News Article | May 24, 2017
A May 5 article on Women’s Health tells the story of Eman Ahmed Abd El Aty, an Egyptian woman who has lost a stunning 713 pounds in just two months, with seemingly good health results so far. The woman, who started out at over 1,100 pounds and who had been confined to her bed for 20 years, traveled to Mumbai, India’s Saifee Hospital to receive the procedure and remained under constant care due to the extreme nature of her condition and the very rapid weight loss she was experiencing. Dr. Feiz & Associates notes that, while Emam’s situation is unusually drastic and requires vastly more medical supervision than is typically required, the success of the woman’s treatment so far is illustrative of the extremely effective and safe nature of today’s weight loss surgery. Dr. Feiz & Associates notes that, while sleeve gastrectomy is obtained by persons who are medically considered to be severely obese, most patients who obtain the procedure are dealing with vastly smaller amounts of weight than the case in Mumbai. They note that, to qualify for a weight loss surgery, patients need to have a BMI of 40 or above, or 35 and above with related health problems, to qualify for the procedure. This would mean, for example, that a 5’ 5”person who weighed 241 pounds, or a person of the same height weighing only 211 pounds but with type 2 diabetes related to her weight, might also qualify for a procedure. The important thing, the clinic notes, is that the patient is aware that the procedure will call for serious lifestyle changes and an entirely new relationship with food in order to be successful. The clinic points out that it is always a serious error to assume that bariatric procedures are in any way an “easy way out” of the serious health challenge faced by people with standard cases of severe obesity. In fact, very often, they are the only way out. This is because the vast majority of severely obese individuals find that permanent weight loss is next to impossible. The clinic notes that the reason for the problem is not because of a lack of will power or determination on the part of obese individuals, it’s that the human body is essentially designed to maintain its present weight, whatever that weight is. Once an obese individual begins to lose weight, hunger inducing hormones such as ghrelin increase significantly, creating ever stronger feelings of hunger which get more and more difficult to ignore as the patient increasingly must struggle to even begin to achieve and maintain a healthy weight. The clinic notes that one of the primary reasons for the effectiveness of sleeve gastrectomy surgeries is that the procedure removes roughly 75-85% of the stomach, including the portion of the stomach primarily responsible for the production of ghrelin. Thus, overeating becomes uncomfortable but, perhaps even more importantly, the incessant urges to eat related to ghrelin are reduced to the point where individuals can focus on maintaining a healthy, reduced calorie diet as well as a sensible exercise regimen. They note that it’s an effort that can still be a challenge, but it is one that most patients are able to live up to. Interested readers who would like to learn more about weight loss surgery are welcomed to contact Dr. Feiz & Associates at (800) 868-5946. They can also the visit it online at http://www.DrFeiz.com.
News Article | April 28, 2017
The world's heaviest woman alive — Egyptian Eman Ahmed Abd el-Aty — will soon be shifted from the ward in Mumbai's Saifee Hospital to VPS Healthcare's Burjeel Hospital in Abu Dhabi for further treatment, rehabilitation, and therapy. VPS officials confirmed that the transfer of the 1100-pound Eman from India to the Abu Dhabi hospital will take place in the coming week, confirmed VPS officials. On Thursday, April 28, Dr. Shamsheer Vayalil, who is the co-founder of the VPS Health Groups, visited Saifee Hospital with his team of doctors and medical practitioners to chalk out Eman's shift. At Saifee Hospital, the 36-year-old underwent bariatric surgery on March 7, following which doctors claimed she lost almost 662 pounds. Eman's sister, Shaimaa Selim, though claimed that the doctors were lying and that it was impossible for someone to lose so much weight so quickly. Muffazal Lakdawala, the bariatric surgeon leading the team, informed Selim that Eman's weight had dropped to nearly 380 pounds. The doctor told Selim that Eman could be taken back to Egypt as there was no need for her to remain in the hospital any longer. "They told me they would remotely monitor her condition under an Egyptian doctor but she could go home as no further treatment was required," Selim shared. This suggestion did not go down well with Selim who reveals that even though her sister lost weight, she still has a long way to go before being completely rehabilitated. According to Eman's sister, currently, she cannot function by herself and needs proper physical therapy. So, Selim decided to shift her to the Burjeel Hospital in Abu Dhabi. Moving the patient in this case is no child's play despite the weight Eman has managed to lose since her admission to the Indian hospital. A specialized ambulance will take her to Mumbai airport. From the airport, doctors will get her aboard the flight by hoisting her stretcher with a crane through the specialized plane's door. Inside the flight, a team of trained medical professionals will attend to Eman. The flight has been equipped with necessary medical equipment and amenities such as ICU medication, ventilator, defibrillator, oxygen cylinders, and more. It is estimated that 13 people will accompany Eman. "Eman will continue to be on the high-nutrition liquid diet being given to her via a feeding tube and we will take utmost care to keep her stable and safe until she is transported to Burjeel Abu Dhabi to continue her treatment," Sanet Meyer, director of Medevac at VPS Healthcare, stated. Eman was diagnosed with elephantiasis as a child and did not leave her Alexandria house for more than 20 years before seeking medical aid in India. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
Lee W.-J.,Min Sheng General Hospital |
Hur K.Y.,Soonchunhyang University |
Lakadawala M.,Saifee Hospital |
Kasama K.,Yotsuya Medical Cube |
And 3 more authors.
