The Implementation of Right to Information Act, 2005 in India

RTI Act is a milestone in the democracy of India as it has tried to build a new institutional mechanism for ensuring transparency and accountability in the functioning of public institutions. The crux of the RTI Act is to create an information dispensation regime in which information can be accessed by any citizen in an affordable manner. In India, the implementation of the RTI Act has been quite uneven across states. Nearly seven years have passed since the enactment of the Act but the implementation of the act has not been successful in the way it should have been. The present Research paper tries to assess the implementation of the Act in India with particular reference to the implementation in Jharkhand, a State of India. The paper concludes that there is less awareness, less usage of the act and the act has not led to much improvement in the information seeking and delivery mechanisms in the state. Keywords: Right to Information Act (RTI), Governance, Public Information Officer (PIO), Public Authority (PA)

An Unusual Association between Unilateral Intracranial Vessels Occlusion with Iron Deficiency Anaemia and Alpha-Thalassemia Trait: A Case Report

We report a 33-year-old Malay woman presented with acute left dense hemiparesis and an NIHSS score of 11/15. Computed tomography (CT) scan brain showed a massive right middle cerebral artery (MCA) territory infarct. The right internal carotid artery (ICA) and right proximal MCA were shown occluded from digital substraction angiography (DSA). Carotid dissection, carotid canal anomaly, and intercavernous communication were systematically ruled out. She had no risk factors for atherosclerosis. The connective tissue screening and thrombophilic markers were negative. However, she was anaemic on admission and subsequent investigations revealed that she had alpha-thalassemia and iron deficiency anaemia. The right ICA remained occluded from a repeat CT cerebral angiogram after one year, but otherwise she was neurologically stable. This case illustrates an unusual association between intracranial vessel occlusion with iron deficiency anaemia and alpha-thalassemia trait

Detection of pia2 gene polymorphism in glycoprotein III in patients with :migraine

Glycoprotein lila CGP lila) is a platelet membrane receptor. which when activated leads to platelet adhesion. Platelet alloantigen <P1Al is normally represented on the GPIIIa of human platelet membrane in the more common homozygous allelic state CP1A1/A1l. or the rarer polymorphic state CP1A1/A2l. The . later polymorphism P1A1/A2 polymorphic state renders the platelet hyperadhesive leading to increased incidence of coronary events and possibly migraine as well. Migraine is also a disorder wherein platelet hyperadhesion and serotonin release have been observed. Migraine is a common headache disorder exhibiting a prevalence of 9% in the Malaysian population. This study was designed to identify the prevalence of the homozygous CP1A1/A1l and the polymorphic CP1A1/A2) state in the population at Kelantan and to determine whether the polymorphic state CP1A1/A2l is more common in our migraine patients. So far no work has been published from Malaysia on this subject. A case control study was conducted between September 2004 and October 2005. eightv (80) patien(s who fulfilled the International Headache Society (IHSl criteria for migraine with or without aura. and a group of eighty healthy volunteers were recruited for the study. The P1A1/A2 genotype pattern of all these 160 individuals was analysed by polymerase chain reaction CPCRl using the Allele Specific Oligonucleotide CASO) technique and the results compared with the nigraine symptoms in the patients concerned. ·It was found that 77 (of the 80) controls and 76 (of the 80lcases with migraine possess the homozygous (P1A1/P1A1l configuration. indicating that in the population here the homozygous state is more common (i.e present in 153 out of 160 individulas studied). Secondly. the occurrence of the P1A1/A2 polymorohism in only four (of the 80) migraine cases and also three (of the 80) controls suggest that the polymorphic CP1A 1/A2) state is not more frequent in the migraine cases. Thirdly. of the four cases positive for P1A1/A2 polymorphism three had classical visual aura (75%). Earlier studies have reported that migraine with aura has an increased familial incidence when compared with migraine without aura suggesting that migraine with aura could well be related to the inheritance of this P1A1/A2 polymorphism state. Although our findings do not totally support the hypothesis that the P1A2 polymorphism represents an added inherited platet risk factor for migraine or even migraine with aura. further searches for such a factor are clearly warrwnted. because of the familial aggregation of migraine headache cases. Thus this preliminary study shows that P1A1/A2 polymorphic state on the GPIIIa platelet membrane receptor does not increase the risk of inheriting migraine. However if present it is more likely to manifest as migraine with aura in the migraineurs with this polymorphism

COLISTIN RESISTANCE IN CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE STRAINS

