Prevalence and correlates of childhood obesity in suburban area of Odisha: A cross sectional study

Introduction: In India obesity and overweight is increasing among urban adolescents. Both under and over nutrition is grappling the country at faster rate. Present study was an attempt to explore obesity and overweight prevalence among school going children in suburban areas of Cuttack city, Odisha, India and their correlates. Methodology: A cross-sectional study was done among school children in suburban area of Cuttack city, Odisha. A predesigned and pretested questionnaire was used to interview the study participants to elicit information about their age, number of siblings, birth order of the child, working status of parents, television screen viewing time, mode of transport to school and dietary habit of the students. A total of 550 children studying in class five to ten participated in our study. Result: Out of 550 children screened, nearly (14) 2.5% students were thin or severely thin, whereas (67)12.1% students were overweight or obese. Univariate analysis revealed that girls were almost five times at higher risk of being overweight/obesity compared to boys (OR: 4.78 95%CI: 1.35-16.93). Children who used motorized vehicles for going to school had an unadjusted Odds ratio of 10.08 [95%CI: 2.08-48.77] of being overweight or obese compared to those who walked to school. Having more than one child at home (OR= 0.15, 95%CI: 0.039-0.6) and doing physical activity for more than 30min per day (0.105, 95%CI: 0.015-0.72) were found to be protective against overweight and obesity. Conclusion: Bearing in mind the burden of overweight and obesity among school children there is a need for periodic screening, awareness at school and parent counselling

The effect of right ventricular apical and non-apical pacing on the short- and long-term changes in left ventricular ejection fraction: a systematic review and meta-analysis of randomized-controlled trials

BACKGROUND The right ventricular apex (RVA) is the traditional lead site for chronic pacing but in some patients may cause impaired left ventricular (LV) systolic function over time. Comparisons with non-apical (RVNA) pacing sites have generated inconsistent results and recent meta-analyses have demonstrated unclear benefit due to heterogeneity across studies. METHODS AND RESULTS A systematic search for randomized controlled trials that compared LVEF outcomes between RVNA and RVA pacing was performed up to October 2014. Twenty four studies (n = 1628 patients) met the inclusion criteria. To avoid between study heterogeneity two homogenous groups were created; group one where studies reported a difference (in favor of RVNA pacing) and group two where studies reported no difference between pacing sites. For group one weighted mean difference (WMD) between RVNA and RVA pacing in terms of LVEF at follow-up was 5.40% (95% CI: 3.94 to 6.87), related in part to group one's RVA arm demonstrating a significant reduction (mean loss -3.31%; 95% CI: -6.19 to -0.43) in LVEF between study baseline and end of follow-up. Neither of these finding were seen in group two. Weighted regression modeling demonstrated that inclusion of poor baseline LVEF (<40%) in combination with greater than 12 months follow-up was three times more common in group one compared to group two (weighted RR 2.82; 95% CI 1.03 - 7.72; P = 0.043). CONCLUSIONS In patients requiring chronic right ventricular pacing where there is inclusion of impaired baseline LVEF (<40%), RVA pacing is associated with deterioration in LV function relative to RVNA pacing. This article is protected by copyright. All rights reserved

Development of a new rutin nanoemulsion and its application on prostate carcinoma PC3 cell line

Biological effects of rutin bioactive are limited due to its poor oral bioavailability and its degradation in aqueous environments. For the purpose of bioenhancement, different nanoemulsion systems of rutin were developed by aqueous titration method using water as dispersion media. The nanoemulsion systems were characterized for sur- face morphology, droplet size, polydispersity index, zeta potential, in vitro release profile and the formulations were optimized. The anticancer potential of optimized nanoemulsion was evaluated by cells viability (MTT) assay, nuclear condensation, and ROS activity using human prostate cancer (PC3) cell line. On the basis of cell viability data the inhibitory concentration (IC50) value for optimized nanoemulsion formulation on PC3 cancer cells was found to be 11.8 μM. Fluorescent microscopic analysis and intracellular ROS generation demonstrated significant ROS induction that might lead to triggering the apoptosis pathway. In conclusion, developed nanoemulsion displayed significant efficacy against prostate carcinoma cells

Formulation Optimization and In-vitro Evaluation of Oral Floating Captopril Matrix Tablets using Factorial Design

