1 August, 2013

Sleep apnoea: ENT surgeon performs robotic surgery live

Over 2,000 doctors across the world viewed a real-time live robotic surgery performed on two patients at the Asian Heart Institute in Mumbai on Tuesday to cure them of obstructive sleep apnoea (OSA) or stoppage of breathing during sleep.

The live ‘workshop’ by well known ENT surgeon DrVikas Agrawal was conducted to display the latest robotic technique called transoral robotic surgery at the base of the tongue – a complex procedure since it is a very heavy muscle situated deep inside the throat. ‘OSA, which afflicts 13 percent of Indians, is a disorder in which a person stops breathing during the night, perhaps hundreds of times. These gaps in breathing are called ‘apnoeas’. The disorder occurs when tissues in the upper throat collapse at different times during sleep, thereby blocking passage of air,’ Agrawal said.

The first-of-its-kind live session was attended by world-renowned robotic surgeons for OSA, Italian doctors Claudio Vicini and Filippo Montevecchi and AHI vice chairman Ramakanta Panda. Agrawal said that both the patients operated upon Tuesday were non-obese and had attempted the continuous airway pressure therapy, but it did not work on them. Though studies have suggested that obese people are four times more vulnerable to OSA, nowadays, more and more non-obese persons are coming up with severe OSA symptoms, he said. Referring to a 2009 study by the All India Institute of Medical Sciences, Agrawal said that the number of patients suffering from OSA could be strongly underestimated.

Of the approximate 13 percent of the population which is suffering from OSA, only four percent approach a doctor, and the incidence is three times higher in men compared to women, he said. Speaking on the occasion, Ramakant Panda, a renowned heart surgeon, said the ‘live surgery’ on TORS is a step towards honing the skills and expertise of the medical community who will benefit from this surgical knowledge-sharing.

Source: http://health.india.com

01.08.2013

Notification of TB cases needs to be made strict: Experts

Strict enforcement of laws on TB notification, infection and control at all levels and uninterrupted laboratory supplies are some of the steps needed for control of tuberculosis, experts said on Monday. ‘It is very important to integrate home-based care, rehabilitation and social support for people with drug-resistant TB,’ Amod Kumar, head of Community Medicine, St. Stephen’s Hospital, Delhi, said.

Kumar and others were part of a team of health advocates who met Planning Commission member Syeda Hameed to hand over a report of the review done on 14 sites in India where multi-drug resistant tuberculosis (MDR-TB) is being treated. (Read: Ten facts you need to know aboutTB)

MDR-TB is a serious and difficult-to-treat form of tuberculosis resistant to many antibiotics. The team has documented how standard guidelines for Programmatic Management of Drug-resistant Tuberculosis (PMDT) of Central TB Division are getting implemented. ‘PMDT guidelines were being followed in all the 14 sites we visited in the public sector. Our team also visited government sites along with few programmes managed by non-profit agencies and a private laboratory in Delhi and were very inspired to see that not only are the guidelines being strictly upheld, but an enormous effort has also gone into establishing and managing these sites,’ Bobby Ramakant of CNS Vote For Health campaign said.

The report has a series of personal stories of cured MDR-TB patients, as well as those with MDR-TB or Extensively Drug-Resistant TB (XDR-TB) who are currently receiving treatment from government PMDT sites. Despite challenges of health systems and the highest TB disease burden globally, India has come a long way in its response to providing access to standard WHO-recommended anti-TB treatment through Directly Observed Treatment Short course (DOTS) to more than 14.2 million (1.42 crore) people across the country.

However, TB continues to remain one of the key public health priorities in India. Drug-resistant TB is one of the major concerns, and India is on track to providing universal access to quality diagnostics and treatment services for all patients with drug-resistant TB in the next five years.

Source: http://health.india.com

01.08.2013

Make rest a necessity, not an objective. Only rest long enough to gather strength

Jim Rohn