IndiaMedToday Sept 2021

SEPTEMBER 2021, VOLUME 5 ISSUE 9 `200 INDIA MED TODAY

Cardiovascular Disease During Covid Times FeaSpec ia Meture l Ho dic on spi a tal

SEPTEMBER 2021

PULSE

INTERVIEW

INNOVATE

FEATURE

Has The Company-Doctor Relation Withstood The Pandemic Storm?

MolBio Aims To Be The Solution in Global COVID Testing

A working prototype of the new 3D printed heart valve

Caring for Cardiac Electrophysiologists

EDIT NOTE www.indiamedtoday.com

September 2021 EDITORIAL Editor Neelam Kachhap Sub-Editor Abishek Raj editorial@ indiamedtoday.com

Cardiovascular Disease During Covid Times

BOARD OF ADVISORS Dr Alexander Thomas

COVID-19 has undoubtedly sparked a lot of debate on the state of

Dr Girdhar Gyani

our healthcare system. At the same time, the pandemic has also

Dr Prem Kumar Nair Dr Bhabatosh Biswas

prompted us to look at our existing disease burden and find ways to

Dr Alok Roy

combat the additional morbidity and mortality in these areas.

Ramesh Kannan

One of the areas of major concern is cardiovascular diseases.

ART & PRODUCTION ScreeTract Shylesh

CONSULTING EDITOR

Cardiovascular diseases (CVD), such as coronary artery disease, are

Dr Libert Anil Gomes

the leading cause of mortality in India, with Indians more susceptible

Dr Salil Choudhary

to suffer from CVD-related mortality as compared to the rest of the

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world. The CVD burden is particularly prevalent in Indian scenario

Gunjan Chauhan

where the prevalence of coronary artery disease in young men

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is twice that of those in western nations. Besides the stressful and sedentary lifestyle, there

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is a rise in the prevalence of other non-communicable diseases in India amongst the younger

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population, including Diabetes Mellitus, obesity and hypertension. All these diseases are very closely linked with CVD. During the COVID-19 pandemic there has been a significant rise in cardiovascular disease. People recovering from COVID 19 are prone to cardiovascular disorders, including myocardial injury, arrhythmias, acute coronary syndrome and venous thromboembolism.

A recent study published in The Lancet said that one in two hospitalised COVID-19 patients develop a complication. The study found that the most common complications included renal, complex respiratory, and systemic complications, but cardiovascular, neurological, and gastrointestinal and liver complications were also reported. cardiovascular complications were reported in around one in eight participants.

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cardiologists were called on to help with some COVID patients at many hospitals. It was widely known that COVID patients with comorbidities were much more likely to have severe symptoms

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requiring hospitalisation. However, data from several hospitals revealed that patients with preexisting cardiovascular diseases suffered the highest mortality rate of all COVID patients. Doctors we spoke to shared that in some cases, COVID causes acute heart failure, myocarditis, shock and thromboembolism, and the drugs being used to treat the virus can compound cardiac issues by

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causing arrhythmias.

Our magazine in this issue focuses on CVD in India. Most of our stories and features in this issue focus on the development of CVD in India in the light of the current COVID pandemic.

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SEPTEMBER 2021

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CONTENTS

19

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28

26

APPROACH

FEATURE

INNOVATE

How To Return To Normal Air Travel Post COVID

Caring for Cardiac Electrophysiologists

A working prototype of the new 3D printed heart valve

32 INTERVIEW

MolBio Aims To Be The Solution in Global COVID Testing UPFRONT

21 COVER STORY

Cardiovascular Disease during Covid Times

03 Editorial 06 Letters 07 Guest Editorial 08 News Roundup 34 Market Report 37 Pulse 41 Start-Up Talk www.indiamedtoday.com

CHECKIT OUT ONLINE

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5

LETTERS Long-lasting symptoms from COVID-19 are rare in children

C

hildren who develop symptoms of COVID-19 typically get better after six days and the number who experience symptoms beyond four weeks is low (4.4%, 77/1,734), a large UK study published in The Lancet Child & Adolescent

Health journal has confirmed.

“It is reassuring that the number of children experiencing long-lasting symptoms of COVID-19 symptoms is low. Nevertheless, a small number of children do experience long illness with COVID-19, and our study validates the experiences of these children and their families.”

Professor Emma Duncan, lead and senior author of the study, King’s College London, UK

Vaccination

coupled

with

strict

adherence

to

preventive

protocols is the most effective way to protect and control the spread of COVID-19. Through this initiative we want to ease the accessibility to the vaccine for all, including those who are unable to come forward to the vaccination centres owing to distance or physical constraints. In the initial phase, we are looking at inoculating around 20,000 and then later expand to a wider population.

Dr Devi Prasad Shetty, Founder and Chairman, Narayana Health This is a historic milestone with ZyCoV-D, a product of Indian innovation becoming the world’s first DNA vaccine being offered for human use and supporting the world’s largest immunization drive. We are particularly happy that our vaccine will contribute to this fight against COVID-19 and enable the country to vaccinate a larger population especially in the age group of 1218 years. I would like to thank all the researchers, clinical trial investigators, volunteers and the regulators who have supported this endeavour.

Pankaj R. Patel, Chairman, Cadila Healthcare Ltd In the wake of the pandemic, there has been a much greater adoption and demand for digital healthcare services. We, therefore, felt the need to further strengthen our digital capabilities and

expand our footprint as well as services’ portfolio. In the last one and a half year, we have worked closely with all stakeholders and served millions of people in various ways across the country. The situation has not only created a favourable atmosphere for digital healthcare in India but also clearly highlighted the areas where stronger digitization strategies are required.

Meena Ganesh, Chairperson, Portea Medical India is rightly described as the pharmacy of the world. The pharmaceutical sector is a strategic sector of India in terms of its contribution to the economy and has been the key to ensuring an uninterrupted supply of medicines during the most difficult circumstances of the COVID-19 pandemic. The exclusion of pharma exports from the RoDTEP scheme will adversely impact the pharma sector's competitiveness. The exclusion deprives pharmaceutical exporters of the level playing field vis-a-vis global manufacturers. This is a highly regulated sector and calls for huge capital investment for setting up manufacturing infrastructure.

The industry presented the data to the RoDTEP committee for consideration. For sustaining India’s export competitiveness, RoDTEP benefits should be extended to the Pharmaceutical sector given the importance of the sector in access to affordable medicine to patients in India and around the world.

Sudarshan Jain, Secretary General, Indian Pharmaceutical Alliance

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6

September 2021

GUEST EDITORIAL

Dr Alok Roy Chair-FICCI Health Services Committee and Chairman, Medica Group of Hospitals

Nation Needs to be Pre-emptive in its Approach India has followed a very closely knitted response towards COVID-19 pandemic with highest level of commitment from all stakeholders. Government, along with the Private sector, has led various measures to address these challenges from ramping up of testing facilities, hospital beds, strengthening health infrastructure to procuring oxygen and medical supplies.

The on-going vaccination drive intends to achieve 100 per cent vaccination coverage, which is expected to leave less population susceptible to the virus.

So far, in a country of 1.4 billion people India has administered over 213 million COVID-19 vaccine doses. Considering the current vaccine delivery rate, which dropped from 3.5 million a day in March to an average of 1.6 million daily doses this week, it will take until February 2022 for the country to vaccinate 300 million people, which is approximately only 20 per cent of the population.

Undetected, Tested (positive) and Removed Approach) Model, the third wave will hit us in coming 6-8 months if the vaccination drive is not ramped up and COVID-19 appropriate behavior is not maintained.

As the spectre of a potential third wave has been haunting the country and many states have begun planning and strengthening the health infrastructure.

The focus is on children, with apprehension that they could be the worst affected. States are ramping up paediatric beds, paediatric intensive care units (PICU), Neonatal Intensive Care Units (NICU) and Sick Newborn Care Units (SNCU) while simultaneously focusing on Paediatric treatment protocols, setting up of Expert Panel and Task force to protect children.

Witnessing a sharp spike in cases and an increase in number of deaths during the second wave, many have predicted that the third COVID-19 wave may be even more lethal in the country.

As the third wave of COVID infection seems inevitable, the Nation needs to be pre-emptive in its approach to mitigate the risk posed by the pandemic and re-evaluate the existing Healthcare systems to enhance our ability to fight back any such upcoming wave soon.

This has led us to adopt agile analytical methods to navigate through the new normal. Going by the SUTRA (Susceptible,

The author is Chair-FICCI Health Services Committee and Chairman, Medica Group of Hospitals

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7

NEWS ROUNDUP Union Health Minister joins Stop TB Partnership Board as Chairperson

business group in Pokhara, and Narayan

Union Minister for Health and Family Welfare Mansukh Mandaviya has taken charge as the Chairperson of Stop TB Partnership Board. The minister will hold the responsibility with immediate effect until 2024. He will lead the efforts of the Stop TB Partnership Secretariat, partners, and the TB community at large, towards reaching the UN TB targets by 2022, a milestone moment in the effort to end TB by 2030.

An agreement was reached between the

Mandaviya said, “I am honoured to take the Chair of the Stop TB Partnership Board and thus secure the continuation of the commitment to global efforts to end this devastating disease worldwide by 2030.

I look forward to working with the Stop TB Partnership Board and Secretariat in leading the efforts to end TB.”

MoH&FW to integrate Ayush in healthcare delivery system A meeting of ministers, secretaries and other senior officials of the Ministry of Ayush and Ministry of Health and Family Welfare was organised recently at Nirman Bhawan to strengthen the process of integration of Ayush system in public health. Under the stewardship of both cabinet Ministers, Mansukh L Mandaviya (MoH&FW) and Sarbanand Sonowal (MoAyush) both Ministries committed to streamline and operationalise a comprehensive approach of integration in the field of healthcare delivery system in the country. A well-defined mechanism has been put in place to achieve the intended integration of modern medicine and the traditional health systems of the country.

Poudel, chairman of Autoways Group, bought the hospital for Rs 3.5 billion. This is according to news in thenepalipost.com.

Government of Nepal and the Manipal

8

September 2021

Round Table India launches project H.E.A.L

Education and Medical Group of India on

Round Table India (RTI), a non-religious,

October 18, 1992, to establish the hospital.

non-political

MBBS was started as a medical college two

organisation, has launched Project H.E.A.L

years after the agreement was signed. At

(Healthcare

present, MBBS, PG and Nursing classes are being conducted in this hospital.

Cinthol Health Plus partners with Fortis Hospital Vadapalani Cinthol Health Plus, the health soap brand from Godrej Consumer Products Ltd (GCPL), and Fortis Hospital Vadapalani

and

non-sectarian

Enhancement

for

Active

Living) with the aim to facilitate the improvement of medical infrastructure across the country. At launch, H.E.A.L has already undertaken relief projects worth Rs 55 crore in partnership with various corporates. Project H.E.A.L entails movable or permanent infrastructure intervention such as building augmentation/repairs, creation of special wards, toilets, donation of medical equipment like ventilators,

have joined hands for a post-vaccine

COVID

sensitisation programme. The objective

line

is to create awareness around post-

ambulances and hospital cots. Through

vaccine precautions, do’s and don’ts while

Project H.E.A.L, RTI has encouraged its

encouraging citizens to keep following

corporate partners to facilitate relief and

hygiene norms even after the vaccination

offer help to those hit hardest in India

is done. The week-long pilot of this

during this uncertain and daunting time.

programme has already started at Fortis

The project will provide holistic support to

Hospital, Vadapalani (Chennai), where a

the wider community in India.

