The COVID-19 pandemic was a turning point for many industries, and one that saw particularly dramatic growth was telemedicine. Before the pandemic, telemedicine was a niche service, often restricted to remote or rural areas. However, the global health crisis necessitated a shift toward contactless consultations, propelling telemedicine into the mainstream. In India, the transformation was particularly profound, driven by the urgency of COVID-19 and the pressing need for accessible healthcare in a country where medical resources are unevenly distributed.

The Indian Telemedicine Market: A Rapid Ascent

In India, the telemedicine market has expanded significantly. The sector is projected to grow at a compound annual growth rate (CAGR) of 31% from 2020 to 2025, reaching a market size of $5.5 billion by 2025. This growth is fueled by the increased demand for services like teleconsultation, telepathology, and telepharmacy, which have become indispensable in both urban and rural areas.

Telemedicine in India is more than just a convenience; it is a crucial tool for addressing the country's healthcare disparities. With a vast population spread across urban centers and rural hinterlands, India faces significant challenges in providing equitable access to healthcare. Telemedicine offers a solution by enabling patients in remote areas to consult with specialists from leading hospitals without the need to travel.

The Indian Space Research Organisation (ISRO) was an early pioneer in this field, facilitating telephonic medical consultations between rural and urban hospitals as early as 2001. However, it was the pandemic that truly brought telemedicine to the forefront, demonstrating its potential to bridge the gap between rural and urban healthcare.

Challenges and Opportunities in Post-Pandemic Telemedicine

While telemedicine saw a surge during the pandemic, its growth has plateaued in the post-pandemic world. Despite this, experts believe that telemedicine needs to evolve beyond its current model to sustain growth. The integration of remote monitoring tools and AI-driven diagnostics could be the key to enhancing the value of virtual consultations.

Moreover, as the sector matures, it is increasingly clear that a hybrid model combining physical and virtual consultations will likely dominate. Patients often prefer in-person consultations for initial visits or serious conditions, but telemedicine can effectively manage follow-ups and less critical health concerns. This hybrid approach not only maximizes convenience but also optimizes healthcare resources.

The Financial Impact and Future Prospects

The financial implications of telemedicine's growth are substantial. The Indian telehealth services market is expected to continue its upward trajectory, with significant investments flowing into the sector. The government's support has also been pivotal. Initiatives like the National Telemedicine Service, eSanjeevani, have facilitated over 12 million consultations since its launch, highlighting the government's commitment to leveraging technology for healthcare access. As India aims to achieve universal health coverage, telemedicine will undoubtedly play a critical role in this journey.

To sum it up

Telemedicine has undeniably catalyzed a transformation in the healthtech sector, particularly in India. From bridging healthcare access gaps to enabling efficient, scalable solutions during a global health crisis, telemedicine's impact is profound. However, as the sector moves forward, it must innovate and adapt to sustain its growth. A focus on hybrid models, advanced technologies, and integrated care solutions will be essential to ensuring that telemedicine continues to be a cornerstone of healthcare in India and beyond. The future of healthtech is digital, and telemedicine is leading the way.

Health conditions often have complex interconnections and can impact one another in ways that might not always be immediately evident. Understanding these relationships is crucial for effective management and prevention of more severe health issues. Being aware of how different conditions can influence each other helps in adopting proactive measures for overall well-being.

Polycystic ovary disease, commonly known as PCOD, is a hormonal disorder that is characterized by the presence of multiple small cysts in the ovaries, which leads to an overproduction of male hormones and a subsequent hormonal imbalance. This imbalance can cause a range of issues, including menstrual irregularities and challenges with conception. Women with PCOS (polycystic ovary syndrome), a related condition, often experience prolonged or irregular menstrual periods and elevated levels of androgen hormones.

Understanding Ovarian Cancer                     

Ovarian cancer encompasses a group of cancers that originate in the ovaries or nearby reproductive organs, such as the fallopian tubes or peritoneum. It includes various types and stages, each with different levels of severity. Risk factors include age, family history, and hormonal imbalances. Early detection and treatment are crucial for improving survival rates and outcomes.

Common Symptoms include

• 
  Irregular or absent periods

• Fluid-filled cysts in the ovaries

• Excessive hair growth (hirsutism), particularly on the face, chest, back, or buttocks

• Weight gain

• Oily skin or acne

• Difficulty conceiving

•  

Exploring the Link Between PCOS and Ovarian Cancer

Recent studies suggest the potential connection between untreated PCOS and the development of ovarian cancer. Women with PCOS often experience hormonal imbalances, inflammation, and insulin resistance, which may contribute to the risk of ovarian cancer.

