scholarly journals Evaluation of Cardioprotective action of Suvarna gairik (Redochre) in Indian Cobra Envenomation, Aluminium Phosphide Poisoning and Doxorubicin Cardiotoxicity in Albino Rats- A Protocol

2021 ◽  
pp. 405-411
Author(s):  
Santoshi Mane ◽  
Nilima Wadnerwar ◽  
Sudhir Ninave ◽  
R. D. Wajgi ◽  
R. R. Dighade
Keyword(s):  
Cardiac Arrest ◽  
Disease Control ◽  
Test Group ◽  
Control Group ◽  
Albino Rats ◽  
Aluminium Phosphide ◽  
Doxorubicin Cardiotoxicity ◽  
Group 3 ◽  
Hospital Cardiac Arrest ◽  
Group 1

Background: Poisoning is major health issue all over the world. Poisoning is one of basic causes for Out Hospital cardiac arrest (OHCA). P-OHCA (Poison induced Out Hospital cardiac arrest) can be prevented by immediate primary management. The agent for poisoning is unknown in most cases, which leads to difficulty deciding the emergency antidote. In Ayurveda Hridyavaranchikitsa (Cardio protection) is one of the treatment modalities mentioned in all types of poisoning as first aid treatment. Suvarna Gairik (Red ochre) is one of drugs mentioned for the cardioprotection. Snake bite and organophosphate poisoning are the threats to life in India. Doxorubicin is commonly used drug for Chemotherapy in malignancies, and its major side effect is cardiotoxicity. Hence these poisonings are included in study. Aim and Objective: Evaluation of cardioprotective activity of Suvarna Gairik (Red ochre) in cardiac biomarker like Lactate dehydrogenase, Creatinine phosphokinase, Alkaline transferase, Cardiac Troponins and Survival Time in Indian Cobra Envenomation, Aluminium phosphide poisoning and Doxorubicin cardiotoxicity in Albino Rats. Methodology: Animal study is designed. 56 wistar rats will be divided in 7 groups as Vehicle Control Group, Disease control Group -1 Indian Cobra envenomation, Disease control Group -2Aluminium Phosphide poisoning, Disease control Group -3 Inj. Doxorubicin induced cardiotoxicity, Test Group -1 Indian Cobra Envenomation and Suvarna gairik Test Group -2 Aluminium Phosphide poisoning and Suvarna gairik Test control Group 3- Inj. Doxorubicin cardiotoxicity and Suvarna gairik. Results: Outcome will be assessed in between groups and among groups. Conclusion: Suvarna Gairik (Red ochre) may show statistical significant cardioprotective activity.

scholarly journals The Effects of Different Instructional CPR Method on the Acquisition and Retention of CPR Skills in Soldiers: A Controlled Randomized Trial

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Moeen Ranjbar ◽  
Seyed Zia Hejripour ◽  
Mohammad Darvishi ◽  
Ebrahim Karimi
Keyword(s):  
Cardiac Arrest ◽  
Military Service ◽  
Instructional Video ◽  
Median Score ◽  
Test Results ◽  
Class Session ◽  
Bystander Cpr ◽  
Group 3 ◽  
Hospital Cardiac Arrest ◽  
Group 1

Background: The mortality rate of out-of-hospital cardiac arrest (OHCA) is high and it's shown that bystander CPR increases the survival rate of these patients by two to three-folds. Several methods are introduced to improve the acquisition and retention of CPR-related knowledge learned in courses. Objectives: The current study aimed to compare three different methods of teaching CPR in terms of primary acquisition and retention of such skills in soldiers. Methods: This study was performed from November 2019 to February 2020 on selected duty male soldiers doing their military service. Participants were randomized into 1 of the following 4 groups: (1) A lecture-based, 30-minute class session followed by a one-hour practice on a manikin; (2) a 20-minute instructional video followed by a one-hour practice on a manikin; (3) a 20-minute instructional video without practice on a manikin (video only); and (4) no intervention. The performance and retention of CPR skills were assessed using a checklist by two referees. The preparation score, ABC score, and total score were assessed using this checklist. Results: Fifty male participants with a mean age of 22.44 ± 2.08 years were included. The median score of groups 1 - 3 increased significantly after the intervention compared to the pre-test results. Group 3 (video only) experienced the highest increment in the preparation score (2.30). Concerning the ABC and total scores, group 1 (class session) showed the highest increment of scores (22.70 and 24.82, respectively). Group 3 (video only) showed the most sustained results compared to groups 1 and 2 one month after the intervention. Conclusions: According to the results, the classroom session teaching with a manikin practice accompanied better acquisition of CPR skills. However, the retention of CPR skills is better maintained with a simple video-only method.

