A telepathology based screening tool for COVID-19 by leveraging morphological changes related to leukocytes in peripheral blood smears

As we approach the aftermath of a global pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2), the importance of quickly developing rapid screening tests has become very clear from the point of view of containment and also saving lives. Here, we present an explorative study to develop a telepathology-based screening tool using peripheral blood smears (PBS) to identify Coronavirus Disease (COVID-19)-positive cases from a group of 138 patients with flu-like symptoms, consisting of 82 positive and 56 negative samples. Stained blood smear slides were imaged using an automated slide scanner (AI 100) and the images uploaded to the cloud were analyzed by a pathologist to generate semi-quantitative leukocyte morphology-related data. These telepathology data were compared with the data generated from manual microscopy of the same set of smear slides and also the same pathologist. Besides good correlation between the data from telepathology and manual microscopy, we were able to achieve a sensitivity and specificity of 0.83 and 0.71, respectively, for identifying positive and negative COVID-19 cases using a six-parameter combination associated with leukocyte morphology. The morphological features included plasmacytoid cells, neutrophil dysplastic promyelocyte, neutrophil blast-like cells, apoptotic cells, smudged neutrophil, and neutrophil-to-immature granulocyte ratio. Although Polymerase Chain Reaction (PCR) and antibody tests have a superior performance, the PBS-based telepathology tool presented here has the potential to be an interim screening tool in resource-limited settings in underdeveloped and developing countries.

Design, synthesis, in silico studies, and antidiabetic activity of several sulfanilamide incorporated 2,3-disubstitut-ed thiazolidin-4-ones

A panel of 2,3-disubstituted thiazolidin-4-ones 4a-n was synthesised from Schiff bases 3a-n derived from sulfanilamide, by reaction with thioglycolic acid. The compounds were characterised by means of IR, NMR, and Mass spectral data. Compounds 4a-n were screened for DPPH scavenging assay and compounds 4e, 4h, 4i, and 4n exhibited moderate activity. Compounds 4e, 4h, and 4i were tested at 200 mg/kg and 4e at 50 mg/kg b.w. orally for antidiabetic activity in fructose induced diabetic rats. They exhibited significant antidiabetic activity compared to the control group. Pioglitazone was used as a standard drug. The tested compounds exhibited better and ignificant serum cholesterol lowering activity when compared with the control and standard groups. They also reduced the triglyceride level after the 21st day; however, it was insignificant when compared to the control group. Compound 4n displayed the highest binding energy when docked with PPAR-γ followed by compounds 4e, 4h, and 4i when compared to pioglitazone. The physicochemical, drug likeness and ADME properties of the title compounds were found to be satisfactory.

Se sintetizó un panel de tiazolidinas-4-onas 2,3-disustituidas 4a-n a partir de las bases de Schiff 3a-n derivadas de la sulfanilamida por reacción con ácido tioglicólico. Los compuestos se caracterizaron por IR, RMN y datos espectrales de masa. Los compuestos 4a-n se analizaron para DPPH y los compuestos 4e, 4h, 4i y 4n mostraron una actividad moderada. Los compuestos 4e, 4h y 4i se probaron a 200 mg/kg y 4e a 50 mg/kg b.w. oralmente para la actividad antidiabética en ratas diabéticas, inducida por fructosa. Los compuestos mostraron una actividad antidiabética muy significativa en comparación con el grupo control. La pioglitazona se utilizó como fármaco estándar. Los compuestos ensayados mostraron una mejor y significativa actividad reductora del colesterol sérico en comparación con los grupos control y estándar. Estos compuestos también redujeron el nivel de triglicéridos después del 21° día, aunque fue insignificante en comparación con el grupo control. El compuesto 4n mostró la mayor afinidad de unión cuando se acopló a PPAR-γ, seguido de 4e, 4h y 4i en comparación con la pioglitazona. Las propiedades fisicoquímicas, la similitud con el fármaco y las propiedades ADME de los compuestos fueron satisfactorias, lo que los convierte en útiles agentes antidiabéticos.

