Niira Radia - Chairperson Nayati Healthcare and Research Pvt Ltd

Niira believed that effective treatment must eliminate this traumatic experience, and should not be restricted only to the big cities. Keeping this in mind, she started Nayati Healthcare in 2012, an establishment directed towards making tertiary healthcare accessible, affordable and accountable in Tier-II and III cities.

She talk about the challenges that exist in the healthcare sector and how Nayati has successfully set an example of an efficient and affordable healthcare provider.  

Treatment of head & neck Cancers

1. Radiotherapy-
a.Radical intent (organ preservation in cases of Ca- Larynx, Oropharynx.
b.Adjuvant intent- after surgery, depending on post op histopathology report.
c.Palliative- for symptom control like bleeding, pain in case of very advanced or metastatic cases.

2.Surgery-
       mainstay of treatment for oral cavity cancers. One must go for surgery, when it is indicated.

3. Chemotherapy-

a.Neoadjuvant- before any definitive treatment, for organ preservation plan.
b.Concurrent- along with radiation for enhancing the effect of radiotherapy.
c.Adjuvant- tried in the past, but no definite role.
d.Palliative- in very advanced/metastatic cases for symptom control.

What are the different types of cancer?

Cancers are often described by the organ they originated from. However, some body parts contain multiple types of tissue. So for greater precision, cancers are additionally classified by the type of cell that the tumour cells originated from. These types include:-

#Carcinoma:

1) This refers to malignant neoplasm that begins in the epithelium (skin) or in tissues that line internal organs.

2) Carcinomas are divided into two major subtypes.

3) Adenocarcinomas generally occur in mucus membrane of an organ or gland.

4) Squamous  cell carcinoma originates in the squamous epithelium.

5) examples are skin cancer, lung cancer, colon cancer, pancreatic cancer, ovarian cancers, Basal cell carcinomas, Melanoma.

  

#Sarcoma:

1) This refers to Cancer that originates in supportive and mesenchymal tissues such as bone, cartilage, fat, muscle, blood vessels, or other connective tissues. Examples: Osteosarcoma or osteogenic sarcoma (bone)

2) Chondrosarcoma (cartilage)

3) Leiomyosarcoma (smooth muscle)

4) Rhabdomyosarcoma (skeletal muscle)

5) Mesothelial sarcoma or mesothelioma (membranous lining of body cavities)

6) Fibrosarcoma (fibrous tissue)

7) Angiosarcoma or hemangioendothelioma (blood vessels)

8) Liposarcoma (adipose tissue)

9) Glioma or astrocytoma (neurogenic connective tissue found in the brain)

10) Myxosarcoma (primitive embryonic connective tissue)

11) Mixed mesodermal tumour (mixed connective tissue types

 #Leukaemia:

1) Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
2) The disease is often associated with the overproduction of immature white blood cells. These immature white blood cells do not perform as well as they should, therefore the patient is often prone to infection. Leukaemia also affects red blood cells and can cause poor blood clotting and fatigue due to anaemia. Examples of leukaemia include:
3) Myelogenous or granulocytic leukaemia (malignancy of the myeloid and granulocytic white blood cell series)
4) Lymphatic, lymphocytic, or lymphoblastic leukaemia (malignancy of the lymphoid and lymphocytic blood cell series)
Polycythemia vera (malignancy of various blood cell products, but with red cells predominating)

#Lymphoma and myeloma:

 

 

surgery for Hernia

Is it necessary to use the mesh in all the cases?

Yes. Now world over, there is consensus that the use of mesh is desirable in majority of patients to strengthen the wall whether surgery is done conventionally or endoscopically. Only the childhood hernias are repaired without using mesh.

Is endoscopic surgery safe?

Yes. Done by a properly trained surgeon in a well equipped centre, it is a safe surgery with excellent results.

What happens after admission for surgery?

Patients are admitted in the hospital on the day of surgery of a day prior to surgery. On admission, patients are examined and investigations reviewed by one of the team members. A member of the Anaesthesia Team conducts the pre-anaesthetic check-up. Pre-operative investigations before the surgery. Next morning, he/she will be shifted to the operation theatre half an hour prior to surgery. After surgery, they are shifted to the recovery room for 2-4 hours under the care and supervision of our Anaesthesia Team for observation and then shifted back to the room. It takes about 4-8 hours before the patient comes back to his/her room. Patient is given sips of water orally on returning to the room and progresses to drinking all liquids on the same evening as surgery. They may sit up, visit the toilet and move around for a few hours after surgery and are encouraged to do so early.

