EHM People

Setting Yet Another Record

A team of Indian surgeons led by Mumbai-based Dr Rakesh Sinha, Dr Neeta Warty and anaesthetist Dr Manju Sinha (Dr Rakesh's wife) had walked their way into the Limca Book of Records in 2003. This was for laparoscopically removing world's heaviest fibroid weighing 3.4 kilograms and measuring 20 x 12 cms (7.8 x 4.7 in) from a 37-year-old woman in December 2000 at Dr Sinha's Bombay Endoscopy Academy and Centre for Minimally Invasive Surgery (BEAMS), a Super Speciality Hospital for Women. Now, after three years, the 49-year-old Dr Sinha was pleasantly surprised to know that the same feat has also notched up a record at the Guinness Book of World Records. His data on this laparoscopic removal of very large fibroids was published in the American Journal of Gynaecological Laparoscopy in November 2003.

"The patient was suffering from great mental agony for being infertile due to her fibroids, which were so heavy that it made her look nine-months pregnant. It is a matter of great pride that we could perform this surgery and it is a clear signal to the world that medical expertise is of the highest standards in India," Dr Sinha tells us. In India, approximately 25 million women between the ages of 18 and 50 are at risk of fibroids. "Besides the discomfort and pain associated with fibroids, the greatest trauma of having a fibroid is that it can hamper pregnancy and child birth. Fibroids do not respond to medical drugs and require surgical intervention if they cause symptoms or grow abnormally. The availability of minimally invasive techniques like laparoscopy make fibroid management easier," says Dr Sinha, who has removed close to 1,000 fibroids.

The People's Man

The boom in Indian healthcare industry has spawned a new band of leaders, who spearhead operations and business development of their groups along with motivating employees to perform. The 44-year-old Dr Sanjiv Malik, Chief Executive, Max Healthcare, is one of them. So, we asked him to define leadership qualities. "A leader can be both democratic and dictatorial. In times of casualty or emergency, he has to be dictatorial. In other situations, he can be democratic," he tells us. Additionally, a leader should be compassionate, understand others' problems and be a part of the team. "He should be a reformist, but he should convince others to accept his ideas and vision rather than foisting his ideas on them," he maintains, adding that he is a complete people's man. And a leader is not a true leader, unless he is accepted by his team.

A believer in delegation of work, he holds that delegation should come with authority. A renowned ophthalmic surgeon, he opted for administration at the peak of his busy career. "I was feeling stagnant and wanted to learn more and grow and hence had changed gears to administration," he explains. Interestingly, he still does consultation, but does not conduct surgeries.

Dr Malik's life has been an interesting melange of fun, struggle, adventure, spiritualism and responsibility. To know more about him, do read our October issue.

Ensuring Pain-free Relief For Breast Cancer

Dr C B Koppiker, 47, associated with starting the first mamographic clinic in Pune in 1993 and introducing screening women for breast cancer in Pune, has recently pioneered the Mammotome Breast Biopsy System in Western and Central India. In association with NGO Prashanti Cancer Care Mission (PCCM), he has installed the Mammotome Breast Biopsy System. The Rs 18.5 lakh system from J&J, used at Ruby Hall Clinic, helps doctors diagnose breast abnormalities.

The advantage of this system is that biopsies are performed in less than an 30 minutes and require no stitches. "The Mammotome system offers women a minimally invasive alternative to an open surgical biopsy, which can leave scarring and result in disfigurement of the breast," says Dr Koppiker, Director, Cancer Center at Ruby Hall Clinic. The only way to diagnose breast cancer early is to pick it up when it is not felt as a lump. But by the time a cancer gets to this size where it can be felt to the hand, it is about eight years late. "Thus mammography is essential as a screening tool to detect breast cancer before it grows to become a lump. Once such a subtle abnormality is detected on mammography it can be easily biopsied with the help of the Mammotome system. Even if a lump is non-cancerous, it can be completely removed with this equipment in an OPD setting," adds Dr Koppiker.

Procedures with the Mammotome system involve the one-time insertion of a thin probe, few millimeters in diameter under ultrasound guidance, directly into the area of the breast that appears suspicious. "Once inside, the Mammotome gently vacuums out the suspicious tissue or the fibroadenoma for analysis," explains Dr Koppiker. The estimated cost of the whole procedure for biopsy of a cancerous lesion or total removal of a non-cancerous lesion averages out to around Rs 15,000.

First Indian To Use HUNA

It was difficult to track down Dr V Nagesh, a psychiatrist from Secunderabad, who is the first Indian doctor to use a phychiatric technique called HUNA. Dr Nagesh, who learnt this technique from the Institute of Hypnosis, Chicago, US, says, "HUNA is a technique used only for some specific cases and works very well on its subjects. It cannot be used on everybody and needs thorough expertise. HUNA is definitely an added attraction in the various techniques we use for treating our patients."

He has been using this technique from around one-and-half-years now in India. "I have used HUNA with 85 per cent success rate," he adds. Surprisingly, HUNA is not yet certified in India, but is a success in many countries. "I always inform my patients, who I think need HUNA, about the non-certification of this technique. Then it is their take," informs Dr Nagesh.

For HUNA to secure a place in the curriculum of medicos, it has to have the approval of the HRD and the UGC first. "These permissions will consume a lot of time and hence medicos will have to wait for HUNA to be established in our country," says Dr Nagesh.

Many psychiatrists have asked Dr Nagesh to help them learn HUNA, but he wants to play safe and do not want to touch teaching before the certification. He has been invited to give lectures on HUNA from France, England, Kuala Lumpur, Sri Lanka, Singapore.