Search

Over the years, survival of children with chronic diseases has significantly improved and a large proportion of them now are entering into adulthood. Transition of Care (ToC) of such patients with having childhood onset of chronic diseases to the adult health care system is well organized in developed countries, although it is an emerging concept in India. In situations where the systems for ToC are not in place, such cases are fraught with unsatisfactory health outcomes. With proper ToC in place, these patients are likely to receive uninterrupted care by the adult care physicians and hence reach their full potential. This document highlights the need, rationale and way forward for ToC of youth with special health care needs (YSHCN) across the country. It also describes the standard operating procedures to develop the ToC at a hospital level for clinicians and administrators. [ABSTRACT FROM AUTHOR]

Introduction: Good Clinical Laboratory Practices (GCLP) play a vital role in early and accurate diagnosis, providing high-quality data, and timely sample processing. Adhering to a robust Quality Management System (QMS) that complies with GCLP standards is crucial for laboratory personnel in a clinical laboratory to deliver outstanding healthcare services and reliable, reproducible reports. Aim: To assess the Knowledge, Attitude, and Practice (KAP) of laboratory professionals towards quality in the laboratory through GCLP training. Materials and Methods: This pre-test, post-test quasi-experimental study was conducted in the Department of Biochemistry at ESIC Medical College and Hospital, Faridabad, Haryana, India, from February 2022 to June 2022. The study included 58 participants, consisting of 22 doctors and the remaining laboratory assistants. GCLP online training program was conducted every Friday in March 2022 for four weeks. An online questionnaire containing 34 questions was administered to all the participants before and after the training. Data were collected and analysed using a paired t-test. Results: A total of 58 responses were received from the participants via Google form before and after the training. The results indicate no significant difference in participants' responses to 12 closed-ended questions regarding QMS before and after training. A similar trend was observed for 22 questions on a Likert scale, where participants rated their agreement, neutrality, or disagreement. Conclusion: The study demonstrates that all technical staff fully complied with GCLP guidelines and accreditation requirements. Furthermore, the laboratory staff acknowledges the importance of Standard Operating Procedures (SOPs), document maintenance, record-keeping, and identifying nonconformities, all of which contribute to effective traceability of the testing process in the clinical laboratory. [ABSTRACT FROM AUTHOR]

The rapid proliferation of smokeless tobacco (SLT) in India has occurred without adequate information on the possible dangers and toxicity of these products. Tobacco flavors as well as nicotine (both protonated and un-protonated) are responsible for health dangers and addiction. The study aimed to offer information on the physical characteristics of commonly used smokeless tobacco products (including microscopic analysis), along with nicotine content (both total and un-protonated), pH, moisture, and flavors. The Standard Operating Procedures (SOPs) validated by the World Health Organization (WHO) recognized Tobacco Testing Laboratory TobLabNet) were applied for the analysis of various constituents of the SLTs. The microscopic analysis indicated that some of the SLT products like khaini were finely processed and available in filter pouches for users' convenience and prolonged use leading to prolonged retention and addiction potential. Nicotine absorption and availability (both protonated and un-protonated) are affected by moisture and pH. Essences provide a pleasant aroma and flavor, with an increased risk of misuse and other health problems. Few chewing tobacco and Zarda had the lowest levels of un-protonated nicotine (0.10–0.52% and 0.15–0.21%, respectively), whereas Gul, Gudhaku, and Khaini had the highest levels, ranging from 95.33 to 99.12%. Moisture and pH ranged from 4.54 to 50.19% and 5.25–10.07 respectively. Menthol (630.74–9681.42 µg/g) was the most popular flavour, followed by Eucalyptol (118.16–247.77 µg/g) and camphor (148.67 and 219.317 µg/g). SLT's health concerns and addiction dangers are exacerbated by the high proportion of bioavailable nicotine coupled with flavors. The findings of this study have important implications for the regulation and use of SLT in countries where use of SLT is prevalent. [ABSTRACT FROM AUTHOR]

