Public Forum on Causes ,Prevention and Treatement of Knee and Hip pain
Sunday, December 13, 2009
Rare and complicated spinal deformity correction surgery gives 14 year old Shah Rukh Khan a new Life
Wednesday, December 9, 2009
Doctors at Wockhardt Hospitals led by Dr. K N Krishna, Senior Consultant in the Brain and Spine service successfully performed a rare and complicated spinal deformity correction surgery to save a 14 year old from leading a complete disabled life. Shah Rukh Khan a 9th standard student was suffering from Neurofibromatosis (an autosomal dominant disorder that affects the bone, the nervous system, soft tissue, and the skin) with a severe spinal deformity. There have been only a few cases reported the world over on surgical treatment for a rotational dislocation of the spine in neurofibromatosis.
Shah Rukh Khan who hails from Malur was suffering from Neurofibromatosis since birth however his condition had progression over the years and it was only in the last four months that it manifested in severe deformity leaving him in extreme pain and on the brink of paralysis. His spine was grossly dislocated and twisted putting pressure on the spinal cord. It was at an advanced stage that the child was brought to Wockhardt Hospitals, Bannerghatta for treatment where he was diagnosed with Neurofibromatosis and a dislocated spine necessitating immediate surgery to prevent him from further deterioration of his condition.
“In India, unlike western countries, spinal deformity in Neurofibromatosis tends to go undiagnosed due to lack of awareness and also very few hospitals have the infrastructure and expertise to treat this condition. In most cases patients advance to a stage where the spinal deformity can become severe, spinal cord damage can become irreparable and correction very dangerous” said Dr Dilip Gopalakrishnan, Consultant Spine Surgeon, Wockhardt Hospitals.
The complex surgery involved spinal decompression, stabilization of the deformity and fusion of the spine thus restoring the function of the spinal cord and protecting it from further damage. Shahruk Khan is now able to stand on his feet unassisted with relatively no pain and will soon be discharged.
“Shahruk Khan’s case required considerable study and preparation as there is so little documentation on the surgery at this stage of Neurofibromatosis. A high level of expertise is needed to perform this surgery” said Dr. K N Krishna, Consultant Neuro Surgeon, Wockhardt Hospitals.
“According to international studies, type 1 neurofibromatosis occurs in approximately 1 of 2,500-3,300 live births, regardless of race, sex, or ethnic background. The carrier incidence at birth is 0.0004, and the gene frequency is 0.0002. The incidence of type 2 neurofibromatosis is 1 case per 50,000-120,000 population” Dr. Krishna added.
Spending his free time in the hospital reading a story book, the much animated Shahruk shares with us about his desire to get back to school soon in the coming year and when asked on which profession he would like to pursue Shahruk promptly replies that he would become a businessman!
Shahruk lost his father when he was 9, due to financial constraints he stays with his aunt in Andhra and his mother lives with grandfather in Malur. Being the only child Shahruk has an aspiration to do something great in life and give his mother all the happiness she deserves. This incident has not dampened the child’s spirit to live life again. At 14 he has victoriously come out of the battle of life and death and with a smile says I would start going to school again from this January.
While the cost of the surgery amounts to Rs 2.5 lakh, the hospital did not charge them much, except for consumable medicines. Shahrukh's family managed to borrow Rs 70,000 for his surgery and further treatment.
Neurofibromatosis (NF) is an autosomal (Pertaining to a chromosome that is not a sex chromosome) dominant disorder that affects the bone, the nervous system, soft tissue, and the skin. It is a neurocutaneous (genetic disorders that lead to abnormal growth of tumors in various parts of the body) condition that can involve almost any organ hence the signs and symptoms can vary widely. There are two major subtypes type 1 neurofibromatosis, which is the most common subtype and is referred to as peripheral neurofibromatosis, and type 2 neurofibromatosis, which is referred to as central neurofibromatosis.
