May 03, 2010

New sub-specialities to be fast-tracked

The Tamil Nadu Dr. MGR Medical University will fast-track initiation of fellowship programmes in new sub-specialities, the University Vice-Chancellor, Mayil Vahanan Natarajan said on Sunday.

Inaugurating a Continuing Medical Education programme on paediatric dermatology hosted by the CHILDS Trust Medical Research Foundation (CTMRF), the academic arm of the Kanchi Kamakoti CHILDS Trust Hospital, Dr. Natarajan said the university recognised the enormous scope for sub-specialities in modern medicine and sought to start more fellowship and research projects in the emerging disciplines.

Noting that the area of research in paediatrics was in a nascent stage, the Vice-Chancellor said it was proposed to launch a fellowship programme in paediatric dermatology in June in association with the CHILDS Trust Hospital.

The University was also examining another proposal from the institution for a similar programme in paediatric emergency medicine, he said.

K. Mathangi Ramakrishnan, CTMRF chairperson said the hospital maintained a balance between teaching and academic activity. The institution, which had earned accreditation from the Department of Science and Technology, was currently pursuing 13 core research projects, she said.

This year's CME on hypospadias sought to highlight a congenital deformity in the male neonate that led to unpleasant adolescent life if it was not properly operated upon, she said.

Prabhavathy, Head of Dermatology, Madras Medical College, launched a souvenir on the occasion.

S. Sridharan, Honorary Medical Director, CHILDS Trust Hospital, Prema Krishnaswamy, Trustee and Priya Ramachandran, organising secretary of the CME also spoke.

Delivering the 19th Dr. M.S. Ramakrishnan Memorial Endowment Oration, UK-based genito-urethral plastic surgeon Aivar Bracka said there was a disconnect between surgeons and their patients in the quality of surgery outcomes. This was mainly because there was no long-term follow-up of apparently well executed hypospadias surgeries on children into their adulthood.

Stating that until a few years ago one-stage hypospadias repair compromised cosmetic appeal for functionality, Dr. Bracka said only a long-term follow-up of patients would reveal the true incidence of complications and patient dissatisfaction. In fact, some surveys, including his own studies, found that at least 50 per cent of the patients preferred further surgery as they were unhappy with their surgery outcomes, he said.

According to Dr. Bracka, while procedures such as “Snod graft repair” provided a reliable and fairly versatile single-stage solution for hypospadias, the two-stage surgical intervention was still an option in a limited number of cases, especially those involving re-operation or salvage surgery where the previous operation had been imperfect.

Pointing to the polar divide between paediatric surgeons and urologists who preferred flaps and plastic surgeons who advocated grafts, Dr. Bracka said graft repairs were an effective choice as they were not prone to dilatation at a later stage.

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