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HEALTH |
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BODY & MIND
One is never too old to fight cancer
Tripti Nath
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Dr Dinesh Katiyar, cancer surgeon at Batra Hospital
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A 91-year-old Gurgaon-based woman suffering from an advanced stage of ovarian cancer has succeeded in combating the disease with a radical and challenging surgery lasting two and a half hours and chemotherapy at Batra Hospital here.Dr Dinesh Katiyar, cancer surgeon at Batra Hospital who led a team of doctors for removal of the tumour weighing 2.5 kg, said that Dakha Devi is now free of disease. The team of doctors comprised Dr Arun Dewan, physician and resident doctors, Dr Firoz and Dr Piyush Chowdhury. “The patient is absolutely fine now. After three cycles of chemotherapy, there is no evidence of disease. The disease has disappeared but follow-up and review after six cycles of chemotherapy is necessary to prevent its recurrence. She has to receive three more cycles of chemotherapy.” Dr Katiyar who has served at Kidwai Memorial Institute of Oncology, Bangalore said that a radical surgery at the ripe age of 91 is rare. “Ovarian cancer is more common among elderly women than the younger lot. Most patients from the urban areas have asthma, diabetes, cardiological and lung problems or obesity. In this case, the patient was hale and hearty. All tests as E.C.G., heart and lung check-up and blood test for kidney were normal. The vitals were stable. So, we had no reason to deny her surgery just because of age. We had to remove the ovaries and the uterus. It had spread to other places in the abdomen like omentum. Besides, there were deposits in the peritonum and in the mesentry.” Dr Katiyar said that Dakha Devi and her 96-year-old freedom fighter husband gave consent for surgery despite the fact that the surgeons at Batra Hospital had warned of certain risks involved in the operation. Dr Katiyar, Consultant Cancer Surgeon, who led a team of doctors, said that the nonagenarian couple were quite keen on surgery. “I told them that anything can happen during surgery but they knew they had no other option. The surgery was challenging because of age-related complications. It was a major operation. At this age, heart and lungs are not strong to tolerate anaesthesia. To avoid heart and lung problems during and after surgery, we completed the surgery in two and a half hours,” Dr Katiyar said. Study on oral healthThe Delhi-based central survey team of the Dental Council of India (DCI) has made satisfactory progress in the preparation of state reports for its national level epidemiological study on oral health problems in the country. The survey was entrusted to the DCI by the Union Ministry of Health in 2001. The DCI is hopeful of submitting reports of 23 states and national report to the Health Ministry by March-end. The central survey team of DCI headed by eminent dental surgeon and DCI president, Dr R.K. Bali and national project in-charge of the epidemiological study, Dr V.B. Mathur is visiting Mumbai on January 10 to hand over model reports of three states to various regional coordinators. The DCI will encourage the regional coordinators to follow the same style in drafting their reports. Prominent among those who will be present during the meeting in Mumbai are Dr Hiremath, Head of Community Dentistry Department, Government Dental College, Bangalore,Dr A. Jai Kumar, Principal of Dental College in Vikarabad, Hyderabad, Dr S.G. Damle, Dental Surgeon and Dean, Nair Dental College and Hospital, Mumbai, Dr N C Rao, Principal, HP Government Dental College, Shimla, and Dr P P Talwar, Consultant, Statistics and Demography. Explaining the significance of the survey, Dr Mathur said, “So far, we did not have an estimate of the dental disease burden in the country. We had no idea of proper utilisation of dental services at various levels. Lots of studies were done in the past but none of them was comparable at the international level. As a result, the data from India was not available in the International Oral Global Data Bank maintained by the World Health Organisation (WHO).” Pointing to several changes that have come about in dentistry in the last 50 years, Dr Mathur said, “Previously, there were hardly any dental surgeons. Until the early seventies, there were only nine government dental colleges. Today, there are 170 dental colleges in the country, most of which are run by the private sector. The number of dental surgeons has increased manifold. Hence, the need to reframe policies so that the best benefits can be provided to the public. There is a definite need to reassess services being provided and modify the service patterns. In the public sector, we have to strike a balance between needs and demands.” Don’t fool around with nutsYoung parents who enjoy eating cashewnuts, walnuts, peanuts, almonds and popcorns during winter should keep their infants away from nuts of any kind, according to Dr Alok Agarwal, ENT Consultant at Sir Ganga Ram Hospital. Dr Agarwal treated more than 50 children in 2003 for respiratory tract obstruction caused by the intake of nuts. An ENT Consultant, Dr Agarwal spends more time with children from September to February every year when the market is flooded with nuts. Already in the New Year, he has treated a 20-month-old boy from Hapur who came to the hospital with obstruction in the respiratory tract. The child had been fed peanuts. In December, he dealt with 10 such cases of children between six months and five years. Dr Agarwal says that obstruction caused by nuts can be life threatening and is best treated as soon as possible. Delay in treatment can cause complications. Parents bring the children with incurable pneumonia and breathing difficulty. “When a foreign body goes into the left or right respiratory tract, the lung stops functioning optimally. We have to admit the child and do bronchoscopy. The treatment costs about Rs 10,000 as the child has to be admitted in the paediatric ward for pre-operative and post-operative care. The bronchoscope is used under general anaesthesia and the invasive procedure is difficult and risky because the entangled piece can disintegrate during surgical removal and enter the right and left respiratory tract simultaneously. Chances of loss of life are fair and the consent of the relatives is, therefore, necessary. We analyse the foreign body and remove it with the help of a pair of forceps. Twenty years back, it was difficult to save such patients and we have acquired this technology and equipment from the West. It was Dr Chevalier Jackson, a doctor based in the US who gave the world the concept of bronchoscopy.’’ The ENT Consultant said that parents should not give children anything that is difficult to chew. They should not allow them to play with coins or miniature toys either. Children who don’t have molars would not be given nuts at all. “A number of children die due to choking caused by miniature toys every year,” he said.
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