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SMOKING

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Smoking is a commonly abused potential to inhale tobacco/ items of substance abuse in the form of smoke through the upper naso-pharyngo-laryngeal passage. The list of substance(s) which could be taken in this manner is quite huge today… a few being… tobacco and a gamut of items under the heading of ‘substance abuse’.. Like opium and its derivatives.. in the form of heroin/cocaine/methamphetamine/PCP/cannabis etc etc.

The most commonly adapted form of Smoking menace is that of Cigarettes/ Pipe smoking/ Tobacco manipulated in many other forms. For those who smoke, it is the mindset which initiates this habit which then culminates into addiction. Youngsters feel it makes them look and act like mature adults with an obvious imaginary style quotient attached with the habit. Persons of slightly older age find that it is an essential habit to relieve them of stress of day to day life and many who feel it helps them to ease bowel habits and then cannot kick the practice as time goes on!

Although various governments across the globe have restricted out smoking in almost all the public areas like passenger transport… such as airports & aircrafts / train stations and rail compartments / public gathering areas-like cinema halls/auditoriums/malls etc. , public awareness is still not up to mark to curb/ get rid of the habit. To add to the woes…stopping tobacco sale is simply not achievable due to the commercial stakes involved in a large scale. The health hazards of Smoking can look like a big list of diseases… some prominent ones being…Hypertensive and other Heart Diseases /Oro-pharyngeal cancers/ Gastro-esophageal Lesions/Stomach

Cancer/Respiratory Conditions like COPD etc. If a person quits the habit of smoking, the good results start kicking in with immediate effect but the damage done to the body cannot be undone!

For such a vast country like ours, the impact of this single habitual menace can easily be understood which causes a huge burden of disease to the already overburdened health system of this country, but results in a mammoth scale of morbidity and mortality which is easily looked upon in the realm of preventable illness. As true Samaritan of India, we can only hope that this problem gets addressed some day and people are freed from the slavery of such potentially harmful addiction… to lead healthy lives.

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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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WHO advice on screen time for children under five?

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1.      That for children under one-year… sedentary screen time (such as watching TV or videos, playing
computer games) is not recommended and that when sedentary, engaging in reading and storytelling
with a caregiver is encouraged.
2.       That children under two years of age should have no screen time whatsoever
3.       For those aged two years, sedentary screen time may be no more than one hour; less is better.
4.       That three and four-year-olds should not play with iPads or watch television for more than an hour
a day ( less is better).
5.       WHO recommends at least 180 minutes in a variety of types of physical activities for three-to-four-
year olds.
6.       Improving physical activity, reducing sedentary time and ensuring quality sleep in young children
will improve their physical, mental health and well being.

The nuances of contemporary society in the above context:

During our childhood, before 1960, there were no TV, video games, mobiles etc. Only radios were
available and that also one radio per 15 to 20 families. Apart from filmy songs at a predefined time, all
programmes were for knowledge and science. Our only pass time was playing all sorts of games starting
from early morning till late evening with  a break for school and when mothers caught hold for feeding.
In the school also there was one hour compulsory physical training. For PT there used to be a PT
Teacher, full attendance was necessary and carried marks in the examinations. Because of that we enjoy
better health at present than our children.
What WHO has recommended is very correct and must be implemented.
The problem is how ? Now majority of middle class  families are living in 2 bed room flats where TV is on
most of the time, If it is stopped the whole family will have to be denied TV. Schools are running in few
rooms with out play ground.
So, it is a big problem and the solution is very much elusive.
Children under FIVE years of age need to spend more time with their parents, trying to imbibe the soft
and hard skills of life over this period and beyond. They learn on the successes and failures of daily
activities of life and experiences too, which is called “imprinting in the brain”.
Many parents indulge in handing over mobile phones/tablets to very small kids to keep them distracted
and occupied in order to complete the task of mechanically feeding them …or getting them ready for
school, as a quick fix measure. This act should be condemned !
That the child in question cries inconsolably without such gadgets, is an unacceptable excuse

Digital Detox

This phenomenon / concept is in crying need of the hour.
The society at large has become a ‘ slave’ to the digital revolution and its nuances. We hardly see
someone who displays a considerable freedom from such digital devices in the present times.
Admittedly…the arrival of digital personal devices have revolutionized our lives in a big way….but the toll
it has taken on our lives is often immeasurable and disastrous. The moral decadence of society cannot be
ignored !

Signs of digital addiction and abuse…………………………………….

1. Engaged with a digital device of any kind, for most waking hours of a day
2. Strong distraction at home and at work place with digital gadgets..thereby causing interactive
issues with peers and those around. This goes to such an extent that house members sitting in
adjacent rooms are often found communicating through digital devices amongst themselves !!!
3. People are very often unable to feel comfortable without looking at their personal gadgets….
many a times….every five-ten minutes. Employees working at office are terribly overpowered to
check their personal emails and social media accounts, every now and then…to that extent that
employees cannot restrain themselves from gazing at their phones during Interview sessions and
important board meetings at office…IN PRESENCE OF THE BOSS !!!
4. People on their mobile devices who scan the social media very frequently feel a terrible urge to
respond to friend requests/postings/comments, to feel that they are of importance to the one at
the other end and that they do not lag behind in any way !! They feel tremendously relieved to live
in a competitive make believe world which is exclusively illusive.,..often bringing in frustrations in
their own lives !
5. School children many a time pester their parents to give them mobile phones citing silly reasons,
to which the parents relent without any after thought and then suffer the consequences in a bitter
manner..at a later date. Prior to the era of digital technology arriving in a big way….there were
generations of students and parents who never faced any problems in their day to day lives !
6. The situation has come to such a passé…that very often personnel in demanding
professions….for ex. Hospital / Aviation industry / Railway personnel… are busy with their
personal devices often at the cost of a set back/potential loss of money/time/even a life-in a few
cases.. to the served target subjects …!! There are many examples which can be cited on such
counts.
7. Crimes of any conceivable nature have arrived in the scene…which are principally committed by
the help of such digital gadgets and persons of all ages have become very vulnerable now to fall
victims of such unhealthy trends,including emotional / otherwise blackmailing, to make any digital
records viral in the social media. The society is grappling in a major way within the framework of
cyber laws and cyber judiciary regulations to grapple with such issues seeking and aiming to
bringing he offenders to book, in the name of justice.
8. Many people feel a vague subjective discomfort without access to their personal digital devices
around them and display overt features of bodily symptoms such as vague aches and
pains..headaches…lack of concentration….suppressed anger…improper sleep….lack of appetite
etc etc. They may get labelled as subjects with psycho-somatic illnesses to which the remedy
though simple , often stays elusive.
9. Clear health issues may overcome the well being of digitally addicted folks….in the form of
“Computer Vision Syndrom”e..affecting the hands/neck/eyes/body muscles in a significant way
following excessive usage of computer devices which require long staring in defective postures at
office/homes.

Suggested ways for a detox from the digital world………………………………..

1. Begin a practice of digital abstinence….initially for short spells..maybe an hour or so…and slowly
increasing it on a daily basis. The abstinence should be applicable to holidays also !

The results of such self-restraint get obvious over a period of time.
2. Parents to decide very critically in allowing their children the personal usage of mobile
phones/tablets etc…based on a no. of factors such as age/necessity/any tendency to
communicate with friends in the sly/duration of holding these devices on themselves/any
tendency to lend these devices to friends/associates for abusive use etc.
3. Parents of children of all ages should be checking on the Internet usage nature very intensely in
order to prevent them having access to obectionable/adult sites and make an effort to ban
such web access in their home/individual devices. Lack of vigilance on the part of
parents/guardians often lands up the concerned under age folks and family in an unanticipated
trouble to their already burdened lives ! This is very important with growing children at home
and should not be neglected.
4. Encourage people as much as possible in offices…..public transport modes…public places..to
engage in more of personalized conversation and exchange of pleasantries, rather than spend
most of the time hooked on the LCD panels of their devices in hand…!!!
Get back to the dying habit of wishing and greeting people on their face with a smile.
( The smiles should come back on their faces, instead of through emoticons in their digital
devices ).
5. Taking a short break from the mundane chores of daily lives……….when the digital devices are to
be totally shunned till normal lives are resumed again ! This shall be a welcome change which
the body may be craving for a long time.
6. Children and students should be encouraged to spend more quality time outside in the
playground at simple games which involve a good amount of physical exercising and running
around for improving their concentration at work and preventing that much hated complication
of ‘Childhood Obesity’…which gets over time transitioned to ‘Adult Obesity’ !!
Addiction to digital devices contribute to Obesity in a major way across all ages.

