This document discusses recent developments in the diagnosis and treatment of leprosy. It describes newer serological tests that detect antibodies against antigens like phenolic glycolipid-1 (PGL-1) and the 35kD protein to diagnose leprosy. It also discusses polymerase chain reaction (PCR) techniques used to detect Mycobacterium leprae DNA in patient samples. Regarding treatment, it outlines newer multidrug regimens being studied as alternatives to WHO-recommended multidrug therapy, including combinations of drugs like rifapentine, moxifloxacin, and minocycline. Immunotherapy approaches are also summarized that aim to modulate the immune response to more effectively clear M. leprae infections.
Uncultivable bacteria and recent trends towards their identificationabhishek yadav
This document discusses uncultivable bacteria and methods used to study them, with a focus on Treponema pallidum, the bacterium that causes syphilis. Some key points:
- T. pallidum cannot be grown in vitro and is difficult to study due to its fastidious growth requirements. Molecular methods and animal models are used instead of traditional culture.
- Serological tests detect antibodies produced in response to T. pallidum infection. Nontreponemal tests like RPR are used for initial screening while treponemal tests like FTA-Abs confirm infection.
- Diagnosis of syphilis depends on clinical presentation combined with serological testing results. Tests on body
Recent advances in diagnosis of hemoparasite infectionsPrernaChoudhary15
1. Several techniques are used to diagnose hemoparasite infections including microscopy, rapid diagnostic tests, serological tests, and molecular methods. Microscopy remains the standard but has limitations like low sensitivity and requiring experienced technicians.
2. Rapid diagnostic tests detect parasites' antigens and are sensitive when parasitemia is high, but can remain positive for weeks after treatment. Molecular methods like PCR are most sensitive and specific but are complex and time-consuming.
3. Flow cytometry is a promising technique for malaria diagnosis as it can distinguish infected red blood cells from white blood cells using DNA-binding dyes and evaluate drug susceptibility rapidly based on parasite growth.
This document provides information on multi-drug resistant tuberculosis (MDR-TB). It discusses the epidemiology and definitions of drug-resistant TB. It describes how to diagnose DR-TB through tests like Xpert MTB/RIF, line probe assay, and culture and drug susceptibility testing. Treatment options for DR-TB are also outlined, including shorter standardized treatment regimens and longer regimens. Criteria for determining appropriate treatment regimens and defining treatment outcomes are also summarized.
Recent advances in diagnosis of malaria By Dr Nidhi RaiDr Nidhi Rai Gupta
This document discusses recent advances in malaria diagnosis. It describes several diagnostic methods including microscopic examination of blood smears, fluorescent microscopy using methods like QBC, antigen detection using rapid diagnostic tests that detect proteins like HRP2 and pLDH, antibody detection methods like IFA and ELISA, and molecular diagnostic methods like PCR, LAMP, microarrays, and mass spectrometry. It provides details on the principles, procedures, advantages, and disadvantages of each method. Microscopic examination remains widely used but newer methods like rapid tests and molecular tools provide improved sensitivity, specificity, and ability to detect species.
Silencing c-Myc translation as a therapeutic strategy through targeting PI3Kd...Mark Lipstein
This document summarizes a study examining the combination of a novel PI3Kδ inhibitor, TGR-1202, with the proteasome inhibitor carfilzomib for treating hematological malignancies. The study found that TGR-1202 synergizes strongly with carfilzomib in lymphoma, leukemia, and myeloma cell lines and primary cells by silencing c-Myc translation. This synergistic effect is driven by TGR-1202's unexpected additional activity of inhibiting CK1ε, which contributes to repressing phosphorylation of 4E-BP1 and lowering c-Myc protein levels. The results suggest that TGR-1202, as a dual PI3Kδ/CK1ε inhibitor, may have
Rapid Diagnostic Techniques for Detection of Infectious DiseasesMubashir Nazir
Early diagnosis always leads to better treatment, which is why the point of care testing holds an essential place in the healthcare setting. This PPT includes different categories of RDT according to their turnaround time and technology.
Lenalidomide maintenance compared with placebo in responding elderlyravi jaiswal
This randomized phase III trial compared lenalidomide maintenance therapy versus placebo in elderly patients with diffuse large B-cell lymphoma (DLBCL) who achieved a response to first-line R-CHOP induction therapy. The trial found that lenalidomide maintenance led to a statistically significant improvement in progression-free survival compared to placebo, with a median PFS not reached in the lenalidomide arm versus 58.9 months in the placebo arm. There was no significant difference in overall survival between the arms. Lenalidomide maintenance was associated with more grade 3-4 adverse events compared to placebo. The benefit of lenalidomide maintenance was seen across patient subgroups.
Uncultivable bacteria and recent trends towards their identificationabhishek yadav
This document discusses uncultivable bacteria and methods used to study them, with a focus on Treponema pallidum, the bacterium that causes syphilis. Some key points:
- T. pallidum cannot be grown in vitro and is difficult to study due to its fastidious growth requirements. Molecular methods and animal models are used instead of traditional culture.
- Serological tests detect antibodies produced in response to T. pallidum infection. Nontreponemal tests like RPR are used for initial screening while treponemal tests like FTA-Abs confirm infection.
- Diagnosis of syphilis depends on clinical presentation combined with serological testing results. Tests on body
Recent advances in diagnosis of hemoparasite infectionsPrernaChoudhary15
1. Several techniques are used to diagnose hemoparasite infections including microscopy, rapid diagnostic tests, serological tests, and molecular methods. Microscopy remains the standard but has limitations like low sensitivity and requiring experienced technicians.
2. Rapid diagnostic tests detect parasites' antigens and are sensitive when parasitemia is high, but can remain positive for weeks after treatment. Molecular methods like PCR are most sensitive and specific but are complex and time-consuming.
