Medical tourism Volume 2 issue No 3 by second

Vol.2 | Issue No.3 | Oct. - Dec. 2017

Cover Story

Love your heart, Live Healthy Not all heart problems are hereditary Prostate Difficulties Suffering from diabetes? Protect your eyesight

Interview: India-Oman relations robust and buoyant

Indra Mani Pandey Indian Ambassador

Infertility in men

Official Magazine

12 - 14 October 2017

A Complete Magazine on Healthcare in Asia

Medical Tourism Oct. - Dec. 2017

A Complete Magazine on Healthcare in Asia

Vol.2 | Issue No.3 | Oct. - Dec. 2017

Medical

tourism RNI No. KERBIL/2016/68979

Editor & Publisher Benny Thomas

Stop this global killer An estimated 17.5 million people die every year globally due to heart failure. This comes to a staggering 31 per cent of all deaths worldwide. In many cases there are no symptoms of an impending heart attack. Death comes unexpectedly. The symptom may be there, but the patient may not be aware of it. The causes for this dreaded killer are many. They include sedentary lifestyle, a lack of adequate physical activity, unhealthy eating, and consumption of alcohol, smoking and obesity.

Executive Editor TKV.Mani

Researchers are working on ways to contain this global killer. It is assumed that controlling the major risks such as high blood cholesterol, high blood pressure, smoking, excess weight, diabetes and physical inactivity can to a certain extent prevent heart failures. Simply adopting sensible health habits can contribute to healthier heart.

Editorial Co-ordinator Ninu Susan Abraham

Worldwide campaigns have been initiated by World Health Organization and World Heart Federation to make people aware of the dangers posed by sedentary lifestyles.

Consulting Editor O.J. George

Medical Tourism joins the World Heart Federation in its global awareness campaign to instil the need of a disciplined life to avert heart diseases. The Federation said in a global appeal on World Heart Day on Sept 29: “Your heart is at the heart of your health. And it's easy to give it the care it deserves.”

Vice President Sunil Nair Layout & Design Lal Joseph

Apart from the cover story, ‘Love Your Heart, Live Healthy’ and other stories on heart diseases, this issue also includes articles like, ‘Suffering From Diabetes?’, ‘Protect Your Eyesight’, and a story about diabetes. These ailments can affect eye, including the retina, macula, lens and the optic nerves. The story on prostate problems, common among men over 50, gives in-depth information on its causes and remedies.

Legal Advisor Adv. Biju Hariharan Arabic Translation Dr. A. Aboobacker BUSINESS ASSOCIATES Overseas USA : CHICAGO: Vincent Joseph Mob: 847 299 9954 USA : Houston: Shaju Joseph Mob: 847 899 2232 USA : NEW YORK Vincent Sebastian Mob: 917 992 9629 USA : CALIFORNIA: Wilson Nechikat, Ph: 408 903 8997 Canada : Jose Sebastian, Ph: 416 - 509 – 6265 UK : Dileep Mathew, Ph: 044 787 743 2378 Switzerland : Dr. George Sebastian, Ph: 527204780 Ireland : Thomas Mathew Mob: 00353 87 123 6584 Middle East : Anil Nath, Ph: 506854500 Singapore : Mahesh A, Ph: +65 906 22828 Germany : Thomas Vallomtharayil Ph: 02305 4455 100 Austria : Monichan Kalapurackal Ph: 0043 6991 9249829 Korea : Dr. A. Thomas, Ph: 0082 10 5822 5820 Australia : S. Mathew, Ph: 61247026086 Oman : Legihas Ussain, 00968 95383199 BUSINESS ASSOCIATES India New delhi : V Murugan, Mob: +91 989 9931 879 Mumbai : Mohan Iyer, Mob: +91 22 6450 5111 Chennai : Ashok Venkat, Mob: +91 701 033 1213 Eastern India : Sanjay D. Narwani Mob: +91 983 120 7202 Ahmedabad : Madanan MA, Mob: +91 989 800 2522 Hyderabad : Vinod Menon, Mob: +91 081 436 17672 Puducherry : K. Ramasubramanian, +91 989 497 7161 Goa : Olavo Edviges Lobo - +91 982 258 9237 Trivandrum : Kuriyan K Raju, Mob: +91 944 610 6644 Kozhikode : Reghunath Mitran, Mob:+91 914 231 9712

CORPORATE OFFICE FM Media Technologies PVT Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India. Tel/Fax: +91 484 403 4055 Email: director@asianmeditour.com www. asianmeditour.com

Medical Tourism Oct. - Dec. 2017

A feature on understanding memory losses talks about the difficulties patients suffer and gives tips to overcome the problems that affect mainly elderly people. There is also an article ‘SRMC Excels in Successful Cancer Treatment’. This details the world-class treatment that Sri Ramachandra Medical Centre at Perur, Chennai, provides, including its state-of-the-art cancer treatment facilities, panel of expert doctors and paramedical staff. ‘Ouch…ha! Painful joints?’ is yet another story that will be interesting to many people who suffer from rheumatoid arthritis. The article says that the onset of this disease most often begins in middle age or later. But it can occur at any age as well. There are two more stories on infertility problems. They show that IVF is not a risky procedure and reviews the Infertility problems in men. The highlight of this issue is an interview with Indian Ambassador to the Sultanate of Oman, Indra Mani Pandey on bilateral relations We are proud to announce that that Medical Tourism is the official magazine of the Oman Healthcare Exhibition and Conference which will be held in Muscat from Oct 9 to 11. It is also the media partner for Advantage Healthcare India 2017 in Bengaluru from Oct 12 to 14. Medical Tourism will also be at the first International AYUSH Conference and Exhibition in Dubai on Nov 9- 11. In the current issue we have our regular features such as Health News, Events, Hospitals and New Medical Devices. We wish everybody healthy reading.

Editor

Printed, published and owned by Benny Thomas FM Media Technologies Pvt. Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India. Editor: Benny Thomas

Printed at Sterling Print House Pvt Ltd, Door No. 49/1849, PonekkaraCheranellur Road,Aims, Ponekkara P.O, Cochin-682041, Ph: 0484 2800406.

Disclaimer: The statements in this magazine have not been evaluated by the Food and Drug Administratin of USA or any other country. Information provided in this magazine are not intended to diagnose, treat, cure or prevent any disease. If you have a medical condition, consult your physician. All information is provided for research and education purpose only.

A Complete Magazine on Healthcare in Asia

Contents Hospitals

New Cardiology Equipment

Medical events

Interview: Indra Mani Pandey India-Oman relations robust and buoyant

Cover story: Love your heart, live healthy

Reflections: Life and death conundrum concealed in the heart itself; Nurse it well for non-stop activity 24 Interview: Dr. Prathap Kumar N - Not all heart problems are hereditary

Heart & you

Heart Health Tests

5 Herbs and spices to keep your heart happy!

Spotlight: Padma Shri Prof. Dr. KALAMANDIRAM PARAMU HARIDAS

Prostate difficulties

Infertility in men

Suffering from diabetes? Protect your eyesight

A couch potato? Beware of the risks

Health News

Surgery of the Future

Significant strides in thefight against cancer

Ouch ha! Painful joints?

Interview: Dr. K U Kunjimoideen - IVF is not a risky procedure

Plan well,Travel safe

Insurance: Key to worriless medical treatment

City Profile: The Garden City calls the shots for flourishing medical tourism

Emergency Medical Services: Indian Perspective

Medical Tourism Oct. - Dec. 2017

Cover Story: Love your heart, live healthy

Life and death conundrum concealed in the heart itself; Nurse it well for non-stop activity

34 Heart & you

Ouch ha! Painful joints?

Prostate difficulties

68 Plan well, Travel safe

Insurance: Key to worriless medical treatment

48 Suffering from diabetes? Protect your eyesight

City Profile: The Garden City calls the shots for flourishing medical tourism

62 Significant strides in thefight against cancer

A Complete Magazine on Healthcare in Asia

Medical Tourism hospitals

Narayana Multispecialty Hospital

Aster Medcity Kochi 0811 199 8115 www.astermedcity.com

HSR Layout Basant Health Centre Building, No. 1 18th main (Opp. HSR Club) Sector 3, HSR Layout Bangalore â&#x20AC;&#x201C; 560 102 Ph: 186-0208-0208 Email : info.hsr@narayanahealth.org

Email : nri@dmhealthcare.com

Fortis Escorts Heart Institute and Research Center

Lords Hospital

Okhla Road, New Friends Colony, New Delhi, Delhi 110025 Ph: 91-11-47135000 Email : contactus.escorts@fortishealthcare.com

Email : info@lordshospital.org

Asian Heart Institute

Medical Trust Hospital MG Road, Cochin - 682 016 Kerala, India. Tel: Hosp: +91 484 2358001 (11 lines) Public Relations: +91 484 2358035

G / N Block, Bandra Kurla Complex, Bandra (E), Mumbai 400 051, Maharashtra Ph: +91-9930333500

Email : info@medicaltrusthospital.org

Email : info@ahirc.com

Indraprastha Apollo Hospitals

Meditrina Hospitals Pvt. Ltd Kollam Bypass Road, Ayathil, Kollam, Kerala 691021 Ph: 0474 272 1111

Sarita Vihar, Delhi Mathura Road New Delhi â&#x20AC;&#x201C; 110076 Ph: 011 2692 5858 Email : info@apollohospitals.com

Email : info.klm@medtrinahospital.com

Amrita Institute of Medical Sciences and Research Centre

Aster Ramesh Hospitals

Email : hospitaladministration@aims.amrita.edu

Ramesh Hospitals Road, Near ITI College Bus stop, Vijayawada- 520008, Andhra Pradesh, India. Ph: +0866-248-4800 Email : info.klm@medtrinahospital.com

Lourdes Hospital

PSRI Hospital

Ponekkara, P. O Kochi, Kerala 682 041, India Ph: 0091 (0) 484 285 1234, 0484 668 1234

Pachalam PO, Ernakulam, Kochi, Kerala 682012 Ph: +91 484 4123456, 4125555

Press Enclave Marg, Sheikh Sarai II, New Delhi -110017. Ph: 9582261515

Email : lourdeshospital@vsnl.com

Email : info@psri.net

Lisie Hospital

Jaslok Hospital & Research Centre

Kathrikadavu, Kaloor, Ernakulam, Kerala 682017 Ph: 0484 2401006

15 - Dr. Deshmukh Marg, Pedder Road, Mumbai - 400 026. Ph: 66573333 / 66573010 /022-2353-3333

Email : contact@lisiehospital.org

Email : online@jaslokhospital.net

PUSHPAGIRI MEDICAL SOCIETY

Rabindranath Tagore International Institute Of Cardiac Sciences

THIRUVALLA-689101 KERALA,INDIA Ph: +91 469 2700755 Email : info@pushpagiri.in

Chackai, Anayara P O Trivandrum 695 029 Kerala, india. Ph: +91-471-3045111 Fax : 91-471-2742424

Medical Tourism Oct. - Dec. 2017

124, Eastern Metropolitan Bypass, Premises No: 1489, Mukundapur, Kolkata, West Bengal 700099

Email : online@jaslokhospital.net

Medical Tourism hospitals

Sri Ramachandra Medical College & Research Institute

Continental Hospitals Ltd. Hyderabad Tel: +91 40 67000000.

No.1 Ramachandra Nagar Porur, Chennai - 600 116 Tamil Nadu, India

Email : vc@sriramachandra.edu.in / registrar@sriramachandra.edu.in

Email : internationalpatients@continentalhospitals.com

Aster MIMS

BLK Super Speciality Hospital

Mini By-pass Road, Govindapuram P.O., Calicut - 673 016, Kerala, India. Ph: + 91-495- 3911 400, 2488 000 Fax :+ 91-495-2741329

Email : mimsclt@astermims.com

Kovai Medical Center & Hospital Coimbatore Ph: +91-422-4323800/4323944 www.kmchhospitals.com

Delhi Ph: +91-11-30653122 www.blkhospital.com

Email : info@blkhospital.com

KIMS Hospital

Trivandrum +91-471-3041385/9995268011 www.kimskerala.com

Email : getwell@kmchhospitals.com

Email : ipr.tvm@kimsglobal.com

Manipal Hospital

VPS Lakeshore Hospital & Research Centre Bangalore Ph:+91 9900027157/88-49360449 mipc@manipalhospitals.com

Cochin www.lakeshorehospital.com Ph:+91-484-2701032

Email : manipalinternationalpatientcare.com

Email : info@lakeshorehospital.com

Rajagiri Hospital

Max Super Speciality Hospitals Aluva, Kerala Ph: 0484 665 5000 www.rajagirihospital.com

Delhi Ph:+91-11-26515050 www.maxhealthcare.in

Email : mail@rajagirihospital.com

Email : ips.query@maxhealthcare.com

Star Hospitals

Ananthapuri Hospitals & Research Institute

Email : coo@starhospitals.in

Hyderabad Ph: 040-44777777 www.starhospitals.in

Trivandrum Ph: +91-471-2579900/2506565 www.ananthapurihospitals.com Email : ananthapurihri@vsnl.net

A Complete Magazine on Healthcare in Asia

Medical Tourism new cardiology Equipment

ZOLL Life

E10000 Linear

Vest Wearable Defibrillator

Torsion Floor Instrument from Instron

The First Wearable Defibrillator - Constant Monitoring, Immediate Protection, Peace of Mind

Email: info@zoll.com

The ElectroPuls™ E10000 Linear-Torsion is a stateof-the-art, all-electric test instrument designed for dynamic and static testing on a wide range of materials and components.

Email: web@instron.com

SH-E12 ECG Holter System - FARUM

With EC-12H Holter recorders 12 channel recordings can be made, depending on the recorder and patient cable type being used. The Cardiospy analysis software provides ECG records of excellent quality. The effective automatic evaluation and editing functions provide evaluations with nearly 100% precision in the shortest possible time. The program performs rhythm analysis, ST, QT, AF, time and frequency based HRV, and it calculates HRT and uVTWA parameters as well.

ElectroForce Stent/Graft Test Instrument TA Instruments

Using the patented high-bandwidth, low distortion linear actuator, ElectroForce® Stent/Graft test (SGT) instruments accelerate stent testing and provide multi-billion cycle reliability. increase crucial speed-to-market and test multiple devices simultaneously. ElectroForce SGT test instruments were developed in response to the needs of our customers. Evolved through several design generations & have become the standard by which other durability test systems are measured.

Email: info@tainstruments.com

Digital Walk FM-150

Cardioplegia Cannulae

Holter Recorder from Fukuda

Maquet

Digital Walk FM-150 Holter Recorder is lightweight and has super-compact body with a newly developed single-use electrode system provides a comfortable environment for the patient.

MAQUET offers a range of different antegrade cardioplegia cannulae. The antegrade cardioplegia cannulae are used as infusion cannulae for cardioplegic solutions. The solution is perfused through the aortic root into the coronary arteries. They may also be used as drainage and de-airing cannulae for left ventricular relaxation and aortic arch de-airing during cardiac bypass. With the retrograde cardioplegia cannula, the solution is perfused through the coronary sinus.

Email: info@fukuda.co.jp

Email: farum@farum.com.pl

SH-P Ambulatory Blood Pressure

ALTRUA 20

Monitoring System from Farum

Pacemaker from Boston

Email: info.zentrale@maquet.de

Cosgrove-Edwards Annuloplasty System from Edwards

The SH-P is the member of the PC based ECG Holter product family. The diagnostic instrument operates with rechargeable batteries, is suitable for 48-hour BP monitoring with up to 250 BP readings, using oscillometric technology. The device computes accurate and comprehensive BP readings, heart rate, mean arterial pressure, BP load and pulse pressure. It provides report generation and editing, a data export-import function. The integrated software can be operated in a network environment with a common database for the entire ECG Holter product family. The software offers a wide selection of languages.

Email: farum@farum.com.pl 10 Medical Tourism Oct. - Dec. 2017

The ALTRUA 20 pacing system from Boston Scientific offers sophisticated pacing therapies and leading-edge diagnostics, including Atrial Tachy Response (ATR) mode switching and stored EGMs with onset and event markers. Ease-of-use tools such as Quick Check help to streamline patient follow-up visits. All ALTRUA 20 pacemakers are programmed using the ZOOM Programming System with the CONSULT™ Model 2892 software application.

Email: info@bostonscientific.com

Cosgrove brings a unique perspective to the field of mitral valve repair with the development of the Cosgrove-Edwards annuloplasty system. It is for use in the mitral or tricuspid position.

Email: info@edwards.com

A Complete Magazine on Healthcare in Asia

Medical Tourism Medical events

HPI 2017 October 6-8, 2017 - Mumbai, India

The 4th edition of Hospital Planning and Infrastructure (HPI) exhibition and summit is scheduled to be held at Bombay Exhibition Centre in Mumbai, India. For details contact: The Ideas Exchange (IX Events Pvt Ltd.), 702, Sunrise Building, Waterfield Road, Bandra, Mumbai -400050, India.

Tel.: +91-22-26171-3200, E-mail: info@ideas-exchange.in ; Website: www.hospitalinfra.co.in

IMTEC 2017 October 9-10, 2017 - Dubai, U.A.E

An International Medical Travel Exhibition and Conference providing a perfect platform for hospital groups is scheduled to be held at Dubai International Convention and Exhibition Centre in Dubai, U.A.E. Contact: Informa Life Sciences, Office No.: 20:01, Level 20, Sheikh Rashid Tower, Dubai World Trade Centre, Dubai, U.A.E.

Tel.: +971-4-3365161, E-mail: info@lifesciences-exhibitions.com, Website: www.medicaltravelexhibition.com

Oman Health 2017 October 9-11, 2017 - Muscat, Sultanate of Oman

The 7th Oman Health Exhibition and Conference will be held at New Oman Convention & Exhibition Centre, Muscat, Oman. Contact: Omanexpo, 1st floor, SABCO Building, Wattayah, Muscat, Sultanate of Oman, P.O. Box : 20, P.C. 117

Tel.: +968-91727050 E-mail: media@omanexpo.com; Website: http://omanhealthexpo.com

LabAsia 2017 Kuala Lumpur, Malaysia

The 6th edition of International Scientific and Laboratory Equipment Exhibition and Conference is scheduled to be held at Putra World Trade Centre in Kuala Lumpur, Malaysia. Contact: ECMI ITE Asia Sdn Bhd (1026375-V), A-11-02A, Empire Tower Office, Empire Subang, Jalan SS16/1, 47500 Subang Jaya, Selangor, Malaysia

Tel.: +603-5022-1966, E-mail: chongnin@ecmi.com.my and/or enquiry@ecmi.com.my, Website: www.lab-asia.com

Medical Myanmar 2017 October 18-20, 2017 - Yangon, Myanmar

Myanmar most complete medical, Dental, Plastic Surgery and Aesthetic Products Event will be held in Yangon, Myanmar. Contact: Fireworks Media (Thailand) Co., Ltd. 1 Promphan 2 Office & Residence, 8th Floor (Office Zone, Room 807) 1 Soi Lat Phrao 3, Lat Phrao Road, Jompol, Chatuchak, Bangkok 10900 Thailand.

Patient Safety 2017 October 24-26, 2017 - Dubai, U.A.E

The 13th edition of Patient Safety Middle East exhibition is scheduled to be held at the Dubai International Convention & Exhibition Centre in Dubai, U.A.E. Contact: Informa Life Sciences, Office No.: 20:01, Level 20, Sheikh Rashid Tower, Dubai World Trade Centre, Dubai, U.A.E.

Tel.: +971-4-4072747. E-mail: patientsafety@informa.com ; Website: www.patientsafety-me.com

ASVS 2017 October 25-28, 2017 - Kuala Lumpur, Malaysia

18th Congress of Asian Society for Vascular Surgery & the 12th Asian Venous Forum will be held at Shangri-La Hotel, Kuala Lumpur, Malaysia. Contact: Faraz Faruqui, Marketing Manager, MCI Management Malaysia Sdn Bhd, Suite 12-9, Level 12, Wisma UOA 2, 21 Jalan Pinang, 50450 Kuala Lumpur, Malaysia. Tel.: +603-21620566, Mobile: +6010 267 6096.

E-mail: faraz.faruqui@mci-group.com; Web: www.mci-group.com

AAPS 2017 October 27-29 , 2017 - Kuala Lumpur, Malaysia

The 2nd edition of Asiaâ&#x20AC;&#x2122;s Aesthetic and Plastic Surgery Expo and conference is scheduled to be held at Mid Valley Exhibition Centre in Kuala Lumpur, Malaysia. Contact: Worldex Trade Media Sdn Bhd, 27-3, Jalan PJU 5/9, Dataran Sunway, Kota Damansara, Petaling Jaya, 47810 Selangor

Pan Arab Orthopaedic Congress 2017 november 1-4, 2017 - Amman, Jordan

The 20th edition of Annual Congress of the Pan Arab Orthopaedic Association dedicated to Orthopedics on Pediatric, Trauma, Spine, Shoulder and elbow etc. is scheduled to be held in Amman, Jordan. Contact: The Services Exhibition & Conferences Valley Jordan

Tel.: +8448 461 6 962, Fax: +4-4618558 6 962 E-mail: info@jordan-valley.com ; Website: www.jordan-valley.com

12 Medical Tourism Oct. - Dec. 2017

Medical Tourism Medical events

Access Abilities Expo 2017 November 7-9, 2017 - Dubai, UAE. Access Abilities Expo is dedicated for the products, services and technologies related to disabilities and rehabilitation sectors. Contact: Reed Exhibitions Middle East, Post Box 77899, Abu Dhabi, UAE

Tel.: +971-2-4917615, Fax: +971-2-4917612. E-mail: info@reedexpo.ae, www.accessabilitiesexpo.com

Gulf Medical Expo 2017 November 7-9, 2017 - Kingdom Of Bahrain

The 2nd Annual edition of Gulf Medical Expo 2017 for showcasing products and interact with both existing and potential customers, an opportunity to merge into business and collaboration with higher international market medical industry leaders is scheduled to be held at The Bahrain International Exhibition Centre in Kingdom of Bahrain. Contact: Newline, Wind Tower, Diplomatic Area, Floor 11, Kingdom of Bahrain

E-mail: Basith@newlineexpo.com ; Website: www.gulf-medexpo.com

CIP 2017 November 12-15, 2017 - Colombo, Sri Lanka

The 6th edition of Global Congress for Consensus in Paediatrics and Child Health is scheduled to be held at Hilton Colombo in Colombo, Srilanka. Contact: Paragon Group, 18 Avenue Louis-Casai, 1209 Geneva, Switzerland

Tel.: +41-22-5330-948, Fax: +41-22-5802-953 E-mail: cip@cipediatrics.org, www.cipediatrics.org

GCC Forensic Science Conference 2017 November 14-15, Abu Dhabi, UAE

GCC Forensic Science Conference with exhibition will be held in Abu Dhabi, U.A.E. Contact: Thomas Gaunt, Event Director, Clarion Events Ltd., Fulham Green, 69-79 Fulham High Street, London, England

Tel.: +44(0)20-73847700. E-mail: info@clarionevents.com ; Website: www.gccforensic.com

Philippines Expo 2017 November 27-28, 2017- Manila, Philippines

The 2nd Edition of Philippinesâ&#x20AC;&#x2122;s Most Complete Medical Technology, Dental Technology and Pharmaceutical Event will be held at SMX Convention Center Manila, Philippines. Contact: Fireworks Trade Exhibitions & Conferences Philippines, Inc., 12th Flr., The Trade & Financial Tower U1206 32nd Street & 7th Avenue, Bonifacio Global City Taguig City, Metro Manila 1634, Philippines. Tel.: +632-9020900 Ext. 115, Mobile: +62-81311115940,

Fax: +632-9020949. Email: phil@asiafireworks.com, www.philmedical.com

IndoMedicare Expo 2017 November 28-30, 2017- Jakarta, Indonesia

The 10th International Exhibition on Medical, Dental & Hospital Equipments, Medicine, Health Care, Supplies & Services is scheduled to be held at Jakarta International Expo, Kemayoran in Jakarta, Indonesia. Contact: Krista Exhibitions, Jl. Blandongan No. 28, 11220 Jakarta, Indonesia.

Tel.: +62216334581, Mobile: +6281310321079. E-mail: ketty@kristamedia.com, www.kristamedia.com

MediPharm Expo 2017 December 7-9, 2017- Hanoi, Vietnam

The 24th edition of Vietnam International Medical, Hospital and Pharmaceutical Exhibition is scheduled to be held at Hanoi International Exhibition Centre in Hanoi, Vietnam. Contact: VINEXAD, 9Dinh Le St., Hanoi, Vietnam.

Tel.: +84-4-3825-5546, Fax: +84-4-3936-3085. E-mail: medipharmexpo@vinexad.com.vn, www.hn.medipharmexpo.com

Nepal Medical Show 2017 December 14-16, 2017 - Kathmandu, Nepal

The 2nd edition of international exhibition on Medical, Hospital, Surgical, Medical Devices and Diagnostic Instruments and Consumables is scheduled to take place at Bhirikuti Mandap Exhibition Ground in Kathmandu, Nepal. Contact: S.D. Promo Media Pvt. Ltd., 2247, 2nd Floor, Hudson Lane, GTB nagar, Delhi-110019, India.

Tel.: +91-11-47034600/ 43003757. E-mail: satish@sdpromomedia.com ; Website: www.nepalmedicalshow.com

A Complete Magazine on Healthcare in Asia

Medical Tourism events

Oman Health Exhibition & Conference: A platform to explore new opportunities

The Oman Health Exhibition and Conference is the result of rebranding the MedHealth & Wellness, which was founded in 2009. This is an annual international trade event that highlights the rapid and continuous advancements of the health and medical sector in Oman. It is a common platform that brings together different segments of the health and medical industry to explore new opportunities, showcases the latest technologies, services and facilities, and leverage potential for trade and investment.This fair is held every 2 years in the Oman International Exhibition Center SAOC, the only public venue that is equipped for this large-scale exhibitions. The aim of the fair is the further development of the health sector in Oman. The exhibition is addressed to all aspects of the health and wellness industry and opens 14 Medical Tourism Oct. - Dec. 2017

the doors for new developments, trends and investments in the sector. The fair is accompanied by the Oman Health Conference, serving as a platform for industry experts and stakeholders to discuss concrete solutions and problems on various health issues and to promote joint efforts to develop and improve the health care industry. The conference is aligned with the government’s Health Vision 2050 and

aimed at addressing the challenges as well as discussing initiatives to improve the sector. Visitors and exhibitors meet for the 7th time on the Oman Health Exhibition and Conference for 3 days from 9.10.2017 to 11.10.2017 in Muscat. The event was granted “UFI-Approved Event status” by UFI-The Global Association of the Exhibition Industry in 2012.

Europe, US, UK, and Asia (including SAARC) would participate at the event, with thousands of international and national business visitors.

Global summit on Health Care in Bangalore

The Advantage Healthcare India 2017, a global summit on medical value travel (www.ahcindia.in) is scheduled to begin in Bengaluru on Oct 12, 2017. This is the third edition of ‘Advantage Healthcare India’ summit. The event is jointly organised by the Ministry of Commerce & Industry, Government of India; Federation of Indian Chambers of Commerce & Industry (FICCI); and Service Export Promotion Council (SEPC). Thousands of delegates and visitors from over 70 countries will participate in the event which is aimed at promoting healthcare services exports from India.

The event was officially announced at an occasion graced by Smt. Rita Teaotia, Secretary, Dept. of Commerce, Ministry of Commerce & Industry, Sh. SudhanshuPandey, Joint Secretary, Dept. of Commerce, Ministry of Commerce & Industry; Dr. A Didar Singh, Secretary General, FICCI, and other dignitaries. This global healthcare summit 2017 is meant to promote India as a premier global healthcare destination and enable streamlined healthcare services exports. Over 70 countries and 600 hosted buyers from Africa, Middle East,

According to Rita Teaotia, Secretary, Dept. of commerce, Ministry of Commerce & Industry, Govt. of India, this global event has emerged as a onestop-shop for all aspects of healthcare and wellness, from world-class hospitals and medical research to Ayurveda, Yoga and quality pharmaceuticals. She also added that in November 2016, a very liberal visa regime was introduced for medical tourists. Also, a comprehensive healthcare portal to guide foreign patients who want to come to India for treatment was setup. A key highlight of the event will be Medical Value Travel Awards 2017 which will recognise and showcase innovations that have helped promote India as a premier medical travel destination. Participants at Advantage Healthcare India 2017 would include international hospitals, government organizations, insurance firms, medical tourism organisations, global medical associations, medical journalists, doctors, and investors. Supporting partners of Advantage Healthcare India 2017 include EEPC India and Pharmaceuticals Export Promotion Council of India (Pharmexcil).

