This study analyzed survival patterns of 716 tuberculosis patients in India who received treatment under the Directly Observed Treatment-Short course (DOTS) program. The study found:
1) Survival rates by the end of the intensive treatment phase were 96%, 93% and 99% for categories I, II and III respectively.
2) Cumulative survival rates by the end of treatment were 93%, 88% and 96% for the three categories.
3) There were significant differences in survival curves between the three treatment categories and different age groups.
4) Age above 40 years was identified as a significant risk factor for death among tuberculosis patients.
— Wound infection is the second commonest complication of wound healing. This study was carried out on 250 post-operative cases operated at a district hospital of western Rajasthan, India with the aim the aim to find out prevalence of post-operative surgical site infection and its causing organism. After taking personal information and detailed clinical, operative and post-operative history of these cases, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Association was inferred with Chi-square test. Post operative surgical site infection rate was found 11.6 % which was found significantly more in intestinal surgeries than the other. Most common causative organism for infection was Staphylococci cases followed by Streptococci, E. Coli and Klebsella. Out of total 11.6% infected cases, majority (8.8%) of patients had infection with more than one organism only 2.8% were having single organism. Keywords— Post-operative surgical Site Infection (SSI), Microorganism , SSI Infection Rate.
This study examined 325 patients with psoriasis at a teaching hospital in Nepal over 5 years. It found a prevalence of psoriasis was 3.6% among patients. The most common type was chronic plaque psoriasis (86.2%) and guttate psoriasis affected 21.8% of patients. The majority of patients were Aryan (90%) and most common ages of onset were the second (31.5%) and third (28.2%) decades of life. Precipitating factors like cold (36.1%) and sun (9.9%) were identified in about half of patients.
Epidemiology of wound_infection_in_a_surgical_ward_of_a_tertiary_care_hospita...Jacob Amofa
This study examined the prevalence and risk factors of wound infections at a tertiary hospital in Northern Ghana. The researchers reviewed medical records from 1096 patients admitted to the surgical ward in 2012. They found that 32.3% of patients had wound infections, with 60.2% acquired in the community and 39.8% acquired in the hospital. Males had a higher prevalence of infections than females. Significant risk factors for wound infection included female gender, living in a rural area, and having diabetes. The study concluded that wound infections were relatively common, with nearly 40% contracted in the hospital setting, and identified several demographic and clinical factors that influenced the risk of infection.
This study assessed the epidemiological patterns and outcomes of self-inflicted burn injuries at a burn care facility in Pakistan over a two-year period. The study found that the majority of patients were young, married, illiterate housewives from rural areas. Marital conflicts were the most common reported motive. Overall mortality was high at 84.95%, with many deaths occurring within the first week. The findings suggest self-immolation is commonly carried out by vulnerable groups in Pakistan to escape intolerable domestic conditions or as a "cry for help".
This study explored the time required for nursing care activities of patients on adult mechanical ventilation admitted to the ICU of BPKIHS hospital in Nepal. Nurses recorded the time spent on 60 patients over 3 months. On average, nurses spent 1002 minutes (16.7 hours) per patient per day, with 329 minutes in morning shifts, 317 minutes in evenings, and 356 minutes at night. The most time-consuming activities were administrative tasks, monitoring vital signs, personal hygiene, and specific nursing procedures. The study found that nursing care of patients on ventilators requires significant time.
1) The study retrospectively reviewed 57 cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) treated at a hospital in Indonesia from 2009-2013.
2) All cases were treated with systemic corticosteroids alone, with dosages varying based on the severity of SJS or TEN.
3) Outcomes were generally positive, with 87.7% of patients improving, though the mortality rate was higher for TEN (36.4%) than SJS (7.7%). The most common causes were drug reactions like paracetamol.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Association of Treatment Outcome of Tuberculosis with type of Category of Tuberculosis-Tuberculosis is the third major cause of adult mortality i.e. 15-59 years of age group on which the nation’s economy depended on. In treatment of tuberculosis, failure of treatment and defaulters of treatment are the main hurdles. So this study was carried out with the aim to find out association of treatment outcome with category of case and diagnosed in various four quarters of year. For the study purpose 160 case sheets of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken, by identify 40 cases randomly from each of four quarter. Chi-square test was used to find out association. It was found in this study that maximum cases were of category II followed by I and II. Cure rate was found 44.38% with maximum in category III (60.42%). Defaulter rate was found 32.5% with maximum in category II (35.48%). Failure rate was found 9.38% with maximum in category I(14%). And Case Fatality Rate was found 32.5% with maximum in category II(20.97%).This variation in treatment outcome was found significantly associated for Cure rate and CFR not for Defaulter and Failure rate.
— Wound infection is the second commonest complication of wound healing. This study was carried out on 250 post-operative cases operated at a district hospital of western Rajasthan, India with the aim the aim to find out prevalence of post-operative surgical site infection and its causing organism. After taking personal information and detailed clinical, operative and post-operative history of these cases, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Association was inferred with Chi-square test. Post operative surgical site infection rate was found 11.6 % which was found significantly more in intestinal surgeries than the other. Most common causative organism for infection was Staphylococci cases followed by Streptococci, E. Coli and Klebsella. Out of total 11.6% infected cases, majority (8.8%) of patients had infection with more than one organism only 2.8% were having single organism. Keywords— Post-operative surgical Site Infection (SSI), Microorganism , SSI Infection Rate.
This study examined 325 patients with psoriasis at a teaching hospital in Nepal over 5 years. It found a prevalence of psoriasis was 3.6% among patients. The most common type was chronic plaque psoriasis (86.2%) and guttate psoriasis affected 21.8% of patients. The majority of patients were Aryan (90%) and most common ages of onset were the second (31.5%) and third (28.2%) decades of life. Precipitating factors like cold (36.1%) and sun (9.9%) were identified in about half of patients.
Epidemiology of wound_infection_in_a_surgical_ward_of_a_tertiary_care_hospita...Jacob Amofa
This study examined the prevalence and risk factors of wound infections at a tertiary hospital in Northern Ghana. The researchers reviewed medical records from 1096 patients admitted to the surgical ward in 2012. They found that 32.3% of patients had wound infections, with 60.2% acquired in the community and 39.8% acquired in the hospital. Males had a higher prevalence of infections than females. Significant risk factors for wound infection included female gender, living in a rural area, and having diabetes. The study concluded that wound infections were relatively common, with nearly 40% contracted in the hospital setting, and identified several demographic and clinical factors that influenced the risk of infection.
This study assessed the epidemiological patterns and outcomes of self-inflicted burn injuries at a burn care facility in Pakistan over a two-year period. The study found that the majority of patients were young, married, illiterate housewives from rural areas. Marital conflicts were the most common reported motive. Overall mortality was high at 84.95%, with many deaths occurring within the first week. The findings suggest self-immolation is commonly carried out by vulnerable groups in Pakistan to escape intolerable domestic conditions or as a "cry for help".
This study explored the time required for nursing care activities of patients on adult mechanical ventilation admitted to the ICU of BPKIHS hospital in Nepal. Nurses recorded the time spent on 60 patients over 3 months. On average, nurses spent 1002 minutes (16.7 hours) per patient per day, with 329 minutes in morning shifts, 317 minutes in evenings, and 356 minutes at night. The most time-consuming activities were administrative tasks, monitoring vital signs, personal hygiene, and specific nursing procedures. The study found that nursing care of patients on ventilators requires significant time.
1) The study retrospectively reviewed 57 cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) treated at a hospital in Indonesia from 2009-2013.
2) All cases were treated with systemic corticosteroids alone, with dosages varying based on the severity of SJS or TEN.
3) Outcomes were generally positive, with 87.7% of patients improving, though the mortality rate was higher for TEN (36.4%) than SJS (7.7%). The most common causes were drug reactions like paracetamol.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Association of Treatment Outcome of Tuberculosis with type of Category of Tuberculosis-Tuberculosis is the third major cause of adult mortality i.e. 15-59 years of age group on which the nation’s economy depended on. In treatment of tuberculosis, failure of treatment and defaulters of treatment are the main hurdles. So this study was carried out with the aim to find out association of treatment outcome with category of case and diagnosed in various four quarters of year. For the study purpose 160 case sheets of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken, by identify 40 cases randomly from each of four quarter. Chi-square test was used to find out association. It was found in this study that maximum cases were of category II followed by I and II. Cure rate was found 44.38% with maximum in category III (60.42%). Defaulter rate was found 32.5% with maximum in category II (35.48%). Failure rate was found 9.38% with maximum in category I(14%). And Case Fatality Rate was found 32.5% with maximum in category II(20.97%).This variation in treatment outcome was found significantly associated for Cure rate and CFR not for Defaulter and Failure rate.
