RESUMO
Background: India Hypertension Control Initiative (IHCI) was launched in 2017 to improve the control rate of hypertensive patients on treatment. Thiruvananthapuram was one of the 26 districts in the coun-try where the programme was initially rolled out. Methods: A qualitative cross-sectional study was conducted among stakeholders involved in the imple-mentation of IHCI of Thiruvananthapuram district. Purposive sampling method was used for the selec-tion of samples. A total of 25 in-depth interviews were carried out. Results: The major facilitators which propelled hypertension control were uniformity in drug prescrip-tion, proper documentation of patient data along with indicators for measuring control rates and a de-faulter tracking mechanism. Clinical inertia among doctors, increased workload and sending of bystand-ers for monthly follow-up are the major barriers that affected hypertension control. Conclusions: Replication of good practices performed under IHCI into similar health settings or pro-grammes can be encouraged. Apart from the few barriers seen at the programme level, the already exist-ing barriers at the health system level need to be addressed immediately through efforts such as e-Health incorporation and trainings.
RESUMO
Background Common carotid artery lumen diameter (LD) ultrasound measurement systems are either manual or semi-automated and lack reproducibility and variability studies. This pilot study presents an automated and cloud-based LD measurements software system (AtheroCloud) and evaluates its: (i) intra/inter-operator reproducibility and (ii) intra/inter-observer variability. Methods 100 patients (83 M, mean age: 68 ± 11 years), IRB approved, consisted of L/R CCA artery (200 ultrasound images), acquired using a 7.5-MHz linear transducer. The intra/inter-operator reproducibility was verified using three operator’s readings. Near-wall and far carotid wall borders were manually traced by two observers for intra/inter-observer variability analysis. Results The mean coefficient of correlation (CC) for intra- and inter-operator reproducibility between all the three automated reading pairs were: 0.99 (P < 0.0001) and 0.97 (P < 0.0001), respectively. The mean CC for intra- and inter-observer variability between both the manual reading pairs were 0.98 (P < 0.0001) and 0.98 (P < 0.0001), respectively. The Figure-of-Merit between the mean of the three automated readings against the four manuals were 98.32%, 99.50%, 98.94% and 98.49%, respectively. Conclusions The AtheroCloud LD measurement system showed high intra/inter-operator reproducibility hence can be adapted for vascular screening mode or pharmaceutical clinical trial mode.
RESUMO
The aim of the present study was to investigate the pancreatic regeneration potential of of diferent fractions of the ethanol extract Clitoria ternatea L., Fabaceae. The antidiabetic and antihyperlipidemic potential was evaluated in streptozotocin-induced diabetic rats and correlated with its in vivo and in vitro antioxidant activity. The extract and its fractions were initially screened for acute and sub-chronic antidiabetic activity in the dose range of 100200 mg/kg. The most potent extract and fractions were further evaluated for pancreatic β-cells regeneration activity along with antioxidant and antihyperlipidemic activity. The polyphenolic, flavonoid and flavanone contents were assessed and correlated with its antidiabetic activity. The most significant pancreatic regeneration activity, antidiabetic and antihyperlipidemic activity and was shown by ethanol extract and butanol soluble fraction at a dose level of 200 mg/kg, while rutin was found to be least potent. In conclusion, pancreatic regeneration studies of ethanol extract treated rats show nesidioblastosis. It is also suggested that the factors causing regeneration are present within the pancreas. The newly generated islets may have formed from the ductal precursor cells and reduced oxidative stress helps in restoration of β-cell function.