scholarly journals Sputum Smear Non-conversion at the End of Intensive Phase of Tuberculosis Treatment at a Tertiary Center: A Descriptive Cross-sectional study

2021 ◽  
Vol 59 (243) ◽  
pp. 1090-1093
Author(s):  
Naveen Prakash Shah ◽  
Anil Regmi ◽  
Aakash Acharya ◽  
Jwala K.C. ◽  
Bidur Khatiwada ◽  
...  

Introduction: Sputum non-conversion is smear positive tuberculosis despite anti-tubercular therapy. Various factors may lead to sputum non-conversion including resistance to anti-tubercular drugs, age, gender, disease severity, non-compliance, drugs unavailability etc. Little is known and studied about the contribution of these individual factors. Our study sought to determine the prevalence of sputum smear non-conversion in patients at the end of intensive phase of tuberculosis treatment visiting a tertiary-level institution in Nepal. Methods: A descriptive cross-sectional study was conducted among recorded data of patients undergoing sputum Acid Fast Bacilli staining at the end of intensive phase at National Tuberculosis Control Center from April 2018 to April 2020. The study was approved by Nepal Health Research Council (Registration no: 76012020 P). The convenient sampling method was adopted. The data were analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Our study found that out of 830 samples that were tested by Acid Fast Bacilli stain at the end of intensive phase, 40 (4.82%) (3.37-6.28 at 95% Confidence Interval) were sputum smear non-converters. The mean age of sputum non-converters was 41.25±15.543 years. Conclusions: The study shows that a significant proportion of patients remain acid-fast stain positive despite the treatment. However, the proportion is low compared to other similar studies around the globe. This study provides program managers with evidence to support the development of more tailored tuberculosis care and need to conduct more intensive studies about various factors that may lead to non-conversion.

2020 ◽  
Vol 29 (2) ◽  
pp. 198-203
Author(s):  
Ibnu Mas'ud ◽  
Ujainah Zaini Nasir ◽  
Ceva Wicaksono Pitoyo ◽  
Ikhwan Rinaldi

BACKGROUND Based on the regulation of the Indonesian Ministry of Health No. 15 of 2016 about health istithaah for the Hajj, patients with tuberculosis (TB) can be categorized into ineligible or temporarily ineligible pilgrims. This study aimed to know the characteristics of pilgrims with TB and determined their level of fitness for fulfilling the health istithaah. METHODS A cross-sectional study of pilgrims from Jakarta who were receiving TB treatment during the Hajj in 2018 was conducted with consecutive sampling. The secondary data was collected from the Hajj Integrated Computer Health System 2018, TB registered form, and six-minute walk test (the fitness level data) conducted by the District Hajj Health Team at district health centers in DKI Jakarta and Pondok Gede before the Hajj embarkation in June–July 2018. The questionnaire to the Indonesian Hajj Health Team during pilgrimage was also included as additional data. RESULTS Thirty-one pilgrims received TB treatment and completed the intensive phase of TB treatment, but 29 pilgrims had no symptoms. Among them, 2 patients had MDR-TB. Most of them were male aged ≥40 years old. Twelve pilgrims with TB have a sufficient fitness. All pilgrims were able to run the pillars of the Hajj. CONCLUSIONS Pilgrims with TB, including MDR-TB, who had completed the intensive phase with a negative sputum smear test were declared eligible for the Hajj with assistance.


2019 ◽  
Vol 47 (2) ◽  
pp. 83-88
Author(s):  
Zain Hadifah ◽  
Yanri Wijayantri Subronto ◽  
M Robikhul Ikhsan

