Brief overview of possible interactions with warfarin.
\r\n\t
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He was a Full-time Postdoctoral research associate at Purdue University, USA (2008-2011). Marie Curie Research Fellow (FP7-PEOPLE- 2011-IOF) (2012-2015) at the University of Western Australia and CSIC working in human health benefits of legume seed proteins, their allergy molecular aspects and cross allergenicity. He is a Senior Research Fellow (Ramon y Cajal research program - MINECO, 2016 - present), currently working in the functionality, health benefits, and allergy implications of proteins from reproductive tissues (pollen and seeds) in crop species of agro-industrial interest (mainly legumes). He is an Author of more than 60 peer-review journal articles, 25 book chapters. His work has been presented in more than 130 international congresses. He is an Active member of different Scientific Societies: Spanish and International Legume Society; Spanish and EU Microscopy societies. He is Editor of multiple books, Reviewer for more than 35 Peer-Review Journals of editorial as Elsevier, Springer, Wiley, Frontiers, etc, and international expert panels member for funding grants evaluation.",institutionString:"Spanish National Research Council (CSIC)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"6",institution:{name:"Spanish National Research Council",institutionURL:null,country:{name:"Spain"}}}],coeditorOne:{id:"149660",title:"Dr.",name:"Alfonso",middleName:null,surname:"Clemente",slug:"alfonso-clemente",fullName:"Alfonso Clemente",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRDEMQA4/Profile_Picture_1615291343716",biography:"Dr. Alfonso Clemente is a staff scientist at the Spanish National Research Council, working at the Estación Experimental del Zaidín (Granada, Spain). He has been working in legume seeds for the last 20 years, being involved in several national and international related projects. Alfonso Clemente joined different labs (Institute of Food Research, 1999–2000; John Innes Centre, 2000–2002; Sainsbury Laboratory, 2003–2004) in the UK to broaden his laboratory skills and scientific knowledge. Currently, he is the President of the Spanish Legume Association (Asociación Española de Leguminosas, www.leguminosas.es) having strong interaction with a relevant network of scientists and agricultural associations and agri-food companies in the field. 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Despite the wide availability of coumarins and their lead compounds and metabolites in natural products [3], their application up till now has been mostly limited to the anticoagulant activity of warfarin derived from dicoumarol and its analogues [4]. The mechanism of action of these anticoagulants lies in the competitive antagonism of vitamin K, through which they inhibit coagulation of blood in the body by preventing the production of prothrombin and several other coagulation factors [5]. Due to this action, these coumarins are a major group of oral drugs with anticoagulant activity. Anticoagulants reduce the risks of undesirable blood clots leading to myocardial infarction, pulmonary embolism, and ischemic stroke among others. This chapter gives an overview of medical applications of coumarins, in particular the history and evolution of warfarin and related compounds as important anticoagulant agents.
The medical application of plants containing coumarins probably started long before the isolation of this chemical compound from the Tonka bean in 1820 by Nicholas Jean Baptiste Gaston Guibourt [6]. Ancient Romans produced a cough syrup from the marshmallow (
The application of coumarin and its derivatives in current western medicine dates to the fifties of the past century with the clinical recognition of coumarins as anticoagulant agents. This event was the result of observations of poisoning of animals with coumarin derivatives that led to massive internal organ bleeding [16]. Soon it became clear that the substance that was responsible for the deadly internal bleeding of cattle was dicoumarol [17]. Shortly after this, the proposal was made to develop a coumarin derivative with rodent killing ability and gradually warfarin found its application as a potent rodenticide [18]. When it became clear that this substance also led to bleeding disorders after poisoning in human beings [19], its application as a therapeutic anticoagulant found its way in medicine [20, 21]. Seven decades later, warfarin is still in use as an anticoagulant [22]. In the meantime, several other coumarins with anticoagulant properties like acenocoumarol, phenprocoumon, and fluindione have been developed, and they are used in a variety of clinical settings [23, 24, 25].
