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Volume III || Issue III || Sept-Oct 2012
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WORLD HEART DAY
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July–Aug 2012
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Editor speak Volume-III Issue-III Sept-Oct 2012
Editor Dr. m.a. Kamal Chief Editorial Adviser Dr. Pradeep Bhardwaj
Chemotherapy Clinic Market in India Is Forecast To Reach A Value of $76.9 Bn by 2013 Representing A CAGR of 5.1percent (2007-13)
National Head Afzal Kamal Sr. Manager I.A Khurshid Cheif Correspondent SA Rizvi l Dr HN Sharma Design and Layout Mohd. Javed Ahmad
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his report covers the chemotherapy clinic industry in India. Chemotherapy in its literal sense refers to a particular treatment that is used to kill micro organisms or cancerous cells to treat a disease and in simple terms Chemotherapy is a treatment method used to treat cancer. Cancer is a disease that is known to almost everybody around the world, yet the complete cure to it, is not very well known to either the common man or the medical professionals. Every year more than 10 million people are diagnosed with some form of Cancer and the most commonly used treatment for it is Chemotherapy. Chemotherapy most commonly treats cancer by killing the cancerous cells that divide rapidly and many a times this treatment also affects the normal cell division process. The global cancer market was worth $56.7billion in 2007, growing at 16.8 percent over 2006, and is forecast to reach a value of $76.9 bn by 2013 representing a CAGR of 5.1percent (2007-13). Oncology is one of the leading therapeutic categories in the global pharmaceutical market and two classes of anticancer drugs represent some of the top 10 global drugs, these are antineoplastics and immunostimulants. The top 10 global cancer brands account for nearly 45 percent of global pharmaceutical sales at $25.7 billion. Have an insightful reading. Your suggestions are most welcome! E-mail: editor@medgatetoday.com
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Sales and Marketing Amjad Kamal Rahul Ranjan Neetu Sinha S.Y Ahmed Khan Subscribtion & Cirrculation Pallavi Gupta All right Reserved by all everts are made to insure that the information published is correct, Medgate today holds no responsibility any unlikely errors that might occur.
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Contents Volume-III Issue-III Sept-Oct 2012
NEWS UPDATE Cancer Treatments Top New Drug Approvals ................................... 6 Aspirin Not Associated with Breast Cancer Risk ............................... 6 Oesophageal Cancer Rates Link to ‘Mystery’ Calander .................... 7 Bone & Joint Day 4th Agust 2012 ..................................................... 12
COVER STORY Prevention of Heart Disease - Dr. Naresh Trehan .............................. 18 Woman & Heart Surgery - Dr. Pavan Kumar ..................................... 20 Minimal Invasive Heart Valve Surgery - Dr. Lalit Kapur .................. 23
DOCTOR SPEAK Ignorance Increasing Cancer... - Dr. Rajiva Kumar ........................... 26 Conquering Cancer - Dr. Sudeep Gupta ............................................ 28 Psychological Approches for Chronic Pain - Dr. Divya Parashar ..... 30
EXPERT VIEWS Ask a Question from Health Care... - Dr. Pradeep Bhardwaj............. 34 Helth Technology Innovation ............................................................. 36
PRODUCT LINE Digital 12 Channel ECG Machine - Scientech 13B .......................... 38
EXHIBITION SPECIAL ............................................................................................. 6
40 - 51
Sept–Oct 2012
NEWS UPDATE
Mazor Robotics Enters India With Distribution Partner Advanced Medaical Systems PTE Ltd.
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enaissance System to be Installed in Apollo Hospitals Chennai -Mazor Robotics Ltd. A developer of innovative surgical robots and complementary products, today announced that Advanced Medical Systems PTE Ltd. (AMS), Mazor’s distribution partner in India, placed an order for its Renaissance™ system. The system will be installed in Apollo Hospitals Chennai. “I’m very pleased that Apollo Hospitals Chennai is the first hospital in India to offer this state-of-the-art robotic system for spine surgeries” said Dr. Sajan K Hegde, Chief Spine Surgeon. “The technology is truly revolutionary and will be a vital tool in performing safely, with precision challenging cases requiring complex reconstruction, besides the routine and minimal invasive procedures.” non-use, neither past nor current aspirin use was associated with overall breast cancer risk.
Cancer treatments top new drug approvals
M
ore new treatments have been approved for cancer over the past ten years than any other health area, a new report reveals, ahead of cardiovascular and gastrointestinal disorders. One hundred and fifteen new cancer medicines were approved between 2002 and 2011, accounting for about 30% of all drug approvals. Treatments for lung, colorectal, prostate, cervical and breast and skin cancers made up around half of the cancer drug approvals.
Aspirin not associated with breast cancer risk
R
egular use of aspirin, NSAIDs and paracetamol are not associated with an increased risk of postmenopausal breast cancer, finds an observational study which followed women for nearly three decades. Using the well-known Nurses Health Study, the authors tracked 84,602 cancer-free women from 1980 until 2008, prospectively collecting data on analgesic use through biennial questionnaires. During the 28 years of follow-up 4,734 cases of incident invasive breast cancer occurred. Compared with non-use, neither past nor current aspirin use was associated with overall breast cancer risk.
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Sept–Oct 2012
Oesophageal cancer
rates linked to ‘mystery’ calendar pattern
G
lobal rates of oesophageal adenocarcinoma have reached near-epidemic heights and researchers believe the trends stem from an environmental introduction dating back to the 1950s. In a world first, a multinational study published in Gut has found the 30-year increases can be more conclusively linked to a mystery calendar-related factor rather than generational determinants. The researchers said the epidemic began somewhere between 1960 and 1990, but the date varies between countries and states, which led them to speculate that the environmental factor was first introduced in Europe and later spread to America and the rest of the world. Over the thirty year period, the average annual increase ranged from 3.5 per cent in Scotland to 8.1 per cent in Hawaii. “It seems reasonable to hypothesise that effects of a strong,
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NEWS UPDATE
The Industry Gives MEDICALL 2012 a Warm Welcome 3rd to 6th August 2012 at Chennai Trade center, Chennai
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edicall was exactly what the doctors ordered. Held recently from 3rd to 6th August 2012 at Chennai, it attracted professional visitors and manufacturers under one roof in large numbers. For the first time in India, MEDICALL organized a Fashion Show on Hospital Garments in cooperation with NID – National Institute of Design, Ahmedabad. This Fashion Show on Hospital Garments was a huge success and was very well received by the industry. MEDICALL is one of the premier medical equipment expo in India was amply proved. Being held in Chennai for the 9th time, MEDICALL had 500 medical equipment manufacturers from India, Czech Republic, Germany, Taiwan, Korea, Singapore, China, Italy etc. A wide range of medical equipment and technology product was displayed to over 8500 serious business visitors from all over India, South Africa, Nigeria, Srilanka. Medicall offered 4 days of focused business platform to explore business opportunities to an exclusive B2B audience. 10th Edition 7th to 9th Feb. 2013
Medicall 2013
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NEWS UPDATE
Masimo’s Noninvasive Pleth Variability Index
as Accurate as Invasive Stroke Volume Variation for Fluid Responsiveness Assessment in Cardiac Surgery
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new study in the Journal of Anesthesia demonstrates that for fluid responsiveness assessment, Masimo’s noninvasive Pleth Variability Index (PVI®) is as accurate as invasive stroke volume variation (SVV) in patients undergoing cardiopulmonary bypass surgery.1 In the study conducted at the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, researchers evaluated 18 patients who underwent elective cardiopulmonary bypass surgery. All patients had a central venous catheter as well as a femoral arterial catheter monitored with the PiCCO monitor (PiCCO2; Pulsion Medical Systems) for continuous measurement of SVV and intermittent assessment of cardiac index. PVI was measured using the Masimo Radical-7® monitor. Fluid responsiveness was defined
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as a >10% increase in cardiac index after fluid administration and non-responsiveness was defined as <10% increase in cardiac index after fluid administration. Out of 22 fluid challenges, four resulted in a significant increase in cardiac index, while 18 did not. The optimal threshold value for fluid responsiveness was ≥11% for SVV and ≥16% for PVI. Both PVI and SVV correctly identified each of the four responders (100% sensitivity), while PVI identified 16 of 18 non-responders (89% sensitivity) and SVV identified 13 of 18 non-responders (72% sensitivity). Receiver operator characteristic curve analysis, which takes into account both sensitivity and specificity, showed a 0.95 area under the curve (AUC) for PVI and 0.87 AUC for SVV (p=0.31 for difference between PVI and SVV). Central venous pressure was a poor predictor of fluid responsiveness, with an AUC of 0.19. The authors stated that both PVI and SVV are “much more valuable for prediction of volume responsiveness than CVP” and that PVI “is of high value, especially regarding sensitivity and negative predictive value. Thus, volume responsiveness is not to be expected when PVI is low.” Fluid administration is usually the first intervention in hemodynamically unstable patients to improve status and enable end organ preservation. Fluid is given to increase a
patient’s cardiac output, but only about half of critically ill patients actually increase cardiac output after fluid administration. Unnecessary fluid administration should be avoided because it’s associated with increased morbidity and mortality.4 Clinical decision making is challenging using traditional invasive measurements such as central venous pressure, stroke volume/index, cardiac output/ index, and pulmonary capillary wedge pressure, as they have not been shown to predict fluid responsiveness. Newer, dynamic indices such as SVV and pulse pressure variation can accurately predict fluid responsiveness and improve outcomes, but are invasive and/or complex and have a high procedural cost, estimated to be about $225 with an SVV monitoring system in one cost analysis. PVI is also a dynamic measurement of changes over respiratory variations, but does so with the Masimo SET plethysmograph waveform instead of the arterial waveform. In contrast to other available methods, PVI is noninvasive, easy to use, and has no incremental procedural cost because pulse oximetry monitoring is already performed on all surgical and intensive care patients. No other pulse oximetry technology provides a parameter like PVI. Once Masimo SET® pulse oximetry or rainbow® Pulse CO-Oximetry™ with PVI is available in a hospital, it can be utilized in all patients. July–Aug 2012
NEWS UPDATE
Country celebrates its first
“Bone & Joint Day” on 4th of August 2012
T
he Indian Orthopaedic Association (IOA) is proud to announce the country’s First “Bone & Joint Day” on the 4th of August 2012, to commemorate the day when the IOA Charter was signed in 1955.
