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Background: Patient satisfaction survey is a valuable tool to measure the outcomes of care rendered by hospitals. Outpatient department (OPD) is a very crucial area of any hospital services as huge number of patient's visits this area for clinical services. Information about quality of services in OPD will serve two purposes, i.e., identifying areas of improvement in the services offered and highlighting the need for corrective actions. Patient satisfaction is the key determinant for assessing the quality of patient care and is the desired outcome of every hospital. The present study was conducted to measure the levels of patient satisfaction and to ascertain any service gaps in OPD of a tertiary care teaching hospital, Mysuru, India. Materials and Methods: This cross-sectional, descriptive study was conducted among 600 patients using a structured questionnaire for assessing the levels of patient satisfaction. Results: The overall satisfaction rate in this study was 97.2%, with major satisfiers being clinical care provided by doctors and nursing staffs and few patients were not satisfied with cleanliness of toilets and medications' availability. Conclusion: Patient satisfaction survey may be a good audit tool and it should be used to improve the standard of services. According to the patient's opinion, the study showed good satisfaction with respect to reception and registration services, physical facilities, doctor's services, nursing services, laboratory services, and pharmacy services. Few deficient areas are identified in terms of service delivery and the same will be bridged as early as possible to achieve universal patient satisfaction.

Rare diseases (RD) of genetic origin are raising public health concern contributing to a massive economic burden in India. Establishing Specialty Centers to bridge the RD community with apex centers is felt as a need in developing countries. Hence a Comprehensive Rare Disease Care (CRDC) model was set up at the department of pediatrics under Center for Human Genomics and Counseling at a medical college hospital in South India. The patients suspected to have genetic disease were evaluated as per the work flow of the designed model. The utilization statistics depict the outcome of this model. In the face of limited resources, it was possible to establish a functional RD unit with meticulous planning, supportive administration and trained interdisciplinary staff. A scalable prototype that could be replicated in other Medical colleges and Hospitals of India is described.

Introduction: Sexual health issues are highly prevalent but are underdiagnosed and underrecognized in day-to-day clinical practice. The lack of awareness of the specific health care needs of the patients with sexual dysfunctions and resource limitations might be certain reasons why many hospitals are not been equipped with the sexual health care units. There is paucity of specialized psychosexual health care services across the country. Trained interdisciplinary team with prepared environment in sexual medicine is the need of the hour. We started this psychosexual medicine unit with an emphasis on sexual wellness to deliver comprehensive sexual health care which will be a primary care linkage to patients presenting with symptoms of sexual disorders, so also treatment emergent sexual dysfunction in psychiatry and other medical and surgical branches.Aim: To portray the methods, opportunities, and challenges that we experienced in establishing a specialty psychosexual medicine facility as a different unit in a private university-based medical college and hospital in Mysuru, India.Methods: This triweekly psychosexual medicine unit is situated in the Outpatient Division of Psychiatry and is staffed with a multidisciplinary group of health care professionals. Structured survey tools and proforma are utilized to assess all patients. Case conclusions are made according to International Classification of Diseases, Tenth Revision, symptomatic/clinical explanations and diagnostic recommendations, and furthermore Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) when required. Patient care included interventions in the form of psychotherapy and pharmacotherapy.Results: It is possible to set up a functional psychosexual medicine facility as a different unit with a trained interdisciplinary group of professionals. Patient-centered approach is vital in our care plan and management. Postgraduate students and internees posted in psychiatry division have been undertaking rotations respectively as per their duty rota. There is also a robust academic program that includes once-weekly seminars pertaining to topics of psychosexual health and monthly journal club gatherings interchanging with seminars on sexual health and well-being appraisal devices.Conclusion: By investing on improving infrastructure and available human resources, the specialty psychosexual medicine unit was established. The psychosexual medicine unit not only gave chances for a more comprehensive assessment of individuals with sexual disorders but also improved training and education for residents with focused interdisciplinary research in the field of sexual medicine. It portrays a versatile model that can be replicated in settings of similar type.

