InnoHEALTH magazine volume 3 issue 4 - October to December 2018

on VOLUME 3

ISSUE 4

OCTOBER-DECEMBER 2018

INR 100/-

OCTOBER 1: INTERNATIONAL OOPS! 5.2 MEDICAL ERRORS DAY FOR OLDER PERSONS HAPPEN ANNUALLY

MEDICAL DEVICES WITNESS CHURNING

National Center for Ageing in New Delhi

AI Engraving Footprints on Healthcare

Resistant STIs on Rise

Low Back Pain cause of Disability Worldwide

Real Time Health Monitoring Devices

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

Environment is in Peril; Unknown Enemy on Prowl

Dear Editor, So many interesting stories regarding medical world makes your magazine an interesting readable stuff. Union Minister Harsh Vardhan’s interview on the Environment Day was very timely, it sensitized people against single use plastic. We must encourage such campaigns to safeguard environment which is really facing threats from all quarters. I urge the magazine to carry more such articles so that people start avoiding one time use of plastic cutlery etc.

Onkareshwar Pandey Senior Journalist New Delhi, India

Dear Editor, I went through the latest edition of the magazine and found contents were really worthwhile to read.

I appreciate the story based on interview of famed film producer and director Ms. Janet Tobia who has been credited with producing really good stuff. We want more such material in the magazine which is bound to make desired growth in the coming months.

Vipin Chaudhary Judges Colony Ghaziabad, India

Dear Editor, I grabbed InnoHEALTH magazine while waiting for a doctor at a hospital in the national capital recently and found that the magazine is stuffed with so many interesting items like Union Minister Harsh Vardhan’s interview, interactions of the magazine with film producer Ms. Janet Tobia and UNICEF India incharge etc. Many science stories which hardly see light of the day in the media were also interesting. We appreciate efforts and feel that the magazine will make rapid strides.

Prof. Vinod Tyagi Delhi University New Delhi, India

Innovation is new buzz word and many more are in offing I

nnovation has become buzz word for every sector and similarly next buzz would be Hackathon, many without knowing meaning of these words tend to use it to show their updated knowledge. My perception regarding health sector is to use innovation for reducing healthcare delivery cost keeping quality and benefit at the last mile and bottom of Pyramid. It is to provide solution to pain of patients and providers to streamline many processes. The use of technology to achieve this aim and to foster innovation is needed. AI, blockchain, cybersecurity - technology terms - are in vogue to be spoken by many without understanding them.

The bringing out of Innovation does not need qualification, experience but idea and passion to do it. There are many success stories of such innovations where young school students have brought out miraculous innovations. These innovators need only hand holding, mentorship and resources. The innovator need not be an entrepreneur as they exit many times for want of capital to scale-up. The ecosystem created is best at present for innovators due to many initiatives placed by the Government.

There is need to put all the information in one booklet because number of schemes from different ministries are available and many of these are not known to people in the arena of innovation. We have evolved in the last four years to greater heights because of constant endeavour from the government as well as our partners.

The idea of creating this magazine is sharing of experience of each other and providing a platform to publicise good work of innovators to global community of 38,000 people with whom this electronic and print magazine is shared. We have published stories of grassroot innovators, InnoHEALTH executive editor Mr. Sachin Gaur travelled to Nagaland for two-weeks to find innovators in the interiors. This is a very interesting time for innovators who are ready to take risk can only succeed. I would like to urge all innovators to use knowledge platform created by us to disseminate and share information through international InnoHEALTH conference which also has young innovators’ award, B2B meetings, meet-ups, master classes, InnoHEALTH magazine, innovators’ club, webinars, trainings and workshops, and planned study tours in 2019.

These activities are under Pvt. Ltd. company InnovatioCuris (IC) means innovation in cure a Latin word which also has an extended arm that is not-for-profit called IC Foundation of Healthcare and Excellence(ICFHE).

Our journey is just three years old but have grown because of support of our ecosystem, partners and advisors. We would like to have regular feedback to make it better and achieve our vision of “Healthcare delivery to all at optimum cost with quality”. Let us join hands to make India a healthy nation leading way for many countries, even developed ones looking for frugal and reverse innovations from India.

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

vksingh@innovatiocuris.com

Dear Reader INDIA’S HEALTH LANDSCAPE UNDERGOING TECTONIC SHIFTS

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he world's most populous democracy's health landscape is witnessing widespread tectonic shifts in its each swathe. The forthcoming biggest ever health protection plan in the world, ever increasing role of artificial intelligence, rationalization of costs of expensive devices, emergence of first ever AI fired Ayurveda protocol etc. are among such developments which mirror rapid shifts.

An innovative Pan-India health scheme will be unveiled as announced by the PM Narendra Modi from Ramparts of the Red Fort on Independence Day on 25th September, the birth anniversary of Pandit Deen Dayal Upadhyaya. Pradhanmantri Jan Arogya Abhiyan would also go operational– it is set to get common man free treatment for serious diseases. The Pradhanmantri Jan Arogya Abhiyan and Ayushman Bharat Yojana will cover 10 crore families with a provision of 5 lakh rupees per annum health assurance for each family. It will also open new avenues of employment in the health sector for youth specially from middle class families. New hospitals will be built in the tier-2 and tier-3 cities.

They will require medical staff in large numbers. Such a gigantic plan will bring forth radical changes.

We, at InnoHEALTH Magazine, are confident to play a major role in highlighting the scheme for the benefit of various stakeholders - may it be public hospitals, private entities or the patients. In view of bringing focus on a slew of issues, which are constantly in debate among the medical fraternity members, our magazine aims to focus on diagnostic tools in the field of treatment through this issue.

In the global business scenario, now a witness to major changes due to growing political reasons, Trade tariffs and Tax structure are bound to be affected badly by such developments. So, we are trying to keep close watch on medical diagnostic tools, medicines price tags and a torrent of new diseases caused by current lifestyles. We had a discussion with Dr. Arvind Lal whose internationally famed pathology labs provide deep insight into disciplines of pathological tests and precise examination of diseases.

Since time immemorial, India is known worldwide for its ancient traditional medicines, but it is for the first time that a new protocol on Ayurveda medicines has been scripted. The AYUSH Ministry is closely studying the same while exploring ways for its effective usage. The protocol has been prepared on the basis of AI (Artificial Intelligence). In the current edition, we are also publishing a detailed report on AI that is making remarkable forays in the field.

As the old age is a natural phenomenon and each one of us has to face this stark reality, we have tried to rivet our eyes to problems afflicting the old people both socially and medically. The world is observing International Day for Older Persons on 1st October, so the topic gains more relevance.

Interesting stories list is unending and some of these are: A Consequence of Modern Day Living – Burnout; Fairy tales of Nano particles from Iceland to Jamia Millia Islamia; AI Engraving Footprints on Healthcare Transcontinental Canvas; National center for ageing coming in New Delhi; Lonely people run the risk of dying early; Low back pain is the leading cause of disability worldwide; Religious people live four years longer than atheists; A study has unknotted long-term impact of stroke; etc. In addition to these, we are also publishing a host of latest researches which gives scientific explanations of many usual occurrences in human beings.

Thanks, Neeraj Bajpai

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

Editor-in-Chief: Dr. V K Singh

Executive Editor: Sachin Gaur Editors:

Alok Chaudhary

Dr. Brijender Singh Dhillon Dr. Avantika Batish

Nimisha Singh Verma Aarti Khanna

Consulting Editor Neeraj Bajpai

Sr. Designers Suraj Sharma, Ritu Versha

Advisors Konda Vishweshwar Reddy, Member of Parliament, India

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

Dr. Ogan Gurel, Chief Innovation Officer, Campus D, South Korea Dr. Chandy Abraham, CEO, Healthcare Project, ITC Limited, India

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

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

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

Š InnovatioCuris Private Limited

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

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

PERSONA Distributedincubationmayhelppromote grassroots innovations 8 Artificial Intelligence (AI) coming big way in Healthcare sector says Dr. Arvind Lal

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THEME Medical Devices in India Witness Churning; Price War Escalates 16 A Consequence of Modern Day Living - Burnout

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Fairy tales of Nano particles from Iceland to Jamia Millia Islamia

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Workshop on Innovations & 3rd Anniversary of InnovatioCuris

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TRENDS Young Indian innovators all set to compete with best brains from 78 countries

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Latest Innovations in Healthcare

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Combat Challenge

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National Strategic plan for elimination of Malaria

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World’s First AI powered Ayurveda Protocols launched in India 54

ISSUES Lonely people run the risk of dying early!

Agonizing Ankylosing Spondylitis is more common in young men than women

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Low back pain is the leading cause of disability worldwide 64 Resistant STIs on Rise: Can we still ignore it?

66 Advantage and Disadvantages of Real Time Health Monitoring Devices 68 A study has unknotted long-term impact of stroke 70

A Neo Diabetic’s Tryst with Destiny & Birth of Innovative Enterprise to

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AI Engraving Footprints on Healthcare Transcontinental Canvas 42 National center for ageing coming in New Delhi

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Religious people live four years longer than atheists: New Research 72 National Technology Awards presented 74 Oops! 5.2 medical errors happen annually in India 76 3 Facts that pushed an Industry from Aspirin to Aspiration 77

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Distributed incubation may help promote grassroots innovations

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By Dinesh C Sharma

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everal grassroots innovations which we often hear about fail to make it to the market. This is due to a number of factors including lack of access to formal incubation facilities, venture capital, and prototyping and mentoring. In order to overcome these hurdles, experts have suggested setting up of special purpose incubators that can provide necessary technical and mentoring support to innovators in the non-formal sector.

“The idea is to develop some kind of distributed incubation and to nurture ventures in their respective regions, in the spirit of in-situ incubation,” said Dr. Ashutosh Sharma, Secretary, Department

of Science and Technology (DST) while presenting recommendations emerging from roundtables held as part of the Festival of Innovation and Entrepreneurship at the Rashtrapati Bhawan few months back.

It was also suggested that since most innovative products fail to compete with large companies and against established products and brands, the government must develop norms for a preference in public procurement for such products.

Besides distributed incubation facilities, the roundtable also came up with the idea of ‘value addition centres’ which should be open for all innovators so that prototypes of innovations could

be further developed and converted into marketable products. At present, academic and research institutions are involved in developing prototypes only and innovators have to look elsewhere for fabrication. Commercial fabricators accept orders for large quantities. “Innovators need special fabrication centres where limited units of a finished product can be developed for a pilot study, market research and test commercialisation,” Dr. Sharma added.

Innovators at FINE 2018 There is a need for testing and calibration of technologies developed by a large number of innovators.

However, many innovators and startups do not have adequate funds for

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in

“We have seen that coming together of innovators from informal sector and institutions in the formal sector can help disseminate innovations on a wider scale,” observed Dr. Anil K Gupta, Executive Vice Chairperson of National Innovation Foundation which organised the innovation festival in collaboration with the Office of the President and DST.

“The exhibition of innovations held at Rashtrapati Bhavan has demonstrated to industry, government and civil society how innovators are collaborating for a creative and compassionate India,” President Ram Nath Kovind said while speaking at the concluding session.

However, he said, merely showcasing innovations was not the sole purpose of this Festival.

(By India Science Wire)

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The roundtable on sustainable agriculture recommended adoption of one innovator by every agriculture institute and university.

The Indian Council for Agriculture Research (ICAR) already runs a program called Innovator Farmers – IARI Fellows. It was recommended that this scheme should be extended to central and state agriculture

universities for innovations agriculture and allied activities.

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In order to correctly ascertain the needs of the people, an appropriate need-gap analysis is essential to guide the R&D efforts in the right direction. If industry could be involved during the initial phase of product development, the chances of the products’ acceptance by the people increases manifold. Hence, industry and R&D linkages at institutions be facilitated.

“We must translate innovative ideas into accessible and affordable products and services for our people. It is important to connect the bottom of the innovation pyramid with the other layers. And to clear the path for grassroots innovations to be scaled up for mass adoption,” the President added.

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this. A fund through which testing and calibration of technologies could be facilitated is required.

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Healthcare infrastructure is skewed towards Urban over Rural India; Disruptive & Innovative Technologies needed; Artificial Intelligence (AI) coming big way in Healthcare sector By (Hony) Brig. Dr. Arvind Lal, Padma Shri

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he critical care environment has undergone significant alterations in the past several years. This has happened because our lifestyles in the fast-paced lives of modern India are ensuring that most people, in the age group of 30-50 years are falling prey to life threatening cardiac diseases and strokes, in addition to diabetes, hypertension, cancers, liver, kidney and lung diseases - these diseases being called Non-Communicable Diseases or NCDs. They are now responsible for killing more than 65% of our population says Dr. Arvind Lal, known for his diagnostic labs across the country.

Flagging concerns on such trends, these patients need high cost intensive care, be it for complications of heart attacks, strokes, diabetes, hypertension, cancer or lung diseases. This is where the importance of Point-of-care testing (POCT) comes in. It helps in almost diagnosing the patient instantly and improves physician’s ability to take immediate corrective action and decreases hospital stay. One such test is Troponin – that has revolutionized cardiac care by diagnosing heart attacks or myocardial infarction.

This article is based on the keynote

address on the occasion of 2nd Annual International InnoHEALTH Conference 2017 – ‘Transforming Healthcare Through Innovation’ in New Delhi, said there are numerous promising diagnostic technologies.

The key message is that in a country where 70% of the population lives in rural surroundings, ‘it is our duty to rapidly adopt disruptive innovative affordable technologies including telemedicine. Thus, our underserved population would be able to avail of the best treatment possible and bring in massive visible change’. He said the importance of bringing quality healthcare needs no reminder and the time has come for India to change the direction of healthcare for the masses.

Healthcare is a right - and access to good healthcare should not depend on where one lives and how much he or she earns. But sadly, that is exactly what plagues India’s healthcare today, he lamented.

India faces a severe shortage of both hard infrastructure and talent.

With about one doctor and one functional bed per 1000 population, healthcare is truly underserved in India. Add to this the regional imbalances and variations in healthcare delivery. The healthcare infrastructure is skewed towards urban over rural India.

Although rural India accounts for

about 70% of the population, it has less than one-third of the nation’s hospitals, doctors and beds, resulting in large disparities in health outcomes across urban and rural India.

British Medical Journal (BMJ) has observed that there is a remarkable saving of lives in India if good healthcare facilities consisting of operation theatres, surgeons, anesthetists, blood banks are available within 50 kilometers of the patient providing quality medical services within the ‘golden hour’.

Though there has been a sea change in the last five decades, India now needs to reinvent the field of diagnostics as laboratory tests are responsible for 70% of all clinical or medical decisions.

In today’s life where internet rules the roost, the patients have become very knowledgeable, thanks to googlisation of healthcare, and are demanding very high-quality healthcare for themselves. They are insisting on a very wholesome and satisfying experience rather than being told that the ‘treatment is over’.

Just a few years ago the patient after giving the sample used to

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Point of Care Testing: Technological advancements in laboratory automation, including POCT, and initiatives to increase patient satisfaction are transforming the clinical laboratory market. POCT has come a long way from a handful of simple tests to a multibillion dollar global market that holds great promise for the future.Not so long ago, laboratory data would often arrive at the bedside too late to be of significant use in the active, continuing care of criticallyill patients. Now, most clinicians acknowledge that POCT is a prerequisite for early recognition of life-threatening conditions as they require that laboratory results are made available in real-time and, if possible, at the critically ill patient's point of care. The College of American Pathologists defines

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‘Wearable Tech is another area which I am personally very excited about. It has the potential to change the world as it helps people understand their own bodies by using mass data collected on a daily basis. From fitness bands to smart watches to eye based wearables, they are being adopted widely. Take the case of Zephyr’s Anywhere Bio Patch which is an FDA-approved, small device that is attached to a patient’s chest and monitors their vitals minute-byminute and collects medical-grade data for doctors’ use. These devices will connect our organs digitally, enabling disease detection at very

early stages. It has the potential to bring down cardiac and other deaths drastically. This offers immense potential to do remote testing, monitoring and thus assisting the doctor in timely treatment’.

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IBM launched another algorithm called Medical Sieve. It is an ambitious long-term exploratory project to build a next generation ‘cognitive health assistant’ that is able to analyze radiology images to spot and detect abnormalities faster and more reliably. This shall help radiologists in the future to look at the most complicated cases where human supervision is essential.

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‘IBM Watson, whose headquarters I had the privilege of visiting a few months back in the Silicon Valley, is an AI based engine that has launched its special program for oncologists to provide clinicians evidence-based treatment options.

