Everyone loves to watch a good video online, but the format is often misused by digital cheats. This is making ‘copy –paste’ forgery a menace. Indian scientists have developed a set of techniques to detect such frauds. 

The fraud detection techniques, developed by Raahat Devender Singh and Naveen Aggarwal at University Institute of Engineering and Technology, Panjab University, can help in validation of digital video content by detecting and localizing copy-paste forgeries. 

Copy-paste forgery involves insertion or removal of an object or region into or from a set of video frames which can alter overall message of the video. Digital videos serve as an important source of information and are also considered evidence in criminal investigation, litigation and defense planning. Easily available video editing software are used for copy-paste forgery. 

However, manipulation of a video alters its original configuration leaving behind particular detectable traces, known as ‘forensic artifacts’ or forensic fingerprints which cannot be detected by mere subjective inspection. Locating such tampering requires statistical analyses of certain relevant features. Manipulated digital content shows variations in normal behaviour or patterns. 

The new techniques involve detecting Sensor Pattern Noise (SPN), interpolation artifacts and clustering of identical pixels to pin down tampered portions in a video. SPN is an improved and forensically stronger version of an existing noise-residue based copy-paste detection.

SPN is the unique uncorrelated noise pattern that every digital recording device introduces in every image or video that it records. “When a video frame undergoes copy-paste forgery, its SPN patterns exhibit certain inconsistencies. They arise due to resultant missing regions or holes in the affected frames which need to be filled-up in a visually plausible manner. By analyzing unnatural similarities or correlations between regions of successive video frames or regions of the same frame, we can detect forgery,” explained Raahat Singh while speaking to India Science Wire. 

Another technique detects copy-paste fraud by detecting abnormalities in interpolation in video frames. Interpolation is the process in which new pixel values are estimated with the help of known values of surrounding pixels. A video frame obtained using a digital camera without any post-processing exhibits uniform ‘de-mosaicing’ artifacts on every group of pixels. “In a frame with tampered regions, these artifacts will be markedly inconsistent. By analyzing local inconsistencies in these artifacts, copy-pasted regions can be identified,” added Singh.  

The third technique uses clustering scheme to detect pixels that are copied and pasted from one frame-region onto another. The techniques have been found to be of high accuracy in test videos. This work has been published in journal Forensic Science International.

The two phase crucial assembly elections in Gujarat next month (December), the home state of Prime Minister Narendra Modi, has put the Centre in a bind about curtailing the Winter session of Parliament. There is no instance of junking it. Though no formal announcement has been made about the dates so far, there is speculation of a short session being convened later this month. 

The poll in Gujarat is scheduled for December ninth and fourteenth. This will be followed by the simultaneous counting of votes of both the assembly elections in Himachal Pradesh and Gujarat on December 18. 

The ostensible reason is to allow politicians and other party leaders to tour Gujarat to pep up support amid growing reports that the BJP is facing a tough time because of widespread disappointment among the small and medium businesses on account of the GST coupled with the widespread distress caused to the farmers. 

Earlier this week the Congress had demanded that the winter session of Parliament be convened immediately and asked the Modi government not to weaken the country’s glorious democratic tradition on the pretext of assembly elections. “…Let not the assembly election in one state or the other become an excuse for the government to run away from facing Parliament. It is not about the government or the opposition, it is about the people as Parliament represents the soul of demoracy,” emphasised Manish Tiwari of the Congress.  

The notification for the winter session of Parliament should have been issued by now in the normal course. As it has not been done so far there is avoidable confusion in the polity. Parliament has met by and large for 20-day winter session beginning in the second half of November. 

The Centre’s ambivalence is creating serious doubts. There has to be a 15-day gap between the notification and the start of the session. Questions are being asked if this is another instance of the BJP leadership not giving Parliament the importance it deserves in convening the winter session along with side stepping the opposition. 

It may be recalled that the one-day polling in Himachal Pradesh concluded on November ninth. The meeting of the Cabinet Committee on Parliamentary Affairs can be convened at short notice for issuing the necessary notification convening the winter session of Parliament. 

There is discernible apprehension in ruling circles that the opposition is gearing up its loins to put the government on the mat connected with last November’s demonetisation fiasco coupled with the poor and hurried implementation of the GST from the first of July this year. 