Introduction Wrong blood transfusion (BT) is a medical negligence. Every hospital must have a strong policy to check incorrect BT and see to it that these policies are strictly implemented at the time of transfusion. Wrong BT can occur due to carelessness of the staff and shortcomings in verification of the blood bag. The reasons can be avoided and wrong BT can be prevented by the formation of a checklist consisting of the important details to be verified before initiating transfusion. The checklist should not be very long and time-consuming, but very comprehensive and consists of only absolutely essential things to be checked. Aim To study the BT process and providing suggestions for streamlining the process of BT. Objectives • To analyze the nears miss incidents during BT. • To identify the errors in the process of transfusion. • To streamline the process by introducing checklist/work instructions for reducing errors. Materials and methods • Analysis of safety reports regarding BT. • Process-based root cause analysis was done at the time of issue and at ward level. • Feedback regarding BT was taken from the staff working at blood bank and nursing professionals. The study was divided into two phases: Phase 1: January—April 2014 Phase 2: May—August 2014 All the reports from phase 1 of the study were analyzed. Based on the observations, interventions in the form of checklist and work instructions to the nursing staff were implemented in the hospital in the month of April and then the safety reports for the next 4 months were analyzed. Interventions done: A “4C” checklist was created with just four elements that could be orally or mentally reviewed before beginning transfusion. Specific work instructions were also issued to the nursing staff at the ward level to prevent any errors during labeling of the samples being sent for cross match and blood grouping before BT. Results The number of BT-related safety incidents observed in phase 1 reduced in phase 2 though the workload in terms of samples received remained comparable for the two phases. However, a declining trend for the reporting of incidents was also seen through the phases. How to cite this article Shrivastava AA, Somu G, Dayananda M. Good Clinical Practices toward Safe Blood Transfusion: A Study of Blood Transfusion Process and providing Suggestions for streamlining the Same. Int J Res Foundation Hosp Healthc Adm 2016;4(1):1-4.

The novel coronavirus disease (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2, has rapidly escalated into a global pandemic which leads to declaration of national health emergency in several countries and is having a profound impact on private health-care systems globally including India in unprecedented manner. However, the impacts are very serious, especially on global economics and health care due to COVID-19 pandemic. During this pandemic, private hospitals and clinics are experiencing a reduction of in patient footfalls due to nationwide lockdown and several other factors as well which are leading to inadequate utilization of health-care services by the patients and decrease in medical services volumes which resulted in acute economic crisis. In this article, various factors that caused a significant reduction in utilization rates of private health-care systems such as hospitals and clinics were outlined and discussed.

BACKGROUND: Preanesthesia evaluation (PAE) (also called preanesthetic assessment or preanesthesia checkup) is a detailed medical checkup and laboratory investigations performed by the anesthesiologist before a surgical procedure, to assess the patient's physical condition and any other medical illnesses or diseases the patient might be suffering from. Dedicated outpatient PAE clinics are fairly latest phenomenon, and information is thin from developing world. The role of PAE clinic is to evaluate all patients for surgical procedures requiring general or regional anesthesia before hospital admission, whether for day-care surgical procedures or for inpatient surgical procedures. Optimal use of PAE clinic avoids unnecessary postponements, suboptimal utilization of operation theater, and personnel and parental time. AIMS: The aim of this study was to describe the methods, challenges, and opportunities that we came across in setting up a PAE clinic in a university-based tertiary care teaching hospital attached to a medical college at Mysuru in South India. MATERIALS AND METHODS: The PAE clinic was planned to set up in the outpatient department area of this medical college cum tertiary care hospital, manned by a multimodal team. RESULTS: With the utilization of available resources, the establishment of daily PAE clinic was possible in this university-based tertiary care teaching hospital. CONCLUSION: PAE is a clinical base and framework for perioperative patient management. This article describes a scalable model that can be replicated in similar resource-constrained hospitals/health-care organizations.

The cleavage of the A2 domain of von Willebrand factor (VWF) by the metalloprotease ADAMTS13 regulates VWF size and platelet thrombosis rates. Reduction or inhibition of this enzyme activity leads to thrombotic thrombocytopenic purpura (TTP). We generated a set of novel molecules called VWF-A2 FRET (fluorescence/Förster resonance energy transfer) proteins, where variants of yellow fluorescent protein (Venus) and cyan fluorescent protein (Cerulean) flank either the entire VWF-A2 domain (175 amino acids) or truncated fragments (141, 113, and 77 amino acids) of this domain. These proteins were expressed in Escherichia coli in soluble form, and they exhibited FRET properties. Results show that the introduction of Venus/Cerulean itself did not alter the ability of VWF-A2 to undergo ADAMTS13-mediated cleavage. The smallest FRET protein, XS-VWF, detected plasma ADAMTS13 activity down to 10% of normal levels. Tests of acquired and inherited TTP could be completed within 30 min. VWF-A2 conformation changed progressively, and not abruptly, on increasing urea concentrations. Although proteins with 77 and 113 VWF-A2 residues were cleaved in the absence of denaturant, 4M urea was required for the efficient cleavage of larger constructs. Overall, VWF-A2 FRET proteins can be applied both for the rapid diagnosis of plasma ADAMTS13 activity and as a tool to study VWF-A2 conformation dynamics.