The severity of both types of neurofibromatosis varies greatly. In families where more than one person has NF, the symptoms and complications for each affected person can be different. At diagnosis, it isn't possible to know right away whether a case will be mild or lead to severe complications. Both types of neurofibromatosis are a dominant genetic disorder, which means an affected person has 50% chance of passing it on with each pregnancy. Neurofibromatosis also can be the result of a spontaneous change (mutation) in the genetic material of the sperm or egg at conception in families with no previous history of NF. About half of cases are inherited, and the other half are due to spontaneous genetic mutation
While the cost of the surgery amounts to Rs 2.5 lakh, the hospital did not charge them much, except for consumable medicines. Shahrukh's family managed to borrow Rs 70,000 for his surgery and further treatment.
68 year old Gets a New Lease of Life at Wockhardt Hospitals
Saturday, November 21, 2009
Doctors at Wockhardt Hospitals,Bangalore led by Dr. Ganeshakrishnan Iyer, Consultant Cardiovascular Surgeon, gave a news lease of life to 68 year old man who was suffering from Chronic Type B Dissection of the Aorta with rupture in the Plura (space around the lung) a condition with high fatality rate. He was returned to normal life after a marathon ten hour surgery to repair the breached aorta.
Sampangi, a retired employee of BHEL, first complained of pain in the chest, back and knee as early as 2003. After, initial treatment at a hospital in the city, he was sent home as the doctors felt that his condition was too risky for surgery. He was normal for a while and then the symptoms resurfaced within a couple of years. Once again he started complaining of pain in the knee, back and chest which his family ignored it initially. As time went by the pain became unbearable and he found it difficult to walk a few steps. He was confined to bed for more than 3 months. Later, he stopped taking solid food because of pain while swallowing.
At this stage he was brought to Wockhardt Hospitals to consult Dr. Ranganath Nayak, Consultant Cardiologist, who diagnosed him with Chronic Type B Dissection of the Aorta with rupture in the Plura. He was loosing blood in the chest (plural cavity) and his lung was compressed necessitating surgery. He was then referred to Dr. Ganeshakrishnan Iyer, Consultant, Cardiovascular Surgeon, Wockhardt Hospitals who performed the surgery.On 7th November 2009 Sampangi underwent the surgery which surgery lasted for more than 10 hours.
“On opening the chest the lung was found to be completely compressed by a thick layer of blood clot. On removal of the blood clot the lung was still not expanding and hence it had to be removed. Subsequently the Aorta was repaired using a left heart bypass where part of the blood is drained from the heart and pumped to the lower body using a heart lung machine in order to supply blood to the lower body while the aorta is repaired.” said Dr. Ganeshakrishnan Iyer.
Post surgery, Sampangi was kept under observation for 3 days and later shifted to the room. He started having solid food the next day and started walking for 5 minutes with minimal help.
“Generally most cases of Aortic Dissection are associated with hypertension (High BP); about 80% of cases occur in patients with a history of High Blood Pressure. According to studies the occurrence of Type B Dissection of the Aorta is about 2.7% to 3.5 % per 100,000 patient-years. The condition is more common in men than women at about 5:1 ratio. Most incidents occur between 60 to 70 years. In women less than 40 years of age 50% of cases occur during pregnancy,” Dr. Iyer added.
The Aorta is the main artery that carries blood to the body. It is made up of three layers, the intima, the media, and the adventitia. During Aortic Dissection the blood penetrates the intima and enters the media layer creating a false lumen (abnormal channel of blood within the wall of the involved artery). Aortic Dissection is caused by tear in the wall of the aorta (between the intima and the media layers).
Aortic Dissection can be classified as type A and B based on the involvement of the ascending aorta or the descending aorta respectively. This condition is extremely serious and there is a high fatality rate even with immediate emergency treatment. If the tear in the aorta goes through all three layers then there is rapid blood loss resulting in 80% mortality. A high percentage of patients die before reaching the Hospital.
