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InnoHEALTH magazine - Volume 3 Issue 2 - April to June 2018 - High resolution


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InnoHEALTH magazine, started in July 2016 is a magazine which brings forth innovations in the healthcare sector from all around the world.

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InnoHEALTH magazine - Volume 3 Issue 2 - April to June 2018 - High resolution

  1. 1. 1 Volume 3 | Issue 1 | Jan-Mar 2018
  2. 2. 2 Volume 3 | Issue 1 | Jan-Mar 2018
  3. 3. 3 Volume 3 | Issue 1 | Jan-Mar 2018 Dear Friends, India is a country of diversity with 1.3 billion population of which 70 per cent resides in villages and have access to 30 per cent of medical assets of the country. Poverty is a significant issue of the country, despite having one of the fastest-growing economies in the world, clocked at an economic growth of 7.6 per cent in 2015. It is estimated that 23.6 per cent of Indian population, or about 276 million people, live below $1.25 per day. As Health is a state sub- ject-there is lot of mismatch in states like Kerala and Punjab have best health indicators, while Uttar Pradesh is the poorest as per the NITI Aayog report. Indian government spends approx. 1.5 per cent of its GDP on health sector and plans to make it 2.5 per cent which is much less than many developing coun- tries while the USA has dedicated 16 per cent of its GDP. India is riddled with very basic public health issues leading to disease burden. Keeping this in mind, Prime Minister Narendra Modi has launched six initiatives: Open Defecation free country by 2019, Swachh Bharat Mission, National Health Policy 2017, Digital India with ehealth, medical device manufacturing and door-to-door screening of chronic diseases. The healthcare needs holistic approach which depends on multiple factors. The present government has taken many positive steps including launching of National Health Policy 2017 after the gap of 12 years. It has announced many initiatives like health insurance of people who cannot afford basic healthcare and upgrading of health infrastructure. The regulation of medical devices have been brought out and is applicable w.e.f January 1, 2018 ending uncertainty of medical device manufacturers having global market of 220 billion US dollar. Challenges bring opportunities such as Indian healthcare market is around US$ 100 billion while it is expected to grow US$ 280 billion by 2020. The healthcare IT market is US$ one billion and is expected to grow 1.5 times by 2020. There is requirement of 7 lakh hospital beds which need investment opportunities of 25-30 billion US dollar. We need to bring innovations in hospital planning,de- vices, diagnostics, drugs and use of technology to reduce healthcare delivery cost and yet quality. We failed targets of Health for All by 2000, National Rural Health Mission, and Millennium Development Goals and now launched Universal Health Coverage; its success would depend on providing healthcare facilities and strict account- ability. We need to focus on primary health care and customise our healthcare delivery system by learning from experiences of other countries. The concept of Diagnosis Related Group (DRG) making financial package for group of dis- eases which is known to patients, providers and third party payors should be considered by improving deficiency found in its execution by the USA. The various schemes of present government are appreciable but success would depend on strict monitoring, corporate hospitals have high cost and many unethical practices are reported every day in media. Public hospitals to National Rural Health Mission have not delivered as required because of cor- ruption, lack of resources and application of management practices. The need is not old wine in new bottle but strict control in implementation of various schemes launched. NewIndia,DigitalIndia,Make India,InnovateIndiainmaking a‘Healthy’India Dr VK Singh Editor in Chief & MD, InnovatioCuris
  4. 4. 4 Volume 3 | Issue 2 | April-June 2018 Dear Readers, A big ticket announcement of medical insurance cover for ten crore poor people in India recently has triggered a major debate whether the world’s largest healthcare scheme, being billed by many as Modicare on lines of Obamacare can be a runaway success or just an another show? Skepticism apart, any such initiative has to be religiously adopted by well-intentioned governments. Such stepsthoughposemassiveburdenonexchequerononesidebutvaultingaspirationsanddireneedofhealth protection of huge chunk of populace on the other side of scale cannot be rubbished either. So, sooner the better! Now only option left is to implement the initiative in right spirit at the earliest. UnionHealthMinisterJagatPrakashNaddahoggedlimelightaftertheannouncementintheBudget2018- 19. Prime Minister Narendra Modi addressing party’s law makers on the budget day directed Mr. Nadda to get on the job immediately in close rapport with his two ministerial colleagues and others to ensure its successful implementation. Official machinery is working on full gear to unspool the mega initiative. Our magazine contacted the minister and he firmly reiterated that the government was committed to its implementation and the resource details are being worked while addressing intricate nifty gritty. The Health Minister also has given a bird eye view of India’s Healthcare scenario and government plans to meet the challenges. To keep our readers abreast of researches being done world over on health related problems, we are carrying various studies for benefit of readers. We have also highlighted innovative practices adopted in various zoos to save endangered animals. In this issue, we are carrying acknowledged good work done by the erstwhile Allen Forest Zoological Garden. The magazine is striving hard to highlight innovations in the health sector while focusing its binoculars on latest developments in the health sphere. The magazine salutes a doctor who ensured safe delivery of a baby on Air France flight (mid air) recently. Interestingly, a study by PEW offers a new insight of science issues coverage. It says Americans offer a mixedevaluationofhowwellthenewsmediacoverscience,butmoresaythatoveralltheydoagood,rather thanabadjob.Whendelvingmoredeeply,however,Americansshowskepticismintheaccuracyofgeneral newsoutlets,insteadplacingmoretrustinspecialtyinformationsources.And,whilemanyseeproblemsin coverage of scientific research stemming from a range of players, when asked to choose, most Americans saythebiggerproblemstemsfromhowreporterscoverscientificresearchthanfromthewayresearchers publish their findings. The situation is no different in other countries, and mostly people prefer trusted information from niche brands, and we are sure that we will be able to provide trusted information with support of all stakeholders. Thanks. Neeraj Bajpai Consulting Editor The Message AMAZING! TEN CRORE POOR PEOPLE TO GET HEALTH INSURANCE
  5. 5. 5 Volume 3 | Issue 1 | Jan-Mar 2018
  6. 6. TRENDS Latest Innovations! 12 30 min of sunbath a week can make infants’vitamin-D sufficient 18 Iron and zinc deficiencies can be addressed through simple measures 20 ISSUES World's Largest Health Scheme Unspooled in India 24 Software as Medical Device? 30 Health Card of Indian States 32 IIT Kanpur braces up to thwart cyber attacks in India 34 Kanpur Zoo adopts innovative methods for animal health management 36 RESEARCH Insomnia – A Short Communication Study 40 Skin patch to detect‘silent’ heart attacks 42 Meet world’s first cloned monkeys-- Zhong Zhong Hua Hua 44 High Blood Pressure : 130 mm Hg is the new reading 46 Rotating night shifts may trigger Type 2 diabetes 48 WELL BEING Infertility no more a curse; scientists develop new artificial ovary prototype 50 Caution! Energy drinks not safe for kids 51 Insurance needs to go global: Expert 52 Why head face pain keeps you furious? 54 PERSONA A Right Gesture Saves Life! 56 Minds of Medalists behind their Medals! 58 WOMEN’S CORNER Workplace harassment has adverse consequences 62 Arunachalam Muruganantham: A Tale of Menstrual Hygiene Movement 63 NEWSCOPE How crucial are business models for the healthcare organisations?68 6 Volume 3 | Issue 2 | April-June 2018 66
  7. 7. 7 Volume 3 | Issue 1 | Jan-Mar 2018
  8. 8. Editor-In-Chief: Dr. V. K. Singh Executive Editor: Sachin Gaur Editors: Alok Chaudhary Dr. Avantika Batish Nimisha Singh Verma Consulting Editor Neeraj Bajpai Sr. Designer Suraj Sharma, Ritu Versha Advisors Konda Vishweshwar Reddy, Member of Parliament, India Amir Dan Rubin, Executive Vice President, United Health Group, USA Thumbay Moideen, Founder President, THUMBAY Group, UAE Prof Prabhat Ranjan, Executive Director, Technology Information Forecasting and Assessment Council, India Global Editorial Board Dr Shailja Dixit, Chief Medical Officer, Scientific Commercialization, Fellow of Health Innovation Technology Lab, USA Ronald James Heslegrave, Chief of Research, William Osler Health System, Canada Dr Ogan Gurel, Chief Innovation Officer, Campus D, South Korea Dr Chandy Abraham, CEO and Head of Medical Services, the Health City, Cayman Islands Dr Sharon Vasuthevan, Group Nursing Quality Executive at Life Healthcare Group, South Africa Dr Kate Lazarenko, Founder and Director, Health Industry Matters Pte. Ltd, Australia Major General (Retd) A K Singh, Advisor, Telemedicine and Health Informatics, Rajasthan, India Dr. Sarita Jaiswal, Ex-Research officer at University of Saskatchewan, Saskatoon, Canada and now in Delhi, India Printed and Published by Sachin Gaur on behalf of InnovatioCuris Private Limited. Printed at Lippe Scan Private Limited 89, DSIDC, Okhla I, Okhla Industrial Area, New Delhi, Delhi 110020. Editor: Sachin Gaur. DCP Licensing number: F.2.(I-10) Press/2016 © InnovatioCuris Private Limited. All rights reserved. Neither this publication nor any part of it maybe reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission from InnovatioCuris Private Limited. Disclaimer: Readers are requested to verify and make appropriate enquires to satisfy themselves about the veracity of the advertise- ments before responding to any published in this magazine. Sachin Gaur, the Publisher, Printer and Editor of this maga- zine, does not vouch for the authenticity of any advertisement or advertiser or for any the advertiser’s products and/or services. In no event can the Publisher, Printer and Editor of this magazine/ company be held responsible/liable in any manner whatsoever for any claims and / or damage for advertisements in this magazine. Authors will be solely respon- sible for any issues arising due to copyright infringements and authenticity of the facts and figures mentioned in their articles. InnoHEALTH magazine is not liable for any damages/copyright infringements. 8 Volume 3 | Issue 2 | April-June 2018
