Living under phototherapy since birth, liver transplant enables peaceful sleep in the dark in a cozy bed – finally nights dawn in the life of a girl with Criggler Najjar syndromeWhere there is despair, hope….where there is darkness, light…..goes the famous prayer by St. Francis of Assissi. But what if light becomes one’s despair and a peaceful night’s sleep in the dark someone’s biggest hope? How many of us know that snuggling up in the sheets for a peaceful night’s sleep, something we all take for granted, is denied forever to patients with a disease called Criggler Najjar Syndrome?This was Amal Abubakkar Sayeed’s predicament.….she was to remain under direct light for hours together, ever since she was born, for she was born with this rare disease that affects about 1 in a million. A disease in which an enzyme deficiency in the liver causes impaired excretion of a pigment called bilirubin that accumulates in the body causing severe jaundice starting within a few hours of birth. Untreated, the high bilirubin enters the brain causing fits, permanent brain damage and hearing loss. To prevent this, the jaundice needs to be controlled by keeping the baby naked, with only the eyes and genitalia covered, under lights of a specific wavelength through specially designed phototherapy machines. Phototherapy metabolizes the bilirubin allowing it to be excreted in the urine. Beyond a limit, to protect the brain, the jaundiced blood is removed from the body and simultaneously replaced with normal blood in a process called exchange transfusion.This is the life that was given to Amal. On the day she was born, she developed severe jaundice and the phototherapy unit became her destiny. The comfort of her mother’s lap was not meant for her, for she had to be under the lights, taken out only for feeding. For 2 months she was in hospital, undergoing repeated exchange transfusions and intensive phototherapy.And then she came home, along came her phototheray unit. For 16 -18 hours in a day she would remain under the lights. Born in Yemen, the first child of young consanguineous parents,  who never got a day to enjoy their parenthood. This light was their curse, they learnt to live with their curse.At around 1 ½ years of age, Amal was brought to India. The only cure was a liver transplant that could provide a healthy liver capable of producing the deficient enzyme. The parents were prepared but none of them was a suitable donor. For lack of a donor, they opted for stem cell treatment – an experimental therapy for the disease, at another city in India. Her jaundice decreased partially for a few months decreasing the need for phototherapy, but she was back to square one within 6-8 months.She was 2 years and 3 months of age when they returned to India to Apollo Hospital, Delhi. By now, she had developed some slurring of speech, difficulty in walking and weakness in both the legs indicating early brain damage. Our pediatric neurologist, an authority in her field, opined that her MRI changes could possibly reverse after a liver transplant. Any further delay and she would be a cripple forever. Her hearing was intact.A liver transplant for this disease had never been performed in India. Amal’s maternal aunt volunteered to donate. Amal became the first successful liver transplant recipient for Criggler Najjar Syndrome in India. Within 2 weeks, her jaundice had normalized and for the first time in the 27 months that she had lived, her eyes were white instead of yellow.More than 12 years down the line, she is like any normal girl going to regular school, growing normally, her speech and gait perfect. Only her mother’s moist eyes when she puts her to bed, kisses her goodnight and switches off the lights, speak of her extraordinary tale. She has finally been blessed with darkness.The Clinical Perspective This was the first case of liver transplant for Criggler Najjar syndrome in our country. We were skeptical of the neurological prognosis fearing the deficits, though they were mild, would not improve. Her totally normal development and neurological recovery were well predicted by our pediatric neurologist.

Dr. Sanjay, India’s first successful pediatric liver transplant recipient in 1998 paves the way ushering in a new era in Tranplant SurgeryDead ends force us to seek new routes and history has shown us that adversity brings out the best in humanity. The potential of the human mind is beyond measure. To be a catalyst in the chemistry of breakthrough is a great honour. Just as the world celebrates Louis Brown as its first test tube baby, India celebrates Sanjay Kandasamy as its first successful pediatric liver transplant recipient.Sanjay was born with biliary atresia, a disease of infancy that affects about one in 15,000 babies. When a baby has biliary atresia the flow of bile from the liver to the intestines is absent or blocked. The biliary system is a network of ducts and channels that drains bile from the liver cells to the gall bladder. Bile is then released to the intestines. Bile helps to digest fat and carry waste products for excretion. In biliary atresia, it gets trapped inside the liver causing damage and scarring that leads to cirrhosis. As the liver becomes scarred, it presses against the walls of the veins and blood cannot pass through them properly. The result is portal hypertension (high blood pressure in the portal vein). Biliary atresia in 1997 was a death sentence in our country and most parts of the world.Survival beyond 1-2 years was unfathomable.  The only hope was a Kasai surgery that helps re-establish bile flow from the liver to the intestine by joining the two directly. It has a dismal success rate if delayed beyond 2 -3 months of life.  