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Dr Neha Mishra, Consultant - Infectious Diseases, Manipal Hospital Old Airport Road, Dr Basavaraj Kuntoji, Consultant - internal medicine Manipal Hospital Malleshwaram, Dr Sundar C Ingaleshwar, Consultant paediatric intensivist Manipal Hospital Yeshwanthpur. 

TV actress Chhavi Mittal was diagnosed with breast cancer in April 2022 and had a successful surgery. Despite defeating the disease, physicians advise survivors to continue specific health measures after surgery, such as frequent checkups, medical testing, or both, to track their successful recovery. 

A few days back, she was at Manipal Hospital Old Airport Road, Bengaluru, to celebrate cancer warriors on World Cancer Day. During the event, Chhavi Mittal elaborated on her journey to promote hope to people with cancer. At the event, there were two-panel discussions where the team of medical oncologists and haematologists spoke extensively on the necessity of early detection, screening, and innovative treatment approaches that can aid in rapid recovery.

At the event, the actress said, ”I would like to thank Manipal Hospitals for organizing this event where the cancer warriors can inspire people with their experience. I am also a breast cancer survivor and know that along with the medication, mental strength and courage help fight this battle. It is essential to follow the routine and medication set by your doctors for immediate recovery.”

In a candid chat, Chhavi Mittal revealed what happened when she got to know she had lumps in her breasts, "When my radiologists told me the first time “Chhavi, you have three lumps in your breasts, two of them are fine. But this one is the non-mass enhancement, please get it checked”. And of course, the reports were positive. When I got to know that I had cancer. Somehow fear is not what I felt. I just knew.

"I was in denial when | first felt a lump in my left breast in February 2021 said Dr Vinutha Lakshman, 57, who told herself a thousand times the tumour could not be malignant.

Almost two years and eight chemotherapy sessions later, the physician is free of cancer. "I'm looking after my house. | sing and cook and beautify the place around me," Dr Lakshman said.

"Doctor or not, you hesitate to go to the doctor. It happened with me too. I knew as a physician that with a tumour, I had to go. But there was this wishful thinking that it couldn't be cancer. I then thought of the whole procedure before me.  I had to get it tested, a biopsy, and chemo. There were two other doctors we knew who kept postponing their diagnosis and treatment too. One of my sisters cited their examples to me and they are absolutely fine now and are even practising medicine," she said.

Dr. Nitin Yashas Murthy, Consultant - Medical Oncologist & Hemato - Oncologist, Dr. Mallikarjun Kalashetty, Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation, Dr. Hemanth G N, Consultant - Surgical Oncology, Dr. Amit Rauthan, HOD & Consultant - Medical Oncology, Dr. Poonam Patil, Consultant - Medical Oncology, Dr. Ashish Dixit, Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation and Dr. Manish Rai, Hospital Director, Manipal Hospital Old Airport Road.

The number of cancer survivors has increased tremendously over the past three decades with improvements in healthcare to detect and provide therapeutic treatment. As per international statistics, with current treatment techniques, almost two out of three cancers are curable. However, being cured is often not the end of the road for most cancer survivors. The goals of cancer survivorship care include promoting physical and emotional well-being, reducing the risk of late effects, and providing ongoing monitoring for the potential recurrence of cancer or the occurrence of secondary cancers.

Dr Kakoli Lahkar, Consultant - Medical Oncology. Manipal Hospital Old Airport Road believes that due to a lack of awareness and education and widespread societal stigma, women often avoid seeking medical care until it is much too late, losing their lives to a highly preventable and curable form of cancer. According to Globocan 2020, cervical cancer has over 1 lakh new cases reported yearly. It is the fourth most prevalent cancer in women worldwide, with 85% of occurrences happening in developing nations such as India, where rural women are more likely to be impacted.

Risk Factors

Dr Kakoli Lahkar shares, ‘unlike other malignancies, we know that the persistent presence of the human papillomavirus (HPV) is the primary cause of cervical cancer, particularly in high-prevalence developing nations. As HPV is a virus that is transmitted through sexual contact, a lack of cleanliness, early marriage and delivery, several sexual partners (especially when the sex is unprotected), repeated childbirths, and smoking. the presence of sexually transmitted diseases (STDs), and persistent immunosuppression owing to infections such as HIV are all risk factors for cervical cancer”.

The champions of robot-assisted surgery (RAS), the top surgeons from all over India, discuss why and how RAS will witness revolutionary growth very soon.

The healthcare sector has seen many developments and innovations in the digital healthcare space worldwide. The innovations span across the spectrum including new drug discovery, drug delivery methods, packaging and distribution, diagnostics, and treatment methods. One of the disruptive tech-led innovations of the 21st century has been assistive robotic technology for surgeries. Due to its rising popularity, minimally invasive surgeries are today almost becoming synonymous with robot-assisted surgeries in India’s top metropolitan centres.

