Haematology has recently witnessed remarkable advancements in laboratory techniques and technologies to assess blood coagulation and fibrinolysis. This has improved processes and is making an impact on the diagnosis, monitoring, and treatment of various haematological disorders.Automated coagulation analysers, for instance, have improved testing efficiency and accuracy, allowing a comprehensive assessment of coagulation profiles. 

The direct measurement of fibrinolytic components provided valuable insights into fibrinolytic activity and related disorders, while molecular genetic techniques, such as PCR and DNA sequencing, enabled the precise detection of genetic mutations associated with coagulation disorders. Advanced imaging techniques, including electron microscopy and confocal microscopy, have further shed light on clot formation and dissolution at the molecular level. “In the past years, blood coagulation and fibrinolysis monitoring has become crucial to diagnose causes of bleeding, assess bleeding risk, develop anticoagulant therapy, and measure the efficacy of the treatment,” explained Prof. Phandee Watanaboonyongcharoen, Associate Professor and Medical Director at the Department of Laboratory Medicine, Chulalongkorn University in Thailand.

Related: Improving Efficiency in the Haematology Laboratory

“Point-of-care testing for coagulation monitoring plays an important role in blood coagulation detection and treatment.”

Latest developments in flow cytometry

Recent advancements in flow cytometry is revolutionising the field of haematology. The introduction of high-dimensional flow cytometry has led to the simultaneous analysis of multiple parameters, enabling a more comprehensive understanding of haematological disorders. Additionally, the utilisation of mass cytometry, or CyTOF, has expanded the repertoire of markers that can be measured, offering increased sensitivity and specificity. Furthermore, the integration of single cell genomics and transcriptomics with flow cytometry has facilitated the identification of rare cell populations and the exploration of gene expression profiles within specific cell subsets. “Over the decades, flow cytometry has been used in various applications of haematology field to sort cells in accordance with their size and complexity. It can also be used to detect and quantify the amount of foetal red cells in maternal blood. To prevent obstetric-related complications during pregnancy, we used flow cytometry to predict medicine to prevent foetal-maternal haemorrhage,” Prof. Watanaboonyongcharoen added. These developments have greatly enhanced our ability to characterise and diagnose haematological conditions with improved accuracy and precision. 

Related: Spotlight on improving quality in haematology

Breakthroughs in the diagnosis of haematologic malignancies

The development of molecular and genetic technology played a critical role in the modernisation and modification of the 2016 WHO Edition for classification of haematologic malignancies, said Prof. Watanaboonyongcharoen. Targeted and novel therapies have been introduced for the treatment of haematological malignancies such as lintuzumab, midostaurin, ulocuplumab, and sorafinib. Current advancements in the diagnosis and treatment of haematologic malignancies have brought significant breakthroughs. Precision medicine and targeted therapies based on genetic profiling have improved patient outcomes. Immunotherapies, such as CAR-T cell therapy, have shown promising results, and advancements in stem cell transplantation techniques have enhanced curative potential for these malignancies. 

Latest screening methods and diagnosis tech

Methods and technologies for screening and confirming haemoglobinopathies have greatly advanced the diagnosis and management of these disorders.  Molecular techniques, such as polymerase chain reaction (PCR) and DNA sequencing, are now widely employed for detecting genetic mutations associated with haemoglobinopathies, such as sickle cell disease and thalassemia. High-performance liquid chromatography (HPLC) and capillary electrophoresis (CE) are utilised for rapid and accurate identification of abnormal haemoglobin variants. Additionally, newer technologies like next-generation sequencing (NGS) enable comprehensive analysis of multiple genes involved in hemoglobinopathies. These advancements have improved early detection, genetic counselling, and personalised treatment strategies for individuals affected by haemoglobinopathies. “Thalassemia diagnosis relies on measuring red blood cell indices and haemoglobin analysis and assessing the clinical severity of anaemia. DNA analysis could be useful to predict the clinical phenotype and pre-symptomatic diagnose of at-risk family members and prenatal diagnosis,” she said.

