Information Technology and Bureaucratic Reform: A Case Study from India

Most governments see the use of information systems as part of a reform strategy to reconfigure relations both among various government departments as well as between governments and other stakeholders. However, there is little empirical evidence to support whether these systems achieve this intended outcome. Therefore, the overarching question that guides this study can be articulated as follows: given that the information systems used by governments are proposed to institute new relational patterns within governments and between governments and other stakeholders, has this happened, if it so how and if not why not. I suggest that e-governance systems are designed and implemented with the context of existing institutionalized social structures, which constrain actors who come together to build and implement a new system. However, this does not mean that these actors are mere puppets. They are capable of strategic action and can choose whether to reinforce the existing institutionalized set up or to change it. In either case, these constrained actors build coalitions by using strategic and assumptive frames in their attempt to move from interpretive flexibility towards institutionalization. This study uses the extended case study approach with in-depth interviews and participant observation as the data elicitation techniques. My data analytic approach stems from the notion of a hermeneutic circle that sees the process of social construction and institutionalization as a series of constructed dialogues

Surgical Apgar score in prediction of post-operative complications in gynecological surgery

Background: This study was aimed at estimating the ability of 10-point “Surgical Apgar Score” (SAS) to predict postoperative complications in gynecological surgery.Methods: All women undergoing laparotomy (elective and emergency) in the Department of Obstetrics and Gynecology at Kasturba Hospital, Manipal, between November 2014 and June 2015, were included. Age, BMI, comorbidities and postoperative complications were analyzed. The SAS was calculated from the estimated blood loss, lowest heart rate, and lowest mean arterial pressure. Descriptive statistics and univariate statistics were used. Occurrence of major postoperative complications represented the primary outcome.Results: A total of 146 cases meeting the inclusion criteria were analyzed. The patients belonged to the age group of 20-60 years. One or more comorbidities were seen to be present in 50 (34.2%) of the patients. With regard to BMI, 62 (42.5%) of the patients were in the normal category. Major post-operative complications were identified in 11 cases (7.5%). On univariate analyses, occurrence of postoperative complications were associated with presence of comorbidities (p=0.047) and SAS belonging to the high-risk category (p=0.001).Conclusions: The SAS is a significant predictor of postoperative complications following gynecological surgery. This metric, along with a consideration of comorbidities, can be helpful in determining prognosis, directing decision making in the operation theatre, and in postoperative care.

How (not) to make WPS count

Anu Mundkur and Laura Shepherd offer a commentary on the WPS Index and caution those attempting to measure progress in the complex worlds of peace and security

A clinical audit of hysteroscopy in a tertiary care teaching. What challenges did we face?

Background: The aim of the study was to evaluate indications, operative findings and complications in patients undergoing hysteroscopy.Methods: The data of all patients who underwent hysteroscopy in the department of obstetrics and gynecology in a tertiary care teaching hospital were included retrospectively from November 2017 to October 2018.Results: There were 59 patients who had hysteroscopy for various indications. Twelve patients and forty-seven patients were subjected to diagnostic and operative hysteroscopy respectively.  Indications for diagnostic hysteroscopy were for postmenopausal bleed (3), carcinoma of the breast on tamoxifen with bleeding PV (3), recurrent implantation failure (6). Operative hysteroscopy was performed for endometrial polyp (30), myomectomy (9), septal resection (7), copper T removal (1). Complications of hysteroscopy were: media efflux and poor visualization in 10 (17%), minor hemorrhage (9) 15.1%, perforation 2 (3.3%). Minor hemorrhage was managed with tranexamic acid. The perforation in two patients happened during the dilatation of the cervix with metal dilators.Conclusions: One of the major challenges encountered was the efflux of the distension media due to excessive cervical dilatation, which did not provide satisfactory hysteroscopic view. Another complication was perforation during cervical dilatation using Hegars dilator. Use of misoprostol and the use of small sheath hysteroscopes have minimized the need for cervical dilatation

Ruddy Shelduck Tadorna ferruginea home range and habitat use during the non-breeding season in Assam, India

