BACKGROUND: Predicting complete closure of large ventral hernias without component separation (CS) could have clinical value. The utility of multidetector computed tomography (MDCT)-based component separation index (CSI) was derived and evaluated for these hernias. METHODS: In 60 patients with a ventral hernia, a CSI was calculated based on their MDCT. In group I (first 30 patients), hernia repair was performed by an open approach and operative assessment determined the need for CS to effect complete closure. A CSI value above which defect closure needed CS was taken as the CSI reference point. In group II (second 30 patients), the hernia repair was done laparoscopically. Patients with a CSI at or below the reference point of group I underwent intraperitoneal onlay mesh (IPOM) after direct closure of the defect (IPOM-plus). The other patients had bilateral endoscopic component separation (ECS) before entry into the peritoneal cavity for an intended IPOM-plus. RESULTS: A CSI above 0.067 and 0.044 in open and laparoscopic approaches respectively required CS for complete defect closure. A CSI above 0.25 and 0.125 in open and laparoscopic approaches respectively, despite CS, predicted complete closure of defect was not possible. CONCLUSION: CSI is a more comprehensive parameter for evaluation of ventral hernia than the conventional two-dimensional parameters and can predict the need of component separation prior to complete closure of the defect in both laparoscopic and open approach.

Abstract Present study analysed the therapeutic potential of traditionally acclaimed medicinal herb Nanorrhinum ramosissimum, using plant parts extracted with different solvents (10 mg/mL). Shoot extracts exhibited comparatively better antimicrobial properties, in comparison to root extracts. Total phenolic content was estimated, to ascertain its dependency on antioxidant properties of plant extracts. Antioxidant assay revealed promising results in comparison to IC50 value of standard ascorbic acid (52.2±0.07 µg/mL), for methanolic extracts of shoot (61.07±0.53 µg/mL and 64.33±0.33 µg/mL) and root (76.705±0.12 µg/mL and 89.73±0.28 µg/ mL) for in vivo and in vitro regenerants respectively. Correlation coefficient R2 values ranged between 0.90-0.95, indicating a positive correlation between phenolic contents and antioxidant activity. Plant extracts were also able to inhibit DNA oxidative damage again indicating their antioxidative potential. Antidiabetic potential was confirmed by alpha amylase inhibition assay where shoot methanolic extracts (invivo, in vitro) exhibited the best IC50 values (54.42±0.16 µg/mL, 66.09±0.12 µg/mL) in comparison to standard metformin (41.92±0.08 µg/mL). Ethanolic extracts of roots (in vitro, invivo) exhibited the relative IC50 values (88.97±0.32µg/mL,96.63±0.44 µg/mL) indicating that shoot parts had a better alpha amylase inhibition property; thus proving the herb’s bioactive potential and its prospective therapeutic source for curing various ailments. ramosissimum 10 (1 mg/mL. mgmL mg/mL . mg mL mg/mL) estimated IC IC5 52.2±0.07 522007 52 2 0 07 (52.2±0.0 µgmL , µg 61.07±0.53 6107053 61 53 (61.07±0.5 6433033 64 33 64.33±0.3 76.705±0.12 76705012 76 705 12 (76.705±0.1 8973028 89 73 28 89.73±0.2 respectively R 0.900.95, 090095 0.90 0.95, 90 95 0.90-0.95 activity invivo, invivo (invivo 54.42±0.16 5442016 54 42 16 (54.42±0.1 6609012 66 09 66.09±0.1 41.92±0.08 4192008 41 92 08 (41.92±0.0 µg/mL. 88.97±0.32µg/mL,96.63±0.44 8897032µgmL9663044 88 97 32µg 96 63 44 (88.97±0.32µg/mL,96.63±0.4 property herbs s ailments 1 ( 52.2±0.0 52200 5 (52.2±0. 61.07±0.5 610705 6 (61.07±0. 643303 3 64.33±0. 76.705±0.1 7670501 7 70 (76.705±0. 897302 8 89.73±0. 900 0.900.95 09009 090 0.9 095 0.95 9 0.90-0.9 54.42±0.1 544201 4 (54.42±0. 660901 66.09±0. 41.92±0.0 419200 (41.92±0. 88.97±0.32µg/mL,96.63±0.4 8897032µgmL966304 (88.97±0.32µg/mL,96.63±0. 52.2±0. 5220 (52.2±0 61.07±0. 61070 (61.07±0 64330 64.33±0 76.705±0. 767050 (76.705±0 89730 89.73±0 0.900.9 0900 0. 0.90-0. 54.42±0. 54420 (54.42±0 66090 66.09±0 41.92±0. 41920 (41.92±0 88.97±0.32µg/mL,96.63±0. 8897032µgmL96630 (88.97±0.32µg/mL,96.63±0 52.2±0 522 (52.2± 61.07±0 6107 (61.07± 6433 64.33± 76.705±0 76705 (76.705± 8973 89.73± 0.900. 0.90-0 54.42±0 5442 (54.42± 6609 66.09± 41.92±0 4192 (41.92± 88.97±0.32µg/mL,96.63±0 8897032µgmL9663 (88.97±0.32µg/mL,96.63± 52.2± (52.2 61.07± 610 (61.07 643 64.33 76.705± 7670 (76.705 897 89.73 0.900 0.90- 54.42± 544 (54.42 660 66.09 41.92± 419 (41.92 88.97±0.32µg/mL,96.63± 8897032µgmL966 (88.97±0.32µg/mL,96.63 52.2 (52. 61.07 (61.0 64.3 76.705 767 (76.70 89.7 54.42 (54.4 66.0 41.92 (41.9 88.97±0.32µg/mL,96.63 8897032µgmL96 (88.97±0.32µg/mL,96.6 52. (52 61.0 (61. 64. 76.70 (76.7 89. 54.4 (54. 66. 41.9 (41. 88.97±0.32µg/mL,96.6 8897032µgmL9 (88.97±0.32µg/mL,96. (5 61. (61 76.7 (76. 54. (54 41. (41 88.97±0.32µg/mL,96. 8897032µgmL (88.97±0.32µg/mL,96 (6 76. (76 (4 88.97±0.32µg/mL,96 (88.97±0.32µg/mL,9 (7 88.97±0.32µg/mL,9 (88.97±0.32µg/mL, 88.97±0.32µg/mL, (88.97±0.32µg/mL 88.97±0.32µg/mL

