Innovative breast cancer early warning system developed by Chennai firm

Oct 31, 2017 0

Chennai– llumina 360, a robot-assisted breast cancer early warning system developed by a city-based medical technology firm, can help in early detection of tumours through thermal imaging and be a boon in tackling the disease that is fast spreading in India, an official said.

Cura Healthcare developed the innovation with funding assistance from the central government-run Bio-technology Industry Research Assistance Council (BIRAC) under the Department of Bio-Technology.

Cura Healthcare has got a US patent on hand for its Illumina 360 and is looking at healthcare providers for the machine.

According to M. Balasubramaniam, chief executive officer Cura, the system is the first of its kind in the world in breast cancer detection.

With incidence of breast cancer seen in younger women, Illumina 360 can detect presence of variance in the breasts of women irrespective of their age and without any pain, Balasubramaniam said.

According to him, the existing screening systems have negative factors like pain when the breasts get pressed by the machine, women feel shy to be exposed during the screening process, age (only women over 45 can be subject to mammography) and non-ionizing radiation.

However, Illumina 360 eliminates all these handicaps.

“All that a woman has to do is to lie down on a table just unbuckling her tops and without exposing her breasts. An advanced robot in the scanning chamber will take a 360 degree view of the breast and acquire thermal signature – an early warning signal for breast cancer,” Balasubramaniam said.

“On seeing an abnormality in the thermal image, the person may be advised some lifestyle changes. After some period similar scan could be taken to check on the status,” Sandeep Jaipurkar, Consultant Radiologist, Image Art, Vijaya Health Centre said.

According to Balasubramaniam, with Illumina 360 mass breast screening from early age can be a reality in India.

Balasubramaniam said the equipment will be priced similar to the analog mammography whereas the digital mammography costs around Rs 1 crore.

Renu Swaroop, Managing Director, Bio-technology Industry Research Assistance Council (BIRAC), Department of Bio-Technology, Government of India, in a statement said: “We at BIRAC are here to stimulate, foster and enhance bio-tech innovation that can bridge existing healthcare gaps and improve lives of 1.3 billion Indians. This is a critical mandate of Government of India.

“We are pleased to announce the birth of one such innovation -CURA’s Illumina 360 degree, to bridge one of the biggest gaps in the country – addressing the biggest killer disease of the country – Breast Cancer. We are proud to have been part of innovating this disruptive innovation.”

Balasubramaniam said India today is staring at a breast cancer epidemic and breast screening is non-existent in India.

One in 28 women get breast cancer and one in two die due to late detection, making survival one of the lowest in the world.

According to Balasubramaniam, the Rs 175 crore turnover Cura Healthcare is targeting a revenue of around Rs 200 crore this year.

“We will be targeting hospitals, diagnostics labs and primary health centres for Illumina 360,” he added. (IANS)

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Cell cycle-blocking drugs can shrink tumors by enlisting immune system in attack on cancer, study finds

Aug 27, 2017 0

BOSTON–In the brief time that drugs known as CDK4/6 inhibitors have been approved for the treatment of metastatic breast cancer, doctors have made a startling observation: in certain patients, the drugs – designed to halt cancer cell division — do not just stop tumors from growing but can cause them to shrink, in some cases markedly.

New research by scientists at Dana-Farber Cancer Institute (Dana-Farber) and Brigham and Women’s Hospital (BWH) reveals an unexpected mechanism behind these tumor regressions. In a study published online today by the journal Nature, the investigators show that CDK4/6 inhibitors not only stymie the division of cancer cells but can also spur the immune system to attack and kill the cells. When the drugs were coupled with other immunotherapy agents, the anti-cancer effect can be even greater, they report.

The findings, which follow Dana-Farber scientists’ recent discovery that CDK4/6 inhibitors can slow the growth of cancer cells carrying a surplus of a certain protein, suggest that the drugs’ potential in cancer treatment has only begun to be tapped. If their effectiveness increases in combination with immunotherapies, as early evidence indicates, that potential may be greater than is even now apparent.


Shom Goel, MD, PhD, and Jean Zhao, PhD

“The CDK4 and 6 proteins are critical drivers of the cell-division cycle and are required for the formation and growth of various types of solid tumors,” says Dana-Farber’s Shom Goel, MD, PhD, co-first author of the study with Molly DeCristo of the Hematology Division at BWH.

