The Tribune, Chandigarh, India

HEALTH

Revolutionary craniotomy to reduce chances of neurological damage
Tribune News Service

New Delhi, March 23
The mind boggles at the very thought of actually seeing a hole being cut through one’s head, but that’s exactly what the unnerving experience was for 36-year-old Dilawar Singh, a security guard from Panipat. In a daring surgery, the patient was operated upon for brain tumor in a state of full consciousness. He observed and spoke to the staff even as the doctors were all deftly focusing on performing the intricacies of the operation.

Dr Pankaj Kumar Jha, Consultant Neurosurgeon, at Capital’s Dharamshila Cancer Hospital, who performed this challenging feat, believes that Awake Craniotomy could be a revolutionary and major advancement over the conventional craniotomy, in which the patient is given general anesthesia before being operated upon. “The objective of doing such surgery in an awaken state is to monitor neurological functions like facial and limb movements, to pro-actively observe the possibility of and prevent any damage during the surgery,” said Dr Jha.

In the conventional brain surgery, since the patient is on general anesthesia and is unconscious, it cannot be ascertained at the time of operating if the brain has received any accidental injury. Even if it is observed after the surgery, it’s already too late and may render the patient incapacitated for life.

During a CT Scan after his first and only fit (convulsion) on March 4 this year, Dilawar was diagnosed for brain tumor in the right posterior-frontal area of the brain. Besides the fit, the patient also had facial palsy on the left side. He was admitted to Dharamshila Cancer Hospital on March 10, where after a detailed evaluation, Dr Jha collectively decided to remove the tumor surgically.

After having been explained the reasons for symptoms, nature of his tumor, the urgency for a surgery and the risks associated, the patient agreed to go in for awake craniotomy. During the surgery on March 18, Dilawar was fully awake and was able to move his body as directed by Dr. Jha, who constantly monitored the facial and motor functions. The tumor size was approximately 4 x 4 cms.

Elaborating on the advantages of this promising new technique over conventional technique, Dr Jha said, “The major disadvantage of conventional craniotomies is that during the surgery, it is not possible to do functional monitoring, because the patient is under anesthesia. Also, in conventional craniotomies, because of the fear of causing further neurological damage, sometimes the tumor is not radically excised, with chances of recurrence in the future. Conventional procedure also is more time consuming, requiring large flap (3-5 times) and prolonged hospitalization and the need for blood transfusion. Awake craniotomy overcomes all these limitations.”

Midway discontinuation of TB drugs dangerous, opines expert
Bijendra Ahlawat
Tribune News Service

Faridabad, March 23
Tomorrow may go down as just another World TB Day. Our country, which is home to one-third of the global burden of the deadly tuberculosis, is perhaps still away from the offensive that was required to get proper control over it. As the scourge engulfs a human life every minute here, the all-powerful DOTS (Directly Observed Treatment Short-Term Course) programme has not been free of problems so far.

Dr Raman Kakar, a well-known physician and an expert in the field here, said even though effective tools for the eradication of TB had been available since the 1950s the disease had been continuing unabated, mocking all efforts being made at various levels to eradicate it.

Commenting on the main factors responsible for the situation, Dr Kakar held the discontinuation of medication by patients as the main culprit. He disclosed as many as 60 percent of the TB patients in India gave up medicines prematurely, failing to complete the full course, a must for such patients. He said incomplete treatment had became a norm rather than an exception. In a majority of such cases the disease resurfaced and even became drug-resistant which many a times proved to be deadly.

Stating that discontinuation of drugs midway by ignorant, misguided and gullible patients on such an enormous scale had been the single largest challenge in the efforts made to control the TB menace, he said the DOTS Course had the potential to check it properly if its implementation went ahead smoothly. He said DOTS was a WHO recommended strategy and used worldwide. It was designed in a manner which could check default by the patient. The address of the patients was carefully recorded and health workers kept a strict check on him or her to ensure that each dose was taken properly. He said what was striking was that no hospitalisation was needed and the treatment could be continued at the home of the patient for six months. He claimed the scenario had been different in the rural and semi-urban areas where the patient gave up medication as soon as the recovery signs appeared. He said the ball was in the court of doctors and workers as DOTS was quite a labour-intensive programme and its entire success rested solely on human effort and concern. He said even though TB was a common chronic infection in the country the doctors hardly followed a uniform pattern of treatment.

He informed that according to a study conducted in Maharashtra of the 100 doctors interviewed 80 different prescriptions emerged and nearly every one was found to be treating this disease in his own way. He said while the development of TB vaccine could take at least 15 more years and at least $ 500 million it was only the discontinuation of medicines that was making the TB germ resistant. This led to dodging the bactericidal effects of the medicine. Unlike other treatments, he said this disease required a combination of two to five medicines taken simultaneously. He warned that resistant TB was on the rise at an alarming rate and the only option left was to create maximum awareness, involving private doctors, clinics and voluntary agencies in the DOTS drive and motivating the health staff involved in it.

Dr Kakar has authored a book titled “A Death Every Minute”, which has been published in several languages, and made an award-winning Hindi telefilm, ‘Teen Baten’, on this disease.

SPORTS

Surinder, Mukesh star in FCC win
Our Sports Reporter

New Delhi, March 23
A sparkling knock by Surinder Bajaj (99, 11x6, 4x4, 48b) and deadly bowling by Mukesh Dewan (3 for 26) helped Foreign Correspondents Club (FCC) defeat World Bank by 130 runs in the third Raymond Commonwealth High Commission Cricket Tournament.

