Displaying publications 1 - 20 of 92 in total

Abstract:
Sort:
  1. Rehman AU, Khattak M, Mushtaq U, Latif M, Ahmad I, Rasool MF, et al.
    Front Public Health, 2023;11:1244450.
    PMID: 38074769 DOI: 10.3389/fpubh.2023.1244450
    BACKGROUND: The existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.

    AIM: To investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.

    METHODOLOGY: The PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.

    RESULTS: Tuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60-0.96, p treatment failure, TB-DM patients were at higher risk to experience treatment failure rates as compared to TB-non-DM patients (HR 0.46, 95% CI: 0.27-0.67, p treatment failure rates in TB-diabetes patients as compared to TB-non-DM patients. Our study highlights the need for earlier screening of MDR-TB, thorough MDR-TB monitoring, and designing proper and effective treatment strategies to prevent disease progression.

    Matched MeSH terms: Treatment Failure
  2. Khamis KM, Kadir Shahar H, Abdul Manaf R, Hamdan HM
    PLoS One, 2022;17(11):e0277888.
    PMID: 36441678 DOI: 10.1371/journal.pone.0277888
    BACKGROUND: Treatment failure and disease relapse among tuberculosis (TB) patients are commonly caused by non-adherence. It can lead to prolonged infection, increased transmission, drug resistance, and loss of life. Even though the causative microorganism of TB has been identified for more than a century, the disease is still a substantial public health problem worldwide. This research aims to devise, implement, and assess an educational intervention to improve adherence to TB treatment.

    METHODS AND FINDINGS: A randomised clinical trial involving 146 Sudanese TB patients will be conducted at the Abu Anga hospital in Khartoum. The participants will be randomly assigned to the intervention and control groups. A 2-hour session will be offered to the intervention group in a one-day TB educational intervention course. The same educational materials will also be provided to the control group after the randomised controlled trial (RCT). Data will be collected at baseline, one month, and four months after the intervention. The primary outcome of interest is TB treatment adherence, while secondary outcomes include quality of life score, tuberculosis knowledge, and health belief domains. Generalised estimating equations (GEE) in SPSS software version 25.0 will be utilised to evaluate the changes over time.

    CONCLUSIONS: This trial will provide information that could be used in improving TB control strategies to achieve better results in the adherence of healthcare services to the norms of the National Program and patient adherence to the disease treatment and cure.

    TRIAL REGISTRATION: This study is registered at TCTR: (TCTR20210607006).

    Matched MeSH terms: Treatment Failure
  3. Boettiger DC, An VT, Kumarasamy N, Azwa I, Sudjaritruk T, Truong KH, et al.
    J Acquir Immune Defic Syndr, 2022 Jun 01;90(2):193-200.
    PMID: 35125475 DOI: 10.1097/QAI.0000000000002931
    OBJECTIVE: To assess recent trends in the monitoring of antiretroviral therapy (ART) and detection of ART failure in adult and pediatric HIV clinics.

    METHODS: We used data collected from 21 adult and 17 pediatric sites (across 13 and 6 countries/territories, respectively) in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific cohort. ART failure was defined as viral, immune, or clinical consistent with WHO guidelines.

    RESULTS: A total of 8567 adults and 6149 children contributed data. Frequency of CD4 count monitoring declined between 2010 and 2019 among adult sites (from 1.93 to 1.06 tests/person per year, a 45.1% decline) and pediatric sites (from 2.16 to 0.86 testsperson per year, a 60.2% decline), whereas rates of viral load monitoring remained relatively stable. The proportion of adult and pediatric treatment failure detected as immune failure declined (from 73.4% to 50.0% and from 45.8% to 23.1%, respectively), whereas the proportion of failure detected as viral failure increased (from 7.8% to 25.0% and from 45.8% to 76.9%, respectively). The proportion of ART failure detected as clinical failure remained stable among adult and pediatric sites. The largest shifts in ART monitoring and failure type occurred in lower middle-income countries.

    CONCLUSIONS: Although viral failure in our Asian cohort now comprises a larger portion of ART failure than in prior years, the diagnostic characteristics of immune and clinical failure, and recommendations on their management, remain important inclusions for regional ART guidelines.

