Robotic Kidney Transplant Beyond the Learning Curve: 8-Year Single-center Experience and Matched Comparison With Open Kidney Transplant.

OBJECTIVE: To investigate the medium to long-term outcomes of robotic-assisted kidney transplantation (RAKT) and propensity-matched comparison with open kidney transplant (OKT). MATERIALS AND METHODS: We retrospectively reviewed 342 patients from database, who underwent RAKT and OKT from January 2015 to May 2022, at our center. Various demographic, intraoperative, and postoperative parameters were evaluated. Statistical analysis including propensity matching using nearest neighbor algorithm was performed to ensure comparability between the RAKT and OKT groups. The statistical analyses were performed using SPSS v.22.0 (IBM Corp, Armonk, NY) and STATA 13 (Stata Corp, College Station, TX). All statistical tests were two-sided, and a significance level of P < .05 was considered statistically significant. RESULTS: After applying exclusion criteria, 196 RAKT patients and 102 OKT patients were included in the analysis. Propensity score matching resulted in the inclusion of 173 patients in the RAKT group. In the propensity-matched comparison of intra/perioperative parameters, RAKT showed significant reductions in total surgical time (P < .001), wound length (P < .001), blood loss (P < .001), blood transfusion rate (P < .001), pain score (P < .001), and analgesia requirement (P < .001). Graft survival and patient survival rates were comparable in RAKT and OKT groups at the end of 60months. CONCLUSION: RAKT offers several advantages over OKT in terms of reduced operative time, blood loss, pain, and analgesia requirements. RAKT shows comparable graft and patient survival rates to OKT in the medium to long term.

An analog-AI chip for energy-efficient speech recognition and transcription.

Models of artificial intelligence (AI) that have billions of parameters can achieve high accuracy across a range of tasks1,2, but they exacerbate the poor energy efficiency of conventional general-purpose processors, such as graphics processing units or central processing units. Analog in-memory computing (analog-AI)3-7 can provide better energy efficiency by performing matrix-vector multiplications in parallel on 'memory tiles'. However, analog-AI has yet to demonstrate software-equivalent (SWeq) accuracy on models that require many such tiles and efficient communication of neural-network activations between the tiles. Here we present an analog-AI chip that combines 35 million phase-change memory devices across 34 tiles, massively parallel inter-tile communication and analog, low-power peripheral circuitry that can achieve up to 12.4 tera-operations per second per watt (TOPS/W) chip-sustained performance. We demonstrate fully end-to-end SWeq accuracy for a small keyword-spotting network and near-SWeq accuracy on the much larger MLPerf8 recurrent neural-network transducer (RNNT), with more than 45 million weights mapped onto more than 140 million phase-change memory devices across five chips.

Baghel Prakash Prognosis Scoring System - Conceptual framework and preliminary psychometric validation.

BACKGROUND: The assessment of prognosis in a patient using a rigorous methodology is documented in old Ayurveda texts. But in present times, practitioners employ varied clinical assessment methods, which results in low inter-observer agreement. OBJECTIVES: This study proposes a conceptual framework for developing a prognosis scoring system, which we refer to as the "Baghel Prakash prognosis scoring system" (BPPSS), and presents its preliminary psychometric validation. MATERIALS AND METHODS: Classics of Ayurveda were extensively reviewed for item generation. Thirty-nine items were pooled initially. The Content Validity Index for Items (I-CVI), Scale-level Content Validity Index (S-CVI), and Content Validity Ratio (CVR) were calculated. The final framework contained 30 items. The scoring system was pilot-tested in a sample of 30 patients with various disease conditions. The reliability checks were done to evaluate internal consistency. Inter-item correlations, item-total correlations, and Cronbach's alpha (if an item is deleted) were used to conduct item analysis for the instrument. RESULTS: The framework developed includes a set of early clinical warning signs and a prognosis scoring system of 30 items with a provision for clinical adjustment of scores for selected items. Internal consistency of the scoring system during the initial psychometric validation revealed a value of .761 for Cronbach's alpha (based on standardized items), and item analysis revealed that most of the items had acceptable correlation coefficients between .3 and .7. CONCLUSION: Based on this preliminary validation study, we found that this prognosis framework, based on the principles of Ayurveda, may be used in varied clinical situations. The preliminary psychometric validation experiments yielded satisfactory results. The framework also has potential in clinical research, such as selecting patients with similar prognostic scores for comparability in case and control groups of clinical trials. This tool can be utilized as a reliable outcome measure after conducting enough validation studies.

