Healthcare Professionals In India Research Articles

A survey of awareness, knowledge, attitude, and skills of telemedicine among healthcare professionals in India

BackgroundTelemedicine Practice Guidelines were promulgated in India in 2020. There is little information about the awareness, knowledge, attitude and skills (AKAS) of the healthcare professionals regarding telemedicine and its practice guidelines a year after. The aim of the study was to study the awareness, knowledge, attitudes and skills of the healthcare workers of the country about telemedicine especially in the context of telemedicine practice guidelines 2020. MethodsAn online survey was conducted over 12 weeks from active healthcare workers in India. A standard AKAS Questionnaire for telemedicine and other close and open ended questions were used. ResultsA total of 602 active healthcare workers participated in the study. It was seen that a majority of participants had high scores for awareness, knowledge, and attitude toward telemedicine but a mere 39.53% scored high for skills related to telemedicine. A majority of the respondents had no knowledge of the existence of telemedicine practice guidelines and very few had seen or read them. A majority of the respondents were keen to attend a course or training to enhance their understanding and practice of telemedicine. ConclusionThe results of the study show that the basic awareness and background knowledge regarding telemedicine exists in the healthcare professionals in the country. The requirement is to train and educate them about the skills and provisions of the telemedicine practice guidelines 2020 to ensure optimal use of telemedicine and to avoid medico-legal issues.

Comparative study of themental health impact of the COVID-19 pandemic on health care professionals in India.

Aims: This study aimed to investigate how the psychological health of health care professionals (HCP) on COVID duty was different from those who were not directly in contact. Methodology: Of 473 (76%) randomly selected respondents (doctors and nurses) to a WhatsApp request message, 450 subjects’ data were finally analyzed. Result: The prevalence of stress, anxiety and depression among HCP was 33.8, 38.9 and 43.6%, respectively. Compared with nonexposed professionals, COVID-19-exposed professionals had roughly double the score of these morbidities (t = 6.3, p < 0.001; t = 6.9, p < 0.001; t = 6.0, p < 0.001). Most worry (71.11%) was about the health of their family, followed by themselves (35.55%). Conclusion: The level of exposure, feelings of uncertainty and fear of infection emerged in our study as possible risk factors for psychological morbidities among HCP.

Survey on individual experiences after first dose of COVID-19 vaccination amongst Indian oral health care personnel

Apprehension pertaining to adverse events associated with vaccine can create hesitancy in population which undermines their confidence in vaccination programmes. Clarity regarding what could be expected post-vaccination through reliable scientific data helps in allaying the apprehension. Our research aims at gauging the adverse experiences of oral health care professionals following first dose of immunization against COVID-19 with ChAdOx1 nCoV-19 (COVISHIELD™) and BBV152 (COVAXIN®). Data was collected by means of e-questionnaire circulated through online media such as social media platforms to oral health care professionals in India. Data was subjected to statistical analysis using Statistical package for social sciences (SPSS v 26.0, IBM). Descriptive statistics like frequencies and percentage for categorical data, Mean &amp; SD for numerical data has been depicted. Comparison of frequencies of categories of variables with groups was done using chi square test. Pain at site of injection (n=243) was the most frequently reported AEFI, followed by fever (n=225), headache (n=185), body ache (n=156) and fatigue (n=146). Majority of the AEFIs were perceived to be of mild (58.22%) to moderate (31.50%) severity by the respondents and resolved within first two days of immunization. AEFIs are almost inevitable when population on a nation-wide scale is involved in the vaccination scheme Availability of scientific data pertaining to AEFIs that could be expected post-vaccination such as our findings could provide clarity to general population about the issue, thereby purging any apprehension developed due to myths circulation through various modes of media.

Vaccination induced complacency in adherence to COVID-19 precautionary measures among oral health care professionals in India and the United States: a retrospective pretest-posttest design

