Imagen’s product ‘OsteoDetect’, an Artificial Intelligence-based diagnostic tool that can quickly detect distal radius wrist fractures is one of the latest products to get US FDA marketing clearance. Its machine learning algorithm studies 2 dimensional x-rays or radiographs for signs of fracture by analysing the posterior-anterior and medial-lateral x-ray images of adult wrists. Studies conducted on comparing fracture detection aided by OsteoDetect and certified orthopaedic surgeons showed that the readers’ ability to detect wrist fractures was improved by using the software as evident by greater sensitivity, specificity, and positive and negative predictive values, compared with unaided standard clinical practice.

https://www.engadget.com/2018/05/27/fdaapproves- ai-wrist-fracture-detection/

2. Alterego

A Device that Let’s Others Hear Words You Are Thinking

Arnav Kapoor, an Indian-origin researcher at MIT, has developed a device named ALTEREGO that lets others hear words you are thinking without your making a sound. The product looks like a curved bone hooked to one ear that touches the jaw on the chin and under the lower lip which works by using ‘subvocalisations’ which are the tiny, imperceptible movements in the jaw each time you say a word in your mind. There are four sensors which pick up the signals and transmit them to a computer that has been trained to recognize and convert them back to words which are conveyed to the listener’s mind through bone conduction in the listener’s jawbone, instead of words being openly spoken and conveyed. With the use of Alterego’s technology, one could ask questions soundlessly and get a voice reply only in your ears. Presently the product has an accuracy of 92% which claims to keep improving with the exposure to more types of vibrations and words. Times of India

3. Inito

New Portable Diagnostic Device: Affordable and Accessible

A study undertaken by Dr. Satish Dubey at IIT Delhi has revealed a new portable diagnostic device which is developed by Inito, Bengaluru-based company that can do a dozen tests with the comfort of a person being at home. It has the advantage of reading dozens of diagnostic test strips with a 99.12% correlation when compared to lab grade scanners irrespective of the mobile phone used. This makes it a very reliable tool for portable diagnostics. The device uses patent-pending imaging technology called flat lens that allows a single portable device paired with a smartphone to conduct dozens of diagnostic tests with the same device. The first test that the company has launched is a fertility monitor targeted at couples trying to have a baby. Soon tests for Thyroid, Diabetes and Vitamin D will be added to the device. To add more tests to the device, you just need to update the App and order the strips for the user. Advantages of the device are that it is easy to use, portable, small size, affordable and also third-party strips can be added to the Inito platform by just an App upgrade. The device has won CII Design Award, India Design Mark and Japanese Good Design Award. The device is priced at INR 3195 and is available on Inito’s official website and Amazon. Soon the device will be made available at pharmacies. HT Team

4. Paper Battery

An Indian Innovation Developed using Sewage Water

An innovation by an Indian research scholar, Ramya Veerubhotla at IIT Kharagpur, is the development of a disposable and flexible battery made from paper that could generate power from the bacteria present in sewage water. The battery is made using air cathode and the anode can be made from any carbon-based material. The product is unique because it is very light in weight and the power generation starts within ten seconds, unlike other usual microbial fuel cells which take a couple of days to start power production as the bacteria need time to adjust to the environment. The capacity of power generated from one cell is in the range of a few microwatts. For more power production, one can stack and fold these cells together giving it a compact shape. This research recently received the First prize and a cash award of INR 10 lacs at KPIT Sparkle 2018. www.news18.com

5. NakedLabs

World’s First Home Body Scanner

The product Naked 3D Fitness Tracker is a health and fitness tool for people to track changes in their measurements, body fat percentage, lean mass, fat mass, circumference and overall shape. The start-up has recently raised a $14 million Series A led by Founders Fund. The device has two parts, first is a scale that has sensors and a computer and second being a weight scale that spins a person around so that the stationary mirror can grab the body scan of the user in about 15 seconds. Naked uses infrared light to capture your 3D body model which then gets visualised on the Naked App and alerts the user when there is progress being made by the user in terms of their fitness and also where there is potential for more work to be done. The device has an Intel x86 processor, RAM, 4GB DDR4 RAM and a 64GB SSD which makes it easy to beam the image directly from the device to the user’s phone. The depth data of the users’ body is not uploaded to the cloud instead is being handled on the device itself and also the resultant image is more of a TSA body scan image rather than a 3D avatar. A person can permanently delete the data from his phone if he/ she wishes to. Presently the device is priced at US$ 1395. www.techcrunch.com

