Microbioz India : Medical fair Mumbai 2018 Special by Microbioz India,Laboratory Equipment,Magazines,Pharma and Healthcare News,Laboratory News

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Product Launches

The edition brings for you a cover story titled “Are we treating Urinary Tract Infections Right?” authored by Dr.Riyaz Sheriff and Dr.Prasobh KK from Department of Microbiology, Azeeia Institute of Medical Sciences & Research, Kollam, Kerala.

Featured Article

Added to this is an article on “Quality Healthcare & Beyond-PSRI Perspective” authored by Dr. Dipak Shukla, CEO, PSRI Hospital, New Delhi. Further, the edition highlights some of key innovations and developments in the Medical Industry which is coming to the rescue of the people in the coming time by providing the best and affordable healthcare services to common people.

The edition also covers recent Healthcare news articles and product launches collected from worldwide sources to update the readers with the current trends in the industry

Childhood cancer survivors at great risk of heart problems

According to a European Society Of Cardiology-led study, such survivors are at increased risk of suffering prematurely from cardiovascular disease in adulthood.

Prosthetic limbs represented like real hands in brain

According to a University College London-led study, the human brain can take advantage of brain resources originally devoted to the hand to represent a prosthetic limb.

Microbioz India March 2018

ear friends, once again I would like to thank you for continuously extending your love towards Microbioz India and helping it achieve an immense success not just in India but all over the world. I would also like to express my sincerest thanks to the complete team of Microbioz India who are putting their tireless efforts on continuously improving the publication month after month and year after year. This issue is the Event Special Edition focusing on India’s No. 1 Trade fair for Hospitals, Health Centres & Clinics i.e. Medical Fair to be held in Mumbai from 16th March 2018 to 18th March 2018. The show is held by Messe Düsseldorf India, a subsidiary of Messe Düsseldorf, and takes in close cooperation with the team of Düsseldorf leading global trade fair. The edition brings for you a cover story titled “Are we treating Urinary Tract Infections Right?” authored by Dr.Riyaz Sheriff and Dr.Prasobh KK from Department of Microbiology, Azeeia Institute of Medical Sciences & Research, Kollam, Kerala. In this cover story, they have discussed in brief about the types of Urinary Tract Infections, the microorganisms that causes it and how antibiotics resistance has become a menace in treating these infections along with some results from the research they conducted on it. Please read it for more information. Added to this is an article on “Quality Healthcare & Beyond-PSRI Perspective” authored by Dr. Dipak Shukla, CEO, PSRI Hospital, New Delhi. Further, the edition highlights some of key innovations and developments in the Medical Industry which is coming to the rescue of the people in the coming time by providing the best and affordable healthcare services to common people. It also covers recent Healthcare news articles and product launches collected from worldwide sources to update the readers with the current trends in the industry Dear friends and readers, once again I would like to thank you for your invaluable love and support. As always, we hope that you find value in this issue. We are always eager to receive your valuable feedback and suggestions as they help us come with better content each time. For any further value addition, please write at editor@microbiozindia.com.

Cover Story

Are we treating Urinary Tract Infections right?? Dr. Riyaz Sheriff, Dr. Prasobh KK

Introduction Infections are as old as mankind. The discovery of antibiotics gave us the power to control infections. Bacteriae were smarter to develop ways to escape action of antibiotics and thatâ&#x20AC;&#x;s what we now call as Antibiotic resistance. The antibiotic resistance spread far and wide and currently is one of the main concerns plaguing the medical fraternity. Antibiotic resistance has forced us to treat common infections with stronger and costlier antibiotics. This means the patient has to spend more in terms of buying costlier antibiotics and also for the extended hospital stay in some cases. Millions of dollars are spent every year to devise methods to combat antibiotic resistance. International agencies like the CDC& WHO have worked out the reasons for the emerging antibiotic resistance. Few reasons postulated by experts are misuse of antibiotics, uncontrolled over the counter sale of antibiotics and use of antibiotics in animal husbandry.

Indian perspective India has realised the need to take steps to prevent further spread of antibiotic resistance. The way ahead is to devise a uniform National antibiotic policy so that few life saving antibiotics are reserved at the times of need. India has already taken its baby steps towards formation of an antibiotic surveillance network. Initially the data available from the premier institutes like PGI Chandigarh, AIIMS, JIPMER & CMC Vellore will be analysed. In the next stage, all antibiotic resistance data will be collected from Government Medical

colleges and hospitals. The need to involve all the private institutions has been well recognised and will be involved as well. By analysing the whole data a presumptive antibiotic policy can be drafted so that the clinician can handle the patients better.

Urinary tract infections There are many types of infections affecting human beings. The most common is the urinary tract infection (UTI). UTI is more common in females. UTI can be classified as upper and lower UTI. CAUTI (Catheter Associated Urinary Tract Infection) emerged along the advent of medical devices came. The medical advances have given us better life expectancy but along with it rises spread of infections within the hospital. Such a urinary infection which a patient acquires in a health care set up after 48hours of admission is termed as Nosocomial UTI. In most cases it is due to the lapses in infection control. Hand washing is considered the most important step in order to prevent inadvertent transmission of infection by health care workers.

The culprits The main cause of urinary tract infection in India remains to be the members of Enterobacteriaceae family. This is followed

Microbioz India March 2018

Cover Story by members of Pseudomonas family, Staphylococcus aureus and Staphylococcus aureus from 16 samples. Minor isolations were Enterococcus sp. Among the members of Enterobactor aerogenes, Pseudomonas aeruginosa, candida sp. SemiEnterobacteriaceae,Escherichia coliremains the most important quantitative cultures were carried out on Blood agar and pathogen causing uncomplicated UTI. E.coli infections are MacConkey agar supplied by Himedia labs, Mumbai. more common in women which may be attributed to the anatomical proximity to the gastrointestinal tract which The antibiotic sensitivity was carried out on monobacterial harbours E.coli as a commensal. Klebsiella first isolates of E.coli with more than pneumoniae is the next most commonly 1,00,000 CFU/Ml (Significant The antibiotic resistance is spread isolated gram negative bacteria from the bacteruria). A total of 132 samples of same family. A few infections are also E.coli were selected for analysis. The far and wide and currently is one of caused by Klebsiellaoxytoca, Proteus mirabilis, isolates were then subjected to the main concerns plaguing the Proteus vulgaris and Citrobacter sp. Among Antibiotic sensitivity testing as per medical fraternity. Antibiotic the gram positive bacteriaeStaphylococcus Clinical and Laboratory Standards aureus and Enterococcus are responsible for Institute (CLSI) 2017 guidelines. The resistance has forced us to treat few uncomplicated UTI‟s. Antibiotic sensitivity testing was done common infections with stronger on Meullerhinton agar. Standard strain American Type Culture Collection and costlier antibiotics. This means Compilation of our (ATCC) strain of E.coli 25922 was the patient has to spend more in used as a control. The isolates were resistance profile of E.coli tested for sensitivity to the following terms of buying costlier antibiotics discs Ampicillin(10μg), and also for the extended hospital We analysed the antibiotic sensitivity Gentamicin(10μg), Tobramycin profile of E.coliisolates collected from (10μg), Amikacin (30μg), stay in some cases. urinary specimens from January to Ciprofloxacin(5μg) Levofloxacin(5μg) December 2017. This study was carried out Cotrimoxazole(1.25/23.75μg) Amoxat Azeezia Medical College in Kollam district of Kerala. Clean Clavulanic Acid(20/10μg) Piperacillin-Tazobactum(100/10μg) catch midstream urine samples (CCMSU) were collected and Norfloxacin(10μg) Amikacin(30μg) Cefuroxime( 30μg), processed using standard protocols. A total of 1152 urine Ceftriaxone (30μg), Ceftazidime(30μg), Ceftazidimesamples were received during the study period. 610 (52.9%) Clavulanic Acid(30/10μg), Cefotaxime(30μg) samples did not grow any bacteria. 148 samples grew E.coli. Imipenam(10μg), Tetracycline(30μg), Nitrofurantoin(300μg). Klebsiella pneumoniae were isolated from 67 samples. The sensitivity was recorded and reported as per the CLSI Enterococci were isolated from 27 samples followed by 2017 guidelines. The results are shown below., Antibiotic class Penicillin Penicillin + Inhibitors Cephalosporins

Carbepenams Aminoglycosides

Tetracyclines Fluroquinolones Folate pathway inhibitors Nitrofurans

Antibiotic Ampicillin Amoxicillin – Clavulanic acid Piperacillin – Tazobactum Cefuroxime Cefotaxime Ceftriaxone Ceftazidime Imipenam Gentamicin Tobramycin Amikacin Netilmicin Tetracycline Ciprofloxacin Levofloxacin Norfloxacin Cotrimoxazole Nitrofurantoin

S ≥17 ≥18 ≥21 ≥18 ≥26 ≥23 ≥21 ≥23 ≥15 ≥15 ≥17 ≥15 ≥15 ≥21 ≥17 ≥17 ≥16 ≥17

CLSI 2017 I 14-16 14-17 18-20 15-17 23-25 20-22 18-20 20-22 13-14 13-14 15-16 13-14 12-14 16-20 14-16 13-16 11-15 15-16

%S R ≤13 ≤13 ≤17 ≤14 ≤22 ≤19 ≤17 ≤19 ≤12 ≤12 ≤14 ≤12 ≤11 ≤15 ≤13 ≤12 ≤10 ≤14

14 11 77 30 27 26 32 91 66 72 91 100 46 34 39 41 49 97

Discussion: Evidence based The current national policy suggests use of Nitrofurantoin 100mg B.D for 7days or Cotrimoxazole 960mgBD for 3-5days or Ciprofloxacin 500mg BD for 5days as first line of treatment for uncomplicated cystitis. Alternatively cefuroxime 250mg can be prescribed twice daily for 3-5days. Acute uncomplicated pyelonephritis can be managed with Amikacin 1gm OD or Gentamicin 7mg/kg/day. Alternatively

Piperacillin-Tazobactun 4.5gm QID or Cefaperazone – sulbactum 3gm IV BD or Etrapenam 1g IV OD may be prescribed. Complicated pyelonephritis can be managed using Piperacillin-Tazobactun 4.5gm QID or Amikacin 1gm OD or Cefaperazone –sulbactum 3gm IV BD. If resistance has been observed previously to these antibiotics Imipenam or Meropenam may be given at a dose of 1GM IV 8th hourly.

Microbioz India March 2018

Cover Story Acute prostatitis can be managed using Doxycycline 100mg BD or Cotrimoxazole 960mg BD. The above mentioned guidelines are intended to help the clinician to manage the patient till urine culture and sensitivity reports are available. These guidelines lay specific emphasis on urine culture and sensitivity. Based on the urine sensitivity report of the patient the clinician can take a well informed decision of down scaling the antibiotic. It is recommended that every health care facility form an antibiotic policy of their own as resistance pattern varies in different geographical areas. This policy can be updated once in six months. Conservation of antibiotics is the topmost priority in view of emerging antibiotic resistance in India. This is coupled with the fact that there are no promising antibiotics in the pipeline for management of such resistant infections. One important measure which can prevent

infections is proper hand washing with a non-alcoholic disinfectant as per the WHO protocol. Letâ&#x20AC;&#x;s all join hands to handle the menace of antibiotic resistance and provide our patients anevidence-based cure.

About the authors Dr.Riyaz Sheriff M.B.B.S., M.D Assistant Professor, Department of Microbiology, Azeezia Institute of Medical Sciences & Research Kollam, Kerala Co-author Dr.Prasobh KK Ph.D., Associate Professor , Department of Microbiology Azeezia Institute of Medical Sciences & Research Kollam, Kerala

Microbioz India March 2018

Latest News

High level of Vit D may lower cancer risk Washington D.C. [U.S.A.], Mar 08 (ANI): High levels of vitamin D may be linked to a lower risk of developing cancer, including liver cancer, revealed a new study. The study, conducted by a team of international researchers in Japan, stated that the findings support the theory that vitamin D might help protect against some cancers. Vitamin D is made by the skin in response to sunlight. It helps to maintain calcium levels in the body to keep bones, teeth, and muscles healthy. While the benefits of vitamin D on bone diseases are well known, there is growing evidence that Vitamin D may benefit other chronic diseases, including some cancers. But so far, most studies have been carried out in European or American populations, and evidence from Asian populations is limited. As Vitamin D concentrations and metabolism can vary by ethnicity, it is important to find out whether similar effects would be seen in non-Caucasian populations. So an international Japan-based research team set out to assess whether vitamin D was associated with the risk of total and site-specific cancer. They analysed data from the Japan Public Health Center-based Prospective (JPHC) Study, involving 33,736 male and female participants aged between 40 to 69 years. At the start of the study, participants provided detailed information on their medical history, diet, lifestyle, and blood samples were taken to measure vitamin D levels. Vitamin D levels varied depending on the time of year the sample was taken, tend to be higher during the summer and autumn months than in the winter or spring. After accounting for this seasonal variation, samples were split into four groups, ranging from the lowest to highest levels of vitamin D. Participants were then monitored for an average of 16 years, during which time 3,301 new cases of cancer were recorded. After adjusting for several known cancer risk factors, such as age, weight (BMI), physical activity levels, smoking, alcohol intake and dietary factors, the researchers found that a higher

level of vitamin D was associated with a lower (around 20 percent) relative risk of overall cancer in both men and women. Higher vitamin D levels were also associated with a lower (3050 percent) relative risk of liver cancer, and the association was more evident in men than in women. No association was found for lung or prostate cancer, and the authors note that none of the cancers examined showed an increased risk associated with higher vitamin D levels. Findings were largely unchanged after accounting for additional dietary factors and after further analyses to test the strength of the results. The researchers pointed to some study limitations, for example, numbers of organ-specific cancers were relatively small. And while they adjusted for several known risk factors, they cannot rule out the possibility that other unmeasured (confounding) factors may have influenced the results, making it difficult to draw firm conclusions about cause and effect. Nevertheless, key strengths included the large sample size for overall cancer, a long follow-up period and a large number of blood samples analysed. The authors said their findings support the theory that vitamin D may protect against the risk of cancer, but that there may be a ceiling effect, which may suggest that there are no additional benefits beyond a certain level of vitamin D. "Further studies are needed to clarify the optimal concentrations [of vitamin D] for cancer prevention," they concluded. The findings from the study are published in The BMJ. (ANI)

Effective treatment for comorbid cardiovascular risk in COPD patients New Delhi [India], Mar 9 (ANI): COPD is no longer 'just a disease of the lungs'. Many COPD patients develop heart diseases that lead to higher mortality. A new study gives hope of a better treatment protocol.

