A Complex Surgery to Save Eyes of A 26-year-old Accident Victim with Multiple Facial Fractures

 Wockhardt Hospitals, Mira Road Successfully Performed A Complex Surgery  to Save Eyes of A 26-year-old Accident Victim with Multiple Facial Fractures

 

Mumbai: A team led by Dr. Abdul Hameed, a Consultant Maxillofacial Surgeon, Wockhardt Hospital, Mira Road, successfully operated a 26-year-old accident victim for multiple facial fractures to save his eyes and eliminate the risk of vision loss. The patient was discharged without any post-operation complications and under follow-up for two-three months.

A 26-year-old Yash Kanojia, a resident of palghar, met with an accident while traveling on a bike. Initially, he was admitted to the local hospital for primary care later patient was shifted to Wockhardt Hospitals, Mira Road.

Dr. Abdul Hameed, Consultant Maxillofacial Surgeon, Wockhardt Hospitals, Mira Road, said, “On arrival in an emergency the patient was critical and was advised immediate CT Scan to rule the situation of the eye and facial fractures. His CT scan revealed that there were multiple fractures on the face involving the bones around his eyes and that could have led to the vision impairment. Hence, the patient was advised to undergo fixation of all the facial bone fracture and exploration of eye and repair of the orbital bone fractures impinging on the eyeball, once he was neurologically fit for the surgery till then he was managed with medications.”

Dr. Hameed added, “To avoid further complications, it was decided to perform the surgery in one go.  The surgery lasted for 3-4 hours. The surgery was carried out smoothly with desired results. Timely intervention, proper diagnosis, and treatment can save people.”

 

“His life was shattered after that ghastly accident. He had bruises all over his face and he couldn’t even see properly as the facial fractures compressing his eye.  We were disheartened and not able to understand but doctors at the hospital gave us hope and assurance that he will be fine. We thank the doctors for their prompt treatment for saving his eyes in fact his eyes. 2021, have got a fresh lease of life to our son,” concluded the patient’s father Papu Kanojia.

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Conjoined Twins Return Home In The New Year After Successful Separation At Wadia Hospital

 Conjoined Twins Return Home In The New Year After Successful Separation At Wadia Hospital

~A team of doctors at B.J. Wadia Hospital Performed a landmark surgery of 6-hours on the twins conjoined at abdomen~

Mumbai: A team of paediatric surgeons, neonatologist, paediatric anesthesiologists, plastic surgeons, radiologists, cardiac surgeons at Bai Jerbai Wadia Hospital for Children, Parel successfully separated conjoined twins through a 6-hour complicated surgery on January 3, 2021. Both girls who were joined at the abdomen and shared a liver, lower chest bone and abdominal cavities are now living as two healthy kids.

A young couple were delighted with their pregnancy. But, the lady felt devastated after an antenatal ultrasound scan performed suggested that they have twins who are joined at the abdomen probably conjoined. However, the couple approached Bai Jerbai Wadia Hospital for Children, Parel in brave determination to bring these two lives to the world overcoming all the problems with a lot of hope.

Doctor said, “The twins were Omphalopagus joined together from chest bone toumbilicus. Extensive counseling of parents about the complexity and rarity of the condition and knowledge preparation of treating team started soon after they approached the Wadia Hospital. Every aspect of treatment was challenging starting from the safe delivery of children to successful separation. The mother was followed up closely till term and then the twins delivered by a planned cesarean section in the presence of whole team. The babies had a combined weight of 4.2kg at birth, were kept in the NICU after birth. The babies were clinically active and fused at the abdomen from the lower part of the sternum to the common umbilicus. The babies then underwent extensive investigations to understand the anatomy and complexity of separation surgery.

Doctor added, “On CT scan imaging, the twins shared a liver, lower chest bone, and presumably intestines. They were nursed maintaining some distance to stretch the tissues so as to obtain adequate cover at the time of surgery. The decision of going into separation was a perplexing task. Delaying surgery till babies grow makes surgery easier for surgeons but difficult for parents to look after them.” 

Doctor underscored, “One baby was pink while the other was pale. CT scan also showed one major vessel going from one baby to another resulting in differential circulation. This is known in omphalopaguses sharing common liver which ultimately leads to overloading one baby in turn cardiac failure. All the complexities, risks, and benefits of early versus late surgery were discussed with parents who opted for separation surgery which was carried out on Day 14 of life on 3/1/2021. The surgery was performed by the team of paediatric surgeons anesthesiologis in the presence of  neonatologists and cardiovascular thoracic surgeons in the operation theatre.”

