PINK MEDICO - November 2017

Estrogen Essence of

Feminity 5Waysto ControlDiabetes Electronic Health Record

Stem Cells for Cancer Treatment

MEDICAL TOURISM Strategy to Adopt

PINK MEDICO

Contents

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NEWS AND UPDATES • • • • •

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Indian doctor is the new WHO Deputy Director General Aravind Eye Hospital opens super speciality eye care centre in Chennai Intensified Mission Indradhanush launched by Honourable Prime Minister Fosun revises Indian drug maker acquisition Bharat Biotech’s next-gen typhoid vaccine....

ACCREDITATION Promoting Quality and Patient Safety

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MEDICAL TOURISM Strategy to Adopt:

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ESTROGEN THE MAIN FEMALE HORMONE, SHAPES THE UNIQUENESS OF A WOMAN’S BODY.

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MEDICAL EVENTS WORLDWIDE

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ELECTRONIC HEALTH RECORDS The development of electronic health records (EHR) and technology offers consumers and medical providers around the world a green, efficient and fast way to transport medical information from primary care providers to facilitators around the globe.

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Aventyn® Supports Intel® Health Application Platform with Next Generation Vitalbeat®

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5 WAYS TO CONTROL DIABETES

38

STEM CELL TRANSPLANT - FOR CANCER TREATMENT

People with certain types of cancer can sometimes be helped by a stem cell transplant to treat or even cure the cancer.

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Nov 2017

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NEW TECHNIQUE TO AID IVF EMBRYO SELECTION

Pink Medico

EDITORIAL TEAM: Executive Editor: Prakash Subramanian Consulting Editor: S S N Sastry DESIGN & DEVELOPMENT TEAM Creative Director: S Vidhyaa Prakash CORRESPONDENCES: Email: contact @pinkmedico.com Tel: 080 4959 0544 Cell: +91 88610 55444 Owner : Anarghyaa ETech Solutions Pvt Ltd Published By: Prakash Subramanian on behalf of Anarghyaa ETech Solutions Pvt Ltd No.29, SVS Plaza, 4th Main, Vinayakanagar, Hebbal Bangalore 560 024 Email: info@pinkmedico.com Web: www.pinkmedico.com Tel: 0804959 0544 Mobile: +91 88610 55444 Printed At: Omkar Printlab Pvt Ltd #504, East End Main Road, 9th Block, Jayangar Bangalore 560069

Disclaimer: All the details published in this magazine contain opinions, ideas and experiences of various writers, professionals and sources. It is intended to provide informative material on the subjects contained therein. It is sold or presented with the understanding that the members, managers, writers, publisher and Pink Medico are not engaged in providing medical or health or healthcare services, do not dispense, directly or indirectly, medical advice, or do not prescribe the use of any technique or products as a form of treatment for any medical or similar issues of any kind or nature whether physical, mental or otherwise, and do not recommend any of the product or services directly or indirectly. Pink Medico does not have any intention to provide specific medical advice, readers should not use any Content for diagnosing or treating a medical or health condition. If you have or suspect that you have a medical problem, you should contact your professional healthcare provider through appropriate means. You agree that you will not under any circumstances disregard any professional medical advice or delay in seeking such advice in reliance on any Content provided herein, reliance on any such Content is solely at your own risk. You should carefully read all information provided by the manufacturers of any products advertised or promoted before purchasing and/or using such productS.

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PINK MEDICO NEWS & UPDATES

NEWS & UPDATES 2

1 Indian doctor is the new WHO Deputy Director General

Dr Soumya Swaminathan, director-general of the Indian Council of Medical Research

(ICMR) and secretary to the department of health research, has been appointed the World Health Organisation’s (WHO’s) deputy directorgeneral, programmes, in Geneva.

This is the second-highest position at the UN agency.

The new WHO leadership team was announced by Director-General Dr Tedros Adhanom Ghebreyesus, who was elected to the post in May. “The team represents 14 countries, including all WHO regions, and is more than 60% women, reflecting my deep held belief that we need top talent, gender equity, and a geographically diverse set of perspectives to fulfil our mission to keep the world safe,” Ghebreyesus said.

Swaminathan, widely recognised for her research on tuberculosis, is a renowned paediatrician and clinical scientist. She will replace Dr Anarfi Asamoa-Baah of Ghana, who joined the WHO as a senior policy adviser to the director-general and had served as the assistant director-general of the communicable disease programme and the HIV/AIDS, tuberculosis and malaria programme.

Swaminathan is one of the three daughters of Dr M S Swaminathan, known as the father of India’s green revolution. Her mother Mina is an educationist, and as chairperson of the study group on the development of preschool children, had submitted a report that formed the basis of the Integrated Child Development Services.

Swaminathan brings with her a vast experience spanning over three decades in clinical care and research. She also worked with Unicef from 2009 to 2011 as coordinator of the Unicef/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) in Geneva.

She was also part of several WHO and global advisory bodies and committees, including the WHO expert panel to review global strategy and plan of action on public health, innovation and intellectual property, the strategic and technical advisory group of the global TB department at the WHO, and co-chair of the Lancet Commission on TB. She was also the director of the National Institute for Research in Tuberculosis, Chennai.

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Aravind Eye Hospital opens super speciality eye care centre in Chennai

M

adurai-based Aravind Eye Hospital has launched its first super speciality eye care centre in Chennai. With 500 beds exclusively for the underprivileged, treatment will be either free or at subsidised rates.

Hospital chief medical officer Dr Aravind said this would be the 12th hospital of the group.

“There is an increase in the number of patients visiting the hospital year-on-year in Madurai and other locations for speciality eye surgeries which are complex and to avail quality eye treatment at subsidised cost,” he said.

“The physical environment and infrastructure developed at Aravind-Chennai is a reflection of the values for which the organisation stands for - transparency, integrity, and compassionate care,” he added.

Pink Medico

Intensified Mission Indradhanush launched by Honourable Prime Minister

Prime Minister Narendra Modi on 8th Oc-

tober ‘17 launched an intensive immunisation drive from Gujarat’s Vadnagar, saying no child should suffer from any vaccine-preventable disease.

3

Through the ‘Intensified Mission Indradhanush’ or IMI, the government aims to reach every child below the age of two years and pregnant women still uncovered under the routine immunisation programme, an official statement said.

Under the IMI, a seven-day immunisation drive will be conducted each month from now till January 2018 in 173 districts and 17 cities, the statement said. These districts include 52 in eight northeastern states and 121 in 16 other states, it added.

The programme will cover low performing areas in the selected districts and cities.

The programme will focus on improving immunisation coverage in the districts and cities to ensure 90 per cent coverage for full immunisation by December 2018 instead of 2020, the statement said.

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Fosun revises Indian drug maker acquisition

China’s healthcare giant Shanghai Fosun Pharmaceutical (Group) Co Ltd announced it will pur-

chase an approximate 74 percent stake in Indian drug maker Gland Pharma for more than $1 billion. The stake’s size has been revised down in this new announcement, as the company made a deal to acquire an approximate 86.08 percent stake in Gland Pharma for no more than $1.26 billion last July. Gland Pharma’s founder shareholders wanted to maintain a higher stake in the company because of its good performance, Fosun Pharmaceutical said in its announcement.

Though it will still hold a controlling interest in Gland Pharma, Fosun said the new agreement will establish closer cooperation between the management teams of the two companies.

According to the announcement, the $1 billion deal also included a payment of no more than $25 million contingent on consideration for Gland Pharma’s Enoxaparin sales in the US market. Gland Pharma, as one of the world’s largest providers of injectable generic medicines, is India’s first injectable drugs manufacturer to be approved by the US FDA. Its revenue mainly

nies represented by Fosun Pharma and Gland Pharma will help promote the internationalization of Chinese pharmaceutical companies in R&D innovation and generic drug export,” Chen Qiyu, co-president of Fosun Group and chairman of Fosun Pharmaceutical, said in the announcement. For Gland Pharma, the partnership with Fosun Pharmaceutical will enable the company to contribute further to the Indian bio-tech market, accelerate its investment plans and create more jobs in India’s pharmaceutical industry, the Indian drug maker said in the announcement.

comes from the markets of the US and Europe. “China and India are complementary in the field of pharmaceuticals. The resource grafting of Chinese and Indian pharmaceutical compawww.pinkmedico.com

Nov 2017

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PINK MEDICO NEWS & UPDATES

5 Bharat Biotech’s next-gen typhoid vaccine

Hyderabad-headquartered vaccine-maker Bharat Biotech an-

nounced on October 2, that its “next generation typhoid vaccine, Typbar-TCV, has demonstrated its safety and efficacy in a high risk human challenge clinical study carried out at Oxford University.

What is very significant is the clinical studies produced 87 per cent effectiveness as per the trial results published in Lancet.”

A note issued by the company says: “Published in The Lancet, the study is the first to demonstrate that immunization with TypbarTCV is safe, well tolerated and will have significant impact on dis-

ease incidence in typhoid endemic areas that introduce the vaccine.

This study was conducted in 112 adult volunteers and used a “controlled human infection model”.Those within the industry see this

as an important development as the study points to the conjugate vaccine being superior to polysaccharide vaccine. The company says: “The trial led by Prof. Andrew Pollard, Director, Oxford Vac-

cine Group, was designed based on human infection models where many of the participants, mostly University students, were to consume a drink containing bacteria.The results of the trial clearly show

that the new Typhoid Conjugate vaccine gives significantly superior performance compared to the Typhoid Vi polysaccharide vaccine.”

The note from the company also says: “According the study pub-

lished in Lancet vaccine is safe, 100 per cent immunogenic, and prevents 55 per cent of typhoid infections in the challenge trial and up to 87 per cent of infections, when using real life definitions of typhoid fever. Efficacy data from this trial will help to fill a long existing knowledge gap regarding Vi-conjugate vaccines.”

Also, it says: “This data is highly significant since the currently available vi-ps typhoid vaccines cannot be administered to children below 2 years, and do not confer long term immunity. Typbar-TCV can be administered to children below 2 years of age and does confer long term immunity. Protection over a longer term reduces the need for repeat vaccinations.”

The company says: “The Product Summary File has been submitted to World Health Organisation for prequalification. WHO prequalification would allow for UNICEF to procure this vaccine for low-income countries where the disease burden is very high. TypbarTCV, it says, is currently licensed in India, Nigeria, and Nepal, with registrations underway in Malaysia, Turkey, Thailand, Uganda, Kenya, Bangladesh, Pakistan, Vietnam among 30 other countries.

Typhoid is caused by the bacterium Salmonella Typhi, and is responsible for around 20 million new infections and 200,000 deaths each year, mainly in South and South East Asia and Africa.

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PINK MEDICO NEWS & UPDATES Joseph Jimenez, Chief Executive Officer (CEO) of Novartis, has informed the Board of Directors of his desire to step down as CEO in 2018, after eight years in position. The Board of Directors has appointed Vasant (Vas) Narasimhan, M.D., Global Head of Drug Development and Chief Medical Officer, as CEO of Novartis, effective February 1, 2018. Dr. Narasimhan is a member of the Executive Committee and joined Novartis in 2005.

Dr. Narasimhan has held numerous leadership positions across Novartis in commercial, drug development and strategy roles. Prior to his current role he served as Head of Development for Novartis Pharmaceuticals. Before joining Novartis in 2005, he worked at McKinsey & Company. He received his medical degree from Harvard Medical School in the US and obtained a master’s degree in public policy from Harvard’s John F. Kennedy School of Government. In addition, he holds a bachelor’s degree in biological sciences from the University of Chicago, also in the US. During and after his medical studies, he worked extensively on a

DR. VASANT NARASIMHAN

range of health issues in developing countries. Dr. Narasimhan is an elected member of the US National Academy of Medicine.

Philips India, announced the appointment of Daniel

Mazon as Vice Chairman &

DANIEL MAZON

Managing Director for India subcontinent, effective from 3rd October, 2017. In his new role, Daniel will be responsible for driving the overall growth for Philips businesses in India, while focusing on customers and operational excellence.

Daniel is a seasoned leader with close to two decades of work experience in the healthcare industry.Commenting on his new role at Philips India, Daniel said, “I am thrilled to join Philips India at a time when the company is responding to the country’s toughest challenges of providing a healthy lifestyle and affordable access to healthcare. We have the right focus on innovation and the technological capabilities to make this happen and you will see Philips India playing a big role in transforming this great country. I am excited to join a highly capable team which understands our clients and consumers needs and is focused on delivering the right solutions. Going forward, we will work closely to sharpen our offerings while strengthening relationships with the government and key partners”.

Nightingales to raise $20 mn for Expansion

M

edwell Ventures-owned Nightingales Home Health Services plans to take the home

healthcare services to newer markets and strengthen presence in existing cities. From single-city operations in Bengaluru, Nightingales has now expanded to Hyderabad, Mumbai and Pune. The company will launch operations in Chennai this year, enter national capital region by early 2018 and Kolkata by mid-2018. Nightingales which has raised $21 million in the last 3 ½ years is looking at raising $20 million in future to meet its growth needs.

The company is piloting technology-led patient monitoring services in Hyderabad and Mumbai that will use internet of things (IoT) devices..

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Pink Medico NEWS & UPDATES Nightingales is looking at acquisitions in the

Neuberg Diagnostics, Combined Diagnostic

home healthcare space primarily candidates that will bring to the table new geographic advantage or have expertise in specific dis-

Expertise of 5 Leading Labs Launched in Bengaluru

ease categories The company that has four branches in Hyderabad is planning for further expansion including exploring partnerships with existing hospitals in the city. It has tied up with Citizen’s Hospital..

Lalit Pai, co-founder, Medwell Ventures, and CEO, Nightingales, “We are actively involved in product development that includes creation of protocols, techniques, training and standard operation procedures (SOPs) in the areas of ophthalmology and dermatology.

We are using latest technologies and devices to bring comfort and care to patients. We have deployed functional electrical stimulation (FES) devices that help in reducing impairments and increase daily functional activities in patients with neurological diseases or injuries.”

In a first-of-its kind step in consolidating the fragmented diagnostic sector of

Supratech Micropath, Ehrlich lab, Global

the country, four nations joined hands

labs and Minerva Labs, which have already

to form first global Pathology Labora-

made their presence in their respective

tory

Consortium-

Neuberg Diagnos-

tics- launched recently in Bangalore.

countries and states such as Karnataka, Gujarat, Tamil Nadu, South Africa & UAE.

Founded by the renowned healthcare entrepreneur, Dr GSK Velu, the international alliance brings together leading laboratories from India, Sri Lanka, South Africa and UAE under one umbrella, positioning it among the top laboratory chains of the country from the day of its inception, both in footprints and revenue.

Neuberg will have 3 world class global reference laboratories located in Bangalore, Ahmedabad, and Durban (South Africa) carrying out advanced range of testing using new generation In vitro diagnostics techniques along with total lab automation & big data analytics tools supported by robust world-class laboratory information system.

Neuberg Diagnostics (Neuberg literally translates to New City or New Neighbourhood apart from also being the namesake in honor of the Father of Modern Biochemistry, Carl Neuberg), was conceived with the goal to erase geographical borders and make the world of healthcare one, bringing advanced diagnostics affordable to people across the globe.

The conglomerate, which has a combined diagnostic expertise of over two centuries, is an alliance of top laboratories like Anand Diagnostic Laboratory,

The global brand was launched in the presence of the esteemed guests, Ms. Anupriya Patel, Minister of State in the Ministry of Health and Family Welfare, Government of India, Dr Rajitha Senaratne, Minister of Health, Nutrition & indigenous Medicine, Sri Lanka, Dr Awatif Juma al Bahar, Medical director of Dubai Health Authority, UAE and Prof. Salim S Abdool Karim, Director of CAPRISA & Pro vice-chancellor, University of KwaZulu-Natal in Durban, South Africa .

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Nov 2017

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PINK MEDICO

ACCREDITATION

PROMOTING QUALITY AND PATIENT SAFETY

H

Accreditation can be the single most important approach for improving

ospital accreditation is gaining prominence due to globali-

zation efforts and especially trading in health services. It will eventually become a tool for international categorization and recognition of hospitals. Hospital accreditation by a recognized quality certifier is an increasingly important way for hospitals to demonstrate their clinical expertise and commitment to quality and patient safety. The choice of ISO 9001 principles as the managementsystem model for hospitals is not accidental. The continual improvement requirements which are the core of that standard make it the preferred quality system around the world adopted by complex businesses of all types. This emphasis on continual improvement is also congruent with emerging trends that show hospitals adopting so called “industrial� quality management concepts borrowed from other sectors, among them Aviation, methodologies that include Lean and Six Sigma, And naturally, once hospital migrate to the more advanced quality management principles. It is important that countries introduce their own standards for accreditation based on the best interests of their health system in order to safeguard primary health care

the quality of health care structures. In an accreditation system, institutional resources are evaluated periodically to ensure quality of services on the basis of previously accepted standards. Standards may be minimal, defining the bottom level or base, or more detailed and demanding. Accreditation is not an end in itself, but rather a means to improve quality.

The accreditation movement is gaining prominence due to globalization and especially the global expansion of trade in health services. It will eventually become a tool for international categorization and recognition of hospitals.

When implemented appropriately, accreditation can strengthen the fundamental leadership and steering role of national health authorities.

Objectives of hospital accreditation: Continuous quality improvement: Using the accreditation process to bring about changes in practice that will improve the quality of care for patients.

principles of universality, equity, quality, efficiency and sustainability.

Informed decision-making:

Establishing national accreditation systems according to the re-

Providing data on the quality of health care that various stakeholders, policy-

gional guidelines will help to ensure that hospitals, whether public or private, national or expatriate, play their expected roles in national health systems.

Improved accountability and regulation:

Accreditation can be the single most important approach for improving the quality of health care structures 14

Nov 2017

makers, managers, clinicians and the public can use to guide their decisions.

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Making health care organizations accountable to statutory or other agencies, such as professional bodies, government, patient groups and society at large, and regulating their behaviours to protect the interests of patients and other stakeholders.

Under the Patronage of H.H. Sheikh Ahmed bin Saeed Al Maktoum, President of Dubai Civil Aviation Authority, Chairman of Dubai Airports, Chairman and Chief Executive of Emirates Airline Group

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ENABLING COMMUNITIES INTEGRATING LIVES Held from 9-7 November 2017 at the Dubai International Convention & Exhibition Centre, AccessAbilities Expo aims to bring the world’s latest robotic and assistive technology products under one roof with the goal of enhancing lives of more than 700 million people with disabilities worldwide of whom over 50 million reside in the Middle East. AAE is committed to supporting Government and Private Sector initiatives toward accessibility in education, transportation, public services and equal opportunities to persons with disabilities.

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SPORTS AREA

Sports Zone organised in partnership with Dubai Club for Disabled where regular kids work together with kids with disabilities to play different games, explore physical challenges and compete with other team across different sports activities

KNOWLEDGE CENTER

‘Free-to-attend’ series of seminars and workshops by presenting what is new and relevant to the industry professionals and other event attendees

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PINK MEDICO MEDICAL TOURISM

MEDICAL TOURISM Strategy to Adopt

ADAPTING TO THE CHANGES IN THE MEDICAL TOURISM INDUSTRY 16

Nov 2017

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Pink Medico

M

edical tourism has gone through its early growing pain and has developed into a large

and viable medical option for global travelers from countries around the world. The medical tourism market offers big industry opportunities for providers willing to take the time and make the effort to create sustainable, patient-centered resources that meet the needs of medical patients.

In order to do this, we also have to understand the growing competition between countries around the world, which currently involves over 20,000 providers in 60 countries competing for the same medical tourism. Due to this, the industry is currently facing a critical challenge of more supply than demand, which creates a highly competitive marketplace.

Under these circumstances, the medical service providers must research and understand their specific market viability before providers can reap the full potential of medical tourism The medical tourism market is extending beyond the needs of early adopter’s market to the mainstream market, which requires special attention and focus to gain a competitive edge.

As little as five years ago, medical tourism offered opportunities, though such opportunities offered often incomplete solutions to medical travelers. Today, the medical tourism market is changing. Healthcare consumers are becoming more educated, exploring the available global choices and looking for more structured environment, which offers knowledgeable people, seamlessly integrated processes, along with cutting edge technologies, research and medical developmental methodologies and tools when it comes to their medical care.

To attract these new mainstream customers one must take the time to learn, adopt and align your products and services to meet their needs. As medical providers enter the next phase of medical tourism, it’s essential to understand the different demands of every individual. Patient-centered care requires open communication, transparency in pricing and communication, technologies and procedures, and careful research and development when it comes to wining patients.

“There is growing competition between countries around the world, which currently involves over Medical tourism” www.pinkmedico.com

Nov 2017

17

PINK MEDICO Following the patient through the medical

is the difference between success and failure

contacting a provider, to arranging important

care process, from point of contact to post

today.

documentation such as visas and passports,

treatment or surgical caremay also require

processing medical records and accessing

the use of electronic medical record (EMR)

Understanding the customer, their concerns,

multiple and sometimes-complex informa-

technology involving telemedicine, docu-

and their focus directly affects sales efforts

tion systems and language barriers in other

mentation and report transactions facilita-

by providers. Consultation and easy yet con-

countries.

tion, telemedicine conferences, and longdis-

fidential transfer and sharing of medical in-

tance pre and post operative care offered to

formation is essential whether patients are

Understand your patient. Establish a foothold

each and every individual patient. Doing so

looking for traditional surgical procedures or

in the mainstream market. Focus on details

ensures a complete solution to a medical

taking advantage of the growing field of tel-

and demands of the consumer market, with

situation and encourages positive feedback

emedicine.

sustainable medical options and a willingness

and excellent customer satisfaction, not only

to adapt services to meet the needs of poten-

with medical care provided, but also with

The development of electronic medical re-

tial patients. Find your consumer market, sell

care, attention, and courtesy provided by

cords (EMR) and technology offers consum-

them a specific product, and profit by your

the medical provider facilitating the entire

ers and medical providers around the world

concept. Nurture relationships and ensure

process.

a green, efficient and fast way to transport

complete customer satisfaction in services.

medical information from primary care proIn order to be competitive in this growing

viders to facilitators around the globe. Confi-

Select the right marketing channel that meets

market place, medical providers must pro-

dentiality and security of such information is a

your needs, which will enable you to reach

vide transparency in information. Medical

concern to medical consumers and facilitators

your business goals. Create a distinct message

consumers want to know about:

regardless of their origins are destinations.

that attracts customers, nurture communication through multi-touch and multi-mode

• Surgical Procedures in Detail

Electronic records help boost efficiency in

strategies. Patient-centered care requires

health care delivery options and offer in-

open communication, and transparency in

• Price Ranges for Surgeries with Upfront

creased use of telemetry, an increasingly

pricing and communication.

Pricing

popular mode of communication between

• Travel Packages for Consumer Viewing

patient providers, regardless of location. For

Define your customer value proposition. De-

example, a cardiac specialist in Rochester,

velop your own identity. Define how consum-

New York, may discuss patient care with phy-

ers will perceive your organization - whether

• Issues Regarding Airport Arrival and

sicians in India, sharing information found in

you offer best product, best total solution, or

Departure

patient’s records including but not limited to

best cost. The mainstream consumer relates

images and other valuable data. Telemetry

to a distinct identity, which separates them

engaged live conference calls that may or

and gives competitive edge in their category

may not include the patient himself.

class.

Medical providers and facilitators around the

Stay competitive in today’s market. Integrate

world should be ready, willing and able to

the people, processes and systems involved

inform consumers regarding accumulation

in the tourism market by tailoring sales and

The Internet offers medical travelers from

of health information, how such information

marketing strategies to meet the needs of the

every corner of the world access to the

will be disseminated, and openly and hon-

customer, not the other way around.

availability, technology, and credentials and

estly answer questions or concerns regarding

qualifications of surgeons, facilities, and

confidentiality, security, effectiveness, and

The bottom line is to communicate with

other health care providers with the click of

quality healthcare protocols in regard to such

your customers. Communication is essential.

a mouse. Generation X and Generation Y

transfers. EMRs are the future of medical in-

Without communication, your marketing ef-

demand and expect transparent informa-

formation and recording.

forts will fail. When it comes to crossing the

• Transportation to and from Hospital • Access to Local Amenities and Sightseeing • Language Issues/Translators

tion models. They know how to access in-

chasm creating the best in healthcare delivery

formation and have grown accustomed to

In this respect, it takes a well-defined and

systems abroad, communication was, is, and

it. Therefore, access to such information,

workable team of providers to cross multiple

will continue to be the foundation of your ef-

resources and access to medical providers

gaps in the medical tourism process, from

forts.

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Nov 2017

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ESTROGEN - THE MAIN

ESTROGEN

PINK MEDICO

FEMALE HORMONE, SHAPES THE UNIQUENESS OF A WOMAN’S BODY. E

strogen ignites the physical transformation from childhood to

womanhood, regulates, along with pregesterone, the menstrual cycle, keeps the vagina lubricated and generates the proper womb environment for implantation and nourishment of the early embryo. it maintains bone density and skin elasticity, protects the brain and the cardiovascular system. While the ovaries stop releasing viable eggs at

menopause, the body’s need fro estrogen never stops and the body tries to make estrogens in other tissues and organs - the skin, the liver and fat tissue for example. Estrogen is necessary for healthy living.

Estrogen is primarily formed in the ovaries and is a combination of three compounds - Estrone (E1), Estradiol (E2) and Estriol (E3). For

much of a woman’s life, estrogen fluctuates up and down. This occurs within the monthly cycle and also within the general framework of a life time. It peaks in young adulthood and ebbs with the years.

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Pink Medico

controls ovulation.

Estrogen increases and decreases depending on the changes occurring in women through-

•

only produced in significant quantities dur-

Protects pregnancy by regulating progesterone levels

sleep, mental fogginess and emotional insta-

•

It kick-starts one of the major process of fetal maturation, without it a fetus lungs, liver and other organs and tissues cannor mature.

ing pregnancy. During menopause, ovarian secretion of estrogen and progesterone ends. Although the ovaries stop producing estrogen, they still continue to produce small amounts of male harmone testosterone, which can be converted to estrogen in body fat. In addition the adrenal gland continues to

nal discomfort.

•

tion, pregnancy and menopause.

that decrese after menstruation; estriol is

Headaches, migraines and gastrointesti-

Some of the above reactions occur nearly si-

out their life starting from puberty, menstrua-

The body maintains high level of estrogen

•

Prepares the uterus every month for possible conception and causes lining of the uterus to thicken during the menstrual cycle.

•

Low estrogen levels causes miscarriage

•

Estrogen stimulates the growth of the vagina to its adult size

•

multaneously whenever the estrogen levels falls. Most notable are hot flashes, inability to bility.

