This week is the bittersweet ending to my time in Costa Rica. Though I’m sad to end this amazing experience with Dr. Bogantes at Hospital Nacional de Niños, I am looking forward to being back home in Texas. Wrapping up this internship, I did a mix of shadowing and working on my project.
While shadowing I encountered a patient taking phenytoin to control her seizures. Unfortunately, a side effect of this medication is gum hypertrophy. This is basically an overgrowth of the gum — this patient was bullied in school due to this side effect.
I also learned about a condition called holoprosencephaly which causes brain abnormalities before a baby is born. Currently, there are no solutions to prevent this condition. The holoprosencephaly in the patient we saw may have been caused by the mother’s infection with varicella virus in the third semester of her pregnancy.
In terms of the project work, I synthesized multiple needs statements and filtered them initially by morbidity/mortality and prevalence/incidence. Then, I researched the organ systems discussed in each statement, performed a detailed disease state analysis for each, researched the markets and stakeholders, explored existing solutions and their limitations, and did a SWOT analysis for each before using a weighted matrix to further filter the needs.
The resulting unmet needs I pitched are listed below:
A way to treat generalized epilepsy without removing parts of the brain in patients with drug resistant epilepsy in order to minimize brain loss.
- Drug resistance occurs in ~30% of epilepsy patients amounting to around 400,000 patients in the US [1,2]
- Drug resistant epilepsy poses a serious economic burden costing about $138,600/year/patient [3]
- Treatment options include electrical stimulation, corpus callosotomy, resective surgery to remove the part of the brain causing epilepsy, and thermal ablation to destroy epilepsy causing cells. However efficacy of each of the treatments is not great.
A way to treat occlusions in patients with peripheral artery occlusions in order to restore normal blood flow.
- Peripheral artery disease (PAD) is caused by atherosclerotic plaque buildup [4]
- PAD affects 200 million adults worldwide [5]
- Combined annual costs for PAD exceed $21 billion [6]
- Treatment options include exercise therapy, medications, balloon angioplasty/stent, bypass grafts, and endarterectomy [7]. However, these treatments can be expensive.
The feedback I got from my professors and mentors, Dr. Wettergreen and Dr. Howard, was really helpful throughout this process. I ended the week with a heartfelt thank you to Dr. Bogantes and the neurology team! I will miss them all 🥹
References
[1] J. Hartzfeld and C. B. Thompson, “Understanding Drug-Resistant Epilepsy,” Epilepsy Currents, vol. 19, no. 1, pp. 18-22, Jan. 2020. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/31852003/
[2] “Evaluation and management of drug-resistant epilepsy,” UpToDate, [Online]. Available: https://www.uptodate.com/contents/evaluation-and-management-of-drug-resistant-epilepsy#:~:text=This%20condition%20is%20also%20referred,likely%20to%20have%20refractory%20epilepsy. [Accessed: Aug. 10, 2024].
[3] E. Brodie, S. Kwan, and J. C. Sills, “Current understanding of drug-resistant epilepsy,” Epilepsy Research, vol. 52, no. 1, pp. 137-144, 2002. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/11599228/#:~:text=Drug%2Dresistant%20epilepsy%20is%20a,treated%20epilepsy%20is%204%2C272%20USD
[4] M. Abou-Khalil and E. H. Wyllie, “Drug-resistant epilepsy: Definition and treatment,” in Epilepsy: The Intersection of Neuroscience, Biology, Mathematics, Engineering, and Physics, National Center for Biotechnology Information, 2017. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK430745/
[5] M. Abou-Khalil and E. H. Wyllie, “Economic impact of drug-resistant epilepsy,” in Epilepsy: The Intersection of Neuroscience, Biology, Mathematics, Engineering, and Physics, National Center for Biotechnology Information, 2017. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK430745/
[6] D. J. Powell and M. A. Garcia, “Economic analysis in peripheral artery disease,” Endovascular Today, vol. 15, no. 10, pp. 30-35, Oct. 2016. [Online]. Available: https://evtoday.com/articles/2016-oct/economic-analysis-in-peripheral-artery-disease
[7] M. Abou-Khalil and E. H. Wyllie, “Strategies for management of drug-resistant epilepsy,” in Epilepsy: The Intersection of Neuroscience, Biology, Mathematics, Engineering, and Physics, National Center for Biotechnology Information, 2017. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK430745/#article-27004.s8