Analysis of Fluoroquinolone Resistance in Clinical Isolates ofMycobacterium tuberculosisfrom India

Clinical isolates of Mycobacterium tuberculosis (47 ofloxacin-susceptible and 71 ofloxacin-resistant) strains obtained from individual patients from various parts of India were analyzed for gyr A mutation in quinolone resistant determining region (QRDR). Most of the mutations were seen clustered in the codons 90, 94 and 95, which is a hot spot region of QRDR. The types of mutations were correlated with the in vitro susceptibility pattern of the strains to ofloxacin. The mutations: A90V was found coded for low-level resistance (MIC <or=16 microg/ml), D94A and D94V were coded for moderate level resistance (MIC 32-64 microg/ml) and S91P, D94G and D94N were coded for high level resistance (MIC >64 microg/ml) to ofloxacin. The resistance to fluoroquinolones was observed predominantly due to gyr A mutations. There were 2 highly resistant strains that did not show any mutations for gyr A, were further analyzed for gyr B mutations and were found negative for any mutations. However, there were two novel mutations, namely R68G and L109V, which were found in sensitive strain that did not code for any change in the susceptibility pattern and require further investigation.

The coexistence of anxiety and depressive personality traits in migraine

INTRODUCTION

Migraine is associated with a variety of personality traits. The objective of this study was to reevaluate the personality traits using Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in migraine patients diagnosed by applying the new International Classification of Headache Disorders-2 criteria.

METHODS

This was a case control study involving 70 migraine patients and 70 age- and gender-matched controls. The personality traits in the two groups were analysed using the MMPI. Data was analysed using the chi-square test.

RESULTS

The migraine patients showed a higher MMPI score on the following personality traits: depression (39 versus 15, p-value is less than 0.0005), and anxiety (24 versus 11, p-value equals 0.011). Both depressive and anxiety personality traits were significantly higher in migraine patients.

CONCLUSION

All migraine patients should probably be screened for their personality traits and psychopathology using the MMPI.

The electroencephalogram changes in migraineurs

Migraine is associated with a variety of electroencephalographic (EEG) changes. Previous studies using analogue EEG and old diagnostic criteria may under or over report the prevalence of EEG changes in migraine. The objective of this study was to reevaluate the EEG changes in migraine patients diagnosed by applying the new International Classification of Headache Disorder -2 criteria. This was a case control study involving 70 migraine patients and 70 age and gender matched control who were subjected to scalp EEG. The EEG changes during hyperventilation (HV), which were significantly more common in the migraine group were theta activity (34 vs 22, p = 0.038) and frontal intermittent rhythmic delta activity (FIRDA) (10 vs 3, p = 0.042). Applying the new ICHD -2 diagnostic criteria and digital EEG, this study yielded previously unrecognized features including FIRDA during HV on EEG.