RNI No. DELENG/2010/33833
www.medgatetoday.com
Medgate today
Volume II || Issue I || May-June, 2011
The Gateway to Health & Medical World
Cervical Ectopia cordis, The Gateway to Health & Medical World
First Live case from India
Medical Tourism
Vol. II Issue I May-June 2011
vacwound@gmail.com, info@vacwound.com +91 9971722111, 9350042848, 9999405050
` 75
JCB ENTERPRISES PVT. LTD.
AN ISO 13485: 2003 & 9001: 2008 Certified Company
News Update | Doctor Speak | Eye Care | Dental Hygiene | Health & Fitness | Expert Views
PRICE ` 100
400 + Customer Base in India in Just 7 years
Driven by Customer Insights, Satisfaction & Expectations Fuelled By NNOVAT ON PRODUCT PORTFOLIO
• • • • •
Patient Privacy Screens with Strongest Tracks & Runners “Soflex” Unique IV Hangers “Double Telescopic” with provision for infusion pump holders “JH DMF” IV Hanger Non-Telescopic “OHMH” All S.S. Pedestal IV Stand “Classique” Bed mount IV Stand “Companion”
CORE COMPETENCIES & BUSINESS ETHICS • Transparent Approach to the Business 90% of our Sales is reference driven • Need Based Selling If there is no need we do not sell • Layout Specialization Our forte, Best, Spacious Practical, Economical Layout • Reasonable & Competitive Price Our Prices are affordable • High Quality “Customer is our Quality Guru” • High Deliverability Project Deadlines are also Efficiency Guidelines • High Commitment Levels We make customer for Lifetime
www.hospaccx.com
Mobile : +91-98452-08778 +91-9902140405 +91-9902861413
An A & R (ACCESSIBLE & RESPONSIBLE) Company
Lets Make it Simple Through Commonsensology… Bangalore | Bhubeneshware | Bhopal | Bilaspur | Chennai | Calicut | Lucknow | Indore | Mumbai | Delhi
Y M C A
Announces Admission to
1-Year Post Graduate Diploma Programme in Hospital Administration * Approved by Director General of Health Services, Govt. of India.
* Participants will be attached to Different Govt. Hospitals for Residency Training. ELIGIBILITY: MBBS, BUMS, BAMS, BHMS,Sr. Paramedical staff & Science Graduates. TIMINGS: Two Batches 3 to 5 P.M. & 6 to 8 P.M. Course Fee: Rs. 65,000/- Payable in Two Installments (Rs 40,000/-+ Rs 25,000/-) Dual Certificate option: N G O Management Course Commences from: 18th July 2011
For Further Details Contact Institute Of Management Studies New Delhi YMCA Cultural Centre Building 4th Floor, 1-Jaisingh Road New Delhi-110001
Ph: (011)-23362159 ,43644020 Email –ndyimsdir@gmail.com
Editor SPEAK
Volume-2 Issue 1 Editor
Dr. Ma Kamal
Editorial Adviser Success is the good fortune that comes from aspiration, desperation perspiration & inspiration
Dr Shakilur Rehman
National Head Afzal Kamal
“Booming Medical Tourism in India”,
Sr. Manager I.A Khurshid
Cheif Correspondent
India as a global healthcare destination. Consequently, it is expected that the country’s medical tourism market will grow at a CAGR of over 26% during 2011-2013. India is a perfect destination for medical tourism that combines health treatment with visits to some of the most alluring and awe-inspiring places of the world. A growing number of tourists are flocking in large numbers because of the superlative medical care, equipments and facilities that India offers. India excels in providing quality and cheap health care services to overseas tourists. The field has such lucrative potential that it can become a $2.3 billion business by 2012. Healthcare in India features a universal health care system run by the constituent states and territories of India. The Constitution charges every state with “raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties”. The National Health Policy was endorsed by the Parliament of India in 1983 and updated in 2002. However, the government sector is understaffed and underfinanced; poor services at state-run hospitals force many people to visit private medical practitioners. Government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayer expense. Most essential drugs are offered free of charge in these hospitals. Government hospitals provide treatment either free or at minimal charges. For example, an outpatient card at AIIMS (one of the best hospitals in India) costs a onetime fee of rupees 10 (around 20 cents US) and thereafter outpatient medical advice is free. In-hospital treatment costs depend on financial condition of the patient and facilities utilized by him but are usually much less than the private sector. For instance, a patient is waived treatment costs if he is below poverty line. Another patient may seek for an air-conditioned room if he is willing to pay extra for it. The charges for basic in-hospital treatment and investigations are much less compared to the private sector. The cost for these subsidies comes from annual allocations from the central and state governments.
Dr MA Kamal Editor-in-Cheif 2
Dr Ajay Kumar Dr Alan Norish
SA Rizvi
Dr HN Sharma
Design and Layout Zia
Sales and Marketing
Amjad Kamal Rahul Ranjan Shakir H. Yahiya Neetu Sinha Kashif Saigal 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.
Published by
Advance Media Group
Circulation Office
Add: 92/17 Zakir Nagar, Opp. New Friends Colony, Okhla New Delhi-110025 Tel: +91 11 26981342, Fax: +91 11 26982464 Mob: +91 9289336800, 9212366351 Email: info@medgatetoday.com medgatetoday@gmail.com Visit us: www.medgatetoday.com Mumbai Office: 7 Ground Floor Aradhna CHS Ltd, Bal Samant Marg, Bandra (W), Mumbai 400050 Chennai Office: 11, Krishnan, Koil Street 3rd Floor Rotary Lane Chennai-600001 Mob: +91 9840054355 Kolkata Mob:9331173317
Printed by
Artxel: 76, DSIDC Shed, Okhla Industrial Area , Phase-II, New Delhi-110020May - June 2011
Saraswati Hospital & Research Centre Pvt. Ltd.
Dr. Ramjee Prasad
Under the leadership of Dr Ramjee Prasad, Saraswati Hospital brings you experts in their field of specialisation
MD(Med), D.T.C.D (Pat), M.C.C.P (USA), F.I.A.M.S, F.R.S.T.M.H (London), F.I.A.C.M. (India) (Professor & Head of the Department Pulmonary Medcine & Critical Care S.K. Medical College & Hospital, Muz.) CARDIODIABETOLOGIST- Saraswati Hospital & Research Centre
Dr. Satyendra Kumar
MD, DTCD, (Mumbai) Physcian & Chest Specialist Ex-RMO VM Medical College & Safdarjung Hospital, New Delhi Ex-RMO Deptt. of Med. & Respiratory disease SKMCH
Dr. (Mrs.) Preeti Singh
MBBS, MS (Mysore) Obst & Gynae
Dr. Amrendra Kumar BDS, MDS Oral & Maxillo Facial Surgeon
Facilities Available 24 hours Emergency Facilities ICU, ICCU with Ultra Modern Equipment TMT, PFT, HOLTER, AMBULATORY BP Monitoring E.C.G. X-Ray, USG, Pathological Lab 24 Hour Pharmacy Internal Medicine Cardiology Pulmonary Disease Diabetes Gastroentrology Gaynee/Obst Normal & High Risk Pregnancy & Delivery Women’s Health & Maternal facilities Child Care
Dental Services
Dr. (Mrs.) Prerna BDS Dental Surgeon
General Dentistry Cosmetic Dentistry Oral Surgery Orthodontics
Saraswati Hospital & Research Centre Pvt. Ltd.
New Police Line Road , (In front of M.I.T. East Gate), Daud Pur Kothi, Muzaffarpur (Bihar) Contact No. +91 9204792918, + 9204552225, +91 9334545669 May - June 2011
3
Content P6
service tax on healthcare
Summer Drinks for Soft and Knee Shiny replacement Skin
P14
cases increases
P40
Cervical Ectopia cordis First Live case from India
P22
Every Ophthalmologist in Corporate World.
P18
Infertility causes and mistakes by Dr. Suman Bijlani
P24
NEWS UPDATE
Emphasising that through this service tax is on high end treatment, Mukherjee said that there would be an abatement of 50 percent so that the actual burder is kept 5% of the value of service.
