Purpose
– Health is an important issue in our life. A person with good health will have peace of mind and will be able to contribute to nation-building. We cannot expect performance from an ill person with a low morale. In the present paper, the authors tried to understand the ground realities of health-care facilities provided in India and more specifically in Odisha, India.
Design/methodology/approach
– This empirical paper used a non-experimental design to test a proposed model based on a review of relevant literature. In this paper, an initial pilot study was conducted by taking 44 various variables; however, after the study and taking the expert opinion, the variables were restricted to only 30. For the purpose of study, only state-sponsored hospitals were considered on a random sampling method.
Findings
– The analysis of data is conducted on a simple percentage method with closed-end options. It is found that even after 67 years of independence, people do not have access to basic medical care facilities in the rural areas and to some extent in semi-urban areas also. The major stumbling block is inadequate infrastructure in these hospitals.
Research limitations/implications
– While this study offers some insight into the status of healthcare infrastructure in rural India, the sample was limited to respondents in state-sponsored hospitals, which may not represent the views about private hospitals.
Practical implications
– It seems that in some interior areas of Odisha, people rely more on their fate than then these health-care services.
Social implications
– Various governments claim that they are spending millions of rupees on health-care service, but the benefits are not being felt by the masses. We are sure that our attempt to highlight the scenario of health-care services in the state of Odisha will be an eye opener and will compel the various stake holders to introspect their involvement in the health-care services provided in these areas.
Originality/value
– A considerable amount of research has been done evaluating the status of healthcare in India, but this is the first empirical research study to date based on respondents from the rural parts of the state of Odisha in India. Some of these areas are not reachable to researchers due to the poor infrastructure. This contribution is also of special importance amid the recent criticism of the healthcare infrastructure in India by prominent management scholars.
Endothelial cells synthesize biochemical signals to coordinate a response to insults, resolve inflammation and restore barrier integrity. Vascular cells release a variety of vasoactive bioactive lipid metabolites during the inflammatory response and produce pro-resolving mediators (e.g., Lipoxin A4, LXA4) in cooperation with leukocytes and platelets to bring a halt to inflammation. Aspirin, used in a variety of cardiovascular and pro-thrombotic disorders (e.g., atherosclerosis, angina, preeclampsia), potently inhibits proinflammatory eicosanoid formation. Moreover, aspirin stimulates the synthesis of pro-resolving lipid mediators (SPM), so-called Aspirin-Triggered Lipoxins (ATL). We demonstrate that cytokines stimulated a time- and dose-dependent increase in PGI2 (6-ketoPGF1α) and PGE2 formation that is blocked by aspirin. Eicosanoid production was caused by cytokine-induced expression of cyclooxygenase-2 (COX-2). We also detected increased production of pro-resolving LXA4 in cytokine-stimulated endothelial cells. The R-enantiomer of LXA4, 15-epi-LXA4, was enhanced by aspirin, but only in the presence of cytokine challenge, indicating dependence on COX-2 expression. In contrast to previous reports, we detected arachidonate 5-lipoxygenase (ALOX5) mRNA expression and its cognate protein (5-lipoxygenase, 5-LOX), suggesting that endothelial cells possess the enzymatic machinery necessary to synthesize both pro-inflammatory and pro-resolving lipid mediators independent of added leukocytes or platelets. Finally, we observed that, endothelial cells produced LTB4 in the absence of leukocytes. These results indicate that endothelial cells produce both pro-inflammatory and pro-resolving lipid mediators in the absence of other cell types and aspirin exerts pleiotropic actions influencing both COX and LOX pathways.
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