High quality health care has always been the most pressing need for a recovering Bhopal. More than half a million people were exposed to the deadly methyl isocyanate gas on the night of December 3, 1984. 20,000 have died to date as a result of their exposure. And even today, more than 120,000 people still suffer from ailments caused by the accident and the subsequent pollution at the plant site.
In 1994, with a motto of caring is a way of life, the Bhopal Memorial Hospital Research Centre was set up under directive of Supreme Court Justice Ahmadi, with the objective of providing advanced tertiary level super-specialty care to these victims as well as to the public at large. The 350-bedded multi-specialty hospital was set up a few years later to provide the required care to the patients and their families. Today the hospital goes beyond offering the best in health care, providing for a serene, soothing and reassuring atmosphere for patients and their families supported by good infrastructure and a motivated team. Over the years, the institute has also developed a very advanced research centre. The teaching facilities include a nursing college and a paramedical institute. DNB courses are offered in some of the super-specialties like Cardiology, Cardio-thoracic Surgery, Gastro-surgery, Anesthesia and Critical Care. This spectrum of courses offered is expected to increase further in the near future.
In the sphere of cardiology the 30-bedded Cardiology Department, has evolved as a leader in the fight against cardiovascular disorders in the state. An immediate response, 24-hour emergency team with a mobile intensive care unit provides speedy access in emergencies and the hospital has serves approximately 10,000 cardiovascular patients annually. Over the past few years, the department has handled a wide variety of cases and has treated patients suffering from various problems. In fact till date Dr. Skand Trivedi has performed over 17000 cases of angiographies and 3000 cases of angioplasty at BMHRC.
The ones that are regularly done for scores of patients include intervention procedures like coronary angiography and angioplasty as well as other diagnoses like echocardiography and stress tests. However, the department, headed and driven by Dr. Skand Trivedi, has also been doing specialized cases like implantation of single and dual chamber pacemakers, implantable defibrillators, and cardiac resynchronization therapies.
Emphasizing the importance of these are highly specialized procedures, Dr. Skand Trivedi, Head of the Department, Cardiology at BMHRC said that device based management of cardiac rhythm diseases and Heart Failure has some of the latest advancements in the field of cardiology.
Dr. Trivedi added BMHRC is the first in the state of Madhya Pradesh, and one of the few centers across the country to carry out complicated procedures like cardiac resynchronization therapy. In healthy people, the four chambers of the heart contract in synchrony to move blood through the body (people experience this as their heartbeat). However, in many patients who have heart failure, the electrical impulses that coordinate the contractions of the hearts chambers may be impaired. As a result, in up to 30 per cent of people who have advanced heart failure, the two lower chambers, called ventricles, no longer contract at the same time. This may worsen the symptoms of the disease, which include shortness of breath, fatigue, and swelling of the feet and ankles.
In cardiac resynchronization therapy, a device is implanted in the upper chest in an attempt to resynchronize the contractions of the ventricles by sending tiny electrical impulses to the heart muscle. Resynchronizing the contractions of the ventricles can help the heart pump blood throughout the body more efficiently and reduce the symptoms. Cardiac resynchronization therapy, also known as biventricular pacing, is intended to complement standard drug treatment, and dietary and lifestyle modifications.
Similarly, at BMHRC Implantable Cardioverter Defibrillators are also implanted for patients with risk of Sudden Cardiac Arrest. Dr. Trivedi updates on this very dangerous heart condition Sudden cardiac arrest (SCA) is a sudden, abrupt loss of heart function. Most sudden cardiac arrest episodes are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia (VT) or ventricular fibrillation (VF). These are diseases of the hearts electrical conduction system that should not be confused with a heart attack (myocardial infarction), which is caused by a blocked blood vessel leading to loss of blood supply to a portion of the heart muscle. However, some people may experience SCA during a heart attack.
Patients with SCA have a solution in the form of ICD (Implantable Cardioverter Defibrillator). A modern ICD is about the size of a small stopwatch and is implanted in the upper chest. It continuously monitors the electrical conduction system of the heart, watching for dangerous patterns and delivering electrical impulses when needed that may range from a tiny pulse like a cardiac pacemakers to a full, life-saving shock that can return the heart to normal rhythm. ICDs now also collect information for the physician to use in diagnosis and programming the device to the exact needs of the patient. For patients with ICDs, the first-year recurrence rate of sudden cardiac arrest has been reduced to 1 to 2 percent.
BHMRC also provides for the best pacemaker solutions for its patients with the latest technology for patients with Bradycardia or slow heart rate. Dr. Skand Trivedi has been amongst the very few to implant an MRI compatible pacemaker called Enrhythm MRI across the country. Dr. Trivedi reiterates The patient who has been implanted a pacemaker till now could not undergo MRI Scan. The MRI has a high intensity magnetic field and radio frequency energy field which interacts with pacemaker battery, its circuitry as well as the leads implanted resulting in permanent malfunction of pacemaker leading to pacemaker failure or induction of arrhythmias. The leads can get displaced and can generate arrhythmia due to heat generation at the tip.
The Enrhythm MRI pacing system has undergone extensive research and design efforts to address and mitigate interactions between pacing system and the MR environment. The system includes modified hardware to minimize the level of energy transmitted through the lead / device connection points. In addition the new system also includes new feature designed to eliminate the impact of MRI generated electric noise. Safety and efficacy data on system presented at recent European Society of Cardiology Congress showed no MRI related complication, arrhythmia or asystole during MRI study in patients implanted with EnRhythm MRITM Sure ScanTM pacemakers. Dr. Trivedi added that this has been a long awaited innovation and will highly benefit pacemaker patients who require regular MRI scans.
Apart from the wide range of treatment options, BMHRCs cardiology department has a very clear focus on education and training. The department is the only recognized center for imparting super-specialty training to post graduate doctors in the State of Madhya Pradesh and Chattisgarh, ensuring the very bests in health care is available to the people of Bhopal and beyond.
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Friday, September 03, 2010
