bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Critical Review of Risk Factors Influencing the Prevalence of Extensive Drug-Resistant Tuberculosis in India
Authors: Khan Amer Hayat , Nagoba Basavraj Sayabanna , Shiromwar Shruti Subhash 
Published: September 2024

Abstract
Globally, extensive drug-resistant tuberculosis (XDR-TB) is a major element to cause morbidity and death among tuberculosis patients. The present study identifies the vital risk variables contributing to XDR-TB prevalence in India. Scopus, PubMed/Medline, Science Direct, and Google Scholar databases were searched thoroughly for the articles, using medical subject heading as a key term published between the years 2012 and 2022. According to the inclusion criteria, 11 publications were selected. Socioeconomic characteristics include employment, educational attainment, undernourishment, and the rest, and demographic factors such as gender, age, and more. Were examined in the review, whereas alcoholics, smoking, and diabetes mellitus were investigated under comorbidities and behavioral risk factors. We observed that noncompliance, poor knowledge, and insufficient health-care facilities could significantly accelerate the spread of XDR-TB, and the present review imparts a remarkable and detailed evaluation of XDR-TB. The study analysis is markedly useful for policymakers as well as researchers to discover and implement effective solutions for tuberculosis-infected patients.
Antibody Reactivity to Mycobacterium tuberculosis-specific Regions of Differences 1 and Regions of Differences 9 Proteins and Peptides in Rabbits, Mice, and Humans
Authors: Hanif Shumaila N. M. , Al-Attiyah R. , Mustafa A. S. 
Published: September 2024

Background:
The major antigens encoded by Mycobacterium tuberculosis-specific genomic regions of differences (RDs) could be useful in the development of new vaccines and/or diagnostic reagents using T-cell and/or antibody assays. In particular, RD1 proteins PE35, PPE68, ESXA, ESXB, and RD9 protein ESXV and their peptides have been identified as major T-cell antigens. However, little is known about their antibody reactivities in different mammalian species. This study aims to determine the antigen-specific antibody reactivities to the above antigens and their peptides in three different mammalian species, i.e., rabbits, mice, and humans.

Methods:
Sera were obtained from (i) rabbits immunized with purified recombinant proteins PE35, PPE68, ESXA, ESXB, and ESXV; (ii) mice immunized with recombinant DNA vaccine constructs of pUMVC6 and pUMVC7 containing RD1 and RD9 genes; and (iii) tuberculosis (TB) patients and healthy humans. Enzyme-linked immunosorbent assays (ELISAs) were performed with the sera to determine the antibody reactivity to purified recombinant proteins, peptide pools, and individual peptides of RD1 and RD9 proteins.

Results:
The ELISA results with sera from rabbits immunized with pure recombinant proteins showed positive antibody reactivity with all of the immunizing proteins and their synthetic peptide pools. Testing of the sera with individual peptides showed positive antibody reactivity with PE35 peptides P1 (aa 1–25), P2 (aa 16–40), P5 (aa 61–85), and P6 (aa 76–99); PPE68 peptides P9 (aa 121–145), P11 (aa 151–175), P14 (aa 196–220), P22 (aa 316–340), P23 (aa 331–355), and P24 (aa 346–371); all peptides (P1 to P6) of ESXA and ESXB; and ESXV peptides P1 (aa 1–25), P2 (aa 16–40), P3 (aa 31–55), P5 (aa 61–85), and P6 (aa 76–94). The sera from mice immunized with DNA vaccine constructs showed antibody reactivity to all proteins and the peptide P6 (aa 76–99) of PE35 and peptides P19 (aa 271–295) and P24 (aa 346–371) of PPE68. In humans, the peptides P11 (aa 151–175), P14 (aa 196–220), P22 (aa 316–340), P23 (aa 331–355), and P24 (aa 346–371) of PPE68 and the peptides P4 (aa 46–70), P5 (aa 61–85), and P6 (aa 76–94) of ESXV showed positive reactivity with sera from TB patients and healthy controls.

Conclusion:
The results demonstrate the presence of several antibody epitopes in each protein, but variations in the epitopes recognized were observed among mice, rabbits, and humans, which could be due to mammalian species differences and/or mode of antigen delivery.
A Systemic Review of Mycobacterium nebraskense Case Reports up to October 2023, Featuring Our Unique Case Study
Authors: Rajani Aayushi J. , Roach Dawn , Raval Darshankumar , Amin Juhi , Kempaiah Prakash , Chitale Rohit , Durvasula Ravindra , Oring Justin 
Published: September 2024

Background:

Mycobacterium nebraskense is a rare, slow growing nontuberculous mycobacterium species with limited documented cases. This systematic review aims to comprehensively analyze the clinical characteristics, presentation, and management of M. nebraskense infections by analyzing the available literature, including a newly reported case that we present in this article.

