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Epilepsy is the Fourth Most Common Neurological Disorder

InnoHEALTH Magazine — Wed, 23 Oct 2019 11:04:03 +0000

Artificial Intelligence can help decode epileptic brains. Epilepsy is the fourth most common neurological disorder affecting nearly 65 million people worldwide. The seizures or ‘fits’ as is commonly known, arise due to unusual electrical activity in the brain and is the chief symptom of epilepsy. Neither dependent on age or gender, the onset of the seizure is unpredictable without a set pattern of frequency of occurrence or severity, often posing a challenge to the caregiver.

Did you know that one student commits suicide every hour in India?

Although epilepsy can be related to previous brain injuries or genetic factors, neurologists have found unprovoked, recurrent seizures in healthy individuals too. How and why these seizures occur remains a mystery. However, research has found that the source of seizures is within the brain. In other words, the brain itself is the generator of epilepsy.

Spatial maps of top 10 networks: If the origin is within the brain, then are there any fingerprints that can be detected? Does the brain often tell-tale signs which can be mapped to predict the tendency of epilepsy?

Reason for Aggression After Drink

Seeking answers to these questions, a team of interdisciplinary researchers conducted a study to peep inside epileptic brains. The results indicate that there exist independent neural networks that can carry disease sensitive information about the anomaly. With the help of machine learning models and artificial intelligence, researchers were able to detect and reveal the hidden patterns.

“Epilepsy is not a disorder but the manifesting of something from within the brain’s electrical activity. Interestingly, each one of us has the neural map of epilepsy within our brain. It is only when the network gets fired and manifests externally, in a recurrent manner, it becomes disorder or epilepsy,” explained Dr. Tapan Kumar Gandhi, lead researcher of the study from Indian Institute of TechnologyDelhi, while speaking to India Science Wire.

The usual diagnosing tool for epilepsy is by EEG (Electroencephalography) readings of epileptic patterns and visible symptoms like convulsions, loss of consciousness or sensory disturbances.

Existing studies reveal specific patterns that represent synchronous activities of sensory, auditory, cognitive and other functions. These activities are indicated by the change in blood flow to the brain and seen as BOLD signals or changes in the Blood-Oxygen-Level-Dependent output.

Recent developments in Magnetic Resonance Imaging or MRI help picture these activities in the brain and detect the cause of seizures such as a lesion or scar. However, MRI is not very useful when a seizure flares up. Whereas, functional MRI — another scanning method — can record regional interactions in the brain when a particular task is being performed.

In 1995, Indian researchers had found that the brain shows prominent neural network connections even in its resting state. Termed as resting-state functional MRI or rsfMRI, the images from this scanning indicate neural patterns in an individual’s brain even when no action is performed.

In the present study, the team utilized rsfMRI technique and performed brain scans on individuals with Temporal Lobe Epilepsy (TLE), which is the most common form of epilepsy.

Dr. Gandhi said, “We hypothesized that there could be ‘disease-specific networks’ in epilepsy prone brain that can be identified with the help of the machine learning model.” Machine learning involves artificial intelligence to read live data instead of pre-programmed information. Such a building block of a machine is analogous to a neuron cell in the brain.

Researchers used a tool called Support Vector Machine (SVM) to deal with the complex and non-linear data obtained from the scans. By using another algorithm called Elastic-net based ranking, the relevant features of the neuroimaging data were extracted. The signals were integrated to reveal the patterns.

The team conducted a pilot study on 132 subjects – 42 with epilepsy, and the rest with healthy individuals. Parameters like age, gender, history of epilepsy, genetic predisposition, incidents of injuries, medications and more, were taken into account. The epilepsy patients underwent three rsfMRI while those in the healthy group were scanned once.

In all, 88 independent components or networks were obtained from the whole brain imaging data and fed as input to the SVM. From the patterns, top 10 strong networks were correlated with clinical features using another standard method called Pearson’s Correlation to generate the rsfMRI epileptic neural networks.

