Descriptive cross-sectional study to evaluate perception, attitude, and practice of parents regarding COVID-19 vaccination in children 10-12 years of age-A step toward prevention of future COVID-19 outbreaks in India.

Purpose: COVID-19 was declared a global pandemic and all age groups were equally affected. Coronavirus had devastating effects worldwide due to the emergence of new variants till vaccination was adopted to eradicate the transmission of the virus and restore normalcy. However, children were not included in the initial phase of vaccination. The purpose of the study was to assess the level of perception, attitude, and practice among parents toward the COVID-19 vaccination drive in children 10-12 years of age. Design and Study: The present research is a cross-sectional questionnaire-based survey including parents of children aged 10-12 years as participants. The survey was conducted between May 2022 and July 2022 with a sample size of 320. Results: A high willingness (80%) among parents was found for getting their children vaccinated. COVID-19 vaccines were perceived to be safe by the parents (59%) and efficacious (75%) for their children. Parents (67%) felt that the benefits of getting their children vaccinated against COVID-19 prevail over the risks of the vaccine. Parents 214 (67%) feel the need of getting their child vaccinated for sending them to school followed by availing of daycare facilities after school 54 (17%) among working parents. A significant association (P < 0.05) was seen between the variables of practice being followed by parents and their children as per COVID-19 norms. Parent's negative attitude toward COVID-19 vaccination was associated with availability of no/unclear safety information (36%), fear of adverse effects of vaccine (3%), and false belief of having long-term immunity due to natural infection (32%). The positive attitude of parents was due to trust in positive information/news about the vaccine (42%), belief in the safety and efficacy of the vaccine (5%), acceptability for mild adverse effects (1%), and the necessity of vaccine to send children to schools (1%). Conclusion and Recommendations: The awareness of parents regarding COVID-19 vaccination for children was limited, high level of acceptance for vaccination was seen in our study. We recommend to continuing educational programs through mass campaigns to increase increasing awareness among parents for getting COVID-19 vaccination for their children. Vaccine hesitancy including vaccine safety concerns of parents should be addressed by presenting myths and facts related to COVID-19 vaccine using television, radio, and social media platforms.

Pharmacology teaching in dental education in India: Time for a reappraisal.

India has a unique position with its vast population and rapidly increasing healthcare demand. Dental health is integral to a holistic health care need, and a robust dental education system is necessary. Dental education in India is mainly regulated by the Dental Councilof India, setting broad guidelines. Universities having dental colleges and institutes develop fine curriculum development and evaluation details. General and Dental Pharmacology and Therapeuticsis a crucial subject taught to undergraduate dental students during the second year of a 4-year duration course. A dental graduate should be well trained in general and systemic pharmacology and rational therapeutics principles. This has been set as an objective by the Dental Council of India. Sound knowledge of the drug action mechanisms, indications, adverse drug reactions, drug interactions and contraindications, evidence-based medicine, and rational use of adrug is core to the allopathic system. The practical exercises on human simulation or computer-assisted learning are critical for understanding pharmacology. The subject of pharmacology for dental graduates has been allotted 70 hours of theory and 20 hours of practicals with almost the same syllabus as medical graduates. This article highlights the areas of concern concerning the deficiency of teaching hours and needed improvement in the curriculum to make it competent to achieve its objective. The authors bring this much-needed topic for discussion among academicians and for the attention of regulatory authorities.

Organizational commitment and intrinsic motivation of regular and contractual primary health care providers.

BACKGROUND: Motivated and committed employees deliver better health care, which results in better outcomes and higher patient satisfaction. OBJECTIVE: To assess the Organizational Commitment and Intrinsic Motivation of Primary Health Care Providers (HCPs) in New Delhi, India. MATERIALS AND METHODS: Study was conducted in 2013 on a sample of 333 HCPs who were selected using multistage stage random sampling technique. The sample includes medical officers, auxiliary nurses and midwives, and pharmacists and laboratory technicians/assistants among regular and contractual staff. Data were collected using the pretested structured questionnaire for organization commitment (OC), job satisfiers, and intrinsic job motivation. Analysis was done by using SPSS version 18 and appropriate statistical tests were applied. RESULTS: The mean score for OC for entire regular staff is 1.6 ± 0.39 and contractual staff is 1.3 ± 0.45 which has statistically significant difference (t = 5.57; P = 0.00). In both regular and contractual staff, none of them show high emotional attachment with the organization and does not feel part of the family in the organization. Contractual staff does not feel proud to work in a present organization for rest of their career. Intrinsic motivation is high in both regular and contractual groups but intergroup difference is significant (t = 2.38; P < 0.05). Contractual staff has more dissatisfier than regular, and the difference is significant (P < 0.01). CONCLUSION: Organizational commitment and intrinsic motivation of contractual staff are lesser than the permanent staff. Appropriate changes are required in the predictors of organizational commitment and factors responsible for satisfaction in the organization to keep the contractual human resource motivated and committed to the organization.

