A theory of change roadmap for universal health coverage in India

The Theory of Change (ToC) approach is one of the methodologies that the Lancet Citizens' Commission has chosen to build a roadmap to achieving Universal Healthcare (UHC) in India in the next 10 years. The work of the Citizens' Commission is organized around five workstreams: Finance, Human Resources for Health (HRH), Citizens' Engagement, Governance, and Technology. Five ToC workshops were conducted, one for each workstream. Individual workshop outputs were then brought together in two cross-workstream workshops where a sectoral Theory of Change for UHC was derived. Seventy-four participants, drawn from the Commission or invited for their expertise, and representing diverse stakeholders and sectors concerned with UHC, contributed to these workshops. A reimagined healthcare system achieves (1) enhanced transparency, accountability, and responsiveness; (2) improved quality of health services; (3) accessible, comprehensive, connected, and affordable care for all; (4) equitable, people-centered and safe health services; and (5) trust in the health system. For a mixed system like India's, achieving these high ideals will require all actors, public, private and civil society, to collaborate and bring about this transformation. During the consultation, paradigm shifts emerged, which were structural or systemic assumptions that were deemed necessary for the realization of all interventions. Critical points of consensus also emerged from the workshops, such as the need for citizen-centricity, greater efficiency in the use of public finances for health care, shifting to team-based managed care, empowerment of frontline health workers, the appropriate use of technology across all phases of patient care, and moving toward an articulation of positive health and wellbeing. Critical areas of contention that remained related to the role of the private sector, especially around financing and service delivery. Few issues for further consultation and research were noted, such as payment for performance across both public and private sectors, the use of accountability metrics across both public and private sectors, and the strategies for addressing structural barriers to realizing the proposed paradigm shifts. As the ToCs were developed in expert groups, citizens' consultations and consultations with administrative leaders were recommended to refine and ground the ToC, and therefore the roadmap to realize UHC, in people's lived reality

INTERNATIONAL JOURNAL OF PHARMACY & LIFE SCIENCES Dendrimers-a novel drug delivery system

Abstract Dendrimers are the polymeric materials for targeted delivery of drug molecule. These are the highly branched nanoscopic structure for the potential delivery of bioactive. The structure of these materials has a great impact on their physical and chemical properties. As a result of their unique behaviour dendrimers are suitable for a wide range of biomedical and industrial applications. The bioactive agents can be easily encapsulated into the interior of the dendrimers or chemically attached i.e. conjugated or physically adsorbed onto the dendrimer surface, serving the desired properties of the carrier to the specific needs of the active material and its therapeutic applications. In addition to supplying a multivalent backbone for drug attachment, dendrimers also provide access to various new polymer architectures that are potentially relevant to drug delivery applications. Through this review we are mainly focusing on the various properties and applications of dendrimer in pharmaceutical sciences

Comparison between continuous ambulatory peritoneal dialysis and automated peritoneal dialysis: An Indian perspective

Background: CAPD & APD are two modalities of chronic PD. Usage of APD has been steadily increasing in western countries. Data regarding APD from India are lacking. This study was undertaken to compare the outcomes of APD & CAPD. Methods: Retrospective study of 40 patients on APD matched with 40 CAPD patients from 2011-2015. Results: A total of 80 (40-APD, 40-CAPD) incident PD patients were retrospectively analysed. Baseline characteristics were similar in both groups. 42.5% in APD and 55% in CAPD group respectively had one or more episodes of peritonitis (Ns). Peritonitis rate in APD group was 0.27 episode per year as compared to 0.30 episode per year in CAPD group. Exit site infection developed in one APD patient & 2 in CAPD. 16 patients in APD and 20 patient in CAPD developed PD peritonitis. 77% were culture negative & 23% were culture positive. 2 patients developed fungal peritonitis. 61.5% responded to standard therapy& 28.5% had refractory peritonitis (APD-7 vs. CAPD-8). Need for hospitalisation for any cause more in CAPD than APD (CAPD-33 vs. APD-29, ns). Hospitalisation rate was also less in APD than CAPD (0.55 episode per year vs. 0.63 episode per year). Residual urine output at tie of admission & the end of follow up was less in APD than CAPD, although non-significant. Technique failure was not significant between groups (APD- 6 vs. CAPD-7). Overall 28.7% had died at the end of follow up. APD had 11 deaths as compared to CAPD who had 12 deaths. Peritonitis related death was commonest cause in either groups. Conclusion: APD when compared to CAPD did not differ significantly in terms of peritonitis rate, hospitalisation rate, preserving of residual renal function, technique failure. All-cause mortality did not differ significantly between groups. Our study did not show any clear benefit of APD over CAPD

Abstracts of National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020

This book presents the abstracts of the papers presented to the Online National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020 (RDMPMC-2020) held on 26th and 27th August 2020 organized by the Department of Metallurgical and Materials Science in Association with the Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, India. Conference Title: National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020Conference Acronym: RDMPMC-2020Conference Date: 26–27 August 2020Conference Location: Online (Virtual Mode)Conference Organizer: Department of Metallurgical and Materials Engineering, National Institute of Technology JamshedpurCo-organizer: Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, IndiaConference Sponsor: TEQIP-