GeneXpert assay for rapid detection of Mycobacterium tuberculosis complex in respiratory specimens from a high TB endemic area of Pakistan.

Tuberculosis is a global health problem, and its early diagnosis is the ultimate strategy for prevention and control. The current study was undertaken to evaluate conventional and molecular diagnostic assays for the detection of mycobacteria in pulmonary tuberculosis (TB) patients from Khyber Pakhtunkhwa region of Pakistan. A total of 259 clinically suspected patients of TB were processed for Zeihl Neelsen (ZN) microscopy, BACTEC MGIT liquid culture and GeneXpert assay. Among 259 samples, 28 (10.81%) were positive for acid fast bacilli (AFB) on ZN microscopy. In liquid culture, the growth of mycobacterium species was obtained in 36 (13.89%) samples while the GeneXpert assay detected Mycobacterium tuberculosis (MTB) in 49 (18.91%) samples. Detection rate of MTB was significantly high (n = 49, p < 0.0095) on GeneXpert as compared to microscopy (n = 28); however no significant difference (p = 0.1230) was observed on GeneXpert (n = 49) and culture (n = 36) based detection of MTB. The strength of agreement between GeneXpert and microscopy was also poor (Kappa value < 0.114, 95% CI: -0.72 - 0.301) which support our results. MTB detection rate among female was high as compared to male TB patients while in age wise, the age group 55-64 years has almost high detection rate on microscopy, culture and GeneXpert assay. Findings of the present study highlighted that GeneXpert is more efficient tool for timely diagnosis and proper TB control in high TB endemic area.

Relationship Between Cardiometabolic Index in Early Pregnancy and Hypertensive Disorder Complicating Pregnancy.

Background This study aimed to examine the cardiometabolic index during early pregnancy in individuals with hypertension-complicating pregnancy, especially preeclampsia. Additionally, this study sought to determine the relationship between cardiometabolic index and the incidence of varying degrees of preeclampsia. Methodology This study included 289 pregnant women diagnosed with preeclampsia who were registered and delivered at our hospital. These women were assigned to the preeclampsia group. Additionally, a group of 289 healthy pregnant women of identical gestational ages within the same time frame was included for comparison. Clinical data on pregnancy, including body mass index (BMI), blood pressure, waistline, triglyceride levels, and cardiometabolic index, were compared between the two groups. An analysis was conducted to examine the association between early pregnancy cardiometabolic index and the occurrence of preeclampsia. Results There was a significant association between the quartile of cardiometabolic index and the proportion of preeclampsia patients (p < 0.001). Furthermore, after controlling for age and BMI, the risk of preeclampsia remained significantly elevated and was associated with the cardiometabolic index. Conclusions A positive correlation was observed between cardiometabolic index during early pregnancy and the occurrence of preeclampsia.

Molecular detection of rifampicin resistance by GeneXpert® assay among treated and untreated pulmonary tuberculosis patients from Khyber Pakhtunkhwa, Pakistan.

OBJECTIVES: Drug-resistant tuberculosis (TB) is an emerging health problem. Rifampicin (RIF) is the major first-line drug against TB. RIF resistance can be used as a marker for the detection of multidrug-resistant TB (MDR-TB). The purpose of this study was to determine the RIF resistance pattern of Mycobacterium tuberculosis complex isolates among treated and untreated patients in Khyber Pakhtunkhwa, Pakistan. METHODS: A total of 349 drug-treated and untreated TB-diagnosed patients were enrolled in this study. RIF resistance was detected using a GeneXpert® assay for amplification of the RIF resistance-determining region (RRDR) region of the rpoB gene. RESULTS: The overall prevalence of RIF resistance was 5.2% (18/349). Among 49 untreated TB patients, 3 samples (6.1%) were found resistant to RIF. Among 235 patients with a category 1 treatment regimen, 10 samples (4.3%) were resistant to RIF, whilst among 65 patients with a category 2 (Cat-2) treatment regimen, 5 samples (7.7%) were resistant to RIF. A comparison based on patient sex revealed high RIF resistance among male compared with female patients. RIF resistance was highest (4/21; 19.0%) in the 21-40 years age group among Cat-2 patients. CONCLUSIONS: The overall prevalence of RIF resistance was high among treated and untreated TB patients. These findings will be helpful for better monitoring and management of RIF resistance in TB patients from Khyber Pakhtunkhwa, Pakistan.