Mulund resident Babu Michael received a new lease of life after a team of Mumbai doctors from Jaslok Hospital & Research Centre successfully performed a complex surgery, in what they are calling a groundbreaking medical achievement. The doctors conducted a simultaneous coronary artery bypass graft (CABG) surgery and deceased donor liver transplant (DDLT) on 63-year-old Michael. It is a complex dual procedure, which they say is a first in India, and highlights the hospital's expertise in complex medical procedures. The case also underscores the growing challenge of managing coexisting cardiovascular and liver diseases, a trend on the rise globally. Michael was diagnosed with cirrhosis seven years ago after secondary to non-alcoholic fatty liver disease (NAFLD), a condition affecting one-third of India's population and increasingly linked to liver cancer. In 2021, he underwent a focussed radiation therapy (SBRT) for liver cancers, a treatment he required again in April 2024. While the tumours were partially controlled, his liver function began to decompensate, necessitating a liver transplant. During his pre-transplant evaluation, it was detected that he has significant blockage in his left main coronary artery. Dr Rahul Chhabria, associate director, Emergency Cardiology said the coronary blockages require revascularisation with surgery prior to his liver transplant and that he was not a candidate for angioplasty as he had complex anatomy of his left main vessel and also it would have postponed his liver transplant. This presented a complex dilemma: delaying the transplant to address the heart condition risked further cancer progression and liver deterioration, while performing either surgery alone carried significantly elevated risks due to the combined impact of both diseases. The doctors came up with the initial plan considering a live donor transplant, but after careful evaluation, prioritising donor health and recognising the potential for recipient instability during such a complex procedure, the team decided against this approach. Michael was then placed on the waiting list for a DDLT understanding the uncertainties and potential wait times associated with cadaveric donation. Hope arrived unexpectedly with the selfless generosity of the family of a 47-year-old deceased donor, turning their tragic loss into a life-saving gift for Michael. This prompted a rapid mobilisation of the hospital's resources, with intensive care units and social workers working tirelessly to facilitate the complex logistical and medical preparations. The intricate surgical process began with Dr. Upendra Bhalerao, consultant cardiac surgeon, performing a beating-heart, off-pump CABG. This technique aimed to minimise surgical trauma and optimise Michael's condition for the subsequent transplant. Dr. Bhalerao emphasised the high-risk nature of the procedure and the need for meticulous precision to ensure Michael's readiness for the liver transplant. Following a period of close observation to ensure stability and the absence of bleeding, the green light was given for the liver transplant. The transplant team, led by Dr. Shailesh Sable, Dr. Pravin Agrawal, Dr. Vibha Varma, and Dr. Vivek Shetty, then commenced the complex procedure. The anesthesia team, comprising Dr. Mohit Rohra, Dr. Nikhil Konde, and Dr. Savi Shah, played a crucial role in maintaining hemodynamic stability and managing Michael's physiological parameters throughout both surgeries, performed within a time duration of 12 hours . Remarkably, Michael tolerated both procedures well. He was taken off the ventilator on the second day and made a steady recovery, being discharged home after two weeks with both his heart and new liver functioning normally. The critical care team led by Dr Shruti Tandan, diligently looked after the patient’s well-being in the pre-operative and post-operative period in the hospital “In the era of modern medicine , we often stretch the limits. Cardiac disease is the leading cause of death in patients with NAFLD and it is important to screen patients for a silent heart involvement. This is one of such cases wherein a simultaneous very high risk dual surgery were performed by multidisciplinary team effort , careful planning and flawless execution. Mr Babu can live a normal life and we all feel satisfied about it,” commented Dr Aabha Nagral, director gastroenterology, chief hepatologist and Liver transplant physician at Jaslok Hospital, who managed the patient over the last 7 years. “This pioneering case underscores the importance of thorough pre-transplant evaluations, multidisciplinary collaboration, and the life-saving potential of organ donation. It also highlights the increasing need for innovative approaches to manage complex cases involving coexisting conditions, particularly in the context of the rising prevalence of NAFLD and cardiovascular