By the time a diagnosis was arrived at, most children would be too old for a favorable outcome. Even with a successful surgery, the child would ultimately develop liver failure over the years in almost 70-80% of the cases.Sanjay developed jaundice a few days after birth. As the jaundice increased, he underwent investigations and a diagnosis of biliary atresia was made. He was referred for a Kasai operation and had the surgery at 62 days of life but his liver had already been damaged. He continued to have jaundice and also developed recurrent episodes of fever and abdominal distension. By 18 months of age, he had severe growth failure, was severely jaundiced, all swollen up because his diseased liver failed to produce appropriate protein leading to fluid accumulation in his body.His only hope for survival was a new liver. His parents knew he didn’t have more than a few months at the most. Their doctors had mentioned the possibility of undergoing a liver transplant abroad. That option was way beyond their financial capacity. A liver transplant programme had been started at Apollo Hospital, Delhi around that time but the only child transplanted (who had received a cadaver liver which did not function) had not survived.They were in a dilemma. Though the financial hurdle was overcome as the hospital was willing to do away with the charges, they were still unsure. They did not want their child to die suffering in hospital, far away from his native place and family. Should they allow him to live peacefully as long as he could? The thought that they could end up losing the few weeks that he had was heart wrenching. Would they be able to live with that guilt? A parent would have to undergo a major surgery to donate a liver segment. To subject oneself to a surgery that had never been done in India was walking a dark, unknown path. What if they ended up losing both their son and their partner?Liver transplant was a difficult and unsure path, nevertheless, it was the one that showed a bleak ray of promise. Hoping against hope, they clung to that miniscule ray. With tremendous courage they swallowed all their fears and chose to risk all they had to give Sanjay a chance. After all, great love and great achievements involve great risk.It was a decision they celebrate to this day when their son hugs them. His mother still finds it difficult to hold back her tears when she recollects his days in hospital. Sanjay had a very complicated postoperative course and was in hospital for 4 months after his transplant. He required prolonged ventilation, developed repeated perforation of his intestines undergoing surgery five times. He required high dose medications to treat liver rejection as his body’s immune system fought the new liver. Repeated surgeries and prolonged ventilation led to infection that was another challenge to overcome. But overcome he did, each and every hurdle that was thrown his way.Today, 22 years down the line, he aspires to be a surgeon himself having already completed his medical graduation to become a doctor. He continues to inspire families facing the transplant option and doctors when tough clinical scenarios daunt them. He is truly the path breaker.  The Clinical Perspective Sanjay was the first child to undergo living related liver transplant in India. He developed one complication after another. The transplant surgery itself had been successful with the graft and blood vessels well taken. To lose a patient to surgical issues in other organs would have been very painful. Sanjay underwent multiple other abdominal surgeries, each a potential threat to his life and our transplant programme.

Twin blessingsTwo sisters save their brother by donating a part of the liver and a kidney in a child from Ethiopia, requiring a combined liver-kidney transplantMukhtar Ahmed Ali Gadkarim, a 13 year old boy from Sudan was brought to Indraprastha Apollo Hospital, Delhi with end stage renal failure. He had been passing stones in his urine since the age of 7 and had damaged both his kidneys requiring hemodialysis thrice a week for a year. He was in complete renal shutdown with no urine output for 12 hours and generalised swelling of the body due to fluid retention.  He was hypertensive, his kidney tests were deranged with a serum creatinine of 5 mg/dl (normal 0.3-1.2 mg/dl) and ultrasound of the abdomen revealed bilaterally calcified kidneys.He was detected to have very high oxalate levels in his blood and bone marrow leading to the diagnosis of a very rare genetic disorder, primary hyperoxaluria. This has a prevalence of only 1 to 3 per million and results due to a biochemical defect in the liver. A deficient liver enzyme leads to excessive production of oxalate that complexes with calcium to form calcium oxalate crystals which accumulate in the kidneys, bone, heart and other organs.  Earlier, a definitive diagnosis required documenting the deficient enzyme in liver tissue by obtaining a liver biopsy. But with the availability of genetic studies, we can isolate the aberrant gene by gene sequencing, thus avoiding a liver biopsy. He tested positive for the AGXT gene that causes primary hyperoxaluria, thus confirming the diagnosis.Dialysis is inadequate treatment for these patients as it cannot overcome the ongoing oxalate production. A kidney transplant alone doesn’t suffice as the oxalates will reaccumulate and damage the new kidney as well. Cure occurs only if the deficient host liver is replaced with a liver that has the deficient enzyme, thus necessitating a combined kidney and liver transplant.Mukhtar was given multiple sessions of haemodialysis over a month and a half to deplete oxalate from the body before transplant. Fortunately, he did not have cardiac damage and was in a position to withstand the formidable surgery. His story is a glorious tale of human courage, bonds and sacrifice. His twin sisters aged 27 years were the donors, one for the kidney and another for the liver. One of the sisters is a doctor and played a crucial role in mentally preparing the family for the transplant.A team comprising of liver and renal transplant surgeons with expert anaesthetists performed the surgery that lasted nearly 12 hours, with the liver being transplanted first followed by the kidney. Mukhtar’s recovery was dramatic and he was off the ventilator within 24 hours. His renal parameters improved, his urine now did not show any oxalate crystals and he was discharged in 3 weeks’ time. Both his sisters also recovered well and the jubilant family returned to their native country with a new lease of life, overwhelmed with gratitude towards our country, our doctors, modern medicine and divine grace.     The Clinical Perspective Arriving at a diagnosis was the first challenge. Increased oxalate excretion in the urine is the usual first line test but Mukhtar wasn’t producing any urine at all. Oxalate crystals were detected in the eyes and genetic tests sent were confirmatory. That he had twin sisters was a blessing. He needed two donors, one each for the liver and the kidney. It was a huge help both for the family and the transplant team that one of them was a doctor herself.  On a follow up of 4 years, he has remained well with no significant post transplant complications.

