Wednesday, August 21, 2019

Are Motor Skills and Problem Solving Ability in Boys Linked?

Are Motor Skills and Problem Solving Ability in Boys Linked | Insights Care

Recently, the University of Eastern Finland conducted a new study, the results of which indicate that boys with good motor skills prove to be better problem-solvers as compared to their peers with poor skills. The study also concluded that boys that are good at motor skills at baseline show less increase in their cognitive skills than those with lower motor skills.

Postdoctoral Researcher from the University of Jyväskylä, Eero Haapala, asserted, “It is important to remember that these results do not necessarily reflect a causal relation between motor skills and cognition. Boys with poorer motor and cognitive skills at baseline caught up with their more skillful peers during the two-year follow-up.
While there the study hints to a link between motor skills and cognitive skills for boys, there was no association found between overweight and obesity or aerobic fitness with cognitive function in them. This contradicts the results from previous studies. This new study showed no difference in the cognition of children with different levels of aerobic fitness. In fact, it was found from the two-year follow-up that boys with lower fitness had higher cognition and vice versa.
Evaluation of motor skills was done using agility, manual dexterity, and balance tests; that of aerobic fitness was done using ergometer and body fat percentage using DXA-device; and cognition was assessed by Raven’s Matrices Test. The longitudinal association of cognition in 371 children between the age group 6-8 years with their motor skills, body fat percentage, and aerobic fitness was investigated in the study. For the analysis, other significant factors like annual household income and parental education were also controlled for a few days.
The researchers found no relation between all the above-mentioned factors and cognitive skills in girls. The reason can be the sociocultural or biological differences between the two genders.
Although the outcomes of the study indicate that motor skills can boost cognition in boys, it is too soon to establish the definite relation between the two.

Constant Low Body Weight can Develop Anorexia Nervosa in Young Kids, Study says

Anorexia Nervosa | Insights Care

A recent study has found that a constant low Body Mass Index (BMI) in boys starting from the age of 2 and for girls age 4, may create a risk factor for the development of Anorexia Nervosa, an eating disorder in adolescence. However, the study published in the issue of Journal of the American Academy of Child and Adolescent Psychiatry found that high BMI in children can develop Bulimia Nervosa, binge-eating disorder, and purging disorder.

Till date, we have had very little guidance on how to identify children who might be at increased risk for increasing eating disorders later in adolescence,” said Dr. Zeynep Yilmaz, PhD, who is also an assistant professor of Psychiatry and Genetics at the UNC Center of Excellence for Eating Disorders in the University Of North Carolina School Of Medicine. Further, she adds, “By noticing the growth records of thousands of children across time, we have seen early warning cases that could take children at risk.
One of the distinguished professors working on Eating Disorders from UNC points that- Pediatricians should now become more alert for children who fall off the below-mark BMI curve, during childhood. Such case could be an early sign of anorexia nervosa. The same case is also applied on the children who exceed their BMI curve. The only difference is their risk gets elevated for the other eating disorders such as binge-eating disorder and bulimia nervosa.
Even though, eating disorders are psychiatric in nature, the study demands various metabolic risk factors to be considered besides the socio-cultural, environmental, and psychological components. “The varying weight of children in their childhood and adolescent age are the signs of eating disorders, initiated at an early stage. Social pressures that promote thinning or dieting can also be the reasons behind unstable metabolic factorsTo elaborate a bit, underlying metabolic factors that are driven by genetics could incline these individuals to weight dysregulation. This brings into line with our other genetic work that has highlighted a metabolic component to anorexia nervosa”, says Dr. Yilmaz.
The study also reveals the multi-factorial composition of eating disorders and urges to develop early detection tools, which can be used for daily-routine check-ups by all pediatricians.

The Sad Prejudice of Fat-shaming

Fat-shaming | Insights Care

Sitting in the waiting area of a clinic was a girl, suffering from obesity syndrome. She looked flushed. Not because of the hustle she had to go through to get in the chair, but because of the embarrassment brought upon her by all the judgmental eyes around. Surprisingly, joining the audience was the compounder, and a well-trained one at that. This, for us, is a normal scenario. Everywhere we go, the stigma of fat-shaming exists. And what is worse, some people even do it openly. Not only has it harmed the mental health of numerous people, but has also made their physical conditions worse.

