Utilization of passenger transport subsidy in Kolkata: A case study of Calcutta State Transport Corporation

The present study tries to see whether the subsidy given to CSTC, which is the oldest and the largest state transport corporation operating in and around Kolkata, is really being used to cover the losses they make over the years or to merely cover-up an inefficient performance. The state owned buses are required to serve, not only non-profitable routes in off-peak hours, but also to give social security or employment to a large section of society. The burden of carrying a huge staff structure and serving at an administered and less than competitive price for welfare reasons, makes CSTC liable to an operating loss. Therefore, it makes a case for subsidy. However, the regular commuters experience regarding the condition of and the services provided by these raises a question about the justification of subsidy. In the study it is seen that the subsidy given is not based on any of the components on which it should, economically

Comparative study of the effects of intrathecal clonidine and fentanyl as adjuvant with low dose hyperbaric bupivacaine for unilateral spinal anaesthesia in lower limb surgery

Background and Aims: Unilateral Spinal anaesthesia with bupivacaine is administered for lower limb surgeries. The aim of the study is to compare between the effects of Clonidine and Fentanyl when added as an adjuvant to low dose bupivacaine in unilateral spinal anaesthesia in lower limb surgery on the basis of onset and duration of sensory and motor blockade and post-operative analgesia. Material & Methods: After obtaining the institutional ethics committee approval total 150 patients ofeither sexbetween 18 to 55 years of age, American Society of Anaesthesiology (ASA) I and II scheduled for elective lower limb surgery were divided into three groups. All patients received 0.5% hyperbaric bupivacaine (7.5mg) 1.5ml intrathecally along with ± adjuvant ( In Group A - clonidine (30 microgram) 0.2 ml diluted with normal saline to make 0.5 ml, Group B- fentanyl 25 microgram or 0.5 ml, Group C only 0.5ml normal saline) to make total 2ml solution . The results of observations were tabulated, compiled and statistically analysed using SPSS (version) 25.0 and Graph Pad prism version 5. Result : Fentanyl and clonidine both when added to low dose bupivacaine in unilateral spinal anaesthesia prolonged the duration of sensory and motor block compared to only low dose local anaesthetic agent. The time duration before the use of first dose of rescue analgesic is more prolonged in the group receiving clonidine as compared to Fentanyl group patient

Efficacy of Online Training of the Elected Representatives of Local Rural Government: A Focus Group Study

Aim. Before COVID-19, training institutions rarely used eLearning to improve Elected Representatives' (ERs) skills in rural development who come from vernacular social and academic backgrounds. Online education has numerous upsides, but there is always some controversy about whether or not every learner will benefit from the same approach. The study was conducted in Tripura, a North-Eastern state of India, examine the efficacy of online training among the ERs responsible for extending the rural local government services to the common people. Methods. This study utilised the qualitative technique of focus group discussion to acquire a comprehensive grasp of the positive and negative opinions of ERs regarding their experiences with online training. Samples were collected from all the districts and all three tiers of rural government. Results. The study is a pioneering work to evaluate views of ERs on e-learning. Lack of technical support, boredom in training sessions, and lack of allowances for internet use, transportation to headquarters for training, and refreshments contributed the trainees' negative experiences. Further, training materials were poorly presented and failed to convey the intended message. Conclusions. This study will enable trainers, administrators, and policymakers to reengineer their andragogic structures of future grassroots online training programmes for higher efficacy. ERs dislike e-learning, and government regulations that favour classroom instruction worsen this issue. Policy initiatives to reconcile demand and supply, such as high-quality capacity building for Rural Local Bodies (RLBs) ERs with vernacular academics, are needed to achieve practical results

Management of Postoperative Hypoxaemia in Patients Following Upper Abdominal Laparoscopic Surgery. - A Comparative Study

Noninvasive ventilation has been shown to reduce acute postoperative hypoxaemia, with significant reduction in the incidence of re-intubation, complications and a trend towards lower mortality. The aim of the study was to determine the effectiveness of CPAP vs venturi therapy in early achievement of oxygenation goals and in prevention of re-intubation for management of postoperative hypoxaemia following laparoscopic cholecystectomy. Forty adult patients of ASA physical status I& II, scheduled for elective laparoscopic cholecystectomy, those were unable to maintain SpO2 > 95% breathing room air after extubation, were recruited for a prospective, randomized comparative study. Patients with PaO2 / FiO2 between 250 and 300 were included in the study and were randomly allocated to one of the two groups to receive oxygen therapy either using a CPAP of 10 cm of water and a FiO2 of 0.5 (Group A) or using a venturi mask of FiO2 of 0.5 (Group B) . All patients were observed postoperatively upto 18 h and were screened by ABG analyses at 6, 12 and 18 h of treatment. SpO2, ECG, heart rate, respiratory rate, temperature and NIBP were monitored throughout the study period. Patients in Group A showed significant improvement in early achievement of adequate oxygenation than those in Group B, although, due to intolerance to CPAP therapy two patients in Group A needed reintubation to maintain adequate oxygenation. To conclude, oxygenation using continuous positive airway pressure is a safe and effective means in improving gas exchange to treat acute postoperative hypoxaemia in conscious and cooperative patients