Apollo Hospitals has launched its first Apollo Day Surgery at Alwarpet in Chennai. An innovative healthcare facility, it has been designed to provide comprehensive healthcare services to address all the health related needs of a family. It is a dedicated facility for minor surgeries requiring short-stay. Apollo Day Surgery was inaugurated by Dr. Prathap C. Reddy, Founder-Executive Chairman, Apollo Hospitals Group in the honorary presence of Mr. Andrew T Simkin, Consul General, US Consulate Chennai and Mr. Ajit Singh, Consul General, Consulate of The Republic of Singapore, Chennai. Apollo Hospitals’ keen focus on minimally invasive surgeries was the genesis of this dedicated facility for Day Surgeries or minor surgeries requiring duration of just 60 minutes or less in the Operation Theatre. Apollo Day Surgery is committed to early mobilization while maximizing patient convenience. Speaking at the inauguration, Dr. Prathap C Reddy, Founder-Executive Chairman, Apollo Hospitals Group, said, “”Apollo Day Surgery represents innovation and is a unique world-class ambulatory offering for enhanced patient convenience. Apollo Day Surgery, a contemporary, state-of-the art facility has been designed to motivate patients going in for elective surgeries and also those requiring short-stay surgeries with an offering that allows them to return home within the same day and recuperate in a familiar environment. I am confident that this new offering from Apollo Hospitals will soon surpass all patient satisfaction benchmarks””. Dr.Preetha Reddy, Managing Director, Apollo Hospitals, Group, added, “”The healthcare revolution in India catalyzed by Apollo Hospitals witnessed its beginnings at the erstwhile HM Hospitals, located in Alwarpet. So, it seemed just right to introduce this pioneering healthcare delivery endeavour – Apollo Day Surgery at Alwarpet. Apollo Day Surgery, co-located with Apollo Clinics, Apollo Emergency 24×7, Apollo Chest Pain Clinics and Apollo Pharmacy, offers a comprehensive and complete spectrum of healthcare services for the entire family””. Facilities at Apollo Day Surgery and Apollo Clinics, Alwarpet: State of art infrastructure spread over 5 floors offering Super-Specialist consultations across multiple specialties Ultra-modern Apollo Day Surgery facility spread over 4 floors, with a suite of 3-Operation Theatres with Laminar Flow, 16-Day beds and a dedicated Recovery bay Apollo Family Clinic with 12-consultation rooms and an Endoscopy suite An entire floor exclusively for Apollo Hospitals’ suite of Preventive Health Checks Comprehensive Laboratory and Radiology services An Emergency bay that provides 24×7 Emergency care Apollo Chest Pain Clinic in readiness for Cardiac emergencies 24×7 Apollo Pharmacy stocked with OTC and ethical medicine and surgical disposables First-rate surgical support for minor procedures   Patients and their families can contact the teams at Apollo Day Surgery by calling at 044-24672200 / 24988865 / 66 / 67 or send across a mail daysurgeryalwarpet_cni@apollohospitals.com for any healthcare assistance.

