Synthesis, spectroscopic, chemical reactivity, topology analysis and molecular docking study of ethyl 5-hydroxy-2-thioxo-4-(p-tolyl)-6-(trifluoromethyl)hexahydropyrimidine-5-carboxylate

The organofluorine hexahydropyrimidine derivatives are used in the drug discovery due to its steric nature to hydrogen and its extreme electronegativity. The Ethyl 5-hydroxy-2-thioxo-4-(p-tolyl)-6-(trifluoromethyl)hexahydropyrimidine-5-carboxylate (ETP5C) compound was synthesized and characterized by NMR (13C and 1H), FT-IR and UV-Vis spectroscopic techniques for experimentally and theoretically and elemental analyses, mass spectra also investigated. The most stable structure of synthesized molecule was studied by PES analysis in gas and liquid medium. The structural parameters such as bond length and bond angle of the title molecule have been obtained by DFT/B3LYP/6-311++G (d,p) set and compared with the structurally related experimental data of the compounds. The π-to-π* transition of the ETP5C molecule is identified using UV-Vis absorption spectral analysis. In addition, the chemical stability and reactivity are investigated using HOMO-LUMO analysis. The minimal HOMO-LUMO energy gap (4.6255 eV) clearly explains that the ETP5C molecule is more reactive for receptors. The nucleophilic and electrophilic regions such as active sites have been shown by MEP, ELF, LOL and Fukui functions. The second order optical effect has been explained by NLO analysis. The docking was performed with antineoplastic proteins that exhibit against the development of tumor cells.

Seasonal Stability Assessment of Reference Genes for Quantitative Real-Time Polymerase Chain Reaction Normalization in Bombus terrestris

Bumblebees (B. terrestris) play a crucial role as highly efficient biological agents in commercial pollination. Understanding the molecular mechanisms governing their adaptation to diverse seasonal environments may pave the way for effective management strategies in the future. With the burgeoning advancement in post-genetic studies focusing on B. terrestris, there is a critical need to normalize quantitative real-time PCR (qRT-PCR) data using suitable reference genes. To address this necessity, we employed RefFinder, a software-based tool, to assess the suitability of several candidate endogenous control genes, including actin (ACT), arginine kinase (AK), elongation factor 1 alpha (EF1), glyceraldehyde-3-phosphate (GAPDH), phospholipase (PLA2), and ribosomal proteins (S18, S28). These genes were evaluated for their efficacy as biological endogenous controls by examining their expression patterns across various environmental conditions corresponding to different seasons (Spring, Summer, Autumn, Winter) and tissues (ovary, fat body, thorax, head) in bumblebees. Moreover, the study investigated the significance of selecting appropriate reference genes for three key genes involved in the juvenile hormone (JH) signaling pathways: Krüppel homolog 1 (Kr-h1), methyl farnesoate epoxidase (MFE), and Vitellogenin (Vg). Our research identifies specific genes suitable for normalization in B. terrestris, thereby offering valuable insights into gene expression and functional metabolic genetics under varying seasonal conditions. This catalog of reference genes will serve as a valuable resource for future research endeavors.

Symptomatic Pneumonitis Rates Among Patients with Stage III Non-Small Cell Lung Cancer Receiving Adjuvant Durvalumab

PURPOSE/OBJECTIVE(S)

Adjuvant durvalumab after definitive chemoradiation for stage III non-small cell lung cancer (NSCLC) has improved overall survival with low reported pneumonitis rates in clinical trials. However, real-world rates of treatment-associated pneumonitis remain poorly defined. We sought to describe pneumonitis rates among a largest-to-date real-world cohort of stage III NSCLC patients receiving adjuvant durvalumab.

MATERIALS/METHODS

We performed a retrospective cohort study of patients with stage III NSCLC in the national Veterans Health Administration who received concurrent chemoradiation alone from 2015-2016 or concurrent chemoradiation followed by at least one dose of adjuvant durvalumab from 2017-2021. Incident pneumonitis was defined as new or worsening symptoms, radiographic changes on CT chest, at least one steroid prescription, and a likely diagnosis of pneumonitis by the treating physician within 2 years of the final radiation treatment; severity was graded by CTCAE v4.03 criteria. Pneumonitis events were ascertained by manual chart review assisted by keyword searches and steroid prescription data. Cox regression was used to identify baseline clinical factors associated with Grade 2+ pneumonitis.

