ARTICLES ON Press Release

On this World Haemophilia Day, Wockhardt Hospitals Nagpur are taking a step to educate people about this lesser-known disease. Dr Gunjan Loney, Consultant- Haematology and Haemato-Oncology informs us that Haemophilia is a rare blood condition where people do not have the clotting factor which enables their blood to clot when bleeding. It’s an inherited disease that is usually passed from mother to child. Haemophilia is a rare bleeding disorder in which the blood doesn’t clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery. Blood contains many proteins called clotting factors that can help to stop bleeding. People with haemophilia have low levels of either factor VIII (8) or factor IX (9). The severity of haemophilia that a person has is determined by the number of factors in the blood. The lower the amount of the factor, the more likely it is that bleeding will occur which can lead to serious health problems. In rare cases, a person can develop haemophilia later in life called acquired haemophilia.  The majority of cases involve middle-aged or elderly people or young women who have recently given birth or are in the later stages of pregnancy.  This condition often resolves with appropriate treatment. Haemophilia can result in: Diagnosis: To make a diagnosis, doctors would perform certain blood tests to show if the blood is clotting properly. If it does not, then they would do clotting factor tests, also called factor assays, to diagnose the cause of the bleeding disorder. These blood tests would show the type of haemophilia and the severity. Treatment: The best way to treat haemophilia is to replace the missing blood clotting factor so that the blood can clot properly. This is done by infusing (administering through a vein) commercially prepared factor concentrates. Performing the infusions on a regular basis (called a prophylaxis), can even prevent most bleeding episodes. Dr Gunjan also informed, “at Wockhardt Hospitals, we not only provide care to address all issues related to the disorder but also provide health education that helps people with haemophilia stay healthy”. About 15-20 per cent of people with haemophilia develop an antibody (called an inhibitor) that stops the clotting factors from being able to clot the blood and stop bleeding. Treatment of bleeding episodes becomes extremely difficult, and the cost of care for a person with an inhibitor can skyrocket because more clotting factors or a different type of clotting factor is needed. People with inhibitors often experience more joint disease and other problems from bleeding that result in a reduced quality of life. Dr Gunjan LoneyConsultant- Haematology and Haemato-OncologyWockhardt Hospitals, Nagpur Source: https://thelivenagpur.com/2022/04/16/world-haemophilia-day-lets-know-more-about-this-lesser-known-ailment/

Parkinson’s disease is a neurodegenerative disorder of the central nervous system that develops slowly and the symptoms are evident over a period of time. Wockhardt Hospitals in Mira Road has launched a support group to bring together patients and their families and caregivers. According to the hospital, this initiative will guide them about the proper treatment and care required for patients with Parkinson’s disease. The hospital’s programme will provide support by addressing the clinical, physical, diet prudence, and emotional needs of the patient. The hospital claimed that the event saw the participation of 50 patients and families. Parkinson’s disease is a neurodegenerative disorder of the central nervous system that develops slowly and the symptoms are evident over a period of time. The disorder affected the locomotor skills of the patient. Shaking, tremors, rigidity, difficulty walking, and moving are some of the common symptoms of Parkinson’s disease. Parkinson’s is also connected to mental disorders such as depression, anxiety, and nervousness as the disease attacks the dopamine-producing neurons of the brain. “A large number of people are living with Parkinson’s disease. The patient and even his/her family are under stress. It becomes challenging to take care of such patients. There is a poor awareness about Parkinson’s disease. People often ignore symptoms like tremors and slow locomotion in their daily activities attributing them to old age, or stress and depression,” Dr Pavan Pai, consultant interventional neurologist, Wockhardt Hospitals, Mira Road said.   Dr. Pai also stated that now, Parkinson’s is sometimes seen in youngsters (under 50) and is known as young-onset Parkinson’s disease (YOPD). He also informed that secondary Parkinson’s occurs due to repeated head injury, chemical exposure, and post-encephalitic (after brain infection). Dr. Pai revealed that the Parkinson’s Support Group encourages the patients to manage the disease via exercise and therapies other than medication. It helps them to improve their quality of life. Dr Pavan PaiConsultant Interventional NeurologistWockhardt Hospitals, Mira Road Source: https://www.financialexpress.com/healthcare/news-healthcare/wockhardt-hospital-launches-support-group-for-patients-suffering-from-parkinsons-and-their-families/2492980/