“They were having a common liver and were joined from the lower chest bone up to the umbilicus. Special technology of cutting liver using a harmonic scalpel and T seal was used which minimized blood loss to less than 10 ml. The entire procedure lasted for 6 hours and the babies needed post-operative ventilator support for 2 days. Gradually, the babies were started on feeds since Post-operation, day 3. The babies are now active on full feeds with gradual weight gain, their wounds have healed well.”

Doctor said “ After discharge, we have designed a multidisciplinary follow-up programme to monitor the growth, development, nutrition, liver function and immunization of the babies.”

 “Conjoined twins are seen in 1:50000 to 1:200000 of all live births and less than 300 successful surgical separations are done in the past.  Omphalopagus twins comprise 10% to 18% of all conjoined twins. This is the fourth successful separation of conjoined twins successfully performed at Wadia hospital, the last three being in the last 7 years.  The success rate of conjoint is about 50 %. The exhaustive preoperative assessment, planning, and encouraging as well as financial support from the management lead to a 100% success rate. At 2weeks, the twins underwent this challenging surgery and are ready to go home”, said  CEO Dr Minnie Bodhanwala.

“We were excited on my pregnancy, but, were petrified when informed that the twins were conjoined. Doctors at Wadia Hospital explained every minute detail about the rare surgery and ensured that the twins can lead a normal life after separation. The surgery was done seamlessly, and the hospital didn’t charge a single rupee for it. After separation, we haven’t faced any problems and are taking care of them like normal kids. We are elated that the kids have got a fresh lease of life this New Year,” concluded twins mother Neha (name changed).  

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Are you suffering from Empty Nose Syndrome?

Anik

et Singh (name changed) had everything going for him — a successful career, fulfiling relationship and steady finances. But despite seeming to have it all, Aniket was depressed. His family started noticing a change in his behaviour and tried to coax him into visiting a psychiatrist. Aniket decided to check with his GP first. As he started recalling his past medical history and medical symptoms, his doctor realised that Aniket wasn't suffering from a psychological disorder. Rather, he had the Empty Nose Syndrome (ENS) — a very unique and rare condition where one loses the sensation that he/she is breathing.

Says stemcell transplant surgeon Dr Pradeep Mahajan, "This happens because the part in the nose called as inferior or middle turbinate that is responsible for this function is excised or disturbed during a nasal surgery. Most of the symptoms in ENS arise because of improper neurosensory receptors, ineffective air conditioning and humidification. Turbinate tissues are recognised sources of certain nerve growth factors, an intrinsic protein that is critical for the natural healing process. When the turbinates are damaged and not functional, the healing process cannot be orchestrated and no nasal message can be carried to the brain."

Adds ENT specialist Dr Sanjay Bhatia, "ENS is a combination of symptoms and causes a sense of nasal obstruction. It was first described by Dr Eugene Kem in 1994."

Symptoms

The most common type is described as ENS-IT. Explains Dr Mahajan, "A patient feels emptiness and very dry in the nose constantly. A person goes into depression in most of the cases. Two other subtypes are also identified based on the symptoms, like in ENS-MT; where there is involvement of the middle turbinate and a patient feels pain while breathing. In the third type, both the turbinates may be involved, with both types of symptoms."

"Watch out for nasal obstruction, crusting and dryness of the nose, which are predominant symptoms. This is inspite of a large roomy nasal cavity after the nasal turbinate resection," says Dr Bhatia.

Diagnosis

According to Dr Mahajan, diagnosis of ENS is based on subjective evaluation.

• A thorough history taking with symptoms evaluation
• History of prior nasal surgeries
• Nasal endoscopy
• Cotton test
• CT-PNS (Plain)
• Modified SNOT 25 questionnaire
• PNIFR evaluation (Peak Nasal Inspiratory Flow Rate)

Treatment

The aim of the treatment should be to restore the inner geometric contours of the nasal passage, to re-establish nasal resistance, to restore normal nasal function including humidification, heat regulation, filtration and airflow sensation. "Once diagnosis is done, conventional medical management involves nasal lavage, use of nasal hydration ointment, directed antibiotherapy, aerosols and local corticosteroids. Until recently, there was no solution for this syndrome; till a few workers tried some treatments using stem cells. The results have been not so consistent. Treatments using platelet rich plasma, platelet rich lipotransfer and Acell have been tried by a few seniors world over, with transient and inconsistent results. A novel and bold approach is to use self-limiting biological scaffolds along with autologous bone marrow concentrate and certain specific growth factors," says Dr Mahajan.

How common is this ailment in India?"As turbinate surgeries are common in routine nasal surgeries and also in malignancies, not many patients have the symptoms," says Dr Bhatia.

ENS is a relatively new entity. In most situations, it goes unnoticed and is under-diagnosed. Recent reports mention a rate of 0.2 per cent of patients who undergo nasal or septal surgery show signs and symptoms of ENS. "In India, though similar prevalence is expected, even the ENT specialists will need to be made aware and educated on this. Protocols for diagnosis as well as composite biological therapy need to be worked upon, developed and standaridised," ends Dr Mahajan.

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http://timesofindia.indiatimes.com/life-style/health-fitness/health-news/Are-you-suffering-from-Empty-Nose-Syndrome/articleshow/53878132.cms 

#Gloocal Communications | AN OPEN HEART: DOCTORS OPERATE, SAVE ABANDONED BABY WITH CARDIAC DEFECT

AN OPEN HEART: DOCTORS OPERATE, SAVE ABANDONED BABY WITH CARDIAC DEFECT

By Lata Mishra, Mumbai Mirror | Feb 20, 2015, 12.38 AM IST

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Dr Suresh Joshi with a Bal Asha Trust employee and baby Maria

Two-month-old Maria was taken to Wockhardt Hospital for treatment by the Bal Asha Trust.

Authorities at the Bal Asha Trust were a worried lot after a woman came in with her baby a day before Christmas last year, saying she couldn't afford medical treatment for 23-day old infant she claimed was born out of wedlock.

Naming the baby Maria, they took her to Wockhardt Hospital near Byculla for medical examination where doctors discovered she was suffering from a congenital birth defect of the heart, and an open heart surgery was the only option to save her life.

Senior cardiac surgeon Dr Suresh Joshi, who operated on her, said, "The baby was brought to the hospital in a very bad condition. She was having breathing difficulty and high fever. After examining her, we came to know that the baby is suffering from cyanotic heart disease that occurs due to deoxygenated blood bypassing the lungs and entering the systemic circulation, or a mixture of oxygenated and unoxygenated blood entering the systemic circulation. It is caused by structural defects of the heart."

He added that this condition is associated with non-development of the right ventricle and with very high pulmonary pressures. "This condition needed a three-stage surgery to correct the defect," added Dr Joshi.

The first stage of the complex surgery was finally completed two weeks ago by Dr Joshi and his team. "The child requires two more operations. We will wait for six months and complete the remaining stages," added Dr. Joshi.

Jaishree Godpa, superintendent at the Bal Asha Trust, said, "The baby's mother approached us and told us that she doesn't want this child as she can't afford the medical treatment. The baby was just 23 days old. We approached the Child Welfare Committee and the girl was handed over to us after following the prescribed legal procedure. We named her Maria as her mother hadn't named her yet."

"We are really thankful to Dr Joshi who operated on the baby and saved her life. The hospital, too, didn't charge a single paisa from us. Otherwise, open heart surgery for children costs up to Rs five lakh in a private hospital," she added.

In the past two years, Dr Joshi had performed surgeries on two orphan girl children from the same trust. "Both girls have been adopted and both are doing well. While one was adopted by a city doctor's family, the other was adopted by a couple from Germany. I'm sure Maria will also get a home and new parents one day," he said

#Gloocal Communications | Infant with rare defect survives heart surgery

Infant with rare defect survives heart surgery

Mar 15, 2015 - Swati Jha | 

• Mumbai

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The case of Zayan Sheikh — the baby who survived a fatal defect where the blood from his heart was being distributed in his body without being purified in the lungs — does not cease to amaze doctors. The five-week-old boy underwent the complicated arterial switch operation and stabilised out of it within 24 hours.

Explaining the rare case, Dr Suresh Joshi, senior paediatrician and surgeon, Wockhardt Hospital, said, “In Sheikh’s case, the blue impure blood coming from the heart was being distributed in the body without getting purified in the lungs. The child had no mixing of blood as he had a very small Patent Foramen Ovale, which is responsible for transportation of blood.”

According to doctors, Sheikh was born blue and was suffering from significant respiratory distress and breathlessness. According to the National Centre of Biotechnology Information, the mortality rate in such a disorder is less than five per cent in the state.

“The survival rate is low in Maharashtra due to non-availability of specialised unit for paediatric care. The other associated reasons are non-availability of experts in the area due to which many a time, doctors lacking in expertise operate the baby,” said Dr Joshi. He added that Sheikh’s case was special for the hospital as he was born with the added complication of a hole in his heart.

About the operation, Dr Joshi said, “In this surgery, the artery on the right side of the heart is detached and implanted on the left side, where it is supposed to be and the pulmonary artery is transferred to the right side from its abnormal left-sided origin.” He said the complexity of the surgery lay in transferring very tiny coronary arteries that are about 1-2 mm in size.

The baby was taken off the ventilator in less than 24 hours and discharged from the hospital within a week; extraordinary considering a child generally takes 20 to 25 days for complete recovery.

