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41 - 152

Title: Liver Transplant


Liver transplantation or hepatic transplantation is the replacement of a diseased liver with a healthy liver allograft.

The most commonly used technique is orthotopic transplantation, in which the native liver is removed and the donor organ is placed in the same anatomic location as the original liver. Liver transplantation nowadays is a well accepted treatment option for end-stage liver disease and acute liver failure.


Before transplantation liver support therapy might be indicated (bridging-to-transplantation). Artificial liver support like liver dialysis or bioartificial liver support concepts are currently under preclinical and clinical evaluation. Virtually all liver transplants are done in an orthotopic fashion, that is the native liver is removed and the new liver is placed in the same anatomic location. The transplant operation can be conceptualized as consisting of the hepatectomy (liver removal) phase, the anhepatic (no liver) phase, and the postimplantation phase.

The operation is done through a large incision in the upper abdomen. The hepatectomy involves division of all ligamentous attachments to the liver, as well as the common bile duct, hepatic artery, hepatic vein and portal vein. Usually, the retrohepatic portion of the inferior vena cava is removed along with the liver, although an alternative technique preserves the recipient's vena cava ("piggyback" technique).

The donor's blood in the liver will be replaced by an ice-cold organ storage solution, such as UW or HTK until the allograft liver is implanted. Implantation involves anastomoses (connections) of the inferior vena cava, portal vein, and hepatic artery. After blood flow is restored to the new liver, the biliary (bile duct) anastomosis is constructed, either to the recipient's own bile duct or to the small intestine. The surgery usually takes between five and six hours, but may be longer or shorter due to the difficulty of the operation and the experience of the surgeon.

The large majority of liver transplants use the entire liver from a non-living donor for the transplant, particularly for adult recipients. A major advance in pediatric liver transplantation was the development of reduced size liver transplantation, in which a portion of an adult liver is used for an infant or small child. Further developments in this area included split liver transplantation, in which one liver is used for transplants for two recipients, and living donor liver transplantation, in which a portion of healthy person's liver is removed and used as the allograft. Living donor liver transplantation for pediatric recipients involves removal of approximately 20% of the liver.

Why this is Done
Liver transplantation is potentially applicable to any acute or chronic condition resulting in irreversible liver dysfunction, provided that the recipient does not have other conditions that will preclude a successful transplant. Metastatic cancer outside liver, active drug or alcohol abuse and active septic infections are absolute contraindications. While infection with HIV was once considered an absolute contraindication, this has been changing recently. Advanced age and serious heart, pulmonary or other disease may also prevent transplantation (relative contraindications). Most liver transplants are performed for chronic liver diseases that lead to irreversible scarring of the liver, or cirrhosis of the liver.

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42 - 153

Title: Urology


Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological disorders.

The organs covered by urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate and penis). Urology is one of the most competitive specialties to enter for physicians.

The urinary and reproductive tracts are closely linked, and disorders of one often affect the other, so a major part of the conditions managed in urology fall in the area of genitourinary disorders.

Urology combines management of medical (i.e., non-surgical) problems such as urinary tract infections and benign prostatic hyperplasia, as well as surgical problems such as the surgical management of cancers, the correction of congenital abnormalities, and correcting stress incontinence.

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42 - 154

Title: TURP


The prostate is a gland about the size of a walnut that is only present in men. It is located just below the bladder and surrounds the urethra, the tube through which urine flows from the bladder and out through the penis.

One of the main functions of the prostate gland is to produce prostatic fluid, one of the components of semen. A man's prostate gland usually starts to enlarge after he reaches 40 years of age.This condition is called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.

Signs & Symptoms

Many men with an enlarged prostate have no symptoms. Common symptoms may include the following:
•    Blood in the urine (i.e. haematuria), caused by straining to void.
•    Dribbling after voiding.
•    Feeling that the bladder has not emptied completely after urination.
•    Frequent urination, particularly at night (i.e. nocturia).
•    Hesitant, interrupted or weak urine stream caused by decreased force.
•    Leakage of urine (i.e. overflow incontinence).
•    Pushing or straining to begin urination.
•    Recurrent, sudden, urgent need to urinate.