~ Health of the Nation 2021 Report gives unique perspective on trends of non-communicable diseases across the country, shows path for early identification and management using AI, ML and data analytics ~National, April 7, 2021: On the occasion of World Health Day, the Apollo Hospitals Group, Asia’s largest and most trusted healthcare group, unveiled a report on the Health of the Nation that puts a spotlight on how the last two decades have seen a steady rise in non-communicable diseases (NCDs).  The contribution of NCDs as the top causes of death in India has risen to a staggering 64.9% as compared to communicable diseases, maternal and other causes that dropped to 25%. The study provides a unique perspective drawn from Apollo Hospitals’ 37 years of experience and its vast footprint across the country and underlines how Artificial Intelligence and Big data analytics can help to predict risk and prevent NCDs. Given the pandemic, this is also important as individuals with NCDs such as diabetes, heart disease, hypertension, chronic kidney disease, and chronic liver disease have a greater mortality risk from COVID-19.Dr Prathap C Reddy, Chairman, Apollo Hospitals Group said,“Even before the pandemic began, we have been facing an unacceptable loss of lives due to non-communicable diseases (NCDs). The silent epidemic of NCDs was evident with NCDs behind 40% of all hospital stays. However, in dealing with the COVID-19 pandemic, the data from our Health of the Nation report made it clear that we have let another epidemic slip, the epidemic of NCDs – the impact of which we are already beginning to see around us. We can overcome NCDs together as a country, only if each and every one of us take our health seriously.“At Apollo, we have been working on preventive health for over 37 years. From the very first Master Health Check in the country, we have been constantly evolving our programs for early detection and better clinical outcomes. Apollo ProHealth is a proactive personalized health management program backed by cutting-edge technology – advanced diagnostics, artificial intelligence and predictive algorithms – to help identify your health risk. It coaches you to stay on the path to wellness until your health goals are achieved. With Apollo ProHealth, we hope to change the health check paradigm from a long checklist of tests to a meaningful conversation with the doctor on the status of your health, with a comprehensive plan to make you healthier tomorrow than you are today. Today, on World Health Day, on behalf of the Apollo Hospitals Group, I dedicate Apollo ProHealth to the health of our nation!”NCDs affect not just health, but also productivity and economic growth. The 2030 Agenda for Sustainable Development adopted by the United Nations recognises NCDs as a major challenge for sustainable development with the target to reduce premature mortality from NCDs by one-third by 2030. The pandemic last year has exacerbated the risks and impact of NCDs manifold, as also shown in the Health of the Nation report.Dr Sangita Reddy, Joint Managing Director, Apollo Hospitals Group said,“Apollo Hospitals’ commitment is to the health of the nation, with a vision to make our nation healthier. With the urgent need to respond to the challenge of non-communicable diseases, we cannot afford a pure treatment and curative approach to health. We believe that a focus on prevention will be transformative for the health of the nation. We are harnessing the power of technology to develop new methodologies for screening, detection, and patient risk profiling. We are using our pioneering experience of over 37 years and countrywide network to create and innovate new models of care to improve clinical outcomes. We have been the first to adopt Artificial Intelligence and Big data analytics to predict risk and personalize care.“Today, we are showcasing our insights into a vast amount of health data that will form the foundation of a healthcare model for our future. Many arms of Apollo Hospitals have worked together, collating their knowledge, data on the incidence of disease, and put that into one holistic report that is a representative study of the Health of the Nation.”NCDs account for 65% of all deaths in India. There is a need to look at new norms of preventive health management that allow us to detect and tackle risks from NCDs before they manifest, even more so in the context of the COVID-19 pandemic. The Health of the Nation report offers a unique perspective of the healthy and unhealthy – across occupations, economic segments, and demographics, and trends of non-communicable diseases across the country.The study will help put in place approaches to improve disease prevention, increase the accuracy of early diagnoses that will, in turn, lead to a more personalized and patient-centric treatment approach.Dr Anupam Sibal, Group Medical Director, Apollo Hospitals Group said,“The Health of the Nation study highlights the need to direct our efforts efficiently towards