EL DESPERTAR SAI: The Heart Beat

Namaskar,

'The Heart Beat' Newsletter of Sri Sathya Sai Sanjeevani Hospitals - Centres for Child Heart Care - Naya Raipur, Chhattisgarh and Baghola, Palwal, Haryana, for the month of June 2018.

All services rendered are Totally Free of Cost to All. As always.

Kind regards,
Sri Sathya Sai Sanjeevani Team.

Shri Manohar Lal Khattar, Chief Minister, Government of Haryana
Inaugurates
SRI SATHYA SAI SANJEEVANI
RESEARCH CENTRE FOR CONGENITAL HEART DISEASES
Palwal, Haryana on 7th June 2018

Read. Be Inspired. Act.

As Sai Sanjeevani grows, so too has its scope in the world of Congenital Heart Diseases. While continuing its crucial work of curative care, Sai Sanjeevani has now undertaken a bold step in trying to understand the causes of CHD, through the establishment of the Sri Sathya Sai Sanjeevani Research Centre for Congenital Heart Diseases. The Centre was dedicated to the service of humanity by Shri Manohar Lal Khattar, Chief Minister, Government of Haryana on 7th June 2018.

Another important element in supporting Sai Sanjeevani's mission to reduce the global burden of CHD is the emphasis on healthy motherhood in begetting healthy childhood. The Divine Mother and Child Health Program, launched by Sai Sanjeevani in September 2017 has already embraced thousands of women and child across several states in India.Representing Sai Sanjeevani, Dr. Shruti Prabhu, presented about DMCHP at Stanford , California, USA, at the "Ideal Village Conference" on 26th June 2018, and was widely received with great enthusiasm and praise.

A wonderful new milestone was reached at Sai Sanjeevani with the Cath lab team in Palwal celebrating the Completion of their first year of selfless love & service, coinciding with the completion of their 500th intervention! Their 500th cath case happened to be little Bhumi, a child who had been detected for having CHD through the DMCHP screening.

The cath lab facilities at Palwal have also been a blessing for Vanshika, who had been waiting for VSD device closure since 2015 and finally received treatment here, on the day of the inauguration of the research centre by the Chief Minister. Additionally, the research centre at Palwal has become a source of inspiration to many, including young Adithya, who underwent surgical closure of VSD, and expressed his desire to become a scientist and join the lab one day!

The ICU and post-op team at Raipur have worked day in and day out for the last few months continuously to ensure the discharge of little Vimal Tiwari, who battled there for more than 150 days. With great difficulty but immense encouragement and care from the team, he has safely returned home healthy and healed!

It is truly remarkable how the different limbs of Sai Sanjeevani work together in moving the mission forward, enabling the treatment of 54085 Pediatric Cardiac Consultations, 5042 pediatric cardiac surgeries and 512 Cath interventions - All Totally Free of Cost.

Understanding that the role of 'Oneness of body, mind and spirit' in health, Sai Sanjeevani also celebrated International Yoga Day at its two centres and has placed emphasis on relaxation and meditation for patient attenders.

With great fortitude and vigour, we continue walking the path of love and service.

Do stay in touch. We sincerely value it.

Your Sai Sanjeevani Team

On June 7^th 2018, we reached yet another milestone in the journey of the Sai Sanjeevani Palwal with the inauguration of the Sri Sathya Sai Sanjeevani Research Centre for Congenital Heart Diseases, housing India's first Biobank.

INAUGURATION

CHIEF MINISTER' S ADDRESS

Chief Minister, Government of Haryana, Shri Manohar Lal Khattar's address during the inauguration of the Sri Sathya Sai Sanjeevani Research Centre.

RESEARCH . . . THE ANSWER

"With arguably the highest birth rate in the world, India loses 78,000 children annually to congenital heart diseases due to the lack of facilities for evaluation and treatment. Resources are limited, dedicated centres are few, and no national policy exists for pediatric heart care. To address this global burden of congenital heart diseases, we need to look beyond surgery and cath interventions as "treatment without prevention is simply unsustainable" (Bill Gates)

And research may be the answer . . .

The team wants to unravel the mysteries of the basis of CHD through various studies in genomics and proteomics. Samples from all Sai Sanjeevani centres will be pooled at Palwal's biobank. From this nodal point, studies, collaboration and discoveries will hopefully lead to early detection and our main focus: prevention.

The research team draws inspiration from the clinicians of the yore who were physician scientists and surgeon scientists, who did not deter from even self-experimentation, and hence firmly believe that a doctor should not only limit himself to treating a patient and must invest time in understanding the disease and strive for its prevention. All clinicians of Sai Sanjeevani will be encouraged to embrace this.

