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INDIA’S FOREMOST HEALTHCARE PUBLICATION VOL. 6 NO.10 PAGES 84

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Coming Soon Regional Review: WEST Mumbai special November issue

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Strategy Reaching out to billion a hearts Page 38

Knowledge Reused pacemakers: Socially correct, ethically wrong Page 41

Life Beating burnout Page 80

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VOL 6. NO 10, OCTOBER, 2012

Chairman of the Board Viveck Goenka Editor

Market

Strategy

Viveka Roychowdhury* Assistant Editor Neelam M Kachhap (Bangalore) Mumbai Sachin Jagdale, Usha Sharma, Raelene Kambli, Lakshmipriya Nair, Sanjiv Das Delhi Shalini Gupta MARKETING Deputy General Manager Harit Mohanty Senior Manager Tushar Kanchan

Andy Roth, Director – Global Public Health Initiative (PHI) from New York ......................40

Assistant Manager Kunal Gaurav PRODUCTION

Knowledge

General Manager B R Tipnis Production Manager Bhadresh Valia

Page 15

Asst. Manager - Scheduling & Coordination Arvind Mane Photo Editor Sandeep Patil

ESIC’s first medical college opens in Bangalore ....................22 Norwest Venture Partners (NVP) invests Rs 25 crore

DESIGN

in NationWide ....................................................................23

Asst Art Director

110 million unit sales predicted in smart healthcare and fitness

Surajit Patro Chief Designer

wireless accessories by 2017 ................................................24

Pravin Temble

Karnataka Govt releases Rs 4 crore for free treatment of BPL

Senior Graphic Designer

people ................................................................................24

Rushikesh Konka Layout

Violation of the PC & PNDT Act cases on the rise: Azad ......25

TK Padmanabhan, Chief Technology Office, Wipro Infotech, India and Middle East ............43

Rajesh Jadhav CIRCULATION

Best of East Special

Circulation Team

Radiology

Mohan Varadkar

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MNBC: Setting new benchmarks..........................................35 *Responsible for selection of news under the PRB Act.

Anandaloke Hospital: The ‘Dream’ Project ..........................36

Vivekananda Hospital: Caring Lives ....................................37

Dr Lawrence Boxt, MD Cardiovascular Disease Physician, Diagnostic Radiologist in Bronx, New York ................46

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OCTOBER 2012

Letters .........................................................................................................................................................10 www.expresshealthcare.in

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Editorial

Humanising and evolving the organ transplantation act Organ transplants offer a lifeline for the living dead, but attempts to bridge the demand-supply gap need to be thought through more carefully

family friend recently described his wait for a kidney as being on death row, interspersed with spells of utter desolation. Today, he thanks God and his doctors for this second chance, and hopes that he can bounce back to his former life, so that he can care for his father, without whose kidney he would not be alive today. He shudders at the long wait and even more at the evaluation that the hospital authorities put him and his father through. The sad fact is that while organ transplants offer a lifeline for the living dead, the demandsupply gap has spawned an organ trade industry. The Human Organ Transplantation Act, 1994 was amended in 2011 and states like Tamil Nadu have further fine-tuned the Act to make it more difficult for unethical conduct, but unfortunately the lawbreakers outnumber the lawmakers. And when the lawmakers do act, it's a hasty reaction. For instance, it took the death of a former Chief Minister of Maharashtra for the state to finally do something about its dismal record of organ donation. Stung by the fact that Vilasrao Deshmukh had to be rushed to Chennai for his transplants, and the fact that crucial time was lost during the wait in Mumbai, the Maharashtra State Government passed four resolutions on the Human Organ Transplantation Act, 1994 in a single day. The first resolution mandates a Brain Stem Death Committee to confirm if a patient is brain dead and, if so, to inform the Zonal Transplantation Coordination Committee. A second resolution deals with the composition of the Brain Stem Death Committee while a third allows non-transplant hospitals with an ICU and an operation theatre to remove organs after a patient is certified as brain dead. The fourth resolution makes it mandatory for hospitals registered under this Act to maintain records of transplant surgeries, the counselling department and the transplant coordinator in order to ensure that there is transparency in the system. The intentions are fine, but as always, the devil is in the details. Practical considerations like maintaining and transporting of harvested organs from non-transplant hospitals to organ transplant centres still need to be worked out. Also, as the state government is contemplating converting and upgrading its district and civil hospitals to retrieval centres, do these hospitals have the facilities and trained personnel to maintain brain-dead patients until their organs can be harvested? On the ethical side, how will the state government ensure that there is equitable distribution of the harvested organs between rich patients and their poorer counterparts? There have been many reports of a nexus between non-transplant hospitals and private hospitals, where the former would tip off the later whenever they received a certified brain-dead patient so that the latter could arrange transplants for its rich patients. Poor patients who cannot afford kick backs to the hospitals and doctors would remain far down the waiting list. But while hospital managements wait for governments to decide on the exact mechanisms and insert safeguards, they can still play a positive role by counselling patients and their relatives on the act of organ donation. Bollywood siren Priyanka Chopra recently pledged to donate all her organs after seeing the work done by the University Of Rochester Medical Centre, where her father was being treated for his liver illness. We need many more such champions of this cause before organ donation becomes more acceptable.

Viveka Roychowdhury viveka.r@expressindia.com

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OCTOBER 2012

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Letters QUOTE UNQUOTE

system. There are opportunities here that can truly bring about change. It's about having an open mind, and understanding that someone could do healthcare better than the government. Anunaya Jain, Strategic Healthcare Executive & Emergency Medicine Physician, Sr. Health Project Coordinator University of Rochester

Rooting for the private sector in healthcare

An enjoyable and informative read

he article (the Edit published in September 2012 issue) builds up on a strong point, something that we had advocated in our study on the status of emergency care in India. A better partnership between the public and the private sector. There are numerous opportunities to do so, have been and we have done so in the past successfully. But only to lose out on the momentum gained. Free markets and competitive organisations are always more efficient than an archaic and red carpet laden

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Health and Family Welfare Minister at the conference on “Responsible Use of Medicines” held in Amsterdam, Netherland

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Dear Raelene, hank you for the positive article on Singapore in the August issue of Express Healthcare. I really enjoyed reading the feature article and the comparative analysis you provided. Ref: 'Learnings from the Lion City', Pg no 13, August 2012 issue

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UPFRONT

Market

SightLife's new centre at LV Prasad Eye Institute to improve corneal transplants

Siemens will soon launch new chemistry analysers for low-volume markets

‘We believe healthcare is an exciting vertical with tremendous potential’

Michael Reitermann CEO, DX Division, Siemens Healthcare

Padmaja Ruparel President, Indian Angel Network

Page 18

Page 20

ightLife, a Seattle-based global health organisation and the world’s leading eye bank has established a corneal tissue cutting centre at The Ramayamma International Eye Bank at LV Prasad Eye Institute (LVPEI) in Hyderabad to enable the use of improved corneal transplant techniques for better outcomes. In the last three years, SightLife has partnered with 10 Indian eye banks to double the annual number of transplants provided by SightLife partners in India to 5,622. The new centre at LVPEI will provide all of the specialised equipment necessary to offer more effective surgical techniques such as endothelial keratoplasty, a less invasive type of corneal transplant surgery. This type of surgery improves outcomes, reduces risk of rejection and hastens healing. Washington State Governor, Chris Gregoire inaugurated the first centre in Asia Pacific region. He said,“I applaud this latest success and new relationship with the L V Prasad Eye Institute. SightLife is creating jobs at home in Washington and, together with their international partners, they are making a vital difference for people in need worldwide.” Dr Gullapalli N Rao, Chairman, LV Prasad Eye Institute said, “The Ramayamma International Eye Bank will be the first centre in the Asia Pacific region to have taken a step in this direction to make the precut donor corneas available to all interested corneal surgeons. This not only reduces the overall cost of the surgery for both the patients and the surgeons but also standardises the procedure.” In addition to the substantial financial gift by a donor, the new centre also received a donation of corneal-measuring equipment by Californiabased Micro Medical Devices, and SightLife’s first Global Leadership Partner, the North Carolina Eye Bank, is providing training for the center’s technician at their facility in North Carolina. EH News Bureau OCTOBER 2012

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M|A|R|K|E|T urrently, the Indian eye care sector is poised on a threshold where on one side there is growth backed by cutting edge technology, and on the other several challenges such as constant increase in visual impairities and blindness, lack of availability, accessibility and affordability of eye care services etc. However, the growing demand for eye care services in the country has propelled the industry towards further progress.

Present scenario According to statistics published by the World Health Organization (WHO) in 2012, India has an estimated 12 million blind people and additional 456 million people who require vision correction. WHO also reports that 80 per cent of blindness in India is avoidable, yet visual impairities and blindness remain significant problems. “The most prevalent ailments leading to blindness or low vision are - cataract (62.6 per cent) refractive errors (19.70 per cent) corneal blindness (0.90 per cent), glaucoma (5.80 per cent), surgical complications (1.20 per cent), posterior capsular opacification (0.90 per cent), posterior segment disorder (4.70 per cent) and others (4.19 per cent),” informs Dr Mahipal Sachdev, Chairman and Medical Director, Centre for Sight Eye Hospitals. “Estimated national prevalence of childhood blindness/ low vision is 0.80 per thousand,” he adds. In addition to this, WHO's report also reveals a growing burden of diabetes retinopathy, glucoma and retinopathy of prematurity (ROP) cases in India. Blindness and visual impairment is not just India's problem. According to WHO global statistics, around 39 million worldwide are blind. In the wake of reducing the worldwide burden of blindness and visual impairment, WHO along with the International Agency for the Prevention of Blindness (IAPB) initiated the Vision 2020. The ‘Right to Sight’ programme that constitutes 120 member NGO groups who work towards eliminating avoidable blindness. This has been achieved through a unique, cross-sector collaboration, which enables public, private and non-profit interests to work together, helping people to see, all over the world. In India, the Vision 2020 works with a strong partnership between Ministry of Health, national and international NGOs, private hospitals

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groups, and civil society groups who together facilitate the development and implementation of effective and sustainable national eye care plans.

Industry watch Giving an industry perspective on the eye care sector in India, Professor Hugh Taylor, Vice President, International Agency of Prevention of Blindness (IAPB) opines, “Today, India is one of the leading countries in the world for eye care services.” “Over the past few decades there has been a significant reduction in the burden of blindness. India was the first country in the world to adopt the National Programme for Control of Blindness in 1976. We have seen a significant reduction in cataract blindness. With over six million surgeries performed, not only have the numbers increased, but also

CAGR and the contact lenses market in India is growing at a CAGR of about 25 per cent. About 40 lakh pairs of contact lens are sold annually and the market is estimated at about Rs 700 crore. This growth is led by a growing demand for daily disposables and frequent replacement contacts, including coloured contacts. “Most eye care in India is geography bound. You would still find thriving single practice ophthalmologists across the country. Optical stores are transitioning from family run businesses to multi store retail chains. The organised sector barely accounts for 20 per cent of the market,” feels Dr Kaushik. He further goes on to say, “Investment in research and realisation by MNCs of the potential in India, fueled by patient awareness has ensured the application of latest equipment and techniques in managing eye diseases.

India was the first country in the world to adopt the National Programme for Control of Blindness in 1976 the quality. The number of Intraocular lens (IOL) implants has increased from four per cent in 1995 to over 95 per cent in 2011,” reveals Dr Murali Kaushik, Paediatric Ophthalmologist, Sankara Eye Hospital. Adding to this, Dr GV Rao, President, Vision 2020, India informs, “The industry, which comprises the eye hospitals, national and international NGO group institutes, opticals chains, contact lens manufacturers and pharmaceuticals, and device manufacturers, is advancing at a faster pace. In the previous year, out of the six million eye surgeries we conducted, five million were cataract surgeries.” He says that the increased burden of blindness in India and the adoption of newer technologies by the sector has been the key driver for growth of the eye care sector in India. In the last 15 years, the industry has been doing a good job in not only increasing the volumes of patients that they cater to but also in enhancing the quality of care they provide. According to an ASSOCHAM study titled 'Indian Optical Sector', the eye care hospital sector is growing at a rate of around 15 per cent year on year. Moreover, the ASSOCHAM study also states that the Indian eyewear market is growing at around 30 per cent www.expresshealthcare.in

This has led to improved outcomes and reduced patient stay in the hospital. Today, a large number of procedures are performed as day care surgeries. There is corporatisation of the eye care industry. Multinational chains today manage a multitude of optical outlets across India. This has led to a moderation of the costs and an overall improvement in the awareness on the need for eye care as the marketing thrust towards eye care has increased. There has been a large venture capital inflow in some hospital chains in eye care. A majority of patients in tier I and tier II cities today, are availing insurance for their surgical care. The government run schemes in Andhra Pradesh and Tamil Nadu have helped thousands to access tertiary facilities for their eye diseases at no cost”.

Major players In India, eye care services are extensively provided by private NGO eye care institutes and the government. The government sector provides care through their own network of government run eye hospitals such as the RP Centre of Opthalmic Sciences attached to the All India Institute of Medical Science (AIIMS) and Guru Nanak Eye Centre. Eye care services are also offered through the National Programme for Control of Blindness which is

probably the most successful public private partnership (PPP) programme in healthcare. This successful PPP model has been an exemplar for all international healthcare organisations. Under the NPCB programme the government has established a MIS for data entry of cataract surgeries done. The programme provides eye care education and services through telemedicine. The NPCB also looks after construction of eye wards in govt sector and setting up of vision centres. Furthermore, the government has also come up with initiatives such as the Motiyabind Mukti Abhiyan programme in order to clear the backlog of cataract cases. The government has also instituted the National Eye Bank situated in AIIMS, Delhi, a non-profitable charitable organisation dedicated to the procurement and distribution of corneal tissue for transplantation. It is one of the oldest eye banks in India and has helped to bring the "Gift of Sight" to over 20,000 men, women and children. Amongst the private players there are around 1000 eye hospitals and 300 medical colleges spread across India. Some of the premuim ones are Aravind Eye Care System, LV Prasad Eye Institute, Sankara Nethralaya, Sankara Eye Care Institutions, Centre for Sight etc. that function on the basis of different models based on their focus areas. These premium institutes are also a part of the Vision 2020 to reduce the burden of blindness in the country. In collaboration with the Vision 2020 programme the private institutes have established primary eye care centres in the rural areas of our country. Apart from these, large private chains are also now established across the country. The Vasan Hospitals, with funding through venture capital, are now established in over 100 centres across India. Dr. Agarwal Eye Hospitals are predominant in the South. Medfort Hospital is trying to foray into South India but as of now they are localised in Andhra Pradesh. As far as North India is concerned institutes such as Centre for Sight have been fore-runners in this field. “About 60 per cent of most eye care establishments’ revenue comes from cataract operations. This is the sector’s main growth driver with a population of 1.2 billion people that will need cataract operations once they cross the age of 60. And technology has enabled this OCTOBER 2012

M|A|R|K|E|T by simplifying the procedure,” chips in Dr Kaushik. Within the eye care equipment sector, domestic players are taking the lead. Dr GV Rao says that eye care institutes are slowly adopting domestic equipment over foreign products. Today, around 80 per cent of equipment used in hospitals are domestic ones and this is definitely a good sign. “In the eye wear and contact lens segment, the major players are Bausch & Lomb, Johnson & Johnson (Acuvue) and Ciba, with B&L accounting for a larger share (60 per cent) of the conventional contact lens market. Among these biggies, Lawrence and Mayo is known to be an early mover. Titan through their Titan Eye franchise outlets and Vision Express has entered the tier II and tier III towns across the country. Ben Franklin Opticals works on different models of offering their services to hospitals and practitioners to run their opticals on their behalf. Today, they manage over 130 counters across the country,” he adds.

Challenges and road blocks Although India, to a certain extent, has achieved its Vision 2020 goals, there is a still a lot more that needs to be accomplished. Availability of service, affordability and awareness are the major road blocks; especially in the hinterlands of our country. Uncorrected refractive errors and cataract are most commonly found in these rural and underdeveloped areas. Here, the other challenge is

the low acceptance level from the patients' side. The reasons being traditional practices, beliefs, fatalistic attitudes towards blindness, fear of treatment, lack of faith in the intervention, and fear about the surgical procedure. “There is a huge gap between the services provided in the urban and rural areas. Rural eye clinics often lack the basic equipment to diagnose or treat eye ailments,” laments Dr Sachdev. Dr Gullapalli N

Rao, Chairman, LV Prasad Eye Institute points out that lack of professionals in this field and lack of models to increase accessibility are major challenges.

Pre requisites for improvement “To improve the current state of eye care in India it is important that the industry learns to strike a balance between demand and supply of service,” believes Professor

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Attracting the investors’ eye As the eye care sector is poised to grow at a double digit rate in the coming years, the industry has attracted the investors’ interest. Industry analysts see increasing number of PE deals in this segment. One of the most talked about deal in this segment this year is the Government of Singapore Investment Corporation's (GIC) investment of Rs 500 crore ($100 million) in Vasan Healthcare. This eye care hospital group will use these funds to expand its network of eye hospitals from its current 102 hospitals and its dental hospitals from the present network of 14 centres. The company is also looking to expand by acquiring hospital chains that fit into its day-care model that doesn’t involve overnight stays. Seeing the growing interest of the PE investors in the eye care segment Dr Kaushik says, “The low capital expenditure, faster gestation period (turning profits within a year) and financial operating efficiency make it worthwhile for private equity firms to invest in the eye care sector”.

Kovin Naidoo, Global Programmes Director at the Brien Holden Vision Institute and Chair, IAPB Africa Region. “Financing for eye care and creating a national fund supported by the government is one of the major factors that can solve the problem of affordability in the country. What India needs is Government intervention in this field,” he adds. Furthering on the same Dr Rao expresses, “The

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M|A|R|K|E|T prerequisites for our country is that we need to scale up eye care services across India. In that regard, the government has already invested around Rs 13 crore in the last five year plan. Yet we need more support from the government”. Some of the preresquisites listed by industry experts are as follows: Awareness: Preventing eye diseases and promoting eye health is essential. This would reduce the burden on the healthcare system and also reduce the economic impact due to reduced productivity from blindness, but this goal can be realised only by spreading awareness among the masses. People need to be made aware about eye ailments as they usually

go unrecognised for long time leading to irreparable damage. Capacity building: Creating infrastructure and human resource for eye care services is also important. It is essential to strengthen the eye care infrastructure at the district and village level. This could be done through the vision centre model or through outreach screening vehicles. Although, we have few vision centres across few states, established by leading eye care groups, we need many more of them. Further, district level centres should be able to handle most surgical eye diseases with only those requiring tertiary care being referred to larger cities. Skill deficits need to be identified and accordingly

training should be imparted. Reducing import duty on certain eye care equipment: Governmental regulations on import of certain devices – low vision (assistive) devices need to be made easy. With a majority of these being developed in China there is a need to create a national distribution hub which could in turn stick these devices from within the country and elsewhere and provide ease of access to practitioners in the country. This would reduce the lead time of importing these devices and also the paperwork needed by individual entities to do so.

Marching forward Opportunities are galore, all we need is the right direction. The eye care sector cur-

rently focuses on the delivery of curative services, but for an effective healthcare system the country requires more emphasis on preventive and promotional strategies, and thus a more convergent approach with the active participation of all stakeholder as well as ‘non-health’ sectors who can and are willing to fund this cause.

On the anvil In a bid to voice the opinion of the industry and to come up with productive strategies, the All India Ophthalmological Society will be organising a national workshop at Dr RP Centre, AIIMS, Delhi in February 2013. raelene.kambli@expressindia.com

30 MINUTE INTERVIEW

Siemens will soon launch new chemistry analysers for low-volume markets Michael Reitermann CEO, DX DIVISION, SIEMENS HEALTHCARE

ichael Reitermann, CEO of DX Division, Siemens Healthcare elucidates about the growing in vitro diagnostics market in India, current market trends and Siemens Healthcare’s plans for India in this segment, in an email interview with Lakshmipriya Nair

How is the diagnostics market in India vis-a-vis the global market? Globally, in vitro diagnostics (IVD) remains a sustainable and attractive market, with anticipated mid- to long-term growth at approximately four per cent. Demographic shifts along with an increasing value being placed on diagnostics in preventive care and therapy guidance are key drivers for this positive outlook. In India, the IVD industry is still in its early stages, yet, it is quickly expanding. The current market is experiencing steady double digit growth and a once highly fragmented competitive IVD manufacturer landscape continues to consolidate. Additionally, the market is rapidly implementing advanced laboratory automation solutions in the higher-end segments. These signs, coupled with the fact that healthcare in India is becoming more acces-

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sible and affordable to the general population, keeps us excited about the growth prospects in the country.

What are the trends reigning in the healthcare diagnostics market in India? Despite downward cost pressures resulting from the ongoing global economic environment, India’s growing middle class is forcing the country’s entire healthcare market, including its IVD market, to expand, so more people can access quality, affordable care. Additional drivers forcing this upward trend include broader access to healthcare insurance, accreditation, more public-private partnerships, market consolidation and changing disease patterns. India’s established clinical laboratories are also beginning to more aggressively elevate their quality standards and maximise productivity of their existing lab footprint: two goals that align very well with the Siemens Healthcare Diagnostics portfolio and Siemens’ recently launched Agenda 2013 programme. India is primed for enhancements to its clinical laboratory infrastructure and Siemens is poised to be a close

partner in this period of growth.

What are the opportunities and challenges offered by the Indian diagnostics market? India offers a number of opportunities, along with some challenges, towards further growth of its IVD market. The opportunities are clear: a noticeable increase in government healthcare spending, coupled with rising income and education levels, are priming the country for a major influx of IVD testing solutions, made available to a much larger population segment than ever before. Leveraging our strong reputation and installed base across the country, we see opportunities to further expand the range of Siemens solutions and services for our Indian customers, particularly in areas like microbiology, haematology and point of care. At the same time, we’re also targeting new business, especially in burgeoning urban settings, where there are large concentrations of people with increasing life expectancies who need access to quality, affordable clinical laboratory tests. However, obstacles do remain that may limit India’s www.expresshealthcare.in

IVD growth potential. They include an evolving countryspecific IVD regulatory framework, a volatile healthcare insurance network, fluctuating currency exchange rates and shifting import rules.

Tell us about the products offered by Siemens’ Healthcare Diagnostics division which would assist in curbing the growing disease burden in India by offering early, fast yet accurate diagnoses. Siemens’ broad spectrum of immunoassay, chemistry, haematology, molecular, urinalysis and blood gas testing systems, in conjunction with automation, informatics and support services, are positioned to work together to deliver fast, highly precise results to help clinicians quickly diagnose and treat disease. While India’s disease profile is expected to begin shifting over the next decade, communicable diseases (including infectious diseases) are still the main cause of death in the country. Viral hepatitis remains one of India’s most prevalent diseases, with estimates that nearly 20 million Indians are Hepatitis B carriers and about

8-10 million may have Hepatitis C infection. As an example, Siemens delivers a comprehensive hepatitis disease management portfolio to provide crucial serologic test results with excellent sensitivity and specificity, minimising the need for repeat confirmatory testing. Our molecular diagnostic viral load monitoring and genotyping assays provide physicians with critical information that aids in optimising treatment decisions.

How does Siemens' Healthcare Diagnostics division play a role in improving the quality and productivity of healthcare delivery in India? As India continues to grow and update its healthcare infrastructure, it must do so with an equal focus on cost and quality in order to be sustainable and effective. Siemens Healthcare Diagnostics, a global leader in in-vitro diagnostics, is providing healthcare professionals in India with vital information required to accurately diagnose, treat and monitor patients. Our innovative portfolio is allowing hospital, reference and physician office laboratories and point-of-care settings to streamline OCTOBER 2012

M|A|R|K|E|T work-flow, enhance operational efficiency and support improved patient outcomes by providing a robust menu and new innovative tests.