Journal of Gastrointestinal Surgery | Year: 2012
Background: Gastrointestinal metabolic surgery has been proposed for the treatment of not well-controlled type 2 diabetes mellitus (T2DM) patients with a body mass index (BMI) <35 kg/m 2. This study aims to describe recent experience with surgical treatment of T2DM in Asian centers. Methods: Patients aged 20 to 70 years with not well-controlled T2DM [glycated hemoglobin (HbA1C) >7. 0%] and BMI < 35 kg/m 2 were included at five institutes between 2007 and 2010. The end point is T2DM remission, defined by fasting plasma glucose <110 mg/dl and HbA1C <6. 0%. Results: Of the 200 patients, 172 (86%) underwent gastric bypass, 24 (12%) underwent sleeve gastrectomy, and the other 4 underwent adjustable banding. Laparoscopic access was used in all the patients. Gender (66. 5% female), age (mean 45. 0 ± 10. 8), and HbA1C (mean 9. 3 ± 1. 9%) did not differ between the procedure among the groups. Until now, 87 patients had 1-year data. One year after surgery, the mean BMI decreased from 28. 5 ± 3. 0 to 23. 4 ± 2. 3 kg/m 2 and HbA1C decreased to 6. 3 ± 0. 5%. Remission of T2DM was achieved in 72. 4% of the patients. Patients with a diabetes duration of <5 years had a better diabetes remission rate than patients with duration of diabetes >5 years (90. 3% vs. 57. 1%; p = 0. 006). Patients with BMI > 30 kg/m 2 had a better diabetes remission rate than those with BMI < 30 kg/m 2 (78. 7% vs. 62. 5%; p = 0. 027). Individuals who underwent gastric bypass loss more weight and had a higher diabetes remission rate than individuals who underwent restrictive-type procedures. Multivariate analysis confirmed that the duration of diabetes and the type of surgery predict the diabetes remission. No mortalities were reported and two (1. 0%) patients had major morbidities. Conclusion: Gastrointestinal metabolic surgery is an effective treatment for not well-controlled T2DM treatment. Diabetes remission is significantly higher in those with duration of diabetes less than 5 years and BMI > 30 kg/m 2. © 2011 The Society for Surgery of the Alimentary Tract.
Report: Asian consensus meeting on metabolicsurgery. recommendations for the use of bariatric and gastrointestinal metabolic surgery for treatment of obesity and type II diabetes mellitus in the asian population
Lakdawala M.,Center for Obesity and Diabetes Support |
Lakdawala M.,Saifee Hospital |
Lakdawala M.,Lilavati Hospital |
Bhasker A.,Center for Obesity and Diabetes Support |
Bhasker A.,Saifee Hospital
Obesity Surgery | Year: 2010
Background The report submitted is a detailed analysis of the happenings and outcomes of a two day deliberation that was organized in Trivandrum, India on the 9th and 10th August 2009. Methods Asian Consensus Meeting on Metabolic Surgery (ACMOMS) was the first ever meeting of its kind in Asia where 52 professionals involved in the field of bariatric surgery, metabolic surgery, diabetes, and medical research from countries across Asia and the GCC met at Trivandrum, India to vote for and create a new set of guidelines for the Asian genotype, which were different from the NIH guidelines set for bariatric surgery. The aim was to set culturally, geographically, and genetically relevant standards for the management of obesity and metabolic syndrome. Results It is known that Asians have a higher adiposity for a given level of obesity, and this is visceral obesity as compared to other populations. Currently, all over the world and in Asia as well, guidelines set by NIH in 1991 are being followed. Surgeons believe that NIH guidelines need to be revisited and modified. It is in light of these observations that the genesis of ACMOMS took place. At ACMOMS, it was recommended that the NIH guidelines are not suitable for Asians, and the BMI guidelines should be lowered for indication of surgery. Waist or waist-hip ratio must gain significance as compared to BMI alone in Asia. Conclusions The collective recommendations were submitted as a report to the executive committee for approval. As the Asia Pacific region consists of more than half of the world's population, the dire health and economic consequences of this epidemic demand urgent action from the medical fraternity in this region, and we hope that the recommendations will help to review the currently accepted guidelines. © Springer Science+Business Media, LLC 2010.
Sankhla S.K.,Dr Balabhai Nanavati Hospital And Saifee Hospital |
Jayashankar N.,Dr Balabhai Nanavati Hospital |
Khan G.M.,Saifee Hospital
Neurology India | Year: 2013
Background and Objectives: The endoscopic transsphenoidal approach is commonly used surgical approach for pituitary adenomas. However, adenomas with dumbbell configuration, pure suprasellar location, and fibrous consistency are difficult to remove by this approach. Recently, the extended endoscopic endonasal approach (EEEA) has been utilized to excise this subgroup of pituitary adenomas successfully. Materials and Methods: Between January 2009 and December 2011, 13 patients with pituitary macroadenomas were treated with EEEA. The tumor subgroups included: Dumbbell tumor configuration (4), pure suprasellar tumor location (2), and large suprasellar tumors with subfrontal extension (2). Five patients had fibrous/recurrent tumors and required addition of transtubercular-transplanum extension to the standard endoscopic endonasal exposure for radical resection. Results: The tumor removal was gross total in 8 (61.5%) patients, subtotal in 4 (30.7%), and partial in 1 (7.7%) patient. Clinical improvement was observed in almost all patients, immediate relief in headaches in 88% and normalization of vision in 90% of patients with pre-operative visual disturbances. Three patients with secreting adenomas, two with growth hormone-secreting adenomas and one with prolactin-secreting adenoma, had normalization of hormonal status. Three patients developed temporary diabetes insipidus two patients suffered transient ischemic attacks and one patient with a recurrent giant pituitary adenoma experienced a serious injury to the perforating artery. Four patients (30.7%) developed post-operative cerebrospinal rhinorrhea and two patients required surgical repair. Conclusions: Our early experience suggests that the EEEA offers a potentially viable treatment option in certain pituitary tumors which are difficult to remove by the standard endoscopic approaches. However, longer follow-up and larger series are needed to establish the efficacy of this approach.
Khubchandani S.R.,Jaslok Hospital and Research Center |
Bichle L.S.,Saifee Hospital
Ultrastructural Pathology | Year: 2013
A 30 year old lady patient of SLE on steroid and hydroxychloroquine therapy presented with lupus nephritis and later developed cardiac symptoms. Her renal biopsy revealed features of Class III lupus nephritis. Also seen was typical lamellated myelinoid material in the glomerulus. The alpha-galactosidase A activity was normal. The clinical morphological and biochemical findings were consistent with Lupus nephritis showing changes of hydroxychloroquine induced phopholipidosis. Electron microscopy along with careful clinical examination and follow up status was instrumental in the diagnosis of the latter. © Informa Healthcare USA, Inc.
