Medical Device ASIA, Jan-Feb'14 issue by Worldwide Publications

Vol.6 No.1 | January-February 2014 | New Delhi

TRAILBLAZER IN Orthopedics

ROBOTS

Research!

TopINNOVATIONS 5

medical technology

e d i t o r i a l

highlights Medical Devices & Equipment | Healthcare | Pharmaceutical Journal

SOLED 15 LED light for examination and minor surgery

EKF Diagnostics’ Quo-Lab HbA1c Analyzer

Got a hair transplant!

Andy McCourt - Australia

the next generation urine analyzer

UK Representative

eHealth technology and convergence

Show Report : Compamed 2013

Arab Health Awards 2014

Top 5 Medical Technology Innovations

Robots taking over to help medical research

Infrared Light Therapy

New Medical Devices

High-tech equipment and imaging IT solutions from Siemens

India Can Be the Healthcare Provider to the World

A Trailblazer in Orthopedics

Apple Hires Medtech Talent

Vol.6 No.1 |January-February 2014 | Annual Subscription: Rs.500

Managing Editor Sarvjit

Associate Editor & Public Relations Director Reny

Joint Editors

Vishwapreet Amrita

Production Rakesh

Marketing & Communications Lovleen

Web Editor

Ravindar

Circulation Surekha

Secretary & Legal Advisor Surinder

China Correspondents Ying Wei / Adrian Liu

Editorial Advisory Board Alex & Lilly - Netherlands

alex@vanbienen.net

Mike Steele, MJ Marketing

20, Spencer Bridge Road Northampton NN5 5EZ Tel: +44-1604 756 100 Fax: +44-1604-750 910 For advertising, subscribing or to submit a press release, write to : D-182, PR House, Anand Vihar, New Delhi - India. Tel : +91 11 22141542 / 4309 4482 Fax: +91 11 22160635 Email: info@medicaldeviceasia.in Published, Printed and owned by: World-Wide Publications, D-182, PR House, Anand Vihar, New Delhi-110092, India and printed at Technical Press Inc. D-182, PR House, Anand Vihar, New Delhi 110092 - India. The publisher does not necessarily agree with the views expressed by the contributors, in this issue, nor do accept any responsibility for any errors or interpretation in the publication.

Medical devices market may grow to $ 5.8 bn by the end of 2014

Medical Devices market in India began with macro economic indicators whereby the basic economic indicators have been depicted. In the introduction section the definition of medical devices as well as risk categories has been defined. In the market overview section the market size of the healthcare industry has been depicted. Thereby, the market size of the medical devices market has been forecasted. Major segments of

medical devices and their relative share has been provided. Major segments of healthcare industry have been explained. Further the report depicts the division of refurbished and new medical equipments in the market and also the regional demand for medical devices. Market size of the major segments in medical equipment market has been calculated. In the next section import and export of medical devices for the last four years has been highlighted. Also the major countries for import and export for medical devices is also depicted. Thereafter, the distribution channel has been explained. The Indian medical device and equipment market is expected to grow to around $ 5.8 billion by 2014 and $ 7.8 billion by 2016,

growing at a CAGR of 15.5 per cent, according to an industry report.

cent,” Grant Thornton India said in its report on medical technology sector.

India’s medical device market is currently the fourth largest market in Asia with 700 medical device makers, and ranks among the top 20 in the world. The outlook for medical devices segment over the next few years remains strong, with more recent trends such as greater adoption of health insurance (private as well as state-funded) likely to further increase the penetration of healthcare across the country.

The financial support in the form of fiscal benefits, technological advancements and policy changes are bound to create a strong opportunity for India to build global competitive edge in the healthcare sector, the report said.

“Currently valued at $ 4.4 billion, the Indian medical device and equipment market is expected to grow to around $ 5.8 billion by 2014 and $ 7.8 billion by 2016, growing at a CAGR of 15.5 per

Collaborative trends across these two segments are visible through deals and acquisitions, setting up of local manufacturing by large international players and other technical alliances. v

The Indian medical devices industry forms a very small part of the total manufacturing industry accounting for only 0.2 per cent of all certified facilities.

Medical Device ASIA | January-February 2014 | 3

SOLED 15 LED light for examination and minor surgery SOLED 15 is the LED examination light for diagnostics, minor surgery and universal applications. It can be used for intensive care, recovery room, first aid, cosmetic and dental sector. SOLED 15 supplements the Starled Series range of lamps manufactured by ACEM Medical Company. SOLED 15 contains all the advantages of LED technology and is suitable for multi-purpose uses thanks to its flexibility. It assures: - excellent light intensity (65.000 lux) - IR-free light beam - colour temperature (CCT) of 4.900°K - colour rendering index (CRI) of 95 - long life - low power consumption (22W). The high technological level combined with the use of high-powered LEDs allow SOLED 15 to have a very linear yield and a negligible performance decay for its entire life duration. Thanks to the high efficiency achieved, SOLED 15 has a light intensity of 65.000 lux and a low power consumption (22W). The LEDs layout gives a visual comfort and produces a uniform, homogeneous and shadowless light. SOLED 15 has a round shape that makes it handy and functional both in use and move. Its easy-to-move structure is suitable for diagnostics, test labs and dental surgery too and its easy-to-grip removable and sterilizable handle makes it suitable even for critical sanitary applications. 4 | January-February 2014 | Medical Device ASIA

SOLED 15 is provided with an I-Sense touch panel to control all the functions of the lamp. 1 – ON/OFF 2 – Light intensity adjustment 3 – Parts selection (SEL) 4 – BOOST The new “SEL” function allows the selection of single parts of the light beam and the activation of the desired LEDs in a sequential way according to the requirements and needs. “Boost” function or “brightness increase” is used to obtain a maximum light intensity in case of a wide light field. This approximate 10% increase deactivates automatically after 5 minutes. SOLED 15 is available in the following versions: Ceiling mounted, Wall mounted, Trolley mounted. For further information: ACEM Medical Company Division of ACEM S.p.A. Tel +39 – 051 – 721844 Fax +39 – 051 - 721855 Email: info@acem.it Website: www.acem.it

d i a g n o s t i c s

EKF Diagnostics’ Quo-Lab HbA1c Analyzer Secures IFCC Certification Point-of-care analyzer meets all standards set by independent certifying bodies About EKF Diagnostics EKF Diagnostics Holdings plc specializes in the development, production and worldwide distribution of point-of-care blood analyzers for use in the detection and management of diabetes, anemia, lactate and kidney related diseases. Its new Molecular division focuses on molecular and companion diagnostics. Point-of-care diagnostics: EKF Diagnostics’ expertise covers the entire in vitro diagnostics chain, from fermentation and enzyme production, to liquid reagent manufacture, design and building of world-class diagnostic devices, and distribution of rapid test kits for infectious diseases and pregnancy. The EKF analyzer range is used widely in GP surgeries, pharmacies, blood banks, sports clinics, hospitals and laboratories for glucose, lactate, hemoglobin, hematocrit and HbA1c measurement.

IFCC certified Quo-Lab HbA1c point-of-care analyzer

EKF Diagnostics, a global diagnostics company, is pleased to announce that its Quo-Lab HbA1c point-of-care analyzer has successfully achieved International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) certification.

he IFCC maintains the JCTLM (Joint Committee for Traceability in Laboratory Medicine) endorsed reference measurement procedure for HbA1c, accepted worldwide as the analytical control for traceability of HbA1c measurement. To participate in the program manufacturers are required to register and report the results of twenty four samples (two per month) from across the measurement range. The samples are supplied by an IFCC Reference Laboratory. “The awarding of this certification allows us to report

6 | January-February 2014 | Medical Device ASIA

results traceable to the IFCC reference method for quantitative determination of HbA1c,” said Gavin Jones, Diabetes Product Manager EKF Diagnostics. “Together with the existing NGSP certification we achieved from 2012, the IFCC award demonstrates conclusively that Quo-Lab meets all of the demanding standards set by independent certifying bodies.” Glycated hemoglobin (HbA1c) testing is globally recognized as the gold standard in monitoring of diabetic patients, enabling more complete control of their disease management. The Quo-Lab analyzer offers laboratory accurate results from just 4 µL of blood with a user friendly interface, simplifying the process even further. For more information on EKF Diagnostics, please visit www. ekfdiagnostics.com.

Companion Diagnostics: In March 2013 EKF set up a new division to focus on molecular and companion diagnostics - EKF Molecular Diagnostics develops technologies for cancer gene detection. Through its acquisition of UK-based 360 Genomics and by offering innovative products with the potential to change current DNA extraction and detection practices, EKF is addressing the fast growing companion diagnostics market. EKF Diagnostics products are sold in more than 100 countries around the globe. EKF Diagnostics’ strengths lie in its multi-national research and manufacturing facilities, teams of experienced analysts and engineers in Germany, Ireland, USA and the UK, and a board led by some of world’s foremost authorities in medical diagnostics. v

The End of Renal Denervation?

enal denervation as a high blood pressure treatment is looking less exciting by the day, with the latest bad news coming from Covidien. The Dublin, Ireland–based medical device giant said that it will exit its OneShot renal denervation program, which involves technology Covidien acquired through its acquisition of Maya Medical. The move, which also includes Covidien not proceeding with its Rapid II randomized study is the result of “slower than expected development of the renal denervation market,” according to a Covidien news release. One major slowdown for development came about two weeks ago, when Medtronic announced its Symplicity system failed on efficacy in a pivotal U.S. clinical trial.

surrounded the technology for years. For instance, Sanjay Kaul of Cedars-Sinai Medical Center (Los Angeles) tells MedPage Today that “[i]mplausibly large treatment effects observed in uncontrolled and unblinded studies are typically unreliable and seldom replicable in rigorously controlled randomized trials.” He continues: “That is the major lesson from the Symplicity HTN-3 trial. If the data are too good to be true, they usually are!” Covidien’s move to abandon the OneShot program is but another sign of reevaluation around the technology, which has received significant media attention in recent years for its potential to benefit millions of patients with resistant hypertension. Renal denervation involves applying radiofrequency

The Symplicity HTN-3 study, which involved a randomized 535 treatment-resistant hypertension patients in 87 U.S. medical centers, demonstrated that the treatment was safe. But it did not meet its goals for lowering blood pressure among those who received the treatment, versus the control group that underwent a sham procedure. Those in the control group had the option to receive the treatment after the six month assessment was over. The news regarding the Medtronic trial led many cardiologists to criticize the hype that had 8 | January-February 2014 | Medical Device ASIA

ablation through a catheter to the renal artery that supplies the kidneys with blood. The minimally invasive procedure is supposed to lower blood pressure by cutting off nerve signals to the artery. Sanjay Kaul and other cardiologists stress that the Medtronic data does not necessarily spell the end of renal denervation. “It is too soon to abandon this procedure,” Kaul notes. “We need to scrutinize the data first.” He does, however, conclude: “If the treatment effect is attributable entirely to a sham effect, then it is difficult to see a future for renal denervation.” Other companies are sticking by the technology for now, even as they take stock of the situation.

St. Jude Medical, for example, called off it Enlightn IV trial in December, possibly on the assumption that Medtronic was going to beat it to the U.S. markets, according to reports in MassDevice and elsewhere. But St. Jude CEO Daniel Starks told MPMN’s sister publication MD+DI that the experience with the atrial fibrillation technology, where it took many years for the technology to become widely used, indicates that, “we have a warm trail and should continue to work at it.” Boston Scientific CEO Mike Mahoney also remains optimistic about renal denervation and the company’s Vessix platform, even as the company takes time to draw lessons from the Symplicity trial.

OneShot renal denervation system has a spiral electrode design that provides a standard ablation pattern.

Welcome to

MEDICAL FAIR ASIA 2014

The No. 1 Medical and Healthcare trade fair in the region As Asia’s leading and most established trade fair focused on equipment and supplies for the hospital, diagnostic, pharmaceutical, medical and rehabilitation sectors, MEDICAL FAIR ASIA 2014 serves as an ideal international platform for the industry’s best suppliers to showcase their latest product innovations and technologies. Since its debut in 1997, MEDICAL FAIR ASIA has strengthened its reputation as Asia’s most definitive medical and health care exhibition that is recognized by local and international medical professionals. Over the years, the trade fair has also received strong support and official endorsements from relevant authorities within the industry that include the Ministry of Health, Singapore, and a wide range of medical and health care associations in the region. Modelled after the sector’s No. 1 global medical trade fair - MEDICA, organized by Messe Duesseldorf in Germany, the 10th edition of MEDICAL FAIR ASIA 2014 will take place from 9 to 11 September 2014 at Suntec Singapore.

10 | January-February 2014 | Medical Device ASIA

Got a hair transplant? Remember the post operation precautions Hair Transplantation is an outpatient office procedure performed under local anesthesia. However, once the new follicles have been implanted on your scalp, they need a few days of precautions and care to recover and get their own life. So, if you are planning to get a hair transplant op done, remember to religiously follow the prescribed precautions after the procedure.bb

But first let’s take a look at what causes baldness Dr. Arvind Poswal, Hair Transplantation Surgeon, A’s Clinic

Losing hair can be a traumatic experience in life and a large number of men go through this trauma, watching their receding hairline closely and praying for a miracle to prevent it. In desperation people try all sorts of products available or recommended in the hope that they will somehow rejuvenate their scalp and bring back the lost hair. However, when baldness is happening due to genetic factors, not much can be done to prevent it. While losing hair can be traumatic, nothing can beat the experience of having them back. Today, this is possible through the revolutionary process called hair transplantation. You might have observed a number of celebrities going from a thick hair scalp to a balding one and then back to a thick hair one. Till some years back, once you lost your hair, there could be nothing done about it, other than wearing artificial hair. For a number of people, losing hair is a nightmare. Particularly for the people in show business, their careers would end if they were to lose their hair. Today hair transplantation has saved many a career from floundering. Revolutions in the technology of hair transplant have meant that millions of people have had the wonderful luxury of refurbishing their receding hairline. In recent years, the process of hair transplant itself has advanced a great deal, making the transplanted hair look more natural and full.

The cause of male pattern baldness is no longer a mystery. Research has shown that when the male hormone - testosterone is exposed to 5-alpha-reductase, an enzyme in the hair follicle, it produces another hormone called dihydrotestosterone (DHT), which causes permanent hair loss. This hormone (DHT) causes the hair follicle to shrink and grow a finer hair that is lighter in color, shorter and less deeply rooted than its predecessor. Most often, the hair in the balding region will continue to grow at an increasingly slower rate until hair growth ceases completely. The pattern of progression, and the extent and speed of male pattern baldness, is largely dictated by genetics, hormones and age. For men, this permanent type of baldness generally follows specific patterns. Even in the most extensive cases, a horseshoe shaped fringe of hair remains. This donor fringe is insensitive to the balding process and will last a lifetime. This is because this hair is genetically programmed in the root, or hair follicle, to be resistant to the effects of DHT. The hair in this donor area provides the basis for surgical hair transplantation. These hairs, when transplanted into thinning or balding areas, will take root and grow, and continue to grow for the rest of a person’s life. This is also referred to as the “principle of donor dominance”. That is, the transplanted hair will grow in its new location as it would have in its original donor location.

12 | January-February 2014 | Medical Device ASIA

Types of hair transplant –

1) FUHT - In FUHT a hair bearing strip of scalp is excised from the permanent donor area. The strip wound is closed using self dissolving sutures/ surgical staples. Individual follicular unit grafts are dissected from the strip under magnification. Meanwhile, recipient slits are created in the bald areas of the scalp using tiny needles/ blades. This too is performed after numbing the scalp using local anesthesia. The individual follicular unit grafts are placed into each such slit. The hair above the suture covers the scar area . The scar mark will be visible if you buzz cut or shave off your hair (it is normally not visible under a hair growth of 1 to 2 cms). 2) FUSE (Follicular Unit Separation Extraction) is a method of extracting individual hair follicles with microsurgical precision but without scalpel and stitches. It is safe, minimally invasive, virtually non-scarring technique of extracting single follicular units (FU). This technique makes it possible to use beard as well as robust body hair for transplanting to the scalp. This additional donor hair ensures that even people with extensive hair loss can get a fuller hair restoration and youthful hairline. The tiny donor hair extraction sites are left to heal on their own and there is very little downtime. World’s first documented beard hair to scalp transplant (without stitches) was accomplished using the FUSE technique at Dr. A’s Clinic, clearly a pioneer/inventor in this field.

How much will it cost you?

Generally hair transplantation has become a dramatically better value over the past several years. For a mega session of 2000 or more all follicular unit micro grafts, the cost per graft can be as low as INR 50 /-per graft ( 1 graft = average 2 hair follicle) for FUHT and INR 160 /- is for FUSE, Of course, the cost of hair transplantation will ultimately depend on how much work you need to be satisfied. We charge by the number of intact

follicular unit grafts (not by hair). We consider charging by the hair as unfair to the patient as a majority of the follicular unit grafts in an average person’s scalp contain multiple hair. The cost of procedure depends upon the choice of procedure and number of grafts. The number of sittings a person would require depends upon the method and number of grafts patient choose.

Maintenance and Post operation precautions Your newly restored hair will grow and require the same maintenance as your original head of hair. It’s your hair and can be colored, permanently waved or styled in a variety of ways suitable to your lifestyle. You can even shave them off, they will grow right back. However, for a few days after the transplant procedure, some strict precautions have to be followed. Once the new follicles have been implanted on your scalp, they need a few days of precautions and care to recover and get their own life. So, if you are planning to get a hair transplant operation done, remember to religiously follow the prescribed precautions after the procedure. The important hair transplant postoperative steps will not only ensure a speedy recovery but also reduce the risk of damage to the newly implanted follicles. The new follicles are very sensitive and prone to damage in the early stages and need to be treated with extreme caution.

Remember: • Do not wash your hair for at least 2 days after the procedure as washing can disrupt the new follicles and damage them • Strictly avoid exposure to sun for two weeks as sun contact too can harm the newly implanted follicles. Better stay indoors and step out only in the night. • Avoid any activity where something or someone may rub against your head. Remember the hair graft are new and need time to fix in their heels inside the scalp. They should be left alone to heal themselves and get firm footing • Follow the hair transplant surgeon’s advice very carefully. You would not like to lose your hair again.

Paradigm VEOTM- a savior for people on Insulin therapy

Currently, the most advanced and best in Insulin Pump technology is Medtronic’s Paradigm® VEOTM. For adults with type 2 diabetes and parents of Type 1 diabetic children, this therapy has proven to be a great boon as VEO Pump can automatically shut-off the supply of insulin, if the patient’s glucose levels drop too low, protecting against dangerous, and potentially life threatening hypoglycemia in patients. Medtronic’s engineers have integrated Continuous Glucose Monitoring – or CGM for short – into the Paradigm® Veo™. Instead of isolated snapshots, you and your doctor will have a clear, continuous picture of what is going on. Readers’ Enquiry: info@medicaldeviceasia.in

Discover Your Vision at Asia’s Leading Medical Exhibition Korea E & Ex Inc. Tel. +82-2-551-0102 Email : kimes@kimes.kr www.kimes.kr 14 | January-February 2014 | Medical Device ASIA

Visit [NEW] IVD Japan 2014 and explore the forefront of “Personalised Medicine” in the leading market, Japan! Asia’s ONLY exhibition and conference specialised in Diagnostics and Testing for Personalised Medicine, 1st Personalised Medicine & Diagnostics Expo (IVD Japan 2014) will open its gate to the Japanese & Asian medical and bio-pharma industry for the first time. [May 14 th-16th, 2014 at Tokyo Big Sight, Japan] industry and where the market is heading for, you should visit IVD Japan 2014. Not only you can compare cuttingedge diagnostic/testing equipment, reagents, contract services, IT, etc. for diagnostics and testing for personalized medicine at the Exhibition, you can learn the latest market trends, government policies and research development from the industry leaders at the Conference.

Launched in response to the huge market potential, its debut gathers great attention from the Japanese & Asian industry. The world’s second largest medical market, Japan is getting more attention from the world as one of the leaders in technical innovations and as a business market. Fueled by a series of government-funded projects and economic recovery, the Japanese medical market is activated. Especially, “Personalised Medicine” being selected as one of the priority areas as a part of the Japanese government’s growth strategy, huge market expansion and rapid technical innovations are anticipated in the market. To see the frontline technologies of the fast-growing 16 | January-February 2014 | Medical Device ASIA

The Keynote Session will be a must-attend session for everyone involved/interested in the Japanese Personalised Medicine market. One of the speakers is expected from Japanese government officials, who will speak about the Japanese market situation and Japan’s medical-related policies. Another Keynote Speaker is Mr. Chia Feng Lu of Baker & McKenzie, co-author of “FDA’s regulation of veterinary drug products”. It is the prime opportunity to learn the current and future perspective of the market from industry leaders of Japan and USA. More sessions and panel discussions will be available, addressed by leaders from national research institute, major pharmaceutical company and so on.

Concurrent Show BIOtech 2014 in Japan – 13th Int’l Bio Technology Exhibition & Conference Asia’s LARGEST bio event consisting of Exhibition, Conference, Partnering and Academic Forum. 2 related shows co-held, 600* exhibitors, 200* presentations and 15,000* will gather from the Japanese and Asian medical/bio/pharmaceutical industry. Regenerative Medicine, iPS/ES Cells, Drug Discovery and many other advanced research fields are covered in BIOtech Japan 2014. (*expected) More detailed information on the exhibitors and conference program is available on the website in March (expected). Please register yourself as a visitor on the website www. ivdjapan.jp/en/ and receive the latest information and the FREE Invitation Tickets. Contact us IVD Japan Show Management, Reed Exhibitions Japan Ltd. Attn: Kyoko Nagakusa (Ms.), International PR TEL: +81-3-3349-8518 / Email: ivdjapan@reedexpo.co.jp Website: www.ivdjapan.jp/en/

Transasia introduces

LAURA M - the next generation urine analyzer in India colour reaction of the diagnostic pads and therefore contributes to the correct diagnosis of the patients. Laura M is designed to nullify the potential errors in urine analysis due to operator bias, operator handling, pre- analytical and sample issues. Equipped with a plethora of sensors to manage the entire workflow Laura M ensures most accurate results along with maximum compliance with strict quality systems prescription.

Transasia Bio- Medicals Ltd. is a leader in the Indian Diagnostic Industry, and over a period of three decades, it has set benchmarks by indigenously manufacturing and providing some of the latest and best technologies across the world. With a wide array of products in specialties such as Biochemistry, Hematology, Diabetes Management, Coagulation, Critical Care, Electrophoresis, Microbiology, Immunology, Molecular Diagnostics and Urine Analysis, Transasia offers Total Solutions in Clinical Diagnostics.

he latest offering from the house of Transasia is Laura M, a quick and simple solution for the analysis of urine. Laura M is produced by ERBA Lachema, the Czech Republic subsidiary of ERBA Diagnostics Mannheim GmbH, of which Transasia is a part. Laura M is the next generation Urine Analyzer with high-throughput, that is capable of measuring all routine parameters in urine along with Microalbumin and Creatinine which are specific urine markers of nephropathy. Objective evaluation of the urine samples by LAURA® M instrument helps to eliminate any subjective interpretation and operator bias of the

18 | January-February 2014 | Medical Device ASIA

ERBA Lachema with a history of path breaking technology in the field of Urinalysis has developed LAURA® M with features which are unparalleled. Major features of Urine Analyzer Laura M: Smooth Workflow Management LAURA® M with its user friendly feature of continuous loading and very a high throughput of 600 measurements per hour allows efficient workflow in a high workload environment. Results are given in just 60 seconds for all its parameters. The instrument can be connected to a bar code reader to simplify work list creation and reduce hands on time. Laura M is capable of interfacing with Laboratory Information System (LIS). Efficient Data Management LAURA® M has internal memory capacity of 2000 measurements. It has a standard interface via RS232 and USB ports which enables the instrument to be connected to the Laboratory Information System (LIS) either for reporting or archiving data. Cutting-Edge Hardware Features The sleek ergonomic design of

LAURA® M denotes quality that the brand Lachema stands for. The large colour touch screen makes operation easy and user friendly. Hygienic disposal of used strips is done by a waste container. It has an in-built thermal printer which flags all abnormal results. Unique dry strip detection in case of operator error of samplication on the reagent strip Multiple sensors detect the strip at different stages and ensure reliable test strip recognition. LAURA® M automatically recognizes if the waste container is full and displays warning on the screen. Sophisticated Software Features Laura M provides extreme flexibility of interchanging between different metric systems for units of measurement. Laura M allows user to set critical values as per laboratory practices. The USB ports can be used for software upgradation for improved and latest features. PHAN Diagnostics Strips for Laura M ERBA Lachema through extensive research and development has mastered the art of manufacturing urine strips. The PHAN range of urine reagents strips are protected against the common concentration of Ascorbic Acid (200-800mg/ dL), ensuring no interference with measurement of Glucose, Blood, or Nitrates on the strip. DekPHAN Laura and MicroAlbuPHAN Laura are routine 10 parameters and 2 parameters specialized Microalbumin and Creatinine test strips respectively . All Phan range of strips have a uniform incubation period of 60 seconds. For further enquiry on Laura M please write to responses@ transasia.co.in

The Three Big Predictions for the Global Healthcare Market

A new insight – based on a ‘2013 Search for Growth’ survey – identifies key areas of eHealth technology and convergence with other industries Frost & Sullivan released its three big predictions for the global healthcare market. Based on a ‘2013 Search for Growth’ survey which involved 1835 executives in more than 40 countries worldwide, Frost & Sullivan’s insight highlights new areas of growth. mHealth, Cloud in Healthcare and Regulatory Environments will be the key subjects in 2014 and beyond. “Frost & Sullivan’s research team has used the findings to select and prioritize the subjects that are deemed to be poised for the greatest growth,” explains Frost & Sullivan Partner Dorman Followwill. “The insight has also been essential in unveiling the business outlook for Pharmaceuticals, Biotechnology, Clinical Diagnostics and Medical Devices, as well as to provide a global perspective on the industry’s geographical hot spots. mHealth expansion has been fuelled by the unprecedented spread of mobile technologies, as well as advancements in their innovative application to address health priorities. It is largely supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs) and other wireless devices. The penetration prospects of mHealth technologies are significant in the following areas: wireless vital signs monitoring, location-aware telemonitoring systems and Bluetooth wireless technology-enabled health trackers. It is an exciting area of opportunity for healthcare growth and will provide innovative solutions for stakeholders, both providers and patients alike, across the spectrum. 20 | January-February 2014 | Medical Device ASIA

In addition, as more healthcare IT and patient monitoring tools are integrated, every hospital facility will eventually have to acquire a fullyenterprise wireless solution. The most innovative mobile healthcare solutions that best meet pressing healthcare needs will be adopted as the gold standard. Enterprise-wide healthcare informatics will also improve the quality of medical services and efficiency of operations while reducing expenditures. Cloud computing is considered to be a key enabler for enterprise-wide solutions. Implementing cloud computing technologies appropriately will help healthcare providers improve the quality of medical services and the efficiency of operations, share information across geographic locations and manage expenditures. The concept can be applied in a variety of ways, including data storage and data loss prevention, maintaining patient information records and authorized sharing of information. The advantages that cloud com-

puting provides can change the dynamics of the healthcare informatics industry over time. The need for efficient sharing of information across locations in a synchronised manner will be a key driver for cloud computing in healthcare. As for Regulatory Environment, recent healthcare reforms and policy initiatives across many countries have emphasised the importance of quality of care more than quantity. In the absence of a sufficient proof of clinical benefit, reimbursements may pose a major hurdle. All in all, three big predictions may be formulated based on the survey’s results: As healthcare is geared towards a personalized medicine model, companion diagnostics will alter drug development and the commercialization process of drug candidates. Combining biomarkers and drugs will result in enhanced therapeutic efficacy and safety. The healthcare and life sciences industry will consolidate further in this decade, with many

The Three Big Predictions for the Global Healthcare Market

big pharma companies seeking alternatives to the blockbuster model. The rise of new technologies capable of integrating medical devices into a connected platform will enhance the functionality of devices, reduce the man power burden and minimize errors. Other hot areas that have emerged from the same survey include: Cancer Market Outlook, Remote Monitoring, Drug Delivery Market, Patient and Consumer Engagement, Healthcare Dashboards, eHealth Medical Records, Medical Devices Growth Drivers, Drug Discovery Research Outsourcing Market, Homecare Market Trends, Video Telemedicine and Cardiovascular Therapeutics. To know more about Frost & Sullivan predictions and to find out where the global and regional hot spots are in the healthcare industry, please contact Carrie Low, Corporate Communications, at carrie.low@frost.com Some insights from the survey are available on Slideshare here About Frost & Sullivan Frost & Sullivan, the Growth Partnership Company, works in collaboration with clients to leverage visionary innovation that addresses the global challenges and related growth opportunities that will make or break today’s market participants. For more than 50 years, we have been developing growth strategies for the global 1000, emerging businesses, the public sector and the investment community. Is your organization prepared for the next profound wave of industry convergence, disruptive technologies, increasing competitive intensity, Mega Trends, breakthrough best practices, changing customer dynamics and emerging economies? Contact us: Start the discussion!

50 Years of Growth, Innovation and Leadership “ Join Frost & Sullivan’s premier global community, GIL: A Frost & Sullivan Global Congress of Growth, Innovation and Leadership Frost & Sullivan Frost & Sullivan, the Growth Partnership Company, enables clients to accelerate growth and achieve best in class positions in growth, innovation and leadership. The company’s Growth Partnership Service provides the CEO and the CEO’s Growth Team with disciplined research and best practice models to drive the generation, evaluation and implementation of powerful growth strategies. Frost & Sullivan leverages over 50 years of experience in partnering with Global 1000 companies, emerging businesses and the investment community from more than 40 offices on six continents. To join our Growth Partnership, please visit http://www.frost.com.

22 | January-February 2014 | Medical Device ASIA

New mammography system for the midrange price segment from Siemens • Mammomat Fusion enhances current portfolio of mammography systems • New, robust detector for high image quality at optimized dose • More efficiency thanks to integrated technologies from premium segment

iemens is presenting the mammography system Mammo-

Optimized dose for every patient

mat Fusion for screening and diagnostics at the annual

thanks to proven technologies

conference of the Radiological Society of North America

In addition, Mammomat Fusion

The Siemens Healthcare Sector is

(RSNA) in Chicago, USA. The latest addition to the family

features selected technologies

one of the world’s largest suppli-

be focused on the patient.

developed for the Mammomat In-

ers to the healthcare industry and

spiration premium system: OpDose

a trendsetter in medical imaging,

ensures that the radiation dose can

laboratory diagnostics, medical in-

be individually set for each patient

formation technology and hearing

– without compromising excel-

aids. Siemens offers its custom-

lent image quality. The appropriate

ers products and solutions for the

parameters can be selected in ac-

entire range of patient care from a

cordance with the patient’s breast

single source – from prevention and

screening: High patient volumes, fast and easy operation,

size and density. The screening

early detection to diagnosis, and on

as well as the right balance between dose and image

process is also much easier for

to treatment and aftercare. By op-

quality. That is why Siemens Healthcare is one of the first

clinical staff thanks to the compact,

timizing clinical workflows for the

manufacturers to integrate a new generation cesium-

syngo-based Acquisition Worksta-

most common diseases, Siemens

iodide detector in a mammography system: Mammomat

tion (AWS). Patient data can be

also makes healthcare faster, better

Fusion delivers reliable, high-quality images quickly thanks

loaded directly from the Radiology

and more cost-effective. Siemens

to this new detector. An innovative layered configuration

Information System (RIS), without

Healthcare employs some 52,000

the need for a second workstation.

employees worldwide and oper-

Clinical personnel also benefit from

ates around the world. In fiscal year

an intuitive and automated work-

2013 (to September 30), the Sec-

flow: The system is ready for scan-

tor posted revenue of 13.6 billion

ning with just one click, and manual

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of mammography systems from Siemens Healthcare combines robust technology with selected product features from the premium segment to address the specific needs of the midrange price segment – volume screening centers and small to medium sized hospitals. Several aspects play an important role in mammography

of the photo diodes within the detector enables more efficient utilization of the radiation. The result is higher resolution with a lower dose when compared with other cesium-iodide detectors. The large image matrix of 23 x 30 centimeters makes Mammomat Fusion the right choice for screening various breast sizes.

Medical Device ASIA | January-February 2014 | 23

COMPAMED 2013: Suppliers win us over with their broad range of skills - Final report Complex projects, 3D printer products and the battle against germs

Nowadays, innovations in medical technology place huge demands upon research and development, and that is why they can often only be achieved as a result of working across disciplines. This was clearly demonstrated at COMPAMED 2013, which ran in parallel to the world’s biggest medical trade fair MEDICA 2013 from 20th – 22nd November in Düsseldorf, and which, with its 681 exhibitors and almost 17,000 visitors, once more impressively confirmed its status as the leading market and information platform for suppliers in the field of medical technology production. In Halls 8a and 8b of the Düsseldorf trade fair centre, the exhibitors presented a multitude of technological and service-based solutions for use in the MedTech industry – from new materials, components, primary products, packaging and services through to complex microsystem and nano technologies. An example of the trend towards interdisciplinary procedures is the research association Ohr-Biofeedback. This is an association made up of institutes, universities and SMEs all working towards improving the treatment of patients suffering from pain. “The basis for this is a sensor which is so small that it fits into the ear and which 24 | January-February 2014 | Medical Device ASIA

measures vital functions in the external auditory canal,” explains Dr. Olaf Brodersen, Head of the MOEMS Department of the CiS research institute for microsensor technology and photovoltaics. Using so-called pulsoximetry, the miniaturised device measures vital parameters such as breathing and heart rate. The procedure is a noninvasive means of determining arterial oxygen saturation by measuring light absorption or remission when light is shone through the skin. This enables it to determine the level of tension in body and soul. If the patient is stressed, an individual biofeedback programme is started and continued until the patient feels well again. The whole process is controlled by a smartphone app. This app offers the particular advantage that the doctor can be involved if desired. Binder Elektronik took on the job of miniaturis-

ing and producing the electronics for controlling the sensors and evaluating their output. The circuit board layout was integrated into the desired casing to fit behind the ear using 3D design, and was manufactured using 3D printing, since no suitable casing was available on the market. The “sedative” in the ear should reduce the need for painkilling medicines. A jet for cells and Proteins A similarly interdisciplinary project is the LIFTSYS Project that was presented by the Fraunhofer Institute for Laser Technology ILT in Düsseldorf. Based on Laser Induced Forward Transfer (LIFT) the scientists in Aachen have developed a plant that can be used for the selective contactless transfer of hydrogels, living cells and other biomaterials. The procedure can be used

anywhere where tiny amounts of material need to be transferred accurately to a receiver substrate. It enjoys a wide field of application in medical and pharmaceutical research, where diseases or active agents need to be examined in specially made test structures. Here precious material, e.g. stem cells, must be used as sparingly as possible. “In this procedure there is a wafer-thin layer of titanium, just a few nanometres thick, between

the substrate and the cells,” says Nadine Seiler, biologist and project manager at ILT. Using a camera system, the cell is selected, a pulsed laser beam evaporates the titanium layer and the test material is transferred by the resulting forwards impulse. Experts call this a jet. The laser-based process does not require a print head and can, therefore, be used to transfer biomaterials such as RNA, DNA, proteins and cells. Measure your cholesterol level yourself A third example of a successful collaboration between physicists, chemists, biologists, physicians and engineers - this time as part of the European SIMS (Smart Integrated Miniaturised Sensor System) programme - is a highly integrated system for testing the cholesterol level in the blood, an important indicator of cardiovascular diseases, on the spot. The diagnostic unit comprises a cholesterol sensitive

biosensor, an electrochromic display which displays the cholesterol level in six colour coded categories, the printed battery, the organic electronics and an interface with the user’s mobile phone in order to transmit the results to a doctor or clinic. “A single drop of blood suffices to carry out the test,” states Dr. Andreas Willert, who is responsible for printed functionalities at the Fraunhofer Institute for ENAS, which is responsible for the printed energy source in the form of a zinc-manganese battery. The little power pack contains no heavy metals, does not require any aggressive electrolytes and does not have to be charged, since it is intended for single use only. The consortium is currently seeking a partner to manufacture and market the system starting in 2015 or 2016. Miniaturisation and molecularisation In addition to their interdisciplinary

Medical Device ASIA | January-February 2014 | 25

approaches, the examples named above also illustrate two trends which Joachim Schäfer, Managing Director of the Düsseldorf Trade Fair Centre, identified even before the start of COMPAMED: miniaturisation and molecularisation. “Especially in the case of mobile terminals, the components cannot be small and light enough,” says Schäfer. And at COMPAMED ever more “industrial heavyweights” are joining the competition to build the biggest possible advances into even the smallest components. Following BASF, Bayer, Schott and Panasonic, now Siemens - a regular exhibitor at MEDICA - discovered COMPAMED this year. “We have been watching this trade fair for a while now. As we also work as a supplier for third parties, 26 | January-February 2014 | Medical Device ASIA

we see it as an ideal place for making contacts,” explains Reiner W. Jung, General Manager for Medical Electronics & Imaging Solutions at Siemens Healthcare. “Even on the first day we made many contacts.” Siemens offers complete elec-

tronic solutions from development right through to servicing. Among other things they are focussing on multi touch systems which function perfectly even in operating room conditions, control panels and the collection and processing of data.

Transparent ceramics A classic theme at COMPAMED is new materials. This time it was the company CeramTec that brought along a real innovation. They presented the first transparent ceramic (Perlucor), which is available on a series-production scale. “In terms of the basic idea, our material could be compared to sapphire, but it has better properties. The high refractive index, for example, is perfect for producing lenses for use in endoscopy,” says Dr. Lars Schnettler, the designer and product manager for

transparent ceramics at CeramTec. The material, a magnesium aluminium spinel, is extremely hard and strong, scratch resistant and resistant to chemicals such as acids and lyes. Furthermore, the new isotropic and polycrystalline material allows infra-red rays to pass through a thickness of up to six millimetres, compared to a maximum of 2.5 millimetres for alternative materials. The material impresses still further by the fact that it offers very good value for money. It was almost inevitable that “Perlucor” should win CeramTec the DeviceMed Award in the category materials, which the magazine awarded for the second time. 3D printing also available for medical technology A new combination of material and process is also presented by 3D printing, which has now found its way into medical technology.

Thus, in the European “ArtiVasc 3D” project, in which 16 partners from seven different countries are participating, soft tissue implants for 3D printing are to be devised and manufactured, to be used as tissue grafts or as test systems for pharmaceutical and cosmetic products. “This includes artificial scaffolding for veins and blood vessels. The challenge is to find the right material which can be processed via 3D printing,” states Dr Martin Wehner from ILT. The Spanish company microLIQUID is also already making use of this technology. “Using this method we produce lab-on-a-chip systems, which make it possible to examine samples such as blood and other body fluids wherever you are,” explains Borja Barredo, CEO of microLIQUID. A special polymer, similar to polymethyl methacrylate (PMMA, Plexiglas), is used for the 3D printing. The integrated components, combining microfluidics and electronics,

Medical Device ASIA | January-February 2014 | 27

are already on the market. “It is for single use components, which are all the rage at the moment, that 3D printing really represents a costefficient procedure with a clear future,” pronounces Dr. Thomas R. Dietrich, who will take up the post of Managing Director of IVAM - the expert association for microtechnology - on 1/1/2014. In view of the growing importance of threedimensional printing, Messe Düsseldorf has developed the brand “3D fab + print”, which should provide visitors to various trade fairs with a relevant, specially adapted for their industry, guide to this topic of the future. Germ-free courtesy of polymers, silver and copper A constant hot topic in the field of medicine is the problem of hygiene. In Europe almost 150,000 patients die from nosocomial infections, which they pick up whilst in hospital. Against this background, SCS Specialty Coating Systems from the USA has developed a new parylene technology – parylenes are polymer coatings - with antibacterial properties. The material, called “microResist”, combines the known properties of parylenes with an additional feature, the elimination of harmful micro-organisms on the coated surface. The coatings are biocompatible and biostable, provide excellent barriers to moisture and gases - even faced with very aggressive media - and also offer the best dielectric properties. Applications include, e.g. stents, catheters, catheter wires, pacemakers, and pharmaceutical containers. BASF has also developed new solutions to the problem of hygiene: With “HyGentic SBC” and “HyGentic PA” we have access to two new polymers with “inbuilt antimicrobial functions”. In both cases the germ killing effect is due to silver ions. But it is not essential to use precious metals: results from current studies confirm that the 28 | January-February 2014 | Medical Device ASIA

use of antimicrobial copper materials can reduce the risk of nosocomial infections in intensive care units by 58 per cent. The Deutsches Kupferinstitut (Copper Institute) has taken advantage of MEDICA + COMPAMED to demonstrate the many possibilities presented by using copper. Laboratory tests have demonstrated that 99.9 per cent of all bacteria are eliminated from copper surfaces within two hours. It is entirely possible that related developments will be presented at the next COMPAMED trade fair. Individual packaging machines. Just like the topic of hygiene, the field of packaging is always an issue at COMPAMED. For

the first time in Düsseldorf, the company KOCH Pac-Systeme was represented, now offering hard blister packaging machines for the medical technology field with its new brand, “KOCH medplus”. It is precisely in this area that machine design based on the principles of “Good Manufacturing Practice” (GMP) is extremely important. “So our machines are made of suitable materials and easy to clean. We avoid hollow spaces, and use suitable lubricants. Naturally we supply all the relevant quality and validation documents with our machines,” says Philipp Bohnet, head of the medical technology business section at KOCH. Individual solutions based on customer requirements are also possible. With KOCH this means that a base model is enhanced with additional components, such as, e.g., film or leaflet feeds, or inspection or mark-

ing systems. So the customer gets the perfect machine, even if space is limited, for example. “We often deal with customers who have only a few square metres available for a blister machine. Together we then work out the best solution,” reports Philipp Bohnet. “That makes our machines very individual. We hardly ever build one a second time.” Put more simply: Innovations in respect of materials, components and systems right through to complete mechanical solutions continue to be the driving force at COMPAMED, as was demonstrated impressively at this year’s trade fair. Date of the next COMPAMED Trade Fair in Düsseldorf: 12 – 14/11/2014 Date of the next MEDICA Trade Fair in Düsseldorf: 12 - 15/11/2014

Medical Device ASIA | January-February 2014 | 29

show|report

Arab Health Awards 2014 Honor the Region’s Exceptional Healthcare Leaders KSA and Qatar emerge as region’s front runners taking home seven out of nine awards Marking its seventh year, the Arab Health Innovation & Achievement Awards continues to honor exceptional healthcare professionals across the Middle East, announcing the 2014 winners at a gala ceremony at the Dubai International Convention & Exhibition Centre. The Awards were celebrated during the Arab Health Exhibition & Congress, the largest healthcare event in the region.

2014 Arab Health Achievement & Innovation Awards winners.

Nine awards were presented to highlight the region’s growth and achievements in the healthcare field with Saudi Arabia and Qatar emerging as the region’s front runners taking home seven out of the nine awards. The judging panel was made up of internationally recognized judges from a broad range of related sectors and disciplines. The judges included Dr. Fadi El-Jardali, Health Management and Policy, American University of Beirut,

Accreditation Canada; Dr. Joel J. Nobel, Founder and President Emeritus, ECRI; Dr Lena Low, Acting Chief Executive, The Australian Council on Healthcare Standards; Ashraf Ismail, Managing Director, Middle East International Office, Joint Commission International; Jan Schmitz-Huebsch, Director for Business Development & Projects, Munich Health Daman Holding. “The Arab Health Awards aim to recognize the accomplishments of healthcare professionals

30 | January-February 2014 | Medical Device ASIA

who continue to contribute to the development of the Middle East healthcare system and standards, and help create consistently reliable and credible medical services for all patients. The growth in the Middle East healthcare market is mirrored in the increasing number of high-quality submissions for the 2014 Arab Health Awards. The maturing yet dynamic industry clearly brings out many best practices as reflected by the award winners,” said Jan Schmitz-Huebsch, Director for Business Development & Projects at Munich Health Daman Holding (MHDH) across the MENA region and former Principal at Booz & Co Dubai. “I was delighted to learn that I was chosen for the Outstanding Contribution of an Individual Award by Arab Health. We are happy that our efforts and commitment towards uncompromising healthcare quality and excellence is recognized regionally. This recognition gives us the motivation to further step up our efforts towards achieving excellence in patient care and medical outcomes and play a lead role as the regional center of excellence,” commented Engr. Sobhi Batterjee, President, Saudi German Hospital – Jeddah, after his win last night.

Hereunder is the list of winners for the 2014 Arab Health Innovation & Achievement Awards are: Excellence in Surgery Services Award Saudi German Hospital - KSA Excellence in Radiology Award Radiology Department at Hamad Medical Corporation - Qatar Roche Excellence in Laboratory Award King Faisal Specialist Hospital and Research Center – Jeddah, KSA Excellence in Patient Centered Care Award Cancer Transformation Team, Hamad Medical Corporation – Qatar Young Surgeon of the Year Award Dr Khaled Abuhaleeqa, Mafraq Hospital – UAE Cleveland Clinic Young Clinician Award Dr Ibrahim M Fawzy Hassan, Hamad General Hospital – Qatar Outstanding Contribution of an Individual to the Middle East Healthcare Industry Award Engr. Sobhi Batterjee, President, Saudi German Hospital Group – KSA Outstanding Contribution to Medical Education in the Middle East Award Dr Saad Aswad, Consultant Gynaecological Oncologist, Tawam Hospital – UAE Outstanding Achievement in the Medical Laboratory Field Dr Samir S. Amr, President, International Academy of Pathology - KSA

About Arab Health Exhibition & Congress The 39th Arab Health Exhibition & Congress, organised by Informa Life Sciences Exhibitions, takes place from 27-30 January 2014 at the Dubai International Convention & Exhibition Centre. With more than 3900 exhibiting companies from 63 countries, 85,000 visitors and 19 healthcare conferences with an estimated 9000 delegates, Arab Health is a much anticipated addition to the 2014 medical event calendar. Website: www.arabhealthonline.com

Medical Device ASIA | January-February 2014 | 31

Transasia demonstrates its market leadership by launching five new instruments

Transasia Bio- Medicals Ltd., is a leader in the Indian Diagnostic Industry and provider of the highest quality products and services. With a wide array of products in specialities such as Biochemistry, Hematology, Diabetes Management, Coagulation, Critical Care, Electrophoresis, Microbiology, Immunology, Molecular Diagnostics and Urine Analysis, Transasia offers Total Solutions in Clinical Diagnosis. Over a period of three decades, Transasia has set benchmarks by indigenously manufacturing and providing some of the latest and best technologies across the world. Through its active participation in various conferences and seminars, Transasia has always showcased its expertise. The recently concluded 40th National Conference of Association of Clinical Biochemists of India (ACBICON) and 62nd Annual Conference of IAPM 32 | January-February 2014 | Medical Device ASIA

& Annual Conference of IAPID (APCON 2013) witnessed Transasia add five more gems to its already studded crown! Transasia launched the following five latest and technologically advanced instruments at the two conferences:

and Easylyte Xpand, Hb Vario was inaugurated by Prof. Venkatesh.

• XL 1000- Automated random access clinical chemistry analyzer with a throughput of 800 photometric tests/hr and 1120 tests/hr with ISE • EM 180 Destiny- Fully automated, random access, discrete clinical chemistry analyzer with throughput of 180 photometric tests/ hr & 400 tests / hr with ISE (optional)

Similarly, at APCON 2013, Dr. K. S. Bhople, Dean, Govt. Medical College, Aurangabad inaugurated XL 1000 while Dr. Rajan Bindu, Head- Pathology and Org. Secretary- APCON inaugurated Laura M. HbVario was launched by Dr. Sujay Prasad- Director, Anand Diagnostics, Bangalore. Dr. Murtaza another Joint Secretary of IAPM, Aurangabad, launched Easylyte Xpand.

• Hb Vario- Fully Automated High Performance Liquid Chromatography Analyzer with HbA1c, HbA2/ F test • Easylyte Xpand- The latest critical care analyzer offering Ca & Li parameters in addition to Na,K,Cl • Laura M- Next generation urine analyzer with Microalbumin and Creatinine results in 60 seconds At ACBICON 2013, Dr. Arvind Lal, CMD of Dr. Lal Pathlabs inaugurated XL 1000 in the presence of some of the most reputed biochemistry experts of the country. At ACBICON, Swami Sarvalokanand Maharaj of Ramakrishna Mission, Mumbai jointly inaugurated EM180 Destiny alongwith Dr. KP Sinha, the Past President and Chairman of ACBICON. While Dr. Praveen Sharma, Head- Biochemistry Dept., AIIMS Jodhpur inaugurated Laura M

Infact the very first order for XL 1000 in India was placed right after the launch by Shyam Tyagi & Sunil Duggal- Founder Members, Wellness Pathcare, New Delhi.

Keeping up to the spirit of the event, the experts from Transasia presented a scientific session on ‘Update in automation of urine chemistry analyzer’ and ‘Launch of high speed biochemistry analyzers.’ Our Global Product Manager, Dr. Pavel from Czech Republic gave the presentation at both the conferences. The evening was made fun too, with a banquet dinner organized for the visitors exclusively by Transasia Bio-Medicals Ltd. The dance and dine and DJ were thoroughly enjoyed by all customers. At both conferences, Transasia had the largest and most significant participation. With these latest additons, Transasia continues in its mission to meet the needs for reliable, affordable and innovative medical diagnostic systems for doctors and patients worldwide. v

MEDLAB Series expands with the launch of MEDLAB Asia Pacific in Singapore The largest largest medical laboratory event in Asia Pacific is a meeting point for all healthcare professionals working within the medical laboratory sector.

ccording to Marketwired, the Asia Pacific region will experience the fastest growth in IVD, accounting for 32% of the world market by 2017. MEDLAB Asia Pacific, the essential platform to showcase the laboratory technology and services in the region, will launch for the first time at the Marina Bay Sands in Singapore from 18-20 February 2014. This event is part of the global success of the MEDLAB series which is supported by Informa Life Sciences Exhibitions, the organisers of Arab Health and MEDLAB Middle East. MEDLAB Asia Pacific will be a meeting point for all healthcare professionals working within the medical laboratory sector and will enable them to witness and share the latest innovations and technology available in the IVD and medical laboratory market. â&#x20AC;&#x153;MEDLAB Asia Pacific is organised in association with Scherago International and is an innovative laboratory exhibition and congress. We are confident that it will provide an opportunity for industry professionals practicing in the Asia Pacific region to learn about the latest advances in their applications

in laboratory medicine as well as current and future industry trends,â&#x20AC;? highlighted Simon Page, Managing Director, Informa Life Sciences Exhibitions. MEDLAB Asia Pacific will extend over 3,000 sqm of exhibition space and will offer the medical laboratory technology industry a complete range of products, materials and services including high-tech solutions, components, pre-products, new materials and innovations. The exhibition will showcase manufacturers and suppliers of all categories of medical laboratory products including disposable items, diagnostic equipment, hospital management, laboratory equipment, and biotechnology. The Congress will feature six CME accredited multi-track conferences providing a diverse range of subjects relating to the science and technology used in laboratories and diagnostics. The topics will cover Laboratory Management, Clinical Chemistry, Haematology, Anatomic Pathology, Microbiology, and Molecular/Advanced Diagnostics.

The organisers of MEDLAB Asia Pacific Conferences are committed to ensuring that all of the scientific conferences presented as part of the event comprise valuable and up-to-date topics that are relevant to the medical disciplines being addressed. AMS Continuing Medical Education (CME) division is responsible for recommending to the Singapore Medical Council (SMC) the accreditation of CME programmes for specialists. Apart from assisting SMC in the recommendation of Core and Non-core CME points for specialist CME activities, it also recommends the claims submitted by fellows, which would include attendances at overseas events, contributions in medical publications and other self-study activities. --------------About Informa Life Sciences Exhibitions: www.informalifesciences.com About MEDLAB Asia Pacific: Website: www.medlabasia.com About Scherago International: Website: www.scherago.com

Medical Device ASIA | January-February 2014 | 33

Top 5 Medical Technology Innovations The ATI Neurostimulator from Autonomic Technologies.

to market more quickly and at a lower cost,” says Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health. As the regulators, politicians, and corporate executives hash out these details, industry engineers and scientists continue to push through new ideas for improving and managing human health. Every year, industry observers like the Cleveland Clinic and the medical device trade press single out their favorite technology trends. These thought leaders agree that today’s best technologies strike a balance between reducing the overall cost of medical care and increasing safety and survival rates—and isn’t that what health care reform is all about?

The MelaFind optical scanner from MELA Sciences.

Against the backdrop of health care reform and a controversial medical device tax, medical technology companies are focusing more than ever on products that deliver cheaper, faster, more efficient patient care. They are also making inroads with U.S. Food & Drug Administration regulators to re-engineer the complex review and approval process for new medical devices. Many in the industry have long felt overly burdened by what they consider to an unnecessarily complex approval process. Critics claim it impedes innovation and delays the availability of

better health care. To change that perception, the FDA last year announced a new Medical Device Innovation Consortium (MDIC) charged with simplifying the process of designing and testing new technologies. With input from industry, government, and other nonprofit organizations, public-private MDIC will prioritize the regulatory science needs of the medical device community and fund projects to streamline the process. “By sharing and leveraging resources, MDIC may help industry to be better equipped to bring safe and effective medical devices

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Here are five emerging technologies to watch in the year ahead. Cutting Back on Melanoma Biopsies With the most deadly form of skin cancer, melanoma, a huge number of dangerous-looking moles are actually harmless, but has always been impossible to know for sure without an invasive surgical biopsy. Today dermatologists have new help in making the right call — a handheld tool approved by the FDA for multispectral analysis of tissue morphology. The MelaFind optical scanner is not for definitive diagnosis but rather to provide additional information a doctor

can use in determining whether or not to order a biopsy. The goal is to reduce the number of patients left with unnecessary biopsy scars, with the added benefit of eliminating the cost of unnecessary procedures. The MelaFind technology (MELA Sciences, Irvington, NY) uses missile navigation technologies originally paid for the Department of Defense to optically scan the surface of a suspicious lesion at 10 electromagnetic wavelengths. The collected signals are processed using heavy-duty algorithms and matched against a registry of 10,000 digital images of melanoma and skin disease. Electronic Aspirin For people who suffer from migraines, cluster headaches, and other causes of chronic, excruciating head or facial pain, the “take two aspirins and call me in the morning” method is useless. Doctors have long associated the most severe, chronic forms of headache with the sphenopalatine ganglion (SPG), a facial nerve bundle, but haven’t yet found a treatment that works on the SPG long-term. A technology under clinical investigation at Autonomic Technologies, Inc., (Redwood City, CA) is a patient-powered tool for blocking SPG signals at the first sign of a headache. The system involves the permanent implant of a small nerve stimulating device in the upper gum on the side of the head normally affected by headache. The lead tip of the implant

The Sapien transcatheter aortic valve from Edwards

The Symphony tCGM biosensor from Echo Therapeutics. connects with the SPG bundle, and when a patient senses the onset of a headache, he or she places a handheld remote controller on the cheek nearest the implant. The resulting signals stimulate the SPG nerves and block the pain-causing neurotransmitters. Needle-Free Diabetes Care Diabetes self-care is a pain— literally. It brings the constant need to draw blood for glucose testing, the need for daily insulin shots and the heightened risk

of infection from all that poking. Continuous glucose monitors and insulin pumps are today’s best options for automating most of the complicated daily process of blood sugar management – but they don’t completely remove the need for skin pricks and shots. But there’s new skin in this game. Echo Therapeutics (Philadelphia, PA) is developing technologies that would replace the poke with a patch. The company is working on a transdermal biosensor that reads blood analytes through the skin without drawing blood. The

technology involves a handheld electric-toothbrush-like device that removes just enough top-layer skin cells to put the patient’s blood chemistry within signal range of a patch-borne biosensor. The sensor collects one reading per minute and sends the data wirelessly to a remote monitor, triggering audible alarms when levels go out of the patient’s optimal range and tracking glucose levels over time. Robotic Check-Ups A pillar of health reform is improving access to the best health care for more people. Technology is a cost-effective and increasingly potent means to connect clinics in the vast and medically underserved rural regions of the United States with big city medical centers and their specialists. Telemedicine is well established as a tool for triage and assessment in emergencies, but new medical robots go one step further—they can now patrol hospital hallways on more routine rounds, checking on patients in different rooms and managing their individual charts and vital signs without direct human intervention. The RP-VITA Remote Presence Robot produced jointly by iRobot Corp. and InTouch Health is the first such autonomous navigation remote-presence robot to receive FDA clearance for hospital use. The device is a mobile cart with a two-way video screen and medical monitoring equipment, programmed to maneuver through the busy halls of a hospital.

but can’t endure the rigors of the operation. Manufactured by Edwards Life Sciences (Irvine, CA), the Sapien has been available in Europe for some time but is only now finding its first use in U.S. heart centers—where it is limited only to the frailest patients thus far. The Sapien valve is guided through the femoral artery by catheter from a small incision near the grown or rib cage. The valve material is made of bovine tissue attached to a stainless-steel stent, which is expanded by inflating a small balloon when correctly placed in the valve space. A simpler procedure that promises dramatically shorter hospitalizations is bound to have a positive effect on the cost of care.

A Valve Job with Heart

The Telemedicine System from InTouch Technologies.

The Sapien transcatheter aortic valve is a life-saving alternative to open-heart surgery for patients who need new a new valve Medical Device ASIA | January-February 2014 | 35

Robots taking over to help medical research

t has been a long and stealthy takeover, but robots now dominate many leading bioscience laboratories, doing in just hours what once took days or weeks. Now the convergence of automation with nanotechnologies, biomedics and advanced algorithms promises to take robotization of medical research much further. Last year, Ross King, professor of machine intelligence at the UK’s University of Manchester, traveled east to talk to students at the University of Nottingham campus in Ningbo, China. His paper “Robot scientists: Automating biology and chemistry” was a vindication of theories he and colleagues first proposed almost a decade ago. In a 2004 letter to the journal Nature, they asked whether it might be possible to automate the actual “discovery” process of observation, deduction and conclusion. This would use a physically implemented robotic system that applied techniques

from artificial intelligence (AI) to carry out cycles of scientific experimentation. Meet Adam and Eve, robot scientists In China, as he had earlier at Brunel University in London, Prof. King named the two “robot scientists” Adam and Eve, constructed at the University of Aberystwyth in Wales. These robots form hypotheses, select efficient experiments to discriminate between them, execute the experiments using laboratory automation equipment, and then analyze the results. Both Adam and Eve have made actual discoveries. Adam was developed to investigate the functional genomics of yeast (Saccharomyces cerevisiae) and the robot succeeded in autonomously identifying the genes that encode locally “orphan” enzymes in yeast. In biblical fashion, Adam was followed by Eve using similar techniques to create a machine

36 | January-February 2014 | Medical Device ASIA

tasked toward automation and integration of drug discovery: screening, hit conformation, and quantitative structure-activity relationship (QSAR) development. Eve uses novel synthetic biology screens that combine the advantages of computational, target-based, and cell-based assays. Robots at work

Liquid handling is one of the four core applications for robotics in the laboratory. The others are: Microplate handling: using robots to move plates around a workcell, between stacks and other devices (liquid handlers, readers, incubators, and so on). Advanced microplate robots integrate with third-party instruments to create work cells that automate

applications and protocols to almost any level of complexity. Automated biological research systems: robots provide automated handling and reading for various aspects of biological and biochemical research, ranging from flow cytometers to specific molecular biology applications such as PCR preparation and purification, colony picking or cell culture development.

Drug discovery screening: the most recent mainstream robotics application allows researchers to run a wide range of cell-based, receptor-based and enzymebased assays typically used in high throughput screening (HTS). Do robots offer an advantage? The laboratory advantages of using robotics seem obvious, starting with the ergonomic benefits of automating tasks that would be tedious, repetitive, injurious or even hazardous for a human. A robot makes no distinction between the backbreaking low rack a few centimeters off the floor and the one up high, for which a human would need to stand on a chair. Robots can also safely handle toxins, biohazards or operate in sealed or climate-controlled areas that we would find unbearable. Laboratories originally embraced robotics because it seemed to offer an escape from the “quantity or quality” dilemma - the constant need to trade off speed for accuracy.

to evolve. By contrast, it seemed robots could perform infinitely repeated operations to a supreme degree of precision that never varied and was infinitely controllable. However, in practice, and particularly with high throughput screening, some limitations began to emerge. These included: Long design and implementation time Protracted transfer from manual to automated methods Unstable robotic operation, and Limited error recovery abilities. Furthermore, the need to reduce steps in robotic processes tended to encourage the use of less accurate homogenous assays over the heterogenous ones that most companies would prefer. Future robot trends Three decades in from the first laboratory use of robotics, it seems clear that the technology is still in its infancy. Robots may seem pervasive in today’s biomedical research, but they have a long way

For one thing, robots cannot easily coexist with humans, needing to work in safely enclosed areas. The Fraunhofer Institute has been studying this aspect and developed LISA, a prototype mobile lab assistant with touch sensitive “skin” and heat sensors to stop her bumping into humans and vice versa. But even LISA is likely to look as clunky as the Wright Flyer once biomedics, 3D printing and nanotechnologies really come into play. A glimpse of the possibilities is offered by the robotic inchworm pioneered by Columbia University. Biobots like these, or the DNA spiders developed at New York University and the University of Michigan are little more than fascinating, if rather scary, toys at the moment. But they point to a future where robotics moves beyond the research lab into the operating room - or even down into the molecular realm.

Medical Device ASIA | January-February 2014 | 37

Music therapy

andmark study reveals positive effects of music therapy among youth undergoing cancer treatment A ground-breaking collaborative multi-site study found that teens and young adults undergoing the rigors of stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board certified music therapist in a therapeutic music protocol that includes writing song lyrics and producing videos. Resilience is the process of positively adjusting to stressors; and, the study’s findings provide evidence supporting the use of a music-based intervention delivered by music therapists to

help patients cope with challenging treatments. Indiana University’s Sheri L. Robb, PhD, MT-BC and Joan E. Haase, PhD, RN, FAAN led the research team. The SMART study - “Stories and Music for Adolescent and Young Adult Resilience during Transplant” - involved 11 sites with 49 board certified music therapists supporting the protocol. Published in Cancer, a peerreviewed journal of the American Cancer Society, the findings indicate that such music therapy interventions can provide essential psychosocial support to help young patients positively adjust to cancer.

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The music therapists’ role included helping patients identify and write about what was important to them through writing song lyrics, while also supporting their efforts to connect with healthcare providers, peers, and family through the process of creating their music video. While the intervention tested in this study requires delivery from a credentialed music therapist, it fosters involvement from patients’ entire team. The authors and AMTA advocate that nurses and other interdisciplinary team members collaborate with music therapists to identify patients/ families who might benefit from

this specific intervention – and use opportunities for involvement in the intervention to connect with their patients. According to Dr. Robb, one challenge in healthcare is “making sure that research findings from studies such as ours are used to inform healthcare practices and service delivery. One of our team’s next steps is to disseminate findings, train professional music therapists on this intervention, and then conduct an implementation study to examine how the intervention may change as it moves into the standard care setting and whether, in the presence of these changes, patient benefits are maintained.”

Infrared Light Therapy Runs Ahead of Science

t sounds too good to be true - a noninvasive, benignsounding treatment to help patients suffering strokes and head injuries recover cognitive and motor function. That’s how near-infrared laser therapy (NILT) is being marketed to patients, typically by chiropractors. But the evidence behind it is extremely scant -- some in vitro data, some animal experiments, and a few isolated case reports in human patients. And the two largest clinical trials, conducted in patients with ischemic stroke, ended in failure. The trials sponsor declared bankruptcy last year. The Rationale for NILT Many studies have shown that electromagnetic radiation in the

near-infrared -- wavelengths just beyond the approximately 700-nm limit to human vision -- can affect cell and organism biology. Some, but not all, of the induced changes can be attributed to the heat generated by absorption of nearinfrared radiation.

have suggested that near-infrared radiation may alter vascular tone to increase blood flow to the brain, and that it may promote differentiation of neuronal stem cells, perhaps by induction of neurotrophic growth factor expression.

Among the effects, seen in multiple cell and tissue types, is increased ATP synthesis in mitochondria -- in essence, an energy jolt for the cell. This has particular relevance in the central nervous system because mechanical and chemical insults to brain neurons can result in impaired energy metabolism. It’s been hypothesized that raising these cells’ energy levels may keep them functioning -- in other words, that near-infrared radiation may counterbalance the effects of injury.

The transformation of near-infrared radiation to NILT had its origins in the laboratory of Paul Lapchak, PhD, of Cedars-Sinai Medical Center in Los Angeles, who had developed a rabbit model of acute embolic stroke considered to be a very close cousin to spontaneous ischemic stroke in humans.

Other in vitro and animal studies

A NILT device delivering moderate doses of radiation at 808 nm proved to be safe in this model. It also was effective, in terms of preserved motor function, when administered up to 6 hours after

stroke onset. In a review Lapchak published in January 2012, he noted that this “therapeutic window” was longer than seen with thrombolytic drugs. Clinical Studies in Stroke A company called PhotoThera supported some of the animal studies, and with these data in hand, commenced a series of randomized clinical trials. The first, called NEST-1, was a phase II study in patients recruited within 24 hours of onset of acute ischemic stroke. Patients were assigned 2:1 to active NILT or a sham treatment. At 90 days after treatment, functional measures were significantly better in the NILT group, with 59% having outcomes rated as “successful” (modified Rankin score of 0-2) compared with 44% of the control group (P=0.021).

Medical Device ASIA | January-February 2014 | 39

HKTDC Hong Kong International Medical Devices and Supplies Fair Concurrently held with Hospital Authority Convention 2014

he 5th HKTDC Hong Kong International Medical Devices and Supplies Fair will run from 7 to 9 May at the Hong Kong Convention and Exhibition Centre. The event is expected to attract over 200 exhibitors to promote medical products as well as related services. Buyers appreciate this valuable occasion to connect to international exhibitors and browse their diversified exhibits at fingertips. In 2013, the fair attracted more than 8,200 buyers from 55 countries and regions. Last year, Hong Kongâ&#x20AC;&#x2122;s total exports of medical and healthcare equipment increased by 7.9% compared with 2012, reaching the amount of USD1.6 billion, with the five top major markets as the Chinese mainland, the United States, Japan, Germany and Russia. There was an impressive growth in exports to mature markets such as Netherlands (+83.2%) and USA (+28.2%), and emerging markets such as Turkey (+163.9%), India (+104%), Russia (+38%) and Thailand (+41.3%). Satisfying market trend and demand According to the United Nations, there are more than 759 million people aged 60 or over, accounting for 11% of the worldâ&#x20AC;&#x2122;s total population. By 2050, there will be 2,000 million people in the world who are aged 60 or over. Ageing population and increased 40 | January-February 2014 | Medical Device ASIA

health consciousness are factors boosting the demand for home healthcare equipment as well as medical equipment for patients suffering from cardiopulmonary disease, diabetes and neurological disorders. According to the latest figure from World Health Organisation, the total global expenditure for health is around US$4.1 trillion a year. According to this, the fair will provide an unrivalled platform for buyers to find all kinds of medical and health-related technology, equipment, devices and supplies. Rehabilitation and Elderly Care zone will feedback to the arising demand from these two areas include patient-monitoring systems, orthopaedic equipment and wheelchairs, which are the main targets of the buyers here. The constant demand for the most updated specialist electro-

medical equipment and medical technology makes the Hospital Equipment zone an attraction for buyers seeking ultrasound, imaging and anaesthetic equipment and surgical instruments. The increasing need for household medical products is under the spotlights. Buyers can visit the Household Medical Products zone to look for portable medical devices which also allow users to conduct point-of-care medical tests or treatments. Other exhibit categories include Accident and Emergency Equipment; Building Technology and Hospital Furniture; Chinese Medical Devices; Communication, Systems and Information Technology; Dental Equipment and Supplies; Diagnostics; Electromedical Equipment / Medical Technology; Laboratory Equipment; Medical Components and Materials; Medical Supplies

distinguished overseas and local speakers to share their knowledge and insights and interact with delegates. It aims to promote the sharing of knowledge and experience on clinical advances and approaches to modern healthcare service, and facilitates exploration and discussion of contemporary concepts among healthcare professionals and stakeholders. To explore business opportunities, medical and healthcare equipment manufacturers, exporters and business agents will participate in the 2014 fair. All buyers representatives of healthcare authorities, public and private hospitals and clinics, and other industry decision-makers such as distributors and agents should not miss this golden sourcing and information exchange opportunity. and Disposables and Medical Textiles. Tech Exchange attracting more institutes

of the regionâ&#x20AC;&#x2122;s largest events for healthcare professionals, with over 4,500 delegates attended last year. The Convention will have about 90

For more information, please visit http://www.hktdc.com/fair/ hkmedicalfair-en

Modern technology is playing a major role in the medical and healthcare equipment industry, and innovations are essential to bring new hopes to many lives. As the fair attracts manufacturers and entrepreneurs, a specialist zone called â&#x20AC;&#x153;Tech Exchangeâ&#x20AC;? offers a perfect platform and a matching opportunity for concepts, innovations and prototypes to be turned into commercial products. The Chinese University of Hong Kong, Hong Kong Polytechnic University, Hong Kong University of Science and Technology, and TEC Edmonton from Canada will participate in this zone to present their ideas and meet potential investors and developers. The fair is an ideal platform for not only trading but also information exchange. A series of seminars and buyer forum will be scheduled to provide the latest market intelligence to industry players and clinicians. Experts will be invited to share insights into regulatory updates, product innovations and market development of medical devices and supplies sector. Exhibitors will present and demonstrate their latest products in exhibitor forum. Distinguished speakers attending the Convention There is considerable value-added in the presence of the concurrent Hospital Authority Convention 2014, one

About the HKTDC

A statutory body established in 1966, the Hong Kong Trade Development Council (HKTDC) is the international marketing arm for Hong Kong-based traders, manufacturers and service providers. With more than 40 global offices, including 12 on the Chinese mainland, the HKTDC promotes Hong Kong as a platform for doing business with China and throughout Asia. The HKTDC also organises trade fairs and business missions to connect companies with opportunities in Hong Kong and on the mainland, while providing information via trade publications, research reports and online. For more information, please visit: www.hktdc. com. Follow us on Google+ Twitter @hktdc LinkedIn Medical Device ASIA | January-February 2014 | 41

Deep UV Microscopy from Rapp OptoElectronic Standard microscopes do not transmit light below ca. 320 nm due to the low transmission of their optics and objectives at these wavelengths. For applications like: Imaging and/or fluorescence excitation below 320 nm DNA damage and repair studies at 266 nm Photoactivation Measurement of spatially resolved UV absorption spectra (OSD) Company offers a complete solution, including: Modification of the microscope pathway to transmit deep-UV wavelengths Quartz objectives Dichroic mirrors suitable for UV Light sources UV-sensitive cameras

X-taLight 100 - Microscope UV from Molecular Dimensions X-taLightTM 100 offers a UV Fluorescence source for existing Microscope. A costeffective, robust and easy-to-use Light Source, X-talightTM 100 utilises integrated UV and white light sources to allow: Clear differentiation of protein/other biomolecules from salt crystals and direct attachment to an existing microscope or imager. Benefits: Clear differentiation of protein/other biomolecules from salt crystals. Direct attachment to existing lab microscopes = cost effective. Visualize small crystals against a background of precipitate. Minimal UV exposure time needed to avoid crystal damage. Reduce time wasted on following up false crystallization hits. Can be supplied with CCD camera for taking live images or stills in UV. Applicable to both Micro Matrix Seeding (MMS) and Lipidic Cubic Phase (LCP) crystalliztion approaches - based on Trp fluorescence. Can operate in cold rooms.

UVM-1 Ultraviolet Microscope from Craic The UVM-1™ is a UV microscope that also can image in the visible and NIR. This UV-visible-NIR microscope embodies both advanced optics for cutting edge UV, color and NIR imaging and visualization. The system is a flexible design, very easy to use and very durable. It is designed with cutting edge CRAIC optics for the highest image quality and to give years of service. The UVM-1™ UV microscope can image in transmission, reflectance, polarization and even in fluorescence from the UV, visible, and NIR regions with high spatial resolution...all with the same microscope and without swapping components. Key Features: Deep UV microscopy Visible range microscopy NIR microscopy...all with the same instrument ! Ultraviolet-visible-NIR imaging in one shot. And without changing optics! Raman spectroscopy of microscopic samples. Transmission, reflectance, fluorescence, and polarization imaging of microscopic samples...all with the same instrument

42 | January-February 2014 | Medical Device ASIA

CRAIC Apollo Raman Spectrometer The CRAIC Apollo™ Raman spectrometer is designed for fast, easy micro-Raman spectroscopy. As such, it is perfect for research, metrology and inspection of microscopic sampling areas by Raman spectroscopy. The CRAIC Apollo™ Raman spectrometer employs optics, software and hardware optimized for Raman spectroscopy of microscopic samples. The CRAIC Apollo™ Raman spectrometer is perfect for rapid, non-destructive analysis in fields such as life sciences, materials science, chemistry and physics. The CRAIC Apollo™ Raman microspectrometer features a modular design. Each module includes laser excitation, optical interface, Raman spectrometer and software. Modules are offered with different lasers wavelengths and can be used together for the ultimate in experimental flexibility. With an all solid state design, The CRAIC Apollo™ Raman microspectrometer is able to measure Raman scattering from microscopic samples quickly, easily and non-destructively. This Raman system is durable, easy to use, highly sensitive and economical to own and operate.

20/30 PV UV-Visible-NIR Microspectrophotometer from Craic The innovative 20/30 PV™ microspectrophotometer is the latest and most powerful instrument from CRAIC Technologies. Built to meet your requirements, this bespoke instrument incorporates the latest technological advances in optics, spectroscopy and software to deliver the superior performance with unparalleled speed and capabilities. The ease-of-use for which CRAIC instruments are known has even been improved, making this instrument the cutting edge of UV-visible-NIR microspectroscopy. The 20/30 PV™ microspectrophotometer combines the latest technologies to allow the user to measure UV-visible-NIR range transmission, absorbance, reflectance, emission and fluorescence spectra of sample areas smaller than a micron across. Even the thickness of thin films and color spaces may be determined. And while microspectra™ are being acquired, the sample may be viewed with high-resolution digital imaging in the deep UV, in color or in the near infrared. Ease of use features also add to the power of the 20/30 PV™ system and include everything from improvements in the instruments ergonomics to software to automation.

Meet us in Medical Fair India For more information: info@medicaldeviceasia.in Medical Device ASIA | January-February 2014 | 43

New approaches for emerging technique in diagnostic imaging for breast cancer

efinements made to nearinfrared spectroscopy during clinical MRI Dartmouth engineers and radiologists are developing new approaches for an emerging technique in diagnostic imaging for breast cancer-MRI with nearinfrared spectroscopy (NIRS) as reported in the journal Academic Radiology, February 2014. Combined MRI/NIRS may benefit women whose mammogram showed an abnormality and requires further testing to rule out cancer. The test would be conducted before an invasive biopsy to look for tumors. For the new method to work successfully in routine patient care, MRI/NIRS must adapt to an individual’s body size as well as accommodate a range of cup sizes. The equipment must also mobilize and maintain contact with the breast.

on her stomach and the breast hangs pendant through the holes of the MRI/NIRS breast coil. The procedure is nearly identical to clinical MRI. Eight women participated in a trial of the new design. “We found that the new interface allowed us to target lesions more effectively than ever before, said Michael Mastanduno, corresponding author of the study. “Set up time was faster and images were of higher quality.”

An MRI/NIRS may offer specific advantages to women with dense breasts, who are more likely to develop and die from breast cancer. A dense breast is harder for a radiologist to “see through” when using traditional imaging equipment, which lacks the sensitivity to penetrate the dense tissue. Standard breast screening is effective 77-97 percent of the time in a normal breast, but when a breast is dense precision falls to 63-89 percent. Prior approaches for MRI/NIRS used parallel plates and relied on custom breast molds for each patient. Biomedical engineers from the Thayer School of Engineering at Dartmouth developed a new, more flexible, convenient, and comfortable approach. They designed a set of eight light transmitting cables that can be adjusted to surround the breast with light tension. A woman lies 44 | January-February 2014 | Medical Device ASIA

The Dartmouth MRI/NIRS offers increased coverage of the chest, giving providers improved visibility for “ hard to see” areas, such as the outside area of the breast near the armpit. “This work is a huge improvement on previous designs of MRI/NIRS systems. All breast sizes and lesion locations can now be effectively imaged. Though there is more work to be done, this technology is promising for improving MRI’s ability

to distinguish cancer from benign abnormalities,” said Mastanduno. As a next step Dartmouth researchers will test MRI/NIRS in women with suspicious lesions.

Leveraging technology

High-tech equipment and syngo imaging IT solutions from Siemens helped Medanta

he Medicity in suburban Delhi, India, offer effective and accessible healthcare and quickly win patients’ confidence. Naresh Trehan, MD, Cardiac Surgeon, Chairman and Managing Director, Medanta - the Medicity, Gurgaon, India Medanta – the Medicity, started by renowned cardiovascular and cardiac surgeon Naresh Trehan, MD, is a multispecialty hospital situated in Gurgaon, a suburb of Delhi, India. This 30-month old hospital has already earned a name for itself in India with its focus on offering world-class healthcare at affordable prices. According to Trehan, he adopted a two-pronged strategy to meet Medanta’s objective of offering affordable, quality healthcare: He hired the best doctors in the country and went for the latest technology.

While the first stage is the acquisition of images through various source-type systems, the second stage is the transportation of these images. Earlier, transporting images took a lot of time. “Doctors would listen to reports over the phone and often perform surgeries without seeing the images. This led to inaccuracies,” says Trehan, Chairman and Managing Director of Medanta. The imaging IT trio of syngo has addressed these challenges by making images from multiple modalities available at the point of care. “The syngo imaging IT solutions help us diagnose, prognosticate, and then plan the treatment for all kinds of diseases,” says Dr. Praveen Chandra, Chairman, Division of Interventional Cardiology. Praveen Chandra, MD, Chairman, Division of Interventional Cardiology

Praveen Chandra, MD, Chairman, Division of Interventional Cardiology

“Real-time transport of images is a great bonus,” says Trehan. With instant availability of images, clinicians can discuss the disease with patients and their family. “Ready access to images makes decision-making a lot faster,” says Chandra. “The syngo imaging IT solutions help give us the

Naresh Trehan, MD, Cardiac Surgeon, Chairman and Managing Director, Medanta - the Medicity, Gurgaon, India

competitive edge over other hospitals in the region,” says Chandra. Faster diagnosis and treatment have led to higher throughput, making Medanta one of the busiest hospitals in and around Delhi. With higher throughput, Medanta is also able to spread its costs over a larger patient base.

Medanta boasts of latest Siemens equipment, such as a SOMATOM® Definition Flash computed tomography (CT) system, an Artis® zeego hybrid room, a MAGNETOM® Verio 3 Tesla magnetic resonance system, and a Biograph® mCT PET•CT system. It also deploys the imaging IT trio of syngo.via1, syngo.plaza, and syngo Dynamics. These imaging solutions help speed up the process of diagnosis, enabling speedier and effective treatment.

Medical Device ASIA | January-February 2014 | 45

“India Can Be the Healthcare Provider to the World” Dr. Devi Shetty, Chairman of Narayana Health, headquartered in Bangalore, India, is on a mission to expand the reach of world-class healthcare facilities to the poorest in India. And he’s convinced that his model can be replicated the world over. Dr. Devi Shetty – Chairman and Founder of Narayana Health (NH) – is known the world over as the ‘Henry Ford of heart surgery’ for applying mass production techniques to healthcare, thereby exploiting economies of scale. His healthcare model has worked, and with tremendous success. From a 300-bed hospital in 2001 at Bommasandra, in Bangalore, NH today is a 6,000-bed healthcare conglomerate, with 17 hospitals in 13 locations across India. Over the next six years, Shetty plans a five-fold increase – to become a 30,000-bed healthcare provider with a global presence. He plans to achieve this by building low-cost, 300-bed, multispecialty hospitals that take just six months to construct.. Shetty’s hospital chain never turns away a patient due to a lack of funds. Despite this policy, NH claims to make higher profits than several American healthcare chains. Working on the Healthcare Challenges in India According to Shetty, countries can reduce the cost of healthcare by increasing the number of healthcare professionals, such as doctors, nurses, technicians, and administrators. And he is optimistic that the scenario will change very soon in India. He is one clinician who has been working on the most common challenges gripping the Indian healthcare industry – the prohibitive cost of healthcare services, lack of specialists, low penetration of medical insurance, and the high cost of medical education – through various initiatives. In his opinion, India has all it takes to emerge as a major healthcare provider to the world.

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FDA Approves Magnetic Device for Migraine Treatment The U.S. Food and Drug Administration recently approved the marketing of a magnetic stimulator device to treat migraine headaches. The Cerena Transcranial Magnetic Stimulator (TMS), produced by Sunnyvale, CA–based eNeura Therapeutics, specifically won de novo premarket approval for treatment of migraine headaches that are preceded by an aura: a visual, sensory or motor disturbance immediately preceding the onset of a migraine attack. “Millions of people suffer from migraines and this new device represents a new treatment option for some patients,” Christy Foreman, director of the Office of Device Evaluation in the FDA’s Center for Devices and Radiological Health, said in a news release. Here’s how the Cerena TMS works: A headache sufferer uses both hands to hold the device against the back of the head. Pressing a button releases a pulse of magnetic energy to stimulate the occipital cortex in the brain. An FDA-reviewed study found that 38% of migraine patients who used the device reported no pain after two hours, versus 17% in the control group. After 24 hours, nearly 34 percent of the Cerena TMS users were pain-free; only a tenth in the control group experienced no pain. The study did not show that the Cerena TMS is effective in relieving the associated symptoms of migraine, such as sensitivity to light, sensitivity to sound, and nausea.

Faster Diagnosis for More Patients

How a Rather Inaccessible Region in India Benefits from Laboratory Automation Babina Diagnostics covers 70 percent market share in the region thanks to automated systems. The new solution means less errors and more productivity of employees. Raising Productivity with Laboratory Automation There is method in Singh’s strategy. He bought the StreamLAB a little over two years ago within months of its launch in India. And the acquisition has since paid rich dividends.

abina Diagnostics in India’s turbulent and relatively inaccessible northeastern region has invested in laboratory automation to provide quality healthcare at affordable rates. The four-storied glass facade of Babina Diagnostics in Imphal, the capital of Manipur, a state in northeastern India, stands out amid the dilapidated structures that dot the city. An even bigger surprise, however, can be found on the third floor of the laboratory: The centerpiece of this laboratory is a Siemens StreamLAB Analytical Workcell, the only one in India. Babina Diagnostics has one of the best-equipped diagnostic laboratories in the region. “I want to give the best to the people of Manipur”

of entrepreneurial balance – what with his significant investments in state-of the art diagnostic instruments in a place like Manipur, where purchasing power is much lower than the national average. But the doctor, who founded Babina Diagnostics in 1983, says: “I want to give the best to the people of Manipur.”

The StreamLAB solution is an intuitive automation solution that consolidates all tasks in a single workstation, which helps streamline workflow. This compact system is fully-automated and offers extensive immunoassay menu options. The StreamLAB solution has helped Babina Diagnostics reduce its turnaround time in the range of 30-35 percent. It has almost entirely eliminated errors on the laboratory floor and has

increased the productivity of employees. Covering a 70 Percent Market Share in the Region With the acquisition of the StreamLAB solution, Babina Diagnostics – which commands a 70 percent market share of Manipur’s diagnostics business – can process a million tests a year. It processes almost 1,000 patient samples per day – approximately 70 percent are walk-in patients while the rest of the samples come from Babina’s 100 collection centers spread across Manipur, Nagaland, Assam, Tripura, and even Myanmar. Patients, who often come from far-off villages, are confident of receiving their test reports by lunchtime. Despite the significant investments, the volumes have helped Babina Diagnostics keep the cost of its diagnostic tests affordable for the average population.

Dr. Th. Dhabali Singh, 59, founder and owner of Babina Diagnostics, says with a chuckle that many in the small world of India’s diagnostic industry think he has lost his sense

Medical Device ASIA | January-February 2014 | 47

Google Rumored to Be Developing Medical Device Google recently sent several of its employees to meet with Jeffrey E. Shuren, MD, who heads up FDA’s medical device branch, and other agency staff. Bloomberg speculates that the new product could be tied to biosensors. The employees in question hail from the company’s Google X division, a secretive productdevelopment branch managed by Google cofounder Sergey Brin. The division is said to be responsible for Google Glass and the company’s self-driving cars. Google employees in the meeting had worked on health-data– tracking contact lenses, according to Bloomberg. Among the Google employees

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48 | January-February 2014 | Medical Device ASIA

A Trailblazer in Orthopedics research has won him numerous international awards including the prestigious ISSLS (International Society for the Study of Lumbar Spine) Prize for Spine Research for 2004, 2010, and 2013; the EuroSpine Open Paper Award for 2008; the MacNab LaRocca Research Award, Canada, 2005; and the ISSLS Sofamer Danek Award for 1996, 2002, and 2006. Dr. S. Rajasekaran on his research in orthopedics

sing simple radiological tools for research to transform international methodologies in orthopedics Dr. S. Rajasekaran of Ganga Hospital, Coimbatore, used simple radiological tools for research to transform international methodologies in orthopedics. Dr. S. Rajasekaran’s office on the ground floor of Ganga Hospital on Mettupalayam Road, Coimbatore, is quite spacious. Yet, display space is almost running out for awards won by Rajasekaran, Chairman of the Department of Orthopedic and Spine Surgery, and his teams. Private hospitals in India rarely undertake medical research. But Ganga Hospital is definitely a cut above the rest, and research has played a key role in its success. It was set up in 1978 by Rajasekaran’s father, Dr. J. G. Shanmuganathan, an anesthetist. Rajasekaran, who joined Ganga in 1991, ensured that the hospital has the right blend of clinical and academic activities. Today, when Rajasekaran adopts a methodology, it impacts on the international community. Award Winning Expert Rajasekaran’s interests relate to spinal tuberculosis, open fractures, genetic studies, back pain and disc degeneration, disc diffusion studies, computer-assisted orthopedic surgery, and diffusion imaging of the spinal cord. His

In 1991, when Dr. S. Rajasekaran and his brother Dr. S. Rajasabapathy, a plastic surgeon, returned to India from the UK, they decided to convert their father’s polyclinic into a specialty hospital for orthopedics and plastic surgery. After his return to India, Rajasekaran realized the huge difference in the approaches adopted by orthopedics in India and their peers in the West. While those in the West believed surgery was the answer to most ailments, orthopedics in India were busy attending to trauma and accident cases. “Mere mention of spine surgery in India would scare patients,” says Rajasekaran. Advancements in Orthopedics Research Even today, very little is understood about back pain. “A magnetic resonance exam may show some changes in the spine, but the pain may be coming from somewhere else – the joint, the disc, nerves, muscles – or the problem may be in the brain. You can also experience pain due to depression, stress, or anxiety.” That was why Rajasekaran decided to get into research. His first published research – The Natural History of Childhood Spinal Tuberculosis – proved that kyphosis progresses in one third of the children even after complete cure of tuberculosis. Rajasekaran also described four radiological signs by which children at risk of kyphosis could be identified. These ‘spine-atrisk’ signs are now widely used throughout the world. Rajasekaran

has also undertaken considerable research on measurement of disc nutrition, disc degeneration, enhancement of disc nutrition, as well as compression and endplate breaks. Research not only prevents the onset of professional fatigue, it gives medical practitioners a fresh perspective. “You start analyzing. And then every patient looks interesting,” says Rajasekaran. MRI plays an important role in research in orthopedics MRI plays a significant role in research at the hospital. Understanding Diseases Through Radiology Radiology plays a key role in research at Ganga. Rajasekaran uses computed tomography (CT), magnetic resonance imaging (MRI), and X-ray systems for his research. “Radiology was previously only meant for diagnoses. Today, it is also being used to understand diseases and their aspects,” says Rajasekaran. Siemens’ systems have played a significant role in all of the research. In fact, Rajasekaran has undertaken a great deal of his research on a MAGNETOM® Symphony 1.5-tesla MRI eco system. “For the spine, the 1.5-tesla provides excellent clarity,” he says. Ganga Orthopedics Research and Education Foundation In 2002, the hospital founded the Ganga Orthopedics Research and Education Foundation (GOREF), funded by Rajasekaran’s family. The next step was to utilize hospital resources for research. The MRI eco system, for instance, was relatively free after 8.30 p.m. “We convinced our consultants to charge less for research,” he says. Today, GOREF has grown and has to its credit various activities such as supporting the academic training of the hospital staff, holding scientific meetings and conferences, funding on-going research activities, and

social projects at the hospital. Ganga Hospital provides fellowship to senior residents from all across India. It has a team of international students coming in every year to learn new techniques in spine surgery. “In the last 15 years, we trained 463 doctors from 42 countries,” Rajasekaran says. Since 1991, Ganga Hospital has grown from a 42-bed hospital with four operating rooms to a 426bed hospital with 18 operating rooms. More importantly, its approach is very different from other private hospitals. For instance, Ganga Hospital never turns away patients – even if they can’t afford the treatment. It organizes donors for the poor. Overall, the treatment costs are affordable. News about Ganga has spread by word of mouth. Even today, Ganga Hospital does not have a marketing department and has never advertised. But still, 30 percent of Ganga Hospital’s turnover comes from patients who do not reside in Tamil Nadu. Looking to the Future For Ganga Hospital, Rajasekaran feels the scope for expansion is huge. However, it must be dovetailed to the needs of the various strata of society. “We need to be aware of the different affordability levels and needs,” he says. “Our health delivery model has to be different from the West.” Rajasekaran is convinced that the private sector must focus on the needy. Rajasekaran is now looking at the next big step. “We have concrete plans to get into sub-specialties,” he says. He is examining whether there is scope for a 300-bed spine hospital, a 300-bed joint replacement hospital, and a 500-bed accident hospital in Coimbatore. “It may not happen today, but it will happen in the next three to four years,” says Rajasekaran.

Medical Device ASIA | January-February 2014 | 49

KAS Fluid Facelift The Fountain of Youth Within By Dr. Ajaya Kashyap, MD, FACS

After treating several thousand patients who were looking for a non-surgical way of finding a young fresh look for their face and have a vibrant glow to their skin, we seem to have pioneered the right solution – KAS Fluid Facelift. Dr. AjayaKashyap, has developed a technique for non-surgical, long lasting rejuvenation of the face. Anyone at any age can be a candidate for the KAS fluid facelift. It is minimally invasive and improves the texture and health of the skin as well as replenishing or enhancing the volume where it is either lost or has been deficient. Dr. Kashyap has done this procedure in young ladies and men in their 20s with skin which does not look fresh, has scars or lacks fullness. This procedure has also been performed on ladies and men in their 70s who

Medtronic, Inc. (MDT)’s Pacemaker Wins FDA OK For Full-Body MRI Scans

want a three dimensional rejuvenation of the face including volume restoration and skin rejuvenation.

Medtronic SureScan® Pacing Systems First to Be Approved for Full Body MRI Scan Without Positioning Restrictions

The face is assessed and three different areas are marked: 1. Areas where volume needs to be removed like chin, jowls and lower part of cheeks 2. Areas where volume needs to be added like upper part of cheeks or lateral parts of the face and forehead or anywhere with hollows or depressed scars. 3. Areas where volume is neither too little nor too much but skin needs rejuvenation.

patients had been contraindicated from receiving MRI scans due to potential interactions between the MRI and device function. According to published literature, up to 75 percent of patients worldwide with implanted cardiac devices are estimated to need an MRI scan during the lifetime of their devices.

Dr. Kashyap performs 2 to 3 KAS facelifts each week. The patient demographics vary widely. The percentage of men to women is 1:3, which is higher in men than for other kinds of facelifts. The benefit for men and working women is the minimal downtime required and no incisions. The natural youth and suppleness of the skin and tissues is restored and enhanced. Stem cell enriched Adipocytes, derived from the patient’s own fat are used, as fillers and rejuvenators along with PRP. The results are very natural and extraordinary resulting in a beautiful youthful you.

Information Technology, Medical Imaging & Diagnostics Products The Siemens Healthcare Sector is one of the world’s largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective.

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Medtronic, Inc. (NYSE: MDT), announced that the Medtronic SureScan® pacing systems - the first and only pacing systems in the United States that have been approved by the U.S. Food and Drug Administration (FDA) for use with magnetic resonance imaging (MRI) - are now approved for MRI scans positioned on any region of the body. Patients implanted with the Advisa DR MRI® or Revo MRI® SureScan pacing systems now can have MRI scans without positioning restrictions, including the chest area, which previously had been restricted. “This approval allows for a more streamlined MRI scanning process and makes scanning the chest easier and more accessible for patients with pacemakers,” said Pat Mackin, president of the Cardiac Rhythm Disease Management business and senior vice president at Medtronic. “Because MRI is the standard of care for soft tissue imaging and is a critical component for early detection, diagnosis and treatment, this FDA approval will help more patients with SureScan pacemakers receive the MRI scans they need.” Until the availability of Medtronic’s SureScan pacemakers, U.S.

The recent approval was made following the FDA review of computer modeling and clinical data confirming that MRI chestpositioned scans are safe for patients. The first MR-Conditional pacemaker available in the U.S., the Medtronic Revo MRI, was FDA approved in February 2011, and the secondgeneration Advisa MRI was approved by the FDA in January 2013. In collaboration with leading clinicians, researchers and scientists worldwide, Medtronic offers the broadest range of innovative medical technology for the interventional and surgical treatment of cardiovascular disease and cardiac arrhythmias. The company strives to offer products and services that deliver clinical and economic value to healthcare consumers and providers around the world.

Apple Hires Medtech Talent in Pursuit of iWatch Wow Factor

lthough reports tracing and speculating on Apple’s progress on wearable medical devices have been periodically surfacing since 2011, the company itself has remained mum about its plans. A search of Apple’s website for the terms “wearable medical” delivers exactly one hit—a story about how Medtronic uses iPads. Still, the usual suspects are once again all a-twitter with another round of wondering centering around recent reports of new hires for the iWatch development team. The platform itself could be used as a health-monitor of sorts, potentially tracking everything from heart rate, activity, skin temperature, and sleep quality. The firm has also hired a number of people with experience designing technology for tracking sleep. Last year, Apple CEO Tim Cook opined that wearable devices could potentially serve as a powerful tool to change users’ behavior. “Can [a wearable] change somebody’s behavior? The book hasn’t been written on that yet.”

on hardware development for the iWatch. On Dougherty’s LinkedIn page she describes herself as the “Hardware Lead” at Sano, “solely responsible for electrical design, testing, and bring-up as well as system integration” for Sano’s transdermal patch that, the company says, will soon be able to monitor glucose levels, kidney function, and electrolyte balance. She previously worked as a senior electrical engineer for device systems at Proteus Digital Health, the maker of an ingestible wireless pharmaceutical tablet tracker. According to Fast Company, which apparently got a look at a prototype of Sano’s device,“There are enough probes on the wireless, battery-powered chip to continuously test up to a hundred different samples, and 30% to 40% of today’s blood diagnostics are compatible with

the device. It’s cheap, too, with a materials cost of just $1 or $2 per sensor (each sensor has a seven day lifespan) thanks to an efficient manufacturing process that’s similar to what’s currently used to make semiconductor chips. The device isn’t waterproof yet, but Sano is working on it.” Narasimhan was formerly vice president of R&D, biosensor technology, at Vital Connect. His LinkedIn page describes his experience in research and development on biosensors, machine learning, systems biology and computational biology and his expertise in biomedical algorithms, data analysis and wireless technologies. At Vital Connect he was “responsible for biosensor technology and algorithms for remote physiological monitoring with wearable medical devices.” He says this sensor processing

included ECG, respiration, human fall detection, posture and activity. Narasimhan also claims “over 40 patents granted and over 15 pending.” As reported by Gurman, “Of course, it is not certain that the work of either Narasimhan or Dougherty will directly appear in an Apple wearable computer or other device. What this information does indicate, however, is that Apple is growing its team of medical sensor specialists by hiring some of the world’s most forward-thinking experts in seamless mobile medical technologies.” Still, considering their new employer, perhaps it’s not surprising that two fashion designers, Ben Shaffer, formerly Nike’s design director, and Paul Deneve, former Yves Saint Laurent CEO, were signed before the iCompany inked deals with the new hardware talent..

The website 9to5Mac.com’s Mark Gurman is widely credited with breaking the story that Nancy Dougherty (one of MD+DI’s 40 Under 40 in 2012) has been snatched up from blood-monitoring startup Sano Intelligence. In addition, Apple hired away Ravi Narasimhan from his post as vice president of R&D, biosensor technology at medtech startup Vital Connect. According to Gurman, the two will be working Medical Device ASIA | January-February 2014 | 54