IntroductionThe effectiveness of Video Observed Therapy (VOT) for treating Tuberculosis (TB) has not been measured in low and middle-income countries (LMICs), where more than 95% of TB cases and deaths occur. In this study, we analyse the effectiveness, and patient cost-difference, of VOT compared to clinic-based Directly Observed Therapy (DOT) in improving medication adherence in Moldova, a LMIC in Eastern Europe.MethodsThe study was a 2-arm individually randomised trial with 197 TB patients (n=99 in DOT control group; 98 in VOT treatment group, MDR-TB cases were excluded). The primary outcome was observed medication adherence, measured by the number of days that a patient failed to be observed adhering to medication for every two-week period during the course of their treatmentResultsVOT significantly decreased non-adherence by 4 days (95% CI, 3.35 to 4.67 days; p<0.01) per two-week period: 5.24 days missed per two-week period for DOT and 1.29 days for VOT. VOT patients spent 504 Moldovan Leu (MDL) (approximately €25; 95% CI, 277 to 730 MDL; p<0.01) and 58 h (95% CI, 48 to 68 h; p<0.01) less on their treatment. VOT also increased self-reported satisfaction with treatment. We found no significant results pertaining to treatment success, patient well-being or patient employment status and some evidence of an increase in side effects.DiscussionIn this trial, Video Observed Therapy (VOT) increased observed medication adherence for tuberculosis patients in Moldova, a LMIC, when compared to clinic-based Directly Observed Therapy (DOT). VOT also significantly reduced the time and money patients spent on their treatment.
The effect of cyproterone acetate (CA) on experimentally induced benign prostatic hyperplasia (BPH) in the castrated dog was investigated. BPH was induced by 6 months' treatment with 3\g=a\-androstanediol (3\g=a\-diol) alone and in combination with 17\g=b\-oestradiol(Oe2). RNA, DNA and zinc content of the glands were determined in addition to histological examination and measurement of the prostates. Two different types of prostatic enlargement were observed. First, 3\g=a\-diolinduced typical diffuse canine hyperplasia with replacement of functional activity. DNA, RNA and the zinc content of total glands were increased compared with intact controls.
Background: Adequate bowel preparation is essential for
accurate colonoscopy. Both oral sodium phosphate (NaP) and
polyethylene glycol-based lavage (PEG-ELS) are used predominantly
as bowel cleansing modalities. NaP has gained popularity due to
low drinking volume and lower costs. The purpose of this
randomized multicenter observer blinded study was to compare
three groups of cleansing (NaP, NaP + sennosides, PEG-ELS +
sennosides) in reference to tolerability, acceptance, and
cleanliness. Patient and Methods: 355 outpatients between 18 and
75 years were randomized into three groups (A, B, C) receiving NaP =
A, NaP, and sennosides = B or PEG-ELS and sennosides = C.
Gastroenterologists performing colonoscopies were blinded to the
type of preparation. All patients documented tolerance and adverse
events. Vital signs, premedication, completeness, discomfort, and
complications were recorded. A quality score (0–4) of cleanliness
was generated. Results: The three groups were similar
with regard to age, sex, BMI, indication for colonoscopy, and
comorbidity. Drinking volumes (L) (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71) were in favor of NaP
(P = .005). Discomfort from
ingested fluid was recorded in A = 39.8% (versus C: P = .015),
B = 46.6% (versus C: P = .147), and C = 54.6%. Differences in tolerability and acceptance between the three groups were
statistically not significant. No differences in adverse events
and the cleanliness effects occurred in the three groups (P = .113).
The cleanliness quality scores 0–2 were calculated in A:
77.7%, B: 86.7%, and C: 85.2%. Conclusions:
These data fail to demonstrate significant differences in
tolerability, acceptance, and preparation quality between the
three types of bowel preparation for colonoscopy. Cleansing with
NaP was not superior to PEG-ELS.
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