Background: One of the 'best buys' for preventing Non-Communicable Diseases (NCDs) is to reduce tobacco use. The synergy scenario of NCDs with tobacco use necessitates converging interventions under two vertical programs to address co-morbidities and other collateral benefits. The current study was undertaken with an objective to ascertain the feasibility of integrating a tobacco cessation package into NCD clinics, especially from the perspective of healthcare providers, along with potential drivers and barriers impacting its implementation. Methods: A disease-specific, patient-centric, and culturally-sensitive tobacco cessation intervention package was developed (published elsewhere) for the Health Care Providers (HCPs) and patients attending the NCD clinics of Punjab, India. The HCPs received training on how to deliver the package. Between January to April 2020, we conducted a total of 45 in-depth interviews [medical officers (n = 12), counselors (n = 13), program officers (n = 10), and nurses (n = 10)] within the trained cohort across various districts of Punjab until no new information emerged. The interview data wereanalyzed deductively based on six focus areas concerning feasibility studies (acceptability, demand, adaptation, practicality, implementation, and integration) using the 7- step Framework method of qualitative analysis and put under preset themes. Results: The respondent's Mean ± SD age was 39.2± 9.2 years, and years of service in the current position were 5.5 ± 3.7 years. The study participants emphasized the role of HCPs in cessation support (theme: appropriateness and suitability), use of motivational interviewing, 5A's & 5R's protocol learned during the training & tailoring the cessation advice (theme: actual use of intervention activities); preferred face-to-face counseling using regional images, metaphors, language, case vignettes in package (theme: the extent of delivery to intended participants). Besides, they also highlighted various roadblocks and facilitators during implementation at four levels, viz. HCP, facility, patient, and community (theme: barriers and favorable factors); suggested various adaptations to keep the HCPs motivated along with the development of integrated standard operating procedures (SOPs), digitalization of the intervention package, involvement of grassroots level workers (theme: modifications required); the establishment of an inter-programmatic referral system, and a strong politico-administrative commitment (theme: integrational perspectives). Conclusion: The findings suggest that implementing a tobacco cessation intervention package through the existing NCD clinics is feasible, and it forges synergies to obtain mutual benefits. Therefore, an integrated approach at the primary & secondary levels needs to be adopted to strengthen the existing healthcare systems. [ABSTRACT FROM AUTHOR]

Background: In 2011, in an effort to increase focus on newborn care and survival, the Ministry of Health and Family Welfare, Government of India, formally introduced the three-tier Facility Based Newborn Care (FBNC) system at various levels of health facilities. This study evaluates the functional status of newborn care facilities in a northern state of India. Materials and Methods: A cross sectional, mixed methods, descriptive study was conducted during the months of May to July 2021. Six districts were selected for the study representing each of the six administrative divisions of the state. A total of 31 facility based newborn care units were assessed, including six Special Newborn Care Units (SNCU), six Newborn Stabilization Units (NBSU) and 19 Newborn Care Corners (NBCC). Human resources availability and training, infrastructure, equipment and supplies, adherence to standard operating procedures, infection control protocols and regular maintenance of records were assessed. Overall functional status was ascertained using five criteria: Equipment, Human resources, Protocol, Infrastructure and Recordkeeping. Results: Though the prescribed strength of manpower was available at almost all facilities, most reported that they had not received specific on-the-job training on newborn care. Infrastructure and biomedical waste disposal facility was found to be adequate at all levels. However, the complete set of prescribed essential neonatal care equipment was not available and functional in any of the NBSUs and in a very small number of SNCUs and NBCCs. Most of the SNCUs and NBCCs were found to be partially functional according to the set criteria. Conclusion: Adequate functionality of NBSUs needs to be ensured in order to maximize the benefits of the three-tier system of FBNC. [ABSTRACT FROM AUTHOR]

This study is an endeavour to investigate the preservation and conservation status of the heritage of indigenous manuscripts in the Central Library at the Jain Vishva Bharati Institute (Deemed University), Rajasthan, India, that are unknown to the scholarly world. A survey of the manuscripts was carried out to investigate their physical status. A structured interview with nine staff members from the manuscripts section was conducted to obtain information regarding the manuscript collections and current preservation and conservation techniques employed. The findings reveal that the overall preservation and conservation techniques used in the library were found to be satisfactory according to the standard operating procedures of the National Mission for Manuscripts. The study also provides an understanding of the nature of the manuscript collections and the preservation and conservation techniques employed with the manuscripts. [ABSTRACT FROM AUTHOR]