RESULTS

Our cohort included 1,994 patients with stage IIII NSCLC, 989 of whom received concurrent chemoradiation alone and 1005 of whom received adjuvant durvalumab. The overall incidence of symptomatic pneumonitis among patients receiving concurrent chemoradiation alone vs those receiving adjuvant immunotherapy was 6.8% vs 11% (Grade 2, p = 0.0005), 6% vs 8.4% (Grade 3, p = 0.007) and 1.1% vs 1.6% (Grade 5, p = 0.292), respectively. The cumulative incidence of Grade 2-5 pneumonitis at 2 years was 13.8% among patients treated with chemoradiation alone versus 22.1% for patients treated with chemoradiation followed by durvalumab (p ≤0.0001). Of those with Grade 2 pneumonitis, pneumonitis occurred in 85% of patients within one year of receiving radiation, and 84% of those with Grade 3-5 pneumonitis developed pneumonitis within one year. Patients prescribed outpatient steroids for pneumonitis had active prescriptions lasting a mean of 153 days, and among those hospitalized for pneumonitis, ¾ needed supplemental oxygen support. On multivariate analysis, the use of durvalumab is associated with higher risk of Grade 2-5 pneumonitis (HR 1.4, p = 0.004). Current smokers have a 50% risk reduction for Grade 2+ pneumonitis relative to never smokers (p≤0.001).

CONCLUSION

In this largest-to-date cohort, we found that adjuvant immunotherapy is associated with higher risk of Grade 2+ pneumonitis. The increase in symptomatic pneumonitis associated with durvalumab should spur future work to refine patient selection, balance the risk/benefit of adjuvant immunotherapy, and potentially modify radiation dosimetric constraints to decrease pneumonitis rates.

Integrated hydrogeophysical and GIS based demarcation of groundwater potential and vulnerability zones in a hard rock and sedimentary terrain of Southern India

This research has identified the groundwater potential and vulnerability zones in Tiruchirappalli district of Tamil Nadu, India. The Schlumberger electrode array has been used to conduct vertical electrical sounding (VES) at 95 sites with a maximum electrode spacing of 150 m. The study area comprises of hard rock and sedimentary formations. Geographical Information System (GIS) has been used to integrate the geoelectrical data and to prepare spatial variation maps for various parameters. Finally, groundwater potential and vulnerability zones have been demarcated, and these outputs have been validated using water level and nitrate data, respectively. The Dar-Zarrouk parameters such as longitudinal conductance (S), transverse unit resistance (T), and aquifer anisotropy (λ) have been used along with the spatial variation of resistivity and aquifer thickness to find out groundwater potential areas with the support of GIS. The thickness of topsoil, weathered zone and fractured zone are not uniform in the research area. Top soil plus weathered zone acts as a water table (phreatic) aquifer, which extends up to 38 m from the surface. Fractured zone extends up to 45 m, which acts as a kind of confined/semi-confined aquifer. Open and bore wells have been constructed to tap groundwater from the unconfined (water table) and confined/semi-confined aquifers, respectively. High to very high groundwater potential areas are associated with low resistivity, high thickness, low longitudinal conductance, high transverse unit resistance and high aquifer anisotropy areas. Very high groundwater potential areas are mostly confined to flood plain (alluvium) deposits in the central portion of the study area. High potential areas are noticed in the northern part, whereas low potential areas are noticed in the southern part. The areas with high longitudinal conductance indicate low permeable zones with less possibility of external pollution. Since agriculture is an important activity in the study region, this work will be useful to provide water supply for irrigation as well as for domestic needs.

Finite element analysis of fractured femur bone with prosthetic bone plates using ANSYS software

Bones are living tissues made of calcium and phosphorus among other elements. In the early years, they replenish themselves and expand quickly. The bone is viewed as a homogenous, isotropic, linear-elastic material. The foundation of the human skeleton are the bones. It aids in supporting the body's softer areas. Trauma is a significant factor in both industrialised and developing nations in terms of mortality and disability. According to the World Health Organization (WHO), trauma will account for the majority of years of life lost in both developed and developing countries by the year 2020. One of the frequent traumas is a bone fracture. Using bone plates to connect the fractured bone is one way to treat the broken bone. This study compares bone plates constructed of several biomaterials (Stainless Steel, Titanium, Alumina, Nylon, and PMMA) to determine which one is the best. SOLIDWORKS is used to model the femur bone, while ANSYS is used for analysis. Also modelled, attached to a fractured bone, and examined are the fracture fixation plates.

