In CEO'S words

Dear Friends,

Our founder, Late Dr. K.B. Grant entrusted us with a unique legacy which continues to pave the path and inspires us to strengthen and grow. Last month, as we commemorated his birth anniversary, the hospital came alive with festivities. He always believed that 'home is where your people are' and true to his spirit, we saluted all those employees who crossed a milestone with us. In addition to this, blood donation drive organisers were felicitated by the hands of renowned social worker Sindhutai Sapkal while we also laid the foundation stone of our cancer building.

Telehealth is no longer just a buzzword — it is fast becoming a viable treatment option and, in some cases, a saviour for the patient population that it serves. Today, the intersection of technology and medicine is creating a more opportune world. For decades, futurists have been predicting giant leaps forward in the quality and speed of healthcare delivery through advances in technology and we got to witness a glimpse of this future at Telemedicon 2017.

Our surgical expertise proved its mettle once again with our surgeons performing not just complex cases but in doing so also scaling new heights. Our patients come to us with hope and our doctors have delivered each and every time. Be it a rare case of penile cancer cured with our growing robotic prowess, our first paediatric liver transplant, the extremely challenging Bentall procedure on a Finnish patient and even the city's youngest bone marrow transplant - we have seen it all in the past month.

We were extremely happy to see such a large turnout at this year's Diabetes Walkathon. Right from young students to even celebrated sportspersons and business men, all walked hand in hand to show their solidarity for this cause. Year on year, this platform helps us remind people of the magnitude of the threat posed by diabetes and the simplicity with which the condition can be managed. This walkathon encouraged people to stay proactive about their own health and the well-being of their loved ones.

It goes without saying that emergency strikes without warning but being prepared can save your life. At our Hinjawadi counterpart, we experienced this not just once but twice this month with our experts putting their best foot forward, acting instinctively and saving the lives of two young men. As a medical organisation, we stand for saving lives, and when the clock is ticking, we are happy that the Ruby Hall family has lived up to all expectations.

The year 2017 will soon come to a close, and while we may still be catching our breath from the activities of this month, December also comes with its share of celebrations. These celebrations for us are always in the form of compassionate patient care. And as the year draws to a close, we continue to offer hope and healing to one and all in the years to come.

Paying homage to our founder

Padmabhushan Late Dr. K.B Grant was one of the most remarkable Indians of his generation, a man who made pioneering contributions to medicine, to research and innovation, global health, philanthropy, public policy, and to public and non-profit sector governance. He was also a truly remarkable human being—humble, funny and kind. His generosity of spirit was simply astonishing. That is why he was loved by so many people from all walks of life.

Venerating the birth anniversary of late Dr. K.B Grant, the brainchild of Ruby Hall Clinic, the hospital observed November 28 as Founder's Day. Over the years, Ruby Hall Clinic has been profoundly committed to those who seek its care. It is known the world over for the expert, compassionate, personalised care given to those who have passed through its doors and will continue to carry forward this tradition.

However, he always believed that the way you treat your employees is the way they will treat your patients, and that people flourish when they are praised. True to this spirit, the hospital felicitated all employees who completed twenty-five or more years with the organisation. We are proud to see that the values cultivated by the visionary, Late Dr. K. B Grant have been imbibed by each and every employee of the hospital.

Felicitating Blood Donation Drive Organisers

Commemorating the 97th birth anniversary of the beloved Late Dr. K.B Grant, the Blood Bank organised a mega-felicitation programme for voluntary blood donation drive organisers. In the presence of Smt. Sindhutai Sapkal, Dr. Sanjay Pathare and Mr. Bomi Bhote, representatives from 128 organisations and 80 donor motivation committee members were felicitated.

"I salute the commitment of the doctors and staff at Ruby Hall Clinic who serve patients 24 hours a day, 365 days a year. The dedication of blood donation drive organisers is second to none when it comes to the noble act of gifting life. I encourage them to keep up their philanthropic work."

Laying the foundation stone

New beginnings are a perfect way to honour those who have built the very foundation of the hospital. In memory of Late Dr. K.B Grant, the Kamalnayan Bajaj Cancer Centre laid the foundation stone of its new building.

The new cancer building is all set to promote hope, healing and recovery for all patients suffering from various kinds of cancer. It will be backed by state-of-the-art technology which is second to none.

