Mr. Mahmud, 50-year-old male from Somalia had a bullet injury 9 months before he had come to Apollo Hospitals. Since then, he was having continuous pain in the abdomen which prevented him from doing his work. He visited lot of hospitals both in his country and in India and was advised surgical removal of the bullet. In all the hospitals, he was advised conventional open surgery – wherein the abdomen is cut open and bullet along with some part of the liver are removed. He was also told that it is a high-risk surgery. He then visited Apollo hospital and after evaluating him thoroughly Dr.P.Siva Charan Reddy and team planned a laparoscopic surgery – wherein two small holes of 0.5 cm are placed in the abdomen and with the help of specialized instruments the exact location of the bullet was identified and the bullet was removed preserving the liver and the surrounding important structures. This surgery was done with very minimal blood loss and the patient was discharged within 24hrs. Post operatively patient was totally pain free and was back to his routine work. Laparoscopic removal of such a bullet injury is probably a first in the country and we at Apollo are proud to have done. With the increased expertise of laparoscopic surgeons, we are able to perform many such complicated and challenging surgeries safely and effectively in many such patients. The conventional or open surgery would have left a large scar about 15 – 20 cms in length and post-operative recovery would have taken about a week to ten days, but with laparoscopic surgery the patient does not have any scar and was discharged in less than a day.

Blood Transfusion Service (BTS) is a vital part of the modern healthcare system, without which efficient medical care is impossible. The aim of BTS is to provide effective blood and blood products, which are as safe as possible, and adequate to meet the patients’ need. Apollo’s Department of Transfusion Medicine is self-sufficient at meeting the blood requirements for all in-house patients, and also provides blood and blood components to other hospitals in Delhi/NCR as and when required. Department of Transfusion Medicine accepts and receives only voluntary/voluntary replacement donors for blood donation. With a warm welcome, Apollo’s well-trained staff performs donor screening, and maintains donor privacy and confidentiality at all times. Trained phlebotomists take the donation in specialised blood collection bags with integral filters; first sample pouch, which diverts the first 15-20 ml of blood, and needle guard to ensure 3-4 log leukoreduced blood, reduced bacterial contamination and prevent needle stick injuries to the phlebotomist respectively. Leucoreduction prevents Febrile Non Haemolytic Transfusion Reactions (FNHTR), HLA alloimmunisation, transmission of lymphotropic viruses such as EBV, CMV and HTLV-I & II. The Immunohaematology Laboratory of the Department is a reference centre providing advanced Immunohaematology work-ups for patients across Delhi. Provision of extended phenotyping for all blood donors is in place, and helps the department to provide phenotypically-matched blood for patients with common type of Rh and Kell alloantibodies. The Department is capable of resolving grouping discrepancies, autoimmune haemolytic anaemia workups, and multiple alloantibody workups. The Department is the first centre to introduce Hepatitis C antibodies and Hepatitis B core antibodies in blood donors in the year 1996, besides the other mandatory tests, i.e., HbsAg for Hepatitis B, HIV I &II, malaria, and syphilis. Hepatitis C antibody testing later became mandatory in the year 2000. The Department is a pioneer in starting Individual Donor (ID)-NAT (Nucleic Acid Test) on all the donated blood units in the country, since 2006. This has reduced the window period of HIV, HBV, and HCV considerably, and is a step forward in our quest for zero-risk blood. The Department caters to the transfusion needs of approximately 75 thalassemic patients. We provide ID-NAT tested, 3 to 4 log leukoreduced blood to these patients. We perform regular screening for any irregular red cell antibodies and extended blood group phenotyping for thalassemic patients, thus providing the safest possible blood to them. These patients are also typed by advanced molecular methods for red cell antigenic profile and receive a phenotype matched blood, thereby reducing the risk of alloimmunisation. The Department has a wellestablished Donor Apheresis Programme that functions round the clock, and has extended its services to the bedside of the patient by performing therapeutic apheresis procedures like plasma exchange and red cell exchange. A well advanced peripheral blood stem cell harvesting programme for autologous and allogenic donors with cryopreservation is in place for treatment of several haematological and non-haematological approved conditions.

