Dr SM Bose , former Senior Prof. and Head of Surgery of PGI, Chandigarh was honoured with Prof. SS Anand Oration Award during the 70th National Conference of Association of Surgeons of India being held in AIIMS, New Delhi . The conference is being attended by more than 6000 Surgeons from all over India and abroad.
40 lakh tobacco consumers in Punjab
CHANDIGARH: Citizens Awareness Group and Delhi-based NGO, Consumer Voice, underlined the need for strict implementation of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution Act, 2003 (COTPA) in the region to protect children from tobacco consumption.
Addressing media here today at Hotel Aroma, Rinki Sharma, Head Projects & CSR for the Voluntary Organisation in Interest of Consumer Education (VOICE) said that the need is to strictly ensure the implementation of the Act especially where the lives of school children and youth to tobacco products is at stake.
An Indian Council of Medical Research (ICMR) report says that tobacco use accounts for about 30 percent of all cancers in men and women in India while tobacco related cancer accounts for 42% of the male deaths and 18.3% of female cancer deaths.
According to National Family Health Survey 2015-16, in the past one decade, the number of men using tobacco products in Punjab has increased from 19.2% to 34%, and Chandigarh itself has 17 percent population consuming tobacco.
Global Adult Tobacco Survey (GATS) India in its 2016-17 reports that out of the total population in Punjab, 7.3% smoke tobacco and 8% use smokeless tobacco.
Dr S.M. Bose, former senior professor and head of Surgery and Emergency in PGI, who has also authored a book, among others, on ‘Cancer’ said that tobacco is a slow poison and there should be total ban on its consumption.
Not only it causes direct cancer but also effects various other organs causing peptic ulcer, esophagus cancer, prostrate, urinary bladder, and pancreas, he said.
He lamented to increasing trend amongst urban women to adopt smoking which the studies have proved cause breast cancer too.
Dr Bose said 114 people die every hour in India due to tobacco use, and expressed his dismay at the results of a recent survey by PGIMER in 25 government schools of Raipur Rani where it found 25 percent children consuming tobacco.
Surinder Verma, Chairman, Citizen Awareness Group, informed that along with Consumer Voice special initiatives are being taken to sensitize all stakeholders and would be approaching the authorities to effective implementation of COPTA, by not only banning the use of its sale within 100 yards of the school premises as also making licensing of the vendors selling cigarettes and all type of tobacco products.
There is a perpetual shortage of beds in hospitals, particularly in government hospitals, where the majority of the patients seek admission. Although new hospitals are being started and more beds are being added in the existing hospitals, there are long waiting lists in every government or charity centre. It is not uncommon to see a patient making multiple trips to a hospital to seek admission. He fails to do so, gets frustrated and ultimately gives up the idea of getting admitted only to land up in the hospital as an emergency case. He may start visiting the hospital again when the condition becomes worse as in cancer.
This is not a problem unique to India. It is being faced by almost all the developing countries. The developed countries have already faced it and come up with the idea of day-care surgery, also known as outpatient surgery or short-stay surgery.
Day-care surgery has been known for a long time. This means that the patients spend only a few hours in the hospital after the operation and are subsequently sent home. But the concept has been implemented on a larger scale over the past 10 years only.
Dr Sujit Pandit, Professor of Anesthesia from Ann Arbor, University of Michigan, delivered an informative lecture at the PGI recently and I would like to share the interesting points in it and the crux of the lively deliberations that it generated.
About a decade back, only 10 per cent of surgical operations were done as day-care procedures, but over the years it has become such a successful venture that almost 50 per cent of 37 million operations performed in the USA every year are now being carried out as day-care procedures. More and more major operations are being included in this programme.
The advantages or day-care surgery are many. Some of these are mentioned below:
(i) Prevention of cross infection to the patient from the hospital’s atmosphere and other patients.
(ii) Sparing the much-needed hospital beds for seriously ill patients who require hospitalisation and close monitoring.
(iii) Sparing the doctors and the nurses the burden of monitoring very sick patients.
(iv) Cutting down the expenses. Health-care has become a very costly affair. In the USA an average hospital bed costs $600 per day and in India it may cost Rs 500 to Rs 5000 a day in a good nursing home. Even the PGI charges about Rs 1000 for a bed only. Other charges are inescapable.
(v) Psychologically, the patient and his relations feel happy to go back home and recover in their known environment.
(vi) The inconvenience to the patients and their relations are minimised.
But all said and done, the implementation of any new system requires planning, infrastructure and proper execution; success is achieved only if periodic evaluation is carried out, followed by the required restructuring and modification.
Here are some of the basic requirements for day-care surgery.
(i) The patient should be thoroughly examined in the outpatient department, not only about his present illness but also to evaluate his suitability for undergoing anesthesia and the operation.
(ii) All the relevant investigations must be carried out as outpatient tests.
(iii) Facilities must exist to receive the patient in the operation theatre complex at least three hours before the operation.
(iv) Pre-operative steps liked the change of clothes, the preparation of the part to be operated upon, the administration of premedication, the attestation of the consent form and other formalities have to be gone through before the operation.
(v) Facilities must exist to keep the patient in the post-operative ward till he comes out completely of anaesthesia and is able to travel to his residence.
(vi) The hospital facilities should be available round the clock so that the operated patient can be cared for promptly if he develops any problem.
(vii) Communication facilities are most necessary.
(viii) Arrangement should be made for a doctor or a nurse to visit the patient at home at night for evaluation and advice — particularly for pain relief, the administration of antibiotics, etc.
(ix) It is desirable that the patient should stay within a radius of 20 to 25 km from the hospital.
(x) The patient should be given complete instructions at the time of discharge.
I am of the opinion that the most important factor is the establishment of mutual trust between the patient and the operating team.
The PGI has been undertaking day-care surgery in a small way and it is likely to get a big boost with the opening of the new OPD complex where day-care surgery has been planned with six operation theatres and various facilities. But we shall have to move cautiously and progress slowly but steadily to make this a successful venture. A multidisciplinary approach and proper organisation are the key to success in this field.
One out of every 22 women in India is prone to the breast cancer, which has emerged as the second largest type of cancer among the females in the country, next only to the cervical cancer.
The doctors say that the breast cancer, which affects women more in urban and educated sectors has over taken the cervical cancer in the metropolitans.
`India is adding nearly 80,000 new cases of the breast cancer each year. The incidence is higher in the urban and educated women, ” said former head of Department of General Surgery at PGI Prof S.M. Bose, who also gave a lecture at the GCG, Sector 42, to create awareness about the disease on the “Breast Cancer Day” yesterday.
Dr SM Bose, former senior professor and head of surgery, PGI, Chandigarh, organised a breast cancer awareness seminar today at the Bhargava Auditorium of the PGI.
He said: “An estimated 1 lakh new patients were added annually to the existing number of breast cancer patients in our country.”
(From left to right) Prof Rajinder Singh, Prof IC Pathak, former PGI director Prof D Behra and Prof SM Bose, former HoD, Surgery, PGI, at a breast cancer awareness seminar in Chandigarh on Saturday.
Tribune photo: Pradeep Tewari