controlling NCDs through optimal use of our healthcare infrastructure.The highest prevalence of pre-diabetes and diabetes is seen in 45-60 year olds and is almost as high as the 60+ age group. Amongst the diabetics, around 50% also have hypertension and are above the recommended weight. Around 60% of these diabetics are also leading a sedentary lifestyle. The data also indicates that while women have lower incidence of NCDs, the difference is marginal. Hence, they must stay vigilant. The economically disadvantaged are also not spared, although with lower prevalence.”There is a significant diabetes population in the major metros and suburbs of India, especially the Delhi NCR – Punjab & Haryana Belt, Kolkata, entire Mumbai-Ahmedabad belt, Hyderabad and Chennai, Kerala and Tamil Nadu, as well as in the predominantly rural areas of MP, Maharashtra, UP, Bihar, parts of Orissa and Gujarat. There is a significant hypertensive population in major metros such as Delhi, Punjab & Haryana, Kolkata, Mumbai, Goa, Trivandrum and Hyderabad and in the predominantly rural areas in Tamil Nadu, Karnataka, UP, Bihar, Orissa and Gujarat.Prof. Nirmal Kumar Ganguly. Former Director-General, Indian Council of Medical Research and President, Apollo Hospitals Educational and Research Foundation said,“Our pilot community health model, Total Health, to reduce premature NCD-related deaths in rural areas was launched in 2013 in Aragonda, Chittoor district. The program saw 31,350 people classified as low risk, moderate risk and high risk, according to their ten-year risk of developing NCDs, and proactively managed with regular follow up, investigations, medication, clinical interventions, counselling and lifestyle modifications for diabetes, hypertension and cancer. In addition, the program also addresses all other social determinants of health in the country (e.g., drinking water, nutrition, kitchen gardening, livelihood generation) to beyond just health to ‘Total Care’ for ‘Total Health’.Around 80% of mortality from NCDs is preventable with early detection and proper management. It is critical to continue to focus on regular health check-ups to detect NCDs along with AI-enabled tools that allow premature health events to be identified early.Under this program 1,980 diabetic and hypertensive patients have been put under regular follow up, who are under now control with proper investigations, medication, counseling and life style modifications. Also 5,391 rural women were screened for cancer and 17 early cancer cases (cervix and breast) were diagnosed and managed with appropriate health intervention services which were free of costDr Sujoy Kar, Chief Medical Information Officer said, “The study gives us the data that will allow the effective use of technology to predict risks and guide our actions to prevent and rein in the NCD epidemic. One such example is to evaluate and manage the High Sensitive Troponin-I (hsTnI)categorical CVD risk in subjects undergoing preventive health checks (PHC).  “AI and predictive algorithms can predict risk, prevent premature health events, and overcome chronic lifestyle diseases, when caught early. For example, we have developed a Cardiovascular Risk Score (AICVD) in the Indian population and it is now prospectively used and followed up on 33000 individuals as part of ProHealth to predict the risk of developing cardiovascular disease.There are various clinical tools using AI and data analytics ready for deployment as well as under research for various NCDs. These include tools and algorithms to identify medical issues early in CT scans, predict various risks including the risk of developing cardiovascular disease, asthma, liver fibrosis in NAFLD, breast cancer, pre-diabetes and stroke.Dr Sathya Sriram, CEO, Preventive Health, Apollo Hospitals Chennai said,“The Health of the Nation study has shown us the importance of shifting the paradigm in India from a curative to a preventive mindset. Apollo ProHealth, empowered by AI and predictive algorithms, is a personalized proactive health management program based on 22 million health checks, building on Apollo’s pioneering efforts in preventive care and led by medical experts committed to making individuals healthier. Apollo ProHealth includes personalized health risk assessment to predict health risks and diagnostics tailored to your profile, physician-led evaluation for a personalized treatment plan and wellness goals, and Health Mentors to regularly monitor your health parameters and help individuals stay on the path to wellness. Over the last 12 months, a cohort of ProHealth guests with diabetes have shown 33%-60% target achievement across multiple health parameters, such as blood pressure, cholesterol, physical activity and HbA1c. The Health of the Nation report is the basis on which NCDs can be managed proactively, with the data used for early identification and management of NCDs using AI and data analytics to enable India to follow an accelerated path to meet SDG goals by 2030.