3. Flow cytometry is a promising technique for malaria diagnosis as it can distinguish infected red blood cells from white blood cells using DNA-binding dyes and evaluate drug susceptibility rapidly based on parasite growth.
This document provides information on multi-drug resistant tuberculosis (MDR-TB). It discusses the epidemiology and definitions of drug-resistant TB. It describes how to diagnose DR-TB through tests like Xpert MTB/RIF, line probe assay, and culture and drug susceptibility testing. Treatment options for DR-TB are also outlined, including shorter standardized treatment regimens and longer regimens. Criteria for determining appropriate treatment regimens and defining treatment outcomes are also summarized.
Recent advances in diagnosis of malaria By Dr Nidhi RaiDr Nidhi Rai Gupta
This document discusses recent advances in malaria diagnosis. It describes several diagnostic methods including microscopic examination of blood smears, fluorescent microscopy using methods like QBC, antigen detection using rapid diagnostic tests that detect proteins like HRP2 and pLDH, antibody detection methods like IFA and ELISA, and molecular diagnostic methods like PCR, LAMP, microarrays, and mass spectrometry. It provides details on the principles, procedures, advantages, and disadvantages of each method. Microscopic examination remains widely used but newer methods like rapid tests and molecular tools provide improved sensitivity, specificity, and ability to detect species.
Silencing c-Myc translation as a therapeutic strategy through targeting PI3Kd...Mark Lipstein
This document summarizes a study examining the combination of a novel PI3Kδ inhibitor, TGR-1202, with the proteasome inhibitor carfilzomib for treating hematological malignancies. The study found that TGR-1202 synergizes strongly with carfilzomib in lymphoma, leukemia, and myeloma cell lines and primary cells by silencing c-Myc translation. This synergistic effect is driven by TGR-1202's unexpected additional activity of inhibiting CK1ε, which contributes to repressing phosphorylation of 4E-BP1 and lowering c-Myc protein levels. The results suggest that TGR-1202, as a dual PI3Kδ/CK1ε inhibitor, may have
Rapid Diagnostic Techniques for Detection of Infectious DiseasesMubashir Nazir
Early diagnosis always leads to better treatment, which is why the point of care testing holds an essential place in the healthcare setting. This PPT includes different categories of RDT according to their turnaround time and technology.
Lenalidomide maintenance compared with placebo in responding elderlyravi jaiswal
This randomized phase III trial compared lenalidomide maintenance therapy versus placebo in elderly patients with diffuse large B-cell lymphoma (DLBCL) who achieved a response to first-line R-CHOP induction therapy. The trial found that lenalidomide maintenance led to a statistically significant improvement in progression-free survival compared to placebo, with a median PFS not reached in the lenalidomide arm versus 58.9 months in the placebo arm. There was no significant difference in overall survival between the arms. Lenalidomide maintenance was associated with more grade 3-4 adverse events compared to placebo. The benefit of lenalidomide maintenance was seen across patient subgroups.
Anti tubercular therapy in Skeletal TBNeelaBiradar
The document discusses management of osteoarticular tuberculosis. It provides an overview of the strategic framework and pillars to end TB in India, including prevent, detect, and treat. Diagnostic tests for tuberculosis are described such as CBNAAT, LPA, MGIT, and IGRAs. Classification of TB based on drug resistance includes mono, poly, rifampicin resistant, MDR, and XDR tuberculosis. Terminologies used in NTEP are also defined.
DIAGNOSTIC APPROACH TO TUBERCULOSIS.pptxIshaChheda
- The document discusses the diagnostic approach to tuberculosis (TB), including types of TB, presumptive TB diagnosis, and various diagnostic tests.
- Types of TB include drug-sensitive TB treated with first-line drugs, as well as mono, poly, and multi-drug resistant TB. Diagnosis involves smear microscopy, culture, molecular tests like GeneXpert, and lateral flow urine tests.
- Newer molecular tests like GeneXpert and line probe assays can rapidly detect TB and drug resistance from sputum samples to help guide treatment.
This document discusses recent updates in the diagnosis of tuberculosis (TB). Direct diagnostic methods discussed include microscopic examination of samples after staining, various culture methods, and nucleic acid amplification tests. Microscopic examination remains the quickest method but has limited sensitivity. Culture allows for identification of the causative organism and is more sensitive but takes longer. Newer rapid culture methods using broth take less time than traditional solid culture. Molecular tests like PCR and LAMP can directly detect TB from samples and provide results faster than culture, but require more validation and quality control.
This document summarizes updates in the diagnosis of tuberculosis (TB). Direct diagnostic methods include microscopic examination of samples by Ziehl-Neelsen staining or fluorescent dyes to identify Mycobacterium tuberculosis, as well as culture-based techniques like traditional culture, radiometric culture (BACTEC), and broth-based methods like mycobacterial growth indicator tubes (MGIT) that provide faster results. Newer molecular techniques like polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) can also directly detect M. tuberculosis DNA or RNA. Indirect methods involve detecting antibodies by tests like ELISA or antigens by methods like TB STAT-PAK.
This document discusses Polymerase Chain Reaction (PCR), including its history, components, process, applications, advantages, and disadvantages. PCR was developed in 1983 by Kary Mullis and allows amplification of specific DNA sequences. It involves cycling between heating and cooling steps to denature and extend DNA using DNA polymerase. Key applications of PCR include detecting infectious diseases, genetic testing, forensics, cancer diagnostics, and cloning.
300 patients with diffuse large B-cell lymphoma (DLBCL) were treated. 200 were cured with RCHOP chemotherapy, while 100 relapsed or were refractory. Of these, 50 were eligible for stem cell transplant while 50 were ineligible. Immunotherapies including checkpoint inhibitors, CAR T-cell therapies, vaccines, and cytokines are being studied in clinical trials for relapsed/refractory DLBCL and other lymphomas with promising response rates seen. Adaptive cell therapies aim to expand tumor-specific T cells in vivo above a threshold needed for cure.
