Private Sector and Waste Management in Delhi: A Political Economy Perspective

Due to their size and rapid growth, large cities in developing countries are increasingly challenged by burgeoning waste generation. Waste management, however, has traditionally provided employment opportunities to the many urban poor in the informal sector. These traditional models, working largely in parallel with state?led interventions, are under pressure because they fail to address the waste management crisis. This failure, coupled with the lack of capacities of local governments, has paved the way for formal private sector participation. We examine the case of Delhi where a complex interplay of competing approaches have accompanied efforts of urban local bodies, civil society and the private sector (informal and formal) at finding a sustainable working solution. Our analysis of the complex relationship within the private sector players, and between private and public actors, provides novel insights into potential contribution of public–private partnerships for effective waste management in developing countries

The History of Diabetes Mellitus

Diabetes has been recognised since antiquity. The first description that resembles the features of the disease is found in Ebers papyrus (1550 BC). The term ";diabetes"; was first coined by Aretaeus of Cappadocia. Galen described it as a disease specific to the kidneys because of a weakness in their retentive faculties. Word mellitus was added by Thomas Willis in 1675 after rediscovering the sweetness of urine and blood of patients (first noticed by the ancient Indians, Chinese and Japanese). He later noticed that some urine samples were sweet (diabetes mellitus) whereas others were tasteless (diabetes insipidus). Later Cullen and John Rollo confirmed these two types. It was only in 1776 that Dobson firstly confirmed the presence of excess sugar in urine and blood as a cause of their sweetness. Claude Bernard discovered in 1857 that liver releases a substance i.e. glycogen which affects blood sugar level. The role of the pancreas in pathogenesis of diabetes was discovered by Mering and Minkowski in 1889. In 1909, Jean De Meyer named glucose lowering hormone as insulin whose existence was hypothetical at that time. Banting and Macleod got Noble prize for isolating insulin in 1923. Discovery of insulin for the treatment of diabetes represents one of the major humanitarian and scientific milestones of the 20th century. Oral hypoglycemic drugs were introduced later. Today researchers are working on insulin patch, implantable pump, insulin-sensitizers, pancreatic or islet cell transplantation and oral insulin solution

Prevalence of Diabetes in Haryana

BackgroundDiabetes will pose a severe burden on the already fragile and under resourced health care system in India. As there is limited data available regarding prevalence of diabetes in northern India, the present study was undertaken to estimate the prevalence of diabetes mellitus and to study the association of risk factors in an urban population of Rohtak.Method  A cross-sectional survey of 1000 eligible persons. A pre-tested semi-structured interview schedule was deployed.ResultsThe prevalence of diabetes in the study population was 8.1% which was higher in females (9.8%) as compared to males (6.1%). Results of impaired fasting glucose showed prevalence of pre diabetics to be 10.3% which was again higher in females (13.3%) as against 6.7% in males. 67% of pre-diabetic and 49.4% of diabetic have family history of diabetes mellitus in first degree relationship while 1.8% of non-diabetic had a family history of diabetes. prevalence of diabetes increased with increasing age up to 70 years. Moreover the prevalence of diabetes was high in two extremes of socio economic classes, being more in low socioeconomic class.ConclusionWe conclude that prevalence of diabetes in urban Haryana is lower than other states. Also the prevalence of diabetes is higher in females. Prevalence is influenced by age, education, occupation, socioeconomic status and marital status

Understanding Sustenance of Small Farm Holders: A Study of Income Inequality among Farm Households in Indian Punjab

The sustenance of marginal and small farm households is a pertinent question given that their number is on the rise in South-Asia. The study aims to assess their present socio-economic profile and the challenges faced in order to draw a roadmap of development for these underprivileged households. The study pertains to Indian Punjab and data from the Situation Assessment Survey of the 70th Round of NSSO are used. The concepts of economic surplus, occupational diversity, farm productivity and vertical and horizontal inequalities are used to achieve the objectives. This study reveals that marginal farm households faced food insecurity as they failed to meet consumption expenditure from the income earned. In fact, small farm households are left with an annual economic surplus of Rs 8890 per capita only, after meeting consumption needs. Income is unevenly distributed among farm households with a Gini coefficient of 0.48. The majority of the marginal and small farm households fall in lower-income quintiles and are occupationally more diversified than their larger counterparts. Horizontal inequalities are lower between the farm-size categories (0.14) than within farm-size categories (0.27). The Gini coefficient within each farm-size category is the highest among marginal farm households (0.50), followed by small farm households (0.45), highlighting their economic stress and tug-of-war survival. Further, the farm households belonging to socially lower castes falls only in the marginal farm-size category and represent the lowest income. Development must be sustainable and inclusive, hence, policies to develop marginal farmers’ centric farming systems and high value crops such as potato, cotton, sugarcane and oilseeds, providing high yielding livestock breeds, value addition through farmer-producer organizations, non-farm employment through MGNREGA, provision of institutional credit at subsidised rate of interest and quality health and education facilities in the public sector are recommended to uplift the affected households

Understanding Sustenance of Small Farm Holders: A Study of Income Inequality among Farm Households in Indian Punjab

