154 research outputs found
Electrocatalytic reduction of CO2 on size-selected nanoclusters of first-row transition metal nanoclusters:a comprehensive mechanistic investigation
Factors Associated with Physician Agreement and Coding Choices of Cause of Death Using Verbal Autopsies for 1130 Maternal Deaths in India
The Indian Sample Registration System (SRS) with verbal autopsy methods provides estimations of cause specific mortality for maternal deaths, where the majority of deaths occur at home, unregistered. We aim to examine factors that influence physician agreement and coding choices in assigning causes of death from verbal autopsies.Among adult deaths identified in the SRS, pregnancy-related deaths recorded in 2001-2003 were assigned ICD-10 codes by two independent physicians. Inter-rater reliability was estimated using Landis Koch Kappa classification ≤0.4--poor to fair agreement; >0.4 ≤0.6--moderate agreement; >0.6 ≤0.8--substantial agreement; >8--high agreement. We identified factors associated with physician agreement using multivariate logistic regression. A central consensus panel reviewed cases for errors and reclassified as needed based on 2011 ICD-10 coding guidelines. Of 1130 pregnancy-related deaths, 1040 were assigned ICD-10 codes by two physicians. We found substantial agreement regardless of the woman's residence, whether the death was registered, religion, respondent's or deceased's education, age, hospital admission or gestational age. Physician agreement was not influenced by the above variables, with the exception of greater agreement in cases where the respondent did not live with the deceased, or early gestational age at the time of death. A central consensus panel reviewed all cases and recoded 10% of cases due to insufficient use of information in the verbal autopsy by the coding physicians and rationale for this reclassification are discussed.In the absence of complete vital registration and universal healthcare services, physician coded verbal autopsies continues to be heavily relied upon to ascertain pregnancy-related death. From this study, two independent physicians had good inter-rater reliability for assigning pregnancy-related causes of death in a nationally-represented sample, and physician coding does not appear to be heavily influenced by case characteristics or demographics
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Gender inequity and age-appropriate immunization coverage in India from 1992 to 2006
Background
A variety of studies have considered the affects of India's son preference on gender differences in child mortality, sex ratio at birth, and access to health services. Less research has focused on the affects of son preference on gender inequities in immunization coverage and how this may have varied with time, and across regions and with sibling compositions. We present a systematic examination of trends in immunization coverage in India, with a focus on inequities in coverage by gender, birth order, year of birth, and state.
Methods
We analyzed data from three consecutive rounds of the Indian National Family Health Survey undertaken between 1992 and 2006. All children below five years of age with complete immunization histories were included in the analysis. Age-appropriate immunization coverage was determined for the following antigens: bacille Calmette-Guérin (BCG), oral polio (OPV), diphtheria, pertussis (whooping cough) and tetanus (DPT), and measles.
Results
Immunization coverage in India has increased since the early 1990s, but complete, age-appropriate coverage is still under 50% nationally. Girls were found to have significantly lower immunization coverage (p<0.001) than boys for BCG, DPT, and measles across all three surveys. By contrast, improved coverage of OPV suggests a narrowing of the gender differences in recent years. Girls with a surviving older sister were less likely to be immunized compared to boys, and a large proportion of all children were found to be immunized considerably later than recommended.
Conclusions
Gender inequities in immunization coverage are prevalent in India. The low immunization coverage, the late immunization trends and the gender differences in coverage identified in our study suggest that risks of child mortality, especially for girls at higher birth orders, need to be addressed both socially and programmatically
Prosthodontic rehabilitation of a mucormycosis patient: a case report
Maxillofacial defects can result from congenital disabilities, cancer surgery, trauma, infection, or disease. Facial deformities can affect how a person looks, feels about themselves, and interacts with others. It can significantly impair phonetics, mastication, and deglutition and cause facial deformation. Maxillectomy due to mucormycosis is one such maxillofacial defect and it becomes essential to rehabilitate these cases with modified techniques based on the extension of intraoral defect, the severity, the degree of resection, the type of mucormycosis, the stability of lesions over time, the presence of contiguous disease, the accessibility of dental and prosthetic resources, and patient expectations. The prosthetic reconstruction with a maxillofacial prosthesis can restore function and appearance, comfort, and quality of life. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight, and convenient for future adjustments. The maxillofacial surgeon, oncologist, and reconstructive dentist should work together to develop a treatment plan based on these considerations. This case report provides the current treatment options for these patients and rehabilitation of the defect. It also discusses the issues that need to be addressed during the planning of prosthetic treatment and highlights some challenges the clinicians face in providing prosthetic treatment for mucormycosis patients
ଓଡ଼ିଶା ଉପକୂଳରେ ଜେଲିମାଛର ବିବିଧତା ଏବଂ ବିସ୍ତାରଣ – ଜେଲିମାଛମାନଙ୍କ ଦଂଶନର ପ୍ରାଥମିକ ଚିକିତ୍ସା (Diversity and distribution of jellyfish along the Odisha coast - First aid measures of jellyfish stings-Odiya Version)
Diversity and distribution of jellyfish along the Odisha coast - First aid measures of jellyfish sting
Performance criteria for verbal autopsy-based systems to estimate national causes of death: development and application to the Indian Million Death Study.
BACKGROUND: Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India's ongoing, nationally-representative Indian Million Death Study (MDS). METHODS: Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of COD distributions with independent resampling; differences in COD distribution of hospital, home, urban or rural deaths; age-, sex- and time-specific plausibility of specific diseases; stability and repeatability of dual physician coding; and the ability of the mortality classification system to capture a wide range of conditions. RESULTS: The introduction of the MDS in India reduced the proportion of ill-defined deaths before age 70 years from 13% to 4%. The cause-specific mortality fractions (CSMFs) at ages 5 to 69 years for independently resampled deaths and the MDS were very similar across 19 disease categories. By contrast, CSMFs at these ages differed between hospital and home deaths and between urban and rural deaths. Thus, reliance mostly on urban or hospital data can distort national estimates of CODs. Age-, sex- and time-specific patterns for various diseases were plausible. Initial physician agreement on COD occurred about two-thirds of the time. The MDS COD classification system was able to capture more eligible records than alternative classification systems. By these metrics, the Indian MDS performs well for deaths prior to age 70 years. The key implication for low- and middle-income countries where medical certification of death remains uncommon is to implement COD surveys that randomly sample all deaths, use simple but high-quality field work with built-in resampling, and use electronic rather than paper systems to expedite field work and coding. CONCLUSIONS: Simple criteria can evaluate the performance of VA-based COD systems. Despite the misclassification of VA, the MDS demonstrates that national surveys of CODs using VA are an order of magnitude better than the limited COD data previously available
Role of Information Communication Technology (ICT) in Nepalese Banking Industry
Public and private sectors, organization has been keen to harness the potential of ICT to enhance its administrative, managerial and clinical performance. Successful implementation of the new technology depended upon acceptance by organizational member targets as its end-users. The experiment is done by the help of both primary and secondary data. Primary data have been collected from the structured questionnaire developed for the employee of the bank and the customers. Secondary data have been collected from the website of Nepal Rasta Bank, ICT related journals, banking articles and other published sources. The study purpose is to gain a more complete understanding of the change management factors affecting the acceptance of the. The present study was aimed to explore the prevailing status of the use of ICT in commercial banking services, assess the extent of perceived benefits of the use of ICT and analyze the key problems and their corrective measures so as to leverage the use of ICT in commercial banking in the country. The study found explores the banking sector using the information and technology. The study helps to provide the information about the corns and pros of using information and communication technology in the present context of Nepalese banking sector
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