COMMUNITY OUT REACH PROGRAM ONGOING RESEARCH PROJECTS Dr.R.R.Kasliwal
ABOUT
(DR RAVI R KASLIWAL)
DR RAVI R KASLIWAL
(MBBS MD DM FIMSA MNAMS) CHAIRMAN CLINICAL & PREVENTIVE CARDIOLOGY, COMMUNITY OUTREACH & EDUCATION MEDANTA HEART INSTITUTE MEDANTA THE MEDICITY SECTOR 38 GURGAON
Clinical Experience 1977 – 1982 At the All India Institute and Medical Sciences (D.M. Cardiology & Pool Officer).
1982 – 1987 Senior Cardiologist at the National Heart Institute, New Delhi.
1987 – 2007 Director Deptt. Of Cardiology, Community Outreach and Academics at the Escorts Heart Institute and Research Centre, New Delhi.Established Diplomat National Board Cardiology (D.N.B.) and Post Graduate Diploma in Community Cardiology (PGDCC – by Indira Gandhi National Open University) at EHIRC.
2007 – Onwards CHAIRMAN CLINICAL & PREVENTIVE CARDIOLOGY, COMMUNITY OUTREACH PROGRAM AND TEACHING PROGRAM MEDANTA The MEDICITY SECTOR 38 – GURGAON NCR
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COMMUNITY OUT REACH PROGRAM Mission Statement A voluntary endeavour to provide free cardiac care for the community at the grassroots level & achieving optimum health by spreading awareness through education, prevention and treatment of cardiovascular diseases was started by me as a community initiative in 1996 and has successfully completed a decade.
Objective RESIST REACHING OUT WHERE IT MATTERS THE MOST Reach out to the masses, esp. rural & underprivileged people at their doorsteps to provide Free Cardiac care.
EDUCATE TO ERADICATE Educate the community on the burning health issues and emphasize on primordial prevention to decrease the threat of Cardiac Diseases. Build interactive education network through social organizations and NGO’s to spread the word on prevention against the heart disease. Educate & train the local health care providers on the latest developments and available techniques in cardiology.
Objective SCREENING AND TIMELY PREVENTION Extensive programs to screen cross-sections of population for risk factors for cardiovascular disease like hypertension, diabetes etc and intervene well in advance to prevent secondary damage. INTERVENTION WHEN NEEDED Prescribe the best cardiac treatment and care when established cardiovascular diseases like coronary artery disease are detected. SUPPORT GROUPS Integrate voluntary organizations, NGO’s, Multinational companies and educational institutions to contribute via this selfless program to the society especially the underprivileged.
Objective ď ą TRAIN SPECIALISTS AND PERSONNEL Training specialists from different parts of India who can then go back and reach out to their native people at grassroots. Continued medical education of the medical personnel and updating them with current world trends
Components of COP Over a decade COP has evolved three main activities, which being: Free Cardiac Camps Public Awareness talks & Continued Medical education for Health Care providers Free OPDs
Trends for Patient participation in COP (Chart:1)
Trends for COP Camps (Chart 2)
Impact of the Services ď ą For any health delivery institute the ideal measure, would be quality services given to the number of patients. Under the umbrella of COP, the total number of patients screened, diagnosed and treated since Yr. 1996 is approximately 2,86,370. The average rate at which penetration of services have increased per year is approximately 23.27%. ď ą Under COP, the cardiac examination includes free ECG and free ECHO.So far approximately, 2 Lk & 45 thousand free ECGs and 73 thousand free ECHOs have been conducted. Through this mass quantum a large number of data has been gathered and compiled, which has been used for extensive study purposes. The studies have lead to interesting findings, which have given a further direction to COP.
TOTAL PATIENTS EXAMINED PER YEAR
Interventions & Initiatives HEALTH AWARENESS through distribution of Reading material, Counselling at the time of Consultations, etc. was being carried out till 2002. However, since 2003 onwards more emphasis is being laid on regular Public lectures, awareness talks and Continued Medical Education (CMEs) for the local health care providers. Even lectures were arranged by Tele-transmission. DATA BASE for Studying important epidemiological trends and prevalence of disease and, important health issues. FREE DIAGNOSIS, PRISCRIPTION & SUBSIDISED TREATMENT for the needy.
