This document discusses a technical analysis of discrepancies found in a recent 483 observation, including issues with aseptic practices, visual inspection programs, and media fill programs. It provides background on the author, Palash Chandra Das, who has expertise in qualification and validation, sterility assurance, quality management systems, investigations, and risk management. The bulk of the document then analyzes and provides recommendations regarding the discrepancies observed in the 483 related to particle investigation, manual inspection processes, environmental monitoring, smoke studies, intervention categorization and risk assessment.
Equipment risk management - a quality systems approachPalash Das
Refer before performing risk assessment for pharmaceutical equipment. Can be considered before preparation of User Requirement Specification. in case of existing equipment can be prepare as a part of annual risk review.
Hosting remote inspection at pharmaceutical facilities Palash Das
COVID-19 pandemic has put manufacturers, affiliates and inspectors in a new and challenging situation where it is in the public interest to continue to supply medicines while ensuring demonstrated compliance. Regulatory agencies coming with the idea for conducting remote inspection across foreign manufacturing site
A review article on visual inspection program for sterile injectable product ...Palash Das
Objective of this article is to conduct a thorough review and understanding on the manually
conduct visual inspection process for liquid Injectable products in liquid and lyophilized form
and to explore the complications identified during the routine process. Along with that
troubleshot to overcome from the challenges. Evaluation quality of product during batch
release and consider continuous process improvement opportunities.
Basic understanding of HAZOP it covers:
-Basic understanding of HAZOP
-HAZOP requirements
-How it works
-Case study
-HAZOP team
-Advantage & disadvantage
1. HAZOP by DAMO
2. What is HAZOP? HAZOP is an acronym that stands for HAZARD and OPERABILITY Study It was pioneered at ICI (Imperial Chemical Industries, UK) during the late 1960s
3. What is HAZOP? ICI no longer exists today in its original form today (it was taken over by AkzoNobel) but the HAZOP technique that it pioneered survives, thrives and grows in importance every day. HAZOP is mainly a Risk Assessment Technique HAZOP is a Qualitative technique
4. Where is HAZOP used? HAZOP is used in a wide variety of industries and sectors including but not limited to •Chemicals & Petrochemicals •Oil & Gas including refining •Power Generation •Mining & Metals •Pharmaceutical manufacturing
5. How is HAZOP Structured? HAZOP is structured in such a way as to evaluate the design intent of a particular part of a plant, called as a node and then use Guide Words to evaluate deviations from the intent
6. HAZOP Example For example a HAZOP node may be a day tank that pumps a reactant to the plant every day. The design intent is “transfer liquid from tank to plant” Possible Deviations from intent are evaluated using Guide Words such as Less Than, More Than, Reverse, No and others.
7. HAZOP Example Thus possible deviations from the design intent would be Liquid Quantity transferred is Less than intented Liquid flows in Reverse direction (from plant to tank) and so on until all possible devaitions are analyzed
8. HAZOP Example Now every deviation is analysed and Mitigated via adequate measures Mitigations may be multiple for each deviation All nodes need to be analysed in this manner
9. HAZOP Types There are different kinds of HAZOPs •Conceptual •Greenfield •Brownfield •Decommissioning •CHAZOP (Computer HAZOP)
10. HAZOP Team HAZOP is a team effort with a HAZOP Leader, a HAZOP Scribe who documents the analysis either manually (with an Excel sheet) or using a documentation software and Team members who contribute to the analysis
A Hazard and Operability (HAZOP) study is a structured and systematic examination of a planned or existing process or operation in order to identify and evaluate problems that may represent risks to personnel or equipment, or prevent efficient operation.
QC Multi rules - Improving Laboratory Performance Through Quality ControlRandox
Randox Quality Control's latest educational guide examines and explains what QC Multi-Rules are, How to identify an out of control event with QC rules, How to use QC Multi-Rules, The different types of analytical errors, The tools to assist labs and how a lab can troubleshoot QC errors.
Acusera 24.7 Interlaboratory Data Management - June 17 LT244Randox
Acusera 24.7 Live Online version 2.0 is here! Faster, smarter and more efficient than ever before, this interlaboratory data management program will be sure to help streamline internal QC in all laboratories regardless of size.