Some people think that through fat-shaming they can push obese people to lose weight and concentrate on the fitness. But, according to a study conducted by the University of Pennsylvania, this actually has an opposite effect. In this study, 159 people underwent a survey where they were asked about how negative they feel about being obese or fat. The results of this study indicated that the people who felt more embarrassed and negative about their weight were actually more prone to the diseases related to obesity. Explaining the reason behind this, the lead researcher of this study said, “When people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with this stress. In this study, we identified a significant relationship between the internalization of weight bias and having a diagnosis of metabolic syndrome, which is a marker of poor health.
Well, having this bubble broken, the world should be today moving towards finding the practices that would actually help. The real problem starts with the bias around weight. Since ages, we have been glorifying slim body types, through movies, shows, magazines, and many more. This has been done to an extent where our mentality is molded according to it. ‘Obesity is just a disease and not a personal problem’- people, including a large number of doctors, have failed to understand this. A wide array of environmental and biological factors contributes in this disease. With risks to so many diseases increased due to obesity, this is a serious concern. Adding to this are the mental health concerns that come with it.
What needs to be done then? Well, for starters, we as a society should move away from the prejudice of fat-shaming. While adding to other people’s growth is kindness, adding to their failures is no less than cruelty. Understanding this is the foremost necessity. Other than that, people, especially doctors, need to start treating obesity as a disease and spread the awareness. They can start with providing the patients with necessary information on all the factors affecting their condition and making them believe that obesity, as any other disease, is curable. Moreover, to patients with very low self-esteem, therapists can be assigned, who can, like angels, bring them back to life. They could help these patients to grow more accepting and less embarrassed about their body type, helping them bring out positivity and the will to be fitter.
It is necessary for us to be more appreciating of ourselves, no matter what the body type, and encourage everyone around to do so, as well. Weight is never the problem, low fitness is. And fat-shaming is never the solution, acceptance is. Looking back at the girl in the waiting area of that old, rusty clinic, the people who really should have been embarrassed where the once observing and judging. Fat-shaming leaves a person with the feeling similar to what one experiences after being bullied. Depression or other mental conditions follow. And so do physical health issues. It’s a shame that, even after being a progressive society, we are not doing enough to protect the people like the girl in that waiting lobby from the existing cruel prejudice. It’s time to step towards living better and making the living for others better.

Healthy Ways to Prevent Drug Addiction

Drug Addiction | Insights Care


Developing a drug addiction is neither a character flaw nor a sign of weakness. But it takes more than willpower to overcome the problem. Abusing illegal or certain prescription drugs can create changes in the brain, causing powerful cravings and creates a compulsion to use drugs. This makes sobriety seem like an impossible goal.


But recovery is never out of reach, no matter how despairing the situation seems. With the right treatment and support, change is not far away. The road to recovery often involves obstacles like bumps, pitfalls, and setbacks. But by examining the problem and thinking about change, you’re already well on your way to live a healthy and sober life.
The lack of ability to deal with normal life pressure is one of the core reasons that drive people to consume alcohol and drugs. For them, drug-intake aids to escape from the toughness of life. Though, learning to cope with these pressures will need a long way, it is always advisable to remain calm and follow a path of serene living.
No doubt, healthy habits play a crucial role in keeping our lifestyle healthy and stress-free. Hence, doctors and counselors highly advise to consume a balanced diet and do regular exercise that makes it easier for people to deal with stressful life. It is because a healthy diet and exercise promotes happy-chemicals in the brain. This in turn, will reduce one’s temptation to rely on drugs and alcohol.
Also, one can pick up an old hobby or can try a new one. Doing things that challenges our creativity and spark imagination will trigger our minds.
Recognizing the problem and then deciding to make a change are the major issues for many people struggling with addiction and for those looking for recovery. Committing to sobriety involves changing multiple things that include the way one deals with stress, self-thinking, the prescription and over-the-counter medications, and many more. It’s normal to feel conflicted about giving up drug of choice, even when we know it’s causing problems in life. Recovery needs time, motivation, and support, but by making a commitment to change, one can surely overcome addiction and regain control of life.
Besides, for bringing change in lifestyle, one is required to keep a keen track on drug use which will give a better sense of the role of addiction in life. One should also consider things that are important such as partner, kids, career, or it may be health. One should think how all these things would get affected by drugs.
Once someone is committed to recovery, the next step is to explore treatment choices. While addiction treatment can vary according to the specific drug, a successful recovery program has various elements such as:
Detoxification: It is usually the first step to purge body of drugs and manage withdrawal symptoms.
Behavioral Counseling and Medication: Individual group, or family therapy can help one identify the root causes of drug use. It can also repair relationships, and learn healthier coping skills. However, medication can be utilized to manage withdrawal symptoms, treat any co-occurring mental health condition such as anxiety and depression as well as relapse prevention.
Follow-up procedure: It can prevent relapse and maintain sobriety. This may subsume attending regular in-person support groups to help keep your recovery on attack.
Instead of doing all alone, it is always advisable to reach out for support. Despite of the treatment program you choose, having positive influences and a rock-solid support is very essential. The more you get encouragement and guidance, the more would be your chances to get recover.
Lean on Close Friends and Family- Having support of friends and family members is an invaluable asset in recovery. If you are reluctant to your loved ones, consider going to relationship counseling or family therapy.
Build a Sober Social Network: If your previous social life involved around drugs, it is the time to make some new sober connections. It is important to have sober friends who will support recovery. Joining a church, class or a civic group, volunteering, attending events in your community can help you building strong and healthy friendships.
Once you are done with addressing immediate problems with addiction and starting treatment, you will still have to confront the problems that led to your drug abuse.
Once you’re sober, the negative feelings that you dampened with drugs will reemerge. For treatment to become successful, you will first need to solve your underlying issues. There are many healthier ways to check your stress level. Also, you can learn to manage problems without falling for addiction. Once you learn to quickly de-stress, facing strong feelings is not as intimidating or overwhelming.
While these are a few ideas that can help prevent drug and alcohol addiction, it’s important for a person who has already developed an addiction to search for drug and alcohol treatment. There are many reliable and best quality treatment centers that may prove to be immensely useful in this regard. Also, positive thinking and implementing the same on our lifestyles will help to get out of addiction.