Um painel de 2,3-disubstituído thiazolidina-4-ones 4a-n foram sintetizados a partir de bases Schiff 3a-n derivado da sulfanilamida por reacção com ácido tioglicólico. Os compostos eram caracterizado por IR, NMR e dados espectrais de massa. Os compostos 4a-n foram rastreados para O ensaio DPPH de limpeza radical e os compostos 4e, 4h, 4i e 4n exibiram actividade moderada. Os compostos 4e, 4h e 4i foram testados a 200 mg/kg e 4e a 50 mg/kg de peso corporal por via oral para antidiabéticos. actividade em ratos diabéticos induzidos por frutose. Exibiram uma actividade antidiabética altamente significativa actividade em comparação com o controlo. A pioglitazona foi utilizada como droga padrão. Os compostos testados exibiu uma melhor e significativa actividade de redução do colesterol sérico quando comparado comde triglicéridos após o 21° dia; no entanto, foi insignificante quando comparado com o controlo. O composto 4n mostrou a maior afinidade de ligação quando acoplado com PPAR-γ seguido de 4e, 4h, 4i quando comparado com pioglitazona. O propriedades físico-químicas, de semelhança com drogas e ADME dos compostos do título de propriedade também foram encontrados paraser satisfatórios, tornando-os agentes antidiabéticos úteis.

Spectrum of Reactive Morphological Alterations in Leucocytes in HIV Patients.

Background: The earliest hematological manifestation of HIV infection can occur at the time of primary infection. Several peripheral blood abnormalities are known in HIV. However, not many studies have reported morphological changes in white blood cells in antiviral naïve patients and even fewer have compared them with HIV seropositive patients. Material and methods: Peripheral blood smears from 100 patients were studied. 50 of them were newly diagnosed HIV seropositive cases and 50 were HIV seronegative. A peripheral blood smear was made to study morphology of various white blood cells A written informed consent was taken. Statistical analysis of the data obtained was done. Results: Morphological abnormalities in the lymphocytes had been the most significant finding, which included nuclear lobulation, nuclear convolution and plasmacytoid and monocytoid features. Neutrophils also showed various morphological abnormalities. Most common were hypogranulation, hypersegmented nuclei and cytoplasmic vacuolations in descending order of frequency. Monocytes also revealed few morphological abnormalities including nuclear irregularities and cytoplasmic vacuolations. Conclusion: The observations from this study will serve as a guide to clinicians as treatment of these patients should include supplements to monitor and improve these changes.

Quantification of sugar intake and mineralization of teeth in 13–15-year-old subjects – A pilot study

Background: Dental caries begins with the initiation of demineralization which is a reversible process. Diet, especially intake of sugar, is an important aetiological factor for demineralization of enamel which eventually leads to caries. Aim: This study aims to understand the quantitative relationship between sugar consumption and mineralization by finding out the change in mineralization of teeth as a result of the change in the sugar score. Settings and Design: This interventional study was done among 119 teeth of 19 subjects who were between the ages of 13–15 years in Hubli city. Materials and Methods: Sugar score was calculated from a 5-day diet history of the subjects and a DIAGNOdent pen was used to indicate the mineralization value of the teeth before the intervention. Diet counseling was given as an intervention after which sugar score and DIAGNOdent scores were measured again after 14 days and compared with the baseline values. Statistical Analysis: Descriptive statistics and a linear regression analysis was done to determine the relationship between the variables. Results: Sugar score and DIAGNOdent score after 14 days were found to have reduced significantly by 41.6% and 20.3% respectively from the baseline values. The Linear Regression indicated that a reduction of sugar score by 5 resulted in a decrease of DIAGNOdent score by 0.16. Conclusion: The findings of the present study suggest that the modification of sugar consumption brought about a significant improvement in the mineralization of the demineralized teeth thus making diet counseling an effective preventive strategy for caries prevention.

To Keep COVID-19 Out of Hospitals in India - Are We Prepared?

