ABSTRACT
Background: Revised National Tuberculosis Control Programme (RNTCP) based on Directly Observed Treatment Short-course (DOTS) strategy has been made available in entire country by March 2006. Given high rate of unfavourable treatment outcomes reported in some provinces, there is a need to analyse outcomes and identify possible trends and associated risk factors that can help for improvement in RNTCP.Methods: After getting Institutional Ethics Committee (IEC) approval, total of 76 cases diagnosed and treated for Tuberculosis (TB) under Category I of RNTCP were recruited from January to March 2017. All patients were followed up for six months from date of initiating the treatment. The data was obtained from TB treatment register, by patient visit and regular follow-up. The information collected include age and gender of patient, category of treatment, date of treatment initiation, initial sputum conversion, outcome of treatment and date of outcome.Results: Out of total 76 patients, 64 (84.21%) were cured, 5 (6.57%) were lost to follow-up, 4 (5.26%) were failed to treat, 1 (1.32%) patient was died, 1 (1.32%) patient had completed treatment but status was unknown and 1 (1.32%) patient was not evaluated because of transfer. Overall treatment outcome of TB patients under DOTS was matching goal of RNTCP with cure rate of 84.21%.Conclusions: Efforts by DOT providers, adequate patient education, motivating ones in need can bring positive outcomes. In this region, DOTS center is at good working condition in terms of functionality as well as ethically. Gender, age group, residence and initial culture colony did not significantly affect treatment outcome.
ABSTRACT
Background: The study was designed to identify value of structured viva (SV) as an assessment tool, to ascertain its correlation with unstructured viva (UV) and to find relationship between viva and theory examination results.Methods: This prospective and observational study was conducted on a total of 135 students of the 2nd professional MBBS. All students faced two viva sessions (SV and UV), each of 10 marks on same topics in general pharmacology and autonomic nervous system. Time limit per student was 10 minutes. SV was conducted on pre-validated, standardized cards (n=40) with 5 questions in each card and 0.5 marks of each question. By draw of lots to be performed by students themselves, each student was given 4 cards. One week prior to the viva, the theory examination of 40 marks on same topics was conducted.Results: The mean marks of all students in SV (3.46�44) were significantly lower (P <0.0001) than those of UV (4.61�02). There was significant less deviation of mean marks in all groups of SV (P <0.05). The mean percentage marks of SV (34.63�.37%) had similarities with results of theory examination (34.67�.49%) (P=0.9720), while the difference between mean percentage marks of UV (46.15�.19%) and theory was statistically highly significant (P <0.0001).Conclusions: SV increases objectivity and reduces subjectivity as compared to UV because of similar pattern of questions, difficulty levels and standardised scoring system. SV provides an opportunity to measure how well students can apply knowledge. Thus, SV can be used for formative and summative assessment.
ABSTRACT
Background: The benefits of optimum blood pressure (BP) control in patients with diabetes exceed the benefits of glycaemic control and extend to the prevention of both macro-vascular and micro-vascular complications in patients suffering from both hypertension and diabetes mellitus. Aims & Objective: To investigate the utilization patterns of anti-hypertensive drugs and to evaluate blood pressure (BP) control among diabetic-hypertensive patients with and without reduced renal function. Material and Methods: A prospective, observational study carried out at medicine department of SBKS Medical College and Research Centre, Piparia. The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function. Results: Total 63 antihypertensive medication episodes were prescribed for 50 patients. Out of which 76% patients were receiving 1 drug, 22% receiving 2 drugs and 2% receiving 3 drugs of different antihypertensive class. Most patients were receiving Angiotensin-Converting-Enzyme-Inhibitors (ACE-I)/Angiotensin-Receptor-Blockers (ARBs) (60%), followed by CCBs (24%), beta-blockers (20%), and diuretics (16%). Patients on monotherapy were mostly receiving ACE-I/ARB (65.78%). Beta blockers were more commonly prescribed in patients with reduced renal function (p=0.005). BP control was achieved in 63.15% patients in monotherapy and 33.33% in polytherapy group. Control of systolic and diastolic BP was significantly higher in patients without reduced renal function than patients with reduced renal function (p<0.05). Conclusion: There was suboptimum use of combination therapy among diabetic-hypertensive patients in general and specifically in developing countries as reflected by control achieved in systolic and diastolic BP which requires concern of all healthcare professionals.