Issues before the thirteenth finance commission.

The Thirteenth Finance Commission faces challenging times. Despite improvement, the fiscal situation continues to be a matter of concern when off budget liabilities and other fiscal risks are considered. In the changing situation of increasing oil prices on the one hand and surge in capital flows on the other, calibrating the transfer system in tune with counter-cyclical fiscal policy stance is a formidable challenge. The paper argues that irrespective of the wording of the Terms of Reference (ToR), the Commission would do well to focus on its primary task of recommending transfers to serve the objective of equity and incentives. While it is required to take into account a number of considerations, the focus should be on the transfer system. As an impartial body, the Commission should make a fair assessment of the union as well as state governments, ignoring the asymmetries in the wording of the ToR. As regards the transfer system itself is concerned, the paper argues that although it may be difficult to make drastic changes in the relative shares of the states, the Commission should give up the gap filling approach. Instead, after recommending the tax devolution, the Commission should recommend grants to fully equalise expenditures on elementary education and basic healthcare. It is also possible to incentivise the transfer system for even those states that have a better record of providing education and healthcare to improve quality of these services. If necessary, the tax devolution percentage can be appropriately adjusted to ensure equalisation of social services. The paper is a revised and edited version of one that was presented in the seminar on Issues before the Thirteenth Finance Commission held at the National Institute of Public Finance and Policy (NIPFP) on May 23-24, 2008.

Role of toll like receptors in bacterial and viral diseases – A systemic approach

Background: Toll like receptors are key-receptors of the innate immune system, but their role against bacterial and viral infections are yet to be understood.Aim: The present study is aimed to investigate the diversity and frequency distribution of 10 TLR genes among typhoid fever and HIV+ patients. In this study, 44 samples were taken from typhoid patients and 55 samples from HIV+ patients.Patients and methods: Widal test positive samples (>1:80) in case of typhoid and the percentage of CD4+ count in case of HIV+ patient were considered for the PCR-SSP analysis.Results: We found that the frequencies of TLR1 and TLR6 were highest in typhoid patients, whereas the frequencies of TLR8 and TLR9 displayed higher among HIV+ patients. Chi-square values were significant for TLR8 and TLR10 in the case of typhoid patients, whereas in HIV patients significant values were considered for TLR2, TLR4, TLR8 and TLR9 respectively. The odds ratio calculated highest for TLR1 and TLR6 among typhoid patients. TLR4 and TLR9 calculated were highest odd for HIV+ patients. A door line association of TLRs with the disease was found when the relative risk was calculated for TLR2 (1.72), TLR3 (1.21) and TLR10 (1.98) in bacterial infection, whereas in case of viral infection relative risk was calculated for TLR4 (1.62), TLR8 (1.18) and in TLR9 (1.16).Conclusion: This study reports the frequency distribution and association of human TLR genes with the bacterial and viral infection in the North Bengal region of India for the first time. It also signified the gene- disease- environment association study in case of infectious diseases and also the risk factors of bacterial and viral infections in this region. It also depicts the role of TLRs in the recognition of the pathogens

Limited Access to Iodized Salt among the Poor and Disadvantaged in North 24 Parganas District of West Bengal, India

Iodine deficiency is endemic in West Bengal as evident from earlier studies. This community-based, cross-sectional descriptive study was conducted in North 24 Parganas district during August-November 2005 to assess the consumption of adequately-iodized salt and to ascertain the various factors that influence access to iodized salt. In total, 506 households selected using the multi-stage cluster-sampling technique and all 79 retail shops from where the study households buy salt were surveyed. The iodine content of salt was tested by spot iodine-testing kits. Seventy-three percent of the households consumed salt with adequate iodine content (≥15 ppm). Consumption of adequately-iodized salt was lower among rural residents [prevalence ratio (PR): 0.8, 95% confidence interval (CI) 0.7-0.9], Muslims (PR: 0.8, 95% CI 0.7-0.9), and households with monthly per-capita income of ≤US$ 10 (PR: 0.7, 95% CI 0.6-0.8). Those who heard and were aware of the risk of iodine-deficiency disorders and of the benefit of iodized salt were more likely to use appropriate salt (PR: 1.2, 95% CI 1.1-1.3). Those who were aware of the ban on non-iodized salt were more likely to consume adequately-iodized salt (PR: 1.1, 95% CI 1.01-1.3). The iodine content was higher in salt sold in sealed packets (PR: 2.9, 95% CI 1.8-4.8) and stored on shelves (PR: 1.6, 95% CI 1.3-2.0). Seventy-two percent of the salt samples from the retail shops had the iodine content of ≥15 ppm. The findings indicate that elimination of iodine deficiency will require targeting the vulnerable and poor population

Loco-regionally advance breast cancer: evaluation of management of breast cancer with special reference to multimodal approach

