Robot surgeries for head, neck and cancer in India: US surgeon

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New Delhi: A leading US robotic surgeon said, “with expertise in traditional head and neck surgical procedures, the country is ready for robot-assisted surgeries to treat head and neck patients in days to come.

Dr Chris Holsinger, 48, who leads Stanford Cancer Centre’s Head and Neck Oncology practice, has been interacting closely with leading Indian head and neck oncologists since 2008.

“I would love to work with more hospitals in India and do collaborative work for providing succour to head and neck cancer patients,” Holsinger told IANS in an e-mail interview.

According to the Indian Council of Medical Research (ICMR), over 200,000 head and neck cancers are reported in the country each year. Of these, nearly three-fourths relate to cancer of the oral cavity, throat and voice box.

“The Stanford Medical Center is working with leading oncologists with Indian healthcare providers like (Delhi’s) Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC) and (Mumbai’s) Tata Memorial Cancer Hospital for a study of Human Papilloma Virus (HPV) negative patients. About 80 percent of Indian cancer patients test negative for HPV,” Holsinger said.

HPV negative is a more aggressive head and neck cancer and may be hard to treat with standard approaches of radiation therapy and concurrent chemotherapy.

“But in the US, the incidence of this disease is too rare. I believe this consortium of Indian robotic head and neck surgeons that gathered in Delhi can pave the way to launch this study and (we hope) to improve outcomes for patients with this disease,” Holsinger stressed.

When it comes to radiotherapy vs robotic surgery, he sees both treatment choices as complementary rather than competitive.

“In the US, we see better results for patients when a multi-disciplinary approach is used. In other words, both the surgeon and the radiation oncologists must be strong but flexible advocates for their patients,” he elaborated.

Consumption of tobacco in various forms – smoking, chewing of paan (betel leaf) and gutka – is a major contributor to head and neck cancer, especially oral cancer.

“Using tobacco and also consuming alcohol only further increase that risk. There are many genes now known to be associated with head and neck cancers, but only rare inherited syndromes are associated with the disease,” said Holsinger, who was in New Delhi last week to attend a workshop.

“I was able to observe Dr Surender Dabas (of RGCIRC) perform two surgical procedures for removal of two head and neck cancers. Afterwards, the team at RGCIRC organised a lively workshop with over 125 attendees,” Holsinger said.

“This kind of collaboration allows the multidisciplinary team to provide a more personalized treatment depending on the stage of cancer and the affected head and neck organs as well as the patient’s preferences and his or her speech and swallowing function at the time of diagnosis.”

Use of computer-assisted surgery (via a surgical robot) to remove cancerous tissues or tumours in the head and neck areas helps the surgeon see the affected areas far more clearly – which is not possible in open surgery.

“A surgical robot helps in accessing the head and neck area through the oral cavity (mouth) thus reducing trauma, pain and blood loss. Best of all, minimally invasive surgical procedures do not leave any scars on the face or neck and recovery is much quicker,” the surgeon said.

Dr Dabas had spent nearly two months with Dr Holsinger at Houston’s MD Anderson Cancer Center some years ago.

Dr Dabas told IANS: “Head and neck cancers represent the fifth most common type and cause of cancer-related deaths worldwide. In India, head and neck cancers account for nearly one-third of all cancer tumours. Poor oral hygiene escalates the chances of contracting oral cancer manifold.”

Any visible lesions, ulcers, difficulty in swallowing food, change in voice and pain in the ear present themselves as early signs of cancer.

Oral and pharyngeal carcinoma represent a significant public health problem worldwide, with more than 400,000 new cases per year.

India and the US, as also western Europe, have the highest incidences of oropharyngeal cancer worldwide, ranging from seven-17 cases per 100,000 people.

“In the US, we are seeing an epidemic of these cancers, especially in the oropharynx, due to an association with the HPV, which may be rising in India as well,” Dr Holsinger stated.(IANS) 

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Here’s Why China is Predictable and Not Inscrutable

India could’ve easily predicted the Chinese coming on 5 August 2019

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The Chinese actions are far away from being Inscrutable. Pixabay

As the tensions rise between India and China along the borders in Ladakh, Shekhar Gupta in his article for The Print invokes an American political satirist P.J. O’Rourke.

