Quality Management in Healthcare.

Clinical governance and better human resource management practices are important planks in the current health policies emphasizing quality of patient care. There are numerous reasons why it is important to improve quality of healthcare, including enhancing the accountability of health practitioners and managers, resource effi ciency, identifying, and minimizing medical errors while maximizing the use of effective care and improving outcomes, and aligning care to what users/patients want in addition to what they need. “Quality in health is doing the right things for the right people at the right time, and doing them right fi rst time and every time.” Quality can also refer to the technical quality of care, to nontechnical aspects of service delivery such as clients’ waiting time and staff’s attitudes, and to programmatic elements such as policies, infrastructure, access, and management. In this oration/article quality initiatives like Reproductive and Child Health (RCH) and National Rural Health Mission (NRHM) of Government of India (GOI), which concentrate on improving the quality of infrastructure of vast rural health facilities including sub-center, primary health center, and community health center has been taken into account with focus on improving quality of health services also. United Nation Population Fund (UNFPA) in collaboration with the GOI has proposed introducing quality assurance program for accessing and improving the quality of services at public sector health facilities. It is felt that improving the quality of health services in public sector will attract the client belonging to low economic strata, and surely will help in achieving the goal of the NRHM, that is, “Reaching the enriched with quality of health services.”

Comparative study of omeprazole and famotidine in the treatment of duodenal ulcer.

In a double blind, multicenter, parallel group clinical trial in patients with symptomatic duodenal ulcers, 129 patients were randomized to receive either omeprazole 20 mg once daily (n = 65) or famotidine 40 mg once daily (n = 64) for 2 weeks, and if the ulcers were not healed, for a total of 4 weeks. Seventy four percent of these receiving omeprazole had healed ulcers after 2 weeks compared with 34.3% of those receiving famotidine (p < 0.001). At 4 weeks, the respective figures were 97.3% and 77.6% (p < 0.001). After 2 weeks of treatment, only 11.1% and 29.8% of omeprazole and famotidine treated patients respectively had day time pain (p < 0.02). Diary cards (successfully completed by 2/3rd of patients) showed that omeprazole treated patients required smaller amounts of antacids (p = ns). Over the first two weeks, ulcer healing rate was similar in smokers and non- smokers. No significant side effects were reported in either group. Omeprazole 20 mg/day provides more rapid relief of symptoms and heals a greater proportion of duodenal ulcers at 2 and 4 weeks than famotidine 40 mg/day.

Studies on triacylglycerol ester hydrolase from bat adipose tissue.

Triacylglycerol ester hydrolase was isolated from bat adipose tissue and characterized. The partially purified enzyme had pH optimum of 8.6 and a Km value of 0.6 mM. The enzyme was denaturated upon freezing and thawing, which was prevented by 25% glycerol. The enzyme was activated by EDTA and NaCl, while it was inhibited by serum and bovine serum albumin. Heparin, sodium fluoride and diisopropyl fluorophosphate had no effect on triacylglycerol ester hydrolase activity. It hydrolyzed triglycerides partially. Triacylglycerol ester hydrolase lost its activity during delipidation but it was reactivated by endogenous lipids and phospholipids, viz. phosphatidyl ethanolamine, phosphatidyl choline and sphingomyelin. The enzyme shows kinetic properties altogether different from lipoprotein lipase and hormone sensitive lipase.