On 23rd April, 2015, Indraprastha Apollo Hospitals today organized a press meet which witnessed presence of organ recipients who were given a new lease of life through cadaver organ donations. The event was addressed by Dr Subash Gupta, Chief Liver Transplant Surgeon, Indraprastha Apollo Hospitals who felicitated the organ recipients and highlighted the significance of organ donation. Dr Gupta motivated the patients to pledge organs and spoke about ‘Gift a Life’ initiative of Apollo Hospitals. Organ donation is quickly evolving into a major treatment protocol across all major hospitals. However, it is yet to make a significant dent in India. With each passing year, the gap between the number of organs donated and the people waiting for organ donation is getting larger. Commenting on the current status of organ transplantation, Dr Subash Gupta, said, “The demand for organ demand outstrips the organ supply. Though we have been slowly picking up, yet despite performing 350 Liver transplants at the Centre for Liver and Biliary Sciences, Indraprastha Apollo Hospitals, Delhi this year there have been very few cadaveric organ donations. Apollo Hospitals ‘Gift a Life’ initiative beckons needy patients for new lease of life. Organ donation from a single brain stem dead donor can give life to seven patients.” Dr Neerav Goyal, Senior Consultant – Liver Transplant, Indraprastha Apollo Hospitals, Delhi said, “Cadaveric donors largely mean “”brain dead”” or “heart beating” donors. However in the west about 15% of cadaveric transplants are being performed from organs retrieved from Non-heart beating donors (donation after cardiac death) and recently the world’s first transplant of a “dead heart” has taken place in Australia. This surgical technique can significantly increase the number of potential donor organs in the near future.” Dr Gupta stressed on creating awareness and motivation amongst masses to make organ donation programme a success. “Though the government has now taken some positive steps to make organ donation simple for patients, people’s mindset has still not changed. Enhanced awareness among people is needed. Initiatives such as Green Corridor project has helped tremendously in strengthening and empowering the organ donation programme. We should build on this initiative and take it up on priority status.” The effective execution of cadaveric organ donation stresses on the education of masses and proactive attitude towards cadaveric organ donation. The Government needs to step in with resources to increase awareness and educate the public on importance of organ donation. Apollo Transplant Institutes were created with the aim of providing world class transplant services across the region. Since the first successful liver transplant in India in 1998, the Apollo Transplant Program has performed 21000 kidney transplants & 5600 liver transplants in children and adults till date. Contributing to this milestone, Indraprastha Apollo Hospitals has performed 5000 solid organ transplants till date. The high quality – affordable cost value proposition that Apollo Hospitals offer has made them the preferred destination for patients not only from India but from more than 30 countries.  

Shri Jagat Prakash Nadda,?Honorable Union Minister for Health and Family Welfare, Government of India released a Textbook on Pediatric Gastroenterology, Hepatology and Nutrition on 7th April 2015. This book is the most comprehensive book on the subject in India. The book has been edited by Prof Anupam Sibal, Group Medical Director, Apollo Hospitals Group and Senior Pediatric Gastroenterologist and Hepatologist and Dr Sarath Gopalan, Senior Consultant, Indraprastha Apollo Hospitals, New Delhi. Dr Vidyut Bhatia, Consultant, Indraprastha Apollo Hospitals and Dr Akshay Kapoor, Consultant, Indraprastha Apollo Hospitals are the editors. The Textbook has been written keeping in mind the latest developments in the field of Pediatric Gastroenterology, Hepatology and Nutrition. Utmost importance has been accorded to incorporating case scenarios which every Pediatrician faces in daily practice in our part of the world. Almost 30% of children who see a Pediatrician suffer from gastrointestinal and liver disorders. The textbook has to its credit many International and Indian authors who are authorities in their respective fields. It will be useful to all readers in the day to day management of gastrointestinal, nutritional and hepatobiliary disorders in children. It has been published by Jaypee Brothers Medical Publishers.

In yet another medical advancement, Apollo Hospitals, Chennai introduces “”the Ideal Knee”” – the future of Total Knee Replacement through a new technique – Attune Rotating Platform Knee Replacement, a first of its kind in South India The surgery was performed on a 63 year old gentleman from Guntur, Andhra Pradesh, India who came with severe arthritis and deformity of both knees. He also suffered from other co-morbid conditions like Diabetes Mellitus, Hypertension, Hypothyroidism and Coronary artery disease for which he had undergone a Bypass surgery 5 years ago. The surgery was performed adopting a new technique – Attune Rotating Platform Knee Replacement using a Minimally Invasive Subvastus approach for both the knees on 09/04/2015. The patented technologies of Attune like Gradius TM curve & Softcam TM contact enables smooth and stable flexion and extension of the knee joint without any abrupt jerks, which makes the patient even forget that a surgery was ever performed on them! As all implants are Hi-flexion implants, Attune gives full flexion like normal healthy knee joint. Advantages of the Minimally Invasive Subvastus approach includes: Small Incision Muscle Preserving Non Dislocation of the Patella and Tibio Femoral joint Results in less pain and quicker recovery to the patient The ultimate benefits for the patient from the technique and implant: The implant may last for more than 30 years, so proves to be an ideal implant for young patients Not only are there various sizes but each size has an different anatomy to match the patients morphology which makes the “”Custom made knees available ready made”” (patients need not do a CT/MRI and wait for weeks for the implant to be designed for them). The surgical technique and the implant design offers the patients less pain, quick recovery and the most comfortable knee almost like their natural knee.

