- 41 minutes ago
Preventive healthcare should be guided by age, family history and individual risk, not expensive packages. Doctors at the India Today HealthWealth Summit explain why appropriate testing matters more than the number of tests.
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00:00How to choose the right path lab?
00:04If Dr. Dang, you could start with that.
00:08Is there a formula to know which path lab to really choose for tests?
00:14It's on already.
00:16It's not a difficult question, but it requires a certain amount of intelligence.
00:22Because like what I always say,
00:25and I've said this to my two esteemed colleagues just two days back
00:29at the common forum we were in,
00:32if we do not diagnose correct, we cannot identify correct.
00:39If we cannot identify correct, we cannot treat correct.
00:43And if we cannot treat correct, we cannot eliminate correct.
00:47Right?
00:48So to choose the right lab, you don't have to go by the rates,
00:54you don't have to go by the advertisements,
00:57you do not have to go by the marketing,
00:59because you're dealing with your own health,
01:02which is of paramount importance.
01:04And that, that one, the lab should be properly run on own by a doctor.
01:12A qualified doctor, maybe a pathologist,
01:15maybe a microbiologist, lab specialist,
01:17or whatever it is, or a radiologist in the case of radiology,
01:20it has to be written by them.
01:22The lab should be properly accredited.
01:25It should be following proper external quality assurance programs.
01:29It should be patient-centric.
01:33There should be somebody who will be able to answer that,
01:36your questions.
01:38There should be total transparency in what is happening.
01:41And, like what I've seen in all of us sitting out here,
01:46one, whatever mild, moderate success which you have had,
01:49is that you are available.
01:51At least if we not personally,
01:54somebody from the Dr. Dang's lab,
01:56some doctors available,
01:57to answer the patient's question,
01:59like I always ask people,
02:01what is the most important part of your body?
02:03I say the most important part is not the heart or the brain.
02:07For a doctor,
02:08the most important part of a body is your shoulder.
02:13Because every patient wants a shoulder to cry on.
02:18Every patient wants to discuss their problems.
02:22I have had the privilege of calling up Dr. Mahajan at 9pm, 9.30pm.
02:28He may be wherever he is.
02:30He has picked up my phone.
02:31I have told him,
02:32Dr. Mahajan at 9pm,
02:34this patient has a lot of trouble.
02:35I have to do an MRI now.
02:38It happened last week.
02:39And it brought tears to my eyes.
02:42And he said,
02:42Naveen, you have called up.
02:43It must be important to send the patient right now.
02:45But I said,
02:46I want the report also right now.
02:48And I got the report by 12pm.
02:51And the patient turned out to be a case of a brain malignancy.
02:54This is only in my country.
02:57This is only in my country.
02:59When in three hours,
03:01the patient has called me,
03:03the patient has called me,
03:03the test has been tested,
03:06the report has been tested,
03:07and the next day,
03:07the patient has also found the tumor of his tumor.
03:09He is standing in America and England.
03:11He is standing in the line.
03:13He is standing in the line.
03:28So all these things have to be kept in mind.
03:30And of course,
03:31the infrastructure itself.
03:34Yes.
03:35Dr. Mahajan,
03:36simple question.
03:38Audience में कोई बैठा है
03:39और वो जानना चाता है कि हम
03:41Dr. Lal से टेस्ट कराएं,
03:43Dr. Mahajan से चेक कराएं,
03:44कि Dr. Dang से चेक कराएं,
03:46कैसे डिसाइड करें,
03:47कहां जाना है?
03:48I think,
03:50आप जो बात आपने की है,
03:53वो तीन नाम आपने ऐसे लिए,
03:56कि आप कॉइंट टॉस करिये,
03:58और कहीं फे भी चले जाएं,
04:00रिपोर्ट सही मिलेगी,
04:02वाजिब मिलेगी,
04:04और जैसे Dr. Dang ने बलता है,
04:07Dr. Lal मिलेंगे,
04:09Dr. Dang मिलेंगे,
04:10Dr. Mahajan मिलेंगे,
04:11जो कि जब आप पूछेंगे,
04:13आपको समझा भी सकते हैं,
04:15कि आपको दिक्कत क्या है,
04:17कोई भीमारी है कि नहीं,
04:20और हमत तुन नहीं बताएंगे,
04:23हालं कि हमें अधिकतर
04:26तुन का ज़्новाइड का जयन तो होता है,
04:29पर we leave that to the treating physician.
04:32So, I think what Dr. Dang has said,
04:36patient eccentricity,
04:38the technology,
04:39and the man behind the machine.
04:41You may have the best machine,
04:43And frankly, I'll amplify it a little more, that profitability, which has somehow come to the center stage for a
04:59doctor-run hospital, lab, diagnostic center, that is a byproduct.
05:06It's not the aim when we start. And that's where I think the difference lies. And I agree with what
05:15Dr. Nang has said.
05:17But let's do it. We are both brothers and sisters.
05:21Dr. Talal, a quick comment from you before I jump in.
05:26Dr. Talal, a quick comment from you.
05:57Dr. Talal, a quick comment from you before it hits your ump.
06:01which is called the diseases of life,
06:05because the human has forgotten itself
06:08and the good things we learned from our parents,
06:10we have forgotten.
06:13And after doctors,
06:14we are not prepared to accept any of this.
06:18I think people are listening to AI today.
06:22I will come to the AI question as well.
06:24But Dr. Ankh, I want to know that
06:27we have to take a newspaper or flyers or Instagram ads.
06:32Today we have a lot of combinations of tests.
06:37You can have 15 tests in 899.
06:41You can have 20 tests in 500 rupes.
06:45Does it really work like that?
06:47Sonal Ji, a very pertinent question.
06:51I will not give this question.
06:52I will not give this question.
06:53Because I do not know that
06:55how to do 500 rupes in 200 tests
06:57and how to do 500 rupes in 1,000 rupes in 500 tests.
07:00But the second question is,
07:04is that every test is necessary?
07:06No.
07:08It is necessary to do the right test.