disease” stated Dr Shailesh Sable, director liver transplant programme at Jaslok Hospital. Speaking about the case Dr Upendra Bhalerao, consultant & coordinator cardiovascular thoracic Surgery mentioned “This was a very high risk and challenging procedure and the surgery also need to be performed well in time so as to make him suitable for liver transplant . The procedure was performed as beating heart of pump coronary artery bypass surgery. The cardiac surgical team was very diligent in maintaining hemodynamic stability , perioperative bleeding control and perfect outcome.” Delighted with the result, Mithila Michael, the daughter expressed, “After knowing the extent of his liver and heart problem, we thought it is impossible for him to survive with a good life. The team at Jaslok has put in Herculean effort to get his heart fixed and liver transplanted. We are extremely grateful for the support and effort and sincerely admire the dedication and team effort. We are also thankful for the donor family for their noble act of donating the liver to my papa." Addressing the media, she added, "It was a very difficult time for us especially because I don't live with my family because I live overseas. I saw how my father was losing upper body mass and it is not only my father but also the family that was stressed. I want to thank all the doctors at Jaslok Hospital for their effort." With the global trend of the challenge of managing coexisting cardiovascular and liver diseases, Dr Nagral speaking exclusively to mid-day explained, "Liver cirrhosis raise the possibility of tumour in people because liver cirrhosis is a pre-cancerous condition and therefore it has been recommended that all patients with cirrhosis should have an ultrasonography and a tumour marker called AFP ( alfafetoprotein) every six months for their lifetime so that these can be picked up early and treated. Waiting for symptoms to develop from a tumour may be too late to treat the tumour." With a case like Michael's, she emphasises, "The possibility of heart attack increases in people with liver disease as the commonest cause of death in patients with fatty liver disease is from heart disease. Therefore it is important to screen them for coronary artery disease." Adding to Dr Nagral, Dr Bhalerao speaking to mid-day added, "Patients with liver cirrhosis and fatty liver often have obesity , diabetes and hypertension as associated conditions - together called as Metabolic syndrome. "This increase chances of developing blockages in coronary arteries causing heart attacks," concludes the Mumbai-based doctor highlighting the complexity of Babu Michael's case.
12 December,2024 09:48 AM IST | Mumbai | Nascimento PintoIn a rare medical case of 49 year old Manpreet Kaur, who suffered from Granulosa cell tumor in her ovary successfully underwent surgery to remove her 9.2 kg tumour, lasting over 10 hours and losing over 1.5 litres of blood. According to Dr MD Ray Department of Oncology Surgery, Institute Rotary Cancer Hospital, AIIMS Delhi, "This kind of complicated recurrent cancer patient should not be considered inoperable unless it is explored by an experienced cancer surgeon with an expert Onco anaesthetic team in a high volume centre." "But with the patience and expertise it was done ultimately. Total blood loss was 1.5l and duration of surgery - 10 hours. Weight of the tumor is 9.2kg , the patient doing fine and her overall survival would be increased." Dr Ray explained On possible treatment and challenges involved for stage 4 rare ovarian cancer cases, he said that doctors have to be very cautious while using the technique, one must have expertise. "Ultimately, we made it possible, and that patient is doing very nice. We are very, absolutely happy for that." Dr Ray said. "Any kind of cancer, when it occurs, particularly it involves multiple organs, you can't get the access to deal with this tumour, because you have to dissect the intestine. Sometimes you have to dissect the maximum length of the intestine, bladder and apart from the bowel, different involve work there and great vessels. So this kind of challenge is there. So it's not easy to take the decision whether you should go or not, but in an expert center, expert surgeon, expert anesthesia team and high volume center, that is practically possible," the doctor said. He further said that such a case should not be declared as a 'palliative case' due to its complexity, and understanding that in certain situations, such treatment is possible. "The message is this kind of patient, because the surgery is the only mainstay of treatment, thereby, without exploration by the expert and high volume center, one should not declare as like this is a palliative case. Surgery cannot be possible, but surgery is possible in this kind of high volume center." Dr Ray explained. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