In severe cases of BPH, another symptom i.e. Acute Urinary Retention (inability to urinate), can result. Acute Urinary Retention causes severe pain and discomfort. Catheterization may be necessary to drain urine from the bladder to obtain relief.

Transurethral resection of the prostate (TURP) is the most common operation for BPH. Your surgeon inserts a thin, tube-like telescope (a resectoscope) into the urethra. The resectoscope includes a camera and specially adapted surgical instruments. This allows the surgeon to see the prostate clearly. A wire loop attachment that carries an electric current is used to "chip away" at the prostate. For further information, please see separate Bupa health factsheet, TURP.

Transurethral incision of the prostate (TUIP) may be appropriate for men who have a less enlarged prostate. It is a quicker operation than TURP and instead of "chipping away" a portion of the prostate, small cuts are made in the bladder neck and the prostate to improve the flow of urine.
Open prostatectomy is only recommended for men whose prostate is very large. It is a major operation carried out under general anaesthesia and may require up to a week in hospital. An incision is made in the lower abdomen in order to remove part of the prostate.

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43 - 155

Title: Stem Cell Theraphy


Stem cell treatments are a type of intervention strategy that introduces new cells into damaged tissue in order to treat disease or injury. Many medical researchers believe that stem cell treatments have the potential to change the face of human disease and alleviate suffering.

The ability of stem cells to self-renew and give rise to subsequent generations with variable degrees of differentiation capacities,offers significant potential for generation of tissues that can potentially replace diseased and damaged areas in the body, with minimal risk of rejection and side effects.

Stem cell therapy has proven to be effective for organs and tissues restoration, and for fight against the incurable and obstinate diseases.

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43 - 156

Title: Somatic Stem Cell Therapy


Leukemia is a cancer of white blood cells, or leukocytes. Like other blood cells, leukocytes develop from somatic stem cells. Mature leukocytes are released into the bloodstream, where they work to fight off infections in our bodies.

Leukemia results when leukocytes begin to grow and function abnormally, becoming cancerous. These abnormal cells cannot fight off infection, and they interfere with the functions of other organs.

Successful treatment for leukemia depends on getting rid of all the abnormal leukocytes in the patient, allowing healthy ones to grow in their place. One way to do this is through chemotherapy, which uses potent drugs to target and kill the abnormal cells. When chemotherapy alone can't eliminate them all, physicians sometimes turn to bone marrow transplants.

In a bone marrow transplant, the patient's bone marrow stem cells are replaced with those from a healthy, matching donor. To do this, all of the patient's existing bone marrow and abnormal leukocytes are first killed using a combination of chemotherapy and radiation. Next, a sample of donor bone marrow containing healthy stem cells is introduced into the patient's bloodstream.

If the transplant is successful, the stem cells will migrate into the patient's bone marrow and begin producing new, healthy leukocytes to replace the abnormal cells.

New evidence suggests that bone marrow stem cells may be able to differentiate into cell types that make up tissues outside of the blood, such as liver and muscle. Scientists are exploring new uses for these stem cells that go beyond diseases of the blood.

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43 - 157

Title: Peripheral Blood Stem Cells


While most blood stem cells reside in the bone marrow, a small number are present in the bloodstream. These peripheral blood stem cells, or PBSCs, can be used just like bone marrow stem cells to treat leukemia, other cancers and various blood disorders.

Since they can be obtained from drawn blood, PBSCs are easier to collect than bone marrow stem cells, which must be extracted from within bones. This makes PBSCs a less invasive treatment option than bone marrow stem cells. PBSCs are sparse in the bloodstream, however, so collecting enough to perform a transplant can pose a challenge.

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43 - 158

Title: Umbilical Cord Blood Stem Cells


Newborn infants no longer need their umbilical cords, so they have traditionally been discarded as a by-product of the birth process. In recent years, however, the stem-cell “rich blood found in the umbilical cord has proven useful in treating the same types of health problems as those treated using bone marrow stem cells and PBSCs.

Umbilical cord blood stem cell transplants are less prone to rejection than either bone marrow or peripheral blood stem cells.

This is probably because the cells have not yet developed the features that can be recognized and attacked by the recipient's immune system. Also, because umbilical cord blood lacks well-developed immune cells, there is less chance that the transplanted cells will attack the recipient's body, a problem called graft versus host disease.

