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Posts Tagged ‘cardiologist’
Posted in dr s venkatesan -Personal, general medicine, tagged best cardiologist india, cardiologist, cardiology fellows training, crash course on cardiology, dr s venkatesan, drsvenkatesan, ethical cardiologist, good cardiologist, madras medical college, teaching video in cardiology, venkatesan sangareddi on August 18, 2011| 10 Comments »
Posted in bio ethics, tagged 64 slice ct scan, bio ethics, cardiologist, cardiology, coronary care, ethics in cardiology, fibroid uterus, hippocrates, master health check up, noble profession, non ulcer dyspepsia, osteoporosis, preventive medicine, preventive screening, stemi on February 24, 2010| 1 Comment »
Common sense would indicate medical care is meant for the sick and ill . Relieving the mankind from all those suffering with a healing hand has made the medical profession noble and sacred .Medical science grew with this sole aim many centuries ago .Some times we succeeded and many times we failed and the journey is continuing .
In those days ,scientists were dedicated , inventions were genuine and were driven by a need to conquer a diseases .Some where along the line, (May be in the last 2-3 decades?) our quest for money power exceeded commonsense . Commerce entered every walk of life and medical science became the biggest causality.
The purpose of noble profession was forgotten . Simultaneously public awareness and quality if life vastly improved in many of the developed countries . So the traditional illnesses either disappeared or reduced to a great extent . Then came the life style diseases.The cost of treating an illness spiraled too much especially in the scientifically advanced countries . What was perceived as great health care system became the most ridiculed health system in the planet ?
Why ? The simplest answer to this q is
In the name of science and modernity , medical treatment was glorified beyond the level it deserves , and hence the cost of treatment is kept at artificially & foolishly high (This often involves diagnostic exploration of human body with modern gadgets without any meaningful purpose ) .
ie , In a nutshell of modern medicine is often a medical mirage than a miracle . We know , the chances of success as we try to chase it. If we think the world is waking on this issue .
We are in for a surprise ! Even as every one is asking for outcome analysis in modern health care
more and more countries just imitate the failed ( Scientific and moral failure ) western models of health care .
When major illness are reducing in a society what will the health care providers do ?
Feel happy ? Yes that’s what a sane mind would do . In a capital rich , health conscious , knowledge driven society the opposite happens .
When the patient input into a top hospital reduces , the MBAs in them plan strategies to bring increase the bed occupancy rate and maintain patient parity.
If sufficient patients are not there in a community what shall we do ?
Create more patients
Creating new patients is a too dangerous game , what shall we do ?
In the name of preventive screening let us label normal persons as patients .
How to do it ?
The following examples are personal observation made in huge city of educated elite in a developing country . Excuse me if it offends a few . . .
Define, redefine all criteria that define the disease (There are
- Make, 130/85mmhg of blood pressure as pre hypertension and make them visit our HT clinic every month.
- In the name of risk stratification do CRP, Micro HDL , Apo a etc and catch them for primary risk reduction for a non existing illness
- Let us label all the age related bone loss as deadly osteoporosis and do bone graft.
- Let us call the occasional post dinner stiff stomach as non ulcer dyspepsia and insert a endoscope into the patient tummy .
- Do a 64slice CT in a master health check and convert many of the healthy normals into carriers soft coronary plaques.
- Do a ultra sound scan in every one who takes alcohol and give our brains a temptation to label the normal fatty streaks as infiltrative fat disorder .
- Do routine pelvic scan and detect sub clinical fibroid uterus as potentially malignant and post them for hysterectomy on the next operation day.
- Convert all healthy women as a potential cervical cancer and administer herpes vaccine and help the vaccine company share move up in wall street !
- Finally , screen all our playful kids for learning disability and label them as slow attention deficit disorder and make their life permanently miserable .
The list is endless . . .
We are in a era , where even a simple illness ( common cold ? ) can be converted into a billion dollar industry . ( Are you aware of H1N1 fiasco , The role of WHO and mystery labeling of pandemic !)
While the above misadventure with scientific excesses goes on merrily , lest we forget , millions of children and adults suffer in misery for want of live saving investigations and drugs in any country .
When a person with a head injury dies due a missed subdural hematoma for want of CT scan in one hospital , ” in the adjacent hospital” a wealthy and healthy man ( who got admitted for master health check up ) undergoes a series of scans all over the body even as he is watching the satellite TV in the comfort of a five star suite !
God will never forgive the noble professionals if they are part of this negative health care forces
Finally ending with a very positive note !
The new initiative by Obama , ” Health care for the uninsured ” is to be welcomed as great move and will do a world of good .
But , our only request to WHO ( or related bodies ) is to create a forum or authority to impeach all fancy diseases from the medical literature !