  9. 9. 9 Volume 3 | Issue 1 | Jan-Mar 2018 Business Line, Outlook India, Down to Earth, Biotech News, Scroll, Biospec- trum etc. I have also written for Indi- an Express, and Indiabioscience. Dr. Swati Subodh, Consultant, India I really enjoyed reading InnoHealth. It gave a great insight on various topics. It is not only meant for healthcare pro- fessionals but anyone and everyone as it covers vast topics. I personally liked the Well-Being and the Trends section; it is indeed one of its kind magazine on healthcare innovations in India. I look forward for the next issue. Vishal Singh, General Manager, Hyatt Regency, Pune, India InnoHealth has been instrumental in bringing out the various new ideas in the field of healthcare and wellness; the magazine in itself helps new in- novators come in the limelight, catch the fancy of investors who have tough time marketing their ideas and find- ing the right kind of people to back them. The healthcare experts also find wonderful new ideas to implement through this. It is indeed a path break- ing in its idea, concept and design and a great platform that helps connects all like minded people as well. Divya Joshi Senior Manager HRD, ITDC, Delhi, India It's heartening to note that India's kh- ichdi has also made a foray in health magazine. We khichdi eaters are rel- ishing history of this food item. Hope such articles will be seen routinely in the magazine which I had bought from a bookshop in Delhi. Arun Agnihotri Bareilly, India I appreciate your magazine for high- lighting medical aspect of smart phones impact on brain. Such revealing re- search really opens our eyes. We should be regular to highlight such studies which hardly get much exposure in rou- tine mill media platforms. I think even one worth reading item pays back us the subscription cost. We hope to get magazine every month rather than af- ter a long wait of three months. P K Pandey Ghaziabad, India It was great to go through an article about your IC club meeting that gave a bird eye view of fair tricks while seek- ing funds for dream projects from international funding agencies. The article was worth reading and very in- formative for aspiring first generation entrepreneurs. We will try to be part of the IC and hope the next issue must be having another meeting detail. Dr. Neha Dhami, London, UK Readers Feedback A Brief Review on InnoHEALTH My congratulations to you and your excellent team for an out- standing program. I really enjoyed the talk by Prof. Paul and Sachin. The concept of the Business Canvas Model was beautifully illustrated. I wonder as to whether the use of the business canvas model can be expanded to do a test run of all projects (for profit and the non-profit ones). For e.g my wife runs a program for children of class eight and nine of various schools in Nagpur, private and govt. on emotion- al intelligence and emotional sobri- ety. My father, on the other hand, is a part of a team of senior citizens, called Jan Akrosh, who stand in the blister- ing sun at mid-day at traffic lights at various places in Nagpur, requesting motorists and two-wheeler drivers to follow traffic rules politely. I would also like to express my deep gratitude and thanks to you and your team for giving me the oppor- tunity to this network and interact to people interested in this field like Prof Venkat, Prof Dash, Sachin, Harsh Desai, Abhinav Singhal, Ankit and of course, the very knowledgeable, Pro- fessor Paul Lillrank and his colleague Paulus Torkii. Dr. Nirbhay Karandikar, Nagpur, India Dear Editors, I recently purchased my first copy of InnoHealth and I was impressed with the content and the information. Con- gratulations! I understand that you are interested for writers to contribute to your mag- azine. I am writing to you in this con- text to express my interest. I am a scientist by education and an entrepreneur by choice. I also write for various platforms. Regular col- umns on StartUps for NRDC's Inven- tion Intelligence NanoDigest on one hand; and scientific articles features for India Science Wire, on the other, through which my work has been pub- lished in various platforms like Hindu Volume 3 | Issue 2 | April-June 2018 9
  10. 10. 11 Volume 3 | Issue 1 | Jan-Mar 2018
  11. 11. About 50% of the cancer patients in India are under the age of 50. Apart from other things, this alarm- ing rate of young cancer victims has also created concerns about pres- ervation of their fertility. Cancer treatment can affect fertility in both men and women. In young women, cancer treatment including chemo- therapy and radiation can cause infertility. In men, exposure of the pelvis to radiation and use of che- motherapy drugs can lead to DNA damage in the sperms. However, ex- perts indicate that the recent tech- nologies and advancements in the IVF sector like egg freezing, embryo freezing, donor eggs, donor em- bryos, donor sperms, sperm freez- ing etc. can help cancer patients to keep their fertility window open for a longer time. With the use of these techniques, cancer victims not only have a better rate of survival but can also think about raising a child and starting a family. Fertility preser- vation is a procedure to secure fertile eggs, ovar- ian tissue, or sperm be- fore a patient undergoes cancer therapy. These can enable the patient to reproduce when they have overcome cancer. The success rate of these methods is about 30% to 40% in younger men and women. In those above the age of 30 and 35, fertility potential of the eggs and sperm may decrease thereby lower- ing the success rate. It is important to consult a doctor as soon as they are diagnosed with cancer and find out the possibili- ties of treatment. Many cancers are detected very early in life often in the prime years for fertility. Cancer survi- vors can now produce their own biological child through fertility preservation. Unfortunately, fer- tility preservation services are rarely offered or even discussed with the patient before starting cancer therapy. A RAY OF HOPE FORYOUNG CANCER SURVIVORS A new technology that promises enhanced vision clarity An increasing number of studies and toxicological evidence shows that burning of solid fossil fuels is associated with cataract forma- tion. Harmful environmental toxic compounds cause “ocular irrita- tion” or irritation in the eyes. Un- refined cooking oil when burned under high temperature emits ben- zene and formaldehyde. The toxic air results in trachoma, glaucoma and cataract.But various viable and effective technological alternatives are now available for cataract pa- tients. Intraocular lenses (IOLs) replace the natural eye lenses after cata- ract surgery for enhanced vision. Previously through conventional multifocal lenses, the quality of vision would get reduced due to division of light. These lenses re- portedly caused high incidences of halos and glare, which are bright rings and sharp light which in- terferes with vision, and the fre- quent need of wearing glasses did not completely fulfill the purpose of getting the lenses implanted In recent times, technological ad- vancement made significant im- provement making it possible for patients to resume a completely normal life post cataract surgery with nearly perfect vision. On the other hand, a new technol- ogy known as ERV IOL commended as the next revolution in eye care gives a perfect balance of contrast, light, near, far and even intermedi- ate vision. Doctors are constantly underlin- ing the utter need for awareness around eye care. Regular checkups, especially for diabetic patients are imperative. ERV IOL promises to be the next revolution in eye care and providing respite from eye ailments. EXTENDED RANGE OF VISION INTRAOCULAR LENSES LATEST INNOVATIONS! TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 12 Volume 3 | Issue 2 | April-June 2018
  12. 12. 13 Volume 3 | Issue 1 | Jan-Mar 2018 The Startup raises $ 3.1 million to boost applications that empowers people to take control of their health Healthi is a 2014 found technolo- gy-backed preventive healthcare plat- form that uses analytics and machine learningtohelpusersmakesmartchoic- es about their health to avoid chronic diseases. This Predictive analysis-based healthcare Startup has recently raised funding of $3.1 million led by VC fund Montane Ventures, which it intends to use to boost applications that empow- ersit’suserstounderstand,engagewith and take control of their health. Co-Founders RekuramVaradharaj and Krishna Ulagaratchagan ofHealthi have been accorded the ‘Entrepreneur of the Year in Product - Healthcare’ category at the seventh edition of the Entrepreneur India Awards 2017 for their efforts in preventive healthcare. Their endeavour is to conveniently provide community an access to the best healthcare practitioners and raise awareness about the prevention and management of lifestyle diseases. Healthi is proving to be India’s fastest growing digital preventive health start- up and is revolutionising the preventive healthcare market by combining scien- tifically validated predictive analytics, machine learning technology, contem- porary design, strong partnerships with healthcare majors and cutting-edge re- search. It has made significant strides within a short span of time and now serves users in over 130 Indian cities. For its health check offering, it has tied up with most of the leading diagnostic and imaging laboratories, clinics and hospitals in India, thus offering 400+ high-quality venue options for users. HEALTHI HELPS USERSTO AVOID CHRONIC DISEASES As healthcare organizations contin- ue to move toward value-based care, there is a growing need for intel- ligent solutions to help address the big- gest challenges radiologists face in im- proving outcomes, simplifying data and insights gathering, lowering the cost of healthcare delivery, and enhancing pa- tient and staff satisfaction. Philips India Ltd, a leading health tech- nology company,never fails to bring something new for the medical frater- nity and so it recently announced the launch of its new range of next gener- ation imaging solutions namely Access CT 32 Slice, Ingenia Prodiva 1.5T MRI and Dura Diagnost F30 Digital X-ray which are customised products sup- ported by artificial intelligence to help radiologists bring about better and faster diagnosis with more accuracy and also improved and better patient care and experience. These imaging solutions have user-friendly interfaces which areeasy to operate and take less- er preparation time for patients. Their other positives are high image quality, streamline workflow and reduce vari- ability thus providing better diagnos- tic outcomes for radiologists.All these Imaging System solutions have their own unique features. Access CT offers flexibility, exceptional image quality, and diagnostic accuracy with lower to- tal cost of ownership. Ingenia Prodiva MR is built on proven dStream digital broadband technology, present in over 2000 installations worldwide which can accelerate patient throughput with a simplified Breeze Workflow. It has an intuitive user interface enhanced by guided and standardized examination procedures helps perform routine MRI exams from day one. DuraDiagnost F30 Digital X-ray provides ease-of entry into the world of digital radiography with a price to performance ratio that’s hard to beat. It also helps simplify the path to clinical decision-making, improves patients’ outcomes and reduces the ra- dio-diagnosis department’s burden. INNOVATIVE IMAGING SOLUTIONS BY PHILIPS Volume 3 | Issue 2 | April-June 2018 13
