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Dr. Shantonu Kumar Ghosh
Born in a small town of Bangladesh called Natore. Studied at Rajshahi
Cadet College and Bangladesh Medical College. Completed his MS
(CVTS) from Bangabandhu Sheikh Mujib Medical University and joined
the department of Vascular Surgery at National Institute of
Cardiovascular Diseases (NICVD), Dhaka. He is a dedicated vascular
surgeon with passion for venous and endovascular surgery. His primary
training was from NICVD, Dhaka, Bangladesh. He took specialized
training from Fortis Hospital, Mohali, India under Prof. Ravul Jindal and
from DIVAS Hospital, Rajkot, Gujrat, India under Prof. Devendra
Dekiwadia. Now working at NICVD and his private center ‘Vasculocare’.
Dr. Ghosh is the Secretary for International Affairs of Bangladesh
Vascular Society (BVS). He is also Treasurer of SAARC Society of Vascular
Surgery, Chairman of Bangladesh Chapter of World Young Experts
Committee of IUA. He is member of VSI, VAI, ESVS, SoDAS and IUAYC.
Vascular surgery in Bangladesh: where do we stand
Dr. Shantonu Kumar Ghosh
Vascular & Endovascular Surgeon
National Institute of Cardiovascular Diseases, Dhaka
Secretary for International Affairs, Bangladesh Vascular Society
Treasurer, SAARC Society of Vascular Surgery
Disclosuers:
• Nothing to disclose
Bangladesh
• Small country according to it’s
land, only 56,980 square mile.
• Large population (180 million
as on july 2019).
• Population density -
2,889.45/square mile
• Rank- 10th in the world.
• The emerging tiger of Asia
• Huge population is the
strength
• Skilled manpower working
all over the world
• Earning billions of dollars
• Stronger economy- fastest
growing in South Asia
• Growing fast in
infrastructure, knowledge
and science
• Lower middle income
country
1971: Birth of the country
Father of Nation Bangabandhu
Sheikh Mujibur Rahman.
Hospital
• Hospital beds – 4 (per 10,000 population) (WHO-2015)
• Density of physicians - 3.0 (per 10,000 population)
• Vascular centers in the country:
04 (Government Hospital and University) – 3 in Capital
07 (Private) – all in Capital
• Government free beds – 30 (male + female)
• Endovascular facilities – 7 centers
Vascular Surgery
•Total number of
vascular surgeons - 36
(as on September 2019)
for 180 million people
•Population per vascular
surgeon: 5.00 million !!!
Centers run by Government
National
Institute of
Cardiovascular
Diseases
(NICVD)
Bangabandhu
Sheikh Mujib
Medical
University
(BSMMU)
Dhaka Medical
College
Hospital
(DMCH)
Chottogram
Medical College
Hospital
(CMCH)
Private Centers
Patients managed at NICVD
(approx)
• Out Patient Department-
Approx. 100 patients/ day, six days a week
Duplex scan- 20 cases/ day, five days a week
Foam Sclerotherapy- 25 cases/ week
• Emergency Vascular Surgery- 150 cases/ month
• Routine Vascular Surgery- 20 cases/ month
• Endovascular Procedure- 20 cases/ month
• Medical Management at Indoor- 10 cases/ month
Procedures performed
(routine & emergency):
• Aorto femoral bypass- 5-6 cases/ month
• Fem-Pop bypass- 6-8 cases/ month
• Extra anatomic bypass- 1-2 cases/ month
• Excision of cervical rib- 2-3 cases/ month
• Creation of AV fistula- 8-10 cases/month
• Varicose vein: Flush ligation/ RFA- 8-10 cases/ month
• Excision of AVM- 2-4 cases/ month
• Repair/ anastomosis of vessels/ hemostasis- 10-30 cases/month
• Fogarty embolectomy- 10-30 cases/month
• Ligation of ruptured fistula- 4-6 cases/ month
• Excision of pseudoaneurysm- 5-6 cases/ month
Procedures performed
(Endovascular):
• Peripheral angiogram- 10-12 cases/ month
• Balloon dilatation- 5-6 cases/ month
