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Background & objectives: Despite significant resources being spent on National Vector Borne Disease Control Programme (NVBDCP), there are meagre published data on health system cost upon its implementation. Hence, the present study estimated the annual and unit cost of different services delivered under NVBDCP in North India. Methodology: Economic cost of implementing NVBDCP was estimated based on data collected from three North Indian States, i.e. Punjab, Haryana and Himachal Pradesh. Multistage stratified random sampling was used for selecting health facilities across each level [i.e. subcentres (SCs), Primary Health Centres (PHCs), community health centres (CHCs) and district malaria office (DMO)] from the selected States. Data on annual consumption of both capital and recurrent resources were assessed from each of the selected facilities following bottom-up costing approach. Capital items (equipment, vehicles and furniture) were annualized over average life span using a discount rate of 3 per cent. The mean annual cost of implementation of NVBDCP was estimated for each level along with unit cost. Results: The mean annual cost of implementing NVBDCP at the level of SC, PHC and CHC and DMO was ₹ 230,420 (199,523-264,901), 686,962 (482,637-886,313), 1.2 million (0.9-1.5 million) and 9.1 million (4.6-13.5 million), respectively. Per capita cost for the provision of complete package of services under NVBDCP was ₹ 45 (37-54), 48 (29-73), 10 (6-14) and 47 (31-62) at the level of SC, PHC, CHC and DMO level, respectively. The per capita cost was higher in Himachal Pradesh (HP) at SC [₹ 69 (52-85)] and CHC [₹ 20.8 (20.7-20.8)] level and in Punjab at PHC level [₹ 89 (49-132)] as compared to other States. Interpretation & conclusions: The evidence on cost of NVBDCP can be used to undertake future economic evaluations which could serve as a basis for allocating resources efficiently, policy development as well as future planning for scale up of services. [ABSTRACT FROM AUTHOR]

Waldenström macroglobulinemia (WM) is a rare B-cell lymphoma characterized by lymphoplasmacytic cell infiltration in the bone marrow and other organs and the presence of a monoclonal immunoglobulin M protein in the serum. Although uncommon, several kidney diseases have been associated with WM. In addition to kidney diseases related to lymphoplasmacytic lymphoma infiltration, a variety of glomerular and tubular lesions have been described in patients with WM. Immunoglobulin light chain (AL) amyloidosis and cryoglobulinemic glomerulonephritis are the two predominant glomerular pathologies seen in WM. In this article we review the kidney diseases associated with WM. We also briefly review some nephrotoxicities of novel chemotherapeutic and targeted therapies used for the treatment of WM. [ABSTRACT FROM AUTHOR]

End‐stage renal disease is associated with dismal long‐term survival in general. Home hemodialysis (HHD) has been advocated as a modality affirming better quality of life and longer survival. We report a 62‐year‐old Caucasian female with end‐stage renal disease who has been exclusively on HHD for a total of 45 years, utilizing various platforms over the years. She has been one of the first home dialysis patients of the founding father of renal dialysis in the state of Mississippi, John D. Bower and cared by him throughout his career. Throughout this period, her life bore witness to the evolving technology of dialysis accesses, platforms, and evolution of HHD in its entirety. After review of the literature, we find that the longest vintage time on HHD documented to date was around 35 years. This extraordinary longevity bears testimony to the extraordinary self‐motivation of the patient, the dedication of her providers and the true potential of HHD in motivated subjects. [ABSTRACT FROM AUTHOR]

