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Following is the top ten surgeon in India, in the five most common surgical specialities: heart, orthopaedic, neurosurgery, ophthalmic surgery and reconstructive surgery from HindustanTimes article.

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NEUROSURGERY
Dr Vipul Gupta, 41, Head, Neuro-intervention, Medanta – The Medicity

Vipul Gupta watched his 33-year-old brother die of a malignant tumour in the brain eight years ago. “We knew it was hopeless but we went all the way. He was operated on thrice, at the All India Institute of Medical Sciences in India and Cleveland Clinic in Ohio and Memorial Sloan-Kettering Cancer Center in New York. That’s when I realised that even when the chips are down, the family does not give up, so you have to give it your best,” says the Delhi-based Gupta. He’s a little embarrassed about the emotional outpouring. “Surgeons can’t be emotional, it won’t help the patient on the table. You have to be calm and think clearly,” he says. At 41, Gupta heads neuro-intervention at Medanta – the Medicity, where he moved after doing his MBBS from Delhi’s Maulana Azad Medial College in 1996 and training in neuro-radiology at All India Institute of Medical Sciences (AIIMS) for three years. “I’m out-doorsy and enjoy swimming, rafting and rock-climbing. I broke my knees twice in school. The operation and forced bed-rest for six months slowed me down, forcing me to study which helped me crack the MBBS easily,” he laughs.

Dr Deepak Agrawal, 40, Associate professor, Neurosurgery, AIIMS
He’s the guy at the frontier, treating accident victims at the AIIMS Trauma Centre, best known for treating some of the bloodiest and most bizarre accident cases in the country. “Most accident victims we get are people with severe head or spinal injuries that are often fatal. It does get you down, but nothing can beat the high of seeing a patient everyone including your colleagues had given up on, walk into your clinic for a follow-up. That’s when you know that miracles do happen,” says Dr Agrawal. Agrawal did his MBBS at the University College of Medical Science in 1994 – where he met his onco-surgeon wife Swati – and his training in neurosurgery at AIIMS. “My professional high was being awarded the ‘Young Neurosurgeon of the Year’ Award by the American Congress of Neurosurgeons in 2008. The personal one was my daughter Ayushi, who is five,” he says. His father Dr Ved Prakash was also a neurosurgeon at AIIMS, so Agrawal’s becoming a surgeon was almost pre-determined. “I like to catch up on my emails before breakfast, so I begin work at 5.30 am. I leave home at 7.30, doing rounds of the ward for three hours, which is followed by surgeries that usually go on till 7. Then come the evening rounds, which finish at 9 pm. Add to this administrative work, teaching and writing and correcting research papers, and my day never seems to end,” says Agrawal.

OPHTHALMIC SURGERY
Sri Ganesh, 44, Eye surgeon and chairman, Nethradhama Hospital, Bangalore

Bangalore residents are used to seeing Dr Sri Ganesh zooming down the streets to his farm on his Suzuki Intruder, which he exchanges for his Audi Q7 or BMW 5-Series when he visits the hospitals he set up. “Both my grandmas were blinded with cataract, one because of a botched up surgery. I think seeing them faltering around the house made me decide I wanted to do all I could to help people see,” says the 44-year-old. Eye surgery techniques have become much safer now. “Back then, there were no intraocular lenses (artificial lenses put inside the eye in place of the natural ones) and the failure rate of a simple cataract surgery was 30 per cent, largely due to infection. Now, less than 0.1 per cent cataract and vision-correction surgeries have complications,” he says. Sri Ganesh met his wife Sumanshree at a paratrooping camp in Agra. He was 17, she was 16. “Someone stole my things and she was very sweet,” he says. They married six years later, in 1990, after Sri Ganesh did his MBBS. The couple have three children, Supriya, Sushant and Skanda. Apart from running six hospitals – four in Bangalore, one in Mysore and one in Mangalore – Sri Ganesh runs a 90-bedded charitable hospital in Padmanabhanagar that does 8,000 free cataract surgeries a year.