  13. 13. Abbott, one of India’s leading healthcare companies recently launched the latest Insertable Cardi- ac Monitor (ICM) across the country which is also the world’s first smart- phone compatible ICM to aid phy- sicians who can remotely monitor their patients for even the most dif- ficult to detect cardiac arrhythmias including irregular heartbeats, atrial fibrillation etc. It is designed to continuously moni- tor a patient’s heart rhythm and proactively transmit information via Bluetooth to Abbott’s dedicated mo- bile app for this, allowing physicians to follow their patients remotely and accurately diagnose arrhythmias that may require further treatment. This device provides a win-win situation for both the doctor and the patient. For doctors the device allows for effective management of patients by diagnosing patients having in- frequent but potentially fatal epi- sodes of cardiac arrhythmias while enhancing patient compliance through smartphone connectivity. For patients it provides a new way to get monitored for abnormal heart rythms while staying connected to their doctors remotely and engaged in their healthcare. Once implanted just under the skin in the chest during a quick, minimal- ly-invasive outpatient procedure this ICM continuously monitors heart rhythms to detect a range of cardiac arrhythmias. It is also the slimmest ICM available today. It is the size of two paper clips, stacked on top of each other. While the ICM continu- ously monitors for abnormal heart rhythms and transmits data to a pa- tient’s doctor, the app also allows pa- tients to track symptoms proactively, sync their data with their clinic at any time, and view their transmis- sion history without having to con- tact their clinic to confirm successful data transfers. Patients can also re- cord their symptoms such as fainting spells or heart palpitations in the app on their smart phones, to comple- ment the information being moni- tored by the device. The device has already received the CE Mark and USFDA approvals and is available in the EU, U.S.A and Austra- lia. The insertable cardiac monitor is extremely useful as it provides early diagnosis and timely treatment to events which could be catastrophic in nature if left unattended. This device for sure is taking cardiac monitoring to a whole new level. INDIA’S FIRST SMARTPHONE COMPATIBLE INSERTABLE CARDIAC MONITOR 14 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  14. 14. 15 Volume 3 | Issue 1 | Jan-Mar 2018 Internet of Medical Things (IoMT) is a collection of medical devices and applications that connect to health- care IT systems through online com- puter networks. These include medi- cal devices equipped with Wi-Fi that allow machine-to-machine commu- nication. Though the rise of the IoMT has improved processes and patient care but has also resulted in an in- creased number of vulnerabilities. Healthcare IT security teams in In- dia must be prepared to face possible cyber-attacks on connected medical devices in healthcare facilities, as well as home health devices. These devices have not been designed with security as its top concern since de- velopers are primarily focused on its functionality and ease of use. According to Allied Market Re- search, the global Internet of Things (IoT) healthcare market is expected to reach US$136.8 billion by 2021, registering a CAGR of 12.5 percent between 2015 and 2021, driven by easy availability of wearable smart devices and decreasing cost of sen- sor technology. Cyber-attacks will continue to be a threat for healthcare providers and likely in greater vol- umes going forward. The resulting overall downtime, incident response and legal fees, as well as long-term reputational damage can cost hospi- tals millions and keep them from pro- viding high-quality care to patients. The best course of action is to ensure every hospital has a robust and inte- grated security strategy. Keeping this in mind Fortinet offers certain strategies for healthcare or- ganizations to prepare against immi- nent IoMT cyber-threats: A dedicated team needs to be put into place to un- cover the latest threat intelligence so that real-time threat and mitigation updates can be made expeditiously, before cybercriminals take advan- tage of any weaknesses in connected IoT devices or the critical services they provide. An organisation needs to ensure that their security posture is up-to-date with prevention and de- tection measures as well as develop and maintain good network hygiene which includes systematic patching and updating of vulnerable systems and replacing outdated technologies that are no longer supported. IoMT: PROTECTION AGAINST CYBER-THREATS Volume 3 | Issue 2 | April-June 2018 15 BABYGOGO It allows parents to connect with paedi- atricians Babygogo, a Delhi-based child health- care startup founded by Siddharth Ahluwalia, Sowrabh N.R.S. and Sa- tyadeep Karnatiin 2016, offers childcare help and medical advice to moth- ers. The startup provides advice, across a range of child care issues, from experienced moms and medical practitioners through its mobile app. It mimics the sense of touch in case of an amputate hand Europe based scien- tists have developed the first portable bionic hand that mimics the sense of touch in case of an amputate hand. The prosthetic hand has sen- sors to detect whether an object is soft or hard. The computer-processed in- formation is relayed to the brain via electrodes implant- ed in the upper arm. PORTABLEBIONICHAND
  15. 15. A PROCEDURE FOR WEIGHT LOSS IN INDIA Obesity continues to be a chal- lenge in all parts of the world, an epidemic which is spreading with an immense pace. Many procedures have been in vogue to tackle this issue in the past decade. Lately Global Hospitals, a multi super specialty tertiary care hospital has successfully per- formed first of its kind, procedure on a 45-year-old who was almost 30 kilos overweight as per the body mass index count. This pro- cess involves reduction in the size of stomach using an endoscopic suturing device. The Food and Drug Administra- tion (FDA) has approved the use of a device commonly termed as ‘over stitch’ which is meant for su- ture perforation. This procedure is intended to facilitate weight loss in obese and adult patients. The outpatient procedure usually takes less time, also the recovery time is less since there’s no inci- sion involved, in most of the cas- es the patients are discharged on the same day. The device does not alter the stomach’s natural anato- my in any way, however; patients are advised to follow medically supervised diet and exercises in future. While this procedure does not guarantee to replace the conven- tional method, however; it can be treated as an option while dis- cussing to perform it on the pa- tient. Since bariatric surgery is expensive and needs post surgery maintenance, this new procedure can be a good option. The benefit being that this procedure is pri- marily performed through an oral cavity rather than through the ab- domen like in the case of bariatric surgeries. It’s absolutely safe and effective to the patients in order OVER STITCH TELE-MEDICINE SYSTEMTO STRENGTHEN HEALTHCARE SERVICES IN INDIA Till date, the Indian Govern- ment has taken various steps to strengthen the telemedicine network to provide healthcare services in the country especially rural India. Some of the efforts in this direction which need a mention are : National Medical College Network (NMCN): With the purpose of e-Edu- cation and e-Healthcare delivery, 50 Government Medical Colleges have been selected to interconnect, riding over NKN (National Knowledge Net- work). For this purpose, one National Resource Centre (NRC) with required centralized infrastructure and 7 Re- gional Resource Centres (RRCs) have been established. State Telemedicine Network (STN): The States/UTs have been supported under National Health Mission (NHM) under Program Implementation Plan (PIP) for strengthening State Telemed- icine initiatives under STN to create reliable, ubiquitous and high speed network backbone, all available and future networks. So far,10 states have been finan- cially supported. Ministry of Health Family Welfare (MoHFW) in collabora- tion with Department of Space has setup Telemedicine nodes at some pilgrim places for health awareness, screening of non-com- municable disease (NCD) and for provid- ing specialty consul- tation to the devotees visiting holy places like Maa Vindhyavasini Mandir, Vindhyachal Dham, Mirzapur (UP), Sheshnag, Amarnath Pilgrimage (JK), Pampa Hospital, Ayyappa Temple at Sabrimala (Kerala) and Kashi Vishwa- nath Temple, Varanasi, Uttar Pradesh Tele-Evidence: The tele-evidence fa- cility streamlines the process of doc- tors appearing in courts in response to summons and saving their time not only for patient care but also for medical education and research. The project is operational in Post Grad- uate Institute of Medical Education Research (PGIMER), Chandigarh since March 2014. 16 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  16. 16. 17 Volume 3 | Issue 1 | Jan-Mar 2018 17Volume 3 | Issue 2 | April-June 2018 SUPERMEAT The Startup raises $ 3 million Supermeat is developing lab-made chicken meat and is working on the meat-making process which involves extracting cells from a chicken and feeding right nutrient to produce mus- cle and fat. The start up has recently raised $ 3 million in seed funding. NATIONAL BIOMATERIAL CENTRE INAUGURATED In India, it is mainly the living donors who are donating organs and only about 23% of the organ transplant is being done with organs obtained from the cadavers. There is a need to promote cadaver or deceased organ donation rather than relying on liv- ing donors in order to avoid the risk of organ trading and also to avoid the inherent risk to the health of the living donor. In view of this, National Biomaterial Centre (National Tissue Bank) was inaugurated in February at the National Organ and Tissue Trans- plant Organization (NOTTO) with the objective of filling up the gap between ‘demand’ and ‘supply’ as well as ‘qual- ity assurance’ in the availability of var- ious tissues.There is a need to spread awareness in the community at large, that a living person can save the life of only one person but a deceased or cadaver organ donor can save up to 9 lives by donating vital organs. The activities of the Centre will in- clude coordination for tissue pro- curement and distribution, donor tissue screening, removal of tissues and storage, preservations of tis- sue, laboratory screening of tis- sues, tissue tracking, sterilization, records maintenance, data pro- tection and confidentiality, quali- ty management in tissues, patient information on tissues, develop- ment of guidelines, protocols and standard operating procedures, train- ings and assisting as per requirement in registration of other tissue banks. SOMNOX—A SLEEP ROBOT The Startup can improve a user’s sleep through its breathing rhythm. A sleep robot has been de- veloped by a Netherlands –based startup Somnox, which it claims can improve a user’s sleep through its breathing rhythm. The technology makes the pillow-like device fall and rise which provides the user with a breathing sensation. The device can help one fall asleep effortlessly, get back to sleep if one wakes up inthe middle of the night and helps one feel safe while sleeping. The app- connected device can also play the sound of heartbeats and music which automatically turns off after the user falls asleep.
