Sep_Oct_2016 by Zyaul Designer

EDITOR EVENT SPEAK

A MAJOR TRIGGER TO YOUR LIFE: CARDIOVASCULAR DISEASE (CVD) Cardiovascular disease (CVD) is generally known as ‘Heart Disease’ or Heart Attack that caused by disorder of the heart or blood vessels includes coronary heart disease. There are so many names to define heart attack, stroke, hypertension. Cardiovascular is a biggest threat for people globally as well as in India. Most of the studies has prevailed that deaths caused by cardiovascular disease are premature and leads to death. Nowadays, it is the most common disease due to unhealthy eating habits and changing lifestyles. Most of the people ignore this problem initially. Cardiovascular diseases include: coronary heart disease (heart attacks), cerebrovascular disease, raised blood pressure (hypertension), peripheral artery disease, rheumatic heart disease, congenital heart disease, and heart failure. According to American Heart Association the latest statistics showed that Cardiovascular Disease (CVD) is the global cause of death accounting for 17.3 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030. About 2,150 Americans die each day from these diseases, one every 40 seconds. It is highest common death disease after combined with all types of cancer. Nearly half of all African-American adults have some form of cardiovascular disease, 48 percent of women and 46 percent of men. In the report of World Health Organization (WHO) over 80% of cardiovascular disease deaths take place in low-and middle-income countries and occur almost equally in men and women. Tobacco use, unhealthy diet, excessive smoking, too much consumption of alcohol, physical inactivity, increases the risk of heart attacks and strokes. High blood pressure, high cholesterol, sudden stroke has no symptoms. It can occur anytime, anywhere with anyone. In some cases it has been showed that overweight can also be the biggest cause of heart attacks. From 2001 to 2011, the death rate from heart disease has fallen about 39 percent – but the burden and risk factors remain alarmingly high. According to the Centers for Disease Control and Prevention more than half a million people in the United States die of heart disease each year.

magazine Volume - VII Issue - III Sep-Oct 2016

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Heart disease strikes someone in the United States (U.S) about once every 43 seconds. Heart disease is the No. 1 cause of death in the United States, killing over 375,000 people a year. Heart disease is the No. 1 killer of women, taking more lives than all forms of cancer combined. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population. Despite wide heterogeneity in the prevalence of cardiovascular risk factors across different regions, CVD has emerged as the leading cause of death in all parts of India, including poorer states and rural areas. In the earlier times we don’t have proper access to cure our disease. But, nowadays we have better facilities better equipment in the hospitals. We cannot describe Cardiovascular Disease (CVD) or heart disease in one word. It caused multiple disorders that affect the heart. But if we want a healthy life we should adopt a balanced diet complied with regular exercise.

Dr. ma Kamal

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DIABETES & HEART DISEASES

Food

From the

Heart 34

Co nten ts

Genetic Testing for Breast Cancer: How it Helps

44 Everything you need to know about how to take care of your health post organ donation

Skin Cancer:

Protecting Yourself From The Most Common Cancer

E-pharmacies: Opportunities amidst uncertainties Don’t take Fever Easy:

Do Small Steps

6 Respiratory Problems surging by 50%in Children �� 8 NCR’s LARGEST DIAGNOSTIC CHAIN, DALMIA MEDICARE LAUNCHED �� 10 Bangalore based start-up, Ventura brings innovation to Indian healthcare with world’s finest GI �� 12 Fortis Healthcare and wayForward �� 14 ADHD market to reach $13.9 billion by 2024, as awareness increases and drugs improve, says GlobalData �� 16 A look into the womb can shape a baby’s future �� 18 ‘Policy Advocacy Meet on NMC Bill, 2016’ organized by ‘Voice of Healthcare’ �� 20 Medtronic names Madan Krishnan Vice President for Indian Sub-continent �� 22 Focus on migrant health: WHO �� 26 Visionary technology �� 35 New advanced technology to detect colorectal cancer �� 40 Indian Railway as a Carrier of Indian Healthcare: Movement & Improvement �� 44 Coagulation Testing and Results: Now@your fingertips �� 48 Welcome to the world of Fujifilm’s effective filmless diagnosis with high quality image processing using SYNAPSE �� 50 Eat Right for Your Belly and Your Baby �� 56 India’s premiere exhibition and summit on hospital infrastructure planning and design �� 58 INTERVIEW with Narendra Nath �� 60 Ventura Business Solutions & Smart Medical Systems launches World’s Smartest GI Endoscopy technology in India ��

WORLD SUICIDE PREVENTION DAY Respiratory Problems surging by 50% in Children

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NEWS Update

Ventura Business Solutions & Smart Medical Systems launches World’s Smartest GI Endoscopy technology in India • Innovative G-EYE™ endoscope technology allows doctors to enhance the prevailing detection rate of 60% to 98% • E arly stage diagnosis and effective treatment of Colorectal Cancers and other severe Gastro Intestinal disorders is now possible in India with this advance technology • Company has introduced innovative and cost effective endoscopy devices- G-EYE™ endoscope and NaviAid™ Ventura Business Solutions introduced India’s first Smart endoscopy technology, G-EYE™ endoscope and NaviAid™ in a strategic partnership with Israel based, Smart Medical Systems, a developer and manufacturer of world-leading gastrointestinal (GI) endoscopy devices. In India and other parts of the world, Endoscopy procedures give only 60% detection rate but with use of SMART's G-EYE Endoscope technology, this detection rate gets enhanced to 98% thus almost eliminating missing of detection of any growth that may need surgery or loss of life later on. This revolutionary solutions can improve the diagnosis and therapy of GI (gastrointestinal) disorders and diseases, most notably, colorectal cancers. Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide and there are a growing number of colorectal cancer patients in India. With this new G-EYE™ endoscope technology doctors can ensure early diagnosis and effective treatment of colorectal cancer and other gastrointestinal diseases which are common in the country. The products have received rave reactions from wellknown hospital chains in India including Asian Institute of Gastroenterology, Fortis, Apollo, Max, Gangaram, Aster CMI, Sunshine, Manipal, Columbia Asia Hospitals, and PGI Chandigarh. The two companies held a special event to launch Smart’s product line in New Delhi as a part of their strategic partnership, under which Ventura will deploy Smart’s products in the Indian and South Asian market. The launch event was graced by internationally acclaimed Nutrition and Gastroenterology Expert, Dr. Zamir Halpern from Tel Aviv Sourasky Medical Center, Israel. SMART's flagship product, the G-EYE™ endoscope, uses innovative balloon technology to uncover pre-cancerous polyps that are hidden behind the colon's natural folds. Pricewise, Smart's solution costs almost 1/5th of the nearest competitor, which means it is highly affordable for the hospitals and patients alike. The company has additional balloon products under development and commercialization, designed to allow standard endoscopes to access and visualize portions of the GI tract currently only accessible with the use of highly specialized equipment. 6

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

The G-EYE™ endoscopy technology also provides the ability to perform double balloon enteroscopy on-demand which means no prior preparations of the equipment or the patient is required. Speaking about the clinical impact of newly launched products on contemporary gastroenterology, internationally acclaimed Nutrition and Gastroenterology Expert, Dr. Zamir Halpern from Tel Aviv Sourasky Medical Center, Israel said, “Smart's new -EYE™ endoscope and NaviAid™ solutions significantly enhance the technical and therapeutic aspects of colonoscopy and enteroscopy procedures. It is a unique opportunity and great privilege for me to share my clinical experience with Smart’s unique product platform, which represents a new standard of care in colorectal cancer prevention and GI endoscopy.” Speaking on partnership with Ventura, Misha Krakowsky, Executive Director of Asia Pacific for Smart Medical Systems said, “Our alliance with Ventura provides us with a great opportunity to serve the medical community in India, enhancing physicians' capabilities during endoscopy procedures and providing better treatment for patients.” Satya K., President & CEO of Ventura Business Solutions said “Smart Medical’s technology offers a unique value proposition to medical centers, physicians and patients. Our mission is to make this unique technology highly accessible to hospitals and endoscopy centers.”

NEWS Update

Respiratory Problems surging by 50%in Children  The dampness in the air has increased the incidence of respiratory problems in children A ir pollution in these conditions worsening the situation, say doctors The combination of humidity and air pollution is leading to a rise in respiratory diseases among children. Pediatricians have noted an increase in acute diseases such as asthma and upper respiratory tract infections. This is besides the regular viral mostly peak in children during the monsoon season. This is because the moisture in the air traps polluting agents, especially particulate matter, keeping them hanging infections, accompanied by a cold, cough, and fever, seen every year. “Respiratory problems in the atmosphere for long periods. Unfortunately, it is not just outdoor air pollution that is causing harm. Indoor pollution too, from fumes, especially those from mosquito repellants, does impact the airways. In addition, spores from fungus and mould around houses and schools can affect those who are already asthmatic,” says Dr. Piyush Goel, Consultant Pulmonology, Columbia Asia Hospital Gurgaon.

Gurgaon has often shown hazardous levels of air pollution, both due to vehicular movement and construction work. The World Health Organization (WHO) Air Quality Guidelines stipulate that PM2.5 (particulate matter) over a 24-hour mean period stand at 25 μg/ m3. However, in Gurgaon, in June 2016, the monthly average stood at 89.38 μg/m3. Air pollution causes more than 3 million premature deaths every year, as per WHO reports.

 Instead

“The toxic air severely impacts schoolgoing children, whose airways are still not developed, and are hence vulnerable to pulmonary (lung) infections. Acute respiratory illnesses are generally short-lived, while chronic ones are persistent in nature. Our worry is that acute infections develop into chronic ones. We see the onset of asthma in this season, and it is appearing in children as young as a few months old. Very often parents come to us by the time their children have deep-set chest infections. My advice is for parents to approach the pediatrician as soon as the problem starts. This will help us start a mild treatment, and avoid antibiotics,” adds Dr. Piyush Goel

 If your child is comfortable with it, give

Tips to Stay Protected

apply DEET-free repellants to your child’s skin

mosquito

 Clean the house of any fungus, especially

in areas that are not seen—under the sink and washbasins

 Take action to eliminate dampness from the walls, as this can breed mould

 Identify a play area that is in a green space, rather than close to a road

him/her a mask when out playing a sport

 If your child is prone to asthma and is on

SOS medicines, keep a track on what time of the day/night he/she gets it, and if it is exercise-induced; report this to the doctor

 If antibiotics have been prescribed for an infection, do keep to the dosage suggested by the doctor

 Wash curtains, pillows , bed sheets, mats, carpets at regular interval

 If someone in your household is allergic

to pet dander, consider getting a non-furry pet. If you already have a cat or dog, don't let the pet sleep in your bedroom, and give it a bath at least once a week

 Avoid the use of insect repellants that need  To help control dust mites and mold, keep to be sprayed—even those that claim they are ‘natural’

humidity in your home below 50% by using dehumidifier

Diabetes and obesity therapeutics market will more than double to $163.2 billion by 2022, says GBI Research The global market for diabetes mellitus and obesity is set to rise from $70.8 billion in 2015 to $163.2 billion by 2022, at a strong compound annual growth rate of 12.7%, according to business intelligence firm GBI Research. The company’s latest report states that although this growth is largely attributable to a large increase in the incidence of type 2 diabetes mellitus (T2DM) and obesity, a number of pipeline T2DM therapeutics are anticipated to be significant contributors to market growth over the forecast period, with some even expected to reach blockbuster status. Callum Dew, Associate Analyst for GBI Research, explains: “Recent approvals and pipeline products that are expected to be key players during the forecast period include Tresiba (insulin degludec), Invokana (canagliflozin) and NN-9535

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

(semaglutide). The disease cluster is dominated by therapeutics indicated for type 1 diabetes mellitus (T1DM) and T2DM, and the majority of the pipeline, in terms of both quantity and quality of products, is attributable to these indications. “While products indicated for obesity do not currently have a large market presence, there are a large number of these products in the pipeline, with the majority in early stages of development. Of course, the growth of the disease cluster is driven not only by the rising global incidence of obesity, but also the subsequent effect that this has on T2DM incidence, given the intrinsic link between the two diseases.” Invokana, which is marketed by Johnson & Johnson, is one of the key players in the disease cluster. It is expected to reach a huge $3.23 billion by 2022, and is set to be approved across T1DM, T2DM and

obesity. Although current top-selling drugs such as Januvia, Novolog and Invokana are expected to remain dominant within the disease cluster, four of the anticipated top 10 best-selling drugs of 2022 will be new to market. Dew concludes: “These products, which include dapagliflozin propanediol plus saxagliptin, NN-9535 and LixiLan, are expected to reach blockbuster status and become key players themselves, indicating the strength and diversity of both the market and the pipeline for diabetes.”

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NEWS Update

NCR’s LARGEST DIAGNOSTIC CHAIN, DALMIA MEDICARE LAUNCHED Business promoter and industry leader Sanjay Dalmia launched Dalmia Medicare

Mr. Sanjay Dalmia, renowned industrialist and philanthropist launched Dalmia Medicare today at a press conference held at The Imperial Hotel, New Delhi. Announcing its foray into the healthcare industry with 32 diagnostic laboratories, Dalmia Medicare is already the largest chain of diagnostic laboratories in NCR offering both pathology and radiology services at the door step. Dalmia Medicare is a wholly owned subsidiary of Dalmia Biz Pvt. Ltd representing its healthcare vertical. Dalmia Biz aims to organize the unorganized sectors in the country such as education, retail, finance, travel &tourism, real estate and hospitality amongst many others through upcoming subsidiaries of the company. With such a vast portfolio of services, Dalmia Biz will be the only company in the country covering each and every aspect of spending as well as saving of an individual. As a holistic platform managing consumer requirements end to end, the company will be equipped to provide optimal returns to the consumers,making a significant impact on the GDP of the country. Dalmia Biz assures trustworthy, reliable and standardized services to consumers in each operating industry.

The company is focused on improving the lives of people in the country with a mission of ‘Indianizing the universe’. “The Indian Healthcare industry is growing at an exponential rate but there is still healthcare deficit in the country. With the advent of technology and innovation in every aspect of life, the new age consumer has numerous expectations from healthcare services. At the same time, there are consumers who still don’t have access to quality healthcare. Dalmia Medicare is well equipped to cater to the needs of all kinds of consumers ensuring both accessibility and quality. With Dalmia Medicare, I wish to create a platform that brings good health to every home. Starting with NCR, we will have our presence across India in the next 2 years”informed Mr. Sanjay Dalmia. On the occasion was also unveiled the logo of Dalmia Medicare by Mr. Sanjay Dalmia. “This is a service industry and in the service industry people are the biggest assets. Likewise, our team is an asset for us. Keeping that in mind, we are offering profit sharing to each and every employee of the company till we get listed. Once we are listed, hopefully in the next 3-4 years, we will be offering stock options to every employee from top to bottom. My

Spencer Emergency Medical Convention, an exclusive meeting in New Delhi The most important EMS influencer in India, the state-of-the-art in ambulance devices: a perfect mix for a wonderful day dedicated to the pre-hospital care. Spencer India, the Best Medical Equipment Company in Emergency Medicine for 2016 (MedGate), will organize in New Delhi the annual EMS Convention, an yearly event for the most important EMS leading manufacturer who fosters innovation in the country. In September 10th, Spencer India will face the biggest issues in the prehospital field with conferences, roundtables and workshops. This Convention is a not-to-miss event to discover, touch and test new medical devices for transport, immobilization and resuscitation. “The EMS system in India is best described as ‘fragmented’” said Mr. Manish Malik, CEO at Spencer India Technologies. “This is the reason Spencer India organizes its annual convention and training program as a support to develop and build the EMS system in India. It has become a platform where EMS rescuers, operators, ambulance builders and other EMS groups from different cities and locations all over India assemble together and get trainer on new innovative systems 10

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

and products and technologies of the world. This exclusive conference from Spencer is a customized platform for its business partners, operators, users and customers to enable them to learn the highly advanced and modern solution in the EMS segment”. Thanks to its network of specialists, Spencer India will assure to the participants a oneto-one conference, that allow professionals to work side by side with experts in their respective fields. This Conference will offer also some roundtable moments, with European and Indian professionals that will discuss about improvements for the Indian Emergency Medical System. Furthermore, Spencer will present its new devices, 10G and 20G certified, like SHARP, the first and only automatic release mechanism for stretchers, S-MAX (the 10G stretcher fastener system) or the extra-light chair 4BELL. In particular Spencer India will present the new 10G fixation systems, that preserve rescuers from jeopardy on ambulance and respect all the international service standards.

endeavour is to see the lowest paid employee of our company becoming a millionaire.” Mr. Sanjay Dalmia further added. Addressing the first alphabet in the healthcare vocabulary - Right diagnosis which is the basis of all medical treatments, Dalmia Medicare plans to grow at a fast pace catering to each and every aspect of healthcare such as pharmacies, doctor clinics, small and medium nursing homes, alternative medicine, fitness centers etc. Dalmia Medicare partners with unorganized players operating in the healthcare sector by supporting them with technology, marketing and quality assistance to enhance their service quality, customer interface and business growth. Dalmia Medicare aims to be the leader in the healthcare segment providing highest quality healthcare services and unparalleled reach on a single platform. “Spencer philosophy improves the attention of the R&D Department to safety and control” explains Mr. Antonio Ciardella, Sales Director of Spencer. “We spend most of our assets on research, and that is why our new fastener systems improve safety and simplify the control of the devices”. “We trust in the opinion of professionals, their passion and competence guides us in creating new products that make EMS world more simple and safe every day”. For this reason Spencer introduces the new 10G and 20G devices in India with a special meeting in New Dehli. “The Spencer India meeting – explained mr. Ciardella - will be a mix of state-of-the-art devices that improve safety and reduce trouble for professionals involved in pre-hospital emergency operations. Testing them will be a pleasure for everyone, and will show clearly why 10G is so important today for ambulances, I promise you”. The innovative Spencer Emergency Medical Convention is a tailor-made service for business partners and professional customers who want to acquire the most innovative solutions in the EMS field. One-to-one meetings are an additional personalized Spencer service that professionals can seize: contact now Spencer India Headquarter for more information about the meeting. Send an e-mail or fill in the form in the official event web page.