Dr Mahipal S Sachdev, 52, Centre for Sight Group of Hospitals

Mahipal S Sachdev, eye surgeon to the rich and powerful, never invests in anything but health. “My last investment was Harshad Mehta and I burnt my fingers there,” says Dr Sachdev. His investments in healthcare – time, energy and money – have shown better results. Sachdev was told he was crazy when he quit as associate professor at the All India Institute of Medical Sciences (AIIMS) to join the newly-opened Indraprastha Apollo Hospital in Delhi in 1996. He was 37. The skeptics got it very, very wrong. Within 15 years of that, he’s running 17 eye hospitals that have become one-stop shops for eye disorders in north India. A year-long fellowship to Georgetown University in Washington DC in ’89-’90 opened his eyes, literally, to the technological imaging and surgical revolution happening in the field of ophthalmology. “I realised less invasive radical surgeries were the way forward, but I needed equipment and trained staff for that. I could not get that in a government set-up. So I set up my own centre, which started in a 8×10 foot room in Safdarjang Enclave in 1996, but we’ve grown a little since then,” he says with obvious pride. Sachdev is arguably the best person to go to for cataract and lasik surgery in India. “This is all I want to do, medicine is in my genes. My mother and brother are doctors, so is my wife Alka and daughters Ritika, 29, and Gitansha, 25,” says Sachdev. Sachdev also has an unexplored, fun side to him. “I did my MBBS from AIIMS, where I was the secretary of the students’ union. We were the ones who threw open Pulse, the students’ festival at AIIMS, to fashion, jam sessions and music. Before that, it was a sporting event. We made it socio-cultural,” he says.

COSMETIC SURGERY
Sunil Choudhary, 42, Aesthetic and Reconstructive surgeon, Max Speciality Hospital, Delhi
Quite like modern day Dr Frankensteins, attaching a hand and replacing chopped fingers with toes is all in a day’s work for reconstructive surgeons. Some, like Sunil Choudhary, who head the aesthetics and reconstruction at Max Speciality Hospital, start a conversation with, “Today, I attached two toes and one finger in the right hand of a 16-year-old who’d lost his fingers in a farming accident. He’ll be able to write now”. This is followed by an MMS of a surgery to fix a congenital defect in which a child’s skull stops expanding naturally, squeezing the brain and making it bulge out of the forehead. Unlike popular perception, silicone implants and other cosmetic procedures make up less than a third of a cosmetic surgeon’s case load. “A lot of what we do is related to reconstruction after cancer surgeries and accident cases, including burns and acid attacks,” he explains. Choudhary grew up in Delhi, went to school in DPS RK Puram and did his MBBS from Maulana Azad Medical College, after which he joined the training programme of the UK’s National Health Service.

Dr Shahin Nooreyezdan, 49, Plastic & reconstructive surgeon, Indraprastha Apollo

He insists on giving you a business card. “I’m the only one in the world with this name, so people often get it wrong,” says Dr Shahin Nooreyezdan. There is, however, a little boy called Shahin Sharma, who was called Golu before his grateful parents renamed him after the surgeon who reattached his finger. “It was deeply touching, but also strange. I guess now there’s another person in the world with a very unusual name,” he says. Nooreyezdan grew up in Mumbai, where he lived with his parents in a flat above Russi J Manekshaw, the granddaddy of plastic surgery in India. “Each day, I’d walk past his door on my way home from school and pass this display box with before- and after-surgery pictures, which kept changing every week. I was hooked and decided this was what I wanted to do,” says the Delhi-based Nooreyezdan. He moved to London in 1996, where he worked at St Andrew’s Hospital for three years and met his wife Neda, a British citizen. “When we decided to move back and I went to the Indian High Commission for a visa for my wife, the clerk there said, why are you going? You have a great future here!” he laughs. Most of his work in India is reconstruction. “Unlike other surgeons who can walk in to do the critical part of the surgery, I have to be there from the first incision to the final stitch because what I do is for everyone to see,” says Nooreyezdan, who gets women as young as 19 who need reconstruction after breast cancer surgery. The deft fingers that reconstruct tissues and reattach blood vessels 1.2-1.5 mm in diameter also help him pursue his hobby: collecting and repairing antique clocks. Nooreyezdan has a collection of over 125 pendulum clocks from all over the world, including grandfather clocks from the UK, clocks from ships and railway stations. “It started when I was 17, when I noticed an old, broken, clock at an Irani dhaba. I bought it for R170, got it home and fixed it. I still do it, though I have to pay a guy to wind them up in rotation once a week,” he says. He clearly knows how to wind down.

