Abstract
This study examines how the Indian CSR law has been implemented and enforced by companies and industries situated in the Malwa region of Punjab state in India. Malwa region, one of the most ...industrialized clusters of the state, is also simultaneously one of its most polluted areas. Given the severe health effects that these polluting industries cause, implementing the law on CSR in its true spirit is of grave importance. This study uses in-depth interviews of the intended project beneficiaries to determine the state of implementation of the Indian CSR regulatory framework for the selected geographical region. Using the above methodology, this article suggests that businesses should strive at mitigation of the risks of their production and manufacturing activities to the community and the environment. Rather, CSR is viewed by companies as donating part of the companies’ profits to CSR activities, and undertaking social-welfare activities to meet statutory obligations. Hence, this article further determines that there is a need to implement the CSR law in its true spirit by developing an understanding among the companies on the concept and importance of CSR, which goes beyond profit donations. This article concludes with several policy recommendations that can be utilized by the government to strengthen the state of implementation of the law in not only the Malwa region, but also the entire country.
Mucormycosis is an opportunistic infection seen in immunocompromised patients or in surgical and trauma settings with Mucorales wound contamination. In immunocompetent people, disseminated ...mucormycosis is uncommon. To ensure survival, patients with mucormycosis require early diagnosis and aggressive treatment using a multi-modality approach. We present a case of disseminated mucormycosis in an immunocompetent patient who also had pulmonary embolism and gastrointestinal bleeding. A recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, identified retrospectively by a positive IgM against SARS-CoV-2, was the only risk factor present. This report emphasizes the increased risk of mucormycosis and thromboembolic complications following a recent SARS-CoV-2 infection, as well as its successful treatment with medical therapy alone.
Critical central airway obstruction has always been a dreaded complication to which interventional pulmonologist commonly encounters. There have been various modalities which are used for the ...management and palliation, which includes mechanical coring, laser, cryoextraction, electrocautery and airway stenting. Rigid bronchoscopy with or without jet ventilation has been corner stone of therapeutics and palliation of central airway obstruction. There are only a few conditions where it is not possible to use rigid bronchoscopy. Here we report a case of metastatic tracheal tumour which presented with critical airway obstruction in a patient who had atlantoaxial instability (AAI) due to rheumatoid arthritis. Here we used endobronchial ultrasound scope (EBUS) via esophageal route, i.e. EUS-B guided approach for sampling of the tracheal tumour, and intratumoral chemotherapy was instilled in multiple sessions, which resulted in shrinking of tumour, thus relieving the critical airway obstruction. This is the first report of using EUS-B approach for intratumoral chemotherapy for tracheal tumors. Bronchoscopic intratumoral chemotherapy therapy (BITC) in tracheal tumors is also one of the options but has not been explored much and there has been a dearth of literature for it.
This study was planned to estimate the proportion of confirmed multi-drug resistance pulmonary tuberculosis (TB) cases out of the presumptive cases referred to DTC (District Tuberculosis Center) ...Jodhpur for diagnosis; to identify clinical and socio-demographic risk factors associated with the multidrug-resistant pulmonary TB and to assess the spatial distribution to find out clustering and pattern in the distribution of pulmonary TB with the help of Geographic Information System (GIS). In the Jodhpur district, 150 confirmed pulmonary multi-drug resistant tuberculosis (MDR-TB) cases, diagnosed by probe-based molecular drug susceptibility testing method and categorized as MDR in DTC's register (District Tuberculosis Center), were taken. Simultaneously, 300 control of confirmed non-MDR or drug-sensitive pulmonary TB patients were taken. Statistical analysis was done with logistic regression. In addition, for spatial analysis, secondary data from 2013-17 was analyzed using Global Moran's I and Getis and Ordi (Gi*) statistics. In 2012-18, a total of 12563 CBNAAT (Cartridge-based nucleic acid amplification test) were performed. 2898 (23%) showed M. TB positive but rifampicin sensitive, and 590 (4.7%) showed rifampicin resistant. Independent risk factors for MDR TB were ≤60 years age (AOR 3.0, CI 1.3-7.1); male gender (AOR 3.4, CI 1.8-6.7); overcrowding (AOR 1.6, CI 1.0-2.7); using chulha (smoke appliance) for cooking (AOR 2.5, CI 1.2-4.9), past TB treatment (AOR 5.7, CI 2.9-11.3) and past contact with MDR patient (AOR 10.7, CI 3.7-31.2). All four urban TUs (Tuberculosis Units) had the highest proportion of drug-resistant pulmonary TB. There was no statistically significant clustering, and the pattern of cases was primarily random. Most of the hotspots generated were present near the administrative boundaries of TUs, and the new ones mostly appeared in the area near the previous hotspots. A random pattern seen in cluster analysis supports the universal drug testing policy of India. Hotspot analysis helps cross administrative border initiatives with targeted active case finding and proper follow-up.
