'CLOSE THE CARE GAP' was the theme of World Cancer Day 2022, celebrated each year on February 4th. The theme signifies the need to spread awareness on cancer and available treatment modalities, while also making treatment accessible to more patients. Dr. Kamakshi Memorial Hospital was established in 2005, and this year's theme resonates with the hospital's motto of providing quality cancer care to everyone.
World Cancer Day was celebrated on the premises - jointly organised by the Radiation Oncology department and the division of Medical Physics. Dr. Surendran J, Senior Consultant - Radiation Oncology welcomed the chief guests and the event itself was presided over by Dr. KMH's Chairman and Founder Dr. TG Govindarajan. He inaugurated the event and also released a booklet called Radiation Oncology Booklet which is written by Prof. K Thayalan - Head of the Medical Physics Department at Dr. KMH. In his address, Dr. TG Govindarajan stated that the booklet would answer any query that might arise in the mind of patients currently undergoing radiotherapy treatment for cancer, but will also prove beneficial to anyone who needs clarity on cancer and its treatment. He also mentioned the importance of a healthy diet and regular workout to patients undergoing cancer treatment. In a bid to reflect the theme of bridging the gap in cancer care, this informative booklet will be handed out to every patient receiving cancer treatment at the hospital this year.
Radiation Oncology Booklet is available in English and in Tamil, in order to ensure that the information is available to every patient that walks in to Dr. KMH for treatment. The booklet contains 100 frequently asked questions about cancer - causes, symptoms, risks, do's and don't's and treatment options. The booklet aims to educate patients on the benefits of currently available cancer treatment modalities.
Other dignitaries present at the event were Dr. TGG Sivaranjini (Financial Director), Dr. TS Swaminathan (Head - Radiology & Imaging Sciences), Dr. KM Radhakrishnan (Advisor), Ms Ramya (Administrative Officer), Dr. Karthikeyan Perumal, Mrs. Sidonai Valas and Dr. Usharani. Several patients were also present and were more than happy to interact with Dr. TG Govindarajan during the event.
When COVID 19 strikes hard, it's not easy to come back un-maimed. 27 year old Sravankumar was admitted to Dr. Kamakshi Memorial Hospital in June 2021 with severe COVID 19 infection and co-existing prediabetes. He had initially been treated at his hometown, but given the severity of the infection he was brought to Dr. KMH. His symptoms indicated a black fungus infection as well, which was confirmed with a biopsy. It was a case of Highly Invasive Mucormycosis that had to be treated with urgency as it was life-threatening.
A multidisciplinary team of expert doctors comprising of Infectious Disease Specialist, Nephrologist, Ophthalmologist, Oro-Faciomaxillary Surgeon, Endocrinologist, ENT Specialist alongwith the Physiotherapy and Intensive Care team under the able guidance of Medical Superintendent was immediately put together to gauge the situation and work out the best possible way to proceed. Contrast enhanced CT (CECT) and MRI FACIAL Bone with brain showed the spread of Mucormycosis into complete left half of his face involving 3/4th upper jaw, left orbital/ eyeball muscles with orbital apex, left Brain cavernous sinus and left Masticatory facial muscle spaces. Due to the highly invasive pattern and vascular spread of the fungal infection it was evident that the surgery would leave the patient with considerable facial disfigurement - but it was the only way to save his life. Sravankumar was made to understand the situation by specialized counselors before he was taken into surgery. Most of his upper jaw and all of his left facial bones along with the floor of his eyeball were removed.
However, four weeks after the procedure CECT and MRI showed that the infection had spread to the rest of the left side of his face including the eye. The doctors recommended an immediate surgery but this meant Sravankumar would lose the entire left side of his face. With no other option, upon the consent of Sravankumar, the second salvage surgery was performed. During the second procedure the rest of his upper jaw and left orbital exenteration (eyeball removal) was done.
Post procedure the patient was kept under observation with IV antifungals for another 4 to 6 weeks under the close monitoring of the MDT. Repeat CECT & MRI suggested an arrest in the spread of infection by the month of August. Sravankumar eventually recovered completely from the black fungus infection but had sustained major morbidity - he had lost one entire side of his face. He could barely talk and had extreme difficulty in eating as well. It was definitely heart-breaking to see Sravankumar suffer this way in the prime of his life. With one side of his face practically flattened, the emotional trauma was perceptible. He had survived a severe COVID infection and a fatal Black Fungus infection, but the journey forward looked bleak for this other-wise active young man. At this point Facio Maxillary, Head and Neck surgeon Dr. Selvakumar C proposed performing advanced facial reconstruction surgery.
Reconstructing Maxillofacial defects, both congenital and acquired, is quite challenging for most surgeons due to the region's complex anatomy and the cosmetic and functional effects it has on patients. From a functional and aesthetic view, it is imperative for surgeons to accurately restore the defect in a way that will ensure patient satisfaction and well being. Previously, the use of premade alloplastic implants and autogenous graft was often associated with infection, resorption and displacement. Recent technological advancements have led to the use of custom made 3D computer designed patient-specific implants(PSIs) in reconstructive surgery. With PSI, even the total temporomandibular joint replacement (Jaw joint) and post cancer surgical defect of Face and Jaws is possible.