Total Knee Replacement (TKR) is the most common and most successful Orthopaedic Surgery in the world. Research data published in Lancet journal in 2019 shows that TKR is a very long-lasting surgery (more than 25 years) in at least 8 out of 10 patients. According to AAOS data 7.5 Lakh TKR surgeries were performed in United States in 2017. According to market research data approximately 2 lakh TKR surgeries were done in India in 2020. There have been tremendous and continuous improvements in surgical techniques, implant designs, surgical materials, longevity and surgical outcomes of TKR. Owing to significant improvements in pain control and anesthesia TKR is no longer a painful or high-risk procedure in expert hands and high-volume centers. Enhanced Recovery after Surgery in TKR (ERAS) Prof. Henrik Kehlet from Denmark proposed various ideas about surgical pain pathophysiology, surgical stress response, multimodal analgesia and fast track surgery in general surgery and gastrointestinal surgery. These ideas were organized in the form of Enhanced recovery protocols (ERPs) and applied to many surgical specialties including orthopedic surgery. ERPs are best suited to total hip (THR) and knee replacement (TKR) surgeries as these are high volume procedures, were associated traditionally with longer hospital stay, higher surgical costs and surgical complications. ERPs help in improving outcomes. Is it time to change surgical practices and adopt Enhanced Recovery Protocols after Surgery? With increasing costs of surgery due to emphasis on quality and standards, expensive implants, strict regulations, numerous healthcare compliances and higher incidence of litigation there is a need to do audit of surgical costs as well as surgical outcomes. Hospitals will be forced to make optimum use of resources and provide best outcomes. The best way to reduce surgical costs in TKR is by reducing complications and reducing hospital stay and scientific evidence proves Enhanced Recovery Protocols achieve both. Advantages of Enhanced Recovery Protocols in TKR ERPs help to reduce hospital stay. Patients experience less pain as there is less tissue damage due to minimal invasive surgical techniques. Patients can resume normal life activities much sooner after surgery. This is important for all ages, but specially in younger and working patients who want to get back to their jobs early as to reduce time off from work and resultant financial losses. According to scientific evidence ERPs are also associated with less bleeding, faster recovery, higher range of motion and reduced risk of complications. Results of Enhanced Recovery TKR at Wockhardt Hospitals Our average length of stay (ALOS) after TKR in Wockhardt is 2.4 days for unilateral TKR and 2.5 days for bilateral TKR which is better than reported TKR ‘LOS’ data from our country. There is no readmission for wound healing related complaints. 90% Patients are walking on day of surgery within 3-4 hours after surgery. All patients are able to use toilets by themselves and climb stairs before discharge which is typically 2nd or 3rd day after TKR.  Patients regain range of motion faster and many patients ae even able to sit cross legged few weeks after surgery. ERPs have improved long term outcomes and satisfaction after TKR at Wockhardt Hospitals and also worldwide. Dr. Alankar RamtekeConsultant- Joint Replacement SurgeonWockhardt Hospitals, Nagpur

