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Tuberculosis is a contagious infectious disease caused by Mycobacterium tuberculosis, and is the leading cause of death from a single infectious agent worldwide. Imaging plays an important role in the early diagnosis of central nervous system tuberculosis and may prevent unnecessary morbidity and mortality. This article presents an extensive review of pathogenesis, clinical symptoms, typical and atypical imaging appearances of intracranial and spinal tuberculosis, and advanced imaging of intracranial tuberculosis. Furthermore, we explore central nervous system infection of nontuberculous mycobacteria and leprosy and their imaging findings., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The diagnosis of abdominal tuberculosis (aTB) is challenging and there is an urgent need for an accurate diagnostic test. We have developed a high affinity DNA aptamer against GlcB antigen of Mycobacterium tuberculosis (Mtb). We further compared the diagnostic utility of in-house-generated high affinity DNA aptamers and polyclonal antibodies against two Mtb antigens, namely GlcB and HspX, in ascitic fluid samples. These diagnostic reagents were assessed in patients (n = 94) who were categorized as 'Definite TB', 'Probable TB', 'Possible TB' (taken together as aTB) and 'Non-TB' disease. Receiver operating characteristic curves were used to derive cut-off values to provide ≥93% specificity. Aptamer Linked Immobilized Sorbent Assay (ALISA) for HspX and GlcB exhibited a sensitivity of ∼84% and 50%, respectively (p-value <0.01). In contrast, antibody-based ELISA exhibited a lower sensitivity of ∼18% and ∼28% for HspX and GlcB, respectively (p-value <0.0001 and p = 0.05 for HspX and GlcB ELISA vs. ALISA, respectively). HspX ALISA detected 32/38 aTB cases, while Xpert detected only 9 samples. In conclusion, HspX aptamer-based test was found to be superior to the other tests for diagnosing aTB and it nearly fulfils the sensitivity criteria of WHO's 'Target Product Profile' for extrapulmonary tuberculosis (sensitivity ≥80%, specificity 98%)., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Abdominal tuberculosis (ATB) continues to pose a major diagnostic challenge for clinicians due to its nonspecific clinical presentation, variable anatomical location and lack of sensitive diagnostic tools. In spite of the development of several assays till date; no single test has proved to be adequate for ATB diagnosis. In this study, we for the first time report the detection of circulating cell-free Mycobacterium tuberculosis (M. tuberculosis) DNA (cfMTB-DNA) in ascitic fluid (AF) samples and its utility in ATB diagnosis. Sixty-five AF samples were included in the study and processed for liquid culture, cytological, biochemical and molecular assays. A composite reference standard (CRS) was formulated to categorize the patients into 'Definite ATB' (M. tuberculosis culture positive, n = 2), 'Probable ATB' (n = 16), 'Possible ATB' (n = 13) and 'Non-TB' category (n = 34). Two molecular assays were performed, namely, the novel cfMTB-DNA qPCR assay targeting M. tuberculosis devR gene and Xpert MTB/RIF assay (Xpert), and their diagnostic accuracy was assessed using CRS as reference standard. Clinical features such as fever, loss of weight, abdominal distension and positive Mantoux were found to be strongly associated with ATB disease (p<0.05). cfMTB-DNA qPCR had a sensitivity of 66.7% (95% CI:40.9,86.7) with 97.1% specificity (95% CI:84.7,99.9) in 'Definite ATB' and 'Probable ATB' group collectively. The sensitivity increased to 70.9% (95% CI:51.9,85.8) in the combined 'Definite', 'Probable' and 'Possible' ATB group with similar specificity. The cfMTB-DNA qPCR assay performed significantly better than the Xpert assay which demonstrated a poor sensitivity of ≤16.7% with 100% (95% CI:89.7,100) specificity (p<0.001). We conclude that cfMTB-DNA qPCR assay is an accurate molecular test that can provide direct evidence of M. tuberculosis etiology and has promise to pave the way for improving ATB diagnosis., Competing Interests: The authors have declared that no competing interests exist.