ABSTRACT In the context of the COVID-19 pandemic, vaccination-induced behavioral complacency in adherence to COVID-19 appropriate behavior emerged as a significant concern. This study was conducted among a convenience sample of 540 oral health care professionals in India and the United States. This was a retrospective pretest-post-test design, a choice to eliminate response-shift bias, where the participants responded online on their adherence or otherwise to COVID-19 precautionary measures before and after vaccination. The difference between post-test and retrospective pretest scores was used in assessing the magnitude of complacency demonstrated by the individual as a function of getting vaccinated, and the process was validated using exploratory factor analysis (EFA) with principal axis factoring and confirmatory factor analysis (CFA) on two randomly split subsets of the overall sample. It was observed that there had been a decline in the adherence to all the considered COVID-19 precautionary measures from the time before vaccination to the time of achievement of the fully vaccinated status. EFA performed on the randomly split sub sample of 240 subjects returned a two factor solution with five items in factor 1 and seven items in factor 2. Items in both the factors demonstrated adequate internal consistency in reliability analysis (Cronbach’s alpha 0.84 and 0.82, respectively). The two factor solution obtained in EFA demonstrated good model fit in CFA [RMSEA (90%CI) – 0.077 (0.063–0.092); TLI – 0.872; CFI – 0.897; SRMR – 0.056]. These results highlight the vaccination-induced complacency in observing COVID-19 appropriate behavior among oral health professionals in India and the United States.

Prevalence and severity of secondary traumatic stress and optimism in Indian health care professionals during COVID-19 lockdown.

The COVID-19 pandemic has brought to light the lacunae in the preparedness of healthcare systems across the globe. This preparedness also includes the safety of healthcare providers (HCPs) at various levels. Sudden spread of COVID-19 infection has created threatening and vulnerable conditions for the HCPs. The current pandemic situation has not only affected physical health of HCPs but also their mental health. This study aims to understand the prevalence and severity of secondary traumatic stress, optimism parameters, along with states of mood experienced by the HCPs, viz., doctors, nurses and allied healthcare professionals (including Physiotherapist, Lab technicians, Phlebotomist, dieticians, administrative staff and clinical pharmacist), during the COVID-19 lockdown in India. The assessment of level of secondary traumatic stress (STS), optimism/pessimism (via Life Orientation Test-Revised) and current mood states experienced by Indian HCPs in the present COVID-19 pandemic situation was done using a primary data of 2,008 HCPs from India during the first lockdown during April-May 2020. Data was collected through snow-ball sampling technique, reaching out to various medical health care professionals through social media platforms. Amongst the study sample 88.2% of doctors, 79.2 of nurses and 58.6% of allied HCPs were found to have STS in varying severity. There was a female preponderance in the category of Severe STS. Higher optimism on the LOTR scale was observed among doctors at 39.3% followed by nurses at 26.7% and allied health care professionals 22.8%. The mood visual analogue scale which measures the "mood" during the survey indicated moderate mood states without any gender bias in the study sample. The current investigation sheds light on the magnitude of the STSS experienced by the HCPs in the Indian Subcontinent during the pandemic. This hitherto undiagnosed and unaddressed issue, calls for a dire need of creating better and accessible mental health programmes and facilities for the health care providers in India.

Perceived Stress During Covid-19 Pandemic Among Doctors and Staff Nurses in India

The present study aimed to determine the level of stress healthcare professionals are going through during the outbreak of COVID-19 pandemic. The sample of the study included 170 healthcare professionals in India who are working in the COVID hospitals. The data is collected through google forms. The tool used to collect the data was Perceived Stress Scale developed by Cohen, Kamarck and Mermelstein (1983). The results of the study indicated high levels of stress among healthcare professionals. There was no significant difference between male and female, single and married healthcare professionals in their level of stress. The healthcare professionals who are working in Government hospitals are significantly prone to stress than healthcare professionals in Private Institutes.

P-740 Socio-cultural and clinical implications of ‘routine’ AMH testing in India: Insights from an interview study with the healthcare professionals (HCPs)

