Wednesday, May 6, 2020
Mahindra Mahindra in South Africa Essay example - 928 Words
Case: Mahindra Mahindra in South Africa In May 2011, Pravin Shah, the CEO at Mahindra Mahindra, was evaluating four possible options of companyââ¬â¢s growth strategy in the South Africa. Those options included: entering into agreement with the local vendor for the contract assembly of MM vehicles, investing in its own manufacturing plant in South Africa, using South Africa as a hub for the further export of the other countries and lastly waiting and watching until enough vehicles are sold for the sustainable long term growth. Once those options were evaluated, Shah needed to present the final chosen one to the board of directors for the final approval on the best strategy for companyââ¬â¢s growth in the South African Market. 1) Whichâ⬠¦show more contentâ⬠¦To date, Mahindra Mahindra shows a very strong entry-level presence in the local market. In short 6 years period, they were able to capture the trust and loyalty of the local populations. Their strategy to manufac ture and export vehicles that were suitable for local roads and, at the same time affordable for the locals, made it possible to secure the market share of 1.2% of the SUV and medium range SUV vehicles. Their localization of dealers in nine South African provinces made it possible for customers of all regions to have the direct access to the vehicle inventory. On the other hand the company faced a challenge of losing sales because of the time it took to process vehicles orders from India. 3) How attractive is the South African auto market for the growth and profitability? In the past decade or so, South Africa showed a stable economic growth among the population. Even though the growth rates are somewhat low compared to the other developing countries, it didnââ¬â¢t have any decline. With economic growth, more locals are able to afford to own a vehicle. As research study presented in the case shows, the buying power of the black African consumers, making the largest segment of the middle-income market, was rising. To the benefit of companies such as Mahindra Mahindra, unlike white South African population, black African consumers were more open and inclined to purchase newly introduced brands to theShow MoreRelatedMahindra in South Africa982 Words à |à 4 PagesMAHINDRA amp; MAHINDRA IN SOUTH AFRICA BACKGROUND AND INTRODUCTION Mahindra and Mahindra is a leading multinational automotive manufacturer headquartered in Mumbai, India which started as a steel trading company in 1945 by two brothers J.C Mahindra and K.C Mahindra. Mamp;M has a labour force of 13000 and in 2001 profit before tax was 45 billion rupees. Currently the company has also extended its operations to small turbo prop aircraft and has a presence in the transportation media across landRead MoreReport On Mahindra Mahindra Ltd774 Words à |à 4 PagesTitle of Company Report : MAHINDRA MAHINDRA LTD I declare (a)That the work presented for assessment in this Report is my own, that it has not previously been presented for another assessment and that my debts (for words, data, arguments and ideas) have been appropriately acknowledged. (b)That the work conforms to the guidelines for presentation and style set out in the relevant documentation . Ã¢â¬Æ' CERTIFICATE IShubhangi Singhhereby certify that Adarsh Sinha student of B.Com (H)at AmityRead MoreTvs Motor Company : The Third Biggest Exporter1677 Words à |à 7 PagesGujarat through discrete JV s â⬠¢2012 Acquisition of Universal Component, United Kingdom PROFILE OF MAHINDRA MAHINDRA Founded Year 1945 Founders Jagdish Chandra Mahindra, Malik Ghulam Muhammad,Kailash Chandra Mahindra Headquarters Mumbai, Maharashtra, India Revenue US$ 11 billion (2016) Total Assets US$ 9.1 billion ( 2015) Net Income US$ 390 million (2015) Mahindra and Mahindra is an Indian multinational car producing partnership headquartered in Mumbai, Maharashtra, India. It is oneRead