Recently one 22 year old male from Balaghat, Madhya Pradesh was admitted in Orange City Hospital & Research Institute, Nagpur under care of Dr. Mohammad Hussain Bhati, Neurosurgeon. He had complaints of headache, vomiting, double vision, limb paralysis, inability to swallow and eat and mainly bed ridden, unable to speak and eat anything. He had multiple cranial nerves involvement from Vth to XIIth. He was thoroughly investigated at OCHRI. His CT & MRI brain showed Huge Tumor classified as Trigeminal Schwannoma, which was compressing the brain stem and multiple cranial nerves.
Dr. Hussain Bhati, Neurosurgeon- OCHRI, informed that “Trigeminal Schwannoma is a rare tumor arising from V cranial nerve and its incidence is almost 0.07 to 0.3 % of all brain tumors.” This patient was already paralyzed, bed ridden, not speaking and eating anything and there was risk of aspiration leading to Pneumonia also. So he decided to operate as these tumors usually require microsurgical excision and OCHRI OT boasts of one of the worlds most advanced Operating Neurosurgical microscope namely OPMI VARIO 700.
The intricate surgery for excision of tumor was carried out by Dr. Hussain Bhati supported by Dr. Neeta Deshpande and Dr. Sweety Pasari as Anesthetists and Dr.Kavita Dhurvey as SMO – Surgery along with Dr.Anit Prakash, SMO -Wards. Dr.Milind Pande- Pathologist and Dr.Raju Khandelwal, Dr.Nishikant Lokhande & Dr.Sudha Ambatkar- Radiologists rendered diagnostic support while full time round the clock stationed Intensivist team consisting of Dr.Ashish Shukla, Dr.Rani Lakhe, Dr.Roshan Jawdekar, Dr. Santosh Gadge, Dr.Saurabh Rathi, Dr.Vasundhara Jain led by Dr.Ganesh Bure provided critical care support. Smt.Ambika Nair and Smt.Preeti Joseph led nursing & paramedical team in Operation theatre and Critical care unit while Dr.Sanil Koyili led the team of Physiotherapists. The tumor was compressing and adherent to brain stem, multiple cranial nerves and basilar artery with its branches. The tumor was separated very delicately from these structures under microscope and safely excised it.
The surgery was uneventful and post operatively he started speaking immediately and started moving all limbs. He was discharged within one week in conscious and walking condition. Cranial nerve palsy also improved significantly and now this young man is doing his normal activity. The parents thanked TEAM OCHRI led by Dr.M.H.Bhati for giving a new life to this young man.
Shri.Udaybhaskar Nair, Chairman- NAIRSONS complimented Dr.M.H.Bhati for taking the risk of conducting such an intricate brain surgery. He stated that public should have total trust on their treating doctors as no doctor desires to harm their patient. However there are risks involved and if relatives show total faith on their treating doctor, such miraculous healing will happen, otherwise no doctor will dare to do any risky surgery which will a great loss to needy public.
The representatives of Association of Charitable Hospitals (ACH) in Nagpur met newly nominated Rajyasabha member Padmashree Dr. Vikas Mahatme on Saturday 10th September. The delegation members consisted of Mr. Vilas Shende, Dr. Deepak Dongre, Dr. Mumtaz Ali, Adv. P.G. Ghatole, Mr. Anil Wairagade, Mrs. Surekha and others. The members felicitated him with Dupatta, Gandhi Topi and presented a Stethoscope on behalf of the association. The members wished him a very successful fruitful tenure as Member of Parliament representing medical fraternity and grassroots masses of Vidarbha region.
The delegation discussed various concerns and issues of the charitable hospitals with the Government. They shared about the ongoing correspondence done with the various authorities in the government to pursue their issues. They requested him to intervene and help them to effectively follow up the matter with the concerned ministry of the state government/central government. Padmashree Dr. Vikas Mahatme, MP assured the ACH delegation that he will study the matter and undertake necessary follow up with the appropriate ministry.
69 Hospitals to attend police personnel in Police Hospital OPD
More than 100 private hospitals of Vidarbha with total bed strength of 10000 had joined hands to form Vidarbha Hospitals Association (A unit of Hospitals Association- Nagpur) which is aimed to help set internal quality standards, ensure cost effective quality health care to incoming needy patients, and support statutory authorities to enhance the image of Nagpur as a health care hub.
Recently Dr. K. Venkatesham, IPS who has taken over as Commissioner of Police of Nagpur City had given a call to Nagpur medical community to volunteer for police welfare. Accordingly Shri.Ishu Sindhu, IPS, DCP- Special Branch discussed the issue with Dr.Bhojraj Madke,CMO-Police Hospital and pursued the idea with office bearers of Vidarbha Hospitals Association in this regard.
Further to said call given by Dr. K. Venkatesham; 69 Hospitals of Nagpur affiliated to Vidarbha Hospital Association volunteered to provide their expertise in Police Hospital OPD- Nagpur. Accordingly, a timetable is being formulated wherein each renowned specialist deputed by these 69 volunteering hospitals will only have to spare 2 hours every month which will be a boon to all police personnel and beneficiaries. The project will commence from 2nd October 2016 after desired infrastructural modifications and equipment procurement are done by police authorities to create the Speciality OPD in Police Hospital.
This working arrangement was formally inked during a meeting in Office of CP- Nagpur which was chaired by Dr. K. Venkatesham. Prominently present on this occasion were Shri.Ishu Sindhu, Dr.Anup Marar, Dr.Bhojraj Madke, Dr.Shishir Shrivastava, Dr.Nandu Kolwadkar, Dr. Gopal Rathi, Dr.Pravin Lad, Dr.Rajasi Sengupta and Dr.Laxmi Shrikhande. Representatives of Sushrut Hospital, Suretech Hospital, Meditrina, Arogyam, Colours, CIIHO, Ashian Renal Care, and Care Hospitals also partook in the deliberations.
Dr. K. Venkatesham conveyed that Nagpur is renowned for its medical proficiency. Police personnel are in need of their expertise. Such model wherein reputed specialists from community volunteer to render their expertise free of cost in OPD of police hospital on selected days is already functioning well in Mumbai and Thane. He commended VHA members for the overwhelming proactive empathetic response. He stated that Identity cards will also be issued to all these volunteering renowned specialists nominated by VHA which will help them for validation.
On behalf of VHA; Dr.Anup Marar, Secretary stated that Nagpur police brethren have always helped doctors in times of crisis. Hence it is our ethical and moral duty to serve them. He concluded that this noteworthy innovative welfare venture undertaken by Dr. K. Venkatesham will go a long way in enhancing the rapport between police and medical fraternity of Nagpur.
OCHRI, Wockhardt, Meditrina, Suretech, Care, Get well , Shatayu , Soni , Child Hospital, Nandan, Kolwadkar , Bhutada, G.T. Memorial , Maxcare, Saboo , Vasant, Junankar, Sawali, Zenith , Desai, Centre Point, Rughwani, Rajan, Manorama, Criticare, Shiv Ganga, Mother And Child Care(2) , Kalpataru, Kunal , Swastik Critical Care, Jaiswal , Colours, Colours, Mandhaniya, Neuron, Indrayani, Crescent, Nerkar, Ashian Renal Care, Bhelonde, Platina, Belsare, Shravan, Shanti Mohan , Arogyam , Deshmane, CIIHO, East End , Shrikhande, Hope, Aditya, Sengupta , Criticare, Asha , Sushrut, Arneja , Rathi, Sarakshi Netralaya, Hatwar, Rathi Nursing Home, Ketki Nursing Home(2), Central Avenue Critical Care, CNMI, Anmol, Gillurkar, Chikhale, Samarpan and Lata Mangeshkar are some of the renowned hospitals of Nagpur that will be deputing their specialists for this daily Speciality OPD at Police Hospital.
Scrub typhus is an acute, zoonotic, febrile illness of humans. Scrub typhus is an emerging disease, which is grossly under-diagnosed in developing countries due to its non-specific clinical presentation, limited awareness, and low index of suspicion among clinicians and lack of diagnostic facilities. Nagpur medical fraternity is recently noticing outbreaks of this disease. Many patients are reaching Orange City Hospital & Research Institute from all corners of Central India with undiagnosed fever with multiple complications.
Highlighting this disease; Dr.Devayani Buche, Physician stated that Scrub typhus usually affects previously healthy active persons and if undiagnosed or diagnosed late, may prove to be life-threatening.
Diagnosis of scrub typhus is based on a high index of suspicion and careful clinical, laboratory and epidemiological evaluation.
Dr.Rajesh Atal, Critical Care Physician added that Scrub typhus is an acute febrile illness caused by orientia tsutsugamushi transmitted to humans by the bite of the larva of mites. It causes disseminated vasculitic and perivascular inflammatory lesions resulting in significant vascular leakage and end-organ injury. After an incubation period of 6-21 days, onset is characterized by fever, headache, myalgia, cough, and gastrointestinal symptoms.
Dr.Milind Pande, Pathologist stated that laboratory studies usually reveal leukopenia, thrombocytopenia, deranged hepatic and renal function, proteinuria and reticulonodular infiltrate. Weil-Felix, Enzyme-linked immunosorbent assay, Rapid lateral flow-assay, Western blot, Immunochromatographic test, indirect fluorescent assay, indirect immunoperoxidase, PCR amplification of orientia genes and isolation/inoculation are some other high end ways and means to confirm the disease.
Dr. Nikhil Balankhe, Physician mentioned that Scrub Typhus also known as tsutsugamushi disease means dangerous bug in Japanese language. O. Tsutsugamushi is transmitted to humans by the bite of the larva of trombiculid mites (chiggers) which are almost microscopic, often brilliantly colored. Infected chiggers are found particularly in areas of heavy scrub vegetation during the wet season, therefore this disease has also been called river/flood fever when mites lay eggs. Rodents are carriers. The word “scrub” was applied because of the type of vegetation that maintains the chigger−mammal relationship.
Dr.Kuldeep Sukhadeve, Paediatrician clarified that in children, scrub typhus may be mild or severe. Most patients present with fever and regional/generalized lymphadenopathy. A single painless eschar, maculopapular rash, hepatomegaly, splenomegaly and gastrointestinal symptoms may be present.
Dr.Ganesh Bure who leads the team of Intensivists at Critical Care Complex of Orange City Hospital & Research Institute for round the clock service emphasized that in the ICU, aggressive management like appropriate ventilator strategy in ARDS patients, dialysis of renal failure patients, and correction of haematological abnormalities etc. Of such patients is imperative to prevent high mortality associated with the complications. Preventing sepsis and multi organ failure can be possible in ICU settings with specific treatment protocols and supportive management.
Dr.Upendra Kumar, Physician cited that preventive measures especially in the absence of an effective vaccine can be primordial, primary and secondary. Primordial prevention entails prevention of emergence of risk factors. Best measure would be to avoid going to places like farms, areas abundant of bushes, rodents and domestic animals. Primary prevention includes health promotion and specific protection.
Dr.Ashish Shukla, Chest Physician added that advocacy, awareness and education activities, Habitat modification , Rat population control, wearing protective clothes, using insect repellents and Chemoprophylaxis are some ways of Primary prevention. Once the disease has occurred in an individual, then comes the role of secondary prevention which includes early diagnosis and treatment.
On the issue of Scrub Typhus and Pregnancy, Dr.Bindu Menon, Obstetrician stated that currently tetracycline and chloramphenicol are recommended for treatment for non-pregnant patients. According to Food and Drug Association tetracycline is classified as a class D drug and should not be used during pregnancy. Chloramphenicol is classified as a class C drug. Hence Single dose of azithromycin is used in pregnant women.
Dr.Ashwini Tayade, Infectious Disease Specialist concluded that early diagnosis of acute scrub typhus can greatly reduce the chance of life threatening complications and guide optimal therapy.
The small permanent Ganesha Temple in Orange City Hospital & Research Institute provides spiritual healing to incoming patients and their relatives. Today Lord Ganesh was welcomed in a traditional manner by staff of OCHRI.
OCHRI conveyed public message to prevent water, air and noise pollution and to maintain sanctity and cleanliness like a temple all around us.
Prominently present on the occasion were Dr.Usha Nair, Dr.Anup Marar, Dr.Abhay Agashe, Dr. Amit Pasari, Dr.Poonam Kachane, Shri. Sunil Sure, Shri.Vishal Kapse, Shri. Priya Sashi, Shri. Sachin Gajbhiye, Shri.Vinit Vijayan and Shri.Rajan Thakur. Shri.Ravindra Dhande assisted by Shri.Dayaram Nimbarte, Smt.Durga Joshi, Shri.Ramesh Pande and Shri.Ganesh Iyer conducted the rituals.
“Man, my shoulder is killing me, and I haven’t done anything to injure it,” or, “Wow. I think I just tore something in my shoulder.” These are all too common complaints that everyone faces.’
The shoulder has the most motion of any joint in the body. Stabilizing this joint are many muscles, ligaments, and tendons—chief among these being the rotator cuff tendons.
The rotator cuff tendons are sandwiched between two bones in the shoulder, and herein lies the problem. With too much activity, especially overhead activity, the tendons are pinched and irritated resulting in a common condition called impingement syndrome. This pinching effect can eventually lead to a rotator cuff tear if left untreated.
Many painful shoulder conditions involve some form of rotator cuff inflammation in the form of tendinitis or bursitis. These conditions usually result from overuse.
Many times shoulder pain results from too much overhead activity. Weekend athletes come with shoulder pain after overdoing it in a sport they have not played in a long time, or working excessively on one day. Rotator cuff tears often cause night pain and difficulty sleeping on the injured shoulder, as well as problems with outstretched or overhead movements.
Most of these painful shoulder conditions will respond to rest, anti-inflammatory medication, and necessitate physical therapy to strengthen muscles so as to prevent such episodes in future. Some painful shoulder conditions will need further evaluation in the form of x-rays or MRI scan. MRI scans are very good at detecting torn rotator cuffs and ligament injuries.
Advanced technology now allows a minimally invasive approach to treating shoulder injuries. New arthroscopic techniques can be used to treat rotator cuff and ligament tears without a large incision. Outpatient arthroscopic repair facilitates faster recovery and is typically less painful.
Avoiding shoulder pain is not always possible. One day of overuse can sometimes equal six months of shoulder pain. It is recommended that you take the time to stretch and warm up, and to use moderation when it comes to activities you have not done in months or years. Strengthening of rotator muscles should be a part of your exercise schedule to prevent such injuries.
The good news is that most shoulder pain will get better with exercise protocols. The even better news is that technological advances with shoulder arthroscopy allows minimally invasive techniques to correct those shoulder injuries that do require surgery with early return to work. Gone are the days when one thought shoulder pain is something one has to live with-With Correct diagnosis and proper treatment one can get back to all routine activities.
For further queries related to shoulder pain or shoulder conditions, contact Dr.Rohan Bansal , Shoulder Surgeon and Joint Specialist-Orange City Hospital and Research Institute, Nagpur.