Introductory Price
COMMON FEMALE SEXUAL DISORDERS
www.futuremedicineonline.com KERENG/2012/44529
The last word in
February 2013 l `100 $8
BEAUTY CARE
EW
IN
VI R E T
Dr Edward C Benzel, Chairman, Department of Neurosurgery, Cleveland Clinic, US
Hospital Focus MIOT, Chennai
EDITOR’S NOTE Better late than never, know about medical facilities
R
Volume 2 Issue 2 | February 2013 Editor Ravi Deecee Deputy Editor Sanjeev Neelakantan Assistant Editor Dipin Damodharan Chief Copy Editor K Rajagopal Senior Reporter & Research Assistant Sreekanth Ravindran Senior Reporters Lakshmi Narayanan Prashob K P RESPONSE TEAM Coordinating Editor Sumithra Sathyan Reporters Tony William Shalet James Neethu Mohan Design & Layout Kailasnath Anil P John Web Manager Sreenath S
Head - Business M Kumar ADVT SALES Senior Managers Kainakari Shibu Rajasree Varma Anu P M Biju P Alex K S Syam Kumar M K Haridas Vinod Joseph ( Delhi) Rohil Kumar A B (Bengaluru) Managers Febin K Francis Bipin Kumar V S MARKETING Sr Manager Sabu Varghese Mathew Assistant Managers Priya P A Mobin E Mathew Circulation Athul P M Sone Varghese Vishnu
Business Office - India
DC MEDIA, DC Books Pvt Ltd No 387, Ist Cross, 4th Block, 80 Feet Road Koramangala, Bengaluru – 560034, India
Business Office - International
DC Books, Near Karama Metro Station Trade Centre Road, Dubai, UAE
Editorial Office
DC MEDIA , DC Books Pvt Ltd 234/C, Adjacent to YMCA, Chittoor Road, Cochin – 35, Kerala, India
Contact
Ph: +91 484 3047 405, Fax: +91 484 4021 145 Mail: editorial@dcmedia.in, info@dcmedia.in
www.futuremedicineonline.com Published from DC Books Pvt Ltd, D C Kizhakemuri Edam, Good Shepherd Street, Kottayam – 686001, Kerala, India and printed at Five Star Offset Printers, Nettoor, Cochin – 40 for DC Press Pvt. Ltd., Industrial Development Area, Poovanthuruth, Kottayam – 686012, Kerala, India. Printed, published & owned by Ravi Deecee
DC Media Publication 4 FUTURE MEDICINE I February 2013
iding on the excellent feedback we are receiving from our readers, we have prepared yet another issue of Future Medicine. It is our strong belief that issue after issue, the magazine has immensely progressed content-wise as well as in the presentation of articles, taking into account its readers in all age groups. We are overwhelmed with the fact that our readers were pleased with the wide coverage of a variety of reports, articles and features in the previous issues. In this issue, we focus on the disease, cancer, and its treatments in India. Besides, special articles, exclusive interviews with experts in the medical field and the latest information regarding the incidents in the global medical scene have been incorporated in this issue for the benefit of the readers.
It is the time for a countywide campaign to make people aware of cancer and its treatment in modern medicine, Ayurveda and Homeopathy as the number of cancer cases is alarmingly increasing in India. Early detection and continuation of the treatment are the principal factors which curtail the intensity of the disease and also prevent it from aggravating further. These measures increase the chances of survival of the patients. Unfortunately in India, most cases of cancer are left undetected in the early stages. It is mainly due to the poor knowledge about various aspects of the disease among the public. People need to know that the early detection is the key to the successful treatment of the disease. Further, people should not succumb to the phobia that cancer is incurable and instead strengthen mental power to live a life despite the disease. Motivational campaigns across the country are there by most essential to fight and survive this curse. Spine diseases and its treatments in various hospitals in Kerala and other southern states is another area discussed in detail in this issue. It is important to note that of late incidence of spine disorders has risen in our county due to change in our life style. There is an array of causes leading to spine-related diseases. No doubt, there is a remarkable progress in spine surgeries which are available in many specialist hospitals. Experts in the field are certain that all spine disorders can be treated and fully cured through surgeries. Cheers for the specialists.
This issue has an interesting cover story-an exclusive interview with Shahnaz Husain, world famous woman entrepreneur and the pioneer of herbal beauty care in India. We are confident that the readers will enjoy the cover story. Wish our readers all the best.
CONTENTS
STORY 18 COVER The last word in beauty care One of the most successful and globally acclaimed women entrepreneurs, Shahnaz Husain, the pioneer of herbal care in India, has a superb story to tell. Known as India’s queen of herbal beauty, Shahnaz, CMD of the Shahnaz Husain Group of Companies, has built a global business empire with her herbal cosmetic cures.
60
13
ASTHMA Dr Mukesh Batra, Founder & Chairman, Dr Batra’s
Spine Care Special How healthy is your spine?
46
A REMARKABLE FEAT Dr Nandakishore Kapadia, Fortis Malar Hospital, Chennai
TRADITIONAL MEDICINE Kelu Vaidyar, Vellan Vaidyar
33
Amid increasing cases of spinal disorders across the globe, development of new techniques and medical methods have become a boon for patients suffering from various spinal problems. However, advanced treatments are very expensive and the poor only have little access to such treatments
Azad Moopen 14 ADrdoctor with Midas touch Dr Azad Moopen, a renowned physician-turned entrepreneur, is the Chairman of DM Healthcare, which owns and operates one of the largest healthcare networks in the Gulf Cooperation Council (GCC) countries – from hospitals to polyclinics, pharmacies and diagnostic centres 6 FUTURE MEDICINE I February 2013
42
MIOT Hospitals Orthopaedic surgery at its best Located in Manapakkam, Chennai, MIOT has grown into a multi-specialty hospital catering to patients from the country and abroad in a short period of time. Dr PVA Mohandas, a leading orthopaedics surgeon, who founded the hospital in 1999, holds the credit for popularising orthopaedic surgery in the country
55
Pathbreaker
Arunachalam Muruganantham
63
Rural Poverty
54
Sexual Health
45
Dental Care
50
Cancer Treatment
58
Healthcare Solutions
Anirudh Krishna
Dr Ajith Chakravarthy
Dr Ravi R Hebballi
Dr Babaiah
Lakshmi Santhosh
February 2013 I FUTURE MEDICINE 7
MEDICAL DIGEST
New device to speed up HIV test Washington: A new low-cost
device, mChip, has been developed which would help speed up the HIV diagnosis manifold.
A combination of cell phone and satellite telecommunication with fluid miniaturization techniques for performing all essential ELISA functions, this new technology is faster in diagnosis and treatment of the HIV-infected who cannot get themselves tested,
because of far flung healthcare centers.
Developed by Samuel K Sia, Associate Professor of Biomedical Engineering at Columbia University, the tool not only checks a patient’s HIV status worldwide with just a finger prick but also synchronize the results automatically and instantaneously with central healthcare records-10 times faster than the bench top ELISA, a diagnostic technique.
Vegetarians have less risk of heart disease Washington: Ditching meat and fish in favour of a vegetarian diet can have a dramatic effect on the health of your heart, research suggests.
A study of 44,500 people in England and Scotland showed vegetarians were 32% less likely to die or need hospital treatment as a result of heart disease. The findings which were published in the American Journal of Clinical Nutrition showed that differences in cholesterol
The device was field-tested in Rwanda by a collaborative team from the Sia lab at Columbia’s Mailman School of Public Health.
New treatment for drug-resistant TB okayed Mumbai: A new line of
treatment for multi-drug resistant (MDR) tuberculosis has been approved by the US Food and Drug Administration for the first time in 40 years. Tested on 440 patients in the US in two phaseII clinical trials, the drug Sirturo could prove to be a game changer. Dr Zarir Udwadia, a TB specialist
8 FUTURE MEDICINE I February 2013
at Hinduja Hospital, said, “We’ve had antibiotics but this is a new class of drugs, it acts by specific and new mechanism. So it is the first new TB molecule which is going to be reserved for MDR TB as well. Since it is a new molecule, there is going to be no resistance upfront at all.” In hospitals, India has been grappling with MDR and the XDR forms of TB - which does not respond to any known treatment. Currently, this new drug is approved only for the US. Right now, the treatment for MDR TB is a two-year course of up to 20 pills a day and around eight months of daily injections. Doctors say that just as with any medicine, the new drug Sirturo also has side-effects.
levels, blood pressure and body weight are thought to be behind the health boost.
Heart disease is a major blight in Western countries. It kills 94,000 people in the UK each year - more than any other disease, and 2.6 million people live with the condition. Scientists at the University of Oxford analysed data from 15,100 vegetarians and 29,400 people who ate meat and fish.
Over the course of 11 years, 169 people in the study died from heart disease and 1,066 needed hospital treatment - and they were more likely to have been meat and fish eaters than vegetarians. The results showed the vegetarians had lower blood pressure, lower levels of “bad” cholesterol and were more likely to have a healthy weight.
Now communicate with doctors via robots Washington: A robot
that allows patients to communicate with doctors via a telemedicine system that can move around on its own has just received 510(k) clearance by the FDA (Food and Drug Administration).
The robot, called RP-VITA, was created by InTouch Health and iRobot. It allows doctors from anywhere in the world to communicate with patients at their hospital bedside via a telemedicine solution through an iPad interface. According to iRobot and InTouch Health, RP-VITA combines the latest from iRobot
in autonomous navigation and mobility technology with state-of-the-art telemedicine, and InTouch Health developed telemedicine and electronic health record integration. RP-VITA makes it possible for doctors to have “doctor-topatient consults.
Global cosmetic surgery set to grow 10% Paris: The global market for cosmetic procedures grew 10 per cent last year and is set to
grow at a similar pace in 2013, according to a report by IMCAS, a French-based forum for plastic surgeons and dermatologists. Surgical procedures such as liposuction and breast
Induce older mums early to cut stillbirth risk London: Pregnant women aged over 40 should be given the option of being induced early to reduce the risks of losing their baby, says a paper from Royal College of Obstetricians and Gynaecologists. Inducing these women at 39 weeks instead of the normal 41 could prevent 17 stillbirths in the UK each year, the authors said. And this would not lead to increased numbers of caesarean sections. A stillbirth charity said induction could save many babies’ lives. Dr Mandish Dhanjal, a clinical senior lecturer at Imperial College Healthcare NHS Trust, and Dr Anna Kenyon, at University College London Hospital, looked at a number of studies that explored the impact of the rising age of mothers on the health of the foetus and the mother.
augmentations, as well as noninvasive treatments like lasers and anti-wrinkle injections, totaled 4.4 billion euros ($6 billion) in 2012 and are expected to reach 4.9 billion euros this year, the report said. Asia is expected to see the strongest growth this year. The European market is forecast to grow 6.6 per cent in 2013 as shrinking discretionary spending among austerity-hit consumers offsets strong demand for anti-ageing treatments.
February 2013 I FUTURE MEDICINE 9
MEDICAL CONFERENCE
ICMIT 2013 to be held from March 28 KHARAGPUR: Indian Conference on Medical Informatics and Telemedicine (ICMIT) 2013 will be held at Indian Institute of Technology, Kharagpur, West Bengal, from March 28 to 30. The conference aims to bring together technologists and medical professionals to exchange ideas and focus on the ways to provide improved healthcare.
Original contributions are solicited for presentation at the conference. All papers will be reviewed and the accepted papers will appear in the conference proceedings. Topics include medical standards, medical instrumentation, medical imaging and computer aided diagnosis, telemedicine systems, practices and case studies, health information systems and healthcare, mobile computing in healthcare, security policies/ framework in healthcare, legal and ethical issues in medical informatics, public health informatics, virtual reality in medicine and surgery, and assisting technology for the physically challenged.
Bali to host ICMIB 2013 next month INDONESIA: The second International Conference on Medical Information and Bioengineering (ICMIB) 2013 will be held from March 16 to 17 in Bali Island, Indonesia. The conference is held every year to share views and experiences in information and industrial electronics and related areas. ICMIB 2013 aims to bring together researchers, scientists, engineers and scholar students to exchange and share their experiences, new ideas, and research results. All ICMIB papers will be published in International Journal of Medical and Bioengineering. 10 FUTURE MEDICINE I February 2013
HEART SURGERY A remarkable feat
Chennai doctors make history By Neethu Mohan
A
group of doctors from Chennai created history recently by conducting a seven-hour long heart surgery. The specialty of this surgery was the surgeons used chisels and hammers to darn the heart of a 53-year-old worker from Salem.
This is the first time in the medical history a surgery has been performed to remove stones from the heart. Speaking about the surgery, Dr Nandakishore Kapadia of Fortis Malar Hospital said: “The patient was brought to the hospital with severe chest pain and lethargy by one of his relatives. We did an echocardiography and found some images which we don’t find normally. His aortic valve, which controls the flow of blood into the aorta, had thickened because of calcium deposits.”
“It affected the blood flow into the biggest artery, reducing the volume of blood pumped out of the heart by nearly half. Echocardiography and coronary cardiography showed stones that were pressing against the left and right ventricles (two of the four chambers) of the heart,” said Dr. Kapadia. The doctors removed the stones, replaced the valves and then conducted a bypass to increase the blood flow. “We had to break the stones before removing them from the heart. It was a two-hour effort,” Kapadia said.
Kapadia said they confirmed that so far no such surgery was conducted in the world although there were reported cases of minor calcium deposits, but not this much. According to Kapadia, the presence of such stones is probably because of the water in particular areas. The stones are composed of calcium, fluoride, phosphate and some iron, he added.
The doctor explained the complicated procedure of the operation: “The aortic valve had to be shifted to the septum, the muscular wall that separates the heart chambers. Doctors used glue as they could not seam some blood vessels.” Later, medical camps were organised in the residential area of the patient to detect whether similar cases exist. The hospital has got three more patients, not similar but who have stony accumulations in their heart. The doctors have already begun writing a scientific paper on this rare medical condition for publication in a medical journal.
HEALTH CARE Dr Azad Moopen
A doctor with
Midas touch Dr Azad Moopen, a renowned physician-turned entrepreneur, is the Chairman of DM Healthcare, which owns and operates one of the largest healthcare networks in the Gulf Cooperation Council (GCC) countries – from hospitals to polyclinics, pharmacies and diagnostic centres. Dr Moopen did MBBS with a gold medal, MD in General Medicine from Calicut Medical College, Kerala, and diploma in Chest Diseases from Delhi University. He had served as a lecturer in Delhi University for five years before relocating to Dubai in 1987 to start his medical practice. He is also actively involved in the development of healthcare facilities in India. He established the 600-bed tertiary care Malabar Institute of Medical Sciences (MIMS) Hospital at Kozhikode in Kerala in 2001 and the 150-bed MIMS Hospital at Kottakkal in Malappuram district in 2009. MIMS is the first multi-specialty hospital in India to receive the NABH (National Accreditation Board for Hospitals & Healthcare Providers) accreditation in 2007. Dr Moopen’s group is setting up a medical college in Wayanad, a MIMS Curie Cancer Centre at Kozhikode, and Community Dialysis Centres in several parts of the state. It has also embarked on a project to establish a medical city in Kochi. It has been conducting free medical camps for labourers in different GCC countries. In 2008, the MIMS Charitable Trust established a Rural Health Centre at the backward Vazhayur Panchayat near Kozhikode and provided free treatment to 7,000 BPL members. Dr Moopen also started the ‘Save the Little Heart’ programme in Dubai in March 2009 to create awareness and raise about Rs 65 lakh for the cardiac surgeries of 60 children from poor backgrounds. He was honoured by the government with the Pravasi Bharatiya Samman in 2010 and the Padma Shri in 2011. In an interview with Future Medicine, Dr Azad Moopen talks about the healthcare initiatives and welfare activities undertaken by DM Healthcare in India and abroad. 14 FUTURE MEDICINE I February 2013
By Sreekanth Ravindran As a major healthcare player in the region, what are the milestones set by DM Healthcare in the Middle East?
DM Healthcare has carved a niche for itself in the healthcare sector of Middle East. We have successfully branded our clinics, pharmacy and hospitals across the region. One of the largest healthcare groups in the region, we have 120 institutions entrusted with providing services within all the three verticals of healthcare such as pharmacy, hospitals and clinics. Also, we employ about 3,000 people in our institutions.
What are the core specialties of DM?