Background: Tobacco use and physical inactivity are major risk factors for NCDs. Adequate physical activity keeps one healthy but sedentary life style may contribute to other unhealthy practices like tobacco use. There is a need to identify if and how the two risk factors are interrelated so as to address them more strategically. Objectives: To assess the level of physical activity and to identify its association with tobacco use among college going youth in Chandigarh. Material & Methods: Data on physical activity and tobacco use was collected from 500 students aged 18-24 years studying in different professional and nonprofessional colleges of Chandigarh in year, through a multistage stratified random sampling technique. We used semi-structured, self-administered questionnaires-namely 78 item Global Adult Tobacco Survey (GATS) for assessing tobacco use status and GPAQ (Global Physical Activity Questionnaire) for assessment of physical activity. Binary logistics regression analysis was done to find association between tobacco use and physical activity. Odd's ratio & 95% confidence interval (C.I.) was calculated. Results: Of the 500 individuals studied, 12.8% (n=64) were physically inactive, 10% (n=50) were active and 76.2% (n=381) were highly active. Females (15.8%) were more inactive as compared to males (12.1%). Highly active respondents were seen more in 18-20 years age group (77.6%) as compared to 21-22 years age group (76.1%). The odds of consuming tobacco is significantly lower among physically active respondents as compared to inactive respondents. Conclusions: Our findings indicate a significant relationship between physical activity and tobacco use among youth. Promotion of physical activity may be a useful educational tool for reducing tobacco use. [ABSTRACT FROM AUTHOR]

Background: The immunization coverage in India is far away from satisfactory with full immunization coverage being only 62% at national level. Targeting the intensive efforts to poor performing areas and addressing the determinants of nonimmunization and dropouts offers a quick solution. In this paper, we assess the inter-district variations in Haryana state, and the association of social determinants with partial and no immunization. Methodology: This analysis is based on data collected as part of a large household survey undertaken in the state of Haryana to measure the extent of Universal Health Coverage. A multistage stratified random sampling design was used to select primary sampling units (i.e., subcenters), villages, and households. A total of 11,594 mothers with a child between 12 and 23 months were interviewed on receipt of immunization services. Determinants of nonimmunization and partial immunization were assessed using multiple logistic regression. Results: About 21% of children aged 12-23 months were partially immunized, while 4.3% children aged 12-23 months had received "no immunization." While the coverage of full immunization was 74.7% at the state level, it varied from 95% in best performing district to 38% in poorest performing district. Odds of a partially immunized child were significantly higher in urban area (odds ratio [OR] = 1.23; 95% confidence interval [CI] = 1.1-1.38), among Muslim household (OR = 3.52; 95% CI = 3.03-4.11), children of illiterate parents (OR = 1.58; 95% CI = 1.22-2.05), and poorest quintile (OR = 1.61; 95% CI = 1.36-1.89). Conclusions: Wide interdistrict variations call for a need to consider changes in resource allocation and strengthening of the government initiatives to improve routine immunization in these districts. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of Smokeless Tobacco (SLT) in India, cost-effective interventions to curb smokeless tobacco use are very low. Taxation is considered as one of the most cost-effective intervention to curb overall tobacco use but taxation on SLT product is very complex and is on ad-valorem basis. Further, Goods and Service Tax has increased the price from 0.8/gram to 1.06/gram, but still the impact of increasing the tax needs to be explored so that harmony between excise revenue generated from these products and decrease in demand of these products can be maintained. Therefore, we carried out a literature review, which involved literature search, data extraction, and synthesis. The evidence suggests that the price elasticity of SLT products has gone closer to the inelastic nature with the passing time suggesting the increasing affordability of these products. The macroeconomic impact of the disease burden resulting from these SLT products is far greater than excise revenue generated by these products. More research is required in this field with updated data. The agricultural aspect of SLT products also need to be explored to determine cost-effective alternative crops for tobacco farming. Also, as the use of SLT is culturally accepted in India, appropriate public awareness program and cost-effective interventions are required to curb SLT use along with increased tax and cessation services. [ABSTRACT FROM AUTHOR]