Objective: The aim of this study was to evaluate the role of whole-body magnetic resonance imaging (WB-MRI) in imaging of extrapulmonary tuberculosis., Methods: Eighteen patients with single-site extrapulmonary tuberculosis were evaluated with contrast-enhanced dedicated MRI of the clinically symptomatic site followed by WB-MRI using contrast-enhanced 3-dimensional (3D) modified DIXON technique (m-DIXON) and diffusion-weighted WB imaging with background body signal suppression (DWIBS) sequences. Studies were read by 2 experienced radiologists, and additional lesions seen on WB-MRI were separately charted., Results: Of 18 patients, 14 were found to have asymptomatic involvement of other organs on WB-MRI. In 5 patients, the information was helpful in choosing an easily accessible site for biopsy/aspiration. Postcontrast 3D m-DIXON was better in picking up brain and lymph nodal lesions, whereas DWIBS was better in detecting vertebral lesions., Conclusions: Whole-body MRI may be used for assessing the asymptomatic involvement of other body organs in tuberculosis. The combination of postcontrast 3D m-DIXON and DWIBS is complementary and may provide a road map for biopsy of accessible lesions.

Background: Tuberculosis poses a great challenge, especially in children. The response of BCG Test may be different in previously vaccinated children and needs to be considered before interpreting positivity for TB. This study has been carried out to determine the pattern of BCG reaction comparing previously vaccinated with non-vaccinated children., Methods: The study was conducted in the healthy school children aged 4-6 years. The BCG skin reaction in Mantoux-negative children was compared between children with and without previous BCG scar. After the Mantoux and BCG Test, the analysis of variance was done as per protocol., Results: Out of 50 children previously BCG vaccinated, 39(78%) showed exaggerated BCG test responses while out of another 50 children who were not vaccinated for TB, only 9(18%) showed exaggerated BCG Test response (p-value < 0.00001). Average induration obtained in children who were immunized with BCG at birth was much greater than those who were not immunized. 80% and 76% males and females respectively in Group I showed exaggerated BCG response while 16% and 20% males and females respectively of Group II showed exaggerated BCG response., Conclusion: The present study indicates that normal healthy children may have a mild exaggerated BCG Test response i.e. induration up to 8 mm because of prior BCG vaccination. Therefore, BCG Test, though important should not be the only criteria for start of chemotherapy for TB in children as the side effects of drugs may cause much morbidity. An induration up to 8 mm after the BCG Test can be normal in Indian settings due to exposure to Mycobacterium in environment and/or BCG vaccine.

AbstractBackgroundMethodsResultsConclusionsIndia relies primarily on direct smear microscopy for tuberculosis (TB) diagnosis. However, the low sensitivity of smear microscopy emphasizes the need to improve its performance. We recently described the development of ‘TBDetect’ kit which showed improved performance over direct smear microscopy at National Reference Laboratories (NRLs) in India.The present study was aimed to assess the operational feasibility of ‘TBDetect’ microscopy in field settings. This was evaluated by (i) assessing the performance of ‘TBDetect’ microscopy vs. LED-fluorescence microscopy (LED-FM) on consecutive presumptive pulmonary TB patients (n = 5300) who attended Designated Microscopy Centres (DMCs, n = 13) under 4 NRLs at Bhubaneswar, Bhopal, Chennai, and New Delhi, and (ii) obtaining feedback from Scientists (n = 10) and laboratory technicians (n = 42) using semi-structured questionnaires under the following parameters: feasibility of initiation of ‘TBDetect’ microscopy in DMCs, sample preparation and testing, training, time-to-result, logistics, and troubleshooting. A scoring questionnaire was also used to assess ‘TBDetect’ microscopy vs. LED-FM and statistical significance of the scores was calculated using paired t-test.The overall positivity of ‘TBDetect’ microscopy was 10.32% (547/5300) vs. 8.96% (475/5300) of LED-FM at all sites and the increment in positivity was significant (p = 0.019). In addition, ‘TBDetect’ microscopy yielded an increment in smear grade status over LED-FM (p = 0.043). The feedback from the study-in-charge and kit users indicated that ‘TBDetect’ microscopy was easily adapted in point-of-care settings. An analysis of scoring feedback suggested that it was easy to perform and observe in comparison to LED-FM (p < 0.005).This study established the feasibility of ‘TBDetect’ microscopy in field settings. [ABSTRACT FROM AUTHOR]