Arterioectatic Spinal Angiopathy of Childhood: Clinical, Imaging, Laboratory, Histologic, and Genetic Description of a Novel CNS Vascular Pathology.

Pediatric patients with myelopathy expressing intradural spinal vascular ectasia without arteriovenous shunting were studied at four tertiary referral neuropediatric centers. Patients were identified by retrospective review of institutional records and excluded if spinal vascular pathology could be classified into a previously described category of spinal vascular malformation. Four patients meeting the study criteria were enrolled in the study. Clinical, magnetic resonance imaging, catheter-directed angiography, laboratory, histological and genetic data were analyzed to characterize the disease process and elucidate underlying pathomechanisms. Our study revealed a highly lethal, progressive multi-segmental myelopathy associated with a unique form of non-inflammatory spinal angiopathy featuring diffuse enlargement and tortuosity of spinal cord arteries, spinal cord hyperemia, and spinal cord edema (Arterioectatic Spinal Angiopathy of Childhood). The condition was shown to mimic venous congestive myelopathy associated with pediatric spinal cord arteriovenous shunts on MRI but to have distinct pathognomonic findings on catheter-directed angiography. Clinicopathological, genetic, and neuroimaging features, which are described in detail, closely overlap with those of mitochondrial disease.

New development and photocatalytic performance and antimicrobial activity of α-NH4(VO2)(HPO4) nanosheets.

α-NH4(VO2)(HPO4) nanosheets were developed by hydrothermal method. Furthermore, it's determined by the several analyses like XRD, Raman, FESEM, TEM, UV-Visible spectroscopy, TGA and DRS UV-Visible spectroscopy studies. The orthorhombic crystalline phase of α-NH4(VO2)(HPO4) nanosheets were recognized by XRD analysis. The α-NH4(VO2)(HPO4) nanosheets functional groups identification was investigated by Raman spectroscopy. Thermal gravimetric analysis of α-NH4(VO2)(HPO4) nanosheets were identified and its attain for three decomposition stages. The nanosheets of the α-NH4(VO2)(HPO4) was clearly evaluated by FESEM and TEM measurements. α-NH4(VO2)(HPO4) nanomaterial band gap energy was determined by DRS UV Visible spectroscopy analysis and the calculated bandgap energy is 1.83 eV. Hence, it was more convenient way for the dye degradation applications. These α-NH4(VO2)(HPO4) nanosheets was will be tested in the photocatalytic and antimicrobial applications. In this case, antimicrobial study was not encouraged in the catalyst. Consequently, this material has more encouraging for electrostatic interaction with enhanced for the applications.

Global popularization of CuNiO2 and their rGO nanocomposite loveabled to the photocatalytic properties of methylene blue.

New advancements of photocatalytic activity with higher efficiency, low price are most important, which is challenging in industrialized and many fields. We have introduced CuNiO2 and CuNiO2/rGO nanocomposite was generally prepared by the hydrothermal treatment and tested to the photocatalytic studies. Photocatalytic measurements of CuNiO2 with different weight percentages CuNiO2/rGO (25/75), (50/50), and (75/25) are achieved to the efficiency under visible light, in this case, CuNiO2/rGO (50/50) composite have the highest performance is scrutinized. This was obeyed for a synergistic effect between CuNiO2 nanoparticles and rGO composites. Furthermore, the CuNiO2, CuNiO2/rGO (25/75), (50/50), and (75/25) nanocomposite were tested by several analyses like XRD, FT-IR, DRS UV Visible spectroscopy, Raman spectroscopy, and FESEM & HRTEM investigations. In this regard all measurements are very clear and satisfied; therefore we are encouraged for future developing environmental applications.

Analysis of normal lung irradiation in radiosurgery treatments: a comparison of lung optimized treatment (LOT) on cyberknife, 4D target volume on helical tomotherapy, and DIBH on linear accelerator.

