Rishikesh (The Hawk): The method of adopting the IONM procedure to make spine surgery convenient was explained during the live surgery workshop organized by the Orthopedic department of AIIMS Rishikesh. It was informed in the seminar that the IONM procedure reduces the risk of spinal cord injuries while performing the surgery and makes the treatment easier.Under the guidance of Professor Arvind Rajwanshi, Director of AIIMS, expert doctors explained the benefits of the spine and neurosurgeries performed through intra-operative neurophysiological monitoring procedure in a workshop. During this Professor Pankaj Kandwal, HOD Ortho Department explained the concepts of IONM. He said that the surgery related to diseases of the spine is quite complicated. In such a situation, the risk of surgery is high. Pro. Kandwal said that the IONM procedure is such a surgical procedure, which reduces the risk while performing spine and neurosurgery. For the inspiration of the seminar, Dr. Kandwal Thanks Dean Academics pro. Manoj Gupta. Pro. Jaya Chaturvedi, HOD Gynecology Department and Chief Guest of the workshop while inaugurating the workshop said that by adopting this process in the treatment of patients, not only the patients but also the team of doctors performing the surgery would be benefited. A live telecast of surgery of a patient undergoing OT through this IONM procedure was also done during the seminar. Dr. Sudhakar and Dr. Ajit of the Department of Orthopedics informed that the teams of Physiologist, Anesthetist, and Neurosurgeon experts work jointly while adopting the IONM procedure. In the seminar, Dr. AK Singh, Director Max Institute of Neuro Sciences, Prof. Ashok Jariyal, Department of Physiology AIIMS Delhi, Dr. Prashant Patil, and Dr. Sudhakar Department of Ortho AIIMS Rishikesh presented lectures on IONM. Dr. Jitendra Chaturvedi of AIIMS Rishikesh gave information related to the use of IONM during the treatment of intradural tumors. Dr. Bhaskar Sarkar shared thoughts related to the experience of IONM surgery. The seminar was also addressed by Dr. Sanjay Agrawal of the Department of Anesthesia and Dr. Purvi Kulshrestha of the Department of Physiology. During this, neurosurgeons of the institute Dr. Rajnish Arora, Dr. Surbhi, Dr. Swati, Dr. Nikhil, Dr. Rhythm, etc. were present.

The method of adopting the IONM procedure to make spine surgery convenient was explained during the live surgery workshop organized by the Orthopedic department of AIIMS Rishikesh. It was informed in the seminar that the IONM procedure reduces the risk of spinal cord injuries while performing the surgery and makes the treatment easier.

Live surgery workshop organized by the Orthopedic dept of AIIMS Rishikesh

The method of adopting the IONM procedure to make spine surgery convenient was explained during the live surgery workshop organized by the Orthopedic department of AIIMS Rishikesh. It was informed in the seminar that the IONM procedure reduces the risk of spinal cord injuries while performing the surgery and makes the treatment easier.



New Delhi (The Hawk): Union Minister for Health and Family Welfare Dr. Mansukh Mandaviya who is on a two-day visit to Tamilnadu and Puducherry, visited the Tamilnadu Government Multi Super Speciality Hospital in Chennai today morning. He witnessed the Robotic Surgery Facility and Early Pregnancy Screening Centre located at the Super Speciality Hospital.Dr. Mansukh Mandaviya also virtually laid the foundation stone of CGHS Wellness Centre and Lab at Avadi. Further, he interacted with trauma care patients and those with severe sports injuries who are being treated with advanced tech-based surgeries&nbsp;and biopharma therapies at the Multi Super Speciality Hospital. Shri M.&nbsp;Subramanian,&nbsp;Minister&nbsp;of Health and Family Welfare, Government of Tamilnadu, Shri P. Senthilkumar, Principal Secretary, Health and Family Welfare, Government of Tamilnadu and higher officials participated in the event.Addressing the gathering, Union Minister Dr. Mansukh Mandaviya said the Tamilnadu Government Multi Super Specialty Hospital is the only centre with 2 surgeon consoles and congratulated the state for achieving the goal set for MMR and IMR well ahead of the rest of the states.Covering 1.58 crore families in Tamilnadu, under the Ayushman Bharat Yojana , 75 lakh people have availed the benefits, he added. Stating that the COVID vaccination status in the Southern state&nbsp;has reached 11 crore 26 lakh doses with 94 % being first doses and 82% comprising of second doses, the Minister mentioned it as a commendable feat. Speaking about the Nikshay Mitr Abhiyan a TB Patient/Village Adoption’ scheme, he said around 50,000 patients suffer from TB in Tamil Nadu. However he appealed to the people to extend their support to this scheme as only 5% of them have given consent, while 35% have not accepted it as yet. “Only with your support, like in COVID, can we overcome together this hurdle to the nation’s progress”, he reiterated. Dr. Mansukh Mandaviya expressed happiness that 17 districts of the state have recorded zero cases of Malaria and lymphatic filarisis has been fully eradicated in Tamilnadu. Even though this is an encouraging progress, the health Minister directed the health officials to stay alert and continue taking necessary actions towards eradication of Malaria, Chikungunia and Dengue. “The dynamic leadership of Prime Minister Shri Narendra Modi is not just visionary but filled with empathy. We are committed to make the nation Malaria Free by 2030.”Informing that the Central Government will soon launch the ‘ One Nation, One Dialysis’&nbsp;programme, under the Pradhan Mantri National Dialysis Programme, Dr. Mandaviya said through this scheme,&nbsp;&nbsp;any patient&nbsp;can get the dialysis facility from anywhere in the country. He also said under the Ayushman Bharat -Health and Wellness Centress programme, so far 7052 Ayushman Bharat -Health and Wellness Centres (as on June 2022) are functional in the state against the target for 9135 Health and Wellness Centress&nbsp;till December, 2022. Till now, 542.07 lakh (upto March 2022) screening tests have been done in these centres for Hypertension, Diabetes, Common cancers etc, he added.

