care institute of medical sciences outcomes2 what's inside n n board of directors n awards n...
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Outcomes2017
Care Institute of Medical Sciences
A premier multi-super specialty hospitalGREEN
Green Hospital
International Centers Of Excellence
2
What's Inside
n
n Board of Directors
n Awards
n Abbreviations
n About CIMS
n Departmental Overview
n In Vitro Fertilization Center
n Heart Transplant
n Bone Marrow Transplantation Unit
n Renal Transplant Center
n Blood Bank
n Genetic Center
n Fever Clinic
n National Cardiovascular Data Registry
(NCDR): Knowledge Processing
n Cardiology
n Cardiac Investigations
n Cardiac Rhythm Disorders
n Cardiac Surgeries
n Heart Failure
n Cardiac Valve Disorders
n Minimal Invasive Cardiac Surgery
n Pediatric Cardiac Sciences
n Vascular and Endovascular Surgery
n Thoracic
n Orthopedic
n Critical Care
n Infectious Disease
n Pulmonary Medicine
n Neurosurgery
n Spine Surgery
n Trauma Center
n Gastro-Intestinal and General Surgery
Vision, Mission and Values n Endoscopy
n Oncology
n Nephrology
n Urosurgery
n Bariatric and Metabolic Surgery
n Plastic Surgery
n Obstetrics and Gynecology
n Neonatal Center
n ENT
n Pain Management
n Dentistry
n Ophthalmology
n Pathology
n Radiology
n Physiotherapy, Rehabilitation and Nutrition
n Code Blue
n Quality Measures
n Ambulance and Transport Services
n Care At Homes
n Patient's Say
n Ethics
n Research Projects
n CIMS Foundation
n CIMS Learning Center
n CIMS Education
n Publication List
3
Vision, Mission and Values
To be one of the most trusted
hospital in India by providing personalized care
for best patient experience.
VISION
Care
Innovation
Manage Lives
Save Lives
MISSION
To provide superior quality
Health Care using Innovation
to Manage and Save lives.}VALUES
Patient’s well-being: It will be our top most priority
To Serve with a Smile
Adopt and encourage ethical practices
Provide a safe and comfortable working environment
to employees and associates
Embrace technology and innovation in the delivery
of healthcare
Provide socially responsible and safe healthcare
Comply with all applicable laws and regulations
4
Board of Directors
Dr. Hemang Baxi
Director
Dr. Anish Chandarana
Executive Director
Dr. Milan Chag
Managing Director
Dr. Urmil Shah
Director
Dr. Ashit Jain
Director, USA
Dr. Dhiren Shah
Director
Dr.(Prof.) Dilip Mavlankar
Director, India
Dr. Satya Gupta
Director
Dr. Kamlesh Pandya
Director, USA
Dr. Ajay Naik
Director
Mr. Kirti Patel
Director, UK
Dr. Keyur Parikh
Chairman
5
Awards
Ethics Committee of Care Institute of Medical Sciences (EC
CIMS) is the first Ethics Committee in India accredited by
National Accreditation Board for Hospitals and Healthcare
Providers (NABH).
We are proud to announce that CIMS Hospital has
been recognized as the Times Health Icon 2018 in 2
categories Multispecialty Hospital- Oncology and
Multispecialty Hospital-Critical Care.
CIMS Hospital is proud to announce that Care at Homes
have received one of the most promising Home
Healthcare Service Providers Certificate.
6
Abbreviations
3-D USG 3 Dimension Ultra Sonography
4D 4 Dimension
ACC American College of Cardiology
ACL Anterior Cruciate Ligament
ADR Adverse Drug Reaction
AHA American Heart Association
ASD Atrial Septal Defect
ATLS Advanced Trauma Life Support
AVM Arteriovenous Malformation
AVR Aortic Valve Replacement
BAS Balloon Atrial Septostomy
BAV Bicuspid Aortic Valve
BLS Basic Life Support
CABG Coronary Artery Bypass Grafting
CAD Coronary Artery Disease
CAE Carotid Artery Endarterectomy
CAS Carotid Artery Stenting
CCB Calcium Channel Blocker
CHF Congestive Heart Failure
CME Continuing Medical Education
CNS Central Nervous System
CO Cardiac Output
CPAP Continuous Positive Airway Pressure
CPK-MB Creatine Phosphokinase Muscle Brain
CPR Cardiopulmonary resuscitation
CRI Chronic Renal Insufficiency
CRRT Continuous Renal Replacement Therapy
CRT Cardiac Resynchronization Therapy
CRT-D Cathode Ray Tube Defibrillator
CT Scan Computed Tomography Scan
CTG CardioTocography
CUSA Cavitational Ultrasonic Surgical Aspirator
D&C Dilatation And Curettage
DCGI Drug Controller General of India
DHS Dynamic Hip Screw
DMLC Dynamic Micro Multileaf Collimeter
DORV Double Outlet Right Ventricle
DVR Double Valve Replacement
DWI Diffusion-Weighted Imaging
EC Ethics Committee
ECG Electrocardiogram
ECMO Extra Corporeal Membrane Oxygenation
ECO Echocardiogram
EF Ejection Fraction
EP Electrophysiology
ER Emergency Room
ERCP Endoscopic Retrograde Cholangiopancreatogram
EUS Endoscopic Ultrasound
EVD External Ventricular Drain
FDA Food and Drug Administration
FFF Field-Flow Fractionation
GERD Gastroesophageal Reflux Disease
GI Gastrointestinal
GIST Gastrointestinal Stromal Tumor
HF Heart Failure
HIV Human Immunodeficiency Virus
HMD Hyaline Membrane Disease
HTN Hypertension
I&D Irrigation and Debridement
IABP The Intra-aortic Balloon Pump
ICD Implantable Cardioverter Defibrillator
ICR Intracardial Repair
ICU Intensive Care Unit
IDET Intradiscal Electrothermal Therapy
IV Intravenous
JIC Joint International Conference
7
Abbreviations
L.S.C.S Lower Segment Cesarean Section
LDH Lactate Dehydrogenase
LED Light Emitting Diode
LOS Length of Stay
LV Left Ventricle
LVEF Left Ventricular Ejection Fraction
MARDS Montgomery-Asberg Depression Rating Scale
MAVRIC Multiacquisition Variable-Resonance Image
Combination
MI Myocardial Infarction
MICS Minimally Invasive Cardiac Surgery
MLC Mixed Lymphocyte Culture
MR Mitral Regurgitation
MRI Magnetic Resonance Imaging
MV Mitral Valve
MV Repair Mitral Valve Repair
MVR Mitral Valve Replacement
MWD Molecular Weight Distribution
NCDR National Cardiovascular Data Registry
NIBP Non-Invasive Blood Pressure
NT Pro BNP N-Terminal Pro B-Type Natriuretic Peptide
O Oxygen2
OT Operation Theatre
PACS Picture Archiving and Communication System
PAH Pulmonary Artery Hypertension
PAMI Percutaneous Arterial Myocardial Infract
PAP Pulmonary Artery Pressure
PCI Percutaneous Coronary Intervention
PCNL Percutaneous Nephro Lithotomy
PDA Patent Ductus Arteriosus
PET Scan Positron Emission Tomography
PFT Pulmonary Function Test
PICU Pediatric Intensive Care Unit
PPHN Persistent Pulmonary Hypertension
PSG Polysomnography
PT Prothrombin Time
PTCA Percutaneous Transluminal Coronary Angioplasty
PTSMA Percutaneous Trans Luminal Septal Myocardial
Ablation
QoL Quality of Life
RAS Reticular Activating System
RCT Root Canal Treatment
RFA Radiofrequency Ablation
RIS Radiology Information System
RTA Renal Tubular Acidosis
SICU Surgical Intensive Care Unit
SpO Saturation of Peripheral Oxygen2
STEMI ST Elevation Myocardial Infarction
SVR Surgical Ventricular Restoration
TAPVC Total Anomalous Pulmonary Venous
Connection
TB Tuberculosis
TEE Tread Mill Test
TEVAR Thoracic Endovascular Aortic Repair
TOF Tetralogy of Fallot
TURP Trans-Urethral Resection of Prostate
TV Triple Vessel
URS Ureteroscopic Lithotripsy
V.P. Ventriculoperitoneal Shunt
VLBW Very Low Birth Weight
VSD Ventricular Assist Device
8
About CIMS
A 350-bedded, multi-super specialty, Care Institute of Medical Science (CIMS) Hospital is one of the best hospitals of
Ahmedabad (Gujarat) providing a range of diagnostic and treatment services.