A Unique Metro Choice Behaviour of Suburban Rail Passengers in India

This study aims to analyse the inter-rail modal shift behaviour of suburban rail passengers to examine ridership for the proposed metro extension corridor in Chennai, India. This investigation was conducted in 2019 as part of a feasibility study for the extension of the metro line spanning between Chennai Airport and Kilambakkam, a southern suburb of Chennai. The same origin-destination pair is also served by the suburban rail system. It is an extension of the operating line from Washermenpet to the airport of the Phase I metro project. For this inter-rail competition study, a sample of 272 suburban rail passengers covering work, education and other trip purposes were interviewed using a stated preference questionnaire. Six stated scenarios were considered for analyses which included travel time saving by using the metro along with the fare difference between metro and bus. The study revealed that suburban rail passengers were less concerned about travel time saving and gave priority to fare difference irrespective of trip purpose. This shows the unique metro choice behaviour of suburban rail travellers in the Indian context.

Effect of Local Anaesthesia with and without Adrenaline on Blood Glucose Concentration in Patients Undergoing Tooth Extractions - A Comparative Study

Introduction

Local anaesthesia (LA) is the usual drug used in dentistry to reduce intraoperative pain. The efficacy of lignocaine is improved by adding adrenaline as a vasoconstrictor. Adrenaline decreases the systemic absorption of LA and reduces blood loss during the surgical procedure. The study was conducted to observe the effect of adrenaline on blood glucose concentration in patients undergoing tooth extraction.

Materials and Methods

The study was conducted on 100 patients needing multiple teeth extraction. On the first appointment, extraction was done using lignocaine without adrenaline (plain), and for the second appointment, extraction was done using lignocaine with adrenaline (1:200,000). Serial blood glucose estimations were carried out at identical intervals on both occasions.

Results

Significant difference in blood glucose level was noted when the patients received lignocaine with adrenaline before administration and after 10 min/20 min intervals (P < 0.05).

Discussion

Constant vigilance and prudence are recommended while using lignocaine with adrenaline in patients suffering from diabetes mellitus.

Mucoepidermoid Carcinoma of Sublingual Salivary Gland: A Rare Case Report

Rationale

Sublingual salivary gland tumours are very rare but are mostly malignant. As very limited literature is available, we present a rare case of mucoepidermoid carcinoma (MEC) of sublingual salivary gland.

Patient Concerns

A56-year-old female presented with an asymptomatic swelling of 15-year duration in the floor of the mouth and chin region.

Diagnosis

Mandibular occlusal view, computed tomography scan, and ultrasonogram revealed calcification and the tumour to be of salivary origin. Incisional biopsy showed clear cell changes.

Treatment

The sublingual and submandibular salivary gland along with the associated nodes was excised through transoral approach with midline osteotomy.

Outcomes

The histopathologic diagnosis of excised specimen was "Intermediate grade MEC" with clear cell changes, stromal hyalinization, and local invasion. The patient was followed up for 12 months, and there was no evidence of any recurrence.

Takeaway Lessons

Sublingual salivary gland malignancies show early invasion and a higher rate of metastases, thus requiring a vigilant intervention.

Effect of 2 h of room temperature storage on salivary glucose concentration

Background of the Study:

Although many studies are available validating the role of saliva as an alternative diagnostic tool, no reliable data are available on the duration of time, a salivary sample can be reliably stored at room temperature for estimation. It varies from one analyte to another and has to be researched.

Aim:

The aim of the study was to determine the effect of 2 h of room temperature storage on salivary glucose concentration.

Materials and Methods:

Saliva samples obtained by spitting method from thirty healthy volunteers were centrifuged and glucose concentration determined in the supernatant obtained. The test was repeated 2 h later following room temperature storage of the supernatant.

Results:

The data obtained were analyzed using wilcoxson signed rank test. No significant difference between was observed between the two values.

Conclusion:

Salivary glucose can reliably estimate on centrifuged samples following 2 h of room temperature storage.

