The Application of Multidisciplinary Cooperative Complete Management Mode in the Management of Multi-Drug Resistant Tuberculosis Patients

2020 ◽  
Author(s):  
Yazhen Lang
Keyword(s):  
Life Quality ◽  
Treatment Compliance ◽  
Treatment Completion ◽  
Completion Rate ◽  
Management Mode ◽  
Control Group ◽  
Observation Group ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Objective: This study aims to explore the effect of multi-disciplinary cooperative complete management mode in the treatment of multi-drug resistant tuberculosis (MDR-TB).Methods: 280 patients were randomly classified into the observation group (n = 140) and the control group (n = 140). The control group was applied with the routine management mode, while the observation group was applied with the multi-disciplinary cooperative complete management one. The treatment compliance, life quality, treatment completion rate as well as the patient satisfaction in the two groups were observed.Results: The treatment compliance of the observation group was better than that of the control group (P༜0.05). The life quality of the observation group was higher than those of the control group (P༜0.05). The treatment completion rate of the observation group was higher than that of the control group (P༜0.05). The patient satisfaction of the observation group was better than that of the control group (P༜0.05).Conclusion: The application of multi-disciplinary cooperative management mode to MDR-TB patients can enhance their treatment compliance, life quality, treatment completion rate and satisfaction degree.

scholarly journals Effect of moxifloxacin on oxidative stress, paraoxonase-1 (PON1) activity and efficacy of treatment in patients with multiple drug-resistant tuberculosis

2017 ◽  
Vol 16 (10) ◽  
pp. 2515-2520 ◽  
Author(s):  
Hongguo Yang ◽  
Yanyan Zhao ◽  
Yunbo Ma ◽  
Qiang Wen ◽  
Minghui Zhang
Keyword(s):  
Oxidative Stress ◽  
Paraoxonase 1 ◽  
Pon1 Activity ◽  
Control Group ◽  
Multiple Drug ◽  
Observation Group ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Multiple Drug Resistant ◽  
Mdr Tb

Purpose: To investigate the effect of moxifloxacin on paraoxonase-1 (PON1)  activity, and serum oxidative stress in patients with multiple drug-resistant tuberculosis (MDR-TB).Methods: A total ofof 130 MDR-TB patients who were treated with moxifloxacin from October 2014 to October 2010 in Eastern Medical District of Linyi People's Hospital of Shandong Province, China were randomly divided into an observation group (65 cases, moxifloxacin group) and control group (65 cases, non-moxifloxacin group). Total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), PON1 levels and treatment efficacy for groups were determined.Results: Compared with pre-treatment levels, TOS (23.3 ± 4.7 vs 13.9 ± 3.3 umol H2O2 Eq/L, t = 13.20, p = 0.00) and OSI (17.4 ± 4.8 vs 5.7 ± 1.4 U, t = 18.87, p = 0.00) of the observation group significantly decreased, while TAS (1.4 ± 0.5 vs 3.5 ± 0.7 umol Trolox Eq/L, t = 19.68, p = 0.00) and PON1 (15.5 ± 6.9 vs 31.1 ± 8.3 U/L, t = 11.65, p = 0.00) significantly increased. TOS (23.3 ± 4.7 vs 13.9 ± 3.3 umol H2O2 Eq/L, t = 7.73, p < 0.05) and OSI (16.9 ± 5.5 vs 7.4 ± 3.2U, t = 12.04, p = 0.05) reduced significantly in the control group. Moxifloxacin correlated positively with △TAS (r = 0.697, p = 0. 04) and △PON1 (r = 0.785, p = 0.01), but correlation with △TOS (r = -0.625, p = 0.01) was negative. Efficacy was significantly higher in the observation group than that in the control group (81.54 % vs 56.92 %, p =0.00).Conclusion: Oxidative stress injury in MDR-TB patients may be effectively managed by combination of moxifloxacin with anti-TB treatmentKeywords: Multiple drug-resistant TB, Moxifloxacin, Paraoxonase, Oxidative stress

scholarly journals Effect of PDCA on Improving the Compliance of Sepsis Bundles

2021 ◽  
Author(s):  
Chunxia Liu ◽  
Yun Liu ◽  
Yiqing Tian ◽  
Kun Zhang ◽  
Guizhen Hao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Staff ◽  
Completion Rate ◽  
Management Mode ◽  
Control Group ◽  
Observation Group ◽  
Central Venous ◽  
Pdca Cycle ◽  
Treatment Measures ◽  
Sepsis Bundle

