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Abstract World health statistics (2022) report that about 1.4 billion people have incurred catastrophic health expenditure (CHE), and half of its population have pushed into extreme poverty due to healthcare payments. The elderly population faces a higher risk of ill health, and seeking treatment reflects in high out-of-pocket health spending (OOPHS) that results in CHE and further impoverishment. This study aims to investigate the incidence and intensity of OOPHS, CHE, and impoverishment among the older adults in India. Data utilizes from the 75th round of the national sample survey (NSS) based on household social consumption: health (schedule 25.0), 2018. The incidence and intensity of CHE and impoverishment among older adults in India estimated by using standard measures. The older adults spend about 17.4% of household consumption expenditure on healthcare services. The poorest older adults are spending the highest share of consumption expenditure (24.8%) on healthcare among economic quantiles. Similarly, the elderly from rural (20.3%), male (18.4%), scheduled castes (21.5%), and Hinduism (17.9%) show a larger share of consumption expenditure on healthcare services. The incidence and intensity of CHE among older adults are 46.5% and 16.1% at 10% threshold level of household consumption expenditure, respectively. However, as the threshold level rises the incidence and intensity of CHE decline. The estimates of normalized poverty gap using the poverty line of Tendulkar committee as well as Rangarajan committee show that the intensity of impoverishment among older adults are 56.4% and 57.9% respectively, which is quite high. Financial protection along with vision might mitigate the risk of CHE and impoverishment among older adults in India.

The current paper focuses on the process of developing clean energy entrepreneurs to facilitate the abundant adoption of clean energy products in rural areas of South Odisha, India. Southern part of the state of Odisha, is characterized by its rich cultural and ecological diversity significance, and it faces the challenges of energy access which subsequently leads to slowing down the socio-economic development of the region. Background: The present study focuses on developing a framework on the role of clean energy entrepreneurs in adoption of clean energy technology or the clean energy products and also further it also focuses on design and development of a solar operated Agri-pesticide sprayer. Method: A case study method is used to, identify the major barriers to clean energy adoption in the rural regions of South Odisha and also explore the different entrepreneurial steps undertaken to overcome the challenges. Moreover, the paper also focuses on the collaborating efforts between the local entrepreneurs, government agencies, and various non-profit organizations so as to create a supportive ecosystem for achieving sustainable development. Results: The findings of the study aims to inform policy makers, Government, etc. that there is a need to collaborate in order to adopt clean energy products so that it will help in paving a way for achieving sustainable development.

In 2021, the Lancet Commission on adolescent nutrition highlighted the need to prioritise the elimination of adolescent malnutrition to tap the human capital potential and break the intergenerational malnutrition trap. The nutritional requirement during adolescence reaches its peak. The present study aims to appraise the prevalence of undernutrition (stunting and thinness) and anaemia among adolescents (10–19 years) in India and the role of socioeconomic, individual-level hygiene behaviour and dietary diversity in nutritional outcomes. We have used the nationally representative Comprehensive National Nutrition Survey (CNNS-2016–18) that covers children and adolescents (0–19 years) in India. The prevalence of stunting, anaemia and thinness among adolescents was 27⋅2, 28⋅5 and 24⋅1 %, respectively. Bivariate and multivariable logistic regression models were applied to estimate the likelihood of undernutrition. The likelihood of stunting was higher for late adolescence (OR 1⋅21, 95 % CI 1⋅15, 1⋅27), low dietary diversity (OR 1⋅37, 95 % CI 1⋅26, 1⋅49) and low hygiene behaviour compliance (OR 1⋅53, 95 % CI 1⋅42, 1⋅64). Adolescents from the poorest quintile were more likely to be stunted (OR 3⋅20, 95 % CI 2⋅94, 3⋅48), anaemic (OR 1⋅66, 95 % CI 1⋅47, 1⋅87) and thin (OR 1⋅68, 95 % CI 1⋅54, 1⋅82). We found that lower hygienic compliance was significantly associated with undernutrition and anaemia. Therefore, promoting hygienic practices should be emphasised to tackle undernutrition and anaemia. Furthermore, dietary diversity and poverty were strong predictors of stunting and thinness, therefore targeting the poor and focusing on improving dietary diversity should be the priority.

Purpose: To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster. Methods: A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated. Results: Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7–53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14–28), 7.84 (7.841–7.841), and 97.4 (91.6–98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure. Conclusion: In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.

Although current programmes to eliminate lymphatic filariasis have made significant progress it may be necessary to use different approaches to achieve the global goal, especially where compliance has been poor and 'hot spots' of continued infection exist. In the absence of alternative drugs, the use of higher or more frequent dosing with the existing drugs needs to be explored. We examined the effect of higher and/or more frequent dosing with albendazole with a fixed 300 mg dose of diethylcarbamazine in a Wuchereria bancrofti endemic area in Odisha, India. Following screening, 104 consenting adults were randomly assigned to treatment with the standard regimen annually for 24 months (S1), or annually with increased dose (800 mg albendazole)(H1) or with increased frequency (6 monthly) with either standard (S2) or increased (H2) dose. Pre-treatment microfilaria counts (GM) ranged from 348 to 459 mf/ml. Subjects were followed using microfilaria counts, OG4C3 antigen levels and ultrasound scanning for adult worm nests. Microfilarial counts tended to decrease more rapidly with higher or more frequent dosing at all time points. At 12 months, Mf clearance was marginally greater with the high dose regimens, while by 24 months, there was a trend to higher Mf clearance in the arm with increased frequency and 800 mg of albendazole (76.9%) compared to other arms, (S1:64%, S2:69.2% & H1:73.1%). Although higher and/or more frequent dosing showed a trend towards a greater decline in antigenemia and clearance of "nests", all regimens demonstrated the potential macrofilaricidal effect of the combination. The higher doses of albendazole did not result in a greater number or more severe side effects. The alternative regimens could be useful in the later stages of existing elimination programmes or achieving elimination more rapidly in areas where programmes have yet to start.

Purpose: To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster.Methods: A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated.Results: Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure.Conclusion: In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims. [ABSTRACT FROM AUTHOR]