Sputum smear conversion at the end of the intensive phase of tuberculosis treatment is positif of the patients response to treatment. This study aimed to determine factors associated to sputum smear non-conversion at the end of the intensive phase treatment. This cross sectional study was perform in Yogyakarta distric by collecting medical record in primary health care, from 2011-2016. Of 722 pulmonary tuberculosis (PTB) patient, 21,05 %  patients were identified as non-converted of the intensive phase of treatment with the median age was 41 years and 58.5 % were male. The factors were associated with sputum smear non-conversion of insentive phase treatment : male, age ≥50, pre-treatment smears graded ≥2+, nonadherence to tuberculosis after 2 months treatment. Multivariate analysis indicated that Pre-treatment smears graded ≥2+and nonadherent to tuberculosis after 2 months treatment were a count highest contribution with sputum smear non-conversion. Patients with these factors non-conversion after two months of treatment should be given a fully supervised treatment to prevent in treatment default. Abstrak Konversi BTA pada akhir pengobatan fase intensif merupakan  salah satu indiaktor respon pasien terhadap pengobatan TB. Tujuan penelitian adalah menentukan faktor risiko yang berhubungan dengan kegagalan konversi BTA setelah pengobatan TB fase intensif. Penelitian ini merupakan penelitian cross sectional berdasarkan data rekam medis di puskesmas, Kota Yogyakarta tahun 2011-2016. Dari 722 pasien TB paru, sebanyak 21,05% adalah gagal konversi setelah pengobatan fase intensif dengan median umur adalah 41 tahun dan sebanyak 58,5% adalah laki-laki. Faktor yang berhubungan dengan gagal konversi setelah pengobatan fase intensif adalah jenis kelamin laki-laki, umur ≥50 tahun, gradasi BTA ≥2+, ketidakteraturan menelan obat. Analisa multivariable menunjukkan gradasi BTA sebelum pengobatan ≥ 2+  dan ketidakteraturan pengobatan sebagai faktor yang paling berkontribusi dengan gagal konversi. Pasien dengan gagal konversi setelah 2 bulan .


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Alshdaifat ◽  
Amer Sindiani ◽  
Wasim Khasawneh ◽  
Omar Abu-Azzam ◽  
Aref Qarqash ◽  
...  

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.


Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.


2021 ◽  
Author(s):  
Yousef Khader ◽  
Ahmad Bawaneh ◽  
Zaid Al-Hamdan

BACKGROUND The Syrian conflict started in 2011 and resulted ever since in a large displacement of Syrians. Conflict-related violence coupled with displacement related stressors such as poverty, poor access to health services, loss of family support and discrimination had a significant impact on the mental health and psychosocial wellbeing of Syrian refugee OBJECTIVE This study aimed to identify the perceived symptoms of severe distress and impaired functioning, identify coping mechanisms and identify the barriers to access mental health services among Syrian refugees and Jordanian adults. METHODS This cross-sectional study study took place in 14 randomly selected sites in Jordan where Syrian refugees are concentered and from Za’tari refugee camp. A toolkit for humanitarian settings was used for data collection. RESULTS Of the 1424 participants, 43.4% had distress; 38.9% among host population, 57.0% among refugees in urban communities, and 23.0% among refugees in camp (p <0.005). Overall, finding comfort in faith and spiritual beliefs was the most common coping mechanism reported by those who perceived to be experiencing distress. CONCLUSIONS A significant proportion of Syrian refugees had distress symptoms. It is recommended to incorporate mental health services into broad-based community settings, such as schools, primary prevention or case management programs.


Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.


Author(s):  
Anupama Pulla ◽  
Asma . ◽  
Nanduri Samyuktha ◽  
Soumya Kasubagula ◽  
Aishwarya Kataih ◽  
...  

Background: Computer vision syndrome is a complex of eye and vision problems related to near work which are experienced due to prolonged computer use. Computers demand near work, for longer duration which increases discomfort of eye and prolonged exposure to the discomfort leads to a cascade of symptoms that can be referred as computer vision syndrome. The aims and objectives of the study were to determine the prevalence of computer vision syndrome among engineering students of Hyderabad, Telangana and to determine the factors related to computer vision syndrome among study population.Methods: A cross sectional study was carried out from March to June 2017 among students of an engineering college in Hyderabad, Telangana. A convenient sample of 300 students was taken and a predesigned, pre tested questionnaire was used to obtain information.Results: Majority of study population were males (56.3%). Around 75.1% of study population were using all the electronic gadgets like computers, laptops and smartphones. The prevalence of computer vision syndrome was found to be 60.3%. Around 46.7% of study population viewed the screen from a distance of 22-40 centimeters.Conclusions: As students pursuing engineering stream are the future IT and Computer software engineers, preventive strategies adopted by them will significantly decrease the burden of computer vision syndrome and improve productivity. In this study a significant proportion of the engineering students were found to be having vision problems, which emphasizes the need to adopt preventive measures to avoid computer vision syndrome. 


