"Revamp academic programme of IIT Kanpur to motivate students": Pandey

"IIT Kanpur must withdraw the expulsion order of students"

"Indian Institute of Technology (IIT) Kanpur must withdraw the expulsion order of students and revamp its system so that the academic programme motivates students to learn and engage in engineering-related socially-useful work rather than go after non-engineering consumerist oriented jobs which are totally non-productive" asserted Dr Sandeep Pandey, Magsaysay Awardee (2002) and a former faculty member of IIT Kanpur and former member of Central Advisory Board on Education (CABE) of Ministry of Human Resource Development (MHRD), Government of India. Dr Pandey also launched a signature petition to mount further pressure on IIT Kanpur (petition is online here). Read more

Development Journalism is crucial for social change

Refresher course must for all journalists: PII editor
Emphasizing the great importance of development journalism in today’s world, Ms Sangeeta Rajeesh, senior editor, Press Institute of India (PII), Chennai said that it is very essential that we sensitize our journalists towards focusing on issues relevant to development. Ms Sangeeta who is the current editor of Vidura – a magazine on mass communication published by the Press Institute of India (PII) since 1963, was addressing media professionals at the fortnightly 'Media for Children' organized at the UP Press Club by Media Nest with the support of UNICEF. Editor of 'Grassroots'- a journal on development journalism published by PII for the last eleven years, Ms Sangeeta is also head of programmes for PII. Read more

Time for grown-ups to listen to young sane voices: Save fuel, save environment

The young people are the true custodian of our future, so their voices must not be ignored. The children who live in urban slums in state capital of Uttar Pradesh gave a powerful message to grown-ups to save the environment. The outcome of rising pollution in the city and other adverse manifestations of environmental hazards, are often worst faced by those from the lower socio-economic group. Read more

Saraswat Samman conferred upon Prof Rama Kant for this year 2010

Saraswat Samman for this year 2010 is being conferred upon Prof (Dr) Rama Kant for his social welfare activities. Professor (Dr) Rama Kant is the Head of the Department of Surgery at Chhattrapati Shahuji Maharaj Medical University (CSMMU - upgraded King George's Medical College KGMC). He is the World Health Organization (WHO) Director-General's Awardee on tobacco control for the year 2005. He is the former Chief Medical Superintendent of Gandhi Memorial & Associated Hospitals (GM & AH), CSMMU. He was conferred upon the Best Eminent Surgical Teacher Award by Association of Surgeons of India (ASI), UP. He is the President of Association of Surgeons of India (ASI) UP. Read more

Media Nest to felicitate newly elected correspondent committee members

Media Nest, a pan India body of media professionals that works for the welfare of journalists and their families, will be felicitating the newly elected members of Uttar Pradesh State Accredited Correspondents committee (UPSACC) at Uttar Pradesh Press Club at 11.30 am on 23 January 2010. Read more

Mind That Diabetic Foot

2010 Dr SC Misra Oration Award [Listen to audio podcast] was conferred upon Dr Ajith Kumar Varma at the 55th Foundation Day of Department of Surgery (General), Chhatrapati Shahuji Maharaj Medical University (upgraded King George's Medical College - KGMC). Dr Varma is an assistant Professor in the Department of Endocrinology at Amrita Institute of Medical Sciences in Kochi, Kerala. After serving the army for 15 years, he is doing excellent work in the field of podiatric surgery, related to the diabetic foot. I had the opportunity to meet him when he was recently in Lucknow to attend the 55th Foundation Day Celebration of Department of General Surgery, CSM Medical University, where he charmed everyone with his suave manners and modesty, as well as his passionate zeal for improving the quality of life of those living with diabetes. Read more

This article is based on an exclusive interview given by him to Citizen News Service (CNS). The concept of reconstructive and corrective surgery for the diabetic foot has evolved very recently, as a means to correct foot deformities. This latest technique is presently being practised in very few countries of the world. There are a few selected centres in the US, UK, Germany, Russia, Spain and Australia, with USA, which has 7 podiatric schools performing such operations, topping the list. In India, Amrita Institute of Medical Sciences, situated in Kochi, is the only institute doing this type of reconstructive surgery in high risk patients of totally deformed diabetic foot, thus obviating the traumatic need for amputations.

There is an entity called 'Charcot' in diabetic foot problems. In prolonged diabetic foot problems there is an increased blood flow to the lower limbs, due to autonomic neuropathy, which causes demineralisation of the bones. It is a tsunami like effect, just washing away the minerals of the bones. Moreover, it stimulates certain cells which simply eat up the bones. All this weakens the bones, and makes them soft and pudgy. This results in the collapse of the foot and ankle bones, making it impossible for the patient to walk. Moreover, multiple increased pressure points are developed on the soles of the affected feet, where ulcers and calluses develop. These act as portals for entry of bacteria. As the cellular immunity of the patient is suppressed, even the slightest bacterial infection can cause a serious life threatening problem, so much so that if the patient is not given proper treatment within 24 to 48 hours of the infection setting in, it may result in amputations or even death.

Worldwide, 50% of all leg amputations happen to people living with diabetes. In India, an estimated 50,000 amputations are carried out every year due to diabetes related foot problems. By employing reconstructive and corrective surgical techniques, to correct the shape of the deformed feet and remove the high pressure points, a large number of such amputations can be prevented. Thus the patient can lead a near normal life, free from complications.

After having trained in the US, two years ago, Dr Varma has been performing different types of foot and ankle corrective surgeries, at the Amrita Institute, to normalise the shape and function of the grossly deformed diabetic feet. Last year, more than 25 such surgeries were performed. The best, amongst the 8 to 10 types of surgical techniques currently available, is the Triple Arthodesis Surgery, which costs around Rs 30,000. The costs of implants, titanium screws and suture fibre wires are additional. This, according to Dr Varma, is quite reasonable, especially when compared to the exorbitant fees charged in the USA for a similar operation.

Not only this, Dr Varma and his team have developed a new 'Amrita Sling Technique' for foot stabilisation, which is one of its kinds in the entire world. This obviates many complications which routinely occur after the reconstructive surgery.

In normal corrective surgery of 'Charcot's Foot' (as is being done in the US and elsewhere), the patient has to take rest for 4 to 5 months before s/he can start walking, as the bones need time to reconsolidate gradually. Moreover, during this period, an external fixture called 'Illazarov Frame' has to be fixed on the foot with screws and pins, which penetrate the bones and flesh. When the patient starts walking, it is very likely for infection to set in, paving the way for amputation.

But the Amrita Sling Technique, when applied once the reconstruction is done, results in quick normalisation of the gait bio-mechanics and ambulation of the patient. This reduces the long recuperation period, and also minimises the post operative complications. It has been successfully tested on 10 patients at the institute who are now leading a normal life.

Apart from doing pioneering work in the field of podiatric surgery, the Amrita Institute happens to be the only one in Asia, offering three specialised courses under one roof, informed Dr Varma. It conducts a one year post doctoral fellowship programme in podiatric surgery with a view to train more doctors in this field. Another 4 year course in diabetes and diabetic foot surgery exists for MBBS students, as also a course for training paramedical staff for management of diabetic foot.

Dr Varma stressed upon the importance of proper and timely foot care and foot wear advice to patients, to prevent limb and life threatening infections. From the day the patient is diagnosed with diabetes, proper foot care and foot wear advice must be instituted to prevent further complications. As far as a good foot wear prescription is concerned, it has to be given with utmost care. Diabetic foot wear are not off-the-counter purchases. They are made of specific material, like micro cellular rubber, micro cellular polymer, or ethyl vinyl acetate, which distribute pressure evenly on the surface, and prevent build up of pressure points, to avoid formation of calluses which are entry points for bacterial infection. Proper footwear should ideally be prescribed only after doing a pedopodogram, in which plantar pressure at each point of the under surface of the feet is measured. This is as necessary as testing the blood sugar levels of a patient before prescribing insulin or other oral medication.

With India earning the dubious distinction of being the diabetic capital of the world, Dr Varma rightly stressed upon the need for awareness about the complications of the disease in the public, in the patients, and, above all, in the primary care physicians, working in rural areas. In his words 'Pick up the lesion at the earliest', so that the problem can be resolved without amputation. In developing countries, as in India, the amputation rate is over 45%, whereas in the USA, and also in patients at Amrita Institute, it is a mere 8.5%, thanks to the novel surgical techniques available. Not only this, as diabetes is a disease of the blood vessels, all the organs get affected, especially the heart, which is strained over 15%. Even with the best of processes in place, there is 85% mortality, within 5 years of the amputation, due to cardiac arrest. Hence it is imperative to salvage the limb. Only then can we improve the quality, as well as quantity of life of patients, many of whom may be bread winners of their families.

