Assessment of protective role of polyherbal preparation, Livina, against anti-tubercular drug induced liver dysfunction
|
|
- Tracy Stewart
- 5 years ago
- Views:
Transcription
1 Indian Journal of Experimental Biology Vol. 48, March 2010, pp Assessment of protective role of polyherbal preparation, Livina, against anti-tubercular drug induced liver dysfunction Kavita Gulati, Arunabha Ray* & V K Vijayan Department of Pharmacology and Clinical Research Centre, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi , India Received 4 November 2009; revised 2 December 2009 The present study evaluated the possible protective role of Livina (a polyherbal preparation) against anti-tubercular therapy (ATT)-induced liver dysfunction in patients of pulmonary tuberculosis. Patients were given intensive phase treatment with 4-drugs (rifampicin, INH, pyrazinamide and ethambutol) used for anti-tubercular therapy for 2 months, followed by a 4-month continuous phase treatment with 2 drugs (rifampicin and INH) under clinical advice and supervision. Both qualitative and quantitative measures of liver function were assessed, at different time intervals, before and after ATT. Analysis of data showed that the incidence of qualitative manifestations of liver dysfunction were greater in the placebo treated group as compared to the test drug group. None of the patients of either group showed clinical jaundice. Most signific changes ant were observed in the SGOT and SGPT levels in the placebo group, wherein the levels of both enzymes were higher at 4 and 8 weeks post ATT, as compared to the respective baseline (0 week) values. When Livina (2 capsules twice daily) was given with ATT drugs, incidence of qualitative manifestation of liver dysfunction was insignificant and SGOT and SGPT levels were also significantly lower than the placebo+att drugs treated group. These results indicate that the test drug (Livina) was efficacious, against ATT-induced hepatic dysfunction in patients of pulmonary tuberculosis. Keywords: Anti-tubercular therapy, Hepatoprotection, Liver dysfunction, Livina, Polyherbal preparation Pulmonary tuberculosis (TB) is a commonly occurring respiratory infection and its incidence has increased globally in the past few years. Chemotherapy, with long term use of potent antimicrobial agents, is the mainstay in the management of this complex disease 1-2. However, anti-tubercular therapy (ATT) is associated with a plethora of adverse effects like hepatic dysfunction which often interferes with the course of antimicrobial therapy, that leads to lack of patient compliance and resultant discontinuation of ATT. This in turn could contribute significantly to inadequate cure and rising incidence of MDR-TB. Thus, it is of paramount importance to device strategies to ensure the successful completion of such chemotherapy. Further, there is also a pressing need to monitor and prevent occurrence of such drug-induced hepatic dysfunction and currently available modalities to counteract this problem are not satisfactory 3-5. Herbal drugs are fast emerging as alternate therapy in a variety of pathophysiological states and some *Correspondent author Telephone: Fax: arunabha14@yahoo.co.in phytopharmaceuticals have widely been reported to act as hepatoprotective agents. For example, medicinal plants like Picrorrhiza kurroa (kutki), Phyllanthis niruri (bhuyumamlaki), Andrographis paniculata (kalmegh), and Selebium marainum, have shown to confer differing degrees of protection to liver during chronic exposure to hepatotoxic agents Thus, hepatoprotective agents used in conjunction with ATT therapy may provide effective protection against liver dysfunction and enable TB infected patients to continue the entire course of ATT, that may result in lower morbidity and mortality rates. The present study was, thus, designed to study the possible protective effect of a polyherbal preparation, Livina, against ATT induced liver dysfunction in patients of pulmonary tuberculosis. Efficacy of Livina was assessed on the basis of qualitative and quantitative liver function test parameters in patients of pulmonary tuberculosis on short term (6-month) chemotherapy. Materials and Methods The study was randomized, single blind, prospective, parallel design, and placebo controlled. The study protocol was approved by the Institutional Ethical Committee of the Vallabhbhai Patel Chest
2 GULATI et al.: PROTECTIVE ROLE OF LIVINA AGAINST ANTI TUBERCULAR DRUG EFFECT 319 Institute, University of Delhi, and conducted according to the guidelines of the Declaration of Helsinki. Freshly diagnosed cases (18 60 years) of pulmonary tuberculosis attending the outpatients department of the Vallabhbhai Patel Chest Institute, University of Delhi, were enrolled for the study. Written informed consent was taken from all participants after explaining to them in detail about the drug, the objectives of the study and the necessary procedures that they have to undergo during the trial. Patients were diagnosed on the basis of clinical, radiological (X-ray) and microbiological (two out of three consecutive sputum samples were positive for AFB) findings. The exclusion criteria were: extra pulmonary tuberculosis, abnormal liver function tests, pregnancy, presence of Hepatitis B or HIV, current alcohol use, any other systemic disease, use of corticostreroids, silymarin or other hepatoprotective or immunomodulatory agents. Antitubercular drug regimen was given as per WHO recommended schedule and comprised of initial intensive phase therapy with four drugs for two months followed by a maintenance phase of four months using two drugs. All selected patients received rifampicin (450 mg) + isoniazid (300 mg) + ethambutol (800 mg) + pyrizinamide (1500 mg) as short course, intensive chemotherapy for 8 weeks. Forty eight patients were enrolled and divided in two groups and administered either placebo or the test drug (Livina), as per a computer generated randomization chart. There were 6 dropouts from the study at different stages of treatment. Out of the 42 remaining patients who completed the study, 22 patients had received the test drug, Livina, and 20 patients had received the placebo. Baseline liver function tests were done at the time of entry (0 week). Subsequently, all patients on anti-tb drug therapy receiving either Livina or