From the pattern inputs, the SVM could identify epileptic individuals to an accuracy of 97.5% and specific lobes in the brain responsible for the condition. The model also revealed correlations such as the age of onset, frequency of seizures, or duration of illness.

By this, researchers concluded that the independently derived rsfMRI contains epilepsy-related networks. ‘Our research establishes that with the help of machine learning methods, we can identify these networks, as we had hypothesized. Increased strength in these networks indicates the possibility of a progressing Temporal Lobe Epilepsy’, explained Dr.Gandhi.

The team included Rose Dawn Bharath, Sujas Bharadwaj, Sanjib Sinha, Kenchaiah Raghavendra, Ravindranadh C. Mundlamuri, Arivazhagan Arimappamagan, Malla Bhaskara Rao, Jamuna Rajeshwaran, Kandavel Thennarasu and Parthasarathy Satishchandra (National Institute of Mental Health and Neurosciences, Bengaluru); Tapan K. Gandhi and Jeetu Raj (IIT, Delhi); Rajanikant Panda (Universitè de Liège, Belgium); Ganne Chaitanya (Thomas Jefferson University, USA) and Kaushik K. Majumdar (Indian Statistical Institute, Bengaluru). The study results have been published in the journal European Radiology.

Credits: India Science Wire

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Exercise in big parks can reduce depression

InnoHEALTH Magazine — Wed, 11 Apr 2018 08:51:44 +0000

Those who exercise in large parks in cities are less prone to depression

Availability of large neighbourhood parks encourages people to increase their physical activity, and those suffering from chronic conditions who regularly exercise in these parks are less prone to major depression, a new study has found. Besides increasing physical activity, regular exposure to outdoor green spaces improves cognitive functioning and lowers mortality risks. This is significant for those with chronic conditions like arthritis, diabetes, asthma and heart diseases as they are the most vulnerable to depression.

The study was done in Delhi, which has several public parks in residential areas. “Large parks in Delhi have diverse landscapes and are more likely to receive regular and frequent visitors, providing an opportunity for regular socialization,” say researchers.

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People who used large-sized neighbourhood parks walked for more than 150 minutes per week, the study found. For overall health, fitness and cognitive maintenance, the World Health Organization recommends adults to engage in 150 minutes of physical activity per week.

Dr. Debarati Mukherjee, lead author of the study says,” High levels of exercise encourage birth of new neurons which aid memory functions and learning.”

Researchers measured the association between park availability and major depression in 1208 adult park-users in Delhi. Major depression was measured using a structured clinical interview. Compared to residents exposed to large parks, major depression was 3.1 times higher among those exposed to small parks. They also showed that large-sized parks reduced stress and increased satisfaction with the immediate living environment.

“There are several mechanisms by which mental health is enhanced by physical activity. This is largely by increasing levels of endorphins in the brain” said Dr Dorairaj Prabhakaran of Public Health Foundation of India and one of the researchers. Endorphins are a group of chemicals that are natural mood elevators.

Dr. Mukherjee says that high levels of exercise encourage birth of new neurons which aid memory functions and learning. Physical activity is also thought to reverse cell and tissue damage as seen in Parkinson’s and Alzheimer’s.

Researchers point out that negative impact of shrinking green spaces due to rapid socio-economic development in metropolitan cities has not been studied, stressing the need for more studies on the matter. In addition to health benefits, urban green spaces reduce air and noise pollution. They also function as an important habitat islands for urban wildlife.

Certain neighborhoods may enable behaviours that promote mental health, while other residents may find it more restrictive to follow a healthy and happy lifestyle.

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Dr. Mukherjee says, “Our study provides the first empirical evidence of the benefits of availability of parks in the Indian context. It highlights the importance of having large parks near people’s living quarters”. The study could be a model for similar studies in other cities across the country.

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The scientists also recommend inclusion of urban green spaces in city planning to increase overall health of people. Their findings come at an important time whena largescale development in major cities is being undertaken in the country. “This is an opportune moment given that development of sustainable cities is ongoing in 109 cities selected in the SMART Cities Mission. Allocating municipal land for large urban parks should have a high priority,” adds Dr. Prabhakaran.