Yoga: A Happy and Healthy Lifestyle

Yoga | Insights Care



“It is health that is real wealth and not pieces of gold and silver.” – Mahatma Gandhi

Isn’t it true that if a person is healthy, he can prosper in his life? Today, people are trying so hard to be successful that they forget to take care of the most important part of life – health. With this fast-paced lifestyle, people face stress and mental breakdown. This type of lifestyle is affecting both physical and mental health. There are many problems like high blood pressure, diabetes, thyroid and many disorders that are becoming common now. To avoid such problems, it is necessary that there should be some type of physical activity. The main purpose of doing physical activity is to increase blood circulation throughout the body.
Yoga is one such exercise that does not have any age restrictions. It is simple yet effective. Yoga was derived from a Sanskrit word ‘Yuj’ which means ‘to unite or to integrate’. It is a 5000-year-old Indian spiritual and ascetic discipline. It is a way to harmonize the body with mind and breath by various breathing exercises, yoga poses, and meditation. A few hundred years ago, people who practiced yoga, lived for a long time without any health problems. Learning yoga can feel like learning a new language and a new culture. Yoga needs thorough dedication. It is all about breath, posture, focus, and movement. Yoga is all about flexibility. In the beginning, it may feel a bit tough and the body might not be that flexible. It may seem difficult but it is the most gentle and effective way to instill flexibility. Yoga becomes a part of the routine after regular practice. The focused breathing helps release endorphins that help to keep the mind and body calm, clear and energized throughout the day. There are various benefits of practicing yoga. Here are a few benefits of yoga:
    • Proven effective for weight loss and back pain
    • Relaxes mind and body
    • Improves breathing
    • Reduces stress
    • Improves sleep quality
    • Relieves anxiety
    • Improves posture
    • Improves self-control
    • Boosts immunity
Inculcating yoga in daily life is very simple. Basically, there are three types that ultimately aim towards relaxing the mind and the body. The three types of yoga are:
  1. Breathing Exercise:

Breathing Exercise | Insights Care

Yogi’s described pranayama as a formal practice of controlling the breath. One can bring peace to mind by paying attention to the breath through various breathing techniques. It helps in enhancing and regulating the life force in the body system. There are a few basic types of breathing exercises one can start with:
A. Nadi Shodhan Pranayama helps increase concentration. To start with this exercise, one should sit straight in a padmasana position with an erect spine. Shut the right nostril with the right thumb and inhale deeply through the left nostril. Repeat the same procedure another way. There is no time limit for doing this exercise. Ideally one can start with 3 to 5 minutes.
B. Bhramari Pranayam or bee breath help relieve hypertension and stress. One should sit in the padmasana position and close the eyes. Stick both the fingers in each ear and breath in. While breathing out, make a loud humming sound. Repeat this technique a few times.
C. Kapal Bhati has been helpful for detoxifying body and clearing energy channels. Start with sitting in Padmasana and close the eyes. Inhale deeply and fill up the lungs. Now exhale forcefully through the nostrils. Begin with 3 to 5 minutes.