WMTC ends winning hearts of delegates and participants The World Medical Tourism Congress (WMTC), the most comprehensive international healthcare conference and tradeshow in the industry that brought together attendees from across the world to collaborate and advance the industry concluded on October 4 in Los Angeles. This summit was a great opportunity for all delegates and participants to meet corporate America. The congress brought together players from across the health tourism and global healthcare industries to discuss building a global healthcare infrastructure that works for all. The event welcomed top Government Officials from across the globe. Some of the topics that the event covered include; attracting foreign investments, positioning for economic growth, optimization of the healthcare infrastructure, destination attractiveness, addressing the immediate health concerns, success stories, and challenges different countries face.

Attendees could network with key leaders and decision makers from provider and buyer countries. The event marked the massive shift of the global healthcare marketplace where population health management has been pushed to the forefront. The event was an ideal arena where strategies were presented to achieve long-term, sustainable results for expansion and growth of the healthcare infrastructure – at the same time addressing the immediate health concerns faced by different countries.

Among the several other topics discussed here were: Thought leadership from every continent on Medical & Wellness Tourism Strategies & Case Studies, Attracting Foreign Direct Investment and Public/Private Partnerships, The Medical Tourism Index as a model for measuring Destination Competiveness, Population Health Management Strategies that work and Insurance Portability, Medical Visas and Patient Mobility. The event took place at the Los Angeles Convention Center. A Complete Magazine on Healthcare in Asia

Medical Tourism interview

India-Oman relations robust and buoyant

Well-known diplomat Indra Mani Pandey, who has been ambassador of India to the Sultanate of Oman for the last two years , has all praise for India-Oman relations. He talks to Medical Tourism in an e-mail interview about enhancing the existing co-operation in different sectors such as medical tourism and tourism and identifying new areas to work together for further strengthening the ties. Your Excellency, you have been Ambassador of India to the Sultanate of Oman for the last two years. How strong, you find, is India-Oman relationship and what are the measures you have in mind to further strengthen the ties? India and Oman, maritime neighbors with civilisational and historical links spanning over 5000 years, enjoy close and friendly relations. India-Oman bilateral relations are anchored in their shared interests, mutual understanding and respect for each otherâ&#x20AC;&#x2122;s priorities, concerns and sensitivities. Regular high-level visits and exchanges have been a key feature of this relationship. The two countries have extensive defence cooperation, including exchange of defence delegations and joint exercises. The economic and commercial relations between India and Oman remain robust and buoyant. Rich and 16 Medical Tourism Oct. - Dec. 2017

diverse people-to-people contacts and exchanges have been a key feature of contemporary India-Oman relations. In recent years, the number of Omanis visiting India for tourism and medical tourism has been increasing. India remains committed to nurture and expand its strategic partnership with Oman through enhancing the existing cooperation and identifying new areas for bilateral, regional and global collaboration, with a view to meet the development aspirations for our two countries. Embassy of India, Muscat, has been encouraging Indian businesspersons to engage more with Oman and benefit from the tremendous opportunities for trade and investment that Oman offers, specially in sectors with untapped potential like engineering goods, power equipment, minerals and mining, Information Technology, pharmaceuticals, etc. Further, there is

a vast scope for enhancing bilateral cooperation in areas such as development of SMEs, skill development, agriculture, healthcare, infrastructure, manufacturing, oil & gas and education. As you know, Health Tourism is gathering momentum on a large scale. Naturally, India and Oman have been beefing up their activities to galvanise this sector. Now an increasing number of Omani citizens prefer to travel to India for medicare purposes. In this connection, would you elaborate on the new amenities the Government of India is offering to take care of the medical and health problems of Omanis visiting India for treatment and tourism purposes? In order to facilitate patients, including Omanis, visiting India for medical treatment, Government of India has decided to open separate counters

Is there any rise in the number of medical visas issued by the Indian embassy in Oman after the Government of India’s announcement relaxing the rules? After liberalisation of Visa regime by Government of India, particularly in case of Medical visas, there has been a sharp increase in number of Medical Visa applicants from Oman. While in 2016, 14585 medical/medical attendant visas were issued till 31 August 2016, Indian Embassy has already issued 17690 medical/medical attendant visas during the same period in 2017, amounting to an increase of 21%.

at Immigration points for speedy and smooth clearance of Medical Visa holders, initially at 6 International Airports viz. Delhi, Mumbai, Kolkata, Chennai, Bengaluru and Hyderabad. Facilitation desks will also be available at these airports, which would have Arabic as well as Russian translators to help patients overcome the language barrier. This facility will be particularly useful for people of Oman visiting India for medical treatment. The Government has also launched a multilingual, including Arabic, 24x7 toll free tourist helpline with a view to facilitate the visit of foreign tourists, including Omanis. The service is available on 1800111363 or on a short code 1363. Visa fees for medical visa have been reduced to OMR 30.900 for visa upto six months and OMR 46.300 for visa valid upto one year. In fact, medical visa fees is less than the tourist visa fees so as to encourage to take medical visas. Various steps have also been taken to speed up processing of medical visa applications, including opening of a separate counter at BLS Centre for receiving applications for medical visas. We process medical visa applications separately from other visa application and we take only upto 3 working days to issue medical visas.

medical treatment. Could you share the details with us about the pulse of medical tourists from there and about the actual response from Omani visitors? Indian Embassy has been working to ensure that Omanis, particularly those seeking medical visa, do not face any difficulty in obtaining visa for visiting India. Omani patients and medical attendants accompanying them generally provide positive feedback about medical treatment and hospitality in India. In fact, Indian healthcare system is rooted in culture of warmth and hospitality. Healthcare facilities across India are now working towards providing holistic healthcare and hospitality packages, including Arabic interpreters, Halal food, etc., from the time of arrival at airport to departure from India.

Now there are e-visas available for tourism, business and medical purposes. These visas are for how many days and can they be extended to suit the convenience of the increasing number of medical tourists? Do the agents fully co-operate with the Indian Embassy to exploit the potential in this realm? Government of India has classified e-Visa into three sub-categories i.e. e-Tourist visa, e-Business Visa and e-Medical visa. Applicants may apply online minimum 4 working days in advance of the date of arrival with a window of 120 days. Applicants need to carry a copy of Electronic Travel Authorization (ETA) along with him/her at the time of travel. The applicant can travel to India within 120 days of the issue of ‘e-Visa’. Duration of stay in India under ‘e-Visa’ has also been increased from existing 30 days to 60 days. Extension can be granted for stay upto 6 months on case to case basis by the Foreigners

Government of India has recently announced changes in the existing visa rules to enable more overseas people to visit India for tourism, business and A Complete Magazine on Healthcare in Asia

of surgery, Ayurveda treatment and others, is growing fast as an international medical hub. Other preferred destinations for foreigners visiting India for medical treatment are Trivandrum, Kochi, New Delhi, Goa, Ahmedabad, Bangalore, Coimbatore, Vellore, and Hyderabad. What are the other areas where India can work further to improve delivery of healthcare services and facilitation of medical tourism to India?

Regional Registration Officer (FRRO) concerned. The applicants availing â&#x20AC;&#x2DC;e-Medical Visaâ&#x20AC;&#x2122; can be issued Triple Entry Visas enabling them to visit India three times on the same visa. The Embassy has been informing tour operators and travel agents in Oman about changes introduced by Indian Government for liberalisation of visa regime so that they are able to inform Omani travellers to India. The Embassy has been working with all stakeholders to exploit the full potential of medical tourism from Oman to India. What are the specific areas of diseases and specialities for which Omanis generally seek treatment in India? Patients from Oman travel to India to avail a wide range of medical treatments available ranging from Cardiac treatment to liver/kidney transplants, cancer, Orthopaedic & Spine related procedures, Ayurvedic treatments, Physiotherapy and wellness programmes. India definitely excels in the tourism sector in view of the fact that there is an unusual rush of people from the Middle East who come calling on India. What about people from Oman as tourists? Are they evincing interest in an increasing level? Yes. There has been a steady increase in the number of visas issued since 2013, with the issuance of over 95000 visas in 2016 as compared to over 50000 visas in 2013. This increase in mostly attributed to the 18 Medical Tourism Oct. - Dec. 2017

increasing awareness and interest in Omanis towards India and a variety of attractions available in India from tourism to business activities to medical treatment to Yoga, to centres of education and excellences. Which is the most preferred destination, our metropolitan cities or even other centres which have ample amenities to take care of their medical woes within comfortable range of expenses? Many cities of India have ample amenities to take care of all medical woes of Omani patients. Chennai is the most popular destination for medical treatment in India and receives up to 200 foreign patients daily. Mumbai, the perfect destination for all types

When it comes to healthcare and specialised medical treatment, India ranks among the best in the work. Quality of therapy, range of treatment options, unmatched healthcare infrastructure, skilled practitioners, zero waiting times â&#x20AC;&#x201C; these are just some of the advantages of undergoing medical treatment in India. India has been endeavoring towards improving the hospitality offered to medical tourists through various means, including developing complete healthcare-cum-tourism packages, increasing ease of travel, assisting in overcoming barriers of language, culture, cuisine, etc. Comprehensive information on various treatments, alongwith costs, in various hospitals in different cities of India is also being made available online. The Government has also focused on enhancing facilitation of medical tourism to India from making available the requisite information to making all the essential arrangements and facilitations.

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Medical Tourism cover story

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Love your heart, live healthy The World Heart Federation says globally cardiac diseases claim more than 17.5 million lives every year. Ironically people die of heart failures when we have the power to protect and prevent heart problems. On the occasion of the World Heart Day on Sept 29, the Federation made this appeal: “Your heart is at the heart of your health. And it’s easy to give it the care it deserves” By T K V Mani

t’s time we understood the fact that heart diseases remained the number one killer of both men and women. Researchers have been working to advance our understanding of various heart ailments to find ways and means not only to improve health but also enhance longevity. They have discovered that one can lower the risks by simply adopting sensible health habits. To protect our heart, the first step is to learn one’s personal risk factors. It basically involves our lifestyles and food habits. If we don’t care to change our habits, they can increase the chances of an existing problem getting worse. Certain factors leading to heart problems like old age or family history can’t be totally changed. But we can certainly have control over some of the important risk factors such as high blood cholesterol, high blood pressure, smoking, excess weight, diabetes and physical inactivity. It’s to be noted that many people have more than one risk factor. To safeguard heart, we must control or eliminate all risk factors as many as we can. If not, they act together and worsen the risks. A large study, supported by the US- based National Institutes of Health (NIH), has highlighted the importance of managing the risk factors leading to a heart attack. The researchers say that middle-aged adults — men and women — with one or more ‘elevated risk factors’ such as high blood pressure, are more likely to have a heart attack or other major heart-related diseases. “For example, women with at least two major risk factors were three times as likely to die from cardiovascular disease as women with none or one risk factor,” A Complete Magazine on Healthcare in Asia

says Dr. Susan B. Shurin, acting Director of NIH’s National Heart, Lung and Blood Institute. “You can and should make a difference in your heart health by understanding and addressing your personal risk,” she says. To tackle the risk factors, it is necessary for you to first check the blood cholesterol and blood pressure. Then determine if your weight is in the healthy range. The higher your cholesterol level, the greater is your risk for heart disease or heart attacks. Routine blood tests can show the overall cholesterol level and separate levels of LDL (‘bad’) cholesterol, HDL (‘good’) cholesterol and triglycerides. All such blood measurements are linked to our heart health. High blood pressure, often called the ‘silent killer’, usually does not exhibit any symptoms. Hypertension is yet another major risk factor for heart disease. Blood pressure is always reported as two numbers, and any numbers above 120/80 mmHg raise the risk of heart disease and stroke. “Scientific evidence is strong that controlling high blood cholesterol and high blood pressure prevents cardiac events such as heart attacks,” says Dr. Michael Lauer, a heart disease specialist at NIH. Body weight is another important factor that should be kept under watch. To find out if one needs to lose weight to reduce the risk of heart disease, he/she should calculate the body mass index (BMI), which is a ratio of weight to height, doctors say. A BMI between 25 and 29.9 means that you’re overweight, while a BMI of 30 or higher means obesity. A waist measurement of more than 35 inches for women and 40 inches for men raises the risk of heart disease and other serious health conditions. Even a small weight loss (between 5 per cent and 10 per cent of your current weight) can help lower the risk. A heart-healthy diet includes a variety of fruits, vegetables and whole grains, as well as lean meats, poultry, fish, beans and fatfree or low-fat dairy products. Try to avoid saturated fat, trans fat, cholesterol, sodium (salt) and added sugar, health experts say. Regular physical activity is another powerful way to reduce the risk of heart-related problems. It also offers a host of other health benefits. To make physical activity a pleasure rather than a chore, choose the 22 Medical Tourism Oct. - Dec. 2017

activities that you enjoy. Take a brisk walk, play ball, lift light weights, dance or do gardening. Even taking the stairs instead of the elevator can make a difference. “At least two-and-a-half hours a week of moderate-intensity physical activity can lower your risk of heart disease, stroke, hypertension and diabetes—a winner on multiple counts,” says Dr. Diane Bild, a cardiovascular epidemiologist at National Institutes of Health. If you have diabetes, it’s important to keep your blood sugar or glucose under control. About two-thirds of people with diabetes die of heart or blood vessel disease. If you’re at risk for diabetes, modest changes in diet and level of physical activity can often prevent or delay its development. If you happen to be a smoker, the best thing you can do for your heart is stop the killer habit. People who smoke are up to six times more likely to suffer a heart attack than non-smokers. The risk of heart attack increases with the number of cigarettes smoked each day. Researchers found that quitting smoking will immediately begin to reduce the risk, and the benefit in reduced risk will continue to increase over time. One should also be alert to certain symptoms and get them checked by a doctor. Common signals that something is wrong with your heart include angina—pain in the chest, shoulders, arms, neck, jaw or back—as well as shortness of breath, irregular heartbeat or palpitations (arrhythmia) and fatigue. However, be aware that the symptoms of a heart attack can vary from person to person. Finally, don’t forget that you can also influence your loved ones’ heart health by setting an example yourself. If you follow a heart-healthy lifestyle, it’s more likely that they will, too. As heart disease begins in childhood, one of the best things you can do for those you love is to help children build strong bodies and healthy habits. The bottom line, however, is it’s never too late to take steps to protect your heart. It’s also never too early. Start today to keep your heart strong. Talk to your doctor about your risk and create an action plan. Love your heart.

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Medical Tourism reflections

Life and death conundrum concealed in the heart itself;

Nurse it well for non-stop activity By O.J.George (Consulting Editor)

he heart of the matter is the heart itself, one can safely say, as the life and death issue lies with maintenance of that closed, fist-shaped, organ working continuously from one’s birth till a nano moment before the last breath. There is no respite for this ever-beating and pumping biological organ which needs blood circulation for its sustenance as well as for the active functioning of 24 Medical Tourism Oct. - Dec. 2017

all other organs in the body, however mighty and minuscule they may be. Nurse it well and it will prolong its active non-stop journey. The motto of the co-operative movement, “Each For All And All For Each,” is perfectly in sync with the functioning of the heart. There can be no disruption in the path of the working of this miraculous biological gear, for a moment’s failure would mean certain,

unrecoverable collapse, bidding adieu to life on Planet Earth, from the fragile physical body. There can be no two opinions about the scope, expansion and spread of artificial methods and appendages developed by research to prop up the all-important cardiac factory of sort. It was South African surgeon, Dr Christian Barnard, who performed the first human heart transplantation in 1967,

even though the recipient lived for only 18 more days after the surgery. Further to this epoch-making development were advancements made in the realm of cardiac surgery throughout the world. In fact, Thomas Morris has written a comprehensive book titled, “The Matter of the Heart”, highlighting eleven landmark operations, exposing “the thrilling, dizzying” story of heart surgery, which Sunday Times had

described as every bit as important as that of the nuclear, computer or rocket ages. All these thousands of years the human heart had remained the deepest of mysteries, believed to be home to the soul and body alike. And then, decades after pioneering efforts started emerging in the late nineteenth century, when the mysteries of the heart stood exposed by surgeons of great expertise with the co-operation

of brave patients as well as sacrificial experimental animals. In “The Matter of The Heart”, Thomas Morris describes stories of triumph, bravery bordering on recklessness, arrogance, coupled with jealousy and rivalry, all of which depict incredible ingenuity in the sphere. In one review the book was described as one that gives us a view over the A Complete Magazine on Healthcare in Asia

surgeon’s shoulder, showing us the heart’s inner working and failings. It was a human story and a history of risk-taking that has saved millions of lives throughout the world by artificial intervention. To add to the rhyming of the title, I must point out that there is another book, which is a novel written by British author Graham Greene, named “The Heart Of The Matter,” which has nothing to do with surgery, but deals with the ambitious subjects of war, espionage, love, adultery, treachery and betrayal. The theme is set in the British colonial outpost in Sierra Leone during the World War II, the novel being one of moral dilemmas as the chief character, Scobie the Commissioner, fakes a heart problem, gets regular medicines which he consumes at one go and falls dead, for he did not want to be known as having committed suicide. We are all resigned to death, but it is life we aren’t resigned to, Scobie commented once. And that brings us back to the topic how to remain heart-healthy to lead an abundant life, taking full care of the organ which is the repository of the secret which will lead to longevity and meaningfulness of life. Let us not forget the fact that the World Heart Day was observed on September 29 with a variety of programmes and awareness initiatives in global corners to drive up the message that, in fact, small changes in life-style and other modes, including selected nourishments, can make redoubtable difference in the quality of life, inspiring millions of people to maintain a robust heart, ensuring happiness and tranquility for life on Earth. Life is not to be wasted by shrugging off all-important protocols for preventing and curing heart ailments. Monuments, landmarks and iconic buildings were shining red on the World Heart Day to alert human denizens that life should not be frittered away by callous carelessness, but extended by fastidious, meticulous march ahead, adopting wholesome life-style that would not be a burden to the heart. In all precaution, let heart-wrenching schedules be given a go-by. Let there be a mandate for discipline and methodical living even in this fast-paced and promiscuous setting of casual and carefree echelons. The Medical Tourism magazine also is involved in this awareness campaign on a global platform highlighting issues of the heart as to how cardiac ailments can be avoided, and even if a problem erupts in an unwelcome fashion as to how one can get the best of treatment from least expensive, high-quality centres as part of medical tourism. Still we have a word of caution for the visiting medical tourists regarding selection of treatment centres as there could be unscrupulous elements out there to fleece the gullible lot by offering the moon. They should verify the authenticity of amenities being offered, the quality of medical hands dealing with the ailments and their qualification, experience and expertise. Instances have come up where some of the wheeler-dealers employ their agents even in airports from where the visitors are whisked away to their centres of vested interests hinting at religious and other factors. In the cut-throat competition existing in the field, it seems, at least in some cases, business ethics has been jettisoned. That would be disastrous for the campaign for good governance in the medical tourism sector when visitors would be enticed through highfalutin advertisements and when some of the doctors themselves refer them to centres with inadequate facilities. The patients should, therefore, be meticulous in selection of amenities being offered by various agencies and should be keen on admitting themselves in quality facilities of care and cure. 26 Medical Tourism Oct. - Dec. 2017

(ojgeorge@gmail.com)

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Coronary Artery Bypass Grafting It was in 1967 â&#x20AC;&#x201C; fifty years ago that Coronary Artery Bypass Surgery became the gold standard for treating Coronary Artery Disease. Since then various other therapeutic options like stenting (1977) have also been developed. Coronary Artery Disease is the blockage of arteries which carry blood to the heart. Coronary Artery Bypass Grafting creates alternate pathways using conduits harvested from other sites (arteries and veins) to bypass these blocks, again allowing oxygen rich blood to reach the heart muscle thereby relieving symptoms and improving heart function. Using this technique multiple blocks can be bypassed resulting in complete revascularization which has a huge impact on long term survival. The conduits used are arteries( Internal Mammary Artery & Radial Artery) and veins(Saphenous veins). Arteries used for bypass grafting have better long term patency. Coronary Artery Bypass surgery can be performed either on the beating heart or using a heart lung machine. Both techniques have equally good results and the decision on which technique to use is based on patient characteristics and surgeonâ&#x20AC;&#x2122;s preference. Recovery after Coronary Artery Bypass Surgery is rapid and patient can return to normal level of activity within three months. Life style modification is essential and patients are strongly advised diet control (to control cholesterol and blood sugar), regular daily exercise(walking) and avoidance of smoking is of utmost importance. A lot of controversy is generated regarding which is better treatment option between Coronary Bypass Grafting(CABG) or Percutaneous Coronary Intervention using stents(PCI). Various international trials have shown the superiority of CABG is patients with Severe Coronary Artery Disease having multiple blocks (Syntax trial) and superior results of CABG are also established in patients with Diabetes Mellitus(Freedom Trial). Based on these seminal trials involving thousands of patients clear guidelines have been formulated by various professional societies for scientific evidence based decision making based on appropriateness criteria. Adherence to these guidelines and decisions made by a heart team comprising cardiologists and cardiac surgeons will serve the patient by providing best outcomes.

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Dr. Shiv K Nair MS[PGI],MCh,FIACS Sr. Consultant and Head, Dept. of Cardiovascular & Thoracic Surgery Rajagiri Hospital, Chunangamvely, Aluva, Ernakulam Dist, Kerala.

Youngest born babies in the country go home after successful treatment at Rajagiri Hospital The Twin babies register a new history

Fr. Johnson Vazhappilly CMI, Executive Director and CEO of Rajagiri Hospital with the team of Doctors who successfully treated the youngest born babies at the Level 3 NICU, Rajagiri Hospital from (Lto R) Dr Ejaz, Dr Sheju, Dr Jino Joseph, Dr V P Paily, Dr Madhu George, Dr Abdul Tawab, Dr. Uma Mohandas, Dr. Anshad with the NICU Nurses.

he youngest premature babies, reported to have ever survived in India, were discharged from Rajagiri Hospital after 5 months of successful treatment. The twin babies were born at just 22 weeks gestation at Rajagiri Hospital. The mother, a native of Kottayam was under treatment for IVF at a private hospital in Kochi for the past two years and she got pregnant last year. But things didnâ&#x20AC;&#x2122;t look good for her as doctors diagnosed complications in her as during the 20th week of pregnancy, her uterus was found to be lying low and since she was carrying more than one baby, the risk level increased. Following this she was admitted to that private hospital and within 2 weeks of admission she developed severe pain and complications. In such situation it would have been difficult to save the babies but as a last resort the mother was shifted to Rajagiri Hospital. Survival of babies born at less than 24 weeks gestation would require special

medical care and advanced facilities and hence their family friend recommended them to shift the mother to Rajagiri Hospital which was capable of handling high risk pregnancies and providing advanced neonatal care. After the mother reached Rajagiri hospital, a group of doctors led by Senior Consultant & Head of Gynecology Dr V P Paily took the babies out alive. The twin girls weighed only 438 grams and 505 grams at the time of birth. The most critical care of the babies was under the supervision of Dr Madhu George, Head of Neonatology and Dr Jino Joseph ( Consultant Neonatologist ). For the first 100 days these babies were kept on ventilator support with the combined efforts of the team of doctors and nurses the baby twins gradually started recovering mainly due to the advanced facilities available at the Neonatal ICU at Rajagiri. After completing 151 days of stay in the hospital, these babies were discharged at a gestational age of 44 weeks,

weighing around 2.3 kg, breathing normally (without any respiratory support) and able to breast feed normally. The Level 3 Neonatal Intensive Care Unit (NICU) of Rajagiri Hospital is one of the best in the country and is led by Dr Madhu George (Consultant-Neonatology) and a team of doctors including Dr. Jino Joseph (Consultant-Neonatology), Dr. Abdul Tawab, Dr. Sheju Thomas, Dr. John Thomas, Dr Sreedeep K S, Dr. Uma Mohandas and Dr. Sis Jose who along with 25 odd Nurses put their best efforts to save these twins. Fr. Johnson Vazhappilly CMI, Executive Director and CEO of Rajagiri Hospital added that the 16 bedded, Level 3 Neonatal ICU at Rajagiri Hospital, has all the latest facilities and is well equipped to look after the sickest babies born in the region. Very shortly, the Neonatology department at Rajagiri also plans to start neonatal transport services, to help and support the other hospitals in the vicinity. A Complete Magazine on Healthcare in Asia

Medical Tourism Interview

Not all heart problems are hereditary Heart attack can manifest as chest pain, dyspepsia, black out, unexplained sweating or sudden death, says Dr. Prathap Kumar N, Angioplasty specialist and Managing Director of Meditrina Hospitals. Dr. Prathap Kumar N MD, DM, FIC (Italy)

By Sunil Nair

What was your inspiration to pursue a career in interventional cardiology? From a dream to become a doctor, the studentâ&#x20AC;&#x2122;s vision now is set on micro-specialisation. Cardiology science is a life-saver, giving utmost inner happiness to the doctor. Heart disease is now a major-killer. It challenges manâ&#x20AC;&#x2122;s skill to confront it. Coming to the aid of the victim at the right time is rewarding and gives life back many a times. Interventional cardiology is highly skilled group in Cardiology and, only the talented and the bright can get admitted to this area of cardiology study. I was not studious but I yearned to be a cardiologist, and this singular obsession saw me through.

Managing Director, Meditrina Hospitals

Are Cardiac problems hereditary? If so, are there any precautions a potential patient can take? Some heart diseases are hereditary and most are not. External causes are many. Genetic cause plays major role especially in young people and these are seen in families where other causes predispose heart attack like smoking, diabetes etc. So those people with a strong family background should avoid smoking, change their life styles in early ages itself to avoid major heart attack. Diabetes in these people is to be controlled to a major extent through good food habits and exercise early in life. Even a minute symptom should

be evaluated by a cardiologist so that if there is any indication it can be addressed early to avoid major complications. How can a person read the signs of a heart attack? Heart attack can manifest as chest pain, dyspepsia, black out, unexplained sweating or sudden death. Typical pain will be centrally located and may radiate to left upper limb or shoulder or neck and may be associated with sweating or breathlessness. Pain may be like burning, heaviness in the chest or unexplained discomfort. Localized pain is generally not heart related. Doctors say that BP level has to be checked regularly. Your Views Please. High blood pressure is one of the major factors leading to heart attack, heart failure and kidney failure. This along with diabetes and smoking leads to heart attack. Early detection of high blood pressure and diabetes is important in preventing major heart attack and complications leading to it. Blood pressure is mainly familial. It is caused by life style changes and also rarely due to some diseases like adrenal tumors, co-arctation of aorta and kidney tumors. These diseases are rare and can be treated fully by removal of tumors.