Microbioz India March 2018

Latest News Patients of chronic obstructive pulmonary disease (COPD) an obstructive lung disease characterized by longterm breathing problems and poor airflow - are at an increased risk of developing co-morbid cardiovascular diseases (CVDs). This, in turn, leads to higher rate of disability and death. Lung hyperinflation is common in people with COPD and has been linked to impaired cardiac function and worsening of COPD symptoms, especially breathlessness.

Organization (WHO) report, faces a heightened risk. Physical inactivity and unhealthy diet, both of which generally accompany COPD, can also cause cardiovascular diseases. Medical experts believe a lot more needs to be done to create awareness about how to diagnose, treat and live with this ailment. Evidence indicates that the increased risks for CVD are particularly diagnosed in COPD patients in midto-late-middle-age. Thus, it becomes imperative to raise awareness about the benefits of early intervention. (ANI)

Childhood cancer survivors at great risk of heart problems

Lung hyperinflation is caused due to blockages in the air passages/sacs that are less elastic, which interferes with the lung function. A recent research - CLAIM Study - is the first to investigate the effects of dual bronchodilation on cardiac function and lung hyperinflation. The CLAIM study, published in Lancet Respiratory Medicine, demonstrated that treatment with dual bronchodilators provided significant improvement in cardiac and lung function in COPD patients with lung hyperinflation. -What is COPD and how it is related to CVDs Chronic obstructive pulmonary disease (COPD) is an umbrella term used to describe progressive, inflammatory lung diseases, including chronic bronchitis and emphysema; it is an often overlooked but serious global health threat. COPD affects an estimated 210 million people worldwide and is the fourth leading cause of death. India accounts for a quarter of deaths caused worldwide by COPD; there were 22.2 million COPD patients in 2016. It is progressive (usually gets worse over time) and can be a life-threatening disease. Among the long list of co-morbid conditions seen in people with chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVDs) are one of the most common and also associated with an increased risk of death. A typical COPD patient is just as likely to die from a cardiovascular cause as they are from a respiratory one. Dr. Lancelot Pinto, Consultant Respirologist at Hinduja Hospital, Mumbai said "Smoking remains an important shared risk factor for both, COPD and cardiovascular diseases, as it contributes directly to chronic, systemic inflammation. However, pollution has also emerged as a new threat. Today, newer treatments are helping COPD patients to breathe and function at the highest level possible. Bronchodilators have proven to be one of the most effective treatment options for a disease that is now the third leading cause of death worldwide." -What causes CVDs in COPD patients Smoking remains an important shared risk factor for both diseases, as it contributes directly to chronic, systemic inflammation. But experts believe pollution has also emerged as the new threat. India, which is home to 16 of the world's 30 most polluted cities, according to a 2016 World Health

London [U.K.], Mar 09 (ANI): Survivors of childhood cancer are at great risk of heart problems in adulthood. According to a European Society Of Cardiology-led study, such survivors of are at increased risk of suffering prematurely from cardiovascular disease in adulthood. To investigate the long-term health of childhood cancer survivors, by means of systematic and comprehensive clinical evaluation of their health in comparison to the general population, researchers in Germany found that as adults these people were at increased risk of having high blood pressure and dyslipidaemia (abnormal, usually high, levels of cholesterol and other fats in the blood). These conditions occurred six and eight years earlier respectively when compared with the general population. In addition, childhood cancer survivors had a nearly two-fold increased risk of cardiovascular diseases such as congestive heart failure and venous thromboembolism.

Cardiovascular disease was found in 4.5 percent of survivors and occurred in the majority before they reached the age of 40, nearly eight years earlier than in the general population. Between October 2013 and February 2016, a total of 951 adult long-term survivors of childhood cancer, underwent a clinical examination that included assessing factors that might put them at higher risk of cardiovascular diseases, such as high blood pressure and dyslipidaemia. The researchers also checked their medical history, whether or not they smoked and whether there was any family history of cardiovascular disease. Their ages ranged from 23 to 48 at the time of this follow-up. The results were compared with over 15,000 people selected from the general population. Researcher Joerg Faber said, "Our results show that these survivors of childhood cancer have a substantially elevated

