World Heart Day was created to inform and educate people around the world about the increasing risk of heart disease . Heart Related Ailments and stroke are the world’s leading cause of death, claiming 17.2 million lives each year.According to the "The World Heart Federation " at least 80% of premature deaths from heart disease and stroke could be avoided if the main risk factors, tobacco, unhealthy diet and physical inactivity, are controlled.
World Heart Day will be observed on Sunday, 27 September 2009 to inspire you to“Work with Heart”. World Heart Federation members, comprising 196 cardiology societies and heart foundations in more than 100 countries, organize activities for World Heart Day. A large number of non-members, whether hospitals, cardiac clinics, universities, schools, individuals and a number of other organizations, also join in by organizing event.This Years World Heart Day Theme is " Work With Your Heart"
Almost half of those who die from chronic diseases are in their productive years . The economic consequences - driven by productivity reduction and increase in costs caused by these diseases among workforces are dramatic. The WHO estimates that between 2005-2015 income loss (in international dollars) could rise to as much as $558 billion in China, $237 billion in India, $303 billion in Russia and $33 billion in the UK.
Wockhardt Hospitals urges you to work hard and most importantly work with your Heart too !! You can download the " Working out with your Heart" Booklet below.
In a rare incidence of spinal cord tumour, Doctors at Wockhardt Hospitals,Bannerghata Road,Bangalore, removed a giant shaped tumour from a 21 year old girl’s neck. The team led by Dr. K N Krishna, Senior Consultant, Brain & Spine, Wockhardt Hospitals,Bangalore successfully removed the tumour which is medically known as Crippling Giant Dumbell Nerve Sheath Tumour or Spinal Dumbbell Schwannoma from the girl who was paralysed for more than a year. Spinal Dumbell Schwannoma is a rare disease which afflicts around 3.75 per 10 million people.
Meenakshi, a married lady from Tumkur was complaining of progressive weakness in her limbs which compromised her mobility and was unable to perform simple day to day activities independently. Her tightness in both her legs made her unable to walk without support. She also noticed a gradually increasing swelling on the left side of neck just above the collar bone (clavicle) restricting her neck movement. Weakness in her four limbs crippled her life and she was bedridden for almost a year. Both her legs and one of her hands were totally paralysed,We consultated around 9 hospitals and all of them turned us back saying that there was not much they could do . Finally we landed up at Wockhardt Hospitals,Bangalore ,said Mahesh Krishnamurthy,Meenakshi's brother.
Finally her family brought her to Wockhardt Hospitals. An initial clinical evaluation showed a severe cervical compressive myelopathy and also a large 5cm diameter mass on the left side of neck. MRI of Cervical Spine and Neck showed an Intraspinal / Extradural Tumour on the left side of the neck pushing the spinal cord to the right side. The tumour also extended outwards through the Intervertebral Foramen reaching in front of the neck over like an hourglass shaped Tumour. The Tumor on the left side of her neck was pushing the spinal cord on the right.
According to Dr. K N Krishna, Senior Consultant, Brain & Spine, Wockhardt Hospitals “Dumbbell shaped tumours have been managed as extraordinary tumours in the spinal cord, because of their varied locations, features, clinical symptoms, different from other spinal cord tumours and therefore, their surgical treatment is also different.
In Meenakshi’s case since the tumour was complicatedly placed involving her neck muscles and blood vessels doctors had to decide on the nature of surgery and approach to the tumour. Ideally anterolateral approach that is, from the front of neck on left side would give sufficient access to remove the tumour completely including the intraspinal part but this would also require a fusion by using plate / screws at that level, which would restrict her neck movements and also add significantly to the cost.”
Finally the doctors decided to perform the surgery in two stages. First step involved removal of the intraspinal by approaching from the back of neck, removing the tumour through a minimal access technique which entails about a 3cm incision, removal of bone on only one side to maintain the stability of spine and avoid fusion.
“After few days we planned the anterior approach from the left side of neck after a thorough planning as it had engulfed the vertebral artery within it. First part of this surgery involved identifying and isolating the vertebral artery at its origin under the collar bone, so as to clip it if the engulfed part tears off while removing the tumour. Next the tumour was debunked and separated from the vertebral artery and brachial plexus (plexus of nerves which control the upper limb movements) and removed completely” Dr. Krishna added.