Posted in Uncategorized, tagged atherosclerosis, barking the wrong tree, c reactive peptide, cardiologist, coroanry angiogram, coronary, crp, foam cells, hb a1c, hdl, intima, ldl, media, oxidised ldl on November 29, 2009| Leave a Comment »
Atherosclerosis remains the number one cause for all vascular disease of human beings. It probably kills more patients than all other causes put together .
Modern medicine has never conquered the disease. How the vascular system ages and why some develop premature atherosclerosis remains largely speculative. While it is true , we have identified some major risk factor for development and progression of the atherosclerosis , patients with out any of those risk factors do develop severe atherosclerosis !So researchers sought to look for some other risk factors . There lies the difficulty and irony .
We always tend to the research with the affected population .When we know millions of people with the so called risk factors live comfortably , there lies an opportunity to analyse why they are protected against the onslaught of atherosclerosis .It is always convenient to blame it or bless it on the genetic predisposition .But we need to look beyond that .Of course . every genetic expression has to manifest phenotypically .
While the search for all those hidden secrets has to continue , we should also realize in pursuit of breakthrough we some times waste our energy in false targets for too many decades !
The reality as on today is , there is no reliable & undisputed drug available to arrest atherosclerosis (Some would love to call statin so . . . )
While our basic science colleagues struggle in molecular factories and biological models in pursuit of answer against atherosclerosis , our elite cardiac physicians carry on with the cosmetic touches over this progressive disease in sophisticated cath labs.
Let us hope man prevails over nature . . .
A cartoon , Just for laughs . . .
Posted in bio ethics, cardiology- coronary care, Cardiology-Coronary artery disese, tagged annals of medicine, cardiologist, coroanry angiogram, cost effectiveness, dr s venkatesan, economics of cardiology, ethics in cardiology, evidence based cardiology, futility in medicine cardiology, inappropriate medicine, interventional cardiologist, jama, madras medical college, nejm, primary pci, ptca, www.drsvenkatesan.com on August 7, 2009| Leave a Comment »
Is he a person in a cosmopolitan hospital who opens up a chronically closed coronary artery , in an asymptomatic patient and live telecasts his achievement trans continentally ?
Is he a person who checks in by the early morning flight and puts multiple wires in an aged patient with class 3 heart failure and make him walk 20 meters extra at a cost of 1000$ / Meter ?
Is he the unknown physician who Intervenes in the natural history of Rheumatic heart disease and arrests immune mediated valve damage by giving the monthly injections penicillin in remote parts of our country ?
Is he the person who Intervenes to prevent young persons from smoking and help maintain their coronary endothelium enriched with nitric oxide & arrest the coronary epidemic ?
Is he the small town doctor who Intervenes to treat a breathless cardiac failure patient with digoxin and frusemide and dramatically alleviate the symptoms and prolong the life of our poor country men?
Is she the village health nurse from an inaccessible health centre located in a hilly terrain , Intervening successfully, by pulling out live babies from severely anemic pregnant mothers with failing hearts ?
Rescue thrombolysis in acute myocardial infarction: Are we closing our mind to this important therapeutic concept in acute coronary syndrome ?
Posted in Cardiology -Interventional -PCI, cardiology -Therapeutics, My presentations, tagged acute coronary, cardiogenic shock, cardiologist, drsvenkatesn, europcr, failed thrombolysis, lancet, nejm, nstemi, primary angioplasty, rescue angioplasty, rescue thrombolysis, scai, stemi, streptokinase, tctmd, thrombolysis, tnk tpa, tpa on October 15, 2008| 1 Comment »
Rescue thrombolysis in acute myocardial Infarction
*Venkatesan sangareddi ,Madras medical college,Chennai.India
Back ground Failed thrombolysisin acute myocardial infarction occurs in 30-40% of patients. The incidence of progressive pathological remodelling and cardiac failure is high in these patients. The approach to the patient with failed thrombolysis is generally considered to be catheter based and the outcome is not clear. Bleeding can be troublesome in patients, taken for interventional procedures in the immediate post thrombolytic state. The option of repeat thrombolysis has not been studied widely and is not popular among cardiologists.
Methods:We present our experience with six patients (Age 42-56, M-6, F-0) who were thrombolysed for failed first thrombolysis. All had anterior MI and had received either urokinse or streptokinase (between four to nine hours) after the onset of chest pain. All of them had persistent ST elevation, angina not responsive to maximal doses of IV NTG and beta blockers. The initial thrombolysis was deemed to have failed. Repeat thrombolysis with streptokinase (15 lakhs) was given between 16 and 24 th hour. The clinical outcome following the second thrombolysis was rewarding. It relieved the angina, ST segment elevation came down by 50% and coronary angiogram done at 2-4 weeks showed complete IRA patency in four out of six patients. The factors responsible for failed thrombolysis is complex and multifactorial. A logical explanation from the fundamentals of clinical pharmacology would suggest that a common cause of failure of any drug is due to a inadequate first dose.