The function of the mechanosensitive, multimeric blood protein von Willebrand factor (VWF) is dependent on its size. We tested the hypothesis that VWF may self-associate on the platelet glycoprotein Ibα (GpIbα) receptor under hydrodynamic shear. Consistent with this proposition, whereas Alexa-488–conjugated VWF (VWF-488) bound platelets at modest levels, addition of unlabeled VWF enhanced the extent of VWF-488 binding. Recombinant VWF lacking the A1-domain was conjugated with Alexa-488 to produce ΔA1-488. Although ΔA1-488 alone did not bind platelets under shear, this protein bound GpIbα on addition of either purified plasma VWF or recombinant full-length VWF. The extent of self-association increased with applied shear stress more than ∼ 60 to 70 dyne/cm2. ΔA1-488 bound platelets in the milieu of plasma. On application of fluid shear to whole blood, half of the activated platelets had ΔA1-488 bound, suggesting that VWF self-association may be necessary for cell activation. Shearing platelets with 6-μm beads bearing either immobilized VWF or anti-GpIbα mAb resulted in cell activation at shear stress down to 2 to 5 dyne/cm2. Taken together, the data suggest that fluid shear in circulation can increase the effective size of VWF bound to platelet GpIbα via protein self-association. This can trigger mechanotransduction and cell activation by enhancing the drag force applied on the cell-surface receptor.

Summary The aim of our study was to estimate the uncultured eubacterial diversity of a soil sample collected below a dead seal, Cape Evans, McMurdo, Antarctica by an SSU rDNA gene library approach. Our study by sequencing of clones from SSU rDNA gene library approach revealed high diversity in the soil sample from Antarctica. More than 50% of clones showed homology to Cytophaga—Flavobacterium–Bacteroides group; sequences also belonged to α , β , γ proteobacteria , Thermus–Deinococcus and high GC gram-positive group; Phylogenetic analysis of the SSU rDNA clones showed the presence of species belonging to Cytophaga spp., Vitellibacter vladivostokensis, Aequorivita lipolytica, Aequorivita crocea, Flavobacterium spp., Flexibacter sp., Subsaxibacter broadyi, Bacteroidetes, Roseobacter sp., Sphingomonas baekryungensis, Nitrosospira sp., Nitrosomonas cryotolerans, Psychrobacter spp., Chromohalobacter sp., Psychrobacter okhotskensis, Psychrobacter fozii, Psychrobacter urativorans, Rubrobacter radiotolerans, Marinobacter sp., Rubrobacteridae , Desulfotomaculum aeronauticum and Deinococcus sp. The presence of ammonia oxidizing bacteria in Antarctica soil was confirmed by the presence of the amoA gene. Phylogenetic analysis revealed grouping of clones with their respective groups.