Sedative-hypnotic Effect of Ash of Silver in Mice: A Reverse Pharmacological Study.

Ash of silver is used in traditional systems of medicine for various neurological conditions like insomnias, neuralgias, anxiety disorders, and convulsions. The present study was conducted to evaluate the sedative-hypnotic activity of ash of silver in comparison to pentobarbitone (standard drug) in albino mice. The mice were divided into four groups as follows: Group 1 (control): Gum acacia [GA; 1% per os (p.o.)], group 2 (standard): Pentobarbitone [50 mg/kg intraperitoneal (i.p.)], group 3 (test): Ash of silver (50 mg/kg p.o.), and group 4: Ash of silver (50 mg/kg p.o.) given 30 min prior to administration of pentobarbitone (50 mg/kg i.p.). Time of onset, recovery, and total duration of loss of righting reflex were studied. Ash of silver (test) produced significant sedation (P < 0.01) compared to control (GA 1%), but the effect was significantly less compared to that of standard pentobarbitone at the doses used. Also, significant potentiation (P < 0.001) of the sedative-hypnotic effect of pentobarbitone was observed with the test drug.

Provider's Constraints and Difficulties in Primary Health Care System.

BACKGROUND: The contractualization of human resource in recent years has resulted into various human resource management issues. OBJECTIVE: To explore the administrative and management issues of contractual model of human resource under primary health care system in Delhi. MATERIALS AND METHODS: Comparative study was conducted on randomly selected sample of 333, comprised of Medical Officers, ANMs, Pharmacist and Laboratory Assistants and Technicians, both regular and contractual cadre. The data was collected using the semi-structured interview schedule and thematic content analysis was done. RESULTS: The five major themes emerged in the analysis; these are (i) physical infrastructure, (ii) organization's working environment, (iii) privileges of staff, (iv) discontentment, (v) human resource development. Comparative analysis of themes between regular and contractual staff revealed significant differences in factors which are embedded into the organization's culture. Element of discontentment is high amongst contractual staff particularly for discrimination in job, undermining of authority, patient care relationship and privileges provided to regular staff. This reflects the area of dissatisfaction which varies between regular and contractual staff in the organization. CONCLUSION: If primary health care system fails to address genuine constraints of human resources of both regular and contractual cadre and perception of discrimination persists, it is bound to result into poor motivation for good performance in the system of health care. So, adopting good practices in human resource management keeping regular and contractual employees grievances at forefront are urgently needed to ensure the availability of adequately trained and motivated personnel's in health facilities.

A comparative study of job satisfaction among regular and staff on contract in the primary health care system in Delhi, India.

BACKGROUND: Job satisfaction is a pleasant emotional state associated with the appreciation of one's work and contributes immensely to performance in an organization. The purpose of this study was to assess the comparative job satisfaction among regular and staff on contract in Government Primary Urban Health Centers in Delhi, India. MATERIALS AND METHODS: The study was conducted in 2013, on a sample of 333 health care providers who were selected using a multistage random sampling technique. The sample included medical officers (MOs), auxiliary nurses and midwives (ANMs), pharmacists and laboratory technicians (LTs)/laboratory assistants (LAs) among regular and staff on contract. Analysis was done using SPSS version 18, and appropriate statistical tests were applied. RESULTS: The job satisfaction for all the regular staff that is, MOs, ANMs, pharmacists, LAs, and LTs were relatively higher (3.3 ± 0.44) than the contract staff (2.7 ± 0.45) with 't'value 10.54 (P < 0.01). The mean score for regular and contract MOs was 3.2 ± 0.46 and 2.7 ± 0.56, respectively, and the same trends were found between regular and ANMs on the contract which was 3.4 ± 0.30 and 2.7 ± 0.38, regular and pharmacists on the contract was 3.3 ± 0.50 and 2.8 ± 0.41, respectively. The differences between groups were significant with a P < 0.01. CONCLUSION: Overall job satisfaction level was relatively low in both regular and contract staff. The factors contributing to satisfaction level were privileges, interpersonal relations, working-environment, patient relationship, the organization's facilities, career development, and the scarcity of human resources (HRs). Therefore, specific recommendations are suggested to policy makers to take cognizance of the scarcity of HRs and the on-going experimentation with different models under primary health care system.