Equipment risk management - a quality systems approachPalash Das
Refer before performing risk assessment for pharmaceutical equipment. Can be considered before preparation of User Requirement Specification. in case of existing equipment can be prepare as a part of annual risk review.
Hosting remote inspection at pharmaceutical facilities Palash Das
COVID-19 pandemic has put manufacturers, affiliates and inspectors in a new and challenging situation where it is in the public interest to continue to supply medicines while ensuring demonstrated compliance. Regulatory agencies coming with the idea for conducting remote inspection across foreign manufacturing site
A review article on visual inspection program for sterile injectable product ...Palash Das
Objective of this article is to conduct a thorough review and understanding on the manually
conduct visual inspection process for liquid Injectable products in liquid and lyophilized form
and to explore the complications identified during the routine process. Along with that
troubleshot to overcome from the challenges. Evaluation quality of product during batch
release and consider continuous process improvement opportunities.
Basic understanding of HAZOP it covers:
-Basic understanding of HAZOP
-HAZOP requirements
-How it works
-Case study
-HAZOP team
-Advantage & disadvantage
1. HAZOP by DAMO
2. What is HAZOP? HAZOP is an acronym that stands for HAZARD and OPERABILITY Study It was pioneered at ICI (Imperial Chemical Industries, UK) during the late 1960s
3. What is HAZOP? ICI no longer exists today in its original form today (it was taken over by AkzoNobel) but the HAZOP technique that it pioneered survives, thrives and grows in importance every day. HAZOP is mainly a Risk Assessment Technique HAZOP is a Qualitative technique
4. Where is HAZOP used? HAZOP is used in a wide variety of industries and sectors including but not limited to •Chemicals & Petrochemicals •Oil & Gas including refining •Power Generation •Mining & Metals •Pharmaceutical manufacturing
5. How is HAZOP Structured? HAZOP is structured in such a way as to evaluate the design intent of a particular part of a plant, called as a node and then use Guide Words to evaluate deviations from the intent
6. HAZOP Example For example a HAZOP node may be a day tank that pumps a reactant to the plant every day. The design intent is “transfer liquid from tank to plant” Possible Deviations from intent are evaluated using Guide Words such as Less Than, More Than, Reverse, No and others.
7. HAZOP Example Thus possible deviations from the design intent would be Liquid Quantity transferred is Less than intented Liquid flows in Reverse direction (from plant to tank) and so on until all possible devaitions are analyzed
8. HAZOP Example Now every deviation is analysed and Mitigated via adequate measures Mitigations may be multiple for each deviation All nodes need to be analysed in this manner
9. HAZOP Types There are different kinds of HAZOPs •Conceptual •Greenfield •Brownfield •Decommissioning •CHAZOP (Computer HAZOP)
10. HAZOP Team HAZOP is a team effort with a HAZOP Leader, a HAZOP Scribe who documents the analysis either manually (with an Excel sheet) or using a documentation software and Team members who contribute to the analysis
A Hazard and Operability (HAZOP) study is a structured and systematic examination of a planned or existing process or operation in order to identify and evaluate problems that may represent risks to personnel or equipment, or prevent efficient operation.
QC Multi rules - Improving Laboratory Performance Through Quality ControlRandox
Randox Quality Control's latest educational guide examines and explains what QC Multi-Rules are, How to identify an out of control event with QC rules, How to use QC Multi-Rules, The different types of analytical errors, The tools to assist labs and how a lab can troubleshoot QC errors.
Acusera 24.7 Interlaboratory Data Management - June 17 LT244Randox
Acusera 24.7 Live Online version 2.0 is here! Faster, smarter and more efficient than ever before, this interlaboratory data management program will be sure to help streamline internal QC in all laboratories regardless of size.
Hazop Fundamentals Online Training iFluidsJohn Kingsley
This course is designed to provide the basics of HAZOP study technique, its outcome and also to perform/review HAZOP report.
Familiarity with HAZOP Terminologies, Methodology, Brief Ideas for taking part /Involve in HAZOP Session. https://trainings.ifluids.com/
Quality Control for Point of Care Testing - White PaperRandox
Point of care testing (POCT) refers to testing that is performed near or at the site of a patient with the result leading to a possible change in the care of the patient. Over the past few years, the popularity and demand of POCT has been growing rapidly. This should come as no surprise as there are many advantages to POCT, for example, the added convenience of being able to obtain a rapid result at the patient’s bedside, thus allowing immediate action, saving time and improving the potential outcome for the patient.