07:10These packages are all of them.
07:13There is no need for them.
07:15The right test is necessary.
07:17The right test at the right time for the right person
07:21is of paramount importance.
07:23We cannot use the smoke.
07:25We need evidence.
07:27I will take one more minute here.
07:29There are two or three examples in front of me.
07:32The first example is coming.
07:34I don't know why I am sitting here.
07:36Jivrad Singh.
07:38In 2011, he picked up the World Cup.
07:47He had been coughing before that.
07:50He ignored.
07:52He did not do the right tests.
07:54He had been coughing.
07:54If he had been diagnosed with Dr. Mahajan
07:57and had been tested,
07:59he had been diagnosed with his lung.
08:00He had been diagnosed with his lung.
08:02But neither did he think of his doctor
08:03nor did he think of it.
08:06Another example.
08:07Again, Bollywood.
08:09Amita, when the child was shooting in 1982 or 1983,
08:15he was injured.
08:16He got injured.
08:17Blood transfusion was given.
08:19He did not check that the blood transfusion
08:22was given.
08:24Amita developed hepatitis B.
08:27As a result of which, his liver got injured.
08:30And now he is an ambassador of hepatitis B all over.
08:34In my personal experience,
08:36people losing weight will never go
08:38and get themselves tested.
08:41Remember one thing.
08:43A movie ticket costs more than a thyroid test.
08:47If I was to give a statistics,
08:4945% of the world does not have access to diagnostics.
08:551.2 million children die because of lack of proper nutrition
09:02in the mothers.
09:03There are 10 crore diabetics and 13 crore pre-diabetics.
09:09There are 30 crore hypertensives and nearly 280 crore people with high cholesterol.
09:17It is necessary to test these tests.
09:20It is right.
09:22But what you asked about
09:23is that all the packages should be done,
09:25or not,
09:26and they are also 900 rupees.
09:27I will ask this question.
09:29Dr. Mahajan will answer.
09:30I will understand more about this.
09:31Dr. Mahajan,
09:32let me tell you about this.
09:34Because there are two types of people.
09:36One,
09:37one,
09:37one,
09:38one,
09:40two,
09:40one,
09:41three tests.
09:42So,
09:43how do you find that balance between what is the right test for you and when?
09:47Dr. Mahajan,
09:48I think something you have to leave to your doctor.
09:52Yes.
09:52And then we talk,
09:54when we talk about testing,
09:56there is one preventive health check,
10:00which is when you have no problem,
10:03or maybe you have some underlying chronic problem.
10:06And second is when you are sick.
10:08Yes.
10:09And what I find,
10:10these advertisements that we see,
10:14most of them are advertising for people to come and get preventive health checks done.
10:21Yes.
10:22And then,
10:23you know,
10:23when they say 20 tests,
10:25it may be two tests.
10:27and the sub-segments,
10:29which are part of that test,
10:31are counted as separate tests.
10:33So,
10:33they may be 100,
10:35whereas,
10:36they may be much lesser,
10:38the way we would say.
10:40So,
10:40there is a certain minimum testing that should be done,
10:45preventive health checks on a yearly,
10:47or once in two year basis.
10:49And that will also vary based on what your age group is.
10:53Yeah.
10:54At 20 years of age,
10:55you need certain minimum tests,
10:57between 30 to 40,
10:59maybe some incremental,
11:0140 to 50,
11:02and then 50 and beyond.
11:03So,
11:04you cannot actually paint everyone with the same brush.
11:09Second,
11:10there is this tendency,
11:13where people say,
11:14my food is taking,
11:16let me do this,
11:17let me do this,
11:18let me do this,
11:18let me do this.
11:19And these are all unnecessary,
11:21you know,
11:21they may not be.
11:22And then,
11:23there are people,
11:23who are getting tested,
11:25once a month,
11:26once in three months.
11:28There may be,
11:29if you have a certain ailment,
11:31then,
11:32getting it done,
11:32maybe,
11:33once in three months,
11:34may be appropriate.
11:35But,
11:36by and large,
11:37this is,
11:38of no use.
11:40And,
11:40so this,
11:41while testing is very important,
11:44it is appropriate testing that's important.
11:47And,
11:48what also happens in these health checks,
11:50there's the silver package,
11:51there's the gold package,
11:53there's the platinum package.
11:56The test that may be necessary for you,
12:01based on your family history,
12:04based on your past history of illness,
12:07based on what problem you have currently,
12:14that test may get left out.
12:17That's why,
12:18so many times,
12:19you hear,
12:19that,
12:20this person,
12:22got a health check,
12:22last week,
12:23and today,
12:24he had a heart attack.
12:25And,
12:26that's because,
12:27the,
12:28appropriate test wasn't done.
12:30And so,
12:30today,
12:31we are talking in terms of,
12:33the,
12:34personalized health checks.
12:36And,
12:37of course,
12:37when it's disease,
12:38then,
12:38please do trust your doctor.
12:41But,
12:41even otherwise,
12:42I know,
12:43general practitioners,
12:45and family physicians,
12:46are very few,
12:48today.
12:48But,
12:49you know,
12:50we need to build that,
12:51and we need to get the appropriate testing,
12:53and not,
12:54you know,
12:55everything under the sun.
12:56Yeah.
12:56Dr. Lal,
12:57can you name some of those,
12:58unnecessary tests for us?
13:01Unnecessary?
13:01Yeah.
13:02Let us,
13:02no, no.
13:03I think,
13:03let's start with the necessary tests.
13:05Okay.
13:05Let's do the test first.
13:07Blood sugar.
13:08Yeah.
13:10your father and mother,
13:14very close relatives,
13:16if they have a very close relative,
13:16so,
13:17you should start the blood sugar testing,
13:20if there is in your family,
13:21by 18 years of age.
13:23But,
13:23if there is no such family history,
13:25at least by 25.
13:27In India,
13:28there is the world's maximum number of diabetics.
13:32And,
13:32diabetes is a disease,
13:34which can happen,
13:36including your shortened life.
13:38Life is short.
13:40So,
13:40this is one thing,
13:41because if you are in your family,
13:43you must have to do it.
13:44The second test,
13:45which people are dying today,
13:48that is heart disease.
13:50So,
13:50what happens in heart attacks?
13:52The plaque of cholesterol,
13:53which is in our heart arteries,
13:56that is,
13:57that will happen as well.
14:00So,
14:00if you are away from this,
14:02that is,
14:03that will happen more than the part.
14:04that will bring up your habits like this,
14:06you'll be able to deal like this.
14:08So,
14:09if you have to deal with some other products,
14:11and as well,
14:16your body shouldn't happen.
14:19So,
14:19So you have to control these two things,
14:22one with fat and the other with salt.
14:24After that, you have to do something necessary to do exercise.
14:27And for us, exercise in India, I have not seen that many people want to do so.
14:36But our task is that you have to do less than less, 18 years,
14:4018 years, not 25 years,
14:42you have to do less than 10-15 hours a day.
14:45And if you have to eat less,
14:47if you have to eat less than 10-15 hours a day,
14:50you have to do less than 10-15 hours a day.
14:51And blood pressure, blood sugar,
14:54if you have to call Dr. Lal,
14:56we will give you blood sugar,
14:58we will give you cholesterol,
14:59we will give you cholesterol,
14:59so this will increase your life.
15:02But Dr. Deng,
15:03we have a very different way of testing,
15:06which is a new kind of problem,
15:09which is people are going to chat GPT,
15:12people are going to these AI tools and testing,
15:14not your regular HB1ACs and your CBCs and LFCs,
15:18they are checking your cortisol levels.
15:21They want to understand their inflammation markers.
15:24Is that good?
15:27I think it is very good.
15:30I strongly endorse this.
15:33Some people have asked me this question,
15:36can our country afford this?
15:37Yes, we can afford it.
15:39Because we are spending so much money on so many irrelevant things.
15:45Now, it is something like we are driving a car,
15:47you can see through your rear window,
15:51what was it before?
15:52I am not diabetic.
15:54I am not diabetic.
15:54I am not diabetic today.
15:56But with the side mirror,
15:59and with the new technology,
16:01you can predict,
16:03you can look ahead.
16:04And the era has come,
16:06the era has dawned,
16:07of predictive and preventive medicine.
16:12Now, people,
16:13I,
16:14last time,
16:15once when we were on a forum together,
16:16you asked me,
16:18the names of few important tests.
16:21And,
16:22well,
16:22I was going to say that time,
16:24that it was like that,
16:25tell all the Hindus,
16:26that you have to wear a car.
16:28Because,
16:29everyone tests,
16:30but,
16:31coming back to what I was today,
16:32what you are talking about today,
16:33is,
16:35like,
16:36sugar is there,
16:37HbA1c is there,
16:38HbA1c is there,
16:40that tells you,
16:40if you are a diabetic or not,
16:44if a diabetes is controlled or not.
16:46But,
16:47more important than that,
16:49is getting a Homa IR done.
16:52That is a combination of insulin and sugar.
16:55Yes.
16:57And,
16:57if that is kept in check,
16:59and that is controlled,
17:01your chances of developing diabetes,
17:04later on in life,
17:05are much less.
17:06So,
17:07check insulin resistance.
17:08Insulin resistance.
17:09So that you don't end up being a diabetic.
17:11Yes.
17:12So that you do not end up being a diabetic.
17:14Now,
17:14we have got tests,
17:16for gut microbiomes.
17:18We have got tests,
17:19which have been,
17:20I have spoken to you about that in my previous forum also.
17:24Test,
17:24which is,
17:26which will predict,
17:27the onset of 10 cancers.
17:30Yes.
17:31In future.
17:32With nearly 98% specificity,
17:35and 70% sensitivity.
17:38This has been launched by Garden Shield,
17:40in US.
17:42And,
17:42in India,
17:42it is being sold by Zydus.
17:45Yes,
17:46but that is for people who can actually afford it.
17:49That is expensive.
17:51But,
17:52things like gut microbiomes,
17:53nobody gets a tissue transglutinase test done.
17:56I think that there is a hidden pandemic of wheat allergies,
18:01so-called gluten intrapathy that is going on.
18:03The demand is less.
18:04People don't care.
18:06People can ask for a lipid profile,
18:08but they do not ask for a homocysteine.
18:11Yes.
18:11Which I feel is extremely important.
18:13Nearly 56% of people in India have a high homocysteine level,
18:19because of the large number of vegetables which are there.
18:23If you Google the term,
18:25who know?
18:26H-U-N-O.
18:28It's a technology which is combining your biomarkers,
18:33your,
18:34all other health parameters,
18:37including excise level,
18:39including your diet,
18:41including the environment,
18:43and including your wearables,
18:45which I think are very important,
18:46which I wear them very regularly,
18:48because they are part of my body now,
18:49it all combines into months
18:51and gives into my logarithm.
18:53And that can only be shared with the doctor
18:56in full confidentiality if they want to.
19:00Now,
19:00if we have got such a vast picture,
19:04first,
19:04we used to be seeing only a trailer of a movie.
19:08Now we can see a full movie,
19:09what is going to happen to us in future.
19:12Isn't that extremely important?
19:13It is,
19:14you're right that,
19:15you're right that,
19:15we were watching the trailer,
19:16we were testing the horse,
19:17we did test the horse,
19:18now we are doing a nuanced and customised test.
19:22Absolutely.
19:22But Dr. Mahajan,
19:24why should we all try to test this?
19:26Because,
19:27I find,
19:28that people are also apprehensive.
19:31It is too much knowledge also a problem.
19:34See, it depends on the individual.
19:36and that's why before doing
19:39predictive tests
19:40in people who are otherwise healthy
19:43they have to be counselled
19:45and we do that counselling
19:47there are counsellors, we also act as
19:49counsellors because there are tests
19:51which may, like genome
19:53testing, where
19:55we may be able to predict
19:57that you have a much
19:59higher chance of developing
20:01cancer and
20:04aapne test, koi aya, aapne test
20:07kar diya aur aapne vada aya, aapko toh
20:0850% general population
20:11se zada chance hai
20:12of developing cancer
20:15how will that person take it
20:17so, you know, everyone
20:19has a different personality
20:21a different outlook
20:22and that's why pre-test
20:25counselling is very important
20:26so that you are able to explain
20:28that if it comes positive, this is what
20:31it means, if it comes negative, then
20:32of course, you're fine
20:34and not everyone needs it
20:36you have to look at
20:38family history
20:39if someone has, you know
20:42multiple people in the family
20:44who have cancer on one side
20:46mothers or fathers
20:47then
20:48if you can afford it, remember
20:50even though we have brought the cost
20:52down dramatically in this country
20:54we started genome sequencing
20:56seven years ago, but yet
20:58it is expensive
20:59so you have to look at India
21:01and as the going goes
21:03you have to look at Bharat
21:05so not everyone can afford it
21:07but as more and more people
21:09come for tests
21:10the costs keep going down
21:12because the reagents you use
21:14the kits you use
21:15you know, you can use the same kit
21:18for five people
21:18and the same for 25 people
21:20and but having said that
21:23it has to be pick and choose
21:25but certain blood tests
21:27simple blood tests
21:28those
21:29if one can
21:30again
21:30if one can afford
21:32are for everyone
21:34a homocysteine
21:35or inflammatory markers
21:38a cortisol level
21:40all those
21:41if possible
21:42should be done
21:43for everyone
21:44but these high-end tests
21:45you have to see
21:47what is
21:47your risk profile
21:49like
21:50in radiology
21:51we do
21:52CT coronary angiogram
21:53we started doing it
21:5522 and a half years ago
21:57in this city
21:58and
22:00unfortunately
22:01those
22:01who need it
22:03never come for it
22:04and there are those
22:05who may not be
22:06at high risk
22:07they are getting it done
22:08every five years
22:09which is the guideline
22:10so
22:11here again
22:12I would say
22:13your doctor
22:14has to play a good role
22:15for you
22:17to go to
22:17chat GPT
22:18and learn about things
22:20is very good
22:21chat GPT
22:22or anything similar
22:23I have no preference
22:24but
22:26when you
22:27actually are talking
22:28about serious testing
22:30predictive testing
22:32preventive health checks
22:33early diagnosis
22:35whole body MRI
22:36for that matter
22:37it's
22:38it's becoming
22:38very very popular
22:39but it has to be done
22:41right
22:42it has to be done
22:43under the
22:44correct guidelines
22:46using the
22:47best possible machines
22:49because here
22:50you are looking
22:51for a needle
22:52in a haystack
22:53in a
22:54absolutely healthy person
22:55but these are important
22:57and
22:58as you know
22:59we pick up cancer
23:00in stage one or two
23:01we can nearly
23:03promise a cure
23:04whereas in
23:05three and four
23:05it's a struggle
23:07for the person
23:08the
23:09you know
23:10morbidity
23:10and
23:11we talk in terms of
23:13one year survival
23:14five year survival
23:15so for the family
23:16for society at large
23:18it becomes a big burden
23:19now we have tests
23:20that can actually
23:21catch cancer
23:22at stage zero
23:23we recently had
23:24being diagnosed
23:25with cancer
23:26at stage zero
23:27and she's had a surgery
23:28and she's out of it
23:28and oh
23:29you have a story
23:31to share
23:32no
23:34these are all
23:35very private
23:37conversations
23:37which can't be had
23:39in public
23:39yes
23:40so
23:40you know
23:41these days
23:41the buzzword
23:42at the moment
23:42is longevity
23:44people want to
23:46have a life span
23:47they also want to
23:48have a health span
23:49and since all three
23:50of you are sitting
23:51here it's so
23:52interesting because
23:52you have more data
23:53points and you
23:54understand you read
23:55numbers much more
23:56Dr. Lal help me
23:58understand this
23:59are we as a country
24:01getting more sicker
24:03or are we doing
24:05better
24:05I asked this question
24:07because
24:07if
24:08if
24:10a disease
24:10is
24:11going to
24:11get rid of it
24:12then it is available in India
24:14if there is a test
24:15which can get rid of your disease
24:17quickly or can get rid of it
24:19then it is available in India
24:20but what people are doing
24:22using it
24:24ndry jy jy india ki jy jy kahani hai na woh to yaan
24:28mein aap sa discuss nhi karun ga kya te na agar magar kintu
24:31aur parantu ye char chizay hai isme har chiz
24:34ap justify kar dhooghe pahar hamarhe hesab se
24:37agar aapke family mein mein aap jas se pehle
24:41bataya family history hai blood pressure ki
24:44to aapko ye test jaldi karane chahiyye ki
24:47kolesterol se high blood pressure bhi ho saktahe
24:49blood sugar se bhi ho saktahe
24:51aur baqi kolesterol aur jy kidney ki test hai
24:55woh aapko karane chahiyye
24:56so by and large
24:58aapko jy 25 sal ki umar me
25:01pehle ye test basic jy test hai karane chahiyye
25:03par agar aapki family mein history hai
25:06mother کو ہے, father کو ہے
25:08chacha, chachi کو ہے
25:10chachi نہیں, chachi کو ہے
25:12تو
25:13اس
25:15karen سے آپ
25:16جلدی بھی ہمارے پاس آ سکتے ہیں
25:17اور
25:18blood sugar
25:19یہ میں سب کے لئے کہنا چاہتا ہوں
25:21blood sugar
25:22ایک ایسی نامراد
25:23بیماری ہے
25:23جو آپ کو
25:25پتہ ہونی چاہیے
25:26بیماری اگر ہو گئی
25:27تو ہو گئی
25:27آپ کی family میں
25:28ہو سکتی ہے
25:29آپ کے کھانے پینے سے
25:30آ سکتی ہے
25:31آپ کے
25:31نا exercise
25:32کرنے سے آ سکتی ہے
25:33پر وہ
25:34الگ بات ہے
25:34پر اگر آپ کو blood sugar ہے
25:36تو آپ کو
25:37سب سے پہلے پتہ ہونا چاہیے
25:39یہاں پہ لوگوں کو
25:40پتہ ہی نہیں ہوتا
25:41جب heart attack ہوا
25:42آئی سیو میں
25:43admit ہوئے
25:45پتہ چلا کہ
25:46ان کو تو diabetes بھی ہے
25:47ان کو کچھ اور بھی ہے
25:48تو اس سے
25:49تھوڑا دور رہنا چاہیے
25:50تو ہمارا
25:51mental make up
25:52especially جو
25:53ہمارے سامنے
25:53youngsters بیٹھے ہوئے ہیں
25:55ان کو پتہ ہونا چاہیے
25:56کہ کس age پہ
25:58کون سے test کرانے ہیں
25:59تو ہماری آپ
26:00لوگوں سے request ہے
26:01کہ
26:02definitely by the age of 25
26:04یہ جو basic test
26:05جو میں ابھی بتا چکا ہوں
26:06یہ آپ ضرور کرائیے
26:07I want to take an opportunity
26:09here to say that
26:10you know
26:11the Health Health Summit
26:12we've organised
26:12a wellness hub
26:13right outside
26:14so everybody here
26:15in the audience as well
26:16the whole idea
26:17of getting this summit together
26:18was to ensure
26:19that we give them access
26:20we don't just talk about it
26:21we actually do some
26:22actionable things as well
26:24but staying with longevity
26:25Dr. Dang
26:27we live in the era
26:28of full body scans
26:31we live in the era
26:32of genome make ups
26:34we live in the era
26:36of testing
26:37every part
26:39every organ
26:40of your body
26:41is it true
26:43that all of us
26:43if these tools
26:45are used correctly
26:46could actually live
26:47forever
26:53interesting question
26:55both yes and no
26:57one
26:58like what my
27:00esteemed colleagues
27:01have pointed out
27:02these genetic tests
27:03etc.
27:04are expensive
27:06but then
27:07the same thing
27:08I said before
27:10that
27:11that
27:11life
27:11should not be
27:13my favourite dialogue
27:15which I tell everybody
27:17that if
27:18we test
27:19genetic markers
27:20tests
27:25then what
27:26I'll give
27:27the example
27:28of Angela Jolie
27:29which everybody
27:30knows about
27:31she got
27:32genetic test
27:33done
27:33and she thought
27:35that she is going
27:35to develop
27:36breast cancer
27:37she got
27:38her breast
27:38chopped off
27:40if she had
27:40a daughter
27:41who was 20
27:42years old
27:43and she would
27:44have also
27:44got the test
27:45done
27:45and if
27:46she had
27:46turned out
27:47to be
27:47positive
27:47what would
27:48she have
27:48done
27:48would she
27:49have also
27:50got her
27:50breast
27:50chopped off
27:51or I put
27:52the other
27:52way round
27:53if there is
27:53a lady
27:54who has
27:55got a
27:55granddaughter
27:56who is
27:56five years
27:57old
27:58again
27:59if that
27:59person
28:00tests
28:00positive
28:00what do
28:01we do
28:02about it
28:02so there
28:04are
28:04innumerable
28:04examples
28:05which can
28:05be given
28:06to say
28:07that all
28:08these tests
28:09are important
28:11but what I
28:12rightly said
28:13and what I
28:14think all
28:14my other
28:15esteemed
28:15colleagues
28:15also support
28:16that they
28:17should be
28:18done
28:18only
28:19under the
28:20guidance
28:21and advice
28:22of a
28:23well informed
28:24physician
28:25or a
28:26medical
28:26practitioner
28:27they should
28:28not be
28:28done
28:29at
28:29random
28:30when talking
28:31about longevity
28:32testing
28:32I've got
28:33one of my
28:34most admired
28:35and respected
28:36gastroenterologists
28:37sitting out
28:37here Dr. Ashwini
28:38Chopra
28:39I call him
28:40my godfather
28:42because he
28:43taught me so
28:44many things
28:45which I never
28:45knew when I
28:46came to
28:46practice
28:47and one of
28:48the things
28:48which he
28:48taught me
28:49was
28:50the ethics
28:51of medical
28:52practice
28:53Ashwini
28:53in this forum
28:54which is being
28:55viewed by so
28:55many people
28:56thank you for
28:57being what
28:57you are
28:58and here
28:59I can
29:00and here
29:01I can
29:01proudly say
29:02one thing
29:04and Ashwini
29:05has Ashwini
29:06means then
29:07I'll go to
29:07a vast
29:08wider range
29:08because now
29:09you consider
29:10gastroenterology
29:11as the most
29:12important part
29:13or GI
29:14as one of
29:15the most
29:15important parts
29:16of the body
29:16people call
29:16it the second
29:17heart
29:18now here
29:19if you find
29:20a problem
29:21I think
29:23there are
29:23very few
29:24people like
29:24Ashwini
29:25who will
29:25pick up
29:25the call
29:26and ask
29:26what is this
29:27meaning
29:27what is this
29:28benefit
29:29then after
29:30properly
29:31deciding
29:31what the
29:32advantages
29:32are
29:33then only
29:35ask for the
29:36test
29:36then only
29:37get the
29:37test done
29:38when
29:38when
29:39I started
29:40this
29:40he said
29:41that
29:41every
29:42test
29:42is not
29:43necessary
29:43but
29:43the right
29:44test
29:44is
29:45necessary
29:46if
29:47the money
29:48is
29:48so
29:48it is
29:49the
29:49knowledge
29:50is
29:50the
29:50land
29:51is
29:51and
29:52can't
29:52leave
29:54and if
29:55leave
29:55and leave
29:56and if
29:57it is
29:57then he
29:59says
29:59that
30:00doctor
30:00has
30:00wronged
30:01the
30:01doctor
30:01had to
30:02test
30:02before
30:02he had to
30:03do
30:03doctor
30:03he had to
30:04he had to
30:04do
30:05he had to
30:10So, if you can afford it and a doctor's advice, get the test done if required.
30:16Dr. Manjir wants to chime in.
30:18Yeah, I just wanted to add, you know, why get these predictive tests done?
30:23The idea is that we are able to pick up those at high risk.
30:28Suppose 1.4 billion population of India were to get genome sequencing done.
30:40So, out of that 1.4 billion, you may pick up 50 million, only 50 million who are at high
30:48risk for cancer or diabetes or heart disease.
30:53Then you have a sub-segment and these people who are at high risk, what is the idea is that
31:00then you will test them regularly.
31:03Whether blood testing, whether by a CT, MRI, ultrasound, X-ray mammogram, diligently, the idea being to pick up disease
31:15just as it happens.
31:18That is the idea of this predictive testing.
31:22And, of course, again I will qualify that it has to be with counseling.
31:28At 20 years of age, if someone gets genome sequencing done and knows that she is at high risk of
31:38breast cancer,
31:39that doesn't mean she requires, you know, preemptive surgery.
31:43Not at all.
31:44That just means that at 30 years of age, you start doing your MR mammography,
31:49which is the most sensitive technique once a year to pick up cancer early in few millimeter size so that
32:00if it comes, you can cure it.
32:02And number two, Ms. Angelina Jolie, I think, did the world a huge service by coming public with the fact
32:13that she was at 80% higher risk of developing breast cancer.
32:18And so they were not chopped off.
32:21There was surgery done and reconstruction done after that.
32:25So even that horrible thing, breast removal, doesn't mean removal.
32:29It just means removal of the parenchyma and then reconstruction done.
32:34So that is the idea.
32:36And I think she really created a lot of awareness about early diagnosis and the fact that someone at high
32:45risk and at very high risk,
32:48she says, I have six children.
32:49I can't afford to die early.
32:51And because of that, she says, I underwent this.
32:54That's an individual's choice.
32:56Not everyone will do it.
32:58Not everyone needs to do it.
32:59But if someone wants to know what is their risk, then even in our country, each and every tool, diagnostic,
33:09is available to determine that.
33:12I think it's down to understanding what your body needs, being aware of your roots, understanding your family history,
33:19and importantly, finding yourself the right doctor, which is always the tricky part.
33:22I think this is a good time for me to open it up for the audience if they have any
33:26questions.
33:26Can I have the mic there, please?
33:28That gentleman in specs over there.
34:01So this is a good time for everyone.
34:45So this is a good time for me to open it up for the audience.
35:23So this is a good time for me to open it up for the audience.
35:55So this is a good time for me to open it up for me to open it up for the
35:56audience.
35:56It is a good time for me to open it up for me to open it up for the audience.
36:04So this is a good time for me to open it up for me to open it up for me.
36:26Why? Because I will say that the new pandemic that is in front of us is antimicrobial resistance.
36:34That means that we do not respond to antibiotics.
36:39Already, you talked about typhoid. There is something called a Karachi pandemic of fact typhoid going on.
36:47Their patients are not responding to any of the antibiotics for typhoid.
36:55So, that is the very interesting doctor.
36:59A doctor who can ask.
37:03Don't do any tests. Don't do any tests.
37:08And the most important thing is that you discuss with the lab what you should do and what you should
37:15not do.
37:16Then only our country can move forward and unnecessary tests should be removed and the right treatment given.
37:23Yeah, yeah. You want to chime in?
37:25Yeah. No, no. This is absolutely right.
37:29I think AMR, antimicrobial resistance is going to be, is already upon us and is going to be a huge
37:37challenge going forward.
37:38Because there is a limit to the new molecules, new antibiotics that you can produce to fight against these absolutely
37:48resistant bacteria.
37:51And so, you know, rational treatment, rational giving antibiotics, unfortunately even now you can get over the counter antibiotics in
38:05our country.
38:05And that has led to the fact that every, you know, people tend to give the strongest antibiotic.
38:14Because they feel, it will be better than this, which is not the right thing.
38:18So, you don't listen to the chemist's talk or the internet's talk.
38:22And please, you don't listen to the doctor's talk.
38:24And please, you don't listen to the doctor's talk.
38:26Because what happens with the antibiotic resistance is that you don't resist your body.
38:30As a community, you are making everybody, you know, resistant, which can get really dangerous.
38:35Last few questions I can pick up from there. The gentleman with the green shirt, please.
38:41Dr. Sir, I'm talking about a test. CT calcium score.
38:46The publicity is very low.
38:50I have recently done CT calcium score.
38:52And my CT calcium score was 1013.
38:55So, I consulted with cardiologists.
38:58They said that if there is no need to take breath in the breath,
39:02And if there is no chest, then they doubled the tablet of cholesterol.
39:08And they also gave me an Epstein, a special tablet.
39:14So, the publicity of this test is very low.
39:16If I do 20-25 years ago, it might be better.
39:19Today, I am 62.
39:21I think what you have said is absolutely right.
39:25The coronary calcium score,
39:27We have started in this country.
39:32And the CT angiogram,
39:34which is the next part.
39:36We have die.
39:37And the arteries of our heart.
39:40We can see them.
39:42We know the narrowing.
39:42The calcium score is 400.
39:47So, the possibility of your arteries is significant problem.
39:53The coronary arteries will increase.
39:55From 100 to 100, low score.
39:58From 100 to 400, intermediate score.
40:01And I have a certain extent to you.
40:03That this is a very important test.
40:07Which is underutilized.
40:10I will say that our medical fraternity,
40:14People will also lose something.
40:16That something will come out.
40:18Whereas, the idea of getting these preventive health tests,
40:22Is that if there is something inside,
40:25What is bad,
40:26That we will fix it.
40:29And your doctor has done that your cholesterol...
40:33But Dr. Mahajan is the counter.