As I have mentioned, we are present in all the three verticals. Though our emphasis is on tertiary care, we are also tapping the potentials in the secondary care. Every hospital has a unique focus along with its specialisation.
What are the challenges facing Indian healthcare?
Shortage of medical professionals, resource crunch and lack of spending on healthcare by the government are the main challenges affecting the healthcare sector. Our healthcare spending to GDP is less than four per cent. It is too low for a country like India with huge requirements. Apart from these, there has to be a comprehensive healthcare policy to address all issues of the sector.
What are the shortcomings in the Indian medical education? Healthcare is not just an industry. A doctor
should have the attitude and inclination to serves the needy. This is the area where we should follow the Western countries. Most of them have at least five years of compulsory rural service. Commercialisation of the medical profession is a worrying trend.
MIMS has already set a benchmark in the healthcare sector of Kerala. With a medical college in Wayanad and a medical city at Kochi on the anvil, do you plan to explore the medical tourism sector, which is slowly catching up in the state?
We are definitely exploring the area. Both modern medicine and Ayurveda have huge potential in the medical tourism industry. Moreover, medical professionals from Kerala are world famous. As of now, we have patients from the Middle East and Africa. I also believe that healthcare players like us can successfully tap the opportunities in the sector only if the state government creates a platform.
Tell us about the social welfare initiatives taken by your hospitals both in India and abroad.
We have a charitable trust attached to MIMS. We have been conducting free treatments, including specialised surgeries, for patients from poor backgrounds in India and abroad. In the Gulf countries, we have been organising medical camps in association with Indian Consulate. Large amounts of money have been earmarked, even from my personal wealth, to support patients from humble backgrounds.
February 2013 I FUTURE MEDICINE 15
HEALTH COVERAGE
Long term plan
Dr Jitendar Kumar Sharma
in the offing 1.04 per cent of GDP in 2011–12 to 1.87 per cent of GDP by the end of the 12th Plan. In such an event, the funding in the central plan would increase to three times the 11th Plan levels involving an annual increase by 34 per cent . SWOT analysis of 12th five year plan with an objective of achieving universal health coverage.
•
B
ased on the HLEG report and after extensive consultations within and outside the government, as well as a close review of the actual performance of the sector during the 11th Plan period, a new strategy for health is being spelt out in the 12th Plan towards rolling out universal health coverage—a process that will span several years. The consensus among stakeholders is that the magnitude of the challenge is such that, a viable and longer term architecture for health can be put in place only over two or even three Plan periods. However, a start must be made towards achieving the long term goal immediately. During the 11th Plan, funding for health by the central government has increased to 2.5 times and of states to 2.14 times that in 12th Plan, to add up to 1.04 per cent of GDP in 2011–12. When broader determinants of health (drinking water ICDS and mid-day meal) are added, the total public spending on health in 11th Plan comes to 1.97 per cent of GDP. The 12th Plan strategy outlined is a first step in moving toward universal healthcare. For financing the 12th Plan, the projections envisage increasing total public funding, plan and non-plan, on core health from
16 FUTURE MEDICINE I February 2013
•
•
Aims to strengthen central government sponsored insurance schemes like RSBY. Envisages drug reforms (including encouraging generic drugs) and regulatory mechanisms to improve safety of medical technologiesEnvisages EHP (Essential Health Package). Primary health services to be declared completely free.
Weaknesses •
•
•
Puts success of plan on a proportional increase in health expenditures by the state- which may not hold practical. UHC time line of 2 to 3 plan periods (over 15 years) may be too long a time to evolve focused and strong long term commitment – in 15 years disease pattern and profiles may change completely. Too much of emphasis on medical colleges; comparatively less on district hospitals.
Opportunities •
•
•
If applied with sufficient technology support, UHC will take country closer to achieving MDGs (Millennium Development Goals). Have plan for extensive patient data tracking – although such extensive data may not be really required for informing policy decisions. Clinical Establishment Act
enforcement across states, could lead to a uniform legal system of healthcare practice. Encouragement to STG (Standard Treatment Guidelines) would be boost to patient safety.
Threats •
Increase to 1.94% of GDP over 5 years from 1.04% of GDP currently means only 0.18% of GDP per annum and by 0.9% over the plan period. The annual increase is too small to fill in the vacuum that exists over many decades- an increase of at least 0.4% of GDP per annum with 2.0% increase over and above current spending taking the total central government spending to 3.0% of GDP would have the least desired level.
•
Community Health Workers cadre to be established with 3 years course after 10+2 would take at least 5 years to be produce the first batch. Country wide shortage of healthcare workers needed a technology and not necessarily a man power solution.
Strengths •
Member, Faculty of Health Sciences at University of Adelaide, Australia
Dr Jitendar Kumar Sharma has served as Hospital Administrator for a number of years at Sri Sathya Sai Institute. He was a consultant to the World Bank and the World Health Organisation in the division of medical devices. He is part of the Faculty of Health Sciences at University of Adelaide, Australia, and Advisor to Health Technology Innovation Centre of the Indian Institute of Technology, Chennai. He has authored many research papers and two books.
e t r o f r u o s i y t d i e . u r . . n u d e s Ing ity is as arallele l p a n u u Q ice is Serv GB D’Care-546
GB-325
25 Parameters & 3-Part Diff Automated Hematology Analiser
GB-235
A Versatile Clinical Chemistry Analyser
An Automated Glycated Hemoglobin (HbA1c) Analyser
GBLISA-W
A rapid Microplate ELISA Washer
UROGB
A Series of Compact Automated Urine Analysers
GBLYTE
A Range of Automated (ISE) electrolyte Analyser
Corporate Office:
No.13, Dhandapani Street, Radha Nagar, Chrompet Chennai-600 044, Ph: 044 - 4989, Telefax: 044 - 4557 4291.
Works:
No.87, Gandhi Salai, Alapakkam, Chennai - 600 063.
www.genuinebiosystem.com
COVER STORY Shahnaz Husain
20 FUTURE MEDICINE I February 2013
The last word in beauty care One of the most successful and globally acclaimed women entrepreneurs, Shahnaz Husain, the pioneer of herbal care in India, has a superb story to tell. Known as India’s queen of herbal beauty, Shahnaz, CMD of the Shahnaz Husain Group of Companies, has built a global business empire with her herbal cosmetic cures. Starting the journey of an entrepreneur in her early 20s, she made her own way into the world of beauty care by extracting the potential of plant ingredients. Shahnaz offers a safe and natural solution to women who want beauty without fuss. What makes her different from other women entrepreneurs? The way in which she approaches her profession,her dedication and passion make her unique. Shahnaz innovated treatments and products herself, marketing them in her own brand name internationally. The products contain herbal and floral extracts, essential oils, minerals and gems and other natural substances. For a long time, this is what the entire beauty industry was looking for, to get rid of dangerous chemical beauty care products. Shahnaz beauty products are very skin-and-hair-friendly. She is not only the leading name in markets in India, but has established her brand name in the international market too. Now, she is aiming to set her foothold in outer space. Astronauts usually suffer from skin problems while in space. Shahnaz is focusing on making products, based on Ayurveda, that can prove to be beneficial for astronauts. So, we can say that Shahnaz Husain is an entrepreneur who has touched the pinnacle of success from earth to space. Starting in 1970 in New Delhi, the Shahnaz Husain Group has more than 400 franchise ventures in India and abroad. In an interaction with Future Medicine, the Delhi-based global beauty care entrepreneur talks about her success story and experience in the beauty care industry
Bureau
COVER STORY Shahnaz Husain
Maintaining beauty is an inevitable part of daily healthcare. In such a scenario, what is the role of Shahnaz products in sustaining beauty in life?
I have always believed that health and beauty are two sides of the same coin. The health of the skin and hair depends on the overall health along with appropriate external care. Four decades ago, when I started my career, I rejected the existing concept of beauty and adopted my own. I brought personal customized beauty care to the level of paramedical care, with diagnosis and prescriptions, based on the fact that the human body is natural and is best treated by nature itself. Cosmetics help only 20%, and 80% of true beauty is good mental and physical health. The external body condition is a barometer of internal health. I propagated the Ayurvedic principles of holistic health, taking diet and exercise into consideration. This concept of holistic beauty care was unique and caught on worldwide. In order to translate my ideas into reality, I started my first herbal salon in 1971 and also started formulating my own products. I drew from the powerful healing properties of plant ingredients and natural substances and adopted the principle of “Care & Cure.� Apart from general beauty care, I also introduced clinical treatments and therapeutic products for the treatment of specific skin and hair problems. Our organic products, based on Ayurveda, not only offer safety from chemical after-effects, but have also increased awareness of the benefits of natural beauty care and physical fitness.
Could you elaborate on the beginning of your career and the growth so far?
I have always believed that health and beauty are two sides of the same coin. The health of the skin and hair depends on the overall health along with appropriate external care
20 FUTURE MEDICINE I February 2013
I was married at the age of 15 and by the time I was 16, I had become a mother. Life seemed perfect, but I was bored with the drudgery of endless routine. Then the mental upheaval began. I was always interested in beauty and in making others beautiful, so I decided on beauty care as a career. I was determined to get the best training possible and decided to work my way to the best institutions of the West, to learn cosmetic chemistry and cosmetology. My husband was posted in Tehran at that time, as head of foreign trade with the State Trading Corporation of India. I was not a graduate, but I loved to write. So I started writing articles for the Iran Tribune. Somehow, I was convinced that if I was highly qualified in my field, I could have the world at my feet. So gradually, I worked my way to leading institutions like Helena Rubinstein, Christine Valmy, Swarzkopf, Lancome and Lean of Copenhagen. While training in London, I came across instances of skin damage caused by chemical treatments. In a way, this changed the course of my life and career. I wanted to find a natural alternative that
was safe and without risks. From my family, I inherited faith in natural healing and my study of Ayurveda strengthened that faith. The ancient Indian system of Ayurveda is the oldest and most organized system of herbal healing in the world. I was convinced that it could offer the ideal answer to modern cosmetic-care.
I came back to India and started my first herbal salon in the verandah of my home in New Delhi in 1971, in a very small way. In order to implement my ideas of natural beauty care, with an emphasis on the good health of the skin and hair, I established customized beauty care with a personalized style based on individual needs and problems. I adopted the concept of “herbal care and cure.� It was a totally unique, path-breaking concept. I rejected the existing salon treatments and devised my own. I also began to formulate my own products using plant ingredients and natural substances, based on the Ayurvedic system. Today, the salon treatments and products have become breakthroughs in natural beauty care. We have become known, not only for our treatments for general beauty care, but also for our therapeutic products and salon treatments for problems like acne, hyper-pigmentation, scars, premature ageing, dandruff, hair damage, hair loss, etc.
I began to extend my salons on a unique franchise system. I started encouraging ordinary housewives to start a beauty salon in their own homes and thus achieve financial independence. This way they could have a career and be close at hand to care for home and family. I trained them and gave them the Shahnaz Herbal franchise. It was the beginning of my franchise system and the beauty training academy. The fast paced extension of the Shahnaz Husain Salons and other ventures is due to our franchise system. Today, the Shahnaz Husain franchise has become a successful business model, with tremendous international goodwill and demand. Today, we operate in more than 100 countries with our franchise ventures and direct product distributors. From one herbal salon to a worldwide chain of ventures, it has been a phenomenal journey.
How did you identify the potential of Ayurveda in beauty care? Explain your innovative Ayurvedic beauty care products?
February 2013 I FUTURE MEDICINE 21
COVER STORY Shahnaz Husain
ÂIndia is a country where traditions have flourished side by side with modern technological advancements. Ayurveda is a holistic system of healing. It believes that diet, nutrition, exercise and relaxation are all part of the healing process. Ayurvedic texts contain the details of thousands of plant products, minerals, metals and other natural substances, along with their medicinal properties. They also tell us how to collect and extract them, along with various combinations. Ayurvedic treatments are not only for those who are ill, but for all those who wish to come closer to a state of perfect health. Similarly, Ayurvedic formulations for external beauty care help both general care, as well as the treatment of specific skin and hair problems. Ayurveda draws upon the healing properties
of plant ingredients and other natural substances that have powerful healing properties and many benefits for skin and hair care. They contain vitamins, minerals, enzymes and other valuable substances, which are essential for the health of the skin and hair. We have applied Ayurveda in beauty treatments and found that it has the ideal answers to the demands of the modern cosmetic care.
One of the advantages with Ayurveda is that it has a long history of safe usage. The human body responds extremely well to natural ingredients, while it has an in-built resistance to synthetic ones. The Shahnaz products combine the ancient system and the latest scientific techniques. The ingredients that have been selected for our formulations not only have specific curative properties, but offer an element of safety as they lack harmful after-effects and reactions. Our products contain herb, flower and fruit extracts, essential oils, precious metals and even gems.
Our Gold, Pearl, Diamond, Plant Stem Cells and the latest Platinum Ranges have taken the international markets by storm. We have also launched Shahnaz Husain’s sensational Telomere range of skin care products. Telemere DNA Defence Age Control is the most dramatic breakthrough in finding the key to skin ageing. Telomere is the real fountain of youth. It will herald a new era in controlling skin ageing‌.the single, most
22 FUTURE MEDICINE I February 2013
powerful way of putting back the hands of the clock.
It is based on the most advanced biotechnology discoveries of our time and is the result of cutting-edge research in chromosomes, the very heart of the cell. A telomere is attached to the protective tip at the end of your DNA present at the end of a chromosome, which protects it from deterioration. The shorter the telomere, the more the skin get ageing.
After intensive research, this latest scientific breakthrough in biotechnology has been applied to formulate the telomere products, comprising intense cell regeneration day complex and advanced cell replenishing night serum. They are designed to lengthen and maintain telomeres and thus control the ageing of skin cells.
Another great scientific formulation is the chemoline products for skin and hair care. They have been specially designed to help alleviate the side-effects of chemotherapy and radiation, like skin sensitivity, hair loss, moisture depletion, dehydrated skin etc. These products draw upon the soothing and healing properties of organic ingredients and are known for their beneficial effects on the skin and hair. They support the body’s natural healing processes and restore health to the skin and hair.
With the concept of “total well being� gaining ground, spa treatments are becoming popular. Ayurvedic treatments are ideal for spa treatments. Therefore, service industries like spas, beauty salons and Ayurvedic centres, have phenomenal scope for growth in the international market. Today, the world is looking at the Indian disciplines of yoga, meditation and Ayurveda. In fact, the Shahnaz Husain organic products are selling at Selfridges, the famous London
COVER STORY Shahnaz Husain
store. Within two weeks of the opening at Selfridges, the products posted record breaking sales, touching £1000 a day. Recently, a single customer bought products worth £4,334 in a single transaction, despite competition from leading international brands. This shows the demand for Ayurvedic products.
How do you ensure the quality and safety of your beauty products before hitting the market?
Our products are tested not only in our R&D units but also in our chain of salons worldwide. In fact, our products have grown out of clinical usage, based on massive client feedback. Research and development always have high priority. To ensure the purity of raw materials, a herbal farm has also been set up near Delhi. Thus quality control is exercised right from the raw material stage. This is done through rigorous testing and research. The extraction of essential oils, infusions, decoctions, tinctures and other extracts is carried out by the Shahnaz Husain Group itself. Various methods of soil culture and cultivation are being followed, using superior natural composts and fertilizers. From the herbs and flowers, various preparations are obtained for use in the formulations, like infusions, decoctions, distillates, essences, powders, tinctures and so on, in keeping with the Ayurvedic system. These are made under strict supervision, using the latest technology. Stringent quality control tests are carried out for various dilutions. Thus, by exercising control at each stage, high quality is
Celebrity
clients • • • • • • •
Princess Diana Indira Gandhi Barbara Cartland Goldie Hawn Vyjantimala Michael Jackson Lila Clerides, wife of the president of Cyprus
ensured.
Playing the lead role in the world of beauty, how do you define the terms “beauty” and “beauty care and cure”?
Beauty is a total impact. It is physical beauty power, brain power and spiritual power. It is the blending of physical, emotional, mental and even spiritual qualities into one integrated whole. To me beauty care is natural care and cure. It should help towards the achievement of healthy skin and hair, because the beauty of the skin and hair lies in their good health. It should not only provide the means for general beauty care, but also include treatments for specific skin and hair problems, based on individual needs.
Each product of Shahnaz carries your picture on it, what is role of your picture logo in building a loyal customer base?
