A Prospective Analysis of Adverse Drug Reactions in a South Indian Hospital

Adverse drug reactions are a great cause of concern to the medical profession, the patients and the pharmaceutical industry. However ADR reporting and monitoring is yet to catch up in India. Hence we undertook a study to record and analyze adverse reactions among all patients admitted to the medical wards of a tertiary care. Centre patients admitted to all medical wards over one year were assessed for ADRs throughout their admission. Suspected ADRs were recorded and analyzed for i) the type of reaction ii) severity iii) Consequence on treatment that is if the drug was continued, or stopped, or needed to be treated with other drugs, iv) Physiological system involved and the v) group of the drugs associated with ADRs. Among 1250 patients admitted during the study period, 250 adverse events were observed. Majority (76.8%) were of mild type, 66% were severe requiring intensive care and 3 patients died. Antimicrobials were responsible for maximum (42.4%) ADRs followed by drugs acting on CNS (20%). When we analyzed the systems affected, CNS side effects were more common in our study. While in many other studies Cardiovascular and gastrointestinal side effects were the most common. Combination of drugs was responsible for a large percentage of ADRs. Inadvertent use of antipsychotics with sedatives led to respiratory failure in 4 patients of which 1 died. Contaminated IV fluids are suspected to be the cause of death in another fatal ADR. In conclusion there is a need for vigilant ADR monitoring to be done by all doctors to prevent morbidity and mortality from ADRs

Knowledge of Pharmacology of Analgesics Among Nurses in a Tertiary Centre

Objectives: To evaluate the knowledge of nurses about the analgesics they administer in our hospital. Methodology: A total of 102 nurses completed the questionnaire which included 20 multiple choice questions based on the dosage forms, mechanism of action, route of administration, adverse effects of the commonly administered analgesics, the nurses’ educational qualifications and their working experience. Frequency, percentage, mean, Kruskal Wallis test and Mann Whitneys test were used to analyse data. Answers were given a score out of 20(100%). Results: The sample comprised of 17(16.6%) senior staff nurses, 38(37%) junior staff nurses and 47(46%) student nurses. Of the staff, 10.8 % were BSc and MSc nurses, 43.1 were GNM staff. The mean knowledge score of BSc & MSc staff was 12.18, GNM staff was 11.7 and of student nurses was 13.38. None of the groups scored more than 15, suggesting their knowledge was inadequate. There was a correlation between knowledge and experience in the staff nurses. Conclusion: The result of this study suggests that the knowledge of pharmacology of analgesics among nurses is inadequate, and thus supports the need for supplementary pharmacology education for nurses in clinical settings, focusing on common drugs they administer and help prevent medical errors

Obstetric violence: a health system study

Background: Disrespect and abuse during facility-based childbirth is a global problem with differing driving factors in different contexts. Obstetric Violence (OV) refers to professional deficiencies in maternity care. The objective of this study was to assess knowledge and attitudes towards OV in a cohort of members of the obstetric healthcare team at a tertiary care, teaching hospital in Western India (Mumbai).Methods: A questionnaire-based study involving 80 participants comprising of trainee doctors and faculty, nursing students, staff and teachers from the department of Obstetrics and Gynaecology and hospital administration.Results: 57.97% of participants had heard the term ‘Obstetric violence’ earlier. 75.36% reported verbal abuse as a form of OV, others being physical abuse, non-consented care, discriminatory care, abandonment/neglect or refusal of care and imposition of interventions without scientific basis. 53% and 89.8% of the participants did not consider routine episiotomies and artificial rupture of membrane respectively as forms of OV. 84.06% and 59.4% of participants considered instrumental delivery without consent and Caesarean section citing safety/convenience respectively as forms of OV. 82.6% participants endorsed the need of birth companion. Improving the number and training of healthcare providers and better institutional policies on respectful maternity care were suggested as solutions.Conclusions: Majority of the participants had witnessed some form of OV. The need for practical training of healthcare personnel and better infrastructure in the healthcare system were emphasised, but there appeared to be a lack of consciousness of the paternalistic mindset and approach to women in labour. Soft skills training of healthcare providers with emphasis on key ethical principles like autonomy, respect and dignity is crucial to address the issue of OV.

