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Jeyashree K.,Velammal Medical College Hospital and Research Institute | Kathirvel S.,Medial Research | Shewade H.D.,Indian Institute of Technology Delhi | Kaur H.,Panjab University | Goel S.,Medial Research
Cochrane Database of Systematic Reviews | Year: 2016

Background: Active smoking increases the risk of tuberculosis (TB) infection 2 to 2.5 times and is significantly associated with recurrent TB and TB mortality. Observational studies have shown associations between smoking and poor TB treatment outcomes such as increased loss to follow-up rate, severity of disease, drug resistance and slow smear conversion. Since most smoking-related immunologic abnormalities are reversible within six weeks of stopping smoking, smoking cessation may have substantial positive effects on TB treatment outcomes, TB relapse and future lung disease. Objectives: To analyse the effect of tobacco smoking cessation interventions (SCIs) on the treatment outcomes of people with adult pulmonary TB. Search methods: We searched the Cochrane Tobacco Addiction Group Specialised Register using free-text and MeSH terms for TB and antitubercular treatment. We also searched MEDLINE and EMBASE using the same topic-related terms, combined with the search terms used to identify trials of tobacco cessation interventions from the Specialised Register. We also searched reference list of articles and reviews, the Conference Paper Index, clinicaltrials.gov and grey literature. The searches are current to 29th July 2015. Selection criteria: Individual and cluster-randomised controlled trials (RCTs), regardless of date, language and publication status, studies of adults with pulmonary TB on first-line anti-tubercular drugs, with interventions at either an individual or a population level, delivered separately or as part of a larger tobacco control package. This included any type of behavioural or pharmaceutical intervention or both for smoking cessation. Data collection and analysis: Using the eligibility criteria, two authors independently checked the abstracts of retrieved studies for relevance, and acquired full trial reports of candidates for inclusion. The authors resolved any disagreements on eligibility by mutual consent, or by recourse to a third author. Two authors intended to independently extract study data from eligible studies into a data extraction form and compare the findings, synthesise data using risk ratios, and assess risk of bias using standard Cochrane methodologies. However, we found no eligible trials. Main results: There were no randomised controlled trials that met the eligibility criteria. A number of potentially eligible studies are underway, and we will assess them for inclusion in the next update of this review. Authors' conclusions: There is a lack of high-quality evidence, i.e. RCTs, that tests the effectiveness of cessation interventions in improving TB treatment outcomes. There is a need for good-quality randomised controlled trials that assess the effect of SCIs on TB treatment outcomes in both the short and long term. Establishing such an evidence base would be an essential step towards the implementation of SCIs in TB control programmes worldwide. © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.


Jayaraman J.K.,Velammal Medical College Hospital and Research Institute | Ganapathy P.,Public Health Center | Indira N.,Public Health Center
Journal of Clinical and Diagnostic Research | Year: 2015

Post-partum pubic symphysis diastasis refers to an abnormally wide gap between the two pubic bones following delivery. It is an uncommon and under diagnosed condition resulting in acute pelvic pain. A case of pelvic diastasis in a 24-year-old G2A1 following normal vaginal delivery is reported. Management consisted of simple conservative treatment with binders and analgesics, which were sufficient in achieving a complete reversal of the condition. The low incidence of 1 in 3700 normal vaginal deliveries over a 5 year period at Public Health Centre, Chennai, coupled with the rarity of the condition renders it as a salient presentation in the practice of our profession. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Suliankatchi R.A.,Velammal Medical College Hospital and Research Institute | Sinha D.N.,World Health Organization
Journal of Obstetrics and Gynecology of India | Year: 2016

