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The article presents speech of the author delivered on October 13, 2014, at Tirupati on the occasion of the 5th convocation of Sri Venkateswara Institute of Medical Sciences, Tirupati, India. Topics discussed in the speech included central objective and mission of medical profession, revolutionary change in the evolution of medicine and pervasive influence of science and technology in medical theory and practice. It also discusses challenges in providing training to physicians.

Ayurveda, according to Caraka, is knowledge which seeks to weigh life in the scales of wholesomeness and happiness against their opposites. Its main themes of health and disease, and recovery of health from disease take the stage against an inspiring background of intuitive philosophy, lofty idealism, and vivid compassion, which are the hallmarks of India's cultural inheritance. After centuries of neglect and stagnation, Ayurveda has witnessed an unprecedented resurgence from the twentieth century in India and abroad. Ayurveda viewed health as a state of many-sided equilibrium, and disease as its reversal. Ayurvedic practice of medicine aimed at the restoration of equilibrium and, in that process, represented more than the sum of dietary regimen, procedures and medications. [ABSTRACT FROM AUTHOR]

In a search for geochemical factors that could play a role in the pathogenesis of tropical endomyocardial fibrosis, endomyocardial tissue samples obtained from patients at necropsy or operation were analysed for major elements present in laterite and monazite, which are important soil constituents of Kerala State of India. Atomic absorption spectrophotometry was used for detecting iron, silicon, aluminium, zinc, magnesium, calcium, sodium, potassium, and manganese and neutron activation analysis for thorium. Compared with control samples from victims of fatal accidents, an excess of thorium, sodium, and calcium and a deficiency of magnesium were present in samples from patients. It has been shown earlier that the staple diets of people in Kerala have high concentrations of thorium, and these data show that thorium can become concentrated in cardiac tissues. It is speculated that thorium excess in conjunction with magnesium deficiency may play a role in the causation of tropical endomyocardial fibrosis. [ABSTRACT FROM PUBLISHER]

The application of various polymers, both synthetic and natural, for biomedical purposes has made such tremendous progress during the last two decades that a wide variety of biomaterials and blood-contacting devices are currently being used in cardiovascular, orthopaedic, and dental applications throughout the world. Implantation of heart valves, catheters, etc. has become more or less a routine affair in cardiovascular surgery. Most of these devices are being fabricated from polymers, and the basic requirements for developing such a biocompatible polymer are very rigid. It has to be sterilizable, nontoxic, easily fabricable, highly resistant to mechanical strains, should not produce allergy or hypersensitivity, not incite any inflammatory response, and also should not degrade chemically [1]. [ABSTRACT FROM PUBLISHER]

Endomyocardial fibrosis is a fatal disease of obscure aetiology which is notably prevalent in Uganda, Brazil, Kerala State in India, and certain other parts of the world. The main disability in the disease results from fibrotic obliteration of ventricular chambers and insufficiency of the mitral and tricuspid valves. The poor response to medical treatment and the bleak prognosis of the patients led to the introduction of endocardiectomy and replacement of the atrioventricular valves as a palliative procedure by Dubost and colleagues. The present report on the early results in 17 patients from Kerala State would support the continued use of this palliative procedure in endomyocardial fibrosis with severe disability. [ABSTRACT FROM AUTHOR]

The survival pattern, morbidity, and clinical course of 145 patients with endomyocardial fibrosis who were followed up between November 1975 and June 1987 were studied. The diagnosis was confirmed in all cases by cardiac angiography, or echocardiography, or necropsy. Percentage survival at the end of one and 9.5 years was 76.11 and 26.35 respectively. History, physical examination, electrocardiography, and cardiac catheterisation were studied at the first presentation. The determinants of early mortality were studied by univariate Kaplan-Meier estimates compared by the log rank test and Cox proportional hazards multiple regression analysis. Significant univariate predictors of early mortality were QRS axis above +90 degrees, intraventricular conduction delay (QRS duration greater than 0.12 s), duration of symptoms before presentation, New York Heart Association functional classes III and IV, presence of embolic episodes, right atrial mean pressures greater than 20 mm Hg, right ventricular end diastolic pressure greater than 20 mm Hg, and aortic oxygen saturation less than 85%. The significant multivariate predictors of mortality were cyanosis, New York Heart Association functional class at first presentation, and right atrial mean pressure greater than 20 mm Hg. The bleak prognosis of endomyocardial fibrosis did not substantially improve despite advances in the medical management of congestive cardiac failure during the period of the study. [ABSTRACT FROM PUBLISHER]