Hemostasis in mammals and humans is the result of three sequential processes. The first of these is the acute vasoconstriction within seconds after damaged arteries and veins, by local activity of the potent vasoconstrictor thromboxane among others [26]. The second step is the formation of a blood clot through the entrapment of platelets by fibrin within hours and finally followed by the organization of the fibrin mesh into an adhesive structure on the vessel wall [27]. In one of the last steps of the coagulation, prothrombin converts to thrombin, an enzyme that converts the plasma protein fibrinogen to fibrin monomers and activates factor XIII of the coagulation cascade. Activated factor XIII synthesizes fibrin from these monomers. The acquired fibrin molecules then trap the platelets and eventually form the blood clot [27, 28]. The coagulation process has both an intrinsic and an extrinsic pathway. The difference is that the intrinsic pathway only requires ionized calcium to be activated while the extrinsic pathway requires both calcium and tissue factor that is released with trauma [28]. Figure 1 gives an overview of the coagulation process along with the interference sites of warfarin.
Overview of the coagulation process along with the interference sites of warfarin.
Warfarin is highly lipid soluble [29, 30, 31]. Between 70 and 100% of the oral intake is rapidly absorbed by the intestines with a maximum plasma concentration within 2 h after oral intake [30]. The half-life of the drug is generally more than 20 h, with a large individual variety [32]. Due to the overt lipid solubility, the major part of the drug is protein bound with less than 3% being biologically available [29]. Consequently, the agent has a slow onset of action and a long duration of activity [33]. In fact, the optimal effect is delayed for a few days, until all remaining activated factors II, VII, IX, and X are depleted from the liver and the circulation [33]. Warfarin accumulates in the liver where it exerts its effect and is inactivated through oxidative metabolism by cytochromes P450 to several isomers of water-soluble hydroxywarfarin with negligible anticoagulant activity [34, 35]. These metabolites are almost completely cleared by the kidneys [36]. The hepatic accumulation and relative easy absorption in the intestines result in an enterohepatic circulation of the drug [37]. Enterohepatic circulation is a process in which substances are secreted by the liver with bile to the intestines and subsequently absorbed again by the latter [28]. This results in recycling of the product with very little elimination.
Warfarin inhibits the enzyme vitamin K epoxide reductase that recycles oxidized vitamin K [38]. Vitamin K activates the coagulating factors prothrombin (factor II) and the structurally related serine proteases known as factors VII, IX, and X in the liver cells [27]. Decreasing the biological availability of vitamin K inhibits the synthesis of these essential factors and eventually leads to inhibition of the coagulation process. This means that this compound affects both the intrinsic as well as the extrinsic cascade of coagulation since prothrombin plays a central role in both of these pathways [28] and renders it a highly effective anticoagulant drug.
Hemostasis is an essential process to prevent significant external as well as internal blood loss after injury. However, under certain circumstances, it is not desirable to activate or continue this homeostatic process like in disorders with spontaneous thrombosis such as deep venous thrombosis in the legs often resulting in pulmonary embolism [39]. In addition, there are conditions that are prone to a reasonable chance of forming a blood clot during stasis of the blood circulation like in atrial fibrillation and in the limbs of patients with prolonged immobility after surgery [39]. Moreover, conditions like myocardial infarction or ischemic stroke form a preventable group of disorders with inhibition of the thrombotic process [5]. Based on its anticoagulant properties, warfarin is thus an ideal compound for the treatment and prevention of these thromboembolic conditions [5].
Based on the pharmacokinetic properties and the challenges they present, dosing of warfarin is not simple, and a careful approach is necessary. On one hand, a low plasma concentration will not achieve the effect of sufficient anticoagulation and, on the other side of the spectrum, there is the constant chance of overdosing with potential lethal internal or external bleeding. Another problem is the great variety of absorption, body distribution, and metabolism of the agent with individual patients based on the pharmacokinetic properties of warfarin [30]. Frequent monitoring of therapeutic efficiency with adequate laboratory tools like prothrombin time (PT) or international normalized ratio (INR) is absolutely necessary [40, 41] and a fixed or constant dose is close to impossible. Nevertheless, warfarin is highly effective in anticoagulation regiments when carefully dosing and assessing the potential bleeding sites as well as other potential side effects. Warfarin is initially dosed at 5–10 mg daily [42]. Subsequent doses depend on the international normalized ratio, with a therapeutic value between 2 and 4. Concomitant administration of heparins like fraxiparine is necessary when fast anticoagulant activity is desirable [43].
