March, 2014
Rs. 100
Women’s Imaging:
Wordsworth: Olivier Billiau
Her Awakening!
Barco Healthcare’s Sales Director Growth Markets EMEAI elaborates company’s future plans
Vol 3, Issue 3, Pages 44
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India's First Complete Medical Imaging Magazine
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The diagnosis The diagnosis is in the details. is in the details.
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Insight. Delivered. Agfa HealthCare India Pvt. Ltd. Technosoft Knowledge Gateway, 2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West)- 400 604 Email for enquiries: sales.india@agfa.com Agfa HealthCare India Pvt. Ltd. Technosoft Knowledge Gateway, 2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West)- 400 604 Mumbai New Delhi Kolkata Chennai Email for enquiries: sales.india@agfa.com 022-40642900 011-41510858 033-22820745 044-42125263 COLOR DOPPLER | MARCH, 2014 Mumbai 022-40642900
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Insight. Delivered. Learn about Agfa HealthCare at www.agfahealthcare.com Learn about Agfa HealthCare at www.agfahealthcare.com
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Inside Scan Under the Scanner –
Her Awakening! COLOR DOPPLER | MARCH, 2014 Volume 3 | Issue 3 KERENG/2012/41766 editor-in-chief Joby Joseph joby@colordopplermedia.com publisher Niranjan Kumar K R M niranjan@indiaultrasound.com
Every advancement in women’s imaging — one of the most significant and popular medical specialties — leads to better and healthy living for every woman. Thanks to the latest developments in technology, women’s imaging has attained high standards of techniques, thus paving the way for more accurate and faster diagnosis
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design editor Gireesh gireesh@colordopplermedia.com
Wordsworth –
Visibly Better
chief coordinator Saraswathy M saraswathy@colordopplermedia.com
Olivier Billiau, Sales Director Growth Markets EMEAI, Barco Healthcare, shares his insights on expanding their healthcare services in the India. We always make sure that we are in direct contact with the end users, hospitals, doctors and also our partners in healthcare, he says
chief correspondent Jumana Engineer jumana@colordopplermedia.com co-ordinating editor Rini Baby Thottil rini@colordoppleronline.com copy writers Ria Lakshman V ria@colordoppleronline.com Purnima Sah purnima@colordoppleronline.com senior designer Sohan V K sohanvishnu@colordopplermedia.com designer, new media Amit Sudhans amit@colordoppleronline.com manager-product & HR Kishore Kumar P S kishore@colordopplermedia.com assistant manager, IT Swetha G swetha@colordopplermedia.com manager, accounts Hariharan V V assistant, accounts Shahana P shahana@colordoppleronline.com
COLOR DOPPLER #2/1775-B, Florican Road, P O Civil Station, Calicut, Kerala - 673020, India Phone : +91 495 2378808/ 09 Email : info@colordoppleronline.com www.colordoppleronline.com Vision and opinions expressed in this magazine are not necessarily those of Color Doppler, its publisher and/or editors. Color Doppler does its best to verify the information provided but will not take any responsibility for the business moves taken by any reader on the basis of any article published in this magazine. No part of Color Doppler can be reproduced without the prior written permission of the publisher, Niranjan Kumar K.R.M. The rights to reproduce any information published in this magazine are vested with Color Doppler. The magazine is sold on the condition that the jurisdiction for all disputes will be courts/ forums/tribunals at Kozhikode, Kerala. Printed, published and owned by Niranjan Kumar K R M, 3/1614 C, Sridevi Niranjan, Near 6th Rly Gate, Nadakkave Post, Calicut-673011 and Printed at Anaswara offset Private limited, 48/2123-c Perandoor Junction, Elamakkara, Cochin 682026 and Published at 34/1347-A, Florican Road, Malaparamba, Calicut-673009. Editor: Joby Joseph.
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page 14 Talking Point –
Bigger Challenges Ahead One of the biggest challenges being faced by the country is the shortage of emergency physicians. We have just 40 or 50 emergency medicine graduates every year, which is too less, says Prof T S Ravikumar, the Director and CEO, Jawaharlal Institute of Postgraduate Medical Education and Research
page 30 Expert Opinion
‘Popularising Routine Screening is a Must’ An increase in routine screening mammography will decrease the mortality related to breast cancer, says Dr Rupa Renganathan, Consultant Radiologist, KMCH
page 24 Expert Opinion
‘Negligence is Root Cause of Cancer in India’
On the occasion of another Women’s Day, Dr Sandeep Chatrath, Chief Executive Officer, Dharamshila Hospital and Research Centre provides insight into various aspects of women’s imaging
page 26 Eventful
Forward Thinking
A vision of Dr T S Ravikumar, the director and CEO of JIPMER when combined with the mission of the Global Academy of Emergency Medicine, ISEMT 2014 harnessed the global interest to promote academic Emergency Medicine in India
page 37 COLOR DOPPLER | MARCH, 2014
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[ news scan ]
64 Patents Awarded to Carestream in 2013
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arestream Health was awarded 64 patents from the US Patent and Trademark Office in 2013 for innovations in radiology imaging, healthcare IT, dental imaging and other areas, reflecting another successful year in developing advanced technology across its global businesses. Highlights of the new patents earned by the company’s scientists and engineers include innovations in Carestream’s growing portfolio of wireless digital X-ray detectors that can enhance medical image quality while helping improve patient care for a wide range of healthcare providers; new software enhancements for Carestream’s Vue PACS that provide flexible, cost-effective review, management, distribution and archiving of medical
images to help optimize treatment decisions; advancements in dental imaging, dental image processing and software, and new dental restoration systems; continued developments in Carestream imagers and
New Online Healthcare Magazine from GE
media that provide affordable printing of digital X-ray exams onto medical film and paper and new product features from Carestream Advanced Materials in the area of transparent conductive films applying innovative silver nanowire technology. “The investment by Carestream in intellectual property is a reflection of our commitment to delivering high-quality products and solutions to our customers that exceed their expectations,” said Susan Parulski, Chief Patent Counsel for Carestream. “The increase in US patents over last year, illustrates the depth of talent and dedication of our technical team.” Carestream was also awarded 33 patents from countries outside the US, including Japan, China, Korea, Taiwan and Hong Kong, and from several countries in Europe as well.
market scan Indian Ultrasound Market Reaches 2,096 Units in CY Q4 2013
GE
Healthcare recently launched its new online magazine, The Pulse. The magazine features topics from healthcare, technology, innovation and science. Designed to appeal to a broad audience, the site focuses on five topics: Cancer, Neurology, Healthcare Innovation and the Industrial Internet. The Pulse also concentrates on the work GE Healthcare is involved in with the industry and other organizations to help
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increase access, quality and affordability of healthcare. The Pulse serves up a visual treat with the site displaying improved slideshow features, and larger videos and is fully optimized, accessible on mobile devices. Designed to appeal to a broad audience, the site focuses on five topics: Cancer, Neurology, Healthcare Innovation and the Industrial Internet. The Pulse also concentrates on the work GE Healthcare is involved in with the industry and other organizations to help increase access, quality and affordability of healthcare.
Research and Markets, the world’s leading source for international market research reports and market data has announced that the Indian Ultrasound equipment market has reached a huge volume of 2,096 units in the fourth quarter of 2013 calendar year. GE Healthcare emerged as the market leader in the industry for the quarter, followed by Philips and Mindray. The three players together captured a total market share of 47 percent. It also reveals that more than 35 vendors shipped ultrasound equipment. The rise in the government spending in the Indian healthcare system along with the growing efforts to raise the standards and accessibility of healthcare services fuelled the growth of ultrasound in India.
COLOR DOPPLER | MARCH, 2014
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[ news scan ]
Barco Showcases Futuristic Diagnostic Displays at HIMSS
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arco, a global leader in healthcare visualization and IT systems showcased their latest diagnostic displays at HIMSS 2014 from February 24 to 27 held at the Orange County Convention Center in Orlando, Florida, USA. Displayed at the event were Barco’s expanding Eonis line of clinical displays, which enhance clinical collaboration by providing specialists with the accurate, precise images they need, ensuring consistent images on every display across the network. Eonis displays are designed for use throughout the medical environment and can be installed on mobile carts, arms and wall mounts for a variety of applications. Eonis also features versions that are fully cleanable when installed in environments where disinfection is critical. Barco also displayed its latest display systems, Coronis Fusion 6MP LED and Barco Mammo Tomosynthesis 5MP. The Coronis Fusion 6MP LED display system for radiology leads the industry in multi-
STAR PHYSICS 2014
modality imaging, featuring optimized glass, intelligent sensors and other patented technologies that facilitate fast and accurate diagnosis. More than 13,500 Coronis Fusion 6MP DL display systems are installed around the globe. The Barco Mammo Tomosynthesis 5 MP is the only digital mammography display that has been indicated by the FDA specifically for breast tomosynthesis, featuring up to 4X brightness and double the lifetime of other mammography displays.
Diagnostic Imaging: Breast, 2nd Edition
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Onco Radiology and Interventional Radiology CME Date: March 7-9, 2014 Venue: Hotel Le Meridian, Bangalore, Karnataka For Details: www.hcgorir.com
book scan
Authors: Wendie A. Berg, MD, PhD, FACR, Wei Tse Yang, MBBS, FRCR Pages: 1,448, Price: $339
event scan
The second edition of Diagnostic Imaging: Breast covers the complete field of breast imaging, including screening and diagnostic mammography, tomosynthesis, breast ultrasound, MRI, positron emission mammography and gamma camera breast imaging. The book also covers topics in breast pathology and management of breast diseases. The 5th edition of the BI-RADS for mammography and 2nd editions of BI-RADS for ultrasound and MRI are cited throughout, providing the essential reporting tools for breast imaging. It includes thousands of illustrations and images, all annotated with essential information. It comes with Amirsys eBook Advantage, an online eBook featuring expanded content, additional eBook images and fully searchable text.