Prof. Phandee Watanaboonyongcharoen is the Associate Professor and Medical Director at the Department of Laboratory Medicine, Chulalongkorn University in Thailand. She will present opening remarks at the Haematology Conference in Medlab Asia 2023 on August 17

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Technology

Digital health has experienced significant changes over the past decade in terms of technology, infrastructure, and adoption. The surge in telemedicine, remote patient monitoring, and artificial intelligence helped improve healthcare delivery to be more efficient, cost effective, equitable, and accessible to patients where they are.

The COVID-19 pandemic has certainly accelerated this transformation. The sophistication of mHealth technologies (such as wearables) and their integration into people’s daily lives opened doors to the wellness and lifestyle industry, bringing us closer to a more holistic patient care, where prevention is as important as treatment. However, truly remarkable is the quiet transformation brought by Digital Therapeutics. Digital is no longer only a support to clinical decision-making and delivery. It has become a viable form of healthcare intervention with these Digital Therapeutics, at the same level of clinical impact as pharmaceuticals or medical devices. In the last few years, studies have been published to demonstrate their effectiveness in chronic disease management, mental health, personalised care, and diagnosis. 

Related: Create a future health system paradigm to reform the industry

Since 2017, digital therapeutics has had the fastest growth of any healthtech segment, increasing by eight-fold in the last five years with an estimated global market value of US$28.7 billion in 2030. With the market projected to grow substantially, digital therapeutics holds immense potential for transforming healthcare systems to help cope with the rising demands of our society, both present and future.

Status of digital health adoption in the Asian market

According to Galen Growth, 27 per cent of digital health ventures were funded in Asia Pacific in 2022, making it the second largest ecosystem globally. Countries like China, South Korea, and Singapore are emerging as innovation hubs, fostering local start-ups. Research and online marketplace clusters captured 49 per cent of the total funds invested. The integration of e-commerce and healthtech has gained momentum, offering convenient access to medication and healthcare services, such as the internet hospitals in China. Telemedicine has been widely adopted and continues even after the COVID-19 pandemic. However, Asia-Pacific is a diverse and complex region. Variations in healthcare systems, legal and regulatory policies, economic and cultural disparities can be significant across different Asian countries. The contrasting and fragmented healthcare infrastructures are compounded by inconsistent levels of connectivity and digital literacy, particularly in rural areas. These challenges can limit the effectiveness and adoption of digital health solutions. 

Moreover, economic disparities necessitate well-designed business models to make digital health solutions affordable for sustainable implementation. However, there is currently no specific evaluation framework in the region to appropriately recognise the full value of these innovations, resulting in fragmented reimbursement coverage and under funding. This lack of evaluation framework tailored to digital health further limit and delay patient access in Asia-Pacific. The reimbursement pathways and evidence requirements are often unclear, and usually not suitable for many digital health technologies. Therefore, there is a need to better craft access strategies for digital health technologies to address these barriers.

Digital health tech vs. traditional health products

The rapid, incremental, iterative nature of digital health technologies make them stand out from traditional drugs or medical devices, making their evaluation more challenging. However, without an appropriate assessment, their value would be under-appreciated. This subsequently would have a significant impact on the willingness-to-pay, purchasing, and funding/reimbursement decisions. Unlike traditional drugs or devices, which remain relatively consistent while in use, digital health technologies are frequently updated. This dynamic nature can make less applicable to the traditional methods of evaluation designed for static products, such as randomised double-blinded clinical trials. 

Moreover, the causal effect between the intervention and the outcome of interest is not linear with digital health technologies, as with traditional health products. The effectiveness of these technologies hinges on product usage and user engagement. Variability in how users interact with these technologies can significantly impact their performance and outcome, a factor that traditional evaluation methods for drugs or devices might not fully account for. 

Related: AI-powered tools drive diagnostic precision in anatomical pathology

Lastly, digital health technologies integration into existing healthcare systems often requires a disruption of workflow and organisational change. Their health economic benefits can vary widely depending on the specifics of the healthcare system. Therefore, digital health technologies would need broader and more comprehensive, fit-for-purpose health technology assessment frameworks. 

Understanding their unique attributes is vital for developing evaluation models and processes that can accurately measure their overall value to different stakeholders in healthcare (patients, practitioners, providers, policymakers and payers).

