A Prospective Study to Assess Efficacy of Directly Observed Treatment Short Course Intermittent Regimen in Different Stages of Spinal Tuberculosis

Despite successful implementation of directly observed treatment, short course (DOTS) in India, the growing number of diabetes mellitus (DM) patients appears to be a cause in the increasing tuberculosis (TB) incidence, affecting their management. In this regard, a prospective study was conducted on DOTS patients in three primary health care centers in urban slum region of South Delhi, India, to evaluate the effect of DM on sputum conversion, treatment outcome, and adverse drug reactions (ADR) due to anti-TB treatment. Eligible TB patients underwent blood glucose screening at treatment initiation. Disease presentation, clinical outcome, and ADRs were compared between patients of TB with and without DM. Out of 316 patients, the prevalence of DM was found to be 15.8%, in which 19.4% and 9.6% were PTB and EPTB patients, respectively. DM patients have observed higher sputum positivity (OR 1.247 95% CI; 0.539–2.886) at the end of 2-month treatment and poor outcome (OR 1.176 95% CI; 0.310–4.457) at the completion of treatment compared with non DM patients. Presence of DM was significantly associated (OR 3.578 95% CI; 1.114–11.494,p=0.032) with the development of ADRs. DM influences the treatment outcome of PTB patients in our setting and also on the ADR incidence.

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Results of management of spinal tuberculosis according to middle path regime and short course chemotheraphy

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20173672 ◽

2017 ◽

Vol 3 (5) ◽

pp. 966

Author(s):

Jairam D. Jagiasi ◽

Mihir R. Patel

Keyword(s):

Spinal Tuberculosis ◽

Antibiotic Sensitivity ◽

Control Program ◽

Drug Regimen ◽

Skeletal Tuberculosis ◽

National Tuberculosis Control Program ◽

Short Course ◽

National Tuberculosis ◽

Directly Observed Treatment ◽

A Prospective Study

Background: Vertebral tuberculosis is the most common form of skeletal tuberculosis and it contributes about 50 percent of all cases of skeletal tuberculosis. The purpose of this study is to delineate the importance of middle path regime and short course chemotheraphy in the management of spine tuberculosis.Methods: A prospective study was conducted which included 44 patients diagnosed as tuberculous spondylitis. Management was started as per middle path regime and drugs were given as per the revised national tuberculosis control program (RNTCP) regime category I under directly observed treatment, short-course (DOTS) therapy. Specimen was collected and studied for smear, culture, antibiotic sensitivity and histopathology. ATT was stopped at the end of 6 months as per DOTS schedule and MRI was done at the end of therapy.Results: Dorsal spine lesions were found in 33 patients. 8 patients were smear positive and 38 patients were culture positive of whom 26 patients were sensitive to first line ATT drugs. 12 patients had MDR tuberculosis and were sensitive to 2nd line ATT drugs. 6 patients having negative culture were diagnosed from histopathology. All patients on 1st line ATT had satisfactory result. Only 8 patients with MDR tuberculosis recovered neurologically. Conclusions: It is mandatory to do obtain tissue biopsy and examine culture, sensitivity and histopathology. Recently there is an increasing tendency in multidrug resistance cases and total drug resistant cases. By doing culture and sensitivity of the specimen we can find out the number of MDR cases and initiate proper drug regimen to avoid further complication and mortality.

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Preliminary Results of a Prospective Study of Dose Reduced Short-Course CHOP followed by Involved Field Radiotherapy for Elder Patients 70 Years Old or More with Localized Aggressive non-Hodgkins Lymphomas (Japan Radiation Oncology Group; JAROG Study)

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2005.07.726 ◽

2005 ◽

Vol 63 ◽

pp. S427

Author(s):

N. Shikama ◽

M. Oguchi ◽

Y. Kagami ◽

K. Isobe ◽

K. Nakamura ◽

...

