scholarly journals A STUDY ON LIVER FUNCTION TEST PROFILE OF 2ND LINE DRUGS IN MULTI DRUG RESISTANT (MDR) AND EXTENSIVELY DRUG RESISTANT (XDR) TUBERCULOSIS CASES REGISTERED UNDER DR-TB CENTRE IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 1-3
Author(s):  
Rupam Kumar Ta ◽  
Pronoy Sen

BACKGROUND: The emergence of drug resistant mycobacterium has become a signicant public health problem creating an obstacle to effective Tuberculosis (TB) control. Freedom from TB is possible with timely, regular, complete treatment, with assurance, prevention and management of side effects of antitubercular drugs. Present study was conducted to evaluate common and rare adverse drug reactions (ADR) of CAT IV and CAT V to analyse demographic, radiological and bacteriological prole and treatment outcome in MDR &XDR patients. Aims and Objectives- To evaluate the common and rare adverse drug reactions of intensive phase treatment of Multi Drug Resistant Tuberculosis (MDR) and Extensively Drug Resistant Tuberculosis (XDR) as per WHO-UMC Causality Assessment Scale. METHODS: 76 patients of MDR and XDR Tuberculosis were admitted in DR-TB (Drug Resistant TB) centre, Burdwan Medical College and Hospital and the adverse drug reaction prole of 2nd line drugs were analysed during the intensive phase for a year after fullling the inclusion and exclusion criteria. Treatment was given as per guidelines by Revised National TB Control Program PMDT (Programmatic management of drug-resistant TB). RESULTS:Adverse drug reactions on GI system were nausea 73 patients (96.10%), vomiting 70 (92.10%), acidity 41 (53.9%), and sulphurous belching and hepatitis 1 (1.31%) each. CONCLUSIONS: The reactions were common in rst 60 days of the regimen and in patients with BMI ≤18. Hence vigilant monitoring is required for these types of patients during the initial period and sputum smear and culture conversion is very well correlated with clinical and radiological improvement.

Author(s):  
Mayur P. Shinde ◽  
Nimish R. Halasawadekar ◽  
Sunita J. Ramanand ◽  
Shraddha M. Pore ◽  
Jayprakash B. Ramanand ◽  
...  

Background: A high frequency of adverse drug reactions (ADRs) is one of the major challenges in the treatment of Multi-drug resistant tuberculosis (MDR-TB). Patients may refuse to continue treatment if ADRs are not properly addressed, drugs may be stopped unnecessarily and treatment may be terminated prematurely by inexperienced health workers, resulting in a high proportion of failure.Methods: Patients diagnosed for MDR-TB and registered in Drug Resistant TB centre (DR-TB) of tertiary care hospital during period of July 2014 to June 2015 were enrolled in the study. Data of patients hospitalized for the complaints of ADR in DR-TB centre during study period was collected.Results: Out of 468 patients, 60 (12.82%) patients developed at least one adverse reaction and were hospitalised for the same. Among 109 reported ADRs, Gastrointestinal upset was the most common ADR reported (5.98%) followed by psychosis (4.91%) and ototoxicity (2.99%).Conclusions: The health providers, the patients and their relatives should be sensitised about these ADRs for early detection and treatment. It can also be suggested that the setup of DR-TB centre should be integrated with psychiatry and ENT specialities, with all the provisions of early detection of ADR and treatment.


Author(s):  
Payal P. Naik ◽  
Arvind S. Pandey ◽  
Swati S. Patel

Background: Drug resistant tuberculosis is an important public health issue in India. The treatment regimen followed is Programmatic Management of Drug resistant Tuberculosis (PMDT) approach. Adverse drug reactions (ADRs) are a serious issue which increases the risk of defaulter rate if poorly managed. Thus study was undertaken to assess the ADRs caused by PMDT therapy in indoor patients of Department of Respiratory Medicine in a tertiary care hospital at Surat.Methods: The prospective and observational study was carried out for one year period. The causality was determined by World Health Organization (WHO) Uppasala Monitoring Centre (UMC) scale and severity was determined by Modified Hartwig and Siegel scale. Fisher exact test was applied for statistical analysis.Results: Among 24 drug resistant tuberculosis patients, 12 (50%) patients developed ADRs due to second line antitubercular drugs. Occurrence of ADRs was more among Category V (100%) as compared to Category IV (36.8%). Occurrence of ADRs was more among females (60%). The commonly involved systems are auditory system (33.3%). Majority of ADRs developed within 61-90 days (66.7%) of initiation of drug therapy. Highest percentage of ADRs causing drugs was pyrazinamide (27.8%). On evaluation of the causality of ADRs, majority were found to be possible (53.3%). The severity assessment showed that most of the patients ADRs were of moderate level (73.3%).Conclusions: PMDT therapy is complicated but early management and reporting of ADRs decreases default rate.


