72 research outputs found

    Extra Hepatic Portal Venous Obstruction in Children

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    Effect of post harvest treatments and harvesting stage on vase life and flower quality of cut Oriental lily

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    An investigation was carried out to study the effect of post harvest treatments and harvesting stage on vase life and flower quality of cut Oriental lily cv. Avocado. The results showed that highest vase life (15.83 days) and vase solution uptake (49.17 ml) was recorded with sucrose (2%) + 5-SSA (200ppm), whereas maximum flower diameter (15.17 cm) was recorded in vase solution containing sucrose (2%) + 5-SSA (100ppm). Earliest opening of florets (4.42 days) reported under sucrose (2%) + 5-SSA (200ppm). Effect of treatments was found non-significant in respect to opening of florets. Harvesting at green bud stage exhibited extended vase life (14.33 days) and higher vase solution uptake (40.43 ml), whereas maximum flower diameter (14.25 cm) recorded at 75% colour development stage. Based on the results it is concluded that 5-SSA could be an inexpensive and potential chemical for delaying senescence and for extending the keeping quality of cut liliums commercially

    The health burden and economic costs averted by ambient PM 2.5 pollution reductions in Nagpur, India

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    National estimates of the health and economic burdens of exposure to ambient fine particulate matter (PM2.5) in India reveal substantial impacts. This information, often lacking at the local level, can justify and drive mitigation interventions. Here, we assess the health and economic gains resulting from attainment of WHO guidelines for PM2.5 concentrations – including interim target 2 (IT-2), interim target 3 (IT-3), and theWHO air quality guideline (AQG) – in Nagpur district to inform policy decision making for mitigation. We conducted a detailed assessment of concentrations of PM2.5 in 9 areas, covering urban, peri-urban and rural environments, from February 2013 to June 2014. We used a combination of hazard and survival analyses based on the life table method to calculate attributed annual number of premature deaths and disability-adjusted life years (DALYs) for five health outcomes linked to PM2.5 exposure: acute lower respiratory infection for children b5 years, ischemic heart disease, chronic obstructive pulmonary disease, stroke and lung cancer in adults !25 years. We used GBD 2013 data on deaths and DALYs for these diseases. We calculated averted deaths, DALYs and economic loss resulting from planned reductions in average PM2.5 concentration from current level to IT-2, IT-3 and AQG by the years 2023, 2033 and 2043, respectively. The economic cost for premature mortality was estimated as the product of attributed deaths and value of statistical life for India, while morbidity was assumed to be 10% of the mortality cost. The annual average PM2.5 concentration in Nagpur district is 34± 17 μg m−3 and results in 3.3 (95% confidence interval [CI]: 2.6, 4.2) thousand premature deaths and 91 (95% CI: 68, 116) thousand DALYs in 2013 with economic loss of USD 2.2 (95% CI: 1.7, 2.8) billion in that year. It is estimated that interventions that achieve IT-2, IT-3 and AQG by 2023, 2033 and 2043,would avert, respectively, 15, 30 and 36%, of the attributed health and economic loss in those years, translating into an impressively large health and economic gain. To achieve this, we recommend an exposure-integrated source reduction approach

    Household Air Pollution Exposures of Pregnant Women Receiving Advanced Combustion Cookstoves in India: Implications for Intervention

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    Background: Household air pollution (HAP) resulting from the use of solid cooking fuels is a leading contributor to the burden of disease in India. Advanced combustion cookstoves that reduce emissions from biomass fuels have been considered potential interventions to reduce this burden. Relatively little effort has been directed, however, to assessing the concentration and exposure changes associated with the introduction of such devices in households. Objectives: The aim of this study was to describe HAP exposure patterns in pregnant women receiving a forced-draft advanced combustion cookstove (Philips model HD 4012) in the SOMAARTH Demographic Development & Environmental Surveillance Site (DDESS) Palwal District, Haryana, India. The monitoring was performed as part of a feasibility study to inform a potential large-scale HAP intervention (Newborn Stove trial) directed at pregnant women and newborns. Methods: This was a paired comparison exercise study with measurements of 24-hour personal exposures and kitchen area concentrations of carbon monoxide (CO) and particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5), before and after the cookstove intervention. Women (N = 65) were recruited from 4 villages of SOMAARTH DDESS. Measurements were performed between December 2011 and March 2013. Ambient measurements of PM2.5 were also performed throughout the study period. Findings: Measurements showed modest improvements in 24-hour average concentrations and exposures for PM2.5 and CO (ranging from 16% to 57%) with the use of the new stoves. Only those for CO showed statistically significant reductions. Conclusion: Results from the present study did not support the widespread use of this type of stove in this population as a means to reliably provide health-relevant reductions in HAP exposures for pregnant women compared with open biomass cookstoves. The feasibility assessment identified multiple factors related to user requirements and scale of adoption within communities that affect the field efficacy of advanced combustion cookstoves as well as their potential performance in HAP intervention studies

    Impacts of household sources on air pollution at village and regional scales in India

