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Paradigm shift

A cardiologist lists 4 medical breakthroughs to watch out for

This can bring tangible change in the lives of millions.

 |  Paradigm shift  |  7-minute read |   05-03-2018
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The aim of all medical research is to improve the quality of healthcare. Different science journals and newspapers present “breakthroughs” to readers and sometimes do make tall claims. Today, while surfing the internet, one stumbles upon diverse information related to health, and more often than not this leads to a conundrum. This is particularly relevant for the internet literate adult who turns to Google at the drop of a hat.

In the quest for better health — be it weight issues or ailments — it is but natural to look for information online. However, the results are often quite disastrous when one gathers information that is contrary to expectation. A patient asked me if it is true that milk does not have any health benefits, as some researchers have claimed, contrary to our conventional habits. Are there better alternatives in soy, almond or coconut milk? Such a contradictory flow of information baffles the layperson. Therefore, it is imperative that one sifts information and does not blindly accept it.

As medical practitioners, we are privy to information related to research in medical science and I am going to share some facts about fatal diseases that can bring about tangible change in the lives of millions.

Malaria

India is one of the countries where, every year, millions are affected by malaria. It is among 15 countries that have reported the highest number of malaria cases and deaths, according to the World Health Organisation’s (WHO's) 2017 World Malaria Report.

India, along with 14 countries from the sub Saharan African region, makes up for 80 percent of the world’s total malaria cases and deaths.

Though there has been a decline in the number of cases per 1,000 people at risk — from 76 in 2010 to 63 in 2016 — India's malaria crisis remains a cause of worry due to the alarmingly poor levels of surveillance.

In 2010, 649 million in India were at risk and close to 1,018 deaths due to malaria reported. While in 2016 the number of reported deaths dropped to 331, a staggering 698 million Indians were at risk.

malariaa_030518055031.jpgIndia, along with 14 countries from the sub Saharan African region, makes up for 80 percent of the world’s total Malaria cases and deaths. Photo: Representational

To arrest the spread of the killer disease, UNICEF launched the "Malaria Must Die - So Millions Can Live" campaign, for which it roped in legendary footballer David Beckham as goodwill ambassador. While malaria would not be eradicated just by Beckham's involvement in the campaign, celebrities do help increase awareness, particularly when the disease — rampant as it is — can easily be conquered with simple measures such as emptying swamps and puddles of stagnant water, and closing open drains that serve as breeding grounds for mosquitoes.

Medical science has come up with a magnetic filter to trap blood infections and fight fatal diseases such as malaria through the “MediSieve therapy”. This filter was developed by George Frodsham, a biochemical engineer from University of London, and works in the same way as dialysis. By circulating blood through external loop filters, healthy blood is returned. With trials underway, treating patients with severe, overwhelming infections may soon be possible.

Statistics estimate that world over, about 7,00, 000 people have pacemakers fitted into their bodies every year. Two years ago, a pacemaker that can directly be inserted into the heart was approved by the US Food and Drug Administration. Scientists are now striving to go one step further by experimenting with a subcutaneous pacemaker, which is implanted under the skin of the chest and would annihilate the chances of a blood infection that modern-day pacemakers come with as they have wires connecting them to the heart through blood vessels.

Coronary heart disease

It is the numero uno killer despite a decline in the overall toll it takes. Close to home too heart disease is also a leading cause of death — according to the 2016 Global Burden of Disease Report, the ailment killed 1.7 million Indians the same year. To contain the crisis, new solutions to maintain healthy cholesterol levels are being devised. A 2011 study shows that 52-60 per cent cholesterol patients are on drugs for reducing Low-Density Lipoproteins (LDL).

heart-attack_s_650_0_030518054908.jpgHeart disease is the numero uno killer despite a decline in the overall toll it takes.

Trials show that patients who were on statin therapy — the present best medication for lowering bad cholesterol — were given new drugs (PCSK9 inhibitors) that reduced their LDL count by an additional 59 per cent. These drugs may also help those born with congenital genetic defects and have high cholesterol in their blood. Reducing cholesterol levels will protect against heart attack, stroke and other life-threatening ailments. Bollywood actress Sridevi, who passed recently, was initially suspected to have died of heart attack — while this wasn’t the case, there are thousands around her age or younger who do die of cardiac ailments.

Lowering "bad" cholesterol is known to be effective against heart attack. However, it is still not clear how low is good enough. It is important to remember that cholesterol is a natural building material for our body and many tissues, including of the brain, have plenty of lipids like cholesterol and need them for normal bodily functions. However, for now, these drugs may help those who have suffered a heart attack or stroke despite being on statins, or those who are unable to take statins due to side effects.

Pancreatic Cancer

Cancer is the second most common cause of death in India according to National Institute of Cancer Prevention and Research (NICPR), a premier institute under Indian Council of Medical Research (ICMR) and, each year, more than 7,00,000 new cancer patients register with it.

Today, there is an app to detect early signs of cancer.

According to World Pancreatic Cancer Coalition, pancreatic cancer is the toughest to detect, the primary reason being patients do not show symptoms in the early stages and when they are diagnosed with the fatal disease, it becomes difficult to treat it. Many a celebrity, including Steve Jobs, has succumbed to the ailment! It is well known that the buildup of bilirubin causes jaundice. University of Washington researchers have created the app BiliScreen to detect cancer in the early stages.

It allows you to take a selfie and ascertains your bilirubin levels based on the photo, using digital algorithms. High levels of the the compound point to pancreatic cancer. Results from a study published in 2017 showed that the app alone identified the incidence of jaundice with 89.7 per cent accuracy. More extensive clinical trials are essential before the screen can be put to actual medical use.

Gene therapy

Another medical breakthrough that may see the light of day in the coming decade is the technique to "edit" embryos to prevent genetic disorders. Popularly known as gene therapy, it involves introducing DNA with functional gene(s) into a patient's body to correct or kill off a disease-causing mutated gene. Clinical trials are starting to show encouraging results. This is particularly true for single gene defects which, in the future, may become amenable to correction.

embryo_030518055106.jpgEditing embryos can go a long way in preventing genetic disorders. 

Among the many trials to modify the effects of defective genes is the experiment to produce structurally abnormal heart muscles. Geneticists have successfully modified human embryos to remove mutation that causes hereditary hypertrophic cardiomyopathy, a life-threatening heart condition. The disorder occurs in about one out of every 500 adults; abnormalities in the heart’s structure ensure that instead of being a pliable organ which accepts and disseminates oxygenated blood, it becomes stiff — thus failing in its functions.

Gene editing holds much potential when it comes to treating a number of ailments, including retinal degenerative disease and other inherited disorders such as cystic fibrosis and haemophilia. Many experts believe that it could pave the way for treating more such critical conditions.

As we advance, the list of “breakthroughs” will continue to grow, and we will keep you posted as more promising ones appear on the horizon.

Also read: Why we need to take heart risk more seriously

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Writer

Indranill Basu Ray Indranill Basu Ray

The author is an interventional cardiac electrophysiologist based in the US and a Vedanta scholar with research in mind-body medicine. He can be contacted at www.ibasuray.com

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