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India needs 35,000 dialysis machines, it has only 1,000

It is a country where an estimated 20 lakh suffer kidney afflictions every year. Of which, 10% are put on dialysis or need to have their kidney transplanted. And, the numbers, according to nephrologists, are alarmingly doubling at the turn of each year. Forty percent of birth defects in children are kidney related.

It is a nation, whose healthcare centers put togther could be barely equipped with 1,000 dialysis machines, when at least 35,000 are required to tackle what can be described as a frightening scourge. In Kolkata alone, around 13,000 people are rushed to clinics and hospitals with rundown kidneys yearly and, of them, normally over a 1,000 are critical patients.

"Sadly, even those in dire need of a transplant wait in a queue. The government’s Organ Transplant Act of 1994 has banned doctors other than relatives of a patient from donating kidneys. Other than that, kidneys can be sourced from cadaver (brain dead) cases. In such a scenario, the demand for kidney replacements far outstrips availability of this life-saving organ", Dr. P Ravichandran, nephrologist and kidney surgeon, told ET.

"If the government enacted the Act, it should ensure that the country has enough dialysis machines to keep the patients alive till they get a kidney", he added. Dr. Ravichandran heads the Institute of Kidney Disease & Organ Transplant at the Madras Institute of Orthopaedic & Traumatology (MIOT).

The situation looks woeful when compared with western countries or southeast regions like Singapore or Malaysia. With treatment costs involvint dialysis and medicines ranging anywhere between Rs.20,000 and Rs.25,000 monthly here, most critical kidney patients are compelled to throw in the towel after 1-2 years.

"In Singapore, Malaysia or the West, even dialysis patients lead normal lives and survive 10 to 20 years. This is largely because of government funded schemes and insurance cover. Singapore is smaller than Chennai. Yet, it has 38 dialyais centers each armed with 32 machines," Dr. Ravichandran said. ‘Delinked centres’ could be one way of countering this predicament, according to him. A dialysis entails half the cost at a delinked center because it is not saddled with a hospital’s or clinic’s extraneous overheads.

(Ref: The Economic Times, Ahmedabad, June 4, 2001)

Chitra Institute to develop heart valves, blood vessels and muscle strengthener

Shree Chitra Thirunal Institute of Medical Sciences and Technology (SCTIMST), Thiruvanathapuram, is working on developing artificial blood vessels, gicuspid valves and cardiac muscle strengtheners for use in cardiac surgery. Though the Institute sources declined to give more details about these new products, it is learnt that the artificial cardiac parts will be made of specialised alloys.

SCTIMST, the premier institute of Kerala in the field of cardiac treatment and research, had recently developed Chitra heart Prosthesis that has been marketed by the Chennai-based TTK Healthcare Ltd.

It is learnt that this is for the first time in Asia, that an Institute is developing an artificial blood vessel and a cardiac muscle strengthener. It may be mentioned that the Russian scientists had been working on developing an artificial blood vessel, a project that was abandoned when the erstwhile Soviet Union split. The project was almost nearing a possible development when it was abandoned.

The artificial blood vessel, it is learnt is being developed using a specialised synthetic material that has both the flexibility and elasticity. Even though, the composition of the synthetic material was not divulged by the sources, they said that it was being developed in association with two private research institutes and a defence research establishment.

"This artificial blood vessel will find use in case of coronary bypass and other ailments of blood vessels. It can, not only be used as a replacement, but also can be joined among with the normal blood vessel. We are currently working on the fusion of the artificial and the natural blood vessels," the sources claimed.

The biscuspid valuve will be another product in the valve range being developed by the institute. The earlier one – Chitra valve, is now available in the market, which is currently known as Chitra TTK valve.

The Chitra-TTK valve is a tilting disc valve design incorporating a metallic housing, which is integrally machined from a cobalt-based alloy. The circular disc inside is made of ultra high molecular weight polyethylene and a polyester suture ring provided for stitching it into the muscles of the heart. The product was developed after almost a decade of research initiated in 1992 by a team led by Prof. Vallianathan, the then director of the institute. The cardiac muscle strengthener is also the first of its kind undertaken by any research institute in Asia. The product, according to the sources, will be implanted in patients who have weaker or fibrous cardiac muscles that lead to myocardiac failure.

However, the sources claim that the Institute would be able to finalise the development process, and likely to be commercialised by 2003. Shree Chitra Institute was first in the country to successfully develop and commercialise the Heart Prosthesis using indigenous technology. The product is said to have even surpassed the performance of imported artificial valves.

[Ref: Chronicle Pharmabiz, May 24, 2001]

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In the News...

India needs 35,000 dialysis machines, it has only 1,000

Chitra Institute to develop heart valves, blood vessels and muscle strengthener

TTK Healthcare plans to export artificial heart valves

First balloon valvuloplasty performed at Rajaji Hospital, Madurai

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