Patients are given a normal breakfast next morning and discharged from hospital after a visit by one of the team members. On discharge, a discharge summary with the advised medication is handed over to the patient.

Can the surgery be performed as a day care procedure?

Yes, day care surgery is being performed on young and fit patient. The patient is called to the operation theatre in the morning in a fasting state of more than 8 hours. After the operation, patient is observed for 4-6 hours post operatively in the day care facility before getting discharged. In case the need arises, there is a provision for overnight admission as well.

Post operative instructions and information

1. After the operation you will be kept in the recovery room. This period may vary from few minutes to few hours. The anaesthetist decides about your shifting to room. The decision depends on many technical factors.

2. You will be sleepy immediately after the operation due to sedation given during anaesthesia and during the recovery period.

3. You may have some discomfort when coming out of the effect of sedation. It gradually reduces to tolerable level within a few minutes without any pain killer. However, if necessary you may ask for pain killer injections/ tablets. You should try to avoid these drugs because they produce drowsiness and you may sleep for a longer period which is not desirable.

4. You may feel nauseated in the immediate post-operative period, and you may even vomit which should not cause any worry. This generally gets over after few hours.

5. You are generally allowed to have sips of water immediately after the operation and liquids on day of operation. In case of vomiting the liquid intake may be stopped and restarted after 30 minutes. The liquids may include water/cold drinks/tea/coffee / milk / juices or some clear soups.

6. You are allowed to have normal home cooked meals of your choice from the next morning at breakfast.

7. You should have small frequent meals for few days after operation following which you can resume your normal diet gradually. This is vital because you may feel bloated and distended if the quantity of food is in large quantities at a time.

No Tobacco day Cancer Educative Questions and answers

1. Does Tobacco cause cancer? I don’t believe. Is there any proof for that?
Ans: Yes, both smoked and chewable forms of tobacco consumption are associated with cancer. Internet is flooded with articles proving the association of tobacco and cancer. You can go through that. Or else, have some faith on your doctor, government and even on the tobacco industries, who indicate the statutory warning on the wrapper “tobacco kills”.

2. What are the common malignancies associated with tobacco consumption?
Ans: Cancers of head & neck area, lung and gastrointestinal tract are commonly associated with tobacco consumption.

3. I am an occasional smoker. Am I at risk of cancer?
Ans: Yes. Definitely you are.

4. I am having constipation; tobacco helps me a lot to relieve that every morning. It also helps me to overcome indigestion. Would it be wise to quit?Ans: Tobacco is not an approved drug for constipation or indigestion; rather it is a slow killer, killing you slowly with a painful death.

5. I do not smoke, but my father/ brother/ friends do that. Thank God, I am safe.
Ans: Who tells you that you are safe? You are smoking passively, if you are there with them during smoking.



6. I feel relaxed by taking tobacco. How can I quit that!
Ans: There are other methods of relaxations you can choose. Tobacco is not the only method, rather it is a risky business too.

7. Now I am afraid of cancer as I am a chronic tobacco user. What to do?
Ans: Quit tobacco use. Consult your physician first. Get yourself evaluated.

8. I am a chronic tobacco user. What are the symptoms to worry for.
Ans:
1> Whitish irremovable patch inside oral cavity- Leukoplakia.

2>Reddish irremovable patch inside oral cavity- Erythroplakia.

3> Repeated mucositis.

4> Reduced mouth opening- Submucous fibrosis.

5> Bleeding from oral cavity while brushing teeth.

6> Painless ulcers in oral cavity.

7> Swallowing difficulty.

 8> Hoarseness of voice.

9> Prolonged cough.

10> Blood in sputum.

11> Breathing difficulty.

12> Blood in vomitus.

13> Black stool or frank blood in stool etc

Read more about Tobacco disease visit at https://nayatihealthcare.com/about-nayati/nayati-hospital-agra/

Radiation Therapy for Cancer

Radiotherapy treats cancer by using radiation to destroy on injure cancer cells. The radiation can be targeted onto cancer sites in your body. Treatment is carefully planned to do as possible to your normal body tissue. Newer techniques of intercity modulated radiotherapy(IMRT) and image guided radiotherapy(IGRT) ensure maximum dose to the tumor safeguarding the normal uninvolved organs from adverse effects.

