Notes

Long-term outcomes of exercise prescribed right after weight loss surgery: Any randomized manipulated demo.
TB deaths.
Multidrug-Resistant Tuberculosis is a fatal form because of high morbidity and poor recovery. Improper use of first line medicines and default treatment are the prime reasons of developing resistance of mycobacterium towards conventional anti- TB drugs. Nurses with refined knowledge, current evidence and positive attitude can prevent arising of MDR TB cases by ensuring adequate treatment, promoting treatment adherence and real time case monitoring. Because of paucity of data, present study was aimed to assess efficacy of m-learning in improving knowledge and attitude of nurses about the prevention and control of MDR-TB.

In this Quasi-randomized study, nurses working in the unit of pulmonary, emergency, respiratory ICU, general medicine of AIIMS Rishikesh during the months of August-October 2019 were involved. The number of participation was 190 (95 in each group; experimental and control) where m-learning intervention was available only for experimental group. There were structured questionnaire to measure knowledge and dichotomous checklist to evaluate attitude of nurses of both group before and one week after the provision of m-learning module.

Both the group was homogeneous and m-learning intervention was effective to improve knowledge, when compared post-test knowledge score between experimental and control group (18.2±5.4 vs 12.4±4.4; P<0.001); however, this one-time social media based intervention could not improve attitude of participants (10.3±1.8 vs. 9.9±1.8; P=0.175).

Hence, m-learning is useful for knowledge development among large number of nurses within limited resource setting but frequent provision of technology based module is recommended to acquire positive attitude among nurses.
Hence, m-learning is useful for knowledge development among large number of nurses within limited resource setting but frequent provision of technology based module is recommended to acquire positive attitude among nurses.
Diagnosis and management of multidrug-resistant tuberculosis (MDR-TB) remains a global challenge and is associated with high morbidity and mortality. Burden of TB among symptomatic household contacts of MDR-TB is not extensively studied and screening of symptomatic contacts may provide a better opportunity for optimum management and effective TB control.

This prospective observational study was conducted in the department of Tuberculosis & Chest diseases, S.N. Medical College, Agra from February 2016 to January 2018. The study recruited 271 symptomatic household contacts of 87 index MDR-TB cases. Symptomatic contacts were screened for active disease and latent TB infection. Risk factors for the spread of disease were also looked for.

Out of 271 symptomatic household contacts, 97 (35.79%) had active TB. Among 97 diseased, 62 (22.87%) had MDR-TB and 35 (12.91%) had drug-susceptible TB. 124 contacts (45%) had latent TB infection. Risk factors associated with occurrence of TB included age less than 18 ypt the chain of transmission. Identifying risk factors help prevent the progression of latent TB infection to active disease.
Non-invasive ventilation is widely used now a days in patients with hypercapnic respiratory failure. Non-invasive ventilation can be used in Intensive Care Unit setting and wards provided trained staff is there to monitor.

This was a prospective observational study of 100 adult patients who were admitted with hypercapnic respiratory failure. Demographic information such as Age, Sex were recorded. Clinical parameters like Respiratory Rate, Heart Rate, Oxygen saturation and Arterial Blood Gas variables like pH, PaCO
, HCO
were measured at the time of admission and at 1st hour, 4 hours and 24 hours after start of non-invasive ventilation. Outcome was recorded as success and failure with Non invasive ventilation.

Out of 100 patients, 76 (76%) managed successfully with non-invasive ventilation and 24 patients (24%) needed intubation and invasive mechanical ventilation in this study. Majority of patients (76%) were with clinical diagnosis of Chronic Obstructive Pulmonary Disease. Respiratory Rate and Heartimprovement at 24 hours are predictors of success of non-invasive ventilation in hypercapnic patients.
Improvement in clinical parameters like respiratory rate, heart rate, Oxygen saturation and improvement in ABG variables like pH, PaCO2 after 1st and 4 hours of start of Non invasive ventilation and maintaining the improvement at 24 hours are predictors of success of non-invasive ventilation in hypercapnic patients.India adopted changes in NTEP (Erstwhile RNTCP, Revised National TB Program, renamed as National TB Elimination Program) in the recent years with an aim to End TB by 2025 way ahead of the global target of ending TB by 2030. It is taking a long time for the changes to trickle down to the grass root level to change the behavior of the ground level force to understand and adopt to the changes that are being ordered and several other changes that are being pushed to the field in tandem. This has made field workers to be on their toes to understand and implement all the changes. The logistics like referral forms, GeneXpert/CBNAAT cartridges, slides etc., required for the program need to be calculated and used as per the changes. Shortages in the procurement or indenting will result in hampering the smooth functioning of the program. Accordingly, we calculated the logistics required for the patients estimated to occur in an area depending on the previous year's patient load. The breakup of the patients was adopted from the available references given. Also, the 2019 data of the load of different type of patients in India and the world were also taken. Total logistics were calculated for two hundred patients. Based on the calculations, a generic formula was derived. When the total number of patients in the previous year/quarter/or any period is N, then below is the formula which can estimate the required logistics for the next similar period.Tubercular liver abscess is a rare entity even in an endemic area for TB. We report here a rare case of pediatric tuberculous liver abscess, the etiology of which was established using recently introduced Cartridge based nucleic acid amplification test (CBNAAT). AZD9291 A 7 years old male child presented with vomiting, pain abdomen and fever. Hepatomegaly was found on examination. Ultrasound of abdomen revealed two liver abscesses in the right lobe. Patient remained symptomatic even after empirical antimicrobial therapy. On diagnostic tap Gram stained smear of the pus showed polymorphs with negative culture. CBNAAT was positive for Mycobacterial tuberculosis and sensitive to rifampicin. Subjecting difficult extrapulmonary specimens to relevant microbiological investigations along with CBNAAT and other newer methods may improve diagnosis of tuberculosis in such rare cases thus leading to an early management and decrease in morbidity.
Homepage: https://www.selleckchem.com/products/azd9291.html