iosr-JDMS   Volume-16 ~ Issue-11 ~ November-2017

Abstract: Vehicular incidents, a cause of unnatural death are the third major preventable one amongst all deaths. Road deaths in India are publicly glaring, while road safety is professionally lacking and politically missing. A retrospective study was conducted in the Department of Forensic Medicine in a tertiary care hospital between March 2015 to February 2017, with an objective to study the demographic, injury profile and mortality pattern in autopsy cases with an alleged history of vehicular incidents and to draw public attention and awareness in order to prevent/control vehicular incidents. Out of 900 autopsied vehicular incidents victims, 65% victims were between 21-40 years of.......

Keywords –Autopsies, Demographic profile, Injury, Road safety,Vehicular incident.

[1]. Singh Y.N, Bairagi K, Das K. An epidemiological study of Road Traffic Accidents victims in Medico legal autopsies. JIAFM 2005:27(3):166-9.
[2]. Odero W, Garner P, Zwi A. Road traffic Injuries in developing countries: A comparative review of epidemiological studies : Trop. Med Int Health. 1997; 2: 445-60.
[3]. World Health Day 2004: Road Safety is No Accident. http://www.thinkroadsafety.gov.uk accessed on 2-9-2007.
[4]. World health statistics 2008 (www.who.int/whosis/whostat/2008/en/index.html accessed on 4-4-2013)
[5]. Institute of Road Traffic Education, a nongovernmental organization based in New Delhi. http://www.newsindiatimes.com/2002/09/13/med30-poor.html as accessed on 2nd June 2008.-.

Abstract: To determine the maternal & perinatal outcome in placentaprevia Method: It is a crosssectional study carried out in a tertiarycare hospital.All pregnant women who were diagnosed to have placenta praevia were included. Introduction:Placenta previa describes placental implantation in the lower uterine segment either over or near the cervical os.various risk factors are high parity, advanced maternal age, previous caesarean scar or any other scar n uterus, prior curettage ,placental size. Results: out of total 6873 deliveries, placenta previa is observed in 19 cases, 0.276%.97% are unbooked&75.% are between 20-25 yrs. 89.4% multiparous women..........

Keywords: Bloodtransfusion,Haemorrhage, Placentapraevia

[1]. 1.Silver RM. Abnormal placentation :placentaprevia,vasaprevia and placenta accretaObstet Gynecol. 2015;126:654-68.
[2]. 2.Rosenberg G. Pariente G, SergienkoR,WiznitzerA,Scheiner E. Critical analysis of risk factors and outcome of placenta praevia. Archives Gynecol. Obstet 2011;284(1):47-51.
[3]. 3.Rajeswari R R, Rubini M. Maternal and perinatal outcome in placenta praevia.-one year study in a tertiary care center in Tamilnadu, IndiaInt J Reprod and ContraceptObstetGynecol 2016;5:2819-22.
[4]. 4.Mastrolia SA,Baumfield Y, Loverro G Placenta previa associated with severe bleeding and hospitalization and delivery A retrospective population based cohort study.JMaternFetal Neonatal Med. 2016;29:3467-71.
[5]. 5.Cieminski A Dugolecki F Relationship between placenta praevia, maternal age, parity and prior caesarean deliveries.Gynekol Pol. 2005;76(4):284-9.

Abstract: To evaluate the comparative efficiency of resistive index (RI), pulsatility index (PI) and peak systolic velocity (PSV) in differentiating malignant and benign breast lesions with cytological & histopathological correlation. Materials and methods: - A prospective study was conducted over a period 1 year 2 months in Bankura Sammilani Medical College among 150 patients with palpable breast lumps from inpatient and outpatient departments of surgery and Gynecology at B.S Medical College, Bankura. Gray scale ultra-sonography and Doppler was carried out on the patients using 7.5 MHZ transducer of Phillips HD-7 machine and RI, PI and PSV were recorded for each patient. Patients were followed up by cytological / histopathological examinations. Data were entered in Microsoft...........