Purpose: To develop a zero-order sustained release floating formulation of captopril, and optimize its drug release for enhanced oral bioavailability.Methods: A relatively new approach, 32 full factorial design, was used to formulate floating captopril matrix tablets and to systematically optimize its drug release using varying levels of xanthan gum and hydroxypropyl methylcellulose (HPMC) K100M polymers. Calcium carbonate was used as gasgenerating agent. After setting the levels by preliminary trials, nine tablet formulations (F1 - F9) were prepared by wet granulation method using Design Expert Software® - suggested combinations of polymers. The concentrations of HPMC K100M (X1) and xanthan gum (X2) were chosen as control variables. Conversely, the response variables selected were timed to release 50 % of the drug (t50%) at 6 h (Q6) and 12 h (Q12). Fourier transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC) were used to assess compatibility between the drug and the excipients. The validity of the developed mathematical equations was assessed by designing three extra check-points.Results: The response surface plots drawn demonstrated the suitability of the hydrophilic matrixforming agents for formulating controlled release floating tablets of captopril. FTIR and DSC spectra showed no noticeable incompatibility between drug and polymers in both physical mixtures and in formulations. Floating time lag remained &lt; 5.5 min with floating duration &gt; 12 h. Considerable agreement was observed between predicted and actual release parameters. Fitting the data into different kinetic models showed that non-Fickian behavior for diffusion exponent (n) differed from 0.588 and 0.811.Conclusion: Optimum formulation (F4) showed satisfactory release profile. Moreover, the study successfully demonstrated influence of polymer blends in controlling release variables.Keywords: Captopril, Xanthan gum, Hydroxy propyl methyl cellulose , Factorial design, Bioavailabilit

Design Techniques in Rock and Soil Engineering

At the initial stage of tunnel design, the tunnel stability can be assessed by different design techniques which are broadly classified into three categories i.e. Mathematical Analysis, Empirical Methods and Numerical Analysis. Mathematical methods or closed form solutions are more precise methods; however, its use is limited to simple geometries and almost impossible for complex geometries due to complex and tedious calculations involved. In practice, Empirical and Numerical Methods are usually used for stability analysis of tunnels. It should be noted that it is not the replacement of final design. Empirical design methods use information about the structural geology and other rock mass properties as input that can be easily obtained at the initial stage of a project. Numerical Methods commonly require mechanical properties, especially strength and deformation of rocks. Numerical methods are also considered as precise due to provision of allowance for variable inputs and geometry and having ability for sensitivity analysis. It is good practice to evaluate the stability of tunnels using at least two Empirical methods and validated through Numerical methods

Multimorbidity, healthcare use and catastrophic health expenditure by households in India: a cross-section analysis of self-reported morbidity from national sample survey data 2017–18

Background: The purpose of this research is to generate new evidence on the economic consequences of multimorbidity on households in terms of out-of-pocket (OOP) expenditures and their implications for catastrophic OOP expenditure. Methods: We analyzed Social Consumption Health data from National Sample Survey Organization (NSSO) 75th round conducted in the year 2017–2018 in India. The sample included 1,13,823 households (64,552 rural and 49,271 urban) through a multistage stratified random sampling process. Prevalence of multimorbidity and related OOP expenditure were estimated. Using Coarsened Exact Matching (CEM) we estimated the mean OOP expenditure for individuals reporting multimorbidity and single morbidity for each episode of outpatient visits and hospital admission. We also estimated implications in terms of catastrophic OOP expenditure for households. Results: Results suggest that outpatient OOP expenditure is invariably lower in the presence of multimorbidity as compared with single conditions of the selected Non-Communicable Diseases(NCDs) (overall, INR 720 [USD 11.3] for multimorbidity vs. INR 880 [USD 14.8] for single). In the case of hospitalization, the OOP expenditures were mostly higher for the same NCD conditions in the presence of multimorbidity as compared with single conditions, except for cancers and cardiovascular diseases. For cancers and cardiovascular, OOP expenditures in the presence of multimorbidity were lower by 39% and 14% respectively). Furthermore, around 46.7% (46.674—46.676) households reported incurring catastrophic spending (10% threshold) because of any NCD in the standalone disease scenario which rose to 63.3% (63.359–63.361) under the multimorbidity scenario. The catastrophic implications of cancer among individual diseases was the highest. Conclusions: Multimorbidity leads to high and catastrophic OOP payments by households and treatment of high expenditure diseases like cancers and cardiovascular are under-financed by households in the presence of competing multimorbidity conditions. Multimorbidity should be considered as an integrated treatment strategy under the existing financial risk protection measures (Ayushman Bharat) to reduce the burden of household OOP expenditure at the country level.Publication Funding was obtained from Research England Policy Impact Fund Grant given by Queen Mary University of London

A study of organizational versus individual needs related to recruitment, deployment and promotion of doctors working in the government health system in Odisha state, India

