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Organ donation following circulatory determination of death (DCDD) has contributed significantly to the donor pool in several countries, without compromising the outcomes of transplantation or the number of donations following brain death (BD). In India, majority of deceased donations happen following BD. While existing legislation allows for DCDD, there have been only a few reports of kidney transplantation following DCDD from the country. This document, prepared by a multi-disciplinary group of experts, reviews the international best practices in DCDD and outlines the path for furthering the same in India. The ethical, medical, legal, economic, procedural, and logistic challenges unique to India for all types of DCDD based on the Modified Maastricht Criteria have been addressed. India follows an opt-in system for organ donation that does not allow much scope for uncontrolled DCDD categories I and II. The practice of withdrawal of life-sustaining treatment (WLST) in India is in its infancy. The process of WLST, laid down by the Supreme Court of India, is considered time-consuming, possible only in patients in a permanent vegetative state, and considered too cumbersome for day-to-day practice. In patients where continued medical care is determined to be futile following detailed and repeated assessment, the procedure for WLST, as laid down and published by Vidhi Centre for Legal Policy in conjunction with leading medical experts is described. In controlled DCDD (category-III), the decision for WLST is independent of and delinked from the subsequent possibility of organ donation. Once families are inclined toward organ donation, they are explained the procedure including the timing and location of WLST, consent for antemortem measures, no-touch period, and the possibility of stand down and return to the intensive care unit without donation. While donation following neurologic determination of death (DNDD) is being increasingly practiced in the country, there are instances where the cardiac arrest occurs during the process of declaration of BD, before organ retrieval has been done. Protocol for DCDD category-IV deals with such situations and is described in detail. In DCDD category V, organ donation may be possible following unsuccessful cardiopulmonary resuscitation of cardiac arrest in the intensive care. An outline of organ-specific requisites for kidney, liver, heart, and lung transplantation following DCDD and the use of techniques such as normothermic regional perfusion and ex vivo machine perfusion has been provided. With increasing experience, the outcomes of transplantation following DCDD are comparable to those following DBDD or living donor transplantation. Documents and checklists necessary for the successful execution of DCDD in India are described. [ABSTRACT FROM AUTHOR]

Introduction: The Transplantation of Human Organs Act (THOA) provided legal status to brain death as a form of death in 1994. However, even after three decades, the deceased organ donation rate in India stands at a mere 0.52 per million population, crucially due to a lack of brain death awareness, and an absence of institutionalized protocols for deceased donations. Objectives: By taking the case of the state of Haryana, this article seeks to understand the existing state of brain death awareness among professionals working in the medical community, and identify the implementation challenges that would be involved in instituting a state‑level policy for donations from deceased persons. Materials and Methods: This paper adopts a qualitative approach, utilizing in-depth interviews with doctors in the districts of Rohtak and Charkhi Dadri in Haryana, and transplant coordinators across the state to gather a nuanced understanding of the issue. Results: The research finds that brain death awareness is lacking among doctors, along with the necessary resources for brain death declarations to become practice. There is also an evident district-wise variation in the responses of doctors when it comes to the potential challenges of instituting a brain death declaration standard operating procedure. It offers recommendations for improved implementation of organ transplant policies and scaling up of deceased donations. Conclusion: To unearth the potential that deceased organ donation holds, some immediate measures that can be taken include mapping all the functional organ retrieval facilities across the state and their closest civil hospitals or postgraduate medical institutions with trauma centres, and focusing on the sensitization of the medical functionaries with respect to brain death and its identification. [ABSTRACT FROM AUTHOR]

