I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Sunday, December 22, 2013

Medical Research in India

“The quantity and quality of medical research being undertaken in India is embarrassingly little”, said Dr MK Bhan, secretary, Department of Biotechnology, Government of India, while addressing a group of Indian gastroenterologists in a meeting in Delhi on 1st Aug.  He painfully pointed out how research was a low priority amongst most medical schools, and how very few doctors were taking up research as a career option.

Many might well wonder why research is important at all in medical science. Is it not well-established medical practice that a patient seeks from his doctor or hospital?

The National Institute of Health in USA has shown time and time again how research improves teaching, and teaching lifts the standards of care. It might be hard to accept at face value, but an example or two may make it clear.

The treatment of breast cancer, for instance has undergone major upheavals over the last few decades. It started more than a century ago with the concept that the tumor should be removed with as wide a margin of normal tissue as possible. Cancer surgeons therefore became more and more aggressive in performing extensive radical surgeries resulting in severe mutilations and death.

It required innovative thinking and a research mind to attempt less aggressive resections, but coupling it with other forms of therapy such as chemotherapy or radiotherapy. Over the last 2 decades, breast cancer survivals have therefore paradoxically improved several folds with less aggressive surgery. That is all thanks to medical research.

Prof BS Ramakrishna, head of the Department of Gastroenterology at Christian Medical College, Vellore, echoed the same sentiments and drove home the point with a simple example. While we all know, that the introduction of Oral Rehydration Solution (ORS) is a single piece of research that has helped pull back millions, especially children, from the jaws of death due to dehydration.

What scientists noticed however, was that although ORS prevented dehydration and death, it did not really reduce diarrhea! Medical research undertaken at Vellore showed that while much attention had been given to the small bowel in reabsorbing fluids and sodium, the decreased capacity of the large intestine in this condition had gone largely unnoticed.

Nursing back the large intestine with its special fodder, short chain fatty acids, therefore emerged as a better alternative, along with ORS, not only in tackling dehydration, but cutting diarrhea as well.

Established medical practiced has been compared to a pond of water. It may be clean to start with, but often gets stagnant and stale. Research is a flowing stream that does not let stagnation set in. It is essential therefore if present forms of medical care and treatment have to improve.

As published in HT City ( Hindustan Times) dated 2nd September, 2012

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