 National, April 6, 2022: On the occasion of World Health Day, Apollo Hospitals, Asia’s largest and most trusted healthcare group, unveiled the Health of the Nation 2022 report highlighting the prevalence and distribution of non-communicable diseases (NCDs) across the country. Based on 16 million anonymized responses to the COVID-19 Risk Assessment Scanner by Apollo 24/7, the report gives critical insights on trends in NCDs such as diabetes, hypertension and heart disease, COPD & asthma, obesity in different regions of the country. The report also underscores the potential of AI and data analytics in prediction of risk and early identification as well as management of NCDs.           Dr Prathap C Reddy, Chairman, Apollo Hospitals Group said, “The last year saw the country steadily building a bulwark against COVID with a robust vaccination program that led to a steady fall in the number of COVID cases. As we emerge from the shadow of COVID, it is imperative to bring the focus back on the pandemic of NCDs, a focus that faced a disruption impacting diagnosis and treatment for millions of patients. It is the only way we will succeed against the multiple challenges we face today with the pandemic, a polluted planet, and an increasing incidence of diseases that form the theme for World Health Day 2022 – Our Planet, Our Health.“For a developing country like India, NCDs are a critical matter that need to be addressed. In India, NCDs kill 6 million people every year of which around 23% are between 30-70 years of age.[1] An analysis of the data from 3.8 Lakh responses to the COVID Scanner shows the criticality of addressing the NCD challenge using all the tools at our disposal. The data indicates a national prevalence for diabetes mellitus of around 7%, over 8% for hypertension, and around 2% for COPD & asthma. Considering our population of 1.2 bn., these are huge numbers that will increase the burden of disease and impact productivity and economic growth. We must address the NCD challenge through promotion of healthy lifestyles, early diagnosis and management. We must approach Health as investment and not as an expenditure”Key findings of the Health of the Nation 2022 report for Diabetes Mellitus show an increased prevalence in the southern and eastern parts of the country with an average national prevalence of 6.96%. Urban areas showed a higher prevalence at 7.01% as compared to rural areas with 6.70%. The study also showed obesity in women over 35 years of age leading to poor diabetes control and increasing risk of heart disease and other complications. Data also indicated poor diabetes control in women with high cholesterol with a 0.5 increase in HbA1c diabetes marker levels. In Hypertension, the study showed a national prevalence of high blood pressure at over 8.18% with a higher incidence in North and East India. Data also indicated that adult males between the ages of 36 to 50 years have a 36% higher chance of developing hypertension than adult females in the same age range. Urban areas at 8.6% showed a higher incidence as compared to rural areas with 7.58%.Chronic Obstructive Pulmonary Disease (COPD) and asthma showed an incidence similar to global numbers at 2%. Here, females between 36 to 50 years of age showed a 1.3 times higher chance of developing COPD as compared to males.NCDs pose devastating health consequences for individuals, families and communities with socioeconomic costs that can derail India’s achieving the target of reducing premature mortality from NCDs by one-third by 2030 in line with the United Nations Agenda for Sustainable Development. It is imperative, that only by adopting Artificial Intelligence and Big data analytics to predict risk and personalize care, we can help give an advantage to healthcare providers!Dr Sangita Reddy, Joint Managing Director, Apollo Hospitals Group said,“The theme of World Health Day this year is ‘Our Planet, Our Health’, which is a powerful reminder to put the health of individual and the planet at the center of our actions to create societies focused on well-being. Our annual Health of the Nation study collating a vast amount of real-world data on the prevalence, incidence and risks of disease has led to insights that will help us allocate resources in an optimal manner and develop the right strategy to tackle the NCD pandemic.”The Health of the Nation study also looked at corporate employee data of about thirty-five thousand, where the average prevalence of at least 1 NCD in employees is about 56%. The NCD risk factors of high cholesterol is prevalent in 48% of employees and obesity in 18% of employees. There is variability across sectors, indicating that more sedentary corporate settings should consider ways to help their employees proactively reduce these risks.Dr Sangita Reddy added,“NCDs are fuelled by many factors that include urban lifestyles with stress and unhealthy diets and an aging population. Study results, derived from 35,000 health checks done with corporates in 2021, has also shown a high prevalence of NCDs among corporate employees. These insights will help us use technology to gain an upper hand in ensuring a healthy workforce. Combined with our pioneering experience of 38 years, we have at our disposal new technologies based on AI and ML for predicting risk scores and developing structured lifestyle programs with new models of care that lead to improved clinical outcomes.”The AICVD risk score predicted a moderate or high risk of a cardiac event within 10 years in half of the 31-50 year olds. Other screening programs, especially for cancer, help with early detection and treatment for improved survival rates.Dr Sathya Sriram, CEO Preventive Health, highlights the silver lining, “On the positive side, the report also showed that structured programs help individuals who are at risk to implement and sustain lifestyle changes that reduce risk and slow the progression of the condition.” Enrollment in Apollo Clinics’ Sugar Program showed a mean HbA1c reduction by 1.2% between the first and fourth visits. Data from Apollo ProHealth, a proactive personalized health management program backed by advanced diagnostics, artificial intelligence and predictive algorithms, showed a mean HbA1c reduction for diabetics by 0.73% over 6-12 months, as well as an average weight loss of 3.9kg for 60% of those who engaged actively with the program.About Apollo Hospitals:It was in 1983, that Dr. Prathap C Reddy made a pioneering endeavor by launching India’s first corporate hospital – Apollo Hospitals in Chennai.  Now, as Asia’s foremost trusted integrated healthcare group, its presence includes over 12,000 beds across 72 Hospitals, 4500+ Pharmacies, over 120 Primary Care clinics and 700+ Diagnostic centers, 500 plus Telemedicine Centers, over 15 medical education centers and a Research Foundation with a focus on global Clinical Trials, epidemiological studies, stem cell & genetic research, Apollo Hospitals has been at the forefront of new medical advancements with the most recent investment being the commissioning of South East Asia’s very first Proton Therapy Centre in Chennai.Every four days, the Apollo Hospitals Group touches a million lives, in its mission to bring healthcare of international standards within the reach of every individual. In a rare honor, the Government of India had issued a commemorative stamp in recognition of Apollo’s contribution, the first for a healthcare organization. Apollo Hospitals Chairman, Dr. Prathap C Reddy, was conferred with the prestigious Padma Vibhushan in 2010.  For 37 years, the Apollo Hospitals Group has continuously excelled and maintained leadership in medical innovation, world-class clinical services and cutting-edge technology. Its hospitals are consistently ranked amongst the best hospitals in the country for advanced medical services.