The current viral outbreak of the Novel Corona virus, or COVID-19 has turned into a global health crisis. The World Health Organization (WHO) has declared it a public health emergency of international concern. Hospitals are known to have played a very important role in giving necessary medical treatment to the society, particularly at the time of a disaster. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. During the current outbreak of COVID-19, a break in these vital modalities and goods would lead to a break in the provision of acute health care by a not fully prepared health-care facility. Adding to it an elevated rate of personnel absence is predictable. A scarcity of important equipment and goods could prevent access to desired care and have a direct impact on health care delivery. Health workers and carers are at high risk of infection, and healthcare associated amplification of transmission is of concern as is always the case for emerging infections. Non-pharmaceutical interventions remain central for management of COVID-19 because there are no licensed vaccines or coronavirus antivirals. To date, effective treatment is lacking; however, clinical trials investigating the efficacy of several agents, including remdesivir and chloroquine, are underway in China. Currently, effective infection control intervention is the only way to prevent the spread of the infection. Considering this, India has issued several notifications on how one can be affected by this deadly disease, what the symptoms are, and what preventive measures could be adopted. In addition, the Government of India has issued guidelines for prevention and preparedness of hospitals. This review is to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus and steps which are to be followed to prevent spread of disease in hospitals.

The prevalence of anti-hepatitis C antibody among acute febrile illness cases in Idar Taluk, Gujarat, West India

Purpose: The major cause of chronic hepatitis is infections with hepatitis B virus and hepatitis C virus (HCV) globally. However, there exists sparse epidemiological data regarding the prevalence of HCV infection from India. Methodology: We carried out a cross-sectional study to estimate the prevalence of anti-HCV antibody among acute febrile illness cases aged between 1 and 65 years in Idar Taluk, Sabarkantha district, Gujarat state located in West India. A total of 702 serum samples collected from the study area during the year 2017, were screened for anti-hepatitis C IgG by enzyme-linked immunosorbent assay. The serum samples screened positive were then subjected to molecular testing for confirmation. Results: Among the 702 study participants screened, 16 cases were reported to be anti-HCV IgG positive with an estimated seroprevalence rate of 2.3% (95% confidence interval: 1.4%–3.7%). Out of the 16 cases, two samples were confirmed positive by molecular testing indicating active infection. When analysed phylogenetically, one strain was genotyped as HCV1b genotype, and the other one was clustered along with HCV3a genotype. Both the patients with hepatitis C infection were observed to be having a probable 1-year survival rate of 100% and a 2-year survival rate of 85% when the Child-Turcotte-Pugh classification was applied. Conclusion: The estimated seroprevalence of hepatitis C in Idar Taluk, Sabarkantha district, west India was 2.3%. HCV genotypes 1b and 3a were observed to be circulating in the study area.

Ethosomes as Novel Drug Delivery System: A Review.

The ethosomes are vesicular carrier comprise of hydroalcoholic or hydro/alcoholic/glycolic phospholipid in which the concentration of alcohols or their combination is relatively high. To provide continuous drug infusion through an intact skin, several transdermal therapeutic systems have been developed for topical application onto the intact skin surface to control the delivery of drug and its subsequent permeation through the skin tissue. Transdermal route is promising alternative to drug delivery for systemic effect. An attempt was made to formulate the highly efficient ethosomal drug delivery system and enalapril meleate is used as model drug. The following conclusion are drown from the result and discussion described in the previous chapter. Liposomal formulation was also prepared by the thin film hydration method. The techniques used were simple and reproducible. The prepared ethosomes were spherical and discrete in shape. The size of vesicles were found to be in the range of 3.26-5.79 tim,o.716-1.3o1 tim and 5.32 tim for unsonicated ethosomes, sonicated ethosomes and liposomes respectively. However ethosomes prepared by sonication method were more uniform and smaller in size, which is essential for skin permeation. While comparing the entrapment efficiency, ethosomes containing 3o% w/w ethanol and prepared by sonication showed highest value with respect to all other formulation, so it is concluded ethosomes prepared by sonication and containing 3o% w/w ethanol as the best formulation considering all other aspects. The highest value of transdermal flux for sonicated ethosomes containing 3o% w/w ethanol is the indication of complete and rapid penetration through the skin may be because of tiny vesicular size.

