Molecular Testing

The market is increasing for point-of-care testing with the growth of boundary -less hospitals and community care and the need for rapid results outside of the clinical setting. Point-of-care testing serves a pivotal function for delivering precision medicine that will both improve quality and affordability of care at a time when outcomes-based medicine is the new model for healthcare. Point-of-care molecular testing is also a rapidly expanding market. A variety
of technologies are being developed for DNA detection and amplification, mostly aiming to detect pathogens. The challenges associated with developing POC molecular tests include the additional steps for sample pretreatment
(e.g., cell sorting, isolation, and lysis) and the requirements for nucleic acid extraction and signal amplification, and sample-prep integration with a complete analytical process that does not require skilled operator involvement, and the need for fast results. In particular, true portability remains a moving target, as most current devices tend to be at least shoe box sized, may depend on external power sources drive thermal cycling for conventional PCR.
Now that device manufacturers have found a way to fit PCR and other nucleic acid amplification techniques into easy-to-use, counter-top instruments, a dozen or more companies likely will rush to develop new products. The first comm¬ercial version of a real-time nucleic acid detection system was Cepheid's Gene¬Xpert system, designed to purify, concentrate, detect, and identify targeted nucleic acid sequences delivering diagnoses from unprocessed samples in approximately 30 minutes. The ability of this relatively small bench-top device
to perform real-time quantitative PCR in approximately 90 minutes with minimal operator interaction offers the potential to perform rapid molecular testing in situations where the need for results is urgent.
While such devices are in development, small, benchtop systems that perform genomic analyses continue to reach the market with an increasing variety of tests that now include infectious diseases, drug responses to drugs used to treat heart disease, pharmacogenetics, hereditary genetics, and recently, cancer. Respiratory infections are likely to be among the leading applications for POC molecular diagnostics through 2020. In addition, POC molecular tests are poised to be used widely in developing countries, both for diagnosing emerging infectious diseases and for more familiar infections.
While the sensitivity and specificity of molecular diagnostics are extremely high, there is a danger of contamination and mistakes in the pre-analytical phase and in interpretation, as with any other POC test. However, investigators and clinicians anticipate that given market forces and current demand in specific markets, most notably infectious diseases, portable, hand-held, inexpensive POC devices, equivalent to currently offered full-size molecular analytical systems, will become available. These devices will aid in the detection of mutations or in the
identification of infectious agents, as well as aid in the management of patient care.

Coffee on Hypertension

Caffeine is most commonly consumed as coffee and tea products. Many people ingest caffeine in daily basis, whether through tea, coffee or soft drinks. Energy drinks, chocolate and some medications may also be sources of caffeine. Some have estimated that these beverages may be the most widely consumed food in the world. While this habit may not create any problems for most people, caffeine can have an impact
on your blood pressure.
Coffee consumption has been hypothesized to be associated with blood pressure. Being caffeine is a stimulant there is good reason to suspect that coffee and high blood pressure might be related. Caffeine is a very mild stimulant and has a short life span in human body. It is also a self-limiting stimulant, because it acts on the kidneys to increase the rate of its own excretion. The relation between coffee consumption and incidence of hypertension is related to smoking status. Consumption of 3-4 cups of coffee per day decreased the risk of hypertension in non smoking men and women only. According to a study of the"American Journal of Clinical Nutrition', drinking coffee substantially raises your blood pressure for up to three hours after consumption. Researchers state that 200 to 300 milligrams of caffeine, equal to 2-3 cups of coffee depending on the strength, raised the systolic number by 8.1 millimeters of mercury and the diastolic by 5.7. This change took place within an hour of consumption. While researchers observed an immediate increase in blood pressure, they say that being a coffee drinker does not necessarily raise your blood pressure in the long term.
Now a day's hypertension is a most common and major health problem. High blood pressure is an obvious risk factor for stroke, kidney disease, coronary artery disease, all cause fatal and decreases life expectancy. By adopting a healthy lifestyle hypertension can be alleviated. Coffee has been reported to be the major source of chlorogenic acids in the diet. Although the acute effect of caffeine intake is to increase Blood pressure by blocking adenosine receptors in the vascular tissue, which leads to vasoconstriction in the general and micro-circulation, the health effect of habitual consumption of long term is not clear.

Paralysis Patient Care

The loss of muscle function is called Paralysis which is usually accompanied by the sensory loss in the affected area. It can affect any part of the body at any time during a person's life. It occurs due to the damage of central nervous system especially the spinal cord. Paralysis can occur either partially or completely, temporary or permanent, localized or generalized. The most common causes of paralysis are stroke, head injury, spinal cord injury, and multiple sclerosis. It also includes trauma, polio, nerve damage etc.
Sometimes what may look like the obvious symptoms of paralysis actually may not be paralysis. The complete loss of muscle function is called paralysis. Paralysis of both arms and legs is called quadriplegia and lower half paralysis is called paraplegia. It happens because the brain can't send messages to the different part of the body due to various reasons. Sometimes the whole body may be paralyzed except the eyes. A paralysis patient may also face a host of medical problems such as bed sores, pneumonia, pressure ulcers etc. Usually paralysis occurs along with some of the following symptoms:
• Loss of consciousness • Difficulty in writing or speaking
• Severe headache • Loss or changes in vision or hearing
• Breathing trouble • Loss of bladder or bowel control
• Clumsiness and numbness • Nausea with or without vomiting
Unfortunately, there is no cure for permanent paralysis till date. Many people with paralysis may not be able to complete some or all of the activities of daily living. Suddenly a bed, a room converts into a war zone of medicines, cotton, gauze, napkins, feeders, cleaning fluids etc. It becomes very difficult situation for the care giver who gets fade up very soon. But life must go on and the patient must be cared for. There is some way to rehabilitate and make your loved one more self-sufficient. Paralysis home care plays an important role in providing the best quality of life possible for the patient. It assists to do all of the activities of daily living with integrity. Specially trained health care professionals assist paralysis patients in the comfort of their own home in activities such as feeding, bathing, dressing, bodily elimination, grooming etc.
Partially paralysis patients care: Treatment will depend upon the cause of partial paralysis, and might include physical therapy, occupational therapy, surgery, prescription medication, or a combination of the above. If the patient is not completely immobile, encourage him/her to do whatever the patient can on his own. One has to alternatively be gentle and firm until the person gets use to being independent as much as possible. This not only gives a psychological boost to the patient but also gives the care-giver respite. It is very important to do physiotherapy or physical exercise as many times a day as is recommended. Vigorous breathing exercises are important. Allow social interaction, a day out keeps the spirits high.
Completely paralysis patients care: If the patient is bed ridden then the care should be intensive. One of the major requirements, here, is a hospital bed which has movable parts, so that the patient can be raised or lowered. Patients have to be turned after every half an hour to avoid bed sores. Always keep the room clean to give a healthy atmosphere to the patient. Do not compromise with the quality of sheets, covers, bed pan, urine pots, feeding utensils even oils and creams. If the patient has a urinary catheter or a stomach bag, then cleaning and emptying would have to be done regularly. A medicine schedule has to be maintained properly. Keep the patient cheerful by celebrating festivals, birthdays, inviting friends, neighbors, relatives for occasional tea. If the patient can be lifted onto a wheel chair, then move out for an evening stroll. Keep the old routine of newspaper and last of all a smiling face of care giver keeps the patient well.

Diagnostics at Home

Diagnostic and monitoring device is one of the biggest product segments of global home healthcare market with highest share. Home diagnostics is gaining recognition as gadgets drives down the cost and provides a reliable degree of accuracy. With increasing health awareness among people, increase in number of young and geriatric people diagnosed with chronic diseases such as diabetes, cardiac disorders and respiratory diseases,the demand for home diagnostics is expected to grow even more in the next few years.

People buy their at-home diagnostic tests and health-monitoring devices at pharmacies or online. At home diagnostic products include blood pressure monitors; blood c holesterollevel monitors; heart-rate monitors; blood glucose monitors, A 1 C test kits, and monitoring supplies (including lancets and test strips); home pregnancy and ovulation tests; and kits that require a blood or other tissue sample to be sent out for testing, such as test kits for blood cholesterol levels, HIV, hepatitis C, and DNA tests that can be used to prove paternity. The latest to be added in this category is at-home cancer testing device

for screening lung, breast and prostate cancer. Some of the key industry participants in global home diagnostic market includes 3M Health Care, Bayer AG, Abbott Laboratories, Phillips Healthcare, Cardinal Health, Inc., GE Healthcare, Gentiva Health Services, Inc., Johnson & Johnson Services, Inc., F. Hoffmann-La Roche Ltd., Medtronic, Inc., Omron

Healthcare, Inc. and Invacare Corporation among others.

Currently the largest market for home tests is blood glucose monitoring (BGM). When tracing the history of home testing it can be seen that some of the technology developments, from initial urine dipsticks to finger-stick testing, are where smaller and smaller amounts of sample are now required. Most home diagnostic systems provide a single test result; but in future a panel of tests might be more applicable and that the

output of these results would need to be displayed in an easy to understand manner for the home user.

Alongside the technology improvements, more recently greater focus is seen on providing better data for the patient to manage their disease. Devices that now provide the calculation of bolus amounts of insulin that the patient should take based on their carbohydrate intake and blood glucose are becoming available. Easier analysis of the results of testing and sharing of that data have become more commonplace.

Palliative Care at Home in Hyderabad

While most terminally ill people die in hospital, many would prefer to die at home. But funding constraints and medical models mean it's a choice not often available. The aim of home palliative care is to achieve the best possible quality of life for the person with

a life-limiting illness and to provide a special end-of-life care service in familiar surround­ings, with family and other loved ones at hand. Real palliative management includes a holistic and integrated approach that looks after the whole person, not just their physical symptoms but also their psychosocial and spiritual needs.

The service is provided by specially trained community care workers who work as part

of the existing multidisciplinary community palliative care teams. Care provided is determined by the patient and their family in consultation with the community palliative care team and may include assistance with personal hygiene, domestic assistance and shopping - providing carers with vital support during the end of life stage. In consultation with the Community Palliative Care team and the patient's doctor, it may also include basic nursing care. The delivery of end of life care may be consecutive hours or may be spread over several weeks.

The great benefit of this care is that the family can focus more fu lIy on the needs of their loved one and can make the most of their final time together, knowing that there is professional care support at hand to help them through this most important and difficult time. All care workers are trained in pain and symptom management; grief, loss and self­care; essence and ethical issues in palliative; and most importantly communication.

Patients who have expressed a wish to die at home or remain at home for as long as possible are subject to few criteria:

• The patient should have either a deteriorating or terminal condition.

·      Family carer is physically/emotionally unable to continue caring at home without support.

• There is limited family support.

• There are specific cultural/spiritual issues necessitating extra support.

• Functional ability of patient is poor.

When treatment is no longer likely to work, palliative care is there to help patients live in the comfort oftheir home and die with dignity.

Corporate Wellness programs

Every company should provide employees with resources to pursue a healthy lifestyle. With corporate working longer hours and dealing with greater levels of stress than ever before, it only makes perfect sense fora company to provide wellness strategies so as to retain their best people and ensure they are continually playing at the top of their game. Corporate wellness programs could be the key ingredient for unlocking a company's earning potential, productivity and morale. They can also help businesses reduce their health care costs by creating a healthier and happier workforce.

A wellness system model with purposeful engagement should be a part of every company. It should not only take care of physical wellness but also spiritual, social, emotional, occupational, intellectual, environmental and financial aspects as well. Before starting off, it is required to set the vision, goals and measurable objectives. Employer should gather health data to get a snapshot of the current state of company's health. Then it is to decide which programs make the most sense to the employees. Key programs could include weight management, smoking cessations, financial wellness, depression management, physical activity etc.

Sustaining high participation in these programs is difficult. It requires aggressive branding and communication strategies in order to promote awareness and help drive participation. Survey and design an incentive program to help encourage participation. Forming a wellness and social media committee can help as well. But most importantly, make it fun- monitor the effectiveness and make adjustments as needed. Employees should also take responsibility of personal wellness.
About 500b employers offer a corporate wellness program. Rest are generally unaware of the benefits of investing in wellness. Accessible and affordable sources of support and advice are rarely available for small and medium enterprises. The current landscape for workplace wellness programs is plagued by interdependent challenges for employers and to address these, there is a need fora clear and coherent strategic approach, effective measurement, adequate resourcing and comprehensive wellness solutions.

The question now is, will we seize the opportunity to optimize the benefits of workplace wellness programs?