“Dr Prathap Reddy, considered a living legend and an architect of modern health care in India, was conferred with Lifetime Achievement Awards 2022 by Forbes India, The Economic Times and Business Standard“In 1983, when most Indians were dependent only on charitable trusts and government-run hospitals, Dr Prathap Chandra Reddy saw potential in India’s healthcare sector and started the first professionally run 150-bed private hospital – Apollo Hospitals in Chennai, India.Over time, Apollo Hospitals has grown to become a pioneer in the corporate healthcare sector in India, with over 70 hospitals under its umbrella having more than 7,500 clinicians who treat 400,000 patients annually. The establishment of Apollo Hospitals stems from Dr Reddy’s dream to make world-class health care accessible and affordable to every Indian.For his courageous and colossal vision to provide world-class, high-quality hospital care in Inda, Dr Prathap Reddy was honoured with three prestigious Lifetime Achievement Awards consecutively from:FILA 2022 Lifetime Achievement Award from Forbes India for leadership ExcellenceBusiness Standard Lifetime Achievement for Corporate ExcellenceThe Economic Times’ Lifetime Achievement Award for filling a void in India’s healthcare systemDr Reddy has been providing quality healthcare in India, showing no signs of slowing down as he says, “health has no holiday.”The awards stand testimony to Dr Reddy’s tireless perseverance in establishing a pan-India group addressing the country’s growing need for high-quality advanced healthcare so patients do not have to go abroad for treatment.Under Dr Reddy’s astute leadership, the Group has established a landmark healthcare chain with a presence in pharmacies, diagnostics and retail healthcare, becoming Asia’s foremost integrated healthcare services provider. His contributions are widely recognized by patients, doctors, the healthcare fraternity worldwide, the community at large, and the Government of India.

OverviewFalls are the most common problem faced by the elderly population. These falls can result in serious injury. As per a study published in the Indian Journal of Public Health in 2019*, falls (especially among the elderly) are the most frequently reported incidents in critical care hospitals accounting for 14 – 53 per cent in India.Multiple research studies on risk assessment of falls have documented well-established fall risk factors in a hospital setting. However, assessments alone does not prevent patient falls. If you or your loved ones is admitted in a hospital, you should take some common measures like staying in bed or staying seated to reduce your risk of falling during your hospital stay. Nurses or other caregivers can ensure that you have easy access to things you may need like food, water, phone, etc.Apollo Hospitals conducted an audit on knowledge and practice of nurses concerning prevention and management of patient falls.Definition of fallA patient fall is defined as an event that results in a sudden, unplanned descent (fall) of a patient to the floor with or without injury.Falls may be at different levels – i.e., from one level to ground level e.g. from beds, wheelchairs or down stairs on the same level as a result of slipping, tripping, or stumbling, or from a collision, pushing, or shoving, by or with another person below ground level, i.e. into a hole or other opening in surface.Not all patient falls are predictable or preventable in acute care hospitals. Some falls are simply the result of individual physiological responses to illness or treatment in care settings in which patient ambulation is essential to recovery.Types of fallAccidental falls– Occur when patients fall unintentionally because of an environmental hazard or equipment failure (14% of all falls).Anticipated Physiological Falls– Occur in patients with known risk factors for tripping related to the patient’s underlying medical condition (78% of all falls)Unanticipated Physiological Fall– Falls which occur in patients who do not have identified risk factors until the fall occurs – e.g. faints, seizures. (8% of all falls)Fall Risk AssessmentIPSG6 (International patient Safety Goals 6), a part of evidence-based fall safety initiative, was developed to prevent patients from falling. For any fall prevention program, the characteristics and activities of patient linked to an increased risk of falling should be the main focus. While there’s some form of assessment for risk of falling among patients that is likely to help determine when special prevention interventions are needed, there is currently very little evidence to support the use of fall risk assessment tools.There is nothing to suggest that the use of a generic assessment tool (identified