405 research outputs found

    Social equity impacts of increased water for irrigation

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    Water distributionIrrigation waterEquityTanksCanal irrigationVillagesEmploymentWagesGenderSocial aspectsWater users associationsFarmers

    A cross sectional study to assess the effects of unsupervised use of illegal over the counter pill for medical termination of pregnancy a cosmopolitan city of Central India

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    Background: In India, lack of awareness about the potential adverse effects of medical termination of pregnancy (MTP) pills and their easy over the counter illegal availability facilitates unsupervised usage. The objective of the study was to analyze the percentage of cases of incomplete abortion associated with unsupervised use of illegal over the counter MTP pill.Methods: This cross sectional observational study is conducted at tertiary level medical college Indore, India, from January 2011 till December 2011. Data of all patients who came during this duration for MTP, D and C for incomplete abortion/retained product of conception or with complications of medical abortion was analyzed prospectively.Results: Total 45 MTP and 60 D and C for incomplete abortion/retained products occurred in year 2011 out of which 44.44% of MTP were done for patients who had received medical abortion pills but not aborted. A staggering 80% of these patients received the pill over the counter without the prescription of the doctor. 61% of D and C performed were for incomplete abortion occurring due to medical abortion pills which were received over the counter. Three percent of the D and C were septic abortions out of which none was following instrumentation but all were following unprescribed medical abortion. Only 1.7% MTP was due to contraception failure, and the rest were due to unwanted pregnancy. 57.77 % women accepted post MTP contraception.Conclusions: Majority of patients who underwent MTP and D and C in this study have received over the counter pills for medical termination of pregnancy before seeking medical advice. Contraception acceptance remains the same. Over the counter availability of medical methods for termination of pregnancy represents a significant public health problem. Administrative measures, media publicity for and reduced cost of methods of contraception, strict legal rules for prescription and sale of medical methods of pregnancy termination is warranted

    A cross sectional study to assess the need of urodynamic studies in lower urinary tract patients attending an urogynaecology clinic

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    Background: Urodynamic studies are gold standard to objectively diagnose lower urinary tract symptoms and dysfunction Aims and Objectives: To correlate clinical symptoms of lower urinary tract with urodynamic study to know whether urodynamics is really required routinely in patients with lower urinary tract symptoms (LUTS).Methods: The study was conducted at Century hospital Hyderabad and Dr Lalitha’s urogynaecology clinic Hyderabad, India during 15 days; from 2 September 2015 till 16 September 2015 with 48 patients. All cases coming to urogynaecology clinic who were taken up for urodynamic study were included. Statistical analysis was done by  student’s t test with p<0.05 considered statistically significant.Results: Total patients with urinary frequency were 13 out of which 7 (53.84%) had cystometric capacity of less than 200ml. Out of 16 patients with urgency and urge incontinence 10 (62.50%) had high detrussor pressure during voiding. 50% patients had max cystometric capacity <200ml. Out of 7 patients with SUI (stress urinary incontinence) only one had genuine stress incontinence; all oth-ers had mixed incontinence with either raised EMG or raised Pdet. Out of 15 patients with com-plaints of voiding dysfunction 14 (93.33%) had low flow rate that is Qmax <15ml/sec. Out of 15 patients 2 had features of DSD (detrussor sphincter dyssynergia). Total 6 patients had raised EMG as cause for difficult voiding.Conclusions: Detrusor sphincter dyssynergia as a cause of dysfunctional voiding is diagnosed using urodynamic study with EMG. Urodynamic study is important and useful tool to evaluate female lower urinary tract symptoms and unnecessary delay in doing a detailed urodynamics should be avoided

    Socio-environmental dynamics and emerging groundwater dependencies in peri-urban Kathmandu Valley, Nepal

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    Groundwater is an increasingly important source of water supply in Kathmandu Valley, one of the fastest-growing South-Asian urban agglomerations. A groundwater policy drafted in 2012 was partly an outcome of an institutional restructuring of water management in Kathmandu Valley. Our findings in this article show that this policy lacks attention to peri-urban dynamics of change and growth and does little to address the unplanned and unregulated groundwater use in peri-urban locations in the valley, which urbanises at a faster rate than the main city. This article discusses the growing use of, and dependence on, groundwater in these rapidly evolving peri-urban spaces. Groundwater use continues to increase, despite growing protests and worries about its consequences. Our findings show that the polarised views and local conflicts around groundwater exploitation are the outcome of multiple entanglements: sectoral divides and overlapping responsibilities in water institutions, governance and management; social and economic transformations in peri-urban spaces; the invisibility of groundwater; and ambiguity in the hydrological dynamics of conjunctive water use. While we see no easy solutions to these problems, the policy-relevant recommendations we derive from our analysis of the drivers and the dynamics of using, governing and managing groundwater draw attention to the complex on-the-ground realities that need to be better understood for addressing macro-micro gaps in (ground)water management

    Flows of change: dynamic water rights and water access in peri-urban Kathmandu

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    Urbanization and the changing climate are increasingly influencing people’s access to land and water. Changes in use of, and rights and access to, land and water are most acutely experienced in peri-urban areas. We analyze these changes in peri-urban Kathmandu, Nepal. Increasing pressures on land and growing water needs of an expanding population in Kathmandu Valley are creating new patterns of water use, water-related conflicts, and (in)securities. We use two case studies that are characteristic of these changes, with a focus on the microlevel redefinitions of, and struggles about, rights, access, and notions of legitimate water use, and what these mean for water security and water conflict in a socially and institutionally complex and dynamic environment. Our findings show that these water-related changes cause contestations and conflicts between peri-urban water users. Amid increasing competition for water, people are using new sources and technologies, searching for negotiated solutions based on local norms and rights, and co-opting other water users through cooperation to create access opportunities and avoid conflicts. Our cases show self-restraint in practices of claiming or accessing water, while avoidance of conflicts also derives from an awareness of unequal power relations between user groups, past experiences of violence used against protesters, and lack of active intervention to regulate increasing exploitation of peri-urban land and water resources.</p

