Cutting-Edge Medical Advances: A Survey by Dr Purnoor Kaur


Cutting-Edge Medical Advances: A Survey

Dr Purnoor Kaur

"To array a man’s will against his sickness is the supreme art of medicine." 

- Henry Ward Beecher


The pursuit of health and well-being has existed from the beginning of time. Be it praying for elimination of wrath of Gods or viewing a scorpion’s sting as purification, the denominator is unshaken. The twentieth century has brought revolutionary changes in understanding of medicine and disease processes and yet the twenty first century is hitting new heights. Alexander Fleming and Penicillin had to wait for ten years but fortunately in recent times medical research has gained momentum, measurability, and validation for accuracy. The evolving challenges and dynamic database have made it possible to pave a road for constant striving. 


Health-related technology


The first robotic procedure was undertaken in 1992, three decades down the line; today, there are three distinct types of surgical robotic systems1 available. Active systems where most of the work is done automatically (though the operating surgeon still has some degree of control) and according to predefined procedures, semi-active systems where the surgeon provides some input alongside the system's pre-programmed components, and the formal master-slave architectures which do not have any pre-programmed or autonomous parts for example laparoscopic surgical equipment that mimic the surgeon's hands to complete a procedure.


Capsule cameras, also called pill or swallowable cameras, are a novel medical device that has been put to use in the diagnosis and monitoring of a wide range of digestive problems. The initial prototype was released in 1998, and the FDA approved it in 2001; the inventor is Gavriel Iddan. These cameras are tiny and capsule-shaped such that they can be ingested and travel through the digestive tract while capturing high-resolution photos of the body from the inside. Capsule cameras have a variety of medical applications, but one of the most common is in the diagnosis and follow-up care of inflammatory bowel diseases (IBD), like Crohn's and ulcerative colitis. Inflammation and ulceration of the digestive tract are hallmarks of these disorders, which can manifest as a variety of unpleasant symptoms like nausea, vomiting, loss of appetite, and even weight loss. Symptoms may be caused by inflammation or ulceration in the digestive tract, which can be seen with capsule cameras. Other gastrointestinal diseases, like gastrointestinal haemorrhage and small intestine anomalies, have also been diagnosed and monitored with the help of capsule cameras. They have proven to be especially helpful when using more conventional diagnostic procedures like endoscopy or x-rays either isn't an option or isn't yielding the desired results. 

One of the biggest contributions of the pandemic is catalysing the use of telemedicine, which allows patients to receive medical care remotely via video or phone. This is especially useful for people who live in rural areas or who have difficulty travelling to a medical facility. However, Alaska has served as a model for the development of telemedicine for decades, and radios were first employed in the 1920s, to give medical advice to clinics on ships. Even, teleradiology has been used for at least 60 years, and radiologists have promoted the Digital Imaging and Communications in Medicine (DICOM) standard for transmitting and storing data. 

One of the earliest instances of hospital-based telemedicine was in the late 1950s and early 1960s: A closed-circuit television link was established between the Nebraska Psychiatric Institute and Norfolk State Hospital for psychiatric consultations. (“3 The Evolution of Telehealth: Where Have We Been and Where Are We ...”) 


The next breakthrough is telesurgery, an emerging surgical method, which uses wireless networking and robotic technologies to connect distant clinicians and patients. The world’s first telesurgery was performed in 2001, which was performed by a surgical team in New York, USA, resulting in a successful two-hour laparoscopic gallbladder removal of a female patient in a hospital in Strasbourg, France.


In 2014, Shenai et al. presented Virtual Interactive Presence (VIP), a revolutionary device that allows remote neurosurgeons to cooperate using high-definition binoculars and a shared 3-Dimensional (3D) display. They used VIP to successfully perform open brain surgeries for bigger sections of brains as well as microscopic approaches to the pineal gland in a cadaveric animal. VIP can be a highly useful tool for surgical training allowing real time interactions within medical facilities around the world. 

3D printing

Since it first gained popularity in the early 2000s, 3D printing has undergone substantial development in the recent decade. Its applications have expanded beyond prosthetics to include customised implants, surgical implements, and other surgical aids. In 2010, the FDA gave its first green light to a business in Italy to use 3D printed orthopaedic implants. In recent times, doctors in Belfast have used a 3D printed kidney (obtained from a CT image of the patient) to pinpoint the precise location and size of a tumour. The patient had a cyst on his kidney that may have developed into cancer, so this served as valuable preoperative preparations in medical data that could indicate the presence of a particular disease or condition, or to predict the likelihood of a patient responding to a particular treatment.


The medical mirror

In 2011, a two-sided glass panel with a webcam and LCD display was developed for use as a medical mirror. An automatic face tracker can pick up on subtle changes in the blood vessels of the face caused by each heartbeat. 