Frenectomy Using Diode Laser.

The labial frenum may impede oral hygiene and result in diastema between anterior teeth and traction of the attached gingiva. High coronal attachment is generally associated with a hypertrophy of the frenum. Labial frenectomy is a common surgical procedure in the field of oral surgery 1. Labial frenectomy is a procedure usually done for orthodontic reasons. Surgical removal of the frenum during puberty has been recommended for these patients 2. This article clinically evaluates the efficacy of a diode laser in removing the frenum in 10 patients using a diode laser at a power setting of 1.5 W or less in a continuous mode. The role of laser surgery in the oral cavity is well established. The use of diode laser in frenectomy has many advantages like no bleeding, no need for suture placement, and placement of orthodontic brackets that can be done on the same day itself.

A overview: non-steroidal anti-inflammatory drugs and mechanisms.

The inflammatory response represents a generalized response to infection or tissue damage and is designed to remove cellular debris, to localize invading organisms and arrest the spread of infection. NSAIDS are metabolized primarily in the liver. They vary in their half-lives and bioavailability. Given the multitude of available NSAIDs, the variability of their half-lives allows for different dosing regimens. The fluid in the inflamed area is known as inflammatory exudates, commonly called as pus. These exudates contain dead cells and debris in addition to body fluids. The inflammatory response is characterized by the following symptoms: Reddening of the localized area, swelling, pain and elevated temperature. Reddening results from capillary dialation that allows more blood to flow to the damaged tissue. Elevated temperature results from capillary dialation which permits increased blood flow through these vessels, with associated high metabolic activities of neutrophils and macrophages. The release of histamine from mast cells during antigen antibody reactions is well known, as is its involvement in the inflammatory response to skin injury. The present review focused on list and precautions of NSAID with its typed and classification, Analgesic activity study, histamine.

UV Spectrophotometric Method for the Simultaneous Determination of Desloratidine and Pseudoephedrine HCl in Combined Dosage Form.

Aims: UV Spectrophotometric Method for the Simultaneous Determination of Desloratidine and Pseudoephedrine HCl in combined Dosage form. Study Design: A simple, rapid and specific UV spectroscopic method with good sensitivity was developed and validated for the simultaneous determination of Desloratidine and Pseudoephedrine HCl in bulk and pharmaceutical dosage form. Place and Duration of Study: Department of pharmaceutical Analysis & Quality Assurance, School of Pharmacy, Anurag Group of Institutions, Venkatapur, R.R Dist, Andhra Pradesh, India during February 2013 and April 2013. Methodology: Vierodt’s (Simultaneous equation) method was performed for Estimation of Desloratidine and Pseudoephedrine HCl in Pharmaceutical dosage form. Results: In Ethanol the max of Desloratidine and Pseudoephedrine HCl was fixed as 240 and 258 nm respectively using a Shimadzu UV-Visible spectrophotometer. In this proposed method both drugs obeyed linearity within the concentration range of 5-30 g/ml and 80-800 g/ml for Desloratidine and Pseudoephedrine HCl respectively. The low RSD values indicate good precision and high recovery values indicate accuracy of the proposed method. The proposed method has been applied to the determination of drugs in commercial formulations. Assay results were in good agreement with label claim. The method was validated as per ICH guidliness. Conclusion: The developed method was simple, accurate, precise, specific, sensitive and reproducible which can be efficiently and easily applied to pharmaceutical dosage forms.