  17. 17. I t used to be a routine practice in India to massage infants and give them a sunbath. But changing lifestyles in recent decades have confined kids to in- doors. This has led to emergence of Vitamin D deficiency as a major problem among infants. A study from Delhi has suggest- ed an estimate for the minimum duration for which infants need to be exposed to sunlight every day to achieve sufficient levels of vita- min-D in their body. Doctors at the University College of Medical Sciences, New Delhi en- rolled 100 infants and asked their mothers to record the time, dura- tion, and the body area exposed during sunbath every day starting 6 weeks of age. The study found that an exposure of as low as about 30 minutes of sunlight per week with about 40% of the child’s body exposed to the sunlight can help achieve adequate vitamin-D status at 6 months of age. The researchers also found that the ideal time to give the sun- bath is between10 AM and 3 PM. “This small intervention can help improve levels of vitamin D in infants without the need for supplements or formula feed, and can possibly benefit more than 16 million babies born in the country every year,” Dheeraj Shah, profes- sor of pediatrics at the University College of Medicine Sciences, New Delhi, who is a co-author of the study said. The study took into account fac- tors like skin colour of infants and season of sunbath. About 90% of the mothers in the study were themselves vitamin D deficient. Mothers who were on vitamin D supplements were excluded so that the study results remained unaffected, researchers explained. The study has been published in journal Indian Pediatrics. “We are planning further studies with a larger group of infants to test it as an intervention therapy”, said Piyush Gupta, corresponding author of the paper. Vitamin D is synthesized in the skin when ul- traviolet rays from the sun convert a molecule,7-dehydrocholesterol, on the skin into an inactive form of the vitamin. This enters the blood circulation and is converted to its active form in the liver and kidney. Several studies over the years have shown that more than 50% of the Indian population is vitamin D deficient. This is a matter of con- cern especially for infants because Vitamin D is important for calcium absorption, normal growth and development, and maintenance of bone health and hair follicles. In- sufficient vitamin D levels cause lethargy, irritability, and a pre- disposition to infections. Extreme Deficiency of vitamin D can cause rickets which results in malforma- tion of leg bones. Umesh Kapil, professor of Gastro- enterology at the All India Institute of Medical Sciences (AIIMS), New Delhi, who is not connected to the study, felt that the proposed strat- egy may not be feasible in winters when the temperature remains low. While agreeing with Kapil, Shah said, “We have reported that for the winter months if the child is fully clothed with only face and hands are exposed, the required sunbath is calculated to be two hours per week or approximately 17 minutes per day.” Ramesh Agarwal, professor of Pediatrics AIIMS New Delhi, sug- gested that randomized control trials must be done to test this intervention as a therapy. He also highlights the need to evaluate the safety of sun exposure in relation to hyperthermia, burns and skin cancer in infants. (Shared from India Science Wire) By Bhavya Khullar The study found that an exposure of as low as about 30 minutes of sunlight per week with about 40% of the child’s body exposed to the sunlight can help achieve adequate vitamin-D status at 6 months of age. 30minofsunbatha weekcanmakeinfants’ vitamin-Dsufficient 18 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  18. 18. 19 Volume 3 | Issue 1 | Jan-Mar 2018
  19. 19. I ndia is one of the leading ex- porters of cereals. It is the sec- ond largest producer of rice and fruits in the world. Overall, the country is self sufficient in food pro- duction. Yet iron and zinc deficien- cies are widespread even amongst well-nourished children. A recent study has found that it could be because cereals, tubers and legumes, which are the major con- stituents of a staple diet, contained a class of substances called phytates in high amounts. Phytates are con- sidered ‘anti-nutrient’ as they attach themselves to the iron and zinc in the food and make them unavailable to the body for its use. This low ‘bio- availability’ is the main cause of de- ficiency of iron and zinc in the Indian population. But, one should not eliminate the phytates from the diet. Phytates help in fighting off cancer and age-related changes in the body. Iron and zinc deficiencies can be addressed through simple measures By Monika Kundu Srivastava The researchers have recommended modify- ing eating habits and cooking practices. South Indian cooking, for instance, follows a pro- cess of fermentation, soaking and germina- tion which reduces the phytate content. 20 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  20. 20. 21 Volume 3 | Issue 1 | Jan-Mar 2018 Volume 3 | Issue 2 | April-June 2018 21 A recent study has found that it could be because cereals, tubers and legumes, which are the major constituents of a staple diet, contained a class of substances called phytates in high amounts.
  21. 21. The researchers have recommend- ed modifying eating habits and cook- ing practices. South Indian cooking, for instance, follows a process of fer- mentation, soaking and germination which reduces the phytate content. Likewise, a simple intervention such as taking a piece of guava or Indian gooseberry (amla) fruit after food or while taking iron tablets would dou- ble the availability of iron and zinc in the body. In addition, they suggest, mea- sures like minimal milling, intake of vitamin C, heating, and enzy- matic treatment of grains with phytates enzyme and consuming curds, yogurts and pro-biotic cul- tures to maintain acid environ- ment in the gut as well as genetic improvement of food crops may enhance bioavailability of iron and zinc. Further, non-vegetarian foods can also make available more iron and zinc to the body. The study, conducted by research- ers at Indian Institute of Horti- cultural Research, Bengaluru, has found that the country as a whole requires 8,170 tonnes of iron and 4,412 tonnes of zinc in the food to meet nutritional iron and zinc re- quirements of the entire popula- tion. Availability of iron from plant and animal food sources is esti- mated at 10,939 tonnes per year and that of zinc at 6,335 tonnes per year. In other words, there is enough supply of iron and zinc through food sources in the country. The intake of the two micronutrients is also ade- quate. Agricultural crops such as cereals, pulses, oilseeds and sugar contrib- ute the major share of the require- ments, at 82.8% for iron and 78.6% for zinc. This is followed by the animal husbandry sector, including milk and milk products, meat, mut- ton, beef, pork, chicken and eggs, which account for 3.9% iron and 11.7% zinc. The horticultural sec- tor (including fruits, vegetables and nuts) contributes 12.9% iron and 9.1% zinc to national produc- tion. The fisheries sector is at the tail end, providing 0.42% iron and 0.62% zinc. The researchers have published a report on the study in a recent issue of journal Current Science. Dr. A.N. Ganeshamurthy, leader of the research team, said, “There was a need for research efforts to focus on methods to reduce phy- tate content of Indian foods to en- hance bioavailability. This should be at the forefront of nutritional programmes rather than trying to improve the quality or yield of crops. “Before a new variety is released for cultivation by a breeder, the In- stitute/State/National-level variety release committees must take into account the issue of absorption of iron and zinc. Efforts to improve the quality and yield of crops or the ‘biofortification programmes’ will prove to be a failure, if they do not address the issue of bioavailability of nutrients. Further, we must do all we can to ensure a healthy soil and a healthy production environment, with good agricultural practices,” he added. Iron deficiency, which may or may not result in anaemia, leads to sub- stantial loss in physical productiv- ity in adults. Iron deficiency during pregnancy is associated with mater- nal mortality, pre-term labour, low birth weight and infant mortality. In children it affects development and increases the likelihood of sickness. Highest prevalence of anaemia is seen in children around 15 years of age, in pregnant women and elderly people. Zinc deficiency, in turn, may cause hair loss, affect the taste and smell, among other things. Dr. Ganeshamurthy conducted the study in collaboration with his col- leagues, Dr. D. Kalaivanan and Dr. B. L. Manjunath. (Shared from India Science Wire) Dr. A.N. Ganeshamurthy, leader of the re- search team, said,“There was a need for research efforts to focus on methods to re- duce phytate content of Indian foods to en- hance bioavailability. 22 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  22. 22. 23 Volume 3 | Issue 1 | Jan-Mar 2018
  23. 23. By Neeraj Bajpai World's Largest Health Scheme Unspooled in India A pparently bracing up to showcase India’s achievements in Health Sector management during general elections due within a year and a half, Union Health and Family Welfare Minister Jagat Prakash Nadda, who recently hogged limelight during mega health plan announced in the Union Budget 2018-19, and also played prominent role in the ruling party activities at the national and states’ level, says the NDA government is committed to advancing Universal Health Coverage (UHC) agenda. World Health Organisation Director-General Dr Tedros Adhanom Ghebreyesus has recently said that India should have UHC. In an interaction with InnoHEALTH magazine, the Minister asserts that the government would her- ald a new era of healthcare and the plan announced in the Union Budget would be implemented with full sincerity. It will take a few months to roll out all nitty-gritty’s of implementation. He dismisses apprehensions of those sceptical of the plan in wake of massive funds required for the implementa- tion of the world’s largest healthcare plan. There would be no laxity in the successful implementa- tion of the scheme and it had nothing to do with elections but it is a well-thought out plan to ensure holistic healthcare to common people. Massive machinery has started churning out plans to bring the scheme to the ground reality. Informatively, a plan to provide health cover to 50 crore people has been proposed in the current budget 2018-19 and is being viewed as precursor to the UHC. WHO’s definition of UHC — one of the goals of sustainable development — includes financial risk protection (against medical expenses), access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The National Health Policy 2017 approved last year envisages the attainment of the highest pos- sible level of health without anyone having to face financial hardship as a consequence. The Min- istry of Health Family Welfare (MoHFW) has taken concrete steps to reduce the Out of Pocket Expenditure (OOPE). Mission Indradhanush, one of the largest global public health initiatives, was launched in 2014. In its four phases till date, Mass Immunisation (MI) has successfully reached over 25 million chil- dren in over 528 Districts. The focus is also on increasing the basket of vaccines. Since 2014, Rota- virus vaccine, Pneumococcal Conjugate Vaccine (PCV), and the Measles-Rubella (MR) vaccine, and also the JE vaccine for adults have been launched. Under Pradhan Mantri Dialysis Program (PMDP) 1.43 lakh patients have availed free services from 1,069 Dialysis Units and also under Free Drugs and Diagnostics Program; Affordable Medi- cine and Reliable Implants for Treatment (AMRIT) outlets nearly 47 lakh patients have benefitted and through purchase of subsidized medicines from AMRIT Pharmacies To provide comprehensive primary care, the Government has announced of transforming 1.5 lakh sub-health centres to Health and Wellness centres i.e. MoHFW is now moving towards provision of comprehensive primary care through the Health and Wellness Centres. The MoHFW has initiated universal screening of common Non Communicable Diseases (NCDs) such as diabe- tes, hypertension and common cancers at the sub-centre and Primary Health Centre (PHC), which will enable the strengthening of preventive and promotive health, improve patient referral and access to secondary care. 24 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  24. 24. 