Search results for: Ajay Panchal

Authors: Kumar Gular, Viswanathan S., Mastour Saeed Alshahrani, Ravi Shankar Reddy, Jaya Shanker Tedla, Snehil Dixit, Ajay Prasad Gautam, Venkata Nagaraj Kakaraparthi, Devika Rani Sangadala

Abstract:

Background: Despite trunk control’s significant contribution to improving various functional activity components, the independent effect of trunk performance on quality of life is yet to be estimated in stroke survivors. Ascertaining the correlation between trunk control and self-reported quality of life while evaluating the effect of demographic and clinical characteristics on their relationship will guide concerned healthcare professionals in designing ideal rehabilitation protocols during the late sub-acute stroke stage of recovery. The aims of the present research were to (1) investigate the associations of trunk performance with self-rated quality of life and (2) evaluate if age, body mass index (BMI), and clinical characteristics mediate the relationship between trunk motor performance and perceived quality of life in the sub-acute stroke population. Methods: Trunk motor functions and quality of life among the late sub-acute stroke population aged 57.53 ± 6.42 years were evaluated through the trunk Impairment Scale (TIS) and Stroke specific quality of life (SSQOL) questionnaire, respectively. Pearson correlation coefficients and mediation analysis were performed to elucidate the relationship of trunk motor function with quality of life and determine the mediation impact of demographic and clinical characteristics on their association, respectively. Results: The current study observed significant correlations between trunk motor functions (TIS) and quality of life (SSQOL) with r=0.68 (p<0.001). Age, BMI, and type of stroke were detected as potential mediating factors in the association between trunk performance and quality of life. Conclusion: Validated associations between trunk motor functions and perceived quality of life among the late sub-acute stroke population emphasize the importance of comprehensive evaluation of trunk control. Rehabilitation specialists should focus on appropriate strategies to enhance trunk performance anticipating the potential effects of age, BMI, and type of stroke to improve health-related quality of life in stroke survivors.

Keywords: sub-acute stroke, quality of life, functional independence, trunk control

Procedia PDF Downloads 80

Authors: Ajay Kumar Sinha, Sharad Singh, Anukriti Sinha

Abstract:

Passive energy dissipation method for earthquake protection of structures is undergoing developments for improved performance. Combined use of different types of damping mechanisms has shown positive results in the near past. Different supplemental damping methods like viscous damping, frictional damping and metallic damping are being combined together for optimum performance. The conventional method of connecting passive dampers to structures is a parallel connection between the damper unit and structural member. Researchers are investigating coupling effect of different types of dampers. The most popular choice among the research community is coupling of viscous dampers and frictional dampers. The series and parallel coupling of these damping units are being studied for relative performance of the coupled system on response control of structures against earthquake. In this paper an attempt has been made to couple Fluid Viscous Dampers and Frictional Dampers in series and parallel to form a single unit of damping system. The relative performance of the coupled units has been studied on three dimensional reinforced concrete framed structure. The current theories of structural dynamics in practice for viscous damping and frictional damping have been incorporated in this study. The time history analysis of the structural system with coupled damper units, uncoupled damper units as well as of structural system without any supplemental damping has been performed in this study. The investigations reported in this study show significant improved performance of coupled system. A higher natural frequency of the system outside the forcing frequency has been obtained for structural systems with coupled damper units as against the other cases. The structural response of the structure in terms of storey displacement and storey drift show significant improvement for the case with coupled damper units as against the cases with uncoupled units or without any supplemental damping. The results are promising in terms of improved response of the structure with coupled damper units. Further investigations in this regard for a comparative performance of the series and parallel coupled systems will be carried out to study the optimum behavior of these coupled systems for enhanced response control of structural systems.

Keywords: frictional damping, parallel coupling, response control, series coupling, supplemental damping, viscous damping

Procedia PDF Downloads 458

Authors: Jitendar Kumar Tiwari, Ajay Mandal, N. Sathish, A. K. Srivastava

Abstract:

Since the last decade, graphene achieved great attention toward the progress of multifunction metal matrix composites, which are highly demanded in industries to develop energy-efficient systems. This study covers the two advanced aspects of the latest scientific endeavor, i.e., graphene as reinforcement in metallic materials and additive manufacturing (AM) as a processing technology. Herein, high-quality graphene and AlSi10Mg powder mechanically mixed by very low energy ball milling with 0.1 wt. % and 0.2 wt. % graphene. Mixed powder directly subjected to the powder bed fusion process, i.e., an AM technique to produce composite samples along with bare counterpart. The effects of graphene on porosity, microstructure, and mechanical properties were examined in this study. The volumetric distribution of pores was observed under X-ray computed tomography (CT). On the basis of relative density measurement by X-ray CT, it was observed that porosity increases after graphene addition, and pore morphology also transformed from spherical pores to enlarged flaky pores due to improper melting of composite powder. Furthermore, the microstructure suggests the grain refinement after graphene addition. The columnar grains were able to cross the melt pool boundaries in case of the bare sample, unlike composite samples. The smaller columnar grains were formed in composites due to heterogeneous nucleation by graphene platelets during solidification. The tensile properties get affected due to induced porosity irrespective of graphene reinforcement. The optimized tensile properties were achieved at 0.1 wt. % graphene. The increment in yield strength and ultimate tensile strength was 22% and 10%, respectively, for 0.1 wt. % graphene reinforced sample in comparison to bare counterpart while elongation decreases 20% for the same sample. The hardness indentations were taken mostly on the solid region in order to avoid the collapse of the pores. The hardness of the composite was increased progressively with graphene content. Around 30% of increment in hardness was achieved after the addition of 0.2 wt. % graphene. Therefore, it can be concluded that powder bed fusion can be adopted as a suitable technique to develop graphene reinforced AlSi10Mg composite. Though, some further process modification required to avoid the induced porosity after the addition of graphene, which can be addressed in future work.