Methods:
A comprehensive search was conducted using PubMed and Google Scholar to identify relevant cases up to October 2023. Only seven reported cases were found, highlighting the scarcity of information on this pathogen.

Results:
Our analysis revealed several key findings. First, gender disparities were observed, with females being more susceptible to M. nebraskense infections. Additionally, a significant portion of patients presented with asymptomatic infections. Most affected individuals were over the age of 60, emphasizing potential age-related susceptibility. Comorbidity profiles varied widely among cases, and patients with preexisting lung comorbidities were at an increased risk of infection. The decision to treat or observe depended on clinical presentation, with even immunosuppressed individuals not always requiring treatment. Regarding treatment, we proposed an empirical approach with amikacin, clarithromycin, or rifabutin, considering the reported resistance to doxycycline and minocycline. Combination therapy was commonly employed to minimize resistance development, consistent with mycobacterial infection management.

Conclusion:
This study underscores the need for further research to validate these findings and enhance our understanding of M. nebraskense infections. As limited data are available, this review aims to provide valuable insights into a rare and emerging pathogen to guide clinical practice and future research endeavors.
Anergy to Purified Protein Derivative and Chronic Energy Deficiency in Sputum-Positive Pulmonary Tuberculosis: Dynamic Assessment at Baseline and Treatment Completion
Authors: Alexander Vijay , Sindhu Kulandaipalayam Natarajan , Ralph Ravikar , Paul Jackwin Sam , Manimegalai Babuji , Zachariah Anand 
Published: September 2024

Background:
Tuberculosis (TB) remains a high burden disease in India. Nutrition plays a pivotal role in holistic recovery of the same.

Methods:
Patients with sputum positive pulmonary TB were consecutively recruited into the study aimed to observe the incidence of under nutrition and anergy purified protein derivative (PPD). Anthropometry and PPD testing were done at baseline. Patients were followed-up at 6 months, with PPD intradermal test repeated to study tuberculin conversion. Nutritional recovery, tuberculin conversion, and determination of persistent anergy were the outcomes of interest.

Results:
Of the 134 patients enrolled in the study, 43.2% were anergic to PPD at baseline. While 50.8% patients had normal body mass index (BMI), 14.2%, 9.7%, and 25.4% had chronic energy deficiency (CED) Grades I, II, and III, respectively. BMI at baseline showed a positive linear correlation with PPD response (r = 0.44, P < 0.001), and anergy was associated with CED (odds ratio - 3.25, P = 0.001). Forty-six patients completed follow-up and 19.6% showed anergy to PPD. At follow-up, 69.6% had normal BMI. Overall, there was an improvement in anthropometry and PPD reactivity in patients at 6 months, compared to baseline assessment.

Conclusion:
Anergy was significantly associated with CED at baseline in patients with TB. While most patients had an improvement in nutritional status and PPD reactivity, a small subset of patients had persistent anergy. Recovery from TB is multifactorial and its determinants include microbiological cure, nutritional status, and immunological recovery.
Specific Targeting to the Mycobacterium tuberculosis P-type ATPase Membrane Transporter, CtpF, of Antituberculous Compounds Obtained by Structure-based Design
Authors: Santos Paola , Salazar Luz M. , Maya-Hoyos Milena , Soto Carlos Y. 
Published: September 2024

Background:
The resurgence of Mycobacterium tuberculosis (Mtb) strains that resist anti-tuberculosis (anti-TB) drugs used currently stresses the search for more effective low-toxicity drugs against new targets. Due to their role in ion homeostasis and virulence, Mtb plasma membrane P-type ATPases are interesting anti-TB targets, in particular, the Ca2+ transporting P2-type ATPase CtpF which is involved in oxidative stress response and persistence.

Methods:
In this study, the effect on the transcription level of the ctpF gene and other Mtb P2-type ATPases of two anti-Mtb hits was assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Both anti-Mtb hits ZINC14541509 and ZINC63908257 had been previously identified using pharmacophore-based virtual screening and MM-GBSA binding free energy. In addition, the bacterial activity of both compounds on Mycobacterium bovis was evaluated to see whether or not there is an effect on other mycobacteria of the Mtb complex.