    Matched MeSH terms: Treatment Failure
  4. Lee YJ, Wang WJ, Mohamad SM, Chandren JR, Gani SMA, Chung WH, et al.
    Eur Spine J, 2024 Feb;33(2):630-645.
    PMID: 37924388 DOI: 10.1007/s00586-023-08007-6
    PURPOSE: To compare the Boston brace and European braces using a standardised Scoliosis Research Society (SRS) inclusion criteria for brace treatment as well as consensus recommendations for treatment outcome.

    METHODS: This was a systematic review that was carried out using MeSH terminology in our search protocol in PubMed, Cochrane Library, Scopus, Clinicaltrials.gov and Web of Science database between 1976 and 29th of Jan 2023. All studies that were included in this review had applied fully/partially the SRS inclusion criteria for brace wear. Outcome measures were divided into primary and secondary outcome measures.

    RESULTS: 3830 literatures were found in which 176 literatures were deemed relevant to the study once duplicates were removed and titles and abstracts were screened. Of these literatures, only 15 had fulfilled the eligibility criteria and were included in the study. 8 of the studies were Level IV studies, 5 were Level III studies and 2 studies were Level I studies (1 prospective randomised controlled trial (RCT) and 1 Quasi-RCT). The percentage of patients who avoided surgery for European braces ranged from 88 to 100%, whereas for Boston brace ranged from 70 to 94%. When treatment success was assessed based on the final Cobb angle > 45°, approximately 15% of patients treated with European braces had treatment failure. In contrast, 20-63% of patients treated with Boston brace had curves > 45° at skeletal maturity. The BrAIST study used a cut-off point of 50° to define failure of treatment and the rate of treatment failure was 28%. Curve correction was not achieved in most patients (24-51% of patients) who were treated with the Chêneau brace and its derivatives. However, none of the patients treated with Boston brace achieved curve correction.

    CONCLUSION: Boston brace and European braces were effective in the prevention of surgery. In addition, curve stabilisation was achieved in most studies. Limitation in current literature included lack of studies providing high level of evidence and lack of standardisation in terms of compliance to brace as well as multidisciplinary management of brace wear.

    Matched MeSH terms: Treatment Failure
  5. Poynard T
    Med J Malaysia, 2005 Jul;60 Suppl B:77-9.
    PMID: 16108180
    Matched MeSH terms: Treatment Failure*
  6. Himratul-Aznita, W.H.
    Ann Dent, 2001;8(1):-.
    MyJurnal
    Until today there are still a high percentage of oral microorganisms have not been identified due to inability to isolate using the cultural method. However, identification of uncultivable microorganisms associated with disease will permits clinicians for a more accurate diagnosis, treatment and preventive measures. Unculturable microorganisms are also involved in disease and may account for treatment failure since their susceptibility to antimicrobial agents would be unknown. Thus, the opportunity for a rational approach to the treatment of disease relies on the state of knowledge concerning its aetiology and pathogenesis. Recently developed molecular methods have made it possible to characterise mixed microflora in their entirety, including the substantial numbers of unculturable bacteria. The development of rapid molecular methods like PCR provides a reliable identification of unculturable microorganisms. This paper will review the current literature regarding the PCR techniques used to identify uncultivable oral microflora.
    Matched MeSH terms: Treatment Failure
  7. Muhammad Najmi, K., Aida Zairani, M.Z., Mushawiahti, M., Bastion, M.L.C., Amin, A.
    MyJurnal
    Pneumatic retinopexy is known as one of the treatment options for a specific type of retinal detachment. It is done in
    an office setting and may be the most cost-effective means of retinal reattachment surgery. Location and size of the
    retinal break remain as the major criteria for a successful outcome. We describe a case that fulfilled all except one
    major criteria for pneumatic retinopexy and underwent multiple procedures but failed. Fluctuation in the resolution
    of the retinal detachment such as in this particular case suggested possibility of early treatment failure.
    Matched MeSH terms: Treatment Failure
  8. Zamani A, Zueter AR, Muhd Besari A, Hasan H, Harun A, Deris ZZ
    Trop Biomed, 2020 Sep 01;37(3):783-790.
    PMID: 33612791 DOI: 10.47665/tb.37.3.783
    Reduced susceptibility in Burkholderia pseudomallei during carbapenem therapy may lead to treatment failure. We isolated a clinical strain that had developed reduced susceptibility to carbapenems while on treatment. After reviewing the patient's clinical notes, the initial isolate (BUPS01/14) was exposed to carbapenem in vitro to mimic the clinical scenario. The stability of susceptibility of the carbapenem-exposed strain (BUPS01/14R) was examined by serial subculture in antibiotic-free broth. Biochemical and morphological comparison was performed by the VITEK® system and electron microscopy. MICs increased 32-fold following carbapenem exposure and became stable in the antibiotic-free environment. On electron microscopic examination, the BUPS01/14R cells were smoother and less wrinkled compared to BUPS01/14 cells. This report highlights a potential anti-melioidosis treatment failure due to the emergence of resistance while on carbapenem monotherapy. Further study of this strain is necessary to understand the mechanism of resistance at a molecular level.
    Matched MeSH terms: Treatment Failure
  9. Mohamed AK, Raja IA, Rukumani DV
    Med J Malaysia, 2020 05;75(3):199-203.
    PMID: 32467532
    INTRODUCTION: There are limited studies on the epidemiology of syphilis in Malaysia. In this study we describe the clinical features and treatment outcomes of patients with syphilis attending a tertiary referral university hospital.