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    Approximately 3 billion people worldwide cook with solid fuels, such as wood, charcoal, and agricultural residues. These fuels, also used for residential heating, are often combusted in inefficient devices, producing carbonaceous emissions. Between 2.6 and 3.8 million premature deaths occur as a result of exposure to fine particulate matter from the resulting household air pollution (Health Effects Institute, 2018a; World Health Organization, 2018). Household air pollution also contributes to ambient air pollution; the magnitude of this contribution is uncertain. Here, we simulate the distribution of the two major health-damaging outdoor air pollutants (PM_(2.5) and O₃) using state-of-the-science emissions databases and atmospheric chemical transport models to estimate the impact of household combustion on ambient air quality in India. The present study focuses on New Delhi and the SOMAARTH Demographic, Development, and Environmental Surveillance Site (DDESS) in the Palwal District of Haryana, located about 80 km south of New Delhi. The DDESS covers an approximate population of 200 000 within 52 villages. The emissions inventory used in the present study was prepared based on a national inventory in India (Sharma et al., 2015, 2016), an updated residential sector inventory prepared at the University of Illinois, updated cookstove emissions factors from Fleming et al. (2018b), and PM_(2.5) speciation from cooking fires from Jayarathne et al. (2018). Simulation of regional air quality was carried out using the US Environmental Protection Agency Community Multiscale Air Quality modeling system (CMAQ) in conjunction with the Weather Research and Forecasting modeling system (WRF) to simulate the meteorological inputs for CMAQ, and the global chemical transport model GEOS-Chem to generate concentrations on the boundary of the computational domain. Comparisons between observed and simulated O₃ and PM_(2.5) levels are carried out to assess overall airborne levels and to estimate the contribution of household cooking emissions. Observed and predicted ozone levels over New Delhi during September 2015, December 2015, and September 2016 routinely exceeded the 8 h Indian standard of 100 µg m⁻³, and, on occasion, exceeded 180 µg m⁻³. PM_(2.5) levels are predicted over the SOMAARTH headquarters (September 2015 and September 2016), Bajada Pahari (a village in the surveillance site; September 2015, December 2015, and September 2016), and New Delhi (September 2015, December 2015, and September 2016). The predicted fractional impact of residential emissions on anthropogenic PM_(2.5) levels varies from about 0.27 in SOMAARTH HQ and Bajada Pahari to about 0.10 in New Delhi. The predicted secondary organic portion of PM_(2.5) produced by household emissions ranges from 16 % to 80 %. Predicted levels of secondary organic PM_(2.5) during the periods studied at the four locations averaged about 30 µg m⁻³, representing approximately 30 % and 20 % of total PM_(2.5) levels in the rural and urban stations, respectively

    Study protocol for economic evaluation of probiotic intervention for prevention of neonatal sepsis in 0-2-month old low-birth weight infants in India: the ProSPoNS trial

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    Introduction: The ProSPoNS trial is a multicentre, double-blind, placebo-controlled trial to evaluate the role of probiotics in prevention of neonatal sepsis. The present protocol describes the data and methodology for the cost utility of the probiotic intervention alongside the controlled trial. Methods and analysis: A societal perspective will be adopted in the economic evaluation. Direct medical and non-medical costs associated with neonatal sepsis and its treatment would be ascertained in both the intervention and the control arm. Intervention costs will be facilitated through primary data collection and programme budgetary records. Treatment cost for neonatal sepsis and associated conditions will be accessed from Indian national costing database estimating healthcare system costs. A cost–utility design will be employed with outcome as incremental cost per disability-adjusted life year averted. Considering a time-horizon of 6 months, trial estimates will be extrapolated to model the cost and consequences among high-risk neonatal population in India. A discount rate of 3% will be used. Impact of uncertainties present in analysis will be addressed through both deterministic and probabilistic sensitivity analysis. Ethics and dissemination: Has been obtained from EC of the six participating sites (MGIMS Wardha, KEM Pune, JIPMER Puducherry, AIPH, Bhubaneswar, LHMC New Delhi, SMC Meerut) as well as from the ERC of LSTM, UK. A peer-reviewed article will be published after completion of the study. Findings will be disseminated to the community of the study sites, with academic bodies and policymakers. Registration: The protocol has been approved by the regulatory authority (Central Drugs Standards Control Organisation; CDSCO) in India (CT-NOC No. CT/NOC/17/2019 dated 1 March 2019). The ProSPoNS trial is registered at the Clinical Trial Registry of India (CTRI). Registered on 16 May 2019. Trial registration number: CTRI/2019/05/019197; Clinical Trial Registry

    Research priorities in Maternal, Newborn, & Child Health & Nutrition for India:An Indian Council of Medical Research-INCLEN Initiative

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    In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priorities in the MNCHN themes for 2016-2025. The Child Health and Nutrition Research Initiative method of priority setting was adapted. The context of the exercise was defined by a National Steering Group (NSG) and guided by four Thematic Research Subcommittees. Research ideas were pooled from 498 experts located in different parts of India, iteratively consolidated into research options, scored by 893 experts against five pre-defined criteria (answerability, relevance, equity, investment and innovation) and weighed by a larger reference group. Ranked lists of priorities were generated for each of the four themes at national and three subnational (regional) levels [Empowered Action Group & North-Eastern States, Southern and Western States, & Northern States (including West Bengal)]. Research priorities differed between regions and from overall national priorities. Delivery domain of research which included implementation research constituted about 70 per cent of the top ten research options under all four themes. The results were endorsed in the NSG meeting. There was unanimity that the research priorities should be considered by different governmental and non-governmental agencies for investment with prioritization on implementation research and issues cutting across themes
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