Tuberculous meningitis (TBM) is the most severe form of tuberculous with substantial mortality. In May 2015, 54 researchers from 10 countries met in Da Lat, Vietnam, to discuss advances in TBM. Among the attendees were researchers involved in pivotal studies on the use of Xpert MTB/Rif for TBM diagnosis. Attendees discussed the 2014 World Health Organization strong recommendation favoring the use of Xpert "in preference to conventional microscopy and culture as the initial diagnostic test for cerebrospinal fluid (CSF) if the sample volume is low or if additional specimens cannot be obtained to make a quick diagnosis." Attendees were concerned that the limitations of Xpert testing for TBM are not emphasized. Clear guidance is needed for the investigational pathway for TBM, including recommendations on the diagnostic package of investigations, which does not stop with Xpert testing. Second, emphasis on the large CSF volumes (ideally 8-10 mL) needed for Xpert testing is required. Guidelines should also emphasize that TBM is a medical emergency and early treatment reduces mortality.

Objectives: This study was planned to define the clinical profile of pulmonary tuberculosis (PTB) patients having renal amyloidosis, to identify the factors responsible for development of amyloidosis, to detect the time period between onset of amyloidosis and PTB, and analyze clinical features of amyloidosis in PTB patients for early diagnosis and timely assessment. Materials and Methods: Patients of PTB having pedal edema, proteinuria, and grossly diseased kidneys on ultrasound abdomen were subjected to renal biopsy and appropriate biochemical investigations. Clinical profile of biopsy proven amyloidosis cases was analyzed. Results: There were 43 patients (32 males, 11 females, age range 20-65 years) having PTB with pedal edema, proteinuria, and renal medical disease on abdominal ultrasound where amyloidosis was confirmed by renal biopsy. The total duration of illness ranged from two months to seven years (mean 2.25 years) and was less than five years in 93% patients. All patients had significant proteinuria. Nephrotic syndrome was seen in 23, hypertension in 19, hypoalbuminemia in 33, hypercholesterolemia in 29, and deranged renal functions in 32 patients. Ninety percent patients had moderate to far advanced pulmonary lesions on chest radiography with smear positivity in 21 patients. Conclusions: Renal amyloidosis is an important complication of PTB and should be suspected clinically in patients presenting with a triad of pedal edema, proteinuria, and medical renal disease on ultrasound. Contrary to general belief, renal amyloidosis may occur in PTB patients having disease for relatively shorter duration, and even if adequately treated.