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NEWS Update

Bangalore based start-up, Ventura brings innovation to Indian healthcare with world’s finest GI Endoscopy technology The advance technology to offer accurate and early stage diagnosis of Colorectal Cancers and other severe Gastro Intestinal disorders With a mission to transform medical diagnosis in the country by shaping the ideas into great innovations, Bangalore based health tech start-up Ventura Business Solutions introduced world’s finest GI Endoscopy technology G-EYE™ endoscope and NaviAid™ in India. The start-up is working towards high-profile technology-enhanced products, in the fields of Medical Devices, Telemedicine and remote medicine. This newly launched technology has received rave reactions from well-known hospital chains in India including Asian Institute of Gastroenterology, Fortis, Apollo, Max, Gangaram, Aster CMI, Sunshine, Manipal, Columbia Asia Hospitals, and PGI Chandigarh to name a few. By introducing the smartest GI endoscope technology, this start-up is looking to change the face of endoscopic detection in the country from a rate of 60% to 98% detection so as to ensure accurate and early stage diagnosis of diseases like Colorectal Cancer and other severe Gastro Intestinal disorders. The company has launched this technology in a strategic partnership with Israel based, Smart Medical Systems, a developer and manufacturer of world-leading gastrointestinal (GI) endoscopy devices. In India, the standard colonoscopy and diagnosis fails to detect over 20% of precancerous polyps resulting in a growing population of colorectal cancer patients whereas, the technology brought by Ventura can enhance the detection rate of endoscopic procedure to 98% thus almost eliminating missing of detection of any growth that may need surgery or loss of life later on. With almost zero preparation time, doctors will be able to conduct more endoscopic procedures and at governments hospitals this technology will reduce the waiting time and long queues in near future. Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide and there are a growing number of colorectal cancer patients in India. The G-EYE™ endoscope, uses innovative balloon technology to uncover precancerous polyps that are hidden behind the colon's natural folds. Pricewise, Smart's solution costs almost 1/5th of the nearest competitor, which means it is highly affordable for the hospitals and patients alike. Speaking on partnership with Ventura, Misha Krakowsky, Executive Director of Asia Pacific for Smart Medical Systems said, “Our alliance with Ventura provides us with a great opportunity to serve the medical community in India, enhancing physicians' capabilities during endoscopy procedures and providing better treatment for patients.” Satya K., Founder, Ventura Business Solutions said “We started the company with an aim to bring a complete change in the way medical and healthcare industry runs in India. With the launch of Smart G-EYE technology, we believe that we have made a great start towards our vision and mission. Adding on, we have Smart Medical’s technology offering a unique value proposition to medical centers, physicians and patients. Our mission is to make this unique technology highly accessible to hospitals and endoscopy centers.” 12

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JK Ansell excels in

‘Leveraging technology in customer engagement’

JK Ansell, an Indian counterpart of Ansell Australia has been honored as most enterprising company for “Leveraging Technology in Customer Engagement”. Business World had created a property - DigiPharmaX to recognize the efforts taken by PHARMA industry in exploring the accessible digital technology. In total 18 awards spread across multiple categories were given away at DigipharmaX on June 24, 2016 at Mumbai. The ceremony was attended by many eminent personalities of industry including renowned policy maker Mr. Rajendra Pratap Gupta as chief guest. JK Ansell - the pioneer in medical glove technologies, developed an exclusive conference delegate mobile app on android and iOS mobile app. This app enhances the way a medical or surgical conference is attended and provided an engaged experience for organizers, faculties & and most importantly delegates.

Indian Radiology & Imaging Association

IRIA Resident Education program was held by the Delhi State Chapter of IRIA in collaboration with the department radiology of Maulana Azad Medical College from 1012 Sep. 2016. The event which highlight the shell role of IRIA in a education of radiologist, this training was attended by more than 475 delegates from various parts of country and abroad. The Faculty was from various teaching institution of the country came together to discuss and educate in the from of lecture, Problem solving techniques in radiology. IRIA has been arranging these educational program to ensure that young Radiologists are trained well in the latest techniques of imaging for batter and latest treatment of patient . On Interacting with the President of IRIA Dr. O.P. Bansal said that we are also spreading the awareness about the PCPNDT act for the saving the Girl child.

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NEWS Update

Fortis Healthcare and wayForward collaborate on a unique emotional wellness programme to combat workplace stress First time in India, a digital health programme to manage stress and related ailments Fortis Healthcare, India’s leading Healthcare provider, and wayForward, a digital, mental and emotional health company based in USA, launched an app-based wellness programme in India, at a special event in Delhi today. The programme uses techniques of Cognitive Behaviour Therapy (CBT) and Mindfulness to potentially help millions solve problems caused by stress, anxiety and other emotional or mental health issues in the comfort of their own homes, without the fear of stigma, through its unique “coach in your pocket” concept. The event was also marked by experts who spoke about stress and its impact on individuals and organizations in the present times. Dr. Samir Parikh, Director, Mental Health and Behavioural Science at Fortis Healthcare said, “Mental and emotional health issues are more common than we imagine and impact almost every family, placing a significant burden on individuals and society. Clinical experience and research data show that stress is ruining relationships and hurting our overall health and wellbeing. I believe this programme would make a positive impact on the wellbeing of individuals, hence benefitting organizations and societies at large.” Launching the program, Mr Bhavdeep Singh, CEO, Fortis Healthcare said, “Many people today find themselves unable to manage daily stress in professional lives. They also find it hard to consult a mental health specialist as they feel embarrassed about it. Despite advancements on many fronts in India, there is a low level of awareness regarding stress and mental health. In such a scenario, this HR conclave by Fortis Healthcare and wayForward is a welcome initiative to bring various stakeholders together. This digital health programme is a very innovative and much-needed solution for our increasingly stressed society.” Dr. Navya Singh, Founder, wayForward and researcher at Columbia University, New York explained, “Our mission is simple – to ensure that everyone has access to mental and emotional health support at all times. To accomplish this goal, we have created a solution based on scientifically proven techniques, which is available to users through their smartphones. Our research with users of the wayForward app in the US has shown that more than 80% cases showed improvement in just 3 weeks. The study also highlighted 14

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

that problems, such as overeating, sleep disturbances and lifestyle diseases, can be consequences of mental and emotional health issues.” While concluding the event with a vote of thanks, Mr. Ritvik Singh, CEO, wayForward said, “Our USP is our unique proprietary app algorithm that overcomes the barrier of limited access to experts. The programme provides highquality wellness support en-mass and allows experts to help many more people than is possible with one-on-one support. This becomes especially crucial in a country like India where there is a severe shortage of mental health professionals.” The Asia-Pacific edition of Staying@work survey (201314) conducted by Towers Watson for Indian employees, revealed almost 1 in every 3 Indian employers had instituted stress or resilience management programmes in 2013 and an almost equal number planned to follow suit in 2014. With stress being ranked as #1 lifestyle risk factor in India, this number was expected to grow.[i] The predictions came true. A recent study conducted by The Society for Human Resource Management (SHRM) showed that a company in the banking/finance sector, with an average workforce of 5,000 employees, loses approximately Rs 100 crore in productivity losses a year because of stress-related issues. Stress costs an IT-ITeS company with 10,000 employees, about Rs 50 crore and a company in the travel and hospitality sector with about 2,000 employees, a little over Rs 10 crore. [ii] Almost 1 in every 3 Indian employers has instituted stress or resilience management programmes in 2013 and an almost equal number plan to follow suit in 2014. With stress being ranked as #1 lifestyle risk factor in India, this number is likely to grow.[iii] A study by the Indian Council for Research on International Economic Relations found that India’s rapid economic expansion has boosted corporate profits and employee incomes, but has also sparked a surge in workplace stress and lifestyle diseases that few Indian companies have addressed 

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NEWS Update

ADHD market to reach $13.9 billion by 2024,

as awareness increases and drugs improve, says GlobalData The market for attention deficit hyperactivity disorder (ADHD) across the seven major markets (7MM) of the US, France, Germany, Italy, Spain, the UK, and Japan, is set to experience an increase from approximately $6.1 billion in 2014 to $13.9 billion by 2024, at a compound annual growth rate of 8.5%, according to research and consulting firm GlobalData. The company’s latest report states that such robust growth can be attributed to the launch of efficacious pipeline products with convenient oral formulations or less frequent dosing than currently available products, an increase in treatment rates, and the continued awareness and recognition of ADHD in the adult age group. Rachel Markwick, Ph.D., GlobalData’s Analyst covering Neurology and Ophthalmology, explains: “Currently, the ADHD market is rife with unmet needs. These include a need for more treatment options, clinically relevant head-to-head comparisons between current marketed and pipeline drugs, improved diagnostic tests, and increased education and recognition of ADHD. “Late-stage pipeline treatments are anticipated to be a key driver in the ADHD market. Promising drugs include Supernus

Pharmaceuticals’ SPN-810 (molindone hydrochloride ER), a late-stage pipeline drug designed to treat a particular set of symptoms that includes impulsive aggression, and Shire’s SHP-456, a late-stage pipeline asset designed to extend symptom coverage into the evening. SHP-456’s commercial success will be driven by the fact it has been formulated to last for 16 hours, whereas its predecessor, Adderall XR, lasts for only 12 hours.” GlobalData expects that the ADHD market would readily open up to both new and existing drugs that address other unmet needs in this space, which include improved diagnostic rates and subsequent patient uptake across the 7MM. Markwick continues: “The late-stage pipeline has a number of stimulant formulations that offer an increased number of options with more convenient dosage forms and extended coverage of ADHD symptoms. However, these stimulant candidate drugs are only seeking approval in the US market. “The majority of the ADHD late-stage pipeline is populated with nonstimulant drugs. Should companies seek approval for these products within the rest of the 7MM, the unmet need of increased treatment options in these markets could be satisfied within the forecast period.”

Address double burden of malnutrition: WHO The World Health Organization today called for a whole-ofsociety approach to address the double burden of malnutrition which affects populations across South-East Asia Region, particularly women and girls. “The current nutrition profile of the South-East Asia Region is characterized by under nutrition rates that are declining slowly alongside rapidly rising rates of overweight and obesity, often within the same communities, and even in the same households. This double burden is depriving people of reaching their potential, and is fueling rising rates of noncommunicable diseases. We need to mobilize multisectoral action to address the problem at the earliest,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia, said. Across the Region, an estimated 60 million children aged 0-5-years are stunted, while 8.8 million are overweight. Thinness affects 24-47 per cent of adolescent girls, while between 2-24 percent are overweight. Among adult women, prevalence of overweight or obesity ranges between 18-30 per cent. “The 2030 Sustainable Development Goals Agenda calls for an end to all forms of malnutrition. As a means of fulfilling this objective, in consultation with all Member countries of the Region, WHO developed the Strategic Action Plan to Reduce the Double Burden of Malnutrition in the South-East Asia Region 2016-2025,” said Dr Khetrapal Singh. “This will provide the basis for action moving forward.”

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The Strategic Action Plan serves as an advocacy and reference tool for Member countries that will ensure national interventions are comprehensive and evidence-based. It lays particular emphasis on promoting a supporting environment for nutrition interventions and securing multisectoral commitment to addressing the problem, including from the private sector. Dr Khetrapal Singh said traditional determinants of malnutrition, which include inequality and inadequate care, economic growth and demographic changes and globalization, have all altered the nutrition profile of the Region and are providing challenges for policymakers. Member countries discussed the trans-generational impact on future generations caused by maternal under nutrition as well as overweight and obesity resulting from inadequate and unhealthy eating habits and low physical activity. The Strategic Action Plan was adopted by Member countries at the Sixty-ninth session of WHO Regional Committee, the highest decision-making body which includes health ministers and senior health ministry officials of the 11 Member countries of the Region – Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.

NEWS Update

LABSYSTEMS DIAGNOSTICS & SHIMADZU CORPORATION IN A STRATEGIC ALLIANCE FOR NEWBORN SCREENING Helsinki, an enterprise of Trivitron Healthcare, the fast growing healthcare multinational headquartered in Chennai, entered into a Joint Association with Shimadzu Corporation, Japan, leader in analytical instruments, for clinical diagnostics in the area of Newborn Screening (NBS). NBS is a preventive pediatric screening service to assess the occurrence of genetic metabolic disorders. These disorders could lead to permanent neurological, cognitive, and physical damage in the child. When these disorders are detected early enough they can be easily treated. The companies will cooperate to leverage Labsystems reagent technology leadership and Shimadzu world class instrumentation to enable their global customer base to detect more disorders in newborns, more rapidly and with greater accuracy. Labsystems furthermore announces the availability of its new generation NeoMass AAAC assay fully validated on Shimadzu mass spectrometry platforms. NeoMass AACC enables investigators for the first time to detect the entire spectrum of Urea Cycle Metabolic Disorders (UCMD) in newborns.

This assay detects the broadest range of non derivatized analytes available today. Fabrizio RADICE, Global Sales & Mktg Director, Labsystems Diagnostics, Helsinki commented “Our alliance with Shimadzu will enable us to develop unparalleled integrated solutions for NBS, of which NeoMass AACC is only the start. Codevelopment on this level allows us to leverage the impressive technology leadership of Shimadzu instrumentation to provide sensitivity to new disorders, and to provide faster throughput and greater accuracy, which is the key to investigators success in detecting disorders in babies. We believe our cooperation will have an impact on the suffering caused by these severe, yet eminently preventable diseases”. Dr. Geraldine Carrard, CEO – Labsystems Diagnostics Oy added, “The deliberations and discussions have paved the way of a trusted and solid partnership. Shimadzu Trivitron Labsystems Diagnostics combination will be an innovative driving force to reckon within the Newborn Screening.” Shuzo Maruyama, General Manager, Analytical & Measuring Instruments

Division Shimadzu Corporation said ‘The agreement between Shimadzu Corporation and LabSystems Diagnostics will help to change the way in new born screening programs can be better, expanding the screening capability with detailed analytics and actionable data creating a new solution for faster, confident diagnosis. Shimadzu is always exploring ways to find a solution that meets a real need and makes a difference to overcome real world challenges. We believe this collaboration with LabSystems Diagnostics will help make smart decisions quicker and will make clinical laboratories more efficient and effective in new born screening’. Dr. G.S.K. Velu, Chairman & Managing Director, Trivitron Group of Companies said, “Two world leaders Shimadzu and Labsystems Diagnostics with several decades of expertise in their respective areas of instrumentation and diagnostic reagents will create a winning combination improving access and affordability for Newborn Screening solutions across the globe. We are very excited with this new global association in the New Born Screening area.”

A look into the womb can shape a baby’s future The Apollo Centre for Fetal Medicine celebrates 10 successful years

 It is estimated that there would be about 487,000 babies born with birth defects in India; out of these 7200 per year are in Delhi  3 out of 20 babies diagnosed with some form of abnormalities every day  Most commonly detected conditions are kidney and cardiac diseases in babies during Fetal scan Indraprastha Apollo Hospitals organized a press conference today to commemorate the successful completion of 10 years of The Apollo Centre for Fetal Medicine. Dr Prathap C Reddy, Founder Chairman, Apollo Hospitals Group congratulated the Fetal medicine team and spent some fun time with children and parents who have been treated at the Fetal Medicine Center over the last decade. Speaking on the occasion, Dr Prathap C Reddy, Founder Chairman, Apollo Hospitals Group, said, “The Apollo Centre for Fetal Medicine started its operations in 2006 as north India’s only dedicated fetal medicine centre. The fetal imaging and prenatal testing technology have improved vastly in the past few decades. Today, fetal therapy is recognized as one of the most promising fields for expert care for

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both mother and unborn baby, and prenatal surgery is becoming an option for a growing number of babies with birth defects. We aim to create awareness around timely check-up and scan to ensure the baby’s health is not compromised.” Addressing the audience, Dr Anita Kaul, Senior Consultant - Fetal Medicine, Indraprastha Apollo Hospitals Delhi explained, “Fetal surgery is a complex surgical procedure to correct abnormalities in the womb for example placental complications in twins which compromises life of one twin. Scientific advances in the last 20 years have raised the hope that many pregnancy complications are potentially detectable from as early as the 12th week of gestation. Fetal evaluation can give patient-specific risk for a

wide spectrum of pregnancy complications, including intellectual disability in fetus, preterm delivery, preeclampsia, gestational diabetes, fetal growth restriction.” The Apollo Fetal Medicine centre has become a one-of-its kind establishment and has attained leadership in fetal medicine in the region. Patients from different cities attended the event along with their children and shared their experiences.

