I am indeed delighted to participate in the inauguration of the PES Institute of Medical Sciences and Research. My greetings to all the students, faculty members, doctors, staff and the distinguished gathering. Medicine is the most challenging professors where human miseries and pain combat with the best out of human intelligence and patience.

Mobile Clinics - Telemedicine

I have witnessed during my recent visit to Uttaranchal, Mobile Clinics and Research Centers being deployed to provide healthcare at the doorsteps of rural people through diagnosis and treatment. It was a project by Technology Information, Forecasting and Assessment Council [TIFAC], the Government of Uttaranchal and Birla Institute of Scientific Research. Such programs should increase in numbers to provide healthcare services through mobile clinics with latest equipments for common treatment to those who are mostly unreached and cannot afford the medical facilities available in cities. I have seen the mobile clinic equipped with modern equipments and onboard facilities like X-Ray, Ultra-Sound, ECG and above all this mobile clinic will be supported by a team of doctors including a Lady Medical Officer, a Radiologist and Paramedics. In addition the vehicle is equipped to impart healthcare education through audio-visual facilities. Large scale participation is required from many institutions and industries in connecting our rural areas through telemedicine that will network well equipped urban hospitals with district hospitals and primary health centers through electronic connectivity including satellite communication to provide in real time latest medical diagnosis facilities. Ninety percent of our problem is related to common ailments. Our PHCs can be made to work with a combination of mobile clinics and tele-medicine to meet some of these challenges.

Cardiac Healthcare

In India, fourth largest number of heart surgeries in the world are conducted. I understand that more than 50,000 heart surgeries are performed every year in our country. Also it is reported that India has the highest number of persons suffering from heart diseases. Why? Is it due to genetic defect, improper food habits or indifference to health awareness? Hence one of our missions has to be directed towards reaching the maximum number of persons to provide the best possible cardiac healthcare in a cost effective manner with surgeon's heart with love. Also we need to bring down heart ailments, heart defects through proper preventive methods, evolving preventive technology such as early diagnostic tool, training for stress free life and above all doing research to learn from a few rural areas and hilly regions where minimum heart ailments are reported. It will be an important component in implementing preventive methods to provide better cardiac healthcare in our country.

HIV / AIDS

HIV is going to be a major threat to the nation. Apart from creating public awareness on HIV, we need to develop preventive drugs and anti vaccine. There are many globally funded agencies working together for developing safe and effective AIDS vaccine suitable for India. We need to participate vigorously in such programs by deploying our young in mission mode, with empowered management & technology research infrastructure, for drug and anti vaccine discovery. Otherwise there will be a large amount of causalities.

In spite of the fact that the average lifespan of population has significantly increased in the recent years including those in developing nations like India, the overall health profile has shown a decline with emergence of new threats like HIV/ AIDS and resurgence of eradicated diseases like small box, controlled diseases like malaria showing virulence due to drug resistance and mutation of different strains. We may need to develop effective vaccines and novel pharmaceutical approach to control the menace of such major health problems. In our national context HIV/TB and Malaria need a special attention. Can we evolve an empowered consortium and integrated approach to find permanent and long lasting solutions? Incidents of non-communicable, stress related and psycho somatic diseases are showing a steep rise due to life style changes of modern human being. The mind-body-spirit in the control and management of such illness may be more effective. Bio-medical scientists need to adopt such holistic approach to health care delivery.

Doctors as health awareness creators

Since every one of you are going to be involved in the noble profession of removing the pain of the people, you can also play a vital role in preventing ailments through proper health education to the patient as well as to his or her relatives and friends through the life style intervention. This can consist of a proper diet with low fat and high fibre, regular aerobic exercise like walking and stress management through Yoga, meditation and other methods. This can help in preventing the recurrence of the disease in the patient as well as promote health awareness at all levels. When you remove the pains of the people, the patient becomes part and parcel of you and considers you almost as God. Hence, the patient will definitely accept your health education considering you as the most respected guru. Every patient receives his family members, relatives and friends when he is receiving healthcare in the hospital. That is the occasion where you can give this message of a healthy life style to all of them.