Delivering the highest standards of global healthcare, CIMS Hospital is accredited by JCI – Joint Commission
International (USA), NABH (National Accreditation Board for Hospitals & Healthcare Providers) and NABL (National
Accreditation Board for Testing and Calibration Laboratories) for providing quality healthcare and patient safety
across India.
Spread across two spacious and state-of-the-art buildings CIMS East and West, CIMS Hospital offers a combination
of the most experienced doctors, latest technology and excellent infrastructure-ensuring world -class patient care
and treatment.
The Hospital has evolved a culture to deliver human and compassionate care to its patients.
Our motto of ‘‘Patient First Always” is the backbone of firm commitment to deliver the best and safest care to our
patients.
CIMS Hospital Scores High on Technology:
n Gujarat’s first digitized operation theatres and ICUs.
n Gujarat’s First ECMO facility
n Latest Cancer Radiation machines
n Latest Radiology- MRI and CT scans
n Gujarat’s first certified GREEN Operation Theaters: certifying for safe practices and environment friendly
features such as low emission of carbon dioxide, infra-red rays and radiation within permissible limits.
n One of the most advanced ultra-modular and fully monitored emergency & trauma facility
n Adding to its clinical triumphs, CIMS Hospital following first heart transplant has further performed a total of 5
heart transplants - the only center in Gujarat to perform heart transplant. Besides, CIMS has also recently
established Paediatric Bone Marrow Transplant program and Blood Bank within the premises of the hospital to
facilitate smoother services for all patients.
9
About CIMS
CIMS Flagship
n JCI (Joint Commission International), NABH(National Accreditation Board for Hospitals and Healthcare
Providers) and NABL(National Accreditation Board for Testing and Calibration Laboratories) accreditation
n NABH Emergency
n NABH Ethics committee (First in India)
n Green OT
n First Heart Transplant Surgery of Gujarat
n Paediatric Bone Marrow Transplant Unit - First in Gujarat
n Radial Lounge (One of the first in the country)
n TAVI (Transcatheter Aortic Valve Implantation ) - First in Gujarat
n Digitized OTs and ICUs for better patient care - First in Gujarat
n Certified Heart and Renal Transplant Center
n First ever ECMO (Extracorporeal Membrane Oxygenation) machine for patients with cardio respiratory failure
n The High level Isolation Unit (HLIU)
n First in Asia Pacific to set up Elekta Versa HD for cancer radiation treatment
n One of the only private Hospital in Western India with 3 Cath labs
n One of the only Indian International Center of Excellence(ICOE) certified by American college of Cardiology
(ACC)
n Care at Homes : A branch of homecare for medical and nursing care at home
n Hospital to Home visits to improve drug (medicine) adherence and patient compliance
n A fleet of well-equipped ambulances with ECMO facility; pediatric ambulance
n Exclusive Trauma Center following ATLS (Advanced Trauma Life Support) protocols Center
n Round-the-clock dialysis facility
n Ethics Committee that provides assistance with ethical issues related to patients' safety and well-being.
10
About CIMS
Technological Excellence
n State-of-the-Art Equipment
n High-end Cath Labs with DSA and stent boost facility
n CT Scan Revolution EVO 128 slice-First in India
n MRI Signa Explorer Electrophysiology with 3D system
n Echocardiography machines with 3D-TEE, 3D adult and pediatric Echo
n 24 x 7 x 365 'stroke' unit with latest CT scan with CT angiography and perfusion scan facilities First in India
n PACS system to view various imaging in ICU and doctor's lounge
n Carto-3 system, state-of-the-art imaging system offers enhanced visualization for treating arrhythmia patients
n State-of-the-art 12 operation theaters 4 modular OT's with class 100 laminar air flow traction device with IITV to
support all types of trauma fully digitized ICUs and OTs
n Extracorporeal membrane oxygenation (ECMO)
n Dedicated Neutropenic Care
n Gujarat’s First Carl Zeiss Pentero 900 Microscope (High - end path breaking innovation for enhanced
visualization during surgery)
11
Departmental Overview
+ Myxoma
12
Departmental Overview
13
In Vitro Fertilization Center
CIMS IVF Center has word class facility with state-of the-art IVF
infrastructure with individualized air handling unit + HEPA filters +
SS modular OT walls in embryology and andrology lab.
IVF is Useful to Treat Patients With
n Blocked or damaged fallopian tubes
n Male factor infertility including decreased sperm count or
motility
n Women with ovulation disorders, premature ovarian failure,
uterine fibroids
n Women who have had their fallopian tubes removed
n Individuals with a genetic disorder
Services at CIMS IVF Center:
n Ovulation Induction
n Intrauterine Insemination
n Reproductive Surgery: Laparohysteroscopy for evaluation of infertility
n IVF- In Vitro Fertilization
n Assisted Hatching
n Genetic Counselling
n Frozen Embryo Transfer
n Cryopreservation
n ICSI -Intra Cytoplasmic Sperm Injection
n Andrology Services
n Surgical Sperm Retrieval
n Family-friendly labour and delivery suites
n Expert in high risk deliveries with continuous monitoring
n Epidural and pain management through in-house anesthesiologists
n Neonatal Intensive Care Unit (NICU)
14
Heart Transplant
CIMS Hospital Ahmedabad achieved one of the rare
feats by performing the first heart transplant surgery in
Gujarat
Heart Transplant is the gold standard treatment for
advanced heart failure patients. Through integration of
transplant research, education, and patient care, the
CIMS Heart Transplantation Center has established
itself as a premier heart transplant hospital in Gujarat.
CIMS's heart transplant doctors and surgeons use
proven innovations to successfully treat people with
congestive heart failure and other serious heart diseases. Their experience in using advanced technology,
specialized procedures
and an in tegra ted
approach focused on
the patient makes CIMS
Hospital a leader in
transplant outcomes.
H e a r t t r a n s p l a n t
surgeons are experts in
a range of complex
procedures. Our center
has Advanced Heart
Failure Unit to treat
Heart Failure cases, and
Heart Transplant Team
consisting of full-time
c o n s u l t a n t s ,
Technicians and Nurses
is working round-the-
clock to deliver world-class results.
CIMS Heart Transplant Team has successfully completed 5 Heart Transplant so far.
15
Bone Marrow Transplantation Unit
High Quality Care at affordable costs at Sankalp- CIMS Center for Pediatric
Bone marrow Transplantation
Sankalap India Foundation jointly with support of CIMS hospital takes care of
the financial, socio-economic and patient management aspects at the Center.