Keyword(s):

Prospective Study ◽

Radiation Oncology ◽

Oncology Group ◽

Preliminary Results ◽

Elder Patients ◽

Short Course ◽

Radiation Oncology Group ◽

A Prospective Study ◽

Involved Field ◽

Involved Field Radiotherapy

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Short course antibiotic prophylaxis to prevent surgical site infections in HPB surgeries. Are we giving too much? A prospective study

HPB ◽

10.1016/j.hpb.2018.06.2524 ◽

2018 ◽

Vol 20 ◽

pp. S780-S781

Author(s):

B. Vasadava ◽

H. Patel

Keyword(s):

Prospective Study ◽

Antibiotic Prophylaxis ◽

Surgical Site Infections ◽

Short Course ◽

A Prospective Study

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The Spectrum of Clinical and Urodynamic Findings in Patients with Spinal Tuberculosis Exhibiting Lower Urinary Tract Symptoms, before and after Spinal Surgical Intervention with Antitubercular Treatment: A Prospective Study

Asian Spine Journal ◽

10.31616/asj.2018.0217 ◽

2019 ◽

Vol 13 (4) ◽

pp. 615-620

Author(s):

Nitin Shrivastava ◽

Prabhjot Singh ◽

Brusabhanu Nayak ◽

Bhavuk Garg

Keyword(s):

Urinary Tract ◽

Prospective Study ◽

Lower Urinary Tract ◽

Surgical Intervention ◽

Spinal Tuberculosis ◽

Antitubercular Treatment ◽

Urinary Tract Symptoms ◽

Before And After ◽

A Prospective Study ◽

Lower Urinary

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Spinal Tuberculosis – Directly Observed Treatment and Short Course or Daily Anti Tubercular Therapy -Are We Over Treating?

The Open Orthopaedics Journal ◽

10.2174/1874325001812010380 ◽

2018 ◽

Vol 12 (1) ◽

pp. 380-388 ◽

Cited By ~ 1

Author(s):

Ravinder Kumar Banga ◽

Jagdeep Singh ◽

Anshul Dahuja ◽

Radhe Shyam Garg

Keyword(s):

Pain Score ◽

Neurological Deficit ◽

Spinal Tuberculosis ◽

Treatment Modalities ◽

Randomised Control Trial ◽

P Value ◽

Short Course ◽

Directly Observed Treatment ◽

Anti Tubercular Therapy

Study Design: Prospective randomised control trial. Purpose: To compare the effectiveness of Directly Observed Treatment and Short Course (DOTS) and Daily Anti Tubercular Therapy (ATT) in spinal tuberculosis with no neurological deficit. Overview of Literature: Spinal tuberculosis is rampant in India with a major cause of morbidity and mortality. There is a lot of conflict regarding management with anti tubercular drugs, the regimen to be followed and the duration the drugs needed for complete cure. Material and Methods: This prospective study was conducted during the period of 2006 to 2009. Thirty cases of spinal tuberculosis were randomly divided equally into two groups of fifteen each and treated with DOTS and Daily ATT and compared at the end of follow up on clinical, radiological and Erythrocyte Sedimentation Rate values (ESR). Results: Pain score on Visual Analogue Scale (VAS) exhibits that mean pain score was 5.93+_1.54 at start and 0.64+_1.01 at the end of follow up with 89.39% change with DOTS therapy whereas mean pain score was 7.08 +_1.61at start of therapy and 0.69+_0.95 at end of follow up with 91.73% change in patients treated with Daily ATT with p value >0.05 (not significant). The radiological recovery in patients with DOTS and Daily ATT have similar results after 1.5 years with p value > 0.05 showing that the radiological recovery by both treatment modalities are comparable. Mean change in ESR scores in DOTS therapy patients and patients on daily ATT were 74.57+_9.34% and 75.69+_9.38% change with p value >0.05 which was not significant. Conclusion: DOTS therapy is an effective means of management of spinal tuberculosis cases with no neurological involvement, however its efficacy in patients with neurological deficit is further to be evaluated.

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