Snakebite and its socio-economic impact on the rural population of Tamil Nadu, India

BACKGROUND: Snakebite represents a significant health issue worldwide, affecting several million people each year with as many as 95,000 deaths. India is considered to be the country most affected, but much remains unknown about snakebite incidence in this country, its socio-economic impact and how snakebite management could be improved. METHODS/PRINCIPAL FINDINGS: We conducted a study within rural villages in Tamil Nadu, India, which combines a household survey (28,494 people) of snakebite incidence with a more detailed survey of victims in order to understand the health and socio-economic effects of the bite, the treatments obtained and their views about future improvements. Our survey suggests that snakebite incidence is higher than previously reported. 3.9% of those surveyed had suffered from snakebite and the number of deaths corresponds to 0.45% of the population. The socio-economic impact of this is very considerable in terms of the treatment costs and the long-term effects on the health and ability of survivors to work. To reduce this, the victims recommended improvements to the accessibility and affordability of antivenom treatment. CONCLUSIONS: Snakebite has a considerable and disproportionate impact on rural populations, particularly in South Asia. This study provides an incentive for researchers and the public to work together to reduce the incidence and improve the outcomes for snake bite victims and their families

Inference about the transition-point in NBUE-NWUE or NWUE-NBUE Models

e(t) \u3c e(0) for [see pdf for notation]. If the inequalities for e(t) are reversed on these time intervals, it is called NWUE-NBUE. Using a characterization of such distributions in terms of the scaled total-time-on-test transform (STTT), we first give tests of exponentiality versus NBUE-NWUE or NWUE-NBUE with to unknown. This extends the work of Klefsjo (1989), who devised tests assuming that [see pdf for notation] is known. Then, assuming that F is either NBUE-NWUE or NWUE-NBUE, we give point estimates and asymptotic confidence intervals for to and [see pdf for notation]. The point estimates are asymptotically normal. We rely heavily on the theory of the empirical STTT process discussed in Csorgo, Csorgo and Horvith (1986). Two examples of real-data applications are provided

Polyherbal Microemulgels as Potential Therapeutic Agents for Psoriasis: In Vivo and In Vitro Evaluation

ObjectiveThis research aimed to investigate the therapeutic potential of two polyherbal microemulsion gel formulations, ABC (encompassing Azadirachta indica, Berberis aristata, and Coleus forskohlii) and BCG (comprising Boswellia serrata, Curcuma longa, and Glycyrrhiza glabra), in mitigating inflammation and restoring skin integrity in a psoriasis-like murine model triggered by UV-B irradiation and imiquimod (IMQ) application.Methods:Psoriasis-like inflammation was experimentally induced in Balb/c mice using a topical application of 5% imiquimod cream for seven consecutive days and in Wistar rats through UV-B irradiation for ten days. A control group, treatment groups that received 25 mg/kg of ABC or 50 mg/kg of BCG, and a conventional treatment group that received Clobetasol propionate were among the seven groups into which the animals were divided. Disease severity was evaluated using the Psoriasis Area Severity Index (PASI). Biochemical analyses measured pro-inflammatory cytokines such as TNF-α, IFN-γ, and VEGF, while histopathological studies examined epidermal structure and inflammatory cell infiltration, substantiating the anti-psoriatic efficacy of the formulations.Results:In vitro analyses demonstrated that both formulations exhibited stability and significant anti-inflammatory effects, with marked inhibition of pro-inflammatory cytokines (TNF-α, VEGF). In vivo, treatment with ABC and BCG substantially reduced PASI scores, with BCG at 50 mg/kg showing the most significant improvement, comparable to the positive control. Histological analysis confirmed reductions in epidermal thickening and inflammatory cell infiltration in treated groups. Conclusion:The polyherbal Microemulgel formulations ABC and BCG effectively reduced inflammation, cytokine levels, and epidermal thickening, demonstrating significant anti-psoriatic effects. These findings highlight the potential of these formulations as safe and effective alternatives for psoriasis treatment, warranting further investigation into their molecular mechanisms and clinical application

