India: A New Player in Asian Production Networks?, Studies in Trade and Investment 75

Chapter IV includes case studies of the automotive components and electronics sectors in order to illustrate the potentially successful example of India emerging as an important regional player in Asian IPNs. The policy challenges and key recommendations for India to integrate into Asian IPNs are analysed.production network, fragmentation of production, Asia, value chain, China, India, PTAs

Educational intervention to improve knowledge, attitude and practice of pharmacovigilance among nursing staff in tertiary care hospital

Background: The present study was planned to assess the knowledge, attitude and practice among nursing staff and to evaluate the effect of educational intervention.Methods: The questionnaire related with knowledge, attitude and practice (KAP) were given to nursing staff before and after the educational intervention in a tertiary care hospital. The data obtained were subjected to statistical analysis.Results: The training given in different sessions has improved KAP among nursing staff. Ninety six percent of them responded correctly regarding who can report ADR as compared to pre training session (69%). Regarding pharmacovigilance as purpose of safe use of medicines was responded by 71% after training as compared to 54% before training. In questions related to PvPI, 94% of nursing staff responded correctly about the scale to be used for causality assessment in comparison to 79% before training. Majority of them were of opinion that only unknown and serious ADR should be reported whereas after training they answered that all the ADR should be reported. A significant improvement has been noticed in questions related to attitude and practice.Conclusions: The educational intervention to improve KAP among nursing staff has resulted in significant improvement

Hepatorenal protective action of Spirulina platensis against beryllium induced hepatorenal dysfunction and histopathological alterations in rats

23-32Beryllium (Be) is highly toxic to human, induces oxidative stress and leads to Chronic Beryllium Disease (CBD) or berylliosis, apoptosis and cancer. In this study, we have investigated the antioxidative and hepatorenal protective potential of Spirulina platensis (SP) against beryllium (Be) induced alterations in hepatorenal biochemical parameters, oxidative stress and histopathological alterations in rats. Different doses of SP (50, 100, 200 and 400 mg/kg, p.o.) were administered (once a day daily for 7 days) against Be(NO3)2 (1 mg/kg, i.p. once a day daily, for 28 days) induced toxic menifestations in female Wistar rats. Be decreased GSH, SOD, CAT, G-6-Pase, ALP and ATPase activities and increased TBARS and ACP activity in liver and kidney. Be enhanced ALT, AST, bilirubin, uric acid, creatinine, total cholesterol and decreased haemoglobin, total protein, sugar in blood. Be deposited in vital organs of rats and altered the histoarchitecture of liver and kidney. Different doses of SP showed dose dependent recovery. SP @400 mg/kg showed significant recovery against Be induced oxidative stress, maintained hepatorenal function towards normal and reduced beryllium body burden. Results of the study. well supported by histopathological observations, conclude that SP possesses hepatorenal protective potential against Be induced toxicity in rats

Protective potential of Moringa oleifera Lam. along with curcumin and piperine against beryllium-induced alterations in hepatorenal biochemistry and ultramorphology in rats

Moringa oleifera Lam. (Moringaceae) is a medicinally important plant, used as traditional medicine all over the world particularly in South Asia and India. Hydroalcoholic (50% v/v) root extract of M. oleifera (150 mg/kg, p.o.) with piperine (2.5 mg/kg, p.o), or curcumin (5.0 mg/kg, p.o.) was administered daily for 1 week in Female Wistar albino rats against beryllium toxicity (1.0 mg/kg, i.p. daily for 5 weeks). Beryllium altered hepatorenal function and enhanced the leakage of AST, ALT, and LDH, depleted SALP activity, and increased the level of urea, uric acid, creatinine, triglyceride and total cholesterol in the blood. Beryllium altered tissue biochemical parameters by a decrease in SDH, ALPase, ATPase activities, and increased ACPase activity, depleted hemoglobin and ALAD activity with an increase in ALAS activity and serum bilirubin. A significant amount of beryllium deposited in the liver, kidney, spleen, and bones. M. oleifera with curcumin showed better antitoxic potential by reversal of hepatorenal function towards normal and restored the activity of SDH, ALPase, ATPase, ACPase, and hemoglobin level normal. M. oleifera with curcumin effectively mobilized beryllium from the body and restored ultrastructure of liver and kidney. It was concluded that curcumin enhances the antitoxic potential of M. oleifera root extract and reduces beryllium body burden in rats

Patent Pooling for Promoting Access to Antiretroviral Drugs (ARVs) – A Strategic Option for India