12 December,2024 09:46 AM IST | New Delhi | ANIIndia has seen significant progress in reducing malaria incidence and mortality rates, according to the latest World Malaria report, from the World Health Organization (WHO) on Wednesday. Malaria is a life-threatening disease spread to humans by female Anopheles mosquitoes. It is preventable and curable. The report showed that the number of estimated malaria cases in India decreased to 2 million cases in 2023 from 6.4 million in 2017 (69 per cent decrease). Similarly, the estimated malaria deaths decreased to 3,500 from 11,100 (68 per cent decrease) during the same period. As a result, “India exited the High Burden to High Impact (HBHI) group officially in 2024”, the WHO said. The HBHI approach is a targeted malaria response that is used in several countries to accelerate the pace of malaria elimination in countries with high malaria burden. India joined the HBHI initiative in July 2019. The HBHI initiative was launched in four states in India: Chhattisgarh, Jharkhand, Madhya Pradesh, and West Bengal. Further, the report showed that in 2023, India accounted for half of all estimated malaria cases in the WHO South-East Asia Region, followed by Indonesia, which accounted for just under one-third. The Region had eight malaria endemic countries in 2023 -- accounting for 4 million cases and contributing 1.5 per cent of the burden of malaria cases globally. Just over 48 per cent of all estimated cases in the region were due to P. vivax. However, from 2000 to 2023, malaria cases reduced by 82.4 per cent, from 22.8 million in 2000, and incidence reduced by 87.0 per cent, from 17.7 to 2.3 per 1000 population at risk, the report said “The decrease can mainly be accounted for by a decrease in India of 17.7 million estimated cases and a decrease in incidence by 93 per cent, from 20 to 1.5 per 1000 population at risk,” the WHO reported. At the same time, India and Indonesia accounted for about 88 per cent of all estimated malaria deaths in this region in 2023. Notably, Bhutan and Timor-Leste, from the Region, reported zero malaria deaths since 2013 and 2015, respectively, while Sri Lanka was certified malaria-free in 2016. “The progress follows the highest ever political commitment by Member countries, matched by tangible actions and unstinted efforts over the years down to the sub-national level,” said Saima Wazed, Regional Director WHO South-East Asia. “However, accelerated efforts against malaria must continue, to eliminate the disease in countries where malaria persists, and to sustain the progress in countries where the disease is on the decline or has been eliminated,” she added. Globally, the WHO data reveals that an estimated 2.2 billion cases of malaria and 12.7 million deaths have been averted since 2000, but the disease remains a serious global health threat, particularly in the WHO African Region. In 2023, there were an estimated 263 million cases and 597,000 malaria deaths worldwide -- representing about 11 million more cases in 2023 compared to 2022, and nearly the same number of deaths. “An expanded package of lifesaving tools now offers better protection against the disease, but stepped-up investments and action in high-burden countries are needed to curb the threat,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. Also Read: Climate change responsible for 19 per cent of rising dengue cases, finds study This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
11 December,2024 03:09 PM IST | Mumbai | IANSThe winter weather can significantly affect the skin, leaving it dry, flaky and sensitive. The cold air and low humidity can worsen skin health while causing a range of skin-related issues. The seasonal shift calls for a change in skincare practices and routines. “During winter, people are often seen complaining about worsening skin conditions like eczema, psoriasis and rosacea. The lower levels of sunlight in winter can impact your skin leading to vitamin D deficiency,” informs Dr Rinky Kapoor, Consultant Dermatologist, Cosmetic Dermatologist and Dermato-Surgeon at The Esthetic Clinics. Skincare tips for winter She shares the following tips to keep your skin healthy, hydrated and glowing during the cold weather: Stay hydrated from within: If you want healthy and glowing skin, make sure you stay hydrated. Drink plenty of water, and you can even try eating fruits like watermelon due to its water content. Additionally, stews, soups, and herbal teas can not only help you stay hydrated but also provide you with much-needed warmth during the colder months. Skip extremely hot showers: Who doesn’t love taking hot, steamy showers during the winter? While it might be tempting to do so, prolonged exposure to hot water can be harmful for your skin. Over time, it can strip the skin of natural oil, making it look dry and extremely rough. Moisturise your skin: Ditching moisturisers during winter is a big no-no. As the temperature drops, it becomes vital to moisturise your skin. Look for moisturisers that contain ingredients like hyaluronic acid, glycerin, shea butter and ceramides. These ingredients provide intense hydration to your skin while strengthening the skin barrier. Don’t forget your SPF: It’s a common myth that you only need to apply sunscreen during the summer or when the sun is too bright. Sunscreen needs to be applied every day, even during the days when sun rays aren’t too strong. Go for broad-spectrum sunscreen with SPF 50 for better coverage and UV protection. Also Read: Ultimate bridal skincare guide: Say ‘I do’ to radiant skin on your big day