“Agents that block the proteins — CDK4/6 inhibitors — have received Food and Drug administration approval for some patients with metastatic breast cancer, but they’ve also shown promise against others types of tumors in clinical trials. In early clinical trials of these drugs, we noticed that in some breast cancer patients the tumors didn’t just remain the same size — as would be expected with drugs that interfere with cell division — but began to recede, sometimes quite dramatically, said Goel.”

To understand why this occurs, they examined the effect of a CDK4/6 inhibitor called abemaciclib in mice with breast or other solid tumors. They found the agent not only stalled the tumor cell cycle but also caused the immune system to mount an attack on the tumors. They confirmed the finding by analyzing tissue samples from women participating in a clinical trial of a CDK4/6 inhibitor for breast cancer.

The drugs trigger an anti-tumor immune response in two ways, the researchers discovered. In cancer cells, the drugs produce a substantial increase in the display of abnormal proteins on the cells’ surface. These proteins, called antigens, serve as a signal to the immune system that a diseased or cancerous cell is present and needs to be eliminated. At the same time, the drugs can spark a reduction in immune system cells known as T regulatory cells (Tregs), which usually tamp down the immune response to disease or infection. Fewer Tregs results in a fiercer immune system attack. The cumulative effect of these processes is a halting or reversal of tumor growth.

“The anti-tumor immune response with CDK4/6 inhibition was somewhat unexpected — some had previously thought that CDK4/6 inhibitors would block anti-tumor immunity, due to effects on T cell proliferation, but our findings demonstrate quite the opposite,” DeCristo states. “This surprising finding opens the door for combining immunotherapy with CDK4/6 inhibitors.”

In clinical trials, about 20 percent of breast cancer patients treated with abemaciclib by itself have a significant response to the drug and another 20 to 30 percent have stabilizations of tumor growth, the authors explained. The responses have tended to appear within four months of starting the therapy, they added.

In the current research, even better results have been obtained in mice when the drugs are used in combination with immunotherapy agents known as checkpoint inhibitors, which can foil cancer’s ability to evade an immune system attack. “It appears that the CDK4/6 inhibitors might be able to sensitize some patients’ cancers to the anti-tumor effects of immune checkpoint inhibitors,” the authors state. “The result might be especially encouraging for breast cancer patients, who have derived little benefit from immunotherapy in trials conducted to date.”

Further research is needed to understand why some patients receive the full spectrum of benefits from CDK4/6 inhibitors while others don’t, and to seek ways to expand these benefits to more patients. The results also should spur future studies of combined regimens of CDK4/6 inhibitors and different types of immunotherapy, the authors state.

The work was carried out in the laboratories of Jean Zhao, PhD, of Dana-Farber and Sandra McAllister, PhD of BWH and the Broad Institute of Harvard and MIT, who were co-senior authors of the paper along with Hye-Jung Kim, PhD, of Dana-Farber. Co-authors are April C. Watt, Haley BrinJones, Ben B. Li, Naveed Khan, Shaozhen Xie, PhD, Otto Metzger-Filho, MD, Ian E. Krop, MD, PhD, Eric P. Winer, MD, and Thomas M. Roberts, PhD, of Dana-Farber; Jaclyn Sceneay, PhD, Jessalyn M. Ubellacker, and Susanne Ramm, PhD, of BWH; Jeremy Hoog and Cynthia Ma, MD, PhD, of Washington University School of Medicine; and Matthew Ellis, MD, PhD, of Baylor College of Medicine.

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Ayush boosting medical tourism in India: Experts

Jul 23, 2017 0

New Delhi– Reviving traditional medicine system, such as Ayush, has helped boost India’s medical tourism market in comparison to western nations, surviving only on modern medicinal system, health experts said here on Sunday.

Observing that despite many recent policy changes, such as demonetisation and GST, the flow of foreign patients in India is increasing, the experts said the major reason for this is alternative medical solutions such as Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) which is available only in India.

“In spite of demonetisation, the nation’s medical tourism has not only seen an exponential growth but generated revenue and employment more than ever. Moreover, the Ministry of Ayush has also kept its upper hand in attracting foreign patients. The alternative treatment options have provided an important edge over the competitors in Asia,” said Ruchi Gupta, Founder and CEO of 3hcare.in, an online platform promoting medical tourism.