Drivers for access of digital health tech in Asia

Despite its many challenges, Asia offers vast potential for digital health. Governments are investing in digital health infrastructure, such as India’s Ayushman Bharat Digital Mission. They should continue this positive trend by implementing supportive policies, providing funding for digital health initiatives, and creating a favourable regulatory and access environment. Until recently, policymakers in the region have tended to rely on existing medical device policies for Digital Health. However, the unique nature and characteristics of digital health call for revised policies that are fit-for-purpose. These innovations introduce a new paradigm for healthcare delivery, where much is still to be created and no one has all the answers. Thus, it is not only incumbent on governments to drive appropriate access and adoption approaches. It falls on all players in the ecosystem to collaborate. Manufacturers should work closely with other stakeholders to ensure their innovative digital solutions meet the needs of diverse populations and bring value. 

Healthcare providers and professionals can ensure effective integration into the healthcare delivery system. They can help articulate and educate patients and policymakers about the benefits of digital health and strengthen trust. Digital offers the possibility for patients to take ownership of their health. Hence, they need to be actively engaged in the development, implementation, and update of digital health solutions throughout the product lifecycle.

Collectively, we can improve the effectiveness of Digital Health Technologies for the care quality that everyone deserves, and simultaneously accelerate the time-to-market for innovations that will have wider socioeconomic benefits.

Anh Bourcet (Nguyen), PhD, is the Strategic Advisor at the Asia Pacific Medical Technology Association (APACMed). A seasoned global market access leader, she will present her topic on “Broadening Patient Access to Digital Health” at the Digital Health conference, and “Digital Health – Reimbursement Pathways” under the Doing Business in Thailand segment on August 16 and 18, respectively, at Asia Health 2023.

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Technology

Anti-neutrophil cytoplasmic antibodies (ANCA) were originally described in the context of chronic inflammatory diseases. Such antibodies were detected by indirect immunofluorescence (IIF) on ethanol-fixed neutrophilic granulocytes revealing a pattern of perinuclear staining (P-ANCA). Many years later it appeared that these antibodies were commonly present in patients with small-vessel vasculitis, although in these patients two distinct patterns were observed, i.e., the P-ANCA pattern and granular cytoplasmic staining (C-ANCA).

In contrast to the C-ANCA pattern, the P-ANCA pattern appeared to be an artefact due to the fixation with ethanol. Indeed, if the neutrophils were fixed with formalin, the sera that were identified with a P-ANCA pattern on ethanol-fixed neutrophils revealed a C-ANCA pattern on formalin-fixed neutrophils (Figure1). 

Figure 1: ANCA-patterns of indirect immunofluorescence. PR3-ANCA reveal a granular fluorescence in the cytoplasm of ethanol-fixed (C-ANCA, upper-left) and formalin-fixed neutrophils (lower-left). MPO-ANCA, however, reveal a linear fluorescence around the de nucleus of ethanol-fixed neutrophils (P-ANCA, upper-right). This is a fixation artefact because formalin-fixed neutrophils reveal a granular fluorescence in the cytoplasm (C-ANCA, lower-right).

At the end of the ‘80s, the antigens recognised by ANCA in patients with small-vessel vasculitis were identified as myeloperoxidase (MPO) and proteinase 3 (PR3). This enabled the development of antigen-specific immuno-assays that were more specific for vasculitis than IIF. Due to the high sensitivity of IIF, the 1999 international consensus on ANCA testing prescribed that screening for ANCA should be performed by IIF with the follow-up of positive results by solid-phase assays of both MPO- as well as PR3-ANCA. In particular, the combination of C-ANCA/PR3-ANCA and P-ANCA/MPO-ANCA was highly suggestive of the so-called ANCA-associated vasculitis (AAV), consisting of granulomatosis of polyangiitis (GPA, previously Wegener’s granulomatosis), microscopic polyangiitis (MPA), and eosinophilic granulomatosis of polyangiitis (EGPA, previously Churg-Strauss syndrome).

