Biomedical Sciences and Clinical Medicine

Visual-Vestibular Rehabilitation Using Orthoptic and Vestibulo-Ocular Reflex Training in Parinaud Syndrome: A Case Report

priyanka jeyaraj, Vanitha Jayaraj, Prathap Suganthirababu — Fri, 10 Apr 2026 00:00:00 +0700

Parinaud syndrome, or dorsal midbrain syndrome, is a rare neuro-ophthalmological disorder characterized by vertical gaze palsy, convergence-retraction nystagmus, light-near dissociation, and impaired convergence. Rehabilitation literature has primarily focused on motor outcomes in stroke, with limited evidence on visual rehabilitation in this Syndrome. A 39-year-old female presented with acute thalamic-midbrain hemorrhage and developed Parinaud Syndrome with vertical gaze palsy, convergence-retraction nystagmus, diplopia, and impaired near point of convergence. A structured visual-vestibular rehabilitation protocol was implemented, consisting of orthoptic training (pencil push-ups, stereogram fusion, saccadic tracking, smooth pursuits) and vestibulo-ocular reflex (VOR) training (gaze stabilization drills). The program was delivered for 4 weeks, 5 sessions per week. The patient showed partial restoration of upward gaze, improved convergence, reduced diplopia, and enhanced gaze stability. Near point of convergence improved, facilitating better reading ability and daily visual tasks with less fatigue. Functionally, she reported greater independence and confidence in activities requiring visual control. This case demonstrates the effectiveness of targeted visual-vestibular rehabilitation in Parinaud Syndrome, highlighting the role of orthoptic and vestibulo-ocular reflex exercises in improving ocular motility and functional vision. Future studies exploring digital eye-tracking and virtual reality may further enhance rehabilitation outcomes in this rare condition.

Etoricoxib in the 21st Century: An Old Molecule With New Possibilities

Mohamamd Anas Ansari, Arun Kumar — Mon, 16 Mar 2026 00:00:00 +0700

Chronic pain conditions, including osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), and acute gouty arthritis (AGA) are responsible for a substantial proportion of global disabilities and healthcare burdens. Etoricoxib, a selective cyclooxygenase-2 (COX) inhibitor, has shown better efficacy in these conditions due to its anti-inflammatory and analgesic properties. Its pharmacokinetic properties allow for rapid absorption and a long half-life, the latter enabling once-daily dosing, which has the impact of enhancing both adherence and symptom relief. Recent pharmacological investigation has evidenced the efficacy etoricoxib intervention in cases of other indications such as dental pain, low back pain (LBP), and postoperative analgesia. Clinical trials and meta-analyses have revealed etoricoxib’s superiority over traditional non-steroidal anti- inflammatory drugs (NSAIDs) such as ibuprofen. Novel delivery systems like nanostructured lipid carriers have been proven with to have improved anti-inflammatory effects and decreased cardiotoxicity in preclinical studies. Etoricoxib has shown synergistic outcomes with combination therapies of etoricoxib with tramadol, pregabalin, or thiocolchicoside in the treatment of both acute as well as chronic musculoskeletal pain. This article assembles the latest therapeutic advances and clinical and safety information on etoricoxib, highlighting its emerging role as an important drug in personalized management of pain and inflammation.

Is Tui Na a Promising Approach for Autoimmune Diseases? A Review of Clinical Studies and Mechanisms

Mon, 16 Mar 2026 00:00:00 +0700

Autoimmune diseases, characterized by immune system dysfunction targeting healthy tissues, affect millions worldwide. While conventional treatments have advanced, unmet needs persist. Tui Na, a traditional Chinese massage therapy, has gained attention as a potential complementary treatment. This review explores Tui Na’s role in managing autoimmune conditions. A comprehensive literature search was conducted to identify studies investigating the use of Tui Na for autoimmune diseases in several databases. The available evidence suggests that Tui Na may offer potential benefits for individuals with autoimmune diseases. Studies have reported improvements in pain, fatigue, and overall well-being. Combining Tui Na with conventional treatments has often yielded enhanced outcomes. However, the evidence base is limited by a paucity of high-quality rando-mized controlled trials. Tui Na’s potential as a complementary therapy for autoimmune diseases is promising. Its ease of application and reported benefits warrant further exploration. However, the underlying mechanisms remain unclear, and the evidence base is insufficient to establish definitive recommendations. Future research should focus on rigorous study designs, larger sample sizes, and mechanistic investigations. Integrating Tui Na into comprehensive care plans requires careful consideration of patient-specific needs and potential interactions with conventional treatments. In conclusion, Tui Na shows promise as a complementary therapy for autoimmune diseases, offering potential benefits in symptom management and quality of life. While preliminary findings are encouraging, robust research is needed to establish its efficacy and safety

