Field Performance Evaluation of Push Type Prilled Urea Applicator in Rice Cultivation

CORRECTION: Due to a number of formatting and layout issues, the PDF of this paper was replaced on 10th October 2016. The page numbers of this article have changed from 68-78 to 71-81.BRRI prilled urea applicator was designed and developed to facilitate deep placement of regular urea. Experiments were conducted to evaluate the performance of BRRI prilled urea applicator in the farmers’ fields at Gosaidanga in Shailkupaupazila under Jhenaidah district and at Rashidpur in Mithapukurupazila under Rangpur district during Boro 2015 season. Three treatments: hand broadcasting of urea (recommended dose) (HB), BRRI prilled urea applicator (70% of the recommended dose) (PUA) and BRRI USG applicator (70% of the recommended dose) (USGA) were compared in the experiments. The experiment was laid out in randomized complete block design (RCBD) and replicated in four farmers’ plots in each location using BRRI dhan28 as test crop both the locations. Prior to field experiment, prilled urea applicator was calibrated and urea dispensed was set to 14 gm in one revolution of drive wheel for Boro season. The field capacity of the PUA and USGA was almost similar (0.09-0.10 ha hr-1) in both the locations. Field efficiency of PUA and USGA had 64-65 and 68-69 percent, respectively. PUA and USGA saved 29-32 percent urea fertilizer compared to HB whereas labour requirement of HB (3.74-4.04 man-hr ha-1) in three splits showed similar to single application of urea by PUA (3.68-4.00 man-hr ha-1) and USGA (3.78-3.97 man-hr ha-1). Urea application cost in HB, PUA and USGA was Tk 4,624, 3,216-3,424 and 3,305-3,483 per hectare in both the locations. Prilled urea application method reduced the production cost. Urea application methods showed insignificant effect on grain yield. BRRI prilled urea safely dispensed urea fertilizer in subsurface, increased the efficacy of urea fertilizer and saved urea fertilizer without sacrificing grain yield. BRRI prilled urea applicator could be a viable technology in rice cultivation. Extensive dissemination works should be undertaken in different agro-ecological zones for wide spread adoption of the applicator.Bangladesh Rice j. 2015, 19(2): 71-81

A claims-based Markov model for Crohn's disease

BACKGROUND

Crohn's disease is a chronic condition that often presents in early adulthood.

AIM

To evaluate health care costs and costs per quality-adjusted life year (QALY) for Crohn's disease.

METHODS

A Markov model was developed using administrative claims data for patients aged > or = 18 years with > or = 3 years of continuous enrolment from 2000 to 2008 and > or =2 Crohn's disease claims. Disease states (remission, mild-moderate, moderate-severe, and severe-fulminant) were defined using the American College of Gastroenterology treatment guidelines criteria. Transition probabilities were calculated from consecutive 6-month periods. Costs were determined from paid claims and QALY utilities were obtained from the literature. The model assumed a 30-year-old patient at the time of entry into the model.

RESULTS

There were 40 063 patients identified, with a total of 420 773 cycles [remission (197 111; 46.8%), mild-moderate (44 024; 10.5%), moderate-severe (132 695; 31.5%), severe-fulminant (46 925; 11.2%)]. The costs/QALY for remission, mild-moderate, moderate-severe, and severe-fulminant disease states respectively were $2896, $8428, $11 518 and $69 277 for males and $2896, $8426, $22 633 and $69 412 for females.

CONCLUSIONS

Overall, health care costs for patients with Crohn's disease increased with disease severity. Although the probabilities of transitioning from other health states to the severe-fulminant disease state were low, the cost/QALY was high.

Association between coronary heart disease and cancers of the breast, prostate, and colon

Coronary heart disease (CHD) and cancers of the breast, prostate, and colon are more common in industrialized countries than in the developing world, and to some degree, these conditions appear to share risk factors. To investigate whether there is an association between these cancers and a prior history of CHD, a hospital-based case-control study was conducted at Columbia-Presbyterian Medical Center in New York. The study was based on 252 breast cancer cases, 256 colorectal cancer cases, and 322 benign surgical controls, all of whom underwent biopsy or surgery between January 1989 and December 1992, and on 319 prostate cancer cases and 189 benign prostatic hypertrophy controls diagnosed between January 1984 and December 1986 (prior to widespread use of prostate-specific antigen screening). Medical records were reviewed on each, focusing on the preoperative anesthesia and surgical clearances. No association was found between a history of CHD and breast or colorectal cancer, but an elevated risk was found for prostate cancer (odds ratio, 2.00; 95% confidence interval, 1.18-3.39), using unconditional logistic regression with adjustment for appropriate confounders. No association was found between cigarette smoking and any of the three cancers. Aspirin use was protective for colorectal cancer (odds ratio, 0.35; 95% confidence interval, 0.17-0.73) but had no association with breast or prostate cancer. The study suggests that individuals with CHD are at elevated risk for prostate cancer but not breast or colorectal cancer. Etiological risk factors associated with CHD should be investigated with regard to prostate cancer. Patients with CHD may represent a high-risk group for prostate cancer and potential future targets for prostate cancer screening interventions.

