Vol.3/ Issue-2
www.insightscare.com March 2019
Proc ient
The Most
Surgeon s to Watch 2019
Nutritious Insights
Tech-trends
Nutrition Post Surgery− The Most Necessary Fuel for a Steady and Quick Recovery
4 Innovations in Surgical Technology that are Improving Patient Care
Editor’s Column
Doctors: The Uncelebrated Heroes
P
ursing surgery as a career is a daunting and strenuous task. The dedication and passion students put into becoming a learned and well-practiced surgeon is unmatched. With the practical training, it also requires a lot of mental and emotional preparation. Doctors have to work round the clock tirelessly, this can be challenging. The surgeons are personally tested by the existential truths of human life in their associations with patients. Surgeons often get yelled at by the patients’ family and also have to handle the emotional backlash of several patients, their families, and friends. On numerous instances numerous doctors have also suffered from physical assault owing to this issue. They have to realize that ethical encounters are an intrinsic part of performing surgery and of life itself. And that they have to acquire to “live with” these times of trial that are a part and parcel of their job. Doctors are constantly subjected to life and death situation, accepting failures positively is a part of their job; the most daunting task being breaking sad news to the family and friends of the deceased. In a way this is confirmed both socially and by their inner moral self. Looking people”s distress, pain, and suffering often takes a toll on a person’s mind. But this is not an option for surgeons and doctors as a whole, they have to accept their personal and professional limitations, being uncertain, being fallible, and being humble at all times. Living with the ethical challenges of surgery seems to add to the surgeons' confidence and vulnerability in their professional identity. It is not everyone’s cup of tea. The efforts and dedication that doctors and surgeons put into their work often goes unnoticed. Acknowledging this issue and respecting the struggles of these heroes is very important. We need to start appreciating the effort and dedication that they put into their work.
Sayali Rane, Editor
Editor-in-Chief Pooja M. Bansal Managing
Ashwini Deshpande
Editor
Sayali Rane
Executive ArtEditor & Design Head Amol Kamble Associate Poonam, Shweta Designer
Art & Rahul Kavnekar
Picture Editor
Co-designer Priyanka Rajage
Business Development Manager Akansha Garewal Sales Executives Pooja, Ruchi, Karishma Technical Head Swapnil Patil Technical Specialist Digital Amar, Pratiksha Marketing Manager
Prashant
S M E - S M O Executives Swati, Manoj Circulation Manager Tanaji sales@insightscare.com
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Healthcare Trends The Burden of Obesity in India
Articles
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Nutritious Insights
Tech-trends
Nutrition Post Surgery−The Most Necessary Fuel for a Steady and Quick Recovery
4 Innovations in Surgical Technology that are Improving Patient Care
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1 4
1 8 Dr. C. S. Ramachandran
Dr. Deepak Govil
A Passionate Surgeon Working For the Good of Humanity
An Experienced Surgical Gastroenterologist & a GI Cancer Surgeon
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3 2 Dr. Kawita Bapat
Dr. Nadeem Niyaz Jan
Marking her Excellence in the Gynecological domain
Opening New Windows of Opportunity
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4 4 Dr. C. S. Ramachandran
Dr. Raju Vaishya A
A Passionate Surgeon Working For the Good of Humanity
Personiď€ cation of Hard-work, Dedication, and Success
Dedicating Their Lives to Their Patients
M
edicine, by nature, is a giving profession. Many years of sweat, studies, training, and skill goes into becoming a doctor, so that they can have the skills in order to serve patients in the future. It requires sacrifice and dedication to a cause greater thantheir family. themselves and Mastering a surgical technique is no less than a work of art. It requires the much required talent, skill development, and training. Student who aspire to become surgeons spend years at a stretch to finally master it. With our issue “The Most Proficient Surgeons to Watch 2019”, we present you with some of the masters in the field of surgery. These surgeons with their dedication and skills have become the epitomes of success and compassion in their respective fields. Dr. Nadeem Niyaz Jan is a Consultant Surgeon and his main domain of interest is vascular surgery. Dr. Palin Khundongbam is a General Surgeon and Plastic Surgery specialist. He is an outstanding surgeon and a successful entrepreneur set to change the medical conditions for the people of Myanmar. Dr. C. S. Ramachandran is a General and Laparoscopic Surgeon, located in Delhi. He is associated with Sir Ganga Ram Hospital. Dr. Deepak Govil is a Surgical Gastroenterologist, he has over 30 years of experience as a Surgeon, and he is currently working with Indraprastha Apollo Hospitals, New Delhi. Dr. Raju Vaishya, Orthopaedic Surgeon, he is a Professor and Senior Consultant in the Department of Orthopaedics & Joint Replacement Surgery at Indraprastha Apollo Hospitals, New Delhi. Dr Kawita Bapat, she is a Consultant Obstetrician and Gynaecologist. Currently, she is a Consultant and Medical Director of ‘One’, Center for Gynecological Excellence and Bapat hospital. Apart from this we have also included an article from an industry expert and penned out a few articles by our in-house editors. So go through the pages to embark on a journey which will inspire you!
Dr Nikhil Agnihotri Director and Head
The
Burden
of
Obes i t in
08 | March 2018 |
In
dia
Healthcare Trends
Biography Dr Nikhil Agnihotri after completing his post-graduation in General Surgery joined the prestigious Sir Ganga Ram Hospital New Delhi for post-doctoral fellowship in Minimal Access Surgery. Academically procient, he trains young laparoscopic surgeons across the globe and is also a peer reviewer for many national and international surgical journals. Dr Nikhil Agnihotri is currently the Director and Head, Department of Minimal Access, Metabolic and Bariatric Surgery at Max Super- specialty Hospital, Shalimar Bagh and Max Multispecialty Hospital, Pitampura New Delhi.