About Spinal Schwanoma Tumor:Spinal Schwannoma is a rare tumour with occurrence of just 2.5 in a million and Spinal Dumbbell Schwannoma is even rarer with 3.75 per 10 million people. Schwannoma originates from the sheath encasing the roots arising from the spinal cord and the cranial nerves leaving the base of skull through various foramina. About 25% of Schwannoma’s are found in the head and neck and also about one third of primary spinal cord tumors are schwannomas.
About 70 to 80% of spinal schwannomas are reported to be intradural in location, and those extending through the dural aperture as a dumbbell mass with both intradural and extradural components account for another 15%. The spinal cord tumors appear more commonly in the thoracic and lumbar spine than the cervical spine. In contrast, the dumbbell tumors are seen most commonly in the cervical spine (44%), followed by the thoracic spine (27%) and the lumbar spine (21%).
Two major unsolved problems with Spinal Schwannomas are high recurrence rate and postoperative cervical deformity especially in teenage patients. An ideal surgical strategy for cervical dumbbell tumor should be able to reduce the recurrence rate and avoid cervical deformity at the same time.
Meenakshi’s recovery was very fast after the surgery.Within a week’s time she was able to walk independently and eat with a spoon and started performing fine motor functions later.
After a complicated heart surgery at Wockhardt Hospitals Bangalore, Orubah Abdulshah, 32 year old Iraqi lady is all set to go back to Iraq with a new lease of life. A team of cardiac experts led by Dr. N S Devananda, Cardiac Surgeon, performed a complex procedure on Orubah Abdulshah who had come to India with some symptoms of heart failure.
Orubah who never complained of any ailment in her life even while raising her 4 children, was feeling shortness of breath and fatigue for the past one year. Upon consultation with the local doctors in Iraq, she was detected of a cardiac disorder called aortic root dilatation where the root of the aorta which is connected to the heart muscles was enlarged. She was told by the local doctor in Iraq that her symptoms were complicated and her survival post surgery was less than 70%. Orubah’s husband without losing faith consulted with Wockhardt Hospitals in India and finally decided to bring her to for the surgery.
On her arrival at Wockhardt Hospitals Orubah went through a round of CT scan and echo where she was diagnosed to have some really serious heart defect in addition to what was detected in Iraq. Orubah was having a severe constriction of aorta (the vessel that comes out of heart and supplies blood to the whole of the body through various branches). This disease is called severe co-arctation of Aorta and mitral valve leakage. Incidentally this disorder is considered to be a congenital defect. “This is combination is a very rare presentation at this age”, commented Dr. N S Devananda, Cardiac Surgeon, Wockhardt Hospitals who operated upon Orubah.
“The most amazing fact was how Orubah was surviving so long with the congenital defect and without showing any symptoms. Above all she has given birth to 4 children whereas pregnancy puts a great pressure on the heart and it is surprising that her heart sustained that sort of pressure” added Dr. Devananda.
The treatment options for Orubah were now either surgical repair through different incisions or through a hybrid approach. Witnessing the complexity of the case the doctors decided to take the hybrid approach and conduct the surgery in two stages. In the first stage was repairing of the co-arctation of the aorta and second was the Mitral Valve repair along with Bentall procedure.
Interventional Cardiologists Dr. Subhash Chandra and his team started the 1st procedure by dilating the constriction in aorta with a help of a balloon and then put a stent graft in the constricted part so as to prevent the aorta from collapsing. It was then followed by the 2nd procedure which was an open heart surgery performed by Dr. N S Devananda, Cardiac Surgeon and his team where. This surgery involved repairing of her mitral valve and her aortic valve along with ascending aorta was replaced. This was an off pump surgery with the use of the heart lung machine. The second surgery was performed within 24 hours of the interventional procedure and there was very minimal blood loss and only 1 unit of blood transfusion was required.
Orubah had a smooth and fast recovery. After 24 hours of her second procedure she was brought to her room. Dr. Devananda explains, “A hybrid approach like this case which was very difficult and complex in nature however made the overall procedure less risky and brought down the magnitude of the procedure so that recovery could be faster.”