Keywords: graphene, hardness, porosity, powder bed fusion, tensile properties

Procedia PDF Downloads 128

Authors: Ashneel Ajay Singh, Naoki Suzuki, Kazumi Sakuramoto,

Abstract:

The North Pacific albacore (Thunnus alalunga) is a temperate tuna species distributed in the North Pacific which is of significant economic importance to the Pacific Island Nations and Territories. Despite its importance, the stock dynamics and ecological characteristics of albacore still, have gaps in knowledge. The stock-recruitment relationship of the North Pacific stock of albacore tuna was investigated for different density-dependent effects and a regime shift in the stock characteristics in response to changes in environmental and climatic conditions. Linear regression analysis for recruit per spawning biomass (RPS) and recruitment (R) against the female spawning stock biomass (SSB) were significant for the presence of different density-dependent effects and positive for a regime shift in the stock time series. Application of Deming regression to RPS against SSB with the assumption for the presence of observation and process errors in both the dependent and independent variables confirmed the results of simple regression. However, R against SSB results disagreed given variance level of < 3 and agreed with linear regression results given the assumption of variance ≥ 3. Assuming the presence of different density-dependent effects in the albacore tuna time series, environmental and climatic condition variables were compared with R, RPS, and SSB. The significant relationship of R, RPS and SSB were determined with the sea surface temperature (SST), Pacific Decadal Oscillation (PDO) and multivariate El Niño Southern Oscillation (ENSO) with SST being the principal variable exhibiting significantly similar trend with R and RPS. Recruitment is significantly influenced by the dynamics of the SSB as well as environmental conditions which demonstrates that the stock-recruitment relationship is multidimensional. Further investigation of the North Pacific albacore tuna age-class and structure is necessary for further support the results presented here. It is important for fishery managers and decision makers to be vigilant of regime shifts in environmental conditions relating to albacore tuna as it may possibly cause regime shifts in the albacore R and RPS which should be taken into account to effectively and sustainability formulate harvesting plans and management of the species in the North Pacific oceanic region.

Keywords: Albacore tuna, Thunnus alalunga, recruitment, spawning stock biomass, recruits per spawning biomass, sea surface temperature, pacific decadal oscillation, El Niño southern oscillation, density-dependent effects, regime shift

Procedia PDF Downloads 307

Authors: Karan Sharma, Ajay Kumar

Abstract:

Epileptic seizure is a type of disease due to which electrical charge in the brain flows abruptly resulting in abnormal activity by the subject. One percent of total world population gets epileptic seizure attacks.Due to abrupt flow of charge, EEG (Electroencephalogram) waveforms change. On the display appear a lot of spikes and sharp waves in the EEG signals. Detection of epileptic seizure by using conventional methods is time-consuming. Many methods have been evolved that detect it automatically. The initial part of this paper provides the review of techniques used to detect epileptic seizure automatically. The automatic detection is based on the feature extraction and classification patterns. For better accuracy decomposition of the signal is required before feature extraction. A number of parameters are calculated by the researchers using different techniques e.g. approximate entropy, sample entropy, Fuzzy approximate entropy, intrinsic mode function, cross-correlation etc. to discriminate between a normal signal & an epileptic seizure signal.The main objective of this review paper is to present the variations in the EEG signals at both stages (i) Interictal (recording between the epileptic seizure attacks). (ii) Ictal (recording during the epileptic seizure), using most appropriate methods of analysis to provide better healthcare diagnosis. This research paper then investigates the effects of a noninvasive healing therapy on the subjects by studying the EEG signals using latest signal processing techniques. The study has been conducted with Reiki as a healing technique, beneficial for restoring balance in cases of body mind alterations associated with an epileptic seizure. Reiki is practiced around the world and is recommended for different health services as a treatment approach. Reiki is an energy medicine, specifically a biofield therapy developed in Japan in the early 20th century. It is a system involving the laying on of hands, to stimulate the body’s natural energetic system. Earlier studies have shown an apparent connection between Reiki and the autonomous nervous system. The Reiki sessions are applied by an experienced therapist. EEG signals are measured at baseline, during session and post intervention to bring about effective epileptic seizure control or its elimination altogether.

