Publications by authors named "Manoharan Tamizhselvan"

Article Synopsis
  • Tuberculosis lymphadenitis is a common form of extra-pulmonary TB, traditionally requiring six months of treatment, but this study explored a potential four-month regimen using ofloxacin.
  • The trial involved adult TB patients randomly assigned to either a four-month ofloxacin-based treatment or a traditional six-month regimen, with outcomes assessed based on TB recurrence and treatment success.
  • Results showed the four-month regimen was as effective and safe as the six-month control, with similar rates of favorable response and manageable side effects, making it a promising alternative.
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Background: Globally, no trial data are available on head-to-head comparison between 10 mg/kg and 25/35 mg/kg rifampicin in treating pulmonary tuberculosis during study initiation.

Methods: A multicentric, phase IIb randomized trial recruited 333 new culture-positive, drug-sensitive adult patients with pulmonary tuberculosis to compare safety and efficacy of high-dose rifampicin (R25/R35), against conventional dose (R10) given daily for 8 weeks followed by standard doses for 16 weeks. Main outcomes were treatment-emergent grade 3/4 adverse events (AEs) and time-to-culture conversion in liquid media, assessed by division of AIDS system for grading the severity of adverse events division of AIDS criteria and Kaplan-Meier methods.

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  • The study aimed to investigate how metformin affects the plasma levels of tuberculosis drugs (rifampicin, isoniazid, and pyrazinamide) in patients undergoing standard antituberculosis treatment (ATT) and the role of specific gene polymorphisms on drug metabolism.
  • In a phase IIB clinical trial, non-diabetic adults with pulmonary tuberculosis were divided into two groups: one receiving standard ATT and the other receiving ATT plus metformin; pharmacokinetic measurements were taken to assess drug levels.
  • Results indicated that metformin increased the clearance of rifampicin, isoniazid, and pyrazinamide, particularly in patients with certain genetic variants, though it had minimal impact on treatment
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Background: We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission.

Methods And Findings: Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among 'survivors' and 'non-survivors'. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets.

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Objectives: With the introduction of newer molecular diagnostic tools to identify , an increasing number of nontuberculous mycobacterium (NTM) is being identified. However, the drug resistance pattern of the NTM species identified is less explored. The objective of this study is to study the drug resistance patterns of species isolated in a tuberculosis-endemic setting at South India.

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Introduction: Despite the exalted status of sputum mycobacterial load for gauging pulmonary tuberculosis treatment and progress, Chest X-rays supplement valuable information for taking instantaneous therapeutic decisions, especially during the COVID-19 pandemic. Even though literature on individual parameters is overwhelming, few studies have explored the interaction between radiographic parameters denoting severity with mycobacterial burden signifying infectivity. By using a sophisticated approach of integrating Chest X-ray parameters with sputum mycobacterial characteristics, evaluated at all the three crucial time points of TB treatment namely pre-treatment, end of intensive phase and completion of treatment, utilizing the interactive Cox Proportional Hazards model, we aimed to precisely deduce predictors of unfavorable response to TB treatment.

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Objective: The influence of tuberculosis (TB)-immune reconstitution inflammatory syndrome (IRIS) on TB treatment outcomes and its risk factors were investigated among people with human immunodeficiency virus (HIV) and co-infected with TB.

Methods: Newly diagnosed, culture-confirmed, pulmonary TB patients with HIV and enrolled in a clinical trial (NCT00933790) were retrospectively analysed for IRIS occurrence. Risk factors and TB outcomes (up to 18 months after initiation of anti-TB treatment [ATT]) were compared between people who experienced IRIS (IRIS group) and those who did not (non-IRIS group).

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Importance: The benefit of daily over thrice-weekly antituberculosis therapy among HIV-positive patients with pulmonary tuberculosis (TB) who are receiving antiretroviral therapy remains unproven.

Objective: To compare the efficacy and safety of daily, part-daily, and intermittent antituberculosis therapy regimens in the treatment of HIV-associated pulmonary TB.

Design, Setting, And Participants: This open-label, randomized clinical trial was conducted by the National Institute for Research in Tuberculosis, south India.

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Article Synopsis
  • The study investigates the relationship between a specific genetic variation (LTA4H polymorphism) and the occurrence and severity of tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in HIV-TB co-infected patients.
  • Researchers analyzed samples from ART-naïve individuals with newly diagnosed TB in South India to determine how the LTA4H enzyme's genetic variants affected the incidence of TB-IRIS.
  • Findings show a total of 142 patients were analyzed, revealing a distribution of genotypes that could help understand the genetic influence on TB-IRIS presentations.
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