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Editorial

Wake-Up Calls

Dr. G. Subramanyam
Director, Prof. & Head of the Dept. of Cardiology, College of Medical Sciences, Bharatpur, Chitwan (Dist.), Nepal

Worldwide data suggest that people are living longer than previously in developed countries.

Reports predict that if the present trend of increase in the life expectancy continues through this

century, most babies born after 2000 will be able to celebrate their 100th birthday. However,

researchers also have noticed an increased trend of the prevalence of obesity in wealthy countries

and assume that it might slow down the trend of rising life expectancy. Similarly increased life

expectancy means increased prevalence of coronary artery diseases and this may also put some

brakes in this trend.  However, there is a greater advancement and achievement in the early

recognition and treatment of coronary artery diseases especially in developed nations; it indicates

that there is no stop in rising life expectancy.

On the other hand, this scenario is markedly different in developing countries. The developing

nations are just getting rid of infectious and communicable diseases as a result of some

improvement in sanitation and living conditions, and also because of the easy availability of

effective antibiotics and antimicrobial treatment. But there is also a rising trend in non-infectious

conditions such as cardiovascular diseases and oncological conditions. This is not only because

of some rise in life expectancy but also due to sedentary life style and diet containing high fat

and carbohydrates. So, it seems the long life is still a distant privilege for the future generations

in these countries until there is satisfactory development in the management of the major

contributors of mortality and morbidity; cardiovascular, cerebrovascular and oncological diseases.

Nepal, being one of the representatives of latter group, is experiencing similar trend. So, the

future generations of the Nepal and other developing world will not be lucky enough to enjoy

the privilege of long life. Therefore, apart from strengthening the efforts against infectious

diseases, there is a strong need in the advancement of facilities dealing with major determinants

of mortality and morbidity in future scenario, such as coronary artery diseases and other

cardiovascular conditions, cerebrovascular diseases, and oncological conditions. In addition,



there is also a strong need for authentic researches on health related matters of the communities.

So, it is high time to start higher education in super specialty such as cardiology, neurology and

nephrology, and other areas of medicine. These courses, apart from emphasizing on clinical

skills and community services as the main objectives, should produce high level researchers

capable of carrying independent researches. In this regard, the steps taken by Kathmandu

University in starting DM and MCh courses on various subjects at the College of Medical Sciences

Teaching Hospital, Bharatpur are timely and appreciable.

Kathmandu University has always been a pioneering institution in starting various innovative

and practical courses in the country and such milestones will also be a leap in medical education.

We fully agree with the idea that Nepal needs to put brakes on the conventional development

and should make leaps not only in economic but also in every aspect of development. The

steps taken by Kathmandu University should be encouraged and supported by the medical

community. We are sure these measures taken by the University and the efforts taken by the

persons behind these programs will be remembered forever not only by the medical community

of the nation but also by the general public.

As these courses are research based advance clinical degrees, priorities are on both advance

research and clinical super specialty subjects.  Therefore, we hope these programs will produce

not only highly skilled, community and service oriented specialists but also well trained researchers

and strengthen the research wing of the medical science. We hope these efforts and steps will

also make a wake up calls to various institutions in collaborating for the success of this history-

making effort of Kathmandu University.