    METHODS: We retrospectively reviewed the case records of patients with positive serology findings for syphilis in University Malaya Medical Center (UMMC) from January 2010 to December 2015. Serological positivity was defined as having a positive rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) with a confirmatory positive Treponema pallidum particle agglutination assay (TPPA). Treatment outcomes were divided into two, success or failure. Demographic and clinical characteristics associated with predictors of treatment failure were assessed using statistical package for the social science (SPSS). This study also included a neurosyphilis descriptive sub-study.

    RESULTS: There were 637 patients identified with positive syphilis serology, but 258 patients were excluded as they did not meet the inclusion criteria. 379 patients were then taken for the demographic study; 14 patients (3.7%) were treated for neurosyphilis; 170 patients with complete data were included. In all 42/170 (24.7%) failed treatment, 12/170 (7.1%) had reinfection and 116/170 (68.2%) had treatment success. A final number of 158 patients were then taken and analyzed for predictors of treatment failure after excluding the 12 reinfection patients. Only low baseline RPR (<1:16) was found to be significant on multivariate logistic regression analysis (p value: 0.007, 95% CI: 1.42, 9.21).

    CONCLUSION: Most of the patients were HIV positive and from the MSM (Men who have sex with Men) population. Low baseline RPR titre is a predictor of treatment failure.

    Matched MeSH terms: Treatment Failure*
  10. Ding CH, Tzar MN, Rahman MM, Muttaqillah NA, Redzuan SR, Periyasamy P
    Pak J Med Sci, 2014 Jul;30(4):914-6.
    PMID: 25097544
    Fungaemia due to Paecilomyces lilacinus is generally not considered in AIDS patients because this condition is not categorised as an AIDS-indicator illness. We report a case of a 25-year-old lady who presented to our hospital with Guillain-Barré Syndrome, with the subsequent development of refractory fungaemia, multi-organ failure and disseminated intravascular coagulopathy. Amphotericin B was given as empirical antifungal therapy. HIV screening was reactive and Paecilomyces lilacinus was isolated from her blood. The fungaemia did not resolve after one week of amphotericin B treatment. The addition of itraconazole was also unsuccessful in clearing the fungaemia. Accurate mycological diagnosis is important in the care of AIDS patients with fungaemia because of the risk of treatment failure with empirical therapy.
    Matched MeSH terms: Treatment Failure
  11. Simbak N, Razak M
    Med J Malaysia, 1998 Sep;53 Suppl A:115-20.
    PMID: 10968193
    A study was carried out on 24 patients (36 clubfeet) surgically treated at the Orthopaedic Department National University of Malaysia, Kuala Lumpur, over a period of four and half years. Nine feet underwent posterior release, 24 feet underwent posteromedial release combined with Evan's procedure. The overall operative result was 63.3% good, 9.5% fairly and 27.2% poor. Patients who underwent surgery between 3 to 12 months showed a high percentage of good results (66.7%). Metatarsal adduction was found to be the commonest residual deformity (63.9%), followed by heel varus (11.1%), cavus (11.1%) and equinus (5.6%). Inadequacy of primary surgery and post operative period of immobilization resulted in a significant high failure rate.
    Matched MeSH terms: Treatment Failure
  12. Kewalramani R, Murthy CS, Gupta R
    J Oral Biol Craniofac Res, 2019 08 31;9(4):347-351.
    PMID: 31528537 DOI: 10.1016/j.jobcr.2019.08.001
    Introduction: Elusive second mesiobuccal canal (MB2) in maxillary first molar are often missed during endodontic therapy and are a major cause of treatment failures. Its prevalence is known to vary among different populations and there is limited information on its prevalence in Indian population.

