Fighting disease with technology

Khyber Medical institute has introduced some latest cardiac procedures in Kashmir, where experts say 12 percent of the population above 30 may be suffering from heart diseases. Ikhlaq Qadri reports.

Doctors at Khyber Cath Lab

With drastic changes in lifestyle and widely prevalent stress an increasing number of people are afflicted with heart ailments. Experts say around 12 percent of population is suffering from heart ailments, which can turn into a pandemic if not given proper attention.

In the absence of any specialised diagnostic support and expertise, the patients, who could afford, had to go to healthcare centres outside the state. The delay in the treatment often led to permanent damage in the patients with heart diseases and high mortality rates.

The valley got its first Cath Lab in 2002 when Khyber Medical Institute installed one. Taking the cue from Khyber, SKIMS started a Cath Lab in late 2004 and SMHS started one more recently.

“The Khyber has shown them the way and still they can’t match it despite having many resources and expertise,” said Rafiq Ahmad, a patient of Khyber Hospital.

The Khyber Medical Institute also started doing some sophisticated procedures. In January this year, angioplasty was performed at the Khyber institute under the supervision of cardiologist Dr. Upendra Kaul.

“We have done eight procedures of angioplasty smoothly in month of January,” Dr Kaul said.

The institute has also started doing radio frequency surgery called as Electrophysiology which is not done in any other part of the state and is new to India as well. In last one year Electro Physiology has been performed on around 80 patients.

“The success rate is 98 percent,” said Dr Khalid Mohi-ud-Din Mir, interventional cardiologist and cardiac electrophysiologist who is in charge of the program.

The institute gets expert faculty from outside the state to avoide any complications.

“The administration is ready to call expert faculty from anywhere in country so that program becomes successful, effective and with least complications,” says Dr Khalid.

Talking about the procedure and its utility he said, “If some person gets multiple palpitations, we give him drugs and they are to be taken life long and drugs can have minor side effects. Once you do radio frequency procedure it stands cured.”

“Drugs are not curative, Procedure is curative,” said Dr. B.Hygriv Rao, consultant cardiologist and Electro physiologist Care Hospitals Hyderabad. Dr Rao was the member of Dr. Khalid’s team while doing the procedure in the Khyber Institute.

The doctor from Care Hospital explaining the procedure said, “We put catheter into the heart and it will record electrical signal in that position of the heart. We put different catheters in different positions of the heart and based on it we reduce the fast heart beat. And by seeing on a computer we can say from where the beat is coming and there we go and give a small energy at the place of abnormality and get it done.”

The cost of procedure in the institute is around Rs. 40000.

“With us this procedure costs around Rs. 40000. But if you look at catheters used, they are imported from United States and from different European countries. Their cost is very exorbitant .The EP system which we have there has cost this institute around 50 lakh rupees. Besides there is recurring cost for the procedure. We have to use cartipora catheter, 10 electro catheters and other catheters.” Dr Khalid said.

Pointing to a patient Dr Khalid said, “This lady is coming from last three years, we gave her two drugs. Despite taking drugs she has to come to hospital regularly. She gets a severe palpitation. She has been referred to me by a cardiologist only. They asked him to do radio frequency surgery. The way we did the procedure, we are sure this is cured. Globally the success rate of the procedure is around 98 percent so there is still a two percent chance of the problem recurring. If, God forbid, that is the case, it is most likely to be less frequent.”

The hospital management claims that in case the problem recurs they will be charging nominal fee for the procedure from such patients.

“It is most likely to be going less severe as far as economy of procedure is concerned. I have done the procedure to 80 patients in last one year and will show their follow up, you will come to know how well they are doing. Couple of patients who had recurrence, next time we did it virtually for free,” said Dr Khalid.

Dr Khalid lauds the role of Dr Kaul in carrying out angioplasty in the institute. Angiography is also done at the institute besides PDA (Patent Ductus Arteriosis) which initially was done as surgical closure and now it is done as device closure.

In premier government hospitals the EP program is still a dream. In SKIMS Cath Lab various procedures are done but the Electrophysiology is yet to start.
“We do angioplasty, angiography, stenting, pulmonary valve, aortic valve dilatation, cock dilatation, cardiac cath, renal stenting. Peripheral stenting, pace maker implantation, ICD (shock given to reduce the heart rate),” said a doctor at SKIMS wishing not to be named.

About the procedure of Electro Physiology he said, “Our equipment is not up to date to carry out such procedure though we do some sessions of it.”
In SMHS the lab which started few months back is conducting some procedures and the patient inflow is significant.

“On an average in a week 10 angiographies, two angioplasties and three pacemaker implantations are done, “said Dr. Khalid under whose supervision the procedures are carried out in the Lab.

The experts believe that the Cath lab in SMHS is grossly under utilised.

“The Lab in SMHS is grossly underutilised,” said Dr Kaul.

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