Issue 1

Note from the Writers

Thank you for reading The Lifeline. Our aim is to provide you
with the latest and greatest advancements in Medicine, Dentistry
and Veterinary Science, in a student-friendly and concise
manner. This journal will be useful for those who are looking to
pursue a career in Medicine/Dentistry/Veterinary Science, and
provide real life scenarios of application. Even if you are not
considering a career in this spectrum, this issue is fulfilled with
recent developments and current affairs which may have a major
impact towards your everyday life and wellbeing.

This is the first major issue being released at Ilford County High
School, and a new issue will be published every fortnight. This
medical journal is for suitable for anyone from Year 7 to Year 12
with terminology that can be easily comprehended. We hope you
enjoy our first release and any feedback will be appreciated.

Please visit our website: www.thelifelineichs.weebly.com or

alternatively scan the QR code below for more information, which
includes more interaction in conjunction to the articles in this
journal amongst other things you may be interested in.

Editor and Writer: Kirishananth Rajaseelan

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 Contents

NHS Celebrates 70 years of Service 4

The Origins of the NHS 6
To Live or Not To Live 8
Ageing 10
Recent Medical Advancements 12
Advancements in Dental Technology 13
Six ways the Veterinary Profession is changing 15
News Flash 17

Writers:
Adnan Digaswala Kirishananth Rajaseelan

Usman Khan Ravi Khiroya (Dentistry)

Kavi Jeshram Sharanhan Kugarajah

Khush Patel (Veterinary

Science)

