Mar-Apr 2014 by Medgate Today

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Volume IV || Issue VI || March - April 2014

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Editors Note magazine

Volume - IV Issue - VI Mar - Apr 2014

sary r e v Anni

Editor Chief Editor Editorial Advisor

Dr. ma Kamal Dr. Pradeep Bhardawaj GP Capt. (Dr.) Sanjeev Sood Dr. Sharad Lakhotia

India Cuts Healthcare Spending by 10% in 2014–15 Government Budget Thank you For taking the time to hold the magazine for 4 years. I sincerely appreciate the significant contribution that you all made for the success of 4th Anniversary issue. Your feedback, suggestion, support has been very helpful and gave me a new perspective on available opportunities. India’s Healthcare & Medical equipment industry is expected to play a critical role in improving its Healthcare infrastructure. Undoubtedly, the health of the Indian medical equipment industry is of prime importance. The industry faces challenges both domestically and internationally. Indian finance minister P Chidambaram has put forward the Indian interim budget for the 2014–15 Indian financial year (1 April 2014 – 31 March 2015), allocating INR337 billion (USD5.4 billion) to healthcare, reports LiveMint. This is a 9.7% reduction on the 2013–14 budget, whereby INR373 billion was allocated to healthcare. It should be noted, however, that budget allocations might be altered around June or July when the new government (sworn in after elections due to be held before 31 May) presents its budget. The report goes on to highlight spending patterns over the 2013–14 spending year. Despite an allocation of INR373 billion for the year, the minister underspent, with a reported surplus of INR50 billion. Programmes that failed to spend allocated funding included public healthcare, where only INR11 billion of INR24 billion was spent, and the “creating human resources in health” project, where INR775 million of INR1.1 billion was spent. Other areas in which underfunding was also recorded included cancer care, disaster management, and vaccination programmes. The 2014–15 budget comprises a number of measures that may affect the pharmaceutical and medical device industry. These include a lower allocation of funding for drug regulation, with INR1.25 billion being allocated in the 2014–15 budget against the INR1.33 billion actual spend for 2013–14 and the INR2.62 billion allocated for this in the 2013–14 budget.

Outlook and implications

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Contents

magazine

Ranbaxy & APICON Break the Guinness World Records™ ��8 Fortis Escorts Heart Institute celebrates 25 years; discusses �� 10 Paracetamol link to ADHD �� 12

India’s Most Influential People in Healthcare

Cover Story

Padmashri Dr. Mohsin Wali Physician to The President of India

Executive Director & CEO Six Sigma Star Healthcare

Ms. Ameera Shah

Managing Director, Metropolis Healthcare Ltd.

Chairman & Managing Director, apka Urgicare Pvt. Ltd.

Dr. MAHIPAL S SACHDEV Chairman & Medical Director, Centre for Sight Group of eye hospitals

Dr. Naveen Nishchal Director, Cygnus Medicare

Rajesh Srivastava

Chairman Rockland Hospitals

Director, Deptt of ENT & Head Neck Surgery Medanta Medicity, Gurgaon,

Director & Head, Medanta The Medicity

Dr. Ashok Garg

CHAIRMAN & MEDICAL DIRECTOR GARG EYE INSTITUTE & RESEARCH CENTRE

Dr. Jean-Claude Tardif

Director of the MHI Research Centre (Canada)

65 66

Dr. Kumud Kumar Handa

Dr. Sabhyata Gupta

Dr. Pervez Ahmed

Founder and Vice-Chairman Asian Heart Institute, Mumbai

Chief Architect Ministry of Health & Family Welfare

Dr. Ramakanta Panda

Dr. R. Chandrashekhar

Dr. Pardeep Bhardwaj

MD & CEO, Manipal Health Enterprises

Executive Director (Nova Medical Centers Pvt. Ltd.)

Rajen Padukone

Dr. Mahesh Reddy

Child Specialist Muzaffarpur Bihar, INDIA

(Director) All India Institute of Medical Science

CHAIRMAN – Fortis Escorts Heart Institute

Dr. Rajiva Kumar

Prof. M.C. Misra

Dr. ASHOK SETH

Director, Cygnus Medicare

Chairman and Managing Director Medanta - The Medicity

Dr. Dinesh Batra

Dr. Naresh Trehan

XVIth National Seminar on Hospital/Healthcare ��14 Alere introduces India’s only US FDA approved ��15 More than 450 Exhibitors from 20 countries ��16 FDA approves Myalept to treat rare metabolic disease ��18 Oxidants not antioxidants the key to diabetes, says DNA ��18

Dr. Anubha Bajaj

M.B.B.S, M.D.(Pathology), A.B.DIAGNOSTICS

Amol Naikawadi

Joint Managing Director, Indus Health Plus (P) LTD

DENTAL SECTION

Sexual Dysfunction........

NEWS UPDATE

Fabric of Africa report highlights innovation in tackling Non-Communicable Diseases

Facing the Future : Tackling Non-Communicable Diseases in Africa” reviews current practical efforts to address NCDs in African countries. Royal Philips (AEX: PHI, NYSE: PHG)today released its latest Fabric of Africa Trends Reportcalled“Facing the Future:Tackling Non-Communicable Diseases in Africa”, showcasing recent successes made by countries in Africa to prevent and treat non-communicable diseases(NCD’s). The report was launched at the Africa Healthcare Summitwhich is currently taking place in London. The number of annual deaths from NCDs in Africa is predicted to rise by more than a quarter over the next 10 years, driven mainly by economic growth and connected lifestyle changes and behaviors, including unhealthy diet, urbanization, tobacco and alcohol use, and physical inactivity. Philips’

16-page report, “Facing the Future: Tackling Non-Communicable Diseases in Africa”, provides an overview of the scale of the problem, and highlights how it is being addressed in different countries by healthcare professionals, policy makers, and non-governmental organizations. Facing the Future discusses programs being conducted in a wide range of countries, including South Africa, Egypt and Uganda, and shows how the predicted rise in NCDs can potentially be detected earlier, halted, or even reversed through innovative solutions to overcome political, economic, clinical and technological barriers. These programs demonstrate how, with appropriate organization,public awareness campaigns, funding, and access to medical equipment and treatment, it is possible to provide effective care, even in remote areas, and make a real difference to people’s lives. Highlights of the report, which incorporates the results of a range of recent studies, include:

• R ecommendations to overcome the negative effects of observed nutrition transition in SouthAfrica, namely the change in dietary patterns and nutrient intake during economic and social development • E gypt is fighting diabetes in its country (the eighth highest prevalence of any country in the world) by promoting awareness through advocacy, providing workshops for health care professionals and assuming a crucial role to guide and inform other diabetes associations on the continent. • P ositive results for increasing role of community health workers in rural settings across the continent to slow down the rise in breast cancer mortality.A successful example in Ethiopia demonstrated that, by providing culturally sensitive support, it is possible to demystify cancer and break down the barriers of stigma that prevent many women from seeking help while their disease is still treatable. • E xclusive insights from experts working in Egypt and South Africa who discuss conditions and treatments, and education initiatives, that are the continent’s unique cardiology challenges. But two doctors from the Texas Heart Institute proposed a revolutionary new solution – install a ‘continuous flow’ device that would allow blood to circulate his body without a pulse. Dr Billy Cohn and Dr Bud Frazier installed the device after removing Mr Lewis’ heart. Within a day, the patient was up and speaking with physicians. Heartless: Craig Lewis, 55, was the first man to have a ‘continuous flow’ pump to replace his entire heart - and now has no pulse No heart: The device uses blades to circulate blood through the body, replacing the heart

Meet the world’s first HEARTLESS man who is able to live without a pulse

• Dr Billy Cohn and Dr Bud Frazier from the Texas Heart Institute installed first ‘continuous flow’ device last March • Patient Craig Lewis, 55, no longer has a pulse • Device first tested in calves In March of last year, Craig Lewis, 55, was dying from a heart condition that caused build-ups of abnormal proteins, and not even a pacemaker could help save his life.

The two doctors had developed the device some time before and had tested it on nearly 50 calves. They removed the animals’ hearts, and by the next day, the calves were doing everything they were the day before – eating, sleeping, and moving – but this time, without a heart pumping blood through their bodies. ‘If you listened to (the cow’s) chest with a stethoscope, you wouldn’t hear a heartbeat,’ Dr Cohn told NPR last June. ‘If you hooked her up to an EKG, she’d be flat-lined.’ Mr Lewis’ amyloidosis was getting worse, and doctors feared he would die soon without necessary efforts. Doctors grimly said he had 12 hours to live.

Mar - Apr 2014

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NEWS UPDATE

Ranbaxy & APICON Break the Guinness World Records™ title for the Largest Vegetable Mosaic Ranbaxy Laboratories Limited (Ranbaxy) and APICON 2014 (69th Annual Conference of Association of Physicians of India) today broke the GUINNESS WORLD RECORDSTM title with more than 1000 participants (including doctors and Ranbaxy employees) to create the Largest vegetable mosaic measuring 5165 sq. ft. made in the shape of a heart at the APICON 2014, beating the existing record set by Japan. The event was held in Ludhiana, Punjab, India. The 7 layered vegetable based heart sign promoting food for healthy heart was made using approximately 19,825 kgs of vegetables comprising cabbage, brinjal, cauliflower, zucchini, carrot, cucumber, garlic, red capsicum and red chillies. Ranbaxy achieved this GUINNESS WORLD RECORDSTM title by clocking it in 10 hours (approx). The previous record for the largest vegetable mosaic measured 402 m² (4,327 ft² 10 in²) and was achieved in Japan. By breaking this record APICON and Ranbaxy has now brought this title to India. On the milestone achievement, Mr. Jack Brockbank, Guinness World Records Adjudicator said, “It’s always exciting to witness a successful attempt to break a GUINNESS WORLD RECORDS title, especially when it’s for a good cause. We are pleased to present APICON Ludhiana 2014 and Ranbaxy with the new title for the Largest vegetable mosaic.” Adhering to Guinness World Records guidelines the mosaic was made entirely of vegetables with their stalks and roots removed. Further, no dyes were used. After the event these vegetables were distributed to charity homes and Gurudwaras, thereby contributing to a noble purpose.

On this occasion, Mr. Rajeev Sibal, Vice President & Head-India Region, Ranbaxy said, “A healthy diet is a major factor in reducing the risk of heart disease. Vegetables are an essential part of a healthy diet. At Ranbaxy, we are committed to supporting and creating awareness on a healthy lifestyle. The underlying thought behind healthy heart mosaic is in tandem with that commitment.”

New research suggests early parenting routines may harm breastfeeding

Dr Brown said: “There are many trends in parenting that encourage new parents to follow a routine for sleep or feeding or not to respond quickly to their infants cries but the impact upon infant development has not been explored. Parents may believe that following a routine could encourage babies to sleep for longer or to be more settled but there is very little research behind these suggestions. Our data is the first to show that a strict parenting routine may be incompatible with or discourage breastfeeding’. Dr Arnott said: ‘We know that breastfeeding is best established with an infant-led feeding approach where babies are fed on demand. Using a strict routine for sleep or feeding, or not keeping the baby close may mean that cues for feeding are missed and milk supply is affected. This could mean that mums perceive that they are not producing enough milk and believe that they need to top-up with formula or stop breastfeeding altogether. Dr Arnott added: “Mums may believe they should follow such strict routines so that their baby will sleep through the night or so that they will have a ‘good baby’ who is ‘settled’, but it is normal and healthy for a young infant to wake frequently and want to be held.” Dr Brown who is also Programme Director for the MSc in Child Public Health added ‘Our findings are significant as they suggest that a parent led routine can affect the success and continuance of breastfeeding. New parents should be aware that parenting philosophies that encourage the use of strict routine and infant independence are largely scientifically untested and could be incompatible with breastfeeding. However, we also know that caring for a newborn infant can be very tiring. More research is needed to explore the outcomes of parenting routines and behaviours and to understand how best health professionals can support new mothers at this time.’

New collaborative research between Swansea and Newcastle University indicates that mothers who choose to follow strict parenting routines for sleep and feeding in early infancy are less likely to breastfeed their baby or to stop in the first few weeks. Dr Amy Brown from the College of Human and Health Sciences at Swansea University and Dr Bronia Arnott from the Institute of Health and Society at Newcastle University explored the relationship between early parenting behaviour and breastfeeding duration. The research surveyed 508 mothers with a baby aged under one year old, examining behaviour such as use of routines for sleep and feeding, beliefs about responding quickly to their infants cries, feelings of anxiety about their baby, and breastfeeding duration. The researchers found that mothers who report adopting a responsive approach to early parenting, following the baby’s cues for feeding and sleeping and responding quickly to infant cries, are much more likely to start breastfeeding and continue to do so. Alternatively following strict routines was associated with stopping breastfeeding in the first few weeks.

Receiving the award on behalf of APICON Ludhiana 2014, Prof. Dr Gurpreet S Wander, Secretary, Organising Committee, APICON 2014 said, “The role of diet in increasing prevalence of non-communicable diseases like heart attack, diabetes and hypertension is well recognised. Inspite of this the young population of our country is attracted more towards fast foods which are high in fat and salt content. The Indian diet in vegetables protects from these diseases. The vegetable heart mosaic will create awareness among public emphasising the health benefits of eating vegetables in plenty. These are low in calories, very low in fat content and if prepared with less oils are the best form of diet. Various studies have shown that individuals consuming vegetables in plenty have less heart attacks. We need to adopt a healthy life style since the prevalence of Coronary Artery Disease (CAD) is one of the highest among South Asians. The prevalence of CAD in Urban population is 10 -11 % and in rural population is 4 – 5%.”

Mar - Apr 2014

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NEWS UPDATE

Shivender Mohan Singh Executive vice Chairman Fortis Healthcare Ltd. Fortis Escorts Heart Institute celebrates 25 years; discusses changing face of Cardiac Care in the 21st Century Delhi Lt. Governor Hon’ble Shri Najeeb Jung felicitates leading cardiologists at two-day International Conclave on Revolutionary Cardiac Therapies

s eminent cardiologists from across the world converged at the international conclave on ‘Revolutionary Cardiac Therapies’ hosted by the Fortis Escorts Heart Institute (FEHI) in New Delhi, Mr. Shivinder Mohan Singh, Executive Vice Chairman, Fortis Healthcare Limited, laid emphasis on the role of preventive care amid the rising incidence of cardiovascular diseases in India. The two-day conclave marks FEHI’s 25-year journey of providing path-breaking cardiac treatment in the country. Mr. Shivinder Mohan Singh said, “Over the past 25 years, radical changes have taken place in the healthcare sector and its delivery. Fortis Escorts Heart Institute has been leading this change by bringing cutting edge technologies to India that were earlier available only in the West, making it one of the world’s leading cardiac care centres. The hospital is committed to leading the next phase of change and revolution in cardiac care.” Delhi Lt. Governor Hon’ble Shri Najeeb Jung, who inaugurated the conclave, felicitated leading cardiologists who have contributed to the progress of cardiac care in India and across the world. He also lauded

the efforts of FEHI for serving thousands of heart patients and bringing the latest technologies to India. He also called for making healthcare accessible to those in need of quality medical treatment. Dr Ashok Seth, Chairman, FEHI, said, “When we started, this was a 150-bed hospital with just one cath lab. Our vision was to revolutionize cardiac care in India so that patients wouldn’t need to go abroad for treatment. Over the years, we have set enviable standards in cardiac treatment. The hospital has to its credit many firsts, including the first Cardio Myoplasty, Atrial Fibrillation Surgery, Total Arterial Grafting and TAVI in India and the Asia Pacific region. Through this conclave, we aim to explore new frontiers in diagnostics, management of CVDs and adult and paediatric cardiac surgery, setting definite benchmarks for the future.” As many as 1200 delegates have come together to discuss medical advances and technologies being introduced at leading heart care institutes the world over. Workshops on the latest cardiac therapies are also seeing the participation of a large number of doctors from India and abroad. Lt. Governor Jung felicitated doctors for their long-standing service to Fortis Escorts Heart Institute including; Dr Anil Karlekar, Executive Director, Anesthesiology and Critical Care; Dr Ashok K Omar, Director, Cardiology; Dr K K Sharma, Director, Anesthesiology and Critical Care; and Dr Suman Bhandari, Director, Cardiology. International cardiologists who were felicitated included; Dr Navin Nanda, Prof of Medicine and Cardiovascular Disease, University of Alabama, Birmingham, USA; Dr Jasbir Sra, Adjunct Prof of Medicine, UWM; Dr Thomas Modine, Cardiothoracic and Vascular Surgeon, France. Luminaries from healthcare and other industries such as leading environmentalist Dr. R K Pachauri, Member of Planning Commission of India Mr. Arun Maira, and MCI chief Jayshree Mehta also shared their views on healthcare in India and the measures required to improve cardiac care in the coming decades.

Mar - Apr 2014

NEWS UPDATE

Paracetamol link to ADHD

Grape seed protects bowel from chemo mucositis

Women taking paracetamol in pregnancy may increase the risk of their child being born with behavioural problems like ADHD and hyperkinetic disorders (HKD), a study finds. Used the world over for pain relief in pregnancy, paracetamol (acetaminophen) has been considered a relatively safe bet but recent studies have suggested that it affects sex and other hormones, which can in turn affect neurodevelopment and cause behavioural dysfunction.

Lamotrigine advised for epilepsy in pregnancy

Use of valproate as an antiepileptic during pregnancy results in far higher rates of fetal malformation compared with lamotrigine and carbamazepine, UK researchers find. The 15-year study included over 5,200 women with epilepsy who had taken one of the three drugs as monotherapy. Risk of fetal malformation in women taking valproate was 6.2% compared with 2.6% for carbamazepine and 2.3% with lamotrigine, the authors led by Dr Ellen Campbell of the Royal Victoria Hospital in Belfast found. The rates for lamotrigine and carbamazepine were not very different from those found in the general population, particularly when the doses were less than 400mg/day and 1000mg/day, respectively, the authors noted.

Mahajan Imaging, Delhi Gets India’s first Silent MRI GE’s revolutionary Silent Scan technology dials down MRI scanning down to a Whisper for patient comfort&reduces the need for re-scans Silence is golden for millionsof patientswho find MRI scans loud and distressing. Patient comfort is onea of the leading factors in getting the most accurate diagnosis. GE Healthcare’s Silent Scan*, a revolutionary technology addresses this significant impediment to patient comfort – excessive sound generated during an MRI scan. Mahajan Imaging, Delhi is the first healthcare facility in Asia to install Silent MRI in India. GE’s exclusive Silent Scan technology is designed to reduce MR scanner noise to near ambient (background) sound levels and thus improve a patient’s MR exam experience. Conventional MR scanners can generate noise in excess of 110 DBA (decibels) levels, roughly equivalent to rock concerts. “One drawback of MRI scans is that they are loud, generating as much noise as a rock concert or an airplane engine. Noisy MRI scans can be quite disturbing, especially brain scansin elderly and children, and hence, since patient comfort is paramount for getting accurate, high-quality images, some times we need to repeat scans to get high quality images. With this new Silent MRI from GE, we are able to get exceptionallyhigh-quality images of the anatomy the first time,since MRI noise is virtually inaudible and the patient is relaxed. We are very proud and thrilled that we are the first diagnostic centre to offer

Viticulturists may have the key to protecting the bowel from adverse effects of chemotherapy, with a study showing that grape seed extract ameliorates the intestinal mucositis caused by 5-fluorouracil. South Australian researchers say an antioxidant and antiinflammatory component of grape seed extract tannins, the procyanidins, is likely responsible for decreasing the histological damage caused by chemotherapy in the jejunum.In an animal model Dr Amy Cheah and colleagues from the University of Adelaide showed that pre-treatment with grape seed extract prevented chemotherapy-induced mucositis while at the same time enhancing the efficacy of chemotherapy in killing malignant cells. Published in PLOS One, their study showed a dose-response relationship with grape seed extract on 5-fluorouracil-induced mucositis. And promisingly, even at the highest doses, grape seed extract appeared to be safe and have no side effects on the healthy intestine.As expected, treatment with 5-fluorouracil resulted in intestinal damage including decreased mucosal thickness, blunting of the villi and disorganisation of the crypts. When compared to a control group, grape seed extract decreased histological damage score by about two thirds in the jejunum and increased jejunal crypt depth by 25%. The extract also attenuated 5-fluorouracil-induced reduction in

this benefit to patients in India. This is in-line with our mission of bringing the latest and mostadvanced medical technologies into the country.”, said Dr. Harsh Mahajan, Director, Mahajan Imaging, a Padmashri awardee. Noise is one of the major complaints from patients who undergo a MRI exam. Historically, medical manufacturers have addressed the noise issue by muffling it using a combination of acoustic dampening material or even degrading MRI machine performance in order to reduce the noise level. Two years ago, GE engineers initiated their quest to reduce noise during an MRI scan. They developed –Silent Scan Technology, a radical new type of 3D MR acquisition methodology, acombination ofproprietary high-fidelity gradient and RF system electronics, by whichthe noise is not merely dampened but is virtually eliminated at the source. The Silent Scan Technologyis co-developed in India by GE. “Silent MRI puts patients first. It is part of our efforts to humanize MRIsystems and make them patient friendly and safe without compromisingonimage quality. The Silent Scan technologyis co-developed in India by our engineers. While it is a boon for patients, it also potentially allows a healthcare facility to see more patients with fewer repeat scans or recalls.” Said Dr Karthik Kuppusamy, Senior Director, MRI Imaging, GE Healthcare South Asia. Silent Scan is available on new as well as existing Discovery MR750w with GEM and Optima MR450w with GEMsystems.

Mar - Apr 2014

NEWS UPDATE

Mar - Apr 2014

NEWS UPDATE

XVIth

National Seminar on Hospital/Healthcare Management, Medico Legal Systems & Clinical Research

Dates: 2nd& 3rd May 2014

stimulating insight into the strategies followed by successful healthcareorganizations.

Venue: Symbiosis International University; Lavale, Pune

A highlight of the of National are four domain master sessions, delegates opportunity with industry one-to-one basis for

Today, the Healthcare Industry has achieved the status of a sunshine industry thanks to technology & advancement on scientific, economic & research fronts. The Healthcare Industry has always been at the frontier of knowledge exchange and has always been infused with a degree of exalted purpose as it involves saving human lives and alleviating human sufferings. Symbiosis Institute of Health Sciences, a constituent of Symbiosis International University (SIU), is proud to present the XVIth National Seminar on Hospital/ Healthcare, Medico Legal Systems & Clinical Research to be held on 2nd & 3rd May 2014 at Lavale, SIU, Pune. This annual mega event with a legacy of 15 years attracts over 1000 delegates from all verticals of healthcare such as doctors, medico legal lawyers, insurance & IT professionals, NGO, hospital administrators & clinical research professionals. The event boasts of stalwart speakers, contemporary topics and provides an opportunity for professional upgradation, liaison & networking. The Seminar will be inaugurated by Dr. Rajani Gupte, Vice Chancellor, SIU. The Indian healthcare sector is expected to become a $280 billion industry by 2020 with spending on health estimated to grow 14 per cent annually. To elaborate on this phenomenon, a Pre-conference symposium on ‘Successful Healthcare Models’ has been structured. The session will be anchored by Mr. RajanPadukone, CEO & MD, Manipal Health Enterprises. The session will be crowned by a cohort of stalwarts covering the hospital, Pharma, Medical Devices & IT sectors. To name a few; Dr. Harish Pillai,CEO,Aster Medicity, Dr. G.S.K.Velu, Founder & MD,Trivitron Group of Companies and Mr. Sadananda Reddy, MD, Goldstar Healthcare Private Limited.The Pre-conference symposium will be followed by select paper presentation by delegates. A session on “The Strategic Management in Healthcare” guided by Mr.Daljit Singh, President, Fortis Healthcare Ltd following the paper presentation promises to be an intellectually

XVIth edition Seminar intensive, specific c l a s s wherein will get an to interact experts on a knowledge sharing.