Date: March 22-23, 2014 Venue: Roentgen Seminar Hall, Dept.of Radiodiagnosis, Stanley Medical College For Details: www.stanleyradiology. com
30th Annual Conference of IRIA Karnataka State Chapter Date: March 29-30, 2014 Venue: The Taj Gateway Hotel, Hubli For Details: iriahubli2014@gmail. com
ULTRAFEST 2014 Date: April 18-20, 2014 Venue: The Renaissance, Powai, Mumbai For Details: www.msbiria.org
INSUOG 2014 Date: May 2-4, 2104 Venue: Hotel Taj Mahal Palace, Mumbai For Details: www.insuog.com
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[ news scan ]
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Dharamshila Hospital and Research Centre Starts World-Class BMT Centre
haramshila Hospital and Research Centre, one of the leading cancer hospitals in India has started world-class Dharamshila BMT Centre with 21 beds. Dr Suparno Chakrabarti, Programme Director BMT and Senior Consultant Haemato-oncology at Dharamshila Hospital and Research Centre said, “Blood and Marrow Stem Cell Transplantation (BMT) is being offered as a treatment option to patients suffering from congenital and acquired disorders of children and your adults, at state-of-the-art Dharamshila BMT Centre.” There is also a separate air conditioning unit (AHU) for each BMT room to provide 12-15 hepa filtered fresh air changes per hour. Automatic and selective control system provides air pressure in the BMT room which is 10-15 pascal higher than the anteroom. Dr S Khanna, President Dharamshila Cancer Foundation and Research Centre said, “We have designed our BMT unit’s air
conditioning, as per clean room level of class 1000 as per international guidelines. This design maintains 10 times higher sterile environment compared to operation theatres.” “To achieve best results in BMT, comparable to foreign countries, we provide facilities for Autologus transplants, fully matched Allogenic transplants, haploin-
face scan Robert Taylor VP, Global Business Development and Technology Innovation, Syngo Imaging Informatics Business, Siemens Healthcare
Robert Taylor joins Syngo Imaging Informatics Business, Siemens Healthcare as the Vice President of Global Business Development and Technology Innovation. Prior to his current position, he served as the CEO of advanced visualization vendor, TeraRecon since 2009. He also served as the CEO of AccuImage Diagnostics.
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dentical (half matched) and Cord Blood Transplants”, added Dr Suparno Chakrabarti. Dharamshila provides advance Blood Transfusion services for Automated component extraction, leucoreduction, apheresis and red cell serology. It has facilities for irradiation of Blood and Intensity modulated radiotherapy based on total body and Marrow irradiation.
GE to Boost its HOM Offerings by Acquiring API Healthcare
E Healthcare is all set to acquire API Healthcare, healthcare workforce management software and analytics solutions provider, headquartered in Hartford, WI. The acquisition aligns with GE’s Industrial Internet strategy to invest in strong, innovative businesses that enhance GE’s portfolio in software, data and analytics. The acquisition, subject to regulatory approval, is anticipated to close in the first quarter of 2014. API Healthcare’s complementary offerings will expand GE Healthcare’s current Hospital Operations Management (HOM) portfolio, which gives hospitals real-time access to operational data. “Labor costs represent over 50 percent of hospital operating budgets,” said Michael
Swinford, President and CEO, GE Healthcare Services. “With this acquisition, GE Healthcare will be able to address a significant portion of hospital operations costs – assets, patients and labor – with a mix of software, real-time data, powerful analytics and professional services.” “Healthcare productivity is more important than ever for hospitals as more patients enter the system and operational costs continue to climb,” said John Dineen, President and CEO, GE Healthcare. “In addition to clinical systems, hospitals need operational management systems to drive enterprise-wide efficiencies, reduce unnecessary costs and enable improved patient care. Over the next five-seven years, we believe sales of these systems will accelerate towards double-digit growth and GE Healthcare will lead the way.”
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[ new product scan ]
Vereos PET/CT
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hilips redefined the PET imaging with its new Vereos PET/CT system imbibed with the cutting-edge Digital Photon Counting technology, thereby marking a new era in clinical performance. The Digital Photon Counting technology adds on the performance level and doubles the sensitivity gain, volumetric resolution and quantitative accuracy. The PET/CT scanner has the capability to change usual black-and-white CT images
into color coded images. These images are filtered for specific masses, such as water, fat, iodine, contrast agents, etc. The system uses digital photon counters instead of conventional analog detectors. PET detector detains pairs of photons produced from the body during decay of an injected radiotracer. Vereos PET/CT gives technological advances with fast scans and fast post-processing. Ensuring Economic Value By ensuring the economical value, Vereos PET/CT has set an example of clinical excellence by enhancing its collaboration, improved treatment planning, increased diagnostic confidence and faster workflows.
Driving Clinical Performance Digital PET technology provides 2x improved volumetric resolution, sensitivity gain with improved quantitative accuracy.
OTHER FEATURES
DPC Technology
Philips proprietary Digital Photon Counting (DPC) technology converts scintillation light directly to a digital signal. The 1:1 coupling of crystals to light sensors produces a linear count rate, faster Time-of-Flight (TOF) performance and overall sensitivity gains compared to analog.
Improved Sensitivity
Vereos PET/CT offers improved
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sensitivity and resolution and delivers high quality images for enhanced diagnostic confidence.
Improved Treatment Planning
The superior technologies incorporated in the system assist the diagnostic process by enabling an improved treatment planning.
Quantitative Accuracy
The diagnostic accuracy provided by the system delivers a key step forward in personalized care for patients.
Enhancing Patient Experience The system delivers an enhanced patient experience with faster scanning, high image quality at low dose with iDose4. Vereos PET/CT is one of the shortest bore in the industry and provides integrated ambient lighting. COLOR DOPPLER | MARCH, 2014
[ new product scan ]
AMULET Innovality Fast and Low Dose Exam AMULET Innovality employs a directconversion flat panel detector. Its Amorphous Selenium (a-Se) exhibits excellent conversion efficiency in the mammographic X-ray spectrum. HCP (Hexagonal Close Pattern) detector efficiency collects electrical signal converted from X-rays to realize both high-resolution and low noise.
Tomosynthesis
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UJIFILM Corporation’s digital mammography system, AMULET Innovality is designed to offer both 2D and advanced applications. With Amulet Innovality, radiologist can view breast tissue detail in a way that was never seen before in sharper, clearer images and can make confident diagnostic interpretations. AMULET Innovality is designed to
enhance patient comfort and the patient experience during annual exams. It has the ability to utilize advanced applications such as ability to study breast tomosyntheses. The design has been made to enhance patient comfort and the patient experience during yearly examination.
B enefits AMULET Innovality provides two suitable modes for a range of clinical purposes:
HR (High Resolution) Mode:
With a larger acquisition angle the depth resolution is improved. This allows the region of interest to be defined more clearly
COLOR DOPPLER | MARCH, 2014
and brought into clearer focus.
ST (Standard) Mode:
The smaller angular range and fast image acquisition allow Tomosynthesis scans to be quickly performed with a relatively low X-ray dose.
X-ray tube in breast tomosynthesis moves through an arc while acquiring a series of low-dose x-ray images. The images are reconstructed into a range of tomosynthesis slices which makes it easier to identify lesions.
Intelligent and Smart Intelligent AEC gives privilege in defining the optimal dose for an examination compared to conventional AEC systems where the sensor position is fixed. It makes possible to consider the mammary gland density (breast type) when defining the x-ray energy and level of dose required.
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[ new product scan ]
Mammomat Fusion
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iemens Healthcare’s Mammomat Fusion is premium mammography system made to enhance everyday screening and diagnostics. Mammomat Fusion delivers reliable, high-quality images quickly with the help of its new detector. It combines robust technology
with selected product features from the premium segment to address the specific needs of the midrange price segment, volume screening centers and small to mediumsized hospitals. With a Click A refined automated workflow performs complex exams with the click of a button. This gives more time for what matters most for the patients.
Peaceful Detector The particularly robust and reliable detector keeps going strong, year after year leaving peace of mind.
B enefits
Refined Automated Workflow
Its RIS data is directly uploaded to AWS so that the RIS clients can also be operated on AWS without any additional RIS PC in the examination room.
Ergonomic Acquisition Workstation
2nd Generation CsI Detector:
The scintillator thickness optimized for the X-ray spectrum of the Mammomat Fusion for lower dose.
It gives a central workstation console with adjustable table and high image storage capacity.
Seamless Isocentric Rotation
Right Dose for Each Patient
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The Low operating costs, interesting service packages and high patient throughput helps to get money worth.
Up to 50 Percent Less Dose
It provides a tube with Tungsten anode. The Tungsten/Rhodium combination saves up to 50 percent dose compared to film based systems. It has high heat storage capacity.
Mammomat Fusion’s detector center always remains at same height, always ready to adjust for any position.
Packages
Personalized OpDose sets optimal exposure parameters for each breast depending on the entire breast density and thickness.
Single-Touch Positioning With just a single touch, it moves the swivel arm to the next projection view.