Keywords: EEG signal, Reiki, time consuming, epileptic seizure

Procedia PDF Downloads 407

Authors: Soumita Banerjee

Abstract:

The State of West Bengal is mostly watered by innumerable rivers, and they are different in nature in both the northern and the southern part of the state. The southern part of West Bengal is mainly drained with the river Bhagirathi-Hooghly, and its major distributaries and tributaries have divided this major river basin into many subparts like the Ichamati-Bidyadhari, Pagla-Bansloi, Mayurakshi-Babla, Ajay, Damodar, Kangsabati Sub-basin to name a few. These rivers basically drain the Districts of Bankura, Burdwan, Hooghly, Nadia and Purulia, Birbhum, Midnapore, Murshidabad, North 24-Parganas, Kolkata, Howrah and South 24-Parganas. West Bengal has a huge number of flood-prone blocks in the southern part of the state of West Bengal, the responsible factors for flood situation are the shape and size of the catchment area, its steep gradient starting from plateau to flat terrain, the river bank erosion and its siltation, tidal condition especially in the lower Ganga Basin and very low maintenance of the embankments which are mostly used as communication links. Along with these factors, DVC (Damodar Valley Corporation) plays an important role in the generation (with the release of water) and controlling the flood situation. This year the whole Gangetic West Bengal is being flooded due to high intensity and long duration rainfall, and the release of water from the Durgapur Barrage As most of the rivers are interstate in nature at times floods also take place with release of water from the dams of the neighbouring states like Jharkhand. Other than Embankments, there is no such structural measures for combatting flood in West Bengal. This paper tries to analyse the reasons behind the flood situation this year especially with the help of climatic data collected from the Indian Metrological Department, flood related data from the Irrigation and Waterways Department, West Bengal and GPM (General Precipitation Measurement) data for rainfall analysis. Based on the threshold value derived from the calculation of the past available flood data, it is possible to predict the flood events which may occur in the near future and with the help of social media it can be spread out within a very short span of time to aware the mass. On a larger or a governmental scale, heightening the settlements situated on the either banks of the river can yield a better result than building up embankments.

Keywords: dam failure, embankments, flood, rainfall

Procedia PDF Downloads 226

Authors: Surinder Pal, Ajay Gupta, Johny Khajuria

Abstract:

Casting simulation helps visualize mold filling and casting solidification; predict related defects like cold shut, shrinkage porosity and hard spots; and optimize the casting design to achieve the desired quality with high yield. Flow and solidification of molten metals are, however, a very complex phenomenon that is difficult to simulate correctly by conventional computational techniques, especially when the part geometry is intricate and the required inputs (like thermo-physical properties and heat transfer coefficients) are not available. Simulation software is based on the process of modeling a real phenomenon with a set of mathematical formulas. It is, essentially, a program that allows the user to observe an operation through simulation without actually performing that operation. Simulation software is used widely to design equipment so that the final product will be as close to design specs as possible without expensive in process modification. Simulation software with real-time response is often used in gaming, but it also has important industrial applications. When the penalty for improper operation is costly, such as airplane pilots, nuclear power plant operators, or chemical plant operators, a mockup of the actual control panel is connected to a real-time simulation of the physical response, giving valuable training experience without fear of a disastrous outcome. The all casting simulation software has own requirements, like magma cast has only best for crack simulation. The latest generation software Auto CAST developed at IIT Bombay provides a host of functions to support method engineers, including part thickness visualization, core design, multi-cavity mold design with common gating and feeding, application of various feed aids (feeder sleeves, chills, padding, etc.), simulation of mold filling and casting solidification, automatic optimization of feeders and gating driven by the desired quality level, and what-if cost analysis. IIT Bombay has developed a set of applications for the foundry industry to improve casting yield and quality. Casting simulation is a fast and efficient solution for process for advanced tool which is the result of more than 20 years of collaboration with major industrial partners and academic institutions around the world. In this paper the process of casting simulation is studied.

Keywords: casting simulation software’s, simulation technique’s, casting simulation, processes

Procedia PDF Downloads 476

Authors: Ajay Mandal, Jitendar Kumar Tiwari, N. Sathish, A. K. Srivastava

Abstract:

A fundamental investigation is performed on the development of graphene (Gr) reinforced stainless steel 316L (SS 316L) metal matrix composite via selective laser melting (SLM) in order to improve specific strength and wear resistance property of SS 316L. Firstly, SS 316L powder and graphene were mixed in a fixed ratio using low energy planetary ball milling. The milled powder is then subjected to the SLM process to fabricate composite samples at a laser power of 320 W and exposure time of 100 µs. The prepared composite was mechanically tested (hardness and tensile test) at ambient temperature, and obtained results indicate that the properties of the composite increased significantly with the addition of 0.2 wt. % Gr. Increment of about 25% (from 194 to 242 HV) and 70% (from 502 to 850 MPa) is obtained in hardness and yield strength of composite, respectively. Raman mapping and XRD were performed to see the distribution of Gr in the matrix and its effect on the formation of carbide, respectively. Results of Raman mapping show the uniform distribution of graphene inside the matrix. Electron back scatter diffraction (EBSD) map of the prepared composite was analyzed under FESEM in order to understand the microstructure and grain orientation. Due to thermal gradient, elongated grains were observed along the building direction, and grains get finer with the addition of Gr. Most of the mechanical components are subjected to several types of wear conditions. Therefore, it is very necessary to improve the wear property of the component, and hence apart from strength and hardness, a tribological property of composite was also measured under dry sliding condition. Solid lubrication property of Gr plays an important role during the sliding process due to which the wear rate of composite reduces up to 58%. Also, the surface roughness of worn surface reduces up to 70% as measured by 3D surface profilometry. Finally, it can be concluded that SLM is an efficient method of fabricating cutting edge metal matrix nano-composite having Gr like reinforcement, which was very difficult to fabricate through conventional manufacturing techniques. Prepared composite has superior mechanical and tribological properties and can be used for a wide variety of engineering applications. However, due to the unavailability of a considerable amount of literature in a similar domain, more experimental works need to perform, such as thermal property analysis, and is a part of ongoing study.