NEWS Update

‘Policy Advocacy Meet on NMC Bill, 2016’ organized by ‘Voice of Healthcare’ Voice of Healthcare (VoH) is an institution conceptualized with the aim of being a discerning and visionary think tank for the Indian healthcare sector. VoH, with support from its knowledge partner, CapBuild, organized a ‘Policy Advocacy Meet’ with changemakers of healthcare industry on Friday, 26th August, at The Lalit Hotel, New Delhi. Distinguished subject matter experts and prominent voices in the hospital and medical education sector deliberated on the ‘National Medical Commission Bill, 2016’, and provided their valuable recommendations and feedback on key features of the Bill. Prominent healthcare experts including Dr. Prof. M Wali (Physician to the President of India), Dr. Anand Prakash (Medical Director, Tirath Ram Hospital; and Ex-Director and Prof. of Surgery, Maulana Azad Medical College), Dr. DP Saraswat (Medical Director, Jaipur Golden Hospital), Dr. Prof. V.H. Talib (Ex. Prof. and HoD, Pathology, Vardhman Mahaveer Medical College), and Dr. Vinod Shah (Dean, NIMS Jaipur) suggested practical and innovative approaches to improve the medical education sector in India. The event also saw active participation from medical institutes such as Sharda University, National Institute of Medical Sciences (NIMS), PGIMS (Rohtak), and SRGH (Delhi). Dr. Wali emphasized the need to open medical colleges in rural areas. In his words, “Educating youngsters in their native towns would help in retaining them in these areas when they graduate as doctors”. Dr. Prakash brought to the fore the need for ‘Integrated Training’ in medical education. He said “To begin with, medical teaching should be replaced by training. Also, practicing doctors in specialties such as general surgery should train under-graduate students in basic medicine disciplines to bring about practical integrated learning”. Dr. Saraswat made specific recommendations wrt the audit & inspection of medical colleges. He suggested implementation of existing quality guidelines (such as NABH) in medical institutes to ensure they meet basic infrastructure and clinical standards laid down by the inspection bodies. Dr. Talib acknowledged the need for correcting the urbanrural imbalance in medical education, however, stressed that it should not be at the cost of quality in UG and PG training. Oft suggested measures such as bringing down the duration of medical courses for rural settings have to be thoughtthrough before implementation. 20

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Dr. Vinod Shah reinforced the need to re-visit the MSR (Minimum Standard Requirements) laid down for audit of medical institutes, to make them more aligned with the practical resource availability in the country. Mr. Vivek Seigell, Director, PHD Chamber of Commerce and Industry, said PPP (public private partnership) models should also be tested in medical education, as has been done in healthcare delivery. Dr. Naveen Nishchal, Director, Cygnus Group appreciated the need of National Licentiate Exam proposed in the Bill, and also recommended re-validation/re-assessment examination every few years for practicing doctors. Mr. Afzal Kamal, General Secretary, VoH, said that it is critical to ensure a robust and transparent process for selection of NMC members, with no unnecessary interference from groups with vested interests. The meeting was successfully concluded with due consideration of inputs from all attending delegates. VoH would collate and present these to the Niti Aayog for deliberation and inclusion in the Bill before it is tabled in the Parliament.

NEWS Update

Medtronic names Madan Krishnan Vice President for Indian Sub-continent - Medtronic plc (NYSE:MDT), the global leader in medical technology, today announced the appointment of Madan Krishnan as vice president, Indian Sub-continent (ISC). In this role, Krishnan will lead the Medtronic ISC business, which includes India, Sri Lanka, Bangladesh and Nepal, as the company further demonstrates its commitment to meaningful innovation, global access, aligning value, and partnerships. “Madan’s demonstrated leadership and roots in this market enable us to take healthcare further, together. He will shape our business and take it into the future by cutting through complexity, building trust and credibility, championing innovation, and setting high standards. We see tremendous growth potential in ISC and I have full confidence in Madan’s ability to be an engaged and collaborative industry leader while

caring for our employees,” said Bob White, president, Asia Pacific at Medtronic. Krishnan brings outstanding leadership credentials to the role, with nearly 20 years of healthcare experience. He has a deep understanding of the healthcare industry with experience in emerging markets, mergers and acquisitions, corporate finance, and sales and marketing excellence. He also led the post-acquisition integration of Medtronic and Covidien across Asia Pacific. Krishnan joined Medtronic in 2011. Prior to this appointment, Krishnan was vice president of finance, Asia Pacific (APAC). A key part of the market leader role will be to develop strategic partnerships with hospitals, payers, and government to help establish aligned, value-based healthcare models that can deliver better patient outcomes. Krishnan earned an MBA from the Sloan School of Management as a Sloan Fellow and

was an elected member of the MIT Senate. He also holds a Bachelor of Commerce from the University of Calicut. Krishnan is a qualified Chartered Accountant, and is fluent in English, Turkish, Hindi, Tamil, and Malayalam and has basic competency in Spanish and Korean. Medtronic began its operations in India in 1979. Headquartered at Solitaire Corporate Park in Mumbai, it has offices at Ahmedabad, Bengaluru, Chennai, Cochin, Dhaka, Gurgaon, Hyderabad, Kolkata, New Delhi, Pune and Vadodara.

Countries in South-East Asia pledge action against noncommunicable diseases To arrest the growing epidemic of noncommunicable diseases that kill 8.5 million people annually in WHO South-East Asia Region, member countries of the Region today adopted the ‘Colombo declaration’ which calls for strengthening delivery of services for these diseases at the primary health care level. “This is a critical moment for health systems and the people they serve across the South-East Asia Region. Noncommunicable diseases (NCDs) are already taking an unacceptable toll on populations, with the burden projected to rise in coming years. To avert this possibility, services for these diseases must be made available at the primary health care level, and high-risk populations must be provided all opportunities to access screening and treatment,” Dr Poonam Khetrapal Singh, Regional Director for WHO South-East Asia, said. The members expressed serious concern at the unacceptable burden of noncommunicable diseases, including cardiovascular diseases, cancers, diabetes and chronic respiratory diseases. As part of the declaration health ministers pledged to undertake targeted screening for early diagnosis, as well as to increase health guidance and counselling to promote healthy choices and self-care. Ensuring appropriate treatment, robust followup, management of referrals and focusing on and expanding NCD services to the high-risk population are key parts of the declaration.

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“This is an important opportunity to reaffirm commitment to the global goal of reducing NCD-related premature mortality by one-third by 2030, and to actually map-out how we will get there. Implementing effective policy solutions is vital to addressing the personal and social tragedy caused by NCDs, as well as their impact on economic development,” said Dr Khetrapal Singh. To fund the primary health care approach for addressing NCDs, which is foundational to the Declaration, health ministers committed themselves to advocating for innovative financing methods, including dedicated taxation of health damaging commodities such as tobacco, alcohol and unhealthy foods and beverages. This will both reduce exposure to NCD risk factors as well as mobilize more resources for NCD prevention and control. The ‘Colombo Declaration’ was adopted on the opening day of the five-day Sixty-ninth WHO Regional Committee Meeting, which was inaugurated here this morning by the Prime Minister of Sri Lanka, Mr Ranil Wickremesinghe, in the presence of Dr Margaret Chan, Director-General WHO, and health ministers and senior health ministry officials of the 11 member countries of the Region - Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.

NEWS Update

58% Indian parents believe that digital learning tools have a positive impact on children’s development, finds survey by AppyStore Reveals link between internet-based learning and inculcation of new concepts Study releases crucial findings about parental concerns and changes in children’s behavior Leading subscription-based learning platform for children’s curated content, AppyStore.in, has published some significant findings based on its insightful survey on the positive impact of digital learning tools for kids. The questionnaire-based study saw participation from 1,167 Indian parents, and covered a wide range of topics concerning the progress of young minds. This enthusiastic contribution by parents is in keeping with the platform’s endeavours to support families in their child’s complete development. The curated content on AppyStore.in is targeted at the fun learning of children upto 8 years. This demographic is particularly significant considering that the 2011 census revealed the number of children below 6 years of age in India was nearly 160 million. AppyStore. in’s frequent surveys allow for a keen understanding of the way ahead in terms

of educating and sensitising the country’s future using the latest technology. The key finding was the tendency of parents to use digital media as a redressal mechanism. This puts immense responsibility on creators of online content, and allows for digital platforms to actively empower parents with helpful information.The survey looked closely at parental expectations and concerns regarding children’s cognitive growth. AppyStore also found digital learning to be almost at par with non-digital learning tools. Here are some of the most significant findings of the survey:  2 6%parents claimed that cultivation of good habits in children was their primaryconcern, and 24% desired sharpening of language skills the most.  While only 12% participants admitted to consulting a doctor when worried, a strong 38% claimed they turned to the internet to clear their doubts.

 6 8% parents use online platforms to teach new concepts, while 17% want to see positive behaviour changes in their young ones.  4 9% parents use worksheets and toys to teach children while42% use DVDs of nursery rhymes as well as mobile apps for helping children hone their intellectual capabilities. N early 1/5th of the participating parents claimed to give dedicated digital devices to their children, but the general trend revealed that kids do not use these devices for more than one hour on average. P arents do depend on digital learning but also seem to be conscientiously wary of the negative impact of handsets on children’s health, with 43% participants monitoring their child’s usage of the device.

HOW I DO IT – PANCREATIC SURGERY

Pancreatitis which may be acute or chronic, is a term used to describe inflammation in the pancreas and is also an increasing cause of hospital admissions in India. Both forms have a strong association with the consumption of alcohol which has seen an increasing trend in India over the last few decades. The incidence varies from 30-80/100,000 population in different parts of the world. While the requirement for surgery in acute pancreatitis arises in a small percentage of patients almost 75% patients with chronic disease need surgery during the course of the disease. These technically challenging surgical procedures are increasingly being performed using minimally invasive (key hole) techniques, also known as laparoscopic surgery. Dr. Deepak Govil and Dr. Vivek Tandon, the team at the department of Gastrointestinal Surgery, Apollo Hospital, felt that an important factor for improved outcomes is that, such surgical procedures be performed in high volume specialise centres and this is well supported by literature.

The department of gastrointestinal surgery, Apollo Hospital, Delhi organised a “HOW I DO IT – PANCREATIC SURGERY “ CME programme detailing the operative techniques of specialised surgical procedures performed on the pancreas. The meeting, on the 6th of August 2016, was organised at Apollo hospital auditorium and was attended by over a hundred surgeons and specialists in the field of gastrointestinal surgery. The presenting faculty included senior faculty from the entire country. Pancreatic diseases, both malignant and benign have seen a rising trend not only in India but all over the world. Changing lifestyles, increasing use of alcohol and smoking are all factors contributing to this increase. Smoking is believed to increase the risk of pancreatic cancer by 75% and the risk due to alcohol is independent of tobacco consumption. While accurate data regarding incidence in India is unavailable it has been increasing over years and is 24

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estimated to be 0.5 to 2.4 per 100,000 population in various parts of India. Only about 10-20% patients with pancreatic cancer are amenable to curative surgical treatment at the time of diagnosis. In USA pancreatic cancer is among the top 5 causes of cancer related deaths. Surgical Procedures to manage pancreatic cancer are extremely complicated, require a high level of expertise and surgeons performing these procedures have over the years evolved into a separate specialized branch. Speaking at the conference, Prof. BML Kapur, former chief of Surgery at the All India Institute of Medical Sciences, New Delhi felt that this is extremely important to achieve the best results. While tertiary care centres in both the private and public sector in India are successfully performing these procedures, detailed presentations and discussions on surgical technique, which was the theme of the meeting, helps to further improve patient outcome after these complicated surgical procedures.

NEWS Update

Focus on migrant health: WHO One in seven people globally is a migrant, refugee or an internally displaced person. With countries across South-East Asia Region host to large migrant populations, WHO today called for focused attention to address their health needs. “Disease is universal and transcends borders and nation states. As health leaders we must tackle the health problems that affect migrant populations. We need to construct better information systems to collect data on the health issues of migrants; institute policy and legal frameworks that facilitate greater health care access; and create inclusive health systems sensitive to the needs of migrants,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia, said here. Health and migration are key concerns of Member countries across the Region, with Thailand, India, Bangladesh and Indonesia named among the top ten countries witnessing large movements of people in Asia. Migration poses greater risk and vulnerability to infectious

Commander Manoj Kumar Appointed, Director (ITTA)

diseases, mental health disorders, maternal and neonatal mortality, substance use, alcoholism, malnutrition, violence and noncommunicable diseases. “As migration continues to accelerate at unprecedented levels, we are presented with an opportunity to come together as a Region to ensure that migrants are able to access adequate health coverage,” Dr Khetrapal Singh said. Mobile populations pose additional challenges to countries often already struggling to cope with day-to-day demands on their health care systems. Migrants also encounter obstacles to accessing quality health care, as provision of health services is contingent on their legal and administrative status. At the WHO Regional Committee meeting here, Member countries shared experiences in addressing this growing regional issue, including the potential of infectious disease and antimicrobial resistance spread. In response to the issue, for example, Thailand has formulated

World Heart Day World Heart Day on 29 September is the World Heart Federation's (and the world's!) biggest platform for raising awareness about cardiovascular disease (CVD). This World Heart Day, we want everyone to understand what they can do to fuel their hearts and power their lives. Your heart is at the heart of your health. And it's easy to give it the care it deserves. Just a few simple steps such as eating more healthily, cutting down on alcohol and stopping smoking can improve your heart health and your overall well-being.

"Cdr Manoj Kumar (Retd ), CEO Hitex Healthcare Pvt Ltd has joined the board of Indian Technical Textile A ssociation ( ITTA ) as Director. ITTA is the voice of Technical Textile in India and acts as an interface between the industry and Government."

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a ‘Healthy Borders’ approach in the Greater Mekong Subregion, a border area with Laos and Cambodia, which focuses on the prevention and control of tuberculosis, HIV, and other prevalent communicable diseases. Additional concerns raised and discussed included the fact that mobile and migrant populations are uniquely vulnerable to contracting malaria. In February 2016, five South-East Region Member countries – Bangladesh, Bhutan, India, Myanmar and Nepal – came together to enhance cross-border collaboration on malaria elimination efforts. The Regional Committee is WHO SouthEast Asia Region’s highest decisionmaking body, and includes health ministers and senior health ministry officials of the 11 member countries of the Region – Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.

Your heart powers your whole body. It lets you love, laugh and live your life to the full. That’s why it’s so important to look after it. If you don’t, you’re putting yourself at risk of cardiovascular disease (CVD), which includes heart disease and stroke. CVD is the world’s number one killer. Each year, it’s responsible for 17.5

million premature deaths, and by 2030 this is expected to rise to 23 million. But the good news is that much CVD can be prevented by making just a few simple daily changes, like eating and drinking more healthily, getting more exercise and stopping smoking. So this World Heart Day, let’s make sure we all take action to keep our hearts charged and make a lasting difference to our health.

Take part… Walks, runs, sporting events, concerts, public talks and screenings… all sorts of activities will be organized by members and partners of the World Heart Federation, and individuals across the world to mark World Heart Day.

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DIABETES & HEART DISEASES H

aving diabetes or prediabetes puts you at danger for heart disease and stroke. You can bring down your risk by keeping your blood sugar level down, blood pressure, and blood cholesterol close to the recommended target numbers for the levels suggested by diabetes specialists. A strong connection between diabetes and heart disease is currently well established. Diabetes independently is now regarded as the strongest risk factor for Heart Diseases. The blood vessels in patients with diabetes are more susceptible to other well-established risk factors such as smoking, high cholesterol level and many more. More than 90% patients with diabetes have 1 or more of these types of risk factors. People with diabetes who have already had one heart attack run an even greater risk of having a second one. In addition, heart attacks in people with diabetes are more serious and more prone to bring about death. High blood glucose levels after some time can prompt to increased stores of fatty materials on the inner parts of the blood vessel walls. These stores may influence blood flow, increasing the chances of clogging and hardening of blood vessels.

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Dr.(Prof) Harsh Wardhan

H.O.D Cardiology Department, Primus Super Specialty Hospital, Chanakyapuri, New Delhi.

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SIGNS & SYMPTOMS • Chest pain or discomfort • Pain or discomfort in your arms, back, jaw, neck, or stomach • Shortness of breath • Sweating • Nausea • Light-headedness Symptoms may come and go. However, in some people, particularly those with diabetes, symptoms may be mild or absent which is most likely due to nerve damage caused by diabetes. About 15% of heart CORONARY ARTERY DISEASE: attacks in a diabetic may be silent. - it is also known as Ischemic Heart Disease which is caused by hardening RISK FACTORS or thickening of the walls of the blood If you have diabetes, you are at least vessels of the heart. The blood supplies twice as likely as someone who does not oxygen to your heart and other and have diabetes, to have heart disease or other body organs. Your heart needs a stroke. People with diabetes also tend oxygen and nutrients for the normal to develop heart disease or have strokes functioning but if the blood vessels at an earlier age than other people. If get narrowed, the blood supply to your you are middle-aged and have type 2 heart is reduced causing Angina or diabetes, risk of having a heart attack heart attacks. is as high as someone without diabetes who has already had one heart attack. CEREBRAL VASCULAR DISEASE: These are known as Risk factors which - It affects blood flow to the brain, leading to strokes and TIA's. It is caused are mentioned below:by narrowing, blocking, or hardening Family History: - If one or more the blood vessels that go to brain. members of your family had a heart Transient Ischemic Attacks (TIAs) are attack at an early age, you may be at caused by a temporary blockage of a increased risk. blood vessel to the brain. This blockage Having High Cholesterol levels:- leads to a brief, sudden change in brain Particularly high LDL Cholesterol, function, such as temporary numbness Low HDL and high triglycerides in a or weakness on one side of the body. Sudden changes in brain function also diabetic. can lead to loss of balance, confusion, High BP:- If you have high BP, your blindness in one or both eyes, double heart must work harder to pump blood. vision, difficulty speaking, or a severe This can strain the heart, damage blood headache. These TIA’s are not to be vessels, and increase the risk of heart ignored as it can later on cause stroke. attacks. PREVENTION Smoking: -Smoking doubles the risk of getting heart diseases. It also The best way to prevent heart disease increases the risk factors of their long is to take good care of yourself, control your diabetes and take care of other risk term complications. factors of heart disease.

TYPES OF HEART DISEASES THAT OCCUR WITH DIABETES

There are two major types of Heart diseases which are very common in people who have diabetes. These are Coronary artery Diseases and Cerebral Vascular Disease.

• Keep your blood sugar as normal as possible. • Control your blood pressure, with medication if necessary. • Get your cholesterol numbers under control. You may need to take medication to do this.