We are unique to the extent that “Shahnaz Husain” is not a faceless brand name or corporate. The image that is foremost in the mind of clients and consumers is that of a real, answerable person, who is herself trained in cosmetology and cosmetic therapy. Every label has become a
symbol, not only of my understanding of herbal beauty care, but of my vision and philosophy. The mere mention of the brand name evokes the image of the person and the personality. This is because my name has become the brand and I am the brand ambassador. To that extent, I am the reality behind the brand. My image is directly related to the brand, because the brand has built up unknowingly, in a very personal way. My name has become a household word and we are the leaders on the strength of brand identity and brand loyalty.
What is the role of family in supporting your ventures?
I always say that I could never have achieved what I have, without the support and understanding of my family. First of all, my father guided me and then my husband became my real inspiration to take up a career. I decided to open a herbal clinic in my own home in a small way. I did not invest a large capital in the business. From my father, I borrowed Rs.35,000 and started the first herbal clinic in the verandah of my home. Behind the success lies my determination and hard work and also my father’s faith that I would succeed. My family’s encouragement and constant support made me what I am today. Whatever fame I have achieved, I owe to them.
Can we turn India into a hub of beauty care? If so how?
As far as the economy is concerned, cultural industries, like Ayurveda, also play an important role in the economy of the developing nations, not only in terms of economic growth, but also in achieving social stability, employment generation and wealth creation. India is a
As far as the economy is concerned, cultural industries, like Ayurveda, also play an important role in the economy of the developing nations, not only in terms of economic growth, but also in achieving social stability, employment generation and wealth creation. India is a country with a rich cultural heritage, with immense economic potential
Our future plans include concentrated international branding, strengthening and widening our global chain of franchise salons, beauty training institutes, shops and spas. We will be extending our Ayurvedic spa treatments. They will be geared towards revitalisation, rejuvenation and stress-reduction, upholding the principles of holistic care
February 2013 I FUTURE MEDICINE 25
COVER STORY Shahnaz Husain
Milestones •
Shahnaz Husain, India’s Beauty Ambassador, is the First Lady of herbal beauty care.
•
Pioneered the herbal beauty movement by setting up the first herbal salon in India at her residence in Delhi in 1971.
•
Pioneered the concept of residence cum salons through her unique franchise system. The first Shahnaz Herbal franchise salon opened in Calcutta in 1979.
•
Entered the international market in 1980 during the Festival of India and broke a 40-year old cosmetic sales records in Selfridges, the famous London store by selling products worth ₤2700 in two hours.
•
Again achieved record breaking sales at Selfridges in London in 2010, when one customer bought products worth ₤4334 in a single transaction.
•
In fact, Shahnaz products sold out at Selfridges in London in even before the inauguration in 2010.
•
Shahnaz Husain received three prestigious awards in London in one month for “Outstanding Ayurvedic Innovation”, the most prestigious among them was received at the British Parliament, in the House of Commons.
•
•
Shahnaz Husain has the rare honour to be invited twice by US President Barack Obama twice in 2010 for the World Summit on Entrepreneurship that was held first in Washington DC, USA and then again in for the Summit on Entrepreneurship that took place in Mumbai. Became the first Asian chain in herbal beauty care to be present at Galleries Lafayette in Paris, Harrods and Selfridges in London, Bloomingdales in New York, Seibu chain in Japan, La Rinascente in Milan and El Corte Inglis in Madrid.
26 FUTURE MEDICINE I February 2013
country with a rich cultural heritage, with immense economic potential. In the present scenario of globalization, the challenge is to develop our cultural industries to compete in the international market. Indeed, there is great interest in Ayurveda in many countries, prompting study and scientific research to assess it in scientific terms. We have seen tremendous demand for the traditional Ayurvedic treatments. There has been a growth in Ayurvedic service industries, like Ayurvedic centres for traditional treatments of panchkarma, dhara and Kerala massage, as well as Ayurvedic skin and hair care. In fact, such treatments are attracting foreign tourists to India due to the worldwide interest in holistic and alternative healing systems. So, expansion of such centres can attract more and more people from India and abroad. Ayurvedic skin and hair care, as well as Ayurvedic spas can also be developed to attract tourists. We have seen how our Ayurvedic beauty care treatments have become popular in the West and we have extended our salons to many countries through our franchise system. There is also a growing global market for alternative medicine and herbal products. This also includes essential oils, which are used in the related field of Aromatherapy. Considering our immense empirical knowledge of the healing power of plants, Ayurvedic industries can be developed for the international market. Medicinal plants can also be grown and processed for export. In fact, India can be a leader in the field. Centres for vocational training can also be set up in order to develop the skills that are needed in the beauty and spa sector. The effort should be to focus on global demands and the global market, which would require meeting international standards of quality. The traditional knowledge needs to be related to modern demands and techniques.
Your expansion plans?
We are expanding our footprints across the globe. We will be taking Ayurveda and Brand India to more countries within the next year. By 2015 we plan to expand our presence in major countries like USA, Canada, Kazakhstan and Kuwait, Bahrain, Oman, Australia, Singapore, Malaysia, South East Asia, New Zealand and other CIS countries including Russia, Belarus and Latvia. Our future plans include concentrated international branding, strengthening and
Chemoline product shots: Chemoline skin cream, scalp tonic
widening our global chain of franchise ventures and appointing distributors in unrepresented new markets. We have introduced an entire new repertoire of salon and spa treatments, using traditional and exotic ingredients. Product innovation has helped our organization to remain a dynamic one. So, we will continue to launch advanced products in Ayurvedic beauty care in the international markets. Shahnaz Herbals also plans to open treatment and de-stress centres along with spas in hospitals where people going through treatment can relax and rejuvenate themselves. We also plan to set up Beauty schools globally to impart training on skin and hair problems with the powerful magic of herbs and plant power. Shahnaz Herbals also plans to supply the Chemoline products for skin and hair care to top Cancer hospitals all over the world, that have been especially designed to help alleviate the side effects of chemotherapy and radiation. These products draw upon the soothing and healing properties of organic ingredients and are known for their beneficial effects on the skin and hair.
I have also been invited to lecture at MIT (Massachusetts Institute of Technology), Cambridge, Massachusetts, USA, on how I built a brand without commercial advertising and publicity. The lecture will be held at the Sloan School of Management at MIT. The audience will comprise of graduate students, MIT faculty, as well as aspiring entrepreneurs. I will also be sharing my journey from one herbal salon to a global network of franchise ventures.
February 2013 I FUTURE MEDICINE 27
HEALTHY DIET
10 heart-healthy foods Oatmeal
Let us have a breakfast with a bowl of oats which are rich in Omega-3 fatty acids, magnesium, potassium, folate, niacin, calcium, soluble fibre . Due to its soluble fibre content, daily consumption of oatmeal can lower blood cholesterol.
Do you have a resolution for 2013 to eat healthy, and then taking care of your heart is a must as heart disease is a leading cause of death in many cases. Here are 10 heart-healthy common foods you can include in your daily diet to prevent heart problems
Almonds
A rich source of carbohydrates, vitamin E, high quality protein, magnesium, fiber, heart-favourable mono- and polyunsaturated fats and phytosterols and almonds are really a hearty treat. Many studies showed that using almonds in daily diet can lower many factors associated with heart disease, including cholesterol and blood lipids. Almonds are a rich source of oil, with values ranging between 36% and 60% of kernel dry mass. Also note that almonds may cause allergy.
Olive oil
Increasingly seen as a fine food choice to protect against viruses, olive oil helps lower cholesterol. Daily consumption of this healthy cooking medium can help in decreasing systolic and diastolic blood pressure.
30 FUTURE MEDICINE I February 2013
Kidney beans
Kidney beans is one of the several varieties of beans, which are often called red beans. The good thing about this food is that there is no need to eat too much to get its benefit. Because of the presence of soluble fiber, it is capable of lowering cholesterol.
Red wine
Having a glass of red wine can improve good HDL cholesterol because of the presence of alcohol and certain substances. The drink is rich of catechins and reservatrol. It is believed that red wine helps in protecting against artery damage. Resveratrol, a key constituent in red wine, helps prevent damage to blood vessels,
Carrots
Carrot is heavily seen as food that has a lower risk of heart disease. Include carrot in your daily diet and reduce cholesterol levels. The presence of soluble fiber in carrots is also good for heart. Rich in Alpha-carotene, fiber, carrots keep your heart healthy.
Sweet potato
High in vitamin B6, vitamin C, vitamin A and vitamin E, sweet potato is truly an anti-stress food item. Daily consumption of sweet potato can reduce the chances of heart attacks. Due to the presence of vitamin B6, it helps avoid homocysteine build-up in the blood. High homocyteine levels could increase the risk of cardiovascular disease and stroke.
Asparagus
Loaded with beta-carotene and lutein, B-complex vitamins, folate, fiber, asparagus reduces the risk of heart disease. The presence of folate makes asparagus a heart friendly food.
Tomatoes
Known as a filling food, tomato is a good source vitamins A, C, K, folate, potassium, carotene, lycopene, lutein (carotenoids), vitamin C, potassium, folate, fiber etc. Various studies proved that daily use of tomatoes can reduce heart related diseases.
Spinach
Rich in carotenoid Lutein B-complex vitamins, folate, fiber, spinach is a hearty food that prevent atherosclerosis, which is caused due to hardening of arteries. The presence of lutein in spinach has could reduce the risk of atherosclerosis, heart attack and stroke.
Prepared by Dipin Damodharan February 2013 I FUTURE MEDICINE 31
CHARITY & WELFARE
A helping hand indeed! Timely medical and financial assistance provided by Health Care Global Enterprises Ltd completely changed the life of the former gymnast from Mysore who was bed ridden after his spinal cord got injured during a practice session Bureau Enterprises Ltd, Bangalore, a specialist in cancer care, brought a ray of hope to Ananth Rao and his family.
“Ananth Rao’s case was studied in detail. The stem cells of the patient were cultured and two injections were given to him. Post the stem cell treatment, the patient progressed significantly. There is increasing evidence in the benefits of stem cell therapies on spinal cord injuries. For patients, who do not have any other option of recovering from spinal cord injuries, stem cell treatment is the way to look forward,” says Dr Pramod Chinder, Consultant, Ortho Oncologist, HCG. Health Care Global Enterprises Ltd took the major part of his surgery expenses. Today Ananth Rao is leading an active life.
Ananth Rao
I
n September 2010, when Ananth Rao, a gymnast from Mysore who has represented the Karnataka state at the national level, injured his spinal cord while practising for an event during Dasara festival, all hopes of the family were shattered. The 24-year-old was left paralyzed neck down and totally bed ridden. The family sought standard treatments but in vain. However, timely medical and financial assistance provided by Health Care Global
32 FUTURE MEDICINE I February 2013
Dr. BS Ajaikumar, Chairman, HCG Group, said: “When I met the patient, he was bed ridden, quadriplegic. Being a gymnast and always loving to lead an active life, I felt we should take up this challenge and regeneration can happen through stem cell treatment. We are glad our efforts are paid off and the patient is currently leading an active life. I believe stem cell therapies will play a crucial role in future healthcare.” Health Care Global Enterprises Ltd, headquartered in Bangalore with over 25 cancer centres, is South Asia’s largest cancer care network. HCG has defined the future of cancer care in India by designing, building and managing cancer care centres with a committed vision. HCG focuses on cancer care treatment, imaging and laboratory services, clinical trials and research services.
SPINE CARE SPECIAL
Dr Ram Kumar Menon Consultant neurosurgeon
Spinal diseases and treatment
Indian scenario W
ith a population of over one billion let us not be skeptical about the fact that the incidence of spine disease and spine injuries is high in India. Unfortunately, we don’t have a national registry like the “Spine Tango� of the European spine society where all the spine surgeries are registered and documented. However, there are sporadic attempts to have a registry where all the spinal diseases could be classified, surgeries registered and complications evidenced. There has to be a concerted effort nationally, not by mere individuals, organizations or groups. The national health mission should include spinal diseases, whatever may be the etiology. Since we have a very high ratio of population approximately 64% in the age group of 15-64 years, high density of traffic and poor lane discipline, the incidence of spine trauma is invariably high. In the next few years, it is this very same age group which will undergo aging, unfolding a huge population with degenerative spine diseases! Centers of excellence offering comprehensive spine care, including total rehabilitation post surgery/post injury, are by far few. NGOs offering aids to the underprivileged are also a few. Government funds for spine rehabilitation are sparse. However, in the urban areas and cities there are a significant number of hospitals offering the state of the art diagnostic and therapeutic solutions .Well trained surgeons, the state of
34 FUTURE MEDICINE I February 2013
the art MRI, CT, PET machines, intra operative imaging and fluoroscopy and intra operative nerve monitoring are now available in reasonably well equipped hospitals. Implants used in spine surgery both domestic and foreign are widely available in the country. The irony is that these facilities cater mainly to the urban population while approximately 65% of our population is still located in rural areas.
The first step towards this should be to evolve a registry at national scale like the national birth registry so that we have a clear demographic picture of the spinal condition, be it congenital, traumatic, oncologic or degenerative. The next logical step should be to register all the spine surgeries in all the hospitals be it public or private, with an online facility linking to a nodal centre. This will help us segregate the type of patient disease wise, surgery wise and region wise. For instance, Kerala has a reasonable number of spine injuries following fall from trees especially coconut trees. This would be practically unheard of in Mumbai which inevitably will rank high in causalities secondary to road traffic accidents. This is the time to act on these data to evolve a preventive strategy that includes educate the tree climbers on safety, provide insurance cover to them, create widespread awareness on safe driving practices and install safety measures in all high rise buildings. Typically in our country, when a patient is
injured especially in rural areas, he is taken to a hospital which is some kilometers away. He is not transported diligently with the required immobilization. So in addition to the primary injury, secondary injury is further inflicted. If the same patient had associated injuries, he may suffer from hypoxia and hypotension adding to the primary insult. By the time he reaches a centre where he is offered surgical or nonsurgical stabilization, his injuries have compounded. Identification of such patients and streamlining the transportation to the right place are needed. Some of these patients require prolonged ventilatory support and remain quadriplegic. This requires intense nursing care which if not offered leads to a cascade leading to bedsore, urinary tract infection, respiratory tract infection, osteopenia and untimely death. Advanced spine surgeries are available in centers across the country. Disc arthroplasty which has evolved over the past decade is now being performed widely. Minimally invasive spine surgery has also evolved significantly in the last 10 years. The traditional open techniques for lumbar and cervical disc disease have been replaced by the microscopic and endoscopic techniques with incisions of about a centimeter. Patients are quickly rehabilitated to the occupation they pursue. Minimally invasive spine stabilization like “sextent” and “viper” are
February 2013 I FUTURE MEDICINE 35
SPINE CARE SPECIAL Dr Ram Kumar Menon
now available for percutaneous stabilization of the lumbar spine, avoiding the need of long incisions. Percutaneous vertebroplasty and kyphoplasty have evolved to treat fractures of spine both osteoporotic and metastatic in a minimally invasive manner despite the co morbidities. The availability of a wide variety of contoured cages has made it possible to perform stabilization in spine surgery in conditions like cancers and tuberculosis (pott’s spine) easier. With the evolution of lightweight titanium implants, it has been possible to use longer constructs with relative ease in conditions like scoliosis. The availability of PEEK (Polyether ether ketone) which is an organic thermoplastic polymer has been used as interbody spacers following cervical microdiscectomy. They are light weight and inert. Nucleoplasty is a very minimally invasive way of treating contained/ closed disc herniation in the lumbar and cervical region using the plasma co ablation technology. Patients can be discharged the same day since this is performed under local anesthesia. In the Ideally indicated cases, patients find relief in 4-6 weeks. The use of biologics in spine has also made the surgeons life easier. Operating in the Thoracic spine has also become easier in view of better anesthesia and post surgical care since the trans thoracic approaches are fraught with higher morbidity. The use of navigation has made it extremely safe for the surgeons to reach the target tissue with precision avoiding the risk of transgressing vital structures.
