Public Health Surveillance of Construction Site Injuries in Delhi, India Using the First Information Reports (FIRs) Registered by Delhi Police

Background: An injury surveillance system can inform strategies to reduce the incidence of injuries. Aim: To explore whether the First Information Reports (FIRs) of Indian police can form the basis of an unintentional injuries surveillance system. Methods: Initially, a systematic review of literature on “The use of police records for injury surveillance” was undertaken. Three different but related studies were then conducted. The Minimum Data Set (MDS) recommended for injury surveillance was identified in the first study; a tool for the extraction of data from FIRs was also developed, and its inter-rater reliability was assessed using Cohen’s Kappa; the percentage availability of each MDS data item in the FIRs was calculated. The total numbers of fatal and nonfatal construction site injuries in the Delhi population in 2017 were estimated by applying the two-sample capture-recapture method in the second study. The third study describes the epidemiology of construction site injuries in Delhi between 2016 and 2018. Results: The systematic review of literature showed that police records are a potentially useful source of information on unintentional injuries. The first study identified 12 MDS data items for injury surveillance; FIRs were found to contain complete information on 5 MDS data items but for 7 MDS data items, information was less complete. The second study estimated that FIRs ascertained 37%, 42.6% and 30.2% of the estimated total, fatal and non-fatal construction site injuries respectively. The third study found that 1,227 construction workers sustained injuries in 939 construction site incidents. Male workers (87%) and workers in the age group of 22 to 44 years (58.77%) accounted for most of those injured. The risk of a fatal injury was higher in migrant workers. The nonfatal injury rate per 100,000 workers per year was almost 3 times higher in female workers (98.55; 95% CI 82.52 to 116.8) than in male workers (34.36; 95%CI 31.92 to 36.94). Workers were at higher risk of injury in the rainy season and during 12:00 to 16:00 hours. Electricians and plumbers were the trade groups at higher risk of injury. Construction sites of government companies, and construction through a construction company, and works related to water supply, road construction, and power generation/distribution works were associated with higher odds of fatal injuries. The head (including face and eyes) was most prone to injury. Conclusion: Information on injuries can be reliably extracted from FIRs, however FIRs occasionally have incomplete information on some of the MDS data items. Furthermore, any epidemiological estimates made using these data must be adjusted to allow for the approximately two-thirds of injuries not reported to the police. Enforcement of existing legal provisions and the training of police personnel could help to reduce the ‘missingness’ of MDS data items and help to improve the ascertainment of injuries by FIRs. Imputation of missing data may help to improve the system further

Utility Of Salivary CA-125 And LDH As Tumor Markers In Oral Malignancy

Background: The mortality and morbidity associated with oral squamous cell carcinoma(OSCC)  can be greatly reduced if tumor markers which can detect OSCC at an early stage are available. This study attempts to use saliva as the diagnostic medium to determine the correlation of salivary CA 125 and LDH in tobacco users with and without potentially malignant disorders. Changes in CA 125 and  LDH level can be used as a marker in patients with and without premalignant disease and can be used as a deterrent in continuation of the habit. Aims: To assess the role of CA 125 & LDH as a tumour marker in Oral cancer patients. Materials and methods: Cross sectional observational study .Time period: December 2015 to August 2017. Study area: OPD of tertiary care hospital in pune. Total participants: 150 persons. Under non-stimulatory conditions whole saliva sample was collected from each individual  and was centrifuged. The resulting supernatant was used for estimation of CA 125 and LDH levels. Results: In present study, mean Salivary LDH level was found to be  lowest among cases of healthy individuals  while it was highest among individuals who were diagnosed and  underwent treatment for malignancy. However there was insignificant difference seen between levels of diagnosed case of oral malignancy and the ones who underwent treatment for oral malignancy. Also mean Salivary CA-125 was lowest in healthy individuals and highest in individuals diagnosed with oral malignancy and the levels were seen to be reduced significantly in the one who underwent treatment for oral malignancies than those who didn't. Conclusion: Salivary CA 125 and LDH has a role in early detection of oral malignancies  and  can be used as a diagnostic marker. However LDH levels are persistently raised even after treatment for oral malignancy

