Evaluation of effectiveness of mass screening for tuberculosis infection in children from 1 to 7 years old in Moscow

The objective: to evaluate effectiveness of mass screening for tuberculosis infection in children aged 1 to 7 years in different periods – before and after the use of tuberculosis recombinant allergen skin test (TRA) in primary health care as an additional diagnostic method.Subjects and Methods. The study was designed as continuous observational prospective-retrospective study. Two different periods were assessed: the first one was 2014-2016 when screening for tuberculosis infection was performed in all children from 1 to 17 years (inclusive) using Mantoux test with 2 TU PPD-L in pediatric primary health care, and then children suspected to have a positive reaction were referred to TB dispensary where they were examined with a skin test with TRA if necessary. The second period was from 2018 to 2020 when children of 1-7 years old were given Mantoux test and if tuberculosis infection was suspected, a skin test with TRA was done both in primary health care network and TB units. In the first 3 years, 1,864,137 children were examined and in the second 3 years, 2,078,800 children from 1 to 7 years old were examined.Results. Among children of 1-7 years old who were screened by two stages (initial Mantoux test, and then in those who had a positive reaction, the TRA test was used), only 10-12% of those referred to a phthisiologist were subject to dispensary follow-up. Thus, with the implementation of the new edict on screening for tuberculosis infection in children with two tests, this proportion has not changed compared to previous years, when screening was carried out only with one Mantoux test. The reason why almost 90% of the children who were referred to TB Dispensary were not subject to dispensary follow-up is the following: children who have had previous conversion of tuberculin tests, along with everyone else are again screened with Mantoux test despite being previously followed up by TB dispensary due to the primary infection.Recommendations:Currently, there is no division of Group VI into Subgroups A, B, C in the dispensary follow up grouping. Why should conversion of Mantoux test reaction from negative into positive not be considered an infection, and the increase in the reaction must be at least 6 mm.Since Order No. 124n of the Russian Ministry of Health allows testing with TRA in the primary health care in case of suspected infection, it is advisable to refer those who have already had this test to a phthisiologist.A child with conversion of Mantoux test should not be re-screened with Mantoux test but the TRA test should be used. If a positive reaction to the TRA test occurs for the first time, it should be considered as conversion of this test, and in this case the child should be examined by computed tomography (CT), and preventive therapy should be prescribed. If in subsequent years the TRA reaction increases by at least 6 mm after previous preventive therapy, the child should be re-referred for CT to rule out the development of active tuberculosis.

Allergic Contact Dermatitis to Temporary Black Henna Tattoo Due to Sensitization to Para-Phenylenediamine

The fashion for temporary “black henna tattoo” is becoming increasingly more common among young adults and teens. An adolescent case with itching, erythema, edema, and inflammatory discharge on the right forearm two days after a temporary tattoo application is presented in this report. To determine the contact sensitizer, a patch test was performed one month after the end of the treatment. A bullous strong positive reaction (3+) was observed against para-phenylenediamine at the 48th and 72nd hours of evaluation after the application. Despite the common belief that henna tattoo application is harmless, the ingredients used in henna tattoo especially para-phenylenediamine can lead to allergenic reactions that can even be severe.Keywords: Adolescent, contact dermatitis, para-phenylenediamine

A study on susceptibility patterns, resistance mechanisms and cross- resistances of antibiotics against Pseudomonas aeruginosa in a teaching hospital at Puducherry

, a gram negative bacteria causes lung and nosocomial infections, mostly infect the body after surgery or invasive techniques. There has been a increasing prevalence in drug resistant variants in the recent years. 1. To determine the antibiotic susceptibility patterns of ; 2. To assess the antibiotics used against and the cross-resistence pattern existing between them; 3. To evaluate the possible resistance mechanisms of by phenotypic techniques.Thirty six consecutive, nonduplicate isolates were collected between January to July in the year 2018 from the hospital pus samples. The isolates showed synthesis of pyocyanin and a oxidase positive reaction. Kirby bauer’s disc diffusion method (HIMEDIA). was used for assessing the sensitivity of drugs. Disk approximation test was done to check the prevalence of inducible β-lactamases. Modified Hodge test was done to assess the metallo-β-lactamase activity. Double disk synergy method had been preferred to evaluate the extended-spectrum beta-lactamase (ESBL) activity. The most sensitive antibiotic was found to be ciprofloxacin which is followed by amikacin and ceftazidime (p < 0.05). 36% of the samples were resistant to more than one antibiotic groups. Cross-resistance was observed between the antibiotics. 53% of the samples had Inducible β-lactamases. Eighty percent of the samples which were non-resistant to ceftazidime showed positive reaction for inducible beta-lactamase. 2% isolates by DDS method showed the presence of ESBLs. The study samples did not show the presence of Metallo-β-lactamases.Strict adherence to the recent trend of “reserve drugs” concept and minimizing the misuse of antibiotics can bring down the drug resistance and morbidity. The addressal of irrational and inappropriate use of antimicrobials among the clinician is the need of the hour.