The Patient was a thirty-five-year-old man who was struggling to live due to his chronic kidney disease and his Mother came forward and donated the kidney. Dr Mohan Patel said that kidney donation from living family member is preferable and is as safe as blood donation. He also added that soon they will be starting SWAP kidney transplant (Paired Kidney Exchange), Paediatric transplant and laparoscopic surgeries for the donor. The transplant was done by the team of consultants involving Nephrologist (Dr Mohan Patel and Dr Prakash Ugale), Transplant surgeons (Dr Kishor Wani, Dr Nandan Vilekar and Dr Pravin Govardhane) and Anaesthesiologists (Dr Chetan and Dr Ketan) along with transplant coordinator Ms Charusheela Jadhav. Apollo Hospitals, being India’s leader in organ transplant, now has fully functional Kidney transplant unit in Nashik hospital with world class standards at affordable rates. It has all facilities required for the kidney patients like pre-transplant evaluation, 24 x 7 dialysis, post-transplant isolation care, 24 x 7 trained intensivists and nursing staff. It has reduced the financial burden on patients travelling to Mumbai and Pune.  

It gives us immense pleasure to inform you that Indraprastha Apollo Hospitals, New Delhi received awards for ‘Best Indian Hospital for Medical Travel’ and ‘Best Organ Transplant Centre’ at ASSOCHAM – Meditravel 2017, held at New Delhi on 21st February 2017. The awards were given by Gen. (Dr) V.K. Singh (Retd), Minister of State for External Affairs Government of India.

The workshop comprised of patients who are very sick to undergo CABG or have been refused angioplasty because of complexity of the lesions or arterial blockages. Dr. Jan Kovak, will be the main Surgeon and will be supported by team of experts from Apollo Hospital, Indore, comprising of Dr. K. Roshan Rao, Dr. Sarita Rao, Dr. Kshitij Dubey, Dr. Vikas Gupta and Dr. Sushil Jain. After the workshop, a scientific meeting was held in the evening where Dr. Kovak addressed the doctors of the city and neighbouring areas and there was a one to one interaction amongst the doctors. This workshop will benefit the patients carefully selected and they will be treated by a world famous and eminent cardiologist from Europe at no additional charges. Dr. Ashok Bajpai, medical director of Apollo Hospital reiterated that it is again an example of high standards and expertise of world class that Apollo Hospital brings to the people of the city at affordable price.  

An 80-year-old lady was having a huge dilation of the arch of the aorta, which was leaking and could have ruptured at any instance, causing instantaneous death. Her detailed work up in the form of aortic angiogram and CT aortic angiogram confirmed the diagnosis as well as the exact extent of the disease. Open surgery would have involved a long incision and splitting of her breast bone, long general anaesthesia, stopping her heart, putting the patient on cardio-pulmonary bypass and then replacing the dilated aorta. She was too fragile to withstand the surgery. Endovascular treatment was the treatment of choice for her but the stent would have caused blockage of the arteries supplying her brains and upper limbs. This led doctors to go for a hybrid procedure – the first part was surgical and the second one – interventional endovascular stenting. In the first part a team of surgeons involving Dr. Kshitij Dubey, Dr. Sushil Jain and Dr. Alok Biyani implanted a graft from her right artery of the brain to the left common carotid artery (supplying to the left side of the brain) and left subclavian artery (supplying to the left upper limb). This ensured that even if the mouths of the arteries are blocked by the stent, the blood supply will be maintained by the innominate artery through the graft. This was done under local anaesthesia thereby minimizing the risk of general anaesthesia. Once the circulation to the brain and the upper limb was secured, interventional cardiologists Dr. Sarita Rao, Roshan Rao and Dr. Vikas Gupta under local anaesthesia, through a puncture in the right lower limb artery, implanted the bulky stent graft in the dilated part of the thoracic aortic aneurysm covering brain and upper limb artery which were already grafted so that there was no risk of any compromise to the brain and the upper limb. Team effort by the surgical and the interventional team led to complete cure of the patient with minimal risk. The patient recovered well without any complications and was discharged from the hospital on the third post-operative day.

