Audiologic monitoring of multi-drug resistant tuberculosis patients on aminoglycoside treatment with long term follow-up

<p>Abstract</p> <p>Background</p> <p>Multi-drug resistant tuberculosis has emerged as a significant problem with the resurfacing of tuberculosis and thus the need to use the second line drugs with the resultant increased incidence of adverse effects. We discuss the effect of second line aminoglycoside anti-tubercular drugs on the hearing status of MDR-TB patients.</p> <p>Methods</p> <p>Sixty four patients were put on second line aminoglycoside anti-TB drugs. These were divided into three groups: group I, 34 patients using amikacin, group II, 26 patients using kanamycin and group III, 4 patients using capreomycin.</p> <p>Results</p> <p>Of these, 18.75% of the patients developed sensorineural hearing loss involving higher frequencies while 6.25% had involvement of speech frequencies also. All patients were seen again approximately one year after aminoglycoside discontinuation and all hearing losses were permanent with no threshold improvement.</p> <p>Conclusion</p> <p>Aminoglycosides used in MDR-TB patients may result in irreversible hearing loss involving higher frequencies and can become a hearing handicap as speech frequencies are also involved in some of the patients thus underlining the need for regular audiologic evaluation in patients of MDR-TB during the treatment.</p

Non-lethal Hallermann-Streiff syndrome with bone fracture: report of a case

The Hallermann-Streiff syndrome is characterized by bird-like face, micropthalmia, cataracts, micrognathia, beaked nose, abnormal dentition, hypotrichosis, cutaneous atrophy and proportional small stature. We present a 35-day-old patient with the classical signs except cutaneous atrophy, additionally he had a healing fracture at the proximal part of the left radius. (C) 2004 Elsevier SAS. All rights reserved

Plasma and liver carnitine levels of children with chronic hepatitis B

WOS: 000188547200009PubMed ID: 14745287Background: Carnitine status of children with chronic hepatitis B is not yet clear. Because it is well-known that carnitine interferes with T-cell immunity, which is closely related to spontaneous or treatment-induced seroconversion in hepatitis B, it was hypothesized that carnitine status would be effective on the end of therapy response (ETR). The aim of this study is to investigate both carnitine status of children with chronic HBV infection and its probable effects on liver histology and ETR. Methods: Thirty-one children with chronic HBV infection, and age and sex matched 20 healthy children were included in the study. Plasma and liver free carnitine level determination was performed before IFN-alpha and lamivudine combination therapy in children with chronic hepatitis B. Mean plasma carnitine level of healthy children was used as control. IFN-alpha was injected as 5 million U/m(2) subcutaneously 3 times a week for 6 months and lamivudine 4 mg/kg per day orally, maximum of 100 mg, for 1 year. Results: The mean plasma carnitine level of patients with chronic HBV infection was significantly lower than that of controls (P < 0.001) The ETR was achieved in 14 (45.2%) patients. While plasma carnitine level was inversely correlated with portal inflammation score (P < 0.05), liver carnitine level was inversely correlated with fibrosis score (P < 0.05). Conclusion: It was found that plasma carnitine level was lower in children with chronic hepatitis B compared with healthy ones and carnitine was inversely correlated with liver portal inflammation and fibrosis scores. The role of carnitine in immunopathogenesis and histology of HBV needs to be clarified with further studies

Is leptin a predictive factor in the end of therapy response in chronic hepatitis B?

Background: The purpose of this study was to determine the leptin levels in children with chronic hepatitis B virus (HBV) infection, and to evaluate the effect of serum leptin levels on the end of therapy response (ETR). It is known that leptin stimulates T-cell immunity and so T-cell mediated immune response is critical in the outcome of chronic HBV infection

Sweat test results in children with primary protein energy malnutrition

Objectives: In underdeveloped and developing countries where protein energy malnutrition (PEM) is common, it is sometimes difficult to exclude the diagnosis of cystic fibrosis (CF) in malnourished children because both primary PEM and CF share similar symptoms, signs, and laboratory findings, such as elevated sweat chloride value. This study was performed to investigate sweat test results and determine percentile values in children with primary PEM