Medical Tourism Vol 3 - Issue 4 April - June

Vol.3 | Issue No.4 |April - June 2019

a s i a n m e d i t o u r . c o m

OBESITY

TOMORROW’S MAJOR HEALTH CHALLENGE

TECHNOLOGY

THE BUZZWORD IN MEDICAL TOURISM

GROWTH OF AYURVEDA TOURISM

ERECTILE DYSFUNCTION

THE MOST COMMON HEALTH CONCERN AMONG ELDERLY

OBESITY HITS WORRISOME DIMENSIONS IN BRITAIN,

SAYS TORY MP MEDIA PARTNER

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Medical Tourism April - June 2019

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OBESITY TURNS A GLOBAL HEALTH THREAT

Vol. 3 | Issue No. 4 | Apr- June 2019

Obesity is one of today’s most blatantly visible – yet most neglected – public health problems. Paradoxically coexisting with under-nutrition, an escalating global epidemic of overweight and obesity – “globesity” – is taking over many parts of the world. If immediate action is not taken, millions will suffer from an array of serious health disorders.

RNI No. KERBIL/2016/68979 Editor & Publisher BENNY THOMAS Group Editor C GOURIDASAN NAIR Executive Editor BYJU ARYAD

In adults, overweight and obesity are linked to increased risk of heart disease, Type 2 diabetes (high blood sugar), high blood pressure, certain cancers, and other chronic conditions. Research has shown that obese children are more likely to be overweight or obese as adults.

Editorial Co-ordinator NINU SUSAN ABRAHAM

Studies have shown a relationship between elevated Body Mass Index (BMI) and chronic medical conditions such as diabetes mellitus, hypertension, hyper lipidemia, and obesityrelated cancers. Epidemiologic studies have also shown an association between adult obesity and premature death from all-cause mortality. One study found that obesity was associated with a 7-year decrease in life expectancy for women and a 6-year decrease for men, which is similar to findings from past studies on smoking.

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Overweight children are at high risk of becoming overweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness, and low self-esteem.

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Medical Tourism April - June 2019

In 1995, there were an estimated 200 million obese adults worldwide and another 18 million under-five children classified as overweight. As of 2000, the number of obese adults has increased to over 300 million. WHO began sounding the alarm in the 1990s, spearheading a series of expert and technical consultations. Public awareness campaigns were also initiated to sensitize policy-makers, private sector partners, medical professionals and the public at large.

Obesity is now accepted the world over as a significant and growing public health issue and theWorld Health Organisation (WHO) has characterised it as a global pandemic and a majorepidemiologic challenge faced by the doctors everywhere. It all boils down to change in lifestyle inthe modern era and lack of physical activity. Obesity-related deaths are projected to soon surpass deaths related to tobacco abuse.

Easy availability of junk food is the major reason for the increase in obesity rates. Earlier, obesity was less in rural population and now the situation haschanged with obesity increasing in the rural areas as well as the junk food availability is the same in urban and rural areas.

The cover story of this special issue is onObesity, the challenges of future, reasons, childhood obesity, diseases related with it, physical inactivity, change in food habits and treatment. There is also an exclusive interview with UK’s Conservative party MP, Bob Blackman, on people falling prey to lifestyle induced diseases.

Technology plays a major role in treating various decease and many innovations have been made in this field for easy diagnosis of diseases and effective treatment. Some of the advanced technologies in the medical field including the 3D technology for surgery are given importance in this special issue.

Tourism plays a major role in the several national economies. Global wellness tourism is growing at a rapid rate and is becoming popular around the world with the acceptance of Ayurveda and Yoga.

The growth of Ayurveda medical tourism and the treatment offered by the two indigenous Indian medical systemsare also included in this issue.

Medical Tourism Magazine was the Media Partner for Middle East Technology Conference held at Jeddah and participant at theArab Health Exhibition at Dubai. We are also the media partner for the CII Kerala Health Tourism 2019 to be held on July 3 and 4, 2019 at Kochi and Medicall Equipment Expo to be held at on July 26 to 28, 2019 at Chennai.

We wish you a happy reading.

Editor

Printed, published and owned by Benny Thomas FM Media Technologies Pvt. Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India.

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Disclaimer: The statements in this magazine have not been evaluated by the Food and Drug Administratin of USA or any other country. Information provided in this magazine are not intended to diagnose, treat, cure or prevent any disease. If you have a medical condition, consult your physician. All information is provided for research and education purpose only.

Official Magazine

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Contents

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08 Cover story:

Obesity Tomorrow’s major health challenge

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Blame it on lifestyle

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18

Obesity hits worrisome dimensions in Britain, says Tory MP

42 Varicose vein Diagnosis and

Treatment

Fast food drives Childhood obesity

44 Alcohol may up breast

22 Diet plans for obese people 26 Medical sector goes virtual

cancer risk

46 News

28 3D printing is the way forward

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30 New jewels on

Sree Chitra’s crown

08 49 Medical Events 50 Hospitals 34

54 Equipment Technology- The buzzword in medical tourismm

36 Multiple sclerosis 38 Growth of Ayurveda Tourism 40 Erectile Dysfunction: The most

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common health concern among elderly

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MEDICAL TOURISM COVER STORY

OBESITY

Tomorrow’s major health challenge

Obesity is a complex condition, one with serious social and psychological dimensions, that affects people of virtually all ages and socio-economic groups and threatens to overwhelm both developed and developing countries. High caloric density of fast food is the sole culprit here, which is a risk factor for both obesity and diabetes.

F

ew notice its onset, but soon it is there, adding to your girth, which no amount of physical exertion can get rid ff. No, you are not alone. Look around, and you will see many living with that extra pound of fat that refuses to go, despite all the solemn vows they take to eschew this and that and burn calories at the gym. And no, it is not a hopeless situation. There is much that you and your neighbour and her neighbours in the same and several cities, towns and villages can do to fight obesity.

Obesity is now accepted the world over as a significant and growing public health issue and the World Health Organisation (WHO) has characterised it as a global pandemic and a major epidemiologic challenge faced by the doctors everywhere. It all boils down to change in lifestyle in the modern era and lack of physical activity. No wonder, several studies say that obesity is rapidly becoming the leading cause of preventable death. Worse, obesity-related deaths are projected to soon surpass deaths related to tobacco abuse.

In adults, overweight and obesity are linked to increased risk of heart disease, Type 2 diabetes (high blood sugar), high blood pressure, certain cancers, and other chronic conditions. Research has shown that obese children are more likely to be overweight or obese as adults.

Nowadays, food is available everywhere and everyone is encouraged to eat, drink and be merry. We can get something to eat in places where it was never available before, even at gas stations. Going out to eat or getting carryout is easy everywhere. And, food portions at restaurants and at home are bigger

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Medical Tourism April - June 2019

• At least one third of the world's adult population is either overweight or obese. • The prevalence is generally lower but increasing faster in low-and middle-income countries than in high-income countries. • Preventative measures should consider addressing the upstream drivers of obesity.

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en, millions will suffer from an array of serious health disorders.

than they used to be. Thanks to Uber and its many clones, you don’t have to go in search of food any more as food items of your choice would be delivered at your doorsteps at a reasonable price through mobile apps and home deliveries from all major restaurants.

colon cancer are high in people who are obese, he says. Becoming obese doesn't happen overnight. Obesity happens over time when the energy we take in by eating is not in balance with the energy we burn from physical activity.

Easy availability of junk food is the major reason for the increase in obesity rates, says Dr Prakash K, Senior Consultant Gastro Surgeon, Aster Medicity, Kochi. Obesity is the major problem faced by all the developing countries, he says. “The change in people’s diet pattern is the major cause for this major health problem.

Earlier, obesity was less in rural population and now the situation has changed with obesity increasing in the rural areas as well as the junk food availability is the same in urban and rural areas,” Dr Prakash says.

At the other end of the malnutrition scale, obesity is one of today’s most blatantly visible – yet most neglected – public health problems. Paradoxically coexisting with under-nutrition, an escalating global epidemic of overweight and obesity – “globesity” – is taking over many parts of the world. If immediate action is not tak-

Obesity is associated with a higher incidence of a number of diseases, including diabetes, cardiovascular disease, and cancer. Consumption of fast food, trans-fatty acids (TFAs), and fructose—combined with increasing portion sizes and decreased physical activity—has been implicated as a potential contributing factor in the obesity crisis.

According to Dr Prakash, obesity leads to multiple diseases including hypertension. The possibilities of 10 Medical Tourism April - June 2019

WHO ON OBESITY

Obesity is a complex condition, one with serious social and psychological dimensions, that affects virtually all age and socio-economic groups and threatens to overwhelm both developed and developing countries.

In 1995, there were an estimated 200 million obese adults worldwide and another 18 million under-five children classified as overweight. As of 2000, the number of obese adults has increased to over 300 million.

Contrary to conventional wisdom, the obesity epidemic is not restricted to industrialized societies; in developing countries, it is estimated that over 115 million people suffer from obesity-related problems.

WHO began sounding the alarm in the 1990s, spearheading a series of expert and technical consultations.

Public awareness campaigns were also initiated to sensitize policy-makers, private sector partners, medical professionals and the public at large.

Aware that obesity is predominantly a “social and environmental disease”, WHO is helping to develop strategies that will make healthy choices easier to make.

OBESITY IN CHILDREN There are several reasons for children becoming obese. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem.

Although weight problems run in families, not all children with a family history of obesity will be overweight.

Dr Prakash says that genetic problem alone is not the reason for obesity in children, but it can be linked to shared family behaviours such as eating and activity habits.

Overweight children are at high risk of becoming overweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness, and low self-esteem.

A child's total diet and activity level play an important role in determining a child's weight. Today, many children spend a lot time being inactive.

On an average a child spends approximately four hours each day watching television. As computers and video games become increasingly popular, the number of hours of inactivity may increase.

OBESITY-ASSOCIATED DISEASES Studies have shown a relationship between elevated Body Mass Index (BMI) and chronic medical conditions such as diabetes mellitus, hypertension, hyperlipidemia, and obesity-related cancers. Epidemiologic studies have also shown an association between adult obesity and premature death from all-cause mortality.

One study found that obesity was associated with a 7-year decrease in life expectancy for women and a 6-year decrease for men, which is similar to findings from past studies on smoking. Furthermore, pediatric

obesity is associated with many of the same cardiovascular risk factors as adult obesity, including hypertension, diabetes, metabolic syndrome, and hyperlipidemia.

FAST FOOD AND TRANS FAT The high caloric density of fast food is the sole culprit, but there may also be a specific component in fast food that contributes to the increased risk for obesity and diabetes. Fast food is indeed characterized by a high caloric density (energy content/food weight ratio), and the total caloric content of a typical fast food meal exceeds that of the average meal by 65%. In addition to high caloric density, fast food has historically had higher amounts of industrially produced trans fatty acids (TFAs). Compared to other fats, TFAs have higher melting points, better taste, and longer shelf lives.

The change in food habits of people like preferring more non-vegetarian food also leads to obesity, says Dr Shafi Ali Khan, Laparoscopic Surgery Consultant, KIMS Hospital, Thiruva-

nanthapuram. Consumption of vegetables has come down and increase in calorie and carbohydrate too need to be added to the increasing obesity cases. “The intake of empty calorie drinks like carbonated foods and alcohol are leading to overweight of children as well as adults. Presence of sugar in pastry, ice creams and other sweet products also result in diseases,� Dr Shafi Ali Khan says.