ABSTRACT- Multiple Drug resistance (MDR) tuberculosis timely diagnose is of utmost clinical relevance and needs to be diagnose at initial stages for the proper treatment. The current study was done to detect the several genes for MDR tuberculosis (TB) in clinical isolates by molecular tools. 60 clinical isolates were collected and subjected for AFB smear preparation, Nested PCR (IS6110) for mycobacterium tuberculosis complex detection and MDR TB PCR targeting rpoB, kat G, mab A promoter. 12 came positive for AFB smears, out of which 08 were pulmonary and 04 were extra pulmonary. Nested PCR targeting IS6110 gene was amplified at 123 base pairs with 340 base pairs as IC (internal control) was seen in 25 cases which include 19 pulmonary and 6 extra pulmonary. The Positive TB PCR specimens were subjected for MDRTB PCR Only 06 cases yielded, an amplicon of 315 bp confirming the rpoB gene resistance for resistance for rifampcin drug. In any of the 06 positives none of the other resistance gene other than rpoB was amplified. Targeting multiple genes at once, additional information will be gained from a single test run that otherwise would require several times the reagents and more time to perform. Current study signifies the usage of quick, cost effective, DNA sequences based method for MDR TB detection where disease will be diagnosed earlier and hence treatment would be started at an early stage.
Keywords: Multiple drug resistance, amplicon, Polymerase chain reaction, Nested PCR, Rifampicin.
This document discusses HLA (Human Leucocyte Antigen) typing methods. It describes that HLA forms part of the Major Histocompatibility Complex found on chromosome 6 and plays an essential role in the immune response. It summarizes various HLA typing methods including serology, cellular typing, and molecular methods such as PCR-SSP, PCR-SSOP, sequencing-based typing, and Luminex technology. It provides details on the procedures and advantages and disadvantages of each method.
This document discusses various techniques for diagnosing malaria, including microscopy, immunological techniques, and molecular techniques. Microscopy techniques include thick and thin blood smears, which are the gold standard, and the quantative buffy coat test. Immunological techniques include indirect fluorescent antibody testing, enzyme-linked immunosorbent assay, and rapid diagnostic tests targeting antigens like HRP-2, plasmodium aldolase, and lactate dehydrogonase. Molecular techniques include polymerase chain reaction and other nucleic acid amplification techniques, which can detect malaria parasites with greater sensitivity than microscopy.
This document discusses antibiotic strategies for community-acquired pneumonia (CAP) and exacerbations of chronic obstructive pulmonary disease (AECOPD). It outlines the mechanisms of action, testing, and spectrum of various antimicrobial drugs. It also describes methods for assessing the severity of CAP cases and determining appropriate treatment and site of care based on severity scores. Empiric antibiotic recommendations are provided for outpatient, inpatient, ICU, and specific pathogen cases of CAP.
- The document examines the role of plasminogen activator inhibitor 1 (PAI-1) in the recruitment of mast cells (MCs) to glioma tumors.
- It finds that neutralizing PAI-1 attenuates the infiltration of MCs into glioma tumors. It also finds that MCs express the PAI-1 receptor LRP1, and blocking LRP1 also attenuates MC migration.
- Activation of the potential PAI-1/LRP1 axis in MCs by purified PAI-1 promotes increased phosphorylation of STAT3 and subsequent MC exocytosis. This indicates the PAI-1/LRP1 axis influences MC recruitment in glioma tumors.
This document provides an overview of tuberculosis diagnosis and treatment in India. It discusses:
1) India's goal to end TB by 2025 and new programs to support TB patients and educate communities.
2) Recommendations that all medical colleges have facilities for multidrug-resistant TB management and that 5 whole genome sequencing facilities be established for surveillance and research.
3) Diagnostic tests for TB including smear microscopy, molecular tests like CBNAAT and line probe assay, and culture. It provides details on each test's methodology, turnaround time, and sensitivity.
4) Classification of TB cases as new, previously treated, clinically diagnosed or microbiologically confirmed. Treatment regimens are outlined according
XXDR-TB is an emerging threat in India and around the world. It refers to tuberculosis that is resistant to all first- and second-line anti-TB drugs. The document discusses the history and mechanisms of drug resistance in TB as well as various detection methods. It notes that India accounts for a large number of global TB cases and deaths annually and that drug resistance levels are high. New diagnostic tools and experimental drugs are being explored but effective treatment options for XXDR-TB remain limited.
Drug resistant tuberculosis is defined as resistance of Mycobacterium tuberculosis to antitubercular drugs. It can be multidrug resistant (MDR), extensively drug resistant (XDR), or have other resistance patterns. Diagnosis involves culture and drug susceptibility testing using solid or liquid media, as well as molecular tests like CBNAAT and line probe assays. Treatment requires specialized regimens using second line drugs for longer periods. Patient follow up assesses treatment response through repeated sputum cultures. Newer drugs like bedaquiline and delamanid are being added to treatment regimens to improve outcomes for drug resistant tuberculosis.
1. HIV is a retrovirus that infects and destroys CD4+ T cells, weakening the immune system.
2. It is spherical and enveloped, around 90-120nm in size, with a genome containing two identical RNA strands and enzymes like reverse transcriptase.
3. HIV is primarily transmitted through unprotected sexual intercourse, contaminated blood transfusions, needle sharing, and from mother to child during pregnancy, childbirth or breastfeeding.
4. Diagnosis involves screening tests like ELISA and rapid tests that detect antibodies to HIV. Supplemental tests like Western blot and viral load tests are used to confirm results.
5. Antiretroviral therapy with combinations of drugs can effectively suppress HIV
The document summarizes research conducted at the National Institute of Pathology in New Delhi on using PCR (polymerase chain reaction) to diagnose and characterize Leishmania parasites in clinical samples from patients with kala azar (visceral leishmaniasis) and post-kala azar dermal leishmaniasis. DNA was extracted from blood samples and skin scrapings and amplified using kinetoplast DNA-specific primers and ITS1-specific primers, then analyzed on an agarose gel to identify Leishmania donovani as the causative species. PCR showed high sensitivity in detecting Leishmania DNA and is a promising diagnostic technique.
