Successfully operated more than 900 cases

All types of Adult Cardiac Surgeries including very high risk cases

Value repair Surgery on regular basis

MICS (Minimal Invasive Cardiac Surgery) a routine affair

Beating heart bypass surgeries

Aortic Aneurysm Surgeries

Pediatric Cardiac Surgery such as surgery for ASD, VSD, PDA, TOF, DORV etc

Surgical RFablation for atrial fibrillation only center in Odisha

Thoracotomy approach for CABG and Valve surgeries

Combined CABG & Carotid end arterectomy

Combined CABG and peripheral artificialbypass surgery

OPCAB in dextrocardia (A rare birth defect where all the internal organs of body are present in the opposite side) with critical LMCA disease (only 2 cases so far reported in the world)

Facilities for mechanical circulator support like ECMO (Extra Corporeal Membrane Oxygenation) available

All adult Cardiac surgery. Valve Repair / Replacement, CABG (Particularly beating Heart bypass surgery), Post MI Ventricular Septal Rupture Repair, Congenital heart surgeries like ASD, VSD, PDA, ICR for TOF etc. Major Vascular surgeries, Aortic aneurysm surgery. Lung resections surgeries. Mediastinal tumor surgeries, Peripheral Vascular surgeries like vascular repair or bypass embolectomy. AV Fistula, Varicose Veins surgery.

FACILITIES :

Twin Modular OT with 13 bedded well equipped ultra modern Cardiothoracic ICU.

Round the clock well experienced doctors, trained nursing and paramedic staff availability in hospital for patient care.

EQUIPMENTS  :

Most sophisticated advanced Heart lung machine, IABP.

Advanced Ventilators with neonatal care facility.

Advance monitors.

High end cardiac surgical instruments particularly for Minimal Invasive Cardiac Surgery.

Heart Valve Changed Without Open Heart Surgery at KIMS for the First Time in Odisha

In a landmark advancement in the medical field in Odisha, the Kalinga Institute of Medical Sciences (KIMS) has done the first case of transcatheter aortic valve replacement (TAVR). This state of the art procedure was done at KIMS by Cardiologist Dr. Anupam Jena and his team Dr. Michael Caskey from USHA helped the team in successfully performing the procedure.

The patient was a 72 years old female who was suffering from narrowing of the aortic valve. She was complaining of chest pain and breathing difficulty. The patient was evaluated by cardiologist and cardiac surgeon and was found to be at high risk zone for carrying out of an open heart surgery. She was advised to undergo Trans-catheter Aortic Valve Replacement (TAVR). Subsequently, the patient underwent TAVR.

She is doing well now and will be discharged in 2-3 days. TAVR or Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure that repairs the Aortic valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place.

Somewhat similar to a stent placed in a coronary artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow. This procedure is fairly new and is FDA approved for people with symptomatic aortic stenosis who are considered an intermediate or high risk patient for standard valve replacement surgery. Usually valve replacement requires an open heart procedure with a “sternotomy”, in which the chest is surgically separated (open) for the procedure.

The TAVR or TAVI procedures can be done through very small puncture in the femoral arteries at the groin leaving all the chest bones in place. A TAVR procedure provides beneficial treatment options to people who may not have been candidates for them a few years ago while also providing the added bonus of a faster recovery in most cases.

A patients experience with a TAVR procedure may be comparable to a balloon treatment or even an angiogram in terms of down time and recovery, and will likely require a shorter hospital stay (average 3-5 days).

Most cancers are preventable if detected early. It can also be due to some other factors such as obesity that tend to run in families and influence cancer risk. These high-risk individuals can be identified by clinical evaluation and genetic tests. Targeted screening can identify cancer at pre-cancer or early stage. Besides improving chance for cure it also lowers the side effects related to cancer treatment. Hence, screening needs to be personalized based on clinical examination.

