This effect could not be assessed in the multivariable analysis due to collinearity. Posterior median VE for the TUR 11 vaccine was 69% [95% credible interval (95% CI): 50%–81%]. No protective effect was detected for the Shamir vaccine (VE = −36% [95% CI: −140%–21%]) (Table 4). Against severe disease VE was 83% [95% CI: 67%–92%] for the TUR 11 vaccine. VE against infection was 63% [95% CI: 29%–81%] for the TUR 11 vaccine. Credible intervals were too wide to interpret the Shamir vaccine effect. Cattle from small herds (≤30 cattle) and cattle that used common grazing had a greater risk of FMD (Table 4). Although there was no difference in squared standardised residuals

in the four different investigations (p = 0.97), model fit did vary by village DAPT research buy (p < 0.0001). Reasons for this were not apparent, but it may result from factors buy Selisistat not included in the analysis that were more important in some villages than others or differences in data accuracy, which may differ by village. In the Afyon-1 and Afyon-2 investigations (TUR 11 vaccine), a within-herd incidence >50% only occurred in herds with <75% vaccine coverage. In the other TUR 11 study (Denizli province) although many of the high coverage herds had low incidence, high incidences (up to 100%) occurred in herds with 100% coverage. Outbreaks in unvaccinated herds always had high incidence (>50%). Unlike the Shamir investigation, in the TUR 11 investigations within-herd FMD incidence tended

to decline with increasing vaccine coverage (Fig. 3). In the Shamir investigation, cattle were at grass and group refers to large grazing groups (16 groups for 32 farms). In the TUR 11 investigations cattle were either permanently housed or housed at night. In the Afyon-1 investigation additional cattle were sampled from a nearby village that did not experience an outbreak but were vaccinated with the Calpain same vaccine batch at approximately the same time. These 50 sera had mean Asia-1 LPB ELISA titres of 119 (or 102.08) for cattle less than seven months old, 153 (102.18), 237 (102.37) and

206 (102.31) for cattle 7–12 months, 13–24 and over 24 months respectively. The proportion with an Asia-1 SP titre ≥100 (102), a threshold associated with clinical protection, in the different age categories (in the same order) was 2/6 (33%), 9/17 (53%), 8/8 (100%) and 15/19 (79%) respectively. In the outbreak villages, 27/29 (93%) of blood sampled cattle that were NSP negative and did not have clinical FMD had an SP LPBE titre ≥100. A single dose of FMD Asia-1 TUR 11 vaccine was effective at protecting against clinical disease, VE = 69%, particularly severe disease, VE = 83%. The vaccine also protected against infection, VE = 63%. The FMD Asia-1 Shamir vaccine did not appear to protect, indicated by (i) the vaccine effectiveness estimate, (ii) the high incidence in vaccinated cattle and (iii) no reduction in incidence until animals had received >5 doses of vaccine.

Similar vaccination centres are also in operation in the routine EPI service of the government of Bangladesh health service delivery system. There were several factors which were key to the MDV3100 price successful completion of the study. At the beginning of the study, study supervisors discussed about the study with all CHRWs in their routine fortnightly meetings and they provided the message in the community which was helpful for smooth conduct of the study. As the

study was conducted in the ICDDR,B demographically defined surveillance area in Matlab; the exact dates of birth of all children were known so the age could easily be calculated. The CHRWs were experienced in giving EPI vaccines in the community through their fixed site clinics, so the procedures for identifying infants eligible for vaccination was previously established. Further continuous training to the study staff by the local and international monitors, investigators and supervisors helped to conduct the study maintaining

GCP standard. The findings of the monitors during the visit helped in filling out different forms properly later on and to conduct the study according GCP guidelines. Since the rotavirus vaccine was given at the standard times for other EPI vaccines, the new vaccine was readily incorporated into the routine schedule during the same visits. The longstanding relationship of the CHRW with the communities Androgen Receptor Antagonist in vivo they served facilitated the communications about the study with the parents of the eligible infants. Nearly all cases of severe gastroenteritis, which occured in the HDSS area, were detected Adenylyl cyclase because the Matlab hospital is well known in the community to have providing high quality treatment for diarrhoea for more than 45 years. Thus, it has been the practice of families in the HDSS

area, as well as surrounding areas to utilize the Matlab Hospital or the Nayergaon treatment center whenever severe diarrhoea occurs. Matlab is an area with endemic cholera, and the community is aware of the serious nature of diarrhoea, so they are not reluctant to seek medical care when diarrhoea occurs. Capture of diarrhea cases is important in an efficacy trial and the efficacy of the vaccine has been found to be low in the African study in Mali during the first year where many cases of severe diarrhoea were treated by the traditional healers and were not reported to health care facilities [22]. This was the first vaccine trial in a rural setting in Bangladesh where online data entry was done. It has several advantages like rapid entry of data, less transcribing error and quick feed back from the central database for any inconsistencies. Data file is closed when the data set is finalized.

