An open randomized comparison of 2 days (Ofx2) versus 3 days (Ofx3) of oral ofloxacin treatment (15 mg/kg/ day) was conducted with Vietnamese children between 1 and 15 years of age with suspected typhoid fever. Of 108 children enrolled, 100 were blood culture positive for Salmonella typhi, and 86% of the isolates were multidrug resistant. There were no significant adverse effects. The therapeutic responses were similar in both groups, with mean (؎ standard deviation) fever clearances of 107 ؎ 60 h in the Ofx3 group and 100 ؎ 64 h in the Ofx2 group (P > 0.2). There were six ''clinical'' failures in the Ofx2 group and two clinical failures in the Ofx3 group (P > 0.2), in which fever and symptoms persisted for more than 1 week after the start of treatment, but only one of these was culture positive (Ofx3). There was one suspected relapse, and one carrier was identified. Short courses of ofloxacin are simple, inexpensive, safe, and effective for the treatment of uncomplicated multidrug-resistant typhoid fever.

The natural history and treatment outcome of hepatitis B viruses (HBV) infection is largely dependent on genotype, subgenotype, and the presence or absence of virulence associated mutations. We have studied the prevalence of genotype and subgenotype as well as virulence and drug resistance associated mutations and prevalence of recombinant among HBV from Bangladesh. A prospective cross-sectional study was conducted among treatment naïve chronic HBV patients attending at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh for HBV viral load assessment between June and August 2015. Systematical selected 50% of HBV DNA positive patients (every second patient) were enrolled. Biochemical and serological markers for HBV infection and whole genome sequencing (WGS) was performed on virus positive sample. Genotype, subgenotype, virulence, nucleos(t)ide analogue (NA) resistance (NAr) mutations, and the prevalence of recombinant isolates were determined. Among 114 HBV DNA positive patients, 57 were enrolled in the study and 53 HBV WGS were generated for downstream analysis. Overall, 38% (22/57) and 62% (35/57) of patients had acute and chronic HBV infections, respectively. The prevalence of genotypes A, C, and D was 18.9% (10/53), 45.3% (24/53), and 35.8% (19/53), respectively. Among genotype A, C and D isolates subgenotype A1 (90%; 9/10), C1 (87.5%; 21/24) and D2 (78.9%; 15/19) predominates. The acute infection, virulence associated mutations, and viral load was higher in the genotype D isolates. Evidence of recombination was identified in 22.6% (12/53) of the HBV isolates including 20.0% (2/10), and 16.7% (4/24) and 31.6% (6/19) of genotype A, C and D isolates, respectively. The prevalence of recombination was higher in chronic HVB patients (32.2%; 10/31 versus 9.1%; 2/22); p<0.05. NAr mutations were identified in 47.2% (25/53) of the isolates including 33.9% novel mutations (18/53). HBV genotype C and D predominated in this population in Bangladesh; a comparatively high prevalence of recombinant HBV are circulating in this setting.

HLA-A*31:01 and HLA-B*15:02 are strongly associated with Carbamazepine (CBZ)-induced severe cutaneous adverse reactions (SCARs). As a result, it is recommended to screen these two alleles before CBZ therapy to reduce the risk of drug allergy. In this study, the authors applied the simultaneous screening test for HLA-A*31:01 and HLA-B*15:02 alleles by multiplex real-time PCR Taqman LNA probe with high sensitivity and specificity in 35 patients that were diagnosed with neurological diseases. Among thirteen patients (37.14% of total) who were positive for single or dual HLA-B*15:02and HLA-A*31:01 alleles were prescribed alternatives to CBZ and monitored for adverse events, only one patient had a mild skin adverse reaction after 24 days using Trileptal (Oxcarbazepine) at a dose of 600 mg/day, 12 patients had no symptoms or allergic reactions. The remaining negative patients showed good tolerance to CBZ therapy without any allergy symptoms. Compared to the data of 30 control samples carrying these one or two alleles and 21 patients exhibiting CBZ-induced severe hypersensitivity reactions (OR=28, 95%CI: 3.15-248.78), these results confirm the importance of screening for HLA-A*31:01 and HLA-B*15:02 alleles before using CBZ in neurological diseases treatment to reduce SCAR rates by replacing CBZ with another drug in patients positive for one of these two alleles.

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