• Stenting- 8-10 cases/ month (iliac, femoral, SCA)
• TEVAR, EVAR- infrequent
• NBCA- 5-6 cases/ month
• Emergency salvage procedures
Procedures performed at other Govt Hospitals
Mostly varicose vein flush ligation and
Femoro-Popliteal bypass
Procedures performed at
Private Centers
• Flush ligation of VV – 10-15 cases / month
• Laser/ RFA of VV- 25-30 cases/ month
• Fistuloplasty- 10-15 cases/ month
• Major arterial bypass (Aorto-iliac/ Femoro-Popliteal
bypass)- 15-25 cases/ month
• Fogarty embolecctomy- 25-30 cases/ month
• Orthovascular procedures- 10-15 cases/ month
• Angioplasty + Stenting- 40-50 cases/month
•Established on 1st November of 2016
•Members- 30 as on September 2019
•Bi-annual conference- 2021 (next meeting)
Activities of BVS
Conference
1st conference took place in 2017. It was a one day long
program participated by vascular surgeons from home and
abroad, surgeons and physician of allied subjects, general
practitioners and nurses
Meetings
Conducted several meetings with doctors of other deciplines
to let them know about the subject and the facilities we can
deliver
Patient Care
Arrangement of medical camps for under privileged group at
different areas of the country
Activities of BVS
Training
Training of young vascular surgeons and surgeons of
other specialties
Social Awareness Progarm
Group discussion with target people suffering from
vascular diseases, eg. Smokers, Diabetics, Traffic Police,
Garment workers etc.
Our Limitations
Every year thousands of limbs are lost throughout
the country just because of lack of vascular trained
doctors in rural areas.
Unavailability of combind
vascular and orthopedic
facilities in major centers
Endovascular procedures
are less popular due to
high
cost
Failure in establishing
newer vascular centers.
Future Plan of BVS
Teaching and training of more surgeons on vascular
surgery
Encourage doctors to build career in vascular surgery
Making guidelines on common diseases suitable for
Bangladeshi people
Make general people to learn about vascular diseases by
campaign, health camps, use of social and print media,
free clinics, awarness program
Negociation with government to creat more vascular
centers to cover whole country
Encourage authorities of government and private
hospitals to increase number of vascular wards and beds
Colaboration with foreign societies for sharing of
knowledge and training programs
Future Plan of BVS
Welcoming foreign experts to enrich our knowledge and skills
Agreements with well known international centers for sending
Bangladeshi vascular surgeons for fellowship training
Establishing vascular clinics at Orthopedic and Trauma centers
Negociation with companies who make the stents and grafts
Making strategy for introduction of medical insurance throughout
the country
We Believe
As our society is small and newly established, we do not
get much sponsor
Though fund is not available and difficult to get, still we
beleive we can spread up the facilities of vascular surgery
all over the country with our limited resources
We believe to encourage more surgeons to join this field
We believe to prepare ourselves competent to stand
before rest of the world with our knowledge and skills
We Believe
And finally, we know, we can fill up all our gaps and
prosper together, if young vascular surgeons come
forward and take the lead. For that we must have
more knowledge, get more training and always be
updated.
We welcome young vascular surgeons of other
countries to make strong bondage between us, to
exchange knowledge, arrangement of training for
the youngs and academic relationships.
