Fortis Hospitals Mulund ,Mumbai Media Coverage in August,2011

S L Raheja , Mumbai (A Fortis Associate) Hospital has successfully treated a patient of breast cancer with conservative breast surgery and IORT. With this treatment, it is possible to avoid complete removal of the breast and only remove the cancerous growth. Normally to make sure that all cancer cells are destroyed and chances of recurrence are minimized, the patient would have to go through 25-30 sessions of external radiation treatment over 5-6 weeks.

IORT is a radiation therapy technique in which a concentrated dose of radiation is delivered to a cancerous tumor site during surgery after the tumor is removed. After surgery, recovery is normal and there is no need for any additional external radiotherapy.

Mrs. Vidhya Agarwal, a 72 year old housewife from Agra, was detected with breast cancer, after a routine mammography & FNAC test last year and was advised a mastectomy. In addition she suffered from hypothyroidism, hypertensive, had a problem with her weight and had difficulty in walking; all of which made taking external radiation therapy daily for 6 weeks, very difficult.

Mrs. Agarwal’s surgery and the IORT treatment did not take more than an hour. She was discharged in three days after surgery.

An elated Mrs. Vidhya Agarwal says, “I came to know about my condition through a checkup I underwent after noticing a lump in my right breast. I was devastated when the doctor advised a mastectomy. This treatment has been a blessing for me. To my delight, the treatment was affordable, convenient and hassle free.”

S L Raheja (A Fortis Associate) Hospital, Mahim, offers the IORT program as part of its progressive, comprehensive approach to cancer treatment. IORT removes the need for external radiation treatment over 6 weeks by giving a single, definitive dose during surgery. INTRABEAM IORT if used as Boost (targeted supplemental dose of radiation) to standard external beam radiation can reduce treatment duration by one to two weeks. This treatment time reduction enhances treatment compliance and clinical outcomes.

With IORT, the targeted radiation dose leads to negligible side effects (that are seen with external radiation therapy) on adjacent healthy breast tissue and other normal organs such as the lungs, heart and the opposite breast.

Dr. Sanjay Sharma and Dr. Nehal Khanna (Radiation Oncologist), the team of doctors for Mrs. Agarwal, are delighted with the results of the treatment. Commenting on his success, Dr Sharma,Surgical Oncologist, S L Raheja (A Fortis Associate) Hospital said, “Statistical data suggests that the recurrence rate with External beam radiotherapy (EBRT) is at around 7% while that with IORT is just 1.7%. Unlike traditional radiation treatment, IORT uses a single radiation dose and treats a more limited area of breast tissue.”

Dr. Nehal Khanna says, “IORT has been a revolution. The treatment has been done on different types of cancers with good results. It is most commonly done for early breast cancers followed by head neck, colo-rectal cancers, pancreatic cancers, vaginal cancers and brain tumors. It can also be taken for recurrent cases, cases who have received prior radiotherapy, palliative settings as well as boost radiotherapy to the tumor bed.”

L Raheja (A Fortis Associate) Hospital is the first in India to offer this service as a component of a definitive treatment approach. The IORT treatment will add to the services provided at S L Raheja The treatment, gaining more traction in leading hospitals across the globe, will be a definitive radiation treatment for patients undergoing treatment for cancer.”

With 5 times failed hip, Iraqi teacher gets stands up tall again post a successful revision surgery at Fortis Hospitals Mulund”

~Denied of medical support abroad, Iraqi woman finds India for clinical excellence~

Mumbai, 22^nd July 2011: Setting yet another milestone in orthopedic surgery, Dr Sachin Bhonsle at Fortis Hospital Mulund performed a complicated hip replacement revision surgery on a 52 year old Iraqi lady who had undergone 6 failed hip surgeries before.

Dr Sachin Bhonsle, Consultant Orthopedic Surgeon took up a challenge to perform the 6^th followed by 7th revision putting the patient back on her feet. Sixth is a preparatory for the final revision (7^th surgery).

Patient Ms Nadia, a teacher from Baghdad had a childhood injury to her right hip which damaged the joint progressively till it developed arthritis.  When she was 40 years of age she decided to opt for a total hip replacement which was performed in her own country. The surgery did not yield good results and her joint soon dislocated. She had to undergo second surgery to revise the socket. This surgery gave her benefit but only for two years.

In 2002 the hip developed problems once again and she had to have a revision surgery for the third time. This failed again after three years.

In 2005 a fourth surgery was performed to change the entire hip joint. She got a good pain relief after this surgery. This hip joint had loosened out by 2010 when a fifth surgery was performed to change the joint surfaces. She did not get any benefit from this surgery.

Reasons for failure:-

1. Unstable joint replacement and poor soft tissue balance
2. Early wear and tear because off poor alignment
3. Loosening because of inadequate fixation in bone and suboptimal cementing
4.  Extensive soft tissue scarring and inexistent muscles because of repeated operation in same place

Meanwhile destiny gave her a sixth chance, having suffered for so long Ms Nadia mustered the courage to rectify her problem and decided to come down to India and get operated upon her hip once again.

Dr Sachin Bhonsle says “This case is a fine example of a very complicated hip replacement operation as Nadia had undergone several hip replacements before and those operations were failures. Bone had become brittle due to intense scarring and there was a major possibility of fracture. Nerve damage was possible during approaching such hips because of nerve entrapment in severe scarring. Her poorly controlled diabetes proved a further challenge.”