6. Wearable Sensor to Detect Stress Levels

A group of researchers under the mentorship of Scientist Alberto Salleo at Stanford University has created a stretchy patch which when applied directly to the skin, takes up sweat and assesses the amount of cortisol the person is producing. This stretchy, rectangular sensor around a membrane/specifically binds only to cortisol but also detects charged ions like sodium or potassium present in our sweat. This patch has a waterproof layer that protects it from contamination. So far, a wearable prototype version has been made but if this is converted into reality it would be very easy to monitor salt imbalances in our bodies and reveal the emotional state of people who are under immense stress and do not open about their situation. The present methods for measuring cortisol levels requires several days of waiting for the lab results. This device seems to solve the waiting problem for the results and is user-friendly. All the user needs to do is to sweat enough to glisten the patch and connect it to a device for analysis which gives results in seconds. The researchers are still working on its reusability though the prototype seems to work multiple times so long as it is not saturated with sweat. A paper co-authored by Scott Keene and Andrew Marais of Stanford University and colleagues at Ecole Nationale Superieure des Mines in France about this wearable sensor was published in Science Advances on 20 July 2018. https://news.stanford. edu/2018/07/20/wearabledevice- measures -cortisol-sweat

7. CustomFlex

World’s First Artificial Flex

Iris is the part of the eye that is colored around the pupil and controls the amount of light entering the eye. It is found to be damaged in conditions like Aniridia in which people are born with a partial or missing iris or it could happen later in life due to traumatic injury or surgical removal due to melanoma. With patients of eye damage, the surgically implanted device known as the CustomFlex Artificial Iris is a boon. Recently this prosthetic iris has got the US FDA approval. The CustomFlex Iris is surgically inserted and held in place either by sutures or eye’s anatomical structures. This iris is made of thin, foldable medical grade silicon and is custom-fitted and colored for each patient. A study of nearly 400 adults and children with Aniridia or other iris defects found that the device was safe and effective, with 70% of participants reporting significant decreases in light sensitivity and glare, as well as improvement in health-related quality of life. The study also found low rates of adverse side effects. As per FDA, the artificial iris is contradicted in patients who have uncontrolled or severe chronic inflammation, abnormally small size of eyes, untreated chronic glaucoma, cataract caused by the rubella virus, abnormal blood vessels on the iris, inner eye infections and certain kind of damaged blood vessels in the retina. Also, pregnant women cannot be its takers.

https://www.cbsnews.com/news /fda-approves-first-artificial-iris/

8. Smart Bandage to Monitor Wounds and Dispense Drugs Made

Sonskusale has recently developed a first of its kind ‘sense-then-respond’ smart bandage which uses sensors to detect subtle biomarkers that signal wound healing. The device has a microprocessor to read the data captured by the sensors, communicate with the mobile and also can direct the bandage to release medication if it is needed. It takes into account things like sensing whether the wound is getting enough oxygen, right pH level is there, what is the temperature near the wound and is there any inflammation? All this information is communicated to a central processor where the doctor already has programmed drug release for antibiotic or growth factor to improve healing. Such a bandage has applications in bed sores, burns and surgical wounds with the advantage of reducing complications from infections and reducing the number of amputations. The key is the timely application of the bandage to the wound site to fasten healing. https://www.digitaltrends.com/cooltech/ smart-bandage

For young people, less heard ailment Ankylosing Spondylitis (AS) is an emerging disturbance, but that is a stark reality: initially, victims develop symptoms such as low back pain and stiffness that lasts for more than 30 minutes and worsens in the morning or after prolonged inactivity.