Altogether, 11 scientists from India, America and United Kingdom contributed to this study. Participating institutions include Centre for Control of Chronic Conditions, Public Health Foundation of India, All India Institute of Medical Sciences, National Institute of Mental Health and Neurosciences, Rollins School of Public Health USA, London School of Hygiene and Tropical Medicine UK. The findings were recently published in journal Health and Place.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw
InnoHEALTH Volume 3 Issue 1 (January to March 2018) – https://goo.gl/fksdQx

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The post Exercise in big parks can reduce depression appeared first on InnoHEALTH magazine.

Testing Times for India

InnoHEALTH Magazine — Thu, 23 Nov 2017 07:34:34 +0000

Brig (Hony) Arvind Lal is a pioneer in bringing laboratory services in India at par with the international world. He has modernized Indian medical diagnostics and initiated the first Public Private Partnership (PPP) in the field of laboratory testing in India. Under his guidance, Dr Lal PathLabs (LPL) has become one of the most reputed laboratories in Asia having to its credit quality accreditations from various national and international bodies. Currently they operate over 172 labs, including Asia’s biggest lab at Rohini, New Delhi with 1,500 collection centers and pick-up samples from another 7,000 medical establishments all over India. The lab tests over 50,000 patients every day or nearly 10 million patients in a year.

He holds the honorary rank of a Brigadier in the Indian Army and the Government of India conferred him Padma Shri (Indian national award) in 2009, for his contributions to Medicine.

In an interview with KANIKA CHAUHAN InnoHEALTH , he sheds light on the evergrowing demands of quality testing and test labs in the country and shares his vision of a healthier future for India and every Indian.

Q1. When the Lal Path Labs started 68 years back, what was the scenario of Indian healthcare industry? How do you see the market now? And how has been the journey?

My late father Dr. Major S.K Lal started this lab in April 1949. He was a displaced person from the partition and came to India from Rawalpindi in 1947. After coming to Delhi he worked in a government lab for one-and-a-half years and then started the first pathology lab in North India. At that point of time there were hardly any pathology tests as we know neither there were any routine tests like, HP, TLC, ESR, Urine Test, Blood sugar Test, Cholesterol test. So there was not any competition then.

Q2. What is your future business plans both at National and International level?

We are running 1700 laboratories in India and about 1600 collection centers. In addition we take another 5000 collections of blood samples from our pick up points. For example Medanta, Fortis, Moolchand and Apollo are some of the pick-up points we have.

Last year we tested about 1.35crore patients, so the average of the samples we can test is about 55000 in a day. We are the biggest Histopathology Biopsy Centre in the world.

Histopathology Biopsy is a test basically to detect cancer. Suppose if a lady has a lump in her breast, so she feels something has to be done about the lump, a part of the lump is surgically taken out which is known as the biopsy, it is the biopsy we test and find out the results. There is a possibility of two things either the tumor is benign (Non-Cancerous) or malignant (Cancerous). If the lady has malignancy she under goes with further tests, chemotherapy and radioactive therapies as per clinical requirement. We are the largest Histopathology in the world. We test about 1000 biopsies in one day and we are the second largest kidney biopsy center in the world. We are the only laboratories in India which have their own electro-microscope for very high end testing. We have our centers in all the major cities of India.

Our next step would be to set up another comprehensive laboratory in Lucknow. We have such research center in Kolkata and next year we will make one in Lucknow. With this we will provide high end services for the people in the region for whom the services are not available.

Q3. With so many market players why people should opt for Dr. Lal? What additional value you bring to the table?

We have many reasons, first of all people know that we are not fly by night operators and also they have faith in us since last 70 years plus people come to us for their pathological tests because 70% of all the medical decisions are nbased upon the pathology test of a patient, hence if the pathological tests result aren’t in place 70% of the medical decision can’t be taken. Gone were the days when people used to visit the “vaids” and doctors and they felt the nerves and pulse gave medicines, now it is evidence based medication. If someone has fever the doctor would suggest the person to get a blood test because it could be malaria, chikungunya, dengue or it could be anything. And if the person is diagnosed with anything she or he will get the treatment for the same. Now the medicines are completely evidence based, there is no hit and trial. These are the reasons why people come to us.