Conclusion :We conclude that repeat (Rescue) thrombolysis can be an effective medical intervention for failed thrombolysis in AMI.
Repeat thrombolysis for failed ( initial ) thrombolysis is still considered a fantasy treatment by most of the cardiologists ! The utility and efficacy of this modality of treatment (Rescue thrombolyis ) , will never be known to humanity , as planning such a study , in a large population would promptly be called unethical by the modern day cardiologists.
While a cathlab based cardiologist take on the lesion head on with multiple attempts , it is an irony , poor thrombolytic agents are given only one shot and if failed in the first attempt, it is doomed to be a failure for ever.Currently, the incidence of failed thromolysis could be up to a whooping 50 % .There has not been much scientific initiative to enhance the efficacy of these drugs.
Common sense and logic would suggest it is the inadequate first dose , improper delivery , pharmacokinetics is the major cause of failure of action of a drug in clinical therapeutics.
If the first dose is not working , always think about another incremental dose if found safe to administer.
Can we increase the dose of thrombolytic agents as we like ? Will it not increase the bleeding risk to dangerous levels ?
This is a clinical trial question.
In patients with prosthetic valve thrombosis and acute pulmonary embolism we have safety data of administering of 1 lakh units for an hour for up to 48 hours.
Can the same regimen be tried in STEMI if the initial thrombolysis has failed and emergency intervention is not possible ?
Logic would say yes . Unfortunately we can’t go with logic alone in medicine .We need scientific data ( with or without logic ! ).But now , as we realise common sense is also a integral part of therapeutics It is called as level 3 evidence / expert consensus by AHA/ACC .
Applying mind , to all relevant issues , continuous streptokinase infusion 1 lakh/hour for 24-48 hours in patients with failed thrombolysis can indeed be an option, especially when the patient is sinking and no immediate catheter based intervention possible .This study question is open to all researchers , and may be tested in a scientific setting if feasible.
Posted in dr s venkatesan -Personal, tagged anna nagar, best cardiologist india, boiler plant high school, bphss, cardiological society of india, cardiologist, cardiologist india, cardiologist madras medical college, cardiologist tamilnadu, chennai, chennai cardiologist, coimbatore, coimbatre medical college, consultant cardiologist chennai, dr s venkatesan, dr venkatesan, famous, india, india cardiologist, india venkatesan, india's famous cardiologist, indian cardiologist, interventional cardiologist, kaniyalampatti, latha venkatesan, leading, madras, madras medical college, mani high school, on line heart care, online cardiologist, pudupatti, shreenila venkatesan, top, top indian cardiologist, top ten cardiologist india, venkatesan assistant professor of cardiology, venkatesan india, venkatesan madras, www.drsvenkatesan.com on October 10, 2008| 1 Comment »
dr s venkatesan ,venkatesan india , india venkatesan , dr venkatesan, cardiologist india, india cardiologist, indian cardiologist, chennai cardiologist, venkatesan madras,cardiologist madras medical college, venkatesan assistant professor of cardiology, top indian cardiologist, top ten cardiologist india, best cardiologist india, online cardiologist, consultant cardiologist chennai, india’s famous cardiologist,cardiological society of india,
Posted in dr s venkatesan -Personal, tagged Add new tag, aiims, anna nagar, assistant professor, cardiologist, chennai, cleaveland clinic, escorts, india, indian, interventional, madras medical college, mayo clinic, sangareddi, shanthi colony, tamil nadu, TAS Narmada enclave, ucla on September 28, 2008| 2 Comments »
Dr. Venkatesan Sangareddi
AK 53/1, # 9
7th main road
Chennai -600 040
42 , 25-5 -1964
1998–2007 Madras medical college Madras
Asst. Professor Of Cardiology
Work involves intensive coronary care, invasive and non invasive cardiology. Has special interest in clinical research in Acute Coronary Syndromes
Has publications in various Journals.
1997-1998 Madras medical college Madras
Asst. Professor Of Medicine
Worked in intensive care medicine and in
Medical oncology for 6 months
1994–1996 Madras medical college Madras
Selected to resident programme toping the state in the super speciality exam
Presented papers in national conferences
Experience gained in invasive and non invasive cardiology
1991–1994 Govt. Health Centre Karur. Tamil nadu
Worked in internal medicine department
Family medicine and community health care.
And socio economic aspects of health care.