Stem cell in the treatment of spine injury is an area of keen interest and research. The two key issues restraining this are: there are not many institutions in the country offering this facility and secondly this procedure being an expensive one is beyond the average population to which belong the majority of spine injuries. We don’t have any project on the lines of the Miami project which has received approval from the US FDA for phase 1 clinical trial to evaluate the safety of transplanting human Schwann cells to treat patients with spinal cord injuries. In this study, Schwann cell harvested from autologous sural nerve will be cultured for three to five weeks prior to surgical transplantation to the injured site. Autologous disc derived cell transplantation offers a potential to achieve functional integration of disc metabolism and mechanics by biological restoration through the use of autologous disc chondrocyte transplantation. Autologous disc-derived cell transplantation is 36 FUTURE MEDICINE I February 2013
technically feasible and biologically relevant to repairing disc damage and retarding disc degeneration. This technique is currently unavailable in the country. Cutting edge in research in spine is what is lacking in the country due to multiple reasons. Doctors have been able to offer the latest in surgical care and in select centers appropriate rehabilitation is offered but the fraction of patients receiving this care is miniscule and often bear the expenses on their own which may or may not weigh down on the family’s financial status.
(Dr Ram Kumar Menon, MS, DNB, MCh, has settled down in Thrissur, Kerala, where he works with Elite Mission Hospital and Care Well Clinical Centre as a consultant neurosurgeon)
SPINE CARE SPECIAL
Needed,
a spine
SPINE CARE SPECIAL
care
system Though treatments for spinal disorders have advanced to a great extent in India, the common people are not aware of these developments in the area. They also have misconceptions about surgeries for the spinerelated problems. It is a fact that advanced treatments for the disorders are very expensive and that the poor have little access to the new facilities in the country
C
Dr Arvind G Kulkarni
Dr Shashidhar B K
Consultant neurosurgeon Bombay Hospital, Mumbai
Consultant neurosurgeon Bombay Hospital, Mumbai
ommon spine care problems in India and abroad are on the rise. Spinal disorders encompass a spectrum of pathologies which result in pain and deformity or paralysis. The surgical correction of the problem is needed irrespective of age and gender. Low back pain and neck pain have become the major health problems of the modern era. Spinal disorders, such as back pain, neck pain, scoliosis and disc disease, to name a few, are common, and they can have a profound effect on a person’s
overall health, impacting a person’s ability to work, to enjoy everyday activities and even disrupting healthy sleep patterns. They cause pain, physical disability and loss of personal and economic independence. They affect millions of people of all ages in all countries. Current estimates of the people affected worldwide are: back pain 632.045 million, neck pain 332.049 million, OA knee 250.785 million and other musculoskeletal conditions 560.978 million. There is a huge gap between
SPINE CARE SPECIAL Hassle-free surgeries
the best spine care providers in India and abroad. Predominance of the rural population, socio-cultural peculiarities, low per capita income, inadequate transport facilities, overcrowding, illiteracy, short supply of resources, unstructured referral practice, and the absence of a health insurance system are holding back the developing countries like India in the area. Whereas, population in the developed countries is relatively small and a high doctor-patient ratio has ensured good treatment to everyone.
The government-run healthcare system, though it provides free treatment to the poor and the needy, has not been put to its maximum use in rural areas and remains overburdened in urban areas because of lack of resources, long-term planning and commitment. The quality of care provided in most public healthcare centres in India is certainly questionable. Indeed, the average time given per consultation in outpatient departments is often around a minute or less. In fact, records maintained in most of these hospitals show the diagnoses are often”backache”, “spine problem”, “neck pain” etc. A long-term solution to this menace lies in medical education reforms and private sector regulation.
The world over, spine surgeries have been carried out by neurosurgeons or orthopaedic surgeons, depending on the exact nature of the spine procedure. The faculty of spine surgery came about far later, with the increasing number and sophistication of spine surgeries. In India, spine surgeries were performed much later. The first formal association of spine surgeons was set up in 1983. As the treatment becomes more surgically oriented, the responsibility of the surgeon also rises to ensure safe delivery of optimum results. Keeping ourselves updated with the recent trends and techniques is essential in medicine in general and spine surgery in particular. The recent advances in spine surgery include minimally invasive spine surgery, also called keyhole surgery in common parlance and robotic surgery. In these surgeries, the skin is not cut in great lengths on the back. The entire surgery is done through one or more small incisions 38 FUTURE MEDICINE I February 2013
robotic spine care surgery the size of small keyholes. This gives the patient the advantage of a faster return to work and easier rehabilitation, lesser blood loss and pain. Robotic surgery is a highly advanced technology, where a small robot aligns itself in the direction of the pedicle, which is a part of the backbone where the screws are placed. The robot does not replace the surgeon. On the contrary, the surgeon is backed up by the foolproof planning done prior to the surgery on the robotic software. The robotic guided
surgery has made spine surgery a safer proposition, in addition to reducing the stress on the surgeon and his team in the operation theatre.
The future of spine surgery is shaping in the direction of minimally invasive surgeries where the stress shall be on earlier return to productive activity of the patient and reduction of the hospital stay and expenses. At present, such facilities are available in a very few centers.
February 2013 I FUTURE MEDICINE 39
SPINE CARE SPECIAL Hassle-free surgeries
The object of the treatment is no longer the mere saving of life. The treatment now aims to preserve function, reduce pain, shorten the length of stay in hospital and speed up the return to normal life. Significant developments in neuro anaesthesia, neurosurgical intensive care and imaging technologies have all helped radically improve the outcome of spine surgeries in India. With the use of the state of the art X-rays, MRI scans, CT scans, and spinal injections, we can make an accurate diagnosis in almost every patient. Spine surgery cost in India is amongst the lowest in the world. The cost of spine surgery in India is about 20% of the cost in the USA. Typically, a spine decompression surgery which costs between $ 22,000 and $30,000 in US will cost approximately $ 6000 at a top spine hospital in India. But still it is out of reach of the common man because of the low average per capita income. An effective insurance system is in place in the developed countries and so even the most specialized diagnostic modalities and surgeries are accessible to virtually all citizens. With increasing awareness of spine related problems and more conditions being treated surgically, there is a need for providing insurance cover to encompass spine related disorders.
There is an urgent need for incorporation of spine care as a key target area under the national and state-run health missions.
Spine surgery despite being safe and effective has a very high patient dropout rate due to the ‘fear’ associated with surgery. Spine surgery was and is still considered dangerous surgery with consequences like neurological weakness. This is because of ignorance about the available treatment options. Now, with specialized spine training and with surgeons devoted to spine care, the success rate as well as the safety of the treatment for spine related problems is on the rise. India offers the world’s second-largest pool of patients. With a significant percentage of the population suffering from spine disorders, spine specialists in India can quickly acquire a great deal of experience, in terms of clinical and surgical skills. There is a need to include spine care as a key target area under health missions to increase public awareness about the spine, spine disorders and available spine care. Orthopaedic training in India should be geared to serve predominantly rural demographics. The incorporation of spine care into the health mission is needed with training of doctors and paramedics. A stratified system of orthopaedic training related to spine care for medical graduates, postgraduates, and paramedics with a well-defined need-based curriculum has to be developed. Public-education through forums and campaigns via multi media has to be done. A referral system has to be developed between primary care physicians and spine care experts. 40 FUTURE MEDICINE I February 2013
TREATMENT FOR SPINAL DISORDERS Dr Edward C Benzel By Sreekanth Ravindran
Operate less
frequently, says expert
You have said that all spinal disorders primarily come under the non-surgical domain. Does this signify the role of traditional medicines such as Ayurveda in curing spinal disorders?
I said: “The treatment of back pain comes primarily under the non-operative domain. Surgery for such a malady should be a relative exception.” I recommend core strengthening exercises, flexibility exercises and other symptomatic treatments. I have little experience with traditional treatments, other than acupuncture. Acupuncture, in my experience, is associated with mixed results – and henceforth is not a mainstream treatment.
Can DNA sequencing technology revolutionise treatments related to spinal disorders, especially spinal deformities?
I am sceptical here. I do not feel that such strategies will have benefit – at least in the next two decades. It is difficult for me to believe that we can make an old disc young, or an unstable joint stable, with such therapy.
What are the milestones achieved by Cleveland Clinic under your chairmanship?
We have developed a multidisciplinary spine programme in which neurosurgeons, orthopaedic surgeons, rheumatologists, physical medicine (rehabilitation doctors), psychologists and psychiatrists work as a team. Our Neurosurgery residency has grown in size to 21 residents, as has our spine fellowship (six fellows per year). Fellowships in all other domains of neurosurgery are also offered. Research in all domains of neurosurgery is flourishing. Resident education is at its all-time high, with residents receiving multiple awards. The training programme has received many accolades as well.
Spinal treatments are very expensive, especially in emerging countries like India. How can we make it more cost-effective without compromising on the quality of treatment?
Dr Edward C Benzel, MD, is the Chairman of the Department of Neurosurgery at Cleveland Clinic in Ohio, US. He also holds a faculty appointment, Professor of Surgery, at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CCLCM of CWRU). Dr Benzel’s major clinical interests are neurosurgery and spinal disorders, including cervical spondylosis and syringomyelia, complex spine instrumentation and spine tumours. In an exclusive interview with Future Medicine, Dr Benzel says that research in all domains of neurosurgery is flourishing at Cleveland Clinic
Chose implants based on value (quality/ cost). Less expensive implants are most often just as good as their more expensive counterparts. Finally, we should operate less frequently. We spine surgeons perform too many spine operations, particularly for degenerative disease. Hence, conservative decision making is warranted. For example, gabapentin has been shown to be very effective for lumbar stenosis symptoms. This can obviate the need for decompressive surgery in the majority of cases.
Could you explain the special “Fusion Surgeries” that you have been recently performing? What makes this surgery unique?
I perform a lumbar insitu (no instrumentation) facet fusion. This eliminates the need for ‘mutilating lateral transverse process dissection, as well as the complications and cost associated with instrumented fusion.
Please tell us about Mazor Robotics guidance system, if you are familiar with it?
It provides image guidance which can be achieved with other strategies. One must take care to secure fixation of the robot, lest movement results in obligatory inaccuracies. February 2013 I FUTURE MEDICINE 41
HOSPITAL FOCUS MIOT Hospitals, Manapakkam, Chennai
Located in Manapakkam, Chennai, the hospital has grown into a multi-specialty hospital catering to patients from the country and abroad in a short period. Dr PVA Mohandas, a leading orthopaedics surgeon, who founded the hospital in 1999, holds the credit for popularising orthopaedic surgery in the country By Tony William
42 FUTURE MEDICINE I February 2013
“M
edicine is not a trade. It is a calling where a physician thinks not just with his head but with his heart,” observes Dr Mohandas, founder and the man at the helm of affairs at The Madras Institute of Orthopaedics and Traumatology (MIOT) Hospitals. MIOT Hospitals was started in 1999 at Manapakkam with a totally different vision. Being situated on the outskirts of the city, the hospital was built with international standards. Equipped with the latest infection-fighting system, it challenged traditional
hospital wards which were flooded with beds. Spacious rooms with plenty of air and light and surrounded by a lush green campus, it had a refreshing look altogether.
“It is a long journey for MIOT Hospitals. Its growth is like a seed sprouting and slowly growing into a tree,” says Mallika Mohandas, the Chairman of the hospital. Started with a single specialty, orthopaedics, it was Dr Mohandas’ expertise in the field that helped MIOT Hospitals scale new heights. One of the pioneers in total hip replacement in India during
Orthopaedic
surgery at its best
Dr P V A Mohandas, Founder & Managing Director, MIOT Hospitals
the seventies, he brought total knee replacement to India, encompassing hip, knee and spine surgeries, and all sorts of accidental injuries. “Under Dr Mohandas, our team of doctors has done almost 37,200 hip and knee surgeries. We can claim that we have done the most number of joint replacement surgeries in India,” adds Mallika
Mohandas.
She is of the opinion that the medical methods, especially surgical techniques must be simplified to the possible extent. “For instance, when we began our laparoscopic surgery, we called it ‘keyhole’ surgery so that it becomes a regular term for the common man. We even did a promotion so as to create awareness for the common man,” she said. Thus MIOT envisages an era when patients can demand something from doctors rather than merely receiving prescriptions from them. MIOT Hospitals is now into liver and bone marrow transplantations
February 2013 I FUTURE MEDICINE 43
HOSPITAL FOCUS MIOT Hospitals, Manapakkam, Chennai
on creating special awareness programmes about organ donation.
Mallika Mohandas, Chairman, MIOT Hospitals apart from kidney transplantation which has been there for a very long time. Kidney transplantation between patients belonging to different blood groups is another uniqueness of MIOT. Pointing out the difficulties in getting donors with the same blood group, Mallika hopes that liver transplantation across blood groups would help patients in finding out donors fast.
“We started ‘MIOT Global Centre for Ideal Joints’ so as to give the perfect, ideal joints for the patients. Market is flooded with implants ranging to all sizes, shapes and materials for hip and knee joint replacement surgery and often the success depends on finding out the perfect implant for your disease. We are the only centre in India working on providing an ideal joint for patients based on their anatomy and lifestyles,” says Mallika. CHIME (Children’s Heart Internationale MIOT), a project close to Mallika’s heart, marks the special commitment it has to the general public. CHIME is a charitable trust maintained by MIOT Hospitals to help needy children. It accepts funds from the public and provides subsidized treatment to the children. Apart from the critical care section, it has also got another division which focuses 44 FUTURE MEDICINE I February 2013
“Our international patients profile began with just one patient in 2001. But there has been no looking back since then. Our international patients today have grown into a ratio of 1:3 Indians. We have got an overseas office and most patients are from Seychelles, South Sudan, North Sudan, Gulf countries, and all east African countries. They come for treatment of heart ailments, cancer, orthopaedics, spine, hip and knee,” says Mallika. Whatever the expenses, MIOT makes sure that all departments have world class equipment for faster diagnosis. “We stand for it so that the benefit is for patients,” she said. MIOT Retreat, an extended facility with all the modern facilities integrated to it like restaurant, gym and beauty salon, is a step forward in the right direction.
Another feature which sets MIOT apart is that instead of inviting doctors to be visiting consultants, MIOT Hospitals has created departments headed by full time specialists. About managing the hospital, Mallika says that if you want to be the best, you have to give the best to the industry. On research, she adds that lack of standardisation in the field makes it difficult for research related activities. “We are only into restricted research in kidney transplantation. In other areas, our research is often restricted to publishing research papers and conducting awareness classes.” Everybody talks about achieving
international standards in healthcare. But is it worth? “International standards are limited with cleanliness, measurements and so on. What is the actual requirement if you ask me, I shall say the care, concern and compassion,” points out Mallika. MIOT International and MIOT Institute for Cancer Cure To serve global patients and to offer international standards of care to Indian patients, MIOT Hospitals started MIOT International. MIOT International, a 6-star facility, will put Chennai on the global healthcare map. MIOT International will house the MIOT Institute for Cancer Cure too. This 500-bed facility will include 10 operation theatres and 90 ICU beds, experts in surgical, medical and radiation oncology. A home away from home MIOT Hospitals’ world class facilities and quality care have made it a favourite with medical tourists. MIOT has received Niryat Shree Gold Award from Federation of Indian Exporters Organisation for the year 2003-2004 for outstanding export performance and for earning the highest foreign exchange in the healthcare industry. It has also received the bronze award for the year 2008-2009 for coming third in all service industries.
MIOT has international tie-ups with many universities like University of Tuebingen (BG Unfallklinik), University of Stuttgart (Katherine Hospital), University of Derby, University of Zurich (Department of Regenerative Medicine Centre, University Hospital Zurich) and Swedish Red Cross University College of Nursing. “Doctors come from there and our doctors, paramedical staff and physiotherapists go there for training,” says Mallika. Future plans With the inauguration of MIOT International, MIOT will soon be a 1000-bed hospital in a single location. As part of a mission of bringing the latest advances in healthcare to India and making them affordable for Indian patients, the hospital also plans to spearhead campaigns in preventive health.
DENTAL CARE
Let the smile last forever Gum disease
Has your dentist told you have a gum disease? Don’t worry you are not alone. Many adults in our country have some forms of gum disease. Gum disease or periodontal disease ranges from simple gum inflammation to serious disease that results in damage to the soft tissue and bone that supports the teeth. Our mouths are full of bacteria. These bacteria along with mucus and other particles form a sticky, colourless plaque on teeth. Plaque that is not removed can harden and form tartar that brushing does not clean. This tartar can be removed professionally by a dentist.
breath, swollen gums, bleeding gums, loose teeth, sensitive teeth and receding gums. Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist.