ORTHOPEDIC SURGERY

Dr Vijay C Bose, 44, Head of orthopaedic surgery, Apollo Chennai
He was part of British orthopaedic surgeon Derek McMinn’s crack team that developed the ‘Birmingham Hip’ – a hip implant that allows people to play contact sports and twist without shouting after a hip transplant – in the late ’90s. Yet what gives Dr Vijay Bose the greatest joy is recognition from his peers. “Three weeks ago, a renowned joint replacement surgeon from the US got his son to our centre for surgery. He’s one of the best in the world and could have done it himself, he could have got it done by the best in his own country, but he still came to India. That’s the quality India offers to the world now,” says Bose. Bose, who joined Apollo Hospital in Chennai in 2000 after six years in Birmingham and Liverpool in the UK, now routinely gets so many patients from overseas that he’s became the face of medical tourism in India for 60 Minutes on CBS News. “I did the first implant in Apollo in 2000 and since then, I have demonstrated the technique across 80 hospitals in India,” says Bose, who did his MBBS from Madras Medical College in 1990. Apart from hip replacement, he does knee and shoulder joint reconstructions.

Dr Suraj Guruv, 36, Orthopaedic surgeon, Asian Heart Institute, Mumbai
Dr Suraj Guruv’s last holiday was spent shooting wildlife at Bandhavgarh National Park in Madhya Pradesh, but he did not break any laws. Guruv is an amateur photographer and rarely leaves home without his Nikon Digital SLR. “I’m crazy about wildlife photography,” he says. When he’s not shooting, Guruv is fixing damaged hips and knees using minimally invasive bone-conserving surgeries in India that make it possible for people to run, drive and work just as they did before, after hip or knee replacements. Guruv is a Mumbai boy, who grew up in Prabhadevi, went to a neighbourhood school, did his MBBS at Mumbai’s Topiwala National Medical College and worked in Bombay Hospital before going to train in Singapore General Hospital. “I belong to a family of chartered accountants, my dad is one, so is my older brother. So when dad said try something else, I thought, why not?” says Guruv, who aced his entrance exam. “Even though I don’t invest in the markets, I still follow financial news very closely, perhaps because that’s what I’ve grown up hearing,” he says. He returned to India because he wanted to be part of the boom in medical care that India is witnessing. “We now have medical facilities at par with any other in the world, with better care,” he says.

HEART SURGERY
Dr Raja Joshi, 40  Paediatric cardiac surgeon, Apollo
He’s called the ‘bandana guy’ because he wears a bandana instead of a surgical cap while operating. Apart from his training as a paediatric heart surgeon during a five-year stint at Cleveland Clinic in the US, what defines Raja Joshi is his bandana collection. “You have to strike a chord with the kids you’re treating, and a bandana with Dalmatians on it sure helps to break the ice,” says the Delhi-based Joshi who, at 36, became one of the youngest surgeons in the country to set up a paediatric cardiac surgery unit in a major hospital. “My dad was in the air force, I grew up wanting to be a fighter pilot. It was after my class 10 boards that my dad told me there were other ways to earn a living,” he recalls. The idea of being a heart surgeon for children came a year later, after a Doordarshan show on a hole-in-the-heart being fixed. “It was so dramatic, the lights and the surgeons in scrubs, this child being immersed in ice to bring the body temperature down. Suddenly, that was the only thing I wanted to do,” says Joshi. He’s had no regrets. “It’s one of the few surgeries where the patients outlive the surgeons. You won’t believe the number of birthday invites I get. Anyone can do adult heart surgery, paediatric is what separates the boys from the men,” said Joshi. His wife Reena Joshi, 36, is a paediatric anaesthetist who’s helped him introduce innovations such as letting the mother stay with the child in the operation room till he sleeps. “Taking away a baby from the mother makes anxiety levels shoot up. Keeping them together till the baby is anaesthetised improves surgery outcomes,” says Joshi.

Pranav Kandachar, 37, Paediatric heart surgeon, Asian Heart Institute, Mumbai
Heart surgery is one of the cleanest surgeries there is, it’s like mathematics. The result is directly related to what you do, there are few surprises,” says Pranav Kandachar, the newest heart surgeon to join Asian Heart Institute’s team of surgeons. “Of course, there are some conditions in which you cannot play god, but in most cases, children can lead active, normal lives after surgery,” he says. After doing his MBBS from Bangalore Medical College in 1997, Kandachar worked at Sion in Mumbai, Apollo Chennai and Colombo, did a year long stint in New Zealand, returned to Bangalore to work at Shirdi Sai Baba Charitable Hospital, and joined the Asian Heart Institute, Mumbai, in January this year. “When you’re training, one institute can’t offer you everything. I’ve trained with the best,” he says. Kandachar describes himself as a nature kind of guy, being big time into hydroponics, a scientific method of growing plants in water – without soil – using mineral nutrient solutions. “I have a virtual vegetable garden in my little balcony, where I grow spinach, beans, cauliflower, coriander and mint. I’m planning to grow strawberries next,” he says. He’s also into ornithology and is part of a nature club that goes birdwatching to sanctuaries at least once a month.