Microbioz India March 2018

Latest News burden of prematurely occurring traditional cardiovascular risk factors and cardiovascular diseases". Researcher Wild added, "In particular, the premature onset of high blood pressure and blood lipid disorders may play an important role in the development of severe cardiovascular conditions, such as heart disease and stroke in the long term". "We also found that a remarkable number attended their clinical examination for this study with previously unidentified cardiovascular risk factors and cardiovascular disease. For example, only 62 out of 269 were aware of having dyslipidaemia. Consequently, 207, approximately 80 percent, were only diagnosed at that point. This applies to high blood pressure in the arteries as well." High blood pressure and dyslipidaemia were the most common cardiovascular risk factors identified in the childhood cancer survivors, 23 percent and 28 percent respectively, whereas diabetes was only found in two percent. The researchers said that these findings show that survivors of childhood cancer have a considerably greater risk of cardiovascular disease - a risk that continued to increase with age rather than levelling off - and this meant that, in the longer term, they may be more likely to die earlier than the general population. However, it might be possible to prevent this, said Professor Wild, "Early systematic screening, particularly focusing on blood pressure and lipid measurements, might be suggested in all childhood cancer survivors irrespective of the type of cancer or treatment they had had. This might help to prevent long-term cardiovascular diseases by intervening early, for instance by modifying lifestyles and having treatment for high blood pressure." Professor Faber added, "Usually survivors are followed for only five to ten years after completion of therapy, and this is focused on the risk of cancer returning and the acute adverse effects of their treatment, rather than on other conditions. Current guidelines recommend cardiovascular assessments only for sub-groups known to be at risk, such as for patients who were treated with anthracycline therapy and/or radiation therapy. However, further investigations are needed to answer questions about the best follow-up care." Treatments for childhood cancer include chemotherapy and radiotherapy, both of which can affect the heart, causing temporary or sometimes permanent damage to heart cells and blood vessels. The mechanisms for this are not all fully understood, particularly for long-term chronic effects, but certain genetic factors seem to increase the probability of adverse effects on the heart. The findings from the study are published in the European Heart Journal. (ANI)

Prosthetic limbs represented like real hands in brain London [U.K.], Mar 09 (ANI): Prosthetic limbs are represented like real hands in brain, a new research has revealed. According to a University College London-led study, the human brain can take advantage of brain resources originally

devoted to the hand to represent a prosthetic limb. Among people with only one hand, the brain area that enables us to recognise hands can also recognise a prosthetic hand, particularly among those who use a prosthesis regularly. The study provides the first account of how artificial limbs are represented in the brains of amputees. "While the use of a prosthesis can be very beneficial to people with one hand, most people with one hand prefer not to use one regularly, so understanding how they can be more userfriendly could be very valuable," said the study's lead author, Dr Tamar Makin. "If we can convince a person's brain that the artificial limb is the person's real limb, we could make prostheses more comfortable and easier to use," he added. The study included 32 people with one hand - half of whom were born with one hand and half had lost a hand due to amputation - alongside 24 people with two hands, used as a control group, most of whom were family or friends of the people with one hand. The participants were shown images of prosthetic hands (including photos of their own prostheses) as well as real limbs. A functional magnetic resonance imaging (FMRI) scan was used to assess the participants' neural responses. Within the visual cortex of the brain is an area that enables people to recognise hands. This area displayed a stronger response to images of prostheses among the one-handed participants, compared to the controls, particularly among those who used a prosthesis most frequently in their daily lives.

Microbioz India March 2018

Latest News This part of the brain also responded to images of prostheses that are functional but do not look like a hand, such as a hook prosthesis. The researchers also investigated the connectivity between the visual hand-selective area and the area of the sensorimotor cortex which would be expected to control the missing hand. They found there was better connectivity between these two brain areas in those people who used their prostheses regularly. "Our findings suggest that the key determinant of whether the brain responds similarly to a prosthetic hand as it does to a real hand, is prosthetic use. As many of our study participants lost their hand in adulthood, we find that our brains can adapt at any age, which goes against common theories that brain plasticity depends on development early in life," said the study's first author, Fiona van den Heiligenberg. "We think the ultimate barrier is simply how much you use the prosthesis," said Dr Makin. The findings from the study are published in the journal Brain. (ANI)

CSIR authorises private path lab for genetic tests New Delhi, March 9 (IANS) Hoping to use private pathology labs to reach out to people, the Council of Scientific and Industrial Research (CSIR) on Thursday licensed a private lab for 27 genetic tests it has developed over years. Officials said that the CSIR's Institute of Genomics and Integrative Biology (CSIR-IGIB) has entered into partnership with Dr Lal PathLabs, a private chain of labs, and licensed it with technology. These tests are expected to be launched over the period of one year.

According to the CSIR, mostly an appropriate diagnosis is not arrived at due to lack of general awareness on genetic diseases, lack of access and high cost of appropriate genetic diagnostic services. Story source and Credit : The Economic times

Roche, GE to Develop Integrated Decision Support Platform Roche, Basel, Switzerland, has entered into a strategic, longterm partnership with GE Healthcare, Chalfont St. Giles, United Kingdom, to develop and comarket digital clinical decision support solutions. The partnership will initially focus on products that accelerate and improve individualized treatment options for cancer and critical care patients. The two companies aim to develop an industry-first digital platform that will use advanced analytics to provide workflow solutions and applications in support of clinical decisionmaking. The collaboration seeks to allow the seamless integration and analysis of in vivo and in vitro data, patient records, guidelines for medical best practices, real-time monitoring, and the latest research outcomes. Clinicians will then have comprehensive decision support for providing the right treatment and quality of care for their patients. For example, oncology care teams that include clinicians from multiple medical specialties can have a comprehensive dashboard that can be used to review, collaborate, and align treatment decisions for cancer patients at each stage of their disease. In the critical care setting, patient data from hospital monitoring equipment can be integrated with the patient‟s biomarker, genomic, and sequencing data, helping physicians to identify, or even predict, severe complications before they strike. “This unique partnership will deliver innovative solutions and insights in clinical decisionmaking,” says Roland Diggelmann, chief executive of Roche Diagnostics. “Our goal is to support clinicians and other relevant stakeholders for the benefit of patients by providing the right decision support at the right time and through comprehensive digital offerings.” “This is the first time that two major players in healthcare have combined digital, in vivo, and in vitro diagnostics to this degree,” says Kieran Murphy, president and chief executive of GE Healthcare. “We believe this alliance will help accelerate the delivery of data-driven precision health for customers, patients, and the healthcare industry.” For more information, visit GE Healthcare and Roche.

"Genetic diseases, though are individually rare, cumulatively affect a large number of individuals -- an estimated 70 million Indians. "It is anticipated that the wide network of Dr Lal PathLabs would enable easy access to the genetic tests to large number of patients across the country and potentially enable wide utility of genetic tests by clinicians," said a statement from the CSIR.

Microbioz India March 2018

New Focal Charge Compensation mode for ZEISS field emission scanning electron microscopes improves image quality

In collaboration with the National Center for Microscopy and Imaging Research (NCMIR) at the University of California San Diego, ZEISS releases a new Focal Charge Compensation module for block face imaging with ZEISS GeminiSEM and 3View® from Gatan, Inc.

Focal Charge Compensation expands versatility and considerably increases data quality without prolonging acquisition times and enables easy imaging of even the most charge-prone samples. Resin-embedded tissues and cells can be imaged without charging artifacts, while the pixel dwell time is reduced. Decreasing beam exposure time not only ensures fast acquisition rates, but also guards against sample damage, which is key to acquiring reliable and reproducible 3D data. Professor Mark H. Ellisman, Director of NCMIR, says “Focal Charge Compensation will breathe new life into block face scanning electron microscopy by allowing high quality imaging of previously intractable specimens, including legacy samples prepared with traditional electron microscopy stains.” Preventing charging effects This extension of the 3View® system from Gatan, Inc eliminates specimen charging. A gas injection system consisting of a tiny capillary needle is precisely located above the sample. Nitrogen is guided through this needle directly onto the block face surface while the chamber is maintained under high vacuum. This eliminates charging without degrading image quality. The needle retracts automatically during the cutting cycle so the workflow is uninterrupted and high acquisition rates are maintained. Producing thousands of serial images in a single day The 3View® system consists of an ultramicrotome directly integrated into the vacuum chamber of the ZEISS Sigma and ZEISS GeminiSEM field emission scanning electron

Microbioz India March 2018

Product News microscopes. It enables automated serial block face imaging of embedded samples (e.g. cells or tissue) with a slice thickness down to 15 nanometers. The sample is continuously cut and imaged, and a three-dimensional rendering of the sample with nanometer-scale resolution can be reconstructed. For more information: https://www.zeiss.co.in

New Affordable Lionheart™ LX Automated Microscope BioTek makes it even easier for laboratories to transition into automated digital microscopy with the new, fully integrated Lionheart™ LX Automated Microscope. The affordable and compact Lionheart LX offers high contrast brightfield, color brightfield and fluorescence imaging with up to 100x air and oil immersion magnification. Users can automatically image microplates, slides, cell culture dishes and flasks with ease.

For more information: BioTek Instruments

Want Great Gel and Chemi Blot Images? Come and See Syngene's New-look Imaging Systems, Stand 130-136, ARABLAB 2018 Syngene, a world-leading manufacturer of image analysis solutions, is delighted to introduce its new look range of gel doc and chemi blot imaging systems on Stand 130-136 at ARABLAB 2018 on 18-21 March.

Gen5™ Microplate Reader and Imager Software controls Lionheart LX. Together they enable Augmented Microscopy™ for fully automated image capture, processing and analysis. User-friendly automated features include autofocus, auto exposure and auto-LED intensity, and the ocular-free hardware eliminates the ergonomic risk factors of manual methods. Gen5 software offers advanced image analysis, and the LED filter cubes and objectives are easily and quickly changed according to user needs. Lionheart LX is suited for a broad range of applications including slide scanning, cell population count and analysis, and intracellular detail analysis. For added convenience, a quick analyze feature provides instant cell count and confluence measurements from the live camera feed, prior to image capture. BioTek Instruments, Inc., headquartered in Winooski, VT, USA, is a worldwide leader in the design, manufacture, and distribution of innovative life science instrumentation. Our comprehensive product line includes cell imaging systems, microplate readers, washers, dispensers, automated incubators, stackers and pipetting systems. These products enable life

science research by providing high performance, cost-effective analysis and quantification of biomolecules, biomolecular interactions and cellular structure and function across diverse applications. BioTek espouses a "Think Possible" approach that sets the tone for fresh ideas, unsurpassed customer service and original innovations.

These compact systems are an excellent choice for costconscious scientists who need versatile gel doc imagers and simple-to-use chemi blot imaging systems. For scientists wanting a complete workstation, the NuGenius is the ideal gel doc. This powerful system features an internal processor and 5 million-pixel CCD camera with motor driven zoom lens,

Microbioz India March 2018

Product News guaranteeing incredible at-system image capture with gels of up to 20cm x 24cm. The NuGenius gel doc system features a compact light-tight darkroom where researchers can choose to fit a UV transilluminator for ethidium bromide gels, a blue light transilluminator for SYBR® Safe and GelGreen™ DNA gels and a White Light Converter screen option to visualise protein gels stained with Coomassie Blue, providing maximum gel imaging versatility at minimal cost. For scientists looking for dedicated chemiluminescence imaging, the new GeneGnome XRQ imager is also on stand. Utilising the system‟s low-light capture camera and optimised short „camera to sample‟ technology, scientists can achieve greater than double the dynamic range of film. This means scientists can with minimal steps capture and produce perfectly exposed images to detect picogram or femtogram levels of protein on chemi Western blots, without the time and effort of using film.

Both systems on show come with unlimited copies of GeneTools software, allowing scientists to rapidly analyse samples and store or print high resolution and publication quality images on any computer, as and when they need to. “We‟re excited to be introducing our new-look imaging systems on Stand 130 – 136 at ARABLAB this year because they combine the latest in technology and value that modern scientists demand”, states Dr Martin Biggs, Divisional Manager at Syngene, “We look forward to showing them the new range and to discussing how Syngene imagers can improve their research results by capturing the best gel and chemi blots images.” More about the NuGenius gel doc system | GeneGnome XRQ imager For more Information : Syngene

Cherwell to Participate in Key Annex 1 Sterile Medicinal Product Manufacture Conference Joint PHSS & PQG event provides forum for revised sterile drug GMP guideline discussion Cherwell Laboratories, specialist suppliers of products for environmental monitoring and process validation, will be exhibiting and participating in a key „EU GMP Annex 1 Draft Revision Insight‟ meeting at Leamington Spa on 12th March. To be jointly hosted by the PHSS (Pharmaceutical & Healthcare Society) and the PQG (Pharmaceutical Quality Group), the event aims to provide a forum for discussion with invited regulatory authorities (MHRA) on this highly significant sterile drug GMP guideline update close to the end of the consultation period.

The conference follows the recent publication of the revised draft of the EU Annex 1 „Manufacture of Sterile Medicinal Products'. This long-awaited revision of sterile drug GMP guidelines is intended to address new issues like quality risk management, as well as new technologies and procedures in the cleanroom environment. Aimed at developing globally agreed standards, the Annex 1 revision will impact both sterile medicinal product manufacturing and also other sectors,

including advanced therapies and hospital pharmacy aseptic services. As a leading supplier of technologies that support aseptic processing and the production of sterile therapeutics, Cherwell‟s Microbiology Product Specialist, Andrew Ramage, has published a series of blogs relating to the update entitled „EU GMP Annex 1 update: The devil‟s in the detail‟, and says that: “The new version of Annex 1 is a far more detailed document aimed at addressing loss of knowledge in recent years caused by experienced staff in the sector retiring. This is reflected by the fact that the new document is 50 pages long, compared to the current version of just 16 pages. However, despite its length, the new version is arguably easier to navigate”. Conference sessions will include a keynote presentation by Andrew Hopkins, MHRA and Annex 1 project leader, who will provide a regulatory perspective, followed by a pharmaceutical industry perspective to be given by Ian Symonds of GSK. There will also be discussion on key concerns, including open questions from the conference audience with responses from the MHRA and pharmaceutical industry representatives. Andrew Ramage will be attending all sessions of the joint PHSS & PQG conference and in his ongoing blog will report on the industry response, and that of the regulators, to the comments made. Cherwell will also be exhibiting its high-quality cleanroom microbiology products designed to meet the very specific requirements of environmental monitoring and process validation applications within the pharmaceutical and healthcare sciences industry. The Cherwell range includes Redipor® prepared media, stainless steel accessories , and SAS microbial air samplers For more Information: Cherwell Laboratories Ltd

Exalenz Bioscience Shares Positive Clinical Trial Results for CSPH Test

Microbioz India March 2018

Product News The BreathID platform, a Helicobacter pylori test from Exalenz Bioscience Ltd, Modi‟in, Israel, has shown positive clinical trial results for detecting clinically significant portal hypertension (CSPH) among nonalcoholic steatohepatitis (NASH) patients with compensated advanced chronic liver disease.1 CSPH has been shown to be the most important independent predictor of several liver-related complications in this population. Data from a total of 257 NASH patients who participated in two parallel studies comparing the use of the

Raffi Werner, Exalenz Bioscience.

