Apollo Health City

Jubilee Hills, India

Apollo Health City

Jubilee Hills, India

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Subhan I.,Apollo Health City | Jain A.,University of Rochester
International Journal of Emergency Medicine | Year: 2010

Background: The Republic of India, the world's most populous democracy, has struggled with establishing Emergency Medical Care. However, with the recent recognition of Emergency Medicine as a formal specialty in medical training, there has been renewed vigor in the developments in the field. Method and Results: We outline here the building blocks of the health care system in India, and the contribution each has made and is capable of making to the growth of emergency medical services. We also provide an account of the current situation of emergency medicine education in the country. Conclusions: As we trace the development and status of emergency medicine in India, we offer insight into the current state of the field, what the future holds for the emergency medical community, and how we can get there. © The Author(s) 2010.

Ganesh Y.,Apollo Health City
BMJ case reports | Year: 2011

A 35-year-old Indian working in Dubai had come to India for his annual vacation. He presented with a shortness of breath and mild chest discomfort of 3 months duration. Routine investigations gave normal results, except for his chest x-ray that showed homogenous opacity in the right mid and lower zones. Chest CT scan revealed a huge mass with fat and soft tissue involving the anterior mediastinum predominantly on the right side extending into the pericardiac region. The mass was pushing the right hemidiaphragm inferiorly and was compressing the right lung superiorly with atelectasis. The patient underwent surgical excision of the mass and recovered uneventfully. Gross specimen showed an encapsulated mass weighing 2.585 kg. Histopathological examination revealed lobules of mature adipose tissue interspersed with islands of mature thymic tissue and prominent Hassal's corpuscles suggesting thymolipoma. There was no evidence of malignancy.

Pingle J.,Apollo Health City
Indian Journal of Orthopaedics | Year: 2014

Background: Nonunion and avascular necrosis (AVN) of the femoral head remains one of the major complications following femoral neck fractures. Despite various surgical techniques and internal fixation devices, the incidence of nonunion and AVN has remained unsolved. Neglected nonunion of femoral neck fracture is common in the developing world. Treatment options include rigid internal fixation with or without bone grafting, muscle pedicle bone graft, valgus osteotomy of the proximal femur with or without bone graft, valgus osteotomy or hip arthroplasty. We conducted a retrospective analysis of cases of nonunion of femoral neck fracture treated by transfracture abduction osteotomy (TFAO). Materials and Methods: Over a period of 35 years (1974-2008), 30 patients with nonunion of femoral neck fractures were treated with TFAO over a period of 35 years (1974-2008), All patients were less than 50 years of age. Absence of clinical and radiological signs of union after four months was considered as nonunion. Patients more than 50 years of age were excluded from the study. Union was assessed at 6 months radiologically. Limb length was measured at six months. The mean duration of femoral neck fracture was 19 months (range 4 months 10 years). Results were analyzed in terms of radiological union at six months. Average followup was five years and six months. Results: Consistent union was noted at the followup after six months in 29 cases. One case was lost to followup after five and one-half months postoperatively. However, the fracture had united in this case at the last followup. Average shortening of the limb at six months was 1.9 cm. Average neck shaft angle was 127° (range 120-145°). Five cases went into AVN but were asymptomatic. Two cases required reoperation due to back out of Moore's pins. These were reopened and cancellous screws were inserted in the same tracks. Conclusions: Consistent union of nonunion femoral neck fracture was noted at the followup after six months in 29 cases. The major drawback of the procedure is immobilization of the patient in the hip spica for eight weeks.

Srivastava A.,Apollo Health City | Radha A.S.,Apollo Health City
Journal of Invasive Cardiology | Year: 2012

A patient presented with a large aortopulmonary window and significant pulmonary hypertension, and underwent successful closure with muscular ventricular septal occluder (Shen-Zhen Lifetech Scientific Inc.) without complications in short-term follow-up.