Panacea lies in regular exercise before AS grips individual like a wasp with stiffened ligaments and muscles. Dr. Uma Kumar, states that such cases were burgeoning, and timely treatment can only stave off complications.

Patients with AS must exercise regularly because it helps to limit spinal deformity and maintain their spinal movement and flexibility, while also relieving the back pain. Swimming and deep breathing are the best exercises. In addition, a hot shower in the morning can help to ease the pain and stiffness. Patients should avoid smoking, eat a healthy diet and maintain a healthy weight.

AS is not curable, but it is completely treatable if detected early. Only 10% of patients have a severely disabling disease. With the help of the correct medication and lifestyle modification, approximately 80% people with AS remain completely independent or just minimally disabled in the long-term.

In an exclusive interview to InnoHEALTH magazine, Dr. Kumar traces the original meaning of the disease, and says the word Ankylosing Spondylitis (AS) is derived from the Greek words ankylosis meaning ‘stiffening’, spondylosis meaning ‘vertebra’, and – it means ‘inflammation’.

She answered several questions on the ailment.

Question: Can you please explain in detail AS?

AS is a chronic inflammatory type of spondyloarthritis (a broad term for all types of arthritis that affects the spine) that is further classified as an ‘axial spondyloarthritis’ because it affects the joints of the spine and pelvis (where the sacral bone attaches to the iliac bone on either side of the body). When spinal ligaments get inflamed at the point where they attach to the vertebrae, the ‘bone-making cells’ of the body get stimulated and start to grow bone within the ligaments, which results in the formation of bony bridges between adjoining vertebrae – this is what leads to a stiff back.

Question: Does it affect other parts of the body as well?

Sometimes, other joints of the body such as the ankle, knee, and hip may also be affected. AS is more common in young men between 20 and 30 years of age than women. It can occur in children as well. The prevalence of AS ranges from 0.8% to 1.8% in the general population.

Question: Are genetic and environmental factors linked to AS?

The exact cause of AS is unknown. However, there is a strong genetic predisposition and most patients with AS have the HLA B27 gene. About 6% to 8% of the Indian population has the HLA B27 gene and amongst them, those with a family history of AS in a first-degree relative have a 30% chance of developing the disease. However, only 2% of individuals with this gene actually develop the disease. It is hypothesized that some stimuli (e.g. environmental factors, gut microbiome) trigger AS development in genetically predisposed individuals. Moreover, AS can also develop in individuals without HLA B27. It is likely that there are some undiscovered genetic factors that could also be involved in its etiology.

Question: Whether Initial symptoms itself are alarming or not?

Initial symptoms may not appear alarming, but they can be serious. Patients with AS initially develop symptoms such as low back pain and stiffness that lasts for more than 30 minutes and worsens in the morning or after prolonged inactivity. They often find it difficult to turn on the bed during the latter part of the night and the pain sometimes wakes them up from sleep. Typically, the back pain improves with activity. Some of the tendons and ligaments of the body may also get inflamed (e.g. costochondritis & Achilles tendinitis).

Question: What are the other symptoms?

Other symptoms of AS are chest stiffness; pain in the neck, hip, shoulder, glutes (buttock) and heel; as well as arthritis of the knee, ankle, toes or fingers. About 30% of the patients may develop uveitis (painful red eye) and a similar number of patient’s long-standing disease may develop osteoporosis (thin weak bones). The lungs, heart (valves) and kidneys may also get affected.

Question: How can it be diagnosed accurately?

We do clinical diagnosis with imaging and genetic tests. AS is diagnosed based on a patient’s clinical profile and radiological (X-ray) investigations. Blood tests include genetic tests to detect the HLA B27 gene; and tests that detect raised erythrocyte sedimentation rates (ESR) and increased C-reactive protein (CRP) levels to help support the diagnosis. X-ray imaging cannot detect bone changes during the initial stages of the disease making early diagnosis difficult. However, MRI scans of the sacroiliac joints can be used to diagnose AS in the early stages, when the X-ray of this region still appears ‘normal’.

Question: Can treatment help to slow down or stop the progression of AS?