Background: There is a constant search across the globe for optimal healthcare solutions with affordability, accessibility, availability, and quality of healthcare services being the burning issue for mankind. The pandemic has further necessitated the need of use of the Telemedicine platform to address healthcare issues which are also non Covid related. Though Telemedicine has been in use for over two decades in India, there have been various challenges and adoption issues which have not yet made the technology an effective solution to address the current healthcare issues. There has been phenomenal growth in the Information and Communication Technology (ICT) over the last decade and its utilization in the healthcare field. Methods: Internet research on the various adoption strategies by healthcare providers coupled with our own experience for using this technology along with guidelines provided by the information and communication technology providers. The Telemedicine Guidelines of 2020 released by the Ministry of Health and Family welfare, India, provides a framework for the implementation of healthcare delivery through this technology. Results: This paper mentions our telemedicine experience in governmental and private institutes and highlights the implementation challenges of this technology and some solutions that made a difference in the execution. However, we discuss to a larger extent the possible challenges and barriers in the implementation of this technology in India. Conclusion: Despite successful work in the field of telemedicine, it is yet to become an integral part of healthcare system because challenges related to adaptability of healthcare users and lack of proper training to fast growing technologies. The future is going to compel the usage of this kind of technology and it is essential for setting up infrastructure and having trained personnel to man these departments to encash the full potential of the telemedicine technology. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe the perceptions of community members and programme partners regarding severity, management and impact of adverse reactions on mass drug administration (MDA) compliance. Methods: Based on various qualitative data collected from five districts of Orissa, India, where MDA had been implemented during 2002 and 2004. The qualitative surveys included focus group discussions with community members and health workers, and semi-structured interviews with key informants in the community, medical officers at primary health centres, district level health officers and private practitioners. Results: It showed that many people suffered from adverse reactions, though the reactions were not serious. The paper reported different ways of management of adverse reactions at the community level. The impact of adverse reactions on MDA compliance was serious, as many people did not consume the drug due to fear of adverse reactions. The rumours of adverse reactions and news in media deterred people from consuming the tablets. Conclusion: All categories of respondents indicates the need of more information to address the problem of adverse reactions during MDA. The present paper warrants incorporating the messages on adverse reactions during health communication and social mobilization campaigns of MDA. [ABSTRACT FROM AUTHOR]

Abstract: India has a great wealth of various naturally occurring plant drugs which have great potential pharmacological activities. Datura stramonium (D. stramonium) is one of the widely well known folklore medicinal herbs. The troublesome weed, D. stramonium is a plant with both poisonous and medicinal properties and has been proven to have great pharmacological potential with a great utility and usage in folklore medicine. D. stromonium has been scientifically proven to contain alkaloids, tannins, carbohydrates and proteins. This plant has contributed various pharmacological actions in the scientific field of Indian systems of medicines like analgesic and antiasthmatic activities. The present paper presents an exclusive review work on the ethnomedical, phytochemical, pharmacological activities of this plant. [Copyright &y& Elsevier]

Abstract: Objective: To assess the virus infection in mosquitoes during different seasons and correlated with various climatic factors. Methods: The field collected vectors were screened for Japanese encephalitis (JE) virus after dessication using ELISA method. Most of the positive pools were recorded from Culex tritaeniorhynchus (Cx. tritaeniorhynchus) and Culex. gelidus (Cx. gelidus) during JE transmission season (winter) and some positive pools were also reported during non JE transmission periods (i.e. summer and rainy seasons). Results: The minimum infection rates (MIR) of 1.75 from Cx. tritaeniorhynchus and 0.17 from Cx. gelidus has been reported in the year 2002 at the beginning of the study and the values were found nil at the end of the study (2006) from the study areas of Kurnool district. Conclusions: From this study it is noted that MIR of Cx. gelidus and Cx. tritaeniorhynchus were modulated by various meteorological parameters. The mosquito vector abundance increases after the monsoon period (winter) and lowest in dry season (summer). Similarly, MIR fluctuated between seasons with higher MIR recorded after monsoon period and lower in the rest of season. Impact of these metrological parameters in JE virus infected mosquitoes is discussed in this paper. [Copyright &y& Elsevier]

