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Volume 3 | Issue 1 | Jan-Mar 2018


Environment and Yoga for Public Health or simple Rhetoric I

ndia is a country of 1.3 billion population out of which 23.6% or about 276 million people live below $1.25 per day. It is a country still with bullock cart economy and is also in space and nuclear power. It is a dichotomy that we are still struggling in having an Open Defecation Free (ODF) country even after 70 years of independence, yet country is rated high in the international arena. Are we - as citizens and country - doing enough to pay attention to basic issues? We keep blaming government but do forget our role in nation building. The issue of ODF is related to health of the community and so is the Environment and Yoga.

Through the current issue of this magazine, we intend to highlight two important activities in June - India hosting World Environment Day on 5th June 2018 and celebrating International Day of Yoga on 21st June 2018. Dr. Harsh Vardhan, Minister for Environment said, “India is excited to host the World Environment Day this year on 5th June. Indian philosophy and lifestyle has long been rooted in the concept of co-existence with nature. We are committed to making Planet Earth a cleaner and greener place”. The theme for World Environment 2018 is “Beat Plastic Pollution”, we need to explore sustainable alternatives and urgently reduce the production and excessive use of single-use plastic polluting our oceans, damaging marine life and threatening human health. Every year, the world uses 500 billion plastic bags and atleast 8 million tonnes of plastic ends up in the oceans, equivalent of garbage truck every minute. We buy 1 million plastic bottles every minute. Plastic makes up 10% of all the waste we generate.

Dr VK Singh Editor-in-Chief & MD, InnovatioCuris

vksingh@innovatiocuris.com

While hosting the World Environment Day, we should rather be the role model for the rest of the world, but we are also in rhetoric to celebrate, give lectures and felicitate but do nothing on the ground. There is a need of strong time bound action and political will, we may have to take a few hard decisions for the sake of the health of the community. India is credited under the leadership of present Prime Minister Mr. Modi to get recognition of International Day of Yoga on 21st June which happens to be longest day in Northern hemisphere. Yoga to be adopted as way of life to prevent and treat many lifestyle diseases, research has proved reversal of heart blocks by yoga, meditation and diet. In fact, Yoga is accepted all over the world by recognising its benefit by adoption. Let us join hands to adopt environment and yoga days in true spirit to keep ourselves healthy by making these as part of our daily routine. To strengthen public health, let us concentrate on small issues like ODF and theme behind movies “Toilet ek Prem Katha” and “Padman” which are not issues of developed nations. We are a country of two sides of the same coin one side is hovering in the space and arena of nuclear power while the other one struggling with issues like Open Defecation Free country and Padman, not having enough nutrition and healthcare. We need to take care of this segment - innovate and show results on the ground - not simply rhetoric.

Volume 3 | Issue 3 | July-September 2018

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Dear Reader YOGA MOJO GOING VIRAL!

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or ages, we are taught to practice yoga and meditation in India and people do that at many places and in many forms but three years ago at India’s initiative, the United Nations recognised its significance and declared 21st June every year as the International Yoga Day.

In the first edition itself, the IYD had a roaring success worldwide and India created two world records. Since then, there is no going back in terms of celebrating the day with traditional gusto and ever vaulting spirits. Both President and Prime Minister led the nation on the day’s observation.

To recap the event’s increasing foot prints, we decided to dedicate the current issue to IYD and run a fleeting flash back of memories to revive afresh what happened in the previous three editions worldwide.

In same spirit, we are running a few items dedicated to imperiled environment as this year India hosts the International Environment Day with the theme to combat ever plaguing menace of plastic that had adversely impacted human lives and virtually choked water ways in variant degrees at many places.

India’s Environment, Forest and Climate Change Minister Dr. Harsh Vardhan, in an exclusive interview to InnoHEALTH Magazine, appealed to the people to give up single use of plastic and expressed confidence that a perceptible and measurable difference in the country will be brought about on plastic pollution and other environmental issues on the occasion of the World Environment Day 2018. He is also the Science and Technology Minister. In March this year, Prime Minister Narendra Modi called for a "Fit India" movement, focusing on the benefits of yoga, in ‘Mann Ki Baat’. Mr. Rajyavardhan Rathore, the newly appointed Minister for Information and Broadcasting, seems to have taken a cue from the PM to take the initiative forward. He recently tweeted a video of himself doing push-ups with the hashtag #HumFitTohIndiaFit. Since then, the fitness campaign zoomed into a debate and many people accepted the challenge and started posting their videos. International award winner filmmaker Janet Tobia who has won laurels for her documentary “Unseen Enemy” flags major concerns over lurking threats on environment. She was interviewed by our magazine to highlight her views on the Environment Day. The Emmy award winner said that her movie Unseen Enemy examines why in the 21st century we are experiencing a rash of diseases that were once only outbreaks but have now become full-blown epidemics. She is precisely right on her perceptions and fresh outbreak of Ebola in Congo vindicates her concerns.

Amid growing number of violent incidents against young children, we interacted with UNICEF’s India In-charge. Fresh from her experience in managing emergency situations, Dr. Yasmin Ali Haque handles tsunami of problems during her current assignment. She has disclosed that the Indian government in collaboration with UNICEF is developing a comprehensive plan on digital safety for children. Digital literacy is key to ensuring that all boys and girls stay informed, engaged and safe online. There is a need to galvanize ‘zero tolerance’ towards violence against children. In the current issue, we are also carrying a number of other articles like forthcoming plans to jail those found guilty of poaching medical data of patients; medical commission bill facing rough weather; monkeys spa in Japan; how to breathe; IC meeting highlighting the era of disruptions; latest trends in healthcare and many more interesting stories of the health sector.

Thanks, Neeraj Bajpai 4

Volume 3 | Issue 3 | July-September 2018


Global Editorial Board Dr. Shailja Dixit, Chief Medical Officer, Scientific Commercialization, Fellow of Health Innovation & Technology Lab, USA

Editor-in-Chief: Dr. V K Singh

Executive Editor: Sachin Gaur Editors:

Alok Chaudhary

Dr. Avantika Batish

Nimisha Singh Verma Aarti Khanna

Consulting Editor Neeraj Bajpai Sr. Designer

Suraj Sharma, Ritu Versha

Advisors Konda Vishweshwar Reddy, Member of Parliament, India

Amir Dan Rubin, Executive Vice President, United Health Group, USA Thumbay Moideen, Founder President, THUMBAY Group, UAE Prof. Prabhat Ranjan, Executive Director, Technology Information Forecasting and Assessment Council, India

Ronald James Heslegrave, Chief of Research, William Osler Health System, Canada Dr. Ogan Gurel, Chief Innovation Officer, Campus D, South Korea

Dr. Chandy Abraham, CEO and Head of Medical Services, the Health City, Cayman Islands

Dr. Sharon Vasuthevan, Group Nursing & Quality Executive at Life Healthcare Group, South Africa Dr. Kate Lazarenko, Founder and Director, Health Industry Matters Pte. Ltd, Australia

Major General (Retd) A K Singh, Advisor, Telemedicine and Health Informatics, India

Dr. Sarita Jaiswal, Ex-Research Officer at University of Saskatchewan, Saskatoon, Canada (currently in India) Printed and Published by Sachin Gaur on behalf of InnovatioCuris Private Limited Printed at Lippe Scan Private Limited 89, DSIDC, Phase-1, Okhla Industrial Area, Delhi 110020 Editor: Sachin Gaur DCP Licensing number: F.2.(I-10) Press/2016 RNI: DELENG/2016/69964

Š InnovatioCuris Private Limited

All rights reserved. Neither this publication nor any part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission from InnovatioCuris Private Limited

Disclaimer: Readers are requested to verify and make appropriate enquires to satisfy themselves about the veracity of the advertisements before responding to any published in this magazine. Sachin Gaur, the Publisher, Printer and Editor of this magazine, does not vouch for the authenticity of any advertisement or advertiser or for any the advertiser’s products and/or services. In no event can the Publisher, Printer and Editor of this magazine/ company be held responsible/liable in any manner whatsoever for any claims and / or damage for advertisements in this magazine. Authors will be solely responsible for any issues arising due to copyright infringements and authenticity of the facts and figures mentioned in their articles. InnoHEALTH magazine is not liable for any damages/copyright infringements. Volume 3 | Issue 3 | July-September 2018

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PERSONA Digital safety plan for children being leveraged 

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Discourage Single use plastic and instead use jute/cloth carry bags, insists Minister Dr. Harsh Vardhan 14

THEME Regular Meditation Sessions

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Déjà vu – YOGA DAY 

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How to Breathe?

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Yoga and Chanting of Prayers

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Environment is in Peril; Unknown Enemy on Prowl

ISSUES Vision on Blindness cure needs aggressive approach 44 Alarming! 26.7 crore tobacco users in India

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RESEARCH

TRENDS Latest Innovations

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Foreign tourists rallying for healthcare 

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WELL-BEING Contracting lifestyle diseases in adulthood 

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When travelling on public transport, you may want to cover your ears 

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Cyber-Biosecurity: Are we ready?  48 Monkeys go for Spa therapy to fight weather stress

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How portions of brain that temper aggression get veiled with alcohol 

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Socioeconomic inequalities in children’s weight reversed 

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NEWSCOPE LaQshya Programme for pregnant women & new born  60 National Medical Commission (NMC) Bill faces rough weather  61 Screws on Health Sector Data Poachers being tightened 

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One Government Medical College in each State of India 

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Readers Feedback

A Brief Review on InnoHEALTH Most liked article of the last Issue....

I recently went through InnoHEALTH, vol 3, issue 2. I never expected such nice content in a health magazine. Really, it's a very good idea to bring innovations from lab to masses through print media. Appreciative of the idea which in itself is an innovative one. I went through the content very carefully and enjoyed reading articles on wildlife specially the ones on Kanpur zoo and cloned monkeys. Request you to keep including such innovative ideas specially on wildlife. I was also intrigued by the article on software as a medical device. The magazine deserves to be an international magazine on the basis of its contents, printing quality and editorials. Would like to encourage use of symbol of Indian Rupees on the cover page. Dr. RK Singh Kanpur, India 8

Volume 3 | Issue 3 | July-September 2018

I read the magazine InnoHEALTH and found very interesting articles which had scientific explanations. An article on medal winners and their last-minute thought process to annex titles was wonderful and gave an insight of chemistry in chambers of brain during moments of climax. I appreciate the manner in which plight of animals was highlighted and innovative practices adopted by vets. Personally, we feel it should be monthly if not fortnightly and the language a bit toned for the common man. Dr. Meena Dhami New Delhi, India

I went through the latest edition of your InnoHEALTH magazine and found that many articles were very interesting especially the one highlighting that people feel more depressed during tooth ache, head ache and ear pain. I would encourage the team to keep highlighting significance of our medicinal plant values so that people take advantage of such resources available in India in abundance. I recall a time tested saying a tall tree of neem is like a tall Hakim standing before you. Krishna Gopal Uttar Pradesh, India


PERSONA

Digital safety plan for children being leveraged; zero tolerance towards violence against children need of the hour

NEWSCOPE

RESEARCH

ISSUES

WELL-BEING

TRENDS

THEME

By Dr. VK Singh & Neeraj Bajpai

Fresh from her experience in managing emergency situations, Dr. Yasmin Ali Haque smilingly handles tsunami of problems as UNICEF’s Representative in India, lying next to her home Bangladesh.

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he says UNICEF is working closely with the government in developing a comprehensive plan on digital safety for children. Digital literacy is key to ensuring that all boys and all girls stay informed, engaged and safe online. There is a need to galvanize the ‘zero tolerance’ towards violence against children. In a detailed interview to InnoHEALTH magazine, she answered a wide range of questions and elaborated at length, UNICEF’s programmes in India where safety of children is emerging as a major concern. Q. UNICEF is guided by the Convention on the Rights of the Child (CRC) and strives to establish children’s rights as enduring ethical principles and international standards of behaviour towards children. UNICEF responds in emergencies to protect the rights of children. What in your views are the steps that can be taken to protect children from violence and to ensure their safety? One important facet of the rights of CRC is to ensure that children grow in a protective and safe environment, free of any kind of violence and abuse. Preventing and responding to sexual violence requires strong collaboration among stakeholders from diverse walks of life. UNICEF is committed to working with the government, civil society organisations, corporates, media and all the other stakeholders to support society and families to ensure that children are safe and free from abuse and exploitation. Guided by the CRC, it is imperative to act now to break the cycle of violence against children and protect survivors of violence. In recent years, India has made significant progress in addressing sexual abuse against children by having enacted legislations and acted on a large number of cases. The public has also become increasingly aware of sexual abuse cases that may have gone unnoticed years ago due to an increase in reporting on the issue. Digital media and immediate reporting have also contributed to this awareness. Still a lot more needs to be done. Building on these positive developments, UNICEF collaborates with partners to enhance awareness of children and parents by focussing on the following stakeholders: 10

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• Teachers and school authorities: Sexual violence in schools is a major area of concern. Schools should provide information on safety to children and online safety guidelines can be included in the curriculum. Schools also need to ensure that teachers are aware of the provisions of the Protection of Children from Sexual Offences Act. • Children: Child-led initiatives empower children to become advocates of change, voice their demands and take leadership in the change itself. Listening to children is also key as they can become vital stakeholders in their own safety. Decisionmakers, including parents and teachers, should listen to children so that their views can be incorporated into policies. • Civil society organisations, including faith-based and community-based organisations, can engage consistently with the communities and share with them important information around the need to protect children from any kind of violence and abuse and co-create local solutions.


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RESEARCH

Volume 3 | Issue 3 | July-September 2018

ISSUES

The Government of India has resolved to eliminate Measles and control Rubella. The Measles-Rubella (MR) vaccination campaign is an important step in that direction. Measles immunisation directly contributes to

WELL-BEING

Q. Please share with us some details about the immunisation campaign in India. Immunisation is one of the most cost effective public health interventions that currently averts an estimated 2 to 3 million child deaths globally every year. India has one of the largest immunisation programmes in the world, in terms of number of beneficiaries, geographical coverage, and quantities of vaccines used, with nearly 26 million new-borns targeted for immunisation annually. However, despite this effort, only 65% of the children in India receive full immunisation during

Q. What is the burden of Measles-Rubella in India and globally? According to WHO estimates, an estimated 1.34 lakh deaths were caused globally by Measles in 2015. Measles and related complications killed an estimated 49,200 children in 2015 in India, contributing nearly 36% to the global figures. An estimated 84% of global decline in Measles deaths from 2000 to 2016 was due to Measles vaccination. In 2010, an estimated 1.03 lakh children were born with Congenital Rubella Syndrome (CRS) globally, of which an estimated 40,000 children were born with CRS in India.

TRENDS

Q. Why are more girls dying in India than boys? Girls have the advantage of being biologically stronger, yet sadly they are extremely vulnerable socially. The discrimination begins even before they are born. Though the gender gap has started shrinking due to the fast decline of mortality for girls as compared to boys in the recent years, the gap still remains high in many states. The neglect of the girl child is a much broader issue and needs interventions beyond health to address the social norms and cultural practices that act as barriers in bridging the gender gap. It will require working at both the policy level for creating an enabling environment, and at the community level, to build awareness and bring emphasis on the value of the girl child. It will also need increased investments in the availability of gender disaggregated data for more informed planning.

Q. What is the Measles-Rubella Vaccine Campaign and why do we need it? The Measles-Rubella (MR) vaccine has been introduced as part of the Universal Immunisation Programme (UIP) in India to protect children from two diseases, Measles and Rubella, which have high mortality and morbidity respectively. Measles is one of the leading causes of death among young children. It is a highly contagious disease caused by a virus and spreads by coughing and sneezing. It reduces the immunity of the child, making a child vulnerable to life threatening complications such as pneumonia, diarrhoea and infection in the brain. Hence, the burden of diarrhoea and pneumonia can also be indirectly reduced by eliminating Measles. Rubella, although a mild viral illness, can lead to serious consequences if pregnant women are infected during early pregnancy. It can result in miscarriages, stillbirths and a set of congenital anomalies in the foetus and new-borns known as Congenital Rubella Syndrome (CRS), which is a cause of public health concern. CRS is characterized by multiple defects, particularly affecting the eyes (glaucoma, cataract), ears (hearing loss), brain (microcephaly, mental retardation) and heart defects - many of which are lifelong disabilities, requiring treatment, surgeries and other expensive care throughout life. Hence, it is important to eliminate these diseases. The MR vaccine is provided free of cost under the campaign.

THEME

Q. UNICEF has recently launched a report called ‘Every Child ALIVE’ focusing on the number of newborn deaths in the country. Has India made any progress in curbing the under-five mortality? India has shown 66% reduction in the under-five mortality rate between 1990 and 2015, nearly meeting its Millennium Development Goal 4 target. This is much higher than the global decline of 55% during the same period. This progress has been due to a holistic approach to health programming for children. However, the progress has been slower for new-borns and has also been inequitable between boys and girls, with the under-five mortality rate for girls currently being 11% higher, at 41 per 1000 as against 37 per 1000 for boys.

the first year of their life. This translates to 9 million children not fully protected against preventable diseases such as Diphtheria, Pertussis, Tetanus, Measles and Preventable pneumonia. To address this issue, Government of India, with the support of UNICEF, WHO and other partners, has launched Mission Indradhanush to achieve 90% immunisation coverage by the end of 2018. UNICEF is also supporting the government for the strategic communication activities on immunisation, in order to create further awareness on the need for complete immunisation as well as create a discourse on the value of vaccines.

PERSONA

• Media, both traditional and digital, plays a vital role in disseminating information, mobilising public opinion and building a discourse around the issue of child safety. Effective use of digital technology for creating further awareness on child safety is another platform that is being leveraged. We need to ensure that all children, every girl and boy, no matter where they live or what their background is, benefit from the learning opportunities and connectivity that the digital world can provide. However, along with the benefits that digital technology provides, it has also put young people at risk of harm online, including abuse, exploitation, trafficking and cyber bullying.


PERSONA THEME TRENDS WELL-BEING ISSUES RESEARCH NEWSCOPE

the reduction of under-five child mortality.

UNICEF is a key partner in the Ministry of Health and Family Welfare’s rollout of the ongoing Measles-Rubella Vaccination Campaign, which is now in its third phase and has vaccinated 7.7 crore children in 16 states till date (3 April 2018). The MR Campaign targets around 41 crore children, making it one of the largest ever immunisation campaign of its kind. It aims to eliminate Measles and control Rubella by 2020. The vaccine has already been rolled out in several states and will soon be launched in Assam, Haryana and Punjab. Q. How safe is the Measles-Rubella vaccine? The Measles-Rubella (MR) vaccine is a safe and costeffective vaccine that has been available for the past 40 years. The presently used vaccine is a WHO-prequalified vaccine and is licensed by the Central Drugs Standard Control Organization of India. As many as 165 WHO member countries provide Measles second dose in their national immunisation programme. The Rubella vaccine has been introduced in 159 countries. India, along with 10 other member countries of South East Asia region of WHO, has resolved to eliminate Measles and control Rubella and Congenital Rubella Syndrome (CRS) by 2020. 12

Volume 3 | Issue 3 | July-September 2018

The surveillance of Adverse Events Following Immunisation (AEFI) is an integral part of MR vaccination campaign. AEFI management kit is provided at all vaccination session sites including schools so that immediate response can be initiated following an AEFI.

The Government of India has recently amended AEFI management protocol. Now Adrenalin injection is part of each AEFI kit, which is life-saving in case of anaphylaxis. Both public and private sector medical practitioners and health workers are trained prior to MR campaign to handle such adverse events. Dr. Yasmin had joined as the UNICEF Representative in India in July last year and prior to that, she was Deputy Director of UNICEF’s Office of Emergency Operations where she played a leading role in the programming and policies for an effective UNICEF response for children in humanitarian crisis. She started her career in UNICEF in 1996 and held many appointments in challenging situations.


PERSONA

Discourage Single use plastic and instead use jute/cloth carry bags, insists Minister Dr. Harsh Vardhan

NEWSCOPE

RESEARCH

ISSUES

WELL-BEING

TRENDS

THEME

By Neeraj Bajpai

O

n a windy summer morning, a muster of peacocks, displaying colorful plumage like a flickering train, flip-flop atop huge green trees and scream at short intervals amid unfazed flocks of twittering birds at India’s Environment, Science and Technology Minister Dr. Harsh Vardhan’s residence in the heart of the national capital.

Filing past the absorbing spectacle, a motely crowd of visitors, many of them holding handwritten petitions or bouquets gently enter a make shift hall to meet the lawmaker who is a Member of Parliament from the moon light crossing-Chandni Chowk-constituency in old Delhi. Much before, the agile Minister, in tearing hurry to pack up his day long tight schedule, makes an appearance and occupies a central chair to lend an ear to visitors – including some burqa clad women from his constituency, his staff ensures trays of piping hot tea cups and coffee mugs are served regularly. The staff introduces itself to the audience and lay out drill for whistle stop meetings with ear nose and throat–ENT specialist turned politician.

The moment, the medium height suave Minister enters the hall, commotion ensues but things settle down fast as professional photographers stand in attendance and race of selfie with Minister ends. He listens and assures for quick redressal of genuine and fair petitions. This is a frequent morning scene at his residence, may it be a sizzling summer or frigid winter. 14

Volume 3 | Issue 3 | July-September 2018

Retreating people stare at a hanging poster which reads –‘Democracy is not the governance by the majority, neither it’s of governance of the minority, but it is the governance of the common inspiration of general public’. The frame with party’s ideologue and leader Dr. Deen Dayal Upadhyay picture hangs innocuously from a bright green bamboo stick partition. Despite shoe string budget of time, the Minister spoke to InnoHEALTH Magazine and said India’s resolve to protect environment and ensure growth is non-negotiable and gave detailed answers to many queries including:

Q. It is not possible to do away with plastic altogether. How does the govt propose to reduce/ recycle plastic? With the growing population of the world and the lifestyle adopted, the amount of garbage production; including plastic waste, is also increasing. However, the accumulation of these products is leading to increased amount of plastic pollution around the country and the world. The Government of India has notified the Plastic Waste Management Rules, 2016, which, inter-alia, regulate manufacture, sale, distribution and use plastic carry bags including carry bags of compostable plastic, and plastic sheets for packaging or wrapping commodities. The use of carry bags made from conventional plastic and less than 50 micron in thickness is prohibited. The use of plastic for packaging gutkha, tobacco and pan masala is prohibited. Based on the requirement and necessity, individual state can take decision

on banning of the plastic bags. Therefore, use of carry bags made of plastic is banned by seventeen States and three Union Territories.

Through the Plastic Waste Management Rules, 2016, the generators of waste have been mandated to take steps to minimize generation of plastic waste, not to litter the plastic waste, ensure segregated storage of waste at source and handovers segregated waste to local body or agencies authorised by the local bodies. The rules have mandated the responsibilities of local bodies, gram panchayat, waste generators, retailers and street vendors to manage the plastic waste.The rules mandated the producers, importers and brand owners to work out modalities for waste collection system based on Extended Producer Responsibility.

Q. How 2017 was different in terms of air pollution in Delhi NCR? Due to extensive efforts by all stakeholders, there has been an improvement in overall air quality in 2017. As per AQI data, the number of good, satisfactory and moderate days in 2017 were 151 as compared to 109 in 2016. The number of poor, very poor and severe days was down to 180 in 2017 as compared to 214 in 2016. Q. What is your message for this World Environment Day to the global citizen? As you are aware the theme of World Environment Day is “Plastic Pollution”, I would like to urge all people to adopt sustainable lifestyle. India has a long history


PERSONA THEME TRENDS World Environment Day has always been a day of special importance to India. The day has

Volume 3 | Issue 3 | July-September 2018

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NEWSCOPE

Also, we understand that the objective of transforming Green Good Deeds into a peoples’ movement can be best achieved by repeatedly bringing multidimensional initiatives and campaigns that can reach out to youth and children and World Environment Day celebrations 2018 could be a great platform which will definitely discourage the use and beat plastic pollution – which is the theme this year.

RESEARCH

I would request all my fellow citizens to follow atleast one Green Good Deed on daily basis and there will be several hundred million Green Good Deeds performed daily to protect environment, it’s not only our moral responsibility for

Q. You have been talking of building a movement for Green Good Deeds. How can this movement help in reducing plastic pollution - the theme of this year’s World Environment Day? Green Good Deeds is a peopleoriented campaign to raise awareness about environmental concerns in a simplified way. Everyone is looking up to India with expectations because they think that Indians have the DNA to protect the environment. Our ancestors had made protection of environment an integral part of their lifestyle. The campaign aims to broaden its base with involvement of teachers, students and other voluntary organisations. There are more than 500 green good deeds listed in the app (Dr. Harsh Vardhan Mobile App). The app includes – planting trees, saving energy, conserving water, use of public transport and promoting carpool, discourage plastic bottles, have glass, steel or clay bottles in offices, etc., many of

them are concerned with the use of environment friendly consumables which means for sure discouraging use of plastics and such materials, if we encourage few of green good deeds it automatically means enhancing use of environmental friendly products and services in our lifestyle and plastic is so deep rooted especially in urban India that if we discourage it and adopt some relevant green deeds it will certainly reduce adverse impact on environment.

ISSUES

• Use of biodegradable and other types of compostable utensils in place of plastic, and bring a fork, knife and spoon from home. • Use of durable, foldable & inexpensive reusable bag that can be carried around in car/ pocket/purse. • Discourage plastic bottles. Have glass, steel or clay bottles in offices. • Encourage employees to refuse, reduce and reuse plastic products in their daily use. Pledge for plastic free environment in the Organization.

our next generation to give them pristine earth to live in but also our green social responsibility.

WELL-BEING

and tradition of harmonious co-existence between man and nature. In addition, people should adopt these practices in their dayto-day life. Let’s discourage single use plastic and instead we may use jute/cloth carry bags:


PERSONA THEME TRENDS WELL-BEING ISSUES RESEARCH NEWSCOPE

been celebrated as rededication of national efforts for sustainable development and mainstreaming environmental concerns in the national developmental agenda. Plastic as it is may not be a problem, but littering and unsafe disposal of single-use plastic products, plastic bottles, food containers and packaging materials is causing concern to the environment. In the age of advanced technology, we cannot live plastic free but we can manage our plastic waste disposal into circular economy and adapting good deeds and the time has come that we must realize the concern and make collective efforts to reduce our plastic footprint by way of adapting green good deeds and 4 R principle (refuse, reduce, reuse and recycle). In India, not less than 25,490 tonnes of plastic is generated every day with mind boggling 40% of plastic waste uncollected. He hopes there will be perceptible to and measurable difference in the country brought about the plastic pollution and other environmental issues. According to him, about 60 million tonnes of solid waste is generated in one year and ‘’Plastic bottle takes between 4501000 years to decompose”.

This year, India hosts the World Environment Day for the second time. MoEF&CC is hosting the World Environment Day 2018, in collaboration with UN Environment. India hosted the event in the year 2011, with the theme: ‘Forests: Nature at your Service’. Informatively, 5th June was designated as the World Environment Day by the UN General Assembly to commemorate the opening of the Stockholm Conference on Human Development. Annual celebrations of World Environment Day began in 1974. 5th June provides an 16

Volume 3 | Issue 3 | July-September 2018

occasion for responsible conduct by individuals, enterprises and communities in preserving and enhancing the environment. Every action counts, and when multiplied by people across the world, its impact becomes exponential. Over 150 countries are celebrating World Environment Day, particularly for promoting the environmental dimensions of the Sustainable Development Goals. During the last three years, the

themes of World Environment Day celebrations included: “Seven billion dreams, one planet, consume with care” in 2015 in Rome, Italy, “Zero tolerance for the illegal wildlife trade” in Luanda, Angola, in 2016 and “Connecting people to nature – in the city and on the land, from the poles to the equator” in Ottawa, Canada, in 2017. He also mentioned writing to Environment Ministers of more than 150 countries to celebrate the day globally and take pledge to cut the use of single-use plastics. More than 10,000 missed calls have been received in the “Missed Call Campaign” titled #BeatPlasticPollution. A pledge to beat plastic pollution can be taken by placing a missed call on 18001371999.

The objectives behind the campaigns for environment are to enhance the global visibility of India as a leader in sustainability actions, support the efforts to Clean India ahead of Mahatma Gandhi’s 150th birth anniversary in October 2019, expand/consolidate public engagement on India’s environmental agenda, inculcate private sector leadership to address plastic pollution and urge citizens to take a pledge to change their behavior around waste management and highlight India’s leadership in the cause of marine litter and beach cleaning. Q. ISFR 2017 reported an almost 1% increase in forest cover. At the same time trees are being cut indiscriminately. Are there any plans to stop the felling of trees? As per the latest “India State of Forest Report 2017” published by Forest Survey of India, total forest and tree cover of the country is 8,02,088 square kilometers which is 24.39% of the total geographical area of the country. As per ISFR 2017, some States/UTs have shown gain in forest cover while some have shown loss. Overall, there is an increase of 8021 square kilometers in forest and tree cover of the country over that of the India State of Forest Report 2015 (updated) which is about 1% of the forest and tree cover of the country. During the diversion of forest land for non-forestry purposes under the FC Act, felling of trees are carried out as required under the concerned project. However, care is taken to ensure that minimum trees are felled. As per the norms, compensatory afforestation is taken up against the diverted forest areas. Illicit felling also takes place sometimes in different parts of the country. These are dealt under Indian Forest Act and various State specific Acts and rules made thereunder.


Theme


By InnoHEALTH Editorial Team

Regular meditation sessions can have a long-lasting effect on a person’s attention span and other cognitive abilities, says an extensive study.

NEWSCOPE

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WELL-BEING

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PERSONA

Regular Meditation Sessions

R

egular and intensive meditation sessions over the course of a lifetime could help a person remain attentive and focused well into old age, the study has found.

This is according to the most extensive longitudinal study to date examining a group of meditation practitioners. Published in Springer’s Journal of Cognitive Enhancement, the research evaluates the benefits that people gained after three months of full-time meditation training and whether these benefits are maintained seven years later. Lead 18

author

Anthony

Zanesco,

Volume 3 | Issue 3 | July-September 2018

now at the University of Miami in US, however, cautions that further research is needed before meditation can be advocated as a sure-fire method for countering the effects of aging on the brain.

This study follows up on previous work by the same group of researchers at the University of California, Davis in 2011, which assessed the cognitive abilities of 30 people who regularly meditated before and after they went on a three-month long retreat at the Shambhala Mountain Center in US. At the center, they meditated daily using techniques designed to foster calm sustained attention on a chosen object and to generate aspirations

such as compassion, loving-kindness, emphatic joy and equanimity among participants, for others and themselves. During this time, another group of 30 people who regularly meditated were also monitored. Other than traveling to the meditation center for a week-long assessment period, they carried on with their lives as normal. After the first group’s initial retreat was over, the second group received similar intensive training at the Shambhala Mountain Center. As part of this study, follow-up assessments were conducted six months, eighteen months and


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This was especially true for older participants who practiced a lot of meditation over the seven years. Compared to those who practiced less, they maintained cognitive gains and did not show typical patterns of age-related decline in sustained attention. decline in sustained attention.

He says the current findings also

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He is aware that participants’ lifestyle or personality might have contributed to the observations. Zanesco therefore calls for further research into meditation as an intervention to improve brain functioning among older people.

provide a sobering appraisal of whether short-term or non-intensive mindfulness interventions are helpful to improve sustained attention in a lasting manner. Participants practiced far more meditation than is feasible for shorter-term programs that might aim to help with cognitive aging, and despite practicing that much meditation, participants did not generally improve over years; these benefits instead plateaued. Zanesco believes this has broad implications for meditation and mindfulness-based approaches to cognitive training and raises important questions regarding how much meditation can, in fact, influence human cognition and the workings of the brain.

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“This study is the first to offer evidence that intensive and continued meditation practice is associated with enduring improvements in sustained attention and response inhibition, with the potential to alter longitudinal trajectories of cognitive change across a person’s life,” says Zanesco.

ISSUES

The participants again completed assessments designed to measure their reaction time and ability to pay attention to a task. Although these did not improve, the cognitive gains accrued after the 2011 training and assessment were partially maintained many years later. This was especially true for older participants who practiced a lot of meditation over the seven years. Compared to those who practiced less, they maintained cognitive gains and did not show typical patterns of age-related

WELL-BEING

seven years after completion of the retreats. During the last appraisal, participants were asked to estimate how much time over the course of seven years they had spent meditating outside of formal retreat settings, such as through daily or non-intensive practice. The forty participants who had remained in the study all reported some form of continued meditation practice: 85% attended atleast one meditation retreat, and they practiced amounts on average that were comparable to an hour a day for seven years.


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By Neeraj Bajpai

I

t was only three years ago when India carved out a niche in annals of history on 21st June 2015 by holding the biggest ever open-air yoga camp with maximum number of international community members on the sprawling lawns of Rajpath on the first International Yoga Day (IYD), proclaimed on its initiative.

Now, taking lead from India following its expertise in the centuries old science, many nations mark the day with gusto, and many of them have imbibed the art in daily chorus amid anxiety ridden lives in the competitive world. Prime Minister Mr. Narendra Modi says it should be matter of pride for any Indian that India proposed before UN the idea of the International Yoga Day and it was approved.

On the first event itself, the country had been awarded with two Guinness World Records in two different categories. Category 1 was for the largest number of participants in a

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Déjà vu – YOGA DAY

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Yoga Lesson at a single venue. The earlier record was of 29,973. To beat that record a target of 30,000 was required. Yogis broke that record as 35,985 participants performed Yoga at Rajpath that morning.

Category 2 was most number of nationalists in a Yoga Lesson. To achieve that, at least participants from 50 countries were required to perform. But that day participants from 84 countries performed Yoga at Rajpath. Mr. Shripad Yesso Naik, then MoS. Ministry of AYUSH and Secretary AYUSH received the awards which were presented by the representatives of Guinness World Records Ms. Victoria from UK and Mr. Marco Frigatti from Italy. Also present on the occasion were Yog Gurus, Mr. Guru Malladi, coordinator of EY Company. The India’s proposal for the IYD was supported by as many as 177 countries for the first time in the history of UNO (United Nations Organisation) and the resolution was passed within 100 days. Mr. Modi, in his first year in office,

addressed the 69th session of UNGA on 27th September 2014 and had urged the international community to celebrate Yoga day.

On 11th December, the 193-member UNGA had approved the proposal by consensus with record 177 countries, including 47 Muslim nation cosponsors, clearing a resolution to establish June 21 as 'International Yoga Day’.

Now, more than 250 cities across six continents in the world performed Yoga to mark the first International Yoga Day, with Mr. Modi leading the nation, along with 35,000 yogis at Rajpath and External Affairs Minister Ms. Sushma Swaraj had represented India at the UN in New York. On the first IYD, Ms. Swaraj says Indians across 650 districts and 192 out of 193 countries of the globe took part in Yoga events being planned to celebrate the Day, with Yemen being the only exception because of war situation. “Our embassy has been shifted to Djibouti from Yemen and this is the reason that we have left out


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only one country," Ms. Swaraj said.

Many are of the firm opinion that the government must ensure that no coercive tactics are used for participation in Yoga programme. They linked it with religious sentiments, but people in general have rubbished grotesque comments. “Yoga is an invaluable gift of ancient Indian tradition. It embodies unity of mind and body: thought and action; Volume 3 | Issue 3 | July-September 2018

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The record book officials closely monitored developments as the event eclipsed previous records participation in such event and

There is no looking back since that day, say officials of the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AYUSH). The biggest challenge was to ensure the turnout much before 0600 hrs. Guinness book of records panelists had insisted that every entry should be bar coded and decoded. The event took off at 6:45 am for 35 minutes with crisp 15 popular asans. A large LED screen was put in place to highlight motions of various exercises which include Muktasana, Makarasana, Kapalbhati, Pranayam, and meditation. The programme had started with Rigveda invocation.

The International Yoga Day is spreading across the country and at most of the places, preparations get underway months before the day. Even in mofussil places, message is loud and clear to observe the day. Now, it is observed with festive fervor and gaiety with no political strings attached.

RESEARCH

Tightest ever security paraphernalia was mounted with air cover by the Indian Air Force to thwart any disruptive design. Security was on lines of the Republic Day and Independence Day celebrations. Tight vigil was being mounted at airports, railway stations, bus stations and other crowded areas. Teaming multitude of people had done a 35-minute session of 15 Asanas at the Rajpath.

Now events are being organised in various cities in different countries including Beijing, Berlin, Bogota, Budapest, Dublin, Ho Chi Minh, Hong Kong, Jakarta, Paris, Port Louis and Tallinn.

ISSUES

PM had led the nation in the celebrations during the function at Rajpath, where the entire stretch from Vijay Chowk to India Gate had turned into a Yoga mat. More than 7,000 copies of coffee table books and 19,000 reference books on Yoga had been sent to Indian Missions abroad.

biggest assembly in a single yoga class. The record was held by Kanyakumari-based NGO, the Vivekanand Kendra at Jiwaji University, Gwalior, on 19th November 2005. There were 29,973 participants. Guinness Book of records has set a benchmark of 50 nation’s participation for another record.


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restraint and fulfilment; harmony between man and nature and a holistic approach to health and wellbeing,” Mr. Modi had told UNGA, setting the tone for the international yoga day proposal.

On the first edition, Mr. Modi, had announced the arrival of a new yoga era, with the first International Day of Yoga being observed across the world. Leading a mass yoga demonstration at Rajpath in New Delhi, the Prime Minister had declared that “today”, as this day was being observed in various parts of the world, the sun would not set on the community of Yoga practitioners.

He said that “today” is not just the first-ever International Yoga Day, but the beginning of a new era that would inspire humanity in its quest for peace and harmony. The Prime Minister had recalled the contribution of ancient sages, yoga gurus, and practitioners across 22

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the world through the ages, for making Yoga what it is, “today”. He said that as mankind advances in various spheres of development and technology, individual human beings must progress too, and Yoga offered an avenue for this. Yoga is not merely an exercise but offered an opportunity for balancing the mind and body and could help harness an individual's inner strength. Yoga is widely considered as an “immortal cultural outcome” of the Indus Sarasvati Valley civilization dating back to 2700 BC – and has proven itself to cater to both material and spiritual uplift of humanity. A number of seals and fossil remains of Indus Sarasvati Valley civilization with yogic motifs and figures performing yoga sadhana suggest the presence of yoga in ancient India.

In 2016, the Prime Minister celebrated the second International Day of Yoga at Chandigarh, where

he joined approximately 30,000 participants in a mass Yoga demonstration. Addressing the gathering at the iconic Capitol Complex there, he said the people in all parts of the country have connected with Yoga.

“The Yoga Day is a day linked to good health, and it has become a mass movement. Yoga is not about what one will get, but it is about what one can give up. That with zero budget, Yoga provides health assurance, and does not discriminate between rich and poor.” PM said and stressed the need for focus, on how to mitigate diabetes through Yoga. He walked amidst people, joined and mingled with the participants of the mass Yoga demonstration. The event was marked across the world with more enthusiasm than it was on the first year. The third International Day of Yoga in 2017, too, was celebrated with great enthusiasm across the country with mass yoga demonstrations taking


The Ministry of External Affairs, through its Indian embassies abroad, celebrated the Yoga Day at iconic locations like, at the Abraham Lincoln Monument, Sylvan Theater in Washington DC, La Villette in Paris, and at the backdrop of Sheikh Zahid Mosque in Abu Dhabi. Yoga gurus conducted seminars and discussions on Yoga in many countries across the world.

WELL-BEING ISSUES

On the occasion of International Day of Yoga, the Ministry of AYUSH organised mass yoga programmes in Delhi in association with NDMC, DDA and eminent Yoga organisations. In Connaught Place, New Delhi, NDMC used drone cameras for aerial photography and videography of the Yoga demonstrations.

Massive arrangements have been made to mark the day this year as by next year, the country would have witnessed general elections. Polls in the world’s most populous democracy always holds mystery in womb about next ruling dispensation at the center. But as it is the international day, come what may world will continue to mark the day with more zest in tensions ridden global scenario. Moreover, Yoga is emerging as public movement bereft of politics.

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Last year, the Ministry of Defence organised Yoga sessions across the country with troops of the Indian Army, Indian Air Force and Indian Navy, conducted at Pahalgam, Srinagar, Kargil. Ahmednagar, Bidar, Bengaluru, Chennai, Dehradun, Dibrugarh, Kolkata, Leh, Mangalore, Nagpur and Sriganganagar, to name of few. The Indian Navy did Yoga sessions on board INS Vikramaditya, Shivalik, Kamorta, Jyoti, INS Jalashwa & INS Kirch in the Indian Ocean & the Bay of Bengal and the Coast Guard

RESEARCH

Many partnership organisations like, Art of Living, Patanjali Yoga Samiti, Vivekanand Yogashram Hospital, Brhamkumari, Isha Foundation and GayatriParivar participated in the Yoga day celebrations in various places in Delhi. Former Union Minister for Urban Development, Housing & Urban Poverty Alleviation and Information & Broadcasting, Mr. M. Venkaiah Naidu also participated. Other Union Ministers participated in mass Yoga events in various states. The Ministry of Home Affairs celebrates the International Day of Yoga across the country including yoga celebrations by BSF, CRPF, CAPF, units of ITBP to mark the occasion. Last year, ITBP personnel performed

TRENDS

The event at Lucknow was attended by Former Union Minister of State (Independent Charge) Ministry of AYUSH Mr. Shripad Yesso Naik; Chief Minister of Uttar Pradesh Mr. Yogi Adityanath; Deputy Chief Minister of Uttar Pradesh Mr. Keshav Prasad Maurya; Deputy Chief Minister of UP Dr. Dinesh Sharma; State Minister (Independent Charge) Ministry of AYUSH, Dr. Dharam Singh Saini.

The Ministry of Human Resource Development announced the winners of the ‘Yoga Olympiad’ held in Delhi from 18th - 20th June 2017 to promote the awareness of yoga and to build up a network of schools, teachers and yoga practitioners at the national level. The awards were given in four categories which included one award each for Upper Primary - Girls and Boys; Secondary - Girls and Boys.

on board ICGS Sarathi, ICGS Samrat. Cadets of National Cadet Corps (NCC) participated in Yoga Day function at DG NCC Camp, Delhi Cantt.

THEME

Addressing the gathering at the iconic Ramabai Ambedkar Maidan in Lucknow, he reached out to people and said, Yoga is a practise that binds humanity together and is helping countries across the world to be connected with India. Yoga is a medium to achieve wellness and it has the power to provide health assurance at zero cost, he said.

yoga at 19000 feet in Ladhak and at 11600 feet at the Bank of Indus River in Ladhak.

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place in various locations. The Prime Minister had participated in the mass Yoga event in Lucknow where he was joined by a huge number of people.


By Neerja Singh

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How to Breathe?

I

agree everybody knows how to breathe, even a newborn child. Still, these days most of us need a breathing program that can help us in dealing with our day-to-day desk work, driving, tension, anxiety and even depression. It is well known that deep breathing exercises can help overcome these stresses in life, so it is necessary for all of us to understand the science of breathing i.e. Pranayama. “When the breath wanders, the mind is unsteady, But when the breath is still, so is the mind still.� Hatha Yoga Pradipika

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Pranayama is a part of yoga system that teaches us the art of extending and controlling our breath in many ways. It teaches us to change the depth, rate and pattern of breathing.

DIFFERENCE BETWEEN PRANAYAMA AND BREATHING

Pranayama is the conscious awareness of breath. The term is derived from Sanskrit, Prana means breath, respiration, vitality or energy. Ayama means expansion or stretching. Thus, Pranayama connotes extension and control of breath. Proper rhythmic, slow and deep breathing, strengthens the respiratory system, soothes the nervous system and increases

concentration. According to Yoga, the breath connects the Body, Mind and Spirit.

The rate of breathing changes with circumstances such as it increases due to emotional or physical disturbances whereas, it automatically slows down when one is calm and peaceful. Like, when we get tired while climbing stairs, we get breathless. Try the following to regulate your breathing and feel less exhausted. Climb keeping shoulders straight and take a deep breath in for two stairs (inhale), and exhale for two steps, with a rhythm of two in and two out. Like this, we expel more carbondioxide and take in great supply of oxygen, thus we


BENEFITS OF PRANAYAMA

Pranayama purifies the psychic channels (nadis) and enables physical and mental stability. Pranayama is known to purify about 72,000 nadis or channels in the body. It helps purify the blood and respiratory system. Deep breathing

Ms. Neerja Singh is a retired scientist with Council of Scientific and Industrial Research (CSIR). Her interests include phytochemistry and non-conventional therapies benefiting the patients. She has practiced many such therapies like yoga, dance etc. Volume 3 | Issue 3 | July-September 2018

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• Ujjayi Pranayama (victorious breath) • Anulom Vilom (alternate breathing) • Brahamari Pranayama (humming bee breath) • Bhastrika Pranayama (air is forcibly drawn in and out) • Shitali Pranayama (cooling breath) • Bahya Pranayama (forcibly breath in, breath out and then hold the breath) • Kapalabhati Pranayama (air from lungs is forcibly exhaled but inhalation is made involuntary)

Pranayama should be practiced with care and it is better to do under the guidance of trained yoga teacher, as certain Pranayama is not advisable to be performed by people having certain ailments.

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A full yogic breath combines all three, beginning with abdomen and continuing the inhalation through thoracic and clavicular area. The abdomen should expand outward on inhalation and contract on exhalation. To get the feeling of this motion, while sitting in any meditative posture preferably Vajrasana, place the hands on the abdomen close to each other. Exhale slowly inhale through the nostrils taking the hands away from each

TYPES OF PRANAYAMA:

PRECAUTIONS

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Abdominal Breathing: Deep abdominal breathing brings air to the lowest and largest part of lungs. Breathing is slow and deep such that diaphragm is used properly.

Pranayama is practiced in a specific posture, especially sitting in Padmasana or Ardhpadmasana and should be performed early morning on empty stomach at a well ventilated quite place. Breathing should be slow and rhythmic, eyes should be closed to control the mind and body. It has three aspects (1) Poorka (Inhalation) (2) Kumbhaka (Retention) (3) Rechaka (Exhalation).

• Improves the autonomic functions. • Helps relieve the symptoms of asthma. • Aids in reducing unnecessary thoughts which helps in calming down the overactive mind thus reduces anxiety and depression. • Causes change in the cardio respiratory system and helps in lowering the blood pressure. • Improves physical fitness by practicing certain asans of yoga, it is excellent for weight loss also. • Deep breathing i.e. bringing focus on breath can be extremely relaxing and rejuvenating. Regular practice improves concentration, memory and overall state of mind.

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Thoracic (Chest Breathing): Breathing takes place by expanding and contracting the chest only, while abdomen is kept under control. The middle lobes of the lungs are fully activated through this breathing.

TYPES AND BENEFITS OF PRANAYAMA

Pranayama techniques are beneficial in treating a range of stress related disorders:

TRENDS

Clavicular Breathing (Sectional Breathing): It is shallow breathing in which the abdomen is completely controlled, and breathing is performed by forcing the air into the upper most region of the lungs. The shoulders and collar bones are raised while abdomen is contracted during inhalation.

The air flow into the lower sections of the lungs is increased. Rhythmic movement of the diaphragm massages the abdomen gently and enables the organs to function effectively.

enriches the blood with oxygen. Large amounts of oxygen reaches the brain, lungs, heart and capillaries.

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TYPES OF BREATHING

other so that the abdomen bulges. Hold the breath for a second. Then slowly exhale so that the abdomen retracts bringing the hands closer. Hold the breath for a second. Repeat the breathing cycle five times, preferably in the ratio 4:2:8:2. Breathing should be deep, slow and rhythmic.

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feel less fatigue. Mostly we use only a fraction of our lung capacity as we do shallow breathing. We barely expand the ribcage, shoulders are often hunched and have painful tension in the upper part of back and neck due to which we suffer lack of oxygen which makes us breathless and tired. So, keep both shoulder blades as close as possible without strain and exhale gently and fully, pause, then inhale with a deep, slow, gentle breath until the lungs are comfortably filled. Then breath out slowly through the nose, without changing the position of shoulder blades. Repeat this cycle many times. By doing this, the brain gets stimulated and ease nerve tension by providing fuller supply of oxygen.

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Does Yoga and Chanting of Prayers provide serenity, intrinsic motivation, and a feeling of eternity beyond the boundaries of the ego? The answer is YES.

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By Dr. Tinni Dutta

H

ealth psychologists have encompassed a very wide domain in modern life. The rapid development of science and technology, on health issues has been one of the most visible of current trends in social and behavioural science. Modern life is full of stress and strain. To be free from stress is to be dead. How to cope up with these unprecedented changes? An answer which is echoed in the heart of human beings are ‘Yoga’ and ‘Chanting of Prayers’. According to Miovic Michael (2008), models of psychotherapy, integrated with yoga principles are as follows: Psychoanalytic and Psychodynamic approaches focus on how important emotional attachments and relationships from childhood are internalized. Meditation during these periods have an impact on future relationship through emotional catharses and motor development. Cognitive Behavioural Therapy examines how behaviour and emotion could be conditioned. Behavioural modification techniques and relaxation training are equally effective. Socratic analysis of automatic patterns of thinking could be included as an interpersonal element.

Suggestive or Hypnotic approaches suggest the desired behavioural outcome and emotional reactions through the technique of guided imagery and thought. Body oriented approaches use various types of touch, massage, psychological posture and breath work. 26

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Creative expressive approaches use the creative arts – music, poetry, painting and thought – as creative expressions and socially acceptable channels. Subtle energetic approaches use pranic energy as a form of touch therapy including acupuncture, reiki and so on.

Deep breathing counting (1-20) could be done thrice a day. It would reveal consciousness as illumination of light in spiritual experiences. Proper deep breathing enables the human beings as all-pervading reality.

Chanting of psychological prayers from Gita and Upanishad are necessary to attain the level of mastery in what you are doing – focused, concentrated. ‘A sense of ecstasy is noticed of being outside everyday reality’. Greater inner clarity in all our day-to-day activities. ‘A sense of serenity – no worries about one self and a feeling of growing beyond the boundaries of ego‘ (quoted from Sanyal, N, 2013).

Thus, yoga and chanting of prayers provides serenity, intrinsic motivation, and a feeling of eternity beyond the boundaries of the ego.

Dr. Tinni Dutta at Ashutosh college, Kolkata, is an eminent Psychologist and a famous educationist. Her research work has been greatly appreciated in India and abroad. She has visited France, Germany, Indonesia, Singapore, Switzerland, Thailand, UK and USA. She is recipient of many awards and fellowships.


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Environment is in Peril; Unknown Enemy on Prowl By Neeraj Bajpai

This year, the world recalls nightmarish memories of 1918 pandemic of influenza and screen through popular movie “Unknown Enemy” on its first anniversary. “I had a little bird, its name was

Informatively, the 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic. Researchers say it infected 500 million people around the world, including people on remote Pacific islands and in the Arctic, and resulted in the death of 50 to 100 million (three to five percent of the world's population). Disease had greatly limited life expectancy in the early 20th century, most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast, the 1918 pandemic predominantly killed

ISSUES

She is not a wizard in crystal grazing to forecast future events,

The Emmy award winning filmmaker Janet Tobia told InnoHEALTH Magazine that her movie Unseen Enemy examines why in the 21st century we are experiencing a rash of diseases that were once only outbreaks but have now become full-blown epidemics.

Enza, I opened the window, and in–flu-enza, was popular rhyme of children while skipping ropes in those outrageous days.

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It all sounds scaring, but it is a stark reality given facts on the ground which are almost ready for such a grim situation if corrective measures are not effected in time.

but certainly, she is a visionary, and envisions that the specter of diseases will loom over the planet earth in future. She is no one else but Janet Tobia who has won laurels for her documentary ”Unseen Enemy”.

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n the 21st century, we are all connected. Population growth, mass urbanization, deforestation, climate change and increased travel have dramatically increased the risk that familiar diseases will spread and mutate, and new ones will emerge. As people enter new spheres of biodiversity, they come in closer contact with other species, increasing the risk of viruses jumping from animals to humans, and then spreading more widely.

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100 Years on Unknown Enemy stares surreptitiously; Janet Tobia flags issue afresh to stave off flu specter looming large on globe.

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More recent investigations, mainly based on original medical reports from the period of the pandemic, found that the viral infection itself was not more aggressive than any previous influenza, but that the special circumstances (malnourishment, overcrowded medical camps and hospitals, poor hygiene, etc.) promoted bacterial superinfection that killed most of the victims typically after a somewhat prolonged death bed.

To maintain morale, war time censors minimized early reports of illness and mortality in France, Germany, United Kingdom and

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previously healthy young adults. There are several possible explanations for the high mortality rate of the 1918 influenza pandemic. Some research suggests that the specific variant of the virus had an unusually aggressive nature. One group of researchers recovered the virus from the bodies of frozen victims and found that the transinfection in animals caused a rapid progressive respiratory failure and death through a cytokine storm (over reaction of body's immune system).

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Ms. Janet says moving across the globe, her team met the film’s characters: doctors, disease detectives, everyday men and women. Every one of them had stepped into the horror of an epidemic and emerged deeply changed. United States. Examining the recent epidemics of Ebola, Influenza and Zika; unseen enemy makes it clear that epidemics bring out the best and worst of human behavior, and that their effect goes far beyond the terrible tolls of sickness and death.

rapport both in field of vaccines and drugs distribution, availability of diagnostic tools and research work in the discipline. Leaders will have to chip in together - make strong health architecture at global level as threat is looming on everyone.

She says political leaders all over the world should address the problem and play key role in combating pandemics threats. There must be early detection and warning systems in place to detect outbreaks faster and countries must work in close

Finally, it is critical to invest in flu research both to improve the effectiveness of the current vaccine and, more importantly, to develop a universal flu vaccine - one that would work against all types of flu, including potentially a new pandemic strain.

‘‘We are all connected to any person, animal, and insect that may have an infectious disease incubating in them. And that connection is either incredibly dangerous or a powerful force for good. It is our choice which of those becomes true.’’

We also need to use new mobile technology to reach out to affected and vulnerable populations, mobilize healthcare and make long-term investments in scientific research.


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She recalls that the 1918 influenza pandemic killed more than 50 million people around the world, in India alone, 17 million lost their lives and so her movie cameras rivet around a potential global scenario. Emerging epidemics have a propensity to burst anywhere and anytime because of fast changing global environment.

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In populous countries, people live in dense pockets in the overburdened urban swathes. Not only that they travel in crowded public transports and if an infected, suffering from a contagious infection, sneezes or coughs, there is an instant spreading of the infection. Virus, the unseen enemy, infects people who are generally oblivious of the lurking threat.

According to her, in case of India,

The seasonal flu shot is the best tool. There is some evidence to show that taking the flu shot two years in a row gives you more protection than if you skipped a year. There is also some evidence on how people receiving a flu shot for the first time have the strongest immune protection reaction, while other studies say this isn’t true. India’s small pox eradication campaign is the most successful healthcare drive in history. During the time more than 100,000 health workers visited over 100 million households to eradicate small pox. So, India has a blueprint to deal with a future pandemic.

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During outbreak of such epidemics, people are advised to be cautious to mount their own defense to protect themselves. In India, a sea of humanity moves every day from one place to another and in case of outbreak of such diseases, travelling of infection can be very fast.

there is a heavy burden of noncommunicable diseases, like diabetes, heart diseases and other chronic diseases that often compromise immunity. Deaths from flu are higher in diabetics than the general population.

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She says reports are in circulation that new strains of influenza are infecting birds in China, but the day

might not be far away when these microbes may learn clandestine art of migrating from birds to human beings.

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The Director of the film minces no words to articulate her views on the unseen enemy. Ebola, for example, may have emerged in West Africa, a new part of Africa, because of deforestation there. AIDS moved out of the forests of Africa to spread around the world and today there are over 20 million people living with HIV-AIDS. In addition to new virus, we now also have new drug resistant strains of once badly feared tuberculosis and malaria developing.

WELL-BEING

In addition to urbanization and living in a highly connected world, deforestation is leading to closer contact with animals, which may infect us with deadly viruses. With climate change, vectors like mosquitoes are moving up north into newer regions. Suppose, antimicrobial resistance is added to this mix, and then there will be new virus and drug resistant infections if we don’t have antibiotics that work, then you would be infected and untreatable.

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She visualizes a scenario where India can play a major role because of its expertise in carrying out past massive healthcare programmes. Small pox eradication and polio vaccination programme vindicates the fact about country’s efficacy to turn tables. It is the need of the hour that such an expertise was implemented for elimination of infectious diseases to stave off threat of outbreak of pandemics in the global village.


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Film makers had looked at previous epidemics and infections. AIDS was lurking in their minds, but sudden spurt of Ebola and Zika virus’ cases turned the film into a real time saga, and both AIDS and SARS slipped into background.

In the global village narrative, every citizen is open to risk factors in case of pandemics. The diseases assail everything whatever comes into their way - may it be health or wealth. When a pandemic happens, people don’t work, economies collapse, and even social fabric is dismembered. People attempt to avoid their own infected close relatives and friends out of fear that they will be the next seizure if precautions were not clamped. She mentions that in case of pandemics, whatever happens on the front line in Liberia affects people in Europe and North America. In the free world, we all 30

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Her realization that in the midst of the fast globalization, people across continents have become more vulnerable to epidemics and pandemics turned into a film idea that caught people’s attention. share knowledge platforms, travel frequently and export and import cheaper goods so microbes also travel freely. For her, Ebola is the test case. According to the Director, Ebola was not handled swiftly at the stage of outbreak otherwise it could have been bridled at that stage rather it turned into epidemic.

She recalls that Zika virus too had sprung a surprise. It was never visualized. No one thought that a virus first identified in the 1940s in Uganda would travel halfway across the world - first to the South

Pacific and then to South America, and now to North America. And no one knew, and we are still trying to understand, why this virus that hadn’t been thought of as particularly dangerous would in Brazil produce such terrible birth defects. Zika is essentially a pandemic as it affects so many countries and continents. And with global warming it could affect even more because the mosquitoes will be able to move further north as the globe warms up.


Trends


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LATEST INNOVATIONS! POWERDOT P

owerDot works via a mobile app that uses Electrical Muscle Stimulation (EMS) to activate your muscle fibres, get your body’s lymphatic system flowing and increase the blood flow to targeted areas. Basically, it gets you moving. The result is the creation of a perfect environment for the body to recover faster, feel better and over all well-being. It also allows you to control your workout. An impulse is sent to the pods based on the muscle group you select to target which causes the muscles to activate. The feeling that it creates can be intense and bizarre at first, but you will get used to it in a few uses. It is also compact enough to carry on a holiday or trip and is available from £275 at PowerDot.

NEEDLE-FREE DIABETES CARE: THE FUTURE OF DIABETES SELF-CARE N eedle-Free Diabetes Care is a path-breaking technology currently under development. The best options available today for automating most of the complicated daily process of blood sugar management are continuous glucose monitors and insulin pumps however they don’t completely remove the need for skin pricks and shots. The new skin in the game is a technology being developed by Echo Therapeutics (Philadelphia, USA) that would replace the poke with a patch. A transdermal biosensor that reads blood analytes through the skin without drawing blood is what the company is aiming for. The technology puts the patient’s blood chemistry within signal range of a patch-borne biosensor with the help of a handheld electric-toothbrush like device that removes just enough top-layer skin cells. The sensor 32

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collects one reading per minute and sends the data wirelessly to a remote monitor. When levels go out of the patient’s optimal range, this triggers audible alarms thus tracking glucose levels over time. There are other start-ups working in the same space as GlucoSense, a spin-

out of the University of Leeds funded by NetScientific is developing a non-invasive device based on photonics technology. Another Dutch start-up called NovioSenseis working on an implantable glucose sensor that uses tear fluid to measure glucose levels.


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sleep data into light sleep, deep sleep and REM (rapid eye movement) sleep. The device also records your heart-rate while you are in bed. In the morning Health Mate syncs all your night’s data, giving you a sleep score measured out of 100. The Health Mate software also features the Sleep Smarter program which is an 8-week coaching program which takes your long-term sleep data and provides feedback as to how to improve your sleep quality over this period. Thus, Nokia Sleep is a sleep monitor under the mattress. However, it can turn off the lights and lower the temperature in the room for you to fall asleep easier apart from performing all the tasks of a good sleep monitor: tracks sleep patterns, sleep duration or the quality of your bedtime.

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ecently Nokia unveiled their first standalone sleep tracking device which is a “Sleep Sensing & Home Automation Pad” named ‘Nokia Sleep’. This pad is placed underneath your mattress and features advanced sleep tracking as well as integrated home automation features. The Nokia Sleep sensor is designed for people who want to learn how to sleep better, but don’t want to be bothered with strapping on a wearable like a Fitbit to their wrist. The sensor slips underneath your mattress and using a technique known as ballistocardiography, monitors your breathing, movement and heart-rate, and translates this into your data about

your sleep. The sensor is wifi-enabled which connects directly to the Nokia Health Mate App. The product can also detect snoring. The Nokia Sleep pad is designed to give a frictionless sleep-tracking experience. Once you’ve placed the sensor under your mattress and connected it to the mains and your wifi, it’s a case of ‘set and forget’. Sleep tracking is automatically detected when you get in and out of bed because it syncs with the Health Mate cloud platform and it doesn’t have to rely on you fiddling with your phone before bedtime. The sensor is also very userfriendly and is covered in a metal grey fabric with a single cable attached which terminates in a USB plug that is used to power the device 24/7. The sensor also claims to be able to break down your

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The YO Clip (a mini-microscope) is supplied in the kit with all the supplies required to run two tests on your Smartphone. The app is easy to follow and takes the user through step-by-step interactive screens and instructional animations to insure a smooth, easyto-understand and secure testing experience with accurate results. There is also humor built into the Sperm Trivia Challenge, which is designed to interact with the user during the sample preparation wait time. The Test results are reported within minutes along with a video of the sperm. This provides both instant test results requiring no interpretation and a “wow” factor when the tester sees his sperm in action. YO test is critical for indicating male fertility potential and with the results already in hand, any male can walk into a Doctor’s clinic with reduced stress of facing additional testing and can sign up for further treatment. The Test kit is sold online through the YO website www.yospermtest.com or through Amazon for about INR 1990. It is delivered in a plain box for confidentiality.

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their home. The cause of infertility is equally shared by men and women. Approximately 40% of the problem is a female factor and 40% a male factor with the remaining 20% unexplained or a combined problem between the man and the woman. Yet, many times, the initial focus of a fertility assessment is on the woman and the man may not be tested until a full female workup and treatment is unsuccessful, which could take a year or more. This delay in testing the male side of an infertile couple, plus the fact that couples are postponing having children until their 30’s places the couple at greater risk of being childless and substantially increases their anxiety about conceiving. YO test is both an accurate and private home test that provides a precise assessment of moving sperm concentration (MSC). Testing moving sperm is critical in a home test because, with a clear video to back it up, the results allow the man to approach the doctor with clear evidence of a problem. The simple, step-by-step app can be downloaded free of charge from Google Play or the App Store.

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ndia is experiencing a decline in fertility due to many reasons like adverse lifestyle habits, pollution, delayed conception and so on. There is a growing awareness that men’s reproductive health issues also contribute to infertility. Also, the doctors here believe that there is a profound need for a device like YO in India which can be made available to as many couples as possible to make their journey to parenthood a reality. So, to address the problem of male testing and to eliminate the stressful public nature of male sperm analysis, Medical Electronic Systems (MES), a Los Angeles based technology company developed the YO Home Sperm Test Kit and recently launched it in India which is first of its kind video-based smartphone platform that is FDA approved. The device is used to determine motile sperm concentration (the number of moving sperm) which is a critical factor in determining male fertility. The device has 97% accuracy and provides consumers the ability to both view and measure the number of motile sperm in their sample on their phone and from the comfort of

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YO HOME SPERM TEST – NOW IN INDIA I


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rtificial intelligence is the future and it aims at making human life easier. With this view, a Delhi-based start-up VISIT was launched in 2016 which is an ondemand healthcare service online platform that provides its users a pool of medical specialists and general physicians to choose from, for consultation. The facility has an artificial intelligence based ‘chatbot’ that acts as a digital assistant to

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VISIT: AN ARTIFICIAL INTELLIGENCE START-UP A

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China–based firm VVFLY Electronics has developed a smart anti-snoring eye mask called Snore Circle priced at nearly INR 9700. Snore Circle is a smart wearable sleeping mask that comes with a little module that uses sound detection and bone conduction to identify when one is snoring. Once that is done, it sends out little vibrations to trick one’s brain into tightening one’s throat muscles. Once the throat muscles are tightened, snoring should subside. The vibrations on the Snore Circle adjust to your snoring level and are tuned well enough so that they don't get so strong that people just end up waking up instead they are just enough to alter your throat muscles. The mask has an 80 mAh battery and can detect snoring by giving out vibrations at 36 levels. It allows the users to monitor and analyse their snoring, its intensity and decibel level along with sleeping data through its Snore Circle App. 34

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provide ‘smart help’ to patients in getting consultation from doctors. The chatbot comes with a USP that when a patient accesses it for help, it learns using the information given by the patient and uses the information to reinforce its decision network. The chatbot tracks user’s activity, sleep, calories and fitness data to help them reach their goals with continuous reminders, insights and motivation. The VISIT offers

paid online consultation, through video and voice channels and seven days of free follow-up check-up over text chat. The service also maintains a pool of MBBS doctors who through its ‘Q’ service offer free health advice by text. The pool of 2200 doctors includes: psychologists, dieticians, dermatologists, sexologists, gynaecologists, preventive cardiology and paediatricians besides general physicians.

S-based start-up Zipline has developed a drone that can deliver urgent medicines, blood and vaccines mid-flight. Hospitals can text orders to Zipline for the required products, which are packed at its centres and then launched aboard the drone that races along at over 100kmph. The autonomous drone then drops the package via parachute at the designated area. Zipline improves access to these supplies by flying over impassable mountains and washed-out roads, delivering directly to remote clinics. The supplies are centralised and

provide on-demand deliveries, completely reducing waste and stock-outs. Zipline provides a seamless delivery system at an affordable price, obsessing over every detail, so that healthcare providers can solely focus on patient health. Zipline created national drone delivery system to ship blood and drugs to remote medical centres in Rwanda. Now the company has developed world’s swiftest commercial delivery drone, with a top speed of 128kmph (a hair shy of 80mph) with its extended services in Tanzania.

WORLD’S FASTEST COMMERCIAL DELIVERY DRONE BY ZIPLINE U


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enmark-based company Oticon, a giant hearing solution manufacturer has launched the world’s first hearing fitness tracking technology that helps track hearing aid use and provides insights you can use to optimise your health. The app is based on big data analytics that combine lifestyle and healthcare data with local sound environment analysis and is designed to measure the impact of one’s hearing on their health. This app was declared the winner of the 2018 CES Innovation Award in the software and mobile apps category. Health Fitness gives advice and encouragement to help users hear better and stay healthy.

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women, which makes a solution like this a welcome one. NIRAMAI uses a high-resolution thermal sensing device that scans the chest area like a camera. It then uses cloud-hosted analytics solution for analysing the thermal images. Its SaaS solution uses big data analytics, artificial intelligence and machine learning for reliable, early and accurate breast cancer screening. The innovative methods used in the solution have led to multiple US patents, and their novel algorithms have also been peer-reviewed in international scientific conferences. The startup has already started two clinical trials with established hospitals.

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NIRAMAI: A NOVEL BREAST CANCER SCREENING SOLUTION T his Bangalore-based start-up, founded in 2016, uses artificial intelligence for a pain-free breast cancer screening. Recently, it had successfully raised money to scale up its efforts.The screening method can detect tumours five times smaller than what clinical examination can detect. It is a safe, non-touch, radiation-free, and low-cost method. Since its cost-effective and does not require heavy equipment this solution seems to be ideal for smaller towns where affordable healthcare is the need of the hour. Mammography works only for women over 40 and increasingly there has been a prevalence of breast cancer among young

50,000 digital medical records to doctors and patients every day. The start-up works with more than 650 diagnostic centres across India and Africa to automate their operations i.e. to manage patients, financial transactions etc.

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his is an endeavour to make medical reports smarter. This Pune-based start-up, founded in 2013, works as a management information system for healthcare providers by using Artificial Intelligence to process a huge data of medical records and ERP transactions. The system collects samples, manages patient records, diagnoses them, generates reports and aids in billing and inventory, making the process smarter and more efficient. In nutshell, it’s an effort that digitises diagnostic lab workflows through its SaaS platform and makes them available on the cloud to patients and doctors. Doctors and consultants get access to their patient records using a mobile app and the patients can use the app to understand their reports, analyse their past health data and monitor their health using trackers. Recently the company has raised US$1.1 mil from Nexus

Venture Partners which it intends to use to expand its platform across India, explore international markets and to strengthen the product and technology. LiveHealth's platform has digitised more than 72 million records, so far, and is delivering over

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EARLY DETECTION OF DENGUE A

s per data from the National Vector Borne Disease Control Programme there has been a 5.5-fold increase in dengue cases from 2010-2017. Deaths due to dengue infection have also more than doubled over the same period. Infact there were 28000 more cases in India in 2017 as compared to 2016 making this a huge public concern. Dengue is a mosquito-borne illness that can cause severe flu-like symptoms with possible complications like haemorrhage and shock. Dengue infection may progress to dengue haemorrhagic fever resulting in severe abdominal pain, vomiting, diarrhoea, convulsions, bruising, and uncontrolled bleeding. The most severe form of the illness that is dengue haemorrhagic shock may lead to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, and multiorgan failure. With such complications, fatality is significant. So, missed or even delayed diagnosis is very dangerous. Twothirds of dengue deaths happen due to missed diagnosis making it imperative to have a quick, reliable method for early detection. Taking a step in this direction with its innovative molecular assays, iGenetic Diagnostics, a Mumbaibased facility has come out with a lab test that can detect dengue virus within 24 hours at a very early stage of the infection whereas the existing labs take 3-4 days. iGenetic has also developed a rapid molecular diagnostic test that can identify the serotype of the virus. It is important here because dengue virus has 4 serotypes and once a person has been infected with one serotype, they have lifelong immunity from that serotype. But if a person gets infected again with a different serotype the disease progression is fastened and more severe, thereby proving deadly. So, another advantage is that the test enables detection of dengue from day 1. Thus, the molecular diagnostic approaches to accurately and rapidly diagnose viral infections have been rightfully employed by iGenetic. 36

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LUMENIS M22 OPTIMAL PULSE TECHNOLOGY – AN EFFECTIVE SOLUTION TO TREAT DRY EYES D ry eyes affect millions of adults and its risk increases with advancing age. Keeping this acute eye problem in mind, Lumenis worked in this direction. Lumenis, world’s largest energy-based medical device company for surgical, ophthalmology and aesthetic applications is renowned for its technological breakthroughs in ophthalmic lasers and has a long list of industry gold standards. Lumenis’ latest M22 optimal pulse technology is the answer to a majority of eye inflammation treatments with optimal pulse technology (OPT). Mumbai’s renowned super specialty eye care Ojas Eye Hospital has brought in India Lumenis M22 Optimal Pulse Technology (OPT) for treatment of dry eyes. The latest eye care technology is seen as a great revolutionary value addition to the ophthalmic applications especially for the treatment of dry eyes. The M22 services will be available at two

branches of Ojas Eye Hospital, one at Bandra and the other at Kandivali. Recent studies have showcased prevalence of dry eyes among patients ranging across age groups. Meibomian Gland Dysfunction (MGD) is one of the leading causes of dry eye disease (DED), affecting millions of people worldwide. Optimal pulse technology from Lumenis has emerged as the most effective alternative for patients, leading to significant improvement in ocular surface quality, gland function and dry eye symptoms. The Lumenis M22 OPT is an excellent technology for treating eyelid inflammation. OPT is selectively absorbed in the haemoglobin of abnormal blood vessels and destroys them by thrombolysis thereby treating the root cause of the problem leading to immediate relief, a safe and comfortable, fast ‘lunch time treatment’ and improves the skin appearance too.

arma Healthcare, a Rajasthan-based start-up in the technology-led healthcare space has recently raised INR 3 crores from different investors. The start-up aims to provide high quality, affordable, equitable and reliable healthcare to India’s underserved population via a differentiated business model. The company has combined the human touch of a nurse with the scalability of shared doctor services via real-time online video consultations. It delivers healthcare to consumers via e-Doctor clinics. The effort is to have e-clinics Pan-India. The company thus seeks to make definitive large-scale impact and in-turn take significant

steps towards ‘healthcare for all’. So far, the company has given over 50,000 consultations and currently has 10 e-Doctor clinics in the states of Haryana and Rajasthan. There is a comprehensive ecosystem of clinical treatment, quality medicines and diagnostics at competitive prices. The company has developed an inhouse technology suite that helps it deliver standardised care including a bespoke Clinical Decision Support System and is extending its capabilities to deep learning driven diagnosis, treatment and monitoring. The company has backing from Tata Trusts, UBS Optimus Foundation and WISH Foundation.

KARMA HEALTHCARE K


module uses light emitting diodes (LEDs) in conjunction with a light sensitive sensor to measure the absorption of red and infrared light by the user’s fingertips. By touching a device’s sensors and electrodes with your fingertips, MediaTek Sensio creates a closed loop between your heart and the biosensor to measure

ECG and PPG waveforms. The product is the first 6-in-1 total hardware and software solution, consisting of optical, electrical and processing components which delivers a package of smart health solutions that will help its users to be more informed about their fitness levels. MediaTek Sensio entered the market in the beginning of 2018.

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Compiled by: Dr. Avantika Batish is working as the Director Strategy and Healthcare at International Health Emergency Learning and Preparedness. Also, she is a guest faculty for MBA (HR) and MBA Healthcare Management at various B-Schoolsand is a soft skills trainer. Volume 3 | Issue 3 | July-September 2018

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so in April this year, Lok Nayak Hospital jointly conducted a oneday patient awareness program “Haem Utsav”, e-learning to empower Haemophilia care in India supported by Novo Nordisk, India. An updated Haemophilia India website (www.haemophiliaindia.com) has been launched for e-learning. Delhi Government has won a global award for introducing yoga sutra in Haemophilia, taken up advocacy and capacity building programs, launched skill-based training programs and a self-infusion program and created self-help groups for Haemophilia.

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HAEMOPHILIA CARE IN INDIA H aemophilia is a genetic disorder of blood coagulation due to decreased levels or a complete lack of clotting factors that results in profuse bleeding into joints, muscles or internal organs either spontaneously or as a result of accidental or surgical trauma. Globally, India is among the top ten countries of people living with Haemophilia A1 with about 18000 cases. Studies have revealed that by the age of 25 years, 79% of people with Haemophilia are likely to become severely disabled if proper treatment is not provided. Efforts are being made to tackle this situation,

THEME

ediaTek Inc. recently unveiled MediaTek Sensio, a powerful advanced health monitoring solution which makes it easy to track heartrate information, peripheral oxygen levels, blood pressure trends and more. It is industry’s first 6-in-1 biosensor that turns smartphones into your personal health companion. Sensio delivers six key health data points such as heart-rate, heart-rate variability, blood pressure trends, peripheral oxygen saturation, ECG and photoplethysmography. The product is available as an embedded module in smartphones which makes it possible for consumers to quickly check and monitor their physical fitness. The MediaTek Sensio MT6381 is a comprehensive software and module solution designed specifically to deliver valuable health data, consisting of optical, electrical and processing components. The customizable, compact solution means device manufacturers have the flexibility to embed the MediaTek Sensio module directly into all types of smartphones, versus using multiple sensors. The

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MEDIATEK SENSIO - A BIOSENSOR SOLUTION TO BRING HEALTH MONITORING TO SMARTPHONES M

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Foreign tourists rallying for healthcare

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ccording to Union Minister of State (Independent Charge) for Tourism Mr. K. J. Alphons, the Union Ministry offers financial support as Marketing Development Assistance for Publicity and for organizing Wellness and Medical Tourism Promotion shows as well as workshops/events/seminars to accredited Medical and Wellness Tourism Service Providers and Chambers of Commerce, etc. A film on Medical Tourism has been produced in association with BBC and is used at various fora for promotional purposes; Medical and Medical attendant visa have been introduced to streamline and ease the travel process of Medical Tourists. The e-tourist visa regime has also been expanded to include medical visits. Steps are afoot to set up facilitation counters at the major airports of Bengaluru, Chennai, Delhi, Hyderabad, Kolkata and 38

Mumbai and for tourists arriving on Medical Visas.

Apart from the above, the Department of Commerce and Services Export Promotion Council (SEPC) has launched a Healthcare Portal www.indiahealthcaretourism.com in Arabic, English, French, Russian and other languages as a single source platform providing comprehensive information to medical travelers on the top healthcare institutions in the country. A National Medical and Wellness Tourism Board has also been constituted under the Chairmanship of the Minister for Tourism to provide a dedicated institutional framework to take forward the cause of promotion of Medical and Wellness Tourism including Ayurveda and any other format of Indian system of medicine covered by Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH).

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The Board has members from the Ministries of Health, Commerce, External Affairs, AYUSH, Home Affairs, the National Accreditation Board for Hospitals and Healthcare Providers (NABH) as well as representatives from the major chambers of commerce, hospitals and independent experts in the field of Medicine and Wellness. The Board works as an umbrella organization to promote this segment of tourism in an organized manner. The Board has formed Sub-Committees on visa issues, accreditation, standards, marketing and promotion. The Ministry of Tourism collates data regarding the arrivals on Medical and Medical Attendant visas provided by the Ministry of Home Affairs. In 2014, Foreign Tourists Arrivals (FTAs) recorded were: 1,84,298 (2014); 2,33,918 (2015); 4,27,014 (2016).


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PERSONA THEME TRENDS WELL-BEING ISSUES RESEARCH NEWSCOPE

Contracting lifestyle diseases in adulthood, reveals a recent study By InnoHEALTH Editorial Team

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recent study has found that about 10% of school children in Bengaluru are obese, while 13.8% children are at risk of contracting lifestyle diseases in adulthood with waistlines which are more than half their height.

School-based screening of 104,105 children studying in 138 private schools has revealed some alarming trends on school students in Bengaluru. The study was conducted by AddressHealth, provider of health 40

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services in schools for children in India. The survey data was compiled over the current academic year and revealed a significant degree of malnutrition (both over and under nutrition) among children - with 9.2% of children being obese and another 13.7% children falling in the overweight category (over nutrition) while about 8.5% of them are too thin for their age (undernutrition). Apart from this, 28.6% school children have dental caries (cavities)

while 15.1% have newly detected/ worsening vision problems. In addition, more than 200 children had previously undetected cardiac murmurs, and 70 children had previously undetected hearing defects. Commenting on the survey results Dr. Anand Lakshman, Founder and CEO, AddressHealth, said, “Children are increasingly vulnerable due to a variety of lifestyle and environmental factors such as proliferation of fast food options, lack of physical activity, too much screen time etc. We believe


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KEY FINDINGS OF THE SURVEY:

• About 10% of primary school children are obese and a further 13% children overweight and 9.4% of those in middle and secondary school are too thin; • Vision problems are more common among children in the primary and secondary age group with 1 in 7 and 1 in 5 children affected, respectively; • Dental caries has emerged as the most neglected chronic condition among children; and • Nearly 8% of children have clinical signs of anemia (a non-invasive, more-sensitive test for anemia will probably reveal a much higher prevalence of anemia).

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AddressHealth’s school health services are designed by a team of pediatricians, public health experts, child psychiatrists, psychologists,

nutritionists and other health professionals. The services include Annual Health check-ups for children; Medical Room / Tele-infirmary; School Emotional/Mental Wellbeing Services (Nurturing Schools Program); and Health Education with Workbooks (Standard 1st to 8th). Currently AddressHealth’s services encompass ~ 200,000 children in over 200 schools in Bengaluru, Delhi NCR, Hyderabad & Pune The AddressHealth School Health Program is based on WHO guidelines for schools.

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but rising rapidly in the schools catering to higher income groups and primary and secondary school children. There is an increasing trend of the risk of lifestyle diseases, due to reduced physical activity, which is reflected in the significant percentage of children with a higher than recommended waist-to-height ratio.

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Obesity is seen across income groups

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The number of children covered by the surveys over the last 12 months include 1,04,105 children in Bengaluru, 652 in Delhi, 18,422 in Hyderabad, and 3,288 in Pune. The prevalence of various conditions across these four cities is as follows: obese as per BMI for age standards (8.8%), over-weight but not obese (12.6%), low BMI (8.5%), risk of lifestyle diseases [Waist/Height Ratio>0.5] (14.6%), vision problems (14.6%), and dental caries (29.7%). About 219 and 9101 children are at risk of potential heart defects and clinical anemia, respectively.

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AddressHealth has conducted surveys in 177 schools covering 1,26,467 children across 4 Indian cities including Bengaluru, and data points to similar trends across cities with a high likelihood of chronic diseases in adulthood.

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schools and parents/guardians should place adequate emphasis on children’s health and wellbeing, beyond the usual vaccines and episodes of sickness, failing which non-communicable diseases will only become more common in the younger generation. The times are changing, and new age problems need to be addressed proactively and continuously. The data from our mental health program also suggests a moderate risk of mental health conditions amongst school children such as emotional difficulties, behavioural issues and lack of social skills”. “Schools are not just centers for imparting formal education but also institutions that influence values, beliefs and importantly practices. A healthy lifestyle including hygiene habits must be inculcated during childhood. These positive behaviors will last through to adulthood and for the rest of a person’s life. Children are naturally inquisitive and keen learners. They can thus become both the beneficiaries and the agents of change in the family,” added Dr. Lakshman.


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When travelling on public transport, you may want to cover your ears

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By InnoHEALTH Editorial Team

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he noise levels commuters are exposed to while using public transport or while biking, could induce hearing loss if experienced repeatedly and over long periods of time, according to a study published in the open access Journal of Otolaryngology - Head & Neck Surgery. Efforts to control noise should focus on materials and equipment that provide a quieter environment, researchers at the University of Toronto suggest. Hearing protection while using public transport should also be promoted.

Dr. Vincent Lin, the corresponding author said: “This study is the first to look at and quantify the amount of noise people are exposed to, during their daily commute, specifically on the Toronto Transit System. We are now starting to understand that chronic excessive noise exposure leads to significant systemic pathology, such as depression, anxiety, increased risk of chronic diseases and increased accident risk. Short, intense noise exposure has been demonstrated to be as injurious as longer, less intense noise exposure.” Dr. Lin said: “We were surprised at the overall average noise exposure commuters experience on a daily basis, especially the peak noise intensity not only on trains but also on buses. Planners need to be more considerate of noise exposure in future planning of public spaces and public transit routes. Toronto in particular, as the transit network expands, needs to consider ways to reduce noise exposure as a preventive measure for future health risks.” According to thresholds recommended 42

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To measure noise exposure, the researchers used noise dosimeters, which they carried on their shirt collars about two inches away from their ears. The researchers collected 210 measurements in total, comparing the noise on subways, buses and streetcars, while driving a car, cycling, and walking. They measured invehicle noise and outside or boarding platform noise for all modes of private and public transportation.

by the US Environmental Protection Agency (EPA), exposure to 114 A-weighted decibels (dBA) for longer than four seconds, exposure to 117 dBA for longer than two seconds and exposure to 120 dBA for longer than 20 seconds may put people at risk of noise-induced hearing loss. A-weighted decibels express the relative loudness of sounds experienced by the human ear; taking into account that sensitivity to noise differs depending on noise frequency. Peak noise levels in dBA across both public and personal transport exceeded the EPA recommended thresholds. The average noise levels by bike were greater than any level caused by modes of public transit. Measuring noise exposure on public (subways, trams and buses) and private (cars, bikes, walking) transport in Toronto, the researchers found that while noise on average was within the recommended levels of safe exposure, bursts of loud noise on both public and private modes of transportation could still place individuals at risk of noiseinduced hearing loss.

The authors found that 19.9% of the loudest noises (peak noise) measured on the subway were greater than 114 dBA, while 20% of the loudest noises inside streetcars were greater than 120 dBA. 85% of peak noise measurements from bus platforms were greater than 114 dBA, while 54% were greater than 120 dBA. All peak noise exposures while riding a bike exceeded 117 dBA, with 85% being greater than 120 dBA.

When the authors extrapolated the EPA recommended noise thresholds for an average Toronto commuter who uses public transport, the recommended level of noise exposure was exceeded in 9% of subway, 12% of bus and 14% of biking measurements but not when using streetcars, bikes or when walking. The authors caution that the number of measurements taken for individual modes of transport is relatively low and that the crosssectional nature of the study does not allow for conclusions about cause and effect. Further studies are needed to investigate other factors that may contribute to noise exposure such as use of music players and lengthy transit times.


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Vision on Blindness cure needs aggressive approach

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By InnoHEALTH Editorial Team

Despite current measures, blindness in the world is increasing by 1 to 2 million cases per year – the result is a 100% increase in world blindness by the year 2020 unless more aggressive measures are in place.

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he World Health Organization (WHO) estimates that 80% of visual impairment is either preventable or curable with treatment. As of 2015, there were 940 million people with some degree of vision loss. 246 million had low vision and over 45 million were blind with 60% of these individuals living in China, India and Sub-Saharan Africa. Majority of people with poor vision reside in the developing world and are over the age of 50 years. Visual impairments have considerable economic costs both directly due to the cost of treatment and indirectly due to decreased ability to work. India is home to over 8 million blind people, another 50 million have moderate to severe vision impairment. The loss of sight causes enormous human suffering for the affected individuals and their families. It also represents public health, social and economic problem for countries, especially the developing ones, where 9 out of 10 of the world's blind live. Visual impairment, also known as vision impairment or vision loss, is a decreased ability to see to a degree that causes problems not fixable by usual means. The term blindness is used for complete or nearly complete vision loss. Visual impairment may cause people difficulties with normal daily activities such as driving, reading, socializing and walking. The most common causes of visual impairment globally are 44

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uncorrected refractive errors (43%), cataracts (33%), and glaucoma (2%). Refractive errors include nearsighted, farsighted, presbyopia and astigmatism. Cataracts are the most common cause of blindness. Other disorders that may cause visual problems include age related macular degeneration, diabetic retinopathy, corneal clouding, childhood blindness, and a number of infections. Screening for vision problems in children may improve future vision and educational achievement. According to Mr. J.P. Nadda, Minister of Health & Family Welfare, “The

central government is committed, inter alia, to developing and strengthening the strategy of NPCB towards ‘Eye Health for All’ by way of preventing visual impairment through provisioning of comprehensive universal eyecare services and quality service deliveries”. Mr. Ashwani Kumar Choubey, Minister of State for Health & Family Welfare says, “Despite greater awareness and policy interventions, blindness in the world is increasing phenomenally and according to WHO, unless more aggressive measures are taken, there may be 100 percent increase in blindness by year 2020.


Mr. Santosh Kumar Gangwar, Minister of State, Labour & Employment says, “The traditional core of optometry has been the assessment of visual health and management strategies centered on spectacle lens and contact lens therapy.

providing two-thirds of all primary eye care in India, organised the 37th edition of The All India Optometry Conference during March 30 – April 1, 2018 in New Delhi.

Dr. Rajeev Prasad, Conference Chairman, AIOC 2018 added that “the All India Optometry Conference (AIOC 2018) engaged collective experience & expertise of practitioners, optometrists, industry partners, academia and technology organizations to discuss, deliberate, share & learn the best of practices and leadership traits”.

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Themed “Innovations in Delivery & Access of Eye care”, the conference provided an opportunity to share research, experiences and eye care advancements to participants from all across the country but also facilitated the development of economically viable primary eye care services that are easily

600 plus industry delegates & 20+ exhibitors; thus, offering exceptional value both as a traditional technical conference & a global networking forum”.

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“The role of optometrists in tackling the problem of refractive error and visual impairment is important. Timely detection of refractive errors and their correction by spectacle can not only improve the child’s potential

AIOC 2018 Organising Secretary, Dr. Subodh Dixit said “the 37th AIOC 2018 conference spread over 16 interactive sessions & 10 workshops showcased over 75 prolific speakers, nearly

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Mr. Ashok Siddharth, MP (Rajya Sabha) & Member Parliamentary Standing Committee on Health and Family Welfare noted that “Optometrists today provide approximately two-thirds of all eye care in the country and are prepared to meet the growing needs of the public”.

In the backdrop of the above, Indian Optometric Association, the apex industry association representing approximately 12,000 Doctors of Optometry, optometry students and paraoptometric assistants

WELL-BEING

Mr. Santosh Kumar Gangwar, Minister of State, Labour & Employment says, “The traditional core of optometry has been the assessment of visual health and management strategies centered on spectacle lens and contact lens therapy. This core, however, has expanded greatly over the past century to include a number of other important services. Today's optometry professionals are well educated and well trained to provide the full range of services thereby enhancing vision, protecting health and preventing avoidable blindness due to refractive errors and visual impairment by over 80%”.

Speaking on the occasion, Mr. Anil Tyagi, President, Indian Optometric Association said “AIOC has become synonymous with providing participants from across India & abroad, an excellent opportunity to share their research, experiences & optometry advancements. They sought to generate, from the conference, a better understanding of the role of optometry in erradicating the 80 percent avoidable blindness in India and other developing countries. The key to success would be making primary eye-care services easily accessible &economicaaly viable for common public”

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Optometrists as the first point of contact for primary eye care services and equipped with the requisite knowledge and expertise, thus create a huge impact in preventing this avoidable blindness & vision impairment.

The hard work and devotion of Indian optometrists within their profession and around their communities thus provides an invaluable service to millions of Indian citizens. Without their dedication, desire to serve the community and professionalism in delivering excellent eye care services; our fellow countrymen would not enjoy the optimal vision they have today.

accessible to common public.

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This calls for reducing the backlog of avoidable blindness through identification and treatment of curable blind at primary, secondary and tertiary levels, based on assessment of the overall burden of visual impairment in the country.

during the formative years but also prevent complications associated with uncorrected refractive error” said Dr. Promila Gupta, Director General of Health Services, Ministry of Health & Family Welfare.

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This is highly alarming & needs drastic wholesale measures”.


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Alarming! 26.7 crore tobacco users in India

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s per the Global Adult Tobacco Survey 2017, there are 26.7 crore users of tobacco in India. 5,500 children initiate tobacco use every day. One-third of these tobacco users will die prematurely. Lacs and lacs of Indian families are devastated with tobacco deaths, which are preventable. "Tobacco is the single most preventable cause of death.” Sambandh Health Foundation (SHF) Trustee and Head of Tobacco Control, Sanjay Seth said at a function in Chandigarh recently.

As the adage goes, “Prevention is better than cure”, tobacco is the singlemost preventable cause of death. With the aim of having a tobacco free society, doctors of PGIMER, Chandigarh got together for a meeting to address the tobacco epidemic. Organizing and leading the doctors meet in PGI Chandigarh, Dr. Anand Mishra, Additional Professor, Department of Cardiothoracic

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By InnoHEALTH Editorial Team

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Surgery said, “tobacco is an epidemic killing 10 lac Indians every year. It is the need of the hour that this issue is addressed at all levels in the Government as well as the community.”

An official statement after the meet said, "If we talk about the healthcare costs, the estimated economic cost of tobacco has been estimated at Rs. 1,04,500 crores (US$ 22.4 billion) which is 1.16 percent of the GDP and 12 percent more than the combined State and Central Government expenditures on health (201112). The financial burden due to direct and indirect costs of tobaccoattributable diseases will continue to push families of millions of tobacco users towards poverty and stealthily decelerate the economic growth of the country.”

The Indian Council Medical Research (ICMR) estimates, India will have more than 17.3 lakh new cancer cases and more than 8.8 lakh deaths due to cancer by 2020. 90% of oral cancers and 50% of all cancers

are caused due to tobacco. This will not only affect the individual’s health and the families of the cancer patients, but also adversely affect the economy of the country as a whole, the statement informed.

Dr. Vedant Kabra, Head of Department Surgical Oncology, Manipal Hospitals and Voice of Tobacco Victims (VoTV) patron, said, “tobacco not only destroys physical health but also is a cause of extreme emotional trauma for the cancer patient as well as the family apart from draining them financially.”


Research


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Cyber-Biosecurity: Are we ready? Bertrand Russell once said, ‘War doesn’t determine who is right−only who is left”, thus ‘we need to update, upgrade and be prepared for our own survival’. These words sound more relevant in contemporary phase in the wake of fast changing global scenario and emerging inevitability for updating virtually by spilt of seconds.

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By Dr. Sarita Jaiswal & Manisha Rawat

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malgamation of biotechnological and information technology advancement in 21st century has altered our world at the fundamental level which is evident in the area of health, manufacturing, and food 48

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security. Humankind has also witnessed malicious bugs like Y2K and Wannacry in biological and cyber field respectively. We have reached new landmarks on our understanding of how biological systems work and also discovered ways to

meaningfully manipulate these systems as per our advantage/ requirement. Biotech tools, such as gene drives, can deliberately engineer inheritable genetic traits into wild populations, offering a powerful new way to escape from certain vector-borne


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Recently Jean and coworkers (2018) highlighted the risks of using gene sequencing technologies to corrupt the databases by altering sequences or annotations. In this article, computer scientists designed a DNA sample that when sequenced, resulted in a data file which enabled the hacker to control the sequencing computer remotely and gave access to the hacker to make changes in DNA sequences. These alterations could delay a research program

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acquire and use biological weapon has been significantly eroded.� The security impact of biotech advances goes beyond bioweapon. For example, developments in metabolic pathway engineering also offer opportunities to produce illegal drugs such as heroin. Scientists have already identified how

to make the active compounds in other narcotics, such as for cannabis and precursors of LSD. What if terrorist group or a despotic regime tries to spread modified organisms aimed at striking troops, frightening civilians, or putting food production in disarray? The failed attempt of Japanese cult to obtain Ebola strains from South Africa is one such indicator.

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Over the last five years “technological barriers to

Our life sciences community has been traditionally evolved to operate under an insecure system that expects participants to self-regulate with often no monitoring for security threats. Now that DNA sequencing, synthesis, manipulation, and storage are increasingly digitized, there are more ways than ever for immoral agents both inside and outside of the community to compromise security.

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diseases. Gene editing tools such as CRISPR-CAS9 (Clustered Regularly Interspaced Short Palindromic Repeats associated protein-9 nuclease) are being used globally for quick and precise gene editing. Researchers like to use computers to analyze DNA, operate lab machines and store genetic information. In the health sector, the digitization of biology & metabolic engineering accelerated the development of new vaccines, drugs and painkillers. Agriculture is becoming smarter/digitized, with farmers relying on datadriven decision acquired through sensors planted in the ground, satellites guiding tractor movements and other new practices. But these emerging capabilities come with a whole new category of vulnerabilities and risks.

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causing capital, labor loss or can be used in act of terrorism for uncontrolled production of toxins or infectious agents. To mitigate these risks, the culture of the life sciences community needs to shift from trusting blindly to a highly aware and trained community. This also requires intricate relationships between the computational and experimental dimensions of product development workflows.

The diverse nature of pathogens and toxins with their potential to be used as biowarfare agent (BW) could be attributed to multiple factors. These include infectivity (the number of organisms required to cause disease), virulence (the severity of the 50

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disease caused), transmissibility (ease of spreading from person to person), and incubation period (the time from exposure of a biological agent to the onset of illness). All these attributes are manageable by modern biotechnology and information related to such experimentation trials is key to any covert attack using these for BW. Similarly, in cyber world there is a diversity of malicious codes. These include viruses (programs that replicate in target machinery); worms (self-sustaining programs) and carriers such as trojan horse to perform a legitimate function with malicious activity. Additionally, Botnets, or networks of computers infected with malicious code, can be coordinated to perform

distributed denial of service attacks. For biological weapons, delivery vehicles range from advanced aerial spray technology to contamination of food products or water, while malicious code in cyberspace can be delivered by usage portals, email, web browsers, chat clients, webenabled applications and updates. The cyber threat has expanded dramatically in recent years with a series of damage. Terrorists are using cyber capabilities over traditional methods to target 104 countries including India. Governments and security experts have singled out the life sciences sector as being significantly vulnerable to cybercrime. In cyber security terms, innovation is fast


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These could also be signed to ensure their authenticity. In the case of file sharing, the sequencing files themselves could be signed by verified research groups before uploading them to centralized databases. This is just the glimpse of long list of strategies that need immediate deployment, continuous review and improvement with time.

Ms. Manisha Rawat, MSc (Analytical Chemistry), pursuing her career as knowledge management specialist (contractual) under the project work at INMAS, DRDO. She is well-versed in dealing with variety of chemicals especially paints and their use in artistic objects. She manages a small team of toxicologists and computer engineers for this arduous task.

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For cyber biosecurity, employee training should be given priority. It can greatly increase an organization’s general awareness of these new risks. Similar to biosafety training, cyberbiosecurity training modules and policies should be introduced. Secondly organizations should perform thorough analysis of its exposure to cyber biosecurity risks not covered by existing biosafety and biosecurity policies. Training exercises based on this type of analysis will encourage participants to review their workflows and identify their vulnerabilities. It is high time now to evolve a policy framework

to detect and prevent security threats that may compromise life sciences assets. It includes guidelines on synthetic DNA targeted companies that provide DNA synthesis services to monitor research focus and relates features. Bioinformatics softwares are still not hardened against attack. Encouragement of widespread adoption of standard software best security practices like input sanitization, the use of memory safe languages or bounds checking at buffers, and regular security audits is necessary. Patching still remains challenging as the analysis software are often located in individually managed repositories and not regularly updated. One solution is to use a centralized repository to manage updates and deliver patches, similar to the APT package manager.

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becoming a double-edged sword for life sciences clients. Recently FireEye disclosed threat posed by two Advance Persistent Threat (APT) groups which gained access to the environment of a leading pharmaceutical company for up to three years prior to detection. They stole IP and business data from the victim, information on bio cultures, products, cost reports, and other details pertaining to the company’s operations abroad. There is nothing more important to a pharmaceutical organization than the formula for one of its new drugs.

Dr. Sarita Jaiswal, an exresearch officer at University of Saskatchewan, Canada,is an accomplished Plat Scientist having 15+ years of R&D experience with specialization in cereal and pulse crop biochemistry and genomics. She has been awarded twice for the category of Young Scientist (Indian Society of Plan Physiology and amp; KK Nanda Foundation for Advancement of Plant Sciences).


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Monkeys go for Spa therapy to fight weather stress,WHAT ABOUT YOU? By InnoHEALTH Editorial Team

Y

ou might be virtually on frypan in scorching summer months following valuating mercury and grope for solutions to fight hot climate stress in India. But in contrast, Snow monkeys in Japan ward off weather stress by regular bath in hot springs, a latest study says. Japanese macaques, also known as snow monkeys, have been enjoying regular baths in the hot spring at Jigokudani in Japan for decades – and have even become a popular tourist attraction.

A team of researchers led by Rafaela Takeshita of Kyoto University in Japan have now published the first study to scientifically validate the benefits of this behaviour. These findings indicate how behavioural flexibility can help counter cold-climate stress and have likely implications for reproduction and survival. The study is available in Primates, the official journal of the Japan Monkey Centre, which is published by Springer. Japanese macaques (Macacafuscata) are the most northerly species of nonhuman primates in the world and have adapted to extremely cold winters.

Researchers believed that those living in the Jigokudani Monkey Park in Nagano maintain their normal body temperature due to having thicker and longer fur during winter. These primates are also the only group of monkeys known to take hot spring baths, a behaviour that was first observed in 1963 when a young female was seen in an outdoor hot 54

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spring belonging to a nearby hotel one snowy day.

Other monkeys soon copied this behaviour, and for hygienic purposes, the park management has since built a hot spring for the exclusive use of the monkeys. By 2003, one in every three females in the group bathed regularly in winter. Although the fact that snow monkeys bathe more often during winter suggests that they use the hot spring to stay warm, to date no physiological

is known to influence concentrations of glucocorticoids, which belong to the family of steroid hormones.

The results confirmed that female snow monkeys use the hot spring more often in winter than in spring, and especially during colder weeks. Dominant females benefited from their status and spent longer time bathing, but they were also involved in more aggressive conflicts, resulting in higher energy expenditure than subordinate females. But taking a spa reduced stress hormone levels in those females. So high social status in this group of snow monkeys has a trade-off between the costs of high rank position and the benefits from a hot spring, which is advantageous for conserving energy by reducing loss of body heat and lowering stress levels.

data had been collected to support this idea. Takeshita and her colleagues studied twelve adult females during the spring birth season, from April to June, and winter mating season, from October to December. They determined how much time the monkeys spent in the hot springs, and which monkeys bathed the most. The researchers also collected faecal samples during times of extreme cold and analysed the concentration of faecal glucocorticoid (fGC) metabolite present. This was done because thermoregulatory stress and the management of a body temperature

“This indicates that, as in humans, the hot spring has a stress-reducing effect in snow monkeys,” says Takeshita, who believes that further investigation using serum or saliva samples might be useful to detect whether there are any further shortterm changes in stress levels. “This unique habit of hot spring bathing by snow monkeys illustrates how behavioural flexibility can help counter cold-climate stress, with likely implications for reproduction and survival.”

In addition, Takeshita and her colleagues found that the around 500 visitors per day, who watch the snow monkeys bathe, had no effect on the levels of stress hormones released.


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A new study highlights how portions of brain that temper aggression get veiled when people gulp alcohol

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By InnoHEALTH Editorial Team

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“Although there was an overall dampening effect of alcohol on the prefrontal cortex, even at a low dose of alcohol, we observed a significant positive relationship between

The results are largely consistent with a growing body of research about the neural basis of aggression, and how it is triggered by changes in the way that the prefrontal cortex, the limbic system and reward-related regions of the brain function. The results of the current study are also consistent with several psychological theories of alcohol-related aggression. “We encourage future, largerscale investigations into the neural underpinnings of alcohol-related aggression with stronger doses and clinical samples. Doing so could eventually substantially reduce alcohol-related harm” adds Prof. Denson.

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According to most theories, alcoholrelated aggression is caused by changes in the prefrontal cortex. However, there is a lack of substantial neuroimaging evidence to substantiate these ideas. In this study, Prof. Denson and his team recruited fifty healthy young men. The participants were either given two drinks containing vodka, or placebo drinks without any alcohol. While lying in an MRI scanner, the participants then had to compete in a task which has regularly been used over the past 50 years to observe levels of aggression

The functional magnetic resonance imaging allowed the researchers to see which areas of the brain were triggered when the task was performed. They could also compare the difference in scans between participants who had consumed alcohol and those who hadn’t. Being provoked was found to have no influence on participants’ neural responses. However, when behaving aggressively, there was a dip in activity in the prefrontal cortex of the brains of those who had consumed alcoholic drinks. This dampening effect was also seen in the areas of the brain that are involved. Also, heightened activity was noted in the hippocampus, the part of the brain associated with people’s memory.

dorsomedial and dorsolateral prefrontal cortex activity and alcohol-related aggression,” explains Prof. Denson. “These regions may support different behaviors, such as peace versus aggression, depending on whether a person is sober or intoxicated.”

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The study was led by Prof. Thomas Denson of the University of New South Wales in Australia in the journal Cognitive, Affective, & Behavioral Neuroscience which is an official journal of the Psychonomic Society.

in response to provocation.

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After only two drinks, the researchers noted changes in the working of the prefrontal cortex of the brain, the part normally involved in tempering a person’s levels of aggression.

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A report from Heidelberg, New York says researchers have used Magnetic Resonance Imaging (MRI) scans that measure blood flow in the brain to better understand why people often become aggressive and violent after drinking alcohol.

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new research has found the reason of aggression among people after a drink or two: it is caused because of changes in the working of prefrontal cortex, the part normally involved in tempering a person’s level of aggression.


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Socioeconomic inequalities in children’s weight reversed in the UK between 1953 and 2015

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ince the post-war period, socioeconomic inequalities in children’s weight have reversed in the UK – with disadvantaged children originally being more likely to be thinner than more advantaged children, but now typically being more likely to be overweight or obese, according to an observational study.

Previously, studies of this kind have analysed trends in body mass index (BMI), but not height and weight separately; this study is the first to disentangle the changes behind increasing BMI inequalities over time.

Between 1953 to 2015, the difference in children’s BMI levels between the most and the least disadvantaged children has expanded, however, the difference in children’s height has narrowed, and fewer disadvantaged children are now of short stature. Authors of the study, published in the Lancet Public Health Journal, say that these trends highlight the powerful influence that the obesogenic environment has had on socioeconomically disadvantaged children, with and the failure of decades of previous policies to prevent obesity and related socioeconomic inequalities. “Our findings illustrate a need for new effective policies to reduce obesity and its socioeconomic inequality in children in UK – previous policies have not been adequate, and existing policies are unlikely to be either. Without effective interventions, childhood BMI inequalities are likely to widen further throughout adulthood, 56

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leading to decades of adverse health and economic consequences,” says the lead author Dr. David Bann, UCL, UK.

“Our results illustrate a need for strong additional legislative changes that focus on societal factors and the food industry, rather than individuals or families. Bold action is needed, such as creating further incentives for food manufacturers to reduce sugar and fat content in food and drinks, reduce the advertising of unhealthy foods to children and families, and incentivise the sale of healthier alternatives. The Soft Drinks Industrial Levy is a positive but likely very limited step in the right direction”

The study included data for children born in England, Scotland and Wales from four longitudinal birth cohort studies beginning in 1946, 1958, 1970 and 2001. In the paper, 22,500 children were assessed at the age of 7 years, 34,873 were assessed at the

age of 11, and 26,128 were assessed at the age of 15. At the ages of 7, 11 and 15 years, the children’s height and weight were measured, and BMI was calculated. The child’s father’s occupation was used as a marker of their socioeconomic position, and the association between socioeconomic position and weight was also analysed from childhood and adolescence. On average, the 2001 cohort was taller, heavier and had a higher BMI than the earlier born cohorts.

In all cohorts, the most disadvantaged children tended to be shorter than the least disadvantaged children. However, the difference narrowed over time – with the most disadvantaged 7-year olds being 3.9cm shorter than the least disadvantaged children in the 1946 cohort, whereas the difference in children in the 2001 cohort was 1.2cm.


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The authors note some limitations,

Informatively, this study was funded by Cohorts and Longitudinal Studies Enhancement Resources’ (CLOSER), a collaborative research programme funded by the UK Economic and Social Research Council, Medical Research Council and based at the UCL Institute of Education and was additionally supported by the Academy of Medical Sciences/the Wellcome Trust. It was conducted by researchers from UCL and Loughborough University.

RESEARCH

These include the end of war time rationing in 1954, when diets typically included higher consumption of vegetables, and lower consumption of sugar and soft drinks. Since that time, the food environment has become increasingly obesogenic, and society has become more unequal, which may have particularly impacted on the access to healthy foods among socially disadvantaged families, resulting in increased childhood BMI among these groups. In addition, inequalities in adult BMI emerged in the 1980s, and may have contributed to childhood BMI changes, as parents’ and children’s BMIs are associated.

As BMI does not account for level of fat, it may be an inexact measure of obesity, and could have led to healthy children being miscategorised as overweight or obese. Lastly, father’s occupation is only one aspect of socioeconomic position, although the results remained the same when repeated using mother’s education level.

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Inequalities generally widened with age. By the age of 15 years, BMI inequalities were present across all cohorts except the 1946 cohort and were largest in the 2001 cohort (1.4 kg/m2 difference between the most

Explaining the differences in childhood height, weight and BMI since the post-war period, the authors point to the considerable changes to diets and physical activity levels in Britain.

including that most children enrolled were white, so the findings cannot be generalised to all ethnic groups in Britain. They also note that dropout rates were higher in more disadvantaged children, which could result in BMI inequalities being under or overestimated.

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As a result of the weight and height changes, BMI inequalities were larger and apparent earlier in childhood in the 2001 cohort than in the earlierborn cohorts. In the 2001 cohort, the most disadvantaged 7-year olds had a BMI that was 0.5 kg/m2 greater than the least disadvantaged children.

and least disadvantaged teenagers, compared with a difference of 0.4kg/ m2 and 0.6 kg/m2 for the 1958 and 1970 cohorts, respectively).

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At the same time, differences in weight reversed, with lower socioeconomic position being associated with lower childhood and adolescent weight in the 1946, 1958 and 1970 cohorts, but with higher weight in the 2001 cohort. For example, the most disadvantaged 11-year olds weighed 2kg less than the least disadvantaged children in the 1946 cohort, however in the 2001 cohort, the most disadvantaged 11-year olds weighed 2.1kg more than the least disadvantaged children.


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InnovatioCuris hosts delegation from Shenkar College of Engineering and Design, Israel on 1st May 2018

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Delegation visit by Dr. Ehud Menipaz, Dean and Dr. Meira Levy, Senior Lecturer of Shenkar College of Engineering and Design, Israel during an interaction with Dr. V K Singh, Managing Director and team of InnovatioCuris, India

Sachin Gaur, Director of InnovatioCuris signed MoU with Shampa Bari, Project Manager at Swecare in Sweden during VITALIS 2018 58

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LaQshya Programme for pregnant women & new born aims at achieving tangible results within 18 months

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By InnoHEALTH Editorial Team

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ith an aim for improving quality of care in labor room and maternity operation theatres, the Union Ministry of Health and Family Welfare has recently announced the launch of program ‘LaQshya’.

The Program aims at implementing ‘fast-track’ interventions for achieving tangible results within 18 months. Under the initiative, a multi-pronged strategy has been adopted such as improving infrastructure upgradation, ensuring availability of essential equipment, providing adequate human resources, capacity building of healthcare workers and improving quality processes in the labour room.

Informatively, India has come a long way in improving maternal survival as Maternal Mortality Ratio (MMR) has reduced from 301 maternal deaths in 2001-03 to 167 in year 2011-13, an impressive decline of 45% in a decade. India is further committed to ensuring safe motherhood to every pregnant woman in the country. A transformational improvement in the quality of care around childbirth relating to intrapartum and immediate postpartum care shall dramatically improve maternal and newborn outcomes.

According to official sources, the Program will improve quality of care for pregnant women in labour room, maternity operation theatre and obstetrics Intensive Care Units (ICUs) and High Dependency Units (HDUs). 60

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LaQshya program is being implemented at all Medical College Hospitals, District Hospitals and First Referral Units (FRU) and Community Health Centers (CHCs); it will benefit every pregnant woman and newborn, delivering in public health institutions.

‘LaQshya’ will reduce maternal and newborn morbidity and mortality, improve quality of care during delivery and immediate post-partum period and enhance satisfaction of beneficiaries and provide Respectful Maternity Care (RMC) to all pregnant women availing public health facilities. To strengthen critical care in Obstetrics, dedicated Obstetric ICUs at Medical College Hospital level and Obstetric HDUs at District Hospital are operationalized under

LaQshya program.

The Quality Improvement in labour room and maternity OT will be assessed through NQAS (National Quality Assurance Standards). Every facility achieving 70% score on NQAS will be certified as LaQshya certified facility. Furthermore, branding of LaQshya certified facilities will be done as per the NQAS score. Facilities scoring more than 90%, 80% and 70% will be given Platinum, Gold and Silver badge accordingly. Facilities achieving NQAS certification, defined quality indicators and 80% satisfied beneficiaries will be provided incentive of Rs. 6 lakh, Rs. 3 lakh and Rs. 2 lakh for Medical College Hospital, District Hospital and FRUs respectively.


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Having considered the common demand by the students not to subject them to an additional licentiate exam for getting license to practice, the Cabinet has approved that the final MBBS examination would be held as a common exam throughout the country and would serve as an exit test to be called the National Exit Test (NEXT). Thus, the students would not have to appear in a separate exam after MBBS to get license to practice. NEXT would also serve as the screening test for doctors with foreign medical qualifications to practice in India.

Provision of Bridge course for

AYUSH practitioners to practice modern medicine removed: the provision dealing with bridge course for AYUSH practitioners to practice modern medicine to a limited extent has also been removed. It has been left to the state governments to take necessary measures for addressing and promoting primary health care in rural areas.

Fee regulation for 50% seats in private medical institutions and deemed universities: the maximum limit of 40% seats for which fee would be regulated in private medical institutions and deemed universities has been increased to 50% seats. Further, it has been clarified that the fee would also include all other charges taken by the colleges.

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The Government has considered the recommendations made by the Standing Committee in its report tabled in the House on 20th March 2018 and general feedback, particularly the views of medical

students and practitioners regarding certain provisions of the Bill.

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he Government has approved a slew of amendments to the National Medical Commission (NMC) Bill. According to the official sources, these Amendments to the NMC Bill come in the backdrop of its consideration in Lok Sabha and subsequently being referred to the Department Related Parliamentary Standing Committee (DRPSC). The Union Cabinet chaired by Prime Minister Mr. Narendra Modi has approved these changes.

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By InnoHEALTH Editorial Team

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National Medical Commission (NMC) Bill faces rough weather


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Number of nominees from States and UTs in NMC increased from 3 to 6: responding to the demands from states to increase their representation in the NMC, the nominees of States and UTs in the NMC have been increased from 3 to 6. The NMC will comprise of 25 members of which atleast 21 will be doctors. Monetary penalty for a medical college non-compliant with the norms replaced with provision for different penalty options. Another major concern gathered during discussion with stakeholders was the wide range of monetary penalty, ranging from one half to ten times the annual fee recovered from a batch, to be imposed in a graded manner on a medical college non-compliant with the norms. The clause has been replaced with a provision which provides different options for warning, reasonable monetary penalty, reducing intake, stoppage of admission leading up to withdrawal of recognition. Stringent

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Amendments among other things include: final MBBS examination to be held as a common exam across the country and would serve as an exit test called the National Exit Test (NEXT). Thus, the students would not have to appear in a separate exam after MBBS to get license to practice. NEXT would also serve as the screening test for doctors with foreign medical qualifications to practice in India.

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punishment for unqualified medical practitioners or quacks: the government is concerned about the quality and safety of health care being made available to the citizens and the need to act strictly against unqualified practitioners or quacks. The punishment for any unauthorized practice of medicine has been made severe by including a provision for imprisonment of up to one year along with a fine extending up to Rs. 5 lakhs. On the other hand, country’s apex body of doctors Indian Medical Association (IMA), which has been on a nationwide march from 25th February 2018 to deprecate the current form of the NMC Bill, protested in Delhi in the last week of March 2018 and held Mahapanchayat at Delhi’s Indira Gandhi Stadium. The IMA has strongly opposed the draft Bill that seeks to replace the Medical Council of India with a new body, claiming it will cripple

the medical profession. "The bill, which has the potential to adversely alter the course of medical education and healthcare delivery in India, will also make irrevocable damage if passed in its current form," IMA's General Secretary Dr. R N Tandon had said. IMA’s National President, Dr. Ravi Wankhedkar had said, vehemently opposing the commission, IMA has organized a march across India.

Informatively, IMA, a selfregulating body run by doctors, has over 1,725 local branches across the country and has held simultaneous yatras across the country to generate awareness among masses. Earlier this month, the IMA had organized a cycle rally across India with an aim to sensitize the masses about the issue. According to the Bill, the government can fix the fee for only 40 percent of the seats in private medical colleges. "As the remaining 60 percent of seats does not come under the guidelines, the colleges shall be charging the higher fee. This clause is paradoxical in nature and makes it pro-rich reservation system," Dr. Tandon had said.

"If functional, this means that the present ratio of 15 percent allotted to private and deemed universities for charging high fees stands augmented to the entire 60 percent which itself is a real travesty of its kind," he added. The IMA is also opposing the clause in the bill which calls for allowing practitioners of traditional medicine system to pursue modern medicine.


It says the owners have the right to privacy, security and confidentiality of their digital health data. The owners have the right to give or refuse consent for generation and collection of such data.

The Ministry of Health and Family welfare plans to set up a nodal body in the form of "National Digital Health Authority" through an Act of Parliament as a statutory body for promotion/adoption of e-Health standards, to enforce privacy & security measures for electronic health data, and to regulate storage & exchange of Electronic Health Records.

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Under the proposed Act, the National

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The Act also talks about a health information exchange, a National eHealth Authority and a State Electronic Health Authority. These three authorities shall be duty-bound to protect the privacy, security and confidentiality of the owner’s digital health data.

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Digital Information Security in Healthcare Act will be an Act to provide for establishment of National and State eHealth Authorities and Health

The draft Digital Information in Healthcare Security Act (DISHA) makes it clear that any health data

including physiological, physical & medical records, sexual orientation, history and biometric information are the property of the person who it pertains to.

WELL-BEING

The purpose of the Act is to provide for electronic health data privacy, confidentiality, security and standardization and provide for establishment of National Digital Health Authority and health information exchanges and such other matters.

The Act shall come into force on such date as the Central Government may, by notification, appoint; and different dates may be appointed for different States and for different provisions of this Act.

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The draft act has been placed in open for stakeholders’ take on that. The proposed legislation is harsh on prowling data poachers with stringent punishment that entails five years imprisonment and a fine of Rs. five lakhs.

Information Exchanges; to standardize and regulate the processes related to collection, storing, transmission and use of digital health data; and to ensure reliability, data privacy, confidentiality and security of digital health data and such other matters related and incidental thereto. This Act may be called Digital Information Security in Healthcare Act (DISHA) and it extends to whole of India except the State of Jammu and Kashmir.

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ognizant of fact that the data breach incidents have deluged various sectors, including highly personal and sensitive data on individual’s health profile, the Union government is all set to create a new narrative in the health sector by unveiling its plan for digital health security act.

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Screws on Health Sector Data Poachers being tightened; Digital Information Security in Healthcare, Act (DISHA) on cards


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eHealth Authority of India (NeHA) will be established by the union government. It will have a full time Chairperson; a member secretary; equivalent to the rank of Joint Secretary to the Government of India. Four full-time members will by appointed by the union government. And these will be from health informatics, public health, law and public policy. Four ex-officio members, not less than the rank of Joint Secretary will also be there.

The NeHA or its representative shall have the right to inspect all such records, or access the premises, including virtual premises of the health information exchange or exchanges at any time. The draft specifically says the rights of the owner of digital health data: an owner shall have the right to privacy, confidentiality and security of their digital health data, which may be collected, stored and transmitted in such form and manner as may be prescribed under this Act. An owner shall have the right to give or refuse consent for the generation and collection of digital health data by clinical establishments and entities, subject to the exceptions provided in Section 29 of the Act.

Digital health data, whether identifiable or anonymized, shall not be accessed, used or disclosed to any person for a commercial purpose and in no circumstances be accessed, used or disclosed to insurance companies, employers, human resource consultants and pharmaceutical companies, or any other entity as may be specified by the central government. The draft says that the insurance companies shall not insist on accessing the digital health data of 64

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persons who seek to purchase health insurance policies or during the processing of any insurance claim. The Act is clear on the ownership of digital health data. The digital health data generated, collected, stored or transmitted shall be owned by the individual whose health data has been digitized. A clinical establishment or Health Information Exchange shall hold such digital healthcare data referred to in sub-section (1) in trust for the owner. A health information exchange shall maintain a register in such form and manner as may be prescribed by the central government, containing all details of the transmission of the digital health data between a

health data accessed within the meaning of this section, in such form and manner, as may be specified by the NeHA. A clinical establishment, health information exchange, State Electronic Health Authority and NeHA, shall be duty bound to protect the privacy, confidentiality, and security of the digital health data of the owner.

Any other entity, which has generated and collected digital health data, shall be duty bound to protect the privacy, confidentiality, and security of the digital health data of the owner. The Central Adjudicatory Authority shall sit at New Delhi and the State Adjudicating Authorities shall

clinical establishment and health information exchange, and between heath information exchanges inter se.

ordinarily sit at the State Capitals.

All clinical establishments and health information exchanges shall maintain a register in a digital form to record the purposes and usage of digital

The Central Adjudicating Authority and State Adjudicatory Authorities shall, for the purposes of this Act, have the same powers as are vested

In cases, where access to digital health data is necessary for investigation into cognizable offences, or for administration of justice, such access may be granted to an investigating authority only with the order of the competent court.

The Adjudicating Authority shall not be bound by the procedure laid down by the Code of Civil Procedure, 1908 (5 of 1908) but shall be guided by the principles of natural justice and, subject to the other provisions of this Act, the Adjudicating Authority shall have powers to regulate its own procedure.


The terms “dishonestly” and “fraudul-

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No civil court shall have jurisdiction to entertain any suit or proceeding in respect of any matter which the Central Adjudicatory Authority or the State Adjudicatory Authority is empowered by or under this Act to determine and no injunction shall be granted by any court or other authority in respect of any action taken or to be taken in pursuance of any power conferred by or under this Act.

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Any person aggrieved by any decision or order of the Central Adjudicatory Authority may file an appeal to the High Court within sixty-days from the date of communication of the decision or order of the Adjudicatory Authority to him on any question of law or fact arising out of such order. Provided that the High Court may, if it is satisfied that the appellant

WELL-BEING

Every proceeding under this section shall be deemed to be a judicial proceeding within the meaning of Section 193 and Section 228 of the Indian Penal Code (45 of 1860).

It has proposed to set up a nodal body in the form of "National Digital Health Authority" through an Act of Parliament as a statutory body for promotion/adoption of eHealth standards, to enforce privacy & security measures for electronic health data, and to regulate storage & exchange of electronic health records.

Compensation for serious breach of digital health information (1) a person or an entity committing a serious breach of digital health information shall be liable to pay damages by way of compensation to the owner of the digital health data in relation to which the breach took place. (2) Where any compensation has been awarded under sub-section (2) of section 37, it shall be taken into account when determining the claim made by the person affected. Penalty for failure to furnish information, return or failure to observe rules and directions, etc.

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All persons so summoned shall be bound to attend in person or through authorized agents, as the Adjudicating Authority may direct, and shall be bound to state the truth upon any subject respecting which they are examined or make statements and produce such documents as may be required.

“Any person who commits a serious breach of healthcare data shall be punished with imprisonment, which shall extend from three years and up to five years; or fine, which shall not be less than Rs 5 lakhs. Provided that, any fine imposed as part of sub-section (2) may be provided to the individual whose data is breached, by the court, as it deems fit as compensation,” the draft says.

ently” shall have the same meaning as assigned to them under the Indian Penal Code, 1860. Any person who commits a serious breach of health care data shall be punished with imprisonment, which shall extend from three years and up to five years; or fine, which shall not be less than Rs. 5 lakhs. Provided that, any fine imposed as part of sub-section (2) may be provided to the individual whose data is breached, by the Court, as it deems fit as compensation.

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(a) Discovery and inspection (b) Enforcing the attendance of any person, including any officer of a Clinical establishment or a health information exchange and examining him on oath (c) Compelling the production of records (d) Receiving evidence on affidavits (e) Issuing commissions for examination of witnesses and documents (f) Any other matter which may be prescribed by the Central Government

was prevented by sufficient cause from filing the appeal within the said period, allow it to be filed within a further period not exceeding sixty days.

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in a civil court under the Code of Civil Procedure, 1908 (5 of 1908) while trying a complaint in respect of the following matters, namely:

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Like if any person required under this Act or any rules made thereunder, fails to furnish any information or document or books or returns or reports etc., within the time specified, to NeHA, or the State Electronic Health Authority, as the case may be, shall be liable to a penalty of minimum Rs. 1 lakh and Rs. 10,000 for each day during which such failure continues subject to a maximum of one crore rupees.

Obtaining the digital health information of another person: Whoever, fraudulently or dishonestly, obtains the digital health information of another person, which he is not entitled to obtain under the Act from a person or entity storing such information shall be punished with imprisonment for a term which shall extend up to one year or fine, which shall be not less than Rs. 1 lakh; or both. Data theft: Whoever intentionally and without authorization acquires or accesses any digital health data shall be punished with imprisonment for a term, which shall extend from 66

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three years up to five years or fine, which shall be not less than Rs. 5 lakhs; or both. No court shall take cognizance of any offence punishable under this Act or any rules or regulations made thereunder, save on complaint made by the central government, State Government, the NeHA, State Electronic Health Authority, or a person affected. No court inferior to that of a Court of Sessions shall try any offence punishable under sections 38, 41 and 42 of this Act.

The draft says where a person committing a contravention of any of the provisions of this Act or of any rule, direction or order made thereunder is a company, every person who, at the time when the contravention was committed, was incharge of and was responsible to the company, for the conduct of the business of the company, as well as the company shall be deemed to be guilty of the contravention, and shall be liable to be proceeded against and punished accordingly. Provided that nothing contained in this sub-section

shall render any such person liable to punishment if he proves that the contravention took place without his knowledge or that he exercised all due diligence to prevent the commission of such contravention.

Notwithstanding anything contained in sub-section (1), where a contravention of any of the provisions of this Act or of any rule, direction or order made thereunder has been committed by a company and it is proved that the contravention has taken place with the consent or connivance of, or is attributable to any neglect on the part of any director, manager, secretary or other officer of the company, such director, manager, secretary or other officer of the company shall also be deemed to be guilty of the contravention and shall be liable to be proceeded against and punished accordingly. Note: There are many other rules and provisions in the draft and details have been posted by the Health Ministry in public domain for reactions. This article has touched a few points to highlight basic features.


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One Government Medical College in each State of India By InnoHEALTH Editorial Team

Phase–II of the scheme for establishment of 24 new medical colleges has been approved by the Cabinet Committee on Economic Affairs in its meeting held on 7th February 2018.

However, detailed project report for Samastipur was not approved as the existing District Hospital land area does not fulfill the minimum land area requirement prescribed under IMC Act, 1956 for establishment of new medical college.

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The objective of the Phase–II of the scheme is ensuring the availability of one medical college in every 3 Parliamentary Constituencies and one Government medical college in each State.

Three districts in Bihar namely Purnia, Saran (Chhapara) and Samastipur were identified under Phase–I of the above scheme to establish new medical colleges. The medical colleges at Purnia, Saran (Chhapara) have been approved.

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Under Phase–I of the scheme, 58 districts in 20 States/UT have been selected. Out of these, 56 colleges have been approved and a sum of Rs.5,188.42 crores has been released

to the States/UT. 8 colleges under Phase – I are functional.

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he Minister of State (Health and Family Welfare) Mr. Ashwini Kumar Choubey has informed the upper house of Parliament recently that his ministry is administering a Centrally Sponsored Scheme to establish new medical colleges attached with existing District/Referral Hospitals in underserved areas of the country.

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ICMeets;Disruptivetechnologies well suited to save environment By Parthvee Jain

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n 7th April 2018, a gush of fresh air of innovative ideas buffeted gently a modest wood paneled auditorium in central Delhi as two enterprising innovators unveiled their ongoing disruptive technologies - based projects to depollute air and save thousands of litres of water as well as million units of electricity. As audience clung to these innovators’ narratives in rapt attention, another eminent speaker Denny John dwelt at length on an absorbing theme of how to assess a healthcare technology for larger interest of society. “Mine is a disruptive technology”, a lanky

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This is the age of Disruption, Sebastian Thrun, computer scientist says, and hits bull’s eye.

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but hefty new age entrepreneur stole lime light at the meet as he, in his baritone voice, said as an industry always have tremendous appetite for future technologies and thereby revolutionize deliverable. He was Monish Bhandari of OptiMaserTM which works for disinfection of hospital wastes including many other things.

An engineer, who appeared firmly grounded and did not betray any sign of tremendous potential his “Shudh Vayu” and “Swasthgram” campaign holds for the society by cleaning tons of carbon in air by a simple filter on roofs of cars threw light on his

disruptive innovation for combating menace of spiking pollution plaguing many cities.

The engineer Amit Bhatnagar said 920,000 children die under 5 years due to air pollution worldwide. In Delhi, it is 3000 in 365 days, almost 8 deaths per day, according to UNICEF report. Air Pollution inhaled during pregnancy can cross the placenta and affect the developing brain of a fetus. Swasthgram and Shudh Vayu was founded by Mr. Amit Bhatnagar and his common friends. Mr. Amit Bhatnagar is an IITian turned into social entrepreneur. He did his M.S.


PERSONA THEME TRENDS A systematic evaluation of the properties of a health technology, addressing its direct and intended effects, as well as its indirect and unintended consequences, to inform

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Being an Associate Editor for IJTAHC and Cost Effectiveness and Resource Allocation journals, he has also conducted various workshops on SR, EE and HTA training for over 300 members in Nepal, Ghana and India. Under his literature, he has

The interventions used to promote health, to prevent, diagnose or treat acute or chronic diseases, or for rehabilitation which includes pharmaceuticals, devices, procedures and organisational systems used in healthcare, defines healthcare technology says Mr. John. After he made listeners to understand what healthcare technology is, he guided them to understand what exactly HTA (Healthcare Technology Assessment) is.

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Marking a step forward towards its promise of providing an encouraging platform to young innovators and innovative startup of health sector, InnovatioCuris organized its fourth IC Innovators Club meeting that day. A date well chosen, celebrating World Health Day, InnovatioCuris called on industry leaders to stand up to the pledges and join hands to take concrete steps to advance #HealthcareForAll.

10 peer-review publications on SR, EE and HTA, 2 book-chapters on Pharmacoeconomics, and 1 book on Systematic Reviews. Co-guiding 1 Masters and 2 PhD students in HTA. He is a task force member on National Registry of Injuries in India. He is also a co-researcher on cost-effectiveness analysis of glaucoma screening in cataract camps.

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The Saturday morning’s meet was a gathering of young innovators and industry experts in a conference hall in the national capital’s prestigious India International Centre to learn how to assess a healthcare technology for a beneficial outcome for the society.

We live in a culture where everyone's opinion, views and assessment of situations are twisted on social media if feared and hated by environmentalists (industry name say) and the public alike. Yet many a times, the scientific assessment of technology is remarkably different and tells all together a different story. And we all know we become what we behold, we shape our tools and then our tools shape us. So, assessment of any new tool or technology is very important. With this agenda, Denny John addressed the listeners which within no time compelled them to shed away their morning blues. Mr. John holds an external PhD in HTA from Maastricht University, Netherlands on cost effectiveness of vaccines related to infectious diseases in India. He is also an adjunct Scientist with ICMR-NIMS.

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in Bio-Engineering from Penn State (US) in 2007 and B.Tech in Mechanical, Hollywood (USA). After relocating to India, he started envisioning his life’s goal and along with common friends established Swasthgram in 2012. He uses disruptive technology, innovated & especially designed to cater all healthcare needs.


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decision-making is HTA. He explains, not only the assessment of the technology but also the evaluation and calculation of any input that goes into the delivery of the technology will be covered under HTA.

Narrating the story about BEMPU, a hypothermia monitoring device, he made a strong point that one should practice evidence-based approach, that stating evidence is very important not only while assessment of a technology but also in day-to -day healthy lifestyle habits. This gives context-specific inputs into the decision-making process at policy and organisational levels.

Evidence-based practice, Health economic evaluation, Policy and market analysis are the formation bricks of the architecture of HTA where Social aspects is also another brick in the wall catering its stakeholders, patients, health professionals, industry, third party players and the government with trust and a good decision-making capability. A feedback from any stakeholder is always a good approach to perform analysis of your technology says Mr. John. Especially when it comes to the customers, patients as (here) the case is, patient engagement is a huge buzz topic and knowing your customer is a great idea to improve. Taking feedback whether they are willing and are comfortable in using the technology and how they feel about the integration of it in their life could give you the taste of your own drug.

So, what is evidence-based practice? Evidence-based approach is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual. Mr. John emphasizing on the usage and reporting of the evidence says, “wherein day-to-day life reporting of evidence is weak, the evidence should be taken based on the studies from multiple trials and research studies and not from a single study or trial�. After stressing on the importance 70

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brand value, potential & technical excellence of OptiMaserTM & its futuristic new Avatars.

for stating the evidence he also explained the impact and need of economic evaluation analysis which addresses the additional health benefit gained from investment in a technology, such as the cost per additional Quality Adjusted Life Year (QALY) gained, by comparison of that technology to a different intervention or to no intervention. Another important component of this valuable session was Budget Impact Analysis (BIA). Mr. John told that BIA addresses the affordability of the technology, such as the net annual financial cost of adopting the technology for a finite number of years.

All this directly or indirectly contributes to the assessment of healthcare technology that one plans to adopt and present. In addition to this, he also explained briefly about the ways a person can perform the economic evaluation of the technology under observation like cost effective analysis, cost benefit analysis or be it cost utility analysis. Mr. John also walked listeners through the schematic structure of Health Technology Assessment in India (HTAIn). Also, telling about how patients and consumers can be engaged in HTA, what all parameters are there on which they can evaluate the technology and how it would be beneficial for the same. Mr. Monish Bhandari said post signing of the CITAR incubation MoU on 2nd May 2017, the entire aura of the association has fast tracked with translating the lab research to commercial success, augmenting the

OptiMaserTM potential in excess is exemplified by the fact that it can achieve systematic volumetric heating for disinfection with its mobility in any diverse industry environment. CITAR’s clinical ability to instantly establish protocols, validate clinical results has given OptiMaserTM the required thrust to develop dedicated cycles for: medical waste disinfection; OT instrument disinfection; blood bag disinfection; dialyzer disinfection; linen disinfection; Bactec (BD) bottle disinfection and animal bedding (rice husk & corn cob) disinfection. He said that the technology being pursued by them, saves hundreds of litres of water and electricity consumption while disinfecting hospital wastes - many prestigious institutions are adopting the mode. The IC meeting came to an end after a very provocative question and answer session.

Ms. Parthvee Jain is an engineering graduate with specialization and interests in fields like Biotechnology, Healthcare, Food Processing and Nutraceuticals. Connecting European Healthcare innovation leaders with the Indian healthcare system and pioneers, she heads the market access program and partnerships at InnovatioCuris: impacting organizational performance through expert research, analysis and evaluating market competitive conditions, current and emerging trends, and industry-specific solutions.


InnoHEALTH magazine - volume 3 issue 3 - July to September 2018  
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