RIQAS is the largest international External Quality Assessment (EQA)/ Proficiency Testing (PT) scheme, there are currently more than 45,000 participants in 133 countries.
Cleaning Validations Using Extraction TechniquesAnita Anzo
Scheduled On : Monday, November 4, 2013 at 1:00 PM EDT
Duration: 60 minutes
this webinar is recorded
visit us at https://www.compliancetrainings.com/SiteEngine/ProductDetailView.aspx?id=MD1141
Sense of urgency, lessons learned, organizational alignment, team approach, training and an increasing engineering and statistical capability at CDER FDA can be expected to facilitate a move by industry towards continues manufacturing, FDA’s current emphasis on ‘statistical confidence’, Process Validation Guidance 2011, is likely to highlight certain issues (e.g., special causes) within current batch processing; these observation will need to be addressed in an appropriate risk-based manner
Ensuring that pragmatic consideration for specifications & control (intended use) is essential and importance of pragmatic decisions should not be forgotten (e.g., as in case of Design Space Vs. SUPAC), Effective regulatory communication (considering the engineering and statistical emphasis) will be crucial for ensuring regulatory uncertainty is managed in a timely manner,
Designing an appropriate QC procedure for your laboratoryRandox
Improving Laboratory Performance Through Quality Control - Five Simple Steps for QC Success.
It is easy to get caught up in an abundance of QC statistics and forget the fundamental reason why
QC exists in the first instance. QC is about detecting errors and ensuring that the results you
produce are accurate and reliable. All QC procedures should focus on reducing the risk of harm
to the patient. We are not examining statistics; we are examining real patients, real results and real
lives. Around 70% of all medical decisions are based on laboratory results, which is why it is of
utmost importance that each and every laboratory, has a well-designed QC procedure in place.
How to establish QC reference ranges - Randox QC Educational GuideRandox
Establishing QC reference ranges is an important aspect of laboratory quality. Find out how to effectively set reference ranges with our educational guide.
Totality of Evidence & Theraputic Equivalence 15 October 2016Ajaz Hussain
Put R back in R&D & recognize It is a “complex” product and process!
Invest smartly in analytics, mathematics & statistics, and large sample sizes; and in systems/integrative thinking and data integration
Get to know the RLD – multiple lots; open the door with large sample size
Build capability to justify measured RLD variability is relevant to development of the proposed generic/biosimilar
Exquisite regulatory communication strategy
This is not a ‘complicated process’ for which typical “good practices” will work seamlessly (e.g., typical project management approach); this is a complex process – with multiple interactions and “emergent properties”
Treat it as it is - a complex process and plan; anticipate and address “emergent issues” - in technical, regulatory and legal dimensions; at a certain point be prepared for stakeholder (payers, patient groups,..) communications
The laboratory shall determine measurement uncertainty for each measurement procedure,
in the examination phases used to report measured quantity values on patients’ samples. The
laboratory shall define the performance requirements for the measurement uncertainty of each
measurement procedure and regularly review estimates of measurement uncertainty.
How to succeed when you get a FDA 483 form letter. What to do and how to handle your FDA 483. For more information go to http://compliance-insight.com/fda-483-warning-letters/fda-483-observations/
Acusera 24.7 is an interboratory data management software capable of automatically calculating measurement of uncertainty and six-sigma. With real time peer group updates and user friendly comprehensive charts and reports including Levey Jennings and histograms, our Acusera 24.7 software is now smarter, faster and more efficient than ever before!
This report presents data derived from a comparative analysis that indicates gaps and security risks between multi-day test administrations with smaller numbers of test takers and single-format testing of large numbers of test takers. Additionally, the report highlights the use of standard best practices adopted around the world by leading test sponsor organisations.
Hazop Fundamentals Online Training iFluidsJohn Kingsley
This course is designed to provide the basics of HAZOP study technique, its outcome and also to perform/review HAZOP report.