In October 2021, once the patient's condition had stabilized after the two surgeries he was prepped for Facial Reconstructive surgery. The first step was to take a 3D CT-Facial Bone scan to assess facial defects and to also design customized implants. The PSI for both left and right face was fabricated along with Implant supported Maxillary prosthesis (upper jaw). Total Facial Reconstruction surgery was carried out by Dr. Selvakumar. There were no complications and the depressed uneven face was corrected cosmetically keeping as close to the original morphology of the patient as possible. The next most important part was to reconstruct the upper jaw to enable the patient to eat and speak. This complex procedure was taken up in December 2021. The maxillary prosthesis was fabricated and fixed with the facial prosthesis with the implant support. Eventually the patient was able to speak better and eat normally. After months of struggle, Sravankumar had finally recovered.
Several cases of mucormycosis in people with COVID-19 have been increasingly reported world-wide, especially in India. The primary cause for Mucorales spores to germinate in people with COVID-19 is the ideal environment of low oxygen (hypoxia), high glucose (diabetes, new onset hyperglycemia, steroid induced hyperglycemia), acidic medium (metabolic acidosis, diabetic ketoacidosis), high iron levels and decreased phagocytic activity of white blood cells due to immune-suppression coupled with other shared risk factors including prolonged hospitalization with or without mechanical ventilators. Thus a carefully planned, step by step, multidisciplinary team approach with judicious use of medications will help patients affected with COVID 19 recover even from fatal infections such as Mucormycosis.
Thanks to the dedication and immense effort of the doctors at Dr. Kamakshi Memorial Hospital, today Sravankumar is living a healthy and normal life. The patient-first attitude is what drives every member of Dr. KMH - inspired and inculcated in each and every one by the chairman, Dr. TG Govindarajan.
A new-born infant went through a one-of-its-kind surgery in the neonatal unit of Dr. Kamakshi Memorial Hospital and has recovered fully. After 100 days of intensive care, the new-born had to be taken in for surgery for Persistent Hyperinsulinemic Hypoglycemia.
Kannan and Nivitha were blessed with a lovely baby girl earlier this year. However, their joy was short-lived. Four hours after birth, the attending nurse noticed that the new-born had turned blue from lack of oxygen. The neonate had stopped breathing and was immediately rushed to the Neonatal ICU at the hospital. She was revived but the situation was quite dire when she was tested with hypoglycemia or extremely low blood sugar levels. The NICU staff headed by Dr. Vaideeswaran (Consultant Neonatologist) started her off on IV glucose but the new-born's sugar levels remained dangerously low. Glucose Infusion Rate was raised from 6 to 8 mg/kg/min, then 10 mg/kg/min and finally 12 mg/kg/min. With insulin levels soaring she was diagnosed with Persistent Hyperinsulinemic Hypoglycemia.
Explains Dr. Vaideeswaran, 'Persistent hyperinsulinemic hypoglycemia in a neonate is relatively rare. Immediate treatment is absolutely necessary in order to save the child from long lasting severe neurological damage. If the situation does not improve it could lead to mental or psychomotor retardation and even prove life-threatening.'
The new-born remained in the NICU for 100 days where her glucose levels and other vitals were constantly monitored. Understanding that every minute counts, the team of doctors at the hospital embarked on an investigative route to find the best suited treatment modality - genetic analysis, endocrine work-up and trials with Hydrocortisone, Diazoxide and Octreotide. The DOTA NOC scan that was conducted revealed Diffuse Nesidioblastosis which is characterized by excessive insulin production by pancreatic beta cells that have an abnormal microscopic appearance. This diagnosis indicated that the only way to save the baby was Total Pancreatectomy. The parents who were already in a state of emotional trauma, had misgivings on the impact of surgery on their new-born and if she would survive it. Multiple hypoglycemic episodes indicated the urgent need for surgery. The new-born's condition worsened and she needed to be ventilated twice for Aspiration Pneumonia and Pericardial Effusion. Realising that the drugs and the IV glucose was not giving satisfactory responses, the parents finally consented to surgery.
Dr. Kamakshi Memorial Hospital's Paediatric Surgeon Dr. Moorthy headed the surgery, and a Total Pancreatectomy was performed on the three-month old baby. This kind of procedure on an infant involves high risk and needs to be conducted with absolute precision. The surgery was a complete success and when she was finally discharged, she was well on her way to recovery. The parents were more than happy to show their gratitude to the doctors and staff at Dr. Kamakshi Memorial Hospital who left no stone unturned to save their baby with a token of love.