Gender analysis and training needs assessment of class 4 staff in a tertiary health care institute

Background: A health care team comprises of doctors, nurses, paramedical staff, medical assistants, administrators and support staff or class 4 workers. Each individual has a role in the execution of proper health care delivery to the patients. Obstetrics and gynecology is a dynamic branch requiring urgent attention in most cases right from admission to discharge. Delivery of prompt treatment is possible with better training and coordination of the health care team. In a tertiary care institute, referred patients have more critical health problems and need urgent assistance by well-trained staff. On the other hand, in a smaller set up with less human resource, agile and well-trained support staff would be an asset to overcome the limitations. Better-trained staff means less loss of man-hours from injuries and illnesses, less medico legal liabilities, reduced maintenance cost of equipment and less expenditure on health-related issues of staff. We conducted an interview based cross sectional observational cohort study of the situation and an assessment of needs for skill building of support staff in a tertiary care hospital. At the end, we propose a structured training program suitable to the local needs that can be conducted by experienced peers, technical staff and medical personnel. We studied unmet training needs of the staff and gender related issues.Methods: A questionnaire based cross sectional study involving 92 class 4 workers in the department of obstetrics and gynecology in a tertiary care hospital was conducted comprising questions regarding their demography, work profile, training, needs and problems faced. Key informants in the relevant area were also interviewed.Results: Graphical representation of the responses received has been made. Professional work profile, health issues, gender issues, training need of any specialized training has been highlighted.Conclusions: As an important part of the health care team, this study has brought out issues related to health especially occupational health, needs for training, hurdles faced at work amongst class 4 staff working in the department of obstetrics and gynecology

Gender Transformative Impacts from Watershed Interventions: Insights from a Mixed-Methods Study in the Bundelkhand Region of India

This study examined gender perspectives on water security by exploring an integrated water management approach for agriculture, livestock, and human consumption. The data were generated in a watershed project to enhance drought resilience of farming through groundwater recharge and agroforestry interventions in the water-scarce Bundelkhand region of Uttar Pradesh in central India. Post-intervention, a quantitative survey and qualitative gender and social analysis tools were applied to understand the benefits of the interventions for women, men, and the community as a whole. Quantitative data were collected from 700 individuals in five villages (three treatment villages and two villages where watershed interventions were not implemented). In addition, 33 semi-structured interviews and eight focus group discussions were conducted to understand local gender norms at the project sites. Data analysis revealed that the community benefits accrued from the watershed interventions included increased crop productivity and diversification of agriculture and livelihoods. However, strict patriarchal norms restricted the visibility, mobility, and communication of women within the household and community during the interventions. Considering gender diversity, this study identifies that women can benefit from participating in watershed interventions and provides a deeper understanding of the constraints and barriers to women’s participation in such projects, including economic, social, and cultural factors. The construction of check dams reduced women’s time per day for fetching water by about 29%. Groundwater level increases reduced the effort required of women to draw water from open wells and hand pumps. Female education is a significant factor related to the benefits of watershed interventions, and regression analysis indicated that households with higher levels of education of adult women were significantly more likely to benefit from the interventions than other households. To avoid perpetuation of the exclusion of diverse local knowledge and gender inequality at the community level, mechanisms must be developed and adjusted continuously such that whole communities, including men and women, are empowered to participate in the decision-making process at various levels and for different purposes. When implementing watershed projects in a highly patriarchal context, as in the Bundelkhand region where women are hidden behind the strong presence of men, advocacy of behavioral change communication must be implemented regularly. The community needs to be sensitized toward systematic and gendersensitive institution building, social engagement, and capacity development for local as well as global water security

Synthesis of a New Class of Heteroaryl Dipyrazolylcarbothioamides and Heteroaryl Dipyrazolyl Thiazoles and Evaluation as Antioxidants