Keywords: selective laser melting, graphene, composite, mechanical property, tribological property

Procedia PDF Downloads 136

Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

Abstract:

Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

Procedia PDF Downloads 135

Authors: Ajay Das, Sandip Basu

Abstract:

Introduction: There is increasing recognition that diverse streams of knowledge can often be recombined in novel ways to generate new knowledge. However, knowledge recombination theory has not been applied to examine the effects of collaborator diversity on the quality of knowledge such collaborators produce. This is surprising because one would expect that a collaborative team with certain aspects of diversity should be able to recombine process elements related to knowledge development, which are relatively tacit, but also complementary because of the collaborator’s varying backgrounds. Theory and Hypotheses: We propose to examine two aspects of diversity in the environments of collaborative teams to try and capture such potential recombinations of relatively tacit, process knowledge. The first aspect of diversity in team members’ environments is geographical. Collaborators with more geographical distance between them (perhaps working in different countries) often have more autonomy in the processes they adopt for knowledge development. In the absence of overt monitoring, such collaborators are likely to adopt differing approaches to knowledge development. The sharing of such varying approaches among collaborators is likely to result in greater quality of the common collaborative pursuit. The second aspect is diversity in the work backgrounds of team members. Such diversity can also increase the potential for knowledge recombination. For example, if one or more members are from a manufacturing center (versus all of them being from a purely R&D center), such members will provide unique perspectives on the implementation of innovative ideas. Again, knowledge that has been evaluated from these diverse perspectives is likely to be of a higher quality. In addition to the above aspects of environmental diversity among team members, we also plan to examine the extent to which individual collaborators are in different environments from the primary innovation center of their employing firms. Proposed Methods: We will test our model on a sample of firms in the semiconductor industry. Our level of analysis will be individual patents generated by these firms and the teams involved in the generation of these. Information on manufacturing activities of our sample firms will be obtained from SEMI, a proprietary database of the semiconductor industry, as well as company 10-K reports. Conclusion: We believe that our results will represent a preliminary attempt to understand how various forms of diversity in collaborative teams impact the knowledge development process. Our dependent variable of knowledge quality is important to study since higher values of this variable can not only drive firm performance but the broader development of regions and societies through spillover impacts on future innovation. The results of this study will, therefore, inform future research and practice in innovation, geographical location, and vertical integration.

Keywords: innovation, manufacturing strategy, knowledge, diversity

Procedia PDF Downloads 353

Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

Abstract:

Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

Procedia PDF Downloads 92

Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

Abstract:

Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

Procedia PDF Downloads 66

Authors: Hitesh Kshayap, Shantanu Arya, Ajay Basod, Sachin Sakhuja

Abstract:

This study was undertaken to measure the overall noise levels in different locations/zones and to estimate the prevalence of Noise induced hearing loss in Hawkers & Shopkeepers in Mumbai, India. The Hearing Test developed by American Academy Of Otolaryngology, translated from English to Hindi, and validated is used as a screening tool for hearing sensitivity was employed. The tool is having 14 items. Each item is scored on a scale 0, 1, 2 and 3. The score 6 and above indicated some difficulty or definite difficulty in hearing in daily activities and low score indicated lesser difficulty or normal hearing. The subjects who scored 6 or above or having tinnitus were made to undergo hearing evaluation by Pure tone audiometer. Further, the environmental noise levels were measured from Morning to Evening at road side at different Location/Hawking zones in Mumbai city using SLM9 Agronic 8928B & K type Digital Sound Level Meter) in dB (A). The maximum noise level of 100.0 dB (A) was recorded during evening hours from Chattrapati Shivaji Terminal to Colaba with overall noise level of 79.0 dB (A). However, the minimum noise level in this area was 72.6 dB (A) at any given point of time. Further, 54.6 dB (A) was recorded as minimum noise level during 8-9 am at Sion Circle. Further, commencement of flyovers with 2-tier traffic, sky walks, increasing number of vehicular traffic at road, high rise buildings and other commercial & urbanization activities in the Mumbai city most probably have resulted in increasing the overall environmental noise levels. Trees which acted as noise absorbers have been cut owing to rapid construction. The study involved 100 participants in the age range of 18 to 40 years of age, with the mean age of 29 years (S.D. =6.49). 46 participants having tinnitus or have obtained the score of 6 were made to undergo Pure Tone Audiometry and it was found that the prevalence rate of hearing loss in hawkers & shopkeepers is 19% (10% Hawkers and 9 % Shopkeepers). The results found indicates that 29 (42.6%) out of 64 Hawkers and 17 (47.2%) out of 36 Shopkeepers who underwent PTA had no significant difference in percentage of Noise Induced Hearing loss. The study results also reveal that participants who exhibited tinnitus 19 (41.30%) out of 46 were having mild to moderate sensorineural hearing loss between 3000Hz to 6000Hz. The Pure tone Audiogram pattern revealed Hearing loss at 4000 Hz and 6000 Hz while hearing at adjacent frequencies were nearly normal. 7 hawkers and 8 shopkeepers had mild notch while 3 hawkers and 1 shopkeeper had a moderate degree of notch. It is thus inferred that tinnitus is a strong indicator for presence of hearing loss and 4/6 KHz notch is a strong marker for road/traffic/ environmental noise as an occupational hazard for hawkers and shopkeepers. Mass awareness about these occupational hazards, regular hearing check up, early intervention along with sustainable development juxtaposed with social and urban forestry can help in this regard.