  1. Asanas (Yoga Poses):
Asanas or Yoga Poses help in various problems from weight loss to back pain. It also relaxes muscles and body pain. Posture can also be improved.
  1. Surya Namaskar or Sun Salutation is an overall body relaxing method. It is very effective for weight loss and overall wellbeing of the body. It involves the basic breathing process and comprises of 12 basic yoga poses.
    1. Pranamasana or Prayer Pose
    2. Hasta Uttanasana or Raised arm pose
    3. Hastapadasana or Foot Pose
    4. Ashwa Sanchalanasana or Equestrian Pose
    5. Dandasana or Stick Pose
    6. Ashtanga Namaskara or Salute with eight points
    7. Bhujangasana or Cobra Pose
    8. Adho Mukha Svanasana or Downward facing dog pose
    9. Ashwa Sanchalanasana or Equestrian Pose
    10. Hastapadasana or Foot Pose
    11. Hasta Uttanasana or Raised arm pose
    12. Pranamasana or Prayer Pose
  1. Trikonasana or Triangle Pose helps reduce the fat in the waist area. It requires strength and flexibility. Start with standing with both feet apart. Stretch the right foot out at a 90° angle. Inhale while keeping the right leg towards the torso. While exhaling, bend the right arm and touch it to the ground. Make sure the left arm is aligned it a straight line to the right hand. Repeat these steps as many times as possible.






Meditation is an age-old practice that helps to calm the mind, improve concentration levels, increase inner strength and helps relaxation. It helps to seek deep rest in a proper direction. Meditation helps a person reduce his anxiety. It  also is effective in increasing immunity. Here is a basic way to meditate:
    • Find a convenient time and a calm place. Wear some comfortable clothes.
    • Sit in a comfortable position with an erect spine, shoulders and neck relaxed.
    • Close the eyes.
    • Take a few deep breaths
    • Breath naturally
    • Now concentrate on the breath, the way air goes in and comes out.
    • One can also use any meditation guide.
    • Continue for 5 to 10 minutes.
It is advised to keep the stomach relatively empty. Meditation will help in relaxing the mind and calm the nerves down. It will keep the person active throughout the day.
Yoga does not only helps physically but it also helps mentally. Not only does it keep one going for the day, but it also helps for a sound and complete sleep. With all these different forms, one can mix and match the exercises according to the requirements. For instance, if someone wants to reduce weight, he can focus more on yoga poses. While, if someone is facing depression or anxiety, he can focus more on breathing exercise or meditation.

Tuesday, August 20, 2019

Euthanasia – A Planned Full-stop

Euthanasia | Insights Care
Euthanasia – A Planned Full-stop
Somewhere in the world, an old man was on his death bed, doctors pumping life into him artificially. He wished to die peacefully in his own home, surrounded by his family, and not on some hospital bed. Placing this will in front of the doctor and his family members, he asked them to take him home when still alive and let him die at his own conditions. After all the arguments and looking at his irreversible medical condition, they had to comply with his wish and they arranged to take him home. Living at the mercy of a ventilator, he asked to be free of this life-support after he met all his family for the last time, dying happily surrounded by everyone that he loved. The old man chose what we today call Passive Euthanasia.
The word Euthanasia, widely known as mercy killing, has created a hustle enough to grab everybody’s attention today. Sometimes attached with sentiments, sometimes with controversies, and sometimes with ethics, it has divided the world population in two parts- those in favor of and those against. Coming from the Greek words- ‘Eu’ meaning good, and ‘Thanatosis’ meaning death, Euthanasia is basically a term for ‘Good Death’. It is a term used for what they call peaceful, dignified, easy, or gentle death.
In our history, we can find countless acts where hopelessly incurable patients were given easy death. Years ago, in Greece, patients with terminal illness suffering with a lot of pain were given a poisoned drink, in the form of a medicine, by the physicians in order to bring them an easy death. Also, in India, incurable patients were drowned in River Ganges, to release them from the life full of pain. These are the perfect examples of active euthanasia- an act to bring upon a deliberate and direct death to a patient. In ancient times passive euthanasia, correctly termed as orthothanasia, was also practiced. In this, the patients are allowed to die, by with-holding or withdrawing the treatment, rather than killing them directly. During the rise of Nazis, under a program to eliminate life unworthy of life, Hitler ordered the sick and disabled to be euthanized on large-scale, in 1939. Although all through the history most of the religions and philosophers deemed euthanasia as a sin or a crime, there were some who advocated the action, for good, bad, as well as horrendous reasons.
There are various forms of Euthanasia- active and passive that we saw before, voluntary, non-voluntary, and involuntary, direct and indirect, and assisted suicide. Euthanizing a person on his/her own request is voluntary euthanasia. In non-voluntary euthanasia, a person is not in the condition to place the request or unable to make the choice, like a child or a mentally unfit patient, so someone on the behalf of them takes the decision. When the patient refuses to die and even then is euthanized, such a case falls under involuntary euthanasia and is mostly ruled as murder. In indirect euthanasia, a patient is given a treatment that has the side effect of speeding up the process of their death. This is usually done with the intention of reducing the pain and also called as palliative care today. As the motto is not to kill the patient but reduce the pain, it is accepted as euthanasia. In assisted suicide, a dying person who needs help to kill themselves is assisted in doing so to allow easy death.
The argument about the morality as well as the legality of mercy killing is age-old. It prevails even today and may exist always.
Most of the religions believe that the life is given to us by god and it is not ours to take. Moreover, euthanasia decreases our respect towards the sanctity of life, they argue. Although free to do our will, by taking someone’s life or helping in the act, we deny god’s right over our lives and hence euthanasia is morally unacceptable.
While this is the religious attitude, there are several practical reasons that put euthanasia under the bad light. People have argued about how there is no way to perfectly regulate euthanasia and how, once legalized, it can be misused to take somebody’s life for other benefits. There is an argument that voluntary euthanasia can be the beginning of the slippery slope towards the involuntary one. Then there is some philosophers’ long-standing feud about mercy killing not being in the best-interest of the patient and no living soul, in how much ever suffering, should be willing to kill themselves, under the pressure of euthanasia. They have also argued about how ending a person’s life not only affects him/her, but also their family and friends as well as society as a whole, and hence is not in the best interests of everyone. It is also said to give too much power to the doctors and hamper their commitment to the patients and demotivates the research of better cures. Many people believe that palliative care eliminates the need of euthanasia.
Recently, a lot of people have spoken up in the favor of euthanasia. They believe that it is a person’s right to choose to end the pain and the right to die. According to some, human rights that exist already cover the right of a person to die. There are arguments about how in the suffering of a patient, their family and friends suffer along with them, emotionally, financially, as well as physically. The patients choose euthanasia to end their pain as well as their loved ones’. Some people do not have resources to afford palliative treatment and hence, the patient suffers immeasurable pain and death may be a better option for them. It is argued that it is possible to regulate euthanasia; some go to an extent to say that the laws against murder are sufficient for such regulations. They say that if the death of a person causes no harm to anyone, their right to die shouldn’t to be taken away from them.
These differences in people’s beliefs and thoughts continue to exist. They exist in the arguments of medical experts as well; while some speak in favor of it, some are completely against. There may never be a definitive answer to the question of ethical validation of euthanasia.
Many efforts have been made to change the laws and policies related to euthanasia in various countries. Even then, we see a limited success to its legality in today’s day. Belgium has the most liberal law for euthanasia; it not only gives the right to physically and mentally ill adults to it, it has also legalized euthanasia for terminally-ill children. Other countries where mercy-killing has been made legal are Colombia, Netherlands, Luxembourg, and Canada. While active euthanasia is illegal in many countries, passive has been made legal by many of them, including Argentina, Chile, India, Germany, Finland, Sweden, to name some. Australia, Turkey, France, and Philippines are one of the few countries where any form of euthanasia is completely illegal. Western countries are seen to become more accepting of people’s right to die, but on their own conditions that are sometimes liberal and sometimes stringent.
Euthanasia, a word associated with morality, ethics, controversies, arguments, and so much more, has been a good and bad story of many people’s life. While it can be exploited for heinous reasons, with proper regulation policies in place it is the end of pain for many. Used as a blessing in disguise, a blessing of peaceful death, it may enforce the complete freedom a person can have over their lives. Yet, the question remains, about its morality and acceptance. And maybe it always will.

Friday, June 28, 2019

Marking her Excellence in the Gynecological domain | Dr. Kawita Bapat


What is Passion? Enthusiasm about something? A compelling desire? We hear a lot of people define this word differently, according to their own perception of it. But, one thing that’s common between all of them is the light in their eyes that comes when they talk of the thing they are passionate about. The ones who can turn their passion into their work are, probably, the happiest in their jobs. It is said that they are also highly productive. As Steve Jobs once said, “The only way to do great work is to love what you do.
One such dynamic personality, who turned her passion into her profession, is Dr. Kawita Bapat. She is a Consultant Obstetrician and Gynaecologist. “I would love to be a gynaecologist in the next 100 lives,” she says. Currently, Dr. Bapat is a Consultant and Medical Director of ‘One’, Center for Gynecological Excellence and Bapat hospital. She has been working for more than three decades for women’s healthcare in India. She is a highly experienced surgeon specializing in minimally invasive vaginal hysterectomy and advanced Gynaecological procedures with a record of more than 5000 hysterectomies in last 15 years. She is a recognized speaker with impeccable reputation, well-renowned in local as well as international circuits, with patients from several countries visiting her for treatment.
The Success Safari
Coming from a family of doctors, Dr. Bapat was fascinated by the day-in, day-out discussion of medical matters by her aunt, father, and grandparents. This started the fire in her; a fire to do something in the medical profession. To pursue her dreams, Dr. Bapat completed her primary medical education and bagged the degrees of MBBS and Master’s from Gajra Raja Medical College, Gwalior (M.P.). She went on to reach miles and miles of success.
She has been a fellow of ICOG. She has also been the Ex-President for FOGSI, Indore, and has been life member of ISCCP and IOGS. At present, she holds the post of Breast Committee Chairperson and ICOG governing council member. Dr. Bapat has been an active part of several government and NGO driven health programmers and also co-founded a NGO – ‘Rajabai Welfare Societies’. She has presented several of her works in prestigious symposiums and meeting at many national and international conferences and medical gathering. This multi-talented personality is actively engaged in teaching, research, and administrative activities related to gynaecology. She strives to provide quality healthcare to all the women of India and is known for her compassion for innovation and bringing new ideas in town.

Thursday, June 20, 2019

New De Novo Mutations Discovery May Lead to Better Treatment

According to ANI, the latest study says that developmental disorders often lead to affect different human skills like attention, memory, and social interaction. This was reported by a study discussed at a meeting of the European Society of Human Genetics annual conference, Sweden.
Kaplanis, one of the researchers involved in this study, said, “We found 307 significantly enriched genes, 49 of which are novel. With all of these genes, we were able to explain about 51 percent of the DNM burden in our dataset. We then modeled different underlying genetic scenarios to get an idea of where the remaining de novo burden lies and how we can go about finding it.”
In this study, genomic data from over 31,000 parent-child trios obtained from the UK’s Deciphering Developmental Disorders Project were analyzed. After the analysis of these trios, more than 45,000 ‘de novo’ mutations (DNMs) were found. Later, they developed an improved method that would test over-representation of individual DNM genes that caused damage. Around 40% of developmental disorders are caused by DNMs, that is one birth in 295 in the UK alone. Such conditions generally develop in childhood and lead to autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), intellectual disability, and Rett syndrome.
An expectation that is possible is the DNMs in the genes that are yet undiscovered are less penetrant. Kaplanis said, “We may need to adapt our system of gene discovery in order to capture these fewer penetrant genes.

Tuesday, June 18, 2019

An Experienced Surgical Gastroenterologist & a GI Cancer Surgeon | Dr. Deepak Govil