Abstract Study question How do Indian healthcare professionals describe their clinical experience with and perspectives on AMH testing in Indian women seeking fertility treatments including fertility preservation? Summary answer The HCPs cautioned against AMH testing as a screening tool in presumed fertile Indian women due to its anticipated impact on women’s arranged-marriage prospects. What is known already AMH test is being increasingly used to assess women’s ovarian reserve (OR) while planning fertility treatments or to guide decisions about fertility preservation (FP). There is weak evidence suggesting that serum AMH level and fertility treatment outcomes vary in different population groups. Surveys with women in reproductive age (e.g. the US, Ireland, the Netherlands) indicate that a majority wants to know their OR to aid reproductive decision making. As yet, both globally and in an Indian context, there are only few qualitative studies exploring the views of HCPs on the OR assessment in clinical practice and its socio-cultural implications. Study design, size, duration This paper reports the findings of an exploratory qualitative research aimed at understanding whether and how elective fertility preservation could influence reproductive autonomy of Indian women. Between June 2018 and April 2019, IVF specialists and obstetricians practicing in ten cities across five Indian states were interviewed in English (language commonly spoken) using a semi-structured interview guide. The discussion about OR assessment with AMH-testing was initiated by the participants indicating its significance in their clinical practice. Participants/materials, setting, methods The study sample included 17 male and 15 female HCPs, the majority (18/32) was practicing in Mumbai. Twenty-six of them were in private practice while six worked as OBGYNs in publicly funded teaching hospitals. Twenty-six participants were interviewed in their clinics and the remaining six using Skype or telephone. After several rounds of immersive reading, the interview sections on OR and AMH-test were analyzed inductively using Braun and Clarke’s thematic analysis. Main results and the role of chance Several participants reported that many of their patients present with decreased OR (DOR) at a younger age and need higher dosages of hormones for ovulation induction compared to the dosages mentioned in international guidelines. They corroborated this experience with a few peer-reviewed articles indicating a six-years age difference in OR of Indian women undergoing IVF compared to Spanish women. A majority of participants advocated for the rational use of OR assessment in IVF patients but warned against its indiscriminate use or interpretation out of context due to concerns about overdiagnosis of ovarian factor infertility and overtreatment with IVF with donor eggs. Although the physicians who had performed elective FP perceived AMH test as a simple, affordable and empowering tool to guide FP decisions, most participants were critical of using AMH-test as a screening tool in young, presumed fertile women completing university education. They were concerned that a diagnosis of DOR as a result of such screening in this population in the Indian context will adversely impact women’s chances of marriage and might further increase pressure on women to get married and complete their childbearing early even if they are not ready for it. Limitations, reasons for caution This is the first qualitative study assessing views of Indian HCPs on AMH testing. These results are indicative rather than a representation of views of Indian HCPs. Almost half of the contacted HCPs did not respond to interview requests; we do not know whether they had different views. Wider implications of the findings The insights on clinical implications of AMH testing in India are relevant to other societies beyond the Euro-American and Australian context where AMH testing will increase in the future. The socio-cultural implications of ‘routine’ AMH testing in India urges us to be aware of similar implications in other cultural contexts. Trial registration number Not applicable

P–740 Socio-cultural and clinical implications of ‘routine’ AMH testing in India: Insights from an interview study with the healthcare professionals (HCPs)

Abstract Study question How do Indian healthcare professionals describe their clinical experience with and perspectives on AMH testing in Indian women seeking fertility treatments including fertility preservation? Summary answer The HCPs cautioned against AMH testing as a screening tool in presumed fertile Indian women due to its anticipated impact on women’s arranged-marriage prospects. What is known already AMH test is being increasingly used to assess women’s ovarian reserve (OR) while planning fertility treatments or to guide decisions about fertility preservation (FP). There is weak evidence suggesting that serum AMH level and fertility treatment outcomes vary in different population groups. Surveys with women in reproductive age (e.g. the US, Ireland, the Netherlands) indicate that a majority wants to know their OR to aid reproductive decision making. As yet, both globally and in an Indian context, there are only few qualitative studies exploring the views of HCPs on the OR assessment in clinical practice and its socio-cultural implications. Study design, size, duration This paper reports the findings of an exploratory qualitative research aimed at understanding whether and how elective fertility preservation could influence reproductive autonomy of Indian women. Between June 2018 and April 2019, IVF specialists and obstetricians practicing in ten cities across five Indian states were interviewed in English (language commonly spoken) using a semi-structured interview guide. The discussion about OR assessment with AMH-testing was initiated by the participants indicating its significance in their clinical practice. Participants/materials, setting, methods The study sample included 17 male and 15 female HCPs, the majority (18/32) was practicing in Mumbai. Twenty-six of them were in private practice while six worked as OBGYNs in publicly funded teaching hospitals. Twenty-six participants were interviewed in their clinics and the remaining six using Skype or telephone. After several rounds of immersive reading, the interview sections on OR and AMH-test were analyzed inductively using Braun and Clarke’s thematic analysis. Main results and the role of chance Several participants reported that many of their patients present with decreased OR (DOR) at a younger age and need higher dosages of hormones for ovulation induction compared to the dosages mentioned in international guidelines. They corroborated this experience with a few peer-reviewed articles indicating a six-years age difference in OR of Indian women undergoing IVF compared to Spanish women. A majority of participants advocated for the rational use of OR assessment in IVF patients but warned against its indiscriminate use or interpretation out of context due to concerns about overdiagnosis of ovarian factor infertility and overtreatment with IVF with donor eggs. Although the physicians who had performed elective FP perceived AMH test as a simple, affordable and empowering tool to guide FP decisions, most participants were critical of using AMH-test as a screening tool in young, presumed fertile women completing university education. They were concerned that a diagnosis of DOR as a result of such screening in this population in the Indian context will adversely impact women’s chances of marriage and might further increase pressure on women to get married and complete their childbearing early even if they are not ready for it. Limitations, reasons for caution This is the first qualitative study assessing views of Indian HCPs on AMH testing. These results are indicative rather than a representation of views of Indian HCPs. Almost half of the contacted HCPs did not respond to interview requests; we do not know whether they had different views. Wider implications of the findings: The insights on clinical implications of AMH testing in India are relevant to other societies beyond the Euro-American and Australian context where AMH testing will increase in the future. The socio-cultural implications of ‘routine’ AMH testing in India urges us to be aware of similar implications in other cultural contexts. Trial registration number Not applicable