Harnessing the power of technology with telemedicon 2017

Over the past few years, telemedicine has proven to be a major innovation in how we think about and deliver health services. Patients love it because it saves them time and allows them to access top-quality, specialised care right from their home, workplace or local clinic. Health care organisations embrace it because it increases their capacity, opens up new sources of treatment and follow-ups, and can even improve patient outcomes.

Tapping into this new era of medical technology, Telemedicine Society of India, Serum Institute of India and Ruby Hall Clinic today came together to inaugurate the thirteenth edition of Telemedicon. Held from November 9 to 11, the three day symposium saw the brightest minds come together to discuss the potential for and implications of telemedicine as an enabler for the transformation of healthcare strategy in India.

While the theme of the conference was 'Digital Health – Shaping the Future of Healthcare', the event was witness to a host of leading international and national faculty who conducted a number of panel discussions, presentations, demonstrations, case studies, debates and an exhibition. With over 200 participants from across the globe, some of the many names that stood out were:

  • Dr. Vijay Bhatkar, renowned computer scientist.
  • Prof. Selva Kumar, President, TSI.
  • Prof. Arun Sen, Department of Information and Operations Management, Texas A&M University.
  • Dr. Khalid Moidu, Program Director, Master of Science in Health Informatics Program, Hofstra University.
  • Prof Mikhail Natenzon, Chairman, Board of National Telemedicine Agency RPU.
  • Dr. Hemant Darbari, Executive Director at Centre for Development of Advanced Computing Technology (CDAC).
  • Dr. B.S. Bedi, Advisor Health Informatics, Centre for Dev. For Advanced Computing (CDAC) Ministry of Communication & IT (MCIT), Govt. of India.

"Traditionally, India is a backward looking society where our past becomes our history. At Telemedicon 2017, we are making people look into the future. Here, we have the talent and knowledge with easy accessibility to the best in technology. We are here to exchange, discuss and execute ideas to become the champions of telemedicine."

- Dr. B.S. Ratta,
Consultant Neonatal and Urosurgeon,
Ruby Hall Clinic and President, TSI, Maharashtra Chapter and Organising Chairman.

The Department of Surgery - Hernia Division presents Hernia update 2017

The reconstruction of abdominal wall defects remains one of the most challenging dilemmas facing surgeons. Congenital, acquired or post traumatic defects all present unique challenges to the surgeon. On the 26th of November 2017, the Department of Surgery - Hernia Division, Ruby Hall Clinic organised Hernia Update 2017 at the Kamalnayan Bajaj Cancer Centre. This conference which saw her 270 members in attendance credited 2 MMC points to its delegates.

Over one million hernia surgeries are conducted in India annually. Males mostly suffer from hernia in the groin area while women mostly suffer from incisional hernia caused mainly due to incisions made on the abdominal wall during procedures such as a caesarian or hysterectomy. Earlier, most hernia surgeries had a recurrence, or failure rate of between 10 per cent and 20 per cent, however the use of advanced technology in the form of minimally invasive methods has reduced this rate to less than 1 percent.

Hernia Update was a comprehensive symposium providing an in-depth understanding of the complexity of different types of hernias and their advanced repair techniques highlighting updates in hernia repair, diagnosis of abdominal diseases, implications of hernia surgery, patient management and other topics related to general surgery and hernia repair. It provided each attendee with education and resources needed to heal wounds and consider alternative resources in hernia surgeries.

The faculty saw a number of celebrated surgeons in this field:

  • Dr. Praveen Bhatia, Delhi
  • Dr. Roy Patankar, Mumbai
  • Dr. B Ramana, Kolkata
  • Dr. Ramesh Punjani, Mumbai
  • Dr. Deepraj Bhandarkar, Mumbai

"In the last 3 decades, hernia surgery has seen significant advances. Among them are a shift from autogenous tissue repair to use of synthetic and biological meshes, as well as the minimally invasive laparoscopic surgical approach to the very recent robotic approach. Today, as surgeons we choose from many prosthetic meshes, fixation techniques, and surgical approaches, each with its own advantages and disadvantages. These choices allow surgeons to select the treatment that is most appropriate and will achieve the best outcomes for each individual patient."

- Dr. Neeraj Rayate
Organising Secretary and Consultant,
Laparoscopic and Bariatric Surgery,
Ruby Hall Clinic.