It is said that where science ends, spirituality begins. However, the research team seeks the blessings of Baba to blend both as they embark on this path of theo-scientific approach."

Dr Prabhatha Rashmi Murthy
Clinical Research Coordinator & Consultant
Pediatric Cardiac Surgery

SAI SANJEEVANI WELCOMES...

PEDIATRIC CARDIAC SURGERIES (June 2018)

95 Pediatric Cardiac surgeries were conducted in June 2018 and 4631 surgeries have been conducted at Sri Sathya Sai Sanjeevani Hospital, Naya Raipur since Inception in Nov 2012, with patients coming from all over the country and other developing countries.

PEDIATRIC OUTPATIENTS ( June 2018)

Out of a total of 1432 ECHOs performed this month, 528 are new pediatric cardiac cases as shown in the table below. Also 358 pre-operative & post-operative and 546 revisit and medical follow up ECHOs were performed. Also the following chart highlights the work of the specialty clinics.

PEDIATRIC CATH INTERVENTIONS ( June 2018)

310 Pediatric Cath Interventions were conducted till date and 74 in June 2018.

PEDIATRIC CARDIAC OUTPATIENT SERVICES (Nov 2016 - June 2018)

Out of a total of 846 ECHOs performed this month, 381 are new pediatric cardiac cases as shown in the table below. Also 90 post-operative, 117 inpatient & TEE screenings and258 revisit and medical follow up ECHOs were performed.

PEDIATRIC CARDIAC SURGERIES AND INTERVENTIONS (Apr 2017 - June 2018)

411 Pediatric Cardiac surgeries have been conducted since April 2017 at Sri Sathya Sai Sanjeevani International Centre for Child Heart Care & Research, Baghola, Palwal, Haryana.502 Pediatric Cath Interventions were conducted till June 2018.

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Pediatric Cardiac Surgeries (June 2018)

Pediatric Cardiac Interventions (June 2018)

All Services are rendered Totally Free of Charge

The work done by Sri Sathya Sai Sanjeevani Hospitals has transcended borders drawing wide acclaim. The Divine Mother & Child Health Program launched by the hospital last year in September 2017 has already touched thousands of lives impacting pregnant women and children in rural areas across 4 states (Chhattisgarh, Haryana, Karnataka & Andhra Pradesh) in India.

The program was presented at Stanford University, California, United States of America at the "Ideal Village Conference" on 26^th June 2018. The vision of the Conference and the Ideal Village program is to provide a holistic, integrated and collaborative technology platform designed to introduce alternate healthcare, energy, education/vocational training, sustainable agriculture, water/waste management systems, and rural entrepreneurship to create self-‐sustainable, economically viable and healthy communities. This year "Empowerment of Women" formed the main theme of the conference, including various sub-themes such as health, education, social impact, rural entrepreneurship and gender equality. Eminent speakers who are stalwarts in their respective fields formed core resource persons for the conference including Dr. Rajiv Bahl, WHO Directorate (Geneva) – Maternal, Newborn, Child & Adolescent Health R&D, Mr. Ashok Venkatesan, Consul General of India, San Francisco, Dr. Kanwaljeet S Anand, Professor of Pediatrics, Stanford School of Medicine and Dr. Sundar Kamath, Senior VP, Sanmina corp. CA. The healthcare session comprised of three talks – the first by Dr. Rajiv Bahl who spoke about WHO programs for maternal and child health implemented across the world, followed by Dr. Clea Sarnquist, Senior Research Scholar, Pediatrics (Infectious Disease), Stanford School of Medicine who shared her experience of initiatives in sub-Saharan Africa.

The Divine Mother & Child Health Program was presented in the healthcare session by Dr. Shruti Prabhu, who heads the Dept. of Public Health & Research at the Naya Raipur hospital. School health screening and maternal health initiative form the main crux of the program. Two videos depicting the work in Chhattisgarh state and Chikkaballapur district, Karnataka state were broadcasted as part of the presentation. Apart from clinical assessment of pregnant women and children in rural government schools and Anganwadis (government pre-school centres), the program lays major emphasis on creating awareness in rural communities about essential information related to a healthy pregnancy & childbirth and combating anaemia & malnutrition through appropriate infant & young child feeding practices. A panel discussion for the healthcare session brought all speakers together where the audience fielded thoughtful questions followed by insightful answers from the speakers.

A short video on the Divine Mother & Child Health Program

The talk was very well received and generated huge interest amongst the participants. HD Medical Company, based in California that designs biomedical devices, dedicated the latest version of its new device called "Vioscope" to the hospital. This device helps in detection of heart conditions with a user-friendly audio-visual interface that could be of major help for detection of Congenital Heart Disease (CHD) in the field even by para-medical or field workers. Founder and CEO of HD Medical, Mr. Arvind Thiagarajan and Consul General, Mr. Ashok Venkatesan presented the device to Dr. Shruti Prabhu, on behalf of the hospital for field trials of the device which will help change the face of CHD detection in rural child health screening.

