The number of privately treated tuberculosis cases in India: an estimation from drug sales data

Background Understanding the amount of tuberculosis managed by the private sector in India is crucial to understanding the true burden of the disease in the country, and thus globally. In the absence of quality surveillance data on privately treated patients, commercial drug sales data offer an empirical foundation for disease burden estimation. Methods We used a large, nationally representative commercial dataset on sales of 189 anti-tuberculosis products available in India to calculate the amount of anti-tuberculosis treatment in the private sector in 2013–14. We corrected estimates using validation studies that audited prescriptions against tuberculosis diagnosis, and estimated uncertainty using Monte Carlo simulation. To address implications for numbers of patients with tuberculosis, we explored varying assumptions for average duration of tuberculosis treatment and accuracy of private diagnosis. Findings There were 17·793 million patient-months (95% credible interval 16·709 million to 19·841 million) of anti-tuberculosis treatment in the private sector in 2014, twice as many as the public sector. If 40–60% of private-sector tuberculosis diagnoses are correct, and if private-sector tuberculosis treatment lasts on average 2–6 months, this implies that 1·19–5·34 million tuberculosis cases were treated in the private sector in 2014 alone. The midpoint of these ranges yields an estimate of 2·2 million cases, two to three times higher than currently assumed. Interpretation India's private sector is treating an enormous number of patients for tuberculosis, appreciably higher than has been previously recognised. Accordingly, there is a re-doubled need to address this burden and to strengthen surveillance. Tuberculosis burden estimates in India and worldwide require revision

Effect of impurity substitution on band structure and mass renormalization of the correlated FeTe0.5_{0.5}Se0.5_{0.5} superconductor

Using angle-resolved photoemission spectroscopy (ARPES), we studied the effect of the impurity potential on the electronic structure of FeTe$_{0.5}$Se$_{0.5}$ superconductor by substituting 10\% of Ni for Fe which leads to an electron doping of the system. We could resolve three hole pockets near the zone center and an electron pocket near the zone corner in the case of FeTe$_{0.5}$Se$_{0.5}$, whereas only two hole pockets near the zone center and an electron pocket near the zone corner are resolved in the case of Fe$_{0.9}$Ni$_{0.1}$Te$_{0.5}$Se$_{0.5}$, suggesting that the hole pocket having predominantly the $xy$ orbital character is very sensitive to the impurity scattering. Upon electron doping, the size of the hole pockets decrease and the size of the electron pockets increase as compared to the host compound. However, the observed changes in the size of the electron and hole pockets are not consistent with the rigid-band model. Moreover, the effective mass of the hole pockets is reduced near the zone center and of the electron pockets is increased near the zone corner in the doped Fe$_{0.9}$Ni$_{0.1}$Te$_{0.5}$Se$_{0.5}$ as compared to FeTe$_{0.5}$Se$_{0.5}$. We refer these observations to the changes of the spectral function due to the effect of the impurity potential of the dopants.Comment: 8 pages, 3 figure

Endophytic Mycoflora of Indian Medicinal Plant, Terminalia arjuna and their Biological Activities

Studies were undertaken to isolate, identify and evaluate the biological activities of endophytic mycoflora of Indian medicinal plant, Terminalia arjuna. A total of 20 isolates of endophytic fungi were obtained from the leaves, twigs and bark tissues of the Terminalia arjuna. Out of 20, six isolates exhibited promising antibacterial, antifungal and anti-inflammatory activities when cultivated at shake flask level. The selected isolates were identified on the basis of morphology and ITS gene sequencing. Three isolates, designated as TA BA 1, TA L1 and TA L2 were identified as Aspergillus flavus whereas; the remaining three endophytic fungi were identified as Diaporthe arengae (TA TW2), Alternaria Sp. (TA TW1) and Lasiodiplodia theobromae (TA BA2). Aspergillus flavus was found as the predominant endophyte in leaves and bark tissues of the plant. The crude extract of the test isolates showed considerable antimicrobial activity against common human bacterial (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris, Salmonella abony and Bacillus subtilis) and fungal (Candida albicans, Aspergillus niger and Penicilium sp.) pathogens. The extract of Diaporthe arengae (TA TW2) significantly reduced the concentration of DPPH free radical as percent DPPH scavenging activity was found to be highest (69.56%) in comparison with other isolates. The % inhibition of hemolysis of RBCs was found to be highest (82.85%) with Diaporthe arengae (TA TW2) in comparison (83.26%) with standard drug (Ibuprofen). Among all, the extract of the Diaporthe arengae (TA TW2) showed excellent biological activities and hence was subjected to further characterization. The phytochemical investigation of the extract revealed the presence of terpenoids as the major phytoconstituents which was supported by TLC and UV spectroscopic studies. The results indicate that the isolated endophytes could be the valuable source of these bioactive molecules with diverse biological activities. The bioactivities may be attributed to the terpenoids present in the endophytic extract

Molecular analysis of autosomal dominant hereditary ataxias in the Indian population: high frequency of SCA2 and evidence for a common founder mutation