Objectives: It is difficult to capture the severity of synovial inflammation on imaging. Herein we hypothesize that diffusion tensor imaging (DTI) derived metrics may delineate the aggregation of the inflammatory cells and expression of inflammatory cytokines and dynamic contrast-enhanced (DCE) imaging may provide information regarding vascularity in the inflamed synovium. Patients and methods: Patients with knee arthritis (>3-months duration) underwent conventional (T2-weighted fast spin echo and spin echo T1-weighted images) as well as DTI and DCE MRI and thereafter arthroscopic guided synovial biopsy. DCE and DTI metrics were extracted from the masks of the segments of the inflamed synovium which enhanced on post-contrast T1-weighted MRI. These metrics were correlated with immunohistochemistry (IHC) parameters of inflammation on synovium. Statistical analysis: Pearson's correlation was performed to study the relationship between DTI- and DCE-derived metrics, IHC parameters, and post-contrast signal intensity. Linear regression model was used to predict the values of IHC parameters using various DTI and DCE derived metrics as predictors. Results: There were 80 patients (52 male) with mean age 39.78 years and mean disease duration 19.82 months. Nineteen patients had tuberculosis and the rest had chronic undifferentiated monoarthritis (n = 31), undifferentiated spondyloarthropathy (n = 14), rheumatoid arthritis (n = 6), osteoarthritis (n = 4), reactive arthritis (n = 3), ankylosing spondylitis (n = 2), and juvenile idiopathic arthritis (n = 1). Fractional anisotropy (FA), a metric of DTI, had significant correlation with number of immune cells (r = 0.87, p < 0.01) infiltrating into the synovium and cytokines (IL-1β, r = 0.55, p < 0.01; TNF-α, r = 0.42, p < 0.01) in all patients and also in each group of patients and adhesion molecule expressed on these cells in all patients (CD54, r = 0.51, p < 0.01). DCE parameters significantly correlated with CD34 (blood flow, r = 0.78, p < 0.01; blood volume, r = 0.76, p < 0.01) in each group of patients, a marker of neo-angiogenesis. FA was the best predictor of infiltrating inflammatory cells, adhesion molecule and proinflammatory cytokines. Amongst the DCE parameters, blood volume, was best predictor of CD34. Conclusion: DTI and DCE metrics capture cellular and molecular markers of synovial inflammation in patients with chronic inflammatory arthritis. [ABSTRACT FROM AUTHOR]

Background: Swine tuberculosis (TB) is a highly progressive granulomatous infectious disease. The cases usually go undiagnosed and become a potent source of infection to other animals and humans. In Ayodhya and Sultanpur districts, no such study has been conducted so far. Keeping in view the zoonotic importance of this disease, the present study was, therefore, designed to study the prevalence of generalized swine tuberculosis in Middle Gangetic Plain Zone of Eastern Uttar Pradesh. Methods: Forty-two (42) pigs were presented for postmortem at Department of Veterinary Pathology, C.V. Sc. and A.H., ANDUAT, Ayodhya from nearby villages of Ayodhya and Sultanpur districts from April 2017 to February 2020. Pigs were screened for typical lesions of tubercles throughout the body during postmortem examination. Result: The prevalence was 7.14% out of 42 pigs presented for postmortem examination. Eight pigs (19.04%) had nodules in either lungs or liver but these were diagnosed negative for TB on ZN (Ziehl-Neelsen) staining. Typical tubercles were evident in liver, spleen and lungs and were characterized by the presence of circumscribed yellowish white raised lesions of various sizes and numbers. Microscopically, granulomatous lesions revealed necrotic areas surrounded by mixed inflammatory cells including macrophages, lymphocytes and plasma cells. The ZN stain reveals presence of acid fast bacilli in impression smear made from lung, spleen and liver. [ABSTRACT FROM AUTHOR]

India has the highest burden of Tuberculosis (TB) and multidrug-resistant TB (MDR-TB) worldwide. Innovative technology is the need of the hour to identify these cases that remain either undiagnosed or inadequately diagnosed due to the unavailability of appropriate tools at primary healthcare settings. We developed and evaluated 3 kits, namely ‘TB Detect’ (containing BioFM-Filter device), ‘TB Concentration and Transport’ (containing Trans-Filter device) and ‘TB DNA Extraction’ kits. These kits enable bio-safe equipment-free concentration of sputum on filters and improved fluorescence microscopy at primary healthcare centres, ambient temperature transport of dried inactivated sputum filters to central laboratories and molecular detection of drug resistance by PCR and DNA sequencing (Mol-DST). In a 2-site evaluation (n = 1190 sputum specimens) on presumptive TB patients, BioFM-Filter smear exhibited a significant increase in positivity of 7% and 4% over ZN smear and LED-FM smear (p<0.05), respectively and an increment in smear grade status (1+ or 2+ to 3+) of 16% over ZN smear and 20% over LED-FM smear. The sensitivity of Mol-DST in presumptive MDR-TB and XDR-TB cases (n = 148) was 90% for Rifampicin (95% confidence interval [CI], 78–96%), 84% for Isoniazid (95% CI, 72–92%), 83% for Fluoroquinolones (95% CI, 66–93%) and 75% for Aminoglycosides (95% CI, 35–97%), using phenotypic DST as the reference standard. Test specificity was 88–93% and concordance was ~89–92% (κ value 0.8–0.9). The patient-friendly kits described here address several of the existing challenges and are designed to provide ‘Universal Access’ to rapid TB diagnosis, including drug-resistant disease. Their utility was demonstrated by application to sputum at 2 sites in India. Our findings pave the way for larger studies in different point-of-care settings, including high-density urban areas and remote geographical locations. [ABSTRACT FROM AUTHOR]