Elaborate about the whole concept of Siemens’ “Agenda 2013”. What role would your division play in achieving the goals set by Agenda 2013? The Agenda 2013 programme was launched by Siemens in November 2011 as a two-year global initiative to further strengthen the innovative power and competitiveness of the company’s healthcare sector. As part of this, specific measures are being implemented in four fields of action: Innovation, Competitiveness, Regional Footprint and People Development. One of Agenda 2013’s principal focuses is addressing the needs of emerging markets, including India and China, where Siemens is identifying ways to deliver local value-add services to our portfolio. We are excited about the growth prospects of India’s IVD industry and are committed to putting the required resources in place to further strengthen our market position there. At the same time, the Diagnostics division has also launched its ‘Competitiveness Program’ to closely align with Agenda 2013 and enable the business to drive innovation leadership, become more competitive and improve financial performance. This programme is the next logical step in a rigorous process to create a more sustainable, healthy future by fostering an environment that will allow us to gain business efficiencies, increase productivity and reduce costs to secure our competitive market position. Both Agenda 2013 and the Diagnostics Competitiveness Programme remain underway and many targets have already been achieved.

Diagnostics formed with ViiV Healthcare and Tocagen were milestone achievements for our company. Siemens’ presence in the emerging companion diagnostics market enables us to leverage our innovation capabilities and deep clinical knowledge to help improve pharmaceutical drug safety and effectiveness. More so, it helps align Siemens with new classes of therapies tailored to the individual that hold the promise of improving patient

care and delivering on the goal of personalised medicine. We continue working closely with both companies on the development of highly accurate in-vitro companion diagnostics tests compatible with their individual drugtherapy counterparts. Additionally, Siemens remains interested in further ventures into companion diagnostics and is actively exploring additional partnership opportunities.

Are there any more such deals in the pipeline with Indian firms Please understand that we do not speculate about this.

What are the new launches from the Healthcare Diagnostics division in the pipeline for the Indian market? What is the projected timeline to their launch? Leveraging our strong local manufacturing capabilities in India and collaborating with

our Corporate Technology research arm in Bangalore, Siemens is in the advance stages of launching new chemistry analysers for lowvolume markets. We’re also planning the eventual launch of an immunoassay analyser for lowto mid-volume laboratories that will specifically address the needs of emerging markets. lakshmipriya.nair@expressindia.com

In March 2012, Siemens’ Healthcare Diagnostics division embarked on a partnership with ViiV Healthcare and Tocagen to develop diagnostic tests for HIV and brain cancer respectively. Can you give us details about the progress of these partnerships? The companion diagnostics partnerships Siemens Healthcare OCTOBER 2012

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M|A|R|K|E|T 30 MINUTE INTERVIEW

‘We believe healthcare is an exciting vertical with tremendous potential’ Padmaja Ruparel PRESIDENT, INDIAN ANGEL NETWORK (IAN)

merging segments like single-speciality hospital chains, diagnostic chains and day care centres within the Indian healthcare sector are drawing in a significant amount of private equity (PE). Increasing number of PE deals in this financial year only proves that the Indian healthcare sector is a preferred choice for investments. Padmaja Ruparel, President, Indian Angel Network (IAN) explains to Raelene Kambli the key drivers for the growing number of PE deals in healthcare, the parameters for an healthcare organisations to qualify for PE investment and IAN’s interest in investment in the medical device sector

What role does PE funds play in the growth of the Indian healthcare sector? What are the opportunities and challenges in this space? Healthcare is one of India’s largest sectors, in terms of revenue and employment, and the sector is expanding rapidly. It is one of the favourite and top investment categories for angel investors. Need of speciality hospitals in India makes Indian healthcare sector ripe for the expansion and significant growth. Looking at the growth opportunities offered in the sector, the number of start-ups is gradually increasing. Within the healthcare

sector, medical devices has been dominating the angel investment opportunities, exceeding pharmaceuticals, drugs and biotechnology spaces. This sector is considered to be a high risk and a high return one. The healthcare industry in India is reckoned to be the engine of the economy in the years to come which encompasses health care instruments, healthcare in the retail market, hospitals enrolled to the hospital networks etc. Hence, there are enough and more opportunities for the entrepreneurs to grow. Opportunity in the healthcare sector and increasingly the spend on health has been increasing. The challenges are also immense – currently the number of trained staff, specially high quality nursing staff, robust healthcare insurance, availability of low cost medicines, culture of preventive medicine all make the healthcare industry more challenging than any developed/developing country

Are there any regulatory challenges that PE investors need to face? What are some of the changes you wish to see especially in terms of regulations? Healthcare insurance needs revamping – today’s needs are very different to what the insurance schemes

provide. For example, medical science has progressed to avoid/reduce the number of days of hospitalisation which means that many of the existing schemes become ineffective. New drug discovery needs a radically different legal framework and this change could make availability of new indigenous drugs much more cheaper.

What would be the triggers for growth of PE in healthcare? Emergence of innovative startups, entrepreneurs working towards India specific products and technology will drive the growth for PE in the sector. Coming up with original technologies that are tailored to the local community will help this sector grow and take the much awaited next step towards development in the sector by filling the gap gradually.

What are the parameters for an healthcare delivery organisation, diagnostic company or a healthcare equipment firm to qualify for PE investment? There are a few key characteristics which we look for in the entrepreneurs and the startups before investing in them, be it in any sector. Most important being their passion for their business idea because that’s what drives their perform-

ance and business. Having domain expertise is the next thing we look for in an individual as it’s equally important for entrepreneurs from an angel investor’s perspective to be well-versed with the operational and regulatory aspects of their respective sectors.

You said that IAN is looking at investing in a medical devices start-up. What is the rationale behind investing in medical device start-ups? IAN realises the scope and opportunity in this segment. Considering the growth opportunity in the sector and the uniqueness of their product, we have taken a step forward by investing in Consure Medical. Also, IAN’s deal table has other healthcare investment opportunities and they are being looking at avidly.

based company has developed a new standard of care for the management of fecal incontinence in non-ambulatory patients. It has developed a novel, disruptive technology that will benefit more than 16 million patients in India and over 100 million patients worldwide. Consure has global applicability and IAN looks to help them scale their business and enhance their global competitiveness. IAN has already closed 11 deals this year and nine deals within seven months of 2012. We do expect to close a few more by the year-end.

What do you think about the healthcare vertical?

Tell us about the recent developments at the Indian Angel Network.

We are sector agnostic and there is a wide variety in our deal flow. We move fast when we see something exciting irrespective of the stage of the company. IAN members include professionals and entrepreneurs with healthcare expertise. We believe healthcare is an exciting vertical with tremendous potential to grow and we will continue our momentum to foster global competitiveness amongst the young, dynamic start-ups in this space. IAN believes in a fast track process for funding. It’s our sincere endeavour at making successful exits in short time span of making an investment.

We have recently invested in Consure Medical; a Delhi-

raelene.kambli@expressindia.com

What potential do you foresee for investments in the medical device market? Medical devices is an exciting space with tremendous potential. This is exactly the kind of space angel investors like which offer innovative products with large markets.

30 MINUTE INTERVIEW

‘We want to be known as a technology leader that pioneers best solutions’ Rekha Ranganathan SENIOR DIRECTOR MARKETING, STRATEGY AND BUSINESS DEVELOPMENT, PHILIPS HEALTHCARE INDIA

ekha Ranganathan, Senior Director Marketing, Strategy and Business Development, Philips Healthcare India, in this interview with M Neelam Kachhap,

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gives an insight into Philips’s thinking on healthcare market in India and the challenges of doing business here

What is Philips Health-

care’s position in the Indian healthcare market? Philips has seen a double digit growth in the healthcare business and we are the market leader in patient monitoring,

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cardiovascular, defibrillators and high-end MRI and CTscanner. In terms of percentage growth, our business grew by 30 per cent plus over the last three years. We believe this

data and our market position reflect the focus we’ve placed on serving the industry.

What are Philips’ strategies to consolidate its hold

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M|A|R|K|E|T on the Indian market? Our new strategies revolve around three core themes: therapeutic focus, India specific products and finance. We made a decision to focus our effort in five critical healthcare spaces; radiology, cardiology, oncology, critical care and obstructive sleep apnea/home respiratory care. Across each of these areas we’re looking to provide both accessible and affordable healthcare products and solutions because we believe everyone needs access to healthcare, regardless of where they live, be it a Metro, a tier one, tier-II or tier-III cities. We’re also developing products specifically for India but also recognising that they have value in other emerging markets. The Philips Innovation Campus in Bangalore is tasked with developing products for us here. We also have a manufacturing facility in Chakan, India. We have introduced over 33 products in the last one year of which more than 10 have been in the value segment space (e.g. Clearvue Ultrasound, Goldway monitors). These products are specifically made for India, designed for the affordable segment. Finally, we recognise that healthcare is evolving in India, as the transition from treating infectious to chronic diseases occurs. Chronic diseases are often more costly and involve ongoing diagnostics to track disease progression. At the same time, our healthcare system is struggling to keep up with the demand. We are now providing financing options so that a hospital or hospital system can make significant purchases such as an MRI or CT-scanner. We are thereby helping to increase access in healthcare as well.

diagnostics provider, education is the mainstay of what we do. We offer training programmes for physicians to ensure that when new technological innovations come into the market, they can take advantage of the technology themselves. For example, with our MRI platforms we help radiologists and technicians learn how to find an abnormality in the shortest amount of time. We also need to educate patients on why early diagnosis

is important and that technology like ‘Time of Flight’ can help detect problems sooner. By providing training to healthcare professionals and educating consumers, we help our customers differentiate themselves in the market.

What do you think is the need of the hour of the Indian medical devices market? The Indian medical devices market is evolving and chang-

ing. We believe there are two key needs in the marketplace at the moment. One has been with us for a while and the other is just starting to make itself known.The first is high performance at an affordable price and the second is connectivity. Philips is addressing the first by understanding the unique needs of our customers and then offering them a portfolio of products, a range so we find the best fit. For example, we have a formidable

patient monitoring portfolio. We can also offer state-of-theart performance through our ClearVue series and at the same time offer affordable solutions through our Suresigns and Goldway series. The need that’s just starting to make itself known is connectivity. We view this as connectivity within the hospital setting and connectivity between hospitals and health centres. Within the hospital, customers want diagnostic

Srinagar JAMMU & KASHMIR

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ASSAM

Gurgaon Lucknow Jaipur

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Bhopal

Ahmedabad

Guwahati

UTTAR PRADESH

RAJASTHAN

Kolkata Raipur

CHHATIS GARH

ORISSA

Nagpur Bhubaneshwar

Mumbai Pune

Hyderabad

KARNATAKA

ANDHRA PRADESH

Bangalore

Chennai TAMILNADU

KERALA

Coimbatore

Cochin

Tell us about your marketing innovations behind the leading brands of Philips Healthcare. We work very hard to ensure that our brand remains strong. The Philips Healthcare brand represents innovation, quality and design in each healthcare product. All our marketing efforts work to support the brand promise. Since we’re primarily a OCTOBER 2012

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M|A|R|K|E|T equipment to share files, share information with each other and centrally. In other words, if you have a patient’s vital statistics and the CT-scan electronically stored in one place, it makes the diagnosis easier, ensures data isn’t misplaced and allows healthcare professionals to easily refer back to older data so that they can chart progress. The second type of connectivity is between healthcare facilities. We believe the time is ripe for our eICU product that lets hospital networks connect to each other and manage patients in small towns and cities. This enables specialists in a major hospital, who are in high demand and time constrained, to monitor a patient and review the patients’ status on screen from their base hospital.

What are the challenges of the Indian healthcare market? How would you navigate through it? Delivering

affordable

healthcare to India’s billionplus people presents enormous challenges and opportunities for the medical community. According to internal estimates, the Indian healthcare delivery market has significant headroom for growth with the country lagging on all key healthcare delivery metrics (hospital beds, physicians per 100,000 population, per cent of Indians insured) when compared to countries like the US and China. We, as Philips, recognise it as a big opportunity to bring in new products and solutions, work with various stakeholders (government, for profit, non-profit) and contribute to the provision of quality healthcare.

Philips Healthcare has re-jigged its product development philosophy, by opening a manufacturing facility here. What is your say on this? Philips is investing in India to manufacture quality healthcare products for a healthier

India. Adding R&D to healthcare manufacturing at Chakan, allows Philips to provide end-to-end solutions at various price points as well as service infrastructure.Through combining human insights and clinical expertise, Philips aims to improve patient outcomes while lowering the burden on the healthcare system.

What would you say about the inherent bias in developed markets where prices were associated with technology? The Indian market has a varied set of customers and segments. There are customer like Fortis, Apollo and Max to name a few who offer the best, world class technology for their patients. For them the best technology is required, similar to Western markets. For expanding affordable segments, we cater to the needs of the customers where pricing and service is the key criteria for purchase. As a technology provider, our products need to

scale to the needs of the different segments and pricing is only one criteria for purchase.

Tell us about Philips Healthcare’s approach to the market in India. We are committed and continue to serve the Indian healthcare market by bringing the best in class technology and supporting it with best in class customer service. Philips is driving 3 A’s – awareness, access and affordability in healthcare. ● Generating awareness about various products and solutions with doctor and patient awareness programmes ● Creating access through solutions in tier-II, tier-III markets ● Driving affordability for customers with models such as financial lease and public-private partnership. We are building an ecosystem of partners by engaging with customers and distributors and increasing our connection

and collaboration with hospitals and healthcare professionals. Philips Healthcare is committing resources to make technology more affordable so we can serve the wide spectrum of our customers’ needs. For a market like India, Philips will have more products which are best in class in terms of technology and yet affordable to serve the need of hospitals in tier-II and tier-III cities.We are building our sales and service footprint to take these products to our customers in tier-II and tier-III cities.

How do you want your customers to perceive Philips Healthcare? As the healthcare leader that collaborates with them to find the right healthcare solutions for their needs, increases access and affordability. We want to be known as a technology leader that pioneers best solutions for their needs. mneelam.kachhap@expressindia.com

COLLABORATIONS

India and New Zealand to collaborate for health solutions They may deal with issues like diabetes and remote medical care ew Zealand and India may join hands to deal with health care issues such as diabetes and remote medical care, informed Gavin Young, New Zealand Consul General and Trade Commissioner to Mumbai. Speaking from Apollo Hospital’s ‘Transforming Healthcare with IT’ event in Hyderabad, Young revealed that New

Zealand has one of the highest rates of diabetes among developed countries, and drew attention to the causes and prevention of the disease. India has the world’s largest diabetes population, according to the World Diabetes Foundation, with over 50.8 million people living with diabetes. “To try to address the disease, New

Zealand has many companies specialising in preventing and supporting the treatment of diabetes and related complications,” says Young. Already several Indian and New Zealand firms are working together towards enhancing healthcare and its services in the country. Orion, a New Zealand firm has worked with the public

health system using decades of data on the best treatments for diabetes and has included this in an advisory programme for doctors dealing with diabetic patients. New Zealand could also assist with remote medical care. Rajiv Gandhi Cancer Centre in New Delhi has collaborated with New Zealand’s Medtech Global, a company specialising in the

digitisation of patient records, to transform their information management systems and provide remote medical services. New Zealand firm SIMTICS has partnered with MedVarsity, a medical e-learning initiative by Apollo Hospital Group to train highly-skilled surgeons. EH News Bureau

MEDICAL EDUCATION

ESIC’s first medical college opens in Bangalore It marks the organisation’s foray into the education sector, apart from healthcare he first medical college established by Employees State Insurance Corporation (ESIC), in Bangalore, has been declared open. ESIC also plans to open seven more medical colleges across the country and at least four is expected to commence by next year provided all approvals by Medical Council of India (MCI) is accorded, informed Minister for Labour and Employment, M Mallikarjun Kharge. He has also requested the state governments to

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establish a ‘single window agency’ to grant all approvals like fire force clearance, electricity board approval and others under one-roof to projects which are of national importance and for the wellbeing of the public. “Everybody is afraid of RTI. In the name of transparency, many development works are held up. Many officials are scared to take decisions. We should set a time frame to give clearances. Getting land allotment itself a major worry,” Kharge said. The labour

ESIC also plans to open seven more medical colleges across the country and at least four is expected to commence by next year ministry has spent Rs 3,000 crore on various projects being implemented by ESIC, he said, adding another medical college would soon come up in Gulbarga, his www.expresshealthcare.in

home district. Inaugurating the Medical College, Union Health Minister Ghulam Nabi Azad informed that the government has

planned to open three to four medical colleges in different parts of the country in the coming years. He asked entrepreneurs from the South to establish more medical colleges in the North and North-East to produce more number of doctors. Chief Minister of Karnataka, Jagadish Shettar, promised his support to the ESIC projects and informed that his government has earmarked Rs 554 crore in its budget for workers’ welfare. EH News Bureau OCTOBER 2012

M|A|R|K|E|T INVESTMENT

Norwest Venture Partners (NVP) invests Rs 25 crore in NationWide It is the largest venture capital funding in primary healthcare sector to date angalore-based NationWide Primary Healthcare Services (NationWide), a retail chain of primary care clinics has received Rs 25 crore in funding from Norwest Venture Partners (NVP). A major part of the current investment will be utilised to rapidly expand operations over the next 18 months and set up a total of 120 clinics in Bangalore.

spearheading a paradigm shift in India’s healthcare delivery system. The company’s strong product offering with

extensive use of technology, combined with its attractive business model and market traction, make it well poised

to disrupt the traditional primary healthcare market in India. We’re excited to partner with the NationWide team to

help expand this already rapidly growing company.” EH News Bureau

The company plans to open new clinics in strategic locations in the peripheral areas of Bangalore Dr Santanu Chattopadhyay, Founder and MD of NationWide Primary Healthcare Services said, “NationWide is a pioneer in bringing back the family doctor concept in the organised sector in India. Receiving funding at this stage of our company’s growth from one of the top-tier venture capital firms in the US is a clear validation of our strong business model as well as the high customer satisfaction that NationWide has established over the past two years. We plan to open our new clinics in strategic locations in the peripheral areas of Bangalore and cater to the largely underserved customers in this region. With 20 hub clinics and approximately 100 satellite clinics across Bangalore in the next year and a half, NationWide will build a strong base for affordable primary care through innovative services and a ‘customerfirst’ mentality.” Mohan Kumar, Executive Director, NVP India, said, “NationWide aims to bring the best international practices in primary healthcare to India, OCTOBER 2012

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M|A|R|K|E|T

New Venture

Kronos eyes healthcare, to increase client base in India

M Neelam Kachhap EH News Bureau ronos India, a subK sidiary of Kronos, a company which is into workforce management, is warming up to the healthcare sector in India. "Healthcare is our largest vertical worldwide and we are confident about our value proposition in the Indian market," said Rob Amor, Vice President, International Operations & Channels, Kronos. "We are hoping to increase our healthcare client base from two to 10 or maybe 15 next year." he added. At present Kronos is working with Medanta hospital and Takshasila Healthcare in India. More than 9,000 healthcare facilities worldwide – including more than 3,000 hospitals and health systems – use Kronos solutions to achieve their workforce management objectives. Kronos is also looking to forge partnership with local channel partners to take on the healthcare sector. Earlier this year Kronos extended its reach into the Middle East through a reseller agreement with Health Matrix Corporation, an expert provider of technology solutions to the healthcare sector. "Total business of Kronos India, is about five million dollars and it would double next year. Kronos would invest three to five million dollars extra into Kronos India next year," said Dick Cahill, Vice President & General Manager, International, Kronos. mneelam.kachhap@expressindia.com

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INDUSTRY UPDATE

110 million unit sales predicted in smart healthcare and fitness wireless accessories by 2017 Intelligent accessories with focus on training, weight management and healthcare monitoring of chronic disease will dominate the market uniper Research has released a report which predicts that the total market for smart wireless accessories will reach 110 million units in 2017, up from 10 million in 2012. It claims that wireless smart devices linked to smartphones and tablets will gain popularity in the coming years. The report also

observes that Nike, Jawbone Up and such other companies are educating the market on how such ‘smart hardware’ can use the smartphones' processing power to analyse and relay information. This, in turn, can be used to manage chronic disease such as diabetes or COPD. Smart wireless accessories

will become an important tool for the self-management of chronic disease, although more complex mHealth ecosystems will require bespoke devices, partly because the smartphone is not yet seen as a medical tool,” says Anthony Cox. “This means that bespoke mHealth devices will also develop,” he

says. Juniper Research found that the smart wireless accessories market has both, newentrants such as Square and iZettle, and established players, like Nike and Adidas. The ‘Smart Accessories ~ Smart Devices!’ whitepaper can be downloaded from juniperresearch.com. EH News Bureau

IMAGING UPDATE

Parvez Ahmed turns entrepreneur with Aapka Urgicare Aapka Urgicare will be a chain of urgent care clinics to provide unscheduled emergency medical attention

M Neelam Kachhap EH News Bureau r Parvez Ahmed, exCEO, Max Healthcare, is launching Aapka Urgicare: a chain of urgent care clinics that will provide round-the-clock, walk-in care to people in need of unscheduled emergency medical attention. “Positioned to bridge the gap between primary care doctors and hospital emergency rooms, Aapka Urgicare clinics will provide treatment facilities for injuries or illnesses that need immediate medical attention,” said Dr

Ahmed, Founder and Medical Director, Aapka Urgicare. With an estimated budget of Rs 2.5 crore per clinic the company plans to start six centres in Delhi in the near future and 34 centres in the next 18-20 months. The first clinic will open in October at Preet Vihar, Delhi followed by one at Kalkaji. These two are ‘proof of concept’ centres. The company envisions having 110 clinics with an estimated budget of Rs 85 crore in the next five years. This self-funded venture hopes to breakeven by the fifth quarter of operation and attain an EBITA of 26 per

cent. “The venture is largely self-funded with help from family and friends,” said Dr Ahmed. When fully functional the clinics will collectively handle 3000-5000 patients per day informed Dr Ahmed. Although there are a few day care centres in India, the concept of pre-hospital care is new. “The clinics will deliver ambulatory care through dedicated facilities for immediate medical treatment outside a hospital’s emergency department, on an unscheduled time,” said Dr Ahmed. Each 5000 sq ft clinic will be equipped with emergency care, basic radiology, minor OT, cardiac life support,

paediatric and asthma care. “The idea is to have an emergency care system with efficient pricing, which will compliment the hospital and GP network,” explains Dr Parvez. The company is collaborating with Denmarkbased Falck, the largest private ambulance company in Europe, for providing ambulances for each clinic. Realising that manpower would be crucial to the success of the venture, Dr Ahmed plans to open a training institute for paramedics and technicians in Delhi by December end. mneelam.kachhap@expressindia.com

GOVERNMENT INITIATIVE

Karnataka govt releases Rs 4 crore for free treatment of BPL people The Chief Minister's Medical Relief Fund, set up to fund medical treatment of people living below poverty line, has provided aid to 26 per cent people till date peaking at the inauguration of 3rd edition of Healthex International in Bangalore, Karnataka Chief Minister Jagadish Shettar informed, “Rs 4 crore has been released for the free treatment of 26 per cent of people below the line of poverty (BPL).” He also said that the health indices in Karnataka has become better over the years, right from the infant and maternal mortality rate to diseases like polio due to special steps taken by the government. Reiterating the need for right to healthcare, Dr Devi