placebo were assessed qualitatively and quantitatively for liver functions at 4 and 8 weeks after initiation of anti-tb drug therapy. At every visit, clinical examination was carried out for symptoms and signs of liver dysfunction and complaints like loss of appetite, fever, abdominal discomfort, pallor, icterus, edema, cough, breathlessness, chest pain, hemoptysis were recorded. General examination like temperature, body weight, pulse rate, blood pressure, and respiratory rate were carried out in addition to other systemic examinations. After completion of 8 weeks intensive phase ATT, the patients were assessed for the efficacy of the drug treatment. On the basis of clinical and laboratory assessment (X-ray and sputum tests becoming negative) the patients were put on a further 16 weeks of continuance phase of anti-tb therapy, i.e. rifampicin + INH, to complete the course of ATT therapy. The drug, Livina (developed and pharmacognostically certified by R&D Division of Dey s Medical Stores, Kolkata) was a polyherbal preparation comprising extracts (50 mg each) of Picrorhizha kurroa (kutaki), Phyllanthus niruri (bhuyamalaki), Andrographis paniculata (kalmegh), Cichorium invitybus (kasni), Tephrosia purpurea (sharphaunka), Solanum dulcamara (kakamarchi), Crenum aciaticum (macchaka), Astonia seholanis (saptaparna), - and 25 mg each of Holarrhave antidysentric (indriyava), Tinospora cordifolia (guduchi), Terminala chebula (Haritaki), Asteracantha longifolia (kakilakshya). Thus, the total quantity of plant extract in each capsule was 500mg. The dosage schedule was 2 capsules given 2 times daily after meals for six months i.e. the complete duration of ATT. The placebo was in the form of a capsule, similar in color, size, shape etc. like the study drug, containing an inert substance and was specifically developed for this purpose. The study drug and placebo were stored in a secure area under the supervision of the investigator as per GCP guidelines and were dispensed by or under the supervision of the investigator. All drugs under study were accounted for during the clinical trial as per standard guidelines laid down for this purpose. Efficacy of the test drug (Livina) or placebo was assessed by performing liver function tests (serum bilirubin, SGOT, SGPT and alkaline phosphatase by Synchron CX5 autoanalyser from Beckman Coulter) at 0, 4 and 8 weeks of ATT treatment. Differences between these qualitative and quantitative data of Livina and placebo treated groups were evaluated and analyzed on the basis of the above efficacy variables. Data of different variables tested for Livina and placebo groups were compared by appropriate statistical tests. Quantal data was analyzed using Chi- Square test with Yate`s modification, whereas, the quantitative data was expressed as mean ± SD and analyzed by the paired Wilcoxon`s test. P value of at least 0.05 was considered as the level of significance in all statistical tests. Results Patients of the test drug and placebo groups were compared for the differences in incidence and
3 320 INDIAN J EXP BIOL, MARCH 2010 intensity of qualitative signs and symptoms of liver disease. Most patients had an uneventful course of ATT. Generally disappearance of fever and cough was seen within 4 weeks of initiation of treatment. Hemoptysis was reported by three patients which disappeared after 2 weeks of initiation of ATT. There was a general tendency for increase in appetite and gain in weight in all patients. Analysis of the data showed that there was a 8% increase in body weight in the test drug (Livina) group as compared to 5.6% in the placebo group, a difference that was not statistically significant (data not shown). A general feeling of well being was also reported in both test drug and placebo groups. Most significant changes were observed in the liver function test (LFT) data. There was 92 and 113% increase over 0 week basal data in SGOT levels, respectively at 4 and 8 weeks after initiation of ATT in the placebo group, whereas these levels were increased by only 27 and 36% in test drug group at these respective time intervals (Table 1). Similarly, the elevations in SGPT levels in the test drug group were far less i.e. by 51 and 40% at 4 and 8 weeks, respectively as compared to the corresponding data of 116 and 179% over 0 week data in the placebo group (Fig. 1 A, B). Further, alkaline phosphatase levels were elevated by 64 and 86% respectively at 4 and 8 weeks as compared to basal values in the placebo group, whereas the magnitude of these elevations were 16 and 11% in test drug (Livina) group (Table 1). The comparative effects of placebo and Livina groups at 4 and 8 weeks post ATT, respectively, are summarized in Fig 1A, B. Serum bilirubin levels were Table 1 Comparison of SGOT, SGPT and alkaline phosphatase levels after Livina and placebo in patients of pulmonary TB on antitubercular chemotherapy [Values are expressed as mean ± SEM] Parameter/Group At 0 week At 4 week At 8 week SGOT (IU/L) Placebo 24.4 ± ± 9.0* 51.9 ± 10.5* Livina 22.0 ± ± ± 8.3 SGPT (IU/L) Placebo 18.8 ± ± 4.2* 52.5 ± 7.6* Livina 20.5 ± ± ± 8.4 Alkaline Phosphatase (U/L) Placebo ± ± 31.4* ± 29.3* Livina ± ± ± 19.7 * Significant at P <0.05 compared to corresponding 0 week data also elevated in group receiving placebo by 41 and 59% after 4 and 8 weeks of ATT, respectively. However, no such rise in serum bilirubin level was observed in Livina treated group. A comparison of the total protein data showed that there was no significant difference at any time interval (4 and 8 weeks) in either placebo or Livina treated group (Table 2). In the hematological parameters, ESR was elevated in most patients at baseline evaluation (0 week), which was normalized after 2 months of ATT schedule. All sputum AFB positive cases were negative after the 2 months treatment with 4 drugs, viz. rifampicin, isoniazid, pyrazinamide and ethambutol. Further, radiological evidence (X-ray chest) of pulmonary TB was also cleared after this intensive phase of chemotherapy. Adverse reactions in both groups were assessed to compare the tolerance and safety in Livina treated and Fig. 1 Comparison of SGOT, SGPT and alkaline phosphatase following placebo or Livina treatment alongwith ATT at (A) 4 weeks; and (B) 8 weeks of drug therapy. [All data are expressed as percentage with controls as 100%].
