ABSTRACT
Abstract: Introduction: Leprosy is a chronic disease that attacks the peripheral nerves, skin and other body tissues. A leprosy reaction is an acute episode in which leprosy occurs as a result of sudden changes in the immune system. Leprosy reactions can occur before, during, and after treatment. In type I leprosy reactions, it is very important to recognize and treat appropriately, otherwise there can be rapid and extensive nerve damage while in mild type II reactions, it can disappear immediately but severe type II reactions can persist for years. Aim: The purpose of this study was to determine and analyze the influence of the determinant factors of leprosy reactions based on Biological, and Psychological reactions in leprosy patients at Naob Hospital, TTU Regency. Material and Methods: This type of research is analytic survey research with cross sectional design. The population in this study was people with leprosy who experienced reactions of leprosy types I and II with a total of 65 people with leprosy. This study uses a total sampling technique, namely sampling in which the number of samples is the same as the population which is 65 people. The data analysis included univariate and bivariate with chi-square test and multivariate with logistic regression test. Results: The results showed that there was a relationship between biological reactions (Type of Leprosy, Duration of Illness and Disability), and there was a significant relationship between psychological reactions (Stress) with the incidence of leprosy reactions in the patients at Naob Hospital, TTU Regency with p-value<α (0.05). Simultaneously, the independent variable (Type of Leprosy, Duration of Illness, Disability and Stress) had an effect of 55% on the dependent variable (Leprosy Reaction) in leprosy patients at Naob Hospital, TTU Regency. The most influential independent variable is duration of illness.

ABSTRACT
Abstract: Background: Tuberculosis (TB) is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, which affects the lungs most of all. Multidrug-resistant tuberculosis (MDR-TB) shows resistance to Isoniazid and Rifampicin both of which are the first-line anti-TB drugs. This is one of the critical health concerns all over the world and MDR-TB represents a major threat to control of the disease worldwide because of its high mortality and limited treatment therapy. Methodology: The present study was designed to determine the spread of MDR-TB in Gujrat, Punjab Pakistan. A total of 300 sputum samples were collected from suspected patients at Aziz Bhatti Shaheed Teaching Hospital, Gujrat. All the information regarding patients and their previous history of infection was collected through a predesigned questionnaire. After collection all the sputum samples were directly screened for acid fast bacilli through Z-N and Fluorescent staining. Molecular confirmation of MDR-TB was done by Gene-Xpert MTB/RIF assay. Results: Out of 300 samples 167(55.7%) were male and 133(44.3%) were females among those 149 were new patients and 49 were previously treated patients. ZN staining reveled 153 (51.0%) positive cases and mostly (n=60; 39.2%) were found in 21-40 years age. Moreover, 199 (66.3%) cases were positive for MTB by fluorescent staining and mostly (n=76; 38%) were observed in 21-40years age group. However, 214 (71.3%) MTB cases were identified by Gene-Xpert and among these, 25 (8.3%) were MDR-TB. Out of 25 cases 18 (72%) were females and 07 (28%) were male patients. Conclusion: There was high prevalence of MTB (71.3%) and MDR-TB (8.3%) in clinical setting of Gujrat. Therefore, it is the need of the hour to conduct surveillance study to overcome this problem.

ABSTRACT
Abstract: Malaria is still a major public health concern which leads to over 400,000 deaths globally especially in the pediatric population under five years. In Kenya, artemether –lumefantrine is the first-line drug recommended for the treatment of uncomplicated falciparum malaria. Although it has shown good efficacy and high cure rates, drug tolerability, patient non-compliance, administration with fat-rich foods for optimal absorption, and the emerging threat of artemisinin resistance are its major throwbacks. Thus, the need for improving the existing artemisinin-based therapies with novel partner drugs like pyronaridine to overcome these limitations. This study was a component of phase III single- blind randomized non-inferiority study in Mbita, Kenya that included patients of ≤ 12 years with a bodyweight of ≥ 5 kg and microscopically confirmed Plasmodium falciparum malaria. Eligible children were randomized (1:1) to receive either pyronaridine-artesunate or artemether-lumefantrine orally for three days according to their bodyweights and followed for 42 days for therapeutic responses. Of 155 patients, 81 received pyronaridine-artesunate while 74 received artemether-lumefantrine. A higher proportion of aparasitemic patients in pyronaridine-artesunate cohort was registered compared with artemether-lumefantrine (96.3% versus 95.8%) on day 3. Time to parasite clearance significantly differed between the treatment arms (p<0.05). Despite the significant difference in the proportions of parasitemic patients on days 28 and 42 (p< 0.05), there was no significant differences in day 28 and 42 ACPR without PCR corrections in both study comparators (p>0.05). This present study showed that pyronaridine-artesunate was efficacious as artemether-lumefantrine in the treatment of uncomplicated falciparum malaria.