I
ndia has come a long way and is now perceived as a progressive economy fighting hard to secure its place amongst the developed nations. On health grounds it has successfully eliminated many infectious diseases, too such as Polio, Leprosy, Yaws, etc. but is now staring at the immense burden of chronic non-communicable diseases. Non-communicable diseases such as cardiovascular diseases, Cancers, Respiratory diseases, Diabetes have been inherited from globalization of unhealthy lifestyles and diets, unplanned rapid urbanization, sedentary lifestyles and lack of physical sports and activity. Overweight and Obesity contribute majorly to these diseases. Obesity is defined as a chronic disease of excess fat storage to the extent that it impairs health of the individual. It brings along with itself a plethora of related diseases such as type 2 Diabetes, Hypertension, Dyslipidemias, Obstructive Sleep Apnea, Joint Pains, Polycystic Ovarian Disease, Infertility, Depression and Hernias. Obesity is also associated with development of Cancers in long term. According to recent estimates of National Family Health Survey Overweight and Obesity almost doubled in a decade (2005 to 2015) from 21% to 39.3%. India now stands third, after USA and China amongst most obese nations. It is no more a disease of only the affluent and affects individuals across all socio-economic spectrums. Even the children and | March 2019 |
09
adolescents are increasingly affected. Worldwide, 33% of populations – a staggering 2.36 billion people are estimated to be overweight or obese - PANDEMIC. Body Mass Index is used to measure and quantify Obesity in adults. It is a simple calculation of dividing weight in centimeters by height in meters2. Moreover we have a typical pattern of fat distribution around the waist which makes us prone to development of insulin resistance and type 2 Diabetes at much lower BMIs. After quantification, management of Obesity becomes easier where mild to moderately Obese are managed by encouraging lifestyle modifications, supervised diets and regular physical exercise. Severely Obese i.e. BMI > 37.5
are advised a Bariatric Procedure. When two or more co morbidities have already set in such as Diabetes, Hypertension, OSA, PCOS etc. surgery is advised at a lower BMI of > 32.5. Bariatric procedures have undergone tremendous innovations, the most significant being the performance of these Laparoscopically compared to when these were first started more than 50 years ago. Laparoscopy has its inherent benefits of being safer, less painful, decreasing hospital stay, providing early return to work and superior cosmesis across all procedures but biggest benefit is reaped by Obese patient when early ambulation is started just a few hours after the surgery, preventing many serious complications in these otherwise susceptible obese subjects.
Common Bariatric Procedures suitable to Asian diet are: Lap Sleeve Gastrectomy Laparoscopic Sleeve Gastrectomy removes a part of stomach along the greater curvature, thus reducing the size of the stomach substantially. It is the most commonly performed procedure worldwide today.It is mainly a restrictive procedure with hormonal alterations. There is a decrease in levels of hormone Ghrelin which produces hunger.
Lap Roux – En –Y Gastric Bypass In this procedure a very small, micro pouch of stomach is created to which small bowel loop is attached. Intestinal rerouting is done to create a Roux-en-Y configuration which prevents reflux of bile into the micro pouch and also provides a very small degree of malabsorption.
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Mini/ One Anastamosis Gastric Bypass This is a loop modification of Roux–En–Y Gastric Bypass where a loop of intestine is attached to long, narrow pouch of stomach. Choosing a procedure : If required, surgeon chooses the procedure depending on age, presence or absence of related diseases, duration of those diseases, dosage of medications and investigative findings and patient’s preference. Usual stay in hospital is 2-3 days and oral liquid diet is initiated a day after the procedure. Detailed diet chart with instructions and follow up is advised. One may expect to loose 4-6 kg weight every month after the procedure and the pattern of resolution of related diseases starts typically with Diabetes (immediate post op, even before weight loss), Obstructive Sleep Apnea ( 15 days to a month), Hypertension ( 2 to 3 months) and reduced pain in joints with significant weight loss. Up to 80% of excess weight is lost in the next one year. Although Bariatric procedures are safe and effective in treating individuals with Class II and III Obesity, a lot of focus, effort and commitment is required for sti prevention beginning with sensitization and education of families, educational establishments, increasing awareness at the community level and in media, labeling and higher taxation of fat rich commercial foods. Those already suffering however, should not be further victimized by social stigma predicated on Hippocratic nostrum that weight can be reduced by ‘deciding’ to eat less and exercise more as it holds no scientific basis.
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Dr. C. S. Ramachandran General and Laparoscopic Surgeon
Dr. C. S. Ramachandran
A Passionate Surgeon Working For the Good of Humanity
14 | March 2019 |
The Most
Proficient Surgeons to Watch 2019
W
atching a loved one especially ones mother suffer, is always traumatic for a young child. Dr. C. S. Ramachandran, a renowned General and Laparoscopic Surgeon, suffered a similar hardship, but it only made him more determined towards becoming a surgeon. Speaking about his motivation for stepping into this profession, he says, “I watched my mother undergo conservative treatment for TB of the hip bone. It was the early 1960s, when immobilization was the standard treatment. This was a painful event for us family members watching my mother in pain. I was watching doctors come and go, this triggered a passion for the profession.” Following his passion and his zeal helped him to get admission into Maulana Azad Medical College for MBBS. After this he moved on to do his Post Graduation in General Surgery, “I stood first in Delhi University in the final MBBS exam and stood first in PGIMER Chandigarh, got many medals in conference and meetings,” he says. Along the way, he had the opportunity to visit Europe and the United States. This kept him abreast of all the latest techniques in surgery and updated his surgical skills.
