Family Planning Market in India

This literature review captures existing knowledge across a range of products and players in India's family planning market. The product scope covers condoms, oral contraceptive pills, injectable contraceptives, intra-uterine devices, and male and female sterilization.The broad reach of this analysis brings diverse perspectives together to provide a complete picture of the current state of the market. The review can be particularly useful for field practitioners, donors, and other players looking to understand the current state of discovery in the India family planning market

Reducing Youth Unemployment in South Africa

South Africa is faced with a crisis of high and rising youth unemployment. Throughout the country, only 1 in 3 young people of working age is employed. This distressing statistic not only plays out through the limited earnings potential and future prospects of these youth, but also emerges within stymied business growth and unsustainable pressure on governmental social programs. The solution will take action from a variety of sectors and actors in order to turn the tide.This report, funded by The Rockefeller Foundation, highlights two cross-sectoral partnerships—the EOH Youth Job Creation Initiative and the Mentec Foundation—that have seen success in placing these disadvantaged youth in jobs throughout South Africa. The report concludes with a table of recommendations for employers, training providers, philanthropic funders, and government officials to begin growing and replicating these efforts.Top TakeawaysThroughout their lives, youth within South Africa are put at an employment disadvantage due to inadequate education and recruiting systems. Despite an estimated 500,000 entry-level vacancies throughout the country, young people often lack the necessary problem-solving skills, business acumen, technological savvy, and communication skills needed for the workplace, and structures that would enable this on-the-job learning (training, mentoring, and coaching) are not standard practice for most workplaces.In order to place more youth in jobs, sectors can bring their unique skills to bear while complementing one another's efforts: government incentives can encourage employers to take calculated risks and reform HR practices; training providers can focus more on skills, including job-readiness skills, that are directly demanded by employers and work with these employers for placement; and funders can strategically deploy grants to such programs and collaboratives.Youth who participate in demand-driven training programs and are then hired into jobs become valuable staff in short order: the youth were more motivated to perform well and assimilated quickly to the work environment

Effectiveness of Jabalpur Score in Predicting Mortality and Morbidity in Patients with Peritonitis caused by Peptic Ulcer Perforation

BACKGROUND: Many prognostic systems have been developed to stratify perforative peritonitis patients. Many are complex and cannot be used in developing countries as the prognostic system depends on sophisticated investigations. So, a simpler scoring system is developed to stratify those patients. AIM OF THE STUDY: To find the efficacy of the Jabalpur scoring system in predicting the mortality and morbidity in patients with peritonitis due to peptic ulcer perforation. OBJECTIVES: 1. Analysis of physical parameters and blood workup as early as possible to every patient diagnosed with perforative peritonitis. 2. Incorporation of Jabalpur scoring system in identifying the high risk group of patients in those diagnosed with perforative peritonitis. 3. Watchful monitoring of those patients with high score to anticipate early complications and for the application of early treatment. 4. Finding out the efficacy of this scoring system and its accuracy in predicting the mortality and morbidity. PATIENTS AND METHOD: Our study included 50 patients who presented with features of peritonitis due to peptic ulcer perforation and underwent emergency laparotomy for the same in Coimbatore Medical College Hospital. RESULTS: Mortality and morbidity steadily increases with increase in the Jabalpur score. All the parameters in Jabalpur score are individually significant in predicting the outcome. For a score of 9, sensitivity is 87.5%, specificity is 83.3%, positive predictive value is 50% and negative predictive is 97.2%. CONCLUSION: Jabalpur score is a simple and effective scoring system to predict the mortality and morbidity in peptic ulcer perforation patients

MULTI-PURPOSE EMBEDDED VOICE ASSISTANCE GADGET

One of the important problems that our society faces is that people with disabilities are finding it hard to cope up with the fast growing technology. In the recent years, there has been a rapid increase in the number of hearing impaired and speech disabled victims due to birth defects, oral diseases and accidents. When a deaf-dumb person speaks to a normal person, the normal person seldom understands and asks the deaf-dumb person to show gestures for his/her needs. Dumb persons have their own language to communicate to us; the only thing is that we need to understand their language. So, we need a translator to understand what they speak and communicate to us. In order to achieve this, we have proposed a system that can provide basic communication needs for a deaf-dumb person and also aid him in many ways. In the proposed system, we have used a speech recognition unit along with audio pre recorder and embedded controllers which will be helpful for deaf and dumb persons to express their needs to normal person. The frequently spoken words are stored in audio pre recorder which can be easily retrieved and also displayed using Liquid Crystal Display. The proposed device is also helpful for born deaf children to learn the basics of any language. In addition, voice based home automation system is also proposed for elderly and disabled people. Home automation system is achieved by wireless RF transmission and reception techniques integrated with our Embedded Voice Translator Kit. The proposed system along with text to speech converter and language translators as future enhancements will provide great assistance to deaf and dumb persons to portray their needs to society. Our system can also be incorporated for various applications like personal security, wireless TV remote control etc