Caratteristiche cliniche e patologiche del carcinoma differenziato della tiro...MerqurioEditore_redazione
This study analyzed clinical and pathological features of 4,187 patients with differentiated thyroid carcinoma (DTC) who were treated at a single Italian institution between 1969-2004. The patients were divided into two groups based on diagnosis before or after 1990. Results showed patients diagnosed after 1990 had smaller tumors, less advanced stage, better prognosis, and an increased proportion of micropapillary carcinoma. Despite differences, advanced stage and older age remained the most important poor prognostic factors for survival in both groups.
This randomized European study evaluated the effect of prostate-specific antigen (PSA) screening on death from prostate cancer. Over 182,000 men aged 50-74 were randomly assigned to screening via PSA tests every 4 years or a control group without screening. After a median follow-up of 9 years, the rate of death from prostate cancer was 20% lower in the screened group compared to the control group. However, screening led to a high risk of overdiagnosis, with many more cases of prostate cancer diagnosed through screening but a small effect on mortality. 1410 men needed to be screened and 48 extra prostate cancer cases needed to be treated to prevent one death from prostate cancer.
A case-control study of injuries arising from the earthquake in Armenia, 1988
H.K. Armenian, E.K. Noji, & A.P. Oganesian.
Bulletin of the World Health Organization, 70(2): 251-257 (1992)
The study attempts to identify predictors of injuries among persons who were hospitalized following the Armenian earthquake of 7 December 1988. A total of 189 such individuals were identified through neighbourhood polyclinics in the city of Leninakan and 159 noninjured controls were selected from the same neighbourhoods. A standardized interview questionnaire was used. Cases and controls shared many social and demographic characteristics; however, 98% of persons who were hospitalized with injuries were inside a building at the time of the earthquake, compared with 83% of the controls (odds ratio = 12.20, 95% confidence interval (Cl) = 3.62-63.79). The odds ratio of injuries for individuals who were in a building that had five or more floors, compared with those in lower buildings, was 3.65 (95% Cl = 2.12-6.33). Leaving buildings after the first shock of the earthquake was a protective behaviour. The odds ratio for those staying indoors compared with those who ran out was 4.40 (95% Cl = 2.24-8.71).
Simbarashe Takuva, AIDS 2010. Durability of first line antiretroviral therapy...Simba Takuva
This study analyzed reasons for modifications to first-line antiretroviral therapy (ART) regimens in a cohort of patients in Swaziland. The most common reasons for modification were gastrointestinal toxicities, peripheral neuropathy, and lipodystrophy related to d4T use. Patients initiating ART with lower CD4 counts or higher weight had poorer regimen durability. The findings emphasize the need to avoid toxic ART drugs, start treatment earlier, and identify patients who may require TB treatment or become pregnant.
Tuberculosis affected mankind for over 5000 yrs and continue to be a major public health problem. So to generate hypothesis about tuberculosis this study was conducted to study the profile of tuberculosis cases attending at DTC Jaipur. A record based cross-sectional study of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken. Chi-square test was used to find out association. It was found in this study that Cure Rate significantly varied with type of case, age and sex of case. It was observed highest in cat.III and below 20 yrs of age. Defaulters were max. in Relapse retreated cases and in elderly (>60 yrs.) cases whereas it was not affected significantly with age . Failure Rate was highest in category I cases and significantly varied with age and sex. About 3/4th of total deaths were observed in Failure and Relapse retreated cases. Case Fatality Rate (CFR) showed not significant variation with sex. So it can be concluded with this study that maximally affected age group with tuberculosis is either children or 40-60 years with male predominance. Category III cases are more easier to cured and Category II cases are most difficult to cured. Cure rate was lesser in 40-60 years of age group and males. Defaulters and CFR were more in category II, 40-60 year of age group and males. And Failure Rate was more in category I, 40-60 year of age group and males
This study evaluated the performance of three pneumonia severity scores - CURB-65, CRB-65, and CURB-age - in predicting 30-day mortality in 559 adult inpatients with community-acquired pneumonia. The study found that CURB-age stratified patients into risk groups that were most closely associated with mortality outcomes. Specifically, CURB-age identified more low-risk patients who had lower mortality than CRB-65, and sorted more patients who died within 30 days into the high-risk group compared to the other scores. Analysis of receiver operating characteristics further indicated CURB-age had better ability to predict 30-day mortality compared to the other scores. The study concludes CURB-age may provide
Neoadjuvant rh-endostatin, docetaxel and epirubicin for breast cancer: effica...Enrique Moreno Gonzalez
This document summarizes a prospective, randomized, phase II clinical trial that evaluated the efficacy and safety of neoadjuvant chemotherapy with or without rh-endostatin for breast cancer. 68 patients received either 3 cycles of docetaxel and epirubicin (DE) chemotherapy alone or DE chemotherapy combined with rh-endostatin. The combination therapy showed a higher objective response rate of 91% compared to 68% for chemotherapy alone, with more complete responses but no increase in adverse effects. The combination appeared to work better in premenopausal patients and those with better performance status.
— The microbiological content of Lettuce (a vegetable), commonly vended in the Benin metropolis of Edo state were evaluated. Five vending locations were chosen for the study. Whole and soft rot samples were purchased and analysed for microbiological composition. Results showed high counts in soft rot samples in lettuce. Nutrient agar plated lettuce samples had bacterial counts in the range of 2.0x 103 to 4.7x10 7. Pseudomonas species was the dominant species found in lettuce samples. Bacillus species was isolated from one location in the lettuce samples. Mac Conkey agar plated lettuce plated had bacterial counts in the range of 2.3 x 10 3 to 5.7x 10 7. Enterobacter species, E. coli, and Klebsiella species were the dominant species isolated. Though, Proteus species was isolated from lettuce samples obtained from location five only. The study observes that consuming soft rot samples could pose a risk of introducing pathogens to the consumer due to their high microbial counts and could be detrimental to the health of the consumer.
This journal club discussion summarizes a randomized controlled trial that compared the glucose-lowering drug rosiglitazone to metformin and glyburide in patients with recently diagnosed type 2 diabetes. The study was well-designed, experimental in nature, and included over 4,000 patients followed for a median of 4 years. The primary outcome was time to monotherapy failure based on fasting glucose levels. The results showed that rosiglitazone delayed monotherapy failure better than the other drugs and had a lower incidence of progression to higher fasting glucose levels. However, the study also reported some safety concerns with rosiglitazone like increased risk of heart failure. Overall, the discussant found the study to be valid and that the
clinical distribution and molecular profiling on postoperative colorectal can...LucyPi1
Abstract
Background: Traditional Chinese medicine (TCM) syndrome, also named syndrome, are comprehensive and
integral analyses of clinical information which helps to guide different individualized treatment prescriptions.
Methods: Thirty healthy controls and 80 colorectal cancer (CRC) patients (including 33 Spleen Qi Deficiency
syndrome, 23 Dampness Heat syndrome, 17 Blood Stasis syndrome and 7 other syndrome) were enrolled into this
study. Human mRNAs were extracted from peripheral blood mononuclear cells. The gene expression for CRC
patients with different TCM syndrome was determined by microarray and qRT-PCR. Results: Spleen Qi Deficiency,
Dampness Heat and Blood Stasis were the most common syndromes in CRC patients. There is a significant
difference was found in mRNA expression levels (especially for PIK3CA, STAT3, SOX9 and KDM5C) among
Spleen Qi Deficiency, Dampness Heat and Blood Stasis syndrome groups. The higher mRNA levels of JNK1, TP53,
MLH1, MSH6, PMS2, SOCS3, TCF7L2, FAM123B, PSAP, FBXW7, SALL4 and the lower expression of
inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types. The higher
mRNA levels of KRAS, MUC16, EGFR, GRASP65, PIK3CA, MAPK7, CD24, STAT3, SLC11A1, Bcl-2, TXNDC17
and some inflammatory cytokines (IL-6, IL-23, TNF-a, CXCR4) were found in Dampness Heat group but not other
syndrome types. Blood Stasis syndrome showed higher expression of SOX9, MLH1, MSH6, KDM5C, PCDH11X,
PSAP and SALL4, and lower mRNA levels of PIK3CA, CD24, STAT3, CXCR4, TXNDC17 and TP53. The CRC
patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types. Conclusion: The
identification of syndrome conditions had different impacts on CRC prognosis, and which might be related with
different mRNA expression levels. Some oncogenes and pro-inflammatory cytokines were highly expressed in
Dampness Heat group but not other syndrome types, suggesting that the CRC patients with Dampness Heat
syndrome might have a poor prognosis. Our results prelimitarily uncovered the molecular basis of syndrome
differences in CRC prognosis, a better understanding for TCM treatment of CRC.
Mate Choice Optimizes Offspring MHC Genetics and Drives Sexual Reproductionscience journals
Sexual reproduction can be maintained only in an ever-changing world of diseases generating a never-ending coevolutionary arms race between infectious diseases and their hosts.
Pentoxifylline Associated with Other Antioxidants (Multimodal Therapy) on Pat...science journals
We carried out a controlled study on 240 patients diagnosed with Peyronie's Disease (PD). We have divided two treatment groups, which differ from each other only for the association with PTX-penile injection.