Warfarin is not an ideal agent in conditions when immediate treatment of thromboembolism is imminent due to the long time of onset. In cases of pulmonary embolism and acute ischemic stroke, it is desirable to start with both the oral anticoagulant and fast-acting agent like heparins [44]. The long duration of action harbors another challenge. When acute termination of anticoagulation is necessary with unwanted bleeding like in menstruating women and after blunt and sharp trauma leading to hemorrhage, it could take days before the process of coagulation completely restores after quitting oral administration [27, 30] due to the depletion of coagulant factors in liver and blood. In these cases, intravenous administration of prothrombin complex, fresh frozen plasma with coagulation factors, and high doses of vitamin K may be helpful [45].
Warfarin readily passes the placenta and may result in spontaneous abortion due to retroplacental bleeding [46], as well as prematurity [47], fetal deformity [48], stillbirth [48], and fetal cranial bleeding [49]. Administration during the first trimester of pregnancy has a high risk of embryopathy [50]. This is accompanied by deformities of bone and cartilage [51], blindness, mental retardation, and other neurologic abnormalities [52]. The occurrence of these complications and defects seem to be dose dependent [47, 53] and are most probably the result of the interference with vitamin K-dependent coagulation [38] and bone formation [54]. The effects of the central nervous system and the blindness are probably the result of microhemorrhages in the developing brain as a result of the anticoagulant activity [55]. Clotting factors are easily depleted in the fetus due to the immature liver and small circulating volume [46]. Warfarin does not enter breastmilk and is thus completely safe during lactation [56].
In conclusion, warfarin must be administered with great caution to women in their child-bearing age [57]. Therapy with this agent must be ceased immediately when it becomes clear that the patient is pregnant. Low-molecular weight heparins are a good alternative, since they do not cross the placenta and have been proven to be safe for mother, embryo, and fetus [58].
To say that anticoagulant coumarins have only a few side effects is an absolute understatement. Warfarin is one of the leading drugs with adverse effects requiring hospital admission [59]. Most of all, there is the constant chance of severe bleeding [60]. This can include internal hemorrhagic conditions in the head, gastrointestinal tract, female genitalia, the bladder and urethra or skeletal joints and muscles [40, 61]. They generally present as severe headache, stomach pain, and black or bloody stool, heavier than normal menstrual bleeding, discoloration of urine, and pain and swelling of the joints or muscles. Prolonged bleeding from external sharp or blunt wounds is always present [61]. All these conditions are the result of inability of the affected tissues to initiate and continue the process of hemostasis after damage to the epithelial barrier [62].
Patients suffering from hypertension, disorders of the liver, bleeding lesions, and the elderly and patients using drugs and substances that affect coagulation are at higher risk to suffer from bleeding when using warfarin [63]. Hypertension poses mechanical defects in the blood vessels, especially the arteries. Disorders of the liver reduce the ability of the body to eliminate the warfarin and thus make it more biologically available. In bleeding lesions, warfarin inhibits hemostasis. Among substances that can lead to bleeding when used with warfarin are steroidal and non-steroidal anti-inflammatory drugs, antibiotics, and alcohol. These potentiate the activity, interfere with the protein binding, and reduce the metabolism of warfarin, respectively [63]. Other side effects include injury to the kidneys with potential nephritis [64, 65, 66], inflammation of the skin [67] and blood vessels [66], and potentiation of rhabdomyolysis by simvastatin [64].
Due to resistance of rodents against warfarin, superwarfarins have been created [68]. These have a much longer time of activity and hence need only to be consumed once by the rodents, contrary to warfarin. The result however is that their effect persists much longer when deliberately or accidently consumed by humans [69] and treatment of this intoxication is a more challenging enterprise.
The efficacy of the anticoagulant treatment with warfarin highly depends on its bioavailability, since inhibition of the target (epoxy reductase) enzyme depends on direct binding of the drug to this protein [38]. In addition, vitamin K from external sources does not rely on recycling through this enzyme [38]. Hence, the absorption, transport, delivery, and elimination of warfarin as well as the external availability of vitamin K are potential sites of interaction with other drugs and with food and dietary supplements.