A new class of indolyl dipyrazoles and indolyl dipyrazolyl thiazoles were prepared from the Michael acceptor (E)-3-(1H-indol-3-yl)-1-(4-aryl-1H-pyrazol-3-yl)prop-2-en-1-one under ultrasonication. All the compounds were obtained in higher yields and in shorter reaction times under ultrasound irradiation method. The lead compounds were tested for antioxidant activity. Amongst all the tested compounds methoxy substituted indolyl dipyrazolyl thiazole displayed pronounced antioxidant activity. © 2019 Author(s)

Synthesis and Spectral Characterization of 1,2,4-triazole derivatives

The olefin moiety presents in styrylsulfonylmethyl-1,2,4-triazolylamine (1) was exploited to build up five-member heterocycle-pyrazoles. The series of novel pyrazolyl-1,2,4-triazole amine derivatives (2-3) have been synthesized. All the entitles compounds were characterized by 1H and 13C NMR spectra. © 2022 Author(s).The authors G. Sravya and N. Bakkthavatchala Reddy are thankful to Ural Federal University, Yekaterinburg, Russia for financial assistance and thankful to Prof. A. Padmaja for providing necessary lab facility to carry out this research work

A review on Phytosome loaded with novel herbal drug and their formulation, standardization and applications

Novel Drug Delivery System is need of time, as it makes bioavailability, securityand overall therapeutics of a drug easy-going and in the bat of an eye. In the recent days, most of the regnant maladies and nutritional disorders are treated with herbal medicines because of their less after math, economical and easily accessible. The potency of any herbal medication is contingent on the delivery of the effectual level of the therapeutically active constituent. But because of high polarity and poor lipophilicity, the active contents are incompletely assimilated resulting in poor bioavailability.Herbal drugs comprises of a vast array of active contents which furnishes us with a number of applications. But due to high polarity and poor lipophilicity the active contents are poorly absorbed resulting in poor bioavailability. These problems can be overcome by formulating a suitable novel preparation of the herbal extract. Phytosomes are one of the novel drug delivery system containing hydrophilic bioactive phytoconstituents of herbs surround and bound by phospholipids.This phytophospholipid complex resembles a little cell which exhibit better pharmacokinetic and pharmacodynamic profile than the conventional herbal extract resulting in better bioavailability. This article highlights recent information, commercial preparation of phytosomes as well as the various other novel approaches for delivery of herbal constituents. Keywords: Phytosomes, Bioavailability, Phosphatidylcholine, Phytoconstituents

Dynamics of Rural Labor Markets in India: Implications for Inclusive Development Strategy

The rural labor market in India has undergone remarkable changes over the years. Diversified opportunities for employment with increased economic growth, introduction of employment guarantee scheme, demographic change along with expansion of universal education for all girls and boys, increased connectivity and mobility from rural to urban areas, changes in trade policies, attitude towards participation of women in economic activities outside their home have altered the rural labor market dynamics. This policy brief deals with the dynamics of rural labor markets in India. It focuses on the trends in rural employment, rural labor markets, and sources of livelihood and living standards of the rural labor class. It documents both short and long-term changes in rural labor markets observed in India. It identifies the key drivers of changes in the rural labor market, determinants of labor supply and wage rate. Finally, some suggestions are put forward to overcome the challenges in the rural labor market and for an inclusive growth strategy in India. The term inclusive growth is used in this policy brief to include landless labor, smallholder farmers, women and youth who will all be an integral part of the growth process and benefit from the rural and overall economic growth in the country..

SYNTHESIS AND SPECTRAL CHARACTERIZATION OF 1,2,4- TRIAZOLE DERIVATIVES

The azole derivatives are the prominent players in the pharmaceutical research as they possess several biological properties. In particular, triazoles represent a class of heterocyclic compounds with a wide variety of biological activities. Furthermore, heterocyclic compounds containing a 1,2,4-triazole nucleus have a broad spectrum of pharmacological activities, including anti-inflammatory, antimicrobial, anticancer, antiproliferative and apoptotic properties. Hence biological importance of heterocyclic compounds containing 1, 2, 4-triazole with their pharmacological potential has thereby made them extremely attractive research targets. Based on the above essential information, we have designed and synthesized different 1,2,4-triazole derivatives