From Neuralink to infectious diseases

(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying there. You can subscribe here to get the newsletter in your inbox.)

It is impossible to ignore the allure of technology, particularly when it cohabits a sweet spot, intersecting with human health. The prospects of this are tantalising, taking us out of the humdrum that surrounds us and allowing us to dream and hope of a phantasmagorical future right out of science fiction. The latest update on Elon Musk’s Neuralink to start human trials of brain implants for paralysis patients will sit squarely in that bracket. Following up on an earlier announcement on what Neuralink will do, Musk went further to announce human trials of a brain implant that will hopefully allow paralysis patients to do more than what physically is possible for them currently. It has received approval from an independent review board to begin recruitment for the first human trial of its brain implant for paralysis patients. Those with paralysis due to cervical spinal cord injury or amyotrophic lateral sclerosis may qualify for the study, it said, but did not reveal how many participants would be enrolled in the trial, which will take about six years to complete.

The study will reportedly use a robot to surgically place a brain-computer interface (BCI) implant in a region of the brain that controls the intention to move, Neuralink said, adding that its initial goal is to enable people to control a computer cursor or keyboard using their thoughts alone. It’s the next frontier, and even as we keenly watch this space for the hope it holds, it is important to ensure that there is adequate supervision of this study trial, even as it enters a space where humans will work with what they little understand about — the brain.

Also last week, more interesting developments on the human transplant front, using animal organs to replace failing organs in men and women. The pig has been a favourite substitute, and the animal’s heart has been used not once, but twice to carry out a heart transplant surgery.  Last week, surgeons performed a second pig heart transplant, trying to save a dying man. Two days after surgery, the man was cracking jokes and able to sit in a chair; the 58-year-old Navy veteran was facing near-certain death from heart failure but other health problems meant he wasn’t eligible for a traditional heart transplant, according to doctors at the University of Maryland Medicine.

The patient, a veteran, Lawrence Faucette, from Frederick, Maryland, was quoted as saying: “Nobody knows from this point forward. At least now I have hope and I have a chance,”, said in a video recorded by the hospital before Wednesday’s operation. “I will fight tooth and nail for every breath I can take.” While the next few weeks will be crucial, his surgeons are apparently thrilled by his progress so far.

Delight in health care advances apart, it was a sobering realisation of the high impact blood pressure has on the people of India thanks to the World Health Organisation’s first-ever report on BP. Approximately four in five are not treated adequately for their condition, as per the report, says Bindu Shajan Perappadan. But if countries can scale up coverage, 76 million deaths could be averted between 2023 and 2050, noted the WHO. “Prevention, early detection and effective management of hypertension are among the most cost-effective interventions in health care and should be prioritised by countries as part of their national health benefit package offered at a primary care level. The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to 1,” the report adds. For a further perspective on this, do read Vijay Shankar Balakrishnan’s analysis on the subject: The Silent Killer: tackling hypertension in India.

This past week there was a ripple effect following the announcement that the Centre was going to reduce the NEET-PG cut-off to the zero percentile mark. The Health Ministry said this was to ensure that more seats are taken, given that a number of PG seats, particularly non-clinical subjects, are going vacant year on year. Now, with this, they said, all seats have been opened for all the PG students who are still to take part in the counselling. The Congress party and the Indian Medical Association were among those who slammed the government for this dilution of standards. 

The dust surrounding the Nipah virus has sort of settled, but The Hindu had a bunch of stories, as part of its continuing coverage on the outbreak. Do follow them here:

Kerala gets ICMR approval to conduct Truenat test to detect virus NiV diagnostics, which can now be performed in Kerala itself.

Community surveillance will continue in Kozhikode, says Health Minister — it is seen as essential to preventing further outbreaks.

Life is returning to normalcy in Kozhikode, reports our Kerala team.

After four outbreaks, it is important, says Sarath Babu George, to identify bat roost hotspots to tackle the Nipah spread.

Kozhikode is likely to be covered under the One Health programme as is the recommended step ahead, says A.S. Jayanth.

Priyali Prakash explains what monoclonal antibodies are and those under trial for Nipah.

K. S. Sudhi analyses the rise of zoonotic viral and bacterial disease deaths in Kerala.

From Nipah outbreak to a more low-profile infectious disease, though its numbers are huge, Tuberculosis. R. Prasad records that the Xpert MTB/RIF molecular test for tuberculosis diagnosis to cost 20% less. A great move, opening up molecular testing to a larger population, and also one that might reduce India’s extraordinary reliance on sputum microscopy to detect TB. 