Parkinson’s disease, a brain disorder that mostly affects people over age 60, may lead to shaking, stiffness, problems in balance and coordination and eventually difficulty in walking and talking as the disease progresses and gets worse over time. The fastest growing neurological condition in the world has no cure so far. It has over 40 symptoms and affects sleep and mental health of those affected apart from pain and stiffness. The disease affects both men and women, however 50% more men are affected by it compared to women. The neurodegenerative movement disorder occurs when the dopamine-producing cells in a part of the brain called substantia nigra start to deteriorate. The symptoms set in slowly and usually begin with a tremor in one hand or stiffness in movement that will over time progress to stiffness, the inability of coordinating movements, posture problems, a reduced sense of smell, mood changes, and sleep problems. But not much is known about this condition. There are many myths surrounding Parkinson’s disease considering the symptoms are not the same for everyone affected by it. The truth is that some people may not have common symptoms like tremors or even younger people can get the disease. World Parkinson’s Day, observed annually on April 11, is aimed at raising awareness about the disorder. Dr Pavan Pai, Interventional Neurologist, Wockhardt Hospitals, Mira Road and Dr Aditya Gupta, Neurosurgeon, bust myths about the brain disorder. Myth 1: Parkinson’s Disease Only Affects the Person’s Movement Fact: This is not entirely correct because patients with the condition also have non-motor symptoms, which can appear before motor symptoms. Some of the non-motor symptoms are sleep dysfunction, pain, depression, anxiety, cognitive impairment, etc. Parkinson’s disease will impact multiple areas of the brain. Non-motor symptoms also include smelling problems, cognitive difficulties, constipation/bladder problems, fatigue, pain, shaking, small handwriting, anxiety, and depression. Myth 2: Only Elders can Get Parkinson’s Disease Fact: This statement is false. It can affect people of any age group. Myth 3: Parkinson’s Disease Happens Due to Genetic Mutation Fact: The exact cause of Parkinson’s disease is not clear yet. But there can be genetic and external factors behind the occurrence of it. It can run in families, which suggests a genetic (hereditary) factor. But it is also seen in people without a family history of the disease. Someone who has a mutation associated with Parkinson’s disease will not necessarily develop the disease. Myth 4: Parkinson’s Disease is Curable Fact: Parkinson’s disease can be well managed, but there is no cure. The disease does not directly cause death. As the disease progresses, one will become more vulnerable to falls, which could result in injury or loss of life. Regular exercise and physical therapy will improve one’s condition. Medication can help to manage the motor symptoms of Parkinson’s disease causes. Even deep-brain stimulation (DBS, surgery) is an option to control abnormal brain impulses. Myth 5: Treatments Only Work for a Few Years, and beyond Drugs, Nothing Can Help Fact: While there is no cure for Parkinson’s disease, there are drugs and medical technologies available that can help manage the condition. Devices like Deep Brain Stimulation (DBS) are surgical procedures that involve implanting electrodes in the brain that deliver electrical impulses that block or change the abnormal activity that causes symptoms. Myth 6: Tremors Always Indicate Parkinson’s Fact: Though tremors are well-known symptoms of Parkinson’s disease, they can occur due to other medical conditions as well. Myth 7: Parkinson’s is Fatal Fact: Parkinson’s is not fatal in the way other medical conditions like a heart attack might be. People with Parkinson’s can live a long and meaningful life with the correct treatments to manage the condition. It is not a life-threatening disease, unlike a heart attack or stroke. Most patients with Parkinson’s, can lead normal lives and manage symptoms with appropriate treatment. Myth 8: People with Parkinson’s Disease will Not Get Dementia Fact: People in more advanced stages of Parkinson’s will have a higher risk of dementia. Are you aware? Being forgetful, difficulties with planning can occur in Parkinson’s. These symptoms worsen over time and lead to dementia. Dr Pavan Pai, Interventional Neurologist, Wockhardt Hospitals, Mira Road Source: https://www.hindustantimes.com/lifestyle/health/world-parkinson-s-day-common-myths-surrounding-brain-disorder-busted-by-experts-101649421849541.html

World Hearing Day 2024: A good hearing ability helps you to connect with people – listen, engage, observe while hearing loss may have an adverse impact on quality of life. While we may not consciously pay attention to it and at times neglect it, but our hearing health is quite significant for our overall well being. A good hearing ability helps you to connect with people – listen, engage, observe while hearing loss may have an adverse impact on your quality of life, to the extent that it may affect one’s mental health. When you lose connection with people a loneliness envelops you making you anxious and prone to depression. World Hearing Day is observed every year on March 3 to raise awareness on ways of preventing deafness and hearing loss and promoting ear and hearing care across the world. WHO hosts an annual World Hearing Day event at its headquarters in Geneva. The World Hearing Day 2024 with the theme “To hear for life, listen with care” will focus on the importance and means of hearing loss prevention through safe listening. On World Hearing Day 2024, WHO will focus on the importance of safe listening as a means of maintaining good hearing across the life course. “It is possible to have good hearing across the life course through ear and hearing care​. Many common causes of hearing loss can be prevented, including hearing loss caused by exposure to loud sounds​ ‘Safe listening’ can mitigate the risk of hearing loss associated with recreational sound exposure​,” according to WHO. Tips to Prevent Hearing Loss Dr. Sheetal Radia, Consultant Otorhinolaryngology and Head & Neck Oncosurgery, Wockhardt Hospitals, Mira Road Source: https://www.hindustantimes.com/lifestyle/health/world-hearing-day-2022-expert-offers-tips-to-prevent-hearing-loss-101646290709836.html

