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Time of India
2 days ago
- Health
- Time of India
Evolution of kidney care: Past lessons, present innovation towards a hopeful future
Evolution of kidney care Past lessons, present innovation towards a hopeful future Kidney disease has long stood as a silent threat—one that quietly erodes health until its effects are irreversible. Among its many forms, chronic kidney failure remains particularly severe. It's important to reflect on how far we've come, the challenges that remain, and the promise the future holds. The past: From hopelessness to hope A century ago, the diagnosis of chronic kidney failure was tantamount to a death sentence. There were no effective treatments, no dialysis, and little understanding of disease progression. Early attempts at dialysis in the 1920s were primitive—massive and complex machines with limited impact and frequent complications. Most patients slipped away quietly, undiagnosed and untreated. The 1950s brought a glimmer of hope. The first kidney transplants—fraught with the dangers of immune rejection—eventually gave way to success, beginning with a landmark 1954 transplant between identical twins. Over time, medical science developed ways to tame the immune system with anti-rejection medications, transforming kidney transplantation from an experimental procedure into a viable, lifesaving therapy. India reached its own milestone in 1971, with the first successful transplant performed at Christian Medical College, Vellore, ushering in a new era of domestic nephrology care. The present: Precision, progress, and accessibility Today, the field of nephrology is a testament to scientific progress. Chronic kidney disease (CKD) no longer hides in the shadows; awareness is growing, diagnostics are improving, and treatments are more accessible than ever. In India alone, an estimated 10–12% of the population lives with some form of kidney disease. The root cause of this- Diabetes—a condition affecting over 77 million Indians, with nearly half already showing signs of kidney damage. Advancements in diagnostic tools—from routine ultrasounds to precise kidney biopsies—allow for earlier detection and intervention. Pharmaceutical breakthroughs, including SGLT2 inhibitors, ACE inhibitors, ARBs, and newer agents like finerenone, are helping clinicians slow the progression of disease and safeguard kidney function. When kidney failure becomes advanced, life does not have to stop. Innovations in dialysis—whether hospital-based or increasingly at home—offer patients a chance at stability and quality of life. Transplantation, once considered a last resort, now stands as a symbol of medical triumph. With decades of research yielding better immunosuppressive drugs and surgical precision, transplant survival rates have improved significantly. From laparoscopic procedures to more refined HLA-matching protocols, the outcomes today are better than ever. Even procedures once thought impossible—transplants across incompatible blood types, combined liver-kidney operations, and pancreas-kidney transplants for diabetic patients—are becoming increasingly common. The future: Toward artificial organs and regenerative breakthroughs Looking forward, the horizon of kidney care is expanding with promise. Scientists are pushing boundaries with novel therapeutics aimed at halting kidney decline earlier and more effectively than ever before. Recently, Zydus Lifesciences also conducted a campaign #LifeKaFilter that revolves around the importance of kidney health. The campaign highlighted various issues including how dialysis and transplants are lifesavers, but prevention is always better. Also, highlighted the government schemes that can ease the burden of kidney treatment costs. Researchers are exploring portable and wearable dialysis devices, which may soon enable patients to achieve even greater independence, offering freedom from the rigid schedules and physical toll of traditional dialysis. Perhaps the most revolutionary prospect lies in xenotransplantation—transplanting genetically engineered animal kidneys, typically from pigs, into humans. Though still in the realm of clinical trials, these experiments hint at a future where organ shortages may no longer be the bottleneck they are today. We are entering a golden era in nephrology, where technology, science, and access are converging to make what was once a life-threatening disease highly manageable, even curable. Author: Dr. Siddharth Mavani, Director, Nephrology and Kidney Transplant, Marengo CIMS Hospital, Ahmedabad The above is non-editorial content and TIL does not guarantee, vouch or endorse any of it. Please take all steps necessary to ascertain that any information and content provided is correct, updated, and verified. Stay informed with the latest business news, updates on bank holidays and public holidays . AI Masterclass for Students. Upskill Young Ones Today!– Join Now
Hindustan Times
7 days ago
- Health
- Hindustan Times
2023 Tamil Nadu outbreak of neurological infection traced to contaminated saline at clinic: Study
New Delhi, A genetic study has traced a 2023 outbreak of a neurological infection in Tamil Nadu to contaminated saline water used at a dental clinic, findings of which were published in The Lancet Regional Health Southeast Asia journal. Twenty-one probable cases of neuromelioidosis a neurological infection caused by bacterium Burkholderia pseudomallei between July 2022 and April 2023 were identified across four districts in the northern part of the state. Seventeen of the 21 cases came from a single district, of which 10 reported undertaking treatment at a dental clinic. The cluster of cases were found to have higher and quicker deaths, compared to the other 11 sporadic cases from environmental sources. Researchers from Christian Medical College, Vellore, Indian Council of Medical Research-National Institute of Epidemiology, Chennai, and other institutes attributed the cluster to invasive dental procedures injecting of a local anaesthetic and repeated irrigation with saline performed under suboptimal infection prevention and control conditions. Whole genome sequencing of 209 isolates, obtained from tissue, blood, and cerebrospinal fluid samples of the affected, revealed 'ST1553' strain of the bacterium B pseudomallei as being associated with the neurological infection outbreak. Along with suggesting a new process by which neuromelioidosis can be contracted, the findings highlighted the importance of molecular methods of analysis in identifying the strain of the bacterium circulating in southeast Asia. Rigorous infection prevention and control practices across healthcare facilities, particularly those performing invasive procedures, need to be enforced, the authors said. "We confirmed a large cluster of neuromelioidosis from south India, likely representing sporadic cases from environmental sources and cases linked to an iatrogenic source at a dental clinic," the authors wrote. "Rapid and high case fatality among dental cases supports the direct trans-neural spread of B pseudomallei to the brainstem following inoculation via contaminated saline," they wrote.