Quantitative retrospective analysis of the normal lung irradiation due to the variations of the ITV volume based on the techniques used for upper lobe (UL), mid lobe (ML), and lower lobe (LL) lung tumours when used with 2-view, 1-view, 0-view based LOT technique on Cyberknife, AveIP on Helical Tomotherapy, and DIBH on VMAT systems. In the treatment of lung tumours, patients medically inoperable or those who are unwilling to undergo surgery have the option to be treated using radiation therapy. There are many motion control techniques available for the treatment of the moving target, such as movement encompassment, respiratory gating, breath-hold, motion reduction, and tumour monitoring. ITV generation is dependent on technique and hence the volume of the PTVs will differ based on the technique used. This study aimed to determine the influence of these ITVs on the irradiated normal lung volume for UL, ML, and LL lung tumours for 23 patients. The mean difference in the PTV volumes generated with the 0-view technique was significant with that of 2-view and DIBH techniques (p-value < 0.04). The mean difference in the PTV volumes generated by 2-view and DIBH was small for UL, ML, and LL tumours. V5 of the combined lung with the 0-view method was 5% compared to the 2-view method for UL tumours (p-value = 0.04) and the same was 9.5%, and 16.8% for ML and LL tumours (p-value < 0.04). In contrast to all other techniques, lung volume parameters V5, V10, V20, and V30 for the 0-view technology were consistently higher irrespective of the tumour location in the lung. The observed maximum mean lung dose (MLD) was 6.2 Gy ± 2.7 Gy with the 0-view technique and the minimum was 3.85 Gy ± 1.75 Gy with the DIBH technique. The difference in MLD between DIBH and 2-view was negligible (p-value = 0.67). The MLD increased for LL tumours from 4 Gy to 6.5 Gy from the 2-view to 0-view technique (p-value = 0.009). There was a significant increase in MLD for LL tumours with the 0-view technique compared to AveIP (1.9 Gy, p-value = 0.04) and DIBH (2.0 Gy, p-value = 0.003) technique. For ML and UL tumours, except for 0-view and 1-view, the difference in the MLD between the rest of the methods was not significant (p-value > 0.11). In the treatment of lung tumour patients with SBRT, this study has demonstrated 2-view with Cyberknife and DIBH with VMAT treatment techniques have optimal normal lung tissue sparing. There was a significant increase in the average lung volume receiving 5%,10%, 20%, and 30% dose when comparing the 1-view, 0-view, AveIP, and DIBH techniques to the 2-view technique. However, DIBH with VMAT was dosimetrically advantageous for ML and LL tumours, while providing significantly shorter treatment times than any other technique studied.

Spontaneous Cerebrospinal Fluid Rhinorrhea in End Stage Renal Disease.

We report a case of spontaneous cerebrospinal fluid (CSF) rhinorrhea in a patient on maintenance hemodialysis. There was no previous history of trauma or surgery. Secondary hyperparathyroidism due to progression of chronic kidney disease (CKD) and a rise in intracranial pressure resulted in spontaneous cerebrospinal fluid rhinorrhea. He underwent endoscopic endonasal repair with theco-peritoneal shunt; CSF leak stopped completely and the patient is doing well on one year follow up.

Dose delivery accuracy on helical tomotherapy for 4-dimensional tumor motion - a phantom study.

BACKGROUND: The advances in image guidance and capability of highly conformal dose deliveries made possible the use of helical tomotherapy (HT) for lung cancer treatment. To determine the effect of respiratory motion on the delivered dose in HT, film dosimetry using a dynamic phantom was performed. This was a phantom study to determine the effect of motion on the delivered dose in HT. MATERIALS AND METHODS: 4D computed tomography (4DCT) was acquired for various target motions of CIRS dynamic phantom (CIRS Inc., Norfolk, USA) with 2.5cm diameter spherical target of volume 8.2 cc moving in the COS4 motion pattern. AveIP images and treatment plans were generated in the HT planning system. Target excursions during treatment delivery were changed in the superior-inferior, anteroposterior and lateral directions. The breathing cycle time was varied from 4 to 5 sec. and also the delivery interruptions were introduced. A film was exposed for each delivery and gamma analysis was performed. RESULTS: The gamma pass rate (GPR) with 3%, 2 mm criteria for the target motion in the S-I direction showed a significant reduction from 97.5% to 54.4% as the motion increased from 3 mm to 8 mm (p = 0.03). For the target motion in S-I = 8 mm, L-R = A-P = 3 mm, the percentage decrease in the GPR was 74% (p = 0.001) for three interruptions. CONCLUSION: The ITV based approach in HT is ideal for a shallow breathing situation when the tumor excursions were confined to 5 mm in the S-I and 3 mm in L-R and A-P directions.

Okur-Chung neurodevelopmental syndrome-linked CK2α variants have reduced kinase activity.