Manipal Teaching Hospital in Nepal sold for Rs 3.5 billion Manipal Teaching Hospital in Pokhara has been sold recently. Anandaraj Batas, Chairman of Batas Organization, a

post-vaccine kit will be given free of cost to those getting vaccinated at the hospital.

Person receiving post vaccine sensitisation kit

vaccine systems,

refrigerators, oxygen

oxygen

concentrators,

Radixact System in Manipal Hospitals

Manipal Hospitals launches Radixact System with Synchrony technology in India

Narayana Health City with Volvo Group India introduces ‘Vaccination on Wheels’

Manipal Hospitals has launched the firstof-its-kind

advanced

Radixact

System

with Synchrony Automatic, a real-time motion synchronisation technology, for the precise treatment of cancer patients.

Manipal

Hospitals

has

obtained

the

requisite license from AERB for Radixact X9 Tomotherapy with Synchrony tumour tracking technology. The Radixact system, with its new generation of Tomotherapy with Synchrony technology, serves cancer patient needs, by far superior clinical results in head and neck, breast, GI and prostate cancers, which consolidate for more than 85 per cent of occurrence. The system delivers 360 degree rotational delivery for the whole body and CT based daily IGRT treatment with Iterative reconstruction.

The combined technologies enable the delivery of radiation using a variety of methods — from image-guided intensitymodulated radiation therapy (IG-IMRT) to stereotactic body radiation therapy (SBRT) — to treat almost any tumour, even those that move with breathing, precision, accuracy and unprecedented flexibility.

Narayana Healthy City in association with Volvo Group India has launched a free mobile vaccination initiative called ‘Vaccination on Wheels.’ The initiative was flagged off by Basavaraj Bommai, Chief Minister, Karnataka in the presence of Dr Devi Prasad Shetty, Founder and Chairman, Narayana Health and Kamal Bali, President and MD, Volvo Group India. Dr Devi Prasad Shetty, Founder and Chairman, Narayana Health, said, “Through this initiative, we want to ease the accessibility to the vaccine for all, including those who are unable to come forward to the vaccination centres owing to distance or physical constraints. In the initial phase, we are looking at inoculating around 20,000 and then later expand to a wider population.”

TATA Health launches a nationwide campaign #SochMatPoochLe TATA Health in its latest TVC and digital film #SochMatPoochLe aims to encourage people to give up the typical habit of overthinking, fostering doubts and debates in their mind to instead seeking a timely medical diagnosis for the symptoms and

health issues they experience. The TVC was released in the Hindi language across India along with the digital film in three other languages, i.e. Kannada, Telugu and Tamil. The campaign #SochMatPoochLe emphasises that one should always consult a doctor whenever they experience any symptoms instead of self-diagnosing and risking one’s health. People should seek timely medical advice to ensure that the situation does not become a health emergency. The film light-heartedly through banter in the head talks about four common health issues that could be mild to something serious when you experience chest pain, headache, stomachache or back pain. It showcases the ill effects of trusting unqualified advice, random home remedies, self-diagnosis, etc., to address health concerns.

Google revises strategy on health division Google is changing its healthcare strategy and dismantling its health division, according to an Insider report. In an internal memo obtained by Insider, the initiatives once housed in the division will now be under more general umbrellas.

Google’s AI healthcare team will now report to the president of search and AI, and Dr Karen DeSalvo, Google’s CMO, as well as the divisions’ clinician team, will now report to the chief legal officer. This

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9

NEWS ROUNDUP comes just months after reports circulated that the tech giant was reorganising its consumer health team and moving 130 of its roughly 700 Google Health employees to the Search and Fitbit group. There were signs last week when Google Health Vice President Dr David Feinberg announced he was stepping down in order to serve as CEO at EHR company Cerner.

GiveIndia launches ‘Vaccinate India Programme’ ‘Vaccinate India Programme’, an ambitious initiative by Bengaluru-based GiveIndia, was inaugurated by Vice President of India M Venkaiah Naidu at the Vidhana Soudha. The programme aims to vaccinate marginalised sections of society across the country against COVID-19. GiveIndia will collaborate with state governments, donors and partner organisations to mobilise excluded communities in rural areas and isolated localities, help people overcome vaccine hesitancy and effectively distribute and administer the vaccines.

The Bengaluru-based non-profit organisation believes that there is a strong need to support existing implementing bodies for accelerating vaccination efforts in the country. While the government is trying its best, philanthropy and the private sector can join hands to reach the underserved across India.

Cipla in JV with Kemwell Biopharma for biosimilars Cipla and Kemwell Biopharma announced the execution of a joint venture agreement to develop, manufacture and commercialise biosimilars for global markets. For this purpose, a joint venture company shall be incorporated with an aim to enter the respiratory biosimilars space.

Under the terms of the agreement, the joint venture will leverage Cipla and Kemwell’s complementary strengths for end-to-end product development, clinical development, regulatory filings, manufacturing and commercialisation of biopharmaceutical products. Cipla’s respiratory prowess combined with Kemwell’s expertise in biologics will accelerate bringing these essential products to market.

Union Health Minister inaugurates OPD services at AIIMS Deoghar Mansukh Mandaviya, Union Minister for Health & Family Welfare dedicated the AYUSH Building and night shelter of AIIMS Deoghar to the nation today in the presence of Dr Bharati Pravin Pawar, Union Minister of State for Health and Family Welfare. He also inaugurated the OPD Services of the institute in the new AYUSH Building.

Vice President M Venkaiah Naidu launching the Vaccinate India Programme

10

September 2021

The OPD facilities in AIIMS, Deoghar are to include Medicine and its allied specialitiesgeneral medicine, pulmonology (TB and respiratory diseases), psychiatry, dermatology (Skin), Surgical and allied specialities- general surgery, orthopaedics, ENT, ophthalmology, paediatricsVaccination of newborn and children, obstetrics and gynaecology, dentistry, pathology and microbiology, radiology etc.

DBT collaborates with BRICS to study impact of COVID-19 on TB patients Department of Biotechnology, Ministry of Science and Technology, Government of India in collaboration with BRICS countries is implementing SARS-CoV-2 NGS-BRICS consortium and multi-centric programme to study the impact of severe COVID-19 conditions on TB patients.

The SARS-CoV-2 NGS-BRICS consortium is an interdisciplinary collaboration to advance COVID-19 health-relevant knowledge and to contribute to improvements in health outcomes. The consortium will accelerate the translation of genomic data leading to clinical and public health research and interventions from clinical and surveillance samples by utilising the high-end genomic technologies, and epidemiologic and bioinformatics tools for future use in diagnostic assays and tracking transmission dynamics of COVID-19 and other viruses.

In doing so, Enzene becomes the only biopharmaceutical company in India to offer all three dosage strengths of the drug (125mcg, 250mcg, and 500mcg).

ITP is a rare haematological disorder (prevalently autoimmune) with a primary clinical presentation of aberrantly low platelet levels, and symptoms including an increased bruising and bleeding tendency.

Romiplostim, a therapeutic fusion protein, acts as a thrombopoiesis stimulating factor, thereby restoring platelet levels and ameliorating the disease. As such, it remains one of the most reliable long-term treatment options for ITP patients.

Dr BK Misra

Dr BK Misra receives AANS International Lifetime Achievement Award in neurosurgery Dr BK Misra, Head of the Department of Surgery, Head, Division of Neurosurgery & Gamma Knife Radiosurgery, PD Hinduja Hospital & Medical Research Centre, received the International Lifetime Achievement Award from the American Association of Neurological Surgeons (AANS) at its Annual Scientific Meeting 2021, Orlando. He is the first Indian ever to be bestowed with this award.

Dr Misra is Honorary President of Asian Australasian Society of Neurological Surgeons (AASNS), is the first Vice President of the World Federation of Neurosurgical Societies (WFNS), and President of the World Federation of Skull Base Societies, all leading international neurosurgical societies.

Healthtech startup Zini. ai bags seed grant from Punjab govt Zini.ai, an AI-powered multilingual virtual physician, a flagship product by Grainpad, was selected for the Startup Punjab seed grant award. Zini.ai was shortlisted from a cohort of 15 startups that were further shortlisted from more than 150 companies from across the country.

The startups selected for the grant will have access to mentors, networking opportunities, interactions with Invest Punjab and other stakeholders. The selected startups were reviewed by prominent institutions like the Institute of Nanoscience and Technology, an

autonomous research institute of Dept. of Science & Technology, Government of India.

Wipro GE Healthcare launches GESonoSimSimulation CoE Lab in Navi Mumbai Wipro GE Healthcare launched its firstever GE-SonoSim Simulation Centre Of Excellence (CoE) Lab in the South Asia Region at MGM Institute of Health Sciences, Navi Mumbai. SonoSimprovides scalable technology will train medical professionals and students in ultrasonography, using real patient cases spanning a broad spectrum of normal and pathologic conditions.

The collaboration focuses on providing enhanced education services to medical professionals who aspire to learn ultrasonography from women’s health and cardiology to point of care and primary care. The SonoSimUltrasound Training Solution is a portable and comprehensive laptop-based ultrasound training platform that offers a curriculum of 60-plus cloud-based courses, image acquisition and interpretation training using the SonoSimulator and performance tracking respectively. The platform allows cases to be obtained from real patients for an on-demand, hands-on authentic scanning experience for ultrasound learning.

Enzene Biosciences obtains MA for Romiplostim Biosimilar drug in India Enzene Biosciences ‘Enzene’ announced a successful Marketing Authorization (MA) from the Drug Controller General of India (DCGI) for its second biosimilar drug ‘Romiplostim’, indicated for the treatment of chronic Immune Thrombocytopenic Purpura (ITP) in adults.

Inauguration of GE-SonoSimSimulation CoE Lab

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11

NEWS ROUNDUP powered, conversation media platform, announced the launch of

Immunise, a

public awareness campaign that is targeted at the millennials and Gen Zies to help bust myths around vaccination.

Bobble AI has designed and developed a series of rich visuals (stickers & GIFs) around COVID-19 vaccinations which can be used as a part of everyday conversations on

chat

messaging

apps

including

WhatsApp. With this collaboration, PI India is attempting to create more awareness about vaccinations by reaching out to the younger generation. Each GIF and Sticker narrates and encourages greater acceptance of available vaccinations with quirky messages such as 2 Shots Zindagi Ke, Safe Hai Surakshit Hai, Who says?

Meena Ganesh

Vaibhav Tewari

Meena Ganesh, Vaibhav Tewari joins Portea Medical as Chairperson and CEO

one of India’s leading research and education institutions has successfully inked a ‘Mutual Understanding and Confidential Disclosure Agreement’ (CCDA) with The Brigham and Women’s Hospital, (BWH) an affiliate of Harvard Medical School to set up world-class cutting edge diagnostic research centre. Expected to be set up with an overlap of $5 million, this will be the cutting edge facility rivalling the best in the world in point of care diagnostics and mobile / tech-enabled diagnostic devices.