Acceptability of coronavirus disease 2019 vaccination among Indian health-care professionals: A cross-sectional survey.

Objective:The epidemic of novel coronavirus disease 2019 (COVID-19) has led to the development of several vaccine candidates which has been progressing at an unprecedented rate. Health-care professionals are somewhere standing between their professional commitments and personal well-being, amid concerns about the safety and efficacy of the vaccine. The present survey was conducted to analyze their approach toward vaccination.Materials and Methods:An online questionnaire-based cross-sectional survey was conducted among 250 health-care professionals comprised of Medical, Dental, Ayurveda, Physiotherapy doctors, and nursing staff working at a tertiary care hospital in Gurugram city. A self-administered 10-item questionnaire in the Google document format was developed to assess their perception and attitude toward vaccination. The present survey was carried out for 2 months from November to December 2020. The responses recorded were subjected to the statistical analysis using the Chi-square test and the level of statistical significance was set at P ≤ 0.05.Results:Among all participants, 72 (28.8%) were male and 178 (72.2%) were female. Of all, 60.4% of the health-care professionals somewhat or completely agreed to accept a vaccine as soon as it is available. Nursing staff reported more likely to accept COVID-19 vaccination than the other health-care professionals. Majority of the HPs (44%) were found to be concerned about the rapidity in the development of vaccine.Conclusion:The overall attitude toward vaccination was positive but specific concerns regarding COVID-19 vaccine are prevalent. Thus, to maintain the benefits of vaccination programs and for its successful implementation, understanding and addressing their vaccine hesitancy will be crucial.

Calling out the COVID blues- how much of a psychological impact does the COVID-19 pandemic have on health care professionals in India

Background: COVID-19 pandemic is one of the rarest health crises the world has ever encountered. As mental health professionals; we need to consider the psychological impact of the pandemic. There are certain groups of people that are largely more vulnerable to pernicious effects on mental health including frontline healthcare workers. Hence, the current study was undertaken look into the minds of our covid warriors.&#x0D; Aims and Objectives: This study aims to assess psychological impact of COVID-19 pandemic among health care professionals, with the primary objectives being to study: 1. Perceived stress regarding COVID-19 pandemic among health care professionals. 2. Stigma associated with the pandemic, faced by health care professionals in their surroundings as well as in the society. 3. Obsessive-Compulsive symptoms among the health care professionals. The secondary objective of the study is to compare between High and Low exposure groups on the basis of different variables.&#x0D; Materials and Methods: This study is an observational, cross-sectional study wherein the sample size is 410, taken by consequent sampling. Data was collected from health care professionals all over India, by manual or digital interview. Health care professionals of a tertiary care hospital were taken up for the study including doctors, nurses and other hospital staff.&#x0D; Results: On K10 scale, 369 (90%) of the subjects had scores below 25, meaning they reported to have no or mild perceived stress, whereas 41 of them (10%) had scores 25 or above, meaning to have moderate or severe perceived stress. Forty (9.8%) subjects reported to be experiencing panic symptoms at the time of the interview. One hundred twenty-eight (31.2%) admitted to have faced stigma from the society in at least one of the facets of the questionnaire based on SARI stigma scale. 39 people (9.5%) reported to be experiencing OC symptoms at the time of interview.&#x0D; Conclusion: With this research we conclude that owing to the ongoing COVID-19 pandemic, the health care professionals are under a lot of stress, many of them have also experienced panic like symptoms. Large scale screenings should be carried out at regular intervals at hospitals to keep a check on the mental health of health care workers. Mental health should be given a priority by the government officials and sufficient awareness campaigns should be rolled out.