Union Minister for Health and Family Welfare Dr. Mansukh Mandaviya who is on a two-day visit to Tamilnadu and Puducherry, visited the Tamilnadu Government Multi Super Speciality Hospital in Chennai today morning. He witnessed the Robotic Surgery Facility and Early Pregnancy Screening Centre located at the Super Speciality Hospital.

Rs 404 Crore For Medical Infrastructure Advancement To Tamil Nadu

Prayagraj: Love, they say, can move mountains and this 20-year-old girl did so -- albeit, in a different way.She was in a same sex relationship with her friend, but the stumbling block were her parents who refused to accept the relationship. Finally, the girl decided to go for a gender affirmation surgery for turning into a man so that she could continue her relationship with the girl. She consulted and convinced the doctors at the Moti Lal Nehru Medical College and the medical procedure for changing the gender of this girl began about four months ago. A team of doctors, led by plastic surgeon Dr Mohit Jain and gynaecologist Dr Amrit Chaurasia took up the challenge of changing the gender of the girl. Dr Jain said the girl approached him a few months ago and said that she felt 'trapped' in the female body and wanted to change her gender. "She told us that her parents were against the decision, but she is an adult and can make her own decisions. We took her consent and started the procedure," said Dr Jain. First, a team of psychiatrists started the girl's counselling to determine her problem and found her to be mentally stable and healthy on all parameters, but suffering from 'gender identity disorder' because of which she could not feel comfortable being a female and wanted to become a man."Around four months back, her breasts were removed surgically, and Dr Chaurasia operated upon her a fortnight back and removed her uterus. Now, she is being administered the testosterone hormonal therapy which would help in growth of male features like beard, moustache, etc.," he added.Around eight months down the line, the plastic surgeon and the urologist would again operate on the girl and graft the male genital organs in another step towards 'her' complete transformation into 'him'. After this, the girl would turn into a man and would be able to marry the girl she loves. The families, hopefully, would not have any objection by then.&nbsp;—IANS

Love, they say, can move mountains and this 20-year-old girl did so -- albeit, in a different way.

To Marry Her Love, 'She' Is Turning Into 'He'

Washington: A group of researchers has discovered during a recent study that surgery can be avoided in children with a rare tumor case of the skull.The research was done by researchers from Cornell Medicine, New York-Presbyterian, Nicklaus Children's Hospital, the University of Texas Southwestern, the University of British Columbia and McGovern Medical School. The findings of the study were published in the New England Journal of Medicine.Langerhans-cell histiocytosis (LCH) is a group of disorders in which immune cells called Langerhans cells overproliferate and cause tissue damage or lesions. When this affects the skull in an isolated way, also known as solitary eosinophilic granuloma, children present with a painful skull mass. These tumors or masses do not represent cancer but usually are managed by neurosurgeons.Historically, these masses have been treated with surgical excision and reconstruction of that part of the skull. Because some retrospective case studies have shown that these lesions may resolve without surgery, a multicenter prospective study was launched. The results showed a spontaneous resolution of the lesions in 88 percent of the observed patients and were published on June 30 in a letter to the editor of the New England Journal of Medicine.The investigators enrolled 28 children with LCH at eight medical centers in the study between September 2012 and January 2020. As a precaution, the team agreed that surgery would be offered to patients in this group if their lesions grew rapidly or for more than two months, didn't shrink within three months, or caused pain.Seventeen of the patients and their parents chose to participate in the observation-only group of the study, while 11 opted for surgical or other interventions. Within two months, all 17 in the observation-only group had their lesions shrink or disappear. By one year, the lesions in 15 out of 17 patients were completely gone, the authors reported.Ten of the 11 patients who opted for treatment underwent surgery to remove their lesion, two received chemotherapy to help shrink the lesion, one received a glucocorticoid injection in the lesion, and six underwent a second surgery to repair the skull defect from the mass or surgery.The parents of one child who started in the observation group changed their mind and opted for surgery after their child's lesion had shrunk but not completely disappeared after about two months, the authors wrote.This first-ever prospective study supports a nonsurgical approach for isolated LCH skull lesions. This approach has the advantage of avoiding surgery and any associated risks with removal.&nbsp;—ANI

A group of researchers has discovered during a recent study that surgery can be avoided in children with a rare tumor case of the skull.

Surgery Can Be Avoided For Children With Rare Skull Tumor: Study

Washington: According to a study, children and teenagers with scoliosis who undergo spinal fusion can still be given an acceptable amount of pain medication while using fewer opioids.The findings of the Michigan Medicine study were published in the Journal of Pediatric Orthopaedics.For the study, researchers enrolled 72 adolescent patients having spinal fusions at the University of Michigan Health and prescribed them 30 doses of oxycodone, as well as standard nonopioid medications, after the procedure. Forty-nine patients, along with their caregivers, received preoperative education on the risks of opioids and the importance of nonopioid pain management options, while the other 35 patients did not receive any preoperative education.The study reveal that, despite being discharged with the same amount of opioid and nonopioid medications, 23% of patients in the group who did not receive preoperative education called for an opioid prescription refill compared to 6% of patients who had received preoperative education. When compared to a group of 77 adolescents who previously underwent spinal fusion where there were no standard discharge prescription guidelines, patients in the current study consumed less oxycodone and had fewer days of oxycodone use."Spinal fusion is arguably one of the most painful procedures we perform in pediatric orthopaedics, but our findings show we can provide excellent pain control by employing multimodal pain management techniques and preoperative education," said G. Ying Li, M.D., senior author of the study and orthopaedic surgeon at U-M Health C.S. Mott Children's Hospital. The previous group of patients consumed a mean of 29 doses of oxycodone when receiving a larger prescription quantity. Based on this data, patients in the current study were prescribed 30 doses of oxycodone, yet they only consumed 16 doses while reporting very low pain scores."Our results show that when we prescribe patients less narcotics, they will take fewer narcotics, so prescription quantity is incredibly important after a procedure like this," Li said. "We want to avoid situations where someone is overprescribed opioids and takes too many or leftover opioids are diverted to others. In the current state of the opioid crisis, preoperative education and use of a multimodal approach to managing pain is key to reducing harm and preventing substance use disorders and overdose."&nbsp;—ANI