The pain of needles may soon be forgone, researchers have developed a novel idea called needle-free injection technology (NFIT), which uses other means (shock waves, pressure, etc.) to administer medication. In 2017, MIT debuted jet injections, one of the newest NFITs. A jet injection shoots a thin stream of medicine (about the thickness of a human hair) under high pressure through the skin at a controlled rate. It syncs with a mobile app that records how the drug is working after each administration.


Gene editing:

What is Gene editing? It is the use of gene editing technologies, such as CRISPR, to modify or repair genetic defects that cause diseases. The invention of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) in  2009, has the potential to revolutionise the way we treat many genetic diseases. For example, gene editing could be used to repair or replace mutated genes that are causing a genetic disease, or to introduce new genes that provide a therapeutic benefit. Sickle cell diseases, cystic fibrosis, and even some forms of cancer have been targeted by gene editing in animal models, and clinical trials are currently underway to test its safety and effectiveness. There are many technical and ethical challenges that need to be addressed before it enters clinical practice. 


In 2015, thanks to Juno, the new desktop DNA lab, the entire human genome could be sequenced in about three hours. This method would not only aid in locating the illness gene, but also in locating novel microbial strains as soon as possible, allowing for the development of efficient antibiotics to be used against them before they cause significant harm to human life.


Artificial wombs

Artificial wombs, extracorporeal gestation systems (sometimes referred to as ectogenesis systems) are a hypothetical medical technology that are currently in the early phases of development. An artificial womb is a device that mimics the uterine environment to allow a foetus to continue developing outside of it, delaying the delivery of premature babies until a safer point in their development.

Medical use of artificial wombs has the potential for a number of advantages. One advantage is that it may allow premature infants to continue developing outside of an incubator, where conditions are less physiologically typical. This has the potential to lessen the likelihood of preterm delivery issues like brain damage and delayed development. Artificial wombs may also be utilised to enhance existing fertility therapies, such as in vitro fertilisation (IVF). An embryo might be implanted into an artificial womb until it reaches a later gestational age, rather than being implanted into a woman's uterus at such a young stage. Because of this, it's possible that fewer difficulties will arise in the first trimester of pregnancy, including miscarriage.

The development of artificial wombs is still in its infancy; hence they cannot be used on people at this time. Before they may be employed in clinical practice, several technological and ethical difficulties must be overcome.

Artificial intelligence (AI)

Artificial intelligence (AI) is the ability of machines to perform tasks that normally require human intelligence, such as learning, decision making, and problem solving. (“Summary of the 2018 Department of Defense Artificial Intelligence Strategy”) 


One of the key ways that AI is being used in medicine is through the development of machine learning algorithms. These algorithms are designed to analyse large amounts of data and to identify patterns and trends that may not be apparent to humans. (“Is Machine Learning Hard? A Guide to Getting Started”) By analysing electronic medical records, imaging studies, and other data sources, machine learning algorithms can help to identify risk factors and predict patient outcomes, allowing healthcare professionals to make more informed decisions about treatment. Artificial intelligence is also being utilised to improve medical diagnostics. Medical imaging (such as X-rays or MRIs) can be analysed by AI-driven systems, which can pick up anomalies that humans might miss. This has the potential to increase diagnostic precision and lessen the likelihood of incorrect diagnoses. Artificial intelligence algorithms are able to sift through mountains of data in search of trends and patterns that can inform how best to meet the needs of each particular patient. AI is also being developed for application in personalised medicine, which tailors approaches to diagnosis, therapy, and illness prevention to an individual's genetic make-up, ecological context, and way of life.


Precision Medicine

Another trend that is likely to shape healthcare in the future is the growing emphasis on personalised medicine. This is an approach to healthcare that takes into account individual differences in people's genes, environments, and lifestyles, in order to better diagnose, treat, and prevent disease. By analysing large amounts of data, healthcare professionals will be able to tailor treatments to the specific needs of an individual patient, rather than using a one-size-fits-all approach.


It is also likely that healthcare in 2050 will be heavily reliant on technology, with the use of electronic medical records, telemedicine, and other digital tools becoming more widespread. These technologies will allow healthcare professionals to access and analyse large amounts of data in real time, improving the accuracy of diagnoses and the effectiveness of treatment.


Overall, it is clear that healthcare in 2050 will be significantly different from what it is today.


In the present times, we need not diagnose by solely reading a pulse: we have an opportunity to explore genomic make up of individuals and look forward to personalised or precision medicine. Undoubtedly, it is one of the most exciting trends, which allows physicians to tailor treatment plans to the specific needs of each individual patient. 


Personalised medicine is based on the notion that because individuals have complex and unique qualities at the molecular, physiological, environmental exposure, and behavioural levels, they may require interventions tailored to their nuanced and unique characteristics for diseases. Emerging evidence has revealed significant inter-individual variation in the effects of disease processes, as well as the mechanisms and factors that contribute to them. This has generated concerns regarding how much inter-individual variation should influence decisions about the best method to treat, monitor, or prevent a disease for an individual.