from the literature) offers greater accuracy than tools developed by institutions based on local patient characteristics.No interventions have, currently, been proven to be effective in fall prevention in the acute care setting. Expert opinion, however suggests that institutions should have a falls prevention program consisting of multiple interventions aimed at minimizing the individual patient’s risk of falling. While the use of multiple fall prevention interventions was the most common approach, results of their effectiveness are contradictory.How Hospitals Can Prevent Patient FallsOur bench mark is 0.5 rate per 1000 inpatients; Apollo Hospitals has taken more measures to reduce the fallThe measures as follows:Identifying the vulnerable groupsAssessment of Vulnerable patient within 2 hrs.Applying yellow band.Applying side railings.Applying brakes for all the cots.Patient First card at the edge of the cot.Education to the relative on fall risk prevention.Education of the staff of fall risk assessment.Uses of grab bars and call bells.Importance of using safety belts on stretcher and wheel chairs.Conducting training classes regularly.High risk assessment through Modified Morse Fall Risk Scale and following Preventive Measures Do’s and Don’ts For Patients to Prevent/Reduce the Risk for FallingIf you are a patient, your nurse will talk about to you about your risk for falling while you are in the hospital. Based on your risk, an individualized fall prevention plan will be developed to keep you safe. A daily mobility plan will keep the patient active and moving. Following are some general do’s and don’ts created for your safety.Do’sAlways sit for some time before standing up and walking to avoid giddiness and falls.Keep the washroom floor dryAt home shower mats can be used to prevent falls in bathrooms for persons having difficulty in walking on wet floor or tiled flooringSeek assistance as and when required to go to the washroom especially in the night and early morningAsk the doctor if any of the prescribed medications can cause giddiness, examples antihypertensive, pain killers like Tramadol so that required precautions can be taken to avoid fallsExercise regularlyWear footwear that do not skidEnsure entryways and staircase areas are well litEducation to the patient and relative on fall risk prevention.Don’tsNever put the side rails downNever forget to call for helpNever make your room darkNever move about or walk (ambulate) without assistance of a health care personnelDo not forget to inform your nurse while change of attendantsFor attendant/Caregiver/NurseNever leave the patient unattendedNever allow the patient alone to washrooms especially during nightReduce the Risk for FallingConclusionPatient fall may result in lacerations, fractures or internal bleeding, resulting in increased health care utilization. Research studies show that close to one-third of falls can be prevented. Fall prevention involves managing a patient’s underlying fall risk factors and optimizing the hospital’s physical design and environment. Therefore, educational module, rounds by night supervisors, fall campaign in the hospital, posters across the hospital on fall prevention, knowing your fall risk will help the organization to overcoming the challenges associated with sustaining a fall prevention program.Authors’ contributions:Department of Quality SystemsApollo Health City, Hyderabad

முன்னணி நாளிதழ்களான “தி டைம்ஸ் ஆஃப் இந்தியா” மற்றும் “தி வீக்” ஆகியவற்றால் வெளியிடப்பட்ட வருடாந்திர சுகாதாரத் தரவரிசையில், 2020-ம் ஆண்டில், அப்போலோ மருத்துவமனைகள் மீண்டும் ஆதிக்கம் செலுத்தியுள்ளன என்பதை அறிவிப்பதில் நாங்கள் மகிழ்ச்சி அடைகிறோம்.குறிப்பாக, இந்தக் கடினமான காலக்கட்டங்களில், உங்களின் தொடர்ச்சியான ஆதரவும், நம்பிக்கையும் இல்லையெனில், இது எங்களுக்குச் சாத்தியப்பட்டிருக்காது. எங்களது மருத்துவத் திறன்களிலும், உயிர்களைக் காப்பாற்றுவதற்கான எங்களின் தினசரி முயற்சிகளின் மீதும் உங்களுக்கு இருந்த தொடர் நம்பிக்கைக்கு நாங்கள் மனமார நன்றி தெரிவிக்க விரும்புகிறோம்.அப்போலோவின் “சீர்மிகு சிகிச்சை மையம்”, சிறந்த மருத்துவ சிகிச்சைக்கான தரவரிசையில் நெ.1—ஆகத் திகழ்கிறது.இதயவியலில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்இரைப்பை குடலியலில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்.நரம்பியலில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்புற்றுநோயியலில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்எலும்பியலில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்நுரையீரலியலில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்நீரிழிவு நோய்க்கான சிகிச்சையில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்குழந்தை மருத்துவத்தில் அப்போலோவின் சாதனைகள் பற்றி அறிய இங்கே கிளிக் செய்யவும்கிழக்கு, மேற்கு, வடக்கு மற்றும் தெற்கு மண்டலங்களில் உள்ள நகரங்கள் வாரியாக தயாரிக்கப்பட்ட தரவரிசை பட்டியலில் அப்போலோ முதலிடம் வகிக்கிறது.