MoreAbstract to Tata Motors1192 Words à |à 5 Pagesbus manufacturer by volume. Tata Motors has auto manufacturing and assembly plants in Jamshedpur, Pantnagar, Lucknow, Sanand, Dharwad and Pune in India, as well as in Argentina, South Africa, Thailand and the United Kingdom. It has research and development centres in Pune, Jamshedpur, Lucknow and Dharwad, India, and in South Korea, Spain, and the United Kingdom. It has a bus manufacturing joint venture with Marcopolo S.A.,a construction equipment manufacturing joint venture with Hitachi and a jointRead MoreCase 11 Mabindra Mabindra B 10337 Words à |à 42 PagesCase 11 Mahindra Mahindra (B): An Emerging Global Giant? I have been on record to say that my philosophy of going global is because if you dont succeed abmad or dont have the capacity to succeed abmad and to carve out some turf abroad you are not going to be safe at home [. . .}. If you want to compete with multinationals you have to be a multinational. So that is the logical rationale for going abmad.HI -ANAND G. MAHINDRA, Vice Chairman and Managing Director, Mahindra Mahindra Ltd., inRead MoreMahindra Case Study4851 Words à |à 20 PagesIBS Hyderabad | Mahindra amp; Mahindraââ¬â¢s Global Diversification Strategies | A Business Strategy Case Study | | Group-9: | Het MavaniHarshit ShethJuhi KashyapJayeeta DuttaHemanta PoudyalHeena GoelKanishk Sharma | 12-Aug-13 | This document is a synopsis of the full case study. | Table of Contents 1. ABSTRACT 4 2. INDUSTRY ANALYSIS 5 GDP and the automotive industry 5 PESTEL framework of Indian automobile industry: 5 a) POLITICAL FACTORS 6 b) ECONOMIC FACTORS 6 Read MoreMahindra Case Study4837 Words à |à 20 PagesIBS Hyderabad | Mahindra amp; Mahindraââ¬â¢s Global Diversification Strategies | A Business Strategy Case Study | | Group-9: | Het MavaniHarshit ShethJuhi KashyapJayeeta DuttaHemanta PoudyalHeena GoelKanishk Sharma | 12-Aug-13 | This document is a synopsis of the full case study. | Table of Contents 1. ABSTRACT 4 2. INDUSTRY ANALYSIS 5 GDP and the automotive industry 5 PESTEL framework of Indian automobile industry: 5 a) POLITICAL FACTORS 6 b) ECONOMIC FACTORS 6 c) SOCIOCULTURALRead MoreFundamental Analysis5657 Words à |à 23 Pagesa benchmark for comparison with the Market price per share. Book Value Per Share=Net WorthNo.of Equity Shares Outstanding The Mahindra and Mahindra Group: The Mahindra Mahindra, a company established in the year 1945 as a franchise for assembling Jeeps now a US $7.1 billion Indian multinational employing over 1 lakh people across the globe. The Mahindra Group today is an embodiment of global excellence and enjoys a strong corporate brand image. The company enjoys a leadership positionRead MoreEconomic Order Supply Driven Structure Essay1570 Words à |à 7 Pagesfinancial year 2000ââ¬â01 seven private sector life insurance companies including HDFC Standard Life Insurance Company Ltd., ICICI Prudential Life Insurance Company Ltd., Birla Sunlife Insurance Company Ltd., Max New York Life Insurance Company Ltd., Kotak Mahindra Old Mutual Life Ins. Ltd., Tata AIG Life Ins. Co. Ltd., and SBI Life Ins. Co. Ltd. were issued licences. In the Financial year 2001ââ¬â02 four companies, namely, ING Vysya Life Ins. Co.Pvt. Ltd., Bajaj Allianz Life Ins. Co. Ltd., Met Life India InsRead MoreNano Tata1335 Words à |à 6 Pagesaffected. We recommend that the Nano tries to parallel the strategy adopted by its Indian counterpart Mahindra motors. The Mahindra group also came up with the first indigenous SUV in India and then took it global. Even though the SUV is a different market and customer, the rational for the geographic expansion may be applicable to the Nano as well. The SUV was first launched in Africa, then South America followed by Europe. The mode of entry was joint ventures in the target country. These developing
Tuesday, May 5, 2020
Environmental Air Pollution Essay Example For Students