The program has an advanced ability to analyze the meaning and context of structured and unstructured data in clinical notes and reports in its encyclopedic memory that may be critical to selecting a treatment pathway’.

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Recently, the AI research branch of the search giant, Google, launched its Google Deepmind Health project, which is used to mine the data of medical records in order to provide better and faster health services. The project is in its initial phase, and at present they are working with Moorfields Eye Hospital of NHS Foundation Trust, UK to improve eye treatment.

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Soon, a time will come when the tests shall be ordered by the patients based on clinical history and clinical findings that shall be answered by an Artificial Intelligence (AI) application.

Artificial intelligence has already found several areas in healthcare from design of treatment plans to assistance in repetitive jobs to medication management and drug designing. The most obvious application of artificial intelligence in healthcare is data management.

Collecting it, storing it, normalizing it, tracing its lineage – it may well be the first step in revolutionizing the existing healthcare systems.

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come back in the evening to the lab to collect a physical copy of the test report. This was replaced by making the report available on the internet that could be downloaded by the patient in the comfort of his home.

These days this has been further replaced by making available an App on his mobile phone wherein he can book an appointment for the sample to be collected at home and the report being later available on the same mobile App.

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or Typhoid, or Dengue fever or Japanese Encephalitis – all in a matter of minutes! The driving notion behind POCT is to bring the test conveniently and immediately to the patient. Needless to add, the patient’s data by POCT shall be made available to update the patient’s electronic health records (EHR).

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Talking about POCT Instruments: Currently, two broad type of POCT instruments are available: Small bench top analyzers (for example, blood gas and electrolyte systems) and handheld, single-use devices (such as urine albumin, blood glucose, and coagulation tests).

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Now let us talk about if POCT is Boon or Bane? The strong point of POCT is speed and the rapidity with which it shall save lives in emergencies.

As India marches towards quality healthcare delivery, in course of time regulatory compliances shall have to be adhered to in the interest of the patient’s health.

POCT as tests designed to be used at or near the site where the patient is located, that do not require permanent dedicated space, and that are performed outside the physical facilities of the clinical laboratories.

Examples include kits and instruments that are hand-carried or transported to the vicinity of the patient for immediate testing at that site (e.g. capillary blood glucose) or analytical instruments that are temporarily brought to a patient care location (like operating room, intensive care unit).

In many cases the simplicity was not achievable until technologies developed that were simple and affordable. For example, various kinds of urine test strips have been available for decades, but portable ultrasonography did not reach the stage of being advanced, affordable and widespread until recently.

Similarly, pulse oximetry can test arterial oxygen saturation in a quick, simple, non-invasive, affordable way today, but in earlier eras this required an intra-arterial needle puncture and a laboratory test. Thus, over decades, testing continues to move toward the point of care.

The lab-on-a-chip (LOC) is another device that integrates one or several laboratory functions on a single integrated circuit (commonly called a "chip") of only a few square centimeters to achieve automation and highthroughput screening. Imagine that a patient comes to one of our 2,100 collection centres in the remote tier three or tier four towns in India with high fever. We take a drop of blood from his finger and inform the clinician almost immediately that the patient is suffering from Chikanguniya and not from Malaria

Brig Arvind Lal, CMD of Dr. Lal Path Labs, is a pioneer in bringing laboratory services in India at par with the western world. In 1977, he took charge of the medical diagnostics laboratory founded in 1949 by his late father. Under his expert guidance and leadership, the initiative has become one of the most reputed laboratories in Asia, having to its credit quality accreditations from various national and international bodies.

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Medical Devices in India Witness Churning; Price War Escalates

By InnoHEALTH Editorial Team

“W

e are moving into a bold era, defined by advanced medical technologies and artificial intelligence. But healthcare will always remain a human business”.

For Dominic Asquith, British High Commissioner to India that is the crux of current situation, but a razor sharp competitive business in medical devices across the world has a different narrative because of market compulsions vis-a-vis human business.

India’s strong position on heart stents’ price regime triggered debate and the price war snowballed into tough positions and international players gaped with a bewilderment.

Many institutions and professional

bodies flew into action and debated price structures while the country’s federal government unveiled its world’s largest health coverage scheme for millions, virtually creating a colossal potential in the health sector. If the government extends healthcare services to its 1.25 billion population as part of India’s Universal Health Coverage (UHC) agenda, it will be a challenge to devise ways to reduce catastrophic Out Of Pocket (OOP) expenditure on healthcare and ensure affordable access to essential healthcare for the entire population with the limited resource envelope.

Amid ongoing trading tussle between US and China, many apprehend that ripple effect will also percolate down

in India as the latter is going ahead with its price regimes and its moves to bring down stent and knee implant devices had raised many eyebrows.

A section of media has reported that AdvaMed (Advanced Medical Technology Association)in its briefing memo for US Commerce Secretary and US Trade Representative last year had conveyed that “Made in India” scheme has been used by parts of the Indian government to justify protectionist measures such as import tariff hike sand preferential market access policies.

The Economist newspaper recently carried a write-up which quoted China Digital times, a California based website, that Chinese media had been

The study also examined various policies and regulations impacting the industry and attempts to make recommendations on the way forward from the perspective of different stakeholders.

The study made a slew of recommendations like cap trade margins and not price to the dealers, should be capped after detailed evaluation of each medical device segment and the role of trade. Trade margins should be fixed differentially for different categories of devices, based on service requirements and role of distributors.

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It says allow the dealers to compete with each other and provide a fair price to the hospitals based on the terms and conditions of services and payments. There is a need to work towards bundled payment models as used in many other countries to better align incentives for hospitals and their business models. Increase government healthcare spending as a percentage of GDP; India lags behind

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Official sources say big schemes can be ensured with the help of Health Technology Assessment (HTA), which is a widely used methodology internationally for optimization of resource allocation in health. HTA is a method of evidence synthesis that considers aspects pertaining to clinical effectiveness, costeffectiveness, social, ethical and legal implications of the use of "health technology" for healthcare intervention.

“The path to realizing healthcare goals is complex, and various fundamental issues and challenges need to be addressed and solved holistically. Long-term plans need periodic policy and regulatory interventions to ensure fair conduct within the industry while providing the support needed for profitable and sustainable growth. These activities will enable the medical device industry to accelerate rapidly and play a key role in making India healthier and stronger.” Mr. Guljit Singh, Executive Chairman of SKP Business and Abby Pratt, Vice President for Global Strategy and Analysis at AdvaMed said in their foreword of the study. AdvaMed had partnered last year with SKP to

publish the study entitled – Medical Device Industry in India –the evolving landscape, opportunities and challenges.

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The 2014 World Bank Report estimated the OOP spending on healthcare in India to be as high as 89%. India is the only country, out of the major world economies, where out-of-pocket expenses are increasing, despite a concurrent increase in public spending. This effectively means that more people are availing private healthcare services due to rising incomes or are forced to spend due to inadequate public expenditure.

The Indian healthcare industry was valued at over USD 100 billion in 2016 and is expected to reach more than USD175 billion by 2020, resulting in a CAGR (Compound Annual Growth Rate) of 20%. The medical device industry is valued at USD 6 billion. The medical device industry was accorded the status of an independent industry in 2014.

The medical device sector today is clearly small and indicates low penetration in the country.

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advised to play down China’s global dominance in various technological sectors, known as “Made in China 2025”.Such developments indicate that India should also dial down the hype on “Made in India”.

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the other BRICS in this regard.

Adequate utilization of government infrastructure to reduce the cost to private players – PPP model could be an attractive alternative to explore. Specify certain quantities/ proportions of supply of different stents at lower prices to specified government agencies for use with underprivileged sections. It advocated to empower the Medical Technology Assessment Board (MTAB) to evaluate the model of tiered pricing as observed in the French healthcare ecosystem, wherein the NPPA caps the generic products and leave the latest generation products with incremental value out of the ‘essentiality purview’.

The incremental value could be on account of efficacy, material used, ease of delivery and shortened recovery time. Various combinations are possible here such as: an increase in the number of tiers, allowing new introductions to be free of price intervention for a certain number of years. Identify priority medical devices and procedures that demonstrate the greatest need stemming from disease burden. MTAB, alongwith other regulators for medical devices, should ensure that there are minimum quality parameters in terms of safety, clinical efficacy, and cost-effectiveness - for medical devices that get used in the public and private health system, such that long-term costs are lowered over a patient’s lifespan, with need for fewer hospital readmissions, lowered need for medication, and overall better health outcomes.

The report said factors such as changing demographics, rising life expectancy, growing incomes and public awareness have contributed to a higher demand for medical care.

A more focused approach from the government, with increased public expenditure on health, greater utilization of technology, vibrant private sector participation, and continued innovation can transform the sector and move India closer to

its goal of providing quality universal healthcare.

Some of the key issues faced by the Indian healthcare industry are evident: with India’s disease burden shifting from acute to chronic diseases, large number of the population continue to not have access to basic healthcare services.

Public health infrastructures are poorly equipped to deal with this shift towards NCDs.

While the government and value chain participants are undertaking several steps to address these issues, they have been executed in silos.

Medical service providers are not only inadequate but are also not evenly distributed across rural and urban areas. This shortfall occurs despite an increase in the number of medical colleges from 23 in 1947 to 398 in 2014. The quality and availability of healthcare deteriorates as one moves away from large urban centers to lower-tier towns and rural areas. The Indian medical device industry, the report found, is highly fragmented. Currently, these sectors are dominated by MNCs with 70-75% of the demand being met through imports.

Approximately 30% of the domestically manufactured devices are exported, in which the consumables and disposables segment has the largest share.

On a mix of technologies such as engineering, electronics, material sciences and information technology - innovation, capital and technology drive the industry. However, India has not been able to bridge the gap between investments, skilled resources and innovation to fully capitalize on these opportunities.

Numerous factors underlie the prevalence of higher imports in the country.

Some of these are: no clear comparative cost advantage in view of other emerging markets; policy issues like inverted duty structured do not help in creating a positive

environment; lack of favorable policy and regulatory framework, the report, compiled last year said.

On segments, the study said, hearing aids and pacemakers form major part of patient aid segment and constitute 70% of the segment collectively. Most of the products are sourced from Australia, China, Ireland, Singapore, South Korea and US. The medical disposables and consumables sector consists of products such as plastic syringes, blood bags and many others.

This segment is dominated by domestic players in India due to its low technology requirements.

Needles and syringes constitute majority of the sales. However, wound management products and medical apparels are the fastest growing products in this segment. The Indian implants segment has witnessed an encouraging growth rate of CAGR 25%.

With a healthy mix of both domestic companies and MNCs, this segment has witnessed intense competition between players due to strong pricing pressure. The domestic players have realized the market potential which demands customization and differentiated product quality. The equipment and instruments section is the largest segment of the medical device industry constituting nearly 54% of the segment and is dependent on imports.

MRI machines, CT scanners, ultrasound machines, dental drills, dental chairs, dental x-ray machines are some of the key products of this segment. It is dominated by MNCs like GE Healthcare, Philips Healthcare, Schiller Healthcare, Danaher Corporation, and Roche.

Drug-eluting stents and bare metal stents form a major part of the stents segment and constitute more than 70% of the segment collectively. Most products are sourced from US and Europe. While domestic companies are manufacturing cost competitive products, they still face competition

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The Indian government is committed to raise public expenditure on health to 2.5% of the GDP. Public and private sectors need to play equally important but different roles in bringing rapid change to the healthcare scenario in the coming decade.

Around opening up, FDI and

infrastructure development are welcome initiatives that will enhance the ecosystem for investment. The Indian medical device industry appreciates government’s efforts to remove bureaucratic hurdles and improve the ease of doing business, but believes that additional steps can be taken to strengthen its approach.

The study identified challenges and said growth in the healthcare industry has been attractive. However, much more needs to be done. Despite the advent of private players and better government spending, most Indians can only afford and/or have access to basic healthcare. Hence, the path

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This, in turn, presents an enormous opportunity given the large population, growing economic

prosperity, and the disease burden.

Major issues such as availability of adequate infrastructure, trained human resources, geographic spread, rapidly changing disease burden, and high/often catastrophic out of pocket expenditures are challenges that the government is keen to address, the report said.

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A clear long-term vision and roadmap for the industry and predictability of policy would excite the industry. The government needs to provide policy support for both the supply and demand side of the medical device industry to successfully accelerate growth. Industry and government need to work together to improve awareness, access has made rapid progress in the last decade, but signiďŹ cantly lags behind other nations in availability and quality of equitable medical care and services for citizens.

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The report had said government initiatives control regulation and the new Public Procurement Policy- the preferential Market Access - do not fully reect this and has alarmed many industry participants.

The report said it is essential that healthcare professionals are appropriately trained and adequate in numbers.

However, the Indian healthcare system continues to lag behind both developed and other developing countries in terms awareness, availability, affordability, and access to quality health services.

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from international players on account of quality. Diagnostics segment is growing due to advanced technology being increasingly applied inmedical procedures.

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to universal healthcare coverage is challenging.

Some of the obstacles faced are - real estate prices and high capital costs limit the growth of delivery infrastructure; insufficient attention by policymakers and a complex tax regime are also responsible for the sector’s underdevelopment; the lack of a comprehensive policy and focus to develop the healthcare ecosystem; low penetration: the per capital medical device spending of USD 3 compared to USD 7 in China and USD 42 in Russia is significantly low.

Another study early this year – “Medical devices in India - an agenda to effective healthcare delivery” said to attract world’s top med-tech players to establish their research and development (R&D) operations in the country and to establish a firm footing in the global market, the Government needs to adopt a robust policy and regulatory framework. India can replicate some of the models being adopted by other nations that have succeeded in attracting leading medical players. The contents of this report are based on a study commissioned by AdvaMed and conducted by IQVIA on behalf of AdvaMed. It said that the government can provide financial incentives in form of extended tax holidays or weighted tax reduction for R&D investments; boost local demand for medical devices by stepping up public healthcare spending which in-turn could catalyze investments in this sector. Further, government should focus on creating an enabling regulatory landscape by creating a separate legislation system for medical devices.

The report said while, Medical Devices Rules 2017 is a welcome step towards regulating the medical devices sector, the setting up separate notified body and distinct legislation system for devices with a

focus on the following could further boost growth of the industry like Grant product approvals; Instituting quality standards; Setting up monitoring mechanisms for devices; Expedite patent approval process for medical devices.

Medical devices form more than USD 200-billion global industry, which develops and manufactures essential healthcare equipment.

The Indian industry is currently valued at USD 4.4 billion with about 700 medical device makers, India’s medical device market is currently the fourth-largest in Asia (after Japan, China and South Korea) and ranks among the world’s top 20.

Imports constitute a substantial part of the medical device market

healthcare challenges. The Adva Medwebsite says in general, we have a received a strong message from the government that they are interested in promoting the medical devices sector and creating an environment that fosters innovation. This is great news not only for manufacturers of medical devices but more importantly for patients who desperately need access to high quality yet affordable lifesaving and life enhancing medical technologies.

The PM’s call to medical device manufacturers is a welcome recognition of this separate and important part of the healthcare system. Several of AdvaMed’s member companies have already established manufacturing units in India, and India is being increasingly viewed as an R&D base.

The website says, the medical device industry in India has grappled with challenges for several years around recognition and regulation. While the Global Medical Device Nomenclature (GMDN) lists more than 14,000 different product types, the current regime only regulates a relatively modest portion of these products. in India. An estimated 80% of India’s demand for medical devices is currently met by imports, nearly 30% of which are supplied by the US. Imported medical devices are often those that are critical, innovative and high-risk in nature - either life-saving or life-enabling, and therefore undergo rigorous testing. These complex, innovative devices are designed to address the growing expectations of India’s population in the country’s rapidly evolving healthcare system, this report said.

The medical device industry has been very encouraged by the Prime Minister’s recognition of the critical role of medical devices in addressing India’s

Moreover, these devices/products are regulated as “drugs” under the Drugs and Cosmetics Act of 1940. This is problematic because medical devices are very different from drugs in terms of diversity, product development, patent structures, types of failures, scientific disciplines involved in assessing performance/efficacy.

In addition to the arbitrary application of the rules for drugs to medical devices, which hinders the development, quality of and access to medical devices, there is also a lack of predictability in the regulatory system. The industry is also concerned about the lack of standardization in line with global best practices.

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A Consequence of Modern Day Living - Burnout

By Dr. Helena Lass

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ave you ever heard someone say, “I’m exhausted”, or “I’m dead tired”? This is often how people unknowingly express the sensation of burnout. It is widely known that burnout is closely linked with stress, but it is much more than simply being tired, and it is often the case that the seriousness of burnout is overlooked.

