Failure In India Research Articles

Unraveling the Collapse: A Study of Failed Startups in India

The Indian startup ecosystem has experienced remarkable growth in a relatively short period, driven by a combination of factors such as government initiatives, improved access to capital, demographic strengths, and rapid technological advancements. Despite ongoing challenges, the resilience and creativity of Indian entrepreneurs continue to foster innovation and inspire optimism for the future. Startup failures in India highlight the importance of adopting a comprehensive approach that includes sound business planning, strategic resource management, and a resilient entrepreneurial mindset. With the right mix of policies, infrastructure, and investment, India is well-positioned to become a global hub of innovation, generating employment, boosting economic growth, and addressing some of the world’s most pressing issues through entrepreneurship. This paper examines the key factors contributing to the recent struggles of startups in India, focusing on 12 companies.

Overview of acute liver failure in India.

Acute liver failure (ALF) is an infrequent, but serious complication subsequent to severe acute liver injury (sALI) due to various hepatotoxic agents such as hepatotropic virus(es) and drugs such as anti-tubercular medications, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics and anti-cancer and anti-epileptic therapy and due to metabolic and autoimmune disease flares. ALF after sALI presents with encephalopathy associated with prolonged international normalized ratio (INR). Mortality in ALF is high and ranges between 50% and 80%. Due to severe liver damage, multiple sequels consequent to hepatic dysfunction result in complications such as hyperammonemia that culminates in encephalopathy associated with cerebral edema; innate immune paralysis resulting in increased frequency of infections and endotoxemia causing decrease in systemic vascular resistance (SVR) and tissue hypoperfusion and damage-associated molecular patterns (DAMPs) released from damaged hepatic parenchyma inducing pro-inflammatory cytokine storm, which may cause other organ dysfunctions. Certain etiologies such as hepatitis E virus and hepatitis A virus-related ALF or paracetamol-ALF (hyper-acute presentation) have better survival than remaining causes. In addition, if etiology-specific treatment (antivirals for ALF related to hepatitis B virus (HBV) or Herpes simplex virus (HSV) or N-acetylcysteine for paracetamol) is available, then the outcome with treatment is better. About half of the patients can be salvaged with medical therapy. All patients need intensive care and organ support to provide time for the liver to regenerate. Various prognostic models to predict high probability of mortality have been described, which should be used to select patient early during the disease for liver transplantation, which is associated with high long-term survival in these sick patients. The Indian National Association for Study of the Liver (INASL) recommends the ALF-Early Dynamic (ALFED) model as a preferred prognostic model in the Indian scenario, where hepatitis viruses are a dominant etiology of ALF and occur on a naïve liver with good regenerative capacity.

Effectiveness and Safety of Sacubitril/Valsartan in Heart Failure in India: A Retrospective Real-world (SAVE) Study

Background Sacubitril/Valsartan is one of the pillars of heart failure (HF) management. Little is known about its uses or impact in real-world practice in the Indian population. We evaluated the effectiveness and Safety of Sacubitril/Valsartan in Heart Failure in India. Methods This retrospective analysis involved newly diagnosed adult patients of HF (class I–IV, per physician clinical assessment and discretion), treated in a tertiary care hospital during period of February–April 2023 and received Sacubitril/Valsartan. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured in addition to demographics, clinical symptoms, comorbidities, and left ventricular ejection fraction (LVEF). Following three months of Sacubitril/Valsartan medication, changes in LVEF, NT-proBNP levels, and clinical symptoms (graded from 1 to 10, with 10 being the maximum severity) were assessed. Results Out of 60 patients eligible for the study, 57% were males and 43% were females. Mean body weight was 60.26 ± 7.00 kg, while mean BP was 130/81 mmHg. 60% patients had both type 2 diabetes and hypertension as comorbidity. There was 23% improvement in LVEF (from mean LVEF of 34 to 42, P < .0001), with a significant decrease in NT-proBNP levels (mean 1220.5 pg/mL to 118.1 pg/mL, P < .0001) after treatment with Sacubitril/Valsartan for 3 months, resulted in marked improvement in clinical symptoms of breathlessness (mean score decreased from 6 to 2, P < .05), edema (mean score decreased from 5.5 to 1.8, P < .05) and palpitations (mean score decreased from 2.4 to 1.1, P < .05. 50 mg BD was the most commonly used dose of Sacubitril/Valsartan (70% patients), followed by 100 mg BD (25% patients) and rest (5%) with 200 mg BD dose. Treatment with Sacubitril/Valsartan was well tolerated, with <5% patients reporting hypotension. Conclusion The findings of this real-world study suggest Sacubitril/Valsartan was associated with an increase in ejection fraction translating into symptomatic improvement in Indian patients of HF.

