ABSTRACT
SETTING: Smoking is reported to be associated with tuberculosis (TB), but its effect on sputum smear conversion remains a matter for discussion. OBJECTIVE: To assess the effects of smoking and smoking cessation on treatment outcomes in patients newly diagnosed with TB in Iran. DESIGN: Newly diagnosed smear-positive TB patients were included in the study. All smokers participated in a smoking cessation programme. Sputum smear status was evaluated at the end of month 2, 5 and 6 of treatment, and smoking status was evaluated at the end of month 2. Differences in smear conversion rates were compared between the three groups, i.e., non-smokers, smokers and quitters. RESULTS: A total of 183 smokers and 151 non-smokers were included. When smoking cessation was assessed after 2 months, 42.6% (78/183) of the smokers were found to have quit. The cure rate at the end of 6 months, precisely compatible with the conversion rate, was significantly higher among non-smokers (P = 0.004) and quitters at 2 months (P = 0.049) than among persisting smokers (83.4%, 80.8% and 67.6%, respectively). CONCLUSION: Cure rates in patients newly diagnosed with pulmonary TB were higher in non-smokers and quitters at 2 months than in smokers. Smoking cessation advice should be included in TB control programmes.
Subject(s)
Antitubercular Agents/administration & dosage , Smoking Cessation , Smoking/epidemiology , Tuberculosis, Pulmonary/drug therapy , Adult , Aged , Female , Humans , Iran , Male , Middle Aged , Sputum/microbiology , Time Factors , Treatment Outcome , Tuberculosis, Pulmonary/diagnosisABSTRACT
BACKGROUND: The association between pulmonary tuberculosis (PTB) and tobacco smoke has been verified by most studies on the subject; figures from different countries for the prevalence of smoking among PTB patients vary. OBJECTIVE: To assess the prevalence of and factors associated with smoking among TB patients in Iran. DESIGN: In this cross-sectional study, subjects were included on a first-come, first-served basis from among newly diagnosed PTB patients using a multistage cluster sampling method during 2012-2014. Data were collected during face-to-face interviews and a questionnaire was used to gather information on smoking habits. RESULTS: Of 1127 newly diagnosed PTB patients included in the study (mean age 50.0 ± 19.8 years), 228 (20.2%) were daily smokers, 20 (1.8%) were occasional smokers and 93 (8.9%) had quit before diagnosis. Simultaneous drug use (P < 0.001, OR 75.21), increasing age (P = 0.001), being single (P < 0.001, OR 16.95), being an Iranian national (P < 0.001, OR 6.26) and living in a rural area (P < 0.001, OR 5.85) were found to be independent risk factors for smoking in study patients. CONCLUSION: The prevalence of smoking among PTB patients in Iran is relatively high. It is therefore necessary to include smoking cessation interventions in the National TB Programme.
Subject(s)
Smoking/epidemiology , Tuberculosis, Pulmonary/epidemiology , Adult , Aged , Chi-Square Distribution , Cross-Sectional Studies , Female , Habits , Health Behavior , Health Knowledge, Attitudes, Practice , Health Surveys , Humans , Interviews as Topic , Iran/epidemiology , Logistic Models , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Prevalence , Risk Factors , Smoking/adverse effects , Smoking/psychology , Time Factors , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/psychologyABSTRACT
Despite the vast improvements of cell therapy in spinal cord injury treatment, no optimum protocol has been developed for application of neural stem/progenitor cells. In this regard, the present meta-analysis showed that the efficacy of the neural stem/progenitor cell (NSPC) transplantation depends mainly on injury model, intervention phase, transplanted cell count, immunosuppressive use, and probably stem cell source. Improved functional recovery post NSPC transplantation was found to be higher in transection and contusion models. Moreover, NSPC transplantation in acute phase of spinal injury was found to have better functional recovery. Higher doses (>3×10(6)cell/kg) were also shown to be optimum for transplantation, but immunosuppressive agent administration negatively affected the motor function recovery. Scaffold use in NSPC transplantation could also effectively raise functional recovery.