Utility Of Salivary CA-125 And LDH As Tumor Markers In Oral Malignancy

Background: The mortality and morbidity associated with oral squamous cell carcinoma(OSCC)  can be greatly reduced if tumor markers which can detect OSCC at an early stage are available. This study attempts to use saliva as the diagnostic medium to determine the correlation of salivary CA 125 and LDH in tobacco users with and without potentially malignant disorders. Changes in CA 125 and  LDH level can be used as a marker in patients with and without premalignant disease and can be used as a deterrent in continuation of the habit. Aims: To assess the role of CA 125 & LDH as a tumour marker in Oral cancer patients. Materials and methods: Cross sectional observational study .Time period: December 2015 to August 2017. Study area: OPD of tertiary care hospital in pune. Total participants: 150 persons. Under non-stimulatory conditions whole saliva sample was collected from each individual  and was centrifuged. The resulting supernatant was used for estimation of CA 125 and LDH levels. Results: In present study, mean Salivary LDH level was found to be  lowest among cases of healthy individuals  while it was highest among individuals who were diagnosed and  underwent treatment for malignancy. However there was insignificant difference seen between levels of diagnosed case of oral malignancy and the ones who underwent treatment for oral malignancy. Also mean Salivary CA-125 was lowest in healthy individuals and highest in individuals diagnosed with oral malignancy and the levels were seen to be reduced significantly in the one who underwent treatment for oral malignancies than those who didn\u27t. Conclusion: Salivary CA 125 and LDH has a role in early detection of oral malignancies  and  can be used as a diagnostic marker. However LDH levels are persistently raised even after treatment for oral malignancy

Risk Factors for Frequent Readmissions and Barriers to Transplantation in Patients with Cirrhosis

Background: Hospital readmission rate is receiving increasing regulatory scrutiny. Patients with cirrhosis have high hospital readmissions rates but the relationship between frequent readmissions and barriers to transplantation remains unexplored. The goal of this study was to determine risk factors for frequent readmissions among patients with cirrhosis and identify barriers to transplantation in this population. Methods: We retrospectively reviewed medical records of 587 patients with a confirmed diagnosis of cirrhosis admitted to a large tertiary care center between May 1, 2008 and May 1, 2009. Demographics, clinical factors, and outcomes were recorded. Multivariate logistic regression was performed to identify risk factors for high readmission rates. Transplant-related factors were assessed for patients in the high readmission group. Results: The 587 patients included in the study had 1557 admissions during the study period. A subset of 87 (15%) patients with 5 or more admissions accounted for 672 (43%) admissions. The factors associated with frequent admissions were non-white race (OR = 2.45, p = 0.01), diabetes (OR = 2.04, p = 0.01), higher Model for End-Stage Liver Disease (MELD) score (OR = 35.10, p30) and younger age (OR = 0.98, p = 0.02). Among the 87 patients with ≥5 admissions, only 14 (16%) underwent liver transplantation during the study period. Substance abuse, medical co-morbidities, and low (<15) MELD scores were barriers to transplantation in this group. Conclusions: A small group of patients with cirrhosis account for a disproportionately high number of hospital admissions. Interventions targeting this high-risk group may decrease frequent hospital readmissions and increase access to transplantation. © 2013 Ganesh et al

Effect of potassium application on yield and quality of green gram (Vigna radiata L.) on coarse textured soils of southern Haryana

