ABSTRACT
Tuberculosis is a major public health problem worldwide and remains one of the most significant causes of death from an infectious agent. India contributes to 25.5% of the global new TB case detection. In recent times, emphasis has shifted from older phenotypically and biochemical methods of diagnosis to molecular methods such as GeneXpert MTB/RIF, a real time PCR that can detect MTB and rifampicin resistence simultaneously. Methods: This study aims at assessing the performance of acid fast bacilli (AFB) smear microscopy in comparison with GeneXpert MTB RIF, in the diagnosis of pulmonary tuberculosis. Study was a cross-sectional study carried out at the Department of Pulmonary Medicine, Muzaffarnagar Medical College, from January 2018 to April 2019. Result: The detection of MTB and rifampicin resistance using the Xpert MTB/RIF assay was assessed in 67 specimens from patients suspected of having pulmonary tuberculosis and compared with conventional smear microscopy. Out of these 67 sputum specimens, 38 samples were MTB positive by smear microscopy while 56 samples were MTB detected by Gene Xpert assay. Gene Xpert detected 18 additional tubercular cases and identify two cases of Rifampicin resistant MTB. Conclusion: Study show that there was no statistically significance in diagnostic value between GeneXpert and AFB smear microscopy in sputum samples however Gene Xpert MTB/RIF is useful method for rapid detection of MTB and Rifampicin resistance simultaneously.
ABSTRACT
Background: Multidrug-resistant tuberculosis (MDR-TB) prevalence is increasing throughout the world. Although, most important risk factor for development of MDR-TB is inadequate and irregular previous treatment for tuberculosis, but newly treated patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. The conventional tuberculosis drug susceptibility tests are sensitive and specific but they are not rapid. Newer molecular methods help in rapid diagnosis. GeneXpert MTB/RIF is a rapid method to detect MTB and rifampicin resistance. Rifampicin resistance is an initial indicator of multidrug resistance. We have tried to ascertain the prevalence of Rifampicin resistance in newly diagnosed and previously treated pulmonary tuberculosis patients. Methods: This study was a prospective cross sectional study that involved all newly diagnosed and previously treated pulmonary tuberculosis patients attending the Department of Pulmonary Medicine, Muzaffarnagar Medical College, Muzaffarnagar from January 2018 to Dec 2018. In the District Hospital, Muzaffarnagar,the sputum specimens were sent for GeneXpert MTB/RIF .On the basis of the result, the patients were labelled as Rifampicin resistance. Results: A total no of 118 sputum samples were sent to District Hospital,Muzaffarnagar for GeneXpert MTB/RIF . Among these 118 patients, 102 patients were newly diagnosed pulmonary tuberculosis and 16 patients were previously treated pulmonary tuberculosis . Prevalence of Rifampicin resistance TB was found to be 0.98 % among newly diagnosed pulmonary tuberculosis, and 25 % among previously treated pulmonary tuberculosis patients. Conclusion: In conclusion, our results showed that the prevalence of Rifampicin resistance TB was high in previously treated pulmonary tuberculosis patient in comparison to newly diagnosed pulmonary tuberculosis patient. Proper administration of first line drugs for susceptible cases is most efficient method in preventing drug resistance.
ABSTRACT
Background: Tobacco usage in adolescents & young adults of state Uttar Pradesh of India is rising to an alarming level; although strategies to curtail them are also running; but the rising usage, can be better known by exploring the role of their perceptions regarding the usage of tobacco. Methods: This cross sectional study was done on total 400 (200 adolescents aged: 10-19 years & 200 young adults aged 20-30 years) by simple random technique using in-depth-interview schedule for 3 months in district Muzaffarnagar (Uttar Pradesh) in India. Results: The 41% Adolescents (AD) and 54.5% Young Adults (YA) were using tobacco (X2 =5.0, P <0.05); and this was mainly in smoked form (62.1% in AD & 54.1% in YA) and that too in the form of cigarettes in AD (56.8%) and bidi in YA (69.4%). Majority of them had also no knowledge regarding harmful effects of tobacco usage in AD & YA groups (50% & 41.2% respectively). Only 39% of AD group and 23% of YA group wanted to quit tobacco in future, that too only for saving money (43.7%) in AD group as compared to 40% of YA group who wanted to leave tobacco to remain healthy despite the information regarding harmful effects of tobacco from family/educational institutions level (X2 =8.1, P <0.05). Conclusions: Tobacco usage perceptions among adolescents and young adults in rural area are not healthy; as per results of this in-depth analysis, for which serious efforts from multiple levels are required to safeguard the health of our future generations.
ABSTRACT
Background: The role of RHTC set up under MCI requirement of medical colleges is rising in implementation of NRHM phase 2 programme (2012 onwards); as private medical colleges are expanding in India and they can be an important supporter in public-private partnership for national health programmes. Objective of current study was to assess the role of rural health training centre as a supporting component to a primary health care system for NRHM programme. Methods: The present study was carried out by comparative evaluation of the rural health and training centre of a private medical college with a sub-centre (Muzaffarnagar) on key RCH services of NRHM: a) Family planning materials distribution, b) ANC services and c) Immunization services. Inclusion criteria: Proper ethical approval from both primary health care system and private medical college authorities were obtained for the study. Study design: Prospective evaluation based study on ANM in SC & SN in RHTC in NRHM programme for 1 year duration from 1st January 2013 to 31st December 2013. Data analysis: The statistical data was analysed by Epi-info version 7.1.3. Results: The ANC services, family planning services and immunization services delivered under NRHM programme was found to statistically significantly contributed (P <0.05) by SN of RHTC as compared to ANM of SC in area of Bilaspur, Muzaffarnagar (Uttar Pradesh). Conclusion: RHTC of a private medical college in Muzaffarnagar (UP) is significantly contributing and supporting in RCH services of NRHM programme for primary health care system. RHTC of medical colleges can be an asset for public private partnership in NRHM programme.
ABSTRACT
Background: Currently adolescents mortality and morbidity in rural areas is featured by many causes such as communicable as well as non-communicable diseases apart from accidents, suicides etc which lead to illness or premature death later in their life and their usage of rural health centre services is also emerging to be a new issue. That’s why it is important to study this area critically. Aims & Objective: To study the rural health centre services utilization by adolescents. Materials and Methods: This was prospective study carried out from 1st January 2013 to 31st December 2013. The study was carried out at the rural health and training center (RHTC), Bilaspur of Muzaffarnagar Medical College, Muzaffarnagar (UP) which covers 6 villages. All adolescents attending OPD in year 2013 according to the WHO defined criteria of adolescents (10-19 years) and who gave consent were included and enrolled in this study. Adolescents who did not attend OPD and those who did not give consent for participation in study at RHTC Bilaspur were excluded. Results: The study found that the majority of female patients utilized OPD services of RHTC (53.3%) but main health care service utilized among adolescents was Medical Problem (20.5%) whereas Obstetrical & Gynaecology problems were least (13.8%). Among the other services; most common utilized were dressing for injuries (11.3%) and least utilized were, immunization services (0.8%). Conclusion: The usage of health services utilization of RHTC suggests that there are emerging problems in different health specialties among adolescents, so this area needs further research in future studies.