A session which promises to deliver an inside ring-side view on “Game Changers in Healthcare: Primary Healthcare” will be discussed by Dr. Gautam Sen & Mr .Kaushik Sen, CMD, Wellspring and Dr. Om Manchanda,CEO, Dr Lal Path Labs covering the diagnostic sector, Hospital being covered by Ms. Zahabiya Khorakiwala, Managing Director, Wockhardt Hospitals& Dr. Adheet Gogate, MD, Health Bridge Advisors Pvt. Ltd in entrepreneurship.A talk in sync with today’s workforce expectations and demands will be conducted by Dr. Azad Moopen, Chairman, Aster DM Healthcare by way of a session on “Challenges in Workforce Management in Hospitals”.The final master class session on “Special Laws and Legal Framework: Surrogacy, PCPNDT, Clinical Establishment Act, Transplantation of Human Organs Act 1994 (THOA)” will be presided over by Dr. Sanjay Gupte, Past President, FOGSI. Day 2 of the XVIth National Seminar is equally diverse and teeming with a horde of industry experts talking on a multitude of industry relevant subjects. Medical tourism has captured the interest of the media. There is a compelling need for all parties involved in healthcare to become familiar with medical tourism and to understand the economic, social, political, and medical forces that are driving and shaping this phenomenon. Driving this concept home will be Mr. Pradeep Thukral – Founder & CEO SafeMedTrip.com who will talk on “Medical Tourism: Present & Future”. Franchising is fast becoming the ‘in’ thing in healthcare industry. To understand the fundamentals of successful franchise models, overcome challenges faced, a session on “Franchising in Healthcare”, comprising Mr. C. K. Kumaravel, Chairman – Indian Franchise Association (IFA), Dr. Sanjay Arora, Director- Suburban Diagnostics from the diagnostic sector has been called upon.

Health insurance business involves managing large repositories of data and information. It is critical to understanding the health profile of the country & plan accordingly. The topic “Health Insurance - Universal Health Insurance: Opportunities and Challenges” shall be discussed by Ms. Yegnapriya Bharath, Joint Director, Health Insurance, IRDA. Ensuring quality healthcare delivery is the focus of all activities in healthcare organizations. To achieve this requiresmultipronged strategies & standards. To ensure quality in healthcare, accreditation of hospitals is the buzz word. Taking the audience through the process of quality assurance will be Dr. Yash Paul Bhatia – MD Astron Hospital and Consultants Pvt Limited, who will talk on “Quality & Accreditation of Hospitals and Healthcare”. In recent years, the increasingly global nature of health research has given a rise to a plethora of drugs which are being brought out into the market. ‘Pharmacovigillance’, deals with the post-marketing surveillance of a drug. Talking on this issue will be Dr. ChandrashekharPotkar – Medical Advisor, Pfizer. Many decisions that healthcare professionals must make each day are affected by legal principles and have potential legal implications. Because law is in a constant state of flux, healthcare management personnel must stay updated on the knowledge of the medico legal law. The topic “Legal Aspects of Healthcare” (Land mark Judgements) shall be discussed by Dr. Gopinath N. Shenoy, Medico Legal Consultant Worldwide all major pharmaceutical companies have a clinical trials regulatory affairs department comprising of people with many years of experience gained within pharmaceutical firms, academia and clinical research institutions. What entails “Regulatory Affairs in Clinical Research” shall be dealt Dr. Raman Gangakhedkar, Deputy Director, NARI. The Valedictory Ceremony will be graced by Chief Guest – Shivinder Mohan Singh, Executive Vice Chairman, Fortis Healthcare Limited. The Guest of Honour for the ceremony will be Adv. Ram Jethmalani, Former Union Law Ministerand Dr. Vidya Yeravdekar, Principal Director, Symbiosis.The ceremony will be presided over by Padma Bhushan Dr. S. B. Mujumdar, President & Founder Director, Symbiosis and Chancellor, SIU. The National Seminar provides an ideal platform for the exchange of ideas in the critical healthcare field. A free flow of information and ideas will certainly enhance the march of healthcare sciences and herald the beginning of a new era in this sunshine industry. It is a must attend event for professionals from all verticals of healthcare.

Mar - Apr 2014

NEWS UPDATE

Alere introduces India’s only US FDA approved Pregnancy test kit ‘Clearblue Plus’

Anxieties related to a missed period, dependence on a mother-in-law or husband to visit a doctor to confirm pregnancy and ignorance around conception could now be a thing of the past for women in India. Alere India has introduced internationally acclaimed Clearblue brand, a new age, in-home pregnancy test kit which gives over 99% accurate results. No test in the country is more accurate. Clearblue Plus is the only US FDA approved pregnancy test kit available in the Indian market today and provides clear and easy reading: Plus “+” means Pregnant and Minus “–“means Not Pregnant, clearing all ambiguities associated with home pregnancy testing. Usually home kits test are used from the day menstrual cycle starts but Clearblue can now be used up to 4 days before the period is due. The Clearblue plus pregnancy technique is quick and easy to use, and produces a result in just 3 minutes. The result window gives a clear positive result if pregnant and a clear negative result if not. Ergonomically Designed Clearblue plus pregnancy test offers a longer, curved stick with an improved grip and a wide absorbent tip for ease in targeting the urine stream. A larger result window and clearer result lines make the test even easier to read. Clinical studies with Clearblue plus pregnancy test have revealed that 56% of women received a ’Pregnant’ result 4 days early, 88% of women 3 days early, 97% of women two days early and 98% of women 1 day early.

The toll free 108 number provides free emergency medical services in Maharashtra.

Maharashtra Emergency Medical Services (MEMS) a project of Government of Maharashtra along with Bharat Vikas Group (BVG) India Ltd was formally launched on 1st March 2014 by Hon. Shri Prithviraj Chauhan, Chief Minister of Maharashtra at Mumbai. The toll free ‘108’ number provides free emergency medical services to entire population in the state of Maharashtra, through ‘state of the art’ ambulances, capable of providing competent care for the sick or injured in any emergency medical setting. All ambulances are manned by Emergency Medical Professionals (EMPs) specially trained in Emergency care, based on the Anglo- American model of care (Load & Go) and imparted over 18days. These EMPs are thus trained in detection of any emergency, immediate response, reporting, on-scene care, en route care and transfer to appropriate hospital. Training also includes reassurance to patients, relatives and bystanders prior to and during transportation to hospital casualty room. A formal MOU has been signed between BVG & Symbiosis International University where by Symbiosis Institute of Health Sciences (SIHS) has been entrusted with the entire academic training, across all districts of Maharashtra. To date, SIHS has trained 3000 doctors as Emergency Medical Professionals. All Zonal & district managers including the Chief Operating Officer of MEMS project are alumni of SIHS.

NEWS UPDATE

More than 450 Exhibitors from 20 countries and anticipated over 8000 visitors from 22 countries Fortis Memorial Research Institute hosts international symposium on ‘Advanced Magnetic Resonance Imaging’ Experts discuss technologies that are transforming disease detection and diagnosis Fortis Memorial Research Institute (FMRI), Gurgaon, Asia’s leading quaternary care hospital, kicked off its second, three-day symposium on ‘Advanced Magnetic Resonance Imaging’ today. The conference brings together renowned international experts to deliberate upon the latest developments in radiology and imaging techniques, with special focus on neuro, musculoskeletal and body conditions. International speakers at the conference include Dr John C. Gore, Professor of Radiology and Radiological Sciences, Vanderbilt University, Dr Ponnada A. Narayana, Professor of Diagnostic and Interventional Imaging, University of Texas (USA), Dr Ron Shnier, Associate Professor, Macquarie School of Medicine (Australia) among others. The symposium, inaugurated by Dr John C. Gore, Professor of Radiology and Radiological Sciences, Vanderbilt University, USA, will focus on technologies that are enhancing the diagnosis of diseases as diverse as cancer, strokes, neurological, bone and joint conditions. Topics include; advanced imaging techniques in MSK, advanced imaging in neuro infections, current status of 7T in Brain, newer contrast mechanism, advancements in breast imaging, among others. Together with lectures by prominent speakers, the symposium will also feature hands-on sessions to teach participants advanced MR techniques as applied to neurology, musculoskeletal systems and body imaging. Dr R K Gupta, Director and HOD, Radiology, FMRI, said, “Cutting-edge techniques have been emerging across the world to improve our understanding of the human body and India has kept abreast with the latest technology in this field over the last few years. Take the example of whole body MR imaging with m-Dixon and DWIBS that FMRI offers. This path-breaking technique is transforming cancer treatment by helping the diagnosis of the disease in its infancy, much before the physical symptoms has manifested themselves and the disease has reached an advanced uncontrolled state.” The symposium will showcase state-of-the-art radiology and imagining technologies at FMRI which includes the Digital Broadband MRI, 256 Slice CT Scanner, Dynamic Contrast Enhanced Perfusion Imaging, MR Spectroscopy, Digital Mammography, Non-invasive measurement of Intracranial Pressure, etc. Dr Dilpreet Brar, Regional Director, FMRI, said, “Advancements in MR imaging are helping doctors reach more accurate diagnosis than ever before, enhancing the clinical outcomes. This symposium will provide a fertile ground for radiology experts to share knowledge about different developments and train participants in technologies of the future.”

20th MEDICAL FAIR INDIA 2014, being held at Mumbai (India) from March 14 - 16, 2014, to highlight the growth potential of the US $ 100 billion Indian Health Care sector which is growing at 20% annually The 20th MEDICAL FAIR INDIA 2014 (MFI 2014), India’s oldest and largest international trade exhibition and conference on Diagnostics, Medical Equipment and Technology, is to be held at Bombay Exhibition Centre, Goregaon, Mumbai, India from March 14 - 16, 2014. This global event is jointly organized by Messe Düsseldorf, Germany (organizer of “MEDICA” world’s largest medical trade show) and its Indian subsidiary Messe Düsseldorf India Pvt. Ltd. MEDICAL FAIR INDIA is the optimum platform which brings together the relevant target groups from around the globe in order to exchange ideas on current topics, issues and objectives making it the most important international medical event for the Indian The current edition will market over the past few years. have more than 450 exhibitors from over 20 countries with key showcasing of Medical Technology, Hospital Health Centre, Clinic Equipments, Furniture, Laboratory and Analytical Equipments, Pharmaceuticals & Cosmetology, Pharmacy and Dispensary Equipments, and Service providers. Rehabilitation, Components practicing physicians, This expo is ideal for surgeons, Veterinarians, Dentists, dental surgeons & technicians, Doctors, Physiotherapists, ergotherapists, Hospital directors/-managers, Hospital administration managers and staff, Biologists, microbiologists, bio-chemists, chemists, process engineers, Non-Government Organizations (NGOs) for rehabilitation aids, Visitors with medical pharmaceutical vocational training (e.g. medical laboratory assistant, technician, doctor’s assistant, nurse), Visitors from industry/manufacturers, Distributors/traders, Visitors from academies and universities, Visitors from government or international agencies and associations The previous edition held in March 2013 exceeded expectations with some 410 exhibitors from 21 countries and 7,600 trade visitors. The current show is expected to draw in more than 8000 visitors from 22 countries. The Indian Health Care sector is growing at a rate of about 20% annually and will be worth US $ 100 billion by 2015 end. The primary growth areas are the medical equipment segment, Teleradiology or a means of electronic transmission of radiological images such as X-rays, CTs and MRIs from one location to another for the purposes of interpretation and/or consultation, Health Care BPOs, Pathology outsourcing to name a few. Medical Fair, which alternates annually between Mumbai and Delhi, is the ideal platform to meet the “Who’s Who” of the sector, to discuss and seal new deals. About 60% of the exhibitors come from countries such as France, Belgium, Malaysia, Taiwan, Korea, the USA and Germany.

Mar - Apr 2014

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NEWS UPDATE

FDA approves Myalept to treat rare metabolic disease

The U.S. Food and Drug Administration approved Myalept (metreleptin for injection) as replacement therapy to treat the complications of leptin deficiency, in addition to diet, in patients with congenital generalized or acquired generalized lipodystrophy. Generalized lipodystrophy is a condition associated with a lack of fat tissue. Patients with congenital generalized lipodystrophy are born with little or no fat tissue. Patients with acquired generalized lipodystrophy generally lose fat tissue over time. Because the hormone leptin is made by fat tissue, patients with generalized lipodystrophy have very low leptin levels. Leptin regulates food intake and other hormones, such as insulin. Patients with both types of generalized lipodystrophy often develop severe insulin resistance at a young age and may have diabetes mellitus that is difficult to control or very high levels of triglycerides in the blood (hypertriglyceridemia) that can lead to inflammation of the pancreas. “Myalept is the first approved therapy indicated for treating the complications associated with congenital or acquired generalized lipodystrophy and provides a needed treatment option for patients with this orphan disease,” said Mary Parks, M.D., deputy director of the Office of Drug Evaluation II in the FDA’s Center for Drug Evaluation and Research. The safety and effectiveness of Myalept, an analog of leptin made through recombinant DNA technology, were evaluated in an open-label, single-arm study that included 48 patients with congenital or acquired generalized lipodystrophy who also had diabetes mellitus, hypertriglyceridemia, and/or elevated levels of fasting insulin. The trial showed reductions in HbA1c (a measure of blood sugar control), fasting glucose, and triglycerides. Anti-drug antibodies with neutralizing activity to leptin and/or Myalept may develop, which could result in severe infections or loss of treatment effectiveness. T-cell lymphoma has been reported in patients with acquired generalized lipodystrophy, both treated and not treated with Myalept, so healthcare professionals should carefully consider the benefits and risks of treatment with Myalept in patients with significant hematologic abnormalities and/or acquired generalized lipodystrophy. Myalept is contraindicated in patients with general obesity. Myalept is not approved for use in patients with HIV-related lipodystrophy or in patients with metabolic disease, including diabetes mellitus and hypertriglyceridemia, without concurrent evidence of generalized lipodystrophy.

Oxidants not antioxidants the key to diabetes, says DNA Nobel laureate More than 60 years after he helped elucidate the helix structure of DNA, James Watson has put forward a new hypothesis that contradicts the current thinking on diabetes and antioxidants. Writing in the Lancet this week, the 85-year old Nobel Laureate proposes that diabetes is caused by lack of oxidants rather than an excess of the supposedly harmful “reactive oxygen species”. Watson’s hypothesis is based on the premise that one such oxidant, hydrogen peroxide (H2O2), is needed to forge disulfide bonds that stabilise proteins needed for cellular function in areas such as the insulin-producing areas of the pancreas.

Regorafenib Approved for Advanced Bowel Cancer The TGA has approved a new treatment for advanced bowel cancer, regorafenib (Stivarga), that may prolong survival in patients who have become resistant to other therapies. Regorafenib is the first oral multikinase inhibitor approved for bowel cancer in Australia, according to manufacturer Bayer. The TGA approval was based on a clinical showing regorafenib increased survival by an average of 1.4 months in patients with advanced colorectal cancer compared to placebo in patients previously treated with chemotherapy and other therapies such as anti-VEGF therapy and anti-EGFR therapy. In the US, where it is already approved, the cost of regorafenib is about $9000 for a 28 day treatment course. Currently, advanced bowel cancer is not curable and only about 16% of patients with metastatic disease.

MBS items for cardiac resynchronization expanded to mild CHF MBS items for cardiac resynchronisation therapy devices capable of defibrillation (CRT-D) should be expanded to include patients with mild chronic heart failure (NYHA class II), a government advisory board has recommended.Patients with mild CHF may currently receive an implantable cardiac defibrillator (ICD), but evidence supports a change in therapy to include CRT-D in certain groups of patients according to the Medical Services Advisory Committee. It recommended public funding for CRT-D in patients with mild CHF symptoms despite optimal therapy

and who have sinus rhythm, a left ventricular ejection fraction of 35% and QRS duration of ≥150 ms.MSAC based its recommendation on the RAFT trial which showed that the addition of CRT-D reduced death or hospitalisation for heart failure by 25% in patients with mild heart failure compared with ICD (33.2% vs 40.3%). The benefit was confined to patients with a prolonged QRS duration and with a LVEF of less than 35%.

Mar - Apr 2014

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COVER STORY

A True Hero & Faithful

Friend of God Padmashri Dr. Mohsin Wali

MD FACC (USA) Physician to The President of India Former Physician CGHS, RML Hospital Physician to The Former Prime Minister of India

Efforts never go waste, never go unrecognized. If God is kind with you and you are with the people of God, World is yours.

orn out of the wedding of renowned poet of today, Shri Wali Bijnori of Bijnor and Mrs. Alia of Kanpur, Uttar Pradesh after five precious years of waiting, a child was born (whose name was kept “Baba’) on Wednesday, 28th November 1953, at 8:10 p.m. He was nurtured with great pamper and care, and at the same time with great discipline. Besides education by mother and father at home, his education and training was fortified by his aunt who was then Principal of the Government College of Bijnor. He was named as Mohsin Wali. The meaning of his name is Faithful friend of God, and so is he today. The initial education of M. Wali as a child was completed at Louis Lee Parker Girls School and from class 6th onwards at Govt. Inter College, Bijnor, U.P.

Since the childhood, every moment of his day was duly utilized by keeping him busy at an early age by calling him at the shop of his father and later on also by his indulgence into the business activities of his family. During the initial phase from 4 to 5 years of age he subconsciously learnt how to deal with customers, which was a great art of his father and later on he was taught how to take delivery of commercial goods, go to banks and as a salesman to distribute goods, prepare voucher and collect the payments in the evening. This is an important mention, because it taught him patience to stand in front of small shopkeepers and patiently wait for the collection of money for the goods sold to them. Thus he is working since his childhood 24x7. The journey of the medical profession very simply started when he once went to his uncle’s chemist shop at the age of 16, to buy some medicine and the old man told him to become a doctor after observing something in him which he didn’t know at that time. And he came back in a great dismay to know that he was short by one year to qualify for medical education. He decided to go to Aligarh Muslim University to do B. Sc (Hons.) after he qualified in his school class12 examination with the highest marks, four distinctions, as he topped in the whole district of Bijnor. He applied and waited for his admission in the university to know after five weeks of application that his name was not there in the list of admitted candidates of the B. Sc course despite having very good percentage of marks. He came back crying and went to one of the wardens whom he knew from Bijnor and who was at that time the Estate officer of Aligarh Muslim University. He took him to the Vice Chancellor residence to make enquiries and to his surprise, found out that since the percentage of marks was very high, he did not get admission in the B. Sc. Course with zoology which required lower merit and for which he applied, this came as a shock to him even Vice Chancellor could not help him in the first go. But on persuasion the Vice Chancellor helped him in getting admission in chemistry easily as his main subject because it required a higher percentage, a funny thing to know. As a boy, Wali worked hard in the University for a year, residing in the newly built Sir Ross Masood Hall being allotted a triple room in front of the room of Mr. Salim Sherwani, who was allotted a single room. This was very frustrating and one day he queried the provost, why he has been allotted a triple sharing room and Mr. Salim Sherwani, a single room, both being fresh admissions. The provost replied to him that Sherwani family is a benefactor of the University.

Mar - Apr 2014

COVER STORY

Anyway, the struggle continued, he kept going to the classes regularly while others were preparing for medical entrance test in their hostel rooms most of whom could not be selected. But he made it, both at Aligarh at Jawaharlal Nehru Medical College and U.P Medical Combined Exam. He got himself admitted to Aligarh Muslim University, started classes and after two weeks, the date came for admission to U.P Medical College. But where was the letter? It might have gone to his home town address. Anyway, he caught hold of the newspaper with CPMT result and sat down on a STD phone booth and came to know that he stands admitted at Agra medical college and next day was the last date or else he would loose the seat. Despite the fact that day he was running fever of 104 degree F, he went with one of his friends along, boarded the first train to Agra and, the medical admission was completed for the year 1970 and he returned back to Aligarh. When the date lapsed three days later, his father came with the letter for admission to his hostel in Aligarh, informing him that he is admitted in Agra Medical College. Those were the days when there were no mobile phones and STD calls took 3-4 hours to mature, and so by sheer luck he got admission completed. Anyway, he told his father, that he would prefer to study at Kanpur, the motherâ&#x20AC;&#x2122;s home town and a bigger medical college, and got transferred from Agra to Kanpur, which was easy. Having learnt the manners in medicine at Agra and Aligarh, he was well received at Kanpur Medical College and got the best seniors to educate him, rather rag him and was inducted into first year where he worked very hard and made his place. He had a local guardian who would not allow him to stay in the night because he would study till 3 am and keep the lights on. This was the second upsetting episode in a short time. He got into boys hostel, which after a few months was demolished and students who had local guardians, were not accommodated in other hostels. So he was left without hostel what to do? Prof. Hari Gautam was the warden of the Post Graduate hostel at that time, he was a good teacher, jovial person, who smoked pipe with royal looks. While he was walking up to his office. Wali made a brave straight attempt to request him to allot him a room in the Post Graduate hostel. The warden understood the problem, smiled and asked the clerk to allot him a room in the Post Graduate hostel and relax the rules as a very special case. He was the only junior having studied the MBBS course in the Post Graduate Hostel. This gave him a very educative and personal experience to share his company with his seniors most of them

Mar - Apr 2014

became his teachers later on. They also taught him a little extra in hostel as his room was invariably open and seniors would sometime drop in to have a cup of tea etc. In return they used to refresh their pre-clinical subjects with him. Later on, Dr. (Prof.) Hari Gautam became the Vice Chancellor of Banaras Hindu University and as a doctor, Dr. Wali incidentally shared a dias with him as a guest speaker. During both MBBS and MD Courses, Dr. Wali always got the highest marks, competed with his fellows and was awarded the chancellors medal for the Best student in Kanpur University apart from distinctions and Certificate of honours in all the ten subjects of MBBS course, which was a rare accomplishment. he recalls his MD viva examination, where in, his answers were listened like a speech by whole faculty which gathered during his case presentations in the ward exam. to the admiration of external examiners. He made it with merit and was selected at 4th place in all over India through UPSC and got into Central Health services where he is working till date. This set of hard work made Dr. Wali, most compassionate, hard working, laborious, and accommodative clinician, who had the advantage of having the best teachers of his time, who have not only inculcated the clinical acumen in him, but also a set of very high moral values and bed side manners and respect for seniors, which was so exclusive. While starting his service, he recalls his first posting when he was made the chairman of the central standing Medical board at Dr. Ram Manohar Lohia Hospital which was a big welcome indeed. In the CGHS services, he used to see the maximum number of patients which was recognized and reciprocated in the form of Indian Red Cross Gold Medal for compassion, recently. This medal was awarded to him by none other, than the Honourable President of India during 2013.

COVER STORY

Dr Wali. Was fortunate to have served Mrs. Zakir Husain and Mrs. Fakhruddin Ali Ahmed till they were alive. Based on his impeccable credentials, our very kind, graceful and beloved President Shri Pranab Mukherjee gave him his blessings and Dr. Wali made a record of being chosen Physician to the President of India, third time. His recent accomplishments include his many text book chapters in reference books of Hypertension and award of fellowship from Royal College of Physicians. Dr Wali has a humble family of his parents, whom he is serving at old age, three sons one of them an MBA from London, working for Audi, one lawyer working for Green Tribunal and Third son a law student, while daughter Sana is news anchor and producer at Rajya Sabha T.V. His wife Naaz is an accomplished dress designer and home maker. The CV of Dr. Wali is mind boggling with many National and International honors, which are beyond the scope of this article. Dr. M. Wali has been awarded Padma Shree by the hands of former President Dr. A. P. J. Abdul Kalam, in recognition of his Public Service, along with great number of Medals and Citations, book prizes and many more. Dr. M. Wali has been honored with membership of Royal college of Physician Glasgow. The humility, keenness to serve and hard work made him to achieve the rank of Physician to the Honâ&#x20AC;&#x2122;ble President of India at the very young age of 33 years for Mr. R. Venkataraman. Also he was the first Physician in the Rashtrapati Bhawan who was allowed to serve, rather chosen by the next President Dr. Shankar Dayal Sharma. He would have continued but he was assigned a more challenging responsibility to take charge of former Prime Minister Mr. V. P. Singh, during 1997, as he was in a very critical condition. He remained his physician until the last day of his life and simultaneously worked as Professor in Medicine at Dr. RML Hospital and Post Graduate Institute, had many M.D students work with him With he travelled extensively to Mr. V.P Singh U.K and USA and has a chance to learn from those best hospital, a rare kind of knowledge and experience in itself.

Padma Shri Awardee. Dr. (Prof.) M. Wali is highly accomplished and well sought after physician of National repute. Dr. Wali has served as full time physician to Presidents of India Mr. R. Venkataraman and Dr. Shankar Dayal Sharma, besides he has been appointed to serve the families of President Zakir Hussain and Shri Fakhruddin Ali Ahmed. Dr. Wali is honorary consultant to armed forces of India. Dr. Wali, Born in 1953 at Bijnor has been selected to work as a consultant in medicine at Post Graduate Institute of Medical Research and Education-attached to Dr. Ram Manohar Lohia Hospital, New Delhi. Dr. Wali has contributed a sizeable number of book citations, chapters in text book of API, journals of National and International repute. He has published his original articles on Hypertension and water purification. Dr. Wali has been awarded prestigious fellowship of American College of Cardiology (USA) during 2005 in appreciation of his work in preventive Cardiology and is also a W.H.O fellow of Geriatrics. Dr. Wali has been discharging his services beyond the call of duty since June 1980. He is a unique individual, an accomplished teacher and researcher a doctor with empathy, merit and above all a kind and humane person. He has been chosen Best Aluminums of GSVM Medical College Kanpur University (2013) and this was conferred him by the kind hands of The President of India and was awarded Red Cross Presidential Gold Medal for India by the none other than Shri Pranab Mukherjee The President of India

Mar - Apr 2014

COVER STORY

Throughout his career, he has kept institution and its interest above self which has helped him in always taking objective decisions. He has a helping attitude towards others. His specialty fields are project management, business development; Operations; quality management and financial management. He has followed the evolution of Healthcare in India very closely on the basis of which he very firmly believes that next two decades in healthcare belong to tier 2 and tier 3 cities of India, which will see phenomenal growth of tertiary and secondary care respectively. Based on this conviction, he created a business model of providing tertiary care in tier 2 towns of Haryana. Cygnus is carrying forward this model very aggressively.

Dinesh Batra

Director, Cygnus Medicare

A Man Behind Changing

Healthcare Scenario in Haryana Dr Dinesh Batra, Founder Director, Cygnus medicare is amanagement expert in Healthcare. This vehicle which he envisioned and created is currently running 10 hospitals in Delhi â&#x20AC;&#x201C; NCR and Haryana. Due to his clarity in vision of the project, Cygnus has achieved this within 28 months. This has been possible because ofhis ability to develop and lead highly skilled & motivated teams. With over 30 years of experience in the Healthcare Industry in India and other countries, he is aggressively involved in administration, planning and development of these hospitals. He is also attached to many leading healthcare institutes in Delhi NCR as Medical Advisor. Since the beginning of his career, he was always interested in administration and management of the institutions, where he was practicing surgery. Gradually, the work responsibilities shifted from surgical care to management of hospitals. With extensive experience and understanding of establishing and managing healthcareinstitutions, he is now an entrepreneur and a leader,working on a model of providing tertiary care services in Tier-2 cities, secondary care in Tier-3 cities and Primary care in bigger village level, and thus started the journey of Cygnus, in 2011. The journey has also been successful because of him believing in ongoing creativity. New innovative ideas have always interested/ excited him. He believes that one should always play with new innovative ideas while pursuing oneâ&#x20AC;&#x2122;s dreams. Healso has a strong self motivationand is results and target oriented. Mar - Apr 2014

At all the places that he has worked at, he has been involved in designing of functional flow of hospital; planning of equipment & procurement and manpower &recruitment. This was also evident when he played an active role in making Primus Super Speciality Hospitalsfrom a position of new entity to one of the leading hospitals of NCR and commissioning of a 120 bedded super speciality hospital at Abuja, Nigeria, which gavehim an opportunity to have in depth knowledge of international health care business. While working at Brahm Shakti Group of Hospitals and Institute of Paramedical Education, he made his contribution towards setting up quality systems by developing comprehensive hospital manual defining the most critical SOPs & policies; Implementing QMS; conducting medical audit and mortality review; and formation of committees for critical areas of the services. He lead a Management Consultancy teamfew years back which was involved in supporting various medical institutions in developing strategies for managing patient care; developing HR policies and ensuring quality medical services He keeps himself updated by regularly attending conferences of relevance and interest, which gives him opportunity to listen to new ideas and avenues. His topics of interest during these conferences are: Telemedicine; Health insurance; Medical tourism; ISO and NABH; Quality assurance. Dr Batra is a native of Kurukshetra, born to renowned educationist Sh. Dinanath Batra. He grew up in a family environment rich in values like discipline, ethics and honesty. He has a loving, caring and disciplined wife who is a gynecologist, works in the field of public health and has always stood by his side in all the innovative and off beat professional decisions and has two sons. He has a keen interest in the field of education and is involved as a member of advisory committee to two senior secondary schools. He likes visiting places with natural beauty, be it beach or hills. He keeps himself fit with regular Yoga and a healthy diet. He has a vision to create tertiary care hospitals in all districts of Haryana in next 2 years. Six such hospitals have already been created in Sonepat, Panipat, Kohand, Karnal, Kurukshetra and Bahadurgarh. He dreams of creating parallel private healthcare infrastructure in Haryana with primary, secondary and tertiary chain interlinked and he fantasies the similar infrastructure in the country. 23

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Minimally invasive robotically controlled cardiac surgery is the latest frontier in

Heart surgery comprehensive research programme to constantly monitor the data accumulated on daily basis for each patient. He has also presented a number of scientific papers and chaired scientific sessions in national and international conferences in USA, UK, Japan, China, Israel and Far East countries.

Naresh Trehan

Chairman and Managing Director Medanta - The Medicity

id M.B.B.S. from K.G. Medical College ,Lucknow (U.P) in 1968. After training in general surgery and subsequently cardiac surgery at premier institutions in U.S. (NYU Medical Centre), held important academic and clinical positions at the New York University Medical Center, Bellevue Hospital of the city of New York and Veterans Administration Hospital (Manhattan), U.S.A. His pioneering work in the field of coronary artery bypass surgery was at the New York University Medical Centre, New York, USA. In 1988, despite a successful career in United States he returned to India and started Escorts Heart Institute and Research Centre - a pioneering state-of-the-art heart institute in India. This institute is on par or better than the best in the world and has set new standards of cardiac care this part of the world. Within a short period this Centre has become an important land mark the world over in cardiac surgery and cardiology having successfully performed over 48,000 open heart surgeries which includes surgeries of coronary artery, valves, carotid arteries, aortic aneurysm, cardiomyoplasty, cardiac arrhythmias, myocardial total arterial revascularization, transmyocardial laser revascularisation, least invasive coronary artery surgery on a beating heart, reduction ventriculoplasty (Batista Operation), heart port access surgery and robotically assisted cardiac surgery with excellent results. Some of these operations have been performed by him for the first time in India. Besides clinical work he has taken keen interest in training, education and research programmes. He is giving post doctoral training of international standard to 30 surgeons at a point of time at the Institute, The training is of 3 years duration. Over 20 surgeons have already been trained so far. Has established a

Like many Indians,his life was shaped by the partition of the British- Indian empire. He parents were well-to-do doctors in what is now Pakistan.

Overnight, they lost everything, and became refugees in New Delhi. Eventually they found a three room apartment. His father, a surgeon: practiced in one room; his mother: a gynaecologist, in another, The family lived in the third. He saw the gratitude of people so poor. They offered his parents a cooked chicken or handmade shoes in place of cash. He is not all soft edges, however. Since child hood, he has been competitive, a sportsman, who wanted to win. He preferred cricked and field hockey to books and has always had an intense hands-on curiosity about how things worked.

He works 12-hour days, staying fit and staving off stress with exercise, yoga and meditation. What I like about my life is that itâ&#x20AC;&#x2122;s protected me from any useless or negative thought process Mar - Apr 2014

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He had wanted to be a pilot, when his father said no, he turned to medicine. In the United States, he chose heart surgery and then set about finding its best practitioner to teach him. That, he was told, was Dr. Frank Spencer at New York University, who became Dr. Trehan’s idol, even before they had fomally met. Taken out of context, it looks like Naresh Trehan is playing a video game. He stares intently into a console at a three-dimensional image, his feet pressing on pedals, his hands maneuvering levers. But in this case, context is everything. On a television screen several feet from Dr. Trehan, a heart, embedded in gelatinous tissue and blood, throbs insistently, Several feet farther still, lies the body that is home to the heart, on which Dr. Trehan is at this moment, operating. He move a lever, and on the screen, a robot’s claw lifts the internal mammary artery, soon to be joined with the coronary artery in a single bypass. Dr. Trehan is providing the brainpower by remote control. Two robotic arms with tiny hands, inserted through two small incisions in the torso, and a tiny, camera inserted through a third, are doing the work. When he moves the controls inches, the robots move micro millimeters, with more precision, and steadiness than the human hand hand “ Like going to the moon, Dr. Trehan said of the procedure. Minimally invasive robotically controlled cardiac surgery is the latest frontier in heart surgery. It is slowly catching on in the United States, as doctors and industry work to bring the cost down and the clinical value up. But this is Indian, where those who can afford it have been accustomed to going a abroad for state-of-the-art care, often provided by Indian doctors who have migrated themselves. Dr. Trehan was one of them.

HONOURS & Awards ✰ PADMA BHUSHAN AWARD by President of India in recognition of distinguished service in the field of Medicine in 2001. ✰ PADMASHRI AWARD by President of India in recognition of distinguished service in the field of Surgery in 1991. ✰ Doctor of Science Honoris Causa at the “18th Convocation of the Institute of Medical Sciences, Banaras Hindu University, Varanasi” in March 1996, for recognition of his attainment and position of eminence and contributions made by him for the country and the people of India. ✰ Doctor of Science Honoris Causa is conferred on the occasion of the convocation of the Chhatrapati Shahu Ji MaharaJ University, Kanpur, 4th March 2004. ✰ Honorary Fellow Royal Australasian College of Surgeons, Melbourne, Australia in 2002. ✰ Ernst & Young Entrepreneur Award in the services category for yeoman services to the healthcare industry. ✰ Doctor of Science, being conferred by King George’s Medical University, Lucknow, on 22nd Janaury’2007.

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In Bihar, there are substantial gaps in sub-centers, primary health centers, and a very large gap in community health centers along with shortage of manpower, drugs and equipments necessary for Primary Health Care and woefully inadequate training facilities. Other factors affecting the health status include very high fertility rate, low level of institutional deliveries and a high level of maternal deaths, very low coverage of full immunization, low level of female literacy and poor status of family planning programme. Auto Biography: Rajiva Kumar, born in a lower middle class but an educated family background. His father was B.A; L.L.B and my mother is B.A, B.Ed. Rightly said that Education means that process by which character is formed, strength of mind is increased, and intellect is sharpened, as a result of which one can stand on one’s own feet.

Rajiva Kumar

Child Specialist Muzaffarpur Bihar, INDIA

Left Govt. lavish job to serve poor people and worked in charitable Hospital.

Dr. Rajiva Kumar, in an interview with Medgate Today Correspondent Ms. Alisha about his heart touching success story and full of inspirations ,Healthcare scenario in Bihar, his work for noble causes & helpful hand to poor people and his expertise. 26

From my childhood I,with my brothers and sisters was given the very disciplined life and the guidance to serve each-other,which in later life make me to decide to become a doctor to serve the mankind and especially the down –trodden people who were not getting medical attention. After finishing my Intermediate exam I was selected for medical study through a tough competitive exam. After completing my MBBS degree, I was selected in Uttar Pradesh Public Service Commission as a medical officer at SONBHADRA district. In the mean time I got the opportunity to serve for a charitable hospital in my home town. The trust was offering medical facilities at very low cost to the people and ultimately I decided to serve for the charitable hospital (SMT. Krishna Devi-Devi Prasad Kejriwal Maternity Hospital, Muzaffarpur) and refused to join the government services. At that time it was very tough to do so as the charitable trust was paying mere Rs. 1450/- per month and I had the responsibility of my family because I had three children at that time due to early marriage in student life itself. Of Corse, my parents and especially my wife was behind my decision and only due to these people I had the courage to leave the government job. And for my satisfaction I had the wish to serve the poorer. I was an athlete and playing football, cricket and hockey. In my medical collage I have represented as a team member and became captain of medical college team and participated in intermedical college and inter-district tournament. Playing chess was one of obsession and I was champion in that game. After my dedicated service I had been awarded several times at local and national level. I was given numerous honours like “VISHISHT CHIKITSA MEDAL AWARD” ,“AWANTIA SEVA SAMMAN”,”HONEST MAN OF THE YEAR” award and three consecutive year “TOP TEN DOCTORS 0F INDIA AWARD” by a leading health magazine Medgate today. To serve more people in society and community, I joined Rotary Club. Presently after doing my Post Graduation in Paediatrics,

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edgate Today

p Doctor 2013 by M To ’s ia d In d e rd a w A Dr. Rajiva Kumar

Optimum care, Nutrition and protection of children from infection, at birth and during their first three years of life, not only ensure survival but importantly form the foundations for lifelong development. Mar - Apr 2014

I am Head of Department of Paediatrics in the same charitable hospital and worked a lot for the poor people and for dreadful disease ENCEPHALITIS my hospital worked worthily under my guidance and has got many praise from the state and local government. My works has been seen and my name was published in ASIA’S WHO’S & WHO and in INDO-AMERICAN WHO’S & WHO. I got ‘SHANE –SHAHER’ award from a Hindi newspaper ‘Dainik Jagaran’. In my success story, the efforts of my parents especially my mother was great, nevertheless the sacrifice and kind support of my wife and my children are beyond comparison and my whole family’s love and encouragement is the key stone of my successful story .The honest,regular,devoted, punctual, hard-labour is the success mantras.And my massage to the society is live for betterment of the mankind,success will be in your foot

I pray God to give me the strength to serve the mankind till my last breath. 27

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Indiaâ&#x20AC;&#x2122;s Premier Medical College and Hospital,

All India Institute of Medical Science Director Prof. M.C. Misra Tell us about your Areas of Expertise

I possess multifaceted and wide-ranging interests and contributed immensely in the clinical practice.

Prof. M.C. Misra

(Director) All India Institute of Medical Science

r. MAHESH CHANDRA MISRA is known as a leading surgeon and is also credited with developing the AIIMS Trauma centre into a model of care for emergency services in the country. Dr Misra joined AIIMS on 16 July 1980 as a senior resident ,in 1984 as a lecturer and became Prof. & head of the surgery department 13 years later in 1993. He took over as the AIIMS Trauma centre chief in June 2006. Completed 32 years of Distinguished Service at AIIMS Established JPN Apex Trauma Centre & Director of AIIMS. Dr. Misra comes from Tundla (Firozabad) a small town in uttar Pradesh.

Prof. M.C.Misra has been actively engaged in public service by creating awareness about Trauma Prevention and improving trauma care all across India and at International level. 28

I have been involved from the inception of this new technique in India. Actually All India Institute of Medical Sciences, New Delhi was the first Govt. funded institution to acquire this technology for the benefit of the society at large. It was one of the very few Institutions and hospitals (Govt. or Private) across India to acquire the new technique way back in 1991. Laparoscopic technique has been routinely offered to all the patients (Poor or otherwise) for the last 14 years and many thousands of economically compromised patients have benefited by this new technique. I have been actively involved in training of practicing surgeons and residents in the new technique to perform this skill with utmost safety. Towards recognition of his contribution in this field, I was awarded the most prestigious professional award i.e. Dr. B.C.Roy National Award in 1996. The Citation and the medallion were given away on 20th November 1997 by the then President of India in a ceremony in Rashtrapati Bhawan.

Message To Young Doctors:

There are two types of people come to AIIMS one before joining medicine & another completed under graduate. I generally counsel them and tell them that medical profession is different than other professions, where doctors should not think or look forward to become rich very quickly or heavy salaries like other professions. It also takes long years to complete training and get established in your profession.In Surgical discipline it takes more longer to mature and become safe surgeon that people can trust upon you. The other thing is that one should not loose focus one wants to do. Its really a good and noble profession one likes it. You should work hard, willing to sacrifice many times personnel life like entertainment and recreations. One should not try to become rich very quickly, that is not possible in medical profession.

The message to patients:

Every one who comes to AIIMS off course our team willing to see these patients. Patients also need to think that whether for this particular ailment they really need to go to AIIMS, when things can be done locally. Mar - Apr 2014

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Healthcare Group (India’s second largest and fastest growing hospital chain having 45 hospitals network) Sir Ganga Ram Hospital (750 Bed) Delhi and Indian Spinal Injuries Centre, New Delhi. He is an expertise Healthcare 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. He participated in over 145 symposia as “Jury, Faculty, Chairperson, Chief Guest and panelist” at National & International Level. Recently Dr. Bhardwaj organized “Medical Rescue Operations” at Kaidearnath/ Badrinath and saved 311 people.

Pardeep Bhardwaj

Executive Director & CEO Six Sigma Star Healthcare

About

Dr. Pradeep Bhardwaj

r. Pradeep Bhardwaj alumnus of IIM- Ahmedabad, ISB Hyderabad, University of Delhi & Symbiosis, is a young healthcare entrepreneur, who plays on people strengths. He is known for his undying enthusiasm and positive attitude. Dr. Bhardwaj is renowned hospital and healthcare management expert, recipient of many prestigious awards like - Limca Records holder for being the “Youngest Medical Superintendent” at the age of 26 years, Rajiv Gandhi Award -2010, Padma Award-2012 : Nominated by Chief Minister of Delhi, Youth Idol & Youth Icon Award : Delhi University, Indian Achiever Award : UAE Govt., and Rashtriya Ratan Award-2009 (first recipient in healthcare management). He was a nominee for young achiever Medical Excellence Award of Infomedia 18 and Listed Top 10 Doctors of India, Listed in 20 most influential people in healthcare.

Journey to success He has great energy, competitive spirit and the ability to spark excitement. He is currently making waves in healthcare industry at “Six Sigma Star Healthcare Limited, Delhi” (India’s 1st & World 4th largest healthcare company), Six Sigma Health Express Magazine, and Global Institute of Healthcare Management (Offering 245 Masters, PG level Courses recognized by the UGC, AICTE, DEC & Ministry of Science and Technology). Six Sigma Star Healthcare is associated with all top healthcare groups and manages almost a century of large hospitals and institutes across India. He is responsible for driving strategy, value growth, development and success of Six Sigma Star Healthcare - Hospitals & Medical Institutes across the country.

Born on Oct, 1978 (Scorpion) in Military Hospital at Ahmedabad (Gujrat, India) in the family of a valiant soldier (Army Captain) father (who originally belongs to Rohtak district of Haryana). Dr. Bhardwaj is one of the few young leaders who have made a mark for themselves, without having a godfather in the industry. Its his positive thinking which has always given him hope to achieve greater heights. He started his career from DDU Hospital, Delhi (Trainees), Apollo Hospitals Group (Asia Largest Healthcare Provider managing 8000 beds and across 40 hospitals), Fortis

Mar - Apr 2014

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Achievements

Author

☛ Listed under Top 10 Doctors of India – Survey by Medgate

• O pportunities in Healthcare Administration I Latest in Hospital & Healthcare Management (Jaypee)

☛ Rajiv Gandhi Award – 2010 (First in Healthcare Management)

Source of Inspiration : My Parents & teachers have been a source of inspiration for me. Great are those who teach & inspire. I’m extremely grateful to my respected teachers for their immense help, support, motivation and unfailing cooperation.

Today, March 2011/12/13

☛ Padma Award 2012 : Nominated by CM Delhi ☛ 20 Most Influential People in Healthcare – Modern Medicare ☛ Shram Shri Award- 2012 ☛ Best Organizer : Six Sigma Healthcare Excellence Award-

2013, Mount Abu

☛ Youth IDOL & Youth ICON Award 2013 – Delhi University ☛ Indian Achiever Award-2010 (UAE Govt.) ☛ Youngest Medical Superintendent in India – Indian Express (Limca) ☛ Rashtriya Ratan Award – 2009 - (First in Healthcare

Management)

☛ Star Performer in Healthcare Life – Express Healthcare

Management

☛ Medical Excellence Award Yong Achiever - 2006 Final

Nominee – Modern Medicare

☛ Academic Excellence Award – Pharmacy Council of India ☛ Best Medico Legal Expert – IBN 7, Jury : Times of India ‘Lead

India’

Visiting Professor & Faculty / Panel Expert / Assessor: IIM-Ahemdabad, IIM-L, ISB-Hyderabad, Amity University, Symbiosis, GIHM, YMCA, AIIMS, National Board of Exam, NABH, CGHS, NABET, JCI, IMA, AICTE, Bhartiya Vidya Bhavan, Delhi, Formerly at: Sir Gangaram Hospital, New Delhi, Apollo Hospitals Group, Fortis Healthcare, ISIC Hospital Delhi

Mar - Apr 2014

Hobbies:

He loves to drive at World’s Highest Motor able road (18380 Ft.) at Khardungla : Siachin Glaciers, Ladhak . In sports he likes Shooting, Swimming, Horse Riding and Squash. He possess the vast experience of High Altitude Tracking at - Leh, Ladakh, Changla, Pangong – China Boarder, Nubra Valley, Siachin Glaciers, Khardungala- The Highest Motorable Road in the world, Kedarnath, Badrinath, Gaurikund, Amarnath, Baltal, Srinagar, Phelgam, Thar Desert - Jaisalmer etc.