A patient with 100% blockage in three arteries was treated by Angioplasty in Wockhardt Hospitals, Nagpur instead of CABG surgery. The patient from Jabalpur had three 100% blockages in coronary arteries and was advised to undergo an open heart surgery by three doctors whom he had consulted near his hometown. All the doctors suggested that surgery is the only way to treat him. However, the patient was not willing for surgery and wanted to undergo an Angioplasty. He, then, consulted Dr. Nitin Tiwari, Sr. Consultant- Interventional Cardiology about whom he had received a good feedback in the region. Dr. Nitin Tiwari examined the patient and performed the procedure of Angioplasty. The procedure was very complex and needed high skills and three major arteries were blocked. Dr. Tiwari inserted five stents to remove the calcified old occlusion in this patient’s arteries. Patient’s all three arteries had CTO (any block which is 100% and is atleast there since more than 3 months). “I have used Japanese technology of treatment in this patient. For such cases, the success rate is only 50%. However, using the technique I followed, increases it to 70-80%”, said Dr. Tiwari. “When this patient approached me, he was very skeptical as all the doctors whom he had consulted before me had advised him to undergo surgery. But, as the patient was not willing for the same, we opted for this method and treated him successfully”, he added. The level of contrast given to such patients is also to be monitored to manage the patients. Third artery was kept for angioplasty at a later date as the contrast limit was reached. It was treated later and ultimately, the patient was successfully discharged. Dr. Tiwari has been trained in Japan. The reason why angioplasty has progressed more in Japan is because of the notion that they believe soul goes out when the chest is opened for surgery. Hence they prefer non-surgical techniques like angioplasty. Dr. Nitin TiwariSr. Consultant – Interventional CardiologyWockhardt Hospitals, Nagpur To book an appointment call: 0712-6624100 Source: https://thelivenagpur.com/2022/03/29/instead-of-cabg-patient-with-three-100-artery-blockages-treated-by-angioplasty-in-wockhardt-hospital/

Opted for the endoscopic procedure instead of surgery In a highly skilled and complex procedure, the life of a 24-year-old patient was saved in Wockhardt Hospitals in Nagpur. After a road accident, the patient had a ruptured Oesophagus (food pipe), a fracture in the facial bones & skull. Dr Piyush Marudwar, Consultant- Gastroenterology, who was primarily treating the patient, repaired the ruptured food pipe. Dr Rahul Zamad, Consultant- Neuro Surgery, operated on the damaged skull bone and Dr Parikshit  Janai, Consultant- Plastic Surgery, repaired the damaged facial bones. The patient hailing from Jabalpur was brought to the emergency department of Wockhardt Hospitals where he was initially stabilised by giving primary care.  When he came to Wockhardt Emergency room, he was not completely conscious, his O2 level was low. He had a head injury with bleeding from the nose, convulsions and vomiting. Due to a rupture in the food pipe, air and fluid leaked into his chest cavity which further got infected. He was started on O2 support and other supportive care and was admitted under Dr Piyush Marudwar. The same morning Dr Marudwar did UGI endoscopy and site of perforation in Oesophagus using the life-saving, advanced procedure and the latest technique called Full Thickness over the scope Clipping and sealed the perforation. This case was more challenging as the site of perforation was very high up in Oesophagus. Major Surgery was avoided using this latest endoscopic technique. The next day Using a CT scan, it was confirmed that perforation was sealed completely, so he was started on an oral diet. Tricky Facial bone Fracture Surgery was done by Dr Parikshit Janai, to avoid facial deformity in a young boy of 24 years old. Dr Rahul repaired the skull base using innovative endoscopic skull base repair. The patient also had Meningitis (infection of brain coverings).  Meningitis was treated using Epidural and Intravenous antibiotics with the help of Dr Vaibhav Agrawal who is a consultant Physician and Intensives. In good centres across the world Survival rate with this type of meningitis is only 20-30 %. This patient recovered from all of this and was discharged successfully from the Hospital. Dr Piyush MarudwarConsultant- GastroenterologyWockhardt Hospitals, Nagpur

