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One More Reason To Applaud The Saint John's Research Institute

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It is a vetted site for 2009-2010 Fogarty International Clinical Research Scholars /Fellows.

According to Johnite Denis Xavier [batch of 1987] the Director of this program at this site for the FRCIS, the St. John’s Research Institute scores a 2, with one being the highest score and five the least.

The Research Institute can identify research scholars from India who can go to the US for training and similarly the Fogarty center will identify and send scholars from the US to St. John’s for training. The grant includes US$45,000 per annum as stipend and funds for research travel and other relevant expenses. Please see the website for further details.

Background

The Fogarty Scholars Program was created in response to a recommendation in The Report of the External Advisory Panel to Review the NIH/FIC International Program (1997). The purpose of the program is to integrate the Fogarty Scholars-in-Residence Program more closely with trans-NIH and intramural activities.

The new program differs from the former program in that :
1) the nominations process will be broadened to include recommendations from Chairs of Special Interest Groups as well as from IC Directors;
2) funding for Scholars will derive from one or more ICs; and
3) any appropriate appointment mechanism may be used to support Scholars, including an FTE-bearing position or contract support.

Definition

A Fogarty Scholar is an honorific designation for the most distinguished visiting scientists. The purpose of the program is to invite world-renowned scientists to serve at NIH for a period of one year. One explicit review criterion will be the extent of a scientist's association with one or more Special Interest Groups.

IC Responsibilities

ICs must provide necessary resources to effect a successful assignment, including office space and support.

Fellowship Site: India-Bangalore
International Site: St. John's Medical College and Research Institute
Country: India
Denis Xavier, MD
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St. John's National Academy of Health Sciences was started to train medical professionals at the highest level and at the same time with an orientation to serve the medically underserved areas of the country. The institutions at St. John's namely the medical college and the nursing college are amongst the best in the country.

The St. John's Research Institute is the first of its kind in the country with its own dedicated buildings [approximately 50,000 square feet and growing], staff [core leaders, 34 and a total staff strength of over 300] and facilities including state of the art laboratory equipment and clinical / community research facilities, Further the Clinical Trials Division runs its clinical research programs in over 140 sites in the country – the largest network of clinician researchers in the country.

The large hospital [1200 beds] offers excellent clinical material for training in tropical disease as well as in non-communicable disease. This is a preferred destination of medical students from North America and Europe for the last 20 years to complete their posting in tropical diseases and to experience medicine in a developing country. In addition we have several out reach community centers [especially Mugalur approx 25 miles and Palamner, approx 110 miles] where medical students both from St. John's as well as those from other countries use for training.

Research Opportunities:
The Research Projects that would offer strong research training opportunities at our Site may be viewed from three areas
Clinical epidemiology and community interventional projects
Clinical and community nutrition
Molecular biology and proteomics

Housing/Meals/Transportation:
We have two type of housing for visiting scholars. One with air conditioning and internet facilities [Guest House]. There are limited rooms [total of 7]. The other [New Annexe] is without these two facilities, but is still an independent room with en suite bathroom. There are over 100 such rooms. Both of these facilities are within the campus and scholars can walk to the different institutions within the campus.

The monthly cost for the Guest House is US$900 and for the New Annexe is US$ 350. Food is available at a modest cost in the cafeteria [Canteen] and in the several restaurants just outside the campus. We would estimate an average cost of US$120 to 150 for food per month. There is no transportation cost to travel from the above housing facilities to any of the institutions within the campus. For field visits, the research group usually has their own transportation at no cost to the scholar.

http://www.fogartyscholars.org/articles/2009-2010-ficrs-sites-announced

http://www.fogartyscholars.org/fellows/sites/india-xavier

 

Liver Transplant Priorities Better With a Touch of Sodium

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One of the authors of the study discussed in this article, though not mentioned by name, is alumnus Dr. Patrick Kamath.

ROCHESTER, Minn., Sept. 3 -- An improved model to select who gets a liver transplant could potentially avert 7% of deaths on the waiting list, researchers here said.

Adding low serum sodium concentration to the Model for End-Stage Liver Disease (MELD) score currently used to allocate organs made a significant difference in where many patients with low sodium would have been ranked on the priority list for a transplant, according to W. Ray Kim, M.D., of the Mayo Clinic, and colleagues.

Indeed, in 2006, using the new model -- dubbed MELDNa -- would have changed the priority for transplant of 110 of the 477 patients who died on the waiting list, the researchers reported in the Sept. 4 issue of the New England Journal of Medicine.

Dr. Kim and colleagues estimated the changed rankings could have resulted in 32 transplants in that group, averting 7% of the deaths that year.
The effect is relatively modest, Dr. Kim said in a statement, since it only makes large changes to the rankings in patients whose MELD score -- as well as their sodium concentration -- is low.

"In those affected, low sodium has a substantial impact on mortality," he said. "This impact is particularly large in patients with low MELD, who would be placed low on the waiting list under the current system."

The MELD formula was developed in 2001 by Mayo Clinic researchers and adopted by the Organ Procurement and Transplantation Network in 2002 to rank those waiting for transplant in order of urgency. It replaced the earlier Child-Pugh score.

The MELD score is based on three standard tests, total serum bilirubin concentration, indicated by jaundice, the international normalized ratio for the prothrombin time, and serum creatinine concentration.

Testing for low sodium -- defined in this study as a serum sodium concentration between 125 and 140 millimoles per liter -- is also readily available, objective, and reproducible, the researchers noted.

Using data from the transplant network for 2005 and 2006, Dr. Kim and colleagues evaluated what would have happened had sodium concentration been part of the ranking score.

In 2005, there were 6,769 people on the waiting list, including 1,781 who got a new liver and 422 who died within 90 days after registration. Both the MELD score and the serum sodium concentration were significantly associated with mortality:

The hazard ratio for death was 1.21 per MELD point (whose values run from six through 40), which was significant at P<0.001.
The hazard ratio was 1.05 per one-unit decrease in the serum sodium concentration for values between 125 and 140 millimoles per liter, which was also significant at P<0.001.

For most patients -- the 61% who had sodium concentrations above 135 millimoles per liter -- the two scores were essentially identical, the researchers said.

The effect of low sodium was also "quite small" for patients whose MELD score was high, the researchers said, but it could be substantial in those whose MELD scores were moderate.

For instance, a patient with a MELD score of 10 and a serum sodium concentration of 125 millimoles per liter would have a MELDNa score of 21 -- a risk of death equivalent to that of a patient with a MELD score of 21 and normal sodium.

When the researchers applied the findings to data from 2006, they found that 2,159 patients got a transplant and 477 patients died within 90 days of registration.

For most of those who died -- 363 patients -- the two scores were similar, but for 110 (or 23%) the difference "was sufficiently large that the priority for liver allocation might have been altered if the MELDNa score had been used," the researchers said.

The study is "a benchmark in quantifying the risk of death among patients with cirrhosis," according to Andrés Cárdenas, M.D., and Pere Ginès, M.D., both of the University of Barcelona.

"If the implementation of this new score could avert 7% of deaths, as the authors estimate, it undoubtedly should be considered as a major step in refining the MELD score," they wrote in an accompanying editorial.

But the use of the MELDNa score has some practical limitations, they said, including inter-laboratory variability in sodium measurements, which might increase the "already significant variability" of MELD.

Also, the sodium concentration -- unlike the other factors measured by MELD -- is less stable and can be affected by such things as administration of diuretics or intravenous hypotonic fluids, which may affect its prognostic value.

They also pointed out that patients with hyponatremia who undergo transplantation are at increased risk for complications such as neurologic problems and for decreased survival.

Therefore, they said, increasing the number of patients with hyponatremia who undergo transplantation could increase the overall rate of death after transplantation.

Primary source: New England Journal of Medicine
Source reference:
Kim WR, et al "Hyponatremia and Mortality among Patients on the Liver-Transplant Waiting List" N Engl J Med 2008; 359: 1018-26.

 

ESC Gold for INTERHEART Co-ordinator: Salim Yusuf

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Salim Yusuf: "The theme of all my research has been to reduce mortality and morbidity with simple inexpensive treatments"

Date : 02 Sep 2008

INVESTIGATING transformative ideas using simple approaches on a grand scale has been the defining theme of the career of Salim Yusuf, one of this year's three ESC Gold Medallists. Yusuf - whose career spans both cardiology and epidemiology – has been the principal investigator in many of those landmark studies which established today's current practice in cardiology, including SOLVD, HOPE, OASIS, CURE and INTERHEART.

While a medical student in Bangalore, India, the simple idea of using school children to improve the local water supply started Yusuf on a career trajectory that has taken him to McMaster University in Canada, where he is Professor of Medicine, by way of Britain and the USA.

As a Rhodes scholar at Oxford studying with Peter Sleight and Richard Peto, Yusuf developed the fundamental concepts of trial design which would help facilitate the super-studies involving tens of thousands of participants. The three friends, together with Rory Collins, pioneered the concept meta-analysis.

A subsequent registrar's job at Harefield Hospital with Magdi Yacoub provided a unique opportunity to study denervated and innervated hearts beating in the same patient. This project, which he undertook in his spare time, and his work in clinical trials ultimately led to a position at the National Heart, Lung and Blood Institute in Bethesda, USA. Here, working as project officer, he led the SOLVD and DIG trials in heart failure. "The NIH gave me a fantastic opportunity to work with some of the best brains in the US and to concentrate on research full time for eight years," says Yusuf.

In family holidays with his wife and three children (now aged 24, 23 and 18), Yusuf felt drawn to the natural beauty of Canada, its "sensible" healthcare system, and the warmth of its people. In 1992 he was offered the position of head of cardiology at McMaster, a university renowned for the quality of its clinical research.

Since then Yusuf has helped establish the university as a world leader in clinical trials, and set up the Population Health Research Institute to co ordinate population studies, such as the INTERHEART study, the world's largest case control study of risk factors for MI conducted in 52 countries.

"The theme of all my research has been to reduce mortality and morbidity with simple inexpensive treatments," he says. "As a general rule, simple interventions have greater impact than more complex interventions, largely because they apply to millions of people, including individuals in both wealthy and poor countries".


Conclusion
An interest in ethnicity and cardiovascular disease is one legacy from his Indian roots, and he tries to maintain close links with Indian medicine through sabbaticals and exchange programmes with his alma mater, St John's Medical College in Bangalore. And he still works extensively in developing countries. "There is great beauty in health research, and when you make new discoveries which help people, it brings deep satisfaction and immense joy," he says.

Authors:
Janet Fricker

 

Looking Back On a Job Well Done

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The Hindu | Afshan Yasmeen

Father Thomas Kalam ends his stint as Director of Saint John's Academy of Health Sciences

Bangalore: His mission is to ensure that people of medically underserved rural areas get the best healthcare facilities. And his vision is to set up a St. John’s Medical University. He is Thomas P. Kalam, Director of St. John’s National Academy of Health Sciences, who will complete his 24-year stint at the institute on August 31.

Inspired by the positive effect a cat had on his college hostel housekeeper who had a bad stammer, Fr. Kalam developed a pet therapy centre on the premises of St. John’s Medical College. The centre, which has deer, emus and exotic birds, has been providing comfort and companionship to patients in the hospital for years.

In an interview with The Hindu on Tuesday, Fr. Kalam said animal-assisted therapy promoted positive and beneficial health effects. “I observed this when I was doing my doctorate in psychology at Lancaster University in England. Our housekeeper, Audrey, who was in her 40s, communicated with her cat normally when nobody was around, but she stammered while talking to us. This made me think of setting up a pet therapy centre here,” he said.

Fr. Kalam, who holds a master’s degree in philosophy, ethics and psychological sciences awarded by Indian and foreign universities, got associated with St. John’s Medical College in 1984. He worked as a professor of Bio-Medical Ethics in the college and was appointed director in September 2000.

Fee waiver

His decision to waive the tuition fee for postgraduate students, who serve in rural areas for two years, has been appreciated by all. “According to a recent survey, St. John’s stands among the top five medical colleges in the country,” he said.

Under his leadership, St. John’s Research Institute was inaugurated in September 2004. A bio-repository was set up to support the research institute last year. “This is one of the first research institutes to be associated with a medical college in India. More than 400 researchers are working on inventing an effective vaccine for tuberculosis here,” he said. Fr. Kalam, who consistently fought legal battles in connection with the college’s admission procedure since 2003, has ensured that the autonomy of the admission procedure adopted by the institution since its inception was upheld by the courts.

“It was a memorable moment for me when counsel for Karnataka admitted in the Supreme Court that the procedure adopted by us is impeccable, merit-based, fair and transparent,” he said.

The outgoing director, set to take up his new assignment as Director of Carmel Centre in Liberty, Tennessee, U.S., on Monday (September 1), upgraded the hospital to modern standards. “We got a CT scanner and MRI unit in the hospital only this year, after 45 years of the hospital’s inception,” he said.

“My dream is to see a St. John’s medical university, a medical city and a medical township on the campus. But we do not have the finances required for this. We do not want to squeeze money either from our students or our patients. But I am confident this dream will definitely be fulfilled one day,” he added.

http://www.thehindu.com/2008/09/01/stories/2008090150360200.htm

 

Father Lawrence D'souza Featured In Mangalorean.com

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By Felcy D'Souza, PRO, SJMCH

Bangalore August 30, 2008: St. John's National Academy of Health Sciences, Bangalore (SJNAHS), is one of the few organizations which have made a mark in the field of health and health education at the national level. The Institution seeks to make a qualitative contribution to health care, medical education and research through the training of medical, paramedical, nursing, health management, community health workers, and other personnel who are dedicated to healing in the spirit of Christ.

SJNAHS has grown from strength to strength since its inception.  Established in 1963 by the Catholic Bishops' Conference of India, SJNAHS consists of a Medical College, counted as one of the best in the nation, a state of the art Hospital with 1200 beds for all medical and surgical departments including super-specialty departments, a top class College of Nursing, a Research Institute - the first in a medical school - with the most modern facilities including a Bio repository and an Institute of Health Care Management and Paramedical Studies, all spread over 132 acres of verdant campus in the salubrious climate of the Garden City of Bangalore. The mission of St. John's is to train health care professionals who are ready to serve the people in any nook and corner of the nation. In this effort, St. John's has succeeded to harmonize dedication to excellence with commitment to social justice in health care.

God has His own plans. He has blessed the organization in numerous ways all through the past decades of its existence. Several committed, dedicated and service minded people have served the Institution in various capacities. And now God has put a dynamic person at the helm of affairs of the organization. Rev Fr Lawrence D'Souza is appointed to St. John's National Academy of Health Sciences with effect from 01 September 2008 as its new Director.
 
Fr. Lawrence, 59, was born on 28 November 1948 at Pernal, Udupi Dist. He was ordained Priest on 5 May 1977 at Milagres Church, Mangalore.  Fr. Lawrence brings with him expertise, vast experience in Hospital Administration and an insatiable thirst for excellence. He enjoys a brilliant academic career in varied subjects: A B.Sc. Degree with Physics and Chemistry from St Aloysius College, then affiliated to the Mysore University, a Post Graduate in Philosophy from Karnataka University, Dharwad securing Ist  rank in the University, a PG Diploma in Business Management, from St Aloysius College, a degree in Law (LLB) from SDM Law College securing  1st   Rank and 2 Gold Medals. He went for higher studies to Fordham University, New York where he completed MA in Religious Studies & Ph D on "Administration and supervision”
 
People of Dakshina Kannada and Udupi Districts gratefully remember Fr Lawrence for his contribution to the field of education. He was the Secretary, Catholic Board of Education for 7 years and served as Administrator, Father Muller Medical College Hospital & College of Nursing for 8 years. He also worked as an Associate Pastor, Our Lady of Mercy Church, New York from 1992-1994 & Associate Pastor, Sacred Heart Church, New York 1994-1998. He served as a Parish Priest, Holy Cross Church, Cordel, Mangalore Diocese for 2 years. The CBCI appointed him as Director Designate on 01 March 2008 and now from 01 September 2008 he will take over as Director of this Institution.
                  
Fr. Lawrence's appointment as the Director has brought high expectations in the Institution. Fr. Lawrence is blessed with all the qualities, traits and training to make St. Johns National Academy of Health sciences live up to the motto - “He shall live because of me.” The Hospital has to be more patient friendly. The staff has to be more committed to the cause of healing and imbibe the spirit of  St. John's to take the Institution to greater heights of dedicated service and to form future health personnel who excel in expertise and service. His dynamic leadership qualities, hard work, care for the suffering will make him an effective Director. St. Johns National Academy of Health sciences is privileged to have such a qualified Director.
 
Fr. Lawrence and success have been synonymous in all his previous appointments.  He is capable, efficient and experienced.  His integrity, hard work and respect for the principle of subsidiarity and teamwork are well known. We are confident that he will take St. John's National Academy of Health Sciences to greater heights.

We pledge our prayers and support to Fr Lawrence that he may be able to discharge his responsibilities in accordance with God's will. We shall uphold him in prayer, so that God may give him the faith and strength to make his dreams for St. John's National Academy of Health Sciences come true. May almighty God grant him all the strength, courage and wisdom to carry out his new assignment successfully.
 
Hearty Congratulations to you Fr Lawrence on your new assignment and a warm welcome to St John's.

Fr. Lawrence, A Principle-Centred Leader:

In conversation with his friends, well wishers and those who know him from close quarters, we could collect the following characteristics of his leadership style:
 
1. Leadership is service; leadership focuses on purpose.

2. Leadership is to bring out the best in people. His expectations are the key to his subordinates' performance and development.

3. He wants to be a life-long learner. He thinks "What we need today are not learned people but learning people".

4. He believes in the effectiveness of teamwork. He also believes that group of committed individuals working together have greater potential that when those same members work as individuals.

5. He believes that one who comes to him with a problem is capable of solving it by himself with a little help and enlightenment from him.

6. He believes that failure is not final, success is not permanent. Life does not stop when we meet failure. Failure is the junction of success. Journey of life often starts with failure and ends with success.

7. He believes that he should look objectively before judging and listen to both sides before drawing a conclusion.

8. He believes that God will not give him anything if he is not able to handle with grace.

9. He believes that human beings are the most important resources leaders have. Without people material and financial resources are worthless. The most important ingredients of an organization are its people.

10. His motto is to look for the positive in everything and in everyone, to be a good listener, to be fair and to be consistent in his decisions and dealings with people.

11. His role as the Director of this mighty Institution is to be a Facilitator.

12. He is here not because he wants to be here. He is here because he has been sent here with a mission

http://mangalorean.com/news.php?newstype=broadcast&broadcastid=90980

 


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