Environmental Air Pollution Essay My views of the environment are rooted in my belief in creation. I do not believe that life on earth began spontaneously, nor do I believe that the earth is so delicately balanced. I dont believe that the earth and its ecosystem are fragile. Many radical environmentalists do, they believe man can come along, all by themselves and change everything for worse. After hundreds of millions of years, they believe that we are the last two generations of human existence. And they think we can destroy the earth all by ourselves?I simply cannot believe this view of man and his works. I refuse to believe that people, which is also a result of Creation, can destroy the best creation in the universe. Although some arrogant radical scientists believe that they are capable of unlocking every door of the universe and above all else, capable of understanding it, it is a fact that there are some things in this world that man just cant understand, and cannot understand, and we must accept these things in faith. This one small planet has the conditions that are necessary for life and is perfectly placed in our solar system. If we were placed a little further from the sun, we would be a really big ice cube. If we were a little closer, we would be roasting in one big oven. And the placement of the Earth is not by chance, it was placed here for a reason. We humans had nothing to do with earths creation, nor did we have anything to do with its placement or its functioning. We are only a part of it. We are as much part of it as the Spotted Owl, which is a bird. But environmentalists picture humans as a natural enemy of nature. According to them, we are capable of destroying earth merely by being ourselves. I also dont understand how these scientists of whom which say we are powerful enough to destroy earth, can also say we are no better than a frog. Unfortunately for them, this is what they believe. They seem to think that all life forms on the planet, other than humans, peacefully exist together. They think that humans destroy. Most animals and insects depend on each other for food and do not peacefully co-exist. We could not destroy the earth even if we wanted to. The earth is over 4 billion years old. Man has been here for no more than 200,000 of those years. We cannot even come close to creating the forces of nature, yet these forces have been around for 4 billion years. And yet, the earth is still here. Mount Pinatubo, in the Philippines, spewed forth more than a thousand times the amount of ozone-depleting chemicals in one eruption than all the chloro-fluorocarbons ever manufactured by evil man and possessed corporations in all of history (RLimbaugh, The Way Things Ought to Be, p155).So now scientists say that 4-6% of the ozone loss could occur over the Northern Hemisphere over the next 2-3 years (RLimbaugh, The Way Things Ought to Be, p155). Remember: this has been going on for billions of years and we still have a healthy ozone layer. Again, the facts are here, man cant even come close to equaling the CFC output of a volcano. Conclusion, Mother Nature has been attacking her own ozone layer for millions of years, and its still here. We have only been measuring ozone since 1956 (RLimbaugh, The Way Things Ought to Be, p155). And scientists still claim that they know enough for us to change our lives. Maybe the largest environmental worry in the recent years is the potential problem of the Earth heating up because of mans abuse of the environment. There is little evidence behind these theories, and most of these theories are being voided after each new study. .u7ab673a09957e722005f98fe15510847 , .u7ab673a09957e722005f98fe15510847 .postImageUrl , .u7ab673a09957e722005f98fe15510847 .centered-text-area { min-height: 80px; position: relative; } .u7ab673a09957e722005f98fe15510847 , .u7ab673a09957e722005f98fe15510847:hover , .u7ab673a09957e722005f98fe15510847:visited , .u7ab673a09957e722005f98fe15510847:active { border:0!important; } .u7ab673a09957e722005f98fe15510847 .clearfix:after { content: ""; display: table; clear: both; } .u7ab673a09957e722005f98fe15510847 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u7ab673a09957e722005f98fe15510847:active , .u7ab673a09957e722005f98fe15510847:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u7ab673a09957e722005f98fe15510847 .centered-text-area { width: 100%; position: relative ; } .u7ab673a09957e722005f98fe15510847 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u7ab673a09957e722005f98fe15510847 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u7ab673a09957e722005f98fe15510847 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u7ab673a09957e722005f98fe15510847:hover .ctaButton { background-color: #34495E!important; } .u7ab673a09957e722005f98fe15510847 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u7ab673a09957e722005f98fe15510847 .u7ab673a09957e722005f98fe15510847-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u7ab673a09957e722005f98fe15510847:after { content: ""; display: block; clear: both; } READ: Advantages Of Capital Punishment EssayScientists say a supernova 340,000 years ago disrupted 10% to 20% of the ozone layer, causing only a sunburn in prehistoric man (RLimbaugh, See I Told You So, p178). Has man ever created anything even close to the radioactivity and explosive force of a supernova? My answer: doubtful. And if pre-historic man only got a sunburn, how can we get cancer from air conditioners
Wednesday, April 8, 2020
Dreams in Of Mice and Men Essay Example
Dreams in Of Mice and Men Essay Dreams are like goals we want to reach. In John Steinbeckââ¬â¢s novel Of Mice and Menthe characters Lennie, Candy, and Curleyââ¬â¢s wife have dreams that didnt come true. Of Mice and Men is about two best friends Lennie and George. They work on the ranch where all the trouble starts. They have a dream that they will have a piece of land that has animals. The characters of Lennie, Candy, and Curleyââ¬â¢s Wife had dreams that have motivated them to work hard. Lennieââ¬â¢s dream motivated him. Lennie is a large man who is mentally challenged. George repeats his and Lennieââ¬â¢s dream when he says ââ¬Å"Someday weââ¬â¢re gonna get the jack together and weââ¬â¢re gonna have a little house and a couple of acres an a cow and some pigsâ⬠(pg 14). This is important because Lennie stays out of trouble and makes him happy. This quote makes me think that Lennie is feeling excited and happy because he gets to take care of the rabbits. George tells Lennie ââ¬Å"When we get a coupla of acres i can let you tend the rabbitis all right. (pg 15). This is important because George is giving Lennie responsibilities and he likes soft things. Lennieââ¬â¢s dream is similar to Candyââ¬â¢s dream because they want a better life. Lennieââ¬â¢s dream is different to Candyââ¬â¢s dream because he doesnt want to tend the rabbits. Lennieââ¬â¢s dream is similar to Curleyââ¬â¢s Wife because they want a better life. Lennieââ¬â¢s dream is different to Curleyââ¬â¢s Wife dream because she want to be a actress. In the next paragraph will discuss Candyââ¬â¢s dream. Candyââ¬â¢s dream gave him motivation and hope. Candy is a lonely swamper with a crippled hand. Candyââ¬â¢s feeling useless working at the ranch ââ¬Å"sââ¬â¢oose i went in with you guys. Thaââ¬â¢s three hundred and fifty bucks iââ¬â¢d put inâ⬠(pg 59). This is important because Candy wants a gobetter life and wants to join the dream. This quote makes me think Candy is hopeful because he wants to join Lennie and George. Knowing that he is crippled Candy says ââ¬Å"i We will write a custom essay sample on Dreams in Of Mice and Men specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Dreams in Of Mice and Men specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Dreams in Of Mice and Men specifically for you FOR ONLY $16.38 $13.9/page Hire Writer
Monday, March 9, 2020
Free Essays on Trying To Fit In