Type B Dissection of the Aorta accounts for 40% of all Aortic Dissection and its occurrence is more frequent in the mornings between 6 to 10 am and in the winter season.
Treatment
Aggressive blood pressure control should be initiated immediately. The treatment is targeted to reduce aortic pressure and pulsatile flow.
Type B Dissection is managed initially with aggressive drug therapy. Indications for surgical treatment of type B dissections are aortic rupture (as in the case of Sampangi); severe intractable pain; mesenteric, renal, or limb ischemia; and progression of the dissection. Some of the methods used are
• Replacement of the damaged section with a tube graft
• Insertion of a stent, combined with on-going medical management
About Wockhardt Hospitals Cardiac Care:
A center for excellence in interventional Cardiology and Cardiac Surgeries in the country, it has to its name a history of path-breaking procedures, be it the first-ever Conscious Off Pump Coronary Artery Bypass Surgery and Awake Heart Surgery in India. Collectively Wockhardt group hospitals have now have tremendous experience of performing over 40000 Cardiac Surgeries and 75000 interventional cardiology procedures since its inception. The Institute is a preferred destination for adult and pediatric cardiology and cardiac surgeries. The hospital provides treatment on the entire gamut of cardiac diseases from newborn to adolescent. Dedicated operating rooms and post-operative ICUs with state-of-the-art equipment and experienced staff round the clock are provided to continue excellent care.
For enquiries or consultations with our cardiac specialists,please email us at enquiries@wockhardthospitals.net
91 year old back on his feet after a successful bilateral knee replacement surgery
Friday, November 20, 2009
Mr Madhukar seen above with Dr Kaushal Malhan
It’s never too late for a new beginning....
For Mr Madhukar nothing is more apt than these words.
Advantages of Tissue Preserving Total Knee Replacement Surgery
Wockhardt Hospitals,Mumbai,Mulund has successfully performed a bilateral total knee replacement surgery in a single sitting on a 91 year old man from Mulund.In the process “Wockhardt Hospitals puts 91 year old Mr. Madhukar Nimdeo back on his feet after a successful bilateral knee replacement surgery”
Dr. Kaushal Malhan, Knee & Hip Replacement Surgeon, Wockhardt Hospitals performed the surgery on 91 year old Mr. Madhukar Nimdeo who was suffering from end-stage knee arthritis with minimal blood loss with a combination of advanced muscle sparing surgical exposure, specialized mix of navigation techniques and better patient-specific implants.
Mr. Nimdeo a retired central government employee who loves traveling and has always led an active life was suffering from knee pain for the last 8 years. Due the extreme deformity in both the knees caused by arthritis Mr. Nimdeo had to restrict his physical activities. However this couldn’t curb him from exploring adventurous sport for too long. While on his visit to New Zealand five years back he participated in bungee jumping despite his knee condition and recorded as the oldest member in New Zealand to participate in bungee jumping. But once he returned to India his condition worsened. Upon consultation with Dr. Kaushal Malhan he decided to go ahead with total knee replacement of both his knees.
“The results of the surgery are extremely encouraging and it proves that Tissue Preserving Total Knee Replacement Surgery offers good results even for very aged patients because of minimal tissue damage around the operating site. We have almost stopped the use of blood transfusions for knee replacement surgeries, even for patients who have been operated on both knees in one sitting.” said Dr. Kaushal Malhan.
Since the surgery involved minimal damage to the surrounding tissues, post operation, the nonagenarian was able to walk the same day of his surgery and also participated cheerfully in the hospital’s sporting activities held on the occasion of World Arthritis Day recently.
The Tissue Preserving Total Knee Replacement surgery goes beyond the general scope of conventional TKR surgeries that involve cutting through the quadriceps muscle during the surgery. Conventional Total Knee Replacement surgery causes trauma to the surrounding tissues that result in painful, long, recuperation periods. The patient would typically need walking aids for three to six weeks for the tissues to heal. However, in the case of Tissue Preserving TKR, the procedure involves just flipping across the muscles to reach the bone.
