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Telepathology is defined as performance of pathology at a distance using available telecommunication links. With the advent of latest hardware and software technology in computer and imaging and boom in information technology sector, effective and useful telepathoogy practice is now a reality. Potential of telepathology in health care and medical education is being realized in India as well. We present our experience of telepathology at a tertiary care medical centre over last four years. We conducted regular teleeduation and tele-consultation sessions with three medical colleges of Orissa, India. The outcome was satisfactory in terms of participation, experience and knowledge gains. Key Words: Telepathology, Tele-education, Tele-consultation, Digital images, Store & forward telepathology, Dynamic telepathology.
ANTIBIOTIC MICs The MICs were determined for the 11 antibiotics that were given to the patients rifampin, rifabutin, ethambutol, amikacin, doxycycline, minocycline, clarithromycin, and fluoroquinolones [including ofloxacin, levofloxacin, ciprofloxacin, and sparfloxacin] ; against all the strains isolated from the 63 patients but 2 because of insufficient growth ; . For each antibiotic, the MICs were distributed in a narrow range, and the modal MIC was close to the 50% MIC and to the geometric mean MIC Table 4 ; . The MICs of rifampin and rifabutin were lower than the MICs of the other antibiotics 90% MIC of 0.5 and 0.06 g mL, respectively ; . The MICs of the cyclines, clarithromycin. Is 09 for levofloxacin while it is 17 for gatifloxacin. Lansoprazole Tablet, Rapid Dissolve, Delayed Release ql qd . Lansoprazole Amoxicillin Trihydrate Clarithromycin ql Lanthanum Carbonate . Lantus Vials . Lariam ql + . Larodopa Lasix + Latanoprost ql Tier 3, see therapeutic class 12.4 Leflunomide + ql . Lescol ql qd Tier 3, see therapeutic class 4.6 Lescol XL ql qd Tier 3, see therapeutic class 4.6 Letrozole . Leucovorin Calcium 5, 25mg + . Leucovorin Calcium 10, 15mg Leukeran . Leukine 16, 37 Leuprolide Acetate + Tier 2 16, 41 Levalbuterol HCl HFA Aerosol w Adapter ql Tier 1 Levalbuterol HCl Solution, Non-Oral Tier 3, see therapeutic class 13.3.3 Levaquin Tablet, Solution . Levatol Tier 3, see therapeutic class 4.5.2 Levbid + 35, 48 Levetiracetam . Levitra qd Tier 3, see therapeutic class 14.4 Levlen Tier 3, see therapeutic class 11.1.1 Levlite Tier 3, see therapeutic class 11.1.1 Levo-Dromoran Tier 3, see therapeutic class 3.1.1 Levobunolol HCl + Levocarnitine + Levodopa . Levofloaxcin Tablet, Solution . Levonorgestrel ql Levonorgestrel-Ethinyl Estradiol . Levonorgestrel-Ethinyl Estradiol + Levonorgestrel-Ethinyl Estradiol Tablet, Dosepack, 3 month ql + Tier 3 . Levothroid Tier 3, see therapeutic class 7.2 Levothyroxine Sodium . Levothyroxine Sodium + Levoxyl + Levsin + 35, 48 Levsin SL + . 35, 48 Levsin Phenobarbital Tier 3, see therapeutic class 8.2.2 Levsinex + 35, 48 Lexapro ql Tier 3, see therapeutic class 3.9.2.4 Lexiva . Lexxel Tier 3, see therapeutic class 4.5.8 Librax + Libritab Tier 3, see therapeutic class 3.9.5 Librium + Lidex 0.05% + . Lidex-E 0.05% + . Lidocaine HCl Jel, Ointment, Solution + . 28, 30 Limbitrol Tier 3, see therapeutic class 3.9.2.2 Lincocin Tier 3, see therapeutic class 1.11.1 Lincocin Pediatric Tier 3, see therapeutic class 1.11.1 Linezolid Tier 3, see therapeutic class 1.11.1 Lioresal + 20, 39.