Q4. With Dr. Lal Path labs entering into the international market with operations in countries like Middle East, Malaysia, Bangladesh, Nepal and many more, where do you see the potential for growth of your organization?

The first reason is, India is not having the kind of quality labs that it should have. There is a demand and supply problem. That is because there are no large laboratories. There are lots of facilities that claim to do testing, but they are not testing laboratories but testing shops. This is what is to be changed and people give the example of our establishment and say that “they should be like Dr. Lal’s laboratory.” All these countries you have mentioned, we are getting their samples for testing but only one lab is set up in Nepal and next would be in Bangladesh and then we will go to other countries. The reason we are slow on this is because our own country is huge. I usually say to people that if we will take out Uttar Pradesh and put it in the Indian Ocean, India would be the 5th largest country in the world. So this is the reason that we want to look at our country first and then look at the outside market.

Q5. What kind of environment does your organisation provide to patients?

Our organisation provides a very sterile kind of an environment, it doesn’t smell, and blood is not spilled around, there are no flies buzzing around the surroundings. This is a kind of a place where anyone would like to go to.

Q6. Now days there so many machines available in the market for test like sugar, BP etc, which we can be used by the patients themselves. How good is that? What are your views?

These are known as point of care testing and people can test a few things but in India people can only test blood sugar. For which we suggest the patient to check his or her blood sugar on a regular basis of 15 or 20 days, so these are called Point of Care Testing (POCT).

The POCT in India is not established because firstly, it is very expensive and secondly the Indian people aren’t savvy. There are seven types of care testing which is emanated by a lady. A lady can go to the bathroom and test her pregnancy by a UPT (urinal pregnancy test) in which she gets to know whether she is pregnant or not then in this case there is no need of a pathological test. When I was young we never had cats and dogs as pets but we had rabbits , so I never couldn’t understand why my father killed those rabbits and I got my answer when I was studying medicine. The reason why rabbits were killed during that time i.e, in early 1950s people used to check the pregnancy through it. A pregnant woman’s urine was injected into a female rabbit and after killing them they use to dissect the abdomen area to find ovulating ovaries. This is how pregnancy test were conducted.

Q7. Now a days Dr. Lal Path labs is focusing on inorganic growth; how beneficial it is to patients?

The growth in any sphere or in any business is either organic or inorganic, organic means when a person is creating his own set up, say if a person is doing well in Delhi so he decides to open a set up in Uttar Pradesh and then in Uttarakhand, and inorganic growth is when other person is ready to give up her or his lab to somebody else irrespective of any reason the former will give some certain amount of money to the latter in position of the lab this is called inorganic growth. We have done 10 inorganic growths till now and yes we will buy some more from south of India and west of India.

Q8. What innovations you think can bring down cost, keep quality and improve efficiency on which researchers and start-ups concentrate?

There is no start-up in my line, if one is a qualified pathologist either he can work in a pathology lab or can start his own lab. The start-up in Delhi is difficult because Delhi has become a saturated city. there are many people who are running many pathology labs and they shouldn’t run these pathology labs and the reason they are running the labs is because it is very lucrative, which is very unethical and should not be done.

So the government of India has also started the voice to our ways and they said that we are going to have a clinical establishment act which has been passed by the parliament in 2010. Since the healthcare is state subject so all the 29 states have not adopted it or implemented it. There are a chain of pathology labs which are not run by the pathologists they are run by the non-pathologists they are not even doctors they are quacks. So this brings out the quality and efficiency of the whole industry.

They are many diseases which affect the mankind these days and these diseases are called the non-communicable diseases. The non-communicable diseases can’t communicate with others, whereas malaria, chikungunya and dengue are communicable diseases because it happens through a mosquito bite. TB is a communicable disease too and if a person’s lungs are infected by TB people around them will get infected. In India we lose two patients of TB in every three minutes, India has a burden of communicable diseases which includes Hepatitis A.