According to a study, children and teenagers with scoliosis who undergo spinal fusion can still be given an acceptable amount of pain medication while using fewer opioids.

Children, Teenagers Getting Spinal Surgery Don't Need So Many Opioids: Study

San Francisco: Robotic surgeons from the US, India and Spain were named the top three winners in the KS International Robotic Surgery Innovation competition, as robotic surgery slowly becomes mainstream.Advertisements
&nbsp;The winners were selected by an international jury form Oxford and Stanford Universities, and New-Delhi based AIIMS, from the fields of urology, gynaecology, general surgery, hepato-biliary-pancreatic surgery, colorectal, head and neck, paediatric and joint replacement surgeries.
The winning entry of Dr Jihad Kaouk, department of urology, Cleveland Clinic in Ohio was titled ?Single Port Robot-Assisted Kidney Transplantation Extraperitoneal Approach' in the unique competition organised by Michigan-based robotic surgery evangelist Vattikuti Foundation. Dr Kaouk and his team modified the technique of robotic kidney transplant developed at the Vattikuti Urology Institute and Medanta Medicity. Kaouk used a da Vinci single port robot for truly minimally invasive surgery. "The early results of patients who had undergone robotic kidney transplant through this technique could go home in only 2 days," the foundation said in a statement. For 'Robotic Infraclavicular Approach for Minimally Invasive Neck Dissection,' the second award went to Dr Sandeep Nayak, Director, Surgical Oncology, Fortis Cancer Institute, Bengaluru. Dr Nayak innovated a robotic technique to perform very major cancer surgery of the head neck to clear the lymph nodes in the neck with quick patient recovery and minimal discomfort. The third award went to a team of Dr Alberto Piana, Dr Paolo Verri, and Dr Alberto Breda of Oncology Urology and Kidney Transplant Surgery, Fundacio Puigvert, Barcelona, Spain for their entry of '3D Augmented Reality Guided Robotic Assisted Kidney Transplantation'. The KS National Robotic Surgery Video' competition is being organised in India since 2015 by Vattikuti Foundation. This year, it went international for the first time. "As surgeons continue to innovate newer procedures in robotic surgery, the Vattikuti Foundation will continue to invest and make it accessible to other surgeons," said Raj Vattikuti, president of Vattikuti Foundation. —IANS

Robotic surgeons from the US, India and Spain were named the top three winners in the KS International Robotic Surgery Innovation competition, as robotic surgery slowly becomes mainstream.Advertisements.

Indian, US Surgeons Win Global Robotic Surgery Innovation Award

Lucknow: A nine-day-old girl underwent a major heart surgery for a complicated congenital heart disease at the Medanta Hospital.
The infant was a patient of cyanotic congenital heart disease (CCHD) which involves heart defects that reduce the amount of oxygen supplied to the rest of the body.
Director, cardiothoracic and vascular surgery department, Dr Gaurang Majumdar, said, 'The baby was brought to us with a complaint of bluish discoloration of the body on the fifth day of birth. Examination revealed the child had complicated CCHD which means her two large blood vessels did not connect to the heart normally.'
He said that immediate surgery was planned as patent ductus arteriosus (PDA), a small artery providing blood flow to the lungs, was closing, and the baby's oxygen saturation was falling below 50 per cent.
The newborn, who weighed about 2 kg at birth, was admitted and underwent shunt surgery -- a life-saving procedure -- after which she was transferred to neonatal intensive care unit on a mechanical ventilator and discharged within 10 days of admission.
Consultant and head, neonatology, Dr Roli Srivastava said, 'There are some heart problems in newborns in which arteries supplying oxygen to lungs are not formed so the baby becomes oxygen-deficient. In such babies, we have to create a shunt between cardiac system and pulmonary circulation to keep lung flow going on.
—IANS

A nine-day-old girl underwent a major heart surgery for a complicated congenital heart disease at the Medanta Hospital.

