The impact of demonetisation on the utilisation of hospital services, patient outcomes and finances: a multicentre observational study from India.

BACKGROUND: This study assessed trends in healthcare utilisation in relation to the implementation of an economic policy in India wherein 500 and 1000 rupee notes were demonetised. METHODS: In this ambidirectional observational study of private not-for-profit hospitals, data on hospital outpatient and inpatient numbers, surgeries, emergency department (ED) visits, obstetric admissions and mortality were obtained for pre-demonetisation (September/October 2016), early (November/December 2016) and late demonetisation (January/February 2017), and post-demonetisation periods (March/April 2017) and compared with the control period (2015-2016) from 11 centres (three tertiary hospitals; eight secondary). A Bayesian regression analysis was performed to adjust for seasonal (winter) effect. Monthly financial data, including the proportion of cash versus non-cash transactions, were collected. FINDINGS: Overall, at the pooled all-hospital level, Bayesian analysis showed non-significant increase in outpatients (535.4, 95% CI -7097 to 8116) and decrease in deaths (-6.3 per 1000 inpatients, 95% CI -15.45 to 2.75) and a significant decrease in inpatients (-145.6, 95% CI -286.4 to -10.63) during demonetisation. Analysis at the level of secondary and tertiary hospitals showed a variable effect. For individual hospitals, after adjusting for the seasonal effect, some hospitals observed a significant reduction in outpatient (n=2) and inpatient (n=3) numbers, ED visits (n=4) and mortality (n=2) during demonetisation, while others reported significantly increased outpatient numbers (n=3) and ED visits (n=2). Deliveries remained unchanged during demonetisation in the hospitals that provided the service. There was no significant reduction in hospital incomes during demonetisation. In tertiary hospitals, there was a significant increase in non-cash component of transactions from 35% to 60% (p=0.02) that persisted beyond the demonetisation period. CONCLUSIONS: The effect of demonetisation on healthcare utilisation was variable. Some hospitals witnessed a significant reduction in utilisation in some areas, while others reported increased utilisation. There was an increase in non-cash transactions that persisted beyond the period of demonetisation.

A review of chromite mining in Sukinda Valley of India: impact and potential remediation measures.

Sukinda Valley, one of the highly polluted areas of the world is generating tons of mining waste and causing serious health and environmental issues in its surroundings. Several reports are available reporting the severity of hexavalent chromium, yet little efforts have been made to address the pollution and its remediation due to a lack of proper remedial measures. The review highlights the pros and cons of various physical, chemical and biological techniques used worldwide for the treatment of chromium waste and also suggests better and reliable bioremediation measures. Microbes such as Acidophilium and Acidithiobacillus caldus (Bioleaching), Pseudomonas, Micrococcus and Bacillus (Bioreduction), Aereobacterium and Saccharomyces (Biosorption), are widely used for bioremediation of hexavalent chromium owing to their unique metabolic activities, ionic movement through an extracellular membrane, and other cellular adsorptions and reduction properties. The use of native and hybrid combinations of microbes supported by organic supplements is projected as a fast and efficient technique that not only reduces chromium quantity but also maintains the integrity of the microbial sources. Innovation and emphasis on nano-based products like nanocomposite, nano adsorbent, nanoscale zerovalent iron (nZVI) particles and multifunctional plant-growth-promoting bacteria (PGPB) will serve as the next generation environmental remediation technologies in the near future.

Utilization of unconventional lignocellulosic waste biomass for the biosorption of toxic triphenylmethane dye malachite green from aqueous solution.

Biosorption potential of novel lignocellulosic biosorbents Musa sp. peel (MSP) and Aegle marmelos shell (AMS) was investigated for the removal of toxic triphenylmethane dye malachite green (MG), from aqueous solution. Batch experiments were performed to study the biosorption characteristics of malachite green onto lignocellulosic biosorbents as a function of initial solution pH, initial malachite green concentration, biosorbents dosage, and temperature. Biosorption equilibrium data were fitted to two and three parameters isotherm models. Three-parameter isotherm models better described the equilibrium data. The maximum monolayer biosorption capacities obtained using the Langmuir model for MG removal using MSP and AMS was 47.61 and 18.86 mg/g, respectively. The biosorption kinetic data were analyzed using pseudo-first-order, pseudo-second-order, Elovich and intraparticle diffusion models. The pseudo-second-order kinetic model best fitted the experimental data, indicated the MG biosorption using MSP and AMS as chemisorption process. The removal of MG using AMS was found as highly dependent on the process temperature. The removal efficiency of MG showed declined effect at the higher concentrations of NaCl and CaCl2. The regeneration test of the biosorbents toward MG removal was successful up to three cycles.