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

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

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

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

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

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

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

Interventions that are being strengthened are Early diagnosis and complete treatment; Case-based surveillance and rapid response; Integrated vector management; Indoor residual spray (IRS); Long-lasting insecticidal nets (LLINs)/ Insecticide-treated nets (ITNs); Larval source management (LSM); Epidemic preparedness and early response; Monitoring & Evaluation; Advocacy, coordination and partnerships; Behavior change communication (BCC) and Community mobilization and programme planning & management.

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

“And for people with more disability, what bothers them the most? Problems with sleep? Depression? Fatigue? Not many studies have asked people how they feel about these problems, and we doctors have often focused just on physical disability or whether they have another stroke.”

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

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

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

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

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

“The social participation and executive functioning skills are areas that have not received a lot of attention in stroke rehabilitation,” Katzan said. “We need to better understand how these areas affect people’s well-being and determine strategies to help optimize their functioning.”

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

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

Informatively, American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 34,000 members. AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease, and epilepsy.

Evidence suggests that low back pain should be managed in primary care, with the first line of treatment being education and advice to keep active at work.

A 2008 survey of all registered physiotherapists in Maharashtra (India) showed that 46 percent of physiotherapists advised patients with low back pain to rest.

63 percent of Indians believe that bed rest is the mainstay of therapy.

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

According to researchers a prospective study in the period 10th October 2008 of 25251 patients with chronic back pain received in an Indian orthopedic clinic, reported that 100 percent of patients underwent imaging, with 76 % diagnosed with non-specific low back pain and 10 % with spondylosis. According to the Global Burden of Disease study every year, a total of 7.3 million years of productive life is lost in India because of disability from low back pain. Physiotherapist and Assistant Professor Saurabh Sharma, in the Department of Physiotherapy, Kathmandu University of Medical Sciences, told InnoHEALTH magazine in an email interview that he was also aware of practices of low back pain, which is far away from evidence recommendations.” For example, rest, lumbar supports/corsets are prescribed very commonly against the current recommendations.

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Similarly, all patients are prescribed medicines, electrotherapy, taping, and ex-rays. More than half individuals are advised MRI. Similarly, patients are also treated with new treatments that the clinicians claim but have never been tested in clinical trials (research), such as matrix rhythm theory practice in Pune, he said. In reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery or prescribed painkillers including opioids, which are discouraged for treating low back pain.

“The majority of cases of low back pain respond to simple physical and psychological therapies that keep people active and enable them to stay at work,” explains series author Professor Rachelle Buchbinder, Monash University, Australia. “Often, however, it is more aggressive treatments of dubious benefit that are promoted and reimbursed.”

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

Low back pain results in 2.6 million emergency visits in the USA each year, with high rates of opioid prescription. A 2009 study found that opioids were prescribed to around 60% of emergency department visits for low back pain in the USA. Additionally, only about half of people with chronic back pain in the USA have been prescribed exercise. In India, studies suggest that bed rest is frequently recommended, and a study in South Africa found that 90% of patients received pain medicine as their only form of treatment.

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

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

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

The authors say that healthcare systems should avoid harmful and useless treatments by only offering treatments in public reimbursement packages if evidence shows that they are safe, efficient and cost-effective. They also highlight the need to address widespread misconceptions in the population and among health professionals about the causes, prognosis, and effectiveness of different treatments for low back pain.

“Millions of people across the world are getting the wrong care for low back pain. Protection of the public from unproven or harmful approaches to managing low back pain requires that governments and health-care leaders tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo,” says series author Prof. Jan Hartvigsen, University of Southern Denmark. “Funders should pay only for high-value care, stop funding ineffective or harmful tests and treatments, and importantly intensify research into prevention, better tests, and better treatments.”

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

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

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

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

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

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

The mega dissertation on the Nano theme by Dr. Dinda from AIIMS, New Delhi was equally engrossing. He was speaking at the Third IC (InnovatioCuris) meeting which had a talk regarding Nanotechnology and its commercial impact.

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

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

Dr. Dinda has equally cautioned the pitfalls in Nano research and product development, which was very elucidative and useful for the present members and students. His experience with Nanoscience made him realise the importance of collaborative approach, as it is a highly inter-disciplinary science.

Nanotechnology is very liberative and robust in the sense that it offers low cost, and viable and scalable technology, the sort of which is need of the hour in India. Also given the reason that it has been practised in India in Ayurveda, gives a point of leveraging for existing vedic processes. The impacted areas range from health, environment, water purification, therapeutics, organ regeneration, to such hi-fi technologies like nanotised robots for vivo monitoring.

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

The other talk in the meeting was given by Dr. Pavan from Scangene Labs, a first generation entrepreneur in the biotechnology domain with focus on low cost diagnostics. He shared his experience of establishing his start-up and his companies plan A and plan B. His team was instrumental in developing several panels for diagnosis of cancer markers and rare genetic disorders. They developed low cost equipment and devices for use in reserach setups and educational institutes.

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

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

Informatively, with the commitment to giving an encouraging platform to innovators and aspiring startups, InnovatioCuris (IC) was created as a knowledge-based platform to exchange best practices of healthcare innovations across the globe by conducting international conferences, and extending the same message in internationally-acclaimed, quarterly magazine named “InnoHEALTH”, complimentary webinars and training.