Dr Ravi R Hebballi Consultant Oral & Maxillofacial Surgeon
Treatment for gum disease
The primary aim of treatment is to control the infection and stop further destruction. The treatment varies depending on the extent of the gum disease. However, such treatment requires good daily care at home.
Cleaning & polishing
The dentist removes the plaque from the affected tooth and root surfaces to remove bacteria that causes the disease. Polishing follows cleaning to eliminate rough surfaces on the tooth which helps reduce accumulation of plaque in future.
Symptoms of gum disease include bad breath, swollen gums, bleeding gums, loose teeth, sensitive teeth and receding gums
Flap surgery
Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery. This surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that they fit snugly around the tooth again. After surgery, the gums will heal and fit more tightly around the tooth.
Bone grafts
Gingivitis
The bacteria in plaque and tartar cause inflammation of the gums and this is called ‘gingivitis’. The gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing and regular cleaning by a dentist.
Periodontitis
‘Periodontitis’ is a more severe form of gum disease. In periodontitis, gums detach from the teeth and form spaces called pockets that become infected. The plaque spreads and grows below the gum line and the infection breaks down the bone and tissues that hold teeth. If not treated, the bones, gums and tissue that support the teeth are destroyed and teeth become loose.
Do I have gum disease?
Symptoms of gum disease include bad
In addition to flap surgery, your periodontist may suggest procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting wherein natural or synthetic bone is placed in the area of bone loss which helps promote bone growth. ‘Mantra’ for healthy gums! • Brush your teeth twice daily • Floss regularly to remove plaque from between teeth • Visit your dentist routinely for a checkup and professional cleaning • Avoid smoking
Preventing gum disease can save your teeth which is good reason for you to take care of your teeth. Let that smile last forever!
Dr Ravi R Hebballi is a Consultant Oral & Maxillofacial Surgeon based in Bengaluru, Karnataka February 2013 I FUTURE MEDICINE 45
TRADITIONAL MEDICINES
Tribals hold the key Vellan Vaidyar of Thirunelli and Kelu Vaidyar of Kattikulam in the Wayanad district of Kerala are famous for their traditional way of treatment based on wild herbs. While Vellan Vaidyar is known for the treatment of cancer, paralysis, fractured bones, asthma and diabetes, Kelu Vaidyar is famous for the treatment of cancer, asthma, diabetes and skin diseases like psoriasis and eczema. They receive patients from far and wide. The patients who seek treatment from them after hospitals fail to cure their diseases get much relief
T
By Neethu Mohan
he misty mountains and greenery, this is what welcomes every traveller who enters Wayanad in Kerala. The folk etymology of the word Wayanad says it is a combination of Vayal (paddy field) and Naad (land), making it the land of paddy fields. There are many tribes in this area and actually the story of Wayanad is the story of tribals. The tribes can be prominently classified into Paniyas, Adiyas, Kattunayakans, Kurichiyans, Kurumas, Ooralis, UraaliKurumas etc. These tribes still believe and practise their traditional medicines which involve a variety of wild herbs. 46 FUTURE MEDICINE I February 2013
Vellan Vaidyar of Thirunelli and Kelu Vaidyar of Kattikulam belong to the Kurichya tribe and both are famous for their traditional way of treatment based on wild herbs. When the weather began to warm up, I set off to the foot of
Vellan Vaidyar
Thirunelli temple to meet Vellan Vaidyar who is famous for the treatment of cancer, paralysis, fractured bones, asthma, diabetes etc.
“The power of our traditional medicines is indeed unique. We have medicines meant for adults as Kelu Vaidyar well as children,” he said as he examined a patient with a broken arm. The Vaidyar’s assistant proudly narrated how his master had recently cured an eightyear-old paralytic girl who had been admitted in various hospitals in South India, but in vain. Finally, her parents met Vellan Vaidyar. “Often, people are reluctant to stick to traditional medicines, and keep it as a last resort,” says the father of the child. He said the treatment for paralysis began with a detailed diagnosis, followed by the application of medicated oil. The Vaidyar then prepared the medication accordingly, and within a few weeks, the patient was cured partly. According to him, patients who first try modern medicines and then switch to traditional medicines take a longer time to get cured.
As per tribal customs, the ingredients used in the preparation of medicines are always kept as a secret. They believe the medicine loses its curing power if the details of the ingredients are revealed. Moreover, they do not follow the system of naming various wild herbs. “Very little scripted information is passed down from our forefathers about the medicines. We identify the herbs by its features,” says Vaidyar. Vellan Vaidyar is a renowned bone specialist too. He has a special set of formulae to treat fractures. For instance, egg is added to the ‘solution’ to increase its adhesiveness in fracture treatment. The procedure is quiet simple. First, the dislocation is precisely identified, then it is cleared, and finally the fractured area is covered with a special combination of medicines. Recovery is usually expected within a few days. The Vaidyar collects all his medicinal
herbs from the neighbouring forests.
The Vaidyar has patients from India and abroad. They include celebrities and sports persons.
The story of Kelu Vaidyar is the story of a small town called Kaatikulam in Mananthavady. Kelu Vaidyar, a new generation tribal healer, is a famous medical practitioner in the locality, and close to 1500 patients visit him a week. As there has been a heavy influx of patients and medical tourist from all over the world Katikulam has now developed into a small city. He is widely known for the treatment of cancer, asthma, diabetes and skin diseases like psoriasis and eczema.
“Ours is a 100 percent traditional method of treatment. Unlike other alternative methods, we do not make use of metallic ingredients in our medicines and so the effect is immense,” says Kelu Vaidyar. People suffering from various ailments come here from Bengaluru and Dubai for treatment. Workers assist him in the preparation of medicines in a small facility attached to his dispensary.
However, it was not easy for Kelu to become a famous Vaidyar. It took him years to collect the details of the traditional practitioners and document their treatment methods. According to him, the data collection was a Herculean task as the old generation practitioners were unwilling to impart their knowledge to the new generation.
Kelu Vaidyar is very particular about the secrecy of the formulae of medicines he uses. Since the tribals do not have a system for naming the herbs, documentation of medicines is practically impossible. There arises the issue of patenting the medicines. “We have some of the best and most effective medicines in the world, but we are not aptly credited for our efforts,” says the practitioner with disappointment. “Every week, I go into the forests and stay there for a couple of days hunting for the right herbs,” he said.
The culture and the tradition of these tribes exist within a thin sphere of influence. If these tribes become extinct, valuable knowledge of traditional medicines will be lost forever. Thus, we have to ensure that the culture and the ecology of the tribal India is not impinged upon. February 2013 I FUTURE MEDICINE 47
CANCER TREATMENT IN FOCUS Saving precious lives through motivation
Live a life despite cancer Cancer, the name itself raises confusion and anguish but the disease gains significance as it can be prevented, treated and cured if diagnosis is done at an early stage. The disease can be prevented and cured only if there is proper awareness among people. Yet, it affects people on all levels-physical, mental, emotional and spiritual. It presents many challenges and also causes many people to evaluate what is important in their lives, providing a new perspective of family, friends, work and future plans. Here is a doctor who has devoted his life for the cancer patients and their welfare. He has committed to making measurable improvements in the quality of life–physical, physiological, social and spiritual-of all cancer survivors, from the time of diagnosis through treatment and beyond. Dr Babaiah’s mission is to change the lives of cancer patients through motivation. He wants to make them live longer and lead a colourful life. In every sense, his life is a message. Dr Babaiah took MBBS in 1975 from Kurnool Medical College and completed internship in 1976 at Government General Hospital, Kurnool. In 1977, he worked as a resident in the Department of Surgery and Medicine at AIIMS, New Delhi. He did MD in Radiotherapy in 1981at AIIMS. He received training at Booth Memorial Medical Centre, New York, and Royal Marsdon Hospital, London. He worked as an Oncologist at King Fahad Hospital, Saudi Arabia, from 1983 to1988. He was the head of the Department of Oncology at Medwin Hospital and Professor of Oncology, Deccan Medical College, from 1995 to 2012. He has been working as the Medical Director, American Oncology Institute, Hyderabad, since 2012. Here, Dr Babaiah shares with Future Medicine his experience in the field of cancer treatment. By Sumithra Sathyan Please tell us about yourself and what made you choose cancer treatment as your area of specialisation?
I did MD from AIIMS in 1981 and got training in US and UK. At present, I am the Medical Director of American Oncology Institute in Hyderabad. I happened to see the pain of numerous cancer patients. It made me come to the field and 48 FUTURE MEDICINE I February 2013
do something for those suffering from the disease.
As a leading Oncologist in India, could you share with us your unique experience in the field?
I have had very rare experiences while treating cancer during the last 30 years. For instance, Ansari, a businessman from Anantpur district, Andhra
Pradesh, was a rare patient. He was operated upon GBM (an aggressive brain tumour) and he was referred to me for further management. In most cases, the patients die within six to 12 months in spite of the best treatment. But this man miraculously survived and is still alive without any evidence of the disease. So, we can cure it. Yes, we
must cure it.
What is your opinion about the treatment of cancer in India?
Cancer treatment in India has come a long way and we are on it with any developed country. We have the latest technology and professional excellence. But still we have to organise the patients and inspire them to live.
Prevention
Is it curable? What is your experience at American Oncology Institute?
Cancer is both a preventable and curable disease. Cancer is more curable if diagnosed at early stages. We at American Oncology Institute have the state of the art treatment technology, including True Beam and Calipso system. With the help of the advanced technology, we are able to cure more and more cancer patients.
Is this a lifestyle changing disease?
Certainly, cancer is a lifestyle changing disease. Urbanisation, smoking, alcohol, obesity etc, have contributed to the spread of the disease.
What leads to an alarming rise in the disease in the country?
It has been reported that India has one of the largest incidences of cancer in the world. We are likely to have 1.4 million new cancer patients this year. Smoking, gutka, tobacco chewing, viral causes and increased longevity are some of the reasons.
What are the food habits which help prevent the disease?
Food with lots of vegetables and fruits is good. We can also take food containing anti-oxidants.
How can we compare the cancer patients in our country with those in America? Do they have any medical facilities provided by the government?
Compared to America, we have more advanced forms cancer in India and also the incidence of the oral and cervical cancer is high in the country whereas the prostate cancer and colon cancer are high in US.
D
octors order screening tests to help detect the chance a patient has cancer before symptoms occur. Screening tests usually are not definitive. Once they receive results which cause them to suspect cancer, doctors will form a plan to confirm the results of initial tests that can include a variety of other steps, tests, or procedures. Before ordering or recommending a screening test, doctors assess whether a particular patient fits certain risk criteria for developing cancer. Age, sex, family history, previous history, or lifestyle can all be factors which contribute to higher risks of developing specific cancers. Doctors choose specific screening tests based upon a multitude of factors, one of which can be a combination of risk factors and/or symptoms. Both the American Cancer Society (ACS) and Indian Cancer Society (ICan) have issued cancer screening guidelines for specific cancer types or population groups. Other groups have also developed screening guidelines that can be used in addition to these. Guidelines vary among different population groups as a result of many factors and based on the latest available scientific evidence. Most organisations such as ACS of ICan update their guidelines on a regular basis to ensure they reflect the most up-to-date clinical research.
What are the activities of American Oncology Institute?
In addition to imparting high quality cancer care to the patients, American Oncology Institute is involved in academic activities in collaboration with Pittsburgh Group, training young oncologists at UPMC and cancer prevention programmes for the public
What about the research and the latest technology in the field of cancer treatment?
Lots of researches are going on in cancer vaccination and gene therapy in the field. And also lots of new technological advances have come up in the diagnosis of cancer, the imaging of cancer and the treatment of cancer. February 2013 I FUTURE MEDICINE 49
CANCER TREATMENT IN FOCUS Saving precious lives through motivation
Cancer Care Tips Acceptance
You may be shocked to detect cancer in your body but, acceptance is the first step to healing. You must accept the fact and act immediately before it goes to the next phase. Do not entertain any negative thoughts. Instead it would be better to remind yourself that numerous people just like you have been through it, taken action through medical intervention and now lead happy and cancer free lives. Remember – Cancer is not end of life…it is just a phase.
Exercise and physical activities
may be shocked to detect cancer in your body buCheck with your oncologist before you get into a rigorous health regime. It is always better to start with short walks and light exercises. This would help in increasing the oxygen supply to the body and supports the red blood cell count. You can also, try swimming, yoga, water aerobics and warming up sessions. The entire physical activity would boost your confidence and render a positive outlook on life.
Stay positive
Change your perspective about life and towards your loved ones instead of brooding over what has happened. Avoid negative thoughts and discouraging people. Plan your schedule in such a way that you don’t involve into any kind of gloomy interactions. Indulge into hobbies – painting, performing arts, music or reading.
Hair and skin care
mayTake extra care of your hair and skin during cancer treatment. Lot of medications and chemotherapy would result in hair loss. It is better to avoid chemically prepared shampoos, lotions and application for hair and skin. Discuss this with your doctor and then go for the prescribed products.
Add colour to your food
Consume vegetables and fruits of different colours and textures that add lot of flavour to your food. Increase the intake of liquids in the form of fresh fruits juices, vegetable extracts. Add fibrous rich foods like – cereals, whole grain toasts, oats, bran, cornflakes and barely in regular diet. Consumption of whole fruit is very rich source of fiber, vitamins and protein
50 FUTURE MEDICINE I February 2013
Our departments: Fertility & IVF Clinic Obstetrics & Gynaecology Neonatology & Paediatrics Paediatric Surgery Genetics & Research Centre Bariatric Surgery Radiology General Surgery & Advanced Laproscopy Centre for advanced Urology Breast Clinic
First time in Kerala
First time in Kerala
Super Speciality Hospital for fertility
Adoor, Kerala. Tel: +91 4734 223377, 224731
IUI –Intra Uterine Insemination IVF ICSI– Intra Cytoplasmic Sperm Injection PESA- Percutaneous Epididymal Sperm Aspiration TESA – Testicular Sperm Aspiration Embryoscope Hysterolaparoscopy For All Infertility Problems Laparascopic Tubal Recanalization
Consultation at Newlife Medical Centre, Sharjah, UAE. Tel: 0097165773551
Every child is a little bundle of joy that will light up your life. At Lifeline, the latest reproductive technologies help overcome the obstacles of fate and bring the light into your life.
FULLMOON/LL/SEP12/IT
ALTERNATIVE TREATMENT Dr Chinmoy K Bose
Herbal remedy for
Ovarian cancer Tell us about your research that resulted in a possible herbal remedy for ovarian and breast cancer.
I did not know I am going to be a senior citizen soon. It is so strange. I am 56 already. Twenty-five years back when my courtship was going on with my would-be doctor wife, Banani, I told her that I was not going to leave my research in ovarian cancer for this life time. Time flew past like magic. First, I started with enzyme marker of ovarian cancer and got a PhD in medicine in 1995 from Calcutta University where I did my MD, DGO and MBBS. I received a Royal Society Fellowship to study endocrinology of ovarian cancer in St. Barts’, London.
British Council sponsored GMC registration but I did not do membership (MRCOG). I was involved nonlinear dynamics in analysing jeopardy in feedback mechanism in HPO axis in ovarian cancer.
Dr Chinmoy K Bose, MD, PhD, is a Consultant (Gynaecological Oncology Section) at Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata. He led a team of researchers, which discovered that roots of ‘moringa’ plant (sajne) could be a herbal remedy for ovarian and breast cancer. Their research revealed that these roots can retard and destroy the cancer-affected cells. In an exclusive interview with Future Medicine, Dr Bose says that a cheap and practical remedy is an utter necessity in the cancer treatment today By Sreekanth Ravindran
52 FUTURE MEDICINE I February 2013
Aberrant and high gonadotrophin (Follicle Stimulating Hormone Receptor, FSHR) accumulation in ovarian surface epithelium from where this cancer originates may cause it by G-protein mediated signal transduction pathway. Later, it was seen that FSHR actually may come via nerve growth factor centrally from brain or locally in ovary (NGF) and may go into vascular endothelial growth factor (VEGF) production. Many revelations came in the way like why infertile women get more such cancer, why a little late pregnancy or oral contraceptive may prevent such cancer. These could be better explained by my theory. Herbal remedy in the form of a root of common Indian tree, the “miracle plant” ‘moringa’ came after a thorough search of West Bengal anti-cancer herbs. My search was long from Gangetic plains to Himalayas amongst saints, prostitutes and tribals. In studies of the anti-cancer potential of plants used in
the folk medicine of Bengal, extracts of plants such as Oroxylum indicum, Moringa oleifera, Aegles marmelos, Hemidesmus indicus, Polyalthia longifolia, and Aphanamixis polystachya could be considered as potential sources of anti-cancer. But ‘moringa’ has immense effect in the female reproductive system. It is not only abortificient but as tribals’ use of this root is shown it makes the female reproductive organ quiescent preventing cancer. It also kills ovarian cancer cells. It may only do this by manipulation of FSHR. Because of this hormonal property in breast cancer which is also hormone dependant, ‘moringa’ root might have some beneficial effect in such cancer also.
for life? Does it mean a relapse if the patient discontinues intake?