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[ wordsworth ]
Visibly Better Olivier Billiau, Sales Director Growth Markets EMEAI, Barco Healthcare, shares his insights on expanding its healthcare services in the India. We always make sure that we are in direct contact with the end users, hospitals, doctors and also our partners in healthcare, he says
Olivier Billiau Rini Baby Thottil l cd news
We always make sure that we are in direct contact with the end users, hospitals, doctors and also our partners in healthcare, be it local Indian companies or international companies that are active here
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global technology company that provides visualization solutions, Barco operates in more than 90 countries across the globe. The company has been noted for delivering innovations for a variety of selected markets. The company’s healthcare division is believed to be one among the best global providers of reliable diagnostic display systems and visualization solutions that pave the way for a quality healthcare. Olivier Billiau, Sales Director Growth Markets EMEAI, Barco Healthcare shares his insights on the company’s plans and aspirations so as to provide a quality healthcare in India. Prior to his current position at Barco Healthcare, Mr Billiau served as the International Partner Manager at MIPS. He also holds a record of serving as the EMEA Healthcare Distributor Manager at Kimberly-Clark Healthcare, Canon Business Center Director at Canon Belgium NV and Market Development Manager at Agfa Healthcare. Excerpts from an interview: As a global company with products and services delivered across more than 90 countries, how does Barco look at the Indian market? Barco has been operating in India for quite some years and India is indeed important for us. This is the reason why we have a R&D centre in Noida. We have a team of about 550 people in India and among them, most of them are for R&D division. We always make sure that we are in direct contact with the end users, the hospitals, the doctors and also our
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[ wordsworth ] partners in healthcare, be it local Indian companies or international companies that are active here. So, most of the R&D activities for India are being done in India itself and that goes for the commercial aspects of the business and also for service and maintenance aspects. As a global company, you will need to have different strategies for different markets. What are the strategies implemented by Barco in the Indian market to promote your products? The first thing is that we always work business-to-business. This is the global strategy of Barco. We never sell our products and services directly to the end user. We do it by working together with local subsidiaries of global companies in India or with the assistance of local Indian companies. Working this way helps us in getting a much better view of the market, which indeed helps us in adapting the different dynamics of the market. This is where our partners help us by guiding us, and following their instructions specifically help us to a great extent. Though Barco has a global strategy, the way you implement it the way you apply it in a certain country is very much through this channel. So, when it comes to any country around the world, whether it is India or any other, you may find there are certain products that you would need to introduce differently in a country than that you do it in the other country. You might even find similarities between two countries in the way you approach the market. Our partners do play a major role in helping us understand the end users in different markets. This is why we have an Indian team here, who can take our global strategy and tune it to suit the market environment in India. Who are your key competitors? Barco is a leader worldwide. Naturally, there are some competitors. There are different verticals in the healthcare market. A competitor that globally comes back when it comes to the diagnostic market is the company EIZO and another company that I would say is NEC. We are also active in the surgical market where you might find again other competitors. Sony is one of the competitors in this area. Please elaborate on your R&D activities in India. The R&D in India is not specifically for healthcare. It is for other divisions as well. COLOR DOPPLER | MARCH, 2014
Barco always strives for the highest possible quality. This is in our DNA and that’s what we always want to do. People, here, in India might say that Barco indeed provides high quality, but is expensive. At one hand, an investment is what they want. What we actually strive for every single day is when people have those displays, when they have those solutions, they are provided with a warranty of five years As I mentioned earlier, we do have 550 people in India and not all of them are into sales. Majority of them are in R&D, manufacturing and quality control. As a matter of fact, a lot of effort is being put on R&D. If you look at our company profile, you can find that Barco is putting in a lot of its resources into R&D. Barco is really a pioneer among the technology companies. Round-the-clock we aim at delivering superior technologies. When I talk about healthcare, it is not just the technology, but we are also looking at the markets, the direction in which the market is moving towards and how we can assist the market in taking the next step. Naturally, R&D is very important when it comes to these. The whole world is after green technologies these days. How eco-friendly are Barco’s products? For Barco, if you look at our mission statement, you can understand how important green technologies are for Barco. We do comply with a lot of these directives such as Worldwide European directives, naturally. For example, if you look at our diagnostic displays, you can see that there is no mercury anymore. Going for LED technology means that you get rid of mercury. In our CCFL backlights, we have already decreased it substantially to the absolute minimum wherever possible.
With the LED technology, there is no mercury anymore. What are the latest introductions of Barco’s diagnostic displays in the market? We have introduced and we are still introducing one by one a whole lot of displays with LED backlight technology. I already talked about the factor that this is green technology. Not only that there is no mercury anymore, but also there is less power consumption if you compare with our displays, which were introduced some years ago. This is a significant difference. Next to that, we are introducing new designs. We are introducing new technology to make sure that the radiologists can see more, have diagnostic confidence and also that the productivity is being helped or is being supported. There have been some studies and some whitepapers have been produced on the same as well, which are indeed very important. With our fusion technology, our big screens with 32 inch has one big panel instead of a dual head and with the introduction of this technology, it has been proved that Barco does contribute significantly to the productivity of the radiologists, which is very important. Look at India, so many people and so many patients. Here is where the amount of productivity comes to the picture and our latest introductions in the market are exhibiting tremendous performance by contributing in delivering highest productivity. Over the sides, in the new introductions, technology wise we are also looking at lowering the cost of ownership for hospitals. Hence, our diagnostic displays are an investment for the hospital, which contributes to its productivity. It will also contribute significantly in lowering the cost of ownership for the hospitals. There are a set of people with a notion that the quality of the product is directly proportional to the cost of the product. They have this feeling that the quality of low-cost products will be low as well. What is your take on this? Barco always strives for the highest possible quality. This is in our DNA and that’s what we always want to do. People, here, in India might say that Barco indeed provides high quality, but is expensive. At one hand, an investment is what they
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[ wordsworth ] want. What we actually strive for every single day is when people have those displays, when they have those solutions; they are provided with a warranty of five years. But what is very important is the quality brought to the diagnostic workstation. At every single moment of the diagnostic process, the radiologist is using the same and it is the high quality diagnostic experience that is left behind until he/she ends its usage, which is five years guaranteed by us.
At any single moment, whether it’s the day one or whether it’s the fourth or the fifth year, the radiologist should have the diagnostic confidence. He/she should know and should have the peace of mind that what he sees or she sees is what they need to see. That’s very important and when we say that we are striving for an optimized cost of ownership, we don’t mean that at any moment we are going for lower quality, but will be delivering the highest possible quality. The moment you go for products of lowcost that contain low quality components, that is where you come across a low quality product and that is one thing that we do not want to do. What do you think about Barco’s future in the Indian market?
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It’s bright. A lot of evolutions are being going on in the diagnostic segment. For example, digitization is taking place in the field of radiology and our displays can really show you how diagnostic displays are contributing to the digitization in radiology. At the end of the day, the radiologist is using those displays at his/her desk to make the diagnosis. Hence, that is very important and we see that in India, right now there is a momentum in which digitization
We see the same going on in the surgical environments and the operating theatres, where we are introducing with our partners the stateof-the-art technology to stream video, audio, images and data in the operating theatre. So, it is not just about this place, it goes beyond that. This is also where we go beyond just the display of images; we go into the directions of IP solutions, of networking, of integration and workflow
is taking place. We see the same going on in the surgical environments and the operating theatres, where we are introducing with our partners the state-of-the-art technology to stream video, audio, images and data in the operating theatre. So, it is not just about this place, it goes beyond that. This is also where we go beyond just the display of images; we go into the directions of IP solutions, of networking, of integration and workflow. So, it’s our church pillar there. The third solution that we are introducing in the Indian market is our point-of-care solution - CareConnex with bedside terminals at one hand and it comes together with the software. With this, you can integrate with other existing solutions in the hospital and bring in media, entertainment at the bedside together with the access to the clinical data, which is actually the patient file. This can engage the patients within the hospital as well. At present Barco has displays, controllers, software and many other medical solutions. Are you planning to expand into any other segment of healthcare? Well, what Barco has done in the last two to three years is quite an expansion in terms of different markets that we have been approaching. Since 25 years, we are a pioneer with our diagnostic displays and our clinical review displays. What we did over the last two to three years is we really used our knowledge, our experience in order to bring solutions into the surgical environment with surgical displays. With the introduction of Nexxis technology, we were successful in integrating and streaming AV in the operating theatre over IP and over optic fiber and now, we are implementing this technology in different countries together with our partners. A lot of international companies are introducing Barco’s technology in the operating theatres and as we speak in India, the technology is already installed in many places as well. Next to that is the CareConnex solution, a point-of-care solution, hospital IT solution, which is being introduced at different places. So, as a healthcare solution provider, we are expanding. We are approaching different markets and different segments within the healthcare.
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Awakening!
Every advancement in women’s imaging — one of the most significant and popular medical specialties — leads to better and healthy living for every woman. Thanks to the latest developments in technology, women’s imaging has attained high standards of techniques, thus paving the way for more accurate and faster diagnosis
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[ under the scanner ]
The disorders are common to women of any age and thus, women’s imaging remains as one of the most significant and popular medical specialties of the time
Ria Lakshman V l cd news ersist with the most clichéd talk about the complexity of women and the medical world proves this right. Unlike men, the body of women goes through changes, with unexpected twists and turns that demand special kind of diagnostic and treatment methods for them. Women’s imaging fulfils this function of complexity by diagnosing and treating the conditions unique to women. The medical specialty uses all imaging modalities to assess obstetrical and gynaecological conditions, including infertility, pregnancy, breast abnormalities and genitourinary problems. Ultrasound plays the primary role for most of the applications and other modalities such as CT, MRI and nuclear medicine assist in the subsequent evaluations. The absence of ionizing radiation and nonessentiality of sedation for the procedures make it a desirable diagnostic modality for women. Women’s imaging begins even before puberty for women, especially for analysing congenital abnormalities of the uterus, vaginal bleeding, early puberty and certain pelvic disorders. The disorders are common to women of any age and thus, women’s imaging remains as one of the most significant and popular medical specialties of the time. Below assessed are few of the commonly met states in women and how imaging is used in the described medical conditions.
Obstetric Imaging
Pregnancy is a crucial time period, both
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physically and mentally for any woman. The preparedness of a body to deliver life passes through innumerable complications and the imaging helps in keeping track of the changes from time to time. Unlike the general notion, the imaging during pregnancy not always begins when a woman carries a foetus inside. It may begin with infertility as well. Fallopian tubes or uterine tubes are tested for patency as tubal obstruction is a major cause of infertility. The process is performed through hysterosalpingography (HSG), a radiological procedure by which the shape of the uterine cavity and the shape and patency of the fallopian tubes are investigated. In the process, a radio-opaque material is instilled into the cervical canal and fluoroscopy with image intensification is conducted. Fluoroscopy is an imaging technique that uses X-rays to attain realtime moving images of the internal structure of body through fluoroscope. MRI and ultrasounds are also used to assess the cavity, in order to spot problems such as large fibroids, congenital anomalies and scarring of the cavity that can affect pregnancy in later run. During pregnancy, the ultrasound scanning is conducted to check the pregnancy dating and issues such as vaginal bleeding or pain during the early stages of pregnancy. Information such as the location of pregnancy, number of embryos in the uterus, heartbeat and length of the embryo and presence of any uterine fibroids can be detected during early pregnancy scan. First Trimester screening (growth after 12 weeks), Fetal anatomy survey (growth being in 19 weeks) and fetal growth assessment during third term are the other imaging time period. The first trimester screening assesses the pregnancy for fetal chromosomal COLOR DOPPLER | MARCH, 2014
[ under the scanner ] Saline Infusion Sonography, which is also known as Sonohysterogram is a technique used to detect the suspected abnormalities of the uterus, to check the abnormalities seen in transvaginal scan, for analysing conditions like sub-fertility and recurrent miscarriage etc. In this technique, a small amount of fluid is injected into the uterus through a fine tube to outline the uterine cavity. However, pregnant women are excluded from performing this procedure. The diagnosis uses variety of imaging modalities together to determine the medical conditions. MRI or CT may be performed for further evaluation. To say, MRI may be performed to evaluate the myometrium and endometrial-myometrial junction. MRI can be also used to perform conditions like adenomyosis and CT may be used if a pelvic mass is identified and there is a concern for extensive disease.
problems. An early review of fetal structure, assessment of pelvic organs, multiple pregnancy, etc. can also be confirmed in this screening. Fetal anatomy survey confirms that the fetal is alive, measure its size, position, fluid volume etc. To check the pre-term birth, the cervical length is assessed using obstetric ultrasound. If the length of cervix decreases, there is a high risk of increase in preterm birth. This is usually conducted during 1424 weeks gestation and is performed compulsorily in women who have experienced preterm birth, cervical surgeries, multiple pregnancies etc. Fetal growth assessment is mainly to analyse the health and well-being of fetal. heartbeats, size, pattern, amniotic fluid, position of placenta, the proper blood flow through umbilical artery etc are assessed in this scanning.
Gynaecological Imaging Abnormal Uterine Bleeding Abnormal uterine bleeding can occur in women of any age due to complications in pregnancy, medication, systemic disease etc. Dysfunctional Uterine Bleeding (DUB) happens due to abnormalities in hypothalamic-pituitary-ovarian axis. Ultrasound is used for imaging in most of these cases. The imaging helps to identify
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the presence of fibroids and polyps that can cause bleeding, which sometimes extend into endometrial cavity. Based on the thickness and structure assessed, the cause of the bleeding can be easily determined. Performing pelvic ultrasound enables physicians to diagnose the causes of amenorrhea, the absence of menstrual period in a woman of reproductive age. Transabdominal scan is commonly performed to analyse pelvis, mainly the pelvic structures. It uses the full bladder as a window and provides a broad perspective of the organs in pelvis. However, in order to receive significantly detailed images, transvaginal scan is performed with an ultrasound probe covered with sterile probe cover. The imaging provides detailed view of uterus, endometrium and ovaries as the transducer probe is much closer to the organs being viewed. The three dimensional gynaecology ultrasound examination enables uterus to be sonographically ‘reconstructed’ to provide views that are unobtainable with 2D imaging or rather a clearer view. The 3D ultrasound imaging facilitates in evaluation of the presence of endometrial polyps, uterine fibroids etc. 3D ultrasound examination is typically performed at the same time as the 2D transvaginal scan occur using a probe that has both 2D and 3D capability.
Evaluation of Ovaries Imaging is inevitable in the physical examination of adnexa. Ultrasound is used to evaluate ovarian structures and followup ultrasounds in 2-3 menstrual cycles is commonly performed in necessary cases. MRI and CT may be further characterized to determine the extent of diseases. Breast Imaging Data says that every year 10.9 million women worldwide suffer from breast cancer and 6.7 million die from the disease. The unfortunate fact is that many of these deaths could have been prevented, if the disease is diagnosed at the right time. On the occasion of another women’s day, breast imaging is a serious issue to be considered. Several techniques are used to determine breast cancer and the below are few of them. Mammogram is used to find the early signs of breast cancer. They are used for screening in women who show no symptoms of cancer, as well as in women who show symptoms like lump or pain. In mammogram, the images of breast are captured on film or computer. In circumstances when the mammogram fails to show lumps in breasts, or the details of the abnormalities spotted, other imaging methods are considered. Ultrasound and breast MRI are often used in such cases as a follow up test. Ultrasound uses sound waves to make images of the breast. Ultrasound tells the dif-
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[ under the scanner ] tion or financial resources,” says Dr Bijal Jankharia, a breast imaging radiologist and co-owner with her husband, Dr Bhavin Jankharia, of SRL Jankharia Imaging in Mumbai. “Many women struggle to provide food, clothing and shelter, making breast cancer knowledge a low priority. It is also a financial drain since all tests and procedures must be paid out-of-pocket; there is no social safety net. By the time symptoms can no longer be ignored, it is often too late. Roughly half of all patients visit the doctor with palpable lumps of more than two centimetres”, she added. Screening constitutes less than 15 percent of the centre’s mammographic procedures, which substantiates the lack of self-initiative among the women in the country.
ference between the factors such as types of lumps, size, shape, texture and density. A breast MRI uses magnetic fields to create an image. The method can find cancers in dense breasts that are not seen on mammograms.
Other Imaging Techniques There are several other imaging techniques, which are not commonly used. Research studies use them mainly to collect information about a tumour found by other tests. Scintimammography This is performed in women who are found with abnormal mammograms. In this diagnostic test, a small amount of radioactive substance is injected to the woman’s body. A gamma camera is then used to check if the breast lumps have absorbed more of the radioactive material than rest of the normal tissues. Lymphatic Mapping This technique enables to detect the sentinel lymph nodes for cancer staging. PET Scan The Positron Emission Tomography (PET) machine is used to determine the pace at which the glucose level of the body has been used. If there is an abnormality in usage; to say, if the glucose in the body gets used up comparatively faster, a presence of cancer is may be located. Stereotactic Breast Imaging This is conducted to ascertain the accurate placement of breast biopsy instruments.
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Once the area of concern is located, a computer merges the pictures to make 3D image of the breast. This image ensures the right guidance of biopsy needle to the suspicious area.
Breast Cancer in India The Indian scenario of breast cancer stays terrifying. Reports say that the breast cancer cases in India is expected to surge double by 2020. Already the count of new cases is on rise, with an approximate of more than 1,00,000 new cases. This rate of increase is expected to reach 2,50,000 by the year 2020. The disease has overtaken cervical cancer in the past two decades as the leading cause of death among the women in India’s tier one cities. Another fearful fact is the shift in age seen among the patient. The average age of developing breast cancer has shifted from 50-70 years to 30-40s. Although there are no definite reasons highlighted for the cause of this increase, few of the common factors blamed are aging, smoking, lack of childbearing and westernized lifestyle. There is a serious lack of awareness among the women, and a lack of intuitiveness from the governments to support breast health education. Cost has also prevented women from taking diagnostic tests at the right time and thus, contribute to late detection of breast cancer leading to deaths. “The breast cancer awareness is trivialized among some women by their families, especially those with little educa-
Role of Medical Imaging Device Companies The medical imaging device manufacturers perform an admirable work in spreading awareness against the breast cancer. GE is one such company that conducted various awareness programs among in spreading the message last year. GE even commissioned a global study that said developing world faces a breast cancer surge. Philips ran a Husband Initiated Movement (HIM) against breast cancer that encouraged women to conduct selfexamination from time to time. Initiatives like awareness talks further facilitated the campaigns.Hologic, the leading women’s healthcare device company extended a step further by running a website www. promisetome.com.
Women’s Imaging Market in India The global medical imaging equipment market has grown at a healthy pace over the past few years. A study by MarketReportsOnline.com sees a rise in the government funding to improve healthcare facilities in emerging markets like India, China and Russia. Coupled with the increase in demand in the market, suppliers and manufacturers are creating midrange devices with affordable price points. With the growing obstetrics and gynaecological requirements in the country, especially with facts like increase in breast cancer, the market of women’s imaging seems blooming. The recent technological advancements in the field is another factor that would flourish the market further.