Portea Medica announced the appointment of the founder Meena Ganesh as the Chairperson and of Vaibhav Tewari as the company’s CEO. In her new capacity, Ganesh will be building strategy, M&A, driving advocacy and relationships with stakeholders such as institutional partners, government bodies, investors and external communication. Tewari will be working on company growth, strategy roll-out, building business and deploying technologies. The new appointments have been made to further synergies and streamline Portea’s operations in the new normal, and efficiently activate the 2023 growth strategy of the organisation. As the leading brand in its domain, Portea is now all set to move forward with a threepronged approach: transform current business with digital adoption, rapid geographical expansion and digital-led business.

BIHER to set up diagnostics research centre Tamil Nadu-based Bharath Institute of Higher Education and Research (BIHER),

12

September 2021

WHO says, Savdhani Hati, Durghatna Ghati

The CCDA signed between BIHER and BWH paves way for a formal engagement towards the joint development of a state of the art research facility in medical, point of care, mobile-based diagnostics.

The applications of such a centre are numerous: starting from detection of male infertility, ovulation, cancer and even viral loads which are critical as the current world is overwhelmed by the COVID-19 pandemic.

to name a few. The platform is capitalising on the efficacy of its Bharat Keyboards and has introduced these creative content formats in four regional languages Hindi, Bangla, Marathi and Malayalam.

Dr Indu Bhushan joins OxygenForIndia board OxygenForIndia

(OFI),

a

volunteer-run

campaign to deliver medical oxygen in response to the COVID-19 second wave in India, has welcomed on board Dr Indu Bhushan, the founding CEO of Ayushman Bharat. Dr Bhushan will co-lead the effort to form a national oxygen grid. The initiative aims to solve the problem of oxygen shortages across India to ensure that no one ever dies due to a lack of medical oxygen in the country.

Dr Indu Bhushan, Ex CEO, Ayushman Bharat said, “An ideal oxygen grid for the country would work much like an

PI India launches India’s first AI-powered vaccine awareness campaign Immunise

electricity grid, with central generation

PI India (Parliamentarians with Innovators

oxygen when and where it is required —

for

distinguished

needs both centralised and decentralised

parliamentarians across political parties

production, plus reliable transmission, and

in partnership with Bobble AI, the AI-

storage.”

India),

a

group

of

(LMO),

transmission

(tankers

and

cylinders), storage (liquid and gaseous), and decentralised production (PSA generators and oxygen concentrators). A sustainable oxygen grid — one that supplies medical

is the leading Indian manufacturer of pharma packaging products such as vials, syringes, ampoules and cartridges used to package life-saving medications. With this acquisition, Serum is securing its supply of high-quality pharma packaging amid rising global demand.

Sterling Accuris Diagnostics appoints Dr Shakti Aggarwal as Asst VP, clinical operations NABL accredited Sterling Accuris Diagnostics has appointed Dr Shakti Aggarwal as Asst Vice President, clinical operations. Dr Aggarwal is an experienced biochemist with a demonstrated history of working in the health wellness and fitness industry. Skilled in Healthcare Information Technology (HIT), Clinical Research, Medical Education, Life Sciences, and Hospitals. He is a strong research professional with a Doctor of Medicine (MD) focussed in Biochemistry from Lady Hardinge Medical College.

Fujifilm - CXR-AID

Fujifilm, Lunit launch AI-powered product for chest X-ray in Japan Fujifilm Corporation announced its AIpowered product for analysing chest X-ray ‘CXR-AID’ will be commercially available across Japan. CXR-AID is designed to better detect major abnormal findings such as chest nodule, consolidation, and pneumothorax from chest X-ray images.

Findings detected by the AI software are shown in colour as a heatmap display, with each score included. Through this solution, doctors and medical professionals can reduce

missed

cases

and

effectively

diagnose chest diseases from chest X-ray.

The PMDA approved AI-powered software

QubeHealth with OboPay to launch medical credit Health-tech

company

QubeHealth

has

partnered with OboPay, the global mobile payment solutions company to launch a zero per cent interest, collateral-free, pre-approved healthcare credit card for employed Indians and their families. The pre-approved ‘Interest-Free’ credit facility will be available to members across 11,000 hospitals, clinics, pharmacies and other health service providers in India.

This covers OPD & IPD expenses, elective procedures (dental, eye, cosmetic, assisted pregnancy and more), as well as pharmacy and any expense not covered in standard health insurance provided by employers.

Ketto.org introduces ‘Healthnest’ app Ketto.org has introduced an app – ‘Healthnest’ to mark the celebration of its ninth anniversary. Healthnest is a healthcare community app developed for patients, caregivers, medical experts, and doctors. It is a social community platform to connect patients with similar medical conditions and empower them to share information and find emotional support.

Ketto’s Healthnest app is a centralised platform to connect with people who have overcome similar health experiences.

The app also enables its users to connect with medical experts and healthcare practitioners for any medical suggestions and second opinions.

Fujifilm’s PACS system(SYNAPSE) and is

SCHOTT, Serum Institute of India in JV for pharma packaging

to be distributed across hospitals and

Germany’s

medical institutions of Japan for more

SCHOTT has partnered with Serum Institute

efficient diagnosis. A leading medical AI

of India and has bought a 50 per cent stake

company, Lunit provides deep-learning-

in the Indian joint venture SCHOTT Kaisha

Cherian

based AI technology called ‘Lunit INSIGHT

from former co-owners Kairus Dadachanji

India’s first 3D printed heart valve. A

CXR‘ that analyses chest X-rays.

and Shapoor Mistry. The joint venture

working prototype of the new 3D printed

is developed with the core AI technology of Lunit, the company’s solid partner since 2018. The software is provided with

speciality

glass

company

Chennai-based heart surgeon develops 3-D printed heart valve Chennai-based heart surgeon Dr Sanjay has

designed

and

developed

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13

NEWS ROUNDUP and development capabilities and extend service offerings in the space of GMP manufacturing of plasmid DNA and mRNA. In addition to this, another 2000L single-use bioreactor will be added to the US FDA and EMA compliant mammalian manufacturing facility. This is expected to strengthen Syngene’s service offerings for commercial supply. The expansion is building on Syngene’s existing biopharmaceuticals manufacturing capabilities and is aligned with its strategic focus on biologics as one of its future growth drivers.

heart valve was recently displayed by Dr Cherian. According to Dr Cherian, the new 3D printed heart valve could be the future of cardiac surgery, since it overcomes most of the disadvantages/complications associated with the currently available artificial heart valves that are in use today. The scientific innovation was undertaken in collaboration with the Centre for Automation and School of Mechanical Engineering, Vellore Institute of Technology (VIT), Chennai.

with

Mpower partners with Maha govt for rural community mental health project Mpower announced its collaboration with the Government of Maharashtra to launch a rural community mental health project.

The pilot mental health programme will soon commence in the Jalna district of

Fitterfly, Roche, USV, Lal Path Labs to launch pre-diabetes awareness campaign Dr Sanjay Cherian

professionals’ practical learning tomorrow’s healthcare leaders.

Maharashtra and Mpower will closely work with 40 Primary Health Centres (PHCs) to aid the District Mental Health Programme (DMHP). The implementation of rural community mental health projects

In a first-of-its-kind initiative to mark ‘World Prediabetes Day’ on the 14th of August, Fitterfly Healthtech collaborated with top doctors, Roche Diabetes Care, Lal Path Labs and USV Pharma. In the run-up to the event, Fitterfly collaborated with more than 100 doctors and 20 leading corporates for employee wellness webinars and awareness sessions. The partners also launched #FightPrediabetes challenge in which 100 people with a high risk of prediabetes get a chance to win a Diabefly Diabetes Prevention programme and package worth Rs 6000 and reverse their prediabetes in three months.

will

be

three-pronged.

Mpower

will

conduct extensive training programmes and workshops along with the support of all the stakeholders, thereby increasing awareness levels. Mpower will provide high-quality clinical services delivered by trained Psychiatrists and Psychologists with the help of medical officers at all the PHCs. Mpower will create a cadre of trained people on mental health by community participation thereby boosting mental health care and overall support.

Basis the learnings of the pilot project, it will be further replicated in other districts of Maharashtra.

Syngene expands biopharmamanufacturing capacity Syngene International has announced the expansion of its biomanufacturing capacity.

The company has set up and commissioned

HOSMAC to conduct Masterclass Series on ‘Hospital Planning and Design’

Quality of Life for Elderly Index was released by Dr Bibek Debroy, Chairman, Advisory

Council

to

the

Mumbai-headquartered

expanded the capacity of its mammalian

completed 25 years of being leading

Prime

cell manufacturing facility to extend end-

healthcare

planning

has been created by the Institute for

to-end

and

consultancy in Asia. Over the years, the company has grown its presence from

Competitiveness and it sheds light on an

Control (CMC) development solutions for

Chemistry,

Manufacturing

its global clients. Both facilities are located at its Biocon Park campus in Bengaluru, India.

The

and

has

Economic

a new microbial cGMP facility and has also

management

HOSMAC

Govt releases Quality of Life for Elderly Index

India to the Middle East, Africa and certain parts of Europe. To commemorate HOSMAC’s silver jubilee year milestone, it is conducting a thoughtfully curated

microbial

Index

issue often not mentioned-problems faced by the elderly.

The report identifies the regional patterns of ageing across the Indian states and

fermenters of 200 litres and 500 litres

and Design’. These masterclasses are open

capacity.

will

to all and are being held virtually on the

India. The report presents a deeper insight

provide further integration opportunities

third Saturday of every month until June

into how well India is doing to support the

with the company’s existing discovery

2022. The idea is to share the industry

well-being of its ageing population.

September 2021

microbial

has

The

Masterclass Series on ‘Hospital Planning

The

facility

(EAC-PM).

two

14

new

Minister

facility

assesses the overall ageing situation in

Cricketer MS Dhoni with Neuberg team

Neuberg Diagnostics partners with MS Dhoni

and with IQVIA as knowledge partners,

Neuberg Diagnostics has partnered with ace cricketer, MS Dhoni, for creating awareness about Neuberg’s health and wellness campaign. MS Dhoni will also enable the company to generate recall across its global markets in the UAE, South Africa and the US.

Series’. The initiative is set to serve

Dhoni said, “The leaders at Neuberg are committed to providing affordable healthcare across India, and that struck me and it’s a pleasure to be associated with the team and their various programs aimed at providing access to quality and affordable healthcare. Amidst the COVID-19 pandemic, they have taken up the campaign to raise awareness about health and wellness across age groups.

in

NATHEALTH, TiE Mumbai launch startup interface series’

have been implemented so far.

NATHEALTH-Healthcare

Federation

has launched its initiative ‘Reimagining Healthcare:

of

India, in collaboration with TiE Mumbai,

Industry-Startup

Interface

as an effective and credible interface that facilitates meaningful partnerships between the healthcare industry and the startup community.

The Renal Project working in the area of dialysis management; V Engage working the

area

of

teleconsultation

and

telemonitoring; Meradoc working in the area of telemedicine access; CanceRX providing clinical support for oncology and Bynocs which provides a software to accurately diagnose binocular vision anomalies and works for related therapies – were the few start-ups that participated in

the

event

and

shared

successful

collaborative model with the industry that

IIM Calcutta launches Executive Programme in Healthcare Management The

Indian

Institute

of

Management

Calcutta announced to offer a one-year Executive Programme in Healthcare Management commencing from September 2021. Known for its global approach to management education and highly qualified faculty, IIM Calcutta has been at the forefront in the long duration programme(LDPs) domain designed for working professionals.