Let all of us prosper
together
Dr. Shantonu Kumar Ghosh MBBS, MS (CV&TS)
Vascular, Endovascular and Laser Specialist Surgeon
National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Vasculocare, Trauma Center, Shyamoli, Dhaka, Bangladesh
Secretary for International Affairs, Bangladesh Vascular Society (BVS)
Treasurer, SAARC Society of Vascular Surgery
Chairman, Bangladesh Chapter of World Young Experts Committee of IUA
Member, VSI, VAI, ESVS, SoDAS, IUAYC
Fellow, Vascular Society for Limb Salvage (Fortis Hospital, Mohali, India)
Cell: +8801715405567
E-mail: shantonukumarghosh@gmail.com
Web: www.vasculocare.com
www.facebook.com/vasculocare

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Vascular surgery in Bangladesh: where do we stand

  • 1. Photo Dr. Shantonu Kumar Ghosh Born in a small town of Bangladesh called Natore. Studied at Rajshahi Cadet College and Bangladesh Medical College. Completed his MS (CVTS) from Bangabandhu Sheikh Mujib Medical University and joined the department of Vascular Surgery at National Institute of Cardiovascular Diseases (NICVD), Dhaka. He is a dedicated vascular surgeon with passion for venous and endovascular surgery. His primary training was from NICVD, Dhaka, Bangladesh. He took specialized training from Fortis Hospital, Mohali, India under Prof. Ravul Jindal and from DIVAS Hospital, Rajkot, Gujrat, India under Prof. Devendra Dekiwadia. Now working at NICVD and his private center ‘Vasculocare’. Dr. Ghosh is the Secretary for International Affairs of Bangladesh Vascular Society (BVS). He is also Treasurer of SAARC Society of Vascular Surgery, Chairman of Bangladesh Chapter of World Young Experts Committee of IUA. He is member of VSI, VAI, ESVS, SoDAS and IUAYC.
  • 2. Vascular surgery in Bangladesh: where do we stand Dr. Shantonu Kumar Ghosh Vascular & Endovascular Surgeon National Institute of Cardiovascular Diseases, Dhaka Secretary for International Affairs, Bangladesh Vascular Society Treasurer, SAARC Society of Vascular Surgery
  • 4. Bangladesh • Small country according to it’s land, only 56,980 square mile. • Large population (180 million as on july 2019). • Population density - 2,889.45/square mile • Rank- 10th in the world.
  • 5. • The emerging tiger of Asia • Huge population is the strength • Skilled manpower working all over the world • Earning billions of dollars • Stronger economy- fastest growing in South Asia • Growing fast in infrastructure, knowledge and science • Lower middle income country
  • 6. 1971: Birth of the country Father of Nation Bangabandhu Sheikh Mujibur Rahman.
  • 7. Hospital • Hospital beds – 4 (per 10,000 population) (WHO-2015) • Density of physicians - 3.0 (per 10,000 population) • Vascular centers in the country: 04 (Government Hospital and University) – 3 in Capital 07 (Private) – all in Capital • Government free beds – 30 (male + female) • Endovascular facilities – 7 centers
  • 8. Vascular Surgery •Total number of vascular surgeons - 36 (as on September 2019) for 180 million people •Population per vascular surgeon: 5.00 million !!!
  • 9. Centers run by Government National Institute of Cardiovascular Diseases (NICVD) Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Medical College Hospital (DMCH) Chottogram Medical College Hospital (CMCH)
  • 11. Patients managed at NICVD (approx) • Out Patient Department- Approx. 100 patients/ day, six days a week Duplex scan- 20 cases/ day, five days a week Foam Sclerotherapy- 25 cases/ week • Emergency Vascular Surgery- 150 cases/ month • Routine Vascular Surgery- 20 cases/ month • Endovascular Procedure- 20 cases/ month • Medical Management at Indoor- 10 cases/ month
  • 12. Procedures performed (routine & emergency): • Aorto femoral bypass- 5-6 cases/ month • Fem-Pop bypass- 6-8 cases/ month • Extra anatomic bypass- 1-2 cases/ month • Excision of cervical rib- 2-3 cases/ month • Creation of AV fistula- 8-10 cases/month • Varicose vein: Flush ligation/ RFA- 8-10 cases/ month • Excision of AVM- 2-4 cases/ month • Repair/ anastomosis of vessels/ hemostasis- 10-30 cases/month • Fogarty embolectomy- 10-30 cases/month • Ligation of ruptured fistula- 4-6 cases/ month • Excision of pseudoaneurysm- 5-6 cases/ month
  • 13. Procedures performed (Endovascular): • Peripheral angiogram- 10-12 cases/ month • Balloon dilatation- 5-6 cases/ month • Stenting- 8-10 cases/ month (iliac, femoral, SCA) • TEVAR, EVAR- infrequent • NBCA- 5-6 cases/ month • Emergency salvage procedures