Actor and Pinkathon creator Milind Soman visited Apollo Speciality Hospital, Chennai to increase awareness on breast cancer.

Proton therapy will provide Apollo’s team of Oncologists another critical tool in the fight against Cancer. What is Proton Therapy? Proton therapy is an advanced form of radiation therapy that uses beams of high-energy protons rather than traditional X-rays to irradiate a tumor. The protons are precisely aimed at cancerous cells, attack their DNA and induce their destruction. While X-rays tend to also affect surrounding healthy tissues, protons deposit most of their energy at a precise and measurable location that can be calibrated. This phenomenon is called the Bragg peak and allows to significantly reduce the negative effects usually affecting healthy tissues. With this inherent characteristic of protons, it is thus possible to control the radiation dose, to delimit the irradiated region and to identify and treat the tumor with unmatched precision, efficiency and safety. Clinical advantages of Proton Therapy Due to the unique properties of protons, Proton therapy allows the treatment of tumors with unmatched accuracy, security and efficiency. The administered dose is focused on the tumor and spares healthy surrounding tissues, thereby reducing side effects such as radiation-induced cancers. Due to their intrinsic physical properties, X-rays used in traditional radiation therapy can damage healthy tissue. They indeed have the particularity to pass through biological matter and tissues, leaving a large dose of radiation before and behind the tumor. Protons, on the other hand, are stopped at a certain point and deposit most of their energy at a precise and controllable depth in the patient’s body.  

Patients will get reminders through SMS, voice calls and even counselling if they skip taking the prescribed TB drugs. A special software has been developed that will automatically upload patient information to a TB notification website – Nikshay of the Government of India. The software at the same time will support treatment adherence for patients. . Ms. Sangita Reddy, Joint MD,Apollo Hospitals Group, launched the programme. While launching the intervention programme, hospital officials said that out of 2.2 million (22 lakh) fresh cases, 50 per cent prefer private sector for TB treatment. “At present, there is no automatic mechanism in place to notify TB cases to Government authorities. There is no system of follow-up of cases. The new software will address both these issues. The success rate for TB treatment is over 95 per cent. However, the adherence levels to the drugs is low,” said Project Director, The Union,Mr.Sarabjit Chadha. The software would be tested on a pilot basis at Apollo Hospitals and based on the response would be scaled-up. Hospital officials said that The Union was implementing the project to involve all private health care providers in delivering effective and quality TB services. “The software will send reminders everyday to the patients to take medicines. This is very important because in our experience, once patients start feeling better, they tend to discontinue medicines. This invariably causes complex drug resistant TB,” says Head, Infectious Diseases, SunitaNareddy  

India’s first keyhole multiple bypass surgery on Suman Singhal, aged 53 years, was conducted by Dr Naresh Trehan at the Indraprastha Apollo Hospital, Delhi last week. It took him less than four hours to perform the scarless surgery, without cutting any bone of the patient. This technique uses a combination of small holes in the chest and a small incision, made indirectly over the coronary artery to be bypassed. It is often performed using robotics and video-imaging, which help the surgeon operate in a small area. It is the first of its kind surgery. It will benefit patients, especially women. The scar is not seen as it is below the breast. In conventional bypass, the sternum (chest or breastbone) is cut open, which takes at least eight weeks to heal. This is the first time in India multiple grafts have been put, especially at the back of the heart, through minimally invasive coronary surgery.    

Combined heart and lung transplants – a rare surgery which was previously used as a last resort to treat end-stage lung disease is now being peformed in large numbers as there is an alarming rise in number of patients being referred to Cardiothoracic consultants at a much later stage when there is little to salvage. Senior Consultants, Cardiothoracic and Transplant surgeons, Dr Paul Ramesh Thangaraj, Dr Sunder T and Dr Madhan Kumar discussed how comprehensive interdisciplinary end-stage lung disease management has ensured good success rates at Apollo Hospitals. Speaking at the conference, Dr Paul Ramesh said, “The heart and lungs are intricately entwined organ systems. End stage lung disease can cause failure of the heart and end stage heart disease can cause failure of the lungs. Combined heart and lung transplants are an option for selected patients. A lung alone can be transplanted in those patients where the heart is not irreversibly damaged by lung disease. This calls for increased awareness and early referral. “ Apollo Hospitals, Chennai has performed heart and lung transplants on 6 patients in the last 18 months. It has also done the most number of combined heart and double lung transplants in India. The unit has also successfully performed this procedure on a 67 year old (this is second oldest patient in the world to receive this operation – the oldest was 68 year old). Chennai, over the last few years, has witnessed a lot of transplants, but unfortunately there is little documentation on success rates of these transplants. The donor’s family goes through a lot before taking this huge decision. But what happens after they donate their organs? What happens to people who receive these transplants in the long term? Have their lives been changed by the transplant? Has the ultimate altruistic act of the donor family made any impact on the lives of the people who received the gift? Patients Mr Hanifa, Mr Asokan, Ms Devanayaki and Ms Aruna who successfully underwent transplants were also present to address and break common myths associated with transplants.  