Keywords: Breast; benign; malignant; Color Doppler; Resistive Index

[1]. Madjar H, Prömpeler HJ, Sauerbrei W, Wolfarth R, Pfleiderer A; Color Doppler flow criteria of breast lesions. Ultrasound in medicine & biology. 1994; 20(9):849-58
[2]. Sehgal CM, Arger PH; Quantitative vascularity of breast masses by Doppler imaging: regional variations and diagnostic implications. J Ultrasound Med., 2000; 427-40; quiz 441-2.
[3]. Mukta J, Satish KB; Color Doppler ultrasonography study of palpable breast lumpspilot study. Ind J Radiolimag., 1997; 7(2): 79-82.
[4]. Medl M, Peters-Engl CH, Leodolter S; The use of color-coded Doppler sonography in the diagnosis of breast cancer. Anticancer research, 1993; 14(5B):2249-51. [5]. Mehri Sirous, Reza Sirous, Farnaz Khalighi Nejad, Elham Rabeie, and Marzieh Mansouri Evaluation of different aspects of power Doppler sonography in differentiating and prognostication of breast masses J Res Med Sci. 2015 Feb; 20(2): 133–139.

Abstract: Hypertension can lead to myocardial infarction, stroke, renal failure, and death if not detected and treated appropriately. Cilnidipine, dual L/N-type Ca2+ channel blocker, is effective in reducing proteinuria. An open label, parallel group, prospective comparative clinical study was conducted in out-patient department of General Medicine in Osmania General Hospital to compare the efficacy and safety of enalapril and cilnidipine in 60 hypertensive patients. They were divided in to two groups of 30 patients in the age group 25-60years ofeither sex. Group A received Tab. Enalapril 5mg once a day orally for 6 months. Group B received Tab.Cilnidipine 10mg once a day orally for 6 months. Blood pressure, heart rate and spot urinary protein to creatinine ratio were recorded at baseline and...........

Keywords:Cilnidipine, Enalapril, Heart rate, Hypertension, Proteinuria

[1]. Dietz JD, Du S, Bolten CW, Payne MA, Xia C, Blinn JR, et al. A number of marketed dihydropyridine calcium channel blockers have mineralocorticoid receptor antagonist activity. Hypertension 2008;51:742-8.
[2]. Giles TD. Hypertension is taking on a 'new look' Business briefing. US Cardiology 2006:1-4.
[3]. Gillman MW, Kannel WB, Belanger A, Agostino RB. Influence of heart rate on mortality among person with hypertension: the Framingham Study. Am Heart J 1993;125:1148-54.
[4]. Peterson JC, Adler S, Burkart JM, et al. Blood pressure control, proteinuria, and the progression of renal disease. The Modification of Diet in Renal Disease Study. Ann Intern Med 1995;123:754-62.
[5]. Sante D. Pierdomenico, Anna Bucci, Domenico Lapenna, Franco Cuccurullo, and Andrea Mezzetti. Heart Rate in Hypertensive Patients Treated With ACE Inhibitors and Long-Acting Dihydropyridine Calcium Antagonists. Journal of Cardiovascular Pharmacology 2002;40:288–295.

Abstract: The complications of fixed partial dentures and single crowns have a great importance to be evaluated.The objectives of this study were to determine the prevalence of complications associated with crowns and bridges and the effect of service duration on the prevalence of complications among a population of Batterjee Dental Clinic.A total of 98 patients, with 44 FPD and 54 single crowns were selected. Questionnaire had questions pertained to the period, nature of complaint, and type of materials used. Clinical examination was performed. Statistical analysis was done using a Statistical Package for Social Science.The Results of this study showed thatthe percentage of..........

