Cost of Menstrual Hygiene Practices in Gujarat, India

Menstrual cycles are an integral part of a nearly two-third of a woman’s life, and occur every month. Menstruation is a public health concern because irrespective of whether a woman can afford hygienic absorbents or not, she undergoes menstruation phase every month. Therefore, menstruation requires to be examined from public health policy perspective. Choice of menstrual products is not only subject to budget constraint but also to “other regarding preferences”, as can be explained by behavioural economics theories. This study therefore, seeks to get insights into the determinants of choice of menstrual product. The study attempts to devise a method of estimating the minimum yearly cost of menstrual hygiene and also provides an estimate for the same, which can be helpful for the policy prescription. The study is undertaken in Gujarat (India), from a cross-section of districts (developed, developing and tribal), and also a cross-section of socioeconomic status and age. A total of 1025 responses are collected and analysed to get insights into product preferences and resultant cost. The study finds that it is economical to make use of menstrual cups, however, cultural constrains might restrict its use

Surat 2006 Floods: A Citizens’ Report

Surat is situated at the mouth of the river Tapi where it meets the Arabian Sea and has for centuries been a flood-affected area. The most recent floods however, were different because of the magnitude of their effect. Nearly 90 per cent of the households were affected; six of the seven wards of the city had water standing for days. It crippled the economy and affected people's coping abilities. In the wake of the floods the Department of Human Resource Development of the Veer Narmad South Gujarat University and the Centre for Social Studies conducted a study looking at how people coped with the disaster and the impact of the flood on their lives and the economy. It offers some pointers about how the impact can be mitigated in similar situations in the future

Surat 2006 Floods: A Citizens’ Report

Surat is situated at the mouth of the river Tapi where it meets the Arabian Sea and has for centuries been a flood-affected area. The most recent floods however, were different because of the magnitude of their effect. Nearly 90 per cent of the households were affected; six of the seven wards of the city had water standing for days. It crippled the economy and affected people's coping abilities. In the wake of the floods the Department of Human Resource Development of the Veer Narmad South Gujarat University and the Centre for Social Studies conducted a study looking at how people coped with the disaster and the impact of the flood on their lives and the economy. It offers some pointers about how the impact can be mitigated in similar situations in the future

Cost of Menstrual Hygiene Practices in Gujarat, India

Menstrual cycles are an integral part of a nearly two-third of a woman’s life, and occur every month. Menstruation is a public health concern because irrespective of whether a woman can afford hygienic absorbents or not, she undergoes menstruation phase every month. Therefore, menstruation requires to be examined from public health policy perspective. Choice of menstrual products is not only subject to budget constraint but also to “other regarding preferences”, as can be explained by behavioural economics theories. This study therefore, seeks to get insights into the determinants of choice of menstrual product. The study attempts to devise a method of estimating the minimum yearly cost of menstrual hygiene and also provides an estimate for the same, which can be helpful for the policy prescription. The study is undertaken in Gujarat (India), from a cross-section of districts (developed, developing and tribal), and also a cross-section of socioeconomic status and age. A total of 1025 responses are collected and analysed to get insights into product preferences and resultant cost. The study finds that it is economical to make use of menstrual cups, however, cultural constrains might restrict its use

Surat 2006 Floods: A Citizens’ Report

Surat is situated at the mouth of the river Tapi where it meets the Arabian Sea and has for centuries been a flood-affected area. The most recent floods however, were different because of the magnitude of their effect. Nearly 90 per cent of the households were affected; six of the seven wards of the city had water standing for days. It crippled the economy and affected people's coping abilities. In the wake of the floods the Department of Human Resource Development of the Veer Narmad South Gujarat University and the Centre for Social Studies conducted a study looking at how people coped with the disaster and the impact of the flood on their lives and the economy. It offers some pointers about how the impact can be mitigated in similar situations in the future.Surat flood; floods; SMC;

Difference in clinical profile between juvenile onset and adult-onset systemic lupus erythematosus: a meta-analysis

The aim was to systematically review the studies that compared clinical and serological variation between adult-onset systematic lupus erythematosus (aSLE) andjuvenile-onset systematic lupus erythematosus (jSLE). A comprehensive literature search was done, in various available electronic databases for relevant publication that compared juvenile onset SLE and adult onset SLE. The data of adverse clinical features, serological profile and mortality were extracted. Juvenile onset was defined as 18 years. The methodological quality of study was assessed by Newcastle Ottawa scale (NOS) criteria and R version 3.3.1 was used for analysis and ORs and 95% CIs, were used as statistical parameter. A total of 14,920 patients; (12,230: aSLE, and 2,690: jSLE) were included. Renal involvement especially nephritis was significantly more in j-SLE OR: 2.18, 95% CI: [1.81;2.62]; I2=10.8% whereas musculoskeletal was significant in aSLE O.R: 0.64; C.I: [0.44; 0.93]; I2=83.4%. Seizure and malar rash were significantly higher in J-SLE OR:1.69, CI: [1.31; 2.18]; I2=31.1%,1.43; C.I [1.04; 1.97]; I2=82%, respectively. Raynaud’s phenomenon and pleuritis were significantly higher in adult onset SLE. Anemia and thrombocytopenia were significantly higher in juvenile onset SLE. Anti-ds DNA, anti-histone, and anti-ribosomal-P were more frequent in juvenile-onset SLE while, anti-Ro was more common in adult-onset disease. The cause of mortality was not significantly different in both groups. Renal biopsy of class III and IV combined and class V were significantly more in adult-onset SLE. SLEDAI was higher in j-SLE. Meta-analysis indicated that, regardless of many similar clinical and serological manifestations, there is still some variation between adult-onset SLE and juvenile-onset SLE. Although, SLE disease is continuum from juvenile to adult but disease aggressive in juvenile onset SLE

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016