Ameloblastoma Surgery on a Tanzanian Patient

SIMS Hospital gives a new lease of life to a 38-year old Tanzanian affected by ameloblastoma

Ends his 14 year old misery of pain, functional discomfort and social stigma in 14 days

The Chennai based SIMS (SRM Institutes for Medical Science) Hospital, one of the leading super speciality quaternary care hospitals in Tamil Nadu, puts an end to a thirty-eight year old Tanzanian patient’s pain and misery of 14 years caused by more than 1 kg weighing Ameloblastoma in the lower jaw. Lack of early medical intervention and diagnostic facility in his country, made it difficult for him to even chew and eat his food, which in turn affected his overall quality of life significantly. With defective and continuously increasing lump on the jawbone, the Tanzanian patient was referred to SIMS, Vadapalani, Chennai by his Government for a holistic treatment.

Speaking on the medical condition and the technical procedure followed during the treatment, Dr. K. Sridhar, Head-Craniofacial, Aesthetic and Plastic Surgery, SIMS, said, “Our first assessment revealed a huge ball sized tumour that was causing severe pain, swelling and facial deformity for the Tanzanian patient. With initial screenings through, we diagnosed the lump to be ameloblastoma that required complex surgical correction given its unusual size. During the initial virtual observation, assessment we took into consideration and carefully evaluated the key parameters including the size of tumor, the length of fibular graft needed,And the shape of graft for precise calculations and further procedure. For, these are the parameters that will determine the restoration of his oral function and appearance.

It required a reconstruction of the entire mandible including both the sides of the jaw. This necessitated a 4 piece reconstruction having different angulation and dimension. A complex virtual planning in computer was required to have a final result for a natural appearance.

This required a team approach having reconstructive plastic surgeons, maxillofacial surgeons, specialists in implantology and a computer engineer, apart from highly skilled Aneasthesia team.

“Thus began the whole treatment process of transferring a virtual plan to clinical operation with a holistic approach to help that Tanzanian patient regain his normal life, to eat well, become more socially acceptable sans the stigma. The meticulous preparation with the key advanced 3-Dimensional CT techniques of medical image processing and printing, planning of tumor resection, and fibular resection for graft harvesting, graft shaping, and fixation, as well as planning, designing and fabrication of the templates for clinical realization of the plan, all were being discussed to the last details. Such fabricated virtual model significantly improves the quality and efficiency of the surgery, with less time-consumed at the operation theatre and the patient satisfaction with both the recovery of oral function and appearance’.

CTO ( Chronic Total Occlusion in Coronary arteries) WORKSHOP

“CTO ( Chronic Total Occlusion in Coronary arteries) WORKSHOP” organized at SIMS HOSPITAL, Vadapalani on behalf of Institute of Cardiac sciences by Dr. Srinath Sainathan, Senior Interventional Cardiologist today.

Senior Japanese CTO operator was invited to perform some CTO cases, which were done successfully.

This was followed by CME talk and discussion on interesting CTO cases by the senior faculty.

Astigmatism

Astigmatism is a common vision problem caused by a corneal-shaped error. With astigmatism, the eye lens or cornea, which is the front surface of the eye, has an irregular curve. This may change the way light passes, or refracts, to your retina. This causes blurred, blurred, or distorted vision. Farsightedness and short-sightedness are two common forms of problems with the way light passes through your retina. This is termed hyperopia. Near-sightedness is called myopia.

Who is at risk for astigmatism?

Astigmatism can occur in children and adults. Your risk of developing astigmatism may be higher if you have one of the following:

  • A family history of astigmatism or other eye disorders, such as keratoconus.
  • Thinning of your cornea
  • Excessive nearsightedness.
  • Excessive farsightedness.
  • A History of certain types of eye surgery, such as cataract surgery.

What are the symptoms of astigmatism?

The symptoms of astigmatism can vary from person to person. Many may have no symptoms at all. Symptoms of astigmatism include the following:

  • Blurry, Distorted, or fuzzy vision at all distances.
  • Difficulty seeing at night
  • Eyestrain
  • Squinting
  • Eye irritation
  • Headaches

See your doctor if you have signs of astigmatism. Many signs may also be due to other issues with your health or vision.

Astigmatism Treatment

Glasses or contacts may correct almost all cases of astigmatism. But if you have a mild astigmatism and no other vision problems, you may not need them.

