Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting.

Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre (NIC) database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 (3.6%), predominantly H1N1 (63%); most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance.

Synthesis, antiviral and cytotoxic investigation of 2-phenyl-3-substituted quinazolin-4(3H)-ones.

OBJECTIVES: A series of 3(benzylideneamino)-2-phenyl quinazoline-4(3H)-ones was synthesized by reaction of 3-amino-2-phenyl-3H-quinazoline-4-one with various carbonyl compounds. MATERIALS AND METHODS: Chemical structures of the synthesized compounds were confirmed by IR, 1H-NMR and mass spectral analysis. Title compounds were investigated for cytotoxicity and antiviral activity against herpes simplex virus-1 (KOS), herpes simplex virus-2 (G), vaccinia virus, vesicular stomatitis virus, herpes simplex virus-1 TK-KOS ACVr, para influenza-3 virus, reovirus-1, Sindbis virus, Coxsackie virus B4, Punta Toro virus, feline corona virus (FIPV), feline herpes virus, respiratory syncytial virus, influenza A H1 N1 subtype, influenza A H3N2 subtype, influenza B and vesicular stomatitis virus. RESULTS AND CONCLUSION: Compound 3d was found inhibit viral replication of para influenza-3virus, reovirus-1, Sindbis virus, Coxsackie virus B4, Punta Toro virus in Vero cell cultures.

Pain on intramuscular injection of bupivacaine, ropivacaine, with and without dexamethasone.

BACKGROUND AND OBJECTIVES: We wished to determine which long-acting local anesthetic would produce the least pain on injection for treatment of myofascial pain disorders. We compared the pain on intramuscular injection of bupivacaine, ropivacaine, bupivacaine with dexamethasone, ropivacaine with dexamethasone, and needle placement alone. METHODS: Thirty volunteers received 5 injections each: (1) needle only, (2) bupivacaine 0.5%, (3) ropivacaine 0.5%, (4) bupivacaine 0.5% with dexamethasone 0.13 mg/mL, and (5) ropivacaine 0.5% with dexamethasone 0.13 mg/mL. The injections were made in the volunteers' upper trapezius muscles; there was a 15-minute interval between injections. The sequence of injections was randomized by Latin square design. The intensity of pain was rated on a 0 to 10 cm visual analogue scale (VAS) score. Neither the investigator nor the volunteer was aware of the nature of the injectate. The pH of the injected solutions was checked to determine if differences in the intensity of pain on injection were due to differences in the pH of the solutions. RESULTS: The VAS pain scores were 3.1 +/- 2.4 for needle only, 4.4 +/- 2.8 for bupivacaine, 2.5 +/- 2.0 for ropivacaine, 4.7 +/- 2.7 for bupivacaine/dexamethasone, and 3.7 +/- 2.2 for ropivacaine/dexamethasone. The pain on injection of ropivacaine was significantly less than the pain on injection of bupivacaine or bupivacaine/dexamethasone. The pH values of the solutions were as follows: (1) bupivacaine, 5.50; (2) ropivacaine, 5.57; (3) bupivacaine/dexamethasone, 6.64; and (4) ropivacaine/dexamethasone, 6.60. CONCLUSIONS: The pain on intramuscular injection of bupivacaine is significantly more intense than with ropivacaine. The difference in the intensity of the pain on injection between bupivacaine and ropivacaine does not appear to be related to differences in pH. The results of our study have implications on the choice of the local anesthetic used in trigger point injections.

Study of leprosy among slum dwellers in Pune. Part II--Disabilities.

While conducting a leprosy survey in an urban slum in Pune 45 cases of leprosy were detected in a population of 4915 and only 7 of these cases had some disability. Disability rate in the leprosy cases was 15.56 percent, and maximum number had Grade 2 disability of hands or feet. Disability was higher in the higher age groups, males, Hindus, widower/widows, unemployed and lower socio-economic classes. Majority of the cases had a very low Disability Index DI (2) between 0.10 to 0.69 which is heartening and proves the successful implementation of the National Leprosy Eradication Programme.

AN EPIDEMIOLOGICAL STUDY OF BLOOD PRESSURE AMONG SCHOOL CHILDREN.