  • 14. Procedures performed at other Govt Hospitals Mostly varicose vein flush ligation and Femoro-Popliteal bypass
  • 15. Procedures performed at Private Centers • Flush ligation of VV – 10-15 cases / month • Laser/ RFA of VV- 25-30 cases/ month • Fistuloplasty- 10-15 cases/ month • Major arterial bypass (Aorto-iliac/ Femoro-Popliteal bypass)- 15-25 cases/ month • Fogarty embolecctomy- 25-30 cases/ month • Orthovascular procedures- 10-15 cases/ month • Angioplasty + Stenting- 40-50 cases/month
  • 16. •Established on 1st November of 2016 •Members- 30 as on September 2019 •Bi-annual conference- 2021 (next meeting)
  • 17. Activities of BVS Conference 1st conference took place in 2017. It was a one day long program participated by vascular surgeons from home and abroad, surgeons and physician of allied subjects, general practitioners and nurses Meetings Conducted several meetings with doctors of other deciplines to let them know about the subject and the facilities we can deliver Patient Care Arrangement of medical camps for under privileged group at different areas of the country
  • 18. Activities of BVS Training Training of young vascular surgeons and surgeons of other specialties Social Awareness Progarm Group discussion with target people suffering from vascular diseases, eg. Smokers, Diabetics, Traffic Police, Garment workers etc.
  • 19.
  • 20. Our Limitations Every year thousands of limbs are lost throughout the country just because of lack of vascular trained doctors in rural areas. Unavailability of combind vascular and orthopedic facilities in major centers Endovascular procedures are less popular due to high cost Failure in establishing newer vascular centers.
  • 21. Future Plan of BVS Teaching and training of more surgeons on vascular surgery Encourage doctors to build career in vascular surgery Making guidelines on common diseases suitable for Bangladeshi people Make general people to learn about vascular diseases by campaign, health camps, use of social and print media, free clinics, awarness program Negociation with government to creat more vascular centers to cover whole country Encourage authorities of government and private hospitals to increase number of vascular wards and beds Colaboration with foreign societies for sharing of knowledge and training programs
  • 22. Future Plan of BVS Welcoming foreign experts to enrich our knowledge and skills Agreements with well known international centers for sending Bangladeshi vascular surgeons for fellowship training Establishing vascular clinics at Orthopedic and Trauma centers Negociation with companies who make the stents and grafts Making strategy for introduction of medical insurance throughout the country
  • 23. We Believe As our society is small and newly established, we do not get much sponsor Though fund is not available and difficult to get, still we beleive we can spread up the facilities of vascular surgery all over the country with our limited resources We believe to encourage more surgeons to join this field We believe to prepare ourselves competent to stand before rest of the world with our knowledge and skills
  • 24. We Believe And finally, we know, we can fill up all our gaps and prosper together, if young vascular surgeons come forward and take the lead. For that we must have more knowledge, get more training and always be updated. We welcome young vascular surgeons of other countries to make strong bondage between us, to exchange knowledge, arrangement of training for the youngs and academic relationships. Let all of us prosper together
  • 25. Dr. Shantonu Kumar Ghosh MBBS, MS (CV&TS) Vascular, Endovascular and Laser Specialist Surgeon National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh Vasculocare, Trauma Center, Shyamoli, Dhaka, Bangladesh Secretary for International Affairs, Bangladesh Vascular Society (BVS) Treasurer, SAARC Society of Vascular Surgery Chairman, Bangladesh Chapter of World Young Experts Committee of IUA Member, VSI, VAI, ESVS, SoDAS, IUAYC Fellow, Vascular Society for Limb Salvage (Fortis Hospital, Mohali, India) Cell: +8801715405567 E-mail: shantonukumarghosh@gmail.com Web: www.vasculocare.com www.facebook.com/vasculocare

Editor's Notes

  1. a(