A model-based rear-end collision avoidance algorithm for heavy commercial road vehicles

Abstract A rear-end collision is one of the most frequent accidents occurring on roadways. In this paper, a model-based longitudinal collision avoidance algorithm is developed for heavy commercial road vehicles to avoid rear-end collisions. This paper focuses on the inclusion of the dynamics of the pneumatic brake system in the collision avoidance algorithm. The developed algorithm also considers the dynamic behaviour of the heavy vehicle during braking such as the dynamic load transfer, the dynamic brake force distribution between the wheels and the maximum traction available at the tyre-road interface. The pressure transients in the brake chamber are modelled as a linear first-order dynamic system with a time delay. Commercially available vehicle dynamic simulation software, TruckSim, is used for simulating the developed control algorithm for realistic traffic scenarios with different loading and road conditions. The results obtained from the simulations are compared with the experimental results obtained from a hardware-in-the-loop system and the simulation results are found to be promising

Can isolated tibia intramedullary interlocking nailing in fracture distal 1/3rd both bone leg prevent fracture malalignment: will concurrent fibula fixation help?

Background: Different stand point prevails till date concerning fibular osteosynthesis in distal third both bone fracture fixation. This study was done to assess the post op alignment of distal third both bones fracture without fixing Fibula.Methods: A total of 30 patients who had distal 1/3rd extra articular tibia and fibula fractures were included in the study from July 2016 to April 2019. Tibial nailing was done in all cases with care is taken particularly to prevent malalingment of distal fragment. Radiological malalignment were assessed post operatively.Results: Of 30 patients, 5 patients had excellent results and 21 patients had good results, only 4 patients had fair results with valgus and varus malalignment, however these patients did not have any clinical problems associated with these malalignment at one year follow up. No patients had poor results. Valgus tibial malalignment is observed more frequently when fibular fracture is at proximal level.Conclusions: The level of Fibular fracture is important to determine when the fixation of this bone is indicated. Fixing ipsilateral tibial fracture with intramedullary interlocking (IMIL) nailing without fibular synthesis produce no gross change in alignment provided adequate care is taken for intra operative centering of the nail in both AP and lateral views

Immune reconstitution inflammatory syndrome in association with HIV/AIDS and tuberculosis: Views over hidden possibilities

Gut immune components are severely compromised among persons with AIDS, which allows increased translocation of bacterial lipopolysaccharides (LPS) into the systemic circulation. These microbial LPS are reportedly increased in chronically HIV-infected individuals and findings have correlated convincingly with measures of immune activation. Immune reconstitution inflammatory syndrome (IRIS) is an adverse consequence of the restoration of pathogen-specific immune responses in a subset of HIV-infected subjects with underlying latent infections during the initial months of highly active antiretroviral treatment (HAART). Whether IRIS is the result of a response to a high antigen burden, an excessive response by the recovering immune system, exacerbated production of pro-inflammatory cytokines or a lack of immune regulation due to inability to produce regulatory cytokines remains to be determined. We theorize that those who develop IRIS have a high burden of proinflammatory cytokines produced also in response to systemic bacterial LPS that nonspecifically act on latent mycobacterial antigens. We also hypothesize that subjects that do not develop IRIS could have developed either tolerance (anergy) to persistent LPS/tubercle antigens or could have normal FOXP3+ gene and that those with defective FOXP3+ gene or those with enormous plasma LPS could be vulnerable to IRIS. The measure of microbial LPS, anti-LPS antibodies and nonspecific plasma cytokines in subjects on HAART shall predict the role of these components in IRIS

A study on serum potassium and serum magnesium levels in acute myocardial infarction with special emphasis on rhythm disturbance

Background and objectives. Myocardial infarction (MI) is a severe cardiac event associated with plaque formation in arteries, leading to reduced blood flow to the heart. Arrhythmias, such as bradyarrhythmia or tachyarrhythmia, commonly accompany MI, contributing to its morbidity and mortality. Electrolyte disturbances, particularly potassium and magnesium imbalances, can exacerbate arrhythmic risks in MI patients. This study aimed to assess the incidence of alterations in serum potassium and magnesium levels during acute MI and their correlation with rhythm disturbances. Material and methods. A prospective analytical study was conducted with 150 patients diagnosed with acute MI based on ECG changes and elevated cardiac markers. Serum potassium and magnesium levels were measured, and rhythm disturbances were assessed using continuous cardiac monitoring and standard ECG. Spearman correlation analysis was performed to evaluate the association between serum potassium, serum magnesium, and rhythm changes. Results. The study investigated then demographic and clinical characteristics of participants and the potential relationship between serum electrolyte levels and arrhythmic changes. The mean age of the participants was 54.3 years, with a male predominance (76% male, 24% female). Among the participants, 50.67% had diabetes, 52% had hypertension, and 28% had both conditions. Serum electrolyte analysis showed elevated magnesium levels in 6.66% and elevated potassium levels in 12.66% of patients. Notably, arrhythmic changes in ECG were present in 62% of patients, with sinus tachycardia being the most prevalent (17%). However, statistical analysis revealed no significant correlation between serum magnesium, serum potassium, and rhythm changes (p >0.05). These findings suggest that while arrhythmic changes are common, they are not directly associated with elevated levels of these electrolytes, indicating the need for further investigation into other potential factors influencing arrhythmias in this population. Conclusion. Despite the prevalence of electrolyte disturbances in acute MI patients, this study found no significant association between serum magnesium, serum potassium levels, and rhythm disturbances. Further research is warranted to elucidate the complex interplay between electrolyte imbalances and arrhythmias in MI