 Nine-day old baby undergoes heart surgery in UP hospital

Washington: Lowering the amount of noise in the operating room (OR) may have a good effect on a child's behaviour, including fewer temper tantrums and increased willingness to eat, in the days following surgery and anaesthesia, according to researchers.
The research was presented at the ANESTHESIOLOGY 2022 annual meeting.
Excessive noise in the OR is a prominent complaint among patients and providers, especially during induction of and emergence from general anesthesia. High noise levels can distress patients, increase their anxiety, and negatively affect patient safety and comfort. "The period before, during and after surgery is a particularly unpredictable time for parents," said Nguyen Tram, Ph.D., study lead author and a research scientist at Nationwide Children's Hospital, Columbus, Ohio. "By implementing some small measures in the OR, we found we were able to markedly improve some of this uncertainty for parents in the key behavioural areas of mood, eating and engagement."
In the study, 64 preschool children (ages 4 to 5 years old) undergoing general anesthesia for tonsillectomy/adenoidectomy or dental procedures lasting at least 30 minutes, were randomized into either a "reduced noise" group, which had low ambient lighting, muted communication devices and reduced OR personnel, or a control group (33 in reduced noise group vs. 31 in control group). All patients were given a standard oral sedative prior to the induction of anesthesia.
Behavior was assessed using the Induction Compliance Checklist, which measures adverse behavior at induction of anesthesia; Modified Yale Preoperative Anxiety Scale, which assesses children's anxiety during the preoperative period; and Post Hospitalization Behavior Questionnaire, which assesses children's post-hospitalization and postoperative new-onset behavioural changes. The Post Hospitalization Behavior Questionnaire was completed by parents at postoperative days one and five.
The results from the Post Hospital Behavior Questionnaire found that children in the reduced noise group had fewer tantrums, were less fussy about eating, and were more interested in what goes on around them in the first five days following surgery. There were no statistically significant differences found between the two groups in the other assessments. The researchers hypothesize that a quiet environment may positively impact children's behavior after having general anesthesia, similarly to how most people need a quiet environment for a good night's sleep. "For the first time, we've been able to show how reduced noise in the OR can improve postoperative behaviour in children in the first several days after having general anesthesia," said Dr. Tram. "Excessive noise not only directly affects patients, but can potentially impact patient safety by impairing provider communication and recognition of audible and visual alarms during the critical induction period. Future research is needed to further determine the best way to optimize the OR and perioperative environment to improve patient outcomes after surgery and anesthesia." —ANI

Lowering the amount of noise in the operating room (OR) may have a good effect on a child's behaviour, including fewer temper tantrums and increased willingness to eat, in the days following surgery and anaesthesia, according to researchers.

Reducing Noise In Operating Room Improves Children's Behaviour After Surgery

Pennsylvania (United States): A study suggested that the most efficient irrigation solution for use during the surgical treatment of bone tumours appears to be the widely used disinfectant chlorhexidine gluconate (CHG).
The findings of the study were published in the journal of Bone &amp; Joint Surgery.
Of the various solutions used to eliminate remaining tumor cells after surgery, a 0.05% CHG solution appears to be most effective in killing cultured bone tumor cells, according to the laboratory study by Matthew J. Thompson, MD, of the University of Washington, Seattle, and colleagues.
CHG shows highest cytotoxicity against chondrosarcoma and giant cell tumors
Some patients with bone tumors undergo a surgical procedure called intralesional curettage. In this procedure, the tumor is scraped away while preserving as much healthy bone as possible. A common adjuvant treatment is to irrigate the operative area of the bone with some kind of chemical solution. This irrigation is performed to reduce the number of remaining cells that could potentially lead to tumor recurrence and reseeding.
Several different solutions have been used for the irrigation of the tumor bed, including saline, ethanol, and various disinfectants. Dr. Thompson and colleagues performed a series of experiments to determine which of these solutions has the greatest cytotoxic (cell-killing) effects against bone tumor cells. The experiments used cultures of two types of bone tumors: giant cell tumor, a benign but aggressive tumor; and chondrosarcoma, a type of bone cancer. Tumor cell cultures were treated with one of six different solutions - sterile water, 0.9 per cent saline, 70 per cent ethanol, 3 per cent hydrogen peroxide, 0.05 per cent CHG, and 0.3 per cent povidone-iodine. Cytotoxicity was compared for the different treatments.
Of the six treatments, only CHG had cell-killing effectiveness equivalent to a control solution with 100 per cent cytotoxicity, and this outcome was observed regardless of the treatment period (i.e., 2 minutes or 5 minutes). None of the other solutions approached the cell-killing effectiveness of CHG. Only two solutions (sterile water and hydrogen peroxide) were superior to a control treatment with low cytotoxicity. The other three solutions tested - saline, ethanol, and povidone-iodine - showed little or no cytotoxicity.
Chlorhexidine is a familiar disinfectant with various medical uses, including as a topical antiseptic agent before surgery. The researchers write, "[CHG] is commonly used and readily available, with demonstrated in vivo safety in other surgical applications and a lower predicted toxicity compared with some currently used agents."
The new study shows that CHG is highly effective in killing bone tumor cells - at least under laboratory conditions. "Therefore, the use of a 0.05 per cent CHG solution clinically could serve as a potential chemical adjuvant during intralesional curettage of chondrosarcoma and [giant cell tumors]," Dr. Thompson and coauthors conclude.
The researchers emphasize that further studies will be needed to evaluate the outcomes of CHG irrigation in patients undergoing surgery. Dr. Thompson comments: "We believe it is important to continue to explore better ways to achieve durable local control of benign aggressive tumors like giant cell tumor of bone, which are associated with a high risk of local recurrence when treated with conventional extended intralesional curettage." —ANI

A study suggested that the most efficient irrigation solution for use during the surgical treatment of bone tumours appears to be the widely used disinfectant chlorhexidine gluconate (CHG).

