جستجوی مقالات مرتبط با کلیدواژه "داروهای ضد سل" در نشریات گروه "پزشکی"

Hepatotoxicity is a serious complication of anti-tuberculosis drugs, and so far, no ideal preventive measure has been suggested for it.. The aim of this study was determining the effects of Livercare tablet [combination of milk thistle, dandelion, barberry, turmeric (curcumin), and artichoke] in the prevention of hepatotoxicity induced by anti-tuberculosis drugs.

In a randomized controlled clinical trial study, 44 patients with pulmonary tuberculosis were divided into two groups of 22 patients. In the first group (intervention group), Livercare tablets made by HealthAid Company were prescribed twice a day for 2 weeks at the same time with the start of anti-tuberculosis drugs. In the second group (control group), only standard anti-tuberculosis treatment was prescribed. The incidence of hepatotoxicity was determined and compared between the two groups.

Examination of liver enzyme levels during two weeks from the start of anti-tuberculosis treatment showed that 7 patients (15.9%) had hepatotoxicity, of which 6 (27.3%) were in the control group and 1 (4.5%) in the intervention group. The incidence of hepatotoxicity was significantly lower in the intervention group (P = 0.039).

Concomitant use of the herbal drug Livecare seems to reduce the hepatotoxicity of anti-tuberculosis drugs significantly.

Background and The main purpose of this study was determination of different genotypes and phenotypes of N-acetyltransferase 2 gene and its relationship with drug-induced liver injury among patients in Mazandaran province, Iran, which was done for the first time.
A total of 65 newly diagnosed unrelated pulmonary tuberculosis patients (47 men, 18 women) was enrolled in the study. A combination of polymerase chain reaction -restriction fragment length polymorphism method was used to investigate different allels of N-acetyltransferase-2. The patients were followed for occurrence of antituberculosis induced hepatotoxicity during the course of treatment. Relationship between N-acetyltransferase-2 phenotypes and antituberculosis induced hepatotoxicity was evaluated.
Frequency of slow, intermediate and fast acetylator genotypes in patients were 34%, 60% and 6%, respectively. Hepatotoxicity was diagnosed in 13.64% of slow acetylators, in 2.56% of intermediate acetylators and interestingly in none of the fast acetylators. The Chi-Square Test showed no significant difference between different acetylation phenotypes and risk of hepatotoxicity (P = 0.1086).
These results could improve treatment profile, prevent from drug-related adverse effects such as hepatotoxicty and lead to better outcomes in tuberculosis patients.

Nowadays, one of the main problems of tuberculous treatment is drug resistance. Present study was designed to determine drug resistance of mycobacterium isolated from patients with pulmonary tuberculosis to anti-tuberculous drugs and to detect the influencing factors. In a cross-sectional study in 2012-2013, all smear positive sputum)125 samples) cultured and their anitibiogram were done in tuberculous laboratory of Shariati Hospital. Provided checklists were filled with corporation of Vicechancellor Mashhad University of Medical Science of and Mashhad Health Centers and other towns of province. Then by using SPSS software, resistance rate and influencing factors were evaluated. In this study the rate of resistance to Isoniazid was 7%, to Rifampin 7%, to Ethambutol 3.9%, to Streptomycin 11.8%, to Isoniazid and Rifampin (MDR-TB) 4%,. The highest rate of resistance was observed in 15-45 years-age group. Statistically, a close-to-significant relationship was observed between incidence of resistance and two factors including recurrence and grade of smear positivity. Results obtained for 20% of total cultured samples were non tuberculous Mycobacterium (NTM). Considering the MDR TB prevalence in Khorasan, DOTS strategy had to be carried out completely and appropriately to prevent incidence of more resistance cases. Considering the high rate of NTM, was has proposed that when diagnosing tuberculosis, culture and antibiogram had to be implemented for all patients to prevent tuberculosis aberrant treatment, that cause increasing resistance to drugs, and to give appropriate treatment for such patients at initial stages. Acknowledgment: This is no conflict of interest

The side effects of first line anti TB drugs may lead to a huge waste of money and as a result the patients may refuse to continue the treatment and in some cases even leads to death.

To find the side effects coming from such drugs among the patients admitted in Giulan Province، northern Iran.

This is a cross-sectional study on the patients with tuberculosis who were hospitalized in Razi hospital from 2002 to 2008. The information contained in the respective medical files was extracted and entered into the questionnaire.