The current HIV/AIDS scenario in India is quite grim with an estimated 2.4 million people living with HIV/AIDS (PLHA) in 2008, just behind South Africa and Nigeria. The anti-retroviral drugs (ARVs) remain the main stay of global HIV/AIDS treatment. Over 30 ARVs (single and FDCs) available under six categories viz., NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), Protease inhibitors, the new Fusion inhibitors, Entry inhibitors-CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. The major originator companies for these ARVs are: Abbott, Boehringer Ingelheim (BI), Bristol-Myers Squibb (BMS), Gilead, GlaxoSmithKline (GSK), Merck, Pfizer, Roche, and Tibotec. Beginning with zidovidine in 1987, all the drugs are available in the developed countries. In India, about 30 ARVs are available as generics manufactured by Aurobindo, Hyderabad, Andhra Pradesh; Cipla Limited, Goa; Emcure Pharmaceuticals, Pune, Maharashtra; Hetero Drugs, Hyderabad, Andhra Pradesh; Macleods Pharmaceuticals, Daman; Matrix Laboratories, Nashik, Maharashtra; Ranbaxy, Sirmour, Himachal Pradesh; and Strides Arcolab, Bangalore, Karnataka. The National AIDS Control Organization (NACO) set up in 1992 by the Govt. of India provides free ARVs to HIV positive patients in India since 2004. The drugs available in India include both single drugs and FDCs covering both first line and second line ARVs. Even while there are claims of stabilization of the disease load, there is still huge gap of those who require ARVs as only about 150,000 PLHA receive the ARVs from the Govt. and other sources. Access to ARVs therefore is still a cause of serious concern ever since India became fully Trade Related Aspects of Intellectual Property Rights (TRIPS)-complaint in 2005. Therefore, the Indian pharmaceutical companies cannot make generics for those for drugs introduced post-2005 due to product patent regime. Other concerns include heat stable, other better formulations and second line ARVs for adults and more drugs and formulations for paediatric groups, that are still to be widely available in India and other developing countries. To examine whether strong intellectual property (IP) protection systems are to be considered important barriers for the limited or lack of access to ARVs, we studied the patent profile of the ARVs of the originator companies within and outside India. We could record 93 patents in the United States Patent & Trademark Office (USPTO). The originator companies have been also aggressively filing and enforcing patents in India. There have been a few efforts by companies like Gilead and GSK to grant licenses to generic manufacturers in developing countries, ostensibly to promote access to ARVs through lower (two-tier) pricing. These steps are considered as too little and too late. There is an urgent need to look for alternative strategies to promote access to ARVs both linked to and independent of IPRs. Patent pooling as a viable strategy mooted by the UNITAID should be seriously explored to promote access to ARVs. India is ideally suited for trying out the patent pool strategy as most of the global requirement of affordable ARV drugs for HIV/AIDS treatment is sourced from Indian generic companies

Evidence-based national vaccine policy

India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form

Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme

BACKGROUND In 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with indoor residual spraying (IRS) of insecticide. Initially, India applied DDT with stirrup pumps for IRS, however, this did not reduce transmission. After 2015 onwards, the pyrethroid alpha-cypermethrin was applied with compression pumps, and entomological surveillance was initiated in 2016. METHODS Eight sentinel sites were established in the Indian states of Bihar, Jharkhand and West Bengal. IRS coverage was monitored by household survey, quality of insecticide application was measured by HPLC, presence and abundance of the VL vector was monitored by CDC light traps, insecticide resistance was measured with WHO diagnostic assays and case incidence was determined from the VL case register KAMIS. RESULTS Complete treatment of houses with IRS increased across all sites from 57% in 2016 to 70% of houses in 2019, rising to >80% if partial house IRS coverage is included (except West Bengal). The quality of insecticide application has improved compared to previous studies, average doses of insecticide on filters papers ranged from 1.52 times the target dose of 25mg/m2 alpha-cypermethrin in 2019 to 1.67 times in 2018. Resistance to DDT has continued to increase, but the vector was not resistant to carbamates, organophosphates or pyrethroids. The annual and seasonal abundance of P. argentipes declined between 2016 to 2019 with an overall infection rate of 0.03%. This was associated with a decline in VL incidence for the blocks represented by the sentinel sites from 1.16 per 10,000 population in 2016 to 0.51 per 10,000 in 2019. CONCLUSION Through effective case detection and management reducing the infection reservoirs for P. argentipes in the human population combined with IRS keeping P. argentipes abundance and infectivity low has reduced VL transmission. This combination of effective case management and vector control has now brought India within reach of the VL elimination targets

Forward-central two-particle correlations in p-Pb collisions at root s(NN)=5.02 TeV

Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5 2GeV/c. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B. V.Peer reviewe

Event-shape engineering for inclusive spectra and elliptic flow in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

Peer reviewe