At Ruby Hall Clinic, we have once again proved our mettle with a number of rare cases being resolved in the past month. Here is a glimpse of all these cases in this section:

Menses pills triggers Stroke

42-year-old Ranjana Kumbar did not know what hit her. It was on 10 October 2017 that she started complaining of a severe headache while feeling drowsy at the same time. Her family quickly rushed her to the nearest hospital in an unconscious state. They had no idea what was wrong, but what came next certainly left them shocked. An MRI and CT scan at Ruby Hall Clinic revealed a stroke caused by a clogged vessel in the brain — cerebral venous sinus thrombosis (CVST). Ranjana was was immediately rushed in for surgery. The root cause of her serious condition — a medicine she was taking to delay her menses.

"Ranjana was taking a pill to control her menses for the last two or three weeks. She developed speech disturbance, severe headaches and was referred to us in a comatose state. CT scan, MRI, MR Vinogram showed she had a cerebral venous sinus thrombosis (CVST) — the presence of acute thrombosis (a blood clot) in the dural venous sinuses, which drains blood from the brain. The vital vessels were choked. The situation was so delicate that any delay would have caused death."

-Dr. Sanjay Vhora,
Director,Department of Neurosurgery,
Ruby Hall Clinic.

Cerebral venous sinus thrombosis (CVST) occurs when a blood clot forms in the brain's venous sinuses. This prevents blood from draining out of the brain. As a result, blood cells may break and leak blood into the brain tissues, forming a haemorrhage. Acraniotomy (surgical removal of part of the bone from the skull) with evacuation (part of brain removed) of the hemorrhagic infarct with open dura was performed on her. During the procedure, our doctors found that the brain had a mass defect where two blood vessels which supplied blood to the heart were blocked.

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Seven month old girl becomes youngest bone-marrow donor

When three-year-old Prithviraj Sawant was diagnosed with thalassaemia major - a rare blood disorder, his parents knew every single day would be a battle for his life. Thalassemia major occurs when a child inherits two mutated genes, one from each parent. Children born with this usually develop the symptoms of severe anaemia within the first year of life. They lack the ability to produce normal, adult haemoglobin and experience chronic fatigue. This leads to poor growth, impaired physical activities, facial and other bone deformities, fragile bones and enlargement of the liver and spleen. If left untreated, it will lead to death within the first decade of life.

"I suggested the family to have another child who has to complete two years of age in order to donate the bone marrow. The woman got pregnant with another child who was screened and was found to be fit for the transplant. Finally, Rajnandini was born to save Prithviraj's life."

-Dr. Vijay Ramanan,
Sr. Consultant Clinical Haematologist, Director, Clinical Hematology,
Bone Marrow and Stem Cell Transplant.

However, with time, Prithviraj's condition deteriorated. The size of his liver, spleen and pancreas had increased and his parents knew the transplant had to be performed.

When Rajnandini was merely seven months old, Dr. Ramanan conducted the transplant by using her stem cells from the cord blood and bone marrow stem cells. This was done in 2013, however, the surgery was made public four years later, only after ascertaining that the recipient was healthy. Today, both children are healthy and their bond goes so much deeper than that of just a brother and sister.

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Massage causes finnish man to have rare open heart surgery

Thirty-eight-year-old Toni Hautakoski was your usual expatriate working in Pune for the past one and a half years. An otherwise healthy man, he hails from a family with a history of aortic aneurysm wherein heart blood vessels weaken and bulge. Little did he know that a visit to the spa would trigger a heart condition which required a risky procedure to replace the damaged portion of his heart.

Toni was left feeling extremely breathless and had acute chest pain when he was rushed to the hospital. While his ECG was normal, further scans revealed the presence of an acute aortic dissection - an extremely rare condition. In this, the surging of blood through a tear in the aorta leads to the creation of a blockage which, if left untreated, could result in death within the first twenty-four hours.

Owing to an extremely high risk of sudden cardiac death, Toni could not travel to Mumbai or Finland for further treatment. He was rushed into surgery at 1:30 am on Sunday morning where the team of doctors which included Dr. Vivek Gaikwad, Dr. Ranjit Jagtap, Dr. Purvez Grant, Dr. C.N. Makhale and Dr. Munot performed the Bentall Surgery - an extremely complex and rare open heart surgery.

"The operation included several steps in which the aortic valve was replaced, and the aortic root and the ascending aorta upto the descending aorta was also repaired by creating an artificial passage. This was followed by reinserting the native coronary arteries of the heart in the replaced part of the aorta. However, the most dangerous part of the surgery involved temporarily stopping the blood flow to the body and brain. We are very happy that Toni came through without any complications and that he was even discharged two days later."