Decoding startup failures in Indian startups: Insights from Interpretive Structural Modeling and Cross-Impact Matrix Multiplication Applied to Classification

PURPOSE: Start-ups are widely acknowledged as crucial catalysts for innovation and drivers of economic progress. However, their vulnerability to failure continues to pose a persistent and significant obstacle. In light of this, the study intends to ascertain the various elements responsible for the elevated incidence of start-up failures and examine their contextual associations. It further aims to establish the hierarchical structure and identify the crucial factors of start-up failure. METHODOLOGY: The paper uses the Interpretive Structural Modeling (ISM) approach to determine the structural hierarchy and interconnections among the causes of start-up failures identified through the comprehensive analysis of existing literature and experts’ opinions. MICMAC (Cross-Impact Matrix Multiplication Applied to Classification) analysis is also being utilized to categorize these identified failure causes into autonomous, independent, dependent, and linking factors by their driving and dependency powers. FINDINGS: A structural framework depicting the interrelationships among the factors has been derived, showing the failure factor, ‘poor market positioning’ factor at the highest level, and the ‘lack of entrepreneurial efficiency’ at the lowest level of the model. The results also revealed that lack of entrepreneurial efficiency, poor management, and external environmental issues are the most significant independent factors upon which all other failure factors rely. It also categorizes ‘poor market positioning’ as the dependent factor, signifying its passive role in the failure of start-ups. IMPLICATIONS: As previous literature has discussed the various factors responsible for the failure of start-ups in isolation, the current study fills out the gap in the literature by establishing linkages among those factors. The study’s insights emphasize the value of effective management teams and entrepreneurial skills in averting start-up failures. It highlights the importance of skill development and mentorship to enhance the capabilities of entrepreneurs and their teams. Furthermore, the research indicates that policymakers and support groups can create focus initiatives addressing issues like market validation, team dynamics, and financial management to enhance the start-up environment. These initiatives may encompass entrepreneurship training, financial assistance, and mentorship through the ‘Start-up India’ Program, Bharat Fund platform, etc. ORIGINALITY AND VALUE: Previous studies on entrepreneurial failure are based on AHP (Analytical Hierarchical Process), content analysis, and quality management methodologies. This is potentially the first study using the ISM-MICMAC approach that explores the complex world of start-up failures in India and illustrates the relative influence and interdependence of various failure factors of start-ups through a hierarchical model.

Comparative analysis of institution of ombudsman in India and Sweden, focusing on the reasons for failure in India

Comparative analysis of institution of ombudsman in India and Sweden, focusing on the reasons for failure in India

Exploring the Need and Benefits of Digital Therapeutics (DTx) for the Management of Heart Failure in India.

Indian heart failure (HF) registries consistently indicate high hospital readmissions and increased mortality rates after HF diagnosis. The challenges of Indian cardiologists in HF management include limited longitudinal data, frequent readmissions, low medication adherence, inadequate monitoring and follow-up, insufficient patient education, and lack of standard guidelines on cardiac rehabilitation. This article outlines the adoption of digital therapeutics (DTx) in HF management as a potential solution to address these challenges. DTx services offer improved medication adherence, early symptom identification, remote vital monitoring, timely intervention, patient education on symptoms, self-awareness, and lifestyle. Overall, DTx for HFcomprises a dedicated team of cardiologists, health coaches, care managers, and globally certified connected devices to provide comprehensive and proactive monitoring, personalized coaching and support, behavioral engagement to improve adherence, emergency response system, delivery of medications and diagnostic tests at home, and a dedicated application for caregivers. DTx has the potential to enhance HF management in India.