4 GULATI et al.: PROTECTIVE ROLE OF LIVINA AGAINST ANTI TUBERCULAR DRUG EFFECT 321 Table 2 Comparison of bilirubin and total protein levels in serum after Livina and placebo in patients of pulmonary TB on antitubercular chemotherapy [Values are expressed as mean ± SEM] Parameter/Group At 0 week At 4 week At 8 week Bilirubin (mg./dl) Placebo 0.92 ± ± ± 0.5 Livina 1.02 ± ± ± 0.3 Total Protein (g/dl) Placebo 7.01 ± ± ± 0.5 Livina 7.65 ± ± ± 0.9 placebo groups. Anorexia, nausea, fatigue and weakness were amongst the commonly reported adverse events during therapy, particularly in the placebo group. Most patients complained of high/orange coloured urine which was understandably due to rifampicin. None of the patients showed frank icterus and/or hepatomegaly. Among the total of six drop out cases, five were from placebo group (20%incidence), whereas only one patient from Livina treated group (4.3% incidence) discontinued treatment. Discussion Antitubercular chemotherapy is prone to induce hepatic dysfunction as liver plays a central role in the metabolism and detoxification of these agents. This is more likely to occur in the initial intensive phase therapy with four drugs, viz., rifampicin, isoniazid, pyrazinmide and ethambutol. Such drug induced liver dysfunction poses a major problem for effective completion of the course of ATT and hence could influence compliance. Poor compliance may result in stoppage of therapy which not only precipitates recurrence of disease, but also results in the development of drug resistance and MDR-TB. Incidence and nature/extent of hepatotoxicity with antitubercular therapy depends on a plethora of factors and the spectrum of liver dysfunction varies from slight elevation in serum enzyme levels to severe liver damage Several factors could contribute to anti-tb drug induced liver injury and different strategies have been proposed to combat this long standing problem of increasing significance Hepatoprotective agents are therefore, of great importance with respect to the control of the disease and its effective chemotherapy. Herbal hepatoprotective agents have been tried effectively in various forms of liver disease and they not only prevent occurrence but also, in some instances, induce regression and promote recovery 8, 9, In the present study, a randomized, single blind, placebo controlled study was conducted to compare the safety and efficacy of Livina and placebo. Analysis of the compliance data of two groups indicates better tolerance of ATT in Livina treated group, resulting in completion of course of chemotherapy. Analysis of the data of change in body weight showed that Livina tended to increase body weight more as compared to placebo group, and though these changes were marginal, it indicates the possible better efficacy of Livina as compared to the placebo. SGOT and SGPT are reliable markers of liver function and are known to be elevated in a variety of clinical conditions associated with liver damage 15,16,21. In this study, the elevations in these enzymes were apparent in placebo treated group at both time intervals (4 and 8 weeks) of assessment, whereas the same was not seen in the Livina treated group. In fact, the values of SGOT, SGPT and alkaline phosphatase were higher than the reference normal range in the placebo group, whereas they were maintained within the normal range in the Livina treated group. Earlier studies and some pilot experiments had shown that derangement of liver function was most apparent at 4 weeks after initiation of therapy in most patients 22, and thus, 4 and 8 week time intervals were selected for measurements in this study. Alkaline phosphatase, along with SGOT and SGPT, is also a sensitive marker of liver damage and the fact that these levels were less affected in the presence of Livina, suggested that this polyherbal agent was exerting a protective effect against ATTinduced hepatic dysfunction in these patients of pulmonary tuberculosis. The analysis of ADR profile, from among the patients who completed the treatment, showed that Livina and placebo differed marginally in general and hence both treatments could be termed as equally safe and tolerable. However, the fact that most of the dropouts were in the placebo treated group suggested that Livina enhanced the compliance to ATT in patients. The overall observation was that on the basis of the various efficacy parameters measured, it was apparent that Livina was more effective as compared to the placebo when tested for their potential to protect against ATT induced hepatic damage. From the present study, it could be inferred that the polyherbal agent, Livina, prevented ATT-induced
5 322 INDIAN J EXP BIOL, MARCH 2010 elevations of the biochemical markers of liver function tested and maintained them within normal range, which was not seen in the case of the placebo group. Thus, Livina could be an effective and safe adjuvant and can be combined with anti-tb chemotherapy to enhance compliance to ATT, thereby preventing the occurrence of MDR-TB. Acknowledgement The authors thank Dey`s Medical Stores, Kolkata for the generous supply of Livina and placebo for this study. The technical assistance of the staff of the V.P. Chest Institute is gratefully acknowledged. References 1 Tuberculosis, WHO Fact Sheet No. 104, World Health Organization, Petri W A Jr, Antimicrobial agents in Goodman & Gilman s The Pharmacological Basis of The Therapeutics, 10 th edition, edited by J G Hardman, L E Limbird (McGraw Hill, New York) 2001, Parthasarathy R, Sarma G R, Janardhanam B, Ramachandran P, Santha T, Sivasubramanian S, Somasundaram P R & Tripathy S P, Hepatic toxicity in South Indian patients during treatment with short course regimens containing isoniazid, rifampicin and pyrazinamuide, Tubercle, 67 (1986) Dosing M, Wilcke J T, Askgaard D S & Nybe B, Liver injury during anti-tuberculosis treatment : a 11 year study, Tuber Lung Dis, 77 (1996)35. 5 Lee W M, Drug induced hepatotoxicity, N Eng J Med, 333 (1995) The Ayurvedic Pharmacoepia of India, Part I, Vol. II, (Dept. of ISM&H, Ministry of Health and Family Welfare, Govt. of India, New Delhi) 1999, Das P K, Tripathy R M, Agarwal V K & Sanyal A K, Pharmacology of kutkin and its two organic acid constituents cinnamic acid and vanilic acid, Indian J Exp Biol, 14 (1976) Vaidya A B, Antarkar D S & Doshi J C, Picrorhiza kurroa (Kutaki) as a hepatoprotective agent: Experimental & clinical studies, J Postgrad Med, 42 (1996) Anandan R & Devaki T, Hepatoprotective effect of Picrorrhiza kurroa on tissue defense system in d- galactosamine induced hepatitis in rats, Fitoterapia, 70 (1999) Meixa W, Haowei C, Meng L, Zhao Ga & Mai K, Herbs of the genus Phyllanthus in the treatment of chronic hepatitis B: Observation with three preparations from different geographic sites, J Lab Clin Med, 126 (1995) Bagalkotkar G, Sagineedu S R, Saad M S & Stanslas J, Phytochemicals from Phyllanthus niruri Linn. and their pharmacological properties: A review, J Pharm Pharmacol, 58 (2006) Handa S S & Sharma A, Hepatoprotective activity of andrographolide against galactosamine and paracetamol intoxication in rats, Indian J Med Res, 92 (1990) Visen P K S, Shukla B, Patnaik G K & Dhawan B N, Andrographolide protects rat hepatocytes against paracetamol-induced damage, J Ethnopharmacol, 40 (1993) Pradha S C & Girish C, Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine, Indian J Med Res, 124 (2006) Saukkonen J J, Cohn D L, Jasmer R M, Schenker S, Jereb J A, Nolan C M, Peloquin CA, Gordin F M, Nunes D, Strader D B, Bernardo J, Venkataramanan R & Sterling T R, An official ATS statement : Hepatotoxicity of antituberculosis therapy, Am J Respir Crit Care Med, 174(8) (2006) Yew W W & Leung C C, Antituberculosis drugs and hepatotoxicity, Respirolog, 11 (2006) Ahmad Aqil F I, Antibacterial properties of traditionally used Indian medicinal plants, Methods Find Exp Clin Pharmacol, 29 (2007) Desai V R, Kamat J P & Sainis K B, An immunomodulation from Tinispora cordifolia with ant-oxidant activity in cell free systems, Proc Indian Acad Sci, 114 (2002) Damre A S, Gokhale A B, Phadke A S, Kulkarni K R & Saraf M N, Studies on the immunomodulatory activity of flavonoidal fraction of Tephrosia purpurea, Fitoterapia, 74 (2003) Samud A M, Asmawi M Z, Sharma J N & Yusof A P, Anti-inflammatory activity of Crinum asiaticum plant and its effect on bradykinin-induced contractions on isolated uterus, Immunopharmacol, 43 (1999) Pratt D S & Kaplan M M. Evaluation of liver function in Harrison s Principles of Internal Medicine, edited by D L Kasper, E Braunwald, A S Fauci, S L Hauser, D L Longo and J L Jameson (McGraw Hill, New York) 2004, Ray A, Gulati K, Narayan P, Vijayan V K, Tripathi S K, Gaekwad S & Narendar S, A multicentric clinical study to evaluate the efficacy and tolerability of LL-2123, a polyherbal formulation, in antitubercular drug induced hepatotoxicity, Acta Pharmacol Sinica, 27 (2006) 197.
