2010 Dr SC Misra Oration Award was conferred upon Dr Ajith Kumar Varma at the 55th Foundation Day of Department of Surgery (General), Chhatrapati
Shahuji Maharaj
Medical University
(upgraded King George's Medical
College - KGMC). Dr Varma
is an assistant Professor in the Department of Endocrinology at Amrita
Institute of Medical Sciences in Kochi,
Kerala. After serving the army for 15 years, he is doing excellent work in the
field of podiatric surgery, related to the diabetic foot. I had the opportunity
to meet him when he was recently in Lucknow to
attend the 55th Foundation Day Celebration of Department of General Surgery, CSM Medical
University, where he
charmed everyone with his suave manners and modesty, as well as his passionate
zeal for improving the quality of life of those living with diabetes.
This article is based on an
exclusive interview given by him to Citizen News Service (CNS).
The concept of reconstructive and
corrective surgery for the diabetic foot has evolved very recently, as a means
to correct foot deformities. This latest technique is presently being practised
in very few countries of the world. There are a few selected centres in the US, UK,
Germany, Russia, Spain
and Australia, with USA, which has
7 podiatric schools performing such operations, topping the list. In India,
Amrita Institute of Medical Sciences, situated in Kochi, is the only institute doing this type
of reconstructive surgery in high risk patients of totally deformed diabetic
foot, thus obviating the traumatic need for amputations.
There is an entity called 'Charcot' in
diabetic foot problems. In prolonged diabetic foot problems there is an
increased blood flow to the lower limbs, due to autonomic neuropathy, which
causes demineralisation of the bones. It is a tsunami like effect, just washing
away the minerals of the bones. Moreover, it stimulates certain cells which
simply eat up the bones. All this weakens the bones, and makes them soft and
pudgy. This results in the collapse of the foot and ankle bones, making it impossible
for the patient to walk. Moreover, multiple increased pressure points are
developed on the soles of the affected feet, where ulcers and calluses develop.
These act as portals for entry of bacteria. As the cellular immunity of the
patient is suppressed, even the slightest bacterial infection can cause a
serious life threatening problem, so much so that if the patient is not given
proper treatment within 24 to 48 hours of the infection setting in, it may
result in amputations or even death.
