Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions

Background and Objectives: Despite India’s substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI. Data and Methods: The present study used households with a pair of male-female siblings (aged 1–5 years) from two rounds of National Family Health Survey (NFHS, 1992–93 and 2005–06). The overall inequality in the immunization status (after controlling for age and birth order) of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992–93 and 2005–06). Household fixed-effects models for immunization status of children were also estimated. Results and Conclusions: Findings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992–93 to 0.023 in 2005–06. However, as a percentage o

Severe and Refractory Peptic Ulcer Disease: The Diagnostic Dilemma

The recognition of Helicobacter pylori infection as a cause of peptic ulcer disease, medical regimens to eradicate the organism, and the widespread use of proton pump inhibition to suppress gastric acid secretion have revolutionized the management of peptic ulcer disease. As a result, successful medical management of peptic ulcer disease has largely supplanted the need for gastric surgery by general surgeons. Surgery is reserved for complications of the disease, refractory disease, or rare causes of ulcer disease such as gastrinoma and Zollinger–Ellison syndrome. In this report, we describe a case of intractable peptic ulcer disease that progressed to gastric outlet obstruction despite maximal medical therapy. We review the diagnostic studies utilized to evaluate the potential etiologies of peptic ulcer disease and the difficulty in diagnosing gastrinoma and Zollinger–Ellison in the setting of potent medical acid suppression therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44437/1/10620_2005_Article_2999.pd

Financial Satisfaction and (in)formal Sector in a Transition Country

This paper examines the relationship between working in the formal or informal sector and self-reported individual financial satisfaction in a country in transition. It does so by allowing for individual heterogeneity in terms of perceived financial insecurity and tax morale. The empirical analysis uses a dataset for Albania, a country in transition. The method applied is the ‘self-administered questionnaire’, which combines personal contacts with written questionnaire. The results indicate that, for most individuals, working in the informal sector has negative effects on their self reported financial satisfaction. For some individuals, however, this effect is positive. The characteristic defining these two groups of individuals is their attitude towards the perceived financial insecurity related to not paying taxes. These findings have important implications, in particular for transition countries with large informal sectors. Given the involuntary participation in the informal sector in these countries, the majority of individuals working in this sector will remain financially dissatisfied as long as they have no other social safety net

Epidemiology of H. pylori and its relation with gastrointestinal disorders, a community-based study in Dhaka, Bangladesh

Helicobacter pylori infection is common worldwide and its prevalence is higher in the developing countries. Earlier studies in using urea breath test showed a high prevalence (67%) of H. pylori in early childhood in Bangladesh. Data on H. pylori prevalence using bacterial culture is limited in Bangladesh. The aim of the study was to investigate the prevalence of H. pylori in Bangladeshi subjects using bacterial culture. We also determined the prevalence of infection among different age groups and find out the correlation between the prevalence of H. pylori and the related sociodemographic parameters. A cross-sectional study was conducted among randomly selected households from a peri-urban community in Dhaka, Bangladesh to get an idea about H. pylori status in the lower socioeconomic area. Sociodemographic and clinical information and stool specimen for screening H. pylori infection by stool antigen test were collected. Gastric biopsy was collected for culture from those positive in stool antigen test. A total of 287 subjects were screened by stool antigen test, of them, 92.7% were positive for stool antigen test. Of 259 stool antigen positive sample, 59.1% (n=153) were H. pylori culture positive. Our data suggest that H. pylori infection is significantly associated with age and smoking habit (P value <0.05). In addition, dyspeptic symptoms are significantly higher in H. pylori culture positive subjects than the H. pylori culture negative subjects. Endoscopic examination suggests that the gastroesophageal pathologies are significantly associated (P value <0.05) and duodenal pathologies are moderately associated (P value 0.059) with H. pylori infection. So, H. pylori culture test is auspicating the significant colonization that might lead to pathological outcomes

Epidemiology of H. pylori and its relation with gastrointestinal disorders, a community-based study in Dhaka, Bangladesh

Helicobacter pylori infection is common worldwide and its prevalence is higher in the developing countries. Earlier studies in using urea breath test showed a high prevalence (67%) of H. pylori in early childhood in Bangladesh. Data on H. pylori prevalence using bacterial culture is limited in Bangladesh. The aim of the study was to investigate the prevalence of H. pylori in Bangladeshi subjects using bacterial culture. We also determined the prevalence of infection among different age groups and find out the correlation between the prevalence of H. pylori and the related sociodemographic parameters. A cross-sectional study was conducted among randomly selected households from a peri-urban community in Dhaka, Bangladesh to get an idea about H. pylori status in the lower socioeconomic area. Sociodemographic and clinical information and stool specimen for screening H. pylori infection by stool antigen test were collected. Gastric biopsy was collected for culture from those positive in stool antigen test. A total of 287 subjects were screened by stool antigen test, of them, 92.7% were positive for stool antigen test. Of 259 stool antigen positive sample, 59.1% (n=153) were H. pylori culture positive. Our data suggest that H. pylori infection is significantly associated with age and smoking habit (P value <0.05). In addition, dyspeptic symptoms are significantly higher in H. pylori culture positive subjects than the H. pylori culture negative subjects. Endoscopic examination suggests that the gastroesophageal pathologies are significantly associated (P value <0.05) and duodenal pathologies are moderately associated (P value 0.059) with H. pylori infection. So, H. pylori culture test is auspicating the significant colonization that might lead to pathological outcomes