ABSTRACT
This unmatched case-control study aimed to identify factors affecting default from therapy under the national programme of TB control in Alexandria, Egypt. Record reviews and structured interviews were made with 57 defaulters and 187 randomly selected controls. Univariate analysis showed 13 out of 54 factors, investigated were significantly associated with defaulting and, after stepwise logistic regression, 5 factors remained in the model: younger age (adjusted OR = 0.16), rural area of residence (OR = 12.9), long waiting times (OR = 5.81), poor physician-patient communication (OR = 3.06) and fear of information leakage (OR = 3.62). Reasons cited by defaulters included long distance to the clinic, unsuitable clinic times and long waiting times. The main factors associated with defaulting from the national programme of TB control in Alexandria, Egypt were service-related factors, which are amenable to improvement.
Subject(s)
Antitubercular Agents/therapeutic use , Patient Dropouts/statistics & numerical data , Tuberculosis/drug therapy , Adult , Age Distribution , Case-Control Studies , Egypt , Female , Health Services Accessibility/statistics & numerical data , Humans , Male , Medication Adherence/statistics & numerical data , Middle Aged , National Health Programs , Odds Ratio , Patient Compliance/statistics & numerical data , Physician-Patient Relations , Risk Factors , Rural Population/statistics & numerical data , Transients and Migrants/statistics & numerical data , Urban Population/statistics & numerical dataABSTRACT
This unmatched case-control study aimed to identify factors affecting default from therapy under the national programme of TB control in Alexandria, Egypt. Record reviews and structured interviews were made with 57defaulters and 187 randomly selected controls. Univariate analysis showed 13 out of 54 factors investigated were significantly associated with defaulting and/ after stepwise logistic regression, 5 factors remained in the model: younger age [adjusted OR= 0.16], rural area of residence [OR= 12.9], long waiting times [OR=5.81], poor physician-patient communication [OR= 3.06] and fear of information leakage [OR =3.62]. Reasons cited by defaulters included long distance to the clinic, unsuitable clinic times and long waiting times. The main factors associated with defaulting from the national programme of TB control In Alexandria, Egypt were service-related factors, which are amenable to Improvement
Subject(s)
Case-Control Studies , Logistic Models , Rural Population , Physician-Patient Relations , Waiting Lists , Cough , TuberculosisABSTRACT
Typically virtual fluoroscopy systems display the tracked instruments as a projected shadow on a number of 2D x-ray images completely missing the depth information of the third dimension. This paper describes an extra tool for 3D reconstruction in virtual fluoroscopy which is useful to clarify the position of instruments or anatomy and can be used in planning and assessing surgical procedure without further x-ray images. Two examples are given: displaced subtrochanteric fracture and slipped upper femoral epiphysis is presented.
Subject(s)
Fluoroscopy , Imaging, Three-Dimensional/methods , User-Computer Interface , Computer Simulation , Humans , Models, Anatomic , United KingdomSubject(s)
Metacarpal Bones , Osteolysis , Aged , Humans , Male , Remission, Spontaneous , Time FactorsABSTRACT
An advantage of CAOS over traditional surgery is improved precision of implant position and trajectories in 3D space. However, the implementation of these trajectories often adds an extra step to the operation that increases operative time and requires extra training. This paper reports a study of variation in time-to-task and learning curve in performing a standard task of targeting in 3D space using Hull's CAOSS. It shows that time-to-task can be reduced by replacing a 3D targeting task with multiple independent 2D targeting tasks whilst potentially reducing targeting error. Based on this better understanding of targeting a novel jig was developed for performing dynamic hip Screw (DHS) insertion using CAOSS that would provide improved targeting performance by the surgeon.
Subject(s)
Orthopedic Procedures/standards , Surgery, Computer-Assisted , Hip/surgery , Humans , Prostheses and Implants , United KingdomABSTRACT
The C-arm fluoroscope is an indispensable intraoperative 2D imaging device for orthopaedic surgery. However, its frequent use in an operation presents a significant radiation hazard to the theatre staff and patient. A recent technique known as virtual fluoroscopy (VF) enhances the fluoroscope's capability for image guided surgery by tracking optically the position of the C-arm, surgical instruments and the patient. Virtuality is achieved by overlay of surgical instruments onto one or more previously captured fluoroscopic images. A key benefit of VF is that it reduces considerably the radiation hazard. This paper reports on a new VF technique for tracking and calibration of the fluoroscopic C-arm. Also reported is the use of our VF system to provide a new image guided technique for the accurate placement of the femoral component of unicompartmental knee prosthesis.