Ruchi Gupta, Founder and CEO of 3hcare

Commenting on the new government regulations, Gupta said the Goods and Services Tax has a productive effect especially on the healthcare industry and contributing to medical industry.

“India is poised to become the hub of medical tourism by 2020 and GST has a vital role in elevating the chances due to reduced insurance cost, pharmaceuticals and travel without diminishing the service quality. With complete healthcare packages — right from travel, e-visa on arrival until accommodation and treatments — available at three-tenths rate as compared to any developed country, India has an added competitive advantage,” said Gupta.

According to experts, the Indian medical tourism market is expected to more than double to reach $8 billion by 2020. Currently, Bangladesh and Afghanistan dominate the Indian medical value travel with a 34 per cent share.

Sanjay Agarwal, Medical Director of Hinduja Hospital, said that with the integration of surplus talent, technology, tourist attraction, trade and tradition, India is a potential place to promote itself as a premier global healthcare destination and enable streamlined medical services.

He said that among the medical procedures preferred by foreign patients in Indian hospitals are minimally invasive surgery and ayurvedic treatment, which is part of Ayush. (IANS)

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GE Healthcare partners with Partnerships for Affordable Health Access

Apr 25, 2017 0

New Delhi– Aiming to provide medical care to over 2.5 million urban poor in India, GE Healthcare and project PAHAL (Partnerships for Affordable Health Access and Longevity) on Tuesday announced a strategic partnership to address healthcare needs of underserved communities in the country.

The partnership will help in use of transformational medical technology, solutions and services to meet the needs of India’s urban poor.

Project PAHAL, implemented by IPE global — a consulting company providing expert technical assistance and solutions for equitable development and sustainable growth in developing countries — responds to the Indian government’s priorities of reducing morbidity and mortality among women and children in the underserved urban communities.

It leverages private markets and community engagement to promote healthy behaviour change, improve access to affordable primary healthcare, and reduce out-of-pocket expenses.

The MoU was inked by GE Healthcare’s Sustainable Healthcare Solutions President and CEO Terri Bresenham and PAHAL Project Director L.M. Singh.

“Pahal in a short period has built partnerships that provide a platform to serve healthcare needs of over 20 million urban poor in several high priority states of India, in line with National Health Policy and priorities,” said Singh in a statement. (IANS)

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India reports significant reductions in neglected tropical diseases

Apr 21, 2017 0

India has achieved the target for eliminating visceral leishmaniasis (kala azar), a neglected tropical disease (NTD), in 82 per cent sub-districts, according to the fourth World Health Organization (WHO) report on NTDs released on April 19, 2017.

Another significant achievement by India was the elimination of yaws, a chronic skin disease that mostly affects poor children, in 2015; WHO recognised India as the first member state to “achieve this important milestone”.

India has also progressed in treating lymphatic filariasis (elephantiasis), and has stopped mass drug administration in 72 endemic districts after passing evaluations.

NTDs are some of the oldest and most painful diseases, afflicting the world’s poorest communities. It is estimated that one in six people in the world suffers from NTDs-including more than half-a-billion children.

NTDs disable, debilitate and perpetuate cycles of poverty, keeping children out of school, parents out of work, and dampening hope of any chance of an economic future.

An estimated one billion people received treatment in 2015 for neglected tropical diseases (NTDs) such as leprosy, elephantiasis, leishmaniasis (kala azar) and schistosomiasis, a disease caused by parasitic flatworms.

The largest number of people needing treatment and care for NTDs-in excess of 100 million-are found in India, Indonesia and Nigeria, which together account for 47 per vm% of cases worldwide.

India has set a target of eliminating visceral leishmaniasis by 2017 and lymphatic filariasis in endemic pockets by 2017, IndiaSpend reported on February 23, 2017.

“WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and elephantiasis to their knees,” WHO Director General Margaret Chan said.

“Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health,” Chan added.

As more countries and regions eliminate NTDs, the number of people requiring treatments has declined from two billion in 2010 to 1.6 billion in 2015, the WHO report said.

Bangladesh, Brazil, China, Egypt, India, Indonesia, Pakistan and Tanzania have reduced the number of people needing treatment by more than 10 million since 2010.