Dr. Ramachandran’s experience is blended with genuine concern for his patients. All his staff members are dedicated to the patients’ comfort and prompt attention is provided as well. He is an experienced General Surgeon and is currently associated with Sir Ganga Ram Hospital, Delhi. He has been a practicing General Surgery for the past 43 years. He has also attained FICS (Chicago, USA – 1985). This degree is awarded on the basis of an interview conducted by high profile doctor in Chicago. It is conducted by the International College of Surgeons. FCCP (USA, New York – 1985), DNB (General Surgery- National Board of Examination1984), and MS - General Surgery, are some of the other advanced courses and specializations he has obtained. He has received countless delightful feedbacks from satisfied patients. Providing Compassionate Care to All his Patients “Every day, every patient, every surgery-big or small, is a challenge,” the doctor believes. Developing a trusting relationship with patients is a step-by-step process and a challenge in itself; and this coupled with thorough clinical knowledge and surgical exposure, is what helps
“
“
Be sincere, be honest, be thorough, be inquisitive, and don't stop to learn more
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build the trust. With the upsurge of technology, the pharmaceutical industry has undergone a sophisticated change and India has one of the largest productions of quality drugs. “People are more educated and aware. They know their ailment, their doctor, & their treatment. They cannot be fooled,” he says.
himself abreast with the latest technology. Speaking of this quality, he asserts, “I read literature form around the world and discuss minute details with colleagues in foreign countries to keep myself abreast of latest research.” Advice to the New Generation Surgeons
Every patient brings with him a story. These are personnel epiphanies. “I cherish every one of them as they have helped me grow as a person and as a surgeon,” the doctor asserts. Two cases that stood out of the rest and have been engraved in his memory, he says, “First case had swallowed half a kilo of gold biscuits in a smuggling attempt, but developed intestinal obstruction. I was able to remove all the gold and save his life. The second case was a man with a hernia hanging near his knee over 25 years carrying his entire intestine. Over an eight hour operation I was able to repair the entire hernia.” Being Up-to-date with Technology First Laparoscopic surgery and now robotic surgery, the field of medicine has become highly skill-based. From an open wound to bloodless surgery, the progress in the field is truly remarkable. Dr. Ramachandran likes to keep
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India has made rapid progress and our doctors are as competent as any other doctor from any part of the world. The only difference is that Indian doctors are more involved and patient friendly. Being a surgeon by profession is no easy task, it takes immense load of hard work and dedication coupled with passion to become a successful surgeon. It is but natural that a balance needs to be kept between the professional and personal life, but it is pretty tedious to do so, if you have to work round the clock. Speaking of about this the doctor says, “Personal life does take a back seat if you are a dedicated surgeon. But if you are passionate surgeon, this is a small price to pay.” Being sincere to your profession, being honest to your patient, being thorough with your subject, and being ready for a lifetime of learning, is all it takes to be a successful surgeon. “So don’t stop to learn more,” he says.
Dr. Deepak Govil Surgical Gastroenterologist & GI Cancer Surgeon
DR. DEEPAK GOVIL An Experienced Surgical Gastroenterologist & a GI Cancer Surgeon
18 | March 2019 |
The Most
Proficient Surgeons to Watch 2019
S
“
urgery overall is a very interesting field. It’s my passion. Whether you do open Laparoscopy or Robotic surgery, the surgery, basic principles of surgery remain the same and need to be followed strictly to achieve good outcomes for patients,” are the views of a renowned Surgical Gastroenterologist, Dr. Deepak Govil, who has over 30 years of experience as a Surgeon, he is currently working with Indraprastha Apollo Hospitals, New Delhi. Dr. Deepak was fascinated since childhood to see the prefix ‘Dr.’ before his name. Speaking of his motivation to become a doctor he says, “Also this being one of the most respected professions has always impressed me. Coming from a simple family, my parents wanted me to become a Doctor.” His parents never let the limited resources stand in the way of providing him the highest of education and made lot of sacrifices for his education. “I sincerely wanted to fulfill their dreams and worked very hard to get into medicine.” he says. Dr. Deepak’s elder sister was admitted to MBBS at the Lady Harding Medical College, which along with his parent’s motivation was the driving force and a strong factor in his becoming a Doctor. Reminiscing old memories he asserts, “I can never forget the expression of happiness and satisfaction on my mother’s face when I got the selection letter from AIIMS for MBBS entrance.” Inspiring Journey of Dr. Deeepak Govil His journey as a medical student began with getting admission into AIIMS. Here he completed his MBBS, “It was a great experience” he says. Working alongside some of the greatest
surgeons of that time Dr. Deepak thoroughly enjoyed his training at the AIIMS. Speaking of his memories he asserts, “I was always impressed by the great Surgeons at the AIIMS, namely Prof. Atam Prakash, Prof. I.K. Dhawan, Prof. BML Kapur and Prof. S. Nundy.” He has a strong belief that surgery is all about learning and nurturing skills to remove the disease and ailments of a person, and not mere prescription of medication. He says the compliments and blessing of the patients are his most treasured ‘assets’. Earning the prestige of being an expert in GI surgery didn’t come easy, many years of hard work went into developing this skill, “I was fortunate to work in the unit mainly concentrating on GI Surgery during my MS (Surgery). There I learnt the value of discipline and hard work in Surgery.
