Rahi Jain

Medical diagnostic laboratories provisioning of services in India

Context: Diagnostic services have a very important role to play in medical decision-making, which have an impact on the nation′s health status. The understanding of Indian diagnostic services provisioning has certain literature gaps. Aims: This study focused on understanding the functioning of provision of diagnostic services by Indian diagnostic laboratories. Materials and Methods: Exploratory field visits and literature review were used as tools to understand the Indian health system. Results: Indian diagnostic laboratory can be classified into various categories based on the type of services provided and governance. The difference in their financing, resources, quality assurance of services and patient access to services was found in these different laboratories. Conclusions: It was concluded from the study that patient′s access to laboratory services is affected by the functioning of laboratories in terms of governance, financing, resources, quality assurance of services and patient services.

Sugarcane Molasses – A Potential Dietary Supplement in the Management of Iron Deficiency Anemia

ABSTRACT Iron deficiency anemia (IDA) is a serious public health problem that debilitates ∼1.6 billion people globally every year, the majority being pregnant women and children from developing countries. In India, for example, in spite of several operational programs at the national level using iron–folic acid and other allopathic interventions, IDA is still prevalent. Traditional medicines, such as Ayurveda, prescribe herbal formulations containing sugarcane derivatives for the management of pandu, a condition similar to IDA. This article reviews molasses, a sugar industry by-product, as a potential raw material to develop nutraceutical products for IDA. Molasses contains iron and its absorption enhancers, such as sulfur, fructose, and copper, which make it a potential dietary supplement for IDA. More research, product development, and evidence of safety and efficacy of molasses in IDA management can provide a tasty and cost-effective dietary supplement, particularly for children. However, there are challenges, such as competition for raw material from refined sugar manufacturers, quality control, etc., that need to be overcome.

Taxonomy of Challenges in Medical Laboratory Diagnostic Services

The Sustainable development goals 2030 has focused on human health and is dependent on a nation?s healthcare system. Medical diagnostic laboratory services (MDLS) plays an important role in the modern healthcare system as it significantly helps in evidence-based decision-making. The MDLS suffers from many issues identified both globally as well as nationally with steps taken to address those challenges. However, constrained understanding of challenges affecting MDLS made it difficult to design interventions which can cater to laboratory systems in more holistic and standardised manner. Accordingly, it is required to categorize and develop the taxonomy of the various challenges existing in MDLS that will help in defining the scope of challenges and will provide an overview of the various challenges to which a laboratory can get exposed to. This study develops the taxonomy of challenges that can be encountered in MDLS using systematic review. Further, the existence of those challenges in the Indian context is determined that will potentially validate theoretically identified challenges. In the study, the analysis for Indian context is performed using content analysis over the content collected by interacting with various health experts like doctors, lab managers and lab technicians coming from different type of laboratories. The study identified 30 challenges which are categorized in the three-layer hierarchy. The first layer consisted of two challenges followed by eight challenges in the second layer and 20 challenges in the third layer. Out of the 20 challenges in the last layer, 16 challenges could be identified in the Indian context based on the content analysis of the experts interactions. The study concludes that the challenges exist for the MDLS which could be categorized into three layers.

Application of AHP Tool for Choosing a Medical Research Area

Unlimited resource allocation for all types of medical research is not feasible for any nation, funding agency and researcher (decision maker). This study focuses on developing decision making tool/template using Analytic Hierarchy Process (AHP) for decision maker for arriving at focused area of research. Gene therapy based lung cancer treatment is used as a case to demonstrate the template/tool use. The alternatives selected for AHP are immunogene therapy, suicide gene therapy, anti-angiogenic gene therapy, oncogene inhibition based gene therapy, tumor suppressor gene therapy and pro-apoptotic gene therapy. The ability of the tool to provide selection of the gene therapy with process flexibility like criteria selection, technology selection and criteria weightages allows its use by decision maker.