It will possibly also aid in addressing the concerns of this study that found the quality of active TB case finding was suboptimal nationally. 

Meanwhile, a panel has suggested a booster shot of BCG vaccine to fight TB. The Parliamentary Standing Committee on Health and Family Welfare suggests expediting the research programme to study the effectiveness of BCG and, based on the result, to consider a booster dose of recombinant BCG vaccine in the universal immunisation programme. This could be an effective and cheaper option to control TB. 

A walk-in tuberculosis centre opened at Kollumedu PHC in Villivakkam, in Chennai last week.

There’s more, on dementia, as we reach the last lap of September, we have just observed Alzheimer’s Day on the 21st. Here are a few issues that are relevant, in addition to what we have already discussed on the subject in the past: 

Looking at the curious link between Alzheimer’s disease and trauma, Saumya Kalia examines the question: Does stress — trauma, of the brain, the mind, the body — erode brain health to a degree that it hastens neurodegeneration, and consequently, the risk of developing AD? The hypothesis has been tested over and over, yielding conflicting and contradictory results. The Alzheimer’s question boils down to: We know adversity influences symptoms of AD, but can it increase the risk of developing Alzheimer’s too?

Experts also call for more awareness in dealing with dementia patients. One would think that the importance of awareness has been overstated, but apparently not. 

Dementia is now ‘public health priority’ in Karnataka.

This is a story we reported already, but we are going to stay on the subject of the draft Patent Amendment Rules, recently introduced, thanks to the huge ramifications it is likely to have on patient care: Draft patent amendment rules undermine pre-grant opposition.

For our tailpiece this week, read of a hospital near Hyderabad where everything is on the house. Costly diagnosis and complex operations are done free of cost for anyone walking into the Arundhati Institute of Medical Sciences and Hospital in Dundigal, on the outskirts of Hyderabad. Even post-operative facilities are extended without any charge. Hospital records reveal that nearly 2.30 lakh out-patients have availed services during the past three years, while more than 8,000 surgeries by different departments have been performed. Of these, 3,000 were major surgeries. Diagnostics like MRI, CT, ultrasonography, mammography, digital X-ray, EEG and EMG are all done free. The hospital is the result of a promise made by Marri Rajashekhar Reddy to his mother. 

From the Health pages

Do take a few more moments to spend here, for these are very important health stories: 

Dr. Padmasani Venkataraman talks about the criticality of nutrition for infants with cleft. 

Dr. Christianez Ratna Kiruba writes on PCOS and the hidden toll of academic pressure on health among young girls.

Public health advocates demand warning labels and ban on junk food ads.

A new immunology study highlights the importance of COVID-19 vaccination for those who have already been exposed to the virus.

Afshan Yasmeen records the challenges in testing and treatment of rare diseases.

The anatomy of women’s cancers: how does gender shape diagnosis, treatment?, explores Saumya Kalia.

Providing you a gamut of stories from across the regions:

Karnataka

Health Minister visits Hanur villages to meet children suffering from rare skin disease.

Consortium for Tobacco Free Karnataka demands immediate implementation of hookah ban.

One-year-old Omani child undergoes Robot-Assisted Surgery for renal blockage in Bengaluru.

Kerala

Medico-legal protocol in Kerala to be amended.

Government agencies aid nurses’ migration cashing in on global reputation for Kerala nurses.

New Delhi

Outfit advocates male nurses in Army ‘to break gender barriers’.

Tamil Nadu

Doctors and nurses at Kalaignar Centenary Super Speciality Hospital have not paid salaries for three months, Serena Josephine M. writes.

Tamil Nadu Public Health Act invoked for dengue control.

Woman gives birth to baby within hours of pacemaker implantation at Stanley Hospital in Chennai.

A woman from Gujarat underwent a lung transplant to treat a condition caused by exposure to pigeon droppings.

Two mirror image tumours removed from professional’s brain in Chennai hospital.

Prenatal sex determination: five including a nurse arrested in Tamil Nadu’s Dharmapuri.

Uttar Pradesh

Mayank Kumar writes on a vaccine wheel in Uttar Pradesh that helps ASHA workers track newborn immunisation.

Amethi Hospital to move Court against license revocation.

West Bengal

Dengue infections and deaths rise, Kolkata Municipal Corporation pulls up its socks, reports Shiv Sahay Singh

As always, do put us on your radar, as we bring more health content your way. Get more of The Hindu’s health coverage here.