Talking about his works Shekhar points out that in his ‘A Brief History of Man’, P.J. O’Rourke writes a small sentence “Meanwhile, in China, there were the Chinese.”. This sentence is relevant to us today.

Shekhar Gupta believes that the sentence conveys us a sense of resignation about the “inscrutable” Chinese. This thought happens to be familiar thought in the West.

“But we don’t live in the West. We’ve lived next door to China for as long as first civilisations grew.”, writes Shekhar Gupta

Let’s look at the history of Indian interactions with China since independance. What is inscrutable about it? Talking about the military assault across two fronts in 1962, it may have been a surprise to our leaders back then, but that is only because they were delusional.

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Chinese actions in respect to India are predictable now. Pixabay

From Chinese ultimatum to India to “return their stolen yaks and sheep” in 1965, to their appearance along the Ladakh frontier this year, China happens to be completely predictable and far from inscrutable. Especially keeping in mind Chinese actions in respect to India.

The push at Nathu La (Sikkim) in 1967 was probably to check out the resolve from India. Which they saw at its weakest — having fought two recent wars (1962 and 1965), famines, ship-to-mouth existence, political instability and a diminished Indira Gandhi. . The Indian response was a lesson they quickly learnt. What did the Chinese do after that? They have kept the peace for 53 years. Will you call that response evidence of Chinese inscrutability? They probed us, got a rude push-back, and decided to wait and stir the pot in different ways, at different times, says Shekhar Gupta in his artcile for The Print.

The Chinese kept the hold of what they wanted in 1962. According to Shekhar the truth is, they had it in their possession almost fully, barring small, tactically important slivers in Ladakh. They asserted their ownership and let their larger claim, Arunachal Pradesh, fully in Indian control, go militarily uncontested.

The Chinese never gave up claim on it. In 1986-87, they again checked us out at Wangdung-Sumdorong Chu (Arunachal), when they saw Rajiv Gandhi take India’s defence budget to a 4 per cent-plus of GDP. And once more, the response was firm and the Chinese backed off. The lesson we learnt according to Shekhar Gupta is that the Chinese won’t open fire randomly for the sake of it, Or when they are absolutely sure of an easy victory so they could be seen like ‘teaching an upstart a lesson’ as they did in 1962. Predictable.

Each and every action and response of China fits a pattern- Deliver a message, add leverage, and return, according to Shekhar Gupta.

India, China and Pakistan shared this unusual ‘triangulation’ in which China was using Pakistan to keep India preoccupied, said Former Indian Prime Minister Dr. Manmohan Singh during his tenure.

His idea was to break this ‘triangulation’ by seeking peace with Pakistan. He thought, that a country as big and powerful as China, would see less of an incentive for peace with India than Pakistan.

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Former Indian Prime Minister Dr. Manmohan Singh’s idea was to break this ‘triangulation’ by seeking peace with Pakistan. Wikimedia Commons

Also Read: Odisha Govt to Hold Rath Yatra Without Devotees this Year

Shekhar Gupta believes that today, that option is not so available, as hostility with Pakistan is central to the Modi-BJP politics. They’d rather make peace with China than Pakistan. That is why the lavish welcomes and frequent meetings with the Chinese leaders. The objective, still, is escaping that triangle.

Another instance of Vajpayee explaining the Chinese negotiating style. “Dekhiye, aap aur hum baithe hain aur vaarta kar rahe hain (see, you and I are sitting and negotiating),” he said. If two people require something and the first person asks to let go of something, the other will say no. Then the first person again asks for something little less, then again the other person might say no. But ultimately the second person will relent and let go of some. The Chinese would never do that.

Both these leaders underlined that the Chinese are consistent, and predictable. And that is why we should not be shoched or surprised by what they have unveiled across Ladakh. We should have anticipated it on 5 August last year when we made the big changes in Jammu & Kashmir. This Chinese move, like all others in 60 years, was fully predictable. Even the timing, says Shekhar Gupta in his article for The Print.

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COVID-19: Samsung Exclusive Stores get ‘Suraksha’ Certified

The initiative is aimed at the security and safety of customers and employees

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Samsung exclusive stores get 'Suraksha' certified in India. Pixabay

Samsung on Friday said all of its exclusive stores have been ‘Suraksha’ certified to ensure consumer safety at a time when social distancing is the new normal.