Let s Talk TB. A Series on Tuberculosis, A Disease That Affects Over 2 Million Indians Every Year
A Series on Tuberculosis, A Disease That Affects Over 2 Million Indians Every Year Lancelot M. Pinto, MD, MSc Author Madhukar Pai, MD, PhD co-author and Series Editor Abstract Nearly 50% of patients with
More informationA Profile of Adverse Effects of Anti-Tubercular Drugs
Original Article GCSMC J Med Sci Vol (V) No (I) January-June 2016 A Profile of Adverse Effects of Anti-Tubercular Drugs Amit Dedun*, Dharmeshkumar Patel** Abstract : Introduction : Tuberculosis (TB), an
More information1 Organ that controls 6 vital functions of the body
1 Organ that controls 6 vital functions of the body Removes poisonous substances Helps in digestion Stores Energy Purifies Blood Manufactures new proteins Processes Food Liver functions continued... Liver
More informationKEYWORDS: Hepatitis, liver, bilirubin, SGOT, SGPT, Andrographis paniculata, sorbitol INTRODUCTION. Int J Pharm Bio Sci
Page1 IJPBS Volume 2 Issue 1 JAN-MARCH 212 1-11 Evaluation of Efficacy & Tolerability of Trisoliv Syrup (Andrographolides + Tricholine Citrate + Sorbitol) in the Management of Various Liver Dysfunctions.
More informationTB: A Supplement to GP CLINICS
TB: A Supplement to GP CLINICS Adverse Drug events With Anti Tuberculosis Therapy What Every GP Should Know Authors: Kavitha Saravu, MD, DNB, DTM&H; Madhukar Pai, MD, PhD Standards of TB Care in India
More informationClinical Study. Special Reprint 2010
CRO for Natural Healthcare Products Special Reprint 2010 AN OPEN LABEL, NON-COMPARATIVE, MULTI-CENTRE CLINICAL TRIAL OF HEPTOVIT S.G.C, A POLYHERBAL FORMULATION, IN THE TREATMENT OF INFECTIVE HEPATITIS.
More informationAmit R. Dedun*, Ghanshyam B. Borisagar, Rajesh N. Solanki
International Journal of Advances in Medicine Dedun AR et al. Int J Adv Med. 2017 Jun;4(3):645-649 http://www.ijmedicine.com pissn 2349-3925 eissn 2349-3933 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3933.ijam20171512
More informationOriginal article. Role of Risorine in the Treatment of Drug Susceptible Pulmonary Tuberculosis: A Pilot Study
20 Original article Role of Risorine in the Treatment of Drug Susceptible Pulmonary Tuberculosis: A Pilot Study Agam Vora 1, Sanjay Patel 2, Kamlesh Patel 2 Abstract Objective: To study the efficacy and
More informationBRITISH BIOMEDICAL BULLETIN
Journal Home Page www.bbbulletin.org BRITISH BIOMEDICAL BULLETIN Original Article Clinical Evsaluation of Short Term Regieme in Management of Pulmonary Kochs Avinash Shankar* 1, Abhishek Shankar 2, Shubham
More informationFORMULATION AND EVALUATION OF PROPRIETARY POLYHERBAL FORMULATION FOR THEIR HEPATOPROTECTIVE ACTIVITY
International Journal of PharmTech Research CODEN (USA): IJPRIF ISSN : 974-434 Vol.2, No.1, pp 35-39, Jan-Mar 21 FORMULATION AND EVALUATION OF PROPRIETARY POLYHERBAL FORMULATION FOR THEIR HEPATOPROTECTIVE
More informationA Study of Liver Function Tests Abnormalities in Tuberculosis Patients Under RNTCP-DOTS, VIMS Bellary
A Study of Liver Function Tests Abnormalities in Tuberculosis Patients Under RNTCP-DOTS, VIMS Bellary Mudegoudara Lingaraja, Venugopal K, Shashibushan J, Shankar Naik Department of General Medicine, Vijayanagara
More informationLet s Talk TB A Series on Tuberculosis, A Disease That Affects Over 2 Million Indians Every Year
Let s Talk TB A Series on Tuberculosis, A Disease That Affects Over 2 Million Indians Every Year Lancelot M. Pinto, MD, MSc Author Madhukar Pai, MD, PhD co-author and Series Editor Lancelot Pinto is a
More informationEffect of Prophylactic Use of Silymarin on Anti-tuberculosis Drugs Induced Hepatotoxicity
ORIGINAL ARTICLE https://doi.org/.446/trd.217.8.3.26 ISSN: 1738-336(Print)/2-6184(Online) Tuberc Respir Dis 217;8:26-269 Effect of Prophylactic Use of Silymarin on Anti-tuberculosis Drugs Induced Hepatotoxicity
More informationEFFICACY OF KAMALAHAR (An indigenous Ayurvedic preparation for acute viral hepatitis) (A study of cases)
EFFICACY OF KAMALAHAR (An indigenous Ayurvedic preparation for acute viral hepatitis) (A study of cases) Chief Investigator: Dr. S. B. Agarwal Professor & Head, Dept. of Medicine, B. J. Medical College
More informationRamesh P. M.*, Saravanan M.
International Journal of Advances in Medicine Ramesh PM et al. Int J Adv Med. 2018 Jun;5(3):561-565 http://www.ijmedicine.com pissn 2349-3925 eissn 2349-3933 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3933.ijam20181663
More informationMonica Manandhar. 2 ND YEAR RESEARCH ELECTIVE RESIDENT S JOURNAL Volume V, A. Study Purpose and Rationale
Randomized Trial of lsoniazid as Secondary Prophylaxis for Prevention of Recurrent Pulmonary Tuberculosis in HIV-positive Patients After One Episode of Tuberculosis Monica Manandhar A. Study Purpose and
More informationPharmacologyonline 3: (2011) ewsletter Yadav et al.
SEVERITY ASSESSME T A D PATTER OF ADVERSE DRUG REACTIO S WITH A TI-TUBERCULAR THERAPY. Sachdev Yadav, Dr. KK Pillai, Dr. Prem Kapur Assistant Professor, Department of Pharmacy, Banasthali University, Rajasthan-304022.