T
he Union Finance Minister Pranab Mukherjee while presenting the union Budget for 2011-12 has announced that the service tax on health check up or treatment imposed in 2010-11 would now be replaced with a tax on all sevices provided by hospitals with 25 or more beds that have the facility of central air conditioning. Emphasising that through this service tax is on high end treatment, Mukherjee said that there would be an abatement of 50 percent so that the actual burder is kept 5% of the value of service. The finance minister said that levy would be extended to diagnostic tests of all kinds with the same rate of abatement. All government hospital would be outside this levy.
service tax on healthcare 6
May - June 2011
NEWS UPDATE
The 5 per cent service tax on healthcare - that the Government is likely to roll back on Tuesday - would have made the treatment extremely expensive. Ever since the Government announced a new service tax on healthcare services this union Budget, pressure has been growing to announce a roll back
Dr.Pradeep Bhardwaj
CEO,Six Sigma Healthcare Modern healthcare as it is beyond the affordability of a common man. It is a known fact that ,the public sector by it self is not geared up to provide Medicare to all. The Govt. should in fact, consider making “Health Check Up” cheaper by giving benefits like subsidized so that the load on the healthcare industry is reduced by controlling health related problems at preventive stage rather than the curative stage”. Health belongs to the service sector hence we should underline the Social Contract rather than the business contract in healthcare.
Dr Devi Shetty Noted cardiac surgeon Dr Devi Shetty launched a nation-wide appeal - calling this a ‘misery’ tax. “India spends less than 1per cent of its GDP on health care..less than 10 per cent of the population can afford heart surgery, or even cancer treatment,” said Dr Devi Shetty, Cardiologist and Chairman, Narayana Hrudaylaya.
Dr Naresh Trehan “My plea to finance minister is that they’re already stretched, lets not burden them further, said Dr Naresh Trehan, Chairman and MD, Medanta The Medicity”.
May - June 2011
7
NEWS UPDATE
FDA approves new medical device for form of brain cancer
The U.S. Food and Drug Administration recently approved the NovoTTF-100A System, a new device to treat adults with glioblastoma multiforme (GBM) that recurs or progresses after receiving chemotherapy and radiation therapy. Brain tumors are the growth of abnormal cells in the brain tissue. According to the National Cancer Institute, each year about 19,000 people in the United States are diagnosed with primary brain cancers. In 2010, there were 13,140 deaths from brain and other nervous system cancers in the United States. GBM is the most common primary brain cancer. The brain tumor is highly resistant to standard treatments such as surgery, radiation and chemotherapy. When using the NovoTTF-100A System, a health care professional places electrodes on the surface of the patient’s scalp to deliver low-intensity, changing electrical fields called “tumor treatment fields” (TTFs) to the tumor site. The unique shape and electrical characteristics of dividing tumor cells make them susceptible to damage when exposed to TTF, which could stop tumor growth. The device is portable and can be powered with batteries or plugged into an electrical outlet. Patients can use the device at home, allowing them to continue their normal daily activities.
Understaged breast cancers have common features One in four cases identified by core needle biopsy as DCIS were invasive
M
ost ‘palpable’ cancers diagnosed at core needle biopsy as ductal carcinoma in situ are actually understaged invasive breast cancers, research suggests. The findings are part of an Australian meta-analysis of more than 50 studies and 7500 DCIS diagnoses, which researchers hope will help doctors avoid future underestimations of invasive breast cancer. About one in four (25.9%) breast cancers thought to be DCIS at CNB were actually understaged invasive breast cancers, the analysis found. This was the case with 54.1% of palpable cancers and 49.1% of cases where the needle was guided without any imaging.
8
May - June 2011
• • • • •
•
• • • •
• •
• • • • • • • •
• • • • •
• •
May - June 2011
• • • •
9
NEWS UPDATE
Kids’ arteries narrow with TV watching E
ach hour per day spent watching TV was linked with an average 1.53Îźm narrower retinal arteriolar calibre and a reduction of 0.78Îźm in retinal arteriolar diameter. Children who spend too much time watching the idiot box have narrower retinal arteries, new Australian research shows.
FDA approves the first vaccine to prevent meningococcal disease in infants and toddlers
The research, conducted at the University of Sydney, also found the increased risk of heart disease, high blood pressure and diabetes from each hour a day of television was similar to that associated with an increase of 10mmHg in systolic blood pressure.
The U.S. Food and Drug Administration approved the use of Menactra in children as young as 9 months for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135. Menactra already is approved for use in people ages 2 through 55 years.
Meningococcal disease is a lifethreatening illness caused by bacteria that infect the bloodstream (sepsis) and the lining that surrounds the brain and spinal cord (meningitis). Neisseria meningitidis is a leading cause of meningitis in young children. Even with appropriate antibiotics and intensive care, between 10 percent and 15 percent of people who develop meningococcal disease die from the infection. Another 10 percent to 20 percent suffer complications such as brain damage or loss of limb or hearing. 10
May - June 2011
May - June 2011
11
NEWS UPDATE
Colder Products Company Achieves ISO 13485 Quality Certification for Medical Devices
St. Paul, Minn. – April 19, 2011 – Colder Products Company, the leader in connections for medical devices, announces the successful certification of its ISO 13485:2003 Quality Management System. This certification confirms that Colder connectors are designed and manufactured to the highest standards of the medical device market. “We continually seek opportunities to improve our products and processes to exceed our customers’ demands for high quality medical connectors,” states Gary Rychley, president of Colder Products Company. “ISO 13485 certification reinforces our commitment to the medical device market and to partnering with manufacturers to rapidly deliver new devices to market.” Globally, there is an intensifying effort to harmonize the quality systems of medical device manufacturers, and ISO 13485 has been selected as the foundation for quality system compliance. ISO 13485 is a certification specifying international requirements on the ability to continuously provide medical devices and related services to meet regulatory and customer requirements. ISO 13485 certified suppliers can help medical device manufacturers get their devices approved and into production more rapidly.
‘HIROSHIMA SYNDROME’ IN KERALA
“Hiroshima syndrome” as women are refusing to beget children and opting for abortion if they become pregnant. They fear that the babies they beget may have serious congenital disorders as the mothers of Hiroshima and Nagasaki had feared decades ago. Women in Kerala’s Kasaragod district, where indiscriminate use of Endosulfan has played havoc with human lives and led to the birth of babies with congenital defects, are scared of becoming pregnant. Those who become pregnant, opt for abortion The Endosulfan tragedy in Kerala’s northernmost Kasaragod district has begun to cause what scientists now call a “Hiroshima syndrome” as women are refusing to beget children and opting for abortion if they become pregnant. They fear that the babies they beget may have serious congenital disorders as the mothers of Hiroshima and Nagasaki had feared decades ago. Reports from the pesticide-hit areas of Kasaragod show that wilful foeticide by women has become extensive there. Their fears are not unfounded: Most of those who have so far travelled to Mangalore to get their pregnancies terminated have the experience of giving birth to children with serious deformities and diseases. They do not want to give birth to more such babies. This has turned into a syndrome in the region as even women in their first pregnancy are also beginning to choose this path as they fear that the Endosulfan their body systems have been absorbing since birth would cause disorders for the babies in their wombs. 12
May - June 2011
Colour Doppler Ultrasound Ethiroli Tiny 16a®
Classic Trolley with LED Monitor
Indian Made Colour Doppler at Unbelievable Price
Surabi Biomedical Instrumentation (India) Pvt. Ltd., 1A, “Gaa wing”, G.T. Cholayil Residency, Rail Nagar Road Koyambedu, Chennai 600 107.
Ph: 0422-4399716, Cell: 099406 70406 www.surabhi.com kannan@surabi.com
May - June 2011
Be Indian Buy Indian...
13
NEWS UPDATE
Knee replacement cases increases Dr. Ashwani Maichand
M.S. (Ortho) M.Ch. (Ortho) Fellowship Joint Replacement
Your knees work hard during daily routine, and arthritis of the knee or a knee injury can make it hard for you to perform normal tasks. If your injury or arthritis is severe, you may begin to experience pain when you are sitting down or trying to sleep. A total knee replacement is the only option for reducing pain and restoring a normal activity level
Each year, more than 250,000 people in India and 600,000 people globally undergo total knee replacement surgery and it will be doubled after 5 years, Said Dr. Ashwani Maichand a famous consultant joint replacement. The largest joint in the body, the knee is one of the most crucial joints involved in movement. The femur, tibia, kneecap (patella), cartilage, muscles, ligaments, membrane
Each year, more than 250,000 people in India and 600,000 people globally undergo total knee replacement surgery and it will be doubled after 5 years, Said Dr. Ashwani Maichand a famous consultant joint replacement. and fluid all work together to ensure mobility in a healthy knee. Osteoarthritis, injury or disease can interrupt the normal functioning of the joint and cause pain and problems moving. Often, a knee replacement is the best option for relief. This can be done in patients of all ages, including the elderly.