25 Volume 3 | Issue 1 | Jan-Mar 2018 EXCERPTS: Q. Please share some major highlights of 2017 in promoting health initiatives? I am proud to say that there have been several achievements. Few on top of my mind are-- -Release of the new National Health Policy 2017 after a gap of 15 years, the Passing of HIV AIDS (Prevention Control) Act, 2017, the Mental Healthcare Act 2017, and the most recent National Medical Commission Bill, 2017 being approved by the Cabinet. Besides these policy and leg- islature decisions, the MoHFW launched some major health initiatives, starting with the most recent National Nutrition Mission 2017 with Ministry of Women and Child Development (WCD), the intensified Mission Indradhanush. After the success of MI, the annual rate of increase of full immunisation coverage has increased from 1% to 6.7 % during the two rounds. We in- creased the basket of Universal Immunization Programme (UIP) with introduction of new vac- cines i.e. Rotavirus vaccine, MR vaccine and the PCV. The PMS- MA (Pradhan Mantri Surakshit Matritva Abhiyan) has helped detect more than 5 lakh high risk pregnancies. Similarly, Mo- HFWs Rashtriya Bal Swasthya Karyakram (RBSK) has screened 11.7 crore children, 43.4 lakh children were referred to sec- ondary tertiary facilities, 27.8 lakh children availed services in secondary tertiary facilities. The MoHFW also launched the Mission Parivar Vikas (MPV) in 146 Districts of 7 states for substantially increasing the ac- cess to contraceptives and fam- ily planning services in Districts with Total Fertility Rate (TFR) of 3 and above. The MoHFW announced trans- formation of sub-health centres to Health and Wellness Centres (HWCs) to expand the basket of services of primary care to make it comprehensive. The HWCs are expected to provide preventive, promotive, rehabilitative and curative care for a package of services related to reproductive, maternal, newborn, child, and adolescent health (RMNCH+A), communicable diseases, non- communicable diseases, oph- thalmology, ENT, dental, men- tal, geriatric care, treatment for acute simple medical conditions and emergency and trauma ser- vices. In addition, the recent- ly launched population-based Screening of Diabetes, Hyperten- sion and Common Cancers (Oral, Breast Cervical) represents a massive step in identifying and addressing the risk factors at the community level itself. More than 150 Districts are being tak- en up in 2017-18. There have been global achievements in terms of India being declared Infective Tracho- ma free. The MoHFW has also signed MoUs with Italy, Morocco and Cuba. Q. What challenges you aimed to achieve next year? Provisioning UHC and to restrict the growing burden of Non – Com- municable diseases. We have ini- Besides these policy and legislature deci- sions, the MoHFW launched some major health initiatives, starting with the most recent National Nutrition Mission 2017 with Ministry ofWomen and Child Development (WCD), the intensified Mission Indradhanush. Volume 3 | Issue 2 | April-June 2018 25 TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER
  25. 25. tiatives in place to manage both. Q. How to address the fund crunch issue? There is no fund crunch. In 2017-18 Union Budget, the health allocation was increased by 27.7% and the MoHFW is committed to 2.5% of GDP to healthcare in a phased man- ner under the National Heath Policy 2017. So I don’t foresee any fund crunch. Q. Your comments on private sec- tor role in healthcare? Are you satisfied with their contribution? Private sector engagement is a part of new National Health Policy 2017 for a reason. They have a very sig- nificant and important contribu- tion to the country’s health services landscape. In terms of real time support, we are satisfied with their contribution to the Pradhan Mantri Swasthya Matritva Abhiyan (PMS- MA) and provisioning dialysis ser- vices through PPP under the Prad- han Mantri Dialysis Program. Q. Pl throw light on Universal Health Coverage initiatives? There are several, however, I can list a few:- • In 2017-18, the MoHFW an- nounced transformation of sub- health Centres to Health and Wellness Centres (HWCs) to ex- pand the basket of services of primary care to make it compre- hensive. The HWCs are expected to provide Preventive, Promo- tive, Rehabilitative and Curative Care for a package of services related to RMNCH+A, Commu- nicable diseases, Non-Communi- cable diseases, Ophthalmology, ENT, Dental, Mental, Geriatric Care, treatment for acute simple medical conditions and emer- gency and trauma services. The indicative package of services envisaged is: a. Care in pregnancy and child- birth b. Neonatal and infant health care services c. Childhood and adolescent health care services d. Family planning, contraceptive services and other Reproductive Health care services e. Management of Communicable diseases: National Health Pro- grammes f. Management of Common Com- municable Diseases and General Out-Patient care for acute simple illnesses and minor ailments g. Screening and management of Non-Communicable diseases h. Screening and basic manage- ment of mental health ailments i. Care for common Ophthalmic and ENT problems j. Provision of basic dental health care k. Geriatric and palliative health care services l. Trauma Care (that can be man- aged at this level) and Emergen- cy Medical Services 26 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  26. 26. 27 Volume 3 | Issue 1 | Jan-Mar 2018 The Health and Wellness Centre (HWC) will deliver comprehen- sive primary healthcare using a team based approach and would be led by a mid-level service provider with a primary healthcare team in- cluding ANMs, ASHAs, and AWWs, of the sub-centre area. Altogether, 4000 sub-centres are targeted to be transformed to HWCs by March 2018 and 1.25 lakh HWCs by March 2022. So far approval has already been given for 3871 HWCs. • National Programme for Pre- vention Control of Cancer, Diabetes, Cardiovascular dis- eases and Stroke (NPCDCS)--- -In order to prevent and con- trol major NCDs, the MoHFW is implementing the NPCDCS in all states across the country with the focus on strengthen- ing infrastructure, human re- source development, health promotion, early diagnosis, management and referral. As on date, the programme is un- der implementation in total 436 Districts, with setting up of NCD clinics in 435 District Hospitals, and 2145 Communi- ty Health Centres. Cardiac Care Units have been set up in total 138 Districts and Day Care Cen- tres for Cancer Chemotherapy have been set up in 84 Districts. Provision has been made under the programme to provide free diagnostic facilities and free drugs for NCD patients attend- ing the clinics at the District and CHC levels. • Population-based screening for Diabetes, Hypertension and Common Cancer (Oral, Breast Cervical)---The recent- ly launched Population-based Screening of Diabetes, Hyper- tension and Common Cancers represents a massive step in identifying and addressing the risk factors at the community level itself. More than 150 Dis- tricts are being taken up during 2017-18. As on September 2017, approvals given for about 170 Districts in 16309 sub -cen- tres and screening has been initiated in about 60 Districts, 12 states, 2 UTs and 20,15,474 people have been screened. Q. How the Ministry ensures safe pregnancy in rural/remote and tribal areas where access to hos- pitals is not that easy? Our entire Reproductive Child Health (RCH) programme and Na- tional Health Mission is focused around this issue. To list a few viz.- a. Janani Suraksha Yojana (JSY) b. Janani Shishu Surakha Karyakram (JSSK) c. HBNC/HBIC (Home Based Neo- natal Care/Infant Care) d. National Ambulance Service (108/104) e. Tribal Birthing/Waiting Homes f. Pradhan Mantri Swasthya Ma- tritva Abhiyan (PMSMA) Q. What message you want to share with community in their fight against dengue and chikun- gunya? I want to focus solely on preven- tion viz. preventing water logging around house and other measures which we keep reiterating through our regular Information, Educa- tion, and Communication (IEC) campaigns. This requires commu- nity partnership and ownership. Q. What has been the status on new AIIMS being constructed across the country? The Government has been at the forefront to strengthen the tertiary care and as such six new AIIMS are functioning and six will come up in due course. Q. Pl throw light on MoU signed with Morocco. What will be the major gains? The main areas of cooperation in- clude the following: a. Non-communicable diseases, including child cardiovascular diseases and cancer b. Drug Regulation and Pharma- ceutical quality control c. Communicable Diseases d. Maternal, child and neonatal health e. Hospital twinning for exchange of good practices f. Training in administration and management of health services and Hospitals Volume 3 | Issue 2 | April-June 2018 27 TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER
  27. 27. Q. Generic medicines: How to ad- dress availability issue? The MoHFW recently issued a draft gazette notification making it mandatory for Pharma compa- nies to carry generic name of drugs on packs that is at least two fonts larger than the brand name. This clause will be a legal provision as a rule under the existing Drugs and Cosmetics Act and any violation will be punishable under the provisions of the law. The Ministry has sought public comments on the draft, after which it is likely to become part of the drug law. Also, issued orders to the Medi- cal Council of India (MCI), state governments and all central gov- ernment hospitals asking them to ensure that doctors write prescrip- tions with generic names of medi- cines in legible hand writing. In last three years, the govern- ment has capped prices of around 700 essential medicines. It has also capped prices of stents and is working to make drugs for crit- ical diseases like cancer and heart disorders available through vari- ous schemes. It has also launched several programmes to make free drugs and diagnostics available under the National Health Mis- sion. Also our AMRIT stores provi- sion generic drugs. 105 pharma- cies have been set up across 19 states for providing medicines for Diabetes, CVDs, Cancer and other disease at discounted pric- es to the patients. A total of more than 5000 drugs and other con- sumables are being sold at upto 50% discounts. As on 15th No- vember 2017, 44.54 lakh patients benefitted from AMRIT pharma- cies. The value of drug dispensed at MRP is Rs 417.73 crore and savings of Rs. 231.34 crore from AMRIT stores thereby reducing their out of pocket expenditure. Q. Doctors’ shortage: What mea- sures should be put in place to address the concern? • The MoHFW has granted per- mission for establishment of 83 new medical colleges in the last 3 years including 31 in govern- ment sector. The country has today 479 medical colleges with more than 67,000 MBBS seats. • The Ministry has taken various measures to facilitate the setting up of new colleges viz. a. norms for medical colleges have been rationalized b. requirement of minimum area of land has been dispensed with in notified urban areas. c. Companies have been allowed to set up medical colleges. • The MoHFW is implementing a Centrally Sponsored Scheme namely “Establishment of new The ministry has sought public comments on the draft, after which it is likely to become part of the drug law. 28 Volume 3 | Issue 2 | April-June 2018 TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE
  28. 28. 29 Volume 3 | Issue 1 | Jan-Mar 2018 Finance Minister Arun Jaitley recently has announced two major initiatives in health sector, as part of Ayushman Bharat programme. This is aimed at making path breaking interventions to address health holistically in primary, secondaryandtertiarycaresystems,coveringbothprevention and health promotion. THE INITIATIVES ARE AS FOLLOWS:- (i) HealthandWellnessCentre:-TheNationalHealthPolicy,2017 hasenvisionedHealthandWellnessCentresasthefoundation of India’s health system. Under this 1.5 lakh centres will bring healthcare system closer to the homes of people. These centres will provide comprehensive healthcare, including for non-communicable diseases and maternal and child health services. These centres will also provide free essential drugs and diagnostic services. The Budget has allocated Rs. 1200 crore for this flagship programme. Contribution of private sector through CSR and philanthropic institutions in adopting these centres is also envisaged. (ii) National Health Protection Scheme:- The second flagship programme under Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization. This will be the world’s largest government funded healthcare programme. Adequate funds will be provided for smooth implementation of this programme. In order to further enhance accessibility of quality medical education and healthcare, 24 new Government Medical Colleges and Hospitals will be set up, by upgrading existing district hospitals in the country. This would ensure that there is at least 1 Medical College for every 3 Parliamentary Constituencies and at least 1 Government Medical College in each state of the country. medical colleges attached with existing district/referral hospi- tals” • 58 Districts in 20 States/UT have been identified under this Scheme to establish new Medi- cal Colleges attached with exist- ing district/referral hospitals. Out of these, 56 have been ap- proved till date. • Out of 56 approved medical col- leges, 8 are functional and 29 have applied for MCI’s permis- sion to start new medical col- leges from the academic year 2018-19. • Increase of PG seats: • In January, 2017 the teacher student ratio was revised in government medical colleges in clinical subjects and conse- quently around 3,000 PG seats were added as a one-time mea- sure. • 700 seats were added in normal course of permission under IMC Act. Combined with increase of DNB seats, the ministry could achieve an increase of nearly 5800 PG seats in 2017. • The country has today around 38,000 PG seats including Dip- lomate of National Board (DNB). Q. Please throw light on Mental Healthcare Act which was passed in 2016. What steps the govern- ment planned to create aware- ness on this? • The Act adopts a rights-based statutory framework for mental health in India and strengthens equality and equity in provision of mental healthcare services in order to protect the rights of people with mental health prob- lem to ensure that they are able to receive optimum care and are able to live a life of dignity and respect. • The Act strengthens the institu- tional mechanisms for improv- ing access quality and appropri- ate mental healthcare services. • The Act increases accountability of both government and private sectors in delivery of mental healthcare with representation of persons with mental health problem and their care-givers in statutory authorities such as Central and State Mental Health Authority. • The most progressive features of the Act are provision of ad- vance directive, nominated representative, special clause for women and children re- lated to admission, treatment, sanitation and personal hy- giene; restriction on use of Electro-Convulsive Therapy and Psychosurgery. • Decriminalization of suicide is another significant facet of the Act, which will ensure proper management of severe stress as a precursor for suicide attempts. Volume 3 | Issue 2 | April-June 2018 29 TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER
  29. 29. T he tectonic shifts in tech- nology are transform- ing human life in ways unfathomable just a few years ago. Health-tech and med- tech are touching our lives contin- uously through a number of ways - from simple wearable devices to complex invasive devices; sim- ple AI software which can predict and sense to complex AI software which can diagnose; sensors and other hardware devices including the mobile phone with ever in- creasing computing power. Some of these have made human lives so de- pendable on these devices, gadgets, software and in some cases these are dumping human intelligence. We witnessed software wherein by looking at a camera on the mobile phone, the software can predict the heart rate and many other vitals. What if human intelligence gave way in believing the reading as true? The software or the camera is not a medical device and hence outside the purview of regulations usually applicable for medical de- vices. Can we ignore the risks? If so, should software be treated as a medical device? Software as Medical Device (SaMD) A broadly accepted definition of a SaMD is the one issued by the In- ternational Medical Devices Regu- lation Forum (“IMDRF”); currently Australia, Brazil, Canada, China, Eu- rope, Japan, Russia, Singapore and the United States of America are member countries to this Forum. This definition has been adopted by the Food and Drugs Administra- tion (FDA) in the United States, The Medical Device Directive adopted in the European Union in 2010, and in major countries such as Austra- lia, Canada and Japan. The term “Software as a Medical Device” is defined as software intended to be used for one or more medical pur- poses that perform these purposes without being part of a hardware medical device. It includes an in vitro diagnostic medical device. It must be capable or running on a computer platform that is not of a medical purpose, and should not need a hardware medical device to achieve its purpose. It can be inter- faced or used in a combination with other devices, but cannot be used to drive a hardware device. Mobile applications meeting this defini- tion are also considered as SaMDs. The medical purpose‟ that it must intend to serve can be diagnostic, preventive, investigative, life sus- taining, for treatment of disease or injury, disinfection, control of con- ception or purely informative. In some jurisdictions, aids for persons with disabilities, devices for assist- ed reproduction and devices in- corporating animal and/or human tissues are also recognized. A SaMD Software as Medical Device? By Manas Ingle TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 30 Volume 3 | Issue 2 | April-June 2018
  30. 30. 31 Volume 3 | Issue 1 | Jan-Mar 2018 can also be a means to suggest miti- gation of a disease or provide aid to diagnosis. There are further guide- lines on the definition of changes to SaMDs- they can be adaptive, corrective or preventive in nature. The manufacturer of SaMD would be a natural or legal person who has the intention for the software to be used under his/its name. It would not include a distributor or the manufacturer of an accessory. The final legal responsibility lies with the manufacturer unless it is specifically imposed on another party by the country’s regulatory authority. Putting them to use SaMDs are now available in abun- dance in the Indian market. Both foreign manufacturers as well as Indian manufacturers are intro- ducing so many forms of SaMDs. This includes use of artificial intel- ligence, IoT, general software etc. Interesting, many SaMDs are en- joying high adoption rates not only by early users but continued users. The glaring point is that there is no legislative framework or guidance policy which works as a guiding principle for the SaMD manufactur- ers or at least as a self-regulating piece of legislation, in India. The Medical Devices Rules, 2017 which has come into effect from January 1, 2018 has now defined medical devices and has made a clear dis- tinction between drugs and medi- cal devices, but still this definition does not include SaMDs or software as a medical device. Interestingly, the draft Medical Devices Rules, 2016 on basis of which the Medi- cal Devices Rules, 2017 have been formalized included software in the definition of medical device. With the market being flooded with AI, IoT, general software, wearable, and wellness and customized medi- cal devices, software as a medical device as a whole should be con- sidered with equal importance in the sector. Curiously, the definition of medical devices under Foreign Direct Investment policy includes software. REGULATIONS The IMDRF has worked extensively in setting guiding principles for gov- erning SaMD and has put in place a regulatory structure for how the SaMDs shall be governed, regulated, clinically evaluated and how the data shall be evaluated and then used by the SaMD. While India has not yet included any software or apps in its regulation purview, countries like U.S.A, Singapore, Australia, EU and Japan has issued guidance docu- ments to make the app developers aware of what might be subjected to regulation. The common theme that determines the classification is the level of risk that these apps pose to the consumers. For example, let’s take an app which allows a user to take ECG test by putting their fin- gers on an external device which is connected wirelessly to the smart- phone. It checks the electrical activ- ity of the heart. Such apps may be considered as risky and be subject to regulation, since the belief is that any incorrect analysis may hamper a user’s treatment. However, the Gov- ernment authorities need to strike a balance while assessing these risks so that not all apps need to be cer- tified under law, so that innovation is not hampered. It is indeed a very fine balance. General wellness apps or products such as apps tracking and assisting in maintaining healthy body weight, or products are gener- ally kept out of the purview of law versus apps which tracks and as- sists in say monitoring blood sugar or other vitals or treats specific health issues or provides guidance for treatment of specific illnesses. The whole purpose to bring these apps under regulation is that there is a certain amount of rigour before the apps are released to the market and there is onus and responsibility on these makers. It should enable the app developers to be mindful of how is the product or app is ad- vertised, claims as well. To protect consumers, certain jurisdictions, like Singapore, have mandated the manufacturers/ app developers to put a clarification statement on their product or on their apps. This statement should clearly state that this app or product is not intended to be used in a diagnosis, monitor- ing, management or treatment of any disease. Keeping all the inno- vation in health-tech space, India should provide guidance on SaMDs. The regulatory framework in India for medical devices is by the Central Drugs Standards Organization wide- ly known as CDSCO. The new Medi- cal Devices Rules, 2017 are compre- hensive and now extensively covers almost 351 medical devices and about 247 in-vitro medical devices it still does not cover SaMDs. Given the increased use of mobile technol- ogy and awareness, guidelines on SaMDs could contribute to improv- ing the affordability and availability of healthcare, including rural India, which has a huge user base. Gradual rigour in legislation will allow India to meet increased need, according to when resources for monitor- ing and enforcement become more available. India already follows the IMDRF regulations with respect to clinical trials and the clinical evalua- tion of medical devices, with respect to documents, licensing and safety standards. It is important for the legislation to allow the industry to grow and achieve its potential, especially in country like India where there is a need for better point of care medi- cal solutions but at the same time provide unambiguous guidance. A good starting point would be a self- regulating mechanism with a set of standards, methods and proce- dures, clinical evaluation process. Such guidance would help improve innovation as well and guide the nascent Indian SaMD industry. (The author is a qualified lawyer who takes a keen interest in how tectonic shifts in tech- nology is impacting healthcare delivery. The intersection of law, innovation, interaction with man and machine excites him. Ma- nas works with NovoJuris Legal deeply in AI, IOT, health-tech, med-tech, devices and more in the healthcare segment) TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER Volume 3 | Issue 2 | April-June 2018 31
  31. 31. A Government report on comprehensive health in- dex in India states that larger States like Kerala, Punjab, and Tamil Nadu have been ranked on top in terms of over- all performance, while Jharkhand, Jammu Kashmir, and Uttar Pradesh are the top three ranking States in terms of annual incremen- tal performance. Jharkhand, Jammu Kashmir, and Uttar Pradesh showed the maximum gains in improvement of health outcomes from base to reference year in indicators such as Neonatal Mortality Rate (NMR), Under-five Mortality Rate (U5MR), full immunization coverage, institu- tional deliveries, and People Living with HIV (PLHIV) on Anti-Retrovi- ral Therapy (ART). NITI Aayog recently unveiled the comprehensive Health Index report titled, “Healthy States, Pro- gressive India”. The report ranks states and Union territories in- novatively on their year-on-year incremental change in health out- comes, as well as, their overall performance with respect to each other. Health Index has been developed as a tool to leverage co-operative and competitive federalism to accelerate the pace of achieving health outcomes. It would also serve as an instrument for “nudg- ing” States Union Territories (UTs) and the Central Ministries to a much greater focus on output and outcome based measurement of annual performance than is cur- rently the practice. With the annu- al publication of the Index and its availability on public domain on a dynamic basis, it is expected to keep every stakeholder alert to the achievement of Sustainable Devel- opment Goals (SDGs) Goal number 3. States and UTs have been ranked Health Card of Indian States Among the among Smaller States, Mizoram ranked first followed by Manipur on overall perfor- mance, while Mani- pur followed by Goa were the top ranked States in terms of an- nual incremental performance. TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 32 Volume 3 | Issue 2 | April-June 2018