Association Between Polypharmacy and Frailty in Elderly Patients Receiving Care at a Public Hospital in South India

Fri, 06 Feb 2026 00:00:00 +0700

Objective This study analyses the impact of polypharmacy on frailty among the elderly patients visiting the public sector hospitals. The present study was done to assess the frailty status of the elderly patients and to see whether the individuals with polypharmacy exhibited more frailty when compared to those without polypharmacy.

Methods This is a case-control study that included 488 participants age 60 years and above who visited the general medicine department of Public Hospital Ooty, India. Polypharmacy was defined as the concomitant use of 5 or more medications. Frailty status of the participants was assessed using the Tilburg Frailty Indicator.

Results Polypharmacy was found to be present in 34.42% of cases. The prevalence of frailty was significantly higher in the polypharmacy group, affecting 41.07% of the study participants. Finally, three variables emerged as influential predictors of polypharmacy namely, 3 or more diseases (AOR 6.303, Cl 4.009-9.911, p < 0.0001), unsatisfied sleep status (AOR 1.669, Cl 1.068-2.606, p = 0.01), and people taking frailty causing drugs (AOR 4.328, Cl 2.628-7.128, p = 0.003). Additionally, there was a moderate relationship between modified lifestyle (smoking, alcohol consumption) and polypharmacy.

Conclusions The results suggest that polypharmacy is linked with frailty among the elderly population, highlighting the importance of clinician awareness of these factors.

Efficacy of Lidocaine/Prilocaine Cream During Dry Needling of Upper Trapezius Myofascial Trigger Points: A Double-blinded Randomized Controlled Trial

Pimpika Fuktongphan, Thong Phonghanyudh, Chanwit Phongamwong — Fri, 10 Apr 2026 00:00:00 +0700

Objective This study aimed to evaluate the efficacy of a eutectic mixture of local anesthetics (EMLA) cream in reducing pain during dry needling (DN) of active myofascial trigger points (MTrP) in the upper trapezius muscle.

Methods This prospective, randomized, double-blind, placebo-controlled trial was conducted with participants aged 20 years and older who had active MTrP in the upper trapezius muscle. Recruitment occurred from 11 July 2023 to 4 March 2024. Participants were randomly assigned to receive either EMLA cream (n = 32) or a placebo cream (n = 32) which was applied over the active MTrP 60 minutes prior to the DN procedure. After the DN procedure, patients rated their pain using a 100-mm visual analog scale during DN (VAS_TrP) as the primary outcome and during the needle’s skin penetration (VAS_skin) as the secondary outcome.

Results Patients in the EMLA group reported significantly lower scores for VAS_TrP and VAS_skin than those in the placebo group (p < 0.05). Specifically, 53.1% of patients in the EMLA group reported ‘moderate to severe pain’ according to VAS_TrP, significantly lower than the 78.10% in the placebo group (p = 0.035). Moreover, 65.63% of patients in the EMLA group reported ‘no pain’ on the VAS_skin scale, compared to just 15.63% in the placebo group (p < 0.001). Importantly, no significant adverse events associated with EMLA were observed.

Conclusion EMLA cream is effective in providing analgesia during DN of an active MTrP in the upper trapezius muscle.

Biochemical and Genetic Determinants of Early Cardiovascular and Hepatic Dysfunction: A Focus on ADIPOQ Expression

Fri, 06 Feb 2026 00:00:00 +0700

Objective Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) frequently coexist due to common metabolic dysfunctions such as insulin resistance, chronic inflammation, and dyslipidemia. Adipo-nectin, encoded by the ADIPOQ gene, is an anti-inflammatory adipokine vital for glucose and lipid regulation. Reduced adiponectin levels and certain ADIPOQ gene variants (e.g., rs266729, rs2241766) have been linked to both NAFLD and CVD progression. This study aims to evaluate the association between ADIPOQ gene expression and early biochemical markers of hepatic and cardiovascular dysfunction.

