Rare Meniscal repair surgery performed at KIMS, Secunderabad.

Recently a group of doctors at KIMS, Secunderabad led by Dr. Sunil Apsingi and Dr KrishnaKiran Eachempati, performed a rare and highly advanced surgery correcting a deformity around knee joints. The all new arthroscopic Meniscal repair surgery was performed on a twenty three year old woman who was afflicted with a knee injury. She came to KIMS with the complaint of persistent knee pain. After a series of investigations she was diagnosed to be suffering from pain due to a tear in the lateral meniscus.

The Meniscus is the fibrous and cartilaginous tissue that helps in the proper distribution of body weight acting as a shock absorber lubricating the joints. Injuries to the meniscus are common in youngsters leading to temporary lock of the knees. Sometimes tears occur in the meniscus leading to excruciating pain in and around the joints.

This deformity is usually corrected by a traditional surgical procedure called meniscectomy in which the meniscus is totally removed. Complete removal of the meniscus leads to arthritis of the knee more so when one grows old. Meniscal repair so far has been done by an open technique with a big incision. With the latest advancement it is possible to perform meniscal repair with an arthroscopic technique and save the meniscus. Managing of pain using the most advanced surgical procedure of arthroscopic meniscal repair is a boon to the people affected with meniscal deformity.

Neurostimulation Therapy at KIMS

Neurostimulation therapy services have been started recently at KIMS. Neurostimulation is a recent development in the treatment of uncontrolled epilepsy, Parkinson’s disease and chronic pain.

Vagus nerve stimulation (VNS), an uncommon procedure for the treatment of epilepsy was performed at Krishna Institute of Medical Sciences on 22nd June 2010. This is the first time that this surgery was performed at KIMS as a part of functional Neurosurgery services. This was performed by a team of doctors led by Dr.Manas Panigrahi, Senior Consultant Neurosurgeon of KIMS, on a 29 year old patient with uncontrolled epilepsy (fits). Thirty percent of epilepsies do not get controlled with medical management. Epilepsy surgery is an option in patients. with uncontrolled epilepsy. For those who are not candidates for surgery but having frequent fits, VNS implantation is an option, as said by Dr. Sita Jayalakshmi, consultant Neurologist at KIMS.

During VNS therapy small generator is implanted under the skin below the left collar bone. This is connected to a lead with three coils at one end. These coils are wrapped around the vagus nerve in the left side of the neck by a small surgical procedure . The VNS stimulates the vagus nerve at regular intervals to reduce the frequency and intensity of seizures.

Neurostimulation using Deep Brain Stimulation helps patients with Parkinson’s disease. Neurostimulation is also useful in the management of chronic back pain and spinal cord pain

AORTIC TRNSECTION WITH MULTIPLE FRACTURES IN ROAD TRAFFIC ACCIDENT TREATED SUCCESSFULLY IN KIMS.

As every body is aware increasing number of people are dying in road traffic accidents especially on high ways. With more number of vehicles with higher capacity engines and better infrastructure more people are considering traveling by car are prone to road traffic accidents.

We felt we should share with you how successfully we saved a young 51 year old female doctor who was involved in a road traffic accident. After the accident she was immediately shifted to a nearby hospital. She was in Cardiogenic shock with a BP of 80mmHg.They did very good first aid, carried out all investigations and found fracture in right hip and left thigh. The chest X-ray showed left hemithorax. This led to the suspicion that aorta which supplies blood to whole body is torn and it is bleeding into left pleural cavity. They did CT chest in same hospital and told that there is suspicion of Aortic Leak.

The patient was shifted to KIMS Hospital as KIMS is well equipped, Multispecialty Hospital and 24hours supervision of Cardiologist, Cardiac Surgeon, Vascular Surgeon, Orthopedic Surgeon, Neuro Surgeon and good Radiology team. Once she was shifted to KIMS a repeat CT chest was necessary as we have to know exactly the length of the tear which is possible with 64 slice CT Scan. After doing 64 slice CT we could precisely tell where exactly tear was in aorta and were able to take relevant measurements.