Adapting to a new country is really hard. You need to learn the new countryââ¬â¢s language and culture in order to integrate into its citizenship. In the essay ââ¬Å"The Struggle to Be an All-American Girl,â⬠Elizabeth Wong describes her tough experience of trying to fit in while her mother is trying to remind her that she has Chinese roots and she should not forget about them. For example, she is forced to go to a Chinese school in order to learn her familyââ¬â¢s language. However, she does not believe Chinese is the language that is going to help her to fit in the crowd. Besides, people at Chinatown always congratulate her for being a young lady who speaks English. This, gave her more enthusiasm to become an ââ¬Å"All-American Girlâ⬠. At last, she finally reaches her main goal by being allowed to stop attending the Chinese school, however, she still not happy. Although my experience did not involve attending any school, I had a similar experience that relates to the authorââ¬â¢s. When I was a child my mom would buy me as many books as she could so I would not forget to speak Spanish. First, Wong says that she is forced by her mother to do things that she did not want to do, ââ¬Å"everyday at 5 p.m. instead of playing with friends, [her] brother and [she] [had] to go to a Chinese schoolâ⬠(114). As the author I was also lectured by my mother every time she had an opportunity to do it. I must admit that it was really hard for her to keep me on track due to the fact that at school I did not use the language. Moreover, I did not believe I needed to learn Spanish because we were in America. Likewise, Wong believes that Chinese is not the language she needs in order to succeed, ââ¬Å"Nancy Drew, [her] favorite book heroine, never spoke Chineseâ⬠(115). Diaz 2 Unlike the author, I remember I used to argue with my parents about why it was so important to them that I learn Spanish. In fact, I remember my parents telling me that just because I liv... Free Essays on Trying To Fit In Free Essays on Trying To Fit In Adapting to a new country is really hard. You need to learn the new countryââ¬â¢s language and culture in order to integrate into its citizenship. In the essay ââ¬Å"The Struggle to Be an All-American Girl,â⬠Elizabeth Wong describes her tough experience of trying to fit in while her mother is trying to remind her that she has Chinese roots and she should not forget about them. For example, she is forced to go to a Chinese school in order to learn her familyââ¬â¢s language. However, she does not believe Chinese is the language that is going to help her to fit in the crowd. Besides, people at Chinatown always congratulate her for being a young lady who speaks English. This, gave her more enthusiasm to become an ââ¬Å"All-American Girlâ⬠. At last, she finally reaches her main goal by being allowed to stop attending the Chinese school, however, she still not happy. Although my experience did not involve attending any school, I had a similar experience that relates to the authorââ¬â¢s. When I was a child my mom would buy me as many books as she could so I would not forget to speak Spanish. First, Wong says that she is forced by her mother to do things that she did not want to do, ââ¬Å"everyday at 5 p.m. instead of playing with friends, [her] brother and [she] [had] to go to a Chinese schoolâ⬠(114). As the author I was also lectured by my mother every time she had an opportunity to do it. I must admit that it was really hard for her to keep me on track due to the fact that at school I did not use the language. Moreover, I did not believe I needed to learn Spanish because we were in America. Likewise, Wong believes that Chinese is not the language she needs in order to succeed, ââ¬Å"Nancy Drew, [her] favorite book heroine, never spoke Chineseâ⬠(115). Diaz 2 Unlike the author, I remember I used to argue with my parents about why it was so important to them that I learn Spanish. In fact, I remember my parents telling me that just because I liv...