- Dr. Vivek Gaikwad,
Interventional Cardiologist,
Ruby Hall Clinic.

It is always a matter of pride when we create more milestones. We have always believed that the right mix of expertise and technology not just helps us grow as a team but also strengthens the hope and trust our patients place in us. In this section, read more about the new heights we soar to every single day!

Paediatric liver transplant is welcomed at Ruby Hall Clinic

A Goan couple could not figure what was wrong with their baby for a long time. Within a few weeks of being born, her skin and eyes started yellowing leading to jaundice. Further investigation revealed the presence of biliary atresia, an extremely rare and fatal liver condition.

Biliary atresia is a chronic, progressive liver problem that becomes evident shortly after birth. Tubes in the liver, called bile ducts, normally allow a liquid produced by the liver called bile to drain into the intestines and kidneys. In biliary atresia, bile ducts in the liver are blocked. When the bile is unable to leave the liver through the bile ducts, the liver becomes damaged and many vital body functions are affected.

In Goa itself, the couple visited a number of doctors and the baby underwent an unsuccessful Kasai procedure. Futile attempts to look for a solution for their ailing child led them to Dr. Sheetal Dhadphale at Ruby Hall Clinic. Thus began the procedure to look for a liver donor to save the life of the child.

"The child came to us when she was about two and a half years old in a severe condition. There was no option but for us to undertake a liver transplant surgery within the next six months. The mother of the patient was more than happy to donate her liver. As luck would have it, she was a perfect match for her daughter. We are happy to see the patient on the road to recovery a month after the surgery. The new liver keeps her happy and healthy and is set to grow as she matures."

- Dr. Sheetal Dhadphale-Mahajani,
Consultant Liver Transplant Physician,
Head - Department of Liver Transplantation,
Ruby Hall Clinic.

The team included the following doctors:

Surgical Team:

  • Dr. Manish Varma
  • Dr. Kamlesh Bokil
  • Dr. Mahesh Gopashetty
  • Dr. Anand Ramamurthy
  • Dr. Manjunath

Paediatricians:

  • Dr. Venkat
  • Dr. Prashant Udawant

Post-operative Recovery:

  • Dr. Vaibhav Meshram
  • Dr. Sheetal Dhadphale-Mahajani

Transplant Co-ordinators:

  • Mrs. Surekha Joshi
  • Mr. Abhijit Shivankar

For the first time in Pune, robotic surgery cures penile cancer

All was not well for a sixty-four-year-old man who had been ignoring his pain for a long time. He was finally diagnosed with squamous cell carcinoma of glans of the penis. Such a cancer is extremely rare not just in India but also across the world and ranges from 0.7-2.3 cases per 100,000 men.

Of course, being cancer, it is always prudent to act in a timely fashion. If left untreated, it spreads slowly across the skin and invades deeper layers of tissue. As the cancer grows, pain and bleeding may also increase along with the risk of the cancer spreading to the lymph nodes and through the lymphatic system, to the groin and other parts of the body.

For such cases, traditional open inguinal lymphadenectomy is the gold standard, but is associated with significant potential morbidity.

The most significant complications include lymphocele, wound infection, and skin flap necrosis. In this case, the patient underwent partial penectomy and was advised to undergo bilateral superficial inguinal lymph nodes dissection as a part of his routine treatment.

As he suffered from a heart problem and underwent an angioplasty during the course of treatment, the robotic approach which offers advantages such as minimal blood loss, shorter recovery time period and increased precision was considered. The result of the surgery too, was so good that the patient could comfortably move around the very next day.

"Penile cancer is rare, but when diagnosed, is psychologically devastating to the patient and often presents a challenge to the urologist. As many as 15-50% patients delay medical attention for more than 1 year from onset. This is attributed to embarrassment, guilt, social stigma, fear, ignorance, and personal neglect. Patients often try to treat themselves with various skin creams and lotions which may appear to be effective for a time, but ultimately worsens the prognosis."

- Dr. Himesh Gandhi,
Robotic Uro-oncosurgeon, Consultant Urologist,
Ruby Hall Clinic.

With this case, the hospital became the first in the city and one of the very few centres in the country to perform such procedures robotically.

