Smoking not only makes one prone to Heart Attacks, but can also cause severe, unbearable pain in the legs. If not treated on time, it can even lead to Amputation. Doctors at BLK Super Speciality Hospital performed a life-saving surgery on a 58-year-old man, after he was advised elsewhere to have his limb amputated.

THE CASE

Patel Singh was a heavy smoker suffering from severe Peripheral Arterial Disease (PAD), a condition in which arteries supplying blood to legs or other vital organs become narrowed or blocked. The patient will experience pain in calves and thighs, which occurs initially only while walking but later ensues even at rest. This symptom is known as Claudication. In severe cases, the patient develops a bluish discolouration of the distal part of the limb or even gangrene. Once gangrene is established, a variable amputation has to be undertaken. Claudication is sometimes not recognised correctly and valuable time is lost during which the disease progresses.

A CT Angiogram usually reveals the full extent and severity of the blockages and helps in planning the surgery. In Patel's case, the abdominal aorta was totally cut off at the level of the renal arteries and other multiple blocks involving Bilateral Iliac and Superficial Femoral Arteries.

THE PROCEDURE

Due to the extensive nature of the disease in this particular patient, complex Peripheral Bypass Surgery was required. The aorta was approached retroperitoneally through a thoracoabdominal incision to access its suprarenal part. The top end of a bifurcated dacron graft was anastomosed to the aorta at the diaphragm.

Breast Augmentation is one of the most in-demand Cosmetic Surgery procedures these days. It is a simple day care procedure with very less downtime involved. Many women who have underdeveloped breasts are coming forward to get this procedure done as this gives them confidence in leading a normal social life. The taboo associated with this surgery is fast disappearing.

Recently, at BLK Centre for Plastic & Cosmetic Surgery a new technique “BEAULI” was introduced to enhance the breast size using body's own tissue. This technique involves usage of high speed water jet stream to separate out fat cells from patient's own body. These fat cells are now easily extractable and can be used all around the breast tissue to give significant enhancement. BEAULI is a natural breast augmentation and enhancement procedure and has several benefits which include:

BLK has performed more than 650 Bone Marrow Transplants within a short span of 4 years, at a success rate of over 80%, which is at par with world’s best. The Centre attracts transplant patients not only from India, but also from countries like Iraq, Pakistan, Afghanistan, Nigeria, Kenya, Sudan, United Arab Emirates, Uzbekistan and Nepal. Today, more than 50% of the patients arrive from different parts of the world.

“In recent years, there have been dramatic breakthroughs in the field of Haematology and Stem Cell Transplant, the latest being treatment through Haploidentical Transplantation technique which virtually eliminates the waiting period for people who need Bone Marrow Transplants on urgent basis. Through this procedure, even if a donor's tissues are only half identical with those of a recipient’s, it works just as well as a complete match. The donor in this case may be the recipient's parent, sibling, child or a family member,” said Dr. Choudhary.

In this transplant program, patients are first put though few days of Chemotherapy / Immunotherapy or Radiotherapy as per the condition of the patient before transplantation..

THE CASE

Rahul is a young IITian who was working with HCL, Bangalore when he was first diagnosed with Plasma Cell Leukaemia and had undergone Autologous Stem Cell Transplant which relapsed in just 3-4 months post transplant. The disease was very aggressive and in search of cure he had visited various hospitals in the country. Rahul was completely unaware about the treatment that would suit his condition the best. Morever, finding a donor was an even bigger challenge. All national and international registries were checked but he could not find the matching donor for transplant. Finally, he got to know about Dr. Choudhary and decided to contact him.

THE PROCEDURE

Dr. Choudhary suggested half-match or Haploidentical Stem Cell Transplant as a treatment option to him. In his family, only his father and sister were his half match. After a few tests and deliberations, his sister was selected as the donor. Rahul underwent the transplant procedure and much to everyone's relief, it was a success.

THE RECOVERY

Six months after the surgery, Rahul is currently asymptomatic and doing fine. He has even started a group named Yoddhas which has several members who are cancer survivors. He counsels patients from all over the world about the treatment.

While the golden rule of reaching a hospital in time is well known, how doctors attend to a stroke patient is also critical in determining the prognosis. Often, patients are made to undergo surgery without evaluation of other non-invasive options to bring them to normalcy, and it is the approach that a doctor adopts that creates a difference.

THE CASE

A 52-year-old man was brought to BLK within 55 minutes of an onset of paralysis on his right side. At the time of admission to Emergency, the patient was not able to stand without support or hold objects with his right upper limb.

THE PROCEDURE

As the patient was able to reach Emergency within 4.5 hours, an urgent MRI of the Brain was done which showed blockage of main blood vessel. Patient was given a clot buster agent through the vein besides host of other non-invasive interventions. With constant monitoring and diligent care, the patient showed significant improvement.

There are many types of complexities associated with certain pregnancies. One such complexity is when the embryo does not split until after the formation of amniotic sac which leads to the formation of monoamniotic twins, wherein the two babies share the same placenta.

THE CASE

As first-time parents, Mr. and Mrs. Gill were thrilled to learn on the first ultrasound that they were expecting twins. But their joy was short-lived when they learnt about the multiple risks involved with monoamniotic twins. They were also informed that this kind of pregnancy is rare and the expectant mothers in these cases are generally advised for termination by most medical facilities.

But Nidhi, the 28 year old twins' mother, was determined to go ahead with her pregnancy, and then she came across an article on 'delivery of monoamniotic twins' by Dr. Khera who had also done one such case earlier. That gave the couple new-found hope and confidence to continue the pregnancy.

Dr. Khera who monitored the pregnancy of Nidhi, mother of twins, advised the parents to be cautious, while highlighting the challenges in such pregnancy. There are chances of cord entanglement between the twins, which can lead to choking; cord compression which could stop the flow of nutrition amongst one twin and twin-to-twin transfusion syndrome (TTTS). Under TTTS, one twin receives majority of nourishment causing the other twin to become severely undernourished.

THE PROCEDURE

Nidhi was advised complete bed rest for 80-90 days to reduce the risk during her pregnancy.