Abstract Background Post-spinal anesthesia hypotension is of common occurrence, and it hampers tissue perfusion. Several preoperative factors determine patient susceptibility to hypotension. This study aimed to assess the effectiveness of the Inferior Vena Cava Collapsibility Index (IVCCI) for predicting intraoperative hypotension. Methods One hundred twenty-nine adult patients who were scheduled for elective surgical procedures after administration of spinal (intrathecal) anesthesia were included in the study. Ultrasound evaluation of the Inferior Vena Cava (IVC) was done in the preoperative area, and the patients were shifted to the Operating Room (OR) for spinal anesthesia. An independent observer recorded the change in blood pressure after spinal anesthesia inside the OR. Results Twenty-five patients developed hypotension (19.37%). Baseline systolic blood pressure and mean blood pressures were statistically higher in those patients who developed hypotension (p= 0.001). The logistic regression analysis for IVCCI and the incidence of hypotension showed r2 of 0.025. Receiver Operating Characteristic (ROC) curve analysis demonstrated the Area Under the Curve (AUC) of 0.467 (95% Confidence Interval, 0.338 to 0.597; p= 0.615). Conclusions Preoperative evaluation of IVCCI is not a good predictor for the occurrence of hypotension after spinal anesthesia. Postspinal Post perfusion (IVCCI twentynine twenty nine intrathecal (intrathecal IVC (IVC area OR (OR Twentyfive Twenty five 19.37%. 1937 19.37% . 19 37 (19.37%) p (p 0.001. 0001 0.001 0 001 0.001) r 0025 025 0.025 ROC (ROC AUC (AUC 0467 467 0.46 95% 95 (95 Interval 0338 338 0.33 0.597 0597 597 0.615. 0615 0.615 615 0.615) 193 19.37 1 3 (19.37% 000 0.00 00 002 02 0.02 046 46 0.4 9 (9 033 33 0.3 0.59 059 59 061 0.61 61 19.3 (19.37 0.0 04 4 0. ( 03 0.5 05 5 06 0.6 6 19. (19.3 (19. (19 (1

ABSTRACT In a recent recommendation, the World Health Organization (WHO) advises that adults and children reduce free sugars to less than 10% of total daily energy intake. This guidance is based on research evidence for the relationship between sugar and chronic non-communicable diseases, specifically obesity, type 2 diabetes mellitus (T2D), cardiovascular disease as well as dental caries. Over-consumption of free sugars has been attributed largely to the availability and popularity of sugar-sweetened beverages (SSBs). Recent data have shown that the Caribbean region as a whole has high consumption of SSBs and Trinidad and Tobago has been singled out for having the highest daily intake in the world. The need to implement the new WHO guidance on sugar consumption is urgent, given the high and apparently increasing prevalence of obesity, T2D and dental caries particularly among the nation's children. This paper recommends that national policy for Trinidad and Tobago aimed at reducing sugar consumption should be developed and implemented and that such policy should be based on strategies that have been shown to be effective internationally and regionally but leave ample room for locally relevant, culturally sensitive and socially acceptable innovative models of intervention.