Background: The aim is to study the clinical features and diagnosis of primary extra-spinal musculoskeletal manifestations of tuberculosis (TB) in otherwise healthy individuals. Methods: In this retrospective study of 10 years duration electronic database and case records of patients with musculoskeletal TB were analyzed. Patient's positive for HIV and rheumatic diseases with or without immunosuppressive drugs or biological agents were excluded from the study. Results: Fifty-one patients were identified with the mean age at presentation of 33.35 years (range 4-72), male: female ratio of 1.1:1 and mean duration of disease was 14.65 months (range, 0.25-120). The most frequent manifestation was articular (arthritis/arthralgia n = 40, monoarthritis n = 28, oligoarthritis n = 10, polyarthralgia n = 2) followed by tenosynovitis (n = 6), tuberculous osteomyelitis (n = 5), isolated bursitis (n = 1), and pyomyositis (n = 1). Poncet's disease was diagnosed in five patients. Disseminated TB was detected in four patients. Pain (n = 50) followed by swelling of the involved site (n = 37) were the most common presenting symptoms. Fever was present in 15 (29.4%) patients. Nine patients had a previous history of TB. Concurrent pulmonary TB was present in two patients. Lymph node enlargement was present in 12 (23.5%) patients. A definite diagnosis of musculoskeletal TB was made in 31 (61%) patients and probable TB in 20 (39%) patients. Conclusion: Musculoskeletal manifestations of TB can occur at any age. Chronic monoarthritis is the most common presentation; however, oligoarthritis and/or tenosynovitis may be a presenting manifestation. The absence of fever should not discourage the diagnosis of musculoskeletal TB. [ABSTRACT FROM AUTHOR]

Kikuchi-Fujimoto disease is a rare, idiopathic, self-limiting necrotizing lymphadenitis of unknown etiology. It usually affects young Asian women. Clinically, it closely resembles with tuberculosis or lymphomas. This pathology has occasionally been associated with various cardiac, renal, pulmonary, and other systemic complications. The association of the disease in context to other neurological pathologies is even more sporadic. We report a case of Kikuchi-Fujimoto disease in a 56-year-old woman associated with the rare presentation as brachial plexus neuritis. The diagnosis was established histopathologically upon surgical resection of lesion. We discuss the peculiar features of presentation, pathological elements, surgical management, and postoperative outcome with special emphasis on complications of this clinical entity. [ABSTRACT FROM AUTHOR]

During the establishment of an infection, bacterial pathogens encounter oxidative stress resulting in the production of DNA lesions. Majority of these lesions are repaired by base excision repair (BER) pathway. Amongst these, abasic sites are the most frequent lesions in DNA. Class II apurinic/apyrimidinic (AP) endonucleases play a major role in BER of damaged DNA comprising of abasic sites. Mycobacterium tuberculosis, a deadly pathogen, resides in the human macrophages and is continually subjected to oxidative assaults. We have characterized for the first time two AP endonucleases namely Endonuclease IV (End) and Exonuclease III (XthA) that perform distinct functions in M.tuberculosis. We demonstrate that M.tuberculosis End is a typical AP endonuclease while XthA is predominantly a 3′→5′ exonuclease. The AP endonuclease activity of End and XthA was stimulated by Mg2+ and Ca2+ and displayed a preferential recognition for abasic site paired opposite to a cytosine residue in DNA. Moreover, End exhibited metal ion independent 3′→5′ exonuclease activity while in the case of XthA this activity was metal ion dependent. We demonstrate that End is not only a more efficient AP endonuclease than XthA but it also represents the major AP endonuclease activity in M.tuberculosis and plays a crucial role in defense against oxidative stress. [ABSTRACT FROM AUTHOR]