Granulomas Sarcóides Sobre Cicatriz: Além da Sarcoidose

Sarcoid granulomas can be found in a wide range of diseases and differentiating sarcoidosis from a sarcoid-like reaction may be a challenge. We present a woman with erythematoviolaceous papulonodular lesions located on the ears where piercings were placed. A skin biopsy showing an infiltrate of sarcoid and focal tuberculoid granulomas did not exclude sarcoidosis. There was a slight increase in the level of angiotensin-converting enzyme. Systemic involvement due to sarcoidosis was excluded. Epicutaneous tests performed revealed a strong positive reaction to palladium and nickel, supporting the diagnosis of granulomatous contact dermatitis. There are only a few reports of granulomatous contact dermatitis to palladium with piercings as the source of sensitization. The formation of sarcoid granulomas can represent either a sarcoid-like reaction or a form of cutaneous sarcoidosis, and patch tests are essential in order to establish the diagnosis.

Regulation of Gastric Acid Secretion of Liriope platyphylla Extract in Gastroesophageal Reflux Disease

Objectives: The purpose of this study was to confirm the effects of Liriope platyphylla extract on relieving Gastroesophageal reflux disease (GERD) through regulation of acid secretion.Methods: 8-week-old ICR mice were divided into untreated control group (Ctrl), GERD elecitation group (GERDE), Omeprazole administrate group before GERD elicitation (OMA), and Liriope platyphylla extract administrate group before GERD elicitation (LPA). After inducing GERD, gross observation and histological examination were performed and ATP6V1B1 (ATPase H+ Transporting V1 Subunit B1), GRPR (Gastrin-releasing peptide receptor), COX-1 (Cyclooxygenase 1), 8-OHdG (8-hydroxy-2’-deoxyguanosine), Cathelicidin, p-JNK (phospho c-Jun N-terminal kinase) were observed to confirm the damage defense effect of the esophageal mucosa, acid secretion regulation, antioxidant, anti-inflammatory, mucosal protection, and apoptosis regulationResults: OMA and LPA showed lower levels of damage compared to GERDE in gross observation and histological examination. ATP6V1B1, GRPR, and 8-OHdG showed lower positive reactions in OMA and LPA than in GERDE. COX-1 were less positive in GERDE and OMA than in Ctrl, but showed higher secretion in LPA than in Ctrl. Cathelicidin showed a decreased positive reaction in GERDE, OMA and LPA compared to Ctrl, but the decrease in positive reaction was smaller in OMA and LPA compared to GERDE. p-JNK showed increased positive reaction in GERDE, OMA and LPA than in Ctrl, but the increase in the positive reaction was smaller in the OMA and LPA compared to GERDE.Conclusions: The effects of Liriope platyphylla extract on esophageal mucosal damage protection, acid secretion regulation, antioxidant, anti-inflammatory, mucosal protection and apoptosis regulation were confirmed.

Effect of Reducing Inflammation of Coptis chinensis Extract -Ceramide Complex through ECS Control in Atopic Dermatitis

Objectives: The purpose of this study was to confirm effect of reducing inflammation of Coptis chinensis extract -ceramide complex through the endocannabinoid system (ECS) control in atopic dermatitis.Methods: 8-week-old ICR mice were divided into normal group (Ctrl), lipid barrier elimination group (ADE), palmitoylethanolamide treated group after lipid barrier elimination (PEAT), and Coptis chinensis extract-ceramide complex applied group after lipid barrier elimination (CRA). After inducing atopic dermatitis, cannabinoid receptor (CB) 1, CB2, CD68, p-IκB, iNOS, substance P and serotonin were observed to confirm the regulation of the ECS, macrophage activity and mast cell activity.Results: CB1 and CB2 showed higher positive reactions in the CRA than in the ADE and PEAT. CD68, p-IκB and iNOS showed higher positive reaction in the ADE, PEAT and CRA than in the Ctrl, but the increase in the positive reaction was lower in the CEA compared to the ADE and PEAT. Substance P and serotonin showed higher positive reaction in the ADE, PEAT and CRA than in the Ctrl, but the increase in the positive reaction was lower in the CEA compared to the ADE and PEAT.Conclusions: The effects of Coptis chinensis extract -ceramide complex were confirmed on the regulation of the ECS, macrophage activity and mast cell activity.