Related: Antibody indices – a growing analysis in the diagnosis of CNS diseases

In the meantime, solid-phase assays gradually improved in terms of test characteristics, and multiple distinct assays, next to the original ELISA, entered the market. Since many of these systems were executed on fully automated analysers, laboratories increasingly abandoned IIF as a screening method, although solid evidence for this approach was not yet available. The multicentre study published in 2017, however, clearly revealed that the current immuno-assays for MPO- and PR3-ANCA outperformed the most optimal IIF strategy, i.e., the combination of ethanol- and formalin-fixed neutrophil substrates. This resulted in a revised international consensus stating that for GPA and MPA detection of ANCA by antigen-specific immuno-assays is to be preferred above screening with IIF. This consensus was subsequently extended to EGPA, although this was an eminent-based consensus because underlying data were lacking. The novel consensus also advised performing a confirmation test if results for MPO- or PR3-ANCA were only low-positive. Again, because antigen-specific assays outperform IIF, confirmation preferentially is performed with antigen-specific immuno-assays.

Based on the above, it might be conceived that ANCA IIF can be completely abandoned. However, several clinical settings may still profit from IIF. First, AAV or clinical mimics may be induced by drugs, one of which is cocaine. This may result in the generation of ANCA directed to human elastase (HLE), which reveals a P-ANCA pattern in IIF. Obviously, such sera may react negatively in antigen-specific assays for MPO- and PR3-ANCA. Many of these sera, however, are also positive for both MPO- as well as PR3-ANCA.

Secondly, ANCA as detected by IIF is not restricted to AAV, but is also encountered in inflammatory bowel disease, in particular ulcerative colitis, and autoimmune liver diseases like autoimmune hepatitis and primary sclerosing cholangitis. The antigens recognised by these ANCA are only poorly defined and, although some assays reveal an increased prevalence of PR3-ANCA in ulcerative colitis and primary sclerosing cholangitis, IIF seems to be the best method of detection.

Finally, ANCA IIF remains relevant in the 2022 classification criteria of the three distinct subtypes of AAV. These criteria are based on a dataset generated from 2011 – 2017, which is before the publication of the revised consensus on ANCA detection. In these criteria, P-ANCA is equivalent to MPO-ANCA while C-ANCA is equivalent to PR3-ANCA. It should be stressed, however, that these criteria should be applied in patients for which a diagnosis of small-vessel vasculitis has been established, but a classification for GPA, MPA, or EGPA has to be made.

Related: Guide to building pharma strategies in oncology

Since ANCA are not only used for diagnosis but also for follow-up of AAV patients, adequate positioning of IIF versus solid-phase assays also holds for this purpose. ANCA detection for follow-up may have three distinct intentions — first, to see if autoantibody levels decline after the start of immunosuppression; second, to determine the risk of relapse at the time clinical remission is achieved; and third, to predict a clinical relapse based on a rise in ANCA.

For the first objective, a decline can be observed equally well by both techniques as long as the end-point titer/level has been determined. For the second objective, it is important to know that this risk evaluation has originally been established by IIF, while more recently it was shown to be less predictive for solid-phase immunoassays. Finally, the added value of serial ANCA measurement for predicting a clinical relapse remains a matter of discussion. However, in general, solid-phase assays perform more accurately than IIF. For this objective, it is crucial that one-and-the same assay is used for follow-up because the results of distinct assays cannot be aligned.

Altogether, it is evident that ANCA IIF has played a very important role in the laboratory diagnostics of small-vessel vasculitis. Although ANCA IIF has recently been included in the criteria to classify the distinct disease entities of AAV, evidence for a multi-centre study clearly indicates that antigen-specific immuno-assays are better for the diagnostic work-up of these diseases. Positioning of IIF in other chronic inflammatory diseases cannot be replaced because the respective antigens are not well known.

Dr. Jan Damoiseaux is the Assistant Professor, Diagnostic Centre, NUTRIM School of Nutrition and Translational Research in Metabolism; Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands. He will be speaking on “ANCA IF Pattern in Current Clinical Practice” at the Immunology Conference on August 18 at Medlab Asia 2023.

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Laboratory

Rare diseases pose a substantial burden on healthcare systems, particularly in underserved regions such as the Middle East. The lack of access to genomic diagnostic services and personalised management plans exacerbates this challenge. To address this pressing issue, Al Jalila Children’s Specialty Hospital (AJCH) has taken a significant step by establishing a clinical genomics and genetic counseling facility. Housed within a multidisciplinary tertiary paediatric centre in the UAE, our facility is dedicated to diagnosing and managing patients with rare diseases. Standard clinical genomic investigations at our facility include exome-based sequencing, chromosomal microarrays, and/or targeted testing. In my session “Current State of Genomic Diagnostics in Pediatrics” at Medlab Asia 2023, I will summarise our experience including the diagnostic yield and implications for clinical management among this population.