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What is the difference between HDL and LDL Cholesterol and how do they affect a patient? High cholesterol is another cause of heart attack. Studies tell that if cholesterol is lowered, heart disease will be reduced. There are two types of cholesterol mainly LDL and HDL. LDL cholesterol is bad cholesterol and HDL cholesterol is good cholesterol. Rise of LDL cholesterol will increase heart attack and higher the HDL cholesterol lower is the risk of heart attack. This is an important marker about heartâ&#x20AC;&#x2122;s health. Regular exercise with diet control can reduce LDL cholesterol and increase HDL cholesterol. You have always maintained a stand of not resorting to Open Heart Surgery unless it is mandatory. Are you going by Hippocratesâ&#x20AC;&#x2122; view that the best medicine of all is teaching people how not to use it? Bypass surgery was the best treatment available for complex coronary artery disease till a few years ago. But with advanced devices like Rotablator for calcified lesions and accurate stent placement with the help of intravascular ultrasound and physiological assessment by fractional flowire, produces the best results with angioplasty and stenting. Now angioplasty and stenting can be done even for cases rejected

by surgeon and I have successfully done two cases where cardiac transplantation was suggested as the only treatment. Angioplasty and stenting started many years ago in India. Why is it not being done more extensively? That is not true. Intervention has gone a long way to beat numbers in India, especially in Kerala. When I was heading cardiology department in Pariyaram Medical College from 2003 to 2006, intervention numbers were going up. In the year 2003, total number of angioplasty in Kerala in a month was 240 when major number was done by Amrita institute and second largest number was done by us. But now all govt medical colleges do a good number of interventions because of skill development of all cardiologists all over Kerala and schemes introduced by the government. Moreover the awareness of the public has gone up by many times. Now the number comes to nearly 4500 per month which is 20 times the number of 2004 when cardiac disease incidence gone up by double. This indicates the angioplasty number gone up by 10 times more than expected compared to 2003. This is not only in Kerala, all over India. That much growth is not created in bypass surgery, probably because it is still controlled by

very few people and others are not able to get established. What are concepts like Telemonitoring of heart failure patients which are being very commonly discussed now? Tele-monitoring is not only confined to heart failure patients and also in many patient subsets. It is nice to monitor ECG for all patients when they visit remote clinics and BP can be monitored by ambulatory BP monitoring and also by rhythm monitoring by holder and other devices which will tell you when these patients are to be intervened. This is important to analyze the rhythm and ECG changes so that treatment can be modified. What would you like people to know about Meditrina Hospital? Meditrina hospital started in 2009 December as a SIH model. SIH is specialty in a hospital which is a new concept. I ventured into this. I was looking for a hospital where we, cardiology dept along with a catheterization laboratory which is needed to do angioplasty and other interventional treatment. The challenge at that time was the cost involved to make a Cath lab with lack of expertise to do intervention. New entrepreneurs will have a lot of issues with money and managing big hospitals and managing many A Complete Magazine on Healthcare in Asia

specialties with multiple doctors. We started 2 SIHs, one in Changanachery and other in Thodupuzha, both are Mission-management hospitals. Both were doing well in the initial phase especially Changanachery which was doing extremely well. Success breeds jealousy, an eye-opener for me. The people you train and employ can gang up with vested interests in the parent company against you. Huge loss followed. That made me to think why team with others and why not have my own unit. Idea is good and running a hospital is easy, but the land and infrastructure will be hard to come by for a professional like me. So, I began in a rented building. This was my second model, initially doing well, but at a great cost, two SIHs and rented building was near bankruptcy. This was the beginning of our PE funding without which survival of the organisation would have been in deep trouble. Matrix partners became our PE fund by which hospital group expanded to seven centers in the next four years. Along with, mean time we started two PPP model hospitals also namely ESIC hospital and IGMH Male. I became CEO of the first PPP model hospital in the country where we offered 46% concession in CGHS rate which will account to 62000 rupees 32 Medical Tourism Oct. - Dec. 2017

for angioplasty with medicated stent giving a saving of nearly 50000 rupees per angioplasty and which gives nearly 12 crores rupees saving for the 2600 angioplasties done in four years time compared to the cases done in other empanelled hospitals. The ESIC has to ask itself as why they did not take judicious steps to refer all the patients to ESIC heart centre in Kollam than to other empanelled hospitals, netting a saving of 120 crores. Cardiac centre in IGMH, Male, Maldives is the first Cath lab in that country bringing interventional cardiology at their doorsteps and saving them time and money. Now Meditrina hospital is having 7 centers with 4 independent hospitals, 3 in rented buildings and one in own building, one O and M model (operation and management) and two PPP models. We will be the first hospital to start PPP model in civil hospitals in Haryana (the first time in county). What are the challenges that the Health Sector is facing now? Is there a disadvantage of associating with Governments? Challenges in the hospital sector now are many. First and foremost is the

non availability of skilled professionals in the deprived places in the country, namely tier ll and tier III cities. Private sector played a key role initially to address the issue by proving better monitory and other facilities to get the professionals into these areas. But strict government rules and lot of political indifference and interference made the private sector to take a step back restraining needed healthcare services in these regions. Communal interests and pressure groups furthered vested interests against genuine healthcare. Politically/communally motivated harassments/pressures on hospitals aggravated by intemperate media reporting, are dampners on healthcare . Here comes the role of government and private parties to join hand in hand, to improve health services especially in tier 2 and tier 3 cities. Unknown factors in government made many big players to withdraw from joining hands with the government. Unknown factors being, clearing finances in the right time, changing rules by government at varying times and indifferent attitudes of beaurocrats. But even then socially committed organisations may join with the government for a noble cause against the conniving unknown factors. Government name has an advantage,

no dearth of patients, no need of marketing and patients can get best care like a private set up inside the government hospital. You have always talked about the PPP model which can be followed in the Healthcare sector. Could you explain that in some more detail? I will tell you that PPP model is the final destiny of health care in the country. One reason is government cannot look after all the needs of the country in health care. Government cannot vary salary for different sectors of people like specialists and super specialists getting better salary than general practitioners. Government cannot provide the adequate facilities everywhere in the country. The above things can be done by private â&#x20AC;&#x201C; partner set-up. Patient care should be vary from case to case which can be best catered to by private. What are your plans for the coming years and what major changes do you foresee in the field of interventional cardiology? Our plans are to start cardiac centers in four civil hospitals in Haryana namely Panchkula, Ambala, Gurgaon and Faridabad as PPP model. This will be fully functional in two months time and this will become the game changer of the country because we are going to

provide angioplasty with single stent at a cost of 47000 to 49000 rupees. This is nearly 50% of the cost of angioplasty in government sector and it leads to availability of cardiology services in the hospitals where it was not there and more over this treatment is totally free of cost for BPL category patients defined by government of Haryana and all ultra modern facilities available here in this hospitals. We are going to start a cardiac centre in Raigarh of Chhattisgarh state in the next month which will take our centre number to 12 with 6 PPP model, 4 independent centres , one SIH and another O and M model. Please tell us about some of your major career challenges and accomplishments. My major challenge is myself. My unprejudiced success as a caring and skilled interventional cardiologist made enemies mainly from my own colleagues and co-cardiac surgeons. Where many had failed or gave up, I intervened to save lives that were given up as bad by others, flaming their Jealousy. But these whimpers and whisperings have done me much good that many have come to view me critically and realize that I have the mettle.

Another factor is, a doctor becoming a successful entrepreneur has not gone well with many in the profession. They want me to fail in either one, or both! And yet another bane of this industry is communal cum political interference. Their benevolence is needed for our survival. Shame, in a state that boasts of highest literacy and rational thinking! And, finally, most ashamedly, you need the support of a political-communal group . How can India compete as a health tourism destination? India creates good number of excellent health care professionals of which 20 to 30 % of highly qualified people move to other countries for better environment. But that trend is changing due to the availability of excellent Heath care opportunities/facilities and good salary. These factors make them stay back in our country thereby attracting many foreign patients to come to India to get treated. This not only leads to create highly specialized hospitals in India, draw foreigners and in turn, the much needed foreign funds. There is still hope. In the next 10 years, India will become the final destination for health care due to highly skilled professionals, excellent facilities and affordable cost.

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Heart & you Medical Tourism

Cover story

Heart disease is one of the leading causes of death across the world. It describes several problems related to plaque buildup in the walls of the arteries, atherosclerosis, irregular heartbeat or heart valve problems. Types of heart disease include coronary artery disease, cardiomyopathy, enlarged heart, heart attack, atrial fibrillation, heart valve disease, congenital heart disease, heart muscle disease, pericarditis, pericardial effusion, Marfan syndrome and heart murmurs.

eart disease, also called cardiovascular disease, mainly affects older people and means that there are problems with the heart and blood vessels.. This disease includes a variety of problems, including high blood pressure , hardening of the arteries, chest pain, heart attack and strokes.

Arteriosclerosis: Also called hardening of the arteries, arteriosclerosis means the arteries become thickened and are no longer as flexible.

What is heart disease?

Atherosclerosis: A buildup of

The heart is the centre of the cardiovascular system. Through the body’s blood vessels, the heart pumps blood to all of the body’s cells. The blood carries oxygen, which the cells need. Cardiovascular disease is a group of problems that occur when the heart 34 Medical Tourism Oct. - Dec. 2017

and blood vessels aren’t working the way they should. Here are some of the problems that go along with cardiovascular disease:

cholesterol and fat that makes the arteries narrower so less blood can flow through. Those buildups are called plaque.

Angina: People with angina feel a pain in the chest that means the heart isn’t getting enough blood.

Heart attack: When a blood clot or other blockage cuts blood flow to a part of the heart.

Stroke: When part of the brain doesn’t get enough blood due to a clot or a burst blood vessel. Treatment Surgeries: If a patient has cardiovascular disease, the doctor will talk about how stopping smoking, losing weight, eating a healthy diet, and getting exercise can help. The person also may need to take medicine, have surgery or both. There are different surgeries for the heart and blood vessels. These include:

Angioplasty: This opens a blocked vessel by using a balloon-like device at an artery’s narrowest point. The doctor may also insert a stent, which is a tiny, stainless steel tube that props the vessel open and makes sure it stays clear. Atherectomy: This involves cutting the plaque out of an artery, so blood can flow freely. Bypass surgery: This involves taking part of an artery or vein from another part of the body (like the arm or leg) and using it to channel blood around a blocked area in an artery.

Pacemakers: A pacemaker is a small electronic device that’s put inside the body to regulate the heartbeat.

Valve replacement: If a heart valve is damaged or isn’t working, a surgeon can replace it.

worn out after the surgery, but you can help by making a “Get Well” card and paying a visit.

Carotid endarterectomy: (say:

Can kids get heart disease?

en-dar-tuh-REK-tuh-me). During this procedure, a surgeon removes plaque deposits from the carotid artery to prevent a stroke. If someone you know is getting one of these operations, you might feel worried. The good news is that these surgeries can help prevent heart attacks, strokes, and other problems. The amount of time the person will need to spend in the hospital will vary, depending on the operation and the person’s health. The person may be tired and

Kids usually don’t have any symptoms of heart and blood vessel problems. But by starting heart-healthy habits right now, kids can reduce the chance they will ever need to worry about cardiovascular disease.

MT Desk. Source: MedlinePlus, National Institutes of Health, Kids Health

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Heart Health Tests

If you do have a heart disease, it is important to find it early, when it is easier to treat. Blood tests and heart health tests can help find heart diseases or identify problems that can lead to heart diseases. There are several different types of heart health tests. Your doctor will decide which test or tests you need, based on your symptoms (if any), risk factors, and medical history.

36 Medical Tourism Oct. - Dec. 2017

Cardiac Catheterization

pictures to create a three-dimensional (3D) model of the whole heart. This test can help doctors detect or evaluate: • Coronary artery disease • Calcium buildup in the coronary arteries • Problems with the aorta • Problems with heart function and valves • Pericardial diseases Before you take the test, you get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures. The CT scanner is a large, tunnel-like machine. You lie still on a table which slides you into the scanner, and the

Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. For the procedure, your doctor puts a catheter (a long, thin, flexible tube) into a blood vessel in your arm, groin, or neck, and threads it to your heart. The doctor can use the catheter to: • Do a coronary angiography.This involves putting a special type of dye in the catheter, so the dye can flow through your bloodstream to your heart. Then your doctor takes x-rays of your heart. The dye allows your doctor to see your coronary arteries on the x-ray, and to check for coronary artery disease (plaque buildup in the arteries). • Take samples of blood and heart muscle. • Do procedures such as minor heart surgery or angioplasty, if your doctor finds that you need it.

Cardiac CT Scan

scanner takes the pictures for about 15 minutes.

Cardiac MRI Cardiac MRI (magnetic resonance imaging) is a painless imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. It can help your doctor figure out whether you have heart disease, and if so, how severe it is. A cardiac MRI can also help your doctor decide the best way to treat heart problems such as: • Coronary artery disease • Heart valve problems • Pericarditis • Cardiac tumors • Damage from a heart attack

A cardiac CT (computed tomography) scan is a painless imaging test that uses x-rays to take detailed pictures of your heart and its blood vessels. Computers can combine these

The MRI is a large, tunnel-like machine. You lie still on a table which slides you into the MRI machine. The machine makes loud noises as it takes pictures of your heart. It usually takes about 30-90 minutes. Sometimes before the test, you might get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures. A Complete Magazine on Healthcare in Asia

Chest X-Ray

A chest x-ray creates pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. It can reveal signs of heart failure, as well as lung disorders and other causes of symptoms not related to heart disease.

Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart’s chambers and valves are working. Doctors use an echo to diagnose many different heart problems, and to check how severe they are. For the test, a technician applies gel to your chest. The gel helps sound waves reach your heart. The technician moves a transducer (wand-like device) around on your chest. The transducer connects to a computer. It transmits ultrasound waves into your chest, and the waves bounce (echo) back. The computer converts the echoes into pictures of your heart.

Electrocardiogram (EKG), (ECG)

Coronary Angiography

Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. Doctors use this procedure to diagnose heart diseases after chest pain, sudden cardiac arrest, or abnormal results from other heart tests such as an EKG or a stress test. You usually have a cardiac catheterization to get the dye into your coronary arteries. Then you have special x-rays while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.

Echocardiography

An electrocardiogram, also called an ECG or EKG, is a painless test that detects and records your heart’s electrical activity. It shows how fast your heart is beating and whether its rhythm is steady or irregular. An EKG may be part of a routine exam to screen for heart disease. Or you may get it to detect and study heart problems such as heart attacks, arrhythmia, and heart failure. For the test, you lie still on a table and a nurse or technician attaches electrodes (patches that have sensors) to the skin on your chest, arms, and legs. Wires connect the electrodes to a machine that records your heart’s electrical activity. Stress Testing Stress testing looks at how your heart works during physical stress. It can help to diagnose coronary artery disease, and to check how severe it is. It can also check for other problems, including heart valve disease and heart failure. For the test, you exercise (or are given medicine if you are unable to exercise) to make your heart work hard and beat fast. While this is happening, you get an EKG and blood pressure monitoring. Sometimes you may also have an echocardiogram, or other imaging tests such as a nuclear scan. For the nuclear scan, you get an injection of a tracer (a radioactive substance), which travels to your heart. Special cameras detect the energy from the tracer to make pictures of your heart. You have pictures taken after you exercise, and then after you rest. MT Desk/ Source: National Heart, Lung, and Blood Institute

38 Medical Tourism Oct. - Dec. 2017

5 Herbs and spices to keep your heart happy! World Heart Day is celebrated every year on September 29. Organised by the World Heart Federation, the day is marked to spread awareness about cardiovascular diseases, which is the worldâ&#x20AC;&#x2122;s biggest killer and claims more than 17.5 million lives all around the world! It is the biggest platform for raising awareness about cardiovascular diseases (CVD). This is a platform for the CVD community to unite in the fight against and reduce the global disease burden. It looks at 5 herbs and spices to keep your heart healthy!

Ginger

sensitivity and function, but cinnamon is off the charts when it comes to antioxidant potential.

Garlic

Savory rosemary has a lot of cancer-protective potential. Rich in canonic and rosemarinic acids, rosemary can help prevent the creation of HCAs during the cooking process, and can help prevent cancers of the breast and colon.

Turmeric/Curcumin

Ginger is commonly used as a digestive aid and is particularly helpful for treating nausea, especially if due to motion sickness or medications like codeine or morphine. Since, garlic and ginger can thin the blood much like aspirin, patients taking pharmaceutical blood thinners should consult with their doctors about how much of these herbs they consume in food or supplement form

Cinnamon

A powerful anti-inflammatory and antimicrobial agent, this alleged vampire repellent has a long history in folk medicine. Today, cardiologists often recommend garlic to promote cardiovascular health. Garlic, one of the most healthy herbs and spices in the world, is both a powerful antioxidant and blood thinner.

Rosemary

Turmeric contains a compound called curcumin, which has powerful healing potential. Curcumin has a long history as an anti-inflammatory agent in Chinese and Indian medicine, and has proven itself in numerous clinical studies. As an effective antioxidant and anti-inflammatory compound, curcumin helps protect against cancer and enhances cardiovascular health.

Cinnamon is one of the powerful healing herbs and spices. It helps lower blood sugar by supporting insulin A Complete Magazine on Healthcare in Asia

40 Medical Tourism Oct. - Dec. 2017

Medical Tourism spotlight

Padma Shri Prof. Dr. KALAMANDIRAM PARAMU HARIDAS A numner of degrees attached to your name may not necessarily make you famous or an expert in your field. But Prof. Dr. Kalamandiram Paramu Haridas is exactly what his degrees speak. After securing his MBBS and MS from the prestigious Medical College in Thiruvanathapuram, he went on to take his FRCS and FMAS from the UK. Currently, he is chairman and Managing Director, Chief Surgeon and Senior Consultant, General, Gastro-Intestinal Minimal Access Surgery at Lords Hospital, Thiruvanathapuram. During his long tenure in the medical profession he held many positions in India and abroad. He worked in India with the Medical College, Thiruvanathapuram from 1968 to 1997 in many roles like Lecturer in Pharmacology, Lecutrer in Surgery, Assistant Professor of Surgery and Associate Professor of Surgery. He has also worked as Professor & Head of Surgery in Medical College, Calicut. He took voluntary retirement in 1997.

British South India Chamber of Commerce (BSICC) on 10.06.2014 • Dr. Balsalam Memorial Award, received from former minister Sri O. Rajagopal at Trivandrum Club organised by QPMPA on 06.08.2014 • Prof. Dr. C. Raghavachari Oration – ASI, Kerala Chapters held at Trissur on 06.02.1999 • ‘Prashasthi Pathram’ – V. Sambasivan Foundation held in Kollam on 20.04.2012 • ‘Prashasthi Pathram’ – Sri Krishna Natya Sangeetha Academy held at Varkala on 13.05.2012

Apart from these positions in India, he has also worked in the UK as Registrar in Surgery, Dept. of Surgery, Musgrove Park Hospital Somerset, Medway Hospital, Kent, and Whip’s Hospital London from 1974 – 1980. He also held the position of Consultant Surgeon – Head of Surgical Division, Adazayed Hospital in the UAE from 1987 to 1992. He has also held the post of Director – Medical Services in the same hospital from 1987 to 1991. The highlights of his career include: weight loss surgery for obesity through laparoscopic through sleeve gastrectomy and mini gastric bypass, Radio frequency ablation for Varicose Veins (Pinhole Surgery), Stapler surgery for Piles Painless Surgery), Video assisted surgery for Anal Fistula Treatment (VAAFT), Single incision laparoscopic Surgery (SILS) – Scar Less and Laproscopic Surgery for all Abdominal Diseases and all types of Hernias. In short, he has 44 years of experience in General Surgery, Gastro – Intestinal Surgery, Minimally Invasive Surgery (Laparoscopic Surgery). His areas of interest include, liver diseases, thyroid, hernias and diseases of the ano-rectum.

AWARDS RECEIVED • Padma Shri Award received from Hon. President of India Shri. Pranab Mukherjee at Rashtrapati Bhavan on 08.04.2015 • Lifetime Achievement Award received from Lord Swaraj Paul at The British Parliament organised by

Prof. Dr. KALAMANDIRAM PARAMU HARIDAS “Deepa”, TC-14/2056 Venpalavattom, Anayara P.O, Thiruvananthapuram- 695029 Kerala, India Tel: 91-471-2743004 E-mail: kphlords@hotmail.com www.drharidas.org

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Medical Tourism Disease Special

Prostate difficulties

The prostate is a gland in men. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine away from the bladder and out of the body. A young manâ&#x20AC;&#x2122;s prostate is about the size of a walnut. It slowly grows larger with age. If it gets too large, it can cause problems. This is very common after age 50. The older the men get, the more likely they are to have prostate trouble. 42 Medical Tourism Oct. - Dec. 2017

Here are some examples of non-cancer prostate problems:

• Blood in urine or semen

Benign prostatic hyperplasia, or BPH, is very common in older men. It means your prostate is enlarged but not cancerous. Treatments for BPH include:

• Painful ejaculation

• Watchful waiting, also called active surveillance. If your symptoms are not too bad, your doctor may tell you to wait to see if they get worse before starting treatment. Your doctor will tell you how often to return for checkups.

• Pain or burning urination • Frequent pain or stiffness in lower back, hips, pelvic or rectal area, or upper thighs • Dribbling of urine Prostate cancer

• Medications. Medicines can help shrink the prostate or relax muscles near your prostate to ease symptoms. • Surgery. If nothing else has worked, your doctor may suggest surgery to help urine flow. • Other treatments. Sometimes radio waves, microwaves, or lasers are used to treat urinary problems caused by BPH. These methods use different kinds of heat to reduce extra prostate tissue. Acute bacterial prostatitis usually starts suddenly from a bacterial infection. See your doctor right away if you have fever, chills, or pain in addition to prostate symptoms. Most cases can be cured with antibiotics. You also may need medication to help with pain or discomfort. Chronic bacterial prostatitis is an infection that comes back again and again. This rare problem can be hard to treat. Sometimes, taking antibiotics for a long time may work. Talk with your doctor about other things you can do to help you feel better.

Your chance of getting prostate cancer may be affected by your: • Age. Men age 50 and older run a greater risk. • Race. Prostate cancer is most common among African-American men, followed by Hispanic and Native-American men. Asian-American men have the lowest rates of prostate cancer.

Chronic prostatitis, also called chronic pelvic pain syndrome, is a common prostate problem. It can cause pain in the lower back, in the groin, or at the tip of the penis. Treatment may require a combination of medicines, surgery, and lifestyle changes.

• Family history. If your father or brother had prostate cancer, you are more likely to have it, too.

Be sure to talk with your doctor about the possible side effects of treatment.

Diagnosing prostate cancer

Symptoms of prostate problems See your doctor right away if you have any of these symptoms: • Frequent urge to urinate • Need to get up many times during the night to urinate

• Diet. The risk of prostate cancer may be higher for men who eat high-fat diets. To find out if prostate symptoms are caused by cancer, your doctor will ask about your past medical problems and your family’s medical history. Your doctor also will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to examine your prostate to check for: • The size, firmness, and texture of the prostate • Any hard areas, lumps, or growth spreading beyond the prostate • Any pain caused by touching or pressing on the prostate You may be asked to give a urine sample for testing. Your doctor also may do a blood test to check the prostate-specific antigen (PSA) level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate. If tests show that you might have cancer, your doctor will refer you to a specialist (a urologist) for a prostate biopsy. The doctor will take small tissue samples from several areas of the prostate gland to look for cancer cells. A Complete Magazine on Healthcare in Asia

Treating prostate cancer Treatment for prostate cancer depends on whether cancer is in part or all of the prostate, or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you and the possible side effects of treatment. You may want to ask another doctor for a second opinion. Treatment for prostate cancer may be: • Watchful waiting, also called active surveillance. If the cancer is not causing problems, you may decide not to get treated right away. Instead, your doctor will check regularly for changes in your condition. Treatment will start if the cancer begins to grow. • Surgery. The most common type of surgery removes the whole prostate and some nearby tissue. • Radiation therapy. This treatment uses radiation to kill cancer cells and shrink tumors. The radiation may come from an x-ray machine or from tiny radioactive pellets placed inside or near the tumour. • Hormone therapy. Men having other treatments, like radiation therapy, also may be treated with drugs to stop the body from making testosterone. This is done if it seems likely that the cancer will come back. Hormone therapy also can be used for prostate cancer that has spread beyond the prostate.

PSA testing Until recently, many doctors encouraged yearly PSA testing for all men beginning at age 50, or even earlier for men at high risk of prostate cancer. As doctors have learned more about the benefits and harms of prostate cancer screening, they have begun to caution against annual PSA testing. Talk with your doctor about what is best for you. Yearly PSA testing in men without symptoms is generally not recommended. However, in men who report prostate symptoms, PSA testing (along with digital rectal examination) can help doctors determine the nature of the problem. In men who have been treated for prostate cancer, the PSA test may be used to see if the cancer has come back. MT Desk- Source: MedlinePlus.NIH 44 Medical Tourism Oct. - Dec. 2017

Some common problems are: • Prostatitis - inflammation, usually caused by bacteria • Enlarged prostate (BPH)-or Benign prostatic hyperplasia - a common problem in older men which may cause dribbling after urination or a need to go often, especially at night • Prostate cancer r - a common cancer that responds best to treatment when detected early It’s true that prostate problems are common after age 50. The good news is there are many things you can do.

Somatheeram Ayurveda Group Again Wins

National Tourism Award

for the Third Time Consecutively

Alphonse Kannanthanam, Minister of State for Tourism, presents the National Tourism Award in the wellness sector to Baby Mathew and Sarah Baby Mathew, Directors, Somatheeram Group.

Somatheeram Research Institute and Ayurveda Hospital of Somatheeram Ayurveda Group has bagged again the prestigious National Tourism Award 2015-16 instituted by Government of India for the “Best Ayurv edic Wellness Centre”. Mr. Baby Mathew, Chairman & Managing Director and Mrs. Sarah Baby Mathew, Director of Somatheeram Ayurveda Group has received this prestigious Award from Honorable Tourism Minister of India Sri. Alphons Kannanthanam. The awards ceremony, held at Vigyan Bhawan in New Delhi on 27th September 2017. Somatheeram has fetched the coveted award three times by considering its performance of excellence towards the Quality & Standard Assurance, Hospital Hygiene and Safe Management policies, Corporate Social Responsibility, Eco-Friendly Concept, Innovative ideas in Ayurveda, Environmental Preservation and Customer satisfaction among the Ayurveda Hospitals and Wellness Centers in tourism sector of India. “Somatheeram” is the winner of twenty five National and International Awards for excellence in Ayurveda which includes Kerala Government Tourism Award for “Best Approved and Classified Ayurveda Centre” consecutively.

Somatheeram Ayurveda Village Kovalam, Thiruvananthapuram- 695501, Kerala, India Email : mail@somatheeram.in

Tel: +91-471-2268101, 2266111 | Fax : ++ 91-471 2267600 A Complete Magazine on Healthcare in Asia

Medical Tourism Infertility

Infertility in men Infertility means not being able to become pregnant after a year of trying. If a woman can get pregnant but keeps having miscarriages or stillbirths, that’s also called infertility. Infertility is fairly common. After one year of having unprotected sex, about 15 percent of couples are unable to get pregnant. About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. The rest of the time, it is because of both partners or no cause can be found. There are treatments that are specifically for men or for women. Some involve both partners. Drugs, assisted reproductive technology, and surgery are common treatments.. 46 Medical Tourism Oct. - Dec. 2017

A look at what causes male infertility The most common cause of male infertility is a varicocele. It occurs when you have enlarged veins in your scrotum. This is the skin sac that hangs behind the male organ. A varicocele can occur on one or both sides. It makes the inside of your scrotum warmer, which reduces sperm production. Age can also be a factor. Fertility starts to decrease in men after age 35.

Other causes include: • A blockage in your reproductive system • Undescended testicles • Low sperm count • Sperm that are abnormally shaped or that don’t move correctly • Hormone problems • Certain health conditions, such as cancer • Some medicines

• Smoking • Alcohol abuse • Drug abuse • Emotional stress • Obesity • Overheated testicles, which can kill sperm. This can occur from frequent hot tub use or wearing underwear or pants that are too tight. Male infertility treatment More than half of male infertility cases can be corrected. Treatment options depend on the root cause. Medicine can improve hormone levels or erectile dysfunction. Surgery can help correct physical problems, such as a varicocele. It also can repair blockages or other damage. Surgery often is minor and done as an outpatient procedure. Living with male infertility There is not always a cure for male infertility. Treatment may not help or a couple still might not be able to get pregnant through physical relationship. In this case, the doctor may suggest other options to father a baby. Assisted reproductive technology (ART) treatments can include: • Intrauterine insemination (IUI). A man’s sperm is collected and inserted into the woman’s uterus. This procedure is done at the time of ovulation. • In vitro fertilisation (IVF). This technique is more complex. A man’s sperm and a woman’s egg are fertilised in the lab. Then it is implanted back in the woman’s uterus.

• An infection or sexually transmitted disease (STD) • Erectile dysfunction. Sometimes the cause of male infertility is unknown. In these cases, it may be genetic, lifestyle, or environmental factors. How is male infertility diagnosed? For most men, a doctor can help find the cause of infertility. It may be a related health problem. The doctor will do

an exam and review the patient;s medical history. A semen analysis will tell the sperm count and quality. These are important aspects of fertility. Another test the doctor may do is a check of patient;s hormone levels.

ART treatments often are effective, but are not a guarantee. If a man cannot produce sperm, a couple may look for a sperm donor. Some people consider adoption in place of ART or if ART is not successful. MT Desk Source National Institute of Child Health and Human Development, Medline Plus • Sical problems with the testicles

Can male infertility be prevented or avoided?

• Blockages in the ducts that carry sperm

One cannot always prevent male infertility. However, there are factors that can affect this condition that you should avoid. These include:

• Hormone problems • A history of high fevers or mumps • Genetic disorders • Lifestyle or environmental factors A Complete Magazine on Healthcare in Asia

Medical Tourism Eye Diseases

Suffering from diabetes? Protect your eyesight

Diabetic eye disease is a group of eye conditions that can affect people with diabetes. It can affect many parts of the eye, including the retina, macula, lens and the optic nerve. A look at the disease – Diabetic Retinopathy, Diabetic Macular Edema (DME), Cataract and Glaucoma--causes, treatment and prevention.

iabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults. Diabetic Macular Edema (DME). A consequence of diabetic retinopathy, DME is swelling in an area of the retina called the macula. Cataract is a clouding of the eye’s lens. Adults with diabetes are 2-5 times more likely than those without diabetes to develop cataract. Cataract also tends to develop at an earlier age in people with diabetes.