Even though the winter session of Parliament has never been dropped, the question doing the rounds is about the Centre giving it a go by this time around. At the same time a determined opposition is keen to pin down the Modi government on the failure of demonetisation and the goof up connected with implementing the GST. 

This can lead to disruptions both in the Lok Sabha and the Rajya Sabha sending contrary signals in poll bound Gujarat with the ruling BJP already under considerable pressure. 

The Lotus party has been in power in Gandhinagar on the trot for for no less than 22 years. The signficance of the Prime Minister being associated with the selection of candidates for the Gujarat elections this time cannot be overlooked. 

The relevance of Parliament in a democratic system cannot be undermined. In the overall scheme of things the number of sittings of both the Houses of Parliament has steadily declined to 60-70 annually which has been causing concern. This despite the understanding reached that Parliament should meet at least for a hundred days every year. 

The Lok Sabha and Rajya Sabha have been witness to the MPs exercising their lung power in a vain bid to be heard above the din in pilloring the Centre. Major legislative matters are being approved in Committees rather than the provisions being dissected and debated purposefully on the floor of the House. 

For shaping of proper policies it has become necessary to have a free, frank and interruption free debates in both the Houses of Parliament. The increasing trend of one-upmanship in the polity has been a major factor leading to disruptions and frequent adjournments not only in Parliament but state assemblies as well. 

It may be recalled Attorney General K K Venugopal had told the court in July that NRIs could not be allowed to vote by merely changing the rules made under the Representation of the People Act. Recently, the Centre informed the Supreme Court that a Bill to amend the electoral law to allow Non-Resident Indians to vote through postal or e-ballots would be introduced in the upcoming winter session of Parliament. 

It is not the first time that assembly elections are being held in the country coinciding with the winter session of Parliament. And it is unlikely to be the last time. The ball is in the court of the Prime Minister. It is for the BJP led NDA government to convene the winter session of Parliament so that it is not accused of deliberately giving a go by to established Parliamentary practices. 

(T R Ramachandran is a senior journalist and commentator. The views are personal.)

NEW DELHI : With an objective of dealing with tuberculosis (TB) at a war-footing, the Ministry of Health & Family Welfare has shifted to a daily regimen for TB patients across the country under the Revised National TB Control Programme (RNTCP).

The Health Ministry has been providing the thrice weekly regimen for the treatment of tuberculosis (TB), however, it has now decided to change the treatment strategy for TB patients from thrice weekly to daily drug regimen using fixed dose combinations (FDC) for treatment. This change will bring transformation in the approach and the intensity to deal with this disease which accounts for about 4.2 lakh deaths every year, a statement issued by the Ministry said here.

The daily FDC anti-TB drugs will be made available to private pharmacy or at private practitioners to dispense to TB patients who seek care in private sector, depending upon the convenience of patient and practitioner free of cost. The Health Ministry will take this forward with all major hospitals, Indian Medical Association, Indian Association of Pediatricians and other professional medical associations to expand the access to daily FDC to all TB patients.

The salient features of this treatment strategy are use of Ethambutol in continuation phase for all patients, drugs to be given daily (as against only 3 times weekly previously), fixed dose combination (FDC) tablets to be used which will reduce pill burden (as against separate 7 tablets previously), for children, child friendly formulations as dispersible tablets and use of Information Technology (IT) enabled treatment adherence support system.

Current WHO Global TB Report, 2017 has reported that incidence of TB has reduced from 28.2 lakh to 27 lakh and mortality by 60 thousand over the last one year, which is a testimony of anti TB drive by the government.