Related: Genomics and its rapid evolution in the Middle East

I will also highlight several new efforts toward enhancing the diagnostic efficacy and earlier identification of patients with rare diseases. These efforts include rapid whole genome sequencing for critically ill patients, newborn genetic screening, and whole genome long read sequencing. According to data from clinical standard testing on 1,000 patients with rare diseases (46.2 per cent females; average age, 4.6 years) representing 47 countries primarily from the Arabian Peninsula, the Levant, Africa, and Asia, the cumulative diagnostic yield was 32.5 per cent (95 per cent CI, 29.7– 35.5 per cent). This was higher for genomic sequencing-based testing than chromosomal microarrays (37.9 per cent versus 17.2 per cent, P = 0.0001) across all indications, consistent with the higher burden of single gene disorders. Of the 221 Mendelian disorders identified in this cohort, the majority (N = 184) were encountered only once, and those with recessive inheritance accounted for ~ 62 per cent of sequencing diagnoses. Of patients with positive genetic findings (N = 325), 67.7 per cent were less than five years of age, and 60 per cent were offered modified management and/or intervention plans.

Interestingly, 24 per cent of patients with positive genetic findings received delayed diagnoses (average age, 12.4 years; range from seven to 37 years), most likely due to a lack of access to genomic investigations in this region. One such genetic finding ended a 15-yearlong diagnostic odyssey, leading to a life-threatening diagnosis in one patient, who was then successfully treated using an experimental allogenic bone marrow transplant.

Related: The role of diagnostics in combatting life-threatening diseases

Finally, we present cases with candidate genes within regions of homozygosity, likely underlying novel recessive disorders. Attendees can look forward to a feasibility study on a newly established pipeline for rapid whole genome sequencing (within 40 hours) for critically ill patients, as well as a discussion on a recent expansion of this pilot study, to include more patients over the next two years and generate evidence (clinical and economic utility) supporting implementation of this technology for patients in NICU/ PICU. I will also show preliminary results from our newborn genetic screening programme on the genetic epidemiology of spinal muscular atrophy (SMA) as a prototype for recessive diseases in the region. Finally, I will highlight the additional benefit of using whole genome long read sequencing in our setting. AJCH believes that early access to genomic diagnostic testing is a tenet to improving clinical outcomes for individuals living with rare diseases.

Facilitating timely and accurate diagnoses enables us to provide tailored treatment and care plans for genetically underrepresented populations in the Middle East. By bringing together advanced technology and expert genetic counseling, our facility strives to improve the quality of life for patients and families facing these medical challenges, fostering hope and empowering them with knowledge and support.

Dr. Ahmad Abou Tayoun is the Director of the Genomics Center of Excellence at Al Jalila Children’s Hospital, and an Associate Professor of Genetics at Mohammed Bin Rashid University of Medicine and Health Sciences. He will present his topic “Current Genomic Diagnosis in Paediatrics” at the Molecular Diagnostics and Genomics conference on August 16 at Medlab Asia 2023.

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Laboratory

Healthcare workers are digital native consumers. The new generation may have grown up without paper, pen and fax, but they know what good service delivery feels like. It is digitally accessible and responsive, self-service and empowering, with transparency of information and choice At the same time, our global health systems are under pressure like never before. The systems we crafted centuries ago to manage battlefield trauma and infectious diseases are not scaling to address the challenges of a population with lifestyleinduced chronic disease. Thanks to modern medical miracles, we are increasingly turning acute conditions like cancer into chronic diseases. In our developed world we simply do not have enough staff, beds and facilities to meet current demand, nor can we scale to meet future projections. Our workforces are increasingly specialised and centralised in metropolitan hubs, while patients are geographically spread. 

We need a new health system paradigm underpinned by new models of care. We need a way to deliver high-quality services that are equitably accessible to patients wherever they are, with the same workforce and ideally at the same or lower cost. We need digital at the core. The good news is that we do not need to imagine the future. It is already here — deployed and delivering the outcomes and results we desperately need. The challenge is turning these pockets of innovation into the default model, as these new models of care include virtual care, self-directed care, preventative care, and precision medicine.