VIMAL TIWARI
In the ICU for over 150 days

"Vimal", "Vimlu", "mera bachha Vimal", "Vimal ki Mummy"! These were some of the phrases each of the staff in ICU would be heard speaking. One pink walker was always around the person saying these and a toddler with a 50 meter long oxygen tube running around the entire ICU complex. Vimal Tiwari was the longest standing patient in Sanjeevani, Naya Raipur. Operated for TOF in the first week of January, 2018 and twice for diaphragm plication, Vimal stayed in the ICU for 5 months. Vimal was not in a condition to be weaned off the ventilator and later oxygen for almost his entire stay.

Vimal received prayers, wishes, faith, hope and most of all love from the entire Sanjeevani team.

Vimal's father, a government primary teacher from Shankargarh, Allahabad in Uttar Pradesh and his mother, Priyanka, who was in the hospital for the entire duration of the child's surgery and long recovery time, have nothing but gratitude towards each staff member of the hospital. Priyanka feels that there is nothing she can do to repay Sanjeevani ever, for all that she has received. Popularly known as Vimal ki Mummy, she volunteered in Santushti Canteen kitchen all the while her child was in the hospital.

Vimal went home on 25.06.2018. It was a happy-sad moment for all his "sisters" in the ICU and the entire hospital. We could not be happier as Vimal is now healthy enough to go home, but all of Sanjeevani will remember Vimal and his antics. We send him more and more love each day.

ADITYA YADAV
Our Budding Scientist

Aditya, a calm and mature boy of 10, displays an understanding and composure beyond his age. Hailing from UP, he is the last of four siblings and has been carrying the burden of congenital heart disease due to lack of finances. He was successfully operated on the 13^th of June at our Palwal centre for closure of ventricular septal defect (VSD) with relief of RVOTO. He made an excellent recovery and a day prior to his discharge, confided in the surgeon that he wants to grow up to become a scientist.

The research team of Sai Sanjeevani were game for "Aditya's Day Out" in the research lab. Keenly listening to what the researchers had to share, he was able to grasp complex scientific concepts quickly. The budding scientist also got his first taste of scientific experiments wherein he was made to participate in the process of DNA isolation and understand about DNA – the building blocks that make you!

The overjoyed boy left the lab with a lot of memories and a resolution to return back as a scientist for our lab! He made the surgeon's and research team's day when he flashed his endearing smile and said, "I will never forget his day!"

SPECIALTY CLINICS @ SAI SANJEEVANI

4 days old baby - Less than 4 hours from admission to discharge

A baby girl who was barely 4-days old was noted to have fast heartbeat from day 1 of her life. She was admitted to a private NICU in Raipur and was started on multiple anti-arrhythmia medications without much success. The heart-rate continued to be around 200 beats per minute. The baby was unable to breastfeed and had fast breathing as well. On being referred to analyze the baby's ECG, it was noted that she has a very unusual form of neo-natal tachycardia-atrial flutter. The baby was immediately transferred to SSSSH and a five joule shock was given to cardio-vert to a normal sinus rhythm. After successful cardio-version, the baby started breastfeeding after 1.5 hours and remained in sinus rhythm and was then transferred back to the tertiary NICU for routine neo-natal care. This story is a perfect example of appropriate and prompt management after accurate diagnosis as this has very low chance of recurrence and the baby can be considered to have been treated for life.

The entire admission to discharge process at SSSSH is about 3.5 hours and about the shortest one.

ANJALI

Women, Men and Machine: For a Little Girl

Extra Corporal Membrane Oxygenator (ECMO) was given by one distributor to Sai Sanjeevani on goodwill for a while. Little did we know, Anjali's life would be the first successful instance of pediatric cardiac ECMO in the region. Anjali came to Sanjeevani with severe cyanosis and was diagnosed with Tetralogy of Fallot. Her surgery was quite uneventful and she was shifted to the ICU for recuperation. There was a sudden low cardiac output syndrome was observed and arrested following which, she required a cardiac massage and resuscitation for over 30 minutes and she could not be revived immediately. There was a parallel preparation and soon Anjali was taken on ECMOi. The entire team of Perfusionists, led by Ms Pooja Gupta worked continuously for over 24 hours on ECMO and the girl recovered by the next day. Anjali was slowly weaned off the machine and had a good recovery run in the ICU, Step-Down ICU and the post-operative ward before she was sent home, smiling.
Sai Sanjeevani, Naya Raipur is now able to provide ECMO facility which makes the existing pediatric cardiac surgery facility more robust and complete.