This could act as preventive as well as curative and as this will be completely non-toxic and safe to use, even lifelong treatment would be cheap and practical.
How did the medical community react to your findings?
There was ovation from every corner; scientists were astonished to know that this is an age-old remedy and heritage of India.
Wouldn’t this change the cost dynamics in Oncology?
Recently, ICMR has recognized this approach of drug discovery for these dreadful killers by a handsome grant. Glucosinolate might be the active substance of such root which might be responsible for such effect. Now about 25 years have passed with this search. My aim was to try to find a cheap remedy of such cancer.
As I said in Nature magazine, a cheap and practical remedy is now an utter necessity in cancer medicine.
What’s the process to get recognition for this herbal remedy?
Are you conducting any parallel studies in Oncology?
We will not stop at finding cancer cell killing activity of this herb but we are trying to separate and identify the active principle/s causing such effect. Then through Phase 1 to 3 clinical trials which I look as HOD in a famous Kolkata cancer hospital, this cheap remedy will see the light of life. We will patent the compound in India after our cell culture experiment. This research will be the first of its kind in such cancer from India. It will go to the market, I hope, as more specific one than other herbs like turmeric and green tea over which lots of money had been spent.
What’s the course you would like to prescribe? Should a patient have to take this herbal remedy
How do you plan to take the research forward?
We are trying to separate and identify the active principle causing such effect. Then through Phase 1 to 3 clinical trials.
I am a senior cancer researcher with above 40 publications in peer-reviewed journal. I have a published a book on nonlinearity of endocrine feedback. I do have published papers in many other cancers as well, but not all of them are in drug discovery. I was a NSTS scholar in 1972. I see that NCERT effort to find science talent had been magnificent and research has remained mainstay of my medical career which is, unfortunately very rare in our country. Academicians and politicians alike are insisting on the need of such realitybased clinical research for the benefit of our country specifically and for the whole of human kind generally. February 2013 I FUTURE MEDICINE 53
SEXUAL HEALTH
Common female sexual disorders
W
omen’s sexual disorders or sexual dysfunction is common these days. Female sexual dysfunction is defined as the continual and repeated problems with sexual response or unsatisfied state in women. Almost 30-50% of women throughout the world suffer from sexual dysfunction. A collapse in any sexual activities such as interpersonal relationship,
attitude and needs may lead to sexual dysfunction. This is a wombto-tomb problem, or it can happen subsequently in life.
Female sexual dysfunction may be due to injury on the genital organ, surgical treatments, hormonal imbalance (estrogen, testosterone and thyroid hormones), and medicaments. Psycho-social problems can also stimulate sexual dysfunction.
Some of the sexual dysfunctions in female are defined as:
Hypoactive sexual desire disorder: It is distinguished as an absence of sexual desire or the lack of desire in sexual relation. It may also resultant from psychological / arousal factors or is medically related problems such 54 FUTURE MEDICINE I February 2013
as hormone deficiencies, and medical or surgical treatments. Disturbance in the hormonal system or thyroidal hormone disorders results in hypoactive sexual desire.
Sexual aversion condition: Sexual aversion is a physiological state characterized by a feeling of intense dislike, avoidance, and termination of sexual contact with a partner. It is a psychological problem as a result of childhood sexual abuse.
Arousal disorder: When a female can’t experience a sexual reaction in her body or is unable to keep up the arousal is the arousal disorder. Some arousal disorders include lessened vaginal lubrication, weak clitoral and labial sensitiveness, and labial congestion with blood or lack of vaginal muscle loosening. These conditions may take place due to psychological as well as medical and physiological factors.
Orgasmic disorder: Female orgasmic disorder is defined as the time lag or absence of orgasm after ‘arousal’, that means can’t attain sexual climax. This may be due to primary or secondary conditions such as a result of surgery, trauma, or hormone deficiencies. Dyspareunia: It is the medical condition that causes genital pain before, during, or after sexual relation. In women, the muscles in the outer
Dr A CHAKRAVARTHY Consultant In Reproductive and Sexual Medicine
part of the vagina stiffen when they start to have sexual activity, and that leads to the irritation. Dyspareunia can also be initiated by certain problems such as vestibule of the vagina (redness of a gland in the genitals area), vaginal atrophy, soreness of vagina, and vaginal infection. It may be mostly due to decreased lubrication. Vaginismus: It is the recurrent or persistent involuntary spasm of the muscle system of the vagina and this intervenes with vaginal penetration. It results in painful penetration during sexual intercourse.
Almost all cases of sexual dysfunction are treatable. Transferring or communicating the fears and understanding ones’ body and its normal reaction to sexual activity are crucial steps toward gaining sexual fulfillment. Treatment • Treatment of hormone imbalance–thyroid hormones both hypothyroidism as well as hyperthyroidism. • Treatment of physical illnesses (Diabetes, genital infections etc.) •
Artificial lubricants in case of vaginal dryness
Medicaments which increase the desire:
Hormone replacement therapy– oestrogen and testosterone therapy Sex therapy Healthy lifestyle–avoid alcohol and smoking, proper exercise and stress relieving exercises like yoga and meditation.
Dr A Chakravarthy, MBBS; MBA (Hospital Management); MHSc (Reproductive & Sexual Medicine) is a Consultant in Reproductive & Sexual Medicine based in Thiruvananthapuram, Kerala mail@drchakravarthy.com
WOMEN’S HEALTH Pathbreaker
The man who made
women
proud Arunachalam Muruganantham is a symbol of great change in Indian healthcare industry. A noble man with a vision of women’s healthcare, Arunachalam finds a low cost solution for the sanitation of rural women after investing eight years in research to bring out a machine which produces low cost sanitary napkins. His invention has saved rural women from using ragged cloth and leaves of plants. Now, he wants to make India a 100% sanitary napkin country. At present, only 2% of rural women are using sanitary napkins By Lakshmi Narayanan
I
n 1998, Arunachalam Muruganantham, a native of the Coimbatore district of Tamil Nadu, came to know that rural women were having hardest days with their menstruation when he noticed his wife gathering ragged cloth for her periods. Rural women were not aware about the importance of sanitary napkins in hygienic life style and health. When Muruganantham asked his wife about the ragged cloth, she said: “It is not economical to use sanitary pads, especially for rural women, if I buy a sanitary napkin, I cannot afford to buy milk for the family.” Her words shocked him. He began to think
about a permanent solution to this problem. There was only one solution- create awareness and availability. Making women aware of the importance of sanitary napkins was not easy. Rural women, especially in Tamil Nadu, Bihar, Uttar Pradesh, West Bengal, Maharashtra etc, were uneducated. Availability of napkins was another issue. Sanitary napkins should be available at an affordable rate. These two factors made him turn himself from a workshop owner to a medical entrepreneur. His mission was to produce low cost sanitary napkins. In an interview with Future Medicine, Arunachalam Muruganantham February 2013 I FUTURE MEDICINE 55
WOMEN’S HEALTH Pathbreaker
talks about his vision of women’s healthcare in India and the strenuous long journey from a workshop owner to a medical entrepreneur.
100% sanitation
Arunachalam began collecting the data of rural women health and their periodic sanitation. He has gathered data from the remote areas of Tamil Nadu. The result was very dreadful. More than 90 per cent of rural women are using ragged cloth and dried leaves for their periods. In some regions, women use ashes also. “Such practices badly affect their health, but majority of them are not aware about this. When I started to educate them about periodic hyginity, they seemed to be indifferent to my ideas. Then I realised that only by providing sanitary napkins at low cost, I can change the situation.” he said.
Napkin production
For producing low cost sanitary napkins, he made serious studies. Things were not that easy. Everyone in his village started teasing him for his strange initiative. But nothing could paralyse his dedication. Muruganantham bought napkins of various companies and analysed its production. But all seemed to be very costly as the machine which produced napkins on commercial basis cost 80-85 lakh. So he decided to make a machine which should be easy to handle and could produce not less than 1000 napkins a day.
Research and experiments
For producing high quality sanitary napkins at low cost, he needed to study more about the materials used for napkin production. He sought help from the students of a Coimbatorebased medical college to know more about menstruation. The students talked about the problems they faced during their menstruation. But his wife couldn’t understand his idea and the depth of his mission. She left him and even sent a divorce notice. At that time, Muruganantham 56 FUTURE MEDICINE I February 2013
was living with his old mother and brother. Nothing could change his mind.
In the second stage of experiments, he needed to analyse the flow of blood, for which he needed used napkins. He gave a polythene bag to the college students to contribute their used napkins for his research. As the students were supportive, he got 35 pads. When he was checking the napkins under the light of a kerosene lamp, his old mother happened to see the strange experiment. The old lady also left him, saying he is mad. The village men also stood against his experiments. Thus in a way, he was abandoned by everyone in the village. When he lost support from his villagers, it was very difficult for him to continue with his experiments. Along with his experiments he had developed some sanitary napkins with locally available materials, and he distributed it to the students at the medical college and got favourable feedback from them. For improving the quality of the pads he produced, he wanted to check the frequency of blood flow. Thus he managed to get a football bladder and filled it with goat’s blood and tied between his legs. Then he went for jogging, cycling and other day to day activities to know the flow of the blood. When he came to the only pond in the village to wash his clothes, the villagers found blood in his undergarments and mistook that he was affected with a kind of
sexual disease.
High quality, low cost napkins
After analysis, he further studied various aspects of the production of sanitary napkins. “I insisted that the product should have high quality, for which the materials should be available at low cost. When I came to know about a UK-based company which provides materials at a cheap rate, I learned English to communicate with them and made arrangements to subscribe materials to India. In the meantime, I invented a machine, which could be easily operated manually. The machine produced 1000 pads in one shift of eight hours. In 2004, I succeeded in the project and started the third stage with production on an industrial basis,” says Muruganantham.
Jayaashree Industries
The machine invented by Muruganantham cost only Rs 1.5 lakh whereas the other machines
cost Rs 3.5 crore for the initial operation. He needed to organize it in the rural areas of Tamil Nadu, highlighting two noble missions of women sanitation and women employment.
Thus he initiated an organisation called Jayaashree Industries in 2005 and produced sanitary napkins in the brand name Raasi. He popularised this brand in the rural areas of Tamil Nadu. By 2007, the organisation expanded to Uttar Pradesh, Bihar, Bangladesh etc. Now the brand has tie-ups with companies in Nepal, Bangladesh, Afghanistan and Pakistan. People from America and Africa also show interest to become a part of Jayaashree Industries now, says Muruganantham. This social entrepreneur is always helpful to those who approach him for starting their own sanitary napkin-making industries with the machine invented by him. Muruganantham re-engineered a sanitary machine, and in 2006 it won the award for the best innovation for the betterment of society from the Indian Institute of Technology, Chennai. He has also received an award from the President for innovation. More than 600 machines made by Jayaashree Industries have been installed so far in 23 states in India. He sells the £1,600 worth machine directly to rural women through bank loans and NGOs. A machine operator can learn the entire towel-making process in three hours and employ three others to help with processing and distribution. Thousands of rural women have been employed and become a part of the big social change. “With 100,000 units, India will become 100% sanitary napkinusing country. It will also generate employment for one million women. With this, rural women can live with dignity,” says Muruganantham. February 2013 I FUTURE MEDICINE 57
HEALTHCARE SOLUTIONS
Advantage technology
Lakshmi Santhosh
In an information age, the mobile phone technology has a vital role to play in the healthcare system in the world. This technology can be used to reduce the existing gap in the system, especially in rural areas. Mobile phone messages and games are found to be useful for patients as they can provide health related data, the latest information on medication, tablets and other sophisticated tools to patients
T
he quest to achieve healthcare equality has been a struggle in both India and in the West. India must expand access to healthcare for its rural and underprivileged population while the United States needs to bring down the costs of its overburdened healthcare system. Both countries need to find new and creative ways to improve efficiency and expand coverage. Mobile phones are one technology that healthcare providers in India and the West can leverage as solutions to gaps in the system. Becker’s Hospital Review outlines four ways in which mobile technologies can be used to improve healthcare. These are increasing medication compliance, improving post-treatment understanding, giving patient’s access to information, and aggregating data to improve population healthcare. The strategies can be applied to healthcare problems in both the United States and India. Recently the US Medicare insurance system placed a fine on hospitals that had re-admittance rates that were higher 58 FUTURE MEDICINE I February 2013
than average for heart attacks, heart failure, and pneumonia. Since Medicare covers the health costs of so many citizens, hospitals in the US are trying to rapidly reduce their re-admittance rates. The best way to prevent patients from being readmitted into hospitals is through better medication compliance and post-treatment understanding. Solutions such as text message reminders to sophisticated pill bottles that will monitor how frequently they are opened are mobile technology solutions that could bring down hospital re-admittance rates. In terms of making more information available to patients, the launch of the MedlinePlus phone app has made health and drug information even easier to navigate. Aggregating data is the next step once mobile applications have been adopted. The data created can be used to fine tune healthcare implantation. India could make use of its thriving IT sector to create similar solutions, explained Dr. KanavKahol PhD, Director of the Division of Affordable Health Technologies at the Public Health Foundation of India in an interview through the National Bureau of Asian Research. He used the example of the Swasthya Slate, a tablet for health workers that includes water quality meter, an electrocardiogram, a thermometer, and a heart rate sensor in a single device. He
also cited Tata DoCoMo providing low cost calls to doctors as well as mobile games by the Public Health Foundation of India which teach important lifestyle habits to prevent obesity and diabetes.
The plethora of problems facing both healthcare systems requires making use of all tools available. The broad reach of telecommunications in both countries means that innovators all over the world can create solutions. Companies like Medic Mobile in the United States are creating software for developing countries and are training health workers on how to use them. IT professionals and enthusiasts wanting to work toward social change and improved healthcare in either country can turn to mobile technology as a way to reach the maximum number of people.
(Lakshmi Santhosh is a freelance journalist. She has an undergraduate degree in Economics from UC Berkeley and is currently completing a Master’s in Biotechnology from the University of Pennsylvania. She has worked for EC Media in Bengaluru and the San Francisco Business Times in California, USA)
February 2013 I FUTURE MEDICINE 59
Asthma
By Dr Mukesh Batra
Most of us are unable to breathe freely, when we are severely allergic to odour, smoke, pollutants, pollen, mould and house dust mite (HDM). Millions of people are suffering from asthma. Asthma comes from the Greek word, aazein, which means, “to exhale with open mouth; to gasp.” It is this typical feeling in asthma that makes its ‘subjects’ run almost out of breath
Breathe freely with Homeopathy A
sthma is a psychosomatic disorder—triggered by allergens, dysfunctional relationships and stress. It not only disrupts a family’s normal functioning, but also deflates the affected individual’s belief in his abilities. It affects millions of people worldwide. Statistics reveals that it ‘distresses’ approximately 1 in 15 children, making it the most common chronic childhood illness.
Symptoms • • • •
Tightness, pain or pressure in chest An audible wheezing sound, especially when exhaling Shortness of breath Persistent cough, especially at night, or in the early morning hours, although this may differ from one individual to another
Diagnosis
A physical examination, followed by noninvasive lung functioning tests (LFT), often helps to determine diagnosis. Your doctor will also examine your skin, and inquire about a medical history of hives (urticaria), eczema, or skin-related allergies. This is analysed, owing to a ‘likely link’ that exists between skin affections and asthma.
Healing with Homeopathy
Twenty-two-year-old Anil (name changed) presented with asthma, which had troubled him for over 10 years. He was tired of using conventional inhalers, steroids and, sometimes, injections to combat his asthma ‘attacks.’ His regular activities were curtailed to such an extent that it affected his academics and, in turn, his grades. Because of this, he was depressed; also, desperate. During case analysis, we found that Anil often felt better by ‘bending his head backwards,’ not forwards, as is the case with most asthmatics. Based on his unique presentation, we prescribed him the homeopathic 60 FUTURE MEDICINE I February 2013
remedy, Hepar Sulphuricum, which relates to such a symptom. After 8-10 months of homeopathic treatment, Anil responded favourably. With extended symptom-free periods, he also got better academic grades.