Dr. Tandulwadkar makes her presence felt at AAGL

As the incoming President of the Indian Association of Gynaecological Endoscopists (IAGE), Dr. Sunita Tandulwadkar, Director - Department of Obstetrics and Gynaecology, Ruby Hall Clinic attended the 46th Annual Conference of The AAGL (American Association of Gynaecologic Laparoscopists). This conference was organised on November 12-16, 2017 at the Gaylord National Resort and Convention Center, in National Harbor, Maryland, Washington DC.

AAGL's Congress is the premier scientific conference that provides gynaecologic surgeons from all over the world with the latest education and best practices in minimally invasive gynaecologic surgery (MIGS). This year the conference welcomed over 1700 physicians from around the world, as well as over 80 exhibitors, and more than 1000 industry representatives, over the course of 5 days.

This years theme was 'Enhancing Minimally Invasive Gynaecologic Surgery Through Quality, Patient Safety, and Innovation', and with the relevant principal of improving patient outcomes through a patient-centred approach that balances both innovation and technology, as well as quality and safety. The delegates also got the opportunity to undergo rigorous robotic training for over three days.

"AAGL's Global Congress embodies their global commitment to women's health care by providing continuing medical education to physicians and professionals to further promote the well-documented high standards of minimally invasive gynaecologic surgery. As a representative of both Ruby Hall Clinic and the Indian Association of Gynaecological Endoscopists, I considered it a wonderful opportunity to meet and interact with medical practitioners across the globe."

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

Making it count at NAPCON 2017

At Science City, Kolkata The Indian Chest Society and The National College of Chest Physicians (I) organised NAPCON 2017. The 19th edition of this conference was organised from the 16th to 19th of November 2017. 'Precision Medicine: Treating A Malady, Not A Label; Tomorrow's Approach to Respiratory Disease' was the theme of this symposium. Dr. Amir Khoja and Dr. Mahavir Modi along with their students attended this conference while presenting five presentations.

"The largest cause of death amongst Indians is COPD and not heart disease, cancer or stroke. This forum therefore became an important platform for chest specialists to come together paving the way for advanced treatment." Additionally, Dr. Mahavir Modi, Chest Physician, Ruby Hall Clinic adds, "In a country such as ours, the risk of lung injury is not just from smoking, but also from biomass exposure and pollution. This adds to the already existing burden of infectious and communicable diseases."

- Dr. Amir Khoja,
Head of Department - Chest Medicine,
Ruby Hall Clinic.

This month, our Spine Clinic at Ruby Hall Wanowarie shines. Be it young or old, spine related ailments can affect one and all. Here, we have two complex cases with outstanding results. Read on to know more!

A rare case of pain in the neck

What happens when a child is born with a rare congenital deformity that affect's their head position? Besides the obvious discomfort, it is heart breaking to see the child lose confidence in themselves. And such was the case of 5-year-old Advika Chandurkar who had to deal with congenital muscular torticollis, an awkward neck deformity. It is an uncomfortable condition that can seriously impact the quality of life and is essentially a twisted neck in which the head is tipped to one side, while the chin is turned to the other.

A rare congenital musculoskeletal disorder, it is seen in only 0.3-1.9% of all live births. However, it is essential to treat this in the early stages of life. If not, it is bound to affect the symmetry of facial features and well as gaze. Treatments too, depend on the severity of the problem and can range from paediatric massages to physiotherapy, and resorts to surgery in more complex cases.

"Advika's parents realised her deformity as she grew older. Besides her chin and neck being tilted, her facial features were also asymmetrical. Luckily she came to us just in time as her condition would get more complex with age. In later stages, the gaze too gets fixed according to the position of the head. A small neck surgery was carried out to correct the shortened neck muscle which was followed by extensive physiotherapy."

- Dr. Bhushan Khedkar,
Consultant Spine Surgeon,
Ruby Hall Clinic Wanowarie.

A month into treatment, Advika's surgical scars have almost disappeared, and she is leading a carefree childhood. Although she will need to continue physiotherapy sessions for some time with exercises, she will be almost 100 per cent fine thereafter. Naturally, her parents too are overjoyed at Advika's chance to enjoy the bright days of childhood with utmost confidence.

"Over the past few years, Ruby Hall Clinic Wanowarie has transformed from just a clinical hospital to one of the leading healthcare specialists in the region and this case further demonstrates the progress we are making. While it is not something that is seen often, we certainly had the confidence we could plan and perform this surgery and have a good outcome at the end. Building a record of doing innovative things, including unprecedented kinds of surgeries in the past, our integrated team has done wonders once again."