Results showed that 61% of the total 387 TB patients were male. The average age of the participants was 45/5±19/3 years and 56 cases (14/5%) were with complicated condition. As observed، %27. 3 of the cases were with more than one complication. Of the patients with complications، 27 patients (48/2 %) were with liver disease (hepatitis drug)، 1 patient (1/7 %) with ocular complications، 46 patients (82%) with gastrointestinal side effects (anorexia، nausea، vomiting، pain epigastric، ichter، diarrhea) and 3 patients (5/3 percent) had skin conditions. Also، treatment was discontinued for 1. 8% of the total 387 patients with tuberculosis due to the drug side effects.

Timely consideration and management of the side effects can help inhibit the progression and prevention of respective complications.

Nowadays, one of the basic problems of tuberculosis treatment is drug resistance. This study was done to determine the drug resistance of mycobacterium strains isolated from patients with pulmonary tuberculosis to anti-tuberculosis drugs and determine the affecting factors.

In a cross-sectional study, all patients with tuberculosis who were covered by Markazi Province Health Center (917 persons) during 2005 to 2010 were included in this study. For all patients with resistant pulmonary tuberculosis, culture and antibiogram by standard method (proportional) were done. Effective factors in drug resistance were identified by logistic regression model using SPSS software.

Overall, the rate of resistance in patients with smear-positive was 7.3% and the rate of MDR-TB was equivalent to 4.3%, and 0.5% of smear positive patients were resistant to all five drugs. The most resistant strains were isoniazid (68.8%), rifampin (62.5%), pyrazinamide (25%), ethambutol (21.9%), and streptomycin (21.9%), respectively. The highest rate of resistance was in the 15-45 years age group. The incidence of resistance was significantly associated with sex, grade of smear positivity, relapse of TB, and HIV infection.

The study of drug resistant mycobacterium strains over six years showed a growing trend. Therefore, close attention to prevent the production and dissemination of resistant strains is very essential.

Tuberculosis in some cases involves spinal column and spinal cord so this disease can cause spine distortion, para paresis or paraplegia and in some cases incontinence. In rare instances, upper limb paresis or plegia may be seen. In overall the incidence of neurological deficit in spinal tuberculosis is high. It is clear that in time diagnosis and appropriate treatment can decrease these complications.This research aim is the comparative surgical modalities in spine tuberclulosis treatment. 24 patients with diagnosis of spinal tuberculosis were studied from January 1996 to august 2002. They divided into three groups: first group were patients that they were treated with anti- tuberculosis drugs. The second group was treated surgically with posterior approach, and the third group was treated surgically with combine posterior and anterior approaches.To analyse the data descriptive statistic methods were used. Since the samples were small in each group the data were analysed manually. From 24 patients 6 were males and 18 females and their ages were between 4-78 years.The neurological status of 66.6% improved and 16.6% got worse. In anterior combine, posterior surgical approach 72% improved and 9.8% got worse. In patients who diagnosed in appropriate time and treated with anti tuberculosis drugs all except one case cured completely without complication. In time diagnosis of spinal tuberculosis can facilitate the treatment is simple and prevent of surgical procedures and complications. Therefore, we must consider spinal tuberculosis in any suspicious spine lesions.In surgical approach, combine posterior and anterior approach spinal alignment can be much better and these combine procedures have better neurological result.

Tuberculosis is a chronic granulomatous infection caused by an acid fast bacillus, mycobacterium tuberculosis or mycobacterium bovis and is the most common cause of death due to an infectious agent. A combination of drugs is prescribed for tuberculosis patients. One of the main adverse effects of prescribed drugs is elevation of liver enzymes.The aim of this study was to evaluate the rate of liver enzymes elevation among tuberculosis patients after drug therapy. 309 tuberculosis patients (15-91 years old) were selected by census method, in 1999-2000. Liver enzymes were measured at the beginning, 15 and 30 days following the treatment initiation. At the beginning of the treatment no one showed liver enzymes elevation. 15 days after the beginning of the treatment 68 subjects (22%) showed an elevation in liver enzymes (2 to 15 times more than normal). 30 days after the treatment initiation only 13 subject (4.2%) showed elevation in the level of their liver enzymes. This study showed that drug-induced elevation in liver enzymes of tuberculosis patients in Sanandaj is within the mean reported in other areas. Even though drugs are tolerated by the patients, more percuation must be considered about older patients and in case of combination therapy.