#Gloocal Communications| Nonagenarian gets back on his feet after hip replacement surgery

Nonagenarian gets back on his feet after hip replacement surgery

When 96-year-old Tribhovandas Udeshi, a Parel resident, fell at his home a few days ago and had a hip fracture, his son Suresh wondered if his father would ever walk again. The accident left the nonagenarian in excruciating pain. He was taken to various city hospitals and clinics where he was advised to undergo hip replacement surgery. However, none of the health care facilities Udeshi was taken to was ready to operate upon him because of the risk involved due to age factor.

• Parel resident Tribhovandas Udeshi, 96, with his son Suresh (extreme left) and Dr Hitesh Kubadia, who performed the surgery

When 96-year-old Tribhovandas Udeshi, a Parel resident, fell at his home a few days ago and had a hip fracture, his son Suresh wondered if his father would ever walk again. The accident left the nonagenarianin excruciating pain. He was taken to various city hospitals and clinics where he was advised to undergo hip replacement surgery. However, none of the health carefacilities Udeshi was taken to was ready to operate upon him because of the risk involved due to age factor.

After referring the case to many specialists in Mumbai, the Udeshi family finally met Dr Hitesh Kubadia, consultant orthopedic surgeon at Nova Specialty Group of Hospitals.

Dr Kubadia recommended full-replacement of the left hip through the minimally invasive procedure. "The minimally invasive hip replacement surgery involves replacing the ball of the femur that is worn from arthritis, degeneration or a serious fracture. Special bone cement is used to heal the fracture. Similarly, with minimally invasive hip replacement, there is less cut-through of tissues. It was not the case of making the 96-year-old mobile, but to allow him to live an independent life," explained Dr Kubadia.

"Major complications do arise as you age. Thus, our effort was to optimise the patient and then go ahead with the surgery. In case of Udeshi, we had to conduct physical investigations for almost two days before deciding on the surgery. A special team of doctors was frequently monitoring his health," Dr Kubadia added.

"My father had always lived an active life until that fall, which not only broke his bone but also broke our heart that the fracture will leave him bedridden. But a few days after the surgery, he has started to walk with the help of a walker. Eventually, we are hopeful of getting him back to his usual self," said Suresh.

Udeshi has made a full recovery, said Dr Kubadia. "The surgery has always given 100 per cent result. Although Udeshi is currently walking with the help of a walker, he is confident enough that he can walk independently," he added.

Doctors say hip fractures in the elderly are critical ailments with possible life-endangering complications. Surgeries to fix breaks are common and effective, while healing can take an entire year. Once a senior citizen gets a broken hip, their health can take a downward spiral as the break can trigger other problems and affect their immune system. By 90 years of age, one in four women and one in eight men have get their hips fractured.

#Gloocal Communications : 97-year-old learns to walk again

97-year-old learns to walk again

Udeshi with doctor Kubadia (right) and a relative

For 97-year-old Tribhovandas Udeshi, regaining the use of his legs is like getting a new lease of life. The nonagenarian had met with an accident 15 days ago and had begun to lose all hopes of recovering after he was denied treatment by 15 clinics in the city.

Mr Udeshi, a Parel resident, slipped and fell at his home a few days back and had a hip fracture that left him in excruciating pain.

Doctors from the various hospitals had suggested that the fall had had severe repercussions on his left hip and surgery was the only option. However, nobody was ready to take the risk of operating on a 97-year-old patient. Being a patient of arthritis (his femur ball was affected) and old age had further complicated matters for him.

It was not just a surgery that Udeshi’s family members wanted; they were looking for a procedure that would allow him to lead an independent life.

Suresh Udeshi, Mr Udeshi’s son said, “My father had always lived an active life and it broke his heart that the fracture will leave him bedridden. The accident and the hopelessness induced by the doctors had left him disheartened.”

The family soon found hope in Dr Hitesh Kubadia, consultant Orthopedic Surgeon at Nova Hospital who took up his case. The doctor recommended full-replacement of the left hip through minimally invasive procedure, though he was uncertain if the procedure would bear fruit or not.

“The minimally invasive hip replacement surgery involves replacing the ball of the femur that is worn from arthritis, degeneration or a serious fracture. Special bone cement is used to heal the fracture. Similarly, with minimally invasive hip replacement, there is less cut-through of tissues,” explained Dr Kubadia.

He added that major complications do arise as one ages because of which the doctor’s effort to optimise the patient’s condition and undertake a surgery becomes difficult. “In case of Mr Udeshi, we had to conduct physical investigations for almost two days before deciding on the surgery. A special team of doctors were frequently monitoring his condition,” said Dr Kubadia.

Though the surgery undertaken was a difficult one, it was minimally painful for Mr Udeshi and he has now made full recovery in just 48 hours despite his advanced age.

Dr Kubadia also said that that patients should believe that despite old age, bones can be set and fractures can be mended