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1.
Iran J Microbiol ; 16(4): 459-469, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39267928

RESUMO

Background and Objectives: Rifampicin (RIF) and isoniazid (INH), two most potent antibiotics, are prescribed to cure tuberculosis. Mycobacterium tuberculosis, the causative agent of multidrug-resistant tuberculosis (MDR-TB), is resistant to these first-line drugs. Here, two molecular techniques were demonstrated such as PCR sequencing-based and GeneXpert assay for rapidly identifying MDR-TB. Materials and Methods: Pulmonary samples (sputum) were collected from 55 MDR-TB suspected patients from the National Tuberculosis Reference Laboratory (NTRL), Dhaka where the research work was partially accomplished and continued in the department of Microbiology, University of Dhaka, Bangladesh. We strived for sequencing technique as well as GeneXpert assay to identify mutations in rpoB and katG genes in MTB strains and sputum directly. Culture-based drug susceptibility testing (DST) was performed to measure the efficacy of the molecular methods employed. Results: When analyzed, rpoB gene mutations at codons 531 (54.54%), 526 (14.54%), and 516 (10.91%) were found by sequencing in 80% of the samples. Nucleotide substitution at katG315 (AGC→ACC) was spotted in 16 (76.19%) out of 21 samples. When comparing the sequencing results with DST, sensitivity and specificity were investigated to determine drug-resistance (rifampicin-resistance were 98 and 100% whereas isoniazid-resistance were 94 and 100% respectively). Additionally, as a point of comparison with DST, only 85.45% of RIF mono-resistant TB cases were accurately evaluated by the GeneXpert assay. Conclusion: This research supports the adoption of PCR sequencing approach as an efficient tool in detecting MDR-TB, counting the higher sensitivity and specificity as well as the short period to produce the results.

2.
BMC Infect Dis ; 18(1): 303, 2018 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-29973153

RESUMO

BACKGROUND: We have previously shown that 8 weeks' treatment with phenylbutyrate (PBA) (500mgx2/day) with or without vitamin D3 (vitD3) (5000 IU/day) as host-directed therapy (HDT) accelerated clinical recovery, sputum culture conversion and increased expression of cathelicidin LL-37 by immune cells in a randomized, placebo-controlled trial in adults with pulmonary tuberculosis (TB). In this study we further aimed to examine whether HDT with PBA and vitD3 promoted clinically beneficial immunomodulation to improve treatment outcomes in TB patients. METHODS: Cytokine concentration was measured in supernatants of peripheral blood mononuclear cells (PBMC) from patients (n = 31/group). Endoplasmic reticulum stress-related genes (GADD34 and XBP1spl) and human beta-defensin-1 (HBD1) gene expression were studied in monocyte-derived-macrophages (MDM) (n = 18/group) from PBMC of patients. Autophagy in MDM (n = 6/group) was evaluated using LC3 expression by confocal microscopy. RESULTS: A significant decline in the concentration of cytokines/chemokines was noted from week 0 to 8 in the PBA-group [TNF-α (ß = - 0.34, 95% CI = - 0.68, - 0.003; p = 0.04), CCL11 (ß = - 0.19, 95% CI = - 0.36, - 0.03; p = 0.02) and CCL5 (ß = - 0.08, 95% CI = - 0.16, 0.002; p = 0.05)] and vitD3-group [(CCL11 (ß = - 0.17, 95% CI = - 0.34, - 0.001; p = 0.04), CXCL10 (ß = - 0.38, 95% CI = - 0.77, 0.003; p = 0.05) and PDGF-ß (ß = - 0.16, 95% CI = - 0.31, 0.002; p = 0.05)] compared to placebo. Both PBA- and vitD3-groups showed a decline in XBP1spl mRNA on week 8 (p < 0.03). All treatment groups demonstrated increased LC3 expression in MDM compared to placebo over time (p < 0.037). CONCLUSION: The use of PBA and vitD3 as adjunct therapy to standard TB treatment promoted favorable immunomodulation to improve treatment outcomes. TRIALS REGISTRATION: This trial was retrospectively registered in clinicaltrials.gov, under identifier NCT01580007 .