There were 2-3 days continuously when we were in the OT on 8th floor at AIIMS and used to watch Delhi from the glasses of that floor and worked just on and on.” here he was exposed to all major surgical procedures. Then he moved on to join Dr. Ram Manohar Lohia Hospital, where he learnt the importance of simple surgical procedures. “I learnt from Dr. KN Shriwastav that no procedure is a minor procedure. One should not take any procedure lightly and do every procedure with same patience and meticulous technique.” Within few years Dr. Deepak decided to move further. Around this time he got married and speaking of his wife, he asserts, “I am very grateful to my wife, who sacrificed her career for me to progress and fulfill my ambitions. She looked after the kids and family and kept me carefree from this aspect.”
His Piece of Advice to Medical Students “Hard work has no substitute- I think this applies to surgery more than anything else. I can remember that during my PhD there were days together when I did not come back home. My children used to behave so differently when I was home. I think it is the sacrices of my family along with hard work and passion for surgery which has made me come so far,” asserts Dr. Deepak. “For Students I will say that try to identify areas which interest you most and then focus on the same areas and keep improvising and auditing your work. Always keep thinking ahead and keep pushing your boundaries while doing surgery. Also important is to develop a good and dedicated team and take them along for good patient care,” Dr. Deepak concludes.
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shared one of the moments of pride and joy that almost wet his eyes when one of his students recently got a Gold medal in the presentation competition at a national level conference. He has also been a visiting professor in the Mayo clinic, USA.
Dr. Deeepak joined PhD in GI Surgery at the Department of GI Surgery, AIIMS under the guidance of Prof Samiran Nundy after taking study leave. He also worked for almost a year without any honorarium or pay during this course. “I owe everything I have to my Alma mata. It is one of the finest training I have ever had in the Department he added. After completing his PhD in GI Surgery, he then joined GTB Hospital as Assistant Professor in Surgery. Fortunately, he got a break to become a consultant GI Surgeon at the PSRI Hospital of liver and digestive diseases. Here he started the Department of GI Surgery under the guidance of the then Director Prof B.N. Tandon. Then he went on to work at the Indraprastha Apollo Hospitals at New Delhi in 2004. Dr. Deepak’s academic interests led him to start DNB in GI
20 | March 2019 |
Surgery at this hospital in 2011. He was able to do this with all support from the Apollo Hospitals management in spite of lot of obstacles at every stage. “Since then, we have been having a good teaching program and have been able to develop our Department as one of the best private GI Surgical unit in the city and country at large,” he says. The department has been performing all major GI Surgical procedures and advanced laparoscopic procedures, apart from academics. In 2012 the hospital also acquired the Robotic surgery instruments and his team has performed many critical Robotic GI Surgeries since then. Experience as a Professor Teaching has always been his passion, he says, “I feel I have learnt a lot from my students. As a doctor, you feel good when your patient gets better and is discharged to go home. Similarly, a teacher is always happy when his student passes and performs well.” He
The Awards and Publications He has received the President’s appreciation award from the IMA, and additionally he has been felicitated at various forums. He has also received felicitations at the Apollo hospitals for patient care. “But I sincerely feel that my patients and their testimonials are the best awards for me,” he continues. He has written various papers which have been published in recognized national and international journals. Apart from these Dr. Deepak has various chapters in different books, to his name. His main areas of interest for publications and presentations have been related to pancreatic surgery and robotic GI surgery, especially colorectal surgery. He has also treated some rare and difficult cases successfully, which have been published Social commitment After seeing some young patients with colorectal cancer who came very late to him and also the rising incidence of this disease in our country, he felt the need and started a colorectal cancer research foundation. Through which he keeps holding free GI and colorectal cancer awareness programs, camps and public lectures. “This is a cancer which can be almost prevented with good diet and lifestyle and cured almost completely if detected and treated in time” he said.
Post Surgery
The Most Necessary Fuel for a Steady and Quick Recovery
22 | March 2019 |
Nutritious Insights
S
urgery of any kind is a traumatic event for the body. The stress and pain the body goes through needs to be accounted for during the recovery period. Proper food nutrition during this period is a must. The rate at which the and body recuperates depends on the amount of nutrients it receives.
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Diet The most important part to watch post your surgery. Strictly keep to the diet the doctor has recommended. The functioning of the intestines becomes a bit weak during this period. To keep a good and healthy bowel following a physician approved diet is a must.
Fluid and fibrous food Intake Make sure you keep yourself hydrated. Water, fruit juice, and coconut water should be an integral part of your daily diet. Keeping yourself hydrated will help with constipation. Fruits and vegetables, especially leafy vegetables, are ď€ brous foods, which aid in a combating constipation.
Small Portions Replace large portions with smaller, more frequent meals and snacks. This will give you energy at all times and help your body to recuperate faster.
Sugar and Alcohol Avoid the consumption of sugar in excess, cut off alcohol consumption completely, and also avoid processed foods altogether. They can be harmful for the health of the body and can worsen it further.
Loss of Appetite In case your appetite is low, ask your doctor for nutritional supplements. Holistic diets, with all the nutrients in a balanced form, are of utmost importance.
Protein Intake These help in boosting the healing process, gives you more energy, and strengthens your immune system.
