This Kashmiri doc's method heals patients worldwide

This Kashmiri doc's method heals patients worldwide
RATHI A MENON

CHANDIGARH, FEB 21: This enterprising young doctor dared to venture beyond textbook practices and diktats of elders and devised a new cure that received global acknowledgement. What Dr Showkat Ali Zargar, who heads the Department of Gastroenterology at the Sher-E-Kashmir Institute of Medical Sciences in Srinagar, has done is to cure a cyst without surgery -- the only method known to the world till he published his research papers in Radiology, one of the leading US medical journals, in 1993. Since then, Dr Zargar's PAIR technique has successfully treated more than 3000 patients across the continents.

The problem area chosen by Dr Zargar is called Hepatic Hydatid Cyst, or in layman's language a water cyst, in the liver. ``Wherever human beings live in close proximity with the sheep and dogs, you can see the prevalence of this cyst,'' Zargar told The Indian Express at Chandigarh where he had come to attend the Second National Update on Gastroenterology held by the Indian Society of Gastroenterology at the PGIMER.

``It is caused by a tapeworm which is just 2-3 millimetres in size and is spread through the faecal matter of the animals. Once the parasite's egg gets into the food and enters human system, it reaches the lever through blood vessels and settles down in the liver. There it develops into an adult parasite and helps cyst formation. It takes four to five years for the cyst to become symptomatic,'' he informed.

But in some patients, the disease remains unsymptomatic and is diagnosed accidentally. For example, often cysts are discovered when a pregnant woman goes in for an ultrasound. In some other patients, the cyst causes pain for it gets ruptured and spreads into other nearby organs like the gallbladder, bile duct etc. It can affect any age group.

The textbook said: ``Don't ever puncture the cyst for it may cause death of the patient''. With the smile of a true rebel, Zargar notes, ``That is what we did. We punctured the cyst, took the contents out and injected the drug to kill the parasites. We call the process PAIR: Puncture first, Aspirate the cyst, Inject 20 ml of Albendazole with either hypertonic saline or even pure alcohol to kill the parasite and Reaspirate to weed out all the remnants.'' In fact, Zargar does the most practical thing: root out the cause.

The discovery of this technique was quite accidental for Zargar and his team at the SKIMC. ``We were doing the ultrasound on a nine-year-old girl and the needle punctured the cyst. The liquid started coming out. And subsequently when we did surgery, we were pleasantly surprised to find out that the cyst was not there. Then we started using this method and thought of injecting the drug,'' he recalled.

Till the early nineties when Zargar's method became popular, surgery used to be the only way out for these patients. ``But even after removing the cyst surgically, at least 10-15 per cent used to develop complications with two per cent of mortality and ten per cent of recurrence of the cyst.

Till date, though little bit of complications like infection has been detected in Dr Zargar's patients, no death has ever been reported from any of the centres using his PAIR technique. Dr Zargar's unit does proper follow-up of the patients for at least ten years. ``The cyst may not recur immediately for it usually takes time. So we follow the case for a long period and no recurrence has been reported too.''

The PAIR method is being followed in centres spread across South America, Australia, New Zealand, Turkey and some parts of Asia. Not to mention some of the premier health institutes of our country.

Tthe only grey area regarding this method is that PAIR cannot be applied on an already raptured cyst.

It was not easy to get recognition in the international medical community. Ever since 1983 when they treated the first patient, Dr Zargar's team had been sending their findings to one journal or the other. Finally, after 10 years, Radiology published it and the medical community recognised the method. With a success rate of 90-95 per cent, Dr Zargar is one of the last millennium's proud inventors from the subcontinent. He, however, shrugs it off: ``Does anyone want to project anything positive about Kashmir?''