YOUR body can stand almost anything – it is your mind that you have to convince! Our brain is one of the most important organs of the body — it controls and coordinates our actions, reactions, consciousness, personality, allows us to move, see, hear, smell, think, remember, communicate and coordinates all our activities. This article explores what’s making news and medical research in the last few days that concerns the mind, aging and those who matter.By. Dr. Amit Dias

SIXTY-seven-old Svante Pääbo has won the Nobel Prize in Physiology/Medicine 2022, for his discoveries concerning the genomes of extinct hominins and human evolution. Paleontology and archeology are important for studies of human evolution and the relationship between Homo sapiens and extinct hominins has long been a topic of great interest and research. Our genes makes us uniquely human and distinct from other species. Our knowledge on our genes and how we function is rapidly changing with advance research and our minds get better insights into what matter to us.

What makes us uniquely human?
The complex nature of our cultures, social structures, and our capacity to communicate, make Homo sapiens different from animal species. It can be assumed that this unique “humanness” results from changes in the genome on the modern human lineage. Access to archaic genomes offers exciting new possibilities to identify critical genetic features that distinguish us from archaic hominins.
According to the Nobel Assembly, Karolinska Institute, there are around 31,000 single-nucleotide positions in the genome where present-day humans from all parts of the world carry only a novel (derived) nucleotide, whereas both the Neanderthal and Denisovan genomes carry the ancestral nucleotide, conserved since the split from chimpanzee.
Elucidating the functional relevance of uniquely human genetic variants is an exciting challenge of relevance to all Homo sapiens, which represents one of Svante Pääbo’s main current lines of research. Our past can throw light on who we are and the determinants of our health. We are reminded of a very famous statement made by Charles Darwin: “It is not the strongest of the species that survives, It is the one that is most adaptive to change.” We are evolving and continue to evolve, we need to become resilient and adapt.

EVOLUTION OF HUMAN BRAIN
THE study of skulls has revealed that across around 7 million years, the human brain has tripled in size, with most of the growth taking place in the last two million years. The skull of the species of the famous Lucy fossil, have internal volumes of around 400- 550 ml (compare this with chimpanzees and gorillas who have a volume of 500-700 ml. Homo habilis, the first of the genus Homo (1.9 million years ago), saw a change in the brain size specially in Broca’s area concerned with language.
The first fossil of the Homo erectus (1.8 million years ago), had brain around 600 ml. This increased slowly to reach around 1000 ml, 50,000 years ago. Early Homo sapiens had brains matching with the people of today — around 1200 ml. Our brains grew to accommodate the developing skills, culture and language of our ancestors. They developed planning, problem solving and advance cognitive functions as we do today. External factors can affect the brain and affect the brain matter leading to the shrinkage of the brain matter. We need to take care of our brains to prevent diseases such as stroke, Alzheimer’s disease and other dementia problems which affect our ability to function independently.

STROKE GENES IDENTIFIED
A STUDY published in the medical journal “Nature” September 30, has reported that a meta-analysis has identified the association signals for stroke and its subtypes at 89 (61 new) independent loci. The sample for the meta-analyses included 110,182 patients who have had a stroke and 1,503,898 control individuals. Participants belonged to five different ancestries- European, Hispanic, African, East Asian and South Asian. Previous genome-wide association studies (GWASs) of stroke were conducted predominantly in populations of European ancestry and this study had a representation of people from other ethnic backgrounds.
The study also had an Indian representation of 4,088 individuals (1,609 were having a stroke). The study states that stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardio metabolic disease. The study provides insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries. The discovery of genes can help develop therapy targeted to neutralize the gene to prevent stroke.
This is certainly something to look out for in the future. Stroke is the second most common cause of death worldwide. In 2019 alone, it was estimated that there were 1.29 million cases of stroke and 6,99,000 deaths due to it. Everyone should be aware of the signs of stroke and BE FAST to take appropriate action to prevent further damage.

