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Background: The World Health Organization's "End TB Strategy" aims to end global tuberculosis (TB) epidemic through a holistic combination of health and social interventions placing the patients and communities at the heart of the response. This study aimed to assess the effectiveness of utilizing school children as ambassadors in TB advocacy. Materials and Methods: We adopted a quasi-experimental intervention design where students' awareness level was assessed before and after the intervention. A total of 185 student ambassadors were trained to conduct interventions in schools, and 920 students were randomly selected to assess the impact of the ambassador's intervention. A structured questionnaire was used to assess the correct and incorrect knowledge on specific aspects of TB. This intervention study was implemented in a phased manner which involved a participatory formative phase. A student-friendly and culturally relevant educational materials and activities for providing TB knowledge for the study student population were developed. Data collected from the baseline and end-line evaluation surveys were analyzed using STAT Ver. 16.0.- Stata Corp., June 2016, USA. Results: A significant increase (>80%; P < 0.05) in the correct knowledge on diagnosis and prevention for TB was noted among sampled students (n = 818) before and after intervention. Reduction in incorrect knowledge, like understanding TB as hereditary disease, was found to be less (50%; P < 0.05). Conclusions: School students lead intervention could significantly improve correct knowledge on TB and could be replicated.
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AIM: To quantify the percentage filling of the gutta-percha in obturated root canal cavity using image processing and analysis. METHODOLOGY: The image processing and analysis using the X-ray radiographs is commonly being used by medical practitioners for easy and speedy diagnosis of patient health. But these methods are qualitative and assessment depends upon dentist's own experience and perception. Fifteen patients were randomly assigned to fifteen Dentists to perform the root canal treatment using warm vertical condensation. X-ray radiographs of pre and post obturation were obtained to carry image processing and analysis. Image enhancement, low pass filtering, k-means clustering algorithm and edge detection technique were applied to get results. Percentage filling of the obturated root canal using X-ray radiography (Dentist's prediction) and proposed algorithm results of the present study were compared. Out of fifteen Dentists, the prediction of twelve Dentists were close in range of percentage filling quantified using proposed algorithm of the present study. When investigated it was found that three discrepancies found due to lack of sufficient experience of the respective Dentist. The proposed algorithm not only helps to overcome this false assessment but also helps to quantify accurate percentage filling of gutta-percha and outlines unfilled cavity gap of root canal. RESULTS: The proposed algorithm of present study provides accurate percentage filling of gutta-percha in the obturated root canal up to two decimal points. The present study used gutta-percha as obturation material but the study can be implemented for any obturation material. CONCLUSION: The proposed algorithm of present study accurately quantified the percentage filling of root canal cavity using image processing. It also locates and outlines the unfilled root canal cavity.
ABSTRACT
AIM: To develop the mathematical model for root canal preparation using Endodontic file. METHOD: The process of obturation consist of the filling of the root canal cavity using heated and softened gutta-percha to get the fluid tight seal in between the canal wall and filled gutta-percha. Any obturation process to perform before it requires the preparation of the root canal which involves the removing dead tissue, substrates and debris from the decayed root canal. The various geometric parameters viz. Taper, relative angle for orientation of cross-section between two planes, pitch and polar symmetry constant of the Endodontic file etc. Geometric parameters are derived. The various performance parameters like Endodontic file life assessment, cutting force components (tangential and normal), substrate removal rate, torque exerted by Endodontic file etc are also derived successfully. The Endodontic file life is estimated based on two approaches viz. speed and volumetric wear approach. CONCLUSION: The mathematical model described is helpful for the Endodontic experts, researchers, design engineers etc. However the applicability of the described mathematical model limited to assumption of study. The gap between root canal to be prepared and Endodontic file is zero while preparation. The Endodontic file weight, speed of rotation and substrate removal rate is assumed to be constant. The mathematical model for Endodontic file discussed above proved to be efficient tool for studying the root canal preparation. The various geometric parameters and the various performance parameters are derived.
