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Fortis Surgeons Create Pharyngeal tube with part of small intestine

Dr Surender Dabas, Director, Head, Neck and Thoracic Surgical Oncology

BS RAWAT

NEW DELHI: Vimla Devi had squamous cell carcinoma in the laryngeal region. The goal of the reconstruction was to protect the carotid artery and to restore speech and swallowing in the patient impacted by the tumour.

By taking a part of her small intestine and creating a new pharyngeal tube with it, the surgeons at Fortis Hospital, Shalimar Bagh, Delhi, proved to be life savers for Vimla Devi from Rohtak.

The patient got a fresh lease of life after undergoing an over 12-hour operation on August 14, 2017, for removal of a malignant neck tumour.

Speaking to DTMT, the Hospital claimed the surgery was a "first of its kind" in North India.

Bimla Devi, 58,  who was earlier treated in Rohtak hospital was brought to the Fortis Hospital at Shalimar Bagh in a state of complete weakness and was being fed through an external apparatus as she had extreme trouble swallowing and breathing, doctors said.

An endoscopy and biopsy were performed proving the presence of a squamous cell carcinoma in the laryngeal region or hypopharynx. She had previously undergone treatment with radiation followed by eight cycles of palliative chemotherapy which had resulted in absolute dysphagia.

Dr Surender Dabas, Director (Head, Neck and Thoracic Surgical Oncology) told DTMT, "After reviewing her case, we decided to perform a total laryngopharyngectomy and reconstruction of pharyngeal tube with a free jejunal flap. Post the surgery the patient was kept on ventilator support for two days."

He said that the post-operative period was uneventful and smooth.

In this case, it was a post-cricoid carcinoma, her food pipe and windpipe that were affected, were removed," he said.

Dr Dabas stated, “ Pharyngoesophageal reconstruction requires great attention to detail, and there is no room for error. The ultimate goals of reconstruction are to provide protection of important structures such as the carotid artery, and restoration of funcctions such as speech and swallowing.”

"Vimla Devi is stable and kept under surveillance in the high-dependency unit. She would be discharged in next week," he said.

Mr Mahipal Bhanot, Director of the hospital, commended Dr Dabas and said: "It is with his positive and can-do attitude that even the most hopeless cases develop a silver lining and can be treated."

6.2 crore Indians suffer visual impairment: AIIMS

Dr Atul Kumar, Chief, RP Centre, AIIMS, Delhi

Rohit Shishodia

Consumption of steroids, tobacco use and even the use of smart phones among children contribute to blindness and visual impairment. Some 80 lakh Indians are totally blind.

Experts have expressed concern over the increasing visual impairment in India. They inform that around 6.2 crore people in India are living with visual impairment.

Out of these 6.2 crore, 20 per cent or 80 lakh people, are blind. It is estimated that India carries 20 per cent burden of blindness of the entire globe.

Dr Atul Kumar, Chief, RP Centre, AIIMS, Delhi, pointed out that a major awareness campaign among the masses is needed to arrest the march of visual impairment and blindness in elderly population and young children.

Dr Kumar informed that disease like diabetes, BP and poor lifestyle contribute to the occurrence of visual impairment. “Diabetes impacts the eyes around ten years after its occurrence. Therefore, people should go for regular eye check-up and consume green vegetables to avoid eye disorders due to other diseases,” added Dr Kumar.

Dr Kumar revealed that consumption of steroids also results in eye diseases. “Around 20 per cent of young children have blindness due to consumption of steroids. Over the counter availability of steroids must be stopped. Steroids cause glaucoma,” explained Dr Kumar.

Dr Praveen Vashist, Professor and Head-Community Ophthalmology at AIIMS-Delhi, says that cataract is the biggest cause of blindness in India. “Thereafter, it is retina which causes blindness. 65 lakh surgeries of cataract are conducted in India,” said Dr Vashist.

Dr Vashist informed that tobacco consumption is one of the major factors which contribute to blindness. “Tobacco consumption impacts the nerves of the patients which also causes blindness. Smart phones also result in visual impairment in kids of very young age. Parents must educate and keep their children away from smart phones,” explained Dr Vashist.

He informed Delhi-AIIMS is conducting a study in Delhi’s Trilokpuri area on 20,000 children to ascertain the number of kids suffering from visual impairment and the causes of the same.

Delhi Govt.'s lab technicians hold protest march

Delhi lab technicians holding protest march

BS RAWAT

NEW DELHI: The technicians have warned that the protest will be intensified if their demands, including the implementation of 7th CPC recommendations, are not accepted.

Demanding implementation of the 7th pay commission recommendations and immediate cadre restructuring, hundreds of medical lab technicians employed in Delhi Government hospitals gathered outside the GB Pant Hospital on September 1, 2017, and took out a protest march to the office of the Dean, Maulana Azad Medical College, and staged a 'dharna' there.

After submitting memorandum, the workers warned of a continuous protest-cum-pen-down-strike from September 6, 2017, in case their demands are not met.

The protesting technicians, under the banner of Indian Medical Laboratory Technologist Federation, had handed over a memorandum to Delhi chief minister Arnind Kejriwal last month warning of a pen-down strike over their long pending issues.

"The response of the Delhi government on our pending issues has been highly disappointing. We met almost every concerned officer, from health secretary to chief secretary and health minister to chief minister many times but we could not find any appropriate solution to our demands,” Pooja Saini, chairperson of the federation and one of the agitators said.

One hospital bed per 2,046 people in India: Govt. report

Rohit Shishodia

Against the WHO guideline of a hospital bed for every 500 people, Bihar has a hospital bed per more than eight thousand people.

The healthcare services in India are running against the standards set by the World Health Organization (WHO) in terms of patient: hospital bed ratio. According to the National Health Profile (NHP) report, 2017, published by India’s health ministry online, there is only one hospital bed available per two thousand people in government hospitals. According to WHO guidelines, there should be one bed available for 500 people.

The situation is even more adverse for people who need treatment in northern states like Bihar and Uttar Pradesh. The report reveals that there is only one bed available for more than eight thousand people in Bihar, while in Uttar Pradesh, there is one bed for more than three thousand people.

In Haryana, there is one bed available for around 3,427 people, in Arunachal Pradesh, there is one bed for 3,819 people, in Jharkhand one bed for 3,079 people and in Delhi there is one bed for 824 people.

The states which fare well and fulfill the WHO guidelines are Sikkim, Lakshadweep and Pondicherry.

The abysmal lack of hospital beds against the number of patients in India is quite worrisome. It may take years to improve the ratio between the availability of beds and patients unless concrete efforts are made to improve the infrastructure.