Mrs. Kamal Vadera, an 82 year old woman from Delhi came to Indraprastha Apollo Hospitals, Delhi with a history of cardiac problem, hypothyroidism, hypertension and breast cancer. She suffered a breathlessness attack in October 2010 when she had gone to visit her daughter in Mumbai. At that time, evaluation revealed no cardiac problems and after a few weeks of rest she came back to Delhi. After 2 months she again suffered an attack of breathlessness and was taken to a local hospital in Delhi where she was diagnosed with a cardiac problem. Because of her age, the doctors at other hospitals in the city advised her not to go undergo a surgery as it involved a lot of risks including death. “”My children were very tensed because of my condition and consulted many senior doctors in Delhi but in vain. Everybody had suggested me not to undergo an operation since it involved the risk of death. Then we consulted Dr B N Das at Indraprastha Apollo Hospitals who told us about the new technique which could save my life,”” recalls Mrs. Kamal Vadera. She further explains, “”Dr Das gave me the strength to undertake the surgery and showed me the confidence that I could lead a normal life post the operation.”” The procedure is most commonly performed for a condition called aortic stenosis, where the valve fails to open properly. A multidisciplinary team of doctors led by Dr B N Das, Senior Consultant, Cardiothoracic Surgery at Indraprastha Apollo Hospitals carried out a successful Aortic Valve Replacement Surgery. In this case, the surgery was prone to risk because of the age of the patient and also because the patient was refused treatment at other hospitals, the doctors had to be extra careful. “”Aortic valve replacement is a cardiac surgery procedure in which a patient’s failing aortic valve is replaced with an alternate healthy valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky (aortic insufficiency / regurgitation) or partially blocked (aortic stenosis). Aortic valve replacement is an open heart surgery and requires a lot of expertise especially in the case of older patients,”” explains Dr B N Das, Senior Consultant, Cardiothoracic Surgery, Indraprastha Apollo Hospitals. He further adds, “”It is critical to note that not all patients experience symptoms prior to aortic valve replacement surgery. Patients can be asymptomatic — without symptoms — and still suffer from severe aortic valve disease. It is for this reason that patients diagnosed with aortic valve disease, or even a tiny murmur, should actively monitor the condition of their heart over time via regular echocardiograms.”” Mrs Kamal Vadera underwent a 2 hour long surgery on 13 April 2011 and is now leading a normal life. She feels that Dr B N Das had given her a new lease of life and is grateful to the entire staff at Indraprastha Apollo Hospitals for instigating the confidence of living in her when she had lost all hopes.

Mr Sundar Raj aged 37 years an electrical engineer by profession can now hope to return to his work in a few months time. He had a tryst with destiny when he was involved in an industrial accident on June 3rd, 2011 and got his arm cut-off. He had a call to attend to a fault in a crane at his work spot at the Chennai port trust premises. Normally his team has four members who move around in a small van within the port. Since the call was for a minor fault he decided to go alone. After finishing his job he was on his way back to his room hoping to pack for home, as his shift was to end in about 10 minutes. However, fate had other plans for him. He tried to negotiate his van between two stationery container lorries and within seconds he found his right upper limb missing from his body. He had the shock of his life when he looked out and found his limb on the ground – he had had a total amputation of his limb. But Sunder Raj was not going to give up. Being all alone he got out of his vehicle, picked up his amputated limb and walked towards his friends seeking help. He was then rushed by the Apollo hospital ambulance to our hospital with the severed limb well preserved in ice. He was seen by the EMR staff and our registrars who resuscitated him and got him ready for surgery. He had sustained a total amputation of his right upper limb at the level of the distal humerus. He needed to have a reimplantation of the cut-off arm and this involved a team of surgeons who would have to work over the next several hours getting his limb reattached. The patient was soon on the operating table when Dr. Gayatri Krishnan Consultant Anaethetist and her team began to work on him to anaesthetize him. He needed to have a good IV access for various fluid and blood transfusions, arterial lines to monitor his pressures, warming of his body and his intravenous fluids and other monitoring devices. While this was being done, the plastic surgical team of Dr. Manjushree Naik and Dr. Ganapathy Krishnan started working on the amputated part. It had to be initially washed with several liters of saline to clean it of all contaminants. Next the muscles and the major nerves of the limb had to be identified and tagged as also the arteries and veins. The artery/vein was then flushed with heparinised saline to wash out the clots and keep the lumen patent. Once the patient was anaesthetized the orthopaedic surgeon Dr. Balaji Srinivasan, got ready to fix his bone. This was done with plate and screws and bony stabilization was achieved. Next the cut nerves, arteries and veins in the arm were identified and the muscles were sutured back. Dr. N Sekar, Vascular surgeon had now to do the vascular repair getting the artery and vein repaired back in place and this established the circulation to the limb. The anaesthesia team had to carefully monitor him now as he could go into a dreaded complication called reperfusion injury wherein once the circulation to an ischemic part is restored the collected toxic metabolites could enter the main circulation and cause several abnormalities. Sunder Raj was lucky not to have any such problem. After the circulation was reassessed and found to be fine the plastic team got to work repairing the major nerves, which are important for the future functioning of the hand. The exposed nerves and arteries/veins were also covered with a local muscle flap to protect them. To avoid a complication called compartmental syndrome the skin and the deeper layers of tissues on the forearm were cut and left open to release the pressure within the muscles, which was bound to develop. With this ended the almost 6 hour effort of the team of surgeons and anaesthetist to reattach the amputated limb and it was a happy ending. Sunder Raj had an uneventful post operative period. After 5 days he was taken back to the OR to assess his wound, which was found to be healthy. At this stage the open wound in the forearm was covered by a skin graft taken from his thigh. At periodic intervals his wounds were examined and all his wounds had healed and he also had a good take of the skin graft. All the while he was monitored closely and was on various medications to avoid complications and to maintain a good blood flow and also needed multiple blood transfusions. Fortunately for him he developed no complications and was discharged after 2 weeks in a stable condition with a viable upper limb. Complete amputation at the arm level is luckily quite rare and reimplantation at that level has the highest failure rate. The amount of muscle bulk below the level of the amputation which becomes ischemic is what causes the failure of the procedure. The factors that were favourable in our case were : Age of the patient with no associated medical diseases. The fact that the Plastic Surgery team were able to advise the emergency exactly how to store the amputated limb – it needs to be wrapped in moist saline gauze and placed in an empty polythene packet, which in turn needs to be placed in a packet filled with ice – never should the part be put directly into saline or be in direct contact with ice.. Since there is very little awareness about this among the lay public and also the health workers the opportunity to salvage the limb is lost many a time due to improper storage. The speed with which we could mobilize the case so that the vascular anastomosis could be done within the ideal ischemic time. The excellent team work by the various specialists.   The road back to complete recovery for the patient is going to be a long one. Though the limb is viable it is not functional yet. The nerves will need to grow from the repaired site up to the tips of the fingers. The rate of growth is approximately one mm per day. He now needs to be on regular physiotherapy to prevent atrophy of his muscles and tendons as well as stiffness of his joints and also needs to have periodic assessment to monitor the functional recovery in the hand. He may even need some ancillary reconstructive procedures at a later date. But as with everything in life, ‘a job well begun is half done’. The day he is back to his usual profession would be the happiest day for the surgeon.

