Today’s Deccan herald

September 12 20119 by Dr Rashmi Ravindra

BGS Gleneagles Global Hospital, hosts a workshop on basics of EUS intervention
Bangalore, September 12, 2019: BGS Gleneagles Global Hospital today hosted a workshop on the basics of Endoscopic Ultrasound (EUS) interventions in its premises. Leading gastroenterologists from abroad and various top city hospitals came together to discuss the numerous treatment modalities, complexities, and advantages associated with EUS. This workshop was also followed by a symposium later in the evening, where experts debated on the advantages of EUS versus widely different treatment methods available in handling various conditions related to gastroenterology. About 120 doctors attended the event.
Dr K Ravindranath, Founder & Chairman, Gleneagles Global Hospitals Group, inaugurated and addressed the EUS workshop, which is third in the series.

Dr Ravindra B S, Chief of Gastroenterology, BGS Gleneagles Global Hospital, Bengaluru added, “Gastrointestinal surgeons are frequently faced with challenging medical cases. As responsible doctors, we have to keep up with the constantly evolving medical innovations. At our center, we believe in investing our time in regular knowledge sharing platforms such as these as it provides an opportunity for our doctors to interact with other experts, thereby helping us expand our proficiency and forming a more integrated network of gastrointestinal surgeons in the country. This benefits our patients essentially, as we progress and learn more. “

“Last month BGS Gleneagles Global Hospital became the first hospital in Karnataka to use the new Hot AXIOS stent for successfully treating a 30-year-old man who was suffering from pancreatic pseudocyst (fluid filled cavity around pancreas) and was high risk patient for laparoscopic surgery under anaesthesia. This procedure hardly takes 5 mins compared to endoscopic drainage which takes around 40 mins. The benefit to the patient is that they are not under anaesthesia for a long time unlike other procedures and it is beneficial for high-risk patients. Patient recovers much faster with this intervention.”

Dr Ravindra BS and his team of Senior Gastroenterologists performed this procedure using this new stent, which has been used less frequently throughout India. New innovations such as these and more were discussed at the workshop.

Today’s Deccan herald

August 20 2011 by Dr Rashmi Ravindra

International Albinism Awareness Day: Symptoms, Causes, And Diagnosis Of Albinism

These vary in severity and often cause white skin, light hair, and vision problems. Melanin is the pigment which is responsible for the colouring of the skin, hair, and eyes. People with albinism often have lighter-coloured skin and hair than the other members of their family.

Albinism affects the sexes evenly, and all ethnic groups are susceptible. Its prevalence varies by region from 1 in 5,000 to 1 in 20,000. An estimated 1 in 70 people carry the genes associated with albinism.

Albinism is a genetic condition. Currently, there is no cure for albinism, but some symptoms can be treated. The most common cause of albinism is an interruption in the functioning of the enzyme tyrosinase. Melanin normally protects the skin from UV (ultraviolet) damage, due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure.
What are the symptoms of Albinism?

The primary symptoms of albinism include a change in colour of the skin, hair, eye, and vision.

1.Skin: The most obvious sign is a lighter skin tone. In some people, levels of melanin slowly increase over time, darkening skin tone as the person ages. The patient diagnosed with albinism is likely to experience skin burn after being exposed to the sun for a brief period of time. After continued exposure to the sun, some people with albinism might even develop some skin problems such as freckles, moles, lentigines, large freckle-like spots.

Some people diagnosed with albinism are also prone to skin cancer. People with albinism should use sun protection cream of SPF 30 or higher to protect the skin.

2. Hair: People with albinism experience change in colour caused due to the absence of pigment melanin. As the patient ages, the hair colour slowly turns lighter to darker in shade.

3. Vision: Albinism always affects vision. Changes in eye function include nystagmus, strabismus, amblyopia, myopia or hypermetropia, photophobia, astigmatism. Vision problems related to albinism tend to get worst in new-borns but improve rapidly over the first 6 months of life.