This meta-analysis combines data from 5 randomized controlled trials investigating adjuvant chemotherapy and chemoradiation for pancreatic cancer. It includes individual patient data from 875 patients across 4 trials, as well as previously unpublished updated follow-up data from 261 additional patients in the ESPAC1 trial. The analysis found that chemotherapy significantly reduced the risk of death, with median survival of 19 months with chemotherapy versus 13.5 months without. However, chemoradiation did not significantly reduce the risk of death compared to no adjuvant treatment, with median survivals of 15.8 months and 15.2 months respectively. Subgroup analyses suggested chemoradiation may be more effective for patients with positive resection margins, while chemotherapy was less effective for this
Opioid Usage Trends in Rheumatoid Arthritis_20151005_SJAJ.A. Zamora-Legoff
- Patients with rheumatoid arthritis (RA) had significantly higher rates of both any opiate use and chronic opiate use compared to non-RA patients over the study period of 2004-2014. 40% of RA patients used opiates in 2014 compared to 24% of non-RA patients.
- Chronic opiate use was substantially higher in RA patients, with 12% using chronic opiates in 2014 compared to 4% of non-RA patients. Younger RA patients aged 18-49 had the highest rates of chronic opiate use.
- RA disease characteristics did not correlate with chronic opiate use, but glucocorticoid use was associated with higher risk of chronic opiate use in RA patients.
Tashia Seeba - Antibiotics and maxillofacial fractures Tashia Seeba
This study evaluated the necessity of routine antibiotic administration to prevent surgical wound infections in patients undergoing treatment for maxillofacial fractures. The study retrospectively analyzed 67 patients with 114 fractures who were divided into 3 groups: no antibiotics, penicillin antibiotics, or cefotaxime antibiotics. The overall surgical wound infection rate was 16.66%. Statistical analysis found no significant difference in infection rates between the groups, suggesting that prophylactic antibiotics may not alter the risk of surgical wound infections in patients with maxillofacial fractures. Delay in treatment and use of catgut sutures were found to have a positive correlation with higher infection rates.
The effect of long-term traditional Chinese medicine treatment on disease-fre...LucyPi1
Abstract Objective: Traditional Chinese medicine (TCM) has been extensively used as one of popular alternative therapies for several cancers. However, it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients. In this study, we explored the effect of long-term TCM treatment on patients with different stages of lung cancer. Methods: All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study. Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group (control group). All patients were regularly followed up by clinic appointment or phone, and all survival data were collected from databases after the last follow-up in October 2017. Results: A total of 575 patients were included in this study, with 299 patients in the TCM group and 276 in the control group. For all patients, 5-year disease-free survival (DFS) was 62.2% in TCM group and 42.1% in the control group, and 6-year DFSs were 51.8% and 35.4%, respectively (HR = 0.51, 95% CI: 0.40 to 0.66, log-rank P ≤ 0.001). For patients with stage I, 5-year DFSs were 83.7% (TCM group) and 57.5% (control group) and 6-year DFSs were 73.7% and 51.9%, respectively (HR = 0.30, 95% CI: 0.18 to 0.50, log-rank P ≤ 0.001). For patients with stage II in the TCM group and the control group, 5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%, respectively (HR = 0.31, 95% CI: 0.19 to 0.52, log-rank P ≤ 0.001), and for patients with stage III, 5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group (HR = 1.06, 95% CI: 0.72 to 1.56, log-rank P = 0.76). Conclusions: This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients, especially in patients with stage I and II disease. However, these observational findings need being validated by large sample randomized controlled trials.
Assessing the effects of prognostic factors in recovery of tuberculosis patie...Alexander Decker
- The study assessed prognostic factors affecting recovery of tuberculosis patients in Ghana's Upper West Region. 400 patients were analyzed.
- Key factors found to significantly contribute to recovery were age, type of patient (pulmonary vs extra-pulmonary), duration of treatment, and HIV status.
- The median recovery time was 25.43 weeks. Older age was found to decrease the risk of relapse. Patients co-infected with HIV had a higher risk of treatment failure.
The two prognostic mortality indices, the PACE Prognostic Index (PPI) and the Walter Index, did not accurately discriminate between individuals at low and high risk of near-term mortality when applied to a PACE site population. The PPI, which was developed in a similar PACE population, showed no discrimination between risk groups at 1, 3, or 5 years. The Walter Index showed minimal discrimination at 3 years but none at 1 year. Recalibration of the PPI may be needed to improve its predictive ability for the current PACE population.
—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
This document summarizes a study on analyzing survival times of prostate cancer patients in Ilorin, Nigeria. The Kaplan-Meier method was used to estimate median survival times and the survival function for patients who underwent surgery (19 days) or chemotherapy (40 days). A log-rank test found no significant difference in survival between treatment groups. Cox regression estimated a hazards ratio of 0.84, indicating chemotherapy carried a lower risk of death than surgery. The study aimed to analyze and compare survival functions, hazards, and fit survival models to the data.
Analysis And Modeling Of Tuberculosis Transmission DynamicsSara Alvarez
This document presents a mathematical model for analyzing the transmission dynamics of tuberculosis (TB). The model divides the population into four compartments: susceptible individuals, infectious individuals, latently infected individuals, and recovered individuals. Ordinary differential equations are used to model the flow of individuals between compartments. The model's disease-free equilibrium and stability are analyzed. Sensitivity analysis determines that recruitment rate and contact rate are the most sensitive parameters affecting the basic reproduction number. The findings show that as contact with infectious individuals increases, TB spread increases, and the latent infection rate must remain below a critical value for TB to persist in the population.
This study compared outcomes for head and neck cancer patients based on age. Younger patients (≤40 years old) had significantly better 5-year survival rates (65%) than middle-aged (41-64 years old, 52%) or older patients (≥65 years old, 38%). Younger patients also developed fewer recurrent tumors or new primary tumors. However, the reasons for the differences in outcomes based on age are unclear. The study aimed to analyze outcomes while controlling for other factors like smoking history, tumor stage, and treatment received to better understand the independent impact of age.
Caratteristiche cliniche e patologiche del carcinoma differenziato della tiro...MerqurioEditore_redazione
This study analyzed clinical and pathological features of 4,187 patients with differentiated thyroid carcinoma (DTC) who were treated at a single Italian institution between 1969-2004. The patients were divided into two groups based on diagnosis before or after 1990. Results showed patients diagnosed after 1990 had smaller tumors, less advanced stage, better prognosis, and an increased proportion of micropapillary carcinoma. Despite differences, advanced stage and older age remained the most important poor prognostic factors for survival in both groups.
This randomized European study evaluated the effect of prostate-specific antigen (PSA) screening on death from prostate cancer. Over 182,000 men aged 50-74 were randomly assigned to screening via PSA tests every 4 years or a control group without screening. After a median follow-up of 9 years, the rate of death from prostate cancer was 20% lower in the screened group compared to the control group. However, screening led to a high risk of overdiagnosis, with many more cases of prostate cancer diagnosed through screening but a small effect on mortality. 1410 men needed to be screened and 48 extra prostate cancer cases needed to be treated to prevent one death from prostate cancer.
A case-control study of injuries arising from the earthquake in Armenia, 1988
H.K. Armenian, E.K. Noji, & A.P. Oganesian.
Bulletin of the World Health Organization, 70(2): 251-257 (1992)
The study attempts to identify predictors of injuries among persons who were hospitalized following the Armenian earthquake of 7 December 1988. A total of 189 such individuals were identified through neighbourhood polyclinics in the city of Leninakan and 159 noninjured controls were selected from the same neighbourhoods. A standardized interview questionnaire was used. Cases and controls shared many social and demographic characteristics; however, 98% of persons who were hospitalized with injuries were inside a building at the time of the earthquake, compared with 83% of the controls (odds ratio = 12.20, 95% confidence interval (Cl) = 3.62-63.79). The odds ratio of injuries for individuals who were in a building that had five or more floors, compared with those in lower buildings, was 3.65 (95% Cl = 2.12-6.33). Leaving buildings after the first shock of the earthquake was a protective behaviour. The odds ratio for those staying indoors compared with those who ran out was 4.40 (95% Cl = 2.24-8.71).
Simbarashe Takuva, AIDS 2010. Durability of first line antiretroviral therapy...Simba Takuva
This study analyzed reasons for modifications to first-line antiretroviral therapy (ART) regimens in a cohort of patients in Swaziland. The most common reasons for modification were gastrointestinal toxicities, peripheral neuropathy, and lipodystrophy related to d4T use. Patients initiating ART with lower CD4 counts or higher weight had poorer regimen durability. The findings emphasize the need to avoid toxic ART drugs, start treatment earlier, and identify patients who may require TB treatment or become pregnant.