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

When back pain gets bad

With severe lower to mid back pain, 76 year-old Mrs. Landge was not only diabetic, but adding to her problems, she developed proximal muscle weakness in her lower limbs and was almost bedridden. In fact, her pain was so bad that she couldn't even manage to get up from her bed and go to the toilet.

Upon evaluation by Dr. Hrushikesh Mehata, it was found that she had an osteoporotic vertebral compression fracture in her dorsal spine with instability and cord compression at the fractured level. To add to this, she also had severe lumbar canal stenosis in her lower lumbar spine level L4-5. Of course, surgery was the only option to relieve her from her pain instantaneously.

"She underwent dorsolumbar stabilisation with cortico-cancellous pedicle screws specially made for an osteoporotic bone along with cement augmentation at the fractured level with vertebropasty. Her spinal cord was completely decompressed at the fractured level and we also addressed the lower lumbar canal stenosis in the same sitting."

- Dr. Hrushikesh Mehata,
Consultant Spine Surgeon,
Ruby Hall Clinic Wanowarie.

Post surgery, Mrs. Landge was put on an aggressive regimen of physiotherapy and rehabilitation. Such was her progress that she managed to walk with support just three days post surgery and six months into the procedure, she has no back or leg pain and completes all her chores in and around her household by herself. She has also been started on aggressive anti-osteoporotic treatment by in the form of daily recombinant parathormone injections as well as calcium and vitamin supplements to prevent osteoporotic fractures at adjacent levels.

"Our society always neglects bone health. We are more concerned about cardiac fitness and never bother to check the status of the health of our bones - the supporting structure of our body. While daily weight bearing aerobic activity such as walking does help maintain bone health, I recommend all women after the age of 60 and men post the age of 65 years to undergo a bone mineral density test for osteoporosis once every two years. It is only early detection and prompt treatment of osteoporosis which can prevent disasters such as the one Mrs. Landge underwent."

- Dr. Mehata

Keeping your weight in check : Diabetes awareness unites us all - the walkathon

The 10th of November saw a flurry of people from all walks of life unite for a single cause - to end the diabetes epidemic. Commemorating World Diabetes Day, which fell on the 14th of the month, Ruby Hall Clinic Wanowarie organised a grand Walkathon.

With a participatory crowd of close to 5000 people, the gala event garnered immense support with participation from several government authorities, medical entities, corporates, local communities as well as school students from RIMS, MKNS, KROOT, Mount Carmel and Lonkar.

And it did not just stop there. A number of well known faces also joined in to lend their support for this noble cause. They ranged from:

  • Hon. Mayor Mrs. Mukta Tilak
  • Indian cricketer Kedar Jadhav
  • Former cricketer Mr. Chandu Borde
  • Chairman of Panchshil Realty Mr. Atul Chordia
  • District Governor Lion Girish Malpani
  • Area corporators

The Walkathon was followed by an exhibition, as well as an interactive presentation and short film on diabetes while yoga enthusiasts put up a stellar performance at the Mahatma Phule Sanskrutik Bhavan. Free health checkups were also conducted throughout the day.

Diabetes is a major cause of blindness, kidney failure, heart attack, stroke and lower limb amputation, but a healthy diet, physical activity and avoiding tobacco use can prevent or delay type 2 diabetes. Moreover, diabetes can be treated and its consequences avoided or delayed with medication, regular screening and treatment for complications and this is exactly what the Dr. K.B. Grant Institute of Diabetes hopes to achieve.

"While there is currently no cure for diabetes, it can be controlled, allowing people to have full, productive lives. For us, the key to managing the disease is having a proactive approach and lies with patient involvement, education and empowerment. This is why we encourage early screening because the early detection of diabetes could save individuals from a number of complications."

- Dr. Abhay Mutha,
Director,
Dr. K.B. Grant Institute of Diabetes.

Advanced head and neck care

Can you imagine a world without laughter, the sense of smell or the power of the voice? Can you imagine being unable to live life to its fullest? Naturally, this has a profound effect on our interaction and connection with our family and friends - after all, life is a sensory experience, and taste, communication and appearance are all key to a person's identity and daily functioning.

It is with this factor of human identity in mind that the Head and Neck Clinic was launched at Ruby Hall Clinic Wanowarie. Here, problems involving the areas of the head and neck, such as vocal cord growths, goitres, dreaded cancers of the oral cavity and thyroid are meted out with the most sophisticated, state-of-the-art treatments available today.