Assessment of the Cost Differences and Variability of Medicines for the Treatment of Heart Failure in India

Assessment of the Cost Differences and Variability of Medicines for the Treatment of Heart Failure in India

Does Safety Matter? Formal Safety Institutions and Women Microenterprise Failure in India

Does Safety Matter? Formal Safety Institutions and Women Microenterprise Failure in India

Failure of India's Renewable Energy Certificate (REC) Mechanism as a Climate Finance Policy

As one of the world's largest economies and a developing nation with significant vulnerabilities to a changing climate, India has taken efforts to address climate change through various policies and initiatives. Climate finance policies play a crucial role in supporting developing countries in their transition to low‐carbon and climate‐resilient pathways. However, despite India's commitment to climate action, there have been instances where certain climate finance policies have failed to achieve their intended objectives. This article examines the failure of a specific climate finance policy in India and analyses the factors contributing to its shortcomings.

Hyperacute Liver Failure with Multi-organ Dysfunction Syndrome (MODS) by Leptospirosis: A Case Report

Introduction: Leptospirosis may have multi-organ involvement in its severe form with potentially life-threatening consequences. However, acute fulminant hepatic failure is very uncommonly reported. A case study is presented here with fulminant hepatic failure and a diagnostic dilemma for etiology.Case history: A 40-year-old man with no significant medical history presented with fever, muscle pain, weakness, and pain in the upper abdomen. On clinical work, he has developed multi-organ hepatic, respiratory, and renal failure. A timely workup was done, but due to the rapid progression of the disease, the patient succumbed to the disease in the intensive care unit by the time his report for positive leptospirosis test arrived.Conclusion: Leptospirosis must be considered as an important differential diagnosis of acute liver failure patients. An early suspicion for leptospirosis in patients with fulminant hepatic failure and multi-organ failure in India particularly in the rainy season is warranted owing to its high mortality rate.

Team based collaborative care model, facilitated by a mHealth enabled and trained nurse, for management of heart failure in India (TIME-HF): design and rationale of a parallel group, open label, multi-centric cluster randomized controlled trial

Background: Heart failure (HF) is a debilitating condition associated with enormous public health burden. Management of HF is complex as it requires care and coordination with different cadres of health care providers. In resource poor settings, physician driven initiatives to improve HF management is difficult due to multiple barriers. We propose to develop a team based collaborative care model (CCM), facilitated by a trained nurse, for management of HF with the support of mHealth and evaluate their acceptability and effectiveness in Indian setting. Methods: The proposed study will use mixed-methods research for assessment. A formative qualitative research will identify barriers and facilitators for implementing CCM for the management of HF and develop components of the intervention. Subsequently, a cluster randomised controlled trial (RCT) involving 22 centres (tertiary hospitals) with more than 1500 HF patients will be conducted to assess the effectiveness of the CCM in improving the overall survival as well as days alive and out of hospital (DAOH) at two-years (CTRI/2021/11/037797). The DAOH will be calculated by subtracting days in hospital and days from death until end of study follow-up from the total follow-up time. Poisson regression with a robust variance estimate and an offset term to account for clustering will be employed in the analyses of DAOH. A rate ratio and its 95% confidence interval (CI) will be estimated. The scalability of the proposed intervention model will be assessed through economic analyses (cost-effectiveness) and the acceptability of the intervention at both the provider and patient level will be understood through process evaluation. Potential Impact: The TIME-HF trial will provide evidence on whether a nurse-led team based CCM with mHealth support is effective in improving the clinical outcomes of HF in India. The findings may change the practice of management of HF in financially constrained low and middle-income countries.

Intersectional Inequalities in Anthropometric Failure among Indian Children: Evidence from the National Family Health Survey (2015-2016).