Background Von Willebrand Factor (VWF) A1‐domain binding to platelet receptor GpIbα is an important fluid‐shear dependent interaction that regulates both soluble VWF binding to platelets, and platelet tethering onto immobilized VWF. We evaluated the roles of different structural elements at the N‐terminus of the A1‐domain in regulating shear dependent platelet binding. Specifically, the focus was on the VWF D′D3‐domain, A1‐domain N‐terminal flanking peptide (NFP), and O‐glycans on this peptide. Methods and Results Full‐length dimeric VWF (ΔPro‐VWF), dimeric VWF lacking the D′D3 domain (ΔD′D3‐VWF), and ΔD′D3‐VWF variants lacking either the NFP (ΔD′D3NFP ─ ‐VWF) or just O‐glycans on this peptide (ΔD′D3OG ─ ‐VWF) were expressed. Monomeric VWF‐A1 and D′D3‐A1 were also produced. In ELISA, the apparent dissociation constant (K D ) of soluble ΔPro‐VWF binding to immobilized GpIbα (K D ≈100 nmol/L) was 50‐ to 100‐fold higher than other proteins lacking the D′D3 domain (K D ~0.7 to 2.5 nmol/L). Additionally, in surface plasmon resonance studies, the on‐rate of D′D3‐A1 binding to immobilized GpIbα (k on =1.8±0.4×10 4 (mol/L) −1 ·s −1 ; K D =1.7 μmol/L) was reduced compared with the single VWF‐A1 domain (k on =5.1±0.4×10 4 (mol/L) −1 ·s −1 ; K D =1.2 μmol/L). Thus, VWF‐D′D3 primarily controls soluble VWF binding to GpIbα. In contrast, upon VWF immobilization, all molecular features regulated A1‐GpIbα binding. Here, in ELISA, the number of apparent A1‐domain sites available for binding GpIbα on ΔPro‐VWF was ≈50% that of the ΔD′D3‐VWF variants. In microfluidics based platelet adhesion measurements on immobilized VWF and thrombus formation assays on collagen, human platelet recruitment varied as ΔPro‐VWF─ ‐VWF─ ‐VWF. Conclusions Whereas VWF‐D′D3 is the major regulator of soluble VWF binding to platelet GpIbα, both the D′D3‐domain and N‐terminal peptide regulate platelet translocation and thrombus formation.

First-principles calculations based on Density Functional Theory have been done on effect of fluorination of an important amino acid - L-Alanine. Its structure has been simulated. The unit cell is orthorhombic with lattice parameters a=5.90A, b=13.85A and c=5.75A with volume 470 (A)3. Bond lengths and bond angles have been estimated. Electronic Density of States calculations show that the material has a band gap of 4.47eV. Electronic band structure indicates that the material can be effectively used for NLO applications. The electronic contribution to the dielectric constant has been calculated and its average value comes out to be 2.165.

Structure of 2-Phenyl-1H-Imidazole has been studied using first-principles. The structural parameters have been compared with the x-ray data available in the literature. Unit cell is orthorhombic having four molecules. Molecules are linked to each other through hydrogen bonds. Lattice parameters are a = 9.7A, b = 16.35A and c = 5.9A. Electronic density of states (EDOS) have been calculated which gives a value of 2.22eV as the band gap.

Noncovalent association between the von Willebrand factor (VWF) propeptide (VWFpp) and mature VWF aids N-terminal multimerization and protein compartmentalization in storage granules. This association is currently thought to dissipate after secretion into blood. In the present study, we examined this proposition by quantifying the affinity and kinetics of VWFpp binding to mature VWF using surface plasmon resonance and by developing novel anti-VWF D′D3 mAbs. Our results show that the only binding site for VWFpp in mature VWF is in its D′D3 domain. At pH 6.2 and 10mM Ca2+, conditions mimicking intracellular compartments, VWFpp-VWF binding occurs with high affinity (KD = 0.2nM, koff = 8 × 10−5 s−1). Significant, albeit weaker, binding (KD = 25nM, koff = 4 × 10−3 s−1) occurs under physiologic conditions of pH 7.4 and 2.5mM Ca2+. This interaction was also observed in human plasma (KD = 50nM). The addition of recombinant VWFpp in both flow-chamber–based platelet adhesion assays and viscometer-based shear-induced platelet aggregation and activation studies reduced platelet adhesion and activation partially. Anti-D′D3 mAb DD3.1, which blocks VWFpp binding to VWF-D′D3, also abrogated platelet adhesion, as shown by shear-induced platelet aggregation and activation studies. Our data demonstrate that VWFpp binding to mature VWF occurs in the circulation, which can regulate the hemostatic potential of VWF by reducing VWF binding to platelet GpIbα.

