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Background: Emergency LSCS can be categorized based on RCOG guidelines into category I and II which indicates maternal or fetal compromise. Here an urgent delivery and the DDI (decision to delivery interval) within 30 and 45 minutes respectively is needed.Methods: This is a retrospective cross-sectional analysis conducted on a sample of 630 patients who underwent caesarean section over a year, from June 2016 to June 2017. The DDI were further classified into ≤30 and >30 minutes for category I, ≤45 and >45 minutes for category II LSCS. The primary objective is to determine whether DDI in Category I and II emergency LSCS has an impact on fetal outcome and secondary objective is to ensure that DDI is within the standard criterion as per RCOG protocol.Results: Out of 630 samples of caesareans, it was found that 173 falls in Category I and 189 falls in Category II. Out of 87 (50.29%) patients delivered within 30 minutes in Category I, 29 babies required NICU admission. DDI was more than 30 minutes in 86 (49.71%) cases in Category I out of which 38 babies got admitted in NICU with low APGAR scores. Out of 176 (93.12%) patients who delivered within 45 minutes in Category II, 56 babies required NICU admission. DDI was more than 45 minutes in 13 (6.88%) cases in Category II and all these babies got admitted in NICU.Conclusions: Decision -delivery interval has a significant impact on fetal outcome.
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Background: The study was conducted with the aim to evaluate the pre-treatment drug susceptibility profile and to assess the influence of drug resistance on treatment outcome among patients treated with category- II (cat- II) regimen under programme conditions.Methods: This study was conducted on 58 smear positive patients with history of previous anti-tuberculosis treatment for more than one month, comprising cases of ‘Failure’, ‘Treatment after Default’ (TAD) and ‘Relapse’. They received cat- II regimen in Chennai Corporation, RNTCP (revised National tuberculosis control programme) centers from July 2006 to September 2006 and they were monitored upto July 2007 as per RNTCP guidelines to assess the outcome of cat-II treatment by sputum smear status.Results: Male dominance (n=40) was seen in the study participants. Most common age group affected was 35-44 years (n=20). Out of 57 cases, 50.9% cases come under ‘Relapse’, 26.3% arises from ‘TAD’ and 22.8% cases were from ‘Failure’. After completion of treatment with cat-II regimen, out of 57 patients 33 patients were cured and 11 cases were into the category of failure, 10 patients were defaulted during treatment and 3 were died.Conclusions: Besides, the low treatment efficiency in MDR-TB cases, cat- II regimen was effective in sensitive and INH resistant cases.
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Background: Worldwide, more than 55,000 people die of rabies every year. 40% of people who are bitten by suspect rabid animals are children under 15 years of age. Dogs are the source of 99% of human rabies deaths. Rabies cases are not rare in Jodhpur. Jodhpur is situated in the North-Western part of Rajasthan. Jodhpur has an overall population of about 3.685 Million (Census-2011) and a literacy Rate of 67 %. Aims & Objective: The present study was undertaken to determine the age and sex wise distribution of animal bite cases and to find out the distribution of victims on the basis of type of animal exposure and site of bite wounds. Material and Methods: The present study was conducted from 1st January 2010 to 31st December 2010. The animal bite patients attending the Anti-Rabies Clinic, M. G. Hospital, Jodhpur. The present study is a Hospital based study, carried out by interview and examination of the animal bite victims. The present study was carried out by interview and examination of the animal bite patients (Interview of attendants if the bite victim is a very young children) attending the ARC, M.G. Hospital, Jodhpur. Results: The study shows that maximum number of animal bite cases 1901 (44.75%) were in the adult males. In case of both the male and female children (less than 15 years age group) maximum number of animal bites 600 (42.46%) and 180 (41.66%) were on the trunk, whereas in case of adult males and adult females the most common site of the bite was lower limbs. Category III bite (exposure) was more common in 3088 (72.69%) cases. The most common biting animal is dog in 4062 (95.62%) cases. Maximum number 831 (19.56%) of animal bite cases have occurred in the 6 to 10 years age group children. Conclusion: The study shows that adult males have higher incidence of animal bite than the adult females. This is due to the more outdoor activity of the males. The most common biting animal is dog and the most common site of bite is lower limbs in adults. The study also shows that Category III bites (exposure) were more common.
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Background & objectives: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant global health concern. The most important risk factor for the development of MDR-TB is previous anti-tuberculosis therapy. Category II pulmonary TB includes those patients who had failed previous TB treatment, relapsed after treatment, or defaulted during previous treatment. We carried out this study to ascertain the prevalence of MDR-TB among category II pulmonary TB patients. Methods: This was a cross-sectional, descriptive study involving category II pulmonary TB patients diagnosed between 2005 and 2008. All sputum-positive category II TB cases were subjected to mycobacterial culture and drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 196 cases of sputum-positive category II pulmonary tuberculosis patients were included. Of these, 40 patients (20.4%) had MDR-TB. The mean age of MDR-TB patients was 33.25 ± 12.04 yr; 9 patients (22.5%) were female. Thirty six patients showed resistance to rifampicin and isoniazid; while 4 patients showed resistance to rifampicin, isoniazid and streptomycin. The prevalence of MDR-TB among category-II pulmonary tuberculosis patients was 20.4 per cent. Interpretation & conclusions : The prevalence of MDR-TB in category II TB patients was significant. However, nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. We stress the importance of continuous monitoring of drug resistance trends, in order to assess the efficacy of current interventions and their impact on the TB epidemic.
Subject(s)
Adolescent , Adult , Cross-Sectional Studies , Female , Humans , India/epidemiology , Male , Middle Aged , Prevalence , Tuberculosis, Multidrug-Resistant/epidemiology , Tuberculosis, Pulmonary/epidemiology , Young AdultABSTRACT
Objective: To assess the influence of drug resistance on treatment outcome among patients treated with Category-II regimen and document drug susceptibility pattern of “Failures” to this regimen. Design: A retrospective analysis of patients registered from May 1999 through December 2004. Results: Treatment success was 42% among 572 patients and was similar among patients with fully susceptible or resistant but non-MDR organisms (41% of 254 and 40% of 128 patients, respectively). Among 49 MDR-TB patients, 27% had successful treatment outcome. The failure rates among patients with fully susceptible, resistant but non-MDR and MDR bacilli, were 6%, 12% and 27% respectively. Default was significantly higher among males (53% vs. 34%: p<0.01) smokers (57% vs. 36%: p <0.001), alcoholics (58% vs. 39%: p <0.001) and patients with higher initial smear grading (2+ or 3+, 56% vs. scanty or 1+, 44%: p <0.01). DST results were available for 60% (31 of 52) of failures and 10 had MDR-TB. Conclusion: The low success rate to the re-treatment regimen was mainly due to non-compliance. Failure was observed among 9% of patients and MDR-TB was 32% among Category II failures. The currently recommended Category II regimen appears to be adequate for majority of re-treatment cases.