Transport of pregnant women and obstetric emergencies in India: an analysis of the '108' ambulance service system data.

BACKGROUND: The transport of pregnant women to an appropriate health facility plays a pivotal role in preventing maternal deaths. In India, state-run call-centre based ambulance systems ('108' and '102'), along with district-level Janani Express and local community-based innovations, provide transport services for pregnant women. We studied the role of '108' ambulance services in transporting pregnant women routinely and obstetric emergencies in India. METHODS: This study was an analysis of '108' ambulance call-centre data from six states for the year 2013-14. We estimated the number of expected pregnancies and obstetric complications for each state and calculated the proportions of these transported using '108'. The characteristics of the pregnant women transported, their obstetric complications, and the distance and travel-time for journeys made, are described for each state. RESULTS: The estimated proportion of pregnant women transported by '108' ambulance services ranged from 9.0 % in Chhattisgarh to 20.5 % in Himachal Pradesh. The '108' service transported an estimated 12.7 % of obstetric emergencies in Himachal Pradesh, 7.2 % in Gujarat and less than 3.5 % in other states. Women who used the service were more likely to be from rural backgrounds and from lower socio-economic strata of the population. Across states, the ambulance journeys traversed less than 10-11 km to reach 50 % of obstetric emergencies and less than 10-21 km to reach hospitals from the pick-up site. The overall time from the call to reaching the hospital was less than 2 h for 89 % to 98 % of obstetric emergencies in 5 states, although this percentage was 61 % in Himachal Pradesh. Inter-facility transfers ranged between 2.4 % -11.3 % of all '108' transports. CONCLUSION: A small proportion of pregnant women and obstetric emergencies made use of '108' services. Community-based studies are required to study knowledge and preferences, and to assess the potential for increasing or rationalising the use of '108' services

Response of the Cutworm Spodoptera litura to Sesame Leaves or Crude Extracts in Diet

The effects of extracts of sesame, Sesamum indicum L. (Liamiales: Pedaliaceae), and whole leaves of some selected cultivars of sesame were tested using a natural host Spodoptera litura (F.) (Lepidoptera: Noctuidae). Indices taken using the immature stages include; diet utilization, growth and development and induction of detoxification enzymes. The results indicate that S. litura generally selects its food amongst cultivars within 6 hours after food presentation. Growth and development of the insect is controlled also by plant acceptability and quality. Although all the cultivars tested significantly limit insect growth and development the variety 56S-radiatum did not allow a complete life cycle as pupation from first instar stage was 0%. Generally the crucial period for immature S. litura was the larval period, especially the first two instars where the weight of an insect fed on an experimental diet was three times lower than that of a control diet. The larval developmental period was greater than 40 days as compared to 17 days for insects fed a control diet. S. litura also had lowered efficiency in utilizing ingested food, from a low of 13% in a sesame cultivar to 45% in the control diet. The key detoxification enzyme was a glutathione s-transferase that was confirmed by a 6-fold increase between S. litura fed a plant cultivar vs. a control diet towards the substrate 1,2-dichloro-4-nitrobenzene. First and second instars of S. litura have a relatively reduced detoxification of enzymes in response to plant cultivar diets leading to low survival. A 3% v/w crude extract of the cultivars increased enzyme induction towards all the tested substrates

THERMODYNAMIC MODELING FOR SUPERCRITICAL-FLUID PROCESS DESIGN

The present paper describes a predictive model for ascertaining the process parameters toward establishing an economically viable supercritical fluid technology. The model utilizes the Peng-Robinson equation of state with a modified covolume-dependent (CVD) mixing rule to be able to predict the solubility of mixed solids in pure and mixed supercritical carbon dioxide from minimum information, such as the pure component solubilities. The model can predict the solubility data at various temperatures by virture of its temperature-insensitive CVD interaction parameter. In order to make the model completely predictive, the CVD interaction parameter has been correlated in terms of the easily available pure component properties, such as solid molar volume, van der Waals volumes, and dipole moments. For mixed solvent, however, a more rigorous correlation is needed to account for stronger solute-cosolvent interactions. The validity of the model has also been tested for the solubility predictions of liquid solutes in the supercritical solvent. Slightly higher deviations of the liquid-phase compositions indicate that the mixing rule is rather well suited for the dilute supercritical solution. The utility of the model has been demonstrated for separation of palmitic acid from tripalmitin. The process parameters have been established under the equilibrium condition utilizing the well-predicted crossover pressures and solubility behavior with temperature