Abstract Background To explore the application effect of plan, do, check and action circulation management mode in improving the compliance of sepsis bundle treatment. Methods 132 patients with sepsis admitted from January 1 to December 31, 2018 were selected as the control group, and the bundle treatment measures of sepsis were routinely implemented, that is, the nurses received the confirmation notice of sepsis, measured the body temperature, blood pressure, central venous pressure (CVP), central venous oxygen saturation (ScvO2), indwelling catheter, etc., and the doctor ordered the infusion of antibiotics, rehydration, application of pressor drugs, blood culture and blood gas analysis, blood routine test, procalcitonin and other sample medical orders were immediately implemented by nurses, and the improvement of blood pressure, urine volume and skin endings was closely observed, Doctors and nurses reminded each other to complete the above treatment measures within 6 hours; 138 patients with sepsis admitted from January 1 to December 31, 2019 were selected as the observation group. The Department established a sepsis treatment group. All medical staff, under the leadership of the medical and nursing team leaders, took the same measures as the control group, supplemented by PDCA cycle management. Objective to compare the changes of compliance of medical staff to sepsis bundle treatment before and after the implementation of PDCA cycle management. Results Compared with the control group, the observation group achieved the completion rate of sepsis bundle treatment in 1 hour was 76.8% (65.9%), the completion rate in 3 hours was 82.6% (69.7%), and the completion rate in 6 hours was 87.7% (77.3%). The difference was statistically significant (P < 0.05). Conclusions The implementation of PDCA cycle management mode can effectively improve the compliance of medical staff to the bundle treatment of sepsis, improve the treatment efficiency of sepsis, and improve the quality of medical care.

scholarly journals Hygienic assessment of the nutritional status of patients with multi-drug-resistant pulmonary tuberculosis

2019 ◽  
Vol 44 (3) ◽  
pp. 79-83
Author(s):  
S.Ch. Mamedsakhatova
Keyword(s):  
Nutritional Status ◽  
Point Of View ◽  
Control Group ◽  
Fatty Tissue ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Priority Direction ◽  
Mdr Tb ◽  
Multiple Correlation Analysis

Introduction. The priority direction of hygienic science at the present stage is the study of the nutritional status of patients with multi-drug-resistant tuberculosis (MDR-TB) of the lungs. The aim of study is to identify the basic patterns of formation of the structure of the nutritional status of patients with MDR-TBof the lungs in order to adopt a reasonable system of measures for their optimization(from a hygienic point of view). Materials and research methods. The actual nutrition of 103 patients with MDR-TBof the lungs was studied using a specially prepared standardized questionnaire, which included information on previous and yesterday nutrition. Nutritional status was determined by evaluating anthropometric indices (height, body mass, chest circumference), on the basis of which the Quetelet index was calculated. Surveyed control group included 20 relatively healthy patients. Bioimpedancemetrywas a special research method. Results and discussion. In the case of multiple correlation analysis, a high direct correlation of the total protein level with the indicator of fat mass according to bioimpedancemetry (r=0.63; p<0.01)was found in patients with MDR-TB of the lungs. Conclusion. There is a need for prevention and correction of excess fatty tissue and a lack of muscle mass, which can be achieved with the help of physical exercise, rational nutrition and nutritional support.

scholarly journals The Effect of Respiratory Rehabilitation Training on the Life Quality of Pneumoconiosis Patients

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Lijun Chen ◽  
Wang Xu ◽  
Xiaoyong Ma ◽  
Genggeng Yu ◽  
Jianfeng Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Knowledge ◽  
Pulmonary Ventilation ◽  
Life Quality ◽  
Control Group ◽  
Observation Group ◽  
Rehabilitation Training ◽  
Pulmonary Ventilation Function ◽  
Respiratory Rehabilitation

Objective: To explore the effect of respiratory rehabilitation training on the quality of life of pneumoconiosis patients. Methods: 76 pneumoconiosis patients who were treated in our hospital from April 2017 to December 2019 were selected as the research object, and randomly divided into 2 groups according to the order of admission by coin tossing, 38 cases in each group. The control group carried out health knowledge education on the basis of conventional treatment, and the observation group combined with respiratory rehabilitation training on the basis of the control group to compare the quality of life and lung function of the two groups of patients. Results: After 2 months of nursing care, scores of GQOLI-74 scale and pulmonary ventilation function indexes in the observation group were higher than those in the control group, with statistically significant differences (P<0.05). Conclusion: Respiratory rehabilitation training can improve pulmonary ventilation function of pneumoconiosis patients, improve the quality of life of patients, has good clinical application value.

scholarly journals Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

2020 ◽  
Author(s):  
Lankamo Ena Digesa ◽  
Aklil Hailu Beyene ◽  
Erdaw Tachbele Betre
Keyword(s):  
Previous Treatment ◽  
Tuberculosis Patient ◽  
Tuberculosis Treatment ◽  
Southern Ethiopia ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
Study Participants ◽  
Control Study

