In CEO'S words

Dear Friends,

It has been a busy month for us in the Ruby Hall Clinic Family. Our newly established robotic surgery programme and its surgeons have yet again set benchmarks we all are immensely proud of besides crossing the twenty-five surgery milestone, each successful surgery reiterates a new era of technology driven healthcare. Our very own Dr. Shimpi completed 9 robotic surgeries in just 90 days becoming the first in Maharashtra to do so. Moreover, the dual cases of robotic ureteral re-implantation by Dr. Ratta was also a first in the city.

'Pink Month' for breast cancer awareness was celebrated at the hospital. The radiology department spearheaded a number of novel campaigns ranging from breast screenings at the hospital to awareness camps at Pune airport as well as a special initiative in partnership with GE Healthcare and Indigo Airlines. The breast cancer support group also honoured survivors and motivated them to continue their brave fight with a tree plantation drive and informational talks by experts.

Our Wanowarie and Hinjawadi counterparts too played an active role in spreading the wings of healthcare through awareness. Be it Obesity Week and World Stroke Day celebrated at Wanowarie where patients received free consultations and a number of cost-effective packages, or even Hinjawadi in its effort to inculcate healthier habits at the workplace. This just goes on to show how much healthcare means to us as an organisation - the focus is not just cure but prevention and healthcare as a whole.

At Ruby Hall Clinic, we always strive to bring in the best in medical technology for our patients. And this is exactly why we invested in the daVinci robot. In a short time since its inception, we are proud to say that our surgeons have shown exceptional skill and our patients have benefitted immensely. We've crossed the twenty-five surgery milestone and the results speak for themselves!

Two Cancers tackled in a Single Surgery

The hard reality of cancer hit 69-year-old Dubai resident Al-Balushi a year ago, when he started passing blood through urine. He was soon diagnosed with bladder cancer and much to his discomfort, doctors suggested bladder removal as a solution. This involved isolating a segment of the small intestine and reconnecting the remaining part. The kidney tubes — ureters — are then connected to this isolated segment of the small intestine. It is brought out, fixed to the abdominal wall and a plastic pouch bag attached to the stoma which collects the urine. This pouch is fixed to the lower abdomen by a sticker and requires changing every few days or weeks when it comes loose. Bathing or any slightly rigorous activity can cause it to fall off, leading to urinary leaks and odour.

Of course, Al-Balushi was not in agreement to undergo such an ordeal post-surgery as it would lower his quality of life and also be a source of embarrassment. This made him seek alternative opinions in Mumbai where similar solutions were suggested. In September, he learnt of Dr. Shimpi and regained hope. After screening and multiple tests, doctors at Ruby Hall Clinic performed a robotic radical cystoprostatectomy (surgical procedure in which the urinary bladder and prostate gland are removed) with extra corporeal neobladder (urinary diversion) on September 20 in a seven hour long procedure. Here they also discovered that he had prostate cancer and operated to remove it. After two days in the intensive care unit, followed by the ward, he was discharged on September 27.

"It was only by accident that we discovered the prostatic cancer which we took care of, however, the biggest challenge lay in creating a new bladder for the patient. It was created from the 60-cm segment of the patient's small intestine. The ureters were connected to this bladder and then were connected to the urinary passage. Fortunately, the urinary valve was preserved due to which Al-Balushi has a normal control on the bladder. He has no infections and is well on the road to recovery. We're happy the surgery was a success and that his visit to Ruby Hall Clinic was fruitful."

- Dr. Rajendra Shimpi,
Director - Department of Urology,
Ruby Hall Clinic.

A first in the city, a robotic approach for vesicoureteral reflux

What happens when a form of urine reflux becomes so severe that surgical intervention is the only hope to lead a normal life? Of course, the sight of a surgical gash with medical tubes is not something any parent would wish on their child, but that's an option two families had to contend with. Characterised by recurring urinary tract infection, two children aged four and six were lucky to be spared the traumatic ordeal of an open surgery when they opted to undergo the procedure robotically at Ruby Hall Clinic.

Normally, urine flows from the kidneys through the bladder. The muscles of the bladder and ureters, along with the pressure of urine in the bladder, prevent urine from flowing backward through the ureters. Vesicoureteral reflux (VUR) occurs when urine dwelling in the bladder flows back into the ureters and often back into the kidneys as the mechanism that prevents the back-flow of urine does not work, allowing urine to flow in both directions. This allows bacteria, which may be present in the urine in the bladder, to reach the kidneys and a child who has VUR is at risk for developing recurrent kidney infections, which, over time, can cause damage and scarring to the kidneys.