Garg G.,Apollo Health City | Tyagi H.,Apollo Health City | Radha A.S.,Apollo Health City
Catheterization and Cardiovascular Interventions | Year: 2014

Sinus venosus atrial septal defect (SVASD) is located high in the atrial septum where the right superior vena cava (RSVC) enters the right atrium, and is commonly associated with partial anomalous pulmonary venous return of right upper pulmonary vein (RUPV) into RSVC. Transcatheter closure of such defects has not been described in the literature. We have developed an innovative technique to close this defect by transcatheter means. We present here a 35-year old patient with SVASD and anomalous drainage of RUPV in RSVC in whom we closed the defect along with rerouting of RUPV to left atrium (LA) using a 12 mm × 61 mm adventa V12 covered stent in the RSVC with good outcome. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Srivastava A.,Apollo Health City | Radha A.S.,Apollo Health City
Journal of Invasive Cardiology | Year: 2012

Right pulmonary artery to left atrium fistula is a rare anatomic variation of pulmonary arteriovenous malformation in which the initial connection exists between a pulmonary artery and a pulmonary vein, but during vascular development the pulmonary vein gets incorporated into the left atrium. Though nearly 60 such cases have been reported in literature, only 6 cases have been tackled by transcatheter technique with various types of devices and coils. This is a case where we demonstrate that large fistulae can be closed successfully with an atrial septal occluder without a conventional method of transseptal puncture and venovenous loop formation.

Srivastava A.,Apollo Health City | Radha A.S.,Apollo Health City
Pediatric Cardiology | Year: 2012

Aneurysms of sinuses of Valsalva (ASOV) are thin-walled saccular or tubular outpouchings of the aortic sinuses, which can be either congenital or acquired. They can rupture into heart chambers, the pulmonary artery, or the pericardial space (Perloff, Clinical recognition of congenital heart disease, [8]). This report presents a rare case of a patient with treated infective endocarditis who had a patent ductus arteriosus (PDA), a coronary cameral fistula, and a ruptured ASOV (RASOV) into the left ventricle (LV). Successful transcatheter closure of the ruptured ASOV and the other two lesions was performed using three Amplatzer duct occluders (AGA Medical Corporation, Golden Valley, MN, USA). © Springer Science+Business Media, LLC 2011.

Ramana K.V.,Prathima Institute of Medical science | Rao R.,Apollo Health City
Annals of Tropical Medicine and Public Health | Year: 2013

Human immunodeficiency virus (HIV) is a retrovirus belonging to the family Lentiviruses, which are responsible for chronic and long-lasting infections including the simian immunodeficiency virus (SIV) in monkeys. Since 1981, when the first acquired immunodeficiency syndrome (AIDS) cases were reported, HIV poses a challenge to human beings, and the UNAIDS global estimate reveals that currently more than 33.2 million people are living with HIV infection worldwide. HIV infection leads to variable disease course in different people. The biological basis of this variability in the disease progression is still unknown. Initiation of highly active antiretroviral therapy (HAART) although reduced the mortality, morbidity arising from antiretroviral side effects was a cause of concern. HIV-infected patient care has now shifted from complications arising from opportunistic infections to other causes attributable to HIV pathogenesis and toxic effects of HAART. Monitoring the disease progression and the response to HAART is traditionally carried out using TCD4+ cell counts and HIV/RNA viral load. Many clinical and laboratory markers have been used to estimate disease progression in HIV1 infection. HIV/AIDS after introduction of HAART has taken a different course where people infected with HIV have been considerably living longer due to reduced incidence of opportunistic infections and other AIDS-related conditions. HIV patient care should be multifaceted involving specialist HIV primary care physicians, infectious disease specialists, and emergency physicians considering the ways by which HIV and HAART have changed treatment and management of HIV-infected individuals.

Sinha R.,Apollo Health City | Sanjay M.,Apollo Health City | Rupa B.,Apollo Health City | Kumari S.,Apollo Health City
Journal of Minimal Access Surgery | Year: 2015

FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon′s console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.

Srivastava A.,Apollo Health City
The Journal of invasive cardiology | Year: 2012

A pseudoaneurysm due to infection after a modified Blalock-Taussig shunt is a rare but potentially fatal complication that can rupture, compress mediastinal structures, produce shunt occlusion, and bacteremia. In these patients, medical management of endocarditis is often incomplete because of the presence of prosthetic material and requires the take down of the shunt, most often by surgery, which can be technically challenging. We outline the use of a covered stent to exclude pseudoaneurysm from circulation.

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