Exclusive Interview ‘Lifestyle changes at pre-diabetic stage lowers risk of heart ailments’

Dr Yugal Kishor Mishra, Cardiac Vascular Surgeon

By Bhavana ‘Aparajita’ Shukla :

From a remote village to national capital’s top notch tertiary care hospital, Dr Yugal Kishore’s name is among the country’s renowned cardiac surgeons. His inclination to community services and simple nature easily connects him with patients and their caretakers. He feels half of the pain can be healed with doctor’s compassionate behaviour. From great human touch to highly advanced procedures like robotic surgeries, Dr Yugal Kishor Mishra is known to give comprehensive treatment to his patients. Who has performed more than 32K surgeries successfully He is willing to give his services to people of teh State who cannot visit Delhi.

Angiography is not the only method to ascertain blockage, TMT, Stress Echo, CT Angio, stress thallium and other means are also available

“If you can dream it, you can do it”.....this is what implied to a small town boy Yugal. He lost his mother when he was only six months old and used to help his uncle who was a Vaidya (traditional Ayurvedic medicine practitioner, who treats patients with traditional medical systems and herbs). He assisted his uncle in making paper packaging of prescribed medicines to their patients. Influenced with the respect, his uncle got in lieu of his clinical practices, Yugal Kishore at the age of six started dreaming to become a doctor. Later, he moved to Rewa from a small Jhanjhbari village in Maihar tehsil, Satna district, where his brother was working and his brother was instrumental in ensuring his school education.

With every passing year, his determination cemented. While talking to ‘The Hitavada’, he did not miss to attribute another main source of his inspiration to a column from medico professionals published in Periodical name “Kadambini” and give way ahead to the impressionable Yugal Kishor’s mind after which he came to know about cardiac stream and was determined to become a cardiac surgeon at the age of 12-13.” Dr Yugal Kishor Mishra gave medical exam and got selected. Since then his thrust to add higher degrees in his curriculum vita continue and he did PHD from a Moscow based institute. Although there was no campus selection procedure officially but a test was conducted by a Delhi-based institute and in view of his excellent performance, an accomplished cardiovascular and cardiothoracic surgeon, Dr Naresh Trehan, founder of the Escorts Heart Institute and Research Centre in Delhi (now part of Fortis Escorts) saw this young man’s answersheet and immediately offered him to join former’s institute. This is how he got the place in the Escort Hospitals experts roster and began an inning in National Capital. Later his verticle carrier journey goes to Manipal Hospital Delhi and currently, Dr Mishra is the Chief of Clinical Services and Head of Cardiac Sciences at Manipal Hospital, Dwarka, Delhi.

When asked if he plans to come to your home state Madhya Pradesh or Manipal group is going to start its one of its wing here? He says,” Expansion plan is in process. Talks of tie up in Pune and in Raipur a project is going on. Definitely, I will come to Bhopal also in future but as of now nothing can be said about the timings. I use to do OPD here as my roots belong here. Since I am born here, I have a bonding with the State. At first stage, I am also giving consultancy here. I use to come here and see patients. During an informal talk, he explained about nuances of heart, liver and blood pressure issues in a very simple and organic way. Giving a ray of hope to pre-diabetic people, he says if a person changes his/her lifestyle and eating habits progression of diabetic condition can significantly delay. Although in medical science there is little or negligible scope of reversible conditions like diabetic but it can be averted to a greater extent if proper preventive and precautionary routine is being adopted fatty liver happens in pre-diabetic patients. It has been seen that with a slight symptom of panic attack and sweating, most of the hospitals jump to the conclusion of possibility of blockage and expressed urgency to go for angiography to confirm presence of blockage in any artery, he said there are several other ways if there is no angina pain to ascertain possibility of blockage like treadmill test (TMT), Stress Echo, CT angiography, stress. Nobody knows why coronary artery disease happened. Best is TMT it has 60-70 percentage reliability. Angiography is gold stage.

If someone with family history of heart disease. But it can be said those who has heart disease history. They need to be vigilant and go for test at the age of 35-40 years. He/she should go for investigation. If there is problem in TMT then he/she should go for further test. Risk factors must also be considered. If a person has high BP then he should not go for stress. Angiography is being considered as golden since it gives explicit picture. Depends up on patient’s condition and symptoms other methods can be opted. It is not advisable to go only for angiography if first times person complaints of sweating or any other uneasiness. In emergency angiography can be done but to rush for angiography and jump to conclusions without considering other factors, it is not advisable. Now every second person after the age of 40-50 years suffers from blood pressure.

They visit doctors and starts Beta Blocker. It has been found some of the patients’ stop to take medicine on grounds of low BP or feeling lethargic etc. No doubt, there are side effects of Beta Blocker, what you have to say on this? Is there any substitute available for this component? To this Dr Mishra says, “There are many types of Beta Blocker. It brings HR down to 6-70. Some people are short tempered or highly aggressive in nature some have high BP problem. Doctors try to keep heart rate under control in both the conditions. For example, Vasoprolal is good for high BP issue while Metoprolol works well in case of heart rate control, lowers your blood pressure. Doctor should decide as per the patient’s condition. Metoprolol is a type of medicine called a beta blocker. Like other beta blockers, metoprolol works by changing the way your body responds to some nerve impulses, especially in the heart. It slows down your heart rate and makes it easier for your heart to pump blood around your body. Bisoprolol is a beta blocker medicine used to treat high blood pressure (hypertension) and heart failure.

If you have high blood pressure, taking bisoprolol helps prevent future heart disease, heart attacks and strokes. Bisoprolol is also used to prevent chest pain caused by angina. Beta Blocker medication primarily used for heart conditions and it works in three ways - first used on patients with aggressive behaviour. It promises in reducing the frequency and intensity of such behaviour in some individuals.

Second to control BP used on patients with hypertension issue and third in heart disease cases angina. How it works suppose this patient has HR 100 they have high energy consumption. Beta blocker brings down to 60-70 HR and it also lowers down energy consumption and heart won’t beat vigorously and it will prevent angina. Meta drastically lowers down heart rate while Bisoprolal impacts on blood pressure more aggresively as compared to Metaprolol. Doctor need to pick the medicine as per patient’s complaint. Patients are advised to take the medications only after consulting the specialist.