The Expert Committee of the American Medical Association says that eating away from home, specifically consumption of fast food, is a risk factor for childhood obesity. In terms of nutrient composition, fast food children's meals are high in total fat and TFAs, have high caloric density, and offer very little nutritional value.

PHYSICAL INACTIVITY Physical activity (PA) has been suggested as an essential requirement for decreasing the incidence of obesity and reducing the number of overweight individuals. Controlling diet and exercise can reverse obesity and it can help in controlling the A Complete Magazine on Healthcare in Asia

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diseases, says Dr Shafi Ali Khan.

One of the factors thought to be responsible for decreased PA is the increase in time spent watching television. A recent study examined the role of increased television viewing on all-cause and cardiovascular mortality. PA in any form helps to tip the balance of energy consumption versus energy expenditure in a favorable direction. A study found that adults who reported low levels of PA were more likely to have gained significant weight over the previous 10-year period.

Probably the most important role for exercise and increased PA in individuals with obesity is the prevention of recidivism after successful weight loss from dieting and the maintenance of lean body mass as body fat mass is reduced. Studies have confirmed that exercise alone usually incurs only a small amount of weight loss and that the more important role of exercise is in maintaining weight loss after a successful diet programme.

intestine. It may also reduce the size of the stomach.

This is generally more effective than restrictive procedures, but there is a higher risk of vitamin and mineral deficiencies, as the body can no longer absorb as many nutrients. A doctor may recommend surgery for a person who has a body mass index of 40 or above, or lower than 40 if they have other health issues.

Dr Shafi Ali Khan says that the surgery has greater chance of attacking obesity. However, the hitch is that surgery is not available in all the hospitals and it is also costly.

A disposable equipment is used for the surgery which costs nearly Rs 1.5 lakh. When the patient starts losing weight the medicines used for the diseases related to obesity could be reduced or even discontinued, he says. Dr Praksah says that only a small section of the patients prefer surgery due to the high cost, especially because insurance companies do not reimburse the hospital bills for treatment of obesity.

TREATMENT Weight loss, or bariatric, surgery involves removing or changing a part of a person's stomach or small intestine so that they do not consume as much food or absorb as many calories as before. This can help an individual to lose weight and also reduce the risk of high blood pressure, type 2 diabetes, and other aspects of metabolic syndrome that can occur with obesity. Surgery can either make the stomach smaller, or it can bypass part of the digestive system.

The surgeon uses a gastric sleeve or a gastric band to make the stomach smaller. After the operation, a person cannot consume more than about one cup of food during each sitting. This significantly reduces food intake. The gastric bypass procedure enables food to bypass parts of the digestive system, specifically the first part of the mid-section of the small 12 Medical Tourism April - June 2019

Obesity can lead to: High cholesterol High blood pressure Early heart disease Diabetes Bone problems Skin conditions such as heat rash, fungal infections, and acne

How can we tackle obesity?

Dietary changes Physical Activity Weight-loss medications Surgery Hormonal treatment Browning white fat cells

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MEDICAL TOURISM LIFESTYLE

BLAME IT ON LIFESTYLE

T

he primary culprit behind the obesity epidemic may be the modern-day environment, and not genes.

People with a greater genetic risk for obesity did appear to be more affected by modern developments that promote obesity, such as wide availability of cheap, high-calorie food, neighbourhood designs that present fewer opportunities to walk, and couch-potato leisure activities.

The burden of lifestyle disorders is rapidly increasing worldwide. Modernization, affluence, science and technological development lead to still more sedentary lifestyles.

Lifestyle diseases are of our own creation. With the evolution of civilization, humans have become more and more physically inactive. Such behavioural patterns are trending across countries and are transferable from one population to another like an infectious disease, affecting disease patterns globally. By exposing oneself to all these factors human beings unknowingly invite a number of diseases, of which obesity is one which disturbs physical, mental and social health of an individual.

In the developed world with the food abundance, obesity has become one of the biggest problems that, in the long term, are threatening health and well-being of large populations. The main reason for the contemporary obesity epidemic is a very short history of our (over) abundance. Time of unlimited amounts of food is too short for human beings to develop effective psycho-biological mechanisms that would limit one's food intake.

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Historically, we have never experienced a problem such as too much food. Thus the human body does not resist excessive food intake as much as excessive fluid intake or excessive workout which means we can eat as much as we want to.

Eating is not only a biological necessity but also a common social custom. Most social events are based on eating and people find it difficult to avoid overeating because of this social lifestyle, unless they are very nutritionally-aware and can put the healthy-eating theory into practice.

On the other hand, eating is also a biological necessity that in the abundance-society is being satisfied more often than any other biological need. Overeating is often a very comfortable compensation for other unfulfilled needs, especially emotional ones that are, in the era of over-consumption, very hard to recognize and satisfy.

Many people want to lose their weight they gain by overeating, because being overweight or obese becomes a trauma in itself. In the society of abundance, the thin figure is what shows higher social class and wealth and thus the representatives of lower social classes are usually facing more problems with obesity. Slim figure shows that a person is never addicted to food abundance and that he or she has enough free time and money for being physically active and lead a dynamic lifestyle.

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MEDICAL TOURISM INTERVIEW

OBESITY HITS WORRISOME DIMENSIONS IN BRITAIN, SAYS TORY MP

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ritain, traditionally a country of health-conscious people, is today worried about obesity becoming a major cause of worry, says Conservative Party MP Bob Blackman.

Blackman, who has been representing Harrow East from 2010 and who is the vice chair of the Parliamentary Group on International Traditional Sciences, told Medical Tourism Magazine in an exclusive interview.

Unhealthy food habits and lack of lack of exercise, particularly among children, is so pervasive that a large number of people are falling prey to lifestyle induced diseases. Most children these days sit glued to TV screens snacking on junk food and sweets.

Another major threat threats today in UK is the addiction to smoking, which has acquired the dimensions of a serious health problem. The government is now encouraging people to quit smoking as it can lead to cancer.

“Our government is encouraging children to engage in sports and also making parents aware about the need for exercise. The government is considering a ban on advertisement of junk food and steps to place sweets out of reach of children in super markets”, 16 Medical Tourism April - June 2019

“We are targeting the youngsters to help them quit smoking. Parents are also being made aware of the consequences of smoking and ensure that their children do not fall prey to it,” he said. He strongly believed that there is a great potential for medical tourism in the United Kingdom. The number

of people coming from UK to India for treatment is on the rise.

As technology has developed, the service of Indian doctors can be used at UK itself with the use of telemedicine.

The huge cost for the travelling can thus be reduced. The NHS does not fund treatment outside UK. So there is a need to encourage people to become practitioners of the traditional systems in the UK itself after gaining expertise in India through the technologies developed for diagnosis and treatment of diseases.

With the increasing awareness about health issues, people are also increasingly turning to a vegetarian diet. Almost all the restaurants have vegetarian food and, today, Indian vegetarian food is very popular in the UK, the senior statesman said.

Blackman thinks that Kerala’s Ayurveda and Yoga could together play a major role in altering the lifestyle and health of the British people.

“There is an increasing interest in Yoga and Ayurveda in Britain. When Indian Prime Minister Narendra Modi announced the International Yoga Day, there was not much of a response from the people. Now, however, more people are interested in Yoga for the way it improves one’s quality of life,” he says.

In Kerala recently, Blackman had a first-hand experience of the traditional healthcare regime and hugely impressed by it.

“We plan to submit a report to the Health Secretary on how to include traditional medicinal practices like Ayurveda into the mainstream to bring down lifestyle related diseases of the British people,” said Blackman, citing the many health threats that people back home confront today.

Blackman, who was Greater London Assembly member for Brent Harrow between 2004 and 2008, said he has been working to popularise Ayurveda and Yoga for long. The lukewarm response to Yoga in the first year’s Yoga Day observance had given way to greater acceptance from the people. In 2018, there was an impressive turnout of people on the International Yoga Day on June 21, clearly indicating the spread of awareness about the therapeutic values of Yoga, he said.

Ayurveda cannot be considered as an alternative to modern medicine, but as a complementary stream.

Yoga already has good acceptance in the UK as a complementary method of lifestyle-based healthcare. The breathing exercises and stretches do help people to have a long healthier life. Although Ayurveda is a aditional medicine system, it is unlikely to be accepted an alternative to modern medicine.

“Our idea is to promote Ayurveda as a complementary means to achieve wellness,” he said, citing the way herbs were used for treatment during the ancient times. In modern medicine, synthesised drugs which are more powerful are used. This results in side-effects.

“Throughout the world, in every village, women used to collect herbs to cure diseases. These herbs were used to prepare medicines in traditional methods for natural treatment across the globe,” he pointed out.

Apart from Yoga and Ayurveda, Unani too has great acceptance in the UK. ‘Unani Day’ was celebrated recently, with various practitioners from around the globe assembling at UK to share their experiences. The Unani practitioners converged at the British Parliament and spoke about its benefits and how this system is helping people to stay healthy. “We have a long tradition of homoeo medical care too,” he said.

Several doctors, technicians and nurses from the Indian subcontinent work at several hospitals in the UK. They know how the traditional medicines could be used and its benefits. But there is the great threat of those practising the traditional systems making tall claims about the curative properties of traditional medicines. “I am not sure about the treatment methods of alternative medicines as different methods are used in each sector”, he said.

“There were huge public exhibitions in various parts of the United Kingdom on Yoga day. Several practitioners from India and British parliamentarians too were part of the observance, said Blackman, who hopes to have traditional medicines and healthcare practices added to the Ten Year Plan of the National Health Services (NHS) unveiled in December 2018.

Kerala is already in forefront of healthcare under various streams. In the UK, A Complete Magazine on Healthcare in Asia

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MEDICAL TOURISM CHILDHOOD OBESITY

FAST FOOD DRIVES

CHILDHOOD OBESITY

Obese children are at high risk for developing high blood pressure, high cholesterol levels, abnormal blood sugar levels, sleep disorders, hormonal changes and growth issues. Data from our “Lifestyle clinic for adolescents and children� showed that one in two obese children/adolescents have abnormal cholesterol levels and an equal proportion has high blood pressure, says Dr. Manu Raj, Professor & Senior Consultant, Paediatric Cardiology & Health Sciences Research, Amrita Institute of Medical Sciences & Research Centre 18 Medical Tourism April - June 2019

cents are often due to multiple factors that contribute to excess weight gain.

The most common causes are unhealthy eating patterns, inadequate physical activity, increased duration of sedentary behavior and genetic factors. Childhood obesity can rarely be caused by hormonal abnormalities as well. Any child/adolescent who consumes more calories than required for normal growth and current activity levels is at risk for obesity. Urbanization and modernization have promoted sedentariness among children and adolescents. Current generation of children/adolescents are less active physically than earlier generations. Modern gadgets like TV, video games, computers and mobile phones have increased sedentary behavior among children and adolescents and keeps them away from physical activity options like outdoor games and competitive sports. The popularity of fast food items has increased the calorie consumption of children/adolescents compared to earlier generations. This high calorie consumption clubbed with reduction in physical activity options results in a net calorie excess in the child/adolescent. Any excess calorie is stored in the child’s body as excess fat and this finally leads to obesity.