Speaking about the 100-day long treatment and the successful surgery, Dr. Vaideeswaran says, "After the procedure, the baby is doing fine. She has not had any hypoglycemic episodes and her periodic check-ups have also shown that she is in good health now. Surgery was the only option to ensure she did not sustain a neurological damage that would impede her growth and development. She does need to come in for monthly check-ups because we need to ensure she is achieving developmental milestones and monitoring her sugar levels is a long-term requirement. If at all she develops diabetes in childhood, it can definitely be managed. We are happy to have been able to help her battle this condition and come out healthy."
About Dr. Kamakshi Memorial Hospital
Dr. Kamakshi Memorial Hospital was established in 2005 by Dr. TG Govindarajan, Founder and Chairman. It is a 75000 square feet 300 bedded multi-specialty hospital at Pallikaranai, Chennai. The hospital is fully equipped with state-of-the-art facilities and expert doctors in every department besides 24/7 emergency services, pharmacy, online consultation, high tech diagnostic and imaging facilities, fully sanitized premises and a support staff that does not hesitate to go the extra mile. The mission of the hospital is to provide quality health care to everyone and it strongly stands by the same.
For details please visit: Paediatrics
TN Minister For Medical & Family Welfare Thiru MA. Subramanian Inaugurates Elekta Infinity, The State Of Art Linear Accelerator Cancer Radiotherapy Equipment At Dr Kamakshi Memorial Hospitals, Pallikaranai. Thirumathi Thamizhachi Thangapandian MP & Thiru Aravind Ramesh MLA also participated in the event as the Guests of Honour.
This Equipment is the only Linear Accelerator in Tamil Nadu to be equipped with Active Breathing Coordinator (ABC) feature that protects Heart, Lungs and surrounding tissues which move with natural respiration while treating Breast and Lung Cancers
Chennai, 29th Aug. 2021: Dr. Kamakshi Memorial Hospitals inaugurated Elekta Infinity, its newly commissioned Linear Accelerator and the latest cutting edge technology in Cancer Radiotherapy Treatment. The facility was inaugurated on August 29, 2021 by HON'BLE THIRU MA. SUBRAMANIAN, Minister for Health and Family welfare, Government of Tamil Nadu in the august presence of THIRUMATHI THAMIZHACHI THANGAPANDIAN, Member of Parliament & THIRU ARAVIND RAMESH, Member of Legislative Assembly, Sholinganallur (Guests of Honour).
Dr. T.G. Govindarajan, Founder Chairman and Managing Director spoke about the genesis of this Hospital tracing its dedication especially to Cancer Treatment and its bid to break the hitherto handheld myth that cancer was incurable and its determined mission driven by a passion to make cancer treatment available to all strata of the Society at affordable cost levels. According to Dr. T.G Govindarajan, The Elekta Infinity Linear Accelerator with its varied applications and add on features which has been installed at a total cost of around Rs. 20 Crores is arguably the finest quality of Radiotherapy Equipment available today and a real boon to Cancer Patients. Among its highlights, it is the only machine in Tamil Nadu to have been uniquely equipped with Active Breathing Coordinator (ABC) feature which ensures that the normal and healthy tissues surrounding the Heart, Lungs and other organs that move with natural respiration are protected from beams of radiation while treating Breast and Lung cancers.
Dr. T.G. Govindarajan also briefed the gathering on the subtle and salient features of this Equipment. The Elekta Infinity offers Volumetric Modulated Arc Therapy (VMAT), a novel Radiotherapy Technique delivering Speed and utmost precision in treating the tumour to the millimetre precision with negligible damage to the surrounding tissues. Besides this, it has other features like Active Breathing Coordinator ™ for Respiratory motion management, BodyFIX ® patient immobilization for Precise patient positioning and immobilization, Fraxion ™ for Patient-Specific Cranial Immobilization and Symmetry ™ for 4D tumor Position visualization all of which ensure delivery of high doses in short periods of time thereby reducing the duration of the treatment and increasing its efficiency. This state of art equipment can be used in treatment of Breast Cancer, Uterine Cervix Cancer, Brain Tumors, Prostate Cancer, Tumors in the Liver & Lungs and even Pediatric Cancers.
Dr. Kamakshi Memorial Hospitals' Oncology team is a dedicated 40-member team of Doctors, 20 from Radiation oncology, five each from Surgical oncology and Medical oncology, and 10 Senior consultants from Neurosurgery, Gynaecology, ENT, Urology, Gastroenterology Pulmonology, Radiology Pathology, Thoracic Surgery and Geriatrics. They cover both diagnostics and treatment methodologies namely surgery, chemotherapy and radiotherapy. The Hospital provides total cancer care under one roof and each member of the team has a contribution at different points of time in the treatment of cancer. No stone is left unturned to ensure the patient recovers fully.
To make this high end treatment available to all sections of Society, Dr. Kamakshi Memorial Hospitals also offers this under the Chief Minister's Comprehensive Health Insurance (Tamil Nadu Government's Maruthuva Kapitu Thittam).
For more details visit www.drkmh.com/linac