Most asthmatics cough and feel breathless. This is typically better by ‘bending forwards;’ it is often worse while lying on one’s back. Anil’s case was ‘unique’ from the rest, in its uncharacteristic presentation — of feeling better by bending backwards. This is the beauty and distinctive feature of homeopathy. It treats the individual, not based on the disorder alone, but also on the basis of the individual’s unique personality, temperament, sensibilities and ‘response’ to illness— because, no two asthmatic individuals present with the same symptoms. In a study conducted at the University of Glasgow, Europe’s largest medical school, asthma patients, given small homeopathic doses of the substance to which they were most allergic, showed significant relief within the first week of treatment. The researchers called this unique method of ‘individualising’ remedies as ‘homeopathic immunotherapy.’ The study provided impressive results, with no side-effects. Over 80 per cent of patients, given a homeopathic remedy improved, while only 38 per cent of patients given a placebo (dummy pill) experienced an equivalent degree of relief.
For the best results, it is imperative for one to seek the advice of a professional homeopathic doctor. This will help create a contingency plan in the event of a sudden asthmatic attack, while aiding the individual to breathe freely, with ease and holistic comfort.
Things to do
Take your homeopathic remedy correctly. Speak to your doctor and find out all you can about your homeopathic asthma remedy, dosages, including how and when to take it, and how it helps to control and manage your asthma. Know your asthma triggers and avoid them. It’s essential to know what brings on —or, triggers — your asthma symptoms. These differ from person to person, so it could take a while to figure out what actually does. Keeping an asthma diary is useful. Once you figure out
THE BASICS
A
sthma attacks are triggered by environmental pollution, cigarette smoke and household cleaning agents, or toxins. Other triggers include change of weather, air temperature, or humidity. Likewise, allergies and physical exertion can also trigger asthma episodes. During an asthma attack, the lung’s airways (bronchioles) become inflamed. They begin to contract and are ‘flushed’ with excess amounts of mucous. This limits the airflow; it also makes breathing difficult.
DUST CONTROL • • • • • • •
Reduce dust and pollen in your household During pollen season, keep the windows closed; use an air-conditioner Reduce dust by replacing carpets with tiles or wooden floors. Choose washable curtains and blinds Vacuum-clean upholstered furniture and mattresses regularly Wear a scarf over your nose and mouth, if you have to go out in winter Avoid physical exercise or yoga sessions in the open air Treat colds and flu at the ‘drop of a sneeze’ February 2013 I FUTURE MEDICINE 61
ASTHMA Dr Mukesh Batra
your triggers, you can do your best to avoid, or at least limit, your contact (odours, dust, pollen and certain foods) with them.
Deal with emergencies. It is important to realise that even people who take their asthma remedy regularly, as prescribed, and who work to avoid triggers can have an occasional asthma attack. So, have an “Asthma Action Plan” in place: • Identify the signs just before your asthma starts to ‘go of control’ • Look at symptoms and their nature • Know exactly what action to take, based on how you are feeling and what stage you are in • Do not ignore your asthma symptoms. Act quickly on danger signals to prevent or stop an asthma attack. Consult your doctor immediately
Coping with asthma. Dealing with asthma may be worrying at times. Stress can be a trigger for asthma attacks. So, it’s important to learn how to cope with stress and living with asthma in a positive manner. You could also draw inspiration from knowing that many eminent people, including sportspersons, have learned how to live with asthma and still succeeded.
Remember, you can live just as successfully with asthma, with professional homeopathic treatment.
Myth: Strawberries and tomatoes cause asthma
Fact: Although people can be allergic to any kind of food, most food allergies are caused by peanuts, cow’s milk, eggs, soy, wheat, fish and shellfish. Myth: Sugar allergy causes asthma
Fact: A condition is called food allergy when the immune system thinks a certain protein in a particular food is a ‘foreign’ agent and fights against it. This does not happen with sugar and/or fats.
Self-help • •
Myth & Fact
Myth: Food allergy causes asthma
Fact: Although 25 per cent of people think they’re allergic to certain foods, studies show that only 6 per cent of children and 2 per cent of adults have a food allergy. Far more people simply have ‘food intolerance,’ which presents with unpleasant symptoms ‘triggered’ by food, but does not involve the immune system.
ABOUT THE AUTHOR: Dr Mukesh Batra, LCEH, FSRH (MED) P (LON), MDH (USA), FBIH (UK), a homeopath of international repute, is Founder & Chairman, Dr Batra’s, the world’s first and largest corporatised homeopathic healthcare group. In a career spanning four decades, Dr Batra has treated over a million patients, including presidents and prime ministers, and revolutionised the way homeopathy is 62 FUTURE MEDICINE I February 2013
•
Eat a balanced diet, with at least 4-5 helpings of fruits and vegetables everyday Exercise regularly. Many asthmatics avoid exercise for fear of an asthma attack. Regular exercise, such as walking, will help strengthen overall lung and heart functioning and also help reduce asthma. Speak to your doctor and a qualified trainer to ‘design’ a ‘customised’ exercise plan that suits you and your needs best Avoid common triggers, such as deodorants, perfumed cleaning agents and cigarette smoke, to the best extent possible
practised today. A writer, photographer, singer and philanthropist, Dr Batra has been honoured with several fellowships and over 50 national and international awards, including the Padma Shri, one of India’s highest civilian honours, by the President of India. He has authored several books, including the cyclopedic work, Healing with Homeopathy (September 2011). He lives in Mumbai. Website: www.drbatras.com
RURAL POVERTY
Anirudh Krishna Professor of Public Policy and Political Science, Duke University
Ruinous healthcare costs For rural people, treatment expenses are not affordable and their live becomes miserable after hospitasation. They are dragged into huge debt and poverty. Indeed, they need affordable and higher quality healthcare to lead a trouble-free life with honour
I
n a small town of Gujarat, I met Chandibai, a woman aged about 50. Fifteen years ago, her husband, Gokalji, had owned a general-purpose shop in the town centre. They also owned a house and some agricultural land. In 1989, Gokalji developed an illness that confined him to bed, sometimes at home but quite often in a hospital ward. Doctors and nurses, testing facilities and pharmacists, steadily exacted a heavy cost. Assets were sold. Debts mounted. Nearly all of their agricultural land had to be mortgaged. Three years later, Gokalji died. Following his death, the shop was taken away by Gokalji’s brothers. As is the custom in this region, the widow inherited only the house in which they had lived, along with a small remaining piece of agricultural land. Two years after her husband died, Chandibai arranged for her oldest daughter’s wedding ceremony. In a manner befitting a middle-class bride, an elaborate ceremony was organised.
More debt was incurred. Eight percent of the outstanding amount was added on as interest every month. Unless she repaid her loan rapidly, the amount she owed would double every year. Faced with these circumstances, Chandibai cut her losses as best as she could. She sold the land and settled her debt. She now works on construction projects, in the land of others and in their homes, usually earning less than the official minimum wage. She has no credit remaining at the local grocery shop, so she eats poorly or not at all
when there is no money. It was a sad sight to see. Hanging above the broken-down string cot where Chandibai sat were two faded sepia photographs of her wedding ceremony, everyone smiling and clearly well fed. There was little hope that things would get better.
An avoidable fate
Such incidents regularly take place in every region that our team studied. Even quite well-to-do people have become poor. This is unfortunate that the majority of these descents into poverty could have been avoided, but nothing much is done to address the problem of poverty creation. Unnoticed and undeterred, poverty grows day by day. No single event is usually its cause. As Chandibai’s story, adverse events are numerous, pushing people into poverty by degrees. Unlike the events like typhoons or earthquakes, civil wars or terrorist strikes, which occur rarely but are paid a great deal of attention, everyday events, like illnesses, deaths, and marriages rarely appear on policymakers’ radar screens. Chandibai’s journey into dire poverty was precipitated by a ruinous illness of her husband and an expensive wedding ceremony.
Remain poor despite best efforts
Despite their best efforts, they do not succeed because, like Robert the Bruce’s proverbial spider, one step forward is followed by two steps back for them. A loved-one’s illness and the February 2013 I FUTURE MEDICINE 63
HEALTH CARE Anirudh Krishna
death of a spouse prove to be huge setbacks in their life. Of course, there are also positive events in the lives of poor people – someone acquires an education and gets a job, someone else obtains a worthwhile supply contract. But the buoyancy produced by positive events is offset when adverse events take place.
The balance of events – positive and adverse – experienced by a family over time determines whether it will climb up, go down, or stay in place. The object of policy is to change this balance in favour of more positive.
It starts with healthcare
Studies show that the source of a great deal of poverty is inadequate healthcare. Several other factors are also associated with poverty, but ill-health and medical expenses predominate. Ill-health imposes a double burden on households when high treatment costs go with the loss of earning power. Researchers who have studied these trends in different countries describe how, because of poverty neglect, a “medical poverty trap” is becoming ever more pervasive. Millions of families are living only one illness away from poverty, and thousands more have become deeply indebted on account of burdensome healthcare costs. Sixty percent of the families who fell into poverty in the Rajasthan communities, 74% in Andhra Pradesh, and 88% in Gujarat experienced one or more catastrophic health episodes. The data collected by other researchers show how a stupendous number amounting to 3.7% of the Indian population is at risk of falling below the dollar-a-day threshold every year on account of healthcare expenses.
Provision, insurance and regulation
Poverty prevention requires investing in affordable, accessible and higher quality healthcare. Becoming richer as a nation will not automatically resolve this problem. Indeed, more than half of all cases of impoverishment in the US are accounted for by unbearably high medical expenses. Purposive action is urgently required. Countries as diverse as Vietnam and Colombia (toward the lower end of the income scale) and Sweden and Japan (toward the higher end) have managed to serve up affordable, high-quality healthcare to their populations. In each case, whether healthcare is publicly or privately managed, government initiatives have been 64 FUTURE MEDICINE I February 2013
central for the success of these efforts.
A policy to improve healthcare in India needs to have at least three components: provision, insurance and regulation. Extending the coverage of medical insurance schemes will achieve little by itself, particularly in areas where doctors and hospitals are hard to access. And having doctors at hand is hardly sufficient when they charge more than people can afford. Regulation is the third rung of medical reforms. The increased commercialisation of medical services coupled with weak or absent regulation has resulted in the proliferation of fly-by-night operators, over-prescription, overcharging by private providers, spurious drugs, and other avoidable evils. Without taking into account of these developments, it is hard to explain why the financial burden of healthcare costs has risen so sharply, especially among poorer and less literate people.
Scaling up successes
Examples abound, albeit on small scale, of how the healthcare needs of the poorest
have been adequately tackled. I work closely with an NGO in Udaipur, headed by Dr Kirti and Dr Sharad Iyengar. I have been following the commendable works that many NGOs in other Indian states have been doing. To scale up notable successes, the government must provide, insure, and regulate the actors. Examples also exist of how other factors of descent have been rendered less influential. Norms related to marriage ceremonies and funeral feasts have been reformed by social and religious movements. Crop diseases have been rendered less ruinous through actions by private foundations, and land degradation has been brought under control by NGOs and government departments.
Multiple actors can contribute positively to this effort. It is much better to help people before they become poor. Assistance should come before these tragedies become full-blown and hard to reverse. Preventing the adverse events will stop the spread of poverty.
Anirudh Krishna is Professor of Public Policy and Political Science at Duke University. His
research investigates how poor communities and individuals in developing countries cope with the structural and personal constraints that result in poverty and powerlessness. Recent research projects have examined poverty dynamics at the household level for 35,000 households in India, Kenya, Uganda, Peru, and North Carolina, USA (www.sanford.duke.edu/krishna), examining both how people escaped poverty – and more important, how some came to be poor in the first place. Republished with the permission of www. ideasforindia.in February 2013 I FUTURE MEDICINE 65
INNOVATION Peanut Safe Syringes
Coming Peanut Safe Syringes!
A time will come soon when safe disposable syringes like Peanut Safe Syringes will be in-thing and people will say goodbye to the old-fashioned syringes which are manipulated for reuse by unscrupulous people for monetary benefit, especially in the developing countries like India
I
By Tony William
t is catastrophic that a few individuals’ greed and carelessness are leading to new infections every year across the globe. World Health Organisation (WHO) report states that every year around 21 million people get infected with diseases like HIV and Hepatitis, transmitted through reused syringes. It was this disheartening situation that led Dr Baby Manoj, radiologist, to the invention of safe disposable syringes.
The uniqueness and identity of the product is conveyed with the name itself, says Baby Manoj. “The two seeds
1 2 3 4
Dr Baby Manoj inside a peanut always are protected by natural layers. These seeds cannot be put back into its shells if it is taken out. Our Peanut Safe Syringes also have this quality. These syringes cannot be used for the second time.”
5
February 2013 I FUTURE MEDICINE 67
INNOVATION Peanut Safe Syringes
The ordinary syringes can be reused either by simple modifications or replacing the needles. In such cases, risk factor is high as there is chance for infection of diseases through syringes. Though most hospital groups and labs have syringe destroyer, often they do not confirm whether they have been properly destroyed. The advantage of using Peanut Safe Syringes is that after use, the user can destroy the syringe that too in less than 10 seconds. Since the barrel is broken, there is no way for using either the syringe or the needle again.
Peanut Safe Syringes are as user friendly as ordinary syringes. The needle-connecting part of a Peanut Safe Syringe can be broken easily. The needle need not be removed from the syringe. In the process, a protective cover saves the fingers from accidental injury. On the quality front, both the syringe and the needle have received the approval of the Drug Controller General. Unlike other syringes, Peanut Safe Syringes need additional processing so as to attach the disposing feature to it. This makes the product much costlier than ordinary syringes. “We are willing to provide it to the healthcare department for a subsidized rate covering only minimal cost and profit,” says Dr Baby, who had filed patent application in 2006.
A recipient of the award for the product from National Research Development Corporation in 2011, Baby is a researcher to the core. “Often research begins with simple modifications of the existing products. It’s the love to face challenges that has been fuelling my research,” says Baby.
Origin of syringes Romans hold the credit for the introduction of syringes. Glass syringes were the first to be in use. They were reused after sterilizing the needle for 10 minutes in the boiling water. But often the emergency factor gave less chance for proper sterilizing. It led to disposable plastic syringes. Eyeing the profit, disposable plastic syringes were used after washing and repacking. Auto disposable syringe was also in use. The defect of auto disposable syringe was that it disabled the piston of the syringe, which does not come directly contact with the body. It can be used again by replacing a component.
68 FUTURE MEDICINE I February 2013
Regarding the market for Peanut Safe Syringes, the doctor said he is optimistic. In view of the alarming increase of blood-borne diseases spreading through infected syringes, he hopes that the world would recognise his product and efforts. Needle less injections is also gaining popularity in the world. ‘Jet injection’ makes use of the high pressure narrow jet to inject the medicine to the body. It is painless too. But the problem is that for each patient the skin could be different. For some, it could be thick and for some it could be thin. How deep the injection would go into an individual’s body is still a problem with jet injection system. Or else, it must be customised according to the specifications of each individual, he adds.
FOCUS BGS Global Hospitals, Bengaluru
Top notch healthcare
on a platter BGS Global Hospitals became fully functional in 2007. Impressed by Dr Ravindranath’s ideas and concept, Sri Balagangadharanatha Swamiji’s Sri Adhichunchanagiri Mahasamsthana Math built the state of the art hospital infrastructure. Later, Global Hospitals took over the administration and maintenance, paving the way for the birth of BGS Global Hospitals
“U
By Tony William
nlike the other industrial units, the healthcare institutions have to maintain the status quo even if the number of patients comes down. Of course, the number will not be the same throughout the year. Sometimes, it could be very high and at other times, there would be fewer patients. But you need to maintain the staff strength all through the year. Further, we don’t have any concession in power tariffs or subsidies from the government. Constant upgrade of technology as well as machinery is a necessity in the field,” says Dr NK Venkataramana, Chief Neurosurgeon and Vice Chairman, BGS Global Hospitals, Bengaluru. Global Hospitals does not need an introduction
in the healthcare industry. In a short time, it has emerged as the second best multi-speciality hospital in Chennai, according a study jointly conducted by a prominent weekly and Hansa Research National Survey.