Abstract: Objective: A new variety of Crotalaria ramosissima is described from the Western Ghats of India. Crotalaria ramosissima Roxb. var. kanuvayensis Binu T., K. M. Prabhu et A. Rajendran (Fabaceae) from Kanuvai hills, Coimbatore district of Tamil Nadu. Methods: Compare this species with available varieties of Crotalaria and cross checked with previous literature for authetification of this taxa. Results: The current paper provides a detailed description of the new taxa along with illustrations, colour plates and other relevant notes. Conclusions: The present study concluded that this taxa is new to science from the Southern Western Ghats of Tamil Nadu, India. [Copyright &y& Elsevier]

Abstract: Objective: To conduct ethnobotanical survey in Yerramalais forest among Sugali tribes and collect information on medicinal plants to used to in the treatment of snake bite. Snakebite has been a major cause of mortality of tribals and their livestock. Methods: The study was conducted during 2009-2011 visiting regularly Sugali Thandas and Lobais. Following the method of Jain and Goel. First hand information on their traditional medicine was recorded, repeated enquiries were made to understand their knowledge, methods of diagnosis and treatment. Data were collected on the specific part of the plants used collection, method of usage of the drug and dosage of the drug, dosage of administration. Results: The paper provides information about Ehanobatanical and Scientific evidences of 23 medicinal plants which are used by sugalis as antidote for snake bite. Conclusion: Traditional medicine remains an integral part of the health system in this area Antidote medicinal plants play an important role in health and livelihood of Sugali Tribal people. [Copyright &y& Elsevier]

Abstract: Objective: To separate the bioactive compounds from crude methanol extract of leaf of Excoecaria agallocha (E. agallocha), a mangrove plant from Bhitarkanika, Odisha, India. Methods: Chromatographic separation was carried out by paper, thin layer chromatography (TLC) and column chromatographic techniques. Bioautography of the column fractionated extract and TLC chromatogram were evaluated in vitro for antibacterial and DPPH free radical scavenging activity. The HPLC and 1H NMR spectroscopy of the extract was also carried out to detect the presence of compounds and possible functional groups in the crude plant extract. Results: Evaluation of solvent system for chromatographic separation revealed that n-butanol: acetic acid: water in the ratio of 4:1:1 was the most appropriate for the separation of phenolic compounds in the crude extract. The antibacterial bioautography screening of the TLC fractionated extract of E. agallocha showed positive activity against Staphylococcus aureus (MTCC-1141) and Pseudomonas aeruginosa (MTCC 1034). Evaluation of antioxidant properties of TLC fraction of E. agallocha showed 23.36% scavenging activity using DPPH assay at 40 μL concentration. HPLC chromatogram of the plant extract produced seven peaks for the leaf and two peaks for the stem/bark with the highest peaks at 2.563 and 2.493 minutes of retention time, respectively. The 1H NMR spectroscopic analysis of the plant extract revealed the presence of acyclic aliphatic and α- mono substituted aliphatic group of compounds in the sample. Conclusions: Thus, it is apparent from the present study that methanol crude extract of E. agallocha is rich in aliphatic group of compounds which can be purified and characterized for possible pharmaceutical utilization. [Copyright &y& Elsevier]

Abstract: Objective: To study the phyto-constituents present in some selected medicinally important pteridophytes from the Western Ghats, India. Methods: The dried and powered leaves materials (50 g) were extracted successively with 250 mL of petroleum ether, ethyl acetate, methanol, chloroform, acetone, benzene and water by using Soxhlet extractor for 8 h at a temperature not exceeding the boiling point of the solvent. The aqueous extracts were filtered using Whattman filter paper (No.1) and then concentrated in vacuum at 40°C using Rotary evaporator. The residues obtained were stored in a freezer −70°C until further tests. Phytochemical screening of the extracts was carried out according to the standard methods. Results: The present study screened the phytochemical properties of ten plants with sixty six extracts and showed varied degree of phyto-constituents present. The presence or absence of the phyto-constituents depended upon the solvent medium used for extraction and the physiological property of individual taxa. Conclusions: From these results, it can be concluded that the ten plants extracts may be used as broad-spectrum antimicrobial, bioactive agent after extensive investigation. [Copyright &y& Elsevier]