Prof. Dr. K. Ganapathy, President, Apollo Telemedicine Networking Foundation was invited to deliver a key note address at the mHealth Summit organized by GSMA and the mHealth alliance. More than 600 delegates from 30 different countries took part in this meeting. Dr.Ganapathy, President, Telemedicine Society of India signed a MOU with American Telemedicine Society to further close collaboration between India and the USA in the field of Telemedicine. The ATA is the world’s largest Telemedicine society and their desire to have a formal relationship with the TSI speaks volume for the growth of Telemedicine in India. Apollo Hospitals is pleased to have played a major role in this. For more details, please visit http://www.mobilehealthlive.org/articles/keynote-health-professionals-have-to-lead-mhealth-market/1414/

Apollo Hospitals will render specialist health services in Tanzania following the signing of a Memorandum of Understanding ( MoU ) between India and Tanzania. Three agreements were signed between India and Tanzania on Friday, among which the first one was a joint venture to increase trade and small-scale industries between the two nations. The second was to start a chain of Indian hospitals especially known for heart treatments in association with the Ministry of Health and Social Welfare of Tanzania. The third agreement was an agreement for the avoidance of double taxation and the prevention of fiscal evasion with respect to taxes on income. Apollo Hospitals Chairman Dr. C Prathap Reddy said that the prime motive of the group’s venture in the African nation would be to spread awareness and render preventive health care. “I am glad that we are at Tanzania, but this is not the beginning or the end of it. There are a lot of expansions going on. We are into 360 degrees of health care. This is why I have said that we have excelled in clinical excellence. We have got the service excellence, technological excellence, but using technology we are trying to build 360 degree of health in bringing awareness, bringing prevention, we have done world’s largest preventive check- ups apart (from) treating 20 million people, ” Dr. Reddy said. He further mentioned the concentration of their hospitals in Tanzania would be to provide world-class health facilities to the patients. This is going to be a brand new land, virgin land on which we are going to build a hospital which will suit our design to deliver tertiary and cardiac care hospital for people who do not have to go to other place majority of times.

