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Disease progression of tuberculosis (TB) depends on the balance between the microorganism's virulence and the host defense systems (mainly T cell-mediated immune response). Interleukin-22 (IL-22) helps in cell proliferation and regeneration and provides protection against microbial diseases. The IL-22-producing T cells can migrate into the granulomas during TB infection. However, disparity exists in literature regarding its role. The present study aims to compare serum IL-22 levels and its' expression in TB patients and healthy controls. 87 TB patients and 85 healthy subjects were enrolled in the study. Under aseptic conditions, venous blood was withdrawn. Serum IL-22 levels were estimated using enzyme-linked immunosorbent assay, and its gene expression was assessed using SYBR green-based quantitative PCR technology. A statistical analysis was performed using SPSS. The median (interquartile range) of serum IL-22 levels was significantly lower in TB patients (18.55 (5.08) pg/mL) when compared to controls (49.38 (162.88) pg/mL) (p<0.0001). The IL-22 expression was significantly upregulated with a fold change value of 29.44 in TB patients. The IL-22 levels were found to be significantly decreased in patients, contradictory to its expression, which is upregulated. It plays a crucial role for the modulation of tissues in response to TB infection. [ABSTRACT FROM AUTHOR]

Drug-resistant tuberculosis remains a major public health concern in many countries. We compared the efficacy and safety of bedaquiline plus optimized background regimen (Bdq+OBR) with high dose moxifloxacin and optimized background regimen (Mfx(h)+OBR) for the treatment of patients with multidrug-resistant tuberculosis with additional resistance to fluoroquinolones. In this prospective observational study, newly diagnosed cases of multidrug-resistant tuberculosis with additional resistance to fluoroquinolone were enrolled. They received either Bdq+OBR or Mfx(h)+OBR and were followed up for six months. The sputum culture conversion rate at the end of six months and the time to culture conversion in each group were studied. The safety profile of both regimens was also studied. The sputum culture conversion was achieved in 41 patients (100%) in the Bdq+OBR group and 36 patients (87.8%) in the Mfx(h)+OBR group at the end of 6 months. The mean time to culture conversion was found to be 3.10±0.8 months in the Bdq+OBR group and 3.32±0.9 months in the Mfx(h)+OBR group. Mortality was 6.8% in the Bdq+OBR group and 10.8% in the Mfx(h)+OBR group at 6 months. Raised serum lipase and dark discolouration of skin were significantly more common in the Bdq+OBR group while vomiting and ototoxicity were more common in the Mfx(h)+OBR group. Bdq+OBR was associated with higher success of sputum culture conversion at 6 months and faster sputum culture conversion rate as compared to the Mfx(h)+OBR. [ABSTRACT FROM AUTHOR]

Background: Asthma is a heterogeneous disease, usually represented by chronic airway inflammation leading to variable respiratory symptoms and variable expiratory airflow limitation. Vitamin D has been shown to have several effects on the innate and adaptive immune systems that might modulate the severity of asthma exacerbations. Vitamin D deficiency and insufficiency is common in asthma patient, which causes frequent asthma attacks, respiratory tract infections, reduced lung function, poor asthma control, poor steroid responsiveness and severe asthma exacerbations. Objective: To determine serum vitamin D levels among asthmatic patients and to correlate them with the severity of bronchial asthma. Methods: A total of 50 patients with stable bronchial asthma between 18 to 60 years ages groups were included in the study. This Observational Study was conducted from April 2022 to December 2022 in Department of Respiratory medicine, Kamla Nehru Chest Hospital, Jodhpur. After taking proper clinical history and system examination, spirometry was done in each patient to obtain forced expiratory volume (FEV1), FVC and FEV1/FVC ratio for determination of the severity of asthma. Asthma control was assessed by using of asthma control questionnaire. Serum vitamin D level and absolute eosinophils count were measured in all participants. Results: In our study out of 50 cases, male patients (n=24) and female (n=26) which Association of Allergic history in Group with Severity of asthma was statistically significant (p=0.0240) and mean Vitamin-D Levels (ng/ml) was significantly higher in Mild [29.2182± 6.0880] compared to Moderate [23.3583± 5.2467] and Severe [14.9067± 5.1568] (p<0.0001). The mean Vitamin D Levels was significantly higher in "well controlled" [27.9071 ± 6.3191] compared to "partly controlled" [22.8706 ± 6.8941] and "uncontrolled" [17.2158 ± 7.0243] (p=0.0002). Conclusion: Vitamin D deficiency and insufficiency are highly prevalent in asthma patients in which prolonged duration of illness, frequently asthma exacerbation and poor asthma control. Hence, vitamin D is a useful for prevention and treatment of bronchial asthma. [ABSTRACT FROM AUTHOR]