Friday, February 21, 2020
Analyzing a Budget Essay Example | Topics and Well Written Essays - 500 words
Analyzing a Budget - Essay Example In addition, the expenditures are clearly indicated as well as the source of income or revenues. Fortunately, the expenditures have been included in the budget. The budget clearly includes expenditures in. This is clearly seen for example the expenditures seen are salaries and wages, janitorial supplies, legal advertising among others. Still concerning expenditure, the budget has clear tracking of expenditure. It clearly shows the amount of cash and for what purpose it will be used. This has helped greatly to prevent loss of cash from managing officials. Like in this case it clearly shows the amount of cash slotted for wages and salaries, legal advertisements among many others. Another strength of the budget is that it has included the revenue collection of income. A good budget includes the sources of revenues in it (Arthur 2003). However, this might not be so evident in other types of budgets. In this type of budget, source of revenue has been included which can be seen as state appropriation, county appropriation, patient fees, insurance and Medicaid. The budget has also included the actual revenue receipts. A good budget should have evidence of the actual receipts of the expected revenue or the already collected revenue (Sullivan 2003). This as a greater percentage will help reduce the loss of funds in a particular company or country. However, despite all the strengths of the budget, it has several weaknesses. To begin with, there is no summary of the budget. A good budget should have a summary of the incomes, average receipts, total costs, net drawings from revenues, total income, total outgoings or even if available the money for creditors in any case the company or country or family had Higher than the actual receipts obtained from the previous revenue collection. The budget has no item showing savings. A good budget should have a line item showing savings from
Wednesday, February 5, 2020
Globalization and its affect on the american economy Research Paper
Globalization and its affect on the american economy - Research Paper Example ld economies results in removal of barriers between nations for free movement of goods, services, investments, and also manpower across national boundaries. Practiced as a strategy, globalization results in enhanced economic activities and hence prosperity of all nations and its impact on the US economy is not different, critics notwithstanding. The second half of the previous century witnessed the rapid growth of the US economy in all spheres. It gained position as by far the most powerful nation on earth in economic and military terms, and had a deciding voice in multilateral organizations like the WTO, IMF and the World Bank. High investments in education, research and development, manufacturing and infrastructure coupled with vast natural resources, low population density and a democratic polity resulted in high prosperity of its population. The prosperity put high wages in the hands of its consumers, and consumer spending on food, personal accessories, leisure and entertainment have become important prime movers of economic growth in a self-sustaining way. Being a free market economy, competitive forces ensured that goods and services are offered at attractive prices and/or features, till the market reached a point of saturation. At this point businesses had to look to ever new products, new markets or newer ways of reducing costs, to sustain in business and grow with profits. Globalization, for which the US and other prosperous Western European countries are the strongest advocates through their dominant position in international bodies, can be seen in this background of saturated local markets and declining competitiveness. A few words about ââ¬Ëpost industrial societyââ¬â¢ are not out of place at this juncture. The US society is often called the ââ¬Ëpost industrial societyââ¬â¢ where the emphasis is on knowledge as opposed to manufacturing (Daniel Bell as quoted by Marshall G, 1998). In other words, knowledge-based services offered by professionals are at a
Tuesday, January 28, 2020
Influence of Cannabis Abuse Variables on Psychotic Symptoms
Influence of Cannabis Abuse Variables on Psychotic Symptoms Influence of variables of cannabis abuse on psychotic symptoms and their severity: an Indian experience Abstract: Context: Cannabis is probably the most commonly used illicit drug. While not all cannabis users present mental health problems, heavy cannabis use may increase the risk of cognitive abnormalities, psychotic illness, and mood disorders. Cannabis-induced psychosis is not easily distinguishable from schizophrenic symptomatology, although it is characterized by more bizarre behaviour, violence, panic, more agitation, and less blunting of affect, and incoherent speech. Aims: To evaluate severity of various psychotic symptoms in relation to variables of cannabis abuse. Settings and Design: A cross sectional study of 30 male patients admitted at tertiary psychiatric centre, with diagnosis of cannabis induced psychosis was carried out. Methods and Material: Cannabis abuse variables along with psychotic symptoms severity on BPRS scale was obtained. Statistical