Familiarity with HAZOP Terminologies, Methodology, Brief Ideas for taking part /Involve in HAZOP Session. https://trainings.ifluids.com/
Quality Control for Point of Care Testing - White PaperRandox
Point of care testing (POCT) refers to testing that is performed near or at the site of a patient with the result leading to a possible change in the care of the patient. Over the past few years, the popularity and demand of POCT has been growing rapidly. This should come as no surprise as there are many advantages to POCT, for example, the added convenience of being able to obtain a rapid result at the patient’s bedside, thus allowing immediate action, saving time and improving the potential outcome for the patient.
RIQAS is the largest international External Quality Assessment (EQA)/ Proficiency Testing (PT) scheme, there are currently more than 45,000 participants in 133 countries.
Cleaning Validations Using Extraction TechniquesAnita Anzo
Scheduled On : Monday, November 4, 2013 at 1:00 PM EDT
Duration: 60 minutes
this webinar is recorded
visit us at https://www.compliancetrainings.com/SiteEngine/ProductDetailView.aspx?id=MD1141
Sense of urgency, lessons learned, organizational alignment, team approach, training and an increasing engineering and statistical capability at CDER FDA can be expected to facilitate a move by industry towards continues manufacturing, FDA’s current emphasis on ‘statistical confidence’, Process Validation Guidance 2011, is likely to highlight certain issues (e.g., special causes) within current batch processing; these observation will need to be addressed in an appropriate risk-based manner
Ensuring that pragmatic consideration for specifications & control (intended use) is essential and importance of pragmatic decisions should not be forgotten (e.g., as in case of Design Space Vs. SUPAC), Effective regulatory communication (considering the engineering and statistical emphasis) will be crucial for ensuring regulatory uncertainty is managed in a timely manner,
Designing an appropriate QC procedure for your laboratoryRandox
Improving Laboratory Performance Through Quality Control - Five Simple Steps for QC Success.
It is easy to get caught up in an abundance of QC statistics and forget the fundamental reason why
QC exists in the first instance. QC is about detecting errors and ensuring that the results you
produce are accurate and reliable. All QC procedures should focus on reducing the risk of harm
to the patient. We are not examining statistics; we are examining real patients, real results and real
lives. Around 70% of all medical decisions are based on laboratory results, which is why it is of
utmost importance that each and every laboratory, has a well-designed QC procedure in place.
How to establish QC reference ranges - Randox QC Educational GuideRandox
Establishing QC reference ranges is an important aspect of laboratory quality. Find out how to effectively set reference ranges with our educational guide.
Totality of Evidence & Theraputic Equivalence 15 October 2016Ajaz Hussain
Put R back in R&D & recognize It is a “complex” product and process!
Invest smartly in analytics, mathematics & statistics, and large sample sizes; and in systems/integrative thinking and data integration
Get to know the RLD – multiple lots; open the door with large sample size
Build capability to justify measured RLD variability is relevant to development of the proposed generic/biosimilar
Exquisite regulatory communication strategy
This is not a ‘complicated process’ for which typical “good practices” will work seamlessly (e.g., typical project management approach); this is a complex process – with multiple interactions and “emergent properties”
Treat it as it is - a complex process and plan; anticipate and address “emergent issues” - in technical, regulatory and legal dimensions; at a certain point be prepared for stakeholder (payers, patient groups,..) communications
The laboratory shall determine measurement uncertainty for each measurement procedure,
in the examination phases used to report measured quantity values on patients’ samples. The
laboratory shall define the performance requirements for the measurement uncertainty of each
measurement procedure and regularly review estimates of measurement uncertainty.
How to succeed when you get a FDA 483 form letter. What to do and how to handle your FDA 483. For more information go to http://compliance-insight.com/fda-483-warning-letters/fda-483-observations/
Acusera 24.7 is an interboratory data management software capable of automatically calculating measurement of uncertainty and six-sigma. With real time peer group updates and user friendly comprehensive charts and reports including Levey Jennings and histograms, our Acusera 24.7 software is now smarter, faster and more efficient than ever before!
This report presents data derived from a comparative analysis that indicates gaps and security risks between multi-day test administrations with smaller numbers of test takers and single-format testing of large numbers of test takers. Additionally, the report highlights the use of standard best practices adopted around the world by leading test sponsor organisations.
Guidance on gloves maintenance in Isolator and RABSPalash Das
A faulty glove or sleeve assembly represents a route of contamination and a critical breach of Isolator integrity. Within this article we will discuss about all these aspects.
