RESUMO
Exploration of factors associated with re-infection of Mycobacterium tuberculosis can be helpful in prevention of disease and reduce the burden of tuberculosis on health care system. This study was designed to identify factors associated with re-infection of tuberculosis in patients with sputum smears positive pulmonary tuberculosis in five bordering provinces of Iran. In this cross sectional study that performed of 2010-2012, different and clinical, socio economic factors were evaluated to identify influencing factors on re-infection. Data were gathered from questionnaires and survey of medical records. Data were analyzed by statistical methods in 300 studied patients with average age 51.9 +/- 24.2 years. 7.2% of patients were diagnosed with reinfection. 64% of patients were in low-income classes, [10.6%] of patients had concomitant renal diseases, 10.2% had diabetes, and 9.8% of patients had liver dysfunction. In multiple analysis, migration from rural to urban areas [P=0.31] and weight loss [P=0.42] were significantly associated with increased risk re-infection. Compared to global reports recurrence rate in our cohort was in a moderate degree. Future studies should be done to identify the influential environmental and socioeconomic factors that affect the M tuberculosis in re-infection
RESUMO
Background and Objectives: Multidrug-Resistant Tuberculosis [MDR-TB] has been lead to complexity in succesfull treatment of Tuberculosis [TB]. The aim of this study was to determine the pattern of first and second line drug resistance on pulmonary TB pateints and study their demografic and clinical links
Materials and Methods: In a cross-sectional study in 2011-2012, 105 Mycobacterium Tuberculosis [M.TB] pateints were collected randomly from east azerbayjan province of Iran. After full clinical history and physical evaluation, standard proportion method was performed for detection of drug resistance in M.TB patients
Results: Frequency distribution of the M.TB in various parts of the city was significantly different. The total prevalence of resistance to any drug was 8.57% [6.1% in new cases and 33.3% in previously treated cases]. Two [1.9%] patients were MDR-TB and a case was Extensively Drug-Resistant [XDR]. In the multiple logistic regrassion analysis, odds of resistance to one or more TB drug was significantly more in retreatment group than newly diagnosed group [OR=7.7]. Frequency of resistance to Streptomycin [5.7%] was the highest and resistance to Etambutol was the lowest [0.95%]. Sputum [88.3%] and coughing [86.4%] were the most common symptoms
Conclusion: Monitoring of drug resistance status by rapid teqnniques is necessary and crucial on patients with previous history of TB. Unexpected distribution of the disease in different parts of the city indicates the need for otherstudies
RESUMO
Background and Objectives: Prevention of pulmonary complications after coronary artery bypass graft is an important fact. The aim of this study was to evaluate the role of pulmonary rehabilitation prior to the surgery for reducing the risk of pulmonary complications after surgery
Materials and Methods: In a randomized clinical trial, 60 patients undergoing heart surgery randomly were divided into two groups [Group A and B]. In group A Patients was performed physiotherapy before and after chest physiotherapy surgery, but on patients in group B were done only chest physiotherapy after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using Spirometry, arterial blood gas [ABG], Visual Analog Scale [VAS] and 6 Minutes Walking Test [6MWT]
Results: Thirty Nine males [65%] and 21 females [35%] patients with a mean age of 56.9 +/- 10.8 was been analyzed. Pneumonia after surgery was observed lower in the group A in compared with group B [0% VS. 40%]. The mean difference in PCO2 and HCO3 indices [of ABG parameters], mean oxygen saturation [Spo2] [of 6MWT parameters] and VAS index were significantly different in the A and B groups [respectively; P =.008 and P =.001, P<.0001 and P <.0001]
Conclusion: The pulmonary rehabilitation program before surgery is recommended to reduce complications of heart surgery
RESUMO
Background: Identifying the factors associated with the recurrence of Mycobacterium tuberculosis (MTB) can help in tuberculosis disease prevention and reducing the burden on the health care system. This study was designed to identify the factors associated with recurrence in MTB patients in five border provinces of Iran. Methods: In a cross-sectional study (2010 to 2012), clinical, economic, and social factors associated with the recurrence of tuberculosis were evaluated. The data were collected by a questionnaire and survey of medical records. Simple and multiple logistic regression analyses were performed using SPSS V.18. Results: A total of 300 patients with an average age of 51.9 years (SD 24.2) were randomly selected. Overall, 7.2% of the patients were diagnosed with a recurrence of tuberculosis. Sixty-four percent (n = 151) of the patients were in a low-income class. The migration from a village to a city (OR = 8.4) and weight loss (OR = 1.5) were significantly associated with an increased chance of recurrence. Conclusion: In this study, the selected provinces of Iran had moderate rates of tuberculosis recurrence in comparison to global reports. Further studies on the relationship of both weight loss and the immigration from a village to a city with tuberculosis recurrence are necessary.