The Hindu
22-05-2025
- Health
- The Hindu
Rise in Japanese encephalitis cases prompts T.N. to expand vaccination coverage
The Directorate of Public Health's decision to increase vaccination coverage for Japanese encephalitis (JE) to five more districts, apart from the existing ones, follows close on the heels of the findings of a study done by Christian Medical College, Vellore. The study found that between 2022 and 2024 more JE cases were recorded in Tamil Nadu, with Chennai recording the highest number of cases. The study is a retrospective trend analysis using data uploaded to the IDSP – IHIP portal (Integrated Disease Surveillance Programme - Integrated Health Information Platform) of Tamil Nadu, from January 2022 to December 2024. The analysis found that 306 cases were recorded and 24.2% of the cases were in the age group of 10 to 19 years. The highest number (120 cases) reported was in 2022. In 2023, 112 cases were identified and in 2024, 74 cases were reported. Chennai accounted for the highest proportion at 40.5%, followed by Tiruvallur (8.2%), Tiruvarur (6.2%), Tiruvannamalai (5.6%), Chengalpattu (4.9%), Thanjavur (4.6%), Villupuram (3.6%), and Madurai (2.6%). The remaining districts accounted for less than 2%. The Health Department has identified 14 districts — Tiruvallur, Tiruvannamalai, Villupuram, Cuddalore, Kallakurichi, Perambalur, Karur, Thanjavur, Ariyalur, Tiruvarur, Pudukkottai, Madurai, Virudhanagar and Tiruchi — as endemic. There has been a noticeable increase in cases (more than five cases) in districts outside of endemic areas such as Chennai, Kanchipuram, Chengalpattu and Tenkasi, the study found. The authors, Regina Elizebeth Joy et al., cited the World Health Organisation's remarks that in endemic areas adults had likely developed natural immunity due to childhood infection, but children under 15 did not have the chance to develop immunity yet. Males more affected The data also showed gender disparity in JE cases, with higher incidence in males (62.04%) as compared to females (37.06%). More JE cases were reported during the post-monsoon and winter months, being attributed to increased breeding of Culex species, which transmit the JE vectors. The increasing number of cases in previously non-endemic regions are attributed to environmental and ecological factors, the authors concluded. Key factors included the presence of paddy fields, bird sanctuaries, field wells, pig populations, and ardeid bird habitats. Though most patients recovered some develop serious neurological sequelae. The neurological complications could lead to long-term disabilities. Many survivors experience cognitive, motor, or speech impairments. Director of Public Health T.S. Selvavinayagam, who is also a co-author of the study 'Epidemiological profile of Japanese Encephalitis in Tamil Nadu, 2022-2024: a secondary data analysis of IDSP-IHIP programme data', published in the recent volume of the Tamil Nadu Journal of Public Health and Medical Research, said the findings led the government to announce expansion of JE vaccination to five districts. 'It's a part of the announcement made in the Assembly,' he said. 'We are getting cases only because of screening, we will only ask everyone to report regularly,' he added. On May 15, the Health Minister had launched the universal Immunisation programme in Chennai. It included 11 vaccines, including for JE.
