Non-invasive hemoglobin screening device: a promising digital method for reducing anemia prevalence through routine screening and timely intervention.

BACKGROUND: Several non-invasive technologies are nowadays available in the market which claim to determine the hemoglobin levels instantly without the requirement of the blood sample. But no study has shown the significance of such non-invasive devices on a routine basis for determining their impact on anemia reduction programs. This study is conducted to determine the impact of regular hemoglobin screening on the women population to determine its potential in reducing anemia, using a digitalized non-invasive device. METHOD: A cross-sectional study was conducted on 203 women of reproductive age group, residing in the Moradabad district. Repetitive readings were taken after a time interval of a minimum of 1 month for determining the impact of regular screening. The entire data collection process was carried out using the EzeCheck mobile app. RESULTS: It was observed that the prevalence of anemia was reduced upon the second time screening and was accepted by the women population. Repetitive testing has a significant impact on reducing anemia prevalence. Also, the simplified non-invasive technology for estimating the hemoglobin values, makes the user more comfortable to take the test. CONCLUSION: Non-invasive devices should be used regularly to keep track of hemoglobin levels which will help in the effective treatment of anemia. The mobile app-based testing could help to easily evaluate the reports of the patients from any remote location with instant result interpretation and health assistance.

Performance of the non-invasive point-of-care device, EzeCheck, for haemoglobin assessment in adults and children in community and institutional care settings.

Anaemia is a major public health problem, especially in resource constrained settings. Dependency on assessment of blood hemoglobin (Hgb) concentration impedes anemia detection, risk stratification and intervention. Thus, valid, frugal and scalable technologies are needed. EzeCheck is a noninvasive portable device developed in India for predicting hemoglobin levels in human beings aged 4 years and above using a finger-tip biosensor. In this assessment, we aimed to: (i) evaluate EzeCheck's performance with an automated whole blood hemato-analyzer (Sysmex XN 1000) as the gold standard, and (ii) estimate EzeCheck's agreement with Sahli's method and HemoCue (Hb-301) in real-world primary and higher care facilities. Paired assessments were done at five sites across India i.e., Bhubaneshwar, Shimla, Solan and Mashobra and Ulhasnagar. Participants across all age groups (4 years and above) were assessed. We used a range of statistical tests to evaluate the performance of EzeCheck. It was found that EzeCheck performed well across age and gender categories with convincing validity, concordance, precision and accuracy, and acceptable bias. While comparing EzeCheck with Hemato-analyzer, no statistically significant systematic bias was found. However, EzeCheck showed significant systematic bias when compared to Sahli's method and HemoCue. We concluded that EzeCheck could detect anemia (as per WHO Hgb cut-offs) in 'real-world settings' and 'across age and gender categories', with high sensitivity, specificity and accuracy, and can serve as a replacement to traditional methods of hemoglobin assessment. Further, for countries with higher prevalence of anemia where universal screening may be mandated, the positive predictive value of EzeCheck will be higher. The likelihood ratios also indicated that the device had moderate-to-good utility. EzeCheck is suitable for embedment into program and out-patient health care settings in resource constrained contexts as a spot-check hemoglobinometer.

Transgenic tobacco plants overexpressing the heterologous lea gene Rab16A from rice during high salt and water deficit display enhanced tolerance to salinity stress.

The full length Rab16A, from the indica rice Pokkali, was introduced into tobacco by Agrobacterium-mediated transformation. The transgene was stably integrated into the genome and they originated from different lines of integration. Expression of Rab16A transcript driven by its own promoter (stress inducible) in T2 progenies, only when triggered by salinity/ABA/PEG (Polyethylene glycol)-mediated dehydration, but not at the constitutive level, led to the stress-induced accumulation of RAB16A protein in the leaves of transgenic plants. The selected independent transgenic lines showed normal growth, morphology and seed production as the WT plants without any yield penalty under stress conditions. They exhibited significantly increased tolerance to salinity, sustained growth rates under stress conditions; with concomitant increased osmolyte production like reducing sugars, proline and higher polyamines. They also showed delayed development of damage symptoms with better antioxidative machinery and more favorable mineral balance, as reflected by reduced H2O2 levels and lipid peroxidation, lesser chlorophyll loss as well as lesser accumulation of Na+ and greater accumulation of K+ in 200 mM NaCl. These findings establish the potential role of Rab16A gene in conferring salt tolerance without affecting growth and yield, as well as pointing to the fact that the upstream region of Rab16A behaves as an efficient stress-inducible promoter. Our result also suggests the considerable potential of Group 2 lea genes as molecular tools for genetic engineering of plants towards stress tolerance.