• Lose weight if you are obese. • Ask your doctor if you should take an aspirin a day. • Exercise regularly. • Eat a heart-healthy diet such as the Mediterranean diet or DASH diet. • Quit smoking. • Work to reduce daily stress. DIAGNOSIS Any symptom of chest pain, shortness of breath or excessive fatigue needs to be investigated for possible heart disease. Even asymptomstic diabetics should get themselves examined periodically for heart disease. Preliminary investigations like ECG may give some clues to the presence of heart disease but a normal ECG will not rule out heart disease. ECG or Echo done during and after exercise known as TMT and Stress Echo may be more helpful to diagnose heart disease. If abnormal, an angiography may be required to assess degree of obstruction in coronary vessels. Coronary Angiography is visualization of coronary arteries under X-Ray. Normally coronary arteries cannot be seen on plain x-ray. They can be seen if a radio opaque dye is injected into them through a small tube which is usually inserted through the artery of groin or wrist. This visualization of coronary artery help to assess the extent and degree of blockade so that further treatment can be planned  w w w.medegatetoday.com Sep-Oct 2016

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Food From the

Heart T

Dr. Amar Singhal Cardiologist, MBBS, MD, DM, FACC, FSCAI Sri Balaji Action Medical Institute, Delhi

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he heart looks like a fist, and like the fist is a powerhouse of strength. Unlike a fist though, the heart contracts and relaxes 70 times a minute, working harder when you’re running or under stress. Mostly, it doesn’t complain, but sometimes, it does groan under the pressure of too much stress, the toxins that tobacco releases, and the unnecessary fat that clogs arteries leading into it. Heart disease is India’s largest killer. But there’s good news: almost 90% of heart-related diseases are completely preventable. While cutting stress and introducing exercise are important, diet is the biggest factor in boosting heart heath. But a diet does not mean a strict regimen that is difficult to follow, because if it’s tough to do for a week, you will never be able to sustain it. It also does not mean you need to cook separate dishes for one person—the whole family can and must eat the same meal, together. In fact, eating as a family has been shown to cut stress and establishes a happy environment at the end of the day, helping everyone wind down. Also, do try and eat at least three hours before sleep.

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What is the heart-healthy diet diet? The aim of a heart-healthy diet is to bring hypertension down or to control blood pressure, which is the main cause of strokes and heart attacks. However, it works to lower diabetes, cholesterol, and for a general healthy lifestyle as well. A good diet is all about keeping a check on portion size, consuming a wide variety of foods and obtaining proper amounts of nutrients. People on a heart-healthy diet must eat lots of fruits, vegetables, whole grains, low-fat dairy foods, poultry, fish, meat, nuts and beans with minimum consumption of ‘bad’ fats and red meat. They should try and eliminate sugar-laden food and drinks. Here are the highlights:  Make your grain whole: Since wholegrains are rich in fibre, they digest slowly, unlike highly processed grain (such as maida). This keeps you satiated longer, reducing the amount of food you eat overall. It also keeps your blood sugar on an even keel, so you don’t feel dips and spikes through the day, when it comes to hunger. They are also high potassium, magnesium, and calcium. It’s a good idea to include 3 wholegrains across the day.  Eat more fruits and vegetables: A plant-based diet has been shown to give heart benefits that no meat-based diet can. It reduces inflammation in the body, and does not have the kind of oxidative effect (build up of toxins) that animal foods have. Try and include 4-6 servings a day.  Include dairy: Calcium has proven heart benefits. It helps to maintain overall heart function, and it’s best taken in its natural form, rather than as supplements. Eaten as yoghurt, it also has probiotic effects, which help to maintain a healthy gut, another factor in maintaining heart health. Have at least 2 servings a day. Eaten as a snack with fruits or vegetables, it also acts as a mini meal that keeps hunger at bay. It’s a myth that the fat in milk is bad.  Stock up on nuts and seeds: These have healthy fats in them, as well as micronutrients, all of which contribute to heart health. Throw them into salads or your breakfast cereal to add crunch and nutrition. You don’t need to eat these every day—even thrice a week is good enough. Try 4-5 almonds, 1-2 walnuts, or a handful of peanuts daily, if you like.

 Look at plant protein: Some of our top athletes are vegetarian, so animal protein is not essential to the diet. Beans, nuts, legumes are all a part of this group, and the ideal amount is 1 gram to every kilo of your body weight, daily—if you are at the weight you should be (ideal body weight). If you do eat meat, eat small portions, choose fish and chicken rather than red meat, and twice or thrice a week is ample.  Know your heart-healthy fats: A high blood cholesterol level can lead to a buildup of plaques in the arteries, called atherosclerosis, which can increase the risk of heart attack and stroke. Ideally, fats should not constitute more than 20% of the diet, and there needs to be a balance of monounsaturated (olive oil), polyunsaturated (groundnut oil), and saturated fats (like ghee), keeping the last one to the minimum. What we need to eliminate is transfats, found in oil that has already been used.  Stop eating sugar: It really is worse than tobacco. While the fact that sugar is just ‘empty calories’ is known to all, the toxicity that has been established, is still not very well known. Besides feeding into the obesity epidemic, sugar impacts the brain, hormone and liver function. Most people do not realize how much sugar they are eating and drinking—yes we mostly drink sugar—through juices, through tea and coffee, through colas. Honey and jaggery, as well as artificial sweeteners are all bad for our body. The moment the tongue tastes sweet, it releases insulin. Insulin releases fat deposition, which results in heart disease in the long run.  Reduce sodium: Excessive consumption of sodium can contribute to high blood pressure, a risk factor for cardiovascular disease. A major portion of salt is consumed from pickles and processed foods, such as chips. Cut these out, as well as using ‘meetha soda’ in dishes to enhance flavour. Processed meats also have a high sodium which we should avoid.  Avoid processed foods: These are usually laden with transfats and made from refined flour, which are both like poison for the body. Maida spikes your blood sugar and you see quick dips very quickly. Biscuits, mixture, bread, pizza, samosa should all be avoided 

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COVER STORY

Everything you need to know about how to take care of your health post organ donation

fter going through a traumatic surgery such as organ transplant, one cannot wait to resume to their normal routine. However, the key is moderation and understanding your limits. Since you’ve undergone a major surgery, initially you will have lesser energy and it’s important to give your body time to heal and adjust to a foreign object. Taking good amount of rest and pacing your activities is recommended to avoid any strains on your recovery. “If a relative or a friend is donating an organ, the person has to go through various tests to be sure that he/she is both psychologically and medically fit. A psychological evaluation is necessary to understand that the patient is not being forced to donate their organs,” After the surgery, the donor needs to keep the following things in mind:  Avoid excessive physical exercise like lifting any heavy objects after the surgery.  Get kidney function test, urine exam and blood pressure check every 3 months for a year right after the surgery  After a year, one should go for regular checkups once in every year. When it comes to the recipient, proper care after the surgery is of utmost importance. The body takes time to adjust to a foreign organ and hence the patients are put on very strong medications. “The immune system of the body reacts to new organ and does not easily accept it. Hence, we recommend immune suppressive drugs to the patient. These medications are very

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strong and increases the susceptibility of an infection in the patient,” added the doctor. After the surgery, the recipient needs to keep the following things in mind:  For the first few months avoid any crowded areas where the chances of getting an infection are high. Also, patients should not eat outside food at least till their body has adjusted to the new organ. The doses are reduced within one year’s time.  The patient should go for a regular check up: • Twice a week in the first 3 months • Once a week in the next 3 months • Once in 2 weeks for the next 3 months • Once a month for the next 3 months • Once in 3 months for life long. One of the most important aspects for organ donation is counseling. Not only the donor or the recipient should be counseled about the risks of organ transplant, but the family of the patient should also be a part of this session. “The recipient goes through a lot of pain in the first few days. The body needs time to adjust to the new organ. Also, occasionally, transplant kidneys get rejected on the table and the kidney has to be thrown away. This can have severe impact on the family members and also on the person donating the organ. In such cases, educating and making the family members understand the risks involved in organ transplant is of utmost importance,”

EXPERT VIEWS

Skin Cancer:

Ms. Tara Heath

ccording to the American Cancer Society, skin cancer is by far the most prevalent type of cancer afflicting our society. Melanoma, usually a growth or change in a mole, is the most deadly type of cancer and will strike over 75,000 Americans each year. Basal and squamous cell skin cancers, found deeper in the skin tissue, are diagnosed much more frequently, affecting over 5.4 million people in the US annually. Early detection is key for treatment, but prevention is also your best line of defense for avoiding these types of deadly diseases. We’re all wellversed about the importance of wearing sunscreen with a high levels of SPF (sun protection factor), at the very least 15. For extended levels of outdoor activity, use a water-resistant, broad spectrum UVA/UVB (the types of rays that cause skin damage) rating in your sunscreen. A Little More On Sunscreen Be sure to read the instructions carefully before applying sunscreen. For example, application instructions often recommend applying 30 minutes before you go outside and

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Protecting Yourself From The Most Common Cancer

every two hours afterwards. For those brands that are water-resistant, they aren’t waterproof and will need to be reapplied after swimming. One more tip, sunscreen isn’t recommended for children under the age of six months, so keep infants out of the sun. Cover Up Even though makeup is now being made that contains sunscreen, experts agree it isn’t enough to protect our skin. According to Dermatologist Dr. Leslie Baumann makeup with built-in sunscreen it, “Does not provide enough coverage. You need seven times the normal amount of foundation and 14 times the normal amount of power to get the sun protection factor on the label.” Hats and Glasses Seek the shade when you’re outdoors and be sure to cover up with broadrimmed hats and sunglasses, again those that are designed to block out up to 99% of the sun’s harmful rays. Not only is skin cancer linked to excessive sun exposure, eyes can be at risk for eye diseases like age-related macular degeneration (AMD) if left unprotected. Don’t Tan While sunburns can be dangerous, so can tanning beds that directly emit

UV rays. If you’re looking for that dark, brown “sun-kissed” look, opt for lotions or spray that offer the same results without unnecessary exposure to harmful UV rays. Examinations You or your partner should check your entire body for possible signs of skin cancer at least once a month. Be on the lookout for new, changing or irregular shaped moles as these are often an indicator of melanoma as mentioned previously. Also check for unusual, lumps, bumps or lesions, anything on the skin that appears out of the ordinary should be examined. It’s important to keep your yearly appointment with your personal physician as they should also be checking your skin for these changes. If you do notice any of these conditions, don’t wait for your annual visit, see them as quick as possible to nip this in the bud before it can spread and possibly become untreatable. Again, remember that early diagnosis, detection and treatment can mean the difference between life and death when it comes to this deadly disease 

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Visionary technology Innovative optical concept offers simple, affordable, fast glaucoma screening test Innovative technology from product design and development firm Cambridge Consultants could help combat glaucoma – a major global cause of blindness, second only to cataracts. It offers a low-cost, user-friendly way of diagnosing and monitoring the disease – so that early intervention and treatment can help slow its progress. The new Viewi optical concept developed by Cambridge Consultants shows how it could be possible for patients to monitor any effect on their vision in the comfort of their own homes. At the moment, patients typically have an annual optometrist or hospital check-up using a visual field analyser. Flashing lights at varying points of the visual field test sensitivity – with the patient pressing a button each time they see a light. The novel Viewi technology performs the same test but at a fraction of the cost – around £20 rather than £20,000 for the clinical device. At the heart of the Viewi concept is the extensive optical expertise of Cambridge Consultants, which has been combined with a smartphone app to reproduce the hospital-based ‘static perimetry’ test. The smartphone is slotted into the light and portable headset, and runs a fast, conventional supra threshold test in less than five minutes per eye. The patient simply presses a button – connected to the headset wirelessly via Bluetooth Smart – each time they see one of the flashing dots. Human factors considerations were a key element in the design of the Viewi system as it had to be user friendly for patients with sight problems, many of whom are also elderly. The results of the static perimetry test are displayed in a nontechnical, intuitive format on the smartphone – tracking the progression of the disease – and can be shared instantly with the patient’s optician. “Loss of vision as a result of open-angle glaucoma cannot be recovered – but early diagnosis and treatment can slow the progression of the disease,” said Simon Karger, head of surgical and interventional products at Cambridge Consultants. “But although the current clinical tests work exceptionally well, the system for glaucoma management is overloaded. “We’ve used our optical expertise – coupled with our algorithm skills – to show how a simple, affordable, fast glaucoma screening test that patients can do at home is entirely feasible.

The Viewi system doesn’t aim to replace the current screening and management system – it’s been designed to augment the clinical tests.” The innovative Viewi concept has been hailed as an important advance by optics expert Chris Dainty, a professor at University College London Institute of Ophthalmology and Moorfields Eye Hospital. “The Viewi technology could provide a valuable early warning system for people at risk of developing glaucoma, as well as patients who need to monitor the effects of the disease on their vision,” he said. “It could also make the static perimetry test accessible to more patients in developing countries, where expensive clinical equipment and trained professionals are often in short supply.” Glaucoma affects more than 60 million people worldwide. It leads to optic nerve damage as a result of abnormally high fluid pressure inside the eye. The most common form is openangle glaucoma, which affects around 95% of patients. It causes a gradual loss of peripheral vision – but can be virtually unnoticeable to the patient until they have lost half of their visual field. The damage is irreversible so, without treatment, an individual can become totally blind. Open-angle glaucoma is hereditary – a family history of the disease increases the risk of an individual developing glaucoma by a factor of between four and nine. So regular checks are crucial for those at risk – and frequent monitoring is needed if problems start to develop. w w w.medegatetoday.com Sep-Oct 2016

EXPERT VIEWS

Genetic Testing

for Breast Cancer: How it Helps Thanks to Angelina Jolie, there has been much talk in recent years about the possibility of genetic testing to check an individual’s risk of developing breast cancer. Ever since the actor underwent preventable double mastectomy after discovering that she carried gene mutations, more people are interested in understanding the concept and whether risk reduction is actually possible. Do I have a genetically higher risk of suffering from breast cancer? Are most breast cancers attributable to gene mutation? Will all people with mutation in BRCA genes go on to develop breast cancer? When it comes to genetic testing for cancers, a lot of questions are abound in the minds of common people. While the “Angelina Jolie Effect” raised much awareness about the hereditary breast and ovarian cancer syndrome (HBOC), there are a lot of prevalent myths and misconceptions that need to be cleared. Breast Cancer: The problem Breast cancer is today the leading cause of cancer related deaths in women in India, surpassing cervical cancer. According to estimates of World Health Organization (WHO), roughly 144,937 women in India were detected with breast cancer in 2012 and 70,218 died of it, making it one death for every two new diagnoses. With the incidence of the disease rising by more than 20% since 2008, India is expected to have a whopping 200,000 new cases of breast cancer per year by 2030. Age, sex, ethnicity and genetic predisposition are main risk factors for breast cancer. However, today there has also been a rise in risk factors propelled by lifestyle. Like diabetes, hypertension and cardiovascular disease, rise in breast cancer incidence in India can also be attributed to the increase

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EXPERT VIEWS

in urbanization, rapid adoption of westernized lifestyles, and shift in reproductive behavior, with increasing number of younger women reporting the disease. Women who are diagnosed at a younger age also are more likely to have a mutated BRCA1 or BRCA2 genes which present poor prognosis. Doctors are also reporting the prevalence of more aggressive cancers in younger women. Hence, it becomes important to educate and create awareness about the need of genetic counseling and genetic testing for breast cancer. What is Genetic Mutation? Some women have a genetic mutation in the tumor-suppressing BRCA1 and BRCA2 genes. These genes, in normal cells, help prevent cancer by making proteins that keep the cells from growing abnormally. However, in case there is a genetic mutation in these genes, the risk of cancer is high for both breast as well as ovaries. In people with normal genes, the risk of breast cancer is 12%. Yet, in a person with mutation in BRCA 1 genes, the risk stands at 50-80%, and in a person with mutation in BRCA 2 genes, the risk is 40-70%. Similar is the case with ovarian cancer. While an individual with normal genes stands a 1-2% risk of developing ovarian cancer, a person with BRCA 1 mutation has her risk amplified to 24-40% and 11-18% in case of BRCA mutation. The cancer risk is amplified by mutation in both genes or one. We need to bust the prevailing myth that one of the BRCA genes is responsible for breast cancer, while the other for ovarian cancer. Benefits of testing for BRCA1/2: Is Genetic testing a foolproof solution? A lot of concerned women ask whether undergoing genetic testing and having its results in hand will help them prevent breast and ovarian cancer with utmost certainty. Or whether having a gene mutation means they will certainly develop the disease at some point of time in life. The answer to both questions is no.

Although they are at increased risk, not all people with BRCA1/2 mutations go on to develop cancer. Among those who do develop cancer, the age of onset and type of cancer varies. The BRCA1/2 mutations run in families. They may be inherited from a person’s mother or father. There is a 50% (or one in two) chance that a child born to a parent who carries a mutation in one of these genes shall inherit the mutation. The test cannot predict ‘if’ or ‘when’ the person will develop breast or ovarian cancer; it can only determine if he or she is at risk because of the faulty gene(s). However, a negative test results affords freedom from anxiety about either your/your progeny’s risk for inheriting the family’s cancer susceptibility. At the same time, an early diagnosis of a positive result could mean better overall prognosis or outlook.  If you test positive, you can consult your genetic counselor and decide on taking a preventive action such as a preventive removal of the ovaries and breasts.  If you test positive, you would also know the need to be additionally alert against these disease; so that you will make sure you undergo regular screenings and mammography. Early diagnosis of breast cancer makes a difference of life and death, and also ensures you have to undergo less aggressive treatments as compared to people diagnosed in later stages.  The Food and Drug Administration (FDA), U.S.A., has approved several drugs, and drug combinations for breast cancer prevention, and treatment. Tamoxifen and Raloxifene reduce the risk of developing breast cancer, and are used for risk management among women who carry BRCA1/2 mutations. Who should undergo genetic testing? Individuals with family history of any of these conditions should undergo testing:

 Cancer in both breasts in the same woman.  Breast cancer diagnosed before 50 years of age.  Breast and ovarian cancers in either the same woman, or in the same family.  Multiple tumors found in the same breast.  Two or more primary types of BRCA1- or BRCA2-related cancers in a single family member.  Case of male breast cancer.  Certain ethnicities, such as the Ashkenazi Jews. What are the tests available in India? A battery of genetic tests are available in India: Hotspot testing, Carrier testing, Full gene sequencing, Deletion/ duplication analysis, and Breast Ovarian Cancer Panel (Massive Parallel Sequencing analysis of multiple genes including BRCA1/2). CORE Diagnostics offers the entire range of testing, along with free genetic counseling for guiding medical followup. Based on the test results, it could also facilitate a patient’s enrolment in on-going research, and clinical trials in HBOC.

