Cystic fibrosis (CF) has been generally well defined throughout the world although its prevalence is very difficult to ascertain for a number of reasons, including the fact that the medical/scientific literature and patient registries vary in quality in different countries. In the present review literature (1938–2017), we found out the higher frequency of registered CF patients in the European Union. This could be due to strong clinical awareness and greater health facilities. In contrast, we found a very irregular report from Asian and African countries. In these countries, the national CF registration system is mostly lacking or it is individualized-based research. In this situation, the estimation of various risk factors such as ethnicity and/or races is remained to be resolved. Overall, this review outlines the urgent need for revitalization of national and global CF registration, worldwide.

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Antibiotics, one of the miracle discoveries of the 20^th century after world war revolutionized the treatment and prophylaxis of infectious diseases. Antibiotics led to an increase in the quality of health-care system but with the emergence of antibiotic-resistant bacterial strains compromised their very potential. The WHO calls bacterial resistance as one of the major threats to global health, food security, and development today. Antibiotic resistance poses a need of alternative therapy to conventional antibiotics. As proved in preantibiotic era phage therapy is effective against a number of successful pathogens and can be used as an alternative strategy to restrain stern infections such as antibiotic resistance tuberculosis (TB). In the present paper, effectiveness of phage therapy and use of model organisms for developing treatment strategy for antibiotic-resistant TB is discussed so as to explore new possibilities in battle against antibiotic resistance.

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Nutrition and infectious diseases are related to each other in some aspects. First, nutrition affects the development of human body immune system. Moreover, nutrition can influence emerge of infectious diseases (e.g., gastrointestinal infections), food poisoning, intestinal diseases, and systemic infectious diseases. In this review, the mentioned aspects of the relationship between nutrition and infections are discussed. Furthermore, the relationship between malnutrition and infectious diseases, nutrition in patients with severe combined immunodeficiency and relationship between overeating and infection are reviewed. Overall, some factors can weaken the body's ability to fight infection and cause malnutrition. The factors include anorexia, traditional behaviors, reduction of intestinal absorption, metabolic damage, disorder metabolism of lipids and carbohydrates, reduction of vitamins, iron, zinc, and copper. In the case of the relationship between malnutrition and infection, a large number of studies have illustrated a bidirectional interaction of malnutrition and infection. In this aspect, to treat serious acute malnutrition and limit the rate of death, some preventive studies applied antibiotics, probiotic bacteria, and prebiotic foods. In the future, studies may be conducted on intestinal or systematic immunomodulation.

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Background: With the advent of many new advanced techniques, sequences of a number of proteins have been made available. But the relative paucity of the experimentally determined three-dimensional structures of these proteins has paved way for the development of computational structure prediction methods. Protein secondary structure prediction is an essential step in modeling the tertiary structure. Among the various secondary structure prediction methods available, three different methods with unique working principles, namely, GOR, HNN, and SOPMA were evaluated for their efficiency to predict secondary structures. Methods: A set of 90 different proteins with known secondary structures from three major classes namely, mainly alpha, mainly beta, and mainly alpha beta was used as reference. Secondary structure data of these proteins obtained through experimental methods were compared with that of predictions made by GOR, HNN, and SOPMA respectively by employing various statistical analyses, namely paired sample test, correlation coefficient, standard deviation, standard error mean and scatter plots. Results: The secondary structure prediction tools namely, GOR and HNN were found to predict helical structures more accurately than the sheets. SOPMA was observed to predict sheets more accurately than helices. Conclusion: Based on the observed results, it could be concluded that there is no single tool that consistently predicts all the secondary structures accurately. It could also be anticipated that a combined use of these secondary prediction tools could further enhance the efficacy of in silico protein secondary structure prediction methods.

