A nexus approach to energy, water, and food security policy making in India

University of Technology Sydney. Faculty of Engineering and Information Technology.Prompted by the rising concerns about the security of Energy-Water-Food (EWF) – innate human needs – and premised upon the contention about the siloedness, and hence inadequacy, of current policy approaches to redress EWF security – this research examines the efficacy of EWF nexus-informed policy-approach for redressing EWF security in the context of India – a country whose future prosperity is critically dependent on the provision of adequate quantities of EWF, at affordable prices and by sustainable means. To achieve this objective this research has developed an EWF-extended Input-Output framework (model), supported by flexible production functions to accommodate price-induced input substitution possibilities. This framework is employed in this research to examine the impacts – in terms of selected attributes for EWF security, economic, social and environmental outcomes, over the period 2015-2047 – of (five) alternative policy pathways (scenarios). These scenarios include: Business-as-Usual (BAU), Energy Security (ES), Water Security (WS), Food Security (FS), and EWF-Nexus-oriented (Nexus). Each scenario represents specific policy emphasis (e.g., ES scenario, on improving energy security; WS - water security, FS - food security, and Nexus - joint EWF security). Accordingly, each scenario is supported by a range of emphasis-relevant technologies and strategic measures to achieve its policy objective. The analysis in this research presents a rather insightful array of indications about EWF security, economic, social and environmental outcomes – over the short, medium, and long-term. For example, the ES scenario, while producing best energy security and economic outcomes in the long-term, is likely produce considerably worsened water security throughout the study period; and yield worst environmental outcomes in the short and medium-term. The FS scenario – while producing consistently superior food security outcomes, also produces the best water security outcomes in the short-term, and worst energy security outcomes in all time periods. The WS scenario, while producing considerably improved water security in the long-term, is likely to produce worst economic outcomes throughout the study period. Overall, the Nexus scenario produces the best joint EWF security outcomes, and considerably superior economic, social and environmental outcomes. These insights – especially cross-sectoral (e.g., energy, water, food), cross-domain (security, economic, social, environmental), and temporal (short, medium and long-term) trade-offs – should provide the Indian policy-makers a robust platform for engendering policy debate and making appropriate policy choices for redressing the EWF security challenge, and for other pressing challenges underscored by multiplicity of interdependencies. Therein resides the significance of this research – it is argued

Small bowel obstruction due to subserosal endometriosis: an elusive condition

The bowel is involved in 3.8 to 37% of women with endometriosis, out of which nearly 1% present with signs of bowel obstruction to the surgeon. This report describes a case of acute small bowel obstruction in a 23 years old woman. The patient gave a history of intermittent episodes of pain abdomen and abdominal distension for the past 1 year with significant loss of weight. The menstrual cycles were normal. Although there was no history of Tuberculosis, a positive history of contact was present. The clinical and biochemical picture was suggestive of peritonitis. CECT of the abdomen revealed a long segment distal ileal stricture. With a provisional diagnosis of Tubercular Ileo-Caecal stricture perforation, a midline exploratory laparotomy was performed. The procedure consisted of right limited hemicolectomy and primary ileo-ascending anastomosis with a proximal loop ileostomy. Ileostomy was done to allow the healing of distal anastomosis and closure was done after 4 weeks. Histopathology of the resected segment of ileum revealed subserosal endometriosis. Postoperatively, the patient was not given any hormonal therapy and recovery has been uneventful over the past 1 year of follow up

Are preeclampsia and small for gestational age baby could be predicted by placental location?

Objective: Preeclampsia is one of the major cause of maternal and perinatal mortality and morbidity. The pathophysiology is complex and involves multiple organs. The purpose of this study was to find out whether the placental laterality as a predictor of preeclampsia and small for gestational age baby.Methods: This was prospective observational study conducted from February 2015 to December 2015, in a tertiary care hospital of Delhi. 347 antenatal patients attending obstetrics OPD without high risk factors were enrolled. After enrolment 50 patients were lost to follow up and 27 not delivered in our hospital. Ultrasonography for placental localization was done at 18-24 weeks of pregnancy. Patients were followed till delivery for pregnancy outcomes such as preeclampsia, small for gestation age (SGA) baby and mode of delivery. Placenta locations were divided into lateral (either right or left) and central (anterior, posterior or fundal).Results: Out of 347, a total of 270 patients were analysed, 39 (14.4%) had lateral placenta and among them 17 (43.5%) developed preeclampsia and 24 (61.5%) had small for gestational age baby (p<0.001). 231 (85.5%) had central placenta and among them 49 (21.2%) developed preeclampsia and 63 (27.2%) had small for gestational age baby (p <0.001).Conclusions: Laterally located placenta had significant association with preeclampsia and small for gestational age babies

Small bowel obstruction due to subserosal endometriosis: an elusive condition

The bowel is involved in 3.8 to 37% of women with endometriosis, out of which nearly 1% present with signs of bowel obstruction to the surgeon. This report describes a case of acute small bowel obstruction in a 23 years old woman. The patient gave a history of intermittent episodes of pain abdomen and abdominal distension for the past 1 year with significant loss of weight. The menstrual cycles were normal. Although there was no history of Tuberculosis, a positive history of contact was present. The clinical and biochemical picture was suggestive of peritonitis. CECT of the abdomen revealed a long segment distal ileal stricture. With a provisional diagnosis of Tubercular Ileo-Caecal stricture perforation, a midline exploratory laparotomy was performed. The procedure consisted of right limited hemicolectomy and primary ileo-ascending anastomosis with a proximal loop ileostomy. Ileostomy was done to allow the healing of distal anastomosis and closure was done after 4 weeks. Histopathology of the resected segment of ileum revealed subserosal endometriosis. Postoperatively, the patient was not given any hormonal therapy and recovery has been uneventful over the past 1 year of follow up