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Volume 2: Number
1 (January-April) 2000
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Abstracts |
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>>>>Editorial |
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Human Genome and
Predictive Medicine
Ravindran P,Former Director & Professor of Respiratory Medicine,Medical College,
Thiruvananthapuram [No
abstract available] |
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>>>>Unresolved Issues |
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Tuberculosis : Role
of DNA Vaccines
Remeshchandra Babu K.M.Institute of Chest
Diseases, Medical College, Calicut
[No
abstract available] |
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>>>>Leading
Article |
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Allergen
Immunotherapy(Relevant Portions from WHO Position Paper – Geneva
27-29, 1997)
Ravindran P,Senior Consultant Pulmonologist, Dept.of Pulmonary and Critical Care
Medicine Cosmopolitan Hospital, Thiruvananthapuram -[No
abstract available] |
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>>>>Original Article |
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Risk Factors for Central
and Obstructive Sleep Apnoea in Congestive Heart Failure
Ajit Vigg, Head, Department of Chest Diseases, Apollo Hospital,
Hyderabad.-[No
abstract available] |
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>>>>Original Paper |
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Causative
Organism in Outpatients with Community Acquired Respiratory Infections – an Indian Experience-[No
abstract available]
Raj B Singh, Arjun P,Apollo Hospital, 21 Greams Lane, Chennai. |
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>>>> Original
Paper |
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Role
of Ayurvedic Drugs along with Antituberculous Chemotherapy in the Management of Tuberculosis
Katiyar SK, Rajiv Kacker,
Manoj Agarwal, Rohatgi S,Department of Chest and T.B.G.S.V.M. Medical
College, Kanpur. |
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Abstract:
Isoniazid and Rifampicin, which are the mainstay of the present
antituberculous therapy, cause two major adverse drug reactions viz
hepatotoxicity and immuno- suppression which interfere with the
recovery of the patient. A study was conducted by including two
multicomponent Ayurvedic drugs – A&B which stimulate the liver
and potentiate the immune system. Comparative results show a
significant improvement in the clinical response and reduction in the
adverse side effects to the antitubercular drugs. |
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Improving Compliance to Chemotherapy
Ghosh CS, Ravindran P, Devi SM, Joshi M
,RCERTC and Respiratory Medicine Department
Medical College, Thiruvananthapuram, Kerala.
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Abstract
Introduction:
The
treatment of TB is ranked as the most cost-effective of all
therapeutic programs in terms of cost per year of life saved.
Neverthless 26% of all avoidable adult death in the developing world
is due to TB. Disability adjusted life years (DALYS) lost from TB is
between 43 and 63 lacs. Drug default is a major hurdle in the
management of TB because it is the chief cause of relapse and drug
resistance. KAP study done by us prior to the present study among 800
consecutive cases of active pulmonary TB cases showed that 80% of them
are not aware of the duration of treatment and the health consequences
of drug default.
Study evaluates the role of
better patient communication by the provider in improving the
compliance rate.
Objective:
To evaluate the effectiveness of a patient communication and
motivation strategy in improving compliance to chemotherapy in
pulmonary tuberculosis.
Design:
Study was conducted as a randomized control trial.
Setting:
Tertiary care setting
Participants:
Newly diagnosed pulmonary tuberculosis cases attending the Chest
Clinic of Medical College and State TB Centre. Sputum smear positive
and X-ray positive pulmonary tuberculosis patients in age group 15 to
70 years included Terminally ill, psychiatric cases, and patients with
history of previous treatment were excluded.
Intervention:
530 Study patients randomized to intervention (267) and control groups
(263). Intervention – daily chemotherapy and innovative
communication and motivation strategy. To augment the communication
and motivation strategy to contract was signed by both the provide and
patient following the initial session. Control patients received daily
chemotherapy with usual motivation.
Outcome
measures:
Proportion of patients who have completed 85% of more of prescribed
medication. Number of death during study period.
Results:
Follow up data available for 504 cases. 253 controls ( C) and 251
intervention (1) group.
Baseline characteristics were similar in both groups. Male female
ratio was 8:2. Mean age, disease severity and prediagnostic cost were
also similar in both groups. Most of default occurred during initial
months of chemotherapy. 76% of default in control and 50% of default
in intervention group occurred during the second and third month of
chemotherapy. Treatment completion rate was 63% (159) for ( C) and 85%
(214) for (I) group ( p = 0.000). Mortality rate was 7% (18) for ( C)
and 2% (7) for (I) group (p=0.004).
Conclusion:
With
better education and communication strategy there was significantly
better completion rate among intervention group compared to control
group. Study indicates that to get better results curing should be
combined with caring mode in the management of tuberculosis.
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>>>>Special Article
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Tuberculosis in India : A Personalised
Overview
[No
abstract available]
M.P.S.Menon
,Professor of Medicine, V.P.Chest Institute,
University of Delhi.
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>>>>Special Article
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Asthma in Pregnancy
[No
abstract available]
James P.T.
Associate Professor, Dept.of Respiratory
Medicine,
Medical College, Alappuzha
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>>>>Case Report
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Traumatic Herniation into the Pericardial
Sac
Joseraj R, James PT, Venugopal P, Raseela
Karunakaran
,Dept.of Chest Medicine, Medical College,
Alappuzha
Abstract:
A rare case of herniation of bowel into the
pericardial sac through diaphragmatic defect following a chest trauma
is reported here.
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