Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Role of Supply Chain Management in Quality of Healthcare Services

Healthcare organizations in Haryana (Kurukshetra) face many supply chain management challenges that can be addressed through effective operational and management decisions. The aim of this paper is to examine the supply chain management of healthcare quality in developing countries, particularly in rural healthcare in Haryana (Kurukshetra), and to consider demographic variables such as gender, age, education level and healthcare experience. Design and Hypothesis Testing Approach Distributed 500 questionnaires to determine the impact of aspects of supply chain management on the quality of health services. 27 of his seven procurement officers and administrative staff in Kurukshetra Haryana. The primary method was to collect data from 73 rural health managers and procurement managers to identify the quality and size of health services. The results of our study show that a combination of timely delivery of health products, specifications, level of health product providers and safety in the rural health sector of Haryana (Kurukshetra) is related to the quality of health services. The scope of this article focuses on employing appropriate human resources and highly trained professionals in supply chain departments to improve the quality of health services in the supply chain. As a practical contribution, this article can help healthcare supply chain managers and organizations do their jobs better or create a competitive advantage by addressing the issues and challenges facing individual healthcare managers, organizations and their partners

Role of liquid membrane phenomenon in biological actions of ACE inhibitors, captopril and lisinopril

The liquid membrane phenomenon in angiotensin converting enzyme (ACE) inhibitors namely, captopril and lisinopril has been studied. Hydraulic permeability data have been obtained to demonstrate the existence of the liquid membrane in series with a supporting membrane generated by the ACE inhibitors. Data on the transport of the relevant permeants in presence of the liquid membrane formed by ACE inhibitors indicate that liquid membrane phenomenon is likely to play a significant role in the action of ACE inhibitors

Transport through liquid membranes containing omeprazole and lansoprazole

Oseprazoe and lansoprazole, the therapeutically important drugs belonging to proton pump inhibitor category are extensively used in the treatment of gastric ulcers. Transport through liquid membranes generated by these drugs in lecithin-cholesterol mixture in series with a supporting membrane has been studied. The data obtained show tire formation of liquid membrane in series with tie supporting membrane, Transport of canons, chloride and bicarbonate ions in the presence liquid membranes generated by omeprazole and lanzoprazole indicate the modification in the permeability of various permeants