The department is a full-fledged unit with a wider range of treatments provided including chemotherapy, radiotherapy and surgical procedures. Highly skilled and qualified onco-surgeon assisted by a team of well-trained junior onco-surgeons and trained nurses and paramedics are available on-board. Outdoor consultation and indoor services are provided in wards and air-conditioned cabins. All sorts of onco-surgeries are conducted in a sophisticated OT complex regularly.

Rare Combination of Diseases Diagnosed and Managed at KIMS

The Department of Surgical Oncology is always at the forefront when it comes to taking up challenging cases, with specialized services being offered for cancer affecting most parts of the human body. Recently, a challenging and rare case was diagnosed and managed by us with the active guidance of Specialists from the disciplines of Orthopaedics, Endocrinology, Radio diagnosis, Pathology and Laboratory services.

A 70yr old male presented to Orthopedics Consultant Dr. Debashis Mishra with complaints of severe incapacitating low back pain progressing over past 1 year, making him bedridden for most part of the day. He had been evaluated at various centres in our state and nearby with repeated MRI scans, and various lines of management without much relief. After admission to inpatient ward, initial evaluation and management of pain and associated problems, the case was referred to Surgical Oncology for opinion and evaluation for any malignant etiology; Dr. Sabyasachi Parida, Consultant, Surgical Oncology took up the case.

Further tests were advised which revealed generalized osteoporosis with multiple lytic skeletal lesions involving entire spine, pelvic bones and multiple collapsed dorso-lumbar vertebrae. Skeletal survey did not reveal any other bone lesions.Such a presentation can be due to several diseases, including several types of malignancies and non malignant diseases. Specific tests were ordered which revealed M-spike in gamma globulin region on serum electrophoresis & plasmacytosis on bone marrow biopsy- suggestive of Multiple Myeloma.

Further evaluation was requested from Endocrinologist to rule out other possible etiologies in view of osteoporosis and atypical presentation of multiple myeloma. Dr. Dayanidhi Meher, Consultant Endocrinology, investigated the case further which revealed very high parathormone and serum calcium levels. He emergently treated the patient to achieve normal calcium levels. MIBI scan revealed increased uptake in left superior parathyroid gland. Dedicated imaging to localize the gland was done by Dr. Sanjeet Mishra, Consultant and Radiodiagnosis.

Thus a diagnosis of MULTIPLE MYELOMA WITH PRIMARY HYPERPARATHYROIDISM was reached. This is significant because such a combination of diseases is rare and could have been easily missed , had it not been for the clinical acumen and dedicated efforts of all the concerned specialists.

Left superior parathyroidectomy was done by team of Surgical Oncologists Dr. Sabyasachi Parida & Dr. Saroj Ranjan Sahoo with intraoperative blood sampling for parathormone pre excision and post excision from both internal jugular veins and peripheral blood which confirmed normalization of parathormone post excision- express reports provided by Central Laboratory , KIMS.

This patient is doing well now and undergoing chemotherapy with significant resolution of symptoms.

Neurosurgery department at KIMS is emerging as a Center Of Excellence . It is credited with round the clock Neurosurgical services by a team of committed Medical and Paramedical staff.

Department is equipped with state of art Neurosurgical equipments and Infrastructure.

We Provide full range of Neurosurgical Specialty services.

OUR SPECIALITIES INCLUDE

Brain tumors

Spinal care

Cerebro-Vascular Diseases

Pediatric Neurosurgery

Endoscopic procedures

Neuro-trauma & Neuro- Critical Care.

VARIETIES OF CASES

Various type of brain tumours, spinal tumours, cervical tumours, head injury, congenital spinal dysraphism, shunt surgery ( Ventriculo peritoneal shunt, Ventriculo arterial shunt, lumbo peritoneal shnt), chronic subdural hematoma, spontaneous infra cerebral & cerebellar hematoma, endoscopic/ microscopic assistant , transphenoidal surgery for pituitary tumour.