Expansion of CTG/CAG trinucleotide repeats has been shown to cause a number of autosomal dominant cerebellar ataxias (ADCA) such as SCA1, SCA2, SCA3/MJD, SCA6, SCA7, SCA8 and DRPLA. There is a wide variation in the clinical phenotype and prevalence of these ataxias in different populations. An analysis of ataxias in 42 Indian families indicates that SCA2 is the most frequent amongst all the ADCAs we have studied. In the SCA2 families, together with an intergenerational increase in repeat size, a horizontal increase with the birth order of the offspring was also observed, indicating an important role for parental age in repeat instability. This was strengthened by the detection of a pair of dizygotic twins with expanded alleles showing the same repeat number. Haplotype analysis indicates the presence of a common founder chromosome for the expanded allele in the Indian population. Polymorphism of CAG repeats in 135 normal individuals at the SCA loci studied showed similarity to the Caucasian population but was significantly different from the Japanese population

Quantum mechanics in multiply connected spaces

This paper analyses quantum mechanics in multiply connected spaces. It is shown that the multiple connectedness of the configuration space of a physical system can determine the quantum nature of physical observables, such as the angular momentum. In particular, quantum mechanics in compactified Kaluza-Klein spaces is examined. These compactified spaces give rise to an additional angular momentum which can adopt half-integer values and, therefore, may be identified with the intrinsic spin of a quantum particle.Comment: Latex 15 page

Scaling law in target-hunting processes

We study the hunting process for a target, in which the hunter tracks the goal by smelling odors it emits. The odor intensity is supposed to decrease with the distance it diffuses. The Monte Carlo experiment is carried out on a 2-dimensional square lattice. Having no idea of the location of the target, the hunter determines its moves only by random attempts in each direction. By sorting the searching time in each simulation and introducing a variable $x$ to reflect the sequence of searching time, we obtain a curve with a wide plateau, indicating a most probable time of successfully finding out the target. The simulations reveal a scaling law for the searching time versus the distance to the position of the target. The scaling exponent depends on the sensitivity of the hunter. Our model may be a prototype in studying such the searching processes as various foods-foraging behavior of the wild animals.Comment: 7 figure

A CMOS-based characterisation platform for emerging RRAM technologies

Mass characterisation of emerging memory devices is an essential step in modelling their behaviour for integration within a standard design flow for existing integrated circuit designers. This work develops a novel characterisation platform for emerging resistive devices with a capacity of up to 1 million devices on-chip. Split into four independent sub-arrays, it contains on-chip column-parallel DACs for fast voltage programming of the DUT. On-chip readout circuits with ADCs are also available for fast read operations covering 5-decades of input current (20nA to 2mA). This allows a device’s resistance range to be between 1kΩ and 10MΩ with a minimum voltage range of ±1.5V on the device

Tuberculosis treatment in the private healthcare sector in India: An analysis of recent trends and volumes using drug sales data

Background There is a pressing need for systematic approaches for monitoring how much TB treatment is ongoing in the private sector in India: both to cast light on the true scale of the problem, and to help monitor the progress of interventions currently being planned to address this problem. Methods We used commercially available data on the sales of rifampicin-containing drugs in the private sector, adjusted for data coverage and indication of use. We examined temporal, statewise trends in volumes (patient-months) of TB treatment from 2013 to 2016. We additionally analysed the proportion of drugs that were sold in combination packaging (designed to simplify TB treatment), or as loose pills. Results Drug sales suggest a steady trend of TB treatment dispensed by the private sector, from 18.4 million patient-months (95% CI 17.3–20.5) in 2013 to 16.8 patient-months (95% CI 15.5–19.0) in 2016. Overall, seven of 29 states in India accounted for more than 70% of national-level TB treatment volumes, including Uttar Pradesh, Maharashtra and Bihar. The overwhelming majority of TB treatment was dispensed not as loose pills, but in combination packaging with other TB drugs, accounting for over 96% of private sector TB treatment in 2017. Conclusions Our findings suggest consistent levels of TB treatment in the private sector over the past 4 years, while highlighting specific states that should be prioritized for intervention. Drug sales data can be helpful for monitoring a system as large, disorganised and opaque as India’s private sector

Analysis of medicinally important compounds and anti-oxidant activity in solvent extracts of coriander (Coriandrum sativum L.) plant parts

Total phenolic, flavonoid content and antioxidant activity of crude extract of seeds, roots, stem and leaves of coriander plant were determined. Maximum phenolic content (62.6 and 50.141 mg gallic acid equivalents (GAE) g-1 extract) was observed in distilled water extract of fresh and dried roots followed by methanol extract (49.53 and 47.32 mg in green and dried stem respectively). Ethyl acetate extract showed more phenolics in dried stem (12.734 mg GAE g-1 extract) and leaves (8.62 mg GAE g-1 extract) as compared to green stem and leaves (1.808 and 5.433 mg, respectively). Distribution of flavonoids content in different green as well as dried plant parts and different solvents showed less variation in phenolic and flavonoid contents which ranged from a maximum of 9.843 mg quercetin equivalents (QE) g-1 extract in green seeds to a minimum of 4.40 mg in green stem. 1, 1-Diphenyl-2-picrylhydrazin scavenging as a measure of antioxidant capacity was more in distilled water extract of green stem (94.49%) followed by methanol crude extract (76.256%) and ethyl acetate extract (59.706%). &nbsp