Management of maxillo-facial cases in dental office: a report of four cases

To expose the importance of evidence based and clinical based treatment plan versus the outdated descriptive method of dental/maxillofacial treatment. We have projected four classical maxillo-facial cases referred to GMC Sharjah oral surgery clinic seeking suitable treatment. In reference to the case reports we executed the treatment plan based on evidence, thorough clinical evaluation and were unique from the earlier treatment as the nidus was treated rather than implementing descriptive routine treatment. So in these clinical cases we noticed that the patients had cosmetic, functional, aesthetic and psychological problems and had lost the hopes of definitive treatment to their needs and comfort. We did all the required invasive and non-invasive investigations and then spend time with patients in conducting detail case study which cracked the nidus and each case was dealt based on the cause and requirement which landed up with less invasive treatment procedure with less expense which was beneficial for the patient. To our clinical experience and with the recent updates we were able to simplify the treatment and execute the treatment such as simple precise excision of lip, changing the position of sleeping, stabilization of teeth with existing orthodontic wires and simple release of spasm of lateral pterygoid muscle under local anesthesia gave results with good prognosis[1, 2, 3, 6]. Detail case study with the existing clinical evidence would be appropriate for treating the cause and implementing the treatment protocol which would account for good efficient favorable treatment with least invasive procedure and with minimal expense. These cases had given full acceptance of the treatment implemented on them and the cases being kept classified and their prior acceptance photos and their treatment are discussed

Falling Between Two Stools: Operational Inconsistencies between ICDS and NRHM in the Management of Severe Malnutrition.

There has been a welcome interest in the issue of malnutrition by policy makers as well as technical experts in the recent years. The current public health systems for management of malnutrition, the ICDS and NRHM, have attempted to evolve approaches to the management of severe malnutrition. This paper makes a fresh analysis of data from well-accepted existing sources, indicating that 36- 44% of all children with Severe Acute Malnutrition (SAM) are likely to be missed by current criteria of screening and referral; simultaneously, a large proportion of children selected for referral to Nutritional rehabilitation centres are likely not to have SAM. The paper also highlights other areas of inconsistencies between the ICDS and the NRHM in the continuum of care required for the prevention and proper management of severe malnutrition. Thus, the paper identifies areas that need further exploration to achieve a seamless and effective program for tackling severe malnutrition.

Dissociative paraplegia and other fleeting dissociative symptoms - difficulties in evaluation and management: a case report

Dissociative symptoms at times amounting to disorders are common and are culturally accepted in manyAsian cultures but presenting not often to the psychiatric facility for management. This case report is todiscuss about problems in evaluation of new symptoms during the course and difficulties in different managementstrategies. This is a case report of a female patient presenting with dissociative paraplegia for more than 8months duration with resistance and substitution of symptoms during the process of management.

Study of psychological morbidity & coping mechanisms in family members of persons with mental illnesses

Background: The psychological morbidity of family members of mentally ill is generally overlooked. This studyfocuses on the psychological morbidity in family members.Aim : To study psychological morbidity and coping mechanisms used by the family members of mentally ill admittedin psychiatric hospital.Methods: A sample of 45 family members of mentally ill admitted in The Institute of Mental Health, Hyderabad wastaken. Severity of illness in patients and psychological morbidity and coping mechanisms used by the family memberswere assessed.Results : There is no significant psychological morbidity among the family membersConclusions Acceptance is the most common coping mechanism used by family members of persons with mental illness.

Evidence of Late Palaeocene-Early Eocene equatorial rain forest refugia in southern Western Ghats, India.

Equatorial rain forests that maintain a balance between speciation and extinction are hot-spots for studies of biodiversity. Western Ghats in southern India have gained attention due to high tropical biodiversity and endemism in their southern most area. We attempted to track the affi nities of the pollen fl ora of the endemic plants of Western Ghat area within the fossil palynofl ora of late Palaeocene-early Eocene (~55–50 Ma) sedimentary deposits of western and northeastern Indian region. The study shows striking similarity of extant pollen with twenty eight most common fossil pollen taxa of the early Palaeogene. Widespread occurrences of coal and lignite deposits during early Palaeogene provide evidence of existence of well diversifi ed rain forest community and swampy vegetation in the coastal low lying areas all along the western and northeastern margins of the Indian subcontinent. Prevalence of excessive humid climate during this period has been seen as a result of equatorial positioning of Indian subcontinent, superimposed by a long term global warming phase (PETM and EECO) during the early Palaeogene. The study presents clear evidence that highly diversifi ed equatorial rain forest vegetation once widespread in the Indian subcontinent during early Palaeogene times, are now restricted in a small area as a refugia in the southernmost part of the Western Ghat area. High precipitation and shorter periods of dry months seem to have provided suitable environment to sustain lineages of ancient tropical vegetation in this area of Western Ghats in spite of dramatic climatic changes subsequent to the post India-Asia collision and during the Quaternary and Recent times.

