Dr Kaushal Malhan, knee and hip surgeon at Mulund’s Fortis Hospital

Woman, 56, needs knee replacement after being over-prescribed steroids

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The Nigerian national was ministered 10 steroid injections in a matter of months, when not more than 3-4 are recommended in a year for one joint

November 20, 2013

MUMBAI

Anuradha Varanasi

In yet another case that points to the dangers of indiscriminate steroid use to treat medical conditions, a 56-year-old woman had to undergo a bilateral knee replacement after she was over-prescribed steroid injections for almost two years, leading to severe ligament damage in both of her knee joints.

On the road to recovery: Rebecca is now undergoing physiotherapy at the hospital and is able to walk short distances without any support. Pic/Sameer Markande

Rebecca Ihejieto, a Nigerian national, had been suffering from osteoarthritis in both knees since 2006, for which she was undergoing treatment back home. While Rebecca, a secondary school teacher, had retired in 2011 due to health problems, she has been wheelchair-bound for the last two years, after her local doctor administered her 10 steroid injections in a matter of months. Usually, a patient should be given steroid injections not more than three to four times a year in a single joint area.

“I would get relief from the pain for a few hours after the injections, but after several months, my knees became even weaker and started bending outwards, due to which I couldn’t walk,” shesaid. With her knees protruded at 45 degree angles, she had to use a stick for support. Rebecca found the pain increasingly difficult to bear — this is when her family friend suggested she visit India for treatment.

Shortly after arriving in the city for her treatment, Rebecca underwent bilateral knee replacement in the first week of November. Dr Kaushal Malhan, knee and hip surgeon at Mulund’s Fortis Hospital, said, “The X-Rays revealed that that there was severe knee joint damage and the ligaments were not supporting her knees any more due to more than 50 steroid injections being administered to her in a span of around two years.” “We performed a tissue-preserving technique before the replacement surgery to preserve her bone, and did not require any blood transfusions,” added Dr Malhan. 

He added that the intra-articular steroids prescribed to her are the standard steroid used all over the world to treat osteoarthritis. Rebecca is now undergoing physiotherapy in the hospital and is able to walk short distances without any support. “I am relieved as the pain has reduced and I am getting better,” she said.  

Woman walks again, thanks to bilateral surgery

Tabassum Barnagarwala : Mumbai, Thu Nov 07 2013, 01:55 hrs

In probably a first-of-its kind knee surgery in the country, a 43-year-old woman has regained her ability to walk after almost four years.
Ujwala Khatavkar has been suffering from osteoarthritis for the last four years now. "I could not walk, stand or sit on the floor for more than a minute. Several doctors prescribed medicines. But the pain was unbearable," she said.
She was advised to undergo knee replacement surgery. However, her case was a little different. "She had lost cartilage in the inner side of her knees. Since the whole of the knee was not affected, it was not wise to perform a total knee replacement surgery," said Dr Kaushal Malhan, orthopedic surgeon at Fortis hospital, Mulund.
In February, Khatavkar underwent microplasty uni-compartmental knee replacement — a surgical procedure to replace just a part of the knee.
While her right knee was partially replaced in February, the procedure was repeated in the other knee in March.
"While I still have to avoid sitting on the floor, I can walk and stand for longer than before without anybody's help. Also, the pain has reduced to a great extent," said Khatavkar. Malhan said this is probably the first such bilateral surgery in the country. "Total knee replacement is common. But in this case, we decided to replace only the affected portion," Malhan said.
A four-cm incision was made in the inner side of both her knees through microplasty, a surgical procedure which reduces the size of the incision required. "The surgery lasted for less than an hour. Through this method, the recovery period is fast. She was able to walk within three days," said Malhan.
tabassum.barnagarwala@expressindia.com

Dr Ashish Arbat, joint replacement surgeon - Miracle surgery has woman back on feet after eight years

Miracle surgery has woman back on feet after eight years

 

 

MUMBAI: For about eight years, Sadhana Sahastrabuddhe had not been in sunlight. She had not stepped out of her house at all due to a severe attack of rheumatoid arthritis which had locked her knees in the sitting position since 2005. It was only last month, that the 45-year-old Kalyan resident got back her ability to walk.
Sadhana had only been married for a year when she started experiencing pain in her heels in 1993.
"When doctors advised me against pregnancy, relatives and friends started telling my husband to divorce me. I too urged my husband to leave me. He had not signed up for a marriage with a disabled partner," said Sadhana. Her husband however, refused to leave her.