Objective: There is an increasing use of colistin consequent to increase in the infections caused by carbapenem-resistant Klebsiella pneumoniae.The present study was conducted to determine the minimum inhibitory concentration (MIC) of colistin and the resistance pattern of colistin in carbapenem-resistant K. pneumoniae (CRKP) strains in our intensive care unit (ICU).Methods: Antibiotic susceptibility testing for other antimicrobial agents was done by Kirby-Bauer disk diffusion method. MIC of colistin was determined by agar dilution method. The results of antibiotic susceptibility testing were interpreted as per Clinical Laboratory Standard Institute guidelines 2016 and MIC of colistin were interpreted as per European Committee on Antimicrobial susceptibility testing. The carbapenem resistance was phenotypically detected by modified hodge test and imipenem/imipenem ethylenediaminetetraacetic acid disk method.Results: Out of 518 K. pneumoniae, 329 were resistant to carbapenems, and 91 isolates showed resistance to colistin. The MIC of colistin ranged between 4 and &gt;512 ug/ml and MIC90 was 16 ug/L and MIC50 was 4 ug/ml. A majority of the colistin-resistant isolates were found in multidisciplinary ICU (85/91).Conclusion: The emergence of colistin-resistant strains is a major problem due to limited treatment options for infections caused by CRKP carbapenemase producing K. pneumoniae. Colistin should not be used alone, combination therapy should be preferred

Patient-specific cancer genes contribute to recurrently perturbed pathways and establish therapeutic vulnerabilities in esophageal adenocarcinoma

Abstract: The identification of cancer-promoting genetic alterations is challenging particularly in highly unstable and heterogeneous cancers, such as esophageal adenocarcinoma (EAC). Here we describe a machine learning algorithm to identify cancer genes in individual patients considering all types of damaging alterations simultaneously. Analysing 261 EACs from the OCCAMS Consortium, we discover helper genes that, alongside well-known drivers, promote cancer. We confirm the robustness of our approach in 107 additional EACs. Unlike recurrent alterations of known drivers, these cancer helper genes are rare or patient-specific. However, they converge towards perturbations of well-known cancer processes. Recurrence of the same process perturbations, rather than individual genes, divides EACs into six clusters differing in their molecular and clinical features. Experimentally mimicking the alterations of predicted helper genes in cancer and pre-cancer cells validates their contribution to disease progression, while reverting their alterations reveals EAC acquired dependencies that can be exploited in therapy

Enhancement of dissolution rate of racecadotril by liquisolid compact technology

The current investigation was used to improve the rate of dissolution of an anti-diarrheal drug i.e., racecadotril (RT) at low pH conditions (i.e., in the stomach) by reducing the water secretion and electrolyte in to the intestine by liquisolid tablets. Different formulations (liquisolid) were prepared using Avicel PH 102 as a carrier. Aerosil 200 as a coating material and sodium starch glycolate used as a disintegrant. Polyethylene glycol 200 was used as a non-volatile vehicle to dissolve the drug. FTIR, DSC, XRD and dissolution studies were conducted to characterise liquisolid tablets. Characterisation studies indicated that no interactions between carrier and drug. Solid state characterization had shown a reduction in crystallinity that further supports increment in solubility and dissolution. The optimised formulation showed a significant increase in dissolution i.e., 99.54±0.62% in 30 min compared to directly compressible tablets (38.47±0.26%). The % dissolution efficiency of racecadotril liquisolid tablets 76.86% compared to marketed tablet (27.56%) and conventional direct compression tablet (17.11%). Significant reduction in mean dissolution time of racecadotril from liquisolid tablets (6.84 min) compared to direct compression tablet (44.57 min), indicating faster release of drug and faster onset of action. Formulation of liquisolid tablets could enhance solubility, dissolution and bioavailability of racecadotril

What motivates government doctors in India to perform better in their job?

Objectives: Addressing the issue of poor motivation of Medical Officers (MOs) to join and continue service in rural India is a major challenge faced by the health system. The present study aimed at assessing the driving factors of motivation for MOs working with rural government health centres in India. The study also aimed at finding out the differences in the preferred factors of motivation based on various job-related aspects of the respondents. Methods: The study participants included MOs from Gujarat, India. The study asked the participants to rank 20 factors of motivation (10 intrinsic and 10 extrinsic motivation factors) important for them to continue in their current job. The factors for the study were selected using Herzberg's two factor theory of motivation and the data was collected with the help of an instrument that has an established reliability and validity. Distribution of ranks of different motivating factors was studied using average ranks assigned by respondents based on different job-related aspects. Average scores were also calculated to see whether the respondents are motivated more by extrinsic factors or by intrinsic factors. Results: The results indicate that 'job security' was the most preferred factor of motivation followed by 'adequate salary' while, the least preferred factor for motivation was 'local political interference'. Adequate salary and job security also emerged as the two most important motivation factors for all the three groups of respondents based on number of years of work experience. For Ad hoc MOs, 'adequate salary' and 'interesting work' were the most important motivation factors while for bonded category of MOs, 'adequate salary' and 'opportunities for promotion' were the two most important factors for motivation. Conclusion: The current study concludes that MOs motivation to continue with the current job is driven both by extrinsic and intrinsic factors. Hence, the health departments and systems need to pay close attention to devising strategies that address both the extrinsic as well as intrinsic factors. However, according to study findings, more attention needs to be paid to providing Job security and better salaries and monetary benefits to MOs. The study results may be useful to health departments and systems to design management strategies that are based on motivational needs of MOs to improve their attraction and retention