1994–1997 Madras medical college Madras
Doctorate in cardiology (DM)
1988-1991 Coimbatore medical college Coimbatore
Doctor of Medicine (MD) Dr.M.G.R Medical university , Madras
Secured three gold medals for excellence in cardiology.
1987-1988 Coimbatore medical college Coimbatore India
Junior resident in Medicine
1987 Coimbatore medical college Coimbatore
1982-1986 Coimbatore medical college Coimbatore
M B., B S. Bachelor of Medicine and Bachelor of Surgery
Madras University Madras
Electro physiology, expert systems in cardiology., clinical research in acute coronary syndromes, preventive cardiology, bio ethics, outcome analysis , logistics in cardiology and publishing online journals.
Professor & Head of Department
Institute of Cardiology, Madras Medical College Chennai
Dr.Latha Venkatesan MD . Gynecologist,
Sundaram Medical Foundation, Chennai India.
AK 53/1, Flat no A- 9
TAS Narmada enclave
7th main road
Chennai -600 040
Tel: 044 6209009
Mobile : 9840059947
E.mail : email@example.com>
List of publications by S.Venkatesan
1.QTc Interval in atrial fibrillation. The Tamilnadu Dr. M.G.R Medical university doctorate thesis 1991
2 .Thrombolysis in hyperacute MI.
Indian Heart Jr 1999:51: 321
3. Circadian Response To Thrombolysis In Acute Myocardial Infarction Indian Heart Jr 1999:51:686
4. Left Ventricular Mass in Pregnancy Induced Hypertension.
Indian Heart Jr. 1999:51
5. Dissection of interventricular septum by unruptured right sinus of valsalva aneurysm resulting in complete heart block.
Indian Heart Jr 1995 Nov-Dec: 605
6.Angiosarcoma of leftventricle presenting as hemopericardium and cardiac tamponade. Indian Heart Jr 1995 Nov-Dec:636
7.Asymtomatic multivessel disease following myocardial infarction
Indian Heart Jr 1999:51: 686
8. Transmitral pulse doppler echo correlates of mitral regurgitation severity Indian Heart Jr 1999:51:636
9. Safety and efficacy of intravenous nicorandil in unstable angina. Indian Heart Jr 1999:51:704
10. Efficacy of nicorandil as monotherapy in ischemic heart disease Indian Heart Jr 1999:51:728
11. Left ventricuar function by angiogram in significant LAD disease. Indian Heart Jr 1999:51:687
12. Aortic root dimension in isolated rheumatic mitral stenosis
Journal of association of physicians of India abst: 1998
13. Serum phosphate in acute myocardial infarction
Indian J Physiol Pharmacol 2000 44(2):225-8
14.Differential Response to right and left coronary artery thrombolysis Indian Heart Jr 2000:52:715
15. Therapeutic issues in Stable Ventricular tachycardia: A coronary care unit perspective Indian Heart Jr 2000: 52: 808.
16.Current cardiology practice: evidence or experience based ? An analysis of ACC/AHA guidelines. World congress of cardiology 2002 sydney Oral presentation.(Published in Journal of American college of cardiology)JACC :2001.39:9 Sup.B 462B
17.Isolated Diastolic Hypertension .World congress of cardiology 2002 sydney poster presentation..
( Published in Journal of American college of cardiology) JACC :2001.39:9 Sup.B 175B
18.Rescue thrombolysis in acute myocardial infarction
Journal of association of physicians of India abst: 2002
19.Canadian cardiovascular society classification of angina:
An angiographic correlation. Indian Heart Jr Abstract issue 2001
20.Non invasive management of high risk unstable angina
Accepted for oral presentation in cardiological society of India annual scientific session Kolkata Dec2003
21.Non dilated cardiomyopathy
Accepted for oral presentation in cardiological society of India annual scientific session Kolkata Dec 2003
22.Safety and efficacy of angiotensin-converting enzyme inhibitors in symptomatic severe aortic stenosis: Symptomatic Cardiac Obstruction-Pilot Study of Enalapril in Aortic Stenosis (SCOPE-AS).
Am Heart J. 2004 Apr;147(4):E19
23.Rheumatic heart disease occurrence, patterns and clinical correlates in children aged less than five years.J Heart Valve Dis. 2004 Jan;13(1):11-4.
24. Estimation of subjective stress in acute myocardial infarction.
J Postgrad Med. 2003 Jul-Sep;49(3):207-10.
25. Serum phosphate in acute myocardial infarction.
Indian J Physiol Pharmacol. 2000 Apr;44(2):225-8.
26. Canadian Cardiovascular Society classification of effort angina: An angiographic correlation.
Coron Artery Dis. 2004 Mar;15(2):111-4.
Coming soon :
List of top ten leading famous cardiologist in india