This is NHL clinical update on 57th ASH Annual Meeting and Exposition (December 5-8, 2015).
It includes only clinical aspects include both chemotherapy and antibody therapy.
This document discusses various laboratory methods for evaluating cellular immunity, including leukocyte phenotyping using flow cytometry to identify cell surface markers, delayed type hypersensitivity skin testing to assess memory T cell responses, lymphocyte activation assays to measure proliferation and cytokine production following stimulation, and assays of monocyte and neutrophil function like chemotaxis and phagocytosis. Flow cytometry is highlighted as the most widely used method for immunophenotyping and allows rapid identification and quantification of leukocyte subsets.
Systematic screening of generic drugs for progressive multiple sclerosis iden...Jalormi Parekh
This document describes experiments investigating the effects of clomipramine in models of multiple sclerosis. Clomipramine showed neuroprotective effects against iron-mediated toxicity in neurons in culture. It also demonstrated antioxidant properties and reduced T-lymphocyte and B-lymphocyte proliferation. In mouse models of EAE, clomipramine decreased disease burden and inflammation when administered from disease onset. Further experiments explored the effects of clomipramine in various EAE models induced with different antigens. Overall, the results suggest clomipramine has therapeutic potential for reducing inflammation and neurodegeneration in multiple sclerosis.
1. Molecular microbiology methods like PCR and hybridization have revolutionized clinical diagnostics by enabling fast and direct detection of pathogens from clinical samples.
2. PCR in particular has become a mainstay technique, allowing amplification of specific DNA sequences from small amounts of input DNA. Variations like real-time PCR, multiplex PCR, and broad-range PCR further expanded diagnostic capabilities.
3. Emerging technologies like DNA microarrays promise even greater multiplexing, with the ability to simultaneously genotype large genomic regions or measure expression of many genes, positioning them as promising future molecular diagnostic tools.
Anti tubercular therapy in Skeletal TBNeelaBiradar
The document discusses management of osteoarticular tuberculosis. It provides an overview of the strategic framework and pillars to end TB in India, including prevent, detect, and treat. Diagnostic tests for tuberculosis are described such as CBNAAT, LPA, MGIT, and IGRAs. Classification of TB based on drug resistance includes mono, poly, rifampicin resistant, MDR, and XDR tuberculosis. Terminologies used in NTEP are also defined.
DIAGNOSTIC APPROACH TO TUBERCULOSIS.pptxIshaChheda
- The document discusses the diagnostic approach to tuberculosis (TB), including types of TB, presumptive TB diagnosis, and various diagnostic tests.
- Types of TB include drug-sensitive TB treated with first-line drugs, as well as mono, poly, and multi-drug resistant TB. Diagnosis involves smear microscopy, culture, molecular tests like GeneXpert, and lateral flow urine tests.
- Newer molecular tests like GeneXpert and line probe assays can rapidly detect TB and drug resistance from sputum samples to help guide treatment.
This document discusses recent updates in the diagnosis of tuberculosis (TB). Direct diagnostic methods discussed include microscopic examination of samples after staining, various culture methods, and nucleic acid amplification tests. Microscopic examination remains the quickest method but has limited sensitivity. Culture allows for identification of the causative organism and is more sensitive but takes longer. Newer rapid culture methods using broth take less time than traditional solid culture. Molecular tests like PCR and LAMP can directly detect TB from samples and provide results faster than culture, but require more validation and quality control.
This document summarizes updates in the diagnosis of tuberculosis (TB). Direct diagnostic methods include microscopic examination of samples by Ziehl-Neelsen staining or fluorescent dyes to identify Mycobacterium tuberculosis, as well as culture-based techniques like traditional culture, radiometric culture (BACTEC), and broth-based methods like mycobacterial growth indicator tubes (MGIT) that provide faster results. Newer molecular techniques like polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) can also directly detect M. tuberculosis DNA or RNA. Indirect methods involve detecting antibodies by tests like ELISA or antigens by methods like TB STAT-PAK.
This document discusses Polymerase Chain Reaction (PCR), including its history, components, process, applications, advantages, and disadvantages. PCR was developed in 1983 by Kary Mullis and allows amplification of specific DNA sequences. It involves cycling between heating and cooling steps to denature and extend DNA using DNA polymerase. Key applications of PCR include detecting infectious diseases, genetic testing, forensics, cancer diagnostics, and cloning.
300 patients with diffuse large B-cell lymphoma (DLBCL) were treated. 200 were cured with RCHOP chemotherapy, while 100 relapsed or were refractory. Of these, 50 were eligible for stem cell transplant while 50 were ineligible. Immunotherapies including checkpoint inhibitors, CAR T-cell therapies, vaccines, and cytokines are being studied in clinical trials for relapsed/refractory DLBCL and other lymphomas with promising response rates seen. Adaptive cell therapies aim to expand tumor-specific T cells in vivo above a threshold needed for cure.
ABSTRACT- Multiple Drug resistance (MDR) tuberculosis timely diagnose is of utmost clinical relevance and needs to be diagnose at initial stages for the proper treatment. The current study was done to detect the several genes for MDR tuberculosis (TB) in clinical isolates by molecular tools. 60 clinical isolates were collected and subjected for AFB smear preparation, Nested PCR (IS6110) for mycobacterium tuberculosis complex detection and MDR TB PCR targeting rpoB, kat G, mab A promoter. 12 came positive for AFB smears, out of which 08 were pulmonary and 04 were extra pulmonary. Nested PCR targeting IS6110 gene was amplified at 123 base pairs with 340 base pairs as IC (internal control) was seen in 25 cases which include 19 pulmonary and 6 extra pulmonary. The Positive TB PCR specimens were subjected for MDRTB PCR Only 06 cases yielded, an amplicon of 315 bp confirming the rpoB gene resistance for resistance for rifampcin drug. In any of the 06 positives none of the other resistance gene other than rpoB was amplified. Targeting multiple genes at once, additional information will be gained from a single test run that otherwise would require several times the reagents and more time to perform. Current study signifies the usage of quick, cost effective, DNA sequences based method for MDR TB detection where disease will be diagnosed earlier and hence treatment would be started at an early stage.