[1]. Johar, A.: Complications Associated with Fixed Prosthodontics in a Population Presenting for Treatment to a Dental School in Jeddah, Saudi Arabia. JKAU: Med. Sci,18, 57-67, 2011.
[2]. Libby,G., Arcuri, M.,LaVelle, W. and Hebl, L.: Longevity of fixed partial dentures, the journal of prosthetic dentistry ,78 ,127- 30, 1997.
[3]. Khiari, A., Hadyaoui, D., Saafi, J., Harzallah, H. and Cherif, M.: Clinical Attitude for Failed Fixed. Dent. Open J;100-104,2015.
[4]. Singh, G., Madan, N., Kumar, M., Walia, C. and Pal Singh, O.: A study to evaluate life span of crowns and fixed partial dentures and various reasons of their failures. Dental Journal of advanced studies. 1, 95-98, 2013.
[5]. Goodacre, C., Bernal, G., Rungcharassaeng, K. andKan, J.: Clinical complications in fixed prosthodontics, The journal of prosthetic dentistry;90:31-41, 2003..

Abstract: Brachial plexus block is a versatile and reliable regional anaesthesia technique with multiple applications. It is among the most commonly studied and performed peripheral nerve blocks, owing to its high success rate and ability to provide prolonged intraoperative and postoperative analgesia. One of the newer long acting amide local anaesthetic, Ropivacaine is the stereoisomer of Bupivacaine,has been shown in earlier a studies to have less central nervous system toxicity and less cardiotoxicity than bupivacaine. In human studies, Ropivacaine has been shown to be less toxic than bupivacaine when injected intravenous. Dexmedetomidine, a highly selective alpha 2 adrenoreceptor agonist with sedative, sympatholytic and analgesic properties, is currently considered a super selective alpha-2 adrenergic.........

[1]. El Saied AH, Steyn MP, Ansermino JM. Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade. Can J Anesth 2000;47:962-7
[2]. Murphy DB, Mccartney CJ, Chan. Novel analgesic adjuncts for brachial plexus block: a systemic review. Anesth Analg 2000;90:1122-8
[3]. Esmauglu A, Mizrak A, Akin A et al. Addition of dexmedetomidine to lidocaine for intravenous regional anaesthtesia. Eur J Anaesthesiol 2005;22:447-51
[4]. Singh S, Aggarwal A. A randomized controlled double blinded prospective study of the efficacy of clonidine added to bupivacaine as compared with bupivacaine alone used in supraclavicular brachial plexus block for upper limb surgeries. Indian J Anaesth 2010;54:552-7
[5]. Duma A, Urabanek B, Sitzwohl C et al. Clonidine as an adjuvant to local anaesthetic axillary brachial plexus block: a randomized, controlled study. Br J Anaesth 2005;94:112-6.

Abstract: Objective: To evaluate the etiological factors of jaundice and its effects on maternal and fetal outcome. Material & Methods: A retrospective hospital based study was carried out in the Department of Obstetrics & gynecology of Guntur general hopsital; a tertiary health care referral centre in guntur, Andhra Pradesh over a period of 1 year from August 2016 to july 2017. Results: 50 patients had jaundice during pregnancy. the incidence of jaundice was 3.9%. 64% of patients were between age group 20-25 .most common cause of jaundice was viral hepatitis 46%.most common complication were thrombocytopenia (28%), ,ICU stay 6%,renal failure 8%,hepatic encephalopathy2%,Maternal mortality was 12% and perinatal mortality-28% Conclusion: jaundice in pregnancy has.........

Keywords: jaundice, fetomaternal outcome ,mortality, morbidity

[1]. NehaN,Juhi A ,BabuS.Outcome of pregnancy in cases of jaundice.International journal of scientific research.2014;3(8).
[2]. Renu Mishra .Ian Donald practical obstetric problems.7thedition.Wolter Kluwer,2014.p 154.
[3]. CunninghamG,Leveno KG et al.Hepatic,biliary and pancreatic disorders.Williams obstetrics.23rd edition.Mc GrawHill,NewYork;2010. p 63. [4]. BegumN,Devi SG et al.Seroprevalence of subclinical HEV infection in pregnant women from north India:a hospital based study.Indian J Med Res.2009;130:709-13.
[4]. Harshad D,WalterKK,Ross D et al.Pregnancy -associated acute liver disease and acute viral hepatitis:differentiation,course and outcomes.Journal Hepatology.2008;49:930-5.
[5]. ShuklaS.Prospective study on acute viral hepatitis in pregnancy;seroprevalance and fetomaternal outcome of 100 cases.JBiosci Tech,2011;2(3):279-86.