Ms Zoya Brar

Founder & Managing Director Core Diagnostics.

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PRODUCT LINE

E-pharmacies:

Opportunities amidst uncertainties The Indian pharmacy market is in the midst of exciting times. While on one hand, online pharmacy is fast catching fancy of the investor, on the other hand, it is facing resistance from brick and mortar retailers demanding a ban on online sale of medicines. The Government is yet to come out with a regulatory regime for online pharmacies. The Indian pharmacy market (domestic prescription) is a huge market estimated at ~USD 15 bn (as per All India Organisation of Chemists and Druggists) in 2016 and expected to witness a long term strategic growth of 15% p.a. While online pharmacies currently account for a miniscule portion of the total market, activity in the segment is gaining traction. As many as 60 online pharmacy delivery startups have mushroomed over the past two years (as per Traxcn). Key players include 1mg, Netmeds, PharmEasy, Zigy, mChemist. Brick-and-mortar stores, concerned about the rise of online pharmacies, have demanded that online pharmacies be banned as they operate outside the purview of Drugs and Cosmetics Rule 1945. The All India Organization of Chemists & Druggists (AIOCD) also called for a nationwide strike on October 14, 2015 with ~850,000 brick-and-mortar drug retailers shutting their shop to express concerns over the booming online drug retail business.1 The sale and distribution of drugs in the country is regulated by the Drugs and Cosmetics Rules, 1945 (D&C Rules). The key provisions of the rules are as below:  Medicines can be sold only by a registered pharmacy that has retail license. Even over-the-counter (OTC) drugs can be sold only by licensed retailers  It is mandatory for the customer to have a prescription for the medicines signed by a Registered Medical Practitioner (RMP). Over the Counter products can be sold without prescription  The pharmacy should also have a registered pharmacist on payroll. All the medicines that go out for delivery has to be verified and certified by the registered pharmacist  Clear guidelines on the sale of Schedule H and Schedule X drugs, which are ‘restrictive drugs’ and can be sold only on the prescription of a registered medication practitioner and adhere to the rules mentioned in the act The members of AIOCD contented that online pharmacies are by-passing these rules which will lead to widespread drug abuse and counterfeit drugs. However, as per online players, they are resisting as e-pharmacies pose a threat to the large brick-and-mortar stores. Online pharmacies, operating

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with low costs, are able to pass discounts to customers who are increasingly shifting to online as a preferred means of purchase. “I strongly feel it is a fight between the big organised players and small stores, who empowered with technology, are giving tough competition to the large players. There have been violations in the offline space too. For example, a drug such as Crocin also needs a prescription, but no one asks for it.” - Dharmil Sheth, Founder of PharmEasy, a Mumbai-based online marketplace for small mom and pop medical stores. In response to the representations by AIOCD, the Drug Consultative Committee has constituted a sub-committee to propose new framework for the regulation of online pharmacies in India. In December, the committee issued a circular not imposing any ban but seeking strict adherence to the Drugs and Cosmetics Act and Rules.

What are the key areas of concern online pharmacies are battling with? As a current practice, online pharmacies mandate customers to upload a scanned copy of the prescription before drugs can be delivered. The question arises as to whether a scanned copy or electronic form of prescription meets the requirements of being ‘signed’ by an RMP. Further, the D&C Rules also require that the registered pharmacist, under whose supervision drugs are dispensed, makes a note that the drug has been dispensed on the prescription itself so that the prescription is not overdispensed. It is tough to make such a note over a scanned or electronic copy of a prescription. Another challenge is related to the place of sale. As per the laws, the sale of drugs must take place at the licensed premises approved by the licensing authority. In case of online sale, it is tough to ascertain whether the sale took place at the chemist shop or the customer’s house.

Despite the inherent challenges in complying with the law, e-pharmacies have significant advantages:  Increased convenience and access: The e-pharmacy is convenient and significantly improves the access of medicines for the patients. The access of medicines is difficult for a significant number of people in the country, especially when one is sick  Improved availability: Offline pharmacies can only keep limited inventory. E-Pharmacies can improve the availability of the drugs with the use of technology and

PRODUCT LINE

access to Inventory of multiple stores at a time. Even tier II/III cities and rural villages can have access to the latest medicines  Improved affordability for customers: The operating costs (real estate, inventory etc) for e-pharmacies are less than the brick-and-mortar pharmacies. They can pass on some of these cost benefits to the consumers. The websites also offer generic alternatives to most medicines; online buyers can thus expect significant savings  Other advantages including Enhanced services of Pharmacist (online chats etc), effective tracking of medicines purchased, medicine authenticity, increased information to customers “Real benefit of e-pharmacies is in the digitization of the data right to the delivery to the customer. Legitimate online pharmacies will bring in transparency, traceability and accountability in the system.” – Rajiv Gulati, Co-Founder of mChemist, a Delhi-based online pharmacy The benefits of e-pharmacies coupled with rise in ageing population and increasing internet penetration in emerging countries is driving the global online pharmacy market. The global e-pharmacy market was valued at ~USD 30 bn in 2014 and is expected to grow at a strong CAGR of 17.5% to reach USD 128 bn by 2023 (Transparency Market Research). North America leads the market with a share of 37% (~USD 11 bn). Asia Pacific region foresees strong potential for the growth of e-pharmacies owing to the large untapped market in emerging economies. Leading US retail pharmacies such as CVS and Wallgreen have online pharmacy services in addition to a vast retail network of drug stores. We see this trend in India as well – Apollo Pharmacy, India’s largest pharmacy with 1,822 stores has launched online portal to sell medicines. Medplus, India’s second largest pharmacy chain with 1,350 pharmacies also launched its online pharmacy & general store, MedPlusMart.com, in 2015.

Increased investor interest in the segment even as the Government is yet to formulate guidelines for e-pharmacies Online pharmacy is at a nascent stage in India but has the potential to become a large segment. It is estimated that online deliveries currently account for a meagre USD 10 million in size1. However, with adoption of e-commerce among Indian

consumers and rising spends on healthcare, this category is likely to grow. With the huge potential the vertical holds, startups are witnessing heightened interest from investors. In one of the largest funding in the space, Chennai-based online pharmacy marketplace, Netmeds.com, raised USD 50 mn led by Orbimed2. Netmeds.com is a fully licensed pharmacy that offers prescription and OTC medicine along with other health products. 1mg, the generic drug search business of online health product vendor Healthkart, was spun as a separate entity in April 2015 and raised USD 6 mn from investors including Sequoia Capital and Omidyar Network. The company raised a Series B round of USD 15 mn round (Rs 100 cr) and subsequently raised an undisclosed amount from HBM Healthcare. The company also acquired online homeopathic drug store Homeobuy for an undisclosed amount. Following the acquisition, Homeobuy will be rebranded 1mgAyush and deal in homeopathic and ayurvedic medicines.3,4 Other notable names include Zigy led by IT industry veteran Phaneesh Murthy. PharmEasy, an app only seller also plans to raise venture funding. There are two operating models – market place model (where the company connects the consumer with a licensed partner pharmacy that fulfills the order) and online pharmacy (where the company holds a pharmacy license itself and sells online). While companies including Netmeds and mchemist are licensed pharmacies selling medications online, others such as 1mg, Zigy, PharmEasy are marketplaces. The companies, besides selling prescription medicines online, also sell a range of OTC, personal care and wellness products and offer other services. For e.g. 1mg connects with doctors and offers home pickup of diagnostic samples. Zigy offers Zigy Healthvault, an online medical health record system for storing healthcare records. Almost all websites offer discounts of upto 20% competing to build share in the high potential online pharmacy industry. While early movers will have an advantage in a category which has the potential to become the next big e-commerce vertical, what will also determine the industry trajectory to an extent is the pending government decision on the e-pharmacy regulation in India. As per industry experts, stringent regulations can be a blessing in disguise as it will put a check on the illegitimate companies and enable to promote legitimate online pharmacies in India.

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EXPERT VIEWS

New advanced technology to detect

colorectal cancer and gastrointestinal disorders at early stage

Innovative G-EYEâ&#x201E;˘ endoscope technology that allows doctors to enhance the prevailing detection rate from 60% to 98% Early stage diagnosis and effective treatment of Colorectal Cancers and other severe Gastro Intestinal disorders is now possible in India 40

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EXPERT VIEWS

technology doctors can ensure early diagnosis and effective treatment of colorectal cancer and other gastrointestinal diseases which are common in the country. The products already have received rave reactions from well-known hospital chains in India including Asian Institute of Gastroenterology, Fortis, Apollo, Max, Gangaram, Aster CMI, Sunshine, Manipal, Columbia Asia Hospitals, and PGI Chandigarh.

n India and other parts of the world, endoscopy procedures give only 60% detection rate. There is a serious gap in detection of gastronomical diseases and colorectal cancer is becoming a growing reason for deaths in western countries. Understanding this situation, Ventura Business Solutions in partnership with Israel based, Smart Medical Systems, a global pioneer in gastrointestinal (GI) endoscopy devices to launch India’s first Smart endoscopy technology, G-EYE™ endoscope and NaviAid™ for accurate and early stage diagnosis of colorectal cancers and severe gastrointestinal disorders. The standard colonoscopy and diagnosis fails to detect over 20% of pre-cancerous polyps resulting in a growing population of colorectal cancer patients in India and other parts of the world. SMART's G-EYE Endoscope technology can enhance the detection rate of endoscopic procedure to 98% thus almost eliminating missing of detection of any growth that may need surgery or loss of life later on. The G-EYE™ endoscopy technology also provides the ability to perform double balloon enteroscopy ondemand, which means no prior preparations of the equipment, or the patient is required. With almost zero preparation time, doctors will be able to conduct more endoscopic procedures and at governments hospitals this technology will reduce the waiting time and long queues in near future. Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide and there are a growing number of colorectal cancer patients in India. With this new G-EYE™ endoscope

Speaking about the clinical impact of newly launched products on contemporary gastroenterology, internationally acclaimed Nutrition and Gastroenterology Expert, Dr. Zamir Halpern from Tel Aviv Sourasky Medical Center, Israel said, “Smart's new -EYE™ endoscope and NaviAid™ solutions significantly enhance the technical and therapeutic aspects of colonoscopy and enteroscopy procedures. It is a unique opportunity and great privilege for me to share my clinical experience with Smart’s unique product platform, which represents a new standard of care in colorectal cancer prevention and GI endoscopy.” Speaking on partnership with Ventura, Misha Krakowsky, Executive Director of Asia Pacific for Smart Medical Systems said, “Our alliance with Ventura provides us with a great opportunity to serve the medical community in India, enhancing physicians' capabilities during endoscopy procedures and providing better treatment for patients.” Satya K., President & CEO of Ventura Business Solutions said “Smart Medical’s technology offers a unique value proposition to medical centers, physicians and patients. Our mission is to make this unique technology highly accessible to hospitals and endoscopy centers.” SMART's flagship product, the G-EYE™ endoscope, uses innovative balloon technology to uncover pre-cancerous polyps that are hidden behind the colon's natural folds. Pricewise, Smart's solution costs almost 1/5th of the nearest competitor, which means it is highly affordable for the hospitals and patients alike. The company has additional balloon products under development and commercialization, designed to allow standard endoscopes to access and visualize portions of the GI tract currently only accessible with the use of highly specialized equipment  w w w.medegatetoday.com Sep-Oct 2016

DOCTOR SPEAK

Respiratory Problems surging by 50% in Children  The dampness in the air has increased the incidence of respiratory problems in children  Air pollution in these conditions worsening the situation, say doctors The combination of humidity and air pollution is leading to a rise in respiratory diseases among children. Pediatricians have noted an increase in acute diseases such as asthma and upper respiratory tract infections. This is besides the regular viral mostly peak in children during the monsoon season. This is because the moisture in the air traps polluting agents, especially particulate matter, keeping them hanging infections, accompanied by a cold, cough, and fever, seen every year. “Respiratory problems in the atmosphere for long periods. Unfortunately, it is not just outdoor air pollution that is causing harm. Indoor pollution too, from fumes, especially those from mosquito repellants, does impact the airways. In addition, spores from fungus and mould around houses and schools can affect those who are already asthmatic,” says Dr. Piyush Goel, Consultant Pulmonology, Columbia Asia Hospital Gurgaon. Gurgaon has often shown hazardous levels of air pollution, both due to vehicular movement and construction work. The World Health Organization (WHO) Air Quality Guidelines stipulate that PM2.5 (particulate matter) over a 24-hour mean period stand at 25 μg/ m3. However, in Gurgaon, in June 2016, the monthly average stood at 89.38 μg/ m3. Air pollution causes more than 3 million premature deaths every year, as per WHO reports. “The toxic air severely impacts schoolgoing children, whose airways are still not developed, and are hence vulnerable to pulmonary (lung) infections. Acute 42

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respiratory illnesses are generally shortlived, while chronic ones are persistent in nature. Our worry is that acute infections develop into chronic ones. We see the onset of asthma in this season, and it is appearing in children as young as a few months old. Very often parents come to us by the time their children have deep-set chest infections. My advice is for parents to approach the pediatrician as soon as the problem starts. This will help us start a mild treatment, and avoid antibiotics,” adds Dr. Piyush Goel

Tips to Stay Protected  Avoid the use of insect repellants that need to be sprayed—even those that claim they are ‘natural’  Instead apply DEET-free mosquito repellants to your child’s skin  Clean the house of any fungus, especially in areas that are not seen— under the sink and washbasins  Take action to eliminate dampness from the walls, as this can breed mould

 I dentify a play area that is in a green space, rather than close to a road  I f your child is comfortable with it, give him/her a mask when out playing a sport  I f your child is prone to asthma and is on SOS medicines, keep a track on what time of the day/night he/she gets it, and if it is exercise-induced; report this to the doctor  I f antibiotics have been prescribed for an infection, do keep to the dosage suggested by the doctor  Wash curtains, pillows , bed sheets, mats, carpets at regular interval  I f someone in your household is allergic to pet dander, consider getting a non-furry pet. If you already have a cat or dog, don't let the pet sleep in your bedroom, and give it a bath at least once a week  To help control dust mites and mold, keep humidity in your home below 50% by using dehumidifier

EXPERT VIEWS

Indian Railway as a

Carrier of Indian Healthcare:

Movement & Improvement It is heartening to witness that Innovation and Constant Changes, Indian Railway has been going through under the visionary leadership of honorable Railway Minister of India Shri Suresh Prabhu. Voice of Healthcare also highly appreciate Shri J.P. Nadda, honorable Minister of Health and Family Welfare, Govt of India, for giving his valuable time to Mr Afzal Kamaal who submitted pre-budgetary recommendations (on healthcare reforms)to him. We hereby humbly request honorable health &family welfare minister to consider some Public Healthcare Initiatives to be undertaken along with Railway Ministry. Voice of Healthcare share these public healthcare initiatives as under:

 VOH proposes either special trains equipped with modern healthcare facilities or two compartments in each train be converted into mini healthcare centers.  These trains and compartments would be a boon to  To attend medical emergency of travelling passengers on board  To offer medical help to patients travelling from one city to another city to seek medical treatment  Being a healthcare center on wheels could promote preventive healthcare among travelling passengers and enhance business potential per passenger.  This opportunity would also be used to make passengers aware of govt healthcare policies and programs  Indian healthcare has scarce resources of manpower as well  Rural healthcare would be greatly benefitted as logistics would be as infrastructure, could further be easier for travelling doctors to start strategically calibrated to cater to from their respective base cities, more areas and population through and report to any PHC/CHC in collaboration with Indian railway. morning and after finishing duties

Manish Rastogi Banglore

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comeback in evening or next morning. They can serve without being permanently located.  In case of special trains with better and more healthcare facilities ,these on board medical centers could cater to larger population  This could be good opportunity for medical practioners of all streams to work together in the welfare of Indian healthcare.  This would create job opportunity for educated rural youth who could be trained in paramedical job responsibilities and make a career in healthcare.  Additional expenditure to be incurred could be met through PPP model, inviting interested private healthcare companies.  There is huge revenue opportunity for Branding of anything related to healthcare- Hospital Brands to Healthy Food Brands.  The telemedicine companies could also better their medical care through hospital on wheels.

DOCTOR SPEAK

Don’t take Fever Easy: Chikungunya affects children more severely. They are more likely to have rashes than adults are. Although joint pain is not as common with children as with adults, it can be quite severe.

Do Small Steps

There is no vaccine against chikungunya. Your best bet is to prevent mosquitoes from biting your child. Mosquitoes breed in stagnant water in warm and humid weather. So make sure your house and surrounding areas are free of uncovered stagnant water, rotting vegetation and old flower pots, especially in the monsoon season.