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cost of these road crash injuries is 3 per cent of our GDP which is almost Rs.550 Crores every year. The financial implication of treating these problems is estimated to be rupees 7 lakh crores.
The announcement of the Day along with the declaration of all the activities performed by IOA was done during a function today at New Delhi. Justice Shri P Sadasivam, Judge, Supreme Court of India was the Guest of Honour & Shri S Gandhiselvan, Minister of State for Health & Family Welfare was present at the occasion.
“Improper management and resultant disability place a huge strain on the economic and social fabric of the family and the society at large. A huge number of accidents can be prevented by public awareness and education programmes which can be focused around an Orthopaedic Day,” said Dr.S.Rajasekaran, President, Indian Orthopaedic Association.
Trauma has become a giant killer of mankind and official statistics show that more than 1,20,000 people die and 10 times more citizens sustain serious injuries every year. This disease load is much more than many other diseases. There is one death due to road accidents every five minutes and much of the outcome depends upon the proper treatment given to the patient. The
According to WHO, musculoskeletal diseases are the major causes of disability in mankind. This is especially so in developing countries like India where there is a huge load of neglected sequelae following bone and joint infections and developmental dysplasias. With an ageing population, more than 2 million fresh cases with severe debilitating arthritis or low back pain are added every year. Sept–Oct 2012
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NEWS UPDATE
Global pharmaceutical regulatory affairs specialist ELC Group increases operational support in Ahmedabad
ELC Group continues Indian expansion with move to new, larger offices in key regional centre
E
LC GROUP, the global pharmaceutical regulatory affairs organisation, today announces that it has established new, larger offices in Ahmedabad, India, to support its continued growth in the region. The new Ahmedabad office will host a growing senior team of regulatory affairs professionals, providing expert support and consultancy across ELC Group’s global service portfolio of specialist regulatory affairs consulting and commercialisation services. The expanded base in Ahmedabad follows ELC Group’s announcement earlier this year of a newly-opened office in Mumbai, located in the world’s largest pharmaceutical hub. The new Ahmedabad operation is staffed by a highly experienced team of RA experts for pharmaceuticals drugs, plus key business development teams focused on
FDA extends review for Pfizer arthritis drug by three months
16
regulatory compliance, medical devices and pharmaceuticals. The new Ahmedabad office is also the centre for ELC Group’s REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) services. From its new location, the expanded REACH support team will continue to deliver EU chemical regulatory compliance services to ELC Group customers worldwide. To support the growth in customer demand for its services, ELC Group has active plans to expand both its REACH and regulatory affairs teams based in the Ahmedabad office, including the recruitment of medical writers, Medical Device experts and a head of Business Development for the entire South-Asian region. The company is also looking for qualified candidates to support the launch of an interim staffing
solutions services capability next year. Commenting on the opening of the new, larger Ahmedabad office, Marco Rubinstein, CEO of ELC Group said: “The opening of larger offices in Ahmedabad is a key milestone for ELC Group, allowing us to expand our senior RA team and providing a solid base from which to extend the breadth of our service offering to our global customers.” He added: “We count among our customers the biggest pharmaceutical companies in India, and Ahmedabad sits at the centre of India’s huge chemistry industry. This expanded regional presence enables us to provide first-class support for our customers’ projects in Europe, as well as new projects across South Asia, including in fast-growth countries such as Indonesia, Vietnam and Thailand.”
T
If approved, the pill could offer a more convenient alternative to Abbott Laboratories Inc’s $8 billion-a-year injectable medication Humira. The FDA now views the additional analysis as a major amendment to Pfizer’s application for approval, and set In July, Pfizer disclosed that a new November 21 deadline for the FDA sought a “routine” anal- reviewing the drug, the company ysis of clinical trial data for the said on Tuesday. It did not give drug that could delay a decision more details of the data analysis by three months or more beyond it provided. the agency’s August 21 deadline. he U.S. Food and Drug Administration extended by three months its review of Pfizer Inc’s experimental rheumatoid arthritis treatment tofacitinib, one of the most promising new drugs in the company’s pipeline.
Sept–Oct 2012
COVER STORY
INDIA’S RENOWNED HEART SURGEONS
Dr. Devi Shetty
Dr. Naresh Trehan
Dr. Ramakant panda
Dr. M. Khalilullah
Narayana Hru Dayalaya Bangalore
Asian heart Institute Mumbai
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Medanta-The Medcity Gurgaon
The Heart Center New Delhi
Dr. Pavan Kumar
Nanvati & Lilavati Hospital Mumbai
Dr. Lalit Kapoor
B.M. Birla Heart Institute Kolkata
Sept–Oct 2012
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COVER STORY
PREVENTION OF HEART DISEASE IN WOMEN AND CHILDTREN
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lthough heart disease is usually diagnosed in adulthood, its roots often begin in childhood. Researchers have demonstrated that deposition of cholesterol in the walls of the arteries starts very early in life, even before 10 years of age. Heart disease is therefore is the result of a life long process and therefore strategies for its prevention should begin in childhood itself. Several studies have been carried out in young people which have revealed that high cholesterol levels, specially LDL, which is the bad cholesterol, are predictive of the degree of blockages that develop later on. Childhood obesity is another important risk factor as excess weight tracks from childhood to adulthood, particularly from adolescence to adulthood. High blood pressure is often missed in children and should be looked for specially when there is a family history of hypertension. It has been demonstrated that children who ate 4 or more servings of fruit and vegetables every day had lesser chances of developing high blood pressure. Lack of exercise and physical activitiy also contribute to a higher incidence of obesity and hypertension. The incidence of smoking is unfortunately on the rise in our children and needs to be strongly discouraged. In women the incidence of heart disease is less than men till menopause
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but 5 years after menopause it becomes identical. Being aware of the risk of the heart disease is important, because it is the first step in taking action to lower the risk. By and large the risk factor for the women are same as in men which are: z z Family history of heart disease below the age of 60. z z Diabetes z z High blood pressure z z Smoking z z Lack of physical activity z z High cholesterol z z Overweight Thus the life style changes required are: z z Stop smoking cigarettes and avoid secondhand tobacco smoke. z z Get at least 30 minutes of physical activity each day. z z Eat a heart healthy diet that includes fruits, vegetable, grains, low fat or nonfat dairy products, fish, pulses and sources of protein low in saturated fat (such as poultry, lean meats and plant sources). Limit intake of tans fatty acids such as those found in hydrogenated oils. z z To maintain a healthy weight, balance the calories you eat with amount you use up each day. To lose weight, you need to use up more calories than you take in. if you need to, enroll in a formal weight-loss program. Dr. Naresh Trehan
Medanta-The Medcity Gurgaon
Septâ&#x20AC;&#x201C;Oct 2012
COVER STORY
WOMAN & Heart Surgery Dr. Pavan Kumar is a cardiac surgeon from Mumbai. He has successfully performed over 10,000 open heart operations besides being associated with over 12,000 major cardiovascular procedures.
“The number of cardiovascular diseases among women in India is rapidly increasing. Cardiovascular disease is the leading cause of death among Indian women, accounting for 17 percent of female mortality. It is a misconception that women usually suffer from breast cancer, but not heart disease. But the fact says that heart disease kills twice as many women as all cancer combined. Women are six times more likely to die of heart disease as of breast cancer” -Dr. Pavan Kumar
M.S,M.Ch. (Cardiovascular & Thoracic), F.I.A.C.S. Consultant Cardiac Surgeon & Head of Department of Cardiovascular Surgery & telemedicine, Nanavati Hospital, Mumbai
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Sept–Oct 2012
COVER STORY
E
very year thousands of mothers, daughters, sisters and wives die due to various heart problems. Statistics indicate that, worldwide 8.6 million women die from heart disease each year, accounting for a third of all deaths in women. 267,000 women die each year from heart attacks, which kill six times as many women as breast cancer. Another 31, 837 women die each year of congestive heart failure, representing 62.6% of all heart failure deaths. The biggest myth among people which says that “only men are at the risk of having heart disease” has been busted, as it is stated that since 1984, more women than men have died each year from heart disease and the gap between men and women’s survival continues to widen. Also, women are twice as likely as men to die within the first few weeks after suffering a heart attack. The scenario is no better in India too. The number of cardiovascular diseases among women in India is rapidly increasing. Cardiovascular disease is the leading cause of death among Indian women, accounting for 17 percent of female mortality. It is a misconception that women usually suffer from breast cancer, but not heart disease. But the fact says that heart disease kills twice as many women as all cancer combined. Women are six times more likely to die of heart disease as of breast cancer. The myth which says, “If you do not have a family history of heart disease, you are safe” needs to be dispelled. The fact shows that today even the women without any family history of heart disease are also prone to it due to various factors such as the changing lifestyle patterns, adoption of western food habits, and high levels of stress at both home and office. Other reasons are high blood pressure, high cholesterol, diabetes, menopause, metabolic syndrome, high sodium intake, physical inactivity, use of contraceptives and low estrogen levels. Habits of smoking and drinking among urban women increase the risk of various heart problems. Women who smoke are at a higher risk of having a heart attack 19 years earlier than non-smoking women. Due to hypertension, women tend to experience a risk of developing chronic heart disease (CHD) 3.5 times than that of females with normal blood pressure. High blood pressure is more common in women taking oral contraceptive pills, especially in obese women. Also, diabetes
Sept–Oct 2012
23
COVER STORY
doubles the risk of heart diseases in women, affecting more women than men after the age of 45. It is said that arteries of Indian women are narrower as compared to men hence they are at a higher risk of coronary diseases.
en. Also, women over the period of time learn to bear pain in the form of menstrual cramps, pregnancy and child birth, thus they often tend to ignore pain related to heart diseases and mistaken it as a normal pain.