Abstract: The decompression of billiary tree after CBD exploration for stones has been a topic of debate for many years. T-tube was conventionally used for this purpose, but now the billiary stents have provided an excellent alternative to the cumbersome t-tube. This randomized control study was done to compare the t-tube with billiary stent as method of decompression after CBD exploration. A total of 60 patients were enrolled into the study, 30 underwent t-tube placement while the rest were decompressed by a billiary stent following choledochotomy. Operative parameters and outcomes are compared. operative time, intraoperative blood loss, post-operative pain and discomfort, abdominal drain removal time, return of bowel sounds and hospital stay were all significantly lower in............

Keywords: Billiary stent, Choledocholithiasis, Choledochotomy T-tube,

[1]. Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005;15:329–338

[2]. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep. 2005;7:132–140

[3]. Halldestam I, Enell EL, Kullman E, Borch K. Development of symptoms and complications in individuals with asymptomatic gallstones. The British Journal of Surgery 2004;91(6):734-8.
[4]. Ahrendt SA, Pitt HA, Biliary tract. In: Townsend M, Ed. Sabiston Textbook of Surgery. Philadelphia: WB Saunders; 2004.p. 486–92
[5]. Perez G, Escalona A, Jarufe N, Ibáñez L, Viviani P, García C, et al. Prospective randomized study of T - tube versus biliary stent for common bile duct decompression after open choledochotomy. World J Surg 2005; 29:869–72.

Abstract: Ectopic pregnancy is associated with increased incidence of morbidity and mortality in women of child bearing age in Nigeria and other developing countries. We sought to determine the incidence, risk factors, clinical presentation and the type of surgical treatment offered in patients who were managed in the General Hospital, Calabar within a 7-year period. Case notes were retrieved from the records department and relevant data extracted for analysis. There were a total of 6,437 deliveries and 1,077 gynaecological admissions. One hundred and thirty (130) ectopic pregnancies were managed giving an overall incidence rate of 2.02% and 12.07% of all obstetrics and gynaecological admissions respectively. The mean age of presentation was 25.23±3.75 years. Majority of the subjects were nulliparous...........

Keywords: ectopic pregnancy, General Practice, Calabar, Nigeria

[1]. WC Orazulike and JC Konie, Diagnosis and management of ectopic pregnancy,Women's Health (Lond, Engl) 9(4), 2013, 373-385.
[2]. GO Akaba , TE Agida, O Onafowokan, Ectopic pregnancy in Nigeria's federal capital city: a six year review, Nigerian Journal of Medicine, 21(2), 2012, 241-245
[3]. GO Igberase ,PN Ebeigbe, OF Igbekoyi, BI Ajufoh BI, Ectopic pregnancy: an 11-year review in a tertiary cenre in Niger Delta, Tropical Document, 35, 2005,175-177.
[4]. J Musa, FH Daru , JT Mutihir , IAO Ujah, Ectopic pregnancy in Jos, Northern Nigeria: Prevalence and Impact on subsequent fertility, Nigerian J ournal of Medicine, 18(1), 2009, 35-38
[5]. D Jurkovic and H Wilkinson, Diagnosis and management of ectopic pregnancy, British Medical Journal, 342, 2011, d3397.

