This study evaluated the treatment outcomes of the first cohort of 168 multi-drug resistant tuberculosis (MDR-TB) patients treated in Egypt. Of these, 65 patients completed treatment. Factors associated with treatment success included younger age, nonsmoking status, no history of previous second-line drug use, less lung tissue destruction on x-rays, and sputum culture conversion within 3 months of starting treatment. The treatment success rate was 68% with failure, default and mortality rates of 9%, 6% and 17% respectively. Recommendations include decreasing unnecessary second-line drug use and ensuring direct observation of treatment for all MDR-TB patients.
journal club and critical appraisal checklist
intensive recruitment versus moderate recruitment strategy in postop cardiac surgery patients to avaoid postop pulmonary complications
Journal Club presentation in Nursing ResearchDhara Vyas
Journal presentation in Nursing Research,
Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic
Covid-19
Abstract
Introduction
Methodology
samples
Analysis
PEPTIC (Holden Young - Roseman University College of Pharmacy)HoldenYoung3
PEPTIC (Holden Young - Roseman University College of Pharmacy)
Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2 receptor blockers on in-hospital
mortality among ICU patients receiving invasive mechanical ventilation (PEPTIC).
JAMA . 2020; 323(7):616-626
PEPTIC (Holden Young - Roseman University College of Pharmacy)HoldenYoung3
PEPTIC (Holden Young - Roseman University College of Pharmacy)
Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2 receptor blockers on in-hospital
mortality among ICU patients receiving invasive mechanical ventilation (PEPTIC).
JAMA . 2020; 323(7):616-626
journal club and critical appraisal checklist
intensive recruitment versus moderate recruitment strategy in postop cardiac surgery patients to avaoid postop pulmonary complications
Journal Club presentation in Nursing ResearchDhara Vyas
Journal presentation in Nursing Research,
Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic
Covid-19
Abstract
Introduction
Methodology
samples
Analysis
PEPTIC (Holden Young - Roseman University College of Pharmacy)HoldenYoung3
PEPTIC (Holden Young - Roseman University College of Pharmacy)
Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2 receptor blockers on in-hospital
mortality among ICU patients receiving invasive mechanical ventilation (PEPTIC).
JAMA . 2020; 323(7):616-626
PEPTIC (Holden Young - Roseman University College of Pharmacy)HoldenYoung3
PEPTIC (Holden Young - Roseman University College of Pharmacy)
Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2 receptor blockers on in-hospital
mortality among ICU patients receiving invasive mechanical ventilation (PEPTIC).
JAMA . 2020; 323(7):616-626
Hello members...this powerpoint deals with A journal presentation, that aims at highlighting the "Efficacy & safety of Lacosamide in painful diabetic neuropathy patients".
This also elucidates a model of "Journal club presentation" for interested students.
Happy reading!!
:)
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
Hello members...this powerpoint deals with A journal presentation, that aims at highlighting the "Efficacy & safety of Lacosamide in painful diabetic neuropathy patients".
This also elucidates a model of "Journal club presentation" for interested students.
Happy reading!!
:)
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
While the world was focused on covid 19, WHO has made and issued consolidated guidelines making changes in how to prevent, diagnose and treat tuberculosis.
Homeopathic treatment of elderly patients - a prospective observational study...home
The severity of disease showed marked and sustained improvements under homeopathic treatment,
but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical
therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on
comparative effectiveness are needed to evaluate this hypothesis.
This phase IV clinical trial (ClinicalTrials.gov NCT01525550) was
conducted as post-approval commitments to the FDA and other
regulatory agencies to confirm the efficacy and safety of sunitinib in advanced and/or metastatic, well-differentiated, unresectable pNETs.
monarchE trial studied the benefit of adding abimaciclib to endocrine therapy (the standard of care for HR+/Her- early breast cancer) compared to endocrine therapy alone.
Similar to Management of drug resistant tb patients (20)
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Study Objective
• To evaluate the so far effect of
treatment on the first treatment
cohort of MDR-TB patients and
analysing some factors that might
affect the interim outcome.
3. Materials & Methods
• The pilot program had the initial approval of the
GLC/WHO to treat 75 patients in the first DR-TB centre in
Abbassia chest hospital for inpatient care of patients with
MDR-TB.
• One floor of 12 rooms was chosen and modified to apply
the necessary infection control procedures.