14
May - June 2011
May - June 2011
NEWS UPDATE
Flat Foot can be cured by running barefoot better than with shoes Barefoot running can be beneficial while heavily cushioned running shoes may be leaving the foot prone to injury, according to a US sports medicine expert.
I
rene Davis of Harvard Unive rsity has been studying both barefoot running and minimal footwear running, which uses a type of running shoe almost like a glove for the foot, but with a thin layer of rubber on the bottom, reports ABC Science. These shoes give the foot its full range of natural movement, but protect the sole from stones or extreme surface temperatures. Davis, a Fellow of the American College of Sports Medicine and a Catherine Worthingham Fellow of the American Physical Therapy Association, said cushioned running shoes encourage runners to land hard on the heel at the end of each stride. “When you land on your heel you end up with a very 16
quick rise to peak in the force that your body experiences. That completely goes away when you run barefoot because you land on the ball of your foot,” said Davis. Davis and co-authors tested their theories by looking at Kenyan runners. “We wanted to find if people who had never worn shoes before demonstrated the same kind of running pattern,” said Davis. “We felt that was a better indication of how we were naturally meant to run because these individuals had never worn shoes. When we tested (the runners) in Kenya, we found exactly those same kinds of mechanics. They don’t land on their heels, they land with a very gentle forefoot strike pattern,” she said.
Once you remove the shoe and take away the artificial shock absorber, the tendons and muscles in the foot, the ankle, calf and thigh start to do the job they were built for, Davis said. She said that causes some runners pain because they aren’t used to using those muscles to control the foot and absorb shock, and they tend to overdo it in the initial stages. “We’ve basically deconditioned our feet by wearing shoes and by wearing very robust motion controlling and cushioning shoes, which takes away some of the function of the foot,” she said. Davis said she has also found that running barefoot can help flatfooted people to strengthen and raise the arches. May - June 2011
Dr. Ashwani Maichand M.S. (Ortho) M.Ch. (Ortho) Fellowship Joint Replacement
Min
o
max
Clinic 7A/75, W.E.A., Pusa Road, Karol Bagh, New Delhi-05 Contact: 09811129607 OPD Timings: 7 to 8.30 p.m.
Minimal Access Orthopaedic Surgery
(Daily except Sunday) www.minomaxorth
Specialist MIS Joint Replacement
Arthroscopic Surgery
�
�
� � � � � �
Cemented Non-cemented Hybrid THR Surface Replacement Arthroplasty Metal on Metal THR Ceramic or Ceramic Replacement Total Knee Replacement Unicondylar Knee Replacement
May - June 2011
� � � � �
Knee Arthritis Ligament Replacement Shoulder Ankie Elbow Wrist Arm 17
EYE CARE
How to set up an Eye care center?
Dr.Sharad Lakhotia M.S (Ophth)
Every Ophthalmologist in Corporate World.
O
phthalmology today is not only a fine art of delivering skillful services in eye care but has acquired significant status of a corporate player with great financial involvement. Had it been simply a profession to perform specialized medical treatment than the prospects & future of different ophthalmologist should not have been so different. When great finances are involved, it becomes a commercial venture and eventually you become a market player. Your role is to study the trends in the market and make a successful profitable business. If you are not trained to handle money matters, you may even lend into great trouble both mentally & financially. Some three decades ago, supporting financially and getting an M.S in ophthalmology was not a big deal for majority of ophthalmologist. Today if we consider capitation fees & other part, it is already a 1 crore deal which has been spent along with a decade of hard working after schooling. When today lots of streams are available where you can complete your study for peanuts to
18
moderate amount, with less than half of time spent and with better financial deals along with better quality of life & better prospects. Compare with 2 siblings, senior one with M.S (Ophth) and placement in hospital with junior one MBA & IIT qualification. Junior may become a great entrepreneur while the senior is still struggling. So the financial planning of an individual begins immediately after schooling. You may have to consider amount and its interest in education and number of years spent in relation to revenue generated. Once you become a full fledged ophthalmologist, the real game begins. If you are a general ophthalmologist, chances of getting a better job are difficult. It is better to do a fellowship, so that door is open for you in govt. hospital, corporate hospital and opportunities in group practice. However if you have good financial back ground, you may start a set up and employ people to make it a complete ophthalmic unit. Otherwise one can join, Trust hospital in small cities, when one can get opportunities to learn and a reasonable life style. With limited recourses a solo practice May - June 2011
EYE CARE
When great finances are involved, it becomes a commercial venture and eventually you become a market player. Your role is to study the trends in the market and make a successful profitable business. If you are not trained to handle money matters, you may even lend into great trouble both mentally & financially with moderate facilities may be an option for constant struggle in years to come. Profits & positions in future are determined now only. As setting up an ophthalmology clinic requires finance from 1 crore to 20 crores, depending on area of practice, in big cities. All the financial implication has to be studied carefully. You have to be like a corporate player, where every move has to be justified in competitive market. While opting for practice one can opt for solo practice or group practice. In either way, one has to consider 2 aspects of business Internal business plan It’s periodical re-evaluation
20
While building a plan, one is always at advantage if one is trained at a specialized institution with fellowship. Then you have to study the market and analyze where there is scarcity & demand for your services and design an internal business plan. You have to collect information from senior colleagues, medical representatives, sales executives and general practitioners of that area. Internal business plan can be a simple mission statement that defines your philosophy of practice and goals. It can be a detailed plan of few years, which you want to establish with your vision, mission, market analysis, defining priorities, objectives and a complete plan of action with periodic revaluation. There should be plan to change depending upon market focus. A mission statement can be a one stop shop for everything in ophthalmology where things are not clear. It can be a “specialized vitro retinal care�, if you have a fellowship & training programme with a distinct mission. You may add up other facilities later.
May - June 2011
EYE CARE
Group Practice: - While joining group practice one has to study need & demand for the specialty in that set up & infrastructure available to work. Many practitioners today have family legacy where individual growth may be restrained & further positions are not apparently easily available. A practice of ophthalmologist of 55yrs plus and already established can give better prospects for future along with present position. If young ophthalmologist identifies practice of a senior ophthalmologist, who has no next generation to sustain practice, it can be a highly mutually beneficial, financially viable & futuristic relationship. Financial Feasibility:- Cost of land & property, cost of equipment, its maintenance, depreciation, cost of electricity, house tax, rent etc & cost of staff have to taken into account before profits are derived. Â If loans are taken then repayment schedule have to be taken into consideration before determining return of your skill. Thus also these factors are not very optimistic for solo practitioner. Need of the Hour:- The solo practitioner of
May - June 2011
neighborhood should group themselves and evolve a common set up for investigation, O.T, Lasik without OPD, where profits & facilities are shared by all group members. Others can be given courtesy attachment for further revenue generation. Eventually this specialized set up becomes a constant source of regular income even at old age, when you are not very active in profession but still would love to retain status of ophthalmologist. This is also the best way for optimal utilization of equipment. Also for Mediclaim insurance business, it is a good idea, as in small set up getting & maintaining TPA’s is a big problem. Alternately one can invest in property and get regular sources of income in old age but without ophthalmic indulgence. Lasik is true revenue earner, after cataract surgery. Lasik is the great revenue earner, as cataract is done every where with a reasonable investment. Lasik requires a large investment & planning. If 10 ophthalmologists of local area can form a group to have a neutral Lasik centre, it almost instantly guarantees success. Of late all great practices in ophthalmology worldwide have been essentiality due to a Lasik centre. Without your own Lasik unit, you can’t make a significant financial success .Thus owning a machine and sharing the utility & cost makes an excellent corporate decision. Now femtolaser technique is in pipeline, which is going to revolutionize cataract surgery and require group participation. Egos, which are integral part of most of ophthalmologist, have to be sacrificed for financial gains & prosperity. In nutshell, a total consideration of various factors makes a great success story.
21
COVER STORY
Cervical Ectopia cordis, First Live case from India Case Diagnose By Dr.Rajiva Kumar,Muzaffarpur (Bihar)
This is a report of a case of the rare ectopia cordis malformation of the thoracoabdominal type without intracardiac anomalies. The patient had a successful single stage repair with reduction of the herniating heart and reconstruction of a cartilaginous cover to protect the heart. The result was very good. About Patient: Presently the baby called “APURVA“ resident of Chandwara, Muzaffarpur is doing well after treatment and operation done at AIIMS under Dr.A.K.BISOI (Consultant)
Traetment: ECTOPIA CORDIS REPAIR.