“Surgery overall is a very interesting field. It’s my passion. Whether you do open surgery, Laparoscopy or Robotic surgery, the basic principles of surgery remain the same and need to be followed strictly to achieve good outcomes for patients,” are the views of a renowned Surgical Gastroenterologist, Dr. Deepak Govil, who has over 30 years of experience as a Surgeon, he is currently working with Indraprastha Apollo Hospitals, New Delhi.
Dr. Deepak was fascinated since childhood to see the prefix ‘Dr.’ before his name. Speaking of his motivation to become a doctor he says, “Also this being one of the most respected professions has always impressed me. Coming from a simple family, my parents wanted me to become a Doctor.”
His parents never let the limited resources stand in the way of providing him the highest of education and made lot of sacrifices for his education. “I sincerely wanted to fulfill their dreams and worked very hard to get into medicine.” he says.
Dr. Deepak’s elder sister was admitted to MBBS at the Lady Harding Medical College, which along with his parent’s motivation was the driving force and a strong factor in his becoming a Doctor. Reminiscing old memories he asserts, “I can never forget the expression of happiness and satisfaction on my mother’s face when I got the selection letter from AIIMS for MBBS entrance.”
Inspiring Journey of Dr. Deeepak Govil
His journey as a medical student began with getting admission into AIIMS. Here he completed his MBBS, “It was a great experience” he says. Working alongside some of the greatest surgeons of that time Dr. Deepak thoroughly enjoyed his training at the AIIMS. Speaking of his memories he asserts, “I was always impressed by the great Surgeons at the AIIMS, namely Prof. Atam Prakash, Prof. I.K. Dhawan, Prof. BML Kapur and Prof. S. Nundy.”
He has a strong belief that surgery is all about learning and nurturing skills to remove the disease and ailments of a person, and not mere prescription of medication. He says the compliments and blessing of the patients are his most treasured ‘assets’.
Earning the prestige of being an expert in GI surgery didn’t come easy, many years of hard work went into developing this skill, “I was fortunate to work in the unit mainly concentrating on GI Surgery during my MS (Surgery). There I learnt the value of discipline and hard work in Surgery. There were 2-3 days continuously when we were in the OT on 8th floor at AIIMS and used to watch Delhi from the glasses of that floor and worked just on and on.” here he was exposed to all major surgical procedures.
Then he moved on to join Dr. Ram Manohar Lohia Hospital, where he learnt the importance of simple surgical procedures. “I learnt from Dr. KN Shriwastav that no procedure is a minor procedure. One should not take any procedure lightly and do every procedure with same patience and meticulous technique.” Within few years Dr. Deepak decided to move further.
Around this time he got married and speaking of his wife, he asserts, “I am very grateful to my wife, who sacrificed her career for me to progress and fulfill my ambitions. She looked after the kids and family and kept me carefree from this aspect.”
Dr. Deeepak joined PhD in GI Surgery at the Department of GI Surgery, AIIMS under the guidance of Prof Samiran Nundy after taking study leave. He also worked for almost a year without any honorarium or pay during this course. “I owe everything I have to my Alma mata. It is one of the finest training I have ever had in the Department he added.
After completing his PhD in GI Surgery, he then joined GTB Hospital as Assistant Professor in Surgery. Fortunately, he got a break to become a consultant GI Surgeon at the PSRI Hospital of liver and digestive diseases. Here he started the Department of GI Surgery under the guidance of the then Director Prof B.N. Tandon.

Monday, June 17, 2019

A Passionate Surgeon Working For the Good of Humanity | Dr. C. S. Ramachandran


Watching a loved one especially ones mother suffer, is always traumatic for a young child. Dr. C. S. Ramachandran, a renowned General and Laparoscopic Surgeon, suffered a similar hardship, but it only made him more determined towards becoming a surgeon. Speaking about his motivation for stepping into this profession, he says, “I watched my mother undergo conservative treatment for TB of the hip bone. It was the early 1960s, when immobilization was the standard treatment. This was a painful event for us family members watching my mother in pain. I was watching doctors come and go, this triggered a passion for the profession.”
Following his passion and his zeal helped him to get admission into Maulana Azad Medical College for MBBS. After this he moved on to do his Post Graduation in General Surgery, I stood first in Delhi University in the final MBBS exam and stood first in PGIMER Chandigarh, got many medals in conference and meetings,” he says. Along the way, he had the opportunity to visit Europe and the United States. This kept him abreast of all the latest techniques in surgery and updated his surgical skills.
Dr. Ramachandran’s experience is blended with genuine concern for his patients. All his staff members are dedicated to the patients’ comfort and prompt attention is provided as well. He is an experienced General Surgeon and is currently associated with Sir Ganga Ram Hospital, Delhi. He has been a practicing General Surgery for the past 43 years. He has also attained FICS (Chicago, USA – 1985). This degree is awarded on the basis of an interview conducted by high profile doctor in Chicago. It is conducted by the International College of Surgeons. FCCP (USA, New York – 1985), DNB (General Surgery- National Board of Examination-1984), and MS – General Surgery, are some of the other advanced courses and specializations he has obtained. He has received countless delightful feedbacks from satisfied patients.
Providing Compassionate Care to All his Patients
“Every day, every patient, every surgery-big or small, is a challenge,” the doctor believes. Developing a trusting relationship with patients is a step-by-step process and a challenge in itself; and this coupled with thorough clinical knowledge and surgical exposure, is what helps build the trust. With the upsurge of technology, the pharmaceutical industry has undergone a sophisticated change and India has one of the largest productions of quality drugs. “People are more educated and aware. They know their ailment, their doctor, & their treatment. They cannot be fooled,” he says.
Every patient brings with him a story. These are personnel epiphanies. “I cherish every one of them as they have helped me grow as a person and as a surgeon,” the doctor asserts. Two cases that stood out of the rest and have been engraved in his memory, he says, “First case had swallowed half a kilo of gold biscuits in a smuggling attempt, but developed intestinal obstruction. I was able to remove all the gold and save his life. The second case was a man with a hernia hanging near his knee over 25 years carrying his entire intestine. Over an eight hour operation I was able to repair the entire hernia.”