Italy based Cure2Children Organization under leadership of Dr. Lawrence
Faulkner joined hands to provide expert protocol based care to such patients.
This joint venture is a conglomeration of three organizations, who are
committed to this noble cause and believe that no child with thalassemia, if
eligible for transplants should be denied the same , either due to lack of funds
or facilities.
The Bone Marrow Foundation supports patients, their families and caregivers
at every step during a bone marrow, stem cell or cord blood transplant. No
transplant patient should ever feel alone.
A bone marrow, stem cell or cord blood transplant is an overwhelming experience—physically, emotionally, logistically
and financially—both for patients and for their families.
The Bone Marrow Foundation was founded in 2016 with a single vital goal: to improve the quality of life for children and
adults who are undergoing transplantation as a life saving treatment for leukemia, Hodgkin’s and non-Hodgkin’s
lymphomas, multiple myeloma, aplastic anemia, severe combined immunodeficiency, neuroblastoma and many other
cancers and genetic disorders.
The Bone Marrow Foundation is guided by a medical advisory board of nationally recognized physicians in the field of
transplantation. Our Bone Marrow Transplantation unit provides vital financial assistance for donor searches,
compatibility testing, bone marrow
or stem cell collection, cord blood
banking, medications, medical
equipment, home and child care
services, housing, transportation
and other patient needs.
In a very short span of time of a months CIMS Bone Marrow Transplant Team has completed 44 successful
transplants.
16
Renal Transplant Centre
CIMS’s Kidney Transplant Program has saved and improved
lives. Every patient benefits from state-of-the-art medical
expertise, the finest renal surgeons and equipment, and a focus
first and foremost on well-being.
Each patient receives unique access to all medical treatments in
one location and benefits from an important personal touch: the
entire team – including a patient coordinator for each transplant
patient – is dedicated to ensure an optimum experience for the
patient and family.
Successful transplant is life-changing – and the start of a lifelong partnership between the patient and transplant team
helps ensure ongoing good quality of life. Patients are closely followed by CIMS Hospital’s team for the first few months
after surgery. Patient’s transition back to their referring doctor’s care, but the transplant team sees patients annually,
for life.
A kidney transplant is necessary when a
patient is diagnosed with end-stage renal
(kidney) disease. Causes include
diabetes, hypertension (high blood
pressure), polycystic kidney disease,
l u p u s a n d g l o m e r u l o n e p h r i t i s .
Immunosuppressive therapy before
surgery and for the lifespan of the
transplanted kidney helps prevent organ
rejection.
CIMS Renal Transplant Team has
completed 9 successful Renal
Transplants.
Photo of successful renal
transplant patient and team
17
Blood Bank
CIMS Blood Bank ensures safety of blood donor and blood recipient (patient)
“Safe Blood” gives life, “Unsafe blood” gives infections.
Standard Operation Process for Blood Transfusion
n “Strict “Donor Screening”
n “Testing” of collected blood as per WHO & NACO specified standards
n Reliable “cross-matching” of blood samples to ensure safe blood transfusion to patient
Medical Examination of Blood Donor.
In Good HealthAge: 18 - 60 years Weight : > 45 kgs Hemoglobin Level:
> 12.5 gms/dl
HIV 1 & HIV 2 Hepatitis B Hepatitis C VDRL (syphilis) Malaria
We follow international protocols of donor eligibility criteria to ensure safety of blood donor.
Blood test for :
Blood grouping | Hemoglobin
Blood pressure
Pulse
General physical
examination
18
Genetic Centre
CIMS Genetics team works into the causes and inheritance of genetic disorders. We treat birth defects and
dysmorphology, mental retardation, autism, and mitochondrial disorders, skeletal dysplasia, connective tissue
disorders, cancer genetics, teratogens, and prenatal diagnosis.
We treat or advice regarding neurologic, endocrine, cardiovascular, pulmonary, ophthalmologic, renal,
psychiatric and dermatologic conditions.
Our clinical geneticist’s advice with particular attention to hereditary disorders.
Examples of genetic syndromes that are commonly seen in patients include chromosomal rearrangements,
Down syndrome, DiGeorge syndrome (22q11.2 Deletion Syndrome), Fragile X syndrome, Marfan syndrome,
Neurofibromatosis, Turner syndrome, and Williams's syndrome.
Services Offered at CIMS Genetics Unit
n Diagnostic evaluation.
n Management of inborn errors of metabolism, skeletal dysplasia, or lysosomal storage diseases.
n A prenatal genetics clinic to discuss risks of pregnancy (advanced maternal age, teratogen exposure,
family history of a genetic disease), test results (abnormal maternal serum screen, abnormal ultrasound),
and/or options for prenatal diagnosis (typically amniocentesis or chorionic villus sampling).
n Support of a clinical geneticist or genetic counselor (cancer genetics, cardiovascular genetics, craniofacial
or cleft lip/palate, hearing loss clinics, muscular dystrophy / neuro degenerative disorder clinics)
n Genetic counseling is the process of providing information about genetic conditions, diagnostic testing, and risks
in other family members, within the framework of nondirective counselling. Our genetic counsellors guide in
family risk assessment and counselling of patients regarding genetic disorders.
Pediatrics Genetics evaluation is helpful in cases of
1) Developmental delay
2) Mental retardation
3) Congenital abnormalities
4) Dysmorphology (unusual physical features)
5) Growth problems
6) Certain syndromes (e.g., mental retardation, distinct facial features, and heart defects)
7) Lysosomal Storage Diseases (LSDs)
8) Inborn errors of metabolism
19
Genetic Centre
The geneticist's advice is helpful in cases of
n Advanced maternal age (age 35 or older)
n First trimester/nuchal screening pre-test education/ counselling
n Abnormal maternal serum screening
n Concerns about genetic disease because of ethnicity – Thalassemia, Sickle Cell Disease
n Abnormal ultrasound findings
n Previous child with a genetic condition, birth defect(s) and/or mental retardation
n Recurrent miscarriages
n Family/personal history of genetic condition
n Family/personal history of birth defect(s)
n Family/personal history of mental retardation
n Medication exposures during pregnancy
n Considering Preimplantation Genetic Diagnosis (PGD)
20
Fever Clinic
The High level Isolation Unit (HLIU) is run by a dedicated team of doctors, nurses and laboratory staff from the CIMS
infectious diseases service. Access to the unit is restricted to the team of specially trained medical staff. The HLIU is
designed to ensure our medical
staff can safely treat a patient with a
dangerous infectious disease. A
special ly-designed tent with
controlled ventilation is set up
around the patient’s bed and allows
the staff to provide clinical care
handling the infection.
n There are various facilities in
place including a specific
entrance for the patient,
a u t o c l a v e s w h i c h
decontaminate waste and a
dedicated laboratory for
carrying out tests, all of which
help to ensure the patient can be
treated safely and securely.
n All the air leaving the unit is
cleaned so there is no risk to
anyone at the hospital.
The high level isolation unit is always fully prepared to admit a patient with a highly infectious disease at very short
notice.
21
A Contemporary View of Cardiac Care at Care Institute of Medical Sciences (CIMS): A Report from
the CathPCI Registry of the National Cardiovascular Data Registry, 2014 through March 2018
CIMS is the only INDIAN Center to be a part of The National Cardiovascular Data Registry (NCDR) of
the American College of Cardiology Foundation (ACCF). This is a system compiled by the American
College of Cardiology to gather cardiovascular data of hospitals across the date to help hospitals to
ensure evidence-based cardiovascular care, improve patient outcomes and lower health care costs.
Since it is a transparent public reporting, not only does it benchmark outcomes, but also serves as a
potent repository of clinical data to answer research questions. CIMS receives quarterly reports
reflecting their aggregate data and a rolling summary of previous quarters. CIMS is proud to be a part
of such world-wide endeavor to provide international quality cardiac care.
Performance, Documentation, Analysis: Ladder to Improvement
At all times organization performances need to be documented and evaluated, thereby extending
scope for improvement. Performance documentation and analysis stands critical more so in
healthcare since it is related to life and living.
CIMS is the only INDIAN Center to be a part of The National Cardiovascular Data Registry (NCDR)
system compiled by the American College of Cardiology to gather cardiovascular data of hospitals
across 2400 US and 6 international (non- US, including CIMS ) centers.
Data Feedback received by CIMS on its performance facilitates quality improvement efforts, which
improves patient outcomes, reducing health care costs.
CIMS receives comparative quarterly reports reflecting its aggregate data and a rolling summary of
previous quarters making it a provider of international quality cardiac care.
National Cardiovascular Data Registry
22
CIMS and US comparative angioplasty (PCI) procedure volumes
According to NCDR report, CIMS stands as a high volume
intervention cardiology center. Annually at an average 1500
angioplasties are performed at CIMS. Such high volumes
(1001-2000) of angioplasty are performed at only 132 US
centers of the total 2400 participating centers and CIMS
stands as one of them(Table 1).
This high volume at CIMS establishes the expertise of the
practicing cardiologists who with time are experienced to
perform diagnostic angiography in 7 seconds- an achievement that comes with experience.
Contributing to this expertise holds the well-equipped PACS 3 Cath labs following ACC/AHA
guidelines driven practices performed by a group of expert cardiologists including interventional
cardiologists, electrophysiologists, cardiac surgeons, cardiac anesthetists, experienced technicians
and nurses.
Table 1: CIMS Angioplasty procedure volumes
National Cardiovascular Data Registry
23
Fig. 1: Experts by Experience
Radial intervention –a day care procedure reduces exposure to radiation, post procedure immobility, has shorter
hospital stay and reduced medical costs
Most of the angiographies and angioplasties are performed through the Radial artery (artery in hand).
CIMS has a radial lounge the first of its kind in India. Radial intervention allows ease of catheter passage even in
over weight patients reducing complications.
National Cardiovascular Data Registry
0
1500
3000
4500
6000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Angiography
Angioplasty
Nu
mb
er o
f P
roced
ure
s
Temporal Trend of Angiography and Angioplasty at CIMS
98.03
44.99
1.71
54.74
0
20
40
60
80
100
120
CIMS US facility
RadialFemoral
Pe
rcen
tag
e
Procedural Approach for Cardiac Catheterization
6
7
5.4
5.6
5.8
6
6.2
6.4
6.6
6.8
7
7.2
CIMS US facility
Average Radiation Exposure During Angioplasty
Min
ute
s
24
National Cardiovascular Data Registry
Heart disease occurs at Young Age in Indians as compared to US population: Early Treatment saves life
The time between patient arrival at the hospital to the time he/she receives percutaneous coronary intervention
(PCI) is Door to Balloon (D2B) time. i.e. the time recorded from the moment the patient arrives in the emergency
room to the stenting done in the Cath lab. Less the time better are the patient outcomes. CIMS.
D2B time averages about 64 minutes which is lower than the international ACC/ AHA guideline protocol of 90
minutes.
36.1
36.8
25.2
2117.9
26.4
42.8
13
0
5
10
15
20
25
30
35
40
45
<55 >55 to <65>65 to <80 >80
CIMS
US facility
Perc
enta
ge
Age Distribution of Patients
50
90
0
10
20
30
40
50
60
70
80
90
100
CIMS ACC/AHAGoal
Door Ballon Time
Numb
erof
Patie
nts
25
National Cardiovascular Data Registry
CIMS cardiology has one of the highest experience in using Rotabletor, Intravascular Ultrasound (IVUS),
Fractional Flow Reserve (FFR) and Orbital Atherectomy devices to treat certain categories of heart vessel
diseases.
Adverse Events are a Portal of Expertise, Technology and Treatment
Angioplasty success is defined as completion of the procedure without death, complications including stroke,
dialysis or vessel injury. As per ACC guidelines on hospital discharge, nearly all patients without a
contraindication are receiving aspirin and a statin medication. CIMS care continues at home through its Care at
Homes department.
2
3.1
0
0.5
1
1.5
2
2.5
3
3.5
CIMS US Hospital
Days
Average Length of Hospital Stay
99.5
0.50
20
40
60
80
100
120
Alive Expired
CIMS
US hospital
Pe
rce
nta
ge
Discharge Status of Patients
0.41
1.68
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
CIMS US Hospitals
PCI in-Hospital Risk Adjusted Rate of Bleeding Events (all patients)
Pe
rce
nta
ge
39.5
21.8
78.1
99.6 97
45.7
20.5
89.699.2 95.2
0
20
40
60
80
100
120
Angiotensinconverting
enzyme (ACE)inhibitors
Angiotensin IIreceptor blocker
(ARB)
Beta Blcokers Aspirin Lipid loweringagents (any)
CIMS
US hospital
Pe
rcen
tag
e
Medication Prescribed at Discharge
26
National Cardiovascular Data Registry
The value of participating in the NCDR CathPCI Registry has disseminated the understanding of invasive
cardiology and has driven a higher level of quality into CIMS group cardiology practice. The actual data has made
CIMS move forward to establish disease specific clinics like Heart failure clinic, Structural heart disease clinic,
and CIMS STEMI initiative and Heart Transplant Center
27
Cardiology
CIMS boasts of the most advanced Cardiology care not only in Ahmedabad, but in the entire Western India. The
hospital has a team of world renowned, experienced and highly qualified cardiologists available 24x7 to attend
to all cardiac emergencies. We follow the latest international
AHA/ACC guidelines in performing all cardiac procedures.
CIMS Cardiology located in the green infrastructure of
CIMS hospital, Ahmedabad is one of the finest
cardiology Centers in the world with its state-of-the-art
medical services. Cardiology specialists have accomplished
superior results in curing complex cardiovascular diseases.
CIMS outstands in the country as a cardiology group
practice. The group comprise of interventional cardiologists,
cardiac surgeons, cardiac anesthetics, physiotherapist,
dietician, Cath lab technicians.
With its well experienced and versatile cardiology team,
cardiology unit at CIMS grows each year in volumes
besides adding novel procedures improving cardiac care
and outcomes.
Facilities:
n 30- bedded CCU well equipped with ventilators,
defibrillators, monitors, electric beds
n 3 state-of-the-art flat panel Cath labs with DSA and stent boost technology
n PACS system
28
Cardiology
Majority of patients who underwent catheterization were of age group of 51-60 years followed by 61-70 years.
CIMS holds the ability to perform interventional procedures in octogenarian (> 80 years) patients as well as pre
mature CAD patients (< 45 years).
Proportion of males undergoing catheterization was higher as compared to females.
1077
221
1299
220
1408
275
1396
299
1416
271
1182
281
1290
284
0
200
400
600
800
1000
1200
1400
1600
Male Female
Nu
mb
er
of
Pat
ien
ts
Gender Distribution of Angioplasty Patients
2011(N=1298)
2012(N=1519)
2013(N=1683)
2014(N=1695)
2015(N=1687)
2016(N=1463)
2017(N=1574)
29
Cardiology
Prevalence of hypertension and diabetes was high among patients undergoing cardiac catheterization.
150
171
201
185 180189
236
0
50
100
150
200
250
2011 2012 2013 2014 2015 2016 2017
Primary Angioplasty in Myocardial Infarction (PAMI)
2011
2012
2013
2014
2015
2016
2017
Nu
mb
er
of
Pa
tie
nts
Data comparison of door-to-balloon time (interval starts
with the patient's arrival in the emergency department, and
ends when a catheter guide wire crosses the culprit lesion
in the cardiac Cath lab) presents CIMS Hospital
comparable to ACC and AHA Goal.
1173
1388
1585
1620 1662
14301541
0
200
400
600
800
1000
1200
1400
1600
1800
2011 2012 2013 2014 2015 2016 2017
Nu
mb
er
of
Pa
tie
nts
Radial Approach for Angioplasty
2011
2012
2013
2014
2015
2016
2017
At CIMS, our well experienced interventional
cardiologists with technical expertise perform
majority of procedures through radial
approach as compared to femoral approach.
30
Cardiology
In the radial approach
n Ease of catheter passage even in overweight or obese patients.
n The patient does not require post-procedural immobility up to 4 to 5 hours.
n Early ambulation and PCI can be performed as a day care procedure.
n According to AHA guidelines of PCI, compared to femoral access, radial access decreases the rate of
access-related bleeding and local vascular complications.
n Over 28 years of experience in interventional cardiology
n Team experience of > 21000 angioplasties, > 80000 angiographies
n 24 x 7 cardiac services with pioneer team of India for Primary Angioplasty in Acute Myocardial Infarction (PAMI)
n CARTO-3 System : First time in Western India, state-of-the-art Imaging System for Enhanced Visualization
for Treating Arrhythmia Patients
n Radial Lounge, the first of its kind in the country - centrally air-conditioned enclave with comfortable semi-
recliners chairs for patients, who may walk in for a day care procedure (Radial Angiography)
At CIMS, PCI through Radial artery is more commonly performed. Angiography through Radial approach is a
walk-in procedure at CIMS Radial Lounge.
At CIMS it has been very often to treat multi-lesions, bifurcation lesions, calcified lesions and no option
patients using high precision techniques like IVUS and FFR.
1040
240
18
1119
354
46
1292
355
36
1386
286
23
1288
330
69
1077
325
61
1180
320
74
0
200
400
600
800
1000
1200
1400
1600
Single Vessel Disease Double Vessel Disease Triple Vessel Disease
Num
ber o
f Pat
ient
s
Percutaneous Intervention
2011(N=1298)
2012(N=1519)
2013(N=1683)
2014 (N=1695)
2015 (N=1687)
2016(N=1463)
2017(N=1574)
31
As per ACC guidelines-on hospital discharge, at CIMS nearly all patients without a contraindication are
receiving aspirin and a statin medication.
Improvement in Cardio Vascular Practice
n Heart Failure Clinic
n Structural Heart Disease Clinic
n Valvular Clinic
n Heart Transplant Center: We are the First hospital in Gujarat(INDIA) to have completed successfully 5
heart transplants
n PGRO: Helps cross cultural bridges between hospital and patient to create a better interaction and
smoother flow of services
n The Hospital to Home (H2H) and Hospital to Family (H2F) program of CIMS takes care of patients after
discharge and counsels family members to take care against CAD risk factors.
n Care at Homes: 24 hour complex clinical care at home
Cardiology
54
8
18
4
15
0
67
2
25
5
22
5
88
4
3
40
8
12
58
2
3
52
0
64
4
40
12
48
80
6
0
10
24
82
8
0
10
59
0
200
400
600
800
1000
1200
1400
Zotarolimus Sirolimus Everolimus
2011(N=1298)
2012(N=1519)
2013(N=1683)
2014(N=1695)
2015(N=1687)
2016(N=1830)
2017(N=1887)
Type of Drug Eluting Stents
Nu
mb
er
of
Pa
tie
nts
Type of Drug Eluting Stents
Nu
mb
er
of
Pa
tie
nts
Da
ys
1.73
1.56
1.55
1.49
1.51
1.581.6
1.35
1.4
1.45
1.5
1.55
1.6
1.65
1.7
1.75
2011 2012 2013 2014 2015 2016 2017
Cardiology Average Length of Hospital Stay
32
Cardiac Investigations
CIMS is well- equipped with latest technologies
to help make right treatment decisions. The
well experienced cardiology team and validated
diagnostics offer best treatment to its patients.
Non-invasive cardiology services at CIMS include
n Electrocardiography (ECG)
n Treadmill Test (TMT)
n 2D-echo and 3D-echo with Color Doppler
n Tran esophageal Echocardiography (TEE)
n 24 hr. ambulatory blood pressure monitoring
n Tilt Table Test
n Signal Averaged ECG
n Non-invasive EP study (NIEPS)
n Perinatal high-risk pregnancy consultation
75
56
1
10
60
28
62
11
60
9
1
66
81
50
59
14
73
4
2
35
85
65
95
15
52
2
2
11
02
64
11
15
68
4
22
20
2
63
44
18
07
7
19
31
4
66
00
15
37
2
19
18
4
52
43
0
5000
10000
15000
20000
25000
ECG ECO TMT
2011(N=21989)
2012(N=33857)
2013(N=45404)
2014(N=43408)
2015(N=44610)
2016(N=43991)
2017(N=39799)
OPD Cardiology Investigation Volumes
Nu
mb
er
of
Pa
tie
nts
26
0
1
44
82
25
0
17
7
138
16
6
27
0
14
4
1
25
65
50
10
6
89 102
77
46595
8
12
0
10
8
28
6673
10
5
92
27
708
0 88 95
27
60
0
50
100
150
200
250
300
Dobutamines Tilt Table TestHolter Monitoring TestTEE Echo Foetal Echo
2011(N=21989)
2012(N=33857)
2013(N=45404)
2014(N=43408)
2015(N=44610)
2016(N=43991)
2017(N=39799)
OPD Cardiology Investigation Volumes
Num
ber
of P
atients
33
Cardiac Rhythm Disorders
CIMS offers various treatments for cardiac rhythm disorders
n Electrophysiology studies (EPS) for diagnosis of cardiac arrhythmia (conventional and 3 Dimensional
Mapping System)
n Radiofrequency Ablations (RFA) of complex cardiac arrhythmias pacemaker Implantation
n Biventricular Pacing (Cardiac Resynchronization Therapy) for heart failure
n Automatic Implantable Cardioverter Defibrillator (AICD) implantation
n Comprehensive Device Follow up Clinic (Pacemaker, CRT, AICD)
Carto-3 Systems
Carto-3 system, state-of-the-art imaging system offers enhanced visualization for treating arrhythmia patients.
