With undaunted focus on quality healthcare, Pushpawati Singhania Research Institute (PSRI) for Liver, Renal and Digestive Diseases believes the  ambiance of the hospital also crucial in healing human body and mind. To explore the mission, vision, achievements of the hospital, eHealth team speaks to the Endoscopic Ultrasonography (EUS) department specialists, PSRI hospital and digs out the following excerpts on different subjects. By Sharmila Das, ENN

Dr (Col ) Arun Kumar
VSM, MD (MED), DM (Gastro), AIIMS, Senior Consultant, Gastroenterology, Liver Diseases & Endoscopy

Tell us about your journey at PSRI. What changes you have noticed during the long stint you have here. What are your views on the current state of Indian healthcare?

There are tremendous changes I have seen in the last 15 years. The healthcare sector has progressed quite a lot. fifteen years back there were no hospitals offering  pecialised services. The advantages of having one to two specilased services are that there is no crowd and secondly you can give more time and attention to patients. Disadvantages are also there! If you stay at one place then patient who are admitted in the hospital may come for a consultation at anytime, may be at some odd hours. At PSRI, the first thing I like most is that management never pushes you for any unethical work and thats a very big thing. Secondly they treat you gently which is also very rare to experience.

Indian healthcare is in shambles; because healthcare is not a priority of the Government. They dont bother that public health is an important part. If we talk about Government hospitals, they are so poor that most patients will go and die if we know that what type of treatment is given there. The Government has not done anything; they dont have strategy for the same. They dont understand 95 percent of health problems are common problems like cough, cold, pneumonia etc.

Dont you think health insurance can solve this situation if Government intervenes?

Government insurance scheme in Andhra Pradesh is a good example to quote here. YSR Reddy did very good job by providing facilities for heart, kidney transplant, heart surgery for the below poverty people. It worked very well there, but again corruption comes here. Government needs to pay attention to the health sector, must identify what the sector needs. We need to treat common problems first, try to get proper emergency treatments; we need to give value to life.

Do you think telemedicine can help treat these issues?

To treat a patient with telemedicine is very difficult, because some doctor has to see the patient. If patients are coming to you, you should welcome them. You should make sure that there is no unethical practice. Dont treat them just as revenue earner; give them good care so that more patients come. See the huge number of patients coming from Afganistan, Nepal and from many more countries.

Dr Manoj Kumar
MD, BHU, DM (Gastro), SGPGI, Lucknow, Currently Senior Consultant at Pushpawati Singhania Research Institute (PSRI)

Brief us about Endoscopic Ultrasonography (EUS) being introduced at PSRI Hospital.

Endoscopy Ultrasound is a very new technique and very few cities and hospitals have it. Like in Delhi, there are only 4 to 5 centers which have introduced this machine. Reason being, the machine is very costly, it costs around `1 crore. To run this machine you need a skilled person. In Delhi, gastroenterologists are may be around 150 to 200 in numbers, but only 5 to 6 are capable of performing this test. Even EUS is not available if you go to other states like Haryana, Bihar and Punjab. For investigating organs which are placed deep inside the body and where the ultrasound probe cant reach well, EUS performs better. With EUS, the investigation is more accurate and easier.

How Indian healthcare is aware of using EUS?

In India awareness level is very low. The need of performing a diagnostic test is not decided by a patient but by the treating doctors. The doctor will understand the need of this kind of therapy and they will refer to patient.

What is your suggestion to increase awareness about EUS?

Writing and publishing it in different media platforms. Let the public, the doctors and let the community read about it.

Dr Suddep Khanna
MD (Med), DM (Gastro), AIIMS, Senior Consultant Gastroenterologist, Specialist in Endoscopy, Liver, Pancreas, Intestinal Diseases & Obesity

Tell us about your journey at PSRI. What are the changes you have seen that technology implementation has brought in the different verticals of PSI?

I would say when I joined PSRI, it was the first phase of the hospital. There were around 60 to 70 beds at that point of time, now there are 120 beds. Third phase of the hospital is now and we are planning to introduce 100 plus beds and probably liver transplant, cardiology and other things would come up. We have primarily two  specialties, one is gastroenterology and another is kidney related treatments. If I talk about gastroenterology, we had huge scope when I came. Gradually, within 2-3 years, we introduced new software, new kind of endoscopy. When I joined, there was hardly an ICU, now we have 14 bedded state-of-the-art ICUs. These ICUs are competitors to any best ICUs in the world so these are the developments. Overall, PSRI is a progressive hospital. As far as gastroenterologist concerned, we were after to get the EUS at PSRI Hospital and last September we finally got it. The scope of EUS is though very huge but the utility has not been so much. However, we are trying to change this. The reasons are lack of awareness and cost of the machine.

What are the benefits of undergoing EUS test?

There may be very small stone that can be missed out by routine ultrasound. ICT never picks up this stone; even MRI can miss almost 10 to 15 percent of stones. With EUS, you cannot miss a Single stone. Lot of unnecessary surgery/ Scans can be avoided

Who provides training to do a EUS procedure?

It depends. Either you can go abroad  for the training sponsored by the manufacturer company from whom youbuy the machine. Because of the high  cost of the machine, these training are conducted by them. However, going abroad for EUS training is not a good idea. Indeed Mumbai serves the hub ofendoscopic ultrasound and Mumbai
was the first place to start giving EUS training in India. I preferred taking necessary training on EUS from Mumbai instead of going abroad.

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