ABSTRACT
Background. Antituberculosis multidrug regimens have been associated with increased incidence of adverse drug reactions (ADRs). This study aimed to determine the incidence and associated factors of ADRs due to antituberculosis therapy. Methods. This is a retrospective cross-sectional study on tuberculosis patients who were treated in tuberculosis clinics in Markazi province in Iran. The information contained in the medical files was extracted and entered into the questionnaire. Data was descriptively analyzed by using statistical package for social sciences (SPSS 18). Results. A total of 940 TB patients of 1240 patients' medical records available in 10 medical offices were included in this study. Of the 563 ADRs found in this study, 82.4% were considered minor reactions and 17.6% were major reactions. No death from antituberculosis ADR was observed. We found that the risk of major ADRs was higher in females (P value = 0.0241), age >50 y (P value = 0.0223), coinfection with HIV (P value = 0.0323), smoking (P value = 0.002), retreatment TB (P value = 0.0203), and comorbidities (P value = 0.0005). Conclusions. This study showed that severe side effects of anti-TB drugs are common in patients who have risk factors of ADRs and they should be followed up by close monitoring.
ABSTRACT
OBJECTIVES: The utilization of molecular techniques in the epidemiology of tuberculosis have provided an opportunity for using effective markers to trace the transmission of the disease. The purpose of this study was to compare the genetic patterns of Mycobacterium tuberculosis by three methods of RFLP technique. MATERIALS AND METHODS: In a cross-sectional and prospective study, 95 strains of M. tuberculosis isolates were selected for DNA fingerprinting. Extraction of DNA from Mycobacterium strains and DNA fingerprinting with IS-6110, PGRS and DR probe were performed by standard protocols. RESULTS: Overall, the diversity of RFLP among 95 tuberculosis patients were 48, 50 and 45 on the basis of IS6110, PGRS and DR patterns, respectively. Twenty of these patterns (21.1%) with IS6110-RFLP, twenty-two (23.2%) with PGRS-RFLP and seventeen (17.9%) with DR-RFLP occurred with unique RFLP patterns, whereas the remaining 28 patterns were communal. The risk factors of clustering among tuberculosis patients were age < 45 years, new cases, degree of sputum smear ≥ 2+, and close contact. CONCLUSION: Our study demonstrated that IS6110-RFLP, PGRS-RFLP and DR-RFLP genotyping could roughly identify similar proportions of clustered (secondary) cases as well as the same risk factors for clustering.
ABSTRACT
BACKGROUND: Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. OBJECTIVES: This study aimed to assess the efficacy of adjunctive coenzyme Q10 (CoQ10) in the treatment of elderly CAP. PATIENTS AND METHODS: Hospitalized elderly patients with CAP (diagnosed by using defined clinical and radiological criteria) were randomized to receive oral CoQ10 (200 mg/d) or placebo for 14 days, along with antibiotics. Primary and secondary outcomes on days 3, 7, and 14 were measured. Disease severity was scored using CURB-65 index. Statistical analysis was performed using SPSS and P value < 0.05 was considered significant. RESULTS: We enrolled 150 patients for this research. Then, 141 patients, including 70 patients in the trial group and 71 patients in the control group were analyzed. Mean age of the trial and control groups were 67.6 ± 7.2 years and 68.7 ± 7.9 years, respectively. Clinical cure at days 3 and 7 were 24 (34.3%) and 62 (88.6%) in the trial group (P value = 0.6745) and 22 (31%) and 52 (73.2%) in the placebo group (P value = 0.0209). Patients on CoQ10 had faster defervescence (P value = 0.0206) and shorter hospital stay (P value = 0.0144) compared with the placebo group. The subgroup analysis of the patients with severe pneumonia showed differences in clinical cure at day 14. Treatment failure was less in CoQ10 group than in the placebo group (10% versus 22.5% and P value = 0.0440). Adverse events in two groups were few and similar. CONCLUSIONS: CoQ10 administration has no serious side effects and can improve outcome in hospitalized elderly CAP; therefore, we recommend it as an adjunctive treatment in elderly patients.