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US Food and Drug Administration remains key issue for investors in healthcare in India

Apr 18, 2017 0

New Delhi– The US Food and Drug Administration (FDA) remains the key issue for investors in the pharmaceuticals and healthcare sector, according to a report released on Tuesday by global investment banking firm Jefferies.

The investment firm’s officials met investors in Asia to discuss healthcare sector – pharma and services.

“The FDA remains the key issue for investors. FDA issues dominated most conversations. We highlighted to investors how the issues are cultural and cannot have a short term fix. These will require substantial re-training, changes in incentive policies and strict monitoring through consultants and internal compliance,” the note said.

According to “India/Healthcare: A Uncertainties Diminish Interest – Asia Roadshow Feedback”, investors agreed with the investment firm’s view that companies need to build redundancy layers in compliance and facilities for key products.

“These will lead to increased cost impacting margins,” it said.

Further, the feedback note said most investors while looking for ideas, had concerns on the rising event risks.

“We had multiple conversations on the high uncertainty in earnings and how valuations are still not in comfort zone. We highlighted that pharma investments need to be bottom-up and not a top-down call, going forward,” it said.

The firm said the increased risk in pharma space has resulted increased interest in healthcare services among investors.

“Hospitals were a key discussion point. While there were concerns on the government focus on affordable healthcare – capping on stent pricing and other measures that can come in – it is still considered a strong growth story,” it added. (IANS)

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India won’t meet National Health Policy 2017 targets

Apr 15, 2017 0

By Swagata Yadavar

Health has never been a national priority and it is one reason why we have the highest number of women dying during childbirth and under-five mortality rates, former Union Health Secretary K. Sujatha Rao wrote in her recently-published book “Do We Care? Indias Health System”.

Drawing on two decades of work in public health, Rao favours increasing the health budget, greater use of technology and providing leadership and good governance for better healthcare. In an email interview with IndiaSpend, Rao said that with the level of under-funding for health and crowding in of ambitious targets, India will not meet the National Health Policy 2017 targets. Excerpts:

Q: Public health spending is 1.16 per cent of GDP while the World Health Organisation (WHO) recommends spending five per cent of GDP. National Health Policy 2017 talks about increasing the spending to 2.5 per cent by 2025 but we haven’t met the 2010 target of two per cent of GDP. Why does India’s public health funding remain low?

A: Public health spend is low for three reasons: First, lack of political will and the absence of political philosophy that places an individual’s health, well-being and education as being central to the development process. Our mindset is still wired to fly-overs and fast trains. Second, the absence of accompanying reforms in the direction of decentralisation, flexibility and greater accountability to enable quicker absorption of funds and utilisation. Thirdly, on the macro-level, we are not collecting enough taxes and have competing demands and liabilities that have constricted space for increasing resources for health.

Q: Most of the health targets mentioned in National Health Policy 2017 are the same as in 2002, which were supposed to be met in 2010. Most targets have been repackaged with new deadlines. What went wrong, and how do we ensure that we meet the 2017 targets?

A: We will not meet these targets either… not with the level of funding proposed and the crowding in of too many ambitious targets, indicating an absence of prioritisation. I see no shift in strategy that could accelerate the process for achieving the targets within the time-frame suggested. Our public health systems are too weak to fulfil the many demands being placed on it.

Q: How important is it to regulate the private consultation system that caters to 75 per cent of the country’s health needs, as a 2016 Brookings India report showed?

A: Since the 1980s, with the gradual emergence of the economic crisis, India had no option but to allow the entry of the commercialised private sector. The structural adjustment following the IMF loan in 1993 accelerated the process due to severe budget cuts.

Health, unlike other sectors, is fraught with market failures such as the asymmetry of information. These characteristics put limitations on the ability of markets to arbitrate equitably necessitating state intervention. Regulations are critical to protect patient interests and ensure that patient vulnerability is not exploited by the provider… or, as we now see, by the hospital managements.

Q: Talking about the cut in health budgets in the 12th Plan (2015-17), you have said: “…reduced public spending on health and pushing of public-private partnership (PPP) is a dangerous cocktail”. Yet, the National Health Policy 2017 talks about partnerships with the private sector to “address specific gaps in public services”. Should India focus on strengthening the public sector than on PPPs?