analysis used: SPSS-17 was used for analysis, and significance level was at p-value Results: The symptoms that were associated with increased severity in majority of patients were hostility (83%), excitement (77%), and elevated mood, grandiosity, suspiciousness and motor hyperactivity were preset in more than 60% of individuals in range of severe to very severe form. Conclusions: Patients with long duration and early onset of cannabis abuse were presented with more severe form of psychosis. Frequency of cannabis use was not significantly correlated with total BPRS score, although amount spent over cannabis was significantly associated with total BPRS score. Family history of cannabis abuse predicted early onset of cannabis abuse. Introduction Cannabis is probably most commonly used illicit drug. [1,2] It is widely used in India and is an integral part of Indian culture and religious customs.[3,4] The correlation between cannabis and negative mental health outcomes has been unequivocally established [1,5,6,7,12]. While not all cannabis users present mental health problems, [5] epidemiological studies suggest that heavy cannabis use during adolescence may increase the risk of cognitive abnormalities and psychotic disorders.[1,8-10] Use of cannabis at early age and high frequency are associated with a greater risk of problems [5,7,11]. Arendt et al. consider that this cannabis-induced psychosis is an early expression of schizophrenia in vulnerable individuals rather than part of the differential diagnosis [12]. Mooreââ¬â¢s review reported a 40% higher risk of psychosis in subjects who occasionally used cannabis and a probability of 50% to 200% higher in regular cannabis users [13]. Swedish Conscripts Study (Andreasson et al.) of inductees into the military reported a risk for schizophrenia 2.4 times higher among those who had used cannabis by 18 years than among non-users [14,24]. This cannabis-induced psychosis is not easily distinguishable from Schizophrenic symptomatology, [15,19] although it has been characterized by more bizarre behavior, violence, panic, more hypomanic symptoms and agitation, and fewer hallucinations and less blunting of affect and incoherent speech.[20,21] Need of the current study Studies have found cannabis associated psychosis a constellation of affective symptoms (euphoria, increased psychomotor activity), [16,17,18] whereas others have found similarity with schizophrenic symptomology of social withdrawal, thought disorder and disorganized behavior [19,22] so there is immense need to define the presenting features of this disorder in Indian population. Additionally phenomenology of the cannabis use disorder need to be explored to clearly define, identify and manage this population. Despite widespread use of cannabis there is lack of research data from most part of the world including India. Aims and objectives: Based on the existing literature we formulated following hypothesis that ââ¬Å"Patients with cannabis associated psychosis have different symptom profile than other common psychiatric disorders, relating to variables of cannabis abuse e.g. dose, frequency, durationâ⬠. To test the hypothesis following objectives were formulated To assess variables of cannabis abuse in patients with cannabis associated psychosis. To explore the relationship between variables of cannabis abuse, and individual symptom profile and total BPRS score. Subjects and Methods: Patients in whom there was temporal association of cannabis use with onset of psychotic illness were included in the study. The study included 30 consequentially admitted, Hindi speaking patients of 18-50 years of age at tertiary psychiatric centre in north India from March 2011 to July 2011. Patients with mental retardation, a significant medical condition compromising ability to participate, history of head injury with any documented cognitive sequele, and inability to provide informed consent were excluded from study. Patients having history of psychiatric illness prior to onset of cannabis abuse, predominant abuse/dependence of other psychoactive substance and having any other significant medical illness were also excluded from study. Study design: A cross sectional study of subjects who satisfied the inclusion criteria was carried out. After recording socio demographic data, each participant in the study was subjected to questionnaire regarding his cannabis abuse and brief psychiatric rating scale (BPRS). To measure the quantity of cannabis intake by individual indirect measure in form of average amount (INR) spent daily was inquired. The age of onset, duration of abuse, and cause of onset- accidental, casual, peer group and offer by elder family members were recorded. The history of cannabis abuse as well as psychiatric illness in other family members was inquired. Results: Majority of the participants were young male adults of the rural background. About 47 % (n-14) of them were unmarried and 60 % (n-18) were belonged to joint family. All the study participants were formally educated and at least one family member of about 43% (n-13) of participants had history of cannabis abuse. As it has been shown in table 2 majority of the study participants were abusing cannabis for more than 10 years with mean duration of cannabis abuse 14.2 years. 