Acute headache, which does not get cured by painkillers intake, could be a sign of brain tumour. This has been revealed in a case study of a 36-year-old woman, presented by Mumbai’s Wockhardt hospitals. Mitasha Agarwal (name changed), a resident of Jogeshwari, Mumbai, housewife and a mother of two children, was leading a normal life until she experienced an unbearable headache, which required hospitalisation at a hospital recently. The doctors instituted first aid which helped her achieve some relief. However, after some time the headache again started and made the patient’s life tougher as she could not do her daily chores. When the woman was taken to the hospital, she was diagnosed with hemangioblastoma, a rare benign brain tumour that starts in the cells that line the blood vessels in the brain, spinal cord and brainstem. The woman has the family history of hemangioblastoma. Doctors at the hospital successfully managed to remove the tumour from a critical part of the brain which controls all vital functions for life. This area has breathing and heart control and all connections from the entire body going up and down. The size of the tumor was around 2×2 cm in dimensions. She was discharged home a few days back. She was aware about this disease as her nephew was operated for the same issue just a year back and cousin three years ago both much younger to her. One sibling had died in the past and knowing was a nightmare for the entire family. By now all family members were aware and knowledgeable about this disease. Dr Vinod Rambal, Neurosurgeon, Wockhardt Hospitals, said, “On arrival in an emergency she was complaining of severe headache and was not able to balance herself. As the diagnosis was already evident, they hardly required any counselling because of past experience with the hospital and the surgeon.” Dr Rambal said that their comfort level for institutions and surgeons was already established. She was relieved of her symptoms and returned home quite early. He added that this disease is a benign disorder called syndrome meaning more than one part of the body can get affected so it is for us to do a full body check-up and establish the other components of syndrome. “Operation at this location is full of challenges and requires good infrastructure and experience on the part of the surgeon. Once the tumour is successfully removed it is a cure for the individual, though they need regular follow up,” Dr Rambal added.  Dr Vinod Rambal, Neurosurgeon, Wockhardt Hospitals Source: http://www.drugtodayonline.com/medical-news/review/15044-woman-suffering-acute-headache-diagnosed-with-brain-tumour.html

The life of a Dhaba worker was saved in Wockhardt Hospitals, Nagpur after a complex surgery was performed on him by Dr. Priyesh Dhoke, Consultant- Spine Surgery. To feed a family of six, this patient toiled and worked in a Dhaba in Madhya Pradesh. One bad night at around 3 a.m. while making tea for a truck driver his leg slipped over a log of wood and his cervical spine(neck) was injured to cause him paralysis in hands and legs. Unable to sit or stand after fall he called for help and rushed to Wockhardt Superspeciality Hospitals in Nagpur. The patient was brought to the Emergency department of the hospital where he was given primary life-saving treatment. Dr. Priyesh Dhoke saw this patient in an emergency. “This was a case of traumatic spinal cord injury with paralysis”, said Dr. Dhoke. “His X-rays, MRI scans were done and emergency medicines were started to reduce the swelling of the traumatic spinal cord. We convinced the relatives and patient for emergency spine surgery”, he added. Emergency spinal cord decompression surgery helps to reduce further damage to the spinal cord in such cases, says Dr. Priyesh Dhoke. His experience with emergency decompression surgery is promising.  Successful spine surgery was performed by Dr. Priyesh Dhoke and his team, early aggressive physiotherapy and rehabilitation were started. The patient showed promising signs of recovery immediately after surgery such as hand grip, hand movements, leg movements and within two months follow up we were happy to see his near-complete recovery and he started back his job. Spinal cord injuries are very serious injuries where the patient loses power in hands and legs after an accident or trauma. Every minute counts in such a situation. Urgent diagnosis, treatment, and emergency surgery have a definite role. We at Wockhardt hospitals Nagpur have all facilities like emergency medical care, CT scan, MRI scan, ICU all under one roof which saves time and an excellent team to fast track in such critical situations. We are also equipped with world-class operating theatre conditions to deliver the best possible care to our patients says Dr. Priyesh Dhoke. This will be memorable for a lifetime as a paralyzed common man starts walking and working again due to his trust in medical care and us. Dr. Priyesh Dhoke, Consultant- Spine Surgery,Wockhardt Super Specialty Hospital, Nagpur

Wockhardt Hospitals in Nagpur celebrated International Women’s Day through its campaign- “I am fearless”. This year’s theme for International Women’s Day, “Women in leadership: Achieving an equal future in a COVID-19 world”, celebrates the tremendous efforts of women and girls around the world in shaping a more equal future and recovery from the COVID-19 pandemic. Women face several personal and professional challenges in their day-to-day lives. To help them manage this pressure, Dr. Sushil Gawande, Consultant- Psychiatry conducted a lecture. This was followed by a lecture by Dr. Riya Mangtani, Consultant- Gynaecology on “Hormonal changes in women in different phases of life”. The event was concluded by various cultural performances. To book an appointment call: 0712-6624100 Source: https://thelivenagpur.com/2022/03/09/i-am-fearless-wockhardt-hospitals-nagpur-celebrate-international-womens-day/