COMMUNITY NETWORKING, mainly through: Local Government &Private agencies, social bodies, NGOs, etc Network of Corporate Primary and secondary health care providers SPANDAN, an initiative for Women and Children of rural India. Its focus is on awareness, early detection, prevention & treatment. Over a Lakh women and children are covered under this initiative every year. ARISE STUDY, Assessment of Rheumatic Heart Disease (RHD) in Indian School children by Echocardiography study. An initiative especially for school going children. It started in 2002. The aim is to assess the prevalence & key features of Rheumatic Heart Disease. The idea was to facilitate timely intervention to prevent progression of the disease in school kids. THANKS GIVING WEEK, an initiative, to provide treatment, cardiac surgeries, interventions like
angioplasties, device closures etc free of cost for a week in the month of February every year. Under-privileged patients are identified from Camps and associate NGOs like Sadhu Vaswani Mission.
Geographical expansion of COP Activities The initiation of the activities started as a local activity in Delhi in 1996. But over a period of time the reach got to deeper, covering more number of states. In a decades time, various villages, cities & towns slums, zilas, districts over 14 states have been covered. They are:
In India 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.
Jammu & Kashmir Himachal Pradesh Haryana Punjab Rajasthan Delhi Uttaranchal Uttar Pradesh West Bengal Gujarat Madhya Pradesh Bihar Jharkhand Assam
Geographical expansion of COP Activities Afghanistan
Nepal
Bangladesh
Cities Covered: 1.Kabul 2.Mazar – E - Sharief 3.Hirat
Cities Covered: 1.Kathmandu 2.Pokhara 3.Virat Nagar
Cities Covered: 1.Dhaka 2.Chitagaon
Parallel, expansion also went further across the Indian borders, catering not only the neighbouring countries but also countries in Africa with its cardiac medical care and treatment. Keeping the best foot forward for cure of the cardiac disease through spreading the word of prevention. Bridge to Kabul…. …. The most exhilarating experience
Geographical expansion of COP Activities As COP was gaining momentum all through and through still the raving desire to reach farther was much more ambitions. There were always patients trickling from beyond Indian borders. The evidence manifested the idea to seat COP in Afghanistan. Kabul with its traumatic history of conquers over decades became our destination. Till 2002 the idea was still airy but the efforts to move beyond borders were consistent. Finally COP made its mark in August 2004. A free health check-up camp & CME over 3 days, from August 28 2004 to 31 August 2004 was organized with help of Ministry of Public Health, Kabul. In spite the political disorder, the ministry of Public Health & Ambassador of GoI, Mr. Rakesh Sood were a big support in the endeavour. The team to travel to Kabul was composite of 17 members including 9 doctors, 3 nurses, 3 coordinators, an assistant and a technician.
CAMP STATISTICS (August 29, 2004 to August 31, 2004)
CAMP STATISTICS (May 4, 2005 to May 6, 2005)
CAMP STATISTICS (JUNE 20, 2005 to JUNE 23, 2005)
CAMP STATISTICS (APRIL & SEPTEMBER 2006)
Ongoing Research Projects IMPROVE-IT trial. The multi-centric international trial in collaboration with Duke Clinical Research Institute, USA. INSPIRE: Indian Stroke Registry. In collaboration with Dr Denis Xavier, St John’s Institute, Bangalore, India. Asia-Pacific Evaluation of Chest pain Trial (ASPECT)- Initiated on 1st March 2009. A multi-centric, International trial in collaboration with Dr Martin Than, Consultant Emergency Services, Christchurch Hospital, New Zealand. Sponsored by Inverness Ltd, Australia Role of carotid intima-media thickness measurement in decision making in patients with chest pain with normal or equivocal stress test- Initiated in August 2008.
Research Projects In collaboration with Dr Julius M Gardin, Associate Editor, Journal of the American Society of Echocardiography, Detroit, USA
Impact of Suboptimal Blood Pressure Control on Early Myocardial Dysfunction Detected by Advanced Echocardiographic Technologies- initiated in March 2009 In collaboration with Prof CM Yu, Chinese University of Hong-Kong Role of 3-D echocardiography in defining mitral valve anatomy in patients with significant mitral regurgitation due to different etiologies- Initiated in August 2008. In collaboration with Dr Roberto Lang, Professor Cardiology, University of Chicago, USA Value of 3-D transesophageal echocardiography in evaluation of mitral valve structure and function before and after percutaneous valvotomy in patients with rheumatic mitral stenosisInitiated in August 2008.
Research Projects In collaboration with Dr Roberto Lang, Professor Cardiology, University of Chicago, USA ď ą To derive normal values of central aortic augmentation index and aortic pulse wave velocity for Indian population- Initiated in Feb 2009. A multi-centric study, involving 10 centers all over India and is being coordinated by Dr Carmel McEienry, Consultant Cardiology, UK. ď ą Effect of consumption of moderate amount of pistachio nuts on sub-clinical atherosclerosis- to be initiated soon. The study is being sponsored by Paramount Farms India Ltd.
Thank You