Increasing body of health planning and policy research focused upon unravelling the fundamental drivers of population health and nutrition inequities, such as wealth status, educational status, caste/ethnicity, gender, place of residence, and geographical context, that often interact to produce health inequalities. However, very few studies have employed intersectional framework to explicitly demonstrate how intersecting dimensions of privilege, power, and resources form the burden of anthropometric failures of children among low-and-middle income countries including India. Data on 2,15,554 sampled children below 5 years of age from the National Family Health Survey 2015-2016 were analysed. This study employed intersectional approach to examine caste group inequalities in the anthropometric failure (i.e. moderate stunting, severe stunting, moderate underweight, severe underweight, moderate wasting, severe wasting) among children in India. Descriptive statistics and multinomial logistic regression models were fitted to investigate the heterogeneities in the burden of anthropometric failure across demographic, socioeconomic and contextual factors. Interaction effects were estimated to model the joint effects of socioeconomic position (household wealth, maternal education, urban/rural residence and geographical region) and caste groups with the likelihood of anthropometric failure among children.More than half of under-5 children suffered from anthropometric failure in India. Net of the demographic and socioeconomic characteristics, children from the disadvantageous caste groups whose mother were illiterate, belonged to economically poor households, resided in the rural areas, and coming from the central and eastern regions experienced disproportionately higher risk of anthropometric failure than their counterparts in India. Concerted policy processes must recognize the existing heterogeneities between and within population groups to improve the precision targeting of the beneficiary and enhance the efficiency of the nutritional program among under-5 children, particularly for the historically marginalized caste groups in India.

Evaluation of Pakistani Challenge to Indian Hegemonic Ambition: A Look into History

South Asia is the largest region in the world in terms of population and India is the most dominant power among the eight member states that comprise the region, two of which possess nuclear weapons. The region is widely regarded as potential conflict zone because of the historic rivalry between India and Pakistan. As the British exited from the subcontinent, India aspired to inherit the hegemonic pole position of the colonial power as its successor. But refusal of nuclear Pakistan, the second most powerful state in South Asia to surrender to the Indian material superiority resulted in the conflict formation during the last seven decades. The enmity between India and Pakistan commenced from the violent partition of British India in 1947. In addition to the three wars that India and Pakistan fought since the British relinquished colonial occupation, there were many other conflicts that could have ignited full-fledged armed confrontation. One of the core reasons for tension in South Asia is the unresolved Kashmir problem. Pakistan’s possession of nuclear arms has further dented Indian ambition to establish unchallenged regional hegemonic stability. The nuclearization of the subcontinent in the 90’s has benefitted much smaller Pakistan by elevating it to a more potent challenger to the Indian military might. The failure of India to rise above the perennial Indo-Pak confrontation not only has acted against fulfilling its dream of achieving the great power status, but also proven to be a formidable barrier in the creation of favorable environment needed for regional cooperation in order to maintain socio-economic development in the poverty-stricken South Asia. This paper focuses on the root causes of the conflict with chronological history of events.

Estimated effect of vitamin A supplementation on anaemia and anthropometric failure of Indian children

BackgroundIndia has an unacceptably high burden of vitamin A deficiency (VAD) among children aged 6–59 months. To mitigate VAD and its adverse effects on child health, the Indian government runs a nationwide vitamin A supplementation (VAS) programme. However, the effect of VAS in reducing child morbidity and mortality remains inconclusive and has been debated globally. In this paper, we estimate the effect of VAS on two indicators of child nutrition—anaemia (categorized into any anaemia, and mild/moderate anaemia) and anthropometric failure (categorized into stunting, wasting, and underweight) among children aged 6–59 months.MethodsUsing the nationally representative 2015–2016 National Family Health Survey data set from India, we set up a quasi-experimental study design and estimated household and mother fixed-effects of VAS on select types of child anaemia and anthropometric failure.ResultsFindings from both the household fixed-effects and mother fixed-effects analysis showed that VAS does not influence any types of childhood anaemia and anthropometric failure in India. We discussed the findings considering existing literature and possible limitations of the study.ConclusionsThe infirm effect of Vitamin A on anaemia and anthropometric failure is probably indicative of targeted VAS intervention, as opposed to a universal VAS programme.ImpactEffects of vitamin A supplementation (VAS) in treating child morbidity and mortality remain inconclusive, which calls for further rigorous studies.This study set up a quasi-experimental research design and estimated the null effect of VAS on child anaemia and childhood anthropometric failure.While the cautious interpretation of findings is urged, this study reliably supports targeted intervention of VAS, instead of the universal VAS programme.The use of nationally representative data and robust research protocol are the primary strengths of this study.