The Executive Programme in Healthcare Management (EPHM) aims to provide an outlook of the healthcare sector across the world, the latest policies and their implementation. This also comprises practices such as disaster and epidemic management which is relevant for professionals in the current environment.

The objective of the programme is to develop an interdisciplinary orientation towards the management of healthcare and training the participants in managerial leadership. The course also familiarises participants with innovation and entrepreneurship in the Indian healthcare sector and inculcating comparative frameworks in the understanding of healthcare challenges in developing countries.

www.indiamedtoday.com

15

NEWS ROUNDUP

MetroMedi team

MetroMedi joins hands with Telangana govt, WE Hub and Credit Fair Hyderabad-based MetroMedi, an e-health store, has partnered with WE Hub, Government of Telangana to jointly foster and promote women-owned or womenled startups in the fields of healthcare, medicine etc. and promote their products through our market linkage and digital platforms. MetroMedi have also partnered with CreditFair fintech company to facilitate personal loans for a medical emergency, buying medicines, diagnostic services etc. on flexible repayment tenures as EMI.

International

has

MSKCC India to open cancer care centre in Chennai

from patients’ homes, making the process more convenient for those utilising this service. Patients across India will be able to obtain a remote opinion from experts at Memorial Sloan Kettering Cancer Center in the comfort of their home or any Internetenabled location without travelling to MSKCC India in Chennai.

Healthium acquires AbGel devices,

has

acquired

AbGel

gelatin

sponge business from Mumbai-based Shri

has launched MSKCC India to provide cancer patients in India with access to the institution’s world-renowned oncologists, appointed

also be able to collect medical records

Healthium, a global player in medical

Memorial Sloan Kettering Cancer Center

Syngene announces senior-level appointments Syngene

pharmaceutical company and pioneers in the oral-health segment has introduced a denture management kit – Replay Kit, for the elderly. The kit consists of a complete denture hygiene and maintenance routine including a denture storage container, Fixon adhesive cream, Clinsodent cleanser and Clinsodent brush. Realising the unique problems encountered by denture users, the company ICPA has assembled the kit for easy-to-use, everyday denture management.

research, clinical trials, and education.

SGK Labs, adding to its product portfolio focused on surgical and post-surgical care.

Earlier

this

financial

year,

the

company had acquired VitalCare Group in the UK to grow its urology portfolio and expand its market in Europe and the US.

two senior leaders, Alex Del Priore and

The effort stems from the institution’s

Dr Alan Collis, with effect from July 26,

core mission of advancing transformative

2021. Priore has been appointed as the

cancer

Senior

Manufacturing

research worldwide. MSKCC India will

Services. Collis joins as the Vice President,

open a physical location in Chennai,

Integrated Drug Discovery Services. They

manufactured from highly purified neutral

centrally located for patients and staff

will both be based in the US, which is one

gelatin with haemostatic capabilities and

members. The location will serve as a hub

is designed to control blood oozing in

for medical staff who will help patients

instances of haemorrhage from multiple

ICPA launches denture management kit for elderly

coordinate written or virtual consultations,

small vessels, and is completely absorbed

and they will be able to communicate in

in four to five weeks with no residue or

English, Hindi, Urdu, Tamil, Telugu and

encapsulation. It is non-toxic, non-allergic,

ICPA Health Products (ICPA), a leading

Kannada. If necessary, employees will

non-immunogenic and non-pyrogenic.

Vice

President,

of the key markets for the company.

16

September 2021

care

through

education

and

Healthium aims to further expand the market access of this portfolio using its wide network of hospitals across India.

AbGel is an absorbable gelatin sponge,

Cancer screening camp in Varanasi

AstraZeneca India, BHU organise cancer screening camp for women in Varanasi AstraZeneca India and the Banaras Hindu University

(BHU)

conducted

a

cancer

screening camp for women in Varanasi.

This is the second such camp set up in and around Varanasi, as a part of the Ganga

Cytecare Hospitals with Brains Neuro Spine Hospital launch neurosciences centre

Home Department, Karnataka State, in

Cytecare Hospitals announced the launch of a comprehensive neurosciences centre in collaboration with Brains Neuro Spine Hospital. The neurosciences centre was inaugurated by Malini Krishnamurthy, IPS, Principal Secretary to Government (PCAS),

The centre will offer services ranging

the presence of Dr Ferzaan Engineer, CoFounder and Chairman, Cytecare Cancer Hospitals and Suresh Ramu, Co-Founder and CEO, Cytecare Hospitals.

from

stroke

management,

paediatric

neuro-oncology and neurorehabilitation to cerebrovascular surgery, stereotactic radiosurgery and comprehensive care for spine tumours as well as brain tumours.

Godavari Cancer Screening programme, since the launch of its current phase in March 2021. The programme strives to spread awareness on the importance and the need for early detection of oral, breast, and cervical cancers in women and facilitate detection of such cancers at this specialised cancer screening camp. More than 100 women were screened in today’s camp, and 5 suspect cases were referred for further evaluation.

The

Department

Gynaecology,

of

General

Obstetrics

and

Surgery

and

Dentistry provided an expert team of medical professionals for the provision of screening services at the Health and Wellness centre at Tikri. More than 300 women participated in the previous cancer screening camp held at Varanasi in March 2021. Fifteen of whom were then referred to the respective tertiary care hospitals for further management.

Launch of neurosciences centre

www.indiamedtoday.com

17

NEWS ROUNDUP

Smile on Wheels mobile health unit

Dr S Omar Ishrak

Amgen appoints Dr S Omar Ishrak to board of directors

athenahealth partners with Smile Foundation

recognised by the Medical Council of India

athenahealth and Smile Foundation announced the launch of the foundation’s flagship Smile on Wheels programme to strengthen public health infrastructure and provide primary healthcare to Chennai residents.

Through the programme, athenahealth is providing financial support for a Smile on Wheels mobile health unit, that will offer primary healthcare services in an area of Chennai with approximately 17,600 households and 88,000 residents.

biological background in basic research.

MUHS, Nashik to conduct fellowship course in regenerative medicine

Bharat Biotech’s ROTAVAC 5D bags WHO prequalification

Maharashtra University Of Health Sciences

Bharat Biotech announced that the World

(MUHS), Nashik granted first affiliations to

Health Organization (WHO) has awarded

conduct a fellowship course in regenerative

prequalification to its rotavirus vaccine,

Glenmark Pharmaceuticals and Canadian

medicine and stem cell-based therapies on

ROTAVAC 5D. The new variant of ROTAVAC,

biotech

a research basis at Dr Mahajan’s Hospital &

ROTAVAC 5D, is a unique rotavirus vaccine

Development

formulation that can be administered

exclusive long-term strategic partnership

without a buffer. Its low dose volume (0.5

to manufacture, market and distribute

mL) facilitates easy vaccine logistics, cold

its

chain management and low biomedical

Spray (NONS) for COVID-19 treatment in

qualified

waste disposal post-vaccination. It is used

India and other Asian markets including

specialists

for the prevention of rotavirus infection,

Singapore, Malaysia, Hong Kong, Taiwan,

which is prevalent in infants and young

Nepal, Brunei, Cambodia, Laos, Myanmar,

children.

Sri Lanka, Timor-Leste and Vietnam.

are eligible for admission. Candidates should have six months of basic molecular The basic research in molecular biology of human body science is the first time in India to give research background

Amgen announced the appointment of Dr S Omar Ishrak to its Board of Directors,

to qualified physicians and surgeons to

effective immediately. Dr Ishrak will also

practice medicine. The two-year fellowship

serve as a member of the Board’s Corporate

programme will have FDA regulations,

Responsibility and Compliance Committee

ethics, emerging technologies in stem cell,

and its Compensation and Management

pre-clinical studies, mesenchymal stem

Development Committee. Following the

cell isolation and transplantation, etc.

appointment of Dr Ishrak, the board will be composed of 12 directors, 11 of whom

Stem Rx Bioscience Solution, Navi Mumbai.

The move will address the education and training gaps in this new area of regenerative medicine.

MD/MS/M.Ch,/DM/DNB surgeons/physicians/super from

allopathy,

undergraduate

or

postgraduate degrees equivalent to and

18

September 2021

are independent.

Glenmark, SaNOtize in tie-up for NONS to treat COVID-19 firm

SaNOtize Corp

breakthrough

Research

announced

Nitric

Oxide

& an

Nasal

APPROACH

How To Return To Normal Air Travel Post COVID AHPI and APAO report recommend measures for safe air travel

Source: Association of Healthcare Providers (India) (AHPI) and the Association of Private Airport Operators [APAO] report Resuming Safe Air Travel

The COVID-19 pandemic has had a devastating impact on the air transport industry. Further, COVID-19 has caused a sense of fear amongst air travellers.

The safe reopening of domestic and international travel is crucial to revive international business travel and help kick start economic recovery. There is an urgent need for an authentic document by experts in the field of aviation and health to allay the fear in the minds of the passengers thereby ensuring the revival of air travel to the pre-pandemic period.

Association of Healthcare Providers (India) (AHPI) and the Association of Private Airport Operators [APAO] have created a joint advisory on 'Resuming Safe Air Travel.' Around 30 experts from various connected fields such as aviation travel medicine, infectious diseases, epidemiologist, virologists, community medicine, the technical advisory committee for COVID-19 members, and The Lancet COVID-19 commission India task force members were involved in creating the document along with inputs from WHO. Two groups of experts independently deliberated on the issue and came up with their recommendations, which was jointly discussed thread-bare and the unanimous decisions arrived upon, was compiled into the document - 'Resuming Safe Air Travel,' which took about two weeks and around 15 zoom interactions.

The document released by the Joint Secretary - Ministry of Civil Aviation, GoI

Handing over of whitepaper to Ministry of Civil Aviation, NITI Aayog & MOHFW

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19

APPROACH

Handing over of whitepaper to Ministry of Civil Aviation, NITI Aayog & MOHFW has been handed over to the Secretary - Ministry of Civil Aviation GoI and the Minister for Health and Family Welfare Government of India.

be taken at the airport seating area, counters, toilets, baggage handling area, cafeterias, lounges, aerobridge, inside the aircraft etc.

Masks should be changed as required.

Both the associations have recommended certain measures which if implemented is bound to encourage air travel and help the revival of the country's economy.

• Proper usage of PPE and gloves and temperature screening at airports is also been recommended. Also, every major airport should have an air ambulance fitted with isolation pods to transport willing COVID-19 patients.

cabin crew/ground crew assistance can

• At the check-in counter, the use of facial recognition technology to confirm identity is recommended. Passengers should display their boarding pass (also containing information about their vaccination status) on their mobile phones. The use of soft copies of documents for identity checks should be encouraged. The authentication of the passenger’s vaccination status should be verified. India should approve the IATA Travel Pass App or the India Digital COVID certificate which will contain the respective passenger’s vaccination status and RT-PCR reports. QR code scanning across airports and airlines should be implemented while QR code requirements in the RT-PCR should be made mandatory to meet international requirements.

wearing and distancing through the

• Onboard the aircraft, masks are to be worn continuously throughout the flight.

distancing, especially in the aerobridge

Excerpts from the recommendations: • The government should facilitate the acceptance of WHO-approved vaccinations given in other parts of the world. The Ministry of Civil Aviation should encourage airlines operating from India to recognise the government approved Travel Pass App. • Airport, airlines, support employees and aircrew should undertake the following measures like following COVID-appropriate behaviours, attending regular sessions on managing mental health issues of all personnel, undergo training to monitor COVIDappropriate behaviour and handle passengers efficiently and strictly follow instructions regarding travel restrictions, isolation, screening and other safety procedures that are to be followed should be provided in multiple languages.