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‘‘
journey Every g lori begins with a ous bright vision
‘
Dr. Kawita Bapat Consultant Obstetrician and Gynaecologist
28 | March 2019 |
Dr. Kawita WBapat
Marking her Excellence in the Gynecological domain
hat is Passion? Enthusiasm about something? A compelling desire? We hear a lot of people define this word differently, according to their own perception of it. But, one thing that’s common between all of them is the light in their eyes that comes when they talk of the thing they are passionate about. The ones who can turn their passion into their work are, probably, the happiest in their jobs. It is said that they are also highly productive. As Steve Jobs once said, “The only way to do great work is to love what you do.” One such dynamic personality, who turned her passion into her profession, is Dr. Kawita Bapat. She is a Consultant Obstetrician and Gynaecologist. “I would love to be a gynaecologist in the next 100 lives,” she says. Currently, Dr. Bapat is a Consultant and Medical Director of ‘One’, Center for Gynecological Excellence and Bapat hospital. She has been working for more than three decades for women’s healthcare in India. She is a highly experienced surgeon specializing in minimally invasive vaginal hysterectomy and advanced Gynaecological procedures with a record of more than 5000 hysterectomies in last 15 years. She is a recognized speaker with impeccable reputation, wellrenowned in local as well as international circuits, with patients from several countries visiting her for treatment. The Success Safari
Coming from a family of doctors, Dr. Bapat was fascinated by the day-in, day-out discussion of medical matters by her aunt, father, and grandparents. This started the fire in her; a fire to do something in the medical profession. To pursue her dreams, Dr. Bapat completed her primary medical education and bagged the degrees of MBBS and Master’s from Gajra Raja Medical
College, Gwalior (M.P.). She went on to reach miles and miles of success. She has been a fellow of ICOG. She has also been the Ex-President for FOGSI, Indore, and has been life member of ISCCP and IOGS. At present, she holds the post of Breast Committee Chairperson and ICOG governing council member. Dr. Bapat has been an active part of several government and NGO driven health programmers and also co-founded a NGO – ‘Rajabai Welfare Societies’. She has presented several of her works in prestigious symposiums and meeting at many national and international conferences and medical gathering. This multi-talented personality is actively engaged in teaching, research, and administrative activities related to gynaecology. She strives to provide quality healthcare to all the women of India and is known for her compassion for innovation and bringing new ideas in town. About ‘One’ Incepted in 1990, ‘One’, the Center for Gynecological Excellence, provides a full range of screening, diagnosis, surgery, care, executive gynaec check-ups, and preventive and treatment services specific to the women’s health. Here, from interventional gynecological to health maintenance and education, women are offered a broad spectrum of highly progressive treatments and compassionate care under one roof. The center is wellequipped with state-of-the-art equipment and guarantees hygiene, related to feminine health. At One, they believe in personalized, comprehensive service tailored to the patient’s gynaecological, reproductive, and pregnancy-related needs. Based in Indore, the center has a team of specialists with an
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abundance of knowledge as well as experience. One is dedicated to delivering best-in-class care to the women of all ages. Major Milestones in her Journey The most memorable achievement for Dr. Bapat, she says, was of removing an eight kg tumor. For her extra-ordinary dedication and work, she has been honored with many accolades. Some of the most significant awards that she received from the Government of India and other prestigious boards are Naiduniya Nayika Award and the Captain of Industry Award. She also made her place in the World Book of Records. But, according to Dr. Bapat, the most remarkable achievement remains the recognition that she gets from her own people. Her mantra for success is ‘Tirelessly working towards better, every day’. Overcoming the Challenges Speaking of the hurdles in the path, Dr. Bapat asserted, “Major challenges were bringing new technologies and making it aware, adapt, and implicated to the city. Another challenge is to do the things without financial support.” To counter these, she has been continuously upgrading herself and her hospital by reading, learning, attending, and teaching. She realizes that every branch in every industry sees more and more developments every day. She has ensured that she stays abreast of all the new advancements. Alongside, Dr. Bapat has led One zealously, helping it grow and branch in different areas. Although, being a surgeon is quite a tedious job, she has brilliantly maintained a proper balance between her personal and professional life. “If you love your job, things will automatically follow in line with the best partner and best of the kids,” she says.
31 | March 2019 |
Dr. Nadeem Niyaz Jan T Opening New Windows of Opportunity
“I solemnly pledge myself to consecrate my life to service of humanity”
his is the first declaration that a Doctor makes while stepping into the medical profession and is considered to be the brand ambassador of wellness and health across the globe. Saving a life is the biggest act of humanity and hence this profession holds a significant prominence in society. With the change of century and advent of the new-age, one thing which remains constant within Doctors is their commitment to challenge themselves every day. We present you the motivational journey of Dr. Nadeem Niyaz Jan who has managed to grab the eyeballs of the medical fraternity within the fastest possible time span. The popular saying “The beginning of everything is small” perfectly summarizes the initial journey of Dr. Jan. His family has played a significant role in shaping his life. The decision to become a Doctor was driven largely by values that were instilled by his Grandfather - Prof. Mohd Yousuf, alongside his parents. While his Grandfather constantly persuaded him showcasing the lucrative side of the medical profession, it was the pursuance and determination efforts of his parents who always wanted to see the prefix of “Dr” before the name of their son.
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He also honors and appreciates the invaluable contributions of his wife Dr. Anisa Nisar Jan in transforming his dreams into reality. Dr. Jan graduated with honors from ASCOMS Jammu in 2003 and thereafter he procured his Master’s degree in 2009 from the prestigious National Board of Education. He completed his fellowship in the field of vascular surgery at Edinburgh from the Royal College of Surgeons and later was awarded the Fellowship at the European board of Vascular Surgery, France.
and instead decided to be on a mission to offer something more to the society.