Source: HindustanTimes, April 10

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Know Your BMI

Body mass index or BMI is a measure of the weight of a person in relation to their height.

BMI is often times used to determine whether or not a person is obese. As BMI increases, the risk of some diseases increases. A BMI of 30 or above is considered obese in adults, which means a person is at a higher risk for certain diseases, including heart disease, high blood pressure, and coronary artery disease (CAD).

BMI can be calculated using either the BMI calculator or the following BMI chart.

BMI Chart

The following table provides information about the extent of the risk factors that may be associated with your calculated BMI. However, it should be noted that BMI is only one of many factors used to predict the risk of developing a disease.

BMI             CLASSIFICATION       HEALTH RISK 
Under 18.5      Underweight *        Minimal 
18.5 - 24.9     Normal Weight        Minimal 
25 - 29.9       Overweight           Increased 
30 - 34.9       Obese                High 
35 - 39.9       Severely Obese       Very High 
40 and over     Morbidly Obese       Extremely High

*Note: A BMI below 18.5 suggests you may be below the safety minimum.

Medical tourism is an affordable option to seek surgery to treat obesity. For more information about medical tourism and to get your free quote log on to Healthbase.

Healthbase is a medical tourism and dental tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals and dental offices overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over two hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

To learn more, visit http://www.healthbase.com and login to view our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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All About Laminectomy

What is a laminectomy and why is it necessary?
Laminectomy is a surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The spinal cord is made up of vertebrae. Laminectomy is performed to remove the part of the vertebra called the lamina. The removal or trimming of the vertebra widens the spinal canal to create more space for the spinal nerves thereby taking pressure off the nerves in either the back or the neck.

One of the most common reasons for laminectomy is a prolapsed or herniated intervertebral disc. If the herniated disc is in the lumbar region, this can cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. It may also be difficult to raise the leg when it is held in a straight position. A herniated disc in the neck region can cause symptoms including pain, numbness and weakness in the arm. A herniated disc may be triggered by, for example, twisting the back while lifting something heavy. The surgeon will attempt to relieve the pressure on nerves and nerve roots by removing the pulpy material that is protruding from the disc.

What are cervical and lumbar laminectomies?
Laminectomies are named depending upon the vertebrae involved. When the procedure is performed on the neck it is called cervical laminectomy as the cervical vertebrae are involved. Cervical laminectomy is most often performed for a trapped nerve (as may happen for example, in arthritis of the neck).

When it is performed on the lower back affecting the lumbar vertebrae, it is called a lumbar laminectomy. This procedure is often performed for disk protrusions, which may occur after a major accident but also sometimes occur after a quite minor twisting injury of the lower back.

Procedure Details of Laminectomy

What do I need to do before surgery?
The patient will have nothing to eat or drink for 6 to 10 hours prior to surgery and an enema will be given to empty the bowel. A pre-medication injection is usually given to promote drowsiness and to dry up some internal secretions. If you take a daily medication, ask if you should still take it the morning of surgery.

A number of tests are performed before the operation, which include blood tests, urine analysis and sometimes an electrical recording of the heart (electrocardiogram, ECG) and a chest X-ray.

Your surgeon should explain to you the nature of your operation, the reasons for it, the outcome and the possible risks involved. They should be able to tell you the approximate length of stay in hospital that will be required and the number of weeks you will need to recuperate before returning to work. Your anaesthetist will visit you to see how suitable you are for surgery.

What happens on the day of the procedure?
On the day of the surgery, your temperature, pulse, breathing, and blood pressure will be checked. An IV (intravenous) line may be started to provide fluids and medications needed during surgery.

What type of anesthesia will be used?
Laminectomy is usually performed under general anesthesia so you are fully asleep during the operation.

What happens during the surgery and how is it performed?
The patient is placed face-down on the operating table. The exact procedure depends on the location of the herniated disc; example, if the disc is located in the neck, the head is clamped to prevent movement. The skin is marked for incision.

During a laminectomy, the lamina (bone that forms the back of the spinal canal) is removed from the affected vertebra. If the operation is performed on the neck (a cervical laminectomy), it is usually performed through a vertical cut, three or four inches long, along the middle of the neck at the back. The surgeon exposes the bones of the neck beneath the skin and a small amount of bone is clipped away, which relieves the pressure on the nerves. Once the nerve is free of pressure, the incision is closed with stitches or surgical staples. An adhesive dressing is applied over the wound. Sometimes, a plastic drain is left in the wound for a few days after the operation to drain any blood that may have collected under the wound.

What happens after the surgery?
After surgery, you’ll be sent to the PACU (post-anesthesia care unit). When you are fully awake, you’ll be moved to your room. The nurses will give you medications to ease the pain and stiffness in your neck or back. You may have a catheter (small tube) in your bladder. You’ll also be shown how to keep your lungs clear.

Usually, after cervical laminectomy you are nursed up-right in bed for the first day and not allowed to lie flat to prevent excessive build-up of fluid under the wound. If a drain has been inserted into the wound, this is usually removed after two days. You may be allowed out of bed one or two days after a cervical laminectomy. The period of bed rest may be a few days longer for a lumbar laminectomy.

How long will I be in the hospital?
The average length of stay in hospital is two to three days, but this can vary somewhat, according to whether your operation was on the neck or back and on the size and exact nature of the operation performed.
While in the hospital, the patient is taught the proper method of rolling the body in order to maintain proper body alignment. This is most important for the first 48 hours or so. A physiotherapist gives specific instructions on how to get out of bed properly in order to avoid stress and strain on the wound site.

The patient is encouraged to walk, stand and sit for short periods. The patient is taught how to prevent twisting, flexing or hyperextending the back while moving around. Patient is later treated with ultrasound therapy to rehabilitate from this surgery.

What are the risks/complications associated with laminectomy?
Some of the possible complications of laminectomy include:

  • Infection of the wound
  • Blood clots in the legs
  • Splitting open of the wound (wound dehiscence)
  • Injury to the spinal cord
  • Paraplegia or quadriplegia (depending on the site and severity of the spinal cord injury)
  • Post-laminectomy syndrome, consisting of chronic back pain and spinal instability

What should I watch out for?
Once at home, call your doctor if you have any of the symptoms below:

  • Unusual redness, heat, or drainage at the incision site
  • Increasing pain, numbness, or weakness in your leg
  • Fever over 101.0°F

When can I expect to return to work and/or resume normal activities?
Most people need to be off work for between one and three weeks after leaving hospital, depending on the nature of their work. Work that is physically demanding or that involves lifting heavy objects may require a longer time off.

What are the post-operative recovery measures that I should take?
Although guided by a doctor, general suggestions include:

  • Continue taking your medications as advised, especially the full course of antibiotics.
  • If the operation was performed on your neck, you will need to wear a cervical collar for about six weeks.
  • Try to rest as much as possible for at least two weeks.
  • Avoid activities that strain the spine – such as sitting or standing for too long, flexing your spine, bending at the waist, climbing too many stairs or going for long trips in the car.
  • Avoid wearing high-heeled shoes.
  • Sleep on a firm mattress.
  • Continue with any exercises you were shown in the hospital.
  • Beware of heavy lifting for a long period.
  • After two weeks at home, try to have a 10 minute walk each day, unless advised otherwise by your doctor.
  • Report to your doctor any signs of infection, such as wound redness or drainage, elevated body temperature or persistent headaches.

Cost and Availability of Laminectomy

How much does it cost?
The cost of laminectomy surgery varies from surgeon to surgeon and hospital to hospital. The price may go up to tens of thousands of dollars and your insurance may or may not cover the costs. However, the same treatment in some countries is very cheap and costs a fraction of the price tag in the US.

Visit Healthbase to find details about affordable lumbar laminectomy, cervical laminectomy, etc. and get a free quote for your surgery.

Which countries/hospitals is it available in?
Check availability of Laminectomy at our overseas partner hospitals. View our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Healthbase is a medical tourism and dental tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals and dental offices overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over two hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

To learn more, visit http://www.healthbase.com and login to view our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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