Study Finds Chlorhexidine Disinfectant Best Solution To Kill Bone Tumor Cells After Surgery

Lucknow / New Delhi: A 34-year-old woman from Uttar Pradesh with a condition called Gender Dyphoria underwent gender reassignment surgery at a private hospital in Delhi and successfully transformed into a man, doctors at the facility said.
The Department of Plastic and Cosmetic Surgery, at Sir Ganga Ram Hospital, received a case of the 34 years old female, Gayatri, (name changed) who wanted to get completely transformed into a man. By all proportions and psychiatric evaluations, it was found that although the patient was female, mentally she was a male, a condition which is called Gender Dysphoria. The woman successfully completed her gender change surgery two months back, the hospital said. Gayatri underwent bilateral breast removal in 2017 and uterus, ovary and vaginal removal in 2019. She was on male hormone replacement therapy since 2016.
According to doctors, when Gayatri arrived at hospital, she had all male characteristics including a beard, hair on the chest, male voice and male behaviours.
"We decided to perform penile reconstruction (Phalloplasty) for complete male transformation by the state-of-the-art micro-surgical technique of tissue transfer. Our aim was to give good shape, length, urethra (to pass urine) and erotic sensation to the patient," said Dr Bheem Singh Nanda, Senior Consultant, Department of Plastic and Cosmetic Surgery, Ganga Ram Hospital.
Of all the techniques we chose the forearm as a donor for penile reconstruction. This was a challenging surgery as the penis was fabricated on the forearm with the preservation of vessels and all the important nerves. The next step was to implant the reconstructed penis from the forearm to the genital area of the patient.
"The second challenge was to join the urethra (urine tube) and then connect the vessels to establish the blood circulation again in the reconstructed penis. The last and the most important step was to join the nerves of the reconstructed penis with the erotic nerves (Pudendal nerve and nerve to clitoris) which is the most important pre-requisite for a penile implant and sexual satisfaction later," Dr Nanda said.
According to a statement by the hospital, the surgery was completed successfully and took about eight hours with minimal blood loss.
Six weeks post-surgery the patient is completely male with 5 inches of the male sexual organ (penis). Now Gayatri is Mahesh and passes urine in a standing position and uses a male urinal, the hospital said. Mahesh is now married to Shalini, "who was the love of his life since his student days." "Phalloplasty has matured considerably over the last decades in reconstructive options and technical refinements, thanks to increasing recognition of gender dysphoria. The primary goals of performing a phalloplasty are to facilitate sexual penetration, protective sensation, orgasm, standing micturition, and natural aesthetic, ideally in a few stages and with minimal morbidity. Radial forearm free flap and anterolateral flap are the most common options, each with a unique profile of complications, aesthetic, and functional outcomes, Dr Nanda said. "Choices for reconstruction must be tailored to the individual patient's goals and available tissue characteristics. In Gayatri's case, we chose the radial forearm flap technique because it gives better shape, urethra quality and good sensation as compared to other techniques," Dr Nanda explained. —ANI A 34-year-old woman from Uttar Pradesh with a condition called Gender Dyphoria underwent gender reassignment surgery at a private hospital in Delhi and successfully transformed into a man, doctors at the facility said.
The Department of Plastic and Cosmetic Surgery, at Sir Ganga Ram Hospital, received a case of the 34 years old female, Gayatri, (name changed) who wanted to get completely transformed into a man. By all proportions and psychiatric evaluations, it was found that although the patient was female, mentally she was a male, a condition which is called Gender Dysphoria. The woman successfully completed her gender change surgery two months back, the hospital said. Gayatri underwent bilateral breast removal in 2017 and uterus, ovary and vaginal removal in 2019. She was on male hormone replacement therapy since 2016.
According to doctors, when Gayatri arrived at hospital, she had all male characteristics including a beard, hair on the chest, male voice and male behaviours.
"We decided to perform penile reconstruction (Phalloplasty) for complete male transformation by the state-of-the-art micro-surgical technique of tissue transfer. Our aim was to give good shape, length, urethra (to pass urine) and erotic sensation to the patient," said Dr Bheem Singh Nanda, Senior Consultant, Department of Plastic and Cosmetic Surgery, Ganga Ram Hospital.
Of all the techniques we chose the forearm as a donor for penile reconstruction. This was a challenging surgery as the penis was fabricated on the forearm with the preservation of vessels and all the important nerves. The next step was to implant the reconstructed penis from the forearm to the genital area of the patient.
"The second challenge was to join the urethra (urine tube) and then connect the vessels to establish the blood circulation again in the reconstructed penis. The last and the most important step was to join the nerves of the reconstructed penis with the erotic nerves (Pudendal nerve and nerve to clitoris) which is the most important pre-requisite for a penile implant and sexual satisfaction later," Dr Nanda said.
According to a statement by the hospital, the surgery was completed successfully and took about eight hours with minimal blood loss.
Six weeks post-surgery the patient is completely male with 5 inches of the male sexual organ (penis). Now Gayatri is Mahesh and passes urine in a standing position and uses a male urinal, the hospital said. Mahesh is now married to Shalini, "who was the love of his life since his student days." "Phalloplasty has matured considerably over the last decades in reconstructive options and technical refinements, thanks to increasing recognition of gender dysphoria. The primary goals of performing a phalloplasty are to facilitate sexual penetration, protective sensation, orgasm, standing micturition, and natural aesthetic, ideally in a few stages and with minimal morbidity. Radial forearm free flap and anterolateral flap are the most common options, each with a unique profile of complications, aesthetic, and functional outcomes, Dr Nanda said. "Choices for reconstruction must be tailored to the individual patient's goals and available tissue characteristics. In Gayatri's case, we chose the radial forearm flap technique because it gives better shape, urethra quality and good sensation as compared to other techniques," Dr Nanda explained. —ANI

A 34-year-old woman from Uttar Pradesh with a condition called Gender Dyphoria underwent gender reassignment surgery at a private hospital in Delhi and successfully transformed into a man, doctors at the facility said.