48 Medical Tourism Oct. - Dec. 2017

Glaucoma is a group of diseases that damage the eye’s optic nerve—the bundle of nerve fibers that connects the eye to the brain. Some types of glaucoma are associated with elevated pressure inside the eye. In adults, diabetes nearly doubles the risk of Glaucoma. All forms of diabetic eye disease have the potential to cause severe vision loss and blindness. Diabetic retinopathy Chronically high blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina, leading to diabetic retinopathy. The retina detects light and converts it to signals sent through the optic nerve to the brain. Diabetic

retinopathy can cause blood vessels in the retina to leak fluid or hemorrhage (bleed), distorting vision. In its most advanced stage, new abnormal blood vessels proliferate (increase in number) on the surface of the retina, which can lead to scarring and cell loss in the retina. Diabetic retinopathy may progress through four stages:

Mild nonproliferative retinopathy: Small areas of balloon-like swelling in the retina’s tiny blood vessels, called microaneurysms, occur at this earliest stage of the disease. These microaneurysms may leak fluid into the retina.

Moderate nonproliferative retinopathy: As the disease progresses, blood vessels that nourish the retina may swell and distort. They may also lose their ability to transport blood. Both conditions cause characteristic changes to the appearance of the retina and may contribute to DME. Severe nonproliferative retinopathy: Many more blood vessels are blocked, depriving blood supply to areas of the retina. These areas secrete growth factors that signal the retina to grow new blood vessels. Proliferative diabetic retinopathy (PDR): At this advanced stage, growth factors secreted by the retina trigger the proliferation of new blood vessels, which grow along the inside surface of the retina and into the vitreous gel, the fluid that fills the eye. The new blood vessels are fragile, which makes them more likely to leak and bleed. Accompanying scar tissue can contract and cause retinal detachment—the pulling away of the retina from underlying tissue, like wallpaper peeling away from a wall. Retinal detachment can lead to permanent vision loss. Diabetic macular edema (DM) Causes DME is the build-up of fluid (edema) in a region of the retina called the macula. The macula is important for the sharp, straight-ahead vision that is used for reading, recognising faces, and driving. DME is the most common cause of vision loss among people with diabetic retinopathy. About half of all people with diabetic retinopathy will develop DME. Although it is more likely to occur as diabetic retinopathy worsens, DME can happen at any stage of the disease.

The risk factor People with all types of diabetes (type 1, type 2, and gestational) are at risk for diabetic retinopathy. Risk increases the longer a person has diabetes. Between 40 and 45 percent of people diagnosed with diabetes have some stage of diabetic retinopathy, although only about half are aware of it. Women who develop or have diabetes during pregnancy may have rapid onset or worsening of diabetic retinopathy. Symptoms and detection The early stages of diabetic retinopathy usually have no symptoms. The disease often progresses unnoticed until it affects vision. Bleeding from abnormal retinal blood vessels can cause the appearance” spots. These spots sometimes clear on their own. But without prompt treatment, bleeding often recurs, increasing the risk of permanent vision loss. If DME occurs, it can cause blurred of “floating vision”. Detection Diabetic retinopathy and DME are detected during a comprehensive dilated eye exam that includes:

Visual acuity testing: This eye chart test measures a person’s ability to see at various distances.

Tonometry: This test measures pressure inside the eye. Pupil dilation: Drops placed on the eye’s surface dilate (widen) the pupil, allowing a physician to examine the retina and optic nerve.

Optical coherence tomography (OCT): This technique is similar to ultrasound but uses light waves instead of sound waves to capture images of tissues inside the body. OCT provides detailed images of tissues that can be penetrated by light, such as the eye. A comprehensive dilated eye exam allows the doctor to check the retina for: Changes to blood vessels Leaking blood vessels or warning signs of leaky blood vessels, such as fatty deposits Swelling of the macula (DME) Changes in the lens Damage to nerve tissue If DME or severe diabetic retinopathy is suspected, a fluorescein angiogram may be used to look for damaged or leaky blood vessels. In this test, a fluorescent dye is injected into the bloodstream, often into an arm vein. Pictures of the retinal blood vessels are taken as the dye reaches the eye. Prevention and treatment Vision lost to diabetic retinopathy is sometimes irreversible. However, early detection and treatment can reduce the risk of blindness by 95 percent. Because diabetic retinopathy often lacks early symptoms, people with diabetes should get a comprehensive dilated eye exam at least once a year. People with diabetic retinopathy may need eye exams more frequently. Women with diabetes who become pregnant should have a comprehensive dilated eye exam as soon as possible. Additional exams during pregnancy may be needed. A Complete Magazine on Healthcare in Asia

Treatment for diabetic retinopathy is often delayed until it starts to progress to PDR, or when DME occurs. Comprehensive dilated eye exams are needed more frequently as diabetic retinopathy becomes more severe. People with severe nonproliferative diabetic retinopathy have a high risk of developing PDR and may need a comprehensive dilated eye exam as often as every 2 to 4 months. DME -treatment DME can be treated with several therapies that may be used alone or in combination. Anti-VEGF injection therapy: Anti-VEGF drugs are injected into the vitreous gel to block a protein called vascular endothelial growth factor (VEGF), which can stimulate abnormal blood vessels to grow and leak fluid. Blocking VEGF can reverse abnormal blood vessel growth and decrease fluid in the retina. Most people require monthly anti-VEGF injections for the first six months of treatment. Thereafter, injections are needed less often: typically three to four during the second six months of treatment, about four during the second year of treatment, two in the third year, one in the fourth year, and none in the fifth year. Dilated eye exams may be needed less often as the disease stabilises. Focal/grid macular laser surgery: In focal/grid macular laser surgery, a few to hundreds of small laser burns are made to leaking blood vessels in areas of edema near the center of the macula. Laser burns for DME slow the leakage of fluid, reducing swelling in the retina. The procedure is usually completed in one session, but some people may need more than one treatment. Focal/grid laser is sometimes applied before anti-VEGF injections, sometimes on the same day or a few days after an anti-VEGF injection, and sometimes only when DME fails to improve adequately after six months of anti-VEGF therapy. Corticosteroids:. Corticosteroids, either injected or implanted into the eye, may be used alone or in combination with other drugs or laser surgery to treat DME. The Ozurdex (dexamethasone) implant is for short-term use, while the Iluvien (fluocinolone acetonide) implant is longer lasting. Both are biodegradable and release a sustained dose of corticosteroids to suppress DME. Corticosteroid use in the eye increases the risk of cataract and glaucoma. DME patients who use corticosteroids should be monitored for increased pressure in the eye and glaucoma. How is proliferative diabetic retinopathy (PDR) treated? For decades, PDR has been treated with scatter laser surgery, sometimes called panretinal laser surgery or panretinal photocoagulation. Treatment involves making 1,000 to 2,000 tiny laser burns in areas of the retina away from the macula. These laser burns are intended to cause abnormal blood vessels to shrink. Although treatment can be completed in one session, two or more sessions are sometimes required. While it can preserve central vision, scatter laser surgery may cause some loss of side (peripheral), colour, and night vision. Scatter laser surgery works best before new, fragile blood vessels have started to bleed. Recent studies have shown that anti-VEGF 50 Medical Tourism Oct. - Dec. 2017

treatment not only is effective for treating DME, but is also effective for slowing progression of diabetic retinopathy, including PDR, so anti-VEGF is increasingly used as a first-line treatment for PDR. Vitrectomy A vitrectomy is the surgical removal of the vitreous gel in the center of the eye. The procedure is used to treat severe bleeding into the vitreous, and is performed under local or general anesthesia. Ports (temporary water-tight openings) are placed in the eye to allow the surgeon to insert and remove instruments, such as a tiny light or a small vacuum called a vitrector. A clear salt solution is gently pumped into the eye through one of the ports to maintain eye pressure during surgery and to replace the removed vitreous. The same instruments used during vitrectomy also may be used to remove scar tissue or to repair a detached retina. Vitrectomy may be performed as an outpatient procedure or as an inpatient procedure, usually requiring a single overnight stay in the hospital. After treatment, the eye may be covered with a patch for days to weeks and may be red and sore. Drops may be applied to the eye to reduce inflammation and the risk of infection. If both eyes require vitrectomy, the second eye usually will be treated after the first eye has recovered. MT Desk. Source-The National Eye Institute (NEI), the US Points to remember Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma. All forms of diabetic eye disease have the potential to cause severe vision loss and blindness. Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working-age adults. DME is a consequence of diabetic retinopathy that causes swelling in the area of the retina called the macula. Controlling diabetesâ&#x20AC;&#x201D;by taking medications as prescribed, staying physically active, and maintaining a healthy dietâ&#x20AC;&#x201D; can prevent or delay vision loss. Because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year. Early detection, timely treatment, and appropriate follow-up care of diabetic eye disease can protect against vision loss. Diabetic retinopathy can be treated with several therapies, used alone or in combination. NEI supports research to develop new therapies for diabetic retinopathy, and to compare the effectiveness of existing therapies for different patient groups.

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52 Medical Tourism Oct. - Dec. 2017

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Medical Tourism lifestyle

A couch potato?

Beware of the risks Being a couch potato. Not exercising. A sedentary or inactive lifestyle. You have probably heard of all of these phrases, and they mean the same thing: a lifestyle with a lot of sitting and lying down, with very little to no exercise. A look at the risks of an inactive lifestyle.

the United States and around the world, people are spending more and more time doing sedentary activities. During our leisure time, we are often sitting: while using a computer or other device, watching TV, or playing video games. Many of our jobs have become more sedentary, with long days sitting at a desk. And the way most of us get around involves sitting - in cars, on buses, and on trains. How does an inactive lifestyle affect your body? When you have an inactive lifestyle, You burn fewer calories. This makes you more likely to gain weight. You may lose muscle strength and endurance, because you are not using your muscles as much

54 Medical Tourism Oct. - Dec. 2017

Your bones may get weaker and lose some mineral content Your metabolism may be affected, and your body may have more trouble breaking down fats and sugars Your immune system may not work as well You may have poor blood circulation Your body may have more inflammation You may develop a hormonal imbalance What are the health risks of an inactive lifestyle?

• High blood pressure • High cholesterol • Stroke • Metabolic syndrome • Type 2 diabetes • Certain cancers, including colon, breast, and uterinecancers • Osteoporosis and falls • Increased feelings of depression and anxiety Having a sedentary lifestyle can also raise your risk of premature death. And the more sedentary you are, the higher your health risks are.

Having an inactive lifestyle can be one of the causes of many chronic diseases. By not getting regular exercise, you raise your risk of

How can you be more active around the house?

• Obesity • Heart diseases, including coronary artery disease and heart attack

• Housework, gardening, and yard work are all physical work. To increase

There are some ways you can be active around your house:

the intensity, you could try doing them at a more vigorous pace. • Keep moving while you watch TV. Lift hand weights, do some gentle yoga stretches, or pedal an exercise bike. Instead of using the TV remote, get up and change the channels yourself. • Work out at home with a workout video (on your TV or on the internet) • Go for a walk in your neighborhood. It can be more fun if you walk your dog, walk your kids to school, or walk with a friend. • Stand up when talking on the phone • Get some exercise equipment for your home. Treadmills and elliptical trainers are great, but not everyone has the money or space for one. Less expensive equipment such as yoga balls, exercise mats, stretch bands, and hand weights can help you get a workout at home too. A Complete Magazine on Healthcare in Asia

How can I be more active at work? Most of us sit when we are working, often in front of a computer. In fact, less than 20 percent of Americans have physically active jobs. It can be challenging to fit physical activity into your busy workday, but here are some tips to help you get moving: Get up from your chair and move around at least once an hour Stand when you are talking on the phone Find out whether your company can get you a stand-up or treadmill desk Take the stairs instead of the elevator Use your break or part of your lunch hour to walk around the building Stand up and walk to a colleague’s office instead of sending an email Have “walking” or standing meetings with co-workers instead of sitting in a conference room How much exercise do I need? If you have been inactive, you may need to start slowly when you add exercise. You can keep adding more gradually. The more you can do, the better. But try not to feel overwhelmed, and do what you can. Getting some exercise is always better than getting none. For ideal health benefits, the recommendations are: For adults: • Try to get at least 30 minutes of aerobic activity on most days. • Aerobic activities include walking fast, jogging, swimming, and biking • Exercise at a moderate intensity. One way to check this is to make sure that you can say a few words in a row while exercising. But you should not be able to sing - that would mean that you are not exercising hard enough. • You can break your aerobic exercise into segments of ten minutes or more • Also do strengthening activities twice per week. • Strengthening activities include lifting weights, working with exercise bands, and doing sit-ups and pushups.

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• Choose activities that work all the different parts of the body - your legs, hips, back, chest, stomach, shoulders, and arms. You should repeat exercises for each muscle group 8 to 12 times per session. For children and teens: • Get 60 minutes or more of physical activity every day. Most of it should be moderate-intensity aerobic activity. • Activities should vary and be a good fit for your age and physical development • Moderate-intensity aerobic activities include walking, running, skipping, playing on the playground, playing basketball, and biking • Also try to get each of these at least 3 days a week: vigorous-intensity aerobic activity, muscle-strengthening activity, and bone-strengthening activity.

• Vigorous-intensity aerobic activities include running, doing jumping jacks, and fast swimming • Muscle-strengthening exercise includes playing on playground equipment, playing tug-of-war, and doing pushups and pull-ups • Bone-strengthening activities include hopping, skipping, doing jumping jacks, playing volleyball, and working with resistance bands. • Seniors, pregnant women, and people who have special health needs should check with their health care provider on how much and what types of exercises they should do. Also, anyone starting a new exercise program should talk to their health care provider first. MT Desk

Medical Tourism Health news

Health benefits of olives & olive oil

The health benefits of olives -- and associated natural products such as olive oil -- have long been recognised and touted by proponents of the Mediterranean diet. However, little was previously known about what specific compounds and biochemical interactions in the fruit contribute to its medical and nutritional benefits such as weight loss and prevention of type 2 diabetes. A Virginia Tech research team discovered that the olive-derived compound oleuropein helps the body secrete more insulin, a central signaling molecule in the body that controls metabolism. The same compound also detoxifies another signaling molecule called amylin that over-produces and forms harmful aggregates in type 2 diabetes. In these two distinct ways, oleuropein helps prevent the onset of disease. The findings were recently published in the journal Biochemistry as a Rapid Report, which is reserved for timely topics of unusual interest, according to the journal. “Our work provides new mechanistic insights into the long-standing question of why olive products can be anti- diabetic,” said Bin Xu, lead author, assistant professor of biochemistry in the in Life Science Institute affiliate. “We believe it will not only contribute to the biochemistry of the functions of the olive component oleuropein, but also have an impact on the general public to pay more attention to olive products in ligCollege of Agriculture and Life Sciences, and a Fralht of the current diabetes epidemic.” The discovery could help improve understanding of the scientific basis of health benefits of olive products and develop new, low-cost nutraceutical strategies to fight type 2 diabetes and related obesity. Source: Virginia Tech

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For connecting Dr. Rajesh Varma: Email: rajesh@namastheayuryoga.com A Complete Magazine on Healthcare in Asia 57 Call: +91 944 656 7790

Medical Tourism Health news

Understanding memory loss We’ve all forgotten a name, our keys, or if we locked the front door. It’s only normal…once in a while. However, forgetting how to make change, use the telephone, or find your way home may signal a more serious memory problem.

What is a serious memory problem?

What is mild forgetfulness?

• Asking the same questions over and over again • Getting lost in places you know well • Not being able to follow directions • Becoming more confused about time, people, and places not taking care of yourself—eating poorly, not bathing, or being unsafe.

Some of us do get more forgetful as we age. It may take longer to learn new things, call up certain words, or find our glasses. These are often signs of mild forgetfulness, not serious memory problems.

Some ways to help your memory:

Serious memory problems make everyday things hard to do. You may find it hard to drive, shop, or even talk with a friend. Signs of serious memory problems may include:

• Learn a new skill.

Memory helpers

• Volunteer in your community, at a school, or at your place of worship.

• Big calendars to highlight important dates and events

• Spend time with friends and family. • Use memory tools—to-do lists, reminder notes to yourself, big calendars. • Put your wallet or purse, keys, and glasses in the same place each day. • Get lots of rest. • Exercise and eat well. • Don’t drink a lot of alcohol. • Get help if you feel depressed for weeks at a time

Some treatable causes of memory loss As we age, our bodies change, including the brain. In older adults, some memory problems are related to treatable health conditions, such as: • Drugs—These include sleeping pills, anti-anxiety medications, painkillers, antihistamines (allergy medications), and antidepressants. • Vitamin B12 Deficiency • Alcoholism • Brain tumors or infections • Thyroid, kidney, or liver disorders • Emotional stress, anxiety, or depression 58 Medical Tourism Oct. - Dec. 2017

• “To do” lists for each day • Notes about safety in the home • Written directions for using common household items (most people with Alzheimer’s disease can still read)

What can family members do to help? If a family member or friend has a serious memory problem, you can help them live as normally as possible. You can help her or him stay active, go places, and keep up everyday routines. You can remind about the time of day, where he or she lives, and what’s happening at home and in the world. You also can help the person remember to take medicine or visit the doctor.

Medical Tourism Health news

Yoga may help treat back pain

NIH-funded researchers have been looking for new ways to treat long-lasting low-back pain. A new study shows that yoga may help relieve moderate to severe low-back pain. The research team recruited 320 people with chronic low-back pain from diverse backgrounds and underserved communities. More than half of the study’s participants were non-Hispanic black and earned less than $30,000 per year. The participants were randomly assigned to three groups. The first group took 12 weekly yoga classes designed for people with low-back pain. The second group had 15 physical therapy sessions over 12 weeks. These included exercises to strengthen back and core muscles. The third group received a self-help book and newsletters to learn how to deal with back pain. The results suggested that a structured yoga class may be an option for treating chronic low-back pain. All three groups reported improvement in physical function and pain reduction. However, people in the yoga and physical therapy treatment groups were more likely than those in the education-only group to stop taking pain relievers after a year. “Chronic low-back pain disproportionately impacts those who are economically disadvantaged,” says research team leader Dr. Robert Saper of the Boston University School of Medicine and Boston Medical Center. “Therefore, we feel that it was important to test whether the yoga would be received well by an underserved population as well as being effective.”

4 Steps to Manage Your Diabetes for Life Each year, 1.7 million Americans, ages 20 and up, are diagnosed with diabetes. People with diabetes have high levels of blood glucose (also called blood sugar). If left undiagnosed or untreated, diabetes can lead to heart disease, stroke, kidney disease, blindness, and other health problems. That’s why it’s important to manage your diabetes ABCs: A1C (blood glucose), blood pressure, and cholesterol. The 4 steps below are a good start. Step 1: Learn about diabetes. If you’ve got diabetes, you need to make healthy food choices, move more every day, stay at a healthy weight, and take recommended medicines even when you feel good. Step 2: Talk to your health care team about how to manage your A1C, blood pressure, and cholesterol. Know your ABC goals, and track your progress. Step 3: Learn how to live with diabetes. Even if you know the steps you should take to stay healthy, you may have trouble sticking with these steps over time. Work with your health care team to make a plan that will work for you. Step 4: Get routine care to stay healthy. See your health care team at least twice a year to find and treat any problems early. Once each year, be sure to get a dilated eye exam and a complete foot exam.

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Medical Tourism Health news

Cough Culprits

What’s the Difference Between Bronchitis and Pneumonia? even toxins like tobacco smoke can inflame the bronchial tubes. Most of the time, though, bronchitis is caused by an infection with one of several types of viruses. If you develop bronchitis during flu season, a likely culprit may be the flu virus. Cold viruses are also common causes at this and other times of year.

Coughs help your body clear your airways of irritants and prevent infection. But a deep cough from your chest may signal bronchitis or pneumonia. Although they may have different underlying causes, their symptoms can be similar—and both can be serious enough to send you to the doctor. Bronchitis and pneumonia both involve inflammation in the chest. Both can cause coughs that bring up a slimy substance called phlegm to help clear out germs and pus. And both can cause shortness of breath and wheezing. Bronchitis is a condition in which the bronchial tubes that lead to the lungs become inflamed. Viruses, bacteria, and

Pneumonia is caused by an infection of the lungs. “About 1/3 of cases are caused by viruses, but most of them are bacterial related,” says Dr. Kenneth Olivier, a lung infection expert at NIH. “They’re from bacteria that are quite common, like Streptococcus pneumoniae, which is the leading cause of bacterial pneumonias in all ages in the U.S.” If you get a fever with bronchitis, it is usually mild (below 101 degrees Fahrenheit). In more serious cases, you may have chest pain, feel short of breath, or wheeze when you breathe in. “Pneumonia, on the other hand, typically is associated with fever, sometimes very high, spiking fever,” Olivier says. Breathing problems, chest pain, and other symptoms also tend to be more severe with pneumonia. If you have a fever and chills, trouble breathing, or a cough that is bringing up thick phlegm—especially if it’s yellow or green—go see your doctor.

Find Help for Low Vision For people with low vision, everyday activities can be a challenge. People with low vision don’t see well even with standard glasses, contact lenses, surgery, or medicine. They may have trouble reading traffic signs or recognising faces. It can be challenging to match clothes of different colors. The lighting in a room may often seem too dim. Low vision can be caused by an eye injury or a disease such as glaucoma. Glaucoma damages the nerves that carry visual signals from the eye to the brain. Millions of Americans have low vision. Most are over age 65. If you have a problem with your vision, you should see a doctor right away. The sooner an eye problem is detected and treated, the greater your chance of keeping your remaining vision. 60 Medical Tourism Oct. - Dec. 2017

Some eye doctors specialise in helping people with low vision. These specialists can help you cope with vision loss. They can teach you new ways to do everyday tasks. They can also offer training and devices to help with reading, cooking, shopping, and other activities. “A vision rehabilitation plan helps people reach their true visual potential when nothing more can be done from a medical or surgical standpoint,” says Dr. Mark Wilkinson, a low vision specialist at the University of Iowa Hospitals and Clinics. NIH offers many resources to help people with low vision. A 20-page booklet Living With Low Vision: What you should know and companion video feature inspiring stories of people living with low vision. You can find these and other resources at www.nei.nih.gov/lowvision.

Your doctor can listen to your lungs by placing a stethoscope on your chest. “Frequently, the physician can hear areas where the breath sounds are altered,” Olivier says. If you have pneumonia, your doctor may hear bubbling, crackling, or rumbling sounds from the lungs. You may be sent for a chest X-ray, which can show whether the lungs contain fluid or pus from an infection. An X-ray is the best way to diagnose pneumonia and rule out bronchitis. Whichever illness you have, resting and drinking plenty of fluids are important ways to care for yourself. If you’re diagnosed with bronchitis, your doctor probably won’t give you antibiotics. Because viruses are the usual cause of bronchitis, antibiotics are seldom helpful. If you’re wheezing, however, you may be given medicine to open your airways. Your cough may last 10 to 20 days. Because bacteria are often the cause of pneumonia, your doctor may prescribe antibiotics. It can take 1 to 4 weeks to recover from pneumonia. Some people require treatment in the hospital. Germs that cause colds, the flu, and lower airway infections are contagious. The best way to prevent getting bronchitis or pneumonia is to avoid getting these infections. And when you’re sick, take care not to spread your germs to others

Medical Tourism

Surgery of the Future

Technology

A glimpse of what’s to come in the operating room

n the not-too-distant future, operation rooms will feature devices that will revolutionize surgery for patients and doctors. You can get a sneak peek at these tools in a new mobile app.

The Surgery of the Future app provides a 3D virtual tour of the operation room of the future. This app is provided by the National Institute of Biomedical Imaging and Bioengineering (NIBIB). More than a dozen surgical technologies are featured in the app. You can download it on iOS and Android devices. All of the featured technologies are still in development and are funded by NIBIB. “NIBIB funds a wide range of advanced technologies, including tools for imaging the body, biomaterials, and robotics,” says Margot Kern, who led the development of the app. “One arena where all of these technologies come into play is in the operating room, in surgery.” “This project demonstrates ways that patients and surgeons may benefit from the next generation of technologies.” “When people think about the types of research NIH supports, they don’t necessarily think of surgery,” she adds. “But surgery is a critical part of our health care system, and advances in surgical technologies have the potential to greatly improve patient care. We thought showcasing some of the technologies NIBIB is funding in a virtual surgical operating

room would be an exciting way for the public to learn how their tax dollars are being used to make surgery safer and more effective.” In the app, users can view a number of NIH-funded technologies. These include robots that can stitch tissues by themselves, biomaterials that change shape or dissolve inside the body, and a tool that reduces a surgeon’s natural hand tremor. “This project demonstrates ways that patients and surgeons may benefit from the next generation of technologies conceived, tested, and developed in biomedical engineering and team science laboratories,” says Roderic I. Pettigrew, Ph.D., M.D., director of NIBIB. “This virtual tour provides a sneak peek at what the surgery of the future could entail, all engineered to assist surgical teams and achieve better outcomes for their patients.” We’ve provided an overview of some of the exciting advances featured in the app. Check out the images and descriptions to find out more about what’s to come. Download the app on your mobile device through the Apple App Store or Google Play. NIH MedlinePlus

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Medical Tourism special report

Significant strides in the fight against cancer In recent times, significant strides have been made by the medical world in the fight against cancer. Once a dreaded disease deemed incurable, continued medical research has opened new vistas for cancer cure none better exemplified than the new comprehensive oncology treatment facility at Sri Ramachandra Medical Center at Porur, Chennai. 62 Medical Tourism Oct. - Dec. 2017

he Department of Oncology at SRMC comprises the following specialities -Surgical Oncology – Team of diverse specialists in surgery comprising surgical oncologists, plastic surgery, neuro surgery, orthopedic surgery, surgical gastroenterology, urology and oro fascio maxillary surgery who offer the best of cancer surgery expertise in organ preservation, reconstruction, limb salvage and cranio facial resection. Medical Oncology – A team of experienced medical oncologists armed with world class infrastructure who offer chemotherapy treatment for a wide variety of solid tumours. Patients receive day care chemotherapy in the security of Hepafiltered pressure control rooms with strict asepsis control where the chemo drugs are reconstituted in a dedicated biological safety cabinet. The hospital is also equipped with ICU facility for managing patients with chemotherapy related side effects. Radiation Oncology– SRMC boasts of a world class state of the art comprehensive Radiotherapy facility equipped with the VERSA HD digital Linac from Elekta U.K. which has the latest 160 leaf AGILITY MLC and USG based Image guidance unit CLARITY which offers the fastest high precision Radiotherapy available today. The VERSA HD enables modern day radiotherapy treatment techniques such as 3D CRT, IMRT, IGRT and VMAT (Rapid Arc), Stereotactic treatment and Triple F treatment. The department also offers HDR Brachytherapy treatment for a wide array of cancers with the help of HDR Microselectron Machine. The hospital is also equipped with the Biograph Horizon model PET CT scanner from M/s Siemens of Germany which facilitates accurate can-

cer staging and Radiotherapy planning. Paediatric oncology– SRMC is one of the unique hospitals with a dedicated paediatric Oncology unit which understands and caters to the needs of children with cancer. The Unit offers diagnostic services, OP-based and IP-based chemotherapy services for children with cancer as well as offers extensive psychological and social support and palliative care services for these children. The Paediatric Cancer Survivor Clinic comprising clinical psychologist, cardiologist, endocrinologist and dietician are available to promote the long term health of paediatric cancer survivors. Adult and Pediatric Hemato Oncology department offers treatment for a spectrum of haematological problems both Benign such as Anemias, bleeding disorders, platelet disorders and hemoglobinopathies) and for Haematological malignancies. The department offers bone marrow / stem cell transplantation treatments as well as provides leukemia

induction/consolidation chemotherapy for adults and children. Both autologous and various types of allogenic stem cell transplantations are done here and family members with only 50 per cent match can be donors. The department offers comprehensive curative, adjuvant and palliative radiotherapy treatments for a wide variety of cancers such as head and neck cancers, brain tumours, gynec malignancies, breast cancers, thoracic malignancies, GI malignancies, genito urinary malignancies, pasediatric malignancies, musculoskeletal cancers and hematological malignancies such as leukemias, myelomas and lymphomas. Our USP includes: All treatment decisions, which are based on Multi Speciality Tumor Board discussions. State-of-the-art radiation therapy facility with PET-based planning facility conforming to international standards.

World class Pathology and Radiology facilities augmented by Molecular biology and Genetic lab to aid accurate cancer diagnosis and staging and facilitate treatment decisions. State-of-the-art infrastructure, dedicated BMT rooms, HEPA-filtered pressure controlled rooms, ¨ Stem cell collection and storage facilities. ¨ Blood banking including apherisis unit ¨ Laboratory facilities with cytogenetic capability have enabled it to perform transplant procedures on par with international centres. Excellent ICU care supervised by highly experienced critical care specialists and intensivist and rehabilitative team. To summarise, world class oncology care as per international protocols and standards at a very nominal cost is provided by SRMC which is the “THE DESTINATION FOR CANCER CARE.” Our passion together with compassion can cancel cancer.