BreathID 13C-methacetin breath test (MBT) to invasive measurement of portal pressure demonstrate that MBT has high sensitivity and specificity in this patient population (88% and 85% respectively). CSPH, a severe complication of chronic liver disease and cirrhosis characterized by elevated pressure in the vein carrying blood from the gastrointestinal tract to the liver, is closely associated with an increase in severe liver complications, morbidity, and mortality. “Diagnosing CSPH in NASH patients is critical for effective intervention that can prevent further loss of liver function, improve patient outcomes, and reduce the cost of care,” says Scott Friedman, MD, dean for therapeutic discovery and chief of the division of liver diseases at the Icahn School of Medicine at Mount Sinai. “Current invasive and complex testing methods are not widely accessible, and thus, a noninvasive CSPH test is essential for meeting the needs of the large and growing population of NASH patients. Results from these studies suggest that BreathID could be the first effective, noninvasive test that would allow us to improve the management of late-stage NASH patients who are at risk for portal hypertension.” The study populations comprised 257 NASH patients with a mean age of 59 years, mean body mass index (BMI) of 34.6, and a CSPH prevalence of 62.3%. A preliminary model to detect CSPH using MBT was developed with an area under the receiver operator curve of 0.88. Cutoffs were established to achieve 88% sensitivity and 85% specificity, with 10% indeterminate results.

management of this growing, complex patient population. We have a strategy in place to bring this innovative test to market with a potential product launch in 2020.” MBT is a noninvasive, point-of-care, breath-based test in which a patient drinks a half glass of a tasteless solution that is metabolized exclusively in the liver. The patient‟s exhaled breath is automatically collected and assayed with the BreathID system to measure the amount of a specific breakdown product of the solution, which reflects the rate of liver metabolism. In addition to detecting CSPH in NASH, MBT is being evaluated for use in monitoring patients with confirmed diagnoses of acute or chronic liver disease. For more information, visit Exalenz Bioscience.

Reference BREATHID Octanoate Breath Test With or Without Methacetin Breath Test for Correlation With Biopsy in NASH. (2017). Retrieved from https://clinicaltrials.gov/ct2/show/NCT02314026?cond=Breat hID+13C-methacetin+breath+test&rank=3 (Identification No. NCT02314026)

Allergy Testing Instrument Gets CE Mark

“Exalenz is committed to leveraging our proven BreathID platform to innovate new breath-based tests for a broad range of liver and gastrointestinal disorders,” says Raffi Werner, CEO of Exalenz Bioscience. “We are very encouraged by the results of these two clinical trials demonstrating that MBT effectively detects CSPH in NASH patients, which could give clinicians a novel noninvasive tool to improve the Hycor Biomedical, Garden Grove, Calif, has applied the CE mark to its Noveos allergy testing system, along with an initial

Microbioz India March 2018

Product News menu of total immunoglobulin E (IgE) and more than 100 specific IgE allergen reagents. Because the tests require only 4 µL of patient sample, they are suited for pediatric and geriatric sampling, where it may be more difficult to retrieve larger samples. Onboard reagents supply sufficient capacity for up to 8 hours of continuous testing. The system can support up to 75 tests per specific allergen and up to 140 allergens at any time. The system also uses standardized extracts to provide more consistent and accurate results. “We are excited to bring Noveos to market in the European Union,” says Fei Li, MD, PhD, president and chief executive at Hycor. “These breakthrough features underscore Hycor‟s commitment to drive immunodiagnostics into the future by offering the first new highly automated allergy platform technology in a generation.” According to Hycor, the company has plans to seek FDA premarket notification (510(k)) clearance. For more information, visit Hycor Biomedical.

WMFTG Unveils Tabletop Peristaltic Liquid Filling Machine The Flexicon PF7 peristaltic tabletop aseptic liquid filling machine from Watson-Marlow Fluid Technology Group (WMFTG), Wilmington, Mass, is designed for precision dispensing by weight or volume using the company‟s Accusil tubing. The PF7 is designed to work with such single-use fluid paths as asepticsu, thus removing the risk of cross contamination. Users can change the fluid path in less than 60 seconds. The PF7 comes programmed with recommended filling parameters. Users can adapt filling parameters to maximize accuracy for their application needs; up to 200 userprogrammable „recipes‟ can be stored and password protected for future use. A user interface, featuring large keys and a color display, aids operation. At the heart of all Flexicon systems is the low shear, gentle pumping action of peristaltic fillers, which ensure the product is transferred undamaged and with high precision. The machine offers repeatable filling of volumes from as low as 0.2 mL up to 250 mL, with accuracy better than ±0.5%, to prevent costly overfilling. For more information, visit Watson-Marlow Fluid Technology Group.

Disinfectant Spray Gets Approval to Kill C. Difficile Spores The US Environmental Protection Agency has approved Bleach-Rite spray from Current Technologies Inc, Crawfordsville, Ind, for killing Clostridium difficile spores on hard, nonporous surfaces in a 4-minute contact time. The spray is a hospital-grade disinfectant and cleaner, ready to use at the recommended 1:10 dilution of bleach. The bleach solution is stabilized for an extended shelf life, with the expiration date on every bottle. The spray can be used in clinical areas where there is a threat of contamination from C. difficile pores, including bathrooms and patient rooms. It is available in 16-ounce and 32-ounce spray bottles and 64-ounce and 1-gallon bottles. For more information: http://www.currtechinc.com/

Microbioz India March 2018