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iKure introduces non-Invasive Hb tests for last mile community

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On a Tuesday afternoon, Shivani while returning from her field, noticed a banner in a primary school about a health awareness campaign for mothers and children. She found few of her friends waiting there too. Shivani enquired about it and came to know that the campaign was providing diagnostic tests for Hemoglobin and with a doctor consultation.

Shivani then asked them won’t it be painful? “I never had any Hb test before, but I have heard, they prick it hard and collects blood in good amount”. As she was thinking of returning back, she noticed, this Hb test was different. It neither involved a needle, nor did it collect any blood sample. Shivani decided to give it a try. And later, she revealed that she made the right choice by staying back!

That day, like Shivani, there were Urmila, Kusum and Malati who attended the health awareness campaign, availed Hb test, doctor’s consultation and discounted medicines before returning back to their home. On way back, for the first time, they discussed about their haemoglobin count and how they need to take care of themselves better.

In the rural region of North Karnataka, and West Bengal, what has changed for these women is access to life-saving diagnostic care within their community, and even their door-steps- all facilitated by iKure.

Globally, rural communities face limited access to point-of-care diagnostic tools. Incidence of anemia in rural pockets are staggeringly high, since a simple Hb test require long distance travel time to diagnostic centres or waiting in long queues in health centres. In such situation, rural women delay getting an anemia test done in the first place, with their family members pay little or no heed towards the importance of such tests.

In response to the need, iKure introduced non-invasive diagnostic tests in rural hinterland that can be conveniently used by its health workers in campaigns and during their home visits.

The diagnostic system takes the images of the lower eyelid, analyses the picture to quantify the conjunctival pallor and studies the paleness of the mucous membranes caused due to reduced amount of oxyhaemoglobin in the blood. Further, the point-of- care can be linked to patient’s smartphone via Bluetooth on which all data can be directly sent to patient as required.

The use of point-of-care technologies for quick tests is widespread in public health system, but the benefits of using them are only limited to health workers. As such device comes with minimal maintenance costs, highly portable and handy, it can be used for self-testing, testing in communities by health workers, testing in clinics and hospitals that can significantly reduce the rapid turn-around time and enable access to treatment regimens almost instantly.

Using conventional technologies in laboratories make turn-around time long and in the process patients do not return for further treatments. But, use of such point of care diagnostics in hard-to-reach communities play an important role in convincing the women community from dropping out of the existing treatment regimens and rapid testing holds prospects in improving the knowledge of the patients about their own medical situation bringing more awareness towards their dietary pattern, nutritional supplements and even in health seeking behaviour.

As iKure is aggressively involved in disseminating new technologies in its existing healthcare model that links its end-users to the higher level of care, it also works with various stakeholders like NGOs, Self-help groups to bring sustainable changes in women’s health outcomesso that do not remain entangled with their family life and complex choices.

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How much does a Pair of Eye Glasses Costs for People at the Last Mile?

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Vision impairment due to lack of access to eyeglasses has been identified as one of the largest unaddressed disabilities in the world. There are many remote villages, where getting a pair of eyeglasses is a distant dream for many. With a pair of glasses costing pittance, 550 million people in India are still in dark. Whereas, there are other parts of the world, where the first reading eye glasses can be picked up easily from a grocery store or a pharmacy.

Of all the eye problems, the commonest eye problem results mainly due to refractive error causing hyperopia, presbyopia, or myopia, and which can be easily corrected using eyeglasses. Refractive error is a condition where a person is unable to focus clearly on an object. Above the mentioned problem, Presbyopia is the most easy to correct just by trying out different corrective glasses. But, quite apart, such diseases remain largely untreated. Vision impairment is more than just a health disorder. It has economic, social and public safety implications and with variety of approaches tried and tested, to date none have succeeded on a larger scale.

iKure’s eye care intervention shows 78 per cent need access to eyeglasses particularly among them are construction workers, bus drivers, and school going children. With the staggeringly high impaired vision, the quality of life remain hampered, translating into reduced productivity, economic losses and huge absenteeism in school.

With the mission to bring eye glasses to all who need them, iKure has potentially paved the way for a new beginning in dissolute communities. With access to simple pair of spectacles, the venture has drastically improved earning power, educational prospects, and enabling every day task easier. Post intervention, our beneficiaries have reported to feel motivated with positive social and economic outcomes, better learning behavior and even fewer road accidents. So far, iKure through its eye care initiative has helped more than 0.5 million people get access to corrective eyeglasses.

Another approach initiated by iKure includes access to power testing using state-of-art technology. The use of advanced technology has facilitated getting corrective eye glasses with reduced chances of manual error, bringing ease of using among the end-users.

While the problem too large to scale, but simple enough to solve, we look forward to working with partners and Govt. initiatives to bring the first pair of eyeglasses needing them.

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5 facts to know on World Mosquito Day !

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On World Mosquito Day, iKure shares 5 important facts to curb the outspread of the menace.

1. This day is observed every year on the August 20th , to commemorate the discovery of the female Anopheles mosquito as the notorious vector for the transmission of Malaria,through the Plasmodium parasite, by the British Scientist Sir Ronald Ross…as back as in 1897. This feat was possible by this great scientist in the premises of the current SSKM Hospital in Kolkata, India.The day is celebrated every year at the Mosquito Center in ‘London School of Hygiene and Tropical Medicine’, amidst wide fanfare of students,researchers and young scientists in honour of the pioneer scientist who discovered the fact.

2. Mosquitoes are of different species….and the dreaded ones are the Anopheles,AedesAegyptiand Culex variants….and they are regarded as creatures of International menace!

3. There are different types of Malaria depending on the specie of the plasmodium parasite…the most fatal one being Falciform Malaria,(Malignant Malaria…being a dreaded complication).If treated properly and in time, many of the Malaria deaths can indeed be averted. It still remains a preventable disease targeted only by mosquito control measures….in the immediate environment of the community.

4. Dengue/ Dengue Fever is, as of recent another dreaded disease, with not much treatment resource being available for the condition and the mortality has been escalating in the past decade or so.It is caused by the Dengue Virus which is transmitted by the AedesAegypti mosquito as vector, and the high morbidity and mortality could be ascribed to the complications developing due to this infection in humans. DHF (Dengue Haemmorhagic Fever) / DSS (Dengue Shock Syndrome) are the two usual complications of this illness and the latter being quite serious, unless hospitalized management begins soon and in a deft manneras per standardized and universal management protocol of the condition!Other mosquito borne illnesses are Japanese B Encephalitis/Filariasis/Chikunguniya/Zika/Yellow Fever etc. which have different degrees of morbidity profile, depending on host resistance/immunity and the treatment available to the affected population.

5. India and the African continent and elsewhere have been affected by such diseases for many generations now and the mosquito control by all conceivable measures still remains a big challenge, which the governments are trying to grapple with!

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Featured, News, Tech

Why celebrate World Senior Citizen Day?

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iKure’s purpose in celebrating world senior citizen day is to raise awareness and support the health conditions of older people.

21st August is regarded as World Senior Citizen Day. Anyone beyond 60 years of age is a Senior Citizen by convention.We cannot help but lamenting that we cannot boast of having done anything remarkable on the welfare of Senior Citizens of this country by the method of policy…and this matter does not fare high in the list of authoritative priorities.

Nevertheless, bodies and associations have come forwards since not too long, to think on this sensitive issue and create a better living for a senior citizen across this country.

Old age homes have started dotting everywhere but the terms and conditions for housing them must be subsidized to include more and more of such population….without too much of a burden for the self-financing groups. Old people remain isolated from the family buzz and children moving to greener pastures leave such hapless people vulnerable to the nuances of social insecurities and bodily morbidities. They become alienated from the families they once took pride in building up and become redundant in the household of younger folks. Their opinions do not matter anymore in the day to day lives of the gen X and the seamless peace of life gets replaced by daily miseries of psyche and dignity. They are made to be figured out as burdens to the society.

Senior Citizens are prone to suffer from several clusters of diseases as below:

Cardiovascular ailments…acquired over their lifetime which needs to be addressed seriously. Coronary Arterial disease/Valvular disorders/Heart Failure/Heart Attacks (AMI) dominate the,list of morbidities in this group.

