Research : a neccessity Research : a neccessity D A il J i Dr Anil - - PowerPoint PPT Presentation
Research : a neccessity Research : a neccessity D A il J i Dr Anil Jain Professor of Orthopaedics University College of Medical U i it C ll f M di l Sciences, D lhi Delhi & Edit Editor Indian Journal of Orthopaedics
D A il J i Dr Anil Jain
It is an art Transformed from an art based on “belief in
This art is learnt by “observations of talented
to documented evidence and than on validated
More and more knowledge based on scientific research For diagnosis For treatment and For prevention of the disease Will reduce guess work to achieve pt care.
Will reduce guess work to achieve pt care.
Modern medicine
Chinese medicine
Ayurveda
Evolved from ongoing body of practical
medical experience passed down orally h h i il through numerous generations until, eventually, it was written down.
Sushruta‐samhita ‐ 1st century BCE, Charaka‐samhita ‐ 1st century A.D.
y
Ayurveda ‐ far ahead of Western medicine in surgery Based upon a combination of empirical treatments. erroneous religious and philosophical
like Ayurveda,
E l d f l i ifi f
Evolved from a long pre‐scientific stage of
development,
applied proper scientific principles
medical foundation. ‐‐‐‐‐ Discarded
This is something that Ayurveda never did;
g y
Unique
R i f
Region of contrasts Highly developed to poorest of poor Excellent health infrastructure to no infrastructure
Bangladesh, Myanmar, ‐population 213 million
I di P ki Vi N h K j d
India, Pakistan, Vietnam, North Korea – just entered
in lower middle income countries
World population – 6900 million
GNI ‐ US$996 and US$3,945 Sri Lanka Philippines Indonesia 561 millions Sri Lanka, Philippines, Indonesia ‐ 561 millions
GNI 8 US
Just entered in upper middle income countries Population‐ 1337 million Total population – 1705 out of world 6900 million
Total population 1705 out of world 6900 million
US$3,946 and US$12,195 Malaysia , Thailand ,Turkey Population 170 millions
World population – 6900 million
World population 6900 million
GNI above US$11,906.
A li H K N Z l d T i
Australia, Hong Kong, New Zealand , Taiwan ,
Singapore, South Korea , Japan
Population‐ 438 million
Population 438 million
AP region ‐ 4086 millions ‐‐‐World – 6900 million LIC and Low middle income countries (87% or
LIC and Low middle income countries (87% or
Practices are guided by the west . Whatever advocated followed in principle and
f ll practice successfully
Reason – there was not much disimilarity in
di fil 6 disease profile 60 yrs ago.
Travel 50‐100 km for basic health services
P id l i
Provide elementary services No financial resource to reach bigger city hospital Hence treated by osteopaths or non‐specialist We get all complicated cases Minimum standard of care not assured
Fresh fractures Neglected fractures
Complication of
All
All spectrum of
Natural history of
Health services – urban based Population rural based Population rural based
Urban based health services
Tremendous intellectual capacity Lack “state of art” infrastructure ‐
l d
Heavy pt load Poor record keeping
f ll
Poor follow up Migratory population No hospital specific – clinical work
State of art technology
Li i d li i l k i l d f
Limited clinical work – in volume and spectrum of
disease N li b b i li
Not generalist but sub‐speciality experts
We should know Burden of musculoskeletal disease and trauma in Burden of musculoskeletal disease and trauma in
total and in specific geographic area.
Not even planning to have data. No disaster plans
Books written by western authors
TB is just mentioned and PPRP removed TB is just mentioned and PPRP removed
Neglected trauma – just mentioned
We have clinical problem at hand
W h i ll l i
We have intellectual capacity We have technical know how What needs to be added ‐‐ will to do Infrastructural support
Total – 66 of over 300 less than 20% of total world contributions less than 20% of total world contributions Over 75% population contributes less than 20 % Low income ‐ 0 ( 15 ,India‐9, North korea ‐6 ) – 30% Lower middle –0 ( 8 china)‐ 12% Upper middle‐ 4 ‐ 6% Upper middle‐ 4 ‐ 6% High –39 –
60%
Transform biological discovery to medical treatment
Research temper Research temper Funding I f
t t
Infrastructure Balance between Service and research
How can we inculcate scientific temper and have a How can we inculcate scientific temper and have a
regular bench of clinician scientist
Stimulate faculty for research Improve research funding Provide institutional support for research Give extra credit for performers Give extra credit for performers Give extra credits for researchers over non
Scarce funding – private
Private funding – clinical trials in development
UNESCO recommonds‐ 2% of GDP for growth and
d l t development
US and Japan – 2.8% Canada‐ 1.5% India ‐ .8%
No research cell
Ancillary facilities‐ biostat . Ethical committee
Time allocation for research Access to information
Literature support –poor
Journals not available, Most of journals cost heavy Most of journals cost heavy Very few open access
No exotic topics
T i i hi hi h f d
Topic is something – which we face everyday Because‐‐‐ You can bring out something new on what you see
most
Define regional needs
C i i f h ’ l
Creating an environment for research‐ can’t leave to
individual clinician’s preference H l i i b i h
Help in overcoming barriers to research Guidance to conduct research Need based teaching curriculum Avenue for publications Rewarding clinician‐scientist
Co‐ordinate credible need based research
Id if i i i i h d i f d
Identify institutions ‐ with good infrastructure and
technical knowhow – such as India, China, Pakistan ‐ We have both worlds and personnels to do that We have both worlds and personnels to do that
In house training
G i f i LIC d MIC
Grooming future mentors in LIC and MIC Because we match developing and developed nations
l l bl in clinical problems
Do it for your problems Do it for others Because we can generate evidence for developed
nations.
Living biology is our strength We should use it for alleviating pains of suffering
g g humanity
To bring about a change in mindset
R h i hi b i f i i l ll
Research is nothing but a summation of a critical well
thought of conclusions about the outcome of treatment we offer to the patients everyday treatment we offer to the patients everyday.
And
W ll h h f i i d k
Well thought of innovations we undertake Which we were doing since time immemorial Only change now ,wish to do at a faster pace Ensuring it is retrievable beyond human life
g y
Could we prevent this We need to diagnose
We have to treat them in
By meagre resources in
Nineteen Member Chapters.
A li B l d h Chi H K I di
Australia, Bangladesh, China, Hong Kong, India,
Indonesia, Japan, Korea, Malaysia, Myanmar, New Zealand Pakistan Philippines Singapore Taiwan Zealand, Pakistan, Philippines, Singapore, Taiwan, Thailand, Vietnam Turkey and Sri Lanka.
Nineteen Member Chapters.
A li B l d h Chi H K I di
Australia, Bangladesh, China, Hong Kong, India,
Indonesia, Japan, Korea, Malaysia, Myanmar, New Zealand Pakistan Philippines Singapore Taiwan Zealand, Pakistan, Philippines, Singapore, Taiwan, Thailand, Vietnam Turkey and Sri Lanka.
Low income countries had GNI per capita of US$995
Lower middle income countries had GNI per capita
between US$996 and US$3 945 between US$996 and US$3,945.
Upper middle income countries had GNI per capita
between US$3 946 and US$12 195 between US$3,946 and US$12,195.
High income countries had GNI above US$11,906.