Press Note
9 March 2012

MULJIBHAI PATEL UROLOGICAL HOSPITAL, NADIAD

Hon�ble Union Health & Family Welfare Minister, Shri. Ghulam Nabi Azad, delivers key note address at MPUH Nadiad

Muljibhai Patel Urological Hospital (MPUH), Nadiad is organizing an international 'Laparo-Robotic Symposium: Cutting edge Technology - Journey from Better to Best - Are we ready to Adapt' during 8th to 10th March, 2012. Dr Mahesh Desai, Medical Director and Managing Trustee of MPUH, and the President of SIU, is the Course Director. A large number of delegates and several visiting Faculty from India and abroad are participating in Symposium. The Hon'ble Union Health & Family Welfare Minister, Shri.Ghulam Nabi Azad, and the Union Minister of State for Mines (Independent Charge) Shri. Dinsha Patel, visited MPUH Nadiad on Friday, 9th March. They visited the Dry Lab and Wet Lab at JPAC. Shri. Ghulam Nabi Azad delivered the Key Note Address at the Laparo-Robotic Symposium. Before his speech, the Minister observed on 3D a robotic surgery for the removal of kidney tumor, performed by Dr Mihir Desai (USA). The Minister said that after watching the surgery, he is wiser and now realize how complicated and difficult the surgery really is. The Minister also inaugurated a new website of MPUH dedicated to Robotic-assisted surgery namely, centreforroboticsurgery.com. In his speech, Shri Ghulam Nabi Azad recalled that though the hospital had a modest beginning in 1978, over the years, it has grown into a super specialty hospital and research institute, a centre of excellence. He noted that the hospital has developed unique treatment for kidney donors, and has done the largest number of multiport as well as single port laparoscopic donor nephrectomies. The minister observed that more than 2100 kidney transplants have been performed in this hospital with results matching international standards. It is also well known for treatment of stone diseases. While there is an acute shortage of trained doctors in the country, MPUH has trained more than 100 post graduates in the last 25 years who have spread out all over India catering to the needs of specialized treatment for the patients suffering from kidney diseases. He was happy to know that the hospital is recognized by SIU and World Endourology Society for fellowship training. The Minister wished the hospital and JPAC, and the Conference all success.

Shri. Dinsha Patel said how happy and proud he is to witness the growth of MPUH into a world class institution that has put Nadiad on the world map. He said that Nadiad has developed into a Health City with all types of medical colleges. He also recalled the contributions of Dr Virendra Desai, Shri Jayaramdas Patel, Shri Rohit Patel, Shri Prahladbhai and Dr. Mahesh Desai and Dr MM Rajapurkar in building, nurturing and developing MPUH into its present international stature. Shri Rohit Patel, Chairman of MPUH also recalled the contributions of his late father Shri Jayaramdas Patel and the founding trustees in setting up of MPUH, and the efforts put in by other trustees and the top leadership and staff of the hospital in making the institution a centre of excellence. Dr Mahesh Desai thanked the hon�ble Ministers for their kind words and appreciation of the work that is being done at MPUH. Dr Desai emphasized the need for specialized training and research and the work SIU is undertaking. He reiterated the commitment of MPUH to the world urology, and also opined that Robot is the future for Urology.

The visiting faculty from abroad who are participating in the Symposium include Dr Joachim Thuroff (Germany), who is the Immediate Past President of Society International d' Urology; Dr.Mihir Desai (USA); Dr Shin Egawa (Japan); and Dr Pilar Laguna (The Netherlands), whereas from within India who are participating include Drs. Makarand Khochikar, Pradeep P Rao, C Mallikarjuna, Shrenik Shah, Jaydeep Date, Deepak Dubey besides Drs Mahesh Desai, R B Sabnis, Arvind Ganpule and Shashikant Mishra from MPUH. Dr. Thuroff conveyed the appreciation on behalf of the European Association of Urology and his own behalf for the excellent work MPUH, Dr Mahesh Desai and his team are undertaking in the field of urology. Dr Suresh Patankar, President (West Zone) of Urological Society of India also spoke on the occasion who called MPUH as the Mecca of Urology.

There are more than 100 delegates from India and abroad including Nigeria, Singapore, Bangladesh, Nepal, Trinidad, Turkey, Sri Lanka and India. A large number of post graduate Urology students are also participating in the Symposium.

