Health marvel

Chennai is becoming the medical capital of India, with patients from different parts of India and abroad coming here for treatment.

One look at the swanky MIOT International Centre, which will be inaugurated soon on the vast premises of the Madras Institute of Orthopaedics and Traumatology (MIOT) Hospitals, and the array of top-end machines installed there for treating various diseases will convince anybody that Chennai is virtually the medical capital of India.

This is the love of my life, declared Mallika Mohandas, chairperson, MIOT Hospitals, as she pointed to the big, white TrueBeam STX machine used in the treatment of cancer. This is the first hospital in the Asia-Pacific region to import the machine, which costs $6 million. It has revolutionised radiation therapy. It is a true warrior that fights the battle against cancer. It is a top-end, third generation machine. It will provide radiation fast without damaging the surrounding cells. It will precisely and quickly kill the tumour. It is the latest in precision radiotherapy and radiosurgery, she said.

The MIOT International Centre already has an OCT (optical coherence tomography) guidance system, which allows cardiac specialists to view the inside of the arteries through a light source and facilitates more effective and long-lasting stenting. The OCT will show, with great clarity where the stent is going in the blood vessel and whether everything is 100 per cent all right, she said. MIOT is the first hospital in Tamil Nadu and the third in India to acquire this invaluable guidance system. Discovery 750 high-definition CT angio scan, another machine useful in the treatment of heart problems, will seamlessly image the entire heart, making it easy for the cardiologist to find out whether there is a block or fat collection in the patients heart.

The Heart Revive Centre was inaugurated at MIOT on May 18. Built at a cost of Rs.30 crore, it has a full-fledged Cathlab and an Electro Physiology Laboratory for the treatment of arrhythmia, or irregular heart beat.

Cut to Sankara Nethralaya, Dr Agarwals Eye Hospital, Apollo Hospitals, Rajiv Gandhi Government General Hospital, Sri Ramachandra Medical College and Research Institute, Rajan Eye Care Hospital Private Limited, Global Hospitals, Madras Medical Mission, M.V. Centre for Diabetes, all in Chennai. You will see hundreds of patients from different parts of India and from countries in the Gulf and Africa waiting to receive treatment for various ailments. Dr Agarwals Eye Hospital has been listed as a Major Eye Centre by the International Congress of Ophthalmology.

Tiruchi, a Tamil Nadu town, has pioneered the concept of setting up a chain of eye care and dental care hospitals across the country. The Vasan Healthcare Group, said its founder Dr A.M. Arun, was one of the fastest-growing health care groups in India. The group has opened 120 hospitals in 12 States and 30 dental care hospitals. It has diagnostic centres and laboratories, and two multi-speciality hospitals in Tiruchi. Vasan Eye Care Hospitals are day-care centres where patients receive treatment for a variety of eye ailments, including cataract, glaucoma, impairment of retina, squint, neuro-opthalmologic disorders, or they undergo refractive surgery. We will make Vasan Healthcare Group the McDonalds of health care. We are going to establish many day care centres in urology, skin care and diabetes. We will be starting eye care centres in Colombo and Dubai in July, said Dr Arun.

Making medical equipment

G.S.K. Velu is a dapper young man, radiating confidence. He is the managing director of Trivitron Healthcare, headquartered in Chennai. He obtained his B.Pharm (honours) with specialisation in biomedical engineering from the Birla Institute of Technology and Science, Pilani, and a PhD in pharmacology from the Indian Board of Alternative Medicines, Kolkata. Trivitron, which began as a small distribution company, has today grown to become a Rs.500-crore enterprise. It is the largest medical technology company of Indian origin. We have multiple products. Our focus areas are cardiology, imaging and diagnostics, he said. Its focus is also on Critical Life Support Solutions (CLSS) and ophthalmology. Trivitron distributes medical technology products such as CT scanners, MRI scanners and digital X-ray machines of the Hitachi Medical Systems, and digital mammography and bone densitometers from Hologic and manufactures ultrasound machines, ECG machines, colour dopplers, operating theatre equipment, X-ray machines and accessories, radiation apparel, and so on at its technology parks located in Sriperumbudur, and Poonamallee (both near Chennai), Pune and Mumbai. Initially, we started as a 100 per cent distribution company. In the past few years, we have taken a lot of initiatives to manufacture medical equipment. One-third of our revenue comes from our manufacturing initiatives, Velu said.

Velu founded Trivitron in 1997 and co-founded Metropolis in 1999. Today, Metropolis has more than 100 laboratories across India, West Asia and Africa. He established Maxivision which, he says, has grown to become one of the top five eye care chains in India. A joint venture between Apollo Hospitals and Trivitron Healthcare has led to the establishment of White Dental Spa, a chain of dental care centres.

Although Trivitron is both distributor and manufacturer of medical technology products, it focusses more on manufacturing and innovation now, Velu said. Almost 90 per cent of the medical technology products, right from the simple glucometer, malaria kits, tuberculosis kits to high-end machines were imported by India. Velu said: My vision is to provide access and affordability in medical technology. We want to do that by mergers and acquisitions, and also through our initiatives and joint ventures. We, therefore, set up the medical technology park at Sriperumbudur.