Tuberculosis affected mankind for over 5000 yrs and continue to be a major public health problem. So to generate hypothesis about tuberculosis this study was conducted to study the profile of tuberculosis cases attending at DTC Jaipur. A record based cross-sectional study of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken. Chi-square test was used to find out association. It was found in this study that Cure Rate significantly varied with type of case, age and sex of case. It was observed highest in cat.III and below 20 yrs of age. Defaulters were max. in Relapse retreated cases and in elderly (>60 yrs.) cases whereas it was not affected significantly with age . Failure Rate was highest in category I cases and significantly varied with age and sex. About 3/4th of total deaths were observed in Failure and Relapse retreated cases. Case Fatality Rate (CFR) showed not significant variation with sex. So it can be concluded with this study that maximally affected age group with tuberculosis is either children or 40-60 years with male predominance. Category III cases are more easier to cured and Category II cases are most difficult to cured. Cure rate was lesser in 40-60 years of age group and males. Defaulters and CFR were more in category II, 40-60 year of age group and males. And Failure Rate was more in category I, 40-60 year of age group and males
This study evaluated the performance of three pneumonia severity scores - CURB-65, CRB-65, and CURB-age - in predicting 30-day mortality in 559 adult inpatients with community-acquired pneumonia. The study found that CURB-age stratified patients into risk groups that were most closely associated with mortality outcomes. Specifically, CURB-age identified more low-risk patients who had lower mortality than CRB-65, and sorted more patients who died within 30 days into the high-risk group compared to the other scores. Analysis of receiver operating characteristics further indicated CURB-age had better ability to predict 30-day mortality compared to the other scores. The study concludes CURB-age may provide
Neoadjuvant rh-endostatin, docetaxel and epirubicin for breast cancer: effica...Enrique Moreno Gonzalez
This document summarizes a prospective, randomized, phase II clinical trial that evaluated the efficacy and safety of neoadjuvant chemotherapy with or without rh-endostatin for breast cancer. 68 patients received either 3 cycles of docetaxel and epirubicin (DE) chemotherapy alone or DE chemotherapy combined with rh-endostatin. The combination therapy showed a higher objective response rate of 91% compared to 68% for chemotherapy alone, with more complete responses but no increase in adverse effects. The combination appeared to work better in premenopausal patients and those with better performance status.
— The microbiological content of Lettuce (a vegetable), commonly vended in the Benin metropolis of Edo state were evaluated. Five vending locations were chosen for the study. Whole and soft rot samples were purchased and analysed for microbiological composition. Results showed high counts in soft rot samples in lettuce. Nutrient agar plated lettuce samples had bacterial counts in the range of 2.0x 103 to 4.7x10 7. Pseudomonas species was the dominant species found in lettuce samples. Bacillus species was isolated from one location in the lettuce samples. Mac Conkey agar plated lettuce plated had bacterial counts in the range of 2.3 x 10 3 to 5.7x 10 7. Enterobacter species, E. coli, and Klebsiella species were the dominant species isolated. Though, Proteus species was isolated from lettuce samples obtained from location five only. The study observes that consuming soft rot samples could pose a risk of introducing pathogens to the consumer due to their high microbial counts and could be detrimental to the health of the consumer.
This journal club discussion summarizes a randomized controlled trial that compared the glucose-lowering drug rosiglitazone to metformin and glyburide in patients with recently diagnosed type 2 diabetes. The study was well-designed, experimental in nature, and included over 4,000 patients followed for a median of 4 years. The primary outcome was time to monotherapy failure based on fasting glucose levels. The results showed that rosiglitazone delayed monotherapy failure better than the other drugs and had a lower incidence of progression to higher fasting glucose levels. However, the study also reported some safety concerns with rosiglitazone like increased risk of heart failure. Overall, the discussant found the study to be valid and that the
clinical distribution and molecular profiling on postoperative colorectal can...LucyPi1
Abstract
Background: Traditional Chinese medicine (TCM) syndrome, also named syndrome, are comprehensive and
integral analyses of clinical information which helps to guide different individualized treatment prescriptions.
Methods: Thirty healthy controls and 80 colorectal cancer (CRC) patients (including 33 Spleen Qi Deficiency
syndrome, 23 Dampness Heat syndrome, 17 Blood Stasis syndrome and 7 other syndrome) were enrolled into this
study. Human mRNAs were extracted from peripheral blood mononuclear cells. The gene expression for CRC
patients with different TCM syndrome was determined by microarray and qRT-PCR. Results: Spleen Qi Deficiency,
Dampness Heat and Blood Stasis were the most common syndromes in CRC patients. There is a significant
difference was found in mRNA expression levels (especially for PIK3CA, STAT3, SOX9 and KDM5C) among
Spleen Qi Deficiency, Dampness Heat and Blood Stasis syndrome groups. The higher mRNA levels of JNK1, TP53,
MLH1, MSH6, PMS2, SOCS3, TCF7L2, FAM123B, PSAP, FBXW7, SALL4 and the lower expression of
inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types. The higher
mRNA levels of KRAS, MUC16, EGFR, GRASP65, PIK3CA, MAPK7, CD24, STAT3, SLC11A1, Bcl-2, TXNDC17
and some inflammatory cytokines (IL-6, IL-23, TNF-a, CXCR4) were found in Dampness Heat group but not other
syndrome types. Blood Stasis syndrome showed higher expression of SOX9, MLH1, MSH6, KDM5C, PCDH11X,
PSAP and SALL4, and lower mRNA levels of PIK3CA, CD24, STAT3, CXCR4, TXNDC17 and TP53. The CRC
patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types. Conclusion: The
identification of syndrome conditions had different impacts on CRC prognosis, and which might be related with
different mRNA expression levels. Some oncogenes and pro-inflammatory cytokines were highly expressed in
Dampness Heat group but not other syndrome types, suggesting that the CRC patients with Dampness Heat
syndrome might have a poor prognosis. Our results prelimitarily uncovered the molecular basis of syndrome
differences in CRC prognosis, a better understanding for TCM treatment of CRC.
Mate Choice Optimizes Offspring MHC Genetics and Drives Sexual Reproductionscience journals
Sexual reproduction can be maintained only in an ever-changing world of diseases generating a never-ending coevolutionary arms race between infectious diseases and their hosts.
Pentoxifylline Associated with Other Antioxidants (Multimodal Therapy) on Pat...science journals
We carried out a controlled study on 240 patients diagnosed with Peyronie's Disease (PD). We have divided two treatment groups, which differ from each other only for the association with PTX-penile injection.
This meta-analysis combines data from 5 randomized controlled trials investigating adjuvant chemotherapy and chemoradiation for pancreatic cancer. It includes individual patient data from 875 patients across 4 trials, as well as previously unpublished updated follow-up data from 261 additional patients in the ESPAC1 trial. The analysis found that chemotherapy significantly reduced the risk of death, with median survival of 19 months with chemotherapy versus 13.5 months without. However, chemoradiation did not significantly reduce the risk of death compared to no adjuvant treatment, with median survivals of 15.8 months and 15.2 months respectively. Subgroup analyses suggested chemoradiation may be more effective for patients with positive resection margins, while chemotherapy was less effective for this
Opioid Usage Trends in Rheumatoid Arthritis_20151005_SJAJ.A. Zamora-Legoff
- Patients with rheumatoid arthritis (RA) had significantly higher rates of both any opiate use and chronic opiate use compared to non-RA patients over the study period of 2004-2014. 40% of RA patients used opiates in 2014 compared to 24% of non-RA patients.
- Chronic opiate use was substantially higher in RA patients, with 12% using chronic opiates in 2014 compared to 4% of non-RA patients. Younger RA patients aged 18-49 had the highest rates of chronic opiate use.
- RA disease characteristics did not correlate with chronic opiate use, but glucocorticoid use was associated with higher risk of chronic opiate use in RA patients.
Tashia Seeba - Antibiotics and maxillofacial fractures Tashia Seeba
This study evaluated the necessity of routine antibiotic administration to prevent surgical wound infections in patients undergoing treatment for maxillofacial fractures. The study retrospectively analyzed 67 patients with 114 fractures who were divided into 3 groups: no antibiotics, penicillin antibiotics, or cefotaxime antibiotics. The overall surgical wound infection rate was 16.66%. Statistical analysis found no significant difference in infection rates between the groups, suggesting that prophylactic antibiotics may not alter the risk of surgical wound infections in patients with maxillofacial fractures. Delay in treatment and use of catgut sutures were found to have a positive correlation with higher infection rates.
