• Published on: Oct 28, 2020
  • 2 minute read
  • By: Dr Rajan ( Medical Second Opinion Cell)

Hepatitis C Nobel Prize

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Earlier this month the Nobel Prize in Physiology and Medicine was jointly awarded to Harvey J Alter, Michael Houghton and Charles M Rice for the discovery of the Hepatitis C virus. This helped push our understanding of blood-borne hepatitis, a major global health problem that is one of the leading causes of cirrhosis and liver cancer alongside Hepatitis B. It led the way in introducing new tests for chronic hepatitis as well as new treatments that have saved the lives of millions.

HEPATITIS

Hepatitis is the inflammation of your liver, the largest solid organ in your body. Though there are numerous other causes of hepatitis, including alcohol abuse, drugs and toxins (including paracetamol overdose), and autoimmune disorders (such as Wilson’s disease), viral infections are the most common worldwide causes for hepatitis. Hepatitis A was the first to be discovered, transmitted by polluted food and water, and results in a short-term transient hepatitis. Hepatitis B on the other hand is transmitted through blood and is more of an issue as it can lead to chronic cirrhosis and possible liver cancer. It can remain indolent in a person, causing disease long after the initial infection.

Blood borne hepatitis was first discovered in the 1960s, when it was found that some patients would become ill after receiving blood transfusions. Despite this discovery and new tests for Hepatitis B reducing the number of transfusion related hepatitis, a large number of cases remained.

NOT A, NOT B

Harvey Alter, working at the US National Institute of Health, was studying the occurrence of hepatitis in blood transfusion patients. His team showed that blood from these infected patients could transmit the disease to chimpanzees, resulting in hepatitis. This agent had the properties of a virus, one that was “non-A, non B” hepatitis.

Further investigation into the virus would require the input of Michael Houghton, working for Chiron pharmaceutical. His team created a collection of DNA fragments found in the blood of infected chimpanzees. Though the majority of these fragments were from the chimpanzee, enough were from the virus. They were able to utilise this information to identify antibodies against the suspected virus, and ultimately identify it as the flavivirus Hepatitis C.

The final piece of the puzzle was shown by Charles M Rice, a researcher at Washington University, St Louis – could the virus alone cause hepatitis. He studied the RNA of Hepatitis C to identify regions that may be used for replication, and areas that might hinder replication. This was key as the virus can lay dormant for years, replicating at a slow rate before causing damage to the liver. For researchers, this was an issue as it was not feasible to wait years and see if the suspected virus caused hepatitis.  By genetically engineering the viral genome, he developed a variant of Hepatitis C that would only multiple rapidly and have no mechanism to inactivate itself for dormancy. This strain caused rapid changes to the livers of infected chimpanzees; the same changes seen in hepatitis patients.

. ;.,hrvxzThe impact was significant. Prior to this, receiving a blood transfusion was like Russian Roulette. You were receiving life saving therapy, but it coZuld also be a hidden death sentence. Now that hepatitis had been discovered, it became possible to screen patients prior to donation, to screen blood transfusion bags, and to start developing treatments for the virus. 

The fight is not over yet. There are still over 70 million people who still live with the virus, and it still kills around 400,000 a year. Its only very recently that we have found treatments that can reduce the viral load in patients to levels that they are considered cured. This treatment remains expensive, and we are very far away from eradication itself.

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Stroke Warning Signs for Indians Over 40

Stroke Warning Signs for Indians Over 40: Early Detection Can Save Lives

Introduction

Stroke is a major health issue in India — both as a cause of death and lifelong disability. For people over 40, the risk climbs sharply. The earlier a stroke is recognized and treated, the better the chances of recovery. In this post, we’ll look at the warning signs of stroke especially relevant in Indians over 40, backed by real survey data, the risk factors common in India, what to do, and how to act fast. Understanding these can help you or your loved ones catch a stroke early and reduce damage.

 

How Big Is the Problem in India, Especially After 40

  • According to a 2024 study using Global Burden of Disease data, stroke incidence in India has increased from 76 per 100,000 people in 1990 to ??88 per 100,000 in 2021 for all ages. 

  • Stroke incidence and burden are especially high among people aged 50-69 and over 70. 

  • Another study in North India showed that a large number of adults over 45 lacked awareness about warning signs of stroke: nearly 46% didn’t know warning signs. 

  • Among hypertensive patients (~mean age 54) from Western Rajasthan, about 75% recognized at least one stroke symptom like slurred speech or body-weakness, but 25-30% still lacked awareness.
     

These figures show that though awareness is improving, there is a significant gap in recognition of warning signs among people over 40 — a high-risk group.

 

Warning Signs of Stroke (What to Look Out For)

In Indians over 40, common symptoms are similar globally, but here are those particularly reported in Indian surveys:

  1. Sudden Weakness or Numbness on One Side
    Many people identified “paralysis of one side of the body” or weakness in an arm or leg. In a Tamil Nadu hospital-based survey, 56% of respondents recognized this symptom.

  2. Facial Droop or Deviation
    One side of face droops or mouth slants. In the same survey, ~20% noted deviation of the mouth.

  3. Speech Problems
    Slurring, garbled speech, or trouble understanding what others are saying. ~16% in that survey recognized speech impairment.

  4. Vision Disturbance
    Sudden trouble with sight in one or both eyes (blurring, loss of vision). Awareness of this is lower: about 53% recognized vision disturbances in a Kerala survey.

  5. Loss of Balance, Dizziness, Severe Headache
    Sudden loss of balance or coordination, dizziness, confusion, or sudden, severe headache are also warning signs. Surveys show these are less well recognized compared to motor or speech symptoms but still important.
     

 

Risk Factors: What Makes Stroke More Likely After Age 40

Understanding risk helps prevention:

  • Hypertension (High Blood Pressure) — arguably the biggest factor. Many over-40 Indians have undiagnosed or uncontrolled high BP.

  • Diabetes Mellitus — often co-exists; increases damage to blood vessels.

  • Dyslipidemia (High Cholesterol / Lipids)

  • Smoking & Tobacco Use — cigarettes, chewing tobacco.

  • Alcohol Use

  • Obesity / Sedentary Lifestyle

  • Dietary Risks — high sodium, low fruits/vegetables.

  • Heart Conditions — atrial fibrillation, prior heart disease.

  • Other — age itself, stress, sometimes air pollution.

 

Awareness & Knowledge: What Indian Surveys Reveal

  • In the Rajasthan survey among hypertensive patients (mean age ~54), around 75-80% knew at least one major warning sign (one?side weakness, speech or vision issues), but 25-30% were unaware.

  • In a community survey in Kerala, 94.2% identified facial weakness, 86.6% speech disturbances, 84.5% limb weakness. But only ~53% recognized vision issues as a symptom.

  • In a North Indian telephone survey, nearly half the participants (?46%) did not know warning signs.

So even in literate, more urban or health-aware areas, a non-trivial proportion of people over 40 are not fully aware.

 

Why Early Recognition Matters

  • Treatments like thrombolysis (clot-busting medications) are time sensitive — often must be given within a few hours (“golden hour”). Delays drastically reduce benefit.

  • Early hospital arrival, correct diagnosis, and starting therapy quickly can reduce severity, prevent permanent disability, reduce mortality.

  • Preventing recurrence: once someone has had a stroke (or mini-stroke), risk of further strokes increases. Early intervention (lifestyle, medicines) matters.
     

 

What to Do If You or Someone Over 40 Notices These Signs

  1. Don’t Delay — If sudden facial droop, weakness on one side, speech issues, vision trouble, or sudden severe headache occurs, seek emergency medical help immediately (call ambulance / go to hospital).

  2. Note the Time — When symptoms started. Critical for treatment options.

  3. Diagnostic Tests may include CT/MRI brain, ECG, carotid imaging, labs (blood sugar, lipids etc.).

  4. Medical Management — Control high blood pressure, diabetes, cholesterol; anticoagulants if needed; lifestyle changes.

  5. Rehabilitation — Speech therapy, physiotherapy, occupational therapy if deficits remain.
     

 

Real Numbers: What Are the Outcomes / Burden

  • Adjusted stroke prevalence in India is estimated between 84 and 262 strokes per 100,000 in rural areas, and 334-424 per 100,000 in urban areas depending on the region.

  • Among those aged 55+, stroke rates jump — e.g., in Trivandrum, rate is ~7.1 per 1,000 people per year for 55+, rising to 13.3 per 1,000 for those aged 75+.

  • The chance of having a stroke after 55 is roughly 1 in 5 for women and 1 in 6 for men in certain studies, though this includes all adults over 55.
     

 

Challenges in India

  • Delays in recognising signs and reaching hospital. Many people don’t know less obvious symptoms.

  • Low awareness of treatments and golden period for therapy. Surveys show only a small fraction know about clot lysis or emergency window.

  • Access issues: hospitals with stroke care, imaging etc. may be far. Costs, transport, awareness all barriers.

  • Comorbidities often unmanaged (hypertension, diabetes).
     

 

Prevention: What Indians Over 40 Can Do Now

  • Regular health checkups: Monitor blood pressure, blood sugar, cholesterol.

  • Lifestyle changes: Healthy diet (low salt, more fruits/veg), active lifestyle, avoid tobacco, limit alcohol.

  • Stay alert to symptoms: Educate self / family about warning signs.

  • Emergency planning: Know nearest hospital that handles stroke, keep travel / transport options ready.

  • Medication adherence: If prescribed (for BP, diabetes, heart conditions), don’t skip.
     

 

Conclusion & Call to Action

Stroke warning signs for Indians over 40 are often clear—but awareness is still incomplete. Because stroke risk increases with age, recognizing the early warning signs like sudden weakness, facial droop, speech trouble, vision disturbance, and balance issues can make all the difference.

If you or someone over 40 feels any of these, act fast. Time matters. Go to the hospital immediately.

CTA: If you’re over 40, schedule a stroke risk assessment today — check your blood pressure, diabetes, cholesterol, and get informed about warning signs. A simple health check can save your life or someone you care about.

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