Weaknesses of VAT in Nepal

Although VAT is a significant source of tax revenue in Nepal, the system displays a number of weaknesses. In this article, the authors discuss the most important shortcomings of the VAT system

Radiation Pattern of Open Ended Waveguide in Air Core Surrounded by Annular Plasma Column

174-177Radiation pattern of open ended waveguide excited in circular symmetric mode (TM1) in an air core having central conductor and surrounded by an annular plasma column is studied. The field distribution at the open end of the waveguide is considered to be equivalent to the vector sum of magnetic current rings of various radii, ranging from the outer radius of the inner conductor to the inner radius of the outer conductor of the waveguide at the open end. The radiation field is obtained as a vector sum of field components due to individual rings of current. Such a configuration gives rise to multiple narrow radiation beams away from the critical angle

Dielectric relaxation study of binary mixtures of ethyl alcohol and N, N-dimethylformamide in benzene solution from microwave absorption data

163-167Dielectric constant (Ɛ′) and dielectric loss (Ɛ″) of ethanol (C₂H₅OH) and binary mixtures of ethanol and N, N-dimethylformamide (DMF) in benzene solutions have been measured at microwave frequency 9.883 GHz at different temperatures 25, 30, 35 and 40ºC. Standing microwave techniques and Gopala Krishna’s [Trans Faraday Soc, 33 (1957)767.] single frequency concentration variation method have been used for above measurements. The measured values of Ɛ′ and Ɛ″ have been used to evaluate dipole moment (μ) and relaxation time (). Various thermodynamic parameters (ΔH ΔFand ΔS) for the dielectric relaxation process of binary mixtures containing 50% mole fraction of OH have been calculated using Eyring’s rate equations. Comparison has been made with the corresponding energy parameters for viscous flow process. It is found that the dielectric relaxation process can be treated as the rate process like the viscous flow process. Non-linear variation of relaxation time with molar concentration of ethanol in the whole concentration range of the binary mixture indicates the existence of solute-solute type of molecular association

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research