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Background: GeneXpert MTB/RIF (Xpert), the fully automated cartridge-based nucleic acid amplification test for simultaneous identification of Mycobacterium tuberculosis complex and rifampicin resistance (RR), directly from samples is considered as a game changer for tuberculosis (TB) control programs worldwide. Methods: We are reporting serious issues with repeatability among a subgroup of Xpert (Version 4) identified RR results from South Indian state recently switched to Xpert by the National TB control program. Results: We have demonstrated that poor repeatability is frequently associated with those Xpert derived RR results, identified by detection of delayed amplification of any probe in the presence of positive analyte results for all probes. Another significant contributing factor was found to be lower bacterial loads in samples. The repeat tests were done by Xpert and/or by line probe assay depending on smear positivity. The finding is worrying as Xpert is recommended over other tests due to its reportedly better performance among low bacterial load samples such as pediatric, extra-pulmonary, HIV-TB co-infected, and smear negative pulmonary TB and the same samples, it seems are more likely to cause error prone RR results. Conclusions: We recommend for additional genotypic tests with specific mutant probes for detecting mutations at rpoB hot sites and growth based tests for all Xpert derived RR-TB cases identified by the above algorithm for confirmation of the presence of mutation, based on our available data.

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In this brief review, the geographic information systems (GISs) and its beneficial influence in the field of health were discussed and highlighted. Basically, GIS is a computerized system that can significantly add to assess and monitor the effects of environmental factors (namely, population, air pollution, location, climatic changes) on public health problems. The main benefits of GIS in health services are mapping and/or visualizing of disease distribution, which will ultimately improves our understanding of disease diversities and their spatial patterns. Therefore, GIS technology is capable of providing the intra- and inter-logical connection between health, social services, and natural environment.

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The aim of this study is well stated to address in recent advances on probiotics in the past 50 years. Probiotics are the living cell organisms. It is a presence in human and animal gut. The probiotic organisms are natural antibiotics in the human-animal gut. This reviews the main role mechanisms of action in probiotics such as probiotics are antibiotics, probiotics in antibacterial activity, probiotic action in fish gut bacteria, dietary supplements of probiotics, gastrointestinal microbiota of fishes, microbial community of the gastrointestinal tract of fish, bioactive compounds from probiotic bacteria, probiotic uses in cancer therapeutic applications, and applications of probiotics. The most common probiotics are used in many ways such as boosting the immune system, inhibition of pathogenic organism, prevention of cancer, reduction of inflammatory bowel disease, reducing cholesterol level, and synthesis of Vitamin A. Nowadays, food products are mainly involved in chemical preservatives. These preservative agents are causing the disease to affect the human health. The probiotic food products are used to the development of human-animal health.

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Background: The incidence of tuberculosis (TB) in the Philippines is 288/100,000 populations (2014), wherein 2% of new cases and 21% of retreatment cases are multidrug-resistant TB (MDR-TB). In addition, the rate of human immunodeficiency virus (HIV) infection has been alarmingly over the past 7 years in the subpopulation of men who have sex with men in the Philippines. In June 2016, there were 841 new HIV-seropositive individuals reported to the HIV/AIDS and Antiretroviral Therapy Registry of the Philippines. In the present study, we aimed to investigate the prevalence of HIV among MDR-TB patients in a Manila hospital from 2011 to 2015. Methods: TB patients who referred to the programmatic management of drug-resistant TB (2012 to 2015) were tested for MDR-TB (using Xpert MTB/RIF assay) and HIV infection. In addition, the available data that belong to patients before the introduction of the Xpert MTB/RIF assay were included. Results: A total of 4515 presumptive drug-resistant TB patients were screened (2012–2015) to determine the percentage of MDR-TB cases: 16% (2012), 14% (2013), and 11% (2014 and 2015). Among the MDR-TB patients, the percentage of HIV-positive cases increased yearly: 0.5% (2011), 3% (2012), 5% (2013), 9% (2014), and 15% (2015). The high mortality rate ranged from 42% to 66%. The cure rate among the enrolled MDR-TB cases was 47% in 2012, which increased from 27% in 2011, but it did not improve thereafter (46% in 2013 and 51% in 2014). Conclusion: A remarkable increase in the prevalence of HIV among MDR-TB patients was found. The raises are alarming and need urgent attention on different risk factors and/or living style of patients.