scholarly journals Evaluation of Cardioprotective effect of Coleus forskohlii against Isoprenaline induced myocardial infarction in rats

2014 ◽  
Vol 2 (01) ◽  
pp. 17-25 ◽  
Author(s):  
Farogh Ahsan ◽  
H. H. Siddiqui ◽  
Tarique Mahmood ◽  
Ritesh Kumar Srivastav ◽  
Ahmad Nayeem
Keyword(s):  
Normal Saline ◽  
Test Group ◽  
Heart Weight ◽  
Control Group ◽  
Albino Rats ◽  
Standard Group ◽  
Marker Enzyme ◽  
Coleus Forskohlii ◽  
Group 2 ◽  
Group 1

Coleus forskohlii is an important ancient root drug of Indian origin, commonly known as gander in indian ayurvedic system of medicine. A lot of research work has been done on Coleus forskohlii regarding various cardiovascular disorders but no work has been done to find out its cardioprotective activity. Wistar albino rats were divided into five main groups having 5 animal each: Group 1 termed as Normal control (NC) received 0.5ml of normal saline throughout experimental period and served as control. Group 2 termed as Isoprenaline group (ISO) received 0.5ml of normal saline for 28 day and received Isoprenaline (85mg/kg, s.c.) on 29th and 30th day at an interval of 24 hours. Group 3 termed as Standard group (STD) received Metoprolol (pure) (10 mg/kg/day, p.o.) for 28 day and received Isoprenaline (85mg/kg, s.c.) on 29th and 30th day at an interval of 24 hours. Group 4 termed as Test group 1 (TG 1) and Group 5 termed as Test group 2 (TG 2) received Coleus forskohlii (50 mg/kg/day, p.o.) (100 mg/kg/day, p.o.) for 28 day and received Isoprenaline (85mg/kg, s.c.) on 29th and 30th day at an interval of 24 hours respectively. The experiment was terminated on 31st day and animal were sacrificed by cervical decapitation after an overnight fast. Blood was collected for estimation of biochemical parameter and heart was dissected out for grading, heart/weight ratio and histopathological examination.the the level of marker enzyme in serum as AST, ALT, LDH, CK, Troponin-I were significantly decreased (P 0.001) in rats pretreated with Coleus forskohlii when compared to that of group which received isoprenaline alone. Further, histopathological examination showed the reduction of necrosis, edema and inflammation following Coleus forskohlii pretreatment. Based on present findings, it is concluded that Coleus forskohliil may be a potential preventive and therapeutic agent against the myocardial necrosis associated ischemic heart disease.

scholarly journals Effects of Methanolic Root Extract of Holarrhena floribunda on the Lipid Profile and Sex Hormones in Wistar Rats

