Wednesday, 29 June 2016

Service to the society and county is the best way to give back

Service to the society and county is the best way to give back Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Prof Dr C V Harinarayan, Director, Institute of Endocrinology, Diabetes, Thyroid and Osteoporosis Disorders, Sakra World Hospitals, Bangalore, Karnataka. Dr CV Harinarayan has been honored with Dr BC Roy National Award for the year 2009 under the category of ‘Oration’'. How does it feel being conferred one of the most prestigious awards in the medical field? I feel humbled and the society expects more dedicated work from me. Tell us about your journey so far. I was the first to document low vitamin D status in Indian population as a part of my DM (endocrinology) project thesis. Our studies showed that low vitamin D status of Indian population is the cause of bone disease in patients with primary hyperparathyroidism. This work on primary hyperparathyroidism is quoted in many textbooks of metabolic bone disease. It is hard to believe that in a sun drenched country like India we have vitamin D deficiency. Later this fact was confirmed by many scientific workers across the country. Our landmark population study from south India is the FIRST and ONLY study till date to document the low dietary calcium intake and low vitamin D status in agricultural laborers residing in villages. Subsequently we documented by in vitro studies on ampoule model of previtamin D synthesis and showed that we as Indians can synthesize enough vitamin D on exposure to sunlight from 11 am to 2 pm, by exposing 10 to 15% of body surface area for 15 to 30 minutes. Our studies documented that correction of vitamin D deficiency and calcium supplementation can improve the pancreatic beta cell secretory function. Our work was the first to show that renal tubular damage is the major cause of metabolic bone diseases in patients with fluorosis (Ranked top 10 publications - year 2006 by Internet). The work with BARC, Mumbai helped to indigenously develop intact IRMA radioimmunoassay for parathyroid hormone in India (make in India concept). With all this background, we were instrumental in developing the “Clinical Practice Guidelines on management of Postmenopausal osteoporosis (2012-13) – Executive summary and Recommendations” for Indian Menopause society. We developed the Department of Endocrinology, SVIMS, Tirupati, (for nearly two decades) with a good dedicated endocrine laboratory infrastructure and now we have MCI recognized seats (two) for DM endocrinology. What were the early challenges faced by you in your career? How did you manage to overcome them? To convince the scientific community about low vitamin D status in Indian population was a major challenge. We conducted population studies in villages in and around Tirupati (Tirupati is nearer the equator and sun drenched most of the year) and showed low dietary calcium intake along with low vitamin D status in agricultural population. It is the first and only study (till date) of dietary calcium intake and vitamin D status from rural India. It would not have been possible but for the dedicated team work of students and staff of the department of Endocrinology, and support of the administration of SVIMS, Tirupati, Andhra Pradesh. Tell us about your family. How important has been the role of your family in your journey? Family has been always supportive and encouraging in my academic work. What would be your message to the community? Service to society and community should be kept in mind of all health care professionals, so that it benefits a larger segment of the society. Given a chance, what changes would you like to bring about in health policies? India being a vast country with diverse cultural habits and limited resources, I would aim to provide adequate dietary calcium and vitamin D to all ages groups and both genders using available resources. What advice would you give to youngsters? Society and our country has given you the opportunity to get knowledge, the best way to return that is service to the society and county.

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