For instance, elevated levels of oestrogen and androgens in women with PCOS can stimulate ovarian cell growth, potentially increasing the risk of cancerous changes. However, it's important to note that while there is some evidence suggesting an association between PCOS and ovarian cancer, more research is needed to establish a definitive link. Having PCOS does not automatically mean a woman will develop ovarian cancer.

Importance of Timely Diagnosis and Treatment

Early diagnosis and treatment are essential for managing both PCOS and ovarian cancer. For PCOS, treatment options often include lifestyle modifications, such as adopting a healthy diet and engaging in regular physical activity. Medications may also be prescribed to manage insulin resistance, regulate menstrual cycles, and address other symptoms. Hormonal therapy can be explored to manage symptoms, reduce the risk of endometrial cancer, and block the body’s natural hormones that fuel cancer growth.

For ovarian cancer, treatment typically involves surgery to remove cancerous tissue, chemotherapy to eliminate any remaining cancer cells, radiation therapy to to target specific areas where cancer has spread, and targeted therapies that attack specific cancer cell functions. Women with PCOS should work closely with their healthcare provider to develop a proactive approach to managing their condition and reducing their risk of ovarian cancer.

Conclusion

While the connection between PCOS and ovarian cancer is still under investigation, the possibility of an increased risk highlights the importance of regular medical check-ups and open communication with healthcare providers. By addressing PCOS symptoms early and effectively, women can better manage their condition and take steps to minimize their risk of ovarian cancer.

The growth of abnormal cells and their multiplication is cancer, when it happens in the airways and lungs; it is termed as lung cancer. Breakthroughs in research over the past decades have led to better survival rates in lung cancer, but it is not enough considering the magnitude of cancer cases diagnosed worldwide.

Lung Cancer Awareness Month is observed throughout November each year from 1^st to 30^th. Early detection of lung cancer can save lives. The insidious nature of lung cancer makes it one of the most formidable public health challenges of our times.

Lung cancer is the leading cause of cancer death worldwide. This is true for Indian males. In 2020 lung cancer was the most common cause of cancer mortality at 48,697 while among females the number was 15,062, ranking 7^th in terms of cancer-related mortality in Indian women.

The history of published data on lung cancer epidemiology in India reflects the impact of industrialization and smoking trends in the community. Smoking tobacco remains the single most important risk factor for lung cancer (80-90%), with a smaller proportion of exposure to various carcinogens.

Current estimates suggest that the number of cases is expected to rise sharply to 81,219 cases among males and 30,109 among females in 2025. So the rising incidence and delayed diagnosis in India is a matter of grave concern.

Historical Perspective of Lung Cancer

Lung cancer is not identified as a disease until 1700. It was an Italian Anatomist Morgagni G B who first described lung cancer. In 1761 Dr. John Hill of London proved the relationship between the use of tobacco and lung cancer. In 1965 the US Congress adopted the ‘Federal Cigarette Labelling and Advertising Act’ as a preventive measure against lung cancer. In India, Kerala was the first state to enforce ‘Smoking in Public’ as a punishable offense under section 278IPC in 1999.

Symptoms of Lung Cancer

·      New onset prolonged cough

·      Shortness of breath

·      Chest pain

·      Blood or blood-tinged sputum

·      Hoarseness of voice

·      Loss of weight and appetite

Lung cancer typically does not cause symptoms earlier in the course of the disease. Symptoms occur only when the disease is advanced. Early lung cancer does not alert patients, so a person can live with lung cancer for many years until signs and symptoms begin to show.

Currently, lung cancer is most often detected only at stage 3 or 4 by the time it is no longer curable. Over half of the patients present with distant metastasis at diagnosis.  This delay is often due to inadequate screening, resource constraints, lack of a structured referral system, and a high burden of Tuberculosis; due to which primary care physicians often miss the diagnosis.

Diagnosis of Lung Cancer    

While India has developed frameworks for screening different cancers, lung cancer is yet to be included. The recent ICMR call to set appropriate guidelines for screening lung cancer is encouraging. Early diagnosis is vital to improve lung cancer outcomes. Concerns regarding the cost of screening, logistical constraints, and concerns regarding high false positive rates owing to the TB burden make lung cancer screening programs impractical in India, although vital to improving lung cancer outcomes.

Lung cancer can be diagnosed by imaging methods like chest X-ray, CT scan, MRI, PET-CT, and using blood biomarkers. Research is going on in newer diagnostic techniques like breath analysis.

