Dear Readers,

It is truly heartening to see that every month we are getting more articles and stories than we can possibly print in each edition. Our editorial team is working efficiently to get the best pieces to reach you. The cover story this month is indeed very emotional and heartwarming.

As you go through it, you will be acquainted with two adorable children who are today smiling and enjoying like any other child. Making use of the ECMO Technology and the expertise of our Paediatric team, we are happy to have played a substantial role in their lives after they were presented with serious lung infection. It is cases like these that give us satisfaction and encouragement to achieve greater heights.

Last month, continuing our international outreach program, we had signed MOUs with Jakaya Kikwete Cardiac Institute (JKCI), Dar Es Salaam, Tanzania and Republican Scientific Centre of Neurosurgery – Uzbekistan. We have also become the first Indian hospital to perform cardiac surgery and procedure at the Jakaya Kikwete Cardiac Institute (JKCI), Tanzania.

This will be the first issue where we are featuring a guest article by Dr. Pradeep P. Bhosale, Director, Arthritis and Joint Replacement Surgery from Nanavati Super Speciality Hospital, a member of our Radiant Life Care family. I know this is just the beginning and we can look forward to many such articles.

As always, we would be happy to receive your valued inputs and suggestions. You can write to the editorial team at editorial@blkhospital.com and continue to support us.

Wishing you all great health.

Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an innovative technique to treat GI & Gynae Cancers which spread but are confined to a peritoneal cavity, usually carrying a dismal prognosis. However, there are chances of improved survival and cure in select patients. It is being performed in select centres across India including BLK Cancer Centre and abroad.

Cytoreductive Surgery (CRS) is aggressive removal of all or most visible Tumours in the abdomen and preventing growth of microscopic cells which are left behind. Hyperthermic Intraperitoneal Chemotherpy (HIPEC) is instilled via a machine which circulates Chemotherapy solution in the peritoneal cavity at 42 Celsius for 60-90 minutes.

THE CASE
A 65-year-old hypertensive lady with Carcinoma Ovary post three cycles of Chemotherapy was admitted to BLK Cancer Centre. Despite undergoing Chemotherapy her disease was present with nearly two liters of ascites and thickened omentum and peritoneum.

THE PROCEDURE
She underwent TAH + BSO + Pelvic and Para-aortic Lymphedenectomy + Peritonectomy + Supraacolic Omentectomy + extended right Hemicolectomy to achieve a CC0 score followed by Hyperthermic Intraperitoneal Cisplatin (HIPEC) for 90 minutes.

THE PROCEDURE

At the time of admission baby Joy was found with Septicemia and acute Respiratory Distress Syndrome or ARDS. He also had poor Heart function. In the case of Naina, she was going through acute breathing problems due to severe fiu. Joy’s condition was critical, as his BP had plummeted to a scary low of 35 on maximum medication and ventilatory support at the outlying hospital. Since Joy’s pupils were incoherent, it indicated some disorder in the brain as well. Given the precarious condition in both the cases, the kids were transported by BLK's team in a very critical state. An urgent call on the use of ECMO was taken, which is an extreme form of life support for such patients.

THE RESULT
After their successful treatment using ECMO, Joy and Naina started to recover soon afterwards. Joy’s Heart function recovered by 40% within 48 hours and Lung function started to show improvement after about a week. Naina also reported remarkable signs of improvement. ECMO was removed from both the kids after 10 days along with the ventilator. After careful observation, they were discharged, turning the worries of their parents into smiles.

The team of doctors at BLK were upbeat after the success they achieved in these two cases. While ECMO technology is present at many centers, its successful application has been an issue. Although, the use of ECMO in patients with Heart ailments was prevalent, its successful usage in life threatening medical conditions like that of Joy and Naina – Septicemia and ARDS – was rare

Ankylosing Spondylitis (similar group like Rheumatoid Arthritis) is a common condition in Asia. It affects mainly young males leading to complete closure of mobility of Spine and Hips. Hips are usually fused in deformed position of both the legs.

THE CASE
A 22-year old man had been suffering from 'Ankylosing Spondylitis' for the past 10 years and became bedridden in the last two years. He studied till high school but could not pursue further education due to his medical condition. Both his hips were fixed in 60 degree bent position with bony fusion having '0' movement.

THE PROCEDURE
The patient had approached Dr. Bhosale in Nanavati Super Speciality Hospital, Mumbai. On examination, it was found, his bones were soft and soft tissues around hips contracted in deformed position. Hence, there was a risk of injuring bones, blood vessels and nerves during surgery. When the hip is mobile, the surgery is easier. In this case, the bone had to be cut first because the anatomy was not very clear. Dr. Pradeep Bhosale performed the Bilateral Total Hip Replacement in a single stage with release of all tight structures.