Methods A case-control study (n = 300) was conducted in Thiruvananthapuram, Kerala, India (2022-2024), analyzing blood samples for fasting blood sugar (FBS), lipid profile, malondialdehyde (MDA), interleukin-6 (IL-6), and ADIPOQ expression (RT-PCR). Statistical analyses included receiver operating characteristic (ROC) curves and quantile regression using Stata 17.0.

Results Cases exhibited significantly elevated FBS, triglycerides (TG), low-density lipoprotein (LDL), MDA, and IL-6, along with reduced high- density lipoprotein (HDL) and adiponectin levels (p < 0.05). ADIPOQ gene expression was markedly downregulated, particularly in individuals with both NAFLD and CVD. A positive correlation was observed between ADIPOQ expression and HDL, and a negative correlation with IL-6. Reduced ADIPOQ expression showed an association with risk in unadjusted analysis, but this association was not statistically significant after adjustment (OR = 0.0220). Nevertheless, ROC analysis indicated potential diagnostic utility.

Conclusions Reduced ADIPOQ expression is significantly associated with early metabolic and inflammatory markers in NAFLD and CVD. These findings highlight the potential utility of ADIPOQ as a biomarker for early detection and targeted prevention strategies in at-risk populations.

Prevalence of Alcohol and Drugs in Fatal Road Traffic Injuries (RTIs) in a Thai Population Between 2018 and 2023

Peerayuht Phuangphung, Patcharanun Chulamanee — Fri, 06 Feb 2026 00:00:00 +0700

Objective To determine and compare the prevalence of alcohol, drugs of abuse and medicines in fatal road traffic injuries (RTIs) in Thailand from 2018 through 2023.

Methods A retrospective study was conducted of fatal RTI cases sent for autopsy at the Department of Forensic Medicine, Siriraj Hospital, Mahidol University from 2018 through 2023. Subject data, including sex, age, type of RTI case, blood alcohol concentration (BAC), and urine drug profile, were collected. Descriptive statistics, Chi-square tests, Mann–Whitney U tests, and Kruskal–Wallis H tests were performed as appropriate.

Results From 2018 through 2023 a total of 1,979 fatal RTI cases were included in this study. Of those cases, 1,649 were male (83.3%) and the mean subject age was 37.3 years. The yearly prevalence of driving under the influence (DUI) of alcohol (BAC > 50 mg/dL) during the study period was between 45.80% and 53.40% with the exception of 2022, which showed a significant increase at 57.10% (p < 0.05). The prevalence of drugs in 2023 was 21.00%, a significant difference compared with the prevalence in 2018 of 13.70% (p < 0.05). The prevalence of cannabis use showed an increasing trend, with a statistically significant increase in 2023 (p < 0.05). The preva-lence of multiple drug use also significantly increased over the study period, particularly in 2023 (p < 0.05).

Conclusions The prevalence of drugs of abuse and medication in fatal RTI cases markedly increased over the study period, particularly in 2023. There was a significant increase in cannabis use and poly-drug use in fatal RTI cases over the period, especially in 2023.

Multimode Evaluation of Pulmonary Rehabilitation in Newly Diagnosed Tuberculosis Patients using chest imaging, Respiratory Culture-Based Microbiome Profiling, and Inflammatory Biomarkers

Mon, 16 Mar 2026 00:00:00 +0700

Objective Pulmonary rehabilitation (PR) plays a vital role in enhancing lung function and exercise capacity in individuals with pulmonary conditions. This study evaluated the clinical effectiveness of an 8-week PR program in newly diagnosed pulmonary tuberculosis (TB) patients through the assessment of lung function, exercise capacity, inflammatory biomarkers, and respiratory microbiome changes.

Methods Sixty newly diagnosed TB patients were enrolled, with 30 completing the 8-week PR program. Pulmonary function (FEV₁, FVC, FEV₁/FVC) and exercise capacity (6-minute walk test, 6MWT) were measured before and after PR. Inflammatory biomarkers (CRP, IL-6, TNF-a) and sputum microbiome profiles were assessed. ROC curves and multiple
regression models identified biomarkers that were predictive of functional improvement.