Explaining India’s Approach to Responsibility to Protect

India has been alleged for adopting a reluctant approach to the doctrine of responsibility to protect (R2P). In light of this allegation, this article explains India’s approach to R2P and attempts to answer why India has adopted a cautious and reluctant approach. To give a comprehensive picture and provide a compelling account of India’s cautiousness and reluctance, this article uses an eclectic approach. The systemic and domestic variables, along with normative and materialistic factors, have been taken simultaneously into account. It points out that India’s approach to R2P is shaped by a set of six variables—historical legacies, especially India’s colonial experience and its applications for its attitude towards the principles of non-intervention and state sovereignty; domestic compulsions such as failure of India to deliver inclusive and equitable development and ensuring human rights and citizen’s dignity in remote areas; the intentions of the great powers; security concerns like insurgency in various parts, including Kashmir; its approach to the doctrine per se; and unintended consequences of conflict escalation and its implication for India—have been a linchpin in shaping India’s approach. It demonstrates how these factors have cumulatively shaped India to neither vote in favor of intervention nor stand up with the governments that fail to protect their citizens, and thus fall in fulfilling their obligations under the first principle of the doctrine of R2P.

Mongolia’s assertive and pragmatic role in India’s Connect Central Asia Policy: Current trajectory and Future Ahead

Mongolia’s uniqueness and importance in contemporary world politics lie in its geographical situating, demography, and economy. Geographically landlocked and situated in the Eurasian intersection, Mongolia has the lowest population density of any sovereign country on the planet. Sandwiched among Russia and China Mongolia's harsh environment limit its economic interests. However, Mongolia's geostrategic position, unexplored energy assets, and democratic governance have expanded its importance in global politics. Because of such Mongolia holds a key position in India's Act East and Connect Central Policy to counter China's expansionist policies in North-East Asia. With regards to India-Mongolia relations, the two nations share a rich historical legacy. Tibetan Buddhism the most prevailing religion in Mongolia makes social linkages, Democracy solidified further connections between India and Mongolia. Because of these old and profoundly established linkages, India-Mongolia are 'spiritual neighbors'. However, China still has an overreaching control over Mongolia’s trade, commerce, and other sectors. China also dominates intra-regional trade in North-East Asia. Under India’s Connect Central Asia India attempts to counter Chinese encirclement by delving into close strategic, economic, and energy relations with China's neighbors like Mongolia and CAS. However, the achievement or failure of India's Connect Asia Policy will depend upon India's political as well as its diplomatic will to transform India's interest in regional integration in reality.

An intersectional analysis of the composite index of anthropometric failures in India

