Τετάρτη, 28 Σεπτεμβρίου 2016

Effect of Counselling and Reminder Text Messages Follow-Up on Adherence to Antiretroviral Therapy in Hajiya Gambo Sawaba General Hospital, Zaria, Nigeria

2016-09-28T09-52-08Z
Source: Journal of Applied Pharmaceutical Science
Mustapha A. Alfa, A. U. Zezi, S. S. Gyang, H. Yusuf, I. M. Aliyu.
Poor adherence is a major challenge to antiretroviral therapy. It is now recommended that patients have 95% adherence in order to maintain sufficient suppression of viral replication and prevent the emergence of resistance. It is therefore of paramount importance device methods to improve patients adherence. The use of mobile phone calls and text messages are being explored in improving adherence. In this study, the effect of counselling plus reminder text messages were determined. A total of 132 patients were allocated into an intervention and control groups. Both groups were given additional adherence counselling at the beginning of the study and on every clinic visit. The intervention group was also sent reminder text messages for a period of 24 weeks. The CD4 count of all patients was recorded at the start of the study, then the final reading after the follow-up period. The difference in the increase in the CD4 counts between the two groups was compared to find out the difference. Additionally, patients self-report of adherence were compared between the two groups. Patients with 95% and above adherence were classified as adherent, while those with less than 95% non-adherent. It was found that the patients who received reminder text messages in addition to counselling had significantly higher mean percentage increase in CD4 count (36.7%) compared to the control group (19.12%), which received counselling only (p=0.007) However, using self-report form, there was no statistical significant difference in the level of adherence between intervention group and control group. It was therefore concluded that regular counselling and reminder text messages have improved adherence to antiretroviral therapy.


http://ift.tt/2d79OsS

Health seeking behavior of lung cancer patients receiving treatment at a tertiary cancer institute: a study from North India

2016-09-28T09-30-45Z
Source: International Journal of Medical Science and Public Health
Vijay Kumar Barwal, Salig Ram Mazta, Anita Thakur, Rajeev Kumar Seam, Manish Gupta.
Background: The morbidity and mortality of lung cancer is directly related to its stage at diagnosis. Only 15% of lung cancers are detected at a stage amenable to curative resection and the overall five-year survival rate is merely 16%. Early diagnosis of lung cancer results in lower stages, less intensive treatment and improved survival as well as it is less costly. Objectives: The aim was to track treatment seeking behavior of lung cancer patients and to study the socio-demographic profile of these patients and their relationship with treatment seeking behavior. Materials and Methods: All the newly registered lung cancer patients >18 years who came for treatment at our institute during the study period ie from 1st September 2011 through April 2012. Data was analyzed using descriptive and inferential statistics. Results: Out of 91 patients included in the study, 73 (80.2 %) were males and 18 (19.8 %) were females. The mean age of the study population was 59.24 ± 10.53 years and the median age was 60 years. Commonest presenting symptoms were cough (72.5 %), dyspnoea (63.7%) and pain chest (61.5%). The mean duration of symptoms was 3.5 months. We found that 42.9% patients reported within one week of appearance of first symptoms, 19.7% between one week and one month and 37.4% after one month. As the age of patients increased the odds of seeking treatment before one month, decreased. On the other hand as the socio-economic status improved, the odds of seeking treatment earlier also decreased. A significant difference was found in married patients, who sought treatment earlier than those who were single/divorced or widowed (p=0.02). 50% patients thought it was a minor cough and cold which would get cured by itself or by minor treatment. 48% said that there was a delay in diagnosis and referral. Conclusion: The findings indicate an urgent need for public health awareness that targets increasing awareness and recognizing symptoms suggestive of lung cancer. Further strengthening of health facilities with the provision of infrastructure with recent diagnostic modalities and manpower is needed which may help to decrease the delay in diagnosis and hence early referral.


http://ift.tt/2dzSuII

A cross-sectional study of association of body mass index and VO2 max by nonexercise test in medical students