மண்டலம்மருத்துவமனைதரவரிசைதெற்குசென்னைஇந்தியாவில் உள்ள சிறந்த மருத்துவமனைகளில் முதலிடம் வகிக்கிறது (டைம்ஸ் ஆஃப் இந்தியா)இந்தியாவில் உள்ள சிறந்த தனியார் மருத்துவமனைகளில் இரண்டாம் இடம் வகிக்கிறது (டைம்ஸ் ஆஃப் இந்தியா)இதயவியல், இரைப்பை குடலியல், எலும்பியல், நுரையீரலியலில் நெ.1 மற்றும் புற்றுநோயியல், குழந்தை மருத்துவத்தில் நெ.2 மற்றும் நீரிழிவு நோய்க்கான சிகிச்சையில் நெ.3 இடத்தில் உள்ளதுஹைதராபாத்ஹைதராபாத்தில் உள்ள சிறந்த மருத்துவனை (டைம்ஸ் ஆஃப் இந்தியா)சிறந்த தனியார் பல்நோக்கு மருத்துவமனை (தி வீக்)நகரத்தில் உள்ள இதயவியல் மருத்துவமனைகளில் நெ.1 (தி வீக்)வடக்குஐஎம்சிஎல் (IMCL)வடக்கு மண்டலத்தில் உள்ள சிறந்த மருத்துவமனை (டைம்ஸ் ஆஃப் இந்தியா)சிறந்த தனியார் பல்நோக்கு மருத்துவமனை (தி வீக்)எலும்பியல் மற்றும் நுரையீரலியலில் நெ.2 மற்றும் புற்றுநோயியல் மற்றும் நரம்பியலில் நெ.3. இடத்தில் உள்ளதுலக்னோசிறந்த தனியார் பல்நோக்கு மருத்துவமனை (தி வீக்)சிறந்த வளர்ந்துவரும் மருத்துவமனை (டைம்ஸ் ஆஃப் இந்தியா)மேற்குபெங்களூருபெங்களூருவில் சிறந்த மருத்துவமனை (டைம்ஸ் ஆஃப் இந்தியா)நுரையீரலியலுக்கென நகரத்தில் உள்ள சிறந்த மருத்துவமனை (தி வீக்)கிழக்குகொல்கத்தாசிறந்த தனியார் பல்நோக்கு மருத்துவமனை (தி வீக்)கொல்கத்தாவில் உள்ள சிறந்த மருத்துவமனை (நெ.2)இரைப்பை குடலியலுக்கு நகரத்தில் உள்ள மருத்துவமனைகளிலேயே நெ.1 மருத்துவமனைபுவனேஸ்வர்கிழக்கு மண்டலத்தில் உள்ள சிறந்த மருத்துவமனை (டைம்ஸ் ஆஃப் இந்தியா)சிறந்த தனியார் பல்நோக்கு மருத்துவமனை (தி வீக்) Book An Appointment 

New Delhi, Apr 23 (PTI) The country”s leading healthcare provider Apollo Hospitals on Friday said it has come out with a book with best practice guidelines for hospitals, nursing homes and healthcare workers amid the COVID-19 pandemic.The COVID-19 Red Book summarises evidence-based best practice guidelines to support big and small healthcare institutions in making quick and timely decisions for diagnosis, treatment and management of COVID and non-COVID cases during the pandemic, Apollo Hospitals said in a statement.

India’s largest hospital chain says it’s ready to administer one million coronavirus vaccine doses a day, but the government has not made clear how vaccines will be distributed and whether private health-care networks will be involved.

Apollo Hospitals has taken a significant leap forward in healthcare innovation with the inauguration of the Centre for Digital Health and Precision Medicine (CDHPM) at The Apollo University in Chittoor, Andhra Pradesh. This ground-breaking initiative, a collaboration between Apollo University, Apollo Hospitals, and the University of Leicester, aims to revolutionise healthcare delivery through advanced digital solutions and personalised medicine approaches. Pioneering Research for Better Healthcare The CDHPM will spearhead research in critical healthcare areas, focusing on: • Cardiovascular diseases • Acute care • Emergency medicine • Multi-morbidity The centre seeks to elevate patient care standards and drive healthcare innovation by concentrating on disease prediction, prevention, and management. This approach aligns with the growing trend in healthcare towards preventive and personalized medicine, which has shown promising results in improving patient outcomes and reducing healthcare costs. Collaborative Education Programs As part of this initiative, The Apollo University is introducing three innovative undergraduate programs in collaboration with the University of Leicester. These programs will be followed by specialized Master’s degrees in healthcare, co-developed by both institutions. This educational partnership aims to: • Equip future healthcare professionals with cutting-edge skills • Foster a new generation of medical innovators • Bridge the gap between academic research and clinical practice Dr. Prathap C. Reddy, Founder and Chairman of Apollo Hospitals Group, commented on the launch: “The Centre for Digital Health and Precision Medicine represents our commitment to shaping the future of healthcare. By combining Apollo’s clinical expertise with the academic prowess of the University of Leicester, we are creating a powerhouse of medical innovation that will benefit patients not just in India, but globally.” Dr. Sangita Reddy, Joint Managing Director of Apollo Hospitals Group, emphasized the centre’s potential: “The CDHPM will catalyse healthcare transformation. By combining digital innovation with precision medicine, we are not just treating diseases; we are reimagining healthcare delivery for the 21st century.” As the Centre for Digital Health and Precision Medicine begins its operations, it stands poised to make significant contributions to medical research, education, and patient care. This initiative reaffirms Apollo Hospitals’ position as a global healthcare leader, committed to pushing the boundaries of medical science and improving lives through innovation and excellence.