• Mission from the GLC in early 2003 before approval of the
program was issued.
• This centre was assigned for the inpatients treatment while
ambulatory treatment was conducted in TB units after the
working staff in these units received 3 days training on
management of those patients before they are discharged for
ambulatory treatment.
4. Materials & Methods
• The national reference laboratory was chosen to do the
initial culture and drug susceptibility testing (DST) to
determine the resistance pattern of the patient before
starting treatment.
• The first cohort of patients to be enrolled in the pilot
project consisted of chronic patients found in the TBMUs
and DSTs were done to all of them to confirm infection
with MDR-TB.
• The frequency of patient enrolment was determined by
the hospital capacity and availability of the drugs.
Patients were eligible for treatment if they were proved to
be MDR-TB with no absolute exclusion criteria.
5. Materials & Methods
• Patient with concomitant diseases or with poor general condition were
considered high risk group for close supervision and frequent evaluation.
• A formal written consent was taken from every patient before starting
treatment.
• The proved MDR-TB patients were put on a treatment regimen based on
the resistance profile of patients to first line anti-TB treatment and would
be modified according to treatment history of the patient.
• If the patient gave any history of previous use of the second line anti-TB
drugs, which are not available in the market in Egypt, except for Amikacin
and Flouroquinolones, the regimen would have been adjusted accordingly.
• DST for second line drugs was made for patients who gave history of
previous use of the previously mentioned second line anti-TB drugs or
showed potential failure to prepare the retreatment regimen. Accordingly,
the regimen used can be considered, more or less an individualized one.
6. Treatment regimens
• MDR-TB patients were started on a regimen consisting Kanamycin,
Ofloxacin, Ethionamide, p-aminosalicylic acid (PAS), Cycloserine.
• Patient received the injectable drug for nine months, the first three
months on daily basis, and then every other day. The treatment
duration was 21 months for patients who were enrolled and
completed treatment before the emergency update of the
programmatic management of DR-TB guidelines were issued with
recommendation of at least 18 months treatment after sputum
culture conversion.
• The duration of hospitalization was about 9 months, during the use
of an injectable drug and the clinical condition of the patient and
tolerability of the drugs. Patients were tested for HIV at the start of
treatment.
7. Treatment regimens
• Sputum smear and culture were conducted monthly, and, when
culture positive
• Chest radiographs were performed at enrolment, and every 6 months
thereafter
• Adverse events were managed rapidly and aggressively with the
ancillary drugs and with the help of specialists like a psychiatrist,
without permanent removal of a drug from the treatment regimen for
any patient of the study cohort.
• All treatment doses of drugs were directly observed during the
hospitalization period, and three times a week after discharge during
the ambulatory treatment period.
• Resection surgery was undertaken for one of the patients who
declared failed and he is now on retreatment as after failure of
second-line anti-TB treatment and not included in this analysis after
surgery
8. Laboratory testing
• Sputum smear microscopy, culture and were
conducted according to international standards in
Abbassia chest hospital laboratory but DST was
conducted only in the national reference laboratory.
Smears were assessed using direct microscopy and
culture using Lowenstein-Jensen media.
• DST was conducted for 4 first-line drugs (isoniazid,
rifampicin, ethambutol, streptomycin) and second-
line drugs (Capreomycin, Kanamyin, Ofloxacin)
9. Data collection and analysis
• A computerized medical record system, Excel based,
was instituted from the start of the pilot program.
• This system was designed to record significantly
more information than that routinely collected in the
DOT program, where patient data from the entire
treatment course were recorded on a single, two-sided
treatment card.
• Analyses were performed using SPSS (SPSS version
16.0)
10. Results
- Description of the studied group: -
• Among the multi-drug resistant (MDR) patients (n=168) admitted to
Abbassia Chest Hospital till 30/6/2009 only 65 patients completed
their treatment course.
• Their age ranges from 17 to 76 years with the mean = 37.8 ± 12.4
years. Male to female ratio is 46 (70.8 %) to 19 (29.2 %). No
statistically significant difference between males and females as
regards their mean age (t-test = 1.2, p > 0.05)
• All of the patients were pulmonary tuberculosis except for 1 extra-
pulmonary (cervical Pott's); 3 (4.6 %) were new cases and 62 (95.4
%) retreated cases.