Does CD4+CD25+foxp3+ cell (Treg) and IL-10 profile determine susceptibility to immune reconstitution inflammatory syndrome (IRIS) in HIV disease?

HIV-specific T-lymphocyte responses that underlie IRIS are incomplete and largely remain hypothetical. Of the several mechanisms presented by the host to control host immunological damage, Treg cells are believed to play a critical role. Using the available experimental evidence, it is proposed that enormous synthesis of conventional FoxP3- Th cells (responsive) often renders subjects inherently vulnerable to IRIS, whereas that of natural FoxP3+ Treg cell synthesis predominate among subjects that may not progress to IRIS. We also propose that IRIS non-developers generate precursor T-cells with a high avidity to generate CD4+CD25+FoxP3+ Tregs whereas IRIS developers generate T-cells of intermediate avidity yielding Th0 cells and effector T-cells to mediate the generation of proinflammatory cytokines in response to cell-signaling factors (IL-2, IL-6 etc.). Researchers have shown that IL-10 Tregs (along with TGF-β, a known anti-inflammatory cytokine) limit immune responses against microbial antigens in addition to effectively controlling HIV replication, the prime objective of HAART. Although certain technical limitations are described herein, we advocate measures to test the role of Tregs in IRIS

<i>In Vitro</i> Activity of Two Cefepime-Based Novel Combinations, Cefepime/Taniborbactam and Cefepime/Zidebactam, against Carbapenemase-Expressing <i>Enterobacterales </i>Collected in India

In recent times, discovery efforts for novel antibiotics have mostly targeted carbapenemase-producing Gram-negative organisms. Two different combination approaches are pertinent: b-lactam-b-lactamase inhibitor (BL/BLI) or b-lactam-b-lactam enhancer (BL/ BLE). Cefepime combined with a BLI, taniborbactam, or with a BLE, zidebactam, has been shown to be promising. In this study, we determined the in vitro activity of both these agents along with comparators against multicentric carbapenemase-producing Enterobacterales (CPE). Nonduplicate CPE isolates of Escherichia coli (n = 270) and Klebsiella pneumoniae (n = 300), collected from nine different tertiary-care hospitals across India during 2019 to 2021, were included in the study. Carbapenemases in these isolates were detected by PCR. E. coli isolates were also screened for the presence of the 4-Amino-Acid insert in penicillin binding protein 3 (PBP3). MICs were determined by reference broth microdilution. Higher MICs of cefepime/taniborbactam (.8 mg/L) were linked to NDM, both in K. pneumoniae and in E. coli. In particular, such higher MICs were observed in 88 to 90% of E. coli isolates producing NDM and OXA-48-like or NDM alone. On the other hand, OXA-48-like-producing E. coli or K. pneumoniae isolates were nearly 100% susceptible to cefepime/taniborbactam. Regardless of the carbapenemase types and the pathogens, cefepime/ zidebactam showed potent activity (.99% inhibited at#8mg/L). It seems that the 4-amino-Acid insert in PBP3 (present universally in the study E. coli isolates) along with NDM adversely impact the activity of cefepime/taniborbactam. Thus, the limitations of the BL/BLI approach in tackling the complex interplay of enzymatic and nonenzymatic resistance mechanisms were better revealed in whole-cell studies where the activity observed was a net effect of b-lactamase inhibition, cellular uptake, and target affinity of the combination. IMPORTANCE The study revealed the differential ability of cefepime/taniborbactam and cefepime/zidebactam in tackling carbapenemase-producing Indian clinical isolates that also harbored additional mechanisms of resistance. NDM-expressing E. coli with 4-Amino-Acid insert in PBP3 are predominately resistant to cefepime/taniborbactam, while the b-lactam enhancer mechanism-based cefepime/zidebactam showed consistent activity against single-or dual-carbapenemase-producing isolates including E. coli with PBP3 inserts.</p