More informationDiagnosis and Treatment of Tuberculosis, 2011
Diagnosis of TB Diagnosis and Treatment of Tuberculosis, 2011 Alfred Lardizabal, MD NJMS Global Tuberculosis Institute Diagnosis of TB, 2011 Diagnosis follows Suspicion When should we Think TB? Who is
More informationDosage and Administration
SIRTURO product information for healthcare providers 2 WARNINGS: An increased risk of death was seen in the SIRTURO (bedaquiline) treatment group (9/79, 11.4%) compared to the placebo treatment group (2/81,
More informationGrand Round Case. An unusual recurrence of antitubercular drug induced hepatotoxicity in a child
Grand Round Case An unusual recurrence of antitubercular drug induced hepatotoxicity in a child Bhatia S, Tullu MS, Kannan S 1, Gogtay NJ 1, Thatte UM 1, Lahiri KR Departments of Pediatrics and 1 Clinical
More informationManagement of MDR TB. Dr Priscilla Rupali MD; DTM&H Professor and Head Department of Infectious Diseases Christian Medical College Vellore
Management of MDR TB Dr Priscilla Rupali MD; DTM&H Professor and Head Department of Infectious Diseases Christian Medical College Vellore Outline Global epidemiology of Tuberculosis Epidemiology of Tuberculosis
More informationEvaluation of Hepatoprotective Effect of Silymarin Among Under Treatment Tuberculosis Patients: A Randomized Clinical Trial
Iranian Journal of Pharmaceutical Research (2016), 15 (1): 247-252 Received: September 2014 Accepted: February 2015 Copyright 2016 by School of Pharmacy Shaheed Beheshti University of Medical Sciences
More informationAmlycure D.S. LIVER FUNCTIONS. Natural Botanical Extracts. Which contributes to Improve Disturbed
A Desired Strength Formula Enriched with Scientifically validated Natural Botanical Extracts Which contributes to Improve Disturbed LIVER FUNCTIONS Helps recover from Anorexia Tones Hepatocellular Structure
More informationHomeopathy as an Adjuvant to Chemotherapy Improves Clinical Outcome in Relapsed Pulmonary Tuberculosis
Homeopathy as an Adjuvant to Chemotherapy Improves Clinical Outcome in Relapsed Pulmonary Tuberculosis Presenting author: Dr. Neha Sharma Authors: S. Sharma, RG Sharma, Chand K NMP Medical Research Institute,
More informationRisk factors for hepatotoxicity from antituberculosis drugs: a case-control study
132 Department of Medicine J N Pande S P N Singh G C Khilnani S Khilnani Department of Gastroenterology R K Tandon All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India Correspondence
More informationTB Nurse Assessment. Ginny Dowell, RN, BSN October 21, 2015
TB Nurse Assessment Ginny Dowell, RN, BSN October 21, 2015 Comprehensive Care of Patients with Tuberculosis and Their Contacts October 19-22, 2015 Wichita, KS EXCELLENCE EXPERTISE INNOVATION Ginny Dowell,
More informationRevised National Tuberculosis Control Programme
Revised National Tuberculosis Control Programme 2015 C e n t r a l T B D i v i s i o n D i r e c t o r a t e G e n e r a l o f H e a l t h S e r v i c e s M i n i s t r y o f H e a l t h & F a m i l y
More informationFREQUENCY OF ADVERSE EFFECTS OF FIXED DOSE COMBINATIONS, IN TUBERCULOSIS AND THERE EFFECTS ON TREATMENT OUTCOME
SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS FREQUENCY OF ADVERSE EFFECTS OF FIXED DOSE COMBINATIONS, IN TUBERCULOSIS AND THERE EFFECTS ON TREATMENT OUTCOME Siribaddana A, Dissanayake KS, Athukorala
More informationWeekly. August 8, 2003 / 52(31);
Weekly August 8, 2003 / 52(31);735-739 Update: Adverse Event Data and Revised American Thoracic Society/CDC Recommendations Against the Use of Rifampin and Pyrazinamide for Treatment of Latent Tuberculosis
More informationTuberculosis Tools: A Clinical Update
Tuberculosis Tools: A Clinical Update CAPA Conference 2014 JoAnn Deasy, PA-C. MPH, DFAAPA jadeasy@sbcglobal.net Adjunct Faculty Touro PA Program Learning Objectives Outline the pathogenesis of active pulmonary
More informationISSN X (Print) Research Article. *Corresponding author Dr. Ramesh B
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2013; 1(6):739-744 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationJyotish Chandra Pandey et al, Asian Journal of Pharmaceutical Technology & Innovation, 03 (16); 2016; Research Article
Asian Journal of Pharmaceutical Technology & Innovation ISSN: 2347-8810 Research Article Received on: 03-01-2016 Accepted on: 16-01-2016 Published on: 15-02-2016 Corresponding Author: * Dr. Jyotish Chandra
More informationJournal of Chemical and Pharmaceutical Research
Available on line www.jocpr.com Journal of Chemical and Pharmaceutical Research ISSN No: 0975-7384 CODEN(USA): JCPRC5 J. Chem. Pharm. Res., 2011, 3(2):144-149 In vitro hepatoprotective activity of ethanolic
More informationA Study of PartySharp in Prevention of Hangover and in Elimination of Acetaldehyde
[The Antiseptic (2001): (98), 6, 206-209] A Study of PartySharp in Prevention of Hangover and in Elimination of Acetaldehyde Prabhakar, B., M.D, Assistant Professor, and Venkataramanappa, P.V., M.D, Professor
More informationSILYMARIN FOR PREVENTION OF ANTI-TUBERCULOSIS DRUG-INDUCED LIVER INJURY: A META-ANALYSIS
SILYMARIN FOR PREVENTION OF ANTI-TUBERCULOSIS DRUG-INDUCED LIVER INJURY: A META-ANALYSIS CO Floro, AMM Fausto, MDS Velasco, JEL Camenforte, MA De Lusong Section of Gastroenterology, Department of Medicine,