What made these two cases special is that the four-year-old suffered from Grade IV bilateral reflux and the six-year-old from Grade IV unilateral reflux. Moreover, this child was part of a religious sect called the Jehovah's Witnesses who refuse any form of blood transfusions, making it all the more important to opt for a minimally invasive procedure. Comparing the traditional open surgery to the robotic procedure,"

"Traditional open surgery for ureteral re-implantation is performed by making an incision and opening the bladder. It has very high success rates but requires a large incision, extended hospital stay and extended recovery time. Using the daVinci Robotic Surgical System, the same procedure was performed through tiny incisions for a shorter hospital stay and faster recovery."

"We dissected the ureter from the bladder and tunnelled it through the bladder wall to prevent reverse flow of urine into the kidney with just micro incisions. It was indeed heartening that one child was discharged a mere twenty-four hours later and the other the very next day"

- Dr. B.S. Ratta,
Consultant Neonatal and Paediatric Surgeon,
Ruby Hall Clinic.

A first in Maharashtra, Dr. Rajendra Shimpi performs 9 Surgeries in 90 Days

Ruby Hall Clinic has always been at the forefront of advances in medical technology and with newer, less invasive methods of surgery being adopted across the world, the robotic surgery programme was a natural addition. This time, Dr. Rajendra Shimpi completed nine complex surgeries with the daVinci surgical robot in a short span of just ninety days. This makes him one of the very few in India and presumably the first in Maharashtra to do so.

Nine surgeries in ninety days is an important landmark in any robotic surgical programme across the globe. It not only empowers surgeons with more confidence about their skills but also enables them to take on a variety of even more challenging cases in the future. Dr. Shimpi has performed a wide variety of complex cases robotically. These range from a radical cystectomy (removal of bladder and surrounding cancerous nodes and organs), a radical cystoprostatectomy with neo-bladder (removal of bladder, prostate glands and surrounding cancerous nodes and organs along with construction of another bladder), a radical prostatectomy (removal of cancerous prostate gland), a partial nephrectomy (kidney sparing surgery where tumour is removed), a Burch colposuspension (support for the neck of your bladder so that it stays closed under pressure) as well as a large prostatomegaly with bladder stones wherein the prostate gland weighed about 200 grams.

"While all surgeries come with a certain amount of risk and challenge, perhaps the most complex one I attempted was the radical cystoprostatectomy with neo-bladder as the patient's old age was also a factor to be considered. The robotic system helps us operate with accuracy and precision. Its magnification is upto ten times more powerful and 360-degree endo wrist movement helps access unreachable places more easily - something extremely important in urology. Moreover, being minimally invasive, virtually all our patients have been discharged within two to three days of their procedures in spite of being complex surgeries."

- Dr. Rajendra Shimpi,
Head - Urology Division,
Ruby Hall Clinic.

The Department of Radiology celebrates Pink Month

October marks Breast Cancer Awareness Month, but what we need more than passive awareness is proactive prevention. By virtue of their sex, all women are at risk of developing breast cancer. Knowing your individual risk can help you minimise the likelihood of developing the disease. For example, we know that having a mother, sister or daughter with breast cancer doubles a woman's risk of developing the disease.

There are many risk reduction strategies that can lower your risk of developing breast cancer. And there is more good news — there has been a steady improvement in the treatment of breast cancer in the 21st century. This improvement is related to advances in breast imaging, recognition of familial risk syndromes and numerous evidence-based interventions including risk-reducing medications and lifestyle changes.

The Department of Radiology at Ruby Hall Clinic conducted both an internal and external campaign in lieu of this month. Senior lady doctors from the institute were invited to get themselves diagnosed at the newly launched Mammography Unit which hosts GE's Senographe Pristina. Additionally, Ruby Hall Clinic is the only tertiary care hospital to have tied up with GE Healthcare and Indigo airlines offering passengers mammograms at discounted prices. An awareness program was also conducted with all airport staff in association with the Airport Authority of India where each employee was taught about self-examination.