Forensic science plays a significant role in crime scene analysis and other evidence collection (such as clothes, cigarette butts, blood, semen, hair, etc.,) to scientifically establish the accused's guilt. In rape and murder cases, DNA tests confirm the victim's identity. It provides certain evidence that is helpful in the speedy investigation and conclusion of a trial. However, it is not a foolproof science and it has certain limitations. Hence, the first responders, such as the Crime Laboratory Ultimate Evidence System team and the forensic experts, must keep these limitations in mind during sample collection and examination, otherwise, it may lead to incorrect results. Such incorrect results may be obtained due to insufficient sample quantity, improper collection methods, or delay in an examination. It is highly recommended to implement standard operating procedure guidelines, failing which the admissibility of such forensic evidence to prove beyond all reasonable doubts is at stake. Accordingly, the court shall acquit the accused giving him the benefit of doubt. This article focuses on the applicability and limitations of forensic science in the Indian Criminal Justice System and the need to adopt due protocols to yield viable results. [ABSTRACT FROM AUTHOR]

In India, Ayurvedic medicine has its own significance and dominance in the Indian Medicine System. The traditional medicine system of India is not well renowned due to the lack of standardization of herbal drugs. To assess the quality, purity, efficacy, potency, and safety of herbal drugs, standardization is the major aspect. Recently, World Health Organization (WHO) and European Medicines Agency (EMEA) have issued guidelines for the quality control of herbal drugs. The aim of the present study is the standardization of the coded polyherbal tablet formulation AYUSH SG-5. A scientific methodology was adopted to perform the standardization parameters like organoleptic parameters, microscopic, macroscopic, physico-chemical analysis, and high-performance thin-layer chromatographic (HPTLC) profiling of AYUSH SG-5. The HPTLC study has exhibited the presence of various phytochemicals such as 6-gingerol in Sunthi (Zingiber officinale rhizomes), Epicatechin in Vetas (stem bark of Salix alba), Colchicine in Suranjan (Colchicum luteum corms), Resveratrol in Chopchini (Smilax china tuber), Guggulsterone E & Z in Guggul (Commiphora wightii resin). Based on the results of the present study, a monograph was proposed in the interests of quality control of the AYUSH SG-5. This research will help pharmacists to develop the formulation of AYUSH SG-5 with greater reproducibility and this document could be treated as a pharmaceutical standard operating procedure (SOP) for the production of AYUSH SG-5 in pharmacy. [Display omitted] • A polyherbal ayurvedic tablet formulation AYUSH SG-5 for rheumatoid arthritis is prepared. • A scientific methodology was adopted to perform the standardization of AYUSH SG-5. • Organoleptic parameters, microscopic, macroscopic studies performed as per API. • Physico-chemical tests and HPTLC profiling of AYUSH SG-5 was performed. • In HPTLC study, marker compounds like 6-gingirol, Epicatechin, Colchicine, Resveratrol, guggulsterol E & Z in Guggul were identified. • A validated SOP was purposed for preparation and standardization of AYUSH SG-5. [ABSTRACT FROM AUTHOR]

Mucormycosis is a life threatening, opportunistic infection often seen in individuals with a weak immune system. With an upsurge of cases of Covid-19, a drastic increase in cases of Rhino-Orbito-Cerebral Mucormycosis is being witnessed at present. This article has been written with the purpose of understanding the factors responsible for it and the challenges it brings along for the Indian health-care system at present. Possible solutions for dealing with these problems have also been included in the manuscript. Google, PubMed and ENT Cochrane databases were searched without a time limit using key words like "Mucormycosis", "Rhino-cerebral-mucormycosis" in conjunction with "COVID-19" and "SARS CoV-2". We found 34 articles to be relevant and hence included them to write this review. Rhino-Orbito-Cerebral Mucormycosis is being seen due to coming together of the three entities-the agent, host and environment that constitute the epidemiological triad for this disease in India. Responsible factors are uncontrolled diabetes mellitus, overzealous use of steroids and antibiotics and other environment related issues. The solutions for these problems lie in spreading awareness about prevention of these practices along with early diagnosis and treatment of mucormycosis. To deal effectively with this situation, particularly when there is an existing overload on otolaryngologists and the rest of the health-care system, a multipronged and multilevel collaborative approach is the need of the hour. With effective Standard Operating Procedures and guidelines promoting a multidisciplinary approach for early diagnosis and treatment, we can surely overcome this situation. [ABSTRACT FROM AUTHOR]