 

Sadhana had stiff joints but her mobility had still not b een affected. The couple took a risk and Sadhana gave birth to a son. But she then suffered from tuberculosis, which worsened her condition.
"I had gone to visit our native village in Satara in 2005. While climbing the stairs one morning, I got such a severe attack of arthritis, that I went stiff as a board and fell forward. That was the last time I walked," said Sadhana, who was then brought back to her Kalyan home which she did not leave eight years since.
It was only last year, that a relative who had undergone knee replacement surgery, suggested the same to Sadhana. Dr Ashish Arbat, joint replacement surgeon at Kalyan's Fortis Hospital, who treated Sadhana, said that her knees were fixed at a 90-degree flexion when she was brought to him. "The complications were severe. Firstly, the immunity system starts acting against the body in case of rheumatoid arthritis. Moreover, the quality of her bone was bad because she had not walked for so many years. Her nerves, too, were extremely tight," he said.
The doctor went ahead and conducted the first a knee replacement on the left leg on November 30 and then on the right limb on December 4.
It was a moment of uncontrollable emotion for Sadhana and her husband, when she stood up and walked on her own on January 4 after four weeks of intense physiotherapy. "I could not believe I could walk again. It was like getting another life," said Sadhana. But it will takemany physiotherapy sessions for Sadhana to gain full mobility. "She has problems balancing her gait. With more practice, she will be able to walk perfectly without support," said Dr Arbat.

 

Dr Suresh Vijan, Interventional Cardiologist - Axxess™ is Biosensors' dedicated bifurcation stent

Dr Rakesh Rai a specialist in Liver, Kidney and Pancreas Transplant Surgeon, Fortis Hospital Mulund

Fortis Hospitals successfully performs Year 2013 First Cadaver Liver Transplant Surgery in the city of Mumbai

 

Mumbai 14th January 2013:  Fortis Hospital Mulund performs city's first successful liver transplantation of the year 2013. The life saving surgery was performed by liver transplant team of Fortis Hospital, Mulund led by senior consultant Transplant Surgeon Dr. Rakesh Rai. Mr. Nivrutti Shinde, 62-year old man who was suffering from advanced liver cirrhosis once again is brought back to life by a cadaver liver transplant from a very young brain dead patient. 

Patient Mr. Nivrutti Shinde got surprise of his life and the best New Year gift when he got a call on 6th of January that a suitable liver is available for him for liver transplantation. Mr. Shinde who is a 68 year old retired principal was diagnosed to have cirrhosis few months ago. When he was investigated for swollen limb. Further investigation revealed that his liver had shrunken and he has developed portal hypertension.  He was listed for cadaver liver transplantation in Fortis Hospital, Mulund only 10 days back on 27th December of 2012. 

On 6th Of January a patient in Fortis hospital ICU was declared brain death following a severe head injury in a Road traffic accident. The grieving family made a courageous decision to donate the organs to save others life.

The donor underwent a 4hr procedure to harvest his kidneys and liver starting in the evening of 6th Janauary’13. The donor was taken in to the operation theatre for harvesting (surgical removal of cadaver organs) of liver and kidneys. The donor's liver along with its vascular pedicles and bile duct, cooled and flushed with special cold preserving solution. The liver was packed in a plastic bag containing preserving solution and kept in a large Ice box to maintain a low temperature. At the same time in another operating room Mr. Shinde was wheeled in. The team of transplant anesthetist led by Dr. Vijay Shetty put him to sleep and then then put several catheters to continuously monitor several vital parameters during surgery.