"One in every eight women will be diagnosed with breast cancer in their lifetime. This is a stark reminder that, despite immense fundraising and research efforts, it is up to everyone to do their part to push for a cure. Fortunately, women have more tools than ever before to minimise risk and catch cancer at the earliest, most treatable stages."

- Dr. Avinash Nanivadekar,
Director - Department of Radiology,
Ruby Hall Clinic.

Breast Cancer survivors conduct tree plantation drive

The Kamalnayan Bajaj Cancer Centre at Ruby Hall Clinic kicked off Breast Cancer Awareness Month with a Breast Cancer Survivors Day Out. This event gave oncology staffers and doctors, along with patients, a way to offer a tribute, hope and inspiration to breast cancer survivors and those just starting their battle. All came together to spread breast cancer awareness and hope for a cure.

One of the highlights of the event was a tree plantation drive in the outskirts of Pune by the Breast Cancer Survivors Group of the Ruby Hall Cancer Centre. A dermatologist and breast surgeon also spoke at length about breast cancer and its after-effects while answering all queries that the participants had. A number of survivors shared their stories in the company of women who have gone through similar experiences in the past. "We all need to accept the fact that breast cancer is a killer. We need to keep fighting and be our own advocates", said one of the survivors.

The rate of breast cancer is rising at an alarming pace in India. It is said that about 2,000 women are detected with breast cancer every day in India, which makes it between 125,000 and 200,000 cases every year.

"Some of the increase in breast cancer incidence in India may be due to the greater life expectancy of Indian women now as well as control of other communicable and non-communicable diseases. As women live longer, they develop a greater chance of getting breast cancer. Lifestyle changes such as bearing a child late in life, lack of breastfeeding, medical use of hormones, menarche occurring in younger people and menopause being pushed to a later age may have contributed to an increase in breast cancer cases."

- Dr. Ashok Bhanage,
Consultant Neurosurgeon, Chairman, Kamalnayan Bajaj Cancer Centre,
Ruby Hall Clinic.

Ruby Hall Clinic participates in Oman Health Exhibition

In the month of October, Ruby Hall Clinic participated in the seventh edition of the Oman Health Exhibition and Conference at the Oman Convention and Exhibition Centre. Highlighting the continued development of the healthcare sector in Oman, this symposium targeted all aspects of the health and wellness industry, opening doors for health products, services and facilities, and opportunities for new developments and trends, and trade and investment. Organised between 9-11 October, this event is recognised as the flagship health and medical event in Oman.

The Oman Health Exhibition and Conference was the perfect opportunity for Ruby Hall Clinic to boost its efforts while connecting with multiple stakeholders, government officials, international experts and private organisations. The exhibition saw meaningful dialogue, interaction and knowledge sharing within the local and global health agenda specially aligned with the government's health policy "Health Vision 2050." Sayyid Dr Sultan bin Yarub al Busaidi, adviser for Health Affairs in the Ministry of Health (MoH) inaugurated the event.

Stuttering Unshackled: Marking International Stuttering Awareness Day

Commemorating International Stuttering Awareness globally celebrated on October 22 every year, this event also marked the beginning of Ruby Hall Clinic's first Stuttering Clinic which will help people who stutter find long term solutions to a problem that affects so many areas of their lives. Moreover, on 29 October, the hospital in association with Books Meridian Library, Pune and The Rotary Club of Khadki conducted a free awareness programme "Stuttering Unshackled".

Is stuttering common? Nearly five percent of children under the age of seven and about three percent under the age of fifteen go through a period of stuttering. For 20 percent of those children, their speech impediment will persist beyond childhood if neglected.<

"It is common because 1 person among every 12 people develops stuttering at some point in their life. In children, it is 'normalised' saying 'he's growing up', in adolescents it gets attributed to "stress", and by adulthood, the person with stuttering has tactfully devised ways to avoid words, people and situations."

- Pallavi Kelkar,
Ruby Hall Clinic's Speech Therapist.

"Stuttering is nothing to be ashamed of It is not a laughing matter. Yet millions of people who stutter suffer each day, 'imprisoned' by this complex, frustrating disorder. As someone who has personally seen a couple of cases — the emotional trauma associated with it is unbelievable"

- Dr. Sanjay Pathare,
Medical Director,
Ruby Hall Clinic.