To the treatment and cure of gonorrhea

Schollz (D. m. W. No. 31, 29), on the basis of his many years of experience in the treatment of gonorrhea, indicates that Protargol and Albargin remain the best drugs to this day, because they act not only in a killing manner on gonococci, but also exert their influence on mucous membrane in the sense of its impregnation. In cases where gonococci sit deep in tissues (prostata, epididymis, ovaries), the author recommends using protein therapy. In stubborn cases, it is recommended to "Fieberbehandlung" with hot baths or inoculation with malaria. To establish the fact that gonorrhea has been cured, the author uses microscopic examination after a series of provocations, and also examines the patient with the help of cultures. An excellent means for establishing the cure of gonorrhea is the B.-G. reaction, and a negative reaction that occurred after the previous positive one is more likely to speak for a cure, while a persistent positive reaction indicates the need for a series of repeated microscopic and bacteriological studies.

Serological diagnosis of gonorrhea

Alf. Cohn (Derm. Ztschr. Bd. 55, H. 2) gives detailed instructions for the preparation of a specific antigen, patient serum, and also describes in detail the technique of the Bordet-Gengou reaction itself. The author received as a result of his observations with acute gonorrhea in men 40% pos. responses, for chronic 60% and for complicated 80-100%. The results are especially demonstrative in gonorrhoid arthritis (100%). It is important to use the reaction in doubtful cases, when microscopic and bacteriological examinations do not give the necessary answer for making a diagnosis. If people who do not have gonorrhea are vaccinated, the reaction may be positive. If a positive reaction persists for months or years, you need to look for a focus with gonococci. According to the author, the complement fixation reaction cannot replace the previously tested diagnostic methods, but it complements them. Together with bacteriological and clinical research methods, the reaction sometimes helps to understand the diagnosis of difficult cases.

Development of Antibodies against HPV-6 and HPV-11 for the Study of Laryngeal Papilloma

Laryngeal papilloma (LP), which is associated with infection by human papillomavirus (HPV)-6 or -11, displays aggressive growth. The precise molecular mechanism underlying the tumorigenesis of LP has yet to be uncovered. Building on our earlier research into HPV-6, in this study, the viral gene expression of HPV-11 was investigated by quantitative PCR and DNA/RNA in situ hybridization. Additionally, newly developed antibodies against the E4 protein of HPV-6 and HPV-11 were evaluated by immunohistochemistry. The average viral load of HPV-11 in LP was 1.95 ± 0.66 × 105 copies/ng DNA, and 88% of HPV mRNA expression was found to be E4, E5a, and E5b mRNAs. According to RNA in situ hybridization, E4 and E5b mRNAs were expressed from the middle to upper part of the epithelium. E4 immunohistochemistry revealed a wide positive reaction in the upper cell layer in line with E4 mRNA expression. Other head and neck lesions with HPV-11 infection also showed a positive reaction in E4 immunohistochemistry. The distribution pattern of HPV DNA, viral mRNA, and E4 protein in LP with HPV-11 infection was quite similar to that of HPV-6. Therefore, it might be possible to apply these E4-specific antibodies in other functional studies as well as clinical applications, including targeted molecular therapies in patients with HPV-6 and HPV-11 infection.

Results of patch tests (using Indian standard battery of allergens) in cement workers with clinically diagnosed allergic contact dermatitis to cement: A cross-sectional study

Objectives: The objective of the study was to identify the allergens showing positive patch test reaction (using Indian standard battery of allergens) in cement workers with clinically diagnosed allergic contact dermatitis (CD) to cement attending a tertiary referral center. Materials and Methods: We included cement workers with clinically diagnosed allergic CD to cement who attended the dermatology outpatient clinic of our tertiary referral center from January 2013 to December 2013. We did patch testing in all the cases ( after subsidence of active dermatitis) with Indian standard battery of patch test allergens and documented the allergens that showed a positive reaction. Results: Forty-seven (94%) of the 50 study participants showed a positive reaction to one or more of the allergens. The most common allergen that showed a positive reaction was potassium dichromate (43/50, 86%). Twenty-five patients (50%) showed positive reactions to more than 1 allergen. Four patients (8%) showed positive reactions only to allergens that were not seen in cement. Limitations: Small sample size and lack of information on clinical response of dermatitis to avoidance of identified allergen were the major limitations. Conclusion: Twenty-five (50%) patients showing positive reactions to more than 1 allergen tested and 4 (8%) showing positive patch test reaction to none of the allergens in cement (but to other allergens) highlight the role of patch testing in identifying the probable allergens in patients with clinically diagnosed allergic CD to cement.