Family was counseled about the Aortic Tear and was told to first address Aortic Tear and later fractures have to be done. Orthopaedic surgeon also felt that we could wait a couple of days for the fixation of fractures.

Within 24hours of arrival to KIMS a team of Cardiologists and Cardiothoracics surgeons lead by Dr. R.K.Jain and Dr. B.Bhaskar Rao did stent graft of the aorta and stopped Aortic Leak. After stopping the leak blood in the left pleural cavity was drained and patient's general condition improved. Patient recovered from Stent Graft procedure with in 24 hours.

Five days later they did surgery for left femur fracture and after another three days right thigh fracture was successfully done. She completely recovered from Orthopedic Surgery. Dr. I. V. Reddy lead the Orthopedic team. With good Physiotherapy the patient walked after three weeks.

This case highlights importance of Multispecialty Hospitals with Multi disciplinary approach and team work. All the facilities like 64 slice CT, Vascular Surgeon, and Interventional Cardiologist, Orthopedic Surgeon and Radiologist,were available,under one roof . The morbidity in Aortic tear is 90% and very few patients survive ever after reaching hospital.

This doctor was fortunate to choose right team of doctors who were available 24 hours to take up this challenging case.This is one of the very few cases done in India and earlier only one case was reported from this country.

Dr. R.K.Jain, director Krishna Institute of Medical Sciences, Minister road, Secundrabad,
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Successful Rare Heart Surgery

REPAIR OF TETROLOGY OF FALLOT IN LEFT SIDED HEART, IN ADULT

A rare heart surgery was performed on 25.5.2009 in Krishna Institute of Medical Sciences in Secunderabad. 19 year old Bhargavi, hailing from Chirala in Prakasam District, came to KIMS Hospital with complaints of breathlessness. On evaluation by Cardiologist Dr. Ravikant with X-Ray, ECG, 2-D Echo and C.T. Angio, it was revealed that she was having heart on the right side of Chest with (Dextrocardia with situs iversus.) multiple defects - this condition is medicaly termed as Tetrology of Fallot (Blue baby). She was taken up for surgery on 25.5.2009. Under Cardio-pulmonary bypass, intra cardiac repair was done by the Cardio-thoracic surgeons, Dr. K. V. Krishna Kumar and Dr. Maruthi Vara Prasad. Anaesthesia was given by Dr. Murali Mohan and Dr. Sai Sreelatha. She recovered well after the complicated surgery and is ready for discharge. This surgery was done under the Arogyasri Scheme.

KIMS Performed 6^th Annual Day Function Grandly.

A Unique Limb-Lengthening Surgical Procedure Performed by Dr. Prasad P.N.V.S.V entered Limca Book of World Records

History was made at KIMS Hospital when their own Dr. Prasad P.N.V.S.V encouraged by Dr. Bhaskar Rao, CEO and MD of KIMS, successfully conducted a unique surgical procedure (Osteotomy of tibia) on Jainab, a young girl suffering from Achondroplasia(gentic dwarfism). During the surgery, Dr. Prasad used an Ilizarov Fixator to lengthen Jainab’s legs by no less than 16 cm in a single stage procedure. The surgery was carried out on August 21^st, 2005, but today Dr. Prasad has been recognized by the Limca Book of World Records in its recently released 20^th edition, for the Longest Limb Lengthening Procedure. Dr. Bhaskar Rao extended his hearty congratulations to Dr. Prasad on his outstanding feat.

KIMS is a world class hospital offering state of the art medical facilities for a variety of health problems. With full fledged departments pertiaing to various spelites of medicine, and a team of experts dedicated to taking Medicare in the Country to new levels of excellence, KIMS is continuosly enhancing its facilities and meeting new challenges. Dr. Prasad’s success and recognition is yet another laurel won by this forward thinking hospital.