Advice to other Healthcare Professionals: Healthcare is the most gratifying profession and professionals must feel lucky to be the part of this system. You must enjoy taking care of people. Consider healthcare profession as a serious profession, as there are very few qualified and trained people leading to this industry. Look at it as a noble profession and ready to dedicate yourself for the benefit of other with honesty. Always remember that “a patient can survive without a doctor, but a doctor can-not survive without a patient” Show Dedication, Self-Confidence and have mettle to fight against all odds. 31

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Ms. Ameera Shah Managing Director

Metropolis Healthcare Ltd.

s. Ameera Shah is the Managing Director and CEO of Metropolis Healthcare Ltd., a multinational chain of Diagnostic Centers. Under her stewardship, Metropolis has evolved from its single pathology laboratory status in 2002 to a fully integrated multinational chain of 85 plus diagnostic centers and 600 plus collection centers across South Asia, Middle East and Africa. Using her deal-making abilities, the company has expanded at a scorching pace in India and has created JV’s in Sri Lanka, UAE and South Africa. Under her leadership, Metropolis has become a well-respected healthcare brand, catering to more than 10,000 laboratories and hospitals and over 50,000 doctors, and processes more than 15 million tests annually.

Tell us about yourself, family background?

If I was to begin my journey with my experience with pathology, the industry I belong to; it began in my childhood. As a child I would frequent my father’s lab and enjoyed my time observing various samples getting processed. I understood the importance of quality in Lab processes very early in my life, as my father was very conscious about the quality of testing and reports. He was acknowledged in the medical fraternity for his quality consciousness. With his lab I also had an opportunity to witness the business side of pathology; which made me very keen on learning various aspects of a business. With this inclination I pursued a degree in Finance from University of Texas at Austin, USA; with which my educational background become quite different from my family of Doctors. I spent some time working with Goldman Sachs, and during my tenure with them my interest to understand business from a macro perspective, grew deeper. 32

I returned to India in 2002, with a motivation to contribute in some manner to my homeland. At that point of time I felt that my motivation could be realized more effectively if I work on converting my father’s vision into reality. He had a vision of developing a chain of pathology labs across India which could deliver uniform and high quality standards across the country. I began working on creating a business model for realizing the vision. It was a huge challenge in those days, since such models were virtually non-existent in India. In ten years, however, we were not only able to bring the business model into existence, but also make it scalable, sustainable and profitable. While working my way forward for Metropolis, I also felt the need to get some more academic international business exposure and to learn from various business models. I completed my Owner-President Management Programme from Harvard Business School in 2012, and returned with rewarding learning and experiences from international faculty and business community.

How you reach in this position as a Managing Director Metropolis, elaborate about your journey since inception?

I began my journey with Metropolis as an Entrepreneur. Any Entrepreneur’s journey is not easy, especially so for a woman entrepreneur. I was entering a completely dark area, where there were no live examples of successful business models of chain of pathology labs. Learning by doing was the only option. Resource constraint is a challenge for most entrepreneurs, which was particularly more complex for this business model where human resources turned out to be a big challenge. This meant I had to take on many responsibilities myself, since there was very limited scope for task delegation. This is strikingly different from a structured corporate environment, where you are backed skilled human resource and infrastructure. In the initial time, I attended most client meetings and my biggest challenge was them accepting me as the business leader for Metropolis. I can say there were two primary reasons for this limited acceptability. First was the perception that I was too young to be a business leader in the healthcare industry and second that I was not a Doctor myself. To overcome this perception I had to literally work twice as a hard as any experienced entrepreneur would have to. I still enjoyed those formative years of the company despite of all oddities. An entrepreneur not only has to push him/herself to raise the bar for personal excellence, but also needs to have deep and strong self-belief that “I can do this”. The candor needed for an entrepreneur is very different from an executive, and you need to really think out of the box to develop the trust of your clients to make them believe in your services and to build their loyalty. I brought in many new aspects to the business, in addition to providing simply pathology reports. We developed in-house logistics, customer care and IT teams so as to deliver complete pathology solutions to our clients. Developing these allied operations worked in our favour and I was able to diversify Mar - Apr 2014

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the business to develop new verticals like Clinical Trials, Corporate Wellness and bring solutions like Lab@Home services. To develop these capabilities I had to closely engage and work with my team members, and get them oriented to the common goal and objective. Just as the business was new to me in the initial time, so was it new for the limited team members we had. Working and growing with people and getting the best out of them really helped me come a long way, and that is one of the strength I gathered being an entrepreneur and was able to reach where I and Metropolis are today.

Tell us about Healthcare scenario in India? Is quality healthcare affordable to all?

Healthcare is still inaccessible to large segment of our population. If we narrow down to saying “Quality” healthcare, many more would be deprived of it. From the diagnostic perspective, we don’t even have a data to know how many people are actually deprived of quality diagnostics. The problem is deeply rooted in the importance accorded to diagnostics, and the irony of the fact being that diagnostics is the mainstay for effective treatment. Quality in any healthcare system begins with Government stewardship that ensures that minimum quality standards are maintained in all healthcare facilities and strict actions are taken against defaulters. In India unfortunately the diagnostic industry is not guided mandatory guidelines. The law of the land doesn’t restrict any person from starting a lab. One can start a lab, even if s/ he is not a qualified pathologist. The lack of regulatory environment drives the science and human touch out of the business, doing more harm than good to people. An erroneous pathology report can be a life and death situation in many circumstances. This scenario is further complicated with almost complete lack of awareness and sensitivity towards pathology quality amongst people. In many areas this lack can even be seen amongst practitioners. The limitation to access to quality diagnostics therefore in many situations begins at a more field level. The unorganized market situation has made price a huge deciding Mar - Apr 2014

factor in choice of service, which is further complicated by the difficulty quality labs face in delivering uncompromised quality. The domestic industry has limited ability to deliver quality analysers and reagents, and quality labs like Metropolis are forced to import them. This created a financial barrier for people to access quality diagnostics and service providers to deliver the services to them at affordable prices. This is like a typical Catch-22 situation which deprives a large number of people from quality diagnostics.

What is your message to the people who just entered in healthcare Industry? (Young Entrepreneurs)?

For anyone who is entering into healthcare needs to first understand and imbibe the fact that healthcare is an industry with deals with life and has a huge bearing on people and their families. It is an industry where errors can have dangerous and even fatal outcomes. In an industry like healthcare delivering quality is not a choice but a mandate. Any entrepreneur who wants to enter healthcare to simply make money, is bound to fail in the long term. A person entering in healthcare must be driven by the zeal to serve people by means of his/ her business and is sensitive towards the outcomes of his services or products. An entrepreneur entering healthcare should be ready to deliver quality at cost and under any circumstances, which calls for extreme quality consciousness. For entrepreneurs seeking to explore the business of healthcare should therefore have two foundation stones, sensitivity and quality consciousness. These two foundation elements differentiate the healthcare industry form any other industry. For younger entrepreneurs, there is one person who they need to trust: themselves. The value system on which you base your business model should be rock solid. Just put down your head and work hard. There would be situations where people wouldn’t put faith in you. You are treated the way you believe who you are. So self-belief is where trust from your clients and team members begins. Self-belief not only keeps

your energy levels high to pursue the tough entrepreneurial journey, but it also helps you think out of the box. Thinking innovative is the only way you can survive the uncertainties of building your own business. Infact what defines an entrepreneur is how s/he stays stable even in uncertainties and unforeseen downfalls and risks. Like other businesses, even healthcare needs a risk-taking attitude. However risktaking should be balanced with sensitivity and the awareness that your service impacts lives. Healthcare is a business where balance needs to be struck between being an aggressive leader and being a sensitive leader.

What are the pillars of your success?

I believe there are 5 important things that determine your success. ☛ It is all about striking a balance. Achieving a balance between short term and long term goals. Balance between asset and liabilities, between topline and bottom line. Even being able to strike a balance between professional and personal life. ☛ To achieve this balance the most important attribute to be nurtured is to have a good emotional quotient. In business, these days, EQ has become more necessary than IQ. Simply because businesses today have become extremely dynamic, demanding the right attitude. A strong EQ is an important attribute for a strong and sustainable leadership. A leader should be able to empathise, especially so in the service sector, dealing directly with people. ☛ Be excellent in whatever you do! Outcome is important, but the process to achieve that outcome is the essence. As beautifully cited in Bhagwat Geeta “KarmanyeVadhikaraste, Ma phaleshoukadachana”. Focus on the process and not to anticipate outcomes. ☛ Leadership to me means getting the best out of people. Even if that means allowing them to be better than you. Learning is always a two way process, and learning from the positives of others enriches your own personality and knowledge ☛ Always take opinions from people about your business. Try understanding why your organisation is important to the society, which unmet needs of the society your business is able to meet, how much your product matters to the society. A sustainable business is more of an economic model for social re-engineering.

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The Early Years

of Dr. Pervez Ahmed

r Pervez Ahmed was born in Shillong Meghalaya – India, to the 5th President of Republic of India, Fakhruddin Ali Ahmed. He schooled at St. Edmund, Shillong. After which, he did his Pre-med at Hindu College, University of Delhi. He completed his MBBS from Armed Forces Medical College, Pune in 1970 and thereafter proceeded to New York, where he completed his Residency in Internal Medicine and Fellow-ship in Cardiology. He is Board Certified by the American Board of Internal Medicine and Cardiovascular diseases as well as a Certified Medical Director.

Pervez Ahmed Chairman & Managing Director Aapka Urgicare Pvt. Ltd.

Dr Ahmed has always believed in spreading knowledge and “good practices” and hence relocated to India in Jan 2007 to make a difference in the Indian Healthcare scenario.

The Knowledge Sphere

Dr. Pervez Ahmed has been an academics enthusiast in the field of medicine for more than three decades. He has contributed immensely to the development of critical care medicine in New York, and was on the faculty of SUNY Downstate since 1976. He was also responsible for a start-up extended care Rehabilitation facility in New York and has extensive experience in Healthcare Management. Dr Ahmed has always believed in spreading knowledge and “good practices” and hence relocated to India in Jan 2007 to make a difference in the Indian Healthcare scenario. He served as a Board Member of Max Healthcare Institute Ltd. from 2005 to 2007 and then in the capacity of the Executive Medical Director from 2007-2009, before being re-designated as the CEO and MD of Max Healthcare Institute Ltd. in Jan 2009. He is an active member of the Confederation of Indian Industries, and spearheaded the taskforce on talks between Health Insurance Companies and Healthcare providers.

The Corporate Life

Dr. Ahmed decided that he should setup a world class Cardiac Care Hospital in India, to fill the glaring gap for a good Heart facility. To this end, he designed, developed processes & programs, initiated 3 different hospital Greenfield projects. Escorts Heart Institute, BL Kapoor Hospital (New Delhi) and Max Healthcare. At Max Healthcare Dr. Pervez Ahmed has implemented a very successful Clinical Governance program, developed unique Clinical measurement tools and brought into focus processes and outcome measures leading to better care, keeping patient centricity foremost in mind. He is a strong proponent for the use of Six Sigma and Lean methodology in healthcare. Max Healthcare is amongst the top two players from a market share standpoint in Delhi & National Capital Region. Under his leadership, MHC has seen 30 % revenue growth, 12% growth

Mar - Apr 2014

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in bed capacity and established “Centres of Excellence”. These programs have marked Max Healthcare’s successful foray into Super Tertiary and Quarternary care space in the fields of Orthopaedics & Joint Replacement, Minimal Access, Metabolic & Bariatric Surgery, Oncology, Neurosciences, Aesthetic & Reconstructive Surgery.

The Present

After spending more than 40 years in the Healthcare Industry in India & US and starting Healthcare facilities for other, Dr. Ahmed started his own venture to provide affordable and high quality emergency, urgent and acure medical care which is accessible in the neighborhood under the name of ‘Urgent Care Centre’, currently with 3 Centres in delhi, with plans to be in Tier II & III towns as well.

The Family

Dr Pervez Ahmed is married to Dr Anjum Ahmed and they have two daughters.

Current Position

☛ V ice Chairman & Lead Director to the Board of Saket City Hospital. ☛ Chairman & Managing Director – Aapka Urgicare Pvt. Ltd. Experience in US

☛ Medical equipment procurement at 30% below budget. ☛ Created quality parameters in MHC ☛ Multiple International & National Speeches. ☛ Chairman of CII 5th National Healthcare Summit. ☛ Led discussions on Private Healthcare & GIPSA & TPA for resolution. ☛ Introduced Post Graduate Education, DNB programs in MHC. ☛ Chairman of FAA Medical College & Hospital, Barpeta India. ☛ Trustee of Operation Smile in India. ☛ Member of Executive Council – Jamia Hamdard University ☛ Trustee of Indian Trust for Rural Heritage and Development ☛ Member of Managing Body – Indian Red Cross Society, nominated by the President of India ☛ Member of Executive Council of Guwahati University ☛ Trustee of Ghalib Institute ☛ Mentor of FAA Academy, High School in Kalgachia, Barpeta Assam

☛ Moved to US, where he obtained American Board in Internal Medicine & Cardiovascular Disease ☛ Forty Years of teaching experience as faculty member of SUNY Downstate. ☛ Developed standard for Critical Care unit in NY State. ☛ Developed & Managed a startup facility in Long Term care in NY and made it financial viable. ☛ Certified Medical Director in US. ☛ Many professional lectures/talks, and program director of CMEs. ☛ Largest Private Cardiology Group Practice with risk sharing contract with HIP, New York.

Experience in India

☛ Designed, developed processes & programs, initiated 3 different hospital Greenfield projects. Escorts Heart Institute, BL Kapoor Hospital (New Delhi) and Max Healthcare. ☛ Executive Medical Director at Max Healthcare. ☛ CEO & Managing Director at Max Healthcare, with huge growth & profitability (26% CAGR) ☛ Implemented EHR in Max Healthcare. ☛ As CEO & MD, grew revenue ten times in 4 years. Made MHC cash positive. ☛ Created 4 new 250-300 Bed Hospitals in 18-24 months and operationalised them.

Mar - Apr 2014

COVER STORY

There is now an increasing interest in

Eye Care with a Growing Corporate Presence

D MAHIPAL S SACHDEV

Chairman & Medical Director, Centre for Sight Group of eye hospitals

Dr. Mahipal. S. Sachdev, Chairman & Medical Director, Centre For Sight group of eye hospitals is a renowned Ophthalmic Surgeon who is recognized for his expertise in the areas of Corneal, Refractive & Cataract Surgery, both nationally and internationally. He is widely credited to be a pioneer in India in propagating the technique of Phaco Emulsification for cataract surgery and Lasik Laser for removal of glasses. He has been honored with Padmashri award for his excellence in the field of Medicine by Hon. President of India Dr A.P.J Abdul Kalam on March 23, 2007. 36

r. Sachdev was born in the city of Delhi in the year 1958 to a reputed gynaecologist mother working in Safdarjung Hospital and an engineer father who was a Hydrologist with the Government of India. He did his schooling from Modern school, Barakhamba Road and he passed out with academic distinctions. He, along with his elder brother pursued his medical education at the graduate and post graduate level at the prestigious All India Institute of Medical Sciences and were perhaps the first brother combination to get selected in AIIMS. His brother went on to become a reputed pediatrician and has done pioneering research in child nutrition. Dr. Mahipal Sachdev is married to Dr. Alka Sachdev who is the CEO of Centre for Sight group. They have two daughters both of whom are ophthalmologists. Few people know that Dr. Sachdev got selected in the prestigious IIT entrance exam too but he was always fascinated with medicine and found his true calling in the medical profession. During his MBBS, though he excelled at all he did, he developed akeen interest for surgery.Dr. Sachdev didn’t chance upon ophthalmology.He opted for this superspecialisation whilestudying at AIIMS, as it was a niche branch and he saw a huge potential in the field. After completing his Masters in ophthalmology,he joined the R P Centre for Ophthalmic Sciences’ corneaand anterior segment unit as faculty in 1986. After three years, he took a year off to do afellowship in cornea and external eye diseases from Georgetown University, Washington, D.C. Hereturned to AIIMS but in 1996 resigned asassociate professor. “The fellowship openedme to the vastness of what a person can dooutside a government set up or institution,”says Dr. Sachdev, It was his tipping point in life.Dr. Dwight Cavanagh, his mentor at Georgetown, taught him to never set limits to one’s aspirations. Dr. Sachdev returned toIndia with his ambitious plans, and took a then ‘unconventional’ decisionof giving up his job at the prestigious All India Institute of Medical Sciences for setting up a world class eye care institute in Delhi. Dr. Sachdev had learned about phacoemulsification (stitchless micro incision cataract surgery)while pursuing his fellowship intheUnited States in 1989 which he was quick to identify as the next big thing in ophthalmology.On his return to India he pioneered the procedure and held his own at a time when cataract surgery was preferred to be done in the conventional way by the existing ophthalmologists as well as the patients and phaco practice was considered risky.Undaunted by the criticism by his peers, he recognised the potential of this technology and went on to championit. Mar - Apr 2014

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So by the time others started practicing the phaco technique, he had already established himself as anexpert phaco surgeon and had moved on to the next step i.e. use ofexcimer laser in refractive surgery. He then went on to pioneer refractive surgery in India. Till date he continues to have a penchant for technology. When he spots a technology with potential, he is quick to acquire and master it. In 2014, he acquired the distinction of having performed the maximum number of bladefree cataract surgeries in India. Dr. Sachdev is a unique blend of a master clinician, surgeon and an entrepreneur wearing two hats simultaneously. Apartfrom attending various CMEsand conferences, he carries over hisorganizational duties too with ease. In his student days in AIIMS too, apart from being a meritorious student, he was also at forefront of extracurricular activities and was among the studentswho started “Pulse”-an annualcollege festival of AIIMS which istoday one ofthe most vibrant and festive eventfor the students. He’s been a state-levelbadminton player, a student unionleader, a Bridge expert, the youngestchairman of the Scientific Committeeof AIOS, and as secretary ofDelhi Ophthalmological Society inthe early 1990s, he’s been creditedwith bringing the five-star cultureto conferences. He had seen an opportunity in eye care and was quick to capitalize on the same. Dr. Sachdev says, “In the past couple of years, healthcare segment evolved from unorganized setups to organized multi-speciality hospitals. However, the focus on eye care was lacking in them. Moreover, the patients weren’t inclined enough to visit multispeciality hospitals for their eye care needs. Hence, there was a need for niche eye hospitals with the latest cutting edge technologies as a one stop solution for all eye care needs across all ages.” In 1996, Centre for Sight was started with a single facility at Delhi with the objective to fill in the gap in the eye care segment. Today we have more than 48centres across India. He started off his entrepreneurial journey with a single room clinic in Safdarjung enclave Delhi, in the same lane which today houses Centre for Sight’s flagship and world class Safdarjung enclave centre. His belief in giving his dream a neutral and corporate identity made him name his clinic as “Centre for Sight,” rather than his own name so that other doctors can join the enterprise without second thoughts. He had noissues with those better than himjoining Centre for Sight. He went on to recruit doctorsfrom AIIMS, and today, more thantwo-thirds of the faculty at Centre forSight are AIIMS alumni or formerfaculty (including two former R.P.Centre chiefs), who are among the best in thecountry. Renowned eye specialists in the field of retina, glaucoma, oculoplasty& ocular oncology have joined So, CFS was created with a vision for providing a world class super specialized eye care to our people. Centre for Sight today is the pioneer in India for providing state of the art eye care services. It is the leading chain of eye care hospitals in India and is also Asia’s largest LASIK network. Our Hyderabad branch houses the National referral centre for Ocular Mar - Apr 2014

oncology (eye tumors) which is fully equipped with state-of-theart diagnostic and therapeutic facilities with an aim to establish a new benchmark in the comprehensive care of eye cancers. There is now an increasing interest in eye care with a growing corporate presence. Inspite of being in a fiercely competitive industry, we continue to enjoy a prized position not only in patient base but also in terms of respect from fellow doctors. This has been possible as Centre for Sight has a no-compromise policy when it comes to its quality of doctors, technology on offer and honest patient centric values and ethics. In keeping with our motto “every eye deserves the best”, Centre for Sight (CFS) has always strived to offer the very best to the ophthalmic patients and have been in the forefront of delivering specialized eye care services for various disorders of the eye. CFS extends its services to all ophthalmic specialties including BladefreeRefractive Procedures (Vision Correction Procedures), Bladefree laser cataract surgery, Micro incision cataract surgery, Glaucoma services, Vitreo Retinal services, Uvea, Eye bank and corneal transplantation, Squint, Paediatric Ophthalmology, Neuro- Ophthalmology, Oculoplasty andEye tumours, Facial Aesthetics, Opticals and Low Vision Aids.Though we have come a long way, even now we are constantly evolving to become the most preferred eye care destination in India and abroad. Dr. Sachdev envisions Centre for Sight as an institution which will outlive personalities. A stepping stone towards this is the upcoming facility at Dwarka. Spread over 55,000 sqft, this superspeciality eye care centre would be the largest of its kind in North India. It will house the latest technology to deliver world class eye care to all. It will have a research and training arm and will also provide quality low-cost services for all eye ailments.

Dr. Sachdev’s advice to young doctors remains,

Set your goals high and chase them with passion. Hard work always pays. Always work with fire in your belly and do not set limits to your dreams. 37

COVER STORY

Biggest Dream is to Start

Quality Primary

Care Health Facilities at the Village Level Naveen Nishchal Director, Cygnus Medicare

After 3 years of rich experience in Govt. Hospital, he explored many ventures before he got an opportunity to run a small hospital and here he along with his team did an innovation in turning this hospital into a profitable venture. Within three months of taking over this hospital, he along with his team did a miracle and with this experience he developed a new model of taking over and running hospitals. 38

r Naveen Nishchal, a young entrepreneur has been serving the common man with a great dedication and enthusiasm as a doctor as well as a philanthropist in the community for the last 8 years. He is always disarmingly modest and unassuming about his achievements. His mild manners and dogged determination continue to inspire many across the world. When asked, “how did you overcome the challenges of life, especially when you come from a rural background?” he replies, “life was hard and difficult, but somehow I got by.” His ceaseless efforts have made a big difference in the lives of thousands of poor and destitute. Presently, he is Director on board of Cygnus Medicare, a healthcare company managing 10 hospitals in Delhi and Haryana He is involved in day-to-day management and operational issues of the company. He leads project team and actively participates in new acquisitions of the company. He heads legal affairs of the company and involved in fund raising as well.