"An evolution in subspecialty medicine, we are proud to offer a comprehensive service in tackling the full spectrum of conditions involving the head and neck region for the very first time in Pune. Our aim is to help people live life to its fullest and we are committed to helping you feel whole again. "

- Dr. Vidisha Bhujbal,
Consultant, Head Neck Oncosurgeon,
Ruby Hall Clinic Wanowarie.

Road accident leads to heart attack in 24-year-old patient

24-year-old IT consultant, Niraj Ranjendran had everything going for him. Having taken a 4-day break from work, he and his friends decided to ride to Lavasa when tragedy struck. He met with an accident around 10 am, when his bike skidded after a car speeded from the wrong side. Subsequently, Niraj fell and suffered a chest injury caused by blunt trauma from the large stem of a tree. Friends rushed the unconscious Niraj to Ruby Hall Clinic Hinjawadi.

"While screening him, we noticed that the ECG showed a massive anterior wall myocardial infarction (heart attack); during clinical examination as well, Niraj appeared to be acutely ill, and on an auscultation, had a rapid heart sound without murmur or rubs. There was no distension, organomegaly (abnormal enlargement of organs), or tenderness in the abdomen. A diagnostic coronary angiogram revealed total occlusion in the proximal left anterior descending artery (LAD), while the right coronary artery and left circumflex artery was normal. There was an endothelial injury to the LAD, which was managed by putting a 4x28 mm drug-eluding stent in"

-Dr. Rahul Patil,
Interventional Cardiologist,
Ruby Hall Clinic Hinjawadi.

Thrombolytic treatments of coronary occlusions cause risk of bleeding from sites of injury during trauma. However, many trauma patients are not candidates for thrombolytic therapy, due to the risk of haemorrhages from coexisting injuries. In complicated cases, immediate surgical corrections are often performed. Considering this particular patient's young age, percutaneous coronary intervention (PCI) along with stent insertion was the only choice. Niraj recovered soon, and was discharged from the hospital in a couple of days.

When your heart runs a marathon without your body

32-year-old Rajiv Phadke* was at work in Hinjawadi. A patient of congenital heart disease, he had undergone a cardiac surgery in 2014 and his life was on track. One afternoon, he suddenly felt uneasy, started palpitating while feeling giddy and sweating profusely. His heart was running a race his body was not prepared for. His life was saved only by a combination of good fortune and quick thinking when he suffered from an irregular heart rhythm that quickly escalated into a life and death situation.

Rajiv had what is medically called a ventricular tachycardia. In ventricular tachycardia (V-tach or VT), abnormal electrical signals in the ventricles cause the heart to beat faster than normal, usually 100 or more beats a minute, out of sync with the upper chambers. When that happens, your heart may not be able to pump enough blood to your body and lungs because the chambers are beating so fast or out of sync with each other that they don't have time to fill properly.

"His heart was racing over 300 times a minute, against the normal rate of 60-100 times. This kind of heart rhythm, originating from the lower chambers, or ventricles, of the heart, is potentially life-threatening. The patient was not only losing consciousness, but was also not responding to intravenous medication. This is when we had to resort to more drastic measures in the form of synchronised shocks exactly timed to the heartbeat,"

- Dr. Rahul Patil,
Interventional Cardiologist,
Ruby Hall Clinic Hinjawadi.

"When your heart is beating as rapidly as it does during an episode of ventricular tachycardia, your blood pressure will drop and your heart won't be able to pump enough oxygen to every part of your body. In fact, we were worried that Rajiv's brain was not getting enough oxygen and this would affect his life at a later stage. Luckily, the timeliness of his visit to the hospital along with quick action converted his abnormal rhythm to normalcy and saved his life."

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

VW Offshore Health Check up comes to the rescue

Odd hours of working and an almost non-existent social life creates stress for individuals. However, the ways adopted for coping with stress, i.e. smoking, binge eating and binge drinking, create further stress on the body and mind. This results in hypertension, high blood pressure, obesity, etc. which lead to further complications such diabetes, heart diseases or cancers.

Taking the responsibility of the health of employees a notch further, Volkswagen India organised an offshore health check-up in association with Ruby Hall Clinic Hinjawadi. This initiative saw over 3500 employees being checked for various health conditions covering the entire range of preventive health care to wellness programmes.

"Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. At Volkswagen India, we set up a facility for conducting health check ups within the premises of the company itself, making it a unique initiative,"

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