Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology. OLP presents as white striations, white papules, white plaques, erythema, erosions, or blisters affecting predominantly the buccal mucosa, tongue and gingiva. Both antigen-specific and non-specific mechanisms are hypothesized to be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8(+) cytotoxic T cells. Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase activation in OLP lesions. These mechanisms may combine to cause T cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T cell migration and keratinocyte apoptosis in OLP. The various hypotheses proposed for pathogenesis of oral lichen planus are discussed in this review.

The research was conducted to evaluate the soft skill competencies and communication among future healthcare professionals. By knowing the level of knowledge, attitude, practices, and Skill-sets and which is assessed as pre and post-test by a questioner and taking the feedback, the data is collected for process improvisation in the training program. Plan, Do, Check and Act (PDCA Cycle) helps in setting the processes for implementation and improving training modules for communication soft skill competency. The PDCA cycle is utilized for the improvement process as a managerial tool in the process setting. The approach helps in competency mapping and evaluating the training module for healthcare managers. This tool helps in enhancing the quality of the training program by assessing the preparation from the participants' perspective. Data is compared by the pre and post-test scores. Results include the data collected as quantitative and qualitative feedback data to assess the effectiveness of the training module. Data is collected on the level of preparation of the participants, participants' expectations for taking the course, level of preparation, and the level of interaction with the training program. Data is collated, compiled, analyzed, and interpreted for evaluation. The research provides information on the insights of customer satisfaction, decision-making capabilities, the importance of reward and recognition in training and development, and changing domains in the quality healthcare management sector. The skill sets and competencies which were an outcome were Communication, Collaborator, Team leader, Change agent, Motivator, Analytical skills, and Logical skills. By taking participants' feedback, the outcome analysis and the effectiveness of training can be evaluated. By evaluation of results, process improvisation, seamless coordination, and continuous improvement are performed. The research concluded as an out comemeasure for the betterment of training programs and to improve the quality of services.

5S-Kaizen-Total Quality Management (TQM) is a hospital management approach to improve with limited resources. The set actions are conducted systematically with commitment and full participation of staff who are working in the hospital. Samples were drawn from the work environment, housekeeping staff, Cardiac counter staff. Data were collected through a cross-sectional, prospective, observational, qualitative study, and a checklist with 5S parameters was used as a quantitative tool to analyze the data for pre-study score and post-study score. The score has been improved from 64 to 104 out of 125 after training on comparing the score of pre-study and post-study which means a considerable improvement of 60% in the health care working environment. It was found that after the training and continuous monitoring 5S was successfully implemented which showed some benefits such as Self-discipline improvement with a positive attitude, Increasing awareness and morale, improvement of inter-human relations, improvement of the internal communication processes. To improve the working environment and to enhance the motivation of staff who are working in a hospital and health care organizations. 5S as a quality improvement tool has made the working environment smooth and safe. It eliminates unnecessary items from the workplace. It prevents the items and documents from being lost or damaged and minimize the wastage of time and resources. It has improved staff morale.

Introduction: Safety concerns of outborn neonatal infant babies during transportation to the NICU had been a concern. Better team coordination and improvement in the technical competency of the care providers helped implement the ambulance policy. Methods: With the background of the Donabedian model and Juran's Trilogy concepts, process improvisation was performed. The RCA (Root Cause Analysis) and HFMEA (Healthcare Failure Mode and Effects Analysis) as tools were used for better deliverables. Results: The measurable outcomes in terms of time taken for departure before and after were compared, which showed considerable significance. By measuring the baby temperatures, a significant difference was seen in clinical aspects. Discussion: Lack of infrastructure, equipment for neonatal transportation was a challenge that required prioritization of budget allocation. The procurement policy of equipment had to be relooked for user-friendly strategies. Lack of trained staff and doctors, which were major issues, required an intense training and development module. The challenges of hypothermia, ventilation issues during transportation of neonates were of major concern, were tackled using quality tools. Application: To minimize the mortality and morbidity of neonates, infants by Specialized Pediatric Critical Care Transport (SPCCT) ambulance policy was implemented. The value addition was to minimize the risks and prevention of hazards. Conclusion: Improvement in the Technical competency of nurses and caregivers was observed. Nurses were well exposed to handling transporting sick babies. Logistics, equipment handling was performed properly.  With better team coordination, the babies were safe. The trust and confidence among the members of the community at large improved. The patient footfall increased in numbers.

Background: As the rural Indian health care sector is providing patient care to the community at large, evaluating the quality of services gives an insight into the level of care provided. The primary health care chose the audit evaluation voluntarily. Objectives: The aim of the study was to assess the service quality provided in the primary health care Centre. The study was to help understand the skill set requirements in improving the quality of care and to identify the service quality gaps and to provide the best possible solutions for the gap closures by nominating the responsible personnel. Methods: The quality of care was evaluated in three ways: staff interview, record review, and observations conducted. Six departments were chosen for evaluation: the out-patient department, in-patient department, labor room, laboratory, National health programs, and general administration. By a prepared specific checklist comprised of standards and measurable elements, an evaluation was performed. The scoring was provided as 0, 1and 2, which implied noncompliance, partial compliance, and full compliance. Results: As per evaluation, national health program areas scored the least, whereas the inpatient departments scored the highest.  There were multiple gaps in the service provision areas and manpower allocation. The average mean score was 77.48. Conclusion: Keeping the national standards and guidelines, an audit evaluation was performed. Quality has to be imbibed with the optimization of resource allocation and with the mindset to provide the best possible care in the interest of the individual's wellbeing.