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Gupta, Anish
- Glenn Shunt:Anaesthetic Concerns for a Non Cardiac Surgery
Authors
1 Department of Anesthesia and Critical Care, MAMC and Lok Nayak Hospital, New Delhi, IN
2 Department of Cardiothoracic Vascular Surgery, AIIMS, New Delhi, IN
Source
Northern Journal of ISA, Vol 2, No 2 (2017), Pagination: 36-42Abstract
Patients with single ventricle physiology have single chamber for pulmonary and systemic venous return that is supplied in parallel leading to cyanosis and ventricular volume overload. Palliative surgeries in the form of superior cavo-pulmonary anastomosis, also known as Bidirectional Glenn shunt (BDG) and complete cavo-pulmonary anastomosis, also known as Fontan procedure are done to divert blood from superior vena cava and inferior vena cava respectively into pulmonary circulation. As a result systemic and pulmonary blood flow run in series and forward flow is dependent on the relationship of systemic vascular resistance and pulmonary vascular resistance. Patients who have undergone Glenn shunt usually have peripheral oxygen saturation in the range of 75-85 % as a consequence of non-diversion of blood from inferior vena cava into pulmonary circulation. Fontan procedure is done in a staged manner to avoid sudden unloading of ventricle leading to failure. Anaesthesiologists encounter patients with Glenn shunt for non-cardiac surgery before they have undergone completion Fontan. A thorough understanding of Glenn and single ventricle physiology is required to deal with such patients and meticulous approach to anesthesia management is required after discussing with the surgeons and cardiologist, regarding the type of non-cardiac surgery, and to know the functional status of Glenn shunt. The present review article aims to discuss the anaesthesia concerns, and search of terms such as 'anaesthetic management', 'Glenn shunt', 'cavopulmonary anastomosis', 'Fontan procedure' was carried out in KKH eLibrary, Medline, PubMed, and Google scholar focusing on current research, randomized control trials, review articles and editorials.Keywords
Cavopulmonary Anastomosis, Fontan Procedure, Glenn Shunt, Non-Cardiac Surgery.References
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- BSNL: A Journey from Top performer to Worst Performer
Authors
1 Department of Commerce, Dr. B.R.A. College, Yamuna Vihar, Delhi, 110094, IN
Source
Indian Journal of Economics and Development, Vol 6, No 11 (2018), Pagination: 1-8Abstract
Objective: A case study on the institutional factors responsible for deteriorating performance of BSNL has been undertaken in this work.
Methodology: Time series data on subscribers’ base, profit, loss and market share have been used in the study. Since the data on the qualification of employees and infrastructure sharing are not publish by any agency, they were collected under Right to Information Act (RTI) from BSNL office at District Alwar in the state of Rajasthan (India). Mostly descriptive statistical analysis has been used to analyze the data and to present findings.
Findings: Apart from the common problems faced by any public sector unit due to the co-existence of private players, BSNL had to face other institutional problems also. One of them is qualification of technical staff. BSNL is the unique example of a technical driven industry, where a lot of non-technical staff is working at the positions of technical requirements. For instance, there wasn’t any phone mechanic (PE) with any technical degree or diploma. Similarly 33.3% of junior engineers (JE) did not have any formal technical education. On a basic level the problem with such non-technically qualified engineers, that too at higher positions, is that the other technical staff finds it difficult to comprehend or communicate them the problems at hand.
Application/Improvement: Since a technical driven company cannot compete without qualified engineers, the policies should be directed towards the placement of surplus employees based on their qualification.
Keywords
BSNL, Employee, Profit, Technical Education.References
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- Emerging Agrarian Trends in Post Economic Reform Period:Village-Level Evidences from Rajasthan
Authors
1 B.R.A. College, University of Delhi, 110094, IN
Source
Indian Journal of Economics and Development, Vol 7, No 6 (2019), Pagination: 1-7Abstract
Background/ Objective: This study is based on the primary survey conducted for doctoral thesis at CESP, JNU New Delhi. The study aims in studying, inter alia, land relations, production relations, and changes in these variables taken place in post economic reform period.
Methods/ Statistical Analysis: The production relations in post economic reform period were studied by means of detailed primary study. A census survey was undertaken in a village of in Rajasthan in 2007. The census survey of the same village was repeated in 2013 to capture the changes.
Findings: Data obtained from study village indicate growing agrarian distress due to increasing land and income inequality, increasing landlessness and disparity in access to government credit as well as government land for leasing. Integration of Indian agriculture with world market has posed many new agrarian challenges. Sudden increase in price of guar in the year 2012 in world market, which persisted even in 2013, has not only benefited guar cultivators but has also brought huge instability in the land rental market. On the one hand, it resulted in the area under cultivation of guar and on the other in the absence of legal tenancy contracts, it has resulted in dishonoring of oral contracts, changing forms of tenancy contracts, fall in tenancy practices and increasing economic insecurity of tenant farmers.
Improvements/ Applications: Increased instability in agrarian market has resulted in more or less similar kind of situations in other part of the country, which requires government intervention to control instability.
Keywords
Agriculture, Land relation, Tenancy, Globalization, Guar.References
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