ABSTRACT
Setting: National Institute for Research in Tuberculosis, Madurai, India. Objective: To determine the efficacy of physician's advice on quitting smoking compared with standard counselling in patients with tuberculosis (TB) and patients with human immunodeficiency virus (HIV) infection. Design/Methods: This was a clinical trial conducted in Madurai, south India, among 160 male patients (80 with TB and 80 with HIV), randomised and stratified by nicotine dependence (low/high according to the Fagerström scale), who received physician's advice with standard counselling or standard counselling alone for smoking cessation. Abstinence at 1 month was assessed by self-report and carbon monoxide breath analysis. Results: The patients' mean age was 39.4 years (SD 8.5). Overall, 35% of the patients had high nicotine dependence. Most patients (41%) smoked both cigarettes and bidis. In a combined analysis including both the HIV and the TB groups, quit rates were 41% of the 68 patients in the physician group and 35% of the 68 patients in the standard counselling arm. Conclusions: Physician's advice to quit smoking delivered to patients with TB or HIV is feasible and acceptable. Smoking cessation could easily be initiated in TB patients in programme settings. Future studies should assess long-term abstinence rates with a larger sample size to demonstrate the efficacy of physician's advice.
Contexte : National Institute for Research in Tuberculosis (NIRT), Madurai, Inde.Objectif : Déterminer l'efficacité des conseils d'un médecin comparés aux conseils standard d'arrêt du tabac chez des patients atteints de tuberculose (TB) et chez des patients infectés par le virus de l'immunodéficience humaine (VIH).Schéma/Méthodes : Cet essai clinique a été réalisé à Madurai, dans le sud de l'Inde. Cent soixante patients masculins (80 TB et 80 VIH) ont été randomisés, stratifiés en fonction de leur dépendance à la nicotine (faible/élevée selon l'échelle de Fagerström) pour bénéficier soit des conseils d'un médecin avec des conseils standard ou des conseils standard seuls pour l'arrêt du tabac. L'abstinence à un mois a été évaluée par déclaration des patients et analyse du monoxyde de carbone dans l'air expiré.Résultats : L'âge moyen (DS) a été de 39,4 (±8,5) ans. Dans l'ensemble, 35% des patients avaient une dépendance élevée à la nicotine. La majorité des patients (41%) fumait à la fois des cigarettes et des bidis (cigarettes indiennes). En analyse combinée (à la fois le groupe VIH et TB), les taux de cessation ont été de 41% sur 68 patients dans le groupe « médecin ¼ et de 35% de 68 patients dans le bras « conseil standard ¼ (non significatif).Conclusions: Les conseils d'un médecin en matière d'arrêt de tabac délivrés aux patients atteints de TB ou de VIH sont faisables et acceptables. L'arrêt du tabac pourrait bien être mis en Åuvre dans le contexte des programmes chez les patients TB. De futures études devraient évaluer le taux d'abstinence à long terme avec des échantillons de plus grande taille afin de démontrer l'efficacité des conseils d'un médecin.
