ABSTRACT
Objective: To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis. Methods: This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan. Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e. 6th month culture conversion or final outcomes (cured, complete, lost to follow-up, failure, death) available, were included in the study. Data was extracted from electronic data management system. For the reporting and management of adverse drug events, active tuberculosis drug safety monitoring and management was implemented across all sites. All the data was analyzed using SPSS version 22. Results: Out of 947 drug resistant tuberculosis patients included in this study, 579 (68%) of the patients had final outcomes available. Of these, 384 (67.9%) successfully completed their treatment. Out of 368 (32%) patients who had their interim results available, all had their 6th month culture negative. Combining new medications was thought to result in serious adverse outcomes such as QT prolongation. However, this study did not record any severe adverse events among patients. Conclusions: All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.
ABSTRACT
To compare the efficacy and safety profile of total dose infusion of low molecular weight iron dextran with divided doses of intravenous iron sucrose for the treatment of iron deficiency anemia during pregnancy. Randomized controlled trial. Shifa International Hospital, Islamabad, over a period of two years from January 2008 to December 2009. Pregnant women at gestational age more than 12 weeks with the confirmed diagnosis of Iron Deficiency Anemia [IDA] were divided into two groups. In the group-A, intravenous iron sucrose was given in divided doses while in the group-B, total daily intake of Low Molecular Weight [LMW] of iron dextran was given. Post-infusion Hemoglobin [Hb] was checked at 4 weeks and at the time of delivery for both groups. Paired sample t-test is applied and comparison [in terms of rise in hemoglobin from pre to post] of both groups was not found to be significant. In the group-A [iron sucrose group], mean pre-infusion Hb levels was 9.09 +/- 0.83 gm/dl. Mean increase in Hemoglobin [Hb] was 10.75 +/- 1.097 gm/dl after 4 weeks of infusion and 11.06 +/- 0.866 gm/dl at delivery [p < 0.001]. In group-B [iron dextran group] pre-infusion haemoglobin was 8.735 +/- 0.956 gm/dl and the mean increase in hemoglobin was 10.613 +/- 1.22 gm/dl at 4-week while mean increase of 10.859 +/- 1.11 gm/dl at the time of delivery [p < 0.001]. Both LMW iron dextran, as well as iron sucrose are equally effective in treatment of IDA during pregnancy, however, LMW iron dextran has the advantage of single visit treatment