59-63Crops need large quantity of potassium for enhancing their yield as well as quality. Pulses are important crops grown in India but their productivity is low. Among production inputs, recommendations for N and P fertilizers are made in most states with no K application resulting in imbalanced nutrient supply and lower crop yields.To quantify optimum dose for green gram ( Vigna radiata L.), a series of field experiments were conducted at Regional Research Station, CCS HAU, Bawal, Haryana, to assess the response of green gram to fertilizer potassium on coarse textured (Typic Haplustepts) soils of southern Haryana. After completion of research trials, crop was tested on farmer’s field through demonstrations and on farm trials (OFTs) to evaluate the response and adoptability of green gram as per the fertilizer potassium doses concluded in research experiment. Five levels of fertilizer potassium (0, 10, 20, 30 and 40 kg K2O ha-1) were evaluated for the response of green gram in randomized block design replicated thrice. The results of research trials revealed that the yield, protein content and growth parameters of green gram increased significantly with the application of fertilizer potassium @20 kg K2O ha-1. Significantly higher yield of green gram was recorded (5.87, 16.29, 19.23 and 22.36 %) due to application of 10, 20, 30 and 40 kg K2O ha-1, respectively over control. The total K uptake by green gram increased significantly with the incremental doses of potassium application which helped to prevent the depletion of available soil K and build-up its content in the soil. The mean K use efficiency varied from 38.30 to 54.15 and maximum (54.15 %) was recorded with the application of 20 kg K2O ha-1. The benefit cost ratio was also increased with the application of potassium and reflected in terms of additional returns per rupee (Rs. 10.94, 15.63, 12.17 and 10.72) invested on application of K @ 10, 20, 30 and 40 kg K2O ha-1, respectively. The farmer’s field trial results with 0 and 20 kg K2O ha-1 revealed that application of 20 kg K2O ha-1 increased the yield of green gram by 10.87% over control

Anti-Hyperglycemic And Anti-Hyperlipidemic Potential Of A Polyherbal Preparation “Diabegon” In Metabolic Syndrome Subject With Type 2 Diabetes

Background: In the present study, “Diabegon” a poly-herbal preparation, with hypoglycemic activity, was evaluated for its preventive effect inmetabolic syndrome subjects with type 2 diabetes and also to reveal its side effects, on liver and kidney.Materials and Methods: Type 2 diabetic subjects with metabolic syndrome (N=58) were categorized on the basis of age and fasting blood glucose.The grouping was as follows: Group I (35-50 yrs), Group II (51-65 yrs), Group III &gt;65 yrs, Group IV FBS&lt;145.9, Group V FBS&gt;145. Each group wasadministered 4 gm of diabegon daily. Blood glucose levels, lipid profile, liver and kidney function of the subjects were regularly monitored within 3months of interval to 18 months.Results: The reduction in fasting blood glucose level ranged from 12.3% (P&lt;0.05) to 42% (P&lt;0.001) after 18 month of therapy whereas in postprandial blood glucose, the decrease ranged from 28% (P&lt;0.05) to 32% (P&lt;0.05) after 18 month of therapy. Overall reductions in the individual parameters of the metabolic syndrome subjects were significantly higher in Group I. Cholesterol level decreased from 11% to 27.2% (P&lt;0.001), triglyceride levels decreased from 24% to 55%, VLDL and LDL levels reduced by 60% &amp; 54% respectively after 18 months of therapy. The HDL-C level increased in all groups. Moreover, diabegon administration for 1.5 years exhibited no alteration in liver and kidney function tests, which indicate its non-toxicity.Conclusion: Our study suggests that diabegon could be included as a preventive treatment in metabolic syndrome subjects with type 2 diabetesespecially for long term treatment as it efficiently shows anti-hyperglycemic and anti-lipidemic effects with no adverse impacts on the liver and kidney.Key words: Metabolic syndrome, Type 2 diabetes, Diabegon, Polyherbal preparation

Do Participatory Learning and Action Women’s Groups Alone or Combined with Cash or Food Transfers Expand Women’s Agency in Rural Nepal?

Participatory learning and action women’s groups (PLA) have proven effective in reducing neonatal mortality in rural, high-mortality settings, but their impacts on women’s agency in the household remain unknown. Cash transfer programmes have also long targeted female beneficiaries in the belief that this empowers women. Drawing on data from 1309 pregnant women in a four-arm cluster-randomised controlled trial in Nepal, we found little evidence for an impact of PLA alone or combined with unconditional food or cash transfers on women’s agency in the household. Caution is advised before assuming PLA women’s groups alone or with resource transfers necessarily empower women

Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

\ua9 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.Background: Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. Objective: This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. Methods: This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1-month follow-up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Results: Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p &lt; 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p &lt; 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre-admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p &lt; 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p = 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre-admission pain duration, acute necrotic collections, and walled-off necrosis also increased the likelihood of opioid prescription at discharge. Conclusion: There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP