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2. Digital elixir for healthcare: market intelligence and policy implications

Author

Gowda, Naveen R., Vikas, H., Satpathy, Sidhartha, Ramaswamy, Anjali, Prabhu, Meghana, Kumar, Atul, Kini, Ananth, Singh, Angel Rajan, Sharma, D. K., Desai, Devashish, Sharma, J. B., Gowda, Praveen R., Rajkumar, Gopinath, Bharath, Huded, Chandrashekhar, Sowmya, K. P., Divya, T. K., Vakharia, Khyati, Viswanath, Somanath, John, Dhayal C., and Gudipati, Neeraj

Published
2023
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3. Transcutaneous electrical nerve stimulation provides early recovery from arthrogenic muscle inhibition post-anterior cruciate ligament reconstruction.

Author

Khan, Firoz, Kushwaha, Sushmita, Vakharia, Khyati, Kumar, Jaswant, BhaVani, Prashant, and Sinha, Skand

Abstract

Background: Quadriceps weakness that ensues anterior cruciate ligament (ACL) reconstruction, a common procedure done in sportspersons, is a hindrance in the active rehabilitation and delays return to sport. This weakness of quadriceps muscle is a complex neural phenomenon ascribed to arthrogenic muscle inhibition (AMI). Purpose: The purpose of the study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in AMI post-ACL reconstruction (ACLR). Methods: A prospective randomized study involving 60 patients with isolated ACL injury above 18 years of age were included. Patients with osteoarthritis knee, multiligament injury, previous knee surgery, and inflammatory knee pathology were excluded from the study. Patients were divided into Groups A and B (n = 30, each). Group A received TENS therapy with exercises and ice packs, whereas Group B received only exercise and ice packs post-ACLR. All patients were assessed subjectively using Visual Analog Scale score for pain, Lysholm, and IKDC score for functional outcome pre and postoperatively on day 2, 1 month, 3 months, 6 months, and 1 year. Objective assessment was done by measuring thigh girth (10 cm above knee joint line) and isometric quadriceps strength (using David Biofeedback Strength Evaluation Machine) pre and postoperatively at day 2, 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year. Results: Pain decreased in both groups at 1 month, 3 months, and 6 months, but there was significantly lower pain in Group A in comparison to Group B at 1 month (P = 0.003), 3 months (P = 0.001), and 6 months (P ≤ 0.0001). There was no pain at 1 year in both the groups. Lysholm score improved in both groups, but there was statistically significantly better Lysholm score in Group A in comparison to Group B at each follow-up. IKDC score improved in both groups, but the improvement in Group A was significantly higher than Group B at each follow-up. No significant difference in mean thigh girth was observed. Mean quadriceps strength was similar in both groups except at 6 months where Group A was better than Group B (<0.001). Conclusion: Addition of TENS in ACLR rehabilitation decreases pain and provides better clinical outcome. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Out of Adversity Comes Opportunity: Smart-Colpo National Program for the Elimination of Carcinoma Cervix in a Post-COVID-19 World.

Author

R., Anjali, Gowda, Naveen R., H., Vikas, Prabhu, Meghana, Sharma, Jai Bhagwan, Vakharia, Khyati, Kumar, Atul, M. V., Akhila, Gatta, Shilpa, Sareddy, Madhuri, K. P., Sowmya, T. K., Divya, Desai, Devashish, Gopinath, Bharath, Viswanath, Somanath, and Kini, Ananth

Subjects
CARCINOMA, CERVICAL cancer, COVID-19, PUBLIC health, WOMEN
Abstract

Background: Carcinoma cervix is one of the leading causes of death among women worldwide. The World Health Organization has put forth the 90-70-90 global strategy for the elimination of cervical cancer as a public health problem. It calls for 70% women to be screened at least once in their lifetime. However, this rate is as low as 1.9% for India and even lower for many other countries, making the target insurmountable, especially in resource-constrained settings. The COVID-19 pandemic made this even more challenging. Objective: This study aimed to identify bottlenecks and high leverage points and propose a technology-driven, national-level program for improving the screening of carcinoma cervix. Methods: Detailed process mapping was done to identify potential bottlenecks. A counterfactual approach was used to identify high leverage points for impact using "What if" scenarios. These findings were used to build program theory-based logic models to propose a national-level program for carcinoma cervix prevention. Results: Availability, accessibility, affordability, skewed distribution of infrastructure, cost implications, and limited specialist workforce were identified as bottlenecks. The COVID-19 pandemic put a strain on existing resources and worsened the situation. The existing network of primary health care workers, changes in health-seeking behavior due to COVID-19 with the increasing role of tele-health, conducive political milieu with initiatives such as Digital India Mission, and a booming start-up ecosystem were identified as high leverage points through the counterfactual approach. Using these findings, a national program was designed with program theory-based logic modeling. Conclusions: The journey from <2% of women screened at least once in their lifetime all the way to 70% would need a drastic increase in funding and resource allocation, which is unlikely considering the current conditions. COVID-19 has not only been an adversity but also opened new thinking and opportunities. Artificial intelligence-driven, cost-effective, easy-to-use, and widely acceptable solutions such as "Smart-Colpo" can be a game changer to achieve the World Health Organization targets. [ABSTRACT FROM AUTHOR]

Published
2023
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