RARE CASES

Clival chordoma, sellar adenoid cyst, multiple tubsculoma brain, multiple clavarical vascular hematoma

A rare case of Spinal Dysraphism having multiple lesions .

(Split cord malformation ,Dorsal Meningomyelocele, Syringomyelia , Chiari- I malformation )

A 7 week old ,3.5 kg body weight, full term baby was brought by parents with the complains of a soft swelling over his back . The swelling was present since birth and was gradually increasing in size. Apart from the swelling in the back child did not have any other problems .

ON EXAMINATION

General condition was good, child was active and playful.

No evidence of any neuro-cutaneous markers , skeletal or urological deformities

Head Size was normal for the age with Lax A.F.

CNS Examination : No Neurological deficits .

Local examination of the swelling: 5x4x4 cm swelling over upper Dorsal spine , soft cystic in nature with positive trans illumination and thin skin cover.

TREATMENT

Although child was not having any neurological deficits but was offered surgery in order to :

Prevent future neurological deficits which are inevitable

Prevent CSF leak

Preserve Motor, Sensory and Intellectual function

And restoring the spinal cord to normal

SURGERY

(A) Dorsal Meningomyelocele

Excision of the sac was achieved with preservation of neural tissue, multilayered closure with good skin covering .

(B) Split cord Malformation (SCM type I ) at D 6-7

The area of split cord was exposed, Bony Spur in between two hemi cords and the sac was removed using high speed drill and microsurgical techniques . After removal of the bony spur , the single dural sac was reconstructed to lodge both the hemi-cords. Water tight closure was achieved.

Department of Gastroenterology and Hepatology, KIMS is headed by Prof Anil C Anand (MD, DM, DNB). The mission of the department is to provide comprehensive high end clinical care as well as emergency services for patients suffering from disorders of digestive tract and liver through a team of highly experienced Gastroenterologists supported by state of art technology.

It provides routine OPD as well as round the clock emergency services for all disorders of digestive system, liver and pancreato-biliary system including both basic and advanced endoscopic diagnostic and therapeutic procedures.

The department has been instrumental in starting the following therapeutic modalities in the state of Odisha which were lacking earlier and patients used to travel out of the state for the same.

Diagnostic endoscopy & colonoscopy

Very thin endoscope (paediatric endoscopy) for small children

Therapeutic endoscopy like sclerotherapy, variceal banding, coagulation, hemoclip application to stop ongoing Gl bleeding

Dilatation (widening) of narrowed food passage

Removal of small tumour by endoscope without surgery (polypectomy)

Liver biopsy

Fibroscan [for noninvasive (painless) assessment of liver fibrosis]

Breath tests for small intestinal bacterial overgrowth and H pylori infection

Enteroscopy (endoscopy of small intestine) to find out the cause of unexplained anemia, obscure GI bleeding, diarrhoea

Pneumatic balloon dilatation of Achalasia Cardia

Percutaneous endoscopic gastrostomy (PEG)

ERCP with removal of bile duct stone, dilatation & plastic stent placement for benign biliary stricture and pancreatic duct stenting and stone removal (for pancreatitis)

Metallic biliary, esophageal, pyloric, enteral & colonic stenting

Endoscopic cystogastrostomy(for pancreatic pseudocyst) & endoscopic necrosectomy(for walled of pancreatic necrosis (WOPN)

Capsule endoscopy

Endoscopic ultrasound (EUS)

Minimally invasive step-up approach in management of necrotizing pancreatitis

A 28 year male patient admitted to the gastroenterology department with pain abdomen, vomiting, abdominal distension after a binge drinking of alcohol. On investigation, serum amylase and lipase was 1400 u/l and 1860 u/l respectively and CECT abdomen showed pancreatic necrosis in tail region with left paracolic gutter extension (Figure 1). He was managed with intravenous fluid, pain alleviation and enteral nutritional support and discharged after 7 days with diagnosis of moderately severe acute pancreatitis based on revised Atlanta classification as he did not had any organ failure during hospitalization.