Médecins Sans Frontières (MSF) and the Stop TB Partnership have called for countries with high burdens of tuberculosis (TB) to implement the latest international treatment and testing standards by World TB Day, 24 March 2018.
The appeal comes ahead of the first-ever WHO Global Ministerial Conference on Ending TB to be held in Moscow.
TB remains the world’s top infectious disease killer, with 1.7 million deaths in 2016. According to the latest World Health Organization (WHO) Global TB report, progress in diagnosing and treating all forms of TB is stalling in most countries: more than 4.1 million people with TB remained undiagnosed or unreported in 2016, and only one in five people with multidrug-resistant (MDR–TB) were started on treatment. Of those people, just over half were cured.
According to a survey in the third edition of ‘Out of Step’, a joint report by MSF and the Stop TB Partnership that reviews TB policies and practices in 29 countries—which account for nearly three-quarters of the global TB burden—40 percent of people with TB remain undiagnosed. Only seven of the countries* have made Xpert MTB/RIF, a rapid molecular test, widely available for diagnosing TB. Newer medicines and regimens for treating drug-resistant (DR-TB) have demonstrated better outcomes than today’s standard regimens, which cure just half of people with MDR-TB and only 28% of people with the even more deadly extensively drug-resistant (XDR-TB). Seventy-nine percent of countries surveyed include the newer drug bedaquiline in their national guidelines, and 62% include delamanid, but globally, less than five percent of people who could have benefitted had access to these drugs in 2016.
This week, MSF and the Stop TB partnership released the report ‘Out of Step in Eastern Europe and Central Asia’ (EECA), presenting the results of an eight-country survey of national TB policies and practices. An epidemic of DR-TB is on the rise in Eastern Europe, where nearly half of all TB cases are MDR and the number of people with DR-TB is increasing by more than 20% each year. Among the countries surveyed, 75% have adopted a policy to use rapid molecular testing instead of older, slower testing methods, yet only half of those countries are actually using the test widely. An estimated 46,000 people with DR-TB in the EECA region went undiagnosed in 2015.
“Despite its deadly toll, most countries lag behind in implementing the existing and new tools that are available to tackle TB,” said Lucica Ditiu, Executive Director of the Stop TB Partnership. “The WHO Global Ministerial Conference is the first step for concrete, bold and measurable commitments by ministers of health towards a strong accountability framework for heads of state and governments during the UN High Level meeting on TB.”
At the Global Ministerial Conference this week, Mariam Avanesova, who was treated for MDR-TB in Armenia in 2010-2012 and represents TB people, the Eurasian network of people with TB experience, will hand over a petition to WHO’s Director-General, Dr. Tedros Ghebreyesus. The petition is an urgent call for health ministers in key TB-affected countries to get their TB policies and practices in line with international standards, as defined by WHO including testing and treatment of TB and its drug-resistant forms. Initiated by MSF and the Stop TB partnership, the petition has been signed by more than 30,000 people from around the world united with people affected by TB.

In a strong message to the trading community to pass on the tax benefits and to the consumers that their interests were being protected, the Union Cabinet on Thursday gave a formal shape to the formation of the National Anti-Profiteering Authority (NAA) under the Goods and Services Tax Regime to ensure that benefits of rate reduction are passed on to the consumers by way of reduction of prices.
The NAA formation comes closes on the heels of reports coming in that despite a reduction of tax from 18 to 5 per cent for restaurants under the GST regime, the owners of these outlets have hiked prices pleading that they had to adjust for the higher costs due to withdrawal of the input credit scheme to them. However, the consumers are up in arms against this move and have complained to the authorities that the restaurants have hiked rates in their restaurants from 7 to 15 per cent.
Keeping this in mind, the Union Cabinet, chaired by the Prime Minister, Narendra Modi gave its approval for the creation of the posts of Chairman and Technical Members of the National Anti-Profiteering Authority (NAA). This paves the way for the immediate establishment of this apex body, which is mandated to ensure that the benefits of the reduction in GST rates on goods or services are passed on to the ultimate consumers by way of a reduction in prices. 
The establishment of the NAA, to be headed by a senior officer of the level of Secretary to the Central Government with four Technical Members from the Centre and/or the States, is one more measure aimed at reassuring consumers that Government is fully committed to take all possible steps to ensure the benefits of implementation of GST in terms of lower prices of the goods and services reach them.
It may be recalled that effective from midnight of November 14, 2017 the GST rate has been slashed from 28 per cent to 18 per cent on goods falling under 178 headings. There are now only 50 items which attract the GST rate of 28 per cent. Likewise, a large number of items have witnessed a reduction in GST rates from 18 per cent to 12 per cent and so on and some goods have been completely exempting from GST. 
The “anti-profiteering” measures enshrined in the GST law provide an institutional mechanism to ensure that the full benefits of input tax credits and reduced GST rates on supply of goods or services flow to the consumers. This institutional framework comprises the NAA, a Standing Committee, Screening Committees in every State and the Directorate General of Safeguards in the Central Board of Excise & Customs (CBEC). 
Affected consumers who feel the benefit of commensurate reduction in prices is not being passed on when they purchase any goods or services may apply for relief to the Screening Committee in the particular State. However, in case the incident of profiteering relates to an item of mass impact with ‘All India’ ramification, the application may be directly made to the Standing Committee. After forming a prima facie view that there is an element of profiteering, the Standing Committee shall refer the matter for detailed investigation to the Director General of Safeguards, CBEC, which shall report its findings to the NAA. 
In the event the NAA confirms there is a necessity to apply anti-profiteering measures, it has the authority to order the supplier/ business concerned to reduce its prices or return the undue benefit availed by it along with interest to the recipient of the goods or services. If the undue benefit cannot be passed on to the recipient, it can be ordered to be deposited in the Consumer Welfare Fund. In extreme cases, the NAA can impose a penalty on the defaulting business entity and even order the cancellation of its registration under GST. 

In India 35-40% women, who develop Gestational Diabetes Mellitus, run the risk of developing type-2 diabetes within 5 years of delivery. However, only 17.5% of women are aware of the disease and its complication, a new research has shown.  

Gestational Diabetes Mellitus is a form of diabetes which develops among women during pregnancy because the hormones secreted by the placenta for the development of the foetus also block the action of the mother’s insulin. These hormones may cause resistance to the actions of insulin and lead to higher blood sugar levels in women who have risk factors for diabetes.

India has a high prevalence of Gestational Diabetes with 17.8% women in urban areas and 9.9% in rural areas developing Gestational Diabetes Mellitus. Type -2 diabetes is the world’s fastest growing chronic disease, according to the research carried out by the George Institute of Global Health.

Gestational Diabetes Mellitus was thought to be a relatively benign condition, however, now it is known to put women at high risk of subsequently developing Type 2 diabetes – a condition that needs lifelong treatment and is associated with a number of serious complications.

Globally, over 380 million people suffer from diabetes with more than 80% of these living in low-middle income countries. Of this, almost 180 million are women.  Around 15% of pregnant women worldwide are diagnosed with gestational diabetes annually.

As per a recent study conducted in South India, there is a high prevalence with 17.8% of women in urban areas and 9.9% in rural areas developing Gestational Diabetes Mellitus. Despite the high incidence of Gestational Diabetes Mellitus in India, only 17.5% of women are aware of thedisease and its complications. Women who have had Gestational Diabetes Mellitus are at higher risk for type-2 diabetes later in life. Data suggests that in India 35-40% of women with Gestational Diabetes Mellitus run the risk of developing type-2 diabetes within 5 years of giving birth.

Researchers from The George Institute for Global Healthhave teamed up with All India Institute of Medical sciences (AIIMS) to conduct research that will explore whether a lifestyle modification program can delay the onset of type- 2 diabetes in women with Gestational Diabetes Mellitus (GDM) in South Asia. The LIVING (LIfestyleinterVentionINGestational diabetes) study is aimed at determining whether an affordable and culturally acceptable lifestyle intervention, provided to women with Gestational Diabetes Mellitus soon after the delivery of their child, can help reduce the incidence of type-2 diabetes.

Talking about the study, Dr.Josyula Lakshmi, Senior Research Fellow, The George Institute for Global Health said, “The impact of gestational diabetes mellitus on the pregnant woman and her baby are acknowledged and addressed to some extent. However, GDM is not to be taken as seriously as it should be. With a substantial proportion of women with GDM going on to develop Type-2 diabetes mellitus within 5 years, GDM should be taken as a call for increased and sustained attention to the health of affected women.”

“The LIVING study is a trial of a cost-effective, efficient, low-intensity intervention to prevent, or at least delay, the onset of type 2 diabetes mellitus in South Asian women (from India, Bangladesh, and Sri Lanka) who have had GDM.” she added.

This randomised controlled open-label trial will be based in around 24 public and private hospitals across India, Bangladesh and Sri Lanka. The intervention will comprise group sessions and text/voice message prompts on physical activity, healthy diet, and stress management. Trained study staff will deliver the intervention, and monitor the outcomes over the study period of approximately three years.

This study will generate knowledge related to the implementation of a preventive strategy embedded in existing resource-constrained health systems. If shown to be successful, the intervention could be scaled up across the region, and has the potential to help prevent or delay the development of type-2 diabetes in more than a quarter of a million South Asian women with prior Gestational Diabetes Mellitus.

