Inequality in Housing and Basic Amenities in India

The paper analyses inequality in housing conditions for India for two time period 2008-09 and 2012. Housing conditions are important determinants of health status. Access to descent housing and basic amenities is essential to improve health status of people. Given this backdrop, we examine the distribution of housing and basic amenities, namely, drinking water, toilets and electricity, across regions and over time. We also study the determinants of access to these basic amenities. The results show unequal distribution of housing conditions with rich households having higher access to better housing. Under the Millennium Development Goals, the Indian government has worked towards improving access to safe drinking water and sanitation. However, the results of multivariate analysis show that the economic and social background of household determine the access to basic services even in the year 2012

Inequality in Housing and Basic Amenities in India

The paper analyses inequality in housing conditions for India for two time period 2008-09 and 2012. Housing conditions are important determinants of health status. Access to descent housing and basic amenities is essential to improve health status of people. Given this backdrop, we examine the distribution of housing and basic amenities, namely, drinking water, toilets and electricity, across regions and over time. We also study the determinants of access to these basic amenities. The results show unequal distribution of housing conditions with rich households having higher access to better housing. Under the Millennium Development Goals, the Indian government has worked towards improving access to safe drinking water and sanitation. However, the results of multivariate analysis show that the economic and social background of household determine the access to basic services even in the year 2012

Abdominal Skin Rash After TACE Due to Non-Target Embolization of Hepatic Falciform Artery

Transcatheter arterial chemoembolization (TACE) is a well-recognized procedure for management of hepatocellular carcinoma. We present a 54-year-old man who presented with a periumbilical maculopapular skin rash that developed after an otherwise uneventful TACE procedure. A retrospective review of imaging was consistent with non-target embolization of the hepatic falciform artery (HFA). He was treated with oral non-steroidal antiinflammatory medication for 3 weeks with improvement, but had slight skin induration and an excoriated papule at 6-month follow-up. Non-target embolization of HFA is very rare, but clinicians and interventionalists should be aware of this complication, especially in patients predisposed to enlargement of HFA

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely