The country’s trajectory has been building for years. A fast-growing middle-income population, rising chronic disease burden, and expanding health infrastructure have created both demand and urgency. What is changing now is the environment in which innovation can move, driving faster approvals, a culture of collaboration, digital infrastructure and a government signaling policy readiness to engage global partners in shaping the next era of medicine.

The economic momentum is significant. The Indian health ecosystem has expanded from roughly $372 billion in 2023 to $638 billion in 2025, making it one of the fastest-growing major health markets in the world. The broader industry is expected to exceed $610 billion by 2026, fueled by rising insurance coverage, expanding hospital infrastructure, and growing demand for chronic disease management. Health growth in India continues at approximately 10–12 percent annually, well above the growth rates typical of mature markets, reflecting both rising access and structural transformation.

BIOAsia 2026 reflects this inflection point. The global gathering in Hyderabad, themed “TechBio Unleashed: AI, Automation & the Biology Revolution,” highlights the (bio)convergence of biology, data, and intelligent systems reshaping health worldwide. Organizers emphasize that the meeting aims to drive health transformation and reinforce India’s position as a leading global life sciences force. For multinational innovators, the message is increasingly clear: India is not only where innovation is deployed; it is also where it is developed. It is where innovation is increasingly defined. India has become a go-to market for multinational enterprises.

Policy Signals and Market Scale: From Opportunity to Strategic Partnership

India’s regulatory and policy environment is evolving in ways that matter deeply to multinational innovators. One pivotal shift came with the country’s decision to allow certain medicines approved in specified developed markets to launch without local clinical trials, a move designed to accelerate patient access while aligning more closely with global regulatory science. This policy shift reflected confidence in international data, a commitment to innovation, and recognition that faster access must remain central to national health strategy.

The scale of India’s pharmaceutical and life sciences market reinforces this transformation. The pharmaceutical sector reached approximately $68 billion in 2025 and is projected to grow to more than $170 billion during the next decade, driven by expanding middle-income demand and strong domestic manufacturing. India already supplies roughly one-fifth of the world’s generic medicines. It produces the majority of global vaccines by volume, positioning the country as a central player in global health supply chains.

As Aman Gupta of SPAG/FINN wrote in Medika Life, “India’s health sector is undergoing a profound transformation, bolstered by government-led reforms and a favorable FDI regime. The allowance of 100% foreign direct investment through automatic routes in health and related sectors has already attracted global giants.” His observation reinforces a central reality for multinational innovators: India’s policy environment is increasingly designed not only to welcome global participation, but to encourage long-term strategic partnership in building the future of healthcare.

Investment trends tell the same story. Health and pharmaceutical private equity and venture investments have reached multi-billion-dollar levels annually. At the same time, India’s contract drug development and manufacturing sector is projected to exceed $22 billion within the next decade. These dynamics position India as a growth market and as a strategic partner across the innovation lifecycle from discovery and clinical development to manufacturing and global distribution.

Shakthi Nagappan, CEO of Telangana Life Sciences Foundation, captured this moment clearly, noting that BIOAsia arrives at a time when technology and biology are redefining healthcare and creating “unprecedented opportunities for innovation, investment, and impact.” The language reflects partnership rather than transaction, a signal that India is moving from market opportunity to strategic collaboration.

Digital Infrastructure, BIOAsia and the Multinational Innovation Imperative

India’s digital transformation may be its most potent catalyst for long-term health innovation. Unlike many mature systems, the country is building a national-scale digital health infrastructure designed to connect patients, providers, and health systems across a population of more than 1.4 billion people, with a rising middle class of 400 million.

The Global Digital Health Market is projected to grow from USD 288.55 billion in 2024 to USD 2,688 billion by 2035, expanding at a CAGR of 22.55% during 2025–2035. This surge is driven by the rapid adoption of AI-powered diagnostics, telemedicine, wearable devices, and data analytics solutions that are revolutionizing patient care and operational efficiency worldwide.

Hundreds of millions of citizens are already using digital health services, including telemedicine, electronic prescriptions, and remote care. The Ayushman Bharat Digital Mission is creating an interoperable national health ecosystem, enabling secure health records, improved care coordination, and population-scale data infrastructure that supports research, real-world evidence, and precision health.

For multinational companies, this digital backbone creates a uniquely strategic environment, enabling large-scale clinical research, faster pharmacovigilance, AI-supported health insights, and rapid deployment of innovation across diverse populations. India’s digital infrastructure is not simply modernizing health delivery. It is enabling national-scale transformation.

BIOAsia sits at the center of this conversation and convergence. The gathering reflects India’s ambition to lead at the intersection of biology, artificial intelligence, and scalable innovation. Leaders from industry, government, and science convene not only to discuss growth but to shape the next phase of global life sciences, where biology, data, and digital systems converge to influence global health.

One conference panel, among the many high-powered sessions, brings together global leaders in advanced therapeutics to explore how next-generation modalities are moving from discovery to scalable care. Panelists across biopharma, translational science, and hospital systems are examining progress in cell and gene therapies, mRNA, and radiopharmaceuticals, underscoring that innovation now depends as much on manufacturable scale and delivery as on scientific breakthrough. India’s expanding capabilities in clinical research and bioprocessing strengthen its role as a key partner in advancing next-generation therapies.

For multinational innovators, the implications are clear. Engagement in India now extends beyond commercialization. It calls for collaboration in research, investment in digital and scientific ecosystems, alignment with national health priorities and partnership in strengthening health delivery.

India’s Strategic Role in Global Health Innovation

India’s rise in global health innovation reflects the alignment of policy, market growth, digital infrastructure, and scientific capability forces that together are reshaping where and how healthcare innovation occurs.

For multinational companies, India now represents a full-spectrum innovation environment. It is a place to conduct clinical research across diverse populations, scale manufacturing and supply chains, deploy digital health at a national scale, and co-develop solutions addressing both local and global health challenges. Increasingly, India is not simply a recipient of innovation developed elsewhere. It is becoming a co-creator of next-generation health.