Dr Naveen Nishchal, born and brought up in a small village of Haryana in a family of a farmer, he went to a Govt. school with bare minimum facilities and finished his early education from the village it self. He cracked all India Pre Medical Entrance Exams in 1993 and got a chance to study MBBS in North Bengal Medical College, Siligiuri, (WB). He has been one of the brightest students during his graduation and received many honors and distinctions during his study. He did his masters (MD-Medicine) from Govt. Medical College, Patiala, Punjab in 2004. In 2004, after finishing his MD Medicine, he came to Delhi in search of a job and joined Sanjay Gandhi Memorial Hospital as a Senior Resident and worked there for 3 years. After 3 years of rich experience in Govt. Hospital, he explored many ventures before he got an opportunity to run a small hospital and here he along with his team did an innovation in turning this hospital into a profitable venture. Within three months of taking over this hospital, he along with his team did a miracle and with this experience he developed a new model of taking over and running hospitals. Mar - Apr 2014

COVER STORY

In 2008, he co-founded a company with the name Altius Healthcare and along with his team members devised a model of management and operation of the hospital. He started taking over sick hospitals and turning them around into aprofitable venture.

idea of providing tertiary care centre in tier 2 cities of Haryana. In Second phase Cygnus has plans to develop these centers all across the country.

This light asset model is first of its kind in healthcare industry. Running hospitals used to be considered as a capital intensive business and he along with his team revolutionized the whole model into low capex model where charges can be kept low to make healthcare affordable and within the reach of every class of community.

When asked about his dream in context of healthcare, he said, majority of India is still represented by Rural Population and his biggest dream is to start quality primary health care centers at the Village level so that the poorest of the poor of the country are given the best of healthcare services. It will save a lot of cost, travel time and energy of villagers. Early diagnosis can further save morbidity as well as mortality of patients.

Dr Nishchal has vast experience of management, operation, business development and handling projects independently. Dr Naveen Nishchal is a well-known name in healthcare industry. Dr Nishchal gave the idea of Management & Operation to other players and now many companies are following his footsteps.

Being a co-founder at Altius Healthcare, he has been involved in various innovative activities focusing on health of a common man. This includes developing an ALPHA CARD for the poor which gives almost free unlimited specialist consultations for one year only for Rs. 100 and making treatment affordable to all.

In 2012, he joined Cygnus Medicare as an active promoter and helped Cygnus in making from one hospital to ten Hospitals Company within 24 months. Now Cygnus is working with the

Dr Nishchal comes from a very humble background and has very strong moral values in terms of ethics, honesty kindness and truthfulness. He has very helping and supportive attitude towards the needy. He belives in the rule of democracy and secularism. Dr Nishchal married Dr Manisha who is also a doctor and pathologist, Dr Manisha works for her own company in pathology.Dr Nishchal believes in the philosophy of a single child norm and has one daughter, who is in fourth Standard. He has the unique honour of receiving the best doctor award 2013 from. Despite achieving so much in his life, he believes that there is still a lot left to be done. His motto of life is to have probity in public life and have commitment to serve the common man. Dr Nishchal is associated with many social activities and has been awarded by many social organizations. . He believes in women empowerment and saving girl child. He is an active part of an NGO on Road Safety with the name of TRY-Ek Koshish. TRY-Ek Koshish is working on awareness on road safety, taking care of victims of road traffic accidents and educating children about road safety at school level itself. He encourages youths to adopt the idea of Social Entrepreneurship which can lead to socioeconomic empowerment. Message from Dr Nishchal- I urge all healthcare providers to join hands to take healthcare services in India to next level. My message to youth is that there is no short cut to success, hard work along with smart work both are required to be successful. Chase your passion and donâ&#x20AC;&#x2122;t get influenced by what other are thinking and saying about you. Lets together make India one of the best countries on the Planet.

Mar - Apr 2014

COVER STORY

Journey from Jeans to

Healthcare

he entrepreneurial journey of Rajesh Srivastava and his brothers, Prabhat and Rishi started in their teens. Their graduation from manufacturing and retailing to healthcare was a seamless transition in search of a long term window of growth. Each venture was marked by innovation as a key to success. In the manufacturing of jeans, introduction of white jeans by bleaching canvass cloth gave them a huge advantage over several large players marketing blue jeans in terms of cost and differentiated branding. In the electronics business, that followed the jeans business, the brothers built an international marketing network from Singapore and New Delhi to dominate markets in South Asia on one side and up to Turkey on the other side through latest technology at lowest rates. The creation of budget hotels providing high quality services consistently got them the rating of Delhiâ&#x20AC;&#x2122;s most luxurious budget hotels. Healthcare attracted the brothers as it was an unorganized sector providing a very long term window for growth and innovation.

Achievements, challenges, which inspired you? The Rockland Hospitalsâ&#x20AC;&#x2122; journey started from 2004 and it was realized early in the business that the investment in tertiary care hospitals had a huge project cost and the secondary and primary care levels had a major challenge in managing operations due to the unorganized nature of the domain. The challenge was to create a healthcare delivery model that would ensure that the patients are provided quality treatment at the right place in right time. The Times of India Newspapers Group and Publicis, one of the worldâ&#x20AC;&#x2122;s largest advertising agencies conducted independent studies among the doctors and patients to find out the gaps in healthcare delivery system. The Rockland team conducted yet another study with a sample size of 3000 doctors operating out of clinics, nursing homes and small hospitals. The findings indicated that the doctors operating out of smaller facilities needed diagnostic, emergency, secondary and tertiary care support. Such a mechanism existed in the market but in a much disorganized manner in bits and pieces. The answers lay in building a healthcare network that could connect the diagnostics, primary, secondary and tertiary care services to provide access to quality healthcare in remote areas. The first and the most capital intensive part of this network were building a chain of tertiary care hospitals. Rockland has built a chain of three tertiary care hospitals with a beds capacity of 808 in the Delhi NCR in the last 10 years. Land has already been acquired for adding another 500 beds at Noida with a training institute equipped with advanced technology. The Rockland Hospitals team has created and tested a unique model to match the needs of the payers through a five layered healthcare delivery mechanism. This network model connects the patients with the clinics, nursing homes, small hospitals with tertiary care hospitals in a seamless manner through an IT and Telecom interface. Rockland crossed several milestones before reaching the take off stage it has reached today. The Indian Healthcare industry did not have any quality parameters in 2004 which could differentiate hospitals on the basis of quality. Little did the Rockland team know then that a small step taken by

Mar - Apr 2014

COVER STORY

them in the form of an Industry seminar would result in Rockland becoming the pilot study center for the National Accreditation Board for Healthcare (NABH), which today sets the quality standards for the Indian healthcare industry. In the years that followed, the best certification of Rocklandâ&#x20AC;&#x2122;s image as a quality hospital came from a study conducted by the India Today magazine in 2009. What made the study even more significant was the fact that it was sponsored by the Government of India. In the Doctorsâ&#x20AC;&#x2122; most trusted hospitals category, Rockland appeared among the top 5 hospitals in India. Managing costs needed creation of cost packages that matched the fixed price packages of the payers. This was a major exercise. Rockland has successfully created packages for almost all the key procedures which have helped it in managing the costs. One of the challenges in implementing the Rocklandâ&#x20AC;&#x2122;s five layered healthcare delivery model in the past was non availability of affordable and proven technology solution which is now available and is being used across the industries. The healthcare industry too can use these technology solutions now. ICT Technologies, our technology partners have successfully tried out a mobile based solution which has removed the last leg connectivity issues with the patients and doctors located in remote locations. The All India Institute of Medical Sciences, the No 1 medical institute in India had recently invited the Rockland team to share their five layered delivery mechanism as a solution to the challenges faced by the healthcare industry with a large number of doctors. This was a rare honour as well as an acknowledgment of the Rockland model of healthcare delivery.

The Rockland group has established cooperative relationships with foreign hospitals and medical specialists in several countries in the Middle East, Africa, CIS countries and South Asia. Its international teams comprising doctors and support staff are frequently conducting OPDs as well as surgeries which can be performed locally in these countries. For tertiary care and high end surgeries the patients are referred to the Rockland hospitals in India. The interest of several global players has gone up in Rockland due to the huge demand and supply gap within the country but also because of the fact that India has the potential to become the medical care hub to the world due to its world class doctors, nurses and huge low cost advantages. The advantages are similar to what we have witnessed in the IT sector. India is already the No 2 country of choice for the medical traveler to Asia. It can easily become the No 1 destination not only for medical treatment but also for human resources in healthcare. A world class infrastructure for treatment is already there in Delhi NCR and some other metros which are driving a robust growth of over 25% in the organized healthcare sector in India.

Message to Readers Rockland is committed to support the doctors through appropriate technology, equipment and medical services and has begun the process of connecting with the doctors in remote locations. In the first phase, a number of Rockland Primary Care Centers have been opened in the Delhi NCR and many more are in the pipe line. The 2nd phase will involve scaling up of the delivery mechanism to 400 districts in north and north east India.

The Rockland healthcare delivery mechanism is capable of supporting the doctors located in remote areas by creating facilities for door to door collection for lab tests and by providing imaging facilities close to their location. These centers are connected through an IT & Telecom interface with a remotely located centralized reporting center. This translates into lower costs for the patients and higher volumes for the doctors and ultimately results in creating cost efficiency and transparency for the payers. Rockland has plans of building primary and secondary care facilities in the first phase of its expansion plans to support the doctors in remote locations with appropriate diagnostics facilities, emergency support and well equipped OTs for primary &secondary level surgeries and treatment locally while referring the tertiary care patients to the Rockland tertiary care hospitals.

Mar - Apr 2014

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awareness in the society about this still less provoked concept of Prevention. The personal loss that we faced was enough for us, to do something in this field. This incident coupled with the fact that many in our country, whether rich or poor, man or woman, die in similar circumstances, due to lack of a proper infrastructure, where prevention is given more importance than curing, made me wonder if I could do something about it. Once the thought captured our hearts, no less my mind, I poured forth all my energies in building a system that would help and encourage people to learn the importance of taking care of health before it’s too late. In the year 2000, I, along with my wife, setup what is known today as Indus Health Plus Pvt. Ltd.

Mr. Amol Naikawadi Joint Managing Director Indus Health Plus (P) LTD

ndus Health Plus is a story of how a personal tragedy and loss turned into a motivating factor to launch a venture that is today steadily filling up a huge gap in essential service.

Autobiography

Hailing from a small town, I did my schooling in a military school in Satara. I pursued higher education in Commerce from Pune, MMCA and was keen to forge my own path ahead, confident that the opportunity would present itself in due course of time. Chartered Accountancy honed my skills and I immediately plunged into the world of business, never to look back. My experience with my first job continues to be so. I always wanted to do something of my own. After having completed my studies, I stepped into the healthcare industry. From then till now, it’s been Indus Health Plus (P) Ltd. Indus is my baby and I have had wonderful experiences and moments since its inception. I have nurtured it for 13 years as a Joint Managing Director of the organization, I feel immense proud to see it flourishing so well.

How did it start?

When my wife Mrs. Kanchan Naikawadi –Director Indus Health Plus (P) Ltd. lost her father due to late detection of an advanced cancer, it struck us real hard that maybe we could have saved him if we would have known about the ailment early. That huge blow in our lives impelled us to take a step further and create 42

‘Prevention Is Better Than Cure’ is something that we have all heard since our school days but seldom do we actually implement it. We lay the odds and we wait and watch – our health. It’s time to wake up to the concept of preventive healthcare. Though prevention is an urgent need, not much was being done in the area. Keeping this in mind, Indus Health Plus was established in the year 2000 by a team of like-minded professionals to make healthcare ‘Affordable, Accessible and Available’ healthcare to all. Indus Health Plus emphasizes on preventive healthcare through its customized healthcare packages. Already in its 13th year of operations, it has already reached out to more than 4 lakh people (and is rapidly growing) across the country.Indus is a mission to save life and change it. With so many serviced all under one roof and the entire testing, reports and counseling compelled in ONE single day, this cost advantage is something that Indus is proud to offer to its customers. The idea behind the name ‘Indus’ comes inspired from the ‘Indus Valley Civilization’. The Indus Valley is one of the world’s earliest urban civilizations, along with its contemporaries. Having said the same, we opted for the name ‘Indus’ in synonym to a civilization of preventive health are that we were then trying to establish. And therefore we named it ‘Indus’.

Challenges

For us the challenge was to come up with an integrated model to combine the strengths of hospitals, diagnostic centers, labs and path services with holistic approach to deliver an affordable and comprehensive preventive health check to masses. Apart from the regular challenges of resource allocation, faced by every new enterprise, the initial challenge for us was to sensitize people about the nature of NCDs and make them aware of their own lifestyles, which could lead to a heart attack, cancer or diabetes. So we started convincing our own extended family and friends by arranging interactive sessions with doctors. Being a Chartered Accountant, it came as an added advantage in explaining the economics of healthcare. The major challenge for us even today is the sheer skepticism that the masses show towards the importance of preventive health check-ups. They believe that they are healthy on the outside, therefore healthy on the inside as well. However, this is simply not true. We seek to promote awareness about preventive healthcare and how significantly it can reduce any

Mar - Apr 2014

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pain or suffering that might arise from ignoring minor health issues that might turn fatal in the future. In a developing economy like ours, Indians are more prone to lifestyle diseases and less than 0.1 per cent of population doing preventive check-ups; the scope for preventive health care is beyond imagination. According to the World Health Organization (WHO), it is indicated that India is increasingly becoming the capital for various diseases like cancer, heart and various other stress related (lifestyle) diseases. According to the report of The Confederation of Indian Industry (CII), 8 per cent of households are pushed below the poverty line each year due to health expenditure. With so many factors that drive the force, there is a substantial percentage of awareness that we have now generated over a period of time. The lifestyle of the populace however has been depleting and therefore affecting their lives in many many ways. It is this concern that we address and would continue to do so to make one and all aware of the fact that a preventive measure is available, accessible and also affordable to the masses. In this domain, the biggest challenge is to spread awareness of what Indus Health Plus as a brand stands for and how our services can help the society. For the last decade, Indus Health Plus has been striving towards inculcating preventive health services as a lifestyle in the society, and as one could understand, trying to introduce & market a new lifestyle, that is maybe one of the single most challenging objectives to attain. Through our marketing efforts, we have been able to reach a good portion of the markets where we exist, but this is an ongoing process as we aim to reach everyone to make this lifestyle change. The preventive healthcare industry on the whole relies strongly on word of mouth publicity. As a brand, we want to expose as much of the society to preventive health solutions and their benefits as possible. Our strategy involves initially exposing the society to this type of solution and then increasing the share of voice within the societies we are present, within the discussions on health and within the media.

Sensitive to the needs of close friends and family, Indus Health Plus was started to educate people on the benefits of preventive check-ups and save lives in the process. The effort was focused on ‘Prevention’ to ensure timely ‘Detection’. Ours is a two-fold vision to make preventive healthcare a way of life and to make quality healthcare ‘Accessible, available and affordable’. We look forward to bring the concept of ‘high-end prevention’ to every corner of India. The transition of Indus from a single service center to a multi-functional organization is a testimony of our skills. Indus continues to grow and at the helm of developments, we have been facilitating a staggering growth rate for Indus on a year on year basis. This was not easy in the beginning. However having convinced a few masses to begin with and then spreading it by word of mouth saw our vision coming to reality. Shifting the thought process from curative to prevention is still a challenge to us and we are sure to overcome the same, seeing the pace at which the awareness to prevention is growing.

Future Plans

Indus aims to achieve pan-India presence by concentrating on multiple location availability of their services for their clientele. We are looking at being in the top 10 cities while also concentrating at a mix of Tier-II and in some cases Tier-III cities as we aim to achieve pan-India presence and make Indus Health Plus, a name synonymous to preventive healthcare all over. Seeing the current success, we wish to consolidate our national presence in the coming years by spreading ourselves in the eastern and north eastern regions. We also wish to improve our presence in the southern regions of India. In the process of facilitating the check-ups to the number mentioned above, we reached about 4 lakh people. In the next 3-5 years we have a modest ambition of facilitating the screening program to around many more with times to come, thereby reaching out on a macro level. With a focus on the high end preventive health checkups, we are always trying to adopt new technologies for early detection mechanism. We are focusing on a geographical expansion in stages with a vision to service not just Tier II and Tier III cities but other smaller towns as well. With the edge in preventive health care that we are embarking on, even international bodies have started recognizing us and in times to come we look forward to extend our services in the international market also.

Achievements

Ours is a niche service in the industry and in fact the only market player in the preventive health care industry. We Leverage our existing inputs to generate innovative outputs for the masses. Practicing prevention was not the trend during the earlier years however with our continuous effort today we have been successful in shifting the focus of people from curative to preventive measure for health. However, we still have a long way to go. There is a sense of prevention and awareness of one’s health that is prevalent, however there are still many who still have to realize and practice prevention. Mar - Apr 2014

COVER STORY

RECENT UNIQUE

INTERNATIONAL DISTINCTIONS

FOR DR. ASHOK SETH (Unprecedented Honour For Any Indian/Asian)

ASHOK SETH FRCP (London), FRCP (Edinburgh), FRCP (Ireland), FACC, FESC, FSCAI (USA), FIMSA, FCSI, D.Sc. (Honoris Causa)-BHU, TMU, Amity University, D.Litt. (Honoris Causa) – Jamia University CHAIRMAN – Fortis Escorts Heart Institute

Dr. Seth has created new standards of excellence and patient care in India by creating the ‘Max Heart & Vascular Institute’, New Delhi, which in a short span of 3½ years has achieved national and international acclaim. Prior to this Dr. Seth was also instrumental in creating the Escorts Heart Institute, New Delhi from its first day when he became the Head of Invasive and Interventional Cardiology on his return from England on 3rd October 1988. He was one of the key pillar to make it into one of the most famous landmark institutes in the World. He left the Escorts Heart Institute in Dec’04 to create a new standard in cardiac care in Max Heart & Vascular Institute. 44

r. Seth has contributed extensively to the growth, development and scientific progress of Cardiology especially Interventional Cardiology in India and across the world. Over the past 25-years he has pioneered numerous angioplasty techniques for India and Asia Pacific region like Directional Atherectomy, Angioscopy, Stents, Thrombectomy devices & Drug Eluting Stents, use of Impella heart support device failing heart, Bioabsorbable Stents and Transcatheter Aortic Valve Implantation (TAVI). His expertise, skills and his pioneering efforts in teaching and training in angioplasty have won him respect and accolades all across the world. He is perhaps one of the most recognized and respected Indian Cardiologist across the globe. His efforts have created a unique respect for India on the international sphere especially in the West. For his unique achievements and contributions he was honoured by the National award of ‘PADMA SHRI’ by the President of India in 2003. Dr Seth has been honoured by the National Award of Republic of Spain “Crus De Oficial Con Insignia Orden De Isabel La Catolica”conferred on the National Day of Spain 2010. He is the Past President of the Cardiological Society of India – the official National Body of all Cardiologists of India. He is a Vice President of the Asian Pacific Society of Cardiology for the term 2013-2015. Dr. Seth is also founder advisory board member / governor to several prestigious international scientific bodies in the world including – Asia Pacific Society of Interventional Cardiologist (APSIC); SAARC Cardiac Society Society of Cardiovascular Angiographies and Interventions (SCAI, USA) American College of Cardiology (ACC) India Advisory Board Asian Interventional Cardiovascular Therapeutics (AICT) India Live Associate Director, TCT Scientific Sessions Mar - Apr 2014

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Dr. Ashok Seth has been highly decorated by the national academia and by citizens’ forums throughout the country and abroad with Lifetime Achievement Awards, ‘Mason Sones Award’ from SCAI (USA) and numerous other awards (list enclosed). His unique contributions have been: Dr. Seth was the first cardiologist in Asia Pacific region to perform Directional Atherectomy, Angioscopy, Stents, Thrombectomy devices & Drug Eluting Stents and use of Impella heart support device failing heart. He has performed one of the higest numbers of angiographies and angioplasties in the world – which is acknowledged by the ‘LIMCA ‘Book of Records. Dr Seth is the first cardiologist in India to perform Transcatheter Aortic Valve Implantation (TAVI) procedure. Dr. Seth has also created new standards of excellence and patient care in India by creating the ‘Max Heart & Vascular Institute’, New Delhi, which in a short span of 3½ years has achieved national and international acclaim. Prior to this Dr. Seth was also instrumental in creating the Escorts Heart Institute, New Delhi from its first day when he became the Head of Invasive and Interventional Cardiology on his return from England on 3rd October 1988. He was one of the key pillar to make it into one of the most famous landmark institutes in the World. He left the Escorts Heart Institute in Dec’04 to create a new standard in cardiac care in Max Heart & Vascular Institute. r. Seth has been invited to demonstrate and teach complex D angioplasty techniques via the satellite transmission from New Delhi to the ‘Transcatheter Cardiovascular Therapeutics in 2003 & 2007’ Meeting in Washington DC (USA) and to EuroPCR in Paris in 2006 (from Bangkok) & in 2003 (from Chennai), which are the most important and biggest meetings of Interventional Cardiologists across the World. This is a unique prestige and privilege for India and a first for any Interventional Cardiologists in Asia. He has also done live transmissions of complex angioplasty techniques from India to international meetings in Singapore, Malaysia, Paris, China, Australia, Korea, Sri Lanka etc. Dr. Seth has been invited to lecture /demonstrate complex angioplasty techniques to more than 400 international courses & meetings across the globe including live transmissions of complex cases from India in 2003 and 2007 to the TCT Meeting in Washington DC (USA) and to EuroPCR in Paris in 2006. Dr. Seth has been highly acclaimed internationally for academics and research. He is the a. Associate Editor of International Journal of Cardiology b. Member, Editorial Board

i. Journal American College of Cardiology Cardiovascular Interventions

ii. Catheterization and Cardiovascular Intervention

Mar - Apr 2014

iii. Euro Intervention.

iv. Indian Heart Journal

Dr. Seth has had the unique distinction to be elected on the Board of Governors of Society of Cardiac Angiographies and Intervention (USA) – the official professional and regulatory body of interventional cardiologists in USA which has a global influence. This is a first for any cardiologist from Asia. He has been invited to be a member of expert committee of “Society of Cardiovascular Angiography & Interventions (USA)” for its international position statement on “Percutaneous Coronary Interventions Without On-Site Surgical Backup” and is a co-author of this ‘Guidelines’ which have been supported by 15 Interventional Cardiology Societies across the World. Dr. Seth is the Chief Coordinator of CSIR funded NTMLI project to manufacture an indigenous low-cost Drug Eluting Stent in India by year end 2008. Dr. Seth has been honoured by Honorary Doctorate from four prestigious Universities – a. Doctorate of Science (DSc) Honoris Causa by Banaras Hindu University in 1998, b. Doctorate of Science (DSc) Honoris Causa by Teerthanker Mahaveer University (Moradabad) in 2012 c. Degree of Doctor of Letters by Jamia Millia Islamia University (New Delhi) in 2012. d. Degree of Hony. Doctorate by Amity University (New Delhi) in 2012. He also was one of the youngest overseas doctors to be awarded the Fellowship of all the three Royal Colleges of London, Edinburgh & Ireland in year 1995. Dr Seth has more than 250 publications to his credit in prestigious Indian and International medical journals. He has also written and edited chapters in 10 text books of Cardiology and Medicine & edited two books in Cardiology. Dr. Seth has trained more than 350 cardiologists from India and abroad in advance techniques of angioplasty. The Govt. of Malaysia, Bangladesh, WHO, SAARC Cardiac Society, China, Hong Kong, Indonesia has all sponsored doctors from their country to train under Dr. Seth. He has had the unique distinction of organizing the ‘2nd AICT’ (Asian Interventional Cardiovascular Therapeutics) conference in India in October 2006. This was a privilege and pride of Nation. This landmark meeting brought together for the first time in India 200 top most Cardiologists of the world and more than 1000 delegates from 27 countries. The President of India, Dr. A.P.J Abdul Kalam gave the inaugural address to the cardiologists and it was acclaimed and lauded internationally. 45

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Dr. Seth is setting up a Foundation in association with patients of heart disease (Prem Lata Foundation - Dil Se Dil) to further the cause of those suffering from heart disease. This foundation aims to prevention in of heart disease, patient education, activities to raise fund for poor patients and forums and activities to decrease the cost of heart care in this country. It also targets burning issues like “awareness of heart disease in women” as well as “valve disease in poor patients in villages”.