What are the causes of Albinism?

Albinism results from a mutation in one of several genes. Depending on the mutation, the production of melanin can either be slowed or completely stopped. There are constant problems with the visual system. This is because melanin plays a vital role in the development of the retina and the optic nerve pathways from the eye to the brain.

How many types of Albinism are there?

Albinism is fragmented into a number of subgroups which depends on the specific genes that are affected.

Oculocutaneous albinism (OCA) is caused by a mutation in 1 of 4 genes. OCA is further divided into seven types depending on the mutations.

X-linked ocular albinism: This type of albinism is caused by a gene mutation of the X chromosome. X-linked ocular albinism mainly affects males. They experience vision problems, but people who suffer from OCA generally have eye, hair, and skin colour in the normal range.

2. Hermansky-Pudlak syndrome: The symptoms for this syndrome are similar to oculocutaneous albinism; however, people with HPS are more likely to suffer from bowel, heart, kidney, and lung diseases or bleeding disorders, such as haemophilia.

3. Chediak-Higashi syndrome: This is a rare form of albinism, caused by a mutation in the CHS1/LYST genes. The symptoms for CHS are similar to oculocutaneous albinism but people with this syndrome experience change in hair colour as it appear silvery, and the skin turns slightly grey in colour.

4. Inheritance: Most types of albinism are inherited in an autosomal recessive inheritance pattern which means you inherit two mutated genes, one from each parent. The exception is X-linked ocular albinism. This is passed on in an X-linked inheritance pattern.

Autosomal recessive inheritance

With autosomal recessive inheritance, an individual must receive faulty copies of a gene from the mother and father to develop albinism. The parent who carries the gene often does not show symptoms. If both parents carry the gene but have no symptoms; there is a 1 in 4 chance that their offspring will have albinism.

X-linked inheritance

X-linked recessive conditions mainly affect males because females carry two X chromosomes, if one gene gets damaged, the other can often make up the shortfall. Men, have one X and one Y chromosome which means that any albino mutations in their singular X chromosome will generate the condition.

However, if the mother has an X-linked mutation, each daughter will have a 1 in 2 chance of becoming a carrier and each son will have a 1 in 2 chance of developing albinism.

How is Albinism diagnosed?

The process of diagnosing albinism most often involves:

Physical examination
Discussion about skin and hair pigmentation changes
Examination of the eyes by an expert (ophthalmologist)
Comparing the individual’s colour with that of family members

Other diseases can also cause changes in pigmentation; however they will not cause changes in vision. If there are changes both in pigment and vision, the patient is likely suffering from albinism.

The most reliable way to diagnose albinism is by doing genetic testing. However, it is not always necessary in families with a history of albinism.
How is Albinism treated?

As the disease is genetic in nature, treatment focuses on minimising the symptoms and watching for changes.

Getting the right care for eye problems is necessary which includes regular eye exams, using prescribed glasses, and dark glasses to protect the eyes from the sun.
People should watch for any skin changes and use sunblock for protection.

Albinism does not worsen with age. A child with albinism can flourish and achieve the same education and employment as a person without the condition.

The Times of India

13 Jun 2019 by Dr Rashmi Ravindra

Now probiotic drugs sold over counter

BANGALORE: Kill your diarrhoea with good bacteria. That’s the latest fad in healthcare. Almost every pharmaceutical company now has a brand of probiotic drug and some are even being commercially marketed off the counter. Probiotics are foods that contain live bacteria. It is the bacteria and metabolites which they produce that give probiotics their health-promoting properties. The best known example is yogurt.

While some doctors are excited about chances of treating even severe intestinal disorders with probiotics, many say this is a huge money-spinner . Doctors are still assessing whether these drugs can be an alternative to antibiotics considering the increasing cases of antibiotic resistance in India.

Indian Council of Medical Research (ICMR)-appointed committee member and consultant gastroenterologist, Manipal Hospital, Dr Dinesh Kini, is part of the research team on probiotics. He says probiotics can’t be an alternative to antibiotics. “They’re a huge money-spinner that are pharmaceutically motivated and currently being used unscientifically. There is less scientific data on probiotics. It may, however, be used by travellers for diarrhoea, colitis, inflammatory bowel diseases and antibiotic-associated diarrhoea . It is not the wonder drug that it’s being projected to be,” he asserts.

“We need robust and randomized clinical trials to say with confidence that they have positive impact on health. The market is flooded with various brands of probiotics,” he adds.

“These are micro-organisms that colonize your intestine and remove harmful bacteria. The best natural probiotics are in yogurt and soy yogurt, which can be eaten on a regular basis even without a prescription. But people consume them less these days. So it is available in tablet and liquid forms. Research is being conducted to see its impact on colon cancer and urinary tract infections,” explains Dr B S Ravindra, consultant gastroenterologist, BGS Global Hospital.

There was a sudden increase in the prescription of probiotics recently. It was seen that they had a positive effect on patients who were under antibiotics for long and suffering from irritable bowel syndrome. Even patients who recurrently suffered from bouts of gastroenteritis showed good recovery. “Use of probiotics has definitely increased . It’s true that yogurt and curds contain probiotics but those cannot be quantified. It is a great source of medication but I do not suggest that people buy it off the counter just for fitness. The quality and dosage of this live bacteria cannot be assured if it’s used without monitoring,” said Dr Ravishankar Bhat, consultant gastroenterologist, Apollo Hospitals.

Teen apes reality show, gulps banana full of blade bits

BANGALORE: Aakash, 18, had keenly watched a contestant of a reality television show swallow bulbs and razor blades. It looked easy as pie, and he thought he could pull it off too.

Early last week, Aakash (name changed) broke a blade into six pieces, stuck them into a banana, and gobbled it up, but it proved to be almost suicidal. Less than a day later, he had to be rushed to hospital where doctors got to work to ease out the sharp blade pieces.

Aakash, who is recuperating, is on a diet of soft food and smoothies.

Having gulped the banana, the teen, a resident of Mysore Road, began experiencing severe pain on the left side of his upper chest and abdomen. He was rushed to the nearby BGS Global Hospital by his uncle Putte Gowda, his guardian in Bangalore.

X-rays and other investigations revealed six pieces of a blade stuck in his food pipe, small intestine and large intestine. Aakash, ironically, did not even remember how many pieces he had swallowed.

“Our surgical team immediately decided to remove the piece of blade stuck in the food pipe through endoscopy. The patient was given general anesthesia and an over tube (a medical plastic tube) was placed in the food pipe. The blade was removed though the over tube without damaging the food pipe. The endoscopy was risky as the blade was cut into pieces and all the edges were sharp. It could have pierced his food pipe. Thankfully, the procedure went well,” said Dr Ravindra B S, senior consultant, gastroenterologist, BGS Global Hospitals.

Aakash continued to suffer severe pain. A CT abdomen scan showed some more blade pieces in the large and small intestine. This time an enteroscopy, a procedure similar to endoscopy, was performed through the anus.

“Through enteroscopy, the blades were guided from the small intestine to the large intestine and were removed. Four pieces were removed in the first procedure and one in the next,” said Dr Ravishankar.

“So far, I’ve removed dentures, a necklace, coins and safety pins from a patient’s food pipe or abdomen. This is the first time I’ve seen someone gulping blade pieces. Such sharp objects can even kill,” said the doctor.

Aakash was discharged from hospital on Monday, and has been advised to avoid sharp objects and stick to a strict diet of soft food and lots of fluids.

Said Putte Gowda: “We are thankful to God for saving Aakash. He is doing fine now and has left for our native town near Mysore with his mother. He was misguided by the TV show and his friends encouraged him too. He’ll be back in time for his II BCom exams.”