Dr. Rajiva Kumar

Child Specialist (Muzaffarpur) 46

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DOCTOR SPEAK

Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash. Joint pain is often debilitating and can vary in duration. The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common. There is no cure for the disease. Treatment is focused on relieving the symptoms. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya. The disease occurs in Africa, Asia and the Indian subcontinent. In recent decades mosquito vectors of chikungunya have spread to Europe and the Americas

Treatment

 There is no vaccine to prevent or medicine to treat chikungunya virus. Treat the symptoms: • Get plenty of rest. • Drink fluids to prevent dehydration. • Take medicine such as paracetamol to reduce fever and pain. • Do not take aspirin and other non-steroidal antiinflammatory drugs (NSAIDS until dengue can be ruled out to reduce the risk of bleeding). • If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.  If you have chikungunya, prevent mosquito bites for the first week of your illness. M ost people infected with chikungunya virus will develop some symptoms. • During the first week of infection, chikungunya virus can be found in the blood and passed from S ymptoms usually begin 3–7 days after being bitten an infected person to a mosquito through mosquito by an infected mosquito. bites.  The most common symptoms are fever and joint • A n infected mosquito can then spread the virus to pain. other people. O ther symptoms may include headache, muscle pain, joint swelling, or rash. C hikungunya disease does not often result in death, but the symptoms can be severe and disabling. M ost patients feel better within a week. In some people, the joint pain may persist for months. P eople at risk for more severe disease include newborns infected around the time of birth, older adults (65 years), and people with medical conditions such as high blood pressure, diabetes, or heart disease. O nce a person has been infected, he or she is likely to be protected from future infections.

Symptoms

Diagnosis

 The symptoms of chikungunya are similar to those of dengue and Zika, diseases spread by the same mosquitoes that transmit chikungunya. S ee your healthcare provider if you develop the symptoms described above and have visited an area where chikungunya is found.  I f you have recently traveled, tell your healthcare provider when and where you traveled.  Your healthcare provider may order blood tests to look for chikungunya or other similar viruses like dengue and Zika.

w w w.medegatetoday.com Sep-Oct 2016

PRODUCT LINE

Coagulation Testing and Results:

Now@your fingertips Prothrombin time is typically analysed by a laboratory technologist on an automated instrument at 37 °C on a Blood draw into a test tube containing liquid sodium Citrate and results reported in Seconds, % Activity or INR. The result (in seconds) for a prothrombin time performed on a normal individual will vary according to the type of analytical system employed. This is due to the variations between different types and batches of manufacturer's tissue factor used in the reagent to perform the test. The INR was devised to standardize the results. The prothrombin time can be prolonged as a result of deficiencies in VitaminK, warfarin therapy, malabsorption, or lack of intestinal colonization by bacteria (such as in newborns). In addition, poor factor VII synthesis (due to liver disease) or increased consumption (in disseminated intravascular coagulation) may prolong the PT. Lupus anticoagulant, a circulating inhibitor predisposing for thrombosis, may skew PT results The INR is typically used to monitor patients on warfarin or related oral anticoagulant therapy. The normal range for a healthy person not using warfarin is 0.8–1.2, and for people on warfarin therapy an INR of 2.0–3.0 is usually targeted, although the target INR may be higher in particular situations, such as for those with a mechanical heart valve. If the INR is outside the target range, a high INR indicates a higher risk of bleeding, while a low INR suggests a higher risk of developing a clot.

Near-patient testing*

In addition to the laboratory method outlined above, near-patient testing (NPT) or home INR monitoring is becoming increasingly common in some countries. In the United Kingdom, for example, near-patient 48

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www.operonbiotech.com www.ptinr.in testing is used both by patients at home, and by some anticoagulation clinics (often hospital-based) as a fast and convenient alternative to the lab method. After a period of doubt about the accuracy of NPT results, a new generation of machines and reagents seems to be gaining acceptance for its ability to deliver results close in accuracy to those of the lab. Local policy determines whether the patient or a coagulation specialist (pharmacist, nurse, general practitioner or hospital doctor) interprets the result and determines the dose of medication. In India, this remains in the hands of a health care professional i.e. the Doctor.

About Qlabs:

The qLabs® platform is a rapid testing system that is composed of a handheld qLabs® ElectroMeter and disposable strips. The advanced biosensor technology of the qLabs® platform enables blood rapid testing by patientside, so that health care professionals and patients themselves can access real-time, lab-quality results within minutes, right at Point of Care or at home. Qlabs is built on a robust platform and presently offering two variants Q1 for PT/INR and Q2 Professional for PT/INR/APTT. E-Station which is compatible for both Q1 and Q2 is an optional unit.

Qlabs design is futuristic and company is actively working towards adding more meaningful parameters. Soon you can expect Lipid profile, CRP, Glucose and ACT panels working on Qlabs platform. Qlabs is manufactured at GMP ISO 13485 facility, CE Certified and has passed the RELAC testing by LUMC Netherlands using rTF 09 / WHO preparation. The US FDA certificate is pending for approval.

Passing Thought:

There is an urgent need in our country to expand Medicare coverage (Insurance) for home blood testing of PT and INR to include beneficiaries who are using the drug warfarin, an anticoagulant (blood thinner) medication, for chronic atrial fibrillation or venous thromboembolism." In addition, "those Medicare beneficiaries and their physicians managing conditions related to chronic atrial fibrillation or venous thromboembolism will benefit greatly through the use of the home test such as Qlabs. For more information write to us on info@operonbiotech.com Follow us on Facebook: @operonbio Twitter: @operon_biotech LinkedIN: @operonbiotechandhealthcare *Wikipedia and other relevant Webpages.

OPERON

®® qLabs PT-INR qLabs PT-INR Monitoring System Monitoring System

Q-2 Plus (PT, INR, APTT) for Professional Point of Care Q-1 Pro ( PT, INR) for Patient Self-Testing

What's My INR Today? • High precision with lab quality: 5% CV • Fingerstick blood: less than 10 µl • Rapid testing: 1-5 minutes • On board quality control • Low ISI as recommended by ACCP, CAP & WHO

qLabs® PT-INR test shows strong correlation with the Stago STA® NEOPLASTINE® CI PT-INR test. The correlation coefficient is 0.96 with an intercept of -0.08 and slope of 1.004.

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Operon Biotech & Healthcare #37, A-1, B-1, B-2, 'SnehaJyothi', Srinivagilu Main Road Koramangala Ring Road Bengaluru - 560 047. 080-42027704 | Fax:25701522 operon@operonbiotech.com

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EXPERT VIEWS

Fujifilm's

Welcome to the world of effective filmless diagnosis with high quality image processing using

Vivek Saxena National Manager – PACS FUJIFILM India Private Limited In today’s world healthcare providers are looking out the way to effectively utilize the available resources to achieve the maximum productivity and efficiency in short time duration. Medical Informatics (MI) is playing a very important role for fulfilling the above said need and providing the flexibility to automate the Internal and external workflows to achieve efficiency, better turnaround time , automatic securing patient records, accessibility anywhere any time. Most of the Brownfield or Greenfield hospitals are looking forward to have a good and robust MI solution like Hospital Information System, Electronics Medical records (EMR) and also other departmental solutions like Radiology Information System (RIS), Picture Archiving and Communication Software (PACS), Advanced Post processing Software (3D) etc. FUJIFILM India Medical has a strong presence in healthcare market. Our Medical offering includes X Ray Films, Computed Radiography 50

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SYNAPSE

(CR), Digital Radiography (DR), Digital Mammography and Medical Informatics solution. FUJIFILM Medical System’s Picture Archiving and Communication System (PACS), brand name Synapse®, was first released in 1999, after web technologies had become standardized. Building on that - Synapse’s design features open standards, on-demand access to images, a scalable design, integrated web technology, and a consistent desktop Graphical User Interface (GUI). FUJIFILM Synapse is your onestop shop. With an integrated mammography, RIS and PACS solution, high end FDA approved 3D post processing applications cater to entire hospital departments right from Radiology, Cardiology, Surgery , Orthopaedics, Neurology, Urology, Dental and Maxillofacial , Podiatry , Forensic Science for Virtual autopsies . We have fully trained clinical and dedicated IT professional’s support team. Fujifilm offers a comprehensive approach to PACS customers. Synapse product range have very unique feature which enables Multi Site hospitals and diagnostic centres to use the interconnected workflows and imaging needs. Tele radiology comes as a default component in our Synapse PACS RIS offering. Synapse PACS also ensure diagnostic confidence, patient data security, interoperability by complying the industry healthcare IT standards like DIACAP(Highest level of security certification), Integrating healthcare Enterprise (IHE) profiles, DICOM, HL7,HIPPA and FDA certifications. Advancement in phone technology and the way Indian user are growing having smartphones and tablets which enable information readily available to the customer finger tips. In Healthcare

also customer, providers all looking to provide the patient health information, reports, lab reports, diagnostic images to the patients or their relatives. As a providers our Synapse solutions provides flexibility in accessing the information on Mobiles and tablets. Our solution can easily integrate with other hospital information systems and EMRs which enables the patient’s complete information consolidation.

Synapse PACS rated 7th worldwide in KLAS 2013 ratings. We have good

installed base in India and continuously growing. Our installed base includes Sathy Sai Hospital - Bangalore (3 hospital connected), Gangaram hospital - New Delhi, Medall Healthcare Chennai (30 centres across southern India with data centre) etc . We are continuously working towards providing the better solution offering to our customers which suits the local requirements as well with powerful global products. We recently have introduced Synapse VNA (Vendor Neutral Archive) Globally. Another feather to our distribution in value PACS category, is iWeb lite 3.0 Value PACS for those customers who want to go digital initially with minimal investment. iWeb Lite 3.0 solution provides the flexibility to customer for storing the images locally, access images on site and remotely on mobile devices with reporting capabilities. We currently are having more than 100+ installation across India On top of all FUJIFILM Synapse offering also provides software obsolescence to our customer under contract by which the customer gets upgrades also as a part of contract and customer don’t have to worry about new technology upgrades in the coming future. Synapse solution products provide complete end to end solution as per the need with complete peace of mind to years to come as well 

Findings of CIMBS Suicide study Released

A large majority of 71% were not aware of what to do in case someone is suicidal  55% people knew someone in their personal, social or professional circle who had lost their life to suicide  61 % people knew someone in their personal, social or professional circle who had attempted suicide (but managed to survive)  53% of respondents felt that they were personally impacted by such incidents of suicide The Mental Health expert team at Cosmos Institute of Mental Health and Behavioural Sciences (CIMBS) recently carried out the ‘CIMBS suicide study’, to understand the public perception and level of awareness about suicide as well as to understand the underlying psychological and triggering causes associated with suicidal behaviour. The study comprised of two parts, with a public survey to gauge awareness, perception and impact of suicide in general public, and a clinical research of data to assess various psychological trends associated with suicidal behaviour. The report of the study was released today in a press conference at Press Club of India, organised on the eve of World Suicide Prevention Day. The Press conference was jointly organised by Nav Sanjeevan, a non-profit organization formed in the memory of Late Capt. Sanjeev Bana to work towards the cause of “Suicide

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Prevention. Brig Chitranjan Sawant, VSM (Social Reformer & Environmentalist), Dr. Sunil Mittal (Psychiatrist & Director, CIMBS, Delhi) , Dr. Anubhav Rathi (Psychiatrist & Director, SANJEEVANI), Brig Vivek Sohal (Educationist, Sujok Therapist), Ms Simple (Hatha Yoga Teacher & Nature Cure Therapist) addressed the Press conference. Upayoga” session by Isha Foundation was also organized on this occasion. “There is a growing need to spread awareness about suicide prevention. People often do not know what to do if someone is suicidal. Awareness, access to care and timely action can help go a long way in preventing suicides” says Ms. Simple founder of Nav Sanjeevan. According to the findings of the CIMBS Suicide study, while most of the respondents (91%) were optimistic that suicides are preventable, a large majority (71%) were not aware of what to do in case someone is suicidal. Study show

Special Feature

that 55% of the respondents from the general population knew someone in their personal, social or professional circle who had lost their life to suicide, while 61% knew of someone who had attempted to do so. A majority (53%) felt that they had been personally impacted by such incidents of suicide (while 25% denied being impacted, 22% could not say yes or no for sure) “The results of this study are alarming. This highlights the profound impact that suicides have on society at large and need for awareness building about recognizing early signs of suicidal behavior and ensuring timely intervention. Suicides can be prevented if early warning signs are recognized and timely help is provided. Untreated Mood Swings, recent life trauma, sudden calmness after mood swings, talking about suicide and making preparations to give away possessions may be red flag signs of potential risk for suicide. If any such signs are noted, family members and next of kin must intervene and help the person suffering from suicidal ideation find timely help from mental health care experts. Timely intervention in the moment of crisis can help save their life,” says Dr. Sunil Mittal, Senior Consultant Psychiatrist and Director, Consultant Psychiatrist at Cosmos Institute of Mental Health and Behavioural Sciences (CIMBS), New Delhi. Presenting an analysis of the study, Dr. Shobhana Mittal, Consultant Psychiatrist at (CIMBS) said, “an analysis of psychological trends in people with suicidal behavior, who came in contact with our team of mental health care experts at CIMBS, revealed that suicidal behaviour on the surface often had a strong association with deeper underlying psychological difficulties, most of which are treatable if timely intervention is done. Surprisingly, barely 7% of respondents from the general population were aware of such underlying causes. 67% of people presenting to us with suicidal behavior had an underlying Major Depressive disorder, 55% had alcohol or other addictions, 26% had

Personality Disorders, 12% had Bipolar affective disorder, 7% had schizophrenia while 2% had Eating Disorders like Anorexia or Bulimia. People attempt suicide when they are no longer able to bear the psychological pain and become overpowered by a feeling of hopelessness. Stressful life events like death of a loved one, financial loss, retirement, academic difficulties, ragging and relationship difficulties can be triggers for an act as serious as suicide. Also, majority of people who presented with suicidal behavior were below 35 years of age (59%), 17% being in their vulnerable teenage years. According to Dr. Shobhana Mittal, an analysis of the clinical data revealed that out of all people presenting with suicidal ideation and attempts, women outnumbered men (62% and 55% respectively). Stressful life events like interpersonal relationship difficulty (32%), academic or career related difficulties (14%), battling chronic illness (11%), death of a loved one (7%) and financial loss (5%) can be the breaking point for triggering suicidal behavior. “The reasons underlying suicidal behaviour can be many and complex. This throws light on the pressures faced by today’s youth and need for developing adequate coping skills to deal with pressures from outside as well as from within,” says Dr. Shobhana Mittal. “Most women today balance work and home, and the challenges faced by today’s woman are many. Suicide has various biological, psychological and social factors which come together and contribute to its manifestation. Those underlying factors must be understood and dealt with in order to prevent suicide. A person who is suicidal may give a cry for help, which may be in the form of voicing suicidal thoughts to family or friends, or even writing about it on social media. This cry for help must be heard and timely intervention from mental health care experts must be done,” says Dr. Sameer Kalani, Consultant Psychiatrist at CIMBS.

“If you know of anyone around you who may be facing such difficulties, it is advisable to provide them with psychological support and watch for talk or gestures of self-harm, as they may be vulnerable at this point in their lives. Support of significant others is crucial, and at the same time psychotherapy can help develop skills for emotional regulation and better toleration of stressful life events,” says Ms. Mitali Srivastava, Clinical Psychologist at CIMBS. Suicides are among the top three leading causes of death worldwide, and the most common cause of death in youth age group in India, with road traffic accidents following in second place. Every year, approximately one million people worldwide lose their life to suicide. The number of people who attempt suicide is even more than the figures that come to light. Suicide remains a big threat that looms large over today’s society and youth, even though suicides are preventable if timely intervention is done. w w w.medegatetoday.com Sep-Oct 2016

Special Feature

 F rom Attempted (but not completed) Suicides Reported

Detail about the Public Survey A survey was conducted to gauge the level of awareness, perception and impact of suicide among the general public

T his was a cross-sectional type of study  S urvey was done with the use of online as well as printed questionnaire

 P articipation in the study was invited on voluntary basis  S ample Size: the first 500 participants were included in the study

 P articipants in the study were from the general public, from

Delhi-NCR region, with ages ranging from 18 years to 62 years (out of which 88% of survey takers were in the age group of 18-35years). Male : Female ratio of participants was nearly equal (52% : 48%).