Several robotic-assisted surgeries which were performed at MPUH were telecast LIVE worldwide through the website of Society International d� Urology for the first time. The surgeries were also seen in 3D by the delegates at the JPAC auditorium of MPUH. All aspects of laparoscopic and robotic-assisted surgeries, e.g. Indian and International experience, why should we change from laparoscopic to robotic, what is wrong with open surgery, effect of learning curve on the result of surgery etc were discussed.



http://ibnlive.in.com/generalnewsfeed/news/union-health-minister-inaugurates-symposium-at-mpuh-nadiad/972877.html



http://timesofindia.indiatimes.com/city/ahmedabad/Lapro-robotics-future-of-surgery/articleshow/12203734.cms



http://www.newsreporter.in/union-health-minister-inaugurates-symposium-at-mpuh-nadiad


www.centreforroboticsurgery.com
www.mpuh.org
joseph@mpuh.org

WEIGHT OBESITY AND NAMASMARAN: DR. SHRINIWAS KASHALIKAR

Obesity of various degrees can be agonizing. It can be pitiable. It can be ridiculous. It can be humiliating. It can be frustrating. It can be depressing. It can be destructive.

The most important way how radical cure from obesity results; is through the change in mind.

Our mind is always trapped in the our opinions about people�s opinions about us! We tend to get dragged in the whirlpool of self pity and self destruction. We keep on indulging or dieting and lazying and working out in alternation with no benefit whatsoever.

If we are eager and desperate to lose weight, we have to come out of this whirlpool!

This is possible only if we are convinced that we are living in a meaningful manner and develop self dignity.

But while we are in the whirlpool of frustration; we always feel worthless! Hence it is very difficult to feel dignified and worthy of accolades.

But there is nothing to worry.

The age old medicine (drug) or in fact panacea of HARI NAMA SMARAN or RAMA NAMA SMARAN can cure us!

It is very true that; NAMASMARAN is actually a mega-process of blossoming of self and the universe, but weight loss is one of its important and beneficial by products.

NAMASMARAN fills every moment of our life with the ambrosia that enlivens to the whole world through and along with us; and realistically lets us feel dignified and worthy!

Our obesity therefore should be treated as blessing in disguise and/or a waking alarm signal to start the practice for RAMA NAMA SMARAN while walking and/or climbing, which are otherwise mechanical, unexciting and boring activities!

ROLE OF INTERVENTIONAL RADIOLOGY IN CANCER
Interventional radiology has a great supportive role in diagnosis and management of malignancy. It adds new dimension to the facilities that can be offered to the patient in an institution.
Diagnosis- various deep-seated biopsies can be done under US and CT guidance. These would other wise need laprotomy. This small procedure can reduce morbidity and facilitate speedy treatment.
Various malignancies where interventional procedures can play a role are following:
1. Liver malignancies-primary and secondaries.
2. Malignant Biliary obstruction
3. Renal malignancies
4. Cervical and other pelvic malignancies.
5. Ca lung
6. GI bleeds.
7. Epistaxis- Secondary, Nasopharyngeal angiofibroma.
8. SVC Thrombosis- thrombolytic therapy.



Liver malignancies-primary small HCC (hepatocellular carcinoma) when detected can be treated with PEIT (percutaneous ethanol injection treatment) or Radiofrequency ablation(RFA) or TACE (transarterial chemoembolisation).
In large inoperable HCC TACE can be done. This procedure involves embolisation of the selective feeding artery. The chemotherapeutic agent is epirubicin and the dose is calculated on body surface area. The epirubicin is mixed in 5-15ml of lipidol. The mixture is well shaken and injected into the feeding artery. The chemotherapeutic agent-lipidol mixture gets concentrated in the tumor tissue and washed off from the normal liver. At end of the injection, the artery is occluded with gelfoam.
Liver malignancies-Secondaries. � If there are few secondaries in the liver and primary lesion has been resected, then lesions less than 30mm can be treated with percutaneous ethanol injection treatment or high frequency thermal treatment.