10.2196/13468 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e13468 ◽  
Author(s):  
Carles Escalona-Marfil ◽  
Andrea Coda ◽  
Jorge Ruiz-Moreno ◽  
Lluís Miquel Riu-Gispert ◽  
Xavier Gironès

Background Accurate measurement of pain is required to improve its management and in research. The visual analog scale (VAS) on paper format has been shown to be an accurate, valid, reliable, and reproducible way to measure pain intensity. However, some limitations should be considered, some of which can be implemented with the introduction of an electronic VAS version, suitable to be used both in a tablet and a smartphone. Objective This study aimed to validate a new method of recording pain level by comparing the traditional paper VAS with the pain level module on the newly designed Interactive Clinics app. Methods A prospective observational cross-sectional study was designed. The sample consisted of 102 participants aged 18 to 65 years. A Force Dial FDK 20 algometer (Wagner Instruments) was employed to induce mild pressure symptoms on the participants’ thumbs. Pain was measured using a paper VAS (10 cm line) and the app. Results Intermethod reliability estimated by ICC(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, indicating good reliability. Intramethod reliability estimated by ICCa(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, also indicating good reliability. Bland-Altman analysis showed a difference of 0.175 (0.49), and limits of agreement ranged from –0.79 to 1.14. Conclusions The pain level module on the app is highly reliable and interchangeable with the paper VAS version. This tool could potentially help clinicians and researchers precisely assess pain in a simple, economic way with the use of a ubiquitous technology.


Healthline ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 15-21
Author(s):  
Manish Jain ◽  
Mayank Jain ◽  
Vinod Kumar ◽  
Kapil Garg ◽  
Asif A Qureshi ◽  
...  

Introduction: The school going age is a formative period, both physically as well as mentally. Poor health status in school aged children is among the causes of poor class performance and high absenteeism. Objectives: to assess the health and nutritional status of the school going children in urban area and to determine the association of health problems with age and gender. Method: A cross sectional study was carried out in government schools of urban field practice area of tertiary care institute, Jhalawar, Rajasthan. Study was carried out among 2193 students in four government schools. A pretested, semi structured questionnaire was used for collection of data on socio-demographic characters and their health profile. A detailed clinical examination was done from head to toe for every child. Weight and height were measured. Data was entered into the Microsoft Excel 10. Chi square test of significance was used for statistical analysis. Results: Most common health problem was dental caries (15.0%) followed by refractive errors (13.1%) and pallor (12.6%). Proportions of pallor and refractive error were significantly increased with increase in age of study participants. 16.8% of the students were found to be having thinness. Moderate stunting was present in 7.3% students. Conclusion: Dental caries, refractive errors and pallor were the common morbidities. A significant proportion of school children were undernourished.


2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Muhammed Kutty Simin ◽  
Sarita Sasidharanpillai ◽  
Uma Rajan ◽  
Najeeba Riyaz

Objectives: With the rise in life expectancy at birth, geriatric population contributes to a significant proportion of those seeking medical aid. Skin problems in the elderly are very common and vary according to region and ethnicity. It is essential for dermatologists to have a better understanding of the pathophysiology of geriatric skin disorders to formulate quality management guidelines. This study was undertaken to document the frequency and the clinical pattern of various physiological and pathological changes in the elderly skin. Materials and Methods: A cross-sectional study was carried out in 200 consecutive patients aged 60 years and above and who attended the Dermatology outpatient clinic of a tertiary referral center in North Kerala. A pre-set pro forma was used to document the patient characteristics, the comorbidities, the medications used, and the clinical findings. Results: All the study participants (100%) had one or more dermatoses. The age of the study population ranged from 60 to 89 years (mean 67.7 ± 6.2 years). This was a female preponderant study with a female to male ratio of 1.4:1. Hypertension (36%), hyperlipidemia (27%) and diabetes mellitus (26%) were the common comorbidities observed. Graying of hair was the most common physiological change, followed by wrinkling. Pruritus was the most common presenting complaint (136, 68%). Statistically significant association was noted between xerosis and generalized pruritus. Fungal infections (30.5%) outnumbered other infections and infestations. Changes of severe photoaging were less frequent. One patient had skin malignancy (basal cell carcinoma). Significant association was noted between photoaging and male sex, smoking, and sun exposure. Limitations: Study conducted in a tertiary referral center not reflecting the status in the community was the major limitation. Conclusion: Photoaging and skin cancers are less frequent in darker skin type. Healthy lifestyle, nutritious diet, frequent application of emollient, better skin care, and judicious use of sunscreen can delay the process of cutaneous aging. More prospective studies in different population groups may go a long way in improving the current knowledge about the less known aspects of geriatric dermatoses.


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