  32. 32. 33 Volume 3 | Issue 1 | Jan-Mar 2018 in three categories namely, Larger States, Smaller States, and Union Territories (UTs), to ensure com- parison among similar entities. The Health Index is a weighted com- posite Index, which for the larger States, is based on indicators in three domains: (a) Health Out- comes (70%); (b) Governance and Information (12%); and (c) Key Inputs and Processes (18%), with each domain assigned a weight based on its importance. Among the among Smaller States, Mizoram ranked first followed by Manipur on overall performance, while Manipur followed by Goa were the top ranked States in terms of annual incremental performance. Manipur registered maximum in- cremental progress on indicators such as PLHIV on ART, first trimes- ter antenatal care (ANC) registra- tion, grading quality parameters of Community Health Centres (CHCs), average occupancy of key State- level officers and good reporting on the Integrated Disease Surveillance Programme (IDSP). Among UTs, Lakshadweep showed both the best overall performance as well as the highest annual incre- mental performance. Lakshadweep showed the highest improvement in indicators such as institutional deliveries, tuberculosis (TB) treat- ment success rate, and transfer of National Health Mission (NHM) funds from State Treasury to imple- mentation agency. The Health Index report notes that while States and UTs that start at lower levels of development are generally at an advantage in notching up incremental progress over States with high Health Index scores, it is a challenge for States with high Index scores to even maintain their performance levels. For example, Kerala ranks on top in terms of overall performance but sees the least incremental change as it had already achieved a low level of Neonatal Mortality Rate (NMR) and Under-five Mortality Rate (U5MR) and replacement lev- el fertility, leaving limited space for any further improvements. However, the incremental mea- surement reveals that about one- third of the States have registered a decline in their performance in 2016 as compared to 2015, stress- ing the need to pursue domain-spe- cific, targeted interventions. Com- mon challenges for most States and UTs include the need to focus on addressing vacancies in key staff, establishment of functional district Cardiac Care Units (CCUs), qual- ity accreditation of public health facilities and institutionalization of Human Resources Management Information System (HRMIS). Ad- ditionally, almost all Larger States need to focus on improving the Sex Ratio at Birth (SRB). Itwouldalsoserveasaninstrumentfor “nudging”StatesUnionTerritories(UTs) andtheCentralMinistriestoamuchgreat- erfocusonoutputandoutcomebased measurementofannualperformancethan iscurrentlythepractice. TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER Volume 3 | Issue 2 | April-June 2018 33
  33. 33. A mid lurking threats of cyber-attacks on all sec- tors including hospitals storing medical records and its long term dangerous impli- cations on country’s’ economy and individual’s personal data, Indian Institute of technology (IIT) Kan- pur is all set to open a cyber secu- rity center. Department of Science Tech- nology, Government of India, has recently sanctioned a grant of INR 14.43 crore to IIT Kanpur in re- sponse to a proposal by the insti- tute to set up the Interdisciplinary Center for Cyber Security and Cyber Defence of Critical Infrastructures. The grant has been sanctioned for a period of five years and covers expenditures for the setting up of the center such as infrastructure, equipment etc. Cyber Security has become a pressing need the world over, with major cyber‐attacks coming to light every few months. Large number of countries is working on strengthening their cyber security technology to protect their national security as infrastructure disabling cy- ber-attacks is a threat to national security. In India though, the work in this field is still in its nascent stages. A consolidated effort from the cyber security expertise present in the country is the need of the hour and the new center coming up at IIT‐K plans to work specifi- cally towards this. To achieve this goal, the Interdisciplinary Center for Cyber Security and Cyber De- fence of Critical Infrastructures would work closely with research- ers from IIT Bombay, IIT Kharag- pur, ISI Kolkata, IIT Delhi and MNIT Jaipur. “Working with various industry and government bodies we are con- vinced that cyber security research, training and man power develop- ment are national imperatives. We are very pleased that DST has de- cided to fund our center and help us build the capabilities to carry out cutting edge research and train- ing in the field of cyber security, in particular with the goal to protect our critical infrastructures. We look forward to the journey in the next five years to the development of world class capabilities here at IIT Kanpur,” said Prof. Manindra Agrawal, Principal Investigator for IIT Kanpur braces up to thwart cyber attacks in India IIT Kanpur has taken a number of initiatives in the field of cyber security research. They recently signed a MoU with New York University Tandon School of Engineering, with whom they also hosted the Cyber Security Awareness Week in November 2016. They also signed a MoU with the Interdisciplinary Cen- ter for Cyber Security at Tel Aviv University in Israel, and MoU with Bombay Stock Exchange to cooperate on cyber security. TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 34 Volume 3 | Issue 2 | April-June 2018
  34. 34. 35 Volume 3 | Issue 1 | Jan-Mar 2018 In October 2016, as many as 32 lakh credit cards from different Indian banks were compro- mised, according to National Payments Corporation of India. There were a number of cyber security attacks post demoneti- zation, according to TAC Secu- rity, a cyber‐ security solutions provider. In 2016 and early 2017, cyber- attacks disabled the power delivery to large number of customers in Ukraine. Turkey's banking infrastructure was at- tacked by denial of service at- tack bringing all banking activi- ties to a halt last year. Bangladesh Central Bank lost equivalent of 80 million dollars through cyber-attacks. the upcoming center. The Cyber Security and Defence Center at IITK plans not only to engage faculty in cutting edge re- search in the domain of cyber se- curity of critical industrial systems (water treatment plants, nuclear power plants, power distribution infrastructure) but also to engage in training through courses with an emphasis on cyber security. They also plan to have summer courses and internships for students from other institutes as well as custom training courses for government and industry executives. Consulting to the government and the critical infrastructure sec- tor by the faculty and researchers at the Center will also be one of the focus areas. One of the major components of the centre will be an Industrial Systems Cyber Secu- rity Test Bed – a first of its kind in India – similar to the test beds at the Idaho National Labs, Sandia National Labs, and National Insti- tute of Standards and Technology in the U.S. It will take about a year to build this facility where research on cy- ber vulnerabilities of critical in- dustrial systems will be carried out along with development of tech- nology to protect them. “We recognized the need for de- veloping a research and education program in cyber security ‐‐ espe- cially in the sector of critical in- frastructures such as power grid, manufacturing automation, elec- tricity generation facilities, build- ing automation, railway signaling etc. and went to DST with a com- pelling proposal to establish a na- tional test bed for experimenting with cyber security of such sys- tems, and carry out research to de- velop defence techniques. Through many rounds of presentations, and revisions we were able to convince multiple panels of experts and ex- ternal reviewers that we have the interdisciplinary expertise at IIT Kanpur. Our center has experts in cyber security, cryptography, ma- chine learning, formal methods, program analysis, electrical engi- neering, networking and computer systems ‐‐ a convergence of which is essential to build cyber security of critical infrastructure. We are very confident that we can build a world class facility and research/ education/training program,” said Prof. Sandeep Shukla, Co‐Principal Investigator for the center. IIT Kanpur Director Dr. Indranil Manna says, “Cyber security is a major thrust area in this institute considering contemporary nation- al need and opportunity for tech- nological innovation where IITK can make a significant impact.” TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER Volume 3 | Issue 2 | April-June 2018 35
  35. 35. F ired by successful cosmet- ic surgery of human be- ings, a team of vets in the Kanpur zoo (erstwhile Al- len Forest Zoo) in Uttar Pradesh had carried out a successful cos- metic surgery of a badly thrashed 15-feet long massive python. The mammoth reptile was kept in an iron barred cage of hospi- tal. The appearance of the python showed that it had recently in- gested medium-sized animal. On examination, all rows of the teeth and the tongue were damaged. On 35th day, he began exhibiting normal activities. The python was released after three months. The case had hit the headlines three years ago. Recently, a barking deer writhed in pain for days after its lower jaw dropped perilously was shifted to the hospital. Its cosmetic surgery was carried out so that his jaws work in perfect unison to chew food. Buoyed by a slew of such ac- complishments, vets are embark- ing upon innovative initiatives to protect the zoo’s wildlife. A rhino developed pus in one of its legs and its dressing was a huge task, but because of pain, the bulky animal squirmed. A new surgical device was designed for the remote wound cleaning. The KanpurZooadopts innovativemethodsfor animalhealthmanagement Cosmetic surgery of a python, barking deer, distant pus cleaning device for squirming rhino, gangrene in Saddam’s tail! Sound bizarre but that’s reality… TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 36 Volume 3 | Issue 2 | April-June 2018
  36. 36. The leopard was treated with antibiotics and other prescribed meth- ods but the recurrence of the disease could not be prevented due to leopard’s tendency to keep its tail on surface. Owing to continuous rubbing of the tail and wild animal managerial constraints it was not possible to dress the tail daily and the only possible successful treatment advocated for the tail gangrene is said to be the amputa- tion from one uninfected coccygeal vertebrae above the gangrene. TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER Volume 3 | Issue 2 | April-June 2018 37