Making us proud at ESGE

ESGE, the European Society for Gynaecological Endoscopy organised an annual conference in Antalya, Turkey from 18th – 21st October 2017. The motto of the congress this year 'East Meets West' truly represented the expansion of the Society and the increasing spread of the ESGE philosophy throughout the world where Dr. Sunita Tandulwadkar, Director - Department of Obstetrics and Gynaecology, Ruby Hall Clinic was invited.

"This scientific program truly brought together doctors from across the globe and I couldn't have been happier to be a part of it. Attended by top medicos of the world, we discussed the safest and most efficacious diagnostic and therapeutic techniques that afford less invasive treatments for gynaecological conditions through the integration of clinical practice, research, innovation, and dialogue."

- Dr. Tandulwadkar
Director - Department of Obstetrics and Gynaecology,
Ruby Hall Clinic.

Dr. Kapil Zirpe attends ISCCM Celebrations

The Indian Society of Critical Care Medicine (ISCCM), Pune chapter organised an organ donation awareness programme at Patrakar Bhavan auditorium on October 9 at 6 pm to mark its foundation day. Dr. Kapil Zirpe, Director - Neuro Trauma Unit, Ruby Hall Clinic and President of ISCCM was the chief guest at the event. The public awareness programme included sessions by experts, as well as a short play on organ donation, 'Sanjeevan - a gift of life.'

"There are many who need organ transplants. A patient in need of organ transplant dies waiting for organs approximately every 17 minutes, so there is a huge gap between number of patients waiting for organ transplant and number of donors. In the past 20 years, people and doctors have been given knowledge on organ donation and transplantation. The city has seen a boost in cadaver organ donations in recent years with Ruby Hall Clinic leading the way."

-Dr. Kapil Zirpe
Director - Neuro Trauma Unit,
Ruby Hall Clinic.

Ruby Hall Clinic makes its presence felt at the annual ecmo conference

Dr. Prahcee Sathe, Director - ICU, Ruby Hall Clinic, has once again made the ICU at Ruby Hall Clinic shine by representing the hospital at the Annual ECMO Conference at Hyderabad this year. Hosted by the ECMO society of India, the conference aims at improving awareness about ECMO, spread knowledge by teaching, help bring down costs and develop a vision for tertiary care facilities in the country.

Since its foundation in 1994, the European Society for Gynaecological Endoscopy (ESGE) has aimed to encourage the exchange of clinical experience, scientific thought and investigation among European gynaecological endoscopists and practitioners in related techniques.

"Has once again made the ICU at Ruby Hall Clinic shine by representing the hospital at the Annual ECMO Conference at Hyderabad this year. Hosted by the ECMO society of India, the conference aims at improving awareness about ECMO, spread knowledge by teaching, help bring down costs and develop a vision for tertiary care facilities in the country."

- Dr. Prahcee Sathe,
Director - ICU,
Ruby Hall Clinic.

Cancer, cardiac diseases and neurological disorders all require a specific diagnosis and treatment. Finding each of these in their early stages specifically helps health professionals to attack, contain and cure them. Ruby Hall Clinic Wanowarie is proud to announce the launch of GE Discovery STE, which offers high resolution fusion imaging coupled with a significantly reduced radiation dose and lower noise. This new scanner will provide the hospital's patients with the very best service available today, providing clinicians with outstanding visual referencing with PET and CT scans in one go.

The Discovery STE provides referring physicians with more sensitivity, speed, resolution and diagnostic confidence when treating patients. By shortening the scan times, the patient will experience less time on the scanning table. "Less time on the table means faster results and greater patient comfort," says Dr. Manisha Karmarkar, COO, Ruby Hall Clinic Wanowarie. "The new Discovery STE allows us to not only 'see' the disease, but to begin to treat it."

"The scanner is of tremendous benefit to our patients. We are able to scan the patients from head to toe in a matter of seconds, reducing their time on the table, stress and anxiety. In fact this scanner uses fusion technology where the areas of cancer are imaged with PET scan and placed over CT images. This particular scanner also creates high resolution images at low radiation dose to patients thus aiding clinicians with the diagnosis and also allows for low dose paediatric imaging,"

- Dr. Sameer Sonar,
Director - Nuclear Medicine and PET/CT,
Ruby Hall Clinic Wanowarie.