The Okur-Chung neurodevelopmental syndrome, or OCNDS, is a newly discovered rare neurodevelopmental disorder. It is characterized by developmental delay, intellectual disability, behavioral problems (hyperactivity, repetitive movements and social interaction deficits), hypotonia, epilepsy and language/verbalization deficits. OCNDS is linked to de novo mutations in CSNK2A1, that lead to missense or deletion/truncating variants in the encoded protein, the protein kinase CK2α. Eighteen different missense CK2α mutations have been identified to date; however, no biochemical or cell biological studies have yet been performed to clarify the functional impact of such mutations. Here, we show that 15 different missense CK2α mutations lead to varying degrees of loss of kinase activity as recombinant purified proteins and when mutants are ectopically expressed in mammalian cells. We further detect changes in the phosphoproteome of three patient-derived fibroblast lines and show that the subcellular localization of CK2α is altered for some of the OCNDS-linked variants and in patient-derived fibroblasts. Our data argue that reduced kinase activity and abnormal localization of CK2α may underlie the OCNDS phenotype.

CS/Au/MWCNT nanohybrid as an efficient carrier for the sustained release of 5-FU and a study of its cytotoxicity on MCF-7.

The chemical reduction method has been used to adeptly synthesize a CS/Au/MWCNT nanocomposite, to be used as a carrier for the effectual delivery of the anticancer drug 5-Fluorouracil. The work aims at utilizing the less investigated ternary nanocomposite system containing chitosan (CS), gold (Au) and MWCNT's to attain higher encapsulation efficiency and to enable a more sustained and prolonged release of 5-FU. This system has improved cytotoxicity when compared to the CS/Au binary system. The prepared sample has been characterized using various techniques that confirm the formation of the nanocomposite, encapsulation of 5-FU into the nanocomposite, the structure of 5-FU and Au in the nanocomposite and the formation of the polymer matrix nanocomposite. An increase in the encapsulation efficiency to 98% and loading efficiency to 43% is observed when compared to the binary composite, elucidating the importance of incorporation of carbon nanotubes into the nanocomposite. A reduction in the release percentage of 5-FU by 40% indicates a more prolonged release, which will enable a reduction of the number of dosages that need to be administered. This in turn leads to a reduction in the side effects posed by the drug 5-FU. Moreover, the effectiveness of the drug loaded nanocomposite system towards the inhibition of breast cancer cells, apparent from the attainment of 50% cell viability while taking sample concentrations as low as 25 µg ml-1, makes this ternary nanocomposite superior and significant.

Are cost advantages from a modern Indian hospital transferable to the United States?

BACKGROUND: Multiple modern Indian hospitals operate at very low cost while meeting US-equivalent quality accreditation standards. Though US hospitals face intensifying pressure to lower their cost, including proposals to extend Medicare payment rates to all admissions, the transferability of Indian hospitals' cost advantages to US peers remains unclear. METHODS: Using time-driven activity-based costing methods, we estimate the average cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two American hospitals and one Indian hospital (NH). All three hospitals are Joint Commission accredited and have reputations for use of modern performance management methods. Our case study applies several analytic steps to distinguish transferable from non-transferable sources of NH's cost savings. RESULTS: After removing non-transferable sources of efficiency, NH's residual cost advantage primarily rests on shifting tasks to less-credentialed and/or less-experienced personnel who are supervised by highly-skilled personnel when perceived risk of complications is low. NH's high annual CABG volume facilitates such supervised work "downshifting." The study is subject to limitations inherent in case studies, does not account for the younger age of NH's patients, or capture savings attributable to NH's negligible frequency of re-admission or post-acute care facility placement. CONCLUSIONS: Most transferable bases for a modern Indian hospital's cost advantage would require more flexible American states' hospital and health professional licensing regulations, greater family participation in inpatient care, and stronger support by hospital executives and clinicians for substantially lowering the cost of care via regionalization of complex surgeries and weekend use of costly operating rooms.

Enhanced Photocatalytic Performance of Sn6SiO8 Nanoparticles and Their Reduced Graphene Oxide (rGO) Nanocomposite.