Suraksha Store is a public private initiative to ensure safe and secure environment for consumers and store employees.

The certification will ensure that consumers feel safe and confident when they visit stores to buy smartphones and other devices.

“The initiative will ensure that consumers and employees working at these Exclusive Stores feel confident about their well-being and safety,” Mohandeep Singh, Senior Vice President, Mobile Business, Samsung India said in a statement.

According to the company, to strictly adhere to government’s social distancing guidelines, the exclusive stores are encouraging consumers to maintain a minimum distance of 1.5 metre between themselves.

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A distance of 1.5 meters is to be maintained according to social distancing guidelines. (Representational Image). Pixabay

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Meanwhile, customers are encouraged to use digital contactless payments and swiping machines will be sanitized before being given to the customer to ensure the highest standard of hygiene is maintained across our Exclusive Stores.

Only a limited number of customers will be allowed within the store at any given point to avoid crowd formation, said Samsung India. (IANS)

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Smoking: Its Ill effects On Fertility and Child Birth

Smoking and tobacco use can have a serious impact on fertility and consequently the quality of life in pregnancy

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Smoking increases miscarriage rates in women. Pixabay

BY SIDDHI JAIN

Smoking and tobacco use can have a serious impact on the fertility of both men and women, and consequently the quality of life in pregnancy. These health tips by expert can help. If a woman is a regular smoker, then it has a double effect on a woman’s fertility. Smoking can harm both the eggs and the uterus. It not only affects her egg quality, but can also have endometrial effect. Many studies too have shown that smoking can have negative effects on fertility, notes Dr Apurva Satish Amarnath, Fertility Consultant, Nova IVF Fertility.

“In women, smoking decreases in vitro fertilization (IVF) and intrauterine insemination (IUI) pregnancy rates by about half. Smoking also increases miscarriage rates. smoking also reduces the egg reserve of the woman which is not a reversible condition. For instance, if we are to compare two women with the same characteristics in terms of egg quality, quantity, BMI, AMH-level, among others, the chances are that the non-smoking woman will conceive faster than the smoking woman. If a woman quits smoking completely, then the chances of conception improve and the risk of miscarriage reduces,” Dr Apurva told IANSlife ahead of the International Anti-Tobacco Day on May 31.

From the male’s perspective, the carcinogen quality of cigarettes in general affects the motility of the sperm and excessive smoking can lead to the poor sperm count and other fertility problems. As compared to females, the condition can be reversible.

If a man completely gives up smoking the quality of his sperms can improve, resulting in his fertility improving in a span of 3-6 months after quitting completely, she said.

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Smoking and tobacco use can have a serious impact on fertility. Pixabay

Smoking during pregnancy

According to Dr Sandeep Chadha, Consultant Obstetrician and Gynecologist at Motherhood Hospital, Noida, smoking during pregnancy are dangerous for both mother and the baby.

If a mother smokes, the 4,000 harmful chemicals present in each cigarette passes directly to the baby through the mother’s bloodstreams. In such cases, the risk of stillbirth and miscarriage goes up besides an increased risk of low birth weight, baby’s heart rate, breathing problem and premature delivery, Dr Sandeep told IANSlife.

These risks to the baby multiply with the number of cigarettes smoked during pregnancy. Not only for babies, but tobacco smoking is also harmful to the mother, increasing her risk of cancers, cardiovascular disease, emphysema, and other conditions.

Passive smoking and childbirth

A study has presented that exposure to secondhand smoke was associated with lower IQs in children. For babies exposed to secondhand smoke, there is an increase in risk for developing asthma attacks, breathing problems, ear infections, impaired lung development, and coughing.

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Smoking tobacco decreases in vitro fertilization (IVF) and intrauterine insemination (IUI) pregnancy rates. Pixabay

Children exposed to secondhand smoke require more ear tube surgeries than those who are not exposed. Sudden infant death syndrome is more common in babies born to women who smoked during pregnancy as well as in babies exposed to secondhand smoke. Exposure to second-hand smoking by pregnant mothers is similar to first hand smoking.

Also Read: Patients of 80% COVID-19 Cases in India Exhibit Nil or Mild Symptoms: Health Minister

If you are planning to conceive, it’s better for the couple to kick the butt as early as possible. (IANS)