The majority of blood donor motivational and awareness activities are directed toward whole blood donation and not much emphasis is given to the plateletpheresis. The study was designed to analyze the effectiveness of the unique concept of platelet drives (PD) to increase voluntary plateletpheresis donations. The study was a retrospective study conducted at a tertiary care oncology hospital-based blood transfusion services (BTS). A total of 13 PDs were conducted from January 2016 to December 2020. A total of 559 potential donors came for the donor registration and 125 donors got deferred on medical history. A total of 434 donors gave their samples for the testing of plateletpheresis. The median age of potential male and female donors was 32 and 30 years respectively. A total of 58 males and two females have donated single donor platelets (14.3% vs. 7.4%, P = 0.319). The median age of male and female donors was 36 and 42 years, respectively. In male donors, 48 had donated once, seven donated twice, two donated thrice and one donor donated four times. Out of two female donors, one donor donated twice and the other donor donated four times. The female donors were more committed to repeat donations (P = 0.004). Since the start of PDs, the number of voluntary donations has increased considerably over the years. PDs have helped in increasing the number of voluntary plateletpheresis donors. All the BTS must have the standard operating procedures in place for these kinds of awareness and motivational drives. [ABSTRACT FROM AUTHOR]

The main objective of this research paper is to highlight the challenges faced by the staffs of the hospitality industry in India during and after the COVID pandemic. It is of utmost importance that the frontline staffs who are working in the hotels & restaurants need to take the optimum safety measures to keep themselves safe while in the operations. After a lockdown of more than 60 days, on 1st June 2020 India started its first unlock. The hospitality industry had to start following new standard operating procedures to prevent the spreading of the disease further. However, the hospitality industry didn't start then. The orthodox practices need to get re-designed according to the situations. The resumption commenced after another one month of the unlocking phase. Hence, with the instantaneous catastrophe there were also serious concerns regards to the continual progression in such times of distress. Many employees were asked to stay back at home as the industry decided to resume with half or less than half of the staffs so that it can combat the revenue crunch. The essayists have collected plenty of information from reputed International & National chain category of hotels' staffs based on which this paper has been presented. [ABSTRACT FROM AUTHOR]

Purpose: Given the pace of global environmental degradation, companies and individuals alike are exploring ways and means of protecting the environment. In this context, the attitudes of hoteliers and their employees toward sustainability are key to the successful implementation of these practices. This paper aims to consider the impact of attitude development and COVID-19 on the sustainability performance of hotels. The study also explores contributions made by hotels to environmental sustainability and society more generally. Design/methodology/approach: The study is based on interviews and survey questionnaires completed by employees of five-star hotels in India, and qualitative methods were used to process the data. Findings: The findings of this study confirm the devastating impact of COVID-19 on both economic and societal sustainability in what otherwise would be a profitable sector of the economy. Practical implications: The study has implications for hoteliers, the government, environmental agencies and for employees and could assist with the formulation of recovery packages by government and in the development of new standard operating procedures to enable hotels to step-up on the self-recovery path. Originality/value: The paper provides an analysis of the direct effects of the pandemic on financial sustainability and its mediating impact on the efforts of hotels to attain sustainable environment. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID-19) has been increasing slowly and steadily in all the districts of Jammu and Kashmir, India. It is essential for the government and health management system to monitor the districts affected due to COVID-19. The main objective of this study is to ascertain and categorize the COVID-19 affected districts into real clusters based on similarities within a cluster and differences among clusters in order to imply standard operating procedures (SOPs) policies, decisions, medical facilities, etc. could be improved for reducing the risk of infection and death and optimize the deployment of resources for preventing subsequent outbreaks. [ABSTRACT FROM AUTHOR]