The sustenance of marginal and small farm households is a pertinent question given that their number is on the rise in South-Asia. The study aims to assess their present socio-economic profile and the challenges faced in order to draw a roadmap of development for these underprivileged households. The study pertains to Indian Punjab and data from the Situation Assessment Survey of the 70th Round of NSSO are used. The concepts of economic surplus, occupational diversity, farm productivity and vertical and horizontal inequalities are used to achieve the objectives. This study reveals that marginal farm households faced food insecurity as they failed to meet consumption expenditure from the income earned. In fact, small farm households are left with an annual economic surplus of Rs 8890 per capita only, after meeting consumption needs. Income is unevenly distributed among farm households with a Gini coefficient of 0.48. The majority of the marginal and small farm households fall in lower-income quintiles and are occupationally more diversified than their larger counterparts. Horizontal inequalities are lower between the farm-size categories (0.14) than within farm-size categories (0.27). The Gini coefficient within each farm-size category is the highest among marginal farm households (0.50), followed by small farm households (0.45), highlighting their economic stress and tug-of-war survival. Further, the farm households belonging to socially lower castes falls only in the marginal farm-size category and represent the lowest income. Development must be sustainable and inclusive, hence, policies to develop marginal farmers’ centric farming systems and high value crops such as potato, cotton, sugarcane and oilseeds, providing high yielding livestock breeds, value addition through farmer-producer organizations, non-farm employment through MGNREGA, provision of institutional credit at subsidised rate of interest and quality health and education facilities in the public sector are recommended to uplift the affected households

Predictors for severe hemorrhage requiring angioembolization post percutaneous nephrolithotomy: A single-center experience over 3 years

Context and Aim: About 1% of the patients undergoing percutaneous nephrolithotomy (PCNL) have bleeding severe enough to require angioembolization. We identified factors which could predict severe bleeding post-PCNL and reviewed patients who underwent angioembolization for the same. Settings and Design: This is a single-institutional, retrospective study over a period of 3 years. Subjects and Methods: We retrospectively studied 583 patients undergoing PCNL at our institute from 2013 to 2016. We analyzed nine patients (three from our institute and six referred patients) who underwent angioembolization for severe bleeding post-PCNL. We analyzed the preoperative characteristics, intraoperative findings, and postoperative course of these patients and compared this with those patients who did not have a severe post-PCNL bleeding. Statistical Analysis Used: Fischer's exact test and Chi-square test were used in univariate analysis. Logistic regression analysis was used in multivariate analysis with a value of P < 0.05 considered statistically significant. Results: Three of the 583 patients (0.51%) who underwent PCNL at our institute required embolization to control bleeding. Preoperative characteristics that were significant risk factors for severe bleeding were a history of ipsilateral renal surgery (P = 0.0025) and increased stone complexity (P = 0.006), while significant intraoperative factors were injury to the pelvicalyceal system (P = 0.0005) and multiple access tracts (P = 0.022). Angiography revealed arteriovenous fistula in two patients and a pseudoaneurysm in seven patients. All patients underwent successful superselective angioembolization with preserved renal perfusion in six patients on control angiography postembolization. Conclusions: History of ipsilateral renal surgery, increased stone complexity, multiple access tracts, and injury to the pelvicalyceal system are risk factors predicting severe renal hemorrhage post-PCNL. Early angiography followed by angioembolization should be performed in patients with severe post-PCNL bleeding who fail to respond to conservative measures

Individualized lifestyle intervention in PCOS women (IPOS): a study protocol for a multicentric randomized controlled trial for evaluating the effectiveness of an individualized lifestyle intervention in PCOS women who wish to conceive

Abstract Background Polycystic ovary syndrome (PCOS) is a common endocrine condition which affects women in the reproductive age group. South Asian women with PCOS have a higher risk of insulin resistance and metabolic disorder compared to women from other ethnic backgrounds. Lifestyle interventions such as dietary advice and physical exercise are recommended as a first-line management option for infertile women with PCOS. Most of the randomized controlled trials evaluating the role of lifestyle interventions in infertile PCOS women were characterized by methodological issues. The uptake of lifestyle modifications as a treatment strategy in the South Asian population is complicated by a difficult-to-change conventional high-carbohydrate diet and limited availability of space for physical activity in the region. Methods The study is designed as an open-label, multicentre, randomized controlled trial in South Asian women with PCOS. Women attending the fertility clinic will be screened for eligibility, and women aged between 19 and 37 years who have been diagnosed with PCOS and wishing to conceive will be invited to participate in the trial. We will include women with body mass index (BMI) between ≥ 23 and ≤ 35 kg/m2 and duration of infertility ≤ 3 years. We plan to randomize women with PCOS into two groups: group A will receive the intervention which will consist of individualized advice on diet and physical exercise along with a telephonic reminder system and follow-up visits, and group B (control) will receive one-time advice on diet and physical exercise. Both groups will receive up to three cycles of ovulation induction with letrozole after 3 months of randomization during the 6-month treatment period. The primary outcome of the trial will be the live birth following conception during the intervention period. The secondary outcomes include clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, ectopic pregnancy rate, stillbirth, time to pregnancy, mean weight loss, differences in anthropometric parameters, improvement in menstrual regularity and quality of life score. Discussion The IPOS trial results could help clarify and provide more robust evidence for advocating an individualized lifestyle intervention in PCOS women who wish to conceive. Trial registration Clinical Trial Registry of India CTRI/2023/04/051620. Registered on 13 April 2023