Assuntos
Tuberculose Pulmonar/imunologia , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Adulto , Peptídeos Catiônicos Antimicrobianos/metabolismo , Colecalciferol , Citocinas/sangue , Estresse do Retículo Endoplasmático , Feminino , Humanos , Leucócitos Mononucleares , Macrófagos/imunologia , Masculino , Pessoa de Meia-Idade , Fenilbutiratos , RNA Mensageiro , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose Pulmonar/tratamento farmacológico , Adulto Jovem , beta-Defensinas , Catelicidinas
3.
Eur J Contracept Reprod Health Care ; 17(2): 144-54, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22242676

RESUMO

OBJECTIVES: To investigate the socioeconomic determinants of childbearing and contraceptive use among married adolescents in Bangladesh. METHODS: The study used the Bangladesh Demographic and Health Survey 2007 data. Both bivariate and multivariate statistical analyses were used to examine the association between the socioeconomic factors and childbearing and contraceptive use among married female adolescents. RESULTS: Overall, 69% of the married adolescents initiated childbearing and 25% of the most recent pregnancies were unintended. The current contraceptive prevalence rate was 42%. The multivariate logistic regression yielded a significantly increased risk of childbearing among adolescents with no formal education, those who were married-off before age 16, the poor and those who had ever used any contraceptive method. Inter-spousal communication on family planning (FP) appeared as the most single significant determinant of any contraceptive use. Number of living children, working status and visitations by FP workers are also important determinants of contraceptive use among the married female adolescents. CONCLUSIONS: Early childbearing, lower use rate of contraceptive methods and unintended pregnancies are common among married adolescents in Bangladesh. Expanded schooling and reproductive health programmes in Bangladesh should promote increased communication about FP within the couples in order to achieve successful contraception and better reproductive outcomes, particularly among adolescents.


Assuntos
Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar , Casamento , Parto , Adolescente , Bangladesh , Anticoncepção/psicologia , Feminino , Humanos , Modelos Logísticos , Pobreza , Gravidez , Fatores Socioeconômicos , Cônjuges , Adulto Jovem
4.
Malays J Nutr ; 17(1): 105-18, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22135870

RESUMO

INTRODUCTION: Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. METHODS: The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. RESULTS: Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father's education, toilet facilities, child's age, birth order of children and wealth index were also important determinants of children's nutritional status. CONCLUSION: Development and poverty alleviation programmes should focus on the disadvantaged rural segments of people to improve their nutritional status.


Assuntos
Transtornos do Crescimento/epidemiologia , Bangladesh/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição Infantil/etiologia , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Recém-Nascido , Masculino , Estado Nutricional , População Rural , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários
5.
Malays J Nutr ; 16(2): 219-32, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22691927

RESUMO

This paper explores the relationship between household wealth and nutritional status of pre-school children in Bangladesh using the nationally representative 2007 Bangladesh Demographic and Health Survey data. Chronic malnutrition was measured by z-score of height-for-age and the effect of household wealth on adverse childhood growth rate was assessed by multivariate logistic regression analyses. Overall, 43% of the children were stunted. The multivariate binary logistic regression analysis yielded significantly increased risk of stunting among the poorest (OR=2.26, 95% CI=1.77-2.89) as compared to the richest. The multivariate multinomial logistic regression produced elevated risk of moderate stunting (OR=1.98, 95% CI=1.50-2.61) and severe stunting (OR=2.88, 95% CI=2.00-4.14) of children in the poorest category compared to their richest counterparts. Children's age, duration of breastfeeding, mother's education, body mass index, mother's working status and place of region were also identified as important determinants of children's nutritional status. The findings suggest that apart from poverty reduction, maternal education, and strengthening of child and maternal health care services are important to improve health and nutritional status of the children.

6.
Malays J Nutr ; 16(3): 349-59, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22691988

RESUMO

This paper examines the prevalence and socio-economic correlates of malnutrition among ever married non-pregnant women of reproductive age of Bangladesh using a nationally representative weighted sample of 10,145. Body mass index was used to measure nutritional status. Both bivariate and multivariate statistical analyses were employed to assess the relationship between socio-economic characteristics and women's nutritional status. Overall, 28.5% of the women were found to be underweight. The fixed effect multivariate binary logistic regression analysis yielded significantly increased risk of underweight for the young, currently working, non-Muslim, rural residents, widowed, divorced or separated women. Significant wide variations of malnourishment prevailed in the administrative regions of the country. Wealth index and women's education were the most important determinants of underweight. The multivariate logistic regression analysis revealed that the risk of being underweight was almost seven times higher (OR=6.76, 95% CI=5.20-8.80) among women with no formal education as compared to those with higher education and the likelihood of underweight was significantly (p<0.001) 5.2 times (OR=5.23, 95% CI=4.51-6.07) in the poorest as compared to their richest counterparts. Poverty alleviation programmes should be strengthened targeting the poor. Effective policies, information and health education programmes for women are required to ensure adequate access to health services and for them to understand the components of a healthy diet.

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