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.

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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.”

New De Novo Mutations Discovery May Lead to Better Treatment

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.

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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.”

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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.

Recent advancements in the anti-cholesterol drugs

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.

Benefits of Inclisiran:

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Medical Care made Available, Accessible, and Accountable

Headquartered in the historical city of Pune, Sahyadri Hospitals is the largest chain of hospitals in Maharashtra. With centers across the state, it operates on the philosophy to make quality healthcare ‘Available, Accessible, and Accountable’. Founded in the year 2004, Sahyadri Hospitals has grown to 8 hospitals, 900 beds, 1200 clinicians, 2300 supporting staff, and has touched over 50 lakh lives.

In April 2016, Sahyadri Hospitals initiated a state-of-the-art Center for Liver and Pancreas Transplant in Pune, with a sole objective to make transplants affordable and accessible to all. Within a short span of time, the hospital has come to be recognized as fastest growing and one of the most reliable Liver Transplant Centers in Western India. The multidisciplinary team of the hospital comprises of Liver Transplant & Hepatobiliary-Pancreatic surgeons who are trained in India and abroad, having an experience of more than 1000 liver transplants; transplant anaesthetist, adult and paediatric Hepatologists, Liver oncologists, Hepatic Interventional Radiology, and supportive services that function as one team.

Sahyadri Hospitals, Pune, has established a center for excellence in the treatment of Liver diseases. It offers the complete range of treatments, including surgical and medical management of jaundice, hepatitis, acute liver failure, chronic liver diseases, treatment of liver cancers, and liver transplantation. The high quality expertise, along with its ambition to provide outstanding affordable care & its access to new research protocol helps in providing patients the treatment best suited to their liver disease.

The Visionary of Sahyadri

“Sahyadri was conceived as a dream; a dream to make healthcare Available, Accessible, and Accountable to the community at large.” With this vision, Dr. Charudutt Apte established Sahyadri. He is the Chairman of Sahyadri Hospitals. He has had a brilliant academic career, culminating in his graduation as a Neurosurgeon from Christian Medical College, Vellore. He was awarded the Best Outgoing Student from B.J.M.C. (Pune) in 1976 and a gold medal from C.M.C. Vellore for his post-graduation.

Dr Bipin Vibhute is the Program Director and Head of Department, of Sahyadri Center for Organ Transplant in Pune, Nashik & Karad. He is a transplant surgeon with specialization in liver, kidney, pancreas, and small bowel. He has received the Organ Transplant surgery fellowship at Apollo hospitals, Chennai. He has done his DNB General Surgery, MNAMS and also has an MBA to his name.

Born at Atpadi in Sangli, he completed his education at prestigious institutes in Chennai, Kerala and Kolhapur. He started his transplant career at Apollo Hospitals Chennai; here he worked for almost seven years. He was part of team for almost 700+ transplants.

Source: https://insightscare.com/sahyadri-hospitals-medical-care-made-available-accessible-accountable/