Reports of site monitoring visits by institutional ethics committees in an Indian tertiary care hospital: A retrospective analysis

The monitoring of clinical trials is an integral function of the institutional ethics committee (IEC)to ensure the ethical conduct of research. The National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2017, of the Indian Council of Medical Research, underline a strong need for active monitoring of clinical trials. A previous study by the authors, of research studies initiated between 2008 and 2010, had found many lapses after site monitoring. In the present study, 12 clinical studies—both sponsored and investigator initiated—were monitored by members of the King Edward Memorial Hospital (Mumbai) IEC between 2011 and 2017. The most common violations seen were related to informed consent (8/12 sites). The other violation themes were lack of investigator understanding of protocol (6/12), deviation from the investigational plan (5/12), non-reporting of the study’s progress to the IEC (4/12), and patient recruitment prior to IEC approval (2/12). The IEC took various corrective actions, such as ordering retaking of consent and good clinical practice (GCP) re-training and requiring interim reports, explanations for deviations, upgradation of facilities, and payment of pending compensation. The IEC even froze review of protocols from a frequently defaulting Principal Investigator’s (PI) site and put study recruitment on hold for the same PI. This study demonstrates that active site monitoring by IECs is a must for ensuring the ethical conduct of studies

Evaluation of the protective effect of Paeonia emodi Wall on rat model of Parkinson’s disease induced by 6 hydroxy dopamine

Background: Generation of reactive oxygen species together with paucity of antioxidant defense is considered as an important cause for dopaminergic neuronal death. Review of literature indicates that none of the drugs so far studied for preventing the PD were found to be promising for use. Therefore, the present study was planned to evaluate the neuroprotective effect of Paeonia emodi Wall (PEW) in 6-hydroxy dopamine induced Parkinson’s disease (PD) model.Methods: The study was conducted on Wistar rats where Parkinson’s disease was induced by producing the striatal 6-hydroxy dopamine lesions. The test animals received ethanolic extract of PEW at dose of 200 and 300mg/kg for 28 days. Circling behavior, spontaneous locomotor activity, muscular coordination and akinesia were studied. Antioxidant levels were assessed by biochemical estimation and histopathology was carried out for dopaminergic neuronal loss.Results: PEW ethanolic extract showed significant dose dependent recovery in number of circlings, line crossing, muscular coordination and akinesia. A significant increase in MDA levels and decreased GSH level in PEW treated groups was observed in test groups as compared to control group (p<0.05). Normal architecture was retained only in PEW 300mg/Kg (p<0.05). L-Dopa did not showed effect on biochemical and histological parameters.Conclusions: The ethanolic extract of PEW showed neuroprotective activity against 6-hydroxy dopamine induced Parkinson’s disease in rats in both 200 and 300mg/kg doses. The protective action of PEW in PD can be because of its ability to reduce the oxidative stress.

Impact of recent regulatory notifications on an institutional ethics committee.

The Government of India came out with a slew of notifications to streamline clinical research in the beginning of 2013 in response to the Supreme Court’s orders and a Parliamentary Standing Committee’s report. The notifications greatly influenced the structure, review process, outcomes and administration of ethics committees across India. In this study, we attempted to objectively evaluate the impact of these notifications on our institutional ethics committee’s (IEC) structure, review process, outcomes and administration. The results revealed that though the number of regulatory studies reviewed by our IEC remained the same, the number of studies actually approved decreased with an increase in the turnover time. The number of serious adverse events (SAEs) reported also fell, although the number of meetings held to discuss these SAEs increased significantly. The administrative workload rose with increased documentation. Though the annual income of the IEC fell marginally, the expenses shot up. We believe that the notifications definitely had an impact on the structure, review process, outcomes and administration of our IEC, although it remains to be seen whether they had a real impact on the research participants’ safety and well-being.

Perception of Medical Students towards Teaching of Pharmacology through Reinforcing Learning Model.

Abstract: Background: There is need of novel methods of teaching subject of pharmacology, which will increase curiosity and retention of knowledge. At the same time, the new method should be student friendly and well accepted. Hence reinforcing learning model (RLM) was developed and current study is conducted to assess perception of students about this method. Methodology: The perception of students was assessed on Likert scale using a 15 point questionnaire. The data was analysed descriptively. Results: Majority of the students (more than 50 %) gave favourable opinion about the module. Majority of them gave neutral opinion (40 %) when asked whether the session should be optional in the curriculum. Conclusion: RLM followed by discussion can be a valuable tool to reinforce didactic method of teaching pharmacology.

Perception of postgraduate (PG) students and teachers on seminar as teaching-learning tool.

Background: The postgraduate education depends on self learning. Knowledge acquisition among postgraduate students is through seminars which form essential part of their training programme. Methodology : This study assesses the role of seminar as a teaching-learning tool amongst students & teachers by recording their perception through a questionnaire based survey. Results : The scores for most of the items in an 18 point questionnaire were above 3 indicating that learning from seminar is satisfactory. There were two items where there was significant difference among students & teachers perception. Conclusion : We found that both the postgraduate students and the postgraduate teachers feel that the technique is useful amidst lots of suggestion to improve the quality. Thus the postgraduate seminar method is a teaching-learning method that is effective and well-accepted among the postgraduate students and postgraduate teachers alike..