Let us then ask the questions that need to be asked when talking about the subject of burnout. Is it possible to prevent burnout? How do we know when we have been exposed to either too much - positive or negative stress? How can we change our lifestyles accordingly to make meaningful and sustained change to make ourselves more immune to burnout?

Stress is perception based It is primarily our perception or evaluation of something that determines whether or not we become stressed. If we perceive an objective to be too challenging or potentially dangerous in some way, the “flight” type of emotional and mental reactions surface, eventually influencing the body – this is the route of negative stress. If something is challenging enough and we deem the odds of success leading to a potential opportunity in our favour, the “fight” type of emotional and mental reactions occur, and we experience positive stress.

Regardless of the polarity of stress (positive or negative), biochemically your body reacts in the same way. Whenever our subconscious

autopilot system detects a stressor, adrenaline and cortisol are released from our adrenal glands located on top of the kidneys. Our blood pressure raises, our muscles tense, heart rate elevates, and digestion is inhibited, all preparing us to either fight or take flight. We all have experienced this feeling, like a sudden rush. However, being constantly exposed to prolonged episodes of stress impacts the health of our body and reinforces unhealthy patterns mentally as well as emotionally. It can weaken the immune system, cause more regular mood swings, and can manifest as if being ‘on the ashes’, ultimately resulting in burnout.

However, whether it is a one-time major life event (think of a tsunami), or

It is not known to most people that burnout is more accurately known as adrenal burnout – a state whereby the adrenal glands are burnt out due to the high demand to constantly release stress hormones.

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the constant day-to-day sub threshold sensation of being ‘stressed’ (think minor but regular waves), at one point you’ll reach your breaking point where the stress reaction gives way to exhaustion, resulting in the sensations of feeling burnt out.

‘mobilizing us for action’ means constant release of adrenaline and cortisol from the adrenal glands – the stress hormones.

One must consider both the physical and psychological sides, understanding that psychological arousal leads to stress reaction in the physical body. It’s not just about reassessing values, setting priorities or time management. The most crucial elements to address are the chronic emotional and mental reactions.

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Lifestyle Changes - No Easy Way Out It is very much the common and accepted prevailing attitude of our modern working world that its perfectly normal to be “stressed”. It is

In order to prevent or recover from burnout, we must adjust our whole lifestyle. Already the term “lifestyle” suggests that this is not just a minor phenomenon that can be simply fixed with a few good night’s sleep or a vacation. This is not a bacterial infection that can be cured by taking a few pills and then rushing back to our “normal” life where stress reaction is considered inevitable. It is this attitude that is what really needs changing leading to skills that help in handling reactions.

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From the perspective of burnout, it is irrelevant whether the events that lead to the need to mobilize are “positive” or “negative” and if this lifestyle becomes habitual, it can quickly lead to near addiction, because one adrenaline rush primes the craving for another. Negative stress is not a problem because everyone already avoids it due to its association with negative feelings.

Most of the cases of burnout today are caused by people “riding the wave” of positive stress because people do not expect it to be dangerous – on the contrary it is almost actively encouraged and often glorified.

no wonder then that more and more of us are facing burnout.

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When you look at that description you may notice that these people seem invincible, they don’t seem to complain and seem to be able to manage everything. However, their lives are filled with dangerous amounts of positive stress, or eustress. Of course, this positive stress feels good in the beginning, and is indeed useful because it helps to get things done and achieve goals. However, in positive stress

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They are burdened with numerous to-do lists and they check their work emails on a Sunday. They are always on the go and find it difficult taking time out. They validate themselves based on their achievements and getting things done. Even during their vacation, they feel the need to be on the go, filling their days with planned activities and engagements. The bigger picture is very often completely lost; they just don’t seem to be able to stop the lifestyle of ‘busyness’.

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Burnout can happen to anyone and everyone, however there are certain types of people more prone than others. Those who are success or achievement oriented, so-called “career” people, managers and entrepreneurs tend to be more susceptible. They are the people who seem capable of anything. These sorts of people live for their work, strive for success and never switch off.

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I can handle everything - Always!

Burnout usually works in either of the two ways, more frequently as a manifestation of chronic stress, or the result of one sudden lifechanging event. Because burnout is closely linked with increasing stress, you may already assume that this isn’t a result of one single event but is rather a question of lifestyle choices and skills to handle the inner turmoil that gets triggered by certain events.

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What can be done to prevent burnout taking hold? By educating ourselves on how we function internally will help us further understand the problems associated with burnout.

This will help you make better and more informed choices for yourself.

Learning relaxation exercises, in particular stress relieving breathing exercises will also help, but in essence it’s already alleviating a consequence caused by a reaction.

It is important to take time out during our busy days to just sit and simply be. It seems obvious, but many of us feel guilty for investing in sufficient leisure time. Make it a point to put aside a certain time each week to do that thing you have been meaning to do, make good on that promise to meet a friend, do something with your loved ones, or do something entirely for yourself.

Just make sure you do it. Making sure we are getting 7-9 hours per night of continuous quality sleep can make all the difference in how

we think and feel.

Finally, try consulting a competent specialist, psychiatrist, psychologist, nutrition therapist, fitness trainer, or a yoga teacher to guide you in all directions – physical, emotional, mental, conscious and the self. Seek a solution that enables you to release automatic emotional reactions. You have found an effective method when the same situations do not trigger the reaction that was previously the problem.

CONCLUSION

Burnout should not be underestimated or downplayed as a mere side effect of modern day living. In understanding the physiological effects, we see just how dangerous burnout can be in the long-term. By implementing a lifestyle adjustment will ensure that burnout is prevented, however learning to discontinue emotional reactions that lead to stimulation of the adrenal glands is the key. Learning intra-personal skills and training

awareness will naturally expand your understanding in many other areas of life, helping to transition from dealing with problematic consequences to skillfully creating your own destiny.

Dr. Helena Lass is a Psychiatrist specializing in Mental Wellness and the Founder of Wellness Orbit. She is passionate about entrepreneurship, medicine, functioning of the mind and the role of awareness in each of these areas. As a medical doctor, she has been treating patients for over 10 years. She is a well-known and highly sought-after public speaker on the topics of awareness and mental wellness.

On a day of plunging temperature at Reykjavik airport in Iceland almost thirteen years ago, a few journalists, while briskly walking on tarmac to embark on a special aircraft, were impatient to find out exact definition of Nano particles.

Nanotechnology is very liberative and robust in the sense that it offers low cost, and viable and scalable technology, the sort of which is need of the hour in India. Also given the reason that it has been practised in India in Ayurveda, gives a point of leveraging for existing vedic processes. The impacted areas range from health,

They have showcased their research into development of a low cost TB resistance screening devise and claimed to make it a less than one dollar possibility. They stressed the importance of having a plan A and plan B for survival in the Biotech Start-up landscape. They concluded saying India needs more PADMAN's in Biotechnology.

The general mood of the meeting

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The mega dissertation on the Nano theme by Dr. Dinda from AIIMS, New Delhi was equally engrossing.

He was speaking at the third IC

Dr. Dinda has equally cautioned the pitfalls in Nanoresearch and product development, which was very elucidative and usefull for the present members and students.

His experience with Nanoscience made him realise the importance of collaborative approach, as it is a highly inter-disciplinary science.

The other talk in the meeting was given

by Dr. Pavan from Scangene Labs, a first generation entrepreneur in the biotechnology domain with focus on low cost diagnostics. He shared his experience of establishing his start-up and his companies plan A and plan B. His team was instrumental in developing several panels for diagnosis of cancer markers and rare genetic disorders.

They developed low cost equipment and devices for use in reserach setups and educational institutes.

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For me, it was an instant revival of flash back memories of Nano particles and developments in India and Dr. Kalam’s vision of Nano particles researches and its usage in various disciplines.

The focus of the IC club meeting was about Biotechnology future innovation, Funding scenario and Start-ups. It was for the first time that the IC club meet was organised in a university to encourage participation of academia.

Dr. Dinda, also stressed on the importance of quality human resource and specially a dedicated one. He has given several examples of his experience abroad during his residency, where he was member of several failure commitees, and stressed on the importance of reasoning a failure.

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Coincidently, on a day of soaring temperature in the same month 13 years after, another Scientist Dr. Amit Kumar Dinda was batting coolly on the subject in a lecture hall of Jamia Millia Islamia central University in the national capital and was giving an absorbing narrative on Nano particles. His chronicle was equally informative and exciting.

The talk highlighted the significance of Nanotechnology as a future driver of innovations and economy. He further exemplified with his own contributions to the field including nanoparticulate ambisomes against Kala azar, nano for mulation based HBV vaccine for oral delivery, nanoformulations against leishmaniasis.

environment, water purification, therapeutics, organ regeneration, to such hi-fi technologies like nanotised robots for vivo monitoring.

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Dr. Kalam, during onboard freewheeling interactions with accompanying media contingent used to ask several simple questions while giving an elaborative narrative of complex science issues in common man language. His narration on Nano particles usage in healthcare discipline was always a gripping one.

(InnovatioCuris) meeting which had a talk regarding Nanotechnology and its commercial impact.

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hey were expecting this midair query from the scientist turned President APJ Kalam with whom they were flying on state visit to a few nations including big bang experiment site at CERN laboratory on the FrancoSwiss border near Geneva.

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By Dr. Pavan Varma

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5th IC Club Meeting: Fairytales of Nano particles from Iceland to Jamia Millia Islamia

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was regarding the buzz in the policy shift towards biological sector

by Government of India. Several important observations were shared by the clubites in this regard, like the present call for grand challenges focussed towards synthetic biology, the present heads of scientific bodies being decorated by emineries from biology background, etc. The other significant dialogue in the meeting was regarding focus on low cost technology, and the importance of quality certification and /or recognition by regulatory bodies.

Informatively, with the commitment to giving an encouraging platform to innovators and aspiring startups, 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.

The club brings innovators, investors, start-ups, technology persons, policymakers, health experts and legal advisers 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 advisers 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.

Dr. Amit Kumar Dinda MD, PhD is a Professor of Department of Pathology at All India Institute of Medical Sciences (AIIMS), New Delhi. After his post graduation in Pathology he did his PhD in the area of Cancer Biology at the same institute. His area of work includes Immunopathology, Inflammation and cell biology, Experimental pathology, Ultrastructural pathology, Biomaterials and Nanomedicine.

In the area of Nanomedicine, he is actively involved in several projects related to nanoparticle mediated drug delivery, antigen and DNA delivery system. He is working in the area of nano-cell biology to understand nanoparticle and cellular interaction.

He is in the editorial committee of 12 national & international journals. He has worked as a Visiting Professor in Long Island Jews Medical Center & Elbert Einstein Medical College, New York, USA as well as University of New South Wales, Sydney, Australia. He has published more than 200 research

articles in indexed journals, edited 4 books, written 14 chapters in books and acquired 3 patents in the areas of nanotechnology and biopolymer.

The other interesting discussion was for the need of an ecosystem for development of tools and devices for Biotechnology.

Dr. Pavan Varma co-founded Biotech start-ups in Varanasi and New Delhi. He has business experience in molecular diagnostics, genomics, contract research and product development. He has conducted several Biotech workshops and training sessions for science graduates in Varanasi and also established several in-house panels for rare genetic disorders, cancers and infectious agents alongwith design and development of low cost DNA tools.

Institute for Industrial Research recently.

Those present at the workshop were awe struck on such absorbing and motivating narrations that kindled hopes and vindicated the time proven fact that nothing was inaccessible by a fertile and intelligent mind of any diligent individual. The import of a day-long meet was that everyone should ignite imaginations encased within their minds rather than sitting tightly over those.

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An inspiring story of a young entrepreneur was narrated as he had designed a multipurpose scissor for operation theatres after quietly peeping through a glass window that a team of surgeons were battling with bunch of varied sized scissors while operating his close kin at a hospital.

Likewise, another speaker delved out an emotional story of currently internationally popular “smart cane”

to the benefit of millions of blinds across the globe.

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or many decades, inspiring and juicy narratives, pertaining to iconic first generation entrepreneurs like Apple’s Steve Jobs, Microsoft’s Bill Gates, Truecaller’s Swedish developers,Flipkart’s launchers are being succinctly dished out at publicly to fire imagination of those fancying own start-ups in the contemporary era of out of the box ideas linked innovative business enterprises, and this is what was exactly scripted at a oneday workshop at the famed Shriram

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By Dr. Bhupesh Sharma

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Ignite imaginations encased within: A recent National meet's takeway

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A One-Day Workshop on “Technological Innovations for Healthcare Start-ups & 3rd Anniversary celebration of InnovatioCuris (IC)” was jointly organized by SRI-Technology Business Incubator (TBI) & InnovatioCuris on 4th August 2018 at SRI Auditorium, New Delhi.

Participants included key members from healthcare start-ups, medical professionals, industrialists, entrepreneurs, medical device manufacturers, plastic industry, officials from govt. institutions and students from various universities.

The event was inaugurated by addressing the distinguished delegates and budding entrepreneurs about the advancement and new innovations in healthcare sectors.

It was a delighted moment to see the positive response from industry stalwarts of the region and Science and Technology start-ups’ keen interest in venturing into new business entities.

Dr. K. M. Chacko, Director, Shriram Institute in his address briefed about the Technology Business Incubation concept. He highlighted the excellent support provided by the Department of Science & Technology (DST) at the Indian Ministry of Science & Technology because of which the Shriram Institute - Technology Business Incubator (SRI-TBI) has been running for past so many years. The center provides services in the fields of healthcare, plastics, rubbers, specialty chemicals, and waste management. Continuing the inaugural session, address of the Surgeon Rear Admiral & MD, InnovatioCuris Prof. (Dr.) V.K. Singh helped in setting the tone for the workshop. He briefed the national & international status of healthcare sector during his delightful thought.

Chief Guest of the event, Mr. Vijay Kumar, briefed about the support available to the start-ups at the Ministry. He appreciated the efforts made by SRI-TBI team and opined that the multidisciplinary activities of SRI would be useful for promotion

of incubator programme. He briefed about the various funding schemes offered by the Ministry to micro, small & medium enterprises which both the existing and the future entrepreneurs can take advantage of. The floor was taken by Dr. Shirshendu Mukherjee who added his appreciation for the joint efforts made by team InnovatioCuris & SRI-TBI. He briefed about the industry-academia interface and implementation of its benefits through a wide range of impact initiatives, be it providing access to risk capital through targeted funding, technology transfer, IP management and handholding schemes that help bring innovation excellence to the biotech firms and make them globally competitive. He added that the supporters of change for building the Indian bio-economy would be biotech start-ups & SMEs & hence our focus is on raising their capabilities.

The inaugural session followed with the launch of a start-up innovative product Nylon Sleeve Anchor Fastener. The product was developed by Mr. Rajendra Gupta, Director, Axel India with the support of SRI-TBI & are in scalingup process for healthcare sector.

The Inaugural session ended with the vote of thanks by Dr. Ajay Tyagi who mentioned that the efficiency, benefits, barriers and challenges for healthcare industry are very process-centric and technology use can be mainly attributed to success of entrepreneurs. This was followed by two technical panel discussions.

The first technical session was on Innovations for Reducing Burden of NCDs. The panelists stated that the Non-Communicable Diseases (NCDs) are reaching epidemic proportions worldwide and present an unprecedented challenge to economic and social development globally. The latest projections from the World Health Organization (WHO) suggest, 57 million deaths occurred globally of which 36 million (63%) were the result of NCDs. Despite the immense burden

of disease, NCDs, defined here as cardiovascular diseases, cancers, chronic respiratory conditions, and diabetes. It is estimated that 80% of NCDs are preventable with appropriate diet and lifestyle choices and good control of NCDs can have substantial effect on the incidence of downstream complications. Hence there exists a need for innovations to reduce burden of NCDs. The panelists also suggested the steps for reducing burden of NCDs in the present scenario.

The second technical session was on What will take Indian Healthcare sector forward. The panelists discussed various aspects about the current scenario of healthcare sector and suggested several notable points including obtain proposals from private insurance companies and the government on ways to provide medical insurance coverage to the population at large and execute the strategy; it is healthy to have competition in healthcare and provide health insurance to the millions who cannot afford it; revise the curriculum in medical, nursing, pharmacy and other schools that train healthcare professionals, so that they too are trained in the new paradigm; the government should appoint a commission which makes recommendations for the healthcare system and monitors its performance; encourage business schools to develop executive training programmes in healthcare, this will effectively reduce the talent gap for leadership in this area; rapidly develop and implement national accreditation of hospitals - those that do not comply would not get paid by insurance companies. However, a performance incentive plan that targets specific treatment parameters would be a useful adjunct.