In recent times Low Dose Computed Tomography (LDCT) has emerged as a game changer. Compared to conventional CT, LDCT uses 5 times less radiation and has become the best early lung cancer detection screening method. Studies show LDCT can lower the mortality rate of lung cancer by 20% compared to screening by chest X-ray LDCT has higher sensitivity to detect potentially cancerous lesions in the lungs, years before the onset of symptoms

Treatment

Treatment of cancer varies depending on the staging, type of cells involved, and location of the cancer. Diagnostic modality aided with biopsy helps in accurate diagnosis and planning the best treatment modality. Early-stage cancer can be treated surgically and is associated with better survival rates. Advanced cancers are treated based on molecular tests from biopsy samples to detect gene mutations and to decide treatment by Radiation, Chemotherapy, Targeted drug therapy, or Immunotherapy. Newer non-invasive methods like CyberKnife are being used in some advanced centers for ablation of tumor cells.

Conclusion

Lung Cancer is a serious problem that demands a concerted effort from individuals, healthcare providers, and policymakers to raise awareness, implement smoking cessation, and ensure compliance with safety laws enacted to prevent occupational exposure to carcinogens. In addition, research for better diagnostic methods and treatment along with a National Lung Cancer screening program will be required to combat this silent epidemic.       

By:- Dr. Sofia Salim Malik, Senior Consultant Pulmonologist, Allergy, Immunology & Sleep Consultant, SUT Hospital Pattom

Organ donations in Karnataka have risen significantly, increasing from 18 in 2013 to more than 500 in 2022. However, there was a notable decline in donations after 2020. However, the demand remains high: 182 patients need heart transplants, 30 require heart and lung transplants, 60 are seeking kidney and liver transplants, and 5,702 people are waiting for kidneys and 1,959 for liver transplants. Misconceptions about organ donation exacerbate this crisis. It's essential to clear up these myths and understand the reality to make the best decisions and improve the chances of saving lives.

Myth: If I consent to donate my organs after death, the hospital team will make less effort to save my life.

Reality: The healthcare team is committed to providing the best possible care and prioritizes saving your life. Organ donation only becomes a consideration after every effort has been made to ensure your well-being.

Myth:  Being an organ donor means I can't donate my body to science.

Reality: You can still donate your body to science even after organ donation. Organ donation is prioritized due to its immediate life-saving potential. Suppose you are not eligible for organ donation, in that case, you may still be a valuable candidate for whole-body donation for medical research and education.

Myth: Wealthy and famous individuals are given priority on the organ donor waiting list.

Reality: The organ donation process is designed to be fair and equitable, regardless of an individual's fame or wealth. While high-profile cases may attract media attention, a computerized system and strict criteria govern organ allocation to ensure everyone is treated equally.

Myth: Health issues make me ineligible for organ or tissue donation.

Reality: Few medical conditions entirely rule out the possibility of organ or tissue donation. While some medical conditions might affect the eligibility of certain organs, others may still be viable for donation. It's crucial to let healthcare professionals evaluate your overall health and the condition of your organs and tissues to determine their suitability for transplantation.

Myth: Registering as an organ donor means I can never alter my decision.

Reality: You can modify or cancel your organ donor registration at any time. Your decision remains in your control, and you can update it as needed.

Myth: Organ donation is not necessary in India.

Reality: With over 300,000 patients on the waiting list and at least 20 people dying each day while waiting for an organ, there is a critical need for organ donors in India. The high demand for organs underscores the urgent need for more people to consider donating.

Myth: My family will have to pay for the organ donation process.

Reality: The costs associated with organ donation are not borne by the donor's family. The donor's family is only responsible for medical expenses related to efforts to save their life before donation.

Myth: Organ donation is limited to friends or family members.

Reality: Organ donations can be made to anyone in need, regardless of whether you know them personally, their racial or ethnic background, or their age. The focus is on saving lives, not on personal connections.

Myth: My age makes me ineligible to donate organs, and older individuals have organs that aren't suitable for transplantation.

Reality: There is no fixed age limit for organ donation. The suitability of your organs depends on their condition and overall health, not solely on your age. As long as your organs are healthy, they can be considered for donation regardless of age.

Becoming an organ donor can profoundly impact many lives. By choosing to donate your organs after death, you have the potential to save or improve the lives of up to 50 people. Families often find comfort in knowing that their loved one's decision to donate has brought hope and healing to others, helping them navigate their grief. A single organ donor can make a significant difference: vital organs such as the heart, liver, kidneys, and lungs can each save a life, while tissues like corneas, skin, and bones can enhance the quality of life for many others. This generous organ donation creates a powerful ripple effect, giving the gift of life to those in need.

By:-  By Dr Prashant G Kedlaya, Prof & Head, Nephrology, St John's Medical College Hospital, Bangalore

*Disclaimer: This information is provided by a qualified healthcare professional. However, it is essential to consult with family members and respective healthcare professionals before making any decisions regarding organ donation or transplantation.