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Background: The present study was planned to study the role of Mg in preeclampsia and its correlation with dietary intake of proteins and calories by analyzing serum Mg at 20 weeks, delivery, and cord blood Mg levels. Methods: The study was conducted in 102 pregnant women aged 17–36 years attending the outpatient department (OPD) before 20 weeks of gestation. The study samples were drawn twice: once before 20 weeks during visit in the OPD and second within 1 h of childbirth. Serum was analyzed for Mg levels using spectrophotometric method. Furthermore, thyroid-stimulating hormone and glucose challenge test were done as per the standard methods. Results: In normal pregnant women, the mean serum Mg level at <20 weeks of gestation was 2.03 ± 0.34 mg/dl, at term was 1.93 ± 0.41 mg/dl, and in cord blood was 1.84 ± 0.35 mg/dl. Conclusion: The study data support the hypothesis that Mg deficiency might be the causative factor in the development of preeclampsia.

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Background: Bovine ephemeral fever virus (BEFV) is an arthropod-borne virus that is highly infective for cattle and water buffalo. The infection has important economic losses and is common in tropical and subtropical regions. Surface glycoprotein (G protein) of BEFV is an immunogenic transmembrane G protein and responsible for attachment and entrance to host cells. The aim of this study was to determine immune dominant epitopes of the protein through immunoinformatics approaches. Methods: A reference sequence and some other related sequences of the G protein were retrieved. Three-dimensional structure of the protein was modeled and refined. Variation analysis of the protein sequences was done, and signal peptide and transmembrane topology were predicted. Finally, linear and conformational (discontinues) epitopes of the protein were predicted. Consensus linear and conformational epitopes were selected and reported as immunodominant epitopes. Results: Five regions were characterized as hyper variable regions (HVRs). Selected consensus epitopes included amino acids 46–60 (AA_46–60), AA_67–74, AA_132–149, AA_156–188, AA_196–225, AA_260–282, AA_315–456, and AA_487–503 were selected as consensus epitopes. Conclusion: Four determined epitopes including AA_67–74, AA_132–149, AA_196–225, and AA_315–456 were determined for the first time in this study. Other predicted epitopes in the current study, has been previously identified, however, new start and end regions for them were suggested here. The predicted epitopes may be experimentally tested to confirm as novel immunogenic candidates applicable in preventive and diagnostic tasks.

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Background: Pulmonary tuberculosis is an important public health problem at present. The disease is still highly prevalent in several areas including tropical Indochina. In the area between Thailand and Myanmar body, the emerging drug-resistant tuberculosis is an interesting problem in the present day. Early diagnose and management of tuberculosis patient is important. Methods: In this specific article, the authors summarize and discuss on the locally available data on smear-negative pulmonary tuberculosis in a drug-resistant endemic foci in Indochina. The relative incidence and the outcome of the treatment are specifically focused. Results: Based on the present study, the outcome of the treatment of cases with smear-negative pulmonary tuberculosis is similar to cases with smear-positive pulmonary tuberculosis. Conclusion: Since the outcome of the treatment of cases with smear-negative pulmonary tuberculosis is similar to cases with smear-positive pulmonary tuberculosis, therefore, it is recommended for therapeutic management of those cases.

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Background: In tropical developing countries, there are several common infectious diseases including tuberculosis and dengue. The concurrence between dengue and tuberculosis is possible. Methods: Here, the authors perform a mathematical model study to estimate the incidence of concurrent dengue and tuberculosis in Thailand, a tropical country in Indochina. The estimation is performed based on joint probability principle. Results: The estimated incidence of concurrent dengue and tuberculosis in the studied setting is equal to 0.148/100,000 population. Conclusion: There is a low incidence of concurrent dengue and tuberculosis, and this might be due to several possible reasons.

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Background: There is no population in the world clear from urinary tract infection (UTI), especially among women. Urinary tract disease is a general term alluding to the bacterial infection anyplace in the urinary tract. It is commonly acknowledged that contamination of the upper urinary tract puts the patient in danger for kidney damage. The aim of the study was to identify the type of bacteria that cause UTI beside elevates the correlation between UTI and some inflammatory markers such as erythrocyte sedimentation rate, white blood cell, C-reactive protein (CRP), and hemoglobin for the UTI among patients in various sex and age groups. Methods: The study was carried in Baghdad Teaching Hospital during July 7, 2017–October 15, 2017. A sum of 45 UTI patients and 20 control group was collected. Results: The study showed that UTI increased in female than in male with 62.2% and 37.8%, respectively, and high risk at age 30–49 years with 42.2%. The microorganisms identified in this study were Escherichia coli (42.2%), followed by Enterobacter (8.9%), Pseudomonas and Klebsiella (6.7% for each), Proteus spp and Serratia spp (4.4% for each), and mixed culture (E. coli + Proteus and E. coli + Pseudomonas with 2.2% for each one). Conclusion: This study showed highly significant correlation between CRP and bacterial isolation.