This presentation is basic knowledge about the aseptic processing and media fill validation in pharmaceutical industry and media fill procedure. How to validate aseptic process in the powder drug products , data guidance and record for media fill validation.
Hazard and Operability Study (HAZOP) | Gaurav Singh RajputGaurav Singh Rajput
Hazard and operability study | hazop | method of conduction | steps involved by gauravsinghrajput | gauravkrsrajput I Gaurav Singh Rajput I gauravsinghrajput I gauravkrsrajput
The Hazard and Operability Study (HAZOP) is a structured and systematic assessment of a complex system, (such as process facility) in order to identify the hazards that can cause potential danger to Personnel, Equipment, Environment, as well as system operability.
iFluids Engineering is a leading provider of HAZOP study consulting services in India & have extensive experience working on HAZOP studies in India, Qatar, Oman, Tunisia, and many other countries
The challenges facing in pharmaceutical maintenanceMANUEL PACINI
Maintenance strategies for the pharmaceutical industry.
Maintenance and service-related items are often the second-largest budget element in a laboratory after salaries and benefits
HAZOP, or a Hazard and Operability Study, is a systematic way to identify possible hazards in a work process. In this approach, the process is broken down into steps, and every variation in work parameters is considered for each step, to see what could go wrong. HAZOP’s meticulous approach is commonly used with chemical production and piping systems, where miles of pipes and numerous containers can cause logistical headaches.
HAZOP and Hazard Analysis Systems
Sterilization mathematics (F0. Fphy, Fbio, Sterility Assurance (SAL) calculat...Palash Das
Sterile means free from viable microorganisms and sterilization is any physical or chemical process which destroys all life forms, with special regard to microorganisms (including bacteria and sporogenous forms) and inactivates viruses.
Therefore, the terms “sterile” and “sterilization”, in a strictly biological sense, describe the absence and, respectively, the destruction of all viable microorganisms. In other words, they are absolute terms: an object or system is either “sterile” or “non-sterile”.
The destruction of a microbial population subjected to a sterilization process follows a logarithmic progression: only a treatment of infinite duration can provide the absolute certainty that the entire microbial population has been destroyed, and that the system is sterile.
Root cause analysis is an important part for identifying failures during investigation. This article will provide you a number of examples of fish bone diagram, which will be useful for all
Pharmaceutical professional.
Version : 00
Pharmaceutical Isolator technology in aseptic processingPalash Das
These articles describe different aspects of aseptic processing Isolator.
Isolators have been around the Pharmaceutical Industry since the early 1980s and in the Nuclear Industry (glovebox technology) since the 1950s. The intent of isolators is to create an airtight barrier or enclosure around a piece of equipment or process which provides absolute separation between the operator and product. The operator can perform tasks through half- suits or glove ports. Isolators provide a specific environment inside the isolator using HEPA filters. The environment can be positive pressure or negative, can have humidity control, oxygen control, use unidirectional airflow, and can either protect the product from the operator as with aseptic processes, or protect the operator from the product as with potent product handling. The earliest uses of aseptic isolators were for sterility testing. Sterility test isolators make up most of the aseptic isolators in use and are available in many different sizes and configurations. Sterility test isolators do not need to be installed in a classified area. No formal requirement exists for a Grade D environment, but the area should be controlled to allow only trained personnel.
This article will provide clarity on all below mentioned points,
FDA Audit - The Do and Don't List
How to Prepare for a FDA Inspection
FDA Basics for Industry > What should I expect during an inspection?
What to Expect When Being Inspected - FDA
FDA Inspections: Face the Challenge Through Proactive PreparationTips to Help You Prepare for an FDA Inspection
Inspection Readiness
US food and drug administration Indian site inspections: An experience
Dealing with a "difficult" FDA investigator
Strategies For Managing FDA Inspection Compliance Risks
Dear Readers,
Through PRES we are trying to connect with the Global Pharma community. Where we discussed, share and explore lots of pharmaceutical hot topics. Being a Pharma professional it is very difficult to get time for own to do something different other than routine responsibilities. Hope you all paraprofessionals are agreed with my views.