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 NHS Celebrates 70 years of Service
By Kirishananth Rajaseelan
The NHS will be celebrating 70 years of
service to the public on the 5th July 2018.
This marks a remarkable milestone,
considering the impact it has made on many
people’s lives, whether the NHS gave them a
second chance to life or whether the NHS
brought them to the world. There are many
reasons why the NHS is close to many
people’s heart.
During the past 70 years, the NHS has seen
many inclines and declines, with majority of
the declines receiving major media
coverage. The NHS has increasingly been a
victim of budget cuts, with the inflow of
money not being sufficient to fund major
elements to ensure smooth operation of the
NHS system. Junior doctors were also in
major dispute over patient safety due to
insufficient numbers of staff presence.
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However with the arrival of the 70th
anniversary of the NHS, it looks as though
things might be taking a turn for the best.
The Government as a gift for the NHS
anniversary has granted a much needed
funding of £20.2bn by 2023, however this is
being questioned over as to whether the
funding is enough, since in 4 years’ time
will actually be lower than 4% increase in
funding annually.
The inflow of money is already having a
significant effect on the NHS, with £36.3m
to be spent in ambulances with over 200 new
ambulances being added to fleets all over the
UK, with improvements to the ambulance
service coming into action as soon as
possible. Many have welcomed the increase
in funding by the government, to improve
quality and care.
Celebrations across the UK
There have been many events that have
taken place over the UK to
mark the 70th anniversary
of the NHS. The Royal
Mint Office has released a
new 10p coin (left) in
recognition of the NHS.
The NHS has launched a dedicated website
in recognition of its service:
www.nhs70.nhs.uk/ The website gives an
outlook to its history and talks in depth
about its service to the community. It is
recommended that you visit the site and dig
deep into the world of NHS and its history.
The NHS Blood and Transplant staff at the
Filton Centre celebrated the anniversary by
holding a ‘NHS Big7 Tea’, by baking and
raising money for cancer research, for a
charity called Bloodwise.
Billy Blood Drop Cake commemorating 70 years of the NHS
In Ebbw Vale, The Prince of Wales met the
staff at Ysbyty Aneurin Bevan (in Wales).
Prince of Wales meeting NHS staff
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On the other side of the UK in Scotland,
Nicola Sturgeon had met with NHS Staff on
a visit to Royal Hospital for children,
situated in Glasgow.
Nicola Sturgeon meets NHS staff in Glasgow
Simon Stevens, Chief Executive of the NHS
England says “The reason why the health
service does so well is frankly due to the
brilliance of the staff. And it’s frankly
because of the staff that the nation has just
recommitted to the idea of a health service
[that is] there when you need us, based on
how sick you are, not whether you can
afford us – a principle that has stood the test
of time.”
The future for the NHS looks strong; with
other healthcare systems across the globe
looking up to what the NHS has to offer in
the UK. With the uncertainty Brexit holds,
the NHS will still remain one of the key
services of the UK. However, there is a lot
of improvement needed to further enhance
the experience people have with the NHS.
The NHS is set to soldier on for a very long
time into the future, with no sight of
stopping.
 The Origins of the NHS
By Usman Khan
On the 5th of July 1948, one of the greatest
administrations of all time had been
founded, the NHS. For almost 70 years now,
the National Health Service has been
supporting citizens and visitors of the UK
with free healthcare.
The NHS provides 597,478 people with jobs
in the UK; this consists of 106,430 doctors,
285,893 nurses and health visitors, 21,597
midwives, 132,673 scientific, therapeutic
and technical staff, 19,772 ambulance staff,
21,139 managers and 9,974 senior managers.
It consists of various different sectors such
as urgent and emergency care, GP services,
pathology services, pharmaceutical services
and many more. In comparison with the
healthcare systems of ten other countries
(Australia, Canada, France, Germany,
Netherlands, New Zealand, Norway,
Sweden, Switzerland and USA) the NHS
was found to be the most impressive overall
by the Commonwealth Fund in 2017.
The NHS was rated as the best system in
terms of safe care, affordability and equity.
It was also ranked first in the 'care process'
category, which encompassed preventive
care, safe care, coordinated care and
engagement and patient preference. Without
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Picture: Aneurin Bevan
the NHS, many individuals living in the UK
would have to pay for the care they receive,
and unprivileged people would suffer greatly
from an inability to pay for treatment as well
as the possibility of an inequitable response
by the doctors which would contradict the
justice component of the pillars of ethics.
Unfortunately, this happens frequently in
other countries. This would mean people
like Aneurin Bevan, the founder of NHS,
who came from a poor background and left
school at the age of thirteen working as a
coal miner, would also have faced this
injustice that could have fallen on the health
sector of the UK.
Before the NHS, philanthropists and social
reformers working alone had tried to provide
free medical care for the poor, but, without
government backing, they were destined to