When it comes to symptoms of cardiac diseases in women, it needs to be noted that they aren’t the same as in men and often require close attention. The symptoms are usually subtler in women. Unlike in men women do not have the symptoms of severe chest pain and pain down the left arm.
It is a wrong belief among people that only older women have heart disease. But, any women even as young as 30-40 years of age can suffer from heart problems. The rate of sudden cardiac death of women in their 30s and 40s is increasing much faster than in men of their same age. Nowadays women in their child-bearing age who regularly take birth control pills are becoming more prone to heart ailments. Women above the age of 65 suffer from silent heart disease, showing no symptoms. Here the heart disease comes as a silent killer among older women. Also the rate of CVD is 2-3 times higher in women who have undergone menopause than those of the same age who haven’t.
As an old saying goes, “prevention is better than cure”, with few simple tips one can prevent cardiovascular diseases. With the soaring prices of heart operations it is rather better to adopt some preventive measures in advance to avoid the onset of the diseases in future. Smoking should be avoided as nicotine is harmful for heart. One should follow a proper diet plan and reduce the intake of transfatty acids as they increase the bad cholesterol that is LDL and decrease the good cholesterol that is HDL. Other than this one should regularly exercise for at least 30 minutes to keep the heart healthy. Also reducing the psychological stress helps a lot. Yoga and meditation could be done to have a peaceful mind.
The biggest challenge for women suffering from heart diseases is to get the appropriate diagnosis. The treatment for CVD is different for various heart diseases depending upon the age of the patient, stage of the disease and complications involved. Only after that it is possible to provide the required medical treatment. If the disease is in its initial stage it could be cured by taking drugs which would reduce the symptoms of heart disease and lower the risk of having any further complications. But if the disease has advanced it
It is estimated that India has the largest burden of cardiovascular disease in the world. An estimate 50-60 millions Indians, suffer from cardiovascular diseases and approximately 25-30 lakh of these people die every year because of cardiovascular diseases in our country. It is projected that if not controlled now, it will increase in an epidemic form by 2015. It is the need of the hour to generate more awareness among people about the various heart diseases and the necessary precautions that one should take.
Some of the early symptoms are fatigue and weakness, shortness of breath, vomiting or nausea, anxiety, dizziness and disturbed sleeping patterns. Signs of coronary insufficiency include discomfort in the chest, indigestion, pain or tightness in the chest that spreads to the jaw, neck, shoulders, ear, or the inside of the arms, gastro- intestinal problems and chronic headaches. Women are prone to heart problems later in life as compared to men, but suffer with worse impact. According to statistics, men suffer from heart diseases ten years earlier than women, but they recover more easily. But as women get older, various problems like high blood pressure, obesity and high cholesterol along with menopause tend to create a more serious impact on the heart disease. This hence develops a critical heart problem in most of the wom24
may require surgical therapies like bypass or angioplasty. Implants like artificial heart valves and pacemakers are now being used in order to provide a healthier life after surgery.
Sept–Oct 2012
COVER STORY
Minimal invasive Heart Valve Surgery
M
ost patients are frightened when they think about cardiac surgery. They perceive it as a very elaborate procedure with substantial risk and discomfort. With the advancement in technology and the field of medicine, cardiac surgery has come a long way and become very safe and convenient. It now promises numerous benefits to the patients and Sept–Oct 2012
gives them long productive lives.
invasive surgery to the patients.
Currently a lot of focus is being given on a new technique called the “minimal invasive cardiac surgery”. This procedure involves approaching the heart through a small incision on the chest to achieve the above goals.
Mr. Munna Rajbansi from Gaya, a manual laborer by profession Bihar was one such candidate who benefited hugely from this surgical technique. After the death of his father, Mr. Rajbansi had been unable to take up his father’s job as a loader, which involved heavy manual work due to recurrent complaints of shortness of breath. He was diagnosed with
Dr. Lalit Kapoor at B M Birla Heart Research Centre, Kolkata routinely offers such minimally
25
COVER STORY
a leaking aortic valve. Not only was he losing his wages, but was also in danger of not being given ‘permanent status ‘ on account of the disease. He was afraid that a surgery of that scale which required a big incision might not enable him to return to his heavy labour soon. All his apprehensions were put to rest when the surgeons decided to perform a minimal invasive AVR on him. By means of this special technique the patient’s heart was approached by through a small Partial upper incision on the breast bone. The normal procedure, which is a full sternotomy (cutting of the breast bone) involves a 10 inch incision through the middle of the chest. Since the full sternotomy could be avoided, the wound healed up within a few days and the pain and discomfort went away. This is in sharp contrast to the much longer 3-4 weeks time the patient usually takes to return to a fully active pain free life. He is now confident of being able to undertake his previous job within the next three weeks and hopes to get “permanent” soon.
Aortic Valve Replacement 26
His sheer excitement post surgery intermingled with a sense of immense gratitude and thankfulness towards Dr. Kapoor for giving him this new life. The patient went back with a newfound belief that “cardiac surgery is unnecessarily feared.” Sept–Oct 2012
COVER STORY
Minimal Invasive
Normal Surgery
Mitral Valve Replacement This new technique of surgery has become a regular method of open heart surgery for such defects at B M Birla Heart Research Centre, Kolkata.
a variety of operations. A similar technique can be use for Mitral Valve replacement and closure of “hole in the heart”. Even Bypass surgery has been performed through a left sided minimal inciDr.Lalit Kapoor – Cardiac sur- sion. The advantages of the procegeon of the institute is regularly us- dure are three-fold. One the length ing this technique for performing of stay in the hospital is shorter, Sept–Oct 2012
Secondly there is less blood loss and less pain. And most important you can say “good-bye” to the disfiguring scar in the centre of the chest. Women are now coming forward and demanding such an approach. 27
DOCTOR SPEAK
Ignorance
Increasing Cancer Cases
Among Children
Dr. Rajiva Kumar
Child Specialist, Muzaffarpur
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Cancer is the second leading cause of death among children between one and 14 years of age. Accidents are the most frequent cause of death in this age group. The most commonly occurring cancers in children are Burkittâ&#x20AC;&#x2122;s lymphoma, leukemias (in particular, acute lymphocytic leukemia), tumors of the central and sympathetic nervous systems, lymphomas, soft-tissue sarcomas, and renal tumors. Septâ&#x20AC;&#x201C;Oct 2012
DOCTOR SPEAK
B
urkitt’s lymphoma (or Burkitt Lymphoma) is an uncommon type of Non-Hodgkin Lymphoma (NHL). Burkitt’s lymphoma commonly affects children. It is a highly aggressive type of B-cell lymphoma that often starts and involves body parts other than lymph nodes. In spite of its fast-growing nature, Burkitt’s lymphoma is often curable with modern intensive therapies. Most children coming are first diagnosed and treated for malaria while others seek treatment from traditional healers, who cut the patient to access the disease. Some of the signs apart from having HIV include high fever and temperatures in the children, awful smells of the mouth and joint pains. The gums and teeth are also pushed out due to the tumor. In such cases I use to refer an oncologist. Types of Burkitt’s lymphoma: There are two broad types of Burkitt’s lymphoma – the sporadic and the endemic varieties. There is a very high incidence of this disease in equatorial Africa, and disease in this region is called endemic Burkitt’s lymphoma. Disease in other regions of the world is much less common, and is called sporadic Burkitt’s lymphoma. Though they are the same disease, the two forms are different in many ways. Endemic Burkitt’s lymphoma: Sept–Oct 2012
In equatorial Africa, about half of all childhood cancers are Burkitt’s lymphoma. The disease involves children much more than adults, and is related to Epstein Barr Virus (EBV) infection in 95% cases. It characteristically has a high chance of involving the jawbone, a rather distinctive feature that is rare in sporadic Burkitt’s. It also commonly involves the abdomen.