There are two treatments for the common levels of astigmatism:

  • Corrective lenses.That means a glass or a touch. If you have astigmatism, your doctor will probably recommend a special type of soft contact lens called toric lenses. If your case is more serious, you may have gas-permeable rigid contact lenses for a procedure called orthokeratology. You’re wearing your glasses when you sleep, and they’re reshaping your cornea.
  • Refractive surgery. Laser surgery also changes the shape of your cornea. Types of refractive surgery include LASIK and PRK.

Irregular astigmatism is far less common and is associated with problems with your cornea, the front part of the eye.

Aortic Dissection at SIMS Hospital

SIMS Hospital arranged media conference with Dr V.V. Bashi, held on Dec 19th 2019. First in India, An Elderly Person Undergoes Complex Surgery for Acute Type-A & Type-B Aortic Dissection at SIMS Hospital, Chennai”

For the first time in India, an elderly gentleman underwent successful surgery to correct multiple Aorta anomalies (Acute Type-A Dissection, Leakage in Aortic Valve and A Tear in the Distal End of Aorta) in a single-stage operation at the Aortic Aneurysm Centre, SIMS Hospital, Chennai.

For the first time in India, an elderly gentleman underwent successful surgery to correct multiple Aorta anomalies (Acute Type-A Dissection, Leakage in Aortic Valve and A Tear in the Distal End of Aorta) in a single-stage operation at the Aortic Aneurysm Centre, SIMS Hospital, Chennai.

Type-A dissection in the ascending aorta itself is a lethal condition that poses a challenge to cardiac surgeons. When this happens suddenly, the majority of patients do not survive unless surgery is performed in the first 48 hours. In addition, the treatment of the leaking aortic valve and the tear in the lower part of the descending aorta was a major challenge in this case. At present, in most centres, only the ascending aorta is corrected in such situations, leaving the other issues to be addressed after 1 or 2 years. Yet, at SIMS, the surgeons repaired all 3 different parts of the aorta in a single operation that lasted about 6 hours.

Case Details:
A 65-year-old gentleman (name withheld) from Coimbatore was admitted to SIMS Hospital with serious chest pain in the back and abdomen. The discomfort was very severe one day before the patient came to SIMS for consultation. He was diagnosed with Acute Type A Aortic Dissection along with a leaking aortic valve and a tear at the lower end of the descending aorta. It was a life-threatening situation for the patient who needed emergency surgery. The patient then rushed in for surgery within half an hour, which is mandatory in such a situation.

Talking on the complexities of aortic disorders, Dr. V. V. Bashi – Director of the Institute of Cardiac & Aortic Disorders (ICAD) at SIMS said, “It is quite difficult to detect aortic conditions on a preventive basis, and it would be difficult to detect 3 conditions in one case unless an appropriate diagnostic approach is taken. Another obstacle for us was to carry out all the surgical corrections in one session, even on an emergency basis.

The patient underwent a successful total remedial replacement of the entire diseased aorta with the repair of the aortic valve as a single-stage operation and had an inadvertent recovery. He’s doing well and expecting a normal life.

Such complex cases are conducted only in a few elite medical institutions in the world because they require superior surgical expertise, the latest technology and the availability of advanced hybrid graft (Thoraflex Graft).

Explaining the complexity of surgery, Dr. Bashi said, “Multi-stage operations over the years leave the patient and family in a state of fear and anxiety due to the risk of temporary mortality.

SIMS Hospital recently launched the First Exclusive Center for Aortic Diseases in India to offer a focused approach to the diagnosis and management of Aortic Disorders. The Center aims to raise awareness of various aspects of the disorders, such as risk factors, innovative treatment methods, etc.

Expressing his joy at this excellent surgical feat, Shri. Ravi Pachamoothoo – Chairman of the SRM Group, said, “It has always been our intention to be at the forefront of healthcare innovation and excellence in India. And our heritage of being in the field of education gives us that edge to bring new ideas and technologies, to cultivate and mentor future clinical talents in order to achieve that aim. We are fortunate enough to have outstanding doctors like Dr. Bashi, who has his own legacy in the field of cardiothoracic surgery, particularly in the treatment of aortic disorders, to guide our young doctors into a bright future.

Approximately 3-4 lakh people in India suffer from various types of Aortic Disorders every year, of which only about 1,000 people are treated. If the illness can be diagnosed early, the majority of patients can be successfully treated with a success rate of more than 95%. Very few centers in our country conduct aortic surgery in large numbers. Dr. Bashi and his team performed more than 1,500 aortic procedures, one of the biggest in any country to reach international standards.

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