    Aim: This study investigated the prevalence and location of second mesiobuccal (MB2) canal in mesiobuccal root of maxillary first molar using cone beam computed tomography (CBCT) images in an Indian population.

    Materials and methods: CBCT images of 598 three rooted maxillary first molars were studied. In each CBCT image, the floor of pulp chamber was located and advanced by 2 mm to standardize the observation for MB2 canal. Its location was determined in relation to mesiobuccal (MB1) and palatal (P) canal.

    Statistical analysis: The data was analysed using descriptive statistics. The presence of MB2 canal was correlated with age, gender and tooth position using Chi square test.

    Results: The prevalence of MB2 canal in three rooted maxillary first molar was 61.9%. It was seen that the prevalence of MB2 was highest in 20-40years age group (67.4%) followed by > 40 years (57.5%) and lowest in <20 years (50.6%) and the difference was statistically significant (p = 0.005). It is located mesiopalatally; 2.5 mm ± 0.6 mm palatally and 1.0 ± 0.4mmmesially to the MB1 canal or present directly on the line joining the MB1 and palatal canal.

    Conclusion: There is a high probability of finding MB2 canal in Indian patients. The access cavity must be modified from a triangular shape to rhomboid shape. Troughingmesiopaltally (about 2.5 mm palatally and 1 mm mesially) from MB1 to a depth of about 2 mm from the floor of pulp chamber may be necessary for locating MB2 canal.