The George Institute for Global Health is works across a broad health landscape by conducting clinical, population and health system research aimed at changing health practice and policy worldwide.   

NEW DELHI: Even as the investigations by premier agencies into the Rs. 6800 crore loan default case of Winsome Diamonds and Forever Diamonds have hit a dead end, in a new twist to the case, questions have been raised over the role of some Independent Directors of the company and over the authenticity of the due diligence report authorised by the banks.

The investigating agencies had rested most of its case on the statements given by one of the Independent Directors and also on Kroll report which now has come under dispute both during investigations and in the court of law. In a related development, Diamond Intelligence Briefing (DIB) termed as world’s most authoritative, staunchly independent and widely quoted international diamond industry resource, and which was instrumental in breaking the story of investigations into synthetic diamond sales involving the above-mentioned company, has in its November 7, 2017 issue stated that it was misled into doing the story by one of the company’s Directors who pasted the “slighting’’ epitaph on them. They have accused certain vested interests and the Director of drawing DIB into overall fraudulent and corporate rivalry schemes in mindboggling scenarios. 

In fact, the investigating agencies had built up their case against J. R. Mehta in the loan default issue based on the Kroll report and statements of some Directors of Winsome Diamonds and Forever Diamonds. Sources in the know of things said the Kroll report has been found to be a non-professional job and was based on hearsay and pre-decided notions. The investigating agencies are apprehensive that the Kroll report and the testimony of the Independent Directors as well as Executive Directors will not stand water in the court of law and the case will fall through. 

Interestingly, the focus has now turned on the testimony of the directors and how there could wrong doing on their part and their attempts to nail Mr. Mehta in order to cover up their own wrong doings and the involvement of some bank officials is not ruled out in the matter.

In 2015, the two companies – Winsome Diamonds and Forever Diamonds — had filed cases in the Sharjah Federal Court arguing that the companies had suffered a business loss of $1 billion (Rs. 6,500 crore) due to non-payment from 13 UAE-based entities. The Sharjah court had ruled in favour of Winsome Diamonds and Forever Diamonds. In May 2017, UAE’s Appellate Court upheld the Sharjah court’s verdict.

In fact, the Enforcement Directorate (ED) had send a Letter Rogatory to United Arab Emirates (UAE) seeking information on the two companies and Mr. Mehta. However, there has been no formal response from UAE till date to the LR but officials said that after the ruling by the UAE’s courts, it is unlikely that UAE will cooperate in this case. Letters Rogatory is a formal communication in writing sent by a Court, in which action is pending, to a foreign court or Judge requesting the testimony of a witness residing within the jurisdiction of that foreign court. Interestingly, for UAE authorities to take action in the case, the crime has to be committed on its soil which has not been the case. The two government agencies are dependent on the United Arab Emirates (UAE) government for information about these two firms and as well as the 13 dealing firms who were connected in the main trading business.

Officials said with new facts coming up in the case, the premier investigating agencies and the consortium of banks will have to start looking at the role of the directors within the company as they are based out of India and can be subjected to scrutiny and investigations. However, the last word has not been said in the case but the Rs. 6800 crore loan recovery remains out of reach of the banks for now.

Bitcoin and other crypto-currencies have been in the news a lot if recent times, often for the wrong reasons but also because of the massive appreciation Bitcoin has been clocking up. To top it off, real estate has now been dragged into the bitcoin controversy, with a handful of projects in some parts of the US and Dubai actually inviting investments via the Bitcoin route. With the ongoing slump in sales, is it possible that developers in India will offer such an option to prospective buyers as well? Let us take a closer look at this.

We should begin by understanding that the viability of any currency as a means with which to transact in real estate in India obviously depends on whether or not the RBI and Government recognize that currency as valid tender in the country. So far, that is not the case with bitcoin. While the RBI was toying with the notion of launching an Indian crypto-currency, it apparently does not see much benefit in doing so. This is quite understandable.

The market needs transparency – not more opacity

The Indian real estate market is currently in the process of transiting from being an opaque and largely unregulated market to a more governed and transparent one. This process has been kick-started by several policies and reformative regulations like the Real Estate (Regulation and Development) Authority or RERA Act, the unified Goods and Services Tax (GST) and the Benami Property Bill. As part of this process of increasing transparency and accountability for real estate and its related transactions, cash flows in and out of the sector need to trackable and accounted for at every level.