Drugs and food that influence the enterohepatic circulation can all affect the absorption of warfarin. Examples of these are the drug cholestyramine [37] and the avocado fruit [70], which prevent the reabsorption of warfarin in the intestines Concomitant administration of other protein-bound drugs may lead to greater amounts of circulating warfarin and increased risks of bleeding. Valproate sodium increases the bioavailability of warfarin through dislocation of its protein-binding sites [71]. Interference with the metabolism of warfarin is a potential of most drugs that are eliminated by hepatic metabolism. Among these are aspirin [72], nonsteroidal anti-inflammatory drugs [72], serotonin reuptake inhibitors [49], antiplatelet agents and some antibiotics [72]. It can go both ways with the metabolism. Induction of the cytochromes will increase the elimination, while occupation of the binding sites by the drugs will increase the availability of warfarin.
Since warfarin acts through elimination of available bioactive vitamin K, variations of the net intake of this vitamin will certainly interfere with the drug action. A high intake of the vitamin will keep the coagulant factors at a higher level and thus inhibit the anticoagulant activity. Likewise, a lower intake will potentiate the effect of warfarin. The vitamin occurs in food in the form of phylloquinone and menaquinone. Phylloquinone is the form mostly found in plants and is also the most abundant form in food [73]. Menaquinones are mainly the product of bacterial production or conversion [74]. Consequently, simple multivitamin and other supplements, food with high vitamin K content [74] as well as antibiotics are sources of fluctuation in vitamin K intake since intestinal bacteria significantly contribute to the production of menaquinones [75].
Recently, another source of interference came into focus. In addition to the previous mentioned parameters, genetic variation in the expression of cytochrome P450 seems to play a role in the metabolism of warfarin [76], thus influencing the availability of the drug [77]. All these considerations make it clear that close monitoring of the individual coagulation ability is necessary for a successful therapy with this agent.
The abovementioned interactions are just a few of the many that are possible. Table 1 gives examples of a variety of interactions with drugs, food, natural products, and supplements. This is only to underscore the cautious approach patients should practice when taking warfarin.
Agent | Category | Possible mechanism | Effect | Reference | |
---|---|---|---|---|---|
Allopathic medications | Amiodarone | Antiarrhythmic | Inhibition of hepatic metabolism | [78] | |
Ciprofloxacin | Antibiotic | Reduction of vitamin K synthesis by intestinal bacteria | Increased bleeding | [79] | |
Paroxetine | Antidepressant | Inhibition of hepatic metabolism | Potentiation | [80] | |
Citalopram | Antidepressant | Inhibition of hepatic metabolism | Potentiation | [80] | |
Clopidogrel | Antiplatelet medication | Inhibition of coagulation cascade | Potentiation | [81] | |
Dipyridamole | Antiplatelet medication | Inhibition of coagulation cascade | Potentiation | [81] | |
Diclofenac | NSAID | Inhibition of coagulation cascade | Potentiation | [82] | |
Naproxen | NSAID | Inhibition of coagulation cascade | Potentiation | [82] | |
Acetaminophen | Analgesic | Interference with hepatic metabolism | Increased bleeding | [83] | |
Food supplements | Fish oil | Lipid profile improvement | Inhibition of coagulation cascade? | Potentiation | [84] |
Pomegranate juice | Antioxidant | Interference with hepatic metabolism | Potentiation | [85] | |
Glucosamine | Cartilage improvement | Unknown | Potentiation | [86] | |
Traditional medications | Chamomile | Medicinal herbal tea | Unknown | Increased bleeding | [87] |
Ginseng | Improving cognitive functions | Unknown | Inhibition | [88] | |
St John’s wort | Against depression | Induction of metabolism | Inhibition | [89] |
Brief overview of possible interactions with warfarin.
Today, coumarins find their application predominantly as anticoagulants in medicine. The narrow therapeutic index of warfarin and related compounds sometimes limit their applicability and consequently there is a constant search for more safe agents in this drug class [90]. Unfortunately, the development of these will probably limit the use of these oral anticoagulants.
Aside from these developments, coumarins with several applications in medical practice are progressively being introduced. Investigators found that coumarin-3-carboxylic acid could be utilized as a dosimeter for radiotherapy. This substance converts to the highly fluorescent 7-hydroxy-coumarin-3-carboxylic acid, with a near perfect linear correlation upon irradiation [91].
