The modern histopathologist: in the changing face of time

The molecular age histopathologist of today is practicing pathology in a totally different scenario than the preceding generations did. Histopathologists stand, as of now, on the cross roads of a traditional 'visible' morphological science and an 'invisible' molecular science. As molecular diagnosis finds more and more applicability in histopathological diagnosis, it is time for the policy makers to reframe the process of accreditation and re-accreditation of the modern histopathologist in context to the rapid changes taking place in this science. Incorporation of such 'molecular' training viv-a-vis information communication technology skills viz. telemedicine and telepathology, digital imaging techniques and photography and a sound knowledge of the economy that the fresh entrant would ultimately become a part of would go a long way to produce the Modern Histopathologist. This review attempts to look at some of these aspects of this rapidly advancing 'art of science.

Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015–2016

Background and objective India contributes the highest global share of deaths among the under-fives. Continuous monitoring of the reduction in the under-five mortality rate (U5MR) at local level is thus essential to set priorities for policy-makers and health professionals. In this study, we aimed to provide an update on district-level disparities in the neonatal mortality rate (NMR) and the U5MR with special reference to Sustainable Development Goal 3 (SDG3) on preventable deaths among new-borns and children under five. Data and methods We used recently released population-based cross-sectional data from the National Family Health Survey (NFHS) conducted in 2015–2016. We used the synthetic cohort probability approach to analyze the full birth history information of women aged 15–49 to estimate the NMR and U5MR for the ten years preceding the survey. Results Both the NMR and U5MR vary enormously across Indian districts. With respect to the SDG3 target for 2030 for the NMR and the U5MR, the estimated NMR for India for the period studied is about 2.4 times higher, while the estimated U5MR is about double. At district level, while 9% of the districts have already reached the NMR targeted in SDG3, nearly half (315 districts) are not likely to achieve the 2030 target even if they realize the NMR reductions achieved by their own states between the last two rounds of National Family Health Survey of India. Similarly, less than one-third of the districts (177) of India are unlikely to achieve the SDG3 target on the U5MR by 2030. While the majority of high-risk districts for the NMR and U5MR are located in the poorer states of north-central and eastern India, a few high-risk districts for NMR also fall in the rich and advanced states. About 97% of districts from Chhattisgarh and Uttar Pradesh, for example, are unlikely to meet the SDG3 target for preventable deaths among new-borns and children under age five, irrespective of gender. Conclusions To achieve the SDG3 target on preventable deaths by 2030, the majority of Indian districts clearly need to make a giant leap to reduce their NMR and U5MR

Behaviours of MeCl2 (Me: Pb and Cd) during thermal treatment of kaolin-lime mixture

This paper reports the emission behaviours of Pb and Cd during heat treatment of their chloride salts with kaolin-lime and kaolin-lime-silica mixtures. The leaching behaviours of Pb and Cd from the heattreated products are also assessed. The results showed that the addition of lime into kaolin increased the emitted amounts of Pb and Cd during heating. Addition of silica into the mixtures further increased the emissions of both elements at low temperature (≤1000°C) and inhibited their emissions at high temperature (≥1100°C). Crystallinity of silica had profound effect on the emissions of Pb and Cd from the mixtures. The heat-treated product containing anorthite as the major crystalline phase not only retain more amounts of Pb and Cd in its composition but also emit lesser amounts of Pb and Cd into solution than the product containing gehlenite as the major crystalline phase during subjected leaching test.Key words: Toxic element,kaolin, lime, silica, heat-treatment, leaching

Excess under-5 female mortality across India: a spatial analysis using 2011 census data

Background Excess female mortality causes half of the missing women (estimated deficit of women in countries with suspiciously low proportion of females in their population) today. Globally, most of these avoidable deaths of women occur during childhood in China and India. We aimed to estimate excess female under-5 mortality rate (U5MR) for India’s 35 states and union territories and 640 districts. Methods Using the summary birth history method (or Brass method), we derived district-level estimates of U5MR by sex from 2011 census data. We used data from 46 countries with no evidence of gender bias for mortality to estimate the effects and intensity of excess female mortality at district level. We used a detailed spatial and statistical analysis to highlight the correlates of excess mortality at district level. Findings Excess female U5MR was 18·5 per 1000 livebirths (95% CI 13·1–22·6) in India 2000–2005, which corresponds to an estimated 239 000 excess deaths (169 000–293 000) per year. More than 90% of districts had excess female mortality, but the four largest states in northern India (Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh) accounted for two-thirds of India’s total number. Low economic development, gender inequity, and high fertility were the main predictors of excess female mortality. Spatial analysis confirmed the strong spatial clustering of postnatal discrimination against girls in India. Interpretation The considerable effect of gender bias on mortality in India highlights the need for more proactive engagement with the issue of postnatal sex discrimination and a focus on the northern districts. Notably, these regions are not the same as those most affected by skewed sex ratio at birth

Polarization asymmetry in CSS sources: evidence of AGN fuel?

The compact steep spectrum and gigahertz peaked spectrum sources are widely believed to be young radio sources, with ages <10^6 yr. If the activity in the nucleus is fuelled by the supply of gas, one might find evidence of this gas by studying the structural and polarization characteristics of CSS sources as these evolve through this gas. We present polarization observations of a sample of CSS sources, and combine our results with those available in the literature, to show that CSS sources are more asymmetric in the polarization of the outer lobes compared with the more extended ones. We suggest that this could be possibly due to interaction of the jets with infalling material, which fuels the radio source. We also investigate possible dependence of the polarization asymmetry of the lobes on redshift, since this might be affected by more interactions and mergers in the past. No such dependence is found for the CSS sources, suggesting that the environments on the CSS scales are similar at different redshifts. However, the polarization asymmetry of the oppositely-directed lobes is larger at higher redshifts for the more extended sources, possibly reflecting the higher incidence of interactions in the past.Comment: 6 pages, 3 figures, two tables, accepted for publication in Astronomy and Astrophysic

Gender Disparities in Health-care Expenditure (HCE) and Financing Strategies (HCFS) for In-patient Care in India

Background Despite the presence of a vast literature on health-care expenditure (HCE) and health-care financing strategies (HCFS) in low- and middle income countries, there is limited evidence of gender disparity in HCFS for in-patient care. Objective We examined gender disparities in HCE and HCFS for in-patient care among adults aged 15 and above in India, a South Asian population giant, widely known for gender-based discrimination in sex-selective abortion, nutrition and access to healthcare. Data and Methods Using data from a nationally representative large-scale population-based survey, we investigated the relationship between the gender of adult patients and HCE as well as sources of health-care financing. Simple percentage distribution, cross-tabulation, two level random intercempt model and multinomial logit regression were carried out to examine the role of gender in HCE and sources of health-care financing for in-patient care. Results Average HCE is lower for females in adult age groups, irrespective of type of diseases and duration of stay in the hospital. This result remained unchanged after controlling other background variables of the patients. Females are also discriminated against more when health care has to be paid for by borrowing, sale of assets, or contributions from friends and relatives (distressed financing). Multinomial logit results show that the probability of distressed financing is less for females than for males (Borrowing: β=-0.27; CI:-0.37--0.17; p=0.001; selling assets/contribution from friends and relatives (β=-0.27; CI: -0.39--0.14; p=0.001). The predicted probability of using health-care finance implies that the health of adult men is considered to be more important in terms of resorting to distressed financing than that of their female counterparts. Conclusion HCE on adult women inpatients is systematically lower than that of adult men inpatients. Further, women in India have less access to in-patient care through distressed HCFS