The effect of OPV in that situation is not known, but might be expected to be even greater than concomitant administration given the replication kinetics of OPVs. Overall, the global plans to move from trivalent to bivalent OPVs, and eventually to inactivated poliovirus vaccines (IPV) would be expected

to have favorable effects on the immunogenicity of oral RVs in low-resource settings. A major issue emerging from rotavirus vaccine trials in high mortality/low resource settings compared with low mortality/high resource settings has been the observation of possible waning of efficacy in the second year of life. Thus, in developing world trials that include follow-up learn more time beyond the first year of life (or over multiple years) the relative person-time accumulated estimate reported during the first versus second year of life is critical to interpreting the summary point estimate of efficacy. For example, the RotaTeq® trial in Africa ended on a specific date, and so the primary outcome included

follow-up to a median of 21 months of age [5]. Thus, the overall efficacy reported in this trial reflects cases occurring at various ages. Relatively more cases during the first year of life when vaccine protection appears to be highest would Palbociclib lead to higher overall cumulative efficacy. Additionally, sites had different follow-up time and contributed cases differently to the first versus second years of life. In the RotaTeq® study in Africa, for example, the site in Mali, with lower point estimates of efficacy during both years, contributed relatively more cases in the second year of life as compared with the first year. So comparisons of efficacy beyond the first year of life are particularly problematic without a full understanding of the mix of cases by year and by site [15] and [16]. Another important element to consider when comparing results from different trials is the outcome measure. Most trials

have focused on severe gastroenteritis as measured by the Vesikari scoring system, as the primary outcome measure. Even in circumstances where the outcome is relatively uniform, how the scoring system is oxyclozanide utilized may differ between sites [17]. In addition, secondary outcome measures (e.g. efficacy according to severity of disease, all-cause gastroenteritis) may offer additional information on the public health value of a vaccine, but also require interpretation of point estimates in the context of the definitions employed. For example, in rural Kenya, multiple measures of severe gastroenteritis were used for children in the trial as a substudy of the larger multicenter RotaTeq® efficacy trial in Africa [18]. The primary outcome measure for the multicenter trial was severe gastroenteritis as measured in healthcare facilities using the 20-point modified Vesikari scoring system.

In patients with primary infection, the median (min–max) of the number (/106 PBMC) of ASC (IgA + IgG + IgM) was 241 (175–613) for those specific to Salmonella Typhi, 85 (32–225) to Paratyphi A, 30 (24–133) to Paratyphi B and 8 (6–10) to Paratyphi C ( Fig. 3A). In the patient with the relapse, the numbers of ASC were 28, 14, 28 and 4/106 PBMC, respectively ( Fig. 3 B). In the patient with a Salmonella Paratyphi A infection, the respective numbers were 13, 23, 19 and 0/106 PBMC, with no response to Salmonella Egusi ( Fig. 3C). The

expressions of HR (mean ± SD) on Salmonella Typhi – and Salmonella RAD001 Paratyphi B-specific ASC in the vaccinees are shown in Fig. 4. Almost all of the ASC expressed the intestinal HR, α4β7-integrin (95 ± 5% to Salmonella Typhi and 97 ± 6% to Salmonella Paratyphi B), while the peripheral lymph node HR, l-selectin, and the cutaneous HR, CLA, were found on smaller proportions of them (27 ± 17% and 0.4 ± 1% to Salmonella Typhi and 49 ± 18% and 7 ± 8% to Salmonella Paratyphi B, respectively). The expressions of HR on pathogen-specific ASC in patients with enteric fever are shown in Fig. 4. Almost all ASC expressed α4β7-integrin (92 ± 7%), while l-selectin and CLA were expressed less frequently (50 ± 25% and 8 ± 10%), Roxadustat thus resembling the HR-profile of the Salmonella Typhi- and Paratyphi B-specific responses in vaccinees in this and previous studies [18] and [31]. There are no vaccines