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Deprived of their liberty, for civil commitment purposes, only if they present enough risk of enough harm sufficiently soon in the future to justify a deprivation of liberty. A mere assessment of risk of any violence, without regard to potential seriousness or immediacy, should never be enough; and mental health professionals should be on guard against allowing or enabling their risk assessments to mean more to legal decisionmakers than is justified by the data whether clinical or actuarial ; . On the other hand, an important finding of this study not commented upon by the authors is that, amongst hospitalized individuals, low risk patients, in terms of their dangerousness to others, can be identified very well: Of the 343 patients in the lowest identified risk class of a total of 939 ; , only 1% were violent, to others, at follow up perhaps unsurprisingly given the incidence of primarily depressed patients in this sample and the second lowest risk class, composed of 248 patients, also exhibited much less post-hospital violence than the sample as a whole. Thus, it is to be hoped that the results of the MacArthur Study of Mental Disorder and Violence can and will be used to avoid mistakenly characterizing mentally disordered individuals as dangerous to others as well as to help identify, and treat, those civilly hospitalized individuals who do pose an especially high risk of violence.

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Canada. Canadian bacterial surveillance network. N Engl J Med 1999; 22: 233-239. Lin ares J, Campa AG, Pallares R. Fluoroquinolone resistance in Streptococcus pneumoniae. N Engl J Med 1999; 20: 1546-1548. Ho PL, Yung RW, Tsang DN, et al. Increasing resistance of Streptococcus pneumoniae to fluoroquinolones: Results of a Hong Kong multicentre study in 2000. J Antimicrob Chemother 2001; 48: 659-665. Nagai K, Davies TA, Dewasse BE, et al. In vitro development of resistance to ceftriaxone, cefprozil and azithromycin in Streptococcus pneumoniae. J Antimicrob Chemother 2000; 46: 909-915. Enoxacin-A new fluoroquinolone. Med Lett Drugs Ther 1992; 34: 103-105. Cooper B, Lawer M. Pneumococcal bacteremia during ciprofloxacin therapy for pneumococcal pneumonia. J Med 1989; 87: 475. Flynn CM, Johnson DM, Jones RN, et al. In vitro efficacy of levofloxacin alone or in combination tested against multi-resistant Pseudomonas aeruginosa strains. J Chemother 1996; 8: 411-415. Dholakia N, et al. Susceptibilities of bacterial isolates from patients with cancer to levofloxacin and other quinolones. Antimicrob Agents Chemother 1994; 38: 848-852. Habib MP, et al. Interscience Conference on Antimicrobial Agents and Chemotherapy 1996; 36. Abstract L002. 36th Interscience Conference on Antimicrobial Agents and Chemotherapy. New Orleans, LA, Sept. 15-18, 1996. 187. Plouffe J, Schwartz DB, Kolokathis A, et al. Clinical efficacy of intravenous followed by oral azithromycin monotherapy in hospitalized patients with community-acquired pneumonia. Antimicrob Agents Chemother 2000; 44: 1796-1802. Vergis EN, Indorf A, et al. Azithromycin vs cefuroxime plus erythromycin for empirical treatment of community-acquired pneumonia in hospitalized patients. A prospective, randomized, multicenter trial. Arch Int Med 2000; 160: 1294-1300. File TM, et al. Abstr Interscience Conference on Antimicrobial Agents Chemotherapy 1996; 36. Abstract L001 LM1 ; . 36th Interscience Conference on Antimicrobial Agents and Chemotherapy. New Orleans, LA, Sept. 15-18, 1996. 190. The choice of antibacterial drugs. Med Lett Drugs Ther 1996; 38: 25-34. Clarithromycin and azithromycin. Med Lett Drugs Ther 1992; 34: 45-47. Pfizer, Inc. Azithromycin package insert. 193. Pfizer product monograph. Azithromycin for IV injection. 194. Feldman RB, Rhew DC, Wong JY, et al. Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: A 3 1 2-year experience from a veterans affairs hospital. Arch Intern Med 2003; 163: 1718-1726. Data on file, Pfizer, Inc. New York, NY. 196. Martinez JA, Horcajada JP, Almela M, et al. Abstract: L-988. Effect of initial treatment with a beta-lactam plus a macrolide compared with a beta-lactam alone on bacteremic pneumococcal pneumonia BPP ; mortality. Citation: 42nd ICAAC Abstracts and nizoral.