This shift changes the strategic equation. Market entry alone is no longer sufficient. Meaningful engagement requires partnership with policymakers, regulators, scientists, health providers, and digital health ecosystems. Organizations that invest in collaboration, align with national health priorities, and contribute to strengthening healthcare systems are most likely to succeed in India’s evolving landscape.

BIOAsia sets the stage for this transformation. It is more than a conference. It is a convergence of global health ambition, scientific capability, and policy momentum. The conversations taking place in Hyderabad mirror a broader reality: the geography of health innovation is expanding, and India is now central to its future.

For global health innovators, the question is no longer whether India matters. The question is how deeply they choose to engage in shaping what comes next.

The post India: The Growing Focal Point for Health Innovation appeared first on Medika Life.

At the hospital, they discovered the swollen lymph node, diagnosed it as a minor infection, and treated it with antibiotics. Her health began a downward spiral afterward as she began to experience symptoms that required further medical exploration.

In January 1994, additional swollen lymph nodes appeared, and tests finalized the diagnosis. Various treatments, including radiation to her brain, were begun, and cancer spread to her liver, spine, and brain. She died within five months. At the time, she would receive world-class treatments at the most prestigious medical centers to no avail. Today, the outlook for the disease is much improved with advances in medicine.

The actress Jane Fonda, age 85, revealed that she, too, has Non-Hodgkin’s Lymphoma and is faring well with treatment. No longer viewed as a fatal illness, the prognosis for patients has improved significantly since 1994.

As Fonda noted on her social media account:

“This is a very treatable cancer. 80% of people survive, so I feel very lucky.

I’m also lucky because I have health insurance and access to the best doctors and treatments. I realize, and it’s painful, that I am privileged in this. Almost every family in America has had to deal with cancer at one time or another, and far too many don’t have access to the quality health care I am receiving and this is not right… I’m doing chemo for 6 months and am handling the treatments quite well and, believe me, I will not let any of this interfere with my climate activism.”

Causes and Treatments

Why someone develops the disease is still a question for researchers to answer. Non-Hodgkin lymphoma is caused by a change (mutation) in the DNA of a type of white blood cell called lymphocytes, although the exact reason why this happens isn’t known.

Even before treatment, diagnosing cancer brings dread and anxiety because “the Big C” has always brought serious stress. As The American Cancer Society notes, Simply finding a lump or possible other sign or symptom of cancer can cause anxiety and fear, along with finding out that they have cancer or that the cancer has come back. Fear of treatment, doctor visits, and tests might also cause apprehension (the feeling that something bad is going to happen). Their website provides ways to help a cancer patient cope with this diagnosis-related anxiety.

The stories we’ve heard over the decades have ingrained this fear into us as hopes for a “cure” seemed dim. Now, instead of cure, we hear that cancers can go into remission and that more effective treatments are available.

Cancer specialists are no longer only found at major research centers but all across the country. Jane Fonda knows that, and she also knows that using her positive attitude to continue her many activities as she receives treatment is helpful. A positive attitude, as we know, is one way to aid our immune system in coping with disease invaders.

Anyone who has experienced cancer-related anxiety should know that evidence of added anxiety in cancer survivors is strong and must be considered in any treatment plan. In a study of 3370 survivors, 40% of the survivors reported moderate to high anxiety scores, and approximately 20% reported moderate to high depression scores. These levels were higher than levels of anxiety in the general population.

Treatments for the disease have come a long way since Jackie Kennedy was diagnosed. Now, in addition to radiation, stem cell transplant, and chemotherapy, we have immune-boosting techniques. A form of immunotherapy known as CAR T-cell therapy is increasingly being used to treat some people with the blood cancer non-Hodgkin lymphoma (NHL).

Even newer treatments are on the horizon, and the belief is that we will have more powerful weapons to fight this and other forms of cancer in the future.

The post Jackie Kennedy and Jane Fonda — Same Diagnosis, Different Decades and Treatments appeared first on Medika Life.

We attended the digital funeral today of an innocent victim, slaughtered in a horrific drive-by shooting. That victim was of course Ivermectin, a wonder drug that has over the last two decades saved countless lives. The vehicle involved was the pandemic and the vehicle’s occupants, none other than individuals from within the medical and wellness sectors.

To understand why people sworn to protect their patients at all costs would cross over to the dark side, we need to highlight facts that have surfaced over the last few months. Understanding motive will I hope also enable those who remain skeptical to accept the truth about Ivermectin.

It is not a treatment or prophylactic for Covid-19 or the SARS-CoV2 virus. It never was.

A small, as yet unvalidated possibility exists that it may offer some benefit to late-stage Covid-19 patients, but that remains inconclusive pending further research. Proving Ivermectin’s efficacy in early-stage Covid or as prophylactic poses very real, and some would argue, insurmountable methodological challenges.

All Ivermectin ever claimed to be, was an anti-parasitic drug. It is as much a victim of the intricate web of deceit and deception spun by certain individuals, as the intended targets, who consume it in the mistaken belief it offers salvation.

Let’s begin by examining how that web has begun to unravel and then we’ll take a closer look at those who engineered the deception and why.

The Preprint

Most of the scientific and medical community speaking up on behalf of Ivermectin used the following pre-print as validation for the efficacy of the drug as a Covid-19 treatment. The paper was called Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic and the first of four versions was made available to the public on the 13th of November, 2020.

The preprint was published on researchsquare.com and if you click on the link above you will see that the preprint has been removed and an investigation initiated into the content and contributing authors. Why is explained below.

ReasearchSquare posts the following text in red font above the preprints it publishes as fair warning that the content is not peer-reviewed and should not be considered as anything more than an unverified opinion.

This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.

Despite this, the preprint was seized upon, Google scholar showing 43 citations. In case you’re not familiar with publication terms, in scientific journals, a citation is a reference from a published article to a published paper (note, not a preprint) intended to provide confirmation or reference for content.

In short, 43 papers that have done exactly what the warning above suggests shouldn’t be done. Why this warning exists and preprints are broadly unreferenced in the scientific community became apparent as peer review set about validating the integrity of the data in the preprint and claims of plagiarism that had been leveled against the authors.

Examining the Data

Much like forensic auditors check for cooked books, forensic data analysts exist to sniff out anything fishy in sets of data. Nick Browne was tasked with examining the data used in the preprint to validate claims made relating to the efficacy of Ivermectin as a treatment for Covid-19. You can read a full breakdown of his analysis here if the summation below is insufficient.

The data file for the research was made available as a locked Excel spreadsheet, rather than an SPSS 21 file, the tool the preprint authors purported they had used for their analysis. Browne was forced to pay for access to the file and then had to manually guess at the password (1234) before gaining access to the Excel data. From there, things rapidly progressed from bad to worse.

Many of the patients who died appear to be duplicates. According to the original data, there were ‘four’ patients with the initials NME, NEM, and NES (twice), who were all males aged 51 years old, all suffered from diarrhoea(sic), had the same blood hemoglobin levels, were all diagnosed on the 22nd of May, and all died on the 29th of May 2020. They also all share identical values in at least four other data columns.

At least a further ten deceased patients also display evidence of being duplicated. Duplicates make up around half of the recorded deaths. Much of the patient data is identical, but minor changes exist, proving that a simple copy and paste error cannot be the cause of the duplicates.

In no particular order, and again, please refer to the linked report for specifics, Browne also identified issues with;

• Formatting
• Numbers containing non-numeric characters
• Confusion around date formats
• Repeated or cloned sequences of data
• Apparent failures of randomization
• Descriptive statistics that did not match the preprint
• Table results that do not match the preprint
• Other issues included age distribution, trailing digits of numerical variables, study entry and exit dates, and last, but not least, the lack of the SPSS file.

In summation, Browne arrived at the following conclusion;

In view of the problems described in the preceding sections, most notably the repeated sequences of identical numbers corresponding to apparently “cloned” patients, it is difficult to avoid the conclusion that the Excel file provided by the authors does not faithfully represent the results of the study, and indeed has probably been extensively manipulated by hand.

We aren’t limited by Browne’s proclivity for professional restraint so we’ll call it as he saw it. The data provided for the preprint are a largely concocted fairy tale, an ambitious con designed to mislead. Manipulation of the data was not accidental but rather intentional, engineered to support very specific predetermined outcomes, for reasons we will examine below.

Plagiarism

Lead-authored by Dr. Ahmed Elgazzar, a Professor Emeritus at the University of Behna, the preprint claimed to represent the results of a multi-center, 600-patient study evaluating the use of ivermectin in preventing and treating COVID-19.

The author’s claims centered around the following;

• Ivermectin significantly reduced both the number of deaths and the length of patient’s hospital stay compared to standard Egyptian treatment protocols
• Ivermectin exhibited a substantial effect in preventing the onset of the disease in the first place, in other words, it acted as a prophylactic against the virus.

The article by Jack Lawrence we will reference with regards to the above can be read in full here, and again, we have provided a summation of his findings below. There are numerous instances in the preprint of text being lifted directly from an original source and not credited. In a schoolboy fashion, the authors have tried to obfuscate the plagiarism by changing a few words in each extract.

Plagiarized Elgazzar et al 2020

“This novel virus infection has incapacitated the world’s medical services framework as well as the political and financial relations [2. As another section in human life opens

up [3, the world is by all accounts divided into two sections pre-and post-COVID19 time.”

Original Heidary & Reza Gharebaghi 2020

“This novel virus has paralyzed not only the world’s health care system but also the political and economic relations [13]. As a new chapter in human life opens up [14], the world seems to be divided into two parts pre- and post-COVID19 era.”

Note: Elgazzar even used the same sources

https://www.nature.com/articles/s414290200336-z

A schoolboy could be chastised and excused for similar behavior, but there can be no excuse offered by the preprint author, Elgazzar, who would be intimately familiar with protocols surrounding scientific publications. The preprint is littered with further examples of plagiarism and Larence uncovered further unethical actions pertaining to the study.

While the disclosures above may shock some, they pale in comparison to what is to follow, namely acknowledging the extent of duplicity and malintent by members of the medical community across the globe. Doctors, scientists, pharmacists, alternate health practitioners, and individuals from the wellness sector have teamed up to exploit vulnerable patients for financial gain in the midst of a pandemic.

That is the only logical and unavoidable conclusion that can be drawn from the Ivermectin fiasco and avoiding confronting this unpleasant reality prevents us from protecting vulnerable patient populations.

Acknowledging the Grift

Medika first became aware of Ivermectin and its ability to kill the SARS-CoV2 virus in a paper in Nature, released in mid-2020. We published an article, highlighting the results, achieved in vitro, and suggested, like others, that immediate trials should be undertaken to see if the effects could be replicated in vivo.

The pandemic was gaining momentum and there would be no shortage of willing trial candidates. The problems though were obvious at the outset. Ivermectin had successfully killed the test tube sample in a laboratory, but achieving similar dosage levels in human subjects was highly inadvisable and patently unachievable without endangering the patient’s health.

Conducting broad-scale trials at tolerable dosages should have been a priority for either the FDA or a recognized European health authority. No one stepped up to conclusively prove or disprove the potential of Ivermectin as a Covid treatment. The lack of credible trials was potentially driven by an industry-wide skepticism of the drug’s ability to impact viruses (it is an anti-parasitic) and although this rationale made sense to scientific circles, the public was unable to make the connect.

A potential ‘treatment void’ had been unintentionally created for Ivermectin and it was into this void, as is so often their want, that the grifters stepped, seizing an opportunity to co-opt the pandemic for profit on a global scale.

Plumbing the dark depths of deception

India was one of the countries that fully embraced the grift. Provincial authorities distributed Ivermectin as a Covid treatment to residents and other countries, notably South American populations, followed suit.

Proving the efficacy of a treatment is often far simpler than disproving its efficacy and the grifters took full advantage, distributing their ‘Covid treatment’ via the global digital conspiracy network surrounding the pandemic. They assured the public that the drug was being intentionally withheld and the rest is history. Across the internet, both the public and many from within the medical community bought into the Ivermectin lie.

A lie that was cemented in many minds as fact by anecdotal evidence, falsified data and manipulated trials like the one conducted by Elgazzar and his colleagues. It is far easier to believe a convenient lie than face an unpleasant truth.