Dr Bhonsle had to first perform the surgery (6th) to remove all the implants, bone cement and clean up the infection. He performed the final revision surgery (7th surgery) during 1st week of July.

“I opened up the wound and thoroughly cleaned it again. I first prepared her socket (used a cement less socket of a modern design which can last for many years) and put some bone grafts in the depth. Then i went on to prepare the femur which proved a huge challenge. There were many holes and breaks in the femur. I had to use a titanium stem of great length to span breaks in the bone. In addition i had to strengthen the bone using- bone grafts, titanium mesh, plates and screws. It took almost 7 hours to complete the procedure with satisfaction.” adds Dr Bhonsle.

The surgery was successful with an uneventful recovery and Nadia was able to walk within 48 hours of surgery. Dr. Bhonsle is very optimistic that the patient will lead a normal life and will not require another revision in her lifetime.

“Having undergone 5 surgeries before, doctors abroad told me that a sixth correction could never be performed on my hip. I thought that I will have to lead a challenged life for the rest of the years. But like the saying goes every cloud has a silver lining! I too got hope after 12 years of suffering from Dr Bhonsle who took up the challenge and cured me. All I want to say is there is a solution to every problem, only thing is we need to hunt out for the opportunity and everything else falls in place”, says Nadia with a comforting smile on her face.

Fortis wishes all its Medical Fraternities

Fortis Hospitals in continuum of its endeavor to building a healthier society, today organized A Basic Life Support (BLS) skills training workshop on the basic steps of cardio-pulmonary resuscitation, commonly called CPR at Fortis Hospital, Anandapur, EM Bypass Road. BLS is basic medical aid which is offered to people before they reach a hospital or in situations where high-level medical care is not immediately available.

The programme was launched by Mr. Dilip Bandyopadhyay, Deputy Commisioner of Police, Traffic, Dr. Debasish Sharma, Head, Medical Services, Fortis Hospitals and Mr. Jacob George, Head, Non- Medical Services, Fortis Hospitals with an aim to educate the Kolkata Traffic Police on the various ways to provide timely life-saving support to the people in emergency situations. Dr. Arijit Bose, Consultant Emergency Care, Fortis Hospitals led the team of medical experts associated with the BLS Programme.

Addressing the City Traffic Police at the occasion, Mr. Dilip Bandyopadhyay, Deputy Commissioner of Police, Traffic said “BLS trained traffic police could be of tremendous advantage for the people of Kolkata. As one hour after the accident, which is called the golden hour is the most important, if it is properly utilized, it can save a person’s life. These basic CPR skills can definitely help them to rescue the victim’s life at times of emergency and thus playing a role of responsible citizens. I congratulate Fortis’ team for coming up with such an initiative. There is a pressing need to spread this knowledge in the community”.

Research shows that only 2 interventions can save a life, one is to provide Cardio-Pulmonary Resuscitation (CPR) to the patient and the other is to provide Defibrillation. The most common cause of death from a heart attack in adults is a disturbance in the electrical rhythm of the heart called ventricular fibrillation. Ventricular fibrillation can be treated, but it requires applying an electrical shock to the chest called defibrillation. If a defibrillator is not readily available, brain death will occur in less than 10 minutes. The only way to buy time while the defibrillator becomes available is to provide CPR. According to current guidelines, CPR is initiating chest compressions before ventilations. The essence of good quality CPR is chest compression. Nowadays Hands-Only CPR is practiced. It is important to perform chest compressions at a rate of at least 100/min. Chest should be depressed at least 2 inches.

Mr. Faisal Siddiqui, GM, Fortis Hospitals said “Fortis’ emergency team as a part of our CSR activity would like to train and certify 4000 traffic police in the city twice in a week in batches of 25- 30 people on basic life support which can save many lives during medical emergencies.  We have already held similar workshop for the taxi drivers and auto drivers and we have received a tremendous response from them. We are proud to initiate such a programme for the people of Kolkata.

Dr. Arijit Bose, Consultant Emergency Care, Fortis Hospitals stressing on the role of a BLS trained person said “The earlier the CPR is given to a person in cardiopulmonary arrest, the greater the chances of the survival of the patient. Chest compressions number per minute is very  important as it helps in return of spontaneous circulation (ROSC) and survival with good neurologic function.I am sure after undergoing through the BLS programme our fellow traffic police members would definitely carry out the necessary steps being taught to them during the programme and could save a life at times of emergency.”

The BLS programme at Fortis Anandapur was a success as more than 30 traffic police participated today and benefited with the various steps of resuscitation.

About Fortis Hospitals Kolkata

Fortis Hospitals Kolkata is a 400 bedded super specialty hospital located on EM Bypass Road. It is a part of India’s leading healthcare providers – Fortis Healthcare focusing on the tertiary care like cardiology and cardiac surgery, orthopedics, neurosciences, digestive care, urology & nephrology, Respiratory care & sleep medicine, emergency care and critical care. Our amenities include a 24-hour accident and emergency service including trauma treatment, ambulance services, blood bank, fully functional operation theatres, preventive health check, diagnostic and catheterization laboratory, critical and emergency care.