BackgroundNutritional inequality in India has been estimated typically using stunting, wasting and underweight separately which hide the overall magnitude and severity of undernutrition. We used the Composite Index of Anthropometric Failure (CIAF) that combines all three forms of anthropometric failures to assess the severity of undernutrition and identify the most vulnerable social groups and geographical hotspots.MethodCIAF was constructed using child anthropometric data from the fourth round of the National Family Health Survey (NFHS-4, 2015–16). We considered 24 intersecting sub-groups based on intersections across four main axes of inequality i.e., caste [Scheduled Tribe (ST), Scheduled Caste (SC) and Other], economic position (poor and non-poor), place of residence (rural and urban) and gender (male and female) (eg. ST-Poor-Rural-Female). Cross-tabulation and logistic regression were done to assess the odds of CIAF among intersecting groups and to identify the most vulnerable sub-groups. Concentration curve was plotted to visualise economic position inequality in child undernutrition across caste categories. Choropleth maps were constructed and descriptive analysis of the district-level prevalence of CIAF was performed to identify the geographic clustering of undernutrition.ResultsOverall 55.32% of children were undernourished by CIAF and 6.62% of children have simultaneous three anthropometric failure. In sub-group analysis, children from ST and SC caste have a higher risk of undernutrition irrespective of other axis of inequality. Compared with CIAF, economic position inequality was amplified for simultaneous-three-failures among all caste categories. Economic position inequalities within caste are more for other caste and SC categories than with ST. Economic position, caste and gender based inequality in all three failures is more consistent in rural areas than with urban areas. Based on the analysis of the high prevalence in the co-occurrence of two or three failures, 111 districts from 12 of 29 states in India were identified across four geographic clusters.ConclusionsThe study shows social and eco-geographical clustering of multi-dimensional anthropometric failures and indicates the need for focused nutritional interventions among SC and ST community in general and ST children from the poor households. Furthermore, governance interventions that target entire regions across districts and states combined with decentralised planning are needed.

Failure factors–a comparative study of private and government construction firms

PurposeThe purpose of the present study is to examine the failure factors for the construction firms in a developing nation. Furthermore, the comparison of failure factors for private and government firms are evaluated.Design/methodology/approachIn the present study, comparison between private and government construction firms is done in the context of a construction firm failure. About 60 construction firms were selected in and around the Nashik region for the investigation, where a simple multi-attribute rating technique (SMART) is used for analysis purpose.FindingsIt is found that for private firms (private contractors and builders) lack of experience is the major factor for failure of the business as against lack of managerial experience is a critical factor in case of a government contractor.Practical implicationsThe outcome of the present study will be used to guide the policymakers during the implementation of governmental and private projects in order to lessen the construction project failures.Originality/valueConstruction company failure is an important aspect in developing countries like India. The limited studies were available in literature which shows failure factors for government and private firms and distinguished them. Hence, the present study extends the construction company failure literature by focusing on government and private firms. Also, the study provides some theoretical guidelines for management to avoid construction company failure in India.

Covid-19 convalescent plasma therapy: Analyzing the factors that led to its failure in India.

Transfusion clinique et biologique - In corso di stampa. Prove corrette dall'autore. Disponibile online dal jeudi 17 juin 2021

Effectiveness of high flow nasal cannula oxygen therapy in patients of acute pulmonary thromboembolism with acute hypoxemic respiratory failure

BackgroundAcute Pulmonary thromboembolism (PTE) is associated with acute hypoxemic respiratory failure (AHRF), which is a leading cause of death in these patients. High-Flow Nasal Cannula (HFNC) oxygen therapy is a cornerstone of the treatment of respiratory failure. The aim of the present study is to explore the efficacy of HFNC in the treatment of patients of acute PTE with acute hypoxemic respiratory failure in India. MethodsThis is a retrospective study of patients admitted to a tertiary care center with acute PTE with AHRF during the period from January 2018 to January 2020. After reviewing medical files, patients of acute PTE with AHRF treated with HFNC were included in the study. We analyzed the improvement in oxygenation parameters and respiratory rate, as well as outcome in these patients. ResultsDuring the above specified period, 12 patients suffering from PTE with AHRF were treated with HFNC. After 1 h of the initiation of HFNC along with anticoagulation, the respiratory parameters of patients significantly improved. HFNC was applied for a period of 6–10 days. None of the patients required intubation for AHRF, and all patients were discharged from the hospital on oral anticoagulants. ConclusionHFNC oxygen therapy in patients with acute PTE with AHRF showed rapid improvement of oxygenation and respiratory rate. HFNC oxygen therapy is an efficacious treatment for patients with AHRF secondary to acute PTE without any significant hemodynamic effect. It acts as a superior modality of oxygen therapy avoiding noninvasive and invasive ventilatory support.