Sonisha Gupta

Abstract

Background: Elderly population is increasing progressively all over the world. Diseases of respiratory system are important cause of morbidity & mortality in elderly. Health-care utilization is an important element of health care. Materials and Methods: Cross-sectional study of elderly aged 60yrs & above was conducted in urban & rural area of NCR & Ghaziabad district of Uttar Pradesh. First part included socio-demographic characteristics and self-reported co-morbidities. This first part screened out suspected respiratory cases and they were asked questionnaire regarding health care utilization. Results:  In urban 282/1522(18.5%) & in rural. 298/1503 (19.8%) were found to be suffering actually from respiratory illness. For chronic respiratory illness allopathic services were used by 91.8% (259/282) urban & 75.5% (225/298) rural elderly. Urban area were utilizing services of private health care providers most commonly. In our study 36.6% (109/298) & 20.5% (61/298) rural elderly were taking over the counter treatment from medical stores or going to a quack for acute & chronic respiratory illness respectively. During acute illness 60.7% (181/298) rural elderly choose health care service due to belief but during chronic illness only 51.3% (153/298) elderly stated it as a reason for choosing health care service. Affordability as a reason for selection of particular health service increased from 23.2% (69/298) in acute illness to 36.9% (110/298) in chronic illness. Conclusion: Majority of elderly are illiterate & dependent on family for support. Private health care services are preferred especially by urban elderly. Public healthcare services are used more for chronic illness than acute illness. Keywords: Elderly, Sociodemographic, Health care utilization, Respiratiory Diseases, Geriatric.

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Abstract

Background: Tuberculosis (TB) is, one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. Materials and Methods: This Prospective study was conducted at Santosh medical college Ghaziabad from 1 April 2018 to 30 September 2019. All diagnosed PTB patients above 12yrs were taken. Patients with EPTB, HIV positive, MDR TB, XDR TB were excluded from the study. At the end of study treatment outcome was evaluated. Results: Total of 208 patients diagnosed as tuberculosis were enrolled in the study. 6 patients died during course of study, 10 were treatment failure, 4 were lost to follow-up, 3 transferred out & 1 shifted to private treatment. 184 patients completed treatment successfully. Out of 184, only 152 patients were available for interview at 6 months follow up after completion of treatment. 19 could not be traced, 11 patients refused and 2 died. Out of 152, 110 were asymptomatic, 1 relapsed & rest 41 patients were symptomatic. All symptomatic patients were subjected to Chest X-Ray. Fibrosis was seen on CXR of 30 patients, bronchiectasis was seen in 3 patients, 1 patient had destroyed lung, nothing abnormal detected in 7 patients. Conclusion: Even after successful treatment under RNTCP, these patients need to be followed up as many of them relapse or suffer from sequelae of tuberculosis. Keywords: Outcomes, RNTCP, Pulmonary Tuberculosis, Follow­up, Fibrosis, Post­ Tubercular Chest x­ray, DOTS, Treatment Completion

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