Abstract: The prostate is a wall-nut sized organ in the male located at the neck of the bladder. In the prostate, there are three common group of diseases. They include: inflammatory lesions, benign enlargement, neoplastic lesions/tumour-like lesions. Adenocarcinoma of the prostate is the commonest form of cancer in men. Prostate biopsy refers to taking of tissue from the prostate gland and examining them under the microscope for the presence of any pathological lesion. Types of prostate biopsy include: Transurethral biopsy, transrectal biopsy and transperitoneal biopsy. The laboratory handling of prostate biopsy depends on the type of biopsy done. Generally, this include – Fixation:.............

Keywords: Prostate, Paraffin wax, Xylene, Microscopy

[1]. Kumar V, Abbas AK, Fausto N, Aster JC (editors). Prostate, Male genital system, Pathologic basis of disease. 9th edition. Philadelphia: Elsevier 2010; 1011 - 1018.

[2]. Josphine A. Clinicopathological Study of Prostatic Biopsies, Journal of Clinical and Diagnostic Research 2014; 8(9): 4-6.

[3]. Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin. 2001; 51:15–36. doi: 10.3322/canjclin.51.1.15.

[4]. Galic J, Simunovic D. Prostate disease prevalence with epidemiological and hormonal analysis in randomly selected male population in Croata, Coll Antropol. 2008;32(4): 1195-202

[5]. The prostate biopsy procedure, Prostate cancer treatment guide , Prostate cancer treatment overview available through www.prostate-cancer.com/prostate cancer-treatment-overview/overview-biopsy.html

Abstract: Intrathecal opoids are used as adjuvants in spinal anaesthesia to increase the duration and quality of anaesthesia.The present study was designed to quantitatively examine the safety and efficacy of fenatnyl and tramadol to hyperbaric bupivacaine for spinal anaesthesia in lower limb surgeries Materials and Methods: Sixty patients undergoing elective lower limb surgeries under spinal anaesthesia at our hospital were chosen for the study during the period January 2015 and September 2016. Patients were randomly allocated into two groups of 30 each. Both groups compared for sensory and motor blockade characteristics. Statistical analysis was performed using statistical package for social sciences (SPSS) for Windows version 16.0 software, Chicago, SPSS Inc............

Keywords: Spinal Anaesthesia, bupivacaine, tramadol, fentanyl

[1] Saxena AK, Arava SK: Current concepts in neuraxial administration of opioids and non-opioids: An overview and future perspectives. Indian J.Anaesth.2004; 48 (1): 13 – 24
[2] Collins Vincent J: Spinal anesthesia- Principles, Principles of Anaesthesiology, 3rd edition. Edited by Collins Vincent J. USA, Lea and Febiger, 1993, pp 1514-5
[3] John D Loesr, Stephen H Butler, S Richard Chapman, Dennis C Turk, Bonica`s management of pain, 3rd edition, Lippincott Williams and Wilkins 2001; 310-326
[4] Harbhej Singh, Jay Yang, Katina Thronton, Adolph H, Giesecke, Intrathecal fentanyl prolongs sensory Bupivacaine spinal block; Canadian Journal of Anaesthesia. 1995; (42): 11/pp 987-91.
[5] Goel S, Bhardwaj N, Grover V.K. Intrathecal fentanyl added to intrathecal bupivacaine for day case surgery: a randomised study. European Journal of Anesthesia, 2003 Apr; 20 (4): 294-7.

Abstract: The aim of the study is to analyse the results of Ambulatory Extended Recovery Laparoscopic cho-lecystectomy Surgery in a 20 bedded private hospital in Oman which is in nascent stage . Methods. Retrospective study in which patients data were collected from hospital records for a period 4.6 years and reviewed.Patients demographics, indications ,criteria for ambulatory surgery , postoperative complications , readmission rates , failure and success rates were studied. Results: Out of 124 patients, 102 patients successfully subjected to AmbulatoryLaparoscopic Cholecystectomy .The success rate was 82.2% with no major complications, no conversion rate ,nil readmission rate , and nil mortality rates........