nodes, it is the abdomen that is notably affected in more than 90% of the children. Bone marrow involvement is more common than in the sporadic variety. Jaw involvement is extremely rare. Treatment of Burkitt’s lymphoma:
Burkitt’s lymphoma is a highly aggressive tumor, and often life threatening. But it is also one of Sporadic Burkitt’s lymphoma : the more curable forms of lymphoma. With current aggressive The type of Burkitt’s lymphoma forms of chemotherapy that uses that affects the rest of the world, drugs in high doses, and with the including Europe and the Americas availability of new measures to is the sporadic type. Here too, it’s support individuals during intenmainly a disease in children. The sive treatment, this lymphoma is link between Epstein Barr Virus curable in many patients. Near(EBV) is not as strong as with the ly 80% of those with localized endemic variety, though direct ev- disease and more than half the idence of EBV infection is present children with more widespread in one out of five patients. More disease are cured. Late relapses than the involvement of lymph are hardly seen. 29
DOCTOR SPEAK
Conquering
Cancer – By Dr. Sudeep Gupta
Dr. Sudeep Gupta
Consultant Medical Oncologist Tata Memorial Hospital Mumbai
30
C
ancer or the ‘Big C’, as it is fearfully referred to, is no longer considered a death sentence. The number of individuals who have survived cancer has considerably increased over the years. Certain adult cancers have a survival rate of 70% or more, while a few childhood cancers may boast of a greater cure rate. In the last few years the medical science has achieved a lot many successes to cure and prevent a number of diseases – Cancer is one among them. Countries like America have taken it so seriously that they have declared ‘War Against Cancer’. The results of collective efforts, that are taking place across globe, are very promising and it seems that we are very close to conquer this disease. The medical science has been able to cure up to 80 per Cancers if they are diagnosed in early stage. Breast cancer is now completely Sept–Oct 2012
DOCTOR SPEAK
curable. Cancer cure has entered a new era. Now it is possible to cure certain cancers without damaging healthy cells. With the help of improved therapy more and more people are able to get complete cure. The advancements in the field of medical science have enabled survival of more than 10 per cent cancer victims in their last stage. The greatest advancements have been in the area of childhood cancers. Childhood leukemia used to kill about 80 percent of kids with the disease. Today more than 80 percent survive. Similarly, testicular cancer once claimed 95 percent of its victims; today upwards of 95 percent survive. Overall, during the mid-1970s, the five-year survival rate among adults for all cancers combined was 50 percent; today it is about 65 percent. Cancer is always treated as a dreaded disease. People have seen patient dying. But in most cases death occur due to too late diagnosis. If it is diagnosed in advanced stage the likelihood of survival becomes low. Therefore it is always advised to rush to the doctor when you find slightest symptoms. Timely detection is the surest way to get it cure. I would say instead of hiding this disease one should go to the doctor and take proper medication. Generally people know about only few cancers such as breast, lung, liver, bone and blood cancer whereas there are about 200 types of cancers and all these cancers have different initial symptoms and stages. Septâ&#x20AC;&#x201C;Oct 2012
million people worldwide died from cancer in 2008.
of cancer deaths occur in low- and middle-income countries.
b ould c s r e c of can evented pr
e
WHO SURVEY Normally there are three types of Cancer treatment- Chemotherapy, Radiation and Surgery. All these therapies are becoming better and better with new developments. These developments have made it less painful and accurate for patients. Now there is no need to fear from Chemotherapy. Earlier patients suffered vomiting, nausea, change of skin complexion, anemia and infection etc. after receiving chemotherapy. Now certain medicines are available in market which attack only cancer cells and they do not affect other parts of body.
area and the breast remain intact. Patients who are in fourth stage of cancer have to bear less pain, thanks to advanced medicines. There are certain gels and lotions that may give pain relief upto 72 hours.
Similarly radiology has become safer. The X-rays have become more targeted and they do not damage healthy cells in the body. Likewise in the surgery field various improvements have taken place. For example earlier surgeons used to remove entire breast in case of breast cancer now they are able to remove tumor and the affected 31
DOCTOR SPEAK
Psychological Approaches to Management of Chronic Pain
Dr. Divya Parashar
Head of Clinical & Rehabilitation Psychology at Indian Spinal Injuries Centre
P
eople who have painful conditions or injuries are often additionally affected by emotional distress, depression, and anxiety. Chronic pain involves more than the subjective experience of intensity of pain. In recent decades, chronic pain is explained using a biopsychosocial model of understanding where pain is perceived as a syndrome with consequences such as physical and psychological impairment. Psychological factors play a crucial role in the onset and course of chronic pain resulting in increased likelihood of developing
32
anxiety and depression-- some studies have found up to 60% of people with chronic pain have either stress, clinical anxiety or depression. The extended period of pain usually results in a decrease in activity level and reduced functionality which further increases the psychological distress. That, over time, will lead to an increase in muscle tension, poor coping ability, decreased sleep, increased use of pain medications and excess reliance on the health care system which further perpetuates the pain cycle. Some of the psychological symptoms occur as a result of the
pain, while others may have been in existence prior to the development of the pain. Regardless of the chronological order, an adverse effect on oneâ&#x20AC;&#x2122;s condition is likely to occur. In order for long term improvement to be observed, the psychological manifestations will need to be addressed and the vicious pain cycle will need to be broken. Psychological techniques using a mind over body approach have been associated with improved functioning, which includes a decrease in pain perception, deSeptâ&#x20AC;&#x201C;Oct 2012
DOCTOR SPEAK
creased psychological distress, use of more appropriate coping strategies, providing a greater sense of control, changing the way pain is perceived and understood, and increasing sense of well-being and relaxation. The psychologist’s role is twofold: to identify and treat psychosocial factors which can contribute to the pain, i.e., factors that can result in an increase in pain, and to help identify and implement a reasonable set of goals.
gation of activities that increase or decrease pain is also helpful including the thoughts, emotional consequences, and resulting behaviors. Increasing Activities: One of the common reactions to pain is withdrawing from physical activities to temporarily reduce the pain. By mov-
It’s always beneficial to start seeking solutions instead of focusing on the severity and the cause of the pain. The question is not “how did I get the pain,” the question is “how do I manage the pain” The question is not “what is the cause of the pain,” the question is “what factors influence the pain?” The question is not “what can the medical profession do,” the question is “what can I do?” Here are some mind-body interventions to address chronic pain: Pain assessment: Documenting and rating an individual’s recent pain is a very crucial part of treatment. The increased knowledge about the pain, the precipitating factors, and the limitations experienced as a result enable’s one to develop goals for treatment. For instance, how much did the pain interfere with daily activities, how severe has the pain been, how irritable & discouraged has the person felt? A thorough investiSept–Oct 2012
ing less, however, there is a reduction in the strength of the muscles, further compromising flexibility and endurance. If the specialist has allowed the individual to engage in physical activities, a balanced list of activities must be developed that one can do (aerobic activities like swimming, walking, cycling; household chores; yoga; resuming work etc.).
Setting weekly short-term goals and assessing progress over time helps to remain motivated. Relaxation Training: Relaxation therapies include a range of techniques such as autogenic training, various forms of meditation, progressive muscle relaxation, deep breathing, and paced respiration. The goal of these therapeutic approaches is overall relaxation and stress reduction. Practice can produce a set of physiologic changes that result in slowed respiration, lowered pulse and blood pressure, an increase in alpha wave brain activity, and possibly even reduction in the body’s inflammatory response mechanism. Relaxation training may decrease pain, depression and disability by reducing pain and muscle tension, reduced anxiety and insomnia, and increased activity level. It facilitates one’s ability to use suggestion and imagination to provide pain relief because with focused concentration the person learns ways of disrupting preoccupying thoughts, especially those related to pain. Changing behavior, thoughts, and feelings: Expectations, attitudes, and beliefs affect the manner in which persons cope with pain. The extent to which the person experiencing chronic pain patient experiences distress is directly related to that person’s 33
DOCTOR SPEAK
perception and subsequent evaluation of the pain. Inadequate coping mechanisms seen in chronic pain patients are related to errors in thought processes. The goal of the intervention is to correct faulty thought processes that contribute to prolonged suffering and disability, enabling maladaptive beliefs to be replaced with more adaptive ones. There are a wide variety of therapeutic techniques under the cognitive model, but they have common elements. The interventions are structured; action-oriented, and are usually time limited. The person is taught the role that thoughts and feelings have in influencing pain and specific methods including relabeling painful sensations,
attention diversion, reinterpreting pain sensations, relaxation, and imagery are presented. Four steps are involved in this teaching process: preparing for minor painful sensations; confronting more severe pain; coping with feelings that tend to exacerbate pain, such as anxiety or frustration; and learning to provide self-reinforcement for successfully coping with pain.
decreased activity or taking medications.
Counseling: Helps to address personal stressors, managing feelings, and providing coping strategies for depression, anger and stress management. Marital and family counseling helps significant others cope with chronic pain of a loved one, and to clarify roles and responsibilities of family members The relative effectiveness of ac- to enable the family to function tive and passive coping strategies in a healthy manner. has been evaluated. Active coping strategies requires one to engage in Psychological, social, environsome action, such as exercising, to mental and physical factors must cope with the pain. Persons using be treated simultaneously with passive coping strategies either respect, understanding and care withdraw or give up control to for us to better the lives of those an external agent. Examples of who deal with pain, helping them passive coping strategies include have control over their lives.
We are as focused vis a vis your needs & issues.... As you are at the moment. Introducing Online Healthcare Consultancy www.hosconnn.com focused on â&#x20AC;&#x153;Simplifying the complications of Healthcareâ&#x20AC;?