India is an important non-breeding ground for migratory waterfowl in the Central Asian Flyway. Millions of birds visit wedands across the country, yet information on their distribution, abundance, and use of resources is rudimentary at best. Limited information suggests that populations of several species of migratory ducks are declining due to encroachment of wedand habitats largely by agriculture and industry. The development of conservation strategies is stymied by a lack of ecological information on these species. We conducted a preliminary assessment of the home range and habitat use of Ruddy Shelduck Tadornaferruginea in the northeast Indian state of Assam. Seven Ruddy Shelducks were fitted with solar-powered Global Positioning System (GPS) satellite transmitters, and were tracked on a daily basis during the winter of 2009-2010. Locations from all seven were used to describe habitat use, while locations from four were used to quantify their home range, as the other three had too few locations (<30) for home range estimation. A Brownian Bridge Movement Model (BBMM), used to estimate home ranges, found that the Ruddy Shelduck had an average core use area (i.e. the contour defining 50% of positions) of 40 km 2 (range = 22-87 km2) and an average home range (95% contour) of 610 km2 (range = 222-1,550 km2). Resource Selection Functions (RSF), used to describe habitat use, showed that the birds frequented riverine wetlands more than expected, occurred on grasslands and shrublands in proportion to their availability, and avoided woods and cropland habitats. The core use areas for three individuals (75%) were on the Brahmaputra River, indicating their preference for riverine habitats. Management and protection of riverine habitats and nearby grasslands may benefit conservation efforts for the Ruddy Shelduck and waterfowl species that share these habitats during the non-breeding seaso

Nutritional adequacy of daily diets for 2-5-year olds as shown on YouTube: an observational study

Introduction and Aims: Social media has become the main platform for promoting new products, trends, and more recently health information. An increasing number of social media content creators share what they or their children eat, and a large part of the population turns to these platforms to tailor their diets. The aim of this study was to investigate if the daily diets of children aged 2-5 years suggested by social media in the UK and the USA meet official dietary recommendations. Methods: On 24/10/2021 YouTube was searched using the key phrases “what my kids eat in a day”, “what my pre-schooler/toddler eats in a day”. Videos with complete metrics and non-scientific English-language content were further screened for country of origin and accuracy in capturing meals and snacks. Daily diets from 20 videos from the UK and the USA were analysed using Nutritics. Dietary intakes were compared against Public Health England’s dietary recommendations (UK) and the Dietary Guidelines for Americans (USA). Results: Statistical analysis showed that energy, saturated fats, and sodium were overconsumed by 18, 70, and 40%, respectively, while vitamin D intake was 85% below recommendations (all p’s<0.05). Conversely, 65% of children complied with vitamin C recommendations and 50% with recommendations for zinc. Conclusion: Daily diets for children aged 2-5 years captured by YouTube influencers propose dietary intakes which are inconsistent with current recommendations in both UK and USA, especially with regards to energy, saturated fats, sodium, and vitamin D. Concerns about the impact on public health is raised

Response of structures to impact loads, using elastic and plastic analysis

The objective of this work is to study the response of structures to impact loads. Depending on the magnitude of impact the structural response may need elastic or plastic analysis. When the deformations are within the elastic region, normal mode analysis is used to find the response. Structures considered in this study are Beams and Rectangular Plates. The Rayleigh-Ritz method is used to obtain the natural frequency and mode shape coefficients. Different types of displacement shape functions are employed in the analysis in the past such as beam characteristic functions and beam characteristic orthogonal polynomials. An approximate plate function is arrived at by reduction of the plate partial differential equation and solving the resulting ordinary differential equation as in Kantarovich method, and then used in the Rayleigh-Ritz method. The same reduction procedure is also used along with successive iteration until convergence to obtain the natural frequencies and mode shape functions directly. This method takes much less time for response evaluation than that is required by using the Rayleigh-Ritz method. Structural response to impact loads is also carried out using rigid plastic analysis. A cantilever beam with impulsive load applied at the free end is considered with finite blade radius and varying centrifugal forces are considered in the investigation. Experimental simulation of impact loading is carried out in the laboratory using a mass falling from a known height onto the structure under investigation. The elastic response of a plate with two adjacent edges clamped and the other two free are observed, and a equivalent mathematical model formulated by using flexible edge support

Low platelet counts in pregnancy: an alarm signal for abruption!

Background: Thrombocytopenia, defined as a platelet count less than 150 million/mm3, affects 6% to 10% of all pregnant women and other than anemia is the most common hematologic disorder in pregnancy.Methods: We studied all patients with thrombocytopenia in pregnancy from June 2012 to May 2013. There were 86 patients recruited into the study. Pregnant women with preeclampsia and suspected connective tissue disorder were also screened for thrombocytopenia. All women with platelet count of <1.50,000/µl during the study period were included.Results: Patients were grouped in to mild thrombocytopenia (platelet 100,000-149,999/µl), moderate thrombocytopenia (platelet 50,000-99,999/µl) and severe thrombocytopenia (platelet <49,999/µl. Pregnancy specific cause of thrombocytopenia was in 63 (73.2%) women and non-pregnancy specific were in 23(26.7%) patients.Conclusions: Preeclampsia and HELLP syndrome is more common cause of thrombocytopenia in pregnancy. Abruption can occur in patients with severe thrombocytopenia. Though platelet count is not routinely done in pregnancy it is advisable to do so as it may help in detecting gestational thrombocytopenia or other immune related condition