Selections from current literature: cholelithiasis, cholecystectomy and the risk of colorectal cancer

The study by Ekbom et al. clearly demonstrates that, overall, there is no increased risk of colorectal cancer following cholecystectomy. However, it is noted that women have a slight increase in the risk of proximal colon cancer following cholecystectomy. The reasons for this finding remain unclear. However, since this finding has been consistent in several studies, it is probably not an artifact, but a true association that may warrant further investigation. It is possible that the association noted between cholecystectomy and colorectal cancer is due not to the cholecystectomy, but to the reason why cholecystectomies are performed, namely the presence of gallstones. The cholecystectomy itself may simply be a surrogate for cholelithiasis, which may be a true risk factor for colorectal cancer. Excess secondary bile acids may be carcinogenic or the factors which cause the formation of cholelithiasis may also increase the risk for developing colorectal cancer. An answer to the separate question of whether excessive laparoscopic cholecystectomies are being performed, or whether newer indications make the increased number of laparoscopic cholecystectomies appropriate, remain outstanding. This new procedure, despite being cheaper than the open cholecystectomy, has resulted in greater utilization of the world's dwindling health care resources. In conclusion, the decision to perform a cholecystectomy should be made only with consideration of the patient's current medical condition. There is no need to be concerned about any future increased risk of colorectal cancer following a cholecystectomy.

Implementing the Put Prevention into Practice program

Put Prevention into Practice (PPIP) is a national program designed to improve the delivery of preventive care to patients by all primary care clinicians. It covers the full range of clinical preventive services, including immunizations, screening tests, chemoprophylaxis, and counseling interventions. The materials that comprise this program involve patients, office/clinic systems and staff, and clinicians, including nurse practitioners. The need for preventive care, the barriers to be overcome, the PPIP program, and a strategy for its implementation are delineated. Principles for successful implementation include: high level administrative support, ownership by all the players in the implementation process, a person designated to manage implementation, and an ongoing evaluation/auditing process that provides feedback to clinicians and others participating in the program.

Selections from current literature: screening for colorectal cancer

Of the five modalities currently used to screen for colorectal cancer, the DRE is the least useful as a solitary screening tool. Also, while FOBT is widely used, its high false positive rate and uncertain cost benefit ratio make it less than ideal as a screening tool. Flexible sigmoidoscopy in a well defined regimen, has been shown to result in a decrease in CRC mortality. Paramedical personnel with a moderate amount of training have been shown to be able to safely and efficiently perform screening sigmoidoscopy. This has the potential to make it widely available at an affordable cost to the general population; however, its limitations, namely its ability to detect only lesions found in the distal colon, need to be kept in mind. With all limitations in the above mentioned screening modalities, colonoscopy may be the best tool to detect colorectal cancers. It has a significant advantage over DCBE of being both a diagnostic and therapeutic tool; however, it is imperative that a randomized controlled trial be performed to fully document its potential efficacy, advantages and disadvantages. Finally while genetic testing looms on the horizon as a promising new tool for CRC screening, at this time there are still too many unanswered questions and dilemmas, ethical as well as others, to warrant its use in the general clinical setting. However, maybe in the future, CRC screening will involve a simple blood test performed at birth, or perhaps even prenatally.

Selections from current literature: magnesium, myocardial infarction and meta-analysis

If the results of LIMIT-2, the two meta-analyses reviewed and the cumulative meta-analysis by Lau et al. are viewed in aggregate, there can be very little doubt regarding the beneficial effects of i.v. magnesium on mortality in suspected acute MI. The results of ISIS-4 should strengthen these odds ratios and help clarify the role of magnesium and arrhythmias in acute MI. Furthermore, the combined effect of i.v. magnesium and thrombolytics will again be focused upon. Though the cardioprotective effects of magnesium are unknown, this should only spur more studies to elucidate these mechanisms and should not be a reason to delay the inclusion of i.v. magnesium in the usual regimen for treating suspected acute MI. The regimen of i.v. magnesium needs to be standardized. Further studies are also needed to evaluate whether oral magnesium can be used as tertiary prevention for MI. Finally, meta-analyses are studies of studies that are valid and reliable if they follow certain rules. This is true of all types of research. Due to the exponential increase in the medical literature of these types of studies, and the fact that they may eventually supplant the traditional narrative review, it is incumbent upon physicians to understand the process by which a meta-analysis is conducted.

Selections from current literature: inhaled steroid use in asthma management

Though our understanding of asthma has improved, its incidence, prevalence and associated death rate have been increasing in most industrialized countries. Inadequate treatment of airway inflammation may explain some of this trend. Steroids are the most effective anti-inflammatory agents and are effective and safe in inhaled form. Together with sodium cromolyn, they should be used more frequently in the management of all types of asthmatics, especially those who require chronic or acute administration of oral steroids.