A: PPPs work when the risk is shared. They fail when it is a one-sided game with all benefits taken by one partner and all risks borne by one. PPPs in the health sector seem to be more like the latter case.

Secondly, purchasing of health services is based on a contract that is a legal document. So, when you have restricted budgets and contractual obligations, spending priorities get dictated by the legal commitments and not what is in the immediate interest of the people.

Thirdly, the “gap” is more a huge hole. Private sector is the dominant provider. So, if there has to be a real PPP based on a level playing field, the public sector has to be strengthened.

Q: You have mentioned the lack of public discourse and involvement on health in demanding accountability from policy makers. What are the factors responsible for it, and how do we change it?

A: Lack of understanding or perhaps a belief that illness is our fault. Besides, in a very poor country still struggling for basics, health is not a priority — access to water, food and basic incomes to survive are. (IANS)

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New technology can detect tiny ovarian tumors, says Sangeeta Bhatia

Apr 10, 2017 0

CAMBRIDGE, MA — Most ovarian cancer is diagnosed at such late stages that patients’ survival rates are poor. However, if the cancer is detected earlier, five-year survival rates can be greater than 90 percent, MIT said in a statement.

Now, MIT engineers have developed a far more sensitive way to reveal ovarian tumors: In tests in mice, they were able to detect tumors composed of nodules smaller than 2 millimeters in diameter. In humans, that could translate to tumor detection about five months earlier than is possible with existing blood tests, the researchers say.

A high-magnification micrograph of an ovarian clear cell carcinoma. The images show, focally, the characteristic clear cells with prominent nucleoli and the typical hyaline globules. A high-magnification micrograph of an ovarian clear cell carcinoma. The images show, focally, the characteristic clear cells with prominent nucleoli and the typical hyaline globules.
Image: Nephron/CC BY-SA 3.0

The new test makes use of a “synthetic biomarker” — a nanoparticle that interacts with tumor proteins to release fragments that can be detected in a patient’s urine sample. This kind of test can generate a much clearer signal than natural biomarkers found in very small quantities in the patient’s bloodstream.

“What we did in this paper is engineer our sensor to be about 15 times better than a previous version, and then compared it against a blood biomarker in a mouse model of ovarian cancer to show that we could beat it,” says Sangeeta Bhatia, the John and Dorothy Wilson Professor of Health Sciences and Technology and Electrical Engineering and Computer Science, a member of MIT’s Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science, and the senior author of the study.

Sangeeta Bhatia (Photo: MIT)

This approach could also be adapted to work with other cancers. In this paper, which appears in the April 10 issue of Nature Biomedical Engineering, the researchers showed they can detect colorectal tumors that metastasized to the liver.

The paper’s lead authors are postdoc Ester Kwon and graduate student Jaideep Dudani.

Synthetic biomarkers

Bhatia first reported the strategy of diagnosing cancer with synthetic biomarkers in 2012. This method measures the activity of protein-cutting enzymes called endoproteases, which are made by tumors to help recruit blood vessels and invade surrounding tissues so the cancer can grow and spread.

To detect this sort of enzyme, the researchers designed nanoparticles coated with small protein fragments called peptides that can be cleaved by particular proteases called MMPs. After being injected into a mouse, these particles passively collect at the tumor site. MMPs cleave the peptides to liberate tiny reporter fragments, which are then filtered out by the kidney and concentrated in the urine, where they can be detected using various methods, including a simple paper-based test.

In a paper published in 2015, the researchers created a mathematical model of this system, to understand several factors such as how the particles circulate in the body, how efficiently they encounter the protease, and at what rate the protease cleaves the peptides. This model showed that in order to detect tumors 5 millimeters in diameter or smaller in humans, the researchers would need to improve the system’s sensitivity by at least one order of magnitude.

In the current study, the researchers used two new strategies to boost the sensitivity of their detector. The first was to optimize the length of the polymer that tethers the peptides to the nanoparticle. For reasons not yet fully understood, when the tether is a particular length, specific proteases cleave peptides at a higher rate. This optimization also decreases the amount of background cleavage by a nontarget enzyme.