About Dr. Seth: Dr. Ashok Seth, Chairman, Fortis Escorts Heart Institute, redefined modesty for me in his own unique way. Early life For someone having tons of educational qualifications under his hat, it is natural to assume he must have been a bright student right from the start. However, even though Dr. Seth was intelligent as a kid, he was never a topper during his school days. In fact, he even failed grade 4. The reason may be that he had recently shifted from Bihar (where he was born) to a different level of schooling at St. Xavier’s in Kolkata. He was given three months to cope up and try again. It is here that his father played a major role. During the entire three months, he used to daily take young Dr. Seth for morning walks while making him revise his studies. As a result, he passed his 4th grade after three months. However, overall, he says that he was a ‘carefree’ child more interested in acting and elocution.

AWARDED PADMA SHRI by President of India CHAIRMAN Cardiology Council, Fortis Group of Hospitals PAST PRESIDENT Cardiological Society of India VICE PRESIDENT Asian Pacific Society of Cardiology Fortis Escorts Heart Institute (New Delhi) India

Getting into medical college Dr. Seth never wanted to become a doctor, but his father left him with no choice. “Those were the 70s and any profession other than a doctor or an engineer was looked down upon,” he reminisces. Well, it took him four years to get into a medical college! “I was just not qualifying for MBBS! Hence I went and told my father that I have already given umpteen number of pre- medical exams and probably I am not cut out for it.” His father, still consistent, enrolled him in a coaching class, which used to take place in a ‘barsaati’. Finally, the efforts paid off and Dr. Seth got a seat in 1974 at the Aligarh Medical College in the second list on the seventh position. He remembers that his initial six months were again all fun with his friends and acting in the college plays. Then, came the turning point in his life.

OTHER INTERNATIONAL / NATIONAL ACHIEVEMENTS OF DR. ASHOK SETH Concurrently, over these years, Dr. Seth’s contribution in helping to set up similar programs all across the country and the Indian subcontinent has also increased dramatically. He has been instrumental in setting up numerous cardiac catheterization labs and the interventional cardiology program in Govt. sector at SMS Medical College in Jaipur, India, and at the Post-Graduate Institute of Cardiology, Calcutta, India. He provides regular training and guidance in interventional and invasive cardiac procedures to numerous cardiologists from all over the Indian subcontinent (Pakistan, Bangladesh, Sri Lanka). 46

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Mr. Padukone joined Manipal Group in 1998 and over the past 15 years has worked in both their health and education verticals. His experience is the area of education includes managing various initiatives covering the entire spectrum of university education from campus based education to distance and distributed learning and corporate & continuing education. Mr. Padukone is the Co-Chair in FICCI’s Health Services National Committee and is a member of the CII National Committee on Healthcare. He is a member of the Governing Council of the Healthcare Sector Skills Council and a member of the Governing Council of the Healthcare Federation of India(NATHEALTH). Prior to joining the Manipal Group, he was associated with ANZ Grindlays Bank (1985-1998), in the areas of investment banking, international finance and retail financial services. He has also worked with Crompton Greaves Limited and Kirloskar Oil Engines Ltd.

Rajen Padukone

Mr. Padukone is a Post Graduate with a Masters in Economics from the Gokhale Institute of Politics and Economics, and with a Masters in Management Studies from the Jamnalal Bajaj Institute ofManagement Studies, Mumbai.

MD & CEO Manipal Health Enterprises (Manipal Hospitals)

Mr. Padukone is married to Lena, a graphic designer and has two daughters studying at the undergrad.

Rajen Padukone is the MD & CEO of Manipal Health Enterprises (Manipal Hospitals), The corporate Healthcare and hospitals entity of the Manipal Education & Medical Group. Manipal Hospitals’ healthcare network comprises of primary, secondary and tertiary facilities. It has 15 hospitals covering 5,000 beds, largely in South India. Mr. Padukone’s varied experience of over 30 years, covers the healthcare, education, banking and financial services and manufacturing sectors. His healthcare experience includes establishing start-ups, bringing about a turnaround in operations and building & linking healthcare networks across the spectrum of primary to tertiary care.

Mar - Apr 2014

COVER STORY

The Nova idea gained significant momentum when

Mr. Soni met Dr. Mahesh Reddy. Introduced through a common friend, They quickly realized they shared similar visions

Dr. Reddy’s wife, Aishwarya Reddy and his two daughters, Sanjana Reddy (16yrs) and Vaishnavi Reddy (11yrs) are based in Bangalore.

NOVA’S JOURNEY AND SUCCESS STORY Suresh Soni, Founder, Chairman & CEO of Nova Medical Centers, recognized the gaps in the Indian healthcare segment: scarcity of specialized surgical care, very expensive real estate, very significant gaps or alternatives from tertiary care corporate hospitals and the unmet aspirations of doctors to have ownership and management interest in the Corporate healthcare institutions. Mr. Soni conceptualized and launched a unique business model that addresses these shortcomings and inefficiencies, and meets the aspirations of doctors. The aim was to have “doctor owned and doctor managed centers that provide world-class healthcare, and still be accessible and affordable”.

Mahesh Reddy Executive Director (Nova Medical Centers Pvt. Ltd.)

ABOUT DR. REDDY AND HIS FAMILY

Dr. Mahesh Reddy has always been a forward thinker who thrives on challenging himself. He spent 5 years in England to learn a medical super specialty becoming one of the first shoulder specialists in India. He proudly notes that shoulder surgery is amongst the most difficult surgeries to perform and is the latest super specialization in Orthopaedics. Ever since starting in medicine, he knew that he wanted to open a hospital and worked tirelessly toward realizing that goal. Dr. Reddy’s parents are from the Chittoor District in the state of Andhra Pradesh. While his mother, Late Shyamala Reddy was a homemaker, his father, Mr. Venkat Reddy, is a renowned businessman and a veteran in the Sugar Industry and recently retired as Vice Chairman of Bannari Amman Sugars Ltd. He is also active in the Real Estate space, having been involved in the joint development of over 2000 apartments / villas in the city of Bangalore since the early 1990’s. He is a philanthropist and has started an initiative with Iskcon (Tirupati) which feeds over 10,000 children per day in Chittoor district in the midday meal programme. 48

The Nova idea gained significant momentum when Mr. Soni met Dr. Mahesh Reddy. Introduced through a common friend, they quickly realized they shared similar visions. Having completed his medical studies in the UK, Dr. Reddy had always wanted to build and own a hospital and also contribute to healthcare delivery and growth of the country. The meeting with Mr. Soni opened a new avenue for investment in healthcare delivery and Dr. Reddy became convinced of the merits of forming a chain of short-stay surgical centers, especially given the fact that he had seen the efficiencies of this concept during his stint with the NHS in UK. After returning from England, he rapidly became one of the most prominent surgeons in India eventually establishing and heading the Manipal Shoulder Clinic. He actively engages in numerous professional medical associations. He was also witness to the efficiencies of clearly laid out and strictly followed protocols the way of functioning that he wanted to carry with him wherever he would setup his practice. Dr. Reddy was keen to be associated with this novel idea tweaked to suit the India scenario and perform a bigger role within the company. In spite of his busy practice, he committed family funds to making a substantial investment and his addition to the management team contributed credibility and clinical expertise to the company along with his strategic guidance. Mar - Apr 2014

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In 2011, the founders felt infertility treatment sector in India was unorganized and a large number of people did not find comfort in the process and technology available in the country. This realisation led them to set up the infertility business initiative. With 7 centers across India and 5 more underway, Nova IVI Fertility is addressing the growing need for standardised, ethical and latest technology in infertility treatments and is the largest chain in India. Nova IVI Fertility brings the latest infertility treatments to India through its partnership with IVI Spain, the world leaders in Assisted Reproductive Technology. IVI Spain has one of the best rates of pregnancies in assisted reproduction worldwide with 90% success rate over 4 cycles. As a result, IVI has helped in the birth of over 65,000 healthy babies worldwide. IVI also has a dedicated research foundation that has given rise to new treatments & procedures which are shared with Nova. Mr. Soni and Dr. Reddy worked relentlessly to set up 18 centers in a short span of 5 years.

ACHIEVEMENTS & AWARDS

Dr. Reddy holds the credit for being the first doctor in India, who specializes in treatments exclusively for shoulder related injuries.

Dr. Reddy has been conferred with many awards and honors for his invaluable contributions to the medical world. He received the Bharat Jyothi Award in 2008 for excellence in the field of medicine. In the year 2011, he was awarded the Medical Healthcare Innovation Award. Dr. Reddy was featured in an article titled “Hidden Gems of India” in the August 2013 edition of the Forbes Magazine. Dr. Reddy was also recently awarded the Frost and Sullivan ‘Healthcare Entrepreneur of the Year 2013’ award for Nova’s most promising and innovative business model, which has made an impact on the healthcare industry. He founded the Watanabe Cadaveric Course in India with the aim to provide training for Shoulder Arthroscopy Surgeons. He is the Secretary of the Shoulder and Elbow Society of India and Organizing Secretary of the annual Bangalore Shoulder Course. He is an Executive Member of the CII National Committee for health and Vice President of Indian Society of Ambulatory Surgery. He is also the Reviewer of two internationally renowned Orthopaedic research journals- The Journal of Bone and Joint Surgery - England and the British Journal of Shoulder and Elbow Surgery.

Dr. Reddy is pained to see the scenario of healthcare delivery in Rural India and strongly feels that the Industry and the Government need to come together to improve the situation. In his opinion, the need of the hour is to get every citizen in the country insured for their health. He feels that this can be achieved in cities and towns, if employers, be it in the public sector, private sector or even in households, are required to mandatorily cover their employees and domestic help. He also feels gifting health insurance policies should become a trend and large companies can be encouraged to adopt villages as part of their CSR initiatives. Mar - Apr 2014

He has many publications to his credit and has also attended conferences and seminars across the globe and rendered lectures on various shoulder topics as guest faculty. He is a member of many prominent associations like the Indian Orthopaedic Association, Indian Orthopaedic Society in UK, the Karnataka Orthopaedic Association, Indian Arthroscopy Society and the Bangalore Orthopaedic Society and also Advisory Board Member of WWFKarnataka (World Wildlife Fund).

INSURANCE HURDLE WHEN SETTING UP NOVA

The opening of the first center brought with it complications on the insurance front. Insurance companies used to only cover procedures with hospital stays lasting more than 24 hours. This was done to prevent fraud. In the Nova model, many patients would be discharged on the same day. Insurance companies were unaware of the concept of short-stay and day-care surgeries and that the surgeries could be 15 – 20% cheaper than other hospitals. The founders had to overcome insurance companies’ skepticism of the short-stay surgery model in order for Nova to be successful. Nova is the first group to get over 700 procedures approved for the same day discharge.

INSPIRATIONS ☛ Dr. Reddy’s first inspiration is his father

who is a proponent of simple and Satvik living, inculcating the thought of service to society.

☛ Dr. B. N. Muddu, an orthopaedic

surgeon in England, is his Godfather and fuelled his interest in shoulder surgery specialization with a ‘never say die’ attitude.

☛ Dr. Reddy has also been inspired by

Dr. K. Srinivasan, the senior most orthopaedic surgeon in Karnataka and entrepreneurial surgeons like Dr. Devi Shetty & Dr. Naresh Trehan. 49

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Could you tell us about your education and family background?

I was born in Orissa in a place called Jajpur. My parents were landowners. I spent my early childhood with my grandfather who was a freedom fighter. He was the headmaster of a school and a strict disciplinarian. For several years, my elder brother, a cousin, and I lived with my grandfather. I was with him till he died; I was then in the fifth standard. After that, I returned to live with my parents. My grandfather’s discipline had a tremendous impact on me. He loved us; at the same time, he was very strict. He used to insist that we wash our dishes after meals and wash our own clothes.

Where did you study?

Ramakanta Panda Founder and Vice-Chairman Asian Heart Institute, Mumbai

Initially, at my grandfather’s school. After his death, I came back to my village and had to walk around 7-8 kilometres each way to school and back. My three brothers, my sister and I, all went to the same school. All of us used to stand first in our class. After high school, I went to BJD College.

Dr Ramakant Panda’s

name comes up very high on any list of the world’s top heart surgeons who perform high-risk surgeries. Coming from a village in Orissa

r Panda was a topper at the All India Institute of Medical Sciences, New Delhi, but dejected by favouritism, he decided to go abroad. Good for him and for India because Dr Panda went on to do his Fellowship at the Cleveland Clinic, US, where he was trained by the pioneer of bypass surgery, Dr Floyd D Loop. Dr Panda has done over 10,000 bypass surgeries, making him one of the most prolific surgeons in the world. More importantly, he has performed more than 1,500 high-risk surgeries which have offered new life to many patients who were considered ‘inoperable’. He is the first in India to have introduced beating heart surgery, as well as ‘off-pump’ bypass surgery. His failure rate is just 0.5% against a world average of 2%. But being the top heart surgeon is not what makes him stand apart. It is his integrity, passion and humanism. One unique honour he has received was the prestigious Rashtriya Samman from the Income Tax department, for being one of the highest taxpayers between 1994-95 and 1998-99. Unlike many top doctors, Dr Panda refuses to be paid in cash. The same integrity and zeal has gone into setting up of the Asian Heart Institute in Mumbai, probably India’s best heart hospital. Here is his inspirational story

Did you know by then that you wanted to be a doctor?

I had some interest, since one of my uncles is an ENT surgeon. Then, one of my cousins got married to a doctor; that had some impact on me. I clearly remember one incident that made me aspire to become a heart surgeon. In 1969, LIFE magazine had done a cover feature on Dr Denton A. Cooley (president and surgeon-in-chief, who founded the Texas Heart Institute), one of the all-time great heart surgeons, who had done the first heart transplant in the US. My uncle had brought a copy of the magazine, which had a big picture of Dr Cooley. That is when I had the dream of becoming a heart surgeon. I studied for two years at BJD College and then went to SCV Medical College; I was the university topper in both places. It is at Cuttack Medical College that I began thinking of becoming a heart surgeon. The actual drive to become a heart surgeon came in the third year when clinical postings began; my first clinical posting was in the cardiology department. I was fascinated with heart surgery. I was always among the top five in the class at the Mar - Apr 2014

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My surgical failure rate, on an average, in the last seven or eight years is 0.5%, while the US average is 2% to 3%. I still spend around 10-12 hours out of my 1618-hour working day on my clinical practice. That is close to my heart. I still do the highest number of most difficult cases around the country and I don’t want to give that up. I have done over 10,000 operations till date; even tomorrow, I have six to eight heart operations. It is only on weekends that I catch up with research and other work. medical college. For a year after that, I did my post-graduation from Burhampur Medical College, which is near Cuttack. I then appeared for the all-India entrance test to get into the AIIMS at New Delhi (All India Institute of Medical Sciences). I did my post-graduation in surgery and heart-surgery there between1980 and 1985. That is where the real grinding took place. I was always a hard-working student, but the actual drive to excel and do better in life happened at AIIMS. Those were among the toughest five years of my life, but they were also the formative years, which made me work hard. I often work about 18 hours a day. Actually, I used to work 18 hours a day on an average; now I have cut down to 14-16 hours a day. It was a really tough time for me.

When you decided to return to India, did you know which city you would come back to?

I just wanted to set up a heart hospital; that was my dream – my aim was to do it in Delhi. I knew people there. In those days, there was only Escorts Hospital and AIIMS; Batra Hospital had started but it wasn’t doing well and Modi Hospital was supposed to come up. Once I decided to return, I started coming to India on short trips from 1990 onwards. The first time I came here, I thought ‘no way I want to come back’. Then I introspected and decided that I did want to return, so I’d better start acclimatising myself. I came to India eight times in the next two years. Mar - Apr 2014

Were you married by then?

Yes, I got married in 1986 and both my children were born in the US. At Cleveland Clinic, our work routine was 40 hours of work; go home to sleep for eight hours and come back work again for 40 hours – this went on for three years. You earned money, but you got up at 4.30am; by 5am / 5.15am, you left for the hospital; at 5.30am, your morning round starts; 5.30am to 7.00am, you take your ICU round. The previous night’s team hands over charge to you. By 7.00 O’clock, if you are assigned to the operation theatre, the whole day you are in there; otherwise you have 60 patients to see – even at one minute per patient, it takes an hour. There was absolutely no time to eat; you often got time to eat only at 2pm.

This was during the first round of auctions and not very expensive?

It was not very expensive and nobody wanted to come here, since it was not a residential area. My friends said I was mad, but I said, I am not looking at the present; I am looking 10 years ahead. Believe it or not, I didn’t have even Rs30 lakh, out of the Rs60 lakh that we had to pay as a deposit. So we begged and borrowed from friends and put up the money.

You also gave a lot of thought to the capital structure and hospital design, didn’t you?

RP: Yes, that model and thought process came from the Cleveland Clinic. My entire infrastructure and management technique came from the Cleveland Hospital. I also got involved in helping others to get some experience in hospital design and architecture. I read a lot; my cupboard is full of books on hospital architecture, design, layout of the ICCU (intensive cardiac care unit) and the OT (operation theatre). In fact, I now know more about OT and ICCU design than anybody else in the country. The owner of Lilavati Hospital is a good friend of mine, so I helped design their entire first floor. I was also involved with designing seven or eight other hospitals around the country, including Medicity in Hyderabad. I basically incorporated whatever I saw in Cleveland over here. For instance, the doctors’ consulting room, the operation theatre and the ICCU have to be as close to one another as possible because, in an emergency, you need to attend to a patient within seconds. In India, you will find that the doctor’s office is on one floor, the OT is on another floor and the ICCU is on some other floor; you lose patients before the doctor can reach them. In my hospital, the OT and CathLab are only 15 feet away. I can transfer a patient from one to the other in 10 seconds and it can make the difference between life and death. I learnt a lot from other people’s problems.

What kind of problems?

For instance, about raising finances. We decided to have at least 80% of the money in place before starting the construction. I delayed the project by six months to get the finances and spent a lot of time with the architects and consultants, designing and planning everything on paper. My brief to them was: you can break a wall 10 times on paper. But, once you build, I am not going to allow any breakage. 51

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How did you organise the funding?

A lot of my family members and friends chipped in; they are all equity holders. And yes, I raised money from relatives of my patients and colleagues. I also looked for a bank loan, which was very tough to come by then. Healthcare was considered a useless industry those days and the Industrial Development Bank of India (IDBI) had lost Rs1,800 crore. I went to IDBI; luckily I had happened to operate on one Mr MS Verma who was then the chairman of the State Bank of India. We became close friends and I requested him to help me – he also happens to be our chairman now. So Mr Verma spoke to the IDBI chairman Mr GP Gupta. I clearly remember that five of us had gone to meet them and one of the directors said “you guys don’t know sand from cement; how are going to complete this hospital project in 18 months?” He said it would take five years to complete. Mr Verma pushed the case with Mr Gupta and they agreed to give me the loan. While the negotiation was going on, I happened to operate on the then Bank of India chairman, KV Krishnamurthy. He had already undergone two bypass surgeries and everybody had said he was inoperable. I agreed to do the surgery. It took 16 to 18 hours and he came out of it successfully and is doing well. He said, ‘doctor, what can I do for you’? I told him about my dream and that no bank was willing to lend money to a hospital and that I had no collateral. He single-handedly took up my case and convinced the board to give me money. He also roped in Mr Leeladhar (then chairman of Union Bank of India). I decided not to borrow from IDBI but to go to BOI instead; I had a good rapport with them and they would be a little merciful, if we had repayment problems. That is how we started construction. I had a very strict schedule with all my contractors – they were eligible for a bonus if the work was done before time and had to pay a penalty for every day of delay. I had a target of 18 months to complete the project. It was a really crazy schedule; I was working for almost 22 hours a day, seven days a week, and I was sleeping for only two hours a day.

no standardisation. I am among the first in India to push for standardisation in the whole industry. JCIR is for standardisation of the care processes; it is a tough US-based accreditation. ISO mostly looks after the back-of-the-house processes. Then we went for an NIAHO (National Institute for the Accreditation of Healthcare Organizations) accreditation, another accreditation which is basically a combination of both ISO and JCI standards.

What next, any expansion plans?

Yes, we had planned the second phase in 10 years but we are now doing it in five. We are going to add another 150 beds; after that, we have other expansion plans. We have already identified four places for expansion in the next two years -- one of them will definitely be my home town Bhubaneshwar, where we have already got the land from the Orissa government. I will start construction by December 2007. My long-term dream is to start a medical college in the next 10 years; again with quality as the focus.

How mu ch was your cost per bed here?

Very high, around Rs80 lakh. Normally, this would not have been viable; the reason it worked is that my partners and I already had a successful practice in Mumbai and could transfer that here immediately. We have 80% occupancy.

Collectively, how much stake do the doctors hold in Asian Heart Hospital?

All the senior doctors have a stake; collectively, we hold around 70%. I made sure that doctors hold more than 50% because, if it is a question of choosing between quality and cost, we will choose quality; a pure businessman is not going to like that. If a doctor comes tomorrow and wants certain equipment because it is important, I would immediately say yes; while if it is a management decision, they will ask for a business plan and repayment ability, etc. We don’t compromise on quality issues. That’s why ours is the only hospital in the country that has both ISO certification and JCI (Joint Commission International) certification – no other hospital has both. I have insisted on certification right from the beginning. You have standard processes for everything in industry; but a hospital, which is one industry where you are dealing with human lives, has

Mar - Apr 2014

COVER STORY

Most Influential

Medical Architect..

