Breast Cancer in Indian Women Increases as Cervical Cancer cases dips

According to recent analysis of Cancer cases conducted across the 4 metros at Delhi, Mumbai, Chennai and Bangalore between 1982-2005 (24 years) by the Indian Council of Medical Research (ICMR) shows that while cervical cancer cases dipped, in some cases by almost 50%, breast cancer cases during the same duration has doubled. And, the trends contained in ICMR's yet-to-be-released report `Time Trends in Cancer Incidence Rates (1982-2005)', were universal in all four cities.

In 1982, Bangalore reported 32.4 new cases of cervical cancer in women per 100,000 population every year. The number dipped to 27.2 in 1991, 17 in 2001 and 18.2 in 2005.

At Delhi since 1988,there were 25.9 new cases of cervical cancer per 100,000 population, which dipped to 19.1 in 1998 and then to 18.9 in 2005.

The same story was repeated at Mumbai which recorded 17.9 new cases of cervical cancer per 100,000 population in 1982,which dropped to 12.7 new cases in 2005.

Chennai recorded a fall of almost 50% in cases of cervical cancer in this period of 24 years.

It was earlier believed that cervical cancer was most common in India, with more than 1.3 lakh new cases reported each year and 74,000 women dying annually from the disease.

While Bangalore saw breast cancer cases more than double since 1982 - 15.8 in a population of one lakh in 1982 to 32.2 in 2005 - Chennai recorded 33.5 new cases of breast cancer in 2005 against 18.4 in 1982.

Delhi recorded 24.8 new cases of breast cancer a year per 100,000 women which rose to 32.2 in 2005. Mumbai recorded 20.8 new cases of breast cancer per 100,000 population in 1982 which increased by almost 10% in 2005.

However experts believed that breast cancer rate in India was much less than that in the West which records around 100 new cases per 100,000 population every year.

To get yourself a preventive breast cancer check,please email us at enquiries@wockhardthospitals.net

source:Timesofindia

Treatements for Mental Health Disorders in US Doubles

A new government data on shows that U.S. spending on mental illness is soaring at a faster pace than spending on any other health care category.

The cost of treating mental disorders rose sharply between 1996 and 2006, from $35 billion (in 2006 dollars) to almost $58 billion, according to the report from the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services.

At the same time, the report showed, the number of Americans who sought treatment for depression, bipolar disorder and other mental health woes almost doubled, from 19 million to 36 million.

The new statistics come found that antidepressant use among U.S. residents almost doubled between a similar time frame, 1996 and 2005.

Spending on mental illness showed a faster rate of growth over the 10-year period analyzed than costs for heart disease, cancer, trauma-linked disorders, and asthma.

According to the report, spending on heart disease rose from $72 billion in 1996 to $78 billion in 2006; cancer care rose from $47 billion to $58 billion; asthma costs climbed from $36 billion to $51 billion, and expenditures for trauma-related care rose from $46 billion to $68 billion.

In terms of per-patient costs, cancer led the way at $5,178 in 2006 (up slightly from $5,067 in 1996), while costs for trauma care and asthma rose sharply -- from $1,220 to $1,953 and from $863 to $1,059, respectively.

On the other hand, average per-patient spending for heart conditions fell, from $4,333 to $3,964. And spending on mental disorders declined from $1,825 to $1,591.

source: MSNHealth.com

Gyanaecologist and Women Care Doctors at Bangalore

Doctor's Name:Dr. (Padma) Latha Venkataram
FRCOG (UK), MRCPI (Dublin)
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Doctor's Name: Dr Pratima Reddy
MRCOG,FRCOG ( London) Obstetrician & Gynaecologist

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Doctor's Name:Dr. Prabha Ramakrishna
DGO, DNB, MRCOG (London)
Diploma in Advanced Gynaecological Endoscopy (Germany)
Consultant Obstetrician and Gynaecologist