Scores: FCC: 263 in 29.1 overs (Surinder Bajaj 99, Ravi Lekhi 48, Ayanjit Sen 29, Pankaj 4 for 40, Hari Om 3 for 35, Puran Singh 2 for 36).

World Bank: 133 in 24.2 overs (Pankaj 34, N S Sriniwas 20, Mukesh Dewan 3 for 26, Himanshu Manglik 2 for 19, Rajnish Kataria 2 for 29).

Ravindra School win

An all-round display by Chander Thapa (34 and 3 for 23) and dashing batting by Varun Anand (43, 6x4) helped Ravindra School, Pitampura defeat Ramjas School by 88 runs in the second Pankaj Jain Under-14 Inter-School Cricket Tournament at the Bal Bharati School ground. Chander was named the man of the match.

Scores: Ravindra Public School: 175 for 7 in 30 overs (Varun Anand 43, Chander Thapa 34, Hitesh Roy 3 for 38).

Ramjas School: 87 all out in 22 overs (Hitesh Roy 42, Chander Thapa 2 for 23).

Javed, Sumit star for Citi Bank

Fine batting by Javed Khan (44 n o, 39b, 4x4) and Gurman (44, 3x4) and deadly bowling by Sumit (3 for 12) and Satyen Mehra (3 for 32) helped Citi Bank defeat Kuehne and Nagel by eight wickets in the Reebok Cricket Tournament at the Palam ground.

Scores: Kuehne and Nagel: 131 all out in 22.3 overs (Pankaj Sharma 54, Ponit Sharma 30, Sumit 3 for 12, Satyen Mehra 3 for 32).

Citi Bank: 135 for 2 in 19.4 overs (Javed Khan 44, Gurman 44, Sarver Bharati 2 for 25).

Dilip, Gaurav excel
Our Sports Reporter

New Delhi, March 23
A delightful 69 by Dilip T.T and deadly bowling by Gaurav Chabra (4 for 23) helped Lal Bahadur Shastri Club defeat Rehman Club by 113 runs in an A-I Division match of the DDCA League at the Delhi University ground.

Scores: Shastri Club: 220 for 8 in 35 overs (Dilip T T 69, Rajan Gupta 50, Honey Garg 30, Adnan Ali 2 for 44). Rehman Club: 107 all out in 25.3 overs (Mohd Asif 24, Gaurav Chabra 4 for 23, Rajan Gupta 2 for 24).

Pusa Youngsters defeated Ministry of Health by 38 runs in an A-I Division match at the University ground. Scores: Pusa Youngsters: 165 for 7 in 40 overs (Nitin Chouhan 40, Mohd Haneef 3 for 23, Mukesh Kumar 2 for 25). Ministry of Health: 127 all out in 28.2 overs (Surender Dagar 40, Manoj Mahadevan 29, Nitin Chauhan 4 for 17, Lalit Anand 2 for 31).

Pelican defeated GG Dutt by seven wickets in an A-I Division match at the Yamuna complex ground.

Scores: GG Dutt: 155 all out in 35.4 overs (Amit Sharma 68, Saurabh Bali 4 for 29, Harpreet Singh 2 for 18, Mohan Singh 2 for 2).

Pelican Club: 157 for 3 in 24.5 overs (Siddarth Sharma 58 n o, Ratan Lal 52).

Universal Club defeated Canara Bank by ten wickes in an A-II Division match at the Yamuna ground.

Scores: Canara Bank: 97 all out in 31 overs (A K Jain 34, Ravi Pathak 3 for 10, Vipin Bhardwaj 3 for 27, Vikas Sharma 3 for 35).

Universal: 100 for no loss (Lalit Rawat 50 n o, Rajat Sharma 40 n o).

Star-studded field for Indian Open Golf
Our Sports Reporter

New Delhi, March 23
A star-studded field will vie for the top prize of $ 300,000 in the Royal Challenge Indian Open Golf Tournament, to be held at the Delhi Golf Course from March 25 to 28. Over 160 golfers from 19 countries will tee off in the prestigious golf tournament. The field comprises 102 international players, 45 Indian golfers and seven amateurs.

Besides the whopping cash prize on offer for the title winner, there will be a Hyundai Sonata Gold for Pro Am ‘hole in one’ challenge.

The pro-am will be held on March 23 and will consist of 40 teams of one professional and three amateurs. The winner of the title will pocket a hefty cash prize of $ 50,000.

Apollo Tyres enter Turf semis

New Delhi, March 23
A fine knock by Ashok Kumar (76) and deadly bowling by Sunil Sharma (3 for 12) helped Apollo Tyres defeat Pro Agro by 117 rus and entered the semi-final of the fourth Turf Corporate Cricket Tournament at the Guru Gobind Singh College ground.

Ashok Kumar was named the man of the match, Neeraj Khurana the best batsman and Sunil Sharma the best bowler.

Scores: Apollo Tyers: 206 for 6 in 25 overs (Ashok Kumar 76, Neeraj Kathuria 43, Tejpal 34, Hosiyar Singh 3 for 43). Pro Agro: 89 all out in 20.2 overs (S. Sharma 3 for 12, Gautam Bhalla 3 for 3. OSR