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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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Diet Plan for good health and keeping a check on weight gain

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Things NOT to consume


1. All Fried Stuff…KFC / McDonald’s / Deep Fried Items etc.

2. All soft drinks…such as Colas / Fruit Juices and fizzy drinks

3. Mutton of bigger animals… Beef/goat/pork/steaks/non b veg burgers/salami etc.

4. Frequent Fried Rice products… Biryani / Fried Rice etc.

5. Cream enriched – Dairy Derived products………. Butter / Cheese / Marmalade etc.

6. Ice Creams / Cakes / Puddings / Pastry / Confectionery Items with cream etc.

 

Things to be taken in moderation

1. Milk, if it is tolerated

2. Honey / Jam… applied on bread toast

3. Eggs. Two / three per week….more of the white than the yolk!

4. Maida derived products… such as parathas / egg-rolls etc. (Indianised version)

5. Excessive Indianised version of Chinese food (With MSG-Mono Sodium Gluconate

6. Spinach and other leafy green vegetables

 

Things recommended for frequent consumption


1. Fibre rich fruits and vegetables (Banana is calorigenic… once in a while )

2. Oat meal / Breakfast cereals / Brown bread (instead of White Bread)

3. A handful of specific Nuts like Almonds (non-roasted and Walnuts only.

4. Occasional diet of dates / apricots etc. as snacks

5. Tea in place of Coffee….. Tea without milk and sugar… green tea etc.

6. Several glasses of plain water a day… more in summer months

 

Lifestyle habits/practices

1. To use the staircase instead of the elevator…. as much as possible

2. At least 20 minutes of walking on every other day if not every day – swimming is the best.

3. To leave the dining table when you feel you could have eaten some more.

4. Never to take second helpings in parties… particularly oily and greasy items.

5. No junk food like fried chicken / pizza / burgers etc.

6. Wash your face with cold water before the night sleep – sometime cucumber slices around eye.

7. Avoid heavy meal at dinner and not to hit the bed directly after dinner/lunch.

8. Get up at the same time everyday.

9. Pursue any hobby on a daily basis – even for a small duration.

10. Do some household work frequently at home, which entails physical exercise.

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Prevention and Management of Non-Communicable Disease in low-income community

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Non-Communicable Diseases (NCD) are leading cause of premature mortality. According to Indian State-Level Disease Burden Initiative report, disease burden of India has shifted from Communicable, maternal, neonatal, and nutritional diseases (CMNNDS) to non- communicable diseases over the period of 1990 to 2016 from 37.9% to 61.8%.

 

Risk segment and socio-economic impact of NCD

Though major NCD diseases are associated with old age people approximately 42% of all NCD deaths globally occurred before the age of 70 years. Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs. Poverty is another factor closely linked with NCDs. In resource constraint setting of healthcare, NCDs increases out of pocket expenditure of an individual or sometimes loss of breadwinner of the family forcing many families below the poverty line. Vulnerable and socially disadvantaged people get sicker and die sooner than people of higher social positions, especially because they are at greater risk of being exposed to harmful products, such as tobacco, or unhealthy dietary practices, and have limited access to health services.

 

Chronic Disease Prevention Programme, an initiative towards NCD management:


iKure together with MIT Sloan School of Management in the District of Paschim Medinipur, iKure initiated a study on NCD with randomly selected 500 people in test group. The initiative is measured following parameters to get greater insight on the contributing factors towards cause of NCD. Low-density lipoprotein cholesterol (LDL-C), Hb1AC, Systolic Blood Pressure, and BMI are collected to derive the analytics. Using power BI tool following trend has been identified where 25% of all respondents suffered from type1 diabetes, 43% type2 diabetes, 11.8% with high cholesterol, 65.6% hypertensive and 5% obese. Though it is surprising to know such trends were known to affect the elite group, but our findings shows the emergence of NCD trends even in low-income community group.

Moreover, the High-cholesterol, High Blood pressure and High pulse rate was a common trend among identified high risk CVD patient found in 8.4% of the population.

Further, we found high risk CVD zone affected mostly within 56-80 years of age group.
Case of Diabetes was found between 41-56 years age group and females are marginally more prone to diabetic in the catchment areas.

The clinical observation was recorded during door-step screening, monitoring, and doctor’s consultations. The high-risk patients were provided tertiary care through telemedicine platform and appropriate medication. Awareness was created by the CHWs on self-management, prevention and control on NCDs.
 

Conclusion:

In the heterogeneous country like India, iKure is putting the right step forward to achieve WHO’s global targets for prevention and control of non-communicable disease by 2013-2020.

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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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iKure reducing status of anemia by increasing knowledge and healthcare practices

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In India, anemia is identified as a serious health issue where half of the country’s women of reproductive age are anemic. Despite the fact Government of India has implemented several initiatives for eradicating anemia, only 13 per cent improved women cases have been registered as per Global Nutrition Report 2017. Anemia is linked to adverse pregnancy outcomes including preterm delivery and intrauterine growth retardation and associated with various maternal morbidities like fatigue and postpartum depression & increased maternal mortality.

Finding the solution to anemia in rural health iKure’s Community health worker’s follows a step-wise approach to improve status of anemia in its catchment areas namely Hubli, Tabageria and Varanasi. With scheduled home/ camp visit as well as in Hub & Spoke clinic, iKure extends care in the following ways:

 Early detection: Early diagnostic is a first step towards the cure. With Low-cost point-of -care devices, iKure provides diagnostic services at the door Step/Camps/Hub/Spoke to ensure high coverage and penetration of its cost effective care to every women and across the remote belt.
 Awareness building: iKure believes that if expectant women knew of the impact of anemia, they would surely not forget to take the supplement. Informing women about the possible side-effects of these supplements, such as black stools and nausea, also helps improve knowledge and understanding. iKure’s health workers with their stronghold in the village community create awareness among the rural population regarding appropriate feeding practices – including exclusive breastfeeding for the first 6 months of life, and optimal complementary feeding during the first 2 years of life which are crucial for avoiding the development of iron deficiency anemia.

 Regular screening and follow up: Most of the health initiative undertaken by the Government provides iron and folic acid supplements but assurance against consumption is not adequate. Regular follow up by the CHWs improve consumption patterns.
 Targeting Vulnerable groups in a strategic way: Women at reproductive age and the children below 5 years are the most vulnerable group of Anemia. iKure target this vulnerable group in a fragmented way by their specific programmes like school health programme; MCH programme and special screening programme through workgroup and self-help group.
 Distribution of Toolkit: iKure develops creative tools to create awareness among the population. These toolkits are delivered when a patient visit iKure’s clinic. It is a handy way to spread the message regarding anemia.

 Conclusion :- Awareness building in appropriate feeding practices reflects in 90% mothers who have started breast
feeding within 1hr of delivery and has positive effect on improved birth weight. 51% child within 0 to 6 month of age and 31% child between 6 to 12 months of age were identified with no development delays minimizing adverse outcome of anemia in pregnant women.

Identifying anemia is vital because anemia can go undetected until it becomes severe. The multi- factorial disorder needs extensive communication campaign and technology to detect and treat anemia. iKure continues to bridge the gap through improved health practices, nutritional counselling and sanitation and hygiene practices.

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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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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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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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What Causes High Prevalence of Anemia in Rural Hinterland- A case study to assess the gap

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Anemia is most prevalent in low-resource settings, where it goes undetected until becomes severe. Despite the implementation of several initiatives by the Government, India has made only 13 percent progress in eradicating anemia (Global Nutrition Report, 2017).1

Periodic screening and early diagnosis are the keys to controlling anemia. The conventional Hb tests involve invasive methods with the requirement of hygienic infrastructure and skilled healthcare providers. But with the huge gap in basic health infrastructure, rural community members have very little provision for diagnostic facilities.

In Kenduapal Village of PaschimMedinipur, West Bengal shows 88 percent of reproductive-age women have undergone Hb tests for the first time in their lives. They were not aware, if they are prone to a high-risk pregnancy or not. It also indicates the behavioral risk factor which contributes to delay in Anemia detection.

According to WHO recommendation, a non-invasive hemoglobin device is proved to be a good addition. Non-invasive point of care devices can eliminate the potential contamination, bio-hazard handling and can even enable frontline health workers with basic education to perform Hb Test.2 Joseph et al. (2016) also affirm that non-invasive methods are safer than invasive methods and improve patient satisfaction.3Bandyopadhyay S., Neogi, and John D. et al. (2019) further contributed to the fact that as most of the anaemia screening happen in outreach settings, where provision for laboratory support seems difficult, the device ought to be tested in field settings with health workers, non-invasive diagnostic provides viable accuracy.4

iKure’s non-invasive anemia screening initiative started with the vision of reaching out to the last mile community. Members are chosen from the community and are technologically and clinically trained to use them for screening patients. The community health workers are further mobilized to collect other health parameters important to understand the risk of the patients. Instead of using a paper-based format, CHWs use WHIMS that is able to collect patients’ vitals on a cloud server. The data available on the cloud are further sent to medical professionals for referral and counseling.

However, while iron deficiency is the main cause, micronutrient deficiency, inflammations and inherited disorders also contribute to anemia. A baseline report of mother and child health camps reveals that 64% of pregnant women were anemic and 30% with milder anemia. Nutritional experts suggested that a large section of the community are found to be anemic because of women’s ‘‘non-compliance/non-adherence” to the consequences of the anemia and fear and anxiety towards invasive blood drawing.5 Also, women’s consumption rate of IFA supplements are low since they complain of suffering from gastrointestinal upset. Altering such behavior requires regular counselling. iKure’s CHWs are deployed to spread awareness and bring positive health-seeking behavior among pregnant women, new mothers, and adolescent girls.

iKure’s non-invasive anemia testing initiative has been rolled out successfully in school health program and mother and child health camps catchment areas. Within few months, it has gained significant traction such as:

 

  • In West Bengal and Karnataka more than 50% population are found to improve IFA tablets consumption rate.
  • Regular awareness and counseling by iKure medical team during health camps have altered care-seeking behaviour with a reduced percentage of anemic patients
  • The introduction of non-invasive screening devices has improved patients’

    footfall with more women willing for Hb tests

While priorities and approaches may differ according to geographic settings, but strategies to curb anemia remain the same. At iKure, we believe in bringing the desired change soon in India’s rural villages.

Reference :

1. “From promise to impact ending malnutrition by 2030”,Global Nutrition Report,2017,
2. Ma’ayan L., Choppe L., Tikva P., Israel, Lausanne, “Non-Invasive Hemoglobin Screening for Diagnosis and Monitoring of Anemia”, Read More
3. Josheph, Bella., Haider, Ansab., Rhee, Peter., “Non-invasive hemoglobin monitoring”, International Journal of Surgery, 33 (2016):254-257
4. Neogi SB, John D, Sharma J et al. Cost-effectiveness of invasive devices versus non-invasive devices for screening of anemia in field settings in India: A study protocol [version 1; peer review: 1 not approved] F1000Research 2019, 8:861 Read More
5. “Nutritional Anaemias: Tools for Effective Prevention and Control”, World Health Organization, 2017, Read More

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Lifestyle

Peace Proposal

The challenges facing society—a global pandemic, the climate crisis, social and political upheaval, and inequality—are happening at a time when there is a significant trust deficit, and in large part because of it. The implicit social contract between institutions and individuals has frayed.

And we’ve seen the results first-hand. So, the first step in any healing and rebuilding is the reestablishment of trust.

Trust is a relationship in which we are vulnerable to others’ actions—a relationship in which we are not just relying on the other party to do what we want; we are trusting them to do what we want and not hurt us in the process. This means that the poor and downtrodden must feel safe that you will not be inflicting any further misery. Trust goes much beyond following the letter of the law, it is about setting high standards. It is about replacing every iota of greed with purpose. It is about being the change that we want to see and service before self. It is about enabling the best minds and action and service before self. It is about leadership. It is about listening and then acting. It is not about imposing one`s ideas on others, but about letting the people speak. Though the wounds inflicted are medical in nature, it is not about treating, but about healing, it is about the person and not the patient. It is about empathy and humility that we do not know everything, but we shall work with you and find solutions. It is about being sensitive and feeling the pain and misery of others and about giving.

To win the trust of the population at large, all teams, groups or companies must first establish trust among each other and establish purpose. It is about breaking down barriers and silos and reaching out to one another and filling in any deficiencies that the other may have. It is about helping people introspect, meditate, dig deep and bring solutions themselves. It is about building human connections. It is about enabling bringing the whole selves into society. It is about accepting imperfections and making people believe that it is alright to fail. It is about providing people psychological security and its not just about the winners, its also about the people who put in effort and did not succeed. Its about celebrating the little goodness and throwing away the not so good.

This must start from the top and the leadership must by example. We must define leadership as looking after the person to the left and the right of you and win them over with honest deeds. It is important to look at the bigger picture and the haves need to look after the have nots and one must give till it hurts. Greed and hate will only beget destruction which will come back to engulf us. Leaders need to sheath swords, silence war drums and become the missionaries of peace. We should speak the language of humanity, in a language that people understand.

At iKure, we not just hire, but work with people who are aligned with our core values and believe in being good and doing good. We believe in each other and our drive is purpose and not wealth. We believe in managing and healing the whole human being and therefore we are working with like minded musicians and artists to build purpose and community cohesion.

We believe that vaccination is important for our future survival and are making an effort not just to immunise our own team but people in far flung areas where the supply chain may not reach. We are collaborating with government and non-governmental bodies in not just providing medical help but also improve the social determinants like Income and social protection, Education, Unemployment and job insecurity, Working life conditions, Food insecurity, Housing, basic amenities and the environment, early childhood development, social inclusion and non-discrimination, structural conflict, access to affordable health and services of decent quality.

Going by the plight of the migrant labourers, it has now become imperative to find employment near the place of residence, which will mean working with the people and develop a love for their own land and identity and making the villagers to be self sufficient and develop business models for them to thrive. The enormous indigenous wealth in the villages needs to be tapped, which is sustainable and green.

As much as the pandemic has been a cause for death, despondency and destruction, there has also been increased amount of collaboration, cooperation and resilience. People have gone out of the way to help their neighbours and in this strife, there have emerged stories of compassion that have given hope. With digitalisation and less consumption of fossil fuels, there has been gross improvements in the environment. For the first time we have been able to breath fresh air.

We at iKure are committed to continue breathe this fresh air and are committed to do what it takes. We are people with courage, empathy and humility and healers of the mind, body and soul who look at the holistic approach to healthcare and combine the tradition with the modern. We combine human touch with technology and believe in the user experience of both the healers and the healed.

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