Madhu Mailankody: Setting Standards for Sports Presentation

Bengaluru, Mar 28: Sun Tsu, in 'The Art of War' speaks of a skilful general who can subdue his enemy without any fighting. This constitutes the ultimate triumph which is referred to as stratagem. Today, we would need one such when we are faced with the '21-day corona challenge' for India.
Nearly four weeks back, Dr Jyothsna Rao, Dr Gururaj Rao and I sat across the OPD in the afternoon at HCG Bengaluru discussing our ongoing cancer immunology research. While on this topic, we drifted into the discussion on the coronavirus. During this engaging discussion, we wondered the similarity of the enigma between the virus and cancer. I paused to ask Dr Jyothsna and Dr Guru - how we wish we could do something against this virus.
Dr Jyothsna is a PhD from NCBS and had worked under Dr Ralph Steinman, physician and researcher from Rockefeller University, who won the Nobel Prize for his discovery of the dendritic cell and its role in adaptive immunity in 2011. Dr Gururaj is a molecular and cell biologist who did his PhD at the Chapel Hill, University of North Carolina and is the Director of iCrest.
Jyothsna while hearing our perplexing conversation on the covid intervened, "Yes, surely. I think we should take a break from cancer and focus on the innate and adaptive immunity role in COVID-19."
Thus began this sincere attempt to relook the human immune system from the eyes of the COVID-19.
We have 10 types of immune cells at the least which are widely dispersed in millions across the body. When our body is invaded by a foreign organism (bacteria, fungi or virus), these cells work with each other to destroy the invader.
Now, the question is - how do the immune cells talk to each other? They use small-molecule substances called cytokines (cyto means cells; kine means movement). There are many cytokines that are involved in work on the immune system. The most relevant for viruses are interferons.
Interferons (IFN) as the name reflects have an ability to interfere with the viral activity and stop their multiplication. These specialised signal proteins are released by our cells in response to a viral attack to forewarn other cells. They help build the antiviral proteins within the cells to kill the virus as it tries to invade the new cells.
Historically, interferons are a group of cytokines known to be potent antiviral agents against viruses and a hallmark cytokine induced by the host upon viral infections. Interferons possess unique immunoregulatory activities and are signature cytokines released by (TH1) T immune cells, which are crucial in viral infections.
As the outbreak of COVID-19 grapples us, an urgent need for finding strategies to combat the virus is growing. Coronaviruses (CoVs) are a group of RNA viruses. In patients infected with coronavirus, it was indicated that the activation of the IFN does not occur until 48 hours post-infection. Thus the delayed IFN-related antiviral response by the healthy cells leads to coronavirus evade the immune response.
Numerous studies have presented the success in defeating CoVs by the direct administration of IFNs. In a combination as a concoction, it was shown to synergistically inhibit the virus replication in vitro.
Moreover, it is understood that the earlier induction of IFNs in children although they have a less developed immune system could be the reason behind the children being least affected.
The key to success in reducing the disease fatality might be the stimulation of the immune responses to trigger IFN production at the very early stages of the disease, which might be done through the administration of IFN. Despite the evidence for the efficacy of IFNs in treating CoV-induced infections, the proper dosing and ideal timing for such interventions needs to be verified in clinical trials.
For the later stages of the diseases in advance stages where patients are on ventilator and have developed respiratory distress, we propose to utilise the mesenchymal cells derived from donor bone marrow that have been known to treat acute respiratory syndrome. Mesenchymal cells are known to possess anti-inflammatory activity and thus used often in autoimmune diseases.
With this scientific background, we have activated T cells from healthy donors, in a cGMP facility at iCrest - HCG hospital with an enriched cocktail of cytokines rich in Interferons. Injections of this cocktail we believe will result in a surge of cytokines in the body of the infected person and will boost his ability to fight the virus in the early phases. We are in the initial phases of this study and hope to be ready in the coming weeks with meaningful data on its potential utility.
Currently, it awaits government approvals (Union and state) and we have applied to central drugs authority for their initial evaluation and further directions.
As my Guru often expounded the philosophy of 'Seva' - the goal of education is knowledge, the end goal of knowledge is service. In this attempt to serve our fellow humans at this brink of unprecedented crisis, medical fraternity stands with you and promises to do our best for your safety.
We assure to exhaust every bit of our spirit in this fight against coronavirus. We have lost the sight of shores and travelled thus far, but that is the mandatory first step to cross the ocean. Are we going to succeed in this battle, is something only time will answer. 

Bengaluru, Mar 26: In a second coronavirus related death in Karnataka, COVID-19 test results of a 75- year-old woman who had died on Wednesday has come out as positive, Medical Education Minister K Sudhakar said.

"I regret to inform that the COVID-19 test result has come out as positive for patient, who had succumbed to death yesterday. The govt stands committed to curb the spread of Corona Virus in the state. Please stay home, stay safe," Sudhakar tweeted on Thursday.

Health and Family Welfare Minister B Sriramulu too said the lab reports regarding the death on Wednesday have come and it has come out as positive, and death was due to COVID-19.

The exact cause of her death would be known only after the final report comes, both Minister had said on Wednesday.

The woman from Gauribidanur in Chikkaballapura district, had returned from Mecca in Saudi Arabia recently.

Sharing details about the woman, Sriramulu in a tweet on Wednesday had said, she died at Bowring hospital here at 1 am, and was suffering from diabetes, chest pain and hip fracture.

The patient was undergoing treatment in isolation ward at a hospital in Gauribidanur, later for more treatment she was shifted to Rajiv Gandhi Institute of Chest Diseases in Bengaluru, from where she was shifted to Bowring hospital on Tuesday," he had said.

This is the second coronavirus fatality in the state.

Earlier this month, a 76-year old Kalaburagi man died "due to co-morbidity and was also tested positive for COVID- 19", becoming the country's first coronavirus death.

Bengaluru, May 10: Former Karnataka Chief Minister HD Kumaraswamy on Sunday accused the state government of not preparing proper guidelines to bring back people who are stranded near the Karnataka-Maharashtra border areas.

"No proper guidelines have been given to officials to bring back people who are stranded near the Karnataka-Maharashtra border. From the last 45 days, many of these people have not got any relief nor are there any proper directions or guidelines from the state government," alleged Kumaraswamy.

He also accused the state government of cheating the people of Karnataka.

"Karnataka government is cheating people the same way it cheated with the flood compensation. The state government had announced lakhs of rupees as compensation to those who lost houses in the flood last year. But nobody has got the records or details as to how many people got benefited from it," he added.
Fifty-three more COVID-19 cases were reported in Karnataka on Sunday, the state government said.

The total number of cases in the state is at 847, including 405 discharged and 31 deaths so far, the bulletin said.