Doctor

How Yoshinori Ohsumi work on Autophagy will change Medical Science?


On 3rd October 2016, a Japanese scientist Professor Yoshinori Ohsumi, Ph.D has been awarded Nobel Prize for Medicine for his study in mechanism of autophagy.

Autophagy, the word itself means self-eating. It is an essential conserved lysosomal degradation pathway that controls the quality of the cytoplasm by eliminating protein aggregates and damaged organelles. It begins when double membraned autophagosomes engulf portions of the cytoplasm, which is followed by fusion of these vesicles with lysosomes and degradation of the autophagic contents.

autophagy

In simple words, It is the process that cells use to destroy and recycle cellular components.
A recycling program – junk cell components are stored and the useful parts comes out to generate the energy or build new cells.

By the acknowledgement of this mechanism of autophagy, many gates will open for the approaches of treating diseases by further research works.

1. Cancerous cell growths can be prevented, that is the major life threatening disease of developed nations, as the survival rate is very low and unreasonable most of the times.

2. Fight against infections of  pathogenic microorganisms, will be great as most of the biology underpinning infectious diseases can be controlled.

3. Maintenance of a healthy metabolism,  It allows cells to degrade large molecules into basic building blocks, which are used as energy sources.

4. Neurodegenerative illnesses, Dementia (caused by tau), Parkinson’s disease (alpha-synuclein), Huntington’s disease (mutant huntingtin) and other age- related disorders.

5. Diabetes Mellitus Type 2, an endocrine disease due to genetical or sedentary lifestyle getting more common in our India will be prevented by autophagy.

6. Development of Drugs, Intense research is underway to develop drugs that can target autophagy to treat various other diseases.

7. Regenerate Protein Inside Body: Because of this machinery now we’re able to rely on some of our own proteins, maybe the damaged proteins or the long-lived proteins, and they are recycled with this sophisticated machinery so that we can sustain and we survive.

Point of care testing (POCT)

Point of care testing (POCT) can be defined as the provision of a test when the result will be used to make a decision and to take appropriate action, which will lead to an improved health outcome. The basic objective of POCT is to produce a result swiftly yet reliably.

According to Accreditation Canada POCT refers to “any testing conducted outside a lab, in a hospital, in a clinic or by a health care organization providing ambulatory care. This includes testing performed at sites outside the traditional lab dedicated to medical biology, near where care is delivered to the client. POCT results may lead to a change in the care of the client. It ranges between three levels of complexity, from simple procedures such as glucose testing, moderate‐complexity procedures including provider performed microscopy procedures like used in TB or high‐complexity procedures such as influenza testing.”

The healthcare system is changing so quickly. Everyone has to run at that high speed just to keep up. Having a good health is just like happiness, can’t remain constant and whomsoever looking to maintain the status quo should not be in or go into healthcare as a profession. The change process shows no sign of slowing down.

In fact, all aspects of this field are moving equally fast like automobile industries, various new technologies like robotics and information technologies (IT). IT boosted so much in recent decade. Economics is also improving as well etc. It is no wonder that POCT is moving quickly ahead as one of the major approaches to solving what seems to be the major challenge that is how to do more with less.

What is the purpose of POC and why it is important?

1. The result of POCT is so quick that it can be done within seconds, to minutes to a few hours while the patient waits. At least result should be given on the same day depended on the complexity range of the diseases.

2. It provides rapid turn-around results that affects the clinical management of referral system, follow up of patient, treatment decisions and decision to discharge the patient.

3.The results of POCT are very useful in clinical decision making for any doctor. As the final diagnosis helps doctor to take appropriate action for the treatment without any further delay.

4. It is convenient for the patients and care providers as well. It mainly derives from the fact that the diagnostic process is achieved with in the same clinical encounter. And the patients do not have to come back for testing or go far away for some testing in medical laboratory.

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Common POCTs are:
Blood-glucose testing,
Electrolytes analysis,
Rapid coagulation testing (PT/INR, Alere, Microvisk Ltd),
Rapid cardiac markers diagnostics (TRIAGE, Alere)
Drugs of abuse screening,
Urine strips testing,
Pregnancy testing,
Faecal occult blood analysis,
Food pathogens screening,
hemoglobin diagnostics (HemoCue),
Infectious disease testing
Cholesterol screening (cholesterol, VLDL, LDL)

OMG! This is the condition of health facilities in India

‘India spends less of its GDP on health than some of the world’s poorest countries.’

A single government hospital serves an estimated 61,000 people in India, with one bed for every 1833 people, new official data shows. In undivided Andhra Pradesh, every government hospital serves over 3 lakh patients while in Bihar, there is only one bed for every 8800 people.

Union Minister for Health J.P. Nadda released the National Health Profile 2015 prepared by the Central Bureau for Health Intelligence (CBHI) in September 2015 along with officials of the Ministry, the Directorate General of Health Services and the CBHI.

Every government allopathic doctor serves a population of over 11,000 people, with Bihar and Maharashtra having the worst ratios. The number of qualified allopathic doctors registered with medical councils fell in 2014 to 16,000, or less than half the previous year’s number; the data was however provisional, CBHI officials said.

India now has cumulatively 9.4 lakh allopathic doctors, 1.54 lakh dental surgeons, and 7.37 lakh AYUSH (Ayurvedic, Yoga, Unani, Siddha, Homeopathy) doctors of whom more than half are Ayurvedic doctors.
India’s 400 medical colleges admit an estimated 47,000 students annually.

According to World Health Organization, doctor patient ratio should be minimum one doctor for 1000 people. But in India there is only one doctor per 1,700 citizens which is increasing rapidly.
The Union Health Ministry figures claim that there are about 6-6.5 lakh doctors available, India would need about four lakh more by 2020—50,000 for PHCs; 0.8 lakh for community health centres (CHC); 1.1 lakh for 5,642 sub-centres and another 0.5 lakh for medical college hospitals.

Health expenditure per capita (in USD) of India is only $61 (around 4,000 INR) that is even less than poor countries like Haiti, Cambodia and Zambia.
World Health Organization statement that countries should spend 5 percent of national income on health care services. As per 2012 GDP India is only spending 1.3 per cent while developed countries like US and the UK spending 15 per cent and 8.5 per cent, respectively. Though as per the latest 12th Five-Year Plan India aims for 3 per cent till 2017.

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The Centre’s share of total public expenditure on health has fallen over the last two years, and India spends less of its GDP on health than some of the world’s poorest countries. Among all States, undivided Andhra Pradesh had the highest public expenditure on health in 2012-13. Goa and the north-eastern States spent the most on health per capita while Bihar and Jharkhand spent the least.

Out-of-pocket private expenditure on health has risen steadily over the years, with the cost of medicines, followed by that of hospitalisation accounting for the largest share of the household expenditure. Absolute spending, as well as its share in total non-food expenditure, rises with income levels. Kerala spends the most privately on health.

India is having Human Development Index (HDI) of only 0.609 that is even worse than poor African countries like Guyana & Namibia. Best countries are Norway and Australia that having HDI of 0.944 and 0.935 respectively.

Source: The Hindu & Wikipedia