3. WILL CHILDREN BECOME OBESE IF PARENTS ARE OBESE? 1. WHAT IS THE TREND OF OBESITY IN CHILDREN WORLDWIDE? Childhood obesity is currently considered as a massive epidemic with exponential growth on a global scale. Data from more than 2,400 studies across the globe covering 130 million children from 1975 to 2016 suggests that the global rates of childhood obesity have jumped dramatically in the past four decades. The number of children in the age group 5-19 years who are obese has increased more than tenfold from 1975 to 2016. Overall, the number of children and adolescents

with obesity (defined by a measurement of age and gender specific BMI more than 95th percentile) increased from five million to 50 million among girls, and from six million to 74 million among boys. This rapid increase in the span of four decades is alarming and suggests that urgent action is warranted to contain this public health menace.

2. WHAT ARE THE REASONS PROMOTING THE CHILDHOOD OBESITY EPIDEMIC? Obesity among children and adoles-

Childhood Obesity clearly demonstrates a familial tendency. Obesity in one or both parents definitely increases the risk of obesity in their children.

Research suggests that the odds of children aged 7 becoming obese if the father, mother or both had obesity are 3, 5 and 12 respectively. This means that if both parents are obese, the chance of their seven-year-old child becoming obese is 12 times more compared to a child of seven years with both parents in the nonobese range. We should recollect that this higher risk of obesity is a combination of genetic as well as environmental factors. On an average only 1 A Complete Magazine on Healthcare in Asia

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changes during a trial of 6 months to one year. Surgical correction is only considered for obese adolescents with either morbid obesity or with severe comorbidities who fail to benefit from lifestyle changes or drug therapy. All children/adolescents who are either overweight or obese should be on regular medical follow up till their BMI declines to healthy range.

6. WHAT IS THE ROLE OF EATING HABITS IN CHILDHOOD OBESITY?

in 10 obese children report having a parent with obesity and the remaining have parents who are non-obese.

4. WHAT ARE THE HEALTH PROBLEMS SEEN AMONG CHILDREN WITH OBESITY? Obesity at any age has the potential to damage all organs and systems in our body. Children with obesity can have multiple issues that involve different organs of the body. Obese children are at high risk for developing high blood pressure, high cholesterol levels, abnormal blood sugar levels, sleep disorders, hormonal changes and growth issues. Data from our “Lifestyle clinic for adolescents and children� showed that one in two obese children/adolescents have abnormal cholesterol levels and an equal proportion has high blood pressure. Abnormalities in insulin function was seen among one in three obese children/adolescents and an equal proportion had metabolic syndrome.

Obese children/adolescents are also at high risk for future occurrence of diabetes, hypertension, heart disease, liver diseases, kidney diseases, depression, joint diseases, neurological problems and infertility during adulthood.

20 Medical Tourism April - June 2019

5. WHEN SHOULD A CHILD WITH EXCESS WEIGHT SEE A DOCTOR AND WHAT WILL HE/SHE DO? Any child or adolescent who has body mass index (BMI) more than the 85th percentile based on age and sex appropriate BMI reference charts is classified as overweight. Those children/ adolescents having BMI above 95th percentile are classified as obese. All children/adolescents who are either overweight or obese requires a proper medical evaluation by a Pediatric physician. The pediatrician will do some basic measurements along with some routine blood tests and prescribe appropriate treatment for obesity. This treatment schedule is based on the level of overweight/obesity and the presence of additional obesity related comorbidities like abnormal glucose levels, abnormal cholesterol levels and abnormal blood pressure. The components of overweight and obesity treatment include dietary management, physical activity enhancement, sedentary behavior restriction, drug therapy and bariatric surgery.

Drug therapy is reserved for extreme obesity when diet therapy and exercise regimens fail to show beneficial

In the past four decades, the prevalence of snacking has increased, as has the prevalence of overweight in children. Majority of snack foods popular among current generation of children and adolescents are categorized under junk food. Junk food describes any food item or beverages that are low in nutrients (e.g., vitamins, minerals and fiber) and high in calories, saturated fat, added sugar and/or added salt.

Snack-food and sugar sweetened beverage consumption have contributed significantly to the greater prevalence of childhood obesity. Fast food consumption increases with age. Adolescents consume proportionately more calories from fast food items compared to younger children.

This increase can be at the cost of a proportional decrease in energy from other, more nutritious foods that are balanced, natural and healthy. Small families, working parents and busy schedules for all at home add to the unhealthy eating patterns currently seen among children and adolescents. Junk food advertisements and sponsorships aired through TV programs, internet and movies influence the young minds and attract them towards higher consumption of such unhealthy food items.

7. WHAT IS THE ROLE OF PHYSICAL ACTIVITY IN CHILDHOOD OBESITY? Moderate intensity regular physical activity is essential for the prevention

of overweight and obesity among children and adolescents. Children and adolescents should engage in 60 minutes or more of moderate to vigorous physical activity per day to achieve optimum cardiovascular health. Overweight and obese children should target higher levels to achieve similar results. Longer periods of moderate intensity exercises like brisk walking burn more fat as calories and are excellent for reducing body fat. Children should be prescribed physical activity that is safe, interesting and feasible.

Involving other members of the family in the exercise program will improve compliance. In addition to weight reduction, exercise training is associated with beneficial changes in fat and lean body mass, cardiovascular fitness, muscular strength and glucose metabolism, all of which significantly reduce the morbidity associated with excess weight. Obese children/adolescents who are physically active will have less health issues compared to their physically inactive and obese counterparts.

8. WHAT IS THE ROLE OF SEDENTARY BEHAVIOR IN CHILDHOOD OBESITY? Children and adolescents typically indulge in sedentary activity like watching TV, sitting in front of computers, playing with mobile phones and engaging in video games. Every hour of sedentary activity increases the chance of obesity in adolescents and children. Screen time for children/adolescents should be restricted to less than two hours per day as the opposite is associated with increased adiposity and higher weight status. Excessive TV viewing is associated with higher intakes of energy, fat, sweet and salty snacks and carbonated beverages in addition to reducing consumption of fruits and vegetables. TV time restriction is an excellent opportunity to complement dietary management in the fight against childhood obesity.

Restricting TV time also reduces the child’s exposure to junk food advertisements that can promote unhealthy eating.

9. WHAT ARE THE INITIATIVES THAT CAN HELP IN PREVENTING CHILDHOOD OBESITY? Community level initiatives that can prevent childhood obesity include advocacy to increase physical activity at schools and at home through the creation of environments that support physical activity. These efforts could include creation and maintenance of parks, inclusion of child friendly walking and bicycle paths as well as creating awareness about locally available physical activity options. It is essential to engage families with parental obesity or diabetes, because these children are at increased risk for developing obesity later in life. Parents should strive to be role models when it comes to healthy diets, portion sizes, physical activity and screen time.

A strong commitment from government, school managements, parents, local community networks and resident associations can help us a lot in the fight against childhood and adolescent obesity.

Dr. Manu Raj Professor & Senior Consultant Divisions of Paediatrics, Paediatric Cardiology & Health Sciences Research Amrita Institute of Medical Sciences & Research Centre, Kochi

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MEDICAL TOURISM DIET

DIET PLANS FOR OBESE PEOPLE 22 Medical Tourism April - June 2019

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he most established way for an obese person to lose weight is by focusing on diet and cutting calories. According to the National Heart, Lung and Blood Institute, Bethesda, Maryland, U.S., you should cut your caloric intake by about 500 to 1,000 calories a day to lose one to two pounds a week.

Women can lose weight safely by consuming 1,000 to 1,200 calories a day, and men should aim for 1,200 to 1,600 calories a day. A healthy low-calorie diet plan avoids saturated and trans-fats, cholesterol, too much sodium and added sugars. It includes low-fat dairy products; lean proteins, such as fish, poultry and beans; whole grains; and fruits and vegetables.

FOLLOW A LOW CARBOHYDRATE DIET On a low-carb diet plan, you restrict carbohydrates -- particularly high-glycemic varieties that affect your blood sugar -- in favour of eating more protein and fat. While eating this way, you’ll avoid grains such as bread, pasta, rice and oats; some high-sugar fruits; root vegetables; and foods with added sugar, such as candy, ice cream and desserts.

CUT THAT PORTION SIZE Cut back on portions to eat less food and balance your caloric intake. Start by weighing and measuring everything you eat. Other tricks include using a smaller plate for your meals, because it holds less food, and ensuring that you read the nutrition label for serving sizes and adjust your consumption as necessary.

Rather than cut out meals, a more ef-

fective approach is to spread out the calories into about five meals per day.

Three small meals with two healthy snacks would be the norm. Eating more often helps control hunger and reduces the risk of overeating.

BE CHOOSY ABOUT FOOD For breakfast, three egg whites with whole grain toast, a banana, and coffee would supply plenty of protein and complex carbohydrates for energy. An apple and a bottle of water between breakfast and lunch.

Grilled chicken over a salad with lowfat dressing is a protein packed, lowfat lunch. Unsweetened iced tea with lemon would be a perfect low-calorie beverage. Between lunch and dinner, sugar-free yogurt and another bottle of water will prevent the drop in energy normally felt at around 3 p.m.

For dinner, 8 ounces of salmon with mixed vegetables and brown rice can be a great tasting, filling final meal. Decaf unsweetened iced tea is refreshing and will not interfere with sleep.

LIMIT SCREEN TIME Watching television (TV) can be enjoyable and informative; unfortunately it can also be double jeopardy when it comes to weight. It’s a completely sedentary activity that also seems to promote unhealthy eating though the ads, product placements, and other promotions that constantly pitch high-calorie, low-nutrient food and drinks.

GET ENOUGH SLEEP There is more and more evidence that a good night’s sleep is important

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to good health-and may also help keep weight in check. How much a person needs can vary a great deal, but there is good evidence that a lot of children and adults don’t get enough.

JUST RELAX Today’s world is full of daily stresses. This is a normal part of life, but when these stresses become too much, they can take a toll on health and contribute to weight gain by leading to unhealthy eating and other unhealthy activities.

One of the best ways to control stress is also one of the best ways to combat weight gain: regular physical activity.

Mind body approaches, such as breathing exercises, can also be beneficial.

UNDERSTAND EXTREME OBESITY A healthy Body Mass Index (BMI) ranges from 17.5 - 25 kg/m2. If your body mass index is 40 or higher, you are considered extremely obese (or morbidly obese.) A woman is extremely obese if she’s 5 feet, 4 inches tall and weighs 235 pounds, making her BMI 40.3 kg/m2. To reach a healthy BMI of 24.8, she would have to lose 90 pounds to reach a weight of 145 pounds.

A man is extremely obese if he’s 6 feet, 2 inches tall and weighs 315 pounds, making his BMI 40.4 kg/m2. To reach a healthy BMI of 25.0, he would need to lose 120 pounds to reach a weight of 195 pounds. Doctors use BMI to define severe obesity rather than a certain number of pounds or a set weight limit, because BMI factors weight in relation to height.

Simple obesity diet chart

What to eat WHOLE GRAINS (whole wheat, steel cut oats, brown rice, quinoa) Vegetables (a colorful variety-not potatoes) WHOLE FRUITS (not fruit juices) NUTS, SEEDS, BEANS, AND OTHER HEALTHFUL SOURCES OF PROTEIN (fish and poultry) PLANT OILS (olive and other vegetable oils) DRINK WATER OR OTHER BEVERAGES THAT ARE NATURALLY CALORIE-FREE.