2019 ◽  
pp. 1-7
Author(s):  
Dennis, Amaechi ◽  
E. O. Udosen ◽  
V. S. Ekam ◽  
I. P. Ekpe
Keyword(s):  
Lipid Profile ◽  
Sex Hormones ◽  
Wistar Rats ◽  
Test Group ◽  
Control Group ◽  
Root Extract ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim: This study aims to determine the effects of methanolic root extract of Holarrehna floribunda on the level of some serum sex hormones, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, estradiol, progesterone and lipid profile in Wistar rats.   Materials and Methods: Twenty- four male and female Wistar rats (150-250 g body weight) were randomly assigned into 4 groups of 6 rats each. Group 1 (control male) took normal rat chow and drinking water. Group 2 (control female) took normal rat chow and drinking water, Group 3(Male test group), was administered with 200 mg/kg of Holarrehna floribunda extract, Group 4(Female test group), was administered with 200 mg/kg of Holarrehna floribunda. The feeding regimens lasted for 5weeks. Results: The values for the lipid profile shows CHOL in Group 1 and Group 3 were 4.02±0.41 mmol/l  and 5.75±0.09 mmol/l, Group 2 and Group 4 were 3.87±0.22 mmol/l  and 5.80±0.10 mmol/l  respectively, TRIG  for Group 1 and Group 3 were 1.30±0.05 mmol/l  and 2.11±0.15 mmol/l  for Groups 2 and 4 were 1.15±0.03 mmol/l  and (2.10±0.12 mmol/l,HDL-C for Groups 1 and 3 were 30.01±0.82 mg/dL  and 39.88± 1.24mg/dL,for Groups 2 and 4 were 29.98± 0.77 mg/dL  and 38.20± 1.83 mg/dL, LDL-C for Groups 1 and 3 were 2.26±0.37 mmol/L  and 4.17±0.35 mmol/L respectively, for Groups 2 and 4 were 3.27±0.47 mmol/L  and 4.06±0.21 mmol/L  respectively, shows significant increase(p<0.05) in HDL-C (mg/dL) in Groups 1,2,3 and 4.The values obtained showed significant increase (p<0.05) in HDL-C (mg/dL) in Groups 1,2,3and 4The serum concentrations of FSH, Estradiol, LH and progesterone in the control Group 2 were 0.38 ±0.07mIU/mL, 7.83±0.35 mIU/mL, 15.50±0.15 Pg/mL and 0.86±0.03 ng/mL respectively, and in test Group 4 were 0.77±0.04mIU/mL, 8.75±0.17 mIU/mL, 21.09±0.79 Pg/Ml 0.33±0.05 ng/mL. Follicle stimulating hormone levels was significantly higher (p<0.05) in test group compared with control. While in Group 1 and 3, the serum concentrations of FSH, LH, and testosterone in control Group 1 were (0.51 ±0.06) mIU/mL, (16.44±0.31) mIU/mL and (8.41±0.50) ng/mL respectively and in test Group 3 were 0.88±0.06 mIU/mL19.88±1.46mIU/mL and10.68±0.64 ng/mL, respectively. Conclusion: The extract improves the level of sex hormones in both the male and female rats.  which could enhance reproductive functions in normal rats and those with loss of reproductive function.

scholarly journals Evaluation of anxiolytic effect of furosemide in Albino rats

2018 ◽  
Vol 7 (2) ◽  
pp. 337
Author(s):  
Malvika Goyal ◽  
Jyothi C. H. ◽  
Rahul H. Damodar
Keyword(s):  
Locomotor Activity ◽  
Side Effects ◽  
Test Group ◽  
Anxiolytic Effect ◽  
Anxiolytic Activity ◽  
Threshold Dose ◽  
Control Group ◽  
Albino Rats ◽  
Group 2 ◽  
Group 1

Background: Anxiety disorders are the most prevalent class of psychiatric condition. Medications commonly given for treatment can elicit several central nervous system (CNS) side-effects that patients find difficult to tolerate. So there is a need for new pharmacotherapeutic approaches to treat anxiety with greater efficacy and fewer side effects. Hence this study has been taken up to evaluate the anxiolytic effect of furosemide at three different doses (75mg/kg, 150mg/kg and 200mg/kg) in Albino rats.Methods: After obtaining approval from the institutional animal ethical committee 30 Albino rats weighing about 150-200gm were taken and divided into 5 groups of 6 rats each. Group 1: Normal Saline 10ml/kg (control); Group 2: Diazepam 2mg/kg (standard); Group 3: Furosemide 150mg/kg (test group 1); Group 4: Furosemide 200mg/kg (test group 2); Group 5: Furosemide 75mg/kg + Diazepam 1mg/kg (sub threshold dose). The anxiolytic activity of furosemide was tested by elevated plus maze and digital actophotometer models. Data was analysed using one way ANOVA followed by Posthoc Tukey’s test.Results: Furosemide (150mg/kg and 200mg/kg) have shown significant increase in open arm entries (p<0.05) and time spent in open arm (p<0.05) compared to control. Also furosemide (150mg/kg and 200mg/kg) have shown statistically significant decrease in locomotor activity (p<0.05) compared to control in actophotometer model. Potentiation of time spent and number of entries in open arm and decrease in locomotor activity were noticed when sub threshold doses of combination of diazepam and furosemide were used.Conclusions: These results suggest that furosemide possesses significant anxiolytic activity at both the doses. Furosemide given in sub threshold dose potentiates the antianxiety effect of sub threshold dose of diazepam when used in combination. Hence, after further studies, furosemide can be used as an anxiolytic drug.

