Environmental Risk Factors and Social Determinants of Pulmonary Tuberculosis in Pakistan

Tuberculosis (TB), the world’s deadliest communicable disease with an estimated 9.0 million cases of TB and 1.5 million deaths in 2013 throughout the world. TB is a major health issue in resource limited countries. Despite immense progress in medical sciences and improved health care facilities in developed countries, TB remains one of the biggest challenges in resource poor setting and developing countries.

Tuberculosis in Pakistan

One of the obvious reasons for this dilemma is the involvement of multiple factors in increasing the susceptibility of infection and progression of the disease. Pathogenesis of TB in man is a two stage process. In the first stage, the infection is initiated when a person is exposed to an infected individual and inhales the virulent bacterium through sneezing and coughing of an infected individual. Inhalation of droplet nuclei that are smaller enough (1-2 µm) to reach the alveolar surface of the lower respiratory tract can cause the infection. Read more>>>>>>>

Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis

Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are generally thought to have high mortality rates. However, many cases can be treated with the right combination and rational use of available antituberculosis drugs. 

This Review describes the evidence available for each drug and discusses the basis for recommendations for the treatment of patients with MDR and XDR tuberculosis. The recommended regimen is the combination of at least four drugs to which the Mycobacterium tuberculosis isolate is likely to be susceptible. Drugs are chosen with a stepwise selection process through five groups on the basis of efficacy, safety, and cost. Among the first group (the oral first-line drugs) high-dose isoniazid, pyrazinamide, and ethambutol are thought of as an adjunct for the treatment of MDR and XDR tuberculosis. Read more>>>>>>>>>>

Screening of M. tuberculosis with the help of macrophage models

M. tuberclosis is an intracellular pathogen which survives and replicate in macrophages. To combat tuberculosis, complete knowledge of bacteria and macrophage interaction is compulsory. Growth of M. tuberclosis can be done by using microphage models; this eventually helps in screening the intracellular pathogen.  The cell source for macrophages model generally includes human peripheral blood, lungs, cell lines and bone marrow. This cell source is further utilised for screening by Chinese and Western anti-TB drugs, to study the role of SigB and SigFetc.. for figuring out the immune mechanism and pathogenesis.

The online English database PubMed, Chinese databases CNKI, SinoMed, and Wanfang were searched up to December 2010 for published articles. Two groups of terms were used for the information retrieval, one of which includes macrophage model, macrophages model, macrophage models, macrophages models, macrophage, and macrophages; the othergroup of terms comprises mycobacterium tuberculosis. For PubMed, the two groups of English terms were applied, while Chinese terms were used.Inclusion criteria were defined for this review, by which articles on cell sources, screening of anti-tuberculosis drugs, pathogenic mechanisms of tuberculosis or immunomechanism of tuberculosis of macrophage models are collected. Exclusion criteria were also developed, by which articles about other aspects of macrophage models, such as vaccination of tuberculosis, were excluded.  Read more...........