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Background: The purpose of this study was to investigate two-body wear resistance and hardness of different three modern composite materials. Methods: In the conditions recommended by the manufacturer five pieces were produced from each material. All samples were kept in distill water for 1 week and determined Vickers hardness (HV) before two-body wear test. Then, two-body wear tests were performed using a computer controlled chewing simulator. In this study, the chewing simulator was programmed to provide a 2 mm vertical movement and a 0.7 mm horizontal movement. For each wear test, Al₂O₃ with a diameter of 6 mm was used as antagonist material. The mean volume loss of all samples after the wear tests was determined with three dimensional profilometry. In addition to a random specimen was selected from each test group and SEM images were taken for analysis of wear tracks. Mean and standard deviation values were calculated and evaluated with the one-way ANOVA. Results: The hardness values of the materials tested in this study were measured between about 49 HV and 78 HV. Significantly, lowest mean volume loss was detected for the Heliomolar at about 3.1 μm3 whereas the highest mean volume loss was detected for the Silorane at about 6.4 μm3 after 360.000 chewing cycles. Conclusions: However, among the materials tested in this study suggested correlations between HV and two-body wear resistance are not significant.

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Background: Cholesterol degradation pathway is one of the important pathways in survival of Mycobacterium tuberculosis (Mtb) bacilli, and steroid C26-monooxygenase (CYP125) enzyme of Mtb associated with this pathway is reported to be novel drug target. This study aims to find out novel, safe, and effective inhibitors against CYP125 from natural phytochemicals with reported anti-tubercular activity. Methods: Bioinformatics approach such as homology modeling, virtual screening, and molecular dynamics (MD) simulation was applied to identify best hits among all the shortlisted 148 compounds. The Mtb H37Ra bacilli growth was measured at optical density at 600 nm in minimal media supplemented with cholesterol and monitored for 10 days. Two promising compounds, namely, sesamin and β-sitosterol, were studied to determine their effective minimum inhibitory concentrations (MICs) in Mtb H37Ra bacilli culture. Results: In virtual screening, 15 compounds showed comparatively better binding affinity than natural substrate (choletst-4-en-3-one). In MD simulation study, the protein structure was observed to be stable in alls the interaction complexes, i.e., with choletst-4-en-3-one, sesamin, and β-sitosterol. The MICs of sesamin and β-sitosterol were observed to be 2 μg/ml, inhibiting the growth of the Mtb bacilli by 51% and 53%, respectively. Conclusions: From the above experimental findings, sesamin and β-sitosterol may be proposed as safe and potential inhibitors of CYP125 resulting in diminished growth of Mtb bacilli.

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Background: Bacterial resistance is one of the most challenging and emerging public healthcare crisis in the modern era. Along with antibiotic degrading strategies, bacteria also evolved to produce extracellular polymers such as capsular polysaccharide (CPS) which not only provides immune protection but also act as a permeability barrier to antibiotics. The use of therapeutic enzymes alone and in combination with antibiotics has opened a new window for clinicians and researchers. Methods: In the present study, isolation of broad-spectrum capsular depolymerase bacterium was attempted from a number of environmental samples followed by 16SrRNA characterization. Optimization of capsular depolymerase production was performed by the one variable at time (OVAT) method and response surface methodology (RSM). Capsular depolymerase was partially purified using ammonium sulfate saturation method. Capsule stripping effects of depolymerase were analyzed using microscopic visualization of the capsule and antibiotic susceptibility test. Results: Thirty-two capsular depolymerase producing bacteria were isolated in this study and broad-spectrum depolymerase producing Isolate-30 was characterized as Bacillus siamensis SCVJ30 according to the 16srRNA sequencing. Depolymerase production was optimized using OVAT method and RSM. Relatively high yields (1.92 IU/ml) of capsular depolymerase were obtained in a medium containing 1 mg magnesium sulfate, 7 mg peptone and at 9 pH. A 115% increase in capsular depolymerase production was observed under optimal conditions than unoptimized conditions. Microscopic visualization of the capsule and antibiotic susceptibility testing postulates the positive effect of depolymerase on antibiotic effi cacy against Klebsiella pneumoniae. Conclusion: Further characterization of the enzyme will help in developing broad-spectrum depolymerase as a potent therapeutic agent against drug-resistant strains.