Both the versatility and availability of umbilical cord blood stem cells makes them a potent resource for transplant therapies.

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27 - 166

Title: Robotic Heart Bypass Surgery


Robotic surgery is a computer-assisted surgery heart developed to overcome both the limitations of minimally invasive surgery or to enhance the capabilities of surgeons performing open heart surgery.

Robotic Surgery technology is used for Mitral Valve Repair ( MVR) and Coronary Artery Bypass Grafting (CABG ).

Robot Assisted Mitral Valve Repairmay be used to treat:

  • Stenosis (narrowing) of the mitral valve
  • Regurgitation (leakage) of the mitral valve

Robot Assisted Coronary Artery Bypass Grafting (CABG) may be used to treat

  • Blockages in the heart's arteries
  • Severe chest pain ( angina ) that has not improved with medicines

Robot-assisted Atrial Septaldefect repair may be used to treat a hole between the upper chambers of the heart that does not close properly during foetal development.

Robot-assisted Biventricular Pacemakerlead placement may be used to treat heart failure due to Atrial Fibrillation (irregular heart rhythm in the upper chambers of the heart)

 Advantages of Robotic Heart Surgery

1. Less Pain and scarring
2. Minimally Invasive Surgery
3. Shorter Hospital Stay
4. Reduced Blood Loss & need for blood transfusion
5. Reduces the risk of infection
6. Reduction in use of pain medicines
7. Faster Recovery & return to normal activities

Robotic Surgeryis performed by a high end surgical system called the da Vinci Si with 3D HD vision. It combines superior 3D visualization along with great enhanced dexterity, precision and control in an intuitive ergonomic interface with breakthrough surgical capabilities.

By enhancing surgical capabilities, robotic surgery helps to improve clinical outcomes and redefine standards of care.

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39 - 167

Title: Minimally Invasive Spine Surgery


Back problems are one of the most common reasons to see a doctor, a chronic condition of such leads for a spinal surgery. Spine surgery is an advanced treatment option for pain and disability caused by an identifiable lesion in the patient’s anatomy that has not adequately improved with non-surgical treatments.

Although spinal arthritis tends to be chronic, the symptoms are rarely progressive and rarely require surgery on the painful spinal joints. However, surgery may be needed in severe cases, and may include a spine fusion, decompression and or laminectomy.

Minimally invasive spine surgery is the latest technique which is  routinely carried out with results at par with the best centers globally.

Minimally Invasive Spine Procedures are..

  •     Microsurgical Discectomy
  •     Endoscopic Discectomy
  •     Transforaminal Interbody Lumbar Fusion
  •     Posterior Lumbar Interbody Fusion (PLIF)
  •     Kyphoplasty
  •     Nucleoplasty or Percutaneous Discectomy

Minimal Invasive spine surgery involves

  •     use of very small incisions,
  •     minimal muscle retraction,
  •     less normal tissue damage
  •     targeted treatment of pathology.


  • Many surgeries are done under local anesthesia, hence surgeries can bedone even in patients with high risk of anesthesia.
  • There is less blood loss.
  • Minimal morbidity.
  • Patient can be mobilized very early and he can be back to work faster.
  • It prevents complications associated with prolonged bed rest.
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36 - 130

Title: Diagnostics Treatment

Health Checkups
Many common and life-threatening conditions can be treated successfully if detected early. Diagnosis helps in identifying the nature of any such conditions thorough health check ups either by process of elimination or by other analytical methods.
The diagnostic centers and the hospitals offer comprehensive health check up, that screens each organ closely and detects even the smallest symptom that could be an indication of a major health threatening disease. The constant irritants causing minor ailments are also effectively diagnosed thorough these checkups.
However health check ups like Sonography, ECGs, 2D Echos, Bone Density, Dental and Eye exams can be cost prohibitive forcing many of us to avoid this essential step to overall wellness.
In today’s stress-filled life, taking care of your health very of important. It is certainly far more economical to invest in preventive healthcare rather than to wait for cure only once you take a hit and then rush to a hospital. We all know "prevention is better than cure".
We offer access to a full spectrum of customized diagnostic services and have created specific packages for wellness checks designed especially with you in mind.
Some of the advanced diagnostic procedures are…
  • Mammography
  • Ultrasound
  • Nuclear Medicine
  • M.R.I. (Magnetic Resonance Imaging)
  • Cardiac C.T.
  • C.T. Scan
  • P.E.T. Scan(Positron Emission Tomography)
  • Virtual Colonoscopy
A vast range of tailor-made packages have been designed to cater to the needs of specific individuals.
Some of the Health Checks offered by us are:-
  • Master Health Check
  • Executive Health Check
  • Cardiac Check and Advanced Cardiac Check
  • Women Health Check
  • Elderly Health Check
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35 - 168