Woman With Gender Dyphoria Clinically Transforms Into Man After Gender Surgery At Delhi hospital

Kanpur (The Hawk): Six elderly patients who underwent cataract surgery at this facility lost their sight as a result, prompting the Chief Medical Officer (CMO) of the Kanpur Nagar district of Uttar Pradesh to initiate an investigation into the nursing home.
At a recent eye-checkup camp held at the Aradhya elderly home, all six had surgery.
Six of the patients who underwent surgery reported experiencing headaches, eye pain, and vision loss.
They alleged that they were unable to see and that their eyes were in excruciating agony.
CMO Alok Ranjan informed reporters that an investigation into the incident had been ordered following a commotion. He stated that after the investigation is over, any action would be taken.
(Inputs from Agencies)

Six elderly patients who underwent cataract surgery at this facility lost their sight as a result, prompting the Chief Medical Officer (CMO) of the Kanpur Nagar district of Uttar Pradesh to initiate an investigation into the nursing home.

Kanpur cataract surgery loses 6 eyesight, Probe ordered

Lucknow: For the first time in Uttar Pradesh, the Department of Endocrine Surgery of Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) has performed robotic surgery to remove a 10 cm thyroid tumour.
According to the SGPGIMS spokesperson, a 39-year-old married woman, resident of Barabanki had a thyroid lump in her neck, which was continuously increasing post which she consulted doctors at Barabanki.
After examination, the doctors told her that the due to its size and complications, its surgery is not possible without making an incision in the neck. She was uncomfortable and disappointed about the incision marks after the surgery.
She was then referred to Robotic Thyroid Surgeon Dr Gyan Chand of SGPGI Lucknow to get the surgery done without incision in the throat. Dr Gyan, after necessary tests, said that the tumour could be removed through robotic surgery without making an incision in the throat and this will be the first case in itself.
Dr Gyan successfully removed the tumour of thyroid gland in a four-hour operation without making an incision in the throat. After the successful surgery, Dr Gyan Chand said that the whole process of removing such a large thyroid gland by robotic thyroid surgery is very complicated, but it is a scarless surgery and gives relief to the patient. —IANS

 For the first time in Uttar Pradesh, the Department of Endocrine Surgery of Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) has performed robotic surgery to remove a 10 cm thyroid tumour.

SGPGIMS Does First Robotic Surgery For Thyroid Tumour

Washington: According to clinical trial results, immunotherapy after surgery increased bladder cancer patients' chance of staying cancer-free compared to patients who received a placebo.
In February, these results were shared in a late-breaking oral presentation at the American Society of Clinical Oncology (ASCO) 2023 Genitourinary Cancers Symposium.
Matthew Galsky, MD, Co-Director of the Center of Excellence for Bladder Cancer at The Tisch Cancer Institute at Mount Sinai, presented three-year follow-up results from the Phase 3 CheckMate 274 trial. Patients on trial had urothelial cancer of the bladder or upper urinary tract and had tumour features indicating a high risk for recurrence.
"Adjuvant nivolumab became a standard of care based on the initial results of CheckMate 274," Dr Galsky said. "These results, showing patients' continued survival three years out, reinforce adjuvant nivolumab as a standard of care for patients with muscle-invasive urothelial cancer of the bladder or upper urinary tract. Normally, patients with this cancer face a high chance of recurrence, especially within the first three years after surgical removal of the bladder or kidney."
This new data showed that at approximately three years of follow-up, nivolumab increased these patients' chance of staying cancer-free after surgery compared to patients who received a placebo. The average time before relapse doubled in patients who received nivolumab, a monoclonal antibody immune checkpoint inhibitor that harnesses the immune system to fight cancer. For a subset of clinical trial patients who received the immunotherapy, disease-free survival was more than six times that of patients on a placebo. Among the 699 patients in the trial, half received nivolumab, and the other half received a placebo every two weeks for one year. Adjuvant nivolumab versus placebo was not associated with a detriment to the quality of life. This trial was conducted with support from Bristol Myers Squibb, the maker of the immunotherapy, in collaboration with ONO Pharmaceutical Company Ltd. —ANI

According to clinical trial results, immunotherapy after surgery increased bladder cancer patients' chance of staying cancer-free compared to patients who received a placebo.

High-Risk Bladder Patients Can Benefit From Immunotherapy After Surgery: Research 

New York: A study found that for patients with massive weight loss after bariatric surgery, subsequent body contouring to remove excess skin is not itself associated with long-term weight loss.
The findings of the study were reported in the June issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.
"In contrast to previous studies, we found that body contouring procedures do not lead to improved weight loss or weight maintenance after bariatric surgery," comments ASPS Member Surgeon Teresa Benacquista, MD, of Montefiore Medical Center, Bronx, N.Y. "Rather, the reported benefits of body contouring appear to be in improving quality of life."
Body contouring refers to a range of surgical procedures to remove excess skin in patients with major weight loss, with the aim of improving the patient's appearance, reducing discomfort, and improving physical function. Previous studies have suggested that patients who undergo body contouring have more sustained weight loss over time, although some studies have reported conflicting results.
The study included 2,531 patients who underwent bariatric surgery between 2009 and 2012. Of these, 350 patients underwent body contouring a median of two years later. Another 364 patients consulted with plastic surgeons about body contouring, but did not proceed to surgery. The remaining 1,817 patients had neither body contouring nor a consultation. At follow-up, patients who underwent body contouring did indeed have more sustained weight loss. After one year, average body mass index (BMI) was about 3 kg/m2 lower in the body contouring group, compared to patients who had bariatric surgery only. By seven years, BMI was 5 kg/m2 lower for patients who underwent body contouring.
However, weight loss was also greater for patients who had a consultation but did not proceed with body contouring. For this group, average BMI was 1.5 kg/m2 lower at one year compared to patients without a consultation, and 2.3 kg/m2 lower after seven years.
Further analysis focused on 259 patients from the consultation group who had sufficient weight loss to be considered candidates for body contouring. For these patients, average BMI after seven years was about the same as for patients who underwent body contouring: 31 versus 30 kg/m2, compared to 35 kg/m2 for those with no consultation or body contouring. Analysis by percentage of excess body weight lost showed a similar pattern.
Weight loss was also affected by the type of bariatric surgery: patients undergoing a procedure called sleeve gastrectomy had lower sustained weight loss, compared to gastric bypass. Among body contouring patients, average difference in excess body weight loss was about eight percent at seven years' follow-up.
Black patients had lower sustained weight loss, compared to other racial/ethnic groups. In contrast to previous studies of weight loss after bariatric surgery, most patients in the new analysis identified as Black (about 29%) or Hispanic/Latinx (62%).
The study raises questions about the effects of body contouring on long-term weight loss after bariatric surgery. Noting the similar responses in patients who underwent body contouring versus those with consultation only, Dr. Benacquista and coauthors write, "The impact of body contouring on weight loss is likely minimal, and the difference in weight loss as compared to the 'bariatric only' group is secondary to individual patient factors."
The researchers added, "The apparent benefits of body contouring in massive weight loss patients is likely psychosocial, related to improvements in physical functioning." —ANI