Assessing the current medical solutions, especially in the interiors, Dr. Jan was determined to offer lowcost vascular surgeries that would be more inclusive for patients with limited affordability and accessibility. He was the pioneer to perform a successful Laser surgery for varicosity in J&K at Triveni Nursing Home in 2010 with an all-inclusive price of 70K. If compared with the prices prevailing at metro cities at
Unveiling a New Chapter As a vascular surgeon, the ultimate challenge doesn’t get completed after a complex surgery, as in India, this branch of medicine is still gaining momentum and there’s a long road to cover! While his expertise and acumen in managing vascular issues are unparalleled in the state of J&K, Dr. Jan acknowledged that he needs to devote a considerable amount of time in educating the patients about the disease and the recovery process thereafter. Although he could have worked in any of the higher centers across the country, Dr. Jan didn’t want to get contended with the materialistic pleasures of the world
As surgeons, we have to be in the know. But, as human beings, sometimes it’s better to stay in the dark because, in the dark, there may be fear, but there’s also hope
The Most
ProďŹ cient Surgeons to Watch 2019
Dr. Nadeem Niyaz Jan Consultant Surgeon
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that time, the cost of this process would have been nothing less than 90K – 1.8L. Today he takes pride and feels gratified as he offers the same process at 55K – without compromising and degrading the standards of medical solutions that has eventually assisted a large number of patients to afford the treatment.
expanded. The Government can bring in changes in existing policies and reforms that can allow private players to extend their services and assist them by sharing the financial expenses which is a major constraint at this point of time.
Doctor’s Take on Current Scenario
Family virtues and his deep insight into this noble profession have given him loads of lesson and experience – that he is always willing to share with students aspiring to be the Nextgen Doctors. Keeping the essence alive, he asserts that “While money is important, it shouldn’t become a deterrent in providing care to patients, we should not forget that since time immemorial it’s been the most sought-after profession.” Dr. Jan describes this profession as a platform wherein a professional has the liberty to assist others, create opportunities for themselves and never step backward to accept unknown challenges. With the introduction of innovative techniques in the healthcare industry, redefined procedures, he suggests the budding professionals be optimistic as the medical fraternity is the most soughtafter profession that makes them self- reliant.
Dr. Jan is quite confident in saying that the medical profession is undoubtedly the most fulfilling profession. He relates himself with the idea of helping others regardless of circumstances and necessities. He strongly believes that as a surgeon, he is able to create a positive impact on the lives of his patients. He recalls the moments when his expectations met reality that changed the course of his dreams in the initial years – assist the needy, earn respect, decent life to name a few. As he stepped into the professional world, he was quick to realize that the “grass always looks greener on the other side.” He realized that there were huge gaps that stalled the medical solutions to reach the affected people in a seamless manner. Better infrastructure and latest facilities, doctor-patient ratio, differences between the private and Government players working towards creating a conducive environment are some of the burning issues that are unanswered. Offering a possible solution, Dr. Jan suggests that medical insurance to be facilitated and the network should be
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A Piece of Advice for the Beginners
Triumphing Over the Hardships Enlightening the tenacious journey, Dr. Jan opens up about the crucial curves of his life that made huge impact and dents to his life. However, as the saying goes – “the show must go on” Dr. Jan never thought of looking back and
struggled against all odds to realize the dream that his parents had seen. He was forced to face one of the hardest facts of life when he was pursuing his masters in surgery. His mother was terminally ill and passed away and this he counts as the biggest trauma of his life. His financial imbalance also proved to be a major hurdle as the stipend he earned was very meager. However as every dark night ends with a sunny day, his wife stood like a rock and supported him all through the hard times –both emotionally and financially. He remembers a saying to justify his thoughts – “I think you need to go through some stuff to really appreciate life and understand what it means to persevere, overcome and have faith. I think those tough times make you a stronger person.” Crossing the Horizons He admires the constant support from his wife and honors it as the greatest blessing from the almighty. Achieving new milestones, awards, and recognition, Dr. Jan hasn’t stopped and continues to give back something or the other to the society. He is associated with three NGO’s in J&K and Punjab that are working to spread awareness regarding various vascular ailments and offering treatments to the poor section of the society. He also runs an organization by the name of Varicose And More. Carrying a positive outlook of the future, Dr. Jan remains committed to be a contributor to the society by embracing the ethical values of the noble profession.
Techtrends
4
N I NOVATO I NS IN
SURGC I Technolog A L T H A T A R E y Patient Improving
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S
urgery is a field rife with innovation. New techniques, new technology, plus new ways of using existing techniques or technology, there’s always something new brewing in regards to advancements in this sector. Developments in optical imaging, robotics, artificial intelligence, IoT, virtual reality, and other high-tech advances contribute to greater precision and less invasive surgical techniques; the field is optimized to improve surgical outcomes by a significant measure in the near future. Here are just a few of the top innovations in surgery currently in use around the country.
