Treatment Outcomes of the Standardized Shorter MDR-TB Regimen under Programmatic Setting: A Retrospective Study from a Tertiary Care Centre, India

2021 ◽  
Vol 17 ◽  
Author(s):  
Swathi Karanth M.P ◽  
Somashekar M ◽  
Anushree Chakraborty ◽  
Swapna R ◽  
Akshata J.S ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mdr Tb ◽  
Set Up

Background: The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. Objectives: 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.

scholarly journals A cross sectional study on demographic factors affecting low birth weight

2019 ◽  
Vol 6 (11) ◽  
pp. 4896
Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Income Group ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Affecting

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.

scholarly journals Assessment of Knowledge, attitude and practices of Epilepsy Patients’ towards their illness and treatment in a tertiary care hospital in Kuantan Pahang Malaysia

2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Negative Attitude ◽  
Median Number ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Medical Attention ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553

scholarly journals Patients’ knowledge of prescribed medication: a cross sectional study in a tertiary care centre, Mumbai

2019 ◽  
Vol 6 (10) ◽  
pp. 4238
Author(s):  
Ashis Samuel John ◽  
Kamaxi M. Bhate
Keyword(s):  
Tertiary Care ◽  
Treatment Compliance ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Study Population

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.

scholarly journals Psychiatric Disorders in Adolescents Attending Psychiatry Outpatient Department in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Neelam Joshi ◽  
Asim Shrestha ◽  
Deepika Karki ◽  
Pradip Man Singh
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Psychotic Disorders ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Adolescence is the time when most mental illness begins most of the time these problems are overlooked leading to increased morbidity and mortality. The study is undertaken to find out the prevalence of psychiatric disorders in adolescents attending psychiatry outpatient department in a tertiary hospital. Methods: A descriptive cross-sectional study was done from 1st December 2019 to 29th November 2020 at a tertiary care centre of Kathmandu. Ethical approval (Ref No.: 012-076/077) was taken from the Institution Review Committee. A semi-structured proforma was used for the socio-demographic profile of patients and International Classification of Diseases-10 was used to make the diagnosis. Data were analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 174 adolescents were included in the study. Out of the total cases 141 (81.03%) (75.1-86.8 at 95% Confidence Interval) were diagnosed with psychiatric disorders, among them 73 (51.77%) were males and 68 (48.23%) were females. The common diagnoses were anxiety disorders 63 (36.20%), mood disorders 34 (19.54%), psychotic disorders 26 (14.94%), substance use disorders 8 (4.59%), non-organic sleep disorders 5 (2.87%), behavioral and emotional disorders 3 (1.72%) and mental retardation 2 (1.149%). Conclusions: Prevalence of psychiatric illnesses is high in the adolescent population compared to the similar studies.

scholarly journals A study on knowledge, attitude and practices (KAP) towards contraceptive use among married women attending a tertiary care centre

2019 ◽  
Vol 10 (3) ◽  
pp. 1832-1835
Author(s):  
Nithyananthan P ◽  
Jagadeesan M ◽  
Prasanna Karthik S ◽  
Kannan R ◽  
Bavithra K ◽  
...  
Keyword(s):  
Contraceptive Use ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Married Women ◽  
Indian Society ◽  
Care Hospital ◽  
Key Factors ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Contraceptive Usage

In the Indian society, various factors other than mere knowledge have shown to have a more significant impact over contraceptive usage and choice such as educational levels of women, marital duration, cultural and social factors, and exposure to mass media. This study focuses on assessing the knowledge, attitude and practices (KAP) of contraceptive use among married women. A cross-sectional study was conducted among married women aged between 18 to 49 years attending a tertiary care hospital in the city of Chennai from June to September 2018. A total of 146 women were interviewed, and the KAP parameters were assessed using a pretested structured questionnaire. Though 97.9% (n=143) of the women in this study had knowledge about some form of contraception, only 24.7% (n=36) practiced them. Among the users (n=36), the decision to adopt contraception was made by the husband in 69.4% (n=25).Among the non-users (n=110), the major reasons for not practicing contraception were lack of interest in 37.2%(n=41) and fear of side effects in 35.5% (n=39).This study demonstrates a significant gap between the knowledge and practice of contraceptives in our population. Improving doctor-patient relationship and encouraging a positive attitude of the husband towards contraception are the key factors in promoting adoption of the contraceptive practices.