Background An effective health workforce is essential for achieving health-related new Sustainable Development Goals. Odisha, one of the states in India with low health indicators, faces challenges in recruiting and retaining health staff in the public sector, especially doctors. Recruitment, deployment and career progression play an important role in attracting and retaining doctors. We examined the policies on recruitment, deployment and promotion for doctors in the state and how these policies were perceived to be implemented. Methods We undertook document review and four key informant interviews with senior state-level officials to delineate the policies for recruitment, deployment and promotion. We conducted 90 in-depth interviews, 86 with doctors from six districts and four at the state level to explore the perceptions of doctors about these policies. Results Despite the efforts by the Government of Odisha through regular recruitments, a quarter of the posts of doctors was vacant across all institutional levels in the state. The majority of doctors interviewed were unaware of existing government rules for placement, transfer and promotion. In addition, there were no explicit rules followed in placement and transfer. More than half (57%) of the doctors interviewed from well-accessible areas had never worked in the identified hard-to-reach areas in spite of having regulatory and incentive mechanisms. The average length of service before the first promotion was 26 (±3.5) years. The doctors expressed satisfaction with the recruitment process. They stated concerns over delayed first promotion, non-transparent deployment policies and ineffective incentive system. Almost all doctors suggested having time-bound and transparent policies. Conclusions Adequate and appropriate deployment of doctors is a challenge for the government as it has to align the individual aspirations of employees with organizational needs. Explicit rules for human resource management coupled with transparency in implementation can improve governance and build trust among doctors which would encourage them to work in the public sector

Enhancement of solubility and dissolution rate of ebastine fast-disintegrating tablets by solid dispersion method

Purpose: To investigate the efficiency of different solubilizing agents in improving solubility as well as dissolution rate of ebastine (a BCS class II drug) by incorporating prepared solid dispersion into fast disintegrating tablets.Method: The solubility of ebastine was determined in distilled water, lipids and solubilizing agents. Subsequently, the binary solid dispersions were prepared by kneading method using varying weight ratios of ebastine and solubilizing agents. The solid dispersions were then incorporated into fast disintegrating tablets (SD-FDT). Central composite rotatable design (CCD) was used to determine the impact of super disintegrating agents on disintegration time and friability of tablets. The solubility and dissolution rate of developed SD-FDT were compared with a marketed brand. The solid dispersion particles were characterized by Fourier-transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), powder x-ray diffraction (P-XRD) and scanning electron microscopy (SEM).Results: The saturated solubility of pure ebastine in water was 0.002 ± 0.041 mg/ml while the aqueous solubility of EBT/poloxamer solid dispersion SET3 (P) was 0.018 ± 2.510 mg/ml; on the other hand, EBT/soluplus solid dispersion SET1(S) has an aqueous solubility of 0.242 ± 1.390 mg/ml. Within 30 min, drug release was 14.00 ± 1.77, 78.00 ± 2.31 and 98.70 ± 2.54 % from pure EBT, SET3 (P) and SET1(S), respectively.Conclusion: The solubility and dissolution rate of ebastine has been successfully enhanced by incorporating its solid dispersion in fast-disintegrating tablets (SD-FDT). Keywords: Ebastine, Solid dispersion, Poloxamer 188, Soluplus, Solubility, Dissolutio

Numerical Modeling for Engineering Analysis and Designing of Optimum Support Systems for Headrace Tunnel

The empirical and numerical design approaches are considered very important in the viable and efficient design of support systems, stability analysis for tunnel, and underground excavations. In the present research work, the rock mass rating (RMR) and tunneling quality index (Q-system) were used as empirical methods for characterization of rock mass based on real-time geological and site geotechnical data and physical and strength properties of rock samples collected from the alignment of tunnel. The rock mass along the tunnel axis was classified into three geotechnical units (GU-1, GU-2, and GU-3). The support systems for each geotechnical unit were designed. The 2D elastoplastic finite-element method (FEM) was used for the analysis of rock mass behavior, in situ and redistribution stresses, plastic thickness around the tunnel, and performance of the design supports for the selection of optimum support system among RMR and Q supports for each geotechnical unit of tunnel. Based on results, Q support systems were found more effective for GU-1 and GU-2 as compared to RMR support systems and RMR support systems for GU-3 as compared to Q support systems

Impact of Sensor Networks on Aquatic Biodiversity in Wetland: An Innovative Approach

Aquatic biodiversity is in the central field of environmental conservation issues in a wetland. Yet it determinately faced aquatic conservation authorities the loss of biodiversity as a very important global issue for several years due to misuse wireless sensor technology. The study attempts to re-look at the sensor networks that affect the aquatic biodiversity within and around the Tanguar Haor- wetland study at Sunamganj district in Bangladesh. Key aquatic conservation tools provided at the Tanguar Haor and its challenges with gaps in policies for wetland management practices are highlighted. The study shows the aquatic biodiversity-related rules and regulations amended were apex in Bangladesh from 2010 to 2018. The study represents the impact of processed sensor networks on aquatic biodiversity in a wetland to be compared to larger, medium, and smaller animals in a bright, dark and optimum environment, facilitating the design and misuse of wireless sensor networks within GPS locations. Approximately 64% of the respondents agreed on the development of aquatic biodiversity for managing the wetland at Sunamganj with secure peripheral sensor networks. The research also found that the Tanguar Haor is at risk due to misuse of wireless sensor networks compared to other wetlands in the Sylhet Division. Scientific knowledge is indispensable in wetland resource management but it poorly identified such knowledge while various performances are still below par. The research is unique and represents the innovative idea to improve the existing wetland policy linking with the appropriateness for the Ramsar Wetland Conservation Strateg