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01
A True MARVEL for Brain Surgery • The Multi Angle Rear Viewing Endoscopic tooL or MARVEL is an endoscope with a miniscule 3-D camera attached • The camera is only four millimeters in diameter and 15 millimeters in length • MARVEL is designed for minimally invasive brain surgery • The technology emulates other stereo imaging endoscopes that are presently used for minimally invasive surgery in different parts of the body • The tool has provided hope that will enable surgeons to perform very intricate and complex surgery in a minimally invasive manner
02
Smart Surgical Glasses: Making Surgery Smarter
• Smart glasses have been around since 2012, but their use in the operating room still needs refining • These glasses use a “mixed reality method” • Researchers hope that Smart Surgical Glasses will soon become a fixed object in orthopedic surgery and other types of surgeries. • Smart glasses are essentially small computers, which include a head-mounted screen and video camera, and can be connected to the internet or other computers • Remote observation during surgeries by live video streaming, can be done with this tool • This will provide important images to surgeons during the procedures • Live stream video is being used for training classrooms, and recording procedures • Remote experts and trainees can record from their point of view, push diagrams, and charts to their eyes, and annotate that material in real time
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03
Surgical Robots with Artificial Intelligence: Integrating Robotics and AI
• Since the invention of the da Vinci surgical robot 15 years ago, inventors have continued to develop surgical robots that can perform increasingly precise movements • In the second generation of these robots scientists suggest that there will be a huge influence of Artificial Intelligence • These new robots are able to collect and analyze data • Robotics and AI are removing the human constraints and physical limitations on surgery and placement of innovative medicines • With ultra-high resolution robotic assistance, we can now consider the optimal site to place stem cells in the eye, brain, heart to drive regeneration • AI eliminates the restrictions inherent in a human being driving a robotic arm
04
Remote robotics • While telemedicine and robotics are nothing new, remote surgery is taking these concepts a few steps further • Surgeons may soon be using robots to assist with surgery from a remote location • This could help expand surgery options for patients living in remote areas • The Mayo Clinic is working on a clinical study to examine the possibilities of robot-assisted percutaneous coronary intervention (PCI), a process dubbed “telestenting” -Sayali Rane
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Dr. Palin Khundongbam Surgeon
Dr. Palin Khundongbam A Positive and Compassionate Leader Working for a Better Tomorrow 40 | March 2019 |
The Most
Proficient Surgeons to Watch 2019
D
r. Palin Khundongbam, an outstanding surgeon and a successful entrepreneur set to change the medical conditions for the people of Myanmar, believes, “Happiness is the only way to happiness. Unhappiness cannot solve our problems except draining our energy and enthusiasm. Unhappiness can be traced to the thinking of painful past experiences or the fear of the future. If we are conscious of our consciousness, we can remove these thoughts and be in the state of no thought but stillness or awareness at present. This is the time when we can innovate and succeed.” This positive spirit was very much fascinated by the grand stories of a few doctors and set out to pursue the profession. He bagged the degree of MBBS from RIMS, Manipur, and MS (General Surgery) and MCh (Plastic Surgery) from PGI Chandigarh. Beginning of Shija In the 1970s, Dr. Khundongbam saw that many patients from Manipur went to Dibrugarh and Alipore in Assam and CMC in Vellore for healthcare treatment. He realized people lacked trust in the local healthcare facilities. To rectify this situation, he started Shija Clinic, attached to a pharmacy at Paona Bazar, Imphal, in 1985, with minor operation facility and a side laboratory. Soon, Shija became a leader in piles treatment in eastern India by providing non-operative piles treatment facilities. The company grew and shifted to a rented, bigger, 9bedded hospital on RIMS Road in 1988 and later
SET TO BRING POSITIVE CHANGE “Resistance to change is the major challenge we face in the journey of Shija,” says Dr. Khundongbam. “We resist change for fear of uncertainty. We have been conditioned to think the same way right from the childhood period and developed a deep rooted belief system. We have been successful in changing the culture to some extent, but the war is not over until the war is over.” Due to the efforts taken by him and the organization as a whole, their relationship with the patients and their relatives has improved. Having started the journey with a strong passion, they at Shija continue to put the organization into system without losing that passion. Through all the challenges in his way, Dr. Khundongbam has stayed highly motivated and emerged out better and better. Talking about this growth and what drives him, he asserts, “Gradually, we have become more spiritual than ever. We, now, realize that our thoughts are energies and will be manifested externally. We are responsible for our own thoughts and thus the destiny.” He continues, “My relationship with the present moment is my motivating factor. It is the only space we have, nothing else. Everything in life unfolded in the now.” Dr. Khundongbam was a part of the surgery which set a Guinness World Record in April 2004. A ten days baby boy, weighing 3 kg, came in with a huge neck swelling and had a neck tumor. The tumor weighed 1.2 kg and they removed it successfully. The baby tolerated the major surgery well and recovered. The tumor was of 40% of the total body weight (TBW) and was the largest neck tumor ever excised successfully in the world. In 2004, they received the certicate for setting a new Guinness World Record and it was published in the book in 2006.
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Power comes from the consciousness of the power within
expanded to 35-bedded multi-specialty hospital in three different rented buildings across the road. To overcome the structural and environmental problems, Shija visualized its own land with proper hospital architect and shifted to the current eco -friendly location, Langol, at the outskirts of Imphal. Today, Shija has become a 250-bedded NABH (Pre-Entry) super-specialty hospital, having 25 departments with 880 dedicated care givers, post graduate DNB Courses in 5 departments, nursing, and paramedical institutes. It also has NABH Blood Bank and NABL Laboratory. Shija Foundation, an NGO, runs Shija Blood Bank, Smile Train Shija Cleft Project, Shija Eye Care Foundation, Shija Oxygen Plant, Shija Academy of Nursing and Shija Paramedical Research Academy. Over 3500 cleft lip and palate patients have been operated free of cost and given smiles on their faces under Smile Train, USA in Manipur, neighboring states and country of Myanmar. More than 12000 patients with cataract blindness have undergone free surgeries. Relentlessly Contributing to Enhance Care Dr. Khundongbam performs around 100 cosmetic and reconstructive surgeries every month. He is, probably, one of the doctors performing highest number of Asian eyelid surgeries in India and at the same time looks after
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the organization for growth through innovative actions. Till date, Dr. Khundongbam has successfully done 339 free operations for cataract, cleft lip and palate, and keyhole surgeries in the much needed country, Myanmar, under the Shija Mission Myanmar. Customer needs and demands are the strong source of enthusiasm for him, to upgrade the facilities. Trust deficit in the local empathy and facilities has given him positive energy to bring more modern humane technologies in the state. He believes, “If there are thousand disadvantages, there will be thousand advantages also. It all depends upon how you look at the situations. I address the advantages we have in Manipur, rather than disadvantages we popularize.” Take on Recent Developments in Healthcare About the latest developments in this industry, Dr. Khundongbam says, “The diseases which cannot be treated are tolerated. More and more illnesses which were once considered incurable are now curable with the advancement of newer technologies and human skills. It is also, now, realized that our different thoughts release different chemicals in the body and our cells respond to the chemicals. We are directly or indirectly participating in the disease or healing processes of the body. We may be able to halt the aging or reverse it one day.”