against paratyphoid fever in clinical use. This study presents immunological evidence supporting studies that have previously reported the potential of Ty21a vaccine to protect against paratyphoid fever. There

are four studies evaluating the protective efficacy of either Ty21a or the old parenteral whole cell vaccine (no longer in use) against Salmonella Paratyphi A. Two of these report protection [3] and [18] and two of them do not [19] and [41]. In a study in travelers to Nepal, the majority of those immunized with a whole-cell parenteral vaccine and some Rolziracetam with Ty21a, Schwartz et al. estimated an overall efficacy of 95% against Salmonella Typhi and 72–75% against Salmonella Paratyphi A [18]. Meltzer et al. evaluated imported cases of enteric fever in Israeli travelers to India in an observational study. Travellers were immunized with Ty21a until 2001 and after that with parenteral Vi-polysaccharide vaccine. The general attack rate by Salmonella Paratyphi A was 0.26 in 10,000 during Ty21a and 0.79 during Vi-vaccination. Thus, Ty21a was suggested to confer some protection against Salmonella Paratyphi A [3]. In contrast to these studies, in a large field trial in Plaju, Indonesia, Ty21a was not found to protect against paratyphoid A [19]. However, in that study three doses of Ty21a were administered at an interval of seven instead of two days between doses, leading also to a poor protective efficacy of only 42% against typhoid fever.

Immunogenicity of MenACWY-CRM was considered noninferior to MCV4 for any of the four groups if the lower limit of the two-sided 95% confidence interval SB431542 in vivo around the difference of the percentage of participants with a seroresponse (or hSBA ≥8) for that group (MenACWY-CRM minus MCV4) was greater than −10%. A MenACWY-CRM group

was considered to have a statistically superior immune response compared to MCV4 if the lower limit of the two-sided 95% confidence interval around the difference in percentage of participants was greater than 0 (i.e., the CI did not include 0). Geometric mean titers (GMTs) and two-sided 95% CIs were calculated for each vaccine group and for each EGFR inhibitor drugs group pre- and postvaccination by exponentiating (base 10) the least-squares

means of the logarithmically transformed (base 10) titers and their 95% CIs obtained from a two-way Analysis of Variance (ANOVA) with factors for vaccine group and center. Titers below the detection limit were set to half that limit for the purpose of analysis. As an additional secondary objective analysis, the immunogenicity of the combined group of children aged 2–10 years was analyzed. A sample size of 680 per group in the 2–5-year-olds and 560 per group for the 6–10-year-olds was estimated to provide 95–99% power to demonstrate noninferiority for each of the four groups, 88% power within for each age group to demonstrate noninferiority for all four groups and 77% power to show noninferiority of all four groups across both age strata (2–10 years of age). Inclusion of 325 participants who received the two-dose MenACWY-CRM regimen was calculated to provide 84–94% power to demonstrate superiority of the two-dose regimen in children 2–5 years of age at alpha of 0.05. A total

of 2907 children between 2 and 10 years of age were enrolled in the study. There were 1751 children 2–5 years of age randomly allocated 1:2:2 to receive two doses of MenACWY-CRM (n = 359), one dose of MCV4 (n = 696), or one dose of MenACWY-CRM (n = 696). There were 1156 children 6–10 years of age randomly allocated 1:1 to receive MCV4 (n = 574) or MenACWY-CRM (n = 582). The male/female distribution, race, and weight and height were similar within each age stratum ( Table 2). In total, 2802 (96.4%) participants completed the protocol (Fig. 1). There were 105 premature withdrawals (26 in the two-dose MenACWY-CRM group, 27 in the single-dose MenACWY-CRM 2–5-year-old group, 24 in the single-dose MCV4 2–5-year-old group, 11 in the single-dose MenACWY-CRM 6–10-year-old group and 17 in the single-dose MCV4 6–10-year-old group).