Quality of life outcome measures following partial glossectomy: assessment using the UW-QOL scale.

BACKGROUND: The consequences of a diagnosis of head and neck cancer and the impact of treatment have a clear and direct influence on well-being and associated quality of life (QOL) in these patients. AIMS: To determine the QOL in head and neck cancer patients following a partial glossectomy operation. DESIGN AND SETTING: Cross-sectional cohort study; Head and Neck Oncology Unit, tertiary referral center. Materials and METHODS: 38 patients with partial glossectomy were assessed with the University of Washington head and neck quality of life (UW-QOL) scale, version 4. STATISTICAL ANALYSIS: Statistical analysis was performed using the Statistical Package for Social Sciences 10.0 (SPSS Inc, Chicago version III). Information from the scale was correlated using the Mann Whitney test. A P value less than/equal to 0.05 was considered as significant. RESULTS: The mean (sd) composite score of the QOL in our series was 73.6 (16.1). The majority (71.8%) quoted their QOL as good or very good. Swallowing (n = 16, 47.1%), speech (n = 15, 44.1%) and saliva (n = 15, 44.1%) were most commonly cited issues over the last 7 days. On the other hand, the groups with reconstruction, neck dissection, complications and radiotherapy demonstrated a significant reduction of quality of life scores (Mann Whitney test, P < 0.005). CONCLUSION: The composite score and overall QOL as assessed using the UW-QOL scale (version 4) were modestly high in our series of partial glossectomy patients. Swallowing, speech, and saliva are regarded as the most important issues. Stage of the disease, neck dissection, reconstruction, complications, radiotherapy and time since operation were seen to significantly affect domain scores.

Annual risk of tuberculosis infection in Chennai city.

AIM: To study the proportion of children infected with Mycobacterium Tuberculosis in Chennai city. METHODOLOGY: A cluster sampling methodology was adopted to select an estimated sample size of 7000 children from five corporation zones selected systematically from ten zones of the city. A total of 7098 children aged 1-9 years were subjected to Mantoux and test read; 1897 (27%) from slum area and 5201 (73%) from non-slum area. RESULTS: The prevalence of infection among children without BCG scar was estimated to be 10.5 % (ARTI of 2.0%) and was similar to that among children irrespective of scar status. The prevalence of infection was higher among children in slum areas (11.1%; ARTI 2.1%) compared to non-slum areas (8.9%; ARTI 1.7%); but the difference was not statistically different. CONCLUSION: The tuberculosis situation in Chennai as measured by risk of infection was higher in urban city area than rural areas and comparable to that found in other cities as reported from earlier studies. This information can be used as baseline information for monitoring the epidemiological trends in Chennai city in future.

Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force.

