UNFOLDING THE MYSTERIES OF GENETIC SCIENCES IN INCURABLE DISEASES LIKE CORONARY ARTERY DISEASES, CANCER, & RAREST OF THE RARE DISEASES LIKE MOYAMOYA, SLE, TAKAYASU ETC.

             What is Coronary artery diseasE ?

         There are two coronary arteries right and left which branch out and encircle the entire heart supplying nutrition to heart muscles. Diseases of the coronary arteries have become  the single greatest threat to life in industrialized countries throughout the world. Coronary arteries supply blood to myocardium. Any obstruction with the blood flow through the coronary arteries deprives the myocardial cells  with oxygen, causing heart attack and death depending on the severity of  the attack.

Several factors which are termed as risk factors, are  involved in development of coronary artery disease, but  no single mechanism is yet held responsible for CAD.

Sex  and age: CAD is more prevalent in men  than in women. Females at child bearing age are protected from this disease  till the menopause. This sex-age discrepancy suggests that hormonal influence  may be important in the disease. Incidence of CAD increases greatly with age in both the sexes.

Hypertension: This is one of the most serious factor, accelerates the atherosclerosis and increases the oxygen demands of the myocardium.

Heredity: It was thought heredity ranks among the highest risk factors.

Diabetes: CAD develops more frequently at an earlier age among diabetic patients.

Sedentary life style: Lack of physical activity in sedentary workers is also one of the risk factor.

Obesity: This is one of the risk factor even though its mechanism of action is yet to ascertain.

Emotional stress: Rapidly changing socio-economic and socio-cultural life style of  civilized society brings stress and anxiety, with modern life style which helps in fat deposition with reduced myocardial and peripheral perfusion, blocking blood supply to myocardium and sudden death.

Diet: High fatty diet was thought to increases lipid deposition which is one of the important factor in atherosclerosis.

Smoking & excessive drinking: Myocardial infarction is associated with smoking and excessive drinking which raises mortality rate.

 Background & Objectives :--

         Coronary artery disease is commonly known as a killer disease next to cancer and till now, no curative medical therapy or surgical procedure have been found out. Incidence of  Coronary artery disease (CAD) is higher in case of patients with diabetes and hypertension. Females  carry more risks for CAD than males. CAD is commonly found in age group between 30-55 years in case of males and in case of females, it is after menopause. It is thought that high fatty diet, smoking, and type A personality  are the common causes of CAD  compared to genetic involvement.

The symptoms of CAD are commonly known to everyone. However, chest pain is the commonest symptom  if the left coronary artery is involved and breathlessness if the right coronary artery is involved. Till today, there is no cure found except palliative or  temporary relief given to patients by performing coronary artery bypass surgery (CABS).

       Coronary artery bypass surgery has been started a way back in late sixties and presently, it is regularly performed in every small and big hospitals all over the world. Bypass surgery is never found to be curative procedure and disease is always recurring. International statistic figure says the rate of recurrence is 12% interst year and 100% in 13 years. Many surgeons have devised number of devices, but still recurrence is present. When patient comes with recurrence, it is worst than the first time and risk is increased by two fold. Patients’ own saphenous vein, internal mammary artery, gastric- epiploic arteries, radial arteries are used, but still recurrence is unavoidable   because the disease remains in situ., only it is bypassed by the new graft. Disease will crepe off in the graft giving the blockages at more than one place, reducing the blood flow to the myocardium, inducing the heart attack for more than once and cause instant death. It was thought that exercise has major role to play in reducing CAD, but it is not the fact.

In recent years, coronary artery disease (CAD) is recognized as dreaded killer disease, which has superceded the incidence of premature death on this planet. Since many years, researchers have continued to blame the modern civilization, which is the root cause of dreaded disease. Probably, it is not absolutely untrue. However, it was also thought that individual’s life style and food habits are also responsible factors.   Still we have to gather the evidences that  major cause of the coronary artery disease leading to premature death is the highly atherogenic diet.

Eating highly atherogenic diet, drinking alcohol and smoking have become the aristocracy, which lead to the CAD. In the evening, people are eating highly atherogenic diet, drinking alcohol and in the morning go for some form of exercise to feel better. However, my  research work has strong proof, that no matter what type of exercise man does, it is useless and does not play any role to minimize the CAD as it can never alters the blood chemistry. 

Although, it is blamed that change of dietary regime and life style, are the major causes of  CAD, we have found that it is not absolutely true. It plays a small role, but major role is played by change of m-RNA expressed genes which are greatly influenced by the change of mental status of the individual. These changes in mental status make the m-RNA expressed genes to be diseased which brings errors in metabolic pathways and ultimately expressed in diseased form in particular type as applicable. Had the theory of change of life style and regime causing the disease is true, every individual on this planet would have suffered from heart disease as  change of food regime and life style always occurs in certain phase of life of every individual, therefore, I disregard this theory of change of life style and food habit are the major causes of this disease, but however, this is considered to be a one of the contributory factor. 

There are many instances, during exercise man gets heart attack and die instantly and some survive with uncertain future and patient ends up with coronary artery bypass surgery, which is the wrong surgical procedure, I have observed. I feel medical science in particular reference to  cardio-vascular sciences is going in wrong direction. 

I want to bring the change in  medical science in particular reference to  cardio-vascular diseases through my long-term extensive and expensive research work. 

I have started this research work since 1985. I am a cardiac surgeon who has invented artificial biological heart valves mimicking the natural heart valves, artificial heart-Baruah Heart 21, Coronary bio-grafts and several other critical cardiac devices. In 1997, I did first clinical cluster xenotransplantation using pig as a donor. My pioneering work is followed by the world scientists. I have discovered biological molecules from edible medicinal plants, which I have used  for genetic engineering to engineer m-RNA expressed diseased genes which helps in recannalization of diseased coronary artery, to cure diabetes mellitus & hypertension and removes excessive intracellular Calcium to eliminate life threatening arrhythmia and premature death. Confidently, I say that coronary artery bypass surgery is not required to do anymore.

        After performing several thousands of coronary artery bypass surgeries, I have realized that neither me nor my colleagues have done justice to patients, where recurrence is unavoidable and patient has to live with uncertain future. During my several years of experience in cardiac surgery with particular reference to Coronary artery bypass surgery (CABS), I have made the following observations:

Cardiac surgeons, are not doing any justice to the patients with coronary artery disease by performing CABS.

Coronary artery disease is a progressive generalized disease involving entire arterial tree of the individual.

CABS is a temporary and palliative surgical procedure where 100% recurrence is inevitable as the disease remains in situ. Progressiveness of the disease after bypass surgery is quite faster and aggressive. It takes 5-15years for a patient to get symptoms and to go for bypass surgery. But, for recurrence, it takes only few days to few months where premature death is made to be certain.

CAD is  atheromatous  disease involving coronary arteries and entire arterial tree of human body. Patient comes to doctor with chest pain because  heart muscles requires more oxygen in comparison which deprives because of blockage of arterial lumen.

How it affects the other organs?

                  My observations have suggested that all the coronary artery diseased patients have increased viscosity of blood, which further aggravates the low perfusion to end organs.

Surgeons are taking part of radial artery, and whole of internal mammary arteries as the conduit, which are already diseased with atherosclerosis.  These diseased conduits are grafted to bypass the blockage by anastomosing beyond the blockage and proximal end in ascending aorta above aortic valve. These conduits get further blockage quite early compared to  native sites leading to early recurrences. 

Diseased arterial conduit is used to bypass the atheromatous sites of native coronary arteries and according to my view, performing CABS, we are doing totally injustice to CAD patients. I would have accepted bypass surgery if the patient could have come back with  recurrence after 30-40years, but what me and my colleagues have observed that recurrence is inevitable even immediately after performing bypass surgery.

In conclusion, bypass surgery is the mismatch surgical procedure injurious to heart and health leaves the patient with uncertain future leading to premature death.

          Since 1980,  while I was working as a cardiac surgeon in Glasgow Royal Infirmary under Glasgow University, UK, I was thinking to find out the drug to prevent CAD to relieve the misery of the heart patients suffering from CAD as they use to come back with recurrence. However, I was unable to undertake the program as since 1984, I was involved deeply in research activities. At the end of 1995, I established by heart institute-Dr. Dhani Ram Baruah Heart Institute & Research Centre at Sonapur, Assam and carried out first open heart surgery in January 1996, first time in the entire North-eastern region. During this period, I observed that tribal villagers within the vicinity of the hospital campus  appeared to be immune to CAD, but have other communicable diseases. When I enquire about their food habits, they showed me lots of herbs, plants named or unnamed those they were consuming. They use these plants as vegetables or medicines for certain diseases. Accordingly, with the help of villagers, we collected 252 medicinal plants and cultivated in the vicinity of the hospital campus. We have observed that those plants can be grown in the climate of Assam and not in any other parts of North-eastern states. Although those herbs or plants are edible and eaten by villagers for years together, but we wanted to see the efficacy or safety of it as I thought may be one plant is curing one disease, but it may create some other complications, which may not be known to the villagers. So far  we are concerned or our knowledge goes, none of the previous or present researchers have done research work so vigorously or deeply on those herbs or plants.

 

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