This is definitely not possible with money in the form of a currency whose origins and antecedents can, almost by definition, not be established in the majority of cases. The notion of crypto-currencies like bitcoin becoming legal tender for real estate transactions in India must first and foremost be considered in light of this fact.

No significant benefits, massive challenges

For the sake of an argument, let us assume that bitcoin transactions became acceptable in Indian real estate. Would this in any way affect the sector in a significant manner – for instance, would ROI on real estate be positively or negatively influenced? To arrive at an answer to this question, we must first consider that the value of real estate is determined by factors such as size, location, and most importantly local market rates – which, in India, are determined in rupees. This is how real estate is bought and sold in the country.

Hypothetically, If the RBI were to accept bitcoin as legal tender for real estate transactions at some point, it would be to the extent of allowing the rupee value of a property to be paid for in that currency. Remember, this would only happen if the RBI were able to establish the source of these funds to its complete satisfaction. Then consider that bitcoin has become such a popular mode of payment for crime-related transactions precisely because its sources cannot be traced if the person/s transacting in it do not want them to be traced.

Even if real estate deals transactions via bitcoin were to become legal in India, it would at best be extremely challenging – and there would be little or no real benefit to either seller or buyer. First of all, the Government levies statutory taxes on every real estate transaction and requires the payment of these dues to be clearly mentioned in Indian rupees for such transactions to be considered legal.

Likewise, market rates and property prices in India are calculated in rupees per square foot. From an ROI perspective, the currency used in transacting with it does not have any bearing on this value – and for a crypto-currency to become acceptable tender for buying a selling property in India, all these calculations would need to find a parallel monetary avatar that is acceptable to all stakeholders.

Difficult to swallow, harder to digest

Apart from the increased regulation in the real estate industry, the Indian banking and finance sector is extremely conservative and would find it very difficult to accept a currency which cannot be fully traced or regulated. Even if it did find a way to accept it, such a currency would also need to be comprehensible and acceptable to Indian end-users and investors. The currency would first need to be sanctified and accepted by various financial institutions – which is far from the case now. In fact, bitcoin has garnered itself a rather unsavoury reputation in financial circles which would make its adoption in India even more difficult.

Moreover, there is the question of safety of investment – a question which brings the Benami Property Act has now brought centre-stage once more. At the current time, any service or commodity purchased in a form of currency which is not accepted as legal tender in India represents a risk to both buyer and seller. Both end-users and investors want their real estate assets to be legal in every way so that ownership and resale do not become a problem for them. This, perhaps, is the strongest argument against bitcoin in Indian real estate transactions for now.

In short, crypto-currencies like bitcoin are very unlikely to take off in Indian real estate in the foreseeable future.

(Views are personal)

One may say that diabetes is rapidly becoming a global epidemic which spares neither adults nor young children and adolescents. The cause for concern is the need for lifetime medications and/or insulin to manage symptoms and prevent complications. Also, the emotional and financial burden posed by various forms of diabetes (Type 1, Type 2, Gestational Diabetes and Latent Autoimmune Diabetes in Adults) raises the need for development of newer definitive therapeutic modalities.

Today, being Children’s day and World Diabetes Day, we share information on one of the forms of diabetes that affects young individuals and by far is the most challenging to manage considering the early age of onset of the condition.

Type 1 diabetes is becoming one of the most common illnesses in younger individuals. India is home to close to 97,000 children with type 1 diabetes. Although this type constitutes only 5-10% of the total population, it has serious short and long term consequences. The condition results due to pancreatic beta cell destruction which causes absolute insulin deficiency. Genetic and environmental factors as well as disorder of immune mechanism are thought to be the cause of type 1 diabetes. Treatment involves use of insulin/oral medicines, dose of which is adjusted based on regular blood glucose monitoring. Also, continuous monitoring of the general condition of the patient is of paramount importance so as to assess development of complications. Diabetes is associated with microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (cardiovascular, cerebrovascular, and peripheral vascular disease) complications.

Dr. Pradeep Mahajan says “You carry your own repairing kits in your body”. He believes in the power of cellular therapy to address the root cause of many conditions rather than palliative management of symptoms. The rationale behind use of cellular therapy for diabetes is that, stem cells have tremendous regenerative capacity and the flexibility to grow into different types of cells. Progenitor cells in the human body are capable of differentiating in vivo to produce beta cells—the islet cells that manufacture insulin—as well as pancreatic islet cells. Cell-based approach to insulin replacement has been shown to ultimately improve glucose control in patients with type 1 diabetes. Furthermore, mesenchymal stem cells have immunomodulatory property that aids in restoring immune homeostasis/balance in the body.