Results PR led to significant improvements: FEV₁ increased from 2.50 ± 0.60 L to 3.10 ± 0.50 L (p < 0.001), FVC from 3.20 ± 0.70 L to 3.70 ± 0.60 L (p = 0.002), and 6MWT distance from 350.00 ± 40.00 m to 400.00 ± 50.00 m (p = 0.003). Oxygen saturation improved from 93.00 ± 2.00% to 95.00 ± 1.00% (p = 0.022). Inflammatory markers decreased significantly: CRP 18.00 ± 7.00 to 10.00 ± 5.00 mg/L (p < 0.001), IL-6 25.00 ± 8.00 to 15.00 ± 6.00 pg/mL (p < 0.001), and TNF- 50.00 ± 20.00 to 32.00 ± 15.00 pg/mL (p = 0.002). ROC analysis identified CRP as the strongest predictor of improvement (AUC = 0.84). Multiple regression confirmed CRP as an independent predictor of lung function and exercise capacity gains.

Conclusions An 8-week PR program significantly improved lung function, exercise capacity, and reduced systemic inflammation in TB patients, with CRP emerging as a key biomarker for predicting rehabilitation outcomes.

The Effect of Dohsa-hou on Reducing Attention Deficit and Hyperactivity in 6- to 12-Year-Old Children and Adolescents

Maryam Amini, Reza Zeighami, Behzad Rigi, Amir Javadi — Mon, 16 Mar 2026 00:00:00 +0700

Objective To investigate the effect of Dohsa-hou relaxation on reducing attention deficit and hyperactivity.

Methods Eighty attention-deficit/hyperactivity disorder (ADHD) children aged 6-12 years were selected by the block randomization method and assigned to one of two groups, either the experimental or the control groups. The data collection tools included a demographic questionnaire, Conners’ parent rating scale and Conners’ (CPRS-RS) child attention deficit index.

Results The mean score of the children’s hyperactivity and attention deficit decreased after the intervention, which was statistically significant (p < 0.001). The children’s hyperactivity scores were significantly different before and after the intervention in the two groups: a greater reduction was observed in the intervention group than in the control group. Although hyperactivity decreased in both groups, it was more pronounced in the intervention group (p < 0.001). The comparison of children’s attention deficit scores before and after the intervention in the two groups also showed that Dohsa-hou treatment led to a more significant decrease in the scores of the intervention group (p < 0.001).

Conclusion Dohsa-hou exercises can lead to reduced hyperactivity and attention deficit in most children with ADHD.

Antimutagenic Potential of Piper sarmentosum Leaf Extracts: Insights from Culinary Preparation

Fri, 06 Feb 2026 00:00:00 +0700

Objective Piper sarmentosum Roxb., a traditional vegetable in Lanna and Thai cuisine, is valued for its flavor but its health-promoting properties after cooking remain unclear. This study investigated the phytochemical profiles, antioxidant capacity, and mutagenicity of its leaf extracts prepared to mimic typical culinary practices.

Methods Three P. sarmentosum extracts were prepared: an ethanolic extract of uncooked leaves (PEE), a hot water extract simulating curry broth (PHWE), and an ethanolic extract of boiled leaf residues representing the cooked leaves in curry (PREE). Their chemical composition, antioxidant activity, and antimutagenic effects were evaluated.

Results The extracts showed distinct phytochemical patterns. PEE and PREE were rich in phenolics and flavonoids, yielding strong antioxidant activity in ABTS and FRAP assays. PHWE contained higher levels of condensed tannins, reflecting the extraction of water-soluble compounds. None of the extracts showed mutagenicity in the Salmonella assay. Notably, PEE and PREE displayed significant antimutagenic activity against aflatoxin B1 (AFB₁) in Salmonella typhimurium strains TA98 and TA100 with metabolic activation.

Conclusions P. sarmentosum leaves retain considerable antioxidant and antimutagenic potential after cooking, highlighting their value as a safe and functional food ingredient with potential health benefits.

Living Will Completion During Palliative Care Consultations and Factors Influencing Completion: A Retrospective Study in a University Hospital

Mon, 16 Mar 2026 00:00:00 +0700

Objective To determine the proportion of palliative care patients completing a living will and to identify factors associated with completion.

Methods This retrospective study analyzed electronic medical records from Maharaj Nakorn Chiang Mai Hospital, a university hospital in Thailand. Patients who had their initial palliative care consultations between November 1, 2021 and April 30, 2022 were included. Descriptive statistics and multivariable logistic regression were used.