Dr.Rajiva Kumar Child Specialist
22
Relocating the heart into the right side of the chest cavity and reconstruction of the anterior chest wall. Ectopia cordis is a birth defect in which the heart is abnormally located. In the most common form, the heart protrudes outside the chest through a split sternum. Less often the heart may be situated in the abdominal cavity or neck. Often other birth defects are also present. This condition is usually fatal in the first days of life. In some cases surgical treatment is possible. The ectopic heart is not protected by the skin or sternum. Other organs may also have formed outside the skin. Often the heart is not formed properly and many other heart defects are associated with this May - June 2011
COVER STORY
Condition including:
lengthy and very complicated pediatric Tetralogy of Fallot, pulmonary atresia, atrial cardiothoracic surgery. Christopher Wall and ventricular septal defects, double (19 August 1975) holds the Guinness World outlet right ventricle. Other non cardiac Record for the oldest living person with malformations may be present such as condition. cleft palates, and spine malformations that Depending on the position of the heart from birth ectopia cordis can be classified into can cause kyphosis.
Occurrence:
7.9 per million births. Ectopia cordis is a very rare congenital heart malformation. Etiology: No exact cause has been identified but this condition has also been seen more frequently in Turner Syndrome and Trisomy 18; however so far there is no evidence that it is a genetically transmissible disease.
Prognosis:
Most cases result in stillbirth or death shortly after birth. Some cases of ectopia cordis can be treated surgically but in general involve May - June 2011
Four categories:
Cervical - in the neck Thoracic - where the heart would lie within the thoracic cavity. Thoracoabdominal - where the heart would lie somewhere between the thoracic and abdominal cavities. Abdominal - where the heart would lie in the abdominal cavity. The malfunction happens when the sternum forms during the gestation period and the heart begins to grow in the wrong place. 23
DOCTOR SPEAK
Infertility causes and mistakes by Dr. Suman Bijlani
Infertility Lifestyle changes to aid fertility Moderate your alcohol intakeLimit caffeine intakeMaintain ideal body weightPlan pregnancy before 35Practice safe sexExercise regularlyEat healthyStress Management10 monthly mistakes you make when trying to conceive
24
Infertility:
Reproduction is one of the complex, yet wondrous events in human physiology. Nature has given attention to every detail, and a series of events in both the man and woman, ultimately culminate into biological union and the beginning of a new life. Yet, sometimes, untoward happenings can mar this flawless chain of events and the couple find themselves at a loss. Infertility, in medical terms, is described as the failure to conceive after one year of regular, unprotected intercourse. This definition is not inflexible, and anxious couples or those older than 35 are offered treatment sooner. To understand why fertility failure occurs, one must understand the process of reproduction. After being deposited in the vagina through intercourse, millions of sperms, by virtue of their motility (they have tails), move across the cervix into the uterus and further into the fallopian tubes. Around the time of ovulation (egg rupture),the cervical mucus becomes thin and watery to facilitate this passage. Chemical signals from reproductive secretions and the female egg guide the sperm to the site of fertilization, viz the fallopian tubes. If the woman is in her fertile period, meaning peri-ovulatory (near the time of ovulation), her ovum(unfertilized egg),after being released from the ovary, gets sucked into the fallopian tubes and travels through tubal action, up to the mid-tube, where it lies in wait for the sperm. One of the many sperms would penetrate the ovum, an event termed as fertilization. The fertilized egg,again aided by muscular movements of the tube, then moves into the uterus, whose inner lining is already prepared by hormonal changes, for implantation. The egg then implants into the uterus, obtains nourishment, and begins to grow. Fertilization does not occur in every cycle. The chance of conceiving in every cycle is about 25% for a woman younger than 30, and about 15% for a woman who is 35 plus. Most couples would take about 5 to 6 cycles
May - June 2011
DOCTOR SPEAK of regular intercourse to conceive and about 85% would have conceived by the end of one year. The causes of infertility in the woman could be as follows: Ovulatory dysfunction (failure of ovaries to produce eggs) – this is commonly seen in the older woman (more than 35), PCOS, obesity, stress, thyroid dysfunction and women with irregular cycles or ‘hormonal imbalance’. Tubal factor – the fallopian tubes are diseased and this affects their function of sperm and ovum transport. Sometimes the tubes may be completely blocked not allowing the gametes to pass through at all! Sexually transmitted infections such as gonorrhoea, chlamydia, and tuberculosis in our country, are the commonest causes of tubal disease. Pelvic disease- Any inflammatory disease of the pelvic organs can lead to formation of fibrous bands known as adhesions within the pelvic cavity, which may distort the anatomical relationship between the various pelvic organs. This directly affects the ability of the tubes to pick up the ovum and transport it across. Endometriosis and infections are common causes of this condition. Uterine factorthe uterine cavity may be distorted by the presence of anatomical defects such as a septum which may interfere with implantation. Fibroids in the inner aspect of the uterus or ‘adhesions’(fibrous bands within the uterus) may also be responsible for failure to implant. Tuberculosis is again one of the common causes of intra-uterine adhesions.
Cervical factor- the cervical mucus may be thick and impenetrable, as a result of longstanding infection or the cervical canal may be partially closed due to inflammation (stenosis). Multiple factors- in many cases, there may be more than one cause. For example, she may have tuberculosis with damaged tubes and uterus, or endometriosis, where ovulation and tubes may both be affected. Unexplained infertility- there is a subgroup of patients, wherein no cause is found for fertility failure.
Lifestyle changes to aid fertility:
Give up smoking (or at least cut down)Smoking affects the ability of the ovaries to produce eggs as well as the hormone estrogen, especially in women who smoke more cigarettes and over a long period of time. Smoking thus reduces fertility. In addition, it increases your chances of miscarrying or getting an ectopic pregnancy. Women who smoke also jeopardise their partner’s sperm counts and function due to effects of passive smoking.
Moderate your alcohol intake-
There is no doubt that moderate to heavy alcohol intake interferes with ovulation and may increase your risk of developing endometriosis, and promote hormonal imbalance. Whether light drinking harms her fertility potential,is controversial. It is advisable to abstain, or at least limit alcohol to minimum possible, if you are trying to conceive.
Limit caffeine intake-
Caffeinated drinks such as coffee, tea, colas and chocolates form a regular part of our diet in today’s times. Increased caffeine consumption (more than 300 mg per day) can reduce fertility in women, albeit the exact reason is not known. 300 mg is about 2 cups of coffee or 5 cups of tea. So, limit your coffee/tea intake and if you are trying for a test tube baby, abstain altogether for best results.
Maintain ideal body weight-
Body mass index between 20 and 23 is ideal. May - June 2011
25
DOCTOR SPEAK
Women who are overweight tend to have ovulatory problems and PCOS, while very lean women may not have enough estrogen to form eggs and prepare theisr uterine lining. Overweight women would benefit from losing even 5 to 10% of their body weight, even though they may not be able to get back to an ideal weight for height. Anorexic women should seek treatment to gain weight to restore normal cycles and ovulation.
Plan pregnancy before 35-
Focus on career and late marriages are now the reason more and more women are pushing pregnancy to a later age. Research has shown that fertility declines after 35 significantly for women, as the quality and quantity of her eggs suffer. Miscarriages become more common as do genetic defects in the offspring. Whenever possible, it is better that women prioritise pregnancy planning to optimise fertility outcome.
Practice safe sex-
More relevant today than at any other time, this dictum could save many women from the devastating effects of sexually transmitted infections. Blocked fallopian tubes, inflammation of the uterine lining and cervix as well as pelvic adhesions can result from these infections. Tips for women to protect themselves from sexually transmitted infections: » Minimise number of sexual partners, one would be ideal » Use condoms whenever there may be a risk of contracting infection » Test self and partner prior to marriage (pre-marital counselling) or before indulging in sex » Avoid abnormal sexual practices » Watch out for foul smelling white vaginal discharge, especially if accompanied by pelvic pain and painful urination (may signal sexually transmitted infection)
Exercise regularly-
Moderate exercise in the form of walks, swimming, jogging or work outs at the gym, can improve pelvic circulation, general health, maintain body weight and ward off depression. Choose a simple, easy to perform exercise regimen and throw in variety to keep up the pace.
Eat healthy-
There is no particular ‘fertility diet’, however, the importance of a balanced diet consisting of all essential nutrients cannot be undermined. Many micronutrient 26
May - June 2011
DOCTOR SPEAK deficiencies can disturb the delicate balance of hormones and reduce fertility.