COLOR DOPPLER | MARCH, 2014
N O
S T O P P I N G Each year 10.9 million people worldwide suffer from breast cancer; 6.7 million die from it. Over 50% of Indian breast cancer patients present with large tumors, which markedly lowers survival
Every year
1.4 million
women get breast cancer
Every year
459,000 women die of breast cancer approximately
nd
st
2
1
It is the second most common cancer form overall and the most common for women
INCIDENCE NUMBER OF CASES
WORLD ASR*: 42.3
1,384,155 692,634 ASR: 71.7 691,521 ASR: 29.3
MORE DEVELOPED REGIONS LESS DEVELOPED REGIONS
MORTALITY NUMBER OF DEATHS
WORLD
458,503
ASR*: 13.9 MR:IR**: 0.33
189,455 ASR: 17.1 MR:IR: 0.24 269,048 ASR: 11.8 MR:IR: 0.40
MORE DEVELOPED REGIONS LESS DEVELOPED REGIONS
*Age standardised rate per 100,000 population, using the WHO World Standard Population ** Ratio of mortality rate to incidence rate
15 million years of ‘healthy life’ were lost worldwide in 2008 due to women dying early or being ill with the disease
WORLD 15,127,050 million years of ‘healthy life’* MORE DEVELOPED REGIONS
5,533,146
LESS DEVELOPED REGIONS
9,593,905
*DALY’s (Estimated disability-adjusted life years)
SOURCE: ‘Prevention and the economic burden of breast cancer’, a report commissioned by GE Healthcare, authored by Bengt Jönsson and Nils Wilking
COLOR DOPPLER | MARCH, 2014
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USCON XXIII Experience Ultrsound 31st Oct - 2nd Nov, 2014
DELHI CHAPTER
INTERNATIONAL FACULTY
Prof. Anil T. Ahuja Hong Kong
Dr. Hans Peter Weskott Germany
Prof. George Yeo Singapore
Prof. Jan Deprest Belgium
Prof. Lil Valentin Sweden
Dr. Ravi D. Kadasne UAE
Prof. Nirvikar Dahiya USA
Dr. Rakesh Sinha UK
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Ms Tanvi Sawhney C-56, First Floor, Opposite State Bank Of India Mayapuri Industrial Area, Phase II, New Delhi 110064 M: +91-9899675444
Friday, 31st October, 2014
Workshop Programme - Maulana Azad Medical College Gynecology
Dr. Manjula Virmani Dr. Sudheer Gokhale Dr. Anju Garg Dr. Varun Duggal
Obstetrics Workshop Programme at G.B. Pant Hospital Head & Neck Abdomen Musculo-Skeletal Extremity Arteries & Veins
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Dr. Anil Ahuja Dr. Rakesh Sinha Dr. Shalini Thapar Dr. Hans Weskott Dr. Nirvikar Dahiya Dr. Archana Agarwal Dr. Rajesh Gothi
COLOR DOPPLER | MARCH, 2014
Saturday, 1st November, 2014 Conference Programme - JW MARRIOTT Hall A Advances in Gynecologic Ultrasound
Role of imaging in the acquired causes for infertility Imaging of Mullerian duct anomalies Doppler evaluation infertile woman & Implantation Failure & recurrent missed abortions Polycystic Ovaries Ambiguous Genitalia Endometrium Endometriosis and Adenomyosis Imaging of Complex Ovarian Masses Abnormal Uterine Bleeding Gynecologic Sonography in the Breast Cancer Patient Ultrasound evaluation in Gynecologic Causes of Pelvic Pain Ovarian torsion Pelvic floor imaging Pregnancy in Unusual Location Imaging of the Postpartum/Post-termination Uterus Dynamic assessment of Cervix Diagnostic Breast Ultrasound and correlations to Mammogram, elastography and MRI
Dr. Jaideep Malhotra Dr. Manjula Virmani Dr. Sonal Panchal Dr. B.S.Ramamurthy Dr. Arun Kinare Dr. Varun Duggal Dr. Sudheer Gokhle Dr. Kuldeep Singh Dr. Narendra Bhag Dr. S Boopathy Dr. Ashok Khurana Dr. TLN Praveen Dr. Chander Lulla Dr. Ritika Bhandari Dr. Shabnam Grover
Hall B Head & Neck
Evaluation of the Orbit Salivary gland masses Cystic lesions in the neck Assessment of lymph nodes in the neck Recent advances in the assessment of Carotid A
Dr. Bhupendra Ahuja Dr. Anil Ahuja (Hong Kong) Dr. Anil Ahuja (Hong Kong) Dr. Anil Ahuja (Hong Kong) Dr . Arun Kinare
Musculo-Skeletal
US is adequate for evaluation of Rotator Cuff
For: Dr. Ashwin Lawande Against: Dr. Nafisa Batta Dr. Nirvikar Dahiya (USA) Dr. P K Srivastava Dr. P K Srivastava Dr. Nirvikar Dahiya (USA)
Wrist & Hand Knee Assess of Brachial Plexus & Peripheral nerves Swollen lower limb
Sunday, 2nd November, 2014 Obstetrics
Hall A
Scar Thickness: Myth and Reality Cord Around the Neck: An Obstetrician's Delight Fetal Growth Restriction: Current Concepts Non-invasive Prenatal Diagnosis: Will the NT Become Redundant Anomalies Scans: Protocols & Limitations The New Second Trimester Genetic Sonogram Early Diagnosis of Neural Tube Defects. The Fetal Heart: Genetics, Anatomy and Autopsy. Newer Criteria for Viability in Early Pregnancy. The Placenta: How Innocuous are Conventional Parameters. How Safe is Fetal Ultrasound? Pregnancy in Unusual Location Dynamic assessment of Cervix Extensive Case Based Panel Discussions
Heapto-GIT
Quantification of Hepatic fibrosis with ARFI Characterization of hepatic nodules with CEUS Pre & post transplant assessment of Liver Evaluation of GIT in infants Bowel Inflammation & Ischemia Endoscopic Ultrasound in GIT Evaluation of mesentery & retro-peritoneum Portal HT & TIPS evaluation
Uro-Genital
Evaluation of renal infections with CEUS US is adequate for suspected Ureteric Colic? Pediatric UTI Imaging in Prostate Cancer & Male Infertility Cystic lesions in the Scrotum
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Hall B Dr. Mukund Joshi Dr. Hans Weskott (Germany) Dr. Deepak Chawla Dr. K S Sodhi Dr. Rakesh Sinha (UK) Dr. Rajesh Puri Dr. Asif Momin Dr. Nirvikar Dahiya (USA) Dr. Hans Weskott (Germany) For : Dr. Ravi Kadasne ( UAE) Against : Dr. R Sachdev Dr. Alka Karnik Dr. Nitin Ghonge Dr. THS Bedi
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[ under the scanner ]
Expert Opinion
‘Popularising Routine Screening Mammography a Major Concern’ An increase in routine screening mammography will significantly decrease the mortality related to breast cancer, says Dr Rupa Renganathan, Consultant Radiologist, Department of Diagnostic and Intervention Radiology, Kovai Medical Center and Hospital
I
Purnima Sah l CD News n a country where women still hesitate to open up about their illness, there are women who want to empower the rest with the power of knowledge and awareness. On this Women’s Day we have with us Dr Rupa Renganathan who was always keen to learn and research more about women imaging. Her special interest in women’s imaging and great passion for breast imaging drove her to choose the profession. A consultant radiologist at the Department of Diagnostic and Interventional Radiology at Kovai Medical Center and Hospital since 2007, she has also completed a visiting fellowship in Breast Imaging at the Moore’s Cancer Center, University of San Diego, United States. Dr Rupa is also actively involved in spreading ‘Breast Cancer Awareness’ and the importance of ‘Screening Mammography’ through several programmes. Excerpts from an interview: A lot of effort is being taken by both OEMs and clinicians today to support women’s imaging. What do you think are the incentives for this initiative? The incentives are of two kinds — short term and long term. The main short term incentive is better imaging, which will directly result in better treatment and the end result would be better healthcare for women. For example, an early cancer of the breast can be localised accurately with digital mammography aided localisation, following which the lesion alone can be completely removed preserving the breast. Appropriate staging of malignancy of female pelvis through imaging helps in
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Dr Rupa Renganathan
correct treatment planning. Initiatives like routine screening mammography and regular Pap smear can have an impact on the society by decreasing mortality related to breast and cervical cancers and also by decreasing the healthcare cost involved in treating these patients. Detecting breast/cervical cancer early can significantly decrease the cost of the treatment and also can completely cure the disease. What is the potential impact of women’s imaging in healthcare today? The impact could be revolutionary. In the West, things are different and even celebrities like Angelina Jolie are opting for prophylactic mastectomy when they know that their life is at risk. We are still struggling to popularise routine screening mammography. An increase in routine screening mammography will significantly decrease the mortality related to breast cancer. Early detection of cervical cancer or ovarian cancer through the right imaging modality can significantly decrease the morbidity due to these deadly diseases.
When it comes to diseases such as cancer, heart diseases or stroke, women are likely to seek medical attention and often present late in the course of disease. This will result in delay in definitive treatment. What can be done to change this situation? We need to create awareness among women on one side and fight for women’s rights on the other. Both are equally important. Majority of them present late either due to lack of awareness or proper guidance. I do accept that even today women are considered as the inferior sex and their health needs are neglected as compared to men. But this scenario is seen only in rural India. Urban women are empowered and also independent. Apart from this, Indian women are still introverts more so when it comes to breast diseases and disorders of the genital system. They generally have an inhibition to go for a consultation until it becomes advanced and unbearably symptomatic. What measures can be taken in order to spread awareness about the importance of preventive diagnostic testing in the early detection of potential diseases? Government should bring about changes in health policies and make special programmes similar to ‘Pulse Polio’ for screening mammograms and PAP smear to detect breast cancer and cervical cancer respectively, which are the two leading cancers in women. NGOs and voluntary organisations also should come forward and join hands with the government to spread the message among the public. We have seen the success of public-private partnerships in health care with ‘Pulse Polio’ as the standing example. I don’t see any reason why it cannot work for early detection of female malignancies through effective screening.
COLOR DOPPLER | MARCH, 2014
Expert Opinion
[ under the scanner ] Women’s imaging, as a subspecialty, is witnessing a growth in India. How do you see its future in India and how is it going to set a mark in the healthcare practice in India? To be frank, women’s imaging in this country is still in its primitive stages. The awareness among women in our society is minimal and we need to go a long way. Women’s imaging as a specialty too is not popular even among the medical fraternity. However, the need for specialists trained in women’s imaging is enormous. It’s time to have some streamlined training programme for women’s imaging in our country in order to bridge the gap between the need and the availability. What are the recent advancements in women’s imaging that will revolutionize the women’s healthcare in India? We have advancements in all modalities such as USG, CT and MRI. There are painless non-surgical treatment options for fibroids like MR guided HIFU (High intensity focused ultrasound) and key hole interventional procedures such as Uterine artery embolization techniques. Whole body PET/CT and PET/MRI imaging is available for accurate staging of cancers and for post treatment followups. Advanced imaging techniques like Digital Breast Tomosynthesis (DBT)
and MR mammography for detection of early breast cancer and also image guided biopsy techniques are cutting-edge technologies that would change the way we manage breast cancer today. VacuumAssisted breast biopsy techniques are getting popular. What is the latest research that you feel is important to share when it comes to women’s imaging, but may not be so well publicized? The actual rising incidence of malignancies in women especially breast cancer. The changing trends in the age incidence of malignancies in women. The advancements in both women’s imaging and treatment should be known to everyone that complete cure is possible even in women with cancer. People should be aware that cancer is no more a deadly disease when detected early and appropriately treated. What are the untapped areas in women’s imaging that you feel are to be more focused on? There is a huge mismatch between the need for women’s imaging and the available resources. Just making it available at the primary health care level alone is not a foolproof to get 100 percent complaince. We know the mentality of our people and
we need to penetrate into the community. We need to think in terms of getting ‘mobile mammography units’ which would help us to reach out to the community in a better way. Please elaborate on your ongoing researches on women’s imaging. We at Kovai Medical Center and Hospital along with Rotary Coimbatore, are conducting an epidemiological study to know the incidence of breast cancer and cervical cancer in a specific locality. There is also an ongoing study to know the usefulness of MR mammography in women detected with breast cancer in treatment decision making and to know the incidence of cancer in the opposite breast. Your message for the coming Women’s Day. Women in our country are the strongest links in a family unit. She is the homemaker taking care of the whole family and in the bargain may times forgets to take care of herself. In today’s world, majority of women are forced to work to decrease the financial burden of the family and also expected to take care of the family. Obviously, woman’s health is of utmost importance and we need to take care of it to sustain the family. To be precise- ‘Healthy Women, Happy Families!’