    Matched MeSH terms: Treatment Failure
  13. Izadi E, Afshan G, Patel RP, Rao VM, Liew KB, Meor Mohd Affandi MMR, et al.
    Front Pharmacol, 2019;10:881.
    PMID: 31474853 DOI: 10.3389/fphar.2019.00881
    Counterfeit and substandard medicines are recognized as one of serious threats to public health. The product quality of antibacterial medicine will compromise patients' recovery and increase the chance of antibacterial resistance. The review aims to provide a summary of low quality levofloxacin issues and the risk factors as well as suggesting the aspects of product quality that need to be regulated strictly. Quality of the active ingredient, levofloxacin, has an important role to contribute to successful therapy. The poor quality of raw material, directly and indirectly, causes treatment failure as the presence of insufficient dose, mislabeled content, and poor dissolution characteristics can lead to lower bioavailability. Identifying and reporting these factors can potentially help in improving the quality of drug marketed in various developing countries and may also reduce the incidences of treatment failure. Dissolution test is used for testing the dissolution profiles and the rate of drug release from solid formulation such as oral formulations, thus providing information regarding the in vivo performance of a formulation and its bioequivalence. On the other hand, quality-testing procedures are used for comparing the quality of products.
    Matched MeSH terms: Treatment Failure
  14. Ko CCH, Chia WK, Selvarajah GT, Cheah YK, Wong YP, Tan GC
    Diagnostics (Basel), 2020 Sep 19;10(9).
    PMID: 32961774 DOI: 10.3390/diagnostics10090721
    Breast cancer is one of the leading causes of cancer-related deaths in women worldwide, and its incidence is on the rise. A small fraction of cancer stem cells was identified within the tumour bulk, which are regarded as cancer-initiating cells, possess self-renewal and propagation potential, and a key driver for tumour heterogeneity and disease progression. Cancer heterogeneity reduces the overall efficacy of chemotherapy and contributes to treatment failure and relapse. The cell-surface and subcellular biomarkers related to breast cancer stem cell (BCSC) phenotypes are increasingly being recognised. These biomarkers are useful for the isolation of BCSCs and can serve as potential therapeutic targets and prognostic tools to monitor treatment responses. Recently, the role of noncoding microRNAs (miRNAs) has extensively been explored as novel biomarker molecules for breast cancer diagnosis and prognosis with high specificity and sensitivity. An in-depth understanding of the biological roles of miRNA in breast carcinogenesis provides insights into the pathways of cancer development and its utility for disease prognostication. This review gives an overview of stem cells, highlights the biomarkers expressed in BCSCs and describes their potential role as prognostic indicators.
    Matched MeSH terms: Treatment Failure
  15. Mohammed ES, El-Dakhly KM
    Trop Biomed, 2021 Jun 01;38(2):63-67.
    PMID: 33973574 DOI: 10.47665/tb.38.2.039
    Schistosomiasis is a chronic parasitic disease affecting mostly low income and resourcelimited countries. Despite the distribution of the curative medicine, praziquantel (PZQ), the frequency of re-infection is commonly reported, thus, making a difficulty to discriminate treatment failure after re-infection. Therefore, assessing Schistosoma mansoni re-infection after praziquantel administration is crucial to prove the treatment efficacy and to break the transmission of infection in endemic areas. The evolution of highly sensitive and specific diagnostic markers, reliable to detect the re-infection and to evaluate the treatment efficacy, is required to control schistosomiasis. In this study, the potential role of serpin recombinant antigen of S. mansoni as a biomarker of re-infection and chemotherapeutic efficacy has been assessed. Therefore, 20 mice were experimentally challenged and re-challenged with 50 S. mansoni cercariae and divided into 4 equal groups; the first included infected mice (control positive), the second group was twice infected with S. mansoni and left untreated, the third included mice twice infected then treated with praziquantel following the last challenge, and the forth one remained uninfected and untreated (control negative). The current findings demonstrated that high levels of IgG and IgG1 bound to serpin were detected following the re-infection and rapidly declined post treatment. In summary, S. mansoni recombinant serpin could be used as a promising marker to discriminate S. mansoni re-infection and evaluated the efficacy of treatment. The translation of such a potential tool in endemic areas will provide a significant support for the elimination and control programs against schistosomiasis.
    Matched MeSH terms: Treatment Failure
  16. Laghari M, Sulaiman SAS, Khan AH, Memon N
    PeerJ, 2018;6:e5253.
    PMID: 30065869 DOI: 10.7717/peerj.5253
    Background: Regardless of the advancement in medical technologies, the diagnosis of tuberculosis (TB) in children has remained a challenge. Childhood TB is rampant and an important cause of morbidity and mortality. The objective of this study was to determine the trend of TB and treatment outcomes in children aged ≤14 years registered for TB treatment under DOTS course in three districts of Sindh, Pakistan.

    Methods: For this retrospective study, records of TB children (≤14 years) registered for the treatment of TB from January 2011 to December 2015 in three districts of Pakistan, were collected. Demographic data, baseline weight, clinical manifestations, radiography, histopathology results and treatment outcomes were collected from TB unit registers.

    Results: A total of 2,167 children were treated for TB during the study period. Of these, 1,199 (55.3%) were females and 1,242 (57.3%) were from urban areas. Over three-quarter of patients (76.9%) had pulmonary TB with 13.3% of sputum smear positive cases. The overall treatment success rate was 92.4%. In multivariate analysis, rural residents (OR: 2.146, p treatment outcomes. However, age group ≤2 years, male and those who were underweight were found to have the highest risk of pulmonary tuberculosis (OR: 1.953, p treatment failure must be given particular attention. Moreover, strategies are needed to further improve the diagnosis and treatment of TB among children and improve the recording system.