In addition to monthly cycle and age related fluctuations, the following can cause symptoms related to an increase in estrogen: •

Use of birth control pills

Estrogen stimulates growth of breast tissues

•

Hormonal replacement with higher level of estrogen than needed

produce androstenedione - a male hormone

•

It boosts sex drive in women

which is converted estrone and estradiol in

•

Fertility injections

•

It protects against cardio vascular diseases

•

The presence of benign ovarian cysts.

•

Estrogen affects the liver cells to reduce bad LDL and increase good HDL

If you take too much estogen, or if your natu-

•

It maintains good calcium level in bones

ral level is too high, or if the estrogen is not

the body fat. The total estrogen produced after menopause is far less than that produced during a women’s reproductive years.

properly balanced with adequae progester-

During the pregnancy there is a dramatic rise

one, the lining of the uterus will thicken. In

in the levels of estrogen compounds. Most significant is teh rise in estriol. This repro-

For much of your life, estrogen fluctuates up

response the uterus will contract inducing the

ductive mode generates extra progesterone

and down. The degree and pattern of fluctua-

bleeding and sensation of pain or cramping in

which acts as further protector against the

tions are totally unique. So too are the ways

the lower pelvic area.

aggressive estrogens. Indeed the overall bal-

the body reacts to the episodes of deficien-

ance of elevated hormones during pregnancy

cies and excesses created by these fluctua-

offers considerable protection for the female

tions. Following are symptoms of deficency:

body. Research amply shows that the more

Estrogen levels falls after menopause or when woman stops mentruating. This is when women know that they are entering a

full-term pregnancies a woman has in her

•

Forgetfullness

life, the lower the risk of developing breast

•

Depression or Anxiety

•

Mood swings

•

Hot flashes or Temperature Swings

There are three general categories of meno-

of women choosing birth control and fewer

•

Reduced stamina, Fatigue

pause: Onset Menopause, Mid-menopause

pregnancies over the historical pattern of

•

Dry eyes, skin and vagina

multilple childbirth.

•

Sagging of breasts and loss of fullness

•

Weight gain

•

Increased back and joint pain

and ovarian cancer, endometriosis, cysts and fibroids. In a way these conditions can be viewed as modern female diseases, a result

The Function of Estrogen in Women: •

It prepares the girl’s uterus and ovaries for puberty

•

Estrogen levels naturally increases during puberty in order to regulate many processes related to pregnancy.

•

It regulates menstruation in women and

new stage in their life, which is menopause accompanied by some health problems.

and Late Manopause.

“Estrogen is the Essence of Femininity. It makes you feel sensual” www.pinkmedico.com

Nov 2017

21

PINK MEDICO

Onset Menopause:

Estrogen Therapy:

This category refers to the first few years of menopause, where women still experience large fluctuations from time to time, yet less frequently than during perimenopause. There is no menstual cycle.

Estrogen therapy is used to treat certain conditions, such as delayed onset of puberty and menopausal symptoms such as hot flashes and symptomatic vaginal atrophy. Vaginal atrophy is a condition in which low estrogen levels cause a woman's vagina to narrow, lose

Mid-menopause: This category refers to the next five years of menopause, that is women who are three to eight years into the change. Estrogen fluctuations still occur but they are minimal.

flexibility and take longer to lubricate. Female hypogonadism, a condition in which the ovaries produce little or no hormones, as well as premature ovarian failure, can also cause

This category includes women over sixty years of age. They have been in menopause for ten to fifteen years or more. They have been barely any fluctuations in their estrogen.

Some women breeze through menopause, experiencing some loss of breast fullness, dryness of vagine and wrinkling of the skin but none of the changes that make life miseralbe for many others. For some women relatively higher level of estrogen at this stage of life implies the existence of estrogen dominance. Remember there is no progesterone in the body to balance estrogen, which can cause threatening imbalance that could lead to endometrial cancer and or long term effects on women’s health.

If you are in this situation, you have to consult Gyneacologist for pelvic ultra sound and estogen blood level test. If the ultrasound is negative which means there is no thickening of endometrium - you need not worry. Thickening of tissue should be evaluated further as this could possibly be a precancerous condition.

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Symptomatic menopause

Delayed puberty: Delayed puberty can result from a variety of disruptions to normal hormone production, including central nervous system lesions, pituitary disorders, autoimmune processes involving the ovaries or other endocrine glands, metabolic and infectious diseases, anorexia or malnutrition, exposure to environmental toxins and over-intensive athletic training.

vaginal dryness, breast atrophy and lower sex drive and is also treated with estrogen.

Late Menopause:

•

For many years, estrogen therapy and estrogen-progestin therapy were prescribed to treat menopausal symptoms, to prevent osteoporosis and to improve women's overall health. Some uses of hormone therapy include the following situations:

Signs of delayed puberty include: •

Lack of breast tissue development by the age of 13

•

No menstrual periods for five years following initial breast growth or by age 16

Irregular menstrual periods: Once a medical evaluation finds that there

•

Delayed puberty

is no other serious cause of your irregular

•

Contraception

cycles, oral contraceptives or cyclic proges-

•

Irregular menstrual cycles

terone may be used to regulate your cycle, assuming there is no reason you can’t use

Pink Medico

the medical complications that may develop

not reached menopause. This increased risk

in postmenopausal women can be lessened

for cardiovascular disease may be related to

or even avoided by taking steps to lead a

declining estrogen levels, but in light of other

healthy lifestyle.

factors, postmenopausal women are not ad-

Regular exercise can help protect against car-

vised to take hormone therapy simply as a

diovascular disease as well as osteoporosis,

preventive measure to decrease their risk of heart attack or stroke.

Proper nutrition and smoking cessation will reduce the risk of cardiovascular diseases.

Effects of menopause on chronic medical conditions: Osteoporosis: It is the deterioration of the quantity and them. Polycystic ovarian syndrome is a com-

quality of bone that causes an increased risk

mon cause of irregular menstrual cycles.

of fracture. The density of the bone (bone mineral density) normally begins to decrease

Contraception: Oral contraceptives containing estrogen are one of the most popular methods of fertility control in the United States. Other hormonal methods include some types of intrauterine devices (IUDs), the patch and an intravaginal ring.

in women during the fourth decade of life.

However, that normal decline in bone density is accelerated during the menopausal transition. As a consequence, both age and the hormonal changes due to the menopause

Your diet can also help you get through men-

transition act together to cause osteoporosis.

opause:

The process leading to osteoporosis can operate silently for decades. Women may not

Menopausal Symptoms:

be aware of their osteoporosis until suffering

Declining or fluctuating levels of estrogen and

a painful fracture. The symptoms are then

other hormones such as testosterone may begin as early as the late 30s. These hormonal changes trigger many of the physical and emotional changes associated with the transition to menopause. Of course, menopause is a life stage, not a disease, but symptoms associated with menopause can be bothersome and concerning for some women.

Lifestyle factors in controlling the symptoms and complications of menopause Many of the symptoms of menopause and

related to the location and severity of the

Eat foods high in plant estrogens -- such as soy beans and soy milk. Some research suggests soy may ease symptoms such as hot flashes.

fractures.

•

Cardiovascular disease:

•

Prior to menopause, women have a de-

•

and flaxseed oil may also help.

menopause, however, a women’s risk of cardiovascular disease increases.

Raise your calcium intake -- to 1,000 to 1,500 mg a day Do regular weight-bearing exercise to avoid osteoporosis and maintain gen-

creased risk of heart disease and stroke when compared with men. Around the time of

Nuts and seeds, fennel, celery, parsley,

eral good health.

•

An extract of black cohosh is thought to reduce symptoms without causing the problems associated with estrogen.

Coronary heart disease rates in postmenopausal women are two to three times higher than in women of the same age who have

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23

PINK MEDICO

MEDICAL EVENTS Pan Arab Orthopaedic Congress 2017: 1-4 Nov 2017 in Amman, Jordan The 20th edition of Annual Congress of the Pan Arab Orthopaedic Association dedicated to Orthopedics on Pediatric, Trauma, Spine, Shoulder and elbow etc.

Tel.: +8448 461 6 962, Fax: +4-4618558 6 962 E-mail: info@jordan-valley.com ; Website: www.jordan-valley.com

Mena Physical Medicine & Rehabilitation Congress: 2 - 4 Nov 2017 in Dubai, UAE It will cover various areas in Rehabilitation and Physical Medicine including Stroke Rehabilitation, Cardiac Rehabilitation, Sport injuries, Paediatric Rehabilitation, Ambulatory Rehabilitation, musculoskeletal rehabilitation Website: www.menaphysicalrehab.com Email: info@menaphysicalrehab.com, Tel: +971 4 361 9616

Access Abilities Expo 2017: 7-9 NOV, 2017 in Dubai, UAE. Access Abilities Expo is dedicated for the products, services and technologies related to disabilities and rehabilitation sectors.

Contact: Reed Exhibitions Middle East, Post Box 77899, Abu Dhabi, UAE Tel.: +971-2-4917615, Fax: +971-2-4917612.

E-mail: info@reedexpo.ae, Website:www.accessabilitiesexpo.com Gulf Medical Expo 2017: 7 - 9 Nov 2017 in Bahrain, By bringing together an international group of Healthcare industry professionals, this key event will aid exhibitors from different parts of the world considering who are investing their healthcare businesses in the Middle East and using its strategic location to enhance their image Tel: (+973) 1740 4023, Email info@atexinternational.com Website: www.gulf-medexpo.com Mena Pharmaceutical Manufacturing Congress: 14-16 Nov 2017 in Jeddah, Saudi Arabia Gain knowledge at MENA Pharmaceutical Manufacturing Congress on the innovative strategies driving the growth of the pharma manufacturing in the MENA region & leading the industry towards excellence.

Contact: P.O.BOX 939513, Dubai, United Arab Emirates Website: www.pharmamanufacturingmena.com, Tel: +971 4 361 9616 Kerala Health Tourism 2017: 17 18 Nov 2017 Calicut, Kerala International Conference and Exhibition on health tourism wih the theme = “Your Destination of Good Health“, highlighting on the emerging trends, opportunities and changes in the Indian health tourism arena.

Email: gitanjali@cii.in, Tel: 0484 4012300, Website: www.keralahealthtourism.in 24

Nov 2017

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Pink Medico

INDOMEDICARE EXPO 2017 28 - 30 Nov 2017 in Jakarta, Indonesia The 10th International Exhibition on Medical, Dental & Hospital Equipments, Medicine, Health Care, Supplies & Services Contact: Krista Exhibitions, Jl. Blandongan No. 28, 11220 Jakarta, Indonesia.

Tel.: +62216334581, Email: ketty@kristamedia.com, Website: www.indomedicare.com

MedEx 2017: 30 Nov - 2 Dec 2017 in Yangon, Myanmar MEDEX’l 7 will host the Myanmar Medical & Pharmaceuticals Seminar 2017 which will address the key issues in improving the quality of health care and the introduction of new innovations, advances and technology.

Contact: AMB Tarsus Exhibitions (Myanmar) Private Ltd. , Unit 805, Hilltop Condo, Hnin Si Gone Rd, Ahlone Township Yangon, Myanmar.

Website: www.medicasia.org Tel & Fax: 95 1 254765 MediPharm Expo 2017: 7-9 Dec 2017 in Hanoi, Veitnam The 24th edition of Vietnam International Medical, Hospital and Pharmaceutical Exhibition Contact: VINEXAD, 9Dinh Le St., Hanoi, Vietnam.

Tel.: +84-4-3825-5546, Email: medipharmexpo@vinexad.com.vn Website: www.hn.medipharmexpo.com

Nepal Medical Show 2017: 14-16 Dec 2017 in Kathmandu, Nepal The 2nd edition of international exhibition on Medical, Hospital, Surgical, Medical Devices and Diagnostic Instruments and Consumables Tel.: +91-11-47034600/ 43003757, Email: satish@sdpromomedia.com Website: www.nepalmedicalshow.com

Algeria Health Expo 2017: 4 - 7 Dec 2017 in Algeria Algeria Health is a premier event for local and international manufacturers, suppliers, distributors and service providers in the medical and pharmaceutical industries.

Tel: +971 4 424 9988, Fax. +971 4 374 6014, Email info@atexinternational.com Website: www.algeriahealthexhibition.com

www.pinkmedico.com

Nov 2017

25

PINK MEDICO

Why 2017 is a landmark year for the medical device industry in India?

By: Mr. Peeyush Gupta, director, sales and marketing, UL South Asia

After an uphill battle for recognition, India’s medical device sector was greeted by a landmark announcement in the Union Budget 2017. In his budget speech, India’s Finance Minister Arun Jaitley declared that the government would formulate new norms, ‘harmonized with international rules’, for the medical devices sector. This would attract more foreign investment and reduce prices of medical devices, the minister stated. Barely a day after the budget announcement, the Ministry of Health and Family Welfare released a media statement that it had notified the Medical Device Rules 2017 on Jan 31, which would be enforceable from January 2018.

Regulator finally gets a shot in the arm Often quoted as the ‘pharmacy of 26

Nov 2017

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the world’, India has struggled with an ambiguous and archaic regulatory framework for the medical devices sector. Medical devices, 75% of which are imported, are currently treated as drugs under the Drugs and Cosmetics Act. Without legislative backing, the regulator – Central Drug Standard Control Organization – was helpless to curb both the flood of substandard imports as well as the production of poor quality medical devices in the country.

The rules, framed around the guidelines of the Global Harmonization Task force (GHTF) ensure that the Indian norms governing medical devices are on par with those in vogue globally. Medical devices, henceforth, both produced and imported, will conform to the best international practices of manufacturing, ensuring the prevalence of

quality products in India. It needs to be pointed out that India is one of the last few countries that lack a strong device regulation; most of the western world and Asia have had such regulation for decades.

To support the regulator in assessing the capabilities of the manufacturers in this massive regulatory transformation, the Rules allow the participation of third party assessment and certification for Class A (low risk) and Class B (low moderate risk) devices. This call for participation of third party bodies, a feature of regulatory mechanism in the US and Europe, is a sure mark of maturity of the Indian standards system, which was lagging behind even developing countries like China and Brazil.

Pink Medico

Why this is good for the manufacturer Even as the government is making serious efforts to boost domestic manufacturing of medical devices, through the development of manufacturing parks, for instance, the lack of distinct identity for the medical device industry has acted as a substantial deterrent to the expansion of the sector. India is a vibrant ecosystem of MNCs, SMEs and start-ups that are not competing within India for the best quality products, but contending internationally as well.

By establishing a common minimum standard and uniformly calling for changes in manufacturing processes in accordance with global norms, the newly formulated Medical Device Rules will create a level playing field for the industry. Though a tendency for protectionism is expressed by a certain section of the manufacturing community on account of the additional costs that would be incurred to redesign their processes to meet regulatory requirements, it is vital for the industry to embrace the new regulations, as it would help them become globally competitive and enable them to attract foreign investment to funnel their growth.

Consumers get their due The positive policy push for the development of the domestic medical device market, although tardy, has not come at a completely inappropriate time in the industry’s growth trajectory in India. In terms of market size, as the sector is still at very nascent stage – the total medical device consumption in the country at present is to the tune of $5.8 billion.

Considering the country’s the 1.2 billion plus population, the penetration of medical devices into healthcare sector is very minimal, especially in comparison to similar economies, such as China, Korea or Japan. The industry woes aside, an alarming threat to patient safety is the fact that only 22 of 10,000 types of medical devices in use in the country are regulated. By potentially bringing more devices under its ambit, the new Medical Device Rules will bring in a huge wave of relief to consumers, protecting their right of access to high quality and safe products.

As the fastest growing healthcare market in the world, the government can further take several measures to create a conducive environment to consolidate the growth of the medical devices sector. For instance, in their reaction to the Budget, industry associations have pointed out that

the government has failed to tackle the high import duties, which prevent access to innovative and better quality devices to improve patient care in the country. The government should also work toward creating an autonomous body to oversee the regulatory framework for medical devices, along with a dedicated registry that tracks individual instances where a particular device has failed or led to detrimental consequences on life or property. Lastly, as an important measure to encourage compliance to safety standards among stakeholders in the industry, the government could provide incentive schemes for the industry to adopt safety norms through cross subsidies in procurement policies.

With new rules in place, the medical devices sector can catalyze the ‘Make in India’ platform to leapfrog into a stable, affordable and most importantly, patient safety-compliant future. The government’s intent to harmonize Indian medical device rules with global norms will create a dynamic, yet robust standards ecosystem for the industry, boost domestic manufacturing and usher in, as the government hopes it will, greater foreign investment in the sector.

“After an uphill battle for recognition, India’s medical device sector was greeted by a landmark announcement in the Union Budget 2017” www.pinkmedico.com

Nov 2017

27

FREE ENTRY

“DELIVERING EFFECTIVE SOLUTIONS FOR QUALITY HEALTH SERVICE”

MEDEX‘17 �/medex expo

www.medicasia.org

MYANMAR’S OFFICIAL INT’L MEDICAL & PHARMACEUTICALS EQUIPMENT & SUPPLIES EXHIBITION

23-25 NOVEMBER 2017

MEP MINDAMA, YANGON

17

MYANMAR’S NO.1 INTERNATIONAL LABORATORY & INSTRUMENTATION TECHNOLOGY SHOW For more information on participating or visiting, Contact : Ms. Thiri at thiri@ambtarsus.com / +959254277417 Ms. Thu Thu at thuthu@ambtarsus.com

�/myanlab expo Co-located with

MEDI ALTOURISM NOVEMBER 2017 MEP MINDAMA, YANGON ASIA’17 23-25 MYANMAR NO.1 INTERNATIONAL MEDICAL TOURISM EXHIBITION

hosted by:

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Pink Medico

New 'smart' nanoparticles may help treat cancer: study

S

cientists have developed 'smart' self-regulating nanoparticles which heat up to a temperature high enough to kill cancerous cells, while too low to harm the healthy tissue.

The self-stopping nanoparticles developed by researchers from the University of Surrey in the UK could soon be used as part of hyperthermic-thermotherapy to treat patients with cancer, researchers said.

Thermotherapy has long been used as a treatment method for cancer, but it is difficult to treat patients without damaging healthy cells.

However, tumour cells can be weakened or killed without affecting normal tissue if temperatures can be controlled accurately within a range of 42 to 45 degrees Celsius.

"This could potentially be a game changer in the way we treat peo-

ple who have cancer," said Professor Ravi Silva, Head of the Advanced Technology Institute at Surrey.

low in toxicity and are unlikely to cause permanent damage to the body, researchers said.

"If we can keep cancer treatment sat at a temperature level high enough to kill the cancer, while low enough to stop harming healthy tissue, it will prevent some of the serious side effects of vital treatment," said Silva.

"Magnetic induced hyperthermia is a traditional route of treating malignant tumours," said Wei Zhang, associate professor at Dalian University of Technology.

Scientists, including those from the Dalian University of Technology in China, created the nanoparticles which, when implanted and used in a thermotherapy session, can induce temperatures of up to 45 degrees Celsius.

The zinc-cobalt-chromium (ZnCo-Cr) ferrite nanoparticles produced for the study published in the journal Nanoscale are selfregulating, meaning that they selfstop heating when they reach temperatures over 45 degrees Celsius.

The

nanoparticles

are

also

"However, the difficulties in temperature control has significantly restricted its usage.

"If we can modulate the magnetic properties of the nanoparticles, the therapeutic temperature can be self- regulated, eliminating the use of clumsy temperature monitoring and controlling systems," Zhang said.

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29

ELECTRONIC PINK MEDICO

HEALTH RECORD THE DEVELOPMENT OF ELECTRONIC HEALTH RECORDS (EHR) AND TECHNOLOGY OFFERS CONSUMERS AND MEDICAL PROVIDERS AROUND THE WORLD A GREEN, EFFICIENT AND FAST WAY TO TRANSPORT MEDICAL INFORMATION FROM PRIMARY CARE PROVIDERS TO FACILITATORS AROUND THE GLOBE.

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Pink Medico

H

ealthcare records are a valuable resource for the healthcare industry because of the information they contain. The ones predominantly in use today are the electronic health records or EHRs. They are stored with, at the very least, lab results, diagnostic imaging results, and hospital visits.

The EHRs were implemented to serve two primary purposes of giving easy access to patient medical records and keeping those records private. As more time passes with the majority of the population being on an EHR, data will become more and more meaningful to health care providers and patients.

ELECTRONIC HEALTH RECORD

that are set up to be accessible from every computer.

However, every EHR format differs from one manufacturer to another, and the trouble is that not every format is readable on every system.

Unfortunately, many people outrightly reject the practice of using EHRs because of the technical difficulties that might come with it. Most physicians and hospitals refuse to implement them, and complaints abound like high costs, weak interoperability, low functionality, safety and liability risks, etc.

Most hospitals have their own unique EHR databases

“Electronic Health Record is more and more meaningful to healthcare providers & patients“ www.pinkmedico.com

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PINK MEDICO ELECTRONIC HEALTH RECORD

The success of an EHR implementation also depends on the locality of practice. For instance, it is much harder to connect to systems in rural sites within the same network! On top of that, functionality issues such as slow processing, user-hostile formats, and limited capabilities can further deter hospitals from using EHRs. The inability of EHRs to communicate well with each other becomes a barrier to the transparent communication of health information that is essential for providing quality care. Poor interoperability not only prevents proper coordination of care on a small scale but also hinders PHM on a larger scale.

Optimizing the use of EHRs with health IT Many would question the very idea of enabling interoperability in systems that are currently in use, hoping instead for universal standards to be made mandatory. However, that would lead to a complete overhaul of the systems. New EHRs will have to be implemented with the mandatory formats, which would result in more expenditure on the part of physicians and hospitals. A strategic yet, radical change like that would be slow to come by and perhaps will take its own sweet time to settle in with the rest of the industry that is still undecided upon EHRs in the first place. Therefore, in important matters such as those concerning the healthcare of millions, the best thing to do would be to exercise caution.

There is an old expression that is often repeated but seldom put into practice: ‘Make do.’ It means that with whatever you have, make the high32

Nov 2017

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est and best use of it. To contextualize this adage in healthcare, it means that despite the struggles encountered with EHRs, we can achieve full connectivity for a transparent flow of information with the help of technology. For this reason, the role of health IT is significant for the optimization of EHRs in healthcare.

Enabling a direct exchange of health data amongst providers instead of paper copies has the following benefits: •

Saves time – Real-time data exchange reduces the timetaken in the delivery of care thereby making the whole process faster and more efficient.

Health IT solutions can assist in leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. Interoperable EHRs can enable better workflows, and reduce ambiguities by allowing the transfer of information among systems and stakeholders of health care. With EHR interoperability, the ultimate goal, which is improving the delivery of healthcare, would be achieved. Healthcare will improve the quality of care by making the right data available at the right time to the right people.

•

Facilitates care coordination – Transparent flow of data makes it legible, clear and authorized for all providers.

•

Cuts down risks – EHR systems that communicate well reduce the possibility of miscommunications which could lead to malpractice.

•

Increases efficiency – Everything is electronically stored and does not need to be filled out over and over again.

•

Avoids unnecessary tests – It reduces the chance of redundant testing and procedures by a large margin.

•

Over and above this, the mean-

Enabling interoperability in EHRs:

Pink Medico ELECTRONIC HEALTH RECORD

ingful exchange of patient health information relays accurate information to the care teams for a well-informed, coordinated and patient-centered care.

Interoperable EHRs thus, play a crucial role in improving the cost, quality and patient experience of health care.

A sense of urgency is attached to making all EHR systems interoperable for effective communication amongst provider. That’s because, despite considerable investments in health IT, the advancement of electronic information sharing across systems has been slow.

Something that is so fundamental to the success of EHRs has been left out of the center-stage of a value-based ecosystem for too long.

To realize their full potential, EHRs must be able to share information seamlessly and an interoperable health IT environment makes this possible. Interoperability will allow physicians and hospitals to share patient’s health records in realtime. Providers, patients, and insurers all benefit from increased access to patient’s health information.

For interoperability to gain wider prominence in healthcare, there needs to be a push from the policymakers and their encouragement will trickle down to the vendors and providers who will be more keen on making EHRs truly interoperable. The same kind of monetary incentive and promotion that fueled the adoption of EHRs needs to happen for interoperability to bring its importance into the limelight. The actual issue is rallying all the stakeholders of healthcare to form a consensus on the acceptance of interoperability for the better future of value-based healthcare

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PINK MEDICO

34

ntel Corporation and Aventyn Inc., announced collaboration towards innovation in smart IOT connected health solutions, services and commercialization of integrated clinical evidenced solutions for hospitals and healthcare providers. The combined offering of leading edge Intel® Health Application Platform for connected health care with Vitalbeat® integrated remote monitoring and management system is focused on enabling enhanced choices for providers, payers and pharma-life science companies.

These verticals can now improve chronic disease patient population management, prevent avoidable readmissions with advanced patient engagement at lower costs and better outcomes.

with Next Generation Vitalbeat®

Aventyn® Supports Intel® Health Application Platform

I

The collaboration is immediately benefiting Hospital Systems, Accountable Care Organization and Community Health providers in deploying a robust and scalable clinical evidenced patient personalized, preventive health and wellness remote patient monitoring platform.

Vitalbeat next generation cloud platform is the first to integrate novel wireless medical grade devices and wearables with a clinical evidenced platform (Remote-HF-1, American Heart Association Circulation 2014) for home, ambulatory and bedside care settings for chronic disease monitoring and improved patient outcomes.

Vitalbeat from Aventyn is a clinical evidence-based cloud solution that provides simple, cost-effective remote patient monitoring and integrated chronic disease management systems. Heart Failure, Chronic care centers, specialty groups, primary

Nov 2017

www.pinkmedico.com

care physicians, skilled nursing facilities, home health service providers, can now remotely monitor patients’ vital signs, health metrics, symptoms, medication adherence and compliance securely using traditional and mobile computing devices including intelligent home gateways, computers, smartphones, and tablet devices. Clinically proven long-term disease management programs are enabled by Vitalbeat for Congestive Heart Failure (CHF) and co-morbidities such as diabetes, chronic obstructive pulmonary disease (COPD), hypertension, sleep apnea, chronic kidney disease (CKD), amongst other chronic conditions.

Patients and healthcare providers manage vital sign trends, health metrics, diet, physical activity, and medication compliance by configurable alerts and reminders based on personalized thresholds, goals and clinical guidelines. Patient electronic health record (EHR) data integrates with BlueButton, Continuity of Care Document (CCD), FIHR compliant EHR’s, along with secure private social media platforms, to provide care continuity and improved quality of life with better outcomes.

“The time is now to accelerate innovation at the edge of care in order to make remote care models the new Standard of Care, which is critically need to bend the cost curve down and the outcomes curve upward,” said David Ryan, GM Health Sector Intel IoT Group.