At CIMS, patients with EF <35% were also evaluated for risk of sudden cardiac death and a need for ICD. All
patients implanted with defibrillators were followed up. These patients have successfully survived sudden cardiac
arrest episodes due to VT/VF
79 85 89 97 95
191 186
0
50
100
150
200
250
2011 2012 2013 2014 2015 2016 2017
Pacemaker Implantation
16
7
11
15
23
8
13
31
99
1917
8
21
1616
21
13
1
15 16
0
5
10
15
20
25
30
35
CRT ICD CRT-D
2011(N=34)
2012(N=46)
2013(N=53)
2014 (N=45)
2015(N=45)
2016(N=50)
2017(N=32)
Device Implantation
196180
212
171
204
168
203
162
230
191
220
176
205
167
0
50
100
150
200
250
EP Study RFA
2011 ( N = 376)
2012 ( N = 383)
2013 ( N = 372)
2014 ( N = 365)
2015 ( N = 429)
2016 (N=396)
2017(N=372)
EP Study and RFA
113131
142 142 140
241
218
0
50
100
150
200
250
300
2011 2012 2013 2014 2015 2016 2017
CIED Volumes
Nu
mb
er
of
Pati
en
ts
Nu
mb
er
of
Pati
en
ts
Nu
mb
er
of
Pati
en
ts
Nu
mb
er
of
Pati
en
ts
34
Cardiac Surgeries
The Cardiothoracic Surgery team of CIMS is a highly skilled one and is backed
by vast experience comprising of thousands of surgeries. Round-the-clock
emergency services are available in the department supported by an excellent
nursing and paramedical staff.
All international guidelines and Know-how is adopted in performing surgery
on all age groups (including neo-natal) providing a very high success rate and
low mortality.
Facility:
n 2 Class 100 laminas air flow modular operation theatres only devoted to
cardiac surgery
n Positive and Negative isolation chambers in the SICU
n 20 bed surgical intensive care unit
CIMS Hospital surgeons perform a large volume of cardiovascular and
thoracic procedures. Since the inception of the program, we have
performed over 4328 Coronary Artery Bypass Graft Surgery.
Our cardiac surgery program offers surgical interventions including:
n Cardiac Surgery
n Congenital heart surgery
n Lung transplant
n Mitral valve repair
n Single and double valve replacement
n Aortic root replacement
n Off pump CABG (Coronary Artery Bypass Grafting) on beating heart
n MCS ( Minimally Invasive Cardiac Surgery) CABG for LV (Left Ventricular)
dysfunction
n Combined carotid and bypass procedure
n Minimal Invasive Cardiac Surgery (MICS)
n Heart transplant
n Combined carotid and by pass procedure
Nu
mb
er
of
Su
rge
rie
s
640
35
Cardiac Surgeries
N
um
ber
of
Surg
eri
es
Nu
mb
er o
f Su
rge
ries
Num
ber o
f Sur
gerie
s
Num
ber
of S
urge
ries
Num
ber o
f Sur
gerie
sNu
mbe
r of S
urge
ries
Total Volume of Bentall Surgery
36
Cardiac Surgeries
Majority of patients who underwent
cardiac surgeries were of age group of
61-70 years followed by 51-60 years.
CIMS holds the ability to perform
i n t e r v e n t i o n a l p r o c e d u r e s i n
octogenarian (> 80 years) patients as well
as pre mature CAD patients (< 55 years).
With time, average length of hospital stay
following cardiac surgery is reduced,
relating the established protocols
followed and experienced expertise.
There was total 8.9 days hospital stay in
year 2011 which gradually decreased up
to 8 days in the year 2017.
CIMS Hospital’s surgeons achieved
lower-than-expected in-hospital mortality
rates of 1.21% for patients who had
isolated procedures. Isolated procedures
are those done without any other surgical
procedure.
The Hospital to Home (H2H) program
–the only one practiced in the country
takes care of the patient infection rate,
drug adherence, drug compliance,
adverse events and quality of life from
discharge till first follow up visit.
19
3
0
2
4
6
8
10
12
14
16
18
20
ASD VSD
Septal Defect Repair
Nu
mb
er
of
Pro
ced
urs
e
37
Heart Failure
Heart failure (HF) is a major problem in India. As per projections there are at least 8–10 million patients with HF in
India with a prevalence of about 1% adult population.
Risk Factors Include:
n Myocardial Infarction
n Damage to the heart valves or history of a heart murmur
n Enlargement of the heart
n Hypertension
n Diabetes
n Family history of enlarged heart
245
20 194 3 2 2
0
50
100
150
200
250
300
CABG CABG +MV Repair
ValvularSurgery
CABG +SVR
HeartTransplant
CABG +VSD
Bental
Nu
mb
er
of
Pa
tie
nts
Different Surgeries for Heart Failure (N=295)
38
Heart Failure
Stages, Phenotypes and Treatment of HF
39
Different cardiac surgeries have been performed successfully even on patient with low LVEF
At CIMS apart from CABG in LV dysfunction various forms of other modalities are also performed like CABG
+ Mitral repair, LV volume reduction, CABG+ AICD, CABG +CRT-D, CABG +Post MI VSD closure.
n CIMS is certified for Left ventricular assist device implantation for severe LVD.
n CABG in LV dysfunction is treated at CIMS with morbidity and mortality comparable to International standard.
n Because of pre-operative medical optimization IABP usage is very less and patients are discharged
within an average of 6 days
Heart Failure
40
CIMS Hospital standard protocol for the treatment of valvular
heart disease:
n A course of antibiotics is prescribed prior to surgery or dental
work for those with valvular heart disease, to prevent
bacterial endocarditis.
n Long-term antibiotic therapy is recommended to prevent a
recurrence of streptococcal infection in those who have had
rheumatic fever.
n Antithrombotic (clot-preventing) medications such as
aspirin or ticlopidine may be prescribed for those with
valvular heart disease who have experienced unexplained
transient ischemic attacks, also known as TIAs.
n More potent anticoagulants, such as warfarin, may be
prescribed for those who have atrial fibrillation (a common
complication of mitral valve disease) or who continue to
experience TIAs despite initial treatment.
n Long-term administration of anticoagulants may be
necessary following valve replacement surgery, because
prosthetic valves are associated with a higher risk of blood
clots.
n Balloon dilatation (a surgical technique involving insertion
into a blood vessel of a small balloon that is led via catheter
to the narrowed site and then inflated) may be done to widen
a stenotic valve.
Valve Surgery
n To repair or replace a damaged valve may be necessary.
Replacement valves may be artificial (prosthetic valves) or
made from animal tissue (bioprosthetic valves). The type of
replacement valve selected depends on the patient's age,
condition, and the specific valve affected.
Cardiac Valve Disorder
41
36
19
14
25
0
5
10
15
20
25
30
35
40
CABG + MV Repair CABG + MVR CABG + AVR TV Repair
CABG + Valvular Procedure 2017 (N = 94)
Nu
mb
er
of
Pati
en
ts
Cardiac Valve Disorder
51
39
19
0
10
20
30
40
50
60
MVR AVR DVR
Cardiac Valve Replacement Surgeries 2017 (N = 109)
Nu
mb
er
of
Pa
tin
ets
51
58
10
20
30
40
50
60
70
Biological Mechanical
Type of Valve Replacement ( N = 109)
Nu
mb
er o
f V
alv
es
Valve repair, rather than
replacement, is associated with
better survival, improved life
style, better preservation of
heart function and lower risk of
s t r o k e a n d i n f e c t i o n
(endocarditis) with no need of
anticoagulation therapy. CV
surgery Team at CIMS is a pioneer
and does high volume valve repair
surgeries.
42
MICS can treat many kinds of below heart complexities.
n
n Mitral Valve Repair & Replacement
n Aortic Valve Repair & Replacement
n Bentall Procedure – Replacement of Aortic Valve, Aortic Root &
Ascending Aorta
n Replacement of Aortic Root
Coronary Artery Bypass Grafting(CABG)
Minimal Invasive Cardiac Surgery
Different Procedures under Minimally Invasive Cardiac Surgery
(MICS) offered at CIMS.