 A study found that for patients with massive weight loss after bariatric surgery

Study Finds How Body Contouring Affects Long-Term Weight Loss After Bariatric Surgery

Lucknow: Plastic surgeons at the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) have successfully conducted laser surgery for pilonidal sinus in a day-care procedure.
Pilonidal sinus is a small hole or tunnel in the skin at the top of the posterior from where it divides.
A disease of the pilonidal sinus is characterised by pus formation and discharge near the anus. Though common, it is very hard to treat and is often marked by relapse.
The oldest reference to this disease is of US soldiers of late 1800s who were diagnosed with pilonidal disease during the wars and it was therefore also known as "Jeep disease."
It occurs mostly in men with excess hair growth on the backside and the disease is seen in 26 persons per 1 lakh population.
Prof Rajeev Agarwal, head of plastic surgery department, SGPGIMS, said, "The cause of pilonidal sinus is thought to be related to trapped hair follicles. Patients usually complain of a small hole near the upper part of the bottoms with discharge of fluid or pus. It may also be associated with pain if there happens to be fluid collection or infection. Factors causing it include family history, being overweight or obese, trauma or irritation, sedentary occupation or lifestyle, hirsute habitus and poor hygiene."
He explained that the conventional method required surgical intervention followed by regular steps like abscess management.
Compared to this, the plastic surgeons used the minimally invasive laser technique to bring relief to the patient.
"After excision of the sinus, the area is treated by a single beam of carbon dioxide laser which helps in eliminating the entire sinus tract. The key benefits included freedom from pain, cuts and stitches and risk of losing blood besides no hospitalisation, quick recovery, no recurrence of cysts and low chance of infection," he said. —IANS

Plastic surgeons at the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS)

SGPGIMS Conducts Laser Surgery For Pilonidal Sinus

Washington: According to a study, hyperthyroidism therapy such as radioactive iodine or surgery was linked to a lower risk for mortality. The findings of the study presented at ENDO 2023, the Endocrine Society's annual meeting in Chicago. "Hyperthyroidism or an overactive thyroid gland is common, affecting up to 3 per cent of the population, and is associated with long-term adverse cardiac and metabolic consequences. The optimal treatment choice remains unclear," said Kristien Boelaert, M.D., Ph.D., a professor of endocrinology from the University of Birmingham in the United Kingdom. Boelaert and colleagues identified 55,318 patients with newly diagnosed hyperthyroidism, treated with antithyroid drugs (ATD; 77.6 per cent), radioiodine (14.6 per cent), or thyroidectomy (7.8%) from a U.K. population-based electronic health record database for the EGRET Study. They examined all-cause mortality, major cardiovascular events (MACE: cardiovascular death, heart failure, or stroke), and post-treatment obesity. The average follow-up was roughly 12 years. Those treated with antithyroid drugs had an estimated mean survival of 12 years, according to the data. Survival increased in those treated with radioiodine by 1.7 years and thyroidectomy by 1.1 years. People treated with antithyroid drugs had an estimated 10.2% risk of MACE, which significantly increased by an additional 1.3% with radioiodine but not with thyroidectomy. These definitive treatments were associated with a significantly increased survival, despite a small increased risk for overall weight gain. For example, thyroidectomy was associated with an increased likelihood of obesity in both men and women. Radioiodine treatment led to increased obesity risk in women, but not in men. "Our findings are important and will inform decision-making processes for patients and clinicians when considering optimal treatment options and are likely to impact clinical practice guidelines in the future," Boelaert said. —ANI

According to a study, hyperthyroidism therapy such as radioactive iodine or surgery was linked to a lower risk for mortality

Radioactive Iodine, Surgery Linked To Increased Survival In Hyperthyroidism: Study

