CNS: surgery

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[Focus] Challenging nevertheless but possible to make a difference in public health

Management of respiratory diseases beyond drugs: Pulmonary Rehabilitation

Shobha Shukla, CNS Columnist

A very interesting and informative panel discussion on Pulmonary Rehabilitation (PR) of patients of respiratory diseases was held as part of the 20th National Conference on Environmental Sciences and Pulmonary Diseases (20th NESCON), organized by the Academy of Respiratory Medicine, under the auspices of Environmental Medical Association in Mumbai.

A Tumour In The Spine

Chhatra Karki, CNS Correspondent, Nepal

Photo credit: CNS

A spinal tumour is a cancerous (malignant) or noncancerous (benign) growth within or near the spinal cord. A tumour in these locations can compress nerve roots in the spinal cord and therefore even a noncancerous growth can become incurable unless treated timely. Spinal tumour, although it affects people of all ages, is most common in young and middle aged adults. Secondary or metastatic spinal tumours are seen among elderly. A special credit goes to Sir Victor Horsely from London, who first operated on a spinal tumour (Spinal Meningioma) in 1887.

Dr Ajith Kumar Varma

Shobha Shukla, CNS Columnist
The Global Diabetic Foot Conference (DFcon 2014) concluded earlier this week in Los Angeles US. Citizen News Service (CNS) had an opportunity to interact with one of the key faculties and experts on Indian approach to saving the limb for people who are living with diabetes. Dr Ajith Kumar Varma is a Professor and Diabetic Lower Limb and Foot and Ankle Reconstructive Surgeon, in the Department of Endocrinology, Diabetic Lower Limb and Podiatric Surgery, at Amrita Institute of Medical Sciences and Research Centre, Kochi.

Nearly 25% of people with diabetes face diabetic foot related complications in their lifetime. “People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications. Foot problems most often happen when there is nerve damage, also called neuropathy, which results in loss of feeling in your feet. Poor blood flow or changes in the shape of your feet or toes may also cause problems” said Dr Gyan Chand, Associate Professor, Breast and Endocrine Surgery Department, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS).

Despite evidence to prevent occupational exposure to HIV for surgeons and other healthcare providers, people living with HIV (PLHIV) requiring surgical procedures for treatment often face heightened stigma and get discriminated within healthcare settings. But all is not that black and there are surgeons who have championed the cause of treating PLHIV without stigma and challenged discrimination in healthcare settings as well. Few of these surgeon-heroes were sharing their experiences of over 20 years in treating PLHIV at the 6th National Conference of AIDS Society of India (ASICON 2013).

(First published in THE HINDUSTAN TIMES on Tuesday, 6th August 2013)
Diabetes has proved itself a silent killer disease. Today in the world maximum numbers of the patients are suffering from this disease, and moreover they are passing through the complications too. The World Health Organisation estimated that in the year 2000, 150 million people had diabetes mellitus, and it is predicted that this number will rise to 366 million by the year 2030.The life style, diet and addictions are adding fuel to fire. Evidence prove that the patho-physiological process of diabetes have put the foot at increased risk for tissue damage. As soon as tissue damage has occurred,the foot is at risk for end stage complication including gangrene and amputations.

Dr Nguyen Viet Nhung,APRC 2013
Photo credit: CNS

Bobby Ramakant - CNS
There is an overwhelming evidence linking lung cancer to tobacco smoking. Tobacco smoking continues to remain a major risk factor for lung cancer. Among cancers, most deaths every year are attributed to lung cancer, followed by stomach, liver, colon and breast cancers globally. Close to 1.4 million people die every year due to lung cancer. Centre for Disease Control and Prevention (CDC) warns that tobacco smoking causes about 90% of lung cancers. People who smoke are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. "Tobacco smoking is biggest risk factor for lung cancer" stressed Dr Nguyen Viet Nhung, Deputy Manager of Viet Nam’s National TB Programme and Vice President of Viet Nam Association Against Tuberculosis and Lung Disease (VATLD).

Prof Rama Kant to be awarded honorary FCS by College of Surgeons, Sri Lanka

[हिंदी] Renowned Lucknow Surgeon Professor (Dr) Rama Kant will be conferred upon the honorary Fellowship of the College of Surgeons of Sri Lanka in their convocation on 15th August 2012. The Council of College of Surgeons of Sri Lanka informed Prof Rama Kant of the honorary fellowship award on Saturday, 16 June 2012. Prof Rama Kant will also deliver a lecture on ano-rectal surgery at the annual convention of SAARC Surgical Care Society in Colombo, Sri Lanka.

The Department of Podiatric Surgery at the Amrita Institute of Medical Sciences and Research Center (AIMS), Kochi, Kerala, India, recently successfully replaced the destroyed foot and ankle bones in a 30-year-old patient with a novel prosthesis using polymethyl methacrylate (PMMA). The patient had developed a spinal cord injury, four years ago, due to a fall from height. This caused fracture of his spine which was operated in a hospital near his home town in Kerala.

In June 2012, President-elect of Association of Surgeons of India Professor (Dr) Rama Kant will receive honorary fellowship of Royal College of Surgeons of Edinburgh, UK. Earlier in July 2010, Prof Rama Kant was awarded FRCSI without examination (by special election) by Royal College of Surgeons in Dublin, Ireland. Professor (Dr) Rama Kant was conferred upon the Fellowship by Special Election of the prestigious Royal College of Surgeons in Ireland (FRCSI) on 12 July 2010.