The programme concluded with a visit to SRI-TBI Prototype Development Facility. The participants were highly excited to see the actual processing of plastics injection moulding and blow moulding processes and expressed their earnest desire to be incubated in the facility.

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Young Indian innovators all set to compete with best brains from 78 countries

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By Sunderarajan Padmanabhan

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Obesity is on the rise globally, emerging as a major public health challenge. While sedentary lifestyle and unhealthy diets are major causes, there are several other contributory factors which are largely ignored.

Obesogens are a class of what are called endocrine disruptors. These chemicals inappropriately alter lipid homeostasis, change metabolic set points as well as regulation of appetite and satiety to promote fat accumulation. They are found abundantly in the environment including plastic bottles, metal food cans and detergents and are, therefore, difficult to avoid.

Tanya Goyal and S.M.C. Ganesh from Maharaja Agrasen Public School in Delhi have found that fresh water algae named Chlorella Pituita could be a solution. “We have conducted four experiments

including triglyceride assay to check fat storage and expression of genes associated with adipogenesis and fat accumulation. The results showed that the algae helped in regulation of genes against activation induced by obesogens,” the children said while speaking to India Science Wire.

The two went to America and made a presentation at the Global Meet for Young Innovators organised by Intel at Pittsburg from May 13-18.

As many as 1800 young innovators from 78 countries were competing for about USD 34 million in awards.

Antara Raaghavi Bhattacharya of C.D. Somani Memorial School, Mumbai, has been trying to analyse data from NASA’s exoplanet archive and Exoplanet Orbit Database.

“In the last few years, many exoplanetary systems have been discovered, especially by NASA’s Kepler mission. Much recent work

has focused on finding other earth like planets within potentially habitable zones around stars.

However, a lot of exoplanetary data has still not been fully analysed. I am looking at those data”.

In all, 25 school children from India participated in the competition. The other projects presented included a diagnostic tool to identify spatial abilities in scholastically classified slow learners, a new approach to help curb malignancy of tumor cells, a portable real time data acquisition device for lake water quality monitoring and mapping and a project for non-invasive detection of asymptomatic heart attacks using bio-electrics. One of the selected projects was designed by Antara Raaghavi Bhattacharya - for better understanding of formation and evolution of planetary systems.

The programme is part of a partnership between Department

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compete in 17 subject categories.

Flagging off the 25 strong young innovators team at a function, DST Secretary Ashutosh Sharma expressed confidence that students would bring lot of laurels to the

country. So far, 115 Indian students have won 132 awards, competing against more than six million children of their age group from different parts of the world.

(By India Science Wire)

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of Science and Technology (DST), Indo-US Science and Technology Forum and Intel, known as the Initiative for Research and Innovation in Science (IRIS). It is conducted annually for school students from class 8 to 12. They

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LATEST INNOVATIONS! AIR AMBULANCE INDIA

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wo engineering students, Goutham Sharma and Jervis Anthony have recently designed and developed a highspeed hybrid unmanned aerial vehicle (UAV) which can surpass traffic and obstacles to serve as an air ambulance for patients who need intensive medical aid and emergency medical services.

The device is equipped with emergency medical equipment like automated external defibrillators, automated blood pressure apparatus and other emergency medical equipment. Their aim is to provide timely medical access to patients.

The device can carry a person weighing 50kg but in a sleeping position due to the present design constraint. www.thebetterindia.com/132598/

AXIOSTAT......

A HEAMOSTATIC BANDAGE

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n Indian innovation “Axiostat� by Axio Biosolutions, Bengaluru is a haemostatic dressing that stops haemorrhage from actively bleeding vessels within minutes of its application on the wound site. The product is the first Indian woundcare product to receive US FDA approval. The USP of the product is the incorporation of chitosan which is a saccharine biopolymer obtained from the hard-outer

skeleton of shellfish that can stop bleeding under 4 minutes.

Users of axiostat are military, ambulance services, hospitals, industries and relief aid where it has reduced fatality owing to traumatic injuries in battlefields, road traffic accidents and hospitals world over. The product is available in 12 other countries apart from India and promises to save many more lives in the future. www.thebetterindia.com/132937/

A NEW BLOOD PRESSURE APP: A CHALLENGE TO TRADITIONAL ARM CUFF AND ELECTRONIC DEVICES

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S-based scientists revealed the new BP app technology which is easy to use, efficient and accurate in the Journal Science Translational Medicine. The scientists targeted a different artery, the palmer arch artery at the fingertip as their new target point to take the count.

For measuring the blood pressure, users need to turn on the app and press their fingertip against the sensor unit. Now with the finger on their unit, they would just need to hold their phone at heart level and watch their smartphone screen to make sure that they are applying the right amount of finger pressure. Soon the blood pressure will be seen on the screen. www.ndtv.com

ndia is one of the leading countries facing deaths due to typhoid. Until now the available vaccine for typhoid management could be given to children who were two years old and above but the recently developed vaccine Typbar TCV or typhoid conjugate vaccine is a breakthrough for India as it can be given to children as young as six months old.

The vaccine has been developed by Hyderabad-based Bharat Biotech after successful clinical trials in India as well as Oxford. The conjugate vaccine crosslinks the sugar and the protein, successfully fooling a baby’s body into producing antibodies that will give it almost lifelong immunity.

The price for one dose is INR 1500. www.thebetterindia.com/127810/

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esearchers from the University of Bath, UK have developed an adhesive, non-invasive patch which can monitor glucose levels in diabetics through the skin without piercing it. Instead the patch draws glucose out from fluid between cells across hair follicles, which are individually accessed via an array of miniature sensors using a small electric current. The glucose is then collected in tiny reservoirs and is measured. The sensors ensure its calibrations – free approach without using a single drop of blood. The study is published in the Journal Nature Nanotechnology.

The aim is to eventually make the

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STICKY PATCH FOR BLOOD-FREE MONITORING OF BLOOD SUGAR LEVELS

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TYPBAR TCV BY BHARAT BIOTECH

patch convertible into a low-cost, wearable sensor that sends glucose measurements to the wearer’s

smartwatch or phone to take necessary action in time. www.thehindu.com/article 23501858

magen’s product ‘OsteoDetect’, an Artificial Intelligence-based diagnostic tool that can quickly detect distal radius wrist fractures is one of the latest products to get US FDA marketing clearance.

Its machine learning algorithm studies 2 dimensional x-rays or radiographs for signs of fracture by analysing the posterior-anterior and medial-lateral x-ray images of adult wrists. Studies conducted on comparing fracture detection aided by OsteoDetect and certified orthopaedic surgeons showed that the readers' ability to detect wrist fractures was improved by using the software as evident by greater sensitivity, specificity, and positive and negative predictive values, compared with unaided standard clinical practice. https://www.engadget.com/2018/05/27/fdaapproves-ai-wrist-fracture-detection/

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OSTEODETECT.........AN AI-BASED DIAGNOSTIC TOOL DETECTS WRIST FRACTURES

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rnav Kapoor, an Indianorigin researcher at MIT, has developed a device named ALTEREGO that let’s others hear words you are thinking without your making a sound. The product looks like a curved bone hooked to one ear that touches the jaw on the chin and under the lower lip which works by using ‘subvocalisations’ which are the tiny, imperceptible movements in the jaw each time you say a word in your mind.

There are four sensors which pick up the signals and transmit them to a computer that has been trained to recognise and convert them back to words which are conveyed to the listener’s mind

through bone conduction in the listener’s jawbone, instead of words being openly spoken and conveyed. With the use of Alterego’s technology, one could ask questions soundlessly and get a voice reply

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only in your ears. Presently the product has an accuracy of 92% which claims to keep improving with the exposure to more types of vibrations and words.

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NEW PORTABLE DIAGNOSTIC DEVICE: AFFORDABLE AND ACCESSIBLE

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“ALTEREGO” A DEVICE THAT LET’S OTHERS HEAR WORDS YOU ARE THINKING

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study undertaken by Dr. Satish Dubey at IIT Delhi has revealed a new portable diagnostic device which is developed by Inito, Bengaluru-based company that can do a dozen tests with the comfort of a person being at home. It has the advantage of

reading dozens of diagnostic test strips with a 99.12% correlation when compared to lab grade scanners irrespective of the mobile phone used.

This makes it a very reliable tool for portable diagnostics.The device uses patent pending imaging

technology called flat lens that allows a single portable device paired with a smartphone to conduct dozens of diagnostic tests with the same device. The first test that the company has launched is a fertility monitor targeted at couples trying to have a baby.

Soon tests for Thyroid, Diabetes and Vitamin D will be added to the device. To add more tests to the device, you just need to update the App and order the strips for the user. Advantages of the device are that it is easy to use, portable, small size, affordable and also thirdparty strips can be added to the Inito platform by just an App upgrade. The device has won CII Design Award, India Design Mark and Japanese Good Design Award. The device is priced at INR 3195 and is available on Inito’s official website and Amazon. Soon the device will be made available at pharmacies.

HT Team

other usual microbial fuel cells which take a couple of days to start power production as the bacteria needs time to adjust to the environment. The capacity of power generated from one cell is in the range of a few microwatts.

For more power production, one can stack and fold these cells together giving it a compact shape. This research recently received the First prize and a cash award of INR 10 lacs at KPIT Sparkle 2018. www.news18.com

WORLD’S FIRST HOME BODY SCANNER

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n innovation by an Indian research scholar, Ramya Veerubhotla at IIT Kharagpur, is the development of a disposable and flexible battery made from paper that could generate power from the bacteria present in sewage water.

The battery is made using air cathode and the anode can be made from any carbon-based material. The product is unique because it is very light in weight and the power generation starts within ten seconds unlike

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AN INDIAN INNOVATION...... PAPER BATTERY DEVELOPED USING SEWAGE WATER

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that the stationary mirror can grab the body scan of the user in about 15 seconds. Naked uses infrared light to capture your 3D body model which then gets visualised on the Naked App and alerts the user when there is progress being made by the user in terms of their fitness and also where there is potential for more work to be done. The device has an Intel x86 processor, RAM, 4GB DDR4 RAM and a 64GB SSD which makes

it easy to beam the image directly from the device to the user’s phone.

The depth data of the users’ body is not uploaded to the cloud instead is being handled on the device itself and also the resultant image is more of a TSA body scan image rather than a 3D avatar. A person can permanently delete the data from his phone if he/ she wishes to. Presently the device is priced at US$ 1395. www.techcrunch.com

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he product Naked 3D Fitness Tracker is a health and fitness tool for people to track changes in their measurements, body fat percentage, lean mass, fat mass, circumference and overall shape.

The start-up has recently raised a $14 million Series A led by Founders Fund. The device has two parts, first is a scale that has sensors and a computer and second being a weight scale that spins a person around so

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group of researchers under the mentorship of Scientist Alberto Salleo at Stanford University has created a stretchy patch which when applied directly to the skin, takes up sweat and assesses the amount of cortisol the person is producing. This stretchy, rectangular sensor around a membrane/specifically binds only to

cortisol but also detects charged ions like sodium or potassium present in our sweat. This patch has a waterproof layer that protects it from contamination. So far, a wearable prototype version has been made but if this is converted into reality it would be very easy to monitor salt imbalances in our bodies and reveal the emotional state of people who

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are under immense stress and do not open about their situation. The present methods for measuring cortisol levels requires several days of waiting for the lab results. This device seems to solve the waiting problem for the results and is user-friendly. All the user needs to do is to sweat enough to glisten the patch and connect it to a device for analysis which gives results in seconds.

The researchers are still working on its reusability though the prototype seems to work multiple times so long as it is not saturated with sweat.

A paper co-authored by Scott Keene and Andrew Marais of Stanford University and colleagues at Ecole Nationale Superieure des Mines in France about this wearable sensor was published in Science Advances on 20 July 2018. https://news.stanford. edu/2018/07/20/wearabledevice-measures -cortisol-sweat

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ris is the part of the eye that is coloured around the pupil and controls the amount of light entering the eye. It is found to be damaged in conditions like Aniridia in which people are born with a partial or missing iris or it could happen later in life due to traumatic injury or surgical removal due to melanoma. With patients of eye damage, the surgically implanted device known as the CustomFlex Artificial Iris is a boon. Recently this prosthetic iris has got the US FDA approval. The CustomFlex Iris is surgically inserted and held in place either by sutures or eye’s anatomical structures.

This iris is made of thin, foldable medical grade silicon and is custom-fitted and colored for each patient. A study of nearly 400 adults and children with Aniridia or other iris defects found that the device was safe and effective, with 70% of participants reporting significant decreases in light sensitivity and glare, as well as improvement in health-related quality of life. The study also found low rates of adverse side effects. As per FDA, the artificial iris is contradicted in patients who have uncontrolled or severe chronic inflammation, abnormally small size of eyes, untreated chronic glaucoma, cataract

causedbytherubellavirus,abnormalbloodvesselsontheiris, inner eye infections and certain kind of damaged blood vessels in the retina. Also, pregnant women cannot be its takers. https://www.cbsnews.com/news /fda-approves-first-artificial-iris/

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cornea were mixed together with alginate and collagen to create a solution that could be printed, a 'bioink'. Then the bio-ink was successfully extruded in concentric circles to form the shape of a human cornea which took less than 10 minutes to print using a simple 3-D printer. The stem cells were then shown to culture or grow. The gel which is a combination of alginate and collagen keeps the stem cells alive while producing a material which is stiff enough to hold its shape but soft enough to be squeezed out of the nozzle of a 3-D printer. The uniqueness of the product is that a cornea could be built as per a patient’s specifications. The

dimensions of the printed tissue were originally taken from an actual cornea.

By scanning a patient's eye, they could use the data to rapidly print a cornea which matched the size and shape.

These 3-D printed corneas will now have to undergo further testing and it will be several years before we could be in the position where we are using them for transplants. However, an endeavour has been made to show that it is feasible to print corneas using coordinates taken from a patient’s eye and that this approach has potential to combat the world-wide shortage of corneal transplants. https://www.sciencedaily.com/ releases/2018/05/180529223312.htm

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ornea, the outermost layer of the eye helps in focusing vision.

The statistics show that there is a significant shortage of corneas for transplant with nearly 10 mil people worldwide requiring eye surgery to prevent corneal blindness due to trachoma and almost 5 mil people suffer total blindness due to corneal scarring caused by lacerations, abrasions, burns or diseases. To tackle this issue, scientists at Newcastle University, UK have created the first ever human corneas. The proofof-concept research, published in Experimental Eye Research, reports how stem cells (human corneal stromal cells) from a healthy donor

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SMART BANDAGE TO MONITOR WOUNDS AND DISPENSE DRUGS MADE

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onskusale has recently developed a first of its kind ‘sense-then-respond’ smart bandage which uses sensors to detect subtle biomarkers that signal wound healing. The device has a microprocessor to read the data captured by the sensors, communicate with the mobile and also can direct the bandage to release medication if it is needed. It takes into account things like sensing whether the wound is getting enough oxygen, right pH level is there, what is the temperature near the wound and

is there any inflammation? All this information is communicated to a central processor where the doctor already has programmed drug release for antibiotic or growth factor to improve healing.

Such a bandage has applications in bed sores, burns and surgical wounds with the advantage of reducing complications from infections and reducing the number of amputations. The key is timely application of the bandage to the wound site to fasten healing. https://www.digitaltrends.com/cooltech/smart-bandage

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

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AI Engraving Footprints on HealthcareTranscontinental Canvas

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By Neeraj Bajpai

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IR ALEXANDER FLEMING, the discoverer of Penicillin, shared the Nobel Prize for Medicine in 1945. But when he arrived in Stockholm to receive the award he had a bad cold.

Throughout the ceremony he used his handkerchief repeatedly. Later when he was leaving, his eyes were still watery, and he was still sniffing.

One of the officials shook his head sympathetically and said, “No good for colds”. EE Edgar January 1965.

But, it was a stunning discovery that changed the course of history. The active ingredient, which Fleming named Penicillin, turned out to be an infection-fighting agent of enormous potency. When it was finally recognized for what it was, the most efficacious life-saving drug in the world, Penicillin altered forever

the treatment of bacterial infections.