Doctors (the term is used loosely) have taken advantage of a vulnerable patient population to sell them drugs and in case you think this deplorable behavior was limited to non-western countries, the evidence suggests the west drove the trend. This is not simply supposition but fact.

In the US, rapidly formed organizations like America’s Frontline Doctors, a despicable congruence of dishonest doctors, pharmacists, and marketing individuals set about creating the ultimate pill mill for not only Ivermectin but the other darling of Covid conspiracies, hydroxychloroquine. You can read more on that here, including comments from exploited patients, shown below the article.

This pattern of profiting by deception from the sale of Ivermectin and other Covid cures continues unabated. We have unintentionally created the environment where large sums of money can be made from misleading the public in the midst of a pandemic. The fact the public’s health may be forfeit is irrelevant to the quacks and charlatans claiming to be healers.

These individuals are doctors, nurses, pharmacists, caregivers, and individuals of science. The lie could not exist without their duplicity and in many instances, the lie exists at their instigation. It is a hard truth to face and one we look away from. We need to openly acknowledge this and develop effective methods to prevent future occurrences.

Ivermectin’s lasting legacy should not be as the drug that failed to treat Covid and fooled the world. It should be seen as the drug that taught the world about a bitter pill, one we need to swallow now, lest we repeat history.

The post Ivermectin is Dead and Buried Despite NIH Website Misstep and Twitter Buzz appeared first on Medika Life.

The introduction of Walgreens clinical trial offerings coincides with recent steps taken by the U.S. Food and Drug Administration to increase racial and ethnic diversity in clinical trials given 20 percent of drugs have a variation in responses across ethnic groups¹, yet 75 percent of clinical trial participants are white, while only 11 percent are Hispanic and fewer than 10 percent are Black and Asian².

“Walgreens trusted community presence across the nation, combined with our enterprise-wide data and health capabilities, enables us to pioneer a comprehensive solution that makes health options, including clinical trials, more accessible, convenient and equitable,” said Ramita Tandon, chief clinical trials officer, Walgreens. “Through the launch of our clinical trials services, we can provide another offering for patients with complex or chronic conditions in their care journey, while helping sponsors advance treatment options for the diverse communities we serve. This is yet another way we are building our next growth engine of consumer-centric healthcare solutions.”

Patient recruitment and enrollment remain challenges in clinical trials, further exacerbated by the COVID-19 pandemic. Nearly 80 percent of trials fail to meet their enrollment goals in the stated timeframes, often contributing to costly delays.  Walgreens is addressing these challenges and improving the overall clinical trial experience by rapidly scaling three portfolio-integrated, patient-centric service lines:

• With Walgreens patient reach and access to an extensive foundation of pharmacy and patient-authorized clinical data, the company can proactively match diverse patient populations to trials across a range of disease areas based on race, gender, socioeconomic status and location. By leveraging a tech-enabled approach to patient identification and creating a large registry of clinical trial participants, Walgreens will reduce the time it takes to match eligible patients to clinical trials.

• Walgreens is addressing access barriers through a compliant, validated and secure decentralized clinical trial platform built on a rigorous compliance and regulatory framework to ensure patient privacy and security. This approach leverages owned and partner digital and physical assets, including select Health Corner and Village Medical at Walgreens locations, to directly engage patients at home, virtually or in-person. Synergies with AllianceRx Walgreens Pharmacy, as well as investments made by Walgreens Boots Alliance in CareCentrix and Shields Health Solutions, will also support new clinical trials approaches, particularly for specialty indications. This innovative operating model will accelerate patient searches, simplify workflow and enable a faster and more representative collection of trial data.

• Walgreens is building on a legacy of delivering high-quality, real-world evidence to unlock value in therapeutics and help improve health outcomes. Through a robust foundation of real-world insights, Walgreens can support sponsors’ drug development strategies, inform clinical trial designs, optimize trial execution and improve diversity in trials. In fact, real-world insights delivered through the Walgreens COVID-19 Index helped inform national and local health decisions and plans.

More than half of Walgreens nearly 9,000 stores are located in socially vulnerable areas. When combined with Walgreens customer relationships, digital offerings that keep patients connected to care and partnerships with national and local organizations, Walgreens has a proven ability to break down barriers to health engagement and access among diverse patient populations. Most recently, the company hosted vaccine clinics and events to address vaccine hesitancy with help from more than 750 diverse, community-based partners, and administered approximately 40 million COVID-19 vaccines to underserved communities throughout the pandemic.

Pluto Health™ Collaboration Enhances Experience With Comprehensive Health Insights

One of the partners for the Walgreens expanded healthcare offering will be Pluto Health, a multi-layered, smart care coordination service that unifies siloed health information from multiple places (such as medical records, social determinants of health, insurance claims and more) within 30 minutes. The Pluto Health team then evaluates patient health information with the recommended clinical care guidelines and social determinants of health data to identify and close any potential gaps in care. This helps ensure every patient receives the best possible care through up-to-date screenings, vaccinations and other health interventions, such as clinical research as a care option.

“Pluto Health was co-created within the healthcare community to make the provision of care achievable and more equitable for more people with better care coordination,” said Joy Bhosai, MD MPH, Co-Founder, CEO Pluto Health. “As a part of our primary goal to coordinate care and support patients on their terms, we are thrilled to play a part in making the latest medical advances more accessible. It’s time to accelerate healthcare access for all patients, from all walks of life, and from anywhere in the nation.”

The post Walgreens Launches Clinical Trial Business to Address Industrywide Access and Diversity Challenges and Redefine Patient Experience appeared first on Medika Life.

DO YOU GET HEARTBURN? Stomach contents heading back into the esophagus (gastroesophageal reflux) are not unexpected. For many, these episodes are fleeting and do not cause symptoms or injury to the esophagus.

Gastroesophageal reflux becomes a problem when it causes significant damage to the esophagus or symptoms.

Today we look at the physiology of gastroesophageal reflux, causes, symptoms, diagnosis, and potential non-medical interventions for management.

We’ll end with the observation that those who sleep on their left side have less potentially harmful stomach acid than others.

What is reflux (GERD)?

At your stomach’s entrance is a functional valve, a muscle ring known as the lower esophageal sphincter (LES). Usually, the LES closes after food passes through it.

If the sphincter does not entirely close (or it opens too frequently), stomach acid can move backward into your esophagus. With this retrograde acid flow, one can experience symptoms such as burning chest discomfort or heartburn.

WebMD offers that if acid reflux symptoms happen more than twice per week, you may have acid reflux disease, also known as gastroesophageal reflux disease (GERD).

If your symptoms of acid reflux occur more than twice weekly, you may have gastroesophageal (acid) reflux disease.

Reflux: Common risk factors

A common cause of acid reflux is a hiatal hernia. This condition happens when the upper stomach and the lower esophageal sphincter slip above the diaphragm (the muscle separating your stomach from the chest). If you have a hiatal hernia, acid can more easily move up into your esophagus, causing acid reflux disease.

Other risk factors for acid reflux disease include:

• Being overweight or obese
• Consuming large meals or lying down right after eating
• Eating certain foods, for example, such as spicy or fatty foods. Some get heartburn from citrus, tomato, mint, garlic, or onions.
• Drinking beverages such as alcohol, carbonated drinks, coffee, or tea
• Smoking
• Being pregnant
• Taking certain medicines (aspirin, ibuprofen, certain muscle relaxers, and some blood pressure medicines are examples)

Reflux (GERD): Symptoms

The Mayo Clinic (USA) explains that common symptoms of gastroesophageal reflux disease (GERD) include:

• Chest pain
• Heartburn (a burning sensation in your chest, typically after eating). Heartburn can be worse at night.
• Swallowing difficulty
• Regurgitation of food or sour liquid
• Lump in your throat sensation

This burning can occur anytime but is often worse after eating. For many, heartburn gets worse when they recline or lie in bed, making getting good sleep a challenge.

The Mayo Clinic offers that you should seek immediate medical care if you have chest pain (especially if you also have shortness of breath or jaw or arm pain). These may be symptoms of a heart attack.

Make an appointment with your doctor if you have severe or frequent GERD symptoms. Also, check-in with your healthcare provider if you use over-the-counter medications for heartburn more than twice weekly.

The perils of GERD

Did you know that more than 75 percent of individuals with asthma have GERD? Those with asthma are twice as likely to have GERD as those without the condition.

Gastroesophageal reflux disease may worsen asthma symptoms, and asthma drugs can worsen GERD. But treating GERD often helps to relieve asthma symptoms. The mechanism of action is not clear.

GERD (chronic acid reflux) can be dangerous or even life-threatening. It’s not the GERD per see that is the issue; instead, chronic GERD can promote:

• Esophagus inflammation (esophagitis). Stomach acid can irritate and inflame the esophagus lining, culminating in heartburn, chest pain, bleeding, or challenges swallowing.
• Barrett’s esophagus. About ten percent of those with chronic GERD develop this condition. Here, the long-term damage from acid hitting the esophagus lining can cause cells to be abnormal; when this occurs, we call it Barrett’s esophagus, a risk factor for esophagus cancer.
• Esophagus cancer. Adenocarcinoma is a cancer type that typically develops in the lower esophagus. Squamous cell carcinoma more commonly affects the middle and upper esophagus.
• Strictures. The damaged esophagus sometimes becomes scarred, resulting in narrowing of the structure. Strictures can make drinking or eating challenging.

GERD and sleep position

Medicines can help with GERD. Many can benefit from lifestyle interventions. For example, try sleeping on your left side. This position appears to be the best sleeping one for people with GERD, as it reduces reflux episodes. On the other hand, sleeping on your back can make reflux more likely.

An old-school trick is to raise the head of the bed. Propping it up (not just putting more pillows under your head) by at least six inches may reduce your reflux when you are lying down.

You can find some more intense interventions for GERD here:Treatment for GER & GERD | NIDDKYour doctor may recommend that you make lifestyle changes and take medicines to manage symptoms of gastroesophageal…www.niddk.nih.gov.

GERD — my take

If you have symptoms of GERD, please discuss them with a healthcare provider. Having a good weight can help us dodge acid reflux. In addition, don’t eat overly large meals or lie down immediately after eating.

Be careful with spicy or fatty foods, citrus, tomato, garlic, mint, and onions. I try to avoid peppermint in the evening but have no trouble with it during other times of the day.

I don’t drink alcohol but do consume e risk-increasing coffee and tea. I am sure you are not surprised that I don’t smoke. Finally, be careful with the medicines such as aspirin, ibuprofen, certain muscle relaxers, and some blood pressure medicines.

The post Heading Off Heartburn appeared first on Medika Life.

Almost exactly 100 years ago in 1920, hot on the heels of the discovery of x-rays by German scientist Wilhelm Conrad Röntgen, a new machine was introduced into shoe shops across the globe. Called the Fluoroscope or Pedosscope(UK) the device was essentially a portable x-ray machine with a singular and rather ingenious purpose.

The idea was brilliant. Customers could try on a new pair of shoes and pop their freshly shod feet into the Fluoroscope box. The device would then produce an x-ray image of your feet inside the shoes. People were obviously fascinated by the technology and the novelty aspect of the machine made it an overnight winner. After all, no one wants to buy shoes that don’t fit properly. An estimated 10,000 machines were sold in the US, 3,000 in the UK, 1,500 in Switzerland, and 1,000 in Canada before authorities began discouraging their use.

Today we know the dangers of continued exposure to x-rays. In the 1920’s we didn’t. What we had instead, in the 1920s, was a new breakthrough in technology that we bravely (foolishly) embraced with little or no concern for the wider safety implications of the technology. If history is anything to go by, the lessons we should have learned from the Fluoroscope and numerous other then-emergent technologies which now litter scientific literature, were lost. 

Even after the dangers of the Fluoroscope and exposure to radiation were highlighted, the devices persisted in many shoe shops in the US until the mid-1970s, with many choosing to ignore the health warnings associated with prolonged exposure to x-rays. To this day, shoe companies deny any liability for the introduction of the machines.

In reality though, how dangerous was the Fluoroscope? This breakdown of the radiation provided by the devices, courtesy of Wikipedia, offers some insight.

