Leveraging the Integration of Sales Career Cycle with Brand Life Cycle in Indian Pharmaceutical Firms

This working paper confines its scope to performance of National Agricultural Insurance Scheme (NAIS). It examines the progress of NAIS in India and in one selected state, Gujarat. The two dimensions considered are coverage over time and across the states. It is further disaggregated for different seasons. The performance was studied with respect to number of performance indicators, namely, farmers covered, area covered, sum insured, premium collected, subsidy to small farmers, claims made and farmers benefited. The state-wise performance gives the comparative picture of NAIS among the states. Detailed performance was studied for Gujarat. Again the progress was examined over time and among the districts. Though the data shows impressive growth over time it cannot be termed as satisfactory. The coverage of area as well as loanee farmers has been disappointing. The scheme has many flaws. The mandatory aspect has not been appreciated by farmers.

Temporal Trend and Inequality in Immunization Coverage in India

Since 1978, India through its various health policies target to achieve the universal immunization, but profound progress is yet to be seen. This paper examine the trend in immunization coverage and differential access among the population subgroups. Data for the analysis was extracted from the two recent rounds of the National Family Health Survey (NFHS) conducted in 2005–2006 and 2015–2016. Descriptive statistics were used to understand the level of coverage, whereas the ratio method and concentration index was used to understand the inequality. The study identified immunization coverage had improved from 44 percent in 2005–2006 to 62 percent in 2015–2016. However, considerable variation was observed among the regions and various wealth quintiles. In the Southern region, 63 percent of children from the poorest wealth quintile were fully immunized compared to 36 percent in North Eastern region. The coverage of full immunization among richest children was found to be 1.5 times higher than that of the poorest. The concentration index remains positive showing the pro-rich inequality. A positive result was found in the Northern and Northeastern region, where the poorest were showing an impeccable improvement over the period. Moreover, the study found the gap by place of residence and gender was close to convergence. The study suggests that the immunization programs have to be inclusive, with widespread reach, leaving no stones unturned. These steps can be beneficial in diminishing inequalities, acting as an essential ingredient in achieving the sustainable development goals

Ectopic pregnancy: one-year retrospective study on clinical, investigational and operative correlation in a tertiary care hospital

Background: Ectopic pregnancy is a life-threatening emergency which is one of the important cause of maternal mortality. Ectopic pregnancy must be suspected in any woman in the reproductive age group, presenting with lower abdominal pain or vaginal bleeding. Our aim was to review all cases of ectopic pregnancy and determine the incidence, high risk factors, types of clinical presentation and mode of management.Methods: This was a retrospective cohort study, conducted at a tertiary care hospital. Medical records of all women with an ectopic pregnancy between 2016 and 2017 were seen. Demographic data, risk factors, clinical features, and mode of management were noted.Results: 90 patients, diagnosed with ectopic pregnancy during last one year was included in the present study, with an incidence of 1.2%. Majority of women were aged 20-30 years (50%). 74.4% cases were ruptured ectopic. The most common risk factors were previous ectopic (50%) and pelvic inflammatory disease (17.7%). Lower abdominal pain was seen in 80 (40.3%) patients. Majority of patients (91.1%) had tubal ectopic pregnancies. Most common mode of treatment was salpingectomy.Conclusions: Risk factors for ectopic pregnancy must be enquired and early diagnosis and management to be done to avoid maternal morbidity and mortality

Intraperitoneal analgesia for postoperative pain relief after laparoscopic gynecological surgeries

Background: Though laparoscopic gynaecological surgeries are less invasive and produces less post-operative pain, post-laparoscopy pain is still a concern. Intraperitoneal (IP) instillation of local anaesthetics has been shown to minimize the postoperative pain after laparoscopic surgeries. This study was conducted to compare the efficacy of intraperitoneal instillation of dexmedetomidine with bupivacaine and bupivacaine alone in reducing postoperative pain.Methods: 60 patients, enrolled for gynaecological laparoscopic surgeries were divided randomly into two groups of 30 each. Group B: Bupivacaine (30 ml, 0.25%) with 2 ml normal saline was instilled prior to removal of trocars, and Group BD: Bupivacaine (30 ml, 0.25%) with dexmedetomidine (1 mcg/kg, diluted to 2 ml) was instilled prior to removal of trocars. In postoperative period, Visual Analogue Score (VAS) was recorded up to 24 hours. Postoperative analgesic requirements, and side effects were recorded.Results: The Visual Analogue Score (VAS) during the first postoperative 24 hours was significantly lower in group BD compared to group B. Time to first analgesia required was delayed and total analgesic consumption was lower in group BD compared to group B which was statistically significant.Conclusions: Intraperitoneal instillation of dexmedetomidine with bupivacaine is an effective and safe method for reducing pain after laparoscopic gynaecological surgeries