Marco de referencia: El Instituto Nacional de Investigación en Tuberculosis de Madurai, en la India.Objetivo: Comparar la eficacia de los consejos que da el médico con el asesoramiento corriente sobre el abandono del tabaco, en pacientes aquejados de tuberculosis (TB) o infección por el virus de la inmunodeficiencia humana (VIH).Métodos: El ensayo clínico inicial se llevó a cabo en Madurai, en el sur de la India. Se escogieron de manera aleatoria 160 pacientes de sexo masculino (80 con diagnóstico de TB y 80 de infección por el VIH), se estratificaron en función de la dependencia de la nicotina (baja y alta, según la escala de Fagerström) y se asignaron a un grupo que recibiría consejos del médico además del asesoramiento corriente sobre el abandono del tabaco o un grupo que solo recibiría el asesoramiento corriente. Al cabo de un mes, se evaluó la abstinencia a partir de la información proporcionada por los pacientes y la medición de monóxido de carbono en el aire espirado.Resultados: El promedio de edad de los participantes fue 39,4 años (desviación estándar 8,5 años). En general, el 35% de los participantes exhibía una alta dependencia de la nicotina. La mayoría fumaba cigarrillos y también bidis (41%). En el análisis conjunto (ambos grupos: TB y VIH), las tasas de abandono fueron 41% en los 68 pacientes del grupo que recibió consejo médico y 35% en los 68 pacientes del grupo que obtuvo asesoramiento corriente (diferencia no significativa).Conclusión: El consejo sobre el abandono del tabaco ofrecido por el médico a los pacientes con diagnóstico de TB o infección por el VIH es factible y bien aceptado. Es posible iniciar intervenciones de abandono del tabaco con los pacientes TB en el marco programático. Futuros estudios podrían evaluar las tasas de abstinencia a largo plazo con muestras más grandes, a fin de demostrar la eficacia del consejo dado por los médicos.
ABSTRACT
Men who have sex with men (MSM) are at increased risk for HIV infection in India, particularly those who engage in transactional sex with other men (i.e., male sex workers; MSW). Despite the need, HIV prevention efforts for Indian MSW are lacking. As in other settings, MSW in India increasingly rely on the use of mobile phones for sex work solicitation. Integrating mobile phone technology into an HIV prevention intervention for Indian MSW may mitigate some of the challenges associated with face-to face approaches, such as implementation, lack of anonymity, and time consumption, while at the same time proving to be both feasible and useful. This is a pilot randomized controlled trial to examine participant acceptability, feasibility of study procedures, and preliminary efficacy for reducing sexual risk for HIV. MSW (N = 100) were equally randomized to: (1) a behavioral HIV prevention intervention integrating in-person and mobile phone delivered HIV risk reduction counseling, and daily, personalized text or voice messages as motivating "cognitive restructuring" cues for reducing condomless anal sex (CAS); or (2) a standard of care (SOC) comparison condition. Both groups received HIV counseling and testing at baseline and 6-months, and completed ACASI-based, behavioral and psychosocial assessments at baseline, 3, and 6 months. Mixed-effects regression procedures specifying a Poisson distribution and log link with a random intercept and slope for month of follow-up was estimated to assess the intervention effect on the primary outcomes: (1) CAS acts with male clients who paid them for sex, and (2) CAS acts with male non-paying sexual partners-both outcomes assessed over the past month. The intervention was both feasible (98% retention at 6-months) and acceptable (>96% of all intervention sessions attended); all intervention participants rated the intervention as "acceptable" or "very acceptable." A reduction in the reported number of CAS acts with male clients who paid them for sex in the past month was seen in both study conditions. MSW in the intervention condition reported a faster rate of decline in the number of CAS acts with male clients in the past month from the baseline to both the 3-month (B = -1.20; 95% CI -1.68, -0.73; p < 0.0001) and 6-month (B = -2.44; 95% CI -3.35, -1.53; p < 0.00001) assessment visits compared to the SOC condition. Post-hoc contrasts indicated that, at 3 months, participants in the intervention condition reported 1.43 (SD = 0.29) CAS acts with male clients in the past month compared to 4.85 (SD = 0.87) in the control condition (p = 0.0003). Furthermore, at 6 months, the intervention condition participants reported 0.24 (SD = 0.09) CAS acts with male clients in the past month compared to 2.79 (SD = 0.79) in the control condition (p < 0.0001). Findings are encouraging and provide evidence of feasibility and acceptability, and demonstrate initial efficacy (for reducing sexual risk for HIV) of a behavioral HIV prevention intervention for Indian MSW that combines daily, personalized text or voice messages with mobile phone-delivered sexual risk reduction counseling and skills building. Future testing of the intervention in a fully powered randomized controlled efficacy trial is warranted.