Statement about Ownership and other particulars about Color Doppler Form IV (See Rule 8) 1. Place of publication: 34/1347-A, Florican Road, Malaparamba, Calicut - 673009, Kerala 2. Periodicity of its publication: Monthly 3. Printer’s Name: Niranjan Kumar K.R.M Nationality: Indian Address: 3/1614C, Sridevi Niranjan, Near 6th Rly Gate, Nadakkave Post, Calicut-673001, Kerala 4. Publisher’s Name: Niranjan Kumar K.R.M Nationality: Indian Address: 34/1347-A, Florican Road, Malaparamba, Calicut
- 673009, Kerala 5. Editor’s Name: Joby Joseph Nationality: Indian Address: Mullathanathu (H), Mundakuty (PO), Mananthavady, Wayanad-670645, Kerala 6. Names and addresses of individuals who own the newspaper and partners or shareholders holding More than one per cent of the total capital: Niranjan Kumar K.R.M, 3/1614C, Sridevi Niranjan, Near 6th Rly Gate, Nadakkave Post, Calicut-673001, Kerala
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COLOR DOPPLER | MARCH, 2014
Publisher
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Expert Opinion
[ under the scanner ]
‘Negligence is Root Cause of Cancer in India’ On the occasion of another Women’s Day, Dr Sandeep Chatrath, CEO, Dharamshila Hospital and Research Centre provides insight into various aspects of women’s imaging
F
inally there were those who saw the existence of a problem. They found there is no right solution. Instead of grappling with the problem, they decided to act. They discovered that their actions can spread the wings of compassion to millions around and thus, devoted their lives to it. The mysterious ‘they’ described here are a group of relatives and friends of cancer patients, who felt it is their ‘Dharma’ to provide complete cancer treatment under one roof, a facility that was not available when their dear ones suffered with the dreadful disease. They laid the ‘Shila’ of their duty by registering Dharamshila Cancer Foundation and Research Centre (DCFRC), a non-government voluntary organization. Very soon, Dharamshila Hospital grew up to one of the primary cancer centers in the country that provides a complete accessible and affordable cancer treatment. Located in New Delhi, Dharamshila offers high quality treatment, with complete patient safety and satisfaction. Beyond the medical needs, Dharamshila fulfils the physical, emotional and financial needs of the patient. Rather than a hospital, Dharamshila is a mission lead together by a group of people through a path which they have chosen to travel because of the flames burning beneath their hearts. Dr Sandeep Chatrath is currently the man who heads this mission. With 18 years of experience in healthcare industry, medical care and hospital administration, Dr Sandeep has the right solutions to head the mission in the proper channel. He began his career at Sri Ganga Ram Hospital during 1995 as a Deputy Medical Superin-
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Dr Sandeep Chatrath
tendent. He shifted to Fortis Healthcare in August 2005 and headed medical services and quality as a Medical Administrator. Dr Sandeep moved to Wockhardt Hospitals in 2008 and took care of the regional business development for the hospitals in the western region. Subsequently, he grew up as the Chief Operating Officer of Wockhardt Hospitals, Nashik. During 2010, he became the Chief Operating Officer of Rukmani Birla Hospital and Research Institute. He also worked with Metro Hospitals and Heart Institutes as Group Chief Operating Officer before shifting to Dharamshila Hospital and Research Centre. On the occasion of Women’s Day, Dr Sandeep Chatrath sheds light into women’s imaging, his new role as Chief Executive Officer, Dharamshila’s strategies to expand into new horizons and more. What are the efforts taken by the clinicians and the OEMs (Original Equipment Manufacturers) to take women imaging to a better level of treatment and cure? Improving efficiencies in women’s imaging is reducing the risk of breast and ovarian cancer in women. These are greatly enhanced with an automation system that incorporates newer technologies by the time. Consumers of clinical diagnostic
OEMs demand superior performance in their automated lab testing systems. Clinical diagnostic can provide improved system ease of use, intelligence and error proofing to set the systems apart from the competition. It may also reduce the complexity of system design since Advantage products can perform both product inspection as well as code reading with one product. What are the roles of modern advancements in the field of women imaging? Advanced women’s imaging is taking center stage as providers are now looking at the performance of supporting technologies to ensure accurate diagnosis. This report also dives into the biggest obstacles faced by women’s imaging as told by the providers. Reimbursement, patient education, and state notification bills about breast density are some factors that healthcare providers are watching closely as they look to the future of women’s imaging. There is a lot of energy around women’s imaging and how different technologies are coming together to improve the delivery of care. What are the major causes of cancer among the women of 21st century? Negligence is the root cause of cancer in India. When we find cancer cases in metro cities, most of the cases are happening due to late marriage, pollution and junk food in women. Rural women suffer due to late diagnosis, lack of awareness and unhealthy lifestyle. So prevention is better than cure. Every year go for routine health check-up, ultrasonography and Pap smear. What are the different procedures to diagnose a patient suffering from cancer? Please elaborate on the modern techniques to cure cancer. There is a wide array of methods to diagnose cancer. As researchers learn more about the mechanisms of cancer, new diagnostic tools are constantly being COLOR DOPPLER | MARCH, 2014
Expert Opinion
[ under the scanner ] developed and existing methods are being refined. If your primary care physician suspects cancer, he or she may order some tests to confirm the diagnosis. These are some important test for cancer detection: Biopsies are depending on tumour location, some biopsies can be done on an outpatient basis with only local anaesthesia. Endoscopy is flexible plastic tube with a tiny camera on the end which is inserted into body cavities and organs, allowing the physician to view the suspicious area. There are many types of scopes, each designed to view particular areas of the body. For instance, a colonoscope is used to detect growths inside the colon, and a laparoscope is used to examine the abdominal cavity. X-rays are the most common way doctors make pictures of the inside of the body. Specialists can spot abnormal areas that may indicate the presence of cancer. CAT scan (computerized axial tomography), uses radiographic beams to create detailed computerized pictures taken with a specialized X-ray machine. It is more precise than a standard X-ray and provides a clearer image. Magnetic Resonance Imaging (MRI) uses a powerful magnetic field to create detailed computer images of the body’s soft tissue, large blood vessels and major organs. MRI is an accurate process, and patients must lie completely still during the procedure for best results. Ultrasound uses high-frequency sound waves to determine if a suspicious lump is solid or fluid. These sound waves are transmitted into the body and converted into a computerized image.
scan is an imaging test that uses a radioactive substance called a tracer to look for disease in the body. A positron emission tomography (PET) scan is an imaging test that uses a radioactive substance called a tracer to look for disease in the body. Medical imaging strongly depends on technology, its progress and further developments.
Reimbursement, patient education, and state notification bills about breast density are some factors that healthcare providers are watching closely as they look into the future of women’s imaging. Now, there is a lot of energy around women’s imaging A PET scan uses a small amount of radioactive material (tracer). The tracer is given through a vein (IV), most often on the inside of your elbow. The tracer travels through your blood and collects in organs and tissues. This helps the radiologist see certain areas of concern more clearly. The Pap smear is a screening test for cervical cancer. Cells scraped from the opening of the cervix are examined under a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Ultrasonography is an ultrasound-based diagnostic imaging technique used for visualizing subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions. The practice of examining pregnant women using ultrasound is called obstetric sonography, and is widely used. Which are the yet-to-be-focused areas in the cancer imaging that needs to be paid better attention? A positron emission tomography (PET)
According to you, which imaging technologies are playing a key role in cancer imaging? Positron emission tomography (PET) is a medical imaging procedure that can provide information about how an organ or system in the body is working. PET scans can detect cancer in its early stages, help to monitor cancer treatment and check if the cancer is coming back. PET scans are also used to diagnose and assess conditions of the brain and heart. While PET is most commonly used in the fields of neurology, oncology and cardiology, applications in other fields are currently being studied. So, it has been a major breakthrough in imaging cancer. What is your message for our readers on the occasion of Women’s Day observance? Prevention involves various approaches, and one aspect of this many-pronged effort, led by multiple agencies, is conveying clear messages to the public to improve general knowledge about cancer. World Health Organisations (WHO), government and other major health organisations to unite the world and devise strategies in the fight against the cancer and also disseminate the facts about the epidemic disease, treatments and preventive measures among public.
Connecting Connecting users with manufacturers, sellers, service providers and more, Color Doppler launches India’s first medical imaging device consultancy service. Our well-trained, professional customer care team assists you with all your medical imaging device needs. When in doubt, dial+91 495 2378808/09
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[ under the scanner ]
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Expert Opinion
[ under the scanner ] User Feedback
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and speed. Another was our personal rapport with Agfa HealthCare’s specialists over the last 12 years.” MUSICA2 software comes with the DX-M for consistently high image quality and enhanced detail. The dedicated NX workstation and DRYSTAR AXYS imager for hardcopies rounds out the total solution. The workstation and imager are located in the procedure room with the DX-M. Dr Jankharia also has an Agfa HealthCare SE Suite client/ server viewing station in her office for manipulating and managing breast images. “The fine contrast and high resolution from MUSICA2 sealed our decision,” she said. “And the NIP plates provide excellent detail that I’m very pleased with. The DX-M’s 50-micron resolution makes detecting subtle masses and microcalcifications easy.” Once the total solution was installed and running, two interesting benefits resulted: a rise in patient throughput and staff productivity. She credits the operational speed of the DX-M’s five-cassette drop-and-go buffer and the pace at which images are displayed for preview; typically a matter of seconds. “Everything happens fast. There’s less waiting time for patients, which makes them happy because they can go home quicker. The number of patients we can handle has already increased by 25 percent, and we hope that the graph will keep rising.”
quality while offering the potential for significant dose reduction. Eliminates waiting times and allows for a continuous workflow With a five cassette input and five cassette output drop-and-go buffer, DX-M eliminates waiting time and allows continuous workflow, while automatic cassette handling and the ability to switch easily between studies makes it highly productive and user friendly. The fast preview facility on the examination window of the NX workstation starts shortly after a cassette is dropped into the buffer and allows correct positioning and exposure to be determined even while the final image is in the process of being completed.
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The benefits Delivers Mammography quality images ■ Supports General Radiology, including Full Leg Full Spine, extremities, neonatal and pediatric applications
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■ Superb image quality and potential for dose reduction ■ High throughput and fast preview of images ■ Small footprint ideal for space restricted environments ■ Optimal workflow for Full Leg Full Spine ■ DICOM connectivity and integration
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Bigger Challenges Ahead One of the biggest challenges being faced by the country is the shortage of emergency physicians. We have just 40 or 50 emergency medicine graduates every year, which is too less, says Prof T S Ravikumar, the Director and CEO, JIPMER
B Purnima Sah l CD News
ringing experts under one umbrella to set up a strong base of Emergency and Trauma Care in Indian hospitals was a dream of yesterday. The man, who left his handsome well paid jobs in the United States, came back to his country with one aspiration. His sole target was to build the base of proper healthcare service in the field of Emergency and Trauma Care. Some people are born to make a difference in the ineffectual system of society and Dr Thanjavur Ravikumar is no doubt among one of them. During the conference week at the JIPMER auditorium, he shares the story behind the successful summit and his plans for future with Color Doppler. Excerpts from an interview: The Director General of Health Services, Ministry of Health and Family Welfare, Shri Jagdish Prasad designated JIPMER as the apex trauma care centre for South India. What are the programs organized by JIPMER in order to enhance the emergency care?