Good Laboratory Practices (GLP) is a well-established global system that encompass a set of principles or a framework for defining how laboratory studies are planned, performed, monitored, recorded, reported, and stored for future reference. It is important that compliance with the principles of GLP continues to be maintained. Coronavirus disease 2019 (COVID-19) pandemic lockdowns in various countries, including India, have been sudden and over an extended duration. Although every GLP laboratory has Standard Operating Procedure for disaster management, the sudden lockdown due to COVID-19 created specific emergency procedures related to this situation such as travel bans, safe distancing, and work from home notifications. Good Laboratory Practice compliances in the context of animal experimentation during and post lockdown period need effective managerial responses that are not just flexible and innovative but can ensure they are well-calibrated to the challenges of business continuity and maintenance of health directives. On-the-ground realities suggest there may still be practical challenges to compliance, and guidelines may not always be complied with. This article discusses the issues that may be encountered due to COVID-19 that could potentially impact the GLP status of a study and suggests ways to manage them so as to minimize or prevent infection with COVID-19. We propose an MMM (Man, Material, and Medium) strategy to ensure compliance with health directives and guidelines that will help staff to keep themselves and others safe in the workplace while endeavoring to comply with GLP requirements. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to formulate a methodological approach for resuming eye bank services during COVID-19 pandemic.Methods: Eye bank operations were temporarily halted in March after the government-mandated "Lockdown" in response to COVID-19 pandemic. Before restarting eye bank operations in May, we studied sources of exposure, performed risk assessment, instituted additional process validations and redefined the Standard Operating Procedures (SOPs) in consultation with the guidelines published by the Eye bank Association of India and All India Ophthalmological Society. The eye bank staff were rigorously trained before and after operations were restarted. We conducted a survey at the end of July to gauge staff attitude and reaction.Results: Eye banks services resumed on 20th May 2020. Since reopening till the end of July total 41 keratoplasties have been done. 91.75% of all keratoplasties done were therapeutic surgeries and 17% of the surgeries were done using glycerine preserved tissues. No staff had COVID-19 symptoms when the operations restarted and none developed symptoms up to the end of July. All eye bank staff were aware of COVID-19 pandemic and 86% said they felt safe working at the eye bank. 86% of the staff said that they received adequate training and 66% of the staff expressed that they always received proper PPE and kits. Overall, 93% of the staff expressed that the measures taken by the eye bank ensured their safety.Conclusion: Based on our experience we suggest the following activities for planned resumption of eye bank services during the pandemic: Exposure Risk Analysis, Personal Protective Equipment usage training, SOP Revision and staff training on modified SOPs. Criteria based selection of donor sources, participatory planning involving the staff and double-checking at critical process junctions helped us in managing a smooth transition. [ABSTRACT FROM AUTHOR]

Introduction: India's National Mental Health Programme (NMHP) was initiated in 1982. In 2016, the Indian Council of Medical Research (ICMR) organized a Brainstorming Meeting on Prioritization of Mental Health Research. Recognizing the need for improving mental healthcare by building a cadre of mental health researchers based on focus areas of the NMHP, the ICMR organized a research training cum capacity building workshop in collaboration with the Cross-Fertilized Research Training Programme (funded by Fogarty International Centre, NIH, USA) in 2016. The workshop successfully prepared and reviewed 12 single and multicenter research proposals in priority areas of mental health research, which were awarded by the ICMR to middle- and junior-level research faculty and NGO. Methods: A National Coordination Unit (NCU) was set up to mentor investigators and to coordinate, train, and monitor the progress of their projects. Investigators were paired with senior mentors and also participated in four capacity building workshops focusing on proposal-writing, evaluation, and process tracking. Results: Following discussions with ICMR program officers, the NCU formulated standard operating procedures for ethical conduct, data collection, data sharing, progress reporting procedures, and manuscript preparation for all research projects. Regularly scheduled long-distance communications with investigators using social media and group communications were planned. NCU partnered with the ICMR Database Management Unit to build a shared online platform for real-time data entry and storage, and organized two project review meetings where it also coordinated with US faculty to organize public workshops on manuscript writing and qualitative research. Conclusions: The NCU will ensure timely completion of research projects, data entry and analysis, and reports and project publications. It is feasible to evaluate progress with the NMHP through coordinated multisite research that also enables research capacity building. Results from these projects will help in formulating policies by the Ministry of Health Government of India for achieving objectives of the NMHP. [ABSTRACT FROM AUTHOR]

Turnover is an organizational problem that should be kept low by the company, as hiring the employees is costly and time-consuming. There are many available strategies which organizatns can use to retain employees. The manufacturing industry in particular has trouble with employee retention, and has developed a number of standard operating procedures to address this issue. This study is focusing on ascertaining three things. First, what factors can lead employees to stay in the manufacturing industry? Second, what is the dominant factor lead employees to stay in the manufacturing industry? Data was taken by questionnaire from 104 respondents out of a total of 146 employees of PT Pamolite Adhesive Industry. The data was then analysed using confirmatory factor analysis with the Partial Least Square (PLS) technique. The results show that there are thirteen factors that contribute to manufacturing employees staying in their jobs, namely: recognition and appreciation factors; financial compensation; relationships with colleagues; relationship with supervisor; initial training; career development; work challenges; working hours; work conditions; workload; safety; health facilities; and job security. Additionally, the descriptive analysis shows that respondents’ perceptions of those factors are relatively in good condition, however career development is the dominant factor in shaping the intention to stay amongst manufacturing employees. This study confirms a result study conducted in India which suggested that the intention to stay is determined by a cluster of factors not only by a single factor. [ABSTRACT FROM AUTHOR]