Prasad Shetty, Founder and Chairman, Narayana Hrudayalaya Hospitals and Chairman, Healthex International 2012 said, “The Indian healthcare industry is undergoing a rapid expansion phase and in order to survive the healthcare market competition and growth, hospitals today are training and continuously updating themselves on current issues, challenges and the best methods to reach out to and serve their patients better. Healthex 2012 showcases and focuses on affordable, reliable, and sustainable medical www.expresshealthcare.in

equipment and technology under one roof and provide a global overview and comprehensive information on the current technological advancements in the industry. This event will take India to new heights in the field of medicine and allied services. There is a need to increase doctor to patient ratio and this can be done only by increasing hospital facilities across the country. In education sector, now there is Right to Education that guarantees education to all. So such an Act is needed in healthcare services too which

guarantees healthcare to even poor. Time has come for people to start demanding Right to Healthcare.” The exhibition was inaugurated by Dr Shetty, Chairman, Healthex International 2012, Jagadish Shettar, Chief Minister, Karnataka and Aravind Limbavali, Minister for Health & Family Welfare, Gov’t of Karnataka along with several luminaries from the healthcare industry at the Bangalore International Exhibition Centre (BIEC). EH News Bureau OCTOBER 2012

M|A|R|K|E|T INDUSTRY UPDATE

Violation of the PC & PNDT Act cases on the rise: Azad 436 cases have been registered against violation of the PC & PNDT Act registered in last two years here has been a rise in number of cases registered under the PC & PNDT Act, in the country, Union Health Minister, Ghulam Nabi Azad said at a recently held Consultative Committee of MoHFW meeting in New Delhi to discuss the PC & PNDT Act. He said that 436 cases have been registered against violation of the PC & PNDT Act in last two years as against 789 cases between 1996 and 2010. “To strengthen the hands of Appropriate Authorities, Government of India has notified important amendments in Rules under the Act including action against unregistered ultrasound clinics, regulation of portable equipment and enhancement of registration fees of diagnostic facilities. Inspections by the National Inspection and Monitoring Committee (NIMC) have been stepped up in the states of Uttar Pradesh, Madhya Pradesh, Andhra Pradesh, Rajasthan, Odisha, Punjab and Bihar,” he informed. Similarly, State Inspection and Monitoring Committees have scaled up action in states. A total of 69 machines were sealed in the past one year and 19 cases have already been filed in court. Capacity building trainings of Judicial Officers and Public Prosecutors have been conducted in judicial academies of Chandigarh, Andhra Pradesh, Gujarat and Rajasthan. The Ministry is supporting civil society partners through grants-in-aid for enhanced community mobilisation on the issue. Under NRHM, financial support is being provided for building dedicated PNDT cells, both at the State and the District levels to strengthen capacities to effectively implement the law. Support is also being provided for intensifying IEC activities. In his concluding remarks, Azad also said that the Parliamentary Consultative Committee is engaging with the topic of the Pre-Conception and

OCTOBER 2012

Pre-Natal Diagnostic Tests Act of 1994 at a crucial time, when the urgent need to tackle the social evils of sex selection

and sex selective abortions is acutely felt and recognised by our society. He hoped that members will take note of the

serious socio-cultural and economic implications of the declining child sex ratio and help pave the way for mass

involvement in ridding the country of this social evil. EH News Bureau

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M|A|R|K|E|T PRE EVENT

Hospital Build & Infrastructure 2012 The 3rd HBII promises to be once more an opportunity to reach out to Indian hospital infrastructure and healthcare industry leaders he last few years have seen massive investment and expansion in the healthcare industry within India. The current scenario highlights significant developments that should make you sit up and consider showcasing your products and solutions at the Hospital Build & Infrastructure India 2012 exhibition and conference scheduled for December, 14-16, 2012 at the Bombay Exhibition Centre, Mumbai. The healthcare sector in India is expected to see monumental growth. Development of healthcare facilities is one of the focus areas of the 12th Five Year Plan that runs from fiscal 2012-13 to 2016-17. India targets to invest over $1 trillion in infrastructure development during the next five years. The National Rural Health Mission (NHRM) has allocated $10.15 billion for the upgradation and capacity enhancement of healthcare facilities. According to Grant Thornton, India is also expected to witness the largest number of merger and acquisitions (M&As) in the pharmaceutical and healthcare sector in 2012 due to impending patent cliff in the US, the increasing attractiveness of India as a low-cost R&D destination and the increasing success of Indian firms in getting ANDA approval. With 100 per cent foreign direct investment (FDI) permitted for health and medical services under the automatic route, there are already activities from major International Healthcare brands in India.

Delegates attending a session at a past HBII edition Current development and refurbishment plans of new and current hospitals across India include: ● Max Healthcare India plans to develop four hospitals to add 2,000 beds with further plans to increase its capacity to 5,000 beds in the next five years through mergers and acquisitions. ● The Hyderabad-based Global Hospitals Group plans to invest over Rs 500 crore to expand hospital network and improvise the facilities for cancer care centers. ● Vasan Healthcare to invest $65 million for new hospitals. ● Apollo Hospitals Group to increase beds capacity as well as develop five hospitals each year with 200 beds. The Group also plans to develop a hospital in Kerala with an investment of amounted to $35 million. ● Fortis, International Centre for Robotic Surgery (ICRS) to invest $20 million for robotic surgery centres Further to internal developments, according to RNCOS, India’s share in the global medical tourism industry is expected to reach around three per cent by the end of 2013. Medical tourism is expected to generate revenue around US$ three billion by 2013. To encash upon these burgeoning opportunities, HBII 2012 has structured itself to provide the Indian Healthcare industry, a holistic platform to come together under one roof to showcase, discuss and see all the aspects involved in Hospital Build, Design and Upgrade. HBII 2012 has launched its first “HBII Awards” this year to recognise and promote excellence in the Hospital Infrastructure sector. This award will be given to leading hospitals for their respective genres of excellence. The categories will include the Best Physical Environment Award (Built), the Best Sustainable Hospital Project Award, the Best Healing Environment Award, the Best Technology Initiative Award, the Best Initiative to Improve the Design Standard of Healthcare Facilities, the Architect/Designer of the year for Healthcare and the Builder/Construction Company of the year for Healthcare. The nominations will be short listed by an

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Leading healthcare companies who have joined hands to sponsor the 3rd International HBII speak about the event and their expectations from it Hospital Build Infrastructure India 2012, the only dedicated B2B trade show for the Hospital Infrastructure & Healthcare sector is receiving an overwhelming response from the industry for their 3rd edition, which is scheduled for December, 14-16, 2012 at the Bombay Exhibition Centre. Godrej Interiors, Allarch Healthcare, Tata Motors, Portalp International, Draeger India, Tahpi, Alvo, Modular Concepts, Responsive Inds, Hospaccx India systems, Medica Synergie, Zebra Technologies, Bioni Paints India, Sio Vasundhara, CR Medisystems, RR-Eubiq are few of the leading participants who will stamp their presence at this three day awe-inspiring platform. Going by the response and support the platform is receiving, it is indeed evident that HBII 2012 will again captivate the industry’s attention and offer everyone in the hospital supply chain an unmatched opportunity to network, upgrade knowledge, source, sell, share ideas and technology and partner, all under one roof. The event promises to showcase the best range of latest trends and technologies in the healthcare sector. Check out what participants and sponsors have to say on their offerings at HBII 2012: “Looking into the huge demand for Quality HealthCare Services in the coming years in India and so the need to have world class healthcare infrastructure to support the industry, Godrej Interio has launched new series of healthcare furniture in recent times. Our healthcare furniture range is indigenously designed to match global safety standards and offer distinct competitive advantages to patients, healthcare providers and all other stake holders alike. Our presence at 3rd International Hospital Build & Infrastructure India 2012 will provide an ideal platform to show case our offerings in the most appropriate ambience” - Godrej Interio, Gold Partners at HBII 2012 “Allarch offers solution from architecture designs to medical grade mobile computing under one roof with understanding of evidence based healthcare. Allarch Healthcare Technologies is committed to deliver innovative and enabling technologies to healthcare provider for translating vision of safer, optimided and healing environment into practice. Allarch believes that Hospital Build & Infrastructure India 2012 is the right platform to share vision of complementing solutions and introduce more “care” in healthcare” - Allarch Healthcare Technologies, Silver Partners at HBII 2012 “Tata Motors recognises the fact that the healthcare industry in India is slated for a paradigm shift in years to come. With increased awareness and better access to healthcare coupled with increasing congestion in the cities, the demand for advance life support ambulances has to increase. In order to meet the future needs, Tata Motors has developed a wide range of ambulances. We are excited for this opportunity at 3rd International Hospital Build & Infrastructure India 2012 to showcase how Tata Motors is providing a complete transport solution to the healthcare industry” – Tata Motors, Supporting Partner at HBII 2012 “Knauf is one of the world’s leading productions and construction material company with over 220 facilities and 22,000 employees present in over 60 countries. Knauf recognises that each part of a new hospital holds unique challenges, such as mixtures of acoustic, fire ratings and impact performances. It has solutions for special requirements, such as x- ray protection (new technologies), interior and exterior design, and access panels options for operation theatres. Looking at the growth in the healthcare sector and their requirements Knauf is excited to be a part of Hospital Build India 2012” - Amer Bin Ahmed, Managing Director Knauf Middle East, Registration Partner at HBII 2012 “Sio Vassundhara International along with Portalp International will launch a range of automatic doors, security devices and builder’s hardware for the health industry, with their state of art set up, bringing together world class products with the latest technologies for security and safety, thus ensuring true value on investment. We cater to the hospital infrastructure sector in a big way and we look at Hospital Build & Infrastructure India as the best platform to meet our clients from the health sector” – Sio Portalp, Bag Sponsor at HBII 2012 “Eubiq India recognises the fact that healthcare industry in India is going to touch the sky in recent coming years. With increased awareness and better facilities Eubiq India is going to stand in the next line of advancement of Indian healthcare industry. Eubiq Singapore is the inventor and manufacturer of GSS System - The World’s Most Flexible Power Outlet System. GSS System is the infrastructure platform of the future - all your Power, Data and Communication (Audio, Video and Telephone) needs can be

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OCTOBER 2012

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elite panel of jury members comprising of dignitaries from the Indian healthcare sector. HBII will also witness the “HBII 2012 Conference”, a world class technical conference for industry professionals to benefit from the experience of the renowned industry leaders from across the world. The conference will deliberate on some key issues related to hospital design and planning, innovations as well as engineering aspects to look for when building or upgrading small as well as large healthcare units. The topics will be broadly categorised into three segments, namely the Leaders in Healthcare, Hospital Build, Design and Upgrade and Quality of Care. To further add value to the platform, there will be special features like product demonstrations, workshops, seminar forum and business to business meetings. HBII 2012 will be a one stop solution for the Indian Hospital and Nursing Home infrastructural needs and will showcase products ranging from architecture and design, construction, flooring, ceilings, lighting, ambulances, medical equipments, OT medical systems, healthcare IT, Lights and pendants, HVAC, hospital curtains, doors etc. for the healthcare industry. Hiranandani Hospitals, Medica Synergie, American Institute of Architects, Archetype, AWESOME, Ontario, Canadian Govt. and Hosmac are few of the leading players in the Indian Healthcare sector who have confirmed their support as partners for the third edition of Hospital Build & Infrastructure India which is expected to attract over 4000 top decision makers and healthcare professionals from major Hospitals and Nursing Homes. It will open a sea of opportunities for growth, offering scope for branding & networking with bureaucrats, Indian healthcare giants and attract useful partners and associates to work together as a potent business force. With significant industry support and value additions like the HBII Awards and Conference, HBII 2012 is set to captivate the industry’s attention and offer everyone in the hospital

neatly integrated onto a single track. We are enthusiastic and excited for this wonderful opportunity at 3rd International Hospital Build & Infrastructure India 2012 to showcase how Eubiq India is providing all the power, data & gas management solutions” - Eubiq India, Lanyard Sponsor at HBII 2012 “Archetype Group, a leading multi-disciplinary construction consultancy in Asia, and AIA Associés, a French-based firm specialised in the development of high quality and technical healthcare facilities, will showcase our combined skills and competencies at Hospital Build & Infrastructure India 2012. Founded in 1971, and with nearly 600 employees working out of several agencies in France and China, AIA Associés is one of Europe's foremost healthcare design firms, offering a full range of combined expertise and outstanding services in architecture, engineering, urban planning and sustainable development. As the ideal partner to AIA’s activities, Archetype Group brings extensive experience in fast-growing markets in the Asian region, with a particular focus on project management expertise gained over several years in India. Together, we aim to bring our recognised leadership in design and project management to the rapidly developing healthcare sector in India. We look forward to learning more about India’s great potential and specific needs and to meet with key leaders in this industry at Hospital Build & Infrastructure India 2012.” – American Institute of Architects & Archetype Group, Exhibitor at HBII 2012. “Bioni India will introduce a modern coat of paint that can do a lot more than simply look good. Bioni India, in collaboration with Bioni Germany & Fraunhofer Institute will launch paints and coatings based on silver nanotechnology that creates new and eco-friendly painting solutions for building interiors and exteriors. HBII has undertaken a magnificent job by acquainting hospital facilitators and hospital expeditors under one roof and thus creating a smaller world and helping the hospital industry grow in a healthier, efficient and resourceful way" – Bioni Paints, Germany- Exhibitor at HBII 2012.

supply chain with unlimited knowledge, unmatched footfall and unparalleled success for its Supporters and its participants at this two day awe-inspiring platform.

For more information or to participate at HBII please visit www.hospitalinfra-india.com or call +91 22 4048 1705 | +91 99202 88808 Email rakhi.singh@informa.com

POST EVENT

DMAI organises industry government meet Private sector and government officials discuss and debate the road to affordable healthcare n an effort to bridge the gap between the industry and government, the Disease Management Association of India (DMAI) organised an event to bring both the sides together together and engage the private sector in the programmes of the ministry of health and family welfare (MOHFW). Moderated by Rajendra Gupta, President of DMAI, the event was attended by CEOs from the pharma and healthcare industry as well as government officials. Starting the session, Dr K Srinath Reddy, President, Public Health Foundation of India (PHFI) emphasised the importance of a strong health system as a primer to economic growth calling for greater investment in the area. “There is a greater need to go beyond an all government approach to health and adopt a society approach wherein NGOs, healthcare providers, public sector and government work in partnership to help meet the country's challenges and needs.” He said that there is a need to redefine PPPs as partnerships for public purposes that are aligned to the needs

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of the society, giving examples of 108 ambulance service, Chiranjeevi scheme, Gujarat National Blindness Control Programme and Tuberculosis Control Programme. He lamented the long term neglect of public health, citing sub standard health programmes and lack of expertise in programme delivery and optimisation. “The solution lies in empowering non physician health providers who can deliver basic services such as blood pressure management and run hypertension clinics both in rural and urban areas.,” he said. Setting up a regulatory environment that monitors spurious drugs thus ensuring drug safety, a clear cut policy for medical devices and tapping on the tremendous opportunity of using our public health workers to meet global demand can help put India on the global map, he opined. Anil Swarup, Director General, Labour Welfare, who helmed the hugely successful Rashtriya Swasthya Bima Yojana, talked at length about this unique scheme. It is a one of its kind cashless, paperless (in the world)

Industry leaders and government discuss the way forward scheme that is portable specific to the needs of poor, illiterate, migratory workers. The success of the scheme can be gauged form the fact that it has covered 110 million people in 26 states with 32 million smart cards issued till now and 75,000 being issued almost everyday. “The scheme has empowered the poor who can now walk into any of the 72,000 hospitals empanelled under it. 98 per cent of the claims are settled in 30 days. People have found so much value in the scheme that they are ready to pay full premium now”, he said. The scheme has been particularly successful in Tripura, Jharkhand, Chattisgarh and Mizoram, he informed. Sam Pitroda, Advisor to www.expresshealthcare.in

the Prime Minister of India on Public Information Infrastructure & Innovations outlined a five-step road to the achievement of the country's healthcare agenda. Foremost, he suggested modifying the existing healthcare infrastructure facilities and getting them in-line with acceptable standards as well as building capacity in terms of a workforce of trained doctors, paramedics and technicians in rural and urban areas alongwith increasing numbers of those trained as healthcare workers at colleges and universities. He also stressed on the need for strong health information systems in the form of electronic health records, telemedicine etc. “Integration of traditional

healthcare systems such as Ayurveda and Unani medicine that has been passed on from generations would help us meet the challenges of the future,” he reiterated. He also advocated cost effective solutions in the form of uniquely innovative systems of health delivery to address the country's challenges. The dialogue seems to have generated results that could have long term impact, but this is just the beginning. “The private sector has decided to adopt districts for the mass screening programmes, which will result in massive improvement in the number of screenings conducted by the MOHFW. The state of Jammu & Kashmir has decided to adopt RSBY in 10 districts immediately,” informed Gupta. Companies have also come forward to help the Government in leveraging IT capabilities of the sector, forge wider collaborations for various programmes of the Government to make healthcare more affordable, accessible and efficient for the common man, he added. EH News Bureau OCTOBER 2012

ENHANCED SECURITY. ELEVATED PRODUCTIVITY. EXTENDED COST EFFICIENCIES. Zebra ZXP Series 3™ Card Printer Benefits – Optimum Security, Reliability & Cost-Efficiency Equip your healthcare organization with the superior performance and enhanced security of Zebra ZXP Series 3™ card printers to improve your employees and patients identification processes. Incorporate color coding on identification badges so that patients can clearly identify who are members of the staff, with different colors denoting doctors, nurses, technicians and administrative personnel thus save time and costs. Zebra ZXP Series 3™ card printers can print smartcards that can hold patient identification information and health history, thus be able to greatly improve the speed and accuracy of a patient’s care by replacing paper files with superior and enhanced technologies. Key Benefits • Maximise speed and efficiency with high-speed, high-performance printing • Highly-affordable direct-to-card printing solution. • Enhance security with smart card and magnetic stripe encoding • Optimise ease-of-use with quick-replace, Load-N-Go™ ribbon cartridges • Enjoy greater flexibility through better connectivity, easy system integration & single/dual-sided direct-to-card printing options For more information on Zebra ZXP Series 3™, visit us at Smart Card Expo on Oct 10-12 at Stall No. C26! To find out more, visit www.zebra.com/zxpseries3 For further enquiries, please email SGMarcom@zebra.com Zebra Technologies India Pvt Ltd Boomerang A202 Near Chandivali Studio Main Chandivali Farm Road Main Andheri E Mumbai 400072 T: 022 67275555

M|A|R|K|E|T PRE EVENT

Hospital Finance & Marketing … Secrets Revealed Hospi-Fin-Markpromises to be an interesting event which will deal with the current trends and changing patterns of hospital financing and marketing admashree Dr DY Patil University, Department of Business Management in Navi Mumbai presentingthe 4th National conference on Health and Hospital Management. It is called Hospi - Fin – Mark (Hospital Finance & Marketing....Secrets Revealed..! and is slated to held on November 24, 2012. Dr R Gopal, Chairman, National Organising Committee says, “The healthcare sector in India is a booming market; offering a wide array changing pattern of hospital financing and marketing. Hospi - Fin - Mark 2012 aims at providing a platform to the participants to interact with the best and the brightest hospital and healthcare experts. Apart from this, it gives a platform to the participants to showcase their ideas and talents.” Development of healthcare facilities is one of the focus areas of the 12th Five Year Plan that runs from fiscal 2012-13 to 2016-17. India targets to invest over $one trillion in infrastructure development during the next five years. This conference is based to acknowledge the

two grey areas for small to medium sized healthcare providers viz: Hospi-Fin: On the back of continuously rising demand, the hospital service industry is expected to be worth $81.2 billion by 2015. There is also an increasing interest among private equity funds, domestic and international financial institutions, venture capitalists, and banks to examine investment opportunities across an extensive range of segments. The “Fin” (Finance) will examine the various funding options for the expansion, revamping, and other areas for small to medium sized hospitals, nursing homes, diagnostics, day care centres, etc. Hospi- Mark: Gone are the days of typical marketing strategies of reference and plain advertisements. We witness a lot of newer trends viz social marketing, e- marketing, media utilisation, etc. A panel discussion will be held on “Varietal branding and marketing opportunities for small to medium sized Hospitals, Nursing Homes, Diagnostics, Day Care Centres, etc.”

The “ Mark” plans to build custom designed marketing strategies for all delegates. The dignitaries of this conference are ● Varun Khanna, Regional Director – West & East Fortis Healthcare (Chief Guest) ● Dr Nandita Palshetkar (Guest of Honour) ● Dr Sanjay Oak ( Guest of Honour) ● Sandeep Sinha ( Director, Southeast Asia & Middle East, Frost & Sullivan) ● Narendra Karkera (Director – Operations, Hosmac India) ● Ankush Gupta ( Asst Director – HR, Hinduja Hospital) ● Dr Bipin Chevale ( MS –Fortis Hospital, Vashi) ● Gaurav Malhotra (Managing Director & CEO – Patni Healthcare) ● Dr Rajendra Patankar ( Sr Manager – D M Healthcare ) ● Dr Shirish Patil ( Dean – Pad. Dr D .Patil Medical College) ● Dr Sanjit Paul ( Managing Trustee – Platinum Hospitals )

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Viveka Roychowdhury, Editor – Express Healthcare, Express Pharma and In Imaging ● Dr Yasmin Shaikh, GMMarketing and Corporate Communications, Gleneagles Khubchandani Hospital, Juhu Dr Nitin Sippy ( National Convener ) says, “ Hospi-FinMark is a unique conference to satisfy the current need of the Healthcare industry & thus leading to a win-win situation to all the stakeholders.” It will a very pertinent event for hospital promoters, managing/medical directors, hospital administrators / managers / executives, clinicians /consultants / doctors, other healthcare professionals, students (MHA /PGDHA), others interested For more information contact: Asst Professors: Dr Sippy / Dr Shital Mob: 9987090768 / 8692899799) Email: drnitin5683@gmail.com, shitalshinde07@gmail.com Blog: http://dyphospifinmark.blogspot.in/

PRE EVENT

Nursing Leadership Programme The nursing leadership programme organised by DY Patil University's Department of Business Management ( DYPDBM) will focus on improving the management skills of nurses in the area of their practice and thus promises to be very useful for both hospitals and individuals admashree Dr DY Patil University's Department of Business Management ( DYPDBM) is organising a management development programme (MDP) for nurses and its first module focussing on Nursing Leadership is slated to be held on October 6, 2012. The rationale behind the nursing leadership programme is that a great nurse manager is an acknowledged leader; an advocate for her patients, staff, and hospital; a powerful agent for change; a respected member of the nursing administrative team; and a good fiscal manager. It's not easy to balance the competing demands of patients, families, visitors, physicians, unit staff, and personnel from other departments, but an effec-

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tive nurse manager is flexible and organised enough to address everyone's needs in a systematic way. Being a successful nurse manager requires a combination of empathy, good organisational and leadership abilities and strong communication skills. The training programme aims to improve the management skills of nurses in the area of their practice. The objectives of the programme are to: ● To enhance management skills ● To learn various aspects of leadership ● To develop better relationship building with management and peer group Key benefits to be accrued from the event are www.expresshealthcare.in

For organisations: ● Development of personnel ● Compliance with standards of care ● Collaboration among departments ● Improved patient care For individuals: To improve managerial skills which fall under three categories ● Technical - ability to perform a specialised task involving a particular method or process ● Interpersonal motivation and communication management ● Conceptual - ability to see the organisation as a whole, to recognise complex and dynamic issues, examine the factors that influence these problems and resolve such situations

The DYPDBM’s MDP programmes are an intitiative that helps business executives to explore new frontiers of knowledge, sharpen their tools and help their organisations to grow. They also enable organisations to improve productivity and process efficiency, enhance communications and teamwork, improve human performance and morale, retain talent and resources, reduce cost and waste, anticipate workforce and technology changes and stay competitive. Contact details: Asst Professors: Dr Sippy/Dr Shital Mob nos: 9987090768/ 8692899799 Email: drnitin5683@gmail.com, shitalshinde07@gmail.com OCTOBER 2012

