Feasibility and Sustainability Model for Identity Management

National Identity projects and providing such identification to citizens in various countries around the globe has captured attention of late. Although the perceived benefits are numerous, nonetheless the challenges and bottlenecks for a successful rollout are many. The objective of this paper is to put forward the drivers and inhibitors for adopting a common identity management system across various organizations and to suggest a model for determining the feasibility and sustainability of such a system. The paper develops on TAM for proposing a model for identifying the drivers and inhibitors of managing such an identity management exercise. This paper highlights various factors affecting successful implementation of an identity management system and investigates the impact of these factors. The model suggested in this paper would allow organizations and policy makers to determine the critical factors for the implementation of an identity management system in large scale.

Adoption of Mobile Financial Services among Rural Under-Banked

During the last decade, there has been tremendous growth in mobile penetration in many countries across the globe and most interestingly in a number of developing countries. On the other hand around, half of the world’s population is deprived of banking and financial services. This paper is based on a study that was aimed to identify drivers and inhibitors for adoption of MFS among the rural under-banked population and to compare the same with that of the existing studies. During the study, an extensive review of literature was conducted to identify the factors that were studied and found significantly affecting the adoption of mobile financial services. This was followed by an exploratory qualitative research conducted among the rural under-banked population of three distinct states in India. The findings of the study indicate that the demand for banking and financial services and the amount of hardships faced in availing these services through the existing channels of delivery can act as strong drivers for MFS adoption among the rural under-banked. On the other hand, factors like lack of trust on technology and lack of technology readiness were found to act as barriers to the adoption of MFS.

A Meta Analysis on Adoption of Mobile Financial Services

During the last decade, there has been tremendous growth in mobile penetration in many countries across the globe including a number of developing countries. The total number of mobile subscription 5 billion by the end of 2010 and is further expected to grow multi-folds. On the other hand, around 2.5 billion adults worldwide do not have a savings or credit account with either a regulated bank or alternative financial institution (such as a microfinance institution). Around one billion people in emerging markets have a mobile phone but no access to banking services. This scenario has opened immense opportunities for organizations including banks, insurance companies and telecom operators to strengthen their customer base and increase revenue by providing various financial services to the consumers through mobile technology. Hence, it becomes very important to understand the factors that would act as drivers or inhibitors towards the adoption of mobile financial services (MFS). Quite a few studies have been conducted across the globe to determine the factors affecting adoption of MFS. This paper provides a Meta analysis of the existing academic literature on MFS and determines the strength of the factors and their linkages through a scoring model based on the type of publication. The findings of the study would be beneficial for further research in understanding the dimensions to be considered for developing adoption model for MFS. The findings can also be used by the practitioners involved in MFS in understanding the factors affecting demand for such services.

Exploring the Factors Affecting the Adoption of Mobile Financial Services among the Rural Under-banked and its implications for Micro-finance Institutions

Around two and half billion adults worldwide do not have a savings or credit account with either a traditional (regulated bank) or alternative financial institution (such as a microfinance institution). On the other hand, penetration of mobile technology had been substantial in the past few years and is expected to increase in the future. Around one billion people in emerging markets have a mobile phone but no access to banking services and it is said that by 2012 this population will reach 1.7 billion. Financial institutions, which have had difficulty providing profitable services through traditional channels to poor clients, see mobile financial services (MFS) as a form of \u27branchless banking\u27, which lowers the costs of serving low-income customers. The main objective of this study was to determine the factors affecting the adoption of MFS (including mobile banking and mobile payments) among the rural under-banked population that would help the micro-finance institutions like credit cooperative societies to reach to more people with better quality of services