Abstract Background: The emergence of multi-drug resistant tuberculosis (MDR-TB) is a challenge for global prevention and control of the disease. MDR-TB case management is difficult because it exposes to further economic and social costs that the patients face while seeking help and treatment. Ethiopia is one of the 30 MDR-TB burden countries. There is little research evidence of MDR-TB from the peripheral parts of the country.Objective: The study was designed to identify determinants of MDR-TB among patients attending anti tuberculosis treatment from peripheral districts, Southern Nations, Nationalities and People Region, Ethiopia, 2019. Methods: Hospital based case control study was conducted from March to April, 2019 in Southern Ethiopia. Cases were confirmed MDR-TB patients, while controls were those who declared cured or completed first line ant-tuberculosis treatment. The study participants were recruited by stratified random sampling. The data were entered into Epi data 4.4.3, cleaned and analyzed by SPSS 24. Bivariate and multivariable analyses was used to identify determinants of MDR-TB. Determinants with P-value <0.05 were declared as having significant association with MDR-TB and adjusted odd ratio with 95% CI was used to measure degree of association. Result: A total of 180 study participants were recruited (90 cases and 90 controls) and participated in this study. The median age for cases and controls was 29 and 30.5 years respectively. More than two third (78.89%) of case participants were from rural and 49(54.44%) of the controls were from rural. Uneducated [AOR:5.18, 95%CI (1.69-15.80)], rural resident [AOR:2.60,95%CI(1.14-6.88)], body mass index(BMI)<18.5kg/m2[AOR:3.11,95%CI(1.41-6.88], pulmonary tuberculosis[AOR:3.98,95%CI(1.11-14.22)], contact history with tuberculosis patient [AOR:3.99,95%CI (1.75-9.07)] and history of previous treatment[AOR:9.5,95%CI(4.08-22)] were found independent determinants of MDR-TB.Conclusions and Recommendation: Uneducated, rural residence, body mass index <18.5kg/m2, pulmonary tuberculosis, contact history with tuberculosis patient and history of previous treatment were associated with MDR-TB. A community level education to enhance public awareness about MDR-TB, nutritional counseling and support, strengthening contact tracing and directly observed treatment strategies with treatment adherence interventions were recommended.

scholarly journals The effectiveness of application of the standardized terminology for telephone follow-up model in discharge follow-up of patients with cancer pain.

2020 ◽  
Author(s):  
Xin PENG ◽  
Xing ZHANG ◽  
Yi REN ◽  
juan li XIONG
Keyword(s):  
Cancer Pain ◽  
Treatment Compliance ◽  
Control Group ◽  
Observation Group ◽  
Patients With Cancer ◽  
Management Ability ◽  
Communication Method ◽  
Standardized Terminology ◽  
Monitoring Treatment

Abstract Purpose This article aims to explore a standardized telephone follow-up model for patients with cancer pain, thus to promote standardized management of discharge follow-up of the patients with cancer pain.Method We have developed a flow chart of standard terminology for discharge follow-up of the patients with cancer pain. The 80 patients with cancer pain who have discharged from our hospital were divided into the control group (40 cases) and the observation group (40 cases), both groups were followed up by telephone within one week of discharge. The pain nurses have done the discharge follow up by telephone using the communication method of routine follow-up and the communication method of standardized terminology, self-monitoring, treatment compliance, adverse reaction management, self-management ability and satisfaction with telephone follow-up were compared between the two groups. Results The total scores of self-pain monitoring, treatment compliance, adverse reaction management and self-management ability in the observation group were higher than those in the control group (P<0.05). The satisfaction of the observation group was significantly higher than that of the control group (P<0.05).Conclusion The application of the standardized terminology telephone follow-up mode can promote effective communication between nurses and patients, standardize the process and content of telephone follow-up. It can effectively improve the effectiveness of telephone follow-up and the satisfaction of patients with nursing services, which is suitable for clinical reference.

scholarly journals SIDE EFFECTS ASSOCIATED WITH DRUGS USED IN TREATMENT OF MULTI DRUG RESISTANT TUBERCULOSIS AND TREATMENT RELATED FACTORS OF MULTI DRUG RESISTANT TUBERCULOSIS PATIENTS IN KATHMANDU VALLEY

2017 ◽  
Vol 14 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Chandra Prakash Bhatt ◽  
B KC
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Drug Resistant ◽  
Second Line ◽  
Related Factors ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Care Worker