Team of Perfusionists: L to R : Suman Kalyan Mondal; Sharath Kumar K.P.; Sumit Maji; Pooja Gupta; Deepika Singh; Premlata Pal

VANSHIKA DWIVEDI

The Pull of Pure Love

Vanshika Dwiwedi, a 17 year old girl from Jhansi, was first seen at Sai Sanjeevani Raipur in 2015 by Cardiologist Dr Yogesh! She had a large inlet muscular VSD, and was decided for Device closure of VSD. Due to non-availability of Cathlab Services then, at Raipur hospital, the child had to wait. When her parents came to know about Cathlab facilities in Palwal hospital, as well as the cardiologist's transfer to Palwal, they followed him here.

After complete Cardiology workup and the necessary fitness from local Gynecologist, Vanshika underwent a diagnostic angiography procedure and after profiling the size of defect, (which measured 20 mm on both sides and 9 mm in length) she was set to undergo the device closure. Her defect had tried to be closed from the usual approach of leg veins (femoral artery-femoral vein AV looping) attempting to deploy the device from venous end (antegrade approach) then later from Arterial end (tetrograde approach).

As both the above couldn't meet the desired entry across the defect, a neck line approach was utilised (where AV loop was achieved between Right Internal Jugular vein and Right femoral artery). Using neck veinous approach, a Muscular VSD device was successfully used for device closure of Ventricular Septal Defect. It was a very challenging situation as various approaches had to be tried out for desired results.

She tolerated the procedure well and was extubated and observed in CCU for next 12 hours, incidentally on the same day of the Research Centre inauguration by Shri Manohar Lal Khattar, Chief Minister of Haryana. She had a good recovery, started walking and regular activities since next morning! She was discharged the next day.

It was a day of great celebration at Sai Sanjeevani in Palwal, Haryana as the Cath Lab team, lead by Dr. Yogesh, completed 1 year of selfless love & service.

This wonderful milestone was also marked by the team's 500th intervention, on little Bhumi, a child who had been screened and detected through the Divine Mother and Child Health Programme of Sai Sanjeevani.

The cath lab in Palwal is one of a kind exclusive pediatriac cardiac cathlab - children are treated here without invasive surgery, allowing them to return home scar-free within 2 days of their procedure!

After heart-felt messages from our doctors, children who had undergone cath procedures in our facilities performed a sweet dance which was accompanied by visuals of the cath team in action over the last 1 year. The tiny tots also felicitated the team by offering roses to all the staff involved in both the Cath lab and cardiac care unit (CCU).

500th child for cardiac intervention
BHUMI SHARMA, 8 years

Bhumi Sharma is an 8 year old girl who was one of the children present during the DMCHP screening at an 'Anganwadi' (a rural child-care centre) in Deoli.

She was screened by the team and refered to Sai Sanjeevani Palwal where she underwent investigations and was diagnosed with a VSD congenital anomaly. Her parents had come to know about her suspected CHD during a routine full-body check up but they did not proceed forward any further as the child showed no observable symptoms. However, the DMCHP team had counselled the family during the screening and advised them to undergo an ECHO by the Cardiologist at Sai Sanjeevani totally free of cost. The family then took the DMCHP advice seriously and Bhumi successfully underwent VSD device closure on 28th June 2018, the 1 year anniversary of cath lab services.

The family is immensely grateful to the DMCHP and Cath team for guiding them & assisting them towards giving Bhumi a healthy heart. They praised the social work done by the hospital to help children in need, and expressed their willingness to counsel peer parents.

BHUMI SHARMA, 8 years

News Articles on the commencement of a Pediatric and Young Adult Heart Rythm management program at Sai Sanjeevani, Naya Raipur and the inauguration of the Sri Sathya Sai Sanjeevani Research Centre for Congenital Heart Diseases by Shri Manohar Lal Khattar, Chief Minister, Government of Haryana.

INTERNATIONAL YOGA DAY CELEBRATIONS

"Only in the Oneness of body, mind and spirit, can we cure that which needs to be endured and endure that which we cannot cure"

Celebrating International Yoga Day with staff and families at the centres in Naya Raipur and Palwal

PARENT RELAXATION SESSIONS

Sri Sathya Sai Sanjeevani Hospital commenced relaxation and counseling sessions for patient attendants during their stay at the Centre.

LITTLE RITIK TURNS ONE!

VSD patient Ritik Gupta has been in the hospital over the last 20 days, and just turned one at the end of the month! He had a wonderful birthday celebration with staff & families of the hospital.