Large variations in dose were possible depending on the machine design, displacement of the shielding materials, and the time and frequency of use. Radiation surveys showed that American machines delivered an average of 13 roentgen (r) (roughly 0.13 sievert (Sv) of equivalent dose in modern units) to the customer’s feet during a typical 20-second viewing, with one capable of delivering 116 r (~1 Sv) in 20 seconds. British Pedoscopes were about ten times less powerful. A customer might try several shoes in a day, or return several times in a year, and radiation dose effects may be cumulative. 

For perspective, a dose of 300 r can cause growth disturbance in a child, and 600 r can cause erythema in an adult. Hands and feet are fortunately relatively resistant to other forms of radiation damage, such as carcinogenesis, but spare a thought for the operators of these devices who were effectively exposed to massive doses of daily radiation.

What does this have to with my DNA?

Great question and if you haven’t joined the dots yet, allow me. Science has been seriously experimenting with DNA-based medications for well over a decade and in many ways, these medicines are seen as a holy grail by the medical community. With good reason. Many diseases stem from gene combinations gone wrong and our ability to deliver treatment at this level will quite literally revolutionize medicine.

Identifying and isolating faulty genes and our ability to turn on or turn off switches in our genetic coding could mean the end of many diseases we have been previously unable to treat effectively. Most promising in the emergent field of DNA-based medicines is the ability of science to produce treatments specific to an individual. No more hit and miss, but something that’s been built and designed just for you. A treatment that can be deployed within a few days, and that, most importantly, is cost-effective. 

In the above scenario, the patient is the clear beneficiary. Covid accelerated the development and deployment of exactly these types of medicine. mRNA vaccines deliver nano-particle encapsulated genetic instructions directly to our cells. For many patients with co-morbidities and the aged, these vaccines were, and remain, a god-send. 

There is however a need to embrace our newfound mastery of the body’s DNA with extreme and urgent caution. Unlike the Fluorscope that may have caused cancerous lesions in a few feet and rendered a few operators barren, DNA is universal and our current understanding of the technology and its encompassing risks rival that of the early x-ray. We are at the dawn of new technology, and if history has taught us anything, circumspection and caution are called for.

Currently, there are no DNA overlords. There is no national or global oversight of the impacts of these medicines on us, no specific guidelines, or rigorous safety mechanisms to ensure that we are not exposed to the devastating side effects of future treatments gone wrong. 

As of now, we are celebrating our initial medical successes and as I write this, new medications are being prepared or have already been released into the market. Medicines that target our cell structures and DNA and as with the Fluoroscope, we are assured the whole process is completely safe. In fact, why not get your child to try it out? 

I for one, would rather my child were barefoot for a while.

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Many of those people first received an opioid drug, not from a drug dealer, but from a doctor, prescribing it in good faith to treat pain. The question is: are opiates good for treating pain that is not from cancer. The latest research says, “No.” 

Researchers from Australia randomized two groups of patients who had 1 or more bone fractures that required surgery to receive either oxycodone — what they called a “strong” opioid — or acetaminophen and codeine (aka “Tylenol #3) to treat pain after they were discharged to the hospital. 

They found no significant difference in pain between each group, despite the fact that the oxycodone group had a 6-fold higher opioid dose. The study authors concluded, “These findings suggest that ongoing first-line strong opioid use after discharge from the hospital should not be supported” in those patients who had a surgically managed bone fracture. 

This is an important study. It further strengthens the recommendation that strong opioids such as oxycodone should not be used for noncancer-related pain. In fact, when thinking about a bone fracture, the mechanism of the pain after surgery has nothing to do with the opioid receptors in the body, and they are more likely due to the inflammation after the fracture and the surgery to fix it. 

In fact, the absolute best pain medicine I’ve used to treat the surgical pain of patients recovering from heart surgery — and this was confirmed to me by a physician colleague who had the surgery himself — has been ketorolac, which is an NSAID like ibuprofen. The only thing is, NSAIDs such as ketorolac can cause serious complications like bleeding and kidney failure (which I’ve seen in my practice). 

Still, even though opioids are ubiquitously used for post surgery pain, they really are not good drugs for the pain. This also goes for pain after dental surgery and procedures. As clinicians, we need to use less of them. 

Of course, it is not our fault if we prescribe an opioid for pain in good faith and our patients abuse the medication. At the same time, we need to heed the science about opioids for noncancer pain. The literature increasingly suggests that opioids are not effective and can lead to abuse and complications. Thus, we should prescribe less of these medications as much as possible. 

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More than 6 million Americans currently live with Alzheimer’s disease. The FDA recognized the urgency in providing a treatment option now instead of waiting years for further clinical trial data. Alzheimer’s is the 6th leading cause of death in the United States, and cases will increase as our population ages.

Alzheimer’s is a progressive neurological disease affecting memory and causing dementia. Alzheimer’s is the most common cause of detention, accounting for 60-80% of cases. While most people who develop the disease are over age 65, early-onset Alzheimer’s affects approximately 200,000 younger Americans.

Alzheimer’s causes microscopic changes in the brain that destroy our ability to form memories. As the disease progresses, patients lose their ability to interact with others, speak, or care for themselves. The Alzheimer’s patient lifespan varies widely, but on average, people die within eight years of the diagnosis.

The Alzheimer’s Association explains the two main brain abnormalities that cause the disease: plaques and tangles.

1. Plaques: Deposits of a protein fragment called beta-amyloid that build up in the spaces between nerve cells.
2. Tangles: Twisted fibers of another protein called tau that build up inside cells.

The FDA approval of Aduhelm gives families hope as this drug is the first treatment specifically targeting the underlying cause of Alzheimer’s. In addition, Aduhelm helps prevent the development of the amyloid-beta plaques in the brain.

In the Aduhelm clinical trials, patients showed a reduction in the amyloid-beta plaques. Reducing plaque formation should slow the progress of Alzheimer’s dementia. Aduhelm is intended to help patients with mild cognitive impairment and slow the disease progression. The drug does not treat severe dementia.