scholarly journals The effects of electromagnetic waves emitted by the cell phones on the testicular tissue

2014 ◽  
Vol 86 (4) ◽  
pp. 274
Author(s):  
Muhammet Ihsan Karaman ◽  
Ali Murat Gökçe ◽  
Orhan Koca ◽  
Bilal Karaman ◽  
Metin Ishak Öztürk ◽  
...  
Keyword(s):  
Electromagnetic Waves ◽  
Cell Phones ◽  
Testicular Tissue ◽  
Seminiferous Tubules ◽  
Control Group ◽  
Albino Rats ◽  
Negative Effects ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives: Various risks have emerged in parallel to the rapidly increasing use of cell phones. Herein we studied the effects of cell phone emitted electromagnetic waves (EMW) on rat testes. Material and Methods: Twenty one adult male Albino rats were grouped into 3 groups each consisting of 7 rats. The first group was exposed to EMW on talk mode for 8 hours per day for 20 days and then their testes were extracted. The testes of the second group were extracted after 20 days of whole day EMW exposure. The third group was the control group. For the statistical analysis Mann- Whitney U analysis was performed. Results: At light microscopic examination of the testicular tissue, the existence of a high number of immature cells in the lumen of the seminiferous tubule in addition to the normal seminiferous tubules, besides irregular tubules with a reduction in the spermatogenic cell lines and tubules without lumen were observed in groups 1 and 2. Histopathological alterations were scored as 0 = none, 1 = low, 2 = medium, 3 = serious. The average scores of the three groups were found to be 4.25 ± 1.5 for the group 1, 4.33 ± 3.9 for the group 2 and 0.37 ± 1.1 for the group 3 respectively. As a result of the statistical evaluation, group 1 and group 2 had significantly higher scores than the control group (p = 0.001). Conclusion: Infertility is one of the current problems of today due to a rapid increase in its incidence and cost. The negative effects of the EMWs on the testis should be taken into account and the necessary measures should be taken for prevention.

scholarly journals Effect of Distraction Technique During Immunization to Reduce Behaviour Response Score (FLACC) to Pain in Toddlers

2013 ◽  
Vol 33 (1) ◽  
pp. 25-30 ◽  
Author(s):  
DS Gedam ◽  
M Verma ◽  
U Patel ◽  
S Gedam
Keyword(s):  
Pain Score ◽  
Test Group ◽  
Pain Scale ◽  
Control Group ◽  
Staff Nurse ◽  
Design For All ◽  
Group 3 ◽  
Group 2 ◽  
Control Group Group ◽  
Group 1

Introduction: Distraction techniques are important non pharmacological tools to reduce pain in infants and children. Few data are available regarding their effectiveness in toddlers. We have assessed effectiveness of audio-visual distraction techniques in toddlers during and after vaccination. Materials and Methods: The study used a quasi experimental three group pretest post test design. For all the three groups, the injections were administered by same staff nurse. Group- 1 (120 Patient) was encouraged to see and play with light and sound producing toy. Group- 2 (120 Patient) children were encouraged to see cartoon movie and children of control group- 3 (110 patient) were immunized without any distraction technique. A question form was used to determine the infant’s characteristics and the Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale was used to assess the level of pain. Data was collected between 1st April 2012 and 30th September 2012. Results: The mean pain score of test group during procedure (Group-1: 2.30 & Group-2: 3.65) were lower than the score of control group (Group-3: 5.30). Similarly after procedure Score (Group-1: 4.62 & Group-2: 2.79) were lower than the score of control group (Group-3: 6.20). Conclusion: The lower pain score in response to vaccination in test group indicates that distraction technique i.e. light & sound producing toys and cartoon movies are practical way to reduce pain during routine medical interventions in toddler. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7017 J Nepal Paediatr Soc. 2013;33(1):25-30

Influence of Removable Denture Cleaning Agents on Adhesion of Oral Pathogenic Microflora In Vitro: A Randomized Controlled Trial

2021 ◽  
Vol 14 (1) ◽  
pp. 656-664
Author(s):  
I.R. Volchkova ◽  
A.V. Yumashev ◽  
V.V. Borisov ◽  
V.I. Doroshina ◽  
E.A. Kristal ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Candida Albicans ◽  
Test Group ◽  
Control Group ◽  
Removable Dental Prostheses ◽  
Removable Denture ◽  
Group 2 ◽  
Adhesion Index ◽  
Group 1

