Feasibility of a streamlined tuberculosis diagnosis and treatment initiation strategy.

OBJECTIVE: To assess the feasibility of a streamlined strategy for improving tuberculosis (TB) diagnostic evaluation and treatment initiation among patients with presumed TB. DESIGN: Single-arm interventional pilot study at five primary care health centers of a streamlined, SIngle-saMPLE (SIMPLE) TB diagnostic evaluation strategy: 1) examination of two smear results from a single spot sputum specimen using light-emitting diode fluorescence microscopy, and 2) daily transportation of smear-negative sputum samples to Xpert® MTB/RIF testing sites. RESULTS: Of 1212 adults who underwent sputum testing for TB, 99.6% had two smears examined from the spot sputum specimen. Sputum was transported for Xpert testing within 1 clinic day for 83% (907/1091) of the smear-negative patients. Of 157 (13%) patients with bacteriologically positive TB, 116 (74%) were identified using sputum smear microscopy and 41 (26%) using Xpert testing of smear-negative samples. Anti-tuberculosis treatment was initiated in 142 (90%) patients with bacteriologically positive TB, with a median time to treatment of 1 day for smear-positive patients and 6 days for smear-negative, Xpert-positive patients. CONCLUSION: The SIMPLE TB strategy led to successful incorporation of Xpert testing and rapid treatment initiation in the majority of patients with bacteriologically confirmed TB in a resource-limited setting

CHANGES IN OVARIAN DEVELOPMENT AND SERUM LEVELS OF VITELLOGENIN UNDER DIFFERENT ACCLIMATION TO TEMPERATURE IN CHELA CLUPEOIDES (BLOCH, 1795

An experiment to assess the effect of temperature on ovarian development and serum levels of vitellogenin in Chela clupeiodes was conducted at aquaculture division of Central Institute of Fisheries Education (CIFE), Mumbai for a period of 60 days from the month of January to February. Results showed that raising temperature to 30°C significantly enhanced GSI (6.11±0.55 – 14.7±0.42) but beyond that temperature the GSI increment was less (3.5±0.4 - 6.4±0.41). Histological examination revealed better maturity with higher percentage of mature oocytes (24.753±1.366) in treatment T3 (30°C). Elevated temperature exposure beyond 30°C showed poor maturation with lower percentage of mature oocytes (3.486±0.633). Estimation of serum vitellogenin level showed elevated temperature above 30°C resulted in reduction of their capacity to be sequestered into growing oocytes. After 60 days of rearing serum level of vitellogenin attained its peak at treatment T3 (30°C). By the present investigation it can be concluded that elevated temperature may increase ovarian maturation in Chela clupeiodes but up to a certain threshold limit beyond that it has a negative impact on gonadal development and vitellogenin level in serum

Barriers and Determinants of Consistent Offering of HPV Vaccination by Healthcare Facilities.

Expanding access to HPV vaccination is critical to increasing HPV vaccine uptake. We assessed the determinants and barriers to consistent offering of HPV vaccine among healthcare facilities. This was a cross-sectional survey of healthcare providers (HCPs) in Texas. Prevalence of the reasons healthcare practices do not consistently offer HPV vaccination was estimated. Multivariable regression analyses were conducted. Of 1169 HCPs included in the study, 47.5% (95% CI: 44.6-50.3%) reported their practices do not provide HPV vaccination or do not offer it consistently. Compared to physicians, nurses had 77% lower odds (Adjusted Odds Ratio (AOR): 0.23, 95% CI: 0.16-0.32, p-value: \u3c .001), and physician assistants had 89% lower odds (AOR: 0.11, 95% CI: 0.07-0.16, p-value: \u3c .001) of their healthcare practices consistently offering HPV vaccination. Compared to university/teaching hospitals, the odds of healthcare practices consistently offering HPV vaccination were 44% lower (AOR: 0.56, 95% CI: 0.35-0.91, p-value: 0.019) in solo practices but 266% higher (AOR: 3.66, 95% CI: 2.04-6.58, p-value: \u3c .001) in FQHC/public facilities. The common reasons healthcare practices do not consistently offer HPV vaccination were; HPV vaccination is not within the scope of the practice (48.1%), referrals to other clinics (27.7%), and limited personnel (11.4%). Non-physicians were more likely to report that HPV vaccination was not in their scope and to refer patients than physicians. Moreover, solo practices were more likely to report challenges with acquisition and storage of the vaccine and referral of patients as reasons for not consistently offering HPV vaccination than university/teaching hospitals, FQHC/public facilities, or group practices. System-level interventions including training of non-physicians and expansion of practice enrollment in programs that support HPV vaccine acquisition and storage are needed

A pharmaceutico-analytical study of Vidangarishta

In Ayurveda, Sandhana Kalpana is particular dosage form. In Sandhana Kalpana, Asava and Arishta are included. Arishta are self generated herbal fermentation formulation in traditional medicinal system; they are considered as unique and valuable therapeutics in Ayurveda. Through traditional knowledge in literature as well as in practice exists about Arishtas and Asavas. There was great efforts to document, preserve and improve knowledge for the betterment of mankind. Vidangarishta is prepared by traditional method with special reference to Sharangdhara Samhita. This is alcoholic medicaments prepared by allowing the decoction to undergoes fermentation with addition of honey. Vidangarishta keep for fermentation about one month. After fermentation process is completed, was tested according to both Ayurvedic and modern method. Vidangarishta commonly used for Krumi (worm infection) Vyadhi. Pharmaceutical and analytical study discussed in this research article

Impact of TGF-ß1 -509C/T and 869T/C polymorphisms on glioma risk and patient prognosis

Transforming growth factor beta (TGF-ß) plays an important role in carcinogenesis. Two polymorphisms in the TGF-ß1 gene (-509C/T and 869T/C) were described to influence susceptibility to gastric and breast cancers. The 869T/C polymorphism was also associated with overall survival in breast cancer patients. In the present study, we investigated the relevance of these TGF-ß1 polymorphism in glioma risk and prognosis. A case-control study that included 114 glioma patients and 138 cancer-free controls was performed. Single nucleotide polymorphisms (SNPs) were evaluated by polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP). Univariate and multivariate logistic regression analyses were used to calculate odds ratio (OR) and 95 % confidence intervals (95 % CI). The influence of TGF-ß1 -509C/T and 869T/C polymorphisms on glioma patient survival was evaluated by a Cox regression model adjusted for patients' age and sex and represented in Kaplan-Meier curves. Our results demonstrated that TGF-ß1 gene polymorphisms -509C/T and 869T/C are not significantly associated with glioma risk. Survival analyses showed that the homozygous -509TT genotype associates with longer overall survival of glioblastoma (GBM) patients when compared with patients carrying CC + CT genotypes (OR, 2.41; 95 % CI, 1.06-5.50; p = 0.036). In addition, the homozygous 869CC genotype is associated with increased overall survival of GBM patients when compared with 869TT + TC genotypes (OR, 2.62; 95 % CI, 1.11-6.17; p = 0.027). In conclusion, this study suggests that TGF-ß1 -509C/T and 869T/C polymorphisms are not significantly associated with risk for developing gliomas but may be relevant prognostic biomarkers in GBM patients.This work was supported by Fundação para a Ciência e Tecnologia, Portugal (PTDC/SAU-GMG/113795/2009 and SFRH/BPD/33612/2009 to B.M.C.; SFRH/BD/88121/2012 to J.V.C.; SFRH/BD/92786/2013 to C.S.G.; PTDC/SAU-ONC/115513/2009 to R.R.)