The specialised technique perfected by Dr Kaushal Malhan allows the advantage of satisfactory surgical exposure in all patients including the very obese with easy implantation of standard implants with standard instrumentation. Lesser tissue damage means less pain and earlier recovery.
Tissue Preserving TKR surgery aims to reduce the collateral damage which has always been part of this operation. It combines a muscle sparing exposure (which does not damage the quadriceps muscle- the front main thigh muscle) with computer assisted alignment so as to reduce the need for ligament release and appropriate implants which sacrifice less normal bone. This technique offers, among others, the ability to bend the knee almost immediately after the operation, and walk without aids much faster than conventional TKR procedures. Above all, there is no danger of any complication because there is no blood loss.
Advantages of Tissue Preserving Total Knee Replacement Surgery
- On the whole, there is less soft tissue damage and if combined with appropriate implants, one can reduce the amount of bone sacrificed during operation.
- Less post surgery pain
- Less bleeding and no need for blood transfusions.
- Faster return of knee function – muscle strength and control comes back more quickly – allows faster rehabilitation. Patients can walk on day 1 after surgery.
- Shorter hospital stay
- Less soft tissue damage and a better result
- Early return of knee motion
- After surgery recovery time is less than one third of that with conventional TKR technique.
“My painful knees were quite discouraging for me in these 8 years as I had to restrict my physical activity and mobility was also compromised to a large extent. After attending a session on tissue sparing knee replacement by Dr. Kaushal Malhan, I made up my mind to undergo surgery of both the knees and I could see the benefits from day one of my surgery. I could bend my knee on the first post operative day and with a regular physiotherapy regime I am now completely back to what I was 20 years back!” said Mr. Nimdeo.
For consultations and inquiries with Doctor Malhan,please email us at enquiries@wockhardthospitals.net
Trans Nasal Surgery Used to Remove a Woman's Tumor
Wednesday, November 18, 2009
For three years, a host of doctors were unable to diagnose Manju Talwar’s medical problem. The 24 year old school teacher complained of abnormal lactation, irregular menstrual cycles and was unable to conceive.
All symptoms suggested a possible gynaecological problem but despite heavy medication, Talwar’s condition did not improve. However, early this year, a MRI scan revealed a tumour in her pituitary gland.
The pea-sized gland situated at the base of the brain controls growth, metabolism and reproductive functions among others. In Talwar’s case, the tumour was pressing her optic nerve, which could lead to blindness. She was advised immediate surgery.
Talwar’s was not an easy surgery as while removing the tumour we had to ensure that the gland is preserved as she is in the child bearing age,” said Dr. Deepu Banerji, a neurosurgeon at Wockhardt Hospital,Mulund,Mumbai.
The Pituitary gland which is located at the center of the brain manufactures and secretes hormone that regulate growth ,sexual development and fluid balance in the body.
Pituitary adenomas(tumors) are abnormal growth on the pituitary glands which account for about 10% of intracranial neoplasms. They often remain undiagnosed, and small pituitary tumors have an estimated prevalence of 16.7% (14.4% in autopsy studies and 22.5% in radiologic studies). Tumor removal is usually done through transspheoidal approach. Endoscopic surgery is the new approach allowing a surgeon to gain maximum access within the narrow confines of the region avoiding extensive dissection.
Surgery is a common treatment for pituitary tumors. Trans-sphenoidal adenectomy surgery can often remove the tumor without affecting other parts of the brain. Endoscopic surgery has become common recently.
Surgery is a common treatment for pituitary tumors. Trans-sphenoidal adenectomy surgery can often remove the tumor without affecting other parts of the brain. Endoscopic surgery has become common recently.
Dr Deepu Banerji, who operated on Talwar over three months, opted for a relatively new endoscopic trans-nasal technique for the delicate operation. This involved insertion of an endoscope through nasal cavity.