10 December,2024 04:35 PM IST | Mumbai | mid-day online correspondentIn a significant feat, researchers at the Indian Institute of Technology (IIT) Madras on Tuesday released the most detailed 3D high-resolution images of the foetal brain. For the first time in the world, 5,132 brain sections were digitally imaged at cell resolution using cutting-edge brain mapping technology developed by the team at Sudha Gopalakrishnan Brain Centre at IIT. The research is critical for India as the country accounts for nearly one-fifth of the world’s childbirths at 25 million each year. This makes it vital for the country to understand brain development from the foetus to a child, to adolescence, and a young adult, and developmental disorders like learning disabilities and autism. “This study will pave the way for new scientific discoveries, allowing quantification of neurodevelopmental disorders and advances in fetal medicine. This is now the largest publicly accessible digital dataset of the human fetal brain, advancing current knowledge by 20X. This is the first time such advanced human neuroscience data has been produced from India and made freely available as a global resource,” said Prof. Mohanasankar Sivaprakasam, Head, Sudha Gopalakrishnan Brain Centre, IIT Madras. The key applications of generating such high-resolution brain images are advancements to current foetal imaging technologies, for early diagnosis and treatment of developmental disorders. This work termed ‘DHARANI’, is available open source, and will advance the field of neuroscience and potentially lead to the development of treatment for health conditions affecting the brain. “I am delighted that India is at the forefront in generating human foetal brain maps for the first time through this cutting-edge technology developed by IITM’s Brain Centre. We are pleased that the support from our office has seeded this pioneering effort advancing scientific knowledge in this frontier area of brain sciences, and has generated a global resource for researchers worldwide,” said Prof. Ajay Kumar Sood, Principal Scientific Adviser. These findings have been accepted for publication as a special issue by the Journal of Comparative Neurology.
10 December,2024 03:23 PM IST | Chennai | IANSLove to binge on ultra-processed food (UPFs) like chips, biscuits, sausages, burgers, soft drinks, and instant noodles? Beware, these can make you age faster biologically, warned a study. A person's biological age is a relatively new way of measuring a person's health. It refers to how old a person seems based on various molecular biomarkers. A person with a healthy lifestyle may have a biological age younger than their chronological age, while poor lifestyle choices, such as a diet high in UPFs, can accelerate biological ageing, said researchers from Monash University in Australia The study, published in the journal Age and Aging, involved 16,055 participants from the US aged 20-79 and showed that for every 10 per cent increase in UPF consumption, the gap between biological and chronological age widened by approximately 2.4 months. Participants in the highest UPF consumption quintile (68-100 per cent of energy intake in their diet) were biologically 0.86 years older than those in the lowest quintile (39 per cent or less of energy intake in their diet). Nutritional biochemist Dr. Barbara Cardoso, a senior lecturer in the University's Department of Nutrition, Dietetics, and Food said the findings underlined the importance of eating as many unprocessed and minimally processed foods as possible. "The significance of our findings is tremendous, as our predictions show that for every 10 per cent increase in total energy intake from ultra-processed food consumption there is a nearly 2 per cent increased risk of mortality and 0.5 per cent risk of chronic disease over two years," she added. UPFs are industrial formulations typically containing ingredients not commonly used in home cooking, such as hydrogenated oils, high-fructose corn syrup, flavour enhancers, and emulsifiers. These foods are high in salt, sugar, fats, and other unhealthy elements and are designed for convenience and long shelf life. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