Related: ASEAN region ranks high in healthcare competitiveness

At the same time, we need to make progress beyond eliminating paper and implementing systems of record in healthcare. If all we do is digitise, we may be missing the opportunity to transform care. That means using the data that we capture for insights and ensuring that the experience is modern and intuitive. One of the most promising technologies is artificial intelligence and this has delivered compelling capabilities in the field of machine vision for diagnostic imaging. Now we have trained models that are finding a ready home in radiology, pathology, dermatology, and ophthalmology. Creating an accurate diagnostic model for diagnostic imaging is a matter of clinician input, training data, data science skills, and computing resources, then fine-tuning through reinforcement feedback learning. Beyond medical imaging, however, marshalling these inputs has proven a barrier to the broader application of artificial intelligence in healthcare. 

In the last year, however, generative AI has surfaced to provide an answer to these constraints. Large Language Models (LLMs) have decoded communication, i.e., our human operating system and can infer context and content to produce surprisingly insightful responses even for specialised fields like medicine. Forget the higher-order tasks that clinicians already do well, there is a role for AI to address the estimated 25 per cent of waste baked into how we deliver healthcare today. 

Related: Integrated care models offer seamless access to health services

We can solve our workforce dilemma if we could let clinicians diagnose and treat patients, perform the top-of-license care they are uniquely trained to deliver and get satisfaction from, and leverage AI to mop up the administrative complexity, redundancy, fraud, rework, and error. That is latent productivity. Imagine an extra 25 per cent more staff; if we couple this with outreach technologies to engage patients and virtual care models to meet them where they live, we can then address access and equity It is an exciting time for digital health. Powerful technologies are available to modernise health services, leading to better outcomes for patients and experiences for clinicians. We have validated that these technologies can be delivered safely and effectively as new models of care. Now is the time to create a future health system paradigm that will help us address the challenges of today and the future.

References available on request

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Technology 

Healthcare in Southeast Asia boasts a decades-long commitment to innovation and advanced medical facilities with a robust infrastructure. These collectively raised its rank as a competitive global destination for high-quality, affordable medical treatment, attracting patients from the region and abroad. Additionally, it has become a state-of-the-art learning hub for professionals in the healthcare business by offering an immersive platform for the exchange of knowledge and technology.

Investments continue to pour in as governments in Southeast Asia allocate a significant portion of their budget to boost the healthcare industry. Healthcare expenditure in Thailand, for instance, is valued at approximately US$25.3 billion, according to the US-based International Trade Administration. These costs are further expected to mark a 10-year compound annual growth rate of 6.6 per cent by 2026 amounting to US$47.9 billion. The Eastern Economic Corridor (EEC) development plan led by the Thai government is set to play a role in raising the country to an innovation-based economy, which in turn is expected to fuel healthcare projects within the provinces covered under the scheme, namely Chachoengsao, Chon Buri, and Rayong. 

This has welcomed special privileges for healthcare businesses ranging from a 17 per cent flat personal income tax, a corporate income tax reduction of 50 per cent, as well as the provision of a five-year work visa to manage operations and retain skilled medical talent.

Related: Taking a closer look at China's health and wellness market through a consumer lens

Exciting times are ahead for the healthcare industry in the ASEAN region as countries turn their attention to preventive care and technological advancements. Geriatric care is also slowly but surely becoming an important focus area as the ageing population is set to increase by 20.3 per cent in 2050, according to recent statistics published by The BMJ, a peer-reviewed medical trade journal by the British Medical Association.

Keeping the region’s healthcare workforce up to speed with the latest trends, technology and business strategies, premier events — Medlab Asia and Asia Health — return for its seventh edition with a refined portfolio of leading medical laboratory and healthcare innovation, as well as networking opportunities for businesses in the healthcare industry. The event, taking place between August 16 and 18 in Bangkok, further infuses the concept of sustainability into various aspects of the business to leave an economic, environmental and social impact — from operations, logistics, conference and networking programmes to laboratory, patient care, community, and future health planning and development. 