Stress Management-
Stress can affect the higher organs in our brain (the hypothalamus and pituitary), which can lead to suppression of reproductive hormones, leading to anovulation and menstrual disturbances. Moreover, stress can affect her libido and frequency. The unfortunate scenario is that fertility treatments by themselves are extremely stressful and couples have to battle emotional, financial and social pressures during the course of the treatment. The couple has to support each other and may seek the help of a professional counsellor whenever necessary. Most fertility clinics provide support in the form of their own counsellors. One last word from a doctor’s perspective. Often we come across couples who are at the tethers of their patience, and have sought the best possible treatments and cannot understand ‘why it is them’ or how the most expensive doctors and treatments failed to work. We must understand human limitations.
Medical science has not been able to control birth and death and sometimes we have to bow down to the will of the Almighty.
10 monthly mistakes you make when trying to conceive:
» Having timed intercourse just before or after periods (the most fertile period is around mid-cycle) » Having sex during periods (this can increase your chance of getting infections) » Using lubricants like creams, gels and oils (these can harm sperms) » Ignoring white discharge and urinary complaints (treat infections promptly) » Drinking excess caffeinated drinks or alcohol or smoking » Avoiding exercise for fear that it may prevent pregnancy » Eating unhealthy » Trying too hard (that can sky-rocket stress levels) » Crying every time you get your period (remember a normal couple has just about 20% chance of conceiving each cycle) » Not taking folic acid supplements
EXPERT VIEWS
Healthcare Planning and Management an overview of Medical Equipment Management
Part II
A
suggested cycle of systematic equipment management is shown in the Figure.1 The steps are broadly as follows:
Planning
Planning for the provision of medical equipment must involve the following considerations. At the policy making level and at the operational level these would be the decisive factor. »» The population targeted by the health services »» Their health needs, meaning thereby the different levels of services being provided by the health centers at different levels vis a vis the health needs of the people. »» The health service functions required to meet those needs, meaning thereby the activities being performed at different levels of health centers, and the equipment needs based on these functions. »» The health care equipment required to perform those functions, meaning thereby the level of equipment to conform to the functions being performed at the health centers. Neither more nor less. »» The available resources, meaning thereby the resources being available with the centers and their headquarters for performing efficient and effective operation of equipment to achieve optimal output. This will comprise of Man (means staff working at the health centers and their ability and capability to perform), Material (means materials and consumables needed to perform effectively and without interruption), Money (means availability of adequate budget to operate and take care of the needs), Machines (means availability of tools and equipment needed to perform necessary corrective and preventive maintenance for smooth and efficient operation of equipment),
28
May - June 2011
EXPERT VIEWS
Mind (meaning thereby the attitude, will and motivation of the staff at all levels to perform optimally) to perform. Policy National / State Priorities as determined by a National / State planning body
Selection
Budget Planning
Procurement
Staff training
Distribution
Logistic support Information Centre
Utilisation Records
Installation Assembly
Evaluation
Utilisation Inventory storage
Operation
Calibration
Analysis of cost effectiveness
Training Centre
Maintenance
Testing
P.P.M Repair
Diagram: 1: Equipment Management Cycle A state planning body/ executive planning body with an effective information service should be organised to formulate broad policies, determine priorities and allocate budget and resources. A planning group should be organised at the hospital/district level to make decisions on selection and procurement of medical equipment, on the basis of the following considerations: The equipment must be carefully selected to ensure that it:  gives the best value for money, weighing lifetime cost against purchase price May - June 2011
29
EXPERT VIEWS
Staff should be adequately and properly trained before being allowed to use equipment. A national/state training centre should be established or liaisoning with an already established agency should be made for this purpose »»
can be maintained continuously during its expected lifetime, in terms of its upkeep, repair and spare parts (a budget for maintenance contracts, spare stocks and information transfer must be provided). »» Comes from reliable, reputable and experienced manufactures All commercial transactions should preserve the interest of the purchaser and user, as well as that of the supplier and manufacturer. Writing of specifications must involve the direct user of the equipment and qualified technical staff in the hospital/district or if there aren’t any, a consultant should be hired for the same. The financial resources available must be allocated equitable for »» initial purchase and installation, including foreign exchange, if any »» running costs. Arrangements for maintenance should be considered at the time of procurement and should be applied systematically throughout the lifetime of the equipment. Maintenance arrangements can be made either under contract with the manufacturer or in-house by the health care technical service. Staff should be adequately and properly trained before being allowed to use equipment. A national/state training centre should be established or liaisoning with an already established agency should be made for this purpose.
30
May - June 2011
NEWS UPDATE
Utilisation
The utilisation rate of equipment in current use must be assessed and if necessary, increased through adequate manpower and logistic support. The period of delivery, installation and assembly of equipment must be shortened (optimal). Documentation about the use and maintenance of the equipment must be obtained for management purpose. Such documents should always be handed over to the relevant hospital/ center, for their regular perusal. Inventory and storage methods must be improved (either computerized or manual) and the operational procedures regulated.
May - June 2011
31
NEWS UPDATE
32
May - June 2011
expert views
Evaluation Indices can (should) be used to evaluate the utilization of medical equipment. These include: Annual rate of operation of utility = No. of annual visits X average operational time per visit/ annual actual operational time X 100 Annual rate of effective time of utility = No. of annual visits X average operational time per visit/ annual possible operational time X 100 Positive Rate = Positive visits/ total visits X 100 Demand for equipment = Use rate per person per year x population / rate of effective use time of equipment x possible operational quantity. Cost effectiveness and cost benefit analysis may likewise be used in evaluating the effectiveness and efficiency of the use of medical equipment. The potential years of life saved, survival rate and quality of life are some of the indicators in cost effectiveness analysis. Indirectly poor patient satisfaction, and more cost to the people through non-availability of services (and getting treated in the private sector) are also vital factors to be considered Cost-benefit analysis evaluates all outcomes in economic terms. With the start of user-fee system at almost all hospitals at district level, this analysis has more importance since each downtime/nonoperational days of the equipment will lead to reduced revenue through nonfunctioning.
Fastest Growing Healthcare and Hospital Consultancy in India
Our Consultancy Services: Hospital Planning & Architecture Business Development & Promotions Hospital Management Consulting Inventory & Biomedical Equipment Consulting Hospital Information System Human Resource Management
Completion Commissioning Construction Consultancy Concept
Head Office: No. 88, 2nd Floor, Shreya, RMV 2nd Stage, Ashwathnagar, Bengaluru - 560 094. INDIA Tel: 080 40998807 Regional Office: 505, Arcadia, Hiranandani Estate, G. B. Road, Thane (W) 400 607, Maharashtra. INDIA Mobile: +91 9967339880 Tel: 022 41232233
Bengaluru Bhopal Bhubaneswar Bilaspur Calicut Chennai Delhi Indore Lucknow Mumbai Ranchi Vizag
May - June 2011
33
DENTAL HYGIENE
Canker Sores 34
The sores that appear inside the mouth are round in shape, gray or white in color, with a red border or edge. The fever blisters are quite distinct from them.
May - June 2011
dental HYGIENE
Canker sores
C
anker Sores or aphthous ulcer are basically small shallow ulcers, which appear in the mouth seemingly out of nowhere. People suffering from this kind of problem normally find eating food quite difficult as these lesions are painful. It is estimated that 10% of the population suffers from recurrent canker sores and women tend to be more affected than men.
Canker Sores Types
Canker sores can be broadly divided into two categories; simple canker sores and complex canker sores. Simple canker sores are common among the people of age groups 10 to 20. People of this age group suffer from this problem 3 to 4 times in a year and it lasts up to a period of one week. Coming to complex canker sores, these tend to be less common than the simple canker sores. It mainly occurs to people who have a history of canker sore problems.
Canker Sore causes
The precise cause of canker sores is still unknown. But according to scientists and research scholars, it
Canker sores pictures
mainly occurs due to stress or tissue injury. There are some fruits and vegetables with acidic properties, which are capable of making the problem worse. Some of the citrus fruits and vegetables, which directly target canker sores, include oranges, lemons, apples, pineapples, tomatoes, figs May - June 2011
and strawberries. These are some of the natural substances, which can make the problem serious, but there are some related to dental procedures such as ill-fitting dentures, braces, etc. which can take a normal case to a serious level. The causes, which can lead to complex canker sores are mainly associated with an underlying health condition. These underlying health conditions include gastrointestinal tract disease (diseases like Crohn’s disease and Celiac disease), an impaired immune system, nutritional problems related to deficiency of iron, zinc, folic acids and vitamin B-12.