 Dr Rakesh Rai a specialist in Liver, Kidney and Pancreas Transplant Surgeon, Fortis Hospital Mulund Says “Surgery consisted of taking out the cirrhotic liver from the patient which is a very complex and challenging procedure as because of cirrhosis the blood does not clot easily as well as the blood vessels in the abdomen get abnormally dilated. The meticulous dissection as well as continuous monitoring and correction of bleeding tendency led to removal of cirrhotic liver without significant blood loss. Next stage was to implant the harvested liver in the place from where cirrhotic liver was removed. We then first joined the part of Inferior vena cava above the liver of donor and recipient then the cava below the liver was joined. Next both portal veins were joined and then the blood flow to the new liver was established. The new liver immediately started working and producing bile. Next part was to join the artery and bile duct. This whole complex procedure was finished in just 6 hours”.

“Following liver transplantation Mr. Shinde was shifted to liver transplant ICU and he was taken off the ventilator within 12 hrs of his surgery. Mr. Shinde made a remarkable recovery and was out of ICU in the ward within two days of transplantation and he is now ready to be discharged within 7 days of his surgery” Said Dr Rai.

 Ms Rajana Shinde wife of Patient Says “It came us like a surprise to us when we saw first bleeding from Husband. He undergone hernia surgery, but Dr never told us about the cirrhosis. We would have started taking treatment. One doctor said it is a kidney problem & we started taking treatment for kidney. Later his condition was deteriorating &his biopsy report confirmed the liver cirrhosis and need urgent liver transplant”

“We decided to undergo liver transplant surgery but we were told that doctors’ in Mumbai are less efficient for doing transplant surgery, in-fact he was suggesting Delhi as a preferred option for liver transplant” Says Ms. Shinde. Talking on the decision for transplant in Delhi, she said doctor suggested for live donor for Transplant Surgery. We had undergone pain by doing several different processes from Mumbai then in Delhi for liver transplant surgery done at outstation for live donor. Mr. Shinde got admitted for Transplant Surgery in Delhi Hospital as his 28 yr old nephew was ready as a live donor. But unfortunately it didn’t work, as donor said he was having fatty liver.

To get fitted for transplant surgery my nephew lost his weight almost 4- 5 kg, but later Dr’s didn’t showed positive response. We were confused as we were not able to get our query solved inspite of following what Dr has suggested. And we decided to come back in Mumbai Said Ms. Shinde.

“Mr. Shinde was listed for Cadaver at Fortis Hospital, Mulund only 10 days back. Luckily Mr. Shinde did not have to wait long. In New Year 2013, relatives of a 33 yr old young brain dead patient (who was admitted in Fortis Hospitals ICU) when counseled by the hospital social workers team, agreed to donate liver for transplantation” Said Social Worker Neelam Choudankar.

“Post Cadaver liver Transplant Surgery Mr. Shinde is out of ICU only on 3^rd days and will be discharged on Monday” Said Dr Rakesh Rai.

Dr S Narayani, Facility Director, Fortis Hospital Mulund Said “Recent political involvement in organ donation all across the city has created awareness on organ donation. We as a healthcare partner ensure that more and more people should be aware of organ donation and how it can helps one life. Organ donation and sharing among the patients is a very challenging. There has to be development in the infrastructure to support organ donation across the country and finally there has to be a national network for listing patients on the waiting list and sharing of the organ”.

A smiling, visibly elated Mr. Shinde said, "I want to spread the message that just as one donates eyes and kidneys, one must also donate a liver to give new life to someone else. I consider my donor as an angel, since I got a new lease of life thanks to the liver transplant. I'm grateful to Dr Rakesh Rai and his entire medical team at Fortis Hospitals who helped me with New Year gift. And in all this, I'd specially like to thank my wife Ranjana Shinde & Son Sachin, Sudhir & nephew who supported me all the way. She proves the proverb that behind every man there is a strong woman."

 

 

Record For Achieving The Largest Number Of Cervical Cancer Screenings

Fortis Sets A Guinness World Records For Achieving The Largest Number Of Cervical Cancer Screenings

Fortis Sets A Guinness World Records

 ~ Record For Achieving The Largest Number Of Cervical Cancer Screenings ~ 

Mumbai 23^rd December 2012: Fortis Foundation set a Guinness World Record, record for the highest number of cervical cancer screenings today benchmarking their positing within the industry as pioneers. Fortis Hospital at Vashi, Mumbai, screened over 751 women in an 8 hour marathon screening, as part of its ‘Teal To Heal Together’ campaign beating the earlier record of 350 participants held by Kaiser Permanente, San Diego (USA) achieved on the 29^th of January 2011. The hospital left no stone unturned with more than 50 gynaecologists and oncologists working seamlessly and screening participants in more than 20 OPD rooms.