10 December,2024 03:15 PM IST | New Delhi | IANSA large-scale Swedish study on Monday suggested that drinking sweetened drinks can significantly increase your risk of serious cardiovascular diseases like stroke, heart failure, and atrial fibrillation. The study also showed that eating too much-added sugar can increase the risk of stroke or aneurysm. However, limited consumption of treats can be safe. “Consuming sweet drinks was worse for your health than any other form of sugar," noted the study published in the journal Frontiers in Public Health. Suzanne Janzi, a doctoral candidate at Lund University said that the sweetened beverages, which contain liquid sugars, "typically provide less satiety than solid forms" Janzi said this makes people feel less satiated "potentially leading to overconsumption”. Moreover, unlike treats that are "often enjoyed in social settings or special occasions, sweetened beverages might be consumed more regularly.” To understand how sugar consumption affects cardiovascular disease risk, the team collected data from two major studies with a sample of 69,705 participants. The study evaluated the link between honey, treats like a pastry, or sweetened beverages like fizzy drinks -- and seven cardiovascular diseases: two different types of stroke, heart attacks, heart failure, aortic aneurysms, atrial fibrillation, and aortic stenosis. During the 10 years of follow-up, 25,739 participants were diagnosed with cardiovascular disease. High intake of sugar in general raised the risk of ischemic stroke and abdominal aortic aneurysm. It also spiked the risk of heart failure in participants with a normal BMI. Notably, they found that the highest risks of a negative health outcome arose in the lowest intake category for treats, suggesting that "extremely low sugar intake may not be necessary or beneficial for cardiovascular health.” However, Janzi said the study is “observational and cannot establish causation". Also Read: Adopting a healthy diet can reduce severity of chronic pain: Study This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
10 December,2024 10:13 AM IST | Mumbai | IANSAdopting a healthy diet can reduce the severity of chronic pain, an Australian research has found. In a new study, researchers from the University of South Australia found a direct link between greater consumption of food within the federal government's Australian Dietary Guidelines and lower levels of body pain, particularly among women, reports Xinhua news agency. "It's common knowledge that eating well is good for your health and well-being. But knowing that simple changes to your diet could offset chronic pain could be life-changing," Sue Ward, a co-author of the study, said. Previous research has found that over 30 per cent of people globally suffer from chronic pain, with women and people who are overweight or obese more likely to be affected. The new study found that higher consumption of core foods -- vegetables, fruits, grains, lean meats, dairy and alternatives -- reduces chronic pain regardless of a person's weight. "Knowing that food choices and the overall quality of a person's diet will not only make a person healthier but also help reduce their pain levels is extremely valuable," Ward said. The study found that the effect of healthy diets reducing chronic pain was more prominent for women than for men. Ward said it is possible that the anti-inflammatory and antioxidant properties of core food groups are what reduce pain, but the team cannot say with certainty whether poorer quality diets lead to more pain or if pain leads to a poorer diet. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
09 December,2024 06:51 PM IST | Canberra | IANSA team of researchers in the US has shown that a high fibre, plant-based dietary intervention may delay progression to multiple myeloma, a type of rare and incurable blood cancer affecting the bone marrow. The team at Memorial Sloan Kettering Cancer Center (MSK) has reported results from the first-ever clinical trial in this regard. "This study showcases the power of nutrition — specifically a high fibre plant-based diet — and unlocks a better understanding of how it can lead to improvements in the microbiome and metabolism to build a stronger immune system,” said MSK myeloma specialist Dr Urvi Shah, who presented these findings at the 2024 American Society of Hematology (ASH) annual meeting in San Diego, California. These findings further support how we as physicians can empower patients, especially those with precancerous conditions, with knowledge on reducing their cancer risk through dietary changes, she added The study enrolled 20 participants with a precancerous blood disorder and an elevated body mass index (BMI) at risk for developing multiple myeloma. They received 12 weeks of high fibre, plant-based meals and 24 weeks of coaching. Two participants with progressing disease prior to study showed a significant improvement of their disease progression trajectory. Additionally, at one year after enrollment, none of the participants had progressed to multiple myeloma. During the study, participants were encouraged to eat as much as they wanted if it was whole plant-based foods such as fruits, vegetables, nuts, seeds, whole grains, and legumes. With these dietary changes, there were significant improvements in quality of life, insulin resistance, gut microbiome health and inflammation. On average, participants lost eight percent of their body weight after 12 weeks. These findings were confirmed in a smoldering myeloma mouse model where 44 per cent of mice fed the high fibre diet did not progress to myeloma compared to the standard diet where all mice progressed to myeloma. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
09 December,2024 06:41 PM IST | New YorkCrores of devotees are set to assemble for the world's largest religious event Mahakumbh beginning on January 13, 2025, on the holy banks of Sangam in Teerthraj Prayagraj. Besides ensuring a robust pilgrimage framework for pilgrims, the Yogi Adityanath government has placed strong emphasis on their health through the establishment of Netra Kumbh, a special initiative dedicated to eye care. Spread over nine acres, Netra Kumbh targets will examine the eyes of more than 5 lakh devotees and distribute 3 lakh pairs of glasses simultaneously. Moreover, eye patients would also be identified during these examinations who require surgical interventions. They will be facilitated to undergo free operations at hospitals near their homes. This will be possible because of state govt inking agreements with more than 150 hospitals across the country. Kavindra Pratap Singh, chairman of the organising committee of Netra Kumbh, emphasised that for the first time in Mahakumbh history, patients referred by doctors for eye surgeries will be able to receive free operations at a hospital in their home district. "After examination, patients will receive referral cards, one of which will be sent to the respective hospital while the other will go to Saksham, the organising body of Netra Kumbh. Patients or Saksham workers can coordinate the surgeries based on convenience, both during and after the fair," he added. Kavindra Pratap Singh described Mahakumbh as "symbol of social harmony" and highlighted that Netra Kumbh represents a "mass eye treatment Mahayagna" aimed at addressing vision-related issues among devotees. He confirmed that doctors from the Indian Army would also volunteer their services free of cost, offering free examinations, medicines, and refreshments to eye patients. Netra Kumbh was first organised in 2019 and since then has grown substantially. During the 2019 Kumbh, the event entered the Limca Book of World Records by providing glasses to 1.5 lakh people and examining 3 lakh patients. This year, the scale of Netra Kumbh is expected to break the previous records, becoming the largest event of eye examinations and glasses distribution in any religious or medical event worldwide. Dr. Kirtika Agarwal, media coordinator of Netra Kumbh, said that the initiative will be set up in the fair area near Nagvasuki Temple in Sector 6. Netra Kumbh will run daily from January 12 to February 26, excluding the main bathing festival. She further added that approximately 150 doctors from outside the region will provide their services throughout the 45 days of Netra Kumbh, supported by 400 additional medical professionals. On any given day, 40 doctors will operate the Outpatient Department (OPD) from 8 a.m. to 2 p.m., with an extension up to 4 p.m. if needed. In addition to 40 doctors in the OPD, there will be more than 500 optometrists, out of which 100 will provide services daily. This combined team of 200 medical professionals and volunteers will be available to examine and treat eye patients daily throughout the fair. Also Read: Luxury tent city to be set up in Uttar Pradesh for Mahakumbh 2025 This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
09 December,2024 10:05 AM IST | Prayagraj | IANSAs the market for leadless pacemakers grows in India, doctors point out definite advantages of the technology for heart disease patients but also call for more data and analyses on its long-term effects. At the same time, researchers have written about the lack of a national registry tracking pacemaker implants, including conventional ones. A pacemaker helps a heart patient control an irregular heartbeat. In November, Abbott, the US-based healthcare and medical devices company, introduced the AVEIR VR single-chamber ventricular leadless pacemaker in India for treating patients having slow heart rhythms. The device has been approved by the Central Drugs Standard Control