The religious and cultural beliefs impacts the healthcare requirements of Muslim women and many of them suffer without medical attention at the appropriate time. Many women succumb to death due to lack of medical attention and at times are completely ignorant of the ailments residing within their system. But Orubah’s case is a true example of healthcare needs taking an edge over religious belief. Her husband played a pivotal role in giving her a new lease of life and treating her at the right time. A little delay could have worsened things. From a war bound country Orubah traveled across borders leaving her four children back home with a hope to spend the rest of life with them in her healthiest form. Now Orubah is desperately looking forward to go back to Iraq and lead a healthier life with her husband and children.
Expressing his gratitude for the doctors at Wockhardt Hospitals Mr. Abdulshah said, “When the doctors in Iraq told that Orubah has less than 70% of survival chances, we left everything to Lord and prayed fervently that He showed us the right way to save her life. That’s when we were referred to Wockhardt Hospitals. As soon as the visa processing was done without wasting much time we flew down to Bangalore to get her treated. But our worries didn’t stop there. On further diagnosis the doctors revealed that she had severe complications in her heart. But our faith in Lord was undeterred and believing in the Almighty left things in the hands of the doctor and proceeded with the surgery. Today Orubah has come out victoriously battling her life through the complex surgery.”
Single Incision Laparoscopic Surgery (SILS) has now been made routine at Wockhardt Hospital, Cunningham Road, Bangalore .The team led by Dr. Aashish Shah, Consultant Gastrointestinal and Laparoscopic Surgeon, Wockhardt Hospitals, has performed 10 Single Incision Laparoscopic Surgeries which include Cholecystectomies (removal of the gallbladder) and Appendicectomies (removal of the appendix) with remarkable success and getting patients back to their normal life faster.
In Laparoscopic surgery, which is also known as minimally invasive surgery, the surgeons uses instruments and video cameras to perform the surgery with 3- 4 ports (incisions). The instruments are then entered into the patients’ body which helps the surgeon perform the surgery. Now taking Laparoscopic surgery to the next level, Single Incision Laparoscopic Surgery (SILS) has been introduced. This requires making a single incision near the belly button of the patient and performing the surgery through one port. Surgeons at Wockhardt Hospitals are now routinely practicing this surgery which gives immense benefit to the patients. The patients can now experience pain less surgery, less infection post surgery, reduced post operative discomfort and early recovery. The end result is the patients can walk back faster with a very short stay at the hospital.
SILS is an advanced minimally invasive surgical procedure in which the surgery is done through a single entry point i.e. the navel. A 20mm incision at the umbilicus is all that is required for the surgery. A scope is inserted that can be moved around in the body and return images form various angles giving the surgeons a larger field of vision for the surgery and the instruments used to perform the surgery are flexible thereby enabling extra reach and maneuverability.
Earlier, patients had limited choices when it came to surgery i.e. conventional open surgery or laparoscopic with multiple incisions, laparoscopic surgery being the preferred choice. However now with the introduction of Single Incision Laparoscopic Surgery, patients can undergo surgical procedures with just a single incision (approx half an inch) in the belly button and that too with a number of benefits over conventional procedures such as less pain, quicker recovery, less blood loss, less complications and minimal scarring and helping patients getting back to work faster.
“SILS is the next big step in laparoscopic surgery worldwide. It offers a huge cosmetic advantage and also enables much quicker recovery for the patient compared to conventional lap surgery. For the patient it is extremely appealing to be offered surgery through a single small cut, than through multiple incisions”.
SILS is an excellent option for all patients who need laparoscopic surgery more so for uncomplicated Gallstones, Appendicitis and Hernia operations. At Wockhardt Hospital, Cunningham Road, Bangalore, laparoscopic surgery is used as a routine, where SILS is being offered to all suitable patients.
SILS is an excellent option for all patients who need laparoscopic surgery more so for uncomplicated Gallstones, Appendicitis and Hernia operations. At Wockhardt Hospital, Cunningham Road, as a routine, SILS is being offered to all suitable patients.
Swapan Kumar Basu and Ratan Das, strangers till a few weeks back, got a fresh lease of life in a rare case of spousal paired kidney transplants at a Wockhardt Hospital and Kidney Institute at kolkata.
Basu, 59, had suffered renal failure and was undergoing dialysis for the last three years.
Doctors had advised a kidney transplant but the blood group of his family members did not match with his.His wife Suchitra, 57, wanted to donate one of her kidneys to him, but her blood group (B negative) didn’t match his.