Difference between Canker Sore and Fever Blisters
Some people might think that canker sores and fever blisters are the same or confuse one for the other. The nature and symptoms of canker sores are quite dissimilar to fever blisters. Canker sores comprises of painful sore(s) inside the mouth, soft palate and on the surface of the tongue. These sores appear along with a burning sensation. The sores that appear inside the mouth are round in shape, gray or white in color, with a red border or edge. The fever blisters are quite distinct from them. They are caused by Herpes Simplex virus and are highly contagious. In some cases, the patients suffering from canker sores also complain about physical sluggishness, fever and swollen lymph nodes. 35
DENTAL HYGIENE
Canker Sores Treatment:
Generally, canker sores heal within one or two weeks without any kind of treatment. You should try to avoid spicy and acidic food till they heal as they tend to worsen them. Rinsing with salt water or antimicrobial mouth wash is helpful. If the sores include intolerable pain, you should consult your dentist. Some solutions, which dentists normally prescribe to reduce pain and irritation include a corticosteroid ointment and an antimicrobial mouth rinse.
Canker Sores Prevention
»» Some prevention tips for canker sores include »» By avoiding extremely spicy and acidic food if you are prone to canker sores. »» Dental Braces which abrade the oral mucosa should be covered by wax. »» Regular use of mouth wash can prevent or reduce frequency of occurrence of canker sores. »» In some cases, a component of toothpaste might be responsible for them. So if you keep on getting canker sores, you might try changing your toothpaste and see if that helps.
36
May - June 2011
product Line
Scientech Medicare launches a new Digital Portable Ultrasound Scanner Technical Specification General 128 arrays, 32 transmitting and receiving channels Scanning Mode: B,BB,4B, B+M, M Transducer Connector: 2 (standard) Scanning Depth: 40-250 (depending on Transducer) Cine Loop: 2000 frames, several frames (B, 2B, 4B, 9B) Can display simultaneously, also support B/M,M Mode Image Conversion: Up/down, left/right, black/white 8 segment TGC adjustment Gamma correction, stat, histogram, Probe selectable: Convex, linear, microconvex, transvaginal, rectum Display 10 inches B/W SVGA monitor Display: Date, time, name, sex, age, doctor, hospital, annotation, probe name, probe frequency, measurement values, body marks etc. Standard confrigurations R60/3.5 MHz convex (2.5/3.5/6.0MHz) 10 inch B/W SVGA monitor, USB 2.0 port Optional R13/6.5MHz Transvaginal convex (5.0/6.5/8.0MHz) R20/5.0MHz micro-convex (2.0/3.5/6.0MHz) 7.5 MHz linear (6.5/7.5/12.0 MHz) 6.5MHz rectum linear (5.0/6.5/8.0 MHz) Inkjet printer, laser printer, video recorder, trolley puncture frame
Pranay Upadhyay
Scientech Technologies Private Ltd. 94, Electronic Complex Pardesipura, Indore - 4520 10, INDIA Ph: +91-731-42111100 Fax: +91-731-2555643 Email: info@scientech.bz Website: www.scientech.bz
May - June 2011
Portable Ultrasound Scanner (Caddo 11B) is dynamic medical imaging device used to visualize internal parts of the human body. It is used for the diagnosis & analysis of gall bladder, liver, kidney, spleen, pancreas, ovary, uterus, urinary bladder, small parts etc. Scientech Medicare, a Scientech Group Company has launched Caddo11B a new Digital Portable Ultrasound Scanner. This latest model gives user excellent results for diagnosis with its advanced features & applications. It is based on Windows XP operating System which comprises of many features like digital beam former (DBS), real time dynamic aperture (RDA), dynamic frequency scanning (DFS), real time dynamic filtering (RDF), dynamic receiving focusing (DFR) & tissue harmonic imaging technology (THI). As name implied the machine is very portable only 11 Kgs and user friendly. The USP of Scientech Medicare’s Caddo 11B is price. The company has kept pricing very affordable for doctors, diagnostic centers, practitioners without compromising on the quality. The other advantage one can get is after sales service from Scientech. The healthcare industry is growing and demands are for more portable and user friendly devices. Now hospitals, diagnostic centers prefer portable ultrasound machine to big, bulky trolley machines. They are very keen to modify their hospital and facilities that’s why they are shifting for technological oriented systems. Software also plays a very important role in that. Our machines take care of such systems and now our equipments are available with USB, DICOM, Ethernet, etc which is the best feature for Tele-Medicine. Direct ‘Export to USB’ option connects the user to web for telemedicine and save user’s valuable time and cost of printings. Caddo 11B’s advance technology offers user a differential advantage. Scientech Medicare, a Scientech Group Company is a renowned provider of medical equipments. Our world class products provide user a high degree of quality & reliability. Scientech Medicare 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. Scientech Medicare 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. 37
PRODUCT LINE
Por t c u d
Pro
flex o S olio
tf
Patition Solution have two modules:
»» Silver Anodized & Powder-coated Aluminum Track with rolling hooks, and with angular bends of 90° to 160° depending upon partition requirement. »» Netted or without Net Curtains suspended from rolling hooks of the track. »» Patition Solutions are customized as per specific needs of customers vis a vis Length, Width, Height, Color and Shape (L Shape / U Shape). »» Hospaccx india offers “Soft and Flexible (Soflex) Partition Solutions” to Clinics, Nursing Homes, Diagnostic Centers & Hospitals, and cater to privacy needs of patients. »» SoflexPartition Solutions are modern partition solutions and score over conventional partition solutions (Wooden / Aluminium) in following respects: »» SoflexPartition Solutions are suspended from the ceiling hence don’t hamper movements on the floor. »» SoflexPartition Solutions facilitate proper cleaning on the floor in wards. »» SoflexPartition Solutions facilitate better monitoring of patients by the staff. »» SoflexPartition Solutions offer customer a better “Value for money Proposition” at Price, Quality, and Customization levels. »» SoflexPartition Solutions do not cause any physical discomfort to patients of staff. »» SoflexPartition Solutions are easier to relocate to any other wards in Nursing Homes / Hospitals.