Results:
qRT-PCR experiments showed that the ctpF transcription level was significantly higher in the presence of both compounds, especially ZINC14541509, strongly suggesting that CtpF may be a specific target of the selected compound.

Conclusions:
ZINC14541509 should be considered as an alternative for the structural-based design of novel anti-TB drugs.
Systemic Assessment of Solute Carrier Family 11-member A1 (rs17235409) Gene Polymorphism and Mycobacterium Tuberculosis Risk in Asian and Caucasian Population: A Comprehensive Updated Meta-analysis
Authors: Pauline Rashmi , Devaraj Danis Vijay , Sivasubramanian Jayanthi , Velmurugan Saranya , Stephen Sharon Benita , Yasam Santhosh Kumar , Kulanthaivel Langeswaran , Subbaraj Gowtham Kumar 
Published: September 2024

Background:
The present meta-analysis was assessed to confirm the association between solute carrier family 11-member A1 (SLC11A1) gene (rs17235409) polymorphism with the Mycobacterium tuberculosis infection in the Asian and Caucasian populations.

Methods:
A search was conducted using the databases including Google Scholar, Science Direct, Embase, and PubMed to find the case–control studies related to SLC11A1 gene polymorphism and tuberculosis (TB) infection. The MetaGenyo programme was used to perform statistical analyses of the data. The odds ratio and 95% confidence interval were calculated based on genetic models such as allelic model, dominant model, recessive model, and overdominant. The heterogeneity and publication bias for the present study were examined to assess its quality. The study was registered in PROSPERO (ID Number: 461434).

Results:
This current study revealed the association between the SLC11A1 gene polymorphism with TB. The statistical value obtained at P < 0.05 was deemed to be statistically significant. The meta-analysis results revealed that allele contrast and recessive models are significant association between SLC11A1 gene polymorphism with risk of TB infections, and dominant and overdominant models have no significant association with TB risk. In addition, the subgroup analysis based on the ethnicity dominant revealed a significant association with the risk of TB. Therefore, this results that the gene SLC11A1 has a significant association for allelic and recessive and has no significant association for dominant and overdominant with the risk of TB.

Conclusion:
According to the data retrieved from the database with respect to the present study revealed that SLC11A1 gene polymorphism rs17235409 for allelic, recessive models have been associated with TB infections, but dominant and overdominant models have not been associated with TB infections.
Identification of Seven Types of Pili in Mycobacterium tuberculosis: Using Atomic Force Microscopy
Authors: Farnia Parissa , Zhavnerko Gennady Konstantinovich , Farnia Poopak , Poleschuyk Nikolai Nikolaevich , Ghanavi Jalaledin , Velayati Ali Akbar 
Published: September 2024

Background:
Pili are polymeric, hydrophobic, proteinaceous structures generally composed of a major repeating subunit called pilin and, in some cases, a minor tip-associated adhesin subunit. Pili are involved in many virulence-associated functions, such as biofilm formation, adherence, and colonization of mucosal surfaces.

Methods:

Mycobacterium tuberculosis (MTB) strains were isolated from clinically and laboratory-confirmed cases of tuberculosis (TB). The TB isolates were subjected to the Xpert MTB/rifampicin test and then, further susceptibility testing was performed on them against first- and second-line drugs using proportional methods. Thereafter, the selected isolates were subculture in Dubos Tween-albumin liquid culture medium, and at their exponential growth phase (OD600 = 0.05 (5 × 106 colony-forming unit/mL), cells were observed under atomic force microscopy (AFM). For each isolate, 15–20 steel sample packs were prepared and observed under AFM. Here, the data presented are the result of average observation.

Results:
Under AFM, seven different types of pili were detected, out of which four types, i.e., Type III, Type IV secretion pili, and Type IV-like pili, curli-like pili (MTP) were similar to reported pili in Gram-negative and Gram-positive bacteria. Whereas the other three forms, i.e., Type V (relief funnel pili), Type VI (adhesion tapering), and Type VII (adhesion flap pili), were newly identified and named according to their appearance. Both Types of IV pili were detected in all clinical isolates irrespective of their susceptibility patterns, although significant differences were observed from the side of their protruding. Type Curli pili is similar in appearance in all clinical isolates. Types VI and VII were detected only in extensively drug-resistant and totally drug-resistant-TB isolates (100%). The Type III pili (secretion needle pili) was present in both susceptible- and drug-resistant bacilli, although in drug-resistant strains, we found a considerable difference in their length (50 μ ±10 nm in length) and sometimes, they also had tapering at end. The Type V pili was seen in susceptible isolates but it was at the resting stage (100%; lying aside of cell wall) whereas in drug-resistant isolates, they were getting apart from the cell wall of bacilli with a clear tapering or funnel shape structure.

