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Introduction: Quality failures in the clinical laboratories should be analyzed to improve patient safety in hospital. Purpose of this study is to apply failure mode and effects analysis (FMEA) for prospective risks of quality failures and appropriate corrective actions to reduce/prevent errors in clinical biochemistry laboratory. Materials and Methods: Members of multidisciplinary team were trained to notify quality failures. Each quality failures assigned value from 1 to 5 based on severity, occurrence and detection of failure modes. Risk priority number (RPN) was calculated from severity, occurrence and detection scores (RPN = SI x OI x DI). For highest risk failure modes, FMEA tool was applied in two stages: before and after action plan. Results: A total 14 high risk failure modes were found and arranged based on their RPN values from high to low score. In 5 highest risk failure modes RPN values before action plan were as follows: Transcription error (RPN=100), Malfunction of reagent (RPN=75), Malfunction of calibrator (RPN=48), Samples taken in wrong tubes (RPN=36) and Sample misplaced in laboratory (RPN=36). After corrective actions taken, we found decrease in RPN values for 5 highest risk failure modes. Conclusion:FMEA is an effective tool to reduce quality failures in clinical biochemistry laboratories.

Introduction: Quality failures in clinical biochemistry laboratory have an adverse impact on patient care. Identification and correction of the quality failures are essential to decrease risk and improve patient safety in hospital. Materials and Methods: This study was assessed over 14 months from January 2017 to February 2018. A designed 'Quality enquiry forms' were introduced to report quality failures which prioritize corrective action. Quality failures were categorized in three phases: preanalytical, analytical and postanalytical with subcategories in each phase. Quality failures were graded on the basis of actual ('A' score) and potential ('P' score) adverse outcome on patient care using 5 point scoring system. Results: The numbers of quality failures reported were 453 (0.53%) out of 84,569 requisites received by the clinical biochemistry laboratory, during this entire study period. Quality failures were reported as 50.3%, 5.1% and 44.6% in preanalytical, analytical and postanalytical phases respectively. Quality failure severity 'A' score was tilted towards lower side: 58.5% allocated an 'A' score of 1 (least severe grade), while for the 'P' score towards higher side: 45.5% allocated a 'P' score of 5 (most severe grade). Conclusion: Quality enquiry reporting system is an effective method for recognition of quality failures in clinical biochemistry laboratory. Systematic approach in this study encompasses a multifaceted strategy for error analysis based on error detection and prevention.

Background: Hypertension is consistently related to the development of ischemic heart disease, heart failure, stroke, and chronic kidney disease. Oxidative stress has been associated with mechanisms of hypertension which could be nullified by antioxidants such as Vitamin C and Vitamin E. Aim and Objectives: The objectives of the study are as follows: (i) To estimate the impact of antioxidant therapy on antioxidant capacity in hypertensive patients; (ii) to measure serum levels of glutathione, glutathione peroxidase (GPx), glutathione reductase (GR), and superoxide dismutase (SOD) in hypertensive patients before and after giving them antioxidant therapy for 45 days. Materials and Methods: Thirty randomly selected hypertensive patients were given Supradyn tablet once a day for 45 days. Ferric reducing ability of plasma (FRAP), SOD, GR, GPx, and reduced Glutathione assays were measured before and after the intervention therapy. Results: Total antioxidant capacity as measured by serum FRAP in hypertensive patients before and after the therapy was increased significantly from 578.8 ± 60.85 to 592.1 ± 59.66 (μmol/L), respectively. The levels of SOD, GPx, GR, and Glutathione in hypertensive patients before giving antioxidant therapy were 1.6 ± 0.49 U/ml, 184.6 ± 17.1 μmol/L/min, 8.96 ± 1.15 μmol/L/min, and 8.03 ± 0.96 μmol/g of Hb, respectively. The same after giving them antioxidant therapy were 1.7 ± 0.46 U/ml, 182.4 ± 15.98 μmol/L/min, 8.83 ± 1.11 μmol/L/min, and 7.83 ± 0.94 μmol/g of Hb, respectively. The levels of GPx, GR, and Glutathione were significantly decreased after giving antioxidant therapy for 45 days while SOD level did not change significantly. Conclusion: Antioxidant therapies for 45 days led to a significant increase in total antioxidant capacity as shown by plasma FRAP levels and a significant decrease in serum levels of enzymatic antioxidants such as GPx, GR and Glutathione in hypertensive patients. However, serum levels of SOD did not show a significant change.

Background: Conventionally, teaching in the subject of physiology is undertaken with the help of didactic lectures, practical demonstrations, and tutorials. Case-based learning (CBL) is known to impart analytical and problem-solving skills in the students. CBL motivates students to apply clinical knowledge from real-life scenarios to solve problems. Aims and Objectives: The aim of the study was to compare the effectiveness of didactic lectures and CBL in physiology among 1st-year BDS students and to gauge their perception. Materials and Methods: After ethical approval, this study was conducted at physiology department PIMS Udaipur. After taking informed consent, two groups of 40 students were taught two different topics using CBL and didactic lectures with cross-over study design. Students’ learning was assessed by 20 pre-validated MCQs. Mean ± SD of the pre- and the post-test scores of the students was taken. The post-test scores of the students in both the groups were compared using Student’s t test. P < 0.05 was considered as significant. Students’ perception was analyzed on Likert scale. Results: CBL was found to be statistically significant (P < 0.01) in both the topics. MCQ scores of didactic lectures was 7.972 ± 1.765 and 7.667 ± 1.971 while that of CBL was 9.111 ± 2.081 and 9.222 ± 2.257 in anemia and jaundice, respectively. Students gave favorable and encouraging perception on CBL method. Conclusion: CBL was more effective than didactic lectures in teaching physiology to undergraduates. First-year BDS students found interactive case discussions more enjoyable and educationally stimulating than lectures. Students’ feedback indicated that CBL could be incorporated more in undergraduate physiology Curriculum.