38
Product Portfolio - Over Head Mobile Hangers
»» Ceiling-mount IV MOBILE Hangers and IV Stands »» All IV Hangers are functionally based on customers needs & feedbacks. »» IV Hanger, Range is available in »» Non-Telescopic & Telescopic »» M,S. Powder-Coated & Stainless steel
Hospaccx India
6 Chaithanya Complex, Site-1 17th Cross, Sir M.V Nagar TC Palya Main Road Banglore-16 Mob: +91 9845208778 www.hospaccx.com May - June 2011
COVER
STORY
Jan – Feb 2011
23
HEALTH & FITNESS
Skin
Summer Drinks for Soft and Shiny
Try to take Lemon Juice twice or thrice a day. Water Melon Juice for Skin Care Mint Juice for Shiny Skin Cool Smoothies for Soft Skin Gooseberry Drink for Fresh Skin
40
May - June 2011
HEALTH & FITNESS
S
kin is something that adds a lot to one’s personality. It makes half of one’s personality. To naturally have a beautiful and shiny skin is a blessing but if you don’t have it. Do not worry at all there are many things that you can do to make your attractive and beautiful. Every person wants to have soft and shiny skin. They must be spending too much money and time on it. In order to have a smooth skin people are required to take care of the skin or otherwise they will have to say goodbye to their beautiful skin. Summer season is really tough for skin. Our body and skin needs extra care in the summer season. The summer is just about to arrive and we should start preparations in order to save our skin from Sun and Heat. The skin care becomes must in the summer because it can protect the skin from Wrinkles, Black Spots and Skin Cancer. Skin aging occurs mostly occurs in the summer season. So everyone needs regular facials, juices, water, other liquids and good home care. The proper intake of liquids becomes really important in the summer season so that your
May - June 2011
skin may not dehydrate. Dehydration of skin can cause wrinkles, black spots and dark circles around the eyes. Drinking lots of liquid is a secret of beautiful skin in the summer season. Liquids can be taken in 1 form or another. Here are some summer drinks for your soft skin that can be used in the daily routine: Lemon Juice for Smooth Skin Lemon juice is a very good liquid to be taken in summers as it controls the body’s heat and gives great health benefits. It also helps to remove the toxins from the body and strengthen the body to bear the harsh heat radiations of sun. Try to take Lemon Juice twice or thrice a day. Water Melon Juice for Skin Care Watermelon Juice is excellent for the summer season because it contains a lot of water content in it which balances the water level in the body. Mint Juice for Shiny Skin Mint is a green vegetable that has cooling effect. Mint juice is ideal for the summer season as it improves the complexion of an individual and brings glow to the skin. Procedure of Making Mint Juice: Take 1 cup of Mint leaves and half cup of Coriander leaves. Chop them and Juice of half Lemon, black Salt and common Salt in it. Add some water in it and grind this mixture in a grinder. Strain the liquid add ice and drink it 2, 3 times a day. Cool Smoothies for Soft Skin Make Chill Smoothies that are free of calories. It makes the skin healthy and well hydrated. Smoothies can be made of different fruits like Banana, Strawberry and Mango etc. Enjoy Sugarcane Juice Sugarcane is the cool fruit of summer. People should take Sugarcane juice before 6 in the evening. It helps in bringing the body’s temperature down. Gooseberry Drink for Fresh Skin Make a drink of Gooseberries and Cherries. Try to drink it with empty Stomach in the morning. Gooseberry controls the body’s heat and strengthens the body’s resistance to fight with all the problem of skin. 41
MEDICAL TOURISM
Kuwait Medical Tourism W
e are pleased to inform you that Federation of Indian Chambers of Commerce & Industry (FICCI) along with co-partner Trident Exhibitions would be organizing IMTD Kuwait 2011, a two – day over exhibition & conference focusing on 30 International medical travel & tourism countries from 14-15 September 2011 at Kuwait around the International Fair Ground, Mishref, Kuwait globe, mainly from featuring topics on the globalisation USA, Canada, UK, Russia, the Middle East, of healthcare, presented by leading Uganda, Tanzania, Sri Lanka and the academics and industry professionals Central Asian Republics. India’s medical focusing on international medical tourism sector is expected to experience travelling & tourism and related issues. an annual growth rate of 30%, making The purpose is to facilitate networking it a Rs. 9,500-crore industry by 2015. opportunities for industry professionals, Advantages for medical tourists include academics and stake holders and to reduced costs, the availability of latest provide a forum for organizations and medical technologies and a growing institutions to collaborate and create a compliance with international quality new healthcare As per report, last year over 10,000 standards. system. The Middle Kuwaitis came to India for treatment of Over the past Eastern group of Cardiac, Spinal, Cosmetic and various countries namely few years, the other surgeries medical tourism Qatar, Kuwait, story has changed dramatically in India. and Saudi Arabia even though blessed Private enterprises including hospitals, with wealth are in process of building chemists, freelance agents, are all healthcare infrastructure. A majority working in tandem to build a thriving of Kuwaitis tend to travel to the US / ecosystem that educates, facilitates and Canada as they look forward to foolproof ferries medical tourists from across the quality treatment. As per report, last year world. In the year 2010 about 6,00,000 over 10,000 Kuwaitis came to India for patients travelling to India and spending treatment of Cardiac, Spinal, Cosmetic 4,500 crores in getting treated here from and various other surgeries. 42
May - June 2011
May - June 2011
43
PRE SHOW
I
Meditec Clinika 2011 – India’s dynamic networking platform for Medical and Hospital Equipment & Supplies
ndia is on the cusp of accelerated economic growth and its healthcare industry is expected to grow from its current € 12.72 bn to € 29.6 bn in the next couple of years. Since only about 35% of India’s healthcare industry is fully geared to cater to the current demand, there exists a huge demand-supply deficit. Besides, India is also emerging as the most popular medical tourism destination in the world. This creates an opportunity for overseas suppliers to tap this bustling market and grab their share of a lucrative pie. Against this backdrop, Meditec Clinika 2011 now in its third hosting from 2nd - 4th July 2011 at Gayatri Vihar, Palace Grounds, Bengaluru, is geared to provide an indispensable and effective networking platform to showcase top-of-the-line Medical and Hospital Equipment & Supplies. Orbitz Exhibitions Pvt. Ltd., the organizers, have judiciously conceived an exhibit profile aimed at drawing a highly focused and discerning target audience. Meditec Clinika 2011 offers a convenient and economical market place to its neighboring countries and very much fulfils the niche
created by the healthcare industry in South Asia. Besides, Meditec Clinika has consistently attracted many top Indian manufacturers, suppliers and key decision makers from the medical fraternity. The choice of Bengaluru as a venue has always been strategic, in keeping with the profile and potential of the exhibition itself. It helps in meeting the objectives of being the hub of the medical and healthcare industries. As a result, it presents an excellent opportunity for exhibitors and visitors to meet amidst an international setting and tap the huge growth potential that India holds for the medical and healthcare industries. Meditec Clinika 2011 will showcase latest innovations and technology from various countries along with the leading Indian manufacturers of Medical and Hospital Equipment & Supplies. It would invariably attract a large number of international delegates, experts from the medical industry from India & other countries. A business visitor can get comprehensive information on the latest technology and equipment in the Medical Industry and Healthcare Industry, from not
only in India but worldwide. Meditec Clinika 2011 is actively supported by some of the leading hospitals in India namely Seven Hills Hospital, Ruby Hall Clinic, Indraprastha Apollo Hospitals and Hiranandani Hospital. Further, there’s strong backing by associations like The AIDS Society of India, Society of Indian Radiographers and Radiographers’ Association of Maharashtra. One of the major draws at Meditec Clinika 2011 is the” NAMCON 2011” Multi-speciality Medico Legal Conference by the Association of Medical Consultants ( AMC), to be held on 3rd July 2011. This conference would be welcomed by medical practitioners who run their own nursing homes or hospitals. In view of the above, Meditec Clinika 2011 presents an excellent opportunity for exhibitors and visitors to meet amidst an international setting and tap the huge growth potential that India holds for the medical and healthcare industries. It is slated to bring together suppliers and buyers of futuristic technology on a global platform and give the Indian Medical and Healthcare industry the much needed shot in the arm.
Contact details – Orbitz Exhibitions Pvt Ltd., 202 navyug Industrial Estate, Sewri (West), Mumbai 400 015. Tel 022-24102801/02 Fax 022 24102805 email – info@meditec-clinik.com 44
May - June 2011
May - June 2011
45
PRE SHOW
MEDICALL 2011 – Taking Indian Medical Technology to the next level. If one has to pick from a list of successful events which have created a stir within a short span, MEDICALL would turn out to be a winner. Not only is it India’s premier Medical Equipment Expo, but it has emerged as, and earned the envious reputation of being, the first real “supermarket” for hospital equipment and supplies. With India on the fast track to economic growth its healthcare industry is expected to grow from its current $36 billion (approx), growing at 15% CAGR, the Indian Healthcare Industry will be a US$ 280 billion by 2022. In this context the role of MEDICALL assumes even greater significance. This is evident from its awesome and comprehensive range of exhibits. - from Hospital Information System, solutions, surgical and examination furniture, rescue and emergency equipment, to diagnostic/laboratory.O.T.equipment
46
dental / ophthalmology equipment, medical disposables and cleaning equipment. Now in its 7th Edition, MEDICALL 2011 will be hosted from 12-14 August 2011 at Chennai. It will bring together the best in the business of ICU and Operation Theatre equipments, Refurbished equipments, Trolley, wheel chairs, Cots and other furniture, Hospital linen and laundry, Hospital charts and stationary, Office automation equipments, Printers dealing with pamphlet and file designing, Communication equipments, Medical disposables etc. MEDICALL 2011 has a wide range of dental products from Taiwan and other technological healthcare products from Bayern and other countries. Special products at Display will be Ambulance, Mannequins and other teaching aids for nursing, Hospital management software, Energy
May - June 2011
PRE SHOW
saving equipments, Hospital flooring, Housekeeping equipments, Nurses alarm system, Liquid oxygen and central pipeline, Physiotherapy equipments, Autoclave and sterilizer, Chennai is the venue of choice because it is the head quarters of one of India’s first corporate chain of hospitals namely Apollo Hospitals. Besides, Chennai is one of the main cities to attract medical tourists and has seen a proliferation of numerous “Health Cities” in and around given its excellent connectivity by rail, road and air. Moreover, new universal health insurance schemes introduced by South Indian states has attracted lot of investors in the health care sector in South India. Other impressive feature of MEDICALL 2011 will be its concurrent conferences namely: 99 Innovations in Healthcare 99 Hospital Construction 99 Lean Six Sigma in Healthcare 99 Basics of Medical Records 99 Ventilator Workshop 99 International Seminar on Breast Cancer
May - June 2011
Lean Six Sigma management is a new concept in the healthcare industry where industry experts will speak about the Case Studies. Expo on Hospital Infrastructure called Archimedes will focus on new trends in building a hospital. The high point of these conferences will be the presentations by eminent international speakers with a string of achievements to their own credit.