2016-09-28T09-00-18Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Sunita Basavaraj Kalyanshetti, Sumalatha Veluru.
Background: There is an increasing trend of obesity and it affects the physical fitness and persons work output in medical students. VO2 max indicates persons cardiovascular fitness. Aims and Objectives: (i) To evaluate the association between body mass index (BMI) and VO2 max by nonexercise test using NASA/Johnson Space Centre physical activity-rating (PA-R) scale in medical students. (ii) To evaluate the effect of the gender on VO2 max. (iii) To compare VO2 max in obese and nonobese students. Materials and Methods: A total of 98 medical students aged between 17 and 19 years belonging to both the genders, were included for the study. The NASA/Johnson Space Centre PA-R scale was used for nonexercise protocol. VO2 max was calculated taking into account subjects PA-R score, his BMI and gender: (i) Equation for male students: VO2 max (ml/kg/min) = 67.350 (0.381 × age [years]) (0.754 × BMI) + (1.951 × PA-R), (ii) Equation for female students: VO2 max (ml/kg/min) = 56.363 (0.381 × age [years]) (0.754 × BMI) + (1.951 × PA-R). Statistical analysis was performed using Pearsons correlation to know the association between BMI and VO2 max. Results: The correlation factor for association between BMI and VO2 max was significantly negative (P

http://ift.tt/2drOE3Y

Metabolic equivalent task assessment for physical activity in medical students

2016-09-28T09-00-18Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Pranita Ashok, Jayashree S Kharche, Robin Raju, Gayatri Godbole.
Background: The ability to assess energy expenditure (EE) and estimate physical activity (PA) in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity), and diabetes. Metabolic equivalent task (MET) is used as a means of expressing the intensity and EE of activities. Aims and Objective: To assess the PA as MET using the International PA Questionnaire (IPAQ). Material and Methods: It was a cross-sectional study conducted on 87 (29 males and 58 females) medical students aged between 18-25 years. Detailed history of PA was taken, so as to find out the type and quality of PA, they were engaged in. In IPAQ (short), questionnaire information was asked about three specific types of activity such as walking, moderate-intensity activities, and vigorous-intensity activities. MET was calculated. Results: It was found that as per MET score calculated from IPAQ, 40%, 47%, and 13% of students fall in low, moderate, and high PA groups, respectively. Conclusion: MET utilization provides a convenient method to describe the functional capacity or exercise tolerance of an individual. It was observed that PA was very low in medical students as calculated by MET.


http://ift.tt/2d71LMk

Evaluation of random urine sample protein: creatinine ratio as an index of 24 hour urine protein in patients with various renal disorders in tertiary care center

2016-09-28T06-13-31Z
Source: International Journal of Advances in Medicine
P. Shravan Kumar*, U. Ramchander Rao, T. Abhilash, G. Sandeep Reddy.
Background: Commonly used methods to measure protein are 24 hours urine collection, which is time consuming cumbersome and often in accurate, the other method, infrequently used, is estimation of proteinuria from protein-creatinine ratio. The objective of the study was to compare spot urine protein-creatinine ratio with 24 hours urine protein as an index of quantitative proteinuria. Methods: 110 patients with persistent dipstick positive proteinuria with varying degrees of renal dysfunction were included in this study. First morning spot urine sample were used to estimate protein creatinine ratio and then 24 hours urine protein estimation was done and compared. Results: There was significant correlation between 24 hours urine protein and protein creatinine ratio (r=0.70) (P