Blood pressure was measured in 1170 school children between 5 and 15 years of age. Mean blood pressure was significantly higher in boys than girls in all age groups and a steady increase in blood pressure with age was seen in both the sexes. Mean blood pressure was significantly higher among children with positive family history of cardiovascular morbidity. Children from higher socio-economic strata and overweight children also showed higher blood pressure. Nine (0.77%) children had persistent hypertension. However, the degree of hypertension was mild and all these children were asymptomatic. Baseline investigations failed to detect any underlying pathology or target organ involvement. This study suggests that childhood could be a reasonably profitable time to look for such factors and to selectively screen children belonging to the high risk group for hypertension.

RESURGENCE OF MT MALARIA AMONGST TROOPS SERVING IN THE NORTH EAST.

Cases of MT malaria amongst troops serving in the North East are on the increase. Study of the malaria morbidity and mortality data of the past five years covering a population of about 1.65 lakhs revealed that there is a definite resurgence of malaria from an incidence of 0.39 per thousand in 1989 to 0.54 per thousand in 1992. Death due to malaria is a cause for concern especially since most of the troops are on chemoprophylaxis. A more realistic epidemiological approach to malaria control would be required to contain malaria.

Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting

Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre [NIC] database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 [3.6%], predominantly H1N1 [63%]; most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance

La surveillance de la grippe est nécessaire pour contrôler les menaces de santé publique potentielles au moment de l'émergence de nouveaux virus de la grippe. La présente étude a évalué la capacité et la performance du système national de surveillance de la grippe en Afghanistan de 2007 à 2014. Les données ont été recueillies en examinant les registres des hôpitaux et la base de données du Centre national de la grippe [CNG], en interrogeant les points focaux pour la grippe sur neuf sites de surveillance sentinelle ainsi que le personnel du CNG, et en observant les sites. Sur les 6900 échantillons prélevés, le virus de la grippe a seulement été identifié dans 253 d'entre eux [3,6%] ; il s'agissait essentiellement du H1N1 [63%]. De plus, la majorité de ces cas ont été dépistés au cours de la grippe pandémique de 2009. Le CNG avait la capacité d'isolement et d'identification par PCR du virus. Il a en outre obtenu des résultats satisfaisants jusqu'à ce que la troisième Unité de recherche médicale de la Marine américaine [NAMRU-3] lui retire son soutien en 2011. Les insuffisances identifiées dans le système indiquent la nécessité d'obtenir des données plus complètes, d'améliorer les compétences techniques et d'avoir des ressources humaines formées, de rénover les infrastructures/locaux, et de disposer de modes opératoires normalisés pour l'ensemble du processus de surveillance

Observer experience and Cup:Disc ratio assessment.

BACKGROUND: The validity of the Cup:Disc (C:D) ratio as a clinical measure depends on the level of agreement among observers. In this study, we investigated the effect of observer experience on interobserver and intraobserver agreement in C:D ratio estimation. METHODS: Nine 3rd-year (Yr3) and nine 4th-year (Yr4) optometry students and nine optometrists (Opt), determined C:D ratios from 26 optic disc photographs viewed monoscopically and stereoscopically. Observer agreement was investigated using weighted kappa (Kw) analysis. RESULTS: Interobserver agreement was higher (p < 0.01) among optometrists than among 4th-year students and higher (p < 0.01) among 4th-year than among 3rd-year students (mean Kw: Opt = 0.61; Yr4 = 0.51; Yr3 = 0.39). Stereoscopic estimates of C:D ratios were higher (p < 0.0001) than monoscopic estimates, and interobserver agreement was higher (p < 0.001) when evaluating the vertical rather than the horizontal C:D ratio. Intraobserver agreement (mean Kw: Opt = 0.67; Yr4 = 0.66; Yr3 = 0.62) did not vary significantly (p = 0.78) with experience. CONCLUSIONS: The extent to which an observer reproducibly assesses the C:D ratio from optic disc photographs (intraobserver agreement) does not increase with experience. However, the agreement between different observers in assessing the C:D ratio (interobserver agreement) increases with experience.