Proposed correlation of modern processing principles for Ayurvedic herbal drug manufacturing: A systematic review

Quality Ayurvedic herbal medicines are potential, low-cost solutions for addressing contemporary healthcare needs of both Indian and global community. Correlating Ayurvedic herbal preparations with modern processing principles (MPPs) can help develop new and use appropriate technology for scaling up production of the medicines, which is necessary to meet the growing demand. Understanding the fundamental Ayurvedic principles behind formulation and processing is also important for improving the dosage forms. Even though Ayurvedic industry has adopted technologies from food, chemical and pharmaceutical industries, there is no systematic study to correlate the traditional and modern processing methods. This study is an attempt to provide a possible correlation between the Ayurvedic processing methods and MPPs. A systematic literature review was performed to identify the Ayurvedic processing methods by collecting information from English editions of classical Ayurveda texts on medicine preparation methods. Correlation between traditional and MPPs was done based on the techniques used in Ayurvedic drug processing. It was observed that in Ayurvedic medicine preparations there were two major types of processes, namely extraction, and separation. Extraction uses membrane rupturing and solute diffusion principles, while separation uses volatility, adsorption, and size-exclusion principles. The study provides systematic documentation of methods used in Ayurveda for herbal drug preparation along with its interpretation in terms of MPPs. This is the first step which can enable improving or replacing traditional techniques. New technologies or use of existing technologies can be used to improve the dosage forms and scaling up while maintaining the Ayurvedic principles similar to traditional techniques.

Health care facility vulnerability in developing nations: strengthening health care policy-making and implementation

BackgroundIn developing countries such as India, inadequate importance and consideration given to assessment of health care facilities negatively affects progress towards achieving health targets. India has focused on developing Primary Health Centres (PHCs) for rural basic laboratory and curative services. The local decision-makers do not have any national-level framework to evaluate the vulnerability of PHCs which are not meeting national PHC standards, nor do they have resources to meet national PHC standards.AimThe study proposed a framework to assess the public health care facilities for vulnerability.MethodsA cross-sectional questionnaire survey was performed. The study used PHC laboratory services of 42 PHCs of Osmanabad District, India as a case study for proposed framework. The data assessment was carried out at district level, block level, PHC cluster level, and PHC level to provide flexibility to local decision-makers in taking remedial measures.ResultsStaff workload (73.17%), physician’s need (51.22%), and organization structure (36.59%) are the most prevalent challenges across PHCs. Multiple challenges are prevalent in the PHCs across districts. The PHCs with poor medical doctor (MD) capability or many challenges have shown poor laboratory performance.ConclusionGovernance need to be strengthened in PHCs, followed by sustained support in resources and financing. Poor health status in developing nations necessitates a public health response based on health systems. Therefore, an assessment of health facility vulnerability in the form of laboratory services is essential in primary health care facilities.

Comparative analysis of the spectrophotometry based total phenolic acid estimation methods

This paper proposes a total phenolic acid estimation technique for samples with unknown phenolic acid composition and preliminary sample screening in resource-constrained settings. Phenolic acids constitute one of the important secondary metabolites for industry and researchers, but appropriate technique for its estimation by rural entrepreneurs is unclear. This study compared spectrophotometric Arnov test (AT) and potassium iodate test (PT) on the basis of seven parameters namely input requirements, process, limit of detection (LOD), limit of quantification (LOQ), linearity range, interferences and different phenolic compounds response. As per the results of the study PT is better than AT in input requirements, process, interference and different phenolic compounds response whereas AT is better than PT in LOD, LOQ and linearity range. Therefore, the study concluded that PT could be more suitable for rural entrepreneurs.

India's Focus On Medical Diagnostic Laboratories: Indian Planning and Programmes

Healthy lives and well being for all is one of the goals in Sustainable Development Goals 2030 (SDG) that is strongly dependent on a nation?s healthcare system. In any modern healthcare system, laboratory diagnostics play a crucial role for effective system?s functioning as it helps in evidence based decision-making but the focus on laboratory diagnostics system is inadequate especially nationally. However, globally and nationally problems in laboratory diagnostic systems have been raised, but more focus is demanded. This study focuses on understanding the government past Five-yearhealth plans and current national health programmes to understand the focus given to the laboratory systems both historically and in present. This will allow in filling the gap of linking the current status of laboratory systems with the historical approaches of India. This linkage will enable a more comprehensive understanding of the India?s current state of laboratory diagnostic system and will help current and future planners and decision makers like Niti Aayog in better decision-making.The study performed two phases of inductive approach based content analysis. The first phase is involved in the analysis of the Five-Year health plans for understanding the focus areas in health sector over the years. Second Phase is involved in the analysis of major health programmes for understanding the current focus areas of medical diagnostic laboratory system in the health sector. The study has found that laboratory diagnostics was given focus in the various health plans but the scope and the depth of discussion was very limited. Further, the focus on laboratory diagnostic systems and its various components is found to be variable among all major national health programmes and very limited. The study concludes that the India?s focus on the laboratory diagnostic system is very limited and inadequate.