Gated Radiation Therapy for Lung Cancer:

This is a highly specialized form of radiation therapy where moving tumour such as lung tumour is targeted in a particular phase of breathing cycle. It improves accuracy and reduce side-effects associated with radiation therapy.
Treatment is painless and may take only two to three minutes usefully; radiotherapy is given as a number of treatments over a period of weeks. Radiotherapy may be used to cure some early stage lung cancers. It may be used with candidate for cancer surgery. Radiotherapy can be used to relieve pain and others symptoms, for example, pain caused by cancer that has spread to the bones of brain. Treatment that is used to relieve symptoms of disease with our attempting to cure disease is called palliative treatment.

Targeted Therapy (Biological Agents)

Some people, usefully non-smokers (who have never smoked) are suitable for a new kind of drug that targets the growth genes and/or the blood-vessel forming genes of the cancer cells. These drugs tend to have not as many side effects as the usual chemotherapy drugs, although they can cause rashes. Usually targeted therapy will be used after normal chemotherapy no longer controls the disease. Your doctor may order a special gene test to see if your cancer is susceptible to this type of drug.

Prognosis

As in most types of cancer, the results of treatment are best when the cancer is detected and treated early. People who have surgery in the early stages of lung cancer have a very good chance of cure. In many people, lung cancer is not found while it can still be operated upon. In people with advanced cancer, palliative treatment with radiotherapy can effectively treat many symptoms?
People who continue to smoke after lung cancer treatment are at risk of further disease. If you would like information about your own prognosis, you need to speak to a doctor who knows your medical history.

Motto of max Cancer Care

At max cancer, we are committed to recuperating our patients as soon as possible. Our dedicated team of leading oncologist provides the most advanced cancer treatments using cuttings edges technology, based on international standers. Cancer care requires medical professionals from different specialties to collectivity execute an individualized patient care plan for best results. We firmly believe in delivering quality care, support and re-assurance to our patients.
We believed that each patient and his/her disease is unique, hence our team of oncology experts customise a ‘Personalised treatment plan ‘based on the discussions in tumour board conference the participation of our patients as well caregivers to understand the disease and treatment process.
For know more about lung cancer treatment please visit at https://nayatihealthcare.com/ and consult with the surgeon.

DIABETES DIET INSTRUCTIONS

Good Health

Good health begins with good nutrition, and good nutrition starts with balanced diet.

Menu are planned using the food guide pyramid and the seven food groups are cereals, fruits, vegetables, milk and milk products, meat and pulses, fats and sweets.

These seven food groups provide different nutrients, which helps us grow, reproduce and lead a healthy life.

 

Ideal Distribution

•         Carbohydrates 50-60% of total calories prefer complex sources.
•         Sources for carbohydrates: Whole wheat bread, bran Mix Atta Brown Rice.
•         Protein: 15-20% of total calories.
•         Sources of Proteins: Pulses, Milk and milk products, Chicken, fish, egg white etc.
•         Fats and oils: less than 20-30% of total calories,( reduce intake of saturated   fats- ghee, coconut oil, butter etc)
•        Use Combination of (MUFA,PUFA,SFA)
•         Salt: 5 gm/day
•        Fibre: 25-40gms

General Instructions for Diabetics:

•         Adequate rest: well regulated exercise and good hygiene is must.
•         Meals should be taken regularly.
•         Specified amounts to be taken to regulate carbohydrate intake.
•         Mode of action of the insulin being taken should be known.
•         Patient should carry sweet for use in emergency when the blood glucose levels goes down.
•         Attainment and maintenance of an appropriate body weight is a must.
•         Have a small frequent meals 96-7 Meals per day) to prevent hypoglycemia.
•         Whenever taking insulin, proper meal needs to be taken within half an hour after taking insulin to prevent hypoglycemia.
•         No fasting to be done to prevent hypoglycemia.

Food to Avoid:

•         Whole milk & milk products.
•         Cakes, pastries, chocolate, jam, jellies, bournvita, horlicks.
•         Baked products.
•        Aerated drinks, alcoholic drinks
•         Organ meats like liver, kidney, brain, egg yolk.
•         Fried foods like poori, pakoda, paratha, samosa, patties, burger, and pizzas.
•       Pickle in oil.
•         Sauces/Squashes.
•         Colocasia, yam, potato, turnip.
•         Sago, makhana, dates.

Food allowed in Moderation

•         Toned, Double toned and skimmed milk and milk products.
•         Egg white, lean Meat, Chicken, Fish.
•         Tea, coffee not more than 2-3 cups per day. 
•         Honey, refined oil of corn or ground nut.

For more help consult at Best Hospital in Agra and read more about chairperson at https://nayatihealthcare.com/about-us/message-of-chairperson/