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Septâ&#x20AC;&#x201C;Oct 2012
EXPERT VIEWS
Ask a Question from Healthcare Industry Expert
Medgate Today, Introduce a Special Section:
Ask a Question from industry expert in Hospital & Healthcare Planning, Operations, Management, Quality, Medical Education, Medico Legal & Materials Management”. You can mail your query at editor@medgatetoday.com
&
I am planning to do MHA. Can you tell me the career prospects in Hospital Administration ? Dr. Ajay Sharma, MBBS, [Patna]
H
ealthcare is the world’s largest and fastest growing industry. Healthcare professional with a sharp managerial & administrative perspective are in great demand. Healthcare service market is being taken over by the private sector industry . Significant potential for employment exists in the management of health care in our country. Evidently employment opportunities in health care are increasing day by day. Many hospitals and pharmaceutical firms are looking for managers who have an in-depth understanding of Hospital & Healthcare management principles and their applications to health care delivery systems. If you wish to work for a health care organization as a manager or a consultant, or set up a nursing home or hospital, courses in healthcare management will provide the needed training. So, India has a huge potential for hospital & healthcare growth and hence need for more & more healthcare managers / administrator is the need of the hour. 36
Dr. Pradeep Bhardwaj CEO, Six Sigma Health Care
OUR EXPERT : DR. PRADEEP BHARDWAJ, CEO & Executive Director, Six Sigma Healthcare Limited, Delhi will answer your questions through his expertise knowledge & experience in Hospital & Healthcare Management. He is an expertise Healthcare Planning, Management, Medico Legal Consultant, Author’s and Visiting Professor & Faculty in leading Healthcare Management Colleges / Universities like Harvard, IIM – Lucknow, IIM-A, ISB – Hyderabad, Amity University, Symbiosis International University, AIIMS, National Board of Examinations etc. He is also Board of Advisory in many healthcare organizations / management institutes / universities. . Dr. Bhardwaj is renowned hospital and healthcare management expert, recipient of many prestigious awards like Rajiv Gandhi Award -2010, Best Medico Legal Expert – IBN 7 Sept–Oct 2012
EXPERT VIEWS
What is the role of Six Sigma in HR ? Tell me the name of institutes giving training in Six J C Pathak, Sigma ?
MBA-HR, LLB [Delhi]
M
any factors contribute to the success of Six Sigma in HR. Some of these factors will fall within HR’s area of responsibility, such as :-
• Understandable, objective and measurable position requirements and performance standards. • Hiring and candidate selection processes driven by the position requirements. • Identifying leaders for management positions. •Effective, objective & accurate performance appraisals.
Sept–Oct 2012
• Focusing training and development programs on specific position requirements and individual performance. • Integrating individual performance with overall performance and quality management system • Eliminating waste and inefficiencies. • Tracking and measuring continuous improvement in your HR processes. Training InstitutesIndian Institute of Management Bangalore Bannerghatta Road, Bangalore 560 076 E-mail : edp@iimb.ernet.in Website : http://www.iimb.ernet.in Six Sigma Star Healthcare, Delhi
E.Mail- sixsigmahealthcare@gmail. com, www.sixsigmahealth.org Our hospital is keen to get JCI Accreditation ? Please provide JCI Details ? DR. Vijay Gaur, MBBS,
MHA [Mohali]
J
oint Commission International (JCI) is a division of Joint Commission Resources, Inc., a wholly controlled not-for-profit affiliate of The Joint Commission. JCI provides leadership in international health care accreditation and quality improvement. For details visit : www.jointcommissioninternational.org.
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EXPERT VIEWS
HealthTechnology Innovation Leveraging social media to enable Telehealth adoption health, particularly for chronic patients this engagement mean they have improved outcome. For patients such applications go beyond as a source of information, they become a source of assurance and faith, they can talk to doctors when they want and get inputs to their queries regarding their treatments on the go, relieving them from stress and anxiety.
D
espite all the enthusiasm and buzz around Telehealth adoption has not scaled as per the expectations whereas adoption of social media hit a tipping point right at the inception. Social media’s success is primarily because it’s being embraced by everyone across the globe, while adoption and embracing technology is the challenge for Telehealth. Let’s begin by first looking at the definitions of the two: Telehealth simply means application of mobile devices, telecom38
munication networks and software applications to improve healthcare outcomes. Social media broadly means applications that enable interaction between its members. For healthcare these members could be healthcare professionals and patients. Adoption of social media is self-driven by the need of being connected to the world , similarly for Telehealth can’t it be driven by the need to stay healthy . Patients can have improved access to information enabling them to become more engaged in their
For healthcare professionals these applications mean a greater coordination between them to improve patient outcomes, compliance and primarily improve patient health.A common scenario where primary doctor shares his diagnosis with a specialist, wouldn’t it be great if they can share information over a messenger to share diagnosis effectively . When a patient and nurse interact on what’s the status and if this conversation is automatically saved for future use for any symptoms, nurses will save a lot of time to go back and document the changes. Telehealth is a golden opportunity with increasing number of baby boomers in US coupled Sept–Oct 2012
EXPERT VIEWS
Manish Nachnani has over a decade of experience in the field of global Healthcare consulting. He works on cloud strategy, HIS/ EMR implementation, smart apps and social media with bad lifestyle it’s a recipe for success for Telehealth application. However its proving too difficult to realize this opportunity as the legacy mindset needs to change and remolded. Developing countries have harnessed Telehealth to the fullest primarily for the fact they had no legacy, it was a fresh start for them , they experimented freely and innovated to deliver care using mobile phones at fraction of costs compared to traditional models. Telehealth provides capability to do remote health monitoring and share vitals with doctors still theirs no reduction in the number of home visits on the contrary they are increasing every year , so what’s wrong ? Do patients love visiting a clinic, talking to a doctor and being social .
Manish Nachnani B.E , FAHM , PGDIM , CBAP
The key to the success of the Telehealth is to move beyond wellness towards clinical stuff while retaining the social concept of bringing patients and healthcare professionals on a single platform. Social media can be the catalyst to promote Telehealth adoption
Being social is the key element here, why can’t we make Telehealth a social experience. Adoption of Telehealth is primarily an behavioral issue rather than an a technological challenge. Wellness centered Telehealth has been the winner as they have successfully integrated social media concepts and primary reason for the success is that it’s not regulated. They use behavioral change to drive wellness. Calorie counters, gym tracker , speedometers all are examples of this category . Is it truly Social Telehealth, we don’t agree. Also on the other end of the spectrum are clinical applications which help share imaging data and patient stats with healthcare professionals. Is it truly Social Telehealth, we don’t agree. True potential of Telehealth can be leveraged when wellness and clinical paths meets and hit the sweet spot with patients and healthcare professionals interacting with each other. Chronic diseases like hypertension, diabetes, asthma are these sweet spots to save billions of $ by adopting Telehealth . Sept–Oct 2012
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PRODUCT LINE
SCIENTECH TECHNOLOGIES
DIGITAL 12 CHANNEL ECG MACHINE - SCIENTECH 13B by Chaitanya Dev Singh Sisodiya
T
he heart is a two juncture electrical pump and the heart’s electrical activity can be measured by “Scientech 13B, Digital 12 Channel ECG Machine” by placing electrodes on the skin. Thousands of people gone through the electrocardiogram and the scientech 13B has saved lives of inestimable patients by showing a serious circumstance like heart attack with an excellent degree of accuracy. Digital 12 Channels Electrocardiograph (ECG) Machine, scientech 13B is used to measure the electrical activity, rate and rhythm of the heart. It is use to analyze the signal from patient heart and produce the result in graphical output. It is capable of printing all lead waveforms simultaneously with interpretation as well as provide indirect evidence of blood flow to the heart muscle. This is the most important device which can help the doctor to identify the
problems in certain heart failure. Ten electrodes are needed to produce 12 electrical views of the heart. An electrode lead, or patch, is placed on each arm and leg and six are placed across the chest wall. The signals received from each electrode are recorded. The printed view of these recordings is the electrocardiogram. The advantages of scientech 13B also use to solve the underlying rate and rhythm mechanism of the heart. The others advantages of scientech 13B are noninvasive, safe, inexpensive, and easy to perform, the necessary equipment is available in scientech. Scientech 13B is very light, compact, easy to use and space saving machine, comes with 7 inch screen to view ECG waveforms simultaneously. There are standard 12 leads with alarm for lead-off and low battery. Digital 12 Channels Electrocardiograph
Mr. ChaitanyaDev Singh Sisodiya
Scientech Technologies Pvt. Ltd., 94, Electronic Complex, Pardesipura, Indore – 452010, INDIA Cell No. : +91-7389910103 Tel : 0731-4211100 Fax : 0731 2555643 Email : info@scientech.bz Website : www.ScientechWorld.com 40
(ECG) Machine have auto-save function also printed ECG files can be saved automatically. Thousands of ECG files can be saved to the scientech 13B and also having option to save 2000 files to SD card. Built-in ECG simulator for demo purpose along with soft, silicon gel keyboard and automatic adjustment of baseline for optimal printing. One can also connect with the computer which is an optional feature. It also has built -in rechargeable lithium battery, over 2 hour working. Scientech Technologies Pvt. Ltd. is a renowned provider of medical equipments. Our world class products provide user a high degree of quality & reliability. Scientech offer comprehensive range of medical instruments and technical support. Leveraging the heritage and domain expertise of Scientech, the products encompass a board technology spectrum and high customer satisfaction across the globe. Our policy is not just offering customers with products but also in providing them with prompt technical support. Scientech has 16 branch offices in India & their products are exported to over 52 countries. Sept–Oct 2012
EXHIBITION
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Experiencing the Remarkable Success in 2011 the 3rd edition of Meditec Clinika
The Event where serios buyers and sellers from the medical world converge can you afford to miss Meditec Clinika 2012
M
editec Clinika is a unique endeavour by Orbitz Exhibition Pvt Ltd to present the entire spectrum of development in the Indian Medical & Healthcare Industry; the event will be years most important and crucial meeting place for Medical Professionals. The Show will provide an unparalleled opportunity for the manufacturers and distributors of medical devices & technologies to showcase their existing range of products and launch new products. Experiencing the remarkable success in 2011, the 3rd edition of Meditec Clinika had more than 2500 visitor interacting with over 90 exhibitors. The concurrent seminar on Medico-legal organized by Association of Medical Consultants was a real value for money for the visitors. The sheer presence of over 500 key surgeons / doctors from the leading hospitals has ensured
the ROI for the exhibitors and had evolved Meditec Clinika as most imperative event of the medical fraternity in India.