The FDA acknowledged the controversy surrounding the Aduhelm clinical trials. Last year, Biogen pharmaceuticals applied for approval. The FDA did not approve the new drug because one study did not meet the primary endpoint of a reduced cognitive decline. However, a further review of the Biogen data revealed that the high-dose, time-dependent protocol successfully reduced plaque formation.

The FDA approved Aduhelm using the Accelerated Approval pathway to meet an unmet need and to provide early access to a treatment option for those with early-stage Alzheimer’s. The Accelerated Approval pathway allows the FDA to approve a medication for a serious disease when the data shows promise, even if there is some uncertainty regarding the clinical benefit.

The FDA concluded, “the benefits of Aduhelm for patients with Alzheimer’s disease outweighed the risks of the therapy.”

The FDA requires pharmaceutical companies to conduct Phase 4 confirmatory post-approval studies when a drug is approved under the Accelerated Approval pathway. Phase 4 studies must show the medication has clinical benefit to patients, or the FDA can remove the drug from the market.

Many people are concerned about the cost of this new medication. Patients receive Aduhelm through an IV infusion once a month. Each treatment costs $4,312, making the annual treatment price $56,000 per year.

The Biogen instructions for use package insert for Aduhelm list the side effects seen in the clinical trials. As with any medication, allergic reactions or hypersensitivity reactions can occur.

Some patients experienced headaches, confusion, dizziness, vision changes, or nausea. A temporary swelling causes these symptoms in the brain called Amyloid Related Imaging Abnormalities or ARIA. In addition, small areas of bleeding around the surface of the brain can occur. Fortunately, the clinical trials showed these side effects resolve on their own.

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Life Whisperer is the fertility arm of Presagen, a global artificial intelligence company. The company, whose US headquarters is in San Francisco, announced in a press release new women’s health technology applying artificial intelligence to the IVF embryo selection process. IVF clinics around the world can add an artificial intelligence platform to help doctors select the healthiest embryos with the best chance of success.

Embryo selection is an important part of the IVF process, where the healthiest embryos are chosen for implantation. The problem is preimplantation genetic testing is expensive and associated with some small degree of risk. Life Whisperer AI technology seeks to change the dynamics.

Life Whisperer Genetics applies artificial intelligence and machine-based learning to help embryologists in IVF embryo selection. Typically, an embryologist evaluates the embryos using subjective criteria through a process called embryo morphology grading.

Life Whisperer Genetics AI technology can identify characteristics not visible to the naked eye and adds objective measures to improve the chance of successful implantation. Published research shows AI embryo selection is at least 25% more accurate than embryologists’ grading methods at predicting pregnancy outcomes.

Artificial intelligence does not replace the crucial work of the embryologist. It enhances their ability to select the best candidates by adding a layer of objective evaluation.

Life Whisperer Genetics analyzed over 20,000 globally sourced 2D embryo images with known pregnancy outcomes to develop the AI system. With each new analysis, the system becomes smarter and improves its ability to select the embryos with the best chance of success.

In addition, Life Whisperer Genetics technology can reduce the need for preimplantation genetic testing (PGT-A). Genetically normal embryos have a higher chance of implanting reduce miscarriage. Some couples choose to undergo preimplantation testing where the doctor will biopsy the embryo to allow testing. A genetic sample of a healthy embryo is removed and sent to a lab for genetic evaluation. This step adds cost and a small degree of risk.

CEO Dr. Michelle Perugini believes their product addresses these concerns stating in the press release, “Essentially without biopsying an embryo, we can assess the likelihood of it being genetically normal or genetically abnormal just through using artificial intelligence and the images of the embryos.”

Life Whisperer Genetics assesses the genetic integrity of embryos using digital camera images. In a research study, AI detected normal embryos in 82% of the 91,500 simulated patients.

The cloud-based assessment is directly available to IVF couples in an intuitive and easy-to-understand report. These reports help bring IVF patients into the experience, allowing them to see what is happening throughout the process.

Right now, this technology is not FDA-approved for use in the United States. According to the company website, Life Whisperer Genetics is approved for use in the UK, Europe, Australia, New Zealand, Canada, India, Japan, Hong Kong, Singapore, and Vietnam. The technology helps patients who live in countries where preimplantation is not available or too expensive.

In the US, preimplantation genetic testing is widely used. The high-cost prices many patients out of the IVF option. Expanding AI would cut costs making assisted reproductive opportunities available to many people looking for help growing their families.

Life Whisperer Genetics has applied for approval in Europe, Australia, Canada, India, and SE Asia. The company expects approval in May and is currently pursuing FDA approvals in the United States.

Learn more about how artificial intelligence can improve outcomes for IVF patients through Life Whisperer Genetics in this video.

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1. A 100 Billion Dollar Plus Blue Sky Market Valuation

In June of 2020, Moderna was valued at $25 billion despite having no federally approved drugs on the market. Fast forward to April of 2021 and you get an idea of just how much Moderna’s fortunes have changed. Still with no federal approval but now boasting a EUA for its mRNA vaccine, the future looks incredibly bright for this company. In February of 2021 Hartaj Singh, managing director and senior analyst of biotechnology at Oppenheimer said that similar companies’ sales trajectories showed what Moderna could experience in the future.

“What we do is point people to other companies in the biotech sector that have peaked or hit a valuation when they launched their first set of products. Companies as diverse as Alexion, Regeneron, and Vertex, currently, and they essentially peaked at about ten times future sales, future sales being three to five years out.”

“I think with Moderna’s coronavirus vaccine franchise, and they’re also starting to develop flu vaccines which should hit the market in the next couple of years … you know, we could see a $10 billion franchise five to seven years from now. If you put a ten times sales multiple on that then, you can do the math, then it’s a $100 billion-plus market cap company.

In December of 2020, Moderna was valued at $60 billion.

2. The NIH Jointly owns the Moderna mRNA Intelectual Property

NIH and Moderna have researched coronaviruses, like MERS, for several years, and signed a contract this past December that stated “mRNA coronavirus vaccine candidates [are] developed and jointly owned” by the two parties. The contract was not specific to the novel coronavirus, and it was signed before the new virus had been sequenced. Separately, four NIH scientists have filed for a provisional patent application entitled “2019-nCoV vaccine,” according to disclosures in a pending scientific paper. Moderna scientists co-authored that paper, but none are listed as vaccine co-inventors.