The robot-assisted surgery (RAS) helps operating doctors perform surgical procedures with precision, flexibility, and control. With chronic and infectious diseases on the rise, higher disposable incomes, and growing patient demand for minimally invasive surgeries, robot-assisted surgeries are on the rise.

RAS also offers greater precision than traditional surgeries due to the use of higher levels of magnification provided by the cameras. Explains Dr. Deepak Dubey, the HOD and Consultant – Urology, Robotic Surgery, and Renal Transplantation, Manipal Hospital, Old Airport Road, Bengaluru, “A human eye cannot get a magnified view of the tissue, unlike in the case of robotic surgery. Especially in the case of obese, heavily built patients, this would affect the level of precision during the surgery. The robotic camera gives a ten-times magnified view of the area to be operated on. As the operating surgeon gets a detailed vision of the internal anatomy of the kidney, it lends precision to the procedure.”

A combination of genetics, environmental triggers, and the immune system can cause parts of the intestine i kids to get inflamed leading to IBD that lasts a long time.

Inflammatory Bowel Disease (IBD) is a chronic ailment of the intestine. It can occur both, in adults and children. Nearly 25% of all patients with IBD fall in the paediatric age group. It is associated with prolonged inflammation of the digestive or gastrointestinal (GI) tract, affecting one or both the intestines together. In this condition, the body’s immune system starts attacking the intestinal tissue and causes ulcers, swelling, inflammation, and other issues. A few decades ago, IBD was a very rare condition. However, there has been an increase in the incidence of IBD since the Covid-19 pandemic. While only about one case of IBD per year used to be reported earlier, now doctors are witnessing one to two cases in the paediatric age group every month.

As IBD is an auto-immune disorder where the immune system damages the intestine, the body’s immunity goes haywire, and the immune system starts attacking the intestine. Along with immunity, it may also be driven by multiple factors, such as genetics, environmental factors (modern diet and lifestyle), nutritional deficiency, and changes in the gut microbiome.

Prevention

Since this condition originated during industrialisation in western Europe, it is believed to be heavily influenced by modern lifestyles and eating habits, especially the increased consumption of processed foods. Thus, avoiding processed foods and opting for a healthy diet rich in nutrients can help lower the risk of IBD in children. In addition, leading a physically-active life is necessary to keep oneself healthy and away from not only IBD but also other diseases. Even though there is no permanent cure for IBD, children can still live a life of good quality by being aware of all aspects of preventing IBD and following the doctor’s recommended treatment plan.

(The author is a consultant in paediatric gastroenterology & hepatology.)

A 34 year old Suma (name changed), diagnosed with Homozygous Familial Hypercholesterolemia (HoFH) since 2014 was referred to Manipal Hospital, Old Airport Road, Bengaluru. HoFH is a condition where two abnormal genes one from each parent is inherited by the patient. This leads to very high levels of bad cholesterol which deposits in the blood vessels leading to heart disease and premature death. Our patient too developed cardiac symptoms and was referred to Dr. Devananda N S, Head & Consultant – Cardiothoracic Vascular Surgery and Lung Transplant Surgery, Manipal Hospital Old Airport Road, Bengaluru for bypass surgery of the heart in 2021.

Following the surgery she was referred to Dr. WG CDR S.S. Iyengar, Consultant - Cardiologist, Manipal Hospital Old Airport Road for further management and was treated with statins and lipid lowering agents. She had suffered a miscarriage at 7-8 weeks gestation during her first pregnancy in 2018. She conceived again for the second time in early 2022. In view of the high risk pregnancy, the lack of efficacy and inability to use some drugs in pregnancy, lipoprotein apheresis procedure was considered by Dr. S.S. Iyengar and the patient referred to Transfusion Medicine department.

5-year-old undergoes rare, complex heart surgery at Manipal

Saeed Mohammad, a 5-year-old boy from Yemen, was suffering from tiredness and blue discoloration of the skin for over a year. When his family consulted a doctor in Yemen, he was found to have a heart problem and was advised to undergo heart surgery which was not available in Yemen.

The patient’s parents approached Dr Devananda N S, Head and Consultant – Cardiothoracic Vascular Surgery, Manipal Hospital, Old Airport Road, Bengaluru, for immediate medical support. After a few tests, he was diagnosed with a rare type IV truncus arteriosus disease (congenital heart problem) which was treated immediately by undergoing a full correction surgery on August 25, 2022.

The patient underwent an echocardiogram and cardiac catheterisation at Manipal Hospital to understand the exact health condition. He was diagnosed with a rare congenital heart problem called, type IV truncus arteriosus. In this condition, apart from a large hole in the heart (ventricular septal defect-VSD), the arteries to the lung arise from the aorta after the arch. To complicate the matter, his aorta was coursing to the right instead of the normal left and left lung artery was traveling behind the left lung windpipe instead of coursing in front of it. Generally, other types of truncus arteriosus will become in-operable by this age because of high pressure in the lung circulation causing permanent lung damage. However, this child was still operable. This surgery was executed successfully with the support of the cardiothoracic and vascular surgeons (CTVS) and a multidisciplinary team.