event by Association of Medical Consultants; hence announcing the launch of AMC Bengaluru chapter at this important Medical fraternity convention. AMC The 4th edition of Meditec Bengaluru has also announced a 2 Clinika is back with a bang; sched- day scientific session on “Patient uled from 5th to 7th October 2012 Safety” scheduled to be on 6th – at Palace Grounds, Bengaluru 7th October 2012. (Bangalore) - The Fastest growing Healthcare Hub in South East Asia. The session is supported by more than 10 key associations in The Inaugural day of the event the medical industry and around will be a stepping stone with high 18+ key hospitals in Karnataka end Knowledge Sharing Session earmarking the mammoth pres& Panel Discussion on Hospital ence of medical professionals at Infrastructure by Hospaccx India. the event. The Industry experts will share their thought on Challenges inIn a nutshell the 4th edition volved in remodeling and rede- of Meditic Clinika will not only signing of the hospital enabling demonstrate the latest technology the delegates to identify innovative in Medical & Healthcare segment solutions for the teething issues but will also augment the delefaced by them on regular basis. gate with vast pool of knowledge transfer and industry interaction. Meditec Clinika is considered to Truly a pioneer event; no medical be Southern India’s most attended professional would afford to miss. For Detail Contact:
Ms. Rohini Parelkar
Manager - Project Co-Ordination Cell: 09322037957 - Tel: +91 22 67282586 E-mail: meditec.clinika@orbitzexhibitions.com 42
Sept–Oct 2012
Sept–Oct 2012
43
EXHIBITION
SPECIAL
GLOBAL
Healthcare Solutions
G
LOBAL healthcare solutions is one of the fast growing company focusing on the supply and services of complete healthcare related solutions. With the rich experience of being in the health industry, company has ventured in to the same industry with more products added to the group. Advantage of offering the maximum products and services to the customer, will keep the customer at ease during the vendor choosing. Company aim is to provide the comfort level to the customer in selecting the equipments / products and services to meet their quality standards related to healthcare, which in turn should make them to feel like “buy at one stop shop” for healthcare related products.
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• Offering complete healthcare solutions that meet the clients’ expectations not only by realizing the clients’ business objectives, but particularly to keep customer at comfort level during the project executions,
• OT rooms Solutions like, Modular OT Rooms, OT Pendants, OT Lights (LED & HALOGEN), OT Tables
• Continuous search for opportunities beyond the boundaries • Bed Head Panels and business objectives, • Patient Cubicle tracks and Cur• Creative approaches to the cli- tains (Partitions for Beds) ents’ special needs in order to find unique and tailored healthcare • Medical ipe Line Systems solutions, • Professional quality of services provided by a highly motivated team. Products: • Imported patient health care
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furniture’s used in Hospitals - Supply will be for complete ranges of hospital furniture’s
GLOBAL Healthcare Solutions
“KSM’, #39, 2nd Floor, Gandhi Bazaar (Opp Canara Bank), Basavanagudi, Bangalore - 560 004, www.globalhealthcaresolutions.in Sept–Oct 2012
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Commander
Watertech Pvt. Ltd.
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ommander Watertech Pvt. Ltd, pioneers since 1961 in manufacturing & marketing of innovative flushing systems, Seat Covers, Bathrooms for Physically Challenged & Allied products. Commander today is synonymous with quality and technology. Commander boasts of having superior technical expertise in product engineering. Pressalit: The leader in the area of bathroom solutions for people with disabilities. For more than 30 years Pressalit Care has worked to diminish limitations – with knowledge, products and advice. The objective is a better life for people with disabilities, a better working environment for those who help them and a better, longer term solution for managements that invest in the facilities. The way Pressalit attack this task is summed up in two words: Keep Living! Commander Pressalit – Bathrooms for the Physically Challenged: Sept–Oct 2012
• The Functional Room -Creating a well functioning bathroom is a complex task. Pressalit Care therefore works systematically. All of our solutions are developed in relation to three clearly defined elements that set forth the requirements: The user, the carer and the room. • User -People want to take care of themselves. This is fundamental to self-esteem. To be able to manage in the bath is perhaps the most fundamental of all. Pressalit Care not only makes it possible-our solutions make it a pleasurable experience. • Carer - For the carer, the bathroom is a workplace. This is true regardless of whether the carer is a professional, a family member or a friend. Pressalit Care’s carefully planned solutions create a functional, safe and effective workplace. • Room - Space is a scarce resource. Pressalit Care breaks through the room’s limitations. With the wall track, the room adjusts to the user and not the other way around. This
is what we call a functional room. All Commander Products are tried and tested, to validate the quality of spares & the technology used. The intensive research & the ensuing technical solutions are incorporated at the development stage to assure performance, reliability and durability. Commander Watertech provides a nation wide service network with intense marketing and prompt after sales support. Commander Watertech Pvt. Ltd. Joshi Bldg, Saki-Vihar lake Road, Mumbai 400 072 www.commanderwatertech.com
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SOY PROTEIN AND GREEN TEA
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oy Protein and Green Tea are rich sources of Nutraceuticals and antioxidants. Naturally occurring Isoflavones associated with Soy Protein confer several health benefits like reduction in the risk of cardio vascular diseases, Osteoporosis and menopause related problems in aging women in addition to reduction in the risk of certain cancers â&#x20AC;&#x201C; particularly, the breast and prostate cancers. Green Tea and its extract are rich sources of polyphenolic compounds which act as strong antioxidants. The compound epigallocatechin-3-gallate (EGCG) is the major polyphenol compound found in green tea . This polyphenolic compound and several related catechins are believed to be responsible for the health benefits associated with the consumption
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of green tea. Increasing evidence has suggested that EGCG exhibits anti-inflammatory, anti-oxidant and immunosuppressive effects. The potential health benefits ascribed to green tea and EGCG include antioxidant effects, cancer prevention, improving cardiovascular health, protecting the skin from the damage caused by ionizing radiations etc. Recent research has also suggested the insulin-like glucose-lowering properties of epigallocatechin gallate (EGCG) in mammals. Soyvita is a unique health and wellness supplement that provides the combined health benefits of Soy Protein and Green Tea. Soyvita is formulated with great care by combining the best health and wellness ingredients from the reputed global health Companies to bring to you not just a Supplement but a commitment of total health and wellness for the entire family. RIDHI SIDHI MARKETINGS
Regd. Off.: (Old No. 72) New No. 48, Nattu pillayar Koil Street, Chennai-600 001, India Ph.: +91 9841027380, +91 4442166407, 42620936 E-mail: ridhisidhi@eth.net soyvitasarat@gmail.com
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ARTALEGA specialises in the production of premium grade LATEX and NITRILE Gloves for medical, dental, food and semiconductor markets since 1988. Well-known for our technological and innovative initiativesadvances, HARTALEGA has successfully re-modeled the glove industry by being the FIRST to introduce soft thin Nitrile Gloves when it was traditionally commonly hard and uncomfortable. uncomfortable. Taken This product breakthrough triggered a switching momentum from Latex to Nitrile in the USA and Europe. Today, HARTALEGA is the largest nitrile glove manufacturer in the world with an annual capacity of 10 billion gloves. Exporting world wideOur gloves Our gloves are exported to theour gloves are used in the USA, Canada, Germany, United Kingdom, Japan, Australia, Brazil, China, India and many other countries.
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ayer of ons
In operating rooms and critical care areas an electric shock could mean disaster for patients and medical staff. That´s why more and more facilities are turning to Bender for Isolated Power Systems (IPS). With an IPS, you get: ■ Reduced risk of uninterrupted power during a procedure ■ Reduced risk of electrical shock to patients and staff ■ Reduced risk of fire ■ A more dependable source of uninterrupted power vs. ELCB/RCCB ■ Acc. to IEC 60364-7-710 and NEC 2011: India And best of all, a Bender IPS is more cost effective than you think.