The effect of long-term traditional Chinese medicine treatment on disease-fre...LucyPi1
Abstract Objective: Traditional Chinese medicine (TCM) has been extensively used as one of popular alternative therapies for several cancers. However, it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients. In this study, we explored the effect of long-term TCM treatment on patients with different stages of lung cancer. Methods: All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study. Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group (control group). All patients were regularly followed up by clinic appointment or phone, and all survival data were collected from databases after the last follow-up in October 2017. Results: A total of 575 patients were included in this study, with 299 patients in the TCM group and 276 in the control group. For all patients, 5-year disease-free survival (DFS) was 62.2% in TCM group and 42.1% in the control group, and 6-year DFSs were 51.8% and 35.4%, respectively (HR = 0.51, 95% CI: 0.40 to 0.66, log-rank P ≤ 0.001). For patients with stage I, 5-year DFSs were 83.7% (TCM group) and 57.5% (control group) and 6-year DFSs were 73.7% and 51.9%, respectively (HR = 0.30, 95% CI: 0.18 to 0.50, log-rank P ≤ 0.001). For patients with stage II in the TCM group and the control group, 5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%, respectively (HR = 0.31, 95% CI: 0.19 to 0.52, log-rank P ≤ 0.001), and for patients with stage III, 5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group (HR = 1.06, 95% CI: 0.72 to 1.56, log-rank P = 0.76). Conclusions: This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients, especially in patients with stage I and II disease. However, these observational findings need being validated by large sample randomized controlled trials.
Assessing the effects of prognostic factors in recovery of tuberculosis patie...Alexander Decker
- The study assessed prognostic factors affecting recovery of tuberculosis patients in Ghana's Upper West Region. 400 patients were analyzed.
- Key factors found to significantly contribute to recovery were age, type of patient (pulmonary vs extra-pulmonary), duration of treatment, and HIV status.
- The median recovery time was 25.43 weeks. Older age was found to decrease the risk of relapse. Patients co-infected with HIV had a higher risk of treatment failure.
The two prognostic mortality indices, the PACE Prognostic Index (PPI) and the Walter Index, did not accurately discriminate between individuals at low and high risk of near-term mortality when applied to a PACE site population. The PPI, which was developed in a similar PACE population, showed no discrimination between risk groups at 1, 3, or 5 years. The Walter Index showed minimal discrimination at 3 years but none at 1 year. Recalibration of the PPI may be needed to improve its predictive ability for the current PACE population.
—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
This document summarizes a study on analyzing survival times of prostate cancer patients in Ilorin, Nigeria. The Kaplan-Meier method was used to estimate median survival times and the survival function for patients who underwent surgery (19 days) or chemotherapy (40 days). A log-rank test found no significant difference in survival between treatment groups. Cox regression estimated a hazards ratio of 0.84, indicating chemotherapy carried a lower risk of death than surgery. The study aimed to analyze and compare survival functions, hazards, and fit survival models to the data.
Analysis And Modeling Of Tuberculosis Transmission DynamicsSara Alvarez
This document presents a mathematical model for analyzing the transmission dynamics of tuberculosis (TB). The model divides the population into four compartments: susceptible individuals, infectious individuals, latently infected individuals, and recovered individuals. Ordinary differential equations are used to model the flow of individuals between compartments. The model's disease-free equilibrium and stability are analyzed. Sensitivity analysis determines that recruitment rate and contact rate are the most sensitive parameters affecting the basic reproduction number. The findings show that as contact with infectious individuals increases, TB spread increases, and the latent infection rate must remain below a critical value for TB to persist in the population.
This study compared outcomes for head and neck cancer patients based on age. Younger patients (≤40 years old) had significantly better 5-year survival rates (65%) than middle-aged (41-64 years old, 52%) or older patients (≥65 years old, 38%). Younger patients also developed fewer recurrent tumors or new primary tumors. However, the reasons for the differences in outcomes based on age are unclear. The study aimed to analyze outcomes while controlling for other factors like smoking history, tumor stage, and treatment received to better understand the independent impact of age.
Life Style for Adult Patients with Hyperthyroidism at Baghdad Teaching Hospitaliosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Global HIV cohort studies among IDU and future vaccine trialsThira Woratanarat
The author reviewed data on the global HIV epidemic among injecting drug users (IDUs) and identified potential cohorts of IDUs that could participate in future HIV vaccine trials. High HIV prevalence rates were observed among IDUs in many countries in Asia, Eastern Europe, Latin America, and parts of Africa and North America. Several cohort studies also showed high HIV incidence rates among IDUs in China, Thailand, Canada, and Spain. These findings emphasize the seriousness of the IDU epidemic globally and the potential for IDU cohorts to participate in HIV vaccine trials due to demonstrated high participation and retention rates in past studies.
A study on clinical presentation and various risk factors associated with pht...IjcmsdrJournal
Background: Tuberculosis is one of the most ancient infectious diseases caused by Mycobacterium tuberculosis. The population most affected is the young and economically productive one. The social factors include poor quality of life, poor housing, overcrowding, population explosion, under nutrition, lack of education, and last but not the least lack of awareness of cause of illness.
Aims and Objectives:
1. To study the clinical presentation of tuberculosis in patients.
2. To study various risk factors of tuberculosis.
Material and Methods: This study was conducted at selected designated microscopic centre (DMCs) Kanpur Nagar district has a population of 45.73lakh ( Census 2011).All the patients who were registered in the selected DMCs in the last one month of the year 2016 ( between April and May) were taken into consideration for the present study. Data was collected on predesigned and pretested questionnaire using direct personal interview method of patients at DMCs on the DOTS days of the week i.e Monday, Wednesday and Friday. Informed consent of the study subjects was taken before interview. A total of 105 registered patients were interviewed personally and also the treatment card of patients was obtained from their respective DMCs.
Results: Out of 105 cases of tuberculosis which reported at DMCs maximum no. of patients belongs to age group between 21-40 yrs of age group (58%). Majority of cases were married (65.7%) cases. (62%) cases were Hindu by religion and (58%) belongs to other backward caste. In the study we found majority of patient was illiterate (34.3%). Most common clinical presentation was cough, fever and cough with expectoration, anorexia was reported in (61.9 %) of cases (77%) were cigarette/bidi smokers, 60% were tobacco chewer. Diabetes was reported in (12.4%) cases and (3.8%) cases were HIV positive.
This document defines key terminology used in epidemiology and describes some important epidemiological methods. It defines epidemiology as the study of disease distribution and determinants in populations. Descriptive epidemiology organizes health data, while analytic epidemiology searches for causes and effects. Important measurements include rates, ratios and proportions to quantify disease frequency and distribution. Methods like incidence, prevalence, mortality and morbidity rates are used to measure disease occurrence and impact in populations.
Patients with carcinoma of the buccal mucosa treated with postoperative ipsilateral radiotherapy at a single institution were analyzed. 116 patients received ipsilateral radiotherapy to a median dose of 60 Gy. With a median follow-up of 24 months, the 2-year local, regional and locoregional control rates were 88.4%, 89.5% and 80.9% respectively. The 2-year disease-free and overall survival rates were 77.4% and 79.5% respectively. Contralateral neck failures occurred in only 3.4% of patients. Ipsilateral radiotherapy achieved good locoregional control for select postoperative buccal mucosa cancer patients.
This document discusses various methods for measuring outcomes in pharmacoepidemiology studies. It describes measuring mortality, morbidity, disability, disease characteristics, and other factors. There are three levels of disablement that can be measured - impairment, activity limitation, and participation restriction. Common outcome measures include death, disease, discomfort, disability, and dissatisfaction. Outcome studies help evaluate the results and costs of healthcare interventions. Outcomes can be classified as clinical, functional status, patient satisfaction, economic, and humanistic measures. Rates, ratios, and proportions are common tools used to measure and analyze outcomes.
This study investigated drug resistance patterns among Mycobacterium tuberculosis isolates from 239 re-treatment tuberculosis patients in Sudan. 143 bacterial isolates were recovered, with 98.6% identified as M. tuberculosis complex and 1.4% as non-tuberculous mycobacteria. Drug susceptibility testing found that 38.3% of isolates were multidrug-resistant and a further 17% were resistant to a single first-line drug. Multidrug resistance was highest among patients who had previously failed treatment (75% of isolates), while over half of patients who had defaulted on previous treatment were susceptible to all first-line drugs. The findings suggest a considerable level of drug resistance in re-treatment TB patients in Sudan.
2006 presentation at The European Health Psychology Conference in Bath: Can We Bury the Idea That Psychotherapy Extends the survival of Cancer Patients?
Abstract—The frequent occurrence of epidemics even after the launching of the Integrated Diseases Surveillance Programme (IDSP) was an indication toward inadequacy of the control system. These epidemics/outbreaks may be identified if disease status analysis is done properly. The aim of the this study was to find out status of some of major diseases included in the IDSP in a tertiary level hospital of western Rajasthan. It was a record-based analysis carried out in hospitals attached to SMS medical College, Jaipur (Rajasthan) India. Weekly report of IDSP in 'L' Form was collected of year 2015 from SMS Medical College, Hospitals. Data related to major diseases of IDSP were gathered from these reports. These reports were analysed in percentage and proportion. It was observed among major six diseases studied in this present study, majority of cases were of Swine flue followed by Dengue, Scrub Typhus and Malaria. There was no case of Chikungunia and Enteric Fever. When deaths due to these major six diseases were observed it was found that majority of deaths occurred due to Swine flue followed by Dengue, Scrub Typhus and Malaria. Malaria death was due to Plasmodiun Falcifarrum. Maximum PCR was of Swine flue (42.32%) followed by Dengue (29.16 %), Scrub Typhus (21.87%) and Malaria (6.65%). Maximum PDR was of Swine flue (93.08%) followed by Dengue (3.08%), Scrub Typhus (3.08%) and Malaria (0.77%). Overall Case Fatality (CFR) of these diseases was found 9.2%. Regarding variation CFR of these diseases it was found that maximum CFR was of Swine flue (20.23%) followed by Scrub Typhus (1.29%), Dengue (1.06%) and Malaria (0.97%). This variation of CFR as per the type of diseases was found with significant variation (p<0.001).So more emphasis should be given to more fatal disease like swine flue.