More informationInternational Journal of Medical and Health Sciences
International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Original article Treatment Outcome of Tuberculosis in Seropositive Patients in a Tertiary Care
More informationRole of RNTCP in the management MDR-TB
Kamdar DJ, Shah NA, Patel DJ, Parmarr H. Role of RNTCP in the management of MDR-TB. IAIM, 2015; 2(7): 1-5. Original Research Article Role of RNTCP in the management of MDR-TB Deepali J Kamdar 1, Neha A
More informationTB: A Supplement to GP CLINICS
TB: A Supplement to GP CLINICS Chapter 10: Childhood Tuberculosis: Q&A For Primary Care Physicians Author: Madhukar Pai, MD, PhD Author and Series Editor What is Childhood TB and who is at risk? India
More informationNorthwestern Polytechnic University
Clinical Tuberculosis Assessment by Health Care Provider Clinicians should review and verify the information in the Tuberculosis (TB) Screening Questionnaire (attached). Persons answering YES to any questions
More informationFundamentals of Tuberculosis (TB)
TB in the United States Fundamentals of Tuberculosis (TB) From 1953 to 1984, reported cases decreased by approximately 5.6% each year From 1985 to 1992, reported cases increased by 20% 25,313 cases reported
More informationHEALTH SERVICES POLICY & PROCEDURE MANUAL
PAGE 1 of 7 References Related ACA Standards 4 th Edition Standards for Adult Correctional Institutions 4-4350, 4-4355 These guidelines are based on the recommendations of the American Thoracic Society
More informationTB Clinical Guidelines: Revision Highlights March 2014
TB Clinical Guidelines: Revision Highlights March 2014 AIR TRAVEL & TB CONTROL With respect to non-ambulance air travel of patients diagnosed with or suspected as having active Mycobacterium tuberculosis,
More informationJMSCR Vol 07 Issue 01 Page January 2019
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.53 Original Article Occurrence of
More informationRiskFactorsforLiverInjurywithanElevatedSerum Bilirubin Concentration Caused by Antituberculous Drugs
ORIGINAL ARTICLE RiskFactorsforLiverInjurywithanElevatedSerum Bilirubin Concentration Caused by Antituberculous Drugs Hideaki Kato 1, Nobuyuki Horita 1, Naoki Miyazawa 2, Takashi Yoshiyama 3, Atsuhisa
More informationInt. J. Pharm. Sci. Rev. Res., 46(1), September - October 2017; Article No. 07, Pages: 37-41
Research Article Assessment of Clinical Profile and Prescription Pattern of Drugs in Alcoholic Liver Disease and Hepatitis in a Tertiary Care Hospital Christeena James*, Dr.ShirishInamdar, Dr.Bharathi
More informationLatent tuberculosis infection
EXECUTIVE SUMMARY Latent tuberculosis infection Updated and consolidated guidelines for programmatic management Executive summary Latent tuberculosis infection (LTBI) is defined as a state of persistent
More informationHepatoprotective activity studies of herbal formulations
ORIGINAL ARTICLE Hepatoprotective activity studies of herbal formulations Manisha Bhagwat Kamble 1, Rahul Kondaji Dumbre 1, Vinod D. Rangari 2 1 Department of pharmacognosy, Rajgad Dyanpeeth s College
More informationAmlycure. Advanced formulation with Vital herbal extracts Key micro-nutrients & Anti-oxidants. which helps to maintain normal LIVER HEALTH
Advanced formulation with Vital herbal extracts Key micro-nutrients & Anti-oxidants which helps to maintain normal LIVER HEALTH Improves appetite Tones digestion Prevents drug induced gastric discomfort
More informationDiagnosis & Management of Latent TB Infection
Diagnosis & Management of Latent TB Infection Prof. Ashok Rattan, MD, MAMS, INSA DFG, WHO Lab Director Academics, Industry: Research, Diagnosis, Public Health, Academics Adviser: Laboratory Operations,
More informationThe Role of Rifampin for the Treatment of Latent TB Infection. Introduction. Introduction
The Role of Rifampin for the Treatment of Latent TB Infection March 26, 2008 Alfred A. Lardizabal, MD Associate Professor of Medicine New Jersey Medical School Global Tuberculosis institute Treatment of
More informationTB the basics. (Dr) Margaret (DHA) and John (INZ)
TB the basics (Dr) Margaret (DHA) and John (INZ) Question 1 The scientist who discovered M. tuberculosis was: A: Louis Pasteur B: Robert Koch C: Jean-Antoine Villemin D: Calmette and Guerin Question 2
More informationThe volunteers were divided into three parts to study the effect of BESEB.
Brahmi is an important drug known for its memory enhancing property. In Ayurveda this drug is described as a Rasayana drug. The Rasayana therapy (rejuvenating therapy) aims specially at the promotion of
More informationSMEAR MICROSCOPY AS SURROGATE FOR CULTURE DURING FOLLOW UP OF PULMONARY MDR-TB PATIENTS ON DOTS PLUS TREATMENT
Original Article SMEAR MICROSCOPY AS SURROGATE FOR CULTURE DURING FOLLOW UP OF PULMONARY MDR-TB PATIENTS ON DOTS PLUS TREATMENT R. Sarin 1, R. Singla 2, P. Visalakshi 3, A. Jaiswal 4, M.M. Puri 4, Khalid
More informationEtiological Agent: Pulmonary Tuberculosis. Debra Mercer BSN, RN, RRT. Definition
Pulmonary Tuberculosis Debra Mercer BSN, RN, RRT Definition Tuberculosis is a contagious bacterial infection of the lungs caused by Mycobacterium Tuberculosis (TB) Etiological Agent: Mycobacterium Tuberculosis
More informationIndex No. All five (05) questions should be answered. All questions carry equal marks.