HUMAN RABIES ZERO IN GOA
RABIES is an infectious disease that affects the Brain, after a dog or cat bite or scratch, and is almost 100% fatal. September 28 is observed the world over as World Rabies Day. It marks the death anniversary of the French microbiologist Louis Pasteur, who prepared the first rabies vaccine. Remember it not only a bite, but also a scratch from a rabid animal that can transmit the disease. Prevention is the best option to fight rabies.
I remember when I was doing my research on rabies, I found that there were several malpractices with regards to dog bite and prevention of rabies. There are several people who claim to have a cure for rabies and people from all parts of Goa flock to them — this is FAKE. Remember, washing the wound with soap and water and the vaccine is necessary, to protect a person from rabies following a dog bite. During our study we also came across an incident when the whole village rushed to take the anti-rabies vaccine after attending a funeral of a person who succumbed to rabies.
Rabies does not spread by shaking hands. The theme for rabies day this year is “One Health, Zero Deaths.” I am happy to inform all of you that Goa had been human rabies free for more than three years. However, we do get reports of rabies in dogs and one has to be careful and alert. The vaccine are available free of cost at all Government Health Centers and are safe and no longer given on the abdomen as before.

WORLD ALZHEIMER’S DAY
THE messages of hope and support poured in on World Alzheimer’s Day, observed the world over on September 21. The theme was “Know Dementia, Know Alzheimer’s” and this stresses the need to raise awareness and post-diagnostic care for people with dementia. India alone has around 5 million people with dementia and it is estimated that the number of people with dementia in the world is rising at the rate of one every three seconds.
It is encouraging to read the tweets and messages from Health Minister Mansukh Mandaviya, our very own Health Minister Vishwajit Rane, in support of the cause. There was a message from His Holiness Pope Francis on praying for the caregivers of people with dementia. Several messages, including the one from the Ministry of Health, Government of India, stressed on the 12 modifiable risk factors that have the potential to prevent Alzheimer’s disease.
I had the privilege to be part of the Lancet Commission on the prevention of dementia that reported the 12 modifiable risk factors to prevent dementia including Alzheimer’s disease. Our analysis under the guidance of Prof Gill Livingston was published in the “Lancet” in the year 2020. The paper revealed that 12 interventions could delay or prevent 40% of dementia.

CARE OF THE OLD WITH A HEART OF GOLD!
The IMA State Branch under the leadership of Dr Rufino Monteiro and his team organised GIMACON-2022, the annual state conference. This was the first conference in physical mode after a break of three years due to the COVID Pandemic. The IMA played a vital role during the pandemic and worked closely with the government to provide care and support in the state of Goa.
The theme for this year and that of the conference was “Care of the old with a heart of gold.” Given the rapidly aging population in the state of Goa and the weakening of the traditional family care arrangements, this topic on elder care was very appropriate. Psychiatrist Dr Harish Shetty delivered the IMA Oration on the theme and kept his audience captivated — he stressed on the need to take care of our mind and take care of the elderly. “Mind is not made of iron or steel – it’s made of neurons. Nourish it always,” he said.
There is a very famous quote by the American Novelist, Mark Twain, “Age is an issue or mind over matter. If you don’t mind, it does not matter”. Aging is inevitable and one must learn to age gracefully. Active aging make a huge difference to the quality of life. October 1 is observed as the International Day for Older Persons and the theme this year was “Resilience of older people in a changing world.” Older people make significant contribution to society. We need to encourage them to stay fit, stay active and disease free.

MATTERS OF THE MIND: YOU ARE WHAT YOU THINK
WITH age, one tends to become rigid and may be resistant to change. The attitude and the mind matters a lot. All that you think and hold in your mind, will tend to occur in your life. If you think as you always did, you will act the way you always acted, you will continue to get the results you always got. If you want a different result in your life, all you have to do is change your mind and try to become flexible. It’s never too late to do so. One needs to break the cycle. As Mahatma Gandhi once said: Be the change you want to see. By the way, Mahatma Gandhi was a perfect example of active aging. He died at the age of 78. Gandhi walked 18 kilometers per day for 40 years, according to a research paper published in the IJMR (2019).
On the October 2 we celebrated the 153rd Birth Anniversary of Mahatma Gandhi. We need to keep his values alive and pass it on to future generations. An eye for an eye will make the world blind! Don’t let the values of Mahatma Gandhi disappear. I leave you with this thought-provoking picture courtesy The Times of India, a picture speaks a thousand words.
(About the author: Dr Amit Dias is faculty at the department of Preventive and Social Medicine at the Goa Medical College. He has done a lot of research in the area of aging and mental health in the state of Goa.)