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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]

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]

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]

Two-dimensional (2D) heterojunctions with layered structures give high flexibility in varying their photocatalytic/electrocatalytic properties. Herein, 2D/2D heterostructures of MoS 2 /MoSe 2 with different weight-ratios (1 : 1, 1 : 3, and 3 : 1) have been prepared by a simple one-step microwave-assisted technique. The characterization studies confirm formation of crystalline MoS 2 /MoSe 2 nanoparticles with a high surface area (60 m 2 g -1 ) and porous structure. The high synergistic-effect (1.73) and narrow bandgap (∼1.89 eV) of the composites result in enhanced photo-degradation efficiency towards methylene blue dye (94%) and fipronil pesticide (80%) with high rate constants (0.33 min -1 and 0.016 min -1 respectively) under visible light. The effect of pH, catalyst dose, and illumination area on photodegradation has been optimized. Photodegradation of real-industrial wastewater shows 65% COD and 51.5% TOC removal. Trapping experiments confirm that holes are mainly responsible for degradation. The composites were highly reusable showing 75% degradation after 5-cycles. MoS 2 /MoSe 2 composites show excellent electrochemical water-splitting efficacy through hydrogen-evolution-reaction (HER) exhibiting a stable high current density of -19.4 mA cm -2 after 2500 cyclic-voltammetry (CV) cycles. The CV-plots reveal high capacitance activity ( C dl value ∼607 μF cm -2 ) with a great % capacitance retention (>90%). The as-prepared 2D/2D-catalysts are highly active in sunlight and beneficial for long-time physico-chemical wastewater treatment. Moreover, the electrochemical studies confirm that these composites are potential materials for HER activity and energy-storage applications., Competing Interests: The authors have no conflict of interest in the publication of this manuscript., (This journal is © The Royal Society of Chemistry.)

Survival for patients with multiple myeloma has significantly improved in the last decade in large part due to the development of proteasome inhibitors and immunomodulatory drugs. These next generation agents with novel mechanisms of action as well as targeted therapies are being used both in the preclinical and clinical settings for patients with myeloma. These agents include monoclonal antibodies, deacetylase inhibitors, kinase inhibitors, agents affecting various signaling pathways, immune check point inhibitors, and other targeted therapies. In some cases, off target effects of these therapies can lead to unanticipated effects on the kidney that can range from electrolyte disorders to AKI. In this review, we discuss the nephrotoxicities of novel agents currently in practice as well as in development for the treatment of myeloma., (Copyright © 2016 by the American Society of Nephrology.)

Paraproteins are monoclonal Igs that accumulate in blood as a result of abnormal excess production. These circulating proteins cause a diversity of kidney disorders that are increasingly being comanaged by nephrologists. In this review, we discuss paraprotein-related diseases that affect the glomerulus. We provide a broad overview of diseases characterized by nonorganized deposits, such as monoclonal Ig deposition disease (MIDD), proliferative GN with monoclonal Ig deposits (PGNMID), and C3 glomerulopathy, as well as those characterized by organized deposits, such as amyloidosis, immunotactoid glomerulopathy, fibrillary GN, and cryoglobulinemic GN, and rarer disorders, such as monoclonal crystalline glomerulopathies, paraprotein-related thrombotic microangiopathies, and membranous-like glomerulopathy with masked IgGκ deposits. This review will provide the nephrologist with an up to date understanding of these entities and highlight the areas of deficit in evidence and future lines of research., (Copyright © 2016 by the American Society of Nephrology.)