Abstract For a given graph G, its line graph denoted by L(G) is a graph whose vertex set V (L(G)) = E(G) and {e1, e2} ∈ E(L(G)) if e1 and e2 are incident to a common vertex in G. Let R be a finite commutative ring with nonzero identity and G(R) denotes the unit graph associated with R. In this manuscript, we have studied the line graph L(G(R)) of unit graph G(R) associated with R. In the course of the investigation, several basic properties, viz., diameter, girth, clique, and chromatic number of L(G(R)) have been determined. Further, we have derived sufficient conditions for L(G(R)) to be Planar and Hamiltonian.

The present study involves the discovery of quality of soils associated with dump mines and native forest encompassing the Kakari mine, a coal mining site in Sonbhadra, to distinguish the effect of coal mining on associated soil ecosystem. Soil ecophysiological indicator of the site was analyzed in terms of floral diversity by method of quadrat analysis, which revealed that dumps were devoid of any floral community whereas the natural forest around the mines was enriched with a number of plant species. Importance value index (IVI) was calculated and with respect to their IVI index the tree species viz., Acacia mangium (23.17, 24.48 & 26.81) and Acacia catechu (20.34, 22.10 & 25.36) were found to be the most dominant species. Soil enzymatic and physico-chemical analysis were analyzed by standard method and the result emphasized that dump soils possess poor enzymatic activity and acidic pH due to the decomposition of waste material in dumps which eventually affects the microbial diversity of soil and its fertility. The plant growth promotion (PGP) and stress tolerance characteristics of bacterial isolates were further examined so that the potential isolates will be utilized further to reclaim and remediate soil property of degraded soils. The promising isolates were characterized by BIOLOG identification system and isolate NU36 and NU25 showed greatest similarity with Pseudomonas sp. and Acinetobacter sp. respectively. Based on the potential to produce plant growth promoting substances and withstand in stressed environment the most promising isolates will be used to remediate soil and reclaim soil characteristics.

OBJECTIVE: To describe India's National Antimalarial Drug Resistance Monitoring System, measure the efficacy of first-line malaria treatments, and determine risk factors for treatment failure. METHODS: In 2009-2010, prospective studies with 28 days of follow-up were conducted at 25 sentinel sites. Patients infected with Plasmodium falciparum were given artesunate plus sulfadoxine-pyrimethamine (AS+SP); those infected with P. vivax were given chloroquine. Polymerase chain reaction was used to distinguish post-treatment reinfection from treatment failure. Isolates of P. falciparum were checked for dhfr and dhps mutations. FINDINGS: Overall, 1664 patients were enrolled. Kaplan-Meier survival analysis showed an efficacy of 98.8% for AS+SP. Most patients with P. falciparum parasitaemia cleared their parasitaemias within 24 hours of treatment initiation, but six, including four with treatment failure, remained parasitaemic after 72 hours. Double mutants in dhfr were found in 68.4% of the genotyped isolates. Triple or quadruple mutants in dhfr and mutations in dhps were rare. A daily dose of artesunate of < 3 mg per kg of body weight, age of less than 5 years, and fever at enrolment were associated with an increased risk of treatment failure. Chloroquine remained 100% efficacious and generally cleared P. vivax parasitaemias within 48 hours. Vomiting (seen in 47 patients) was the most common adverse event. CONCLUSION: India's National Antimalarial Drug Resistance Monitoring System provides wide coverage. The first-line antimalarials used in the country remain safe and efficacious. The treatment of malaria in young children and the relative benefits of age- and weight-based dosing need further exploration.

OBJETIVO: Describir el sistema nacional de seguimiento de la resistencia a los fármacos contra el paludismo en India, medir la eficacia de los tratamientos de primera línea contra el paludismo y determinar los factores de riesgo en el fracaso del tratamiento. MÉTODOS: En los años 2009-2010, se llevaron a cabo estudios prospectivos con un seguimiento de 28 días en 25 sitios centinela. Se proporcionó artesunato con sulfadoxina-pirimetamina (AS+SP) a los pacientes infectados con Plasmodium falciparum, y cloroquina a los pacientes infectados con P. vivax . Se empleó la reacción en cadena de la polimerasa para distinguir la reinfección postratamiento del fracaso del tratamiento y se examinaron aislados de P. falciparum en busca de mutaciones de DHFR y DHPS. RESULTADOS: Se inscribieron un total de 1664 pacientes. Los análisis de supervivencia Kaplan-Meier mostraron una eficacia del 98,8% para el AS+SP. En la mayoría de pacientes con parasitemia por P. falciparum, ésta despareció en las 24 horas posteriores al inicio del tratamiento. Solo seis, incluidos los cuatro en los que el tratamiento fracasó, siguieron teniendo parasitemia pasadas 72 horas. Se encontraron mutantes dobles en DHFR en el 68,4% de los aislados genotipados. No fue frecuente encontrar mutantes en DHPS ni mutantes triples o cuádruples en DHFR. Una dosis diaria de artesunato de < 3 mg por kg de peso corporal, una edad inferior a 5 años y fiebre en el momento de la inscripción se asociaron con un riesgo superior de fracaso del tratamiento. La cloroquina fue eficaz en el 100% de los casos y eliminó, por lo general, las parasitemias por P. vivax en un plazo de 48 horas. El acontecimiento adverso más frecuente fueron los vómitos (presentes en 47 pacientes). CONCLUSIÓN: El sistema nacional de seguimiento de la resistencia a los fármacos contra el paludismo en India proporciona una cobertura amplia. Los fármacos antipalúdicos empleados en primera línea en el país continúan siendo seguros y eficaces. Se debe seguir examinando el tratamiento del paludismo en los niños pequeños y las ventajas relativas de la edad y las dosis basadas en el peso corporal.