Apollo centre for liver disease and transplantation has completed 100 liver transplantations in less than 4 years with over 90% success rate, creating a milestone in the history of medicine. There is a noticeable rise in the cases of liver diseases in India which will result in a greater need for treatment in the coming future than the current availability. As a pioneer in the healthcare sector, Apollo Hospitals is fortifying the facilities throughout the country to meet and battle the need. Addressing the Media, Dr. Prathap C Reddy, Chairman, Apollo Hospitals Group said, “”Apollo is the only healthcare unit in India to establish a world class facility for an independent liver transplantation program. We offer the patients comfort and care in all aspects of treatment and we also try to provide them a compound financial package which helps them in planning and accounting expenses. Understanding that liver treatment is still an expensive cure in India, we are also working with leading financial institutions for easy arrangement of finances for the patients and their next of kin.”” He further added, “”Apollo Chennai has the largest and only cadaver transplant department in the country. This is again a benchmark in the Indian healthcare scenario where every other program consists of living transplants which is a troublesome process involving the patient and a donor.”” Elaborating on the Liver Transplant Program, Dr. Anand Khakhar, Senior Consultant Liver Transplant & Hepatobiliary Surgery and program Director for the Liver Transplant Program at Apollo Hospitals, Chennai said, “”Liver transplantation is a surgical procedure whereby a diseased or failing liver is either removed and replaced by a whole new liver from a deceased donor, or where part of a healthy liver from a living donor is removed and inserted to the failing liver of the recipient. The 100 surgeries benchmark has been crossed by the Chennai department much faster than the programs in other cities such as Delhi or Mumbai. The goal of the program is to not only raise awareness about the importance of a healthy liver and the dangers that can be caused by a liver disease, but to also provide the access to treatment geographically and financially.”” Liver failure is a potentially fatal condition in which the liver progressively stops performing its functions resulting in episodes of jaundice, accumulation of fluid in the body, blood vomiting and confusion. Conditions such as Hepatitis B or Hepatitis C infection, excess alcohol consumption, diseases such as Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis can cause this state.

Team of super specialist doctors headed by Dr. G. Sengottuvelu, Senior Consultant & Interventional Cardiologist, Apollo Hospitals, used a specially designed mesh covered stent (M GUARD STENT) to capture the 80% blood clot that was formed in his right coronary artery that had migrated down to all the small branches in the downstream which led to acute heart attack. Dr. Sengottuvelu said, “”Dukahram a 27 years old male, glass factory worker with strong family history of premature heart attack (his father had a heart attack at the age of 45 years), was diagnosed with an acute heart attack, and found with blood clot in his right coronary artery that migrated down and unusually blocked all the small branches in the downstream, risking his life. This latest technology the M guard stent was useful in trapping the blood clot without any further breaks, the device also gave us a high procedural success with low rates of clot dislodgement into distal branches during the deployment””. He also added, “”M guard stent helped us to complete the surgery within 20 minutes, thereby reducing the complications and the risk involved in the surgery ensuring quick recovery of the patient””. In order to clear the clots in the small vessels, the clearway catheter another recent technology was introduced through which a strong anti clotting drug was injected directly to dissolve the clot. This unique M guard stent proves very effective in preventing further clot dislodgement. Acute heart attacks are increasingly seen in younger population particularly smokers. There is an urgent need to educate public on the importance of early arrival in the hospital after the onset of chest pain. Acute Heart Attack (Acute myocardial infarction) is on the rise in young adults and carries a significant morbidity, psychological effects, and financial constraints for the person and the family particularly when it occurs at a young age. The protection offered by young age has been slowly taken away by the increased prevalence of risk factors for CHD in adolescents such as smoking, obesity, and lack of physical activity. Better prognosis among young adults is achieved when early appropriate treatment is offered and saving more muscle mass from permanent damage by using these newer devices.