Now, it is turn of AI (Artificial Intelligence) that is making fast forays in a broad-spectrum of disciplines, and medical diagnostics and treatment field is paving way for intrusion of AI. Across the world, race is underway to exploit AI for good of patients.

Many say it is not much away from tipping point: those who will take timely advantage of it or those who are set to miss the opportunity at the initial moments.

In India, AI ball has started rolling in the wake of huge potential of healthcare network and ever burgeoning population of 130 crore people. A discussion paper on National Strategy for Artificial

Intelligence prepared by NITI Aayog team which included, Arnab Kumar, Punit Shukla, Aalekh Sharan and Tanay Mahindru, came up for discussions recently and moves are afoot to proceed further.

The paper delved at length on various dimensions of AI. It said NITI Aayog is working with Microsoft and Forus Health to roll out a technology for early detection of diabetic retinopathy as a pilot project. 3Nethra, developed by Forus Health, is a portable device that can screen for common eye problems. Integrating AI capabilities to this device using Microsoft’s retinal imaging APIs enables operators of 3Nethra device to get AI-powered insights even when they are working at eye checkup camps in remote areas with nil or intermittent connectivity to the cloud.

The resultant technology solution also solves for quality issues with image capture and systems checks in place to evaluate the usability of the image captured.

AI-based healthcare solutions can also help in making healthcare services more proactive – moving from “sick” care to true “health” care, with emphasis on preventive techniques.

AI solutions can augment the scarce personnel and lab facilities; help overcome the barriers to access and solve the accessibility problem; through early detection, diagnostic, decision-making and treatment, cater to a large part of India.

Cancer screening and treatment, the paper says, is an area where AI provides tremendous scope

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for targeted large-scale interventions. India sees an incidence of more than 1 million new cases of cancer every year, and early detection and management can be crucial in an optimum cancer treatment regimen across the country.

In a 300-patient performance study, the Viz.ai LVO Stroke Platform obtained an AUC of 0.91, identifying LVOs and alerting the relevant specialist with 90% sensitivity and specificity and a median scan to notification time of under 6 minutes. In over 95% of cases, the automatic notifications demonstrated faster notification of the specialist, saving between 6 and 206 minutes, with an average time saving of 52 minutes.

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"Timely LVO stroke identification and transfer to a specialist hospital that can perform mechanical thrombectomy is the top priority for LVO stroke patients," said Dr. Raul Nogueira, Professor of Neurology, Neurosurgery and Radiology at Emory University and the Immediate-Past

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Stroke is a serious and timesensitive medical condition that requires emergency care and can cause lasting brain damage, longterm disability and death. A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. When this happens 2 million brain cells die every minute.

"This software device could benefit patients by notifying a specialist earlier thereby decreasing the time to treatment. Faster treatment may lessen the extent or progression of a stroke," said Robert Ochs, PhD, Acting Deputy Director for Radiological Health, Office of In Vitro Diagnostics and Radiological Health in the FDA's Center for

The Viz.ai LVO Stroke Platform was developed using deep learning, a revolutionary technique where algorithms learn how to identify patterns in data from millions of prior examples. The Viz.ai system connects to a hospital CT scanner and alerts the stroke specialist that a suspected LVO stroke has been identified, sending the radiological images directly to their smart phone.

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In US, Viz.ai, Inc., an applied artificial intelligence healthcare company a few months back announced that the U.S. Food and Drug Administration (FDA) has granted a De Novo request for the first-ever Computer-Aided Triage and Notification Platform to identify Large Vessel Occlusion

"The Viz.ai LVO Stroke Platform is the first example of applied artificial intelligence software that seeks to augment the diagnostic and treatment pathway of critically unwell stroke patients," said Dr. Chris Mansi, Neurosurgeon and Chief Executive Officer. "We are thrilled to bring artificial intelligence to healthcare in a way that works alongside physicians and helps get the right patient, to the right doctor at the right time."

Devices and Radiological Health.

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Researchers said Adoption of AI for healthcare applications is expected to see an exponential increase in next few years. The increased advances in technology, and interest and activity from innovators, provides opportunity for India to solve some of its long existing challenges in providing appropriate healthcare to a large section of its population. AI combined with robotics and Internet of Medical Things (IoMT) could potentially be the new nervous system for healthcare, presenting solutions to address healthcare problems and helping the government in meeting the above objective pathology images. Another related project under discussions is an Imaging Biobank for Cancer.

(LVO) strokes in CTA imaging. This regulatory clearance compliments Viz.ai's recent European CE Mark for the product in January 2018.

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It is probably the most intuitive and obvious use case primed for intervention by AI driven solutions, as evidenced by the increasing activity from large corporates and start-ups alike in developing AI focused healthcare solutions.

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NITI Aayog is in the advanced stage for launching a programme to develop a national repository of annotated and curated, despite the obvious economic potential, the healthcare sector in India remains multi-layered and complex, and is ripe for disruption from emerging technologies at multiple levels.

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President, Society of Vascular & Interventional Neurology. "This software is designed to help identify appropriate patients earlier and more often, and enable faster transfer and treatment, which, ultimately may result in improved patient outcomes.

Noted Cardiologist ERC Topol,who is Professor of Genomics and holds the Scripps endowed chair in innovative medicine, has now written a book that calls for the "creative destruction" of the current medical paradigm, which he believes has failed to keep up with the digitized world of interactivity, social media, computers, apps, and advanced engineering and electronics.

In his book, he lambasts currentday medicine as being archaic and wasteful, making his case with a compelling blend of statistics, anecdotes. Prof. Topol believes that consumers teaming up with innovators in the med-digital world are the key to forcing change, which is certainly true. But how exactly will this work?

Adoption of AI for healthcare applications is expected to see an exponential increase in next few years. The healthcare market globally driven by AI is expected to register an explosive CAGR of 40% through 2021, and what was a USD 600 million market in 2014 is expected to reach USD 6.6 billion by 2021. they grow in sophistication.

The paper says healthcare is one of the most dynamic, yet challenging, sectors in India, and is expected to grow to USD 280 billion by 2020, at a CAGR of upwards of 16%, from the current ~USD 100 billion.

Adoption of AI for healthcare applications is expected to see an exponential increase in next few years. Technology disruptions like AI are once-in-generation phenomenon, and hence large-scale adoption strategies, especially national strategies, need to strike a balance between narrow definitions of financial impact and the greater good.

The NITI Aayog discussion paper says AI is a constellation of technologies that enables machines to act with higher levels of intelligence and emulate the human capabilities of sense, comprehend and act. Thus, computer vision and audio processing can actively perceive the world around them by acquiring and processing images, sound and speech.

The natural language processing and inference engines can enable AI systems to analyze and understand the information collected. An AI system can also act through technologies such as expert systems and inference engines or undertake actions in the physical world. These human capabilities are augmented by the ability to learn from experience and keep adapting over time. AI systems are finding ever-wider application to supplement these capabilities across enterprises as

NITI Aayog has decided to focus on five sectors that are envisioned to benefit the most from AI in solving societal needs: a) Healthcare: increased access and affordability of quality healthcare; b) Agriculture: enhanced farmers’ income, increased farm productivity and reduction of wastage; c) Education: improved access and quality of education; d) Smart Cities and Infrastructure:

efficient connectivity for the burgeoning urban population; and e) Smart Mobility and Transportation: smarter and safer modes of transportation and better traffic and congestion problems.

Yet, it faces major challenges of quality, accessibility and affordability for a large section of the population:

A: Shortage of qualified healthcare professionals and services like qualified doctors, nurses, technicians and infrastructure: as evidenced in 0.76 doctors and 2.09 nurses per 1,000 population (as compared to WHO recommendations of 1 doctor and 2.5 nurses per 1,000 population respectively) and 1.3 hospital beds per 1,000 population as compared to WHO recommended 3.5 hospital beds per 1,000 population.

B: Non-uniform accessibility to healthcare across the country with physical access continuing to be the major barrier to both preventive and curative health services, and glaring disparity between rural and urban India. With most of the private facilities concentrated in and around tier 1 and tier 2 cities, patients have to travel substantial distances for basic and advanced healthcare services.

The problem is further accentuated by lack of consistent quality in healthcare across India, most of the services provided is individual driven rather than institution driven, and less than 2% of hospitals in India are accredited.

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By InnoHEALTH Editorial Team

completed by February 2020.

Informatively, on the 70th anniversary of the Universal Declaration of Human Rights (UDHR), the United Nations International Day for Older Persons (UNIDOP) celebrates the importance of this Declaration, and reaffirms the commitment

Growing older does not diminish a person’s inherent dignity and fundamental rights.

On 14 December 1990, the United Nations General Assembly designated October 1 as the International Day for Older Persons.

This was preceded by initiatives such as the Vienna International Plan of Action on Ageing - which was adopted by the 1982 World Assembly on Ageing - and endorsed later that year by the UN General Assembly.

In 1991, the General Assembly adopted the United Nations

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On the occasion, Prime Minister Narendra Modi also dedicated the underground connecting tunnel between AIIMS and JNPA Trauma Centre, and Power Grid Vishram Sadan at AIIMS along with the 500 bedded New Emergency Block and 807 bedded Super Specialty Block at the Safdarjung Hospital to the nation.

to promoting the full and equal enjoyment of all human rights and fundamental freedoms by older persons.

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head of international day of old people on October 1, a foundation stone of the National Centre for Ageing has been laid recently at AIIMS in the national capital. The National Centre for Ageing will provide state of the art clinical care to the elderly population and shall play a key role in guiding research in the field of geriatric medicine and related specialties. The Centre will also be a key training facility for undergraduate and postgraduate courses. The Centre will provide multi-specialty healthcare and will have 200 general ward beds, which will include 20 medical ICU beds.

The center will be developed at a cost of Rs 330 crores and shall be

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National center for ageing coming in New Delhi

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Principles for Older Persons.

In 2002, the Second World Assembly on Ageing adopted the Madrid International Plan of Action on Ageing, to respond to the opportunities and challenges of population ageing in the 21st century and to promote the development of a society for all ages.

Almost 700 million people are now over the age of 60. By 2050, 2 billion people, over 20 per cent of the world’s population, will be 60 or older. The increase in the number of older people will be the greatest and the most rapid in the developing world, with Asia as the region with the largest number of older persons, and Africa facing the largest proportionate growth.

The interdependence between older persons’ social integration and the full enjoyment of their human rights cannot be ignored, as the degree to which older persons are socially integrated will directly affect their dignity and quality of life.

Older human rights champions today were born around the time of the adoption of the UDHR in 1948.

They are as diverse as the society in which they live: from older people advocating for human rights at the grass root and community level to high profile figures on the international stage. Each and

every one demands equal respect and acknowledgement for their dedication and commitment to contributing to a world free from fear and free from want.

The 2018 theme aims to: n Promote the rights enshrined in the Declaration and what it means in the daily lives of older persons; n Raise the visibility of older people as participating members of society committed to improving the enjoyment of human rights in many areas of life and not just those that affect them immediately; n Reflect on progress and challenges in ensuring full and equal enjoyment of human rights and fundamental freedoms by older persons; and n Engage broad audiences across the world and mobilize people for human rights at all stages.

On the day of laying of foundation stone for ageing persons, Mr. JP

Nadda, Union Minister of Health and Family Welfare, Mr. Ashwini Kumar Choubey and Smt. Anupriya Patel, Ministers of State for Health and Family Welfare were also present at the event.

Addressing the participants, PM Modi said that our government has been successful in taking healthcare out of the ambit of the Health Ministry and today we have Rural Development Ministry, Water and Sanitation Ministry, and Child Development Ministry and AYUSH Ministry with our vision of healthcare.

He further added that our vision is not limited to hospitals, diseases, medicines and super specialty care but also with the idea that affordable and equitable healthcare should be ensured for every citizen.

PM Modi said that the government is equipping existing hospitals with all the modern facilities and at the same time it is also making sure

The 2018 theme of UNIDOP is "Celebrating Older Human Rights Champions''. What better way to celebrate this Day than by celebrating the older people around the world who dedicate their lives to championing human rights?

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that the healthcare facilities reach to the remotest areas of the countries.

He added that 58 district hospitals are being upgraded to medical colleges and the government has also sanctioned budgets for 24 new medical colleges.

New emergency block at Safdarjung

Also present at the event were Smt. Preeti Sudan, Secretary (Health); Prof. Randeep Guleria, Director, AIIMS New Delhi; Dr. Rajendra Sharma, Medical Superintendent, VMMC & Safdarjung Hospital, New Delhi and Mr. IS Jha, CMD, Powergrid Corporation along with the senior officers from the Health Ministry and faculty of AIIMS.

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The Powergrid Vishram Sadan has a 300 bedded night shelter facility meant for the patients and their relatives visiting AIIMS main hospital and JPNA Trauma centre at AIIMS. The 11-floor facility has been constructed at a cost of Rs. 32.67 crores and funded by the Power Grid Corporation.

Super Specialty Block at Safdarjung Hospital holds tertiary care facilities in the areas of cardiovascular sciences, neurosciences, pulmonary medicine, nephrology and endocrinology and shall be offering the facility of a Heart Command Centre, respiratory care facility, sleep labs, 24x7 dialysis unit, MRI guided Braine Suite, etc. It also has a 228-bedded private ward. The super specialty block has been developed at a cost of Rs. 920 crores.

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The underground tunnel is providing connecting facility between AIIMS and JPNA Trauma Centre and will reduce the commute time between the two centers. The completed length connectivity between two centers is approximately 1 km and has been completed at a cost of Rs. 44 crores.

Hospital will house 64 triage beds, red zone for children & adults and 90 ICU beds for victims of road traffic accidents, acute trauma suffered by individuals at home or work, acute poisoning and severe medical and surgical emergencies. The block has been developed at a cost of Rs. 346 crores.

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“The HWC would provide preventive,

promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. He further stated that the government has initiated universal screening of common NCDs such as diabetes, hypertension and common cancers along with Tuberculosis and Leprosy and everybody above the age of 30 years will be screened for these diseases and as such this will eventually help in reducing the disease burden of the country. “We will implement the vision of the Prime Minister in letter and spirit,” he added.

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Mr. Nadda said that there has been a visible change in the tertiary healthcare in the country and assured that the government is committed to ensuring that the new AIIMS will meet the same standards of service as AIIMS, New Delhi. No effort will be spared to make them the very best, he added. He said that that the new AIIMS will have the same work culture and the government is taking all the steps to ensure that. He further stated that the Ministry in the past 4 years has not left any stone unturned – from monitoring the clean and effective implementation of national programmes to establishing 13 new AIIMS like institutes across the country. Reiterating the commitment of the government, he said under Ayushman Bharat, 150,000 subcentres will be converted into Health and Wellness Centres (HWCs) that will deliver comprehensive primary healthcare.

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The Prime Minister also mentioned about the Ayushman Bharat programme. He said that under the National Health Protection Mission, 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) will be provided a coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization.

This will be the world’s largest government funded healthcare programme, he stated.

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PM Modi added that the global target for eliminating TB is 2030, but we have set 2025 as our target for India to eliminate TB, five years before the global target. He further stated that the government is providing Rs. 500 to the TB patients towards nutritional support.

The condition I had, essentially, I felt reborn but this time it seemed with a greater purpose. So, I am writing this article - not as 35 years old but a 20-day infant.

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A Neo Diabetic’s Tryst with Destiny & Birth of Innovative Enterprise to Combat Challenge

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It seems the drugs that I am taking have made me as curious as a child - nothing seems impossible. I was able to synthesize few lines on the hospital bed, which summarize my state of the mind. For English readers this poem essentially means that I want to win my diet, win my mind and the exercise that this body can do. I need a resolve, determination and courage from the almighty combined with blessings of my elders and love of dear ones to defeat the vices of the world.

By Dr. V.K. Singh

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HERE THERE’S a will there’s way. For a young man - Sachin Gaur, a medical urgency that too on an alien land sent things topsy-turvy for a while, but he envisioned latent prospect in the disgusting scenario. Soon after stepping out from the hospital, he summarily stitched an innovative group to combat challenges being faced by millions of diabetic patients globe over.

Astoundingly, strange are the ways of the nature to lend you a helping hand in well intentioned initiative. On way back home from Hyderabad, Sachin shared the flight coincidentally with one of the key chemists working with MSD for last 22 years. He is a Harvard alumnus and was part of the team which designed the molecule called

Januvia, which is one of the key drugs for diabetes. Whole gambit of diabetes and afflicted persons was discussed threadbare on board.

It was Sachin Gaur’s tryst with destiny - narration of the sugary tale. “My quest for diabetes cure and management: a health accident that has given me a purpose in life.

