Household costs of breast cancer morbidity: An empirical assessment from Pakistan.

PURPOSE: Health care costs attributable to breast cancer are substantial. In countries with high poverty, lack of public health infrastructure and low availability of health insurance, the economic burden of disease does not accrue solely to health care, but also on patients and their families. This study was conducted to explore the cost burden (i.e. direct medical costs, direct non-medical costs and indirect non-medical costs) incurred by breast cancer patients and their families over diagnosis and treatment. METHODS: Data was collected from 200 breast cancer patients at two hospitals in Lahore, provincial capital of Punjab, Pakistan, by employing purposive sampling technique. Costs were aggregated into three categories and compared with each other as per their weightage. RESULTS: The study found that direct medical care (US$ 1262.18/ Local currency (PKR) 129,717) is the largest expense, followed by direct non-medical (US$ 310.88 / PKR 31,950) and indirect non-medical costs (US$ 273.38 / PKR 28,096). CONCLUSIONS: The results of this study provide rich insight into the financial burden borne by households of breast cancer patients and suggest policy implications.

P-nitrophenol degradation by activated sludge attached on nonwovens.

p-Nitrophenol (PNP) is a toxic compound that enters the environment during manufacturing and processing of a variety of industrial products. This study demonstrates the use of inexpensive and durable nonwovens as a biomass retainer for the biological degradation of p-nitrophenol. An essential aspect of p-nitrophenol degradation was the cultivation of p-nitrophenol degrading biomass prior to its attachment on the nonwovens. Results of continuous flow experiments demonstrated that using the nonwovens could attain consistent high-rate p-nitrophenol degradation. 500 mg-PNP/L was completely degraded at a hydraulic retention time of 11 h. Specific and volumetric p-nitrophenol loading rates were determined to be 165 mg-PNP/g-MLSS/d and 1.6 g-PNP/L/d, respectively. Nitrite released from p-nitrophenol breakdown was not completely nitrified to nitrate. Characteristics of p-nitrophenol degrading sludge were also investigated.