The document discusses headaches and their symptoms. Headaches usually occur at the end of the day and start as a dull ache in the forehead that spreads to the temples and back of the head. Sometimes the sufferer feels a heavy weight or tight band around their head, or that their head will burst. Headaches typically occur in the evening.
PREVAILENCE OF MIGRIANE IN A LOW INCOME COMMUNITY OF KARACHIJing Zang
Migraine is the most common problem affecting large population, with prevalence frequency 10-12 %. This study was conducted to evaluate the prevalence of migraine in a low income community in Karachi from June-Oct, 2013. Three hundred and seven participants were involved in this study. For this purpose cross-sectional community based questionnaire was designed in accordance with the diagnostic criteria given by International Headache Society. Data collection was carried out by personal visit to patients and through clinics. It was observed that females (65.5%) are more affected from migraine then male. 32.9% housewives reported that they are suffering from migraine. This medical problem is common among youngsters (38.1%) than old citizens. Employees working in different organizations (39.7%), were found to be mostly affected from migraine then self employed persons. Majority of the migraine patients (41%) reported that they are suffering from common symptoms including: photophobia, phonophobia, nausea, vomiting etc. Dietary habits of individuals were found to be closely associated with migraine such as use of caffeine, chocolate are prominent; and their use is common among 75% patients cumulatively. It was evaluated that certain disease conditions i.e. stress (33.6%), depression (22.1%) and anxiety (18.9%) are more common among sufferers of migraine.
Abstract- Statistical models include issues such as statistical characterization of numerical data, estimating the probabilistic future behaviour of a system based on past behaviour, extrapolation or interpolation of data based on some best-fit, error estimates of observations or model generated output. If the statistical model is used to analyse the survival data it is known as statistical model in survival analysis. There are different statistical data. Censored data is one of its kinds. Censoring means the actual survival time is unknown. Censoring may occur when a person does not experience the event before the study ends or lost to follow-up during the study period or withdraws from the study. For this type of censored data the suitable model is survival models. Survival models are classified as non-parametric, semi-parametric and parametric models. The survival probability can be obtained using these models. Using the health data of cancer registry in Tiruchirappalli, Tamil Nadu , a study on survival pattern of cancer patients was explored, the non-parametric modelling that is Kaplan-Meier method was used to estimate the survival probability and the comparison of survival probability of obtained by life table and Kaplan Meier methods for each stage of the disease were made. Log rank test has been used for the comparison between the estimates obtained at the different stages of the disease.
Similar to Survival Analysis And Risk Factors For Death In Tubercolosis Patients On Directly Observed Treatment Short Course (Dessy Noor Hadiyah) (20)
Dokumen tersebut membahas model AMMI untuk data binomial yang disebut model bilinear logit atau model GAMMI logit-link. Model ini mengestimasi parameter multiplikatif untuk data binomial dengan menggunakan algoritma baris-kolom pada model dengan fungsi hubung logit. Ringkasan singkatnya adalah model AMMI telah dikembangkan untuk data kategorik seperti data binomial dengan menggunakan pendekatan model linier terampat dan algoritma estimasi maksimum quasi-likelihood.
Analisis Chaid Sebagai Alat Bantu Statistika Untuk (Vita & Dessy)arditasukma
Analisis CHAID digunakan untuk segmentasi pasar dengan menganalisis status kredit nasabah sebagai variabel dependen dan data demografis sebagai independen. Hasilnya menunjukkan segmen dengan penghasilan <Rp1,5 juta, perempuan, dan usia >30 tahun memiliki risiko kredit macet terendah.
Ekspektasi Pelanggan Dan Aplikasi Bauran Pemasaran (Dyah & Rossy)arditasukma
Penelitian ini bertujuan untuk mengetahui pengaruh ekspektasi pelanggan dan aplikasi bauran pemasaran terhadap loyalitas pelanggan toko modern dengan kepuasan pelanggan sebagai variabel intervening. Penelitian dilakukan pada pelanggan hypermarket Carrefour Surabaya dengan 400 responden. Hasilnya menunjukkan bahwa ekspektasi pelanggan berpengaruh negatif terhadap loyalitas dan kepuasan pelanggan, sedangkan aplikasi bauran pemasaran ber
Evaluasi Empiris Teknik Cross Validation Pada Model Regresi Spasial Gangga Ye...arditasukma
Teknik cross-validation digunakan untuk memilih model regresi spasial terbaik untuk menggambarkan hubungan antara karakteristik jaringan sungai dan debit puncak di DAS Brantas. Model regresi spasial lag diperoleh sebagai model terbaik berdasarkan teknik cross-validation.
Model Ammi Untuk Analisis Interaksi Genotipe X Lokasi (Indra Herlangga)arditasukma
1. Model AMMI merupakan teknik analisis untuk menganalisis data percobaan faktor ganda dengan menggabungkan analisis varians untuk efek utama dan analisis komponen utama untuk efek interaksi.
2. Biplot AMMI digunakan untuk menginterpretasikan hasil AMMI dengan memplot skor komponen lingkungan dan genotipe untuk melihat pola interaksi.
3. Penentuan jumlah komponen AMMI yang signifikan dilakukan dengan menguji
Survival Analysis And Risk Factors For Death In Tubercolosis Patients On Dire...arditasukma
1) The study analyzed survival patterns of 716 tuberculosis patients in India who received DOTS treatment in 2004.
2) Kaplan-Meier analysis found significant differences in survival curves between DOTS categories and age groups of patients. Survival was lowest for patients aged over 60 and those in the retreatment category.
3) Cox proportional hazards analysis identified age over 40 as a significant risk factor for death among tuberculosis patients on DOTS treatment.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Survival Analysis And Risk Factors For Death In Tubercolosis Patients On Directly Observed Treatment Short Course (Dessy Noor Hadiyah)
1. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
180
SURVIVAL ANALYSIS AND RISK FACTORS FOR DEATH IN
TUBERCULOSIS PATIENTS ON DIRECTLY OBSERVED
TREATMENT-SHORT COURSE
GEETA PARDESHI
ABSTRACT
BACKGROUND: Tuberculosis is a disease with a high case fatality of 4.65%.
OBJECTIVES: To describe the survival pattern of patients on Directly Observed
Treatment-Short course (DOTS) according to categories, age and sex of patients.
SETTINGS: Tuberculosis unit (TU) at District Tuberculosis Centre (DTC), Yavatmal, India
DESIGN: Retrospective cohort study. MATERAILS AND METHODS: Data of patients
registered for DOTS in the year 2004 were collected from the tuberculosis register.
STATISTICAL ANALYSIS: Kaplan Meier plots and log rank tests to assess the survival
pattern. Cox proportional hazards model for multivariate analysis. RESULTS: A total of
716 patients were registered at the TU. The survival rates by the end of the intensive
phase were 96%, 93% and 99% in categories I, II and III of DOTS, respectively. The
cumulative survival rates were 93%, 88% and 96% in the three DOTS categories,
respectively. There was a significant difference in the survival curves amongst the three
DOTS categories (log rank statistic= 7.26, d.f..= 2, P=0 0.02) and amongst the different
age groups [log rank statistic= 8.78, d.f.= 3, P= 0.012). There was no difference in the
survival curves of male and female patients (log rank statistic= 0.05, d.f.= 1, P= 0.80)
and according to type of disease (log rank statistic= 5.63, d.f.= 2, P= 0.05). On Cox
proportional hazard analysis, age groups of 40 to 60 years [adjusted hazard ratio= 7.81
(1.002-60.87)] and above 60 years [adjusted hazard ratio= 21.54 (2.57-180.32)] were
identified as significant risk factors for death. CONCLUSIONS: Age above 40 years is
a significant risk factor for death in patients of tuberculosis. There was a significant
difference in survival curves of the three DOTS categories and age groups.