For P.aueriginosa Clinafloxacin ciprofloxacin sparfloxaci in gatiflox-acin levofoxacin For S.aureus Sitafloxacin gemifloxacin gatifloxacin levodloxacin ciprofloxacin. For anaerobes Sitafloxacin gatifloxacin trovafloxacin. Adverse effects Nausea, vomitting, diarhhoea. Dizziness, headache. Phototoxicity. QTc prolongation. VIII. Oxazolidinones Linezolid Early protein synthesis inhibitors. Half life of 4-6 hrs. Renal excretion. Does NOT require renal modification Spectrum of activity : Gram positive organisms; Stapyhlococc, streptococci, enterococci. Gram positive anaerobic bacterium, L.monocytogenes. cocci; Coryne. Hronic bronchitis is the most common Table 1 Hospitalizations for Obstructive Chronic condition in the category of chronic Bronchitis with Acute Exacerbation 20002003 ; obstructive pulmonary disease COPD ; . The term COPD refers to any condition that causes difficulty in breath2000 2001 2002 2003 * ing as a result of constant blocking of the airNo. of patients 579, 514 605, ways. Bronchitis occurs when the bronchial Average length tubes become partly clogged with large of stay 7.03 days 7.19 days 7.05 days 7.09 days amounts of mucus and when they become narMedian length rowed because of inflammation and swelling. of stay 5 days 5 days 5 days 5 days These symptoms typically result in continual coughing, and when they have been present Sex for more than three months in each of two Male 45% 46% 47% consecutive years, patients are said to have Female 55% 54% 53% chronic bronchitis.1 Age When breathing suddenly becomes more Under age 60 16% 18% difficult for these patients, they may be Over age 60 84% 82% experiencing an acute exacerbation of chronic bronchitis AECB ; . During an acute exacerMortality rate 5.3% 5.9% 6% bation, breathing is labored because of further * Data from JanuaryJune, 2003. narrowing of the airways and secretion of large amounts of mucus that is often thicker than usual. These attacks are caused by a variety of factors, including allergens, toxins, and viral or 35% bacterial infections. Smoking is often a cause Levofloxscin IJ ; of an episode, and more than 61% of patients 30% with AECBs have the co-existing illness Levofkoxacin oral ; Tobacco Use Disorder ICD-9 code 305.1 ; . 25% More than 600, 000 hospitalizations take place each year as a result of AECBs ICD-9 20% code 491.21 ; , and that number is increasing, 15% according to data from MediMedia's Hospital Moxifloxacin oral ; Diagnosis and Therapy Audit.2 The demoMoxifloxacin IJ ; 10% graphics of this patient population have Gatifloxacin IJ ; remained relatively stable over the past few Gatifloxacin oral ; Ciprofloxacin oral ; 5% years Table 1 ; , but treatment patterns have changed somewhat. Ciprofloxacin IJ ; 0% Quinolones are used more often in 50% of 2000 2001 2002 patients ; than any other class of drugs preYear scribed for the treatment of AECB; next are the cephalosporins in 42% ; and the extendedFigure 1 Use of fluoroquinolones in hospitalized patients with obstructive chronic bronchitis with acute exacerbation 20002003 ; . spectrum macrolides in 28% ; . From 2000 to IJ injectable. 