14 -16 December 2012

Visit Hospital Build & Infrastructure India Exhibition & Conference 2012

M|A|R|K|E|T POST EVENT

Apollo twin conferences: Rooting for healthcare IT and patient safety The twin conferences, organised by Apollo Hospitals group, on healthcare IT and patient safety addressed several pertinent issue in this spheres and was well received by the delegates he Apollo Hospitals Group recently organised twin conferences at Hyderabad: The '3 rd International Conference on Transforming Healthcare with IT 2012' and the '2nd International Congress on Patient Safety; Best Practices for Asia'. They were held at the Hyderabad International Convention Centre, Hyderabad, from 31 August-2 September 2012. The '3 rd International Conference on Transforming Healthcare with IT 2012 was organised to highlight the importance of ICT in reforming healthcare and bring the entire healthcare ecosystem stakeholders on a single platform to participate, propagate and promote the various technology-driven transformational approaches and solutions

Words of Wisdom “The healthcare sector requires new plans and strategies in all spheres. With medical technological advancement, specialised treatment and services are being developed for healthcare across the world. The need for patient safety is being recognised everywhere, especially developing countries, as awareness about medical errors is increasing. Patient safety programmes and such conclaves involving experts provide food for thought and techniques to provide a conducive environment for healthcare.” Dr Prathap C Reddy, Executive Chairman, Apollo Hospitals Group “I am sure this conference will have lot of benefits, not only to the state but to the entire world. We will have better hospital systems after the conference.” AP Chief Minister N Kiran Kumar Reddy “Some major areas that need to be addressed in the healthcare sector include correct and timely diagnosis, affordability, accessibility and awareness. But one major sphere that gets neglected is patient safety. It is essential to focus on critical issues such as how to deal with an insufficient number of appropriately-trained human resources; non-availability of right equipment and technical know how in application; hospital and community-acquired infections; drug errors and surgical errors.” “Technology plays a vital role in facilitating equitable healthcare distribution and helps in creating awareness about various health issues. Thanks to the convergence of healthcare, IT and telecom, transformational solutions are being created to provide better treatment for patients. Sangita Reddy, Executive Director – Operations, Apollo Hospitals "I am of the firm belief that technology has the ability to solve many of the problems we face in delivering quality healthcare for people everywhere." Lee Shapiro, President, All Scripts

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for creating an equitable, sustainable and quality healthcare system. Apart from several national speakers, international speakers from from US, Canada, UK, Middle East, Pakistan, Belgium, Denmark, Bulgaria, Japan, New Zealand, Malaysia and Iran shared their personal experiences on how information and communications technology (ICT) is ushering a global revolution in healthcare. The speakers also discussed topics such as e-health initiatives, globalisation of healthcare and Next-Gen telemedicine. The 2 nd International Congress on Patient Safety, inaugurated by Andhra Pradesh Chief Minister N Kiran Kumar Reddy was an endeavour to bring together experts from across the globe for enabling transformation of healthcare with best practices for patient safety. The objective of the Congress was to discuss current developments and provide a forum for interaction between key stakeholders in connection with patient safety. The conference not only saw the presence of national and international speakers from the healthcare sector, but also from other sectors such as hospitality, aviation and banking. Topics such as 'Top 10 Best Practices to Prevent Patient Falls', 'Patient Safety 365/24/7: Tools, Role of Safety Rounds/Surveys', '?Impact of Laboratory Accreditations on Patient Safety', etc. were discussed with presentations. A panel discussion on 'Leveraging IT capabilities to improve healthcare' outcomes was also held. Another interesting occurrence was the signing of the 'Cyberabad declaration' to transform healthcare using the experiences and expertise of all the stakeholders across the healthcare spectrum. The twin conferences were very well received, as evidenced by packed halls at the sessions.

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Andhra Pradesh Chief Mimister, Kiran Kumar Reddy addressing the crowd at the twin conference conducted by Apollo in Hyderabad

Dr Pratap Reddy felicitating the Chief Minister of Andhra Pradesh

Delegates attending the Apollo twin conferences

Sangita Reddy chairing a panel discussion at the conference OCTOBER 2012

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IAPB 9th General Assembly: Leading the light The 9GA presented new approaches and practical solutions to improving eye care e should aim at reducing visual impairment by 50 per cent by the year 2020,” said Dr A P J Abdul Kalam, Former President of India, who addressed more than 1550 international delegates during the International Agency for the Prevention of Blindness’ 9th General Assembly (9GA) which was held in Hyderabad from September 17-20, 2012. The event brought together ophthalmologists, optometrists, public health specialists and other professionals involved in blindness prevention, from around the world. The 9GA presented new approaches and practical solutions to improving eye care. The theme for this year's meeting was 'Eye Health Everyone’s Business.' During the event, experts from around the world held symposia addressing topics such as the global blindness prevention, importance of ‘health systems’, how social entrepreneurship can be applied in a blindness prevention context and how the eye sector can move towards more effective public-private partnerships (PPP) in terms of Corporate Social Responsibility. Delegates attended courses ranging from, cataract, refractive error, glaucoma, diabetic retinopathy, agerelated macular degeneration, childhood blindness, corneal blindness and eye banking. Delegates learnt also learn of the progress being made towards the goal of VISION 2020: The Right to Sight (IAPB’s joint initiative with the World Health Organization for the elimination of avoidable blindness). Day 1 started of with the opening ceremony which was graced by Dr Kalam, Srinath Reddy, Chairman of the now disbanded High Level Expert Group (HLEG), set up by the Planning Commission, Dr Gullapalli N Rao, Chairman, LV Prasad Eye Institute and Past President of IAPB; Prof Hugh Taylor, Chair of 9GA Scientific Committee; Sujaya Krishnan, National Blindness Control Programme; Maryanne Diamond, World Blind Union; Lord Colin Low, International Council for the Education of the Visually Impaired; Christian Garms, President of IAPB; and Professor Brien Holden, Chair of 9GA Organising

“W

OCTOBER 2012

Lighting the lamp

Dr Kalam inaugurates the IAPB’s 9th General Assembly

Dr Kalam, Prof Brien Holden, and Dr Rao

Dr Rao addressing the audience during the Day 2 panel discussion Committee. During the opening ceremony Dr Kalam released a special issue of the Indian Journal of Ophthalmology. While addressing the audience during the opening ceremony, Dr Gullapalli N Rao, Chairman of the L V Prasad Eye Institute and a Past President of IAPB said, “This www.expresshealthcare.in

deputation demonstrates the on-going commitment by the Government to combat avoidable blindness. The 9GA will provide the ophthalmologists with practical skills and the latest knowledge which they will take back to their districts, enabling improvements to be implemented in existing

programmes. It has the potential to ultimately facilitate thousands of people having their sight restored and blindness prevented.” Day 2 had sessions that covered issues related to health systems. Prof Don De Servigny in his session on Health System Development stressed upon the need to adopt system thinking approaches. He said, “We need to do more system thinking and adopt more system sciences to approach the Vision 2020 goal”. Dr Daniel Etya'ale, IAPB Africa, spoke on pitfalls in bypassing national health system. The other sessions included innovative strategies to improve eye care services. Some experts pointed out that every person should have access to specialised eye care service within 50 metres proximity. Experts from Africa also presented their model programmes that have helped them spread light to the million blind people in their country. Day 3 was a much interesting day where experts met to discuss how the private sector, government and financial institutes could come together to provide high quality services at an affordable cost. The event concluded with the Closing Ceremony on September 20. The ‘Hyderabad Declaration on Promoting Eye Health and Eliminating Avoidable Blindness and Visual Impairment’ was signed by the President of IAPB, Bob McMullan, on behalf of the newly elected IAPB officers. The Declaration states that eye health must be addressed as part of primary health care and health systems. On the occasion, McMullan, “Eye health affects every individual and the economy of every country. Avoidable blindness and vision impairment is a massive problem, but it’s a problem that we can do something about through cost effective solutions. The 9GA was about Action – developing programmes of action that make eye health a priority area in the national health agenda of every country, particularly developing countries. The Hyderabad Declaration will help IAPB to advocate the importance of eye health around the world.” EXPRESS HEALTHCARE

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EVENTS UPDATE 5th SAARC Critical Care Congress (SCCC) & 2nd International Conference on Recent Advances in Anesthesiology (INCRAA)

Contact details: Dr Santhosh Kamath Organising Secretary Phone:91-94462 71247 Website:www.isakerala.org/site/conference/in vitation Email: drsanthoshkamath@yahoo.com

Medex 2012

Date: October 6-7, 2012 Date: October 20-21, 2012

Contact details: UBM Medica India Pvt Ltd 611-617, Sagar Tech Plaza – A Saki Naka, Andheri-Kurla Road, Andheri East, Mumbai – 400 072 Tel: Board Line – 022 66122600 / Direct – 022 66122627 Mob – 9773535446 Fax - 66122626 Harshit Shah, Project Manager Tel: +91 22 6612 2646 Mobile: +91 9820434897 E-mail: harshit.shah@ubm.com

Venue: Manekshaw Centre, New Delhi Venue: Lakshi Sundaram Hall, Madurai Participant profile: Hospital administrators, ICU Head, anaesthesiologists and other healthcare professionals Contact: Prof Chandralekha Organising Chairperson Prof Anjan Trikha Organising Secretary Phone:91-11-26593212 Website:www.incraa-sccc.org Email:incraa-sccc@gmail.com

ISEHCON 2012 Date: October 6-8, 2012

Organiser: Confederation of Indian Industry Participant profile: Medical equipment manufacturers, Facility management experts Healthcare consultants; Hospital design and construction firms; Telemedicine equipment players, Hospital hygiene and sanitation service providers; Contact details: D Naganathan, Executive Confederation of Indian Industry Madurai Zone Plot No 518, 1st floor, 4th Main road, KK Nagar, Madurai 625 020, Tamil Nadu Ph: +91 452 4391 434, Fax: +91 452 2521 705 Mob: +91 99441 18584 ciimadurai@cii.in / ciimedex@gmail.com www.ciimedex.org

Venue: India International Centre, New Delhi, India Organiser: All India Institute of Medical Sciences, Clinical Epidemiology Unit Participant profile: Approximately 300 experts and delegates from diverse fields are expected to participate in this mega event from across the globe. Contact details: Clinical Epidemiology Unit (CEU), Room No-91, Near Examination Section, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi-110029, India Phone No: +91-11-26594436/26588434 Fax: +91-11-26588663/26588641 Email : isehcon2012@gmail.com

ISACON Kerala 2012

CT FEST 2012

Date: October 26-28, 2012 Venue: Grand Hyatt, Mumbai

Date: November 24 and 25, 2012 Venue: Hotel City Park, Kapashera, Gurgaon (near Toll Plaza), New Delhi Participant profile: Hospital/ healthcare promoters, CEOs/COOs, administrators, managers, executives, healthcare management consultants Contact details: AMEN No. 233 6th Main, Rajeevgandhi Nagar, Near Lourdes School, Nandini layout Bengaluru - 560096, Karnataka Ph: 09035189825 Website:http://amenhospiarch2012.blogspot.in/

3rd International Hospital Build & Infrastructure India Date: December 14-16, 2012 Venue: Bombay Exhibition Centre, Mumbai

Participant profile: Radiologists, Hospital Administratiors, Radiology technicians, Radiology Department HODs and Imaging equipment manufacturers Contact details: Dr Sanjeev Mani 1st floor, Jain Arcade, above Costa Coffee CD Marg, Khar (W), Mumbai 400052 Tel: 022- 26463666 Email: ctfestindia@gmail.com Site: www.msbiria.org & www.medconference.in

Venue: PJ & DJ Halls, CPCRI, Kasaragod, India Date: October 13-14, 2012

HospiArch 2012 DELHI

Hospital Management Conference

Organiser: Informa Exhibitions India Participant profile: CEOs, chairman, managing directors, general managers, chief operating officers; presidents; owners; medical directors, executive directors; vice presidents; operating directors; department heads; chief financial officers; ministry of health; quality management; engineering consultants; advisors; project managers/ directors, strategists healthcare investment funds, architects; engineers; interior designers; construction managers and contractors; project managers; hospital planners and designers; hospital managers and administrators, logistic managers; and other healthcare professionals

Organiser: ISA Kerala State Chapter Hosted: ISA KASARAGOD CITY BRANCH Participant profile: Experts and delegates from diverse fields are expected to participate

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Date & venue: November 22-23, 2012, Hotel Crowne Plaza, New Delhi November 29-30 Nov 2012, Hotel Holiday Inn, Mumbai

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Contact details: Sujoy Gomes, Exhibition Manager Phone: +91 22 4048 1705 Mob: 91 9920 288 808 Email: sujoy.gomes@informa.com

OCTOBER 2012

MNBC: Setting new benchmarks Dr (Major) Indranil Mukhopadhyay, CEO, MNBC talks about MNBC's role in the evolution of the private healthcare sector in West Bengal

Private healthcare North Bengal

Private healthcare in North Bengal has changed a lot recently. It has gone to the next level where corporate culture has come with standardised healthcare. Medica pioneered the process in 2007.

Advanced medical services at MNBC

DR (MAJOR) INDRANIL MUKHOPADHYAY CEO, Medica North Bengal Clinic (MNBC)

OCTOBER 2012

MNBC provides the most advanced medical facilities. Our cardiac care is holistic where we give round the clock haemodynamic and respiratory care in the presence of intensivists and medical officers. The ICCU and cardiac care units are going to be expanded shortly. Haemo dialysis and CPAD are given by our dialysis unit. Neonatal intensive care capacity was recently increased and paediatric intensive care is available for children needing critical care. All types of minimal

access surgeries in general surgery, OB/GYN and ENT are done. The endoscopy department looks at all types of endoscopic procedures related to gastroenterology and ENT. We regularly perform brain tumour surgery, micro discectomy, arteriovenous malformation correction, trigeminal neuralgia and other complicated neuro-surgical procedures.

Benchmarks set by MNBC We believe in involving patients in all process of their healthcare. Our patient hand books, health hosts, emergency coordinator, guest relationship executives etc have brought a human touch and compassion to patients. Entire stay of a patient, from admission to discharge is processdriven. Feedback taken from all patients are analysed later.

Spreading wings Our approach will be

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capacity building with more focus on strengthening our services and adding new services like onco-surgery/arthroplasty/maxillofacial surgery.

Ensuring security and safety We are following all aseptic techniques and standard safety protocols as well as maintaining adequate nurse-patient ratio.

CSR activities Under our 'Sahayata Project' (medical transportation service) patients residing in and around Siliguri will be provided free round-the-clock 'medical transportation' to our hospital. We also regularly provide concession to patients from BPL category and organise free medical camps.

Future ahead Healthcare should be made more accessible and affordable with door step delivery. A very strong corporate presence in the region is in the future. Healthcare will be more holistic and movement to faraway places will be lesser.

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Anandaloke Hospital: The ‘Dream’ Project Anandaloke Hospital has traced an impressive growth story from a 25-bed centre to a 100-bedded multi-speciality hospital serving the healthcare needs of the people in East India

The 'Dream' project Born in a small town in Bangladesh, Dr Sushanta Kumar Roy, a noted radiologist did his Bachelor's Degree in Medicine from Dhaka Medical College, DTCT from Kolkata Medical College and then his Master's Degree from Kasturba Medical College. He started his career in 1993 as a Consultant Radiologist at a local nursing home in Siliguri. Later, inspired by his zeal and enthusiasm, he started his own ultrasonography (USG) clinic. After three years, he expanded this USG clinic to a diagnostic clinic with a laboratory and radiological facility along with endoscopy. At present, this diagnostic centre is known as the 'Anandaloke Sonoscan Centre'. Equipped with 1.5

Tesla MRI, 16-slice CT scan and enteroscope, it boasts of an annual turnover of Rs four crores. In 2003, he took up a brownfield project and started 'Anandaloke Hospital & Neurosciences Centre' with 25 beds. Today, that centre has grown up and expanded to a 100-beded multispecialtiy hospital with 500 employees enjoying an occupancy rate of 95 per cent with an annual turnover of Rs 16.5 crores. Besides, neurosurgery, neurology, gastroenterology, nephrology, urosurgery, plastic surgery, trauma, cardiology and orthopaedics, eye, ENT, internal medicine, general surgery, dermatology, super-speciality and speciality services are also offered at this hospital. The hospital is recognised as a Class-I service provider

and it is ISO certified as well.

A Visionary Dr Roy, the Managing Director of the hospital realised the importance of trained manpower and started 'Anandaloke School of Nursing' and 'Anandaloke Paramedical Institute'. At present, 25 GNM and 17 paramedics are trained here every year.

Reaching out to the underprivileged

DR SUSHANTA KUMAR ROY

Dr Roy did not forget his social responsibility and he developed a trust called the 'Uma Suresh Memorial Charitable Trust' in the name of his parents. Besides other social services, regular surgery for cleft lip and palate are performed here, by the plastic surgeon, under the 'Smile Train Project'.

Managing Director Anandaloke Hospital

Road Ahead A work alcoholic and fitness freak, Dr Roy said that his mantra for success is his hard work and belief in his dreams.

ANADALOKE HOSPITAL & NEUROSCIENCES CENTRE (A UNIT OF ANANDALOKE MEDICAL CENTRE PVT. LTD.) OUR USP G MULTISPECIALTY HOSPITAL G CLASS ONE SERVICE PROVIDER(WBHS) G ISO CERTIFIED ORGANISATION G IMPLEMENTING NABH STANDARDS G PATIENT CENTRIC MANAGEMENT G PROFESSIONAL MANAGERS G QUALIFIED AND TRAINED STAFFS G NURSING & PARAMEDICS TRAINING INSTITUTES G EMPANELLED BY MOST TPA, MEDICAL INSURANCE AND CORPORATE OUR DEPARTMENTS G GENERAL MEDICINE G CARDIOLOGY G GASTROENTEROLOGY G NEPHROLOGY G NEUROLOGY G PEDIATRICS G NEUROSURGERY G ORTHOPAEDICS G GENERAL SURGERY

G OPHTHALMOLOGY G E.N.T G UROLOGY G PLASTIC & RECONSTRUCTIVE

SURGERY G OBSTETRICS & GYNAECOLOGY G DERMATOLOGY

OUR SERVICES G EMERGENCY 24 X 7 G ICU – 15 BEDED G 1.5 TESLA MRI G CT SCAN (MULTI SLICE) G ENDOSCOPY G ERCP G ENTEROSCOPY G AUTOMATED MICROBIOLOGICAL G AUTOMATED HAEMATOLOGICAL G AUTOMATED BIOCHEMISTRY G HAEMODIALYSIS G EEG – EMG - NCV G AUDIOMETRY

An ISO 9001 : 2008 Certified Multi-Speciality Hospital Class-I Service Provider of WBHS 2nd Mile, Sevoke Road, Siliguri – 734001 Phone : 0353-2540980 / 2544352, Fax : 0353-2544944 / 2545454 Email : anandaloke19_ecdrid@bsnl, Visit us : www.anandaloke.com

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OCTOBER 2012

Vivekananda Hospital: Caring Lives Vivekananda Hospital, with its quality services and has emerged as a leading healthcare player in East India

SUJIT KUMAR DUTTA Managing Director, Vivekananda Hospital

OCTOBER 2012

ivekananda Hospital provides outstanding care to the people of Durgapur and its adjoining areas since its inception in December 2008 with an objective to provide 21st century medical care through ultra modern facilities at an affordable cost. It provides round the clock services with a human touch to patients with its highly qualified and experienced team of doctors, well trained nursing with para-medical staff and other excellent supportive personnel. It caters to the medical needs of patients from Purulia, Birbhum, Bankura, Burdwan districts of West Bengal and even Jharkhand. Vivekananda Hospital has been serving all categories of patients ranging from ESI, Mediclaim (TPA), WBHS, CGHS and many corporates. The 160-bedded multi-speciality hospital has gynaecology and obstetrics,

general medicine, general surgery, ophthalmology, diabetology, paediatric, urology, plastic surgery, dialysis, anaesthesia, pathology, radiology, dentistry, oncology, neuro surgery and ENT departments. The hospital provides state-of-the-art services for ICCU, high dependency unit (HDU), neonatal care, sophisticated burns, snake bites and dialysis units. Its unique 'trauma care unit' is equipped with full time in-house critical care experts and radiological/pathological investigations remain open 24X7 along with CT Scan, EEG and USG. This hospital will soon introduce facilities like cath-lab, ERCP, MRI, cardio thoracic surgery and blood bank with the latest component separator. Mission and Vision: The mission is to be a trusted leader in caring for people and advancing health as well as to make quality healthcare accessible

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and affordable to all 24x7. The vision of this hospital is to provide quality treatment with tertiary care and provide stateof–the-art multispeciality medical facilities to the patients under one roof. The hospital is built on a total area of 50,000 sq ft, has become a well known entity in the region and hence developing an advance trauma facility level reporting, to measure the performance of hospitals across the country, is a priority initiative for the new hospital project. Visionary leaders: Sujit Kumar Dutta, MD and the brain behind this hospital has vast experience in running healthcare institutions. He started his career by setting up another hospital in Bankura district. Through his hard work, determination and grit, he has been able to establish Vivekananda Hospital as a leading super-speciality hospital in the region within a short

period. On his behest, latest equipment are being inducted to keep pace with the growing technological advancements. In MD's words: “We strive to deliver the very best to every patient every day. The patient is the first priority in everything we do. We communicate openly and honestly, build trust and conduct ourselves according to the highest ethical standards.” Our motto is “Caring Lives & Emotions.” In these endeavours, he has been helped by Basabdatta Dutta, Director, who too has contributed a lot through her expertise in making this hospital a leading healthcare institution in the region.

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Strategy ‘Several hospitals around the world have implemented antimicrobial copper surfaces’ Andy Roth, Director – Global Public Health Initiative (PHI), New York and Louis Koh, Regional Programme Manager (PHI) Asia, Singapore Page 40 MAIN STORY

Reaching out to a billion hearts Contrary to the myth about heart disease being a rich man’s disease, CVDs today are an important cause of mortality and morbidity, across all strata of the society in our country. Lack of awareness about CVDs is the biggest deterrent in curbing their onset. On the occasion of the World Heart Day, the healthcare industry picks up arms against this enemy and uses different strategies to vanquish it, reports Raelene Kambli

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e it the increasing intake of burgers, chips and street food that is high in saturated fats and salt, easy access to tobacco, lack of exercise or stress-filled schedules; every aspect of India's accelerated modern lifestyle has contributed to the rise of cardiovascular diseases (CVD) among Indians. New data released by the World Economic Forum during the UN High-level Meeting (HLM) revealed that noncommunicable diseases (NCDs) will cost economies around the world a staggering $30 trillion over the next 20 years, with one-third being attributed to cardiovascular diseases (CVD). This makes CVDs the most significant NCD not only in terms of the number of deaths and level of disease they cause but also because of the financial strain they put on the country, especial-

ly if it is an emerging economy like India, which is still struggling to serve the healthcare needs of all its citizens. In India, heart diseases and stroke is a leading cause of death. With over three million deaths each year, India is set to be the ‘heart disease capital of the world’ in few years’ time. Experts observe that there is a steep increase in heart attacks among Indians below 45 years. In particular, the occurrence of lesions or blockage in the heart vessels due to deposits of fat, chowww.expresshealthcare.in

lesterol, platelets, and calcium has become a common cardiac ailment. CVDs in India afflict the rich as well as the poor. It is estimated that by 2020, CVDs will be the cause of over 40 per cent deaths in India vis-à-vis 24 per cent in 1990. Globally, it already causes 17.3 million deaths annually. “With rapid change in our economic situation over the last two decades there has been phenomenal increase in incidence of CVDs (partly as a result of increased incidence of diabetes, sedentary lifestyles, change in eating habits etc) in India, whilst the rates of CVDs have been on decline in western world”, updates Dr Venkat

D Nagarajan, Cardiology, Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani, Mumbai. Elaborating on the primary risk factors for CVDs, Dr Mantravadi Rajkumar, Consultant Electrophysiologist, Sahyadri Hospital, Pune informs, “Poor lifestyle choices like smoking, excess alcohol and other stress coping substances, mindless pursuance of diets that are rich in carbohydrates and fats; unbalanced aggressive stressful work ethics cause our bodies to release substances which increase the wear and tear, cause subtle and sustained damages to cardiovascular system and eventually cause immense physical and mental suffering in addition to a foreshortened life”. According to the World Heart Federation, at least 80 per cent of premature deaths from heart disease and stroke could be avoided if these risk factors are controlled. OCTOBER 2012

S|T|R|A|T|E|G|Y Increased incidence in women and children What’s more alarming is the growing incidence of CVDs among women and children in India. According to the World Heart Federation, heart disease is the number one killer of women, causing one in three female deaths (i.e. about one death per minute). Indian women are more vulnerable to CVDs than men. The research reveals nearly two-third of the deaths from heart attacks in women occur among those who have no history of chest pain. Metabolic syndrome — a combination of fat around one’s abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men. Also mental stress and depression affect women's hearts more than men's. Depression makes it difficult to maintain a healthy lifestyle. Moreover, smoking is also said to be a greater risk factor for heart disease in women. The mounting number of CVD patients reveals the dire need to have a preventive and curative system against these diseases in our country.

Overcoming challenges Lack of affordability, awareness and appropriate diagnostic facilities are the biggest challenges faced by Indian cardiologists’ face while providing treatment for CVDs. Dr Ramakanta Panda, Founder and ViceChairman, Asian Heart Institute, Mumbai points out, “Even the most advanced countries such as US can’t afford advanced treatment options for cardiac patients because of the high costs involved. Creating awareness about prevention of heart disease is hence the need of the hour. The focus should be on various education programmes which create awareness about the risk factors (such as smoking, unhealthy diet, sedentary lifestyle, high BP, etc.,) of heart disease and its prevention In addition to this, routine medical treatment is available at affordable rates; however catastrophic treatment options such as bypass surgery come at a high cost, making them out of reach for many. Hence government should make available health insurance schemes whereby patients can pay partially for the treatment hence reducing the financial burden”. OCTOBER 2012

World Heart Day In the quest to reduce the burden of CVDs across the globe, the World Heart Federation designated September 29 as World Heat Day (WHD) in 2000 in a bid to raise awareness around CV risk among patients and healthcare workers. WHD engages millions of people worldwide in diabetes advocacy and awareness. It involves several global diabetes community including IDF member associations, diabetes organisations, NGOs, health departments, civil society, individuals and companies to develop an extensive range of activities, tailored to suit a variety of groups. WHD is celebrated on September 29 every year.

WHD 2012 This year the theme for WHD was 'One World, One Home, One Heart', with the stress on curbing CVDs among women and children. Worldwide, there were a variety of activities organised on the occasion of WHD in order to spread awareness. Some of them included health checks, organised walks, runs and fitness sessions, public

company’s corporate social responsibility (CSR) activity. As part of the campaign, free cholesterol tests were conducted at all Fortis facilities and select SRL Labs in the NCR region covering Delhi, Gurgaon, Noida and Faridabad. A total of 14,161 people starting from 18-year olds to senior citizens availed the benefit of this initiative. Pledging an oath: 3000 NCC cadets across India spread the message of a healthy heart in association with Billion Hearts Beating Foundation and Apollo Hospitals. The campaign aimed at informing people about the basic actions they can introduce into their daily lives to lead a healthy heart existence. To enhance and sustain good heart health in the country, the cadets across five metros – New Delhi, Bangalore, Hyderabad, Chennai and Kolkata – took the pledge to mark World Heart Day. Awareness on CVDs in women and children: Bombay Hospital, Indian Medical Association and General Practitioners’ Association joined together to create awareness among

World Economic Forum during the UN High-level Meeting (HLM) revealed that NCDs will cost economies around the world a staggering $30 trillion over the next 20 years, with one-third being attributed to CVD talks, stage shows, scientific forums, exhibitions, concerts, carnivals and sports tournaments. In India, it was celebrated based on three important factors: spreading awareness, initiating programmes for financing poor patients and encouraging major developments in the field of cardiac treatment.

Spreading the word Several premium hospitals and healthcare bodies organised various awareness programmes across the country that focussed on various aspects of CVDs in order to make people aware of the rising risk factors. Some of them were: Campaign to reduce cholesterol levels: Fortis Healthcare organised an initiative to test cholesterol levels in National Capital Region (NCR) as part of the

healthcare professionals and general public on risk factors for women and children. Experts spoke on the advances in management of hypertension and on acute myocardial infarction. Apart from this, Cardiological Society of India (CSI) organised “World Heart Fest 2012”. Held at the NSIC Grounds, Kalkaji in New Delhi on September 30, 2012, a day after the World Heart Day; it was a daylong awareness event dedicated to the prevention of heart diseases and it was powered by Maruti Suzuki Dezire and partnered by Quaker Oats. This awareness event, which included free cholesterol and sugar check, cardiac check-ups, healthy heart tips and expert advice, was conducted to kick-start a larger prevention drive to fight heart diswww.expresshealthcare.in

eases by the CSI.

Financing the cause Affordability is another barrier in reducing CVDs and to address this issue, Healthy Heart for All (HHFA) programme, a Medtronic business model innovation project provides a financing scheme loan to help qualified families cover the cost of cardiac care for their loved ones. It aims to increase awareness and diagnosis of heart diseases by providing high quality, affordable cardiac care and treatment to underprivileged patients. It also does it through promoting financial assistance to implant heart devices such as pacemakers, stents, ICD and CRTP, HHFA partners with hospitals for aiding heart patients. HHFA started its first pilot project at Durgapur, in September 2010 and is currently present in 18 cities namely Delhi, Kolkata, Ranchi, Durgapur, Coimbatore, Salem, Trichy, Tirnalveli, Calicut, Palakkad, Cochin, Mumbai, Pune, Ahmednagar, Ahmedabad, Bangalore, Mysore, and Mangalore. In a short span, HHFA has partnered with 50 hospitals across these cities and has disbursed 116 medical loans to patients under EMI and easy financing options for heart devices implants. Patients can pay back their loans in easy installments (starting from Rs 600/- a month) in their scheme. The other example in this regard is of the Asian Heart Institute, Mumbai who has tied up with the Rajiv Gandhi Yojana Scheme which reduces the cost of treatment for poor patients. With the help of this collaboration, AHI was able to serve many poor patients with good quality treatment at no cost.

Treatments Besides providing awareness, cardiologists in India are also seeking and adopting innovative treatment modalities to fight against CVDs. One such method is the Transcatheter aortic valve implantation (TAVI), an innovative method for replacing diseased aortic valves. Premium hospitals are resorting to this technique which was first developed by Dr John Webb at St Paul’s Hospital in Vancouver about a decade ago. It has become a more common procedure in the past five years. However, in India the concept is still in its nascent

stage. The technique involves inserting a replacement valve made of cow tissue, strengthened with a stainless steel stent, into the human heart. The valve is inserted into the body by a catheter in the femoral artery [in the groin] and moved through the chest into position. The patient’s malfunctioning aortic valve is pushed out of the way and replaced. If the femoral approach is deemed unsuitable, the valve can be inserted into the heart (again, using a catheter) by making a small incision on the left chest wall, just below the nipple. The entire procedure takes about half the time needed for conventional open-heart surgery. Another interesting treatment method introduced is angioplasty with a 6.5 mm stenting. A 52-year male patient who was on medication for 1½ years due to high BP was brought to AHI. The patient complained of chest pain (left sided), mild, continuous in nature since July14, 2012. The pain extended to left shoulder and left arm. In such circumstances, normally a patient is advised a bypass surgery. However, AHI performed an angioplasty with a 6.5 mm stenting and this eliminated the need for a bypass. It is probably the first time that the procedure has been done with such a long stenting. Usually stenting is only of 4 mm. Thus, innovative measures are also being used to curb CVDs.

Investment in research Along with the healthcare sector, the pharma sector has also joined the fight against CVDs. Pharma companies in India are now pumping billions of pounds into research and development that focuses on Indian genotypes and variations for the development of drugs which can be used to treat CVDs.

Needing a change Thus, the healthcare industry is definitely doing its bit and deploying different strategies to nullify the threat posed by the rising incidence of CVDs. Now, it is to be hoped that Indians would somehow get the message that only a healthy heart can sustain for longer years and take the initiative to lead a healthy lifestyle which would in turn be beneficial to the heart. raelene.kambli@expressindia.com

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S|T|R|A|T|E|G|Y 30 MINUTE INTERVIEW

Several hospitals around the world have implemented antimicrobial copper surfaces Andy Roth & Louis Koh ANDY ROTH, DIRECTOR – GLOBAL PUBLIC HEALTH INITIATIVE (PHI) FROM NEW YORK

ANDY ROTH

LOUIS KOH, REGIONAL PROGRAMME MANAGER (PHI) ASIA FROM SINGAPORE

LOUIS KOH

nternational Copper Association is aggressively pitching for the use of anti-microbial copper in the healthcare sector. Anti-microbial copper, with its ability to reduce hospital acquired infections, are being touted as the best choice for touch surfaces in the hospitals, namely bed railings, chair and door handles, IV stands etc. Andy Roth, Director – Global Public Health Initiative (PHI), New York and Louis Koh, Regional Programme Manager (PHI) Asia, Singapore discuss the current market for antimicrobial copper in India, strategies for paving the way for its wide usage and the challenges they are encountering in their path with Lakshmipriya Nair

What is the current market for anti-microbial copper in India? The market for antimicrobial copper in India is in its nascent stage and we are in the process of creating awareness and building the same through various important stakeholders like the government, private and public hospitals, various medical associations, hospital architects, consultants and PMCs to name a few. The response received has been encouraging.

How has anti-microbial copper been adopted in the healthcare sector globally? How well has it fared? Following recently observed increase in drug resistant strains found in hospitals, anti-microbial copper may be the answer to it as well. And a growing number of hospitals around the world have implemented anti-microbial copper surfaces. Recent installations include WSSK Hospital, located in Wroclaw, south-west Poland where the following surfaces were upgraded to copper - door handles, grab rails in bathrooms and showers, grab rails in toilets and a shower chair in a disabled bathroom, portable drip stands, drip stands for hospital bed use, treatment trolleys, bed rails, toilet flush plates, toilet seats, light switches. In Asia, Chiyoda Hospital, on the island of Kyushu in

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Japan, has become the world's first new hospital to be fitted throughout with antimicrobial copper door furniture. Dr Susumu Chiyotanda, who owns the facility, said of his choice, “I thought about the things patients would touch most

copper supplies, the supply chain consisting of manufacturers and suppliers of copper and copper alloys as well as the fabricators need a sure demand from hospitals and that too in large quantities. Hence, getting companies to be

Scientific research and clinical trials have proven that touch surfaces are a major source of hospital-acquired infections. And the deployment of copper surfaces in clinical trials has led to a 40 to 70 per cent reduction in infection rates

frequently, and focused on those surfaces where deadly microbes could be transmitted to others. We want to shut down the cycle of infection, and these microbes are killed by copper.” The Roberto del Rio Children's Hospital - the oldest paediatric facility in Chile, South America - has installed antimicrobial copper surfaces in its intensive care and treatment rooms.

What are the learnings that can be implemented in the Indian scenario? Self-disinfecting surfaces such as copper are a significant step forward in reducing infection-causing microbial bioloads on clinical surfaces. Facility management teams and infection control professionals in India should now ask the question: why select a nonantimicrobial surface when we now know that some naturallyoccurring metals, such as copper, have this intrinsic antimicrobial activity.

What are the challenges that you face in the Indian market? What is your gameplan to overcome them? In India, hospital administrators like the concept and have requested for supply of the material. For antimicrobial www.expresshealthcare.in

part of this campaign has been a challenging task so far. Yes, there has been interest generated as can be seen from two companies in India signing up for Cu+ (copper).

How are you planning to position anti-microbial copper in the Indian market to drive its use? We will use the global experience and apply what is relevant to the Indian market along with our own experiences so far.

You spoke of setting up a supply chain, so who are your suppliers? What are the criterion for choosing a supplier? As mentioned we have two companies signed up for Cu+. The criteria for selection is based on the conditions of use laid down by the ICA and the local copper centres have been authorised to provide the Cu+ mark based on this.

Which are the hospitals in India that have already adopted it? Which hospitals are your targetting? We are doing a pilot study with the Tata Memorial Hospital in Mumbai for their new ICU. We are targeting the new metro blood bank projects. Some private hospitals have envisaged interest as

well as government hospitals.

How do you plan to persuade Indian hospitals to use anti-microbial copper? What would be the USPs? Scientific research and clinical trials have proven that touch surfaces are a major source of hospital-acquired infections. And the deployment of copper surfaces in clinical trials has led to a 40 to 70 per cent reduction in infection rates. Furthermore, antimicrobial copper is the only solid surface material registered by the US Environmental Protection Agency (EPA) to continuously kill bacteria that pose a threat to human health. No other touch surface, including silver-containing coatings, has this kind of registration.

What is the price differential between anti-microbial copper and the normally used fittings? There is a clear business case for upgrading touch surfaces to anti-microbial copper when you consider its superior performance which has some very tangible healthcare benefits—safer care (significant reduction in the number of infections and as a result the number of deaths related to HAIs), cheaper care (with a significant reduction in the number of patients with HAIs follows a significant reduction in the cost of treating patients with HAIs), more care (fewer HAIs frees up resources, including beds and staff, to be used for the treatment of additional patients).

Has this price differential been a deterrent to its deployment in some markets? If so, what is the market penetration strategy to address these issues? In the US for example, hospital acquired infections (HAIs) can increase the length of time patients stay in hospital by up to almost five times. As a result the average cost of care for a HAI patient increases by 227 per cent. The extra cost of care per bed far outweighs any price differential for specifying antimicrobial copper for touch surfaces. lakshmipriya.nair@expressindia.com

OCTOBER 2012

Knowledge Wipro to use nanotech, cloud, mobility and analytics to deliver breakthrough solutions

Male infertility is out of the closet

TK Padmanabhan, Chief Technology Office, Wipro Infotech, India and Middle East

Dr S S Vasan, Andrologist and Managing Director, Ankur Healthcare, Bangalore

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Reused pacemakers: Socially correct, ethically wrong of eight to 10 years. Once a patient dies, the pacemaker is switched off and can be reused depending on the remaining battery life. “We offer the device to other patients only if the battery still has a life of three to four years,” he further added. “If the pacemaker has sufficient battery and if re-sterilised properly there is no reason why it should be wrong to do so,” opines Dr Anshul K Jain, Sr Consultant Cardiologist, Sri Balaji Action Medical Institute, New Delhi According to a study, 19 per cent of people who die with implantable pacemakers have functioning pacemakers at death and it can be a great help to other people if these pacemakers can be reused.

There is an ongoing debate about the use of refurbished pacemakers as some hail it as the second lease of life for needy patients while others see it as legally and ethically misplaced. M Neelam Kachhap brings the debate to the fore

Refurbished and reused ecently a media report stated that a leading hospital in the National Capital, is experimenting with the idea of refurbishing pacemakers, and has successfully implanted used pacemakers in seven poor patients. Similar cases have been reported by the media in the US also. What these reports did not state is the fact that although pacemakers have been reused it is a certified single use device and mostly cardiologists do not recommend implanting used pacemakers.

Fact file Heart diseases are a huge burden and cause of concern for everybody from doctors to policy makers. Heart disease leading to heart failure is a further cause for worry. In fact, approximately 60 pe OCTOBER 2012

cent of all cardiac deaths occur due to arrhythmias leading to Sudden Cardiac Arrest (SCA). Annual incidence of SCA in India is 0.55 per 1,000 population. Today, pacemakers are used to manage symptomatic bradycardia but rising cost of technology that saves life has been out of reach for many poor patients in India leading to confinement, morbidity and death. Each year 1-2 million individuals worldwide die due to a lack of access to pacemakers. In India, about 1,00,000 patients suffer from bradycardia (slow heart rate) every year. However, only 15,000 patients resort to pacemakers in India annually. In these circumstances, researchers see re-using pacemakers as a safe alternative. According to a recent US study published in the www.expresshealthcare.in

American Journal of Cardiology, implantation of donated permanent pacemakers can not only save lives, but also improve quality of life of needy poor patients. The authors say that reusing pacemakers could “alleviate the burden of symptomatic bradyarrhythmia (abnormally slow heart rate) in impoverished nations around the world.”

Cost concerns In India, the cost of a pacemaker is high, well beyond the means of many patients. “A new pacemaker costs anywhere from Rs 60,000 – to Rs 2 lakh, depending on the type of pacemaker,” informs Dr Aman Makhija, Associate Consultant, Cardiology, Sir Ganga Ram Hospital, Delhi. A new pacemaker has a life

Many patients who have an implantable pacemaker die within six months of the implant due to other co-morbidities. In these cases pacemakers can be removed from these patients and reused in other patients. “The pacemakers are ex-planted from the dead patient after taking consent from the relatives and refurbished for use in another needy patient,” says Dr Rajasekhar Varada, Senior Cardiologist, Yashoda Hospital, Secunderabad. Simple as it may seem doctors believe any device that has been implanted comes in contact with body fluids and should therefore not be reused as it is very likely to cause infection. Therefore, the explanted pacemakers undergo a rigorous process before it is reimplanted. “These pacemakers need to be checked for their EXPRESS HEALTHCARE

K|N|O|W|L|E|D|G|E integrity and battery life, sterilised re-labelled and used in the needy patient,” elaborates Makhija. Agrees Dr Varada, “Once a pacemaker is harvested from the deceased person it is checked for its re-usability and battery life. If deemed useful it goes through a vigorous cleaning and sterilising exercise and then is implanted into the receiver patients.” According to Dr Francis, “The explanted pulse generators are cleaned, tested for remaining power source life and functional integrity by strict protocols and then resterilised.” Consequently any refurbished pulse generator would require new pacing leads at the time of an initial implant. “Old leads cannot be reused so the lead has to be new,” avers Dr Makhija. Even pacemakers whose shelf lives have expired can also be resterilised and used successfully says Dr Makhija.

Indian story The concept of reusing pacemakers has nagged doctors for a long time and published study point out that it has been done for a long time. “The concept of pacemaker refurbishing is not new and has been widely and safely performed since the dawn of pacemaker technology,” says Dr Johnson Francis in one of his published studies. According to a study by Dr M Panja, Department of Cardiology, Institute of Postgraduate Medical Education & Research, Calcutta; refurbishing of pacemakers is being widely employed in Australia, Norway, Asia and Canada. There are published reports from at least 15 countries worldwide on experience of pacemakers reuse. In India, the reuse of pacemakers have been reported by various hospitals like JIPMER and Holy Family

If the pacemaker has sufficient battery there is no reason why it should be wrong to do so Dr Anshul Kumar Jain SR CONSULTANT CARDIOLOGIST SRI BALAJI ACTION MEDICAL INSTITUTE, NEW DELHI

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hospital, Mumbai. “JIPMER, Pondicherry, has a large experience of implanting refurbished pacemakers,” says Dr Ravi Kishore, senior consultant cardiologist, Narayana Hrudayalaya. “For a poor country like ours we have implanted such device several times in government colleges without any major problems,” says Dr Jain. According to a study (Balachander J, Anilkumar R, Sampath M, et al. Efficacy and safety of refurbished pacemakers: 17 years follow up of an international collaborative programme. Stimucoeur. 2003;31:190–193.) this centre has followed up over 500 patients with refurbished pacemakers over the last 20 years. The longevity, performance and complications compare reasonably well with the newly implanted pulse generators. “There are smaller series of refurbished pacemakers from other centres as well,” informs Dr Kishore.

Concerns Even though reusing pacemakers is hailed as a new lease of life for needy patients in developing countries, there are a lot of concerns that need to be addressed. Pacemakers are labelled and sold as single use device. Each device comes with a manufacturer warranty. If the battery runs out after implanting, the manufacturer replaces the pacemaker free of cost. However, once the patient dies and the pacemaker is refurbished this warranty becomes null. In patients who have got refurbished pacemakers, once the battery runs out they need to look for another pacemaker and replace it as manufacturers warranty is now void and will not replace the pacemaker. “What is the point in using these refurbished pacemakers when they run out of bat-

The topic should be debated scientifically and more evidence should be provided so that there is no doubt about the process Dr Devananda HOD & CONSULTANT, CARDIOTHORACIC & VASCULAR SURGEON - MANIPAL HOSPITAL BANGALORE

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tery, you need new pacemakers or other donated pacemaker, which is again a burden,” sighs Dr Varada. There is also the legal aspect. The US Food and Drug Administration considers pacemakers and ICDs to be single-use devices and does not allow it to be reused in the US. In India, there are no clear guidelines for such practice and therefore leaves a lot of gray area in terms of legality and supervision. “We are awaiting guidelines from the MCI and the government and once these are established we will be happy to reuse pacemakers,” says Dr Kishore. Further, informed consent of the patients should be taken from both patients and donors. Also, the decision to reimplant pacemakers should be taken judiciously. “Fully informed consent should be taken both from donors’ relatives and recipients. Use of explanted pacemakers should be considered only if the patient cannot afford a new pulse generator. Companies will obviously not extend the warranty for the refurbished product. Hence, reuse should be only considered when the cost of implantation including that of the new lead is significantly lower than that of the new pulse generator,” says Dr Francis. Also, there are concerns of infections and safety which cannot be totally overlooked.

Viewpoints However, many cardiologists are not aware of this trend even if they do not do it in their hospital and do not support it. “I would personally not recommend reusing pacemakers. I would encourage the patients to garner funds from NGOs and use government subsidies than reusing refurbished pacemakers,” asserts Dr Varada. Airing similar views, Dr Devananda, HOD & Consultant, Cardiothoracic & Vascular Surgeon - Manipal Hospital Bangalore says, “I believe it is not correct ethically, and there is a chance of this being misused as there are no regulations regarding such practices.” He also adds saying, “The topic should be debated scientifically and more evidence should be provided so that there is no doubt about the process.” Dr Kishore, however, says that in the new light of recent researchers establishing the safety and efficacy of reused pacemakers he would like to do it at his hospital and help needy patients. “A good number of pace-

makers with reasonable battery lives can be salvaged with some planning and foresight. This could even be extended to some defibrillators and triple chamber pacemakers whose batteries outlive the patients in whom they are implanted. A central registry or bank, akin to the STIMUBANK, France, can be formed in India where explanted pacemakers from anywhere in the country can be sent. This organisation can refurbish the pacemakers at a very minimal cost and supply, on request, to the needy patients. Thus, with just the cost of one or two pacemaker leads, a single or the costlier dual chamber pacemaker, as indicated, can benefit the economically deprived needy patient. This option needs to be seriously considered,” suggests Dr Francis.

References 1. Bharat K Kantharia, Sandeep S Patel, Gaurav Kulkarni, Arti N Shah, Yash Lokhandwala, Erica Mascarenhas, Daniel A.N. Mascarenhas. Reuse of Explanted Permanent Pacemakers Donated by Funeral Homes. The American Journal of Cardiology, 2011; DOI: 10.1016/j.amjcard.2011.08.036 2. Balachander J, Anilkumar R, Sampath M, Sethuraman KR, Chandrasekhar S, Dodinot B. Efficacy and safety of refurbished pacemakers: 17 years followup of an international collaborative programme. Stimucoeur; 2003, 31:3, 190-193. 3. Johnson Francis,R Anilkumar, Harry Mond.Editorial. Reuse of Explanted Pacemakers: An Option for Economically Underprivileged Patients in Developing Countries. Indian Pacing Electrophysiol. J. 2007; 7(4):192-194 4. Panja M, Sarkar CN, Kumar S, Kar AK, Mitra S, Sinha DP, Chatterjee A, Roy S, Sarkar NC, Majumder B.Reuse of pacemaker.Indian Heart J.1996 Nov-Dec;48(6):677-80. 5. http://www.thehindu. com/todays-paper/tpnational/tp-newdelhi /reused-pacemakers-giving-a-new-lease-of-life-topoor-cardiac-patients/ article3930796.ece 6. http://www.loyolamedicine.org/News/News_Relea ses/news_release_detail.cf m?var_news_release_id= 973441634 mneelam.kachhap@expressindia.com

OCTOBER 2012

K|N|O|W|L|E|D|G|E 30 MINUTE INTERVIEW

Wipro to use nanotech, cloud, mobility and analytics to deliver breakthrough solutions TK Padmanabhan CHIEF TECHNOLOGY OFFICE,WIPRO INFOTECH, INDIA AND MIDDLE EAST

angalore-based IT and software major, Wipro Technologies will soon introduce its smart ECG necklace in India. The ECG necklace targets cardiac activity monitoring in everyday life situations. It has also introduced its NextGen Care Management Solution. Apart from this, Wipro is also helping healthcare providers to offer excellent foetal monitoring by connecting hospital enterprise systems to cloud and mobile. TK Padmanabhan, Chief Technology Officer, Wipro Infotech, India and Middle East, discusses Wipro’s healthcare innovations and speaks about how nanotechnology is going to change the way that healthcare is provided in India, in an exclusive interaction with Raelene Kambli

What is nanotechnology and in which fields of healthcare does it find application? How is it used in the ECG necklace? Nanotech is the science of semiconductor technology at nano metre scale. Shrinking semi-conductor technology enables the integration of a lot of intelligent sensors on a chip to make it affordable for a large population. Small form factor ECG (Necklace) uses the latest nanotech to deliver exceptional quality output (similar to standard medical grade ECG bedside monitors) while adding mobility and providing accelerometer sensor for detecting motion.

What is the difference between medical nanotechnology and nanomedicine? Nanotech is typically used for patient monitoring in a noninvasive way, while nano medicine is the science of using nano particles (materials) for diagnosis or treatment which could be both invasive or noninvasive.

Give us some examples of medical nanotechnology and nanomedicine applications in healthcare delivery? How can nanotechnology change the way healthcare is provided in India ? Nanotech for medical industry has exploded in the OCTOBER 2012

recent times and some examples of it are ECG, heartbeat monitor, vitals monitoring (temp, pulse oximetery, BP, blood glucose and weight), foetal monitoring solutions using EKG as well as the traditional ultrasound Doppler technology and many more. Nanotech is used to have patients monitored from their homes in an affordable manner, it also provides for the screening of larger population by offering it at lower costs and through its excellent mobility. Nanomedicine is a vast area of research. One good example of it can be coating the cancer cells with nanoparticles so that they can be eliminated by our defense systems selectively without affecting

medical nanotechnology? What is in store for India? US, Europe and Japan are the leading countries in this segment. Of late, good international research collaboration between academia and industry has led to widespread adoption of nanotechnology in India. Good examples are centres of excellences like (not limited to) AIMS, AIIMS, IIT Mumbai, IISC etc.

How did you become interested in this area? Tell us about Wipro's contribution in the field of nanotechnology and nanomedicine? We foresee the need to have a point of care system as it is the most important factor in improving healthcare access

Of late, good international research collaboration between academia and industry has led to widespread adoption of nanotechnology in India

the adjacent healthy tissues, which is a common side effect of the current generation chemotherapy systems.

Which type of doctors are using the applications of nanotech in their surgeries and daily practice? It can be anyone from general practitioners using ECG necklace and vaccines stabilised by nanoparticles to advanced interventional radiologists and oncologists using nanoparticle empowered contrast therapeutic agents.

What can be expected in the future, in the field of medical nanotechnology? We can expect to see a rich set of diagnostic devices in small form factor at an affordable price. In future, these devices can even be embedded into patients for monitoring at a granular basis thereby increasing the chance to detect, diagonise and cure diseases.

Which countries are leading in nanomedicine and www.expresshealthcare.in

in emerging countries which is dealing with infrastructural constraints like availability of skilled manpower, connectivity and power. The ideal point of care systems need to be portable, intelligent, wireless, power aware as well as intelligent with sensors that can help a semi-skilled worker with enough information to complete a meaningful transaction for healthcare delivery like screening, data acquisition, drug dispense and so on. So, we need a system that’s built around mobile phone (the prevalent connectivity infrastructure present) which contains or can interface with ultra-portable sensors as well as ultra-low power to have the battery last for more than a day without being recharged. To attain this, nano electronics was the natural way ahead. We are working on smart sensors which are not only appealing due to their wearbility and portability but also can stay active with a single charge for more than couple of days to four weeks of time. In addition

to this, having the data collected but not reaching the place where it can be analysed and some action can be taken on this is like doing the job half way. Wipro’s unique mobile gateway solution takes the data seamlessly collected from any mobile phone and uploads it to a cloud-based data system which can be ubiquitously accessed by those who have the rights (as per privacy and security policy) to see the data. Wipro also has built advanced analytics platforms on cloud which enables better and faster output of data analysis and quick mass scale turn around.

Tell us about your foetal monitoring system? The foetal monitoring solution is a wireless CTG (cardiotogograph) for antenatal care and during labour /delivery using a small wearable wireless foetal-maternal monitoring device. The solution offers ambulatory beltless monitoring solution that needs minimal user intervention (no transducers to reposition) and supports an improved workflow. Accurate FHR/MHR/UA surveillance is additionally supported by electronic storage of clinical data and decision support software that acts as aid to the doctors. The solution also enables remote foetal surveillance during antenatal care for timely detection of morbid changes in foetal status and plans for appropriate intervention. The wearable device is ideal for clinically obese patients providing far greater accuracy than alternative technologies. The data for each patient can be viewed centrally at the nursing station in the LD Ward. Additionally, the network viewer software allows remote viewing of the patient data in the absence of a linked central station.

Tells us about Wipro's plans for India in this field? Wipro’s intention is to use nanotech, cloud, mobility and analytics to deliver breakthrough solutions to solve some of the emerging markets healthcare challenges. raelene.kambli@expressindia.com

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K|N|O|W|L|E|D|G|E 30 MINUTE INTERVIEW

Male infertility is out of the closet Dr S S Vasan ANDROLOGIST AND MANAGING DIRECTOR, ANKUR HEALTHCARE, BANGALORE

ale infertility is not a very well perceived topic in the Indian society and there is little awareness of the magnitude and importance of the male factor infertility. Despite the relative importance of infertility due to the male factor, infertility evaluations have traditionally focussed on women, because women tend to seek gynaecological care and because men often are reluctant to seek advice or do not know where to look for it. Male infertility refers to the failure of a couple to achieve conception due to problems specifically related to the manâ&#x20AC;&#x2122;s sperm, seminal fluid, or reproductive organs which can be effected by a number of factors. Andrology (study of male reproductive system and urological problems that are unique to men) has only been studied as a distinct speciality since the late 1960s but unfortunately has not received its due in the medical field. Andrology remains a sub-speciality area within urology around the world except in a few developed countries. In India, widespread practice of andrology is not prevalent, with few specialists. However, some private specialised andrology clinics have been birthed in India and are making an effort to bring the issue to the forefront. Dr S S Vasan, Andrologist and Managing Director, Ankur Healthcare, Bangalore speaks to M Neelam Kachhap about the importance of andrology and advances in the field.

What is the incidence of male infertility in India? According to a report conducted by the International Institute of Population Sciences, infertility is growing at an alarming pace, especially in the cities. Out of around 250 million individuals estimated to be attempting parenthood at any given time, 13 to 19 million couples are likely to be infertile. Although the national census does not head count infertile couples, this study, which takes into account the national census reports of the past three decades, viz, 2001, 1991 and 1981, showed that infertility has risen by 50 per

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TYPE OF INFERTILITY

FREQUENCY (%)

Untreatable sterility

12%

Primary seminiferous tubule failure

12%

Treatable conditions

18%

Sperm autoimmunity

Obstructive azoospermia

10%

Gonadotropin deficiency

0.5%

Disorders of sexual function

0.5%

Reversible toxin effects

0.02%

Untreatable subfertility

70%

Oligospermia

35%

Asthenospermia and teratozoospermia

30%

Normospermia with functional defects

cent in the country. The report said that in India, 13 per cent of evermarried women aged 15-49 years were childless in 1981 (rural 13.4 per cent and urban 11.3 per cent) which increased to 16 per cent in 2001 (rural 15.6 per cent and urban 16.1 per cent). Over half of married women aged 15-19 years were childless in 1981, which increased to 70 per cent in 2001. Nearly 30 million couples in the country suffer from infertility, making the incidence rate 10 per cent. Earlier, childlessness in a couple used to be talked about in hushed tones, with the problem, without doubt, being attributed to the women. Today, infertility is no longer recognised as only a female problem. In fact, the term infertility is a broad term, often loosely used. It actually refers to a range of disorders, some of which affect the male, and some the female, and contribute to childlessness in a couple.

What are the main causes of male infertility that you see in your practice? Some of the problems that frequently come to us are due to varicocele, infections: Acute: smallpox, mumps, other viral infections; Chronic:TB, leprosy, prostatitis. Other than these we

also see patients with idiopathic - cause unknown or injury related. Then there are direct causes like testicular or pelvic trauma, heat, irradiation and indirect causes like radiotherapy, chemotherapy, environmental toxins, drugs, marijuana, tobacco, alcohol. Undescended testes (cryptorchidism) and obstructions like congenital (aplasia), vasectomy, post-infective ejaculatory disturbances and sexual dysfunctions are also common.

What are the treatment options available? There are some tests done to find the cause of infertility. Physical examination is the basic test done by a doctor. Any male with infertility problem will have to go through semen and sperm analysis to test the size and shape of the sperm, mobility, and number of sperms. Hormone testing is done to test the level of testosterone. Ultrasound is often done to check whether the patient has retrograde ejaculation or obstruction in the tube. Many male infertility treatment options are also available - both nonsurgical and surgical. Treatment options vary depending on the problem. Non-surgical options including counselling, education and/or prescription of medications to improve semen quality. Physical www.expresshealthcare.in

therapy and acupuncture are also available as male infertility treatment options. Spinal cord injury treatments and electro ejaculation therapy can help infertility. Electro ejaculation therapy is very successful and is used in patients with ejaculation problems. It is a noninvasive and pain-free procedure. In patients with varicocele, ligation surgery is done to construct the dilated veins. There are minimally invasive procedures to retrieve the sperms. This is effective even in azoospermia and also in patients who have had vasectomy. If infertility is due to obstruction, then trans urethral resection of the ejaculatory duct or seminal vesicles can be done. If other treatments are not useful, then intra-cytoplasmic sperm injection can be done to overcome all the problems causing male infertility. With the use of these male infertility treatment options, infertility in men can be treated.

Kindly comment on the sociological effect of male infertility? According to research, men and women differ in their psychological responses to infertility. Men undergo various battles like anxiety concerning potency, masculinity, and sexual adequacy. The male partner is either the sole cause or a contributing cause

of infertility in 49 per cent of couples. Throughout history men have recognised the desire for paternity and the possibility for male infertility; however, women are typically the subject of fertility studies and hence the number of studies conducted on male infertility is limited. What is reassuring is that in the last decade importance accorded to male infertility research has increased substantially.

What is the latest research in this area? A new study published in the journal â&#x20AC;&#x2DC;Cellâ&#x20AC;&#x2122; reveals that researchers at Stanford School of Medicine have managed to decode the full genetic blueprint of a single sperm cell. The researchers revealed that there were 23 recombination events in every sperm, wherein the DNA inherited by a sperm is shuffled, thus mixing up the genes passed on by a man's mother and father. Each sperm also had 25 to 36 new mutations which are not seen in any other cells. In older men, intake of micronutrients is strongly associated with improved sperm DNA quality, finds the study. In an analysis of 80 healthy male volunteers between 22 and 80 years of age, the scientists found that men older than 44 who consumed the most vitamin C had 20 per cent less sperm DNA damage compared to men older than 44 who consumed the least vitamin C. The same was true for vitamin E, zinc, and folate. Older men are also more likely to have increased frequencies of sperm carrying certain gene mutations, such as those leading to dwarfism. These findings help explain why aging men are less fertile and are predicted to have more chromosomally defective pregnancies and a higher proportion of offspring with genetic defects. But until now, researchers haven't understood whether diet can protect against the detrimental effects of aging on the sperm genome. mneelam.kachhap@expressindia.com

OCTOBER 2012

Radiology ‘The focus on this year's CT Fest is on neck, chest and cardiac imaging’

‘India is a rapidly growing market for CT scanners’

Dr Sanjeev Mani, Organising Secretary, CT Fest 2012

Dr Lawrence Boxt, MD Cardiovascular Disease Physician, Diagnostic Radiologist in Bronx, New York

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MAIN STORY

CT Fest 2012 CT Fest 2012, in this year's edition focusses on the various aspects of neck, chest (interstitium), and cardiac CT theme at CT Fest 2012 is neck, chest (interstitium), and cardiac CT. Individual sessions have been dedicated to sections on neck, cardiac, interstitium and paediatric chest, with short 'Anatomy Flashback' sessions to tune the delegates about the practical aspects of CT anatomy of these sec-

rganised by MSBIRIA, CT Fest is an exclusive quality educational event focussed on CT Imaging. This year, CT Fest 2012 is being held at The Grand Hyatt in Mumbai from October 26-28, 2012. After focussing on chest and abdominal imaging in its last edition, this year's

tions, as well as the orbit, PNS and the temporal bone. Coupled with this, poster presentations and 'Spotlight Section' (a popular segment at Ultrafest 2012), where five top abstracts sent by delegates will be presented by the delegates themselves in the main hall. They would be judged by the internation-

al speakers and given prizes. Heading the list of international speakers is Dr Lawrence Boxt, a virtual treasure house of information on cardiac CT and Dr Sujal Desai who has done a lot of research in lung abnormalities especially interstitial lung disease (ILD). Alongside a star list of other international

speakers, the scientific programme is chock-a-block with a wonderful array of lectures to cover almost all aspects of neck, chest and cardiac imaging. T20-Top 20 cases conducted by two speakers everyday at the end of the day, and a cardiac workshop by Dr Boxt will complete the proceedings on Day 3, that culminates at lunchtime on Sunday. Thus with a whole range of interactive activities and sessions awaiting the delegates at the event, it is likely to be bigger and better this time.

INTERVIEW

‘The focus on this year's CT Fest is on neck, chest and cardiac imaging’ Dr Sanjeev Mani ORGANISING SECRETARY, CT FEST 2012

T FEST 2012, an event focussed on advances in CT imaging and technology is just around the corner. Raelene Kambli catches up with Dr Sanjeev Mani, Organising Secretary, CT Fest 2012 to know more about the highlights of the event

What is your rationale behind conducting a scientific programme dedicated to CT? How has it evolved and grown over the years? As you know, CT is one of the greatest scientific inventions of the 20th century, and even today its use and protocols are ever changing based on new studies and ideas. The aim of CT FEST is to educate radiologists and students in OCTOBER 2012

India of the changes that take place world wide in the field of CT. By inviting international acclaimed speakers to India, we wish to expose the students to newer protocols and studies that will help them inculcate these protocols in their routine practice; this will eventually improve diagnostics and health care.

How have you geared up for CT Fest 2012? What preparations have been underway? We have moved our venue to Grand Hyatt, Mumbai for this event. All delegates and speakers will be staying at this venue itself.

What will be the focus of CT Fest 2012? What topics

would be covered under the scientific programme? The focus on this year's CT is on neck, chest and cardiac imaging. All topics in these sections will be covered in this year's programme, with a special emphasis on cardiac CT. Dr Lawrence Boxt who is an expert and pionerer of cardiac CT and MR imaging will be addressing the delegates on many topics such as cardiac anatomy variations, stent and plaque evaluation and emergency cardiac CT.

Tell us about the national and international speakers at the event? The international speakers are Dr Lawrence Boxt, Dr Sujal Desai, Dr Moulay www.expresshealthcare.in

Meziane, Dr Kshitij Mankad. National faculty includes Dr Sanjay Vaid.

What are the new additions to look for at CT Fest 2012? This year's event will have a 'RISING STARS' programme in which youngsters selected on the basis of their submitted abstracts and posters will be given a chance to present their material in the hall. These students will be judged by the international speakers.

Will there be any exhibition along with the scientific programme? If yes, any specific launches scheduled? Most of the top CT and

software companies are participating in this event. Sanrad who is India's premium company in CT is our platinum sponsor for this event.

What is your message for the exhibitors and the participants expected at CT fest 2012? We expect almost 400 participants for this event, and have created new sections such as Rising Stars programme, T20, and a Department Head-To-Head contest. We request all radiologists and residents to participate in this event, and we, the organisers would like to make this an event to remember. raelene.kambli@expressindia.com

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R|A|D|I|O|L|O|G|Y INTERVIEW

‘India is a rapidly growing market for CT scanners’ Dr Lawrence Boxt MD CARDIOVASCULAR DISEASE PHYSICIAN, DIAGNOSTIC RADIOLOGIST IN BRONX, NEW YORK

n recent times, the concept of cardiac imaging has been greatly expanded by the advances in CT technology. Raelene Kambli tracks its evolution and understands its scope in the Indian context in conversation with Dr Lawrence Boxt, Cardiovascular Disease Physician, Diagnostic Radiologist in Bronx, New York. Excerpts from the interaction ...

How did cardiac CT begin? How do you see the technology evolving? Cardiac CT (CCTA), as we practice it now, really began after 1999-2000, with the commercial introduction of 64-detector scanners. In a dramatic advance over recent, kindred technology (i.e., 4-, 8, 16-detector scanners), the 64detector scanner produced isotropic voxels. That is, the imaging elements obtained from a scan are cubes; equal length on all sides. Thus, digital imagery of the epicardial coronary arteries reconstructed from these volume elements is of adequate spatial resolution to be artifact-free, and thus reliable for detection and quantitation of coronary artery calcium and the detection of significant coronary stenosis. Prior to 2001, the electron beam CT (EBCT) scanner developed at The University of California should have “revolutionised” cardiac imaging. It produced cine cardiac examinations of adequate quality for evaluation of myocardial wall thickening and valvular function. However, it was limited in spatial resolution, and thus unable to visualise the epicardial coronary arteries. Also, CCTA became commercially available in the early 1980’s, at the same time when magnetic resonance imaging was becoming commercially available. Radiology department chairmen were uncomfortable supporting two new and expensive technologies at the same time. EBCT was seen as a cardiac imaging device,

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and radiology chairmen didn’t want to fight with chiefs of cardiology. Radiology went headlong into MRI, and the EBCT virtually evaporated. As to the future; the spread of multidetector CT technology and the growth of 16- and 64-detector scanners were associated with a dramatic increase in the number of CT scans, and the cumulative patient radiation exposure from multiple scanning. An uproar over patient radiation dose and risk of developing new cancer provided a moment of clarity for the CT and CCTA communities. In a remarkable change in industrial philosophy, there

other imaging studies. Association of particular characteristics of coronary arterial plaque with specific genetic loci on the individual’s genome will open new areas of clinical intervention based on the morphologic appearance of coronary plaque.

Under what circumstances is the prognostic value of CCTA best utilised? CCTA is increasingly used as a clinical tool to visualise the coronary artery lumen and to identify coronary stenosis. That is, the foremost current use for CCTA is to exclude significant coronary artery disease, and avoid bringing the

In 5-10 years, I would expect to see steady growth in the number of scanners and their utilisation in the Indian market

began another “revolution” in CT technology. Conscious attention to dose lowering methods and technologies has lowered the CCTA dose by nearly an order of magnitude. This is the first area of change we will see in the near and intermediate future. We will continue to see advances in tube and detector materials, and continued lowering of patient radiation exposure. The second area of change we will see will come in the arena of computer-based image processing and image distribution algorithms and the network technology to connect scanners with workstations and physicians.We are already seeing “afterhour” exams in the US sent to India for review, and vice versa. Advanced display technology will allow us to visualise cardiac abnormalities rather than infer their presence. Furthermore, association of relevant databases will provide correlation with other tests, other clinical information, or

patient to the catheterisation laboratory for the performance of a diagnostic coronary catheterisation. The predictive power of coronary calcium quantitation, with regard to both future cardiovascular events and overall mortality has been well established. Given the significant contribution of underlying genetic mechanisms for the development of coronary atherosclerosis, and the high prevalence of asymptomatic individuals among those with coronary stenosis, the prognostic value of CCTA lies in the evaluation of asymptomatic or minimally symptomatic individuals with low or intermediate risk of coronary heart disease. These patients can be risk stratified, and directed toward aggressive risk lowering management in face of the presence of coronary calcium and mild-tomoderate arterial stenosis.The results of several prospective, multi-center trials has demonstrated that hospital costs are lowered and patient length of www.expresshealthcare.in

stay shortened when CCTA is performed in low-to-intermediate risk emergency department patients complaining of recent onset of chest pain, but without a known history of coronary heart disease. In these series, individuals in whom no significant coronary artery disease was demonstrated have a near zero cardiac event rate after emergency department discharge.

What is the growth rate of this segment in India and what would be the estimated size of the market in five years’ time? Most CT scanners are installed in the US, Europe and Japan. The number of CT scanners at an institution, as well as the number of scans performed continues to increase (certainly in the US, and presumably in the other markets). Non-64 detector scanners continue to be sold in these markets because of the continued high CT utilisation, and their significant advantage over older (1-to-4-detector scanners) for non-cardiac use. However, nearly 40 per cent of CT scanners installed in the US in 2010 were 16detector scanners. India is a rapidly growing, emerging market for CT scanners; scanner sales and installations will follow an increasing population, domestic economic growth, and increasing healthcare spending, including new hospital construction. There is no reason to expect the demand for high technology to wane. Rapid expansion will be met with installation of conventional (<64-detector) and refurbished CT scanners, as well as the expansion of the 64-detector market. Approximately one-third of all new scanners in India are 64-detector devices; only about 4 per cent are “megascanners” (i.e., 128-256+ detectors). If I could predict the Indian market in 5-10 years, I would expect to see

steady growth in the number of scanners and their utilisation. I would also expect to see growth in the >128-detector market, as older scanners become out of service and are replaced.

Tell us about your association with CT Fest 2012? What will be your area of focus while speaking at the CT Fest 2012? This is my first time to India, much less speaking at CT Fest 2012. Actually, Dr Sanjeev Mani contacted me two years ago, inviting me to speak at the 2011 meeting, but I had a previous engagement, and couldn’t come. I implored him to please remember me for the 2012 meeting, which he did. I intend to discuss the utility CCTA to diagnose not only coronary, but other common, and less common forms of acquired valvular and myocardial heart disease. CCTA is a valuable diagnostic problem solver, and has, and will continue to help elucidate normal and pathologic anatomy and function in patients with difficult to interpret echocardiograms sand electrocardiograms, in a manner analogous to cardiac MRI. I will also point out the value of CCTA for the evaluation of adult patients with congenital heart disease. This growing population (there are now more adult patients than paediatric patients with congenital heart disease) is well-served by the speed, convenience, and accuracy of cardiac CTA. There is a great deal of cardiac CTA performed in India today, and the attendees at the meeting will reflect a broad spectrum of awareness, experience, and utilisation of the technology. I hope to teach a little, reinforce a lot, and learn from my audience.