Keywords: NIHL, noise, sound level meter, tinnitus

Procedia PDF Downloads 204

Authors: Ajay Kumar Pandey

Abstract:

White grub (Coleoptera: Scarabaeidae), locally known as Kurmula, Pagra, Chinchu, is a major destructive pest in western Himalayan region of Uttarakhand state of India. Various crops like cereals (up land paddy, wheat, and barley), vegetables (capsicum, cabbage, tomato, cauliflower, carrot etc) and some pulse (like pigeon pea, green gram, black gram) are grown with limited availability of primary resources. Among the various limitations in successful cultivation of these crops, white grub has been proved a major constraint in for all crops grown in hilly area. The losses incurred due to white grubs are huge in case of commercial crops like sugarcane, groundnut, potato, maize and upland rice. Moreover, it has been proved major constraint in potato production in mid and higher hills of India. Adults emerge in May-June following the onset of monsoon and thereafter defoliate the apple, apricot, plum, and walnut during night while 2nd and 3rd instar grubs feed on live roots of cultivated as well as non cultivated crops from August to January. Survey was conducted in hilly (Pauri and Tehri) as well as plain area (Haridwar district) of Uttarakhand state. Collection of beetle was done from various locations from August to September of five consecutive years with the help of light trap and directly from host plant. The grub was also collected by excavating one square meter area from different locations and reared in laboratory to find out adult. During the collection, the diseased or dead cadaver were also collected and brought in the laboratory and identified the causal organisms. Total 25 species of white grub was identified out of which Holotrichia longipennis, Anomala dimidiata, Holotrichia lineatopennis, Maladera insanabilis, Brahmina sp. make complex problem in different area of Uttarakhand where they cause severe damage to various crops. During the survey, it was observed that white grubs beetles have variation in preference of host plant, even in choice of fruit and leaves of host plant. It was observed that, a white grub species, which identified as Lepidiota mansueta Burmeister., was causing severe havoc to sugarcane crop grown in major sugarcane growing belt of Haridwar district. The study also revealed that Bacillus cereus, Beauveria bassiana, Metarhizium anisopliae, Steinernema, Heterorhabditis are major disease causing agents in immature stage of white grub under rain-fed condition of Uttarakhand which caused 15.55 to 21.63 percent natural mortality of grubs with an average of 18.91 percent. However, among the microorganisms, B. cereus found to be significantly more efficient (7.03 percent mortality) then the entomopathogenic fungi (3.80 percent mortality) and nematodes (3.20 percent mortality).

Keywords: Lepidiota, profiling, Uttarakhand, whitegrub

Procedia PDF Downloads 222

Authors: Neelam Taneja, Abhishek Mewara, Ajay Kumar

Abstract:

Multidrug resistant shigellae have emerged as a therapeutic challenge in India. At our 2000 bed tertiary care referral centre in Chandigarh, North India, which caters to a large population of 7 neighboring states, antibiotic resistance in Shigella is being constantly monitored. Shigellae are isolated from 3 to 5% of all stool samples. In 1990 nalidixic acid was the drug of choice as 82%, and 63% of shigellae were resistant to ampicillin and cotrimoxazole respectively. Nalidixic acid resistance emerged in 1992 and rapidly increased from 6% during 1994-98 to 86% by the turn of 21st century. In the 1990s, the WHO recommended ciprofloxacin as the drug of choice for empiric treatment of shigellosis in view of the existing high level resistance to agents like chloramphenicol, ampicillin, cotrimoxazole and nalidixic acid. First resistance to ciprofloxacin in S. flexneri at our centre appeared in 2000 and rapidly rose to 46% in 2007 (MIC>4mg/L). In between we had an outbreak of ciprofloxacin resistant S.dysenteriae serotype 1 in 2003. Therapeutic failures with ciprofloxacin occurred with both ciprofloxacin-resistant S. dysenteriae and ciprofloxacin-resistant S. flexneri. The severity of illness was more with ciprofloxacin-resistant strains. Till 2000, elsewhere in the world ciprofloxacin resistance in S. flexneri was sporadic and uncommon, though resistance to co-trimoxazole and ampicillin was common and in some areas resistance to nalidixic acid had also emerged. Fluoroquinolones due to extensive use and misuse for many other illnesses in our region are thus no longer the preferred group of drugs for managing shigellosis in India. WHO presently recommends ceftriaxone and azithromycin as alternative drugs to fluoroquinolone-resistant shigellae, however, overreliance on this group of drugs also seems to soon become questionable considering the emerging cephalosporin-resistant shigellae. We found 15.1% of S. flexneri isolates collected over a period of 9 years (2000-2009) resistant to at least one of the third-generation cephalosporins (ceftriaxone/cefotaxime). The first isolate showing ceftriaxone resistance was obtained in 2001, and we have observed an increase in number of isolates resistant to third generation cephalosporins in S. flexneri 2005 onwards. This situation has now become a therapeutic challenge in our region. The MIC values for Shigella isolates revealed a worrisome rise for ceftriaxone (MIC90:12 mg/L) and cefepime (MIC90:8 mg/L). MIC values for S. dysenteriae remained below 1 mg/L for ceftriaxone, however for cefepime, the MIC90 has raised to 4 mg/L. These infections caused by ceftriaxone-resistant S. flexneri isolates were successfully treated by azithromycin at our center. Most worrisome development in the present has been the emergence of DSA(Decreased susceptibility to azithromycin) which surfaced in 2001 and has increased from 4.3% till 2011 to 34% thereafter. We suspect plasmid-mediated resistance as we detected qnrS1-positive Shigella for the first time from the Indian subcontinent in 2 strains from 2010, indicating a relatively new appearance of this PMQR determinant among Shigella in India. This calls for a continuous and strong surveillance of antibiotic resistance across the country. The prevention of shigellosis by developing cost-effective vaccines is desirable as it will substantially reduce the morbidity associated with diarrhoea in the country