Perception of Health Care Professionals (HCPs) on Telemedicine in India

With a nationwide lockdown imposed, there was a substantial drop in the in-clinic patient visits in 2020. Telemedicine gained momentum during the pandemic and virtual modes of teleconsultation were adopted by the health care professionals. A PAN India research survey was carried out to understand the HCP perspective on virtual consultation, ‘Telemedicine’. The survey aims to assess the behavioral shift in HCPs from face-to-face to adapting Telemedicine in clinical practice post-pandemic and foreseeing the future of Teleconsultation for Health Care Professionals in India. A PAN India survey was conducted among 154 participants. The questions were based on Telemedicine as a practice, barriers and influential factors for Telemedicine &amp; the significance of guidelines published by the Telemedicine Society of India (TSI) in clinical practice. The survey included varied forms for the questions such as Multiple choice, Likert scale and Polar Questions. Descriptive statistics were used to analyze the outcomes of this research which will help to identify the influential factors in the uptake of Telemedicine practice by the HCPs and how the Telemedicine Society of India could help them with the guidelines. This research will further uncover the challenges faced by the HCPs during Telemedicine consultation in the post-Covid era, and identify potential platforms for teleconsultation, in a virtual environment.

COVID-19 -Awareness, Attitude &amp; Life Style Modifications Among Undergraduate Health Professional Students of Sumandeep Vidyapeeth Deemed to be University: A Questionnaire Based Online Survey.

The rapid and extensive spread of the COVID-19 pandemic has become a major cause of concern for the healthcare professionals in India due to rise in cases day by day. The Government of India declared a series of lockdowns to prevent the spread of this infection. The aim of this study is to assess the awareness and attitude and lifestyle changes of health care students by physically, mentally or by nutritionally during this lockdown. Online survey was done for all undergraduate health professional students of Sumandeep Vidyapeeth, deemed to be a university. A questionnaire was made according to MOH information and validated to evaluate their knowledge, attitude and lifestyle modifications. Google form link was given to all the students through various online portals as G-mail, Whats app and Instagram page of university. Total 910 students participated in the survey. Incomplete and irrelevant information submitted were excluded from the study. Thematic analysis was done for lifestyle modifications under the headings Daily Routine, Psychological, educational, Physical and dietary modifications. Most of the students were aware about the spread, precautions and preventive measures of COVID-19. Students reported various attitudinal changes significantly during COVID-19 as use of sanitizer, avoiding gathering, washing hands etc. Mixed response was obtained for online lectures and self directed learning during lock down from all levels of students. More studies are recommended to generate evidence and awareness through research on COVID-19. Health care professional Students awareness is one of the future aspects of dealing with the COVID19 and other similar conditions if occurred.