Limit these food and drinks SUGAR-SWEETENED BEVERAGES (Soda, fruit drinks, sports drinks) FRUIT JUICE (no more than a small amount per day) REFINED GRAINS(white bread, white rice, white pasta) and sweets POTATOES (baked or fried) RED MEAT (beef, pork, lamb) and processed meats (salami, ham, bacon, sausage) OTHER HIGHLY PROCESSED FOODS, SUCH AS FAST FOOD

MORNING - Pudina chatni sandwich made with whole wheat bread could be a perfect start to the morning. A bowl of fresh cut fruits along with it is also not a bad idea.

AFTERNOON -Lunch time could comprise of simple roti, a bowl of vegetable and dal. Dal is filled with protein. Protein is essential for weight loss and muscle repair. Since protein takes time to digest, it keeps you satiated for long and thereby preventing you to binge on fattening foods.

EVENING - In evenings, you can have your antioxidant boost with a cup of tea.

You can also team them with fibre-rich whole wheat biscuits. Make sure you stay away from the sugary cookies.

DINNER - For dinner, you can have chapatis, vegetables and swap the dal with vegetable salad.

24 Medical Tourism April - June 2019

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MEDICAL TOURISM TECHNOLOGY

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his is not the old world of tactile things anymore. Much of it is virtual, be it the games we play or the things that we do. Medical science too is turning to Virtual Reality (VR) technology to find solutions to the many challenges the health care system faces today. And, not surprisingly, VR technology today playing a key role areas ranging from general diagnostics, medical training to surgical procedures.

Virtual reality is an immersive, three-dimensional, computer generated environment. Users can interact with the environment in a realistic manner using special electronic sensors. Traditionally, this technology has been dedicated to gaming and entertainment. But increasingly virtual reality is being adopted by other industries ranging from military, aviation to mainstream professional development.

The immense possibilities that VR offers was view at a 3D live open operative workshop, the first of its kind to be held in India, at Amrita Institute of Medical Science, Kochi, Kerala. Conducted using the technology of Rays 3D, an entertainment company, this workshop was held as part of the medical conference of surgeons, Brascon 2019. Virtual Reality (VR) Interactive medical content was used for the surgery.

Anubha Sinha, founder and managing director of Rays 3D, which is the only Indian company selected for the technology award instituted by the Los Angeles-based Advanced Imaging Society, says that Virtual Reality (VR) technology can open a whole new world before doctors. At the workshop, they could feel like they were involved in the surgical procedure. Besides giving a true-life experience to the doctors, VR also help save 30% time needed for surgeries.

MEDICAL SECTOR GOES VIRTUAL

The 3D imaging helps doctors to take quick decisions while performing surgeries. This technology is very useful in surgical oncology and treating obesity.

One of the most obvious applications of virtual reality is in teaching anatomy as 3D visualisations of the human body can be readily manipulated and dissected in similar and perhaps more precise ways than cadaveric dissections.

Another application for virtual reality in medical education is peer learning.

Learning together in a study session is one of the most effective ways to learn as medical students. It forms an essential component of problem based learning, which is adopted by many medical schools in the UK and abroad. There is also enormous scope to use virtual reality in emergency medicine training such as cardio pulmonary resuscitation (CPR). Realistic emergency scenarios can be created on virtual reality giving students an authentic emergency scenario.

Traditionally CPR training is carried out on dummies. However, real life situations can be vastly different from this. Virtual reality can bridge the gap between dummies and reality. An advantage of this is that an infinite number of scenarios can be created instead of practising on a limited number of models in a limited number of scenarios.

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MEDICAL TOURISM 3D TECHNOLOGY

3D PRINTING IS THE WAY FORWARD

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edical models allow surgeons to plan precisely what they must accomplish during a surgery. Given the substantial risks of surgery, new ways to improve the safety and successful outcomes of surgery would have a far-reaching impact on public health.

A patient-specific model gives the surgeon the ability to see and feel what they would encounter during the surgery. This way, the surgeon can plan accurately what must be done during the surgery. This is where 3D printing comes in.

The key benefit of 3D printing is the ability of the surgeon to handle patient-specific anatomical models, rather than viewing X-rays, ultrasound images, computed tomography (CT) images, or magnetic resonance imaging (MRI) images that might not be as clear as what the surgeon would like to see. The information presented by a patient-specific model gives the surgeon greater insight as to what he/she will be facing, which would lead to a more satisfactory outcome for the patient.

Recently, doctors at Gleneagles Global Health City in Chennai, reconstructed the jaw of a 20-year-old woman from Sudan, with the help of 3D printing technology and CT scan image. The doctors created an exact three-dimensional mirror image of the opposite side to reconstruct an entire jaw bone model. The patient had approached the hospital with deformity of the lower jaw, following surgery on her jaw bone.

The patient underwent excision of a benign tumour of the jaw back at Sudan.

During the surgery, a segment of the lower jaw bone was removed and the gap was bridged with the plate, which led to major deformity. As a result, she could not close her mouth and had difficulty in swallowing due to lack of skeletal support.

The team headed by Dr. Selva Seetha Raman, planned for the reconstruction of the jaw bone and restore her appearance. The challenging part was that the length of the bone to be reconstructed, was around 8 cm. Doctors took a bone from the leg, along with its blood supply and transferred the same to the jaw. Then the harvested bone was shaped using specialized cutting instruments to match the missing segment, using the 3D model.

To establish the blood supply to the bone, the blood vessel of the bone flap was connected to the blood vessels of the neck. After the bone flap settled, the doctors reconstructed the teeth with the help of the maxillofacial team.

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MEDICAL TOURISM MEDICAL DEVICE

NEW JEWELS ON SREE CHITRA’S CROWN

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ri Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) has for long occupied a pride of place among research and clinical care centres in the country. True to its reputation, the institute has now come up with a string of cost-effective medical devices that could revolutionise the way high-end healthcare is provided to the commoners in India.

The devices, all products of the innovative genius of the scientists and medical practitioners at the institute, 30 Medical Tourism April - June 2019

were formally launched at the Industry- Innovator Meet, Medical Technology Expo and ‘Technology Conclave 2019’ organised by the Sri Chitra Institute at Thiruvananthapuram recently.

Key among the devices that has hit the market is the Isothermal-based DNA amplification device, developed to detect TB bacterium in sputum samples in less than 30 minutes. The device can simultaneously screen 20 patient samples in one assay and at a considerably lower cost than the existing devices, which costs approxi-

mately Rs. 2500 a sample. Preliminary data from application of the device shows that this device has high sensitivity and specificity (low false positives and false negative results) as compared to the currently used CBNAAT technology.

There are TB detection devices that are currently used in a specialized laboratory conditions, but there is an essential need for a highly sensitive TB detection device at the peripheral centres. The Sri Chitra device will help in mass screening at a substantially

low cost. The device presents a breakthrough in the diagnosis of Tuberculosis and the technology has been patented by SCTIMST. A second technology launched at the expo was the Vein Viewer developed by SCTIMST and manufactured

by Agappe Diagnostics Ltd, Kochi.

The technology was transferred to Agappe Diagnostics last year. The

Bioactive Bone Cement and Calcium Phospho-silicate Composite Granules was relaunched at the expo. Bioactive Bone Cement is a patented bioactive formulation of calcium sulphate and phosphate. It is packed as powder-liquid combination which forms a self-setting putty upon mixing useful for filling bone defects. The bioactive and resorbing properties enable the remodelling of the bone and faster

ideal for grafting periodontal infra-bony defects in dentistry.

The other new technologies that were formally transferred to the industry included a TB Screening Device and PT/INR Monitoring Device to Agappe, Paracorporeal Left Ventricular Assist Device to Meril Life sciences, Injectable hydrogel for cartilage repair and Lint free absorbent wound dressing to Phraction Scientifics, and SCTAC2010: drug conjugated serum albumin to Eight Oaks Bio. PT/INR Monitoring Device is a point of care, battery-operated hand held device for easy measurement of blood parameters carried out with a single drop of finger prick blood applied on a disposable strip. The test of PT/INR in lab will be between Rs 200 and Rs 300.

The Paracorporeal Left Ventricular Assist Device is a third generation device that can be used for supporting the heart, as a “Bridge to Recovery” after surgeries or “Bridge to Transplantation” used while awaiting a donor heart for cardiac transplantation. The device has a pump, controller and battery packs and necessary accessories for supporting the heart for days to few weeks.

hand held Vein Viewer helps to identify the location of peripheral veins for injection that is particularly difficult in small children and in the ICUs. Device for viewing the veins prior to injections can improve the outcome by helping the healthcare professionals to insert the needle to the correct vein. The Chitra Vein Viewer is an easy-to-operate portable and battery-operated device that can precisely locate the position of veins to avoid multiple pricks and to get maximum benefit out of the injection.

healing of the defects. ‘BioCaS’, as it has been named, is an affordable product which could be used as a bone defect filler in orthopaedics and dentistry.

Calcium Phospho-silicate Composite Granules technology offers synthetic bone graft substitute in fine granule form based on calcium-phospho-silicate composite. High bioactivity and osteo-conductivity are the special properties of this indigenous composite prepared in porous ceramic form.

The fine granules of the composite are

The Injectable hydrogel for cartilage repair is used for micro fracture surgery to aid quick and easy repair of damaged cartilages in joints. The gel can also be used as a vehicle to transport cartilage producing cells to the site.

Lint free absorbent wound dressing developed in the Institute is made of materials that don’t shed lint into the surgical site, has high fluid holding capacity and fast wicking properties for management of low to moderately exudating wounds.

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system, enabling 100 fold increase in drug bioavailability. Clinical trials in humans have to be completed and results assessed as the ensuing steps towards commercialization.

The Institute also conducted the technology relicensing of Poly Viny Alcohol (PVA)Sponge and Hydrocephalus Shut to Konikkara Industries and Phraction Scientifics Ltd respectively.

PVA sponge is a synthetic sponge designed for tissue manipulation or absorbing fluid quickly from surgery sites. Hydrocephalus shunt is a device used to drain abnormal accumulation of cerebrospinal fluid (CSF) from the brain to other areas in the body, typically abdominal cavity.

SCTIMST combines specialized medical care with development of medical devices and biomaterials, and pro-

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vides training in advanced medical specialties, public health and biomedical engineering to a talented bunch of future medical professionals. The Biomedical Technology Wing (BMT Wing) at Sri Chitra has been established with the objective of promoting biomedical sciences and technology.

The institute hosts a technology business incubator, TIMed, for fostering start-ups in the medical devices segment.

The BMT Wing has advanced facilities for the development and evaluation of medical devices and biomaterials.

Selected testing services are accredited by NABL, India and COFRAC, France. The Institute holds 110 patents and 51 technologies have been transferred to industries during the last four decades.

The institute’s first technology partner, Terumo Penpol, is one of the largest producers of blood bags in Asia and, together with the other industrial partners, is making more than 50 million bags annually, exporting to more than 70 countries. The premier product of the institute, the mechanical heart valve has crossed 120,000 implantations since 1990.

Various mission mode R&D projects and programmes are going on at the Technical Research Centre (TRC) for Biomedical Devices, which is a program funded by Department of Science and Technology since 2016 for 5 years. The focus areas are cardiovascular devices, neuro-prosthetic devices, hard tissue devices, diagnostics and biological and combinational products.

Welcome to One of India’s Most Advanced Medical Destinations JCI & NABH accredited quaternary care facility 10 Centres of Excellence | One Multispeciality Hospital An exceptional team of 350+ doctors World-class medical technology | Award-winning nursing care 24/7 Emergency care | Aeromedical transfer

Kochi, Kerala, India | Tel: +91 96569 00768 | mvt.astermedcity@asterhospital.com | astermedcity.com A Complete Magazine on Healthcare in Asia

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MEDICAL TOURISM TREATMENT

TECHNOLOGYTHE BUZZWORD IN MEDICAL TOURISM To ensure quality medical treatment, most modern technology should be used for surgeries and other treatments. Robotic surgery and Artificial Intelligence too have a major role to play in the health sector, says P. Venkatesh, Managing Director, Chennai Medical Tourism.

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ndia has emerged as one of the most preferred Medical Tourism destination. The Hospitals providing International Patient Services in India are well equipped with state of art infrastructure, latest technology and highly qualified, experienced staff that can provide timely and quality medical treatment to patients.

THE FUTURE OF MEDICAL TOURISM SHALL THRIVE ON FACTORS WHICH INCLUDES • Virtual Hospitals • e-ICU • Modern Technology

e-ICU The concept of e-ICU is emerging and being used in countries like U.S.A, Israel.

In e-ICU a team of intensive care physicians provides 24 X 7 technical support to their networked hospitals, medical doctors, and ICU nurses managing an ICU set up in a remote location or country.

• In-country Surgeries and Transplant

MODERN TECHNOLOGY

VIRTUAL HOSPITALS

Health Care Industry is driven by the modern techniques and equipment which promotes the well- being of patients and faster recovery time. The current concepts/trend in the industry

Virtual Hospitals /Telemedicine have enabled health care industry professionals in providing door step services to the patients. Today patient avails health care 34 Medical Tourism April - June 2019

services at his/her door step, when the medical expert is connected with the patient, it provides a trust and confidence to the patient helping them for quick decision-making process.

hand tremors. The surgeon thus can operate with enhanced precision, dexterity and control even during the most complex procedures.

Laparoscopic Liver Transplant: The number of people wait listed for liver transplant has increased over the years. Thanks to the development of Living Donor Liver Transplant (LDLT) in which through advanced laparoscopic liver resection a portion of liver is removed and transplanted to the recipient. In- Country Surgery and Transplant Today, Corporate hospitals, Senior Consultants/Surgeons are performing surgeries, transplant in different countries. The local government, hospitals in these countries would like to have medical expert/ surgeons visiting them for OPD camps and Surgical Camps. The visiting medical team shall render their service to more number of patients within few days’ time. The medical team shall provide training and technical support to the local talents. This also promotes post-surgery follow up for the patients within their country.

includes Proton Therapy, Minimally Invasive Cardiac Surgeries, Robotic Surgery, and Laparoscopic Liver Transplant.

Proton Therapy is an advanced Radiation Therapy, which is very precise; the radiation is focused directly into the tumour, without causing any harm to the adjoining tissues. Proton Therapy can be used for Tumours in difficult to access areas such as, in head, neck, brain, pancreas and prostate. Proton therapy enhances the survival rate of the patient, with reduced side effects of radiation.

Minimally Invasive Cardiac Surgeries (MICS) also known as Keyhole Heart Surgery is performed through a small incision, often using specialized surgical instruments. The incision is

about 3-4 inches instead of the 6-8 inch incision required for traditional surgery. Presently MICS are used for surgeries like bypass grafting, heart valve repair or replacement, closure of holes in the heart. MICS or keyhole heart surgery does not require the breast bone to be cut and overcomes the associated problems of pain and slow recovery.

Robotic Surgery or Robot-assisted surgery integrates advanced computer technology with the experience of the skilled surgeons. In robotic Surgery, the surgeon uses controls in the console to manipulate special surgical instruments that are smaller, as well as more flexible and manoeuvrable than the human hand.

The robot replicates the surgeon's hand movements, while minimizing

Chennai Medical Tourism networked with globally reputed hospitals and surgical centres providing the above services. Chennai Medical Tourism focuses and promotes holistic health care and wellness management to all our clients.

P. Venkatesh Managing Director, Chennai Medical Tourism

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MEDICAL TOURISM DISEASE

MULTIPLE SCLEROSIS

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ultiple sclerosis is a common disease of the brain, where the brain undergoes progressive demyelination and degeneration over years. Over the years, it leads to progressive disability and most patients end up in a wheelchair or are totally dependent for activities of daily living after 15-20 years. So far, medications for MS concentrated on slowing the progression of the disease. As Multiple sclerosis predominantly affects young people in the most important phases of life [in the 2nd and 3rd decades], it causes considerable social , marital and financial difficulties. In the last few years, revolutionary new therapies have been introduced for Multiple sclerosis which can halt or in rare cases even reverse some of the symptoms of the disease. These include drugs such as Natalizumab, Alemtuzumab and Stem cell transplantation. Nowadays these tools are increasingly used very early in the disease to even attempt to 'cure' Multiple sclerosis.

At Aster Medcity, Kochi, we have launched our Multiple sclerosis and Autoimmune neurology Clinic to offer all these tools [Natalizumab, Alemtuzumab and Stem cell transplantation] at Kochi. It is run by a multidisclipinary approach involving the Dept of Neurology, Physiatry, Ophthalmology and allied specialities. We are the first center in South India to initiate an Alemtuzumab [Lemtrada TM] infusion in patients.

36 Medical Tourism April - June 2019

The company Sanofi Genzyme has also certified us as an approved and preferred center for Lemtrada infusion in Multiple sclerosis. Lemtrada [Alemtuzumab] is a monoclonal antibody that offers high efficacy and high rates of cure in MS with just 2 cycles of drug over 2 years. With minimal side effects and risks, Alemtuzumab is a promising new hope in the treatment of Multiple Sclerosis.

The MS and autoimmune neurology clinic is run every Tuesdays by Dr Boby Varkey Maramattom, Lead consultant Neurologist in the Aster Neurology center of excellence.

We collaborate with international experts to arrive at the best options for the treatment of Multiple sclerosis. After examining the patients, depending on the patient preferences and characteristics, both medications and stem cell transplantation are offered by our MS clinic.

Dr Boby Varkey Maramattom Consultant Neurologist Aster Medcity, Kochi

Media Partner

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MEDICAL TOURISM WELLNESS

GROWTH OF AYURVEDA TOURISM

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lobal wellness tourism is a $640 billion industry that is expected to grow at an average annual rate of 7.5% to $919 billion by 2022. While Yoga has become very popular across the world, Ayurveda is catching up rapidly. In 2018, Ayurveda sector saw a landmark achievement, touching a gross market size of $4.4 billion and it is projected to record a Combined Annual Growth Rate (CAGR) of 16% until 2025.

AYURVEDA TOURISM IN INDIA Ayurveda is a 5,000-year-old system of natural healing that has its origins in the Vedic culture of India. Ayurveda has been enjoying a major resurgence throughout the world. Kerala has been a pioneer in promoting Ayurveda and practise this system of medicine with absolute dedication. Today it is the hub of Ayurveda Tourism in world map.

38 Medical Tourism April - June 2019

AYURVEDA GOES GLOBAL Ayurveda is now spreading across the world and is available as one of various spa offerings amongst various wellness retreats and hotels across the world. Sri Lanka, being an island nation with its beautiful beaches and tropical climate is best suited for curative and restorative therapies. It is rapidly gaining momentum as a favourite destination for Ayurvedic retreats, especially amongst Europeans.

Wellness retreats in Bali, Thailand and other East Asian countries offer Ayurveda as one of their main offerings and is becoming increasingly popular in European countries like Germany, Italy, Spain apart from UAE, USA, Canada and Costa Rica. A delightful collection with pure natural ingredients for beauty and indulgent pampering solutions for body, mind and soul is offered across the world.

International hotel chains such as Six Senses, Taj, Oberoi, Jet Wings, etc., have now embraced Ayurvedic treatments in a holistic way.

AYURVEDIC OFFERINGS Ayurvedic offerings range from general massages like Abhyanga and relaxing Shirodhara, detoxification, rejuvenation, weight loss, anti-ageing and beauty programs are extremely popular. Ayurvedic treatments for beauty, wellness and ailments (obesity, arthritis, diabetes and preventive cancer) focus on curing the root cause by cleansing the channels, strengthening and balancing the internal system.

This holistic approach of Ayurveda is offered in all reputed and verified centres across India.

AYURVEDA IN MEDICAL TOURISM Ayurvedic wellness travellers are typically categorized in two types: the primary wellness traveller who travels with the primary purpose of wellness and the secondary wellness traveller whose travel plans include various wellness activities — spas, health resorts, yoga retreats. With better un-

derstanding of Ayurveda, its principles and its holistic management of preventive cure, there is now a growing demand from primary wellness travellers who are turning to Ayurveda as their first choice of treatment for serious conditions like Arthritis, Diabetes, Rheumatism, Parkinson’s and post-chemo management etc.

Ayurveda offers powerful solutions to many lifestyle health issues such as Arthritis, Diabetes, Psoriasis, Insomnia, etc. and people across the world are turning to Ayurveda to help them combat various ailments and health issues. Customers from India and other countries have benefitted from Ayurveda.

SOME OF THE OTHER TREATMENTS OFFERED BY AYURVEDA INCLUDE: • Post cancer rejuvenation program • Depression • Back pain • PCOD • Infertility • Sexual Wellness (Vajeekarna) Treatments by Ayurveda is now covered by Insurance for people in India.

On special cases, some customers from Europe have been able to get insurance coverage once certified by GP that Ayurveda is essential for treatment.

benefits of Ayurveda. Accreditation of Ayurvedic Hospitals by NABH (National Accreditation Board of Hospitals)

by Ministry of AYUSH, Certification by Kerala Tourism of various Ayurvedic resorts, etc have immensely helped bring some focus to this system.

CONCLUSION Ayurveda Tourism is poised to grow at high double-digit levels in the coming years as increasing number of resorts and hotels across the world are likely to adopt Ayurveda as one of their first choice of wellness offerings. Some of the key factors favouring the market growth include, increasing demand for natural and organic products, expanding medical tourism across the globe, rising consumer awareness and growing demand for ayurvedic product. In addition to expanding consumer base, rising consciousness towards a healthy lifestyle are anticipated to fuel the market growth.

Moreover, practical developments in ayurvedic medicines will offer great investment opportunities for players in the market. The excellent health benefits that Ayurveda has, it is only a matter of time before Ayurveda and Ayurveda Tourism becomes the mainstream focus to global audience as Yoga is today.

THE CUSTOMER DILEMMA While the customers from across the world are increasingly becoming aware of Ayurveda, the wellness offerings by various wellness centers and retreats vary a lot. Customers find it hard to search for the authentic Ayurveda centre of their choice and this ranges from simple authentic ayurvedic hospitals to 5-star luxury resorts and a host of places.

INDUSTRY EFFORTS Tourism Ministries of India and Sri Lanka are promoting Ayurveda Tourism in a big way. Research conducted by Ministry of Ayush, FRLHT and many others have helped authenticate the A Complete Magazine on Healthcare in Asia

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MEDICAL TOURISM SEX LIFE

ERECTILE DYSFUNCTION:

The most common health concern among elderly

Diabetic men got three fold risk of developing Erectile Dysfunction (ED) compared to those without diabetes. The longer the duration of DM the chances for ED and heart disease is high, says Dr Promodu, Consultant Sex Therapist Clinical Psychologist, Dr Promodu’s Institute of Sexual Medicine Urology, Kochi.