The patient, a five-year-old girl had multiple health problems including advanced liver cirrhosis, congenital heart defects, severe growth retardation and rickets. Briefing media about this amazing accomplishment, Dr Manish C. Varma, Head of the Liver Transplant Department, Apollo Hospitals, Jubilee Hills; Dr Girish Warrier, Consultant Pediatric Cardiac Surgeon, Apollo Hospitals, Jubilee Hills and Ms Sangita Reddy, Joint Managing Director, Apollo Hospitals; said the baby was suffering from a rare genetic disorder. Though the ailment was diagnosed two years ago elsewhere, the complexity of performing a liver transplant and heart defect correction in one go and not having a precedence to this, prevented them from providing succour to the baby. Five-year-old baby girl, Parvati Rohra, hailing from Hyderabad, was suffering from a rare genetic disorder called Alagille Syndrome. It occurs with a frequency of 1:1,00,000 children and can impact the liver, heart, lungs, kidneys, bones among others. However, the severity of the problem varies from patient to patient. Because of Alagille Syndrome, Parvati had advanced liver cirrhosis, severe cardiac defects including Pulmonary Artery hypoplasia, Pulmonary valve dysplastic, Atrial and Ventricular septal defect, resulting in severe Pulmonary Artery Hypertension, severe growth retardation and rickets. Compounding the problem was her weight of just about ten kilograms. She was leading an extremely traumatic life, deprived of the normal childhood which kids of her age longed for. Although she was mentally developed, she was not going to school or out to play, as any attempt to walk would lead to fractures of the leg bones due to rickets. She was leading a very restricted life and was not able to achieve motor milestones. Her medical history indicated that she presented initially with jaundice in the first few months after birth. Her parents consulted a hospital in Mumbai, which diagnosed this as biliary atresia and were counselled for a liver transplant. However due to the baby being underweight – 10 kgs, the transplant team was not confident of operating on such a small child. Though the problem was later diagnosed elsewhere in Hyderabad, two years ago, looking at the complexity of the patient with heart defects and advanced cirrhosis of liver occurring together and there being no precedence in treating such cases earlier, the hospitals she approached expressed its inability to treat. The family was desperately exploring all avenues known to them in the last 2 years, before they came to Apollo Hospitals. Commenting on the high-risk nature of the case, Dr. Manish C. Varma said “Trying to deal with the problem one at a time would have been definitely fatal. If we attempted to perform liver transplant with a bad heart, she was at risk of dying in the operation theatre. On the other hand, if we tried to correct the heart alone, she was at a very high risk of dying after the heart surgery.” A multidisciplinary team of doctors led by Dr. Manish Varma, consisting of specialists, Liver Transplant Surgeons, Pediatric Hepatologists, Liver Transplant Anesthetists, Pediatric Cardiac Surgeon, Pediatric Cardiologist, Pediatric Anesthetists and Pediatric critical care specialists, took up this case as a challenge. The task ahead was daunting for the team, especially since there is no precedence of treatment for such a complex case being attempted in medical history. “We had no roadmap for us. We could find only one case in medical literature from a different country. However, that was a less complex case and the doctors in that case were able to correct the cardiac defect by endovascular balloon dilatation. We attempted that in our patient’s case but, unfortunately, that failed to correct the heart defect” explained Dr. Girish Warrier. Left with no other option, the doctors at Apollo decided to do something that was never attempted before in medical history. They decided to perform an open-heart surgery for the cardiac defects and then a liver transplant in quick succession. During an eight hour cardiac surgery performed on 23rd January 2017, by Dr. Girish Warrier and his team, the holes in the heart were closed, Pulmonary Artery was widened, Pulmonary valve was excised and an artificial flap valve was created. This was followed by an observation in the ICU for about 12 hours during which the baby was monitored closely for the improvement in heart function and for any deterioration in liver functions. Thereafter, a live donor liver transplant was performed by Dr. Manish Varma and his team, using a part of her mother’s liver, in the earliest available window of opportunity on 24th January 2017. The baby has since recovered and was discharged on February 7th, 2017. Elaborating on the complexity of the case and the importance of clinical decision making, Dr. Manish Varma said, “All our investigations suggested that an open heart surgery would be able to achieve a cardiac function that would enable us to do the liver transplant. However, the most important thing was to identify the correct window of opportunity to do the liver transplant. Attempting a transplant too early would have meant that we would be stressing the heart which had still not recovered fully, and attempting it late meant that the failing liver would have made Baby Parvati so sick that a liver transplant would be impossible. We could attempt this only because we had a living donor transplantation option in her 32-year-old mother Prerna Rohra, as the mother’s liver was a perfect match for the baby.” After this surgery, the baby will have a better growth curve and is likely to catch up on her growth over the next 2 years. The rickets will get treated with vitamin D supplements which will now work due to a functioning liver. The jaundice and itching will go away. She will need to be on some medicines for her heart and will need to be monitored for her heart status. After a few months, she will be able to walk, go to school, and do other age appropriate activities. The multidisciplinary team which was part of this historical surgery consisted of Dr. Manish Varma, Dr. Girish Warrier, Dr. Anand Khakhar, Dr. Anand Ramamurthy, Dr. Mahesh Gopashetty, Dr. L. Sasidhar Reddy, Dr. Manjunath Balasubramaniam, Dr. Meena Trehan, Dr. Kavitha Chintala, Dr. Dinesh Babu, Dr. Vishnu Vardhan Reddy, Dr. Sunita Nareddy, Dr. Shweta Priyadarshini, Dr. Ramesh Srinivasan, Dr. Senthil, Dr. Kirubakaran, Nutritionists, Physiotherapists and pediatric nurses, among others.

