ABSTRACT
Background: DOTS has given very good results in terms of cure and satisfaction among tuberculosis patients. But still some failure and relapse cases occur. Hence studies on effectiveness of DOTS are required. The objectives of research were to study the effectiveness of DOTS regime in terms of cure, failure, default and relapse in the treatment of TB patientsMethods: A hospital based prospective follow up observational study was undertaken in the department of general medicine at a tertiary care medical college and hospital. The present study was conducted among the 60 eligible subjects as per the inclusion and exclusion criteria laid down for the present study.Results: 41 were pulmonary cases and 19 were extra pulmonary patients. At the end of intensive phase only 7 cases were sputum positive out of 37 which reduced to three at the end of extended intensive phase of treatment which further reduced to two at the end of two months of continuation phase. But by the end of completion of continuation phase, one case again became sputum positive i.e. failure case making a final tally to three. It was seen that there was significant weight gain over the period of time in both pulmonary and extra pulmonary cases. The cure rate was 78%. One patient died. Two defaulted and three were failure cases.Conclusions: The DOTS was found to be 78% effective in terms of cure rate. Still there is a huge gap of 22% found in the present scenario which needs to be addressed seriously and by all to prevent multi drug resistant tuberculosis.
ABSTRACT
Background: Awareness about the infection is scarce especially in the developing countries as a consequence of which, it is rarely thought of in the differential diagnosis of febrile illnesses. Failure to diagnose leptospirosis is particularly unfortunate: severely ill patients often recover completely with prompt treatment but if therapy is delayed or not given, death or renal are likely to ensure. Methods: A total 50 patients who were admitted with fever at JSS hospital, medicine department over a period of 2 years that is during August 2005 to August 2007 who have been diagnosed to have leptospirosis fulfilling the inclusion and exclusion criteria. Present study design is a prospective study during which patient will be followed up during hospital stay, recovery and one month after discharge. Results: In our study out of 5 patients 16 patients (32%) had no complications, 34 patients (68%) have developed various complications. 4 patients (8%) developed ARF, 7 patients (14%) developed hepatitis, 17 patients (34%) ARF with Hepatitis, 2 patients (4%) Hepatitis with altered sensorium, 1 patient (2%) developed Myocarditis; Hepatitis; ARF, 1 patient (2%) developed ARF; ARDS; Hepatitis; Myocarditis, 2 patients (4%) ARDS with ARF and Hepatitis. Conclusion: Early diagnosis & initiation of treatment of leptospirosis prevents mortality and morbidity.