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Thursday, July 19, 2018

Handy Technique

Four-year-old Pratik Sardar suffered complete amputation of his left hand,from wrist down,after it got stuck in a motorcycle

Written by Anuradha Mascarenhas | Published: July 3, 2013 3:55:24 am

Handy Techniques

Four-year-old Pratik Sardar suffered complete amputation of his left hand,from wrist down,after it got stuck in a motorcycle last December. He was immediately taken for surgery to the Hand and Microvascular department of Poona Hospital and Research Centre. It was vital to re-establish circulation within six to eight hours in order to save the hand that had blocked veins. Following an eight-hour surgery by Dr Shrirang Pandit,Dr Rajendra Gandhi and Dr Abhishek Ghosh,the hand was re-attached. Sardar was then taken for re-exploration by Dr Ghosh who anastomosed the damaged blood vessels under a microscope,keeping the young boy’s dream of becoming a cricketer alive.

Examining Joints

Bharati hospital is conducting an arthritis awareness campaign. “Arthritis is a degenerative condition when one or more joints become painful and inflammed,” says Dr Sanjay Lalwani,medical director at the hospital. Osteoarthritis commonly becomes symptomatic in the older age-group. Unlike their Western counterparts,most Indian children spend their childhood playing on the streets,which results in higher stress sustained by the joints as compared to playing on a grass field. Increased stress can lead to chondral (cartilage) injuries. A patient suffering from these injuries would present with pain,occasional locking and restriction of movement,among other symptoms,Lalwani explains.

Treating Trauma

trauma care specialists from the US conducted a two-day training programme for 70 state doctors at JJ Hospital. The first phase of the Rs 1,000-crore Emergency Medical Services (EMS) is likely to become operational in July-August in Mumbai. Maharashtra’s EMS has plans to have a fleet of over 900 free ambulances. The four-member American team included Dr Navin Shah,Dr T Scalea,Dr Amy Hildreth and Dr Manjari Joshi. The doctors who teach at the University of Maryland,Baltimore,and Wake Forest School of Medicine,North Carolina,will offer two fully paid one-week scholarships for local doctors to visit their centres. Dr Shah,who is heading the US team said,“Annually,Mumbai records 8,600 accident deaths,including 4,000 in railway accidents,12,600 deaths due to heart attacks,6,200 infant deaths and over three lakh serious emergency patients.” He said that the state EMS could pick up points from the 50-year-old US trauma care programme.

No Sound Sleep

According to a new research,there are approximately 120 million adults with Obstructive Sleep Apnea (OSA) in India,including children,who are also at high risk. A majority of OSA sufferers remain undiagnosed and untreated. “OSA is the most common category of sleep-disordered breathing. The muscle tone of the body ordinarily relaxes during sleep,and at the level of the throat,the human airway is composed of collapsible walls of soft tissue which can obstruct breathing during sleep,” says Dr Shripal Shrishrimal,an American board certified sleep specialist and the director of Keystone Center for Sleep Disorders. He adds,“Mild occasional sleep apnea,which many people experience during an upper respiratory infection,may not be important,but chronic severe obstructive sleep apnea requires treatment in order to prevent low blood oxygen (hypoxemia),sleep deprivation and other complications.”

Saving Lives

After remaining in coma for 45 days,three-month-old Irfaz was weaned off the ventilator at Jehangir hospital. Irfaz was referred to the hospital in a state of shock with slow pulse and breathing. He was put on fluid resuscitation and medicine to increase his blood pressure along with ventilatory support,factors which set his case apart,say doctors. Detailed investigations gave indications about fluid from his spine (CSF). “This condition of Encepalopathy occurs due to infection,” says Dr Sagar Lad,paediatric intensivist at Jehangir Hospital,who has been trained in Australia in managing such complex cases. The EEG showed electrical activity in the brain,which was a ray of hope. As there was need for prolonged ventilation,a small hole was made in patient’s windpipe (tracheostomy) for ventilation. “Tracheostomy at the age of three months is challenging because of a small windpipe and a short neck,” explains Dr Dasmit Singh,paediatric surgeon at Jehangir Hospital. The child had two episodes of cardiac arrest and increased pressure in brain. “Such crisis periods need to be managed critically as these are golden minutes and if not treated spontaneously,can life threatening,” says Dr Lad. But after one and half months of treatment and observation,Irfaz began to move his lower limbs and responded.

Compiled by Anuradha Mascarenhas

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