The reduction in current amplitude during zero flow conditions was likely due to the formation of a diffusion-limited concentration gradient resulting in reduced

surface [Glu], because the ratio of the current amplitudes click here with and without flow were dependent on the concentration of glutamate in the perfusate, and in all cases the amount of glutamate transported was <1% of the total glutamate in the chamber (i.e. a pseudo-infinite glutamate source; Fig. 1B–D). This gradient was also reflected in a significant shift in the concentration-dependance of steady-state currents in flow and stopped-flow conditions (KM value for l-glutamate of 32 ± 2 and 216 ± 37 μM, respectively, n = 4; p < 0.002), while the Imax values were not significantly different. Glutamate transporters are

expressed at different densities among structures in the CNS, and transporter density and/or kinetics can be altered in different pathological circumstances such as trauma and ischemia. Because steady-state ambient [Glu] reflects a homeostatic balance of uptake and leak sources, changes in transport may result in significantly different steady state glutamate levels. We tested the influence of the surface density of glutamate transporters on the concentration gradient formed by passive glutamate diffusion during stopped-flow experiments by monitoring currents induced by 10 μM glutamate. With increasing transporter expression levels, the steepness of the concentration gradient formed during stopped-flow conditions was see more increased, as reflected in the changing ratio of the steady-state currents in flow and stopped-flow conditions (Fig. 2A and B). Even with continuous flow, evidence for formation of a concentration gradient between the cell surface and bulk solution was observed. Oocyte

membranes have a microvillar structure that can act as tortuous diffusion barrier (see Supplisson and Bergman, 1997). In a group of 29 oocytes with varying expression levels, steady-state KM values measured with chamber flow (20 mm/s) increased approximately 4-fold as transporter current induced by 1 mM glutamate increased from ∼200 to ∼1100 nA ( Fig. 2C and D). Thus, there is an effect of the concentration STK38 gradient formed by transporters even with continuous flow, resulting in a discrepancy between the measured and actual glutamate KM value. We extrapolated a linear function relating the measured KM value to the transport current density ( Barry and Diamond, 1984), yielding an estimate of the intrinsic KM value of approximately 27 μM (r = 0.78; Fig. 2D). While the dependance of steady-state KM on transporter density reflects the fact that the true glutamate concentration at the cell surface is reduced by uptake, the concentration difference associated with the diffusion gradient is minimal at when high concentrations of glutamate are applied by continuous flow.

Page 5327, Table 2 • Row “Geometric mean titer + S.D. 581 + 3380, 474 + 1830, 4076 + 7058”, at the month 2, month 6 and month 7 columns. “
“Neisseria meningitidis is a gram-negative diplococcus that causes severe invasive disease including septicemia and meningitis [1]. Most invasive disease is the result of infection with one of five groups (A, B, C, Y, W-135) as characterized by their capsular polysaccharide [2]. Epidemic group A disease occurs in sub-Saharan Africa, the Middle East and in some areas of Asia [3], [4] and [5]. Endemic group B and C disease predominates in Europe and North America; an increase in group Y disease has been reported over Adriamycin clinical trial the last 20 years in the United States [6]. Outbreaks of W-135 disease have been reported

NVP-BKM120 price in the Middle East and Africa [4] and [7]. Meningococcal disease is seen in all age groups including children 2–10 years of age; in the US, groups A, C, Y and W-135 account for approximately 60% of meningococcal disease [8]. Using similar conjugation technology that led to the development of effective vaccines against Haemophilus influenzae type b and pneumococcal diseases in infants and young children [9] and [10], group C meningococcal conjugate vaccines (MenC) were

developed that led to dramatic decreases in invasive disease caused by N. meningitidis group C in European countries and Australia where universal immunization programs were implemented [11], [12], [13] and [14]. By chemically conjugating capsular polysaccharide to a protein carrier, the polysaccharide antigen is converted from a T-cell independent antigen to a T-cell dependent antigen with the resultant induction in immune memory in all ages after immunization and improved immunogenicity in infants [15], [16] and [17]. A quadrivalent meningococcal conjugate vaccine was developed in an attempt to improve upon the quadrivalent meningococcal polysaccharide vaccine that has been available for decades. Menactra® (MCV4; Sanofi Pasteur, Swiftwater, PA) was licensed for use in the United States January

17, 2005, for individuals 11–55 years of age and October 19, 2007, for children 2–10 years of age, and is recommended for universal use as a preadolescent dose [18] and for children 2–10 years of age with increased risk of meninogococcal infection [19] and [20]. Menveo® (MenACWY-CRM; Novartis Vaccines and Diagnostics, Cambridge, DNA ligase MA), a quadrivalent meningococcal conjugate vaccine, was recently licensed in the United States February 19, 2010, for individuals 11–55 years of age and in Canada on May 21, 2010 for individuals 11 years and older; further studies were undertaken to support its use in infants [21], [22] and [23] and younger children [24]. The purpose of this study was to compare the safety and immunogenicity of MenACWY-CRM to the licensed MCV4 vaccine in children 2–10 years of age. The investigational quadrivalent meningococcal conjugate vaccine (MenACWY-CRM; Menveo®, Novartis Vaccines and Diagnostics, Cambridge, MA) contained (per 0.