Introduction: Removable dentures are used by 20% of the population. These may be accompanied by denture stomatitis in 15-70% of patients. The choice of the optimal cleansing agent for removable dental prostheses is of high significance. Aim: The aim of our research was to study the influence of removable denture cleansing products on the adhesion of microorganisms and yeast. Materials and Methods: We manufactured 144 specimens of standardized round shape with a diameter of 10 mm from 4 types of modern polymeric materials used by prosthetic dentistry to produce removable dentures, 12 specimens of each material were placed into suspensions of bacterial cultures of Staphylococcus aureus, Escherichia coli, Candida albicans, then into “ClearaSept” (Test group 1), “Рrotefix active cleanser” (Test group 2), saline solution (Control group), followed by nutrient media. The adhesion index was calculated and analyzed. Results: There was no reliable lowering of adhesion index of Staphylococcus Aureus to all materials detected in Test group 1 (U=6, p>0.05 for Bio XS; U=8, p>0.05 for Dental D, Denotokeep Peek, Vertex Rapid Simplified). In Test group 2, the adhesion index of Staphylococcus Aureus reliably decreased to all materials compared to the Control group (U=0, p≤0.01). The adhesion index of Candida albicans and Escherichia coli to all materials in Test group 1 had a minor to moderate reliable reduction compared to the Control group (U=0, p≤0.01). Test group 2 showed a significant reliable decrease in Candida albicans and Escherichia coli adhesion index to all materials in comparison with the Control group (U=0, p≤0.01). Conclusion: The research showed an unreliable or minor and moderate reliable decrease in microorganisms adhesion index depending on the microorganism species after treatment of denture material specimens by antibacterial soap “ClearaSept” and a reliable significant decrease in microbial and yeast adhesion after application of Protefix active cleaner solution, which demonstrates a more significant antimicrobial effect in comparison to “ClearaSept” against Staphylococcus aureus, Escherichia coli, and Candida albicans.

The Effects of the "XGTQ" Medicine in Treating Cirrhosis in Wistar Rats

2020 ◽  
Vol 06 ◽  
Author(s):  
Ngan Nguyen Hoang ◽  
Thang Duong Minh ◽  
Tuan Anh Hoang ◽  
Son Le Ngoc Bich ◽  
Duong Nguyen Huu ◽  
...  
Keyword(s):  
Wistar Rats ◽  
Reference Group ◽  
Control Group ◽  
Plain Water ◽  
Group 4 ◽  
White Rats ◽  
Collagen Accumulation ◽  
Activity Of Enzymes ◽  
Group 3 ◽  
Group 1

Objectives: Evaluate the effects of "XGTQ" in the treatment of cirrhosis induced by Carbon tetrachloride (CCL4) in combination with alcohol and high-fat diet on Wistar rats. Materials and methods: Cirrhosis on white rats was induced by subcutaneously injecting CC14 at an initial dose of 5,0ml/kg, followed by 1,2ml/kg once a week in 10 weeks. Then, fed with synthetic food, added 20% fat, and 0.05% cholesterol and iron oxalate. Rats were administered every day with plain water and 1 day with water mixed with 30% ethanol. The rats were randomly divided into 5 groups and given distilled water (group 1 and 2 or control group), silymarin (group 3 or reference group) or the "XGTQ" drug extract (group 4, 5) for 4 weeks. Collected blood for biochemical test and liver were dissected to evaluate weight, morphology and quantified 4-hydroxyproline to evaluate fibrosis and collagen accumulation. Results: In cirrhotic wistar rats, "XGTQ" drug at 19.6 g/kg/24h and 58.8 g/kg/24h showed the ability of reducing the activity of enzymes AST, ALT in the blood (p<0.01), increasing plasma albumin and decreasing prothrobin time (p<.05); improving physical condition, macroscopic and microscopic images of H&E-stained liver; decreasing the concentration of hydroxyproline in the liver and reducing the level of cirrhosis on the masson-stained templates. The effects of "XGTQ" increased with the dose, and was equivalent to silymarin at the dose of 70 mg/kg/24h. Conclusion: The extract of "XGTQ" drug is effective in treating cirrhosis in Wistar rats.

scholarly journals Preservation of Contractile Reserve and Diastolic Function by Inhibiting the NLRP3 Inflammasome with OLT1177® (Dapansutrile) in a Mouse Model of Severe Ischemic Cardiomyopathy Due to Non-Reperfused Anterior Wall Myocardial Infarction