Patients and their families are generally unaware of this recent form of therapy for diabetes. It is therefore mandatory, that the patient is explained about his/her disease condition and what benefits may be achieved through cellular therapy. At StemRx, during the patients’ first visit, a detailed case history is taken. When the patient consents for treatment, he/she is directed to undergo hematological and radiological investigations specific to his/her health condition. This is followed by a second round of consultation during which reports of investigations and treatment protocol for the patient are discussed in detail.

Cellular therapy protocol at StemRx involves harvesting cells from the patients’ own body (autologous stem cells) from bone marrow, fat tissue and peripheral blood. These sources are rich in mesenchymal stem cells and have the advantage of availability of cells and ease of harvest. After activation the cells are transplanted into the appropriate site in the patients’ body. Hospitalization is advised for 48 hours after the procedure to monitor the general condition of the patient and to allow for homing of cells. Since the source of cells is from the patients’ own body, treatment is safe and is not associated with any adverse events.

Lifestyle and diet are two other factors that play a major role in prognosis of diabetes. Food is a major concern for parents as children in particular tend to have specific tastes and can be quite demanding. This poses even greater difficulty when the child is diabetic. Meal planning can get tricky, but should be consistent, flexible, and supply the necessary nutrients. The aim of diet planning is to satisfy the child’s appetite along with balancing sugar and promoting normal growth and development.  The patient discusses the diet followed by them with our in-house dietician. Based on the requirements, modifications may be advised to achieve a balanced diet, specific for the patient. A diet that is high in fiber, low in saturated fat and sugar is generally advised to diabetic patients.

Another important factor, physical activity has been shown to improve lipoprotein profile, cardiovascular health and reduce blood pressure. Prevention of long-term complications arising due to diabetes may be possible through physical exercise. However, it should be ensured that hypoglycemia be avoided, which occurs immediately or after prolonged intensive workout. Children in particular are more prone to variability in blood glucose levels. Therefore, we advise moderate intensity leisure activities, recreational sports as well as physiotherapy exercises depending on the overall status of the patient. The goal is to teach patients to incorporate exercise in their daily lives, in addition to diet management as a means to improve/maintain insulin sensitivity post treatment.

Results of cellular therapy are generally observed after 1-2 sessions of cellular therapy. Reduction in blood glucose levels are noticed along with improvement in general health of patients. However, changes in the patients’ ongoing insulin doses/oral hypoglycemic drugs are made only after a steady state of blood glucose is achieved. Accordingly, dosage is adjusted and ultimately discontinuation of medications/insulin may be advised.

Cellular therapy addresses the root cause of diabetes, ie: beta-cell destruction and insulin resistance.  Therefore, results achieved, although gradual are permanent. The number of sessions of cellular therapy required differs with each individual, based on age, diabetic status and presence of co-morbid conditions as well as lifestyle. Additionally, patient compliance with respect to following diet and allied therapies is equally important to achieve optimum benefit from therapy.

Union Minister of Environment, Forest and Climate Change, Science & Technology & Earth Sciences, Dr. Harsh Vardhan has said that there is a declining trend in the levels of Particulate Matter at present, indicating an improvement in air quality due to the efforts made by implementing agencies. “There has been a decline in PM10 values – from 712.1 to 566.6 micrograms and decline in PM2.5 levels from 480 to 385.7 micrograms at 2.00 p.m today”, the Minister said. He added that with the present trend, it is expected that the decline in Particulate Matter levels will continue and air quality is likely to fall back in the Severe category. 

Dr. Harsh Vardhan pointed out that the present air quality in Delhi NCR has been in the Severe Plus category and emergency conditions due to adverse weather conditions because of western disturbances, stubble burning and high levels of relative humidity. 

The Minister said that initially the conditions started on November 7, 2017 at 6.00 a.m and declined to severe category (concentration less than 500 micrograms/m3 for PM10 and less than 300 micrograms/m3 for PM2.5) on November 11 at 3.00 p.m. Later, the level has gone up again because of adverse weather conditions, which is further improving now.