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Medical Tourism special feature

Ouch…ha! Painful joints? Anyone can get rheumatoid arthritis. The disease most often begins in middle age or later. But it can occur at any age. Early treatment for rheumatoid arthritis is key, say experts.

ainful, swollen, and stiff joints can be a sign of arthritis. Rheumatoid arthritis is one of the most common forms. The pain and stiffness can interfere with your life at home and at work. For some people, the disease is mild, but for others it can be disabling. Scientists continue to search for the cause of this disease and for ways to improve treatment – a report. Arthritis is an inflammation of the joints. There are over 100 types of arthritis. While their symptoms can be similar, their underlying causes vary. Osteoarthritis is the most common type of arthritis. It’s far more common than rheumatoid arthritis. Osteoarthritis is caused by wear and tear on your joints. In rheumatoid arthritis, your immune system—which normally helps protect your body from infection and disease— starts attacking your joint tissues. Anyone can get rheumatoid arthritis. The disease most often begins in middle age or later. But it can occur at any age. Even children sometimes get a similar form of arthritis. Some types of arthritis affect one joint at a time,

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but rheumatoid arthritis can affect your whole body. It’s important to get the correct diagnosis because each form of arthritis needs to be treated differently. To diagnose rheumatoid arthritis, doctors use medical history, physical exams, X-rays, and lab tests. There’s no single test for the disease. It’s not easy to diagnose. “The joint swelling in rheumatoid arthritis is squishy, and very different from the hard bony enlargement of the finger joints that is sometime present in osteoarthritis,” explains Dr. Michael M. Ward, who oversees rheumatoid arthritis research at National Institutes of Health (NIH) in the US. Your joints may appear red and feel warm. Pain and stiffness may be worse after you wake up or have been resting for a long time. Over time, your immune system damages the tough, flexible tissue (cartilage) that lines joints. This damage can be severe and deform your joints. Scientists don’t know exactly what causes rheumatoid arthritis. It’s likely a combination of genetics and environmental triggers, such as tobacco smoke

or viruses. Hormones may also play a role. More women are diagnosed with rheumatoid arthritis than men. The disease sometimes improves during pregnancy or flares up after pregnancy. What scientists do know is that the damage is caused by the immune system gone awry. The body’s defense system mistakenly attacks the membrane that lines joints, such as in the wrists, fingers, and toes. Joints in the neck, knees, hips, ankles, and elsewhere can also be affected. “The immune system is supposed to be something that does good things for you,” says Dr. M. Kristen Demoruelle, an NIH-funded arthritis expert at the University of Colorado Anschutz Medical Campus. “It’s supposed to help you fight infections. But in rheumatoid arthritis—for reasons that we don’t yet understand—the immune system gets confused and then starts to attack your joints instead.” There’s no cure for rheumatoid arthritis. But there are effective treatments. Treatment can relieve pain, reduce joint stiffness and swelling, and prevent further joint damage.

Research advances have improved patient outcomes in the past 10 to 20 years. Doctors no longer wait to start treating a person with rheumatoid arthritis. Now, they know to begin treatment right away—before joint damage worsens. Early detection is very important to increase the chance that treatment is successful. “If we can get you into low disease activity by 6 months and remission [no signs of the disease] by 1 year, we’ve got an incredibly good chance of the disease having a very minimal impact on your life,” says Dr. Vivian P. Bykerk, an NIH-funded arthritis researcher at the Hospital for Special Surgery in New York. There are many different classes of drugs available. Many of the drugs, like NSAIDs (nonsteroidal anti-inflammatory drugs) and steroids, work by reducing inflammation. Such drugs may be used in combination with others that have been shown to slow joint destruction. NIH scientists helped develop a new class of drug for rheumatoid arthritis called Janus kinase (JAK) inhibitors.

These drugs work by suppressing the body’s immune response. Several years ago, the first drug in this new class was approved by FDA for moderate to severe rheumatoid arthritis. Researchers continue to investigate new types of drugs and drug combinations. “We really have to rely on our experience. We consider the combination of signs, symptoms, and blood tests to choose the right treatment,” Bykerk explains. Once treatment for rheumatoid arthritis is underway, patients need frequent checkups. Doctors may need to try and adjust different drugs or drug combinations to find the best fit for each person. Treatments are usually required for the long term to maintain control of the disease. For some people, symptoms go on for years, even a lifetime. Sometimes after months of mild disease, symptoms can flare up again. Bykerk also works on an NIH-supported team of scientists who are searching for more effective treatment approaches. The team analyses joint tissue and blood samples from people with rheumatoid arthritis to better understand

the genes and proteins that trigger and drive the disease. The researchers aim to learn why some people respond differently to different treatments. They also hope to one day be able to tailor treatments to each person. Other studies are exploring how long people need to be treated once the disease is under control to prevent it from returning. Rheumatoid arthritis can affect virtually every area of your life, from work to relationships. If you have rheumatoid arthritis, there are many things you can do to help maintain your lifestyle and keep a positive outlook. Exercise helps keep your muscles healthy and strong, preserve joint mobility, and maintain flexibility. Rest helps to reduce joint inflammation, pain, and fatigue. Ask your doctor how best to balance exercise and rest for your situation. New research advances continue to help improve quality of life for people with rheumatoid arthritis. Talk with your doctor about how to treat your joint pain and stiffness so that you can lead a full, active, and independent life.-MT Desk

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Medical Tourism interview

IVF is not a risky procedure IVF means In Vitro Fertilization. Normal fertilization happens inside the human body in the fallopian tube. When it happens, or is carried out outside the human body it’s termed as ‘In vitro’. IVF is not a difficult or risky procedure. It can be done even without any hospital admission, tells Dr. K.U. Kunjimoideen, MD, DNB, Managing Director and Consultant IVF Specialist, ARMC IVF Fertility Centre in South India in an interview to Sunil Nair.

‘Fertility treatment (or IVF) has evolved a lot since the first Indian IVF baby was born. We have never seen the subject of fertility and its treatment popularised in the media as much as it is today. What is the reason for this?

in their town. Secondly, infertility problem has a social stigma. The affected couples may have to face lots of uncomfortable situations in the society. They tend to gather information privately from all sorts of digital platforms, due to this stigma.

Yes, it’s a reality that the subject of Infertility and its treatment options are very much popularised these days. We can interpret it in a positive aspect. The current age is an era where all the information is on our fingertip in this digital age. So, the awareness about any health problem is important for its prevention and early treatment. So, as the awareness increases the demand for facilities also will increase. Hence more and more treatment centres are coming up and those centres need to inform the public that such facilities are available

How and why did you choose this branch of medicine?

66 Medical Tourism Oct. - Dec. 2017

To be frank, I have not selected this specialty as a “child hood dream’ as people in general used to say. I got selected to MD course in Obstetrics and Gynaecology at JIPMER, Pondicherry, a premiere medical institution in the country. After Post graduation, I tried to practise this sub specialty of Reproductive medicine, after necessary training programmes in India and abroad and I could establish my career in a bright way

What are the main causes of infertility? We cannot pin point a particular cause for infertility. It can be due to reasons in male, female or both. Male fertility potential of mankind is on a decreasing path. Nowadays more and more males are coming up with fertility issues. It may be related to increased pollution, work stress, unhealthy lifestyle and food habits etc, whereas female infertility has been largely caused by improper health style and lack of exercise. In a certain percentage of couples the reasons can be genetic too.

What are the different types of fertility treatments? There is a whole spectrum of treatments for infertility. It starts from a counselling regarding how and when to try for preg-

sperms from inside the testes and do ICSI (Intra cytoplasmic sperm injection)

What techniques do you use to increase success rates for women who undergo IVF treatment? There are lots of new techniques,which come to the help of couples to increase the chance of treatment such as Time lapse embryo monitoring, Laser hatching, PGS etc. These are ICSI (Intra Cytoplasmic Sperm Injection). IMSI,

What are the costs associated with the IVF process? Are they very high? Is stem cell treatment involved in IVF? Average costs for a single IVF cycle ranges from Rs1.5 lakhs to Rs2 lakhs rupees. It varies due to the varying drug requirement for different individuals. The stem cell treatment in infertility is still in research stage.

Can you describe the most challenging case you have handled so far?

nancy during a menstrual cycle. Then the treatments can be with drugs, injections, laparoscopy for female partners, Intra uterine insemination(IUI), IVF and ICSI treatments

How would you explain IVF to a layman? Is IVF a difficult procedure? IVF means In Vitro Fertilization. Normal fertilzation happens inside human body in the fallopian tube. When it happens, or is carried out outside human body itâ&#x20AC;&#x2122;s termed as â&#x20AC;&#x2DC;In vitro. IVF is not a difficult or risky procedure. It can be done even without any hospital admission

Does IVF deal only with female infertility or does it address male infertility as well? It deals with both female and male infertility. For example, in males with no sperms in semen sample we must take

It was once when a 40 year old aged lady presented with infertility for more than 15years and had multiple surgeries and many attempts of IVF treatments from abroad consulted me. The couple was very determined to have their own genetic child if at all any pregnancy were to happen. Our team has put all the efforts and could succeed after collecting her own eggs in two different cycles and IVF was done and the couple was blessed with a baby girl. It was only one among many situations we have faced.

What makes ARMC different from other clinics? The most important is that ARMC paved the way by opening its first day care IVF centre in 2009. Before that the concept was that IVF is a procedure which requires many days of hospital admission and burdens. We could simplify the treatment procedures and made the cost come down drastically. Ours is one network of centers where we do not use donor eggs, sperms or embryos for treatment

What advice do you have for couples going through IVF process? Always take a second opinion before

proceeding with IVF treatment. Nowadays even without visiting a doctor the couples can take second opinion about their case. We also provide an online platform for the purpose through our mobile applications. Secondly adopt a healthy life style and correct the existing lifestyle patterns if any required.

What preparations must a couple make before travelling abroad for IVF? I think the question targets the Indian couples who stay abroad. They must take the consultation before leaving for abroad and plan the treatment properly so that they can reduce the time spent in India for an infertility treatment. To facilitate this, we have our consultation facilities available in both Dubai and Doha.

What in your opinion are the prospects of medical tourism in India? The prospects are very good. The Indian healthcare sector is witnessing 2225 per cent growth in medical tourists from across the globe due to its ability to offer world-class patient care at an affordable price compared to other countries. Healthcare providers expect the medical tourism industry to reach $6 billion by 2018 from the current $3 billion per year. A visa-on-arrival system for tourists from few selected countries has been instituted by government of India, which allows foreign nationals to stay in India for 60 days for medical procedures. This is a good initiative and still we have to go a long way. The governments must make sure of the cleanliness of our cities, improve the facilities at airport etc.

What kind of support is offered by ARMC to patients who travel from abroad? We have set up a dedicated international patient care division. This staff in this section are properly trained and are aware of the arrangements to be made for the foreigners right from the travel from their home country, the visa arrangements, stay in India etc. We provide both female and male translators as well. Also, the same couples can do the follow up treatments at our consultation facilities in Dubai and Doha. A Complete Magazine on Healthcare in Asia

Medical Tourism healthy Travel

Plan well, Travel safe Traveling can increase your chances of getting sick. A long flight can increase your risk for deep vein thrombosis. Once you arrive, it takes time to adjust to the water, food, and air in another place. Water in developing countries can contain viruses, bacteria, and parasites that cause stomach upset and diarrhea. Be safe by using only bottled or purified water for drinking, making ice cubes, and brushing your teeth. If you use tap water, boil it or use iodine tablets. Food poisoning can also be a risk. Eat only food that is fully cooked and served hot. Avoid unwashed or unpeeled raw fruits and vegetables.

f you are traveling out of the country, you might also need vaccinations or medicines to prevent specific illnesses. Which ones you need will depend on what part of the world you’re visiting, the time of year, your age, overall health status, and previous immunisations. When your family travels, being away from your household’s usual eating and sleeping routines means it’s more likely that someone might get sick. It may take time to adjust to the food, water, and air in a new environment. And kids can be especially vulnerable to

68 Medical Tourism Oct. - Dec. 2017

travel-related problems such as motion sickness, diarrhea and infections. But some early planning and smart packing can help you keep the trip healthy for everybody. Here are some things to keep in mind when your family prepares to travel. If you’re heading overseas, start preparing well in advance. For instance, it’s important to find out what vaccinations your kids (and even you) might need because: Different countries have different risks and requirements and may require specific vaccines..

Some vaccines require more than one dose and are given in a series over a period of days or sometimes weeks. Most vaccines take time to become effective in your body. Most immunisations should be given at least 1 month before travel, so try to schedule a doctor’s visit 4-6 weeks before your trip. Even if you’re leaving in less than 4 weeks, you should still make an appointment, as kids might still benefit from shots or medications. Depending on your travel plans, your doctor may recommend that in addition

to routine immunisations, you and/or your child be vaccinated against: Typhoid Yellow fever Japanese B encephalitis Meningitis Rabies Although all kids get the measles, mumps and rubella (MMR) vaccine at 12-15 months of age,. Also, kids of any age can get malaria so if you’re travelling to a country with a malaria risk, talk to your doctor about antimalarial drugs. The doctor will

decide the best preventative medication based on your destination and your child’s health status. Common travel troubles No matter how far you’re traveling, there are some health issues that your family is likely to face, including jet lag, ear discomfort, travel (or motion) sickness, and diarrhea. Jet Lag When you fly across time zones, it can take time for your internal body clock to catch up with the local timeIn addition to tiredness, jet lag can also cause A Complete Magazine on Healthcare in Asia

an upset stomach and even insomnia. Here are some tips for dealing with jet lag: Try to adjust your family’s sleep schedules 2-3 days before departure. Get plenty of rest before your trip. If possible, sleep on the flight. Dehydration contributes to the side effects of jet lag so make sure everyone drinks plenty of water during the flight. Avoid alcohol, coffee, tea, and other caffeinated beverages. On a long flight, try to stretch regularly and even walk up and down the aisles when they’re clear and it’s OK to do so. After arrival, encourage kids to be active outside or in brightly lit areas during daylight hours. Try to follow local time at your destination (for example, try to keep kids awake until their usual bedtime). Ear pain It’s common for kids to experience ear discomfort during a plane’s takeoff and descent caused by pressure in the middle ear as it tries to keep up with the rapidly changing air pressure. Encourage kids to swallow, yawn, or if they’re old enough, chew gum. It may help infants to nurse or suck on a bottle. Motion sickness Travel (or motion) sickness is caused by a conflict between the eye and ear: The inner ears detect movement, but the eyes — focused within a car or other vehicle — do not. These mixed signals coming into the brain can cause nausea, dizziness, vomiting, paleness, and cold sweats. Motion sickness often happens on ships and boats, but it also can affect kids when they travel in planes, buses, and cars. Some ways to help combat travel sickness: Before you leave, have kids eat a light meal or snack, as motion sickness seems worse on an empty stomach. Provide foods that are easily digested, such as complex carbohydrates, and avoid fatty foods. Try to avoid eating during short trips. For longer trips, sip drinks and eat light, small meals and snacks. Encourage kids to look outside the car, rather than inside. They should focus 70 Medical Tourism Oct. - Dec. 2017

on still objects — not moving ones (like other cars) — or a distant point.

Meats and fish should be well cooked and eaten just after preparation.

Keep the window open a little to allow fresh air to circulate.

Avoid food from street vendors.

Use a headrest to minimise head movement. Make frequent stops, if possible, at places like rest stops and parks. And if your child complains of feeling sick and it’s safe to stop, a short walk for some fresh air might help. Diarrheas Diarrhea and other stomach problems can be common during travel. Often, they’re caused by bacteria or other germs entering the digestive tract, usually from contaminated food or water. Diarrhea is especially a problem for young kids and babies, who can become dehydrated more quickly than adults. Water in many developing countries isn’t treated in the same way as water supplies in developed nations and may contain bacteria, viruses, and parasites. Take precautions to ensure the water is safe: Consider drinking only bottled water when traveling. Fresh fruits and vegetables should be cooked or washed well and peeled.

Be prepared When you pack, include any medicines and other medical supplies you and your family use regularly because they may be hard to find at your destination. Don’t forget inhalers, allergy medication, and insulin, if needed. Other items you might want to pack: over-the-counter (OTC) pain reliever a small first-aid kit that includes antiseptic, antibiotic ointment, bandages, and other OTC medications your doctor may recommend Do some research before your trip to find the hospital or medical care facility closest to your destination.Before you leave, consider asking your doctor for other information about how to protect your family from illness and injury during travel. This advance planning can help make sure that when the time comes, all you’ll have left to do is relax and enjoy your vacation. MT Desk. Source: Kidshealth/ MedlinePlus Centers for Disease Control and Prevention

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Medical Tourism medical insurance

Insurance:

Key to worriless medical treatment

Medical tourism across the world is fast changing from a market of underinsured or uninsured patients, to one of wider scope and accessibility. A much larger population is now getting insured. Even then people wake up to the need to have insurance cover only when they fall sick or become invalid. By T K V Mani

72 Medical Tourism Oct. - Dec. 2017

he need to have an insurance cover becomes a compelling need when the reality strikes. Money that is needed for hospitalisation and treatment may not come easily for the uninsured. Relatives and friends may turn their faces away. Very often they desert you. However wealthy you are, if there is no cash in the pocket you are driven to desperation, unless of course you have an insurance cover. In case you get afflicted with multiple health problems, insurance comes to your need. Remember all of us are vulnerable to diseases and medical emergencies. it is, therefore, wise to take adequate health cover, Any untoward things could happen in life, any time. Even a â&#x20AC;&#x2DC;healthyâ&#x20AC;&#x2122; person can fall sick unexpect-

provide their patients treatments at rates that are strikingly low under various insurance packages. These not only cover the medical costs but also travel expenses of the patient as well as that of the person travelling with the patient. Many international health insurance firms not only cover expenses but also travel, accommodation and other charges. In short, taking adequate insurance cover is more like a holiday package for the patient and his/ her attendant. A report by global consultancy company McKinsey & Co says insurers have started providing travel medical insurance. Annually around 500,000 to 700,000 Americans travel overseas for surgeries. It is estimated that the money spent on treatments abroad could reach $20 billion yearly. This is why they encourage people to go abroad for medical treatment. Another reason is the quality of the service and facilities that are available abroad are world-class. It is an accepted fact that Asian countries, such as India, Malaysia, Thailand, Singapore and South Korea provide medical treatments to overseas patients at costs that are highly competitive when compared to the healthcare services in the West. A heart-bypass surgery, which costs approximately $130,000 in the US can be done in India for a fraction of it, somewhere around $ 6,650.

edly or become a victim of accident. It is then that one regrets not having medical insurance. The ever changing busy lifestyles and food habits point to the need to protect your health. Anything can happen any time. Life is unpredictable. At a time when hospital expenses and medicine costs are sky rocketing, you realise the benefits of health insurance. For those who frequently travel abroad international health insurance is a must. It should be understood that all countries have highly reputed insurance providers â&#x20AC;&#x201C; be it government owned or in the private sector. Many governments, especially in Europe and the US, encourage their citizens to take medical insurance in

order to seek treatment abroad, especially in countries like India, Malaysia, Thailand and Singapore, where the services are at par with those available back home and at comparatively cheaper rates. The surge in interest in taking health insurance cover is encouraging competition among the service providers. The result is competitive pricing that is beneficial to the customers. Medical tourism, which was earlier a sector of low insurance coverage, is facing buoyancy. Insurance firms are going through a complete makeover. New products and competitive pricing are being offered to lure travellers.

While some insurance companies are partnering directly with hospitals, many are looking to have tie-ups with medical tourism facilitators. An insurance cover will commence from the time the patient leaves home for the trip and is valid till he/she returns home. If the patient is unable to return before the scheduled date for reasons beyond his/ her control, which are not related to the treatment, the insurance cover will be extended for up to 21 days without any extra charges. So whether you are hit by the travel bug or looking for high quality medical services abroad, remember to have adequate insurance cover. Enjoy tension-free holidays.

Insurance providers work closely with internationally reputed hospitals to

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Aster DM Healthcare Limited is proposing, subject to receipt of requisite approvals, market conditions and other considerations, to make an initial public offer of its Equity Shares and has filed the DRHP with SEBI on June 24, 2016. The DRHP is available on the Goldman Sachs (India) Securities Private Limited at www.investmentbank.kotak.com, www.dspml.com and www.goldmansachs.com and the Book Running Lead Managers at www.edelweissfin.com, www.icicisecurities.com, www.jmfl.com and www.sbicaps.co decision. This announcement has been prepared for publication in India and may not be released in the United States. This announcement is not an offer to sell or a solicitation of any offer to buy securities of our company in the United States. The Equity Share from, or in a transaction not subject to, the registration requirements of the U.S. Securities Act and applicable state securities laws. The Equity Shares have not been and will not be registered, listed or otherwise qualified in any other jurisdiction outside India an will only be offered and sold (i) in the United States to â&#x20AC;&#x153;Qualified Institutional Buyersâ&#x20AC;? (as defined in Rule 144A under the US Securities Act in transactions exempt from the registration requirements of the US Securities Act and (ii) outside the United States in com

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Medical Tourism City profile

The Garden City calls the shots for flourishing medical tourism By Sunil Nair

edical tourism- the concept of travelling across borders for better medical treatment- has become very popular in recent times, thanks to globalization, technological advancements, availability of information and ease of connectivity.

According to a report by KPMG, India ranks among the first three countries in Asia to have developed strategies specifically as the ideal Medical Tourism destination. Medical tourism is a growing sector in India. In October 2015, Indiaâ&#x20AC;&#x2122;s medical tourism sector was estimated to be worth US$3 billion. It is projected to grow to $7â&#x20AC;&#x201C;8 billion by 2020.Advantages of medical treatment in India include reduced costs, the availability of latest medical technologies and a growing compliance on international quality standards, doctors trained in Western countries, including the US and UK, 76 Medical Tourism Oct. - Dec. 2017

as well as English- speaking personnel and Good and Hygienic food. The Medical Tourism Market Report: 2015 found that India was having one of the lowest cost and highest quality of all medical tourism destinations and

that it offers a wide variety of procedures at about one-tenth the cost of similar procedures in countries like the United States. Bengaluru, the capital of the South Indian State of Karnataka also known as

the Silicon Valley of India, is a popular tourist destination and attracts millions of tourists from around the world. Bengaluru is also a major place of interest for Medical Tourists and has seen an inflow of thousands of Overseas Patients during the past few years since the tourists also get the opportunity to explore the cultural, historical, and natural beauty of the country. Some of the popular tourist places to visit in Bengaluru are Vidhana Soudha, Lal Bagh, Bannerghatta Park, Tipu Sultan’s Summer Palace, Cubbon Park, Visvesvaraya Industrial and Technological Museum, Chowdiah Memorial Hall etc. Other interesting places within a day’s travel from Bengaluru include Ramanagara, Nandi Hills, Skandagiri Trek, Bheemeshwari, Kunti Betta Trek, Mysore, Yelagiri and B R Hills. Of late, tourists have lessened their sight -seeing trips in the city as they prefer to stay indoors in good Home Stay facilities. This trend is broadly referred to as Experimental Tourism. These Home Stays are eco-friendly and the tourists prefer this along with the food prepared at such Home Stays. The reason for the spurt in Medical Tourism centres round availability of a number of World- Class Medical facilities and world- renowned doctors trained in the top- class medical schools of the world. Many hospitals of the city also have international accreditation. The connectivity of the city by

air to major airports of the world is yet another reason. Medical tourism is a growing phenomenon in the city which is now catching up with the metros like Chennai, Mumbai and New Delhi. The city has the advantage of being a well-known destination in the world, thanks to the Outsourcing Industry there. To add to the Garden City’s beauty, the weather is very pleasant round the year and appeals to the visiting Medical Tourists. With its cosmopolitan life-style and rapid technological advancements, Bengaluru has always been popular among a majority of globe trotters. Now, Medical Tourists have also begun to throng this beautiful city for treatment. They get the opportunity to consult many eminent doctors and also doctors from other countries who offer

consultancy at the city’s hospitals. Hospitals have been competing with each other to provide customized services and facilities to the tourists from other countries. The fast life of the city and the friendly nature of the residents ensure the tourists an enjoyable stay. It is no wonder then that Bengaluru has been the hub of Healthcare since the British era. With the growth in the city’s population, many hospitals have expanded their services, thereby capitalizing on the opportunities. Alternative systems of therapy like Ayurveda and Yoga are also available in the city. The facilities have also ensured that the treatment packages offered are not very expensive. Most tourists come here for Cancer care, Organ transplants, Cardiac care, and problems related to Nephrology,

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from select countries was also instituted which allows foreign nationals to stay in India for 30 days for medical reasons. In 2016, citizens of Bangladesh, Afghanistan, Maldives, Republic of Korea and Nigeria availed the bulk of medical visas. A number of hospitals have hired language translators to make patients from Balkan and African countries feel at home while at the same time helping in the facilitation of their treatment.

Urology, Neurosurgery and Orthopaedics, in addition to Cosmetic and Dental Procedures. Statistics show that Bangladesh, Iraq, Yemen, Maldives, Oman, Mauritius, Tanzania, Kenya, Nigeria and Indonesia are the top 10 countries from which the city hospitals receive maximum number of patients. The cost of treatment in Bengaluru is lesser than in Singapore, Europe and the US, and the quality of care is said to be better. Patients from other countries come for needs ranging from general surgeries to joint replacements, and from neurosurgery to complex tertiary care procedures like paediatric cardiac surgeries and organ transplants. The city was in the limelight last year when there was news about the Afghan woman, Sharbat Gula, the iconic face of refugee struggle made famous by National Geographic, planning to come to India for treatment of Hepatitis C.This disease was not very common in the city but was recorded more in places like Punjab. The treatment was available only from April 2016. Until 1985, the infection was not known even to many doctors .Sources point out that before April this year, Hepatitis C was treated with the combination of a drug called Ribavirin and an injection called Interferon but success rate was comparatively low. In April, after Indian drug- manufacturing units got the patent for producing direct-acting agents, the mode of treatment for the infection has changed dramatically. While the total cost of the treatment by the use of these drugs elsewhere would go up to Rs 1 crore, in India the treat78 Medical Tourism Oct. - Dec. 2017

ment is covered with a very low cost. This disparity in the cost of treatment brought about a revolution in Medical Tourism in India. Tourists from Pakistan and Bangladesh are also coming to Bengaluru. Most Bangladeshis were earlier travelling to Kolkata, which was very close to their country. Medical tourism is largely promoted by the Ministry of Tourism, both at the State and Central Government levels. Advocacy initiatives brought forward by the Ministry include hospital accreditation schemes, revising and extending medical visas, and featuring Medical Tourism in the international Incredible India Campaign. The Government of India has also also chipped in, promoting medical tourism through various ways like the introduction of a National Health Policy in 2002, framing of the Statutory Regulations and Standards to Healthcare Providers (National Accreditation Board for Hospitals and Healthcare Providers), creating the Department of AYUSH for the Complementary and Alternative Medicines and Treatments, initiating the Marketing Development Assistance Scheme for Travel Agents to promote Medical Tourism and encouraging the Public-Private Partnership initiatives through the 11th Five Year Plan and issue of Medical Visa up to one year, which can be extended for a further period of one year. The government removed visa restrictions on tourist visas that required a twomonth gap between consecutive visits for people from Gulf countries and this has also boosted Medical Tourism. A visa-on-arrival scheme for tourists

Besides treatment, patients on the road to recovery and care-takers also get to go on sight-seeing or package tours with help from the Medical Tourism Operators. Many hospitals are now offering Service Apartments to Overseas Patients and the charges are less than what the normal Service Apartments would cost in other places of the city.Several private hospitals have also tied up with governments of other countries. Besides overseas patients, a sizeable number of patients come from within India. Medical Tourism Operators have now tied up with many hospitals both in the city and in other places of India. They take care of the selection of hospital treatment, travel, accommodation and follow-up camps in the patientâ&#x20AC;&#x2122;s country. India issued more than 1.78 lakh medical visas in 2016, including those for follow- up treatment, as against 1.22 lakh in 2015. The Medical Tourism Facilitators of India are doing very well and have been able to attract many Medical Tourists to India. They only need to be wary of Global Political and Security situations; Domestic Unrest and Epidemics, say Sources in the Industry.