Results Of the 389 patients in the study, 205 (52.7%) were female, and the median age was 68 (IQR: 59–79). Most had cancer (67.6%) and poor performance status (PPS 10–30: 69.9%). Decision-making capacity was present in 177 patients (45.5%). A living will was introduced to 83 patients (21.3%) and was completed by 26 (6.7%). Higher PPS (70–100) were associated with being introduced to a living will. The most common reason for not introducing patients to a living will was poor patient symptom control. No factors were significantly associated with living will completion among those who were introduced to a living will.

Conclusions Most patients presented to palliative care with advanced disease and poor performance status, limiting opportunities for living will discussions and emphasizing the need for early consultation. Strengthening symptom management may support earlier and more frequent introduction of a living will, potentially improving completion rates.

In vitro Antioxidant, Acetylcholinesterase, and Amyloid-beta Inhibitory Effects of Captopril, An Angiotensin-Converting Enzyme (ACE) Inhibitor

Fri, 10 Apr 2026 00:00:00 +0700

Objective This study aims to investigate the potential of captopril, an angiotensin-converting enzyme (ACE) inhibitor, to reduce reactive oxygen species (ROS) production and address critical factors associated with Alzheimer’s disease (AD) pathology, including acetylcholinesterase (AChE) activity and amyloid-beta (A) peptide aggregation. The broader goal was to explore captopril’s neuroprotective properties and its potential as a therapeutic agent for AD.

Methods The antioxidant effects of captopril were evaluated using DPPH and ABTS assays, as well as xanthine oxidase inhibition tests. The impact of captopril on AChE activity and A aggregation was assessed through in-vitro experiments. Molecular docking studies were conducted to analyze captopril’s binding affinity with essential AD-related proteins.

Results Captopril demonstrated notable antioxidant activity with IC₅₀ values of 71.99±0.40 µM (DPPH) and 106.3±0.28 µM (ABTS), comparable to ascorbic acid (92.32 ± 0.26 µM and 110.1±0.24 µM). Significant inhibition of xanthine oxidase activity was observed; however, the IC₅₀ value exceeded the maximum tested concentration of 320 µM for both captopril and ascorbic acid. Captopril showed AChE inhibitory activity with an IC₅₀ of 208.2 ± 0.36 µM, whereas donepezil exhibited an IC₅₀ of 79.05 ± 0.25 µg/mL. In the A aggregation assay, captopril had an IC₅₀ of 87.69±0.25 µM, while donepezil also displayed significant inhibition, with an IC₅₀ above 320 µM. Molecular docking analyses revealed favourable binding interactions of captopril with AChE and A-related targets, supporting its multitarget mechanism.

Conclusions Captopril demonstrated notable neuroprotective effects, including antioxidant activity and the inhibition of AChE activity and A aggregation. These findings indicate that captopril holds promise as a therapeutic agent for AD, warranting further research and clinical trials to evaluate its efficacy in combating neurodegeneration.

Influence of the Frequency of Speech Therapy on the Velopharyngeal Gap in Cleft Lip and Palate Patients After Primary Palatoplasty

Fri, 10 Apr 2026 00:00:00 +0700

Objective The craniofacial conditions of cleft lip and cleft palate (CLP) have been found to be common worldwide, especially in Asia and Thailand. Nevertheless, there are few studies of the association between the frequency of speech therapy and the impact on the velopharyngeal (VP) gap and speech outcome. This study aimed to evaluate the association between the frequency of speech therapy and the VP gap after primary palatoplasty.

Methods This retrospective cohort study collected data on 95 patients with CLP or isolated cleft palate who underwent primary palatoplasty at Maharaj Nakorn Chiang Mai Hospital between 2006 and 2018. Log risk regression analysis was carried out to identify the effect of frequency of speech therapy in reducing the VP gap including relative risk (RR) and 95% confidence interval (95%CI).

Results From univariable analysis, influence of speech therapy frequency on the presence of a VP gap showed a crude RR = 0.70 (95%CI = 0.49-0.98). Additionally, the frequency of speech therapy in the multivariable analysis showed an adjusted RR = 0.74, 95%CI = 0.46-1.19. The associated anomalies and syndromes showed a statistically significant correlation with a VP gap (adjusted RR = 1.60, 95%CI = 1.12-2.28).

Conclusion Patients who receive speech therapy 5-10 times or more showed a decrease in the incidence of a VP gap of at least 26%; however, this did not reach statistical significance. Nevertheless, it is recommended that speech therapy with cleft lip and cleft palate patients should be continued for at least 5 to 10 sessions.