India-EU Engagement and International Migration: Challenges and policy imperatives

CARIM-India: Developing a knowledge base for policymaking on India-EU migrationIn the absence of a multilateral framework and a rule based global structure for the governance of international migration of people in all its complexities, countries engage in bilateral or regional cooperation in an attempt to engage and harmonize international movements and strive for a win-win situation. India and the EU are major trading partners and are engaged in a strategic Joint Action Plan with annual summit level talks; both sides are on the cusp of a new beginning through the soon to be concluded Free Trade Agreement (FTA). India-EU engagements, while underlining the importance of engagement on movement of people, have not clearly spelt out, as of yet, any roadmap for facilitation and enhancement of movement of people between the regions. The current paper examines if, and how, the bilateral relationship or engagement between India and the EU over the years has influenced international migration flows between the two sides and what potential challenges and policy options they face for a successful engagement and facilitation of movement of people. The paper suggests that given India’s strategic position as a major country of origin for skilled and semi-skilled migrant workers, coupled with foreseeable requirements in the EU domestic markets. There is need for a closer examination of policy initiatives to embrace bilateral flows and make the exercise beneficial for both partners. The International migration flows between India and Europe in the past had always depended on the quality and strength of engagement between the countries and regions. Currently, the EU however has a low profile in India in terms of its ability to attract the best of the talent compared to competitors such as the US and Canada. Therefore, the main challenge is to enhance the EU’s presence in India through greater participation, outreach and building of networks among academia, think tanks and the media. Student mobility need to be increased in all important sectors such as IT, healthcare, science and technology, research and development so as to help create advocacy groups and to enable a greater synergy of talent between India and the EU and enhance future cooperation, partnership and development. Easing of immigration policies for selective sectors of employment and education which are of strategic concern is also important. This will require measures for mutual recognition of degrees and skills, and a minimal window for long-term immigration and integration of third country migrant professionals and workers.CARIM-India is co-financed by the European University Institute and the European Union

Energy Optimization of ZigBee Based WBAN for Patient Monitoring

AbstractThis paper proposes an energy efficient wireless telemonitoring scenario of cardiac patients through ZigBee, based on variable duty cycle being rendered to sensors. In an intra hospital telemedicine scenario, Electrocardiogram (ECG) signals of patients are acquired through ECG sensor nodes having transmission capability and these ECG signals are received by Personal Digital Assistant (PDA) kept at nursing station through ZigBee network. ECG signals are further transmitted to Doctor's PDA. If the duty cycle is varied as per the load or number of active sensors, total energy consumed in idle mode can be avoided and total energy consumed by sensors is reduced hence increasing total network lifetime. This paper, comparatively analyzes the energy efficiency of ZigBee sensors with different percentage of duty cycle on the basis of energy consumption parameter under variable load conditions. The matrices used in performance evaluation are energy consumption in transmit mode, energy consumption in received mode and energy consumption in idle mode using Qualnet 5.0.2 simulator

Assessment of LNAPL in subsurface under fluctuating groundwater table using 2D sand tank experiments

