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

1 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
vksingh@innovatiocuris.com

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

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
66

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.
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Editor: Sachin Gaur.
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© 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.

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

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

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

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

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
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

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.

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.

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

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.

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.

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.

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.

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.
TRENDSISSUESRESEARCHWELLBEINGPERSONANEWSCOPEWOMEN’SCORNER

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

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

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.

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.

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

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)

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.

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.

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.

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.”

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…

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.

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.

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

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.

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

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.

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

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

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