Over the past two decades, our understanding of Parkinson's disease (PD) has been gleaned from the discoveries made in familial and/or sporadic forms of PD in the Caucasian population. The transferability and the clinical utility of genetic discoveries to other ethnically diverse populations are unknown. The Indian population has been under-represented in PD research. The Genetic Architecture of PD in India (GAP-India) project aims to develop one of the largest clinical/genomic bio-bank for PD in India. Specifically, GAP-India project aims to: (1) develop a pan-Indian deeply phenotyped clinical repository of Indian PD patients; (2) perform whole-genome sequencing in 500 PD samples to catalog Indian genetic variability and to develop an Indian PD map for the scientific community; (3) perform a genome-wide association study to identify novel loci for PD and (4) develop a user-friendly web-portal to disseminate results for the scientific community. Our "hub-spoke" model follows an integrative approach to develop a pan-Indian outreach to develop a comprehensive cohort for PD research in India. The alignment of standard operating procedures for recruiting patients and collecting biospecimens with international standards ensures harmonization of data/bio-specimen collection at the beginning and also ensures stringent quality control parameters for sample processing. Data sharing and protection policies follow the guidelines established by local and national authorities.We are currently in the recruitment phase targeting recruitment of 10,200 PD patients and 10,200 healthy volunteers by the end of 2020. GAP-India project after its completion will fill a critical gap that exists in PD research and will contribute a comprehensive genetic catalog of the Indian PD population to identify novel targets for PD. [ABSTRACT FROM AUTHOR]

Compliance with pharmacopeial standards is mandatory to ensure the quality, safety, and efficacy of medicines. In India, allopathy, Ayurveda, Siddha, Unani, and homeopathy are the recognized systems of medicine and come under the provisions of different regulations. Promulgation of the “Drugs and Cosmetics Act, 1940” and the rules thereunder provide a regulatory framework for medicines of all of these systems and also prescribe “Pharmacopoeia and Formularies” for regulatory quality standards. Unlike in many other countries, the Act prescribes independent pharmacopeias for each system of medicine. The Unani Pharmacopoeia of India (UPI) and the National Formulary of Unani Medicine are the regulatory compendia for quality standards and manufacturing of Unani medicines, respectively. The Pharmacopoeia consists of Part I (single drugs) and Part II (formulations). Unani medicines are presented as classical or patent and proprietary formulations prepared using single ingredients or multiple ingredients of plant, animal, mineral, and/or metal origin. UPI Part I is published in six volumes comprising 298 monographs on Unani drugs derived from plants (single drugs). Part II is published in three volumes encompassing formulations, standard operating procedures, and quality standards for 150 classical formulations of Unani medicines, which are chosen from the National Formularies of Unani Medicine. The National Formulary of Unani Medicine is published in six parts comprising 1229 formulations of Unani medicines. Each monograph of the Pharmacopoeia provides specific analytical parameters and limits (standards) to ensure the quality of drugs or medicines. This communication reviews the UPI, the National Formulary of Unani Medicine, regulatory quality standards (parameters), and analytical techniques adopted for pharmacopeial standards of Unani drugs and medicines. [ABSTRACT FROM AUTHOR]

In this article the author talks about Enterprise Risk Management (ERM) which is an integrated approach to look at entity level risks in a holistic way and evaluate the same at an organizational level and the broad strategic approach is to identify and assess core perceived risks. It mentions that Most organizations at some point in time face certain crisis scenarios and objective is to ensure that organization tides over and manages the crisis effectively.

Background and objectives: A wide range of errors (all deviations from standard operating procedures) occur at various steps of the transfusion process. This study was conducted to identify the nature and cause of errors in the process of blood transfusion. Materials and methods: A prospective study was conducted in the department of Transfusion Medicine at a tertiary care hospital in India over a period of 18 months. All the errors that occurred during the process of blood transfusion starting from the donor phlebotomy till the transfusion of blood component to the patient were reported and analysed. Results: A total of 156 errors were found during the study period. The actual events which include no‐harm and adverse events were 10% and 5%, respectively, whereas near‐miss events were 85% (ratio of actual to near miss was 1:5.6). Laboratories were found to have the highest level of error occurrence (48% of all errors). Wrong blood in tube errors was found to be 1 per 3308 samples received. Frequency of haemolytic transfusion reactions due to ABO incompatibility was found to be 1 in 6770. The majority of errors (74.4%) were recovered due to system check built within the departmental standard operating procedures (SOPs), and thus, recovery was planned. However, the remaining 25.6% events were discovered only after the product was issued. Conclusion: The data obtained through this study highlight the various critical steps where errors can occur in the long chain of blood transfusion. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to identify quality indicators of the eye bank and validate their effectivity.Methods: Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016.Results: Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator.Conclusion: These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time. [ABSTRACT FROM AUTHOR]

