Using ‘Appreciative Inquiry’ in India to improve infection control practices in maternity care : a qualitative study

ACKNOWLEDGEMENTS The inputs and facilitation of field work from the Gujarat state government officials are acknowledged. We express our gratitude to the doctors, nurses and other health facility staff for actively participating in the study. Our special thanks to Dr. Pritam Pal for capacity building of the research team for appreciative inquiry and Mr. Sanjay Joshi for follow-up of the AI process. We appreciate the help of Dr. Purvi Shah in data collection and preparing transcripts for the study. The study was funded by the John D. and Catherine T. MacArthur Foundation.Peer reviewedPublisher PD

Maternal Health Situation in India: A Case Study

Maternal Health Services are one of the basic health services to be provided by nay government health system as pregnant women are one of the most vulnerable victims of dysfunctional health system, India, in spite of rapid economic progress is still farm away from the goal of lowering maternal mortality to less than 100 per 100,000 live births. It still accounts for 25.7% maternal deaths. The maternal mortality in India varies across the states. Geographical vastness and socio-cultural diversity make implementation of health sector reforms a difficult task. The chapter analyses the trends in maternal mortality and various maternal health programs implemented over the years including the maternal health care delivery system at various levels including the recent innovative strategies. It also identifies the reasons for limited success in maternal health and suggests measures to improve the current maternal health situation. It recommends improvement in maternal death reporting, evidence based, focused, long term strategy along with effective monitoring of implementation for improving Maternal Health situation. It also stress the need for regulation of private sector and proper Public Private Partnership (PPP) policy together with a strong political will for improving Maternal Health.

A prospective randomised double-blinded study of intranasal midazolam atomizer spray for procedural sedation in paediatric patients

Background: Premedication prior to anaesthesia in children provides anxiolysis, facilitates parenteral separation and lessens adverse psychological effects on young minds. The present study was designed to study the safety, acceptability and degree of sedation by intranasal midazolam spray in children undergoing short procedures like endoscopy and CT scan. Methods: Sixty children scheduled for CT scan or endoscopy were randomly divided in to two groups. Thirty patients received intranasal midazolam spray 0.2 mg/kg, 20 minutes prior to procedure (group M) while other thirty patients received intra-nasal 0.9% normal saline spray (group C). Vital parameters such as heart rate (HR), systolic and diastolic blood pressure, respiratory rate (RR), SpO2, ramsay sedation score (RSS) and anxiety score level was observed and recorded prior to the premedication and then every 5 minutes till the end of the procedure. Parenteral separation and behaviour of the patient while entering the procedure room was also evaluated in both groups.Results: The mean heart rate, systolic blood pressure, respiratory rate, oxygen saturation were comparable between groups M and C. The mean diastolic blood pressure was significantly lower in group M as compared to group C. RSS and anxiety level score achieved were significantly higher in group M thereby facilitating easy parenteral separation.Conclusions: We can thereby say that administration of preservative free intranasal midazolam atomizer spray in dose of 0.2mg/kg as premedication in paediatric patients produces satisfactory level of sedation and anxiolysis with minimal adverse effects

Minimization of Latency and Power for Network-on-Chip

Network-on-chip (NoC) has emerged as a imperative aspect that determines the performance and power consumption of many-core systems. This paper proposes a combination scheme for NoCs, which aims at gaining low latency and low power consumption. In the presented combination scheme, a peculiar switching mechanism, called virtual circuit switching, is proposed to interweave with circuit switching and packet switching. Flits traveling in virtual circuit switching can pass through the router with only one stage. In addition, multiple virtual circuit-switched (VCS) connections are granted to share a common physical channel. Moreover, a path allocation algorithm is used in this paper to determine VCS connections and circuit-switched connections on a mesh-connected NoC, such that both communication latency and power are optimized. DOI: 10.17762/ijritcc2321-8169.15022

Antioxidant Activity in Pulp and Peel of Three Mango Varieties

The aim of the present study was to estimate the content of total polyphenols and flavonoids and to investigate in-vitro antioxidant potential of methanolic extracts of peel and pulp in three Indian mango varieties. Antioxidant activity was assessed using [2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid)] ABTS+ assay, 2,2-diphenyl-1-picryl-hydrazyl (DPPH) assay, ferric-reducing ability of plasma (FRAP) assay, and phosphomolybdate assay for Total Antioxidant Capacity (TAC). Total phenolic and flavonoid content was also determined, and expressed in gallic acid equivalent (GAE) and quercetin equivalent (QE), respectively. Results of this study indicated that methanolic extracts of mango peel had significantly higher antioxidant activity compared to that of pulp (29.69 and 3.12), irrespective of the method or variety used. Free radical scavenging and antioxidant activity may be attributed to presence of phenolic (24.61mg GAE/g DM in the peel and 2.01mg GAE/g DM in the pulp) and flavonoid compounds (24.95mg QE/g DM in the peel and 16.15mg E/g DM in the pulp). Antioxidant activity determined by ABTS, DPPH and FRAP assays in mango peel was significantly higher than in the mango pulp (24.95 1.96mg TE /g DM, 23.68 versus 4.60mg BHA/g DM and 40.52 versus 2.781mg TE/g DM), respectively. Results for scavenging activity against DPPH were 96.18% for the peel and 23.86% for the pulp, while, free radical scavenging activity results using ABTS+ assay were 99.62% in the peel and 13.46% in the pulp. Our study justifies research in processing of mango peel into useful, functional food ingredients (powders or extracts)