Results:  5 5% people knew someone in their personal, social or professional circle who had lost their life to suicide

 6 1 % people knew someone in their personal, social or professional circle who had attempted suicide (but managed tosurvive)

 F rom Completed Suicides Reported • 12% were teenagers (13-19years age) • 27% were young adults (19-24 years) • 35% were 24-35 years old • 15% were 35-49 years old • 10% were over 50 years old NOTE: In 75% of cases where incidents of suicide were known, the victims were younger than 35 years of age 54

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• 22% were teenagers (13-19years age) • 34% were young adults (19-24 years) • 35% were 24-35 years old • 5% were 35-49 years old • 4% were over 50 years old NOTE: In 91% of cases where incidents of suicide were known, the victims were younger than 35 years of age  5 3% of respondents felt that they were personally impacted by such incidents of suicide (while 25% denied being impacted, 22% could not say yes or no for sure)  9 1% of respondents were optimistic, that suicides can be prevented (while 9% disagreed) A large majority of 71% were not aware of what to do in case someone is suicidal W hen asked about their opinion about most common causes for suicides, respondents attributed suicides to the following causes: • Academic difficulties 38% • Relationship difficulties 43% • Difficulties at work 9% • Financial difficulties 10% O nly 7% of respondents were aware of association between suicides with underlying psychiatric or psychological difficulties like depression, addictions, psychosis, personality disorders,etc

Part 2: Clinical Research Data A n analytic type of study was carried out to analyse the

psychological trends in people presenting with suicidal behaviour, and to understand the underlying factors associated with suicidal behaviour T otal Number of clinical cases analysed : 1000 D uration of presenting to the hospital: January 2016 to August 2016 T otal number of people presenting with suicidal behaviour: 372 • Number of Patients Presenting with suicidal attempts: 57 • Number of people presenting with ideations/ plans about suicide: 315 O ut of people presenting with suicidal behaviour • Suicidal Thoughts and Ideation: 62% were females • Suicidal Attempts: 55% were females  A ge Distribution of people presenting with suicidal behaviour • Teenagers 13-19 years: 17% • Young Adults 24-35 years: 42%

Special Feature

• 35-49 years: 33% • Over 50 years of age: 8%  P rofession of people presenting with suicidal behaviour • Self Employed: 18% • Professionals: 22% • Retired: 2% • Students: 26% • Unemployed: 32%  I mmediate precipitating events prior to suicidal behaviour: • Interpersonal Problems (Marital difficulties, break up in relationship, Family problems): 32 % • Academic/ Career Difficulties or failures: 14% • Battling chronic illness (Cancer/ terminal illness): 11% • Death of a loved one: 7% • Financial Loss: 5% • Without any immediate trigger: 31% A ssociated Psychiatric and Psychological difficulties in people presenting with suicidal behaviour

• 67% had Major Depressive Disorder • 12% had Bipolar Affective Disorder • 7% had Schizophrenia • 55% had Alcohol or other addictions • 26% had Personality Disorders • 2% had Eating Disorders (Anorexia/ Bulimia nervosa) (Percentage figures in this category overlap, as some people had multiple diagnoses as well, for instance, Depression along with addiction, or bipolar disorder along with personality disorder, or addiction along with personality disorder, and so on)

Discussion:

The above findings highlight the need for awareness building about suicide and its association with underlying psychological and psychiatric difficulties. Identification of at risk populations, timely intervention and clarity about what to do if someone is suicidal are important for suicide prevention.

w w w.medegatetoday.com Sep-Oct 2016

EXPERT VIEWS

Eat Right for Your Belly and Your Baby Pregnancy is a life-changing experience, and youâ&#x20AC;&#x2122;ve got to be armed with the right nutrition to take it on! For many moms-to-be, pregnancy is the time to rest, relaxation, and pampering and while for some, it may be stressful, especially if the pregnancy involves medical complications. Either way, it is a turning point in your life, physically, mentally, and emotionally. And food is an important part of this journey which requires a lot many changes in the diet, which has to be rightly balanced so that you are eating right for your belly and your baby. A nutritious, balanced diet through pregnancy is important not only to maintain maternal nutritional needs, but also for the development of a healthy fetus. Remember, nutrition at this time needs to cater to the continuous adjustments in maternal body composition and metabolism. The number of calories you will need to consume in addition to your regular diet is just 150 Kcal in the first trimester and 350 Kcal in the second and third. These surely need to be healthy calories, not empty calories. A clinical dietician will help you navigate the distribution of calories, but do keep them in check, as your maternal obesity puts you at risk for other serious medical conditions such as gestational diabetes. It may also put your baby at risk for future obesity and other diseases. Similarly, if you have morning sickness, you may not feel the urge to eat, and you may be underweight. In this case make each calorie count 56

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EXPERT VIEWS

check, with nutritionally rich foods. Ensure that total weight gained throughout your pregnancy is between 12 and 14 kg. Cut down on refined sugar, and while ghee and butter are okay if you are not already overweight, avoid binging on them. When it comes to pregnancy, there are certain foods that need to be definitely avoided. Foods that are too high in mercury or Vitamin A can pose a health risk to your baby, as can foods that are known to cause food borne illness such as Listeriosis and Salmonella poisoning. List of foods that are right for you and your baby. FOR BOOSTING YOUR BABY’ BRAIN AND YOUR OWN HEART HEALTH: Eat: fish, vegetable oils, nuts (especially walnuts), flax seeds, flaxseed oil, dark leafy vegetables Why: These are rich sources of Omega-3 fatty acids, an important component in boosting the development of the brain formation in the fetus, especially in the second half of pregnancy. According to the Harvard School of Public Health, US, Omega-3 is an integral part of the cell membranes and forms the building blocks of the fetal brain. While fish does contain mercury, US guidelines stipulate that two servings of fish in a week is safe. If you are not able to eat fish, ask your doctor if you should have a fish oil supplement. The two most beneficial forms of Omega-3s come from aquatic sources. But if you are vegetarian, you could try the other sources as well. This essential fatty acid is also known to reduce cholesterol, hence blood pressure.

them against infections. They’ll help you do the same. Each colour gives a different benefit, so eat the rainbow through the week. Probiotic foods help maintain gut health. Set your own yoghurt, as this contains many more ‘good, healthful’ bacteria than store-bought varieties.

FOR THE PREVENTION OF BIRTH DEFECTS IN BABY: Eat: legumes, green leafy vegetables, citrus fruits, nuts, beans

Why: Legumes include lentils, peas, beans, chickpeas, soybeans, and peanuts. The group is a rich source of folic acid, which helps in prevention of neural tube defects (birth defects of the brain, spine or spinal cord). Folate is one of the B-vitamins (B9), especially important in the first trimester. Your doctor will provide you with supplements, but you can also make sure you get the vitamin in your diet. Folic acid works closely with vitamin B12, to make red blood cells and make iron work properly in the body. If possible, eat organic, so you’re not taking in too many chemicals.

FOR OVERALL GROWTH AND DEVELOPMENT Eat: small amounts of red meat, chicken, spinach Why: Iron is an essential nutrient, and is needed for fetal and placenta growth, as well as for the development of the mother’s own tissue. About 50-70% of Indians are anemic, and this is a cause of serious concern. Your doctor will prescribe additional iron in the form of a supplement; however, you can also get it in the diet.

FOR THE BUILDING AND STRENGHTING OF BONES, FOR THE BABY AND YOU:

Foods to be avoided when you’re pregnant:

Eat: milk and dairy products, ragi (finger millet), broccoli,

 Avoid Alcohol.  Avoid raw or undercooked meat, fish and eggs.  Avoid unwashed vegetables and fruits.  Avoid raw sprouts (Eating raw sprouts increases your risk of salmonella poisoning, which causes fever, vomiting and diarrhea. Be sure to cook sprouts thoroughly.)  Avoid excess of caffeine.

spinach

Why: To fulfill its own bone development requirement, the fetus will derive its calcium from the mother, whether or not the mother is getting adequate calcium herself. The National Institute of Nutrition has set the calcium needs for pregnant women and nursing mothers as double compared to non-pregnant women. You will need 1,200 mg per day. Two glasses of milk will give you approximately half the requirement. You can derive the rest from the other sources. Also make sure you get some sun, preferably in the morning, when it is not too warm, to help create vitamin D, necessary for good bone health. UP YOUR IMMUNITY:

Avoid unpasteurized milk.

Eat: colourful fruits and vegetables; probiotic foods such as yoghurt

Why: Pregnancy is a time when you want to be safe and not catch any infections, especially those that can harm the fetus. Fruits and vegetables are antioxidant-rich. They have phytochamicals that naturally occur in plants, protecting

w w w.medegatetoday.com Sep-Oct 2016

PRE EVENT

India’s premiere exhibition

and summit on hospital infrastructure planning and design is back with its 3rd edition in Mumbai Hospital Planning & Infrastructure (H.P.I.), South Asia’s leading exhibition and summit on hospital infrastructure, design and planning comes back with its third edition on 6-8 October 2016 at Bombay Exhibition Centre, Mumbai. Hospital Planning & Infrastructure (H.P.I.) is the focused trade fair bringing together senior industry buyers including key budget holders, policy makers and investors, who represent the real power behind the development of world-class hospital infrastructure in South Asia. H.P.I. also educates the industry on how to efficiently run a hospital and meet the growing demands of the healthcare consumers.The exhibition focuses on the tremendous opportunities in the Indian healthcare sector and the challenges of building sustainable and profitable hospital infrastructure across the region. The previous edition of Hospital Planning & Infrastructure (H.P.I.) was an exhilarating success with more than 2300 buyers attending the expo and over 370 crores worth of business generated. In its third edition, H.P.I. is set to further raise the benchmark for the industry with a greater contingent of industry experts attending the expo. Spread across more than 4000sqm floor space, H.P.I. this year expects participation from almost 105 national and international companies from the healthcare industry which would attract 5000+ visitors at the exhibition. H.P.I. in its third run is powered by world’s third largest laminate brand, Greenlam Industries along with Mindray as the Gold Partner, Draeger as Silver Partner and HOSMAC as Knowledge Partner. Other leading exhibitors showcasing solutions include, Aastha Medical Technologies Pvt Ltd, Airox Technologies Pvt Ltd, Agora Climate Systems, CQM 58

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

Raj Enviro India Pvt Ltd, Esteem Industries Inc, Evolis India, GE Healthcare, Janak Healthcare Pvt Ltd, KEF Infra, Kryptonite Solutions, Mandev Tubes Pvt Ltd, Mehta Tubes Pvt Ltd, Meditek Engineers, Medisys Enterprises, Medimek Industries, Philips India Ltd, Precision UK Ltd, Pratibha Medinox, Saint Gobain Gyproc India Ltd, Srishty Medical Pvt Ltd (SNG India), Shuter Enterprises India Pvt Ltd and many more. Alongside the expo, the H.P.I. Summit is a 3 day-long seminar that educates the industry on how to efficiently run a hospital and meet the growing demands of the healthcare consumers. It’s focused on bringing together experts from the domestic and global healthcare industry allowing them to exchange their ideas and opinions to facilitate the building and management of world class healthcare infrastructure in India. The H.P.I. Summit focuses on key topics around the broad themes below: S ustainable architecture and hospital engineering N ew trends in hospital planning and B est practices in healthcare The summit this year will witness 30+ eminent speakers which include Amit Mookim, Consulting Head - South Asia, IMS Health; Amit Varma, Founder, Critinext; Anand Pande, Country Director, OCD; Ashish Yadav, Head of Planning & Pre Construction, Synergy; Ashok Kakkar, Senior Managing Director,Varian Medical Systems International; Balamurgan N R, Director - Oncology Segment, GE Healthcare South Asia; C K Babu, Director & COO, dWise Healthcare IT Solutions; Gautam Khanna, CEO, Hinduja Hospital; Hiten Sethi, CEO, Hiten Sethi & Associates;

Joy Chakraborty, COO, Hinduja Hospital; Jaspreet Singh, Managing Director, Masters PMC; Lalit Varma, VP Project, Apollo Hospital; Nandini Bazaz, General Manager-Architceture, Hosmac India; Sumesh Sachar, CEO, KEF Infra; Uday Kumar, General Manager, Hosmac Dubai; Vivek Desai, MD, Hosmac and many others who will address the concerns of the Indian healthcare infrastructure and discuss the latest developments and technology in this field. Additionally, the summit will also host an architecture competition in association with Hosmac, the “Hosmac & H.P.I. Architecture Competition (HHAC)” that aims to help architecture students get an insight into healthcare design and functioning of healthcare centres. Why you should attend the summit: Get updated information on key issues that your organisation is concerned with Learn about new emerging trends and product developments in your industry Network with industry leaders and key decision makers Have your issues addressed on a specific topic by recognised expert speakers who are up-to-date with the latest developments in the field The learning environment encourages you to exchange your experiences, ideas and practices from your company with others, helping you optimise your learning In anticipation for the exhibition, Mr. Vikas Vij, Managing Director at H.P.I said,“Hospital Planning & Infrastructure (H.P.I.) being the only dedicated trade fair and summit in hospital infrastructure, planning and design sector, serves as the perfect platform for companies showcasing high end capital goods and trying to win tenders, drive sales and increase their market share in the healthcare build space. With more visitors attending from across India and globally this is a great platform to support the development of India’s healthcare manufacturers and hospital planners”.

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HYDROCOLLATOR

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INTERVIEW

â&#x20AC;&#x192; Manufacturer is a person, an enterprise, or an entity who himself makes a product through a process involving raw materials, components, or subassemblies, usually on a large mass production scale with different operations divided among different workers

Narendra Nath & Rajiv Nath Joint Managing Director

We wished to draw the attention of Prime Minister Shri Narendra Modi Ji towards the menace of unsafe injection practices and sincerely urge him to use his good office to launch â&#x20AC;&#x2DC;Rashtriya Swachh Injections Abhiyan

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

INTERVIEW If we have to compete with World's brand leaders you can't have anything less than they have. Medical Device Industry is Un-Regulated, as Forum Coordinator of AiMeD you are striving very hard for this Industry. So, tell us your progress in this area? To make medical devices you need to address patient safety and concerns of quality - discipline is needed and for ensuring this regulations are needed. There has been a long outstanding demand from AIMeD for a Separate Rule Book and Separate Law to regulate medical devices. Finally the Govt. has accepted to do so .The changes are being done in 4 phases. Step 1- Schedule MIII under D&C Act that provided regulations for Infrastructure and Equipment requirements for 3 types of medical devices was inadequate to regulate the 15 medical devices notified as Drugs. This did not have a provision of QMS or GMP and the regulators used to arbitrarily apply Schedule M for pharmaceutical to Medical Devices which was inappropriate, incomplete and incorrect leading to harassment. Now on request of AiMeD, Schedule MIII has been amended and notified on June 29th with the provision of QMS requirements and these are aligned to ISO / IS 13485 Standard. Step 2- In addition to the Schedule MIII revision, the balance Rules are being created to meet specific need of medical devices (and IVD) sector but under the current Drug and Cosmetic (D&C) Act as the Government decided not to amend the existing act as was initially being proposed by the Ministry of Health and Family Welfare(MOH&FW) by adding a chapter specific to medical devices . These New Rules will meet our requests of the delegation of Quality Management System(QMS) inspections to third party certification bodies . Additional medical devices may be regulated on being notified . The draft rules have been discussed with the key stakeholders and now these have been posted on MOH&FW website to gather public comments . Step 3- A separate Medical Devices Bill 2016 is under drafting by MOH&FW and will be on lines of earlier proposed amendment to D& C Act but hopefully better drafted with wider consultation . This is targeted to be issued for public comments in September and tabled to the Parliament by the winter session . Step 4- The current rules are being drafted keeping in mind the regulatory framework being proposed in the new revised Bill so that they would need minimal tweaking or change once the new Act is made . The main impact of the Bill, when enacted, would be that all devices would get regulated at one go within a defined transition period instead of being notified item by item that lead to confusion of terminology and applicability.

ensure they have to do minimal changes to documentation and processes to be compliant with these Rules .

What are the proposed legislations? Any comments?

The forthcoming bill later this year will cover the legislative part of regulations for which Govt. needs the backing of Parliament. In the case of Rules - the GoI can amend rules without pre-approval from Parliament. The major strategic elements are common with the Rules being drafted eg it permits GOI to regulate through 3rd party certification bodies and consider a 4 tiered risk-based proportionate regulatory controls of low, medium, medium - high and high risk with risk proportionate controls . Then there will need to be some penal disciplinary requirements but hopefully not like Pharma industry as we are an engineering industry .In essence, we welcome these separate set of proposed Rules as this has been our long outstanding request. There are however some challenges as these Rules need to be tweaked to enable the dual needs of patient safety and ease of doing Business to enable Make in India. In terms of key elements, they are now getting aligned to some or all the major economies. Eg. - Who will regulate? Here we had proposed Central Government to delegate to 3rd Party Certification Bodies as done in EU but find that GOI is willing to consider this for Class A & Class B devices but still wishes to use Medical Officers for inspection of Class C and D devices .We have to negotiate with GOI to consider voluntary 3rd Party certification for C & D high risk devices too.

Who will regulate the Indian National Medical Devices Regulator?

For the currently proposed Law we propose a Central Regulatory Authority to regulate the market access authorisation holder ,whether the MAAH is the manufacturer or a marketing company or an authorized agent of the overseas manufacturer) and the SLA regulates the Domestic Reseller – Wholesaler or Retailer or Healthcare Provider. Our Proposal, in Line with the Japanese Regulatory System, is as follows for being a manufacturer:  Required Value Condition (RVC): Value Addition of at least 45%,  Change of Tariff Sub Head (CTSH): There will be a change of the 8 Digit ITC Sub Heading of input for enabling ‘Substantial Transformation’ to produce output. Reason for Proposal : The definition of ‘Manufacturer’ as proposed by CDSCO in Draft Rules is in conflict with labeling defined in Weights & Measures Act and will be against ‘Make in India’ as it legalizes a pseudo manufacturer and allow traders/ Marketing Company to be called and labeled as manufacturer which is unfair for actual manufacturer who have toiled and invested in Greenfield projects. This What should manufacturers do to plan differently? definition of legal manufacturer coined in Europe has hurt Manufacturers should aim to be voluntarily self-compliant to the European domestic industry as complete products have ICMED voluntary certification or CE certification, this will been farmed out to manufacturers in China, India, Malaysia w w w.medegatetoday.com Sep-Oct 2016