“Aventyn technology represents the growing innovation in digital health.

I am pleased to assist in the translation of clinical trials and studies to everyday practice for improving patient’s quality of life indicators,” said Dr. Kris Vijay, Abrazo Arizona

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Heart Institute medical director. “We have been involved in original work at our center and collaborative hospitals and believe in the potential of Aventyn technology. My expertise in heart failure treatment and non-invasive cardiology will assist in convergence of clinical practice with Aventyn technology. I look forward to the eventual everyday of connected digital health.�

Vitalbeat integrated chronic disease management platform."

"We have taken a big step forward in personalized intelligent health solutions with the Intel Health Application Platform connected products for global anyplace, anywhere remote care for the chronically ill population." said Navin Govind, founder and chief executive officer of Aventyn "This innovative technology helps our health care partners advance delivery of reliable remote care solutions enhancing patient engagement, user experience with diverse wearable, medical devices connected to our next generation

Contact Puja Chandler: puja(at) aventyn(dot)com or by phone +1 (231) RX4-BEAT

Healthcare providers, payers, pharma-life science research centers and home care service providers can contact Aventyn to participate in upcoming clinical studies and trials towards commercial deployment for patient engagement and population health.

About Aventyn, Inc. Aventyn is an innovative, award winning connected health company delivering clinical evidenced solutions for Personalized Chronic Care, Medical Imaging, Predictive Analytics and Risk Assessment. Our standards based, secure core to cloud connected solutions Lower Costs - Improve Quality - Better Out-

comes for health Providers, Insurers, Pharma-lifesciences Cogenetics for population health management.

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5 WAYS TO CON

1 Food:

Healthy eating is a cornerstone of healthy living — with or without diabetes. But if you

have diabetes, you need to know how foods affect your blood sugar levels. It’s not only the type of food you eat but also how much you eat and the combinations of food types you eat. Car-

bohydrates are the foods that often have the biggest impact on your blood sugar levels. And for

people taking mealtime insulin, it’s crucial to know the amount of carbohydrates in your food, so you get the proper insulin dose. s much as possible, plan for every meal to have a good mix of starches, fruits and vegetables, proteins and fats. Too little food in proportion to your diabetes medications — especially insulin — may result in dangerously low blood sugar (hypoglycemia).

Too much food may cause your blood sugar level to climb too high (hyperglycemia). Talk to your Diabetologist & Dietician about how to best coordinate meal and medication schedules.

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Avoid junk food, sugar-sweetened beverages, alcohol and smoking.

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Exercise: Physical activity is another important part of your diabetes management plan. In

general, most adults should exercise at least 30 minutes a day on most days of the week. When you exercise, your muscles use sugar (glucose) for energy. Regular physical activity also helps your body use insulin more efficiently. even light activities — such as housework, gardening or being on your feet for extended periods — can improve your blood sugar.

There are three main kinds of exercise—aerobic, strength training, and flexibility work. You should aim to have a good balance of all three:

1) Aerobic Exercises which include:Walking, Jogging/Running, Swimming, Cycling;

2) Strength training gives you lean, efficient muscles, and it also helps you maintain strong, healthy bones. It’s really good for you when you have type 2 diabetes because muscles use the most glucose,, then you’ll be better able to control your blood glucose level 3) Flexibility training - you’ll improve how well your muscles and joints work. Stretching before and after exercise reduces muscle soreness and actually relaxes your muscles..

Always ensure you have a small snack or glucose tablets with you during exercise in case your

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blood sugar level drops too low. Drink plenty of water or other fluids while exercising because dehydration can affect blood sugar levels.

Medication: Insulin and other diabetes medications are designed to lower your blood sugar levels, diet and exercise adds your effort to control your blood sugar count. Ensure you

take your medications or insulin on time as adviced by your doctor. If your diabetes medications cause your blood sugar level to drop too low or if it’s consistently too high, the dosage or timing may need to be adjusted. It’s important you take your medications on schedule because they

have a timed-release. Controlling type 2 diabetes through medication and lifestyle changes can help you avoid serious complications such as heart disease, blindness, and kidney and nerve damage. Also ensure you never skip your dose of medicine or insulit.

Keep track of your blood sugar count on regular basis and take HBA1C test every 3 months,

which will give a clear picture whether the medicine, diet and exercises are helping you contorl your sugar level If not your doctor can help ajdust the doses / diet plat to ensure the blood

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sugar level is under control.

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NTROL DIABETES

Pink Medico

4

Check your Oral Health, Eyes and Feet: 1) If you have diabetes, you are

at higher risk for gum problems. Poor blood glucose control makes gum problems more likely.

If your blood glucose levels are poorly controlled, you are more likely to develop serious gum

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disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control. take good care of your teeth and gums, along with regular

checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking.

2) If you have diabetes, regular visits to your ophthalmologist for eye exams are important to avoid eye problems. The three major eye problems that people with diabetes may develop and should be aware of are cataracts, glaucoma, and retinopathy. o prevent eye problems in diabetes, you should: Control your blood sugar and Control high blood pressure.

3) If you have diabetes, nerve damage, circulation problems, and infections can lead to serious foot problems. However, you can take precautions to maintain healthy feet. Check your feet and toes frequently, inspecting the tops, sides, soles, heels, and the area in between the

toes. Pat your feet to keep them dry, Infections tend to develop in moist areas, so make sure you dry the area between your toes well.

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Complete Health Checkup: Diabetes can harm your nerves. That damage, called neuropathy, may be painful. It can happen

in several ways, and they all seem to be related to blood sugar levels being too high for too long.

To prevent it, work with your doctor to manage your blood sugar. High levels of triglycerides, a key blood fat which is measured during a cholesterol check, are also associated with the development of nerve damage.

Diabetes is an independent risk factor for CVD in both men and women, whose blood sugar leve is not under control. Thus, patients with diabetes are unusually prone to congestive heart failure and moreover, are likely to suffer irreversible brain damage, They are also prone to kidney related problems.

So to overcome all these, people with diabetes has to ensure he or she undergoes complete health checkup atleast once a year and also ensure keep their blood sugar level under control to lead a healthy and happy life

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PINK MEDICO

STEM CELLS TRANSPLANTS

STEM CELLS TRANSPLANTS FOR

CANCER TREATMENT ?

People with certain types of cancer can sometimes be helped by a stem cell transplant to treat or even cure the cancer.

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Pink Medico

STEM CELLS TRANSPLANTS Red blood cells (RBCs) carry oxygen away from the

All of the blood cells in your body start out as young (immature) cells called hematopoietic stem cells. Hematopoietic means blood-forming. Even though they’re called stem cells, they are not the same as the embryos’ stem cells that are studied in cloning and other types of research. These stem cells are blood-forming stem cells.

lungs to all of the cells in the body. They bring carbon dioxide from the cells back to the lungs to be exhaled.

A blood test called a hematocrit shows how much

Stem cells mostly live in the bone marrow (the spongy center of certain bones). This is where they divide to make new blood cells. Once blood cells mature, they leave the bone marrow and enter the bloodstream. A small number of stem cells also get into the bloodstream.

These are called peripheral blood stem cells.

Stem cell transplants are used to give back stem cells when the bone marrow has been destroyed by disease, chemotherapy (chemo), or radiation. Depending on where the stem cells come from, this “In cancers, such as certain procedure may be called: • Bone marrow transplant (BMT) • Peripheral blood stem cell transplant

of your blood is made up of RBCs. The normal range is about 35% to 50% for adults People whose hematocrit is below this level have anemia. This can make them look pale and feel weak, tired, and short of breath.

leuke-

mias, multiple myeloma, and some lymphomas, stem cell transplant can be an important part of treatment”

• Cord blood transplant They can all be called hematopoietic stem cell transplants.

White blood cells (WBCs) help fight infections caused by bacteria, viruses, and fungi. There are different types of WBCs. • Neutrophils are the most important type in fighting bacterial infections. The absolute neutrophil count (ANC) is a measure of the neutrophils in your blood. When your ANC drops below 1,000 per cubic millimeter (1,000/mm3) you have neutropenia, and you have a higher risk of infection. The danger is greatest when levels are below 500/mm3.

Stem cells make the 3 main types of blood cells: red blood cells, white blood cells, and platelets. We need all of these types of blood cells to keep us alive. For these blood cells to do their jobs, you need to have enough of each type in your blood.

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PINK MEDICO STEM CELLS TRANSPLANTS • Lymphocytes are another type of white blood cell. There are different kinds of lymphocytes, such as T lymphocytes (T cells), B lymphocytes (B cells), and natural killer (NK) cells. Some lymphocytes make antibodies to help fight infections The body depends on lymphocytes to recognize its own cells and reject cells that don’t belong in the body, such as invading germs or cells that are transplanted from someone else.

Platelets (thrombocytes) are pieces of cells that seal damaged blood vessels and help blood to clot, both of which are important in stopping bleeding. A normal platelet count is usually between 150,000/cubic mm and 450,000/cubic mm, depending on the lab that does the test. A person whose platelet count drops below normal is said to have thrombocytopenia, and may bruise more easily, bleed longer, and have nosebleeds or bleeding gums. Spontaneous bleeding (bleeding with no known injury) can happen if a person’s platelet count drops lower than 20,000/mm3. This can be dangerous if bleeding occurs in the brain, or if blood begins to leak into the intestines or stomach.