[Photo] [Audio podcasts] Although estimates of people with diabetes in India are getting updated on an ongoing basis, there are at least 47 million people with diabetes in India. "That means we have 94 million feet to look after" said Dr Arun Bal, founder-President of Diabetic Foot Society of India (DFSI) and one of the legendary diabetic foot surgeons in the country, associated with Raheja Hospital, Fortis Hospital and Hinduja Hospital, besides being a visiting Professor at Amrita Vishwa Vidyapeeth. "13.5 million feet will develop ulcers and 100,000 amputations will take place in India alone due to diabetic foot. Diabetic foot is a major public health problem in India" said Dr Bal.

[Photo] [Audio podcasts] In an award-winning research paper presentation at the Amrita Diabetic Foot Conference (ADFC 2011), Dr Shibin T Sudevan, Department of Endocrinology and Podiatric Surgery, Amrita Institute of Medical Sciences and Research Centre (AIMS) presented the study 'Bacteriological profile of diabetic foot infections' making a clear conclusion: judicious use of antibiotics will decide the treatment outcome of diabetic foot infections. ADFC 2011 is being held in Kochi, India (6-7 May 2011). "The treatment of diabetic foot involves offloading, proper wound care and judicious use of antibiotics. Selecting an effective antibiotic regimen requires the knowledge of the prevailing microbial pattern" said Dr Shibin Sudevan.

[Photo] [Audio podcasts] A collaborative approach between different specialities in a hospital can save the limb in people with diabetic foot who are slipping towards amputation. "There is always room for change and betterment" said Dr Sarnarendra S Miranpuri, Section of Podiatric Surgery, Detroit Medical Centre, USA, who was delivering the keynote address at the Amrita Diabetic Foot Conference (ADFC 2011). The ADFC 2011 is being organized by Amrita Institute of Medical Sciences and Research Centre (AIMS) in Kochi, India (6-7 May 2011).

(Based on an interview given exclusively to CNS by Dr KR Suresh, Director, Jain Institute of Vascular Sciences)
[Audio recording] Diabetes is a disease of the nerves and the blood vessels. Poor blood sugar control affects almost all organs of the body, but the worst sufferers are the feet, said Dr KR Suresh, Director, Jain Institute of Vascular Sciences, Bangalore, India, who spoke to CNS at the Amrita Diabetic Foot Conference (ADFC 2011), organized by Amrita Institute of Medical Sciences and Research Centre (AIMS), Kochi, India (6-7 May 2011). The two main components of diabetes are blood vessel damage and nerve damage (neuropathy). Blockage of the blood vessels results in lack of blood supply. In the case of nerve damage, the patient may not know about it in the initial stages, especially in a country like India where people generally do not go for annual medical checkups, said Dr Suresh.

[Photo] [Audio podcasts] Thus spoke Swami Sampoojya Poornamritanandapuri, at the inaugural function of Amrita Diabetic Foot Conference (ADFC 2011), organized by Amrita Institute of Medical Sciences and Research Centre (AIMS), Kochi, India (6-7 May 2011). In the words of Swamiji, 'we can reach a supreme state of bliss if we respect our body, as the human body is a temple in which God resides.' So we must refrain from insulting anybody and must respect everybody. It is important for all of us to keep our bodies healthy and pure as they are too precious to be neglected. This can be done by eating proper and pure food so that we remain fit to perform our duties towards society. Out of this respect arises the need to control diseases like diabetes.

Amrita Diabetic Foot Conference (ADFC 2011) will open soon next month in Kochi, India. "Over one million lower extremity amputations are performed each year, 70% of which happen to people with diabetes. In India, almost 40,000 legs are amputated every year as a consequence of diabetes" had said Professor Jean Claude Mbanya, President of International Diabetes Federation (IDF) in his message to CNS earlier. "The latest data from the International Diabetes Federation indicates that diabetes affects 285 million people around the world, and is increasingly on the rise. Of the many serious complications that can affect individuals with diabetes, it is the complications of the foot that take the greatest toll" further added Dr Mbanya.

Surgical Site Infections (SSIs) are infections associated with surgical procedures and are a major source of post-operative illness. "These infections are responsible for approximately one quarter of all nosocomial infections and affect 1.4 million people worldwide at any time. SSIs result in longer hospitalization, increased patient mortality and higher costs for healthcare providers and payers" said Professor (Dr) Rama Kant, who is the national President-elect of Association of Surgeons of India (ASI) 2012 and former Head of Surgery Dept, King George's Medical College (KGMC) and former Chief Medical Superintendent of Gandhi Memorial and Associated Hospitals.

A dedicated symposium and workshop on “ano-rectal problems revisited” which will bring together distinguished ano-rectal surgeons from the country shall be organised at SIPS Super-speciality Hospital, Shahmeena Road, Chowk, said Professor (Dr) Rama Kant, Executive Director of Piles To Smiles Clinics, who is also a former Head of the Surgery Department at CSM Medical University (erstwhile KGMC). One of the senior-most and reputed surgeons of the country, Professor (Dr) RP Sahi shall inaugurate this meet.

(Based on an Interview, given exclusively to Citizen News Service by Dr RC Shah, honorary surgeon to the Governor of Gujarat, and recipient of President’s Gold Medal)
We are indeed living in hostile times. There is violence not only at the war front, but also in our homes, on the roads and even in hospitals. It seems as if each of these places has become a battlefield. Hospital rage is increasingly becoming a common phenomenon. Every day, we hear about patients’ relatives creating a ruckus in hospital premises, protesting against doctors’ apathy—either treatment is not given timely or it is wrong treatment. Sometimes doctors also retaliate in self defense to show that they are above reproach like Caesar’s wife.