A leader with difference

Thereafter, he got a chance to see the works of a renowned architect Raj Rewal and he was mesmerized by the way he used the external finishing material in different forms, keeping pace with local architecture and interknitting of spaces. While studying various such locations and works, he realized that he cannot do justice to his projects if he continues to stay in Mumbai, mainly due to space constraints.

R. Chandrashekhar Chief Architect, Ministry of Health & Family Welfare (Govt of India)

here are many quotes, lines and words that define a leader. However, instead of quoting a dictionary or a line by another we thought of introducing you to a man who has epitomized leadership in his domain for close to three decades. With the distinction of being India’s first medical architect Dr. Chandrashekhar has his finger on the pulse of today’s fast evolving healthcare market – both global and Indian. His vision has indeed given perspective to the Indian healthcare industry as a whole.

After becoming the first Indian to hold a PhD in Medical Architecture, Dr. R. Chandrashekhar has given 30 invaluable years to this field. He is currently serving as the Chief Architect with the Central Design Bureau for Medical and Health Buildings, Ministry of Health& Family Welfare, Government of India.

The Journey: Tanjore to Mumbai to New Delhi

Born in Tanjore in Tamil Nadu, Dr. Chandrashekhar did his schooling and college in Mumbai . While pursuing his Bachelor degree in Architecture from Sir JJ College of Architecture , Mumbai, he was involved in the redevelopment of the Back Bay reclamation area. This is where he first discovered his love for recreational spaces. In his thesis project, Dr. Chandrashekhar realized that there was no earmarked recreational space for children. He then charted a redevelopment plan wherein he connected the first floor common areas in such a way that it became an interconnected play area without any hindrance from vehicular traffic. After this project, during his study tour covering locations like Ahmadabad , Chandigarh and Delhi, opened his eyes to a new world of architecture and he was completely fascinated with the landscaping and the way Delhi infrastructure had used natural materials for constructions. 54

“One day I wanted to enjoy one of my own architectural creations, and wished to have a complete look at it from a bit distance. I wasn’t able to do so. Mumbai does not have enough space to even stand back and enjoy a building.” says Dr. Chandrashekhar. This is when he decided to shift to Delhi. He chose Delhi over Chandigarh due to the pace of life in Mumbai and Delhi came the closest to this.

Career Graph: A Mixed Bag At the initial stages of his career Dr. Chandrashekhar worked with Delhi’s Pradhan Ghosh & Associates for 3 years. He describes his tenure there as interesting and competitive. After this, he joined the Tata Institute of Fundamental Research where he was involved in a project called Semi-conductor complex. The project duration was planned for three years however we could manage to complete the working on this project in just a year. This made the government churn out 3 increments at a time for these architects; a rarity in those times. During this period he got another “chance of a lifetime”, as he describes it, to work at BARC. He worked on numerous path-breaking projects at BARC; one of them being creating a lab with clean rooms for a class 10,000. After working with the planning department in TIFR and then the exposure to atomic plants [at BARC], Dr. Chandrashekhar moved towards aviation in International Airports Authority of India (IAAI). He was involved in airport planning and during that time he was familiarized with the concept of Aerobridges which was non existence in India at that time. He was actively involved in the planning of the four metro airports. After working for more than 3 years in aviation, Dr. Chandrashekhar got an opportunity to work with DGHS, Ministry of Health & Family welfare, where he still works with full fervour.

A paradigm shift from active work to extensive studies? While working in DGHS, in 1989 the School of Planning and Architecture, Delhi came up with a PG Diploma course in Health Facilities planning. He grabbed this opportunity and was among the first batch of students. After working for 14 years he was motivated to do a Ph.D ably supported by his mentor and the Dean Mar - Apr 2014

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Dr. Chandrashekhar has come a long way since he started his career. His achievements are a testimony to his constant pursuit for perfection, excellence and uniqueness, combined with his boundless energy and optimism. That Dr. Chandrashekhar is a stickler for punctuality is something that all who know him can affirm. “Time management is the key; you can achieve a lot more in life simply by doing a little managing of your time,” he added. of R&C Division, BITS Pilani Dr. L.K. Maheshwari. In fact it was Dr. Maheshwari who highlighted the fact that Medical Architecture was a relatively unknown sector in India. He encouraged Dr. Chandrashekhar to utilise his healthcare field experience, to do research and ultimately leading to Ph.D under their off campus program. Prof. H. D. Chhaya, who was the course director of HFP at the, School of Planning & Architecture and the HOD of the Architecture Department, further guided Dr. Chandrashekhar . Prof. Chhaya noted that the research topic of Norms and Standards in Healthcare Facility in India’ was immense and asked him to focus on space out of 3 main parts: i.e. staff, equipment and space. He also pointed out that norms get outdated quickly. Hence, he felt that Dr. C’s Ph.D should be to work on the methodology of making norms rather than the specifics. There was no looking back after this, and rest, as they say, is history. This game changer took out some time from his extensive schedule and spoke to Medgate. Excerpts from his interview…

Nature seems to have been the inspiration for so much of your work and it seems to be an intrinsic part of your life? One of the main off-shoots of this journey is that it allows you to view ‘NATURE’ with more compassion and intensity. Moreover, when nature enters any domain, including architecture there is a different kind of chemistry that comes in to play. You suddenly became more aware, ‘activity’ recedes and it is replaced by ‘action’. Sensitivity to all; be it the climate, the sun and wind, sociology, local materials/craftsman, become the bulwark of the design process. Therefore my approach to architecture is more fluid, no doctrines or ‘isms’ no baggage. Each site, each project presents a completely different set of conditions and therefore response cannot be the same: this brings in diversity and the only under-current that exists is the ‘balance’. Evidence Based Design is what it represents in Healthcare healing Architecture. Mar - Apr 2014

What would you like to be remembered for, by your peers as well as by succeeding generations? Yes, definitely I would like to be remembered by my peers or the succeeding generation - nonetheless more as a good human being than anything else. I would thrive to do such works which are user friendly for the purpose it is designed and lasts for generations to follow. For example if I design a hospital, the next generation should remember, may not be for its design but the spaces encouraged in imparting better education, Healing environment and so on....

Punctuality and a desire to develop something unique are your trademarks. Can you tell us how these traits became intrinsic to you? Well, people usually hear of how great Homi Bhabha was, I got a chance to work in an environment created by him at BARC. It is there that he taught us time management like nobody else could. Even the bus at the center was punctual to the second. In fact, BARC had a famous saying, “Time, tide and BARC bus wait for no one!” Homi Bhabha’s concept put us into the most disciplined phase of our lives. Moreover, I was also fortunate to have worked with Shri Robey Lal when I was in aviation, he was the Chief of Planning and also the first Indian to earn a Master’s Degree in Aviation planning. People like him motivated me to be unique. And my father taught me to have goals for each step in life, which has led me to a stature where I am.

Tell us about your transition from TIFR to atomic power to aviation to healthcare? Well, I just had one answer to this. Although currently my knowledge is specialized in one domain, an architect is a person who can back himself to do well in any industry once he is briefed about the project. Both aviation and healthcare were new domains for me when in first joined. However, my aforementioned point was proved as I went on to get a senior position at DGHS at the age of just 29, whereas people have to work their entire life to reach that stage. I was also supported a lot by Sh. P.C Jaitely, who was the Chief Architect then. He gave me a free hand at things, which instigated our innovations further.

What was the most special part in being the first Indian to hold a Ph.D in Medical Architecture? When I was in the last phase of my Ph.D, before the completion of my thesis, WHO offered me a fellowship to Medical Architecture Research unit [MARU] of South Bank University, London,UK. This was another fantastic opportunity for me. Moreover, by the time I had completed my fellowship I had touched upon all areas in my Ph.D; government, private and global. Moreover, during my fellowship, I was able to learn the space planning methodology used in government and private hospitals, which I was able to adopt later in India.

What is the inspiration behind your usage of non-conventional resources in your healthcare projects ? Ministry of Health under the Technical collaboration program, gave me an opportunity to visit Sydney at the University of New south Wales [UNSW] to study the usage of non-conventional energy sources under the inspiration of Sh. Indrajit Chaudhary who was the

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Additional Secretary of Health at that time. Australia was chosen as they were pioneer in utilizing natural energy-sources and were the closest to Indian climate . During one of the village visits 350 kms from the city, we noticed that instead of bringing the electricity cable all the way down from the city, they had built hybrid technology for utilizing non conventional sources of energy with solar, wind and bio. The entire village received electricity through such nonconventional routes. This was a learning experience. While we were on a tour we witnessed solar energy photovoltaic system being used to deliver polio drops in one of the Australian deserts. The outside ambient temperature of 45 degree C temperature via solar power was used to keep the temperature inside the thermal ice packs at 4 degree! This inspired me to use solar photovoltaic system in one of our research campuses in Kolkata to generate power for the campus. I also started using them in my pilot projects of PHCs. We went on to initiate a solar pumping programme at a homeopathic herbal garden in West Bengal where electricity was in short supply. In fact, we used solar power in quite a few unlikely places. Under one of the Govt. scheme, we had distributed hearing aids to the poor needy people in rural areas. After few months, we realised that they are not using them anymore, as they had no money to buy the batteries to keep those aids running! Hence, we introduced hearing aids with solar cells. These are the places where I derived my inspirations from.

How do you plan to tackle the major maintenance issues prevalent in government hospitals? We are working towards rectifying this situation. To make sure this does not happen in future, the Ministry of Health & Family Welfare GOI has issued an order that all healthcare infrastructure under PSU and the government will have a 5-year maintenance in-built at the Tender Stage, so that the person who’s delivering the project has to take the responsibility of maintenance for 5 years. We all know that commissioning a hospital is not easy. Usually, it gets delayed because the infrastructure is ready but the equipment is delayed, or the equipment is there but trained manpower manning it are not there. Earlier, till the time things used to get set , the contractor used to run away! This order will not allow him to do so, thus ensuring timely commissioning and better maintenance of public hospitals.

over. Government hospitals witness about 10000 OPD patients a day. We are planning to set up a call center for the registration process, so that we can ease the crowd and parking spaces. Smart cards are introduced to fasten the payment process. The role of a medical architect and engineers is not just limited to making the infrastructure. Things like IT implementation and crowd management is a part of our work too. In fact, to demolish the practice of biased recruitment of architects for the new AIIMS, we have, with the help of MOHFW, evolved a fixed fee for architects. This has happened perhaps for the first time in India. We believe in paying the right price for the best quality architects. This will ensure that there are no loose ends.

Infection control is an area very close to your heart. How are you implementing in your projects. Yes, infection control and IAQ (Indoor Air Quality) is a vital aspect an architect needs to keep in mind. I was fortunate enough to add more knowledge when I had participated in “Building Design & Engineering Approach to Airborne Infection Control” at Harvard School of Public Health, Boston, Massachusetts, USA recently. I shared a number of things. For instance, There has to be seamless ceilings and walls, as joints give birth to infections. “the right angle is not really the ‘right angle’! in clinical areas,” one needs to cove the corner, curve them, so that the dirt does not settle. Indoor air quality is of utmost importance. In the new institutions we are building, 80% of hospital acquired infection is thru touch surfaces, we will be using copper at all touch surfaces, like handles, grab bars, railings, IV fluid stands, patient bed holders, since copper has an anti-microbial property and kills germs on its own. In fact, even the pen I use is of copper and I recommend copper stethoscope for doctors..

Can you tell us the Government’s initiative in tackling the shortage of manpower in the healthcare industry? MOHFW has recently upgraded 13 state government medical colleges in India and 13 more are in the process of up gradation under PMSSY(Pradhan Mantri Swasthya Suraksha Yojana) and 39 more in 12th plan which will add more PG seats in these existing Medical colleges, so that we are able to generate a greater number of faculty for those new upcoming 6 AIIMS like institutions across the country.

Update us on usage of Information Technology in Government hospitals? The government is very serious about upgrading the use of IT. We do believe that technology will help us in faster patient turn56

Mar - Apr 2014

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The use of technology to control infections rate which are generally spread to or via patient relatives. For me, an ideal situation would be to separate the patient right at the time when he/she enters the hospital. Relatives will be able to communicate through CC Tv which are connected to Plasma TV in waiting area, which is designated area for relatives. Even the ICUs will have CCTV/plasmas which helps keeping the social, emotional and cultural parameters in tact, thus we can manage infections to quite an extent.. Some of the hospitals that have implemented this claimed to have brought down 30-40% of HAIs.

What is the roadmap of MOHFW to enhance the future of Medical Architecture in India? With a huge amount of healthcare infrastructure being planned in 12th Plan like setting up of two more AIIMS like institution and up-gradation of 39 state medical colleges and 8 Regional & 1 National Institute of Allied Health sciences, up-gradation of 642 district hospital and a number of new medical colleges, there are huge challenges ahead and trained Medical architects are the need of the hour. To attain this, MOHFW has formed a committee of experts for setting up the National Institute of Healthcare Engineering and Architecture and to start a Masters programme in medical architecture. Dr. V.M Katoch, Secty. (DHR), DG ICMR is taking the lead as Chairperson and I am the member Secty. The course curriculam is ready and approved by AICTE and the working group hopes to start this 2-year course in 2014. The course will have multiple entry and exit options, taking into account the hectic work life of a healthcare professional. Also, currently, there is no written engineering maintenance manual on different departments within a hospital. The expert professional, who will be enrolled in healthcare engineering, will be able to produce maintenance manual for various segments of the healthcare, which is presently non-existence in the country. Almost 80% of the faculty would be guest faculty and this course is the first of its kind in the whole of South East Asia. The School of Planning & Architecture Delhi has taken initiative to start this programme in their institution with MoHFW funding and The National institute will function at PGI Chandigarh and we plan to put the entire curriculum on the web, so that every institution can make use of it.

Please share your Global experiences? I was fortunate to be nominated by The Indian Institute of Architects to represent India in the UIA PHG (International Union of Architecture - Public Health Group) forum and in their convention at Toranto, Canada, I made a presentation on the Healthcare Scenario in India and the Government of India’s effort in this field. I also represented GUPHA (Global University Programme in Healthcare Architecture), wherein there were a representative from around 17 countries, who were running Healthcare Architecture Programme in their universities at master level. I made a presentation about Ministry of Health & Family Welfare, Government of India initiative regarding setting up of NIHEA (National Institute of Healthcare Engineering & Mar - Apr 2014

Architecture to be set up at PGIMER (Post Graduate Institute of Education & Medical Research) at Chandigarh for starting two courses at master’s level: ☛ Health facility Planning & Design. ☛ Healthcare Engineering & Management. Since this programme would be first of its kind in South East Asia. My presentation was well appreciated by all members of these countries and also offered Global Universities collaboration, so that this become platform to share the knowledge & experience in the field and get the expert faculty support. I was also invited by Texas A & M University by Centre for Health System & Design (CHSD) to deliver a talk entitled “Challenges of Designing Healthcare Facilities for 1.2 billion population of India”. The lecture were well attended by student & faculty members and some of the experts of the healthcare field and I was awarded the 1st humanitarian award for outstanding contributions to the people of India for my work in improving the state of the art of “Architecture for Health” in India. I was also invited by South Bank University, London in MARU (Medical Architecture Research Unit). They felicitated me and appointed me as visiting Professor, so that the students of MARU could be benefited by my rich experience of working in healthcare sector in India. I have also been invited by IHEEM (Institute of Healthcare Engineering & Estate Management) of U.K. to deliver a keynote address in their conference at Manchester. A similar opportunity was also given to me when I made a presentation in APW (Asia Pacific Week) in Berlin, Germany, wherein the topic was on sustainable healthcare architecture. Thus, besides speaking in various conferences in India in different states, I was fortunate to share my experience and thought with global audience.

How would you describe your 30 Year career in Health sector in few words? Be generous with your human resource and other resources where your work goes and I have been- to the limit and beyond and always will be… I am fortunate enough to be surrounded with motivated and highly influential people, who have been supportive of my multitasking skills. Working towards providing healthcare for masses itself is a huge task. Even if I have been able to contribute 1% to it. I am satisfied. Our seniors used to say, keep sensitizing people and success will follow, the live example is eradication of dreaded disease like Polio from our country. However, there is a lot more to be done in Indian healthcare. Volume and population have always been blamed for non-delivery of adequate healthcare facilities. But then, if the other similar countries can do it, why can’t we? 57

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Areas of interest ☛Voice, Phonosurgery and Laryngology ☛ Lasers and robotic surgery ☛Surgery for speech disorders ☛Micro-ear surgery including Cochlear implants ☛Endoscopic sinus surgery ☛Head and Neck surgery ☛Sialology ► Among the first few in India to do Trans-oral Laser Surgery Thyroplasty for vocal cord paralysis, transoral robotic surgery and botulinum toxin injection in spasmodic dysphonia ► Spend 18 years of Professional career in All India Institute of Medical Sciences New Delhi and PGIMER Chandigarh. ► Conducted following workshops in Medanta, The medicity-:

KUMUD KUMAR HANDA Director, Deptt of ENT & Head Neck Surgery, Medanta Medicity, Gurgaon,

Experience in Specialty

24 years

Successful Because of Hard Work, Passion for Specialty and Caring for Patients

◆

◆ Larynx

◆ ENT

I nternational workshop on lasers in ENT and Head Neck surgery, January 2010 and beyond May, 2011

Live 2012, April, 2012

► Conducted 4 Phonosurgery workshops in AIIMS New Delhi in 1999, 2002 and 2006 and 2008 ► Been Guest speaker and faculty for number of surgical workshops (Total 47) in India and abroad ► Founding Secretary and Past President of Association of Phono surgeons of India

Awards and Orations

✰ Awarded the “best Otorhinolaryngologist of the Year 2012” by Times Research Media ✰ Marquis World’s Who’s who 2009

stablished the Department of ENT and Head Neck surgery at Medanta Medicity Gurgaon. Medanta Medicity is the foremost and best healthcare facility in the country today. ENT & Head neck Surgery Department was one of the earliest departments to start in Medanta and has the latest technology and best manpower.

✰A warded the First prize for the best video presentation in the Annual Conference of Association of Phonosurgeons of India held in Bhuwaneshwar 4rth to 7th January 2007.

► Associate Professor Deptt. Of ENT (Otorhinolaryngology) and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi

✰ Awarded SILVER MEDAL of the First Order in the MS (ENT) examination held in June 1993.

► Commonwealth Fellowship in Lasers and Laryngology at Glasgow Royal infirmary Glasgow ► Worked as Assistant Professor ENT, All India Institue of Medical Sciences New Delhi ► Worked as Senior Resident, Deptt. Of ENT, PGIMER, Chandigarh ► ( MS ENT ), from Deptt. Of ENT, PGIMER, Chandigarh

✰ Awarded the Khosla Gold Medal for the paper “Sensorineural hearing loss in unsafe CSOM in children” at the AOI North chapter held in Chandigarh from Nov 4-5, 1995.

✰ Awarded the British Academic Conference Fellowship for the BACO conference held in Cambridge, Great Britain from 4th to 9th July 1996. ✰ Awarded the First prize for the video presentation “Video stroboscopy” in the Jaiswal video competition held in the Annual conference of Association of Otolaryngologists of India held in Chandigarh in Jan 2001. ✰ Awarded the First prize in the SP Pamra Essay contest held by Delhi Medical Association in 1989. Mar - Apr 2014

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✰ Awarded the AOI Travel Fellowship for 1995-96. ✰ Awarded the President’s appreciation award by IMA South Delhi branch for services rendered in 2005 ✰ Awarded and delivered Dr R.D Kumar Oration in the Annual conference of the Bihar branch of Association of Otorhinolaryngologists of India on “ Phonosurgery Past present and Future “ on 3rd Dec 2006 ✰ President appreciation award by IMA South Delhi Branch for services to the IMA South Delhi branch . Presented on 18th Dec 2005

Research ► Member technical advisory group and Co investigator for INCLEN study, “Neuro developmental disabilities among children in India” (Funding Autism speaks, The National trust). ► Co investigator for ICMR funded project ; Cleft lip and palate being jointly carried out by AIIMS, Medanta and other institutions ► Chief investigator Project “TNF factor estimation in the oral cancer” along with the department of Biotechnology, AIIMS on a research grant given by AIIMS. ► Chief guide for the AIIMS research project “Role of Botulinum toxin in Spasmodic dysphonia”

Specialized in Medical Equipment Transportation

► Chief Guide for CSIR funded project “ Study on voice changes in elderly and in central nervous system disorders”. ► Guide and co-guide for number of MS/MD thesis

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Caring for

Womanhood Sabhyata Gupta Director & Head, Deptt. of Gynaecology/Gynaec. Oncology/Robotic surgery Medanta The Medicity

Dr. Sabhyata Gupta is the first gynaecologist in India to do Robotic Gynaecological surgery for cancerous and benign (non cancerous) gynaecological conditions. She has expertise in Gynaec Oncology, colposcopy, advanced Gynaec laparoscopy, robotic surgery & hysteroscopy. She has authored a number of publications, and has been actively involved in various seminars, workshops and conferences throughout the country and at international level. She is currently senior vice president, Fertility preservation society of India. Executive member, Association of Gynaecologic and obstetrician of Delhi 60

with better than the best.

Till date Dr Gupta has performed highest number of gynaecological surgeries for benign and cancerous conditions in India. Runs fellowship and training program for advanced laparoscopy and robotic surgery Dr Sabhyata believes that doctor should be a good listener & cognisant of the sensitivity involved. They should always remain updated with latest technologies. They should have empathy. Be truthful and respect fellow humans.

➨ Trained in Robotic surgery in France and established the first gynaecological robotic surgery department in India at Medanta –The Medicity, Gurgaon in 2010. ➨ She is an active member of Society of European Robotic Gynaecological Surgery. ➨ Trained in advanced laparoscopy at Germany. ➨ Has consistently delivered results of robotic surgery at par with the best in the world and strived to create benchmark for gynaecologists in India. ➨ Actively engaged in training of gynaecologists in laparoscopic and Robotic surgery ➨ Experienced Gynaec Oncologist ➨ Delivered invited lectures at national and international level. ➨A uthored chapters in books and have contributed in national and international journals Mar - Apr 2014

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ORGANIZATIONAL POSITION ➨ Coordinator, (North India), Clinical Research Committee, Federation of Obstetrics & Gynecology Society of India (FOGSI) 2003- 2008 ➨ Executive member, Adolescent committee, Association of Obstetrics & Gynaecologists of Delhi (AOGD ) 2006 - 2007 ➨ Executive member, Association of Gynaecologic Oncologist of India,2009 -2011 ➨ Chairperson, Gynaec. Oncology committee,Gurgaon obstetrics and Gynaecology Society, 2011 ➨ Executive member, Gyanec.Oncology Committee, Association of Obstetrician & Gynaecologists of Delhi (AOGD) 2012 -2013 ➨ Executive member, Gurgaon obstetrics and Gynaecology Society, 2012 -2013 ➨ Coordinator – Young Women Club ( National Project under the aegis of National adolescent Health Committee, FOGSI) 2012 -2013 ➨ Treasurer, Asia Oceania Research organization in Genital infections and Neoplasia ( AOGIN) –India, 2012 -2013 ➨ Executive member, Gynaec Oncology Committee, Federation of Obstetrics & Gynecology Society of India (FOGSI). 2012 -2013 ➨ Peer Reviewer for the Journal of Federation of Obstetrics & Gynecology Society of India (FOGSI).