scholarly journals Clinico-demographic profile of deceased patients with coronavirus disease in a tertiary care centre of central India

2021 ◽  
Vol 8 (5) ◽  
pp. 2474
Author(s):  
Rupali A. Patle ◽  
Ashok R. Jadhao ◽  
Priya B. Dhengre ◽  
Manjusha A. Dhoble
Keyword(s):  
Clinical Characteristics ◽  
Tertiary Care ◽  
Case Fatality ◽  
Central India ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
The Difference

Background: The covid pandemic started from Hubei, Wuhan in December 2020 then covered many other countries including India. Understanding the demographic and clinical characteristics of deceased COVID-19 patients could inform public health interventions focusing on preventing mortality due to COVID-19. The present study was done with the objective of studying the socio-demographic and clinical profile of deceased patients with coronavirus disease.Methods: This is a hospital based cross-sectional study on 1190 deceased patients of coronavirus disease in a tertiary care hospital of central India which is a dedicated covid hospital from 11 March 2020 to 28 February 2021. Socio-demographic and clinical characteristics of deceased patients were recorded.Results: Overall case fatality rate was 13.24%. Maximum number of deaths occurred in the month of August 2020 and September 2020 were 372 (31.26%) and 477 (40.08%). It was higher in the males 791 (66.47%) as compared to females 399 (33.53%), but the difference was not significant. The most common symptom was fever on hospitalization 924 (77.65%), followed by generalized weakness 771 (64.79%). 352 (29.58%) patients died within 24 hours of the admission to hospital. Hypertension and type 2 diabetes mellitus were the most prevalent morbidity in 557 (46.80%) and 357 (30.00%). It was found that 232 (19.50%) deceased patients had oxygen saturation less than 50% on admission.Conclusions: Higher age and presence of co-morbidities at the time of admission were significantly associated with mortality.

scholarly journals STUDY OF SPECTRUM OF BENIGN THYROID LESIONS ON FNAC AT TERTIARY CARE CENTRE

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
M. Reeta Devi ◽  
Babina Sarangthem ◽  
Keerthivasan .
Keyword(s):  
Tertiary Care ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Thyroid Swelling ◽  
Thyroid Lesions

Background: Thyroid lesions are one of the commonly encountered disorders in any hospital. Majority are non neoplastic and malignancy accounts for about 5-10%. Fine needle aspiration cytology is a simple, cost effective, reliable and minimally invasive tool for the evaluation of these lesions and it can differentiate benign from malignancy. Material and methods: This cross sectional study was conducted on the thyroid swelling attending the cytology OPD of Regional Institute of Medical Sciences (RIMS) during October, 2016 to October, 2019 a tertiary care hospital. All smears are air dried and stained with Giemsa stain. Results: The most common age group affected is 41-50 years of age followed by 31-40 years age group. Females outnumbered males with female to male ratio of 16.9:1. Out of 729 cases, colloid goiter constitute a total of 387 (53%), Hashimto's thyroiditis 318 cases (43.3%), adenomatous goiter (1.2%) and Graves disease contribute 1.1% Conclusion: Thyroid Swelling are very common clinical presentation. FNAC is a cost effective, reliable, easy to perform test with commendable sensitivity. It can spare patients to undergo unnecessary surgery. It also helps in differentiating solid from cystic lesions.

scholarly journals Prevalence of Diabetes and Dyslipidemia in Hypertensive Young Adults in a Tertiary Care Centre in Nepal, a Cross Sectional Study