Keywords: Shigella, antimicrobial, resistance, India

Procedia PDF Downloads 229

Authors: Shradha Parsekar, Suma Nair, Ajay Bailey, Binu V. S.

Abstract:

Background: Concealing of cancer-related information is seen in many low-and-middle-income countries and may be associated with multiple factors. Comparatively, there is lack of information about, how breast cancers diagnosed women disclose cancer-related information to their social contacts and vice versa. To get more insights on the participant’s experience, opinions, expectations, and attitudes, a qualitative study is a suitable approach. Therefore, this study involving in-depth interviews was planned to lessen this gap. Methods: Interviews were conducted separately among breast cancer patients and their caregivers with semi-structured qualitative interview guide. Purposive and convenient sampling was being used to recruit patients and caregivers, respectively. Ethical clearance and permission from the tertiary hospital were obtained and participants were selected from the Udupi district, Karnataka, India. After obtaining a list of breast cancer diagnosed cases, participants were contacted in person and their willingness to take part in the study was taken. About 39 caregivers and 35 patients belonging to different breast cancer stages were recruited. Interviews were recorded with prior permission. Data was managed by Atlas.ti 8 software. The recordings were transcribed, translated and coded in two cycles. Most of the patients belonged to stage II and III cancer. Codes were grouped together into to whom breast cancer status was concealed to and underneath reason for the same. Main findings: followings are the codes and code families which emerged from the data. 1) Concealing the breast cancer status from social contacts other than close family members (such as extended family, neighbor and friends). Participants perceived the reasons as, a) to avoid questions which people probe (which doesn’t have answers), b) to avoid people paying courtesy visit (to inquire about the health as it is Indian culture to visit the sick person) making it inconvenient for patient and caregivers have to offer something and talk to them, c) to avoid people getting shocked (react as if cancer is different from other diseases) or getting emotional/sad, or getting fear of death d) to avoid getting negative suggestion or talking anything in front of patient as it may affect patient negatively, e) to avoid getting stigmatized, f) to avoid getting obstacle in child’s marriage. 2) Participant concealed the breast cancer status of young children as they perceived that it may a) affect studies, b) affect emotionally, c) children may get scared. 3) Concealing the breast cancer status from patients as the caregivers perceived that they have fear of a) worsening patient’s health, b) patient getting tensed, c) patient getting shocked, and d) patient getting scared. However, some participants stressed important in disclosing the cancer status to social contact/patient to make the people aware of the disease. Conclusion: The news of breast cancer spreads like electricity in the wire, therefore, patient or family avoid it for many reasons. Although, globally, due to physicians’ ethical obligations, there is an inclination towards more disclosure of cancer diagnosis and status of prognosis to the patient. However, it is an ongoing argument whether patient/social contacts should know the status especially in a country like India.

Keywords: breast cancer, concealing cancer status, India, qualitative study

Procedia PDF Downloads 136

Authors: Anush Patric, M. Jadeyegowda, M. N. Ramesh, M. Ravikumar, C. R. Ajay

Abstract:

Kodagu district which is situated in Central Western Ghats regions falls in one of the hottest of hot spots of biodiversity which is recognised by UNESCO. The district has one of the highest densities of community managed sacred forests in the world with rich floral and faunal diversity. It is a habitat for more than ten different types of Ethnic Indigenous tribal groups commonly called ‘Girijanas’ (Soligas, Yarvas, Jenukuruba, Bettakuruba etc.), who are having the rich knowledge of medicinal value of the plants that are commonly available in the forest. The tribal men of this region are the treasure house of the traditional plant knowledge and health care practices. An ethnobotanical survey was undertaken in tribal areas of the district to collect information about some of the indigenous medicinal plant knowledge of tribal people by semi-structured interviews, ranking exercises and field observations on their native habitat in order to evaluate the potential medicinal uses of local plants. The study revealed that, the ethnobotanical information of 83 plant species belonging to 45 families, of the total 83 species documented, most plants used in the treatment were trees (11 species), shrubs (41 species), herbs (22 species) and rarely climbers (9 species) which are used in the treatment of Hyperacidity, Respiratory disorders, Snake bite Abortifacient, Anthelmintic, Paralysis, Antiseptic, Fever, Chest pain, Stomachic, Jaundice, Piles, Asthma, Malaria, Renal disorders, Malaria and many other diseases. Maximum of 6 plant species each of Acanthaceae, Apiaceae and were used for drug preparation, followed by Asclepiadaceae, Liliaceae, Fabaceae, Verbenaceae, Caesalpinaceae, Bombaceae, Papilonaceae, Solanaceae, Rubiaceae, Myrtaceae, Amaranthaceae, Asteraceae, Ascelepidaceae, Cucurbitaceae, Apocyanaceae, and Solanaceae etc. In our present study, only medicinal plants and their local medicinal uses are recorded and presented. Information was obtained by local informants having the knowledge about medicinal plants. About 23 local tribes were interviewed. For each plant, necessary information like botanical name, family of plant species, local name and uses are given. Recent trend shows a decline in the number of traditional herbal healers in the tribal areas since the younger generation is not interested to continue this tradition. Hence, there is an urgent need to record and preserve all information on plants used by different ethnic/tribal communities for various purposes before it reaches to verge of extinction. In addition, several wild medicinal plants are declining in numbers due to deforestation and forest fires. There is need for phytochemical analysis and conservation measures to be taken for conserving medicinal plant species which is far better than allopathic medicines and these do not cause any side effects as they are the natural disease healers. So, conservation strategies have to be practiced in all levels and sectors by creating awareness about the value of such medicinal plants, and it is necessary to save the disappearing plants to strengthen the document and to conserve them for future generation.

Keywords: diseases, ethnic groups, folk medicine, Kodagu, medicinal plants

Procedia PDF Downloads 263

Authors: Ajay Kumar Pandey, Mayank Kumar

Abstract:

White grub (Coleoptera: Scarabaeidae) is a major destructive pest in western Himalayan region of Uttarakhand. Beetles feed on apple, apricot, plum, walnut etc. during night while, second and third instar grubs feed on live roots of cultivated as well as non-cultivated crops. Collection and identification of scarab beetles through light trap was carried out at Crop Research Centre, Govind Ballab Pant University Pantnagar, Udham Singh Nagar (Uttarakhand) during 2018. Field trials were also conducted in 2018 to evaluate pre and post sown application of different insecticides against the white grub infesting soybean. The insecticides like Carbofuran 3 Granule (G) (750 g a.i./ha), Clothianidin 50 Water Dispersal Granule (WG) (120 g a.i./ha), Fipronil 0.3 G (50 g a.i./ha), Thiamethoxam 25 WG (80 g a.i./ha), Imidacloprid 70 WG (300 g a.i./ha), Chlorantraniliprole 0.4% G(100 g a.i./ha) and mixture of Fipronil 40% and Imidacloprid 40% WG (300 g a.i./ha) were applied at the time of sowing in pre sown experiment while same dosage of insecticides were applied in standing soybean crop during (first fortnight of July). Commutative plant mortality data were recorded after 20, 40, 60 days intervals and compared with untreated control. Total 23 species of white grub beetles recorded on the light trap and Holotrichia serrata Fabricious (Coleoptera: Melolonthinae) was found to be predominant species by recording 20.6% relative abundance out of the total light trap catch (i.e. 1316 beetles) followed by Phyllognathus sp. (14.6% relative abundance). H. rosettae and Heteronychus lioderus occupied third and fourth rank with 11.85% and 9.65% relative abundance, respectively. The emergence of beetles of predominant species started from 15th March, 2018. In April, average light trap catch was 382 white grub beetles, however, peak emergence of most of the white grub species was observed from June to July, 2018 i.e. 336 beetles in June followed by 303 beetles in the July. On the basis of the emergence pattern of white grub beetles, it may be concluded that the Peak Emergence Period (PEP) for the beetles of H. serrata was second fortnight of April for the total period of 15 days. In May, June and July relatively low population of H. serrata was observed. A decreasing trend in light trap catch was observed and went on till September during the study. No single beetle of H. serrata was observed on light trap from September onwards. The cumulative plant mortality data in both the experiments revealed that all the insecticidal treatments were significantly superior in protection-wise (6.49-16.82% cumulative plant mortality) over untreated control where highest plant mortality was 17.28 to 39.65% during study. The mixture of Fipronil 40% and Imidacloprid 40% WG applied at the rate of 300 g a.i. per ha proved to be most effective having lowest plant mortality i.e. 9.29 and 10.94% in pre and post sown crop, followed by Clothianidin 50 WG (120 g a.i. per ha) where the plant mortality was 10.57 and 11.93% in pre and post sown treatments, respectively. Both treatments were found significantly at par among each other. Production-wise, all the insecticidal treatments were found statistically superior (15.00-24.66 q per ha grain yields) over untreated control where the grain yield was 8.25 & 9.13 q per ha. Treatment Fipronil 40% + Imidacloprid 40% WG applied at the rate of 300 g a.i. per ha proved to be most effective and significantly superior over Imidacloprid 70WG applied at the rate of 300 g a.i. per ha.