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Medical Tourism developing trends

EMERGENCY MEDICAL SERVICES: INDIAN PERSPECTIVE Emergency Medical Services (EMS) is fast becoming an important segment of Medical profession unlike olden days. Many hospitals in cities have well equipped trauma care centres which can handle the most critical patients. Many hospitals in India are taking initiative in the training of paramedics as well as educating the rural population. Scope in India “Sky is the limit” as far as EMS is concerned in India which is evident from the entry of almost all known companies into medical insurance. Air Ambulance has become an efficient link in the complete process of EMS in India whereby patients from interior parts of the country could reach the cities with good hospitals in time for treatment. More and more people are becoming aware of the “golden hour” concept wherein a patient has better chances of survival in case proper medical care is made available in the first hour. A new dimension to this aspect is that in case a patient cannot reach the places of proper medical care during golden hour, the same can be extended if the medical team reaches the patient within the first hour. Emergency Medical Services Emergency Medical Services (EMS) provide critical medical care to patients who otherwise cannot transport themselves, from far away from the hospitals right from the occurrence sites, through transportation by ground or air ambulance to the most specialised hands at the best of hospitals without wastage of time. All efforts are diverted to get the medical care in the “golden hour” so that chances of survival are maximum. The goal of most emergency medical services is to either provide treatment to those in need of urgent medical care, with the goal of satisfactorily treating the presenting conditions, or arranging 80 Medical Tourism Oct. - Dec. 2017

for timely removal of the patient to the next point of definitive care. The term emergency medical service evolved to reflect a change from a simple system of ambulances providing only transport, to a system in which preliminary medical care is given on scene and during transport. In some developing regions, the term is not used, or may be used as medical care inaccurately, since the service in question does not provide treatment to the patients, but only the provision of transport to the point of care. Status of EMS in India India is the biggest unexplored market for EMS since it is the second most populous country in the world. We do not have a centralised body which needs to regulate the training and operations of EMS. Many People are not aware of the numbers to be called in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models which exist with wide variability in their dispatch and transport capabilities.

Air ambulance & helicopter emergency medical services During the last year, Directorate General of Civil Aviation (DGCA), regulatory body in India for civil aviation had taken initiative to issue govt policy on EMS as Civil Aviation Requirement (CAR). Orders are elaborate and quite friendly for the EMS to be functioning without any hitch. Subsequent to the same orders, “Aviator’s Air Rescue” Company based in Bengaluru acquired three helicopters for the air ambulance. Telangana is in the final stages of acquisition of twin engine helicopters for HEMS. Transfer of “Organs” from one hospital to another hospital have become a regular affair through air ambulance. Many businessmen are planning to invest in Air Ambulance Services along with high-tech ground ambulances. Good hospitals with trauma care centres supported by motivated ground & air ambulance team can surely reduce the fatality rate in the years to come.

‫شارب سايت‬ ‫(مجموعة من مستشفيات العين)‬

‫عين من‬ ‫رعاية ال‬ ‫مية لكل‬ ‫جة العال‬ ‫الدر‬ ‫ي مكان‬ ‫حد من أ‬ ‫وا‬

‫من كبار السن إلى الشباب‪،‬‬ ‫رؤية صحية للجميع‬ ‫رحيم‬

‫‪‬‬

‫بأسعار معقولة‬

‫‪‬‬

‫مركزية للمريض‬

‫الخدمات‬ ‫• فحص شامل للعيون • جراحة استئصال الساد بالجرعات الدقيقة • جراحة الساد فيمتو الروبوتية‬ ‫• الليزك بدون فيمتو • الليزك ‪ /‬الليزك بدون اللمس (إل زالة النظارات) • خدمات الشبكية‬ ‫• الزرق • أوكولوبالستي واألورام • البصرية والصيدلة‬ ‫اسأل خبرائنا لمزيد من التفاصيل‪ :‬هاتف‪91 - 8588861296 ,91 – 11 – 30051818 :‬‬ ‫أ – ‪ ،15‬سواسثيا فيهار‪ ،‬مقابل عمود مترو رقم ‪ ،82‬فيكاس مارغ الرئيسي ‪ ،‬بريت فيهار‪ ،‬نيودلهي‪.‬‬

‫دلهي ‪ /‬والية اوتار براديش ‪ /‬نيجيريا ‪ /‬طاجيكستان ‪ /‬ميانمار ‪ /‬منغوليا‬ ‫‪81‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫وهي تشمل‪:‬‬ ‫التدخين‬ ‫مدمن كحول‬ ‫تعاطي المحذرات‬ ‫الضغظ العاطفي‬ ‫البدانة‬ ‫الخصيات المحمومة‪ ،‬والتي تمكن أن تقتل‬ ‫الحيوانات المنوية‪ .‬ويمكن أن يحدث هذا‬ ‫من االستخدام المتكرر للحوض الساخن أو‬ ‫ارتداء المالبس الداخلية أو السراويل الضيقة‬ ‫جدا‪.‬‬ ‫عالج العقم عند الذكور‬ ‫يمكن تصحيح أكثر من نصف حاالت‬ ‫العقم لدى الذكور‪ .‬تعتمد خيارات العالج‬ ‫على السبب الجذري ‪ .‬يمكن للطب أن‬ ‫يتم تحسين مستويات الهرمون أو ضعف‬ ‫االنتصاب ‪ .‬ويمكن للجراحة أن تساعد‬ ‫في تصحيح المشاكل الجسدية مثل دوالي‬ ‫الخصية‪ .‬كما يمكن إصالح االنسداد أو‬ ‫األضرار األخرى‪ .‬غالبا ما تكون الجراحة‬ ‫قاصرة ويتم ذلك كإجراء للمرضى الخارجيين‬ ‫العيش بعقم الذكور‬ ‫ليس هناك دائما عالج لعقم الذكور‪ ،‬قد‬ ‫ال يساعد العالج أو ال يزال الزوجان غير‬ ‫قادرين على الحمل عن طريق العالقة‬ ‫الجسدية‪ .‬وفي هذه الحالة قد يقترح الطبيب‬ ‫خيارات أخرى إلنجاب طفل‪ ،‬يمكن أن تشمل‬ ‫العالجات المساعدة على العالج اإلنجابي‬ ‫التلقيح داخل الرحم (‪ )IUI‬يتم جمع النطفة‬ ‫المنوية للرجل إو�دراجها في رحم المرأة‪ .‬ويتم‬ ‫‪.‬‬ ‫هذا اإلجراء في وقت اإلباضة‬

‫يكون سبب العقم عند الذكور غير معروف‬ ‫أحيانا‪ .‬في هذه الحاالت قد يكون وراثيا أو‬ ‫نمط الحياة أو العوامل البيئية‪.‬‬

‫المنوية وجودتها‪ .‬وهذه هي الجوانب الهامة‬ ‫للخصوبة‪ .‬ويقوم الطبيب باختبار آخر هو‬ ‫فحص مستويات هرمون للمريض‪.‬‬

‫ّ‬ ‫تشخص العقم عند‬ ‫كيف يتم‬ ‫الذكور؟‬

‫هل يمكن منع العقم عند‬ ‫الذكور أو تجنبه؟‬

‫وفي شأن معظم الرجال يساعد الطبيب أن‬ ‫ييكتشف سبب العقم‪ .‬قد تكون مشكلة ذات‬ ‫صلة صحية‪ .‬سيقوم الطبيب بإجراء فحص‬ ‫ومراجعة طبية بالمريض‪ ،‬سوف يخبر‬ ‫تحليل السائل المنوي عن عدد الحيوانات‬

‫ال يمكن للمرء أن يمنع دائما العقم عند‬ ‫الذكور‪ .‬ومع ذلك هناك عوامل يمكن أن‬ ‫تؤثر على هذه الحاالت التي يجب تجنبها‪،‬‬

‫اإلخصاب في المختبر (‪ )IVF‬هذه التقنية‬ ‫أكثر تعقيدا‪ .‬يتم تخصيب النطفة المنوية‬ ‫للرجل وبيض المرأة في المختبر ثم يتم‬ ‫زرعه مرة أخرى في رحم المرأة‬ ‫العالجات ‪ ART‬غالبا ما تكون فعالة ولكنها‬ ‫ليست مضمونة‪ .‬إذا كان الرجل ال يمكن‬ ‫أن ينتج النطفة المنوية قد يبحث الزوجان‬ ‫عن المتبرع للنطفة المنوية‪ .‬وبعض الناس‬ ‫يفكرون في التبني بدال من عالجات ‪ART‬‬ ‫أو إذا كانت عالجات ‪ ART‬غير ناجحة‪،‬‬ ‫مكتب السياحة الطبية‪ ،‬المصدر‪ ::‬المعهد الوطني لصحة الطفل‬ ‫والتنمية البشرية‪ ،‬مدلين بالس‬

‫‪82 Medical Tourism Oct. - Dec. 2017‬‬ ‫‪27‬‬

‫السياحة الطبية‬

‫العقم عند الرجال‬ ‫العقم يعني عدم القدرة على إحداث الحمل بعد عام من المحاولة‪ .‬إذا كانت المرأة تمكن‬ ‫الحمل ولكن ال تزال على اإلجهاض أو اإلمالص وهذا ما يسمى أيضا العقم‪.‬‬

‫العقم هو مشكلة شائعة‪ .‬وبعد عام من‬ ‫الجماع المستمر دون المحمي اليسيطيع‬ ‫حوالي ‪ 15‬في المائة من األزواج على‬ ‫الحمل‪ .‬ويمكن تتبع حوالي الثلث من العقم‬ ‫إلى المرأة‪ .‬وفي الثلث األخرى من الحاالت‬ ‫يكون بسبب الرجل‪ .‬والبقية من الحالت هي‬ ‫بسبب كل من الشركاء أو لم يتم اكتشاف‬ ‫أي سبب‪ .‬هناك عالجات خاصة للرجال‬ ‫أو للنساء‪ .‬وبعضها يشمل كال الشريكين‪.‬‬ ‫العقاقير والتكنولوجيا المساعدة اإلنجابية‬ ‫والعملية الجراحية هي العالجات الشائعة‪.‬‬

‫‪83‬‬ ‫‪26‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫نظرة على ما يسبب العقم عند‬ ‫الذكور‬ ‫السبب المهم لشيوع عقم الذكور هو دوالي‬ ‫الخصية‪ .‬يحدث هذا عندما يكون لديك‬ ‫األوردة الموسعة في كيس الخصيتين‪ .‬هذا‬ ‫هو كيس الجلد الذي يعلق وراء األعضاء‬ ‫ال ّذكرية‪ .‬يمكن أن يحدث دوالي الخصية‬ ‫على جنب واحد أو كال الجانبين‪ .‬فإنه يجعل‬ ‫داخل كيس الخصية أدفأ‪ ،‬مما يقلل من إنتاج‬ ‫النطفة المنوية‪ .‬يمكن أن يكون العمر أيضا‬ ‫عامال‪ .‬تبدأ الخصوبة تنخفض في الرجال‬ ‫بعد سن ‪.35‬‬

‫تشمل األسباب األخرى‪:‬‬ ‫انسداد في الجهاز التناسلي‬ ‫خصيات غير نازلة‬ ‫قلة عدد الحيوانات المنوية‬ ‫الحيوانات المنوية بشكل غير‬ ‫طبيعي أو ال تتحرك بشكل صحيح‬ ‫مشاكل هرمون‬ ‫بعض الظروف الصحية‪ ،‬مثل السرطان‬ ‫بعض األدوية‬ ‫العدوى أو مرض منقول جنس ّيا (‪)STD‬‬ ‫ضعف االنتصاب‬

‫مستشفى كونتيننتال‬ ‫مرفق غيلن إغلز‬

‫معتمد بمسرح العملية الحضراء‬

‫جائزة لمركز للخدمات‬ ‫الرائعة لسنة ‪ 2016‬م‬ ‫في مؤتمر السياحة الطبية الهندية‬ ‫الدولية الثالث (‪IIMC‬‬

‫جائزة التفوق في خدمات‬ ‫الوطنية في الرعاية الصحية‬ ‫من منظمة التربية والتعليم وتطوير‬ ‫الموارد البشرية ‪2015 & 2014‬‬

‫جائزة للعيادة الرائعة في طب‬ ‫الطوارئ‬ ‫جمعية لطب الطورئ في الهند‬

‫رائد أول في الهند للطاقة و‬ ‫التصميم البيئي‬ ‫مستشفى التخصصات الرائعة في‬ ‫الهند مؤهل ب ليد (‪)LEED‬‬

‫جائزة لمستشفى الحضراء‬ ‫للسنة‬ ‫مؤتمر و جائزة لألعمال الحضراء في‬ ‫الهند ‪2014‬م‬

‫جائزة للخدمات الرائعة في‬ ‫رعاية الطب‬ ‫في مؤتمر ومعرض الهند العالميي لرعاية الطب ‪،2014‬‬ ‫‪2015‬‬

‫جائزة لمركز الخدمات الرائعة‬ ‫لسنة ‪2016 -2015‬‬ ‫في الجمعية الدولية اآلسيوية والمحيط الهادئ الثامنة‬ ‫لمكافحة العدوى‬

‫توفيض لمسرح العملية الحضراء‬ ‫المستشفى الثاني في تيلونغانا و‬ ‫الثالث في تيلونغانا ووالية أندرا براديش مجتمعة بالمستشفى‬ ‫المعتمد لمسرح العملية الحضراء‬

‫‪84 Medical Tourism Oct. - Dec. 2017‬‬

‫مستشفيات كونتيننتال جزء من مجموعة بارك وي بانتي المحدودة و تابعة بالكامل ل أي أتش أتش للرعاية الصحية برهاد‪ .‬أي‬ ‫أتش أتش للرعاية الصحية هي حامل درجة مجموعة الرعاية الصحية الثانية الكبيرة في العالم بالقيمة السوقية مع العمليات‬ ‫في ‪ 9‬أوطان حول العالم بشبكة ‪ 49‬مستشفى مع ‪ 10000‬من سرير‪ .‬إنها تقدم مجموعة كاملة من خدمات الرعاية الصحية‬ ‫المتكاملة من العايدة إلى المستشفيات مع رعاية رباعية ومجموعة واسعة من الخدمات المساعدة شامل بالتعليم الطبي‬

‫‪ 7*24‬وحدة الطوارئ عند الصدمة‬

‫أكثر من ‪ 28‬تخصصات‬

‫مجهز بالكامل بوحدة العناية المركزة‬

‫الغرف المكونة بالتقنية المتقدمة لمسرح العمليات‬

‫‪ 5‬أجنحة خاصة‬

‫مركز زراعة األعضاء‬

‫‪85‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫طب األسنان‬

‫‪ 750‬سرير‬

‫الغرف للوالدة تحت الماء‬

‫طب أمراض‬ ‫الجهاز الهضمي‬

‫طب العظام‬

‫طب األعصاب‬

‫طب العظام‬

‫طب األورام‬

‫مستقبل الرعاية الصحية المتقدمة و‬ ‫بأسعار معقولة‬

‫أبرز المالمح لدينا‪:‬‬

‫< جراحة السمنة‬ ‫<‬

‫‪RFA‬‬

‫لداء الدوالي‬

‫< جراحة دباسة للبواسير‬ ‫< عالج الناسور الشرجي‬ ‫بمساعدة الفيديو‬ ‫< جراحة شق اللفة‬ ‫الواحدة‬ ‫< الجراحات العامة‬ ‫والمناظير المتقدمة‬

‫مستشفى لوردز هو مركز طبي بالتخصصات الفائقة مع مرافق‬ ‫جراحة ثقب المفتاح المتقدمة‪ .‬وبفضل التسهيالت المتطورة‬ ‫إلجراء عمليات جراحية قصيرة ‪ ،‬يوفر المركز الذي تم تأسيسه‬ ‫في بداية األلفينات الجديدة خدمات صحية عالية الجودة يمكن‬ ‫الوصول إليها في بيئة مركزة ورعاية‪ .‬يقع بالقرب جدا من‬ ‫الطريق السريع الوطني االلتفافي في تيروفنانثابورام‪ ،‬يمكن‬ ‫الوصول إلى المستشفى بسهولة من محطة سكة حديد بيتا‬ ‫ومطار تيروفنانثابورام الدولي‪ .‬ميزة فريدة لمستشفى لوردز‬

‫خدمة‬ ‫الرعاية الحرجة‬

‫مستشفى لوردز‬

‫صحتكم العاطفة لدينا‬ ‫تشاكاي‪ ،‬البريد‪./‬أنايارا‪ ،‬تريفاندروم ‪ ، 695 029 -‬كيراال‪ ،‬الهند‬ ‫هاتف‪+91-4713045111 :‬‬

‫البريد اإللكتروني‪Iords@lordshospital.org :‬‬

‫الموقع‪www.lordsh0spital.0rg :‬‬

‫‪86 Medical Tourism Oct. - Dec. 2017‬‬

‫• أي ألم عن لمس أو الضغط على البروستاتا وقد يطلب منكم‬ ‫إحضارعينة من البول لالختبار‪ .‬قد يقوم طبيبكم أيضا بإجراء فحص‬ ‫الدم للتحقق من مستوى مستضد البروستاتا (‪ )PSA‬يمكن أن‬ ‫تكون مستويات (‪ )PSA‬مرتفعة في الرجال الذين يعانون من غدة‬ ‫البروستاتا الموسعة أو مع سرطان البروستاتا ‪.‬قد تحتاج أيضا إلى‬ ‫اختبار الموجات فوق الصوتية التي تأخذ الصور الكمبيوتر من‬ ‫البروستاتا‪.‬‬ ‫إذا أظهرت االختبارات أنك قد تكون مصابا بالسرطان‪ ،‬فسيقوم طبيبك‬ ‫بإحالتك إلى أخصائي (طبيب المسالك البولية) لخزعة البروستاتا‪.‬‬ ‫سوف يأخذ الطبيب عينات األنسجة الصغيرة من عدة مناطق من‬ ‫غدة البروستاتا للبحث عن الخاليا السرطانية‪.‬‬ ‫عالج سرطان البروستاتا‬ ‫يعتمد عالج سرطان البروستاتا على ما إذا كان السرطان في جزء‬ ‫من البروستاتا أو كلها‪ ،‬أو إذا انتشرت إلى أجزاء أخرى من الجسم‪.‬‬ ‫كما يعتمد أيضا على عمرك والصحة العامة‪ .‬تحدث مع طبيبك‬ ‫حول أفضل خيار عالج لك واآلثار الجانبية المحتملة للعالج‪ .‬وينبغي‬ ‫أن تطلب من طبيب آخر للحصول على رأي ثاني‬ ‫قد يكون عالج سرطان البروستاتا‬ ‫االنتظار الحذر‪ ،‬وتسمى أيضا المراقبة النشطة‪ .‬اذا كان السرطان‬ ‫ال يضرر يمكنك العزم على عدم الحصول على العالج على الفور‪.‬‬

‫إختبار‬ ‫حتى في وقت قريب كان العديد من األطباء يشجعون اختبار ‪ PSA‬سنويا‬ ‫لجميع الرجال الذين هم في بداية من سن ‪ ،50‬أو قبل ذلك في شأن الرجال‬ ‫بخطركثير لإلصابة بسرطان البروستاتا ‪.‬وألن األطباء فهموا عن فوائد وأضرار‬ ‫اإلختبار لسرطان البروستاتا فقد بدؤوا في التحذير عن اختبار ‪ PSA‬السنوي ‪.‬‬ ‫ال ينصح عموما اختبار ‪ PSA‬سنويا في الرجال دون األعراض‪ .‬ومع ذلك‬ ‫في الرجال الذين يبدون عن أعراض البروستاتا‪ ،‬يمكن اختبار ‪( PSA‬مع‬ ‫الفحص المستقيم الرقمي) أن يساعد األطباء في تحديد طبيعة المشكلة‪ .‬إن‬ ‫الرجال الذين هم تحت العالج لسرطان البروستاتا‪ ،‬يمكن استخدام اختبار‬ ‫‪ PSA‬للمعرفة عن إعادة السرطان مرة أخرى‬

‫وبدال من ذلك سيقوم الطبيب يالفحص بانتظام من إجراء تغييرات في‬ ‫حالتك‪ .‬سيبدأ العالج إذا بدأ السرطان في النمو‪.‬‬ ‫العملية الجراحية ‪ :‬النوع األكثر شيوعا من الجراحة إزالة‬ ‫البروستاتا كلها وبعض األنسجة القريبة‬ ‫العالج اإلشعاعي‪ .‬يستخدم هذا العالج األشعاع لقتل الخاليا‬ ‫السرطانية وتقلص األورام‪ .‬قد يأتي اإلشعاع من آلة أشعة سينية أو‬ ‫من كريات مشعة صغيرة توضع داخل الورم أو بالقرب منه‪.‬‬ ‫العالج بالهرمونات‪ :‬الرجال الذين يخضعون لعالجات أخرى‬ ‫مثل العالج اإلشعاعي‪ ،‬يمكن عالجهم أيضا باألدوية المتناع الجسم‬ ‫من صنع تستوستيرون ) هرمون ذكري(‪ .‬يمكن استخدام العالج‬ ‫الهرموني أيضا لسرطان البروستاتا الذي انتشر خارج البروستاتا‪.‬‬ ‫‪87‬‬ ‫‪22‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫بعض المشاكل الشائعة هي‬ ‫• التهاب البروستاتا – االلتهاب وغالبا بسبب البكتيريا‬ ‫• البروستاتا الموسع (‪ -)BPH‬أو تضخم البروستاتا الحميد‪-‬‬ ‫مشكلة شائعة في الرجال األكبر سنا والتي قد تسبب المراوغة بعد‬ ‫التبول أو الحاجة للتبول في كثير من األحيان وخاصة في الليل‬ ‫سرطان البروستاتا‪ :‬وهو سرطان عام يستجيب بشكل أفضل‬ ‫للعالج عند اكتشافه مبكرا‪.‬‬ ‫وصحيح أن مشاكل البروستاتا شائعة بعد سن الخمسين‪ .‬ومن‬ ‫السرور أن هناك أشياء كثيرة يمكنكم القيام بها‪.‬‬

‫وفيما يلي بعض األمثلة على مشاكل البروستاتا‬ ‫غير السرطان‪:‬‬

‫يرجى الرجوع إلى الطبيب فورا إذا كان لديكم أي‬ ‫من هذه األعراض‪:‬‬

‫• تضخم البروستاتا الحميد‪ :‬أو ‪ BPH‬شائع جدا في الرجال األكبر‬ ‫سنا‪ .‬وهذا يعني أن البروستاتا الخاص بكم هو موسع ولكن ليس‬ ‫سرطانا‪ .‬وتشمل العالجات لـ ‪: BPH‬‬

‫المترددة في التبول‬ ‫• الرغبة‬ ‫ّ‬

‫• االنتظار الحذر ويسمى أيضا المراقبة النشطة‪ .‬إذا كانت األعراض‬ ‫ليست سيئة للغاية‪ ،‬قد يخبركم طبيبكم باالنتظار لمعرفة ما إذا كانت‬ ‫تزداد سوءا قبل بدء العالج‪ .‬سيطلب منكم طبيبكم أحيانا للفحوص‬ ‫الطبية‪.‬‬

‫• تحتاج إلى النهوض على ما يصل عدة مرات خالل الليل للتبول‬

‫• الدم في البول أو النطفة المنوية‬ ‫• ألم أو حرق عند التبول‬ ‫• القذف المؤلم‬ ‫• آالم متكررة أو تصلب في أسفل الظهر أوالوركين أومنطقة الحوض‬ ‫أو المستقيم أو الفخذين العليا‬ ‫• التقاطرمن البول‬ ‫سرطان البروستاتا‬ ‫يمكن أن تتأثر فرصتكم في اإلصابة بسرطان البروستاتا من قبل‪:‬‬ ‫• العمر ‪ -‬الرجال بين ‪ 50‬سنة وأكثر عرضة لخطر أكبر‬

‫• المداواة‪ :‬يمكن لألدوية أن تساعد في تقليص البروستاتا أو استرخاء‬ ‫العضالت بالقرب من البروستاتا لتخفيف األعراض‪.‬‬ ‫• العملية الجراحية‪:‬إذا لم يعمل أي شيء آخر‪ ،‬قد يقترح طبيبكم‬ ‫العملية الجراحية للمساعدة في تدفق البول‪.‬‬ ‫• العالجات األخرى‪ :‬وفي بعض األحيان يتم استخدام موجات‬ ‫الراديو‪ ،‬أو الموجات الدقيقة‪ ،‬أو الليزر لعالج المشاكل البولية الناجمة‬ ‫عن ‪ ، BPH‬هذه األساليب تستخدم أنواعا مختلفة من الح اررة للحد‬ ‫من األنسجة البروستاتا اإلضافية‪.‬‬ ‫• التهاب البروستاتا الجرثومي الحاد‪ :‬وعادة ما يبدأ فجأة من عدوى‬ ‫بكتيريا‪ .‬ينبغي مراجعة الطبيب على الفور إذا كان لديكم حمى‬ ‫أوقشعريرة أو األلم باإلضافة إلى أعراض البروستاتا‪ .‬يمكن عالج‬ ‫معظم الحاالت ب مضادات حيوية ‪ ،‬قد تحتاج أيضا إلى أدوية‬ ‫للمساعدة في حالة األلم أو عدم الراحة‪.‬‬

‫• الجنس‪ :‬سرطان البروستاتا هو األكثر شيوعا بين الرجال األمريكيين‬ ‫من األصل األفريقي‪ ،‬يليه الرجال من األصل اإلسباني وثم من‬ ‫األصل المواكنين األمريكيين‪ .‬والرجال اآلسيويين األمريكيين لديهم‬ ‫أدنى معدالت اإلصابة بسرطان البروستاتا ‪.‬‬ ‫• التاريخ العائلي‪ .‬إذا كان والدكو أو أخوكم مصابا بسرطان‬ ‫البروستاتا‪ ،‬فمن المرجح أن يصيب بكم أيضا‪.‬‬ ‫• الغداء‪ :‬قد يكون خطر اإلصابة بسرطان البروستاتا أعلى بالنسبة‬ ‫للرجال الذين يتناولون وجبات غذائية عالية الدهون‪.‬‬ ‫تشخيص سرطان البروستاتا‬ ‫لمعرفة أعراض البروستاتا التي يسببها السرطان فسوف يسألكم‬ ‫الطبيب عن مشكالتكم الطبية السابقة وتاريخ عائلتكم الطبي‪ .‬وسيقوم‬ ‫الطبيب أيضا بإجراء الفحص البدني‪ .‬وأثناء اإلجراء سوف يضع‬ ‫طبيبكم إصبعا بالقفاز في الشرج لفحص البروستاتا للتحقق من‪:‬‬ ‫• حجم وثبات وملمس البروستاتا‪.‬‬ ‫• أي مناطق ثابتة أو مكتلة أو نمو ينتشر وراء البروستاتا‬

‫• التهاب البروستاتا الجرثومي المزمن‪ :‬هو العدوى الذي يعود م اررا‪.‬‬ ‫هذه المشكلة النادرة يمكن أن يكون من الصعب عالجها‪ .‬وفي بعض‬ ‫األحيان قد يستغرق تناول المضادات الحيوية لفترة طويلة‪ .‬ينبغي أن‬ ‫تتكلم مع طبيبكم عن إجراءات أخرى يمكنكم القيام بها لمساعدتكم‬ ‫على الشفاء‪.‬‬ ‫• التهاب البروستاتا المزمن‪ :‬ويسمى أيضا متالزمة آالم الحوض‬ ‫المزمنة‪ ،‬يمكن أن يسبب األلم في أسفل الظهر أو في الخاصرتين أو‬ ‫في طرف القضيب‪ .‬قد يتطلب العالج إلى مزيج من األدوية والجراحة‬ ‫وتغيير نمط الحياة‪.‬‬ ‫التنسى ان تتحدث مع طبيبكم حول اآلثار الجانبية المحتملة للعالج‪-‬‬ ‫عالمات مشاكل البروستاتا‬ ‫‪88 Medical Tourism Oct. - Dec. 2017‬‬ ‫‪21‬‬

‫مشاكل‬ ‫البروستاتا‬ ‫مرض القلب هو واحد من األسباب الرئيسية للموت في جميع أنحاء العالم‪ .‬ويصف من‬ ‫المشاكل العديدة المتعلقة بتراكم الصفيحة في جدران الشرايين وتصلب الشرايين‬ ‫وعدم انتظام ضربات القلب أو مشاكل لصمام القلب‪ .‬تشمل أنواع أمراض القلب مرض‬ ‫الشريان التاجي واعتالل عضلة القلب والقلب الموسع والنوبات القلبية والرجفان األذيني‬ ‫ومرض صمام القلب وأمراض القلب الخلقية وأمراض عضلة القلب التهاب التامور وانصباب‬ ‫التامور ومتالزمة مارفان ومورم القلب‬

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‫‪A Complete Magazine on Healthcare in Asia‬‬

