A randomised controlled trial to assess the impact of audiotaped consultations on the quality of informed consent in cardiac surgery

<b>Context</b>: Informed Consent has become a contentious issue over the last few decades. It has been discussed and debated in all specialties of medicine. <b>Objective</b>: We have used a previously published and validated questionnaire, which was designed to measure patients’ level of knowledge within the domains described in the General Medical Council’s informed consent guidelines, to evaluate the impact of audiotaping outpatient consultations on informed consent in cardiac surgery. <b>Design</b>: Randomised Controlled Trial <b>Setting</b>: Tertiary health care centre in Scotland <b>Participants</b>: Patients attending outpatient clinic prior to first time coronary artery bypass grafting were recruited. We made audiotape recordings of outpatient consultations conducted by a single consultant surgeon with 84 patients. <b>Intervention</b>: The participants were randomly allocated to three trial arms. The control group (Group A; n = 29) received no tape. The 'generic' group (Group B; n = 25) received a copy of a tape which contained general information about coronary artery surgery which we scripted to include information covering each of the domains described by the General Medical Council. The 'consultation' group (Group C; n = 30) received a tape of their consultation interview. Patients were then interviewed on admission to hospital, shortly after giving consent. As well as the knowledge questionnaire, the Multidimensional Health Locus of Control (MHLC) and Hospital Anxiety and Depression Scale (HADS) were administered. <b>Main outcome measures</b>: Impact of audiotape in improving the informed consent process, as measured by a knowledge questionnaire, in cardiac surgery. Its impact on health locus of control and anxiety and depression was also assessed. <b>Results</b>: The mean knowledge score of patients who received a recording of their consultation was almost two-and-a-half times greater than that of the controls (p<0.001). Patients who received a consultation recording reported a significantly greater sense of control over their own health (p<0.001) and were overall less anxious and depressed. <b>Conclusion</b>: Providing an audiotape of the consultation before cardiac surgery appears to improve patients’ knowledge whilst increasing their perceptions of control of their health status and reducing levels of anxiety and depression

In vitro and in vivo activities of the nitroimidazole CGI 17341 against Mycobacterium tuberculosis

CGI 17341 (2-ethyl-5-nitro-2,3-dihydro[2-1b]imidazo-oxazole) is a novel orally active representative of the 5-nitroimidazole series of antimicrobial agents. At concentrations ranging from 0.1 to 0.3 micrograms/ml, CGI 17341 inhibited the drug-susceptible and multi-drug-resistant strains of Mycobacterium tuberculosis. CGI 17341 had no cross-resistance with isoniazid, rifampin, streptomycin, or ethambutol. While the in vitro activity of CGI 17341 against M. tuberculosis was comparable to those of isoniazid and rifampin, it was superior to those of streptomycin, ciprofloxacin or norfloxacin, and oxazolidinone DuP 721. The MIC of CGI 17341 was not affected when the pH of the medium was decreased from 6.8 to 5.6, while four- to sixfold increases in the MICs of ciprofloxacin and isoniazid were observed. In mice infected with M. tuberculosis, the 50% effective dose for CGI 17341 was 7.7 mg/kg of body weight (95% confidence limits, 3.5 and 10.27) when administered on days 11 and 12 postinfection. CGI 17341 gave a dose-dependent (r = 0.995) and significant increase in the survival time. Our data indicate that the 5-nitroimidazole CGI 17341 is a promising and novel antituberculosis compound with potent in vitro and in vivo activities. Further investigations on this compound are warranted

Not Available

Not AvailableMarker assisted backcross breeding (MABB) is aimed at introgression of trait(s) into a popular variety to augment specific trait(s) in an otherwise popular variety. While MABB can improve a variety with respect to introgressed trait(s), it offers very little scope for improvement of other traits. Marker assisted restricted backcross breeding (MARBB) is an alternative which can help in identifying transgressive segregants especially, when the donor parent is an elite genotype with several desirable traits. In the present study, restricted backcrossing followed by pedigree selection was used for the development of improved genotypes of Basmati rice with BB and blast diseases using an early maturing Basmati rice variety, Pusa Basmati 1509 as recurrent parent and an elite restorer line, Pusa 1790 as donor. Foreground selection for xa13, Xa21, Pi2 and Pi54 in the backcross progenies was combined with phenotypic selection for agronomic and grain quality traits to ensure premium Basmati grain quality in the progenies. Multi-location yield trial was conducted to evaluate the performance of the improved Basmati rice genotypes with both BB and blast resistance. Pusa 1847-12-62-115-20-6 and Pusa 1847-12-62-190-39-7 recorded significantly higher yields of 68.88 and 62.44 q/ha, espectively, compared to PB 1509 (57.88 q/ha). The improved progenies exhibited resistance to BB with an average lesion length of 2 cm, and blast with scores between 0-2, while PB 1509 was highly susceptible. Another genotype, Pusa 1847-12-62-37-8-3 exhibited head rice recovery (HRR) of 63.99 %, which was significantly higher than in PB 1509 (56.40 %). Marker assisted selection was also effected for fertility restoration genes and improved grain quality traits based on which two improved Basmati rice genotypes pyramided with BB and blast resistance namely, Pusa 1847-12-62-115-20-6 and Pusa 1847-12-62-190-39-7 were found promising, along with improved grain and cooking quality as well as restoration potential, which could be used in breeding better quality hybrids.Not Availabl