Second, the researchers added a targeting molecule known as a tumor-penetrating peptide to the nanoparticles, which causes them to accumulate at the tumor in greater numbers and results in boosting the number of cleaved peptides that end up secreted in the urine.

By combining these two refinements, the researchers were able to enhance the sensitivity of the sensor 15-fold, which they showed was enough to detect ovarian cancer composed of small tumors (2 millimeters in diameter) in mice. They also tested this approach in the liver, where they were able to detect tumors that originated in the colon. In humans, colon cancer often spreads to the liver and forms small tumors that are difficult to detect, similar to ovarian tumors.

Earlier diagnosis

Currently, doctors can look for blood biomarkers produced by ovarian tumors, but these markers don’t accumulate in great enough concentrations to be detected until the tumors are about 1 centimeter in diameter, about eight to 10 years after they form. Another diagnostic tool, ultrasound imaging, is also limited to ovarian tumors that are 1 centimeter in diameter or larger.

Being able to detect a tumor five months earlier, which the MIT researchers believe their new technique could do, could make a significant difference for some patients.

In this paper, the researchers also showed that they could detect disease proteases in microarrays of many tumor cells taken from different cancer patients. This strategy could eventually help the researchers to determine which peptides to use for different types of cancer, and even for individual patients.

“Every patient’s tumor is different, and not every tumor will be amenable to targeting with the same molecule,” Bhatia says. “This is a tool that will help us to exploit the modularity of the technology and personalize formulations.”

The researchers are now further investigating the possibility of using this approach on other cancers, including prostate cancer, where it could be used to distinguish more aggressive tumors from those that grow much more slowly, Bhatia says.

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Rs 30 crore neuro spine care hospital launched in Bengaluru

Mar 30, 2017 0

Bengaluru– Bengaluru Regenerative Advanced Institute of Neurosciences (Brains), a neuro spine care hospital, with an investment of Rs 30 crore, was launched in Bengaluru on Thursday.

Brains, launched in association with Sparsh Hospital here, is the first private sector specialty tertiary neuro spine care hospital chain in India.

“We have invested Rs 30 crore on medical equipment and technology and are planning to invest Rs 70 crore more within two years,” N.K. Venkataramana, founder and Chief Neuro Surgeon, Brains, told reporters here.

Brains aims to set the golden standards with cutting edge services encompassing prevention, awareness, advocacy, acute and chronic care, regeneration, rehabilitation and research and training. Among the Brains’ primary focal areas is infusing vitality to brain health.

“At Brains, we offer comprehensive healing services to create a healing eco system for every patient suffering from neuro spinal issues,” Venkataramana said.

Brains has developed a dedicated neuro emergency team excelling in 24×7 neuro emergency, offering specialised consultation and surgery under four categories: neurosurgery, neurology, neuro critical care and neuro emergency.

“We are mulling having similar facilities in other metropolitan cities in the country,” Venkataramana added.

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IIT Hyderabad offers fellowship for healthcare entrepreneurs

Mar 28, 2017 0

Hyderabad– The Indian Institute of Technology Hyderabad’s Center for Healthcare Entrepreneurship (CHE) is offering a one-year, fully-paid fellowship training programme.

This is a world-class programme for aspiring healthcare entrepreneurs and currently one of India’s most competitive and coveted fellowships. The full-time in-residence fellowship and training will be strongly hands-on, the CHE said in a statement.

The fellowship is designed as a simulated entrepreneurial journey with clinical immersion, needs, analysis and design, ideation, business model development and culminates in the pitch to investors. In designing solutions, fellows avail the deep technological expertise of over 100 research labs at IIT Hyderabad.

The fellowship has been conceptualised, administered and mentored by a global team from India and the US, including entrepreneurs from Silicon Valley, academics from Stanford University, biomedical industry professionals, and some of India’s well-known healthcare NGOs.

This fellowship comes with a stipend of Rs 50,000 per month, and is open to applicants from all backgrounds ranging from doctors, management graduates, engineers, designers, the statement said.

The final number of fellows will vary depending on the quality of applicants. The first batch of fellows will pass out by end of summer 2017.

Candidates can apply online at http://bit.do/che2017, on or before April 15. Shortlisted candidates have to appear for interview over video link from May 1 onwards. Selected candidates will be appearing for final interview in person during last week of May, the statement added. (IANS)

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