Conclusion:
The results of this study highlight the importance of new types of pili expressions in respect of susceptibility patterns in TB. The identified new types of pili would be promising approaches for the treatment and prevention of drug-resistant TB, which needs further investigation.
Serum Zinc Level and Its Association with Multidrug-Resistant Tuberculosis
Authors: Barman Nilima , Haque Khan Md Maruf , Ghosh Debabrata , Ibne Towhid Muhammad Ibrahim , Uddin Md. Nasir , Paul Debatosh , Haque M. Atiqul 
Published: September 2024

Background:
Zinc deficiency is evident in chronic diseases, but little is known about its association with multi-drug resistant tuberculosis (MDRTB). We aimed to measure serum zinc level in MDRTB patients and explore its association with MDRTB compared to drug-sensitive tuberculosis (DSTB).

Methods:
We recruited 107 MDRTB and 87 DSTB patients from a tuberculosis referral hospital in Bangladesh. After overnight fasting, 5 ml venous blood was collected from each patient to measure serum zinc level through graphite furnace atomic absorption spectrophotometry method. Multivariate logistic regression was done to measure its association with MDRTB.

Results:
The mean age of all patients was 36 years, where 70% were male. About 27% MDRTB patients and 2.3% DSTB patients had low serum zinc level (P < 0.0001). An inverse correlation was observed between serum zinc level and duration of anti-TB therapy (r-value: −0.252, P < 0.01). Reduced serum zinc level (odds ratio, 0.957; 95% confidence interval 0.923–0.992) was found as a significant associating factor for MDRTB after adjusted with age, sex, occupation, residence, tobacco consumption, Bacillus Calmette–Guérin-vaccination, and duration of anti-TB therapy.

Conclusion:
A lower serum zinc level is significantly associated with MDRTB. The tuberculosis control program should address this in the MDRTB control strategy.
Project Extension for Community Healthcare Outcomes Improves Care and Treatment for Multidrug-Resistant Tuberculosis Patients in Tanzania
Authors: Peter Daud Dunstan , Mziray Shabani Ramadhani , Lekule Isack Augustino , Kitundu Victor , Mohamed Salum , Kisonga Riziki Michael , Mpagama Stellah George , Struminger Bruce Baird 
Published: September 2024

Background:
Project Extension for Community Healthcare Outcomes (Project ECHO) is a telementoring, case based virtual community of practice training and education model connecting experts to primary care clinicians (PCCs). Project ECHO has good evidence for favorable treatment outcomes on wide range of diseases. Since 2017, Tanzania hosts multidrug resistant tuberculosis (MDR TB) ECHO with hub at Kibong'oto Infectious Diseases Hospital. However, little is known on outcomes of MDR TB ECHO. This study aimed to describe the outcomes of MDR TB ECHO in managing MDR TB patients in Tanzania.

Methods:
Review of case studies was conducted at MDR TB ECHO hub in Tanzania. Up to June 2020, a total of 134 sessions and 60 patient cases were presented in MDR TB ECHO. This article describes outcomes of MDR TB ECHO in managing three selected complicated MDR TB patient cases presented. Case 1: Child with MDR TB, neck abscess, and anemia secondary to chronic illness. Case 2: Adult with MDR TB and end stage renal disease co morbidity. Case 3: Adult failing standard MDR TB treatment.

Results:
Anemia resolved in Case 1; surgical dressing was done to neck abscess and neck healed. Case 2 was initiated with end stage renal disease management; uremic encephalopathy and lower limb edema resolved. Case 3 was initiated with individualized MDR TB treatment. All three patients attained smear and culture conversion and continue with MDR TB treatment.

Conclusions:
To our knowledge, this is the first report on effectiveness of project ECHO in supporting PCCs in bringing favorable treatment outcomes to MDR TB patients. We advocate adaptation and scale up of ECHO model as an effective approach for strengthening management of MDR TB and other infectious diseases.
Orthodontic-prosthetic rehabilitation of alveolar cleft
Authors: Salkar Yash , Singh Shubhaani , Singla Anu , Sindwani Suruchi 
Published: September 2024

