India has unique disease threats especially from viral agents such as Rabies, Dengue and JE. Most of the PhDs and post docs prefer to work abroad on HIV and Cancer. Is the Indian government responding adequately? How can the Indian government organizations promote research and build opportunities for young scientists who wish to focus on these diseases? What are the research priorities now?
Actually, the students of the current generation are much more knowledgeable and well informed. In our days we had minimal information about our teachers. We just knew the good ones from the bad ones. But today a student visits Pubmed and explores the teacher’s horoscope- the number of publications he has, the journals in which he has published and the impact factor of those journals. The students compete to enroll under the best scientist that he locates. In India we have only a few institutions with brilliant scientists who have a captivating track record. Amongst research institutes, Indian Institute of Science (IISc), International Center for Genetic Engineering & Biotechnology (ICGEB) and National Institute of Immunology (NII) are our premier institutes. For MBBS, the foremost institutes are All India Institute of Medical Sciences (AIIMS) and Jawaharlal Institute of Post Graduate Medical Education & Research (Puducherry). As I mentioned earlier, there is no dearth of money for research purposes. The number of truly initiated research scholars however is steadily diminishing. The most brilliant students would like to pursue their knowledge in a foreign land. A lot of social factors also contribute to this brain drain. Young persons are very honest, and want everything right. When he does not find everything right in this country and is not able to adapt, he looks for better and the glamorous conditions outside this country. Of course, they have to struggle a lot to establish their work, but still, people are moving out of our country. Another reality is that in some of the foreign countries the worth is in one’s talent, for a human being and not for ill gotten money.
Clinicians apprehend to ask a biological question and basic scientists apprehend to ask a question regarding health care. What is your comment on it? How can we bridge this gap? Recently, many of the medical institutes of national importance have started MD with Ph.D programmes and M.Sc in medical subjects. What is your opinion about these courses?
There is always diversity in clinical features and symptoms caused by virus. 23 different genotypes of Measles virus cause classical measles with text book described symptoms in patients. Other viruses like Rabies, Dengue and JE show unusual symptoms in patients. What could be the role of host factors in preventing the viral infection and in controlling the sneaky way in which the virus evades immune mechanism?
In any infection, the outcome depends on host factors as well as the invading pathogen. Inbuilt mechanism of the body is strong enough to prevent the entry of virus or any microbial agents. A variety of mechanisms are included in ‘innate immunity’ which plays a major role. But this is a world of survival of the fittest; so viruses have developed different modes of invading the human body. Normal intact skin cannot be invaded, but if there are some aberrations or cuts, they are successful in intruding. The same is true for nasal mucosa and gastrointestinal mucosa. Once the virus gains access to the human body it will successfully replicate and host responses will also precipitate. You might have heard about Vibhishan in Lanka who provided information stealthily, leading to the defeat and death of Ravan. Similar is the case with viruses. In our body we have cells of the reticular endothelial systems whose job is to kill the enemy ie., the virus. In some viral infections the macrophages are the sites of replication for the virus providing food, shelter and everything that the virus needs to replicate. They act like Vibhishan, causing damage to the body. The reticular endothelial system is designed to resist and not protect the invaders. There are intracellular mechanisms to prevent virus replication. Specific protection is provided by antibodies. But in certain circumstances, for example, Dengue hemorrhagic fever, cross-reacting antibodies precipitate more severe conditions of the disease. Intracellularly, there are mechanisms which can promote virus replication. In short, even though our body has so many basic mechanisms, it is not able to control virus replication on several occasions.
Viruses infect large number of host bodies, but do not necessarily cause clinical illness in all infected persons. Even in any epidemic, 100% of infected people will not show clinical illness. With Japanese encephalitis virus infection, clinical illness may be seen in 1 in 1000 to 5,000 or more infections.
Researchers use innumerable methods and techniques but they often end up with contradictory results. What do you have to say about that?
Research is driven by different forces. You document what you observe when research is driven by curiosity or a craving for new knowledge. If it doesn’t fit into your thinking, you repeat it a number of times and finally you arrive to a concrete conclusion. Such data will be reproduced by some one else. The second type of research is driven by other interests and then conflicting data will be produced. Thirdly, if the method used differs from a conventional or standard one, or if a faulty technique, reagent or instrument is employed, one is more likely to obtain contradictory results. Therefore researchers should be very careful with different quality control measures.
India has a unique and indigenous method of treating patients. Will it be useful in antiviral discoveries and treatment?
Before I answer your question let me tell you one thing. Mr. Rajiv Gandhi had established different technology missions and in one of the missions he had made a plan to organize an interaction between modern scientists and Ayurveda acharyas. I was one of the 5 members chosen to represent modern science. The meeting was held in Ahmedabad. I listened to 50 Ayurveda acharyas as they narrated on physiology, pathology and even about intracellular mechanisms. They could comprehend the mechanisms and describe it in their own terms. When they were talking I could visualize about lysosomes, mitochondria and intracellular enzymes. There I realized the wealth of information in Ayurveda, but the truth is that it has been suppressed by vested interests. The lead for a large number of medicines has come from Ayurveda. Treatment of chronic diseases and persistent diseases is very efficient, but their management of emergency situations is slow. In modern medicine we talk of an active principle in a medicine; in Ayurveda we talk about a crude extract which has so many different components. It is very difficult to quantitate the effect of crude extract because it will depend upon many factors such as the age of the plant, habitat, soil constitution and the prevailing climate. All these factors will determine the content in the plant, and so the homogenate is a mixture of a large number of necessary ingredients. Therefore quantization becomes a problem. If we can overcome these hurdles using modern tools, certainly we can get much better results.
What is your advice and suggestions to young investigators, scientists and medicos who would like to pursue research and publsh in high impact top tier journals?
There are two aspects of judging the quality of a paper. First of all one should ascertain how much it has improved the quality of our life. A simple paper published in a journal with no or low impact factor, but which has definitely improved the quality of life is probably the best. The other aspect is, impact factor driven research means generally that we are technology driven. Apart from that there are fashionable topics. The general assumption is that if I work on a particular fashionable topic it will be published in the best of the journals. Who determines, what is a fashionable topic? It is definitely not the individual scientist, but somebody else who has their own interest. So in the best interest of the country, my advice to youngsters would be to locate a local problem and attempt to solve that problem. Leave the high impact journal to some other scientists and let them publish. There are institutions that can do it. For a medical scientist, the aim is to find out better treatment, better management, better diagnostic tools or provide a new understanding of a disease processes. Of course, tremendous advancement has occurred in medicine in the last so many years, especially in surgery.