IMPACT OF COVID 19 PANDEMIC ON BLOOD PRESSURE OF HEALTHCARE PROFESSIONALS DURING LOCKDOWN - AN INDIAN STUDY

Objective: Covid-19 pandemic has challenged the healthcare system globally. Hypertension is one of the risk factors associated with increased mortality and morbidity with Covid-19 infection. Few studies have looked into the impact of the Covid-19 pandemic on the mental health of healthcare professionals (HCPs). However not much is known about its impact on physical health and blood pressure of HCPs. Objective is to to Study the distribution of blood pressure and impact of Covid 19 on blood pressure of HCPs. Design and method: Prospective cross-sectional survey Methods: The study was conducted among Indian HCPs. A self administered survey asked about the socio demographic data, known risk factors, past history of hypertension, working conditions in lockdown (work from home or working at a healthcare establishment with potential to exposure to Covid-19), work hours and blood pressure measurement for three consecutive days during lockdown. Results: Six Hundred and eighty seven HCPs (52.8% doctors, 25.1% nurses &amp; paramedics, 22.1 allied HCPs), 63.78% males and 36.22% females, mean age 34.8% (SD = 11.5 years) participated in the study. 14.4% (98) had known hypertension while 28.8% (198) were found to be hypertensive for the first time (50% Doctors, 26.26% Nurses/Paramedics and 23.74% Allied Healthcare Professionals). 79.3% (n = 198) of these had normal blood pressure when checked in the past 12 months. 76.26% (n = 198) of these were directly at risk of exposure to Covid-19. The pandemic has seriously impacted the mental and psychological health of HCPs. Our study highlights that Covid 19 pandemic significantly impacts the blood pressure of HCPs with an alarming rise in risk for their health. Conclusions: Health care professionals developed hypertension in significantly higher numbers during COVID-19 pandemic. While working on the frontline with COVID-19, they are already on higher risk of getting infection. COVID-19 has been found to have serious complications with hypertension. Apart from this hypertension itself is known to lead adverse cardiovascular outcomes. Unfortunately, the majority of them are not aware of their elevated blood pressure. HCPs should remain more careful for their own blood pressure while working in pressure of COVID 19.

Health Care Professionals in the Digital Landscape in India

Internet has become essential to everyone during the Covid-19 pandemic lockdown as everything went to virtual. This has made the interactions between Pharmaceutical companies and Health Care Professionals (HCPs) explore digital channels as Medical Representatives (MRs) were not able to efficiently reach the HCPs. This pioneering study was conducted to evaluate the scope of digital channels and uncover insights into the digital behavioral landscape of HCPs to reach them effectively. A proctored, PAN India survey was conducted for health care professionals across diverse specialties and the responses were collected through in-clinic visits, mobile phones (via WhatsApp &amp; SMS) and e-mails. 407 HCPs had actively participated in this survey from across the country. Descriptive statistics were used to analyze the outcomes of this research which will help to develop programs directed at the HCPs in India to enhance their knowledge, medicine practice, HCP – patient &amp; HCP – Pharmaceutical company interactions, engagement with the medical community and highlight the areas that they face challenges while accessing information online to better fit in this fast-growing digital landscape of the health sector. This will also cover insights to bridge both physical and digital interactions as ‘Phygital interactions’ that could be followed in the hopeful Post – Covid-19 scenario.

Evidence-based medicine during the COVID-19 pandemic: a survey among healthcare professionals in India

<h3>Abstract</h3> In vertebrates, motor control relies on cholinergic neurons in the spinal cord that have been extensively studied over the past hundred years, yet the full heterogeneity of these neurons and their different functional roles in the adult remain to be defined. Here, we developed a targeted single nuclear RNA sequencing approach and used it to identify an array of cholinergic interneurons, visceral and skeletal motor neurons. Our data expose markers for distinguishing these classes of cholinergic neurons and their extremely rich diversity. Specifically, visceral motor neurons, which provide autonomic control, could be divided into more than a dozen transcriptomic classes with anatomically restricted localization along the spinal cord. The complexity of the skeletal motor neurons was also reflected in our analysis with alpha, beta, and gamma subtypes clearly distinguished. In combination, our data provide a comprehensive transcriptomic description of this important population of neurons that control many aspects of physiology and movement and encompass the cellular substrates for debilitating degenerative disorders.

The Role of Image Quality in Telehealth: Adoption Challenges in the Subcontinent

Abstract Background: The purpose of this paper is to explore the underlying challenges in the telehealth environment in India and Pakistan that impede the delivery of high-quality images between a patient and health care professional. Method: An exploratory study was conducted among healthcare professionals in India and Pakistan to assess their perceptions regarding image quality, which is used for the diagnosis and treatment decision making. This cross-sectional qualitative study used semi-structured interviews with healthcare professionals in both India and Pakistan. Results: The interviews were analyzed using a thematic analysis, which revealed three major themes. These themes being: ICT infrastructure and connectivity, expertise of persons taking images, and multiple transmission degrading image quality. Conclusions: Findings indicate that in both countries, the main underlying challenge is the lack of consistency in the network infrastructure between urban, rural and remote areas. Additionally, training patients to use hand-held devices to take high-quality images could hold the key to improving the reliability and, consequently, the quality of images transmitted between patients and health care professionals.