Lucknow: A 32-year-old woman underwent a heart surgery and also a c-section operation to deliver her twins. Doctors at the city-based Medanta Hospital successfully conducted the two operations. The woman, who complained of breathlessness, was pregnant with twins through IVF. The patient had an obstruction in the right ventricular outflow. In view of her condition, she was referred from Varanasi to Medanta Lucknow. “The right (side) heart that pumps blood into the lungs effortlessly had a severe obstruction. The woman was taken to the cardiothoracic operating theatre. Firstly, the gynaecology department team conducted the delivery and then the heart surgery was performed,” said Gaurang Mazumdar, the head of the cardiothoracic vascular surgery department. Due to the obstruction, blood was not reaching her lungs properly. It was a tricky case that required a multi-specialty focus. Counselling of the family was also done regarding the risk and procedure being adopted. Akash Pandita, head of the neonatology department, said: “Babies born were 1,200 and 1,300 grams in weight (respectively) and had breathing problems initially. However, this was solved without the use of a ventilator. "As the mother was not in the condition to breastfeed her twins, she was shown the two newborns via a video call. The woman has been discharged now. Her babies are healthy.” According to doctors, such patients fall into a special group where pregnancy is accompanied by features of heart failure. —IANS

A 32-year-old woman underwent a heart surgery and also a c-section operation to deliver her twins

UP Woman Undergoes Heart Surgery, Delivers Twins Via C-Section

Mumbai: Shah Rukh Khan reportedly met with an accident while shooting in Los Angeles. He was rushed to hospital where he underwent minor nose surgery. The actor has now returned to India and is resting at his home, Mannat, in Mumbai. On the work front, he will be next seen in Atlee's Jawan with Nayanthara and Vijay Sethupathi. The trailer will be out on July 12. He also has Rajkumar Hirani's Dunki with Taapsee Pannu.—PTI

Shah Rukh Khan reportedly met with an accident while shooting in Los Angeles

Shah Rukh Has Accident, Undergoes Surgery

Hyderabad: In a rare case, a person has been found with both male reproductive organs and doctors at KIMS Hospitals Secunderabad here performed laparoscopic surgery on him.&nbsp;
A 40-year-old person from Mancherial was diagnosed with Persistent Mullerian Duct Syndrome, a rare condition, doctors said.&nbsp;
He was suffering from infertility and lower abdominal pain. Doctors said he had undescended testis. He appeared physically normal but harbored female internal reproductive organs like the uterus, fallopian tubes, and part of the vagina too.&nbsp;
According to Consultant Urologist, Andrologist, Renal transplant, and Robotic surgeon Dr. YM Prashanth both male and female different reproductive organs will be present at the fetus stage and later with the effect of certain hormones, only one will be left.&nbsp;
So, by birth itself it'll be decided whether it is a male or female baby. But, in very rare cases, due to the mutation of genes, hormones are not released sufficiently, the person will have both male and female reproductive organs.&nbsp;
It is called Persistent Mullerian Duct Syndrome.&nbsp;
Only 300 such cases are reported worldwide so far. In India, there are only 20 cases till now. Such people look quite normal.
They will have a beard and mustache. Penis will also look normal but as the testes don't descend and sperm is not produced. Thus infertility issues arise.&nbsp;
The doctor said in this case Testosterone, LH, FSH, and Prolactin hormones were normal but his testis is absent in the scrotum, and they are located intra-abdominally.&nbsp;
After the tests, they decided to take up laparoscopic hysetro salpingectomy surgery.&nbsp;
"In the process, we have dilated the uterus, a part of the vagina, fallopian tubes, and testes embedded in a broad ligament. We have also dilated the cyst attached to the prostate. The patient was uneventful in the post-operative period, so discharged him on the third day. He was started on quarterly Testosterone replacement.&nbsp;
"If he could come for the same procedure before the age of 18, he could have the chance of fertility. But now, he doesn't have such a chance. Due to illiteracy, poverty, and social taboo, such people don't visit proper medical facilities," said Dr. Prasanth.&nbsp;
—IANS

In a rare case, a person has been found with both male reproductive organs and doctors at KIMS Hospitals Secunderabad here performed laparoscopic surgery on him. 

Man with male, female reproductive organs undergoes surgery in Hyderabad

New Delhi: All India Institute of Medical Science (AIIMS) in the national capital conducted a specialised in-house teaching session for its Master of Chirurgiae (MCh) in plastic and reconstructive surgery residents earlier this week. The session was held on August 19 and 20 at the Burns and Plastic Surgery Block of AIIMS.    AIIMS has a strong reputation for its comprehensive training programmes, and in line with its commitment to excellence, the department has recently introduced a unique approach to training residents in Aesthetic and cosmetic surgery, enhancing the scope of their education. As part of this innovative training initiative, a two-day in-house workshop was organised, focusing on hands-on training and cadaveric exercises. The department invited Dr. Sanjay Parashar, a distinguished cosmetic surgeon and educator based in the UAE, to serve as a guest faculty for the event.  Prof. Maneesh Singhal, Head of the Department of Plastic Surgery, highlighted the importance of incorporating cosmetic surgery into the holistic curriculum for plastic surgery. This integration ensures that MCh residents gain the necessary confidence and skills to practice cosmetic surgery effectively upon completing their residency. Dr Shashank Chauhan, Associate Professor, stated that during the intensive two-day programme, various surgical procedures were conducted, with a focus on body contouring surgeries (tummy tuck) for patients who had undergone significant weight loss, as well as rhinoplasties (nose job). Dr. Shivangi Saha, Assistant Professor, stated that the use of cadavers and simulation models could offer a unique and valuable approach to learning the intricacies of cosmetic surgery. These procedures not only provided residents with practical experience but also deepened their understanding of the complex challenges and techniques involved in cosmetic surgery. The Department of Plastic Surgery is preparing its residents to meet the growing demand for cosmetic procedures in India while maintaining the institution's reputation for excellence in healthcare education and practice. (ANI)

All India Institute of Medical Science (AIIMS) in the national capital conducted a specialised in-house teaching 

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Live surgery workshop organized by the Orthopedic dept of AIIMS Rishikesh

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Live surgery workshop organized by the Orthopedic dept of AIIMS Rishikesh

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