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Posts Tagged ‘Medicine


About 9.86 crore people (8%) in India suffer from sinusitis, according to the Government of India’s Union Ministry of Health and Family Welfare. Of these, for the chronic cases who do not benefit from medication, a team of researchers at InnAccel, Bangalore, has developed a device called SinuCare to provide long-term relief within a day.

Sinusitis is a condition in which the openings of the sinuses (the cavities in the bones in our forehead, cheeks, and the nose which form the respiratory tract from the nose into the throat) swell and clog the airflow inside them. The inflammation (swelling and redness) is caused due to infection, allergies, air pollution, or structural issues in the nose. Some of the common symptoms of sinusitis are thick nasal mucus, a plugged nose, pain in the face, fever, headaches, poor sense of smell, sore throat, and/or cough.

Why it matters

In most cases, sinusitis can be treated by medication. However, it is considered as a chronic case if the condition continues beyond three months. To chronic sinusitis patients who fail to benefit from medicines, doctors usually suggest functional endoscopic sinus surgery (FESS) to widen the sinus openings, clear any collected secretions, and to ventilate the sinuses and the nasal cavity. However, FESS is not only an expensive procedure, but is also quite invasive, as it requires surgical removal of many bony structures within the nasal cavity. It, therefore, carries a higher risk of complications and over-ventilation of the sinuses which can hamper its normal functioning.

As per a survey conducted by the InnAccel team, of the total number of sinusitis patients who visit an ENT doctor, on an average nearly 45 percent are counseled for FESS. However, most patients choose to try alternative forms of healing and avoid surgery till the extent it becomes essential. Two major reasons for this that emerged from the survey are: the cost (in India FESS cost ranges from Rs. 60,000 to Rs. 130,000) and the fear of complications or physical damage due to the operation under general anesthesia.

SinuCare

SinuCare is a minimally-invasive balloon sinuplasty device meant primarily to provide chronic sinusitis cases a cost-effective and safer alternative to FESS.

Complete kit of SinuCare

Complete kit of SinuCare

“With SinuCare we have tried to alleviate the concerns of chronic sinusitis patients. SinuCare is a simple metal device that uses a disposable double-balloon dilator, which is inserted into the blocked sinus openings through the nose. When the double-balloon dilator is inflated with saline in the blocked cavity, it expands and remodels the sinus openings, clearing the respiratory cavities by causing tiny bone fractures. Unlike FESS, balloon sinuplasty using SinuCare does not require any tissue removal, thus decreasing the risk of complications that arise from excessive removal of bony tissue and reducing the time for recovery. Moreover, an ENT doctor can operate SinuCare in his or her clinic, thereby reducing the cost of hospitalization for the patient,” explains Dr. Jagdish Chaturvedi, 33, who is a co-inventor of SinuCare.

Dr. Chaturvedi is an ENT specialist in Bangalore. In 2016, he won the MIT Technology Review’s TR35 Award for Young Innovators under 35 for one of his medical device innovations. At InnAccel, he develops new medical devices with cross-disciplinary teams and mentors young researchers and professionals in their entrepreneurial endeavors.

He is now conducting awareness sessions for ENT doctors on the use and benefits of SinuCare. “We have trained over a 100 ENT surgeons across the country and some of these doctors have started counseling and treating patients with SinuCare and the feedback from them and the patients has been very satisfying. I am also travelling to various cities to perform surgeries and train doctors on how to use SinuCare,” he adds.

Double-balloon sinuplasty with SinuCare

(L-R) Dr. Jagdish Chaturvedi gives SinuCare training to ENT doctors on a 3D model of the sinuses. On the right, he is conducting double-balloon sinuplasty using SinuCare on a patient in Kolkata.

The InnAccel team has filed a patent in India for SinuCare. They have also applied for the CE (European Union) quality certification for the device.

How it works

SinuCare comprises a navigation system through which the doctor manually inserts a soft polymer double-balloon dilator into the nose, to unclog the openings of blocked sinuses.

When the double-balloon dilator reaches the target, the doctor infuses the balloons with saline at 12 atmospheric pressure with the help of a pressure pump. As the balloons expand to their maximum diameter of six millimeters, they remodel the sinus opening and allow the mucus to drain out from the cavity, giving way to better ventilation. Finally, the dilator is removed and the device is pulled out of the patient’s nasal cavity.

The procedure is repeated for each blocked sinus. Following the complete procedure, the doctor keeps the patient under observation for an hour as a precautionary step to watch for any bleeding or dizziness. It takes about four to five hours for the entire procedure to complete, from the time the patient is given anesthesia to the clearing of the sinuses to when the patient is advised to go.

Key Differentiation

Unlike existing balloon sinuplasty devices which use a guidewire for inserting the balloon dilator into the nose till it reaches a clogged cavity, SinuCare has provisioned for ENT doctors to mount their endoscopic camera for a clear view of the sinuses and blockages. A guidewire is a polymer wire that is put alongside/inside the dilator to allow the doctor to feel the sinus blockage. However, it increases the cost of the device, the number of components it comprises, and the skill requirement to carry out the procedure.

The other key different feature of SinuCare is that its guiding system is a reusable product. The double-balloon dilator is the only disposable material in SinuCare whereas other sinuplasty devices are completely disposable. Without the dilator, SinuCare can be completely sterilized for reuse, enabling reduction of the total cost of the device for the doctors as well as that of the overall treatment.

Currently, SinuCare is being recommended and used by co-inventor Dr. Sunil Narayan Dutt, world renowned Otolaryngologist and Head of ENT at Apollo Hospitals, Bangalore and by Dr. P.S. Pradeep Kumar, Founder and Medical Director, Meenakshi ENT Specialty Hospital, Bangalore. They have been contributing feedback in the making of SinuCare.

The product is being packaged as a kit that comprises the main device, three dilators, and a pressure pump. SinuCare kit is priced at approximately Rs. 30,000 for the ENT doctors, and the treatment cost ranges between Rs. 40,000 and Rs. 60,000.

Next Step

While the guiding system of SinuCare has been designed and manufactured in India, the disposable double-balloon dilator for it, also designed in India, is being contract manufactured by Surmodics in Ireland. “We want Indian manufacturers to come forward and create good quality products for us. Under the government’s Make in India initiative, we are trying to manufacture devices in India – one for giving business within the country and second to minimize the cost. The manufacturing scope is big in the field of medical devices. However, we are yet to see innovative manufacturers who are willing to work with a development team, experiment with business models and to give the same quality as foreign suppliers,” says Pooja Kadambi, the team’s lead engineer and co-inventor who has significantly contributed in designing and manufacturing of SinuCare.

ENT doctors, patients with chronic sinusitis, and manufacturers can write to Dr. Jagdish Chaturvedi at jagdishc@innaccel.com or call 080-40923864.

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A spoonful of yogurt could soon offer a cheap and simple way to screen for colorectal cancer. MIT Professor Sangeeta Bhatia is working to replace costly and uncomfortable colonoscopies and MRIs with a helping of yogurt followed by a urine test—a cheap method that could improve the early diagnosis of colorectal cancer.

Bhatia is developing synthetic molecules that can be introduced into the body via yogurt, and will interact with cancer in a way that produces telltale biomarkers. These molecules can then be detected easily when passed in urine.

Bhatia previously developed nanoparticles that find their way to tumors, and are then broken into smaller pieces by enzymes produced by the cancer. The broken up particles are small enough to be collected and concentrated by the kidneys, after which they are excreted. The first iteration of the technique involved the use of lab instruments to analyze urine and find the telltale markers. Now Bhatia has developed a paper-based urine test—like the one you’d use for pregnancy. So far this test has been demonstrated in mice for colorectal cancer and liver fibrosis. Read more


Scientists at the Indian Institute of Science, Bangalore, have developed a handheld device that can diagnose malaria within 30 minutes, from just a little drop of blood.

The team has developed a lab prototype of the low-cost diagnostic instrument that takes a small sample of blood, analyzes individual cells, and detects cells that are infected by malaria.  

A team of researchers led by Dr Sai Siva Gorthi, assistant professor at the Department of Instrumentation and Applied Physics, IISc, developed and incubated the device at the Robert Bosch Centre for Cyber Physical Systems (RBCCPS) at IISc.

The device, which is small enough to fit into a hand, has a common optical reader into which the user slides the blood sample in a replaceable microfluidic cartridge, each time a new test is to be performed. Cartridges are preloaded for automated processing of the blood samples. The affected blood cells display morphological features that are different from normal cells; just by looking at the cell images on the LCD display, it’s clear if the cell is infected or not. The device uses algorithms that run on a smartphone-like platform for automatic evaluation and therefore does not require a skilled technician for handling the instrument. Qualitative test results can be known instantaneously while quantitative parasitemia levels are assessed and displayed in about 30 minutes. 

Malaria, a mosquito-borne disease, is rampant in developing countries. In India, over 13 lakh malaria cases were reported in 2011 of which 754 people died. In rural India, due to lack of primary healthcare, villagers have to travel to the nearest town or city for diagnosis. The diagnostic process — from taking blood samples, to manually analyzing them under a microscope, to preparing a report — usually takes more than a day and makes it challenging for healthcare workers to get back with recommendations for treatment. The new approach, however, combines technologies like image processing, microfluidics and microscopy.

Compared to traditional diagnosis methods, the new device collects significantly lower quantities of blood. It analyzes each and every cell present in this tiny drop of blood and gives a visual representation as well as quantitative count of the malaria affected cells. The portable handheld device can easily be modified and extended for diagnosing other diseases as well. Read more


A team of scientists and engineers at the Indian Institute of Science (IISc.), Bangalore, have created a ‘microneedle’ that take the sting off injections. The new microneedle is one-third of the thickness of conventionally used needles. With a diameter of just 130 microns, these injections can deliver drugs almost painlessly. The innovation can definitely prove to be good for diabetics who need frequent insulin injections.