merely scratch the surface of need. Even the
established hospitals could only deal with
serious illnesses. Healthcare was so
expensive for poorer people that families
started to rely on dangerous home remedies
or on the charity of doctors who gave their
services free to their poorest patients. Local
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authorities of large towns provided
municipal hospitals, maternity hospitals,
hospitals for infectious diseases like
smallpox and tuberculosis, as well as
hospitals for the elderly.
However, due to the social upheaval caused
by the industrial revolution, there was a
large growth in unemployment and poverty.
Sickness became a primary cause of poverty
so the Poor Law authorities were forced to
develop 'infirmaries' for sick people.
Although initially resisted by the
government, the number of infirmaries grew
very rapidly.
Infant mortality rate was around one in 20,
and there was little the smaller healthcare
companies of the day could do to improve
matters. Against such a bleak background, it
Source: Office for National Statistics
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is clear how massive an impact the
introduction of the NHS was. Although
medical science was still at a basic level, the
NHS for the first time provided decent
healthcare for all and transformed the lives
of millions.
The NHS has had a greatly positive effect on
health in the UK. Life expectancy increased
by about 11 years for both males and
females. Infant mortality rate has decreased
significantly by 29 deaths per 1000 births.
The NHS has become renowned for its
pioneering system of free care at point of
use. It is now assumed that the principle of a
tax-funded health service, free to its citizens,
and offering care for all conditions and
diseases, is firmly embedded in the British
psyche. The NHS has so successfully
planted itself as one of the bases of the UK
that any political party attempting to change
could face disaster at the polls. We hope that
the NHS will continue to progress at the rate
it has been for the last 70 years and retain
the power of the Hippocratic Oath.
 To Live or Not To Live
By Adnan Digaswala
Alfie Evans (left) and Parents of Alfie Evans, Kate James and Tom Evans (right)
On the 20th of February 2018, High Court
judges ruled that the ventilator system which
had been maintaining the life of the
terminally ill Alfie Evans should be turned
off. A 23-month-old child’s life was hanging
on a thread, supported by his parents on one
end, and the justice system on the other.
Opinions on this matter of medical ethics
have provoked anger and passion from
across the spectrum, which has led to the
judicial ruling being so contentious.
Alfie Evans has been suffering from an
undiagnosed, degenerative neurological
condition since the latter stages of 2016. It
was at this point he was hospitalised in
Alder Hey Children’s Hospital after
experiencing a seizure. Due to his unstable
condition, medical professionals have
advised that Alfie should be taken off his life
support system as they declared "continued
ventilator support is not in Alfie's best
interests and in the circumstances, it is not
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lawful that such treatment continues". They
have also mentioned that scans of the brain
showed "catastrophic degradation of his
brain tissue" and that further treatment was
not only "futile" but also "unkind and
inhumane". In stark opposition, Alfie’s
parents believe that his condition is
“improving”, as he is physically responding
to contact. They also wish to take him to
Italy, namely the Bambino Gesu Hospital.
They say that operations and staff are
available on site to help the breathing and
ventilation of the child. Alder Hey have
responded by saying that, primarily, the
reactions to contact are mere side effects of
seizures due to physical stimulation, and the
High Court rules that even though Alfie had
gained Italian Citizenship, the baby was
under jurisdiction of the law of the United
Kingdom. The Italian Embassy was then
forced to clarify that they were in no way
aiming to pervert the course of justice by
granting him citizenship. This was granted
only a day after the father, Tom, flew to the
Vatican, and had a private meeting with
Pope Francis. He asked the Pope to “save
our son” and to do all in his might to
convince the British government to allow
Alfie to be flown to Rome for pioneering
treatment.
Picture: Pope and Tom Evans
Alfie is not the only child to go through this
traumatic situation. A few months prior, a
high-profile case involving Charlie Gard
was brought to the attention of the British
public and press. He passed away last year
with a mitochondrial disease. In 2006,
another child, Mahdi Bacheikh, was also
kept on the ventilator. He suffered from
spinal muscular atrophy, and was totally
paralysed. He could not breathe unaided;
hence his ventilator was his gateway to life.
He had no sign of brain damage, but sadly
died at the age of 2. All of these cases have
involved one particular segment of the law,
The Children’s Act 1989. It states that the
concept of parental responsibility must be
upheld, however this is not absolute. If a
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public domain, such as medical
professionals feels as if the parents’ decision
does not take into account the interests of the
child, they can appeal to withdraw or
administer medication.
Alfie’s army has garnered a heap of negative
attention over recent months. Pictures have
emerged of this group, claiming to be
supporters of prolonging the life of the child,