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ost men are concerned about their ability to satisfy a woman. As the age advances their worry also worsens. Erectile Dysfunction (ED) is common particularly among men over 40 years and increases with the age. ED is an inability to achieve or sustain an erection for a satisfactory completion of sexual activity. Fifty percent men aged 40 to 70 years suffer from ED. Dr. Promodu’s Institute data shows that out 21,690 patients (87.5%

men and 12.5% women) sought treatment for various sexual problems.

Among men 64% had ED as the major concern or problem. Do all men develop an erectile dysfunction? By the age of 70 almost 70% men are affected by ED. So it is one of the most common health concerns among the elderly.

Ironically they are either reluctant to reveal to anybody including health professionals or to seek treatment, especially in Asian countries.

WHAT CAUSES ED? Sexual functioning is a very complex phenomenon involving human mind, hormones and other bodily systems.

When there is impairment or problem with any of these aspects men can develop erectile dysfunction. ED may be due to physical causes such as impairment of blood flow to the penis, major systemic illnesses, side effects of medications, alcohol drug abuse etc and psychogenic causes like mental stress, anxiety, relationship problems etc.

DIABETES MELLITUS Erectile dysfunction occurs in 50% of men with diabetes mellitus. Diabetic men got three fold risk of developing ED compared to those without diabetes. The longer the duration of DM the chances for ED and heart disease is high. Increased blood glucose can cause damage to blood vessels that supply blood to the heart and penis, there by increasing the risk for ED as well as heart diseases.

HYPERTENSION

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Hypertension can damage lining of arteries and interferes with the blood flow to the penis. 30% of men with hypertension got ED.

can affect the erectile ability. Occupational stress, problems in interpersonal relationships, attitude towards the partner, marital discord, partner’s reactions or approach, incongruence in expectations of married life etc leads to impairment in erection.

TREATMENT OPTIONS

CHOLESTEROL High cholesterol can damage the arteries by clogging and restricting the blood flow. Low density lipoprotein (LDL) leads to deposition of fat in the inner walls of arteries known as atherosclerosis which reduce the blood flow. This is a common cause for ED as well as heart attack.

HEART ATTACK ED may be a first sign of cardiovascular disease for many men. There is close relationship between ED and heart attack. Studies show that 66% of men with cardiovascular diseases had developed erectile problems within the previous five years of heart attack.

ED may be considered as a premonitory sign of impending cardiac disease at least for a few. Men aged 45 years and above without any known cardiac disease suffering from ED got 50% more risk to develop heart disease compared to those who doesn’t have ED.

ALCOHOL AND TOBACCO Excessive drinking increases the risk for ED. As Shakespeare said alcohol increases the desire but takes away the performance. Alcohol impairs erection. Chronic smoking leads to atherosclerosis.

Tobacco use is linked to ED and cardiovascular disease. Life style factors such as obesity, excessive consumption of fatty food etc can add to the risk for ED.

PSYCHOGENIC FACTORS Anxiety is one of the most common psychogenic factors leading to loss of erection. Mental stress in any form

There are different treatment options such as medication, sex therapy, vacuum erection devices, extracorporeal shockwave therapy, penile implants.

Vacuum erection devices are outdated ones and very cumbersome to use.

In the recent past though experiments started with extracorporeal shockwave therapy, the results are not very promising.

LIFESTYLE MODIFICATIONS Evidences show that lifestyle modifications got an important role in the management of ED. Increasing physical exercise, reducing weight, stopping smoking and excessive consumption of alcohol, controlling other systemic illnesses such as diabetes mellitus, hypertension, reducing increased cholesterol, adopting healthy copying mechanisms for mental stress etc can help in restoring erectile function. Adopting these methods can also help to delay the onset of ED.

SEX THERAPY Sex therapy is one of the most effective methods of treatment for psychogenic ED. Most of the psychogenic EDs are curable. In certain cases a combination of medicines and sex therapy is more effective.

PHARMACOTHERAPY Pills for erectile dysfunction are mainly belongs to the group of drugs known as PDE5 inhibitors. It doesn’t have any effect on desire, but only helps to maintain the erection. But ED occurring due to problems like impairment in penile blood flow is not curable. However medicines will help such patients to get temporary benefit while on medications.

PENILE IMPLANTS For those who doesn’t respond to drugs or those who cannot take drugs due to side effects or not interested to take medicines can undergo this operation. Penile implants are used for such cases. When all other treatment fails penile implants are the only option left and it is very effective. These are either malleable (bendable) or inflatable devices fixed inside the penis through an operation. The simplest type of prosthesis consists of two malleable rods surgically implanted into the penis. These implants will help to get sufficient rigidity for penetrative sex and sustain the erection even after ejaculation and continue the sexual act if the man or his partner wishes. Inflatable devices are either two piece or three piece devices. Two piece devices got an additional reservoir cum pump which is implanted in the scrotal sac and connected to the cylinders or tube placed in the penis.

When using three piece devices, reservoir is kept inside the abdomen and pump in the scrotum and connected to the cylinders placed inside the penis. These inflatable implants look more natural and achieve the erection by inflating the device only when the man needs and deflate after the sexual intercourse. The major advantage of implant is that man got full control over the erection and use the device as and when he requires it. One need not worry or get upset about the erectile problems. You can consider it like any other diseases and seek treatment. There is effective treatment to help the man to enjoy sex life as long as he or his partner wishes.

Dr Promodu M Phil, M&S, PhD (Clin Psy) Consultant Sex Therapist & Clinical Psychologist Email: info@drpramodusinstitute.in

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MEDICAL TOURISM DISEASE

VARICOSE VEIN Diagnosis and Treatment

V

aricose veins are large, swollen veins that often appear on the legs and feet. They happen when the valves in the veins do not work properly, so the blood does not flow effectively.

Any superficial vein may become varicosed, but the veins most commonly affected are those in your legs.

That's because standing and walking upright increases the pressure in the veins of your lower body. If treated at the right time this condition can be completely cured.

SYMPTOMS: Varicose veins may not cause any pain. Signs you may have varicose veins include: • Veins that are dark purple or blue in colour • Veins that appear twisted and bulging; they are often like cords on your legs When painful signs and symptoms occur, they may include: • An achy or heavy feeling in your legs

• Burning, throbbing, muscle cramping and swelling in your lower legs • Worsened pain after sitting or standing for a long time • Itching around one or more of your veins • Skin discoloration around a varicose vein

CAUSES Weak or damaged valves can lead to varicose veins. Arteries carry blood from your heart to the rest of your tissues, and veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.

Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart.

Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the vein, causing the veins to stretch or twist.

COMPLICATIONS Complications of varicose veins, although rare, can include: • Ulcers. Painful ulcers may form on the skin near varicose veins, particularly near the ankles. A discolored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you've developed an ulcer.

• Blood clots. Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may become painful and swell.

Any persistent leg pain or swelling 42 Medical Tourism April - June 2019

warrants medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.

• Bleeding. Occasionally, veins very close to the skin may burst. This usually causes only minor bleeding.

But any bleeding requires medical attention.

PREVENTION There's no way to completely prevent varicose veins. But improving your circulation and muscle tone may reduce your risk of developing varicose veins or getting additional ones. The same measures you can take to treat the discomfort from varicose veins at home can help prevent varicose veins, including: • Exercising • Watching your weight • Eating a high-fiber, low-salt diet • Avoiding high heels and tight hosiery • Elevating your legs • Changing your sitting or standing position regularly

DIAGNOSIS AND TREATMENT To diagnose varicose veins, your doctor will do a physical exam, including looking at your legs while you're standing to check for swelling. Your doctor may also ask you to describe any pain and aching in your legs. You also may need an ultrasound test to see if the valves in your veins are func-

tioning normally or if there's any evidence of a blood clot.

Treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. With help of less invasive procedures, varicose veins can generally be treated on an outpatient basis.

RADIOFREQUENCY ABLATION Radiofrequency ablation is a minimally invasive treatment for varicose veins. (Ablation means a doctor uses heat to damage tissue, which makes scar tissue form. This scar tissue closes the vein) This technique uses radiofrequency energy to heat up and damage the wall inside a vein. This usually closes off a varicose vein in the leg. To treat a varicose vein, radiofrequency energy is directed through a thin tube (catheter) inserted through a small incision in the vein. It can be used on large veins in the leg and can be done in an office setting using local anaesthesia. You will be able to walk following the treatment and recovery typically is short.

LASER TREATMENT Doctors are using new technology in laser treatments to close off smaller varicose veins and spider veins. Laser treatment works by sending strong bursts of light onto the vein, which makes the vein slowly fade and disappear. No incisions or needles are used.

ENDOSCOPIC VEIN SURGERY You might need this operation only in an advanced case involving leg ulcers if other techniques fail. Your surgeon uses a thin video camera inserted in your leg to visualize and close varicose veins and then removes the veins through small incisions. This procedure is performed on an outpatient basis.

SCLEROTHERAPY In this procedure, your doctor injects small- and medium-sized varicose veins with a solution or foam that scars and closes those veins. In a few weeks, treated varicose veins should fade.

Although the same vein may need to be injected more than once, sclerotherapy is effective if done correctly.

Sclerotherapy doesn't require anaesthesia and can be done in your doctor's office

COMPRESSION STOCKINGS Wearing compression stockings all day is often the first approach to try before moving on to other treatments.

They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently. The amount of compression varies by type and brand.

Dr.Vinayakhram KPS, MS, FMAS, FIAGES Consultant surgeon Baby Memorial Hospital Kozhikode

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MEDICAL TOURISM HEALTH

ALCOHOL MAY UP BREAST CANCER RISK

44 Medical Tourism April - June 2019

D

rinking one alcoholic drink daily as well as being overweight can increase the risk of developing breast cancer, warns a study of over two lakh women. This means that consumption of even relatively small preventable proportions can translate into large numbers of preventable breast cancers. Maintaining a healthy weight and not consuming alcohol regularly could help prevent thousands of breast cancer cases.

Over the next decade, drinking alcohol will lead to 13% increase of breast cancer cases in pre-menopausal women and 6% in post-menopausal breast cancers. Being overweight or obese will contribute to 13% cases.

Together, these modifiable risk factors -- regular alcohol consumption and excessive weight gain -- will be responsible for nearly 30,000 breast cancer cases by next decade, noted the study published in the International Journal of Cancer.

Further, the use of menopausal hormone therapy has also been found to account for 7% of post-menopausal breast cancers, with over 90% of this burden caused by a long-term use. Similarly, long-term use of oral contraceptives is found to account for 7% of pre-menopausal breast cancers.

LIFESTYLE CHOICES Obesity does not just happen overnight, it develops gradually from poor diet and lifestyle choices.

UNHEALTHY FOOD CHOICES COULD BE: *Eating processed or fast food high in fat *Not eating fruit, vegetables and unrefined carbohydrates, such as wholemeal bread and brown rice *Drinking too much alcohol – alcohol contains a lot of calories, and heavy drinkers are often overweight *Eating out a lot – you may have a starter or dessert in a restaurant, and the food can be higher in fat and sugar *Eating larger portions than you need - you may be encouraged to eat too much if your friends or relatives are also eating large portions *Comfort eating – if you feel depressed or have low self-esteem you may comfort eat to make yourself feel better *Unhealthy eating habits tend to run in families, as you can learn bad eating habits from your parents.

