Efficacy and safety of a single-tablet regimen containing tenofovir disoproxil fumarate 300 mg, lamivudine 300 mg and efavirenz 400 mg as a switch strategy in virologically suppressed HIV-1-infected subjects on nonnucleoside reverse transcriptase inhibitor-containing first-line antiretroviral therapy in Pune, India.

OBJECTIVES: As per National AIDS Control Organization (NACO) estimates, there are 2.1 million people living with HIV (PWH) in India, of whom 1.2 million are on first-line antiretroviral therapy (ART). This study explored the use of a single-tablet regimen containing tenofovir disoproxil fumarate 300 mg + lamivudine 300 mg + efavirenz 400 mg (TLE400 STR) as a first-line switch strategy in PWH in Pune, India. METHODS: This retrospective cohort study was conducted in private sector ART clinics in three tertiary-level hospitals in Pune, India. PWH > 12 years of age (n = 502) who initiated first-line ART (predominantly TLE600 STR), completed ≥ 6 months of follow-up and achieved virological suppression [plasma viral load (VL) < 1000 HIV-1 RNA copies/mL] were identified and switched to TLE400 STR. The virological and immunological efficacy of TLE400 STR at 6 and 12 months of follow-up were noted. Grade 3/4 adverse events (especially efavirenz-related neuropsychiatric adverse events) leading to regimen discontinuation were also noted. RESULTS: Of 502 PWH who switched to TLE400 STR, complete virological suppression (VL < 20 copies/mL) was maintained in more than 97% of patients at follow-up. TLE400 STR was successful in maintaining CD4 counts within the range observed at the start of the regimen. Grade 3/4 adverse events leading to TLE400 STR discontinuation were seen in 11 (2.2%) patients. Virological failure (VL > 1000 copies/mL) and treatment regimen failure were seen in six (1.2%) and 49 (9.8%) subjects, respectively. CONCLUSIONS: TLE400 STR exhibits excellent efficacy and safety as a switch strategy and should be introduced in the Indian National ART Program, especially for PWH who are virologically suppressed on TLE600 STR.

The use of solar energy for powering a portable autoclave.

Climate change and the depletion of fossil fuels have forced the developed world to look for clean energy alternatives. Solar cooking is developing in Asian and African countries blessed with ample sun, but is still at an early stage. A portable autoclave was developed in India using this technology. The Prince-40 Concentrator provided adequate capacity to autoclave culture media and treat biomedical waste in a small laboratory set-up, and could save electricity worth Rs. 15,000 (188.10 GBP)/year or LPG worth Rs. 37,500 (470.25 GBP)/year. This technology would be of immense use in health centres in rural areas with frequent power cuts or no power supply.

Gastroenteritis due to Vibrio cholerae El-Tor Ogawa in Dhule.

For V. Cholerae isolation, stool sample is better than rectal swab. Direct oxidase test on stool is easy and reliable. V. cholerae El-Tor Ogawa is predominant type in Dhule area. New phage type T27 was reported. Tetracyclin resistance needs further studies.

Differential identification of Mycobacterium tuberculosis from various clinical specimens from Sassoon General Hospital, Pune.

A total of 619 clinical specimens from cases of pulmonary and extrapulmonary tuberculosis were processed by smear, culture and biochemical tests. Acid fast bacilli could be demonstrated in 93 samples (15.02%) by Z.N. staining method. Culture yielded positive growth in 95 samples (15.35%) M. tuberculosis human type was the most predominient pathogen obtained from 82 cultures (13.40%) M tuberculosis bovine type was isolated from 2 cases of ascitic fluids (0.32%). Atypical Mycobacteria were isolated from 11 samples (1.73%). 5 turned out to be M. scrofulacium, 4 were M. Kansasii, 1 was M. phlei and 1 was M. smegmatis.

Osteomyelitis: a rare complications of Salmonella senftenberg infection--a case report.

A case of chronic osteomyelitis is rare complication of salmonella senftenberg infection and is reported.

Salmonella newport isolations from a general hospital in Pune.

Salmonella newport had not been reported from the Pune (Maharashtra) area till 1983. After the first isolate in 1984, the isolation rate showed a significant increase. A total of 64 isolates todate (two isolates in 1984, six in 1985 and 56 in 1986) have been encountered at Sassoon General Hospital, Pune. It has been commonly isolated from adults (54.7 per cent). Most of the strains were multi-drug resistant.