Times View

Young people must learn to separate fact from fiction on television and realize that not everything they see on the small screen is real. With reality shows, this distinction needs to be made even more so. For, in the race for TRP ratings, TV shows often push the envelope in content and it’s for viewers to take things as entertainment and not gospel truth. Also, contestants on these shows have to undergo some basic training and perform the stunts under expert supervision. When channels warn viewers not to try it at home, they shouldn’t and that’s non-negotiable.

Livelier becomes a lie without liver

Liver-related ailments now one of the most reported ailments in city: Docs.

Along with lifestyle ailments like diabetes and hypertension, liver-related diseases have emerged as one of the most reported ailments in the city. Apart from consumption of alcohol, which is the primary reason for liver cirrhosis, random intake of antibiotics and over-the-counter (OTC) drugs often lead to liver dysfunction.

“The city is known for its pub culture. Hence, it is no surprise that so many cases of liver disorders are reported every day in the city,” says Dr B Ramana Rao, consulting physician and cardiologist.

I”It is not only Bangalore, liver disorders have become rampant in Karnataka as well. Every four persons out of 100 suffers from Hepatitis B in the state,” says Dr Ravindra BS, senior consultant, gastroenterology, hepatology and therapeutic endoscopy, BGS Global Hospitals.

Problems of the liver can lead to Hepatitis A, Hepatitis B as well as Hepatitis C, making liver disorders one of the top killer diseases in the country.

Experts say that Bangalore is also seeing a spurt of Hepatitis C cases. There is still no vaccine for Hepatitis C. People who suffer from it have high chances of getting cancer.

Hence, it is mandatory to get liver check up done on a regular basis. In 90% of cases, people are unaware that they have a liver disease. “Diagnosis happens at a very late stage because of lack of awareness,” says Dr Rangesh, head of drug discovery, The Himalaya Drug Company.

Liver experts urge Centre to step up hep- B vaccination drive to check deadly disease in India

Union government should rapidly put in place measures to control hepatitis B on similar lines that it tackled polio virus. The growing incidence of hepatitis or liver inflammation is seen as major public health concern as over a lakh patients are seen to succumb to the deadly disease, stated liver experts.

The big task for the government is to increase the coverage of the hepatitis immunization programme implemented under the National Health Mission just like what it did for polio eradication.

On the occasion of the World Hepatitis Day, observed annually on July 28, has this year’s theme as ‘Say No To Ignorance’. “While it is equally important to dispel ignorance, it is important to create awareness about hepatitis B & C which are curable with early detection,” stated experts.

A big advantage for hepatitis cure in India is the drastic reduction of drug cost to half the price following the inclusion of these medicines in the Drug Price Control Order (DPCO) 2013. In fact, the booster shot to the patients is that prices have reduced from Rs.6,000 to Rs.3,000 per vial. The deadly health condition which can impact any strata of the population has been an expensive therapy protocol, Dr Ravindra BS, consultant Gastroenterology and Hepatology Therapeutic Endoscopy Specialist at the BGS Global Hospitals, told Pharmabiz.

Hepatitis is one of the most prevalent and serious infectious conditions in the world, but many people including health policy makers are unaware of its staggering toll not just on global but national and state health. Hepatitis B and C viruses are the cause liver cancer and liver transplants.

“There is a serious lack of awareness among the public that both Hepatitis B and C are curable with access to affordable drugs besides availability of vaccines for Hepatitis B control,” pointed out Dr Ravindra.

“The rampant rise in the number of hepatitis cases are seen to be induced by excessive alcohol and fatty food consumption besides hectic lifestyles leading to drug abuse. Most of the antibiotics, pain killers are toxic and causes liver failure if it is indiscriminately prescribed. Therefore there is lot of onus on the doctor to caution on the patient on the liver toxicity reactions,” said Dr Satya Prakash, senior professor & head of the Department of Gastroenterology, M S Ramaiah Memorial Hospital.

Therefore the need to sensitize the patient is the big task on hand and ensure prevention of unsupervised drug therapy which could control hepatitis B, added Dr Prakash.