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There has been an increased use of cardiac pacemaker device utilization in cardiac patients with a corresponding increase of device-related infections in these patients. The common cause of postpacemaker implantation infection is either Gram-positive or Gram-negative bacteria. Infection of pacemaker implantation site due to nontuberculous mycobacteria is rare. Globally, thirty-two cases of pacemaker device infections caused by nontuberculous mycobacteria were reported. It is important to carry out not only species identification of mycobacteria but also drug susceptibility testing to start precise treatment to those patients, who are infected with atypical mycobacteria. We report a patient with pacemaker pocket infection due to Mycobacterium chelonae.

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Background: Endothelial dysfunction has been associated for the cause of atherosclerosis or cardiovascular diseases (CVDs). Endothelial progenitor cells (EPCs) are exposed to oxidative stress during vascular injury as residents of blood vessel walls or as circulating cells homing to the sites of neovascularization. The current study was designed to analyze various subpopulations of EPCs and their DNA damage in CVDs. Methods: The study included 50 coronary artery disease (CAD) patients which was confirmed by angiography and 50 age-matched healthy controls without CAD. Flow cytometric analysis performed to measure subpopulations in EPCs in the peripheral blood using markers such as CD34, CD133, VEGFR2, and CD45. Oxidative DNA damage was analyzed in CD34+ cells. Mean EPC count was expressed as a percentage of total white blood cells. Three different subpopulations with CD45−/CD133+/VEGFR2+, CD45−/CD34+/VEGFR2+, and CD45−/CD34+/CD133+ coexpressions were measured with various percentages. Results: Subpopulation of CD45−/CD34+/VEGFR2+ cells had shown significant (P = 0.001) decrease in CAD patients in comparison with the healthy controls. There was no significant difference in the subpopulations of CD45−/CD34+/CD133+ cells (P = 0.005) and CD45−/CD133+/VEGFR2+ cells (P = 0.005) in CAD and healthy controls. The CD45−/CD34+/VEGFR2+ subpopulation EPC showed positive correlation with the severity of coronary stenosis (r = 0.35, P = 0.026), while other EPC subpopulation count did not show any correlation. Oxidative DNA damage was higher in CAD compared with controls. The number of EPC subpopulation CD45−/CD34+/VEGFR2+ was inversely correlated with oxidative DNA damage (P = 0.001), hypertension (P = 0.001), and diabetes mellitus (P = 0.004). Conclusion: We observed an association between CD45−/CD34+/VEGFR2 subpopulation EPCs and DNA damage in CAD condition. These findings support a cell biologist in searching the role of EPC populations in the pathophysiology or diagnosis of the disease by a clinician.

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Background : Daily intake of air is 30 Ib as compared with 2-Ib of food and 4½ of water. Thereby, breathing-contaminated air is as harmful as drinking or eating contaminated water or food, respectively. Recent research has highlighted the extent of outdoor air pollution in large cities and warranted high-quality studies to clarify the magnitude of the problem. Here, we evaluated the possible association between tuberculosis (TB) development and exposure to outdoor air pollution in a metropolitan city of Tehran. Methods: Extraction and analysis of relevant data. Investigation performed on TB patients (n = 1167) that were residing in Tehran for the past 10 years. The average concentration of sulfur dioxide (SO₂), nitrogen dioxide, carbon monoxide (CO), and particles with an aerodynamic diameter of ≤ 2.5μm (PM_2.5) and ≤ 10.0 (PM₁₀) was measured from Tehran Air Quality Control Corporation (TAQCC). Patient and ecological informations were analyzed using geographical information system. Results: Based on TAQCC, Tehran had an average of 180–250 polluted days per year for the last 10 years. The high incidence of pulmonary TB (18 to 31/100,000) was detected in populations which were exposed to high concentration of CO (2.7 to 5.2 parts per million, 95% confidence interval [CI]; 1.10 to 1.90) and PM_2.5(35 to 42μg/m³; 95% CI 1.03 to 1.80). The level of SO₂,NO, and PM₁₀was also high but not significantly related to TB (P > 0.05). Conclusion: The long-term exposure to PM_2.5 and CO was positively associated with TB development.