A Complete Magazine on Healthcare in Asia

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MEDICAL TOURISM NEWS

KERALA HEALTH TOURISM SUMMIT AT KOCHI T

o attract more Medical Tourists to Kerala, Confederation of Indian industry (CII) is organizing the Seventh edition of Kerala Health Tourism (KHT) 2019 on 3 and 4 July 2019 at Le Meriden, Kochi. The summit will deliberate on the theme: Kerala – an emerging Global Hotspot for MVT. India has been growing as a hub for the medicaltourists every year and the prime reason being the cost ofmedical treatment in India which is cheaper when compared to Western Europe, North America and some Southeast Asian countries. According to a recent study it was understood that India has nearly 18% of the global medical tourism market.

Also, it has been estimated that India’s medical tourism industry could be worth $9 billion, and account for 20% of the global market share by 2020. NITI Aayog identified that Medical Value Travel as a major source of foreign exchange earnings for India.

Although Kerala is the leading state in India for tourism, tourists travelling to Kerala for medical needs remain very minimal. A rare combination of advanced facilities, skilled doctors, and low cost of treatment are the advantages Kerala possess but unfortunately the State is not able to attract the medical tourists to the fullest of its potential.

International delegation from nine countries including Bangladesh, Oman, Africa, Jeddha, Cambodia, Iraq, Maldives, Yemen and Uzbezkistan will participate in the summit. Procurement managers from leading hospitals in Kerala will be joining for the event.

46 Medical Tourism April - June 2019

There will be an exclusive exhibition on Medical Equipment Manufacturers and Medical Technology as part of the summit.

The speakers at the event include Sudhanshu Pandey , Additional Secretary, Ministry of Commerce and Industry, Government of India,Sangeeta Godbole, Director General, Services Export Promotion Council, Gokulam Gopalan, Chairman, Sree Gokulam Medical College, M I Sahadulla, Chairman & Managing Director, KIMS Healthcare Management Limited, Fr. Johnson Vazhappilly , ED & CEO, Rajagiri Hospital, Rohit Sathe, President – Healthcare, Philips Indian subcontinent, Dr Abhitabh Gupta, Managing Director, Paramount Health Services and Insurance TPA Pvt. Ltd, Dr Pradeep Kumar, Chairman, Kinder Medical Group, Singapore, Dr Dilip Panikar, Sr. Consultant Neurosurgery, Aster Medcity, Dr Sundaramoorthy, Chairman & MD, Lotus Eyecare, Junaid Rahman, Medical Director, Sree Sudheendra Medical Mission and Dr AM Anvar, Chairman & Managing Director, Punarnava.

The topics covered in the summit include Clinical excellence in Kerala: The value proposition, Health insurance: A key catalyst to promote MVT, Role of healthcare facilitator: Critical link or underbelly, Role of Government to promote MVT: Centre and State, Accreditation and Quality initiatives in Kerala, Role of holistic medicine in promoting MVT – The Kerala model and Role of medical equipment manufacturers in promoting MVT.

MEDICAL EQUIPMENT EXPO, MEDICALL CHENNAI, FROM JULY 26 TO 28

T

he Medical Equipment Expo, Medicall Chennai, will be held from July 26 to 28, 2019.

Medicall is India's largest B2B trade fair for medical devices and hospital supplies. Approx. 750 exhibitors and 15,000 trade visitors from over 20 countries, among them physicians, but also biomedical engineers, sales people, decision makers, consultants and hospital owners, are represented at this important industry event.

In addition to the presentation of the best and the latest medical and medical-technical equipment, software, supplies and other devices in the market has to offer. The fair mainly serves as a platform to exchange knowledge and Laboratory Equipment, Dental Equipment, Ophthalmology experiences among renowned industry experts. Various Equipment, Medical Disposables, Hospital design and conPenta Square, Opp. Kavitha Theatre, M.G Road, Kochi-35, conferences and innovation awards in different categories Kerala, India, Tel: +91 484 4034055 struction, Hospital Staffing Service, IT provider for hospital, complement the event.

Email: marketing@ayurvedamagazine.org Communication Equipment, Medical Waste Management, www.ayurvedamagazine.org Medical Textiles, Financial and Health Insurance Services, The expo will have Hospital Equipment, Surgical EquipOffice Automation, Equipments and Accreditation Agenment, Rescue and Emergency Equipment, Facility Managecies. ment & Support Services, Hospital Furniture, Diagnostic,

Vol.3 | Issue No.1 | Jul - Sep 2018

Cover Story

KIDNEY DISEASE

Diabetes: Main cause of Chronic Kidney disease

TOURISM

Kerala Bounces back after floods

KTM FOCUSES RESURGENCE OF TOURISM STRESS CAN AFFECT ORGANS

A Complete Magazine on Healthcare in Asia

1

Penta Square, Opp. Kavitha Theatre, M.G Road, Kochi-35, Kerala, India, Tel: +91 484 4034055 Email: marketing@ayurvedamagazine.org www.ayurvedamagazine.org A Complete Magazine on Healthcare in Asia

47

MEDICAL TOURISM NEWS

KIMS: World-class Healthcare Destination in Kerala

K

IMS Healthcare Group has been instrumental in revolutionizing healthcare delivery In India through its quality focused systems and practices. The group was established in 2002, with a noble vision to provide quality healthcare with affordability and accessibility.

With its flagship hospital at Thiruvananthapuram, Kerala, the Group is the largest healthcare network in the state of Kerala and is among the top leading hospitals in the country; it has also become a renowned brand in healthcare in the Middle East. Within a short span of 17 years, it has expanded its footprint to six countries – 7 Hospitals and 10 Medical Centres, with a strong presence in the GCC region.

KIMS is the only medical institution in Kerala to have earned the accreditations of ACHSI, NABH Hospital & Radiology), NABL (Blood Bank), and Neonatology Level 3 B confirming its superior tandards in patient-centric care, nursing, and pathology/laboratory services. It is home to numerous centres of excellence and specialized clinical services that provide patients with the highest standards of evidence-based treatments using a multi-disciplinary approach to care.

The academic wing of KIMS has been recognised as one of the leading academic centres in healthcare. Academic endeavours have been an integral part of its persistent pursuit for excellence.

"Medicine, management and ethics - these three fundamental passions came together when I co- founded KIMS. My endeavour is to impart this passion to each and every new talent joining our organization” – says Dr M I Sahadulla, CMD, KIMS Healthcare Group.

different parts of the world. Its International Patient Relations (IPR) desk forms the central coordination point for complete end-to-end service.

OUR UNIQUE FEATURES • Over 49 specialties backed by comprehensive, best-inclass technology and well-trained para-medical staff • Hi-end cardiac catheterization laboratory • State-of-the-art operation theatres • Advanced facilities for conducting open heart surgeries, cardiac bypass, valve replacement surgery, and correction of Congenital Cardiac malformations • Dedicated intensive care units • Advanced diagnostic laboratory services • 128 Slice CT scan, 1.5 Tesla MRI Scan and PET Scan System that provides outstanding image quality for precise diagnosis of various disorders.

• Specially designed preventive health check-up packages.

• One of the best blood bank facilities in South India with facilities for component separation.

ADAPTING TO MEDICAL TOURISM

CSR INITIATIVES

“International patients come to India for treatment from accredited facilities and cost effectiveness,” asserts Dr. Sheriff Sahadulla, Chief Executive Officer & Chief Medical Officer of KIMS Healthcare Group.

KIMS has been serving the underprivileged patients through its various foundations like, KIMS charitable trust, KIMS Guruvandanam, Touch a life foundation, KIMS Spine foundation, KIMS Liver foundation, Dialysis foundation and Voice foundation. Apart from these, KIMS has done 100 free heart surgeries for needy heart patients through its CSR initiate - KIMS Hrudaya Spandanam. KIMS also has recently launched KIMS Jaipur Foot clinic to provide Jaipur foot, limb, calipers and aid for free of cost for the patents of Kerala.

“Medical tourism is a growing sector in India and is projected to grow to US$7 billion to US$8 billion by 2020. Within India, Kerala has attracted medical tourists due to its super speciality hospitals, alternative treatments and abundant natural attractions.” KIMS treats over 50,000 patients from 48 Medical Tourism April - June 2019

MEDICAL TOURISM MEDICAL EVENTS

KERALA HEALTH TOURISM SUMMIT (July 3 and 4, 2019), Hotel Le Meridien, Kochi

To attract more Medical Tourists to Kerala, Confederation of Indian industry (CII) is organizing the Seventh edition of Kerala Health Tourism (KHT) 2019 on 3 and 4 July 2019 at Le Meriden, Kochi. The summit will deliberate on the theme: Kerala – an emerging Global Hotspot for MVT. There will be an exclusive exhibition on Medical Equipment Manufacturers and Medical Technology as part of the summit.

ACN- INTERNATIONAL CONFERENCE ON MEDICAL AND HEALTH SCIENCES (ICMHS)

SCIENCEFORA - INTERNATIONAL CONFERENCE ON MEDICAL ETHICS AND PROFESSIONALISM (ICMEP) (July 14, 2019), Bangalore, Karnataka

An elegant and rich premier global platform for the International Conference on Medical Ethics and Professionalism (ICMEP) that uniquely describes the Academic research and development across globe. This event will fill in the void that is being created by the current global academic and research by the different global challenges.

MEDICALL CHENNAI

(July 21, 2019), New Delhi, India

(July 26 to 28, 2019), Chennai Trade Centre, Chennai)

ACN- International Conference on Medical and Health Sciences (ICMHS) is a prestigious event organized with a motivation to provide an excellent international platform for the academicians, researchers, engineers, industrial participants and budding students around the world to SHARE their research findings with the global experts.

The Medical Equipment Expo, Medicall Chennai, will be held from July 26 to 28, 2019 at Chennai Trade Centre, Chennai. Medicall is India's largest B2B trade fair for medical devices and hospital supplies. Approx. 750 exhibitors and 15,000 trade visitors from over 20 countries, among them physicians, but also biomedical engineers, sales people, decision makers, consultants and hospital owners, are represented at this important industry event.

INTERNATIONAL CONFERENCE ON HEALTHCARE AND CLINICAL GERONTOLOGY (ICHCG)

5TH WORLD CONGRESS ON EPILEPSY AND TREATMENT

(July 28, 2019) Chennai , Tamil Nadu

5th World Congress on Epilepsy and treatment will be held on August 14-15, 2019 at Radission Narita in Tokyo, Japan. Epilepsy Treatment 2019 revolves around the theme Breakthrough in Epilepsy Research and Care. Epilepsy Treatment 2019 offer a unique experience with the Keynote/Plenary Talks, Poster Presentations, and Workshops by eminent personalities

An elegant and rich premier global platform for the International Conference on Healthcare and Clinical Gerontology (ICHCG) that uniquely describes the Academic research and development across globe. This event will provide unique and rational opportunities to all the attendees, researchers from different domains.

(August 14 and 15, 2019), Tokyo, Japan

INTERNATIONAL CONFERENCE ON INTERNAL MEDICINE AND HOSPITAL MEDICINE

ISER- 646TH INTERNATIONAL CONFERENCE ON SCIENCE, HEALTH AND MEDICINE (ICSHM)

(August 19-20, 2019), Paris, France

(August 23, 2019), Chennai , Tamil Nadu

International Conference on Internal Medicine and Hospital Medicine will be held on August 19-20, 2019 at Paris, France The theme of the conference is ”Crossings Frontiers In The Field of Internal Medicine”. Interesting and interactive scientific sessions have been designed accordingly for this conference which includes the diagnosis, care and management of different acute and chronic medical conditions, comprises of various medical specialties such as cardiac health issues, brain

ISER- 646th International Conference on Science, Health and Medicine (ICSHM) is a prestigious event organized with a motivation to provide an excellent international platform for the academicians, researchers, engineers, industrial participants and budding students around the world to share their research findings with the global experts.