storming the gates of the hospital at which
Evans is in, alongside allegations of verbal
abuse towards NHS staff members and
volunteers. They have held candle-light
vigils in honour of him, as well as initiating
a social media campaign, educating people
of their side of the story.
Alfie’s case has been taken to the High
Court, the Supreme Court and the Court of
Appeal domestically. In all three instances,
the legal bid for the parents to take control
of their child’s medical treatment were
rebuked. The European Court of Human
Rights were also contacted but ruled that no
human rights infringements had taken place.
Professor Dominic Wilkinson, a professor of
medical ethics at Oxford University, outlines
two key questions that must be asked. One is
that “what is the right thing to do for the
child?” And the second is “who should
decide?” Now that is the conundrum facing
lawmakers, judges and juries all over the
nation.
Ageing
By Kavi Jeshram
Ageing is something that we are all very aware
of, either it being wanting to grow up as a child
or to stay physically capable as an adult due to
the many disadvantages old age brings with it.
But even though every single human and the
majority of living organisms undergo this
process, scientists are still uncertain about the
exact nature of it. This is due to the fact ageing
is most likely multi factorial event and has many
reasons for it to occur.
One of the most prominent theories is 'oxidative
damage' by oxygen free radicals to the DNA
inside cells. These are oxygen atoms with an
unpaired electron which are highly reactive and
hence disrupts the cell function heavily. They
can react with proteins, changing their tertiary
structure and since enzymes are proteins, they
can cause enzymes to become damaged. They
can also react with the cell membrane (the
phospholipids). This change can propagate and
cause the membrane to become unstable.
However, the worst damage occurs when the
free radical damages the DNA. This results in
mutations to be produced. This doesn’t seem
that bad at first, but cells replicate. This
mutation can be copied thousands of times and
the mutations can be stacked. If the mutation
affects mitosis and the way the cell divides it
could become uncontrolled causing tumour
growth also known as cancer eventually
resulting in the rapid decline of the health of the
individual. This is why if a relative gets cancer,
it means you are more susceptible to develop it
as your DNA is close to developing a cancerous
mutation too.
One theory of ageing is the wear and tear
theory. This states that bodily damage
accumulates over time to the point where the
body cannot heal the damage any longer. This
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can be seen in arthritis, a common joint problem
in the elderly. It also makes sense as the older
you are, the more your heart has beaten, hence
its elasticity declines and the heart’s muscles are
weaker.
Another theory is that radiation and other
triggers cause mutations to occur in the DNA.
These mutations are called somatic mutations.
These can be visible in wrinkles as they are
more exposed to external environmental factors
e.g. the sun and show these somatic mutations
sooner with mass skin cells
which aren’t properly formed.
One type of theory which is of a completely
different nature is the programmed cell death
theory. This theory states life expectancy is
determined by genes and decides how many
times cells can divide. This means that the
number of cells that the body can grow is
limited hence people are given a maximum
lifespan the second they are conceived due to
genes. This would also mean it would then be
possible to find out the latest date you would die
at. There are obviously many ethical issues
surrounding this.
But in the end, we age and with this ageing
comes negative drawbacks. The elderly are
more prone to diseases due to weaker immune
systems, to dementia and Parkinson’s disease
and heart failure leading to strokes as well as
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many more potentially life threatening diseases.
Naturally of course, scientists are trying their
best to combat it. Now armed with various
theories they can attempt to directly fight
against the ageing process. As we know that
DNA mutations probably play a big part in why
our cells deteriorate. Due to this, scientists have
designed a way for bacteria to be used such that,
damaged DNA / mutated DNA can be extracted
and replaced with functional DNA.
The company Editas Medicine, a biotech
laboratory, started using brand new gene cutting
techniques [(called Crispr) Clustered, Regularly
Interspaced, Short Palindromic Repeat] This
consists of usually a natural defense mechanic
of a bacteria to cut out sections of DNA.
Bacteria contain small sections of viral DNA so
that it can identified by the bacteria. If the
bacteria discover a viral molecule with the same
dna as the virus it produces an enzyme which
cuts that data from the virus to stop it from
making more viruses. In this way, if human
DNA is placed in the same manner, it can cause
the bacteria to cut out the selected DNA from
human cells. Editas medicine is now working on
using this technique to get rid of faulty DNA in
the retina of some people with leber congenital
amaurosis a condition which is caused by ‘bad’
DNA in the retina due to a disease. This would
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stop the disease in theory allowing people who
suffer from this disease to live life happily. This
method could be used to reset cancer cells into
normal cells as it would eradicate the cancerous