Contact us today. Bender India Private Limited 805, B-Wing, 8th Floor, TECHNOCITY mean disaster for Plot No X-4/1 & X-4/2, MIDC, TTC Industrial Area Mahape, NaviMumbai - 400710 Maharashtra, INDIA Power Systems (IPS). : n i s u it Tel: +91 22 2778-8501, -8502, Fax: -8503 s i v info@bender-in.com Clinika
Meditec
ibition 2012, Exh 2012 r 7 OctobeGroup 5-BENDER
www.bender-de.com
CCB Sept–Oct 2012
49
EXHIBITION
SPECIAL
PALASH TM Transforming Healthcare through Innovative Technologies
PALASh healthcare Systems (PhS) is specialized healthcare-IT organization offering various software services and solutions to healthcare sector on its TM proprietary platform PALASh . Tm
PalaSH is a platform which enables Healthcare Providers to implement various frameworks for automating their processes in verticals such as multi-specialty, Diabetes, Ophthalmology, Dental, IVF, Cardiology, Eye laser, medical Colleges, Diagnostics and many more. PalaSH Healthcare Systems (PHS), Pune (India) based company, began its operations in 2006 under the management of mr. Narendra Barhate, Founder and Chairman, and mr. Dinesh Samudra, Director and CTO.
About PALASh
TM
Tm
PalaSH is a comprehensive Framework designed and developed for Healthcare industry for managing the workflow Tm processes across the all types of healthcare faculties. PalaSH is capable of maintaining Patient Clinical and Financial data generated across the healthcare enterprise. Tm
PalaSH is compatible with all types of medical codification standards viz. disease coding (ICD, CPT, HCPCS, Dental etc), drug coding, Hl7, etc. Tm
PalaSH is tightly integrated with other Healthcare products like Picture archival and Communication System (PaCS), laboratory Equipments and other Financial applications viz. Tally, mS Dynamics Navision, Oracle Finance, SaP and Business Intelligence applications. Tm
PalaSH is very user friendly and provides all clinical information at a glance on a single screen.
PhS Associations Microsoft Corporation (Gold Certified Partnership), IBM Tm (ISV Certification), Zensar Technologies (PalaSH Sales, Implementation and Consulting), NOVARAD, U.S.A (PaCS Software and Tele-Radiology solution), CltrS (Cloud Based Server), iTree Consulting (SaP Business Objects)
PhS Clientele PHS has solutions implemented in more than 150 major healthcare providers across India, middle East (UaE, Oman, and KSa), Jordon, Sudan, West Indies and Netherlands.
Recommendations We commend PALASH’s staff for their sincerity and dedication. They have always handled our queries very much with efficiency & in time Sai Snehdeep hospital, Mumbai. Tm
With PalaSH Hospital Information Management Systems, our hospital is working efficiently and as per our need and has helped us in improving our patient care and institute management. We are proud to be associated with you as your solution has met all our expectations which the earlier vendor could not Inamdar hospital, Pune.
Contact PALASh healthcare Systems Pvt. Ltd.
100-B1,Sunit apartment, Near Telco Club, Erandwane, Prabhat Road, Pune – 411004, India. Tel No: +91-020-25651178/79, Fax No: +91-020-6620 3648 www.palashhealthcare.com www.palashhealthcare.com info@palashhealthcare.com
: visit us in Meditec
Clinika
ibition 2012, Exh 2012 ber 5-7 Octo
50
Sept–Oct 2012
EXHIBITION
SPECIAL
Technologies A irox Technologies is a highly skilled team of professionals serving Hospital & Medical industries from last 12 years along with its sister concern S.A.Medical systems. By virtue of its strategic alliances with Airsep Corporation & above all an extensive marketing & distribution network, Airox Technologies is one of the fastest growing companies in India. Airox Technologies is promoting Airsep Oxygen Generators all across India. Airsep PSA Oxygen generators gives hospital a competitive edge & greater economical benefits. PSA Oxygen for Modern Hospitals is fast becoming the NORMAL supply of Oxygen. Innovative equipments like PSA Oxygen generators gives hospital a competitive edge & greater economical benefits. PSA Oxygen for Modern Hospitals is fast becoming the NORMAL supply of Oxygen. Oxygen is traditionally supplied to hospitals by truck in high pressure cylinders or cryogenic storages (Liquid oxygen).It is a costly situation which exposes hospitals to several risks and constraints. 52
On site production by generators is a safe and efficent alternative to this situation. The Pressure Swing Adsorption(PSA) Oxygen Generating Process. Air contains 21% oxygen, 78% nitrogen, 0.9% argon, and 0.1% other gases. AirSep Oxygen Generating Systems separate oxygen from compressed air through a unique Pressure Swing Adsorption (PSA) process. The PSA process uses molecular sieve (a synthetic zeolite), which attracts (adsorbs) nitrogen from air at high pressure and releases (desorbs) it at low pressure. AirSep Oxygen Generators use two vessels filled with molecular sieve as adsorbers. As compressed feed air flows through one of the vessels, the molecular sieve adsorbs nitrogen .The remaining oxygen passes through the vessel and exits as the product gas. Before the adsorber becomes saturated with nitrogen, the feed air is diverted to the second vessel. At that point, the sieve in the first vessel regenerates by desorbing the nitrogen through depressurization
and purging it with oxygen from the second vessel. This process is then repeated in the second vessel to complete a cycle that allows the oxygen generator to deliver a constant flow of product oxygen at 90% minimum purity. Under normal operating conditions, the molecular sieve is completely regenerative and will last indefinitely. Airox Technologies 2nd Floor,shinde Avenue, Sawarkar Chowk, Samarthnagar, Aurangabad 431001,Maharashtra. www.airoxtechnologies.com
: visit us in Meditec
Clinika
ibition 2012, Exh 2012 ber 5-7 Octo Septâ&#x20AC;&#x201C;Oct 2012
EXHIBITION
SPECIAL
Haribharath Equipments Pvt. Ltd.
H
aribharath Equipments Pvt. Ltd came into scenario in the year 2004. The company is growing steadily and set a strong foothold amongst the leading scientific instruments manufacturers. We have been expanded our business network throughout the country under the expert guidance of Mr. Harilal Bhargavan (CEO). A well established scientific instrument manufacturing company is well equipped with highly advanced infrastructural facilities and motivated team of workforce that is the key to the success in the most competitive marketplace. We specialize in conceptualizing the modern requirements of the clients and offer best solutions for every requirement. The first hand knowledge of specific functions and features helps to fulfill the client’s need at the first instance. We implement Total Quality Management System to delivering consistent quality scientific instruments. Sept–Oct 2012
z z Ready.
BLOOD BAG TUBE SEALER Model No: - BB 126
z z Seal.
Features: -
z z Battery.
z z Heavy Duty, Bench Top Sealer. z z Weight 5.5 kg. Trigger:-Optical Sensor. Frequency – 40.68mhz z z Sealing Time 1.5 To 2 Sec. Automatic Trigger Sealing With The Help Of Optical Sensor. z z In Built Battery Backup System. z z Sealing Capacity 500 Seals Per Full Charged Battery For Tubes Of Up to 6 mm Outer Diameter. z z It Works On RFK Technology. Sealing Operation Is Activated Automatically, When The Tube Is Placed Between The Electrodes. z z Power Sources 230V AC, 50 Hz Single Phases. z z Power Consumption:- Operating: 230W, Standby: 5W. z z LED Indicators for.
Haribharath Equipments Pvt. Ltd. 1, Shukla Bhavan, Opp.CEAT Ltd, Village Road, Bhandup (w), Mumbai-400078, Maharashtra. www.haribharathequipments.com
: visit us in Meditec
Clinika
ibition 2012, Exh 2012 ber 5-7 Octo
z z Mains. 53
19th International Exhibition and Conference on Diagnostics, Medical Technology, Rehabilitation, Medical Equipment and Components
8-10 March 2013 Pragati Maidan New Delhi/India www.medicalfair-india.com
54
Septâ&#x20AC;&#x201C;Oct 2012
Covidien Healthcare India Pvt Ltd 10Th Floor. Building No.9B Dlf Cyber City Phase Iii, Gurgaon, Haryana 122002
91-124-4709800 [T] 91-124-4206805 [F]
www.covidien.com
PRE EVENT
HOSPITAL INFRASTRUCTURE INDUSTRY TO COME TOGETHER IN MUMBAI IN DECEMBER! Hospital Build & Infrastructure India to grow by leaps and bounds in 2012-International Exhibition |Congress| Awards rd
The 3 edition of Hospital Build & Infrastructure India exhibition scheduled for 14 – 16 December at the Bombay Exhibition Centre will bring together key regional and international healthcare industry players from UK, USA, Australia, France, Canada, Norway, Korea, Taiwan, China, UAE, Bahrain, Poland, Singapore and India. Exhibitors at the event will showcase products, technology and solutions within the healthcare and hospital infrastructure sector. Commenting on the growth of the exhibition, Guru Prasath, Exhibitions Director of Informa India said: “There is a significant gap between the demand and supply in the hospital infrastructure sector. Through HBII event we would be offering our exhibitors, visitors and the industry at large, a professional platform to develop and consolidate their business contacts within the healthcare industry.” The Healthcare infrastructure expenditure in India is expected to touch USD 14.2 billion by 2013. The last few years have seen massive investment and expansion in the healthcare industry within India. As investment in India's Healthcare Infrastructure continues to rise, Hospital Build & Infrastructure India 2012 is bound to become a milestone in the tireless journey to update, upgrade and fine tune global strategy in the field of Healthcare Infrastructure. The 3rd edition will be bigger and better and will thrive to leave a perceptible impression over 4,000+ focused industry visitors, more than 100 exhibitors from 15 countries, covering 6,000sqm of exhibition floor space, as well as more than 400 conference delegates. HBII is setting new standards within the industry as a premier regional event with an international appeal, attracting exhibitors, visitors and delegates from across the globe. Investors, Planners, Builders, Contractors, Architects and Designers will meet Senior Managers and Commissioners of PSU and private healthcare facilities in India. An exhaustive range of products, solution and services across all areas of hospital investment, planning, designing, building, operating, managing and refurbishing will be showcased and highlighted here. HBII will also host the first ‘Hospital Build & Infrastructure Awards’ and an exclusive 03 day ‘Healthcare conference’ and will witness the launch of the flagship session on Leaders in Healthcare with the top dignitaries of the Hospital & Healthcare industry making their presence felt. Knowledge partners for the conference, HOSMAC, have zeroed in on conference topics like Hospital Build & Design, Quality Care and few other industry related topics. The event will also feature International Pavilion, Product Demonstration Area, B2B meetings and various other attractions. Major participants at HBII include Draeger India, Tata Motors, Tahpi, Portalp International, Alvo, Modular Concepts, Responsive Inds, Hospaccx India systems, Medica Synergie, Zebra Technologies, Bioni Paints India, Sio Vasundhara, CR Medisystems, RR-Eubiq and many others. HBII 2012 has already started receiving a good response from the industry with most of its stall space been sold out, it’s receiving support from various industry associations, Canadian Ontario Govt. support and a strong speaker line up for the conference. HBII will provide a unique gateway to new business opportunities and partnerships in and across the complete spectrum of healthcare facilities in India - from investment to maintenance. Over a short period of time, it has become India’s leading strategic gathering which attracts the best in the Indian Healthcare Industry and delegates from all across the globe and is a must for everyone who has a stake in the Indian Healthcare & Hospital Infrastructure Sector. HBII is a part of the Hospital Build Series that is organized in Middle East, Europe, China, Russia & Turkey by the Informa Group of Exhibitions which also boasts of many very strong partnerships that it maintains and constantly builds upon in over 70 countries worldwide, for global mega-events. One of them being, the Arab Health, world’s leading event for the Healthcare Industry.