OBJECTIF: Décrire le système national indien de surveillance de la résistance aux médicaments antipaludiques, mesurer l'efficacité des traitements antipaludiques de première ligne et déterminer les facteurs de risque de l'échec du traitement. MÉTHODES: En 2009-2010, des études prospectives, avec 28 jours de suivi, ont été menées dans 25 sites sentinelles. On a administré aux patients infectés par le Plasmodium falciparum de l'artésunate et de la sulfadoxine-pyriméthamine (AS+SP). Ceux qui étaient infectés par le P. vivax ont reçu de la chloroquine. La réaction en chaîne par polymérase a été utilisée pour distinguer la réinfection après traitement de l'échec du traitement. Des isolats de P. falciparum ont été vérifiés pour déceler les mutations de dhfr et de dhps. RÉSULTATS: Un total de 1664 patients ont participé à l'étude. L'analyse de survie de Kaplan-Meier a montré une efficacité de 98,8% de l'AS+SP. La plupart des patients infectés par le P. falciparum ont vu disparaître leurs parasitémies dans les 24 heures suivant le début du traitement, mais 6, dont 4 avec échec du traitement, sont restés parasitémiques après 72 heures. Des doubles mutations de dhfr ont été trouvées dans 68,4% des isolats génotypés. Les triples ou quadruples mutations de dhfr et les mutations de dhps étaient rares. Une dose quotidienne d'artésunate inférieure à 3 mg par kg de poids corporel, un âge inférieur à 5 ans, et de la fièvre au moment de l'enregistrement ont été associés à un risque accru d'échec thérapeutique. La chloroquine restait efficace à 100% et faisait généralement disparaître les parasitémies de P. vivax dans les 48 heures. Les vomissements (observés chez 47 patients) étaient l'effet indésirable le plus fréquent. CONCLUSION: En Inde, le système national de surveillance de la résistance aux médicaments antipaludiques offre une large couverture. Les antipaludéens de première ligne utilisés dans le pays restent sûrs et efficaces. Le traitement du paludisme chez les jeunes enfants et les avantages relatifs de la posologie en fonction de l'âge et du poids nécessitent une étude plus poussée.

Cinco produtos de degradação (I-V) do hidrobromidrato de citalopram (CTL) foram formados sob condições diferentes de degradação forçada. Os produtos I e II foram formados sob condições hidrolíticas, enquanto que os produtos III-V sob condições fotolíticas. Os produtos II e IV foram encontrados como impurezas conhecidas, citalopram carboxamida e citolopram-N-óxido, respectivamente. O produto I foi encontrado como sendo uma nova impureza, que foi caracterizada como 3-hidroxicitalopram N-óxido. A droga e todos os cinco produtos de degradação foram resolvidos de uma maneira otimizada em uma coluna C8 com fase móvel composta de acetonitrila e tampão acetato de amônia (pH* 4,5) na vazão de 0,50 mL min-1. O método foi linear, preciso com RSD < 3 (desvio padrão relativo) e exato com recuperação de 88-97% no intervalo de concentração 5-500 µg mL-1 de citalopram. Os limites de determinação (LOD) e de quantificação (LOQ) foram 1 µg mL-1 e 5 µg mL-1, respectivamente. A análise por arranjo de fotodiodo de uma solução da droga degradada contendo a droga e todos os cinco produtos de degradação revelou picos isolados, puros. Sendo assim, o método pode ser sugerido como estável

Five degradation products (I-V) of citalopram hydrobromide (CTL) were formed under different forced degradation conditions. Products I and II were formed under hydrolytic conditions while product III-V were formed under photolytic conditions. Products II and IV were found known impurities as citalopram carboxamide and citalopram N-oxide, respectively. Product I was found to be a new impurity which was characterized as 3-hydroxycitalopram N-oxide. The drug and all five degradation products were optimally resolved on a C8 column with mobile phase composed of acetonitrile and ammonium acetate buffer (pH* 4.5) flowing at a rate of 0.50 mL min-1. The method was linear, precise RSD < 3 (relative standard deviation) and accurate (recovery being 88-97%) in the concentration range of 5-500 µg mL-1 of citalopram. The limits of detection (LOD) and of quantitation (LOQ) were 1 µg mL-1 and 5 µg mL-1, respectively. The photodiode array (PDA) analysis of the degraded CTL solution containing the CTL and all five degradation products revealed each peak to be pure. Hence, the method was suggested to be stability-indicating