40:35And I get where this question is coming from.
40:37Because yesterday, we had Dr. Nene over here.
40:39Who said...
40:40Who gave an India context to this.
40:42He said that Indians have soft plaque.
40:44So, a lot of times, it can give you...
40:46So, that's why...
40:47Yeah.
40:47No, no.
40:47That's why what I am saying is,
40:49Calcium score is step one of the testing.
40:53Yes.
40:53What we do is CT coronary angiogram.
40:55With injection of the dye.
40:57Which is able to see the soft plaque.
40:59And that's important.
41:01What was said.
41:02Because even soft plaque,
41:03Which is causing only 10, 15, 20% narrowing.
41:06Can be very important.
41:08If it is fatty in nature.
41:10Because it can break.
41:13And cause a heart attack.
41:14Sure.
41:15That's when you get, you know,
41:17The chest pain and stuff like that.
41:19Discomfort.
41:20But more importantly,
41:21The area from which it is broken.
41:24A clot can form over it.
41:26And block the artery completely.
41:28And give you a massive heart attack.
41:29Yeah.
41:30So, even in the new guidelines that have come for cholesterol.
41:35CT angiogram and the plaque that is there.
41:38Is playing a role.
41:40And previously, it used to be that without medication.
41:44The LDL.
41:46Which is the bad cholesterol.
41:47Should be below 100.
41:49And your total should be below 200.
41:51Yeah.
41:52Then it was.
41:53If you are on medication.
41:54And for many years.
41:55It used to be that it should be below 70.
41:58On medication.
42:00Statins.
42:00Or whatever else.
42:02Now it is.
42:02It should be below 55.
42:04Yeah.
42:04And in fact they say.
42:06HDL.
42:07The good cholesterol and bad cholesterol ratio being one is to one.
42:10So.
42:11Calcium score.
42:12Step one.
42:13Is.
42:13Is.
42:14Is.
42:14Is.
42:15What.
42:17Is.
42:17Is.
42:23Is.
42:23Sometimes it fails because there are artifacts from it and we tend to overestimate the degree
42:31of narrowing.
42:32Here we test which is called stress thallium.
42:35This is a nuclear medicine test which shows the effect of narrowing on your heart, on
42:43its pumping, on its blood flow, into the myocardium, muscle of the heart.
42:49So, this is your cardiologist and if you need to understand it, then you will do it.
42:56There is a whole armamentarium that we have with us.
43:00You know, we have spoken in so much of depth about these tests as well.
43:04We have last few minutes, so I want to talk about the testing mindset a little bit.
43:08Dr. Lala, do you start with me?
43:10Can you tell me why some people are scared to test?
43:14I'll give you an example.
43:16I've been after my father's life to get a sleep test done.
43:19He snores at night.
43:20There's a family history of, say, heart disease in the family.
43:24But is there a certain generation which is very scared to test?
43:28How do they get out of their mindset?
43:31You send them to a psychiatrist before you.
43:35Because they can't do their treatment.
43:39We are not able to do it.
43:40I have to say that every year or two years in the younger age group, blood sugar, cholesterol, liver, liver,
43:48STPT, kidney, creatinine, and one test.
43:53I'm not sure I forget about it.
43:54I'm not sure if I get out of my life.
43:55I have to do it.
43:58I'm not sure if I get out of my life.
43:59If I get out of my life, I'm not sure if I get out of my life.
44:02I don't know if I get out of my life.
44:02But the problem that I have done in India is that it's a bulk.
44:05The quantity is so increased.
44:07If you start talking about blood sugar, I'm going to talk about cholesterol.
44:12If I get out of my life, I'm going to talk about cholesterol.
44:13So if you need healthy India, I'm going to talk about these 5-6 tests that I have told you.
44:19I need to do it in a few years.
44:22Dr. Dying and Dr. Mahajan, I will come to you as well.
44:24So there are two kinds of people.
44:25One, who will refuse to get a test.
44:27Because something will go out.
44:29Right?
44:29And there are those who are obsessed with it.
44:31Who want to track everything possible.
44:33They've got their CGM monitors.
44:34They've got their tracking devices.
44:36And a little spike they run to the doctor and they want to get it fixed.
44:39In that, is there a balance really that one must get?
44:42And how do you achieve that?
44:44Dr. Dying for then, I will come to Dr. Mahajan.
44:45Actually speaking, Sonal, lots of people say that ignorance is bliss.
44:51Yeah.
44:51What happens, what happens, what happens, what happens, what happens, what happens.
44:57What I face, right?
45:01There is a difference between foreign countries and foreign countries.
45:04There is a difference.
45:05There is a difference here.
45:06People come here and give us one thousand rupees.
45:09They give us one thousand rupees.
45:10They do all the tests.
45:11They do all the tests.
45:13They do all the tests.
45:14There is so much money and everything is normal.
45:18And while abroad,
45:21while abroad,
45:22when they do tests and everything is normal,
45:25they say,
45:26Thank God, everything is normal.
45:28So this is a mindset.
45:30We have to ask ourselves,
45:32we have to ask ourselves,
45:32we have to take so much money,
45:33we have to test so much,
45:34we have to take so much money and nothing is left.
45:37So what can I give to him?
45:39What the answer was,
45:39Dr. Lal said that it was right.
45:41That it is a mindset,
45:43ignorance is bliss.
45:45Now,
45:46you can tell them,
45:48that dad, please cry.
45:51But,
45:51as I and Dr. Mahajan
45:53talked about this,
45:55we were not agreeable about Angela Jolie.
45:58But,
45:59I was going to say,
45:59I started with the garden shield test.
46:02That test,
46:03we have to test,
46:04because we have to take a predictive value.
46:06If the colon cancer is in a family,
46:09and if it is a colonoscopy every year,
46:12then how much will it be?
46:14Correct.
46:14If the history of cancer is best,
46:16and every two years,
46:18every year,
46:20mammography,
46:21ultrasound,
46:21MRI,
46:22then how much will it be?