Preprocedural sedation is the part of standard operating procedures for pediatric intrathecal chemotherapy in developed countries and uses predominantly intravenous route. In India, due to the limited availability of pediatric oncology facilities and the increased patient numbers at those centers, no such intervention is possible. This article discusses this issue and proposes the use of oral midazolam in this context for large-scale utilization. [ABSTRACT FROM AUTHOR]

Pharmacovigilance is one of the priority programs of World Health Organisation(WHO), aims at detection, assessment, prevention of Adverse Drug Reactions of Drugs in post marketing scenario. In India under National Pharmacovigilance program initiated by Central Drug Standard Control Organisation (CDSCO) and Indian Pharmacopoeia Commission (IPC) functioning as National Coordination Centre (NCC) under which various Zonal, Regional, and Peripheral Pharmacovigilance centres ( ZPC, RPC, PPC) along with Adverse Monitoring Centres (AMC) are engaged in Pharmacovigilance program of Adverse Drug Reactions reporting process. Still Adverse Drug Reactions reporting percentage in India is very less as compared to European countries due to various reasons. To bridge the gap between Pharmacovigilance Centres and the patients facing various adverse drug reactions going unreported, the Community Pharmacist is primary Health Care Professional who can play a vital role in this process. It is very important to evaluate and increase the Knowledge, Awareness, Attitude Practice (KAP) among Community Pharmacist regarding expected ADR reporting standard operating procedures. Every district should have atleast one Peripheral Pharmacovigilance Centre monitored by Food and Drug Administration and every Community Pharmacy should be provided Adverse Drug Reporting forms for reporting which could be submitted monthly to PPC. All State Pharmacy Councils, conducting various refresher courses for Pharmacist like Patient Counseling Courses, Drug information activities should conduct seminars, workshops on Adverse Drug Reactions Reporting Procedures and use of PVPI software for ADR online reporting. India is a country with very large population consuming big percentage of medicines, Pharmacist along with upgradation of his dispensing pharmacy by providing cognitive pharmaceutical services should necessarily provide services in Pharmacovigilance process for Drug Safety use and Excellent Patient Care. [ABSTRACT FROM AUTHOR]

The recycling of end-of-life vessels is a complex activity that generates an enormous amount of hazardous waste, including asbestos-containing materials (ACM). Efforts by the Government of India to comply with national and international regulations and improved standard operating procedures are expected to lower the exposure risk of the workforce to hazardous substances, including asbestos. The current workers are likely to face lesser risks than did those exposed in the past. The present study assesses the health risks from past exposure of asbestos for those workers engaged in handling and removing ACM in ship recycling yards before environmentally sound recycling of obsolete ships was introduced in the early 2000s. Estimates were made of the number of workers exposed, and the intensity of exposure and these data were used to estimate the likely number of mesothelioma deaths in the future. It was estimated that nearly 15% of the total workforce engaged in ship recycling will suffer from mesothelioma which translates to about 4,513 mesothelioma deaths among the total of 31,000 workers estimated to be ever employed in the yards from 1994 till 2002. Recommendations are made for a practical approach to the safe handling of ACMs in Indian ship recycling yards. [ABSTRACT FROM AUTHOR]