Banerji claimed that so far in Mumbai most doctors have been using microscopic transeptal technique, which involves a microscope inserted through the nasal cavity. This, he claimed has led to post-operative complications like numbness around nose and lips, nasal deformity or pain and incomplete removal of tumor.
In the new technique, an endoscope provides good view of the tumor to the doctor. Also, it makes it easier to differentiate between the tumor and the gland – leading to greater chances of complete tumour removal and preserving hormonal functions.
Talwar said she has so far not complained of any post-operative complications.For inquiries please contact us at enquiries@wockhardthospitals.net
Wockhardt Hospitals Bangalore Celebrates Children's Day
Tuesday, November 17, 2009
14th November,2009 was a special day for Wockhardt Hospitals,Bangalore.Apart from being Children s Day .. the day also celebrated as the day when Children from all over the city assembled at the hospital to say a big Cheers to Life. These Children were all at some point of their lives threatened by life threating congenital disorders,who managed to overcome their medical problems with a little help from the Hospital.
More than 50 children aged between 3 and 13 who had undergone cardiac surgery at Wockhardt Hospitals were treated to a variety of fun filled activities on the occasion of Children’s Day. Dr Devananda, Pediatric, Cardiac Surgeon Wockhardt Hospitals, who took part in the celebrations spoke on the prevalence of Congenital Heart Disease in India vis-à-vis the developed countries and stressed the need to create awareness among people that the Congenital Heart Disease is curable.
“Congenital Heart disease in a child is not the end of the world. This is a treatable condition with excellent success rate, the children present here today of all ages are a testament to this fact.” Dr Devananda, Pediatric, Cardiac Surgeon Wockhardt Hospitals
“Today, India has the expertise and the knowledge to treat this condition, however there are two major obstacles we need to overcome that is that lack of awareness of the disease and the non availability of finance as insurance companies in India do not cover pre-existing diseases” he added.
Magic shows, caricature, face-painting, interactive games and competitions enthralled the children who were eager to participate, adding to the happiness and joy of this special occasion.
More than 50 children aged between 3 and 13 who had undergone cardiac surgery at Wockhardt Hospitals were treated to a variety of fun filled activities on the occasion of Children’s Day. Dr Devananda, Pediatric, Cardiac Surgeon Wockhardt Hospitals, who took part in the celebrations spoke on the prevalence of Congenital Heart Disease in India vis-à-vis the developed countries and stressed the need to create awareness among people that the Congenital Heart Disease is curable.
“Congenital Heart disease in a child is not the end of the world. This is a treatable condition with excellent success rate, the children present here today of all ages are a testament to this fact.” Dr Devananda, Pediatric, Cardiac Surgeon Wockhardt Hospitals
“Today, India has the expertise and the knowledge to treat this condition, however there are two major obstacles we need to overcome that is that lack of awareness of the disease and the non availability of finance as insurance companies in India do not cover pre-existing diseases” he added.
Magic shows, caricature, face-painting, interactive games and competitions enthralled the children who were eager to participate, adding to the happiness and joy of this special occasion.
But these were not your regular kids. All of them had suffered from life-threatening heart problems , at some point or the other and had gone through complicated surgeries at the Bannerghata Road,hospital at Bangalore.
"It was great to see these children doing so well and enjoying themselves at Children's Day. Seeing them so happy, no one would have guessed that they were suffering from fatal heart problem at one time," said Dr Devananda, pediatric cardiac surgeon.
The "reunion" party was as emotional for the families as it was for the doctors. And in between the celebrations, the parents recalled those difficult times when they were scared about their children safety.
Deepak Singh, father of Vikram Singh, who had a serious heart disease, said, "We had to take him to the hospital daily for checkups and after a lots of tests, we got to know that he had a hole in his heart. Those were the most difficult times of our life. But now that he is healthy, I have no words to explain how happy we feel."