Photocatalysts provide excellent potential for the full removal of organic chemical pollutants as an environmentally friendly technology. It has been noted that under UV-visible light irradiation, nanostructured semiconductor metal oxides photocatalysts can degrade different organic pollutants. The Sn6SiO8/rGO nanocomposite was synthesized by a hydrothermal method. The Sn6SiO8 nanoparticles hexagonal phase was confirmed by XRD and functional groups were analyzed by FT-IR spectroscopy. The bandgap of Sn6SiO8 nanoparticles (NPs) and Sn6SiO8/GO composites were found to be 2.7 eV and 2.5 eV, respectively. SEM images of samples showed that the flakes like morphology. This Sn6SiO8/rGO nanocomposite was testing for photocatalytic dye degradation of MG under visible light illumination and excellent response for the catalysts. The enhancement of photocatalytic performance was mainly attributed to the increased light absorption, charge separation efficiency and specific surface area, proved by UV-vis DRS. Further, the radical trapping experiments revealed that holes (h+) and superoxide radicals (·O-2) were the main active species for the degradation of MG, and a possible photocatalytic mechanism was discussed.

Visible-Light Driven Effective Photocatalytic Degradation of Methylene Blue Dye Using Perforated Curly Zn0.1Ni0.9O Nanosheets.

Herein, we report the facile synthesis, characterization and visible-light-driven photocatalytic degradation of perforated curly Zn0.1Ni0.9O nanosheets synthesized by hydrothermal process. The X-ray diffraction (XRD) and scanning electron microscopy (SEM) studies confirmed the cubic phase crystalline structure and growth of high density perforated curly Zn0.1Ni0.9O nanosheets, respectively. As a photocatalyst, using methylene blue (MB) as model pollutant, the synthesized nanosheets demonstrated a high degradation efficiency of ~76% in 60 min under visible light irradiation. The observed results suggest that the synthesized Zn0.1Ni0.9O nanosheets are attractive photocatalysts for the degradation of toxic organic waste in the water under visible light.

Cerebral white matter microstructural changes in isolated maxillofacial trauma and associated neuropsychological outcomes.

Isolated traumatic maxillofacial injury without concomitant brain injury may cause delayed post-concussive symptoms. Early identification allows optimal diagnosis, prognostication, and therapeutic intervention. The aim of this prospective observational study was to investigate longitudinal microstructural changes of the white matter (WM) tracts based on diffusion tensor imaging (DTI) indices in patients with isolated maxillofacial injuries, immediately and 6 months post-trauma, and to correlate these DTI indices with neuropsychological changes observed. Twenty-one patients with isolated maxillofacial injuries and 21 age-matched controls were recruited. DTI was performed and indices were calculated for 50 WM tracts. The neuropsychological evaluation was done using the screening module of the Neuropsychological Assessment Battery. Patients were subjected to repeat DTI and neuropsychological evaluation at 6 months post-trauma. Reduced fractional anisotropy (FA) and increased median (MD) and radial diffusivity (RD) in the acute phase were seen in major association, projection, and commissural fibre bundles, indicative of vasogenic oedema. These changes correlated with attention and executive function deficits in the acute phase, as well as improvement in memory and visuospatial function in the chronic phase. Isolated maxillofacial trauma patients develop WM microstructural damage, which may impair cognitive performance acutely and over time. DTI indices can serve as predictive imaging biomarkers for long-term cognitive deficits in isolated maxillofacial injuries.

Facile Synthesis of Phase Tunable MoO3 Nanostructures and Their Electrochemical Sensing Properties.

MoO3 nanostructures with tunable phases such as α-MoO3, ß-MoO3 and their mixed phases were synthesized via a simple solid state decomposition method and employed as electrocatalyst for the detection of biomolecule. The phase and crystal structure of the synthesized MoO3 nanostructures were confirmed through X-ray diffraction (XRD) studies. The MoO3 nanostructures were also characterized by Fourier transform infrared spectroscopy (FT-IR), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and UV-Vis spectroscopy for their structural, chemical state and optical properties, respectively. The observed results confirmed the successful formation of phase tunable MoO3 nanostructures. The surface texture and morphology of the samples was characterized by field emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM). The obtained images showed the formation of hexagons, cubes and rods morphology of MoO3. The synthesized MoO3 nanostructures were used to modify the surface of glassy carbon electrode (GCE) to detect biomolecule (quercetin).

Fabrication of Ag@Co-Al Layered Double Hydroxides Reinforced poly(o-phenylenediamine) Nanohybrid for Efficient Electrochemical Detection of 4-Nitrophenol, 2,4-Dinitrophenol and Uric acid at Nano Molar Level.