AIMS: To study the profile of irritable bowel syndrome (IBS), and the frequency of such symptoms among the general population, in India. METHODS: In this prospective, multi-center study, data were obtained from 2785 patients with chronic lower gastrointestinal symptoms (complainants) with no alarm feature and negative investigations for organic causes visiting physicians at 30 centers, and from 4500 community subjects (non-complainants), using separate questionnaires. RESULTS: Most complainants were middle-aged (mean age 39.4 years) and male (1891; 68%). The common symptoms were: abdominal pain or discomfort (1958; 70%), abdominal fullness (1951; 70%); subjective feeling of constipation (1404 of 2656; 53%), or diarrhea (1252 of 2656, 47%), incomplete evacuation (2134; 77%), mucus with stools (1506; 54%), straining at stools (1271; 46%), epigastric pain (1364; 49%) and milk intolerance (906; 32%). Median stool frequency was similar in patients who felt they had constipation or those who felt they had diarrhea. Information to subtype symptoms using standard criteria was available in 1301 patients; of these, 507 (39%) had constipation-predominant IBS ( 3 <or= stools/week), 50 (4%) had diarrhea-predominant IBS (>3 stools/day) and 744 (57%) had indeterminate symptoms. Among non-complainants, most subjects reported daily defecation frequency of one (2520 [56%]) or two (1535 [34%]). Among non-complainants, 567 (12.6%) reported abdominal pain, 503 (11%) irregular bowel, 1030 (23%) incomplete evacuation, 167 (4%) mucus and 846 (18%) straining at stools; a combination of abdominal pain or discomfort relieved by defecation, and incomplete evacuation was present in 189/4500 (4.2%) community subjects. CONCLUSIONS: Most patients with IBS in India are middle-aged men, and have a sense of incomplete evacuation and mucus with stools. Abdominal pain or discomfort is frequent but not universal. Importantly, stool frequency was similar irrespective of whether the patients felt having constipation or diarrhea. Most (90%) non-complainant subjects had 1 or 2 stools per day; symptoms complex suggestive of IBS was present in 4.2% of community subjects.

Tobacco control in schools of India: review from India Global School Personnel Survey 2006.

School personnel are role models for students, teachers of tobacco use prevention curricula, and key influencers for tobacco control policies in schools. With their daily interactions and strong influence on their students they represent an influential group for tobacco control. Data collected through the Global School Personnel Survey during 2006 in 180 school; of 6 regions of India have shown that a large proportion (29%) of school personnel used tobacco. The scarcity of tobacco free school policies and relevant teaching materials (non existent in 62% of schools surveyed) and lack of training among school personnel (84%) reported in this study indicate the extent of undermining the scope of prevention efforts in schools to reduce adolescent tobacco use prevalence in India. Majority of school personnel in India strongly agreed that they should receive specific training to help students avoid or stop using tobacco. Training of school personnel along with introduction of comprehensive school policies and its vigorous enforcement will help adolescent students and school personnel to adopt and maintain a tobacco free lifestyle.

Avaliação do tamanho do átrio esquerdo pelo ecocardiografia tridimensional em indivíduos com anatomia cardíaca normal, em pacientes com cardiopatia dilatada ou cardiomiopatia hipertrófica: comparação com medidas do ecocardiograma bidimensional / Evaluation of the left atrium by tridimensional echocardiography in normal volunteers, in patients with dilated and hypertrophic cardiomyopathy: comparison with bidimensional echocardiography

Introdução: A análise do átrio esquerdo (AE) é importante para o entendimento da fisiopatologia de diferentes doenças cardíacas. Objetivo: Comparar as medidas do AE pelo ecocardiografia bidimensional (eco 2D) com as realizadas ao ecocardiograma tridimensional (eco 3D). Método: estudo prospectivo de medidas do AE ao eco 2D e 3D em 110 indivíduos: 47 com anatomia cardíaca normal (N),44 com cardiomiopatia dilatada (CMD), 19 com cardiomiopatia hipertrofica (HOCM), 62 eram homens, e a média de idade de 42 mais ou menos 16 anos). As medidas do AE pelo eco 2D foram: diâmetro ântero-posterior (AP), diâmetro inferior-superior(IS), médio-lateral (ML), área (2DAr), volume (2DV). Pelo eco 3D foi medido o volume do AE (3DV).Para a análise estatística foram aplicados: coeficiente de correlação de Spearman(r), 95 por cento IC, teste de Bland & Altman e regressão linear. Resultados: Os valores do volume do AE (ml) ao eco 3D e eco 2D, foram, respectivamente, no grupo N de 38 mais ou menos e 32,2 mais ou menos 78, no grupo CMD de 81,2 mais ou menos 30 e 63,6 mais ou menos 24 e no grupo HOCM de 75 mais ou menos 26 e 62,8 mais ou menos 21. No grupo N o coeficiente de correlação entre o 3DV com o...