Molecules ◽  
2021 ◽  
Vol 26 (12) ◽  
pp. 3534
Author(s):  
Joseph Aliaga ◽  
Aldo Bonaventura ◽  
Eleonora Mezzaroma ◽  
Yogesh Dhakal ◽  
Adolfo Gabriele Mauro ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Function ◽  
Nlrp3 Inflammasome ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Control Group ◽  
Contractile Reserve ◽  
Standard Diet ◽  
Group 3 ◽  
Group 1

Interleukin-1β (IL-1β), a product of the NLRP3 inflammasome, modulates cardiac contractility and diastolic function. We proposed that OLT1177® (dapansutrile), a novel NLRP3 inhibitor, could preserve contractile reserve and diastolic function after myocardial infarction (MI). We used an experimental murine model of severe ischemic cardiomyopathy through the ligation of the left coronary artery without reperfusion, and after 7 days randomly assigned mice showing large anterior MI (>4 akinetic segments), increased left ventricular (LV) dimensions ([LVEDD] > 4.4 mm), and reduced function (LV ejection fraction <40%) to a diet that was enriched with OLT1177® admixed with the chow in the diet at 3.75 g/kg (Group 1 [n = 10]) or 7.5 g/kg (Group 2 [n = 9]), or a standard diet as the no-treatment control group (Group 3 [n = 10]) for 9 weeks. We measured the cardiac function and contractile reserve with an isoproterenol challenge, and the diastolic function with cardiac catheterization at 10 weeks following the MI surgery. When compared with the control (Group 3), the mice treated with OLT1177 (Group 1 and 2) showed significantly greater preservation of their contractile reserve (the percent increase in the left ventricular ejection fraction [LVEF] after the isoproterenol challenge was +33 ± 11% and +40 ± 6% vs. +9 ± 7% in the standard diet; p < 0.05 and p < 0.005 for Group 1 and 2, respectively) and of diastolic function measured as the lower left ventricular end-diastolic pressure (3.2 ± 0.5 mmHg or 4.5 ± 0.5 mmHg vs. 10.0 ± 1.6 mmHg; p < 0.005 and p < 0.009 respectively). No differences were noted between the resting LVEF of the MI groups. These effects were independent of the effects on the ventricular remodeling after MI. NLRP3 inflammasome inhibition with OLT1177® can preserve β-adrenergic responsiveness and prevent left ventricular diastolic dysfunction in a large non-reperfused anterior MI mouse model. OLT1177® could therefore be used to prevent the development of heart failure in patients with ischemic cardiomyopathy.

Abstract P75: Dissemination of CPR Skills to the Public - Can Schoolchildren Ensure Success?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tonje Lorem ◽  
Aud Palm ◽  
Lars Wik
Keyword(s):  
Cardiac Arrest ◽  
Large Fraction ◽  
Age Groups ◽  
Health Benefit ◽  
School Students ◽  
The Public ◽  
Group 3 ◽  
Second Tier ◽  
Group 2 ◽  
Hospital Cardiac Arrest

Training a large fraction of the general population in CPR could have major public health benefit if those most likely to witness cardiac arrest are trained. Mass distribution of self-training manikins as a two-tiered strategy with school children as first tier has been described as successful, but without information on second tier age or information strategy to second tier. We studied three different attempts at reaching older second tier persons. In groups 1 and 2 first tier consisted of 7 th graders and in group 3 high school and medical school students. Information about the desirable second tier age group was given in writing prior to the distribution. In groups 1 and 3 information was only directed towards first tier. In group 2 both first tier, their parents and teachers were informed. The first tier participants reported the number of second tier trained for age-groups 12–25 years, 25–50 years, and >50 years. Approximately 64000 (group 1), 63000 (group 2) and 81 (group 3) self-education kits were provided with 2.7, 1.9, and 3.7 lay-rescuers trained per kit respectively (p<0.05) (Table 1 ). Informing also the parents of the first tier prior to the distribution did not positively impact the number of second tier trained lay-rescuers, but higher age of first tier did. We speculate that 7 th graders are too young to successfully disseminate CPR to those most likely to witness out of hospital cardiac arrest. Table 1. Percentage reported trained in first and second tier divided into age-groups.

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