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Purpose The purpose of this paper is to identify reasons as to why firms operate informally, and to explore the rationalisation of not moving towards formalisation. Design/methodology/approach Building on empirical data collected through interviews with the entrepreneurs of the informal service enterprises of Delhi and peripheral areas, this paper presents the results of the survey conducted in 2017. By using the analytical tool developed by I. Bross, the authors have identified the most significant contributing factors to informality. Findings In the research, the authors establish that competition and lack of awareness are the most dominant reasons due to which informal firms are hesitant in moving towards formalisation. For successful transition towards formalisation, a “new pact” between the workers, enterprises and governments needs to be developed, based on capacity building, productivity gains, enabling business environment, empowerment and entitlements to social and economic rights. Research limitations/implications The research is limited only to informal service enterprises located in Delhi, the national capital of India, and the peripheral areas. Practical implications By identifying the most dominant factors, focussed steps can be taken to reduce the size of the informal sector. Originality/value The informal service enterprises are not a widely explored community by researchers and policy makers. This sector can employ more people with less investment, and hence requires intensive study. The use of RIDIT approach to rank the identified factors due to which the firms do not move towards formalisation is the novelty of this work.

Purpose The purpose of this paper is to study the characteristics of the workers in the informal economy and explore the reasons for workers migrating from rural to urban area. The authors also explore and enumerate various reasons why the migrants choose to work informally and study whether internal migrants treat this sector as temporary or transitory before moving to the formal sector. The authors reconnoitre the issues in coverage of factors in unregistered service, this research is carried out at a smaller scale of operations of the service enterprises having a minimum of three (or more) employees, which poses significant issues in the enumeration. This work further emphasises on the reasons why people migrate and choose the informal sector (IS) and to estimate the contribution of technology towards productivity of this sector. Design/methodology/approach Building on empirical data collected through interviews with the migrants, who are now part of the informal service enterprises of Delhi and peripheral areas, this paper presents the results of a survey conducted in 2017. This research is based on appropriate scale driven by the instrument of choice by the sampling of units. Data were collected by conducting field survey using structured questionnaire. By performing the estimation at the unit rather than the industry level, the authors reduce difficulties of mis-measured output and inputs, thus, potentially obtaining a more accurate estimate of technologies contributions towards the firm productivity. Findings The small service enterprises are making poorer value addition towards measured productivity due to the factors such as lack of equipment or technical know-how. The authors find that marginalisation thesis holds true only partially and the rest are in this sector by choice, considering it as an opportunity. Maximum number of entrants had been attracted by opportunities in this sector itself; actual and potential mobility from the informality towards formalisation is quite low; education is one of the important determinants for entrepreneurs shifting from informality towards formalisation. Research limitations/implications The research is limited only to informal service enterprises located in Delhi, the national capital of India and the peripheral areas. Practical implications By identifying the factors, proper policy measures can be designed which will be in a focused direction to reduce the size of the IS and to improve the working condition of the migrants who are part of this sector. The estimation is at the unit level using primary data. Originality/value The estimation is at the unit level using primary data, the research contributes to the literature on informal service sector, and this sector needs more intensive large-scale studies in order to design policies which can result in betterment of the society as a whole, benefiting the segment that needs immediate attention from government and society as well.

Introduction: There are manifold effects on neuro-endocrine and metabolic systems due to critical illness. Abnormalities in thyroid hormone levels in a critically-ill patient with no pre-existing hypothalamo-pituitary-thyroid dysfunction is seen in Euthyroid sick syndrome or Non thyroidal illness syndrome. The understanding of different endocrinal changes in acute phase of critical illness may help us to intervene early and improve by pharmacological intervention. Materials and Methods: Critically ill children admitted in PICU, RIMS, Ranchi, aged 29 days to 17 years. Results: In our study, it was seen that FT3 and FT4 were low at admission at admission in critically ill children. And among them, the non-survivors had significantly lower values compared to survivors. Discussion: Among this critically ill patient, more than 70% of patients have shown low free T3 (Type I NTIS) and around 50% of low free T4 levels and free T3 levels (Type II NTIS). We have done this study to assess the thyroid dysfunction in critically ill children admitted in our PICU and its correlation with disease severity and clinical outcome.

According to the thrifty (Barker's) phenotype hypothesis, poor nutrition in fetal and early infancy plays a role in the development and function of the beta cells of the islets of Langerhans, which leads to the development of type 2 diabetes mellitus. Insulin resistance is due to decreased suppressive effect of insulin on hepatic glucose production. Thus, elevated insulin levels during perinatal life may predispose the infant to the development of diabetes mellitus in future life. Intrauterine undernutrition plays an important role in causing adult insulin resistance and diabetes but the exact cause is still unknown. Preterm infants born small for gestational age (SGA) show lower adrenocortical response to stimulation due to an immature hypothalamic-pituitary axis. MethodsThe cross-sectional study conducted at Rajendra Institute of Medical Sciences, Ranchi from June 2020 to November 2021 included 216 newborns enrolled as per the inclusion and exclusion criteria. Maternal and neonatal details were collected at birth and recorded. Cord blood samples for measurement of serum insulin, glucose, and cortisol were collected from 84 preterm and 132 term neonates. Using this information, homeostasis model assessment-insulin resistance (HOMA-IR) was calculated using a mathematical formula. Insulin resistance was defined as HOMA-IR > 2.5. Based on birth weight and gestational age, they were further categorized into SGA, appropriate for gestational age (AGA), and large for gestational age (LGA). The parametric data were presented as means ± standard deviation (SD), and nonparametric data as medians (first quartile and third quartile). The Student's (independent samples) t-test and Mann-Whitney U test were used to compare mean differences between the two groups for parametric and nonparametric data, respectively. The Spearman correlation coefficient was used to determine the significant association between variables. ResultsUmbilical cord plasma glucose and serum insulin were high in preterm in comparison to term newborns. Serum cortisol levels were high in term than in preterm newborns. HOMA-IR showed a very strong positive correlation with serum insulin and a moderate positive correlation with serum glucose. HOMA-IR showed a strong negative correlation with gestational age and a moderate negative correlation with birth weight. Insulin resistance was seen in 34 preterm newborns and two term newborns. Insulin resistance was seen in 29.8% (n = 25) of SGA preterm babies, 7.1% (n = 6) of AGA preterm babies, and 1.5% (n = 2) of AGA term newborns. A total of 55.6% of newborns were below normal weight (48.1% had low birth weight, 4.6% had very low birth weight, and 2.8% had extremely low birth weight). ConclusionOur study suggests that preterm newborns are more insulin resistant at birth than term newborns. SGA preterm babies are having a higher incidence of insulin resistance compared to AGA preterm babies. It is clear that high insulin level is needed to overcome high insulin resistance in the very early gestational period. Serum...