‫احضار‬

‫الرعاية الصحية‬

‫المتقدمة في متناول اليد‬ ‫كان عمر شرين إحدى عشر شهر (تغيرت اإلسم)‪.‬عندما تم تشخيصها‬ ‫بهيموفاغوسيتيك ليمفوهيستيوسيتوسيس (‪ ,)HLH‬حالة مميتة‪ .‬وكانوا يبحثون عبثا‬ ‫عن العالج حتى سمعوا عن نارينا للرعاية الصحية‪.‬‬ ‫يحتاج زرع نخاع العظم إلى اإلجراء الذي كان لنارايانا للصحة خبرة واسعة فيه‪ ،‬ولكن‬ ‫كانت هذه الحالة معقدة‪ ،‬كما كانت شرين صغيرا في العمر‪ ،‬وكان المتبرع المطابق‬ ‫الوحيد شقيق لها يبلغ من العمر ‪ 8‬أشهر‪ .‬وفي حين ان الآلباء في كآبة عميقة‪ ،‬كان‬ ‫ّ‬ ‫وملطفا خوا ئفهم‪ .‬كانت عملية الزرع ناجحة‪ .‬تم‬ ‫فريق الخبراء في المستشفى واثقا‬ ‫شفاء شرين في حين أصبح شقيقها أصغر المانحين لزرع نخاع العظم من أي وقت‬ ‫مضى في الهند‪.‬‬ ‫هذه ليست سوى واحدة من العديد من قصص النجاح التي قمنا بتدوينها في ناراينا‬ ‫للصحة‪ ،‬واحدة من أكبر شبكات المستشفيات في الهند ورائدة في توفير الطراز‬ ‫العالمي‪ ،‬والرعاية بأسعار معقولة‪ .‬منذ عام ‪ ،2000‬كنا في الصدارة أمام التميز الطبي‬ ‫في الهند‪ ،‬و مستشفياتنا أحدث و المحترفين المجربين طبيا يوفر الرعاية الراقية أكثر‬ ‫من ‪ 30‬تخصصات طبية؛ يضمن أن القصص مثل شرين لديها نهاية سعيدة‪ .‬و األمر‬ ‫العجيب لما نفكر عن الميزة في الرعاية الطبية يتم إختياركم على نارينا للرعاية الصحية‪.‬‬

‫ناراينا للصحة‬ ‫الصحة لجميع‪ ،‬الجميع للصحة‬

‫‪90 Medical Tourism Oct. - Dec. 2017‬‬

‫فائدة ناراينا‬

‫(تجربة ال مثيل لها)‬ ‫• ‪ 23‬من المستشفيات و ‪ 7‬مراكز للقلب في جميع أنحاء الهند‬ ‫و المستشفى الدولي في جزر كايمان‪.‬‬ ‫• أكثر من ‪1400‬طبيبا‬ ‫• أكثر من ‪30‬تخصصات طبية‬ ‫• ‪ 13‬من المستشفيات معتمدة من قبل ‪ NABH 3‬من قبل‬ ‫موثوقة بها من قبل المرضى‬ ‫• أكثر من مليونين‬

‫‪JCI‬‬

‫من المرضى تم معالجتهم في عام ‪2016‬‬

‫• أكثر من ‪10,000‬من المرضى الدوليين من ‪ 77‬بلدا‬ ‫• فائز " العالمة التجارية للسياحة الطبية للعام"‬ ‫وجوائز‬

‫الصحة الهند والعافية ‪2016‬‬

‫مراكز التميز‬

‫جراحة العظام‬

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‫‪A Complete Magazine on Healthcare in Asia‬‬

‫ي‬ ‫اله ْ‬ ‫ب ِ‬ ‫ضمِ ّ‬ ‫ِط ّ‬ ‫الج َها ِز َ‬

‫ِي‬ ‫ب ِ‬ ‫ِط ُّ‬ ‫الجها ِز ال َبول ّ‬

‫علم األعصاب‬

‫علم األورام‬

‫ب القَ لْب‬ ‫ِط ّ‬

‫رأب الوعاء‪ :‬هذا اإلجراء يفتح الوعاء‬ ‫المسدود باستخدام جهاز يشبه البالون في‬ ‫أضيق نقطة الشريان‪ .‬يمكن للطبيب أيضا‬ ‫إدخال الدعامات وهو أنبوب الفوالذ المقاوم‬ ‫للصدأ الصغير الذي يدعم الوعاء مفتوحا‬ ‫ويأكد من أنها تبقى واضحة‬ ‫استئصال األثير‪ :‬وهذا ينطوي على‬ ‫قطع الصفيحة من الشريان ولذلك يمكن للدم‬ ‫أن يتدفق بحرية‪.‬‬ ‫الجراحة االلتفافية‪ :‬وهذا ينطوي على‬ ‫إخراج الشريان أو الوريد من جزء آخر من‬ ‫الجسم (مثل الذراع أو الساق) واستخدامه‬ ‫لتوجيه الدم حول المنطقة المسدودة في‬ ‫الشريان‪.‬‬

‫أجهزة ضبط نبضات القلب‪ :‬هو‬ ‫جهاز إلكتروني صغير يتم إدراجه داخل‬ ‫الجسم لتنظيم ضربات القلب‪.‬‬ ‫استبدال الصمام‪ :‬إذا كان صمام‬ ‫القلب معطوبا أو ال يعمل‪ ،‬يمكن للطبيب‬ ‫الجراح تبديله‪.‬‬ ‫استئصال باطنة الشريان السباتي‪ :‬خالل هذا‬ ‫اإلجراء يزيل الجراح رواسب الصفيحة من‬ ‫الشريان السباتي لمنع السكتة الدماغية‬ ‫إذا كان هناك شخص تعرفه هو يخضع‬ ‫لواحدة من هذه العمليات فإنك تشعر بالقلق‪.‬‬ ‫والخبر السار هو أن هذه العمليات الجراحية‬ ‫يمكن أن تساعد في منع النوبات القلبية‬ ‫والسكتات الدماغية وغيرها من المشاكل‪.‬‬ ‫سوف تختلف المدة الزمنية التي يحتاج إليها‬

‫الشخص في المستشفى تبعا للعملية وصحة‬ ‫الشخص‪ .‬قد يكون الشخص متعبا ويرتد بعد‬ ‫الجراحة‪ ،‬ولكن يمكنك أن تساعده عن طريق‬ ‫جعل بطاقة "الشفاء" وزيارته‪.‬‬ ‫هل يمكن لألطفال اإلصابة من‬ ‫أمراض القلب؟‬ ‫عادة ال يكون عند األطفال أي أعراض من‬ ‫مشاكل القلب واألوعية الدموية‪ .‬ولكن عن‬ ‫طريق بدء عادات صحة القلب اآلن يمكن‬ ‫لألطفال تقصير فرصة القلق حول مشاكل‬ ‫القلب واألوعية الدموية‪ .‬مكتب ‪.‬السياحة‬ ‫الطبية‪.‬المصدر‪ :‬مدلينبلوس‪ ،‬المعاهد الوطنية للصحة‪ ،‬صحة األطفال‬

‫‪17 Medical Tourism Oct. - Dec. 2017‬‬ ‫‪92‬‬

‫السياحة الطبية‬

‫القلب و‬ ‫أنت‬ ‫مرض القلب هو واحد من األسباب الرئيسية للموت في جميع أنحاء العالم‪ .‬ويصف من‬ ‫المشاكل العديدة المتعلقة بتراكم الصفيحة في جدران الشرايين وتصلب الشرايين‬ ‫وعدم انتظام ضربات القلب أو مشاكل لصمام القلب‪ .‬تشمل أنواع أمراض القلب مرض‬ ‫الشريان التاجي واعتالل عضلة القلب والقلب الموسع والنوبات القلبية والرجفان األذيني‬ ‫ومرض صمام القلب وأمراض القلب الخلقية وأمراض عضلة القلب التهاب التامور وانصباب‬ ‫التامور ومتالزمة مارفان ومورم القلب‬

‫إن أمراض القلب وتسمى أيضا أمراض‬ ‫القلب واألوعية الدموية تؤثر أساسا على‬ ‫كبار السن ويعني أن هناك مشاكل مع‬ ‫القلب واألوعية الدموية‪ .‬ويشمل هذا المرض‬ ‫مجموعة متنوعة من المشاكل بما في ذلك‬ ‫ارتفاع ضغط الدم وتصلب الشرايين وألم في‬ ‫الصدر والنوبات القلبية والسكتات الدماغية‪.‬‬ ‫ما هو مرض القلب؟‬ ‫القلب هو مركز نظام القلب واألوعية‬ ‫الدموية‪ .‬والقلب يضخ الدم إلى جميع خاليا‬ ‫الجسم من خالل األوعية الدموية في الجسم‪.‬‬ ‫يحمل الدم األكسجين الذي تحتاج إليه‬ ‫الخاليا‪ .‬أمراض القلب واألوعية الدموية هي‬ ‫مجموعة من المشاكل التي تحدث عندما ال‬ ‫تعمل القلب واألوعية الدموية بالطريقة التي‬ ‫ينبغي‪.‬‬ ‫‪93‬‬ ‫‪16‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫وهنا بعض المشاكل التي تترافق مع أمراض‬ ‫القلب واألوعية الدموية‬ ‫تصلب الشرايين‪ :‬يسمى أيضا تكتل‬ ‫الشرايين‪ ،‬وتصلب الشرايين يعني الشرايين‬ ‫تصبح مثخنة ولم تعد لينة‪.‬‬ ‫تصلب عصيدي‪ :‬تراكم الكوليسترول‬ ‫والدهون الذي يجعل الشرايين أضيق حتى‬ ‫يمكن تتدفق أقل من الدم من خالله‪ .‬ويسمى‬ ‫هذا تراكم الصفيحة‬ ‫الخناق‪ :‬الناس الذين يعانون من الخناق‬ ‫الصدري يشعرون بألم في الصدر وهذا يعني‬ ‫أن القلب ال يحصل على ما يكفي من الدم‪.‬‬ ‫نوبة قلبية‪:‬عندما يقطع تخثر الدم أو انسداد‬ ‫آخر تدفق الدم إلى جزء من القلب‪.‬‬

‫السكتة الدماغية‪ :‬عندما ال يحصل جزء من‬ ‫الدماغ على ما يكفي من الدم بسبب الجلطة‬ ‫أو انفجار األوعية الدموية‪.‬‬ ‫العالج‬ ‫العمليات الجراحية‬ ‫إذا كان مريض لديه مرض القلب واألوعية‬ ‫الدموية سوف يتحدث الطبيب كيف تساعد‬ ‫قطع التدخين وفقدان الوزن وتناول نظام‬ ‫غذائي صحي والقيام بممارسة التدريب‪ .‬قد‬ ‫يحتاج الشخص إلى تناول الدواء أو إجراء‬ ‫عملية جراحية أو كالهما أيضا‪ .‬وهناك‬ ‫عمليات جراحية مختلفة للقلب واألوعية‬ ‫الدموية‪ .‬وهذه تشمل‪:‬‬

‫إيالكيزي‬

‫بونارنافا‬ ‫آيورفيدا‬

‫كاتي فاستي‬

‫العناية الدقيقة • عالج األيورفيدا‬

‫إن األيورفيدا علم الحياة‪ ،‬هو أقدم نظام الرعاية الصحية في العالم‪ .‬قام القديسون العظماء من‬ ‫الهند بالبحوث والدراسة في عمل جسم اإلنسان قبل أكثر من ‪ 5000‬سنة وقاموا بممارسة نظام‬ ‫طبيعي من الطب‪ .‬وقد تم نقل علم األيورفيدا من جيل إلى جيل منذ ذلك الحين‪ .‬على عكس‬ ‫معظم أنظمة أخرى من الطب فإن نهجه ألمراض عديدة هو المشهود بأنه شمولي‪ ،‬وهو ما يعني‬ ‫يتم العالج ليس فقط للجسم ولكن للعقل والروح كذلك‪ .‬يركز األيورفيدا ليس على أعراض‬ ‫المرض ولكن يعالج الفرد‪ .‬وبالتالي فإنه يهتم ليس فقط للجزء المتضرر ولكن لكامل الجسم‬ ‫كلمة بونارنافا تعني التجديد‪ .‬بونارنافا وهي مؤسسة حائزة على الجوائز الوطنية والدولية‬ ‫ومعتمدة من إسو ‪ 9001-2015‬والورق الخضراء ‪ ،‬وهو أعلى درجة في الفئة من إدارة‬ ‫السياحة لحكومة والية كيراال‪ .‬مستشفى بونارنافا األيورفيدي المحدودة هو مستشفى‬ ‫في كوتشي والمعتمد من قبل المجلس )‪ (NABH‬األيورفيدا الوحيد المعتمد بـ‬ ‫‪ CGHS‬الوطني العتماد للمستشفيات ومقدمي الرعاية الصحية وأيضا مدرج في‬

‫موقع الويب ‪:‬‬ ‫البريد اإللكتروني‪:‬‬

‫‪94 Medical Tourism Oct. - Dec. 2017‬‬

‫أودوارتانم‬

‫مراكزنا‬ ‫مستشفى بونارنافا األيورفيدي المحدودة الخصوصية‬

‫بونارنافا بامبو الغون‬

‫إيدابالي‬

‫فايتيال‬

‫مكز كيمس لآليورفيدا والبحوث‬ ‫تريفاندروم‬

‫مستشفى بونارنافا األيورفيدي المحدودة‬ ‫الخصوصية‬ ‫كالور‬

‫مستشفى بونارنافا األيورفيدي‬ ‫المحدودة الخصوصية‬ ‫فورت كوتشي‬

‫مستشفى بونارنافا األيورفيدي المحدودة الخصوصية‬ ‫البريد إيدابالي الشمالية‪ ،‬كوتشين – ‪ ،24‬كيراال – الهند‬ ‫هاتف‪0091 484 2801415 / 16 / 17 ،0091 9449 05065 :‬‬ ‫‪95‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫ذلك سجالت العمليات الجراحية السابقة‪.‬‬ ‫تأكد من أن لديك هذه التقارير الطبية‬ ‫واألدوية المرتبطة بها في جميع األوقات في‬ ‫حقيبتك أو األمتعة‪.‬‬ ‫• تحمل عملة كافية أو شيكات المسافر أو‬ ‫بطاقات االئتمان ‪ /‬الخصم‬ ‫مرافق اإلقامة الفاخرة للمرضى‬ ‫الداخليين‬

‫القس جونسون فازابيلي سي يم آي‪ ،‬المدير التنفيذي والموظف التنفيذي الرئيسي لمستشفى‬ ‫راجاجيري يتلقى شهادة ختم اللجنة الدولية للموافقة للجنة المشتركة الدولية العتماد‬ ‫المستشفي من السيدة باوال ويلسون‪ ،‬الرئيسة والمديرة التنفيذية للجنة المشتركة الدولية (‪)JCI‬‬ ‫في مقرها الرئيسي في شيكاغو‪ ،‬الواليات المتحدة األمريكية‪.‬‬

‫الخدمات التي يقدمها مكتب‬ ‫المساعدة لرعاية المريض لدى‬ ‫راجاجيري الدولية‬ ‫• التعامل مع االستفسارات الطبیة عن طريق‬ ‫الهاتف والبريد اإللكتروني الخ‬ ‫• ترتيب التعيينات ورعاية المتابعة‬

‫• مرافقة التمريض في حالة النقل الجوي‬ ‫للمرضى‬ ‫• االتصال مع التأمين و ‪TPA‬‬

‫المستشفى لألسر األكبر حجما‬

‫• إصدار الوثائق الالزمة مثل ملخص‬ ‫العالج وطلب اتإلجازة إلخ‬

‫مكان للعبادة‬

‫• تقدير التكلفة للعالج الطبي المقترح‬

‫• ترتيبات اإلقامة للمرضى الخارجيين في‬ ‫دار راجاجيري للضيوف أو تفضيل المريض‬

‫• مرافقة شخصية للتعيين الطبي‬

‫• ترتيبات السفر لمشاهدة المناظر الطبيعية‬

‫• ترجمة اللغة‬

‫• المساعدة في حجز الطيران إو�عادة الحجز‬ ‫للعودة عند تخطيط السفر إلى والية كيراال‬ ‫للعالج الطبي‪ ،‬فمن الضروري إعداد وحفاظ‬ ‫الوثائق الالزمة المطلوبة لضمان تجربة‬ ‫سلسة وخالية من المتاعب‪:‬‬

‫• نحن نقبل الدفع بالعملة األجنبية ‪ /‬بطاقات‬ ‫االئتمان والخصم الدولية‬ ‫• المساعدة في دخول المستشفى وعملية‬ ‫المغادرة‬ ‫• المساعدة أثناء إقامة المرضى الداخليين‬ ‫وبعد التفريغ‬ ‫• المساعدة في طلب التأشيرة والتمديد‬ ‫• المساعدة في السجالت الطبیة والوصفات‬ ‫الطبية‬ ‫• إستقبال ‪ /‬والوداع بالمطار‬ ‫• المساعدة في ‪MEDIF/MEDA‬‬ ‫(النموذج الطبي الصادر من الخطوط‬ ‫الجوية) للعودة‬ ‫• شهادة من مكتب التسجيل األجنبي‬ ‫اإلقليمي‬

‫يوفر مستشفى راجاجيري غرف المرضى‬ ‫الداخليين من فئة واحد أو ديلوكس لنقدم‬ ‫إقامة مريحة لكم مع مرافق التلفزيون وخدمة‬ ‫الواي فاي المجانية وقائمة مأكوالت متعددة‬ ‫وخدمة الغرف وخدمة الغسيل الخ‪ .‬ونحن‬ ‫نقدم أيضا الفندق ‪ /‬اإلقامة بدار الضيوف‬ ‫في بالقرب من المستشفى لكل من األيام قبل‬ ‫الدخول وكذلك بعد التفريغ‪ .‬وخالل الدخول‬ ‫في المستشفى يسمح لمصاحب واحد للبقاء‬ ‫مع المريض في الغرفة‪ .‬وفي وسعنا أيضا‬ ‫تسهيل إقامة الفندق ‪ /‬دار الضيوف بالقرب‬ ‫من‬

‫• جواز السفر والتأشيرة حيث يجب أن‬ ‫يكون المريض على تأشيرة طبية‪ .‬يرجى‬ ‫اإلتصال مع خط المساعدة لرعاية‬ ‫المرضى الدوليين لدى راجاجيري في عنوان‬ ‫‪international@rajagirihospital.com‬‬ ‫للحصول على خطاب الدعوة للتأشيرة‬ ‫• تقرير صحتك ‪ /‬التاريخ الطبي أو أي‬ ‫بيانات تتعلق العالج الطبي السابق أو‬ ‫الجاري‬ ‫• نسخ من شهادات التطعيم (الحمى‬ ‫الصفراء‪ ،‬شلل األطفال‪ ،‬الخ)‪ ،‬األشعة‬ ‫السينية‪ ،‬التصوير بالرنين المغناطيسي‬ ‫والتقارير‪ ،‬سجالت التحصين‪ ،‬الوصفات‬ ‫الطبية‪ ،‬الوثائق الطبية ذات الصلة بما في‬

‫مستشفى راجاجيري يتلقى المرضى مع‬ ‫معتقدات وممارسات دينية متنوعة من جميع‬ ‫أنحاء العالم‪ .‬يفهم فريقنا حاجتكم للحرية‬ ‫الدينية حتى عندما كنتم بعيدا عن المنزل‪.‬‬ ‫وسيقوم فريقنا بتسهيل االتصال في المجتمع‬ ‫المحلي للحصول على معلومات عن توقيت‬ ‫الصالة ‪ /‬الخدمة‪ .‬كما نقدم مناطق الصالة‬ ‫المخصصة داخل مستشفى راجاجيري لتلبية‬ ‫االحتياجات الخاصة بكم‬ ‫ألي استفسار محدد أو مزيد من‬ ‫المساعدة في تنظيم الوثائق ‪ /‬خطط‬ ‫السفر يرجى‬ ‫االتصال بنا‪:‬‬ ‫‪international@rajagirihospital.com‬‬ ‫خط المساعدة على مدار ‪ 24‬ساعة‪:‬‬ ‫‪91+ 7356600866‬‬ ‫‪www.rajagirihospital.com‬‬

‫‪96 Medical Tourism Oct. - Dec. 2017‬‬ ‫‪13‬‬

‫مستشفى‬ ‫راجاجيري‬ ‫نحن نهتم بالرعاية ونحن نقوم بالعالج‬

‫وجهة عالمية للرعاية الصحية بالدرجة الثالثية‬

‫العديد من األمم‪ ،‬وجهة واحدة‬

‫مستشفى راجاجيري الذي يقع في موقع مركزي في والية كيراال يقدم‬ ‫الرعاية على مستوى عالمي في أكثر من ‪ 40‬تخصصات طبية‬ ‫للسياح الطبيين من جميع أنحاء العالم‪ .‬وبعض منها أمراض القلب‪،‬‬ ‫الجراحة العامة ورعاية الصدمات النفسية‪ ،‬الطب العام‪ ،‬جراحة‬ ‫السمنة‪ ،‬أمراض الدم السريرية وهيماتو األورام‪ ،‬األورام‪ ،‬أمراض الرئة‪،‬‬ ‫علم األعصاب‪ ،‬المسالك البولية وأمراض الكلى‪ ،‬جراحة العظام‪،‬‬ ‫طب األطفال‪ ،‬طب وجراحة الجهاز الهضمي‪ ،‬حديثي الوالدة‪ ،‬الغدد‬ ‫الصماء‪ ،‬األمراض الجلدية‪ ،‬جراحة التجميل‪ ،‬األشعة‪ ،‬التخدير‪ ،‬علم‬ ‫األمراض‪ ،‬األنف واألذن والحنجرة‪ ،‬الرعاية الحرجة‪ ،‬الصحة الوقائية‬ ‫فحص‪ ،‬الطوارئ‪ ،‬أمراض النساء والتوليد‪ ،‬دعم التخصصات الطبية‪،‬‬ ‫جراحة الوجه والفكين كرينيو ‪ -‬زراعة األسنان وعلوم األسنان‪ ،‬الطب‬ ‫الشرعي وعلم السموم والطب الفيزيائي إو�عادة التأهيل‬ ‫‪97‬‬ ‫‪12‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫رعاية المرضى الدوليين في مستشفى راجاجيري‬ ‫يعمل مكتب مساعدة المرضى الدوليين في مستشفى راجاجيري كنافذة‬ ‫واحدة على جميع الخدمات المقدمة في مستشفى راجاجيري‪ .‬ويقوم‬ ‫فريقنا بمساعدتكم من التسجيل إلى المغادرة على التحرك بسالسة‬ ‫بين اإلدارات السريرية لنقدم لكم أفضل من الرعاية الطبية ضمن‬ ‫ممارسات صارمة لمكافحة العدوى‪ .‬يمكننا أيضا مساعدتكم على‬ ‫تخطيط سفركم أفضل عن طريق توفير خطة عالجية مؤقتة على‬ ‫أساس تقارير طبية مرسلة بالبريد اإللكتروني‪.‬‬ ‫الدكتور فيجاي أغروال رئيس ‪ CAHO‬قدم لوحة شهادة ‪CQP‬‬ ‫لألب جونسون فازابيلي ‪ ، CMI‬المدير التنفيذي والموظف التنفيذي‬ ‫الرئيسي‪ ،‬مستشفى راجاجيري‬

‫• القدرة على تحمل التكاليف أعلى في كوشين مقارنة مع المدن‬ ‫العواصم األخرى مثل نيودلهي وبنغالور ومومباي‪ ،‬الخ‪.‬‬ ‫لقد تم اعتمادكم من قبل ‪ JCI‬و ‪ .NABH‬هل أحدث هذا فرقا في‬ ‫كيف يراكم السوق الدولي ؟‬ ‫في المقام األول المقصود من جميع االعتمادات لضمان سالمة‬ ‫المرضى‪ .‬ونتيجة لذلك فإنه قد يؤدي إلى تدفق المزيد من المرضى‬ ‫األجانب إلى مستشفى راجاجيري‬ ‫ما هي وجهات نظركم على مرافق التأمين الصحي المتاحة هنا؟‬

‫األب جونسون فازابيلي سي يم آي‬ ‫المدير التنفيذي والموطف التنفيذي الرئيسي‬ ‫‪ 2‬للقيام بخدمات الرعاية الصحية المتخصصة والشاملة من المستوى‬ ‫العالمي‪ ،‬وتوفيرها لجميع الطبقات من المجتمع مع اهتمام خاص‬ ‫بالمهمشين‬ ‫‪ 3‬لينمو ليصبح نموذجا وقائدا عالميا في مجال الرعاية الصحية‬ ‫ومدرسا مبتك ار في العلوم الطبية ومرك از رائدا للبحوث في الرعاية‬ ‫الصحية‪ .‬ولكوننا مستشفى الرعاية العالية نحن متخصصون في جميع‬ ‫مجاالت الخدمات لدينا‪.‬‬ ‫ومن الصعب للغاية على اإلنسان العادي أن يتحمل المرافق الطبية‬ ‫المتقدمة في بلدنا‪ .‬ولكونكم منظمة كبيرة مع األنشطة الخيرية‪،‬‬ ‫كيف حاولتم على الوصول إلى هذا القطاع؟‬ ‫نحن نحاول الجمع بين القدرة على تحمل التكاليف والجودة‪ .‬وال يكون‬ ‫مستشفى راجاجيري موجها نحو الربح ولكن علينا أن يتم التنمية‬ ‫على موقعنا وأن نكون مكتفين ذاتيا‪ .‬وتكون االستدامة هي القاعدة‬ ‫ألسعارنا هنا وليس الربح‪.‬‬ ‫نحن نفهم بأنكم تريدون تأسيس كلية الطب ودار التقاعد باإلضافة‬ ‫إلى برامج دبلوم الماجستير‪ .‬أين ستكون هذه المؤسسات وماذا‬ ‫ستكون أهدافها؟‬ ‫نحن في عملية الحصول على التصاريح القانونية الالزمة لبدء كلية‬ ‫الطب‪ .‬ونحن نتوقع أن ندرك ذلك في السنوات الخمس المقبلة‪ .‬وفي‬ ‫مشروع دار التقاعد الخطط جاهزة‪ .‬وتجري دراسة الجدوى المالية‬ ‫والسوق‪ .‬وسيكون مستشفى راجاجيري‪ ،‬كلية الطب لدينا ودار التقاعد‬ ‫في نفس رحاب ‪ 40‬فدانا في ألوفا‪ ،‬كوشين‬ ‫لديكم الميزة أنه يقع قريبا جدا من مطار كوشين الدولي‪ .‬ما‬ ‫الخطوات التي تتخذونها حاليا لتعزيز السياحة الطبية وجذب‬ ‫المرضى الدوليين إلى المستشفى الخاص بكم؟‬ ‫• نهدف إلى المعايير الدولية للجودة ورعاية المرضى‬ ‫• وجود أحدث الدراية التقنية والمواهب البشرية المطلوبة لتقديم‬ ‫الرعاية الصحية‬