ABSTRACT
This case report presents the treatment of an 18-year-old girl with a unilateral alveolar cleft and impacted deciduous teeth. The patient had a gap in her upper front teeth and sought treatment for the alveolar defect. The initial treatment plan included alveolar bone grafting, fixed mechanotherapy, and prosthetic rehabilitation. However, the patient declined the bone grafting surgery. To address the issue, orthodontic treatment began with the extraction of a lower incisor to correct the overjet and the removal of over-retained deciduous teeth and a resorbed lateral incisor. The impacted lateral incisor was brought into the arch to stimulate bone formation. The treatment lasted 21 months, and an interim prosthetic rehabilitation with a natural tooth pontic was placed before the final rehabilitation using a Maryland bridge. The outcome of the treatment showed improved dental esthetics, harmonious soft-tissue profile, and parallel roots. This case highlights the importance of early intervention for alveolar clefts and the collaborative effort required for comprehensive oral rehabilitation in cleft lip and palate patients.
Prevalence of anemia in children with cleft lip and palate in Karnataka: A cohort study
Authors: Kumar Chetana , John Centina Rose , Rao Krishna Shama , Amanna Rolson Sandeep , Jain Tarun , Lohitha K. Krishna 
Published: September 2024

ABSTRACT

Introduction:
The poor nutritional status and lower socioeconomic conditions among the Indian population have influenced the decisions on elective cleft lip surgeries. These factors may delay the treatment, as well as affect the overall development of the child. This study aims to identify the prevalence of microcytic hypochromic anemia in the Indian population to formulate the protocol in need for iron and nutritional supplementation in elective surgical planning of cleft lip and palate, thereby providing a comprehensive care in clefts.

Methodology:
A cohort study was designed comparing 100 children with nonsyndromic cleft lip or palate, who were undergoing surgical repair in our institution cleft deformity and without congenital anomalies under the age of 2 years. The blood parameters (hemoglobin [Hb], mean corpuscular volume, mean corpuscular Hb concentration [MCHC], MCHC, and red cell distribution width cell volume) for identifying the microcytic hypochromic anemia were assessed before the surgical repair and compared with the normal population. Descriptive analysis was performed to extract results.

Results:
The study population had a mean age of 10.56 ± 7.02 months (55 boys and 45 girls). We identified 61% of the population having anemia, with 2% having severe anemia (Hb <7 g/dL). It was observed that higher levels of Hb were in the age group of 4–6 months, and the lowest was documented in the older children.

Conclusion:
The study helps in identifying the prevalence of iron-deficiency anemia in children who are undergoing surgical repair for nonsyndromic cleft lip or palate. Therefore, the comprehensive cleft care should be the focus, addressing the feeding difficulties, malnutrition, and failure to thrive, before surgical intervention.
Clinical assessment of the efficacy of Ayurvedic management in PCOS: Study protocol for a randomized open-label standard control trial
Authors: Rajput Shivshankar , Mata Shweta , Saxena Upma , Ota Sarada , Tripathi Arunabh , Gupta Bharti , Srikanth Narayanam , Acharya Rabinarayan 
Published: September 2024

Abstract

INTRODUCTION:
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder, typically characterized by anovulation, hormonal imbalances, obesity, infertility, and associated features, with a significant impact on the physiological and psychological wellbeing of females belonging to the reproductive age group. Due to the multifactorial etiology, treatment is often personalized with specific targets, and monotherapy is rarely used. In the present study, the efficacy of an Ayurveda regimen, comprising the Ayush-SSM tablet (a coded Ayurvedic formulation) administered after Virechana therapy (purgation), is being explored against conventional standard care.

MATERIALS AND METHODS:
This study is an open-label, randomized, controlled clinical trial consisting of 180 participants diagnosed with PCOS. The participants in the trial group will receive Ayurvedic treatment consisting of Virechana therapy followed by administration of Ayush-SSM (500 mg), two tablets twice a day for 6 months. The participants in the control group will receive metformin tablet 500 mg once a day in the first week, 500 mg twice a day in the second week, 500 mg thrice a day in the third week, and 850 mg twice a day from the fourth week till 6 months. The primary outcome is the proportion of study participants who attain normal menstrual cycle length (21–35 days) or ovulation and change in hirsutism as per the modified Ferriman–Gallwey (FG) Score. The secondary outcomes are change in acne score and acanthosis nigricans; change in abdominal girth, waist circumference, and BMI; and clinical safety of the trial interventions.

CONCLUSION:
The findings of the study could potentially demonstrate that the Ayurveda regimen, including Virechana therapy followed by administration of the Ayush-SSM tablet, may be as effective as conventional standard care.

Trial registration:
Clinical Trial Registry of India (CTRI/2022/09/045478, dated August 4, 2022).