3. Modified and DNA combined

Originally known as ModeRNA Therapeutics, the companywas formed in 2010 to commercialize the research of stem cell biologist Derrick Rossi. Rossi had developed a method of modifying mRNA. He approached fellow Harvard University faculty member Tim Springer, who solicited co-investment from Kenneth R. Chien, Bob Langer, and venture capital firm Flagship Ventures. The group formed ModeRNA, the result of the combined terms “modified” and “DNA”.

4. A record-breaking IPO in 2018

In 2018, the company rebranded as “Moderna Inc.” with the ticker symbol MRNA. In December of the same year, Moderna became the largest biotech initial public offering (IPO) in history, raising $621 million (27 million shares at $23 per share) on NASDAQ, and implying an overall valuation of $7.5 billion for the entire company. Not too dusty, considering Moderna had not as yet brought a product to market in their 8-year lifespan.

5. Board Members and Star Trek

In March of 2020, the FDA approved clinical trials for the Moderna vaccine candidate, with Moderna later receiving an investment of $483 million from Operation Warp Speed. Moderna board member, Moncef Slaoui, a Moroccan-born Belgian-American researcher was appointed head scientist for the Operation Warp Speed project.

6. Dictatorships and domination

CEO Stéphane Bancel, a French businessman with a pharmaceutical sales and operations background has led Moderna since 2011. His leadership style has been described as egotistical, authoritarian and secretive, with a zero-tolerance policy for employees that do not fully embrace the company ethos. Interestingly Bancel is listed as a co-inventor on more than 100 of Moderna’s early patent applications, unusual considering Bancel is not a Ph.D. scientist. Bancel is the third-largest individual shareholder in the company after Noubar Afeyan (Flagship Ventures) and Robert Langer. His current net worth is $5.6 billion according to Forbes. Bancel, when questioned about his abrasive management style, had the following comment.

“You want to be the guy who’s going to fail [patients]? I don’t. So was it an intense place? It was. And do I feel sorry about it? No.”

STÉPHANE BANCEL, MODERNA CEO

7. Get your cancer cure here

Where other CEOs are cautious about raising unrealistic expectations of their companies and products, Bancel suffers from no such restraint, often touting the mRNA technology as a potential cure for cancer, right down to having it engineered for each patient. In 2018, in an article published in Wired, Moderna president Steven Hoge made the following statement;

“We’re going to be able to make medicines that address diseases in different people in very different ways as a result of mostly removing humans from the process, It’s not something that is like ‘oh, this is the right color for you,’ it’s actually, “no, we invented this color for you.’”

8. AstraZeneca bets big

In 2013 Moderna, who had up to that point been subsisting on the financial smell of an oil rag, signed a staggering $240 million partnership with UK pharmaceutical giant AstraZeneca. It was the most money pharma had ever spent on drugs that had not yet been tested in humans. The NYT article published in the wake of the deal sums it up aptly in its headline: “AstraZeneca Makes a Bet On an Untested Technique.”

9. Regenerating your heart

It’s not just vaccines and cancer that interest Moderna. An excellent example of the widespread applicability of mRNA to treat disease is their therapeutic, AZD8601, developed in conjunction with AstraZeneca, for restoring blood vessels and oxygenation to the heart muscle. Currently, in Phase 1 Clinical trials, the vice-president of AstraZeneca’s IMED Biotech Unit Dr. Regina Fritsche-Danielson made the following comment in a blog post.

“In preclinical studies [for AZD8601], we have seen new blood vessels appear at the borders of damaged heart muscle. This was in response to injections of VEGF-A mRNA, carefully targeted at areas where oxygen levels were low. More than that, we have also seen improved cardiac function in these preclinical models as a result of the improved blood and oxygen supply being delivered to the heart.”

10. 2021 Shkreli Award winners for blatant overpricing

Every year The Lown Institute issues its top ten list of the worst examples of profiteering and dysfunction in health care. This year they highlighted bad actors from the Covid-19 pandemic. In February, CEO of Brigham and Women’s Hospital Dr. Elizabeth Nabel wrote an op-ed defending high drug prices as a necessity for innovation. In the piece, she did not disclose her role as a member of the board of biotech Moderna, which was developing a Covid-19 vaccine at the time. As a Moderna board member, Nabel received $487,500 in stock options and other payments in 2019.

Nabel sold $8.5 million worth of Moderna stock in 2020, after the company’s stock nearly quadrupled this year on news of early success with its COVID-19 vaccine. In response to criticism, Nabel resigned from the Moderna board.

In August, biotech company Moderna set an estimated price for its Covid-19 vaccine at $32-$37 per dose for “some customers” (the vaccine requires 2 doses). This price is higher than any other Covid-19 vaccine so far, even though 100% of Moderna’s development costs were covered by US government funding. Since Moderna was nominated, their lower bound for vaccine price has declined, in part due to public scrutiny.

Moderna’s CEO clarified in November that they will charge governments $25 — $37 per dose, depending on the amount ordered. Although the US has placed an order for $1.5 billion in doses of the vaccine at a discounted $15 per dose, given the upfront investment by the US government, we are essentially paying for the vaccine twice.

An insane achievement

As a final thought, it may be worthwhile to mention that this company produced a working and administrable version of the vaccine within 25 days of receiving the DNA sequencing for the coronavirus. This is an unprecedented achievement in vaccine development. To place it onto context, it is akin to Edmund Hillary running up to Everest’s summit in a few hours, rather than his arduous trek over weeks.

On March 16, 2020, Jennifer Haller was the very first recipient of the Moderna vaccine for Covid to be administered in America and globally. This signaled the beginning of phase 1 trials in the US. The rest, as they say, is history. The article below describes in detail Bancel and Moderna’s journey through the development of the vaccine and makes for insightful reading. It’s from the Boston Magazine and we highly recommend it.

The potential of this method of delivering instructions to the body to produce its own chemicals and drugs is almost limitless. The technology is being explored as a treatment for almost every disease and condition we can think of including cancers, HIV, heart conditions, atrophied blood vessels, the list never ends and we’re as excited and hopeful as Bancel.

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