Santhosh, 27, went into the emergency room of a hospital sweating profusely and with complaints of fatigue and mild chest discomfort after playing a cricket match on Sunday noon. Doctors quickly concluded that he was exhausted and dehydrated. Santhosh, who works for a glass factory, was sent home after doctors advised him fluids and rest. Four hours later, when he returned with breathlessness, an ECG was taken. The results showed that he suffered from acute heart attack. His family whisked him away to the cardiology care unit of Apollo Hospitals on Greams Road, Chennai. Investigations there showed that a huge clot in a big blood vessel of the heart had migrated into the smaller ones affecting the blood supply to different parts of the heart muscle. This triggered a heart attack. Doctors instantly told his relatives that his condition was critical. They wheeled him in for an emergency surgery. A new equipment and advanced technology saved his life. Summer exhaustion, cardiologists say, can be misleading and delay diagnosis of heart attacks. The most common condition that delays diagnosis for heart attacks are heart burns. When stomach acid gets into the esophagus or throat it causes a burning sensation. Patients with heart burns mostly complain of chest uneasiness like in heart attack. “”This misleads many doctors. Now there are cases misconstrued as heat exhaustion,”” Dr G Sengottuvelu, Senior Consultant and Intrvention Cardiologist at Apollo Hospitals, Chennai. Doctors who first saw Santhosh probably assumed that he was too young to have a heart attack or that it was normal for people to feel uneasy if they tire themselves out under the scorching sun. But what the doctors did not see was that Santhosh was in the high-risk group. He was a smoker and had a family history of heart attacks. His father died of heart attack at the age of 45 and his grandmother suffered heart attacks at the age of 55. If the doctors had suspected a heart attack and given him blood thinners, it would have delayed some problems like migration of the clot. “”Surgery might have been unavoidable. In heart attacks, there is no golden hour, it is platinum minutes,”” Dr Sengottuvelu said. Santhosh came to Apollo Hospitals after five hours of the symptoms. Had the clot moved further down, he could have had a massive attack. If it had gone up to the brain, it could have caused a stroke. A week after the surgery, Santhosh has now been declared fit for discharge. He will have to be on blood thinners for a long time. “”I am being counselled to kick the butt. I used to smoke five cigarettes a day. I will do my best to care for my mended heart,”” Santhosh said. But many aren’t as lucky as Santhosh. Three years ago, 29-year-old Vijay, who was taken to the hospital with severe chest pain and shoulder pain was treated for acid reflux. By the time doctors diagnosed a heart attack, it was too late. Vijay, a thin tall boy, who never smoked, died. Heart attacks are the biggest killers in the country. Studies have shown that Indian hearts age faster than those of Westerners. Results of a 2010 study by Apollo Hospitals with the Indian Council of Medical Research found that some heart disorders including blood vessel blocks found in 35-year-old Indians are similar to those found in an average 60-year-old in the US. “”Indians are predisposed to heart diseases and the progression of the diseases is faster,”” said Dr. Prathap C Reddy, Chairman Apollo Hospitals Group. Nearly 40% of patients with heart attack die before they come to hospitals.

The cardiac surgery department of Satguru Partap Singh Apollo Hospitals, Ludhiana, has introduced multi-vessel beating heart coronary artery bypass surgery, using Minimally Invasive Cardiac Surgery (MICS) technique. The full range of MICS surgery is now available on regular basis at the hospital. “”Major advantages of MICS surgery is very early return to active life, with minimal pain and need for painkillers. Requirement of blood, hospital stay and chances of infection are significantly low as compared to the older technique,”” said Dr K C Mukherjee, Senior Consultant, Department of Cardio Surgery. Rashpal Singh, 78, had suffered a heart attack a few months ago and his angiography revealed critical coronary artery disease requiring bypass surgery. Dr.Mukherjee said his team performed a surgery on him and the patient was discharged within five days.

Super specialist team of doctors headed by Dr. Sunder, Cardio Thoracic surgeon, Apollo Hospital Chennai, reduced the agony of Mr.Karunakaran by performing a demanding surgery ensuring him a quick recovery from deep organ burns that deprived him of his vocal ability and breath. Dr. Sunder, Cardio Thoracic Surgeon, Apollo Hospital Chennai, said “After a 3 hours surgery Mr. Karunakaran from Ramanathapuram, is now quite a celebrity among the doctors and nurses at Apollo Hospitals since he has survived a severe organ burn, where in the iron rod burned the outer part of his wind pipe and the food pipe puncturing his lung and affecting his thoracic duct that brings the khyle fluid to the heart for its proper functioning”. Dr.Sunder, explained “It was an extremely complicated grafting done with the help of endoscopy in which the inner part of the food and the wind pipe were found to be intact where as the outer part of the both suffered burns, we further proceed with the actual surgery where all his cooked up tissues were transferred with a fresh ones. Sustaining a life threatening injury with a red-hot-iron rod shows the patient’s remarkable courage”. It is a known fact that burn victims with 50 percent of external burns have low survival rate. The patient had a part of his lungs and other organs burned this could have led to dysfunction of organs too. Hence this unbeaten surgery was to ensure his recovery.