Organization, Abbott said in a statement. The AVEIR VR device is implanted directly into the heart's right lower chamber (ventricle) through a "minimally invasive, catheter-based procedure from the groin", thereby requiring no surgical cuts to the chest or wires, it said. Doctors consider a 'leadless' pacemaker an advancement over a conventional wired one, which has been commonly associated with infections. "A leadless pacemaker offers a powerful option for the treatment of people with cardiac arrhythmias or irregular heartbeats. Leadless pacemakers address known complications associated with traditional pacemakers," Dr Balbir Singh, group chairman-Cardiac Sciences, Pan Max, and chief of Interventional Cardiology and Electrophysiology at Max Hospital, Saket, said in the statement. Dr Singh, who recently implanted the AVEIR VR device in a 74-year-old woman, explained that the patient "came in a bad shape with a conventional pacing that had got badly infected". "She was running a high fever and was septic. There were vegetations (infections) on the valves of the heart. The leads, which reach the heart via valves, were infected and with them, the valves. The situation called for urgent intervention," he told PTI. He added that the pacemaker causing trouble was removed surgically and the leadless device implanted, following which the patient is now going about her daily life. Dr Ajay Kaul, chairman of Cardiac Sciences at Fortis Hospital, Noida, said the technology has definite advantages as the leads or wires in conventional pacemakers increase the chances of infection. "Most of the complications with conventional pacemakers were because of the leads -- they go to the heart via the tricuspid valve, where they can cause regurgitation (backflow). These problems are not present with a leadless pacemaker," he told PTI. However, even as patients with a high risk of infection are likely to benefit from leadless pacemakers, being a "new technology", there are concerns, especially those related to its long-term effects, according to Dr Kaul. Research from around the world has documented high success and safety rates, suggesting the leadless device's promise in the field of cardiac pacing, while also calling for clinical trial data to confirm the perceived advantages. Researchers from the UK's Royal Stoke University Hospital reviewed 18 studies that looked at almost 2,500 patients implanted with a leadless pacemaker and found that success rates ranged between 95.5 and 100 per cent. The results were published in 2022 in the Indian Pacing and Electrophysiology Journal. Another trial, titled 'LEADLESS II', that enrolled 200 patients from across the US, Canada and Europe found that the implant success rate was about 98 per cent, with a safety (no complications) of 96 per cent. "The most frequent complications were three cases of cardiac tamponade and three premature deployments," the authors, including those from the Mount Sinai Hospital in the US, wrote in the study published in the Journal of the American College of Cardiology (JACC): Clinical Electrophysiology. Cardiac tamponade can be life-threatening and occurs when excess fluid or blood fills the 'pericardium sac' surrounding the heart, preventing the organ from filling and functioning properly. While the technology "shows promise in the field of cardiac pacing", researchers from Emory University's School of Medicine in the US called for more clinical data. "As this technology continues to mature, randomised clinical trials comparing this technology to traditional transvenous pacemakers are needed to confirm or refute the perceived advantage of this technology," the authors wrote in a 2018 review article published in the Journal of Geriatric Cardiology. Meanwhile, researchers from India pointed out a lack of national data on pacemaker implants, including conventional ones. "More than 20,000 pacemakers are implanted each year in India and the numbers are growing annually. Despite this, there is no national registry in India that collects or tracks data of implanted devices," the authors from Bengaluru's Sri Jayadeva Institute of Cardiovascular Sciences and Research wrote. The 2018 study, which examined the profiles of heart patients undergoing pacemaker implants at the tertiary care centre between 1999 and 2014, was published in the Journal of Clinical and Diagnostic Research. "We need long-term data before we can fully rely on leadless pacemakers," Dr Kaul said. "Although some data is available, which has justified the use of this technology, more evidence is needed, particularly regarding its safety." Other leadless pacemakers available in India are Micra AV, developed by Medtronic, a medical device company headquartered in the US and Ireland, and Abbott's Nanostim. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
08 December,2024 01:32 PM IST | New Delhi | PTIADVERTISEMENT