Keeping your weight in check : Celebrating 'Obesity Week'

When your weight surpasses a particular limit, even daily routine tasks become a chore. The smallest task of getting up from your bed every morning to tying your shoe laces could be the most difficult thing you have to do. In a country where over 2.7 crore people live below the poverty line, it is indeed surprising that India ranks third on the global obesity index. In fact, obesity has been flagged as a major public health concern in India with one in every five individuals being affected.

Primarily known to be a lifestyle disease, obesity is associated with the consumption of junk foods and an increasingly sedentary lifestyle. It is also the root cause of a number of chronic diseases such as diabetes, cholesterol, blood pressure, joint pain and cardiovascular ailments to name a few. Looking at these facts, the hospital celebrated World Obesity Day, which falls on 11 October with 'Obesity Week' celebrations from 11 to 17 October.

The hospital offered free body composition analysis as well as a fifty percent discount on diet consultations and concessions on surgical packages. Moreover, a mega World Obesity Day event was carried out on 14 October wherein Dr. Neeraj Rayate provided free obesity consultations for those walk-in patients whose BMI was greater than 30. This was followed by a health talk.

"Our hospital is well-equipped to handle cases of morbid obesity, not only in terms of medical facilities but also treatment precautions. The most important aspect is generation of awareness and it is events such as these that have a tremendously positive effect. In the fight against obesity, Ruby Hall Clinic Wanowarie continues to play a pivotal role with its perfect mix of talent, technology and compassionate care."

- Dr. Manisha Karmarkar,
COO,
Ruby Hall Clinic Wanowarie.

Striking out stroke

Worldwide, stroke is the second leading cause of death. Globally, stroke takes the lives of more than 6.5 million people each year, and permanently disables another 5 million. It is also the most prevalent cause of chronic adult disability. However, while stroke threatens humankind all across the globe, developing countries like India account for more than four-fifths of all strokes. The stroke incidence rate in India is much higher than in other developing countries with approximately 1.8 million Indians out of a population of 1.2 billion suffering from stroke every year. Ruby Hall Clinic Wanowarie marked World Stroke Day on 29 October with the global theme "What is your reason for preventing stroke?"

"Pretty much like a heart attack, a stroke can be called a brain attack. It can result in permanent disabilities and damage to the brain and in extreme cases even death. Survival of the patients depends upon immediate intervention of the experts within the golden hour which includes the first hour after the onset of a stroke. Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke."

- Dr. Nilesh Palasdeokar,
Consultant Neurologist,
Ruby Hall Clinic Wanowarie.

"Over the years, a number of studies have shown that stroke survivors face better odds and get better functional outcome if they are admitted to dedicated stroke units, staffed by experienced physicians, nurses and therapists. At Ruby Hall Clinic Wanowarie, we stand tall, ready with rapid response care, an ambulance facility and state-of-the-art technology to ensure stroke victims have the best shot at life."

- Dr. Manisha Karmarkar,
COO,
Ruby Hall Clinic Wanowarie.

4,500 employees participate in health checkup at Synechron

The IT industry is known for its long work hours and stress related ailments. It is, therefore, imperative for corporations to understand that employee health and well-being is their key to success. Last month, Ruby Hall Clinic Hinjawadi conducted a health-checkup at international IT giant Synechron's campus in Hinjawadi. Synechron, one of the fastest-growing digital, business consulting and technology services providers is a $500 million firm based in New York. The response too, was overwhelming with about 4,500 employees participating in the camp.

"As a continued promise to everyone in the vicinity, we undertook yet another corporate health camp. Such events only amplify the importance of tackling work and stress related ailments. We look forward to a fruitful association with Synechron and other business conglomerates in the area. After all, a healthy workforce is the heart of a healthy economy."

- Dr. Sudheer Rai,
COO,
Ruby Hall Clinic Hinjawadi.

Fitness, Health and Fun at Regal Marathon Electric Corporate

It's rightly said that 'all work and no play makes jack a dull boy'. Keeping check on your fitness is just as important as taking care of your health. With this in mind, Ruby Hall Clinic Hinjawadi conducted a fun-filled Aerobics, Zumba and Health Awareness Camp at Regal Marathon Electric Corporate. This was organised by marketing manager Sandeep Mange and physiotherapists Jamini and Ritika.

"The camp we organised was more than just music and exercise - it showed participants the importance of staying healthy. We attempted to show individuals that taking a little time out of their busy schedules can do wonders for both their mind and body."

- Dr. Sudheer Rai,
COO,
Ruby Hall Clinic Hinjawadi.