(Look out for the full interview in the forthcoming October issue of In Imaging.) raelene.kambli@expressindia.com

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TECHNOLOGY FOR HEALTHIER LIVES EXPRESS HEALTHCARE USER CONNECT INITIATIVE

A Lullaby for the babies Lullaby LED PT, a phototherapy system from the prolific stable of GE Healthcare, with its simple yet effective features, manages to find favour in the eyes of Dr Sushma Kaul, a reputed neonatologist working with Apollo Hospital in New Delhi

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OCTOBER 2012

TECHNOLOGY FOR HEALTHIER LIVES EXPRESS HEALTHCARE USER CONNECT INITIATIVE

doctor often plays God incarnate with his/her ability to save lives. It is even more so when the doctor concerned is a neonatologist. Neonatology is the field of providing medical care to infants who are born premature, with a birth defect or a serious illness. At times, the neonatologist is involved right from the time of pregnancy if the problem is detected before the birth.

Neonatologists and their vital role in care giving Thus their role is very vital

since often it is only their expertise and skill that stands between the life and death of the newborns. They have to

tackle several impediments and challenges, both known and unknown, in their battle to give the newborns a chance to survive and lead normal lives.

An impediment Hyperbilirubinemia, a frequently encountered condition in term newborns, is one OCTOBER 2012

of the challenges that every neonatologist is expected to tackle. Statistics reveal that 80 per cent of pre-term and 60 per cent of full-term infants are at risk of hyperbilirubinemia, the medical term for jaundice in the newborns which is caused by too much biliurubin in the baby’s blood, a substance created when the body breaks down old red blood cells. Most of the time newborn jaundice is curable but at times it can also be the underlying reason for severe illnesses such as haemolytic disease, metabolic and endocrine disorders, anatomic abnormalities of the liver, and infections. So, if the jaundice does not disappear in two to three weeks’ time, it becomes necessary to down the levels of biliurubin from the infants’ body through medical treatment. Phototherapy (light treatment) is one the most commonly used form of treatment for this kind of jaundice. Here the baby is kept in an incuba-

tor and exposed to a certain kind of fluorescent light that gets absorbed by the baby's skin. This treatment is continued for some days until the liver manages to handle the biliurubin on its own. Though this method has been considered one of the simplest and most effective ways to treat neonatal jaundice, it has also been observed that bilirubin phototherapy can cause side effects like skin burns, rashes, excessive tanning and skin irritation if it is not given properly. The bright light can also cause harm to the infants’ eyes if one is not careful enough. Moreover, the infants also need to be safeguarded against dehydration which www.expresshealthcare.in

THE PRODUCT PROVIDES HIGH IRRADIANCE AND OFFERS MORE CONTROL TO THE USER. THIS, IN TURN, OFFERS GREATER CLINICAL EFFICACY AND HELPS TO TREAT INFANTS FASTER Dr Sushma Kaul

NEONATOLOGIST, APOLLO HOSPITAL, DELHI might be caused by the process of phototherapy. Given the fact that significant responsibilities rest on the shoulders of neonatologists, it is very imperative that they should be given all possible assistance to perform their tasks in the best possible manner. Dr Sushma Kaul, a neonatologist from Apollo Hospital, Delhi believes that she has received some measure of assistance through GE Healthcare’s Lullaby LED PT, a phototherapy system

She also informs how the machine is designed to minimise the spillage of light and thus saves both the small patients as well as the nurses from any kind of unnecessary exposure to the light thereby reducing the possibility of side effects to a great extent. She calls the phototherapy system “very compact and portable” and states that is very easy to move around, fits in easily within the NICU and very low on maintenance. She also finds the product very “user-friendly” with effective features that make it a preferred choice.

designed to treat indirect hyperbilirubinemia in infants by administering concentrated LED light. She finds it a safe and appropriate way to provide phototherapy for treating infants who suffer from hyperbilirubinemia. Though she chose a GE machine because of its repute in the market and has been using it for only over a year, Dr Kaul informs that she found it very useful for her very small patients. She says that the product provides “high irradiance” and offers “more control to the user” which translates into rapid breaking down of bilirubin. This, in turn, offers greater clinical efficacy and helps to treat infants faster.

Dr Kaul is also of the opinion that the Lullaby LED PT is a good investment since it works for 50,000 long hours and hence has a “longer shelf life” apart from saving money by being less power-consuming. This fact also makes it an environment-friendly product which finds even more favour in the eyes of the neonatologist from Apollo. Thus, Lullaby LED PT, like the connotations of its name, seems to be a safe and soothing product suited for newborns. Dr Sushma Kaul definitely thinks so, but whether her counterparts will have the same opinion is something to wait and watch for.

A solution

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Trade & Trends Multi-function beds from Medilit

New age real-time PCR system from Thermo Fisher

Medilit’s BDE—105, a multifunction bed offers great features which ensure the patients’ comfort Page 53

Thermo Scientific PikoReal delivers outstanding performance in a small bench-top footprint Page 53

Carestream enhances its family of DRX imaging systems Introduces smaller, lighter console for its DRX-1 system to further reduce footprint arestream has upgraded its CARESTREAM DRX-1 System with a new console that is much smaller and lighter. The console is 20 x 8 x 15 inches and weighs just 36 pounds. This newly designed console minimises the footprint of the DRX-1 system, which allows facilities to convert existing X-ray rooms to digital radi-

ography with Carestream’s wireless, cassette-size DRX detector. The new console fits into even the most crowded X-ray room and is easy to move if needed. All wiring and power components are mounted inside the cover. The company recently launched its new DRXRevolution Mobile X-ray System and introduced new capabilities and software features for its DRX-Evolution DR Suite that can help manage dose, improve image quality and enhance patient care, especially for

critically ill or injured patients. The DRX-Evolution is a modular DR room that utilises the wireless DRX detector and can be configured to fit each user’s budget, space and workflow needs. The DRX family of imaging systems includes: DRXRevolution Mobile X-ray

System, CARESTREAM DRX-1 System, CARESTREAM DRX-Mobile Retrofit Kit, CARESTREAM DRX-Evolution, CARESTREAM DRX-Transportable System; and CARESTREAM DRX-Ascend System. A DRX detector can be easily transferred for use with any DRX system to allow facilities to maximise the functionality of each system. Each DRX system also employs the same user interface to increase staff productivity and reduce the need for training. The flexibility and

image quality offered by the DRX family of digital X-ray systems makes these solutions an ideal fit for general radiography exams including orthopaedic, trauma and paediatric as well as other speciality care environments. For more information contact Nilesh Dattatray Sanap Carestream Health India Tel: 022-67248816 email: inilesh.sanap@ carestream.com

Sysmex XP-100: Innovative Hematology Analyzer from Transasia Bio–Medicals Sysmex XP-100 is a Japanese true 3-part differential hematology analyzer with innovative technology and cutting edge features ransasia Bio-Medicals, India’s leading IVD company has launched Sysmex XP – 100, a new automated 3-part differential hematology analyzer. This next generation product is manufactured in Japan by the Sysmex Corporation. Transasia is a leader in the three-part differential analyzer (3PDA) segment

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with more than 10,000 customers in India. XP-100 provides realtime external quality assurance programme with the help of Sysmex Network Communication System (SNCS), amongst other critical and cutting edge features and will positively impact the growing 3PDA segment in India. “Transasia is committed to add value to our customers and to improve the quality of healthcare. Our objective is to optimise and bring latest medical technologies to India. In order to provide better care for more people, we adopt and adapt technologies, thus making

them suitable for the Indian market,” stated Suresh Vazirani, Chairman and Managing Director, Transasia Bio-Medicals Limited. He further stated, “The new Sysmex XP-100 will further strengthen our mission to provide innovative solutions for the prevention, early detection, diagnosis and monitoring of diseases.” The new state-of-the-art hematology analyzer is made in Japan, and will prove to be useful in screening and clinical diagnosis of anemia, thrombocytopenia, thalassemia, other hematological disorders, inflammation and malignancies. The instrument has been specialwww.expresshealthcare.in

ly designed to meet the demands of healthcare professionals and deliver and beyond.

SysmexXP-100 - Product overview ●

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Fully automated 3-part differential hematology analyzer (3PDA) Enumerates 20 parameters (both in whole blood and pre-diluted mode) which includes WBC, RBC, HGB, HCT, MCV, MCH, MCHC, PLT, LYM%, MXD%, NEUT%, LYM#, MXD#, NEUT#, RDW-SD, RDWCV, PDW, MPV, PCT and P-LCR Absolute Neutrophil

SURESH VAZIRANI

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count Throughput 60 samples/hour Real-time online quality control availability with SNCS module Large colour touch screen with user friendly intuitive graphic icons Equipped with bar code reader for positive sample and reagent identification Extended data storage. EXPRESS HEALTHCARE

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Biozeal’s brilliant offerings BioZeal has a range of eclectic equipment with great features to serve the healthcare segment

iozeal is an authorised dealer for Wipro GE Healthcare. Some of its products include a pulse Oximetre (Ohmeda), which is one of the most preferred brands among doctors because of its accuracy, reliability and its efficiency, even in low perfusion index. It is available in both handheld and table top monitor type

For more information about the company and its products contact Jimmy Makhija Mobile: + (91)-9768156266 Address: C- 23, Santmira CHS, Kanya Nagar, Kopari Colony, Thane - 400 603, Maharashtra, India Email: info@biozeal.in, biozeal@yahoo.in

Features of Tuffset (Handheld Pulse Oximeter) ● Small and lightweight for simple, one-hand operation ● Rubber grip offers secure handling ● Intuitive features require minimal training ● Backlit with large LCD displays and easy-toread numbers for excellent visibility ● Low battery indicator Features of Trusat (Tabletop Pulse Oximeter) • TruSignal enhanced SpO2 delivers improved performance during clinical motion and low perfusion ● Backed by a full, three-year warranty ● Up to 30 hours of uninterrupted battery life (up to 20 hours with TD option) and a fast, full battery recharge in only 3.5 hours. Note: Continuous use of backlight can significantly affect the battery life. ● Small, lightweight design. Only 2.76 lb (1.25 kg) ? less than half the weight of most bedside oximeters ● Alarm limits are always visible and saved between uses ● Pulse bar waveform

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OCTOBER 2012

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Multi-function beds from Mediliit Mediliit’s BDE—105, a multi-function bed offers great features which ensure the patients’ comfort

ediliit Medical Furnitures is a professional joint stock company specialising in the production and marketing of healthcare equipment. Their product range includes all type of electric bed and manual hospital beds, transfer trolleys, over bed dining tables, bed side cabinets, electric home care beds and portable field beds. The company is abundant in technique and resources. With its in-house facility for manufacturing blow molding components

Specifications of BDE 105 Back section articulation Knee section articulation Minimum height Maximum height Safe working load Platform dimension approx and expertise in steel fabrications, Mediliit products undergoes rigorous inspection and quality audit. Its products are designed specifically for durability, high serviceability and end users’ comfort of operation. Continuous R&D also helps

: 0 through 700 : 0 through 400 : 500 mm : 750 mm : 200 kg : 2060 mm (L) X 900 mm W) to improve the products and services. The prices of the company’s products are very competitive in comparison with similar products in the market.

One of its products is BDE—105: A five-function electric bed is built to last for years. It combines the comfort of hospital bed with the mobility of a stretcher. This rugged motorised bed with remote control handset offers outstanding safety, patients’ comfort and quality.

The features of this bed are as follows ●

Head board, foot board, bed board and side rail of the bed is made of high strength engineering plastic (HSEP). ● Head board and foot board are easily removable, which allows rapid access to the patients’ head/feet.

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The bed has a retracting side rail design which shields the patient and help prevent the patient entrapment and fall. At the same time side rail can be easily lowered to aid both routine and emergency nursing tasks. ● The bed board has smooth surface and removable panels by six plastic head bolts to facilitate steam or chemical cleaning and decontamination. ● The frame of the bed is made of heavy-gauge CRCA tubular section duly powder coated. This makes the bed durable, sturdy and long lasting. ● Caster size is 125 mm dia twin wheels with double ball bearing in each wheel ensures stability, safety and durability. Contact: Mahesh Shah Mediliit Medical Furniture Pvt Ltd 116A, 2nd Floor, Government Industrial Estate Kandivali (W), Mumbai-400 067, India Tel: +91-22-28681398 Email: www.mediliit@gmail.com Mob: 9324522300

New age real-time PCR system from Thermo Fisher Thermo Scientific PikoReal delivers outstanding performance in a small bench-top footprint

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hermo Fisher Scientific Inc, the world leader in serving science, has introduced Thermo Scientific PikoReal Real-Time PCR Systems, which complete its molecular biology workflow. Available in 24- and 96-well formats, the PikoReal offers outstanding performance in a small bench-top footprint. The unique heating block design of PikoReal systems maintains excellent temperature uniformity and fast heating and cooling for optimal amplification. The proprietary ultra-thin wall (UTW) Piko PCR plates minimise running costs, plastics waste and energy consumption. Although these plates are a quarter the size of standard plates, their well volumes and spacing ensures compatibility with multichannel pipettes and liquid handling instrumentation. Finally,

PikoReal systems use half the power of typical real-time PCR instruments and consume less reagent, providing a cost-effective and environmentally friendly option for personal bench-top or field use. The combination of the unique heating block and www.expresshealthcare.in

UTW Piko consumables ensures data uniformity for more reliable and repeatable results. The built-in optical system of the PikoReal contains five channels, pre-calibrated for the most common dyes, so users can perform multiplexing with four dyes while dedicating the fifth channel to SYBR Green and HRM experiments. The instruments are controlled by PikoReal software, which enables absolute and relative quantification, melting curve analysis and genotyping. Systems can also be used as stand-alone by transferring an amplification protocol from PikoReal Software to the instrument using a USB

stick. The software also uses a Virtual Pipetting Tool that guides users through plate setup. Thermo Fisher provides a comprehensive portfolio of products for nearly all realtime PCR applications. Customers can obtain everything required for a complete molecular biology workflow, including reagent kits for SYBR Green and probe chemistries, as well as instruments and equipment for sample storage, DNA/RNA extraction, analysis, amplification and liquid handling. For more information contact Thermo Fisher Scientific India 403-404, B-Wing, Delphi, Hiranandani Business Park, Powai. Mumbai - 400 076, Telephone: +91 22 6716 2200 Toll Free No: 1800 22 8374 www.thermofisher.com or www.thermo.com EXPRESS HEALTHCARE

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Periclave launches intelligent transducer technology Periclave’s Horizontal Cylindrical High Steam Sterilizer (Autoclave) gets intelligent transducer for heater protection

ounded by Zoru Bhathena, PERICLAVE is backed by 65 years of family experience in manufacturing sterilizer, autoclave, CSSD, TSSU, laundry and kitchen equipment for hospitals. Now, it has introduced an intelligent transducer for heater protection of the traditional horizontal autoclave. The transducer has a static sensor with unlimited life compared to a traditional sensor which had moving parts because of which they used to malfunction. The sensor works at low voltage of 12 volts compared to the old one which used to work at 230 volts, and hence is very safe. The controller of the transducer has an indication for low water and heater status. This indication helps in preventing human error and helps to decide the schedule for preventive maintenance for servicing the sterilizer and is also very friendly for new users as all the information is indicated on the LED. The height of the sensor is adjustable because of which it can control the water level in the steam generator thus setting the water level at optimal level which helps to reduce heater failure and saves power. The intelligent

transducer for the heater protection is totally developed in India. 80 per cent failure in an autoclave is caused due to boiler failure. However, Periclave engineers have worked to develop a technology, which has helped to reduce the boiler failure rate and thus ensure trouble free working of the autoclave thereby increasing the reliability and uptime of the sterilizer. Autoclave up time is very important for a hospital as autoclave is directly associated with the OT operation, which is the major source of revenue for the hospital and if the Autoclave is down for Maintenance it affects the earning of the hospital because the OT cannot work without sterile material and sterile material is the output of the working Autoclave. The intelligent transducer for the heater protection is available for Periclave manual and automatic Autoclave with chamber volume starting from 80 litres to 2,500 litres. For more information contact Zoru Bhathena Periclave House,

63-A, Kandivali Co-op Industrial Estate, Charkop, Kandivali (West), Mumbai – 400067 Tel: 022-2867 3130, fax: 022-28673140, E-mail: info@periclave.com, www.periclave.com

‘Ultra’ cool offering from Kitten K Ultra Flat Reel from Kitten is a new age product with great features which ensures great and fool-proof packaging

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itten is a Mumbai-based marketing company with representatives in over 25 overseas companies. In 2003, Kitten started marketing sterilization indicators and since then, there has been no looking back. Today, it uses its expertise to source and import market innovative products that improve productivity for hospitals, pharmaceutical and biotechnology, alcoholic and non alcoholic beverages and fluid processing industries. Ultra Flat Reel is one of its products which serve the packaging needs of these industries. Its features are as follows: ● Storage and Transport: Ultra offers mechanical strength never before attained for packaging intended for steam sterilisation and EtO. Tests carried out show resistance to tearing or perforation up to five times greater than with conventional packaging. ● Resistance to sterilisation process: By virtue of its design, Ultra considerably reduces the risks of bursting observed during steam sterilisation

ISO 11140-1. peelability, no fibre tears, no particles emission. ● Excellent mechanical strength Good penetration of the sterilizing agent and facilitate / improve the drying phase. ● Sterilization - Steam, Ethylene Oxide and Formaldehyde. ● Designed for the packing of a large variety of product including rubber bungs, garment, and machine component medical devices: instrument trays, sets, surgical packs, heavy and bulky devices, complex instruments and every device that requires a specific protection. ● Excellent

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(e.g. vacuum phases during pretreatment). The preforming of the industrial seals is four or five times higher than the minimum value given by standard EN 868-5. Peelability: Through studies of the risks of aseptic faults when packaging is opened, up to 65 per cent noncompliance has been observed on standard-type packaging. Under the same opening conditions, Ultra eliminates any risk of defibration on opening, including on the two seals carried out by the user. One side laminate (printed) one side porous material (polyolefin). Process indicator for steam and EO Gas sterilisation according to

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For more information contact Kitten Enterprises Pvt Ltd W-407, TTC Industrial Area, MIDC Rabale, Near Golden Garage, Navi Mumbai - 400 701 Direct Tel No: +91 22 2764 9249 Board Tel No: +91 22 2764 9292 Fax No: +91 22 2764 9299 Mail ID: kittenmailer@gmail.com www.kitten.co.in ISO 9001 - 2008 certified OCTOBER 2012

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Pushpanali Crosslay Hospital launches Home Health Care Programme It also commenced the 4th Batch of Home and Community-Based Care (HCBC) certificate course being run by IGNOU at Pushpanjali Crosslay Hospital

distinguish between ‘home healthcare’ meaning skilled nursing care and ‘home care’ meaning non-medical care Home healthcare can be provided for medical or psychological assessment, wound care, pain management, disease management including IV, physical therapy, speech therapy, or occupational therapy.

Home Care Life assistance services include: ●

ushpanjali Crosslay Hospital recently launched the Home Health Care programme and commenced the 4th batch of Home and Community-Based Care (HCBC) certificate course being run by IGNOU at Pushpanjali Crosslay Hospital. Dr Bimla Kapoor, Chief of Central Zone, IGNOU informed that this course provides complete quality health services at home and in community to help restore and maintain people’s health standards and way of living by providing health services at home. Home Care will provide back-up for people, commonly occurring diseases/situations can be effectively managed at home, institutionalised care is not the most appropriate care for many problems. Home and CommunityBased Care offers services to people with:Physical impairment: People recovering from illness, terminally ill persons, at risk people with moderate to severe functional disability. People who are suffering from any physical injury such as critical road side accidents, paralysis patients, people who are unable to walk or unable to do their work on their own. Medication adherence support: These services help elderly adults with their medical needs, as well as help them with bathing and hygiene. This type of support

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is needed for very old patients and people who are having prolonged disease. Counseling to people: Services such as assisted living, hospice, adult-day services, physical therapy and senior centres. Communitybased long-term care allows elderly adults to stay in their homes for care.

Role of IGNOU in the course:

Objectives of the course:

1. Admission of CHBCP Students @ Rs 1,500 per student 2. Providing study material and certificate of the course after successful completion 3. Organising theory exams in their centre/ online 4. Providing assignment questionnaire

To prepare a work force in the country with the skills required to look after elderly and people suffering from chronic progressive illnesses (sickness). To provide care to people in their home setting after discharge from tertiary care. To help the family members and patients cope with the stress of care to their long term ailing relatives. To provide quality of life for the patient and the family members. Dr Ruby Bansal, Head of this programme told that Pushpanjali Crosslay Hospital in collaboration with Indira Gandhi National Open University (IGNOU) is running a certificate course in home based patient care provider. It is a six-month certificate course. Three batches of 10, six and eight students have finished this course. The fourth batch started from September 20, and has 36 students for this course. After successful completion of this course, a home-based care provider can earn Rs 300-500 per 12 hours.

Pushpanjali Crosslay Hospital is providing them theoretical and hand on practical training which includes: 1. Conducting theory classes for eight days 2. Conducting practical classes for 19 days under special guidance of nursing manager and nursing supervisors 3. Provide BLS training to the students 4. Conducting practical exams Dr Vijay Agarwal, Executive Director of Pushpanjali Crosslay Hospital said that Pushpanjali Crosslay has launched the home healthcare programme based on the concept of ● ‘Home care’, ‘home health care’ and ‘in-home care’ which are terms used interchangeably to mean any type of care given to a person in their own home. ● Used in the past interchangeably regardless of whether the person requires skilled care or not. ● Growing movement to

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Activities of daily living (ADL) refers to six activities - bathing, dressing, transferring, using the toilet, eating and walking that reflect the patient’s capacity for self care. ● Instrumental activities of daily living (IADL) refers to six daily tasks: (light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money) that enables the patient to live independently in the community. Pushpanjali Home Health Care Programme aims at Home Care PLUS Home Health Care, Home Care: Training Aides, Health Care: Partnering with Trained, Providing Medical Equipments and Pharmacy. Pushpanjali Crosslay Hospital will co-ordinate for all such activities and will provide medical care to needy at home. Contact: Gaurav Pandey Sr Manager Marketing and Corporate Relations Pushpanjali Crosslay Hospital, (400 beds Multisuperspeciality Tertiary Care Hospital) W-3, Sec-1, Vaishali, Ghaziabad-201001 Mob: 9811778998, Direct ph: 0120-4173823, Board no. 0120-4173000, 4188000 Web:www.pushpanjalicrosslayhospital.com Alternate E: gphealthcare@rediffmail.com EXPRESS HEALTHCARE

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Eclectica – Alere’s new age hybrid bench top analyser Alere Medical has introduced Eclectica, a hybrid immunoassay and clinical chemistry analyser to serve India’s IVD market

About Alere Medical Alere Medical, India is a fast growing diagnostic company in India and it is committed to advancing patients health by empowering the user with simple, accurate and reliable tests, by directly connecting them to the doctors, healthcare providers, so that users can make smart choices and decisions. Alere believes that better health starts with better information. That’s why it brings together advanced diagnostic tools and integrated health management solutions that deliver timely, accurate information and drive better outcomes. It’s an integrated approach that is called connected health — and it’s built upon the technology and vision of more than 40 leading diagnostic and health management companies with expertise in over 100 disease categories. “It means connecting the widest range of products and services in the widest range of environments — from hospital to home. It means connecting everyone — providers, physicians and the people they treat — to the same reliable, up-to-date data. And it means getting the diagnosis right, selecting the least invasive interventions and allowing health management to continue away from traditional points of care. So whether it’s in an emergency room in China, a doctor’s office in Spain or a home in New York City, our solutions make it possible to connect with the information needed to make the best health decisions. Because at Alere, it is understood that connected health is the smart path to better health.”