MICS can treat many kinds of below heart complexities.
n Coronary Artery Bypass Grafting(CABG)
n Mitral Valve Repair & Replacement
n Aortic Valve Repair & Replacement
n Bentall Procedure – Replacement of Aortic Valve, Aortic
Root & Ascending Aorta
n Replacement of Aortic Root
Advance Benefits of MICS:
n Small 2 to 3-inch incision, no bone separation
n 3 to 5 days hospitalization
n Recovery in 10 days
n No use of heart-lung machine
n Reduced possibility of infections, ideal
for old, diabetic patients
n Smaller incisions and fewer scars
n Less bleeding, less blood transfusion
n Less pain and discomfort after surgery
n Less trauma to the breastbone –
improved breathing
n shorter hospital stay
12
9
4 4
0
2
4
6
8
10
12
14
CABG MICS ASD MICS AVR MICS TAVI
MICS
Procedures 2017 ( N = 29)
Nu
mb
er
of
Pati
en
ts
Pediatric Cardiac Science
43
Key features of Neonatal and Pediatric Critical
Care Unit
n
critical neonates and children
n State-of-the-art 12 bedded advanced
neonatology setup, well equipped with
conventional as well as high frequency
oscillatory ventilation (HFOV-SLE 5000)
with facility of Nitric Oxide(NO) delivery
n Multi-disciplinary intervention program with
f a c i l i t i e s l i k e i n - h o u s e p e d i a t r i c
surgery,pediatric cardiology and pediatric
cardiac surgery, fibreoptic bronchoscopy,
post trauma care
n 24x7 emergency support and pediatric
transport team equipped with pediatric
ventilators
The department houses pediatric cardiologists,
pediatric cardiac surgeons, pediatric intensivists,
cardiac anesthetists, perfusionists and trained
pediatric nursing personnel. As a result, we offer
treatment to low birth weight babies, premature
kids and children with complex congenital heart
defects.
Highly qualified intensive care team to treat
44
Pediatric Cardiac Science
45
35
21
14
8
8
7
5
4
3
3
2
2
1
1
0 10 20 30 40 50
VSD
Other
ASD
ICR for TOF /DORV
PDA Ligaion
TAPVC Repair
Arterial Switch
B.T.Shunt
PA Band + Septotomy
Pericardiectomy
Coarctation Repair
BDG with Arterial Speptectomy
Fontan Procedure
MV Repair
Aortic Valve Repair
Pediatric Cardiac Surgeries 2017 (N=159)
Number of Procedure
36
25
22
10
7
7
5
4
2
2
0 5 10 15 20 25 30 35 40
Diagnostic Study
PDA Closures
Renal Plasty
VSD
ASD Dense
BAV
BAS
PDA Stenting
Coil embolization
Coarctation Angioplasty
Number of Procedures
Pediatric Cardiac Catheterization Procedures (N =120)
Vascular and Endovascular Surgery
45
CIMS offers endovascular, surgical, and medical treatment of vascular disease.
They perform vascular interventions, carotid stenting and renal artery stenting, new endovascular therapies for
peripheral artery, aneurysm, carotid, and venous conditions, advanced ischemic diseases of lower extremity, diabetic
foot care, deep vein thrombosis, varicose and spider veins.
At CIMS, surgeons perform a full range of vascular and endovascular procedures, including:
n Endovascular and open repair abdominal aortic aneurysms, thoracic Aortic aneurysms, and thoracoabdominal
aneurysms, including fenestrated and branched stent grafts.
n Endovascular and open surgical reconstruction for deep vein occlusions
n Hemodialysis access
n Open surgical reconstructions and balloon angioplasty and stenting in all vascular areas
n Carotid endarterectomy and carotid artery stenting
n Bypass surgery and endovascular therapy for peripheral artery disease and gangrene of the limbs
n Endovascular and open surgical treatment for peripheral artery aneurysms
n Endovenous laser therapy treatment, radiofrequency ablation or sub fascial endoscopic perforator surgery for
varicose veins and venous ulcers
n Treatment of vascular malformations, median arcuate ligament and nutcracker syndromes, lymphedema, and
chylous effusions
n Endovascular surgical intervention, such as angioplasty and stenting, in all vascular areas.
5573
240
112
6946
94
0
50
100
150
200
250
300
2011 2012 2013 2014 2015 2016 2017
Total Vascular Surgeries
Num
ber
of P
atie
nts
46
Vascular and Endovascular Surgery
13
6
2
13
67
19
766 6
4
13
5 5
10
6 6
12
34
0
2
4
6
8
10
12
14
16
18
20
Coarctation Coil Embolisation PTSMA
2011
2012
2013
2014
2015
2016
2017
Vascular and Endovascular Procedures
Nu
mb
er o
f P
atie
nts
3
13
3
78
2
7
13
1
4
14
2
5
9
1
8
11
2
78
00
2
4
6
8
10
12
14
16
Carotid Angiography Carotid Angioplasty CarotidEndarterrectomy
2011
2012
2013
2014
2015
2016
2017
Nu
mb
ero
f P
ati
en
ts
Total Carotid Procedures at CIMS
3
24
4
7
22
11
37
9
21
3
26
5
29
8
25
0
5
10
15
20
25
30
35
40
Renal Angiography Renal Angioplasty Renal Denervation
2011
2012
2013
2014
2015
2016
2017
Renal Procedures atCIMS
Nu
mb
er
o
f P
ati
en
ts
3.27
3.23
3.1
2.39
3.94 3.96
5.64
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
2011 2012 2013 2014 2015 2016 2017
Vascular Surgery Average Length of Hospital StayIn
Days
Thoracic Surgery
47
The surgeons within CIMS Hospital Department of Thoracic Surgery are leaders in the surgical treatment of
diseases of the lung and esophagus, including lung cancer, chronic obstructive pulmonary disease (COPD), lung
failure, esophageal cancer, Barrett's esophagus, achalasia, thoracic outlet syndrome and hyperhidrosis.
132
182 184
0
20
40
60
80
100
120
140
160
180
200
2011-2012-2013 2014-2015 2016-2017
Thoracic Surgeries
Nu
mb
ero
f P
ati
en
ts
2920
29
69
123
103
3439
52
0
20
40
60
80
100
120
140
< 30 year 30-60 year < 60 year
2011-2013
2014-2015
2016-2017
Age Distribution of Thoracic Patients
Nem
bero
f P
ati
en
ts
95
37
136
46
132
52
0
20
40
60
80
100
120
140
160
Male Female
2011-2013
2014-2015
2016-2017
Gender Distribution of Thoracic Patients
Nu
mb
er
of
Pa
tie
nts
We provide care for all diseases of the chest,
including:
n Esophageal Cancer
n Lung Cancer
n Chronic Pleural Effusion
n Other Chest Tumors
n The Range of such operations, routinely done
include:
n Lobectomy
n Pneumonectomy
n Thoracotomy
48
Thoracic Surgery
6
1
4
4
12
4
5
4
6
27
9
10
13 11
5
9
15
7
8
36
16
13
18
10
42
18
14
25
12
46
6
9
14
5
31
0
5
10
15
20
25
30
35
40
45
50
Thoractomy Decortication Emboiestomy Lobectomy Other
2011(N=28)
2012(N=49)
2013)N=55)
2014(N=78)
2015(N=104)
2016(N=119)
2017(N=65)Nu
mb
er
of
P
roc
ed
ure
Types of Thoracic Surgeries
Orthopedic
49
Compendious Pursuit in Orthopedic Care of Canonical Standards
n CIMS Hospital in Ahmedabad provides comprehensive orthopedic surgery facility, i.e. the surgical treatment of
diseases and injuries affecting the musculoskeletal system.
n The aim of orthopedic surgery at CIMS Hospital in Ahmedabad, therefore, is to restore lost function in any part of
the musculoskeletal system to allow the patient to return to their former way of life.
n At CIMS we have highly skilled orthopedic surgeons who are committed to give the latest options in joint
replacement surgery so as to get back to routine normal activities.
n Besides this we have highly experienced surgeons, CIMS dedicated team of anesthesiologists, nurses,
physical therapists, occupational therapists, and social workers who guide patients from pre-surgery
education to post-surgery rehabilitation and recovery.
n CIMS orthopedic teams are devoted to make the hospital experience as comfortable as possible. Our dedicated
team provides best services right from pre-surgery assessment to surgery and post operative hospital stay,
including physical therapy to resume normal activity
n Among the list of specialties, common procedures involve knee surgery, shoulder surgery, hip surgery and hand
surgery.