That’s you, the readers and followers of my blog, who always encouraged me a lot to do something different than my routine schedule. All the information are easily available web media, I am just trying too collate all those information in a single article.
I have collated the information’s broadly from the Pharmacompliancemonitor, FDA and other regulatory website for this article.
Once again I would like to thanks my readers, followers and seniors, who has encourage me a lot.
PRES Mission
To develop scientifically sound, practical, technical information and resources to advance science and regulation for the pharmaceutical industry
PRES Vision
To be the foremost global provider of science, technology, and regulatory information and education for the pharmaceutical community
Workshop On Risk Assesment by Palash Ch DasPalash Das
Risk management principles are effectively utilized in many areas of business and government including finance, insurance, occupational safety, public health, pharmacovigilance, and by agencies regulating these industries. Although there are some examples of the use of quality risk management in the pharmaceutical industry today, they are limited and do not represent the full contributions that risk management has to offer. In addition, the importance of quality systems has been recognized in the pharmaceutical industry and it is becoming evident that quality risk management is a valuable component of an effective quality system.
Pharmaceutical Company Facility PresentationPalash Das
This presentation is dedicated to all pharmaceutical organization. this can be use as a standard template for presenting your organization during audit. The concept is designed based on the sterile pharmaceutical facility.
Pharmaceutical HVAC (Heating, ventilating, and air conditioning; also heating...Palash Das
This slide is represent the HVAC design,qualification and operational approach. As we know HVAC is important system for maintaining clean room. This presentation is made based on the requirement of Pharmaceutical Industry. All parameter are considered based on the current guidelines aspect.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Nursing Care of Client With Acute And Chronic Renal Failure.ppt
483 case study
1. 483 CASE STUDY
Technical analysis
Chandra Das Palash
Palash.ds@gmail.com
Abstract
Case study consider from a recent 483, mostly we have discussed here the discrepancy
observed in Aseptic practices, Visual inspection program and Media fill program
2. ABOUT AUTHOR
Palash Chandra Das
M. Pharma
LinkedIn Link
Pharmaceutical Chemistry
Core Technical Area: Qualification & Validation , Sterility
Assurance, QMS, Investigation, Risk Management
Palash Chandra Das is the Technical Writer focuses on technical writing including
investigative reports and operating procedures. His passion for writing is displayed in the
many writing sessions he hosts via his Blogs at https://pres.net.in.
Mr. Palash Chandra Das is recognized as an expert in the field of aseptic manufacturing of
parenteral products, and is a frequent presenter at several web conferences and technical
training for Sterile Drug Manufacturing.
He earned his Master’s for Pharmaceutical chemistry from the University of West Bengal
University of technology in India.
Since 2011 Palash has associated with installation, qualification and operation of several
production-lines in standard Clean room Technology as well as in Isolator Technology at
major regulatory facility across India.
3. 483 Analysis
Investigator
Source of particle can be extrinsic, intrinsic or inherent. Based on the nature of particle investigation
to be initiate to identify the root cause. Exact root cause may not be identifiable but probable source
of generation to be identified. Routine trend and defect library some time use as very helpful tool
for investigation.
Inherent: intact therapeutic protein, denatured therapeutic protein, degree of degradation, other
protein component(s)
Intrinsic: silicone, glass, rubber, stainless steel, fibres (cellulose, polyester), etc.
Extrinsic/process related: autoclave tape, gowning materials, Tyvek wrap, etc.
Extrinsic/foreign: hair, insect parts, clothing fragments, metal, paint, etc.
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Unidentifiable material is always add risk to your process. If it is unidentifiable also we should find
the similarity in terms of Symmetrical, asymmetrical/irregular, rigid, thick, thin, fragile, flexible,
malleable, charged, chemical composition, metallic components, surface characteristics, bio
reactivity, leachability, infectivity, sterility, infection risk.
Get article link >>
Sometimes, a small piece of the stopper can be sheared off following needle insertion. This piece of
rubber can be pushed through to the liquid medication and subsequently can be injected into the
patient. This problem is called as “Coring”.
Coring is still an issue in markets globally. Fragmentation tests are carried out to measure the
number of fragments (or “coring”) generated by needles following the insertion to a rubber stopper.