The coumarin 2-hydroxycinnamic acid demonstrated inhibitive properties on the enzyme carbonic anhydrase [92]. Inhibition of this enzyme leads to diuresis [93] and decreases intraocular pressure in glaucoma patients [93] with clear therapeutic potential and clinical perspective.
Furano(pyrano)coumarins found in the roots of the Korean angelica (
Probably since ancient times, coumarins found their application in medicine. Currently, however, coumarins with predominantly anticoagulant properties are applied in daily medical practice. These have been developed from the initial discovery of a cattle killing weed more than six decades ago. Initially applied as a rodenticide, soon a therapeutic usable oral anticoagulant was developed, and slowly other agents entered the market. They have a small therapeutic index, rendering them toxic in a number of circumstances. The search for more safe agents with anticoagulant effects is ongoing and this may result in a decline of the use of coumarins in this field. Nevertheless, coumarins gradually find their way in other fields of medicine. Nevertheless, all these developments promise a bright future for coumarins in medical applications.
The author declares no conflict of interest.
My gratitude goes out to my colleague Prof. Dr Dennis Mans, who encouraged me to write this chapter. I also want to thank the Anton de Kom University of Suriname for allowing me to do this on top of my regular job.
I want to thank my lovely wife and children who understand why I spend so much time in front of my PC. You are all such a supporting force for me.
Technological improvement has boosted the economic growth in India. Science and technology have an important role in the economic development of India. Compared to other developed countries, India has more youth manpower. Proper education will play a significant role in making youth future-ready and increasing economic growth by providing skilled persons which will also boost industrial development. In the modern era of education, every institution or university is adapting new teaching methods using their teaching methodologies. Indian education is the biggest and well-known education systems in the world. During ancient education, there were 5 big well-known universities like Takshashila, Nalanda, Vallabhi, etc., which focus on the all-round development of students and those in the medieval period there exists 2 institutions madrasah and maqtabs which mostly focus on building student religious and leaders of the future. In modern education, there are well known autonomous institutes like IITs and IIMs which are famous all around the world.
During ancient education, students live away from their parents, their education comprises of subjects like physical education, mental education, politics, economics, etc. They were shaped in a way that they can live in any condition considering how difficult the situation will be? Medieval education also followed the same protocol as ancient education in spite that their education mostly focuses on religion. In today’s modern era of big institutes like the Indian Institute of Technology (IITs) and Indian Institute of Management (IIMs), everything is changed like the living standard of students, curriculum, all-round development. The principle objective of the student has been to just achieve its goal and be successful. Only the big institutes like IITs, IIMs, and some other private and aided universities have adopted modern methods of learning. There is a difference in curriculum, teaching methods, and living standards of students in every institute. The syllabus of the current education system is not industry-oriented and also not according to new upcoming trends. The main objective of education is mostly theoretical and not practically implemented [1].
The main purpose of this paper is to convey what all the things need to adopt in our current education system from ancient and medieval times and also some new trends associated with it. The paper is mainly categorized into three sections Ancient, Medieval and Modern education system, including sub-sections such as curriculum, method of learning, the aim of education, characteristics of education, educational institutes, higher educational institutes, advantages, and disadvantages of the particular education system.
During the ancient period, two systems of education were developed, Vedic, and Buddhist. The medium of language during the Vedic system was Sanskrit, while those in the Buddhist system were pali. During those times the education was of Vedas, Brahmanas, Upnishads, and Dharmasutras. From the Rigveda onwards, our ancient education started with the objective of developing the students not only in the outer body but also on the inner body. The ancient education focused on imparting ethics like humility, truthfulness, discipline, self-reliance, and respecting all creations to the students. The education was mostly imparted in ashrams, gurukuls, temples, houses. Sometimes pujaris of the temples used to teach students. The education system of ancient India has some special features and uniqueness which was not found in any other ancient education system of the other countries. The education was mostly given in forests under the blue sky, which keeps the student’s mind fresh and alive. During ancient times people used to live a simple life and doing their work with devotion and hard work [2].
The main objective of education was to equip the students with a good quality of education. The education mostly focused on the enrichment of culture, character, and personality, development, and cultivation of noble ideals. The objective was gaining the mental, physical, and intellectual personality of students, to make the students future-ready and survive in any situation [3].
During the ancient period, the state government and the people did not interfere in designing curriculum, payments of fees, regulation of teaching hours. There was a strong bonding between teacher and student. Every student was allotted with one teacher and more emphasis was given to the student-teacher relationship, each student used to meet teachers personally to learn and gain instructions from them. During ancient times, royal families, as well as kings of states, used to donate their wealth to improve the education system and quality. The syllabus was designed in accordance with the demands of that era. At that time students used to leave their houses and went to live with their gurus until their education was completed. During the early Vedic period, women’s education was also given more emphasis. The education focuses on the physical and mental development of students. The course duration was about 10–12 years, as there were no books so students used to memorize all things, memory played a crucial role during learning. The education was imparted in forests away from cities and peoples to give students a pleasant and silent environment of study.
Curriculum plays an essential role in the education system. It was dynamic and not static; it was made up of different stages. The fundamental goal of building a good curriculum was to develop students physically and mentally. The curriculum consists of four Vedas, six vedangas, Upnishads, darshanas, Puranas, Tarka Shastra. The six vedangas were Shiksha, Chhandas, Vyakarana, Nirukta, Jyotisha, and Kalpawhile the darshanas were Nyaya, Baiseshika, Yoga, Vedanta, Sankhya, Mimasa. Algebra, Geometry, and grammar were also given more importance at that time. Panini was famous in the domain of grammar at that time. The curriculum of the Buddhist system consists of pitakas, Abhidharma, and sutras. Besides this medicine, Vedas were also given importance. Hindu learning was a part of Buddhist learning, although more emphasis was given to Buddhist learning. Both the systems were going hand in hand at that time. The education was totally through orals and debates, and the exams were conducted every year. The education system of the ancient period focused on subjects like warfare, military, politics, religion.
The teachers at that time paid special focus to their students and teach them according to their knowledge and skill level. Teaching was basically via orals and debates, and the different methods were as follows:
At that time books were not there, so students had the habit to learn and memorize all the things taught in the class, and teachers also helped them in memorizing.
The students used to deep dive into the concepts taught by their teachers and explore new methods to learn it.
Listening, Contemplation, and concentrated contemplation were some new methods of exploring the way of learning.
The teachers used the storytelling methods to teach the students.
Students used to ask questions about the topics taught by the teachers and these topics were discussed and then answered to the students.
The education of that time mainly focused on practical knowledge of the topics taught in the class.
The students got plenty of knowledge through seminars and debates conducted at frequent intervals.
Gurukul was the hometown of teachers where students come after completing their initiation ceremony and learn until the completion of their study. The parishads or academies were the places of higher learning and education where students learn through discussions and debates. Goshti or conferences were the places where the kings of the states used to invite scholars from every institute to meet and exchange their views. Ashramas or hermitages were the other learning centers where students from various parts of the country used to come and learn from saints and sages. Vidyapeeth was the place of spiritual learning founded by great Acharya, Sri Shankara in places like Sringeri, Kanchi, Dwarka, and Puri, etc. Agraharas was an institution of Brahmins in villages where they used to teach. Viharas were the educational institutions founded by Buddhists where the students were taught the subjects related to Buddhism and philosophy.
The system focuses on the all-round development of students.
More emphasis was given to practical knowledge rather than theoretical knowledge.
The students were not just involved in bringing the ranks, but their main focus was on knowledge.
Classrooms were built-in forests which provide a pleasant study environment to the students.
There was no pressure laid on students related to studies so that they can learn effectively.
The government did not interfere with the formation of curriculum, kings at that time helped in the development of education.
Women were not admitted to the Gurukuls.
There was caste discrimination as only Kshatriya was allowed, Eklavya was not given admission to the Gurukul.
During the eighth century Anno Domini (A.D) a huge number of Mohammadian invaded India. Mahmud Ghaznavi captured India and set up a large number of schools and libraries in the country by the looted wealth. Later Muslim leaders established their permanent empire in India, they brought a new system of education. The ancient education system was drastically changed. The Arabs and the Turks bought some new cultures, traditions, and institutions in India, in that the most remarkable change was the Islamic pattern of education which was different from the Buddhist and Brahmanic education system. The medieval age, education system primarily focused on the Islamic and Mughal System.
The main objective of education during the medieval period was the spread of knowledge and the propagation of Islam. The objective behind this era of education was to spread Islamic education its principles, and social conventions. The purpose of the education system was to make people religious minded [4].
The rulers helped in the spread and development of education. They helped in the establishment of different educational institutes and funded it, big landlords also gave them some wealth in the development of institutes. There was no control of rulers over the educational institutes and also to their management. The student-teacher relation was also good like the Buddhist and Brahmanic period, although students did not live with their teachers at that time. Teachers took interest in learning, at that time teachers were used to teaching students individually.
During that time books were not there, therefore the students were used to write on taktis. The stress was laid on teaching the student from the beginning that is teaching them first alphabets and then words. Calligraphy and grammar were the most important subjects taught during those days. Students also learned “paharas”(multiple of numbers), and also they memorized it while learning. Arabic and Persian were the main languages of communication and these languages were important for the students who wanted to get higher posts. The recitation of the Quran was made compulsory, the students used to learn the Quran by heart as this was an important part of their curriculum. The students at their early ages were taught to recite the first 13 chapters of the Quran as a poem. Ibn Sina, an Islamic Persian scholar, and a teacher write that students during the age of 14 should be given the choice of selecting their favorite subjects for masters, for example, reading, manual skills, literature, medicine, geometry, trade, and commerce. There were two types of education during medieval times like secular and religious education. Religious education consists study of the Quran, Mohammad, and his invasions Islamic laws and Islamic history. The secular education consists of the study of Arabic literature, grammar, history, philosophy, mathematics, geography, politics, economics, Greek language, and agriculture.
Orals, discussions, and recitations of the lesson taught were the main methods of learning at that age.
Emperor Akbar encouraged the students to focus more on reading and writing and to reform the scripts. He wanted the education system to be systematic and advised teachers to first teach students about the knowledge of alphabets, then words-knowledge, and then sentence formation.
More emphasis was given on practical education.
There was no half-yearly or annual examination fixed for students, but the students were evaluated based on practical situations of life.
Maktabs:-Maktabs were the center of the primary education for the children of general people. Along with religious education, students were also taught subjects like reading, writing, and arithmetic. They were also taught some romantic literature of Persian example, Laila-Majnu, Yusuf-Julekha, etc. Along with practical education, letter writing applications, and accountancy were also taught in Maktabs.
Madrasas:- After completing the primary education in Maktabs, the students were sent to the Madarsas for higher education. Madarsas were the centers of higher learning and Emperor Akbar did remarkable development in the education of the medieval era. Along with religious and practical education, Akbar stopped the tradition of the Islamic religion and instructed to teach Hinduism and philosophy in many Madrasas. The subjects such as medicine, history, geography, economics, political science, astrology, philosophy, and mathematics were taught in Madarsas. Akbar made subjects like Vedanta, Jurisprudence, and Patanjali compulsory for Sanskrit students.
Practical education was given more importance, students and teacher’s relations were good. Students were taught from the basics and rulers also supported the development of education.
Religious and Islamic education was given more importance.
The student aimed to focus on leadership for ruling the country.
In the middle of the medieval age, the British invaded India and started to capture it. The modern education was introduced during the British empire. In the 1830s Lord Thomas Babington Macaulay introduced the English language. The subjects and the syllabus were limited to some extent, the main aim of modern education of the British was to spread Christianity. As time passed education started to develop and entered into the modern era that is in the twenty-first century, the era of science, technology, and innovations. And the demand and the need for education stills remain the same as it was in ancient and medieval times. In the modern era of science and technology, the industrial sector is increasing day by day. As demand increases our education sector also needs to change and adapt to that environment [5, 6].
The objective of modern education was to inculcate values in students such as equality, secularism, education for all, and environmental protection, etc. To understand the culture as well as people of our country, every student must be provided at least a minimum level of education and also to provide education to the people who cannot afford it, to prepare the students with the ever-increasing demands.
The student-teacher relations remained the same as it was in ancient and medieval, but students did not live in the teacher’s house. As technology is increasing day by day, the education sector is also following the trend of technology by teaching the students through online lectures and Massive Open Online Course (MOOC). In Aviation and the medical sector, more emphasis is on practical knowledge as compared to other sectors. Women’s education is giving more importance, and the Government has launched many programs to encourage women’s education. In the modern era electronics gadgets like projectors, Light Emitting Diode (LED), and computers are used to teach the students. The Government has established many programs and there are many organizations that promote education in India.
The whole curriculum of a student is divided into three sections primary, secondary, and graduation. Primary education is from 1st to 10th standard, Secondary education is 11th and 12th, and in Graduation, students were given the choice to choose a field for further studies example computer, electrical, civil, etc. But after secondary education students also have choices to choose their career path. In primary education, students are taught subjects like history, geography, mathematics, science, Hindi, and Marathi. The languages may differ from state to state. At the early stages, students were taught alphabets, poem recitation, word formation, etc. Different prayers, the National Anthem is also in the schools. Along with studies different sports and extracurricular activities are also conducted in schools to keep the students fit and for their all-round development. The pupils are assessed based on the term exams conducted at frequent intervals. In secondary education, students are given choices to choose from science and commerce. According to the student’s choice, they were given an education. Secondary education is an advanced version of primary education. Pupils were assessed based on term examination. After secondary education, students were given entry to the universities through some entrance examination, according to their marks scored in entrance examination they are admitted to the universities. Pupils were assessed based on semester exams or in-sem exams.
In modern education along with studies, the emphasis is given on extracurricular activities and sports for all-round development of students.
Students mostly learn concepts through online platforms like YouTube, Coursera, and Udemy.
Students refer to the notes given by the teacher’s side by side while learning online.
During class hours doubts are solved through discussions, debates, etc.
Pupils were assessed based on mid-sem written exams and practical exams to check their practical knowledge.
The other top universities are Birla Institute of Technology and Science (BITS), National Institute of Technology (NIT), Indian Institute of Science (IISC).
Use of technology in learning, students is learning free-lancing and many other new technologies.
Many programs and missions have started to increase the employment of India.
Top class universities and colleges with good infrastructure and environment.
Interference of government in education, management, and syllabus.
Lack of quality teaching as well as the environment in government schools and colleges.
Increase in fees of schools and colleges of private institutes.
Lack of practical knowledge orientation.
Due to the increase in fees, the family, which is below the poverty line cannot afford education and hence there is an increase in the number of laborers in India.
Lack of connectivity of the students who lived in rural areas.
In the modern era, industries and technology are increasing day by day. Every industry sector is looking for a person who best suits their industry. With the ever-increasing demand for industrial sectors, our current education system also needs to be upgraded. In universities, students are learning just for competing with each other to come first, no practical knowledge is gained. There is a lot of pressure and burden of work and studies on them, due to this student are committing suicide. Our education system needs to learn from ancient and medieval education system regarding the implementation of practical knowledge, student-teacher relations, ways of life student lived in that age, the contribution of kings towards the education, there was no stress laid on students and much more. The future of industries and commercial sectors will be very tough and ever demanding, so our government has to provide such an education system which will bring all-round development in students and make them future-ready and also teach them to live in any critical situation.
The authors declare that there is no ‘conflict of interest’.
Ove Odredbe i uvjeti ističu pravila i regulacije u svezi korištenja IntechOpenove stranice www.intechopen.com i svih poddomena u vlasništvu IntechOpena, tvrtke sa sjedištem u 5 Princes Gate Court, London, SW7 2QJ, Ujedinjeno Kraljevstvo.
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\\n\\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\\n\\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
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\\n\\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\\n\\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\\n\\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\\n\\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
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\n\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\n\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\n\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\n\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\n\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
\n\nOsim ako nije suprotno navedeno, IntechOpen i/ili svi davatelji licence vlasnici su intelektualnog vlasništva nad svim materijalima na www.intechopen.com. Sva prava intelektualnog vlasništva su pridržana. Stranice sa www.intechopen.com možete gledati, preuzimati, dijeliti, dijeliti poveznice i printati za osobnu uporabu, a temeljem pravila sadržanih u ovim Odredbama i uvjetima.
\n\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\n\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\n\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\n\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\n\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\n\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\n\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\n\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\n\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
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