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First thing we did in order to empower the emergency services is that we created a formal department last year. As announced by Shri Jagdish, the Director General of Health Services, Ministry of Health and Family Welfare at the inaugural ceremony of ISEMT 2014, JIPMER is going to introduce a MD course in Emergency Medicine with six candidates from this April. The biggest challenge is how to meet the requirements of emergency physicians in our country. We have just 40 or 50 emergency medicine graduates every year, which is too less. So, this alone will not serve the man power. To expand this plan, the Director General of Health Services also said that they are going to ask significant number of medical colleges to run this program. Our agenda is creating emergency departments, empowering the head of the department, recruit more faculty who are very few in numbers. JIPMER has got three full time core faculties in emergency department with one substitute faculty to train and teach six candidates. This is an ongoing process and will continue to recruit emergency physicians through capacity building programs. In addition to that, we have already started training Emergency Medical Technicians (EMT). We want to expand that EMT training program for pre-hospital
care in integration of emergency care. JIPMER will also be introducing an MD course in Emergency Medicine, with six candidates being admitted this year. Third, we are not only using doctorcentric technicians, but also emergency technician. To build this program, we are getting all other types of allied health workers, nurses to start with. We have already empowered nurses to improve their workflow process. We want to start short and long term courses in Post-Baccalaureate Nursing program and also postgraduate MSc programs in nursing. Lastly, we want to be the training sight for allied health workers. We already have one national training centre and we are going to add a curriculum for allied health workers that will make them start thinking right from the ground level like the social health associates. Our campaign is to improve the capacity building and to enhance the capabilities of the individual people, and building this with the community level teams. This process will serve the emergency care and that is why we want to call this as ‘Golden Hour’. This conference is a very important catalyst. As you have seen, this summit has set a mark of international learning at one platform. The logo of ISEMT 2014 symbolises the global mission to expand
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emergency and trauma care. Please shed some light on your plans on the Advanced Trauma Life Support (ATLS) training program. ATLS started a very long time ago. It is a very well-structured training program. ATLS gives an insight on how to perform the overall function in a structured way. It standardizes trauma life support, teaching what to give first, what and which test to order, and when to order. Advanced Trauma Life Support is a three-day course, which is designed not only for teaching, but also to build instructors for this.We have conducted one of the first of its kind for JIPMER and also the fewer in the country. We organize small batches of 15 or 16 at a time to run this course. The candidates are taken through lectures, theory sessions and practical training programs. They rotate through several stations and they practice on mannequins. Three days ago, we started the course and we graduated 16 of them yesterday. We wish to run this program on a monthly basis. Even though you are not any emergency physician or trauma surgeon, this ATLS course is for all providers of trauma care which gives you insight of how to save a life in the first hour. What are the striking developments that have set a mark in the field of Emergency Medicine? Since the early days of your career to till date what are the changes have you seen? When I started my career more than 30 years ago, we were just in the beginning phase to think about ATLS. We had a trauma program but we did not have any full-fledged trauma systems. The systems which has developed now is a big difference in the field of emergency and trauma care. The content keeps changing in terms of how to deal with onsite and how to build a well establish 24/7 ambulance services with the EMTs. When I started my career, for example, there was no usage of ultrasound in the operation theatres. It was just used by radiologists. How we developed
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When I started my career more than 30 years ago, we were just in the beginning phase to think about ATLS. We had a trauma program but we did not have any fullfledged trauma systems. The systems which has developed now makes a big difference in the field of emergency and trauma care the usage of ultrasound in emergency and trauma care, was never there. In the 80s, I was very keen to know the usage of ultrasound in the operating room. I remember using it in the operating room and calling it ‘surgeon’s stethoscope’. That term is very popularize now and is used by almost every one working in the OT. Ultrasonography really helped in the OTs. I remember when I used it for a liver surgery, it was working as my guide, avoiding all the sharp bleeding procedures in the patient’s body. Ultrasound became a bedside tool and now it is very popular in trauma and emergencies. It became one of the instructors in the mid 90s. In the American College of Surgeons, when we started running ultrasound courses, I was one of the early instructors of ultrasound for surgeons. The first Focused Abdominal Sonography for Trauma was coined to describe a standard set of ultrasound examinations. It was a big achievement. Slowly, other imaging services also entered into our lives for better care like CAT scan and MRI. I also believe that a lot of things were learnt in emergency and trauma from the World War I, World War II, Korean War, Vietnam War, Iraq War and many more. I shouldn’t say that these wars are our fortune because wars are never good for anyone. But, among all these worst situations, we learnt a lot in terms of emer-
gency and trauma care and now, we have fine-tuned the system. Emergency Medicine is still in its developing stage in most of the countries or we can rather say, it is on its way in almost every country. So, how is it going to transform the healthcare sector in a highly populated country like India? In my opinion, we are already 20 to 30 years behind. In the US, the concept of emergency and trauma care stirred up in 70s and 80s. The previous paradigm was that the casualty doctors were considered to be like general medical officers. When a patient comes in, they have to call the specialists for everything as they are not trained enough to provide a holistic treatment to an injured person. That model still exists. It is high time, we change that practice. In western countries, the emergency physicians are well trained; they check the patient as a complete person and take care of the patient to perform the initial checkup whether its trauma, poisoning, heart attack, kidney stone or any other fatal cases. Emergency physicians should be able to triage the patient, able to diagnose the condition under broad categories, do the appropriate tests at correct time, call for the specialist as needed and then, enhance the level of care if the targets are not met. Do you think that India’s every hospital will have an emergency department in the next five years from now? I cannot comment on that. It will be a good thing if every multi-specialty hospital has an emergency department. But for individual hospital, for example, if it is a diabetic centre, we may not need an emergency room. But every general hospitals or multi-specialty hospital must have an emergency department. There are many hospitals that are still not aware of what an emergency department is, they consider it as casualty. Do you think the necessity of proper awareness program on Emergency and Trauma Care is really needed here? They can call that as casualty, but they should understand the modern concepts
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of treating the emergency case or treating the injured patient. Government is also making an effort to give levels of 1, 2, 3, 4 tiers of trauma and emergency centers. So, level 1 will be like a tertiary level centre, level 4 is the ground plan and is already at the community level, ambulance plus primary care centre. So, what we are looking for is even though a primary care centre does not have an emergency room, physicians should be given proper education about emergency medicine, how they deal with an emergency case, give them a little compendium or give them a reference. The 11th plan of the government has come to a conclusion, now it is the 12th plan. Please throw us some light on the healthcare allocations in the 12th plan, which you have mentioned during the inauguration ceremony. In the 12th plan, I have mentioned about our own institute Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). It is already planned with the planning commission to make JIPMER as the apex trauma care disaster management centre for South India. We can’t cover whole India, but at least we want to be an apex centre. They may equate more apex centres in future, but right now there is no apex centre available in South India. Hence, we have placed one. We have recently started a bureau of intensive care units with six beds. We have enhanced a number of operating rooms in the emergency department. So, we now have two operating theatres functioning, but in future we are planning to increase it to six. In addition, we have one more area, which we call the ‘cathlab’ for cardiac. When cardiac emergency cases come in, we do the treatment right in the emergency department rather than sending it to the cardiology. Also, we have just started a burn treatment centre. We are also expanding our triage system. ‘Golden Jubilee’ is a few months away. What are your plans for the same? This is one major area for the emergency and trauma care. We are trying to develop
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We are working with the ministry to improve the quality of care in the public sector hospitals in India. We are also coming up with a manual on patient safety. We are going to have our Golden Jubilee day on the occasion of our foundation day, July 13, 2014
committed to do it on a long term basis. Hopefully, we are going to continue ISEMT from 2014 to 2015. This will support our emergency departments for training our new candidates. These organizations will be sending their faculty to teach our postgraduate students. This will be our faculty building program. We will have program development as well. They will also provide us with the technical expertise for programs that you would want to develop, which can assist your research in emergency and trauma care.
excellent emergency and trauma care system. We want to go with institutes for allied health professionals. We want to expand the program of JIPMER quality council. We are working with the ministry to improve the quality of care in the public sector hospitals in India. We are also coming up with a manual on patient safety. We are going to have our Golden Jubilee day on the occasion of our foundation day, which is on July 13, 2014. We are expecting the presence of His Excellency, the President of India and that will be the major highlight of the Golden Jubilee celebration. Our Golden Hour celebrations will involve a lot more of institutes in the emergency area, all the institutes across Pondicherry, all the people from ministry, from central government and other major leaders of different institutions such as vice-chancellors. Our alumni will also be supporting us in this endeavour. We want to bring our entire alumni working for different organizations. As a part of our Golden Jubilee, we are also raising a fund of 50 crores for 50 years. We are also raising foundation funds in order to initiate education research and community programs.
We, together, would like to continue organizing similar conferences. May be a conference or two in a year. Conferences of these kinds can create a strong impact on a lot of physicians across the country. Another important point is that these conferences can mould many faculty members who can impart education on emergency preparedness and also for developing emergency systems in India through JIPMER.
AAEMI, JAANA and GAEM have been supporting you in order to leverage the emergency medicine in India. How long is it going to take to achieve your goal? This is an ongoing process. We all are
What are your future plans with AAEMI?
How did the idea for a conference such as ISEMT sprout up? The idea did come to my mind when I went to US in the end of July 2013. I wanted to meet our alumni association in Boston. Before meeting them, I met Dr Kumar Alagappan, Dr Anita Bhavnani and Dr Pankaj Arora. Prior to this visit to US, Dr Anita and Dr Pankaj Arora have come to visit JIPMER; so did Dr Kumar Alagappan, and we have planned to meet in the New York City. We did come up with a variety of names and it was not just a single person’s idea. ISEMT was the result of an idea developed together by all the three organizations, JIPMER, AAEMI and GAEM. We then added JAANA as a partner. ISEMT was chosen because it had to resonate with many things such as the international standard, the summit and we wanted to include emergency and trauma. We are planning to take it forward, for which we have started the arrangements for ISEMT 2015.