Stem Cell Research

The recent identification and characterization of progenitors with stem cell properties has opened new avenues that may be useful for treating functional impairments caused by the death of specific cell population. The stem cells may help restore functioning of certain defective organs, by repopulating or rescuing the damaged cells from further degeneration. Particularly, in the field of ophthalmology, stem cells can be used for two different but complimentary ways to treat the degenerative diseases of the eye. Cell replacement therapy explotis the plasticity of stem cells progentors to replace cells and repair tissue damage by diseases or injury. The LV Prasad Eye Institute, Hyderabad have demonstrated the efficacy of the limbal stem cell transplantation in severe ocular surface injuries caused by chemical burns. Currently they have also successful in culturing adult bone marrow cells that differentiate into retinal neural cells. Confirmed with several immunohistological tests, these cells have the greatest chance for replacement and rescue of many incurable retinal diseases. The ability to maintain and manipulate stem cells progenitors in culture suggest that genetically engineered stem cells can be used to target gene products to sites of degeneration. These gene products can include survival-promoting factors to rescue degenerating cells, factors that can act in an autocrine manner to promote survival and differentiation of grafted cells into site specific neurons or to deliver neuro transmitters to permit functional recovery.

Emerging evidence suggest that multi potential stem cells progenitors hold considerable promise. Therapeutic applications of ocular surface (limbal) and retinal (neural) stem cells have special appeal for the treatment of otherwise intractable inflammatory and incurable degenerative diseases of the eye. The novelty of the approach lies in harnessing the pleuri potential capacity of the adult limbal and bone marrow cells, and the ability to use the cultured cells from the same patient so as to avoid past treatment immunosuppressive therapy. Stem cell research is expected to give remarkable results also the areas of cancer and heart related diseases etc.,

Networking the Institutions

Our country is rich in human resources, particularly of scientists, doctors, technologists and engineers. The basic infrastructure is available for the advanced research. The need of the hour is to network the existing facilities and expertise with commitment and conviction to augment and facilitate the pace of research and development. There are tremendous opportunities for technologists to work for an 'Integrated Health For All' in a mission mode which can be suitably evolved for implementation. The mission may include:

� Networking of medical universities, institutions, R&D Labs, industries and social organisations in key areas of assistance to the handicapped and disabled.

� Networked insurance scheme for healthcare coverage

� Launching of awareness-cum-prevention programmes to check the growing incidence of TB, Cancer and HIV.

� Creating a nationwide cold storage chain for polio and other temperature sensitive vaccines.

� Conducting hospital linked diploma level courses on medical technology maintenance at the state technical education institutions.

� Establishing an industry-supported system for maintenance and upgradation of medical equipment.

� Productionising selective assistive devices like hearing aids and medical consumables like electrodes, catheters and leads etc.

In India, we have rich clinical data which are getting generated from our various healthcare centres. We have only a few medical research institutions in India. The objective of research gets sidelined as these institutions need to cater to increased patients flow for treatment. Time has come to establish full fledged research centres leading to new discovery of prevention and treatment methodologies using modern methods and heritage healing in an integrated manner.

Conclusion

There is a need to redesign and transform our healthcare system. An action plan can be drawn that may include prime focus areas like prevention, diagnostics and treatment. The prevention will include sanitation, availability of safe drinking water, basic education and nutritional awareness. The diagnostics will include availability of X-ray, Ultrasound and ECG at every PHC and a CT scan and Colour Doppler at every district hospital. Both would be linked to Tertiary care hospital by telemedicine. Tertiary care hospitals will focus on interventional technologies such as angioplasty, brachytherapy, prosthetics, and molecular level management of immune, endocrine and other systems.

I would like to conclude with the words of Jeff Lyon and Peter Gorner in Altered Fates, "We humans have evolved intellectually to the point that, relatively soon, we will be able to understand the composition, function, and dynamics of the genome in much of its intimidating complexity. Emotionally, however we are still apes with all the behavioral baggage that brings to the issue. Perhaps one day our spices will rise above it baser heritage and learn to apply its new knowledge wisely."

God bless you.

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