Although coring most likely occurs infrequently, studies have recognised it to be a potential health
hazard with serious implications for the patient. Get article link >>
4. 483 Analysis
Investigator
Gasket replacement frequency is maintaining by number of organization. Although if the particle is
not exactly black then probable source may be filling line , filter medium or product nature. Because
if any particle travel through tunnel it will be charred and become black.
As part of investigation firm verified vial sealing machine and found height did not include during
validation. Same day inspection machine malfunctioning identified and probability of mixed up
during initial set up vials is interpreted.
Vials capped at an insufficient force may leak from the sealing surface. On the other hand, vials
capped at an excessive force may experience cracking and bulging, also risking the integrity of the
closure system.
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RSF tester can be beneficial to establish the sealing force. The function of the Residual Seal Force
Tester is to evaluate seal tightness by measuring the Residual Seal Force in the stopper/seal
combination created as a result of the sealing process.
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Manual inspection process is always a difficult task. Procedure should to be elaborate all the aspect
and proper training need to be ensured. Otherwise it will result number market complaint as well as
increase the patient risk.
Get article link >>
5. 483 Analysis
Investigator
Any new identified defect during process or market complaint should to be part of your defect
library. And should to be incorporate to your inspection training program.
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Rationalization is very important during finalization of any test in qualification protocol. Selection of
NVPC counting should to be based on the criticality. If number of HEPA unit representing an area
then risk based approach to be followed to identify the location for NVPC.
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In case selection of fixed particle counter probe in Grade A area , locations normally not more than 1
foot away from the work site, within the airflow, and during filling/closing operations. Some
operations can generate high levels of product (e.g., powder) particles that, by their nature, do not
pose a risk of product contamination. It may not, in these cases, be feasible to measure air quality
within the one-foot distance and still differentiate background levels of particles from air
contaminants. In these instances, air can be sampled in a manner that, to the extent possible,
characterizes the true level of extrinsic particle contamination to which the product is exposed.
Initial qualification of the area under dynamic conditions without the actual filling function provides
some baseline information on the non-product particle generation of the operation.
Get article link >>
6. 483 Analysis
Investigator
It is important for area qualification and classification to place most emphasis on data generated
under dynamic conditions (i.e., with personnel present, equipment in place, and operations
ongoing). An adequate aseptic processing facility monitoring program also will assess conformance
with specified clean area classifications under dynamic conditions on a routine basis.
Evaluation of smoke study is equally important. Your study should review the study CD/DVD for
follow criteria,
Studies should demonstrating Laminarity over the product path
Sweeping action should to be away from the product path
Activity/intervention should to be performed as per procedure
Any Turbulence observed in smoke flow shall be relook
Airflow should demonstrate unidirectional path
Airflow should to be from supply and evacuate through return
Clip should to demonstrate the complete interventions
Adequate density of Smoke is preferred
Continues smoke flow during intervention is preferred
Visibility of intervention should to be part of evaluation
If in case poor visibility mentioned the reasons e.g. Reflection / less lighting/denser smoke and
repeated the study.
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Sealing station NVPC normally firms are not performing for getting false pick during process. But in
bunging station for liquid or in case of lyophilized unloading station NVP monitoring are considering.
Get article link >>
Intervention are categorized as inherent and corrective, previously it called as routine and non-
routine. Inherent means as a part of process it is mandatory to intervene the within the Grade A
airflow. Corrective means apart from routine intervention if any correction action we are performing
during process. Is may be happened due to machine break down or any other adjustment. Always
7. 483 Analysis
Investigator
there a possibility of new corrective intervention , that new intervention to be capture during air
flow visualization study as part of interim action and finally need to be capture in media fill program.
A latest PDA technical paper discussed about risk assessment of intervention. Assessment should to
be based on the three aspect.
Proximity: How much distance of your intervention from critical process path? E.g. adjustment of
load cell
Durability: How much time takes to perform the intervention? E.g. Fill volume adjustment
Repeatability: How many time we need to perform during batch? E.g. Rubber stopper or seal re-
supply
Number of firms are identified with same problem. Pre-start up activity does not capture in the
equipment log. It is very important machine set up, prestart up checks should to be part of batch
activity. Environmental monitoring of Grade A filling area should to be consider during aseptic
assembling.
All these interventions are highly recommended to demonstrate during airflow visualization and
need to be a part of media fill program.
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