Biomedical subjects
Publications and source records attributed to V Ramalingaswami.
The plague outbreak in Surat, India in September 1994 stirred a nationwide panic and a near international isolation of India. These are aspects that need serious attention. A large amount of damage to India's image and an immense economic loss occurred. Some advice for the future is suggested.
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This paper reinforces the idea of integrating more closely the social and medical sciences with an emphasis on people. The nexus between health and development is examined together with national research capability building as part of essential national health research progress. Suggestions are made identifying the most urgent requirements for further action.
Millions of people suffer and many die from lack of minute traces of nutrients. Methods of prevention are cheap and simple. Their universal application could yield health and economic benefits comparable to those achieved by smallpox eradication.
The challenge to medical education as we enter the last decade of the century and face the next millenium is how to utilize the new knowledge of human learning to train medical students in applying the fruits of rapidly advancing science and technology to the moral imperative of fulfilling social needs. To bring about the reforms defined in the Edinburgh Declaration, adopted as globally applicable by the World Conference on Medical Education, intrinsic and extrinsic elements must act in synergy. The intrinsic elements are teachers, students and institutional frameworks; the extrinsic elements political will, administrative commitment and societal pressure. In the developing world, while there is much that medical schools themselves can do through intrinsic changes, their dependence on government support is so pervasive that such government support becomes an essential prerequisite for change. The creation of a cohesive organizational framework involving health and education ministries, the academic sector and professional bodies for a systematic and continuing study of medical education and for inducing and sustaining change are essential to facilitate the change process.
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Waterborne non-A, non-B hepatitis (NANB) is responsible for outbreaks of hepatitis with a predilection for young adults. The disease is usually mild, except in pregnant women, who have a high case-fatality rate from fulminant hepatic failure. Diagnosis is largely based on the epidemiological findings of faecal contamination of drinking water and serological exclusion of hepatitis A and B virus infection. Histological features of liver biopsy specimens are characteristic and virus-like particles in the stool are aggregated by antibody present in acute and convalescent phase sera of the test subject. NANB is widespread in India and several countries of South-East Asia; it is increasingly recognised in Africa and may occur in Latin America. Control measures include provision of clean water supplies, safe disposal of human excreta, and sound personal and food hygiene practices. Passive immunisation with immunoglobulin derived from healthy donors resident in the countries affected by the disease may protect vulnerable groups.
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Short-term effects of small doses of aflatoxin (0.05 mg/kg of body weight twice a week) were studied in rhesus monkeys fed low-protein and high-protein diets. Animals on high- and low-protein diets without aflatoxin administration served as controls. There was no difference in weight gain, hemogram, serum protein levels, and liver function test results between aflatoxin-treated and control animals. However, morphological alterations in hepatocytes in the form of mild degenerative changes, focal areas of necrosis, and increased regenerative activity were seen in the aflatoxin-treated monkeys. Data on cell cycle analysis done by DNA content estimation through microfluorimetry on DNA-fluorescent, acriflavin-stained liver imprints revealed larger number of cells in the S and Gi2 phases in animals given aflatoxin. However, the changes in cell cycle, as well as in morphology, were more marked in the aflatoxin-treated, low-protein-diet group.
It is obvious that any strategy for village health care must involve the people actively--something that is more easily said than done. There is hardly any technology for rural health that does not have a significant software component. Why is it that so much that is known cannot be applied? What factors may be important in the diffusion of technology in a rural society? Technology must address itself to the needs as perceived by the people (in addition to what is perceived as their needs by the health care system). It must be compatible with the knowledge and skill levels of the community. Benefits must be visible to the community through appropriate assessment and feedback procedures so as to secure greater and greater involvement.
1. A study was conducted in two centres in southern and northern India of the effects of the addition of ascorbic acid and protein supplements to iron, pteroyglutamic acid and cyanocobalamin, in the prophylaxis and treatment of anaemia of pregnancy. 2. A dose of 500 mg ascorbic acid/d had no beneficial effect. Women who received 15 g calcium caseinate/d showed a superior haematological response. The reasons for this are unknown, but are more likely attributable to an increased absorption of the supplemental iron than to the correction of a protein deficiency.
1. The relative efficacy of oral and parenteral iron administration in the prophylaxis and treatment of Fe-deficiency anaemia of pregnancy has been studied. 2. Intravenous administration of Fe by total dose infusion of Fe dextran was not superior to oral Fe 120 mg/d, 6 d/week for 10-12 weeks. 3. Intramuscular Fe dextran, 100 mg twice per week for 10-12 weeks, produced a significantly greater rise in mean haemoglobin concentration than oral Fe therapy. 4. The superiority of intramuscular Fe as compared with intravenous Fe is probably related to the different handling of the Fe dextran by the reticulo-endothelial system. 5. In spite of the better response to intramuscular Fe dextran, it is not recommended for public health practice because of the risks associated with its use and the much higher cost of the preparation and its delivery.