Wastage of rarest blood and blood components can be stopped: 9 years retrospective and cross-sectional study at tertiary hospital

Background: Inventory of blood/blood components suffer due to outdating of Rh Negative units. Rationale of this article is strategy of transfusion of O Rh Negative red cells to all. A Rh Negative red cells can be given to A Rh Positive, AB Rh Positive. B Rh Negative red cells can be given to B Rh Positive, AB Rh Positive. AB Rh Negative red cells to AB Rh Positive recipients. AB Rh Negative FFP/PRP can be given to all. Objective was to avoid out dating of Rh Negatives by studying the percentage of outdated Rh Negative units amongst the all outdated.Methods: This was 9 years observational, retrospective, cross sectional and descriptive study conducted at tertiary care hospital. Outdated units of Rh Negative blood and components were analysed from the year wise discard registers of blood bank. Percentage of Rh Negative units within all outdated units were calculated.Results: 198 Rh Negative units of whole blood and blood components within all outdated units was 29.11%. Out of 198 the 20 Rh Negative blood components were discarded.Conclusions: Adopt type and screen protocol to prevent outdating. Avoid to bleed the rare blood groups. Audit by hospital transfusion committee and implementation of MSBOS. Track O Rh Negative red cells transfusion to Rh Positive as quality indicator. Track/review transfusion of O Rh negative red cells to Non O Rh negative recipients. Track AB Rh Negative FFP/PRP transfusions to all

Growth Pattern of the Kamars – A Primitive Tribe of Chhattisgarh, India

A cross sectional study of the physical growth status was made on 655 Kamar children (341 boys and 314 girls), aged 5 to 18 years, in the Raipur district of Chhattisgarh. The study aimed to find out the growth pattern of the Kamar children, which is considered to be a primitive tribe of Chhattisgarh, India and was compared with another Indian tribe and the official data for all India (ICMR). Anthropometric measurements included height, weight, sitting height, biacromial diameter, biilliocristal diameter, upper arm circumference, calf circumference and measurements of the triceps and subscapular skinfolds. All anthropometric measurements except skinfold thickenness exhibit uniform increase with age in both sexes. However, when height and weight of the Kamar boys and girls were compared with the data for other tribes and for all India, the Kamar children (both boys and girls) indicated lower weight and height and the difference showed to be significant, for almost all ages. Kamar boys showed higher anthropometric values than girls in almost all measurements except in biilliocristal diameter and in measured skinfolds. Poor socio-economic status of this primitive tribe may be one of the reasons for this poor growth pattern. However, in-depth study is necessary in order to arrive at any basic conclusions and to recommend any policy and interventions

STABILITY INDICATING RP-HPLC METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF AMLODIPINE AND HYDROCHLOROTHIAZIDE IN PHARMACEUTICAL DOSAGE FORM

The Aim of present work is to develop a simple, selective and precise, stability indicating RP-HPLC method for the simultaneous estimation of Amlodipine and Hydrochlorothiazide. The chromatographic separation of the two drugs was achieved on a reverse phase Hypersil Gold, C18, 250 × 4.6 mm, 5μm column using mobile as Potassium dihydrogen buffer – Acetonitrile in ratio of 600:400 v/v (pH adjusted to 3.2±0.05 using orthophosphoric acid) with flow rate of 1.0 ml/min with injection volume 20 μl and the detection was carried out at 237 nm using UV detector. The retention time of amlodipine (Amlo) and hydrochlorothiazide (HCT) were found to be 3.80 and 6.48 min respectively. The linear regression analysis data for the calibration plots showed good linear relationship in the concentration range of 0.84-1.98 μg/ml for hydrochlorothiazide and 4.2-9.8 μg/ml for amlodipine. The method was validated for precision, linearity, LOD and LOQ, specificity, accuracy, system suitability and ruggedness as per ICH guidelines and the results were found to be within the limits. The developed method was used for the stability studies. The validated method can be used for routine quality control testing for HCT and Amlo combine dosage form

STABILITY INDICATING RP-HPLC METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF AMLODIPINE AND HYDROCHLOROTHIAZIDE IN PHARMACEUTICAL DOSAGE FORM

Objective: The aim of present work is to develop a simple, selective and precise, stability indicating RP-HPLC method for the simultaneous estimation of Amlodipine and Hydrochlorothiazide. Methods: The chromatographic separation of the two drugs was achieved on a reverse phase Hypersil Gold, C18, 250 × 4.6 mm, 5μm column using mobile as Potassium dihydrogen buffer–Acetonitrile in ratio of 600:400 v/v (pH adjusted to 3.2±0.05 using orthophosphoric acid) with flow rate of 1.0 ml/min with injection volume 20 μl and the detection was carried out at 237 nm using UV detector. Results: The retention time of amlodipine (Amlo) and hydrochlorothiazide (HCT) were found to be 3.80 and 6.48 min respectively. The linear regression analysis data for the calibration plots showed good linear relationship in the concentration range of 0.84-1.98 μg/ml for hydrochlorothiazide and 4.2-9.8 μg/ml for amlodipine. Conclusion: The method was validated for precision, linearity, LOD and LOQ, specificity, accuracy, system suitability and ruggedness as per ICH guidelines and the results were found to be within the limits. The developed method was used for the stability studies. The validated method can be used for routine quality control testing for HCT and Amlo combine dosage form