Stem cell transplants are used to replace bone marrow that has been destroyed by cancer or destroyed by the chemo and/or radiation used to treat the cancer.

People with certain types of cancer can sometimes be helped by a stem cell transplant to treat or even cure the cancer.

In some cancers, such as certain leukemias, multiple myeloma, and some lymphomas, a stem cell transplant can be an important part of treatment. It works like this: high doses of chemo (sometimes along with radiation), work better than standard doses to kill cancer cells. But high doses can also kill all the stem cells and cause the bone marrow to completely stop making blood cells, which we need to live. This is where stem cell transplants come in. The transplanted stem cells replace the body’s stem cells after the bone marrow and its stem cells have been destroyed by treatment. Transplant lets doctors use much higher doses of chemo to try to kill all of the cancer cells.

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A stem cell transplant from another person can also help treat certain types of cancer in a way other than just replacing stem cells. Donated cells can often find and kill cancer cells better than the immune cells of the person who had the cancer ever could. This is called the “graft-versus-cancer” or “graft-versusleukemia” effect. It means that certain kinds of transplants actually help fight the cancer cells, rather than simply providing normal blood cells.

The chemotherapy and growth factor injections help your bone marrow to make lots of stem cells. These stem cells then spill out of the bone marrow into the bloodstream.

Stem cell transplant means that you can have higher doses of treatment. So there may be more chance of curing the cancer than with standard chemotherapy.

This is because there are a lot of blood cells being made inside the bones.

Having your own stem cells: You might have your own stem cells given back to you after high dose treatment. This is called an autograft.

Growth factors: You have growth factors before, and sometimes after, a stem cell transplant. Growth factors are natural substances that make the bone marrow produce more stem and blood cells. You have them as small injections under the skin.

You have daily injections of growth factor for between 5 and 10 days. Sometimes you may have low doses of a chemotherapy drug alongside the growth factor injections.

Growth factor injections can cause some side effects. Some people have itching around the injection site. Some people get a high temperature (fever). You might have some pain in your bones after you have had a few injections.

Collecting the stem cells: After your growth factor injections, you have blood tests every day to see if there are enough stem cells in your bloodstream.

When there are enough cells, you have them collected. This is called harvesting.

Collecting the stem cells takes 3 or 4 hours.

You are awake during this process. You lie down on a couch. Your nurse puts a drip into each of your arms and attaches it to a machine.

Your blood passes out of one drip. It goes through the machine and back into your body through the other drip. The machine filters the stem cells out of your blood. They are collected and frozen until after your high dose treatment.

Pink Medico

You might feel very tired after donating stem cells. Your calcium level might also get low during your collection, which means you may have: tingling around your mouth or muscle cramps.

Having stem cells from a donor:

Mismatched transplant You can have a transplant without a perfect match. This is called a mismatched transplant.

If you have a mismatched transplant, you are more likely to have a reaction afterwards. The reaction is called graft versus host disease (GVHD). This means the immune cells from the donated stem cells attack some of your body cells.

GVHD typically causes skin rashes, diarrhoea and liver damage. You will have anti rejection drugs to help stop it developing. GVHD can be severe and even life threatening for some people. But mild GVHD can also be helpful for some people. It is an immune system reaction and can help to kill off any cancer cells left after your treatment.

Some people have stem cells from another person. These are called donor stem cells.

They are collected from the donor in the same way described above.

If you have donated stem cells they need to closely match your own. A brother or sister is most likely to be a close match.

Sometimes, if you don't have a brother or sister (a sibling donor) who is a match, you can have stem cells from a donor who is not related to you but whose stem cells are similar to yours. This is called a matched unrelated donor (MUD) transplant.

Your doctor may consider a half matched transplant (haplo identical transplant). This means the donor is at least a 50% match with you. This could be one of your parents, a sibling or your child.

In the past these transplants have been difficult to do due to the increased risk of severe GVHD and infection. But doctors are finding new ways of improving this type of transplant and reducing the risk of GVHD. Cord blood stem cells

First, laboratory staff check the surface of your blood cells and the donor blood cells for certain proteins. The proteins are called HLA markers or histocompatibility antigens. So the test is called HLA typing or tissue typing.

The results of your blood test and the donor's test tell your doctor how good the HLA match is between you. Members of your close family are most likely to have similar proteins to yours.

Mini transplants Stem cells can be used in mini transplants.

These are also called reduced intensity conditioning (RIC) transplants. You have lower doses of chemotherapy than in a traditional stem cell transplant. So you might have this treatment if you are not fit or well enough for a traditional transplant.

Deciding to have a stem cell transplant Although a stem cell transplant can help some patients, even giving some people a chance for a cure, the decision to have a transplant isn’t easy. Like everything in medicine, you make the final choice about whether or not you’ll have a stem cell transplant. Transplant has been used to cure thousands of people with otherwise deadly cancers. Still, the possible risks and complications can threaten life, too. The expected risks and benefits must be weighed carefully before transplant. Transplants have serious risks, and patients can die from complications. The stage of the cancer, patient’s age, time from diagnosis to transplant, donor type, and the patient’s overall health are all part of weighing the pros and cons before making this decision.

It’s important to know the success rate of the planned transplant based on your diagnosis and stage in treatment, along with any other conditions that might affect you and your transplant. In general, transplants tend to work better if they’re done in early stages of disease or when you’re in remission, when your overall health is good.

Matching donor stem cells

Everyone has their own set of proteins. Staff compare the proteins on the cells in the blood samples to see if the HLA markers are the same or very similar. Usually 10 HLA markers are checked.

Cord transplants are mostly used for children because a smaller amount of cells is collected. You could have a stem cell transplant from 2 different umbilical cords. This is called a double cord transplant.

You might have a stem cell transplant using stem cells from umbilical cord blood. Doctors take blood from the umbilical cord and placenta that is very rich in stem cells. The blood bank may give the donated stem cells to a person whose blood cells closely match the donated cells. www.pinkmedico.com

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NEW TECHNIQUE TO AID IVF EMBRYO SELECTION

T

he research, reported in the journal Human Reproduction has the potential to significantly benefit the IVF industry of the future, improving assisted reproduction outcomes for women.

other embryos," she says.

"We use a special type of imaging to show differences in the metabolism and chemical make-up of embryos before they've been implanted," says lead author Dr Mel SuttonMcDowall, from the University of Adelaide.

Dr Sutton-McDowall sees the use of hyperspectral imaging as a new tool that can be combined with other diagnostic methods to provide a more accurate and objective embryo viability assessment.

"This technique can give us an objective measure of which embryo to choose as part of the IVF process."

"The benefit of hyperspectral imaging is that it can capture information-rich content of inspected objects. It analyses every pixel in an image for its light intensity at differing wavelengths," she says

This 'hyperspectral imaging' measures light that cells naturally produce during their normal activities. The light or 'autoflorescence' produced changes according to the chemical reactions or metabolism going on in the cell.

Being able to measure embryo metabolism is viewed by many researchers as one of the most important factors as to whether a particular IVF program will be successful.

However, says Dr Sutton-McDowall, fertility specialists take a largely subjective approach in deciding which embryos should be used.

"Pre-implantation screening of embryos generally takes place under a normal optical microscope. Although it's quite easy to discern poor embryos (due to differences in uniformity), it is far harder for the clinician to determine objectively, the viability of the

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"The challenge is how to choose the single healthiest embryo out of this group to maximise the chances of pregnancy."

"This lets us drill down and analyse the hyperspectral signature of each individual embryo, looking for known or anomalous characteristics. It lets us discriminate between embryos, but also measuring metabolic differences within individual embryos. We predict that embryos that have cells with homogeneous (uniform) metabolic profiles are the healthier ones."

To date, this imaging technology has only been tested on cattle embryos but Dr SuttonMcDowall notes that the technique is extremely promising.

"It offers benefits of being a non-invasive imaging approach that provides real-time information to the clinician," she says.

The likely development of a specialised hy-

perspectral imaging tool for actual use in the IVF clinic is several years away but SuttonMcDowall believes that there is a strong surge of interest from IVF clinics to better predict embryo development outcomes through technology.

"I think we'll see this innovative approach commercialised fairly quickly," she says "IVF is a costly and complex treatment. Any new method that can help improve the odds of women successfully having babies is of benefit to both clinicians and their patients."

Not just limited to human IVF practice, Dr Sutton-McDowall also sees commercial opportunities for the hyperspectral technology across the farming, animal and livestock sectors as well.

"Many beef and dairy producers include advanced reproductive technology programs as a regular part of their farming practice," she says "Identifying and breeding from elite animals improves herd quality and maximises productivity. If we can enhance the IVF process and improve pregnancy outcomes, farmers will see better animals with healthier genetics and more desirable traits. I see a lot of potential for our imaging technology in this economically important area too.

RNI Ref No: MAG(1)/NPT/258/2016-2017