    Masculinities and hydropower in India:A feminist political ecology perspective

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    Mainstreaming gender in water governance through "how to do gender" toolkits has long been a development focus. It has been widely argued that such toolkits simplify the complex, nuanced realities of inequalities by gender in relation to water and fail to pay attention to the fact that the proposed users of such gender-water toolkits, i.e. mostly male water sector professionals, lack the skills, motivation and/or incentives to apply these toolkits in their everyday work. We adopt a feminist political ecology lens to analyse some of the barriers to reduce social inequalities in the management of global commons such as international rivers. Our findings highlight the leap of faith made in the belief that gender toolkits, as they exist, will filter through layers of a predominantly masculine institutional culture to enable change in ground realities of complex inequalities by gender. Analysing the everyday workings of two hydropower development organisations in India, we show how organisational structures demonstrate a blatant culture of masculinity. These two organisations, like many others, are sites where hierarchies and inequalities based on gender are produced, performed and reproduced. This performance of masculinity promotes and rewards a culture of technical pride in re-shaping nature, abiding by and maintaining hierarchy and demonstrating physical strength and emotional hardiness. In such a setting, paying attention to vulnerabilities, inequalities and disparities are incompatible objectives

    The consensual politics of development: a case study of hydropower development in the eastern Himalayan region of India

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    Criticism and contestation of large dam projects have a long, strong history in India. In this paper, we analyze diverse civil-society responses to large dam projects in the Eastern Himalaya region of India, which has in the past decades been presented as a clean, green, climate-mitigating way of generating energy, but critiqued for its adverse impacts more recently. We draw our findings primarily based on interviews with NGOs involved in environmental and/or water issues in Darjeeling, interviews with those involved in a local people’s movement ‘Affected Citizens of Teesta’, and participatory research over the course of three years between 2015 and 2018. Our findings show how doing development for the state, the market and/or donor organizations compromises the ability of NGOs in the Darjeeling region to hold these actors accountable for social and environmental excesses. In the same region, dam projects in North Sikkim led to a local people’s movement, where expressions of indigeneity, identity and place were used to critique and contest the State’s agenda of development, in ways that were symptomatically different to NGOs tied down by relations of developmental bureaucracy. Our findings reveal how the incursion of State authority, presence and power in civil-society undermines the civil society mandate of transformative social change, and additionally, how the geographical, political, institutional and identity-based divides that fragment diverse civil-society institutions and actors make it challenging to counter the increasingly consensual politics of environmental governance

    The hydro-social dynamics of exclusion and water insecurity of Dalits in peri-urban Kathmandu Valley, Nepal: fluid yet unchanging

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    Processes of urbanisation create peri-urban spaces that are socially and institutionally fluid. In this article, we analyse how contestations and competition over declining water resources in peri-urban Kathmandu Valley in Nepal reshape water use, access and rights as well as user communities themselves, by creating and reproducing new and existing exclusions and solidarities. Traditional caste-based discriminatory practices, prohibiting Dalits from physically accessing water from sources used by higher castes, are said to be no longer practiced in Nepal. However, our findings show that, exclusion persists for Dalits even though the characteristics of exclusion have changed. In situations of competing water claims in the research location, Dalit households, unlike higher-caste groups, are unable to exercise prior-use water rights. Their water insecurity is compounded by their relative inability to mobilise political, social and economic resources to claim and access new water services and institutions. By juxtaposing the hydro-social and social exclusion analytical frameworks, we demonstrate how exclusions as well as interpretations and experiences of water (in)security are reified in post-Maoist, supposedly inclusive Nepa

    Eclampsia: an enigma

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    Background: Eclampsia is the commonest cause of convulsions in pregnancy next being epilepsy. Incidence varies from 1 in 100 to 1 in 2000 pregnancies. Eclampsia accounts for 24% of all maternal deaths in India. Eclampsia is a significant cause of perinatal mortality and morbidity in non-industrialised countries (up to 40% perinatal deaths).Methods: We are reporting a retrospective study on the patients of eclampsia attending a tertiary care hospital. The study included 3907 deliveries conducted in VCSG Govt. Medical Science & Research Institute, Srinagar, Pauri Garhwal, Uttarakhand from April 2012 to Sep. 2014.Results: The total number of eclampsia cases was 98. The antepartum eclampsia cases were 87 and the postpartum eclampsia cases were 11.The incidence of antepartum eclampsia was 2.22% (87/3907) at our center. The total number of maternal deaths due to eclampsia was 6. The total Case Fatality Rate was 11.11% (6/57). There were 6 early neonatal deaths most commonly due to prematurity. There were 20 (22.99%) intrauterine deaths.Conclusions: Early prediction and diagnosis requires high index of suspicion and comprehensive training of health professionals at all levels of health care. The answer to poor management of eclampsia lies in better education and training of all obstetricians, anesthetists, midwives, and general practitioners in the diagnosis and treatment of severe pre-eclampsia and eclampsia
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