The club brings innovators, investors, start-ups, technology persons, policymakers, health experts and legal advisers under one large umbrella to be members and hold hands by sharing success stories and challenges and to incubate their ideas to take the dream and vision of India forward. It has a very strong band of advisers to support the activity of club and mentor projects. The aim is to bring down healthcare delivery cost yet maintain quality through innovations. IC has an outreach of 30,000 people globally to share its activities.

Dr. Amit Kumar Dinda MD, PhD is a Professor of Department of Pathology at All India Institute of Medical Sciences (AIIMS), New Delhi. After his post graduation in Pathology he did his PhD in the area of Cancer Biology at the same institute. His area of work includes Immunopathology, Inflammation and cell biology, Experimental pathology, Ultrastructural pathology, Biomaterials and Nanomedicine. In the area of Nanomedicine, he is actively involved in several projects related to nanoparticle-mediated drug delivery, antigen and DNA delivery system. Dr. Amit is working in the area of nano-cell biology to understand nanoparticle and cellular interaction. He is in the editorial committee of 12 national & international journals. He has worked as a Visiting Professor in Long Island Jews Medical Center & Elbert Einstein Medical College, New York, USA as well as University of New South Wales, Sydney, Australia. Dr. Amit has published more than 200 research articles in indexed journals and edited 4 books. He has written 14 chapters in books and acquired 3 patents in the areas of nanotechnology and biopolymer.

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

Patients often “drop dead” while feeling completely normal. This collapse happened to my grandfather on July 3rd, 2015 which served as an impetus for me to find a solution to this problem. In these “silent” cases, doctors are unlikely to administer the crucial FABP3 blood test because there is no visible presentation of symptoms to warrant a diagnostic test. As a result, silent heart attacks go unnoticed.

“I realized that if at-risk patients could test themselves daily for the presence of FABP3 in their blood. They would have higher chances of detecting silent heart attacks as they occur. A method that allows daily self-testing would have to be non-invasive, safe, and easy to use. Ultimately, 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 examined the various distinguishing characteristics of blood proteins that would allow them to be identified transcutaneously. I found that proteins have distinctive 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 isolate 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 potentially be coupled with transcutaneous 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 scientific conventions to further his knowledge in the science field. Internet gave him a 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, assuming nothing goes wrong.

“I have already filed for a patent and I would tie up with the department of biotechnology for the trial. I would want the Government of India to take the project instead of selling it to a private company because it is for the public good,” he says on his website.

To monitor, regular use small silicon patch stuck to your wrist or back of your ear. 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 —protein to the surface; If the amount of FABP3 is high, then the person would need immediate medical attention; Experts recommend to use the device twice a day. The product can soon be in the market. It 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 attack, experts say. Having a silent heart attack puts people at a greater risk of having another heart attack, which could be fatal. Having another heart attack also increases the risk of complications, such as heart failure.

Chest pain, pain in the left arm or shortness is when of breath characterizes a silent heart attack. A silent heart attack may not show symptoms of chest pain and shortness of breath that doesn’t feel heart attack. Akash aims to study cardiology at the country’s premier All India Institute of Medical Sciences in Delhi.

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

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

Followings are the some of the key challenges that remain to improve healthcare:
• Investment – Compared to the other countries, very small % of Indian GDP is spent on developing healthcare which is about 100 times less than the United States.
• Geography – A wide gap remains between rural and urban healthcare. Most of our healthcare resources are concentrated in big cities leaving the rural areas with no or almost no resources to meet the growing healthcare need.
• Infrastructure – The number of hospitals and health centers in India are far less than what is required. Except for a few super specialty hospitals, most of the hospitals and health centers in India do not have proper infrastructure to provide quality services.

It makes sense then that in India where there is always a huge gap between demand and availability of quality healthcare that cloud technology can play a huge role. Cloud based technology solutions can be leveraged to provide efficient and high-quality services in healthcare at an affordable price for remote locations with little to no infrastructure. With the advancement of technology, cloud is becoming more and more secured and compliant with regulations. Adopting cloud based technology solutions will all organizations engaged in healthcare to focus more on their core activities and reduce utilization of resources that manage technology.

Key research tells us that with digitization of medical data, medical knowledge has increased by 2 times or more in past 3 to 5 years. The way cloud is being adopted more and more by the industry globally and with the growing need for collaboration, flexibility and improved patient care, we can say that cloud will eventually become a commonplace in the industry.

As seen in countries that have developed healthcare systems, these capabilities were key in the development of healthcare to a point where no avenue is left unexplored in the strive towards improvement of healthcare for its citizens.

While the road to these advances may have been littered with challenges, impediments, false starts and hurdles, technologies today and the lessons learned therein will allow developing nations to avoid such pitfalls and leapfrog their healthcare eco-system into the future!

(Contributors: Kausik Bhattacharya, Johnson & Johnson, Sandipan Gangopadhyay, President and COO, Galaxe Solutions. Dheeraj Misra and Anusha Panduga also from Galaxe Solutions.)

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