2015 ◽  
Vol 7 (4s) ◽  
pp. 425-431 ◽  
Author(s):  
Sangita Vashrambhai Patel ◽  
Nimavat Kapil Bhikhubhai ◽  
Alpesh Bhimabhai patel ◽  
Kalpita Samrat Shringarpure ◽  
Kedar Gautambhai Mehta ◽  
...  

Author(s):  
Payal P. Naik ◽  
Arvindsingh Panwar ◽  
Swati Patel

Background: Tuberculosis is a serious public health issue in India. The treatment regimen followed is Directly observed treatment short-course (DOTS) and Programmatic Management of Drug resistant Tuberculosis (PMDT) approach. In a long period of treatment adverse drug reactions (ADRs) can be an important programmatic issue. Thus, study was undertaken to assess the ADRs caused by antitubercular therapy in indoor patients in a tertiary care hospital at Surat.Methods: The Observational, prospective study was carried out for one year period. The causality was determined by WHO UMC scale and severity was determined by Modified Hartwig and Siegel scale. Chi square test was applied for statistical analysis.Results: Among 255 tuberculosis patients, 85 (33.3%) patients developed ADRs. Occurrence of ADRs was more among females (46.6%). The commonly involved systems are gastrointestinal (40.6%) followed by haematological (17.9%). The most common ADRs observed were nausea and vomiting (21.7%). High percentage of ADRs causing drugs were isoniazid (30.6%) followed by rifampicin (26.1%). Causality assessment showed 60.4% ADRs were possible, 37.7% ADRs were probable and 1.9% ADRs was certain. Severity assessment scale showed 81.1% of moderate, 12.3% of mild and 6.6% of severe grading. Occurrence of ADRs was more among PMDT (60%) in comparison to DOTS therapy (31.06%) [p value = 0.0084 (significant p value < 0.05)].Conclusions: Antitubercular treatment is safer but early detection, management and reporting of ADRs is required to prevent it at initial stage and helps to decrease default rate.


Author(s):  
Kishor B. Rathod ◽  
Mangala S. Borkar ◽  
Avinash R. Lamb ◽  
Sanjay L. Suryavanshi ◽  
Gajanan A. Surwade ◽  
...  

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>As per WHO’s “Global Tuberculosis Report, 2012”, India accounts for an estimated 64000 patients out of 310000 cases of drug resistant TB estimated to have occurred amongst the notified cases of TB across the globe in a year. <strong> </strong><span lang="EN-US">MDR-TB is a man-made phenomenon– poor treatment; poor drugs, poor adherence lead to the development of MDR-TB. </span><span lang="EN-US"> </span><span lang="EN-US">Treatment of MDR-TB is difficult, much costlier, challenging and needs experience and skills. Reserve drugs are frequently associated with high rates of unacceptable adverse drug reactions, needing change of regimen. Therefore, it is imperative to monitor and treat adverse drug reactions. <strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>The present prospective observational study was carried out at Drug Resistant Tuberculosis Centre at Govt. Medical College, Aurangabad, Maharashtra, to monitor patients for early detection of adverse events after starting treatment till the patients were admitted and later followed up personally or telephonically at regular intervals.</p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> We observed adverse drug reactions among </span>90/265 (33.96 %) patients of whom 90/265 (33.96 %) had gastro intestinal ADRs, followed by ototoxicity 15/265 (5.66%), psychiatric manifestations 14/265 (5.28%), injection site pain swelling 13/265 (4.90%), arthralgia 11/265 (4.15%), dermatological ADRs 7/265 (2.64%), peripheral neuropathy 5/265 (1.88%), renal dysfunction 3/265 (1.13%), <span lang="EN-US">change of therapy was only required in 13 psychiatric and 12 ototoxic ADRs.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> ADRs are more common in MDR TB patients on second line anti tubercular treatment. Good counseling, spacing drugs, high protein diet helps patients to tolerate therapy better and default rate to drop.</span></p>


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