INDUSTRY SPEAK
“Hospital Infrastructure India has brought together some renowned healthcare professionals delivering state of the art and trend in hospital design, sustainability and project delivery. Hospital Infrastructure is a must for continued education and a place to meet your healthcare professionals” Ted Jacob, Ted Jacob, Ted Jacob Engineering Group Inc. USA “I am here first time & on the last day I consider it a great exhibition and a good platform to gather knowledge. I am richer in many aspects even in a day.” Dr. P.N. Kakar, Head of Anaesthesia, Chief of Inspection Control Committee, Fortis Healthcare, India “Great show! A good panel of speakers with varied and a good mix of topics for discussions. An excellent platform to exchange information, innovations, new trends and ideas to improve healthcare practices. Good footfalls of serious healthcare professionals. The stall witnessed some serious leads to generate business.” Dr. Rashi Agarwal, Praxis Healthcare Consultancy, India “It is a great opportunity to meet people. It is a platform to meet prospective clients and interact with people who intend to enter the Ivy League of hospitals.” Ayanabh DebGupta, CEO-Project & Consultancy, Medica Synergie For further information on exhibition you may contact +91 9920288808 or can register online for free fast track entry to the exhibition and conference at www.hospitalinfra-india.com 56
Sept–Oct 2012
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Sept–Oct 2012
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USAIM’s The M. Ch. ( Ophthal ) Certification Programme Admission Announcement ( Batch no. 7 ) September’12 - February’ 13 Don’t Miss this time…!
Programme Highlights • • • • • • • •
6 months ONLINE programme 24 X 7 Advanced Contents ( Study anytime ) Theory designed toward Clinical Exposure 6 Specialties covered ONLINE Post Assessment Thesis Submission & presentation at KXP 3 days KXP after 6 months Final MCQ based Exam at KXP
Programme Takeaway
• The M. Ch. Certification in Ophthalmology • CME Credit hours awarded by AACME • Letter confirming attendance at the Lecture program • Knowledge sharing with the experts and fellow professionals during the KXP • Letter of acceptance of thesis which is subject to publication in the Journal of M.Ch.
Who Should Enroll? “Ophthalmologist with minimum 8 posts of surgical experience” To Avail Early bird offer & EMI scheme submit Enquiry Form here: http://www.booleaneducation.com/mch-ophthal/enquiry.aspx OR send email to registrar@mch-ophthal.com
CALL +91 9225545711 +91 2066858107
www.mch-ophthal.com
*** M. Ch. Ophthal is not a registerable certification with MCI
Medicine & The Law: The Necessities, Conflicts & Liabilities
This programme is HRDF Claimable
A Review on the Current Healthcare System of Malaysia
l
Specia
7 – 8 November 2012 • 9.00am – 5.00pm • Novotel Kuala Lumpur City Centre PROGRAMME OvERviEw
Pforr ieacrtlyeion registr
a
OuR diSTiNGuiShEd SPEAKERS
The rights and duties of the medical profession and the rights of the patients are changing rapidly in the ever growing field of medical law. With the advancement of medicine and technology, the three main branches of medical law on confidentiality, negligence and other torts are developing as issues on ethics increasingly come before the courts.
Professor Dato’ Dr. Syed Mohamed Aljunid
Dato’ Mahadev Shankar
Dato’ Dr. Jacob Thomas
Datuk Nancy Ho
Dr. David Quek
Associate Professor Dr. T. Thurairatnam
President MALAySIAN SOCIETy fOR PHARMACOECONOMICS AND OUTCOME RESEARCH
The Medicine & The Law: The Necessities, Conflicts & Liabilities Conference will be focusing on the current issues and major changes impacting public health today. Participants will benefit tremendously from key case studies and presentations imparted by professionals at the forefront of both the medical and legal fraternities.
President ASSOCIATION Of PRIVATE HOSPITALS Of MALAySIA
Do not miss out on this exclusive opportunity to network and discuss practical strategies and solutions with Malaysia’s leading Medico Legal professionals.
Past President MMA, Elected Member MMC Senior Cardiologist PANTAI HOSPITAL KUALA LUMPUR
KEY BENEFiTS OF ATTENdiNG
2. A REVIEW of the challenges & future direction of the Malaysian public healthcare 3. An OVERVIEW of how justice, medicine, healing & responsibility should prevail 4. UNDERSTANDING how human rights, ethics and medical law are linked
6. ENGAGING in the Panel Discussion on Euthanasia & discussing the distinction between mercy & murder 7. DISCOVERING strategies & measures that can assist in minimising costly litigation & risk
Consultant Dental Surgeon Mediator KUALA LUMPUR REGIONAL CENTRE fOR ARbITRATION
fifa Rahman
Sumytra Menon
Dr. Chan Chee Khoon
Senior Associate in Research LIEN CENTRE fOR PALLIATIVE CARE, DUKENUS GRADUATE MEDICAL SCHOOL
5. EVALUATING how modern day technology can affect the quality of life & the ethical issues tied with it
President MALAySIAN PHARMACEUTICAL SOCIETy
S. Radhakrishnan
Advocate & Solicitor Consultant SHEARN DELAMORE & CO Past President MEDICO LEGAL SOCIETy Of MALAySIA
1. MITIGATING the damages with a proper grievance mechanism
Former Court of Appeal Judge Former Consultant ZAID IbRAHIM & CO
Policy Executive MALAySIAN AIDS COUNCIL Regional Rapporteur, South East Asia HARM REDUCTION INTERNATIONAL
Consultant, Faculty of Medicine Department of Social And Preventive Medicine UNIVERSITy Of MALAyA
Dr. Hj Nordin Saleh
Siti Z Kasim
Advocate & Solicitor SAHA & ASSOCIATES
Deputy Director for Health Policy Planning Unit, Planning and Development Division MINISTRy Of HEALTH
Dr. Sharon Kaur
Shanti Abraham Mathew
To register for this Conference, kindly contact:
Kavita
Lecturer UNIVERSITy Of MALAyA
Tel: (603) 6201 5607 / 8508 | Fax: (603) 6201 5611
Partner PUTHUCHEARy
Email: kavitarai@medicallawmalaysia.com Website: www.medicallawmalaysia.com Facebook: www.facebook.com/MedicineAndTheLaw
In Collaboration with:
Sponsor:
Endorsed by:
Gandhi
Memorial Trust
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“SOUTH-EAST ASIA’S LARGEST MEDICAL SHOWCASE!”
The international exhibition on Thailand’s healthcare services and public healthcare.
The International Exhibition on Medical, Hospital, Diagnostic, Pharmaceutical & Rehabilitation Technology and Equipment.
Hosted by:
The Medical Council of Thailand
Endorsed & Supported by:
The Ministry of Public & Health
The Society of Plastic & Reconstructive Surgeons of Thailand
Organized By:
The Society of Aesthetic Plastic Surgeons of Thailand
Singapore Industrial Automation Association
Technology Promotion Association (Thailand-Japan)
Fireworks Media (Thailand) Co., Ltd.
Contact Us : Fireworks Media (Thailand) Co., Ltd. | tel: (+66) 2513-1418 | fax: (+66) 2513-1419 | e-mail: thai@asiafireworks.com | website: www.asiafireworks.com