Keywords: Multiple drug resistance, amplicon, Polymerase chain reaction, Nested PCR, Rifampicin.
This document discusses HLA (Human Leucocyte Antigen) typing methods. It describes that HLA forms part of the Major Histocompatibility Complex found on chromosome 6 and plays an essential role in the immune response. It summarizes various HLA typing methods including serology, cellular typing, and molecular methods such as PCR-SSP, PCR-SSOP, sequencing-based typing, and Luminex technology. It provides details on the procedures and advantages and disadvantages of each method.
This document discusses various techniques for diagnosing malaria, including microscopy, immunological techniques, and molecular techniques. Microscopy techniques include thick and thin blood smears, which are the gold standard, and the quantative buffy coat test. Immunological techniques include indirect fluorescent antibody testing, enzyme-linked immunosorbent assay, and rapid diagnostic tests targeting antigens like HRP-2, plasmodium aldolase, and lactate dehydrogonase. Molecular techniques include polymerase chain reaction and other nucleic acid amplification techniques, which can detect malaria parasites with greater sensitivity than microscopy.
This document discusses antibiotic strategies for community-acquired pneumonia (CAP) and exacerbations of chronic obstructive pulmonary disease (AECOPD). It outlines the mechanisms of action, testing, and spectrum of various antimicrobial drugs. It also describes methods for assessing the severity of CAP cases and determining appropriate treatment and site of care based on severity scores. Empiric antibiotic recommendations are provided for outpatient, inpatient, ICU, and specific pathogen cases of CAP.
- The document examines the role of plasminogen activator inhibitor 1 (PAI-1) in the recruitment of mast cells (MCs) to glioma tumors.
- It finds that neutralizing PAI-1 attenuates the infiltration of MCs into glioma tumors. It also finds that MCs express the PAI-1 receptor LRP1, and blocking LRP1 also attenuates MC migration.
- Activation of the potential PAI-1/LRP1 axis in MCs by purified PAI-1 promotes increased phosphorylation of STAT3 and subsequent MC exocytosis. This indicates the PAI-1/LRP1 axis influences MC recruitment in glioma tumors.
This document provides an overview of tuberculosis diagnosis and treatment in India. It discusses:
1) India's goal to end TB by 2025 and new programs to support TB patients and educate communities.
2) Recommendations that all medical colleges have facilities for multidrug-resistant TB management and that 5 whole genome sequencing facilities be established for surveillance and research.
3) Diagnostic tests for TB including smear microscopy, molecular tests like CBNAAT and line probe assay, and culture. It provides details on each test's methodology, turnaround time, and sensitivity.
4) Classification of TB cases as new, previously treated, clinically diagnosed or microbiologically confirmed. Treatment regimens are outlined according
XXDR-TB is an emerging threat in India and around the world. It refers to tuberculosis that is resistant to all first- and second-line anti-TB drugs. The document discusses the history and mechanisms of drug resistance in TB as well as various detection methods. It notes that India accounts for a large number of global TB cases and deaths annually and that drug resistance levels are high. New diagnostic tools and experimental drugs are being explored but effective treatment options for XXDR-TB remain limited.
Drug resistant tuberculosis is defined as resistance of Mycobacterium tuberculosis to antitubercular drugs. It can be multidrug resistant (MDR), extensively drug resistant (XDR), or have other resistance patterns. Diagnosis involves culture and drug susceptibility testing using solid or liquid media, as well as molecular tests like CBNAAT and line probe assays. Treatment requires specialized regimens using second line drugs for longer periods. Patient follow up assesses treatment response through repeated sputum cultures. Newer drugs like bedaquiline and delamanid are being added to treatment regimens to improve outcomes for drug resistant tuberculosis.
1. HIV is a retrovirus that infects and destroys CD4+ T cells, weakening the immune system.
2. It is spherical and enveloped, around 90-120nm in size, with a genome containing two identical RNA strands and enzymes like reverse transcriptase.
3. HIV is primarily transmitted through unprotected sexual intercourse, contaminated blood transfusions, needle sharing, and from mother to child during pregnancy, childbirth or breastfeeding.
4. Diagnosis involves screening tests like ELISA and rapid tests that detect antibodies to HIV. Supplemental tests like Western blot and viral load tests are used to confirm results.
5. Antiretroviral therapy with combinations of drugs can effectively suppress HIV
The document summarizes research conducted at the National Institute of Pathology in New Delhi on using PCR (polymerase chain reaction) to diagnose and characterize Leishmania parasites in clinical samples from patients with kala azar (visceral leishmaniasis) and post-kala azar dermal leishmaniasis. DNA was extracted from blood samples and skin scrapings and amplified using kinetoplast DNA-specific primers and ITS1-specific primers, then analyzed on an agarose gel to identify Leishmania donovani as the causative species. PCR showed high sensitivity in detecting Leishmania DNA and is a promising diagnostic technique.
This is NHL clinical update on 57th ASH Annual Meeting and Exposition (December 5-8, 2015).
It includes only clinical aspects include both chemotherapy and antibody therapy.
This document discusses various laboratory methods for evaluating cellular immunity, including leukocyte phenotyping using flow cytometry to identify cell surface markers, delayed type hypersensitivity skin testing to assess memory T cell responses, lymphocyte activation assays to measure proliferation and cytokine production following stimulation, and assays of monocyte and neutrophil function like chemotaxis and phagocytosis. Flow cytometry is highlighted as the most widely used method for immunophenotyping and allows rapid identification and quantification of leukocyte subsets.