For more information we welcome your opinionline at panchal@medicall.in or visit our website www.medicall.in
47
PRODUCTS ON DISPLAY
Drugs and Pharmaceutical Equipment Radiology Equipment HMO & Health Insurance Services
7 - 9 September, 2011
Medical IT Health Education & Training
9am - 5pm daily
Hospital Equipment & Supplies Diagnostic/Laboratory Equipment
@ New Convention Centre, Eko Hotel & Suite, Victoria Island, Lagos Nigeria
Electro Medical/Medical Technology Surgical Equipment & Accessories Recuse and Emergency Equipment Physiotherapy and Orthopaedics Equipment Dentistry, Dental Equipment
Government Endorsement By
Official Media Partner
Supporting Magazines
Endorsed By
MEDI-LINK JOURNAL Federal Ministry of Health, Nigeria
NACCIMA
French Embassy ECOWAS
NACCIMA
For on-line registration and payment log onto: www.westafricanhealth.org 48
For Further enquiries: GLOBAL RESOURCES & PROJECTS NIG. LTD 40, Adegbola Street, Anifowoshe, Ikeja, Lagos. Tel: 01-764768, 4800305, 08051444457, 08023537519, 08055819992 E-mail:info@westafricanhealth.org, globalpri@yahoo.com
May - June 2011
GASTRO UPDATE
Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review Proton–pump inhibitors (PPIs) are not effective in reducing gastroesophageal reflux disease (GERD) symptoms in infants. Placebo–controlled trials in older children are lacking. Although PPIs seem to be well tolerated during short–term use, evidence supporting the safety of PPIs is lacking. Methods »» The authors searched PubMed, Embase, and the Cochrane Database of Systematic Reviews for randomized controlled trials and crossover studies investigating efficacy and safety of PPIs in children aged 0 to 18 years with GERD for reduction in GERD symptoms, gastric pH, histologic aberrations, and reported adverse events. Results »» 12 studies were included with data from children aged 0–17 years. »» For infants, PPIs were more effective in 1 study (compared with hydrolyzed formula), not effective in 2 studies, and equally effective in 2 studies (compared with placebo) for the reduction of GERD symptoms. »» For children and adolescents, PPIs were equally effective (compared with alginates, ranitidine, or a different PPI dosage). »» For gastric acidity, in infants and children PPIs were more effective (compared with placebo, alginates, or ranitidine) in 4 studies. »» For reducing histologic aberrations, PPIs showed no difference (compared with ranitidine or alginates) in 3 studies. »» 6 studies reported no differences in treatment–related adverse events (compared with placebo or a different PPI dosage).
Magazine
www.medgatetoday.com
May - June 2011
51
Medgate Today Magazine Now in Hindi Also
Now on Stand
P
Ltd. ) Bandra (W
To Advertise in Hindi Edition
Call: 09212366351
Email: medgatetoday@gmail.com
WINDOW WINDOW SECTION SECTION
Book your space to:
Advertise in this section Call us: 09212366351
Email: medgatetoday@gmail.com www.medgatetoday.com
Factory & Display Centre: 427/11, Gultekdi Industrial Estate, Lahane Road, Pune - 411037 Tel: 020 - 24262562, Cell: +91 - 9422080591 / 9850374403 Email: sales@meelanhospicare.com Website: www.meelanhospicare.com June 2011 Jan May – Feb-2011
49 55
POST EVENT Krista Exhibitions kembali menyelenggarakan pameran medis, farmasi, kedokteran, kecantikan & kesehatan pada tanggal 5 – 8 Mei 2011 di Jakarta International Expo (JIExpo) – Kemayoran, Jakarta. Pameran bertaraf internasional ini akan diresmikan oleh Menteri Kesehatan RI, Dr. Endang Rahayu Sedyaningsih, MPH. Dr. PH., dengan menampilkan berbagai produk kesehatan & kecantikan yang mempunyai daya saing dengan produk luar negeri. INDOMEDICARE 2011, INDOBEAUTY 2011 & PIE – PREGNANCY & INFANT EXPO 2011 akan diawali dengan acara pembukaan pada pukul 10 pagi di Hall D1. Berbagai acara juga turut diselenggarakan untuk memeriahkan suasana pameran, diantaranya adalah seminar “Thai Beauty Products” dengan topik “Opportunities & Market for Beauty Products in Indonesia” yang dibawakan oleh Jakoep Ezra, serta “Prosedur Pendaftaran Produk Kosmetika dari Dalam & Luar Negeri di Indonesia” yang dibawakan oleh Badan POM RI. Selain itu juga diadakan demo kecantikan oleh perusahaan-perusahaan kosmetik dari Thailand. Pada tanggal 8 Mei 2011, juga diadakan seminar dengan tema “Healthy Mommy, Healthy Baby” yang ter-akreditasi oleh IDI (Ikatan Dokter Indonesia) dengan 8 SKP. Berbagai topik yang menarik turut diangkat dalam seminar ini, diantaranya adalah Fertility & Sexuality, Pregnancy & Beauty, Healthy Baby, yang dibawakan oleh para pakarnya, seperti Dr. Ferryal Loetan, ASC & T, SpRM, Mkes-MMR; Dr. Taufik Jamaan, SpOG; Dr. Boy Abidin SpOG, dan beberapa dokter yang merupakan pakar di bidangnya. Pameran ini akan dibuka pukul 10 pagi hingga pukul 7 malam WIB setiap harinya. Para pengunjung dapat melakukan registrasi secara langsung di lokasi pameran dengan membawa 2 buah kartu nama, atau dengan membawa undangan yang telah dikirimkan oleh Kristamedia.
INDOMEDICARE 2011, INDOBEAUTY 2011 & PIE – PREGNANCY & INFANT EXPO 2011
SELESAI Untuk informasi lebih lanjut dapat menghubungi: A. Dori Nataly Tel : +62 21 634 5861; 634 5862 Public Relations Fax : +62 21 634 0140; 634 2113 Krista Exhibitions E-mail : dori@kristamedia.com PT. Kristamedia Pratama Website : www.kristamedia.com Jl. Blandongan No. 28 D/G Jakarta 11220 – Indonesia Tanggal : 5 Mei 2011
May - June 2011
57
400 + Customer Base in India in Just 7 years
Driven by Customer Insights, Satisfaction & Expectations Fuelled By NNOVAT ON PRODUCT PORTFOLIO
• • • • •
Patient Privacy Screens with Strongest Tracks & Runners “Soflex” Unique IV Hangers “Double Telescopic” with provision for infusion pump holders “JH DMF” IV Hanger Non-Telescopic “OHMH” All S.S. Pedestal IV Stand “Classique” Bed mount IV Stand “Companion”
CORE COMPETENCIES & BUSINESS ETHICS • Transparent Approach to the Business 90% of our Sales is reference driven • Need Based Selling If there is no need we do not sell • Layout Specialization Our forte, Best, Spacious Practical, Economical Layout • Reasonable & Competitive Price Our Prices are affordable • High Quality “Customer is our Quality Guru” • High Deliverability Project Deadlines are also Efficiency Guidelines • High Commitment Levels We make customer for Lifetime
www.hospaccx.com
Mobile : +91-98452-08778 +91-9902140405 +91-9902861413
An A & R (ACCESSIBLE & RESPONSIBLE) Company
Lets Make it Simple Through Commonsensology… Bangalore | Bhubeneshware | Bhopal | Bilaspur | Chennai | Calicut | Lucknow | Indore | Mumbai | Delhi
RNI No. DELENG/2010/33833
www.medgatetoday.com
Medgate today
Volume II || Issue I || May-June, 2011
The Gateway to Health & Medical World
Cervical Ectopia cordis, The Gateway to Health & Medical World
First Live case from India
Medical Tourism
Vol. II Issue I May-June 2011
vacwound@gmail.com, info@vacwound.com +91 9971722111, 9350042848, 9999405050
` 75
JCB ENTERPRISES PVT. LTD.
AN ISO 13485: 2003 & 9001: 2008 Certified Company
News Update | Doctor Speak | Eye Care | Dental Hygiene | Health & Fitness | Expert Views
PRICE ` 100