5 ml extract solution and observed for white precipitation which indicates presence of tannin. 0.2 g of the extract was shaken with 5 ml of distilled water and then heated to boil. Frothing shows the presence of saponin. 0.2 g of the extract was dissolved in 10% NaOH solution, yellow colouration indicates the presence of flavonoid. To 2 ml of extract solution, added 2 ml of alcohol and few drops of ferric chloride solution and observed for colouration. Five ml of each extract was treated with 2 ml of glacial acetic acid containing one drop of ferric chloride solution. This was under layered with 1 ml of conc. sulphuric selleck acid. A brown ring at the interface indicated

the present of cardiac glycoside. (A violet ring may appear below the ring while in the acetic acid layer, a greenish ring may formed). 0.5 g extract was boiled with conc. HCl and filtered. 0.5 ml of picric

acid and Mayer’s reagent was added separately to about 1 ml of the filtrate in a different test tube and observed for coloured precipitate or turbidity. To 0.2 g of extract, added 5 ml of chloroform and 5 ml of 105 ammonia solution. The presence of bright pink colour in the aqueous layer indicated the presence of anthraquinone. Five ml of extract solution was mixed in 2 ml of chloroform, and 3 ml of conc. sulphuric acid was added to form a layer. A reddish brown colouration of the interface Venetoclax order was formed to indicate the presence of terpenoids. Red colour at the lower surface indicates presence of steroid. To 0.5 ml of extract solution, 1 ml of water and heated after adding 5–8 drops of Fehling’s solution. Brick red precipitation indicated the presence of reducing sugar. Antioxidants react with 1, 1-diphenyl-2-picryl-hydrazyl (DPPH) radical and convert it to 1, 1-diphenyl-2-picryl hydrazine. The degree of change in colour from purple to yellow can be used as a measure of the scavenging potential of antioxidant extracts. Aliquots of ethanol extract solutions (1 mg/ml) were taken and made up the volume to 3 ml with methanol. 0.15 ml of freshly prepared DPPH Ketanserin solution

was added, stirred and left to stand at room temperature for 30 min in dark. The control contains only DPPH solution in methanol instead of sample while methanol served as the blank (negative control). Absorbance was noted at 517 nm using the Systronics make spectrophotometer (Visiscan 167). The capacity of scavenging free radicals was calculated as scavenging activity (%) = [(Abscontrol−Abssample/Abscontrol)] × 100 where Abscontrol is the absorbance of DPPH radical + methanol; Abssample is the absorbance of DPPH radical + sample extract/standard. The ABTS assay was carried out following the method of Re et al.9 The stock solution included 7 mM ABTS solution and 2.4 mM potassium persulfate solution and mixed them in equal proportion then allowed to react for 12 h at room temperature in the dark and diluted by mixing 1 ml ABTS solution with 60 ml methanol to obtain an absorbance of 0.706 ± 0.

Pour les antiagrégants,

l’utilisation de l’aspirine reste malgré tout assez homogène, tandis que celle des antiagrégants les plus puissants (anti-GP IIb-IIIa et prasugrel diminue très fortement avec l’âge ; l’utilisation du clopidogrel reste stable dans le NSTEMI, et augmente avec l’âge dans le STEMI). Pour ce qui est des anticoagulants, les héparines de bas poids moléculaire sont moins utilisées quand l’âge progresse, alors que l’héparine non fractionnée l’est plus ; l’utilisation du fondaparinux n’est pas Pifithrin-�� manufacturer affectée par l’âge. Les bêta-bloquants et les statines sont en net retrait dans les groupes d’âge élevé ; à l’inverse, l’utilisation des diurétiques croît de manière importante. Dans la population STEMI, la proportion des patients ayant reçu un traitement de reperfusion décroît avec l’âge ; néanmoins, 72 % des patients