IVD Market in India During the last 15 years, India’s IVD market has grown at an average of 12 – 15 per cent continuously. The key growth drivers for the IVD industry have been more awareness, urbanisation, higher income and more importantly govern-

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ment’s focus on healthcare. The global IVD market was valued at $44 - $46 billion in the year 2011, growing at a CAGR of seven to eight per cent from 2011 to 2016. Asia is the fastest growing region of the global market and accounts to be 22.88 per cent of the global market and is estimated to reach the market of $17.20 billion with a CAGR 11.3 per cent from 2011 to 2016. The global IVD market accounts for about 45 per cent of the total global med-

duced the Eclectica - Hybrid Immunoassay and Clinical Chemistry Analysers manufactured by Adaltis, Italy. Eclectica is a hybrid analyser addressing the growing need for consolidation of automation platforms in clinical labs. Eclectica, whose name is derived from the Greek word ‘Eklektikos’ meaning ‘assorted’, combines the best of different methods into a compact, single workstation with the ability to perform both immunoassay and clinical

Eclectica, whose name is derived from the Greek word ‘Eklektikos’ meaning ‘assorted’, combines the best of different methods into a compact, single workstation with the ability to perform both immunoassay and clinical chemistry tests ical devices and diagnostic market. The Indian IVD market is estimated to be $700, seven million as of 2012-2013 with a CAGR of 16.7 per cent. The Indian IVD segment can be classified into eight broad based categories – clinical chemistry, immunochemistry, haematology, infectious immunology, microbiology, histology and cytology, genetic testing and coagulation. Of all these segments infectious immunology has seen the highest growth trends of almost 18.9 per cent over the last few years.

Eclectica - Hybrid Immunoassay and Clinical Chemistry Analyser The buzzword in the IVD corridors is automation as this reduces dependency on skilled manpower, increases efficiency, reduces errors and benefits all the stakeholders. Hence, Alere India has introwww.expresshealthcare.in

chemistry tests. It is a bench top analyser consisting of two carousels, one to process samples and the other to process reagents, each with its own barcode reader. Each carousel numbers the samples in a counter-clockwise sequence in two rows: from 1 to 30 and 31 to 60 for 60 position plate. The identifying numbers are skiled-screened on; each number is printed in advance of its respective position. The system for sampling samples, specific reagents, controls, calibrators, diluents and separation solutions is composed of two sampling needles, syringe, perstaltic pump, needles wash stations. It is small-in size fits easily on any lab bench. It has interactive touch screen, colour-integrated monitor, together with the separate, alphanumeric keyboard, provides the user with a friendly and fast interface.

An embedded PC controls all steps from primary tube allocation to the printing results. One can easily download and upload data through a direct connection between Eclectica and a laboratory information system (LIS). Positive barcode ID of samples and reagents, master curve calibration, refrigerated on-board reagent carousel, internal and external washing needle all combine to guarantee a complete and reliable system. Complete diagnostic profiles is available through combined integration of clinical chemistry and immunoassay tests offered by Eclectica. A wide parameter menu as well as our continuous product development program makes Eclectica able to fulfill present and future laboratory needs. The immunoassay menu includes a broad range of tests for fertility, pregnancy, thyroid, tumour markers, anaemia and diabetes. Extensive panels of clinical chemistry are provided as well. Open Lab software functions allow running Immunochemical and Clinical Chemistry analyte assays on samples of biological fluids of human origin. We can navigate around the various programme modules without the module being closed each time you switch from to another. The easy interface allows you to programme a worklist, execute it, record the executed worklist, manage the data warehouse and perform daily/weekly maintenance activities on the instrument. For more information about the product contact: Gaurav Kaushik/Piyush Nath Alere Medical Pvt. Ltd No.404, 4th Floor, BPTP Park Centra NH. 8, Opp. 32nd Milestone Gurgaon – 122001 (Haryana) India Ph.: 911244569000 Email: india.custsupport@alere.com Toll free no: 18001029595 OCTOBER 2012

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Conmed: Contributing to progress C Conmed, with its range of automatic shoe cover dispensers and hand sanitisers serves varied sectors

onmed Devices Pvt Ltd is an exclusive importer and distributor of wide range of automatic shoe cover dispensers and hand sanitisers which have application across various sectors such as hospitals, pharmaceutical, food processing, real estate, research lab, glass industry, beverage industries, diary industry, ketchup industry, rice industry etc. The company is managed by professionally qualified persons and has sales network of dealers and sales representatives across the

country. Its USP is quick delivery and efficient after sales service as we maintain sufficient stock of machines, its spare parts and disposable shoe covers. Its products are innovative and enjoy good reputation on PAN India basis. The company believes in honesty, integrity and fairness in the way they conduct their business.

Why Conmed? They have carved a niche in the sector of importing and distributing of automatic shoe dispenser, automatic hand sanitiser and consumables such as face masks, surgical gloves, and examination gloves, surgical aprons etc. Today, it has achieved the zenith of success due to the following factors: ● Years of experience ● Team of diligent professionals ● 99 per cent success rate ● Machine work without electricity ● High efficacy product range ● Formidable network ● Unmatched after sales service ● On time delivery ● Competitive prices

Specifications: Item

Specifications

Item

Model

DH1598T

Executive standard

Voltage

AC200-240V, 50/60Hz

Spay Amount per second

0.6-0.8ml/s

Power

Less Than 25W

Sensing distance

8-13cm

Working temperature

5-400

N.W.

3.3kg

Working humidity

less than 80 per cent;

G.W.

4.0Kg

Capacity

2000 ml

Dimensions (mm)

220(L)×185 (W)×380 (H)

OCTOBER 2012

Specifications

Some of its customers/clients are: 1. Food processing and beverage companies Dabur, Nestle, Britannia, Bonn Foods, LT Foods, Imperial Food Industries, Tata Tea 2. Real estate sector Supertech, 3C, M3M, IREO, Unitech, BPTP, Prateek Group, VVIP, Sunworld Developers, Raheja Developers, Puri Constructions, Amrapalli (Heart Beat City) 3. Health - AIIMS 4. Glass manufacturers Saint Gobain 5. Pharmaceutical compawww.expresshealthcare.in

nies - Cipla, Dr Reddy’s Lab, Venus Remedies, Getwell , Sun Pharma, Vivek Pharmaceutical, Piramal Healthcare Now Abbott 6. Space Lab - ISRO

Product information Conmed’s product portfolio also includes the following products Automatic shoe cover dispenser: Conmed is introducing a very unique and innovative device called the automatic shoe cover dispenser which makes the wearing of shoe covers easy, quick without requiring extra space and there by helps in ensuring and maintaining cleanliness at the work place. With automatic shoe cover dispenser – ● There is no need to use hands to wear on shoes ● No sitting space is required ● No electricity is required ● Portable and can be conveniently placed anywhere. Automatic hand sanitiser — Sprays alcoholbased sanitising liquid auto-

matically when hand is brought below the spray nozzle. This prevents touching any unhygienic taps, knobs or lever, thus maintaining complete hygiene and eliminating cross contamination. Usage: Just put your hands into below automatic hand sanitiser. The sensor detects your hand and automatically starts spraying hand sanitiser liquid on your hands. EXPRESS HEALTHCARE

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U N I F O R M S

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C - ARM OT TABLE & L 5002 OT LIGHT

C- ARM HYDRAULIC OT TABLE

FIVE BULB OT LIGHT [ L-5002 ]

Manufactured by

Health Care Equipments

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Experiment With The Truth Bacteriological Incubator Blood Bank Refrigerator Cooling Incubator Deep Freezer

ISO 9001:2008 Autoclave Vertical Model Horizontal Model

Cooling Incubator Blood Bank Refrigerator

Deep Freezer

Incubator

Autoclaves

Address: B-44, New Empire Industrial Premises, Kondivita, J.B. Nagar, Andheri (E), Mumbai - 400 059 Tel.: +91-022-28320880/ 28390487; E-mail: info@osworldindia.com; Website: www.osworldindia.com

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Clear the way for Better Outcomes

PAEDIATRICS

MED/SURG

The Vest® Airway Clearance System

CRITICAL CARE

For further information please contact:

With mucus retention often contributing to the development of pulmonary complications in hospitalised patients, eﬀective clearance of the airways is an important issue to address.1

Hill-Rom International

Treating all lobes of the lung simultaneously without the need for special techniques or patient positioning, The Vest® Airway Clearance System delivers High Frequency Chest Wall Oscillation proven to deliver a safe, eﬀective alternative to chest physical therapy.2

T: +91 9987267889 | +91 9916143616 pankaj.vadhavkar@hill-rom.com

406, Ansal‘s Majestic Tower, G-Block Community Centre (Behind PVR Sonia Multiplex), New Delhi 110 018. INDIA.

Suitable for use with children and adults suffering from acute or chronic airway clearance problems, The Vest® Airway Clearance System is now available in India.

www.thevest.com www.hill-rom.com References: 1. Smith MC, Ellis ER. Is retained mucus a risk factor for the development of postoperative atelectasis and pneumonia? – Implications for the physiotherapist. Physiother Theor Prac 2000;16:69-80. 2. Arens R, Gozal D, Omlin K, Vega J, Boyd K, Keens T, Woo M. Comparison of high frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis. Am J Respir Crit Care Med 1994; 150: 1154-1157.

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Express Healthcare Business Avenues MODI MEDICARE

RADIOLOGY WORKSTATIONS

Advanced Liver Volumetry - A Complete Solution  Liver Transplant Planning  Liver Surgery Planning  Liver Volumetry  Tumor Volume Estimation and Vessel Analysis  Right Lobe and Left Lobe Evaluation  Liver Segmental Analysis – Couinaud 8-Segments Volumes  Liver Hepatic Drainage Analysis – Congestion Volumes  Pre – TACE / Post – TACE Evaluation of Lesion Volumes  Pre – RFA / Post – RFA Evaluation of Lesion Volumes  Radio-Embolization Evaluation  LAI – Liver Attenuation Index  Liver Hemochromatosis Evaluation  THAD and THID Volumes measurements

Liver Volumetry

Hepatic Drainage Territories

Couinaud Segments

Radio-Embolization Planning

MYRIAN® FAMILY OF MODULAR WORKSTATIONS: BASE PLATFORMS SPECIALITY CLINICAL MODULES o PRO (Basic CR/DR Workstation) XT- CARDIAC CT XT-CARDIAC MRI o ADVANCED (Double oblique MPR / XP-LUNG XP-LUNGNODULE MIP, CPR, etc.) XT-BRAIN CT PERFUSION XT-BRAIN MRI o EXPERT (3D Workstation) XP-COLON XP-COLONCAD o EXPERT VL (3D With Volumetry) XP-ORTHO XT- DENTAL o XL-REGISTRATION (Elastic Registration) XL-2D/3D STITCHING XP-FUSION o XL-4D NAVIGATOR XP-LIVER XP-CT CTA sub XL-ONCOLOGY (RECIST 1.0, Modified RECIST 1.1, CHESON) For more details, please contact : JIGISH B MODI PH: 2506 5664, 98670 01110, email: modimedicare@gmail.com Skype: modi.medicare 4/102, DEEP SUNIL, GARODIANAGAR, GHATKOPAR(E),MUMBAI– 400077.

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Beating burnout Feeling overworked and under supported, with increasing work load doctors are prone to stress resulting in burnout. M Neelam Kachhap takes a closer look at this growing tendency

octors are a vulnerable lot but they would hardly admit it. They are trained to be perfectionists and are overly conscientious, after all patients’ life depend on them. In addition, doctors need to be obsessional and self-critical in order to avoid mishaps. In fact, we do not expect a doctor to be sick, we either assume that a doctor never falls ill or treats himself and is always well. Which is hardly true. Added to this, doctors are experiencing an explosion in clinical cases with greater complexity and more patient volume. These and a plethora of other stressful situations that a doctor deals with everyday results in burnout. “Burnout is overload of stress which is mostly in repetitive form. Usually burn out occurs with chronic repetitive stress or with severe intense stress for a short period of time,” says Dr Rohan Jahagirdar, Consultant Psychiatrist, Aditya Birla Memorial Hospital, Pune. The symptoms of burn out are identifiable in four areas: emotional, cognitive, behavioural and physical. These can manifest themselves in a number of ways. “Burnout is an experience of physical, emotional, and mental exhaustion, caused by long-term involvement in situations that are emotionally demanding,” explains Dr Meena Gnanasekharan, Consultant Psychiatry, Columbia Asia hospital, Bangalore. “The doctors who experience burnout can manifest symptoms ranging from insomnia, depression to substance dependence,” she further adds.

nerability. Thus it is very difficult to survey doctors about burnout symptoms and estimate the true incidence. (Many doctors I spoke to for this feature were unwilling to admit to burnout or even stress) H o w e v e r, researchers opine that at any given time about 1/3 of the doctors feel burnout. A recent study published in the Archives of Internal Medicine reports that 45.8 per cent of physicians reported at least one symptom of burnout. The study found that burnout in physicians is more common than among other workers. Substantial differences in burnout were observed by speciality, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Similarly, a study of general practitioners (GPs) in one area of South East England, published in BMJ Open suggested that levels of burnout in UK general practice are high. Male doctors, those who work in group practices, and those who repeatedly see the same patients seem to be at significantly greater risk, the research shows, prompting the authors to declare that "a significant group of doctors is in trouble."

How many doctors feel ‘burnt out’?

There is no India-specific data to suggest the incidence of burnout among doctors in the country, however anecdotal references suggest a

The mentality of doctors is such that they do not want to ask for help or show vul-

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Are Indian doctors more prone to burnout?

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high possibility. “We see doctors regularly. Usually works out to about 1-2 a week,” reveals Dr Neville Misquitta, Consultant Psychiatrist, Pathfinder Clinic, Pune. Yet some experts feel that Indian doctors are less likely to be burnt out than their western counterparts. “I think that burn out in doctors in India would be much less compared to their US counterparts. This is because most doctors in India do not have to deal with mundane issues like paperwork, insurance companies and regulatory bodies that plague the US. This situation is fast changing and we will face the same problems very soon. It is better that we are proactive and train doctors how to deal with burn out now and help decrease their chances of suffering from it,” explains Dr Gnanasekharan.

Is long working hours the culprit? It’s not that all doctors experience burnout. The ones that do are those who work

long h o u rs without break and feel like the weight of the world is pressing down on them. “Doctors generally in our country don’t have a fixed working time and that is major cause of dis-balance. If compared to other fields where some people practice five days a week and some have fixed time to work , doctors end up working a lot more without a fixed break,” says Dr Jahagirdar. “I have experienced the signs of burnout on occasions but they are not consistently present and not for long periods,” accepts Dr Sreenivasa Murthy TM, Consultant ENT & Cochlear Implant Surgeon, Columbia Asia Hospitals. “In fact when things do not go according to the set plan, it is then when surgeries take longer, attending OPDs gets delayed, there are calls from the wards and emergency, when they over lap, it is at these times that I feel helpless, frustrated and irritated. Above all, there are some patients who expect us to work like a well oiled wrist watch, without understanding the unpredictable nature of problems that we have to OCTOBER 2012

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Proper planning of the day’s work and proper communication with people around mitigates majority if not totally eradicate stress Dr Nayaran Garkar

Its only a few of them who are so dissatisfied that it is a problem for them. Even for these, most recover with promotion of the wellness cycle Dr Neville Misquitta

There is lot of burnout in cardiologists as we have to attend emergencies and life and death cases. You have to be available 24/7 Dr Rammurthy Bingi

INTERVENTIONAL CARDIOLOGIST, KOHINOOR HOSPITAL

CONSULTANT PSYCHIATRIST, PATHFINDER CLINIC, PUNE

CHIEF CARDIOLOGIST, BGS GLOBAL HOSPITALS, BANGALORE

handle,” he further adds. Narrating his experience Rakesh Ranjan, Consultant, Neurosurgery, Aditya Birla Memorial Hospital, Pune says, “There would be occasional sense of fatigue and feeling of helplessness due to inability to control the schedule of work.” Similar views are expressed by Dr Lakshmi Gangadharan, Consultant Emergency Physician, Columbia Asia Hospital Bangalore, who says, “My work timings are uncertain, starting at 9 am, and many a times continues till late evening. I am on call 24 hours a day, 365 days of the year, unless I am out of station, when my colleague would attend the call. Even when on leave, I am responsible for all major decisions taken at the hospital in my absence.”

Are some speciality doctors more stressed than others It is commonly thought that specialised doctors feel more stress and therefore experience burnout. Dr Ramamurthy Bingi, Chief Cardiologist, BGS Global Hospitals, Bangalore agrees, “There is lot of burnout in cardiologists as we have to attend emergencies and life and death cases. You have to be available 24/7.” “Surgeons may be more stressed out than general physicians,” he further adds. However there is no conclusive study on this subject and a lot of opinions exist. “No such statistics are presently suggestive of which medical professionals will have more stress but anaesthesia, oncology and psychiatry are common professions with higher incidence of work related stress,” declares Dr Jahagirdar. Talking through his experience Dr Misquitta says, OCTOBER 2012

“Surprisingly, the largest number come to us from ophthalmology.” However, Dr Gnanasekharan provides a different insight. She says, “In the recent survey in the US burn out was highest in the doctors who worked in the emergency room and family doctors. In a small study in India it was found that burn out is less in private practitioners compared to doctors working in hospitals.” To this Dr Misquitta adds saying, “It's a combination of age and experience. The young intern is likely to experience burnout towards the middle of her posting, when she has demonstrated competence and is left to handle cases on her own. The mid-career specialist is overwhelmed by demands from the family and children and loses interest in everything that motivated her. Yes, its mainly (but not only) women doctors who seek help.” Citing an example he elaborates, “We had an enthusiastic resident doctor in the hospital general ward. She was later taken to the ICU where she was relied as she was able to work well with the consultants. She was kept on for longer than the usual rotation and most instructions were routed through her. She took on excessive responsibility and would phone in when off duty to check on a patient. When she came to us she felt emotionally 'drained out', forgetful, unable to take decisions and wondered if she was in the wrong profession. We helped her back with wellness cycle stress management. She is now again enjoying her work. Hopefully, she'll keep it in balance.”

Work-life balance is critical To reduce stress and avoid burnout, the answer is www.expresshealthcare.in

to maintain a work-life balance yet most doctors are dissatisfied with work-life balance . “Sometimes it happens as you are too busy. At times even on weekends you are unable to give time to your family and take a break from work,” laments Dr Ramamurthy Bingi, Chief Cardiologist, BGS Global Hospitals, bangalore “Most doctors in India do not know the meaning of a work-life balance. Fortunately, doctors trained abroad and the younger generations of doctors realise the importance of work life balance and limit their working hours and try to enjoy things other than work. This will really help them and their families in the long run,” averts Dr Gnanasekharan. Agreeing Dr Misquitta says, “Statistics say so. However, most doctors we know are excited about their work and take time off to pursue other interests and be with their families. Its only a few of them who are so dissatisfied that it is a problem for them. Even for these, most recover with promotion of the wellness cycle.”

Tried and tested Therapy is the solution for doctors who feel burnt out but there are a lot of tried and tested simple remedies which aid the process of self renewal. Many doctors feel that hobbies like music and reading help them remain sane. “Sharing some problems/feelings and looking at the lighter side of life, make things a little more bearable. Music, reading and spending time with my child helps me deal with stress,” shares Dr Gangadharan. While others feel that enjoying work keeps them going. “It is very important to enjoy your work. I enjoy my work and that com-

I am on call 24 hours a day, 365 days of the year, unless I am out of station, when my colleague would attend the call Dr Lakshmi Gangadharan, CONSULTANT EMERGENCY PHYSICIAN, COLUMBIA ASIA HOSPITAL, BANGALORE

pletely takes care of my stress. I avoid taking up work that I do not enjoy. Work becomes fun when you enjoy what you do and fun never involves stress. Proper planning of the day’s work and proper communication with people around mitigates majority if not totally eradicate stress. My other hobbies like preparing for marathons helps to de-stress at work and gives an opportunity to look forward to something good in life,” says Dr. Narayan Gadkar, Interventional Cardiologist, Kohinoor Hospital. “The passion to work in the field keeps you going, with gratification, with outcomes of patients, a bit of sense of humour and hobbies to de-stress one,” says Dr Ranjan. Still others find solace in academia. “On occasions when I feel I am going in no direction, I usually book myself into an academic course to upgrade my skills, which allows me to learn newer techniques/subjects and gives me a break from the schedule which can be boring if it becomes monotonous. This also provides an opportunity to interact with peers, seniors and juniors - accounts for a social meeting and gives an opportunity to let the steam out. If nothing seems to work - take a break with family away from the city,” reveals Dr Sreenivasa Murthy TM. Yet some like to spend time with family. “Dinner with family is the best time to reduce stress. I watch movies, travel and living and history channels on TV. I listen to music and read too. Another way of dealing with stress is by emotional outburst. My wife is the buffer,” discloses Dr Ramamurthy Bingi mneelamkachhap@expressindia.com

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People Three distinguished doctors join Fortis The new joinees will handle vital positions in departments of Bariatrics and Neurosurgery hree renowned doctors, i.e. Dr Muffazal Lakdawala, Dr Sandeep Vaishya and Dr Rana Patir have joined the Fortis Memorial Research Institute, a multi-super speciality, quaternary care hospital recently to provide latest and cutting edge solution to complex medical problems. Dr Muffazal Lakdawala is one of Asia’s most eminent laparoscopic and bariatric surgeons. He has joined the Fortis Group of hospitals as Director & Chief – Bariatric, Advanced Minimal Access and Metabolic Surgery, as well as Chairman – Bariatric Surgery Council. He is the first surgeon in Asia to perform scar-less sleeve gastrectomy weight-loss surgery and the only Indian surgeon to perform live bariatric surgeries in almost every country of the continent. Also, Dr Lakdawala is the first Indian surgeon to be awarded the prestigious International Centre of Excellence accreditation by the US-based Surgical Review Corporation (SRC).

Dr Rana Patir - Director and Head of Department of Neurosurgery to his credit has the unique feat of establishing successful epilepsy surgery, paediatric neurosurgery, skull base surgery, neurovascular surgery and spine surgery during his span of 10 years in this profession. Prior to this he served at various senior levels in different hospitals in Delhi. An accomplished neurosurgeon, Dr. Rana is an MBBS & MS (General Surgery) from AIIMS and has performed complex head and neck procedures and reconstructive surgery in the specialty unit at AIIMS. Dr. Rana was also a Professor of Neurosurgery at Guwahati Medical College. He has authored several papers and chapters in peer reviewed national and international medical journals and text books. Dr Sandeep Vaishya - Additional Director, Neurosurgery is an experienced doctor, proficient in

intracranialtTumour surgery, functional beurosurgery (DBS), spinal surgery and peripheral nerve surgery with special interest in brachial plexus injuries and gamma knife radio surgery. Prior to this he served as a Faculty in the Department of Neurosurgery at AIIMS. He was also the Head of the Department of Neurosurgery in a renowned hospital in Delhi. He has been awarded the Life Membership Award by Mayo Alumni Association and was a Gold Medalist in medical school. Moreover, he has delivered more than 60 guest lectures in India and abroad Dr Ashok V Chordiya, Zonal Director, Fortis Memorial Research Institute said “I am delighted to welcome Dr Lakdawala, Dr Patir, and Dr Vaishya to Fortis. I am confident that their enormous expertise in their respective speciality areas will be a huge asset for our patients, at our state-of-the-art flagship facility”

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