2002, lrvofloxacin LevaquinTM, Ortho-McNeil ; was the most commonly prescribed quinolone, but in 2003 it began losing some ground to gatifloxacin For information about joining PharmScope Insights, a divi Tequin, Bristol-Myers Squibb ; Figure 1 ; . However, cef- sion of MediMedia USA, Inc., please visit the Web site at triaxone sodium Rocephin, Roche ; not shown in the mminfotech and click on Hospitals. figure ; surpassed levofloxacin as the top agent prescribed for this indication 29% vs. 21% ; in the first quarter of 2003. REFERENCES The data cited in this article are available free of charge 1. Heath J, Rupa M. Chronic bronchitis: Primary care management. American Family Physician, May 15, 1998. American to hospitals that participate in the PharmScope Insights proAcademy of Family Physicians. Available at aafp gram. This program specializes in helping hospital pharafp 980515ap heath . Accessed November 10, 2003. macies target areas for performance improvement by pro- 2. Hospital Diagnosis and Therapy Audit, 19992003. Yardley, PA: MediMedia USA. viding benchmarks from a panel of 80 hospitals nationwide and nolvadex and levofloxacin. 32. Betarbet R, Sherer TB, MacKenzie G, Garcia-Osuna M, Panov AV, Greenamyre JT. Chronic systemic pesticide exposure reproduces features of Parkinson's disease. Nat Neurosci 3: 13011306, 2000. Hernan MA, Takkouche B, Caamano-Isorna F, Gestal-Otero JJ. A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson's disease. Ann Neurol 52: 276 284, Tanner CM, Ottman R, Goldman SM, Ellenberg J, Chan P, Mayeux R et al. Parkinson disease in twins: an etiologic study. JAMA 281: 341366, 1999. Polymeropoulos MH, Lavedan C, Leroy E, Ide SE, Dehejia A, Dutra A et al. Mutation in the alpha-synuclein gene identified in families with Parkinson's disease. Science 276: 20452047, 1997. Kruger R, Kuhn W, Muller T, Woitalla D, Graeber M, Kosel S et al. Ala30Pro mutation in the gene encoding alpha-synuclein in Parkinson's disease. Nat Genet 18: 106 108, Spillantini MG, Schmidt ML, Lee VMY, Trojanowski JQ, Jakes R, Goedert M. Alpha-synuclein in Lewy bodies. Nature 388: 839 840, Ueda K, Fukushima H, Masliah E, Xia Y, Iwai A, Yoshimoto M et al. Molecular cloning of cDNA encoding an unrecognized component of amyloid in Alzheimer disease. Proc Natl Acad Sci USA 90: 1128211286, 1993. Engelender S, Kaminsky Z, Guo X, Sharp AH, Amaravi RK, Kleiderlein JJ et al. Synphilin-1 associates with alpha-synuclein and promotes the formation of cytosolic inclusions. Nat Genet 22: 110 114, Uversky VN, Li J, Bower K, Fink AL. Synergistic effects of pesticides and metals on the fibrillation of alpha-synuclein: implications for Parkinson's disease. Neurotoxicology 23: 527536, 2002. Conway KA, Rochet JC, Bieganski RM, Lansbury PT Jr. Kinetic stabilization of the alpha-synuclein protofibril by a dopaminealpha-synuclein adduct. Science 294: 1346 1349, Yamin G, Glaser CB, Uversky VN, Fink AL. Certain metals trigger fibrillation of methionine-oxidized alpha-synuclein. J Biol Chem 16: 2003. Paxinou E, Chen Q, Weisse M, Giasson BI, Norris EH, Rueter SM et al. Induction of alpha-synuclein aggregation by intracellular nitrative insult. J Neurosci 21: 8053 8061, Cole NB, Murphy DD. The cell biology of alpha-synuclein: a sticky problem? Neuromolecular Med 1: 95109, 2002. Clayton DF, George JM. The synucleins: a family of proteins involved in synaptic function, plasticity, neurodegeneration and disease. Trends Neurosci 21: 249 254, Maroteaux L, Campanelli JT, Scheller RH. Synuclein: a neuronspecific protein localized to the nucleus and presynaptic nerve terminal. J Neurosci 8: 2804 2815, Abeliovich A, Schmitz Y, Farinas I, Choi-Lundberg D, Ho WH, Verdugo JMG et al. Mice lacking alpha-synuclein display functional deficits in the nigrostriatal dopamine system. Neuron 25: 239 252, Cabin DE, Shimazu K, Murphy D, Cole NB, Gottschalk