August 4, 2010

Second-year student takes on multi-country hypertension research

A second-year medical student at the Wayne State University School of Medicine is conducting a tri-country research project into hypertension in African-Americans whose roots trace back to the Caribbean and Africa.

John Purakal, of Grosse Pointe Shores, won a $2,400 Alumni Summer Research Grant from the School of Medicine, awarded by a panel of faculty researchers and administered through the Office of Graduate Studies, to fund his research.

He is collecting data from patients in Tanzania, Jamaica and Detroit who have hypertension in an attempt to evaluate the potential relationships between psycho-social understanding of high blood pressure and potential risk factors, including social demographics, medication and self-reported dietary changes. The study, he said, will assess the relationship in potential cross-cultural differences in perceptions of hypertension, susceptibility to complications and self-management practices.

"The results of this study would help inform future research and enable more effective, population-specific initiation of anti-hypertensive therapy, which, in turn, could provide a facile mechanism for widespread reduction in the burden of cardiovascular disease," he said.

Purakal designed the study under the mentorship of Phillip Levy, M.D., M.P.H., associate professor of Emergency Medicine and associate director of Clinical Research for the Department of Emergency Medicine.

"The idea stemmed from my interest in cardiovascular disease and my experiences conducting clinical research with Dr. Levy at Detroit Receiving Hospital's Emergency Department," Purakal said. "While conducting various studies investigating hypertension over the past two years, I found that a large facet of the high prevalence can be correlated to the patients' understanding of their own disease. The emerging prevalence of cardiovascular disease in Tanzania and urban Jamaica are uniform and of increasing concern. Since hypertension is the most common cardiovascular risk factor worldwide, and one of the most important treatable causes of premature cardiovascular death, I thought a study looking into patient understanding of hypertension and cardiovascular disease, as well as their ideas on compliance and nutrition, was necessary."

Purakal already interviewed 50 patients at St. Francis Designated District Hospital in Ifakara, Tanzania. In Jamaica, the study is being implemented by Dr. Jean Williams-Johnson, chief of the Department of Emergency Services at the University Hospital of the West Indies, located in Kingston, Jamaica, who is expected to interview at least 50 patients. Dr. Williams-Johnson will visit the WSU School of Medicine this fall for two months to study hypertension research as part of a Fulbright Scholarship. In Detroit, Purakal has already interviewed 50 of a planned 100 patients for the study.

Purakal, 25, is a member of the American Medical Association, Emergency Medicine & Surgery Interest Groups and the Co-Curricular Program. He assisted medical student Joel Miller in planning the AMSA Africa Medical Mission Externship, and was one of 10 School of Medicine students who just returned from that externship in Tanzania. In addition to allowing him to interview people with hypertension for his study, the trip saw Purakal and fellow students rotate throughout a number of wards at St. Francis Designated District Hospital to gain hands-on exposure to medical care in an underdeveloped country. The students scrubbed in on a number of surgeries, assisted in the labor ward with deliveries and took part in rounds in other wards.

This year, he will create a project through the Medicine and Political Action in the Community program, part of the school's Co-curricular Credit Program. He plans to facilitate discussion with youth and the elderly in the city of Detroit on common diseases prevalent in the population, including hypertension, obesity, diabetes and hypercholesteremia. He hopes to increase awareness of the conditions and how to halt their escalation through preventive measures and nutrition.

Purakal, who recently received a $1,500 American Medical Association Scholars Fund scholarship for his 2009 mission work in Costa Rica and his current research, said his primary role model in medicine is his mother, a pediatrician who has served the city of Detroit for more than 30 years. He became further interested in a career in medicine while an undergraduate at Michigan State University, when he began shadowing physicians and conducting research projects. "I found that medicine would give me a chance to serve my community while constantly challenging myself in the life-long learning process that is science," he said.

He said he selected WSU for his medical training because the school affords its students "every opportunity they have the initiative to pursue.  The large class size promotes collaboration, while Z-scores drive competition. This school's relationship with the urban hospitals in Detroit played a large role in my decision-making, as well."

After graduation, Purakal hopes to complete residency training at an academic institution in a Midwestern urban setting.

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