|Year : 2016 | Volume
| Issue : 2 | Page : 69-70
From Neeti to Niyat
Sandeep Seth1, Shymal K Goswami2, SK Maulik3
1 Department of Cardiology, AIIMS, New Delhi, India
2 School of Life Science, Jawaharlal Nehru University, New Delhi, India
3 Department of Pharmacology, AIIMS, New Delhi, India
|Date of Web Publication||7-Oct-2016|
Department of Cardiology, AIIMS CN Centre, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Seth S, Goswami SK, Maulik S K. From Neeti to Niyat. J Pract Cardiovasc Sci 2016;2:69-70
I will speak not only of Neeti(policy) but also of Niyat(intent).
As India celebrates 70 years of Independence, and the Prime Minister says, “I will speak not only of Neeti (Policy) but also of Niyat (Intent),” we also look at what we can do to relieve the emerging burden of cardiovascular disease in India. Cardiovascular disease is rising at an alarming rate in India. For the Indian population, the onset of coronary artery disease (CAD) is early and it is more malignant. Heart failure is also more severe in India and the patients have the worse outcome. Guidelines/policy statements (Neeti) for the management have been taken out for the management of risk factors for CAD and heart failure. These are available from the AHA, from the ESC, and also from the Indian Associations handling these diseases. What we need now is a concerted action (Niyat) to implement these guidelines by spreading the message by simple action cards/calendars/posters, etc. In the previous issues, we took out simple guidelines on heart failure for India, and in this issue, we have simplified algorithms for the management of risk factors for CAD (hypertension, diabetes, dyslipidemia, and others). These have been abstracted from the elaborate guidelines and made highly succinct for both professionals and others. We hope that these will spread the message of these guidelines far and make its implementation easier.
Going from guidelines to research, in an article on “Medical Research in India,” Dr. KK Talwar talks about the scientific achievements of Indian stalwarts such as Har Gobind Khorana and AS Paintal, who were leaders in the research in India. He highlights the designing of the Chitra valve and testing the DOTs regimen. At the same time, he emphasizes the need to improve the quality of research in India if we have to compete with the best in the world.
Gene expression has the nodal role in the function of any cell type. It is precisely controlled and largely dependent on various pathophysiological conditions. RNA can code for proteins (i.e., they are messenger RNAs [mRNAs]) or be non coding RNAs. These noncoding RNAs are involved in controlling gene expression. MicroRNAs (miRNAs) are one type of small noncoding RNAs that regulate gene expression either by directing their target mRNAs for degradation or by translational repression. In this issue, Dr. Madhu Khullar from PGIMER, Chandigarh, discusses the importance of miRNAs in regulation of gene expression and illustrates it with their experience with control of gene expression in diabetic cardiombyopathy experiments.
The article on prosthetic heart valve  shows the importance of careful documentation of outcomes and data analysis. In a simple, observational study, the authors have shown that in prosthetic heart valve thrombosis, streptokinase (STK) given as a slow infusion causes less complications as compared to the newer and more specific tissue plasminogen activator and it is also more successful in opening the valves. In another study on iron deficiency in heart failure, more than half the patients with heart failure had iron deficiency and only one-third of these had manifest anemia. Iron deficiency, even in the absence of anemia, attenuates aerobic performance and replacing it improves cognitive function and exercise performance in patients with systolic dysfunction. This therefore is a simple parameter to check and correct in our patients.
The story of heart transplantation traces the race to the first heart transplant  and brings out lesser known stories from India. We also show the clinical approach to a patient presenting with “Cyanosis in an Adult.”  The book review on “The Checklist Manifesto”  is very important in an era of high volumes and recent reports of surgery on the wrong leg in a Delhi hospital. Letters from the Lipid Association of India  and the 55/65 rule  highlight different approaches to tackling the CAD epidemic.
“The Journey of a Thousand Miles begins with one step”
– Lao Tzu
In this issue, we have talked about simple steps such as algorithms for CAD reduction, using older drugs such as STK for valve thrombosis and looking at iron deficiency in heart failure. We have also talked about a simple checklist to prevent errors and a simple 55/65 rule for risk prevention for CAD. With these small steps, we hope to go a thousand mile journey to reduce the burden of CAD and heart failure in India.
| References|| |
Seth S, Ramakrishnan, Roy S, Karthikeyan G, Verma SK, Bhargava B, et al
. Algorithms for Cardiovascular Disease Prevention. J Pract Sci Cardiovasc 2016;2:86-94.
Talwar KK, Malhotra S, Medical Research in India: Time to Act. J Pract Sci Cardiovasc 2016;2:71-4.
Raut SK, Kumar A, Khullar M. Epigenetic Role of MicroRNAs in Diabetic Cardiomyopathy. J Pract Sci Cardiovasc 2016;2:79-85.
Patil NC, Doshi S, Singh S, Karthikeyan G, Bahl VK. Streptokinase versus Recombinant Tissue-type Plasminogen Activator for Thrombolysis of Mechanical Prosthetic Heart Valve Thrombosis. J Pract Sci Cardiovasc 2016;2:103-9.
Verma S, Dua P, Saini A, Chakraborty P. Iron Deficiency in Chronic Systolic Heart Failure (INDIC Study). J Pract Sci Cardiovasc 2016;2:99-102.
Kalra A, Seth S, Hote MP, Airan B. The Story of Heart Transplantation: From Cape Town to Cape Comorin. J Pract Sci Cardiovasc 2016;2:120-5.
Krishnan S, Krishnamurthy P, Ramakrishnan S, Gupta S. Case of Cyanotic Congenital Heart Disease. J Pract Sci Cardiovasc 2016;2:114-9.
Singh M. The Checklist. J Pract Sci Cardiovasc 2016;2:132-3.
Iyengar SS, Puri R, Narasingan SN. Lipid Association of India Expert Consensus Statement on Management of Dyslipidemia in Indians 2016 - Part 1. J Pract Sci Cardiovasc 2016;2:134-5.
Bhargava B, Bhargava R. 55/65 Rule for India Risk Prevention. J Pract Sci Cardiovasc 2016;2:136.