成長都市における容積率規制の最適化

学術(情

Cost-effectiveness of long-acting reversible contraceptive methods: a review

Long-acting reversible contraception (LARC) methods are proven to be effective in preventing unintended pregnancies. Evidence on cost-effectiveness of these methods will enable policy makers to introduce them in national policies and programs to improve contraceptive access. The aim was to review the studies based on economic evaluations of LARC methods and provide evidence to policy makers to renew their commitment to family planning access. A review of studies on economic evaluations of LARC methods was done. This article uses data from three electronic databases: PubMed, Cochrane and Web of Science to examine whether LARC is cost-effective for clinical trials. The results are presented as a narrative review and summary tables. The literature search yielded 87 studies and 12 studies (five economic evaluations studies from USA) and (five studies from Europe while two studies were from low and middle-income countries) were included. Out of 12 papers, nine had multiple comparators; seven included female sterilization as a comparator, while two studies compared one individual LARC contraceptive method with an individual SARC method. All studies consistently showed that LARCs dominated all SARC (short acting reversible contraceptives) methods. Within LARC, copper IUD, LNG-IUS and implant were more cost-effective than DMPA. After a period of five years, female sterilization turned out to be more cost-effective than LARC methods. LARC methods are cost-effective as compared to SARC methods, especially after 1 year of use. Vasectomy is more cost-effective than LARC methods. Policy makers can consider the findings of this review to aid decision making in contraceptive method introduction or scale-up access

Quality Comparison of Vegetables Dehydrated in Solar Drier and Electrical Oven

Ascorbic acid, sugars, dehydration ratio and moisture were determined in the vegetables dehydrated separately in solar drier and in electrical oven under similar conditions by standard methods. Vegetables examined were cabbage, cauliflower, tomato, radish, turnip, lahi, methi and palak. It was revealed that in each case, contents of ascorbic acid were higher in solar-dried vegetables in comparison to oven-dried stuffs. This finding indicated superiority of solar driers over electrical ovens, both in reference to quality of the dehydrated vegetables and its overall cost of operation

A narrative review comparing clinical effectiveness of commonly used uterine balloon tamponade devices for postpartum haemorrhage management in India

 Background: World Health Organisation recommends using Uterine Balloon Tamponade (UBT) for refractory atonic postpartum haemorrhage (PPH) management provided treatment protocols and surgical recourse is possible. Methods: This review collated literature from three electronic databases between January 2010 to December 2019 to compare clinical effectiveness, safety and use related parameters for condom-UBT, Bakri balloon and Every Second Matters (ESM) UBT devices used in India. Results: Thirty-three eligible studies reported effectiveness in managing all PPH causes ranging from 84.2% to 98.3% for condom-UBT and from 65.3% to 94.8% for Bakri-UBT. Three ESM-UBT studies reported PPH survival rates of 94% to 97.4%. Mean UBT effectiveness in controlling atonic PPH was 92.3% for condom-UBT, 84.3% for Bakri-UBT and 97.3% for ESM-UBT. Condom-UBT and Bakri-UBT were comparable across parameters whereas limited ESM-UBT evidence reported success in preventing maternal deaths. Conclusions: For limitations and heterogeneity in methodology and outcome parameters with existing evidence, a robust comparative RCT between UBT devices in India is recommended

Diagnostic utility of α-methylacyl CoA racemase (P504S) & HMWCK in morphologically difficult prostate cancer

<p>Abstract</p> <p>Background</p> <p>To evaluate the diagnostic utility of alpha-methylacyl CoA racemase (P504S) & HMWCK (34beta E12) in morphologically difficult prostate cancer.</p> <p>Methods</p> <p>A total of 1034 cases were reviewed and divided into benign (585) malignant (399) and suspicious (50). Immunohistochemistry with HMWCK and AMACR was done on the 50 suspicious cases along with controls.</p> <p>Results</p> <p>Forty nine suspicious cases were resolved by using both markers where as 1 case was resolved by further support with CD68. The original diagnosis was changed in 15 of 50 (30%) suspicious cases from benign to malignant, one case from benign to high grade PIN and in one case from malignant to benign. Change of diagnosis was seen in 17 of 50 (34%) suspicious cases with a significant p value of 0.002. The overall diagnosis was changed in 17 of 1034 cases (1.64%) of prostatic disease (p < 0.001).</p> <p>Conclusions</p> <p>A combination of HMWCK and AMACR is of great value in combating the morphologically suspicious cases and significantly increasing the diagnostic accuracy in prostate cancer. Although, in this study the sensitivity and specificity of HMWCK and AMACR were high, yet it should be used with caution, keeping in mind all their pitfalls and limitations.</p

Expression of nm23 in the spectrum of pre-invasive, invasive and metastatic breast lesions

BACKGROUND: Nm23 protein is a metastasis suppressor protein, expressed in all tissues. Reduced Nm23 expression is related to a high incidence of lymph node and distant metastasis and poor prognosis in patients with cancers. The present study was done to analyze the expression of Nm23 using immunohistochemistry in non-neoplastic and neoplastic breast lesions. METHODS: Sections from 93 samples were studied and classified into non-proliferative breast lesion (13), fibrodenoma (7), proliferative breast lesion (13), carcinoma in situ (20), invasive carcinoma (23) and metastatic deposits in lymph nodes (17). RESULTS: Nm23 expression in these groups showed a progressive down regulation with increasing neoplastic transformation. On comparing the various groups, nm23 expression was significantly different between the various subgroups with greatest expression in non-proliferative lesions and least in metastatic deposits (p < 0.050). CONCLUSION: It is concluded that the modulation of nm23 in a spectrum of breast lesions can be indicative of metastatic phenotype and help to predict the aggressiveness of disease

The COVID‐19 Pandemic Not Only Poses Challenges, but Also Opens Opportunities for Sustainable Transformation

The COVID-19 pandemic has impacted social, economic, and environmental systems worldwide, slowing down and reversing the progress made in achieving the Sustainable Development Goals (SDGs). SDGs belong to the 2030 Agenda to transform our world by tackling humankind's challenges to ensure well-being, economic prosperity, and environmental protection. We explore the potential impacts of the pandemic on SDGs for Nepal. We followed a knowledge co-creation process with experts from various professional backgrounds, involving five steps: online survey, online workshop, assessment of expert's opinions, review and validation, and revision and synthesis. The pandemic has negatively impacted most SDGs in the short term. Particularly, the targets of SDG 1, 4, 5, 8, 9, 10, 11, and 13 have and will continue to have weakly to moderately restricting impacts. However, a few targets of SDG 2, 3, 6, and 11 could also have weakly promoting impacts. The negative impacts have resulted from impeding factors linked to the pandemic. Many of the negative impacts may subside in the medium and long terms. The key five impeding factors are lockdowns, underemployment and unemployment, closure of institutions and facilities, diluted focus and funds for non-COVID-19-related issues, and anticipated reduction in support from development partners. The pandemic has also opened a window of opportunity for sustainable transformation, which is short-lived and narrow. These opportunities are lessons learned for planning and action, socio-economic recovery plan, use of information and communication technologies and the digital economy, reverse migration and “brain gain,” and local governments' exercising authorities