Background: Breast cancer is one of the most common human neoplasms, accounting for approximately one-quarter of all cancers in females worldwide and 27% of cancers in developed countries with a western lifestyle. The aims of this study were to evaluate the management of loco-regionally advanced carcinoma of breast with special reference to multimodal approach.Methods: The study was conducted on patients with loco-regionally advanced carcinoma of breast, reporting for treatment in a large multi-specialty teaching institute. All patients of stage IIIB were initially treated with neo-adjuvant (induction) chemotherapy (3 cycles), except 4 patients in the study group offered surgery as initial treatment because of small tumor size with limited peu’d orange change in the skin. After this treatment all patients were reassessed with a thorough clinical examination and restaging work upto detect the response of the chemotherapy. All patients who achieved objective response (complete + partial) were offered surgery, followed by CT and RT.Results: About 60% of the patients were in stage IIIB and 32% in stage IIIA. Majority of the tumors were in T4 category (64%). In 28% cases ipsilateral fixed lymph nodes were found. Histopathological examination revealed 76% (38) patients with infiltrating duct carcinoma, 4 patients (8%) had comedo carcinoma, 2 patients (4%) had lobular carcinoma, 2 patients (4%) had medullary carcinoma and 4 patients (8%) had mucinous carcinoma. Both nonresponsive (NR) and disease progression (DP) patients were in stage III B group. About 76.9% patients of stage IIIB (20) achieved partial response. Only 1 patient (33.3%) developed local recurrence after 10 months of completion of treatment. Median disease free survival (DFS) period of this group is 30.2 months. Recurrence rate is stage IIIA patients was 27.7% and in stage IIIB 37.5%. Maximum numbers of disease free patients were found in T3N1 group (85.7%). Patient with N2 and T4 disease chances of recurrence was more than N1 and T3 lesions.Conclusions: Patients with LBAC who are able to complete treatment with chemotherapy, mastectomy, and postmastectomy radiation have a high probability of locoregional control. Neo-adjuvant chemotherapy can make inoperable locally advanced breast cancer operable and with the use of neo-adjuvant CT, breast conservation surgery is possible even in locally advanced breast cancer. Use of post-operative CT and RT can increase the disease free survival period. Use of multimodal treatment in the form of CT, surgery and radiotherapy can increase the disease free survival period in locally advanced breast cancer. The advent of successful multimodal regimens incorporating systemic treatment (chemotherapy or chemohormonal therapy) as well as local therapy (surgery and radiation) has significantly improved disease-free and overall survival as well as local-regional control. Longer follow-up of these conservatively treated patients will be needed, however, to determine whether local-regional control is preserved

Limited access to iodized salt among the poor and disadvantaged in north 24 parganas District of West Bengal, India

Iodine deficiency is endemic in West Bengal as evident from earlier studies. This community-based, cross-sectional descriptive study was conducted in North 24 Parganas district during August-November 2005 to assess the consumption of adequately-iodized salt and to ascertain the various factors that influence access to iodized salt. In total, 506 households selected using the multi-stage cluster-sampling technique and all 79 retail shops from where the study households buy salt were surveyed. The iodine content of salt was tested by spot iodine-testing kits. Seventy-three percent of the households consumed salt with adequate iodine content ( 6515 ppm). Consumption of adequately-iodized salt was lower among rural residents [prevalence ratio (PR): 0.8, 95% confidence interval (CI) 0.7-0.9], Muslims (PR: 0.8, 95% CI 0.7-0.9), and households with monthly per-capita income of 64US$ 10 (PR: 0.7, 95% CI 0.6-0.8). Those who heard and were aware of the risk of iodine-deficiency disorders and of the benefit of iodized salt were more likely to use appropriate salt (PR: 1.2, 95% CI 1.1-1.3). Those who were aware of the ban on non-iodized salt were more likely to consume adequately-iodized salt (PR: 1.1, 95% CI 1.01-1.3). The iodine content was higher in salt sold in sealed packets (PR: 2.9, 95% CI 1.8-4.8) and stored on shelves (PR: 1.6, 95% CI 1.3-2.0). Seventy-two percent of the salt samples from the retail shops had the iodine content of 6515 ppm. The findings indicate that elimination of iodine deficiency will require targeting the vulnerable and poor population

Outcome of Post-Operative Mastoid Cavity Obliteration with Autologous Adipose Tissue

Introduction Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of better functional results while canal wall down mastoidectomy offers excellent exposure for disease eradication and post operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages the concept of mastoid cavity obliteration was introduced. This study analysed the outcomes of mastoid cavity obliteration and to assess the outcomes of mastoid cavity obliteration with autologous adipose tissue. Materials and Methods A prospective, experimental, randomized study was conducted over a period of 18 months among patients presenting with active squamous variety of Chronic Otitis Media. The patients were randomly allocated to two groups, A and B. Both groups underwent canal wall down Mastoidectomy followed by obliteration with autologous adipose tissue in Group B . Results In group A, the mean duration required for complete epithelialization was 10.8 weeks. In group B, the average time taken for complete epithelialization was 5.6 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks. In group B, debris was found for a mean duration of 3.33 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 3.33 weeks. Conclusion Cavity problems encountered is considerably less in the group obliterated with adipose tissue

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio