InnoHEALTH magazine volume 2 issue 4 - October to December 2017 by innohealthmagazine

An Initiative of

Indiaâ&#x20AC;&#x2122;s First Magazine of Healthcare Innovations Volume 2 | Issue 4 | Oct-Dec 2017

Special Report on InnoHEALTH 2017

INNOVATIVE APPROACH TO A HEALTHY LIFE 1

Volume 2 | Issue 4 | Oct-Dec 2017

INR 100/-

Volume 2 | Issue 4 | Oct-Dec 2017

Contents TRENDS

POLICY

11 DocsApp 13 Fetal Medicine Makes

56 The startup coordi

Treatment Of Abnor malities in the unborn child possible

nates and e-health destination

15 ‘TRAVEL NINJA’

India’s first travel insur ance chatbot

WELL BEING

PERSONA 64 THE DYNAMIC TRIO

60 Travelling abroad 61 Opening Up A

New Paradigm In Healthcare

ISSUES 68 Food For Thought 70 Real Time Patient

Monitoring System

WOMEN’s CORNER 74 A

Breast Lump? Here’s Why You Shouldn’t Panic

77 Dance Therapy: A Paradigm Shift

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Editor-In-Chief: Dr V K Singh

Executive Editor: Sachin Gaur

Editors: Alok Chaudhary Dr Avantika Batish Nimisha Singh Verma

Production Editor: Vigyan Arya

Assistant Editor Kanika Chauhan

Designers Pankaj Singh Rawat Abdul Gaffar

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

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

Printed and Published by Sachin Gaur on behalf of InnovatioCuris Private Limited. Printed at Poonam Printers, C-145, Back side Naraina Ind. Area, Phase I, New Delhi. Published at E-2/9, First Floor, Malviya Nagar New Delhi 110017. Editor: Sachin Gaur. DCP Licensing number: F.2.(I-10) Press/2016 ÂŠ InnovatioCuris Private Limited. All rights reserved. Neither this publication nor any part of it maybe 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. Editorial Design & Production: Indus Inc. #1 Ganga Apt., Alaknanda, New Delhi-19 Tel. : 011-41704107; e-mail: info@indusinc.co; www.indusinc.com 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 advertiserâ&#x20AC;&#x2122;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.

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EXECUTIVE OPINION

Improvisation, Jugaad, Innovation, Indovation and Invention, what it means

Innovation has become buzz word and being used by many without even knowing its meaning and difference in improvisation, Jugaad, innovation, indovation and Invention. It would be appropriate to explain these terms for benefit of many. Improvisation: Process of devising a solution to a requirement by making-do, despite absence of resources that might be expected to produce a solution. Jugaad: A colloquial Hindi-Urdu word that can mean an innovative fix or a simple work-around, used for solutions that bend rules, or a resource that can be used as such, or a person who can solve a complicated issue Innovation: The process of translating an idea into a good or service that create value for which customer will be ready to pay and replicate at economic cost. There are various types of innovations like process and product innovations, frugal Innovation, reverse Innovation, disruptive innovation, IndovationandInnovation Excellence Indovation: It is an abbreviation of Indian innovation, conceptualised in 2009 by Navi Radjou, the executive director of the Centre for India & Global Business at Judge Business School, University of Cambridge Invention: New scientific or technical idea, and the means of its embodiment or accomplishment. To be patentable, an invention must be novel, have utility, and be non-obvious. To be called an invention, an idea only needs to be proven as workable. Every person interested in innovation need to know that what internet age provides... “Just about anyone can have an idea at breakfast, design it with online CAD software, produce a prototype on a 3D printer, receive financing and market analysis from a crowd funding site, rent supercomputer time from Amazon, contract a manufacturer and be done by lunch without even leaving the table”.

www.innovationexcellence.com/blog/2014/05/18/5-thingsmanagers-should-know-about-the-big-data-economy/

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To make everyone aware what innovation means if they need to work on it either by start-up or otherwise we have created a knowledge platform InnovatioCuris (IC) to delineate innovations in healthcare to reduce healthcare delivery cost and yet keep quality. The dissemination of knowledge is done through International InnoHEALTH conference and registered magazine with same name, complimentary webinars, training and Innovators’ club. In fact, this issue gives post conference and club glimpses, which included young innovators award and nine companies of European Union participated to bring healthcare innovations suiting Indian needs. B2B meetings in Delhi and Bangalore were organized, to learn from each other’s experiences. In case you missed conference or wish to refresh moments this issue will update you. We are also encouraging grass root innovations from far and wide. The next paragraph explains how developed countries take Indian innovations. Alexander Blass, CEO of Innovation Institute of America, Inc. and winner of Top Innovator of the Year award states, “It is no secret that many of the world’s top innovators come from India. Within the past few decades, India has embarked upon an incredible transformation from an agrarian-based society to a knowledge-based economy. Along with the population growth came survival instincts and the need to be different, better and unique. One can see innovation everywhere in India, whether in large game changing innovations that garner lots of publicity, or in less obvious yet important incremental fashions” Hence join in many initiatives of IC a knowledge and hand holding platform to take innovation in healthcare forward which is need and national movement of country, buzz word of innovation is to be converted into reality for benefit of community through participation of all stakeholders.

Dr VK Singh Editor in Chief & MD, InnovatioCuris

Feedback:

A Brief Review on InnoHealth

Thanks for an impeccable event and we wish InnoHEALTH 2018 bigger success. Hope the business meetings and contacts made at the event results in meaningful business outcomes for all. Karthik Anantharaman Chief Marketing Officer Vice President – Marketing BPL Medical Technologies, India It was a pleasure and a privilege to be part of the InnoHEALTH conference and the Innovators Club experience. I enjoyed some of the sessions and the experiential knowledge in this domain so freely shared by all, was most fascinating and gratefully accepted. I wish you many such successful ventures ahead and if I can contribute in any way, it would be a great. Santanu Biswas Founder & Chief Executive Officer Resident Logic ConsultInc., FZE United Arab Emirates Thank you for the very productive and informative conference. Was a pleasure being associated with it and meeting some fantastic people. Dr Rahil Qamar Siddiqui C-Founder, Eventus, India Thanks for sharing wonderful memories and giving me an opportunity to be part of this landmark event. Great team work. Kudos to all of them for a well organised summit. Dr Sandeep Bhalla Faculty and Researcher Public Health Foundation of India

My compliments for holding a successful seminar. The sessions I attended were knowledgeable and people I met were brilliant in their field of work. Thank you for the opportunity. Dr Nimmi Rastogi Advisor Health: Delhi Government Team Lead: Dialogue & Development commission, India It was a great event. Congratulations to the entire team. I would appreciate in case you can share the contact details of Digital X-Ray innovation as it did not participate but we are keen on this. Dr Shashi Bhushan Sinha Advisor Healthcare Technologies National Health Systems Resource Centre(NHSRC), India Great work Innohealth team. I was extremely delighted to see a strong participation from the clinical/ physician community at the conference. Can you rope in start-ups to showcase their innovation via presentation/ showcase or via a competition – maybe you can have VC’s join. Biten Kathrani Director, R&D & NBD Asia, Middle East, and Africa (AMEA) Boston Scientific

Awesome work by the whole team. Dr Sanjay Sharma Founder Yostra Labs Private Limited Please accept my heartiest congratulations for a wonderfully organised event. I can say almost flawless!! Truly a congregation of health care innovations right from astute technological innovations to core practice based health care delivery innovations!!...Each most completely important when it comes to improving health. Thanks for allowing me to be a part of it and letting me share my work before this elite audience! Kudos to the team... Keep up your great work...a contribution of sorts to improve quality of healthcare in our country. Dr Arti Maria Professor and Head Department of Neonatology Dr RML Hospital & PGIMER, India

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Kudos for creating an exclusive platform for innovation in healthcare. May it grow in strength!! Great discussions. Some of them could be converted into podcasts and posted on your blog :) Sharda Balaji Founder NovoJuris Legal, India Thank you for letting me participate in your conference. It was a great success by all standards and it will get better with time. Wish you more success in the future. Dr Shiban Ganju Chairman, Atrimed Pharmaceuticals Founder, Save A Mother Foundation USA

Trends 9

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TRENDS

SWARTANTRA, A DIGITAL HEALTH STARTUP LAUNCHES MOKSHA AND SIDDHAM Two audible vibrations devices to heal stress led diseases

98% of all Degenerative Diseases such as depression, heart ailments, weight fluctuations, hormonal imbalances and sexual disorders are caused by Stress Founder: Samir Pandit

WOMEN’S CORNER

ISSUES

PERSONA

WELL BEING

POLICY

This breakthrough technology ‘SWARTANTRA’ aims to manage a happier and healthier existence of one self. SWARTANTRA is a device that combines spiritual world with modern science. It eliminates the stress from one’s daily life and brings relaxation to the body. Its unique vibrations soothe the body, mind and soul by building positive energy every time the device is used. One can use this technology through the two devices Moksha and Siddham.

wartantra, a digital health startup was founded to make first of its kind audible vibration devices using a very unique combination of ancient spiritual science and modern technology to create a better everyday life for people by making oneself healthy mentally, emotionally, physically and at the soul level. In this endeavor Swartantra recently announced the launch of Moksha and Siddham, two audible vibration devices to heal stress led diseases. The devices are made using Swartantra technology based on sound vibrations which is amongst one of the oldest healing modalities. The products work directly on the central nervous system.

The device signifies the startup’s aim to pioneer a new category of digital health: Audible Vibrations. Swartantra is the perfect mix of faith and technology. The vibrations are positive, natural, and therapeutic. The science behind it is the customization of vibrations by sharing the place of birth of an individual because the place of birth helps identify the latitude and the longitude making the vibration of this place extremely specific. Similarly, date of birth, time of birth and their present location helps in singling out what vibration works best for the person. This vibration is a permutation and combination of many healing vibrations that suit one by targeting the pituitary gland that releases both positive and negative hormones. The vibrations help regulate the flow of hormone in pituitary gland and thereby providing a complete and thorough attunement of body, mind and spirit.

‘SAKSHI’ the biodegradable sanitary pads

he self – help group “SAHELI” in Pilgao village in Bicholim taluka of Goa(India) is the first SHG in Goa to manufacture and sell eco-friendly sanitary pads. According to a 2011 survey, only 12 per cent women in India use sanitary napkins which still makes for at least 9,000 tonnes of garbage and India produces over 1 billion non-compostable sanitary pads every month. And with modernisation this number is continuously increasing. Jayshree Parwar, with the help of three other women, had started this initiative in 2015. These pads are manufactured at Jayshree’s home where utmost care is taken regarding hygiene and sanita-

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tion. Till now they have sold 1000 pads and they manufacture 50 packets in a day. One packet consists of eight pads and its retail cost is Rs 40. They sell it under the brand name ‘SAKHI”bio-degradable sanitary pads. The raw material is procured from Tamil Nadu and the main component of it is the pine wood paper. This pad when buried in mud gets degraded within eight days. These sanitary pads consist of pine wood paper, silicon paper, butter paper, non-woven paper and cotton. They are UV light radiated which helps kills germs. As there is no retail outlet of this SHG, they sell it at various cultural fests like Lokotsav (annual art and culture festival organised by Gov-

ernment of Goa in joint collaboration of West Zone Cultural Centre, Udaipur in Panaji, Goa) and also at a café like Saraya Art Café at Sangolda.

The First Online Healthcare Service Provider to Bag ISO Certifications Satish Kannan, CEO & Co-founder

The ISO norms remain same for online and offline processes. The certification process works to identify and implement corrective actions to eliminate non-conformance to the quality management standard. For the online processes, quality management, customer satisfaction and complaints handling becomes very important. All these certifications will definitely enhance DocsApp’s solid reputation in the market and further consolidate its position as the go-to app for all healthcare services.

PERSONA

Over the years, DocsApp has taken several measures to ensure the safety and security of all the medical records of patients with the help of advanced technology and management procedures. Customer

satisfaction and complaints resolution management certification boosts the trust of the customers in it further.

WELL BEING

latest norms of standardization. Whilemany offline healthcare services such as hospitals and service providers have got ISO 9001:2015 and 27001:2013 certifications. This is for the first time that an online healthcare service provider has received ISO certifications. DocsApp is commitment towards bringing superlative and convenient diagnostic services virtually.

POLICY

ocsApp, a mobile app that connects patients to specialist doctors via chat or call in less than 30 mins, has received three International Organization Standardization (ISO) certifications from Euro American Joint Accreditation. The certifications garnered are, ISO 9001:2015 for quality management system, ISO 27001:2013 for information security management system and ISO 10002:2014 for quality management, customer satisfaction and complaints handling. These certifications are valid for three years in all 163 Euro-American countries and are issued as per the

TRENDS

DocsApp

“CLINIC ON WHEELS”

Senior citizens of Thane and Mulund to benefit from this initiative, a free of cost service at their doorstep

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is also equipped with Oxygen support which is vital during emergencies. It also wheelchair enabled for patients with special needs. In light of the view that It is imperative that we, as a society at large, are responsible for well-being of our elders. This initiative is an attempt to reach out to elders who may need medical care within comfort of their home. The trained teams are capable and will provide best possible medical care to the senior citizens of the region. The initiative has witnessed support from many senior citizen groups. Appointment for the Clinic on Wheels service, to your doorstep, can be taken on 91670 01122.

WOMEN’S CORNER

ecently a team of doctors and staff at Fortis Hospital, Mulund launched ‘Clinic on Wheels’ at Wamanrao Munjaran Vidyalaya Complex, Mulund. The Clinic on Wheels is set to provide free OPD services and medical consultation to all senior citizens. It will remain on-call from 7am to 7 PM for six days in a week. Services provided at this clinic include ECG check, Random Blood Sugar check and Blood Pressure check. The mobile clinic, manned by a trained team of a Geriatrician and a nurse

Founder: Samir Pandit

ISSUES

Fortis Hospital and EzyMov launch a first of its kind Mobile Clinic for Senior Citizens

hospital announces first-of- its-kind Digital Breast Tomosynthesis for women not aware of the available technology and expertise in the field of breast cancer diagnosis. Needless to say, women undergoing screening have little understanding of the tests or the results thereof.

WOMEN’S CORNER

ISSUES

PERSONA

WELL BEING

POLICY

TRENDS

BENGALURU

reast Cancer has been ranked as the number one cancer among Indian women with age adjusted rate as high as 25.8 per 100,000 women, as per the latest statistics published in the Asia Pacific Journal of Clinical Oncology. Bengaluru has ranked third with age adjusted incidence rate of carcinoma of the breast found as high as 34.4 per 100,000 women. Projections for India suggest the number of breast cancer cases will likely go as high as 1,797,900 by 2020. Though there has been an increase in health check-ups among women recently and we can still see that screening is low on priority even in major cities. Cytecare hospital is the first hospital in the city to introduce Digital Breast Tomosynthesis (popularly known as 3D-Mammography) for women. Mammography continues to be the only screening test proven to decrease mortality from breast cancer. However, 2D mammography is less accurate in women with dense breasts for whom cancer may be masked by overlapping breast tissue. When a 2D mammogram

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detects an area of concern, radiologists further investigate with a diagnostic mammogram, ultrasound or biopsy. Looking at the same breast tissue in 3D, the radiologist may now be able to see that the abnormality on 2D mammogram in fact represents normal breast tissue. This avoids further investigation in large number of patients undergoing routine screening. 3D mammography or Tomosynthesis is a special kind of mammogram that uses several low dose x-rays obtained at different angles to create multiple images or “sequential slices” that step through the breast tissue and allows radiologists to see more clearly. The breast is positioned and compressed in the same way as for a 2D mammogram but the x-ray tube moves in a circular arc around the breast. It takes less than 10 seconds for the scan. The information from the x-rays is sent to a computer, which produces a focused 3-D digital image of the breast. There is no organised national or regional breast cancer screening program in India. Naturally, majority of those involved in women’s health are

In contrast to the western world, breast cancer incidence is much higher in premenopausal age group (<50 years) in India. As compared to both screen-film and Computed Mammograms (older but most widely used technologies), 2D and 3D Digital Mammography has significantly higher accuracy in cancer detection in younger women and in women with dense glandular breasts. This will have large impact on decreasing the number of women undergoing unnecessary recalls or biopsies. It is most important to avoid anxiety in women opting for screening tests. 3D mammography serves as an excellent problem solving tool and reduces misdiagnoses. Contrary to common practice, ultrasound alone has significant limitations as a screening tool and must always be combined with a 2D or 3D Digital Mammogram. The x-ray dose of 3D mammography is comparable to that of a 2D mammogram. Therefore the cumulative dose of the combined screening is still below the FDAregulated limit and found to be safe and effective for patient use. Incorporating this aspect Cytecare hospital’s breast imaging services are complete with Digital Breast Tomosynthesis (DBT or 3D Mammogram), Full Field Digital Mammogram (FFDM), Stereotactic and Vacuum Assisted Breast Biopsy (VABB). 3D mammography has shown to reduce percentage of missed cancers by 15%. More recent studies show about 30% increased 3D mammography sensitivity and specificity compared to 2D Mammography with a recalls reduction in screening by approximately 40%.

Abnormalities in the unborn child possible

TRENDS

FETAL MEDICINE MAKES TREATMENT OF

POLICY WELL BEING

Fetal medicine practioners try to spread awareness and say that one needs to see a fetal medicine specialist if they have any of the following conditions:

• Pregnancy with previous history of structural defect in the baby in previous pregnancy or in the family

• Recurrent pregnancy loss/ death of baby in womb/death immediately after birth or delivery before date. • Mothers who’s blood group is Rh negative • family

Known genetic disease in

• Pregnancy with previous child or family member affected by thalassemia/ haemophilia etc • Pregnancy with h/o fever with rash/chickenpox • Pregnancy with Diabetes/high BP/heart disease//Systemic Lupus Erythematosus (SLE), Sjogren’s

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• Pregnancy with hepatitis/ cancer/seizure/organ transplant • Pregnancy with slow growth of fetus.

• Pregnancy with previous history of mental retardation or heart defects in previous pregnancy or in the family •

IVF conceived pregnancy

Latest studies reveal that approximately 3-4% of pregnancies are diagnosed with a fetal defect. This can either be a genetic defect or a structural defect. With a lack of awareness in mothers; lack of exact diagnosis and monitoring this can result in a severe mental or physical handicap in a new-born and can prove to be traumatic for the family and pose a significant mental burden on the new mother. So India, now is the time to look up, ask and use the available expertise to join hands for the healthy next generation.

WOMEN’S CORNER

syndrome, Rheumatoid arthritis

ISSUES

In India where Fetal medicine is still an upcoming discipline, the pregnant women aren’t much aware about its scope from diagnosis to therapy. Fetal medicine pertains to the use of Ultrasound, genetic tests, MRI etc. in the pregnancy period to determine the health of the newborn. Though fetal experts in India usually restrict themselves to treating complications of Identical twins, bladder outlet obstruction , fetal anaemia , the horizon for diagnosis has touched the Western mark. The motive is diagnosis of birth and chromosomal defects as early as possible so as to offer a fair

chance to the couple on deciding fate of pregnancy .Fetal echocardiography is one worth mentioning which can pick up most early manifesting cardiac problems in the unborn in expert hands.

PERSONA

edical advancements in heart treatments have taken giant steps and is poised to treat congenital problems in the heart of a fetus today. However, due to a severe lack of awareness in India about what problems can be detected at fetal stages, expectant mothers are in oblivion about the health of their unborn child. This leads to an uniformed decision and many children are born with challenges that could have been detected and treated even before they were born.

TRENDS POLICY WELL BEING

Revfersal of multiple sclerosis through adult stem cell therapy

dvancells, an India-based research oriented company recently announced successful reversal of Multiple Sclerosis using Adult Stem Cells and Regenerative medicine in the pilot patient of a planned clinical trial. An Auckland, New Zealand resident has become the first patient to be recruited under a pilot study to ascertain the efficacy of Autologous Adult Stem Cells in reversing Multiple Sclerosis (MS). MS is a disease of the nerves where the insulating covers of the nerve cells in the brain and nerves are damaged, thus effecting the communication between those nerves and the brain. This results in disabling the patient in their muscle movement, vision, coordination and sensation. The Patient from New Zealand was first diagnosed with MS in 2010 and has had multiple relapses of the disease in the past 7 years. His symptoms had been progressing at a fast pace and he had almost lost his power to walk. The patient then approached the Institute and was accepted as a trial patient for Advancells unique Adult Stem Cell

WOMEN’S CORNER

ISSUES

PERSONA

“ADVANCELLS” ANNOUNCES SUCCESSFUL

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therapy program and the procedure was carried out in New Delhi in June 2017. Advancells gets approached by a lot of patients from around the world who wish to be a part of their program but they cannot take commercials therapies just yet. Patient selection is a key criterion for them and the approached patient suited the criterions perfectly. He is young, still at a moderate level of the disease and in a very positive frame of mind. Patients at this stage are best suited for this kind of treatment and thus he was accepted as a pilot case. To perform the therapy, bone marrow of the patient was aspirated and adult stem cells were separated from them. These unmanipulated cells were then reinjected back in the patient at specific points and the patient was put under physiotherapy and dietary routine. Straight after the treatment the patient saw major improvements wherein he could walk a lot better, could climb stairs (which he was unable to do after 2012) and even go

on the treadmill. As per Advancells It will take approximately 3 months for them to review changes in the MRI of the patient but the drastic changes in symptoms clearly are an indication of the fact that the treatment is working and could become a hope for millions of patients across the world, who are suffering from this disease. The company believes this is a good start to a lengthy research phase and it seems that they are on the right track and hopefully they will be able to make a significant contribution in eradicating not only MS but a host of untreatable diseases existing today and in the future.

India’s first travel insurance chatbot

First chatbot in the travel Insurance industry to sell travel policies to its customers The chatbot has generated great interest among users, leading to over 1,500 interactions since its inception few days ago

TRENDS

‘TRAVEL NINJA’

POLICY

Travel Ninja is the only chatbot which enables the end-to-end process of buying a plan as compared to other chatbots in the industry which are mostly limited to addressing customer queries, giving insurance advice and providing insurance quotes. The chatbot has had close to 1500 interactions in just over a month since its inception. This is a step to uncomplicated health insurance in India and is based on speed and accuracy.

DRIVER DROWSINESS DETECTION SYSTEM

The device works through a facereading mechanism and has a camera attached to it, where a person’s eye movement and the number of yawns they take are monitored before sending alerts. The cut-off time for a person to blink his eye is 1.5 seconds. If a driver has his eyes shut for more than that, alerts would be sent. The same happens even if he yawns more than 3 times.

WOMEN’S CORNER

tudents of PES University, Bangalore have Innovated a Device that keeps drivers from dozing off during long trips. The ‘driver drowsiness detection’ system alerts driver through sound alerts and vibration to the steering wheel, prompting him to stay awake throughout the journey.

ISSUES

Seems now that, if a customer realises they need travel insurance even as they are waiting for their flight at the airport, they will not hesitate

before buying a plan, as it would just take them 5 minutes. With Artificial Intelligence (AI) being utilized across industries, Apollo is leveraging the benefits of these technological advances in their business processes. Gradually, with the help of Machine Learning, the chatbot will better understand the customer’s intent and behavioral characteristics for being able to offer them a more personalized and helpful experience. The icing on the cake is the travel advice Travel Ninja offers its customers after issuing their policy. From the right plug type used in their destination to emergency numbers and information on cost of living, Travel Ninja leaves its customers well-armed with the right information for a memorable travel experience.

PERSONA

Travel Ninja is available 24/7 on Apollo Munich’s website and Facebook Messenger. It suggests customers the right travel insurance plan and sum insured, creates a policy proposal for them and gives them a payment link; all in just a couple of minutes. During the process, Travel Ninja also offers users the option to view details about

features and benefits of all available plans.

WELL BEING

ndia’s leading standalone health insurer Apollo Munich, taken a giant technology leap recently announcing the launch of India’s first travel insurance chatbot – ‘Travel Ninja,’ which will enable its customers to secure their trip in an easier and faster way. Travel Ninja is the first chatbot in the Indian travel insurance industry to sell travel insurance policies to its customers.

Comparing similar alert systems in the market, the device is less expensive and the cost is around INR 10,000. It’s a low cost product compared to other products available in the market today and is a much needed solution for those long yawn drives.

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After necessary fields trials and validation, the Government, transporters and taxi, cabs can adopt it. The Auto industry especially the cars segment badly needs this as a standard feature.

The innovative turning and moving system

needed and the staff. TurnAid is easily mounted on most care beds as it comes with a built-in universal fitting together with length and width adjustment. This enables TurnAid to comply with the Medical Directive’s strict demands to the area.

POLICY

TRENDS

“TURNAID”

Benefits of turnaid: For the user/patient:

HEALTH

• Bed rail you can look out of (not like laying in a coffin)

PEOPLE ISSUES

Bed rail you can hold on to

•

Gentle turning and moving

For the caregiver:

WOMEN’S CORNER

•

urnAid founded in 2014, has developed the turning and moving system TurnAid, which is a unique combination of an electrically driven turning sheet and two bed rails. TurnAid is both designed and produced in Denmark. TurnAid is developed to optimise the situations in relation with care of, moving of, and bed solutions for persons with severe physical disabilities in hospitals, institutions, or their own home. TurnAid improves the working environment just as it

increases the safety and the dignity of the work with and the stay in care beds as turning and moving of persons become easy and discrete. In “stand by” mode, the turning system is set in a low position, where the care-needed is not only shielded by the safety of the bed rails but the person is also placed in an ethical and dignified position with a free view to the surroundings. TurnAid handles persons with a weight up to 200 kg and does so with maximum consideration to the care-

• Reduces careres form 2 to 1 (it only takes 1 person to turn/move the patient, normally it takes 2) •

Easy and simple to operate

• Easy to move the patient from side to side to reduce working distance (good for the back) and easy to turn the patient on the side • Possible to mount 1 or 2 foot control •

Easy to change sheets

• The lower position of the bed can still be used, also on extra low beds

NANOCHIP TO DELIVER BIOLOGICAL “Cargo” for cell conversion

esearchers at the ohio state university wexner medical center and ohio state’s college of engineering have developed a new technology, Tissue Nano Transfection(TNT), that can generate any cell type of interest for treatment within the patient’s own body with a single touch. This TNT does not require any laboratory-based procedures and may be implemented at the point of care. This technology may be used to repair injured tissue or restore function of aging tissue, including organs, blood vessels and nerve cells. Results of the regenerative medicine study is published in the journal Nature Nanotechnology.

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Researchers studied mice and pigs in their experiments where they were able to reprogram skin cells to become vascular cells in badly injured legs that lacked blood flow. Within one week, active blood vessels appeared in the

injured leg and by the second week, the leg was saved. The technology was also shown to reprogram skin cells in the live body into nerve cells that were injected into brain-injured mice to help them recover from stroke.

Dinesh C Sharma

he Hyderabad-based National Institute of Nutrition (NIN) has developed the country’s first Nutrition Atlas to provide all the relevant data and information about nutrition.

helping the user track data on under nutrition, over nutrition, overweight, obesity and communicable and noncommunicable diseases. It can also provide different time trends on each of these parameters. The development conducted the research under ICMR. Article shared from ‘India Science Wire’

To remove harmful drugs from wastewater

Researchers have developed a slurry photocatalytic membrane reactor which involves a filtration process similar to the one used to purify drinking water. This device needs a light source like an LED to work. Scientists used a catalyst, titanium dioxide, to breakdown drugs. It is easily available, efficient, stable

and not toxic. The membrane used as a barrier to stop the drugs could be made up of a polymer or ceramic. Though polymers have small and distinct pore sizes and are capable of stopping the large-sized cytostatic drugs, previous studies have proved that ceramic membranes are able to withstand the inevitable `wear and tear’ associated with the filtration process better when these membranes also come in contact with various chemicals. Ceramic membranes were used in this study. As waste water with cytostatic drugs enters photoreactor, the light source activates or ‘fires up’ the catalyst (titanium dioxide) breaking it up into two parts—titanium and ‘free’ oxygen. The ‘free’ oxygen then combines with the cytostatic drugs in waste water and breaks them into smaller parts thus making them ‘safer’.

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Monika Kundu Srivastava WOMEN’S CORNER

ospital wastewater is very toxic due to the presence of drugs in it which in turn leads to major environmental issues. A group of researchers from Belgium and India have developed a novel method of treating wastewater to get rid of such harmful substances from hospital waste. The wastewater may contain cytostatic drugs which are known to cause severe and irreversible damages to human body especially from hospitals specializing in cancer treatment.

ISSUES

New method developed

PERSONA

The Atlas is interactive and displays information in the form a user may select and has been developed through a long drawn, cohesive

and technical exercise by a multidisciplinary team in the bioinformatics division of NIN. It makes use of publicly available data sources like reports of National Nutrition Monitoring Bureau, National Family Health Survey, World Health Organisation and other public databases. The Dashboard acts like an information management tool,

WELL BEING

The portal also includes information on nutrition rich foods and nutri-guide for various nutrients, minerals, essential amino-acids, fatty acids, dietary fibers and proteins, along with their biochemical cutoffs, recommended dietary allowances, signs and symptoms and dietary sources.

POLICY

The Nutrition Atlas provides information and data on nutritional status of population groups at national and state levels, along with an overview of nutrition-related deficiencies, disorders and prevalence levels in various parts of the country alongwith information on nutrients, nutrient rich foods, nutritional deficiency disorders and a host of other topics.

TRENDS

India’s Nutrition Atlas goes live

If any drug particles are left unchanged, the membrane prevents them from passing through. Thereafter, the mixture goes into another part of the reactor where the catalyst is removed and re-circulated to the photoreactor. The results of this study were published in the journal Science of the Total Environment recently. Article shared from ‘India Science Wire’

TRENDS POLICY WELL BEING PERSONA ISSUES WOMEN’S CORNER

New method developed To forecast dengue spread

Dr. Shikha T. Malik

iven its close link with both temperature and rainfall, it is possible to forecast outbreak of dengue. But for such disease forecasting to be effective it should be based on models specific for different climatic zones in the country, a new study has shown. The study has been jointly done by the Hyderabad-based Indian Institute of Chemical Technology (IICT), National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, in collaboration with scientists at the University of Liverpool. Scientists have reached this conclusion after evaluating the relationship of climatic factors in the spread of dengue in different climatic zones in the country – Punjab, Haryana, Rajasthan, Gujarat and Kerala. They focused on changes in a factor called ‘extrinsic incubation period (EIP) of the dengue virus by taking into account daily and monthly mean temperatures in these areas. The extrinsic incubation period (EIP) is the time taken for incubation of the virus in the mosquito. During this period, after the mosquito draws virus rich blood meal, the virus escapes the gut and passes through the mosquito’s body and reaches it salivary glands. Once this happens, the mosquito is infectious and capable of transmitting the virus to a human host. It has been found that climatic conditions play an important role in EIP. Lower temperatures (17–18 °C) result in longer EIPs thereby leading to decreased virus transmission. With increasing temperatures, feeding increases because of enhanced metabolism of the mosquito, leading to shorter EIPs. Even a 5-day decrease in the incubation period can hike transmission rate by three times, and with an increase in temperature from 17 to 30 °C, dengue transmission increases fourfold. However, a further increase in temperature beyond 35 °C is detrimental to the mosquito survival.

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The researchers observed that except for Gujarat which comprises of arid regions, there was a strong correlation between rainfall and dengue disease burden. The study found that Kerala being warm (temperature range 23.5-30 °C) and wet and with short EIPs (9-14 days) experiences the highest number of dengue cases.It has been found that EIP is the shortest during the monsoon season in most states and therefore there is an enhanced risk of dengue during this time. This climate-based dengue forecasting model could help in planning effective and efficient disease control operations well in advance and optimize the use of resources meticulously. With changes in temperature affecting the extrinsic incubation period of the virus, future changes in the climate might have a substantial effect on dengue and other vectorborne disease burden in India. “Though such methods are in vogue for disease control operations, we are still in the initial stages of implementation of such strategic control methods,” Dr Rao

told India Science Wire. Factors such as population density and migration also need to be included for future risk assessment studies. The study was published in journal Emerging Microbes & Infections. Article shared from ‘India Science Wire’

Compiled by: Dr. Avantika Batish is working as Director Strategy and Healthcare at International Health Emergency Learning and Preparedness. Also, guest faculty for MBA (HR) and MBA Healthcare Management at various B-Schools and is a soft skills trainer.

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two-day national INNOVATIVE APPROACH Alevel event InnoHEALTH 2017 was TO A HEALTHY LIFEw

hosted in the capital with international participants. Vigyan Arya reports about the two-day high profile event attended by leading industry representatives from India and abroad.

voice to raise concern about the increasing cost of health and medical facilities was given a platform at the two-day InnoHEALTH 2017 that was hosted on September 18th and 19th in the capital. In the second year of its running, the event was co-hosted by InnovatioCuris and Indiattitude that extended a stage for innovations in the field of health and medicine. Addressing the large gathering of doctors and high-profile professionals from the industry, Dr V.K. Singh, the visionary behind this event conveyed that the prime objective of this mega event is to contribute towards bringing down the healthcare delivery cost yet maintaining the quality. InnoHEALTH 2017 helped in doing

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Dr V.K. Singh Innovation is not very old. Despite that Public Health is the most curative neglected area as most doctors do not wish to go in that direction. Most prefer to work in the preventive medication that is more lucrative and appeals to most, even to the students, much before they even become qualified doctors.

so by creating deliberations among policy makers, industry and academia on topics linked with Innovations in Hospitals, diagnostics, medical devices, pharma, biotech, digital healthcare and new delivery models. The conference saw an attendance of around 250 Delegates with an overwhelming response of 170 on the very first day including 50 elite speakers from all over the world. H.E. Riho Kruuv, Estonian Ambassador to India, DG Armed Forces Medical Services and Prof. Anil Gupta known for his work of innovations were some of the key speakers. The attendance saw presence from renowned healthcare personalities such as Dr. Arvind Lal of Lal Pathlabs, Dr. Ravi Gaur CEO Oncquest Labs, Dr. Padam Khanna – NHSRC, Mr. Partha Dey – IBM India, Mr. R Rengarajan Iyengar from HCL Healthcare. On the first day of the powerpacked two-day event, the conference hosted a B2B meeting to connect the Indian stakeholders with a visiting European Union delegation pertaining to innovative health sector companies. The companies were selected through a competitive program with a focus on cost-effective innovations for the Indian market. With the objective of making it an international platform for the industry professionals with similar aims and goals, the conference had very high-profile brands, corporate and government organizations shouldering their support. Conference also hosted young innovators award.

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His Excellency Riho Kruuv; Estonian Ambassador to India I am very proud to be representative of Estonia as Country Partner for this conference on Innovations in Health Care because Estonia is a country that is all about innovations and fast adaptation of new technology. Estonia did not invent internet but we use it to the maximum especially in the health care society. In fact, in 26 years since independence, we have now become a digital society.“

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The big boost in the confidence and capabilities of the conference was extended by the Embassy of Estonia, as the country partner. Other leading partners included, NHSRC representatives of MoHFW, Government of India, Public Health Foundation of India; CAHO as the association of accredited hospitals of India and AHPI that represents more than 10,000 private healthcare providers. IAMI brought in the clinicians involved in healthcare analytics while ScanBalt brings the outreach to more than 22,000 professionals in 11 European countries. There were many more that contributed feathers to the hat to make InnoHEALTH 2017 a very successful event in terms of the perceived outcome. The two-day event saw some very insightful discussions on, Innovations for Hospitals; Diagnostics of Tomorrow; Innovations for Affordable Healthcare – A Medical Device Perspective and Public Health and Biotech, on the first day of the conference. The second day started off with a very informative keynote address by Professor Rishikesha T. Krishnan of IIM Indore. He is a Director and Professor of Strategic Management at the Indian Institute of Management in Indore. It was followed by discussions on Healthcare Beyond Hospitals; Innovations in the Pharma Sector; Digital Health: Giving birth to new delivery models and fostering innovations, finally followed by Challenges and Redefining Healthcare Landscape.

The last two sessions of the day opened a very important chapter in the field of innovations in health sector. Indian and international companies were given a platform to make their pitch claiming the coveted Innovations titles. The finale was the dispensing of Young Innovations Awards.

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Overwhelmed by the encouraging response this year, the organizers announced the dates for the next InnoHEALTH 2018, to take place on 5th – 6th October 2018, with a raised hope to come back next year keeping shared goals in healthcare with only, bigger, better and meatier roles for all stakeholders.

Dr Anil Kumar Gupta We need to have all the four [accessibility, affordability, availability and adaptability] elements of a solution to ensure the innovation to actually becoming a problem solving solution. This platform can help these young inventors and innovators by linking them with different institutions. There’s a need for linking startups with the large public sectors that can procure these innovations and provide encouragement to young breed of inventors and innovators.”

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Lt Gen Manoj Kumar Unni Innovation is the corner stone of any advancement and we as scientists and doctors must acknowledge that. The days of discovery in the medical field are largely over. Inventions, however will help garner new technology to overcome the new challenges that India has been facing today. India has seen a lot of inventions and innovations through the ages in all fields and therefore having this conference here today would be just the right step forward to see how we can introduce more and more innovations in healthcare industry and medical field.â&#x20AC;? Volume 2 | Issue 4 | Oct-Dec 2017

First Meeting of IC Innovator Club (IC)2:

Supporting the Aspirations of Innovators

ith the commitment to giving an encouraging platform to innovators and aspiring start ups, InnovatioCuris (IC) was created as a knowledge based platform to exchange best practices of healthcare innovations across the globe by conducting international conferences, and extending the same message in internationally-acclaimed, quarterly magazine named “InnoHEALTH”, complimentary webinars and training. On the third day of the event, a special seminar was hosted by IC Innovator Club (IC)2 with its first meeting held on 20 Sept 2017 at India International Center (IIC, Annexe), New Delhi. The club brought all innovators, investors, start up, technology persons, policy makers, health experts and legal advisors under one large umbrella to be members and hold hands by sharing success stories and challenges and to incubate their ideas to take the dream and vision of India forward. It has a very strong band of advisors to support the activity of club and mentor projects. The aim is to bring down healthcare delivery cost yet maintain quality through innovations. IC has an outreach of 30,000 people globally to share its activities. The first of the club meetings was supported by Amity University, represented by Dr. Ajit Kumar Nagpal and three of the leading investors in the field of health and medical facilities.

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Dr Vijay Agarwal There’s a rapid adoption of innovations in technology. Potential impact of mobile technology on health care is so immense that a health worker can be fully operational and productively useful in 60 to 70% less time than before. What’s impacting hospitals is the online information searching; Realtime data analysis; RFID technology, mobile diagnostics, wellness apps, 3D printing and bio printing to name a few.”

â&#x20AC;&#x153;

Brig (Honorary) Dr Arvind Lal Access to good health is a right and should not depend on where you live and how much you earn. But sadly, that is the reality in our health care system today. With less than 7.5 doctor to a thousand patients, we are at the lowest end of the pyramid and we have a severely underserved health care industry in the country. Even though we have more than 70 per cent of the country population in the rural areas, but less than a 3rd of the medical resources including doctors, laboratories, hospitals and hospital beds.â&#x20AC;?

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Session One: Innovations for hospitals

Adopting new technology to cross physical barriers High profile panel of speakers from different fields of health and medical facilities explored the option of inducing innovations and new technology in the operations of hospitals and clinics, at the InnoHEALTH 2017 conference in New Delhi

Keynote Address: Dr. Vijay Agarwal, Moderator: Dr. Arati Verma Speakers · Prof. A.K Gupta, · Partha Dey, · Surjeet Thakur, · Prof. Arti Maria

ospitals are the core of health and medical care and adaptation of new technology and innovations will make the biggest difference to our medical needs while improving the health conditions of all. Highlighting the concern of data security and reluctance to depend on technology because of that concern, the keynote speaker for the first session Dr. Vijay Agarwal shared his views on the subject emphasizing on the fact that technology is rolling out at a very fast pace. Stating an example of landline telephones that took more than 100 years to reach the one billion mark of users, was reduced to less than 20 years for mobile technology to do the same. This way he highlighted the fact that newer technology will be

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very rapid in implementation requiring hospitals and clinics to adapt and be prepared to utilize it rather than be apprehensive about it. Professor AK Gupta of the esteemed PGI Hospital in Chandigarh, also, supported this view and shared his personal experiences and experimentation with management and administration of the hospital. He emphasized that it’s not just in the medical and clinical field that we have to embrace innovations and technology, but in fact it will fetch very positively encouraging results if adopted in the management and administration of hospitals. He shared his views on reducing the time stay of patients in hospitals by means of using an innovative approach provided

Dr Arati Verma Artificial intelligence has been there since ages. But big corporates throw things at you to claim that they have something new and latest. Most artificial intelligence uses software and the software is as good as the users. Which means even the artificial intelligence needs human intervention for efficient execution. In the field of health and medical, AI is even more depending on the involvement and interpretation of human beings.”

by tailored software and mobile apps. These efforts were recognized by the hospital; national level authorities and even internationally and was rightly awarded for this approach. He concluded his speech by asserting that you don’t have to discover new technology, but innovative utilization of existing technology can also provide very good results. Touching the humane element in the hospitals, Prof Arti Maria of RML Hospital shared her experiences of involving mothers and non-hospital staff in caring for the young ones in ICU units. “A soft touch by the mothers, who are otherwise distanced outside

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the ICU units, has resulted on faster recovery of infants in the ICU.” “In fact, this experimentation has also resulted in enhanced confidence of mothers and improved their social status with respect to their husbands, families and the social fabric as such.” Prof Maria, who specializes in Neonatology as Head of that Department is keenly working with other authorities beyond the hospital to promote this concept and is getting very encouraging results from hospitals, and relevant bodies. Partha Dey, with years of experience at IBM shed some light on the subject of innovations with the

Professor Arti Maria Innovation doesn’t have to be in technology alone. Anything that has not been measured doesn’t mean it doesn’t exist. So if stress on a child straight out of the womb and placed in an ICU has not been measured for any reason; it does not mean that the child is not undergoing any stress. Our new approach to introduce mother and family members in the ICU area has shown very encouraging results that resulted in speedy recovery by the child.”

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simplicity that the IBM is known for. The three products and services of IBM, Watson, Block Chain and Cloud data are the way forward, according to Mr. Dey, Healthcare Leader and SME and IBM, India. Watson, according to Mr Dey, is the most innovative friend for health care workers and doctors alike, as it understands many languages, including regional and Oncology. This helps medical staff to interpret and diagnose ailments with a high grade of accuracy and ease. Watson can, not only, analyze and conclude at a faster pace, but can also eliminate human error contributed in the form of emotional stress and personal bias.

Block Chain, on the other hand is the best mode of data utilization and can contribute to tracking of product and their status. Block Chain can also help eliminate counterfeit medicines by clever tracking of products and their batches. IBM is constantly pushing the boundaries of innovations with introduction of new products and services. Watson and Block Chain are latest in the field of health and medical welfare. In totality, the high profile panel of speakers from different fields of health and medical facilities explored the option of inducing innovations and new technology in the operations of hospitals and clinics beyond clinical procedures, leading to heightened efficiency and operational advantages resulting in a healthier society and population at large.

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Siddharth Sangwan We have been hearing of telemedicine has been from the Nehru and Indira Era. But what is accomplished so far is very less. We have now integrated the telemedicine system where the doctor explains the report to the patient and in the process takes the customer/patient in a walk through his report and diagnosis. Next step of telemedicine will be to integrate Artificial Intelligence so that patients can contribute to the clinical process and recover faster, with the additional help of doctors and medicines.â&#x20AC;?

Session Two: Diagnostics of Tomorrow

Towards a healthier future Keynote Address: Brigadier (Hony) Dr. Arvind Lal, Moderator: Dr. Ravi Gaur Panelists: • Dr. Kamini Khillan • Pieter Spee • Pavan Asalapuram • Siddharth Sangwan

he session was fittingly addressed by a very highprofile group of panelists from the diagnostics industry, who shared their experiences and concerns about the state of laboratories despite the fact that innovations have been very emphatically used in this segment

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health

and

medical

facilities.

Taking a lead on this vital subject, Dr. Arvind Lal highlighted the need of accurate and reliable diagnostics to bring the best treatments. Sharing some startling facts and figures, he highlighted that with less than 7.5

Dr Ravi Gaur Healthcare industry has probably seen the maximum innovations in India. Diagnostics has been moving from incremental to being disruptive with innovations; and that’s what the need of the hour is today. We need to cut short the timings; we need to cut short the process of diagnosis and arrive at a conclusion at the earliest so as to be usefully effective to the clinical process.”

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Panelists at the InnoHEALTH 2017 discuss and share their experiences on the subject of Diagnostics of Tomorrow and opine about how diagnosis will play a pivotal role in ensuring a healthier future

doctors to a thousand patients, we are at the lowest end of the pyramid and have a severely underserved health care industry in the country. Access to good health is a right and should not depend on where you live and how much you earn. But sadly, that is the reality in our health care system today. With less than 7.5 doctors to a thousand patients, we have a severely underserved health care industry. Even though we have more than 70 per cent of the country’s population in rural areas, but less than a third of the medical resources including doctors, laboratories, hospitals and hospital beds. Emphasizing his and the establishment’s 50 years contribution to providing good health, he highlighted that he may have to rediscover the business of diagnostics, yet again. Laboratory tests are responsible for 70% of clinical or medical decisions. This makes diagnostics the spine of the entire medical and healthcare system anywhere in the world. Session moderator Dr. Ravi Gaur of Oncquest Laboratories opened the floor with his opinion on the subject. “Healthcare industry has probably seen the maximum innovations in India. Diagnostics has been moving from incremental to being disruptive with innovations; and that’s what the need of the hour is today. We need to cut short the timings; we need to cut short the process of diagnosis and arrive at a conclusion at the earliest so as to be usefully effective to the clinical process.”

Dr. Pieter Spee from Estonia, the Partner Country, gave international perspective to the process of diagnostics. He highlighted that innovations are even more important in diagnostics as it’s the early detection that enhances the medical treatment. Estonia is emphatically developing new products, facilities, techniques and tests that support the process of diagnosis. Beyond that, access to lab results and sharing data in real time is the key to improved medical facilities and clinical treatment. Diagnostics is complemented with very high intervention by innovations and inventions, and IT companies like

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IBM are also pitching in with their state of the art products like the Watson and Block Chain. Taking the diagnosis beyond a laboratory process, Siddharth Sangwan of Hindustan Wellness highlighted the newly defined telemedicine process with new innovations and a new approach. Explaining the process, he said that “We have been hearing of telemedicine from the Nehru and Indira Era. But what is accomplished so far is very less. We have now integrated the telemedicine system where the doctor explains the report to the patient and in the process takes the customer/patient in a walk

Dr Kamini Khillan Innovations in India need to be brought to the grass root level. Handling blood, collection, storing and transfusions, requires innovative approach to handle the scarcity and the unfortunate reality of overstocking that goes wasted in our country. Need of the hour is to establish network between all the players in the supply chain that can eliminate crucial challenges faced by patients, clinics and blood banks as well.”

through his report and diagnosis. Next step of telemedicine will be to integrate Artificial Intelligence so that patients can contribute to the clinical process and recover faster, with the additional help of doctors and medicines. Other panelists also unanimously highlighted that diagnostics takes the lead in extending quality medical facilities and clinical treatment, and new innovations, should be encouraged in the industry in tandem with hospitals and doctors to be productively more useful and affective.

â&#x20AC;&#x153;

Pieter Spee Innovations is even more important in the diagnostics as itâ&#x20AC;&#x2122;s the early detection that enhance the medical treatment. Estonia is emphatically developing new products, facilities, techniques and tests that support the process of diagnosis. Beyond that, access to lab results and sharing data in real time is the key to improved medical facilities and clinical treatment.â&#x20AC;?

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Session Three: Innovation for Affordable Healthcare – A medical device perspective

Innovate to be affordable Moderator: Eur Ing Muthu Singaram Panelists: • Stephen Victor • Dr. Karthik Anantharaman • Biten Kathrani • Ashim Roy

New technology and its implementation will be effective if only it contributes to bringing the cost of health and medical care at a reasonable level

ffordability on its own isn’t going to solve the problem of health care if we do not address other issues, voiced the panelists of the third session based on their professional experience and expertise. Costing alone isn’t the only factor in making healthcare affordable; as what is affordable to some may not be the same yard stick of affordability for others. Intelligently moderated by the guest from IIT Madras Eur Ing Muthu Singaram, with intense participation by the audience and focused response by the panelists, the session highlighted standard problems that are universal in nature and are a concern for industry representatives from the emerging markets and the industry leaders as well. Highlighting his concern, Biten Kathrani of Boston Scientific voiced

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his opinion saying, “Affordability today is very important not just for emerging markets but for the global health care environment. But in the guise of affordability and much talked about affordability, one of the critical things that we have forgotten to do in health care is to figure out challenges associated with awareness, access and adoption. So today we must look beyond affordability and not ignore awareness, access and adoption.” Addressing the flip side of the subject of beating around about affordability, Dr. Karthik Anantharaman of BPL Medical Technologies highlighted, “Traditionally developing medical devices is very capital intensive with years of R&D that adds to the cost and makes it very unviable for the product to be of any commercial viability. The best

Pavan Asalapuram Providing complex solutions to simple problems is very easy but providing simple solutions to a complex problem is challenging. The choice of appropriate antibiotics is the simplest of solutions to a complex problem that is caused by regular intake of antibiotics especially in the case of ailments like TB, Cancer or most of the communicable diseases. “

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Dr A.K. Gupta Human resources is the greatest asset. But scratch a problem and you will find a human at the bottom of the problem. Aim is to motivate and improve the knowledge skills and attitude of the employees, which will benefit the system. If you want to be successful, its very simple: Know what you are doing; Love what you are doing; and believe in what you are doing. Future of management is that there’ll be more problems than human capacity to handle that. Motivation and new technology is the way forward to face these problems.”

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way forward is to produce products that are of need by the doctors and not indulge in ambitious research programs that can take as long as 4-5 years of development time and just the research alone can cost a couple of millions of dollars.” Highlighting the concern of the market towards the newly-launched products and services, another panelist Stephen Victor said, “Life cycle of a diagnostic device is not predictable as some competition may arrive in the market within six months of its launch, with additional

facilities, extra benefits and probably at a cheaper cost. And there are other factors that can contribute to failure of the product despite it being very innovative and technically superior. For this, you need Curators for startups or need big corporates to invest in service and maintenance for new innovative products.” With an emphatic conclusion about the worries of many of the startup aspirants, M.V. Amaresh Kumar, who works for Abdul Kalam Institute in Andhra Pradesh, a quasi-government establishment, emphasized, “Cost of

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innovation is always high as it involves immense research and investment in resources with no guarantee of market share. Government establishments like the Andhra Metric Zone and Abdul Kalam Institute have come to the rescue of such innovators who need hand-holding by someone for making new products commercially viable and relieving the inventor of such mental burden. Only such a marriage between innovators and non-profit establishments can ensure innovations to be introduced at reasonable price – not necessarily at a cheap rate, but affordable.”

Biten Kathrani Affordability today is very important not just for emerging markets but for the global health care environment. But in the guise of affordability and much talked about affordability, one of the critical things that we have forgotten to do in health care is to figure out challenges associated with awareness, access and adoption. So today we must look beyond affordability and not ignore awareness, access and adoption.”

Session Four: Public Health and Biotech

Health should start with Public Keynote Address: Dr. D Prabhakaran Moderator: Dr. V.K Singh Panelists: • Dr. Jaanus Pikani • Dr. Pranav Gupta • Dr. Sanjiv Kumar • Maj Gen Jagtar Singh

iting the example of global data about Diabetes, Dr. Prabhakaran brought to the notice of the audience that what is relevant to a specific area may not be applicable elsewhere, hence not very usable for health service providers in that region This is very important and relevant as biotechnology can be best put to use with good quality data for a specific region and disease. “We need to understand the mechanism of the disease. Innovations are needed in the management of acute illness. You, also, need data to apply biotechnology at its best and develop guidelines. Especially for contagious diseases, we need to keep track of various demographic realities on ground through good quality data that should be available to medical experts, without any corruption in the data,” said Dr. Prabhakaran. He concluded his thoughts on the

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problems with suggestions that what is required is a simple device available at the location and operational without the need of any complex operations. We need to develop such devices for monitoring of communicable devices that can be used for self monitoring, patient management in hospitals and screening. In contrast to the scenario above, Maj Gen Jagtar Singh, an expert in the field of medicine with our armed forces sketched a very different scenario and raised very relevant points. “Outbreaks are a huge threat in the army as we have a large body of human beings living together. For this we have a large army of efficient doctors and medical staff to contain such outbreaks”, he explained. He continued his thoughts on the same and said, “The second challenge is harsh ground realities as our soldiers

Dr Karthik Anantharaman Traditionally developing medical devices is very capital intensive with years of R&D that adds to the cost and makes it very unviable for the product to be of any commercial viability. The best way forward is to produce products that are of need by the doctors and not indulge in ambitious research programs that can take as long as 4-5 years of development time and just the rearch can cost a couple of million of dollars.”

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Initiating the discussion on the subject of Public Health and Biotechnology, the Keynote Speaker Dr. D. Prabhakaran emphasized the need to start with working with collated data, for the purpose, from the location and find solutions that are unique to that area.

work in extreme conditions. To treat them at these extreme conditions, the Indian army has done some specific research that has been accepted all over the world and not just with our soldiers. “In the field of acclimatization, we are working with innovative approaches to cut down the acclimatization period and counting on such platforms as this to understand our unique problems and extend their service to find acceptable solutions,” concluded Maj Gen Jagtar Singh. Dr. Jaanus Pikani has been an active member of the team that orchestrated transition of the Estonian health care from the Soviet type system to the most cost-efficient health care system globally recognized by the World Bank. Dr. Pikani was among the initiators and architects of the Estonian Genome Project, a globally unique population based health and genome databank of 50,000 participants or 5% of Estonian population, as of now. Highlighting this as a new yardstick of providing public health, he shared that the Genome Project is now supported by various European states and in fact has reached as far as Vietnam and around. European countries and the World Bank have been in support of the project and eagerly back the project with good intentions. Dr. Pikani feels that what they have achieved may be small in number especially when compared to India, but the same can be replicated with faith and dependence on technology

and innovations. Highlighting the efforts and intentions of the Government of India, Dr. Sanjiv Kumar, Director of International Institute of Healthcare Management (IIHMR) shared his excitement regarding the positive steps of the government. “I am excited about the shape of things to come in the near future with acceptance and adaptation of innovations and new technology.”

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In fact, he took a very encouraging approach and said, “Technology is available in your pocket for your good health. Starting with your smart phone, by which you can count the steps you take and the calories that you burn in a day, innovation hence has already become part of our life and we our using technology of today with very innovative approach and amazing outcomes.” “Even the shortage of doctors

Stephen Victor Life cycle of a diagnostic device is not predictable as some competition may arrive in the market within six months of its launch, with additional facilities, extra benefits and probably at a cheaper cost. And there are other factors that can contribute to failure of the product despite it being very innovative and technically superior. For this you need Curators for startups or need big corporate to invest in service and maintenance for new innovative products.”

or specialists is taken care of by telemedicine or long distance consultation. This is not in the future, but is in fact happening with the best of the doctors and specialists being consulted by clinics and medical facilities from all over the country – some as newly-formed private establishments or many more backed by the government to maximize the utilization of doctors and specialists who are in terrible shortage.” All the panelists unanimously voiced their positivity about the fact that the health and medical field in India has been most encouraging in embracing innovations and new technology with amazing results.

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M.V. Amaresh Kumar Cost of innovation is always high as it involves immense research and investment in resources with no guarantee of market share. Government establishments like the Andhra Metric Zone and Abdul Kalam institute have come to the rescue of such innovators who need hand-holding by someone for making new products commercially viable and relieving the inventor of such mental burden. Only such marriage between innovators and non-profit establishments can ensure innovations to be introduced at reasonable price – not necessarily at a cheap rate, but affordable.” 37

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Session Five: Healthcare Beyond Hospitals

Keeping Hospitals in the best of Health Hospitals will remain at the core of healthcare and with good quality medical facilities limited to corporate hospitals or a few of the governmentrun large hospitals, altering the health map of the country has to start from the hospital premises.

Keynote Address: Dr. S. Venkataramanaiah Moderator: Dr. Sandeep Bhalla Panelists • Dr. Santana Biswas • Dr. Tarun Marole • Dr. Mukesh Taneja • M V Amaresh Kumar

ospitals in India play a vital role in healthcare with most of the high-end medical facilities available only at the hospitals. But these large institutes are very far away from the masses as more than 70 percent of the Indian population lives in rural areas. That leads to a reality that medical facilities must go beyond hospitals, with an innovative approach, to serve the masses and make India a healthy place. Addressing the issue as keynote speaker, Professor Krishnan from IIM, shed light on the management aspect of innovations and spelled out the needs of the industry for the sake of ensuring that all innovations become a reality and benefit the masses. In his words, he said, “Innovations in healthcare must consider three

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aspects: Begin with identifying core functionalities of equipment without having to sacrifice on the safety aspect. Secondly, start from scratch. Build upwards and incorporate all the technical features that you feel are essential to the product; downscaling features will not necessarily downscale your cost; lastly, collaborate and team up with others who will complement your product, effort and intentions. There’s no one entity that has all the knowledge and resources to develop any product in its entirety. So build up on sound partnerships using complementary technology and process.” In support of the view, Dr. S. Venkataramanaiah highlighted data usage as one of the most effective tools to implement an innovative approach

Dr D. Prabhakaran We need to understand mechanism of disease. Innovations are needed in the management of acute illness. You also need data to apply biotechnology at its best and develop guidelines. Especially for contagious diseases, we need to keep track of various demographic realities on ground through good quality data that should be available to medical experts, without any corruption in the data. What is required is a simple device available at the location and operational without the need of any complex operations.”

for spreading good health. He said, “Data clearly indicates that there’s a huge demand for private players in the health sector. Everyone is and needs to be medically insured and ensured of good health by private or a government body. On the other hand, healthcare has some major deficiencies like availability of medical help at anytime and anywhere. Like you have roadside assistance available all over the country, such a facility for health and medical urgencies is still not available. “So innovative approach in production, processing, delivering service or business management is the answer to finding solutions to new challenges faced in the health sector,” he said In a more myopic approach to the topic of distance solutions Dr. Mukesh

“

Dr Sanjiv Kumar Technology is available in your pocket for your good heal. Starting with your smart phone, by which you can count the steps you take and the calories that you burn in a day, innovation hence has already become part of our life and we our using technology of today with very innovative approach and amazing outcomes. “Even the shortage of doctors or specialists is taken care of by telemedicine or long distance consultation, he said”

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Taneja shared some startling data from the WHO. “According to World Health Organization’s 2010 data 285 million people are visually impaired; 90 percent of these are in the developing world; and 80 percent of these are preventable,” he said. And speaking of India, 70 percent of the population lives in rural areas, however 90 percent of the medical facilities are located in urban areas. So, there’s a huge gap between the care providers and the population who they should be reaching. And we believe that telemedicine – a very innovative approach -- is the answer to bridge this gap. Eye problems can more effectively be pictured and online imaging of affected eye can easily be examined and diagnosed by a distant located ophthalmologist. “We, at LV Prasad Eye Institute, extensively use this telemedicine platform and are reaching out to the rural population with the help of health workers and specially trained technicians who operate our remotely located Vision Centers.” The next panelist, Dr. Santanu Biswas, from the UAE shared his international perspective and said, “If you are to work on remote distance technology, you cannot work in isolation. You choose partners in technology, data procurement and delivery system. This means your dependence on your partners is even more critical as you depend on their credibility, technical compatibility and similar intentions. This is the reason

that even though we have been talking about digital health and e-health; but other than the fact that it’s been a buzzword for the last 15 years, it has not become a well-charted module. We are still talking about the concept and exploring innovations that will truly support the telemedicine or e-health platform. This is because we are trying to marry and merge a conventional health system with an imposed telemedicine process.” Concluding his views on the subject he summed it up saying, “I think we need to rediscover a totally new innovative approach to telemedicine, which will use innovative technology, innovative approach and an all-new processing and delivery system. And this will evolve, as this is the future.” Dr. Tarun Ramole, speaking in the

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role of an investor and entrepreneur spoke candidly about the business aspect of telemedicine. In his opinion, Telemedicine, as a business is a very lucrative platform. The gap between the resources and the users remains very high and in a country like India is not going to be easy to fill that. “Telemedicine will be a very reliable option to bridge the gap and that makes it a very viable business option. But, like most businesses, telemedicine also has challenges that are very unique. Starting with, most start-ups end up replicating what is already there in the market “with improvisations”. What we need is new solutions and not improved solutions. You must think innovatively to innovate things,” he concluded his opinion with a very upfront approach on the subject.

Dr Pranav Gupta Cost is the most important element to determine easy diagnostics and cheap diagnostics. With that intent, we started our lab for local operations in Varanasi. With the advancement of biotechnology and implementation of biotechnology, we have developed some very affordable tools and devices to test and analyse clinical tests. Initially it was done locally in Varanasi with support from Banaras Hindu University, but our results also received encouraging support from doctors and specialists at All India Institute of Medical Medical Sciences in Delhi.”

Session Six: Innovations in the Pharma Sector

Understanding the chemistry of good health Keynote Address: Dr. Ronald Heslegrave Moderator: Dr. Shiban Ganju Panelists: • Dr. V.K, Sharma • Dr. Vinod Nikhra • Dr. Anjana Batni • Ashish Kumar

t all started with a chemical reaction and hence it’s very obvious that it can only be controlled with a series of chemical reactions. And, so came the pharma industry more than 200 years ago.

“

That’s history, today the pharma industry, especially in India is very modern in its approach and is shouldering the health sector with its innovative approach and modern innovations. But growing back to the

Maj Gen Jagtar Singh Outbreaks are a huge threat in the army as we have a large body of human beings living together. For this we have a large army of efficient doctors and medical staff to contain such outbreaks. The second challenge is harsh ground realities as our soldiers work in extreme conditions. To treat them at these extreme conditions, the Indian army has done some specific researches that have been accepted all over the world and not just with our soldiers.”

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Today’s pharma industry has gone beyond molecular structures and rolling out tablets. Since the first Pharma Policy by the Indian government in 1986, the industry has come a long way and today every third pill consumed in the world is from India

future, India is also taking lead to promote its age-old Ayurveda that is as effective as any other modern science. Opening the floor to this highvoltage discussion, Dr. Shiban Ganju Atrimed Pharmaceuticals in the US said, “Until now human body has been an amalgamation of cells, tissues and organs. Now, the human body has emerged as a conglomeration of biochemical process that are scattered around and work in close coordination with each other with the sole purpose of keeping the human body alive.” “Another baffling reality for me is that Ayurveda introduces us to the benefits of plants and their properties. After all, trees and plants appeared much before the pharma industry. Plants have been in existence for more than two billion years and our pharma industry is less than 200 years old. Not only that, plants have a self-preserving system and can fight any bacterial attack or any foreign infection; that makes them the most natural source for our pharma industry – even in these modern times. More so in the modern times!” he concluded his thoughts with his faith in age-old Ayurveda. Closer to the ground, Dr. V.K. Sharma shared some startling facts about the Indian pharma sector: “We are the most economical medicine manufacturer in the world. India is the third largest producer in volume and 10th largest in business globally. Thirty percent of US requirements are catered by Indian pharma manufacturers. We export to almost 200 countries in the world. One out of

every three pills consumed in the world is from India. And all this has been achieved in the last 30 years when the Indian government came out with its Pharma policy in 1986.” “Despite that India pharma industry has been facing many challenges and to address those issues now there’s a new Drug & Pharma policy that will encourage more research and development in the country making the pharma industry more robust and bigger than ever.” Dr. Vinod Nikhra highlighted the contribution of Indian pharma industry beyond the “pill factor” as he emphasized the broad developments in the sector and what makes it click internationally. “India has been on the forefront of providing some of the leading medical facilities that are uniquely innovative and ingenious. Indian pharma industry has gone beyond molecular contributions and is in fact manufacturing some ground breaking gadgets and machines that contribute to curing people from extreme ailments like heart and lung diseases, transplants and coronary diseases,” he said. On the flip side, he added, “Of course pricing is an issue that is faced by the industry and the irony is that despite the price being much cheaper than the international market, it still remains out of reach of most Indians. For this we are counting on government to extend some encouraging and bold steps to make medical facilities and good health within the reach of all.”

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Highlighting the problems of the Indian Pharma industry, Ashish Kumar from Medicea Technology Solutions said that, “The problem that we are trying to solve is two-fold. First one is facing the encroachment of fake and counterfeit drugs which is growing at 25% CAGR per year and is valued at $10 billion annually. We are working closely with IBM to address this problem and are on the brink of perfecting a fool-proof system that will block every fake or counterfeit drug in the country.” “Second project that we are working on is to track and design demographics of drug consumption. Use of a particular drug in a zone or a larger region can give a very useful insight to health authorities as to what is the cause of those ailments that are leading to high consumption of particular drugs in that particular area.” Dr. Anjana Batni, an Ayurveda researcher from Atrimed Biotech brought glory to Indian past highlighting the relevance and importance of age-old Ayurveda that is getting increasingly accepted universally and is completing the modern medicine and not competing with it. Highlighting the contributions of her organization, she said, “With the intention to modernize Ayurveda, we are collating data about the plants and their use. Ayurveda texts identify how to diagnose, manage and how to cure diseases; and they also have vast information on plant molecules and

Dr Rishikesha T. Krishnan Innovations in health care must consider three aspects: Begin with identifying core functionalities of equipment without having to sacrifice on the safety aspect. Secondly, start from scratch. Build upwards and incorporate all the technical features that you feel are essential to the product; downscaling features will not necessarily downscale your cost; lastly, collaborate and team up with other who will complement your product, effort and your intentions. There’s no one entity that has all the knowledge and resources to develop any product in entirety.”

so far, less than 10 percent of these plant molecules identified in Ayurveda texts are in practice. Our efforts are to classify all the plant molecules and store them digitally for use by Ayurveda practitioners and other medical platforms. As of now we have a library of 2.8 lakh plant molecules identified and digitally stored at our facility.” “We are soon embarking on clinical trials of our discoveries and we hope that our efforts can bridge the gap between modern pharma and Ayurveda with our discoveries,” concluded Dr Batni to a welcome applause from the audience.

“

Dr S. Venkataramanaiah Data clearly indicates that there’s a huge demand for private players in the health sector. Everyone is and needs to be medically insured and ensured of good health by private or a government body. On the other hand, health care has some major deficiencies like availability of medical help at anytime and anywhere. Like you have road-side assistance available all over the country, such a facility for health and medical urgencies is still not available.”

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Session Seven: Digital Health: Giving birth to new delivery models and fostering Innovations

Delivering Innovations

International panelists discuss at length the need for standardization and effective implementation of these standards in the country – if any

Keynote Address: Sandipan Gangopadhyay Moderator: Dr. Oomen John Panelists: • Dheeraj Misra • Kausik Bhattacharya • Dr. Dayaprasad G Kulkarni • MariliaCavaco • Reggie George • Srinivas Peri • Dr. Rahil Qamar Siddiqui

nnovations will remain the spine of modern health and medical facilities, but regulations, standardization will be the need of the hour as India strides towards improving health standards with innovations and innovative approach. Initiating discussion on this topical subject, Sandipan Gangopadhyay of GalaxE from the US said, “E-Health is the need of the time and you need quality data to implement it. Collating data in a country with 1.3 billion people should not be a concern, but it’s a challenge. Once you gather data, the challenge shifts towards protection

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of data, exploitation of data and mismanagement of data. These are common challenges all over the world and will be faced in India more so due its complex demographics.” Extending his keynote address on the subject, he added, “As we learn about solutions adopted in different countries, India should take advantage of that and adapt those solutions to avoid mistakes and complications associated with handling large data. Adhaar, the hottest thing in India, seems to be the most suitable solution for various things, including health and medical facilities.

Dr Sandeep Bhalla Health care is focusing only on hospitals, hospitals and only hospitals. However we do not have to limit our innovations to hospitals only. The corporate culture of hospitals today leaves lot more to be innovated in the hospital management and processes and I believe that innovations in this field will contribute to better health and much better health facilities for all.”

Taking the subject forward, Dheeraj Misra of Galax E, as moderator of the session said, “The way I see, technology can not only help reduce cost and make solutions more affordable and improve efficiency, but can also make things more transparent, which we are missing in our ecosystem.” “Simply identifying standardization isn’t the solution for enhancing the health and medical industry, but implementation of the same, with international partnership at the government and private/public sector will definitely induce transparency and invite every player to join hands and work together towards a healthy society.” His inquisitive approach uncovered some very relevant and important notions on the subject. Kausik Bhattacharya from Johnson & Johnson highlighted the technological advantage at the corporate level as he spelled out the dependence on Cloud Technology. Explaining the term he said that “Cloud technology may not

“

be new, but its disrupting the way things are happening or will happen in future in the field of health and medical facilities.” Elaborating on the subject, he added that Cloud is giving rise to a completely new set of delivery models, which are trying to make it more agile or faster in terms of converting ideas

Dr Mukesh Taneja According to World Health Organization’s 2010 data 285 million people are visually impaired; 90 percent of these are in the developing world; and 80 percent of these are preventable; And speaking of India, 70 percent of the population lives in rural areas, however 90 percent of the medical facilities are located in urban areas. So there’s a huge gap between the care providers and the population who they should be reaching.”

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into a product of service that will ultimately help the doctors, nurses and also the patients. The biggest advantage of cloud technology is its potential to implement scalability. Cloud technology can also help in connecting different technologies and evolve into complete solutions. Marilia Cavaco, also from John &

Johnson, highlighted other aspects of J&J that makes them one of the global leaders in the health sector. “At Johnson & Johnson we touch over a billion lives on a daily basis with our products, medications and services. Since we touch so many lives it’s imperative for us to maintain safety and hygiene as the top concern in our operations. That being our ground standard, we have made investments into artificial intelligence and machine learning and have been getting very encouraging support from our partners at FDA in the US,“ said Ms. Cavaco. Mr. Misra, asked some penetrating questions of Dr. Dayaprasad G Kulkarni regarding the ever-important subject of transparency. In response, Dr. Kulkarni said, “The current efforts of the government to digitalize India

and services in India are contributing to inducing transparency and also democraticize and cut down on the seepage of sources, which is a huge problem in both private and public sectors. Next step is for us to engage in these facilities and platforms and take advantage of this transparency.” “WHO’s Global Digital Health Index is another good tool to bring transparency at international level and will provide a standard platform of digitization. This is an index that looks at tracking, monitoring, evaluating and scoring the use of digital technology that will help bring all the players at one unified level.” On the home front, Dr. Rahil Qamar Siddiqui, Founder of Eventus, brought to everyone’s attention that standardization is available in the country and how it’s helping to spell

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out the health policy and also keep the industry under control. “There are EHR standards in India; it’s unfortunate though that not many in the industry know about it. In addition to the Bureau of Indian Standards the ministry is also involved in setting a lot of standards in India. Ministry of Health Holding (MOHH) has in fact published a document spelling out HER standards for India,” clarified Dr. Siddiqui. “So there’s a standard for vendors to apply for even though there’s no accreditation body – yet. In fact, there are standards in various fields and segments of health sector that Government of India has compiled, to be used within India and opportunities like this (InnoHEALTH) help us to educate the public at large,” concluded Dr. Siddiqui.

Dr Santanu Biswas If you are to work on remote distance technology, you can not work in isolation, You choose partners in technology, data procurement and delivery system. This means your dependence on your partners is even more critical as you depend on their credibility, technical compatibility and similar intentions. This is the reason that even though we have been talking about the digital health and e-health; but other than the fact that its been a buzzword for the last 15 years, it has not become a well charted module.”

Session Eight: Challenges and Redefining Healthcare Landscape

Accessibility changes the landscape Keynote Address: R. Rengarajan Iyengar Moderator: Sachin Gaur Panelists: • Anjali Kaushik • Dr. Sanjay Sharma • Dr. Nimmi Rastogi • Amit Bhatnagar • Deepak Mittal

pening the discussion, R. Rengarajan Iyengar of HCL Healthcare started very strongly saying, “The need of the hour is to get the authority of the public

“

sector married with the energy and efficiency of the private sector. With changes in the demographics of the country, health care sector is growing into a very profitable sector as more

Dr Tarun Ramole Telemedicine, as a business is a very lucrative platform. The gap between the resources and the users remains very high and in a country like India is not going to be easy to fill that. Telemedicine will be a very reliable option to bridge the gap and that makes it a very viable business option. But, like most business, telemedicine also has challenges that are very unique. Starting with, most start-ups end up replicating what is already there in the market “with improvisations”. What we need is new solutions and not improved solutions. You must think innovatively to innovate things.” 47

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As India evolves from four-cosmo cities to a vast population coming under the modern cities the healthcare landscape evolves tremendously – discuss high profile panelists at the last session of the InnoHEALTH 2017

and more cities are emerging as modern cities and expect only the very best in health and medical facilities.”

our dependency on digital platform doesn’t become a liability to the system,” said Dr Anjali Kaushik.

In support of his belief, he emphasized, “To achieve the above goals, we need to turn to innovative approach of things that may include new technology, newer processes and modern approach to processing and delivery of the best of the facilities. Concepts like telemedicine and cloud computing are also encouraging new players to enter as investors and at the same time luring corporates to invest in this sector.”

In contrast to the skeptical approach of Dr. Anjali, Sachin added that, “Hacking of data remains a grave concern for depending on that tool, but that’s only one aspect of it. There are, however, larger benefits of this holistic approach of using digitization with innovative tools. The way forward is for different players to gather their efforts and handle the challenge of collating quality and accurate data with a unified effort,” said Sachin.

Sachin Gaur, took over as the moderator of the session and brought in his international exposure sharing his experience in the Scandinavian countries and opened the discussion with his view: “New Age requires New Solutions.”

“This is what I have witnessed during my trips abroad, especially in the Scandinavian countries where even the government contributes to gather data and process it suitably,” he concluded.

Starting with Dr. Anjali Kaushik, he engaged the panelists with their thoughts on the subject. “When you are handling large data sets, and that too, sensitive data like the details of patients, their illness; their personal details and their current medical status – there’s always a threat of cyber attack and we have recently seen in the case of UK’s NHS site being hacked and data was compromised. India is no exception to this as many hospitals have been subject to hacking leading to a freeze in the system where doctors could not treat patients without any access to their vital information. For this we have to induce digital hygiene and put systems in place to ensure that

Dr. Sanjay Sharma, from Yostra labs and Vital Sense added, “We have made an effort to innovate in the field of scarcity and help in extending trained hands to help patients recover fast. There are always well-wishers with patients in the hospital, and they are close relatives of the patient who, we realized, can be utilized to help the patients recover fast and contribute to extending health care beyond doctors and medical staff. So, we initiated an innovative approach to train these well-wishers who contribute with total honesty and good intent to learn healthcare basics. The results have been amazing and have in fact contributed to relieving nurses who are over-worked and short staffed.” Close to Delhi, the latest break

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through in the healthcare sector is Mohalla Clinics and Dr. Nimmi Rastogi, shared her thoughts on the concept as Health Advisor to the Government of Delhi. “Mohalla Clinic is a nofrills attached basic clinic to provide primary health services to people in the neighborhood. The facility has one doctor and four medical staff including a nurse and a compounder. It’s a prefabricated, air-conditioned facility in less than 100 sq yards with two rooms and basic facilities to store medicines and conduct essential tests.” Elaborating on the facility, Dr Nimmi added, “The facility extends free facilities – free consultation, free medicines and 110 tests are conducted free of cost for anyone, irrespective if they belong to Delhi or not. Within the first year of its operations we are handling 80-100 patients a day using innovative tools and digital platform.” Adding human element to innovations, Amit Bhatnagar of Accuster Technologies shared his personal and professional opinion on the subject and said, “When you talk of innovations, it must involve the people and not just development of technology. With such a large number of technically qualified manpower available to us, innovations without involving them are missing the bigger picture. Our journey of innovation is based on the fact that more than 85 crore people do not have access to diagnostic facilities as they live in rural areas. Our objective has been to develop technology that can be rugged enough to reach out to these rural grounds and help provide

Dr Ronald Heslegrave It’s a huge problem and its problem that’s been prevalent for as long as the Clinical Trials themselves. But we often ask ourselves, ‘Do we know how big the problem is?’ And in all fairness, we didn’t know how big the problem is. Research Integrity can be questioned if the Clinical Trials have been unfair in the process and there have been papers that have been withdrawn by Canadian authorities that have been involving questionable practices – especially involving clinical trials.”

accurate diagnostics leading to better remedies.” Deepak Mittal, concluded the session spelling out the mission of his company that has gone beyond technology and has extended healthcare by clever use of data in relation to the demographics. “The mission of our company is to prevent and control diseases, improve quality of care and reduce cost of care. With the help of algorithms and artificial intelligence we can map the trends and predict unexpected ailment attacks with respect to the demographics of the region and population,” explained Deepak. “For this our dependence on data

“

is crucial and I must share that data in the healthcare sector is probably the worst data with no unified parameters on any filter. So the biggest challenge

Dr Shiban Ganju We have learnt until now that human body is an amalgamation of cells, tissues and cells. Now, the human body has emerged as a conglomeration of biochemical process that are scattered around and work in close coordination with each other with the sole purpose of keeping the human body alive. Another baffling reality for me is the Ayurveda that introduces us to the benefits of plants and their properties. After all, trees and plants appeared much before the pharma industry. Plants have been in existence for more than two billion years and our pharma is less than 200 years old.” 49

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in executing our intentions with honesty and accuracy totally depends on acquiring and collating good quality data,” concluded Deepak.

Innohealth in Bengaluru OCT 2017

Handholding Innovative companies from EU for Indian Market Access: A day well spent in Bengaluru. Sachin Gaur spells out the details of the magical meeting between the two sides opening doors for a brighter and fruitful future.

A booster shot for Innovations in India

nnovatioCuris, IC in partnership with NovoJuris and with support of Honorary Consul of Estonia in Bengaluru, Karnataka Drugs and Pharmaceuticals Manufacturers’ Association, (KDPMA) organized the Bengaluru leg of InnoHEALTH conference followed by B2B meetings.

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When in the planning stages of the delegation visit we were strongly advised by the Department of Biotechnology, Government of India to include Bengaluru in our itinerary. As you know Bengaluru is probably the center of all the action in the country when it comes to biotech industry.

Dr V.K. Sharma To share some positive facts about the Indian Pharma Industry: We are the most economical medicine manufacturer in the world; India is the third largest producer in volume and 10th largest in business globally; Thirty percent of US requirements are catered by Indian pharma manufacturers; We export to almost 200 countries in the world; One out of the three pills consumed in the world is from India. And all this has been achieved in the last 30 years when Indian government came out with Pharma policy in 1986.”

So, we looked at a stakeholder approach considering that many of the companies/delegates were to visit India for the first time. We realized that the main stakeholders for such a visit would be experts on Indian health sector, distribution channel experts, investors and legal experts. Since, Estonia was our country partner we reached out to the Honorary Consul in Bengaluru who further connected us with KDPMA and other industry bodies. We, also, partnered with NovoJuris given their expertise in legal matters and strong interest in

â&#x20AC;&#x153;

the health sector. The whole program was put together in partnership with a strong collaboration of the IC and the NovoJuris team. The Bengaluru visit was planned for 21st of September 2017 with the first half of sessions with experts in the areas identified. The session about Indian health sector was delivered by Dr. V C Shanmugandan from Association of Private Hospitals of India and Ms. Swetha Suresh from Swissnex. The legal session was delivered by various experts of the NovoJuris team. The investor session saw experts from Accel Partners and

Dr Vinod Nikhra India has been on the forefront of providing some of the leading medical facilities that are uniquely innovative and ingenious. Indian pharma industry has gone beyond molecular contributions and is in fact manufacturing some ground breaking gadgets and machines that contribute to curing people from extreme ailments like the heart and lung diseases, transplants and coronary diseases. Of course pricing is an issue that is faced by the industry and the irony is that despite the price being much cheaper than the international market, it still remains out of the reach.â&#x20AC;? 51

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PWC. The distribution session was run by officials of KDPMA, Mr. Sunil Attavar and Mr. Harish Jain. Post lunch and evening sessions were reserved for the B2B meeting followed by cocktails, where various business leaders interested in partnering with the EU companies engaged the delegates. The EU delegation was very happy with the quality of the conference and the contacts made during the B2B sessions. It was a good learning experience for us as well to bring the stakeholders together and we gear up to do it again in 2018!

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Dr Anjana Batni With the intention to modernize Ayurveda, we are collating data about the plants and their use. Ayurveda texts identify how to diagnose, manage and how to cure diseases; and they also have vast information on plant molecules and so far less than 10 percent of these plant molecules identified in Ayurveda texts are in practice. Our efforts are to classify all the plant molecules and store them digitally for use by Ayurveda practitioners and other medical platforms. As of now we have a library of 2.8 lakh plant molecules identified and digitally stored at our facility.”

Sandipan Gangopadhyay E-Health is the need of the time and you need quality data to implement it. Collating data in a country with 1.3 billion people should not be a concern but it’s a challenge. Once you gather data, the challenge shifts towards protection of data, exploitation of data and mismanagement of data. These are common challenges all over the world and will be faced in India more so due its complex demographics. As we learn about solutions adopted in different countries, India should take advantage of that and adapt those solutions to avoid mistakes and complications.”

Kausik Bhattacharya Cloud technology may not be new, but its disrupting the way things are happening or will happen in future in the field of health and medical facilities. Cloud is giving rise to a completely new set of delivery model, which is trying to make it more agile or faster in terms of converting ideas into a product of service that will ultimately help the doctors, nurses and also the patients. The biggest advantage of cloud technology is its potential to implement scalability. Cloud technology can also help in connecting different technologies and evolve into complete solutions.”

“ “ “

Ashish Kumar The problem that we are trying to solve is two-fold. First one is facing the encroachment of fake and counterfeit drugs which is growing at 25% CAGR per year and is valued at $10billion annually. We are working closely with IBM to address this problem and are on the brink of perfecting a fool proof system that will block every fake or counterfeit drug in the country. Use of a particular drug in a zone or a larger region can give a very useful insight to health authorities as to what is the cause of those ailments that are leading to high consumption of particular drugs in particular area.”

Dheeraj Misra The way I see, technology can not only help reduce cost and make solutions more affordable and improve efficiency, but can also make things more transparent, which we are missing in our ecosystem. Simply identifying standardization isn’t the solution for enhancing the health and medical industry, but implementation of the same, with international partnership at government and private/public sector will definitely induce transparency and invite every player to join hands and work together towards a healthy society.”

Marilia Cavaco At Johnson & Johnson we touch over a billion lives on daily basis with our products, medications and our services. Since we touch so many lives it’s imperative for us to maintain safety and hygiene as the top concern in our operations. That being our ground standard, we have made investments into artificial intelligence and machine learning and have been getting very encouraging support from our partners at FDA in the US.

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TRENDS

The startup coordinates and e-health destination T

his year May 24-26, 2017 was big startup event Latitude 59 in Tallinn,Estonia. I attended the event and got a flavor of the startup scene and healthcare sector discussions were held. I aligned my visit to Estonia along with the visit of my meeting with

WELL BEING

POLICY

By Sachin Gaur, Director operations IC

CBHEALTHACCESS delegates, innovative healthcare companies from Finland, Sweden, Estonia and Latvia. I could witness many startups and meet some friends. At any point in the premises of the conference there were over 1000

people and all engaged about future trends and opportunities. One way to know future is always by observing what problems best startups are engaged in solving. I could witness many biotech (genetics) based startup trying their hands on personalized medicine and new age diagnostics platform. Also, interesting was the cyber security companies.

WOMENâ&#x20AC;&#x2122;S CORNER

ISSUES

PERSONA

One cyber security startup from Switzerland, OneVisage, that attracted my attention was working on 3D face scanning as authentication mechanism and looked promising for applications like online banking with your own face as your password. Estonia in general has made great advances in two areas, one that of e-governance including e-health and the other cyber security. Hence, it was no surprise for me to see both kind of startups flocking in conference and building upon the existing good work happening in that country. The other exciting thing to see was the countries collaborating and there were many international visitors including from India. Japanese and Finnish presence was quite visible. There was also heavy promotion of e-residency program with some exciting announcements about easier account opening with a Finnish provider. It lured me also to try my hands on registering a company and post conference it took me only few minutes with the help of some local friends to register a company! Although, I am yet to make it fully functional, but that was already something for me. The highlight for me was the healthcare session on the second 56

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POLICY WELL BEING PERSONA ISSUES

Followed by the keynote was a panel discussion, which comprised of panelists from USA, Finland, Germany, Italy, Netherlands and Estonia. They were healthcare practitioners, investors, incubators, startups and large company representatives. The session was interesting and demonstrated that how international best practices sharing and collaboration is need of the hour cutting across all type of stakeholders. I really enjoyed my two days not just in the conference but also in after parties with loads of intellectual discussions. Look forward being there again next year!

TRENDS

day, which had a keynote by Nicky Hekster from IBM Watson. Nicky started by asking everyone in the room to standup and asked first those who have been to a hospital in last six months to sit down or someone in their close family. Next, he asked if they knew someone in friends/relatives who have been to the hospital. To my surprise there were only 2-3 people standing in the room which had over hundreds of people. This was a master tactic to drive the point home, that healthcare matters to all.

WOMENâ&#x20AC;&#x2122;S CORNER

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Well Being 59

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Protect your health when far from home

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Travelling abroad

ess than 100 years ago, world travel was a rare treat reserved mostly for the wealthy. Today, retirees cruise to South America, college students study in foreign land and modem day adventurers journey through the wilderness of Africa. But as small as the world has become, there are still health concerns to be aware of when you travel abroad. Get your shots If you travel to countries other than Western Europe, Canada, Austra1ia, New Zealand or Japan, you will probably need additional vaccines and medication. Sometimes these shots must be given weeks or months before your departure to allow than time to take effect, so visit your doctor early. If you visit countries in the Indian sub-continent, East Asia and South America, you will probably need vaccinations for Hepatitis A and B, Japanese encephilitis, typhoid and malaria. Visitors to the Middle East and Africa will need the above vaccinations along with meningitis and yellow fever vaccines. Pack the medicine cabinet although it may feel like you’re packing everything but the kitchen sink, there are certain items you’1l need while traveling internationally,

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including: An extra pair of eye glasses (or contact lenses. along with a current eye prescription. A medical identification bracelet to alert others about any health problems you may have. Any prescriptions medications and a signed and dated statement from your physician indicating the proper dosage and explaining why you take the medication. Over-thecounter medications and treatments that you may need, such as diarrhea medicine, cough syrup, allergy medicine, aspirin, eye drops sunscreen and insect repellant. While traveling, avoid buying over-the-counter medicine unless you’re familiar with the product. Not all countries have the same quality and safety standards for medications as required and many standard medicines are known with different brand names. Stop Stomach Bugs No one wants to spend his or her vacation in the bathroom, but the risk of intestinal infections can be high in non-industrialized countries with poor sanitation. To avoid traveler’s diarrhea, it is recommended that you: Drink only canned, bottled or carbonated beverages. Also, wipe off bottle and can rims to avoid contamina-

tion. Don’t drink beverages with ice. Wouldn’t know in water the ice has been produced. Don’t eat food purchased from street vendors. Don’t eat pasteurized dairy products. Boil, peel and cook all raw food, including vegetables. If you’re going to be in an area where you won’t be able to boil your water, you can purchase disinfecting iodine tablets from your local sporting goods/camping store or pharmacy . Insure your health If you break your leg while hiking through the jungles of Thailand, you’re going to need more than a suitcase full of antacids and aspirin. However, a trip to a local hospital usually requires payment up front in advance of treatment. A short-term health insurance policy for travelers may help protect you from these large out-ofpocket expenses. A travel policy may also be invaluable if you need to be transferred to another city or country for a medical emergency. If your health insurance company won’t cover you outside the country of your residence, there are insurance companies that specialize in travel health insurance. By: Jennifer Foss

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Tech and Disruption: Opening up a new paradigm in Healthcare

Volume 2 | Issue 4 | Oct-Dec 2017

Author: The writer is Swadeep Srivastava, Managing Partner & Founder, IndiaVirtualHospital.com

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Internet-of-Things (IOT) is another technology which has begun revolutionising healthcare. Consider the pacemaker. With the IOT, it will be possible to track its functioning and take medical advice at the required time before things go out of hand. And for the exercise conscious ones, they can count the number of steps they walk in a day through an app on the iPhone or other Android phones. This is especially helpful to those who set a target per day. So, the treadmill will not be as sought after, say, in three years from now, as it is now, because that simple app on your phone calculates the number of steps you have walked during the past 24 hours, the and calories shelved.

So, how far can all this go? Consider the Origami robot. This tiny robot placed in a capsule is swallowed by a patient. In the stomach, the capsule dissolves and the Origami robot begins its job. It can remove unwanted items, such as coins or pins from the stomach, and patch up wounds on the stomach lining, all the while being controlled by a technical expert. So, going forward, would it fanciful to think that humans could be imbedded with a chip which would measure all their vital parameters on 24x7-basis and the chip would send out an alert to a medical expert should any of the parameters show signs of going askew? That would be 24x7 medical diagnoses for you by a chip through the IOT!

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services to patients at the click of a button, and too, to the comfort of their homes. For instance, a person suffering from extreme pain of the lower back and is unable to go to a hospital to take treatment can now book for a physiotherapist to visit his house and give him/her physiotherapy sessions. Sites such as Practo, DocEngage and Lybrate, among others, bring this and many other services to patients at their homes. Similarly, our IVH app is facilitating the whole patient journey and empowering patient from decision making to surgery to recovery process in a transparent and unbiased way.

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Healthcare as we know today is undergoing many exciting transformations. For instance, the surgeon may no longer have to depend only on his skills or eyesight or even a computer screen to do complicated surgeries. He can take the help of the da Vinci Surgical System, which os a 3D high definition vision system with tiny wristed instruments that rotate and bend at angles not possible by the human hand. The end result: far greater accuracy and precision in the surgeonâ&#x20AC;&#x2122;s work. Then there is the exo skeleton, which has now begun helping paralysed people to walk again. And then there are the healthcare aggregators who are bringing various

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Welcome to the world of tech and disruption

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ne of my close relatives was suffering from Multiple Myeloma Cancer, which was diagnosed at a super specialty hospital in Delhi and the course of treatment was suggested. Since, I have been in the healthcare arena for about two decades, I was asked to arrange for a second opinion from a reputed government oncologist. While the diagnosis was correct, the course of treatment suggested by this government specialist was quite different creating a bit of apprehension and panic. Since, time was running out and the obvious choice for third opinion was Tata Memorial Centre, I logged on to Navya, which offers an expert decision service in oncology in association with Tata Memorial Centre. By simply uploading some of the medical case reports, Navya offered us evidencebased expert decision on the course of treatment, which was in sync with the second opinion offered. The treatment started on time and the relative is doing fine. By click of a button, we could get the advice from one of the best institutions of oncology sitting thousands of miles away.

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The Dynamic TRio Honored for their discoveries of molecular mechanisms controlling the circadian rhythm

ife on Earth is adapted to the rotation of our planet. For many years we have known that living organisms, including humans, have an internal, biological clock that helps them anticipate and adapt to the regular rhythm of the day. But how does this clock actually work? Jeffrey C. Hall, Michael Rosbash and Michael W. Young were able to peek inside our biological clock and elucidate its inner workings. Their discoveries explain how plants, animals and humans adapt their biological rhythm so that it is synchronized with the Earth’s revolutions. Using

fruit

flies

model

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organism, this year’s Nobel laureates isolated a gene that controls the normal daily biological rhythm. They showed that this gene encodes a protein that accumulates in the cell during the night, and is then degraded during the day. Subsequently, they identified additional protein components of this machinery, exposing the mechanism governing the self-sustaining clockwork inside the cell. We now recognize that biological clocks function by the same principles in cells of other multi-cellular organisms, including humans.

the dramatically different phases of the day. The clock regulates critical functions such as behavior, hormone levels, sleep, body temperature and metabolism. Our wellbeing is affected when there is a temporary mismatch between our external environment and this internal biological clock, for example when we travel across several time zones and experience “jet lag”. There are also indications that chronic misalignment between our lifestyle and the rhythm dictated by our inner timekeeper is associated with increased risk for various diseases.

With exquisite precision, our inner clock adapts our physiology to

Our inner clock Most living organisms anticipate

influence the circadian rhythm?

2017 Nobel Prize winners in Physiology or Medicine

Other researchers found that not only plants, but also animals and humans, have a biological clock that helps to prepare our physiology

for the fluctuations of the day. This regular adaptation is referred to as the circadianrhythm, originating from the Latin words circa meaning “around” and diesmeaning “day”. But just how our internal circadian biological clock worked remained a mystery.

Identification of a clock gene During the 1970’s, Seymour Benzer and his student Ronald Konopka asked whether it would be possible to identify genes that control the circadian rhythm in fruit flies. They demonstrated that mutations in an unknown gene disrupted the circadian clock of flies. They named this gene period. But how could this gene

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Such a regulatory feedback mechanism explained how this oscillation of cellular protein levels emerged, but questions lingered. What controlled the frequency of the oscillations? Michael Young identified yet another gene, doubletime, encoding the DBT protein that delayed the accumulation of the PER protein. This provided insight into how an

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and adapt to daily changes in the environment. During the 18th century, the astronomer Jean Jacques d’Ortous de Mairan studied mimosa plants, and found that the leaves opened towards the sun during daytime and closed at dusk. He wondered what would happen if the plant was placed in constant darkness. He found that independent of daily sunlight the leaves continued to follow their normal daily oscillation (See figure). Plants seemed to have their own biological clock.

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and Michael Rosbash

The model was tantalizing, but a few pieces of the puzzle were missing. To block the activity of the period gene, PER protein, which is produced in the cytoplasm, would have to reach the cell nucleus, where the genetic material is located. Jeffrey Hall and Michael Rosbash had shown that PER protein builds up in the nucleus during night, but how did it get there? In 1994 Michael Young discovered a second clock gene, timeless, encoding the TIM protein that was required for a normal circadian rhythm. In elegant work, he showed that when TIM bound to PER, the two proteins were able to enter the cell nucleus where they blocked period gene activity to close the inhibitory feedback loop.

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Jeffrey C. Hall, Michael W. Young

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The next key goal was to understand how such circadian oscillations could be generated and sustained. Jeffrey Hall and Michael Rosbash hypothesized that the PER protein blocked the activity of the period gene. They reasoned that by an inhibitory feedback loop, PER protein could prevent its own synthesis and thereby regulate its own level in a continuous, cyclic rhythm.

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A self-regulating clockwork mechanism

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This year’s Nobel Laureates, who were also studying fruit flies, aimed to discover how the clock actually works. In 1984, Jeffrey Hall and Michael Rosbash, working in close collaboration at Brandeis University in Boston, and Michael Young at the Rockefeller University in New York, succeeded in isolating the period gene. Jeffrey Hall and Michael Rosbash then went on to discover that PER, the protein encoded by period, accumulated during the night and was degraded during the day. Thus, PER protein levels oscillate over a 24-hour cycle, in synchrony with the circadian rhythm.

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oscillation is adjusted to more closely match a 24-hour cycle. The paradigm-shifting discoveries by the laureates established key mechanistic principles for the biological clock. During the following years other molecular components of the clockwork mechanism were elucidated, explaining its stability and function. For example, this year’s laureates identified additional proteins required for the activation of the period gene, as well as for the mechanism by which light can synchronize the clock.

The biological clock is involved in many aspects of our complex physiology. We now know that all multicellular organisms, including humans, utilize a similar mechanism to control circadian rhythms. A large proportion of our genes are regulated by the biological clock and, consequently, a carefully calibrated circadian rhythm adapts our physiology to the different phases of the day. Since the seminal discoveries by the three laureates,

An internal biological clock. The leaves of the mimosa plant open towards the sun during day but close at dusk (upper part). Jean Jacques d'Ortous de Mairan placed the plant in constant darkness (lower part) and found that the leaves continue to follow their normal daily rhythm, even without any fluctuations in daily light.

circadian biology has developed into a vast and highly dynamic research field,

with implications for our health and wellbeing.

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Keeping time on our human physiology

A simplified illustration of the feedback regulation of the periodgene. The figure shows the sequence of events during a 24h oscillation. When the period gene is active, period mRNA is made. The mRNA is transported to the cell’s cytoplasm and serves as template for the production of PER protein. The PER protein accumulates in the cell’s nucleus, where the period gene activity is blocked. This gives rise to the inhibitory feedback mechanism that underlies a circadian rhythm.

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How important is your Mental health for your physical performance

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Food for thought

o you have days when your mind feels foggy; when you can’t seem to think straight or concentrate on anything no matter how hard you try? If your answer is yes, then it might be time to re-evaluate your diet and daily habits. Some things that we do deplete the body’s system and in turn will affect the ability to think clearly and concentrate. Not eating regular healthy meals can be a drain on the brain, affecting your ability to focus without becoming distracted. Iron is essential for the transportation of oxygen to the brain, too little iron in your diet means that the brain literally suffocates. Inadequate oxygen supply prevents cells from converting glucose and other calorie containing foods to energy, quick enough to meet your cellular needs. In such case, many cell functions will either slow down or stop altogether. Leaving you feeling tired, and irritable. You may also find it difficult to think clearly or concentrate. Smoking has similar adverse ef-

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fects. The nicotine in tobacco smoke constricts the blood vessels and interferes with circulation. This can gradually reduce the number of brain cells, increasing free radicals. These in turn, damage the whole system, due to oxygen deprivation. Again this can make feel sluggish and will also be a burden on your immune system. Acute or chronic stress can also result in the inability to concentrate and thus reduce the effect of short-term memory. Likewise, high blood pressure is linked to reduced attention span and memory loss. Concentration can further be affected by lack of physical exercise and obesity. Smartening up your diet If you want to restore you concentration and memory skills then a good place to start is with your diet. Mental performance and relaxation can both be improved by choosing the right combination of foods. Foods rich in iron include whole grains, beans, and fortified cereals. Though these are generally more dif-

ficult to absorb than animal sources, vitamin C will help enhance your intake, so you should consider including sources such as citrus fruit, strawberries, red peppers, broccoli, potatoes, watermelon, cantaloupe, cauliflower, and kiwis in your meal. There are two amino acids in the brain (L-tryptophan and L-tyrosine) which compete with each other to control brain function. The brain uses L-tyrosine to synthesize neurotransmitters such as dopamine and norepinephrine. Both these chemicals are essential to the processes of alertness, clear thinking and concentration. L-tyrosine production is stimulated by protein rich foods such as beans, nuts and soya. The brain uses L-tryptophan to synthesize the neurotransmitter serotonin, which is responsible for relaxation and satiety and slowing down reaction time. L-tryptophan production is stimulated by foods such as sunflower seeds, milk and carbohydrate rich food. Because these chemicals compete with each other, if you want to stay focused and alert throughout

Does cutting carbs lead to weight loss? As many people will attest to, lowcarb diets do help you lose weight rather quickly. But -- and this is a big but -- studies show that you will have most likely have given up on your diet by the end of a year, because after all, how many steak dinners can one woman take? In addition, it’s highly likely that you will eventually hit a serious plateau or put the lost weight back on. When you deprive yourself of easy fuel in the form of carbohydrates, your body begins breaking up muscle, converting muscle protein into glucose as a last resort. At first, this cannibalization of muscle mass causes you to lose water weight, but less muscle means fewer calories burned and an inevitable slowdown of your metabolism. Which foods qualify as “low-carb”? Good question -- although there’s

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Does carb quality count? The types of carbs you put into your body do make a difference for your health. The most healthful kinds are those that go through the least processing, including whole-grain foods like whole-wheat bread and pasta, oats and brown rice. These wholesome carbs have more fiber, which helps keep your blood sugar levels steady, leaves you feeling full longer, and aids in digestion. A recent study reported in the American Journal of Clinical Nutrition showed that eating whole-grain carbs may protect women from developing diabetes. What happens if you eat too many carbs? As with any food, if you eat too much, you will gain weight. After all, weight gain occurs when you take in more calories than you expend; an excess of 3,500 calories creates one pound of fat. But in and of themselves, carbs are not fattening. They are a necessary part of your diet. If you eat healthfully and stay active, carbs will not make you fat.

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. By: Edwina Coram

If you don’t get enough, your mood, memory and sleep patterns are likely to be negatively affected, since carbs help create the brain chemical serotonin, which plays a key role in these processes. Exercise also becomes more difficult, since your muscles prefer to burn carbohydrates above all else, especially during aerobic workouts like running and cycling.

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Several mini-meals and snack throughout the day rather than a few large meals with long intervals will help your metabolism function better by balancing nutrients and keeping the brain supplied with oxygen. A moderate meal every four hours is adequate to balance brain chemical and improve mood and blood sugar levels. But don’t be tempted to nibble, this will lead to craving and gorging and will disrupt concentration further. It is also beneficial to increase your water intake to at least 6 glasses daily, and to limit caffeine (coffee, tea, and coke) to two beverages per day. Remember, if you are consuming less than 2,500 calories daily then it is advisable to at least consider taking a moderate vitamin supplement, but don’t be tempted to use supplements as replacements for nutritious foods.

How important are carbs?

no clear answer. The packaging terms “low-carb” and “low net carbs” (carbs able to be digested by the body) have no official definitions, unlike, for example, the terms “low-fat” and “nonfat.” As a result, there are no rules as to what qualifies a food as low-carb. To create foods lower in carbohydrates than their regular versions, companies simply subtract fiber and sugar alcohol content, which aren’t really absorbed into the body anyway. In truth, a food said to have low net carbs often contains the same number of calories as its non-labeled counterpart. For example, one slice of low-carb Atkins bread has 60 calories and 8 grams of carbs, while one piece of regular “light” bread has 2 more grams of carbohydrates, but 10 fewer calories. Ultimately, it’s the number of calories you eat that affects your weight.

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There are also a number of herbal drinks, which are nutritious as well as helpful for detoxification processes. Dandelion, licorice root, yellow dock root, milk thistle, red clover and burdock root taken in extract or tablet form will each help to remove toxins from the body and boost the immune system. Lemon, beet, carrot, wheat grass and the juices of all leafy greens are the best juices for purifying the blood because as they help to build up essential nutrients.

nless you’ve been living under a rock for the past few years, you know that people are in the midst of a low-carbohydrate craze! Low-carb diet books consistently top best-seller lists, food manufacturers are creating low-carb versions of familiar foods like bread and cookies, fast food chains are offering low-carb meals, and even beer companies have entered the fray with low-carb brews. Basic scientific truths, like the fact that carbs are actually important for your health, have been lost in all the marketing hoopla. Read on to find out the truth about the carbs:

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Adding friendly microflora to your digestive system by eating yogurt or probiotic supplements can also help to detoxify your system and prevent buildup of damaging bacteria in the intestines.

The truth about carbs -- are they evil or essential

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If you don’t allow your body a chance to self-cleanse then poor concentration and fatigue can become daily problems. You can help your body relieve itself of toxins by adjusting your dietary routine. Including alfalfa sprouts soybeans, brown rice, sesame salt, miso, and sea vegetables can help to clear toxins from your body and enervate your digestive and metabolic processes.

Carb Reality

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the day, then the best thing it to eat protein rich foods. That way L-tyrosine will reach the brain first, thus keeping your mental performance at maximum potential.

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Real time patient monitoring system At a destination healthcare facility The era of technology and digitization has been a catalyst for all the improvements in the healthcare industry. It has bridged the communication gap between healthcare providers and patients and it has been the driving force for better and more accessible treatment, improved patient care and efficiency. Patient satisfaction is of paramount importance. And this article speaks about our journey of improving the patient feedback system and response rates in order to address the needs of the patient in real time. Digital survey tools are nothing special in the business world, but they are the new tool in the healthcare system still burdened with paper. Traditional paper-based surveysâ&#x20AC;&#x201D; usually used by a subset of patients often yield feedback from less than 10 percent of the patient population, can be subject to transcriber error and typically do not provide timely or statistically reliable data.

Paper Patient Survey forms Six months ago,we were worried as we were not gettingthe desired response rates of patient surveys and we were spending lot of time in analyzing the results and the time consuming step of segmenting and sending the results to the concerned department. It was difficult and time consuming to keep a track of the complaints and also patients were not very keen to fill a paper feedback form. Of course, one of major drawbacks in a fledgling but growing organization is that the data was retrospective and helped with system changes but did nothing for the patients while a

commitment to excellence in the hospital, our top management and the board decided to digitize this process as a way to manage the patient complaints efficiently. From the end of last year, Health City Cayman Islands started managing the Patient satisfaction surveys and feedback digitally with the help of an App to capturereal time patient experience and to act on patient concerns quickly. Touchscreen kioskswere placed in strategic locations of the hospital with a message for the patients to use

Challenges faced with Paper feedback system Less response rates

Background: Patient experience has become an increasingly important component in the assessment of healthcare systems worldwide. The measurement of patient experience is important because it provides an opportunity to establish benchmarks and to monitor the performance of health care organizations, to improve care, to enhance strategic decision making, to pay attention to patientsâ&#x20AC;&#x2122; expectations and to make healthcare organizations more transparent and accountable to their local populations With the evolution of digital applications, such as app-based surveys and touchscreen kiosks we choose to move away from the paper based surveys to a digital methodology to measure patient experiences real time and act on it quickly.

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problem occurred.

Time consuming to analyze the results Being a new organization and also working on the principles of lean management, our customer care manager does multitasking and collecting the surveys every week, analyzing it and sending it to respective departments didconsume a good chunk of time.

Moving to Digital Patient satisfaction Surveys As patient satisfaction is one of the key components of our all-round

the feedback system and also surveys were given to Inpatients at the time of discharge using tablet computers.

Emailing Survey links to the patients: To capture the unbiased feedback we also started sending the survey link to all the patients via emails and the links were directly merged with the kiosk survey responses. This system helpedour team to analyze patient feedback instantly and accurately, eliminating the use of paper and long wait times for results to be analyzed. Furthermore, it has encouraged more participation from patients.

Benefits we experienced Increase in the volume of feedbacks

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Better Patient experience Majority of the patients are tech savvy these days and they feel comfortable to use the kiosk compared to the paper forms.

All heads of the departments have access to the feedback dashboards on their computers and they can see the complaints real time which has helped with action on complaints quickly.

Studies in several countries suggest that healthcare managers and clinicians often struggle to link patient experience data to local improvement initiatives. Robert et al. found that appointing a champion or leader on patient experience resulted in a significant improvement in the quality of patient experience research and in the ability of organizations to act on the results Track the progress The dashboard has a section to see all the assigned tasks and the 71

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The Quality manager assigns the task to the concerned departments for all low rating feedbacks.

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The assigned tasks and the status of the action taken is also available on the dashboards.

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Quick action on complaints

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The digital system has helped us to see the responses in real time on the dashboards of the heads of departments which helps them act on the concerns in quick time.

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Real time feedback

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status of the task. The concerned department has to complete the task by taking corrective actions like speaking to the patients and taking necessary actions.

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Email alerts for low ratings We get emails for all the low rating feedbacks and also daily, weekly and monthly summary of the responses. Reduced time in analyzing the results The system automatically analyze the results and it takes two less than minutes to get the detailed summary of the results. Net Promotors Scores The system automatically calculates the net promotors scores which is consider more relevant in assessing the patient’s satisfaction level. Conclusion: Many hospitals have adopted digitized patient feedback systems and continually gauging patient satisfaction and using the digital feedback system to build on quality improvement initiatives will help demonstrate a commitment to patient-centred care and improve the overall healthcare experience. Digital survey data can be captured automatically and downloaded quickly without transcription error thereby saving time, reducing costs, and maximizing data accuracy For those patients who are not tech savvy, the staff can help the patient by using the paper survey forms and feed the data into the digital system. As with paper surveys, digital surveys need to be designed well to be usable in practice and acting on the feedbacks and communicating the actions to patients is best service recovery method which every hospitals should strive for.

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Currently, we areworking towards increasing the response rate by creatingawareness campaigns with posters informing patients of surveys and by increasing the frequency of emails with the survey links to the patients. Reference: NLCAHR July 2016 | Rapid Evidence

Author: Dr. Chandy Abraham has extensive experience of working in both clinical as well as academic settings in India and the United Kingdom and is currently Chief Executive Officer, Medical Director. Dr. Chandy is a “lead surveyor” for the “National Accreditation Board for Hospitals and Healthcare organisations,” the Indian accreditation agency which works for ensuring quality in the healthcare sector.

Report: The Effectiveness of Digital Surveys for Patient Feedback Robert G, Cornell, J. Bearley, S.et al. “What matters to patients?” Developing the evidence base for measuring and improving patient experience. Project Report for the Department of Health and the NHS Institute for Innovation and Improvement. 2011.

Author: Dr. Vinit Raj, Quality Officer, A Certified Healthcare Quality Professional with a Masters in Hospital Administration and over 9 years of experience in healthcare quality. He has successfully Completed 8 Joint Commission International surveys for the hospitals in India, Middle East and North America. He has completed a Certificate Program on Patient Safety and Quality from National Association for Health Care Quality & Harvard Medical School USA.

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It’s every woman’s greatest fear: Finding a breast lump while showering or doing a monthly breast self-exam. But the truth is, a lot of that fear is unfounded, due to the fact that 80% of all lumps turn out to be benign. Here’s what those lumps really mean. Writes Indu S.

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a breast lump? Here’s why you shouldn’t panic

e all know the stats: One in nine women will develop breast cancer in her lifetime. For most of us, those numbers make every bump in our breasts a cause for panic. But while a lump should never be ignored, the fact is that the texture and feel of a perfectly healthy breast — whether lumpy or smooth, sore or sensitive — can vary from month to month, woman to woman. So when should a bump evoke concern? Read this B&S advisory article compiled by information from leading doctors in the field.

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Why your breasts are lumpy Doctors have a scary name for lumpy breasts: Fibrocystic breast disease. But although the word disease may induce panic, doctors reassures that lumpy breasts are common. “Many women experience lumpiness, tenderness or thickening of the breast tissue due to monthly hormonal changes. It’s not unusual.” In fact, there isn’t even a specific test to diagnose these kinds of lumps. It’s not like having a mammography or biopsy and finding a result. It’s kind of in the fingers of the beholder.

Sussing out the good lumps from the bad If your breasts are on the lumpy side, it can be tough to know what to feel for during those monthly selfexams. The good news is that “normal” breast lumps tend to feel distinctive; usually they’re soft, smooth and movable. Cancerous lumps, on the other hand, tend to be hard, roughedged and immobile. The best way to keep yourself healthy is to examine your breasts every month so that you’re intimately familiar with their geography — every

Lumps and cancer risk: Is there a connection?

What to do when your breasts hurt

Your Breast Health Breast cancer is the most common form of cancer in women today, and every woman is at risk. Although there is no proven way to prevent the disease, there are ways that each woman can protect her health. Here are steps you can take to maintain good breast health.

* There are other steps you can take for good breast health. Researchers are continuing to explore the effect that a healthy, active lifestyle can have on reducing breast cancer risk. While it is not yet known whether losing weight will reduce your risk of developing breast cancer, maintaining a lifelong healthy weight is good for your breast health as well as for your heart and bones.

Results of breast cancer research also suggest you should: * Maintain a diet low in fat; one that includes fruits, vegetables and whole grains. These low-calorie, high-fiber foods have proven health benefits. * Drink alcohol in moderation, if at all. Regular use of even small amounts of alcohol — whether it is liquor, beer or wine — has been shown to increase breast cancer risk.

Many breast irregularities are found by women themselves, yet women often do not know how to perform breast self-examination (BSE), and few do so regularly. Although BSE has never been proven to affect survival (BSE usually finds lumps at a later stage), becoming familiar with your breasts and what feels normal for you is a recommended component of every woman’s breast health program. Your annual exam is a good time to ask your doctor or nurse about how to do a good self-examination every month. Giving yourself a correct and comprehensive breast self-exam is vital to your health.

For Monthly Exams:

Breast

Self-

* Don’t smoke. Smoking causes cancer, heart disease and many chronic illnesses; it also negatively affects the health of others.

* Use the flat part of your fingers of your three middle fingers to feel your breast. Always use your left hand for your right breast and your right hand for your left breast.

* Exercise regularly. Work out, do aerobics, bike or walk briskly — exercise in some way so as to raise your heart rate — three or more times

* Go from your neck, down under your arm, across and to the bottom of your rib cage and up the breastbone. This area is all breast tissue.

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Go easy on caffeine. Though studies haven’t proved a connection between lumpiness and caffeine, some doctors recommend that women with monthly breast pain cut back on the coffee.

* Learn the normal feel of your breasts, and perform monthly selfexams. Many women have lumpy breasts, which are usually not cause for concern. However, if you feel a change or a lump that is new, be sure to have it checked by a doctor or nurse right away.

Breast cancer cannot be prevented, but it can be detected at an early, treatable stage. Women ages 40 and older should go for regular screening mammograms, a simple procedure that can reveal breast cancer at its earliest stage — up to two years before it can be felt. Annual screening mammography should begin at age 40. And, annual breast examinations by a medical professional are a required complement to screening mammography. Every woman, age 20 and over, should have a clinical breast exam by a doctor or nurse every year.

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Ditch that skimpy lingerie — at least on top. Some women find that wearing a supportive bra (read: one with underwires) can help ease pain.

* Have a breast examination by a doctor or nurse, every year, starting at age 20.

Reducing your risk: Self examination techniques

PERSONA

Try taking the Pill. Birth-control pills seem to ease pain and lumpiness for some women. This is probably because they keep a woman’s hormone levels more stable throughout her cycle.

* Get regular mammograms, beginning at age 40; one every year or as directed by your doctor.

a week. Several studies have shown that regular vigorous exercise can reduce breast cancer risk.

WELL BEING

The good news is fibrocystic breast condition does not increase your risk of breast cancer. There is no relationship between this condition and breast cancer, claim doctors.

early-detection

POLICY

Once you have a sense of the normal texture of your breasts, it will be easier to figure out when something doesn’t feel right and merits a trip to your doctor.

Follow an program:

TRENDS

dip and lump and thickening. The best time to do it is about a week after your period, when breasts tend to be least lumpy. (Breast lumpiness and soreness is most likely to occur the week before a woman’s period and ease up after menstruation begins.)

TRENDS

Check for any lumps, hard knots, swelling, dimpling or thickening. Perform your self-exam in front of a mirror and observe for any abnormal change in size, shape, color or discharge.

WOMEN’S CORNER

ISSUES

PERSONA PEOPLE

WELL HEALTH BEING

POLICY

Top 10 questions breast cancer 1. Can breast prevented?

about

cancer

There is no certain way to prevent breast cancer, since the cause of the disease has not been determined. Early detection followed by prompt care offers the best chance of treating breast cancer successfully.

2. What are the risk factors for breast cancer? Every woman is at risk for breast cancer. More than 70% of all women diagnosed with breast cancer have no identifiable risk factors. The risk of developing breast cancer increases as a woman gets older; it also increases if she has a family history of breast cancer, has never had children or had her first child after age 30, and if she has had prior radiation treatment for Hodgkin’s disease.

3. Do diet and exercise affect breast cancer risk? Researchers are continuing to explore the effect that a healthy, active lifestyle can have on reducing breast cancer risk. Maintaining a diet low in fat may be beneficial. Following a healthy diet and exercising regularly is good for your overall health, and it may reduce breast cancer risk.

4. Do birth-control pills influence breast cancer risk? Although some studies have shown increased risk for women who used oral contraceptives before 1975, the risk may not be the same for women using oral contraceptives today. Today’s birth-control pills contain less estrogen and progestins than those manufactured before 1975. Research

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is still ongoing, and the decision about whether or not to take these medications should be made by each woman and her doctor, based upon her individual case.

5. When should women start having mammograms? Most cancer organizations recommend that women have annual screening mammograms starting at age 40. Mammography is most effective when it is done regularly — just one mammogram is not enough.

6. Besides having mammograms, what else can women do to detect breast cancer? In addition to annual mammograms, all women should have a clinical breast exam (by a doctor or a nurse) every year, starting at age 20. After age 20, every woman should also check her own breasts regularly.

7. Are all cancerous?

breast

lumps

More than 80% of all breast lumps are benign (not cancerous). Breast lumps are very common, especially in younger women, and can come and go with menstrual cycles. Any unusual lump or a lump that doesn’t go away

should be checked by a doctor.

8. How does early detection affect breast cancer survival? When breast cancer is detected and treated at its earliest stage, the five-year survival rate is 97%.

9. What is the best treatment for early-stage breast cancer? There is a wide range of treatment options, and the best treatment is one that a woman and her doctor decide upon together. For women with early-stage breast cancer, surgical choices include breast-conserving treatment (lumpectomy) that removes the cancer but not the breast. Lumpectomy is usually followed by radiation, chemotherapy and/or hormonal therapy.

10. Is there a cure for breast cancer? No woman treated for breast cancer can be promised a certain cure, but breast cancer is highly treatable. Many women, especially those who find and treat their breast cancer early, go on to live long and productive lives. There are millions of breast cancer survivors in the world today.

TRENDS

DANCE THERAPY: A PARADIGM SHIFT

There is nothing new about dance. It is well known that dance benefits our body and mind. People have been dancing for centuries

movement psychotherapy (DMP) in the UK is the psychotherapeutic use of movements and dance to support intellectual, emotional and motor functions of the body,as a form of expressive therapy. DMT uses movement and expression with the skills of psychotherapy, counseling, and rehabilitation to help individuals to achieve both physical and mental health, stress reduction, disease prevention and mood management. Following are the benefits of Dance Movement Therapy 1. Improves endurance

cardiovascular

2. Improves coordination

balance

and

Improves body posture and

ISSUES

3. Improves muscular strength and flexibility 4.

PERSONA

The purpose of dance is to express oneâ&#x20AC;&#x2122;s emotion freely and take pleasure in performing it. If one is angry, cheerful, melancholy, afraid or feel strongly about something, one may choose to show it through eyes, facial expression,and body movements in dance.

or you can say since childhood for entertainment. However, dance as a type of therapy was recognised back in modern dance movement of 19th century. During this movement, it was realized that dance could go beyond simple entertainment, and can be used as a form of expressions. By mid of 20th century, dance therapy developed in US and Europe which added observation, interpretation and manipulation of dance elements into the practice. In 1966, a professional organization, the American Dance Therapy Association (ADTA) was established. Dance movement therapy (DMT) in USA, Australia, and dance

WELL BEING

hat is DANCE? It is not justa form of art wherein you move rhythmically to music for entertainment. But, it is also a type of therapy. Here is how?

POLICY

Dance is an art wherein you can express yourself and have a therapeutic experience. Dance movement therapy is an old concept but needs a grip in India. The author shares her experience on how dance therapeutically heals her mentally and physically

WOMENâ&#x20AC;&#x2122;S CORNER

Volume 2 | Issue 4 | Oct-Dec 2017

TRENDS

mobility 5.

Reduces muscle tension

Reduces stress and anxiety

Mood elevator

8. Improves feelings

expression

PERSONA PEOPLE

WELL HEALTH BEING

POLICY

9. Builds confidence and get over shyness Following are some recent research which showcases that dance therapy can be effective in the treatment of mental health issues like eating disorder, depression, and anxiety. A study from the Journal of Arts in Psychotherapy (2007) found that dance therapy had a positive effect on participants experiencing symptoms of depression. A study from Alzheimer’s care (2009) suggests that DMP improves memory recall in people with dementia. American Journal of Dance Therapy indicated that DMT may be a treatment option for children on the Autism spectrum.

At my golden age with silver hair and a young heart, I must say, dancing helps me feel a lot better. I did all sorts of exercise,

WOMEN’S CORNER

ISSUES

Also, it can be considered as a treatment option for childhood obesity

yoga, meditation, walking, jogging, etc. but I didn’t enjoy any of it and discontinued it sooner or later. Then, I realized that my body moves with emotions and expressions whenever I hear beats of music. I become thoughtless, feel happy and energetic. My mind connects with my body and soul, it’s like meditation to me. It therapeutically heals my aching joints and stiffness of body due to lifestyle diseases, much better than any physiotherapy ever could. This article is not some kind of scientific research, as lot of research on this topic has already been done all over the world. It’s only my insight and personal experience after joining a dance class. A group or couple dance class helps motivate you to do better each day and builds your confidence. Some people might think, “A dance class? At this age? ”. Yes, I know it is uncommon but why not. One of the reasons that people of my age do not turn up at dance classes is because they are shy. Many North Indian families in earlier days did not appreciate dancing and did not allow girls to dance as it was looked down upon. I was never allowed to dance but allowed to do higher education in those days. I will not tell you how to move your body or on which song you should dance or how you should dance…… No. I am only going to tell you to move your body and express your

feelings as we all know that dancing makes us feel light, joyful, releases happy hormones such as Seratonin, Endrofin, Dopamin etc. Dance moves can predict our feelings like if we are anxious, or self-conscious while dancing, it will show through our moves. You can do any type of dance i.e. Ballroom, Ballet, Tango, Zumba or just wiggle slightly, do what you love or what you feel comfortable with. Dance like no one is watching and just let go of yourself is the secret of good health. You do not have to be a dancer to get benefit from dance movement therapy. Do not let shyness, age or stamina come on the way. Let your heart dance with joy and happiness, your eyes will dance with emotions and your body movements will improve motor skills. The concept of DMT is new to India and needs more attention. India being the motherland of traditional and modern dance forms can be the new platform for DMT. A new concept like beer yoga is becoming a fad in our society wherein I feel DMT is much more scientific and effective in gaining holistic health. So be happy, enjoy and destress yourself, have a good diet and get better sleep. That is a secret of a happy and healthy golden age. If you wish,sometime instead of sport shoes, put on your dancing shoes……Hey…..Come on…..Dance.

Neerja Singh is a retired scientist of Council of Scientific and Industrial Research (CSIR). Her interest is in phytochemistry and non-conventional therapies benefiting the patient. She has practised many such therapies like yoga, dance etc.

Volume 2 | Issue 4 | Oct-Dec 2017