Key words: Tuberculosis, death, directly observed treatment-short course, revised
National Tuberculosis Control Programme
DOI: 10.4103/0019-5359.53163
INTRODUCTION burden of tuberculosis (TB), the Directly
Observed Treatment-Short course (DOTS)
In India, which accounts for 30% of the global program has undergone massive expansion
as treatment success rate has doubled and
death rate has fallen.[1] With an approximate 18
Department of PSM, Dr. Shankarrao Chavan
Government Medical College, Nanded, India additional lives saved per 100 patients treated
Correspondence: under the Revised National Tuberculosis
Dr. Geeta Pardeshi, Control Programme (RNTCP), the program has
SnehaNiwas, Workshop road, Nanded, Maharashtra, India
E-mail: geetashrikar@yahoo.com substantially reduced deaths amongst patients
Indian J Med Sci, Vol. 63, No. 5, May 2009
2. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
SURVIVAL RATES IN TUBERCULOSIS PATIENTS 181
treated and saved an estimated over 1.4 million done by the investigator. As secondary data
additional lives since its inception.[2] was collected and the study did not have direct
patient involvement, ethical clearance was not
Reducing the morbidity and mortality due needed.
to tuberculosis is one of the major goals of
RNTCP. The death rate amongst the new Kaplan Meier analysis was used to study
smear-positive patients has been reduced to survival pattern, in which the probability of
less than 5%.[3] Yet amongst the infectious survival in each month after treatment initiation
diseases, TB continues to be a disease with a was calculated followed by calculation of
high case fatality, viz. 4.27%.[4] cumulative probability of survival by the end
of that particular month. The group variables
Studying the survival patterns in this scenario studied included category of DOTS, age and
will help in identifying the risk factors for sex of the patients. The end point studied was
mortality in these patients and planning death. The time of death was ascertained by
effective interventions to further reduce death calculating the difference between the date of
rates. initiation and date of outcome. The difference
was divided by 30 to determine the month in
The aim of the study is to describe the survival which the event occurred. For example, if the
probability with respect to the DOTS category, difference was 100 days, it was divided by 30
type of disease, age and sex of the patient. to get the Þgure 3.33, the inference being that
the outcome occurred in the fourth month. The
MATERIALS AND METHODS events which were censored were default,
treatment completion, cure, failure and transfer.
RNTCP was initiated in Yavatmal district in
August 2002. By the end of the year 2004, the The Kaplan Meier curve was drawn to arrive
entire district was covered under DOTS. The at the overall estimate of patients surviving at
district has an annualized total case detection the end of each month. The difference in the
rate of 134 per 100,000 of the population and a survival patterns over time between different
cure rate of 85%. groups was studied using the log rank test. The
Cox proportional hazards model was used for
A retrospective cohort study was conducted in multivariate analysis to identify the risk factors
which all patients registered for DOTS at the for death.
tuberculosis unit in the District Tuberculosis
Centre, Yavatmal, from 1st January 2004 to RESULTS
31 st December 2004 were included in the
study cohort. The data regarding age, sex, A total of 716 patients were registered at
DOTS category, treatment outcome and time the DTC during the year 2004. Of these,
of outcome of treatment were collected from 275 belonged to category I, 106 to category
the tuberculosis register at the DTC. The entire II and 335 to category III. Amongst the 235
process of data retrieval and data entry was new smear-positive cases, the treatment
Indian J Med Sci, Vol. 63, No. 5, May 2009
3. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
182 INDIAN JOURNAL OF MEDICAL SCIENCES
success rate was 86.06%, default rate was were censored, it was 88%. In category III,
6.3%, death rate was 4.7% and failure rate probability of survival was 99% at the end of
was 2.94%. the intensive phase and 96% by the time all
patients were censored. Of the total deaths,
The median time of death was 2 months for 57.89% (11/19) in category I, 63.63% (7/11)
majority of the groups. The death rate in in category II and 36.36% (4/11) in category
category I was 6.8%; in category II, 10.38%; III occurred at the end of the intensive phase.
and in category III, 3.28%. The death rate
was more than 10% in category II (re- These Þndings are represented in the Kaplan
treatment group) and in the age group ‘more Meier plot in Figure 1, which describes the
than 60 years’ [Table 1]. Out of the 19 deaths survival curves of the three DOTS categories.
in category I, 11 occurred in smear-positive
cases, 6 in smear-negative cases and 2 in Category=Cat I Category=Cat II Category=Cat III
1.00
extra-pulmonary tuberculosis cases. All the
0.99
11 deaths in category III occurred in smear- 0.98
negative tuberculosis cases. 0.97
0.96
Survival_Probability
0.95
The Kaplan Meier analysis of the data [Table 0.94
2] showed that in category I the probability 0.93
of survival at the end of the intensive phase 0.92
0.91
was 96%. The probability of survival at the
0.90
end of 6 months and till the time all patients 0.89
were censored remained at 96%. In category 0.88
II the probability of survival at the end of the 0 1 2 3 4 5
Months
6 7 8 9 10 11
intensive phase was 93%; and by the end Figure 1: Kaplan Meier plot of survival probabilities
of the 10th month, by which time all patients according to DOTS categories
Table 1: Death rates and median time of death in various groups
Variable Deaths (N) Death rate (%) Median time of death (month)
[Interquartile range]
Category
Category I (n=275) 19 6.91 2 [1-4]
Category II (106) 11 10.38 2 [1-6]
Category III (335) 11 3.28 4 [2-5]
Sex
Male (448) 26 5.80 3 [2-5]
Female (n=268) 15 5.59 2 [1-4]
Age group
Age ≤20 years (n=129) 1 0.77 8 [na]*
Age 21 to 40 years (n=384) 23 5.98 2 [1-4]
Age 41 to 60 years (n=168) 11 6.55 2 [2-4]
Age > 60 years(n=35) 6 17.14 2 [2-4]
Type of disease
New Pulmonary (476) 30 5.67 4 [1-5]
Extra-pulmonary(134) 2 2.23 2 [na]*
Re-treatment (106) 11 10.37 2 [1-6]
*na= not applicable
Indian J Med Sci, Vol. 63, No. 5, May 2009
4. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
SURVIVAL RATES IN TUBERCULOSIS PATIENTS 183
Table 2: Kaplan Meier analysis of deaths according to the Directly Observed Treatment-Short categories
Category Months Number of No. of No. Probability of Probability of Probability of
patients initiated deaths Censored death in survival in survival up to the
on treatment the month the month end of the month
Category I 1 275 7 9 0.03 0.97 0.97
2 259 4 9 0.02 0.98 0.96
3 246 1 5 0.00 1 0.96
4 240 4 6 0.02 0.98 0.94
5 230 2 3 0.01 0.99 0.93
6 225 1 98 0.00 1 0.93
≥7 126 0 126 0.00 1 0.93
Category II 1 106 3 4 0.03 0.97 0.97
2 99 4 8 0.04 0.96 0.93
3 87 0 4 0.00 1.00 0.93
4 83 1 3 0.01 0.99 0.92
5 79 0 3 0.00 1.00 0.92
6 76 1 2 0.01 0.99 0.91
7 73 0 4 0.00 1.00 0.91
8 69 2 45 0.03 0.97 0.88
≥9 22 0 22 0.00 1.00 0.88
Category III 1 335 1 15 0.003 0.997 1.00
2 319 3 8 0.009 0.991 0.99
3 308 0 7 0.000 1.000 0.99
4 301 3 4 0.010 0.990 0.98
5 294 2 5 0.007 0.993 0.97
6 287 2 135 0.007 0.993 0.96
≥7 150 0 150 0.000 1.000 0.96
There was a significant difference in the 0.002). Survival rate at the end of the intensive
survival curves for the three DOTS categories phase was 100% in the patients in the age
(log rank statistic= 7.26, d.f.= 2, P= 0.02). A group ‘up to 20 years,’ while it was 96%, 97%
high proportion of deaths in category II and I and 91% in the patients in the age groups ‘21
occurred in the intensive phase. to 40 years,’ ‘41 to 60 years’ and ‘more than 60
years,’ respectively. The cumulative survival
A similar type of analysis was done for sex, rates were 95%, 94%, 93% and 86% in the four
age and type of disease. age groups, respectively.