POSTGRADUATE INSTITUTE OF MEDICINE UNIVERSITY OF COLOMBO POSTGRADUATE DIPLOMA IN TUBERCULOSIS & CHEST DISEASES EXAMINATION - MAY 2016 Date :- 4 th May 2016 PAPER I CASE HISTORIES Time :- 9.00 a.m. -11.00
More informationHEPATOPROTECTIVE AND ANTIOXIDANT ACTIVITY OF TEPHROSIA PURPUREA WHOLE PLANT AQUEOUS EXTRACT. Summary
HEPATOPROTECTIVE AND ANTIOXIDANT ACTIVITY OF TEPHROSIA PURPUREA WHOLE PLANT AQUEOUS EXTRACT Gunjegaonkar S. M., Saraswathi C.D.*, Hrishikeshavan H.J., Harish M.S. Nargund L.V.G Department of Pharmacology,
More informationStudy IV: 2000mg Single Dose
Project Report Evaluation of Cardiovascular and Pharmacodynamic effects of Terminalia arjuna with special reference to arterial stiffness and endothelial function in healthy human male subjects Study IV:
More informationIntroduction to TB Nurse Case Management Online February 4, 11, 18 and 25, 2015
Introduction to TB Nurse Case Management Online February 4, 11, 18 and 25, 2015 Initiation Phase Part 1 Ginny Dowell, RN, BSN February 4, 2015 Ginny Dowell RN, BSN has the following disclosures to make:
More informationDr. Harish. S 1, Dr. Beena Thomas 2 INTRODUCTION ABSTRACT
International Journal of Research in Pharmacy and Biosciences Volume 3, Issue, January 6, PP 39-53 ISSN 394-5885 (Print) & ISSN 394-5893 (Online) A Prospective, Randomized, Double Blind, Parallel Group,
More informationMRIMS Journal of Health Sciences 2016;4(3) pissn: , eissn:
MRMS Journal of Health Sciences 2016;4(3) pssn: 2321-7006, essn: 2321-7294 http://www.mrimsjournal.com/ Original Article Drug Sensitivity Pattern among Category Relapse Cases of Pulmonary Tuberculosis
More informationORIGINAL ARTICLE. Naresh Patel 1, K Jagannath 2, Agam Vora 3, Mukesh Patel 4, Anand Patel 5. Introduction. Abstract. Editorial Viewpoint
48 ORIGINAL ARTICLE A Randomized, Controlled, Phase III Clinical Trial to Evaluate the Efficacy and Tolerability of Risorine with Conventional Rifampicin in the Treatment of Newly Diagnosed Pulmonary Tuberculosis
More informationMARKETING AUTHORISATION NO. 403/2007/01-02 Annex 2 Summary of Product Characteristics
Pyrazinamide 500mg tablets ( Antibiotice S. A. ), TB267 WHOPAR part 4 supplier s translation of the text as approved by the stringent regulatory authority June 2014 MARKETING AUTHORISATION NO. 403/2007/01-02
More informationMethodology. Methodology
The methodology of the Study is as follows: Topic of the Study: Clinical Efficacy of Vyghriharitaki in the Management of Chronic bronchitis. Clinical Trial Protocol ID: ACT-BTS-2010. Null hypothesis Vyaghriharitaki
More information*Corresponding Author: Shivani Chauhan
Int. J. Pharm. Med. & Bio. Sc. 2014 Shivani Chauhan et al., 2014 Research Paper ISSN 2278 5221 www.ijpmbs.com Vol. 3, No. 3, July 2014 2014 IJPMBS. All Rights Reserved A STUDY TO EVALUATE THE SAFETY AND
More informationCase Report Successful diagnosis of hyperpyrexia induced by isoniazid in a child with suspected extra-pulmonary tuberculosis
Int J Clin Exp Med 2015;8(5):8249-8253 www.ijcem.com /ISSN:1940-5901/IJCEM0005890 Case Report Successful diagnosis of hyperpyrexia induced by isoniazid in a child with suspected extra-pulmonary tuberculosis
More informationProtects and Maintains a Healthy Liver
AOR CODE: AOR04238 Premium Liver Support Protects and Maintains a Healthy Liver Stimulates liver regeneration and detoxification Protects liver tissue from damage and toxins Clinically researched herbs
More informationHEPATOTOXICITY WITH ANTITUBERCULOSIS DRUGS: THE RISK FACTORS
HEPATOTOXICITY WITH ANTITUBERCULOSIS DRUGS: THE RISK FACTORS Khalid Mahmood 1, Akhtar Hussain 2, Krishan Lal Jairamani 3, Abu Talib 4, Badar-uddin Abbasi 5, S. Salkeen 6 ABSTRACT Objective: To assess the
More informationCase presentation. Dr REESAUL R
Case presentation Dr REESAUL R Mr S. 25 years old Case 1 Ref on 06/ April /2006 to Chest Clinic from a private GP of Port Louis for : Cough + haemoptysis and dyspnoea Case 1(6/April/2006) Mr S Single 25
More informationDG MEMORANDUM FOR TUBERCULOSIS
DG MEMORANDUM FOR TUBERCULOSIS Introduction 1. Tuberculosis (TB) is a curable condition but requires prolonged treatment for its cure. During last 3 decades tremendous advances have been made in the diagnosis
More informationNATIONAL TUBERCULOSIS CONTROL PROGRAMME- SCC AREA Quarterly Report on New and Retreatment Cases of Tuberculosis
NATIONAL TUBERCULOSIS CONTROL PROGRAMME- SCC AREA Quarterly Report on New and Retreatment Cases of Tuberculosis Patients registered during quarter* of 20 Name of area No.# Name of the Reporter Signature:
More informationEffect of Cardiotonic Pills on Chest Pain and Discomfort: A Multi-center Double-blind Randomized Controlled Trial.
26 2 (2005 6 ) J Korean Oriental Med 2005;26(2):95-104 Effect of Cardiotonic Pills on Chest Pain and Discomfort: A Multi-center Double-blind Randomized Controlled Trial. Jang Insoo, 1) Ko Changnam, 2)
More informationCHAPTER:1 TUBERCULOSIS. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY
CHAPTER:1 TUBERCULOSIS BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY GLOBAL EMERGENCY: * Tuberculosis kills 5,000 people a day! * 2.3 million die each year!