The aim of treatment is to relieve pain; slow down or stop disease progression, and maintain mobility of the spine. Medicines for AS include non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, disease modifying anti-rheumatic drugs (DMARDs) and biologics (targeted therapy). NSAIDs provide pain relief and also retard the progression of AS and patients prescribed these medicines must take them regularly and NOT ‘as and when required’. DMARDs like methotrexate, sulphasalazine, and leflunomide are prescribed for patients with peripheral arthritis. Patients who do not respond well to these drugs may be prescribed biologics such as anti-TNF alpha agents and anti-IL-17 inhibitors, as long as they have not had TB or a similar significant illness in the past.

These biologics and other tools that help us assess the disease have made it possible for patients to lead an almost normal life. Oral or parenteral glucocorticoids have no role in the management of AS though intraarticular steroid injections may sometimes be needed.

Question: Is surgical intervention a solution?

Surgery is rarely required for correcting spinal deformity, though a hip or knee replacement surgery may be needed if there is significant joint damage.

Question: What should be a frequency for consulting doctors?

Regular follow-up with the doctor is extremely important to adjust the dose and to detect any drug adverse effects or any complication or comorbidity at the earliest.

The first institution to train individuals in the field of physiology and medication was established in Italy, around the 15th century.

Although the first landmark in the healthcare industry was the accidental discovery of Penicillin by Scottish scientist Alexander Fleming, in the year 1928; the widespread use of Penicillin was initiated only in 1942 to treat infections caused by Streptococci Bacterium. But over time, Penicillin-resistant bacteria began to come to life.

And it wasn’t an isolated situation, as overtime viruses and parasites begun mutating and developing resistance over their target medication that it became important to continuously develop more advanced strains of medicines, and this sparked off the birth of the Pharmaceutical and Drug testing industry!

In 2018, the pharmaceutical industry is one of the top 3 industries in the world. In 2017, the pharmaceutical industry pumped nearly USD 24 bill into advertising and PR, with USD 12 bill from the United States alone!

The industry invests nearly USD 40 bill a year on drug development and clinical trials, making it one of the biggest contributors to the international economy.

The need for constant innovation and development of drugs has risen drastically over the last 15 years. The growth spurt arose due to the birth of certain strains of bacterium and viruses that have begun adapting to the medication. As the causal organisms began to adapt to the quintessential drugs, the industry had to keep researching drugs to fight this mutation.

(By Trescon)

To increase the quality of care, developed countries had already initiated incentive payment model to encourage and reward healthcare providers (hospitals, public health centers, school-based hospitals, and group practices) for delivering high-quality care.

Centre for Medicare and Medicaid Services, United States has developed value-based purchasing program rewarding the healthcare providers who had provided quality care to their patients.

Similarly, in 2017 the Singapore Health Ministry started to focus on the quality of care. Healthcare system in India pays the provider for the quantity of care, not for quality care and has not initiated any policies with regards to the increase in quality of care.

Mr. Bhargav Dasgupta, Managing Director, and CEO of ICICI Lombard in a recent press release about Indian government increasing GDP for healthcare to 2.5 said, it is a good move and this spending can be used to initiate quality programs. To measure the quality of care, the government should implement Quality metric tools in the major areas of medical error namely, reduce medication and hospital-acquired infection.

The quality metric tool will help the Indian Health Ministry to assess whether the provider has delivered high-quality care. For example, to assess whether a hospital has delivered high-quality care in prescribing medication to the patient with upper respiratory tract infection, the provider should report how many patients are being prescribed with proper antibiotics – for how many days.

Suppose the first year if the provider proves that 100 patients were prescribed with proper antibiotics then the number of patients should increase to 10% each year and finally achieve 100% goal in the consecutive year. The government should reward the provider with the incentive for providing evidence of high-quality care. Once two major medical errors have been addressed and controlled, the government can use the same model to all the areas of medical error. Hence, this incentive program will eventually increase the quality of care and decrease the cost of healthcare. This incentive program should be initiated first in government hospitals, profit hospitals, and physician group practice. This will further attract more medical tourist to India due to the high quality of care.

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