• Apart from these, precautions should

20

September 2021

The placement of cabin luggage in the overhead luggage compartment is to be done by the passenger. If necessary, be sought. Sanitiser should be used appropriately and regularly. The air vents above the seats should be kept open. The flight crew should remind passengers

repeatedly

about

mask-

public address system. In-flight snacks should preferably be avoided as serving meals on flights can pose a challenge in this environment.

• On

flights

where

it

cannot

be

avoided, snacks can be delivered using a contactless method such as wrapping the plate with cellophane wrap. The option of staggered meals can also be explored.

• While plane,

disembarking passengers

from

should

do

the so

row by row. Standing in the aisle should be prohibited. Touching other people or inanimate surfaces and use hand sanitisers should be avoided.

Passengers

should

maintain

area, as ventilation is poor.

safe

COVER STORY

Cardiovascular Disease During Covid Times

www.indiamedtoday.com

21

CARDIOLOGY FOCUS

Innovations in Cardiology at Medica Hospitals How the Kolkata-based hospital is using new technology and techniques to improve patient outcomes M Neelam Kachhap Medica Superspeciality Hospital, Kolkata has invested in the latest technology since it first opened its doors to patients in 2010. The hospital is known for treating complex cases and its thought leaders regularly speak at the cardiology conferences about new research and technology innovations they work with. Some of the thought leaders are Dr Kunal Sarkar, Senior Vice Chairman, Senior Cardiac Surgeon & Head (Medica Institute of Cardiac Sciences); Dr Rabin Chakraborty, Senior Vice Chairman, Medica Group; Dr Dilip Kumar, Director, Cath Lab; Dr Sanjeev Garg, Head, NonInvasive Cardiology and Dr Anil Kumar Singhi, Senior Consultant, Paediatric Cardiology.

The hospital is the largest chain of private hospitals in Eastern India with hospitals in West Bengal, Jharkhand, Odisha, Bihar, and Assam. The flagship hospital at Kolkata attracts patients from neighbouring countries too. In, 2018-19 the hospital treated 9183 (OP & IP) international patients, mainly from Bangladesh, Myanmar, Nepal, Bhutan and other neighbouring countries, while in 2019-20, the numbers were 7057 (OP & IP) International patients.

Recently, Medica Superspeciality Hospital, Kolkata introduced a new technology for angioplasty treatment by introducing and implanting the latest

22

September 2021

available indigenous Absorbable Stent / Bio Resorbable Scaffold (BRS). This BRS is the world’s first-ever 100-micron thinstrut scaffold and has received approval from the Drugs Controller General of India (DCGI) and CE Approval in Europe and has been studied in research trials in India and globally, supporting its positive safety and efficacy.

Top Ranked Structural Heart Programes Medica Superspeciality Hospital is known as a pioneer in structural heart interventions, including transcatheter aortic valve replacement (TAVR), transcatheter mitral valve replacement (TMVR) and transcatheter repair, and left atrial appendage (LAA) occlusion.

Several of its doctors are also well known experts in complex percutaneous coronary intervention (PCI), including chronic total occlusion (CTO) procedures.

The hospital is the first centre in Eastern India that has managed cardiogenic shock patients with mechanical circulatory support (ECMO). The device subspecialty has the distinction of performing one of the largest conduction system pacing in India.

The hospital conducts unique and innovative procedures in the cath lab and its cath lab services run round the clock to provide life-saving procedures

Dr Kunal Sarkar Senior Vice Chairman & Head Medica Institute of Cardiac Sciences like primary angioplasty. Medica also runs active pediatric cardiology and electrophysiology programmes

Advanced Teaching Programmes The

cardiac

team

at

Medica

Superspeciality Hospital is very active

Dr Rabin Chakraborty Senior Vice Chairman & Group Head Cardiology Services Medica Superspeciality Hospital looked for cutting-edge systems that could provide both improved image quality and reduce dose for both the cath lab staff and patients. Some of the imaging technologies used are: IVUS - Intravenous Ultrasound • imaging tool to understand the plaque morphology as well as the stent optimization. and energetic. They frequently conduct

academic programme through social

active

media like Medica Cardio Talk.

programmes

for

out

station

camps at the district level in various Tripura, Assam, Jharkhand, Bihar.

State-of-the-art Technology at Medica Hospital

The hospital also has a reputed DNB

As cardiac cases become more complex,

Super Speciality training programme in

especially with longer and more involved

Cardiology. They also run various active

CTO and structural heart procedures,

parts of Bengal and Eastern Indian like

• Rotablation - Fibrocalcific lesion is very hard to open. Rotablation helps to cut the calcification, which helps a smoother delivery of the stent and a proper expansion.

• IVL Therapy Intravascular lithotripsy is a novel technique based on an established treatment strategy for vascular calcium, in which multiple lithotripsy emitters mounted on a traditional balloon catheter platform deliver localised pulsatile sonic pressure waves to circumferentially modify coronary calcium. This therapy is less time consuming, safer and easier compare to traditional Rotablation therapy.

• FFR - Fractional flow reserve measurement involves determining the ratio between the maximum achievable blood flow in a diseased coronary artery and the theoretical maximum flow in a normal coronary artery.

Dr Dilip Kumar Director Cardiac Cath Lab

Dr Sanjeev Garg Head Non-Invasive Cardiology

• CSP - The aim of conduction system pacing (CPS) is to provide physiological ventricular activation by directly

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23

CARDIOLOGY FOCUS

Yogesh Joshi Vice President- Marketing & BD External Hospitals & International Marketing stimulating the conduction system. In eastern India, Medica has performed the highest number of CSP. The hospital has conducted three successful training programme of CRT, where cardiologist from pan India came for training.

• 3D RFA - 3D mapping creates a multidimensional image of the heart’s anatomy. It reduces conventional fluoroscopic radiation. The tip of the catheter sends RF energy to destroy the abnormal cells in that area.

Leader in Reducing Cardiac Mortality In recent years, Medica Superspeciality Hospital has spearheaded several initiatives to reduce cardiac mortality.

At Medica Superspeciality Hospital Veno-venous (VV ) ECMO has been used for both Covid and non-Covid ARDS which causes extensive lung damage, compromising oxygen delivery to

Dr Arpan Chakraborty Senior Consultant Medica Institute of Cardiac Sciences

24

September 2021

tissues leading to multi-organ failure and even mortality. VV ECMO bypasses the lungs and provides adequate oxygen washes out carbon dioxide, maintains tissue perfusion and prevents organ damage.

VA

ECMO has been used in Acute

The team at Medica has experience in using VV ECMO in a patient post LUCS with amniotic fluid embolism that caused acute lung injury. The patient was resuscitated with ECMO and nurses back home.

pulmonary embolism before pulmonary

Veno-arterial (VA) ECMO for low cardiac output due to cardiac dysfunction has been used to support both the lungs and the heart by bypassing both. Here tissues that are devoid of oxygen are provided with adequate oxygen and hemodynamics is maintained, thus, buying time till the recovery of the damaged organ.

CPR) plays an important alternative

coronary

syndrome

,

Acute

MI

leading to ventricular septal rupture, Cardiogenic

shock,

myocarditis

of

various origin, Stuck prosthetic valve, intractable arrhythmias,

in massive

embolectomy, as a bridge to a patient awaiting transplant and in surgeries with impossible airways like tracheal stenosis.

VA ECMO as E CPR ( Extracorporeal to traditional CPR due to available resources with a hospital in etiologies of cardiac arrest with reversible causes during a limited period of mechanical cardiorespiratory support. It not only stabilizes addresses

hemodynamics reperfusion

prevents immediate death.

but

also

injury

and

palliative surgeries like BD Glenn and BT shunts.

Some of these small patients require ECMO support postoperatively before their

hearts

become

independently

functional.

Team’s has a lot of experience in adult cardiac surgeries, like Coronary revascularization, replacements, procedures,

prosthetic

Aortic

valve

reconstruction

Transesophageal

fistula

repairs and other vascular repairs, thoracic

surgeries

,mediastinal

mass

like

bullectomy

removals

needs

mention.

Cath Lab team with Mr Arnab in centre (on chair) The team has initiated VA ECMO as part of E CPR for a patient with a history of DVT who suffered cardiac arrest due to sudden massive pulmonary embolism.

He was resuscitated and stabilised on ECMO before taking up for pulmonary embolectomy.

The cardiac team has had a patient of laryngeal CA post-irradiation and laryngectomy with severe Aortic stenosis presenting with syncope, who was stabilised on VA ECMO before undergoing CAG followed by tracheostomy and bioprosthetic aortic valve replacement.

They have also performed MICS ( Micro Incision Cardiac Surgery) and VATS

Trans Oesophageal Echocardiography

(video-assisted

The hospital has experience in using TEE (trans oesophageal echocardiography) regularly in ORs and ICUs on pre and postoperative patients.

TEE serves as eyes and hands for cardiac anesthesiologist and intensivists as it serves in

anatomical and functional

assessment of the heart: cardiac output, new onset myocardial insufficiency, adequacy of revascularisation surgery, defects in valvular structures, functional adequacy of prosthetic valves, fluid and

The team also has experience in using VV ECMO with IABP (intra aortic balloon pump) for Acute lung injury with reversible LV dysfunction where use of VA ECMO could be avoided .

requirement

responsiveness,

In last five years, Medica Superspeciality Hospital has administered ECMO in over 300 patients, more than 200 cases of Covid and non Covid ARDS. The team has retrieved patients on ECMO successfully on land and through air transport. The hospital is positioned on the ELSO map as Centre No.738. The hospital has been associated with training programmes of personnel form different part of the country. Medica is integrally associated with the initiation of Government ECMO programmes by the Government of West Bengal and Odisha.

embolism . TEE also serves in identifying

evidence of pericardial effusion and identification

of

life-threatening

emergencies like postoperative cardiac tamponade

and

intraoperative

air

complex structural anatomy of the heart with congenital anomalies and in assessing the adequacy of surgical correction in such hearts.

Surgeries Medica

Superspeciality

Hospital

performs successful complex congenital cardiac

surgeries

Thoracic

Surgery).

Last but not the least, the team also

like

Norwood

procedure, Arterial Switch

surgeries,

Senning's procedure; apart from regular surgeries like VSD and ASD closures and

has experience in administration of LVAD ( Left Ventricular Assist Device) and

performing

successful

cardiac

transplant.