Background Malaria is a tropical disease caused by protozoan parasite, Plasmodium, which is transmitted to humans by various species of female anopheline mosquitoes. Anopheles stephensi is one such major malaria vector in urban parts of the Indian subcontinent. Unlike Anopheles gambiae, an African malaria vector, transcriptome of A. stephensi midgut tissue is less explored. We have therefore carried out generation, annotation, and analysis of expressed sequence tags from sugar-fed and Plasmodium yoelii infected blood-fed (post 24 h) adult female A. stephensi midgut tissue. Results We obtained 7061 and 8306 ESTs from the sugar-fed and P. yoelii infected mosquito midgut tissue libraries, respectively. ESTs from the combined dataset formed 1319 contigs and 2627 singlets, totaling to 3946 unique transcripts. Putative functions were assigned to 1615 (40.9%) transcripts using BLASTX against UniProtKB database. Amongst unannotated transcripts, we identified 1513 putative novel transcripts and 818 potential untranslated regions (UTRs). Statistical comparison of annotated and unannotated ESTs from the two libraries identified 119 differentially regulated genes. Out of 3946 unique transcripts, only 1387 transcripts were mapped on the A. gambiae genome. These also included 189 novel transcripts, which were mapped to the unannotated regions of the genome. The EST data is available as ESTDB at http://mycompdb.bioinfo-portal.cdac.in/cgi-bin/est/index.cgi. Conclusion 3946 unique transcripts were successfully identified from the adult female A. stephensi midgut tissue. These data can be used for microarray development for better understanding of vector-parasite relationship and to study differences or similarities with other malaria vectors. Mapping of putative novel transcripts from A. stephensi on the A. gambiae genome proved fruitful in identification and annotation of several genes. Failure of some novel transcripts to map on the A. gambiae genome indicates existence of substantial genomic dissimilarities between these two potent malaria vectors.

We tested the possibility that immune complexes formed following platelet factor 4 (PF4/CXCL4) binding to anti-PF4 antibody can stimulate neutrophil activation, similar to previous reports with platelets. Monoclonal Abs against PF4 and IgG from a heparin-induced thrombocytopenia (HIT) patient were applied. We observed that although PF4 or anti-PF4 antibody alone did not alter neutrophil function, costimulation with both reagents resulted in approximately 3-fold increase in cell surface Mac-1 expression, enhanced cell adhesion via L-selectin and CD18 integrins, and degranulation of secondary and tertiary granules. The level of Mac-1 up-regulation peaked at an intermediate PF4 dose, suggesting that functional response varies with antigen-antibody stoichiometry. PF4 binding to neutrophils was blocked by chondroitinase ABC. Cell activation was inhibited by both chondroitinase ABC and anti-CD32/FcγRII blocking mAb, IV.3. Confocal microscopy demonstrated that immune complexes colocalize with CD32a. Studies with HIT IgG demonstrated that neutrophils could be activated in the absence of exogenous heparin. These data, together, show that leukocyte surface chondroitin sulfates promote neutrophil activation by enhancing immune-complex binding to CD32a. Studies with recombinant PF4 suggest a role for arginine 49 in stabilizing PF4-chondroitin binding. Neutrophils activated via this mechanism may contribute to thrombosis and inflammation in patients mounting an immune response to PF4-heparin.

BACKGROUND: Aeromonas sp. can now be considered relatively common enteropathogens due to the increase of diseases in humans. Aeromonas culicicola is a gram negative rod-shaped bacterium isolated for the first time from the mosquito mid-gut, but subsequently detected in other insects and waters also. Our previous study discovered that A. culicicola harbors three plasmids, which we designated as pAc3249A, pAc3249B and pAc3249C. We investigated and report here the existence and genetic organization of a Conjugal Type IV Secretion System (TFSS) in pAc3249A.METHODOLOGY/PRINCIPLE FINDING: The complete operon is 11,061 bp in length and has G+C content of 47.20% code for 12 ORFs. The gene order and orientation were similar to those found in other bacteria with some differences. We have designated this system as AcTra for Aeromonas culicicola transfer system. BLAST results of ORFs and phylogenetic analysis showed significant similarity towards the respective proteins of the IncI2 plasmid R721 of E. coli. Other bioinformatics studies have been performed to predict conserved motifs/domains, signal peptides, transmembrane helices, etc. of the ORFs.CONCLUSIONS/SIGNIFICANCE: BLAST results of ORFs and phylogenetic analysis showed significant similarity towards the respective proteins of the IncI2 plasmid R721 of E. coli.

The polymorphism of the 18S rRNA gene in Wuchereria bancrofti microfilariae (mf) collected from three different zones in India was analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The RFLPs of the amplified products obtained after digestion with restriction enzymes Ssp I, Msp I and Hha I showed no difference in the banding patterns among the mf isolates from different endemic zones. Further the sequencing of PCR products did not show any difference in the nucleotide sequence either. The phylogenetic analysis of the sequences of W. bancrofti mf isolates from different endemic zones has shown branching with the earlier reported sequences of W. bancrofti and its close relative Brugia malayi.