Cardiovascular tuberculosis ( TB) is a relatively uncommon manifestation of Mycobacterium tuberculosis infection. TB can affect all three layers of the heart; endocardial tuberculoma is the rarest form. Endocardial tuberculoma, when it occurs, can easily be confused with other common causes of intracardiac mass lesions, especially in echocardiography. Timely diagnosis and appropriate treatment is essential, as only this can lessen the associated morbidity and mortality. Here, a case of cardiovascular TB has been described in a middle-aged woman from the SAARC nation; the woman presented with simultaneous pericardial constriction and multichamber endocardial tuberculoma. Combined pharmacological and surgical approach was successful. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the performance of the 'TB Detect ' kit-based bio-safe fluorescent microscopy filter (BioFM-Filter) microscopy in comparison with direct smear microscopy and culture for the detection of pulmonary tuberculosis (TB) in a multi-centric setting in India. The TB Detect kit enables sputum concentration through filtration using the BioFM-Filter for improved and bio-safe smear microscopy. We evaluated the performance of the TB Detect kit in a six-site multi-centric validation study on sputum collected from 2086 presumptive TB patients. The combined positivity of TB Detect microscopy performed on these sputum samples was 20% (n = 417/2086) vs 16.1% of light-emitting diode fluorescence microscopy (LED-FM, n = 337/2086) and 16% of Ziehl Neelsen (ZN) smear microscopy (n = 333/2086). The increment in positivity of TB Detect over both LED-FM and ZN smears was significant (p < 0.001). The overall sensitivity of TB Detect for six sites was ~55% (202/367, 95% confidence interval (CI): 50, 60%) vs 52% (191/367, 95% CI: 47, 57%) for LED-FM (p 0.14) and 50.9% (187/367, 95% CI: 46, 56%) for ZN smear (p < 0.05), using Mycobacterium Growth Indicator Tube culture (MGIT, n = 1949, culture positive, n = 367) as the reference standard. A bio-safety evaluation at six sites confirmed efficient sputum disinfection by TB Detect ; 99.95% samples (1873/1874) were sterile after 42 days of incubation. Scientists and technicians at the study sites indicated the ease of use and convenience of TB Detect microscopy during feedback. TB Detect added value to the smear microscopy test due to its improved performance, convenience and user safety. These findings indicate that equipment-free TB Detect technology has the potential to improve TB diagnosis in basic laboratory settings by leveraging on the existing nationwide network of designated microscopy centres and primary healthcare centres. [ABSTRACT FROM AUTHOR]

OBJECTIVETuberculosis of the adrenal glands is a common cause of Addison's disease in developing countries. We conducted a study to determine if treatment of such patients with modern anti-tuberculous chemotherapy would lead to an improvement in plasma cortisol and aldosterone levels. DESIGNProspective study. PATIENTS5 patients with Addison's disease secondary to tuberculosis. MEASUREMENTSBasal and ACTH stimulated plasma cortisol and aldosterone levels were measured prior to instituting anti-tuberculous chemotherapy, as well as one month after its conclusion. Four patients were again studied over the next 2–5 years. RESULTSPeak plasma cortisol levels prior to treatment were markedly reduced (range, < 14–110 nmol/l). There was no improvement one month (< 14–143 nmol/l) or 2–5 years (< 14–69 nmol/l) after completing anti-tuberculous chemotherapy. Peak plasma aldosterone at diagnosis was < 56–210 pmol/l; it was undetectable in 4 patients. No improvement was observed one month (< 56–210 pmol/l), or 2–5 years (< 56–389 pmol/l) after stopping anti-tuberculous chemotherapy. Plasma aldosterone levels at both these time points were far lower than those in control subjects (median 763 pmol/l, 560–1512 pmol/l; p < 0.01). One patient had an increase in peak aldosterone from < 56 pmol/l to 389 pmol/l, though peak cortisol actually declined in this subject (from 110 nmol/l to 69 nmol/l). CONCLUSIONSTreatment of tuberculous Addison's disease with anti-tuberculous chemotherapy does not lead to normalization of ACTH stimulated plasma cortisol or aldosterone levels during the 2–5 year period of study. However, prolonged follow up with regular adrenal function tests is warranted in all such patients. [ABSTRACT FROM AUTHOR]