OBJECTIVE: To determine the antimicrobial resistance profile of Escherichia coli (E coli) isolated from the shell membrane and yolk of commercial chicken eggs in Grenada. METHODS: A total of 450 eggs were collected from different locations including small (33.3%) and big farms (26.7%), roadside vendors (26.7%) and supermarkets (13.3%). The shell membranes and yolk were cultured separately on blood agar and McConkey Agar. Escherichia coli were identified using biochemical tests and API20E strips. The isolates were tested for antimicrobial sensitivity. RESULTS: A total of 55 E coli isolates were obtained. Of which 34 isolates were from shell membrane and 21 from yolk samples. Twenty-two of the total 34 isolates from shell membrane exhibited resistance to one or more ofthe antibiotics used in the study whereas 11 of the 21 yolks isolate also showed resistance to one or more ofthe tested antibiotics. Among the six antibiotics tested, the highest level of resistance was observed for ampicillin, 42.9 per cent and 31.8 per cent respectively for shell membrane and yolk isolates. The lowest resistance rate among all the antibiotics was observed against enrofloxacin (0%). Multi-drug resistance (resistance to > 3 compounds) was observed in 10.9% of the isolates. CONCLUSIONS: This study on E coli drug resistance in commercial chicken eggs in Grenada generated baseline data indicating that chicken eggs used for food can harbour resistant E coli. A regular monitoring ofcommensal and clinical isolates of E coli for antibacterial resistance is warranted.

OBJETIVO: Determinar el perfil de resistencia antimicrobiana de Escherichia coli (E coli) aislada de la membrana de la cáscara y la yema de huevos comerciales de gallinas en Granada. MÉTODO: Un total de 450 huevos fueron recolectados de diferentes localidades, incluyendo granjas pequeñas (33.3%) y grandes (26.7%), vendedores a la orilla de los caminos (26.7%), y los supermercados (13.3%). Las membranas de la cáscara y yema fueron puestas por separado en un cultivo de agar sangre y agar McConkey. Las Escherichia coli fueron identificadas usando pruebas bioquímicas y tiras API20E. Los aislados fueron sometidos a pruebas para determinar su sensibilidad antimicrobiana. RESULTADOS: Se obtuvo un total de 55 aislados de E coli. De estos, 34 aislados provenían de la membrana de las cáscaras y 21 de las muestras de yemas. Veintidós del total 34 aislados de la membrana, mostraron ser resistentes a uno o más de los antibióticos usados en el estudio, mientras que 11 de los 21 aislados de yemas también mostraron resistencia a uno o más de los antibióticos probados. Entre los seis antibióticos probados, el nivel más alto de resistencia se observó frente a la ampicilina, 42.9 por ciento y 31.8 por ciento respectivamente para la membrana de la cáscara y los aislados de yema. La tasa de resistencia más baja entre todos los antibióticos se observó frente a la enrofloxacina (0%). Una resistencia multidroga (resistencia a > 3 compuestos) se observó en 10.9% de los aislados. CONCLUSIONES: Este estudio sobre la resistencia medicamentosa de E en los huevos comerciales de gallina en Granada, generó datos básicos que indican que los huevos de gallina usados para la alimentación pueden ser fuente de E coli resistentes a los medicamentos. Se garantiza un monitoreo regular de aislados comensales y clínicos de E coli a fin de detectar su resistencia antibacteriana.

The population of India harbors one of the world's most highly diverse gene pools, owing to the influx of successive waves of immigrants over regular periods in time. Several phylogenetic studies involving mitochondrial DNA and Y chromosomal variation have demonstrated Europeans to have been the first settlers in India. Nevertheless, certain controversy exists, due to the support given to the thesis that colonization was by the Austro-Asiatic group, prior to the Europeans. Thus, the aim was to investigate pre-historic colonization of India by anatomically modern humans, using conserved stretches of five amino acid (EPIYA) sequences in the cagA gene of Helicobacter pylori. Simultaneously, the existence of a pathogenic relationship of tyrosine phosphorylation motifs (TPMs), in 32 H. pylori strains isolated from subjects with several forms of gastric diseases, was also explored. High resolution sequence analysis of the above described genes was performed. The nucleotide sequences obtained were translated into amino acids using MEGA (version 4.0) software for EPIYA. An MJ-Network was constructed for obtaining TPM haplotypes by using NETWORK (version 4.5) software. The findings of the study suggest that Indian H. pylori strains share a common ancestry with Europeans. No specific association of haplotypes with the outcome of disease was revealed through additional network analysis of TPMs.

