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Health Corner- Myths versus Facts

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Preface: I was given a rather daunting task by one of my acquaintances to put down some tips on good health for general information to my fellow crowd and beyond to humanity at large. Naturally it was difficult to decide where to start from, since the target readers may be from all strata and communities of our society and of all age groups.

But let me begin somewhere….

In the beginning, I would like to put some very general lifestyle habits which should be followed by all people for general good health to one and all. Many of what I am about to unfold are known to public, but some new concepts will also he hereby known-to undo any faulty /wrong habits which the reader may have inculcated, inadvertently.

Let me suggest a listing of never do’s & don’ts:

Never to skip your Breakfast in the morning. This is the most important meal of the day.

              1. You may skip your lunch/take a light lunch.
              2. Never take a heavy dinner moreover with lots of spicy and oily food. Night is the time of metabolic house-cleaning. The less the task assigned to the body in the form of digestion and metabolism at night, the better the body gets self-cleansed and detoxified by the next day.
              3. Drink at least l0 glasses of water in a day. Maybe more in the hotter regions.
              4. Soft drinks are real nuisance consumables with lots of empty calories. They are never to be considered for replenishing the fluid content of the body.( I have found hardly anybody drinking water along with any food-it is invariably a soft drink to go along !!!)
              5. If milk is tolerated, one can go for it, it helps one to go off to sleep. But it should be avoided by people who are trying to get into shape and lose some weight! Dairy products in general are fattening with the exception of some skimmed milk, etc. All the same, rnilk is regarded as one of the compact forms of nutrition…for calcium supplementation .
              6. Eggs are nutritionally recommended for calcium/protein etc. and they do not contribute to high Cholesterol, unless one is predisposed to high lipids in the blood.. (as per recent research). The no. of eggs should be restricted to 1-4 in a week! Not to forget that eggs go into the making of a lot of confectionery products as well, at home. This should also be considered.
              7. Red Meat/Meat of bigger animals should be avoided at all cost. Mutton maybe very delicious to the taste buds and a gratification to cook at home and places of formal eating, but it is a strict no-no as far as good health is concerned. Its fibers arc very much loaded with fats.
              8. Country chicken is always better-they run around a lot and their flesh is tastier as well than poultry bred chicken!!! Chicken should always be taken with the skin removed preferably before cooking. Ideally eggs of such country chicken are good to taste and good for health also. Duck’s Eggs are tastier but rich in Cholesterol!
                Recently the eggs of Quail birds are available locally too.
              9. Green vegetables and at least one serving of fruits should be present in the platters of all meals. Bananas are good in conditions of constipation/diarrhea but they are fattening as well as they contain a lot of calories. ( Bananas are an item with high GI –Glycaemic Index–They can be taken in moderation from time to time. People suffering from ‘Acid Peptic Disorders’ should refrain from Oranges and all sour fruits.
              10. Dry fruits – recommended best ones are Almonds and Walnuts. Cashew nuts although are common and tasty, they are rich in lipids. Peanuts are very good as well.
              11. Chocolates in general should be taken occasionally-but the darker ones with cocoa are said to be now good for heart, as per recent research, although in moderation .Teeth must be brushed at all times after ingesting chocolates to avoid Dental Caries and related conditions by people of all ages, more so children.
              12. Microwave Cooking is to be discouraged-as it robs the food element of their nutritious values! Microwave ovens can best be used as Food Warmers.
              13. The pattern of eating should ideally be when you leave the dining table you feel as if you could have eaten some more………..!!!
              14. Brown Bread is better than White Bread. But Breads again should be taken in moderation, to keep a check on carbs.
              15. Visits to places like McDonald’s and KFC should be avoided in principle, particularly if children are there in the family. Deep fried junk food is just not advisable for good health for persons in any age group-particularly kids and adolescents.
              16. Not to hit the bed immediately after lunch/dinner. It is better to sit upright for about half an hour (watching TV can be done) before one retires tor the day. This prevents conditions of Reflux Oesophagitis/ Heartburn/Waterbrash etc. which are very common. One should not stoop down to do anything just after main meals!
              17. It is better to avoid eating in between principal meals-as this distorts the real appetite and calories cannot be controlled.
              18. Given the option between Tea and Coffee – it is better to go for Tea. Due to its Tannin content, it acts as a good anti-oxidant. (An anti-oxidant is a substance which mops up the potential carcinogenic radicals in the human body.)
              19. Salad dressing/salted preservative added food/fruit Cocktails/ Creamy pastries/ Pudding/ concentrated Kheer products/ Cheese/Butter/ Non-skimmed milk are better avoided.

Few topics relevant to people with certain known disease conditions:

Persons known to have Renal/Ureteric Stores should refrain from eating tomato/related products. A lot of water should be consumed daily.

              1. Persons known to have Diabetes/with father or mother a known diabetic, should maintain a vigilant Diet Chart at home and also, as much as possible outside home. Everything can be taken but in moderation, depending on one’s body weight. What matters is the daily calorie consumption in the guidance of a Dietician or a Doctor.
              2. People with Diabetes should ‘keep their feet as clean as their face’. It is a very well believed saying, respected by Doctors and well educated patients alike. Diabetics are very prone to develop foot ulcers which do not show a tendency to heal can cause big problems to the patient and Doctors and many people have ended up losing their limbs (by amputation) simply arising out of sheer neglect of themselves and their Physician’s advice !!!
                A word of caution here – today children are also diagnosed to suffer from Diabetes simply out of leading an erratic life style!!!
              3. Elderly people with Diabetes for many years are typically prone to have some of the following. So their care takers should be aware of them:
                            1. Silent Heart Attacks – which has a high mortality;
                            2. Sudden Strokes ending up with paralysis of different grades;
                            3. Sudden infective episodes inside their system requiring urgent Surgery;
                            4. Sudden/Early Blindness arising out of a process called Retinopathy…even Cataracts;
                            5. Damage of Kidneys-causing renal failure and heading for dialysis etc. which are very expensive, even by Indian standards and the outcome is always grim;
              4. People with Hypertension (High blood pressure) should try to lead a stress free life, with regular checkup of BP) and medication from Doctors. Long standing improperly treated Hypertension can also lead to damage of Eyes/Kidneys/Heart etc. excess salt on the dining table to be avoided, salt may be used, albeit sparingly in the kitchen.
                ( Less than 5-6 gms a day)
              5. Persons suffering from both ‘Diabetes and ‘Hypertension’ need to be doubly cautious with respect to their day to day life, follow-up with Doctors, dietary habits and medications. All the potential complications of these silent killers get multiplied in such people, but with regular supervision from medical personnel they can lead very compatible normal lives.
              6. Persons known to suffer from a condition called as “Gout” need to have a real look into their diet and consult Doctors when they have episodes of acute pain in joints etc. This is usually due to a genetically inherited metabolic deficiency of an Enzyme, which takes part in Purine metabolism in the body. Simple analgesics after seeing a Doctor may be tried and usually the attacks subside within a few days, in some cases other medication are required and even to go on for life in resistant chronic cases. Beer is to be strictly avoided in such patients and Red Meat and certain leafy vegetables too, should be avoided from their Diet.

I think this has been a synopsis of handy health tips- which all good samaritans of this country need to know-.in order to lead a healthy life here . I have chosen this simplistic approach, as it is easy to be followed by lay persons, avoiding complicated terminology which might intimidate the readers and will defeat the purpose. The List is exhaustive and it goes on and on! It is only a humble effort to pick up a glass full of knowledge from an Ocean of the same . Parents should be rather strict on their children on many such issues. Working men and women must take care of themselves in an adequate manner as hinted above . Elderly people must be closely taken care of by their sons/daughters and taken to visit Doctors if something sinister really comes up with them.
Good Luck and Good Health to all my brethren & friends – young and old.

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Taking on anemia by readdressing antenatal care in Karnataka

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Keywords: Anemia, Antenatal Care, Data analysis, cloud computing, MMR and IMR
 

Context:

The Burden of anemia in India is a major public health issue. More than 50% women and 20% children suffer from anemia and a leading cause of 40% maternal deaths in the country.
In the state of Karnataka, 79% of maternal deaths are found to occur due to anemia Karnataka State Health system 2015, 16). Antenatal period is crucial among pregnant women, lending adequate access to prevention, care and monitoring. However, rural communities in the region face several healthcare challenges, making pregnancy a high risk one,followed by poor pregnancy outcomes.
Anemia during pregnancy is preventable, if it is picked up well in time in the antenatal period through basic blood tests and clinical examination ( ).
How we contribute: In north Karnataka where many pregnant women face significant barriers to obtaining quality antenatal care, iKure is bringing care at the door steps of the rural people.
Through app. based diagnostic device, and innovative healthcare solutions, pregnant women are identified and regularly screened and monitored by trained health workers at the convenience of their home. They take health status assessment on their mobile app. perform blood tests and clinical examinations, organize health camps and message dissemination programs.
Patients who are at high risk of developing anemia or afflicted with the disorder are monitored frequently and supported by medical team to connect with doctors virtually through telemedicine platform or hospital referral system.
To provide patients with better healthcare outcomes, iKure using data analysis technology extracts useful knowledge with respect to anemia for better decision making and management. Through various technology innovations such as cloud computing, mhealth technology and smart applications supported by WHIMS, iKure is generating multiple data sources allowing doctors and researchers to make informed clinical and behavioural decisions, improving treatment processes and detecting anemia well in advance.
 

Impact:

The strategic antenatal care adopted by iKure provides the potential to significantly reduce the prevalence of anemia in Karnataka. In north Karnataka, with a sample size of 91 pregnant women, the insights collected in the Ist round of antenatal checkup reported 64% of the respondent with low haemoglobin count, which interestingly reduced to 57% in second round and 43% in third round checkup. Low blood pressure reduced from 24 respondents in the first round of health check up to 14 in third round. The programme is already demonstrating positive health outcomes, including raising health seeking behaviors among pregnant women who did not knew that they were at risk of developing severe anemia and other chronic ailments, increasing consumption of folic acid and iron tablets and reducing abortion rates.

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CHWs-Newfrontier to drive innovations in rural healthcare delivery

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The need:

Jayashree,is a Community Health Worker(CHWs) in her village called Hubli, in Karnataka. One day,while she visited a woman named Pushpa in her first trimester,she looked quite unwell. On enquiring Pushpa was found to suffer from Epilepsy. Her family also revealed, she has been prescribed with medicines by a local doctor, but she didn’t take them regularly. Epilepsy is a disorder of the nervous system and such patients during pregnancy have major concerns. Jayshree felt the need! She promptly captured her vitals on her smart phone loaded with Wireless Health Incident Monitoring Systems, (WHIMS), and pushed the patient’s vitals on to the cloud for a quick doctor reference. For the next few days, Jayshree monitored and screened her closely and counselled her and family about different preventive measures pertaining to her health conditions. Soon after,Pushpa recovered and gave birth to a healthy child. Like Jayashree, there are over 330 CHWs who are trained and strategically deployed across six states in rural India to become the frontier in iKure’s healthcare delivery system.
 

Context:

India faces large disparity in workforce distribution especially in rural regions where burden of diseases is high. With 44,000 doctors for 833 million people, the shortage of doctors in rural areas is severe where each doctor serves a community close to 19,000 people. The severe lack in rural areas has been attributed to lack of effective training and recruitment, ineffective distribution of workforce and failure to retain labour where needed the most.
With the urgent need of creating new cadres of frontline health workers that meets the demand of rural health, iKure implements strategic training, evaluation and monitoring programe with the judicious use of digital technology to address the gap. iKure has developed a cloud based platform called Wireless Health Incident Monitoring System (WHIMS) designed with an intuitive graphics user interface that health activists, with basic education can use. WHIMS is accompanied with instruments to measure vital statistics of patients, and for it to be a more reliable diagnostic tool, iKure created Medic Bags with low-cost POC instruments to assist CHWs to measure basic statistics. iKure has established ecosystem partnership with Public Health Care (PHC) system, and low-cost private healthcare providers, under which diagnostics collected by the CHWs are shared in real-time with doctors in these hospitals, who suggest treatments and prescribe medication through the WHIMS platform to the health workers, who relay this information to the patients. The evidence based data collected using WHIMS platform offer huge potential to drive policy and advocacy on the health status of the rural community.
 

CHW’s MEDIC BAG:

To address the fragmented approach of primary care delivery in rural community, iKure establishes integrated care enabled by the CHWs at different levels of the delivery system. To ensure quality care at each level, we build the capability (both technology and clinical) of the CHWs as the first step, to build technology enabled health system support, improve health practices at the household level, and bring integrated actions for health at community level. These cadres will be mobilized by iKure for different handholding of their designated roles in performing household visits, community level outreach camps, and facility based concept clinics. CHWs equipped with a Medical Kit that consists of devices such as BP machine, Stethoscope, pulse oxy meter, Thermometer, First Aid Kit, Weight machine, Height measuring scale, gloves etc., they carry medicines for basic common ailments, non-invasive haemoglobinometer, Haemoglobin kit to measure Hb level, mobile phone based sphygmomanometer, urine analyzer, calorimeter, ECG, flipcharts/Hoardings & registers. Through these CHWs, every patient is also provisioned with Digital Health Card (DTH) encrypted with a QR (Quick Response) code and during home visits, DTH gets updated with latest clinical indicators. The health data obtained from the health cards is synced to a cloud for effective utilization in the upward heath chain at both secondary and tertiary levels.

Prior to working as CHW, these village women remained mostly confined as homemakers performing daily household chores. As iKure build their capacity both technologically and clinically to work as frontline health workers, they also gain respect and position from their communities in the long run. Further, their contact and association with the community helps iKure drive effective community mobilization measures and act as a catalyst to drive behavioural change. While they interacts and communicates the necessity on the ground and identifies appropriate health needs, they conduct street plays, demonstrates hoardings and facilitates automatic health nudges through mobile phones of the beneficiaries at different levels. They are also attuned to provide nutritional counselling, and spectacle services based on the community needs.

iKure also build sustainable model for its CHWs. Through robust supply chain model, these CHWs promote various lifestyle products such as sanitation pads, branded spectacles, hair care, skin care products etc, which helps them gain daily incentives apart from monthly income.

 

Conclusion:

The CHW model of empowering the women community and gender mainstreaming represents transformational change in rural healthcare delivery. As they champion tech-savvy cultural values in otherwise austere facilities, and limited supply of doctors, such effort has established inspirational leaders driving catalyst change in public healthcare delivery.

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DIABETES MELLITUS

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What is Diabetes Mellitus?

Diabetes is a condition in which an abnormality in the metabolism results in high glucose level in the blood due to defective insulin production, secretion or utilization.

Classic Symptoms

  1. Increased thirst
  2. Excessive urination
  3. Fatigue
  4. Delayed recovery from infections
  5. Increased hunger
  6. Sudden unexplained weight loss
  7. Delayed healing of wounds

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Integrated approach to healthcare

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Never sees how rich or poor you are or neither judge you being affluent or dissolute, but when it hits, it hits equally hard to all of us- helpless, clueless and money less! In India, where the healthcare is being the most neglected for decades, and accessibility, affordability and quality underpinned with political and policy discourses, people have little hope left, as they witness the deeply rotten system within.

While the govt. is making every amendment to make quality care and treatment available at fair and affordable price, the balance between public needs with commercial aspirations has failed to bring efficiency in the system.

But this can be solved, if we look at the healthcare system in totality but not in isolation and I am happy iKure has put the right step forward where it seems health as an outcome of a holistic and integrated effort. Though started at a minuscule level, iKure is looking at health in totality as against in silos. We are bringing path-breaking innovation, sustainable approaches and best players under one roof that are seamlessly integrated across and impact every levels of the larger system.

Though the clamor of the rising healthcare costs, inefficient system and highly compromised quality create havocs in one’s mind during any episode of illness, iKure serves its beneficiaries with a difference, where it not just treats illnesses but creates good health by acting in totality. This integrated approach will be the game changer in future bringing efficiency in the system to serve better and act responsibly.

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The Main Types of Vaccines

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Adapted from: National Network for Immunization Information) Copyright 2000, and the National Immunization Program of the Centers for Disease Control and Prevention (CDC).

The safety and effectiveness of a vaccine depends on how it is made and what it contains. There are four main ways to develop vaccines:

 

Live attenuated vaccines contain bacteria or viruses that have been altered so they can’t cause disease. Killed vaccines contain killed bacteria or inactivated viruses. Toxoid vaccines contain toxins (or poisons) produced by the germ that have been made harmless. Component vaccines contain parts of the whole bacteria or viruses.

 
 

Live Attenuated Vaccines

Live attenuated vaccines usually are created from the naturally occurring germ itself. The germs used in these vaccines still can infect people, but they rarely cause serious disease. Viruses are weakened (or attenuated) by growing them over and over again in a laboratory under nourishing conditions called cell culture. The process of growing a virus repeatedly-also known as passing–serves to lessen the disease-causing ability of the virus. Vaccines are made from viruses whose disease-causing ability has deteriorated from multiple passages.

 

Examples of Live Attenuated vaccines:

Measles vaccine (as found in the MMR vaccine)
Mumps vaccine (MMR vaccine)
Rubella (German measles) vaccine ( MMR vaccine)
Oral polio vaccine (OPV)
Varicella (chickenpox) vaccine
Inactivated (Killed) Vaccines
Inactivated (killed) vaccines cannot cause an infection, but they still can stimulate a protective immune response. Viruses are inactivated with chemicals such as formaldehyde.

 

Examples of Inactivated (Killed) vaccines:

Inactivated Polio Vaccine (IPV), which is the shot form of the polio vaccine
Inactivated Influenza Vaccine
Toxoid Vaccines
Toxoid vaccines are made by treating toxins (or poisons) produced by germs with heat or chemicals, such as formalin, to destroy their ability to cause illness. Even though toxoids do not cause disease, they stimulate the body to produce protective immunity just like the germs’ natural toxins.

 

Examples of Toxoid Vaccines:

Diphtheria Toxoid Vaccine (may be given alone or as one of the components in the DTP, DTaP, or dT vaccines)
Tetanus Toxoid Vaccine (may be given alone or as part of DTP, DTaP, or dT)

 

Component Vaccines

Some vaccines are made by using only parts of the viruses or bacteria. These vaccines cannot cause disease, but they can stimulate the body to produce an immune response that protects against infection with the whole germ. Four of the newest vaccines are made this way.
Examples of component vaccines: Haemophilus Influenzae Type B (HIb) Vaccine/Hep B Vaccine/Hep A Vaccine/ PCV (Pneumococcal Conjugate Vaccine)

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Malaria

 

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Malaria is a dreaded disease since primitive times and time immemorial.

There is no statistics on how many lives has been lost since the dawn of civilization, from this preventable malady…this far.

It is a vector borne disease caused by the parasite Plasmodium species transmitted by the ubiquitous mosquito…Anopheles type…the female variety.

The parasite variants are Plasmodium Vivax/Plasmodium Falciparum/Plasmodium Malariae and Plasmodium Ovale responsible for causing the different clinical types of Malaria, each with different characteristic features and morbidity potentials.

The essential symptoms are Fever with chill and rigor and a subjective combination of headache/nausea/vomiting/abdominal ache/body pain etc.in an apparently non-complicated case of malaria. In complicated cases, the signs and symptoms become more sinister.

The fever often takes a typical periodical rhythm and gets the typical name of Tertian/Quotidian types of fever…associated with other typical/atypical symptom complex. Out of the whole galaxy of Malaria variants, what is dreaded most by the medical fraternity is Falciparum Malaria…which often ends up with fatal complications unless treated promptly and appropriately. The usual complications are affection of the central nervous system (Cerebral Malaria) manifested by convulsions and passing of black urine ( hence the name of Black Water Fever)….due to massive intravascular haemolysis of the parasitised RBC-s and the haemoglobin finding its way out through the kidneys….ending up with Renal failure… ! However with prompt and adequate treatment ,the complications may be avoided completely !

The treatment of Malaria is simple following its correct diagnosis and goes by a certain protocol adapted from country to country depending on the epidemicity of the disease and the resistance/susceptibility pattern of the region to the different drugs meant for the same. The basic tenets of malaria treatment remains the same guided by the parasite species and the nature of treatment required…..prophylactic / therapeutic. Travellers destined for Malaria prone areas are recommended to undertake Malaria prophylaxis prior to travel in those countries.

For some species relapse of Malaria isa big potential problem and some typical medication needs to be taken to prevent this relapse,due to characteristics of its lifecycle in the Red Blood corpuscles in blood/liver…over a certain period of time.
Some typical drugs used in Malaria prophylaxis / treatment /relapse control are..Chloroquine/Mefloquine/Quinine/Artemisin group of Drugs/Primaquine etc. guided by the indication of the type of approach required.

Prevention of Malaria is a daunting and herculean task targeted to different strategies of vector control ,through adult and larvicidal measures and adopting self protective measures like avoiding mosquito bites at all costs and steps to drastically reduce the adult mosquito population through strategic measures.
Emphasis should be placed on diagnostic approach to Malaria by proper facilitation of blood collection through Smear preparation on slides….thin and thick smears ..and identifying the exact variant of the parasite and its density.

Immediate treatment begins as soon as results are available and confirmation is also seeked through Immunological Tests for Malaria. (Malaria Antigen)…on select cases,as per the decision of the clinician.
Trained manpower is also a perquisite in Malaria control at all stages of its management approach.
In spite of adopting all the recommended measures in Malaria control…old and new….the menace of the disease is far from over and the human race needs to take particular precautions to prevent its transmission and spread to the community and keep the mortality as low as possible !

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iKure’s effective technology integration to address public health data challenges

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“It is not because countries are poor that they cannot afford good health information; it is because they are poor that they cannot afford to be without it.”
– Health Metrics Network, World Health Organization

Introduction
Health data is of paramount importance for public health policies, programs, budgets and evaluations, forming a strong ground for effective implementation and the basis for optimum health functions. Even a small scale data resource can turn highly effective to estimate highly resolved health effects. However, India’s existing health information remains skewed with large gaps in data collection, dissemination and analysis. With burden of diseases on the rise and the Millennium Development Goals’ deadline drawing closer, addressing the data challenges has grown imperative for effective healthcare delivery.

Data Challenges in India’s public health system

India’s public health department is limited with health statistics cadre with little or no statistical training. The system continues to lack data management, analysis, interpretations of large-scale public policies. Further, issues related to standardized health data collection. The aggregated data are collected and tabulated using different reporting formats by the health record department which leads to dublicacy and redundant data capture. Another challenge of the public health system is the medium on which records are stored. Health departments maintain paper based format and very few of them have opted the computer medium.

With the continuous emphasis of collecting and maintaining correct data for medical and research purposes, another obstacle among record keepers of recent trends is data utility. The practice for data collection is not well known and request for data collection is often misinterpreted.
With the given issues on data collection and sharing, the quality of data obtained from different locations also varies. Key data points when captured are difficult to accurately translate into a common language, which can influence the quality of data.

Integration of patient’s data using technology

The potential of health information technology in transformative healthcare delivery has achieved significant traction, but such technology holds huge potential in streamlining the aggregated data into aunified data management system to address the data challenges in public healthcare system.

iKure’s healthcare delivery is enabled by cloud hosted technology platform that seamlessly integrates various cutting edge technology allowing collection, display, transmission of patient’s generated health data accurately even with least human interface.

Mobile health technology holds great potential to address the data challenges, since it has reached in various segments of the population that have been underserved by healthcare settings for ages. The rapid growth of consumer mobile health market reveals that patient’s interest and use of mobile technology for sharing and receiving information have grown extensively.1 The high rate of adoption for digital technology presents massive opportunity to track patient’s clinical health outcomes, better characterize the behavioral and environmental effects on health and intervene constantly to improve health.2
For example, a basic cell phone is used to collect and disseminate information, identify locations, social contact and connectedness and these opportunities expands with the use of modern applications, computing power, and interface capabilities such as smart phones, wearable devices and m-health applications.

iKure’s Data sources

iKure believes health data will influence every step of the healthcare cycle, from patient experience to care delivery, innovative model and medical research. iKure helps medical practitioners analyze data creating a single data repository.
The data collected through various sources are stored through following medical devices:

Point-of-care diagnostics: iKure’s use of various point-of-care testing device such as digitalized ECG, glucose tests, Blood pressure etc., that create continuous streams of data which can be leveraged by medical field to interpret trove of information for early detection and diagnosis.

EMR Technology: iKure provides quick access to EMR, creating complete atomization of its patient’s medical records. Leveraging algorithm with machine learning, it offers medical experts to answer specific questions based on patient’s health rather than from global and national statistical averages.


Telemedicine platform: iKure extends access to healthcare for the underserved population through telemedicine platform. This has enabled iKure patient’s get access to specialized care in rural areas with no proper infrastructure. As its long term benefits is still unknown in medical research, studies on doctor’s effectiveness to collect patient’s information through digital settings can offer better insights and outcome on patient’s health.

Data for Research Analysis

iKure leveraging disruptive technology innovations are bringing together diverse kinds of data including socio-economics, environment, and genetic information along with individual health status, behavior and outcomes providing a powerful resource for medical research to pose new questions, uncover new findings and validate hypotheses. Towards this, iKure is working in association with Tandem Research organizations, which aims at developing and applying technology to detect early diseases and maximize the potential of its patient database to achieve high efficiency and make meaningful impact in patient’s life. This project will bring meaningful insights drawing from the field of Science and Technology Studies to develop frameworkto understand the sociology of the user and development of ethical and safe AI applications to protect user’s interest and privacy. It will draw qualitative information that is essential to understanding the socio-cultural factors that affect the system and the patient.

Data for Drug Trials and Analysis

With the ability of iKure to capture real-time patient’s health data, it presents wider scope for pharmaceuticals to leverage such data for clinical trials and analyze drug usage. Collaboration with iKure will provide access to million patients’ database providing granularity where pharma companies will know if there is greater benefit of using certain drug for a particular health issues based on highly specific characteristics. Going forward, we aspire to work with Pharma companies wanting to market-test their drugs usage and new trials. We intend to collaborate with public health agencies that are looking to understand what kind of treatments are efficacious and can be plugged together with regard to specific epidemics and save data collection costs.

Conclusion

In view of the privacy challenges related to Data access, iKure is using anonymization algorithm to effectively preserve both patient’s privacy and data utility. iKure’s data anonymization ensures balance between data utility and required participant data privacy. iKure is also using high security measures for the Data Security & Privacy.

References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603303/
2. https://www.nih.gov/sites/default/files/research-training/initiatives/pmi/data-collection-mobile-technologies

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Sleep

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Sleep is a periodical “switch off” from the immediate and remote surroundings…without any shut off of the body and brain…..a time for cellular rejuvenation and metabolic ‘house cleaning’…processing information acquired during wakefulness and a complex mechanism of warding off many illnesses….which is still in the process of research and understanding by mankind !

It is a stage of reversible consciousness with a few subtle physiological changes being at command, by a process of natural default, which happens with all human beings.

Sleep patterns are being governed by a circadian rhythm which is again controlled by several factors such as….daylight/darkness….genetic programming of our bodies….demands of our occupation…..fullness/emptiness of stomach…mental status..presence of/absence of pain in our body…..effect of medication etc. and the interplay of a lot of other factors…in day to day life.


Sleep deprivation…if continued for long, leads to a cumulative quantum of ‘sleep debt’ which is detrimental to the day to day functioning of the human body, until it leads to a sudden,,catastrophic let down of the whole system and a system collapse !

Symptoms of sleep deprivation could be any/all of the following……….. Excessive sleepiness during the day/Abnormal yawning/Irritability and lack of concentration/Daytime fatigue etc. A brief daytime shut eye…….often yields better performance in work or activities demanding greater concentration.

A minimum period of 6-7 hours of sleep a day is the basic requirement of our system….and more sleep or less sleep has its own consequences. Some occupations demand night shifts and wakefulness…such as Doctors..Pilots….Security and Army Personnel…Call center Employees etc. Although such people tend to balance it with sleeping through daytime hours….in the long run it may cause problems due to an alteration of the biological clock of the body.

Also……studying throughout the night by students ‘burning midnight oil’…is a common practice. This is detrimental to the cognitive performance the following day , due to lack of proper sleep. A good night’s rest works wonders for such anxious students and leads to better examination performances,it is noticed.

Sleep Disorders are often diagnosed in a sleep laboratory by tests referred to as Polysomnography and interpreted and treated by Sleep Specialists ! Some typical sleep disorders are…………………………

Narcolepsy and Cataplexy / Parasomnias / Somnambulism (sleep walking) /Hypersomnias versus Hyposomnias in the form of Early morning wakefulness/Delayed onset of sleep etc.to mention a few of the many identified conditions under this heading. They are often accompanied by psychiatric illnesses, to be addressed by Psychiatrists,if not by Sleep Physicians.

Self-medication with sleeping drugs through OTC purchases is forbidden for its addicting potentials and other significant side-effects of such medications and should be strictly prescribed by Doctors with mention of the exact duration of such a therapy.

( In many countries sleeping pills in general are all controlled drugs with stringent rules guiding their sale and usage)

To ensure a sound sleep overnight, a ‘sleep hygiene’ needs to be followed by all who suffer from sleep disorders as also otherwise normal people………………

The immediate environment should be controlled/modified as below..
   Switching off all electronic devices for the sleep period
   Light instrumental music in the ambience
•   All lights to be switched off ( the sleep hormone Melatonin gets released during darkness !! )
   A comfortable bed which is non-hurting to the body areas
   A cool bedroom
   No arguments just before sleep time with partners, spouses ,or children,or, other family members
   Some may read books with softer- to- mind content
   Light dinner about two hours prior to bedtime…aided by a warm cup of milk..may be, to induce sleep…just before retiring for the day
   A brief walk around may help some people just after dinner
   No vigorous exercise / gym regime just after dinner..avoiding bending down to steer clear of reflux issues in the upper GI tract
   Late night trepidation in the world of social media is mentioned to be discouraged around sleeping time…which often robs one of quality sleep in the night.( Social media has turned out to be one of the most strong‘predators’ of sleep !)
   Evacuation of bladder and bowels is an essential mandate before going to sleep.( A full bladder and ignoring the call is a main cause of restlessness during sleep…particularly during early morning hours).Of course people with Enlarged Prostate/Diabetes may need to get up a few times in the night, to respond to the call of nature !

Alcohol and/or smoking does not in any scientific way help in inducing sleep…one should note.
A brief meditation or a short prayer may help to soften the frayed nerves earned from the vagaries of life in the waking hours..!!
A person who sleeps well regularly has a sound immune system in general and wards off many illnesses…apart from staying non-obese and not falling prey to Hypertension ,Diabetes and a few other lifestyle diseases. For a long and productive quality of life (QOL)..proper and regular sleep plays a very important role..improving our efficiency and memory and all cognitive functioning as a whole.
So…..the message is Sleep well and take care of the body as a whole…in a preventive and prophylactic manner .

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Meshing of Big Data, AI And ML in Cardiac Care Continuum

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Introduction:
Every year 2.1 million patients die due to heart ailments in India. We have just 1 Cardiac Specialist for every 3 lakh patient. Although secondary and tertiary health care providers are engaged in doing ECGs and several other vital collections to analyze heart health conditions, but none of the existing solutions can identify high-risk cases from such reports and respond in time.

To address this gap, iKure combining Big Data, AI, and machine learning works on ECG signal anomaly detection & Patient risk model using stank ranking & deep learning that can assist cardiologists to offer preventive care much faster in the human life cycle. In association with IBM data science, iKure’s integrated platform provides seamless automation and interpretation of patient data to enable instant feedback for high-risk cases and offers high quality and cost effective continuity of cardiac care both for rural and semi-urban population.


Timely interventions can reduce the time span between critical and stable heart health conditions. However, failure of such gets magnified typically in last mile populations that constitute over 16 million cardiac patients out of total 30 million people. It has been observed that over the year from 2000 to 2015, the age-standardized rate of mortality (per 100,000 person-years) due to coronary heart diseases increased among rural men by 40% and for female it rose to 56%, whereas decline was registered among urban residents. Cardiac care in rural India is limited and inaccessible due to major shortfalls like shortage of doctors, diagnostic centers, equipped facilities, coupled with lack of awareness.

Cardiac diseases can be addressed through effective treatment plans, constant screening, and monitoring. Artificial Intelligence(AI) and Machine-learning(ML) can provide life-saving care in general and CardioVascularDiseases(CVD) specifically as high risk conditions can be identified early, impending strokes and heart attacks spotted in advance. Studies have established that AI is set to revolutionize cardiac care. This is particularly relevant in today’s context, as India is home to 16% of the global population, 25% of the world’s Coronary Heart Disease (CHD) burden, 120 million hypertensives, and a large number of individuals with Rheumatic heart disease (RHD). CVD will be the leading cause of morbidity and mortality in the country by 2020. Researchers have started meshing up Big Data with AIand machine learning algorithm to predict the anomalies quickly, cheaply and accurately without using the invasive methods.However, implementation of such advanced technology in primary healthcare delivery is still in its nascent stage in last mile communities. iKureusingAI and ML into their primary healthcare delivery, has taken cardiac care to advanced level of treatment.

The Cardiac Risk Model: The initiative is jointly done by iKure and the IBM Data +AI elite team that work on ECG signal anomaly detection and Patient risk model using stack ranking & deep learning. By leveraging iKure’s cloud based platform, it brings the power of AI with respect to patient’s clinical data stored in an AWS, MySQL data store to develop high risk pattern and can predict cardiac arrest in patients in much earlier stage.

Data is knowledge and when big Data from EKG signals coupled with a large volume of patient data from IBM cloud, cardiologists will get empowered to deal with cardiac problems through risk ranking of cardiac patients. It could also classify the EKG data as normal or with anomalies and present a prioritized list of patient cases to the call center physician for review based on potential acuteness via a cloud-based web application. It will help them to treat patients based on acuteness. In that way resources are utilized in the best possible way. Proof of concept is already developed that demonstrated that the platform can bring the power of AI to iKure’s data stored in an AWS, MySQL. The pilot project is showcased at IBM’s technology conference, Think 2019 in San Francisco. Accuracy of this model is already proved using patient clinical and demographic variables and physician feedback with the added benefits of rapid model development, publication and iteration.

Analysis of arrhythmia anomaly to predict cardiac arrest

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Conclusion: The analytics help screening of vital parameters including Heart Rate monitoring, a disorder in application sequence, arrhythmias, an electric axis of heart, myocardial ischemia and infarction and cardiac rhyme diagnosis vital for the prevention of early cardiac arrest. Leveraging iKure’s integrated model together with machine learning algorithm and Artificial Intelligence will enable specialists to have a more logical approach to diagnosis and treatment of cardiac arrhythmia. The output of such effort will enhance continuity of cardiac care even in last mile communities.

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