates were tested for sensitivity to first line anti-TB drugs by the 1% proportion method. One hundred and forty three (143/239, 59.8%) mycobacterial isolates were successfully recovered. The majority (98.6%, 141/143) of the isolates were Mycobacterium tuberculosis complex strains. Two strains (2/143, 1.4%) were identified as RIF/INH-resistant MOTT, while fifty four isolates (38.3%, 54/141) were MDR. Multi- drug resistant Mycobacterium tuberculosis complex (MDR-TB) among re-treatment patients from national referral centers for tuberculosis diagnosis and management was considerably high in the study isolates.

Risk factors of regression and undercorrection in photorefractive keratectomy: a case-control study

AIM: To determine risk factors of regression and undercorrection following photorefractive keratectomy (PRK) in myopia or myopic astigmatism. METHODS: A case -control study was designed in which eyes with an indication for re-treatment (AT) were defined as cases; primary criteria for RT indication, as assessed at least 9mo postoperatively, included an uncorrected distance visual acuity (UDVA) of 20/30 or worse and a stable refraction for more than 3mo. Additional considerations included optical quality symptoms and significant higher order aberrations (HOAs). Controls were chosen from the same cohort of operated eyes which had complete post-operative follow up data beyond 9mo and did not need RT. The cohort included patients who had undergone PRK by the Tissue-Saving (TS) ablation profile of Technolas 217z100 excimer laser (Bausch & Lomb, Rochester, NY, USA). Mitomycin C had been used in all of the primary procedures. RESULTS: We had 70 case eyes and 158 control eyes, and they were comparable in terms of age, sex and follow -up time (P values: 0.58, 1.00 and 0.89, respectively). Pre-operative spherical equivalent of more than -5.00 diopter (D), intended optical zone (OZ) diameter of less than 6.00 mm and ocular fixation instability during laser ablation were associated with AT indications (all P values <0.001). These factors maintained their significance in the multiple logistic regression model with odd ratios of 6.12, 6.71 and 7.89, respectively. CONCLUSION: Higher refractive correction (>-5.00 D), smaller OZ (<6.00 mm) and unstable fixation during laser ablation of PRK for myopia and myopic astigmatism were found to be strong predictors of undercorrection and regression.

Vitamin E treatment for children with chronic hepatitis B:A randomized placebo controlled trial

AIM:To evaluate the safety and efficacy of vitamin E in children with chronic hepatitis B.METHODS:We randomly assigned patients with chronic hepatitis B,positive for hepatitis B e antigen(HBeAg),to receive either vitamin E or placebo once daily for 6 mo in a 3:1 ratio and double-blind manner.The primary end point was HBeAg seroconversion,defined as the loss of HBeAg,undetectable levels of serum hepatitis B virus DNA,and the appearance of antibodies against HBeAg 12 mo after therapy.RESULTS:At baseline visit,49 patients had normal and 43 had increased serum aminotransferase levels.Twenty-nine patients did not respond to previous treatment with interferon-α or lamivudine.Seventy-six children completed the study;16 were non-compliant(n = 7),lost to follow-up(n = 7),or started another antiviral treatment(n = 3).Intention-to-treat analysis showed HBeAg seroconversion in 16 children(23.2%) treated with vitamin E and two(8.7%) in the placebo group(P = 0.13).Vitamin E was well tolerated.CONCLUSION:There is only a tendency that vitamin E may promote HBeAg seroconversion.Therefore larger studies are needed to clarify the role of antioxidants in the therapy of chronic hepatitis B.