Global Hospitals, Hyderabad, the flagship hospital of Global Hospitals Group, was initiated by Dr Ravindranath in 1999, a world-renowned expert in surgical gastroenterology, with a passion for transplants. He introduced laparoscopic surgery and transplants, including cadaver liver transplant and live donor transplant in addition to the existing kidney transplant. Global Hospitals has done the largest number of liver transplants, says Dr Venkataramana, adding February 2013 I FUTURE MEDICINE 69
FOCUS BGS Global Hospitals, Bengaluru
that it has already forayed into multi organ transplant.
BGS Global Hospitals became fully functional in 2007. Impressed by Dr Ravindranath’s ideas and concept, Sri Balagangadharanatha Swamiji’s Sri Adhichunchanagiri Mahasamsthana Math built the state of the art hospital infrastructure. Later, Global Hospitals took over the administration and maintenance, paving the way for the birth of BGS Global Hospitals. Simultaneously, Global Hospitals took over Tamil Nadu Hospital in Chennai as part of their expansion plans. “The hospital was rechristened Global Health City and today it is one of the biggest healthcare providers in Chennai. The group also took over Aware Hospital in Hyderabad. Mumbai will be the next city Global Hospitals plans to gain a foothold. “Our hospitals, including the ones at Bengaluru, Chennai, Mumbai and Hyderabad have about 2,000 beds in total,” says Dr Venkataramana.
BGS Global Hospitals has specialisation in the core areas like neuro sciences, cardiac sciences, GI and bariatric surgery, multi organ transplant, critical care, orthopaedics and oncology. Urology, nephrology and neuro science have well-equipped infrastructure, says Dr Venkataramana. “We have separate operation theatres, the state of the art equipment and technology, competent service, post-operative ICU, trauma ICU, stroke ICU and level one trauma center with
Dr Ravindranath, Chairman, BGS Global Hospitals international standards. In addition, we have clinical programmes, diagnostics, paramedical training programmes and research. The latest technology in neurosciences is available at BGS Global Hospitals, Bengaluru,” adds Dr Venkataramana.
The hospital has every single sub speciality in neurosciences. Neurosurgeons, neurophysicians, neurodieticians, neurocritical care specialist, neuropathologist, neuroanesthesian, neuropsychologist and neuroendocrinologist are there at the hospital. The hospital also has a liver specialists’
team. Another unique feature is the liver ICU to facilitate dialysis. The critical care unit at BGS Global Hospitals needs a special mentioning.
“In Bengaluru today, we have the largest critical care unit. We have 110 beds for critical care only. It is a sort of various specialised ICUs which include neuro ICU, stroke ICU, surgical ICU, medical ICU, liver ICU, transplant ICU, and cardiac ICU. These are manned by well trained, competent and dedicated teams,” adds Dr Venkataramana. The oncology department of BGS Hospitals is the state of the art centre. “We recently acquired a machine called Truebeam STX. It is very fast, focussed and a very specific type radiation therapy machine which can radiate specific parts of the body without damaging the surrounding cells,” says the doctor. BGS Global Hospitals has also introduced a pattern called ‘organ specific oncology’ which consists of breast oncology, neurooncology, thoracic oncology, head and neck oncology, liver oncology and orthopaedic oncology. “With the introduction of bone marrow transplant, we have almost all oncology departments,” he adds. BGS Global Hospitals today is in a position to take any complex problems, says Dr Venkataramana. “We never refuse any trauma patients. We consider it as the fundamental thing,” he adds. “The hospital also treats many patients free of cost. We have a scheme funded by Dhanavantri Trust. BGS Global Hospitals at Ramanagaram offers free treatment to rural
Dr N K Venkataramana, Vice Chairman, BGS Global Hospitals people. A school for blinds is also run by the Swamiji. We have also started a centre near Yeshwantpur Railway Station to provide free consultation and advice to commuters. We plan to begin more such centres across Karnataka,” adds Dr Venkataramana. “Every day, camps are held in different parts of Karnataka by the hospital.” The hospital has also explored the possibilities of medical tourism in India. Patients are coming from Sri Lanka, Maldives, South Africa and the Middle East and other countries to the hospital for treatments.
SKIN CARE
Dr Divya Ramkumar Dermatologist & cosmetologist
Rejuvenate skin with S
chemical peeling An examination of the patient is necessary to determine the appropriate type of peel. It is important to take an extensive history of the patient and the appropriate agent can be selected based on the patient’s condition and skin type
ince the days of ancient Egypt, people have been using chemexfoliation methods to rejuvenate skin. The initial chemexfoliant used was lactic acid, an active ingredient of sour milk. Later, old wine with tartaric acid as its active ingredient was used.
Modern day chemical peeling is done with various acids like glycolic acid, salicylic acid, resorcinol, phenol, trichloroacetic acid (TCA), tretinoin, pyruvic acid, mandelic acid etc. From the 1980s, an explosion has occurred in research in this subject with different types of peels being used for a specific problem. An evaluation of the patient by the clinician is necessary to determine the appropriate type of peel. It is important to take an extensive history and the appropriate agent can be selected based on the patient’s condition and skin type, and other variables that may affect peel penetration. Sebaceous skin usually requires priming with topical retinoids or alpha hydroxy acids. The patient must be educated on the chemical peel process and consent is needed for a medium or deep peel. The patient’s general health status, medications, previous cosmetic procedures like surgical lifts and fluid silicone injections, recurrent herpetic outbreaks, and keloid formation need to be recorded. Peels are done for a variety of conditions like pigmentary disorders (melasma, post inflammatory hyperpigmentation, freckles, lentigines and facial melanoses, acne and its scarsjavas
cript:showrefcontent(‘refrenceslayer’), aesthetics( photoaging, fine lines, dilated pores) and also for removal of certain growths like milia and seborrheic keratoses.
Contraindications • • • • • • • •
Active bacterial, viral, fungal infection Open wounds Patient on photosensitizing drugs Preexisting inflammatory dermatoses Uncooperative patient (Especially those will not follow the post-peel instructions). Patient with unrealistic expectations History of keloidal tendency History of isotretinoin use in the last 6 months
Technique
Chemical peels are divided into three categories depending on the depth of the wound created by the peel. Superficial peels penetrate the epidermis only, medium-depth peels damage the entire epidermis and papillary dermis, and deep peels create a wound to the level of the midreticular dermis. The depth of the peel is dictated by a number of factors, including the chemicals applied and their concentration, mode of application, and skin type and its condition. In general, the depth of the peel determines the healing time, the rate of adverse effects, and the results. Following the peel, the patient must follow the instructions given to prevent complications. The patient should be made aware that the skin will exfoliate and may look cosmetically unattractive for a period of time depending on the depth of the peel. If the patient has a history of herpes labialis, treating the patient with acyclovir or an equivalent drug is advisable, two days prior to the peel and for five days after the peel. Superficial peel is a simple procedure which takes about 20 minutes and can be repeated at a gap of three weeks for about six sittings. Maintenance peels can be done once in three weeks if needed while medium-depth peels can be performed at six-month intervals if necessary.
Application methods
The skin should be defatted properly with acetone before the procedure to ensure the penetration of the peeling solution. Delicate areas that need to be protected should have petroleum jelly applied, including the lips, inside the nose, and optionally in the nasolabial fold, medial canthus, and lateral canthus. The correct peeling agent then is applied. The peeled area should be neutralised and then adequate sunscreen application. Skin preparation with bleaching creams like hydroquinine in the immediate post peel period are crucial to avoid postinflammatory hyperpigmentation in dark skin types.
The patient should be in the supine position with the head tilted up. The acid should not form pools in the facial folds nor drip from the face. The eyes should be kept closed during the procedure. Apply the peeling agent in cosmetic units, beginning with the forehead and finishing with the chin.
The duration the peeling agent is in contact with the skin also helps determine the depth of the peel. After the appropriate time, neutralization is performed. Some chemical peels, such as salicylic acid and trichloroacetic acid, do not require a neutralization. The patient’s face is washed with water following the peel and a sunscreen applied.
Complications
Complications like pigmentary alterations,blistering and edema,secondary infections, reactivation of herpes labialis, milia, prolonged erythema ,scarring etc, are more common in the medium and deep peels and also in the dark skin types. Proper patient selection and expertise in the application technique of various peeling agents help in bringing out best results.
Dr Divya Ramkumar, MD, works with Sun Medical and Research Centre & Carewell Clinical Centre in Thrissur, Kerala February 2013 I FUTURE MEDICINE 73
FOCUS Krishnendu Ayurvedic Wellness Centre
Keeping a legacy aloft
This famous family of Vaidyans in the Chingoli village of Alleppey District in Kerala has been successful in building its rich legacy in traditional medicine, which dates back to more than a centaury and spreads over four generations. With expertise in general medicine, arthritis, spine care, and rejuvenation therapies, Krishnendu Ayurvedic Wellness Centre has attracted thousands of ailing patients to experience the divine healing touch. The sustained flow of patients from across the country and many foreign nations is a telling testimony of its ever growing reputation. Late Shri MC Kunjuraman Vaidyan, deciple of MoothaKoyi Thampuran, better known as Kerala Vagbhatan, and a close associate of Ananthapuram Palace, had sown the seeds of this legacy .Later his son and renowned aurvedic physician of yesteryears, Vaidya Kalanidhi late Shri R Krishnan Vaidyan had developed it to a real temple of traditional medicine and a sure source of solace for ailing thousands. The present chief physician and son of the latter, Dr.Mohan Babu has perfected the practice to find out a traditional treat to modern minds by adding treatments for obesity, women care, diabetics, infertility, stress and hypertention etc. Dr.Sandeep Krishna who is to bear this torch of tradition in the days to come is also here with dedication and commitment commensurate to the family legacy.
74 FUTURE MEDICINE I February 2013
All medicinal formulations of this wellness centre are prepared in own facility having G M P and ISO 9000- 2011 certifications in strict adherence to prescriptions in the ancient texts on Ayurveda, and the therapies are administered by a group of well experienced therapists under the guidance of qualified doctors. Restoration of optimal health and all round wellbeing is the ultimate goal of this wellness centre. Other than routine treatments, it offers a number of Ayurvedic packages, including ‘Samridhi’, ‘Nirvana’, ‘Aishwarya’, ‘Swanthanam’, ‘Mukthi’, and ‘Sampoorna. those who look forward for a place for a few days stay for retreat, rejuvenation or rehabilitation..
Samridhi This is a combination of different Ayurvedic techniques devised for treatment of minor and major ailments as well as emotional imbalances. Nirvana (Total body rejuvenation) This therapy helps a person overcome stress and strain, both physical as well as mental. Aishwarya (Weight reduction) Different types of therapy, including ‘focus massages’, can help people lose extra fats. These therapies make one’s skin healthy and radiant by improving blood circulation and other key functions of the body. Swanthanam (Pain relief therapy for muscles and joints) This therapy relieves one of joint and muscle discomforts brought on by ageing. It is a combination of ‘Abhyanagam’ (therapy and focus massages), different types of ‘Dhara’ (application of medicated oil on the forehead and other vital parts of the body), and Kizhi (a body-soothing treatment given with the gentle application of pressure with a cloth tied up with hot medicated oil and herbs).
Its separate wing for modern physiotherapy, occupational therapy, and spot weight reduction centre etc. renders and added attraction. The wellness centre has a special team of doctors to attend to the patients from India and abroad, mostly from Germany, U.S, Canada,MiddleEast and Russia.
Rajasree, Managing Director
Mukthi (detoxification) This is a body detoxification process falling under the Panchakarama, or the five-fold cleansing technique. This process includes internal medication as well as external application of medicated oil and medicated hot packs Sampoorna (Stroke and accident rehabilitation) Different kinds of massages and rejuvenation therapies are provided under this programme. It improves blood circulation and strengthens weak muscles. This treatment rehabilitates patients faced with disabilities caused by a stroke or an accident. In extreme cases too, a slight improvement in the quality of life can be expected. Krishnendu Ayurveda Wellness Centre believes in providing the best care for its guests and ensures stainless stay at its envious environment. Its fascinatingly furnished rooms, meticulously decorated deluxe suits supported by a crystal clear swimming pool, present a peerless passion for
Dr C K Mohan Babu, Medical Director
A team of expert doctors and other supporting staff are there round the clock.
The first among the list of recent awards and accreditations to the credit of Krishnendu Ayurveda Wellness Centre is the Global Excellence Award 2010 of Global Malayalee Council presented by Honorable Minister for Health,Government of Kerala. .Again The Kerala Private Ayurveda Hospital Management Association has put its stamp of assurance of quality by awarding Krishnendu Ayurveda Wellness centre the Best Inpatient Management Centre in Kerala for the year 2012. Likewise Krishnendu Ayurveda Wellness Centre has earned the title of Best Ayurveda Hospital in Kerala from World Malayalee Council at Cologne,Germay in the year 2012. Krishnedu Ayurveda Wllness centre, an ISO 9001-2008 certified one and with Green leaf certification, has now been developed as a dependable destination with international fame and standards for health conscious and nature loving people from India and abroad.
February 2013 I FUTURE MEDICINE 75
YOGA
Uttanasana (Intense forwardbending pose) How to do? Stand with feet together and then hinging forward from the hips, letting the head hang, with palms placed flat on the floor near the feet. Benefits The pose gives a complete stretch to the entire back of the body, particularly the hamstrings. Strengthens the thighs and knees Keeps your spine strong and flexible Reduces stress, anxiety, depression, and fatigue, calms the mind and soothes the nerves
Tadasana (Mountain pose) It is the basic standing asana in most forms of yoga with feet together and hands at the sides of the body. There is some contention between different styles of yoga regarding the details of the asana which results in some variations. Benefits It allows the body and consciousness to integrate the experience the preceding ﾄ《ana and prepare for the next
76 FUTURE MEDICINE I February 2013
Mermaid Pose Benefits • • • • •
It lifts and opens the heart Provides a deep stretch to the thighs, groins, shoulders, and chest Improves mobility in the spine and hips Strengthens the abdominal muscles Stimulates the organs of the torso
February 2013 I FUTURE MEDICINE 77
INSPIRATION
Bringing smile on their faces
Photographs of a cleft lip child before and after treatment
S time.
By Shalet James
mile is the most beautiful expression but there are some people who are just waiting to smile at least once in their life
Yes! The cleft lip patients are the ones who are dying for an opportunity to express their happiness through their smile. These hapless children who are suffering from a congenital deformity caused by abnormal facial development during gestation period have been condemned to a life of neglect and ridicule. Recognising the plight of these cleft lip and cleft palate patients of the world, Charles Wang and Brian Mullaney decided to embark on a project which could help cleft lip patients to lead a happy life ever after. The project named Smile Train was launched in 1999 in New York. Though this project was launched in the US, the mission of treating cleft patients was much before started by Dr K R Rajappan, one of the senior most plastic surgeons in Kerala. Dr Rajappan along with his wife C K Nalini established Specialists’ Hospital in Kochi in 1983.
“I started attending operations for cleft lip and cleft palate in 1975. Those days, there were only a few hospitals which dealt with these types of cases. As cleft patients were plenty in number, I thought providing treatment to these people will be the greatest service I could do. I used to travel all over Kerala, visiting private hospitals and identifying poor cleft patients. The treatment, food and accommodation were provided for the patients and their families free,” says Rajappan, Medical Director, Specialists’ Hospital. He treated more than 10,000 patients
suffering from cleft lip, cleft palate deformities. In 1980, Rajappan was awarded the Individual International Meritorious Service Medal by International Lions president Lyod Morgan for his free services to the poor people.
Dr K R Rajappan, Medical Director, Specialists’ Hospital
With a sole aim of eradicating the problem, Rajappan happily extended his support to the Smile Train project and became one of the partners of this divine mission. The project with main focus on cleft patients started its philanthropic activities in India in 2000. This international venture made hospitals and clefts surgeons equal partners in this programme and helped them treat as many cleft patients as they could. “The Smile Train project was a real boon to the cleft patients as their service reached every nook and cranny of India. This project has really helped many patients to come out of their pathetic life,” he says. In India, one in 700 people are born cleft lip, the major reasons being heriditary problems and food habits. Cleft lip and palate patients are mostly found in the developing countries.
Dr K R Rajappan is also planning to start more innovative outreach programmes for the poor who are suffering from cancer.