Systematic screening of generic drugs for progressive multiple sclerosis iden...Jalormi Parekh
This document describes experiments investigating the effects of clomipramine in models of multiple sclerosis. Clomipramine showed neuroprotective effects against iron-mediated toxicity in neurons in culture. It also demonstrated antioxidant properties and reduced T-lymphocyte and B-lymphocyte proliferation. In mouse models of EAE, clomipramine decreased disease burden and inflammation when administered from disease onset. Further experiments explored the effects of clomipramine in various EAE models induced with different antigens. Overall, the results suggest clomipramine has therapeutic potential for reducing inflammation and neurodegeneration in multiple sclerosis.
1. Molecular microbiology methods like PCR and hybridization have revolutionized clinical diagnostics by enabling fast and direct detection of pathogens from clinical samples.
2. PCR in particular has become a mainstay technique, allowing amplification of specific DNA sequences from small amounts of input DNA. Variations like real-time PCR, multiplex PCR, and broad-range PCR further expanded diagnostic capabilities.
3. Emerging technologies like DNA microarrays promise even greater multiplexing, with the ability to simultaneously genotype large genomic regions or measure expression of many genes, positioning them as promising future molecular diagnostic tools.
Similar to Recent diagnosis and newer drugs in leprosy (1).pptx (20)
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
3. Serology
1. Anti Phenolic glycolipid-1 (PGL-1)
a) IgM ELISA
b) Dipstick assay using ND-O-BSA-based ELISA
c) ML-flow test
2. 35-kD based serology
3. Anti MM2 IgG
4. Anti LID-1 and NDO-LID rapid test
4. Phenolic glycolipid-1 (PGL-1) is one of the first mycobacterial antigens which was identified and isolated
from the major glycolipid cell wall antigen of the bacterium.
Initially ELISA based method was developed
Sensitivity- 90-95% in LL/BL vs. 0-40% in PB cases
Trisaccharide and disaccharide components of PGL-1- react specifically with IgM antibodies in patients’
sera..
Hence, natural trisaccharide (NT), and natural disaccharide (ND) were synthesized individually and
conjugated with either bovine serum albumin (BSA) or human serum albumin (HSA) using either octyl
(O) or phenyl (P) linker arms (ND-O-BSA/HSA or NT-O-BSA/NT-P-BSA) and used in standardization of
ELISA for diagnosis of leprosy.
1) PGL-1 anti IgM
5. It was noted that these glycoconjugates had higher affinity for IgM antibody than PGL-1 and
showed a rising trend in the antibody levels from tuberculoid to lepromatous spectrum
associated with increase in bacterial load.
Using this neoglycoconjugate, newer assays known as M. leprae dipstick assay , Particle
agglutination assay and ML-flow test were developed.
Sensitivity of ND-O-BSA dipstick assay – 94.9%
6. In order to make the ML-dipstick assay suitable for field conditions, the
neoglycoconjugate-based assay was modified by developing it on a solid support using
immunochromatographic technique in a lateral flow assay, termed as ML-flow test.
In this assay, the nitrocellulose (NC) strips are loaded with 1-mm wide parallel lines of human
IgM (positive control) and neoglycoconjugate, which react with the IgM antibody present in
patient serum.
The NC strip is encased in a plastic module with a sample charging slot and is followed by a
reagent pad area for serum or whole blood sample with diluents to flow through and to be
absorbed in the absorbent pad at the bottom of the case.
Samples while flowing through the reagent pad pick up the colloidal gold-labeled antihuman
IgM which binds specifically human IgM present on the parallel lines to give positive results for
the test and IgM.
The test is read generally within 10 min of charging of the samples.
Sensitivity – 97.4% (MB) 40% (PB) specificity – 90.2%
7. ADVANTAGES-
1. Levels of PGL-1 antibody will decline after adequate chemotherapy. Hence useful method
to monitor leprosy patients under treatment.
2. Useful in determining the efficacy of MDT
3. Relapse – levels of antibody increases
4. Resistance – Levels of antibody remains persistent
DRAWBACK –
False positive : in highly endemic area , 10% uninfected individual may come positive.
8. 35-kD protein is present in the cell membrane of M. leprae
After identification of the gene encoding 35kD of ML, it could be cloned in Mycobacterium
smegmatis and was available in sufficient quantities in pure form as recombinant 35kD (r35kD)
Sensitivity – 98.5% (MB) 46.7% (PB) Specificity – 97.5%
Cross reacts with M. avium, Mycobacterium kansasii, Mycobacterium paratuberculosis, M.
smegmatis
2) 35-kD-based serology
9. The number of anesthetic patches in patient positively correlates with the level of antibody
Antibody levels were also found to correlate positively with the number of nerves involved in
primary neuritic leprosy
Antibody level against 35kD was found to decline following effective chemotherapy of patients.
10. Considering a low level of false positivity with PGL-1 antigen, Antigens which reacted strongly
with patients’ sera and minimally with control sera, were selected for further analysis.
The proteins selected were ML0405 and ML2331. These two proteins have been made as a
fusion construct and have been named as LID-1 [Leprosy Infectious Disease Research Institute
Diagnostic-1]
A rapid test based on NDO-LID has been developed and has been named as NDO-LID rapid test
for field purpose/point-of-care.
3) Anti LID-1 and Anti NDO-LID antibody
11. Serum sample (10 µl) and running buffer (100 µl) are charged in the well. The reaction of the
test and control yields a red color. Readings are recorded within 20 min of charging of samples.
A positive result is established when both the lines of control and test are developed. Visual
reading scores are graded as 1+, 1.5+, and 2+ and development of a faint color or no color is
considered as negative.