Background: In India, smokeless tobacco (SLT) use among pregnant women is high and its adverse effects on pregnancy outcomes have not been properly documented in. Objectives: To collate available evidence on the association between SLT use and three adverse pregnancy outcomes, i.e. low birth weight, preterm birth and stillbirth among women in India. Search Strategy: A systematic search was conducted in MEDLINE, IndMed, Web of Science, Google Scholar and major journals. Two authors independently reviewed the studies and extracted data. Selection Criteria: Inclusion criteria were English articles published till December 2014, case control, case cohort or cohort, and exposure and outcome variables meeting predefined criteria. Exclusion criteria were case series, case reports, cross-sectional designs, risk estimate not restricted/adjusted for smoking with or without adjustment for other factors and duplicate data. Qualitative synthesis was followed by meta-analysis. Attributable burden was estimated using the population attributable fraction method. Main Results: Pooled odds ratio was significant for all three outcomes: low birth weight (1.88, 95 % CI 1.38, 2.54), preterm birth (1.39: 1.01, 1.91) and stillbirth (2.85: 1.62, 5.01). We found that 0.87 million low birth weight babies, 0.19 million preterm births and 0.12 million stillbirths occurring annually in India could be attributed to maternal SLT use. Conclusion: There was a suggestive evidence of SLT use associated with adverse pregnancy outcomes among women in India. Further studies in this field are required to generate more conclusive evidence. © 2016 Federation of Obstetric & Gynecological Societies of India


Jeremiah S.S.,Velammal Medical College Hospital and Research Institute | Ohba K.,National University of Singapore | Yamamoto N.,National University of Singapore
Current Drug Targets | Year: 2016

The global Human Immunodeficiency Virus (HIV) pandemic is still spreading due to the lack of ideal anti-retroviral measures and their availability. Till date, all attempts to produce an efficient vaccine have ended with unsatisfactory results. The highly active anti-retroviral therapy (HAART) is the only effective weapon currently available and is widely being used for curtailing the HIV pandemic. However, the HAART is also expected to fail in the near future due to the emergence and dissemination of antiviral resistance. This review sheds light on the reasons for the failure of the conventional anti-viral measures against HIV and the novel anti-retroviral strategies currently being developed. The various principles to be considered for the success of a novel anti-retroviral strategy are elaborately emphasized and an innovative concept is proposed on these lines. The proposed concept intends to use receptor decoy traps (RDT) called cancellers which are erythrocytes expressing the HIV entry receptors on their surface. If successfully developed, the cancellers would be capable of active targeting of the free HIV particles leading to the trapping of the viruses within the canceller, resulting in the neutralization of infectivity of the trapped virus. The possible ways of translating this concept into reality and the probable hurdles that can be encountered in the process are subsequently discussed. Also, the scope of cancellers in therapeutic and/or preventive strategies against HIV infection is envisaged upon their successful development. © 2016 Bentham Science Publishers.


Ganesan V.,Jawaharlal Institute of Postgraduate Medical Education & Research | Ganesan V.,Velammal Medical College Hospital and Research Institute | Mandal J.,Jawaharlal Institute of Postgraduate Medical Education & Research
International Journal of Mycobacteriology | Year: 2016

Pulmonary tuberculosis (TB) is the most common form of TB. Primary infection can also affect the pharynx, cervical lymph node, intestine, or oral mucosa. Historically, the observed incidence of concomitant infection with leprosy and TB is high. However, reports of concomitant infection in modern literature remain scarce. Most cases reported in the literature had borderline/lepromatous leprosy and pulmonary tuberculosis. Extrapulmonary tuberculosis is reported in only 3.2% of leprosy cases. To the best of our knowledge, this is the first case report of primary oral tuberculosis of the tongue in a patient with lepromatous leprosy with Type 2 lepra reaction. The patient was referred to Directly Observed Treatment, Short-Course clinic and started on Category I treatment. She received oral prednisolone for lepra reaction, which was subsequently tapered and stopped, however, she continued to receive other antileprotic drugs (thalidomide and clofazimine). The patient's general condition improved and she is on regular follow up. © 2015 Asian African Society for Mycobacteriology.

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