A study on cardiovascular fitness of male medical students

Background:Cardiovascular fitness has been found to be significantly compromised by obesity, whose prevalence is increasing rapidly. The present study aimed to assess the aerobic exercise performance in terms of maximum aerobic power (VO2 max) of the male students of North Bengal medical college in the age range of 18-22 years.Methods:The subjects were divided into two groups viz. control (N=52) and study (N=43) on the basis of Body Mass Index (BMI) and Waist Circumference (WC), according to the current Indian guidelines for obesity. The VO2 max was compared among the two groups. It was evaluated using the Bruce protocol, and also expressed in terms of ‘Metabolic equivalents’ (MET).  Results:VO2 max exhibited significant negative correlation with BMI (r=0.75, P <0.000) and WC (r=0.72, P <0.000). VO2 max was higher for the normal group compared to the study group, and the mean difference was significantly different [P <0.05(0.000)].  Conclusion:The study thus showed that cardiovascular capacity is compromised by excess adiposity

Outcome following emergency surgery for refractory severe ulcerative colitis in a tertiary care centre in India

Background: Steroid-based intensive medical therapy for severe ulcerative colitis is successful in 60-70% of such patients. Patients with complications or those refractory to medical therapy require emergency colectomy for salvage. Little is known about the impact of timing of surgical intervention and surgical outcomes of such patients undergoing emergency surgery in India where the diagnosis is often delayed or missed in patients who are poor, malnourished and non-compliant to medical treatment. Methods: The clinical records of all patients undergoing emergency surgery for severe ulcerative colitis or its complication in the Department of GI surgery AIIMS, New Delhi, India, between January 1985 and December 2003 were retrieved and data pertaining to demographic features, duration of intensive medical therapy, presence of complications, time from admission to emergency surgery, surgical procedure, in-hospital morbidity and mortality and follow up status extracted. Results: A total of 72 patients underwent emergency surgery (Subtotal colectomy: 60; ileostomy alone under local anaesthesia: 12). Poor nutritional status was seen in 61% of the patients. Twenty-one patients (29%) underwent emergency surgery for complications of severe ulcerative colitis such as colonic perforation (spontaneous 6, iatrogenic 4), massive lower gastrointestinal haemorrhage (5), toxic megacolon (4) and large bowel obstruction (2). The remaining patients (n = 51) underwent emergency surgery following failed intensive therapy; 17 underwent surgery ≤ 5 days (Group I) and 34 were operated >5 days (Group II) after initiation of intensive therapy. In this group all the post-operative deaths (n = 8) occurred in those who were operated after 5 days. The difference in mortality in these two groups (i.e. surgical intervention ≤ or > 5 days) was statistically significant {0/17 (Group I) vs 8/34 (Group II); p = 0.03}. Overall, 12 patients died (in-hospital mortality: 16.7%). The mortality was higher (10/43; 23.3%) in our early experience (i.e. 1985-1995) when compared to our subsequent experience (2/29; 6.9%) (1996-2003). A total of 48 patients (including 3 awaiting a restorative procedure) are alive on follow up (66.7%; 3 patients lost to follow up). A restorative procedure could be successfully completed in 81% of the survivors of the emergency procedure. Conclusion: To optimize the outcome, a combined team of physicians and surgeons should be involved in the management of patients with severe ulcerative colitis with focus on nutritional support, correction of metabolic derangements, close clinical monitoring and timely assessment for the need for emergency surgery. This retrospective analysis shows that improved results can be achieved with experience and by following a policy of early surgical intervention within 5 days, especially in patients who have failed intensive medical therapy

Acute cholecystitis with massive upper gastrointestinal bleed: A case report and review of the literature