Jain S.,Saifee Hospital |
Khety Z.,Saifee Hospital
Journal of Association of Physicians of India | Year: 2012
Objective: To study the changing patterns of antimicrobial resistance in gram negative bacilli esp. E. coli, Klebsiella Pneumoniae, Pseudomonas and Staphylococcus aureus isolates from a 37 bedded ICU of a private hospital. Methods: All isolates obtained from a wide range of clinical samples (e.g.: urine, pus, blood, sputum, BAL, tracheal secretions) from ICU patients were evaluated for sensitivity patterns by Kirby-Bauer disc diffusion method. Results: In the 2 year study period the rise in the number of gram negative isolates was proportionally high along with increase in their resistance pattern. Dramatic rise in ESBL's has led to multidrug resistant E.coli and Klebsiella pneumoniae. Also organisms like Acinetobacter spp. and Pseudomonas aeruginosa are multiresistant making optimal therapy selection difficult. The incidence of ESBL's has increased from 30-75% of the total isolates. The sensitivity of Pseudomonas aeruginosa to meropenem has decreased from 90% to 60%.The antibiotic that remained most active against all gram negative organisms for 2 years was Imepenem, Piperacillin-Tazobactum and Amikacin. The positive result from this study was decrease in the number of S.aureus isolates from 25% in 2008 to 12% in 2009. The reason for this achievement was implementation of good and strict infection control practices. Conclusion: 1) Antibiotic resistance continues to rise among hospital acquired gram negative pathogens and complicates empirical selection of antibiotics in the ICU. 2) Klebsiella pneumoniae and Pseudomonas are still the dominant organisms in the ICU. 3) Imepenem, Piperacillin-Tazobactum and Amikacin are still highly active against Enterobacteriacea. 4) Local data and strict infection control practices can only control the spread of virulent and resistant organisms. © JAPI.
Arsiwala S.,Saifee Hospital
Indian Journal of Dermatology, Venereology and Leprology | Year: 2013
Moderate to severe psoriasis often needs to be addressed with standard disease modifying therapies such as methotrexate, cyclosporine, acitretin or ultraviolet radiation, which have their potential benefits and limitations. The tumor necrosis factor-alpha (TNF-α) is elevated in psoriatic plaques compared to non lesional skin as well as in the plasma of patients with moderate to severe psoriasis. Infliximab, a TNF-α blocker, has been recommended for the treatment of moderate to severe plaque psoriasis in adults who have failed to respond to these therapies or who cannot tolerate them. Its specific action on the bound and membrane forms of the pro-inflammatory cytokine TNF-α has made it the molecule of choice for obtaining quicker and longer remission in recalcitrant cases. However, the widespread use of infliximab in the Indian subcontinent is limited by its cost. This article reviews the international guidelines for use of infliximab, its dosage patterns, and efficacy in chronic plaque psoriasis, nail psoriasis, erythrodermic psoriasis, and pustular psoriasis as well as Indian experience.
Kulkarni A.G.,Saifee Hospital
Journal of orthopaedic surgery (Hong Kong) | Year: 2013
Brown-Sequard syndrome secondary to compression of the spinal cord by an epidural haematoma following minor trauma is rare. A 65-year-old woman presented with neck pain and sudden onset hemiplegia with contralateral anaesthesia. Magnetic resonance imaging showed a haematoma in the epidural space in the C3 to C5 levels. She underwent open-door laminoplasty for evacuation of the haematoma. At the 2-year follow-up, she had regained normal sensations and a neurological grade of 5/5.
Lakdawala M.A.,Saifee Hospital |
Bhasker A.,Saifee Hospital |
Mulchandani D.,Saifee Hospital |
Goel S.,Saifee Hospital |
Jain S.,Saifee Hospital
Obesity Surgery | Year: 2010
Background: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a procedure for the treatment of morbid obesity. Its indications and long-term results are currently under evaluation. Initially started as a first-stage procedure for superobese patients, it is now emerging as a standalone procedure in Asia and other parts of the world. Early results suggest that, at the end of 1 year, weight loss and resolution of comorbidities with LSG is comparable to laparoscopic Roux-en-Y gastric bypass (LRYGB). Whether LSG alone can replace LRYGB as a standard bariatric procedure is questionable. The aim of this study is to compare the results, resolution of comorbidities, and complications between LSG and LRYGB. Methods: A retrospective comparative analysis was done of 50 patients in each arm who underwent LSG and LRYGB from October 2007 to March 2008. Both groups were matched for age, sex, and body mass index. The resolution of comorbidities, percentage of excess weight loss (EWL), and complications were studied at 6 months and 1 year in our study. Results: It was seen that resolution of most comorbidities such as type 2 diabetes, hypertension, dyslipidemia, sleep apnea, joint pains, and percentage of EWL in both groups was comparable at the end of 6 months and 1 year. Though early resolution of type 2 diabetes was seen to be better in the LRYGB group, the results matched up at 1 year. There was increased incidence of gastroesophageal reflux disease in LSG patients. On comparison, it was also observed that the Asian studies have shown better results with LSG when compared to studies done in a largely Caucasian population. Conclusions: Long-term studies are needed to evaluate the efficacy of LSG alone as a procedure for the treatment of morbid obesity and its comorbidities. © 2009 Springer Science + Business Media, LLC.