Surrogacy and women's right to health in India: issues and perspective.

The human body is a wonderful machine. The future of child birth in the form of test tube babies, surrogate motherhood through new reproductive and cloning technology will introduce undreamt of possibilities in the sexual arena. Surrogacy is a method of assisted reproduction whereby a woman agrees to become pregnant for the purpose of gestating and giving birth to a child for others to raise. In some jurisdictions the possibility of surrogacy has been allowed and the intended parents may be recognized as the legal parents from birth. Commercial surrogacy, or "Womb for rent", is a growing business in India. In our rapidly globalizing world, the growth of reproductive tourism is a fairly recent phenomenon. Surrogacy business is exploiting poor women in country like India already having with an alarmingly high maternal death rate. This paper talks about paternity issues and women's right to health in context of surrogacy. Government must seriously consider enacting a law to regulate surrogacy in India in order to protect and guide couples going in for such an option. Without a foolproof legal framework, patients will invariably be misled and the surrogates exploited.

Job satisfaction of primary health-care providers (public sector) in urban setting.

INTRODUCTION: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. MATERIALS AND METHODS: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. RESULTS: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01). Age and education level of health care providers don't show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. CONCLUSION: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.

Analgesic activity and safety of ash of silver used in Indian system of medicine in mice: a reverse pharmacological study.

OBJECTIVE: To study the analgesic activity of ash of silver used in Indian system of medicine and to explore its safety. MATERIALS AND METHODS: Albino mice of either sex (20-30 gm) were used to investigate the role of ash of silver against noxious stimuli: thermal (Eddy's hot plate and analgesiometer), mechanical (tail clip), and chemical (0.6% acetic acid induced writhing). An effort was made to find nature and site of action of ash of silver following naloxone pre-treatment. Maximum tolerated dose (MTD) and lethal dosage 50 (LD50) were also studied along with toxicological aspects of ash of silver. RESULTS: Test drug (ash of silver) at a dose of 50 mg/kg p.o exhibited analgesic activity against thermal, mechanical, and chemical stimuli. Analgesic effects were compared with the standard drug, morphine, in thermal and mechanical noxious stimuli and to aspirin in chemical stimulus. Analgesic activity of the test drug was reduced following naloxone pre-treatment. MTD was found out to be greater than 1.5 g/kg p.o. LD50 was 2 g/kg p.o. Fraction of mice showed symptoms of argyria as explained by autopsy reports. CONCLUSION: Test drug exhibited moderate analgesic activity at 50 mg/kg p.o against all type of noxious stimuli, also suggesting a role of opioidergic system. The ash of silver was been found to be safe upto a dose of 1.5 g/kg p.o. in mice without any untoward toxicity. Further studies are required to explore the effect of ash of silver on pain mediators and excitatory neurotransmitters like glutamate, aspartate, or N-methyl-D-aspartic acid (NMDA).

IFN-α-2a (Interferon) and ribavirin induced suicidal attempt in a patient of chronic HCV: A rare case report.

Interferons (IFNs) are proteins produced by cells, fibroblasts and macrophages, in response to viral invasion, and mediates immune response. IFN-α and ribavirin are the approved treatment for HCV infection, but also carries a risk of neuropsychiatric adverse effects, viz. insomnia, irritability, mood changes, and depression.We present a case report of depression induced by IFN-α and ribavirin, leading to attempted suicide. Following the episode, antidepressant paroxetine (20 mg o.d.) and zolpidem (10 mg h.s) were added with psychotherapy. No significant improvement was observed. Patient was given a drug dechallenge (IFN-α and ribavirin). Dramatic improvement was seen over 1 month. Following rechallenge with combination, patient again experienced depressive symptoms with suicidal ideation. IFN-α and ribavirin were promptly stopped. Naranjo causality assessment scale revealed probable association with IFN-α and ribavirin. The report intends to improve awareness among clinicians to facilitate early diagnosis and intervention of similar cases.