1. Lifestyle diseases such as Hypertension/Diabetes/Dyslipidaemias/Obesity form the prominent members of this groupacquired as a result of erratic/unrestricted lifestyle and often with genetic predisposition. They need lifelong care from Physicians attending them periodically, for as long as they would survive.

2. Gastrointestinal conditions like..Colonic disorders/Chronic constipation/GERD/Anorectal diseases/ Genitourinary diseases…. form another group which need either one time attention, or, follow up with the respective Speciality Doctors.

3. Neurological conditions like Stroke causing bedridden morbidity with/without paralysis needing prolonged close care by family members/attendants…or….physiotherapy for extended sessions form a bulk of suffering in this age group..

4. Miscellaneous category…comprised by Psychiatric illnesses/ Abandoned cases /Victims of physical abuse/Discharged from Hospitals or infirmaries with no family contact/ Addicts to Drugs and Alcohol / Homeless ones… etc.

All the above ailments require financial help and social inputs to manage the vulnerable segment of population and the dreaded solitude that it entails…which in itself brings down the life span of such seniors….the octogenarians and nonagenerians in society.

There are many countries where such people form a major part of the living society…such as Japan…who can boast of well laid down policies and generous grants from the government, to take care of the issues related to old age survivors and their health matters.

In india we are still far from this achievement in a mentionable way but efforts have just begun! The discipline which deals with medical issues of this age is called “Geriatrics” and Doctors are getting specialized in this field to work with only senior citizens.

Our mindset needs to change to support and care for the people of such advanced age in their twilight years and not regard them as just ‘gone over the hill’. ..!

Children need to be more sensitive and empathic to the needs of their parents who brought them up and not forget that they are also going to reach this age one day in future.

We need to approach this social malady in a holistic and pragmatic way seeking cooperation from NGO-s and similar social workers and a teamwork of trained personnel to come forwards in solving this growing issue of ‘unattended in old age’ concept.

How iKure is working towards the welfare goals of senior citizens?

“iKure” is an exemplary organization striving towards the very challenging goal of making the lives of our citizens better through many of its innovative ways and means, often defeating the challenges of human resource mobilization and deployment………..meaningful utilization of available resources…and constantly looking for areas of intervention in healthcare…in domestic & international geography, to mention a few!

In its ambit of operations…iKure has allotted priority to some areas of suffering of fellow human beings,such as Lifestyle diseases ( NCD-s) which is a modern scourge to humanity.

Across the intervention areas of this organization, a sizeable portion of the target community served hails from this group….the Senior Citizens….for whom we pay a little added focus, because of the enumerous socio-economical nuances, that such people have to face in their day to day lives.

iKure organizes medical camps from time to time…..serving the regional population…many of whom are of advanced age..in the areas of NCD-s….with regards to an holistic approach…which includes not only management of such ailments but the relevant health education required to understand such diseases…up..close..and personal ..by gaining knowledge on the occurrence causes…preventive modalities…and complications which may come up…for those who unfortunately have fallen victim to such diseases.

iKure attaches a lot of importance on Eyecarewhich is predominantly skewed towards the elderly folks, in addressing the conditions arising in old age such as Cataract/Glaucoma/ARMD/Retinal deterioration etc. The organization applies modern technology to detect such conditions in a proactive manner, screens the population of such sinister eye diseases and guides them through the scientific protocol of management /referral of such cases, being affected by specific eye diseases. Had this not been in place, a lot of hapless and underprivileged people would have lost their eyesight by now!

The mechanism is on.. to increase the door-to-door surveillance of the segment of the senior population affected by Cardiovascular Disease by means of remote monitoring and coordination through wearable devices …..under experimentation for implementation policy. This will go a long way to detect major and minor cardiac ailments for a timely referral to the domain of specialists to address the particular issues.

Last but not the least…iKure is in the planning stage to enter into a rather new concept of “ Continuum of Care“…wherein….it can collaborate with secondary/tertiary Medical Centres,to take care of interim/transitory patient care for the welfare of patients in the home settings of such clientele, many of whom are senior citizens.

With iKure’s integrated efforts, we can only hope that the plight of senior citizens gets better with time in this country and around the world…in order that this day is celebrated with increasing fervor in society…in times to come.

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