Surrounded by healthcare experts, my quest of promoting healthcare innovations could not have been better. Until I was diagnosed with high blood sugar and the week immediately after with a medical emergency, which has no direct link with my diabetic condition, but the treatment is such that I need to have a strict regime of brisk walk, frequent meals and schedule of oral drugs and insulin. As, I am writing this I have spent 6 days in hospital bed (which was first time since I was born) and 14 days out of it.

With this thought-process in my mind, the project “Experiments with Sugar” (www.ExperimentsWithSugar.in) was born. With a team of 11 - from different walks of life: medical experts, researchers, a filmmaker, and more joining every day; we aim to enable 1 million people living with diabetes either cure or better manage their diabetes by the end of September 2021. I will be reporting the progress to you for next three years via the InnoHEALTH magazine. This is the first social cause project we have undertaken at “InnovatioCuris Foundation for Healthcare and Excellence” (ICFHE), a not-for-profit organisation as a mission mode project.

With the support of our experts, I managed to meet with some of the top experts and we are getting a great response. To name a few: Dr. Rakesh Sahay, Head of Department at Osmania Medical College; Joseph Duffy, Executive Director, Head of

PERSONA roundtable in December 2018 in Hyderabad to validate our findings and further record the proceedings on the best science knowledge on diabetes.

Please write to me by sending an email with suggestion and queries at sachin@innovatiocuris.com."

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We plan to release few episodes every month as a web series to provide scientifically correct information but in an accessible way to common man. So, as a reader do guide us and send good suggestions our way. By

the year-end, we also aim to produce a very high-quality report on the unmet needs of the stakeholders involved in life of a person living with diabetes. This will then feed into the Smart India Hackathon planned in February 2019 as a diabetes track to support innovation in the country.

We need suggestions for a planned

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External Discovery Chemistry Kenilworth, Merck & Co.

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Sachin Gaur is a researcher cum entrepreneur in space of mobile and Internet solutions. He was in top 10 innovators in India under India Innovates Growth Programme 2013 by FICCI. He is involved in multiple ventures in the domain of digital marketing, mobile solutions and Internet of Things. He has worked in past with organizations like Adobe, C.E.R.N. and in research at the Aalto University in security related topics.

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National Strategic plan for elimination of Malaria being implemented vigorously in India

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mid ongoing plans to eliminate malaria, experts have found the incidence of malaria in India is 0.66 cases per one thousand population last year.

Official sources say in the year 2017, reported malaria cases have declined by 23% as compared to 2016 in India.

As per the World Malaria Report 2017 of World Health Organization (WHO), the estimated malaria cases from India are 87% in South East Asia region.

Malaria is mainly concentrated in the states of Chhattisgarh, Jharkhand, Meghalaya, Mizoram, Orissa and Tripura because of the inaccessible terrain – many areas get cut off post monsoon, presence of efficient vectors – mosquito that transmit malaria and difficult terrain because of which malaria continues to be high in many pockets.

Global Technical Strategy (2016-30) announced by WHO and adopted by World Health Assembly in May 2015 calls for malaria elimination by 2030.

According to the Minister of State (Health and Family Welfare) Ashwini Kumar, the Government has unveiled a plan to eliminate Malaria by 2030. The National Framework for Malaria Elimination (NFME) 2016-2030 document launched on 11th February 2016, lays out the vision, mission, broad principles and practices to achieve the target of malaria elimination by 2030 synchronizing with the Global Technical Strategy (GTS).

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has

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lasting insecticidal nets (LLINs)/ Insecticide-treated nets (ITNs); Larval source management (LSM); Epidemic preparedness and early response; Monitoring & Evaluation;

Advocacy, coordination and partnerships; Behavior change communication (BCC) and Community mobilization and programme planning & management.

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Interventions that are being strengthened are Early diagnosis and complete treatment; Case based surveillance and rapid response; Integrated vector management; Indoor residual spray (IRS); Long

The estimation of the malaria cases is based on mathematical modelling and projected cases of malaria are not the actual cases reported in the country. Major contribution is by India because of its population.

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National Strategic Plan for malaria elimination (2017-2020) wherein the country has been stratified based on the malaria burden into four categories – category 0 to category 3 and based on this the intervention of malaria control and prevention are being strengthened.

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Dr. Rajesh Katocha, Secretary AYUSH with Dr. Partap Chauhan and Rishi Pal Chauhan

World’s First AI powered Ayurveda Protocols launched in India; prospects of its linkage of AYUSH grid brighten up

By Neeraj Bajpai

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oarding a wobbly roadways bus, a dhoti-kurta clad young man, with protuberant vermillion dash on forehead, used to head for mythological twin city of Mathura and Vrindavan in Uttar Pradesh, clutching tightly his voluminous bag, stuffed with Ayurvedic medicines in tiny folded paper pouches for distribution to patients at ISKON center every weekend in early nineties.

But, recently, sporting a brick colored shirt and creamy Nehru jacket and matching black tight trousers, Ayurveda medicines practitioner Dr. Partap Chauhan unveiled world’s first Artificial Intelligence (AI) powered protocols modeled on the basis of a mind-boggling database of patients and their successful cure.

Moved by the protocols’ apparent efficacy, India’s AYUSH Secretary, Dr.

Vaidya Rajesh Kotecha, has minced no words for exploration of a possibility to have link of the protocols with the Ministry’s recently floated grid for popularization of India’s traditional medicines at international fora.

The world over, he said, moves are underway to reduce cost of quality treatment.

Recently, Amazon, Berkshire Hathaway and JP Morgan have announced a company with an

and his protocol would help according it a scientific explanation on various parameters.

wellness information with content exclusively curated by Dr. Partap Chauhan.

He had started his journey from a small dispensary in a garage in Haryana in 1992, and now a globe trotter, is interacting with world famous universities for deeper scientific researches on country’s 5000 years old traditional medicines.

JIVA group President Rishi Pal Chauhan, has said the JIVA’s unique protocols are like operating system for Ayurveda practice that structures the practice of Ayurveda and creates wealth of data. It is well known that unlike Allopathy, which is focused on symptoms and standardized drug

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Dr. Kotecha envisions Indian traditional medicines’ colossal potential in ensuring cheap and best treatment and country’s values, coupled with such medicines, have answers of all these emerging

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“Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of ageing and death, what medicine can do often runs counter to what it should”. Says Dr. Gawande in his book “Being Mortal”.

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He is the Founding Executive Director of the health systems innovation center, Ariadne Labs. He also is a staff writer for the New Yorker magazine, has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and Being Mortal, and has received numerous awards for his contributions to science and healthcare.

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Amid these developments, the protocols have been framed. Dr. Partap Chauhan, Director Jiva Ayurveda, narrated his arduous journey and said India’s traditional medicines efficacy was being recognized the world over,

These protocols, meant to standardize the practice of Ayurveda, have taken four years to develop after analyzing the consultation records of more than two lakh patients; the protocols have been successfully run on 20,000 patients till now, with dramatic results. This system will create a wealth of data and evidence that will go on to validate Ayurveda as a legitimate science of treatment, boosting its acceptability worldwide.

The JIVA health app will provide authentic and actionable health and

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“I’m thrilled to be named CEO of this healthcare initiative,” said Dr. Gawande, “I have devoted my public health career to building scalable solutions for better healthcare delivery that are saving lives, reducing suffering, and eliminating wasteful spending both in US and across the world”. This work will take time but must be done. The system is broken, and better is possible.”

The AYUSH Secretary was of the view that Indian traditional medicines should be included in ICD -11 as Chinese medicines have entered the classification already.

The International Classification of Diseases (ICD) is the international "standard diagnostic tool for epidemiology, health management and clinical purposes." Its full official name is International Statistical Classification of Diseases and Related Health Problems and is maintained

by WHO.

The personalized treatment syndrome is catching up and researchers are underway how to promote personalized treatment for more accuracy. He said the World’s first Diagnostic Protocols for Ayurveda would turn this ancient healing tradition into data-and evidence-driven system of medicine and JIVA Health App.

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Dr. Gawande is a globally-renowned surgeon, writer and public health innovator. He practices general and endocrine surgery at Brigham and Women’s Hospital and is a Professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School.

challenges. He spoke briefly about the “Being Mortal” book and the newly formed company.

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Indian American Dr. Atul Gawande as its CEO to work out healthcare of US employees. It might be typical of disrupting the healthcare industry whale cost, conundrum is raging madly. The new company will be headquartered in Boston and will operate as an independent entity that is free from profit-making incentives and constraints.

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patient, Ayurveda practice can surely be standardized. In other words, the way Ayurveda practitioners diagnose patients can be standardized by laying down definite protocols.

This methodology currently exists only in the mind of the Ayurveda practitioner and each arrives at the diagnosis in his own way. The result of this is that no consistent data can be generated, and the methodology cannot be validated. And so began at JIVA the painstaking process of writing diagnostic protocols around the practice of Ayurveda by scanning the consultation records of lakhs of patients.

Yet, Ayurveda is not accepted as a medical science. As a result, Ayurveda medicines can’t be exported to other countries and Ayurveda practitioners abroad are forced to operate as “Health & Wellness Coaches.”

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choices, Ayurveda is fundamentally a personalized system of medicine.

Even though thousands of years old, this traditional system of healing, conceptually, is a far more evolved science. For instance, personalized medicine (based on genomics) and the “systems view” of human health is only now beginning to come into fashion in allopathy, when Ayurveda has been built around these very concepts.

The reason is that the scientific community asks for data and evidence – on what basis are the medicines given and how is their effect proven?

This data and evidence Ayurveda does not have. The big question is: “How do you standardize a system of medicine

that is fundamentally personalized, with patients being given different treatment based on the root cause, even if the symptoms are the same?”

This is the challenge of mapping intuitive Eastern systems of medicine over objective Western frameworks.

Data Analysis of Consultation Records of two lakh patients four years ago, Jiva Ayurveda began a huge data analytics project, reviewing the consultation records of two lakh patients that its doctors had treated over the decades.

After analysis, running into thousands of hours using artificial intelligence, machine learning and computer modelling, the Jiva analysts concluded that while the Ayurveda treatment cannot be standardized for every

India’s first-ever Protocols for Ayurveda: the protocols that have been created over the last four years

by Jiva. These protocols, and the decision support system built over them, help Ayurveda practitioners anywhere in the world arrive at the correct diagnosis in a data-driven way. The system also categorizes the diseases in terms of severity, which has a direct bearing on prognosis.

As the consultation protocol flows, based on patient answers, the system starts assigning weights to different diagnostic possibilities and makes calculations to arrive at an authoritative diagnosis. It helps avoid judgmental errors and the cost of wrong diagnosis. It also suggests diagnostic clues that the doctor may have missed which may lead to a possible different line of treatment.

Narrating all these, Dr. Chauhan says these protocols to standardize the practice of Ayurveda, the first-ever to be attempted in India, signal a revolutionary shift. They are akin to Ayurveda’s operating system that is accessible to everybody. This system will create a wealth of data and evidence that will eventually go on to validate Ayurveda as a legitimate science of treatment, boosting its acceptability worldwide. The protocols have been run successfully on 20,000 patients so far, with dramatic results. Three international universities are collaborating with JIVA to validate this data.

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Lonely people run the risk of dying early!

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By InnoHEALTH Editorial Team

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EFORE WE meaningfully or unwittingly leave our parents or acquaintances alone, we must be aware that a latest study has found that Loneliness is bad for the heart and a strong predictor of premature death.

Recently, at a scientific congress in Dublin, Ireland, a paper was presented which minced no words to assert that feeling lonely was a stronger predictor of poor outcomes than living alone, in both men and women. The study found “Loneliness is more common today than ever before, and more people live alone,” said Anne Vinggaard Christensen, study author and PhD student, The Heart Centre, Copenhagen University Hospital, Denmark. The soul-searching paper was presented at EuroHeartCare 2018, the European Society of Cardiology’s annual nursing congress.

“Previous research has shown that loneliness and social isolation are linked with coronary heart disease and stroke, but this has not been investigated in patients with different types of cardiovascular diseases."

The study investigated whether poor social network was associated with worse outcomes in 13,463 patients with ischaemic heart disease, arrhythmia (abnormal heart rhythm), heart failure, or heart valve disease.

Data from national registers was linked with the DenHeart survey, which asked all patients discharged from April 2013 to April 2014 from five heart centers in Denmark to answer a questionnaire about their physical and mental health, lifestyle factors such as smoking and social support.

Social support was measured using registry data on living alone or not, and survey questions about feeling lonely – Do you have someone to talk to when you need it? Do you feel alone sometimes even though you want to be with someone? “It was important to collect information on both, since people may live alone but not feel lonely while others cohabit but do feel lonely,” explained Ms. Vinggaard Christensen. Feeling lonely was associated with poor outcomes in all patients regardless of their type of heart disease, and even after adjusting for age, level of education, other

diseases, body mass index, smoking and alcohol intake.

Loneliness was associated with a doubled mortality risk in women and nearly doubled risk in men.

Both men and women who felt lonely were three times more likely to report symptoms of anxiety and depression and had a significantly lower quality of life than those who did not feel lonely.

Ms. Vinggaard Christensen noted that people with poor social support may have worse health outcomes

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The study has highlighted growing concerns about the issue and assumes great significance at places where loneliness is turning

On December 14, 1990 the United Nations General Assembly voted to establish October 1 as the International Day of Older Persons as recorded in Resolution 45/106.

The holiday was observed for the first time on October 1, 1991.

The holiday is celebrated by raising awareness about issues affecting the elderly, such as senescence and elder abuse. It is also a day to appreciate the contributions that older people make to society. This holiday is similar to National Grandparents Day in the United States and Canada as well as Double Ninth Festival in China and Respect for the Aged Day in Japan.

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She concluded: “We live in a time when loneliness is more present and health providers should take this into account when assessing risk. Our study shows that asking two questions about social support provides a lot of information about the likelihood of having poor health outcomes.”

European guidelines on cardiovascular prevention state that people who are isolated or disconnected from others are at increased risk of developing and dying prematurely from coronary artery disease. The guidelines recommend assessment of psychosocial risk factors in patients with established cardiovascular disease and those at high risk of developing cardiovascular disease.

The study assumes significance and greater attention as the world marks the International Day of Older Persons on October 1, each year.

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because they have unhealthier lifestyles, are less compliant with treatment, and are more affected by stressful events. But she said: “We adjusted for lifestyle behaviours and many other factors in our analysis, and still found that loneliness is bad for health.”

into a bane for victims due to lack of support system.

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“Loneliness is a strong predictor of premature death, worse mental health, and lower quality of life in patients with cardiovascular disease, and a much stronger predictor than living alone, in both men and women,” said Ms. Vinggaard Christensen.

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Agonizing Ankylosing Spondylitis is morecommoninyoungmenbetween 20 and 30 years of age than women; occurs in children as well

By Neeraj Bajpai

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or young people, less heard ailment Ankylosing Spondylitis (AS) is an emerging disturbance, but that is a stark reality: initially, victims develop symptoms such as low back pain and stiffness that lasts for more than 30 minutes and worsens in the morning or after prolonged inactivity.

Panacea lies in regular exercise before AS grips individual like a wasp with stiffened ligaments and muscles. Dr. Uma Kumar, states that such cases were burgeoning, and timely treatment can only stave off complications.

Patients with AS must exercise regularly because it helps to limit

spinal deformity and maintain their spinal movement and flexibility, while also relieving the back pain. Swimming and deep breathing are the best exercises. In addition, a hot shower in the morning can help to ease the pain and stiffness. Patients should avoid smoking, eat a healthy diet and maintain a healthy weight.

Dr. Uma Kumar, Professor and Head, Department of Rheumatology, All India Institute of Medical Sciences

AS is not curable, but it is completely treatable if detected early. Only 10% of patients have severe disabling disease. With the help of the correct medication and lifestyle modification, approximately 80% people with AS remain completely independent or just minimally disabled in the long-term.

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Other symptoms of AS are: chest stiffness; pain in the neck, hip, shoulder, glutes (buttock) and heel; as well as arthritis of the knee, ankle, toes or fingers. About 30% of the patients may develop uveitis (painful red eye)

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Question: Are genetic and environmental factors linked to AS? The exact cause of AS is unknown.

However, there is a strong genetic predisposition and most patients with AS have the HLA B27 gene. About 6% to 8% of the Indian population has the HLA B27 gene and amongst them, those with a family history of AS in a first-degree relative have a 30% chance of developing the disease.