Keywords: Ambulatorysurgery , extended recovery ,laparoscopic Cholecystectomy, Oman

[1] Verma R, Alladi R, Jackson I, et al. Day case and short stay surgery: 2,Anaesthesia2011; 66: pages 417-434
[2] I.kakandae ,G.Nassali ,O.Kituuka Day Surgery- The Norm for Elective Surgery ,East and Central African Journal of Surgery ,Volume 10 number 2 –December 2005 ,page 1.
[3] Textbook of Day Surgery –Development and practice,international association for ambulatory surgery.paulolemos ,paulJarrett, Beverly Philip page 58,76
[4] Smith R, Kolyn D, Pace R. Outpatient laparoscopic cholecystectomy. HPB Surg. 1994;7(4):261-264.
[5] Taylor E, Gaw F, Kennedy C. Outpatient laparoscopic cholecystectomy feasibility.LaparoscEndoscSurg J 1996;6(2):73-77..

Abstract: This case report describes hemisection in a mandibular molar with socket preservation with help of an alloplastic bone graft and subsequent restoration of the tooth with fixed prosthesis Hemisection represents a form of conservative procedure, which aims at retaining as much of the original tooth structure as possible. It may be a suitable alternative to extraction. Hemisection of the affected tooth allows the preservation of tooth structure, alveolar bone and cost savings (time and money) over other treatment options. The keys to long term success appear to be thorough diagnosis followed by interdisciplinary approach with endodontic, surgical and prosthetic procedures. Preservation of a hopeless tooth is possible by selecting patients with good oral hygiene, and careful surgical and restorative management.

[1]. Behl AB. Hemisection of a Multirooted Tooth-A Case Report. Open access scientific reports ,2012; 1(6):336-38
[2]. Pushpendra K. Verma, Ruchi Srivastava, Harak C. Baranwal, Anju Gautam.A ray of hope for the hopeless: Hemisection of mandibular molar with socket preservation .Dental hypothesis,2012;3(4):159-163
[3]. Zvi Artzi,Haim Tal,Dan Dayan.Porous bovine bone mineral in healing of extraction socket part 1:Histomorphometric evaluations at months.J periodontol 2000;71:1015-1023
[4]. Park SY, Shin SY, Yang SM, Kye SB. Factors influencing the outcome of root-resection therapy in molars: A 10-year retrospective study. J Periodontol 2009;80:32-40.
[5]. Lekovic, E. B. Kenney, M. Weinlaender T. Han, P. Klokkevold M. Nedic, M. Orsini. A Bone Regenerative Approach to Alveolar Ridge Maintenance Following Tooth Extraction. Report of 10 Cases. J Periodontol 1997;68:563-570.

Abstract: Unanticipated difficult airway is a major cause of mortality and morbidity. Aims: To compare ratio of neck circumference/thyromental distance (NC/TM), Mallampatti grade and Wilson score, using intubation difficulty scale (IDS), in predicting difficult intubation and to estimate the prevalence of difficult intubation in obese population. Methods And Material: 197 ASA grade I,II obese patients(BMI≥25kg/m2) were assessed for NC/TM, mallampatti grade and Wilson score. Difficult intubation was determined using IDS≥5. These parameters were compared to determine the diagnostic accuracy of individual..............

Keywords: Difficult intubation, Mallampatti grade,Obesity, Wilson score

[1]. Mallampati SR, Gatti SP, Gugino LD. A clinical sign to predict difficult intubation. Can AnesthSoc J, 32, 1985, 429-434.
[2]. Juvin P, Lavaut E, Dupont H et al. Difficult tracheal intubation is more common in obese than in lean patients. AnesthAnalg 2003;97:595–600.
[3]. Wilson M, Spiegelhalter D, Robertson J, Lesser P. Predicting difficult intubation. Br J Anaesth 1988; 61: 211–6
[4]. Frerk CM. Predicting difficult intubation.Anaesthesia. 1991 Dec;46(12):1005-8.
[5]. Brodsky JB, Lemmens HJ, Brock-Utne JG, Vierra M, Saidman LJ. Morbid obesity and tracheal intubation. AnesthAnalg 2002;94:732-6..