http://ift.tt/2dr4j87

Study profile of recurrent pain abdomen in children examined by ultrasonography

2016-09-28T05-04-06Z
Source: International Journal of Contemporary Pediatrics
Vikram Hirekerur, Ajay Bhagawat.
Background: Abdominal pain is a frequent condition in children, pain localization in younger children is poor, and in a suffering child, physical examination is often limited, thus, sonographic evaluation of the abdomen is frequently performed in children to investigate the reason for the pain and to exclude other acute abdominal surgical conditions. With the routine use of high-frequency transducers, detection of enlarged abdominal lymph nodes (EALNs) is very common. Methods: After approval from ethical committee 50 patients within age range from 1 to 16 years attending paediatric department at BLDE Shri BM Patil medical college hospital Bijapur, Karnataka, India from January 2014 to December 2014 presenting with abdominal pain of various etiological causes subjected to ultrasonographic examination were included in this study. Results: Maximum numbers (46%) of patients are from 5-8 years age group, more number of boys (54%) is affected as compared with the girls. Maximum (62%) patients had total of 1-5 episodes and next infrequency are patients of multiple episodes, 30 % of patients had school loss due to pain abdomen. Right lower quadrant of the abdomen was most commonly affected (30%) followed by left lower (24%) and para-aortic (16%). Conclusions: We can conclude that -EALNs are frequently seen children with pain abdomen 5- 8 yrs with girls more commonly affected than boys. Most paeirnts presented with 1-5 episodes, 30 % of patients had school loss due to pain abdomen. Right lower quadrant of the abdomen was most commonly affected (30%) followed by left lower (24%) and para-aortic (16%).


http://ift.tt/2dCxW4X

Diagnostic Efficacy Of Gene X-Pert/ MTB-RIF Assay And Its Implication For The Treatment Of MDR TB In Rural Medical College

2016-09-28T04-53-46Z
Source: National Journal of Integrated Research in Medicine
Dr. B.B.Bhadke*, Dr.R.K.Rathod**, Dr.D.G.Deshmukh***, Dr.A.B.Luniya****, Dr.P.A.Bulle*****, Dr.A.V.Surjushe******.
Aims and objectives: To diagnose and treat the MDR Tuberculosis by XPERT MTB/RIF assay as early as possible so that transmission of infection can be minimized and To find out prevalence of MDR TB in our rural district of Maharashtra. Methods: This is a observational ,prospective study conducted over a period of 14 months ( Jan 15 to April 16 ) in the Dept. of Pulmonary Medicine, Shri Vasantrao Naik Gov.t Medical College, Yavatmal, Maharashtra. We have subjected 613 patients who fulfill the clinical criteria for RNTCP - MDRTB suspect 1.Treatment failure. 2. Retreatment case sputum positive at the end of 4 months, 3.Contact of known MDRTB case, 4.Sputum positive at diagnosis, retreatment case, 5. Any follow up sputum positive, 6.Other category (sputum negative retreatment cases), and 7. HIV-TB Cases. We have excluded all new cases (sputum positive, sputum negative and extrapulmonary cases ). With all precautions two sputum samples collected in the designated microscopy centre. One sample was subjected for routine ZN staining and other one for GENE X-PERT MTB/RIF assay. Result. Out of 613 MDR suspect subjects, 314 (51.23%) were found in the age group 30 to 50 which is economically productive age group. There were 428 (69.82%) male and 185 (30.18%) female. Out of total study patient 44 (7.18 %) were detected Rifampicin resistance by X-PERT MTB/RIF assay. Amongst MDR suspect criteria highest no (4.07 %) of Rifampicin resistant were found in Retreatment cases ( group 4 ) followed by 1.47 % in any follow up sputum positive ( group 5 ) , 0.65 % in sputum negative retreatment cases ( group 6), 0.32 % in treatment failure ( group 1 ) , 0.49 % in HIV TB cases (group7 and0.16 % in contacts of known MDR ( group 3) .There were 144 ( 23 .5 ) were co infected with HIV.TB. Conclusion: We conclude that GENE XPERT MTB /RIF assay has significant role in detecting Rifampicin resistance, patient can be started on treatment at the earliest thereby reducing morbidity, progression to XDR, mortality and transmission of MDR/XDR TB in the community can be minimized. However it has some shortcomings that it cannot detect resistance of other anti- tubercular drugs and atypical mycobacteria. [B.B.Bhadke NJIRM 2016; 7(5):1-6]


http://ift.tt/2dCxcwR