Drainage morphometric analysis of the Nagavathi watershed, Cauvery river basin in Dharmapuri district, Tamil Nadu, India using SRTM data and GIS

A drainage morphometric analysis of Nagavathi watershed in Dharmapuri district has been chosen for the present study. Geospatial tools, such as remote sensing and GIS, are utilized for the extraction of watershed and its drainage networks. The Shuttle Radar Topographic Mission (SRTM) data have been used for drainage morphometric analysis and evaluating various morphometric parameters Linear aspect, Aerial aspect Relief aspect. The morphometric parameters of Nagavathi watershed have been analyzed and evaluated by pioneer methods, such as Horton and Strahler. The bifurcation ratio varies from 0.8 to 43.1. The elongation ratio of Microwatersheds varies from 0.13 to 0.43, indicates Microwatersheds fall under elongated pattern. This study would help the local people to utilize the resources for planning rainwater harvesting and watershed management.

Risk Factors for Post-Traumatic Endophthalmitis in Patients with Positive Intraocular Cultures

Purpose

To determine the risk factors for post-traumatic endophthalmitis in patients with positive intraocular culture.

Methods

An institutional-based prospective nonrandomized interventional study of patients older than 15 years who presented for primary repair of open globe injury between June 2003 and April 2005 was undertaken. The main outcomes measured were initial and final visual acuity, type of injury, presence of uveal and vitreous prolapse, time interval between injury and primary repair of the globe, length of wound, location of wound, and virulence of organism. Statistical analysis tests used were Student t-test, Fisher exact test, and chi-square test.

Results

Fifty patients were included in the study. They were divided into two groups: Group 1 (n=19) patients, who developed clinically significant endophthalmitis; and Group 2 (n=31) patients, who did not develop clinically significant endophthalmitis. Delay in primary repair more than 36 hours (p=0.042), length of wound more than 8 mm (p=0.050), and isolation of organisms like fungus (p=0.006, OR=14), Bacillus cereus (p=0.01, OR=11.25), and Pseudomonas aeruginosa (p=0.05–0.10, OR=11.3) significantly increased the risk of endophthalmitis. Mean initial and final visual acuity was better in Group 2 but was not statistically significant (p=0.21).

Conclusions

Final visual outcome in the presence of positive intraocular culture is poor. Isolation of virulent organisms, longer length of laceration, and delayed primary repair of open globe injuries have high risk of developing endophthalmitis. Prophylactic intraocular antibiotics should be considered in cases with longer length of wound and delayed primary closure.

Estimation of cytogenetic risk among coke oven workers exposed to polycyclic aromatic hydrocarbons

Polycyclic aromatic hydrocarbons (PAHs) result from the incomplete combustion of natural or synthetic organic materials. The working environment at a coke plant can negatively affect the employed workers who were exposed to coke oven emissions containing PAHs, which formed and released into the environment by the process of pyrolysis of coke. This study aims to analyze the relationship between the exposure of PAHs and the risk of genetic damages such as chromosomal alteration (CA), micronucleus (MN), and DNA damage (PCR-RFLP) in peripheral blood lymphocytes of 27 coke oven workers and equal number of control subjects. The exposed subjects and controls were divided into two groups based on their age (group I

Estimation of cytogenetic risk among coke oven workers exposed to polycyclic aromatic hydrocarbons

Polycyclic aromatic hydrocarbons (PAHs) result from the incomplete combustion of natural or synthetic organic materials. The working environment at a coke plant can negatively affect the employed workers who were exposed to coke oven emissions containing PAHs, which formed and released into the environment by the process of pyrolysis of coke. This study aims to analyze the relationship between the exposure of PAHs and the risk of genetic damages such as chromosomal alteration (CA), micronucleus (MN), and DNA damage (PCR-RFLP) in peripheral blood lymphocytes of 27 coke oven workers and equal number of control subjects. The exposed subjects and controls were divided into two groups based on their age (group I<35 years and group II ≥35 years). The exposed subjects were further classified into two groups based on the exposure period (<12 years and ≥12 years). The frequencies of CA and MN in exposed subjects are relatively high with respect to controls. The XRCC1 399 Arg/gln polymorphism showed a substantial smaller difference in allele frequencies between exposed and control subjects. Based on present data, it was concluded that coke oven workers under risk should be monitored for adverse effects of the any long-term exposure.

