International Science Week: Exciting Recent Advances in Medicine Science

By Dr (Lt Gen) CS Narayanan,

In 1928, a chance event at the St Mary’s hospital changed the face of medical practice forever. The discovery of Penicillin by Dr Alexander Fleming empowered healers with tools to conquer infectious diseases that took countless lives in the pre-antibiotic era. Thereafter we have witnessed exciting advances big and small, at a steady clip.

In the last decade, monumental advances in digital technology have revolutionized healthcare so drastically that we are still coming to terms with its great potential, and insights into avoiding potential trip wires.

We have ushered in a new era of human-machine collaboration that will improve treatment, and lower costs by democratizing healthcare in multiple dimensions.

The collection of health-related big data continues to accelerate at a pace that is mind-boggling. Considering that these data goldmines contain some of the most private and valuable information about an individual, the security implications of preserving their integrity grows as fast as technology does. Built around a system of currently unhackable cryptography, blockchain keeps a distributed ledger of vast amounts of information in a secure manner.

If the biggest drivers of cutting-edge technology—AI, IoT, and Big Data—are to reach their full potential in healthcare, they need reliable and lightning-fast connectivity. The ever-increasing footprint of access to 5G will be a force multiplier to bring these grand designs to fruition.

The most immediate benefits are being seen in telemedicine, expanding access to care for millions. Patients have access to healthcare when and where they need it. This medium took a great leap forward during the Covid-19 pandemic and there is no looking back. Many healthcare organizations are now focusing on how best to integrate telehealth services with existing physical ones.

With next-to-zero latency, 5G-connected sensors and medical devices can capture and transmit data nearly instantaneously. Such high-speed connectivity will improve patient monitoring, which will in turn improve patient outcomes. The marriage between 5G, healthcare, and robotics has unlimited possibilities.

Augmented and virtual reality (AR and VR) have several applications in the medical world. Simulated and hybrid environments which engage our hearing, visual, and kinaesthetic senses have changed the face of medical education. Students now study anatomy more effectively by virtual reality rather than from cadavers. VR is being used in physical therapy to help patients recover from complex limb injuries and to alleviate phobias and post-traumatic stress disorder (PTSD) through customized exposure and treatment.

Wearable health sensors make patients the point of care. They are being used to diagnose critical health conditions such as oxygen saturation, blood glucose, irregular heartbeat, sleep disorders and brain activity. Some of them incorporate algorithms that can accurately predict a heart attack or an epileptic seizure.

These sensors are increasingly being used to monitor and collate health-related data. Health insurance companies and wearable manufacturers are actively advancing the principle of gamification. This involves motivating and nudging people into desired behaviours. We are grappling with the ethics of this relationship between employers, employees and health insurance companies.

Implantable devices like pacemakers and defibrillators can now be remotely monitored and controlled. Digital tattoos have now been developed for invisible tracking of vital signs every minute of day and night. Bioresorbable electronics can be placed in the body and dissolve when they are no longer needed.

Neuro-prosthetics like cochlear implants and bionic eyes are a boon to patients who have been incapacitated by irreversible hearing and visual impairment. Electrodes implanted deep into the brain for people with Parkinson’s disease activate pathways involved in motor control of the body increasing their mobility and ability to perform daily activities. Chips inserted into the brain coupled with exoskeletons are enabling completely paralyzed people to walk.

Advances in future medical technology will not just restore function but used to augment the limits of human ability. Earbuds powered with artificial intelligence are now available to translate any spoken language, making one instantly multi-lingual.

Robotic surgery is being routinely performed in minimally invasive procedures that offer precision, control and flexibility. With rapid advances in communication technology remote surgery with the patient and operator present in different continents will soon become a reality.

Nanomedicine has applications in imaging, sensing, diagnosis, and delivery through medical devices. Nanoparticles and nanodevices can operate as precise drug delivery systems or tiny surgeons. A Japanese Pharmaceutical firm has created a digestible sensor as an integral part of a drug to treat mental illness. The ingestible sensor communicates with a wearable sensor patch if the drug is taken. The information is transmitted to the smartphone of a caregiver to monitor compliance to the prescribed drug dose regimen.

3-D printing of human tissue will soon make organ transplants obsolete. Scientists have been able to create blood vessels, synthetic ovaries and even a pancreas. These artificial organs can grow within the patient’s body and obviate the need for lifelong medication to prevent rejection of transplanted organs.

Precision medicine allows physicians to personalize medication and therapies to treat diseases such as cancer. Doctors can now study an individual’s likely responses to drugs based on their genetic makeup and select personalized regimens accordingly so that they avoid undesirable side effects of prescribing a certain drug.

Monoclonal antibodies (MABs) have revolutionized therapeutics in a broad spectrum of disorders from cancer to migraine. Research into the molecular mechanism of how these disorders develop has enabled development of these highly effective and targeted therapies. Calcitonin gene related peptide antagonists are now being routinely prescribed to prevent migraine headache.

RNA-based therapeutics, which seeks to interfere with genetic data at the RNA level and intercept a genetic abnormality before it gets translated into abnormally functioning proteins. Such antisense nucleotides are being developed to combat genetic conditions such as Huntington’s Disease.

CRISPR-Cas9 is a unique technology that enables geneticists and medical researchers to edit parts of the genome by removing, adding or altering sections of the DNA sequence. It is currently the simplest and precise method of genetic manipulation. Many of the applications involve editing the genomes of somatic (non-reproductive) cells. Changes made in germline cells will be passed on from generation to generation which has important ethical implications. Emmanuelle Charpentier and Jennifer A. Doudna were awarded the Nobel Prize in 2020 for discovering the CRISPR/Cas9 genetic scissors

Medical diagnostics has been taken to a new level with the development of ‘labs on chips’. About half the size of a credit card, these contain a complex network of channels smaller than the width of a human hair that can deliver test results almost instantly, enabling expeditious institution of life-saving treatment.

Ongoing advances in digital technology such as quantum computing will be used to treat, prevent, or predict diseases. Artificial Intelligence (AI) and Machine Learning (ML) are disruptive technologies that get better with use. They are being increasingly used to assist physicians in pattern recognition and decision making.

The increasing burden of global food insecurity and its health implications are being circumvented by rapid advances in the development of synthetic food products. Laboratory grown and cultured meat now match the nutritional value, taste and texture of meat derived from animal sources.

Medical supplies and vaccines are now being routinely delivered by drones to far-flung-areas and inaccessible areas. Zipline, a Silicon Valley start-up has pioneered this approach in Rwanda and Ghana.

The digital age is also witnessing the emergence of a slew of new and novel illnesses. Virtual post-traumatic stress disorder (v-PTSD) occurs in virtual battles wearing VR masks. These gamers experience symptoms similar to those in soldiers who fight in real wars.

A consequence of these breath-taking advances in Medicine is that more than half of the healthcare workforce is projected to need reskilling in the near future.

We are now in an exciting era where all care is patient centric. Every patient is now enabled, empowered, and engaged in this new health care paradigm which is predictive, preventative, personalized, and participatory.

(The author heads the Department of Neurology at Manipal Hospitals, New Delhi after a career in the Armed Forces Medical Services spanning close to four decades. Views expressed are personal and do not reflect the official position or policy of Financial Express Online. Reproducing this content without permission is prohibited).