BACKGROUND: Cystic artery pseudoaneurysm is a rare complication following cholecystitis. Its presentation with upper gastrointestinal hemorrhage (UGIH) is even rarer. Thirteen patients with cystic artery pseudoaneurysm have been reported in the literature but only 2 of them presented with UGIH alone. CASE PRESENTATION: We report a 43-year-old woman who developed a cystic artery pseudoaneurysm following an episode of acute cholecystitis. She presented with haematemesis and melaena associated with postural symptoms. Upper gastrointestinal endoscopy revealed a duodenal ulcer with adherent clots in the first part of the duodenum. Ultrasonography detected gallstones and a pseudoaneurysm at the porta hepatis. Selective hepatic angiography showed two small pseudoaneurysms in relation to the cystic artery, which were selectively embolized. However, the patient developed abdominal signs suggestive of gangrene of the gall bladder and underwent an emergency laparotomy. Cholecystectomy with common bile duct exploration along with repair of the duodenal rent, and pyloric exclusion and gastrojejunostomy was done. CONCLUSION: This case illustrates the occurrence of a rare complication (pseudoaneurysm) following cholecystitis with an unusual presentation (UGIH). Cholecystectomy, ligation of the pseudoaneurysm and repair of the intestinal communication is an effective modality of treatment

Splenectomy and proximal lieno-renal shunt in a factor five deficient patient with extra-hepatic portal vein obstruction

BACKGROUND: The clinico-surgical implication and successful management of a rare case of factor five (V) deficiency with portal hypertension and hypersplenism due to idiopathic extra-hepatic portal venous obstruction is presented. CASE PRESENTATION: A 16-year old boy had gastro-esophageal variceal bleeding, splenomegaly and hypersplenism. During preoperative workup prolonged prothrombin time and activated partial thromboplastin time were detected, which on further evaluation turned out to be due to factor V deficiency. Proximal lieno-renal shunt and splenectomy were successfully performed with transfusion of fresh frozen plasma during and after the surgical procedure. At surgery there was no excessive bleeding. The perioperative course was uneventful and the patient is doing well on follow up. CONCLUSION: Surgical portal decompressive procedures can be safely undertaken in clotting factor deficient patients with portal hypertension if meticulous surgical hemostasis is achieved at operation and the deficient factor is adequately replaced in the perioperative period

Hepatobiliary and pancreatic tuberculosis: A two decade experience

<p>Abstract</p> <p>Background</p> <p>Isolated hepatobiliary or pancreatic tuberculosis (TB) is rare and preoperative diagnosis is difficult. We reviewed our experience over a period two decades with this rare site of abdominal tuberculosis.</p> <p>Methods</p> <p>The records of 18 patients with proven histological diagnosis of hepatobiliary and pancreatic tuberculosis were reviewed retrospectively. The demographic features, sign and symptoms, imaging, cytology/histopathology, procedures performed, outcome and follow up data were obtained from the departmental records. The diagnosis of tuberculosis was based on granuloma with caseation necrosis on histopathology or presence of acid fast bacilli.</p> <p>Results</p> <p>Of 18 patients (11 men), 11 had hepatobiliary TB while 7 had pancreatic TB. Two-thirds of the patients were < 40 years (mean: 42 yrs; range 19–70 yrs). The duration of the symptoms varied between 2 weeks to 104 weeks (mean: 20 weeks). The most common symptom was pain in the abdomen (n = 13), followed by jaundice (n = 10), fever, anorexia and weight loss (n = 9). Five patients (28%) had associated extra-abdominal TB which helped in preoperative diagnosis in 3 patients. Imaging demonstrated extrahepatic bile duct obstruction in the patients with jaundice and in addition picked up liver, gallbladder and pancreatic masses with or without lymphadenopathy (peripancreatic/periportal). Preoperative diagnosis was made in 4 patients and the other 14 were diagnosed after surgery. Two patients developed significant postoperative complications (pancreaticojejunostomy leak <abbrgrp><abbr bid="B1">1</abbr></abbrgrp> intraabdominal abscess <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>) and 3 developed ATT induced hepatotoxicity. No patient died. The median follow up period was 12 months (9 – 96 months).</p> <p>Conclusion</p> <p>Tuberculosis should be considered as a differential diagnosis, particularly in young patients, with atypical signs and symptoms coming from areas where tuberculosis is endemic and preoperative tissue and/or cytological diagnosis should be attempted before labeling them as hepatobiliary and pancreatic malignancy.</p