There was no signiÞ cant difference in the There was no significant difference in the
survival curves between the male and female survival curves of the different types of the
patients (log rank statistic= 0.05, d.f.= 1, disease (log rank statistic= 5.63, d.f.= 2, P=
P= 0.80). Survival rates at the end of 0.05). The survival rates at the end of the
intensive phase in males was 97%; and in intensive phase were 97%, 98% and 93% in
females, 96%. The cumulative survival rate the new pulmonary, extra-pulmonary and re-
at the end of the treatment period was 92% treatment groups, respectively. The cumulative
in males and 93% in females. survival rates at the end of the treatment period
were 94%, 98% and 88% in these three groups,
The difference in survival curves amongst respectively.
the four age groups studied was statistically
signiÞcant (log rank statistic= 14.08, d.f.= 3, P= On multivariate analysis [Table 3], age was
Indian J Med Sci, Vol. 63, No. 5, May 2009
5. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
184 INDIAN JOURNAL OF MEDICAL SCIENCES
Table 3: Cox proportional hazard analysis of deaths in patients on DOTS
Variable Univariate analysis Multivariate analysis
Hazard ratio Z stat P *Value Adjusted Hazard Z stat P *value
(95% CI) ratio (95% CI)
Category II vs. Category I 1.40 (0.65-2. 99) 0.86 0.38 1.86 (0.001-2527.55) 0.16 0.86
Category III vs. Category I 0.47 (0.22-0.99) -1.98 0.04 0.56 (0.25-1.25) -1.4 0.16
21 to 40 yrs vs. ≤ 20 yrs 8.13 (0.09-60.20) 2.05 0.04 7.17 (0.96-53.28) 1.92 0.05
41 to 60 yrs vs. ≤ 20 yrs 9.16 (0.18-70.95) 2.12 0.03 7.81 (1.002-60.87) 1.96 0.04
> 60 yrs vs. ≤ 20 yrs 22.79 (2.74-189.23) 2.89 0.003 21.54 (2.57-180.32) 2.83 0.004
Male vs. female 1.08 (0.57-2.04) 0.24 0.80 0.87 (0.46-1.67) -0.39 0.69
Extra-pulmonary vs. new pulmonary 0.40 (0.12-1.31) -1.50 0.132 0.61 (0.71-2.20) -0.74 0.45
Re-treatment cases vs. new pulmonary 1.69 (0.82-3.49) 1.42 0.153 0.75 (0.0006-1010.78) -0.07 0.93
identified as a risk factor for mortality. The appropriately will be important.
patients aged 41 to 60 years were 7.8 times
more at risk of death as compared to patients In this study, out of the total 41 deaths in
aged less than 20 years, and patients aged patients of tuberculosis, 11 deaths occurred
above 60 years were 21.54 times more at risk in smear-positive patients; and remaining
of death as compared to the patients aged less 30 deaths, in other groups of patients. In
than 20 years. another study conducted in the state of Delhi,
mortality due to tuberculosis was considerably
DISCUSSION reduced among new sputum-positive cases
with the implementation of RNTCP. However,
The survival rates in this study were found to mortality among smear-negative and new
be 93%, 88% and 96% in categories I, II and extra-pulmonary and re-treatment cases did
III, respectively. The survival rates reported not show any significant decline. [12] This is
in another study were 96%, 94% and 97% in presumably because the emphasis during
categories I, II and III, respectively.[5] phase I of RNTCP had been mainly on
new smear-positive cases. As these goals
Age has been identified as an important are achieved, it is necessary to look at the
risk factor for death in tuberculosis patients. treatment outcomes in other groups of patients
Higher death rates have been noted in the and study the underlying causes of death and
elderly patients.[6-9] Apart from the increased effect of HIV co-infection in these groups. In a
physiological risk of death, the vague study on extra-pulmonary tuberculosis it was
symptoms in the elderly, diagnostic problems noted that 47% patients had co-morbidities,
and concomitant illness could be some of and death was related to tuberculosis in 48%
the contributing factors for the increased of the patients.[13] In a study on extra-pulmonary
death rate in the elderly. [7,10] Concomitant tuberculosis, HIV co-infection was associated
diseases like cardiovascular diseases, COPD, with high mortality rates.[14] In another study HIV
diabetes mellitus and malignancy have been infection was found to signiÞcantly increase the
found to be frequently present in the older risk of death in smear- negative tuberculosis.[15]
patients with tuberculosis.[10,11] Screening the
patients for these diseases and managing them As secondary data was utilized for our study,
Indian J Med Sci, Vol. 63, No. 5, May 2009
6. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
SURVIVAL RATES IN TUBERCULOSIS PATIENTS 185
a number of other factors such as addictions, tuberculosis patients treated under DOTS in a
co-morbidities, HIV status could not be studied. rural Tuberculosis Unit (TU), south India. Indian
J Tuberc 2008;55:64-9.
A lower survival rate at the end of the intensive 6. Gaur SN, Dhingra VK, Rajpal S, Aggarwal JR,
Meghna. Tuberculosis in the elderly and their
phase was noted in re-treatment cases
treatment outcome under DOTS. Indian J Tuberc
(category II) and in patients with age above
2004;51:83-7.
60 years. More than half of the total deaths in
7. Sood R. The problem of geriatric tuberculosis. J
categories II and I occur in the intensive phase
Acad Clin Med 2000;5:156-62.
of treatment. Category II includes patients 8. Pardeshi G, Deshmukh D. Disease characteristics
receiving re-treatment after default, failure or and treatment outcome in elderly tuberculosis
relapse. Incomplete treatment is a known risk patients on DOTS. Indian J Community Med
factor for mortality in tuberculosis patients.[16,17] 2007;32:292-4.
It would be interesting to study whether old age 9. Mukherjee A, Saha I, Paul B. Tuberculosis in
and incomplete treatment, which are known risk Patients Below and Above 60 years and Their
factors for mortality in tuberculosis, also result Treatment Outcome Under RNTCP: A study in
in early deaths during the course of treatment. Rural West Bengal, India. J Indian Acad Geriatr
2008;4:60-3.
10. Perez-Guzman C, Vargas MH, Torres-Cruz
It is important to study the characteristics
A, Villarreal-Velarde H. Does aging modify
of patients who die within two months of
Pulmonary Tuberculosis? A meta-analytical
treatment and those who die later in the
review. Chest 1999;116:961-7.
continuation phase. This will help in planning
11. Dewan PK, Arguin PM, Kiryanova H, Kondroshova
effective interventions to prevent deaths due to NV, Khorosheva TM, Laserson K, et al. Risk
tuberculosis. factors for death during tuberculosis treatment in
Orel, Russia. Int J Tuberc Lung Dis 2004;8:598-
REFERENCES 602.
12. DhingraVK, Aggarwal N, Chandra S , Vashist
1. DOTS prevents TB deaths in India. India, RP. Tuberculosis mortality trends in Delhi after
Tuberculosis [cited on 2008 Apr 24]. Available implementation of RNTCP. Indian J Tuberc
from: http://www.who.int/inf-new/tuber3.htm 2009;56:77-81.
2. Tuberculosis, Communicable diseases and 13. Bukhary ZA, Alrajhi AA. Extrapulmonary
disease surveillance. Core programme clusters tuberculosis, clinical presentation and outcome.
[cited on 2008 Apr 24]. Available from: http://www. Saudi Med J 2004 ;25:881-5.
whoindia.org/en/Section3/Section123.htm. 14. Kourbatova EV, Leonard MK, Romero J, Kraft C,
3. Central TB division .I am stopping TB.TB India Rio C, Blumberg HM. Risk factors for mortality
2009 RNTCP status report. DGHS, Ministry among patients with extrapulmonary tuberculosis
of Health and Family Welfare, Govt of India. at an academic inner-city hospital in the US. Eur
2009,10. J Epidemiol 2006;21:715-21.
4. Central Bureau of Health Information. National 15. Hargreaves NJ, Kadzakumanja O, Whitty CJ,
health proÞle 2008.DGHS, Ministry of Health and Salaniponi FM, Harries AD, Squire SB. ‘Smear-
Family Welfare, Govt of India.2009, 57. negative’ pulmonary tuberculosis in a DOTS
5. Vasantha M, Gopi PG, Subramani R. Survival of programme: Poor outcomes in an area of high
Indian J Med Sci, Vol. 63, No. 5, May 2009
7. [Downloaded free from http://www.indianjmedsci.org on Friday, September 11, 2009 from 202.93.36.78(Indonesia)]
186 INDIAN JOURNAL OF MEDICAL SCIENCES
HIV seroprevalence. Int J Tuberc Lung Dis 17. Kolappan C, Subramani R, Karunakaran K,
2001;5:847-54. Narayanan PR. Mortality of tuberculosis patients
16. Kolappan C, Subramani R, Kumaraswami V, in Chennai, India. Bull World Health Organ
Santha T, Narayanan PR. Excess mortality and 2006;4:555-60.
risk factors for mortality among a cohort of TB
patients from rural south India. Int J Tuberc Lung
Dis 2008;12:81-6. Source of Support: Nil, Conßict of Interest: None declared.
Author Help: Reference checking facility
The manuscript system (www.journalonweb.com) allows the authors to check and verify the accuracy and style of
references. The tool checks the references with PubMed as per a predefined style. Authors are encouraged to use
this facility, before submitting articles to the journal.
• The style as well as bibliographic elements should be 100% accurate, to help get the references verified
from the system. Even a single spelling error or addition of issue number/month of publication will lead to
an error when verifying the reference.
• Example of a correct style
Sheahan P, O’leary G, Lee G, Fitzgibbon J. Cystic cervical metastases: Incidence and diagnosis using fine
needle aspiration biopsy. Otolaryngol Head Neck Surg 2002;127:294-8.
• Only the references from journals indexed in PubMed will be checked.
• Enter each reference in new line, without a serial number.
• Add up to a maximum of 15 references at a time.
• If the reference is correct for its bibliographic elements and punctuations, it will be shown as CORRECT
and a link to the correct article in PubMed will be given.
• If any of the bibliographic elements are missing, incorrect or extra (such as issue number), it will be
shown as INCORRECT and link to possible articles in PubMed will be given.
Indian J Med Sci, Vol. 63, No. 5, May 2009