Four-yr-old Isha, who was diagnosed with thalassaemia major, underwent stem cell transplant surgery at Apollo Hospitals Ahmedabad. Doctors told the parents, Mansukh Gohel & Kanchan that she will have to undergo regular blood transfusions to stay alive. The couple was disheartened but instead of crying about the situation, decided to fight for their daughter’s better life. Mansukh and Kanchan had brought Isha to Apollo Hospital in Ahmedabad, seeking a new lease of life for their daughter who had had been receiving blood transfusions since she was 18 months old. Dr Chirag Shah, who consulted the case, advised a stem cell transplant surgery, the only curative option for thalassaemia major. “”After diagnosing Isha, we found that the four-year-old was a Class 3 thalassaemia major case, which was a major challenge for us. Such patients are not usually advised to undergo this surgery,”” said Dr Shah. The first step to Isha’s treatment was to reduce her iron overload which required extensive iron chelation medicines and regular follow-ups. In January, a minor operation was performed to remove her spleen. A small biopsy from her liver showed very high levels of iron deposition (4+ which is the highest level). There were signs of liver damage, too. In February, she was put on a special protocol of medicines to reduce her risk of being Class 3, which went on for over a month. She underwent the surgery in April. The donor was her brother Pratik who is now two and a half years old. Soon the couple, who faced financial difficulties during Isha’s treatments, got the news that her stem cell transplant had succeeded. “”Isha was given special medicines to clear her old blood-producing stem cells. Transplant was then performed, wherein Pratik’s stem cells, collected from his bone marrow, were transplanted in her,”” said Dr Shah. Isha is now on the road to recovery and would be transfusion-free forever in a couple of months, assured Dr Shah.

S N Bhatt, a 93 year old man from Bhilai came to Indraprastha Apollo Hospitals, Delhi with a 10 year history of progressive knee pain and deformity in both the legs. A multidisciplinary team of Dr. Raju Vaishya, Senior Consultant, Orthopedics at Indraprastha Apollo Hospitals carried out a successful Bilateral Total Knee Arthroplasty in a single sitting. Mr. Bhatt who is a retired college principal and has always led an active life. Apart from having keen interest in horses, he was an avid hockey player and had played with the legendary, Dhyanchand. He came to the Hospital in April 2010 and was diagnosed with severe arthritis of both the knees and has been unable to walk for the last 10 years. He had been confined to using a wheel chair to ambulate for the past one year. The surgery performed is one of its kinds as Mr. Bhatt is the one of the oldest men in India to have undergone this procedure. It proves the point that in some selected and determined patients with good medical condition, it is possible to replace both the knees in single stage even at the age of 93. Usually, patients of such an old age are not recommended to undergo this surgery because of the complications involved. Owing to Mr. Bhatt’s good medical condition, the doctor decided to go ahead with the operation. “On evaluation and pre assessment it was found that due to extreme deformity in both knees caused by arthritis, the patient was unable to walk. The only option available was a total knee replacement surgery which is not suggested to patients over 90 years and is very rarely performed. Apart from controlled hypertension, he did not have any other co-morbid problems. So we decided to perform a single staged bilateral total knee replacement surgery post discussions with the patient and his son,” said Dr. Raju Vaishya, Senior Consultant, Orthopedics, Indraprastha Apollo Hospitals. “While operating, we found bone defects in the tibia. These were corrected through bone grafting,” added Dr Vaishya. Mr. Bhatt underwent a 3 hour surgery on 14th April 2011 under spinal/epidural anesthesia. At surgery, huge bone defects in the tibia were found which also required bone grafting. Bilateral Total knee replacement, or total knee arthroplasty, is a surgical procedure in which parts of the knee joint are replaced with artificial parts (prostheses).”The patient started walking after 4 days of surgery and his knee deformities have been fully corrected. His post-surgical period and the surgery went successfully,” said Dr. Raju Vaishya. Mr. Bhatt feels that these new pair of knees have given him a new lease of life and with his positive frame of mind, he feels that it would be possible for him to lead his life comfortably without any pain and disability.