    Matched MeSH terms: Treatment Failure
  17. Cheong FW, Dzul S, Fong MY, Lau YL, Ponnampalavanar S
    Acta Trop, 2020 Jun;206:105454.
    PMID: 32205132 DOI: 10.1016/j.actatropica.2020.105454
    Transmission of Plasmodium vivax still persist in Malaysia despite the government's aim to eliminate malaria in 2020. High treatment failure rate of chloroquine monotherapy was reported recently. Hence, parasite drug susceptibility should be kept under close monitoring. Mutation analysis of the drug resistance markers is useful for reconnaissance of anti-malarial drug resistance. Hitherto, information on P. vivax drug resistance marker in Malaysia are limited. This study aims to evaluate the mutations in four P. vivax drug resistance markers pvcrt-o (putative), pvmdr1 (putative), pvdhfr and pvdhps in 44 isolates from Malaysia. Finding indicates that 27.3%, 100%, 47.7%, and 27.3% of the isolates were carrying mutant allele in pvcrt-o, pvmdr1, pvdhfr and pvdhps genes, respectively. Most of the mutant isolates had multiple point mutations rather than single point mutation in pvmdr1 (41/44) and pvdhfr (19/21). One novel point mutation V111I was detected in pvdhfr. Allelic combination analysis shows significant strong association between mutations in pvcrt-o and pvmdr1 (X2 = 9.521, P < 0.05). In the present study, 65.9% of the patients are non-Malaysians, with few of them arrived in Malaysia 1-2 weeks before the onset of clinical manifestations, or had previous history of malaria infection. Besides, few Malaysian patients had travel history to vivax-endemic countries, suggesting that these patients might have acquired the infections during their travel. All these possible imported cases could have placed Malaysia in a risk to have local transmission or outbreak of malaria. Six isolates were found to have mutations in all four drug resistance markers, suggesting that the multiple-drugs resistant P. vivax strains are circulating in Malaysia.
    Matched MeSH terms: Treatment Failure
  18. Sharma D, Patel RP, Zaidi STR, Sarker MMR, Lean QY, Ming LC
    Front Pharmacol, 2017;8:546.
    PMID: 28871228 DOI: 10.3389/fphar.2017.00546
    Ciprofloxacin, a second generation broad spectrum fluoroquinolone, is active against both Gram-positive and Gram-negative bacteria. Ciprofloxacin has a high oral bioavailability and a large volume of distribution. It is used for the treatment of a wide range of infections including urinary tract infections caused by susceptible bacteria. However, the availability and use of substandard and spurious quality of oral ciprofloxacin formulations in the developing countries has been thought to have contributed toward increased risk of treatment failure and bacterial resistance. Therefore, quality control and bioequivalence studies of the commercially available oral ciprofloxacin formulations should be monitored. Appropriate actions should be taken against offending manufacturers in order to prevent the sale of substandard and spurious quality of ciprofloxacin formulations.
    Matched MeSH terms: Treatment Failure
  19. Zayzan KR, Yusof NM, Sulong AF, Zakaria Z, Ab Rahman J
    Singapore Med J, 2020 Dec 02.
    PMID: 33264560 DOI: 10.11622/smedj.2020164
    INTRODUCTION: The clinical outcomes and factors associated with treatment failure of post-traumatic osteomyelitis have been investigated by many studies. However, limb functionality and quality of life following treatment for this condition have not been thoroughly studied.

    METHODS: This was a cross-sectional study that included 47 patients with post-traumatic osteomyelitis of the lower limb. Functional outcome was assessed using the Lower Extremity Functional Score (LEFS), and quality of life was assessed using the validated Malay version of Short Form-36 version 2.

    RESULTS: Mean follow-up time was 4.6 (range 2.3-9.5) years. Median age was 44 years. Osteomyelitis was located in the tibia for 26 patients and in the femur for 21 patients. Osteomyelitis was consequent to internal infection in 38 patients and due to infected open fractures in nine patients. 42 (89.4%) patients had fracture union and control of infection. Bone defect was found to be a significant contributing factor for treatment failure (p = 0.008). The median LEFS for the success group was 65 when compared to 49 for the failure group. Although the success group showed better scores with regard to quality of life, the difference between the two groups was not statistically significant.

    CONCLUSION: The success rate for post-traumatic osteomyelitis of the lower limb was high. The presence of a bone defect was associated with treatment failure. Successfully treated patients had significantly better functional outcomes than failed ones.

    Matched MeSH terms: Treatment Failure
  20. Zul Khairul Azwadi I, Norhayati MN, Abdullah MS
    Sci Rep, 2021 Mar 23;11(1):6613.
    PMID: 33758312 DOI: 10.1038/s41598-021-86136-y
    Acute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters), hospitalisation duration, quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient's post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.
    Matched MeSH terms: Treatment Failure
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links