Malignant Biliary obstruction
Inoperable patients of malignant biliary obstruction need palliation to reduce itching and jaundice to improve the quality of life and well-being. Procedures that can be performed are external drainage, external internal drainage, and biliary stenting. Metallic stents are preferred over plastic stents due to low profile and long patency of 6mths to one year. In case the lesion cannot be crossed then external biliary drainage is done.
Renal malignancy- Inoperable renal malignancies can have life-threatening hematuria. For this renal artery embolisation can be done. .
Alcohol ablation of the kidney can be performed using absolute alcohol. This procedure gives severe pain in there loin due to infarction. Also patient can suffer from nausea, vomiting, fever and leucocytosis. This needs symptomatic treatment for few days.
GI malignancies- The lesion that are causing excessive GI bleeding and the lesion is not amenable to immediate surgical treatment then embolisation of the visceral arteries can be done.

Cervical and other pelvic malignancies. Patients with carcinoma cervix can suffer from uncontrolled bleeding per vagina spontaneously or following radiotherapy. Here the uterine artery can be embolised. Similarly bladder malignancies with hematuria can be treated with embolisation of vesical arteries. In pelvis arteries of both sides are embolised, as rich anastomosis exists between two sides.
Lung malignancies patients with primary lung malignancies can suffer from massive hemoptysis. Embolisation of bronchial arteries can control such episodes.Radiofrequency ablation can also be offered in selected cases.
SVC(superior vena cava) syndrome. - Patients with carcinoma bronchus can invade mediastinum and obstruct SVC resulting in uncomfortable clinical features of SVC syndrome. Metallic stents can be placed to relieve such symptoms.
Also patients can develop SVC thrombosis. Here thrombolytic therapy can be done. This involves infusion of urokinase in the thrombus at the rate of 50,000-100,000 units/hour.

Head and neck malignancies- secondaries in nose or Nasopharyngeal angiofibroma, which is a highly vascular tumor, can be embolised. This results less bleeding at the time of surgery and also complete removal of the tumor is possible.

There are large numbers of interventional procedures that can be helpful in diagnosis, treatment and palliation. These procedures save patients from a life threatening hemorrhage in malignancies. It helps in improving the level of medicare provided to the cancer patients in a given institution.

STRESS AND MARRIAGE: DR. SHRINIWAS KASHALIKAR

We become weak, arrogant, irritable, cynical, skeptical, suspicious, dry, indifferent, feeble, timid, touchy, whimsical, rigid, inflexible, coward, petty, greedy, querulous and so on; as a result of mismanagement of STRESS! We overreact to every small trivia. This leads to discord to different degrees, with differing seriousness in marital life.

The life becomes hell!

One of the ways the marriages fail; is in terms of culminating in divorces. But the other ways of failures in marriages can be even worse. The marriages may end in dowry violence, honor killing or social, economic and spiritual downfall due to violence towards self such as suicidal behavior or addictions or murderous behavior.

NAMASMARAN, which is a core of Total Stress Management or SUPERLIVING; enables us to realize that marriage is an opportunity to blossom together in every possible way! It empowers us to realize our true self, overcome our ego and shun the causes of clashes by sublimation of every whim, fancy, fetish and idiosyncrasy into sublime romance.

This way the married couple and their home; become; the source of enlightenment, wisdom, love, harmony, vitality, courage and strength; and contribute to individual and global blossoming.

STRESS AND PRALHAD: DR. SHRINIWAS KASHALIKAR

Pralhad said:
PRAYENA DEVA MUNAYAH SWAVIMUKTIKAMA
MAUNAM CHARANTI VIJANENA PARARTHA NISHTHA
NAITANVIHAYA KRUPANAN SWAVIMUKTI EKO
NANYAM TADASYA SHARANAM BHRAMATONUPASHYE

Which means

Oh Lord, in general, most of the great saints, sages, yogis and rishis renounce the world, live in seclusion and observe silence in search of salvation/liberation for themselves.

Since you are the only savior for my billions of brothers and since they can not get salvation from anywhere else (in case I do not seek it from you for them),
I do not want to be a mean person to seek liberation for myself alone.

SHRIMAT BHAGAVATAM.

This is an extremely vital guidance because; though stress [and hence conceptual stress also] is a universal phenomenon, to start with; only a few fortunate ones would be able to understand and manage it. It is their privilege and DHARMA; to help others in Total Stress Management.

In this regard it is interesting to note that in these days; neither individual liberation nor individual stress management are possible; in isolation! They are intricately and inseparably bound with the liberation and stress management of billions others!