  37. 37. technique clicked and pro- vided instant relief in pain for mega herbivores. The tech- nique got international accla- mation. It was displayed on website by Rhino Resource Centre sponsored by the WWF. Usually, the mating among rhinoceros is violent and fe- male is chased by male be- fore mounting with frequent infighting and biting. The act may last for hours before co- itus which is also a long pro- cess and sometimes takes more than an hour. A unique method was de- vised by the zoo veterinar- ians by using a half horse power water lifting pump, thick walled PVC/Rubber tube, tube with nozzle and a large container of around fifty litre capacities. Tube with nozzle was connected at outlet end of the water lifting pump and on other end i.e. inlet end a thick walled PVC/Rubber tube was connected. The other end of inlet tube was submerged into a large container containing 2 per cent potassium permanga- nate and 4 per cent povidone- iodine solution. The rhino was taken into his night house and the wounds were washed with the solution daily for two days and then alternatively for three more occasions. The zoo is presently housing 12 leopards; many of them are zoo born. Among them leopard named Saddam, born to dam Mona and Wild Sire, is very ferocious and have well-built body. The animal was quite healthy up to the age of nine but then got its tail tip injured which slowly developed into gangrene. Sastry (1983) de- fined gangrene as ‘necrosis of the tissue with putrefaction by saprophytic bacteria’. The leopard was treated with antibiotics and other pre- scribed methods but the recur- rence of the disease could not be prevented due to leopard’s tendency to keep its tail on surface. Owing to continuous rubbing of the tail and wild animal managerial constraints it was not possible to dress the tail daily and the only possible successful treatment advocat- ed for the tail gangrene is said to be the amputation from one uninfected coccygeal verte- brae above the gangrene. According to doctors, the possible reasons behind suc- cessful treatment of Saddam was prevention of infection by confinement of the animal and by making a coating of turmer- ic and ayurvedic antimicrobial agent which further prevented residual infection and helped in healing of the tissue. After a thorough and efficient monitoring, leopard was again released in the enclosure af- ter a long period and has not shown any sign of infection in tail in last more than one year. Now, a new operation the- atre with modern machines is being established in the zoo in order to facilitate the more complicated surgeries. A trio of vets – Dr. R.K. Singh, Dr. U.C. Srivastava and Dr. Mohd. Nasir have been working not only to save the wild animals but also helped to develop the zoo as one of the best managed zoo of the country with respect to animal health management. The trio has applied inno- vative ideas of treatment. Ef- forts were also made by vets in attracting corporate word to not only adopt the animals but were also encouraged to make adoptions in wild animal health field and leading pathol- ogy of Kanpur began to analyse the pathological samples free of cost. New surgical technics were developed to surgically treat the animals. These vets got their several papers published in several international jour- nals and Kanpur zoo became first zoo in India to receive ISO 14001:2004 to “conserve, breed and provide alternate home for fauna of national im- portance”. Apart from above, another feather has been put in their caps by coining a new English word ‘WILDOMESTIC’ for the wild animals in captivity. This has been widely recognized and accepted by wild lifers and print and electronic media and it has been recommended by all for inclusion in several dic- tionaries such as oxford and chambers few to name. A unique method was devised by the zoo veterinarians by using a half horse power water lifting pump, thick walled PVC/Rubber tube, tube with nozzle and a large container of around fifty litre capacities.Tube with nozzle was connected at outlet end of the water lifting pump and on other end i.e. inlet end a thick walled PVC/Rubber tube was connected. TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 38 Volume 3 | Issue 2 | April-June 2018
  38. 38. 39 Volume 3 | Issue 1 | Jan-Mar 2018
  39. 39. T he impact of stress on phys- ical health varies between diseases. Chronic or severe stress can lead to variety of mental health problems-post trau- matic stress disorder, anxiety, depres- sion, insomnia and different types of psychosomatic disorder. The field of sleep disorder medicine has pro- gressed to a great extent. Sedatives, Hypnotics and Anxiolytics are used for ameliorating these symptoms. But medicine alone cannot do much. Yoga, meditations coupled with in- dividualized counseling is urgently needed. As we find in DSM V (Diag- nostic Criteria) sleep wake disorders is intended for use by general mental health and medical clinicians. It encompass 10 disorders or dis- order groups: insomnia disorder, hy- persomnolence disorder, narcolepsy, breathing related sleep disorder, cir- ca din rhythm sleep wake disorders, non-rapid eye movement (NREM), sleep arousal disorders, restless leg syndrome, and substance/medica- tion induced sleep disorder. In this article we would limit our discussion only on Insomnia. Pathways between stress and disease I. A predominant complaint of dis- satisfaction with sleep quantity and quality, associated with one of the following symptoms: • Difficulty initiating sleep • Difficulty maintain sleep, charac- terized by frequent awakening • Early – morning awakening with Insomnia – A Short Communication StudyBy Dr. Tinni Dutta TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 40 Volume 3 | Issue 2 | April-June 2018
  40. 40. inability to return to sleep. II. The sleep disturbance clinically significant distress or impairment in social, occupational, education- al, academic, behavioral or other important areas of functioning. III. The sleep difficulty occurs at least 3 nights per week. IV. The sleep difficulty is present at least for 3 months. V. The sleep difficulty occurs despite adequate opportunity for sleep. VI. The insomnia is not better ex- plained by and does not exclusive- ly during the course of another sleep related disorder. VII. The insomnia is not attributable to the physiological effects of a substance VIII. Coexisting mental disorder and medical conditions do not adequately explain the predomi nant complaints of insomnia. Different manifestations of insomnia can occur at different times of sleep period. Sleep onset insomnia involves difficulty initiating sleep at bed times. Sleep maintenance insomnia refers frequent or prolonged awakenings throughout night. Late insomnia in- volves early – morning awakening with an inability to return to sleep. Insomnia is related to sleep physi- ological and cognitive arousal which interferes with sleep. The more an individual strives to sleep, the more frustration builds. The more impairs sleep. It is also associated with oth- er psychological complaints like fa- tigue, boredom decreased energy and mood disturbances. Dr. Dutta at Asutosh College, Kolkata, is eminent Psycholo- gist and a famous educationist. Her research work has been greatly appreciated in India and aboard. She has visited U.S.A, U.K, Switzerland, France, Germany, Thailand, Singapore and Indonesia. She is recipient of many awards and fellowship. Thefieldofsleepdisordermedicinehaspro- gressedtoagreatextent.Sedatives,Hypnot- icsandAnxiolyticsareusedforameliorating thesesymptoms.Butmedicinealonecannot domuch.Yoga,meditationscoupledwithin- dividualizedcounselingisurgentlyneeded. AswefindinDSMV sleepwakedisorders isintendedforusebygeneralmentalhealth andmedicalclinicians. Stress exposure Emotional, social occupational stress Resulting in disease-- Insomnia Premorbid Personality Vulnerability to stress. Vulnerability to stress. Volume 3 | Issue 2 | April-June 2018 41
  41. 41. T he death of his grandfa- ther due to heart attack led Manoj Akash, a class 10th student of Ashok Leyland School in Hosur, Karnata- ka, to invent skin patch which has to be attached to the wrist or the back of the ear and it will release a small ‘positive’ electrical impulse, which will attract the negatively charged protein released by the heart to signal a heart attack. If the quantity of this protein – FABP3 -- is high, the person must seek immediate medical attention. Since class eight he started vis- iting library of the Indian Insti- tute of Science in Bengaluru – an hour away from his hometown. He could not afford expensive books and journals so the library visit was the only option left for this enterprising adolescent who had an extra knack to compre- hend complexities of cardiol- ogy just because of his penchant for the heart diseases studies. He was chosen for the President’s Innovation Scholar’s In-Resi- dence Programme at Rashtrapati Bhavan. The 16-year-old says that he investigated a novel concept that could potentially allow patients to detect silent heart attacks by non-invasively sensing the FABP3 biomarker in the blood- stream. ABP3 is a lightweight protein released quickly from heart muscle into the blood- stream during a heart attack, and therefore, it is an optimal cardiac diagnostic marker. According to him, doctors may test a patient's blood for FABP3 if he or she experiences char- acteristic symptoms like chest pain. However, not all heart at- tacks make themselves known through easily noticeable signs. Silent heart attacks, which are becoming increasingly common, are asymptomatic, making them more dangerous than conven- Skinpatchtodetect ‘silent’heartattacks TRENDSISSUESRESEARCHWELLBEINGPERSONAWOMEN’SCORNERNEWSCOPE 42 Volume 3 | Issue 2 | April-June 2018
  42. 42. 43 Volume 3 | Issue 1 | Jan-Mar 2018 tional heart attacks. Patients often drop dead while feeling completely nor- mal. This collapse happened to my grandfather on July 3rd 2015 which served as an impetus for me to find a solution to this prob- lem. In these silent cases, doc- tors are unlikely to administer the crucial FABP3 blood test be- cause there is no visible presen- tation of symptoms to warrant a diagnostic test. As a result, silent heart attacks go unnoticed. “I realized that, if at-risk pa- tients could test themselves daily for the presence of FABP3 in their blood, they would have higher chances of detecting si- lent heart attacks as they occur. A method that allows daily self- testing would have to be non-in- vasive, safe, and easy to use. Ulti- mately, it would have to involve a transcutaneous blood analysis, which examines the contents of one's blood without penetrating the skin. In searching for ways to tackle this challenging prospect, I ex- amined the various distinguish- ing characteristics of blood pro- teins that would allow them to be identified transcutaneously. I found that proteins have distinc- tive masses and electric charges in blood. So, I used a model to test whether different magnitudes of charged electricity, when applied to a thin area of skin, would iso- late FABP3 from the other blood proteins and attract FABP3 to the capillary walls. My results showed that this is true. This means that the technique that I investigated can poten- tially be coupled with transcuta- neous UV-protein quantification to non-invasively measure the amount of FABP3 in a patient's blood and alert him or her of a silent heart attack.” Help Million Hearts Stay Healthy! Is his web page that narrates his vision. He was frequenting scien- tific conventions to further his knowledge in the science field. Internet gave him lot of insight, he admits Clinical trials for the medical device are on and it could be approved for a human trial. The product would be fit to be launched in the market after two months of human trial, as- suming nothing goes wrong. “I have already filed for a patent and I would tie up with depart- ment of biotechnology for the trial. I would want the Government of India to take the project instead of selling it to a private company be- cause it is for the public good,” he says on his website. A small silicon patch stuck to your wrist or back of your ear can be used regularly to monitor whether there has been a heart attack instead of waiting for a doctor to prescribe a test. The patch uses a positively charged electrical impulse to draw negatively charged ---pro- tein to the surface; If the amount of FABP3 is high, then the person would need immediate medical attention; People who are at risk are recommended to use the de- vice twice a day -- in the morning and at night, before going to bed; The product can soon be seen in the market and would cost around R 900, cheaper than a glucometer symptoms at all. Diabetes, high blood pressure, high cholesterol levels all put you at risk of a silent heart at- tack, experts say. Having a si- lent heart attack puts people at a greater risk of having another heart attack, which could be fa- tal. Having another heart attack also increases risk of complica- tions, such as heart failure. Experts say a silent heart at- tack a heart attack is character- ized by chest pain, pain in the left arm or shortness is when of breath. A person who has a si- lent heart attack may not show these the symptoms like chest pain and shortness of breath that is indicative of heart attack is not felt. Akash aims to study cardiology at the country’s premier All In- dia Institute of Medical Sciences in Delhi. Volume 3 | Issue 2 | April-June 2018 43