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Doctor:Dr.Aviva Pinto Rodrigues
MD,Consultant Obstetrician & Gynaecologist

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Doctor's NameDr. Anu Sridhar
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Doctor's Name:Dr. Geetha Belliappa
MD,Consultant Obstetrician & Gynaecologist

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Doctor's Name: Dr.Susheela Shetty
MD, DGO, DRCOG(London)
Consultant Obstetrician and Gynaecologist

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Joint Replacement Consultants at Mulund,Mumbai

Our Joint Replacement Surgeons at our Mulund Facilty,Mumbai


Doctor's Name: Dr Kaushal Malhan
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MS (Orth) Bombay, D (Orth) Bombay
Joint Replacement / Resurfacing and sports Surgeon


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Doctors Name : Dr Sachin Bhonsle
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Doctor's Name: Dr Sawant Milind
FRCS Orth, FRCS(Edin), FRCS(Glasg), MS Orth, FCPS Orth, D Orth, DNB Orth.
Knee Surgeon

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The The "Specialist Knowledge" Series on Clinical Specialties

The advent of new treatment modalities in medicine brings with it the opportunity to develop better clinical outcomes, while emphasizing a higher level of comfort and safety to our patients. You will, find in the pages of The Specialist, the acumen and expertise of our highly accomplished clinicalteams in Cardiology/Cardiac Surgery, Neurology/Neurosurgery, Orthopaedics, GI & Advanced Laparoscopic surgery besides Womens health.

‘The Specialist’ is a part of our Clinical Knowledge Series which we hope to share with with fellow doctors and medical fraternity on our latest clinical outcomes across various specialties.In this issue, we have some interesting case studies in all our core specialities mainly Heart care, Brain & Spine, Bone and joint and digestive care.

The Specialist Knowledge Series on Clinical Specialties Wockhardt Hospitals,Bangalore

Total Knee Replacement in Severly Deformed Rheumatoid Knee: A Case Study

Rheumatoid arthritis is a well known systematic inflammatory disease wherein arthritis of synovial joints is a major component. This disease is common in females and affects during third, fourth and fifth decades of their life. Initially the disease starts with pain and joint stiffness in small joints of hand and later involves big joints like hip, knee, shoulder and elbow. In an advanced rheumatoid arthritis all the joints of the body are involved.

Treatment of rheumatoid arthritis is ideally to be done by rheumatologist. Start with NSAIDS and later go on to combination therapy of DMARDS (steroids, methotrexate, leflunomide, sulfasalazine chloroquine and oral gold salts).

An Orthopedics role comes only after joint pain/ swelling and deformity are not controlled by medical treatment.

Indication of joint replacement in rheumatoid arthritis.

1. Severe pain in joints
2. Inability to do daily activities
3. Progressing deformity
4. Joint stiffness

Advantages of joint replacement

1. Painless and stable joints
2. Good functional movements of joints
3. Improvement in quality of life
4. Better disease control after surgery

With advent of new implants, good operation theatres, laminar flow and surgical expertise, it is possible to perform joint replacements even in severely deformed joints which was thought impossible previously.

Knee Replacement on a patient with severe Rheumatoid Arthritis

A 58 year old female patient consulted us with severe knee pain for four years. She was a known case of rheumatoid arthritis on medical treatment,she was unable to stand or walk and had severe pain on bending the knee.

This lady was poorly nourished and anemic. Local examination of both knees revealed that she has wind-swipe deformity. Right knee was in 30 varus deformity and range of movement was 0-90. Left knee was in 40 valgus and further valgus till 70. Range of movement was 0-30. X-ray of right knee showed severe varus deformity with medical tibial condyle defect and lateral subluxation of tibia. Left knee - severe valgus deformity with central tibial bone defect and lateral patellar subluxation.

