Type of task force
2020 Annual Report
This year has been a turbulent one with Covid-19 hitting the world hard. 2020 has been a memorable year, sadly for all the wrong reasons. It was the year that introduced us all to a new species of the Coronavirus which turned out to be deadly. Almost every activity of the world came to a standstill, including some aspects of scientific research. This significantly affected output for this Task Force. Firstly the two planned face to face meetings in India and Kyrgyzstan had to be cancelled. This did prompt the two organisers and PVRI to discuss the value of a coordinated approach in the future with one combined high altitude meeting from the Task Force each year henceforth.
Early this summer Max Gassmann visited the highest research facility in Switzerland, the Jungfraujoch Hut, located at an altitude of 3500m. Research planning there involved a project to keep human volunteers and animal models at that altitude for weeks to analyse the impact of high altitude on a variety of gene expressions. The Swiss high altitude research facility might be complementary to facilities in Leh (India), Puno (Peru), Lhasa (Tibet) and many other locations in the word and PVRI could coordinate joint research.
Project on gene drug development 2020 and acute exposure to altitude
Dr Qadar Pasha’s genetic study was awarded support for the next two years by The Cardiovascular Medical Research and Education Foundation, in Philadelphia, however work had been postponed due to the pandemic. His institute CSIR-IGIB which has received PVRI support decided to divert research time to the Coronavirus.
One important experiment looking at the effects of travelling from sea level to high altitude and back in a population of young volunteers was undertaken. The team of 35 youngsters, who volunteered for the drug based study where taken rapidly from sea level (Delhi) to high alititude (Leh) and back. The team were put through rigorous Coronavirus testing whilst visiting the Himalayan region and were able to achieve their desired goals without any unwarranted events. Clinical observations, Lake Louise score, chest-radiography and echo were all recorded, along with blood samples. The volunteers greatly enjoyed the visit to Leh and everyone conveyed their wish to be apart of any future research activity allowing them to re-visit.
Coronavirus effect in Ladakh, the Himalayan highland
Despite the high altitude environment of Ladakh, like most counties it could not escape the grasp of the Coronavirus. Reports from other similar highland regions of South America had suggested that the native people are resistant to Covid-19. Minimal travel, and maximum precautions coupled with sanitisation will prevent the spread of infection and these are more likely causes for that highland region. The virus appears to be resistant to any extreme environment and all our observations suggest that the clinical effects of Covid 19 are the same at high altitude as sea level.
Research activities in this period
Naturally every academician come researcher focused their attention on to the Coronavirus, stalling ongoing research, with everyone actively sharing their own knowledge on the virus whether or not their expertise was in the microbiology and virology field. Official websites including the WHO have done a commendable job sharing information and protecting lives. Even PVRIs own Task Force leader Dr Qadar Pasha devoted three months of his time assembling knowledge on the Coronavirus, and subsequently producing a couple of manuscripts, one of which was published.
This year, a visit was made to Leh in February and the venue and programme was finalised for the 6th International Leh Symposium, alas it had to be postponed. The next date will be in August or September 2021 and hopefully the venue will be the Mahabodhi Global Family Resort in the serene surrounding of the model village Saboo Dho, near Leh, where they organised their scientific expedition.
Two reviews from us in 2020:
Sex-derived attributes to SARS-CoV-2 fatality in co-morbid patients.
Neha Chanana, Tsering Palmo, Kavita Sharma†, Rahul Kumar, Brian Graham, Qadar Pasha. AM J Physiol Endo&Met 2020
Vascular homoeostasis at high altitude: role of genetic variants and transcription factors.
Neha Chanana, Tsering Palmo, John H Newman and M.A Qadar Pasha. Pul Circa 2020
2019 Annual Report
This year we had two successful meetings to raise awareness about pulmonary hypertension:
12-13 April 2019 - Paediatric Pulmonary Arterial Hypertension Symposium, Mumbai
This one-and-a-half-day symposium, co-sponsored by the PVRI and pharma, was held at Kokilaben Dhirubhai Ambani Hospital & Research Institute, Mumbai.
Invited speakers sponsored by the PVRI were Professor Sheila Glennis Haworth CBE and Professor Shahin Moledina, together with a host of Indian faculty. The symposium was attended by 87 delegates and was covered by nationwide live telecast, viewed by 103 delegated on day 1 and 110 delegates on day 2.
The event provided a broad insight into the diagnosis and management of paediatric pulmonary hypertension. The conference had a unique design. Each session had two to three didactic lectures followed by three case studies or research papers presented by young paediatric cardiology fellows.
- The symposium was opened with a welcome note from Dr Snehal Kulkarni and Dr Prashant Bobhate. This was followed by a keynote lecture given by Professor Sheila Glennis Haworth CBE, University College London, UK, discussing advances in diagnosis and management of paediatric pulmonary arterial hypertension (PAH) over the last five decades.
- This was followed by a presentation on experiences of pulmonary hypertension (PH) registry from the UK by Dr Shahin Moledina, Great Ormond Street Hospital, UK, and Dr Sanjay from Kerala, India. Experience of the first paediatric PH registry from India was presented by Dr Anuj Sharma.
- The day progressed with presentations, including the diagnostic of PH, infective endocarditis (IE) echocardiogram; cardiac catheterizsation, CT angiogram and exercise testing. Towards the end of the day, talks on the assessment and management of PAH in single ventricular physiology were delivered.
- Day 2 started with a session on management of paediatric PAH, which was chaired by Prof Dr. BKS Sastry and Dr Snehal Kukarni. Dr Shahin Moledina presented his experience on upfront combination therapy vs sequential add-on therapy.
- This was followed by talks regarding assessment of PH patients on medial therapy, management of PH and PVD in the intensive care unit, and caring of pulmonary hypertension patients beyond medical management.
- The second session raised awareness on the interventional management of pulmonary hypertension patients and the faculty shared their experience regarding the use of atrial flow regulator, Potts shunt and lung transplant in India.
- The last session of the day consisted of two very useful talks, given by Dr Shahin Moledina and Professor Sheila Haworth, on epigenetic and the future of managing paediatric PH. The conference ended by a vote of thanks by Dr Prashant Bobhate.
- The second event was held in association with the Paediatric Cardiac Society of India during their annual conference at Raipur, India on 13 October 2019. This event had a special focus on humanitarian models of healthcare with an emphasis on developing and sustaining paediatric cardiac programmes in lower and middle-income countries.
- The faculty included Dr Mark Gweling, Dr S. Radhakrishnan, Dr Prashant Bobhate and Dr Shine Kumar. The dedicated pulmonary hypertension session, which featured three lectures followed by three interesting case presentations by young fellows.
13 October 2019 - Paediatric Cardiac Society, Raipur, India
We have planned a two-day symposium, which is going to be co-sponsored by the PVRI and the international faculty for the same are Professor Paul Hassoun, Johns Hopkins University Medical School, USA, and Professor Michele D’Alto, Ospedale Monaldi, Italy.
The conference, which is set to be held in Mumbai, is aimed at physicians, rheumatologists, pulmonologists and cardiologists interested in managing pulmonary hypertension. More information will be published on the PVRI website.