Keywords: bio efficacy, insecticide, soybean, white grub

Procedia PDF Downloads 129

Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

Abstract:

Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

Procedia PDF Downloads 213

Authors: Vasundhara H. Krishnani, Ajay Saini, Dibesh Karmacharya, Salit Kark

Abstract:

Illegal Wildlife Trade is one of the most pressing global conservation challenges. Unregulated wildlife trade can threaten biodiversity, contribute to habitat loss, limit sustainable development efforts, and expedite species declines and extinctions. In low-income and middle-income countries, such as Nepal and other countries in Asia and Africa, many of the people engaged in the early stages of illegal wildlife trade, which includes the hunting and transportation of wildlife, belong to Indigenous tribes and local communities.These countries primarily rely on punitive measures to prevent and suppress Illegal Wildlife Trade. For example, in Nepal, people involved in wildlife crimes can often be sentenced to incarceration and a hefty fine and serve up to 15 years in prison. Despite these harsh punitive measures, illegal wildlife trade remains a significant conservation challenge in many countries. The aim of this study was to examine factors affecting the participation of Indigenous communities in Illegal Wildlife Trade while recording the experiences of members of the Indigenous Chepang community, some of whom were imprisoned for their alleged involvement in rhino poaching. Chepangs, belonging to traditionally a hunter-gatherer community, are often considered an isolated and marginalized Indigenous community, some of whom live around the Chitwan National Park in Nepal. Established in 1973, Chitwan National Park is situated in the Chitwan Valley of Nepal and was one of the first regions that was declared as a protected area in Nepal, aiming to protect the one-horned rhinoceros as a flagship species. Conducted over a period of three years, this study used semi-structured interviews and focus group discussions to collect data from Illegal Wildlife Trade offenders, family members of offenders, community Elders, NGO personnel, community forest representatives, Chepang community representatives, and Government school teachers from the region surrounding Chitwan National Park. The study also examined the social, cultural, health, and financial impacts that the imprisonment of offenders had on the families of the community members, especially women and children. The results suggest that involvement of the members of the Chepang community living around Chitwan National Park in the poaching of the one-horned rhinoceros (Rhinoceros unicornis) can be attributed to a range of factors, some of which include: lack of livelihood opportunities, lack of awareness regarding wildlife rules and regulations and poverty.This work emphasises the need for raising awareness and building programs to enhance alternative livelihood training and empower indigenous and marginalised communities that provide sustainable alternatives. Furthermore, the issue needs to be addressed as a community solution which includes all community members. We suggest this multi-pronged approach can benefit wildlife conservation by reducing illegal poaching and wildlife trade, as well as community conservation in regions with similar challenges. By actively involving and empowering local communities, the communities become key stakeholders in the conservation process. This involvement contributes to protecting wildlife and natural ecosystems while simultaneously providing sustainable livelihood options for local communities.

Keywords: alternative livelihoods, chepang community, illegal wildlife trade, low-and middle-income countries, nepal, one-horned rhinoceros

Procedia PDF Downloads 112

Authors: Ajay Ivan

Abstract:

This paper focuses on the cultural politics of health-promotional and disease-preventive pedagogic practices in the context of the national tobacco control programme in India. Tobacco consumption is typically problematised as a paradox: tobacco poses objective health risks such as cancer and heart disease, but its production, sale and export contribute significantly to state revenue. A blanket ban on tobacco products, therefore, is infeasible though desirable. Instead, initiatives against tobacco use have prioritised awareness creation and behaviour change to reduce its demand. This paper argues that public health communication is not, as commonly assumed, an apolitical and neutral transmission of disease-preventive information. Drawing on Michel Foucault’s concept of governmentality, it examines such campaigns as techniques of disciplining people rather than coercing them to give up tobacco use, which would be both impractical and counter-productive. At the level of the population, these programmes constitute a security mechanism that reduces risks without eliminating them, so as to ensure an optimal level of public health without hampering the economy. Anti-tobacco pedagogy thus aligns with a contemporary paradigm of health that emphasises risk-assessment and lifestyle management as tools of governance, using pedagogic techniques to teach people how to be healthy. The paper analyses the pictorial health warnings on tobacco packets and anti-tobacco advertisements in movie theatres mandated by the state, along with awareness-creation messages circulated by anti-tobacco advocacy groups in India, to show how they discursively construct tobacco and its consumption as a health risk. Smoking is resignified from a pleasurable and sociable practice to a deadly addiction that jeopardises the health of those who smoke and those who passively inhale the smoke. While disseminating information about the health risks of tobacco, these initiatives employ emotional and affective techniques of persuasion to discipline tobacco users. They incite fear of death and of social ostracism to motivate behaviour change, complementing their appeals to reason. Tobacco is portrayed as a grave moral danger to the family and a detriment to the vitality of the nation, such that using it contradicts one’s duties as a parent or citizen. Awareness programmes reproduce prevailing societal assumptions about health and disease, normalcy and deviance, and proper and improper conduct. Pedagogy thus functions as an apparatus of public health governance, recruiting subjects as volunteers in their own regulation and aligning their personal goals and aspirations to the objectives of tobacco control. The paper links this calculated management of subjectivity and the self-responsibilisation of the pedagogic subject to a distinct mode of neoliberal civic governance in contemporary India. Health features prominently in this mode of governance that serves the biopolitical obligation of the state as laid down in Article 39 of the Constitution, which includes a duty to ensure the health of its citizens. Insofar as the health of individuals is concerned, the problem is how to balance this duty of the state with the fundamental right of the citizen to choose how to live. Public health pedagogy, by directing the citizen’s ‘free’ choice without unduly infringing upon it, offers a tactical solution.

Keywords: public health communication, pedagogic power, tobacco control, neoliberal governance

Procedia PDF Downloads 84