Effect of smoking cessation interventions on abstinence and tuberculosis treatment outcomes among newly diagnosed patients: a randomized controlled trial.

The study evaluates the effectiveness of smoking cessation interventions [Behavioral Change Communication (BCC) and Behavioral Change Communication plus bupropion (BCC+)] compared to conventional Directly Observed Therapy Short Course (DOT) treatment in improving pulmonary tuberculosis treatment outcomes and abstinence among newly diagnosed pulmonary tuberculosis (PTB) patients, highlighting the scarcity of robust experimental studies. The current randomized controlled trial, conducted at Ojha Institute of Chest Diseases between October 2017 and June 2019, randomized 292 patients who were current smokers with newly diagnosed pulmonary tuberculosis into three arms: control (n = 97), BCC (n = 97), and BCC+ (n = 98) arms. The outcomes of the interventions were compared in terms of favorable treatment outcomes and abstinence achieved at the end of 6 months. Baseline characteristics were compared between groups. Cox regression quantified the effect size of interventions for both outcome variables and reported as (crude and adjusted) hazard ratios with 95% confidence intervals (CI). No statistically significant difference was observed in baseline characteristics in each arm. Both BCC+ and BCC showed a statistically significant effect in achieving favorable PTB outcomes at 6 months (aHR 2.37, 95% CI 1.52-3.70 and aHR 2.34, 95% CI 1.51-3.60), as well as for abstinence from smoking at 6 months (BCC+: aHR 4.03, 95% CI 2.18-7.44 and BCC: aHR 3.87, 95% CI 2.12-7.05) compared to the control arm. Both BCC and BCC+ aided by pharmacologic agents such as bupropion when incorporated with conventional DOTs were found to be significantly effective in attaining favorable tuberculosis treatment outcomes as well as in attaining smoking abstinence at the end of the 6-month treatment.This study shows that adding smoking cessation programs (with or without extra drugs like bupropion) to standard Directly Observed Treatment Short Course (DOTs) treatment for people who have recently been diagnosed with pulmonary tuberculosis has a great positive impact on how well the overall antituberculosis treatment works. Our trial shows very promising results for such a combined therapy (DOTs and smoking cessation) in a country where the burden of both tuberculosis and smoking is very high.

Prevalence of Migraine among patients of Depressive Disorder.

OBJECTIVE: To find out the prevalence of Migraine among patients of Depressive Disorder. METHODS: A descriptive cross sectional study, conducted at Department of Psychiatry and Behavioral Sciences, JPMC, Karachi from 1st January 2014 to 30th June 2014. Total 272 patients were enrolled in the study. Depressive disorder was diagnosed as per ICD-10 criteria and Migraine headache as ICHD-2 criteria for diagnosis. RESULTS: A total of 272 patients with mean age of 31.85 ± 8.7 were enrolled. Out of 272 cases 64% were females; Out of total cases 86.4% were married. Migraine with aura was seen among 6.6% and migraine without aura was present among 26.1%. Migraine was linked more with females and married and of those having severe Depressive disorder. CONCLUSION: Migraine headache is common among depressed people, particularly females and having severe depression, so it ought to be remembered that while looking for Depressive disorder or headache the other condition must be remembered.