The Poonamallee unit has a division for CLSS, where it manufactures products needed for intensive care units, operating rooms and modular operating theatres. Out of Trivitrons current turnover of Rs.500 crore a year, its own manufactured products account for Rs.150 crore to Rs.200 crore.

MIOTs promise

MIOT Hospitals began as an independent entity, specialising in orthopaedics, at Vijaya Hospital in 1988. It moved to Manapakkam, a suburb of Chennai, in 1999. Its founder and managing director, Dr P.V.A. Mohandas, is also chief surgeon in the Department of Orthopaedic Surgery. Dr Prithvi Mohandas, son of Mallika and Mohandas, is an expert in revision hip surgery. In the 13 years since it relocated to its spacious 14-acre campus at Manapakkam, MIOT has witnessed a spectacular growth. It has metamorphosed from a centre for orthopaedics into a multi-speciality hospital dealing with thoracic and cardiovascular care, cardiology, nephrology, neurosurgery, oncology and radiation oncology, hip replacement surgery, knee replacement, accident surgery, plastic surgery, craniofacial and cosmetic surgery, paediatrics, obstetrics, and so on.

Mallika Mohandas spoke about the promise made by the Heart Revive Centre. The promise is that within 90 minutes, the person who has suffered a heart attack will be received by the cardiac specialists at the centre. He/she will be examined and investigated, an angiogram will be done and an angioplasty performed if necessary We will give result-oriented treatment to the patient, she said. If the person has arrhythmia, he will be taken to the Electro Physiology Laboratory. A two or three-dimensional mapping of his heart will be done and he will receive radio-frequency ablation. If he has symptoms of a heart attack, the heart attack will be arrested. The cornerstone of the Heart Revive Centre is the new generation Cathlab, where the best possible angiogram and angioplasty will be done. The Cathlabs proud possession is the OCT guidance system, which is superior to the conventional angiogram.

The MIOT International Centre will house the Departments of Oncology, Radiation Oncology, Medical Oncology and Surgical Oncology, which are already functional. While the Liver Transplant Centre will be inaugurated in August, the Bone Marrow Transplant Centre will become functional in September. There are plans to open a Heart Transplant Centre in the future.

The centrepiece of the MIOT Institute of Cancer Cure is the TrueBeam STX machine, which gives a fast and precise dose of radiation to cancerous cells so that the surrounding normal cells do not get damaged. This machine is outstanding in technology. It is a game-changer. The radiation beam will go accurately to the targeted area A patient can breathe comfortably while undergoing radiation, Mallika Mohandas said.

Dr Sollin Selvan, Chief Consultant Medical Physicist, said the TrueBeam could do gated radiation therapy in which there would be 100 per cent confirmation that the targeted area was being irradiated. The TrueBeam STX gives a radiation dose four times more than from a conventional machine. That is, if the patient has to lie down in a normal machine for four minutes, it is enough if he/she lies down in the TrueBeam STX for a minute. The machine will be beneficial for stereotactic body radiotherapy and for treatment of lung and liver cancers. TrueBeam STX is capable of delivering a high-precision dose with sub-millimetre accuracy, Dr Sollin Selvan said. The patient could be imaged during treatment to position the target area accurately.

Dr Rajni Gupta, Consultant Radiation Oncologist, said the TrueBeam STX delivered a high-energy X-ray beam of the order of million volts to the affected cells. In CT scan, it was kilo electronvolts (KeV). The TrueBeam STX was far superior to the cyber knife because it was more precise in delivering the radiation dose. It could precisely irradiate a tumour even if it was close to a critical structure, she said. The machine could detect 0.3 mm movement in moving organs affected by cancer and provide accurate treatment.

The Radiation Oncology Department has a brachytherapy machine to treat cervical and prostate cancers and a digital mammograph to detect cancer of the breast.

This molecular diagnostic laboratory is difficult to establish. You need efficient persons and a good infrastructure to run it, said Dr C.N. Srinivas, Head of the Department of Laboratory Services, as he showed us round the molecular diagnostic laboratory. Multiflex, an important device in the laboratory, helps a person who has received a transplant to know whether his/her cells and those of the donor match. In May 2013, the laboratory will get Flow Cytometry. This machine will help carry out immunophenotyping analysis to study whether a patient who has blood cancer or lymphoma will respond to treatment.

Vasan Eye Care

The ambience at the Vasan Eye Care hospital at Alwarpet in Chennai is inviting. There is a board which claims, We are not just Indias largest eye care hospital but also the worlds largest. In one of the rooms, Dr M. Santhoshi was performing a slit lamp examination, which is a routine check-up, on the eyes of a girl. Vasans Healthcare Group has a 65-year history.

Dr Aruns grandfather established Vasan Medical Centre, a drug store, in Tiruchi in 1947. Arun, who obtained his MBBS from Annamalai University, took over the shop in 1991, established a diagnostic centre and laboratory and later founded two multi-speciality hospitals in Tiruchi. Arun said: In 2001, I realised that ophthalmology had a great future and potential.

So he started his first eye care hospital in Tiruchi in 2002, and it has become a success. I believe in two things: trust and care. People trust you and you should take care of them, he said.

There is no competition in health care, he said when asked about other health care groups starting a chain of eye and dental care hospitals.