Context: Lung cancer is the leading cause of cancer-related deaths in the world. Computed tomography perfusion (CTP) parameters can be used to evaluate the vascular flow dynamics of lung tumours. We ...set out to evaluate the CTP parameters in lung cancer and correlate them with histopathological subtype and other characteristics of patients with Lung Cancer. Settings and Design: This prospective study was conducted at a tertiary care referral hospital in western India. Methods: Between January 2019 and July 2020, CTP was performed in 46 patients of lung cancer with histopathological confirmation. The CTP parameters were evaluated in detail and correlated with histopathological subtypes, staging and immunohistochemistry (IHC) markers. Analysis of variance (ANOVA) test, receiver operator characteristic (ROC) curve, Box and whiskers plot graph and Pearson correlation tests were used for statistical analysis. Results: The most common subtype was adenocarcinoma (AC) in 21 patients, followed by squamous cell carcinoma (SCC) in 15 patients and others in 10 patients. Statistically significant difference in blood flow (BF) (f = 5.563, P = 0.007), blood volume (BV) (f = 3.548, P = 0.038) and permeability/flow extraction (FE) (f = 3.617, P = 0.036) were seen in different histopathological subtypes of lung cancer. BF is the main perfusion parameter for differentiation of AC from SCC. P63 positive lesions showed statistically significant lower BF, BV and FE parameters compared to P63 negative lesions (P = 0.013, 0.016 and 0.014, respectively). Different T stages showed statistically significant differences in BF (f = 3.573, P = 0.037), BV (f = 5.145, P = 0.010) and in FE (f = 4.849, P = 0.013). Conclusion: CTP is a non-invasive imaging method to assess the vascular flow dynamics of the tumours that may predict the histopathological subtypes in lung cancer. It can be used to target large-sized lesions during biopsy and to predict the chemotherapy response.
Pleural effusion is easily diagnosed often managed optimally with standard protocols. It at times, is a diagnostic dilemma as it comes with big list of differential diagnosis. Pleural effusion due to ...pancreaticopleural fistula (PPF) is a rare and on right side is even rarer. Detailed history along with high index of suspicion in required to diagnose PPF, which is confirmed by increased level of pleural fluid amylase and lipase along with magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP) demonstrating fistula tract. Here we report the case of a young patient who presented with respiratory distress and was wrongly diagnosed as right sided tubercular effusion which later turned out to be pancreatic effusion. Management in our case was multi-disciplinary involving pulmonologist, gastroenterologist, radiologist and thoracic surgeon.