There are several hurdles involved with individualised medicines, particularly acquiring authorisation for routine use from various regulatory organisations. Furthermore, there have been numerous challenges related with the widespread acceptance of personalised medicines among various health care stakeholders, including physicians, health care executives, insurance companies, and, ultimately, patients.


Origin story 

Archibald Garrod, an English physician, began examining disorders that would eventually be known as inborn errors of metabolism more than a century ago. Garrod researched a variety of rare disorders with obvious phenotypic characteristics, such as alkaptonuria, albinism, cystinuria, and pentosuria. He concluded that alkaptonuria was caused by a specific altered course of metabolism in affected persons, which was later confirmed to be correct. In addition, when considering other rare diseases such as alkaptonuria, Garrod argued that "...the thought naturally presents itself that these [conditions] are merely extreme examples of variation in chemical behaviour that are probably everywhere present in minor degrees and that just as no two individuals of a species are absolutely identical in bodily structure, neither are their chemical processes carried out on exactly the same lines." This hints at his notion that, at least in terms of metabolism, humans vary greatly, and that these changes in metabolism could help explain overt phenotypic differences between individuals, such as their various susceptibilities to diseases and the ways in which they display diseases.

Although personalised medicine has its roots in genetic studies, it is commonly understood that additional factors (environmental exposures, developmental phenomena, epigenetic modifications, and behaviours) must also be considered when identifying the best strategy to treat an individual patient.

Laura H. Goetz M.D. and Nicholas J. Schork Ph.D.

Fertility and Sterility, 2018-06-01, Volume 109, Issue 6, Pages 952-963, Copyright © 2018 American Society for Reproductive Medicine

Access to health care is critical because some people may be unable to access expertise and technologies owing to geographical or economic restrictions. As a result, interventions for those persons may need to be designed with this in mind. Inherited genetic information can only be predictive or diagnostic. However, somatic DNA alterations can provide valuable information about disease processes. Tissue biomarkers (e.g., routine blood-based clinical chemistry panels), imaging and radiology exams, and data obtained routinely via wireless monitors are all valuable for detecting changes in health status. Environmental exposures and behaviours can have an impact on intervention outcomes and have a high intra-individual variability. Epigenetic events, which remodel gene function because of exposures and developmental or stochastic phenomena, should be examined as markers of a change in health status.

Although straightforward in theory, the practical challenges associated with acquiring more information about a patient and conducting an empirical evaluation of a personalised remedy can be overwhelming. Questions such as how to know if a chosen intervention works without meticulous patient follow-up data, how to know if a patient is satisfied with what they are experiencing with the intervention, and how to assess the difference between other interventions that could have been chosen and the chosen personalised intervention would all need to be addressed. 

Examples of individualised medicine in the modern era

Drugs such as warfarin, PQ, and imatinib that appear to only work, or work without side effects, when a patient has a specific genetic profile have sparked intense interest in identifying factors, such as genetic variants, which influence an individual patient's response to a variety of drugs and interventions. This interest in developing tailored medicines to treat diseases has widened to include personalised disease surveillance, such as early detection techniques and personalised disease preventive strategies. After detailing a few more recent examples of tailored medicines, we briefly highlight a few very recent examples of this activity.


Immunotherapies, a new group of cancer treatments, are another example. Immunotherapies come in many different forms, but they all try to get a person's own immune system to fight cancer. This type of immunotherapy basically works by taking cells from a patient that control their immune reactions and changing them so they can find and attack the neo-antigens found in the patient's tumour. Then, these changed cells are put back into the patient's body, where they attack tumour cells and send out signals for neo-antigens. 


Early Detection Strategies

If a person is prone to getting sick that person should be closely watched. Epidemiologic data and population surveys are used to make population thresholds. For example, a cholesterol level of more than 200 is a sign of a higher risk of heart disease, and a systolic blood pressure of more than 140 is a sign of hypertension, stroke risk, or heart disease. The past values of a measure for a person are used to make a personal threshold, which is then used to predict how different the future values of that measure may be for that person. Significant changes from historical or average legacy values are seen as a sign of a change in health status, regardless of whether the new values exceed a population threshold 


Individualizing Disease Prevention

Even though it is well known in the scientific community that genetic information can be used to create personalised ways to prevent disease, this is not yet widely used in clinical practice. There are many notable examples of how genetic information can be used to lower the risk of getting a disease and the problems that come with current treatments and screening methods. 



  1. Medicine I of, Services B on HC. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary. National Academies Press; 2012.
  2. Laura H. Goetz M.D. and Nicholas J. Schork Ph.D. Fertility and Sterility, 2018-06-01, Volume 109, Issue 6, Pages 952-963
  3. Summary of the 2018 Department of Defense Artificial Intelligence Strategy
  4. Is Machine Learning Hard? A Guide to Getting Started,
  5. Henry Ward Beecher - To array a man's will against his... - BrainyQuote,