Tuberculosis is a chronic, granulomatous infectious disease caused by Mycobacterium tuberculosis. Multidrug resistance is a chronic problem associated with treatment of tuberculosis where a substantial proportion of tuberculosis cases reported in India are multi-drug resistant. Poor patient compliance plays a major role in development of resistance. The main objective of the study was to monitor the events associated with ATT in pulmonary and extrapulmonary tuberculosis patients and to achieve better patient outcomes by regular monitoring. This was a prospective observational study which analysed patients diagnosed with pulmonary and extra-pulmonary kochs', attending inpatient and out-patient departments as well as registered under the RNTCP at Dr. B.R Ambedkar Medical College and Hospital for a period of 1 year for any events associated with ATT. Routine investigations which are carried out by the patient at the treatment initiation and whenever required were monitored. A total of 175 patients were monitored in the study out of which majority were males. Most patients were category 1 patients. More than one-third of the patient population reported an adverse event. Most ADRs were related to the GI system, followed by Skin Allergy. Most of the events (72%) were patient reported during physician visit while 26% were reported on investigation. The study found that ADRs has led to medication incompliance which leads them to discontinue the medication for a short duration. Close monitoring of these events from the treatment initiation should be emphasized to prevent medication in adherence. It is suggested that the establishment of pharmacovigilance programs in DOTS centres is essential.
Objectives: Tuberculosis (TB) is a foremost public health problem worldwide. In current years, increasing efforts have been devoted for assessing the health related quality of life of people infected with tuberculosis. The objective of study is to assess the tuberculosis treatment compliance in smokers and non-smokers in Bengaluru region. Methods: TB patients meeting the inclusion criteria had enrolled for the study. The frequency and percentage of each parameter such as occupation, education, patient type, diagnosis, treatment, duration of hospitalization, abdominal pain and dizziness were evaluated. Results: After the treatment of 3month, out of 300 patients 24 patients of smokers and 12 patients of non-smokers were suffered from abdominal pain and 8 patients of smokers and 24 patients of non-smokers were suffered from dizziness. The duration of hospitalization in smokers was 383 days whereas in non-smokers it was 115 days. Maximum numbers of TB patients were found to be unemployed in smokers than in non-smokers patients.In smoker group 82 patients have gotCAT-1 and 68 patients have gotCAT-2 treatment but in non-smoker group 129 patients were taken CAT-1 and 21 patients were received CAT-2 treatment. Conclusion:The percentage of abdominal pain and dizziness, duration of hospitalization was seen more in smokers as compared to non-smokers. Percentage of education, occupation level and salary was found to be less in smokers than the non-smokers as it causes low hygienic and easy susceptibility to TB infection. Final diagnosis suggests that pulmonary TB was seen in smokers and extra pulmonary TB in non-smokers patients.
Background: Continuous positive airway pressure (CPAP) is the first line non-invasive and safest treatment of obstructive sleep apnoea (OSA). Optimal CPAP therapy prescribed is obtained by manual titration in lab setting. Due to lack of data in Indian population predicted CPAP pressure proposed by Hoffstein is used using body mass index (BMI), neck circumference (NC) and apnoea-hypopnoea index (AHI) to correlate with the optimal pressure by automatic CPAP titration.Methods: The study was of retrospective and observational type. It included OSA patients diagnosed by overnight polysomnography (PSG) who had undergone automatic CPAP titration. The correlation of optimal pressure of automatic CPAP and predicted CPAP was studied.Results: A total of 30 patients were included in the study of which 23 were males and 7 were females. It was found that 28 patients had severe OSA and 2 had moderate OSA. AHI significantly improved (P = 0.000) with automatic CPAP titration. The mean CPAP predicted pressure (8.77±2.05) was found lower than the therapeutic optimal pressure (13.03±3.18) prescribed and the value exceeded the range ±2 in 76% of patients.Conclusions: Use of automatic CPAP limits the role for predicted formula for in lab titration/unattended home setting and patients who don’t undergo CPAP titration study, reducing the cost of testing. However, the predicted pressure could be used as a starting pressure for initiation of CPAP titration in lab setting for manual titration.
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