The simultaneous occurrence of pulmonary carcinoid tumor and tuberculosis is very rare. A case of pulmonary carcinoid tumor is described in a 35-year-old male patient who had concomitant ipsilateral pulmonary tuberculosis. The importance of dual pathological diagnosis in clinical practice is also emphasized. [ABSTRACT FROM AUTHOR]

• A series of rare earth substituted [((RE) 4 (H 2 O) 6 Sb 6 O 4)(SbW 10 O 37) 2 (SbW 8 O 31) 2 ]22– has been synthesised. • Dihydrogen phosphate plays crucial role in the synthesis. • The compounds show good heterogeneous catalytic activity for thioether oxidation. A series of eight rare-earth substituted antimony tungstates with the formulae [((RE) 4 (H 2 O) 6 Sb 6 O 4)(SbW 10 O 37) 2 (SbW 8 O 31) 2 ]22– [(RE)III = Y(1), Gd(2), Tb(3), Dy(4), Ho(5), Er(6), Tm(7), Yb(8)] has been synthesized under ambient conditions. The compounds were isolated using rare-earth salts and Na 9 [B-α-SbW 9 O 33 ]•19.5 H 2 O as precursors along with sodium dihydrogen phosphate in 1 M NaCl solution. The addition of dihydrogen phosphate was found to be a crucial step for the isolation of these polyanions. The polyanions were characterized by various analytical techniques such as single crystal X-ray diffraction (1a – 6a) (SC-XRD), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA). The compounds were found to show efficient heterogeneous catalytic activity for oxidation of thioethers. [ABSTRACT FROM AUTHOR]

In view of WHO's "End-TB" strategy, we developed a non-invasive, urine-based ELISA, targeting 2 Mycobacterium tuberculosis antigens namely MPT51 and MPT64 for extrapulmonary TB (EPTB) diagnosis. Suspected EPTB patients (n = 137) [Pleural TB, Abdominal TB and Tuberculous meningitis] were categorized in "Definite" EPTB (n = 10) [Xpert-MTB/RIF and/or culture-positive], "Probable" EPTB (n = 77) and "Non-EPTB" (n = 50) groups using defined composite reference standards. ROC-curves were generated using ELISA results of "Definite" EPTB and "Non-EPTB" groups for both antigens independently and cut-off values were selected to provide 86.3% (95%CI:73.3–94.2) specificity for MPT51 and 92% (95%CI:80.8–97.8) for MPT64. The sensitivity of MPT51-ELISA and MPT64-ELISA was 70% (95%CI:34.7–93.3) and 90% (95%CI:55.5–99.7) for "Definite" EPTB group and 32.5% (95%CI:22.2–44.1) and 30.8% (95%CI:20.8–42.2) for "Probable" EPTB group, respectively. Combining the results of both ELISAs showed a 100% (95%CI:69.1–100) sensitivity in "Definite" EPTB group and 41.6% (95%CI:30.4–53.4) in "Probable" EPTB group, with an 80% (95%CI:66.3–89.9) specificity. The results demonstrated the potential of urine-based ELISAs as screening tests for EPTB diagnosis. [ABSTRACT FROM AUTHOR]