Over 250 school children and teachers along with gym instructors received training in “Basic Life Support and First Aid” at Apollo Institute of Medical Sciences & Research (AIMSR) recently The training in Cardio-Pulmonary Resuscitation (CPR) was done by a team of Life-Support Instructors from the Department of Emergency Medicine as a part of the National Assembly on Pediatric Emergency Medicine (NAPEM) conference. NAPEM 2017 is being conducted by the Society for Trauma and emergency Pediatrics (STEP) in collaboration with the Society for emergency Medicine India (SEMI), the India Academy of Pediatrics (IAP) and Apollo Hospitals. The conference is hosted with the intent of raising awareness and standard of care for pediatric emergencies in all hospitals. Dr. Imron Subhan, Head of the Apollo Hyderabad Emergency Department, said, “In an emergency, bystanders who witness an accident should provide first-aid and quickly get the victim to the hospital. If they hesitate or delay the transportation, then even Emergency Doctors cannot do much for the Patient”. “Every family should have at one person trained in Basic Life Support and First-Aid skills” said Dr. Dinakar who was the lead Instructor. Dr. Imron, who is also the organizing secretary for the conference said, “We have to make all emergency departments safer for children and better take care of sick and injured pediatric patients. Children with emergency conditions are bound to land up both in pediatric as well as adult emergency departments. All emergency doctors have to be ready to resuscitate and stabilize infants and children, and this can happen only with good training by using simulated scenarios on manikins”.

While frontline staff have to brave difficult terrain, harsh weather conditions, wildlife and poachers in their daily lives, forest-fringe communities are also faced with issues of human-wildlife conflict, and extreme climatic events for which medical assistance is required. The tie-up between Apollo Hospitals Foundation and WWF, India continues after one year of partnership. The continuing tie-up, to be effective from April 2017 for a one-year period, will extend immediate medical support to affected frontline staff of forest department and local community members in the states of Jammu & Kashmir, Himachal Pradesh, Sikkim, West Bengal, Arunachal Pradesh, Assam, Uttarakhand, Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, Chhattisgarh, Maharashtra, Tamil Nadu, Karnataka and Kerala. The partnership covers quality medical treatment of patients that also includes air ambulance services in critical and emergency conditions. This unique partnership between the two organizations will cover medical camps and cases including (but not confined to) grievous injury due to attacks by wild animals; fall from elevated areas (like hills or machines); accidents while patrolling in vehicles (collision, falling off etc); burns during fire-fighting operations; injuries in crowd control operations during incidents of human-wildlife conflict ; medical emergencies during extreme climatic events, life threatening diseases like malaria, dengue etc; venomous bites / stings, and electrocution. Speaking on the necessity of enhancing the welfare of brave wildlife protectors and community members, Mr. Ravi Singh, Secretary General and CEO, WWF-India said, “This partnership is a key milestone where WWF-India and the Apollo Hospitals have come together to provide specialized medical care to both the frontline forest staff and members of the local community, who form an important part of our work. Initiatives such as medical treatment and health check-ups will go a long way in ensuring that people have access to medical care.” Ms. Upasana Kamineni Konidela  Vice Chairperson, Apollo Hospitals Foundation said, “We at Apollo Hospitals Foundation understand the perils that these frontline staff face and we are always there to support them in their endeavour to help conserve our wildlife”.

This minimally invasive surgery could help patients suffering from spine problems like back pain, sciatica, neck pain and tingling numbness. “We are committed to bringing latest procedures, skill and technology for the benefit of population of Nashik and more such procedures will be introduced in future” informed Maj Gen (Dr) Vijay Saraswat, Chief Operating Officer, Apollo Hospital. Dr Shekhar Chirmade, Neurosurgeon, at Apollo hospitals, Nashik, elaborated on the technique, informed that spinal disorder including Lumbar Disc Prolapse, Lumbar Canal Stenosis, Cervical disc prolapse, Injury and fractures of spine frequently require surgery when medical treatment fails. Traditionally, these conditions are treated with open surgery involving long incision, cutting and removal of muscles, ligaments, and some bony parts of spine. It may also involve stabilizing the spine with plates and screws which required more cutting of muscles. All this leads to more pain, long hospital stays and delayed in return of full activity. The scarring of muscles may also lead to long-term spinal pain. Minimal access spinal surgery also known as ‘Key-hole Surgery’ is advanced and innovative technique. It involves smaller skin incision and instead of cutting muscles they are split open with the help of serial dilatation with tubular retractor creating a tunnel. To reach the specific level of spine tube is inserted under X ray fluoroscopy. Once the tube is inserted surgery and decompression of nerves is performed with the help of advanced operating microscope. Spinal fixation, if required, can be performed by fixing screws percutaneously by placing a guide-wire under real time X-Ray guidance and threading the screw over it. The minimally invasive spine surgery offers Very small incision, faster recovery, short hospital stay, no blood loss, less pain and faster return to activity. Dr Chirmade was assisted by team of Anaesthesiologists, Dr. Chetan Bhandare, Dr. Ketan Thombare and Dr. Amita Tipre.  