Patient was admitted and complete pre-operative work done. The team of Orthopaedic surgeons headed by Dr. Sanjay Pai, Rheumatologist .A total knee replacement was done in a staged manner. First the right knee with varus deformity was operated using a revision total knee replacement implants. After five days, the left knee with severe valgus deformity was operated. Post operative period was uneventful and without complications.

The patient was mobilized on the third day with walker and was discharged on the sixth day. On the 12th day, the patient was able to walk without support, able to climb stairs and do her daily activities.

With Good surgical expertise along with highly efficient support staff now available in India and , these patients can get back their normal daily life style which was thought impossible in the past.

Courtesy: Dr. Sanjay Pai, M.S.
Dr. Srinivas J V, M.S.
Dr. Vasudev N Prabhu, M.S.
Department of Orthopaedic Surgery Wockhardt Hospitals, Bangalore

Treatement in Movement Disorders

Movement is triggered through the pyramidal system, the basal ganglia and the cerebellum in the brain.These are discrete parts of the brain which perform specific but different functions, which are wired to each other for the performance of normal movement. The movement disorders are a diverse group of pathological dysfunctions in the nervous system, giving rise to any of these: an abnormal movement, a paucity of movement, an abnormality of muscle tone or a disturbance in posturalreflex.

The common movement disorders are Tremors, Chorea, Parkinson's disease, Dystonia and Writer's cramp.

The patient gives a detailed history of what has been occurring in terms of the symptoms. The investigation is followed by a neurological physical examination. Scales are used(basically written proformas) to assess the severity and type of movement disorder. Various movement sequences are recorded on video as a baseline before any treatment, to later compare the patient's performance in specific functions. This is followed by basic bloods tests, a CT/ MRI brain scan and EEG or EMG along with some specific tests that may be needed, depending on the diagnostic possibilities that the physician is thinking of.

The various treatments in Movement Disorders that are generally followed includes

1) Medications: Medications that either stimulate or inhibit the specific receptors for central nervous system chemicals (neurotransmitters) are the mainstay of treating such disorders

2) Botulinum toxin injection: This toxin is injected into muscles to partially paralyze them, and thereby control the abnormal movement.Several sites are injected in one sitting, and several such sessions may be required at 4 week intervals.

3) Stereotactic surgery: After detailed visualisation using CT/ MRI and mapping the brain, ablation (destruction) of certain parts of the brain nuclei and/ or its circuits will generally give relief from the abnormal movement.

4) Deep brain stimulation: The position of the basal ganglia nuclei are identified using CT/ MRI brain scans. Electrodes are placed onto specific brain nuclei and electrical signals are sent from a generator placed under the skin, in the chest. The patient has the option of controlling the current from the generator, for symptom relief.

The first task of the physician is to arrive at a diagnosis, or a highly probable diagnosis, using variouslines of investigation.The best line of treatment: Each patient would need to be tried on a specific combination of drugs which may vary from 1 to 3 months, to assess the best outcome with drug management.

Specific Medical Concerns on Movement Disorders

Following this minor adjustment in drug dosages may be required once every three months
.
Likely outcomes: It is usually expected that the abnormal movement decreases to a remarkable extent. If the problem had been one of rigidity and paucity of movement, then movements should be more easily performed. A small sub-set of patients are not likely to improve on medications, for which deep brain stimulation or Stereotactic surgery should be considered to give optimal relief.

Movement disorders are generally progressive degenerative disorders, which means that the pathological course cannot be greatly altered, though significant improvement in function can be provided. However, the goal of management is to provide optimal relief and restore normal functionality, with the least side effects and thereby significantly improve the quality of life for the patients.

source:

The Department of Neurology at Wockhardt Hospitals

Dr. Chandran Gnanamuthu ,MD, DM, FIAN, FAAN DM PhD (Neuro Sciences)
Dr. C. Udaya Shankar,Specialist in Movement Disorder
Dr. Vijay Chockan,Consultant Neurologist Consultant Neurologist Consultant Neurophysiologist