In case of a liver transplantation, the liver is normally used for a single recipient, occasionally split for the benefit of an adult and child, but in this occasion, the donated liver was successfully split and transplanted in two adults; a feat that is rarely achieved. Surgeons who have also performed the first Multi-Visceral transplant in India repeated this rare feat by performing an isolated Intestinal transplantation from the same donor to a young adult who had been struggling for life since childhood due to intestinal failure. Simultaneously, surgeons also successfully transplanted the abdominal wall of the same donor over and above the intestines of another recipient, in-order to overcome the difference in size between the donor and recipient’s abdomens – a first of its kind in South India. These series of feats was achieved by The Centre for Liver Disease & Transplantation, Apollo Hospitals, Chennai led by by Dr.Anand Khakhar,Senior Consultant, Program Director and Dr.Anil Vaidya, a leading Multi-Visceral transplant surgeon from Oxford University along with the CLDT team comprising of Dr.Manish Varma,Consultant; Dr.Anand Ramamurthy,Consultant; Dr.Mahesh Gopashetty, Consultant; Dr.Bipin Vibhute, Consultant and Dr.Prashant Rao, Consultant who undertook this endeavor with courage and outstanding clinical skills.

  Hip Arthroscopy is a cutting edge procedure that involves viewing the interior of the hip joint through a arthroscope, and then using minimally invasive techniques to treat the disorder. Swifter, safer and with superior success rates, experts are convinced that hip arthroscopy will eventually reduce the need for replacement by as much as 50%. It is an intricate and technically demanding domain that has been perfected by very few healthcare providers, globally. Apollo Institute of Orthopaedics is leading the revolution in our country. The Group is launching the first centre of excellence in Hip Arthroscopy in India. This comes on the back of intensive training, assembling a team of highly skilled doctors, and making huge investments in infrastructure.

The World innovation Summit for Health (WISH), a global initiative of Qatar Foundation for Education, Science and Community Development, is a melting pot of Ministers, experts, policymakers and academics all dedicated to overcome the growing health threats of today. At the summit, Apollo Hospitals showcased its eACCESS initiative, which aims to make critical care specialists available round the clock in order to provide high quality care to patients in the ICU. The state-of-the-art hardware and software products enable clinicians to connect to and monitor multiple ICUs from a central location. The central command center acts as a hub and the peripheral ICUs as spokes. Clinical data from equipment connected to patients in the peripheral ICUs is displayed as a “dashboard”, enabling continuous monitoring of vital data and laboratory values alongside the patient’s electronic medical record. This initiative will benefit hospitals that face challenges managing ICU patient.

Kidney transplants are an expensive surgical intervention for patients suffering from renal failure. Under the programme, titled ‘Peace Clinic’, the two healthcare institutions will work together on cases of patients who are in need of kidney and liver transplants. The diagnosis and screening will be conducted by doctors at Dr.Ziauddin hospital, who will then discuss the case with experts at Apollo Hospitals in India. For now, the two medical facilities have jointly set up a combined liver ward for pre- and post-transplant care at Dr.Ziauddin hospital. At this facility, the patients will be assessed for their transplant needs and then referred to India for the procedure, if necessary. The experts also plan to add an internet-based help facility for patients in addition to a telephone helpline. Speaking at the launching ceremony of the Peace Clinic, Apollo Hospitals Group Medical Director, Dr.Anupam Sibal said, “This programme will not only save money and time for the citizens of Karachi, but will also give them access to better health facilities.” He added that till now, they had received approximately 540 cases of kidney and liver transplantation from Pakistan. “Each year, we receive around 100 to 140 cases from Pakistan.” The success rate of these cases is almost 90 per cent, he said. Dr.Sibal hoped that through this flagship programme, they would be able to bridge the geographical barriers and provide better health facilities to the people of Pakistan. The Medical Superintendent of Dr.Ziauddin Hospital, Dr.Anoop Dawani said, “I am proud that Dr.Ziauddin Hospital is the only facility in Pakistan to have taken the initiative to address the transplantation needs of the people of our country”.