2020 ◽  
Vol 42 (2) ◽  
pp. 21-25
Author(s):  
Kamal Sharma Lamsal ◽  
Keshab R Neupane ◽  
Niranjan Acharya ◽  
Dinesh K Lamsal ◽  
Niraj Karmacharya ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Cardiovascular Complications ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Increased Risk

Introduction Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with increased risk of cardiovascular complications requiring close follow-up and more aggressive treatment. Hence, the present study was done to study the prevalence of diabetes and dyslipidemia in young hypertensive patients i.e. <40 years in a tertiary care hospital, Nepal. MethodsThis is a hospital based cross-sectional study carried out in Civil Service Hospital, Kathmandu. Study included 165 patients of <40 years who had hypertension, either newly diagnosed or undergoing antihypertensive treatment from September 2018 to September 2019. Blood pressure was measured two times on right upper arm in sitting position at interval of 30 minutes and the aver­age was taken. Fasting Lipid Profile and Fasting Blood Glucose was measured after 12 hours of fasting and the prevalence of dyslipidemia and diabetes were analyzed from the data collected. All calculations and statistical analyses are processed by the SPSS 25.0. ResultsAmong 165 patients included, majority of patients, 107 (64.8%) were among 31-39 years, followed by 53 (32.1%) patients among 21-30 years. In total, 98 (59.4%) were male and 67 (40.6%) female. The prevalence of diabetes was 24 (14.5%) and pre-diabetes was 49 (29.7%). The prevalence of dyslipidemia was 125 (75.6%), high triglyceride being the most common disorder followed by low HDL in 87 (52.1%). Elevated total cholesterol was found in 53 (32.1%) patients and 48 (29%) had high LDL cholesterol level. ConclusionA high prevalence of diabetes, pre-diabetes and dyslipidemia was observed in the hypertensive patients <40 years of age.

scholarly journals Anaemia among Patients of Heart Failure in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 833-838
Author(s):  
Abhishek Bhandari ◽  
Prashant Shah ◽  
Naveen Kumar Pandey ◽  
Richa Nepal ◽  
Ojaswee Sherchand
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patients With Heart Failure

Introduction: Anaemia is an important comorbidity common in patients with heart failure and is associated with poor clinical status and worse outcomes. In Nepal few studies have evaluated anaemia amongst patients suffering from heart failure. We intended to find out the prevalence of anaemia in patients with heart failure in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among patients of heart failure presenting to tertiary care hospital in eastern Nepal from April 2017 to January 2018. Ethical approval was taken from the Institutional Review Committee of a tertiary care centre (reference number: IRC/0842/016). Using the convenience sampling method, 100 patients were enrolled in the study. Blood samples from the patients were taken for haemoglobin and serum iron studies. Data was analysed using Statistical Package for Social Sciences version 11. Point estimate at 95% Confidence Interval was calculated, with frequency and percentage. Results: Among 100 patients with heart failure, 82 (82%) (74.47-89.53 at 95% Confidence Interval) had anaemia. Mean haemoglobin level of the study population was 10.40±2.73 g/dl. Fifty four (54%) of patients had iron deficiency status irrespective of presence or absence of anaemia. Conclusions: Prevalence of anaemia among patients of heart failure in our study was found to be higher than various other homologous international studies.

scholarly journals Cavities Herald Persistent Sputum Positivity

2021 ◽  
Author(s):  
Nadia Jawad ◽  
Nausheen Saifullah ◽  
Naseem Ahmed ◽  
Saira Jafri
Keyword(s):  
Pulmonary Tuberculosis ◽  
Medical Center ◽  
Tertiary Care ◽  
National Policy ◽  
Cross Sectional Study ◽  
Tuberculosis Patient ◽  
Sputum Smear ◽  
Care Hospital ◽  
Cross Sectional ◽  
Directly Observed Treatment

Abstract Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

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