A magic show, dance programmes and many other interactive sessions made the day special for the children. The enthusiasm of the kids soon inspired the adults too as many of them joined the little ones in the buoyant celebrations and some even shook a leg.
"Apart from the fun that we had, this event was a great platform to spread awareness about heart ailments. Also, families, which had gone through similar trauma, were brought together and the sharing of their knowledge and experiences, made the event a memorable one," said Dr Devananda.
He went on to add, "India, today, has the expertise and the knowledge to treat heart ailments, but we face two major obstacles. One is the lack of awareness and second is the non-availability of finance as insurance companies in India do not cover pre-existing diseases. We need to look into these issues now."
DR Harinarayan Conferred "Fellow of Academy of Medical Sciences (FAMS)" For Metabolic Bone Disease
Prof. Dr. C.V Harinarayan, Chief Consultant Endocrinologist, Specialist in Metabolic Bone Disease and Osteoporosis, Wockhardt Hospitals,Bangalore has been conferred the prestigious Fellow of Academy of Medical Sciences (FAMS) degree for his outstanding contribution in the field of metabolic bone diseases.
Prof. Dr. C.V Harinarayan through his work on metabolic bone disease has documented through extensive population surveys, the high prevalence of low dietary calcium intake and varying degrees of Vitamin D deficiency in South India. His groundbreaking work could potentially contribute to revision of national guidelines of dietary allowances for calcium and Vitamin D.
The FAMS degree is one of the highest and most coveted hallmarks of distinction in the medical profession given for original academic work in India.
Prof. Dr. Harinarayan M.D. (Int. Med.), D.M. (Endocrinology)has completed his DM in Endocrinology from AIIMS, New Delhi. He has many National and International awards to his credit. Prof. Harinarayan is an excellent clinician, accomplished researcher and scientist, with over two decades of experience. He is specialized in Endocrinology, Diabetes, Thyroid and Metabolic Bone Diseases. He has won several laurels for demonstrating wide prevalence of Vitamin D deficiency, as the predominant cause for radiological bone changes in Primary Hyperparathyroidism in India.
For appointments please click here or email us at enquiries@wockhardthospitals.net
World Epilepsy Day: Beware of Unwashed Vegetables
November 17th is observed as World Epilepsy Day .Eplilepsy is the commonest serious neurological disorder; prevalence figures ranging from 2 to 5 per thousand people.The World Health Organisation (WHO) estimates that 10% of people have a seizure at some point in their lifetime, with 50 million suffering from active epilepsy. A study conducted by the Christian Medical College in Vellore in 2006 estimated that neurocysticercosis is the cause of nearly one-third of all the cases of active epilepsy in both urban and rural regions of Vellore. The study estimated that "about 1 million patients in India with active epilepsy attributable to neurocysticercosis''.
Neurocysticercosis is a condition in which parasitic tapeworms, from contaminated water and food, find their into the brain of an unsuspecting individual. The colony of tapeworms, which are breed in the brain, can trigger headaches, epilepsy, imbalance and even sudden death. On National Epilepsy Day on Tuesday, most doctors feel the battle against epilepsy can be won to a great extent if two of the preventable causes, namely birth injuries and neurocysticercosis, are dealt with firmly and effectively.
Neurocysticercosis is caused by ingestion of undercooked food, such as pork or vegetables grown in fecally-contaminated water or near sewage tanks. "People don't wash vegetables or sometimes eat undercooked pork. Tapeworm eggs that could be present in these items get injested into the body and find their way to the brain,'' said Dr Praveena Shah, who runs the city's E-Cell and is attached to Wockhardt Hospital in Mulund.
About 50 million people worldwide have epilepsy, with almost 90% of these people being in developing countries. Epilepsy is more likely to occur in young children, or people over the age of 65 years, however it can occur at any time. Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. However, over 30% of people with epilepsy do not have seizure control even with the best available medications. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms but all involving episodic abnormal electrical activity in the brain.
source: times of india
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