Basis of the Study: Radiation technologists play a vital role in treatment delivery across radiotherapy facilities in the country. Correctsimulation and delivery are intended to facilitate accurate therapeutic radiation in conformance to the planning and dosimetry schedules for each patient. Studies have shown high error rates and geographical misses leading to local recurrence due to faulty process and lack of quality and training. In this study, we evaluate the role of Quality and Uniform Practice of Radiotherapy Technologists (QUPORTT) training program on adherence to quality practices across a chain of radiotherapy facilities in the country. The present study analyses data between 2013 and 2016. Materials and Methods: In this study quality audit was carried out in radiotherapy facilities of a private oncology chain of hospitals across the country in the years between 2013 and 2016. Chronologically audit was carried out for 11, 10, 8, and 16 centres each year from 2013 onwards. Process implementations with approved radiotherapy forms, prescription cards, treatment charts, demographic stickers, radiotherapy process protocols and standard operating procedures (SOP) including a professional outlook (grooming and dress code) as per NABH audit standards were audited. Entries in registers of different radiotherapy process chains in mould-rooms, treatment rooms, X-ray and Computed Tomography (CT) simulations, were systematically evaluated. Audit on treatment machine variables (daily LINAC checklists, EPID quality assurance, and CT/X-ray daily checks) were recorded. Uniformity of practice in different centres based on initial training programme (Quality and Uniform Practice of Radiotherapy Technologists (QUPORTT-2013) was checked. Advanced training (QUPORTT-2016) along with the discussions on audit programme and internal department audits were carried out in 2016. Results: This quality audit resulted in achievement of 82.4% on the professional outlook variables, 88.9% standards of quality assurance in NABH approved patient documents, 94.4% in radiotherapy process standards and SOP and 100% in treatment registers. Recommendations based on these quality indicators included development of mandatory radiotherapy and allied infrastructure and achieving excellence in the expertise of RTT personnel. Conclusions: Present-day care for patients receiving radiotherapy, calls for high standards in treatment delivery with complex technology in order to ensure accurate tumour control and treatment outcomes. RT Technologists play a crucial role in treatment set-up, reproducibility and execution of treatment delivery. Quality practices are ensured whereby; complex situations are made streamlined and implementable even in tier 2 and tier 3 cities, by the help of QUPORTT. This training also could help upcoming centres at an initial level for ensuring gold standard practices. [ABSTRACT FROM AUTHOR]

Background: The primary mission of any Blood Transfusion Service of ensuring the safety of recipients and donors can only be achieved through constant and consistent efforts of improving the quality system in the organization. Audit is a management tool for monitoring quality assurance system and plays an important role in achieving the quality standards. Aim: To study the role of internal audit in monitoring and improving the Quality system of a blood centre over a period of 3 years. Materials and Methods: At Prathama Blood Center, internal audit is being carried out once in a year, as a part of QA system. Audit is done of procedures, documents and equipment. Auditee is the head and the senior technical staff of the section being audited. Auditor is from QA in charge and another departmental head, who has training and knowledge of that section. Analysis of the observations of the internal audit findings of previous 3 years was done. In procedures audit, the parameters studied were: 1. New SOP introduced. 2. Revision done in SOP 3. Point missing in SOP. 4. Procedures are performed as per SOP or not. 5. SOP made obsolete. In document audit, the parameters studied were: 1. New documents/format introduced. 2. Documents removed 3. Completeness of documentation (incomplete documents/Incorrect way of documentation) 4. Others. In Equipment audit, parameter was: If equipment operated as per SOP and regular maintenance. Results: Over a period of 3 years: Total observations were 178. Of which, observations in procedures were 53 (29.77%); documents - 113 (63.48%); equipment - 12 (6.74%). In Procedures: New SOP introduced: 6/53 (11%). Maximum were in testing lab. Point missing in SOP: 7/53 (13%). SOP not followed: 11/53 (20%). Revision done in SOP: 28/53 (52%). Maximum revisions were in donor lab SOP. SOP made obsolete: 1/53 (1.8%). In Documents: Document/format introduced: 32/103 (31%) Maximum in component lab. Documents removed 22/103 (21%) Again maximum in component lab. Completeness of documentation: 42/103 (40.7%). Incomplete documentation was maximum in donor lab. In all labs, equipment maintenance register was not maintained properly. This point was emphasized and in the next audits, this non-conformance was not raised again. But findings like countersigning any cutting, continued to be there, though reduced in percentage by approximately 70%. Others 7/103 (6.7%). Conclusion: In Procedures: Firstly, it was observed that the majority of observations were in the revision done in SOPs. This helped to improve the SOPs. Secondly, wherever SOPs were not followed cent percent, corrective action and follow up was done. In the next audit, these were followed. Thirdly, audit is done by a third person (auditor) who has not prepared the SOP. So SOPs also get reviewed. In Documents: In component lab, documents were both added and removed. Therefore ultimately reframing of documents of component lab was done. It was also noted that incomplete documentation was maximum in donor lab. The possible reason may be rapid turnover of staff in this lab. Overall, improvements in maintenance of registers were observed. To conclude, audit was a means of inspecting our Quality System and also a mode of interaction with the staff. It helped the staff in understanding the importance of SOPs and standards they are following. Overall audit made the operations of the organization more efficient. [ABSTRACT FROM AUTHOR]