But a bigger set of diseases have come out which are called NCDs (Non Communicable Diseases) and the NCDs are killing 65% of our people and if we will not control the NCDs it will also affect the two per cent of our GDP. The NCDs are headed by the high blood pressure, obesity, smoking, cardiac diseases, lung diseases, cancer, kidney diseases and stroke. Why it is becoming so important to us because it is also called the life style diseases, it changes the lifestyle of the person which has suddenly come up. India has large number of cancer patients and also large number of blood pressure patients. There is an element of genetic transfer of physical appearance of a person but some diseases are also transferred which only run in families.

The problem with Indian people is they only come in illness, but they should know that they should get their self-check on a regular basis to keep a check on their health, my main point is to make people aware of the annual healthcare which is very important for one’s health which is in between the doctor and a patient and also make them aware of the testing in wellness not in illness.

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Healthcare Innovations in India

InnoHEALTH Magazine — Fri, 03 Nov 2017 11:15:18 +0000

Nidhi Saxena is seasoned healthcare entrepreneur. She has 16 years of healthcare, life sciences & technology expertise. Currently driving Zoctr.com, India’s first healthcare aggregator patient engagement platform and mobile application that leverages a unique, disruptive and fully integrated business model to offer home, tele-health & remote monitoring services to patients on a Pan-India basis thereby improving overall quality and accessibility of care, improved patient compliance and medical outcomes and dramatically reduced healthcare costs.

Zoctr Health Network is a first-of-its kind pan-India Home & Telehealth Company that provides a comprehensive portfolio of home based medical services including long term Intensive Care, Chronic Care & Wellness, Corporate Wellness and Health Check-up programs and other subscription based value added services such as Teleconsulting, Home Laboratory Pick-ups, Home/Online Pharmacy and Emergency Management Support to its customers leveraging a proprietary, fully integrated and technology led business model. It also integrates several health services like doctor appointments, home health services, remote monitoring services, laboratory, pharmacy, medical equipment, telehealth, and ambulatory support. Zoctr raised a funding of $1 million from certain angel investors to improve and expand its presence in Pune, Mumbai, Bengaluru, Delhi, Ahmedabad and Kolkata.

Dr Srivats Bharadwaj is the founder, chairman & CEO at Vatsalya Dental, Bangalore, India. After completing his studies he has traveled far and wide across the world lecturing, teaching and for research activities. His innovative approach to dentistry applies two guiding principles derived from his international exposure and life experiences.

Statistics reveal that there is one dentist for every 10,000 people in urban areas in India. In rural areas, however, there is one dentist for 150,000 people. This is an indication of the challenge that exists in India when it comes to oral health. In an endeavour to contain this challenge “Vatsalya” was launched.

Vatsalya is a dental care firm for oral healthcare which provides end to end dental treatment at your doorstep. Recently the firm launched its 24/7 emergency home dental care services where it charges only the transportation cost as extra. The team had recently acquired a funding of Rs 11 crore from S-Squared Captial Investments, USA. The home healthcare company focuses on special needs dentistry and preventive dentistry. The team at Vatsalya also provides services like surgical removal of teeth, laser surgeries, complete or partial denture prosthesis, root canal therapy and fixed and bridge crown prosthesis.

A brainchild of IIT alumni Vipin, Abhishek and Garima, Care24 offers professional care from trained caregivers that help the patient recuperate at home. Care24 has been in operation since 2014 and has successfully helped 40000+ families heal at home in Mumbai and Delhi.

The Mumbai-based home healthcare platform offers verified caregiver services across Mumbai. The startup raised a series A funding of $4 million led by SAIF Partners and seed investor India Quotient. As of February this year, the startup had clocked 600 transactions in a day. They have a network 24×7 nurses, attendants, and certified physiotherapists, who help individuals through the rehabilitation process.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6

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