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Background: The most practical test for identifying tuberculosis (TB) in developing countries remains smear microscopy. However, due to its low sensitivity, a new point-of-care diagnostic method has been developed. The purpose of this study was to assess the performance of TB-Loop-mediated isothermal amplification (TB-LAMP) test on sputum samples of suspected TB cases. Methods: Suspected pulmonary TB patients (527) from Jamot Hospital and without any history of anti-TB treatment were consecutively included in the study. Smear microscopy, TB-LAMP, GeneXpert® MTB/RIF, and liquid culture using BACTEC 960 Mycobacteria Growth Indicator Tube (MGIT) were performed on sputum samples collected from these patients. The sensitivity and specificity of TB-LAMP were compared with smear microscopy and GeneXpert® MTB/RIF. MGIT culture was the gold standard. Results: TB-LAMP and smear microscopy showed sensitivities of 82.6% (95% confidence interval [CI], 76.9–87.2) and 53.6% (95% CI, 46.8–60.3), respectively, and specificities of 96.0% (95% CI, 93.2–97.7) and 99.0% (95% CI, 97.1–99.7), respectively. The sensitivity and specificity of TB-LAMP were similar to GeneXpert®, (89.9%; 95% CI, 85.0–93.3 and 97.0%; 95% CI, 94.4–98.4). Conclusion: TB-LAMP is more sensitive than currently used microscopy. It presents a favorable diagnostic tool for TB in peripheral laboratories with limited equipment, such as those in developing countries.

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Background: Irrigants plays a vital role in disinfection of the root canal system. Although concentration dependent, a fine balance between antimicrobial efficacy and biocompatibility need to be maintained at all times. The aim of the present study was to evaluate the cytotoxicity of conventional irrigants on two different cell lines in a dose-dependent manner in vitro. Methods: Sodium hypochlorite (NaOCl), chlorhexidine digluconate (CHX), and iodine potassium iodide (IKI) were prepared in concentrations of 5%, 2.5%, 2%, and 1%. About 0.9% saline served as negative control and Biopure MTAD^TM (100%) as positive control. Permanent (Henrietta Lacks [HeLa]) and primary (human gingival fibroblast [HGF]) cell lines were chosen to evaluate the cytotoxicity of the irrigants by trypan blue assay. A volume of 30 μl of the cell suspension was treated with 20 μl of irrigants. The cell suspension was loaded into Neubauer chamber after 5 min, and cell count was performed under inverted microscope and expressed as viability percentage. Results: NaOCl at all concentrations was cytotoxic on both cell lines; MTAD on HeLa had nonviable scores with limited viability on HGF. Only 1% IKI had better viability than higher concentrations. Although 1% CHX had higher viability on both cell lines, bactericidal concentration of 2% CHX showed promising results. Conclusion: Target cell line (HGF) appears to be more sensitive than the use of nontarget cell line (HeLa) for evaluating cytotoxicity. NaOCl and MTAD were cytotoxic and should be used with caution. Lower concentrations of CHX appear to be less cytotoxic than any irrigant and concentrations tested.

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Background: There is a wide variation in existing Mycobacterium tuberculosis strains across the globe, and false results in line probe assay (LPA) can occur due to the presence of unique genetic mutations in different settings. Objectives: An attempt was made to observe uncommon mutations in multidrug-resistant tuberculosis (MDR-TB) strains and determination of genetic diversity by spoligotyping and to study the treatment outcome in patients with uncommon mutations. Materials and Methods: Band pattern analysis of LPA strips was performed as per manufacturer's instructions. DNA sequencing was performed to confirm the presence of uncommon mutations in Intermediate Reference Laboratory in Delhi state. Results: Four uncommon mutations were recognized along with 12 unique spoligotype patterns which serve as an update to worldwide databases. The noteworthy presence of a spoligotype previously rarely seen in India was the SIT53/T1 pattern. Central Asian (CAS) spoligotype was highly associated with MDR followed by Beijing type. During follow-up, the treatment outcomes of cases showing uncommon mutations were considered as cured, after completion of their treatment. Conclusion: The rifampicin resistance appears to be an effective marker of MDR-TB. The presence of uncommon mutations confirms genetic polymorphism that may require treatment targeted at both drug-resistant and drug-susceptible phenotypes for the better management of patients with MDR-TB.