With inputs from Dr Kunal Sarkar, Senior Vice Chairman & Head Medica Institute of Cardiac Sciences Dr Rabin Chakraborty, Senior Vice Chairman & Group Head Cardiology Services Dr Dilip Kumar, Director Cardiac Cath Lab Dr Sanjeev Garg, Head Non-Invasive Cardiology Dr Arpan Chakraborty, Senior Consultant - Medica Institute of Cardiac Sciences Mr. Arnab De, Senior Manager Cathlab Mr.Yogesh Joshi, Vice President- Marketing & Business Development External Hospitals & International Marketing

www.indiamedtoday.com

25

FEATURE

Caring for Cardiac Electrophysiologists How Indian cardiologists can get free electrophysiology continuing education (CE) course Team IMT

Electrophysiology

is

a

niche

topic

in cardiology which deals with the electrical

activities

measuring,

of

diagnosing

the and

heart treating

problems of electrical activities. The first Indian registry, the Indian Heart Rhythm

Society

(IHRS)

AF

study

reported an incidence of 33 per cent in the study group for atrial fibrillation.

However, there are only about 250300 cardiac electrophysiologist in India.

Very few hospitals have established programmes

for

formal

cardiac electrophysiology.

26

September 2021

training

in

By 2050, it is projected that more than 5.6 million people in the US will be affected by atrial fibrillation, but less than half of the hospitals in the US today offer EP services. Once considered a mainstay in the cardiac EP lab of a hospital, the employee landscape is now evolving as the pandemic caused many leading cardiac EP clinicians to become travelling clinicians.

A US-based healthcare company Medline ReNewal recently announced the launch of a continuing education (CE) course series to help cardiac

electrophysiology (EP) clinicians learn

education units and covers EP basics,

more about the fundamentals of cardiac

including

electrograms,

EP lab procedures. Available through

ablation,

pharmacology,

Medline, the courses are led and created

protocols.

by Angela Massen, senior clinical EP sales specialist at Medline ReNewal and

a

registered

cardiovascular

electrophysiology specialist (RCES) with 14 years of experience in the Cardiac EP Lab. "Cardiac

• This

arrhythmias, and

pacing

Cardiac EP Technical Education: programme

gives

participants

access to in-depth advanced cardiac EP education, covering arrhythmias, ultrasound basics, basic intracardiac echo (ICE), carto connections, mapping

EP

clinicians

are

vital

to

healthcare and as the industry continues

basics, and troubleshooting.

Basic Ultrasound Education: This

to shift due to dynamic forces like

•

COVID-19 and staffing shortages, access

programme covers the ultrasound basics

to educational resources are needed to

of ICE, including ultrasound basics, ICE

meet the continuing education needs of

basics, troubleshooting and knobology.

clinicians," says Angela Massen, RCES,

"Cardiac EP lab clinicians are at the

senior clinical EP sales specialist at

cutting-edge of healthcare and with

Medline. "Medline ReNewal has deep experience working in the cardiac EP lab and our course offering reflects our in-depth knowledge of the needs of cardiac EP clinicians."

a lack of readily available courses, continuing education can be a challenge," Massen continued. "Our course provides an

easy

to

use

resources

created

through the lens of the cardiac EP lab

This course is open to cardiologists

clinicians, so the learning is instantly

across the world and is offered free

applicable on the job."

of charge through Medline. The three courses include: •

Cardiac

course

EP

provides

Medline is a healthcare company; a manufacturer, distributor and solutions

Fundamentals: students

with

This an

opportunity to earn two continuing

provider focused on improving the overall

operating

performance

of

healthcare

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27

INNOVATE

A Working Prototype of the New 3D Printed Heart Valve Dr Sanjay Cherian, Vice President and Cardiac surgeon at Frontier Lifeline Hospitals, explains the importance of 3D printed heart valves and introduces the scientific innovation

Heart valves are crucial as they allow blood to flow only in one direction so that the blood is pumped as valves open and shut with each beat of the heart. Valves are one-way doors, allowing blood to flow forward. In the human body, there are four valves; two valves located between the atria and ventricles, the tricuspid and mitral valves, are known as atrioventricular valves. The other two valves the pulmonary and aortic, are called semilunar valves, because each of those valves has leaflets that are shaped like half-moons.

When these valves do not function as intended the heart function gets affected and the valves need to be replaced. Sometimes the valve opening is smaller than normal due to stiff or fused leaflets while some valves are damaged and do not close tightly such that blood flows backwards.

Valvular heart disease (VHD) incidence is rising in India and the number of valve replacements have also gone up in the recent years.

The

currently

available

artificial

heart valves are either made of metal Dr Sanjay Cherian with the 3D heart valve

components animal

(mechanical),

tissues

or

from

(bioprosthetic),

each

with its disadvantages / complications,

28

September 2021

surgeons and cardiologists to navigate and choose the best approach to treat heart diseases. This time, we focused our

efforts

to

on

using

manufacture

heart

3D

printers

valves

using

specialised biopolymers that are very similar to human tissue, which can be directly implanted in heart patients,” Dr Cherian explained.

Innovation at its Best A working prototype of the new 3D printed

heart

valve

was

displayed

by Dr Cherian recently during a press conference. “This new 3D printed heart valve could be the future of cardiac surgery, since it overcomes most of the disadvantages and complications associated with the currently available artificial heart valves that are in use today,” he said.

“Another added advantage of this 3D printed heart valve is that its design was

developed

using

specialised

computer-aided design software and modelling techniques, based on the MRI scan images of the human heart, as a result of which, we are now able such as the risk of blood clot formation, valve failure due to degeneration, valve infection, the need for long-term blood thinner medications, etc.

Scope of 3D-Printed Valve With the recent advances in technology and research-led innovation, the scope of using 3D printing to design new heart valves that could overcome these problems related to “We have designed and artificial heart valves, was proposed by developed India’s first 3D Chennai-based heart printed heart valve,” surgeon, Dr Sanjay Dr Sanjay Cherian, Vice Cherian.

President and cardiac surgeon, Frontier Lifeline Hospitals, Chennai

“We have been doing extensive research on the concept of 3D printing in the field of Medicine. Earlier, 3D printing was used to plan the surgical approach, especially for complex procedures, to help cardiac

to customise and 3D print heart valves that will fit exactly to the dimensions of the patient’s heart,” said Dr Cherian.

This scientific innovation is a giant leap in the field of cardiac surgery, and was undertaken in collaboration with the Centre for Automation and School of

Mechanical

Engineering,

Vellore

Institute of Technology (VIT), Chennai.

The team is in the process of patenting this 3D printed heart valve, and testing it

to

confirm

its

bio-compatibility,

efficacy and durability. When it will be available in the market the cost of this novel heart valve could be much lower than that of the imported heart valves that are currently used in India.

What is the 3D printed valve made of?

This novel heart valve is made of a new specialised bio-polymer that is very similar to human tissue.

www.indiamedtoday.com

The

29

INNOVATE

exact composition of materials cannot

eventually torn in at approximately 10

be disclosed at the moment, since the

years.

patent process is going on but once the product is patented, we can disclose the details.

What equipment was used for the same?

We

used

proprietary

3D

printing

How is your 3D printed valve better?

This can be customised to get the exact size for each patient. The valve is made of biological tissue and there may not

machine. Besides, MRI scan images of

be a need for long-term blood thinner

the patient’s heart and heart valves

medicines may not be required and it is

were taken after which the new heart

not from any form of animal tissue.

valve was made by using special 3D printing techniques including a DLPbased photo polymerization technology

The valves that are currently available are imported from other countries

and fused deposition modelling (FDM)

and is expensive. In India, 3D printed

technique.

valves can be much cheaper and easily

What are the current options to replace heart valves?

Now there are two types of valves,

affordable to the common man.

By when can this be used in human?

either a mechanical valve which is made

Currently,

of metal components or there are tissue

confirming

valves (bio-prosthetic valves) which are made from animal tissues. Since it is made from bio polymers, hence does not have any of these complications. This

testing

is

the

going

on

for

biocompatibility,

strength and the flow in the valve, following which animal study will be undertaken and following this, we can

new 3D printed valve is different from

go for clinical trials.

both these valves. Patients have to be

approximately six months to one year

on long-term blood thinner medications

before we officially commercialise this

and these valves can get stuck or

product.

30

September 2021

It may be for

The affordable non-invasive COVID-19 test that connects to a digital passport is here

Contact Us

For general inquiries contact@achiko.com For investor inquiries ir@achiko.com www.indiamedtoday.com www.achiko.com

31

INTERVIEW

MolBio Aims To Be The Solution in Global COVID Testing Sriram Natarajan, CEO, Founder & Director, Molbio Diagnostics explains how the company’s innovative technology could offer POC COVID testing

Team IMT The Truelab Real Time quantitative micro PCR system from Molbio Diagnostics brings PCR technology right to the point-of-care, at all laboratory and nonlaboratory settings, primary centres, in the field, near patients, essentially at all levels of healthcare. Sriram Natarajan, CEO, Founder & Director reveals more in interaction with IMT about the journey of the company and the way forward

How has the molecular diagnostic testing market evolved during COVID-19 pandemic?

The outbreak of COVID-19 dramatically increased the need for RTPCR tests that has resulted in the market size suddenly growing many folds. This has not only increased the uptake of Truenat but has also significantly increased the number of labs doing molecular testing. This has also resulted in enhanced manufacturing capacity for Covid RTPCR tests in the country and the number of players in the conventional laboratory segment.

Molbio has been working at the front line from the very first day of the pandemic and Truenat has played a significant role in India’s fight against COVID-19 by expanding access to RTPCR testing in rural, resource-limited geographies across the country.

With the growing awareness, the demand for early diagnosis of infectious diseases is high, and various public and private organisations are investing funds to accelerate R&D in the field of

32

September 2021

existing 80,000 tests per day to 3.5 lakh tests per day that will ensure the uninterrupted availability of Truenat test kits in the domestic market and help cater to global requirements of COVID-19, TB and other infectious diseases.

How affordable are the tests introduced by Molbio Diagnostics?

molecular diagnostics. Recently, the infectious disease application segment accounted for the largest market share and will grow in the coming years. The increasing prevalence of infectious diseases such as tuberculosis, hepatitis B, and hepatitis C, coupled with tests for sexually transmitted diseases/ infections like HIV and HPV will propel the segment’s growth and molecular testing is expected to become more of a routine clinical diagnostics tool not only for covid but for a wide range of infectious diseases soon. Further, point of care molecular tools such as Truenat will help in providing equal access to high-quality diagnostics across all segments of society, to minimise the devastating impact of delayed diagnosis.

How is the new manufacturing facility going to have an impact in your business?

Looking at the growing global demand for point of care molecular testing, Molbio Diagnostics launched a new manufacturing facility in Goa in June 2021. This facility will be used to increase manufacturing capacity of existing and upcoming Truenat kits and reagents in addition to the Truemix range. The manufacturing capacity has been increased five-fold, from the

Truenat tests are priced affordably and effectively cost lower than conventional reagents considering wastage during batch testing and high dependency on complex infrastructure in the case of the latter. However, the overall cost the benefit of the early point of care diagnosis and the resulting impact on reduced morbidity and mortality, improved disease management and consequently reduced burden on the healthcare system far outweighs the cost of testing.

Which new technologies have been implemented while conducting tests?

