'Exercise Heart Disease' - Blog by Dr Arun Kochar,

As part of our Corporate Social Responsibility, while delivering a talk on the prevention of heart ailments for the staff of a leading hotel recently, I was prodded by a probing question from the audience regarding the effectiveness of exercise in the prevention of a heart attack.  A forty year old staff member of the hotel who had been an avid gym enthusiast and was extremely fit physically, had died suddenly although he did not have any addiction or disease.  Apparently, he had had a heart attack.

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Hydrogen Breath Test (HBT)

Fortis Hospital, Mohali, has added the Hydrogen Breath Test (HBT) Procedure. HBT is a simple, non-invasive test based on analysis of breath hydrogen using breath test analyzer. It is used for diagnosis of gastrointestinal disorders like lactose/fructose/IBS/SIBO and other sugar intolerance, small intestinal bacterial overgrowth, intestinal malabsorption, gastrointestinal dysmotility, etc.

Glue Closure Technique to treat Varicose Veins

Fortis Hospital, Mohali, has introduced a new technique Glue Closure Technique to treat Varicose Veins for the first time in India. This modern technique is a simple technique that doesn’t require application of tumescent anesthesia. A special catheter is introduced in the vein of the patient and vein is ablated along with a special Turkish glue. Dr Ravul Jindal, Director, Vascular Surgery, and Dr Merts, Proctor, RD Global, Turkey, spoke about this unique technique.

 

Varicose Veins can occur in any part of the body but it is especially seen in legs. Beyond being a cosmetic concern, this painful condition results in enlarged and gnarled veins and it should be treated at the earliest to avoid any further complexity. Some of the most common symptoms include veins that are purple or blue in color along with twisted veins. The situation becomes painful when there is a heavy feeling in the leg or burning, throbbing, muscle cramping and swelling in lower legs. One can experience worsened pain after sitting or standing for a long time. The new Glue closure treatment uses a patented VENABLOCK catheter which is a relatively new endovascular technique to cure venous reflux disease.  Dr Ravul Jindal who was the pioneer of MOCA technique (Mechanico Chemical Ablation of Varicose Veins) in India is yet again the first to introduce this even more painless technique in India. The technique is specially recommended for those who are sensitive to needle pricks as well as those who are overweight.

 

Complete cure of a 24-hour old stoke by Mechanical

A 36-year old resident of Patiala suffered sudden onset paralysis (acute ischemic stroke). He belonged to a family of doctors who noticed weakness of the right side of his body when he woke up at 6.00 am. The panic in the family was instant. They rushed him to the nearest hospital with neurological care but were told that the clot dissolving medicine could only be administered within 4.5 hrs of the onset of stroke. In this case, the exact time of onset was not known. Moreover, they had already spent 5 hrs in finding the right place to treat their patient. It was 11 am when a young anesthesia doctor in the family researched and found that a study about mechanical removal of clot upto 24 hours called DIFFUSE 3 was published in The New England Journal of Medicine, a renowned journal in medical sciences.

Not wasting any time, they shifted their patient to Chandigarh Government Hospital. They were advised to visit Department of Neurointerventions at Fortis Hospital, Mohali, for clot retrieval. By the time they reached Fortis, 20 hours had lapsed.

Dr Sandeep Sharma, Head, Department of Neurintervention and Interventional Radiology, Fortis Mohali, treated the patient. Advanced imaging, non-invasive angiography and salvageable tissue was studied and decision to remove the clot was undertaken. At midnight, the clot was removed from within, without requirement of anesthesia and clogged blood vessel was opened to restore the flow into the brain. The patient recovered over the next 3 days and showed no signs of any problem on the 3rd day. He was discharged with advice, and on follow-up for the next two months. He had no residual occupational or physical abnormality and is doing well. His risk factors like blood pressure, sedentary lifestyle, and lipid profile have been modified and he is leading an active life. We wish him the best of health and happiness!

 

 

17-year old boy is back to normal routine post spi

A 17-year old boy was admitted at Fortis Hospital, Mohali, with inability to move both upper and lower limbs for eight months. He was wheelchair bound, and totally dependent on his parents for feeding and toilet care since 8 months. The sensations in both upper and lower extremities were decreased, but bladder and bowel were intact. His past history included an odontoid fracture that was treated at a local hospital with hartshill rods 8 months back. 2 weeks after the surgery, his neurological condition deteriorated.

The x-ray of the cervical spine showed complete dislocation of C1 over C2 with failed hardware. CT scan showed broken wires and rods with defect in lamina with complete dislocation of C1 over C2. The MRI scan confirmed dislocation of C1 over C2 with severely pinched spinal cord. The flexion extension x-ray showed irreducible dislocation.

Complex re-do surgery was performed; the normal anatomical land marks were lost as the bones of the vertebra were already destroyed by the previous surgery. Surgery involved exposing the vertebra, removing the previous implant and fixing it with screws and rods, with the help of a special technique. The cord was found to be freed at the end of the surgery.  

Post-surgery, within 24 hours, the patient started moving his feet and hands and by the third day, he was able to sit and stand in the hospital. Fourth day after the surgery, the patient was discharged. 9 months post-surgery, he recovered fully. He is going to school, playing badminton and helping his father in the fields. We wish him the best of health and spirits!

Robotic Kidney Transplant marks new era of Kidney

Manoj Kumar, 55-year old native of Haryana, underwent robotic Kidney Transplant Surgery at Fortis Hospital Mohali, with the help of the most modern third generation Xi da Vinci Robotic Surgical system. He required a 5 cms incision (against a standard 30 cms incision) for kidney transplantation and had an excellent recovery following the same. His transplanted kidney was placed in the most painless way and the patient had an uneventful recovery. The kidney started functioning immediately on the table after the transplant. The main renal artery was joined with the external iliac artery and the renal vein was joined with the external iliac vein with the help of the robot. The ureter was then joined with the urinary bladder.

Robotic Kidney Transplant Surgery has an excellent outcome as compared to traditional surgery. It requires a very small incision thus all problems of long incision are avoided such as pain and use of painkillers, wound infection, hernia, wound dehiscence etc. The patient usually starts eating well on day 1 and is discharged by day 4.Patients usually have an excellent recovery following the procedure and usually the transplanted kidney starts functioning on the operation table only.

 

 

Refresher Course in Critical Care Nursing

A six days refresher course in critical care nursing was organized recently by Fortis Hospital Mohali. Aimed at providing comprehensive training and a simulation-based practical exposure to various aspects of nursing care for critically ill patients, the refresher training was facilitated by the nursing education department.

The training was provided by various clinical instructors including some members of the nursing team from the hospital. Doctors from the critical care team also interacted with the participants during the course of the training. The participants were also tested under various parameters through an Objective Structured Clinical Examination (OSCE).

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