OBJECTIVES: The study aimed to investigate whether elevated plasma high sensitivity C-reactive protein (hs-CRP) levels are independently associated with an increased risk of cardiovascular disease (CVD) and to then assess the effectiveness of the addition of hs-CRP testing to cardiovascular risk assessment by standard lipid screening. METHODS: A retrospective hospital-based case-control study was designed. All patients attending Cross Crossing Medical Centre (CCMC) for routine cardiovascular assessment or emergency treatment were included. Cases were defined as patients with a cardiovascular event and controls as those without an event. Data collected included blood measurements of hs-CRP and cholesterol, demographic data, drug and risk factor history. RESULTS: Odds ratio of 1.84 (95% CI 1.00, 3.38) indicated that a patient with elevated hs-CRP is 1.84 times more at risk of CVD than one with normal hs-CRP. Additionally, the association between hs-CRP and CVD was found to be independent of the other risk factors (p = 0.058). Hs-CRP ranked fourth as an indicator of risk above smoking and diabetes, and patients with both high hs-CRP and high cholesterol (OR = 9.5) were 3.5 times more at risk of CVD than someone with high cholesterol alone (OR = 6.0). CONCLUSIONS: Hs-CRP testing enhanced the clinical identification of patients at risk of cardiovascular events. It can therefore contribute to timely implementation of effective lifestyle modification and pharmaceutical intervention.

OBJETIVOS: El estudio apuntó a investigar si los niveles de proteína C reactiva (PCR-hs) de alta sensibilidad de plasma elevado están independientemente asociados con el aumento del riesgo de la enfermedad cardiovascular (ECV), y luego evaluar la efectividad de añadir la prueba PCR-hs para la evaluación del riesgo cardiovascular mediante detección (screening) estándar de lípidos. MÉTODOS: Se diseñó un estudio caso-control retrospectivo con sede en el hospital. En el mismo fueron incluidos todos los pacientes que asistían al Centro Médico Cross Crossing (CCMC) para una evaluación cardiovascular de rutina o para tratamiento de urgencia. Los casos fueron definidos como pacientes con controles y eventos cardiovasculares, o sin un evento. Los datos recogidos incluyeron mediciones sanguíneas de PRC-hs y colesterol, datos demográficos, historia de factores de riesgo y de drogas. RESULTADOS: El odds ratio de 1.84 (95% CI 1.00, 3.38) indicó que un paciente con PCR-hs elevado tiene un riesgo de ECV 1.84 veces mayor que uno con PCR-hs normal. Además, se halló que la asociación entre el PCR-hs y la ECV era independiente de los otros factores de riesgo (p = 0.058). La PCR-hs alcanzó el cuarto lugar como indicador de riesgo, por encima del hábito de fumar y la diabetes, y los pacientes con alto PCR-hs y alto colesterol (OR = 9.5) presentaban riesgo de ECV 3.5 veces mayor que aquellos que sólo tenían colesterol alto (OR = 6.0). CONCLUSIONES: Las pruebas de PCR-hs mejoraron la identificación clínica de pacientes con riesgo de eventos cardiovasculares. Por lo tanto, estas pruebas pueden contribuir a implementar oportunamente una modificación para un estilo de vida y una intervención farmacéutica que sean efectivos.

OBJETIVE: To determine the seroprevalence of Leptospira and the serovars responsible for Leptospira exposure in rats in Grenada in order to assess rats as a reservoir host for human infection. DESIGN AND METHODS: Rattus norvegicus rodents were collected representing each of the six parishes on the island of Grenada. Serum from 237 rats was tested by the microscopic agglutination test (MAT) and an Immunoglobulin G (IgG) Enzyme-Linked Immunosorbent Assay (ELISA). Seroprevalence rates among parishes were compared using a chi-squared test of homogeneity. RESULTS: Of the 237 serum samples tested, 64 were positive by either MAT or ELISA for an overall seroprevalence of 27%. The ELISA identified 24.5 % (57/233) of the rats positive at a titer of > 1:160. The MAT identified 7.1% (13/183) of the rats positive at a titer of > 1:100. Six of the 13 MAT positive samples had antibodies to multiple serovars. The serovars identified by the MAT with the greatest frequency were from the Icterohaemorrhagiae serogroup. Two rats had antibodies for serogroup Cynopteri, the first time this serogroup has been identified on Grenada. CONCLUSIONS: Our results for Leptospira exposure in rats in Grenada support R. norvegicus as an important reservoir host for Leptospira, particularly those from the Icterohaemorrhagiae serogroup. Because this serogroup is the primary serogroup responsible for documented human exposure in Grenada, exposed rats represent a public health threat.