‫يقع ما يقرب من ‪ 20‬في المئة فقط من المرضى في المستشفى‬ ‫تحت قوس التأمين حاليا‪ .‬ومع التكلفة المتصاعدة للرعاية الصحية‪،‬‬ ‫فمن الضروري أن خطط التأمين الصحي سوف تهيمن في السنوات‬ ‫القادمة‪ .‬وعالوة على ذلك إن الحكومة أيضا تقدم خطط التأمين‬ ‫الصحي لتلبية احتياجات الرعاية الصحية للمجتمع كله‪ .‬وال يزال‬ ‫يتعين على بلدنا أن تقطع شوطا طويال لزيادة سلسلة تغطية التأمين‬ ‫الصحي‪.‬‬ ‫لكونكم منظمة خيرية‪ ،‬ما هي الخطوات المتخذة للوصول إلى‬ ‫المهمشين في قطاع الرعاية الصحية؟‬ ‫نحن نتأكد من أن مرضانا ال يحرمون من العالج حتى إذا لم يكن‬ ‫لديهم المال الالزم‪ .‬نحن نقوم بتسهيل هذا داخليا وخارجيا مع الناس‬ ‫الذين لديهم حسن النية لمساعدة المحتاجين‪.‬‬ ‫لقد بدأتم أيضا اإلتصال إلى المستشفيات األخرى في البلد‬ ‫عن طريق اإلرتباط‪ ،‬مثل مستشفى فيكتور في غوا‪ .‬ماذا هي‬ ‫االستراتيجية وراء هذا؟ هل تريدون أن تكون سلسلة من‬ ‫المستشفيات في جميع أنحاء البالد؟‬ ‫كانت مؤسسات راجاجيري سواء في مجال الرعاية الصحية أو التعليم‬ ‫تحاول دائما أن يكون هناك ارتباط مع المؤسسات األخرى‪ .‬اآلن لدينا‬ ‫المؤسسات التعليمية التي لها ارتباط أكاديمي مع أكثر من ‪ 20‬معهدا‬ ‫وطنيا ودوليا‪ .‬يتبع مستشفى راجاجيري أيضا نفس خطة العمل‪.‬‬ ‫انها عملية التقاسم بين األطراف المعنية‪ ،‬يمكن أن يكون المعرفة أو‬ ‫الموارد‪ .‬إننا قد بدأنا في هذا االتجاه مع مستشفى راجاجيري فيكتور‬ ‫في غوا ونعم نود التقدم إلى األمام‪.‬‬ ‫وسيكون المرضى الدوليين سعداء أن يالحظ أن مستشفى راجاجيري‬ ‫يجري تحت منظمة ‪ CMI‬ولذا يكون فعاال من حيث التكلفة منذ ال‬ ‫ينصح الفحص أو االختبارات غير المطلوبة من قبل األطباء‪ .‬وكيف‬ ‫تدير هذا مع البنية التحتية الكبيرة مثل هذه؟‬ ‫نحن نعتقد في األرقام وسر األرقام في الثقة التي تقيمها بين‬ ‫الجمهور‪ .‬وبالتالي فإن االختصار الرئيسي للوصول إلى الجمهور‬ ‫وتوليد الثقة في الجمهور هو لتكون حقيقية في نهجكم وعمليتكم ‪.‬‬ ‫وأعتقد أن أي اختصار غير صادق هو هزيمة الذات‬ ‫ماذا سيكون رسالتكم إلى كل من السياح الطبيين الهنود والدوليين‬ ‫يريدون زيارة مستشفى راجاجيري؟‬ ‫انه مكان آمن حيث يمكنكم الحصول على عالج الجودة وبأسعار‬ ‫معقولة‪.‬‬

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‫مستشفى راجاجيري‪:‬‬ ‫توفير الرعاية الصحية األكثر تقدما‬ ‫الذي يؤدي إلى "وفرة الحياة"‬

‫من وقت توفير األرض إلى تأسيس المستشفى في ‪ 40‬فدانا من‬ ‫األراضي‪ ،‬وقد وضع مستشفى راجاجيري معايير عالية‬ ‫ألنفسهم حتى لمختبرهم لالختبار والمطبخ‪ .‬وهذه الممارسات من‬ ‫المستوى العالي والتفاني والمثابرة لمستشفى راجاجيري لم تكن بدون‬ ‫مالحظة من قبل المنظمات المشهورة مثل اتحاد منظمات الرعاية‬ ‫الصحية المعتمدة (‪ )CAHO‬الذي أعلن مستشفى راجاجيري ‪،‬‬ ‫تشونانغامفيلي‪ ،‬ألوفا كمركز لتعزيز الجودة‪ )CQP( .‬إو�ن المستشفى‬ ‫قد تعاون مع ‪ CAHO‬في تدريب ومساعدة المستشفيات األخرى‬ ‫ومنظمات الرعاية الصحية للحصول على اإلعتماد‪ .‬ويكون مستشفى‬ ‫راجاجيري هو معتمدا من قبل ‪ NABH‬و ‪ JCI‬ويقوم اليوم حتى‬ ‫بتوفير الدعم لمستشفيات أخرى للحصول على اعتماد ‪. NABH‬‬ ‫ويضم المستشفى العديد من اإلدارات التي تشمل من األطباء األكثر‬ ‫تأهيال‪ .‬كما حصل مطبخ المستشفى على إعتماد إسو ‪22000‬؛‬ ‫‪ 2005‬في خدمات األغذية والمشروبات‪.‬‬ ‫وفي مقابلة حصرية مع السياحة الطبية‪ ،‬يقوم االب‪ .‬جونسون فازابيلي‬ ‫سي يم أي المدير التنفيذي لراجاجيري بتوضيح كيفية امكان هذا‬ ‫وكذلك عن توقعات المستشفى والمبادرات في قطاع السياحة الطبية‬

‫‪99‬‬ ‫‪10‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫جمعية سي يم أي ال يحتاج إلى تعريف في الهند‪ .‬ومع ذلك سيكون‬ ‫مستشفى راجاجيري هو الخطوة الرئيسية األولى في قطاع الرعاية‬ ‫الصحية من قبل سي يم آي كالمستشفى الراقي بالتخصصات‬ ‫المتفوقة باستثمار أكثر من ‪ 300‬كرور‪.‬‬ ‫و ما الذي حث سي يم آي للقيام بذلك؟‬ ‫وكانت كارمليتس مريم الطاهرة(‪ )CMI‬نشطة في الرعاية الصحية‬ ‫من خالل مبادرات رئيسية أخرى مثل كلية أماال الطبية‪ ،‬تريسور‪.‬‬ ‫وفي اإلنجيل هناك لكهنوت يسوع جزآن رئيسيان‪ :‬كهنوت التعليم‬ ‫وكهنوت الشفاء‪ .‬راجاجيري هو في كل من الكهنوتين‪ .‬وبمستشفى‬ ‫راجاجيري نحاول الوصول إلى المرضى‪ .‬ويعطي راجاجيري أهمية‬ ‫قصوى للتعليم‪ ،‬وبالتالي فإن مستشفى راجاجيري سيمتد أيضا في‬ ‫النهاية إلى مجال التعليم الطبي والبحوث‪.‬‬ ‫ماذا ستكون مهمة مستشفى راجاجيري وما هي األنشطة التي‬ ‫تتخصص فيها؟‬ ‫تكون مهمة مستشفى راجاجيري هي‬ ‫‪ 1‬لتوفير الرعاية الصحية العلمية والعالجية والوقائية األكثر تقدما‬ ‫التي تؤدي إلى "وفرة من الحياة"‬

‫إن قياس الخصر أكثر من ‪ 35‬بوصة للنساء و ‪ 40‬بوصة للرجال يثير‬ ‫خطر اإلصابة بأمراض القلب وغيرها من الظروف الصحية الخطيرة‪.‬‬ ‫وحتى فقدان الوزن الصغير (بين ‪ 5‬في المائة و ‪ 10‬في المائة من وزنك‬ ‫الحالي) يمكن أن يساعد على تقليل المخاطر‪.‬‬ ‫ويشمل نظام غذائي صحي للقلب مجموعة متنوعة من الفواكه والخضروات‬ ‫والحبوب الكاملة‪ ،‬وكذلك اللحوم الخالية من الدهون والدواجن واألسماك‬ ‫والفاصوليا ومنتجات األلبان الخالية من الدهون أو قليلة الدسم‪ .‬ويقول‬ ‫خبراء الصحة‪ ،‬حاول لتجنب الدهون المشبعة والدهون غير المشبعة‬ ‫والكوليسترول والصوديوم (الملح) والسكر المضافة‪.‬‬ ‫النشاط البدني المنتظم هو وسيلة قوية أخرى للحد من خطر المشاكل‬ ‫المتعلقة بالقلب‪ .‬كما يقدم أيضا مجموعة من الفوائد الصحية األخرى‪.‬‬ ‫ولجعل النشاط البدني متعة بدال من روتيني يرجى اختيار األنشطة التي‬ ‫تستمتع بها‪ .‬قم بالمشي السريع ولعب الكرة ورفع األوزان الخفيفة والرقص‬ ‫أو العمل في الحديقة‪ .‬وحتى الصعود بالساللم بدال من المصعد يمكن أن‬ ‫يحدث فرقا‪.‬‬ ‫يقول الدكتور ديان بيلد وهو اختصاصي في علم األوعية القلبية والوعائية‬ ‫لدى المعاهد الوطنية للصحة‪" :.‬على األقل ساعتين ونصف في األسبوع‬ ‫من النشاط البدني المعتدل الشدة يمكن أن يقلل من خطر اإلصابة‬ ‫بأمراض القلب والسكتة الدماغية وارتفاع ضغط الدم والسكري"‬ ‫إذا كان لديك مرض السكري فمن المهم الحفاظ على نسبة السكر في الدم‬ ‫أو الجلوكوز تحت السيطرة‪ .‬ويموت حوالي ثلثي المصابين بمرض السكري‬ ‫من أمراض القلب أو األوعية الدموية‪ .‬إذا كنت في خطر لمرض السكري‬ ‫إن التغيرات المتواضعة في النظام الغذائي ومستوى النشاط البدني يمكن‬ ‫في كثير من األحيان منع أو تأخير تطورها‪.‬‬ ‫إذا كنت مدخنا فإن أفضل شيء يمكنك القيام به لقلبك هو وقف هذه‬ ‫العادة القاتلة‪ .‬إن الناس الذين يدخنون يصلون إلى ست مرات أكثر عرضة‬ ‫للنوبات القلبية من غير المدخنين‪ .‬ويزداد خطر اإلصابة بالنوبات القلبية‬ ‫مع عدد السجائر المدخنة كل يوم‪.‬‬ ‫وقد وجد الباحثون أن تجنب التدخين يبدأ الحد من المخاطر على الفور‬ ‫وسوف تستمر الفائدة في انخفاض المخاطر أن تزيد مع مرور الوقت‪.‬‬ ‫وينبغي أيضا أن يكون في حالة تأهب ألعراض معينة وفحصها من قبل‬ ‫الطبيب‪ .‬اإلشارات الشائعة بأن هناك خطأ ما في قلبك تشمل الذبحة‬ ‫الصدرية واأللم في الصدر والكتفين والذراعين والرقبة والفك أو الظهر‬ ‫فضال عن ضيق في التنفس وعدم انتظام ضربات القلب أو الخفقان (عدم‬ ‫انتظام ضربات القلب) والتعب‪.‬‬ ‫يقول الدكتور مايكل لوير‪ ،‬أخصائي أمراض القلب في المعاهد‬ ‫الوطنية للصحة‪" :‬إن األدلة العلمية قوية بأن السيطرة على‬ ‫ارتفاع نسبة الكوليسترول في الدم وارتفاع ضغط الدم تمنع‬ ‫حدوث أمراض القلب مثل النوبات القلبية"‪.‬‬ ‫ويكون وزن الجسم هو عامل مهم آخر يجب أن يبقى تحت‬ ‫المراقبة‪ .‬ويقول األطباء أنه لمعرفة ما إذا كان المرء يحتاج إلى‬ ‫تقليل وزنه للحد من خطر اإلصابة بأمراض القلب يجب عليه‬ ‫‪ /‬عليها احتساب مؤشر كتلة الجسم (‪ )BMI‬وهي نسبة الوزن‬ ‫إلى الطول‪ .،‬إذا كان مؤشر كتلة الجسم بين ‪ 25‬و ‪29.9‬‬ ‫يعني أنك تعاني من زيادة الوزن‪ ،‬وفي حين أن مؤشر كتلة‬ ‫الجسم من ‪ 30‬أو أعاله يعني السمنة‪.‬‬

‫ومع ذلك يجب أن تدرك أن أعراض نوبة قلبية يمكن أن تختلف من‬ ‫شخص آلخر‪.‬‬ ‫وأخي ار ال ننسى أنه يمكنك أيضا التأثير على صحة قلب أحبائك عن طريق‬ ‫وضع مثال بنفسك‪ .‬إذا كنت تتبع نمط حياة صحي للقلب‪ ،‬فمن المرجح‬ ‫أنهم أيضا يتبعونه‪ .‬وألن أمراض القلب تبدأ في مرحلة الطفولة‪ ،‬من أفضل‬ ‫األشياء التي يمكن القيام به ألولئك الذين تحبونهم هو مساعدة األطفال‬ ‫على بناء أجسام قوية وعادات صحية‪.‬‬ ‫وفي النهاية أنه لم يفت االوان التخاذ خطوات لحماية قلبك‪ .‬وانه أيضا في‬ ‫وقت مبكر جدا أبدا‪ .‬ابدأ اليوم للحفاظ على قلبك قوية‪ .‬تحدث مع طبيبك‬ ‫حول خطورتك ووضع خطة عمل‪ .‬أحب قلبك‪.‬‬ ‫‪100 Medical Tourism Oct. - Dec. 2017‬‬ ‫‪9‬‬

‫تقول الدكتورة سوزان بي‪ .‬شورين‪ ،‬المديرة بالنيابة للمعهد الوطني‬ ‫للصحة في القلب والرئة والدم‪" :‬على سبيل المثال كانت النساء‬ ‫اللواتي لديهن عامالن رئيسيان للخطر على األقل ثالثة أضعاف‬ ‫احتمال الموت بسبب أمراض القلب واألوعية الدموية‪ .،‬وتقول‪:‬‬ ‫"يمكنك ويجب أن تحدث فرقا في صحة قلبك عن طريق الفهم‬ ‫ومعالجة المخاطر الشخصية"‪.‬‬ ‫فمن الضروري بالنسبة لك لمعالجة عوامل الخطر أوال التحقق من‬ ‫الكوليسترول في الدم وضغط الدم‪ .‬ثم يجب القيام بتحديد ما إذا كان‬ ‫وزنك هو في نطاق صحي‪ .‬وكلما يرتفع مستوى الكولسترول يزيد‬ ‫خطر اإلصابة بأمراض القلب أو النوبات القلبية‪.‬‬ ‫‪8‬‬ ‫‪A Complete Magazine on Healthcare in Asia 101‬‬

‫يمكن أن تظهر اختبارات الدم الروتينية مستوى الكولسترول الكلي‬ ‫ومستويات منفصلة من ‪ LDL‬الكوليسترول('السيئة') ‪HDL ،‬‬ ‫الكوليسترول('الجيد') والدهون الثالثية‪ .‬وترتبط جميع هذه القياسات‬ ‫للدم بصحة القلب لدينا‬ ‫ارتفاع ضغط الدم وغالبا ما يسمى "القاتل الصامت"‪ ،‬عادة ال يظهر‬ ‫أي أعراض‪ .‬ارتفاع ضغط الدم هو عامل خطر رئيسي آخر ألمراض‬ ‫القلب‪.‬‬ ‫يتم اإلبالغ عن ضغط الدم دائما كرقمين وأية أرقام فوق ‪120/80‬‬ ‫مم زئبق تزيد من خطر اإلصابة بأمراض القلب والسكتة الدماغية‪.‬‬

102 Medical Tourism Oct. - Dec. 2017 7

‫السياحة الطبية‬

‫أحبب قلبك‬ ‫وعش بصحة‬ ‫جيدة‬ ‫يقول االتحاد العالمي للقلب إن أمراض القلب في العالم‬ ‫تدعي أكثر من ‪ 17.5‬مليون شخصا كل عام‪ .‬ومن المفارقات‬ ‫أن الناس يموتون من فشل القلب عندما يكون لدينا‬ ‫القدرة على حماية ومنع مشاكل القلب‪ .‬وبمناسبة اليوم‬ ‫العالمي للقلب في ‪ 29‬سبتمبر ‪ /‬أيلول‪ ،‬وجه االتحاد هذا‬ ‫النداء‪" :‬قلبك هو في صميم صحتك‪ .‬ومن السهل إعطاؤه‬ ‫الرعاية التي يستحقه "‬ ‫بقلم‪ :‬تي كيه في ماني‬ ‫وحان الوقت أن نفهم الحقيقة أن أمراض القلب ظلت القاتل األول لكل من الرجال والنساء‪.‬‬ ‫وقد عمل الباحثون على تعزيز فهمنا ألمراض القلب المختلفة إليجاد الطرق والوسائل ليس‬ ‫فقط لتحسين الصحة ولكن أيضا لتكثير طول العمر‪ .‬وقد اكتشفوا أنه يمكن للمرء أن يقلل من‬ ‫المخاطر ببساطة عن طريق تبني عادات صحية معقولة‪.‬‬ ‫ولحماية قلبنا فإن الخطوة األولى هي معرفة عوامل الخطر الشخصية‪ .‬انها أساسا ينطوي على‬ ‫أنماط حياتنا وعاداتنا الغذائية‪ .‬إو�ذا كنا ال نهتم لتغيير عاداتنا فإنها يمكن أن تزيد من فرص‬ ‫وجود المشكلة الموجودة تزداد سوءا‬ ‫إن بعض العوامل التي تؤدي إلى المشاكل في القلب مثل الشيخوخة أو التاريخ العائلي ال‬ ‫يمكن أن تتغير تماما‪ .‬ولكن يمكننا بالتأكيد السيطرة على بعض عوامل الخطر الهامة مثل‬ ‫ارتفاع نسبة الكوليسترول في الدم وارتفاع ضغط الدم والتدخين والوزن الزائد والسكري والخمول‬ ‫البدني‪.‬‬ ‫ومن الجدير بالذكر أن العديد من الناس لديهم أكثر من عامل خطر واحد‪ .‬وللحفاظ على‬ ‫القلب يجب علينا السيطرة أو القضاء على جميع عوامل الخطر قدر ما نستطيع‪ .‬إو�ال فإنها‬ ‫تعمل معا وتزيد من المخاطر‪.‬‬ ‫وأبرزت دراسة واسعة بدعم من المعاهد الوطنية للصحة (‪ )NIH‬ومقرها الواليات المتحدة أهمية‬ ‫عالج عوامل الخطر المؤدية إلى نوبة قلبية‪ .‬ويقول الباحثون إن البالغين في منتصف العمر‬ ‫ الرجال والنساء ‪ -‬مع واحد أو أكثر من "عوامل الخطر المرتفعة" مثل ارتفاع ضغط الدم هم‬‫أكثر عرضة لنوبة قلبية أو أمراض القلب األخرى ذات الصلة‪.‬‬ ‫‪6‬‬ ‫‪A Complete Magazine on Healthcare in Asia 103‬‬

‫في لداخل‬ ‫‪6‬‬

‫أحبب قلبك وعش بصحة جيدة‬ ‫القلب و أنت‬

‫‪16‬‬

‫مشاكل البروستاتا‬

‫‪20‬‬

‫العقم عند الرجال‬

‫‪26‬‬

‫‪6‬‬ ‫أحبب قلبك‬ ‫وعش بصحة جيدة‬ ‫‪14‬‬ ‫القلب و أنت‬ ‫‪18‬‬ ‫مشاكل البروستاتا‬

‫‪24‬‬ ‫العقم عند الرجال‬ ‫‪104 Medical Tourism Oct. - Dec. 2017‬‬

‫أوقف هذا القاتل العالمي‬

‫‪Vol.2 | Issue No.3 | Oct. - Dec. 2017‬‬

‫يقدر أن ‪ 17.5‬مليون شخصا يموتون كل عام على الصعيد العالمي بسبب فشل القلب‪.‬‬ ‫ويصل ذلك إلى نسبة مذهلة تبلغ ‪ 31‬في المائة من مجموع الوفيات في جميع أنحاء العالم‪.‬‬ ‫وفي كثير من الحاالت ال توجد أعراض ألزمة قلبية وشيكة‪ .‬الموت يأتي بشكل غير متوقع‪.‬‬ ‫األعراض قد تكون هناك‪ ،‬ولكن المريض قد ال يكون واعيا عن ذلك‪.‬‬ ‫إن أسباب هذا القاتل اللعين كثيرة‪ .‬وهي تشمل نمط الحياة المستقرة ونقص النشاط‬ ‫البدني الكافي واألكل غير الصحي واستهالك الكحول والتدخين والبدانة‪.‬‬ ‫ويعمل الباحثون على سبل الكبح عن هذا القاتل العالمي‪ .‬ومن المفترض أن السيطرة على‬ ‫المخاطر الرئيسية مثل ارتفاع نسبة الكوليسترول في الدم وارتفاع ضغط الدم والتدخين‬ ‫والوزن الزائد والسكري والخمول البدني يمكن إلى حد ما من منع فشل القلب‪ .‬وإن تبني‬ ‫عادات صحية معقولة فحسب يمكن أن تسهم في صحة القلب‪.‬‬ ‫وقد بدأت حمالت عالمية على نطاق العالم من قبل منظمة الصحة العالمية واالتحاد العالمي‬ ‫للقلب لتوعية الناس بالمخاطر التي تشكلها أنماط الحياة المستقرة‪.‬‬ ‫السياحة الطبية تنضم إلى االتحاد العالمي للقلب في حملته للتوعية العالمية لغرس الحاجة‬ ‫إلى حياة منضبطة لتفادي أمراض القلب‪ .‬وقال االتحاد فى نداء عالمى بمناسبة يوم القلب‬ ‫العالمى يوم ‪ 29‬سبتمبر "ان قلبكم هو فى صميم صحتكم‪ .‬وأنه من السهل إعطائه الرعاية‬ ‫التي يستحقها "‪.‬‬ ‫وبصرف النظر عن المقالة الرئيسية‪" ،‬أحبب قلبك‪ ،‬وعش بصحة جيدة" وغيرها من المقاالت‬ ‫عن أمراض القلب‪ ،‬وتشمل هذا العدد أيضا مقاالت مثل "المعاناة من مرض السكري؟" و‬ ‫"حماية بصركم" ومقالة عن مرض السكري‪ .‬هذه األمراض يمكن أن تؤثر على العين بما في‬ ‫ذلك الشبكية والبقعة والعدسة واألعصاب البصرية‪ .‬المقالة عن مشاكل البروستاتا الشائعة‬ ‫بين الرجال فوق ‪ ،50‬تفيد بمعلومات متعمقة عن أسبابها وعالجاتها‬ ‫ومقالة خاصة لفهم فقدان الذاكرة تتحدث عن الصعوبات التي يعاني منها المرضى ويعطي‬ ‫النصائح للتغلب على المشاكل التي تؤثر أساسا على كبار السن‪ .‬وهناك أيضا مقالة "‪SRMC‬‬ ‫تفوق في عالج السرطان الناجح"‪ .‬وهذه تقدم تفاصيل العالج من الدرجة العالمية التي توفرها‬ ‫المركز الطبي سري راماشاندرا في بيرور‪ ،‬تشيناي‪ ،‬بما في ذلك أحدث مرافق عالج السرطان‪،‬‬ ‫وفريق من األطباء الخبراء والموظفين الطبيين‪.‬‬ ‫"آو ‪ ...‬ها! المفاصل المؤلمة؟ 'هي مقالة أخرى تكون مثيرة لالهتمام لكثير من الناس الذين‬ ‫يعانون من التهاب المفاصل الروماتويدي‪ .‬وتقول المقالة أن بداية هذا المرض غالبا ما يبدأ في‬ ‫منتصف العمر أو بعده‪ .‬ولكن يمكن أن يحدث في أي سن أيضا‪.‬‬ ‫وهناك مقالتان أخرى عن مشاكل العقم‪ .‬وهما تظهران أن التلقيح اإلصطناعي ليس إجراء‬ ‫محفوفا بالمخاطر وتستعرض مشاكل العقم لدى الرجال‪.‬‬ ‫وأبرز هذا العدد هو مقابلة مع إندرا ماني بانديه سفير الهند لدى سلطنة عمان بشأن‬ ‫العالقات الثنائية‬ ‫نحن نفتخر بأن نعلن أن السياحة الطبية هي المجلة الرسمية لمعرض ومؤتمر عمان للرعاية‬ ‫الصحية الذي سيعقد في مسقط من ‪ 9‬إلى ‪ 11‬أكتوبر‪ .‬كما أنها الشريك اإلعالمي لميزة‬ ‫الرعاية الصحية الهند ‪ 2017‬في بنغالور من ‪ 12‬إلى ‪ 14‬أكتوبر وستكون السياحة الطبية أيضا‬ ‫في أول مؤتمر ومعرض دولي أيوش في دبي يومي ‪ 9‬و ‪ 11‬نوفمبر‪.‬‬ ‫وفي العدد الحالي لدينا مقاالتنا الخاصة مثل أخبار الصحة واألحداث والمستشفيات واألجهزة‬ ‫الطبية الجديدة‪.‬‬ ‫نتمنى للجميع القراءة السليمة‬

‫‪RNI No. KERBIL/2016/68979‬‬ ‫‪Editor & Publisher‬‬ ‫‪Benny Thomas‬‬ ‫‪Consulting Editor‬‬ ‫‪O.J. George‬‬ ‫‪Executive Editor‬‬ ‫‪TKV.Mani‬‬ ‫‪Editorial Co-ordinator‬‬ ‫‪Ninu Susan Abraham‬‬ ‫‪Vice President‬‬ ‫‪Sunil Nair‬‬ ‫‪Layout & Design‬‬ ‫‪Lal Joseph‬‬ ‫‪Legal Advisor‬‬ ‫‪Adv. Biju Hariharan‬‬ ‫‪Arabic Translation‬‬ ‫‪Dr. A. Aboobacker‬‬ ‫‪BUSINESS ASSOCIATES Overseas‬‬ ‫ ‪USA‬‬ ‫‪: CHICAGO: Vincent Joseph‬‬ ‫‪ Mob: 847 299 9954‬‬ ‫ ‪USA‬‬ ‫‪: Houston: Shaju Joseph‬‬ ‫‪ Mob: 847 899 2232‬‬ ‫ ‪USA‬‬ ‫‪: NEW YORK Vincent Sebastian‬‬ ‫‪ Mob: 917 992 9629‬‬ ‫ ‪USA‬‬ ‫‪: CALIFORNIA: Wilson Nechikat,‬‬ ‫‪ Ph: 408 903 8997‬‬ ‫ ‪Canada‬‬ ‫‪: Jose Sebastian, Ph: 416 - 509 – 6265‬‬ ‫ ‪UK‬‬ ‫‪: Dileep Mathew, Ph: 044 787 743 2378‬‬ ‫ ‪Switzerland‬‬ ‫‪: Dr. George Sebastian, Ph: 527204780‬‬ ‫ ‪Ireland‬‬ ‫‪: Thomas Mathew‬‬ ‫‪ Mob: 00353 87 123 6584‬‬ ‫ ‪Middle East‬‬ ‫‪: Anil Nath,‬‬ ‫‪ Ph: 506854500‬‬ ‫ ‪Singapore‬‬ ‫‪: Mahesh A, Ph: +65 906 22828‬‬ ‫ ‪Germany‬‬ ‫‪: Thomas Vallomtharayil‬‬ ‫‪ Ph: 02305 4455 100‬‬ ‫ ‪Austria‬‬ ‫‪: Monichan Kalapurackal‬‬ ‫‪ Ph: 0043 6991 9249829‬‬ ‫ ‪Korea‬‬ ‫‪: Dr. A. Thomas, Ph: 0082 10 5822 5820‬‬ ‫ ‪Australia‬‬ ‫‪: S. Mathew, Ph: 61247026086‬‬ ‫ ‪Oman :‬‬ ‫‪Legihas Ussain, 00968 95383199‬‬ ‫‪BUSINESS ASSOCIATES India‬‬ ‫ ‪New delhi‬‬ ‫‪: V Murugan, Mob: +91 989 9931 879‬‬ ‫ ‪Mumbai‬‬ ‫‪: Mohan Iyer, Mob: +91 22 6450 5111‬‬ ‫ ‪Chennai :‬‬ ‫‪Ashok Venkat, Mob: +91 701 033 1213‬‬ ‫‪Eastern India : Sanjay D. Narwani Mob: +91 983 120 7202‬‬ ‫‪Ahmedabad : Madanan MA, Mob: +91 989 800 2522‬‬ ‫ ‪Hyderabad‬‬ ‫‪: Vinod Menon, Mob: +91 081 436 17672‬‬ ‫ ‪Puducherry‬‬ ‫‪: K. Ramasubramanian, +91 989 497 7161‬‬ ‫ ‪Goa‬‬ ‫‪: Olavo Edviges Lobo - +91 982 258 9237‬‬ ‫ ‪Trivandrum‬‬ ‫‪: Kuriyan K Raju, Mob: +91 944 610 6644‬‬ ‫ ‪Kozhikode‬‬ ‫‪: Reghunath Mitran, Mob:+91 914 231 9712‬‬

‫(نهاية)‬

‫‪Disclaimer: The statements in this magazine have not been‬‬ ‫‪evaluated by the Food and Drug Administratin of USA or‬‬ ‫‪any other country. Information provided in this magazine‬‬ ‫‪are not intended to diagnose, treat, cure or prevent any‬‬ ‫‪disease. If you have a medical condition, consult your‬‬ ‫‪physician. All information is provided for research and‬‬ ‫‪education purpose only.‬‬

‫‪A Complete Magazine on Healthcare in Asia 105‬‬

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106 Medical Tourism Oct. - Dec. 2017

A Complete Magazine on Healthcare in Asia 107

Vol.2 | Issue No.3 | Oct. - Dec. 2017

‫مشاكل‬

‫البروستاتا‬

‫العقم‬

‫عند الرجال‬ Official Magazine

12 - 14 October 2017

108 Medical Tourism Oct. - Dec. 2017

‫أحبب قلبك‬

‫وعش بصحة جيدة‬

‫القلب و‬ ‫أنت‬