Understanding the limitations of conventional molecular platforms, Molbio and its R&D subsidiary Bigtec labs had to completely re-engineer the conventional Real Time PCR technology into a point of care solution by leveraging on technologies such as Micro Electro Mechanical Systems (MEMS), micro and meso fluidic cartridges, nanotechnology, low power thermal cycling using disposable intelligent ceramic chips, lyophilization and other drying techniques and special sealing techniques. The platform was made rugged by minimising moving parts, miniaturised to occupy little floor space, enabled for portability and battery operation, with onboard memory, touchscreen interface and wireless data transfer capability and the reagents were designed for single testing capability, ready to use and stable at room temperature (up to 30 degree C) for two years. The intelligent chip carries a lot of information and standard curve values for generating quantitative results. The intelligent

chip also ensures that wrong chips, previously run chips and expired chips are not run.

The

system

requires

no

special

environmental conditions, no specific maintenance or calibration requirements has inbuilt diagnostic features and error reporting features.

What are your plans for the next five years?

Truenat is already being viewed as a multi-disease platform and in addition to the TB programme, we expect other programmes such as the Viral Hepatitis programme, NACO and vector borne diseases programme to add to the wider deployment and usage of the technology at the grass-root level. The Indian private sector is also able to use the Truenat platform for delivering high quality diagnostics for the full range of tests available.

Over 28 infectious diseases can already be tested on the Truenat platform while tests for another 30 new diseases are in development which is expected to be launched over the next two years.

A

range of open format reagents by the name Truemix are also planned again in ready to use, room temperature stable format.

There

is

also

a

much

larger

and

growing global demand for high quality molecular diagnostic tools that can be especially deployed at the point of care.

We expect to establish ourselves as a major player in the global molecular diagnostics market in the coming years.

At the same time, we are also working on other points of care technologies for providing better solutions for AMR and

non-infectious

disease

testing

applications.

How did the company perform in the previous quarter?

The

company’s

performance

in

Q1

FY21/22 was strong and consistent with last year’s average quarterly sales.

www.indiamedtoday.com

33

MARKET REPORT

What is Driving the India Cardiovascular Devices Market Growth?

Affordability, innovation and rising awareness of treatment options Source: Mordor Intelligence, Fortune Business Insights

Cardiovascular diseases (CVDs) are the leading cause of mortality in India.

Growing lifestyle disorders, obesity,. etc have been the major causes of heart diseases. No wonder then the major cardiac care hospitals and devices players are offering various treatment modalities to capture the fast growing market share of the country.

Rise of CVD in India India is seeing a rising burden of cardiovascular diseases with deaths.

Recently actor Siddharth Shukla died due to a massive heart attack, bringing CVD into focus in young Indians. Doctors opine that stress and lifestyle changes are the major causes of cardiovascular diseases (CVD) among young adults and untimely deaths.

According to the National Institute of Health, the age-standardised prevalence of CVD in India per 100,000 people was around 5,681 during the year 20162017. The prevalence of heart diseases and stroke in India has increased by 50 per cent from 1990 to 2016. In 20162017, CVD alone contributed to 28.1 per cent of the total deaths in India among which, heart disease caused 17.8 per cent whereas stroke contributed 7.1 per cent of total deaths. The country witnessed approximately 300,000 angioplasties.

CVD Treatment Private

34

players

September 2021

and

hospitals

run

By Device Type

Diagnostic and Monitoring Devices

Electrocardiogram (ECG)

Remote Cardiac Monitoring

Other Diagnostic and Monitoring Devices

Therapeutic and Surgical Devices

Cardiac Assist Devices

Cardiac Rhythm Management Devices

Catheter

Grafts

Heart Valves

Stents

Other Therapeutics and Surgical Devices

by government organisations are providing CVD treatment facilities and it is indicated that the CVD market in India is growing rapidly. Some of the notable private players are Fortis Escorts Heart Institute, Asian Heart Institute, Mumbai Apollo Hospitals, Chennai, Indraprastha Apollo Hospital, New Delhi, Nanavati Hospital, Mumbai, Max Superspecialty Hospital, Delhi, MaxCure Hospital, Hyderabad, Manipal Hospital, Bangalore, Fortis Hospital, Bangalore, Artemis Hospital, Delhi, The Wockhardt Heart Institute, Mumbai, BLK Heart Center, Delhi, Ruby Hall, Pune, Continental Hospitals, Hyderabad and Fortis Hospital, Kolkata to name a few.

CVD Devices The cardiovascular devices are designed to help control various conditions or abnormalities that are associated with the heart. These devices include cardiac rhythm management devices, catheters, grafts, heart valves etc. The market for cardiovascular devices in India consists of several global players along with the local players. However, the number of local players in the country is less and the market share is majorly grabbed by global companies such as Abbott Vascular, Boston Scientific, Medtronic, etc. Since India is a growing economy, more global companies are expected to penetrate the market in the coming future.

There is a constant focus to develop

new techniques, low-cost devices for cutting down operation costs, R&D, merger and acquisition, innovation, and technological advancement. This is where Indian companies like TTK and Sahjanand Medicals struggle to keep pace with the vast portfolio and R&D capacity of the global players.

Key market trends Increasing cardiovascular diseases, such as arrhythmias, stroke, and high blood pressure, are increasing the demand for cardiac rhythm management devices across the country.

Cardiac rhythm management (CRM) devices, including pacemakers, implantable defibrillators, cardiac resynchronization therapy, etc., are among the best treatment solutions for cardiac arrhythmias. The pacemaker implant rate is gradually increasing, in line with the ageing population.

The technological advancements are leading to the increasing adoption of pacemakers, and one of the recent advancements include the development of a leadless pacemaker that is onetenth the size of the predecessor devices by Medtronic.

A report from Mordor Intelligence states that in recent years, heart rhythm problems (arrhythmias) have become prevalent and are expected to further experience an increase.

According to the PAN Arrhythmia and Heart Failure Registry (PANARM HF),

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35

MARKET REPORT in 2017, approximately 15 per cent of the total heart failure patients suffer from atrial fibrillation in India. This represents an opportunity for cardiac rhythm management devices in India.

Cardiac arrhythmia is also expected to drive steady growth due to a surge in the adoption rate of pacemakers with futuristic technology to treat this condition. For instance, the Indian subsidiary of Medtronic launched the Azure pacemaker enabled with BlueSync technology. Heart failure cases are also expected to observe positive growth due to devices such as ventricular assist devices (VAD) for treating the disease.

Furthermore, the significant reduction in critical cardiovascular therapeutic devices prices such as coronary stents boosts the expansion of this market, especially in markets such as India.

For example, according to a study by the Harvard TH Chan School of Public Health (HSPH), a reduction in prices for coronary stents in the Indian state of Maharashtra led to a 43 per cent increase in the number of individuals who go through heart procedures (FortuneBI report).

Society for Cardiovascular Angiography and Interventions (SCAI), percutaneous coronary intervention (PCI) for an acute heart attack is considered urgent. Still, a PCI for stable ischemic heart disease can

be

delayed.

Furthermore,

the

pandemic has negatively impacted the market due to the reduced diagnostic procedures across the globe because of the reserved resources for the COVID-19 pandemic. Since the start of

As the demand for these devices is expected to sustain strong growth, key market players are anticipated to show robust involvement in R&D initiatives. This is expected to give rise to innovative product launches, resulting in the improved condition of heart patients. Such novel product developments are also anticipated to result in a substantial patient population base. Furthermore, with the strong increase in cardiovascular diseases in all regions, the market is anticipated to grow at a robust rate in the near future.

the pandemic, regular check-ups and

CVD Market and COVID-19

Also, other players such as Abbott and

The impact of COVID-19 on the global market has been negative due to deferral in elective cardiovascular procedures globally as the number of hospital visits declined. While few procedures are considered urgent, some of them were rescheduled due to the ongoing COVID-19 pandemic. For example, according to the American College of Cardiology (ACC) and the

36

September 2021

diagnoses have been postponed. Adding to it, many key players have witnessed a decline in sales due to the cancellation of procedures.

Prominent companies such as Medtronic and

Boston

Scientific

Corporation

reported strong sales declines in their annual

revenues

of

FY

2020.

For

instance, Boston Scientific Corporation, an essential company in the global market, reported a decrease of -7.9 per cent in revenue compared to FY 2019.

LivaNova PLC also recorded substantial declines in the sales performance of their cardiovascular device products segment by 2.9 per cent and 12.1 per cent, respectively. However, greater adoption

of

these

devices

coupled

with the gradual launch of new devices worldwide is expected to enable the market to return to its pre-pandemic growth levels.

PULSE

Company - Doctor relationship: Has it withstood the pandemic storm ?

Marketing Communication teams had to pull up their socks as sales teams were refrained from meeting the HCPs due to COVID-19 lockdown restrictions. Sangeeth G Kini, VP, Hemogenomics, gives an insight on how the medtech and pharma companies engaged the HCPs during lockdown by augmenting the digital outreach activities; and also analyses the criticality of sales function in the industry

Sangeeth G Kini, VP, Hemogenomics

Since March 2020, the healthcare landscape has been on a rollercoaster ride due to the ever-evolving nature of the pandemic as well as the changing governmental guidelines. Lockdowns, containment zones, travel restrictions, essential services passes to commute, etc have become the new normal between the two waves that we have witnessed. The healthcare delivery segment be it hospitals, laboratories, imaging centres, pharmacy shops; as well as allied healthcare facilities –had to make drastic changes in their operations. The professionals associated with these institutions – hospital administrators, doctors, nurses, paramedics too had to adapt to this new normal balancing their safety with the interests of the patients.

While a lot had already been written about the newer ways of healthcare delivery system, the focus of my article is how the medical products industry such as pharma companies, diagnostics companies and other segments evolved to continue to engage with the doctors, hospital administrator and other stakeholders during and after the lockdown period, as well as to analyse the criticality of sales personnel for the medical companies.

The Lockdown The lockdown declared on March 24,

2020, was abrupt. Many companies were caught unprepared. Work from home became a compulsion than a choice for many professionals. The immediate questions in the minds of corporate leaders were how long would it take to get back to normalcy and what can we do to engage with the Healthcare Providers (HCPs) during this lockdown period.

Traditionally, medical and healthcare companies are highly sales teamcentric. The salespeople would meet the doctors and other stakeholders in hospitals and clinics and promote their products. Over time, the sales person develops relationship with the Healthcare Providers (HCP) and the HCPs too find comfortable to deal with such sales professionals. Negotiations that took place across the table and deals were closed over fruitful face-toface discussions. It was easier for both sides to understand each other better over a cup of Coffee. All these had come to an abrupt stop on 24th March 2020.

Relationship Dynamics in New Normal Most companies were caught unawares, not sure how to stay connected with their core customer base. It was clear that we were heading towards a new normal where digital channels would

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37

PULSE

gain prominence over traditional practices. The companies that were already active in the digital space had the advantage while others followed.

What we saw was a barrage of webinars!

Every company conducted webinars and most companies managed to get a good number of doctors attending these seminars. For example, an international webinar conducted by Bio-rad Laboratories on Diabetes Testing and Glycated Hemoglobins was attended by about 700 Indian doctors that included diabetologists and pathologists.

Over the last year, all companies put together, thousands of webinars were conducted. This has led to digital fatigue. The attendance slowly started dropping down. Companies like Siemens Healthineers now organises small group meetings where doctors of specific territories or specialities are invited for webinars. The number of webinars conducted went up but the attendance per webinar dropped down in 2021.