However, only 2% of individuals with this gene actually develop the disease. It is hypothesized that some stimuli (e.g. environmental factors, gut microbiome) trigger AS development in genetically predisposed individuals.

Moreover, AS can also develop in individuals without HLA B27. It is likely

Question: Whether Initial symptoms itself are alarming or not?

Initial symptoms may not appear alarming, but they can be serious.

Patients with AS initially develop symptoms such as low back pain and stiffness that lasts for more than 30 minutes and worsens in the morning or after prolonged inactivity. They often find it difficult to turn on the bed during the latter part of night and the pain sometimes wakes them up from sleep. Typically, the back pain improves with activity. Some of the tendons and ligaments of the body may also get inflamed (e.g. costochondritis & Achilles tendinitis).

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Question: Can you please explain in detail AS? AS is a chronic inflammatory type of spondyloarthritis (a broad term for all types of arthritis that affects the spine) that is further classified as an ‘axial spondyloarthritis’ because it affects the joints of the spine and pelvis (where the sacral bone attaches to the iliac bone on either side of the body).

When spinal ligaments get inflamed at the point where they attach to the vertebrae, the ‘bone-making cells’ of the body get stimulated and start to grow bone within the ligaments, which results in the formation of bony bridges between adjoining vertebrae – this is what leads to a stiff back.

that there are some undiscovered genetic factors that could also be involved in its etiology.

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She answered several questions on the ailment.

Question: Does it affect other parts of the body as well?

Sometimes, other joints of the body such as the ankle, knee and hip may also be affected. AS is more common in young men between 20 and 30 years of age than women. It can occur in children as well. The prevalence of AS ranges from 0.8% to 1.8% in the general population.

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In an exclusive interview to InnoHEALTH magazine, Dr. Kumar traces the original meaning of the disease, and says the word Ankylosing Spondylitis (AS) is derived from the Greek words ankylos meaning ‘stiffening’, spondylos meaning ‘vertebra’, and – it means ‘inflammation’.

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Arthritis includes more than 100 different conditions that affect joints and the surrounding tissue. The most common form of arthritis in the Unites States is osteoarthritis, followed by gout and rheumatoid arthritis.

Symptoms include pain, aching, stiffness, and swelling in or around the joints. Arthritis affects people of all ages, including children.

Although the risk of developing arthritis increases with age, more than half of adults with arthritis are younger than 65. About 1 in 4 adults has arthritis in US.

and a similar number of patient’s long-standing disease may develop osteoporosis (thin weak bones). The lungs, heart (valves) and kidneys may also get affected.

Question: How can it be diagnosed accurately?

We do clinical diagnosis with imaging and genetic tests. AS is diagnosed based on a patient’s clinical profile and radiological (X-ray) investigations.

Blood tests include genetic tests to detect the HLA B27 gene; and tests that detect raised erythrocyte sedimentation rates (ESR) and increased C-reactive protein (CRP) levels to help support the diagnosis.

X-ray imaging cannot detect bone changes during the initial stages of the disease making early diagnosis difficult. However, MRI scans of the sacroiliac joints can be used to diagnose AS in the early stages, when the X-ray of this region still appears ‘normal’.

Question: Can treatment help to slow down or stop the progression of AS? The aim of treatment is to relieve pain; slow down or stop disease progression; and maintain mobility of spine.

Medicines for AS include: non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, disease modifying antirheumatic drugs (DMARDs) and biologics (targeted therapy). NSAIDs provide pain relief and also retard

the progression of AS and patients prescribed these medicines must take them regularly and NOT ‘as and when required’. DMARDs like methotrexate, sulphasalazine and leflunomide are prescribed for patients with peripheral arthritis. Patients who do not respond well to these drugs may be prescribed biologics such as anti-TNF alpha agents and anti-IL-17 inhibitors, as long as they have not had TB or a similar significant illness in the past.

These biologics and other tools that help us assess the disease have made it possible for patients to lead an almost normal life. Oral or parenteral glucocorticoids have no role in the management of AS though intraarticular steroid injections may sometimes be needed.

Question: Is surgical intervention a solution?

Surgery is rarely required for correcting spinal deformity, though a hip or knee replacement surgery may be needed if there is significant joint damage.

Question: What should be frequency for consulting doctors?

Regular follow-up with the doctor is extremely important to adjust the dose and to detect any drug adverse effects or any complication or comorbidity at the earliest.

According to Centers for Disease Control And Prevention in US, Arthritis affects about 1 in 4 adults in the United States; That’s 54 million men and women; As the US population ages & obesity increases, the number of adults with arthritis is expected to increase to 78 million by 2040; one-third of adults living in rural areas have Arthritis; over 1 in 2 adults with Arthritis in rural areas are limited by it; Arthritis is a leading cause of disability in the US. Twenty-four million adults report limitations due to Arthritis.

And, the most common form of Arthritis in US is osteoarthritis.

People with arthritis can manage symptoms & reduce pain by learning self-management strategies and being physically active.

Prevention tips - Early diagnosis and appropriate management of arthritis, including selfmanagement activities, can help people with the condition live well without pain. Everyone should exercise regularly to stay healthy, including people with Arthritis.

Physical activity has been proven to reduce the pain and restore function. There are proven exercise programmes that can help people with arthritis increase their physical activity safely and comfortably. Maintaining a healthy weight has shown to decrease the risk of developing Osteoarthritis and gout and may decrease disease progression and arthritisrelated activity limitations.

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Low back pain is the leading cause of disability worldwide Affecting an estimated 540 million people at any one time, butunfortunately, the condition is mistreated against the best-known guidelines. Worldwide, overuse of inappropriate tests and treatments such as imaging, opioids and surgery means patients are not receiving the right care, and resources are wasted.

By InnoHEALTH Editorial Team

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vidence suggests that low back pain should be managed in primary care, with the first line of treatment being education and advice to keep active at work. A 2008 survey of all registered physiotherapists in Maharashtra (India) showed that 46 per cent of physiotherapists advised patients with low back pain to rest. 63 percent of Indians believe that bed rest is the main stay of therapy.

A new series of papers in The LANCET highlights the extent to which the condition is wronged, often against best practice treatment guidelines.

According to researchers a prospective study in the period 10th October 2008 of 25251 patients with chronic back pain received in an Indian orthopedic clinic, reported that 100 per cent of patients underwent imaging, with 76 % diagnosed with non-specificlow back pain and 10 % with spondylosis.

According to Global Burden of Disease study every year, a total of 7.3 million years of productive life is lost in India because of disability from low back pain. Physiotherapist and Assistant Professor Saurabh Sharma, in the Department of Physiotherapy, Kathmandu University of Medical sciences, told InnoHEALTH magazine in an email interview that he was also aware of practices of low back pain,which is far away from evidence recommendations.” For example, rest, lumbar supports/corsets are prescribed very commonly against the current recommendations.

Similarly, all patients are prescribed medicines, electrotherapy, taping and

ex-rays. More than half individuals are advised MRI.Similarly, patients are also treated with new treatments that the cliniciansclaim but have never been tested in clinical trials (research), such as matrix rhythm theory practice in Pune, he said.

Rachelle Buchbinder, Monash University, Australia. “Often, however, it is more aggressive treatments of dubious benefit that are promoted and reimbursed.”

“The majority of cases of low back pain respond to simple physical and psychological therapies that keep people active and enable them to stay at work,” explains series author Professor

Low back pain results in 2.6 million emergency visits in the USA each year, with high rates of opioid prescription.

A 2009 study found that opioids were prescribed to around 60% of

In reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery or prescribed pain killers including opioids, which are discouraged for treating low back pain.

The series reviews evidence from high-and low-income countries that suggests that many of the mistakes of high-income countries are already well established in low-income and middleincome countries. Rest is frequently recommended in low and middleincome countries, and resources to modify workplaces are scarce.

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The authors say that healthcare systems should avoid harmful and useless treatments by only offering

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Low back pain mostly affects adults of working age. Rarely can a specific cause of low back pain be identified so most is termed nonspecific and evidence suggests that psychological and economic factors are important in the persistence of low back pain. Most episodes of low back pain are short-lasting with little or no consequence, but recurrent episodes are common (about one in three people will have a recurrence within 1 year of recovering from a previous episode) and low back pain is increasingly understood as a longlasting condition.

The global burden of disability due to low back pain has increased by more than 50% since 1990 and is due to increase even further in the coming decades as the population ages.

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The Global Burden of Disease study (2017) found that low back pain is the leading cause of disability in almost all high-income countries as well as central Europe, Eastern Europe, North Africa and the Middle East, and parts of Latin America. Every year, a total of 1 million years of productive life is lost in the UK because of disability from low back pain; 3 million in the USA; and 300,000 in Australia (see GBD for country specific estimates available).

“Millions of people across the world are getting the wrong care for low back pain. Protection of the public from unproven or harmful approaches to managing low back

pain requires that governments and health-care leaders tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo,” says series author Prof. Jan Hartvigsen, University of Southern Denmark.

“Funders should pay only for highvalue care, stop funding ineffective or harmful tests and treatments, and importantly intensify research into prevention, better tests and better treatments.”

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“In many countries, painkillers that have limited positive effect are routinely prescribed for low back pain, with very little emphasis on interventions that are evidence based such as exercises. As lowerincome countries respond to this rapidly rising cause of disability, it is critical that they avoid the waste that these misguided practices entail,” adds series author Professor Nadine Foster, Keele University, UK.

treatments in public reimbursement packages if evidence shows that they are safe, efficient and cost-effective.

They also highlight the need to address widespread misconceptions in the population and among health professionals about the causes, prognosis and effectiveness of different treatments for low back pain.

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emergency department visits for low back pain in the USA. Additionally, only about half of people with chronic back pain in the USA have been prescribed exercise. In India, studies suggest that bed rest is frequently recommended, and a study in South Africa found that 90% of patients received pain medicine as their only form of treatment.

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Resistant STIs on Rise: Can we still ignore it?

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By Dr. Sarita Jaiswal & Pooja Yadav

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hen we discuss life in general, we run across various issues that influence our lives, some which we physically observe and some which we candidly feel.

As such, subject of sex in India is surrounded by a multitude of social standards, religious confinements and taboos which leave no scope for discussion about sexually transmitted infections.

There are more than 20 types of sexually transmitted infections (STIs) which are caused by bacteria, parasites, viruses and yeasts. Bacterial infections such as gonorrhea, chlamydia, and syphilis are such little-discussed STIs. Though gonorrhea is as pervasive as chlamydia, it is rarely diagnosed and tested. These infections may cause infertility in women as well as in men and have the potential to become the next SUPERBUG within a decade.

From Khajuraho to condoms, we as country are known for hypocrisy about ‘SEX’ in our mindset. A nation that has swung from the extremes of religious rigors to the extremes of uninhibited debauchery, STIs duck and display voluntarily. It leaves us no surprise when ongoing reports point at expanding patterns of STIs among teenagers. The reasons are their undisclosed curiosity and no sex education at schools or home.

Numerous reports point towards increasing number of child abuse reports in both rich and economically backward sections of our country.

Many people in India, consider STI as an 'appearance from God,' 'an indication of developing youthfulness,' 'an indication of development,' 'the consequence of

These infections do not spread by shaking hands or toilet seats. The bacteria that cause syphilis can enter the body through cut in the skin or through contact with a partner’s syphilis sore. eating nettle leaves' and 'from sex with menstruating lady'. Not just in our country, such misleading thoughts regarding the causation of STIs are common throughout the world with shifting accentuation.

STIs are in general, more dynamic than other existing community infections. It is important to keep track of epidemiological changes in STIs especially in a densely

populated country like India.

Thorough understanding about the patterns of infections spread in a geographical region is important for planning its control strategies.

Each year about 357 million STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) are reported worldwide. As per the warning from World Health Organization (WHO), anti-microbial resistance in gonorrhea is emerging strongly

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The incubation period, the time

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Pooja Yadav is a science postgraduate with specialization in toxicology. She is currently working as a project assistant at INMAS, DRDO. She is involved in the preparation of many techno-knowledge documents and activities of Biothreat-mitigation project.

She is a talented researcher with zeal for microbiology and toxicology and is also a fine artist and performer.

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Dr. Sarita Jaiswal, an ex-research officer at University of Saskatchewan, Canada,is an accomplished Plat Scientist having 15+ years of R&D experience with specialization in cereal and pulse crop biochemistry and genomics.

She has been awarded twice for the category of Young Scientist (Indian Society of Plan Physiology and amp; KK Nanda Foundation for Advancement of Plant Sciences).

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Peoples, who have chlamydia, are more susceptible to gonorrhea and syphilis. These infections do not spread by shaking hands or toilet seats. The bacteria that cause syphilis can enter the body through cut in the skin or through contact with a partner’s syphilis sore. It can also be passed from mother to newborn as the baby passes through the infected birth canal.

Researchers in India have isolated around 124 strains of gonorrhea from Delhi, Hyderabad, Mumbai, Pune, and Secunderabad for testing antimicrobial susceptibility. As per their results, 98% isolates were resistant to ciprofloxacin, 52% to penicillin, 56% to tetracycline and 5% to azithromycin. Irrational use of antibiotics, gradual accumulation of antibiotics in the food chain, innate antimicrobial resistance and development of resistance due to mutation were major culprits for developing resistance. MDR in Neisseria gonorrhoeae is a big public health challenge.

Infection and symptoms of chlamydia and gonorrhea are common which makes it difficult to distinguish these from each other.

In comparison to men, women are around five times more prone to have asymptomatic urogenital infections. This infection can spread throughout the body, and affect joints, heart valves or other vital organs which can be deadly.

Unlike testing for chlamydia and gonorrhea, routine screening for syphilis is not recommended for women who are not pregnant.

Diagnosis of these is cumbersome and time consuming. Also, one may be tested for chlamydia and gonorrhea at a time as these two often occur together.

Oral medicines and injectable antibiotics are prescribed in general to the patient and his/her partner to kill the infection and prevent its spread.

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Symptoms of syphilis include 3 stages. In primary stage of syphilis, it first appears as a painless chancre which goes away without treatment in 3-6 weeks. If it is not treated, the secondary stage begins as the chancre is healing or several weeks after the chancre has disappeared, when a rash may appear. The rash usually appears on the soles of the feet and palms of the hands, flat warts may be seen on the vulva. Some patients may exhibit flu-like symptoms. The rash and other symptoms may go away in a few weeks or months, but that does not mean the infection is gone. It still exists and referred as latent stage of its infection.

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from exposure to the bacteria until symptoms develop depends on the sex of the patient, age and immune status of the infected person. In case of gonorrhea, it is usually several hours to 4-5 days in males while in women it takes much longer and ranges from 7 to 14 days. In younger people, it proceeds rapidly, and its incubation period is also very brief. In older patients, sometimes infection is asymptomatic, progress to become chronic and eventually evident after a few months. In case infected person was taking antibiotic for other medical ailment, its incubation period may extend further. In chlamydia, incubation period is one to three weeks while in syphilis it is 21 days but can range from 10 to 90 days.

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while cases of untreated chlamydia and syphilis with reported antibiotic resistance are also making news. Multidrug-resistant (MDR) is defined as resistance to at least ≥3 antimicrobial categories which are used earlier successfully.

The gonococcus mutates rapidly and acquiring resistance even against new classes of antibiotics.

Chlamydia is world’s most common non-viral STI and gonorrhea is second most common MDR infection. Gonorrhea might have existed since ages but its authentic records in India can only be found during and after British Empire in India. It was referred as “clap” disease before the actual cause was discovered and is caused by the obligate pathogen Neisseria gonorrhoeae which infects only humans. Chlamydia and syphilis are caused by Chlamydia trachomatis and Treponema palladium respectively.

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Advantages and Disadvantages of Real Time Health Monitoring Devices

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By Devendra Khardekar

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eal time health monitoring devices provide real time analysis of the patient’s health parameters. Patients are sharing their healthcare information in real time with their caregivers through these devices for flexible health monitoring and management. Internet of medical things is vastly improving the healthcare condition of patients.

Tracking patient monitoring and drug management has become possible because of the usage of the above Internet of Things (IOT) medical devices in the healthcare sector. Increasing ageing population, surging healthcare expenses and an increase in the occurrence of chronic diseases is driving healthcare stakeholders to follow remote health management and patient monitoring seriously.

“Reacts’ secure, versatile and interactive collaboration platform deployed on technology solutions like Philips Lumify can change education and patient care models and enable a positive disruptive change to healthcare,” Dr. Yanick Beaulieu, CEO and Founder of IIT, said in a statement. “For years, clinicians in the field have been trying to piece together systems that offer real-time, interactive teleultrasound capabilities. Now, it has truly arrived.”

