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Hi-tech revolutions to transform medical scene, but diseases & infections not far behind too

Currently, population of the urban agglomerate, including satellite towns of Navi Mumbai and Thane, is 1.25 crore, which is set to triple up to 3.30 crore by 2030, according to a report by McKinsey.

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The scene of city’s tertiary medical landscape will transform rapidly over the next decade, suggests data
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Mumbai is bursting at its seams. With no potential for horizontal expansion and a constant influx of people, the city of dreams is hurtling towards becoming unhealthier. Here, the future of health and medicine looks bleak and promising, at the same time — promising because of cutting-edge revolutions, and bleak because their affordability and reach to every sick person is questionable.

Currently, population of the urban agglomerate, including satellite towns of Navi Mumbai and Thane, is 1.25 crore, which is set to triple up to 3.30 crore by 2030, according to a report by McKinsey.

Mostly, the future of preventive and curative health care is virtual, except in cases of dire emergencies or severe chronic illnesses, which will require hospital-based intervention, say tech researchers. A city-based IT entrepreneur in Mumbai, Naitik Vyas, is slowly treading towards formation of www.doctrs.in to make doctor-patient interactions easier. At the click of a button, patients can choose which doctor to consult, and the interface sets up a video-conferencing facility for both parties at a mutually convenient time.

"Technology will soon make going to a clinic for check-up obsolete. You will only go to hospitals for a severe chronic or an emergency problem," says Vyas.

Medical technology service providers like Vyas are working on models where a patient's phone will be fitted with an application and s/he will be wired in from home with the help of a medical kit, which will measure blood pressure, sugar levels, electrocardiogram, oxygen saturation and other basic parameters. The data will be uploaded via the app and accessed by the doctor remotely.

Websites such as www.doctrs.in, www.practo.com, www.lybrate.com, which may facilitate doctors' appointment, medical tests from home and timely health reminders, have begun springing up in the urban medical scene, and these services will only expand, suggests data.

Also, the scene of city's tertiary medical landscape will transform rapidly over the next decade. Last month, paediatric interventional cardiologist Dr Swati Garekar at Fortis Hospital in Mulund was grappling with an impending heart surgery on an eight-year-old. In a brainwave that struck her, she fed the data of the child's heart size and dimensions into a 3D printer and obtained a model of it. "We got an exact idea of how the hole in the child's heart looks. Had it not been for the model, an open-heart surgery was on the anvil. Many a times, entirely opening up a child's heart is risky," says Garekar.

3D printing of organs for easing surgeries will percolate in a big way by 2030, she believes. "In totally sterile labs, 3D printers will be fed data and organic human tissue cells will form the base for printing heart valves, which can then be replaced in surgeries," she adds.

Another revolution set to occur by 2030 could be farming of human organs, starting with kidneys. "The availability of human organs through cadaver or live donors is poor. Ample research is underway on xenotransplants, where human organs will be grown inside bodies of animals and then extracted for transplant. Human tissue cells are injected in the animal's kidney, so it takes on human characteristics, which can then be used for transplant," says Dr Ravi Mohanka, liver transplant surgeon, Global Hospital in Parel.

But it's not a completely rosy and positive future. Lifestyle diseases — diabetes and obesity — are set to blow up in India. By 2030, the number of diabetics in India is set to double from 60 million to 120.9 million. Lack of infrastructure, like sports fields and cycling tracks in Mumbai, worries doctors.

Mumbai also faces a double whammy of infectious and non-infectious lifestyle-related diseases. "In 2009, we thought H1N1 virus only occurs in cold, dry climates, but that's not the case now. In the next decade, a fair amount of overcrowding and generation of thousands of tons of waste will lead to a spurt in infections," says Dr Om Shrivastava, infectious diseases consultant at Saifee Hospital in Charni Road.

"Up to 20% of those who have acquired infections and antibiotic drug resistance die. By 2030, we may have moved to a post-antibiotic era, where drugs to treat such conditions will become scarce."

World Health Organization guidelines mandate a minimum of four beds for every 1,000 people. In Mumbai, a disappointing deficit of affordable hospital beds is observed. Despite influx of nearly 3,000 beds in civic hospitals over the next few years, there will be a shortfall of affordable services, say experts. "Considering that the city's population will triple by 2030, the deficit will widen if health care infrastructure is not boosted at a similar rate," cautions Desai.

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