‘Super specialty hospitals put India on international map’

Jayashree Padmini - New Delhi

As one enters the consulting room of Padma Shri Dr Ashok Seth of Escorts, an array of awards, honours and citations look at you. While making oneself comfortable among them, enters the vibrant Dr Seth himself.

"In the last forty years heart disease incidence in the country witnessed more than four-fold increase and it is projected that 50 per cent of deaths owing to cardiac ailment would be from India alone by 2015," the chief of invasive and interventional cardiology at Escorts Heart Institute and Research Centre opened the conversation. The Government of India honoured Dr Seth with the prestigious Padma Shri on January 26, 2003.

Dr Seth said, "It is super specialty hospitals that put the country on the international map of cardiac therapy. For us at Escorts, the focus of international exposure has been on transferring expertise and skills in complex angioplasty."

"Surgical procedures done at Escorts have been transferred live to overseas destinations such as Washington where more than 30,000 doctors were watching," he added. Such overseas live demonstrations occurred on several occasions and has been extended to Japan, Singapore, Hong Kong, Perth and Rawalpindi as well.

Talking on the advances in cardiac therapy, Dr Seth said that Sirolimus coated stents are found to be giving promising results, cutting down restenosis to a bare minimum. "So far, we have done 658 implants, may be the second biggest in world, and we encountered only one case of restenosis," pointed out Dr Seth. The result of the global randomized blind fold study puts the relapse possibility at less than two per cent level.

"The effort is now towards perfecting this technology. This calls for multiple factors. We need to work at different levels from diffusion property of the drug used, design of stent, the way stent is implanted, etc," informed Dr Seth. These could help achieve zero per cent relapse rate, a revolution in cardiac therapy. "Experience shows that longer stents increase the restenosis susceptibility factor where as short stents cut down the risk of relapse".

While a genetic factor is involved in susceptibility towards cardiac disease, more studies are needed to assess the genetic component and this could lead to maturing better therapies and preventive methods, according to Dr Seth. Over the past few years, the healthcare scene in the country has been witnessing revolutionary developments. Access to hi-tech therapies are on the rise owing to increased awareness coupled with insurance schemes. "We need to channelise therapy and take advantage of technological advances. Cost reduction will happen at various levels, say, TPAs, health insurance, competition, large customer base and increased usage," explains the doctor. Dr Seth calls for a legislation that will make it mandatory for corporates to provide insurance cover to employees.

"Only a few corporates are utilising TPA services in the country. However, there is a 30 per cent increase in TPA services now compared to a mere 2 per cent 10 years before," states the doctor.

The main hindrance in cost reduction is that we do not have such quality control systems in place that will change the whole perception of locally manufactured products/ technology. Dr Seth says, "We need to create confidence. We should have quality control bodies that could do this effectively". In the US, no product will see market, either domestic or overseas, without the mark of the quality control body. In India, the case is entirely different and the consumers do not have any confidence in local quality markings or local products. The QA should be acceptable not only domestically, but globally too."

The list of invited lectures at international academic forums on advancements in cardiology by Dr Seth crosses 65 and at the national forums, it is a voluminous 132. Dr Seth has to his credit more than 10 invited/review articles and 24-odd-peer reviewed articles. He has presented about 15 abstracts at international meetings and the total number of abstracts run to about 77. Dr Seth is the Vice-President of the Cardiac Society of India from the year 2001 onwards and is on the executive committee member of SAARC Cardiac Society from 1997.

An internationally renowned cardiologist who performs the maximum number of angiographies and angioplasties in the whole of Asia-Pacific and one of the highest numbers of them in the world, Dr Seth is in the Limca Book of Records. He and his team perform nearly 9000 angiograms and 2500 angioplasties per year.

National and international acclaim are in abundance and these include, IJCP Interventional Cardiologist of the Year 2001-02 Award, Delhi Ratan Award, Shresth Shree, Khatri Ratan - National Award, 20th Century Award for Achievement, Distinguished Intervent-ional Cardiologist Award and Andreas Gruentzig Award among others.

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