The latest edition of the show is home to the region’s only multidisciplinary congress, featuring 13 accredited conferences in various trending sectors, namely laboratory management, molecular diagnostics, haematology, and immunology under Medlab Asia, and emergency medicine, patient safety and infection control, total radiology and nursing under Asia Health. 

The conferences will also feature the voices of leading female leaders in the healthcare industry, from opening remarks for the nursing track by Prof. Dr. Siriorn Sindhu, President of the Nurses Association of Thailand (NAT), and Dr. Associate Prof. Nanthaphan Chinlumprasert as moderator for the ‘Redesigning palliative care in all dimensions for optimum results’ panel. The show will also have inspirational insights from Assistant Prof. Pimpun Kitpoka, Director of Blood Bank at Ramathibodi Hospital, Mahidol University who will speak at the emergency medicine conference, alongside keynotes delivered by Lisa Mckenzie, VP Asia Pacific at the Australia-based Institute for Healthcare Improvement (IHI) and Prof. Le Thi Anh Thu, President of Vietnam Infection Control Society Safety under the patient safety track.

Related: Entering New Markets: Discovering Asia's Untapped Potential

The ‘Doing Business in Thailand’ track, which will take place on August 17 and 18 in partnership with the Thai Medical Device Technology Industry Association (THAIMED), is specially curated to give industry leaders — entrepreneurs and policymakers to investors and decision makers alike — key insights into the country’s dynamic healthcare market and highlight business opportunities and solutions. The two-day agenda will highlight thought-provoking topics such as digitalisation agility in healthcare business, future medical device support for the private sector, good manufacturer distributor practice, and digital health reimbursements, to name a few.

Learn more about Medlab Asia and Asia Health and click here to register for the event

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Management

A substantial demographic shift is underway in the UAE and a significant part of the population is expected to suffer from age-related conditions such as dementia and Alzheimer’s. According to statistics, the year 2050 will see a spike in seniors where approximately 16 per cent of the country’s population — that’s two million people — will be in the age range of 60 and above, adding a burden to healthcare systems.  

Alzheimer’s education and training for caregivers 

A progressive and irreversible neurological disorder, Alzheimer’s is the most common form of dementia, that affects the brain causing memory loss and cognitive decline. In the next three decades, the number of people living with dementia in the UAE could reach 220,000 individuals, according to a study in the Lancet medical journal. These statistics not only make it crucial to increase awareness about the severity of the disease but also require encouraging government entities, healthcare organisations, and medical professionals to focus on addressing the challenges that come with an aging population.  

Related: New drug to slow down Alzheimer’s disease

Healthcare professionals play a significant role in helping educate individuals and communities about the risk factors associated with Alzheimer’s, says Dr. Zemer Wang, Medical Director of Aviv Clinics Dubai. Through periodic screenings and assessments, they can identify early signs and symptoms of cognitive decline, allowing for timely intervention and better management of risk factors contributing to the development of the disease. They can assist with managing symptoms and slow down disease progression by prescribing appropriate medications and recommending lifestyle modifications to individuals previously diagnosed.  

Early intervention can allow medical practitioners effectively connect patients and their families to relevant resources and support services and offer emotional support and counselling to those affected and their families.  

New technology for Alzheimer's  

While education and early intervention have resulted in curbing disease progression, advancements in technology have also increasingly helped in improving communication and tracking in Alzheimer's care. 

Researchers are exploring the use of digital biomarkers, which are objective and quantifiable measures derived from data collected through digital devices. “Biomarkers can provide continuous and remote monitoring of cognitive performance, enabling early detection of changes associated with the disease,” says Dr. Wang.  

He further adds that advanced brain imaging techniques, such as positron emission tomography (PET) scans and magnetic resonance imaging (MRI), have significantly contributed to understanding the progression of Alzheimer's disease. These imaging methods can visualise changes in brain structure, detect amyloid plaques and tau tangles, and assess brain metabolism and blood flow patterns. Integrating artificial intelligence and machine learning algorithms further enhances the analysis and interpretation of these imaging data, aiding in early detection and monitoring. 

Related: Much-awaited breakthrough for treatment of Alzheimer’s

Additionally, applying artificial intelligence and machine learning techniques to large-scale data including electronic health records, genetic profiles, lifestyle data, and imaging data, can help researchers identify patters, risk factors, and predictive markers associated with Alzheimer's disease progression. This could then lead to personalised approaches for monitoring and intervention.  

