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Thread: Need your advice

  1. Need your advice

    As a junior member, I seek your guidance in the following matter:

    Kendriya Vidyalaya Sangatan comes under the HRD ministry. In the guidelines they have issued for request-transfer of their staff on medical grounds, I have come across one peculiarity. In respect of Coronary Artery Disease, persons who have undergone Bye-pass surgery alone are considered eligible to apply for a transfer on medical grounds, while those who have undergone Angioplasty technique for the same ailment are declared ineligible.

    Cardiologists are of the opinion that, the these are two of the available techniques for treatment of the disease, while the post operative care for both the procedures are similar and to be continued life long.

    Can I seek informaion under RTI, the file notings and other relevant matters which made them to take a decision in favour one and excluding the other types of treatment. If so what should be my line of approach.
    Kindly guide me.

  2. Hello,
    First of all let me clarify about both the treatment condition:
    1. Angioplasty is the mechanical widening of a narrowed or totally obstructed blood vessel by introduction of simple catheter, and is infact non-invasive heart surgery and the patient though kept under observation, does not have much serious need of post operative care.
    2. Where as in By Pass surgery, Veins or arteries from elsewhere in the patient's body are grafted from the aorta to the coronary arteries, bypassing coronary artery narrowing and also improve the blood supply to the myocardium (heart muscle). Thus by inherent nature the Coronary artery Bypass Surgery is much complicated and require serious after attention.

    Even though you might secure information, to my view the decision is in coherence with the prescribed Law.

    Coming to securing information under RTI Act, you can get information both about file noting, and copy of the Rule under which the decision was based.

  3. Very good answer Kushal.

  4. Hello
    Thank you Mr Kushal for your prompt reply.

    No doubt, the post operative care in respect of the two different types of treatment differs. But the possibility of a re-stenosis or a recurrence of a block in some other part of the artery always exists for both the groups, say after a period of 2 or 3 years after the surgery or interventional procedure, as the case may be. I think that is the reason why these patients are kept on life long medication.

    Under such conditions, will it not amount to discrimination?

    Regards, Ganpat.

  5. Actually, By pass surgery poses rejection of the external artery and require critical attention, where as ballooning of artery is a simple operation and complication because of operation is minimal even though the risk cannot be ruled out as you say.
    If I say generally , By pass surgery is resorted to only after other options like Angioplasty has been explored. The criterion of severity is way different between the two, even if they pose same risk of sclerosis and thereby stenosis.

    On the part of Post Operative risk: Risk of operation per se is more with bypass than angioplasty. If you say risk of re-stenosis or Heart ailment, many other cardiac deficiency can occur like mitral stenosis, aotic stenosis, Atrial fibrillation (AF) to name a few, and the debility cannot be decided by the risk.

    Even with these clarifications it would be a good idea to get a copy of the decision on which the case was decided. You never know what clue you can get out of that.

  6. Thank you Mr Kushal for your enlightening response, in such a short span of time. I really felt as if we were chatting on line.

    As rightly suggested by you, let me take a chance with the authorities on this issue and get their clarifications. If I get any clue out of it, I shall post it for the benefit of the RTI community.
    Thanks & Regards

  7. Off course you can expect the best response from a Doctor, and Dr. Kushal has proved that even being an Officer now, he still is good with his old profession

  8. Oh! That's great. I never imagined that Mr Kushal is a doctor. But his replies gave an indication that he might be a medico-legal practioner. I am really thrilled to be part of this RTI group.

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