A comprehensive analysis of plausible genotoxic covariates among workers of a polyvinyl chloride plant exposed to vinyl chloride monomer

The aim of this study was to assess the frequency of chromosomal aberrations-including chromatid type aberrations (CTAs), chromosomal type aberrations, micronucleus (MN) comet assay, and XRCC1 399 Arg/Gln polymorphism-in peripheral blood lymphocytes of workers occupationally exposed to vinyl chloride monomer (VCM). A total of 52 workers and an equal number of controls were recruited into the study to explore the potential cytogenetic risk of occupational exposure to VCM. Questionnaires were administered to obtain details of habitual cigarette-smoking, alcohol-consumption pattern, and occupation, etc. The exposed subjects and controls were classified into two groups based on age (group I <40 years; group II ≥40 years), and exposed subjects were further classified based on exposure duration (>8 and ≥8 years). CTA, MN, and comet assay frequency were significantly greater in polyvinyl chloride (PVC) factory workers (p < 0.05) with long-duration work. CTA, MN, and comet assay values were found to be increased with age in exposed subjects as well as in controls, with exposed subjects showing a statistically greater degree. An extensively greater MN frequency was observed in smokers exposed to VCM than in the control group (P < 0.05). The mean tail length of exposed subjects was greater compared with controls. The study on XRCC1 399 Arg/gln polymorphism in PVC factory workers showed less significant difference in allele frequency compared with controls. In conclusion, this results of work provides evidence for an apparent genotoxic effect associated with VCM exposure. Our results reinforce the greater sensitivity of cytogenetic assays for biomonitoring of occupationally exposed populations. Statistics indicate that workers exposed to VCM are at carcinogenic risk and should be monitored for long-term adverse effects from their exposure.

Double-layered closure of oroantral fistula using buccal fat pad and buccal advancement flap

Some of the traditional methods that are being employed in the repair of oroantral communication can be broadly divided into local and distant flaps. Recently, because of various advantages, buccal fat pad is increasingly being employed in the repair of oroantral fistula and other oral defects worldwide. However, there are some problems that can be encountered while harvesting BFP which has to be taken care of. In this paper, we present a case with one of such problems, its management, and review of literature on the same.

Fluoride contamination - Artificial neural network modeling and inverse distance weighting approach

The underground waters in the Mamundiyar basin, India, present real chemical quality problems. Their fluoride content always exceeds the recommended levels. The Inverse Distance Weighted (IDW) method has been used for spatial interpolation of various key chemical parameters. Artificial Neural Network (ANN) modeling was applied to understand the correlation and sensitivity of all chemical parameters with respect to fluorides. The correlation of all the considered parameters is found to be poor where the highest correlation observed was only 0.37. This result showed that four of the parameters, namely pH, chlorides, sulphates and calcium, were found to have greater capacity of influencing fluorides than the other eight parameters. Chlorides were found to be the parameter that was the most sensitive and most correlated to fluorides.

Spatial assessment of groundwater quality in Mamundiyar basin, Tamil Nadu, India

Understanding the groundwater quality is important as it is the main factor determining its suitability for drinking, domestic, agricultural, and industrial purposes. In order to assess the groundwater quality, 30 groundwater samples have been collected in year 2008. The water samples collected in the field were analyzed for electrical conductivity, pH, total dissolved solids (TDS), major cations like calcium, magnesium, sodium, potassium, and anions like bicarbonate, carbonate, chloride, nitrate, and sulfate, in the laboratory using the standard methods given by the American Public Health Association. The groundwater locations were selected to cover the entire study area and attention was been given to the area where contamination is expected. The expected groundwater contaminants were chloride, nitrate, TDS, etc. The results were evaluated in accordance with the drinking water quality standards given by the World Health Organization (WHO 1993). To know the distribution pattern of the concentration of different elements and to demarcate the higher concentration zones, the contour maps for various elements were also generated, discussed, and presented.

Investigation of groundwater quality in hardrock terrain using Geoinformation System

Two hundred sample sites were selected systematically and samples were taken for a baseline study to understand the geochemistry of the groundwater and to assess the overall physicochemical characteristics. Sampling was carried out using pre-cleaned polyethylene containers. The physical and chemical parameters of the analytical results of groundwater were compared with the standard guideline values recommended by the World Health Organization for drinking and public health standards. Thematic maps pertaining to TDS, EC, Cl, NO(3), SO(4), and Na were generated using Arc View 3.1 platform. Results showed that most of the locations are contaminated by higher concentration of EC, TDS, K( + ), and NO3(-). Major hydro-chemical facies were identified using Piper trilinear diagram. Based on US salinity diagram, most of the samples fall in the field of C3-S1 indicating high salinity and low sodium water, which can be used for almost all types of soil with little danger of exchangeable sodium. Majority of the samples are not suitable for domestic purposes and far from drinking water standards. However, PI values indicate that groundwater is suitable for irrigation.