Introduction: Treatment of multi drug resistant Mycobacterium tuberculosis (MDR-TB) with second line drugs is associated with adverse drug reactions and toxicity. Aim of this study were to determine side effects associated with drugs used in treatment of multi drug resistant tuberculosis and treatment related factors of MDR-TB patients.Methodology: A prospective study was carried out in National Tuberculosis Centre Bhaktapur Nepal. Questionnaires were used to collect data from patients.Results: Total 101 MDR TB patients were included among them majorities were male (52%) and mean age of the patients was 31.2 years. Majority of patients (87.1%) had previous history of tuberculosis treatment and 54.5% were in intensive phase of treatment. The side effect associated with drugs used in treatment of MDR-TB reported by patients were joint pain (21.2%), nausea (20.3%), hearing disturbances (11%), gastrointestinal disturbance (9.9%), depression (9.6%), itching (8.1%), hypothyroidism (6.4%), dizziness (6.4%), seizures (3.8%) and hepatitis (3.5%). Last month 25.74% patients missed one or more doses of drugs and 3.9% missed drug doses due to side effect of drugs. Majorities of the patients used vehicle to reach health centre (92.07%), time to reach the health center (59.4%) were less than 30 minutes but majorities of patients (57.4%) were not satisfied by the counseling of health care worker.Conclusion: The finding of this study shows that in MDR patients 12.8% were found new cases. Last month 3.9% patients were stopped the drugs due to side effects of drugs. Majority of patients (57.4%) were not satisfied by counseling of health care worker. Treatment of multi drug resistant tuberculosis with second line anti tubercular drugs is associated with side effects, health care worker counseling to MDR- TB patients with full attention is essential to encourage the patient’s moral and complete the treatment. Timely managing the side effects of medication is important in helping people to complete their treatment.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), Page: 1-6

scholarly journals Intensive phase treatment outcome and associated factors among patients treated for multi drug resistant tuberculosis in Ethiopia: a retrospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teklu Molie ◽  
Zelalem Teklemariam ◽  
Eveline Klinkenberg ◽  
Yadeta Dessie ◽  
Andargachew Kumsa ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Retrospective Cohort ◽  
Multinomial Logistic Regression ◽  
Drug Resistant ◽  
Contributing Factors ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia. Methods A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors. Results At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04–10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR = 1.047, 95% CI (1.024, 1.072)] and those with a history of hypokalemia [ARRR = 0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR = 3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR = 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR = 0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.

scholarly journals Risk factors of Multidrug Resistant Tuberculosis in central Nepal: A pilot study

2012 ◽  
Vol 8 (4) ◽  
pp. 392-397 ◽  
Author(s):  
S B Marahatta ◽  
J Kaewkungwal ◽  
P Ramasoota ◽  
P Singhasivanon
Keyword(s):  
Risk Factors ◽  
Social Stigma ◽  
Smoking Habit ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
National Tuberculosis ◽  
Mdr Tb ◽  
History Of

Introduction Tuberculosis is the most widespread infectious disease in Nepal and poses a serious threat to the health and development of the country. Incidences of drug resistant tuberculosis in Nepal are increasing and this tuberculosisis a major threat to successfully controlling tuberculosis . Objective The general objective of the study was to assess the risk factors of multi-drug resistant tuberculosis among the patients attending the National Tuberculosis Centre, Bhaktpur Nepal. Methods An observational study/ case-control study with a Atotal number of 55 multi-drug resistant tuberculosis cases and 55 controls. The study was conducted among the patient attending in the National Tuberculosis Centre , Bhaktpur Nepal for six months, between May–October 2010. sImulti-drug resistant tuberculosis wasThe collected data was analysed in SPSS 11.5 version. The association between categorical variables were analysed by chi-square tests, OR and their 95% CI were measured. Results The total number of patients used for the study was 110, of which among them 55 were cases and 55 were controls . Our study revealed that there were significant associations between history of prior TB MDR-TB OR =2.799 (95 % CI 1.159 to 6.667) (p=0.020); smoking habit OR =2.350 and (95%CI 1.071 to 5.159) (p=0.032); social stigma social stigma OR 2.655 (95%CI r 1.071 to 5.159) (p=0.013); knowledge on MDR-TB OR =9.643 (95% CI 3.339 to 27.846) (p < 0.001)and knowledge on DOTS Plus OR=16.714 (95% CI is ranging from 4.656 to 60.008) (p< 0.001). However, there was no association found between alcohol drinking habits and ventilation in the room. Conclusion Our study revealed that there were significant associations between history of prior tuberculosis, smoking habit social stigma social stigma, knowledge on multi-drug resistant tuberculosis and knowledge on DOTS Plus with multi-drug resistant tuberculosis However there was no association between alcohol drinking habit and ventilation in room with multi-drug resistant tuberculosis. http://dx.doi.org/10.3126/kumj.v8i4.6238 Kathmandu Univ Med J 2010;8(4):392-7

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