50 % of the individuals experienced first cannabis intake before age of 13 years with average onset of cannabis use 14.5 years. Majority of the participants (66%) were daily cannabis abusers. More than 2/3 rd of the subjects was spending Rs. 15 per day on average over the cannabis. Onset of cannabis was occurred mostly due to influence of peer group (n-21). The symptoms that were associated with increased severity in majority of patients were hostility 25 (83%), excitement 23 (77%), and elevated mood, grandiosity, suspiciousness, distractibility and motor hyperactivity in more than 60% of individuals. Other symptoms that were present in severe to very severe form in more than half individuals were hallucinations, unusual thought content, uncooperativeness, and self neglect. Suicidability and tension was absent in 28(93%) of p atients, depression and motor retardation was absent in 25(83%) of participants, guilt was absent in 70% of patients and blunted affect, conceptual disorganization and emotional withdrawal were completely absent in >60% of individual patients. Correlation with duration of cannabis abuse Long duration of abuse was negatively correlated with depression and hostility but other symptoms like suspiciousness, hallucinations, unusual thought content were positively correlated. Duration of cannabis abuse was significantly associated with total BPRS score (p-0.002). Patients with long duration of cannabis were presented with more severe form of psychosis than patients with short duration of cannabis abuse. Correlation with Age of onset of cannabis abuse Older age of onset of cannabis use was significantly associated with depression (p Correlation with frequency of cannabis abuse Frequency of cannabis abuse was significantly associated with self neglect (p-0.007) and tension (p Correlation with amount spent over cannabis The amount spent over cannabis was significantly correlated with anxiety (p-0.030), hallucinations (p-0.001), bizarre behavior (p Discussion: This study was aimed at determining clinical symptoms in relation to variables of cannabis abuse. All subjects were male. This could be attributable to low levels of substance use among females in general and cannabis in particular. Age range was wide and may be due to variation in genetic vulnerability to psychosis, dose of cannabis and duration of illness leading to variable age at presentation. Positive symptoms (motor hyperactivity, excitement, hostility, elevated mood, suspiciousness, grandiosity) were found at higher frequency than negative symptoms (blunted effect, emotional withdrawal and motor retardation). Hallucinations were present in only half of the participants. Other symptoms of the psychosis like conceptual disorganization and catatonic symptoms were absent. Our result was in support of Vani Kulhali and colleagues [23] finding that patients with cannabis associated psychosis had high positive scores (>5) on respective BPRS items were hostility 25 (83%), excitement 23 (77%), and motor hyperactivity, elevated mood, grandiosity, suspiciousness, distractibility in more than 60% of individuals. The least common symptoms were suicidability and tension 2 (6), depression and motor retardation 5 (15%), guilt was present in 30% of patients and blunted affect, conceptual disorganization and emotional withdrawal were completely absent in >60% of individuals. Most studies have reported that cannabis produces psychosis with prominent positive symptoms [16,1718]. Our findings are in keeping with these studies. Scores on BPRS reflected both the total intensity and the profile of psychopathology. Thus our findings largely confirm that reports of other authors that cannabis produces a psychosis with predominantly affective features and more of positive symptoms. Family history of drug disorders is regarded as risk factor for substance use including cannabis, whether it also results in increased vulnerability to cannabis psychosis is not clear. Conclusions The implication of this study is that cannabis contributes in causing and modifying psychosis. Several noteworthy findings emerged from this heterogeneous sample of cannabis associated psychosis. First the severity of psychotic episode was significantly associated with younger age of onset of cannabis abuse and increased spending was associated with more severe psychotic episode. Second family history of psychosis was not associated with increased severity of cannabis abuse, although family history of psychosis predicted more severe excitement, elevated mood and grandiosity and early onset of cannabis abuse. Limitations of the study As this was a cross sectional study and cannabis variables were obtained from interview possibility of ââ¬Å"recall biasâ⬠can`t be ruled out. It was not possible to measure the amount of cannabis in unit time. Proxy used to represent this variable may not be representative of active ingredient of delta- 9THC. We have to rely on the subjects `self- report` of not using any other substances and were unable to objectively verify this report. Thus, the possibility that some symptoms were related to abstinence from other drugs cannot be completely excluded. Wide age range could be a drawback of study since homogeneity in duration of illness and amount of cannabis abuse could not be ensured.
Subscribe to:
Posts (Atom)