He was re-admitted 3 weeks later with increased pain abdomen and fever. USG abdomen showed collection in pancreatic tail region with left paracolic gutter and iliopsoas extension with air foci inside the collection (Figure 2 and 3). Presence of air foci inside pancreatic collection in a previously non-intervened patients raise suspicion of either fistulous communication with bowel loop or infection of pancreatic necrosis. CECT abdomen with rectal contrast was done and it did not reveal any fistulous communication. He was started on carbapenem empirically and USG guided 12 fr percutaneous catheter drain (PCD) was placed. Pus was drained through the PCD and culture grown Escherichiacoli, which was sensitive to carbapenem. He received 10 days of antibiotics and discharged with PCD in-situ (draining approximately 100 ml daily) and advice of daily catheter care.

Two weeks later he was doing fine on out-patient follow up, drain out put of 20 ml per day but USG showed approxmately 700 ml of residual collection. The PCD was upgraded to 16 fr and again it started draining 100 ml per day. A fortnight later re-evaluation showed drain output of approxmately 100 ml per day and pancreatic external fistula was suspected. He was taken for endoscopic retrograde cholangiopancreatography (ERCP) and pancreatic duct stenting. Pancreatogram showed contrast leak from the tail region and 7 fr x 12 cm pancreatic stent was placed. Post-pancreatic duct stenting drain output started decreasing and stopped on day 10. USG assesment showed no significant residual collection and PCD was removed. Now into 2 month follow up post pancreatic duct stenting he is doing fine with no radiological evidence of any residual collection (Figure 4) and plan is to remove the stent after another 1 month.

Figure 1: CECT andomen showing necrosis in tail region of pancreas

Figure 2: CECT andomen showing collection in left paracolic gutter with air foci

Figure 3: CECT andomen showing collection in left paracolic gutter with air foci

Figure 4: Follow-up USG showing only inflammatory changes, no collection

Total Hemodialysis done=37500(approx)

Certain special categories of these patients are mentioned here

Sepsis induced kidney failure 1000 (approx)

Falciparum malarial ARF =432

Snake Bite - 05 appox.

Bee Sting Bite- 07 appox.

Scorpion Bite- 03 appox.

Road traffic accidents with crush injury & myoglobinuria - 15 appox.

Hepato Renal Syndrome - 18 appox.

Multiple Myeloma associated Kidney Failure

Department was established in 2006 after joining of Prof. (Dr.) S. C. Dash with following Objectives.

Diagnose & treat patients of kidney diseases & kidney failure, hypertension & diabetes, Immunological ailments with renal involvement.

To start hemodialysis & other forms of dialysis, blood purification, CAPD, SLED, Plasmapheresis, etc.

To start Renal Transplantation

State of art hemodialysis & Kidney Care advice

Medical Colleges & practicing Institutes. constantly during the period of dialysis

Emergency dialysis done any time between midnight till morning.

Unit works in close associations with ICU.

A. Renal Pathology  :

Kidney Biopsy studies

Light microscopy

Immunofluorescence

Immuno peroxidase

Immuno histochemistry

Renal Serology

Correlated to serology

(Tests to detect infection & dysproteinurimia or autoimmunity)

B. Renal Radiology & Imaging :

USG, Doppler USG

CT, Spiral CT

MR Urography

Constrast angiography

MR Angiography

C. Renal Biochemistry & Immunologic Screening

D. Nuclear Study (TC, DTPA Scan, DRCG) :

Acute Kidney Injury / Failure

Chronic Kidney Failure

Diabetic Nephropathy

Hypertensive Kidney Failure

Pregnancy related kidney failure

Complicated AKI

Auto Immune Kidney Diseases like SLE & ANCA

Vasculities

Adult polycystic kidney Disease & other

hereditary diseases

Kidney stone disease

Prostatic Obstruction

Dysproteinemias like multiple myeloma, MGUS,

MGRS, APLA etc

Post kidney Transplant complications