Background: In March 2020, the Indian Council of Medical Research (ICMR) issued guidelines that all patients presenting with severe acute respiratory infections (SARI) should be investigated for ...coronavirus disease 2019 (COVID-19). Following the same protocol, in our institute, all patients with SARI were transferred to the COVID-19 suspect intensive care unit (ICU) and investigated for COVID-19. Methods: This study was planned to examine the demographical, clinical features, and outcomes of the first 500 suspected patients of COVID-19 with SARI admitted in the COVID-19 suspect ICU at a tertiary care center. Between March 7 and July 20, 2020, 500 patients were admitted to the COVID-19 suspect ICU. We analyzed the demographical, clinical features, and outcomes between COVID-19 positive and negative SARI cases. The records of all the patients were reviewed until July 31, 2020. Results: Of the 500 suspected patients admitted to the hospital, 88 patients showed positive results for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) of the nasopharyngeal swabs. The mean age in the positive group was higher (55.31 ± 16.16 years) than in the negative group (40.46 ± 17.49 years) (P < 0.001). Forty-seven (53.4%) of these patients in the COVID-19 positive group and 217 (52.7%) from the negative group suffered from previously known comorbidities. The common symptoms included fever, cough, sore throat, and dyspnea. Eighty-five (20.6%) patients died in the COVID-19 negative group, and 30 (34.1%) died in the COVID-19 positive group (P = 0.006). Deaths among the COVID-19 positive group had a significantly higher age than deaths in the COVID-19 negative group (P < 0.001). Among the patients who died with positive COVID-19 status had substantially higher neutrophilia and lymphopenia (P < 0.001). X-ray chest abnormalities were almost three times more likely in COVID-19 deaths (P < 0.001). Conclusion: In the present article, 17.6% of SARI were due to COVID-19 infection with significantly higher mortality (34.1%) in COVID-19 positive patients with SARI. Although all patients presenting as SARI have considerable mortality rates, the COVID-19-associated SARI cases thus had an almost one-third risk of mortality.
•Novel Approach: introducing data corpus creation of a monolingual balanced dataset for the telugu language and a multi-model comparison approach that leverages transformer models tailored for ...Telugu, this paper sheds light on the intricate mechanisms behind hate speech, highlighting potential vulnerabilities in NLP models.•Ethics in AI Application: beyond technical advancements, the paper earnestly engages with the ethical implications of hate speech augmentation, advocating for responsible AI usage and the establishment of ethical guidelines for hate speech detection and moderation in language-specific contexts.•Actionable insights for Mitigation: through meticulous analysis and robust experimentation, this research generates actionable insights crucial for understanding and combating hate speech, laying the groundwork for the development of more potent moderation and counter-speech tactics in Telugu. A hate speech classification system – social media management system is proposed to deploy the model and achieve the results in real time.•Academic and social Impact: this research significantly advances scholarly understanding by unraveling hate speech dynamics in often underrepresented languages, concurrently fostering critical discussions on responsible AI deployment for hate speech mitigation across diverse linguistic landscapes, marking a pivotal contribution to both academia and societal discourse.
In today's digital era, social media has become a new tool for communication and sharing information, with the availability of high-speed internet it tends to reach the masses much faster. Lack of regulations and ethics have made advancement in the proliferation of abusive language and hate speech has become a growing concern on social media platforms in the form of posts, replies, and comments towards individuals, groups, religions, and communities. However, the process of classification of hate speech manually on online platforms is cumbersome and impractical due to the excessive amount of data being generated. Therefore, it is crucial to automatically filter online content to identify and eliminate hate speech from social media. Widely spoken resource-rich languages like English have driven the research and achieved the desired result due to the accessibility of large corpora, annotated datasets, and tools. Resource-constrained languages are not able to achieve the benefits of advancement due to a lack of data corpus and annotated datasets. India has diverse languages that change with demographics and languages that have limited data availability and semantic differences. Telugu is one of the low-resource Dravidian languages spoken in the southern part of India.
In this paper, we present a monolingual Telugu corpus consisting of tweets posted on Twitter annotated with hate and non-hate labels and experiments to provide a comparison of state-of-the-art fine-tuned deep learning models (mBERT, DistilBERT, IndicBERT, NLLB, Muril, RNN+LSTM, XLM-RoBERTa, and Indic-Bart). Through transfer learning and hyperparameter tuning, the models are compared for their effectiveness in classifying hate speech in Telugu text. The fine-tuned mBERT model outperformed all other fine-tuned models achieving an accuracy of 98.2. The authors also propose a deployment model for social media accounts.
CT pulmonary angiogram revealed diffuse pulmonary A-V malformation (PAVM) involving apical and anterior segments of right upper lobe with multiple pulmonary arterial branches directly communicating ...with the pulmonary veins (figure 1B). A subcentrimetric area of diffusely enhancing soft tissue attenuation was seen alongside right lower end of trachea adjacent to PAVM, for which endobronchial ultrasound (EBUS) was advised by the radiologist for possible diagnostic sampling to rule out any associated chronic inflammatory lesion. Ethics approval This study involves human participants but since the procedure was performed as a part of patient management and is now being submitted as case report, ethics approval was not required.
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