Abstract: Tuberculosis (TB) continues to be a major cause of high morbidity and mortality in Kenya. Adherence to TB treatment is one of the interventions that lead to increase in cure rate thus reducing mortality and emergence of Multi drug resistant tuberculosis (MDR) and high cost of treatment. This study focused on TB patients in urban and rural areas of Kericho and Nakuru Counties of Kenya. Objective:The objective of the study was to identify medical education interventions that can reduce non-adherence to Tuberculosis Treatment among Tb patients in Kericho and Nakuru counties. Methods: A purposive sampling method was used to carry out a cross sectional descriptive survey with retrospective cohort of non-adherent TB patients. Target population...........

Keywords: Non-Adherence, TB Treatment, Defaulter, Patient Factor, Tuberculosis

[1]. World Health Organization (WHO) (2012) Global Tuberculosis Report 2012. Geneva: WHO, .http://www.who.int/iris/bitstream/10665/75938/1/9789241564502_eng.pdf. Accessed April 15, 2013).
[2]. Raviglione, M., Marais, B., Floyd, K., Lönnroth, K., Getahun, H., Migliori, G. B., ...&Chakaya, J. (2012). Scaling up interventions to achieve global tuberculosis control: progress and new developments. The Lancet, 379(9829), 1902-1913.
[3]. World Health Organization. (2013) Global tuberculosis report 2013. http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf?ua=1. Access 2014 June 2
[4]. Zhao Y, Xu S, Wang L, Chin DP, Wang S, Jiang G, (2012) National survey of drug-resistant tuberculosis in China. New England Journal Medicine. 366:2161–2170. doi: 10.1056/NEJMoa1108789.
[5]. Abubakar I, Zignol M, Falzon D, Raviglione M, Ditiu L, MashamS(2013) Drug-resistant tuberculosis: time for visionary political leadership. Lancet Infect Dis. 13:529–39. doi: 10.1016/S1473-3099(13)70030-6.

Abstract: Tuberculosis (TB) continues to be a major cause of high morbidity and mortality in Kenya. Adherence to TB treatment is one of the interventions that lead to increase in cure rate thus reducing mortality and emergence of Multi drug resistant tuberculosis (MDR) and high cost of treatment. This study focused on TB patients in urban and rural areas of Kericho and Nakuru Counties of Kenya. Objective: The objective of the study was to isolate the healthcare givers' factors that contribute to non-adherence to medication among Tb patients.........

Keywords: Non-Adherence, TB Treatment, Defaulter, Patient Factor, Tuberculosis

[1]. World Health Organization (WHO) (2012) Global Tuberculosis Report 2012. Geneva: WHO, http://www.who.int/iris/bitstream/10665/75938/1/9789241564502_eng.pdf. Accessed April 15, 2013).
[2]. Raviglione, M., Marais, B., Floyd, K., Lönnroth, K., Getahun, H., Migliori, G. B., ...&Chakaya, J. (2012). Scaling up interventions to achieve global tuberculosis control: progress and new developments. The Lancet, 379(9829), 1902-1913.
[3]. World Health Organization. (2013) Global tuberculosis report 2013. http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf?ua=1. Access 2014 June 2
[4]. Zhao Y, Xu S, Wang L, Chin DP, Wang S, Jiang G, (2012) National survey of drug-resistant tuberculosis in China. New England Journal Medicine. 366:2161–2170. doi: 10.1056/NEJMoa1108789.
[5]. Abubakar I, Zignol M, Falzon D, Raviglione M, Ditiu L, MashamS(2013) Drug-resistant tuberculosis: time for visionary political leadership. Lancet Infect Dis. 13:529–39. doi: 10.1016/S1473-3099(13)70030-6..