Through good healthcare and informed self-care, it is possible to prevent diabetes-related amputations in the majority of cases. Prevention is always better than cure, more so in the case of diabetes.

Shobha Shukla
(The author is the Editor of Citizen News Service (CNS), has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

Published in:
Hindustan Times, Lucknow, Uttar Pradesh
Central Chronicle, Bhopal, Madhya Pradesh
Citizen News Service (CNS), India/Thailand
The Colombo Times, Sri Lanka
The Asian Tribune, Sri Lanka
Media From Freedom, Nepal
Bihar and Jharkhand News Service (BJNS)
News Blaze

CSMMU Surgery Department celebrates its foundation day

The Department of Surgery (General) of Chhatrapati Shahuji Maharaj Medical University (CSMMU, upgraded King George's Medical College - KGMC) has been functioning for almost a century now (98 years to be precise). Just for the sake of records, the post-graduate course in surgery was started in the year 1928, and the first Masters of Surgery (MS) in General Surgery was awarded to Dr MAH Siddiqui in the year 1930. Read more

State Media Schools' Summit in Lucknow

Lucknow will for the first time play host to a summit of media schools of Uttar Pradesh on 21 January 2010. UNICEF and Amity school of mass communication, Lucknow, are the joint organizers of this unique event. Cine star Ms Sharmila Tagore, will open the summit, while actor Farooq Sheikh will conclude it. The Member Secretary of the National Commission for Protection of Rights of Children will chair the concluding session. Read more

Will you marry only a fair-skinned girl?

“My mother jokes about how I am too dark to be her daughter” 

“Kaali ho rahi hai. Tujhse shaadi kaun karega”?

The latest Tweets? Let us hope not but beware of them! And perhaps go a step further. Like Kannan Mehta and her friends who designed and organized the ‘Kya aap sirf ek gori ladki se shaadi karenge?’ campaign [Will you marry only a fair-skinned girl? campaign] on one of the Bangalore's main streets in November 2009. Here's what I learned about the protest during an e-chat with Kannan a student of the Srishti School of Art, Design and Technology in the city. Read more

Counterfeit medicines can result in treatment failure

Counterfeit medicines are medicines that are deliberately and fraudulently mislabelled with respect to identity and/or source. According to the World Health Organization (WHO), use of counterfeit medicines can result in treatment failure or even death. Public confidence in health-delivery systems may be eroded following use and/or detection of counterfeit medicines. Both branded and generic products are subject to counterfeiting, says the WHO. Read more

NREGA Social Audit in Unnao

A social audit of national rural employment guarantee scheme (NREGS) shall be conducted by Asha Parivar and National Alliance of People's Movements (NAPM) in Unnao district of Uttar Pradesh (UP), during 15-21 January 2010.

"Commitment to transparency and accountability runs through the Mahatma Gandhi National Rural Employment Guarantee Act (NREGA). This commitment also flows from the right to information Act 2005. The Right to Information (RTI) Act should be followed in both letter and spirit in all matters relating to NREGA. No request (for information) should be refused under any circumstances. All NREGA-related information is in the public domain" says the chapter 10 of the NREGA operational guidelines. Read more

State Information Commission slapped fines on errant officers

In a significant order, the State Information Commisison has slapped a fine of Rs 9,750 (about USD 200) on two errant public information officers of the Nandurbar district administration (Maharashtra) for having caused enormous delay in satisfactorily responding to an application for information filed by a Sardar Sarovar project affected adivasi Siyaram Singa Padvi. Read more

Gandhians appeal to respect people's inalienable rights

"Freedom of expression is a fundamental right enshrined in the constitution of India. We are proud to live in a nation that believes in the ideal of universal human rights. However, sometimes the state expediently forgets its professed ideals and tries to ride roughshod over the rights of citizens. These transgressions have become more frequent as commercial, industrial and mining interests from all over the world have become more interested in the resources of this country" said veteran Gandhians Narayan Desai and Surendra Gadekar in a statement issued on DailySouthAsian. Read more

2010 is Year of the Lungs

The year 2010 was declared as year of the lungs to recognize that hundreds of millions of people around the world suffer each year from treatable and preventable chronic respiratory diseases. This initiative acknowledges that lung health has long been neglected in public discourses, and understands the need to unify different health advocates behind one purpose of lung health, informed Dr Nils Billo, Chair of the Forum of International Respiratory Societies (FIRS). Read more