Message to women : Women in their mid-life tend to juggle several things at the same time, inviting unwanted stress. Being a woman, with growing age, your chances of suffering from several health problems increase. But these health problems can be avoided by adopting healthy life style practices like regular exercise, healthy diet , maintaining balanced body weight etc. and also getting following tests done in consultation with your doctor

Women should health test frequently as follows: ➨ Pap smear or HPV test ➨ Mammogram (Breast cancer screening) ➨ Colonoscopy ➨ Lipid profile test ➨ Heart health test (BP, electrocardiogram) ➨ Diabetes test ➨ Bone-mineral density test ➨ Thyroid test ➨ Fertility check ➨ Blood test for anaemia Mar - Apr 2014

AWARDS & Achievements: BHARAT JYOTI AWARD

Award Conferred By “INDIA INTERNATIONAL FRIENDSHIP SOCIETY”, New Delhi, March, 2009.

BHARAT EXCELLENCE AWARD

& GOLD MEDAL Conferred by the “FRIENDSHIP FORUM OF INDIA”, New Delhi 25th Feb. 2009.

PRIDE OF INDIA GOLD AWARD

Conferred by the “FRIENDSHIP FORUM OF INDIA”, New Delhi.

RISING PERSONALITIES OF INDIA & GOLD AWARD by “International Penguin Publishing House”, New Delhi.

ARCH OF EXCELLENCE (AWARD MEDICARE)

at All India Achievers’ conference at Delhi on 31st May, 2009.

BHARAT NIRMAN SUPER ACHIEVER AWARD in the field of Medicine, 2011, New Delhi.

BEST GYNAEC. ROBOTIC SURGEON OF THE YEAR AWARD by Times Research Media on 26th Dec,2012

MOTHER TERESA EXCELLENCE AWARD

by Integrated Council for Socio-Economic Progress, Thrissur, Kochi, 25th Nov 2012 at Bangalore.

Doctor NEWS Speak UPDATE

World

Glaucoma Day Dr. Ashok Garg M.S. Ph. D (Bel.), FLAO (BEL.) FRCS, CHAIRMAN & MEDICAL DIRECTOR

GARG EYE INSTITUTE & RESEARCH CENTRE

235, Model Town, Dabra Chowk, Hisar -125 005 (Haryana)

he year 2008 is a pivotal one for glaucoma awareness. To combat the ignorance that leads to so much loss of vision, the World Glaucoma Association (WGA) and the World Glaucoma Patient Association (WGPA) have joined forces to launch a global initiative aimed at raising awareness of glaucoma through an annual World Glaucoma Day. They selected 6 March 2008 for the first observance of the day, as a way to jump-start awareness activities and to enlist the active support of governments, eye care professionals and patient support groups in many nations. Rather than have a single large event held in conjunction with a major conference, the day will consist of the sum total of local, regional and national initiatives and events organized by willing groups and individuals around the world. Recent years have seen considerable progress in the diagnosis and treatment of glaucoma. Technological advances in optic nerve and retinal nerve fibre layer imaging and visual field testing make it possible to diagnose glaucoma in earlier stages, when treatment can significantly improve the prognosis. Medical treatment is available and effective in controlling glaucoma for most patients), while for those uncontrolled, laser and surgical interventions are often successful. Optic nerve and visual field damage are irreversible. Because damage progresses gradually, often unnoticed by the patient, early detection and treatment are of paramount importance to prevent blindness. For individuals with known risk factors for

Recent advances in molecular genetics of glaucomas glaucoma – particularly elevated intraocular pressure, increasing age, African descent, family history of glaucoma, vasospasm, low blood pressure and high myopia – the importance of routine examinations cannot be understated. Also, despite strong evidence that lowering intraocular pressure can delay the onset and progression of glaucoma , reported rates of non-compliance with glaucoma therapy range from 5% to 80% (This high variability results from different definitions of non-compliance and the way in which it is measured. Glaucomas are a heterogeneous group of eye conditions with manifestation from as early as birth to very late age of onset in life. The primary type of these conditions affecting children and juveniles are less frequent, but the prevalence of glaucomas affecting older people of ≥70 years progressively rises to 5%. The molecular genetics of three types of glaucoma have been the subject of investigation in the last few years. As a result, two loci (GLC3A and GLC3B) have been identified for primary congenital glaucoma, one locus (GLC1A) for juvenile-onset primary open angle glaucoma and a further two loci (GLC1B and GLC1C) for late-onset chronic open angle glaucoma. Early this year, the first set of mutations was described in the CYP1B1 (Cytochrome P4501B1) and TIGR (Trabecular Meshwork Inducible Glucocorticoid Response Protein) genes for the GLC3A and GLC1A-linked families, respectively. The mapping of different types of glaucoma and mutation identification in these two genes are the focus of this review. Mar - Apr 2014

Doctor SPEAK

Glaucoma is a progressive disease causing irreversible visual loss, usually without warning until relatively advanced. The disease is characterized by increased pressure in the eye resulting inÂ progressive damage to the optic nerve. Approximately 2-4% of the Indian population is affected by this disease, while 13% of the blind in India have been blinded due to Glaucoma. Various factors like diabetes, blood pressure, poor eyesight, family history, +45 years of age, etc can lead one to Glaucoma. Since the symptoms are unknown, it becomes difficult to detect the disease at the initial stage, thus reducing the chances to cure the same. Glaucomas are a group of optic neuropathies that, if untreated, can result in total blindness. The condition is classified according to the etiology (primary versus secondary), anatomy of the anterior chamber (open angle versus closed angle) and time of onset (infantile versus juvenile versus adult). However, a more precise classification of this condition may only be possible when all the etiological factors, including primary defective molecules and other contributing risk factors, are identified.

conditions could start at birth or may appear after the age of 80, depending on the type of glaucoma present in an individual. The pediatric form of glaucoma (Buphthalmos) usually occurs at birth and up to the age of three, while juvenile-onset glaucoma may appear somewhere between the ages of 3 and 30. The late-onset form of this condition rarely starts before the age of 40 and is the most prevalent type observed in an everyday glaucoma clinic. The pediatric and juvenile types of glaucoma are generally rare conditions and, while the incidence of the primary congenital type varies between 1 in 1250 and 1 in 10 000, no comparable estimates are available for the juvenile-onset type of glaucoma. Although a large number of affected subjects have no previous family history, a significant proportion show a clear familial aggregation with multiply affected subjects in their respective pedigrees. Whereas the main mode of inheritance for primary congenital glaucoma is autosomal recessive, for juvenile and adult-onset glaucoma the more frequently reported mode of inheritance is autosomal dominant with reduced penetrance. A significant proportion of other ocular conditions associated with glaucoma are also inherited as autosomal dominant traits. Table 1 provides a summary of the chromosomal location for different types of primary glaucoma and other associated conditions. In this article, the molecular genetics of different types of glaucoma will be reviewed in order to provide some insight into the molecular etiology of two well studied types of glaucoma, namely, the juvenile-onset primary open angle glaucoma and the pediatric form of primary congenital glaucoma. A brief summary on the current status of other types of ocular conditions associated with glaucoma will also be presented.

Different forms of glaucoma share some common clinical manifestations that usually include specific abnormal appearance of the optic nerve head, characteristic loss of the visual field and chronic painless progression. Furthermore, the condition frequently is associated with increased intraocular pressure (IOP), but this elevation is neither necessary nor sufficient for onset or progression of the disease. The manifestation of this group of eye Mar - Apr 2014

DOCTOR SPEAK

A $49.2M investment for patients with or at risk of cardiovascular disease:

The Montreal Heart Institute will pilot the -ARTERIA Research Program Dr. Jean-Claude Tardif Director of the MHI Research Centre (Canada)

he Montreal Heart Institute (MHI) announced last week the launch of ARTERIA, a research program aimed at developing ground-breaking treatments for cardiovascular diseases, the number one cause of death worldwide. “Once again, the Montreal Heart Institute and its team of dedicated physicians, researchers and professionals have established themselves as world leaders in the fight against heart disease. This program will have tangible positive effects on patients living with or at risk of developing cardiovascular disease,” declared Dr. Jean-Claude Tardif, Director of the MHI Research Centre who will be leading the project. The discoveries and innovations that will stem from this unique program will substantially benefit patients over the medium and long term by transforming medical practices in the treatment of heart disease, all while realizing major savings for the health system as a whole. Among its many benefits, ARTERIA will make it possible to deliver increasingly personalized medicine and to treat and medicate patients more effectively, thus saving lives. It is noteworthy that cardiovascular diseases are the leading cause of hospitalization and deaths in the world, and that 1.3 million Canadians suffer from various forms of the illness. Cardiovascular diseases also represent the largest economic burden of all diagnostic categories with total annual costs of approximately $22 billion in Canada. Unprecedented partnership yields major investment of $49.2M This monumental cutting-edge project has been made possible thanks to the $49.2 million it

has received in funding. Of this amount, $31M has come from private investments linked to the biopharmaceutical sector and $18.2M has come from the Government of Quebec. “We are very proud at the Montreal Heart Institute Research Centre to have succeeded in attracting to this research program such key stakeholders as the Quebec Government, Université de Montréal, and the world’s most innovative pharmaceutical companies, so that our patients may benefit from the fruits of this important research,” added Dr. Tardif. ARTERIA will also lead to the creation of 150 new direct, high-skilled jobs. The announcement was made in the presence of Quebec Premier, Pauline Marois, Ministers Nicolas Marceau, Jean-François Lisée and Élaine Zakaïb, Montreal Mayor, Denis Coderre, and representatives of international pharmaceutical companies. The program’s main private partners attending the event were eager to praise the MHI Research Centre’s initiative in establishing this innovative project. In doing so, they attested to the Institute’s indisputable leadership on the world stage. “Through our collaboration, we will be able to combine the MHI’s worldwide network of scientific and medical research with our capabilities in translational medicine and clinical development. For this reason, to Hoffmann-La Roche Ltd, the Montreal Heart Institute is unequivocally a world-class Quebec institution,” noted Ronnie Miller, President and Chief Executive Officer of Hoffmann-La Roche Ltd. Canada. Frédéric Fasano, Canadian CEO of major ARTERIA partner Servier Canada Inc., for his part underscored the long-standing collaboration between the two organizations: “Our collaboration with the Montreal Heart Institute began over 15 years ago. It has been extremely productive in terms of research and innovation, case in point being a medication to treat patients with heart failure which was

largely developed within the walls of the Institute. To work with the Montreal Heart Institute is to work alongside cardiologists and researchers of one of North America’s top cardiology centres.” Lastly, major partner MedImmune (a subsidiary of AstraZeneca) stressed the uniqueness of the MHI and its model. “In taking part in the ARTERIA program, AstraZeneca, like all other public and private partners and all patients, will benefit from the internationally outstanding facility that is the Montreal Heart Institute. The Institute is the only one to offer an integrated model that runs the gamut from genetics, to cellular analysis, to major clinical studies. The Montreal Heart Institute is simply the only centre of its kind in the world,” added Dr. Fouzia Laghrissi-Thode, Global Vice-President in charge of Astra Zeneca’s Cardiovascular and Metabolic division. Dr. Guy Breton, Rector of the Université de Montréal, to which MHI is affiliated, was thrilled about the announcement. “We are very proud of the three Université de Montréal research teams that received funding as part of this new program. I especially congratulate Dr. Tardif and his team at the Montreal Heart Institute who are set to lead a research program that is innovative from every standpoint. On this Valentine’s Day, which calls to mind the importance of the heart, I am delighted to know that researchers of such high calibre will have access to resources and partners that will enable them to develop new avenues to improve heart health.” The product of a vast and diversified partnership, ARTERIA has also been made possible by the significant contribution and tangible support of the following partners: Valeant Canada, Pharmascience Inc., Thrasos Therapeutics Inc., Pfizer Canada Inc., Spartan Bioscience Inc., and the Montreal Heart Institute Foundation. Mar - Apr 2014

DOCTOR SPEAK

Achievement & Awards ✰ From Cambridge in 2011 & her appointment

Dr. Anubha Bajaj

with the IMA governing council as an alternate member in 2013. ✰ Prestigious citations held by her are; Leadership in health professionals 2011 by International Biographic Centre , Cambridge, U.K. ✰ Best consultant Histopathologist, New Delhi by Time Research 2012 ✰A lternate member governing council IMA - Academy of medical specialities 2013. ✰ Worldwide Achievers in 2013.

M.B.B.S, M.D.(Pathology), Fellow-IMA AMS A.B.DIAGNOSTICS

Key to Success is Her Integrated, Honest & Patient Centric Approach.

thoroughly enjoyed my previous junior appointments which included compulsory rotating internship at General Hospital, House officer in Paediatrics & Gynaecology & Obstetrics, Specialist Registrar in Pathology at DMC & H, (Panjab University Chandigarh) Junior Consultancy in Pathology at Jaipur Golden Hospital, Senior Residency at Lady Hardinge Medical College & also as a Consultant Incharge of a Diagnostic Histopathology/ Cytopathology Laboratory. I feel I have all the necessary Clinical & Interpersonal skills to perform the duties of the post to a high standard. In particular my specialist registrar training has provided me with a wide & varied experience both in Histopathology & Cytopathology. During my time at DMC & H I have had an extensive training in Histopathology & Cytology both techniques & reportingincluding a thesis project) & now I regularly practice it. Finally, I recognize the importance of continued contribution to Pathology & of participation in audit, research & teaching.

Latest trend in pathology: Early & correct cancer detection is the panacea for long term survival , enhanced quality of life with psychological benefits & reducing costs while improving healthcare. Mar - Apr 2014

DENTAL SECTION

Say No to braces for a

great smile!

lear Path Orthodontics an American company, introduces a breakthrough technology which revolutionizes the way we treat malocclusion (irregular teeth and bite). ClearPath provides new improved quality 3D aligners through its unique proprietary, patented process which provides a hygienic, convenient and a clear solution for the correction of malocclusion without having to wear brackets and wires. ClearPath Aligners are removable, almost invisible, US-FDA approved medical grade plastic appliances, a custom made plastic trays which fit snugly onto patients teeth instead of wires and brackets to correct malocclusion. ClearPath Aligners are a modern alternative to braces for straightening teeth. ClearPath Aligners are becoming a popular choice among teens and adults, females and males alike. People aged between 13 years to 60 years are making aligners their first choice of treatment for malocclusion. ClearPath Aligner system is practiced by many leading dentist in the country and are available in hospitals and dental chains like Apollo, Axiss, Vasan Dental Care, Fortis, Dentzz, Beyond Smiles, My Dentist, Dentistree, Dr.Smilez,

KIMS, Breach Candy hospital among many others. Aligners have been the first choice of many celebrities as well such as Oprah Winfrey, Tom Cruise, Serena Williams, Justin Bieber, Katherine Heigl, Cheryl Cole etc. and quickly this is becoming the first treatment option for correction of malocclusion in many parts of the world including India where people can now avail of this revolutionary technology. Clear aligners treatment hit the US markets approximately 10 years back; however had negligible presence in the Asian & African orthodontic markets primarily due to the cost factor and no established manufacturer. With the launch of the first ever 3D aligners in India, Clearpath paves the way for this redefining treatment modality to take these markets by a storm. This computerized & digital clinical system is used in hundreds of clinics in the USA, India, Jordan, UAE, Lebanon, Oman, Qatar, Kuwait, Syria, Egypt and across the Middle East. The popularity is growing at an incredible rate.

Mar - Apr 2014

SYMBIOSIS INSTITUTE OF HEALTH SCIENCES (SIHS)

A Constituent of Symbiosis International University (SIU), Pune Accredited by NAAC with ‘A’ grade Accredited by Proudly Presents MMC XVI National Seminar On Hospital and Healthcare Management, Medico Legal Systems and Clinical Research

SYMBIOSIS INSTITUTE OF HEALTH SCIENCES (SIHS) Venue:

Seminar Dates:

Symbiosis International University Gram: Lavale; Tal: Mulshi: Dist: Pune-412115

2nd & 3rd May, 2014

Key Speakers*

Issues in Focus*  

         

Successful Healthcare Models :  Hospital / Medical Devices / Pharma / IT Game Changers in Healthcare  Primary Healthcare Diagnostics  Hospitals Entrepreneurship Challenges in Workforce Management in Hospitals Special Laws and Legal Framework Medical Tourism Quality & Accreditation of Hospitals and Healthcare Universal Health Insurance Pharmacovigillance Franchising in Healthcare Regulatory Mechanism in Clinical Trials Legal aspects of Healthcare : Landmark Judgments Strategic Management in Healthcare



  

Dr. Adheet Gogate, MD, HealthBridge Advisors Pvt. Ltd. Dr. Azad Moopen, Chairman, Aster DM Healthcare Dr. C. Potkar, Director, Pfizer Mr. C. K. Kumaravel, Chairman, Indian Franchise Association

     

Mr. Daljit Singh, President, Fortis Healthcare Ltd. Dr. Gautam Sen, Chairman, Wellspring Healthcare Dr. Gopinath N. Shenoy, Medico Legal Consultant Mr. Kaushik Sen, Co-founder, Wellspring Healthcare Dr. Om Manchanda, CEO, Dr Lal Path Labs Mr. Pradeep Thukral, Founder, SafeMedTrip Consultant

    

Dr. Raman Gangakhedkar, Deputy Director, NARI Dr. Sanjay Arora, Director, Suburban Diagnostics Dr. Sanjay Gupte, Director, Gupte Hospital Dr. Vandana Luthra, Founder VLCC Group Dr. Yash Paul Bhatia, MD, Astron Healthcare Ms. Yegnapriya Bharath, Joint Director, Health



Pvt. Ltd

Insurance ,IRDA

Media Partner

 MAGAZINE

Ms. Zahabiya Khorakiwala, Managing Director, Wockhardt Hospitals

*Tentative

Pre Conference Symposium 9.30 am to 1.00 pm, Friday, 2nd May, 2014

Successful Healthcare Models

Mr. Rajen Padukone, CEO & MD, Manipal Health Enterprises Dr. Harish Pillai, CEO, Aster DM Healthcare Mr. Sadananda Reddy, MD, Goldstar Healthcare Private Limited Dr. G. S. K. Velu, Founder & MD, Trivitron Group

Admissions open for

Valedictory Ceremony 3.00 pm, Saturday, 3rd May, 2014

Chief Guest

Shivinder Mohan Singh Executive Vice Chairman, Fortis Healthcare Limited Guest of Honour Adv. Ram Jethmalani Former Union Law Minister Dr. Rajiv Yeravdekar Dean, Faculty of Health & Biomedical Sciences, SIU

Post Graduate Diploma in Hospital and Healthcare Management Post Graduate Diploma in Medico Legal Systems Post Graduate Diploma in Clinical Research Post Graduate Diploma in Health Insurance Management For further details please visit : www.schcpune.org. Tel.+ 91 20 25655023, 25667164, 20255051 Contact Dr. Sanika/Dr. Abhijeet/Dr. Manali on 8888892258 Email : distancelearning@schcpune.org, info@schcpune.org

DOCTOR SPEAK

Revolutionary Botox Injections to Rectify Refractory Sexual Dysfunction in Women Dr. Sanjay Pandey

Refractory Vaginismus is a sudden onset of involuntary gross spasm in women that happens due to any penetration be it from fingers to tampons to erect male shaft to a gynaecological examination.

his means that any kind of penetration through vaginal inlet is restricted by the muscle and it causes immense pain for the patient and causes problems in sexual intercourse. Refractory Vaginismus accounts for approximately 1-7% of unconsummated marriages with little treatment innovation in this area. Sonia and her husband, a Mumbai-based couple, discovered the problem immediately after their marriage. However, they had no idea what the problem was and initially thought they might be incompatible. In the six years that they have been married, the couple tried several ‘remedies’ including lubrication, exercises, counseling, self-dilation, etc; but nothing helped. When these didn’t work, the couple visited many doctors including several gynecologists. Recounting her painful and humiliating experience she faced at the hand of certain doctors, Sonia says, “I just did not know where my vagina was and any form of penetration was not possible. One of the gynecologists used a speculum that was big and forced it through my vagina. There was tremendous pain. This is when my hymen got ruptured. There was bleeding because of forcing it inside my vagina and the doctor proved it to me that anything can go inside, even my own fingers.” The experience with the doctor put her into a trauma and caused immense psychological trouble. For two years she did not try anything. During this time Sonia’s sugar levels and blood pressure shot up. She was put under medication for stabilizing it. One of the gynecologists had even asked Sonia’s husband to force himself upon her and slap her if she did not comply. An online search lead the couple to Dr Sanjay Pandey, Consultant – Andrology, Urology and Gender Reassignment Surgeon, Kokilaben Dhirubhai Ambani Hospital, whose specialization in the field of sexual Genito-Urinary reconstructions and Female urology interested the couple. Highlighting the need for education on various kinds of sexual dysfunctions and the need to keep abreast of international trends, as practiced at KDAH, Dr Pandey said, “The treatment met to Sonia by some of the doctors had left her totally shattered. There is immense

need for a fresh perspective on sexual problems in India and we need to treat the patients from the eyes of the medicine rather than imposing old practices on them. When Sonia came to me, she was depressed and scared. I explained the procedure to establish the minimally invasive and complication free method of management of this refractory condition through Botox injection and she was amazed at how easy this could have been for her if someone had guided her well.” Dr Pandey further explains the treatment, “Botox has property of relaxing neuromuscular junctions of muscles when injected by bringing about synaptic transmission interruption that keeps the vaginal muscles relaxed, that never was before and couldn’t be achieved by all non invasive means thus allowing penetration and consummation. The span of activity lasts 6 to 7 months which is enough for couples to have the learned the behavior

of coital activity with relaxation and dilatation, away from the refractory state of yester years.” Three weeks post injection Ms Sonia could capably take the largest vaginal dilator and soon consummate her long awaited dream. Having seen the largest dilator go with ease and be able to participate in coital activities took away the huge stress and never ending pain and discomfort of an endless journey. Refractory Vaginusmus is a deep hidden burden in the minds of many couples who seek answers and fail to get one. Botulinum toxin is an innovative step forward in this difficult management and will go a long way in relieving many women of their never ending agony. Dr Pandey at Kokilaben Dhirubhai Ambani Hospital in Mumbai is involved in Botulinum toxin therapy of various refractory lower urinary tract disorders namely Overactive bladder that leads to bothersome incontinence and Detrusor Sphincter dyssenergia leading to blocked urinary pathways in spinal and neurological diseases. Both above refractory conditions like the vaginismus have found minimally invasive satisfactory treatment resulting by Botox.

Mar - Apr 2014

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