46:24But,
46:25not to take any drastic action,
46:27and it should always be done.
46:29I will underline the fact again,
46:31that it should be done,
46:32only under the supervision,
46:35guidance,
46:36and advice,
46:37of a qualified medical practitioner.
46:39Absolutely.
46:40Last few minutes.
46:41So, Dr. Mahajan,
46:41I want to come to you with this one.
46:43The use of AI in testing,
46:45is a bit of a double-edged sword.
46:48Right?
46:48On one hand,
46:49you have these AI assessment tests.
46:51We are talking about Angelina Jolie,
46:52another actress,
46:53very famous,
46:54who has done a breast analysis,
46:56a breast assessment test,
46:58and found out how high risk it was.
47:00Her mammogram had missed her breast cancer.
47:04And that breast cancer assessment test
47:07told her that she was at risk,
47:08and she finally got rid of it later.
47:11So, she is very thankful to AI.
47:12On the same hand,
47:14when you upload your tests on ChatGPT,
47:18or say any other AI tool,
47:19it can give you a very different perspective as well.
47:22So, how do you see this double-edged sword?
47:23How do you see it?
47:25Look, we have been involved with building AI,
47:28and using AI for the last ten years.
47:31In fact, the first paper ever to be published on AI,
47:36in the Lancet, which is the ultimate,
47:39came from our group,
47:40along with our collaborators from Mumbai.
47:42And so, India published the first paper,
47:46in the Lancet, on AI.
47:48So, you know, it has been there.
47:51But, you know, when we talk of AI,
47:53there's general AI,
47:54which is available to everyone,
47:56like a ChatGPT or others like it.
47:59And then you have specialized AI.
48:03What medical institutions use is specialized AI,
48:07which is US FDA approved,
48:09which is CE marked.
48:11Even in India,
48:12if a healthcare institution has to use AI for testing
48:17or for treatment,
48:18it has to be CDSCO approved.
48:21Yes.
48:21No one can just take it.
48:23So, you're right, it's a double-edged sword.
48:25I would say AI can be used by people at large,
48:31by patients, to get some, you know, education,
48:35to gain some knowledge,
48:38but not for self-diagnosis or for self-treatment.
48:42That you have to leave to specific AI algorithms.
48:47In fact, we've built, in Mahajan Imaging and Labs,
48:51a startup called Carpal.AI,
48:56which is for helping institutions, hospitals,
49:03diagnostic centers to use AI.
49:06It's a platform which helps in validation,
49:10testing, fine-tuning and monitoring.
49:14So, all along this value chain,
49:18you have to first build trust in an AI algorithm.
49:21You just can't use it out of the blue.
49:25An AI algorithm that works well in, say, All India Institute
49:28may not work well in Kalawati Saran Hospital
49:31because the way scans are done,
49:34the way treatment is done may be entirely different.
49:36So, you have to pick and choose
49:38and then you have to validate, you have to test,
49:41you have to see whether it works in your environment.
49:43Only then will you use it.
49:45And for your case about, you know, AI for breast cancer,
49:51this is being used in our centers as well.
49:55We use it as a second read.
49:58But it's our specialist radiologist who has the final word.
50:03So, two reads, one by AI, one by our radiologist
50:08and then you reach a conclusion.
50:11However, going forward, especially when we talk in terms of use of AI
50:18by healthcare institutions, I see more and more autonomous use of AI coming in,
50:26even though we as radiologists or pathologists as doctors may not want that.
50:32But AI is going to get stronger and stronger.
50:36When we started, we used to build with deep learning.
50:40Then came generative AI and now you have agentic AI.
50:43And already there is, you know, Alibaba from China has built AI algorithm.
50:53This was a paper published in Science, which is again one of the finest medical journals,
50:59where they have shown for abdominal CT scan that the AI that they built works like a radiologist,
51:10is able to diagnose everything in the abdominal CT.
51:16And when they compared it against 26 radiologists, and this is published in Science,
51:21so this is not, you know, hocus pocus.
51:24This AI algorithm, which is still in its infancy, was better than 23 out of 26 radiologists.
51:32So, appropriate use, use within guardrails, ethical, responsible use of AI in healthcare,
51:42I think is going to be a major plus.
51:46It will make us doctors better at our job.
51:50It will improve turnaround times of reports.
51:54It will improve our efficiency, productivity.
51:58And hopefully, because of all of this, reduce mistakes and also reduce costs.
52:04I think that is a good note to end on.
52:07I will add one small request to all my friends who are out here,
52:12that Dr. Dang's lab outside in Zone 2 has set up a booth for your preliminary cognitive testing for Alzheimer's
52:22disease.
52:22Yes.
52:23And I want you all to try it out.
52:26Here you are not paying anything.
52:28We are doing it because Alzheimer's is something which I am very scared of.
52:32But lots of us are very scared of.
52:34What did I do yesterday?
52:35What did I do yesterday?
52:36What did I do yesterday?
52:37I don't remember anything.
52:38Who did I get to see yesterday?
52:39I forgot.
52:40Actually, it is time that you throw junk from our brain.
52:43We should only use things or remember things which are of importance.
52:47Outside, we have put up a booth where you can go and do your cognitive test.
52:51And if your score is good, that means you are nowhere going to be close to Alzheimer's.
52:55But if your score is poor, then get a blood test done, which is available with all of us out
53:01here,
53:02and then proceed further.
53:04But initially, if you ever feel the risk, we have got a booth out here.
53:07That is all based on AI.
53:09That is what I want to remember.
53:11This is a predictive test which can tell you 15 to 20 years before you get Alzheimer's that you are
53:19at risk.
53:19The key from this session is this, that there is no disease now in this world which cannot be treated.
53:24We live in such brilliant times of science and technology.
53:27There is, if only, you catch it early.
53:30And the means to catch it early is to ensure that you have the right doctor and you are using
53:34the right tools
53:35to ensure that you actually get there.
53:37Two words.
53:38I am out of time.
53:39Test, test kirao, zindagi badao.