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The fight on tuberculosis initiated after World War II with the imposition of the Bacillus Calmette–Guérin (BCG) vaccine by the WHO in 1950, and the discovery of the drug streptomycin, which was rapidly followed by a recommended 4 drug regimen (isoniazid, ethambutol, rifampicin, pyrazinamide, and streptomycin being reserved to resistant cases). The diagnostic that justified a treatment was based on the microscopic examination of bacterial presence in sputum, that is, the bacilloscopy, and on culture in vitro of the pathogen, which is more expensive and much more demanding on time. During the following 7 decennia, this approach remained unchanged: no new vaccines were developed despite the documented observed ineffectiveness of the BCG, and the 4 drug regimen (plus streptomycin) admitted additional drugs only from 2012 on. The ineffectiveness of the original 4 + 1-drug cocktail, that became obvious in France in 1994, is traced in part to the immunodepressing effect of some of them. The use of only four drugs also favors defensive mutations by the pathogen. The late addition of more antibiotics to the regular regimen applied to multidrug-resistant-cases may be useful on the immediate term but side effects are crimpling and evidently, measures in addition to “more drugs” must be taken to control the disease. A diagnostic based exclusively on antigen detection remained the norm during nearly 7 decennia. This detection benefited from technologically improved methods (e.g., the interferon test and the numerous nucleic acid amplification tests). The latest of these is the GeneXpert/RIF test. This newly devised antigen test is a quantitative improvement on previous tests detecting the presence of the antigen. However, due to its centralized system of analysis and inaccuracy, it is not suited for rural areas, and it does not favor communication between mycobacteriologist, immunologist, and clinician. In this review article, the concentration is on those rare publications that highlighted the problem posed by various diagnostic tests and their application.

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Informatics studies represent the useful tool for development of the biologic-based therapeutics including proteins, antibodies, and vaccines. In this context, the bioinformatics studies are able to give more insights into the assessment of the effectiveness of the protein constructs, which have been developed as biologic-based therapeutics. Such investigations need a variety of data processing and analysis based on existing knowledge of gene functions and molecular interactions. Here, it is attempted to review some in silico approaches to assess physicochemical properties, posttranslational modification, hydrophobic behavior, solvent accessibility, allergenicity, and other properties of protein drugs and vaccines. Besides, in a part of this review, in silico strategies that are applicable during codon optimization of a recombinant protein are discussed.

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India is the world's second most populous country, accounting for a quarter of the world's annual incidence of tuberculosis (TB). Every year around 2 million people develop TB in India and 300,000 die due to the TB. The emergence of drug-resistant-TB (DR-TB) has become a major public health concern in India. This situation is worsened by the appearance of multi-drug-resistant (MDR) strains of Mycobacterium tuberculosis. We sought to determine the characteristics and relative frequency of transmission of MDR-TB in North India and their association with the clinical and epidemiological characteristics of TB-patients and to mitigate the impeding drug-resistant TB epidemic in the country; it will help to established TB surveillance system effectively in the country. Diagnosis of MDR-TB prompts an appropriate treatment for patients with presumptive MDR-TB or rifampicin resistance in TB patients who have failed treatment with first-line drugs. If left undiagnosed or poorly treated, MDR-TB patients suffer for months to years before succumbing to the disease; hence, transmission of MDR-TB continues MDR-TB patients were found to be significantly higher in previously treated patients in comparison to newly diagnosed patients. The emerging drug susceptibility testing patterns and enlisting the help of an expert in DR-TB should be sought sooner rather than later through more than 100 established DR-TB centers across the country. To control the primary transmission of MDR-TB in Northern India, we recommend that improving the social support, living standards, and medical security of each patient should become a priority.

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