Unlike the conventional stainless steel needles, these microneedles are made of silicon and are arranged in a set of several needles to deliver drugs of a required quantity. Initially the team had a challenge to resolve as silicon is not always “biocompatible”. It reacts with blood plasma and can corrode with time. Therefore, the researchers decided to coat the needle with fine layers of titanium and gold through electroplating. The coated microneedle are currently at the animal-testing stage and it could be a while before they are tested clinically on humans. Read more in a report by Divya Gandhi.


 

Veinus

The Veinus displays vein map of a man’s hand during the pilot at St. John’s Hospital, Bangalore.

A Bangalore-based startup has developed India’s first vein detector, ‘Veinus’, a non-invasive device that could help doctors locate good veins for inserting venous cannula. Veinus is likely to cost about 80% less than the imported vein detectors. Better cannulation with the help of Veinus may mean less number of needle pricks for millions of patients worldwide.

According to a report, even though venous cannulas are often needed for a week or more, they frequently fail before the end of treatment because of irritation of the vein and therefore necessitate cannula removal and replacement. Replacement requires additional needle pricks for patients, increases work for clinical staff, and contributes to insertion of cannulas being the most common invasive medical procedure and therefore a substantial contributor to healthcare costs.

In a step to aid this medical procedure, Bangalore-based Infraeyes Private Limited developed Veinus, a vein detecting device that uses infrared light to display map of good, thick, as well as thrombosed veins under the skin.

Founded in 2011 by Priyank Saxena, 38, along with Mayank Saxena, his brother, and  Saurabh Gupta, Infraeyes now has a team of six engineers who have contributed in  making Veinus. The device is set to be launched in the market this month (July  2014). Read full report on Page 2

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A student of the Indian Institute of Technology (IIT), Delhi, Ambar Srivastava, has developed a mobile phone-size haemoglobin metre, called TrueHb Hemometer, which works like a conventional glucometer with a tiny drop of blood from a pinprick on the disposable strip.

TrueHb has been validated by the All India Institute of Medical Sciences (AIIMS) for its efficacy, and is expected to help identify and tackle anaemia effectively. It is the first case of innovation from the IIT-Delhi’s biomedical engineering department getting “productized”.

TrueHb works like a conventional glucometer with just a tiny drop of blood from a pinprick on the disposable strip. It not only reads the accurate level within 45 seconds, but also stores up to 1,000 such readings. It can be charged like a mobile phone and allows up to 300 tests per charge. While the price of the TrueHb meter has not been fixed as of now, it is expected to be cheaper than most other similar devices in the market, which cost well over Rs 25,000.

It will be very useful on the field for health workers, blood banks, primary health centres, the school health scheme of the government, and all point of care use, including for use at home, explained Srivastava. Read more in the report by Rema Nagarajan.


Indian-American scientist Sangeeta Bhatia, professor at the Massachusetts Institute of Technology (MIT) and Howard Hughes Medical Institute investigator, has developed a cheap, simple, paper test that can detect cancer, circumventing expensive approaches such as mammograms and colonoscopy.

The diagnostic, which works much like a pregnancy test, could reveal within minutes, based on a urine sample, whether a person has cancer. The new technology will do allow non-communicable diseases to be detected using the same strategy.

The paper test essentially relies on nanoparticles that interact with tumor proteins called proteases, each of which can trigger release of hundreds of biomarkers that are then easily detectable in a patient’s urine.

In 2012, Bhatia and colleagues introduced the concept of a synthetic biomarker technology to amplify signals from tumor proteins that would be hard to detect on their own. These proteins, known as matrix metalloproteinases (MMPs), help cancer cells escape their original locations by cutting through proteins of the extracellular matrix, which normally holds cells in place.

The MIT nanoparticles are coated with peptides (short protein fragments) targeted by different MMPs. These particles congregate at tumor sites, where MMPs cleave hundreds of peptides, which accumulate in the kidneys and are excreted in the urine.

When Bhatia and her colleagues invented the new class of synthetic biomarker, they used a highly specialized instrument to do the analysis. However, for the developing world, they created a paper test that could be performed on unprocessed samples in a rural setting, without the need for any specialized equipment. The simple readout could even be transmitted to a remote caregiver by a picture on a mobile phone.

To create the test strips, the researchers first coated nitrocellulose paper with antibodies that can capture the peptides. Once the peptides are captured, they flow along the strip and are exposed to several invisible test lines made of other antibodies specific to different tags attached to the peptides. If one of these lines becomes visible, it means the target peptide is present in the sample. The technology can also easily be modified to detect multiple types of peptides released by different types or stages of disease.

In tests in mice, the researchers were able to accurately identify colon tumors, as well as blood clots. Bhatia says these tests represent the first step toward a diagnostic device that could someday be useful in human patients. Read more in this report by Chidanand Rajghatta.


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