W, McIlwain KL et al. Synaptic vesicle depletion correlates with attenuated synaptic responses to prolonged repetitive stimulation in mice lacking alpha-synuclein. J Neurosci 22: 8797 8807, Murphy DD, Rueter SM, Trojanowski JQ, Lee VM. Synucleins are developmentally expressed, and alpha-synuclein regulates the size of the presynaptic vesicular pool in primary hippocampal neurons. J Neurosci 20: 3214 3220, Perez RG, Waymire JC, Lin E, Liu JJ, Guo F, Zigmond MJ. A role for alpha-synuclein in the regulation of dopamine biosynthesis. J Neurosci 22: 3090 3099, Lee FJ, Liu F, Pristupa ZB, Niznik HB. Direct binding and functional coupling of alpha-synuclein to the dopamine transporters accelerate dopamine-induced apoptosis. FASEB J, 15: 916 926, Singleton A, Farrer M, Johnson J, Singleton A, Hague S, Kachergus J, Hulihan M et al. Alpha-synuclein locus triplication in PD. Science 302: 841, 2003. Dauer W, Kholodilov N, Vila M, Trillat AC, Goodchild R, Larsen KE et al. Resistance of alpha -synuclein null mice to the parkin. We thank Professor 0. E. Brodde, University of Halle, Germany and Dr. M. C. Michel, University of Essen, for assistance in establishing radioligand binding studies and fruitful cooperation and orlistat.

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Brain-specific benzodiazepine receptors and putative endogenous "benzodiazepinelike" compounds. Psychopharmacol Bull. 1980 Jan; 16 1 ; : 9-20.
The pharmaceutical industry contributes financial aid, medicine and expertise to the world's leading government and humanitarian organizations to help relieve suffering and improve public health in the developing world. A selected list of our partners includes. KEY WORDS fluoroquinolones; phototoxic dermatitis; comet assay ABSTRACT AIM: To compare two methods of measuring DNA damage induced by photogenotoxicity of fluoroquinolones FQ ; . METHODS: Lomefloxacin LFLX ; , sparfloxacin SPFX ; , ciprofloxacin CPFX ; , and levofloxacin LELX ; were tested by comet assay and photodynamic DNA strand breaking activity under the different conditions of UVA irradiation. RESULTS: In comet assay, photogenotoxicity was evident at SPFX 1 mg L, LFLX 5 mg L, and CPFX 5 mg L, and LELX 10 mg L. In photodynamic DNA srand-breaking activity, SPFX and LFLX induced the conversion of the supercoiled form into the nicked relaxed form at 10-50 mol L, while CPFX at 25 mol L and LELX at 50 mol L. CONCLUSION: There were good correlations between the two methods to detect DNA damage induced by phototoxicity of fluoroquinolones. Photodynamic DNA strand breaking activity was a good method to detect DNA damage induced by photogenotoxicity of fluoroquinolones as well as comet assay.

With the potential for patent protection and improved performance, SuperGenerics may offer a premium pricing opportunity in comparison with generic drugs. SuperGenerics also have a similar regulatory risk profile to generics, as they are based on existing registered pharmaceuticals.

Concentration in epithelial lining fluid in lungs of levofloxacin 750 mg is more than twice that of levofloxacin 500 mg and nearly 12 times that of ciprofloxacin 500 mg. PPMs responsible for the acute exacerbation were isolated in 125 50% ; patients in the levofloxacin group and 131 51.6% ; in the clarithromycin group. The most frequently isolated strains were: H. influenzae n 80; 38 23.9% ; in levofloxacin group and 42 25.8% ; in clarithromycin group.

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