INTERVIEW etc. and are still claimed to be made by a European company.  Govt. pulls back its Auto Approval Brownfield FDI Our proposal will enable regulation to be used strategically Policy & retains this for 100% Green Field Projects for for driving ‘Make in India’ as is being done by Japan for manufacturing, not trading - for ensuring choice of Indian boosting and protecting their domestic manufacturers and brands to Indian consumers. the labelling proposed by us is also in line with existing  Govt. assists creation of medical device parks in 'Weights and Measures Act'. Andhra Pradesh, Maharashtra, Gujrat & Karnataka and These are exciting times and hopefully, GOI will use the aids existing clusters in NCR, Gujrat & Maharashtra – opportunity to address Patient Safety needs as well as those Mumbai- Pune, with a ‘Revenue Support Model’ with needed to enable ease of doing business and drive 'Make in common testing and manufacturing Facility centre – No India'. capital subsidy, for making India hub of medical devices (started in A.P.). Tell us about AIMED initiatives and ICMED  Govt. creates a Medical Device Export Promotion Council Certification? and a Medical Device Import Substitution Council In absence of regulations, ICMED acts as a stepping under medical device department in a New Ministry of stone to create the eco system for the proposed regulatory Life Sciences to enable the balance of facilitation and framework with unbundled regulations and the certification regulation. provides credibility to Indian products and low-cost access to local certification rather than getting expensive overseas What is your take on Swachh Injections? certification for CE/ ISO 13485 etc. to address twin objective We had earlier this year urged Prime Minister Narendra of patient safety by voluntary self-regulations and respect for Modi to launch a nationwide “Rashtriya Swachh Injections Indian brand as a law to regulate all devices may not be there Abhiyan” to end the continued practice of unsafe injections for few years. which result in avoidable loss of life, serious health risks and  At central govt. level- Association of Indian Medical increased healthcare burden. Device (AiMeD) is working with various ministries and “Injections should be life giver, not life taker but unsafe government departments on the release of following key injection practices, mostly in the form of reuse of safety 8 policies, injections from dirty contaminated needles, continues to  Govt. to revise basic duty on import of medical devices be a serious threat to life of patients and health workers, to minimal 10% basic, as earlier (now 7.5% on Jan 19th casting shadows over public healthcare and immunization after concessional duty notification was withdrawn for 67 programme while raising individual and national healthcare items, rest 20 are pending). cost burden.”  Govt. to revise special additional duty on medical devices We are delighted by the announcement of the Injection to 4%, as earlier to enable business viability (done on Jan Safety Project at Mumbai by Government of India (GOI) and 19th, 2016 for 67 items, rest to be covered). World Health Organization (WHO) as a component and key  Govt. puts 2% Excise Duty (on MRP less than 50% intervention strategy to address blood borne infections like abatement) for addressing artificial inflation and enabling Hepatitis B&C. For WHO to hold its Global Conference in India and the presence of Shri Amitabh Bachan as the Brand consumer protection- pending.  Govt. introduces ICMED 13485 quality certification Ambassador to lead the campaign to decimate Hepatitis system as a precursor to medical device regulations for by 2030 is indicative of the importance being given to the enabling confidence in the quality of Indian products issue. Globally 400 million persons (approx 40 million in India) are estimated to be infected by Hepatitis and is the (Done on 15th March 2016). 2nd biggest killer disease after TB. Such a campaign would  Govt. releases a preferential market access policy for be a relatively lower cost but concomitant benefits in terms Indian manufactured product having over 45% value of health, safety and hidden savings in saving lives or loss addition and ICMED certification to boost domestic from income due to extra days on a hospital bed or taxpayers production of quality devices - awaited. money in treatment costs, would be humungous.  Govt. gives a 15% preferential pricing for Indian origin According to a WHO study, for every 1$ (67₹) invested in medical devices like in World Bank financed tenders to injection safety, savings are to the tune of over 14 $ (938₹) counter Chinese subsidy of 17%. in hidden cost of public welfare spending for treatment of  Govt. creates a separate Medical Device Regulations ailments. Act (based on international best practices) in India, This is substantial and to correlate one can compare with independent of D&C Act for ensuring patient safety- another WHO study- every 1$ (66.60 ₹)invested in intention announced - the opportunity to Make in immunization has been resulting in 16$ savings to a Nation. India and not allow traders to be incorrectly defined as Prevention is far less costly than Cure. Remember One manufacturers - underway. Syringe, One Injection. 62

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

2nd Edition

09/10/11 December 2016 Dr. Prabhakar Kore, Convention Center, Bengaluru

Indiaâ&#x20AC;&#x2122;s definitive exhibition & conference on products & services that aid the inclusion of differently abled

Highlights

Exhibitors from all over India and from abroad.

Many dedicated workshops covering all facets of rehabilitation.

Latest products and services on display.

Eminent speakers at the workshops

Active support from leading medical and trade associations

Training sessions for the differently abled.

Strong presence of both manufacturers / suppliers and end-users.

www.IndiaRehabExpo.com

NGO Partner

Media Partner

Organised By

For more details, contact Ritu Raj +91 9599389544 rituraj@infinityexpo.in

ASSOCIATION OF HEALTHCARE PROVIDERS INDIA

Consortium of Accredited Healthcare Organizations

Media Partners

Supporting Associations

Would you like to be a part of this High Proﬁle event? Get in touch with us if you would like to participate as a speaker or a panel

Want to be part of the exhibitor lineup? Let us know and we will do our best to oﬀer you package that meet your needs.

IBC

HEALTHCARE

3RD ANNUAL

22-24 NOVEMBER 2016

Millennium Hotel Sirih Jakarta, Indonesia

Delivering Accessible, Affordable and Quality Healthcare in Indonesia! SEE WHO IS ATTENDING! BY INDUSTRY

■ Public and Private Hospitals / Medical Centers / Clinics / Hospital Chains 50% ■ Healthcare Providers / Healthcare Networks 10% ■ Government 3% ■ Industry Associations / Academic Institutions 2% ■ Pharmaceutical Companies / Insurance Companies 5% ■ Banks / Venture Capitalists /Investors 5% ■ Medical Equipment / Medical Device / Technology Companies 10% ■ Solution / Technology Providers 10% ■ Distributors 5%

BY GEOGRAPHY

■ Indonesia 50% ■ Singapore, Malaysia, Thailand, Philippines 20% ■ China, Japan, Korea, Hong Kong and Taiwan 10% ■ Europe, USA 15% ■ Australia, New Zealand 3% ■ RoW 2%

KEY THEMES IN 2016 Government Initiatives, Hospital Facilities, Healthcare Plans and Current Updates Business Models: Evolving Healthcare Models, Partnership Models and Public-Private Case Studies Universal Healthcare Coverage and BPJS Scheme Updates Focus on Indonesia’s Healthcare Workforce: Talent Development, Retention & Medical Education Indonesia’s regional Change Management in Hospitals Hospital and healthcare facilities Technology Adoption Case Studies Upcoming Hospital Facility Expansion and Investments in Indonesia Remote Healthcare Provision and Increasing Access to Care Balancing Quality, Affordability and Safety in Indonesian Healthcare Planning, Resources and Operational Efficiency Telemedicine and Remote Consulting: Regional Success Stories in Asia

PRE-CONFERENCE FOCUS DAY | 22 NOVEMBER 2016 | 9:00am - 4:00pm

Indonesia’s Healthcare Market Access Supporting Sponsor:

Media Partners:

P46318MGT

Produced by:

Healthcare Supporting Association: International Marketing Partner:

+65 6508 2401

www.indonesia-healthcare.com

Winners of

ongratulates

Business Excellence awards nd

22 August 2016

Lounge area Hall no.7 A, B, C, Pragati Maidan, New Delhi

Fastest Growing Company in Herbals

Innovations in Cosmetic Formulations

Afflatus Pharma

Ancalima Lifescience Ltd.

Export Driven Cosmeceutical Company

Best Sports Nutrition Manufacturing Company in Western Region

Most Trusted Herbal Brand of the Year

Individual Excellence in Pharmaceutical Servicing

Fixderma India Pvt. Ltd.

Zandopa (Emami Limited)

Influx Healthcare

Mr. Mukesh Jain

Fastest Growing PCD Company in North

Biochemix

Fastest Growing Pharma Co. in Partnering & Outsourcing

Iscon Life sciences

Pharma Entrepreneur of the Year

Zee Labs

Pharma Marketing Company - North

Biomax Biotechnic Pvt. Ltd.

Fastest Growing Pharma Company Mid Segment

Estrellas Life Sciences Pvt. Ltd

Brand of the Year

Cadila Pharmaceuticals Limited

Innovation in Process and Formulation Development

Finecure Pharmaceuticals Ltd.

Pharma Company with Ethical Marketing Practice

Arlak Biotech

Company of the Year in Customer Satisfaction and Distribution Network

Aster Medipharm Pvt. Ltd.

Emerging Pharma Company - North

Emerging Formulation Company

Ridley Life Science Pvt. Ltd.

Synokem Pharmaceuticals Ltd.

Fastest Growing Pharma Company - PCD

Pharma Company for Best Marketing Practices

Company of the Year â&#x20AC;&#x201C; Mid Segment

Zenon Healthcare Ltd.

Zenacts Pharma

Zota Healthcare Ltd.

Fastest Growing Pharmaceutical Manufacturer of the Year

Pure and Cure Healthcare Pvt. Ltd.

Company of the Year-PCD

Cubit Healthcare

Best Pharma Franchise Company - North

Elisa Biotech

Winners 2016

ASIA

MEDITECH HEALTHCARE

Leading the way in MEDICAL & HEALTHCARE excellence

ORGANIZED BY

February 2017 The Gujarat University Convention & Exhibition Centre, Helmet Circle, AHMEDABAD, GUJARAT, INDIA

KNOWLEDGE PARTNER

supported BY

MEMBER OF

MEDIA PARTNER

For Further Detail:

RADEECAL COMMUNICATIONS

+91 99788 51007, 98251 20200

+91 79 26401101/02/03,

expo@mthasia.com, mthasia@mthasia.com

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YELLOW PAGES

Ambulance Equipments

diagnostic & lab products

Shree Balaji surgical pvt ltd A/002, Ruchi CHS, Grd Flr Devidas Lane Borivali (W) Mumbai - 400103 M: 9820430338, E: sbsjaipur@gmail.com

ANESTHESIA EQUIPMENTS Allied Medical Ltd.

T: 0124-4111444 akhand enterprises

G- 12, Shivlok House 1, Commercial Complex, Karampura, New Delhi- 110015 9350445559, 9717445559 akhandenterprises@gmail.com Medion Health Care Pvt Ltd

201, Shiv Industrial Estate, K.B.B. Marg Marg, Chinchpokli (E),Mumbai-12, M:9987642222 sales@medion.co.in

Autoclave & Sterilizers Jaiveer Surgical emporium

1570, Bhagirath Palace, Delhi-110006 T: 011- 23866065, 2386066, M: 9810880087 jainco.jain@gmail.com Creative Healthtech Pvt. Ltd.

M: 9811339989 Drager Medical Pvt. Ltd.

T: 022-40843826 Saras Life Solution

M: 9923455413 Haribharath Equipments Pvt. Ltd.

T: 022-25666869

Blood Pressure Apparatus Lab Hosp International

M: 9324152433 Remi Sales And Engineering Ltd

T: 022- 40589888 Sanlar Imex Services Pvt. Ltd.

M: 9833192894

construction & interior work ASG INTERIORS

MOB: 9911301556

diabetic care Products

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Anand Bhuvan Ground Floor 84-A, Princess Street T: 022-66379370 76

www.m e d e g a t e t o d a y. c o m Sep-Oct 2016

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biogene Diagnostics & Surgicals Deals in:

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Surgical house,44,Mission compound,Ajmer Road,Jaipur T: 141 2373125, 2368568

GLOVES Shree Balaji Surgical Pvt. Ltd. A-002, Ruchi CHSGround Floor, Devidas Lane Borivali (W), Mumbai 400103 Ph.: 022- 28954442 Nulife Global Medical Devices Pvt ltd

B6,Byculla Service Indl. Premices, D.K. Marg, Sussex Road,Byculla, Mumbai-27 T: 2374 8371/2/3

HEALTHCARE PRODUCTS Shree Balaji Surgical Pvt. Ltd. A/2, Ruchi CHSGround Floor, Devidas Lane Borivali (W), Mumbai 400103 Ph.: 022- 28954442

HOME CARE Easy Care Group

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Nulife Global Medical Devices Pvt ltd

Email: manojvtuli@gmail.com

Shree Balaji Surgical pvt ltd

1-B-30,Lalita Shashtri Nagar, Behind Kalpatru Shopping Centre, Jaipur-16 T: 0141- 2309675

ECG Equipments Hygeia Incorporation

S No. 16, Navghar Bldg 59/ 60, Poonam sagar Complex Mira Road (E) Mumbai 401107 M: 9967064947 Nasan Medical Electronics Pvt. Ltd.

Rangoli Ist floor.,opp Karve Statue Kothrud Pune-411038 M: 8237032389

Endoscopy Instruments

Healthware Pvt. Ltd.

B6,Byculla Service Indl. Premices, D.K. Marg, Sussex Road,Byculla ,Mumbai-27 T: 022-2374 8371/2/3 Shree Balaji Surgical pvt ltd

1-B-30,Lalita Shashtri Nagar,Behind Kalpatru Shopping Centre, Jaipur-16 T: 0141- 2309675

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1211,Tower-2, Pearls Omaxe,Netaji Subhash Place, New Delhi-110034 T: 011 42488393 Fortis Escorts Heart Institute & Research Centre

serene Tower 8-2- 623/A Rd No. 10, Banjara Hills Hyderabad -500034 T: 040-23318229

Okhla Road, New Delhi-25 M: 91 11 4713 5000

Helios Endovision

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1/1, Sahkar Niwas, Tekri Bunglow, nr.3 Petrol Pump Old Agra Road, Thane- 400602 M: 9820276976 Om Surgicals

65, Unique. Est., Nr.Jammunadas, Opp jawahar Talkies, Mulund (W)Mumbai-400080 T: 022- 25670626

Manaipal Hospitals

Pushpawati Singhania Research Institute

Press Enclave Marg, Sheikh Sarai, Phase-II, New Delhi â&#x20AC;&#x201C; 110 017 Tel: 011 30611900

YELLOW PAGES

HOSPITAL CONSULTANCY

Medical Equipment

Nurse Calling System

Hosconnn

Technocare Medisystems

CR Medisystems Pvt. Ltd.

6, Chaithanya Complex Site 1, 17th Cross, Sir MV Nagar T.C. Palya Main Road, Bangalore M: 9845208778, Email: info@hosconnn.com

C/1310-11,New Bombay Market, Umarwada, Surat- 395010 T: 261 2332042,6569308

Mumbai, India. Tel : 91-022-23094416, 23004930 E-Mail : medisystems@gmail.com

DDF Consultants 501, B-9, ITL Tower, Netaji Subhash Place, Pitampura, New Delhi-110034 T: 011-47400500 Hospiteck Healthcare Consultancy

Bangalore T: +91-9739708532

Hindustan Syringes & Medical Devices Ltd.,

174, Sector - 25, Ballabgarh - 121 004 (Haryana) Tel : +91 129 4289000, Fax : +91 129 4061164 & 2233242 E-mail: info@hmdhealthcare.com, hmduk@hmdhealthcare.com

MOdular- Operation Theatre

Six Sigma Star Healthcare Pvt. Ltd.

Sai Sumeet Appliances

New Delhi T: 011 25324000 E-mail: sixsigmahealthcare@gmail.com

Hyderabad M: 08099119595

Health care Institution Global Institutte of Healthcare Management

6 sigma house, 10A, Phase -1, Najafgarh New Delhi-43 T: 011 2532 4000,4001

HOSPITAL FURNITURE Godrej & Boyce Manufacturing company ltd.

Pirojshanagar, Vikhroli, Mumbai- 400079 T: 022- 67965656 Jaiveer Surgical Emporium

1570, Bhagirath Palace, delhi-110006 M: 9810820087 Janak Healthcare Pvt. Ltd.

kalpataru Point, Unit No. -12 1st floor, sion (E) Mumbai-400022 T:022- 49153000

Hospital Garments Kaustubh Hospital Garments

4- 401, Vanrai Colony, Opp Nirlon, off W.E. Highway Goregaon (E)Mumbai-400065 M: 9869051352

ICU Equipments

Monitoring Equipments & Accesso Afford Medical Technologies Pvt. Ltd.

230, 2nd Main Road, Sainikpuri Secunderabad-94 T: 040-32908880 Drager Medical Pvt. Ltd.

Gold line Business Centre, Link Road Malad (W) Mumbai-400064 T: 022- 40843826 Medion Healthcare Pvt. Ltd.

201, Shiv Industrial Estate, K.B.B. Marg Chinchpokli (E) Mumbai-12 T: 022-23771737 Nihon Kohden India Pvt. Ltd.

308, Tower- A, Spaz Edge, Sector- 47, Sohna Road Gurgaon- 122002 T: 0124-4931000

Neonatal Pediatric Intensive c Bird Mediteck

109, 110, NidhiIndl Est, Shankar Industrial Complex No. 2, Waliv, Vasai, Thane-08 T: 0250-3212729

operation theatre equipment

operation theatre Light Magnatek Enterprises

97, SVC Indl Est., Balanagar, Hyderabad-500037 T: 040-65501094

Rehabilitation Product &AIDS Vissco Rehabilitation AIDS Pvt. Ltd.

517, Tulsiani Chambers, Nariman Point Mumbai-400021 T: 022-43330300

Shoes Cover Dispenser BIO-X

5th floor, Span center, South Avene Santacruz (w) Mumbai-400054 M: 9820355995

Software and IT Solution Schrack Seconet AG

T: 124 414150 Kodak Alaris

www.kodakalaris.com

SURGICAL BLADES Ribbel International Ltd

20th Mile, Jatheri Road, P. O. Rai Near Rai Industrial Area Sonepat Haryana 131029 M: 8053111016, 8053111011 SURGICAL BLADES

Niraj Industries Pvt. Ltd. 177, Sector - 25, Ballabgarh - 121 004 (Haryana) Tel : +91 129 4289000, Fax : +91 129 4061164 & 2233242 E-mail: info@hmdhealthcare.com, hmduk@hmdhealthcare.com

Agora Climate Control system

Unit No. C-1/2/3/, Sagar Sangam Ind. Est., Sativali Vasai (E) Thane-24 T: 0251-2872193 Bird Meditech

109, 110, Nidhi Ind. Est., Nh No. 8, waliv, Vasai (E) Mumbai- 401208 T: 0250-3212729

Philips India Ltd.

Magnatek Enterprises

9th Flr, DLF, 9b, DLF, Cyber city, DLF Phase- 3 sec 25, Gurgaon-122002 T: 0124- 4606000

97, SVC Indl Est.Balanagar, Hyderabad-500037 T: 040-65501094

UROLOGY Ribbel International Ltd

20th Mile, Jatheri Road, P.O.RaiNear Rai Industrial Area Sonepat Haryana 131029 M: 8053111016, 8053111011, sales@ribbel.com

X- Ray Equipment Allengers

S.C.O 212-213-214, sector 34,Chandigarh - U.T 160 022 (India) T: 172 3012280-84 w w w.medegatetoday.com Sep-Oct 2016