The focus of this study was to investigate the fate and transport of toluene, a light nonaqueous-phase liquids (LNAPLs) in the subsurface region under dynamic groundwater table conditions. A series of experiments were conducted using two-dimensional (2D) sand tank setup having dimensions 125×90×10  cm 125×90×10  cm (L×H×W L×H×W ) and integrated with an auxiliary column of inner diameter 14 cm and height 120 cm. Initially, a steady-state flow and LNAPL transport experiment was conducted under stable groundwater table condition. Thereafter, three groundwater table fluctuation experiments were conducted on a rising and falling groundwater table in 2, 4, and 8 h to maintain rapid, general, and slow fluctuation conditions, respectively. The pure phase of toluene was injected at a rate of 1  mL/min 1  mL/min for a total duration of 5 min. Soil-water and soil-vapor samples were periodically collected and analyzed for toluene concentrations. Later, the representation of the 2D sand tank setup was numerically simulated to obtain the response of flow and the LNAPL transport under varying groundwater table conditions. Analysis of the results shows that a large LNAPL pool area (250  cm 2 250  cm2 ) develops under rapidly fluctuating groundwater conditions, which significantly enhances the dissolution rate and contributes to a high concentration of dissolved LNAPLs at the receiving receptors. Estimated values of Sherwood and Peclet numbers show that the dissolution rates were highly affected by groundwater table dynamics, which may cause loss of pure-phase pollutant mass around the pollutant source. The concentration isolines of toluene show that the transport of dissolved LNAPL plumes was also comparatively fast in the case of rapidly fluctuating groundwater. A high biodegradation rate was observed in plume regions having concentration ranges of 140–160 ppm, while it decreases in plume regions having very high (>160  ppm >160  ppm ) and low concentrations (<140  ppm <140  ppm ) of dissolved LNAPL. In the sand tank, microbial growth was found to increase as the plume moved away from the LNAPL pool toward a low gradient, which intensifies the detrimental impact of toluene on the survival of indigenous microorganisms near the LNAPL pool. The results of this study may help in implementing effective remediation techniques to decontaminate LNAPL polluted sites under fluctuating groundwater table conditions, especially in (semi)-arid coastal aquifers

Electrocatalytic properties of La1-xCuxCoO3 (0 ≤ x ≤ 0.8) film electrodes for oxygen evolution in alkaline medium: Part II. A comparative study

1295-1301The present study is concerned with the preparation of perovskite-type oxide film electrodes of La, Cu and Co having composition La1-xCuxCoO3 (0 ≤ X ≤ 0.8) on Ni conducting support and study of their electrocatalytic properties towards oxygen evolution reaction (OER) in alkaline medium. Materials have been synthesized by using malic acid sol-gel route at pH 4.00. X-ray diffraction study of the material indicated the formation of almost pure perovskite phase with hexagonal crystal geometry. The electrocatalytic activity of the material has been determined in three electrode single compartment glass cell. Techniques used in the electrochemical studies are cyclic voltammetry (CV), oxide roughness factor and anodic polarization (Tafel plot). Each cyclic voltammogram exhibits an anodic and a corresponding cathodic peak prior to the oxygen evolution reaction. The observed anodic and cathodic peak potential values are 553±31 and 312±27 mV, respectively. The study of anodic polarization curve indicates that the oxide with 0.6 mol Cu-substitution (ja = 182.4 mA cm-2 at 750 mV) shows highest electrocatalytic activity with lowest Tafel slope value (b = 65 mV decade-1) towards OER. Thermodynamic properties of the material have also been investigated by recording the anodic polarization curve at different temperatures. The value of electrochemical activation energy has been found to be lowest with most active 0.6 mol Cu-substituted oxide material. Electrocatalytic activities of the oxide electrodes, so obtained, have been compared with the similar oxide prepared at 3.75 pH

Functional constipation in children; changing clinical spectrum with unusual presentation: A case report

Constipation in children is progressively increasing day by day because of changing lifestyle and dietary intake. Sometimes, functionalconstipation cases are misdiagnosed as functional abdominal pain because of inappropriate history and examination. We present an8-years-old boy with a history of intermittent moderate to severe abdominal pain for 2 months. Basic blood investigations andultrasound of the abdomen were normal, surprisingly, X-ray of the abdomen revealed the diagnosis. Simple X-ray erect abdomen isvery useful in a special situation for the diagnosis of functional constipation

Structural Insights of the Cysteine Protease Heynein from Induction and Characterization of Non-native Intermediate States

Cysteine proteases are vital to cell physiology and many plants secrete these proteases for defense purposes. Many recent studies have reported unusually high stabilities for several plant cysteine proteases which possibly enable these proteases to function under adverse environmental conditions. Here, we have examined the conformational features of a new plant cysteine protease heynein using spectroscopic tools to understand the basis for its robust functional stability. The studies revealed structural integrity over a wide range of pH (2.5-12.0), temperature (65 oC) and urea (8M). However, at pH 2.0, the protein gets acid-unfolded (UA-state) with exposed hydrophobic patches, which upon addition of more protons (pH 0.5) or anions (0.5 M KCl and 0.2 M Na2SO4) yields conformationally distinct refolded intermediates respectively termed: A-, I1- and I2-states. Strikingly, a high methanol level drives the UA-state into a predominantly beta -sheet rich conformation (O-state). We observed three-state unfolding kinetics of the I2-state by urea, possibly suggesting presence of two domains in the heynein molecule