Comparison of Contrast-Enhanced MRI Using Hepatocyte-Specific Contrast with Contrast-Enhanced CT in Evaluation of Hepatobiliary Space-Occupying Lesions

Vijay Pratap , Ankur Malhotra , Shruti Chandak — Fri, 10 Apr 2026 00:00:00 +0700

Objective This study aimed to evaluate the diagnostic accuracy of multiphasic contrast-enhanced computed tomography (CECT) and contrast- enhanced magnetic resonance imaging (CEMRI) in assessing hepatic mass lesions.

Methods A cohort of 120 patients underwent imaging with both CEMRI and CECT to compare their diagnostic capabilities. Findings were analyzed for lesion size, enhancement patterns, sensitivity, specificity, and predictive values. Statistical tests were conducted to assess the significance of differences between the modalities, with p-values reported for critical metrics. To ensure consistency and minimize bias, a standardized imaging protocol was followed, and radiology experts independently reviewed all images.

Results CEMRI demonstrated higher sensitivity (90%) and specificity (87%) compared to CECT (85% and 80%, respectively), with statistically significant differences (p < 0.05). CEMRI also outperformed CECT in posi-
tive predictive value (88% vs. 82%) and negative predictive value (90% vs. 84%). While the mean lesion size detected by CEMRI (4.0 ± 2.0 cm) was slightly smaller than that detected by CECT (4.4 ± 2.2 cm), the difference was not statistically significant (p = 0.45). Additionally, CEMRI identified 112 lesions compared to 108 lesions detected by CECT, further highlighting its superior diagnostic accuracy, particularly in detecting heterogeneous lesions.

Conclusion CEMRI outperforms CECT in diagnostic sensitivity, specificity, and predictive values, making it the preferred modality for lesion detection and characterization. However, both modalities performed similarly in assessing lesion size and total lesion count. These findings underscore the value of CEMRI in clinical scenarios requiring detailed lesion evaluation. Future studies with larger cohorts and a broader range of pathologies are recommended to confirm and extend these results for greater clinical applicability.

Performance of Diagnostic Methods for Detection of Drug Resistance Among New Cases of Mycobacterium tuberculosis

Fri, 10 Apr 2026 00:00:00 +0700

Objective The increasing incidence of new cases of drug resistant-TB (DR-TB) infection is worrisome, with high rates of new pulmonary morbidities occurring mostly among the vulnerable populations. The performance of diagnostic methods of GeneXpert MTB/RIF assay and phenotypic Drug Susceptibility Test (pDST) for detection of drug resistance among new cases of Mycobacterium tuberculosis (MTB) infections was evaluated.

Methods Sputum samples (n = 546) from newly suspected MTB cases were analysed for phenotypic drug resistance using BACTEC MGIT (B-MGIT) and genotyped with xpert MTB/RIF assay. The predictive performance of B-MGIT culture-based methods and xpert MTB/RIF assay for MTB detection were determined.

Results Of the collected sputum samples (n = 546), the highest rates of phenotypic drug resistance (66.7%) were AFB3+ smear positive and MTB with detection rates of 98.2% and 92.7%, respectively, with B-GMIT and Xpert MTB/RIF (p = 0.63). B-MGIT detected higher resistance rates to isoniazide (inh) and rifampicin (rif) of more than 60.0%, and less than 20% resistance to ofloxacin (ofx) and protionamide (proth) compared to Xpert (p < 0.05). B-MGIT had a higher detection rate (98.2%), sensitivity (87.8%), specificity (91.4%), positive predictive value (PPV) (95.8%) (95%CI: 0.778-1.04; p = 0.001) and likelihood of detection of rifampicin resistance (OR:5.76;95%CI:1.01-7.56) compared to Xpert MTB/RIF methods. B-MGIT provided higher AUC-rifampicin of 0.9339 (95%CI: 0.8398 to 1.000) than gene xpert (AUC-rifampicin = 0.9019 [95%CI: 0.7899 to 1.000]). B-MGIT is needed for further confirmation of new cases of MTB identified from acid-fast bacilli (AFB) smear positive sputum.

Conclusions The inclusion of B-MGIT examination of sputum in new TB cases would enhance early detection of drug resistant MTB, mostly from rifampicin negative sputum investigated with GeneXpert and mostly in low resource settings.