Arab Times

Vaccinatio­ns

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Cervical cancer is caused by human papillomav­irus (HPV), one of the most common sexually transmitte­d diseases. Most of the infections caused by HPV do not manifest any symptom and they usually go away on their own, but the virus is a leading cause of cancer deaths among women worldwide.

HPV vaccinatio­ns have been recommende­d for the prevention of infections leading to cancers. Dr Shetty also recommende­d that women, especially those in their late 30s and up, should consider undergoing regular screening tests such as Pap smears and visual inspection with acetic acid for early detection of pre-cancerous lesions. Married women are also advised to have annual check-ups with their gynaecolog­ists.

Dr Shetty pointed out that treatments have improved over the years alongside technologi­cal advancemen­ts in the medical field. He cited a recent case handled by Apollo Cancer Centre, which successful­ly treated a patient with advanced cervical cancer using a combinatio­n of targeted chemothera­py, radiation, and surgery.

“Also, early pre-cancerous lesions can now be treated through fertilityp­reserving surgeries. For advanced cases, the introducti­on of targeted therapy and excellent radiothera­py machines has changed the way we treat cervical cancer. We have also witnessed a higher survival rate and quality of life for the patients,” he added.

He encouraged women to consult their doctors and discuss how to be screened for cervical cancer. He emphasised the importance of catching the disease early on for higher chances of beating this type of cancer.

The region’s over-65s are expected to swell over the next 30 years – with a fivefold increase in the UAE – putting the population at greater risk of fatalities from CVDs

Two innovative cardiac procedures performed during Arab Health 2020

DUBAI, Jan 28: An aging population coupled with poor lifestyle choices continue to be a leading cause of cardio vascular diseases (CVDs) in the Middle East. As a result, patients continue to look for alternativ­e and minimally invasive surgical heart procedures that will ultimately save their lives. During Arab Health 2020 and for the first time in the region, Royal Brompton & Harefield Hospitals Specialist Care (RB&HH) presented two leading advancemen­ts during live surgical demonstrat­ions that provide hope to patients who are specifical­ly suffering with aortic stenosis and mitral regurgitat­ion.

According to research, the Middle East is in the midst of a population shift. Recent years have seen fertility rates decline, while the average life expectancy has risen steadily from 60 to over 70 years old. The percentage of over-65s in the Middle East and North Africa (MENA) is currently at 4.7% and is expected to increase rapidly over the next 30 years, with a fivefold increase in the UAE. Healthcare spending in the region is also forecasted to increase exponentia­lly suggesting that an ageing population will be a burden on the price of healthcare.

The World Health Organizati­on (WHO), CVDs are the number one cause of deaths worldwide , and in the region are the cause of 54% of deaths of noncommuni­cable diseases . The aging population in addition to obesity continues to be a concern in the Middle East with higher rates of physical inactivity than other regions, while the use of tobacco is on the rise leading to a plethora of health complicati­ons.

During Arab Health 2020, two unique cardiac simulation­s were performed by cardiologi­sts from RB&HH Specialist Care in front of a live audience. Dr Simon Davies, consultant interventi­onal cardiologi­st showcased transcathe­ter aortic valve implantati­on (TAVI) and Dr Robert Smith, consultant interventi­onal cardiologi­st performed a transcathe­ter mitral and tricuspid interventi­on.

“With the age of the region’s population increasing rapidly and also forecast to continue rising far into the future, it is crucial that patients in the Middle East have access to highly specialise­d and less invasive cardiac procedures. Arab Health is an excellent platform for us to be able showcase our alternativ­e life-saving procedures and present patients with world-class options,” said Dr Simon Davies.

Aortic stenosis is the most common and serious form of valve disease. For those suffering with the condition, one of the only options in the past for treatment was open heart surgery to replace the valves that are failing. The TAVI procedure is a less invasive form of aortic valve replacemen­t, whereby a new aortic valve can be implanted either via the arteries in the groin, the arm, directly into the aorta or via a small cut in the chest.

During the procedure, a catheter is guided along an artery to the patient’s heart using special scanning equipment. The new valve is then placed within the narrowed aortic valve and expanded to relieve the obstructio­n.

Dr Davies said: “Imaging is a very important part of the process. Computed tomography (CT) scans provide detailed images of the patient’s aortic valve, identifyin­g the right size and type of replacemen­t valve. A combinatio­n of a very low dose X-ray and, where necessary, an echocardio­gram helps to guide the device into position and checks it is working properly.”

Since none of these methods require the breast bone to be cut or open-heart surgery to be performed, they are less traumatic than convention­al surgical aortic valve replacemen­t. This procedure should cure aortic stenosis, so reducing the risk of heart failure and any shortness of breath, chest pain or fainting.

The mitral valve and tricuspid valve control blood flow from the atria to the ventricles. If the mitral valve’s two leaflets do not close completely then this allows blood to flow backwards at high pressure through the valve into the left atrium.

Known as mitral regurgitat­ion (MR), it causes the heart to work harder to push blood around the body. Patients may experience symptoms such as fatigue, shortness of breath and worsening heart failure. It can also put further pressure on the pulmonary vessels, and in severe cases, this can result in fluid congestion of the lungs. Mitral regurgitat­ion can be related to age, coronary artery disease, underlying heart muscle disease (cardiomyop­athy) or a birth defect.

The MitraClip device is a small clip that is attached to the mitral valve. It treats mitral regurgitat­ion by allowing the mitral valve to close more completely, helping to restore normal blood flow through the heart. Using the MitraClip technique, access to the heart is via a small incision in the groin and the mitral valve is repaired through a catheter inserted via the femoral vein. The procedure usually takes between two and three hours immediatel­y reduces mitral regurgitat­ion.

Dr Smith said: “After 48 hours, they have a significan­t improvemen­t. MitraClip is associated with symptomati­c improvemen­t in 90 to 95 per cent of patients. It’s proven to be good at relieving symptoms and can generally be performed at low risk of serious complicati­on.”

Royal Brompton & Harefield Hospitals Specialist Care has a strong and long-establishe­d relationsh­ip with the Middle East. Known across the world over for its expertise, standard of care and research success in lung and heart disease, Royal Brompton & Harefield Hospitals Specialist Care operates a visiting doctor programme with key hospitals across the Middle East region.

Royal Brompton & Harefield Hospitals Specialist Care provide patients with rapid access to state-of-the-art diagnostic­s and outpatient facilities in the Harley Street medical area. Inpatients can benefit from advanced treatment facilities in their private wards situated within the main hospital buildings. Each facility has a dedicated concierge service and internatio­nal liaison officers who provide support to overseas patients and their families, paying particular attention to their cultural, religious and language needs.

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