âgés de 75 à 84 ans et 54 % de ceux de 85 ans et plus sont traités soit par angioplastie primaire, soit par fibrinolyse (figure 3). La grande majorité des patients fibrinolysés ont ensuite une coronarographie : 100 % des patients de moins de 75 ans, 96 % de ceux de 75 à 84 ans et 87,5 % de ceux de 85 ans et plus, celle-ci étant presque toujours suivie d’une angioplastie. Dans la population this website NSTEMI, l’utilisation des stratégies invasives (coronarographie avec ou sans revascularisation myocardique), quasi-systématique avant 65 ans, diminue avec l’âge (figure 4) ; l’angioplastie suit la même tendance alors que l’utilisation du pontage est maximale entre 65 et 74 ans. La mortalité hospitalière augmente considérablement avec l’âge (figure 5, tableau V). Dans le NSTEMI, elle reste cependant faible jusqu’à l’âge de 85 ans, tandis qu’elle croît nettement à partir Rutecarpine de 75 ans dans le STEMI. L’insuffisance cardiaque sévère augmente également (6,6 % avant 75 ans, 14,8 % entre 75 et 84 ans et 26 % à partir de 85 ans) ; les récidives de nécrose restent

rares (0,8 %, 1,2 % et 3,2 %, respectivement), alors que les AVC sont peu influencés par l’âge (0,4 %, 0,4 % et 0,7 %). Le risque de saignement TIMI majeur est peu influencé par l’âge (2,2 %, 2,6 % et 2,5 %, respectivement), mais le recours aux transfusions sanguines augmente fortement avec l’âge (2,2 %, 6,3 % et 7,6 %, respectivement). L’augmentation d’utilisation des transfusions paraît finalement plus liée à l’augmentation de prévalence d’une anémie documentée à l’admission (12,3 % des moins de 75 ans, 35,2 % entre 75 et 84 ans, et 43,9 % à partir de 85 ans) qu’à une augmentation du risque de complication hémorragique. De façon prévisible, les patients âgés représentent une population très spécifique, caractérisée par la présence plus fréquente d’antécédents cardiovasculaires et de comorbidités. Il s’agit pourtant d’une population numériquement importante, représentant près de 40 % des NSTEMI et plus de 25 % des STEMI.

The characteristic pain intensity score ranges from 0 to 100 and is evaluated by calculating the mean of pain intensities reported for current pain status, as well as the worst and the average pain in last 6 months. The disability score (0–100) is based on the mean ratings of how much the pain has interfered in performing activities of daily living, work and social activities in the last 6 months. The disability points are scored 0–3 and are derived from a combination of ranked categories of the number of disability days (the number of days that the respondent was away from usual activities in the last 6 months due to pain) and disability

score. Based on these scores, the respondent’s chronic pain and disability status can then be classified into one of the 5 hierarchical categories of chronic pain/disability: BI 6727 cost no pain (Grade 0), low disability and low intensity (Grade I), low disability Selleckchem 3-deazaneplanocin A and high intensity (Grade II), high disability and moderately limiting intensity (Grade III), high disability and severely limiting intensity (Grade IV) (Von Korff et al 1992). Being a patient-reported measure, the CPGQ is extremely easy to administer, score, and interpret, therefore it requires minimal training. The administrative burden of the CPGQ is less than 10 minutes. Reliability,

validity and responsiveness: CPGQ was originally administered via telephone interviews for patients with back pain, headache, and temporomandibular joint pain. However, subsequent research has expanded its utility in postal surveys in general population and chronic musculoskeletal pain. It was found to have good correlation with the equivalent dimensions of SF-36 questionnaire; highest for pain and least for mental health dimension (convergent validity). Factor analyses demonstrated that all the seven items contributed significantly to the explained variance (> 75%) ( Smith et al 1997). Furthermore, moderate to good internal consistency (Cronbach’s alpha, 0.74 to 0.91) and good test retest reliability has been demonstrated in primary care patients with back pain (weighted kappa –0.81, 95% CI 0.65 to 0.98) (

Smith et al 1997). A study by Elliot et al showed that changes in CPGQ score over a period of time in patients with chronic musculoskeletal pain correlated Thymidine kinase significantly with changes in SF-36 scores ( Elliott et al 2000). Responsiveness statistics and minimal clinically important difference (MCID) of the CPGQ have not been reported in the literature. CPGQ is a reliable and valid measure for evaluation of chronic pain in the general population as well as in the primary health care setting. A recent study demonstrated that even though CPGQ was developed prior to the WHO International Classification of Functioning, Disability & Health (ICF), it measures all the ICF outcomes ie, impairment, activity limitation and participation restriction (Dixon et al 2007).