Each of us have been endowed with a unique identity, reflected in the individuality of our faces and fingerprints. Similarly, the journey of undergoing a transplant procedure is a unique and deeply personal experience for each individual, as well as for their family and friends. One of the most crucial initial steps in your organ transplant journey is to empower yourself with comprehensive information. Understanding how to care for yourself and your transplant is essential for a successful outcome.

Assessment: Your transplant journey begins when the doctor determines that you need a transplant. The journey will depend on the type of transplant required and the urgency of your medical condition.

To get ready for your transplant, it's crucial to maintain good overall health, both mentally and physically. Stay positive, eat and drink healthy, maintain a healthy weight, avoid smoking and drinking alcohol and take medication on time. All this will help to increase the likelihood of a successful transplant.

Identifying an eligible donor: There are two types of donor organs: Organs from either a deceased or a living donor. Typically, heart transplants, as well as most lung and liver transplants, come from deceased donors. Many individuals become organ donors during their lifetime, consenting to donate their organs after their death. While on the other hand, most living donations are from family members.

Pre-Transplant Screening: To determine your transplant eligibility and needs, the pre transplant screening process involves three main types of clinical diagnostics: blood-type testing, HLA typing, and HLA antibody testing.

Recovering the organs: A specialised surgical team respectfully recovers organs from the donor in a formal procedure. In case the organ has been taken from a deceased individual, they ensure the donor's body is left in a condition suitable for the chosen funeral arrangements. The recovered organs are carefully preserved in specialised containers and transported to the recipient's transplant hospital for transplantation.

Organ transplantation: The organ recipient should be at their transplant hospital when the donor organ arrives. Surgery will be performed as soon as possible to ensure the organ remains viable. Organ transplant surgery is a complex procedure that can take several hours to complete.

Caring for Yourself and Your Transplant: After transplant surgery, your hospital stay typically ranges from 2 to 5 days, depending on your health condition. Generally, you will be discharged once you are awake and alert, eating well, moving around comfortably, and your pain is well controlled.

Once you return home, following your doctor's instructions carefully is crucial for a smooth recovery. They are:

●      Incision Care: Ensuring your incision heals properly after surgery is crucial. Check your incision daily for any signs of fluid, redness, or new openings to prevent complications.

●      Preventing Infections: Wash your hands with hand wash and water before eating and after using the bathroom. Shower or bathe regularly to maintain hygiene.

●      Medication: Take your medicines on time and do not miss any doses. These are crucial to the success of the procedure.

The journey to organ transplantation is a transformative and complex process that requires resilience, dedication, and support. By staying informed, adhering to medical advice, and prioritising your health, you can navigate this journey successfully and embrace the opportunities for a renewed and healthier life.

By Dr. Siddachari Ravichand , Chief of HPB and Liver Transplantation KIMS Hospitals, Hyderabad

Disclaimer: This information is provided by a qualified healthcare professional. However, it is essential to consult with family members and respective healthcare professionals before making any decisions regarding organ donation or transplantation.

Recently, a 130 kg patient underwent a successful bilateral total knee replacement using robotic assistance. This procedure is particularly challenging due to the patient's obesity, which often complicates surgical outcomes and recovery.

The patient had both knees operated on by her knee surgeon, Dr. Chintan Patel, an Orthopaedic & Joint Replacement Surgeon at Wockhardt Hospitals Mumbai Central in a single session with the MAKO robotic system. This is an advanced method and along with an expert surgeon, provides the precision and efficiency needed for a patient with significant weight.

Remarkably, the patient was able to walk on the second-day post-surgery, adhering to the anticipated recovery timeline despite her weight-related challenges.

Typically, knee replacements for patients over 100 kg are performed one knee at a time to minimize risks and complications. However, in this case, both knees were replaced simultaneously using the robotic system, showcasing Dr. Chintan Patel and his team's expertise and the advantage of robotic assistance.

Dr. Chintan Patel and his team noted that robotic systems have their limitations, but they successfully navigated these to achieve a positive outcome. The decision to use a robotic approach allowed for enhanced precision in implant placement and alignment, which is crucial for long-term success in knee replacements.

The patient's recovery was impressive; she did not require a walker and was able to walk independently before being discharged from the hospital. Her positive outcome highlights the potential benefits of robotic assistance in complex knee replacement surgeries, offering hope for similar patients facing the challenges of obesity.

By:- Dr. Chintan Patel, an Orthopaedic & Joint Replacement Surgeon at Wockhardt Hospitals Mumbai Central