Major ion chemistry and hydrochemical studies of groundwater of parts of Palar river basin, Tamil Nadu, India

Groundwater is almost globally important for human consumption as well as for the support of habitat and for maintaining the quality of base flow to rivers, while its quality assessment is essential to ensure sustainable safe use of the resources for drinking, agricultural, and industrial purposes. In the current study, 50 groundwater samples were collected from parts of Palar river basin to assess water quality and investigate hydrochemical nature by analyzing the major cations (Ca, Mg, Na, K) and anions (HCO(3), Cl, F,SO(4), NO(3), PO(4),CO(3), HCO(3), and F) besides some physical and chemical parameters (pH, electrical conductivity, alkalinity, and total hardness). Also, geographic information system-based groundwater quality mapping in the form of visually communicating contour maps was developed using ArcGIS-9.2 to delineate spatial variation in physicochemical characteristics of groundwater samples. Wilcox classification and US Salinity Laboratory hazard diagram suggests that 52% of the groundwater fall in the field of C2-S1, indicating water of medium salinity and low sodium, which can be used for irrigation in almost all types of soil with little danger of exchangeable sodium. Remaining 48% is falling under C1-SI, indicating water of low salinity and low sodium.

Fluorine contamination in groundwater: a major challenge

Fluoride in high concentration in groundwater has been reported from many parts of India. However, a systematic study is required to understand the behavior of fluoride in natural water in terms of local hydrogeological setting, climatic conditions, and agricultural practices. The present study is an attempt to assess hydrogeochemistry of groundwater in parts of Palar river basin pertaining to Kancheepuram district Tamil Nadu to understand the fluoride abundance in groundwater and to deduce the chemical parameters responsible for the dissolution activity of fluoride. The study area is geologically occupied by partly sedimentary and partly crystalline formations. A total of 50 dug cum borewell-water samples, representing an area of 2,628.92 km2. The results of the chemical analyses in September 2009 show fluoride abundance in the range of 1 to 3.24 mg/l with 86% of the samples in excess of the permissible limit of 1.5 mg/l. Presence of fluoride-bearing minerals in the host rock, chemical properties like decomposition, dissociation, and dissolution, and their interaction with water are considered to be the main causes for fluoride in groundwater. Chemical weathering with relatively high alkalinity favors high concentration of fluoride in groundwater. Villagers who consume nonpotable high fluoride water may suffer from yellow, cracked teeth; joint pains; and crippled limbs and also age rapidly.

Deciphering groundwater potential zones in hard rock terrain using geospatial technology

Remote sensing and geographical information system (GIS) has become one of the leading tools in the field of groundwater research, which helps in assessing, monitoring, and conserving groundwater resources. This paper mainly deals with the integrated approach of remote sensing and GIS to delineate groundwater potential zones in hard rock terrain. Digitized vector maps pertaining to chosen parameters, viz. geomorphology, geology, land use/land cover, lineament, relief, and drainage, were converted to raster data using 23 m×23 m grid cell size. Moreover, curvature of the study area was also considered while manipulating the spatial data. The raster maps of these parameters were assigned to their respective theme weight and class weights. The individual theme weight was multiplied by its respective class weight and then all the raster thematic layers were aggregated in a linear combination equation in Arc Map GIS Raster Calculator module. Moreover, the weighted layers were statistically modeled to get the areal extent of groundwater prospects with respect to each thematic layer. The final result depicts the favorable prospective zones in the study area and can be helpful in better planning and management of groundwater resources especially in hard rock terrains.

Quality grading for cervical smears

Three thousand five hundred and eighty cervical smears were taken in 1990-1992 at a Genitourinary Medicine Clinic with various spatula or spatula brush combinations. The unsatisfactory rate and the detection of cellular abnormalities showed some relation to spatula type. However, the satisfactory smears screened in the laboratory are routinely assigned a quality grade-good, fair or poor. Analysis shows higher rate of detection of cellular abnormalities in good quality smears, the detection of dyskaryosis being twice as high, in contrast to the fair or poor quality smears. It is suggested that quality grade is a better way of classifying smear quality in the cervical screening programmes rather than the presence or absence of endocervical and/or metaplastic cells.