Some of well known F2 layer anomalies might have their origin in lower atmosphere and some have extra terrestrial sources. It has been suggested that the phenomena occurring below the ionosphere such as thunderstorms, lightning/sprites, volcanic eruptions and earthquakes and above the phenomena like corona mass ejection, solar flares and extra terrestrial events may produce F2 layer signatures. In the present paper we have tried to summarize the effect of some phenomena occurring below the ionosphere like thunderstorms, lightning/sprites and seismic activity and the phenomena such as solar flares which occur above the ionosphere, on the ionospheric electron and ion temperatures. The paper also discusses possibilities. The ionospheric electron and ion temperatures were measured by the RPA payload aboard the Indian SROSS-C2 satellite. The normal day's ion and electron temperatures have been compared to the temperatures recorded during the disturbed day. The satellite data corresponding to the disturbance period were analyzed in such way that the other possible effects were eliminated. The data used are from the period 1995-1998 in the altitude range 430-630 km over the Indian region. The data of thunderstorms activity have been obtained from IMD, Pune and details of seismic events during this period downloaded from the USGS website and existing literature. The data of solar flares have been obtained from NGDC, Boulder, Colorado, USA.

Algunas de las anomalías bien conocidas de la capa F2 pueden tener su origen en la atmósfera baja y otras pueden tener fuentes extra terrestres. Se ha sugerido que los fenómenos que ocurren bajo la ionosfera, tales como truenos, relámpagos/duendes, erupciones volcánicas y temblores, y los que ocurren arriba, como eyecciones masivas de la corona solar, erupciones solares y otros eventos extra terrestres, pueden producir efectos específicos en la capa F2. En este trabajo hemos tratado de resumir los efectos que tienen sobre las temperaturas iónica y electrónica algunos fenómenos que ocurren bajo la ionosfera como los truenos, relámpagos/duendes y la actividad sísmica y otros que ocurren sobre ella como las erupciones solares. El artículo también discute posibilidades. Las temperaturas iónica y electrónica se midieron con el RPA (por sus siglas en inglés) abordo del satélite indio SROSS-C2. Las temperaturas iónica y electrónica normales se compararon con las registradas durante el día anormal o alterado. Los datos del satélite correspondientes al periodo alterado fueron analizados de manera que otros posibles efectos fueron eliminados. Los datos utilizados son del periodo 1995-1998 en el rango de altitud 430-460 km sobre la región india. Los datos de actividad eléctrica se obtuvieron del IMD, Pune, y los detalles de los eventos de actividad sísmica durante este periodo se extrajeron del sitio de internet del USGS y de la literatura existente. Los datos de erupciones solares se obtuvieron del NGDC, Boulder, Colorado, EUA.

Os efeitos da solarização do solo associados à adubação no controle de nematóides e na produtividade da alface cultivar "Verônica" foram avaliados em solo naturalmente infestado. Dois experimentos foram conduzidos, um com e outro sem solarização, em casa de vegetação, ambos com cinco tratamentos: adubação orgânica; nitrogênio na forma amoniacal (NH4); adubação com NPK; adubação orgânica mais NPK; testemunha (sem adubação). No experimento solarizado, o solo foi coberto durante 132 dias com filme plástico transparente. A população de nematóides foi avaliada em duas camadas (0-10 cm e 10-20 cm), e as coletas de solo foram feitas em três épocas (antes da implantação do experimento; após a solarização; após a colheita). O delineamento experimental foi o de blocos ao acaso com três repetições em parcelas sub-subdivididas, com medidas no espaço e no tempo (5 adubações x 2 camadas x 3 épocas), e a comparação entre experimentos foi feita pela análise conjunta. O efeito da solarização sobre o controle de nematóides dependeu da adubação e camada do solo. A solarização reduziu a população de nematóides na camada de 0-10 cm em todos os tratamentos de adubação. A solarização associada ao NH4 reduziu a diversidade na camada de 10-20 cm. A solarização combinada às adubações orgânica, N-NH4, NPK e orgânica mais NPK reduziu de maneira eficiente o número de galhas, o número de massas de ovos e a população de nematóides fitoparasitas nas raízes, em especial de Meloidogyne spp. Solarização combinada à adubação orgânica apresenta potencial para controle de nematóides e redução do uso de agrotóxicos.

The effect of soil solarization and fertilization was evaluated for nematode control in 'Veronica' lettuce in naturally infested soil. The two greenhouse experiments consisted of five fertilization treatments: organic fertilization; ammoniacal nitrogen (ammonium sulphate); NPK fertilization; organic and NPK fertilization; control (without fertilization), in solarized and non-solarized soils. In the solarized plot the soil was covered during 132 days with transparent plastic film. The nematode populations were evaluated in two layers (010 cm and 10-20 cm) with soil collections done at three times (before solarization; after solarization; and after harvest). The experimental design was of sub-subdivided blocks plots with assessments in space and time (5 fertilization x 2 depths x 3 times). The effect of solarization on nematode control was dependent on fertilization and soil depth. Solarization reduced nematodes population at 0-10 cm depth in all the fertilization treatments. Solarization associated to ammoniacal nitrogen reduced nematode diversity at 10-20 cm depth. Solarization associated to organic, ammoniacal nitrogen, NPK and organic + NPK fertilization reduced efficiently gall numbers, egg masses number and phytoparasitic nematodes, specially Meloidogyne spp., in lettuce roots. Solarization associated to organic fertilization has a potential to be used in nematode control and to reduce pesticides application.