Indian Express
22-05-2025
- Health
- Indian Express
Cancer therapy gets cheaper and effective: CAR T-cells developed in hospital, patients in remission
In a significant breakthrough, CAR T-cell therapy, which uses patients' T-cells to fight cancer by re-engineering them, was developed by and infused at the hospital where they were admitted. Normally, this is done in specialised centres, which pushes up cost and logistics. But with this method, the therapy becomes affordable, costing almost 90 per cent less than the global average. The phase 1 VELCART trial was conducted successfully at Christian Medical College(CMC), Vellore and was funded by the Indian Council of Medical Research (ICMR). 'It is the first trial in the country to do point-of-care development of T-cells in a hospital setting. Once produced, these can be infused to treat patients at a low cost,' says CMC Vellore director and principal study author Dr Vikram Mathews. What were the study findings? Altogether 10 patients, aged between 6 and 59, were selected after other treatments failed to improve their condition. Six of them had acute leukemia and four had lymphoma. They were treated with CAR T-cells developed at CMC Vellore over nine days as part of a point-of-care (PoC) strategy. The study found that the therapy brought about 100 per cent remission in acute lymphoblastic leukaemia patients and 50 per cent remission in large B-cell lymphoma patients. 'Overall, eight of the ten patients remained cancer-free at a median follow-up of 15 months. The therapy was safe, well-tolerated and had minimal side effects,' says Dr Mathews. If successful in Phase II trials across multiple centres, this model can be replicated in tertiary hospitals across the country. How was the therapy developed? Dr Mathews explains that chimeric antigen receptor T-cells (CAR T-cells) are normal T-cells that are part of the patient's own immune system. 'This process usually involves inserting the required genetic information into normal T-cells to produce an antibody receptor that will recognise the antigen/substance on the surface of the cancer cell. This is usually done in large centralised commercial corporations, which contributes to logistic challenges, increased costs, and decreased efficacy,' he says. But produced at the hospital site itself, this could be effective at a lower cost. 'Just imagine if 100 centres could manufacture CAR T-cells at the hospital. Wouldn't it significantly bring down cost in the long run?' he asked. Why is the trial significant? Access to CAR T-cell therapy is limited by cost and turnaround time, even in developed countries. The current centralized model with industry-driven CAR T- cell manufacturing is not viable to the requirements and realities of developing countries like India. Researchers, however, have provided evidence that this is feasible in India. 'The early data from this study establishes its safety and also shows promising results,' says Dr Mathews. Redefining cancer therapies Dr Mathews says researchers used fresh, unfrozen CAR T-cells, which resulted in better outcomes. Unfrozen CAR T-cells are infused directly into the patient after the modification and expansion process, bypassing the freezing step. This approach aims to preserve the cells' fresh, robust state, potentially leading to better anti-tumour activity. This also means that infusion can occur sooner after the cell modification process, potentially shortening the treatment timeline. 'Our trial redefines how cancer therapy can be delivered — efficiently, affordably and close to patients. India is leading the way in developing next-generation, in-house biotherapies with global relevance,' Dr Mathews says. The study, titled 'Safety, efficacy and total cost of point-of-care manufactured anti-CD19 CAR-T cell therapy in India: VELCART trial', has been published in the journal Molecular Therapy. Anuradha Mascarenhas is a journalist with The Indian Express and is based in Pune. A senior editor, Anuradha writes on health, research developments in the field of science and environment and takes keen interest in covering women's issues. With a career spanning over 25 years, Anuradha has also led teams and often coordinated the edition. ... Read More
Time of India
21-05-2025
- Health
- Time of India
Japanese encephalitis cases rise in urban and periurban areas of tamil nadu
(JE), a that can cause inflammation of the brain, is expanding beyond its traditional rural agricultural areas in to urban and peri-urban areas, including Chennai, says a new study. Tired of too many ads? go ad free now The state has identified 14 districts as endemic to the disease, but between 2022 and 2024, cases of the viral disease surged in areas not typically associated with high infection rates. "Chennai recorded the highest number of JE cases (40%) during this period, followed by Tiruvallur and Thiruvarur," says Regina Elizebeth Joy, the study's corresponding author, from Christian Medical College in Vellore. For the retrospective analysis, published in the state public health journal, doctors from CMC and the directorate of public health (DPH) used surveillance data from the integrated health information platform and identified 306 cases. While more than 86% of patients recovered completely, 8% died, and 5.3% had neurological complications. Scientists found that cases began increasing in June, dipped slightly in September, and increased in December and January for all three years. Trend analysis showed that most people affected were between 10 and 19 years (24.2%), followed by those under five years (19%). The prevalence was higher among males (62.4%). District-wise prevalence put Chennai at the highest proportion at 40.5%, followed by Tiruvallur at 8.2% and Thiruvarur at 6.2%. The highest number of cases occurred in 2022, with 120 cases, followed by 2023 with 112 cases, and 2024 with 74 cases. "The urban spread is because of agricultural encroachment in peri-urban zones, climate change and population migration," says study author Dr T S Selvavinayagam, DPH director. Tired of too many ads? go ad free now "Rural areas remain vulnerable as paddy fields, wells and pigs create perfect conditions for mosquitoes and virus spread." Despite a high recovery rate, there is a chance of severe, long-term neurological complications developing in survivors. To stop the spread of JE, the authors stressed the need for mandatory vaccination. "We also need pre-monsoon strategies such as stronger mosquito control, awareness drives and real-time tracking to manage and reduce cases," says co-author Dr Subhashini K J from DPH.