Hemogenomics too augmented the digital outreach activities through social media platforms. More than product marketing, Hemogenomics took up various important causes such as plasma donation and cervical cancer screening to create awareness amongst the public.

38

September 2021

In short, as the sales team were refrained from meeting the HCPs due to lockdown restrictions, the marketing team had to pull up their socks and conduct more marketing programmes. Of course, the sales teams did a lot of coordination with the HCPs over the telephone, email and Whatsapp.

Presently, companies such as Abbott and Siemens conduct quite a few digital media activities, such as mass emails, social media posts, e-brochures, microvideos, a virtual demo of products, even a live demo of medical equipment for a specific potential buyer. Physical conferences paved the way for virtual conferences and company-sponsored stalls evolved into virtual stalls/booths.

While the marketing teams of companies steered all these new activities, the sales team too had to acquire newer skills.

For example, influencing a potential customer over a phone call to buy a product needed much more impactful communication skills than a face-toface meeting. Persuading a doctor over the phone or Whatsapp to attend a webinar organised by their company was a test of the persuasive skills of the sales team. Talking about Whatsapp, this medium became a primary medium to inform the doctors about all various activities of the company. Doctors too

got used to receiving technical updates through Whatsapp from company personnel.

During the lockdown time, the salespeople of many companies made a 'Must Call' list of their customers whom they had to call over the phone every day and report back to the company.

Post Second Wave The physical meetings slowly made a return, but many hospitals have put strict restrictions on sales personnel and medical rep visits to their premises.

The meetings are allowed with prior appointments only in most hospitals.

By now, the HCP community too have got used to online interaction with company personnel. Most pre-sales activities such as sharing product details, presentations, technical updates etc take place through the digital route.

At times, even negotiation meetings happen over a VC. In certain cases, the local salesperson visits the doctor and takes senior colleagues on a video conference on his laptop for a discussion with the doctor or hospital authorities. So, for the HCP, it acts like a hybrid meeting: both face-to-face with the company’s local representative and online with other company personnel.

Companies find it more convenient that while the local salesperson reaches the client’s office for a physical meeting, other team members be available for

an online discussion. In the pre-covid time, multiple company personnel had to travel to far off city for an important client meeting, which has greatly become an old way of doing things.

Even the service engineers these days provide telephonic guidance to clients for a piece of equipment that needs repair. Earlier a service engineer or a technical person needed to visit a client site to attend to a trouble-shooting call.

Now, the first attempt to troubleshoot is through remote assistance. Only if that fails to yield desired results, the engineer would travel to the client location. Till recently, many hospitals demanded a covid negative test report (Antigen/RT PCR) to allow company personnel to enter the hospital. There was reluctance from a company employee to subject himself/herself to frequent testing as a pre-requisite to visit a hospital.

Well, not all HCPs were equally savvy with or keen to go online to discuss with company representatives. While doctors and administrators working at corporate hospitals and Referral labs were fine to connect over an online meeting with company people, HCPs from Tier II or III towns were not very keen on that. They were open to meet the salespersons and discuss their products than get online.

Pharma and Surgical Sales For pharma companies, the field force is their greatest strength. In fact, during the difficult times, these Medical Reps

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39

PULSE stood by the doctors to co-ordinate and arrange various medicines, O2 cylinders, hospital beds etc. A few pharma companies saw it as an opportunity to build relations with the HCPs by providing them PPE kits, sanitisers and other personal safety products.

The surgical market was badly hit by covid, as the elective surgeries were postponed. The number of surgeries performed during the lockdown period and the peak of covid infections were only about 10-15 per cent of the normal.

Many surgeons were even engaged in covid care as it was the need of the hour. Today the number of surgeries conducted is at almost 75 per cent of the earlier levels. The salespeople are welcomed back by the HCPs, as they play a vital role in surgical and invasive care by closely working along with the surgeons by providing demos, clinical inputs, query handling etc.

How Doctors Perceived I was curious to know how the doctors perceived the change in this approach by the companies from an offline to an online mode of engagement. I reached out to a few eminent doctors and hospital administrators to hear from them. All of them had one thing in common, that they value the comfort associated with a face-to-face meeting with the company professionals. Most newer technology up-gradation or adoption of a new product in their practice required a two-way freeflowing communication between the doctor and the company person. A webinar, an email or a social media post from the company could never offer the comfort of a free-wheeling discussion between the doctor and the company person and the trust and relationships that would develop as a result of such interactions.

While the number of emails sent by various companies has exponentially increased, the attention span to read an email has diminished to only those products that are technologically advanced, or new or have something to do with covid care.

Doctors felt that they continued to

40

September 2021

prescribe the drugs and brands that were well registered in their minds, while not trying out a new drug or brand due to perceived gaps in the information flow. While doctors found quite a few webinars organised by the companies very informative, they had to attend a few other webinars only to oblige to the requests of the company sales personnel.

During the peak of the pandemic, most upgrades and the introduction of newer products and technologies (for noncovid purposes) had been put on hold due to the shift in focus towards covid care. The focus is now back to other patient categories and therefore a direct and closer interaction with company personnel to understand their product offerings has resumed.

Conclusion Online medium of communication could reach more HCPs faster, easier, cheaper and of course, safer! Some of the noncore business activities could move from offline to online medium too.

However, the importance of a good sales team and the value addition that they would bring to the healthcare delivery ecosystem was strongly felt during the lockdown. As they say, the value of an eye is felt when one loses it!

I thankfully acknowledge the inputs from: Dr Debasish Gupta, HoD Transfusion Medicine, Shree Chitra Institute of Medical Sciences, Thiruvananthapuram; Dr Gayatri Deshpande, Sr Consultant, Obstetrics & Gyn, Nanavati Super Speciality Hospital, Mumbai;Dr Prashant Deshmukh, COO, CIMS Hospital, Ahmedabad; Abhinav Thakur, Managing Director, Accurex Biomedicals; Bimal B K, Divisional Manager, Bio-rad India; Bijesh KV, Head – Marketing, Abbott Diagnostics India Joy Lawrence, Head – Marketing, Siemens Healthineers India; OT Rajesh, Zonal Manager – South, Maxer Endoscopy; Debajyothi Debnath, Regional Manager – North East, Lupin Pharma.

(Views expressed by the author are personal)

START-UP TALK

DoctCo Aims to Redefine Rural Healthcare Nimith Agrawal, Founder of DoctCo speaks to IMT about revamping rural healthcare in India

Team IMT

Heath startup DoctCo has been instrumental in bringing a change in the healthcare system with the launch of Swasthya Ghar Tak buses in Uttar Pradesh. Nimith Agrawal, Founder of DoctCo, reveals more about the startup in interaction with IMT.

DoctCo recently flagged off a bus Swasthya Ghar Tak in Meerut, Aligarh and Varanasi.

How can these buses bring in a change in the healthcare system?

The path-breaking initiative was conceived during the second wave of covid when the founders of DoctCo decided to help out the people residing in rural areas suffering from the debilitating effects of the covid pandemic. Once the first bus made the desired impact, like-minded people and organisations came forward to increase the scale and scope of the initiative. We have now decided to scale it up to 11 buses (three in Aligarh, two each in Agra and Meerut, three in Varanasi and one in Mathura).

Seeing the desired impact and success of the initiative, we have decided to increase the scope of the screening of patients for non-communicable diseases (NCDs), including diabetes, hypertension and cardiac diseases to name a few.

Founders Nimith Agarwal, DoctCo and Sandeep Nailwal, India Crypto Relief Fund

We wish to increase the number to 100 buses in the coming months. Each bus will be manned by a doctor and a nurse and will be equipped with telemedicine equipment. This will help needy patients

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41

START-UP TALK by close to 400 NGOs and philanthropic organisations, chief among them Crypto Relief NGO led by crypto visionary Sandeep Nailwal, Umeed Project, United away and Lung Care Foundation, although many more organisations are coming forward to support us.

However, the initial expense was incurred by the founders of DoctCo on humanitarian grounds, before others came forward to support us.

Where will DoctCo want to position itself five years down the line?

obtain super-specialist consultation on the go, totally free of cost.

How are these buses equipped to handle critical data?

The telemedicine equipment will also have Internet of Medical Things (IoMT) devices, which will transmit critical clinical data to the consulting doctor in a real time frame, helping him take an appropriate clinical decision.

Each bus will cover five to seven villages every day with a population size of between 2000 and 3000 residents. One hundred buses will be able to cover 500-700 villages every day, impacting two to three lakh lives on a daily basis and millions every month.

The support from the Government of UP has been invaluable and has helped us scale it up rapidly. If nurtured well, this could be a role model for rural India in future.

In which other areas do you plan to launch the initiative?

Our initial plan is to launch the services in UP and later scale it up to the other neighbouring states of Haryana, Rajasthan, Bihar, HP and Chhattisgarh, depending on the funding support.

Tell us about the funding mechanism?

The initiative is currently being funded

42

September 2021

DoctCo aims at redefining the surgical experience in Tier II/III cities and rural areas. We aim is to bring super speciality support to Bharat to improve healthcare delivery at the last mile. This would require a pan India presence. We wish to, therefore, have 700-800 such centres pan India over the next two to three years, commencing with North India first, especially the three adjoining states of Delhi-NCR – UP, Haryana and Rajasthan.

We aim to obviate the need for a patient in smaller cities and rural areas to travel to bigger cities for super-specialist consultations, minor or more complex surgeries to bigger cities by bringing high quality and affordable treatment right at their doorstep. We wish to substantially improve the overall patient experience besides giving them exceptional healthcare services.

How has the start-up performed during the first quarter of FY 2021-22?

We got incorporated in the month of April 21 and the covid second wave hit the country immediately afterwards.

So, we’re still in a stage of infancy but scaling up rapidly. Over the next few months, we shall be opening more than a dozen new centres. The future looks very vibrant for our growth and sustenance.

Our services are already drawing attention from customers and investors alike. 2022 is going to be the year of growth for us.

The Evolving Cybersecurity Landscape Remote working has increased cyberthreats.

But even after the global pandemic is over, it’s going to be important to take actionable steps to combat the sizable security risks.

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Require multi-factor authentication to reduce risks of credential theft

Set policy in the cloud for routine device checks

https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pdf https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pd Source: https://www.darkreading.com/cloud/as-cloud-adoption-grows-dlp-remains-key-challenge/d/d-id/1335000 https://newsroom.ibm.com/2020-07-29-IBM-Report-Compromised-Employee-Accounts-Led-to-Most-Expensive-Data-Breaches-Over-Past-Year https://www.gartner.com/smarterwithgartner/is-the-cloud-secure/ https://media.nominet.uk/wp-content/uploads/2019/02/12130924/Nominet-Cyber_CISO-report_FINAL-130219.pdf

8 https://www.mcafee.com/enterprise/en-us/assets/reports/rp-cloud-adoption-and-risk-report-work-from-home-edition.pdf McAfee and the McAfee logo are trademarks or registered trademarks of McAfee, LLC or its subsidiaries in the US and other countries. Other marks and brands may be claimed as the property of others. Copyright © 2020 McAfee, LLC. 4619_0920 SEPTEMBER 2020

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