A neuro-surgical procedure called Deep Brain Stimulation (DBS) offers patients of advanced Parkinson’s disease a new ray of hope, enabling them to lead near-normal life, neurology specialists at Amrita Institute of Medical Sciences said on the eve of World Parkinson’s Day. They also announced the formation of a Parkinson’s Disease Patient Support Group, which was formally inaugurated by Dr. Jayshree Ben Mehta, President, Medical Council of India.
Said Dr. Anand Kumar, Head, Dept. of Neurology, Amrita Institute of Medical Sciences: “The Parkinson’s Disease Patient Support Group is initially made up of about 500 patients of Parkinson’s from the Amrita Hospital, but any patient from anywhere in India is welcome to join. Patients will be provided support and counselling through WhatsApp groups.”
Day-long activities were conducted at Amrita Institute of Medical Sciences to create better awareness about Parkinson’s disease and the latest treatment options available. Apart from Dr. Jayshree Ben Mehta of MCI, other prominent people in attendance included Swami Purnamritananda Puri, General Secretary, Mata Amritanandamayi Math, Dr. Prem Nair, Medical Director, Amrita Hospital, Dr. Col.Vishal Marwaha, Principal, Amrita School of Medicine; and Dr. Rani Nair, Professor, Dept. of Neurology, Amrita Institute of Medical Sciences.
Addressing the media about the breakthrough DBS procedure, Dr. Ashok Pillai, Clinical Professor, Dept. of Neurosurgery, Amrita Hospital, said: “Deep Brain Stimulation surgery is now being offered in Kerala. It involves the implantation of a neuro-stimulator, often called 'brain pacemaker,’ in the patient’s body. It is connected to the head through wires which send electrical impulses to specific areas deep in the brain. DBS is a boon to patients with advanced Parkinson’s Disease with drug-induced problems or where drugs are failing. It offers patients much better control over the symptoms and an enhanced quality of life. In addition, robotic technology called ROSA can ensure very high precision during the implantation of the neuro-stimulator. It enables minimally invasive surgery of the central nervous system with a level of precision not possible by human hand.”
DBS is meant for Parkinson’s patients up to 70 years of age who do not respond well to treatment and are unable to manage their day-to-day activities because of their motor problems. They either have frequent ‘off’ periods when they are hardly able to make motor movements, or they have excess of unwanted movements which can be very troublesome and present upto 75% of the time that they are awake. Patients who have had at least five years of symptoms of Parkinson’s Disease are eligible for this procedure, which takes just four to five hours. Nowadays, robotic frameless surgeries are coming into vogue which are much more comfortable for patients.
Added Dr. R. Suresh Kumar, Professor, Dept. of Neurology, Amrita Hospital: “DBS is not a cure but it significantly improves quality of life of the patient. However, there are less than 20 centers in India which offer DBS implantation. In Kerala, only two or three hospitals offer a regular DBS program. This is not enough as about 33 to 41 patients per one lakh population suffer from Parkinson’s disease in the country. DBS is a costly treatment and there is a lack of awareness among patients about this procedure, which is an obstacle to its widespread adoption.”
DBS surgery involves two stages. The first is the “awake stage” in which the patient remains awake when the surgeon inserts the electrodes in the head, and a neurologist assists the surgeon in deciding the exact target based on a clinical examination of the patient. The second stage is done under general anesthesia and involves fixing the neuro-stimulator in a pocket made in the chest muscles and tunneling the wires through the neck tissue to the head.
Last year, Amrita Institute of Medical Sciences conducted Asia’s first Robotic Assisted DBS Implantation for Parkinson's disease on a 45-year-old auto-rickshaw driver Zubair, hailing from Guruvayoor district, fully curing him of symptoms and allowing him to return to his job.
The Interventional Pulmonology Team at Amrita Hospital, Kochi successfully removed a gold nasal stud (Mookuthi) from the lungs of a 21-year-old lady from Palarivattom. The stud reached the lungs inadvertently while she was sneezing. Initially she thought she had swallowed it into her stomach. For confirmation a chest x-ray was taken from a nearby hospital, which showed aspirated gold stud in lowest part of her right lungs. Generally a keyhole surgery of lungs is done at many hospitals to retrieve any sharp objects which get trapped in lower part of lungs.
In order to avoid a surgery, the patient consulted Dr. Tinku Joseph, Interventional Pulmonologist at Amrita Hospital, Kochi. He performed an endoscopic procedure using a newly designed hooked forceps which was guided through the endoscope into the lower lobe of patient's lung were the gold stud was located. After 2.5 hours of effort he managed to successfully retrieve the gold stud from lungs, thereby saved her from the trauma and the high cost of undergoing a surgery.
“When there is a foreign body in the lung, the lungs gets destroyed. When the lung gets destroyed, there could be pus formation, pneumonia and over a period of time it could cause irreparable damage," said Dr. Tinku Joseph. “Among people who are suffering from asthma and allergy, there is a high risk of aspiration of nasal piercings and studs if they are not worn properly. Also such objects can lead to persistent nasal irritation and sneezing among people who are suffering from allergy,” he added.
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Radiosurgery for Intracranial Indications : Update 2017 was a one day CME and workshop aimed at divulging the underexplored scope of radiosurgery in the treatment of intracranial indications through evidence-based approach to provide insight for the young radiation oncologists, neurosurgeons, allied professionals and to the practicing consultants about the comprehensive approaches of robotic radiosurgery and neurosurgery for intracranial indications. It was the second academic programme of the year hosted on December 16, 2017 in connection with radio-surgery following the “AAHPRT”- CME & Liver SBRT Workshop on June and July 2017.
The CME also portrayed the protocol-based novel approaches developed and practiced in Robotic Radiosurgery at the Centre for High Precision Radiotherapy, Amrita Institute of Medical Sciences.
There was an overwhelming response from divergent group of professionals pan India and especially from Kerala. The event was jointly organised by the Department of Radiation Oncology and Neurosurgery, Amrita Institute of Medical Sciences in association with AROI (Association of Radiation Oncologists of India) - Kerala Chapter. This tri-point amalgamation marked a memorable union of experts and thus resulted in an unbounded knowledge exchange. Expert from different parts of India shared their experience with the young and budding aspirants wishing to take radiosurgery treatment as carrier option.
The National Centre for Disease Informatics and Research (NCDIR) held the 33rd Annual Review Meeting of National Cancer Registry Programme at Amrita Institute of Medical Sciences, Kochi, during November 28 - 30, 2017. The meeting was presided over by Dr. Prasanth Mathur, Director, NCDIR.
Almost 45 registries and their representative staff participated in the three-day programme. Such registries are spread over in many parts of the country. The representatives presented reports on cancer in Arunachal Pradesh, Nagaland, Gujarat, Delhi, Kolkata, Assam, Mizoram, Hyderabad, Tamil Nadu, Kerala, Karnataka, Maharashtra etc. From Kerala, almost ten registries took part.
In the meeting there were detailed presentations and discussions of the experiences in cancer registry operations. There was also a strong suggestion that cancer be made a notifiable disease in the country. Many scientists from different parts of the country participated in the meeting. Dr. Sanjeev K. Singh, Medical Superintendent, Amrita Institute of Medical Sciences; Dr. Vishal Marwaha, Principal, Amrita School of Medicine; Prof. P. Gangadharan, Chief, Cancer Registry, Amrita Institute of Medical Sciences and several doctors from Amrita Institute of Medical Sciences participated. Dr. N. K. Kuttappan, District Medical Officer, Ernakulam also actively participated in the proceedings.