“I didn’t want to buy a kidney from a commercial donor and there seemed to be no hope for me,” recalled Basu, who was undergoing treatment at Wockhardt Hospitals and Kidney Institute.
Meanwhile Mr Ratan Das, a 43-year-old businessman from Howrah, was also undergoing dialysis since November 2008. He was facing a similar problem — his B negative blood group was a mismatch for his wife, Barnali, 35, whose blood group is A positive.
Barnali approached the doctors with a request for paired transplant.
“It was an ideal situation and after getting the necessary clearance from the state health department, we went ahead with the transplants,” said Arup Ratan Dutta, the chief nephrologist at WockhardtHospitals who performed the surgery along with urologist Shivaji Basu and transplant surgeon Sasanka Saha.
The transplants took place on July 28 and the couples are out of hospital. “They can go back to work in three months,” Dutta said. “The transplants saved two families from financial, emotional and physical drain,” he added.
According to doctors, tissue matching, although preferable, is not mandatory because of advanced immuno-suppresive drugs. “Tissue mismatch is not as significant as it used to be. So, the number of spousal donations is going up,” said Dutta.
Urologist Shivaji Basu from Wockhardt hoped this case would motivate others to opt for paired kidney transplants.
Doctors say renal transplant for patients whose blood groups do not match with near relatives becomes a serious problem as cadaver organ transplant is yet to become popular here.
Surgeons at Wockhardt Hospitals,Mulund ,Mumbai led by Dr S.K Mathur performed a major liver resection which took 11 hours when they operated on a 58 year old man to remove a cancerous tumor.
Mr R. Jain, a 58-year-old male from Jodhpur, Rajasthan was diagnosed with a cancerous tumor in his liver (Hepatocellular Carcinoma- HCC) in October 2006. What followed the diagnosis was a liver resection involving removal of a part of the liver containing the tumor.
Almost two-and-a-half years later, a follow-up ultrasound and a CAT scan of the liver revealed the presence of three new tumors, one of which was extending dangerously behind the IVC – Inferior Venacava, the big vein in the abdomen that runs behind the liver, carrying blood from the lower half of the body to the heart. Owing to the dangerous location of the tumor, doctors whom the patient was consulting advised against a second surgery, and had put him on palliative treatment in the form of TACE (Transarterial chemoembolisation) -- a procedure in which the blood supply to a tumor is blocked and chemotherapy is administered directly into the tumor.
While two of the three nodules could be treated with TACE, the nodule close to the IVC could not be embolised (blocked), thereby causing him untold mental distress and helplessness. That’s when the patient decided to consult doctors at the Wockhardt Hospitals’ Department of Hepato Biliary- Pancreatic Diseases and Liver Transplantation
“Since the tumor was limited only to the liver and had not spread anywhere else in the body, we took an informed decision to perform a Right Hepatectomy and remove the tumor behind the IVC,” recalls Dr. Surendra Kumar Mathur, Senior Consultant Surgeon, HPB Surgery & Liver Transplantation, Wockhardt Hospitals who successfully headed the 11-hour surgery.
This was a a technically challenging surgery since liver as such is densely adhered to other organs in the vicinity like the diaphragm, colon and the duodenum, and more crucially, a first surgery had already been done on the patient’s liver. The patient required three units of blood, was shifted from the ICU two days post operation, and was immediately started on orals. Patient recovery was uneventful and he was discharged on the sixth day of the surgery.
Speaking to the media, Mr. Jain said, “When I was told in the other hospital that the liver tumor has recurred and this time only palliative treatment can be administered and no surgery, we had almost lost all hope and became averse to any kind of treatment. I just took this as another decision of God and to take things as it comes. That’s when we encountered Dr. Mathur and his team who came as a miracle to our lives, giving me a new lease of life with this miraculous surgery.”
Liver tumors and complexities of re-resection surgery
Major or complex resections of the liver are performed mainly for malignant tumors of the liver which can be either primary, i.e. arising from the liver like hepatocellular carcinoma (HCC), or metastasis, i.e. they originate in some other organ and then seed the liver.
World over, though the recurrence of HCC liver tumor after first surgery is reported to be around 30 percent over five years, only one third of these cases are known to be retreated successfully. Commonly, many surgeons choose to avoid an excision surgery of a liver tumor very close to the IVC due to a possible life-threatening bleeding of the IVC during the surgery.