Life Saving Drugs, Health Policy and Mental Health

This dissertation has two chapters that broadly fall in the fields of health and public economics. The first paper explores the effect an innovation in HIV/AIDS treatment of the suicide rates of affected population. The second chapter is coauthored with Sherajum Monira Farin and Shyam Raman and explores how states respond to exogenous changes in federal funding for the provision of life-saving HIV/AIDS treatments. Chapter 1: The introduction of Highly Active Antiretroviral Therapy (HAART) in 1995, transformed the prognosis of an HIV infection from a death sentence to a manageable chronic health condition. Using a difference-in-differences and triple-difference strategy, this paper exploits spatial and demographic variation in HIV incidence at the time HAART treatment was introduced and finds that, in addition to reducing HIV/AIDS deaths, the introduction of HAART led to a disproportionate decrease in suicide rates for men aged 25 to 44. Estimates suggest that HAART saved approximately 500 men aged 25 to 44 from suicide each year following its introduction. Chapter 2: As part of the Ryan White HIV/AIDS program, the AIDS Drug Assistance Program (ADAP) serves as a payer of last resort for people living with HIV (PLWH) who are uninsured or underinsured and have a low income. ADAP provides recipients with access to life-saving antiretroviral treatments which transforms an HIV diagnosis from a death sentence to a manageable chronic health condition. The ADAP program is funded through a combination of federal and state funds but is administered by the state. I exploit a rule change which was part of the 2006 reauthorization of the Ryan-White Care Act and resulted in an exogenous shock to federal funding for ADAPs. Using this unique setting, the study finds that changes in federal contributions to ADAPs have a near dollar-to-dollar effect on expenditures and increased federal funding results in an increased number of clients served. These findings underscore the importance of federal support for ADAPs in providing critical care for people living with HIV

Central nervous system lymphomas: a histologic and immunophenotypic analysis

Objective: To observe the spectrum of non-Hodkin’s lymphomas involving the central nervous system including morphological subtypes and immunophenotypic status. Setting: Retrospective analysis of eleven years (1986 to 1996) data from surgical pathology files of Department of Pathology. Results: orty-three cases of non-Hodgkin’s lymphomas were diagnosed during the period of eleven years (from 1986 to 1996), all of which were diffuse types. A total of 1177 Central Nervous CNS biopsies were examined, out of which 937 cases were diagnosed as CNS neoplasms, the remaining were non-neoplastic in nature. Among 937 CNS neoplasms, 43 cases (4.6%) were reported as non-Hodgkin’s lymphomas. As most of the cases were outside referrals, the primary or secondary nature of the lymphomatous process could not he assessed. Seventeen cases were intracranial, while 26 cases were spinal in location. Majority of the intracranial Eymphomas were hiopsied from the cereherum (12 cases). Male to female ratio was 1:2. The median age for intracranial lvmphomas was 50 years and for spinal lymphomas 29 years. There were 16 cases (37%) of diffuse large cell lymphomas; 7 cases (16%) of diffuse mixed small and large cell lymphomas; 3 cases (7%) of diffuse large cell immunoblastic lvmphomas; 2 cases (4.6%) of lymphoblastic lymphomas and diffuse small non-cleaved cell lymphomas and one case of small Iyrnphocytic lymphoma and diffuse small cleaved cell Ivmphoma. One case of T cell rich B cell lvmphoma was also diagnosed in the thoracic spine as primary extranodal lymphoma. Eight cases were unclassifiable and in 2 cases the features were suggestive of lymphoma. Immunophenotypic analysis was performed in 20 cases, however, in 2 cases the results were inconclusive. Fifteen cases (83%) showed immunoreactivity for B cell markers and 3 cases showed T cell phenotype out of which one case was lymphoblastic lymphoma. Conclusion: CNS lymphomas were uncommon tumors and comprised 4.6% of the total CNS neoplasms in our study. Moreover, these CNS lymphomas accounted for 2.2% of the total non-Hodgkin’s lvmphomas, including both nodal and extranodal. There was a higher incidence of location of these lymphomas within the spinal cord than brain. Most of the lymphomas were of intermediate or high grade (75%) according to the working phenotype in 84% 3f the lymphomas, in which it was formulation. lmmunophenotypical status revealed B-cell teste