In this paper, Co-Al layered double hydroxides (LDHs), Co-Al LDHs/poly(o-phenylenediamine) (PoPD) and Ag nanoparticles decorated Co-Al LDHs/PoPD (Ag@Co-Al LDH/PoPD) samples were prepared. The as-prepared samples were characterized by XRD, Raman, XPS, FT-IR, DRS-UV-Vis, PL and TGA techniques. The salient features of morphology and size of the samples were determined using FESEM, and HR-TEM. Then, the samples were coated on glassy carbon electrode (GCE) and employed for sensing of 4-nitrophenol (4-NP), 2,4-dinitrophenol (2,4-DNP)) and uric acid (UA). It was found that Ag@Co-Al LDH/PoPD/GCE showed superior electrochemical sensing behaviour than other modified electrodes. It exhibits the detection limit (DL) of 63 nM, 50 nM and 0.28 µM for 4-NP, 2,4-DNP and UA respectively.

Regulating E-cigarettes in India: A conundrum for the global giant in tobacco production.

Electronic cigarettes which are termed as e-cigarettes, e-cigs or e-vaporizers are used by the people for creating the inhalable aerosol which carries nicotine in it. Also, commonly referred as vaping. E-cigarettes are used as an alternative to the regular cigarettes and aids in the cessation of smoking. However, there has been tough strife and debate regarding e-cigarettes that are accompanied in the media stories which bring different opinions among consumers, experts as well as regulators who are involved in making decisions from no regulation to regulating e-cigarettes to banning of e-cigarettes which will bring direct impact on public health. In this article, an overview about the controversy of e-cigarettes with respect to the device, its market, regulation norms of e-cigarettes at different platforms and amidst the debate over e-cigarettes banning in India has been portrayed. It is surveyed that India being a hub of around 110 million tobacco smokers and a global giant in tobacco production, where the Indian government is planning to bring a complete ban over e-cigarettes throughout the country propels an elementary question of banning safer alternatives and not regular cigarettes which makes no sense from the point of banning e-cigarettes until or unless regular cigarettes are banned. Varying point of views from experts, scientists, users with respect to e-cigarettes has been addressed which shares a mix opinion with the supporters promoting ban as well as the antagonist with the concept of regulating the e-cigarettes in India.

Enhanced Photocatalytic Behavior of (GO/Cu2O) Composite with Cu2O Being Synthesized Through Green Route.

Graphene oxide/Cuprous oxide (GO/Cu2O) composite is a visible light photocatalyst for the degradation of dyes. A simple and efficient approach for preparing GO/Cu2O composite adopted in this study involves reducing cuprous oxide precursors in the presence of graphene oxide using an aqueous solution of pulp derived from banana fruit. The GO/Cu2O composite was characterized by Fourier transform infrared spectroscopy (FT-IR), Diffused reflectance Ultraviolet visible spectroscopy (DRS UV-Vis), Raman spectroscopy and Field Emission Scanning electron microscopy (FE-SEM). Cu2O particles were distributed randomly on the graphene oxide sheets due to the template effect of GO. The results showed higher photocatalytic activity for the composite (band gap 2.13 eV), for the degradation of the organic dyes (Methylene blue and Rhodamine-B). The enhanced photocatalytic activity is due to effective charge transfer from GO to Cu2O, and high specific surface area which improves the effective separation of the generated electron-hole pairs. Our present study is inspired by a facile, low cost, green production of (GO/Cu2O) composite whose photocatalytic activity can be extended to degradation of all other water-born textile dyes.

A national approach to pharmacovigilance: The case of India as a growing hub of global clinical trials.

Pharmacovigilance is the pharmacological science associated with the detection, understanding and prevention of adverse effects, especially long-term and short-term adverse effects of medicines. In the present day pharmaceutical scenario, where the development and marketing of an ever-growing array of medicines has rendered their safety and therapeutic efficacy key to determining the success of a drug, pharmacovigilance has come about to play a critical and significant part. While pharmacovigilance, as a system, has witnessed considerable progress and evolution in the West, not as much has been accomplished in India. With India now being recognised as a hub of global clinical trials and with an increasing number of clinical trials and clinical research studies being conducted actively, the need for a dynamic pharmacovigilance network with an efficient and prudent operation methodology is felt, now more than ever. This article observes the evolution of the pharmacovigilance system in India, with a fundamental overview of the present system in place and also various schemes and proposals to establish and sustain the same. It also examines the challenges faced in the execution of an effective pharmacovigilance network as well as the future prospects with regards to the Indian market.