11. Results
• The number of treatment courses taken before starting second-line
treatment ranged from 1 to more than 7 with the median = 3 and mode = 2
courses.
• As regards the resistance pattern: - 51 (78.5 %) patients were resistant to
the four first-line drugs hence, they received the treatment regimen I (36
males and 15 females). 13 (20.0 %) patients were resistant to three of them
and on treatment regimen II (9 males and 4 female). There is one (1.5 %)
male patient resistant to 2 drugs (RH) and on regimen III. Resistance
pattern was not significantly different between males and females (Chi-
Square = 0.4, p>0.05).
• 12 (18.5 %) patients (10 males and 2 female) gave positive history of
receiving the second line anti-tuberculosis drugs (Ofloxacin and Amikacin
in addition to one Sudanese male patient received all second line drugs)
and 53 (81.5 %) patients (36 male and 17 females) denied their use. The
sex difference was not statistically significant (Fisher’s Exact test, p>0.05).
12. Results
• The duration of TB illness before starting treatment with the
second line anti-tuberculosis drugs, it was found that the mean
duration = 7.3 ± 6.1 and the median = 6 years
• Co-morbidity: - 12 (18.5 %) patients were found to be diabetic
(6 males and 6 female) and only 2 (3.1 %) male patient was
HCV positive. No statistically significant sex differences were
observed for both variables (Fisher’s Exact test, p > 0.05).
• There were no HIV positive cases.
17. • Some factors that might affect treatment outcome were
studied. Of them the following showed significant association
with successful treatment:
- young age of patients,
- non smoking,
- no past history of intake of the second-line anti-tuberculosis
drugs,
- the extension of lung tissue destruction on x-ray findings and
- the sputum culture conversion within 3 months of treatment.
more than half of the total patients and about 83% of those
achieved successful outcome were converted culture negative
within the first 3 months of treatment. These factors could be
taken as parameters to predict a successful outcome
18. • Alcoholism and smoking are among the factors that
might contribute to the development of drug
resistance and hence, the unsuccessful outcome. The
difference in the rate of treatment success was
significant with smoking but did not reach the
statistical significance among the alcohol or drug
users most probably because of the small number of
this group of patients.
• The clearly observed high mortality rate (about 17%)
could be due to that 52.3 % of the cases (34 patients
out of the 65) showed extensive unilateral or bilateral
lung tissue destruction, and of those who died this
proportion was 90.9% ,10 out of 11 patients.
19. Conclusion
• About 68 % treatment success is achieved with the
first group of MDR-TB cases admitted to Abbassia
chest hospital.
• The proportion of failures, defaulters and deaths were
9, 6, and 17% respectively. These rate that are
comparable with the average treatment success rate
reached within the GLC projects and with other
reported literatures.
20. • The high mortality rate (about 17%) highlighted the
importance of continuing the ongoing efforts for the
rapid diagnosis and treatment of MDR patients and
the urgency of applying the direct observation
throughout the whole treatment period.
• The significant risk factors for successful outcome
included young age of patients, non smoking, and the
factors related to treatment which are the most
important factors. These are negative history of intake
of 2nd line anti-tuberculosis drugs, no cavity in x-ray
findings and sputum culture conversion before 3
months of treatment.
21. Recommendations
• Decrease the inefficient and unnecessary use of the
second-line anti-TB drugs
(aminoglycosides&floroquinolones).
• Encouragement of the application of direct observation
for MDR TB patients throughout their treatment
period.
• Application of rapid diagnostic techniques for prompt
enrollment of patients in the correct treatment regimen.
• Strong patient support and follow up system is
mandatory to achieve better results especially with
MDR TB patients
22. Limitations
• The effect of surgical intervention on the
treatment outcome of MDR TB patients was
not investigated as this treatment modality was
not performed widely enough with our patients
to evaluate its role.
• More data from high risk patients is needed for
better evaluation of treatment especially those
with diabetes, HCV and HIV infections.
Editor's Notes
After three months, about 78.5 % of the patients were converted smear negative. The rest of the 65 patients were as follows: two failed to convert (3.1%), two died before conversion (3.1%), one defaulted, one was extra-pulmonary and one was pulmonary smear negative.
* These cases include 5 patients died before culture conversion and 6 cases failed treatment.