Financial Structure and Economic Welfare: Applied General Equilibrium Development Economics

This review provides a common framework for researchers thinking about the next generation of micro-founded macro models of growth, inequality, and financial deepening, as well as direction for policy makers targeting microfinance programs to alleviate poverty. Topics include treatment of financial structure general equilibrium models: testing for as-if-complete markets or other financial underpinnings; examining dual-sector models with both a perfectly intermediated sector and a sector in financial autarky, as well as a second generation of these models that embeds information problems and other obstacles to trade; designing surveys to capture measures of income, investment/savings, and flow of funds; and aggregating individuals and households to the level of network, village, or national economy. The review concludes with new directions that overcome conceptual and computational limitations.National Science Foundation (U.S.)National Institutes of Health (U.S.)Templeton FoundationBill & Melinda Gates Foundatio

Variability of systemic and oro-dental phenotype in two families with non-lethal Raine syndrome with FAM20C mutations

Background: Raine syndrome (RS) is a rare autosomal recessive bone dysplasia typified by osteosclerosis and dysmorphic facies due to FAM20C mutations. Initially reported as lethal in infancy, survival is possible into adulthood. We describe the molecular analysis and clinical phenotypes of five individuals from two consanguineous Brazilian families with attenuated Raine Syndrome with previously unreported features. Methods: The medical and dental clinical records were reviewed. Extracted deciduous and permanent teeth as well as oral soft tissues were analysed. Whole exome sequencing was undertaken and FAM20C cDNA sequenced in family 1. Results: Family 1 included 3 siblings with hypoplastic Amelogenesis Imperfecta (AI) (inherited abnormal dental enamel formation). Mild facial dysmorphism was noted in the absence of other obvious skeletal or growth abnormalities. A mild hypophosphataemia and soft tissue ectopic mineralization were present. A homozygous FAM20C donor splice site mutation (c.784 + 5 g > c) was identified which led to abnormal cDNA sequence. Family 2 included 2 siblings with hypoplastic AI and tooth dentine abnormalities as part of a more obvious syndrome with facial dysmorphism. There was hypophosphataemia, soft tissue ectopic mineralization, but no osteosclerosis. A homozygous missense mutation in FAM20C (c.1487C > T; p.P496L) was identified. Conclusions: The clinical phenotype of non-lethal Raine Syndrome is more variable, including between affected siblings, than previously described and an adverse impact on bone growth and health may not be a prominent feature. By contrast, a profound failure of dental enamel formation leading to a distinctive hypoplastic AI in all teeth should alert clinicians to the possibility of FAM20C mutations

Testing Exponentiality Against IDMRL Distributions with Unknown Change Point

Guess, Hollander and Proschan (1986) proposed tests for exponentiality versus IDMRL (increasing initially and then decreasing mean residual life) distributions when the change point, or corresponding quantile, is known. In this paper we propose two tests which do not require such knowledge of the change point. The tests are based on estimates of functionals of the cdf which discriminate between the exponential and IDMRL families

Robotic excision of a difficult retrorectal cyst â a video vignette

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153653/1/codi14862_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153653/2/codi14862.pd

Malaria Diagnosis and Hospitalization Trends, Brazil

Malaria Diagnosis and Hospitalization Trends, Brazi

Traumatic brain injury in young children with isolated scalp haematoma

Objective Despite high-quality paediatric head trauma clinical prediction rules, the management of otherwise asymptomatic young children with scalp haematomas (SH) can be difficult. We determined the risk of intracranial injury when SH is the only predictor variable using definitions from the Pediatric Emergency Care Applied Research Network (PECARN) and Children’s Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE) head trauma rules.Design Planned secondary analysis of a multicentre prospective observational study.Setting Ten emergency departments in Australia and New Zealand.Patients Children 5 cm haematoma in any region of the head) rule-based definition of isolated SH in both childre