The global market for Real Time Health Monitoring Devices is expected to reach USD 67,982.2 mil by 2022.

Segments: Global Real Time Health Monitoring Devices Market has been segmented on the basis of type which comprises of wearable

devices, home health medical devices. On the basis of end user, the market is segmented into hospitals, clinics, ambulatory centers and homecare settings.

Incorporating Real Time Health Monitoring Devices in chronic disease management can significantly improve an individual's quality of life. It allows patients to maintain independence, prevent complications and minimize personal costs. RPM facilitates these goals by delivering care right to the home. In addition, patients and their family members feel comfort knowing that they are being monitored and will be supported if a problem arises. This is particularly important when patients are managing complex self-care processes such as home hemodialysis.

Key features of Real Time Health Monitoring Devices, like remote monitoring and trend analysis of physiological parameters, enable early detection of deterioration; thereby, reducing number of emergency department visits, hospitalizations, and duration of hospital stays. The need for wireless mobility in healthcare facilitates the adoption of RPM both in community and institutional settings. The time saved as a result of RPM implementation increases efficiency and allows healthcare providers to allocate more time to remotely educate and communicate with patients.

Technological components of Real Time Health Monitoring Devices n The diverse applications of RPM lead to numerous variations of RPM technology architecture.

However, most RPM technologies

follow a general architecture that consists of four components. n Sensors on a device that is enabled by wireless communications to measure physiological parameters. n Local data storage at patients’ site that interfaces between sensors and other centralized data repository and/or healthcare providers. n Centralized repository to store data sent from sensors, local data storage, diagnostic applications, and/or healthcare providers. n Diagnostic application software that develops treatment recommendations and intervention alerts based on the analysis of collected data. n Depending on the disease and the parameters that are monitored, different combinations of sensors, storage and applications may be deployed.

Application of Real Time Health Monitoring Devices Physiological data such as blood pressure and subjective patient data are collected by sensors on peripheral devices.

Examples of peripheral devices are: blood pressure cuff, pulse oximeter, and glucometer. The data are transmitted to healthcare providers or third parties via wireless telecommunication devices. The data are evaluated for potential problems by a healthcare professional or via a clinical decision support algorithm, and patient, caregivers, and health providers are immediately alerted if a problem is detected. As a result, timely intervention ensures positive patient outcomes. The newer applications also provide education, test and medication

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There are common obstacles that health informatics technologies encounter that applies to Real Time Health Monitoring Devices.

Depending on the comorbidities monitored, Real Time Health Monitoring Devices involves a

diverse selection of devices in its implementation. Standardization is required for data exchange and interoperability among multiple components. Furthermore, Real Time Health Monitoring Devices deployment is highly dependent on an extensive wireless telecommunications infrastructure, which may not be available or feasible in rural areas.

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Real Time Health Monitoring Devices - Limitations and Overcome Real Time Health Monitoring Devices is highly dependent on the individual’s motivation to manage their health. Without the patient’s willingness to be an active participant in their care, Real Time Health Monitoring Devices implementation will likely fail. Cost is also a barrier to its widespread use. There is a lack of reimbursement guidelines for RPM services, which may deter its incorporation into clinical practice. The shift of

accountability associated with RPM brings up liability issues.

There are no clear guidelines in respect to whether clinicians have to intervene every time they receive an alert regardless of the urgency.

The continuous flow of patient data requires a dedicated team of healthcare providers to handle the information, which may, in fact, increase the workload. Although technology is introduced with the intent to increase efficiency, it can become a barrier to some healthcare providers that are not technological.

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reminder alerts, and a means of communication between the patient and the provider. The following section illustrates examples of RPM applications, but RPM is not limited to those disease states.

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A study has unknotted long-term impact of stroke: it is more than just the Physical

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By InnoHEALTH Editorial Team

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new study looks at what problems affect people most after a stroke and it provides a broader picture than what some may usually expect to see.

programs,” said Katzan.

The thinking skills of people with stroke in executive functions, or planning and organizing, were also affected, with 46 percent having scores that were meaningfully worse than the population average.

Stroke affects more than just physical functioning, according to a study recently published in Neurology, the medical journal of the American Academy of Neurology.

“People who have only mild disability can often have ‘hidden’ problems that can really affect their quality of life,” said study author Irene L. Katzan, MD, MS, of the Cleveland Clinic in Ohio and a member of the American Academy of Neurology.

“And for people with more disability, what bothers them the most?

Problems with sleep? Depression?

Fatigue? Not many studies have asked people how they feel about these problems, and we doctors have often focused just on physical disability or whether they have another stroke.”

The study involved 1,195 people who had an ischemic stroke, or a stroke where blood flow to part of the brain is blocked. They were asked questions about their physical functioning, fatigue, anxiety, sleep problems, thinking skills such as planning and organizing, how much their pain affects other aspects of their life and their satisfaction with their current social roles and activities. Participants took the questionnaires an average of 100 days after their stroke, and about a quarter of the participants needed help from a family member to fill out the questionnaires.

Researchers also measured their level of disability.

The people with stroke had scores that were considerably worse than those in the general population in every area except sleep and depression. Not surprisingly, the area where the people with stroke were most affected was physical functioning, where 63 percent had scores considered meaningfully worse than those of the general population, with an average score of 59, where a score of 50 is considered the population average.

On the question about whether they were satisfied with their social roles and activities, 58 percent of people with stroke had scores meaningfully worse than those of the general population.

“People may benefit from social support programs and previous studies have shown a benefit from efforts to improve the social participation of people with stroke, especially exercise

“The social participation and executive functioning skills are areas that have not received a lot of attention in stroke rehabilitation,” Katzan said.

“We need to better understand how these areas affect people’s well-being and determine strategies to help optimize their functioning.”

Limitations of the study include that the questionnaires did not ask about other problems that can occur after stroke, such as communication issues.

Also, the study participants had milder strokes on average than people with stroke overall and the average age of participants was 62, which is lower than the average age of 69 for people with stroke overall.

Informatively, American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with 34,000 members. AAN is dedicated to promoting the highest quality patient-centered neurologic care.

A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, concussion, Parkinson's disease and epilepsy.

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Religious people live four years longer than atheists: New Research

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By InnoHEALTH Editorial Team

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f you are a religious person then there is chance that you live on an average four years longer than yours agnostic and atheist peers.

A study in United Sates asserted this about religious people and analyzed their four years boost in more ways than one. The difference between practicing worshippers and those who were not part of a religious group could be down to a mix of social support, stress-relieving practices and abstaining from unhealthy habits, the authors suggest.

The Ohio State University research was based on a new nationwide study of obituaries. It has found that people with religious affiliations lived nearly four years longer than those with no ties to religion. That four-year boost – found in an Analysis of more than 1,000 obits from around the country– was calculated after taking into

account the sex and marital status of those who died, two factors that have strong effects on lifespan. The boost was slightly larger (6.48 years) in a smaller study of obituaries published in a Des Moines, Iowa, newspaper.

“Religious affiliation had nearly as strong an effect on longevity as gender does, which is a matter of years of life,” said Laura Wallace, lead author of the study and a doctoral student in psychology at the Ohio State University.

The researchers found that part of the reason for the boost in longevity came from the fact that many religiously affiliated people also volunteered and belonged to social organizations, which previous research has linked to living longer. In addition, the study showed how the effects of religion on longevity might depend in part on the personality and average religiosity of

the cities where people live, Baldwin Way, an Associate Professor at Ohio State University said.

The first study involved 505 obituaries published in the Des Moines Register in January and February 2012. In addition to noting the age and any religious affiliation of those who died, the researchers also documented sex, marital status and the number of social and volunteer activities listed. Results showed that those whose obit listed a religious affiliation lived 9.45 years longer than those who didn’t. The gap shrunk to 6.48 years after gender and marital status were taken into account.

The second study included 1,096 obituaries from 42 major cities in the United States published on newspaper websites between August 2010 and August 2011. In this study, people whose obits mentioned a religious

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Way said there are limitations to the study, including the fact that it could not

Overall, the study provided additional support to the growing number of studies showing that religion does have a positive effect on health, Wallace said. Other authors on the study were Rebecca Anthony, who is in her final year of medical school at Ohio State University, and Christian End, associate professor of psychology at Xavier University. The study was supported by grants from the National Science Foundation and the National Institutes of Health.

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The fact that the researchers had data from many cities also allowed them to investigate whether the level of religiosity in a city and a city’s “personality” could affect how religious affiliation influenced longevity. The findings showed that a key personality element related to longevity in each city was the importance placed on conformity to community values and norms. In highly religious cities where conformity was important, religious people tended to live longer than nonreligious people. But in some cities there is a spillover effect.

control for important factors related to longevity such as race and health behaviors. But a potential strength was that, unlike other studies, religious affiliation was not self-reported, but was reported by the obituary writer.

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So what else explains how religion helps people live longer? It may be related to the rules and norms of many religions that restrict unhealthy practices such as alcohol and drug use and having sex with many partners, Way said. In addition, “many religions promote stress-reducing practices that may improve health, such as gratitude,

prayer or meditation,” he said.

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Many studies have shown that people who volunteer and participate in social groups tend to live longer than others. So, the researchers combined data from both studies to see if the volunteer and social opportunities that religious groups offer might explain the longevity boost. Results showed that this was only part of the reason why religious people lived longer.

“We found that volunteerism and involvement in social organizations only accounted for a little less than one year of the longevity boost that religious affiliation provided,” Wallace said. “There’s still a lot of the benefit of religious affiliation that this can’t explain.”

“The positive health effects of religion spill over to the non-religious in some specific situations,”Wallace said. “The spillover effect only occurs in highly religious cities that aren’t too concerned about everyone conforming to the same norms. In those areas, non-religious people tend to live as long as do religious people.”

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affiliation lived an average of 5.64 years longer than those whose obits did not, which shrunk to 3.82 years after gender and marital status were considered.

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National Technology Awards presented

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By Sunderarajan Padmanabhan

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resident Ram Nath Kovind presented the National Award for successful commercialization of indigenous technology to Hyderabad-based Bharat Biotech Ltd. and Ernakulambased Agappe Diagnostics Ltd.

Bharat Biotech Ltd. has won the award for taking to the market a vaccine for rotavirus disease.

The vaccine, Rotavac, is currently licensed in two countries, while grant of license is under process in 30 other countries. It has also been prequalified by World Health Organisation (WHO), making it eligible for procurement by UN and other humanitarian organisations for their public health vaccine programmes.

Agappe Diagnostics Ltd. has won the award for commercializing an automated cartridge based specific protein analyzer. The instrument has become highly popular as it is smaller and cheaper compared to similar machines available from multinational companies.

Blackbio Biotech for working on a kit for diagnosis and prognosis of chronic myeloid leukemia.

Envision Scientific got the award for commercializing an indigenously developed drug eluting stent for diabetic patients and Hind High Vacuum got for commercializing thin The President presented the film metallized alumina circuit for awards to mark the 20th National space applications.

Technology Day. Three start-ups got award for He also gave away national awards developing technologies that have to five medium and small-scale commercial potentials - Astrome enterprises for commercializing Technologies at the Indian Institute indigenous technologies.

The of Science, Bengaluru, for its work on winners are Synkromax Biotech, GigaMesh, which is said to be the first ANTS Ceramics, 3B Blackbio Biotech, point to multi-point millimeter wave Envision Scientific and Hind High wireless communication solution in the Vacuum. world; CyCa Onco Solutions at Kalinga Institute of Industrial Technology, Synkromax got the award for Bhubaneswar, for developing two drug marketing a life-saving implant delivery devices for delivery of antideveloped by IIT Madras, while cancer drug, Crisplatin; and Xcellence ANTS Ceramics got the award for in Bio Innovation and Technologies commercializing high-end zirconia at BITS Pilani Hyderabad campus, for ceramic products and carbon developing a point of care device for sulphur analysis crucibles and 3B testing antibiotic sensitive of pathogens

causing urinary tract infections.

Speaking on the occasion, the President noted that the National Technology Day was landmark day for the country as it was on this day two decades ago that the Pokhran nuclear tests took place and demonstrated India’s capacity as a nuclear weapons state as well as a mature and responsible technology power, capable of harnessing sensitive knowledge.

He said technology was a destiny for the country as all national programmes required a force multiplier in the form of technology.

But, at the same time, it must also be about equity. “Its (technology’s) fruits must be accessible to all. Finance and resources should be available to all technologists who may wish to turn entrepreneurs – and to migrate from the lab room to the shop floor.” Above all, the President said, gender equity must be integrated with technology production and technology sharing.

(By India Science Wire)

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OOPS! 5.2 medical errors happen annually in India

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By Dr. Thamarai Selvi Sundararajan

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he Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and World Health Organization (WHO) has estimated that medical errors happen in 1 out of 10 patients every year globally but according to Harvard Study conducted by Prof. Jha revealed that 5.2 medical errors happen annually in India and among that, medication and hospital acquired infection errors are the major ones.

To increase quality of care, developed countries had already initiated incentive payment model to encourage and reward healthcare providers (hospitals, public health centers, school-based hospitals, and group practices) for delivering high quality care.

Centre for Medicare and Medicaid Services, United States has developed value-based purchasing program rewarding the healthcare providers who had provided quality care to their patients.

Similarly, in 2017 Singapore Health Ministry started to focus beyond quality of care.

Healthcare system in India pays provider for quantity of care not for quality care and has not initiated any policies with regards to increase in quality of care.

Mr. Bhargav Dasgupta, Managing Director and CEO of ICICI Lombard in a recent press release about Indian government increasing GDP for healthcare to 2.5 said, it is a good move and this spending can be used to initiate quality programs.

To measure the quality of care, the government should implement

Quality metric tools in the major areas of medical error namely, reduce medication and hospital acquired infection.

Quality metric tool will help the Indian Health Ministry to assess whether the provider has delivered high quality care. For example, to assess whether a hospital has delivered high quality care in prescribing medication to the patient with upper respiratory tract infection, the provider should report how many patients are being prescribed with proper antibiotics for how many days.

Suppose first year if the provider proves that 100 patients were prescribed with proper antibiotics then number of patients should increase to 10% each year and finally achieve 100% goal in consecutive year. The government should reward provider with incentive for providing evidence of high quality care. Once two major medical errors have been addressed and controlled, the government can use the same

model to all the areas of medical error. Hence, this incentive program will eventually increase quality of care and decrease cost of healthcare.

This incentive program should be initiated first in government hospitals, profit hospitals, and physician group practice. This will further attract more medical tourist to India due to high quality of care.

Dr.ThamaraiSelviSundararajan, a dentist from India, finished Master’s in Healthcare Administration from Texas State University, US. Currently working as Financial Analyst in a county hospital at US and recipient of many healthcare research awards and scholarships at national and international levels.

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In 2018, the pharmaceutical industry is one of the top 3 industries in the world. In 2017, the

The industry invests nearly USD 40 bil a year on drug development and clinical trials, making it one of the biggest contributors to the international economy.

The need for constant innovation and development of drugs has risen drastically over the last 15 years. The growth spurt arose due to the birth of certain strains of bacterium and viruses that have begun adapting to the medication. As the causal organisms began to adapt to the quintessential drugs, the industry had to keep researching drugs to fight this mutation.

(By Trescon)

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Although the first landmark in the healthcare industry was the

And it wasn’t an isolated situation, as over time viruses and parasites begun mutating and developing resistance over their target medication that it became important to continuously develop more advanced strains of medicines, and this sparked off the birth of the Pharmaceutical and Drug testing industry!

pharmaceutical industry pumped nearly USD 24 bil in to advertising and PR, with USD 12 bil from the United States alone!

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The first institution to train individuals in the field of physiology and medication was established in Italy, around the 15th century.

accidental discovery of Penicillin by Scottish scientist Alexander Fleming, in the year 1928; the widespread use of Penicillin was initiated only in 1942 to treat infections caused

by Streptococci Bacterium. But over time, Penicillin resistant bacteria began to come to life.

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ow technology and innovation will drive the Pharma industry?

Ever since the pyramids were erected in Giza, the need for medication and surgery were required. During the Stone Age, as early as 3,300 BC, studies have shown that primitive forms of herbal condiments were used to treat wounds and certain lung disorders. Ayurveda, from the annals of the Hindu Veda scriptures, can be traced back to almost 4,000 BC.

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3 Facts that pushed an Industry from ASPIRIN to ASPIRATION