Cost of health care delivery is increasing day by day due to a multitude of factors. More emphasis is being laid on cost containment. The author has deliberated on types of budgeting and accounting techniques with a special emphasis on investment decisions and fund generation. The author explains in detail formulation of departmental budget by doctors by providing adequate illustrations which help in cost containment. The book is recommended for all specialists, as well as, hospital administrators.

Medical Service has made unprecedented progress during the last two decades leading to phenomenal growth in healthcare industry. Healthcare organizations are thus increasingly required to concentrate on evidence based healthcare and cost effective service. This book emphasizes the need to incorporate principles of organizational effectiveness, behavioural sciences and business administration in day to day managerial practices by health care administrators. The book is written exhaustively, single handedly and runs into 8 sections viz. Health planning: past, present and future; Hospital Management: Principles and practice: Managing health care technology; Organizational behaviour; Modern approach to Quality; Healthcare Reforms; Research for health, and Medical Ethics. Though the style of presentation is user friendly and language simple, addition of more schematic diagrams, colour photographs and highlighted boxes would have made the subject clear. Dr Tabish's experience of having worked in UK, USA and Middle East has made topics like healthcare in various countries a treat to read. Health care administration related topics have been covered in an innovative manner. Legal aspects of health care in terms of Consumer Protection Act, Labour laws applicable to hospitals, Biomedical Waste Management and Handling rules and Ambulances services have not been handled to the satisfaction and actual requirement of hospital administrators. Hospital management topics are a straight lift from many General management books and lack examples, case studies from hospital field. Overall the book is recommended for healthcare administrators, hospital administration students and as a reference book in medical college libraries.

Summary We determined the gyrB gene sequences of all 17 hybridizations groups of Aeromonas . Phylogenetic trees showing the evolutionary relatedness of gyrB and 16S rRNA genes in the type strains of Aeromonas were compared. Using this approach, we determined the phylogenetic position of Aeromonas culicicola MTCC 3249 T , isolated from midgut of Culex quinquefasciatus . In the gyrB based-analysis A. culicicola MTCC 3249 T grouped with A. veronii whereas, it grouped with A. jandaei in the 16S rRNA based tree. The number of nucleotide differences in 16S rRNA sequences was less than found with the gyrB sequence data. Most of the observed nucleotide differences in the gyrB gene were synonymous. The Cophenetic Correlation Coefficient (CCC) for gyrB sequences was 0.87 indicating this gene to be a better molecular chronometer compared to 16S rRNA for delineation of Aeromonas species. This strain was found to be positive for the cytolytic enterotoxin gene. PCR-Amplicon Sequence Analysis (PCR-ASA) of this gene showed that the isolate is affiliated to type I and is potentially pathogenic. These PCR-ASA results agreed in part with the gyrB sequence results.

The first edition of “Applied Hospital Administration” published by OTS, AMC Centre and School deals with administrative issues related to Service Hospitals in an elaborate manner. While written primarily from the point of view of a “Handbook for Commanding Officers”, it also addresses the needs of any officer engaged in administrative duties in a hospital. The book is divided into six parts – general administration of service hospital, hospital logistics management, human resource management, hospital asset management, patient care management and management for total consumer satisfaction. The book cites up-to-date policy letters and instructions that govern various areas of operations in a service hospital. The book also refers to current concepts in hospital management and offers practical suggestions for effective and efficient management of hospitals. Overall the book is well written and the author has a good knowledge of the subject and the ability to present the subject with clarity and usefulness. The book is recommended in conjunction with existing policies and procedures that govern administration of service hospitals.

Hospital marketing while slowly coming of age in our country still carries a stigma in the eyes of many hospitals. Author has tried to handle such a sensitive and controversial subject in a successful manner in this book. This book has been divided into six parts gradually building up the subject from introduction to marketing concepts to marketing of hospitals in India. Author has made a special reference to private practice in terms of useful and ethical tips to increase the client base. The book also has sections on contemporary marketing, public relations and marketing for non profit organizations. Appendices consisting of sample advertisements, patient's guide, public relation checklist etc. help the management student in conceptualizing ideas of marketing. This book is recommended as a reference book for students of hospital administration and public relation in charge of the hospitals.