A
dreamer is a soul that dares to see the future, to realize the ambitions, and to hope. However, to shape these dreams into a reality, it takes more just courage. As an American statesman and four-star than general of the US once rightly said, “A dream does not become a reality through magic. It takes sweat, determination, and hard work.” One such passionate personality, who with his continuous hard work and dedication achieved everything he dreamed of and more, is Dr. (Prof) Raju Vaishya. “I have experienced that the hard work, a focused approach, commitment, and passion are the critical ingredients for success in life. Thomas Edison once said ‘there is no substitute for hard work’, and it is undoubtedly the stepping stone to success. Hard work does not go waste, it gives a sense of satisfaction and makes one disciplined in life,” he believes. He is a Professor and Senior Consultant in the Department of Orthopaedics & Joint Replacement Surgery at Indraprastha Apollo Hospitals, New Delhi. Dr. Vaishya has bagged an endless number of awards, in both academic and non-academic areas, has more than 300 publications, in peer-reviewed and indexed medical journals. He is also engaged in the editorial board of several reputed medical journals and has many more such achievements. He has also featured in the Limca book of records four times, for his clinical achievements. He has completed his primary medical education (MBBS, MS) from Gajra Raja Medical College, Gwalior (India), and subsequent higher super specialty training and education (MCh, FRCS) from the UK. He has had an outstanding academic career throughout. Dr. Vaishya has been working at Indraprastha Apollo since 1996, where he is involved in patient care, teaching, and research. He is the team leader of his unit, comprising of seven to eight younger surgeons. Their practice focuses on the management of complex Orthopaedic cases like
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crippling arthritis, sports injuries, problematic and challenging fracture cases, and so on. Dr. Vaishya has been running a training program for the younger Orthopaedic surgeons for two decades and has trained hundreds of such doctors from abroad and India. The Journey to Success According to Dr. Vaishya, his desire to obtain adequate education and experience before jumping into the real practical world was of immense benefit in his later professional life. He completed the most coveted and prestigious degree of MCh (Orth) from Liverpool University, UK, at the age of 30 years only and became the youngest to do so. Also, during his training at the Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, UK, he was awarded the Professor’s gold medal for the best research. Soon, after completing his higher surgical training and education in England, Dr. Vaishya returned home, in the quest to serve to his countrymen. “It was quite challenging to start and practice what I learned, in my home town Gwalior. Hence, I decided to move to Indraprastha Apollo Hospitals, New Delhi, on the suggestion of Shri Madhav Rao Scindia (our Member of Parliament) and was appointed as a Senior Consultant Orthopaedic Surgeon, at the age of 36 years only. From here, there was no looking back. I worked tirelessly hard in Delhi, but also did not disconnect with my roots in Gwalior, where I have been still visiting regularly for the past 22 years,” he says. Due to his clinical innovation, research, and publication work, Dr. Vaishya was awarded the title of an adjunct Professor of Orthopaedics by Apollo Hospital Educational Research Foundation (AHERF). Later on, the Royal College of Surgeons of England honored him giving the prestigious FRCS for his contributions toward medical field.
The Most
ProďŹ cient Surgeons to Watch 2019
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Driving Motivation from Within Talking about what motivates him to work tirelessly towards better every day, Dr. Vaishya said, “I have a passion for serving humanity, through my profession. I feel that self-worth, self-esteem, and self-satisfaction are the main intrinsic motivating factors, which drive me to exceptional work performance. Setting individual targets and goals have also helped to enhance the performance. I believe that developing our motivation depends on recognizing our achievements and celebrating successes in order to keep us heading towards our goals.” He added, “However, sustaining the motivation is not easy, and I found that one way of doing it is by sharing our skills by coaching others to achieve their potential.”
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Other than that, all of Dr. Vaishya’s family has a significant role to play in supporting him throughout his professional journey. His better half, Pallavi, encourages him to deliver the best in his work. His father, Dr. P.D. Vaishya was a leading physician and his mentor, who taught him the ethics and moral values in dealing with the patients and their families. Advice from the Wise Achieving all that he has today, Dr. Vaishya is an inspiration to many. He believes that leadership lies in producing more leaders, not followers. Guiding the young, upcoming doctors, he says, “Stay focused, go after your dreams and keep moving toward your goals. It may be a rough road that leads to the heights of greatness. It is not enough to have a good mind; the main thing is to use it well. Try to help others; if you cannot do that, at least do not harm them. Thomas Jefferson rightly said, “it is neither wealth nor splendor, but tranquility and occupation which gives happiness.” Empathy and commitment towards your patients and colleagues are crucial ingredients for being famous and successful. Last, but not the least, Ethics and Morality are the two main pillars for success and goodwill and must, therefore, be strictly followed.”