Speaking of the newly won Guinness World Records achieved by Fortis Foundation, Mr. Varun Khanna, Regional Director (East & West) ,Fortis Healthcare said, “Although cervical cancer ranks as the number one killer disease in India, it is breast cancer that has received utmost attention. Through the ‘Teal To Heal Together’ campaign, Fortis is aiming to revolutionise the manner in which cervical cancer is perceived and prevented nationwide. The golden rule of prevention being better than cure is the guiding principle that has driven this campaign.”   

Dr. Vandana Gawdi, Senior Consultant, Gynaecologist, Fortis Hiranandani Hospital, Vashi a proponent of cervical cancer said, “Cervical cancer is both preventable and curable if detected at the HPV virus stage, Oncogenic HPV infection in Indian women varies in different locations. Studies have brought out certain demographic and other lifestyle factors on the development of abnormal cytology in Indian women.  This justifies the need for screening women for cervical cancer including Oncogenic HPV testing (HPV infection among various Indian women).”

Dr. Shalini Varma, Consultant Gynaecologist at Fortis Hospital Vashi, Says” Cervical cancer in India accounts for one fifth of the cervical cancer prevalent globally. On a yearly basis over 1,30,000 new cases are detected and it is estimated the number of new cervical cancer cases in India will increase to nearly 2,26,000 by 2025. Due to the lack of awareness and social stigmata, the mortality rate among patients suffering from cervical cancer has risen from 74,118 reported deaths in 2002 to 2,70,000 reported deaths at present. Over 10% of all cancer deaths annually are accounted to cervical cancer.” 

 

“These mortality numbers can be partly attributed to the lack of awareness of the prevention techniques and the need for early detection through periodic health check-ups. Although cervical cancer is known to have a higher mortality rate than breast cancer, it is not yet perceived to be a social killer. It is widely believed, and a fallacy that the disease is transmitted only through consummation.  The social perception attached to the disease therefore is a common deterrent for many women to come forward for a preventive examination. However awareness amongst healthcare providers and women for the need of pap screening and preventive services is a must and should go towards alleviating the problem.” Says Dr Varma.

 

Improving the nutrition of the girl child, avoiding early marriage, a monogamist lifestyle, engaging in personal hygiene (to prevent HPV infections) and routine checks can prevent the occurrence of the disease to a great extent. For a developing country like India, as per the WHO norm, all women should get at-least one pap smear test undertaken before the age of 40 years and preferably at-least once in 3 years from the time of consummation of marriage or first sexual intercourse. If all the women between 35-65 years of age are screened at-least once in 2-3 years, the frequency of cervical cancer can be greatly reduced to 93%.  

 

Fortis Foundation in association with Fortis Hospital, Vashi hosted an awareness campaign titled ‘Teal To Heal Together’ to educate women on the importance of pap smear screenings and vaccination for the prevention and cure of cervical cancer. The campaign included public lectures and a registration drive that reached out to over 20 lac women across Mumbai making them aware of issues related to the prevention and management of cervical cancer. On the final day of the campaign over 10,000 women took a pledge to undergo cervical cancer screening.

 

Mr. Nikhil Shukla, Guinness World Records, Representative was present at the event to adjudicate and announce the entry of Fortis Hospital, Vashi into the Guinness World Record and presented a certification to Fortis Foundation once satisfied with the endeavour.

Fortis Foundation will continue to promote the cause of cervical cancer through various activations across as a part of their on-going corporate social responsibility program.  

Dr Vijay Agarwal, pideatric cardiac surgeon

Dr Sachin Bhonsle, Joint Replacement Surgeon

Dr Kalyan Dutta,Consultant Interventional Cardiologist,and Electrophysiologist, Fortis Hospitals ,Mulund & Dr Nilesh Maru, Cardiac Surgeon

Dr Kalyan Dutta,Consultant Interventional Cardiologist,and Electrophysiologist, Fortis Hospitals ,Mulund