The National Board for Hospitals and Health care (NABH) Organization is an institutional member of International Society for Quality (ISQua) in Health Care. This esteemed certification is a landmark in our journey of progress and reaffirms our capability to deliver world-class integrated healthcare services to our patients. This accreditation is considered as a symbol of excellence in Clinical Quality and Safety in Patient Care and Apollo Hospitals, Nashik is proud to be in the league of such exceptional and elite organizations in India. The hospital has undergone almost a year of thorough screening process to receive this honoured accreditation. The 118-bedded facility with 3 state of the art Operation Theatres, Cathlab, exclusive infrastructure, finest doctors and dedicated support staff is intended to deliver the topmost level of specialized medical expertise and care to patients across various specialities. Patients will be the biggest beneficiaries of this accreditation as getting NABH accreditation, fully endorses the fact that the hospital has a 360-degree approach towards patient care which entails ethical & safe practices at par with the National Standards; that patient’s interests are kept foremost and patient and family’s rights are respected. The scope of this extends to a number of super specialities like Neurology, Cardiology, Nephrology, Orthopaedics, Gastroenterology, Paediatrics, Trauma Care etc. This will facilitate the patients especially from North Maharashtra to get lifesaving procedures done like Organ Transplant, Heart/Brain surgeries etc. in a NABH accredited hospital that too locally. With this recognition, Apollo Hospitals is committed to exhibit excellent Quality and medical standards with utmost focus on patient care.  

It was a special day when two of India’s largest entities joined hands in the service of the People of Bangladesh – Apollo Hospitals Group and Jet Airways announced their joint service ‘FLY FOR GOOD HEALTH PROGRAM’. This was facilitated by Health Connect International-Bangladesh, a medical consultancy firm. The launch was announced at a joint press meet of Apollo Hospitals and Jet Airways at Dhaka Press Club. The announcement was made by Mr. Rajkumar Bhattacharya, Country Manager – Jet Airways Bangladesh, Mr Jithu Jose, Senior General Manager Apollo Hospitals Group and Mr Shafeeq Azam, Managing Director –Health Connect International, Bangladesh. The program will provide all the guests of Apollo a 10% discount on their flights to Chennai (via Kolkata & Mumbai) and direct flights to Mumbai & Kolkata. The boarding pass will further entail a 10% discount on Apollo’s room rent and health check programs. Speaking at the occasion, Mr Jithu Jose stated that “We are delighted to have this service for our guests from Bangladesh and together with this we are also commencing the Apollo Connect initiative. The Jet offer is a very unique offer and possibly the first of its kind where two major Indian entities have joined hands to provide such a service to our brothers and sisters in Bangladesh, which has become a home away from home. We would also like to announce the Apollo Connect Initiative by our partner Health Connect International and this would be unique service to provide free second medical opinion and I would like to invite all the clinics and doctors to join us in this initiative. Rajkumar Bhattacharya, Country Manager, Jet Airways said, “At Jet Airways, we have always shared a special bond with our guests which goes beyond travel. This unique travel option in collaboration with Apollo Hospitals Group is one more initiative aimed at making air travel more cost-effective for those seeking medical support at a premier institution. This tie up with Apollo seeks to deliver exceptional value while attempting to foster stronger relationships with our guests.” Mr Shafeeq Azam, Managing Director of Health Connect International stated that the service will be offered through their office and in association with Jet airways office at Dhaka Airport. This would help people to have a hassle-free service and absolute handholding right from Dhaka. Mr Md. Abdur Rob, Director of Health Connect International, stated that such initiatives are the need of the hour and especially in healthcare. The established hospitals like Apollo and airline like Jet Airways can help health many lives.