Monday, June 10, 2019

Inclisiran: A New Advancement in the LDL-Cholesterol Drug Industry


People all around the world try to keep a watch on their cholesterol levels. There a lot of hysteria around the increased levels of cholesterol. But not all of it is bad for you. It is an essential fat that the cells of our body need. The type that is harmful to us is the LDL cholesterol (low-density lipoprotein).
LDL is bad because eventually and slowly it becomes a part of the plaque, which is basically that stuff which clogs arteries and causes heart attacks frequently. For a decade now the anti-cholesterol drug market has been ruled by small molecule drugs, mostly statins.
Statins predominantly block the first enzyme in the cholesterol synthesis pathway, subsequently blocks the production. But statins aren’t the only way to lower cholesterol. Other approach consists of altering diet, having a surgical procedure to reduce part of the intestines, taking diverse drugs. There is also an increased need, among patients who are already receiving statin therapy and are still at high risk of cardiovascular disease and who have tenacious high levels of LDL cholesterol levels, necessitating the development of additional therapies.
The recent development which the industry has witnessed is the approval of monoclonal antibodies that bind to and inhibit Proprotein Convertase Subtilisin-Kexin type 9 (PCSK9) near the catalytic domain, namely- Alirocumab and Evolocumab by the Food and Drug Administration (FDA). These monoclonal antibodies target the serine protease PCSK9, which has been recently validated as an important regulator of LDL cholesterol.
PCSK9 is currently the most potent improvement in the cholesterol-lowering therapies since the discovery of statins. Both these drugs are currently being used as add-on therapies with statins.
Inclisiran is a novel, synthetic, siRNA molecule, and a new class of cholesterol-lowering medications that has captured the eye of the market all over the world. Primarily, RNAi therapeutic is likely to be used when statins alone are unsuccessful to lower the patient’s cholesterol level competently or when their use causes objectionable side effects.
How siRNA system works
The siRNA is produced from dsRNAs and small hairpin RNAs, by catalysis using the Dicer enzyme.  The silencing RNA (or siRNA) system consists of two strands, namely the guide RNA and the passenger RNA. The guide RNA carries the sequence information essential to target the gene of interest. While the passenger strand serves as geometry required in loading the RNA- induced silencing complex (RISC).
The cells are then introduced to the siRNA, where the guide strand passes into RISC and reprograms the potent RNAi (RNA interference) mechanism. Once inside the RISC complex the siRNA unwinds and binds to the target mRNA, thus inducing the cleavage of the mRNA. The cut mRNA is recognized as defective by the cell, eventually silencing the target gene.
The loaded complex has a longer half-life, and 100 to 200 loaded complexes are vital per cell to eradicate expression of the target gene.
Mechanism of action of Inclisiran
PCSK9 is a proprotein convertase and encodes a protein with 692 amino acids. LDL receptors present on the surface of cells is responsible for removing the LDL-particles from the blood and are taken inside the cells.
The LDL cholesterol receptor is broken down by PCSK9 in the liver; the more LDL receptors are broken down, the higher the LDL levels in the blood. PCSK9 inhibition thus marks the lowering of LDL levels.
The monoclonal antibodies vary from Inclisiran, mainly in the mode of inhibition of PCSK9. Another major difference between monoclonal antibodies and Inclisiran is that it inhibits the PCSK9 binding to the LDL receptor specifically in the liver, as opposed to the entire body in case of antibodies.
This drug mainly targets the intracellular PCSK9 synthesis, due to which the drug is able to achieve a dose-dependent, long-term reduction of LDL levels. It targets the RNA directly to silence the target RNA and stops the assembly of the PCSK9 enzyme beforehand.  Because of this unique mechanism of action Inclisiran has become a first in class therapeutic against LDL-cholesterol.