Anaemia, hypoxia and jaundice, the three (the trio) intimately interrelated health problems in military services particularly in fragile and conflict-affected settings take care of significant preventable casualties. while anaemia (less haemoglobin) is the direct result of blood loss (haemorrhage), hypoxia (less oxygen supply) is the consequence. jaundice (less liver function) could often indication of active hepatic disease due to excessive alcohol intake practice in stressful survival settings. of particular concern for military deployments (even without real war) in tropical zones have been vector-borne diseases, such as malaria, dengue, yellow fever, crimean-congo haemorrhagic fever etc. while the disease like dengue (also known as dengue haemorrhagic fever) due to aedes mosquito bite causes anaemia and hypoxia, jaundice can be direct consequence of yellow fever (the “yellow” in the name refers to the jaundice itself) due to same mosquito bite. the trio can also occur due to other viral (hepatitis a for example) haemolytic disorder in the deployment. the multiplexed health monitoring of soldiers in the environmentally challenging settings (including high altitude, low temperature) is also very important. these diseases not only affects life of the soldiers, but also a serious problem to their family members. almost 60% of the neonates come up with high bilirubin level at birth, and maximum women of our country suffers from moderate to severe anaemia, and hypoxia at pregnancy is very common. these facts imposes the requirement of an easy to use, inexpensive, online health monitoring system. while conventional gold standard detection strategy pulse oximetry for hypoxia in human subject across the races/age groups is in question, the diagnostics for the jaundice and anaemia involving invasive blood sampling are redundant in fragile and conflict-affected settings. thus following requirements in the point of care of the above settings are unavoidable: 1. efficient non-invasive strategy, preferably non-contact. 2. immediate delivery of test results, preferably online monitoring. 3. involvement of minimally trained health-workers, preferably non-experts. 4. compatibility with mobile phone platform for data transceiving for treatment plan. 5. low cost and no cost for consumables for economically challenging countries. 6. full of scale up possibility for commercialization. given the above requirements in the context of fragile and conflict-affected settings existing gold standard detection strategies for the hypoxia, jaundice and anaemia in military services in battle field are hardly applicable and revealing the scope of our innovation. regular routine health check up of army people who always devoted his or her life to protect the nation and its populations are very crucial point in respect to fitness. not only good physical condition, family members’ health plays vital role to provide the soldiers a psychological stress free condition. however, conventional health check up procedure is expensive, time consuming and painful. so, nation needs a complete non-contact package of heath check up device that produces accurate data within a shorter time and without hazards. in this study, we explore the possibility of developing prototype of a low cost, non-invasive, easy to use diagnostic device for online monitoring of the above mentioned diseases in both conflict affected and normal clinical settings. development of such diagnostic tool for monitoring of multiplex diseases will not only serve the requirement of army but also have a huge impact on society, as most of the people of our country live under poverty line. to date, there are few methods described in the literature for noninvasive assessment of anaemia at the point-of-care, like pronto-7™ developed by masimo corporation (irvine, ca) and nbm-200 developed by orsense (israel) (path, 2013). all of those devices use a finger probe and the technology is analogous to noninvasive pulse oximetry to provide total hemoglobin value within few minutes (path, 2013). for bilirubin measurements, the possible alternative for invasive blood sampling is transcutaneous bilirubinometer (bilichek and jm-103 is the commercial version of the device) that provides instantaneous cutaneous bilirubin concentration (tcb). the method is based on optical spectroscopy that relates the amount of light absorption by bilirubin (yellow skin) to the concentration of bilirubin in the skin. all the non-invasive devices, described here faces several common drawbacks. firstly their accuracy is very low (belardinelli, a. et. al., 2013). secondly, their accuracy depends highly on skin colors due to the variation in melanin content (lister, t. et. al., 2012). as a result they cannot be used in indian scenario due to our diversity in people and their skin pigmentation. thirdly, their value does not directly reflects the blood concentration of the target parameter (polley, n. et. al., 2015). the main problem of the gold standards in daily monitoring is their requirement of invasive blood sampling. invasive blood sampling is painful and stressful, may result in blood loss, have an increased risk of osteomyelitis (lilien l. d. et al., 1976), and have high chance of infection at the site of sampling, especially in case of neonates (bosschaart n. et al., 2012; dai j. et. al., 1997). in addition, a factor which is of particular concern, is that in the developing world, the conventional method is expensive, laborious, time consuming and dilatory which prevents possibility of immediate diagnosis. this serves as a basis for setting up the hypotheses we propose to test (detailed in “objectives” and “hypothesis”).
Dear Sir, Thank you very much for your kind email. Please find enclosed the details of the idea along with the test data and device calibration data for Jaundice (Bilirubin) and Anemia (Hemoglobin) obtained by our self and our collaborating medical experts in the Nil Ratan Sircar Medical College and Hospital, which is one of the biggest government hospital in the eastern region (Kolkata, West Bengal). I am, also attaching two recently published papers, where you may kindly recognize our collaboration with the medical experts mentioned above. The calibrations results for Jaundice (Bilirubin) and Anemia (Hemoglobin) is duly evident in those publications. The measurement for the Hypoxia is under investigation in the hospital (neonatology department). Our collaborating medical experts who tested our device are: Dr. Prantar Chakrabarti http://dr-prantar-chakrabarti.business.site/ Professor & Head Department of Clinical Haematology Nil Ratan Sircar Medical College and Hospital, Sealdah, Kolkata, West Bengal, India Prof. Debashis Bhattacharya, Principal, Nil Ratan Sircar Medical College and Hospital, Sealdah, Kolkata, West Bengal, India Dr Asim Kumar Mallick Professor, Department of Paediatrics Nil Ratan Sircar Medical College and Hospital, Sealdah, Kolkata, West Bengal, India Please let me know if you need further clarification in this matter.