Anti NDO-LID Sensitivity – 95% (MB), 75%(PB) and specificity – 96.1%
Advantage- positivity seen one year before development of clinical MB and detection of anti
PGL-1 antibody.
Antibody level to LID-1 decline more rapidly after MDT regimen compared to that of
PGL-1-antibody level
12. Cytokine profile in leprosy
Leprosy develops in a patient mainly due to altered host response to M. leprae which depends
on microbiological and immunological characters of the individuals.
Studies on cytokines revealed involvement
TT leprosy - Th1 cytokines like interleukin-2 and IFN-γ
LL patient - Th2 type cytokine like IL-4, IL-5 and IL-10
14. Polymerase chain reaction (PCR)
•First done by Williams in 1990.
•To detect M. leprae DNA by extraction , amplification and identification.
•Specimens : skin biopsy, skin sections/paraffin blocks, skin smears, nerve sections, biological fluids (blood,
pleural effusion, ascetic fluid, CSF, saliva, nasal swab) etc.
•PCR is able to detect even 10-30fg of M. leprae (equivalent to 2.8-8.3 bacilli)
•ML specific gene sequences used – RLEP, hsp65, 18kDa, 36kDa, 16SrRNA, sodA
•RLEP-PCR is most sensitive and specific of all other gene targets
•To know viable bacilli –
15. Types of PCR
Reverse Transcriptase PCR – since PCR is
based on DNA detection , did not reflect
live bacilli
Real Time Quantitative PCR : measure
total DNA content
Correlate with BI (molecular BI)
So RT –PCR developed which is basically
RNA detection- reflect nucleic acid from
only live organism
Here 16SrRNA gene used. Biopsy sample
is sent in RNALater
16. 1. In case of diagnostic dilemma
2. Pure Neuritic Leprosy – inconclusive biopsy report
3. To differentiate between relapse and reaction by detecting viable bacilli.
4. To differentiate reinfection from relapse
5. Suspected drug resistance
6. To detect early disease in household contact
7. In monitoring patient under chemotherapy
ADVANTAGES
17. q(RT)-PCR or Real-Time PCR based on hsp18mRNA, shows no viable ML detected after 2years of
MDT, however considerable amount of DNA could be detected in many samples suggesting that
RT-PCR could be used effectively in monitoring patients under chemotherapy.
Status of PCR after treatment ?
18. Mouse foot pad technique for detection of drug resistance takes minimum 6 months.
PCR used to find the mutation in drug-resistant determining region (DRDR) of ML by gene
sequencing, i.e.,
1. folP1 region for dapsone
2. GyrA region for ofloxacin
3. rpoB region for rifampicin
Specimen - SSS or Biopsy preserved in 70% ethanol
For mouse foot pad & PCR, fresh biopsy specimen (BI 2+) to be sent and to be inoculated in mouse
foot pad with in 2 hr.
PCR for drug resistance !
19. PCR using RLEP: specificity 100%; Sensitivity 73.6% (In PB- 73%; MB- 100%)
Can detect 53% of BI negative leprosy cases
PCR using 16SrRNA : specificity 50%; Sensitivity 100% (PB- 51%; MB- 100%)
Duplex-droplet digital PCR – more accurate than Qpcr in quantifying (give accurate number of
initial template nucleic acid)
- greater sensitivity
- can detect gene expression variation <30%
20.
21.
22. High Resolution Ultrasound in leprosy
HRUS is a non-invasive, imaging technique, which provides real time examination of deeper
tissues including peripheral nerves in static and dynamic states such as blood flow.
Since the hall marks of leprosy are nerve enlargement and inflammation, HRUS and colour
Doppler imaging can be used to demonstrate nerve damage.
Peripheral nerve ultrasound provides information on the exact location of nerve enlargement
and morphological alterations in the nerve including echo texture, fascicular pattern and
vascularity.
More useful in pure neuritic leprosy
23. Colour Doppler imaging - Normally there is hypo-vascularity of nerve trunks. Increased blood
flow signals seen in colour Doppler in thick and tender peripheral nerves of leprosy denotes
oedematous and hyperaemic changes secondary to inflammation leading to alteration of an
effective blood nerve barrier during reactions.
Other imaging studies- MRI (Magnetic Resonance Imaging) and nuclear magnetic resonance