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What are the challenges faced by you in order to bring all your partners on one platform to collaborate with JIPMER? There were no such challenges. We have overcome the huge distance between countries and did collaborate from Australia to US and then to India, and successfully brought in everyone on one platform. So, it was nice and good experience and all these were made possible with the coming together of a set of likeminded people. So, I don’t see this as a barrier. Funding travel was not something we could afford. But, I thank them for being generous to fund their own international travel. We did manage to fund the travel expense within India. The most important thing to quote is the time they spent with us to make ISEMT 2014 a reality. What are the programs initiated by JIPMER so as to spread the awareness on the importance for a strong emergency medicine practice in the country? We have already been in the news so many times since last year for our effective campaign on the need of emergency medicine. Our students organized a marathon rally in last September and the event was called ‘Spandan’. More than 10,000 school students participated in the marathon.
It is already planned with the planning commission to make JIPMER as the apex trauma care disaster management centre for South India. They may create more apex centres in future, but right now there is no apex centre available in South India
out is that we were successful in bringing 10 different courses such as ATLS, TALS, leadership development, nursing and so on under one roof. Second is that we could bring in all our stakeholders including doctors, nurses, emergency technicians, allied health professionals, policy makers, director general of health services and health secretary of Pondicherry, along with the experts from around the world. We were also successful in bringing in stakeholders from the field of disaster preparedness such as the police departments, the first responders, etc. together and this makes ISEMT 2014 a unique one.
Students of the age group 8 to college students participated in the program. The program was mainly initiated to improve road safety. We have also organized a rally on the beach so as to raise the awareness. Every time we organize similar events, which have a public relevance, we invite the media to cover them. We would like to come up with more initiatives in this area and as a part of this, we have started providing small courses as well.
What are your expectations from this conference? The first expectation of mine is to continue spreading the knowledge we gained from here and putting it into practice, thereby developing emergency and trauma systems in many regions with JIPMER being the catalyst for these initiatives. We cannot do it alone. We definitely need JIPMER to facilitate those regions where there is a need to develop a trauma or an emergency system. So, that’s what I am trying to come out with and also to continue the collaboration with our partners and elevate this conference to more than just a conference.
How is ISEMT 2014 going to set a mark in the field of Emergency Medicine in India? The first thing that I would like to point
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[ eventful ]
Forward Thinking!
D Purnima Sah l CD News
edicated to the mission of providing the best patient care to millions across, Dr T S Ravikumar, the director and CEO of JIPMER had a vision; a vision that initiated the saga of ISEMT 2014. To say in his own words, “At JIPMER, our goal is Excellence in Patient Care and as a part of JIPMER’s Golden Jubilee celebrations we want to focus on that care of the Emergency and Trauma patient.” Sitting in a cafe in New York City last year, Dr Ravikumar, Dr Anita Bhavnani, president of GAEM and Dr Kumar Alagappan, Past President of the American Academy of EM in India gave that vision a name: The International Summit of Emergency Medicine and Trauma 2014 and on February 12 of this year, the festivities began. The pre-conference workshops were led by leading experts in their super specialties: Dr David Bradt for Disaster, Dr Justin Bowra for Ultrasound, Dr Pankaj Arora for The Difficult Airway, Dr Mahadevan for the Prehospital Setting and Dr Arun Nandi for Work Flow, just to mention a few. Faculty to student ratios, which were as low as 2:1, made for a highly interactive and personalized exchange. Plenary Sessions with world renowned speakers such as, Dr Mark Fitzgerald and Dr S V Mahadevan were inspirational discussing the impact of Trauma Registries and Cutting-Edge Advances in Emergency and Trauma Care. The theme of the conference was ‘The Golden Hour’. The Golden Hour refers to the time following a traumatic injury during which appropriate medical care could mean the difference between life and death. Going beyond trauma, the summit also focused on emergencies of all
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A vision of Dr T S Ravikumar, the director and CEO of JIPMER when combined with the mission of the Global Academy of Emergency Medicine, ISEMT 2014 harnessed the global interest to promote academic Emergency Medicine in India
The biggest challenge for us is the increasing number of patients. We must keep up the number of physicians.
Dr Gerard O’Reilly Emergency Physician and Head of International Operations, Emergency and Trauma Centre, Alfred Hospital, Melbourne specialties including Paediatrics, Cardiology, Neurology, Pulmonology, Toxicology, Gastroenterology, Ophthalmology, Oncology, Obstetrics and Gynaecology. The conference was a grand success
with 110 faculty and 1057 delegates. Dr Pankaj Arora, the International Organizing Secretary said, “I don’t want to go to India and just put on a conference and leave. I want the conference to be the platform from which we can launch progress.” He gave a promising speech at the conclusion of the conference titled, ‘International Collaboration, The Way Forward’ and true to his word; several announcements were made about the progress made at the conference. An MoU was signed between the Global Academy of Emergency Medicine and JIPMER to support JIPMER MD Residency programs for the next three-year with international faculty from GAEM. The Global Academy Faculty Development Program was launched by Dr Pankaj Arora where Dr Ravikumar was awarded with the first Honorary Faculty Scholar of GAEM from India. A Research Mentorship Program to guide Emergency Medicine Residents across India in effective research was also launched by GAEM with its first office in Sydney.
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[ eventful ] We need to make sure that the community-based paramedics learn the basics of life saving.
Dr Lekshmi Vaidyanathan Dr Anita Bhavnani, Dr Pankaj Arora, Dr Kumar Alagappan, Dr S V Mahadevan, Dr L S Amernath and Dr Latha Ganti were awarded with the title of Visiting Professors of Emergency Medicine at JIPMER. Director General of Health Services, Ministry of Health and Family Welfare, Jagdish Prasad designated JIPMER as the apex trauma center for South India. He lauded JIPMER for starting a residency program and declared, “Emergency Medical courses will be started in six medical institutions in the current year. There is a plan to establish burn treatment centers in 90 Government Medical Colleges across the country with Rs 900 crore under a five-year plan.” The Director of the All India Institute of Medical Sciences, Dr M C Mishra stressed on the need for understanding Trauma in India. ISEMT 2014 secured its space as one of the best Emergency Medicine conferences aimed at enhancing the importance of saving lives. JIPMER hosted this international summit. The international collaboration of AAEMI and GAEM brought leading experts from across the globe to the steps of JIPMER. The generosity of the JIPMER
Alumni Association of North America (JAANA), helped make it happen. Dr Lekshmi Vaidyanathan, MD, MPH, Section of Pre-hospital Medicine and Disaster Emory University said, “A lot of minds have come together in the conference to propagate great ideas.” Dr Latha Ganti, Professor of Emergency Medicine, North Florida South Georgia (NFSG) Veterans Affairs Medical Center, commented, “The international collaboration that went into making this event happen was an amazing feat.” Dr Ganti, a world renowned expert in research also said, “I have the privilege to listen to and moderate all the oral abstracts and I have to say that I think the research has been outstanding. ISEMT 2014 has been an extremely successful conference and really well done!” Dr Gerard O’Reilly, Emergency Physician and Head of International Operations, Emergency and Trauma Centre, The Alfred Hospital, Melbourne, believes that the most important thing about conferences similar to ISEMT 2014 is bringing together people who have similar objectives and goals. “I have already met a few people who are interested in setting up trauma systems and emergency care
The conference was with defined goals and we believe we were able to achieve it. Dr Pankaj Arora, President, American Academy for Emergency Medicine in India and International Organizing Secretary, ISEMT 2014
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Faculty, Section of Pre-hospital Medicine and Disaster, Emory University
Oral abstracts presented at event were outstanding.
Dr Latha Ganti Professor of Emergency Medicine, North Florida South Georgia (NFSG) Veterans Affairs Medical Center
Thanks to the collaboration of like-minded people, state-of-the-art Emergency Care in India can soon widespread
Dr Anita Bhavnani President of the Global Academy of Emergency Medicine systems. Continuing this dialogue is the first step,” he said. Talking about the challenges during the initial stage of setting up emergency department in Australia, Dr Reilly added,
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Emergency medicine is a new field in India and to see the advances made internationally is extremely encouraging.
Dr Balaji Natarajan Final year Resident, Emergency Department, Sundaram Medical Foundation, Chennai “In the early years of EM in Australia the emergency physicians faced the challenge of change, of being recognized, and gaining respect. Now, the biggest challenge for us is the increasing number of patients. We must keep up the number of physicians.” Dr Balaji Natarajan, a final year Resident at Emergency Department of Sundaram Medical Foundation, Chennai, said,
Musical Shower with Banquet Dinner The second day of the conference was one to cherish forever with the fusion of Carnatic music and banquet dinner. An hour of musical stream in the JIPMER Auditorium made everyone relaxed and chilled. The moment the magical fusion of Carnatic tunes were stringed by Sangeet Samrat Chitravina N Ravikiran, it took the audience to another level of enjoyment and togetherness. It was indeed a perfect valentine eve for the music lovers. Ravikiran was accompanied by Akkarai Shubhalakshmi on Mridangam, Guruprasad on Ghatam and
“As a postgraduate, it is a great exposure for me to learn from the best emergency physicians from around the world. Emergency medicine is a new field in India and to see the advances made internationally is extremely encouraging. It also reinforces the fact that we practice international standard of medicine at SMF.” Dr Anita Bhavnani, the President of
Master Narayanan on Keyboard. The tones of ragas turned on the mood of everyone to dance with joy in the shower of harmony. The musical extravaganza was inaugurated by Puducherry Lt Governor, Shri Virendra Kataria. The evening was followed up by the banquet dinner at The Sunway GRT Grand. It was indeed a perfect banquet treat where people from around the globe, came together, exchanged gestures, shared lovely moments, got to know each other and promised to be in touch forever.
Global Academy of Emergency Medicine, stressed on the importance of collaboration, “There are many groups and institutions in India and abroad that are taking steps to promote EM here. Through collaboration, these steps can become giant strides and by adopting the best international practices and adapting them for India, state-of-the-art Emergency Care in India can soon widespread.”
Picture Perfect
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