A Complete Magazine on Healthcare in Asia

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MEDICAL TOURISM HOSPITALS

ADK HOSPITAL

RAK HOSPITAL Sosun Magu Male', 20040 Maldives Phone: (+960) 331 3553 Email: info@adkhospital.com

www.adkhospital.mv

Al Qusaidat Ras Al Kaimah UAE Phone: +971 72074444 Email: mail@rakhospital.com www.rakhospital.com

HOSPITALS IN INDIA

MVR CANCER CENTRE &AMP RESEARCH INSTITUTE

CIMAR COCHIN

Calicut, India Email: info@mvrccri.co

Ernakulam, Kerala India Phone : +91 484 4134444 Email : cimarcochin@gmail. com

www.mvrcancerhospital.com

cimarindia.org

BABY MEMORIAL HOSPITAL

NARAYANA HEALTHCARE Bangalore , Karnataka Ph: +91 99860 13353 Email: international@narayanahealth.org

Kozhikode, Kerala Phone: +91 - 495 – 2723272 Email: info@babymhospital.org

www.babymhospital.org

www.nhinternational.org

SRI RAMACHANDRA MEDICAL COLLEGE

ASTER MEDCITY Kochi Phone: +91 484 66-99999 Email: astermedcity@asterhospital.com www.astermedcity.com

www.sriramachandra.edu.in/medical/

RAJAGIRI HOSPITAL

MANIPAL HOSPITALS Bangalore Ph: +91 80 2222 1111 Email: info@manipalhospitals.com

www.manipalhospitals.com 50 Medical Tourism April - June 2019

Chennai India Ph: +91 984 096 9698 Email: ipcs@sriramachandra.edu.in

Cochin, India Ph: +91 484 290 5037 Email: international@rajagirihospital.com

http://www.rajagirihospital.com/

MEDICAL TOURISM HOSPITALS

ARMC IVF FERTILITY CENTRE

BELIEVERS CHURCH MEDICAL COLLEGE HOSPITAL Thiruvalla India Ph: +91 469 2703100 Email: info@bcmch.org

BMT Annex, Puthiyara, Kozhikode Kerala, India .

Phone:+91 495 272 7376 Email: bdm@armcivf.com www.bcmch.org

www.armcivf.com

CHENNAI FERTILITY CENTER

CONTINENTAL HOSPITALS

Aminjikarai, Chennai India Phone : +91- 44 – 6458 2299 Email: cfcivf@gmail.com

Hyderabad Ph: +91 40 67000000

www.chennaifertilitycenter.com

www.continentalhospitals.com

APOLLO HOSPITALS CHENNAI

SIR H.N. RELIANCE FOUNDATION HOSPITAL AND RESEARCH CENTRE

Chennai, India Ph: +91 40 4344 1066 Email: internationalcare@ apollohospitals.com

www.apollohospitals.com

Mumbai Ph: +91 22 6130 5005 Email: rfh.international@rfhospital.org

www.rfhospital.org

KIMS HOSPITAL

ASTER MIMS Kozhikode, India Ph: +918157880111 Email: mvt@asterhospital.com,

Thiruvananthapuram, India Ph: +91 471 294 1888 Email: ipr.tvm@kimsglobal.com

anvarhusain@asterhospital.com

astermims.com

https://trivandrum.kimsglobal.com/

MEITRA CALICUT

SHARP SIGHT Delhi, India Ph: +91 11 401 28881 Email: info@sharpsight.in, ceo@sharpsight.in

www.sharpsight.in

Kozhikode, India Ph: +91 495 7123456 Email: info@meitra.com

www.meitra.com

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MEDICAL TOURISM WELLNESS CENTERS

NIMBA NATURE CURE

KAIRALI AYURVEDIC GROUP

Ahmedabad Gujarat India Phone: +91 276 228 3313

New Delhi Phone: +91 11 65028307 Email: info@kairali.com

www.nimba.in

www.kairali.com

SHATHAYU AYURVEDA YOGA RETREAT

KALARI KOVILAKAM

Bangalore Phone: +91 8884133300 Email: info@shathayuretreat. com

Kollangode, Palakkad, Kerala Phone: +91 4923 305500 Email: admissions@cghearthayurveda.com

www.shathayuretreat.com

www.cghearthayurveda.com/kalari-kovilakom

SWASWARA

DHATHRI AYURVEDA HOSPITAL Om Beach, Gokarna Phone: +91 484 4261751 Email: greswaswara@cghearth.co.in

Kayamkulam, Kerala Phone: +91 90200 28888 Email: hospitals@dhathri.in

www.cghearth.com/swaswara

www.dhathriayurveda.com

SREEDHAREEYAM AYURVEDIC EYE HOSPITAL AND RESEARCH CENTRE

PUNARNAVA AYURVEDA HOSPITAL PVT LTD

Koothattukulam, Kerala Phone: + 91 485 2253007 Email: mail@sreedhareeyam.com

Kochi, Kerala Phone: +91 484 2801415 Email: mail@punarnava.net

www.sreedhareeyam.com

www.punarnava.net

AYURGREEN HOSPITALS

SOMATHEERAM RESEARCH INSTITUTE AND AYURVEDA HOSPITAL

Malappuram, Kerala Phone: +91 494 305 5555 Email: info@ayurgreenhospitals.com

www.ayurgreeenhospitals.com 52 Medical Tourism April - June 2019

Kovalam, Thiruvananthapuram Phone: +91 471 2268101 Email: mail@somatheeram.in

somatheeram.in

MEDICAL TOURISM WELLNESS CENTERS

AYUR BETHANIYA

AYURVAIDYA Athani, Thrissur, Kerala Phone: +91 703 40 99 999 Email: info@ayurbethaniya.org

Edappally North Kochi, Kerala Phone: +91 4842802383 Email: mail@ayurvaidyahospital. com

www.ayurbethaniya.org

www.ayurvaidyahospital.com

SHINSHIVA AYURVEDIC RESORT

NIKKI’S NEST

Balaramapuram, Thiruvananthapuram Phone: +91- 471-2266331, Email: ayurveda@shinshivaresort.com

Chowara, Thiruvananthapuram, Kerala Phone: 91-471-2267822 Email: info@nikkisnest.in

www.shinshivaresort.com

www.nikkisnest.com

FRAGRANT NATURE

PRAKRITI SHAKTI Paravur, Kollam, Kerala Phone: +91(0) 474 251 4000 Email: enquiries@fragrantnature.com

www.fragrantnature.com

Panchalimedu, Idukki, Kerala Phone: +91 90726 10130 Email: admissions@prakritishakti.com

www.prakritishakti.com

Our next Issue is the

Official Magazine for

To associate with the biggest Medical event in the Sultanate of Oman please contact us: Sunil Nair: +91 989 537 4449 Tijo Jhony: +91 974 544 8285

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53

MEDICAL TOURISM EQUIPMENT WORLD

ALUMINIUM FINGER SPLINT

Aluminum Finger Splints are useful in terms of treating fractures and protecting against further injury. They are made of an aluminum alloy and purified special-density foam rubber strips for improved comfort metal edges have been butfed smooth.

Lined and padded with foam.

AMBU® HEAD WEDGE

The unique Ambu Head Wedge is designed to immobilize a patient’s head instantly and effectively when placed on a backboard. It is applied easily and quickly in just four simple steps.

FREEEMG 1000

FREEEMG 1000 is a surface electromyography device with wireless probes for the dynamic analysis of muscle activity. The wireless miniaturized probes even the weakest signals and accurately captured. Each probe is equipped with internal memory to ensure uninterrupted recording in case of temporary connection loss and to allow for acquisitions in wide spaces and open fields. The software analyzes the collected information and generates graphical results allowing for immediate comparison to normal classes. A large variety of predefined analysis protocols allow for assessment of muscle activity during specific exercises.

https://www.china-firstar.com/product/222-en.html

Website: https://www.ambu.com/products/ emergency-care-and-training/head-immobilizers/ product/ambu-head-wegde

THE PEDICLE SCREW SYSTEM

RIGID SPINE PLUS

AVALO EMERGENCY CART - RED

Manufactured to the highest international standards, together with 100% tested and approved high quality raw material.

The Traumec Rigid Spine Plus system offers a safe solution for surgical procedures, by means of high quality technology applied to implants and precision instruments.

It has screws designed with conical threads, providing high mechanical strength, Polyaxial Screws with 25º inclination, Counter-screws with square profile thread and hexalobe fitting, Cross Link Hook, length from 30 to 80mm and High quality Instruments with anatomical and rubber coated handles.

The Avalo Emergency Cart / Crash Cart defines a new standard of organization and function with a new list of previously unavailable features in a hospital or healthcare critical care environment.

The unique breakaway locking handle offers the security you require and the simple access essential to every emergency response. Stable maneuverability is built-in to every crash cart and a full line of accessories enhance user efficiency to support code team performance.

Website:

The GPC spineHEAL System is a posterior non-cervical pedicle screw system intended to provide precise & segmental stabilization of the spine in skeletally mature patients.

Website: https://www.indianorthopaedic.com/ spineHEAL/spineheal-the-pedicle-screw-system. htm

NEWSTER STERILBOX

Newster Sterilbox is a machine used to wash and sanitize hospital waste containers made in special plastic materials. This industrial front-loading bin washer is fitted with four 22 W ultraviolet lamps in the washing chamber. It has a 55x61 cm stainless steel tub, with a door aperture of 65 cm. The ultraviolet lamps have a microbiocidal action and sterilize the surfaces, liquids and air inside the washing chamber.

Website: http://www.newstergroup.com/ newster_sterilbox

Website: https://www.btsbioengineering.com/ products/freeemg-surface-emg-semg/

Website https://www.capsahealthcare.com/product/avalo-emergency-cart-red/

Website: http://traumec.com.br/en/produtos/10/ Rigid-Spine-Plus

HIGH PRESSURE CYLINDER FILLING SYSTEMS

ASTRALTM 150

NOVAIR Medical offers a full range of high pressure cylinder filling systems allowing to fill daily 10 to 100 medical oxygen cylinders at a pressure of 150 to 200 bar.

Designed to be connected to a NOVAIR oxygen generator, the systems provide full autonomy to healthcare facilities : they can easily manage peak consumption flows and fill their own cylinders.

Benefits include 100% oil free high pressure booster, designed to fill back up cylinders on site, Long service life, Heavy duty design for continuous operation (24h/7) and CPU controller smart monitoring system for HP45 to HP360

All the features of Astral 100 are included in the Astral 150, but the 150 is a step ahead with its additional offerings. From integrated FiO2 capabilities, to the option of double limb circuit and two additional therapy programs, the award-winning Astral offers greater freedom, confident care and designed efficiency to enrich life for you and your patients.

It also offers the same treatment options, for both adult and pediatric patients, as the Astral 100, and is compatible with a variety of interfaces to deliver excellence in invasive and noninvasive life support ventilation, as well.

Website: https://www.resmed.com/us/en/healthcare-professional/products/devices/astral-150.html

Website: https://www.novairmedical.com/en/production-equipment/high-pressure-cylinder-filling

Esteemed manufacturers of medical equipment /devices may forward details of new products for free featuring in Medical Tourism Magazine.

The details can be forwarded to: director@asianmeditour.com For more information call: + 91 98461 21715 54 Medical Tourism April - June 2019