25. Why newer / alternative treatment regimen?
• Current WHO-MDT regimen is too long
• Compliance issues – patient who cannot take Clofazimine and Rifampicin need alternative
regimen
•Daily dose of Dapsone and clofazimine cannot be supervised
•To help in drug resistant cases
•To develop a common regimen for PB and MB leprosy
26. Ideal characteristic of a new regimen
•It should be oral
•Should be bactericidal and should not antagonise rifampicin in combination
•Should not have debilitating side effect
•Should be first tested in labs
•Bactericidal effects should be studied in clinical trials
•Long term relapse rate should be assessed
29. RIFAPENTIN (P)
Derivative of rifampicin with
Peak serum concentration
Serum T1/2 > Rifampicin
More effective
MOXIFLOXACIN (Mx)– More active and bactericidal than ofloxacin
Bactericidal activity identical to rifampicin
P > R = Mx > O or Clarithro or M > Clofa or Dapsone
30. Alternative regimens
ROM (Rifampicin 600 + Ofloxacin 400 +
Minocycline 200mg )
(Single dose or multiple dose monthly
for 12months)
• Studies shows single dose in PB ineffective
• Multiple doses showed equal efficacy that of WHO-MDT in
MB patient but with high rate of relapse. So multiple dose
can be considered in PB
• Advantage – fewer side effects
monthly supervised dose
Rifampicin + Ofloxacin for 28 days Far more risk of relapse
Uniform MDT (Rif+Clof+Dap) MDT for
6months for PB and MB)
• Appears promising - effective and well tolerated in patients
with PB leprosy
• Adv – MB cases misclassified as PB can be adequately treated
Concerns :-
• Seems to be too short in MB leprosy (more reactions than
those on MDT in some studies)
• Regarding relapse long term followup more than 7 yrs needed
before concluding
• Addition of clafazimine in PB will add to side effects may
31. Moxifloxacin based regimen
Rifampicin sensitive
(PMMx)
Rifapentin 900mg (or Rifampicin 600mg)
+
Moxifloxacin 400mg
+
Minocycline 200mg (or Clarithromycin 1g)
Rifampicin resistant INTENSIVE PHASE – daily for 6months
Moxifloxacin 400mg
+
Minocycline 100mg
+
Clarithromycin 500mg
+
Clofazimine 50mg
2009 suggestion by “WHO report of the global programme managers” meeting on “Leprosy Control Strategy”
Monthly supervised
for 12months
CONTINUATION PHASE- monthly for 18months
Moxifloxacin 400mg
+
Clarithromycin 1000mg
+
Minocycline 200mg
32. Other newer drugs
Gatifloxacin : flouroquinilone antibiotic
Dose – 100-400mg/day
Linezolid : Dose 600mg per day
can cause maroow suppression or optic atrophy
33. Limitations of newer drugs
1. PB patient treated with ROM therapy were twice as likely to have a relapse
2. There are insufficient data to conclude on the efficacy of multidose ROM therapy in MB
leprosy
3. Though bactericidal activity of moxifloxacin and rifapentine are comparable to rifampicin,
they are too costly to afford
4. The effectiveness and possible sideeffects of newly proposed drug regimen must be carefully
tested in controlled trials and in field trials before being applied to patients
34. Prophylaxis
Chemoprophylaxis :
◦ Previously used Dapsone or
◦ LPEP was launched globally to evaluate the feasibility and efficiency of contact tracing and
provision of preventive treatment for leprosy and to determine its impact on leprosy incidence
◦ Under this, the close contact of leprosy case were screened; symptomatic patients referred for
MDT and others were given SDR to decrease their risk for developing leprosy by 50-60%
◦ Dose : >35kg- 600mg ; 20-35kg – 450mg; <20kg- 10-15mg/kg
◦ Only few trials available on this
◦ Limitations :
◦ Chemoprophylaxis is confined to household contacts only
◦ Effect is temporary(<2yrs) and has to be repeated
◦ Implementation studies needed to assess acceptability and feasibility
◦ Potential risk of rifampicin resistance - but a review study of multidisciplinary experts
concluded that SDR given in contacts, in the absence of symptoms of active TB , poses a
negligible risk
35. Immunotherapy
• Manifestation of disease depends to a large extent on host immune response.
• Immunomodulators are required to modulate immune response which damages nerves
in host.
36. EFFECTS OF IMMUNOTHERAPY
Promotion of CD4 Th1 cells effective antibacterial process
Overproduction of CD4 Th2 cells is switched off.
Regulatory activity of CD8 cells is relaxed to allow Th1 activity
More efficient killing viable bacilli including persisters.
37. OUTCOME
Faster clearance of dead & viable bacilli including persisters leads to-
DECREASE IN
-Duration of treatment
-Morbidity & mortality
-Transmission & relapse
-Incidence & severity of
reaction
INCREASE IN
-Case holding & better
compliance
-Clinical improvement
-Improved host immunity
38. CLASSIFICATION OF IMMUNOMODULATORS-
Related mycobacteria sharing antigens with M
leprae(Vaccines)
Drugs
Miscellaneous agents or components of M.
leprae which mount an immunogenic response
39. Leprosy Vaccine
Regulate & optimize immune system –
-Rapid clinical & bacteriological improvement.
-Prevention of disease on exposure to pathogen
-Granuloma clearance.
-Treatment and decrease incidence of reactions.
-Prevention of nerve damage.
Vaccine can be used for
Prophylactic Therapeutic
40. CLASSIFICATION OF CANDIDATE VACCINES-
1st GENERATION-
NON CULTIVABLE(M leprae) CULTIVABLE M. leprae
1. Killed M leprae 1.BCG
2.Killed M leprae + BCG 2.BCG+ M. vaccae
3.Acetoacetylated M. leprae 3. Killed M. welchii
4.Killed ICRC
5.M. vaccae
6.M. habana
7.M. gordonnae
8.M. phlei
2ND GENERATION(IN VITRO/ANIMAL STUDIES ONLY)
Subunit vaccine
Shuttle plasmid vaccines
41. BCG Vaccine
• Indian studies- protective efficacy ranging from 20-70%
• Additional dose of BCG more protective in prevention than single dose where leprosy continues to
be a public health problem (At the start of MDT & every 6 months till end of treatment)
• Faster attainment of smear negativity & faster fall in BI, More rapid killing of bacilli.
• Increased risk of type 1 reaction, tuberculoid & indeterminate leprosy.
BCG + KILLED M. leprae
• The combined vaccine was tested worldwide but was not more effective than regular BCG.
42. ICRC (Indian cancer research center) Vaccine
◦ Cultivable mycobacteria belonging to M. avium intracellulare complex
◦ More accessible making the organism a stronger immunogen.
◦ From a cultivable organism & hence cheap.
◦ No contamination with animal products.
◦ Induce stable immunity
43. MiP Vaccine(Mycobacterium indicus pranii)
Earlier known as Mycobacterium w
NLEP has introduced MiP vaccine in a project made in India from the year 2016.
Shown to have both immunotherapeutic and immune-prophylactic effects in multibacillary
leprosy patients and their contacts in both hospital and population-based trials
It also reduced the bacillary load, upgraded the lesions histopathologically, led to complete
clearance of granuloma, reduced reactions and neuritis and reduced the duration of MDT in
leprosy patients.
In the new field project undertaken under ICMR and NLEP, the index leprosy patient will receive
the MIP vaccine over and above the MDT. His family members and contacts would be immunized
with MIP twice at an interval of 6 months.