Title: Chronic Cerebrospinal Venous Insufficiency


CCSVI stands for Chronic Cerebrospinal Venous Insufficiency. CCSVI is an ongoing condition where blood from the brain and spine has trouble getting back to the heart. CCSVI is caused by with stenosis (abnormal narrowing of veins) of the jugular veins (veins that bring deoxygenated blood from the head back to the heart) and azygos veins (carries deoxygenated blood from areas of the chest and abdomen to the heart). Blood takes longer to get back to the heart, and it can reflux back into the brain and spine or cause edema (abnormal accumulation of fluid) and leakage of red blood cells and fluids into the delicate tissue of the brain and spine. This causes a delay in deoxygenated blood leaving the head. Due to this partial blockage, deoxygenated blood either stays too long in the brain or can reflux back into the brain causing various adverse effects, including:1) A lack of oxygen (hypoxia) in the brain;2) Inflammation caused by plasma and blood, which can also set off an autoimmune reaction; and 3) Iron from blood deposited on brain tissue can damage Myelin, and over time results in nerve damage (think of rust built up on a motor).

Highlights of CCSVI Treatment Programs in India: 
Availability of BrainSuite Image analysis tool at the hospital. Brainsuite permits the neurosurgeons to have an MRI scan of the patient during surgery. This helps the doctors to perform the surgery with more accuracy.
Medical qualifications for CCSVI surgery in India 
Not all Multiple Sclerosis patients can opt for CCSVI treatment. Only those patients who are diagnosed to have clots in the veins of brain can be treated by Liberation Surgery. Such clots are known as stenosis or Chronic cerebrospinal venous insufficiency (CCSVI).
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27 - 169

Title: Atrail Fibrillation


Atrial fibrillation (A fib) is an irregular and often rapid heart rhythm. The irregular rhythm, or arrhythmia, results from abnormal electrical impulses in the upper chambers of the heart that cause the heartbeat to be irregular and usually fast. The irregularity can be continuous, or it can come and go. Some individuals, especially patients on medications, may have atrial fibrillation constantly but not have a rapid rate of rest. Variations of A fib may be termed paroxysmal, persistent, or permanent 

A fib is the most common heart arrhythmia.Variations of A fib may be termed paroxysmal, persistent, or permanent (these are further described below). A fib is the most common heart arrhythmia. Normal heart contractions begin as an electrical impulse in the right atrium. This impulse comes from an area of the atrium called the sinoatrial or sinus node, the "natural pacemaker" that causes the normal range of regular heartbeats.
Atrial Fibrillation causes:-
Atrial fibrillation may occur without evidence of underlying heart disease. This is more common in younger people, about half of whom have no other heart problems. This is often called lone atrial fibrillation
Symptoms of atrial fibrillation vary from person to person.
  • A number of people have no symptoms.
  • The most common symptom in people with intermittent atrial fibrillation is palpitations, a sensation of rapid or irregular heartbeat. This may make some people very anxious. Many people also describe an irregular fluttering sensation in their chests. This irregular fluttering sensation is due to the irregular rapid ventricular response (rvr) of the ventricles to the rapid irregular atrial electrical activity.
  • Some people become light-headed or faint.
  • Other symptoms include weakness, lack of energy or shortness of breath with effort, and chest pain or angina.
Atrial Fibrillation (A Fib) Medical Treatment:-
Treatment for atrial fibrillation traditionally seeks three goals: to slow down the heart rate, to restore and maintain normal heart rhythm, and to prevent blood clots that may lead to strokes. some the treatments carried away for atrial fibrillation
Cardiac rate control
Restore and maintain normal cardiac rhythm
Prevent clot formation (strokes):
Cardioversion (also termed defibrillation)
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Title: 3

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Title: 3

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