Ongoing research and clinical trials aim to better understand the underlying mechanisms of Alzheimer's and develop more effective treatments and preventive strategies. 

On the medical treatment front, options like the Hyperbaric Oxygen Therapy (HBOT), in which a patient breathes 100 per cent oxygen in a pressurised chamber have shown notable strides, says Dr. Wang. “The new protocols of HBOT have been proven to induce the generation of new blood vessels, reduce inflammation, and promote the growth of new neurons in the brain and thus reverse some of the core, common elements that are believed to be responsible for the development of Alzheimer's disease and dementia,” he adds. 

The US Food and Drug Administration (FDA) also recently granted approval for a new drug, Leqembi, designed to slow the progression of the Alzheimer’s. Also known as Lecanemab, it is the second major drug introduced for the treatment of the disease and targets a protein called amyloid which builds up in the brain in people with Alzheimer’s. 

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Central Sterile Services Department (CSSD) in healthcare settings has witnessed significant improvements in workflow efficiency. Automation of sterilisation processes through advanced sterilisers with precise parameters has enhanced consistency and minimised errors, according to Dr. Sherbaz Bichu, Chief Executive Officer of Aster Hospitals and Clinics in the UAE, Oman and Bahrain.  

Emphasising the pivotal role of CSSD and the transformative impact of technological advancements in ensuring patient safety and infection control in healthcare facilities, Dr. Bichu said that CSSD maintains the highest standards of hygiene and prevents healthcare-associated infections (HAIs) in hospital settings. 

CSSD, also known as the Sterile Processing Unit (SPU), is a critical department responsible for the cleaning, sterilisation, and distribution of medical and surgical instruments, equipment, and supplies.  

Related: Highlighting effective elimination of pathogens

“The CSSD is the backbone of infection control in our hospitals. It is a key component of patient safety, ensuring that all reusable medical devices and instruments are decontaminated, sterilised, and prepared for safe use in patient care areas,” said Dr. Bichu. 

Highlighting the significance of CSSD in hospital management, Dr. Bichu said that it plays a crucial role in maintaining infection control, adhering to industry standards and regulations, and ensuring the reliability of medical equipment. 

“Technological innovations have revolutionised CSSD operations. Automation and sophisticated tracking systems have streamlined the sterilisation process, leading to increased efficiency,” he said. 

In addition, barcode and RFID tracking systems have transformed inventory management, offering real-time visibility and optimising stock levels to minimise stockouts and delays. Electronic documentation and traceability systems have replaced paper-based records, saving time and enhancing compliance with regulatory requirements. 

The CSSD team, comprising highly trained technicians and supervisors, performs a series of essential activities to uphold the highest standards in healthcare practices. Decontamination marks the initial step, where used instruments and equipment undergo meticulous cleaning using specialised agents, ultrasonic cleaners, and mechanical washers. 

“Effective decontamination is the foundation of a successful sterilisation process. Our technicians follow strict protocols to ensure that all organic matter is thoroughly removed, leaving the instruments ready for sterilisation,” he added. 

Related: Environmental cleaning gains prominence for infection control

The sterilisation process follows decontamination and employs various methods, such as steam sterilization (autoclaving), ethylene oxide (ETO) sterilisation, hydrogen peroxide gas plasma sterilisation, or low-temperature sterilisation systems. This ensures complete eradication of any remaining pathogens, minimising the risk of infections. 

After sterilisation, the CSSD team meticulously assembles the instruments into procedural and surgical sets, ensuring they are readily available for immediate use during medical procedures. The department also plays a crucial role in managing sterile supplies, monitoring inventory levels, tracking expiration dates, and coordinating with other hospital departments to meet their specific equipment needs.  

According to Dr. Bichu, communication and collaboration tools have further facilitated effective teamwork, reducing errors and bottlenecks in the workflow. Virtual reality (VR) and augmented reality (AR) technologies have revolutionised training and education, offering immersive learning experiences to CSSD technicians. 

The amalgamation of skilled CSSD professionals and transformative technology continues to drive healthcare facilities towards safer and more effective patient care, he added. 

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