mutation in the DNA in theory.
Another method scientists are developing is
printing organs for patients. This enables people
to get new hearts tailor it for them and this
would allow patients to get new livers and
hearts negating the ageing process and restarting
it. This means that maybe 20 years from now
everyone would just replace their organs with
printed ones instead at the sign of any slight
injury. This will keep individuals healthier and
extend their maximum age drastically.
Despite these, we still have not found some
form of halting ageing and achieving
immortality. So still, we still create strange
concoctions like Anti-AGin, a gin that contains
distilled drinkable collagen in an effort to
reduce the visible effects of ageing or even
creating dark chocolates like Esthecho, which is
a chocolate created by Cambridge students
designed to “keep skin looking youthful”. But
ultimately, we still age and eventually die.
On the other hand, if everyone was immortal,
the earth would become very overpopulated
very quickly. Over the course of writing this
article roughly 25 thousand people have died
and 60 thousand are born. If people didn’t die of
old age or diseases as a result of old age, the
population would increase at a much faster rate.
So, for the time being we should value how
fragile life is and continue to make the most out
of our lives and accept ageing is something that
we just have to deal with and is a part of life.
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Recent Medical Advancements
By Sharanhan Kugarajah
Advancements in technology have always
been looked at closely by those in the field
of medicine as they could make or break
treatments in the future. Many medical
representatives have supported the
incorporation of technology within the NHS
and scientists all over the country have been
researching various new and exciting
methods.
Here are some of the medical breakthroughs
of the previous year:
Regenerating body parts
Ohio State University announced the
development of an innovative technology
called tissue nanotransfection. This chip
reprograms cells to repair organs and blood
vessels. The procedure is relatively simple
and non-invasive. A stamp-sized chip is
placed on a patient’s skin, small electrical
currents are sent through the skin. These
currents deliver DNA vectors, a vehicle that
carries foreign genetic material, into the
body.
So far, this process has been tested on mice
with successful results including the
regeneration of nerve cells. The clinical
trials are due this year.
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Contact lenses with various health
monitors.
Scientist at Oregon University have
developed transparent sensors. Simple
contact lenses can become complex health
monitors that can monitor blood sugar and
uric acid levels.
“We believe we could integrate more than
100 sensors into the lenses,” says Gregory
Herman, the chemical engineering professor
in charge of this research. He estimates these
lenses to be available in the market in the
next 5 years provided the research continue
well.
Pig organ transplants for humans
In 2017, scientists have been able to
genetically modify pigs, so their organs can
be transplanted into humans safely. The
company responsible for this achievement,
eGenesis, used the gene editing tool
CRISPR to eliminate more than 24 pig genes
that could potentially harm humans.
This xenotransplantation can save millions
of patients that are at risk of death due to the
lack of organs.
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Advancements in Dental Technology
By Ravi Khiroya
Invisialign – an alternative to metal braces
The field of dentistry is constantly changing
and evolving to offer better care to patients
and to create a more efficient and effective
system, with many recent advancements
having a critical impact on the field as a
whole.
We recently saw the introduction of
Invisalign, offering sets of transparent braces
(as the name suggests) that were often more
comfortable and effective than previous
metal braces, offering a better user
experience, and now being offered as an
extra offer to patients, with numerous
Invisalign open day events taking place in
dental practices across the country. This new
system indicates a major change to
Orthodontics, placing considerably less
restrictions on patient’s diets, as well as
being hassle- free, with easy removal for
cleaning especially in comparison to older
systems. As well as being more attractive
than other braces, Invisalign is significantly
safer, with no sharp edges that can cause
discomfort, and result in damage to the
mouth or gums. Invisalign’s shorter duration
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also makes it a great option, with metal
braces often having to remain for up to and
over 5 years. In general, Invisalign is a great
example of developments in the field of
dentistry that are currently being
implemented to improve customer service.
Implants are often used in dentistry to act as
a synthetic replacement for missing teeth,
and while the creation of implants is
becoming more streamlined, the techniques
used to create a mould of the tooth are also
developing, with new scanners (e.g. Itero
scanners and Cerec) being implemented to
take a 3D scan of the mouth, allowing a
replacement tooth to be computer generated,
to be built and implanted into the mouth.
Cerec – Revolutionary 3D scanning
This developed system replaced previous
methods of taking a mould of the mouth,
which left an unsavoury taste in the patient’s
mouth and generally being an uncomfortable
experience for the patient. It also saves time,