More informationTreatment of Active Tuberculosis
Treatment of Active Tuberculosis Jeremy Clain, MD Pulmonary & Critical Care Medicine Mayo Clinic October 16, 2017 2014 MFMER slide-1 Disclosures No relevant financial relationships No conflicts of interest
More informationSA TB Guidelines The interface with Advanced Clinical Care
SA TB Guidelines The interface with Advanced Clinical Care Dr Kogie Naidoo (MBCHB, PHD) Head: CAPRISA Treatment Research Programme Honorary Lecturer - UKZN Department of Public Heath Medicine Annual Workshop
More informationRecognizing MDR-TB in Children. Ma. Cecilia G. Ama, MD 23 rd PIDSP Annual Convention February 2016
Recognizing MDR-TB in Children Ma. Cecilia G. Ama, MD 23 rd PIDSP Annual Convention 17-18 February 2016 Objectives Review the definitions and categorization of drugresistant tuberculosis Understand the
More informationAdverse events among patients of multi drug resistant tuberculosis receiving second line anti TB treatment
International Journal of Scientific Reports Rathod KB et al. Int J Sci Rep. 2015 Oct;1(6):253-257 http://www.sci-rep.com pissn 2454-2156 eissn 2454-2164 Research Article DOI: http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20150955
More informationISSN X (Print)
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2016; 4(3C):836-841 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationTB Grand Rounds. Reynard McDonald, MD & Henry Fraimow, MD January 30, Outline
TB Grand Rounds Reynard McDonald, MD & Henry Fraimow, MD January 30, 2007 Outline Overview of 2006 ATS statement regarding hepatotoxicity of anti-tb therapy Case examples highlighting management of patients
More informationCASE-BASED SMALL GROUP DISCUSSION MHD II
MHD II, Session 11, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD II Session 11 April 11, 2016 STUDENT COPY MHD II, Session 11, Student Copy Page 2 CASE HISTORY 1 Chief complaint: Our baby
More informationClastogenic effect of Picrorhiza kurroa rhizome extract on cultured human peripheral blood lymphocytes
J HerbMed Pharmacol. ; (): -. Journal of HerbMed Pharmacology Journal homepage: http://www.herbmedpharmacol.com Clastogenic effect of Picrorhiza kurroa rhizome extract on cultured human peripheral blood
More informationTuberculosis Intensive November 17 20, 2015 San Antonio, TX
Treatment of Tuberculosis Elizabeth S. Guy, MD November 17, 2015 Tuberculosis Intensive November 17 20, 2015 San Antonio, TX EXCELLENCE EXPERTISE INNOVATION Elizabeth S. Guy, MD has the following disclosures
More informationManaging the Patients Response to TB Treatment
Managing the Patients Response to TB Treatment Barbarah Martinez, RN, BSN September 13, 2017 TB Nurse Case Management September 12 14, 2017 EXCELLENCE EXPERTISE INNOVATION Barbarah Martinez, RN, BSN has
More informationInternational Journal of Pharma and Bio Sciences COMPARISON OF EFFICACY AND SAFETY OF RIMONABANT WITH ORLISTAT IN OBESE AND OVERWEIGHT PATIENTS
International Journal of Pharma and Bio Sciences RESEARCH ARTICLE PHARMACOLOGY COMPARISON OF EFFICACY AND SAFETY OF RIMONABANT WITH ORLISTAT IN OBESE AND OVERWEIGHT PATIENTS Corresponding Author DR.JAIN
More informationTB in Corrections Phoenix, Arizona
TB in Corrections Phoenix, Arizona March 24, 2011 Treatment of Latent TB Infection Renuka Khurana MD, MPH March 24, 2011 Renuka Khurana, MD, MPH has the following disclosures to make: No conflict of interests
More informationTreatment of Latent TB Infection (LTBI)
Treatment of Latent TB Infection (LTBI) Mahesh C. Patel, MD June 14, 2017 2014 MFMER slide-1 Mahesh C. Patel, MD Associate Professor Treatment of LTBI Department of Internal Medicine, Division of Infectious
More informationImpact factor: 3.958/ICV:
Impact factor: 3.958/ICV: 4.10 77 Pharma Science Monitor 7(4), Oct-Dec 2016 PHARMA SCIENCE MONITOR AN INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES Journal home page: http://www.pharmasm.com REVALIDATION
More informationT. Schaberg, K. Rebhan, H. Lode
Eur Respir J, 1996, 9, 2026 2030 DOI: 10.1183/09031936.96.09102026 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1996 European Respiratory Journal ISSN 0903-1936 Risk factors for side-effects
More informationGlobal epidemiology of drug-resistant tuberculosis. Factors contributing to the epidemic of MDR/XDR-TB. CHIANG Chen-Yuan MD, MPH, DrPhilos
Global epidemiology of drug-resistant tuberculosis Factors contributing to the epidemic of MDR/XDR-TB CHIANG Chen-Yuan MD, MPH, DrPhilos By the end of this presentation, participants would be able to describe
More informationTreatment of Tuberculosis
TB Clinical i l Intensive Seattle Treatment of Tuberculosis June 16, 2016 Masa Narita, MD Public Health Seattle & King County; Firland Northwest TB Center, University of Washington Outline Unique features
More informationLiv.52 A Clinico-Biochemical Trial in Hepatic Cirrhosis
[Current Medical Practice (1973): (17), 4, 185-188] Liv.52 A Clinico-Biochemical Trial in Hepatic Cirrhosis Mehrotra, M.P., M.D. (Luck.), F.R.C.P. (Edin), F.C.C., F.I.C.A. (U.S.A.) Professor of Clinical
More informationExperience with Pyrazinamide and Rifampin Regimens for Latent TB Infection
Experience with Pyrazinamide and Rifampin Regimens for Latent TB Infection Krista Powell, MD, MPH Co-Project Officer, National Surveillance for Severe Adverse Events Associated with LTBI Treatment Lead,
More information1 yr old girl presented with Fever on and off 3 months H/o frequent semisolid bulky stools 3 months Progressive abdominal distension 3 months Failure
Dr Rajasree S Dr Srinivas S, Dr Bagdi RK, Dr Satheesh C Apollo Childrens Hospital, Chennai 1 yr old girl presented with Fever on and off 3 months H/o frequent semisolid bulky stools 3 months Progressive
More informationStudy setup: Medicine units of tertiary care teaching hospital
3. Methodology 3.1. Development of indicators for identifying ADEs 3.1.1. Study Period: November 2007- April 2008 3.1.2. Study setup: Medicine units of tertiary care teaching hospital 3.1.3. Development
More informationStudy of Multi-Drug Resistance Associated with Anti-Tuberculosis Treatment by DOT Implementation Strategy in Pakistan
Journal of Basic & Applied Sciences, 2018, 14, 107-112 107 Study of Multi-Drug Resistance Associated with Anti-Tuberculosis Treatment by DOT Implementation Strategy in Pakistan Sana Saeed 1, Moosa Raza
More informationNerlynx (neratinib) NEW PRODUCT SLIDESHOW
Nerlynx (neratinib) NEW PRODUCT SLIDESHOW Introduction Brand name: Nerlynx Generic name: Neratinib Pharmacological class: Kinase inhibitor Strength and Formulation: 40mg; tabs Manufacturer: Puma Biotechnology
More informationLatent TB Infection Treatment
Latent TB Infection Treatment Douglas B. Hornick, MD Pulmonologist w/ Infectious Attitude Division of Pulmonary/Critical Care/Occ Med UI Carver College of Medicine 2014 MFMER slide-1 Disclosures: None
More informationAAYUSHANTI GENERIC RANGE
AAYUSHANTI GENERIC RANGE Ayurvedic medicines have been tried and tested over centuries and still hold fort even today. A product like Triphala Churna which since centuries is considered one of the best
More informationTUBERCULOSIS. Presented By: Public Health Madison & Dane County
TUBERCULOSIS Presented By: Public Health Madison & Dane County What is Tuberculosis? Tuberculosis, or TB, is a disease caused by a bacteria called Mycobacterium tuberculosis. The bacteria can attack any
More informationAnri Uys (MSc Pharmacology, BPharm NWU) Medicines Information Centre, Division of Clinical Pharmacology University of Cape Town
Anri Uys (MSc Pharmacology, BPharm NWU) Medicines Information Centre, Division of Clinical Pharmacology University of Cape Town Since March 2008 26 700 Queries to date 450 Queries per month South Africa:
More information