Invasive retroperitoneal infection due to basidiobolus ranarum with response to potassium lodide: Case report and review of the literature

We report a case of invasive retroperitoneal zygomycotic infection caused by Basidiobolus ranarum in a healthy 8-year-old boy. The youngster responded dramatically to potassium iodide. The clinical and pathological features are reviewed to highlight the problems encountered in the management of this rare infection

On provision of resilient connectivity in cognitive unmanned aerial vehicles

Mobile ad-hoc network (MANET) can be established in the areas/scenarios where the infrastructure networks are either out of service or no more available. MANETs have a lot of applications in sensor networks. Generally, a MANET deploys mobile ground nodes to set up a network. However, there can be some severe scenarios such as flood, battlefield, rescue operations, etc. where these ground nodes cannot be deployed. In such cases, a network of unmanned aerial vehicles (UAVs) can be a more viable option. Normally, UAVs operates on IEEE L-Band, IEEE S-Band or ISM band. These bands are already overcrowded, therefore, UAVs will face the problem of the spectrum scarcity. To resolve this issue cognitive radio (CR) is a most promising technology. Hence, in this work, we focus on CR based UAVs. As CR is based on opportunistic spectrum access, therefore, it is quite possible that all UAVs do not have one single channel available to communicate with each other. They need to form clusters for their communication depending on the availability of the channel. However, channel availability is intermittent because of opportunistic spectrum access. This may result in reforming of the cluster again and again. To avoid this frequent re-clustering and to maintain connectivity among the UAVs, in this paper, we present a resilient clustering technique with a concept of introducing a backup channel for each cluster. Simulation results show the significance of the proposed technique

The lncRNA NRON modulates HIV-1 replication in a NFAT-dependent manner and is differentially regulated by early and late viral proteins

A majority of the human genome is transcribed into noncoding RNAs, of which the functions of long noncoding RNAs (lncRNAs) are poorly understood. Many host proteins and RNAs have been characterized for their roles in HIV/AIDS pathogenesis, but there is only one lncRNA, NEAT1, which is shown to affect the HIV-1 life cycle. We profiled 90 disease-related lncRNAs and found NRON (noncoding repressor of Nuclear Factor of Activated T cells [NFAT]) to be one of several lncRNAs whose expression was significantly altered following HIV-1 infection. The regulation of NRON expression during the HIV-1 life cycle was complex; its levels were reduced by the early viral accessory protein Nef and increased by the late protein Vpu. Consequently, Nef and Vpu also modulated activity of the transcription factor NFAT. The knockdown of NRON enhanced HIV-1 replication through increased activity of NFAT and the viral LTR. Using siRNA-mediated NFAT knockdown, we show the effects of NRON on HIV-1 replication to be mediated by NFAT, and the viral Nef and Vpu proteins to modulate NFAT activity through their effects on NRON. These findings add the lncRNA, NRON to the vast repertoire of host factors utilized by HIV for infection and persistence

On Generic submanifolds of a locally conformal Kahler manifold with parallel canonical structures

The study of CR-submanifolds of a Kähler manifold was initiated by Bejancu [1]. Since then many papers have appeared on CR-submanifolds of a Kähler manifold. Also, it has been studied that generic submanifolds of Kähler manifolds [2] are generalisations of holomorphic submanifolds, totally real submanifolds and CR-submanifolds of Kähler manifolds. On the other hand, many examples C2 of generic surfaces in which are not CR-submanifolds have been given by Chen [3] and this leads to the present paper where we obtain some necessary conditions for a generic submanifolds in a locally conformal Kähler manifold with four canonical strucrures, denoted by P, F, t and f, to have parallel P, F and t. We also prove that for a generic submanifold of a locally conformal Kähler manifold, F is parallel iff t is parallel