"There is an increasing requirement of superspecialists in cardiology as the incidents of coronary artery disease is rapidly on the rise in Bangladesh” said Dr Ashok Seth, an internationally renowned cardiologist from India who has contributed extensively to the growth, development and training in the field of Interventional Cardiology (Angiography & Angioplasty) in Asia Pacific Region.

On his recent visit to Bangladesh to attend the 15* annual convention and scientific sessions organised by the Association of Physicians of Bangladesh Dr Seth, Chief of Department of the Invasive & Interventional Cardiology at Escorts Heart Institute and Research Centre, India, spoke to The Daily Star.

He said, "Quality cardiac care in Bangladesh is gradually picking up and more and more young cardiologists are showing interest in the field with good background knowledge. This is the right environment like it used to be in India twenty years ago. What you now need is to put up sustainable programmes to expose these young enthusiasts to international level of cardiac care."

Speaking on the need for superspeciality in Bangladesh, Dr Seth said, “For matters of the heart you need a large number of ‘generalists’ in district towns who can provide basic care and act towards prevention of heart diseases.

Although superspecialisation is seen as professionally glamorous and financially rewarding, we must realise that every doctor whether a generalist or a specialist plays an important and valuable role in society.”

Dr Seth pointed out, “There is an excellent career ahead in superspeciality for young

Bangladeshi cardiologists, full of challenges and requiring a lot of determination and hard work."

Referring to prospects of the National Institute of Cardiovascular Diseases (NICVD), Dr Seth said, "NICVD is an institution where one can pursue such determination and hard work. In fact, these courses in cardiac care in government medical colleges are less costlier."

cians."

In response to a question on the private sector's role in the field, Dr Seth, hounoured in 2003 with the Indian national award of Padma Shri, fourth in the hierarchy of civilian awards, said, "Without competition you cannot expect quality care and to maintain that quality you need partners in the private sector. In fact, private sector also need incentives from the gov-

said, "It is time for the private sector to come forward to encourage more and more young cardiologists. For instance, in India, some of the best cardiac care institutes were established in the late eighties and most of the cardiologists have been exposed to foreign trainers like myself trained in the United Kingdom. So there was a growing competition and look how the hospital-cum-institutions are

seek treatment for cardiac care abroad but that trend of Bangladeshi patients going abroad has eventually reduced over the last few years and it should continue to decline. But to bring full confidence the focus of international exposure on transferring expertise and skills in complex cardiac care must continue."

Sighting examples of superspeciality hospital Dr Seth

"There are centre of excellence for such superspelised subjects and Bangladesh also needs to have at least one or two such centres where trainers from abroad can come and enlighten local talents. In fact, I have already trained a number of Bangladeshi cardiologists from NICVD at Escorts and would continue to train more in batches not only cardiologists but also nurses and lab techni-

ernment to reach international standard and I know a few Bangladeshi private hospitals have attained such standards, of course, through extensive training."

Dr Seth who holds record for performing the maximum number of angiographies and angioplasties in the whole of Asia-Pacific region and one of the largest numbers in the world

at international level."

Talking on the advances in cardiac therapy today, Dr Seth said that Sirolimus coated stents are found to be giving promising results, cutting down restenosis to a bare minimum. "So far, we have done 658 implants, may be the second highest in world.'

"The effort is now towards perfecting this technology. This calls for multiple factors. We need to work at different levels from diffusion property of the dmg used, design of stent, the way stent is implanted, etc."

Speaking on the high cost of cardiac care, Dr Seth explained, "Access to hi-tech therapies are on the rise owing to increased awareness coupled with insurance schemes in India. Whatyou now need is to channelise therapy and take advantage of technological advances. Cost reduction will happen at various levels like, health insurance, competition, large customer base and increased usage,"

Dr Seth also suggested enacting legislation that will make it mandatory for corporate houses to provide insurance cover to employees, which he said, may increase use, even by middle class patients, of high-tech cardiac care in Bangladesh without having to pay from their own pocket.

The list of invited lectures at international academic forums on advancements in cardiology by Dr Seth crosses 65 and at the national forums, it is 132.

now able to offer quality care in India and I am sure Bangladeshi hospitals would reach such level soon."

Speaking about confidence of patients on surgeons and cardiologists Dr Seth said, "It is superspecialty hospitals that can put Bangladesh on the international map of cardiac therapy. Until that level is attained people, perhaps, would continue to

said, "Surgical procedures done at Escorts have been transferred live to overseas destinations such as Washington where more than 30,000 doctors were watching. Such overseas live demonstrations occurred on several occasions and have been extended to Japan, Singapore, Hong Kong, Australia and Pakistan as well. This has been possible only because Escorts continuously pursued on quality care

Dr Seth has to his credit more than fO invited review articles and 24-odd-peer reviewed articles. He has presented about 15 abstracts at international meetings and the total number of abstracts run to about 77.

Dr Seth is the Vice-President of the Cardiac Society of India from the year 2001 onwards and is on the executive committee member of SAARC Cardiac Society from f997.