as the mould does not need to be sent, often
over long distances, yet instead can
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instantaneously be sent to the laboratory for
quicker processing. Improvements in the
field of dentistry are therefore constantly
helping improve the service it provides.
As well as improving dental services, it is
crucial to be able to recognise issues in
dentistry early on. With new dental
microscopes, it is easier to identify cracks
and areas of weakness in the teeth, as well as
identify nerve locations, often for
anaesthetics. New technology can also be
used that is able to identify cavities in the
teeth using lasers and pulse technology,
further allowing the recognition of issues in
the teeth. Intraoral cameras are also being
further defined and developed to allow
dentists to have a better understanding of
their patient’s mouth with high quality
images taken by a small scanner, whilst
causing minimal discomfort to the patient.
There are various other advancements that
have further aided the development of the
X-Ray Scanning of the teeth
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field of dentistry from new, more modern X-
rays to provide scans of the teeth for
examination, to new veneer technology:
mouldings that cover small areas of teeth, to
replace damaged areas, yet needing some of
the tooth to be removed as a result.
Recent changes to laser dentistry will further
improve various aspects of the industry,
often being used to remove inflamed areas
of the gums, and being required as a
precursor to other processes. In general, we
may suggest that these changes show that
dentistry is constantly evolving and
developing as a field, to further improve
customer’s comfort, as well as the
efficiency, effectiveness, and cost, in terms
of both time and money, of dental practices.
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Six ways the Veterinary Profession is changing
By Khush Patel
The modern day veterinary profession has
changed quiet dramatically in the last 20-30
years. In this article I will cover the ways the
veterinary profession has changed and thing
that aspiring vets should expect in the future.
1. Pet owners’ expectations will continue
to rise
As time has gone on people have grown
stronger attachments to their pets. These
stronger attachments along with increases in
wages mean people spend more money for
their pets to obtain treatment and therefore
expect the upper most care for their pets.
Future vets who are likely to succeed are
those that match these expectations and
don’t give their clinic a bad reputation.
2. The vet businesses will increase in size
There has been a significant increase in the
UK veterinary practice ownership by
corporatisation over the past decade and this
is set to continue. Currently around 50% of
vet practices are owned by corporates and
this is set to peak at 70% within the next
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four years. This will mean that many vet
owners will be taking their pets to
corporately owned clinics rather than
independent ones. This has benefits (e.g.
increased representation, standardisation of
care) but also has drawback (e.g higher
focus on profit rather than animal care, less
freedom for vets, stricter management and
control). Any aspiring vets should weigh up
these
Benefits and drawbacks before deciding
on this career path.
There won’t be enough vets to work at the
consultation tables
There are severe shortages of UK educated
vets. Brexit would cause a massive issue for
the veterinary work sector if Europeans
aren’t allowed to stay in the country. Many
vets are from different parts of Europe so
Brexit would leave staff shortages in the
veterinary sector. To attract more students to
become vets’ wages would have to rise
which would mean treatment prices for
animals would also have to increase.
3. Increasing amounts of specialised vets
An increasing number of vets are educating
themselves further after vet school, to
develop expertise in small unique areas.
They seek qualifications to become things
like soft tissue surgeons which attract more
lucrative work while also giving personal
satisfaction.
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4. Greater use of technology

The level of technology for recreational uses

has increased significantly in the last decade.
This is no different from the increase of
technology in the veterinary sector. There
have been advances in things like diagnostic
equipment and monitoring equipment. Pets
are also being supplied with wearable
technology to check their progress after
treatment.

5. Vets will enjoy a better working-life

balance

In previous years working in a vet practice

was labour intensive. If you weren’t treating
animals you would always have something
else to do. If you were ever needed in the
practice even on days off you would be
expected to come. A lot of hours would need
to be put in to satisfy your higher ups.
Nowadays this has changed vets have much
less dedicated hours and a healthy work-life
balance is trying to be sustained by the
veterinary sector.

6. Is this a good time to become a vet?

This question differs depending on who is

answering it. If you want to join a profession
where there are lost of available jobs and
increasing wages then being a vet at this
time may be suitable for you. However if
you want to join a profession which is
independent and not heavily strenuous you
may want too look elsewhere. All in all the
new veterinary world is uncertain but very
exciting and promising.

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