India is a high-risk country for cervical cancer which accounts a quarter (126 000 new cases, 71 000 deaths around 2 000) of the world burden. The age-standardized incidence rates range from 16-55 per 100 000 women in different regions with particularly high rates in rural areas. Control of cervical cancer by early detection and treatment is a priority of the National Cancer Control Programme of India. There are no organized cytology screening programmes in the country. The technical and financial constraints to organize cytology screening have encouraged the evaluation of visual inspection approaches as potential alternatives to cervical cytology in India. Four types of visual detection approaches for cervical neoplasia are investigated in India: a) naked eye inspection without acetic acid application, widely known as 'downstaging'; b) naked eye inspection after application of 3-5% acetic acid (VIA); c) VIA using magnification devices (VIAM); d) visual inspection after the application of Lugol's iodine (VILI). Downstaging has been shown to be poorly sensitive and specific to detect cervical neoplasia and is no longer considered as a suitable screening test for cervical cancer. VIA, VIAM and VILI are currently being investigated in multicentre cross-sectional studies (without verification bias), in which cytology and HPV testing are also simultaneously evaluated, and the results of these investigations will be available in 2003. These studies will provide valuable information on the average, comparative test performances in detecting high-grade cervical cancer precursors and cancer. Results from pooled analysis of data from two completed studies indicated an approximate sensitivity of 93.4% and specificity of 85.1% for VIA to detect CIN 2 or worse lesions; the corresponding figures for cytology were 72.1% and 91.6%. The efficacy of VIA in reducing incidence of and mortality from cervical cancer and its cost-effectiveness is currently being investigated in two cluster randomized controlled intervention trials in India. One of these studies is a 4-arm trial addressing the comparative efficacy of VIA, cytology and primary screening with HPV DNA testing. This trial will provide valuable information on comparative detection rates of CIN 2-3 lesions by the middle of 2003. The expected outcomes from the Indian studies will contribute valuable information for guiding the development of public health policies on cervical cancer prevention in countries with different levels of socio-economic and health services development and open up new avenues of research.

La India es un país de alto riesgo de cáncer cervical, donde se presentan cerca de la cuarta parte de los casos del total mundial (126 000 casos incidentes y 71 000 muertes durante 2000). La tasa de incidencia estandarizada por edad se encuentra en el rango de 16 a 55 por 100 000 mujeres en diferentes regiones con tasas particularmente altas en áreas rurales. El control del cáncer cervical por detección temprana y tratamiento es una prioridad del Programa Nacional de Control de Cáncer y, desafortunadamente, no hay programas organizados de tamizaje citológico en este país. La infraestructura técnica y financiera para organizar tamizaje en este tipo de cáncer, ha promovido la inspección visual como una potencial alternativa de la citología cervical en la India. Se investigan cuatro tipos de opciones de detección visual de neoplasia cervical: a) inspección a ojo desnudo sin la aplicación de ácido acético, opción ampliamente conocida como downstaging; b) inspección de ojo desnudo después de la aplicación de ácido acético de 3 a 5% (VIA); c) VIA usando un dispositivo de aumento (VIAM); d) inspección visual después de la aplicación de yodo-lugol (VILI). Se ha mostrado que el Downstaging ha sido pobremente sensible y específico para detectar neoplasia cervical y no es considerado ampliamente como una prueba de tamizaje conveniente para cáncer cervical. VIA, VIAM y VILI son frecuentemente investigados en estudios de corte transversal multicéntricos (sin verificación de sesgo), en los que se evalúan simultáneamente la citología y las pruebas del VPH; los resultados de esas investigaciones estarán disponibles próximamente. Estos estudios proveerán información valiosa sobre el desarrollo de pruebas comparativas para detectar lesiones de alto grado precursoras de neoplasia cervical, y cáncer invasor. Los resultados de los análisis de los datos de dos estudios previos indicaron una sensibilidad aproximada de 93.4% y una especificidad de 85.1% para VIA en la detección de CIN 2-3 o lesiones invasoras, comparadas con las de citología con 72.1% y 91.6% de sensibilidad y especificidad, respectivamente. La eficacia de VIA para la reducción de la incidencia y la mortalidad de cáncer cervical y su costo-efectividad están siendo actualmente investigadas en dos ensayos de intervención aleatorizados controlados en población de la India. Uno de esos estudios es un ensayo con cuatro brazos que establece la eficacia comparativa de VIA, citología y tamizaje primario, con pruebas de ADN del VPH. Este ensayo proveerá información valiosa sobre la detección comparativa de tasas de lesiones de CIN 2-3 que podrá ser utilizada para guiar el desarrollo de las políticas en salud pública sobre prevención del cáncer cervical en países con diferentes niveles socioeconómicos y abrir nuevos caminos de investigación.