[Display omitted] • MoS 2 /Ag/GO composite with different weight-ratio prepared via microwave-route. • Effective photodegradation of antibiotic/pesticide was done under visible light. • Catalyst show effective real wastewater degradation with high COD/TOC removal. • Catalyst with high efficiency/photostability is efficient for wastewater treatment. Herein, various weight ratios (1:1, 1:3, and 3:1) of MoS 2 /GO composites decorated with Ag nanoparticles (named as MAG) have been prepared by microwave-assisted route. XRD and XPS investigations indicated the catalyst crystallinity and elemental oxidation states. Morphological analysis revealed presence of small MoS 2 nanopetals scattered on GO sheets with Ag NPs dispersed on surface whereas BET-analysis disclosed its excellent surface area (∼88 m2/g). Optical properties of MAG catalysts revealed that they were highly visible-light active, with a bandgap of 2.15 eV and a lower charge recombination rate. Excellent efficiency was observed for TC (90.7%; 0.0186 min−1) and FIP-degradation (85.2%; 0.0177 min−1) with 4 mg MAG (3:1) catalyst at neutral pH under visible-light irradiation owing to high synergistic interaction (∼2.21) in the composite. Effects of catalyst amount, pH, and effective area of illumination on degradation were investigated. High reusable nature of the catalyst (65% (TC) and 58% (FIP) efficiency after 5 cycles) was supported by post-photocatalytic characterization studies. Photodegradation products of TC were determined via LC-MS studies. Holes and hydroxyl radicals were majorly involved in degradation process revealed by trapping studies. High COD (70.4%) and TOC (55.1%) removal rates confirm high photo-mineralization of real-wastewater without any pre-treatment. The current investigation, combined with comparative literature, illustrates real-world potential of MAG catalysts for eradication of resistant pollutants. [ABSTRACT FROM AUTHOR]

Palliative care (PC) training and experience of United States (US) adult nephrology fellows was not known. It was also not clear whether nephrology fellows in the US undergo formal training in PC medicine during fellowship. To gain a better understanding of the clinical training and experience of US adult nephrology fellows in PC medicine, we conducted a national survey in March 2012. An anonymous on-line survey was sent to US adult nephrology fellows via nephrology fellowship training program directors. Fellows were asked several PC medicine experience and training questions. A total of 105 US adult nephrology fellows responded to our survey (11% response rate). Majority of the respondents (94%) were from university-based fellowship programs. Over two-thirds (72%) of the fellows had no formal PC medicine rotation during their medical school. Half (53%) of the respondents had no formal PC elective experience during residency. Although nearly 90% of the fellows had a division or department of PC medicine at their institution, only 46.9% had formal didactic PC medicine experience. Over 80% of the respondent's program did not offer formal clinical training or rotation in PC medicine during fellowship. While 90% of the responding fellows felt most comfortable with either writing dialysis orders in the chronic outpatient unit, seeing an ICU consult or writing continuous dialysis orders in the ICU, only 35% of them felt most comfortable 'not offering' dialysis to a patient in the ICU with multi-organ failure. Nearly one out of five fellows surveyed felt obligated to offer dialysis to every patient regardless of benefit. Over two-thirds (67%) of the respondents thought that a formal rotation in PC medicine during fellowship would be helpful to them. To enhance clinical competency and confidence in PC medicine, a formal PC rotation during fellowship should be highly considered by nephrology training community. [ABSTRACT FROM AUTHOR]

A total of 100 candidates (equal number of males and females) aspiring for civil services were selected. The result of correlational analysis revealed that test anxiety, worry and emotionality are positively related to self-distraction and behavior disengagement aspects of problem-focused coping as well as denial, religion, and self-blame aspects of emotion-focused coping. Test anxiety and worry are significantly related to venting, and emotionality alone is positively and significantly related to the use of emotional support aspect of emotion-focused coping and the use of instrumental support aspect of problem-focused coping. Achievement motivation has been found to be significantly and negatively related only to the humor aspect of emotion-focused coping. Relevant discussion has been presented. [ABSTRACT FROM AUTHOR]

The current research work is based on the development of an electrode modified by using an indicator, poly(eriochrome black T) (poly-EBT) for the determination of methdilazine hydrochloride (MDH). Excellent electrocatalytic, semiconducting properties of poly-EBT influences the enhanced peak current of MDH. Different voltammetric techniques like cyclic, square wave voltammetry were employed. The association happens among metallochromic indicators, poly-EBT, and positively charged MDH at the surface of the working electrode. The characterization of poly-EBT modified CPE was studied with the help of atomic force microscopy technique (AFM). The concentration of MDH was determined using poly-EBT modified electrode in the wide concentration range 1.0 × 10−7 M to 0.5 × 10−4 M with LOD value of 2.57 × 10−8 M. Poly-EBT modified electrode showed enhanced the sensitivity and selectivity for the determination of MDH in human urine samples and pharmaceutical dosage forms. Image 1 [ABSTRACT FROM AUTHOR]