Reasons of Generic Medicines avoidance by Patients in India: A Quantitative Investigation

The high cost of healthcare is a major concern for patients in India, and one of the ways to reduce this burden is by increasing the use of generic medicines. However, despite the availability and affordability of generic medicines, their usage remains low in the country. This study aims to investigate the reasons behind the avoidance of generic medicines by patients in India. This can highlight the need for improving the perception and trust in the quality of generic medicines among patients and healthcare professionals in India. Furthermore, policymakers could also introduce regulations that mandate the use of generic medicines in public health facilities and incentivize doctors and pharmacists to prescribe and dispense generic medicines. By addressing the factors contributing to this issue, policymakers, healthcare professionals, and pharmaceutical companies can work together to increase the use of generic medicines and improve access to affordable healthcare for all.

Consensus on the use of DPP4 Inhibitors and SGLT2 Inhibitors in T2DM with Chronic Kidney Disease-from Indian Context

Chronic Kidney Disease and Diabetes are diseases of concern globally including developing countries like India. The delayed intervention of non-communicable disease management, the unique socioeconomic condition, etc makes chronic kidney disease a potential threat in the future. Diabetes in India plays an important role in developing CKD &amp; its associated complications. To treat diabetes, many innovative antidiabetic agents were introduced in the last two decades. Some of these newer anti-diabetic medications have established cardio-renal safety in diabetic patients. Many endocrine and cardiovascular societies have already adopted these anti-diabetic agents into the respective algorithms. Overall for newer anti-diabetic medication, there is no available published guidance in India that has prioritized both renal safety and other parameters related to nephrology practice. A group of Indian nephrologists, after analyzing existing published evidence and guidance from different guidelines, prepared a simple common algorithm to manage diabetes patients with associated CKD. This new algorithm, having both DPP4i and SGLT2i, will surely help Indian health care professionals to manage diabetes in CKD patients, in a more efficient way.

Pharmacovigilance: Perspectives in India

ABSTRACT Background Adverse drug reactions are a significant burden on the health system across the world. Paradoxically, a considerable chunk of ADRs is missed or not reported on account of avoidable reasons, resulting in bottlenecks in carrying out the proper management. This problem is much more evident in India and other resource-limited communities than in the prosperous countries of the West. Aim and objective To provide a state-of-the-art update on pharmacovigilance with special reference to perspectives in India and make appropriate recommendations for improving ADR reporting. Design The contents are based on a review of English medical literature augmented with the author's first-hand experience in the field over the past more than a decade. Results Well-organized pharmacovigilance started in India with the launching of the Pharmacovigilance Programme of India in 2010. Despite it making a perceptible improvement in ADR reporting, high underreporting of ADRs still prevails. The yet greater thrust on inculcating awareness comprising knowledge attitudes and practices among the healthcare professionals is likely to lead to further improvement in ADR reporting, resulting in augmentation of the safe use of drugs. Conclusion Pharmacovigilance, a mandatory drug safety activity, needs to be propagated with yet greater vigor among healthcare professionals in India. How to cite this article Gupte N, Pradhan S. Pharmacovigilance: Perspectives in India. J Med Acad 2020;3(2):59–62.

IUPS Physiology Education Workshop series in India: organizational mechanics, outcomes, and lessons.

Active learning promotes the capacity of problem solving and decision making among learners. Teachers who apply instructional processes toward active participation of learners help their students develop higher order thinking skills. Due to the recent paradigm shift toward adopting competency-based curricula in the education of healthcare professionals in India, there is an emergent need for physiology instructors to be trained in active-learning methodologies and to acquire abilities to promote these curriculum changes. To address these issues, a series of International Union of Physiological Sciences (IUPS) workshops on physiology education techniques in four apex centers in India was organized in November 2018 and November 2019. The "hands-on" workshops presented the methodologies of case-based learning, problem-based learning, and flipped classroom; the participants were teachers of basic sciences and human and veterinary medicine. The workshop series facilitated capacity building and creation of a national network of physiology instructors interested in promoting active-learning techniques. The workshops were followed by a brainstorming meeting held to assess the outcomes. The aim of this report is to provide a model for implementing a coordinated series of workshops to support national curriculum change and to identify the organizational elements essential for conducting an effective Physiology Education workshop. The essential elements include a highly motivated core organizing team, constant dialogue between core organizing and local organizing committees, a sufficient time frame for planning and execution of the event, and opportunities to engage students at host institutions in workshop activities.