99
502
538 515
731
495
590
0
100
200
300
400
500
600
700
800
2011 2012 2013 2014 2015 2016 2017
Orthopedic Procedures
Nu
mb
er
of
Su
rge
rie
s
50
Advances in total knee replacement
n
surgeons to preserve the important central ligaments of the knee called the anterior and posterior cruciate
ligaments.
n This design allows a knee replacement to move, respond, and feel more like a normal knee .
n By comparison, patients with hip replacements report extreme satisfaction with their replacement well above
90% of the time.
n The ability to perform total knee replacement surgery and preserve the key central ligaments of the knee, the
ACL and PCL, offers a promising answer to knee arthritis for today's patients that suffer from knee arthritis.
Recently, there has been a paradigm shift in the design of total knee replacements. This new design allows
Orthopedic
6
19
24
31
32
38
43
49
67
127
154
0 50 100 150 200
Multiple Trauma
Amputation of Limbs and Digits
Elbow / Ankle Fixation
Total Hip Replacement
Humers and Radius Ulnar…
Knee Arthroscopy + ACL…
Shoulder Arthroscopy +…
Hip Joint Arthroscopy + DHS…
Femur and Tibia Nailing
Others
Total Knee Replacement
Number of Patients
Orthopedic Surgery 2017 (N = 590)
51
Steps Followed During Treatment
Orthopedic
Services we provide:
n
n Cruciate ligament reconstruction and meniscus repair
n Osteotomy around knee
n Osteonecrosis of hip and knee
n Frozen shoulder and rotator cuff surgery
n Cartilage replacement
n Rheumatoid and infective arthritis
n Cartilage regeneration and repair all types of fracture including complex and complicated fractures
Total management of sports injuries from acute trauma to repetitive stress associated with athletics.
•Basic care to prepare person to undergo surgery and increase the succes of surgery
•At same time fitness of person to have surgery is checked by health care provider
Preoperative treatment
•While in surgery patients are cared by dedicated team of specialists including specially trained technicians to make sure that all the equipment required by surgeon are available and the drugs and
medication availabilty during
During surgery •Care required depends on type of
surgery and health and fitness history of person
•We take care of the immediate startup of post operative care after surgery to ensure early removal of drains and pain reliving medications
Post operative/surgery
critical shoot ups
52
Orthopedic
38
43
49
67
127
154
29
36
43
65
69
133
35
21
39
81
131
289
17
9
19
68
128
195
22
13
91
96
225
26
3
10
87
226
4
4
4
10
55
0 100 200 300 400
Knee Arthroscopy + ACLreconstruction
Shoulder Arthroscopy +Fixation / Replacement
Hip Joint Arthroscopy +DHS Fixation
Femur and Tibia Nailing
Others
Total Knee Replacement
2011 (N=99)
2012 (N=502)
2013 (N=538)
2014 (N=515)
2015 (N=731)
2016 (N=495)
2017 (N=590)
Numberof Patients
Orthopedic Surgeries
0
6
19
24
31
32
3
25
13
15
21
43
2
11
19
56
47
1
9
7
24
38
7
1
9
9
27
38
3
51
1
36
59
3
6
2
5
6
0 20 40 60 80
Facial Bone Fracture
Multiple Trauma
Amputation of Limbs and Digits
Elbow / Ankle Fixation
Total Hip Replacement
Humerus and Radius Ulnar Nailing
2011 (N=99)
2012 (N=502)
2013 (N=538)
2014 (N=515)
2015 (N=731)
2016 (N=495)
2017 (N=590)
Number of Patients
Orthopedic Surgery
53
Orthopedic
53
46
30
3
28
7
19
9
25
127
7
2
38
39
0
34
1
29
1
2
04
36
0
23
0
0
50
100
150
200
250
300
350
400
450
Males Females
2011 (N= 99)
2012 (N=502)
2013 (N=538)
2014 (N=515)
2015 (N=731)
2016 (N=495)
2017(N=590)
Gender Distribution of Orthopedic Patients
Nu
mb
er
of
Pati
en
ts
12
33
54
85
22
7
19
0
75
22
6
23
6
87
22
1
20
7
12
0
30
2
30
9
10
5
22
7
16
3
12
1
28
5
18
4
0
50
100
150
200
250
300
350
< 30 year 30-60 year >60 year
2011(N=99)
2012(N=502)
2013(N=538)
2014(N=515)
2015(N=731)
2016(N=495)
2017(N=590)Nu
mb
er
of
Pa
tie
nts
Age Distribution of Orthopedic Patients
6.55
4.93
5.74
4.82
3.934.12
3.71
0
1
2
3
4
5
6
7
2011 2012 2013 2014 2015 2016 2017
Day
s
Orthopedic Surgery Average Length of Hospital Stay
Critical Care
54
n
urgent healthcare needs of critically ill or emergency
patients. Constant availability and comprehensive care by
qualified and trained intensivists with a multi-disciplinary
team approach at CIMS hospital ensures best possible care
and outcome of all complex medical and surgical cases.
Well-planned specialty ICUs for cardiac, medical, surgical
and trauma patients.
n Multi-disciplinary, intensivist driven extracorporeal
membrane oxygenation (ECMO) program.
n Management of cardiorespiratory arrest, Acute respiratory
embolism and ischemic stroke, Kidney and liver failure.
n All kinds of sepsis including oncology, post-transplant, immuno-compromised patients, Neurological
emergencies, Surgical and obstetrics emergencies, Poly trauma and burns care, Total parental nutrition, Care of
poisoning/toxicities, Pain relief for terminally ill.
For all your high-risk patients, CIMS Critical Care is well-equipped to cater to all needs
Well-planned specialty ICUs for cardiac, medical, surgical and trauma patients
Multi-disciplinary, intensivist driven extracorporeal membrane oxygenation (ECMO) program
Treats critically ill or emergency patients including-
n Management of cardiorespiratory arrest
n Acute respiratory embolism and ischemic stroke
n Kidney and liver failure
n All kinds of sepsis including oncology, post-transplant, immuno-compromised patients
n Neurological emergencies
n Surgical and obstetrics emergencies
n Poly trauma and burns care
n Total parental nutrition
n Care of poisoning/toxicities
n Pain relief for terminally ill
n All medico-legal cases management
CIMS Critical Care is dedicated to the emergency and
ECMO
55
First in Gujarat, Rajasthan, Madhya Pradesh ECMO ECLS (Extracorporeal Membrane Oxygenation - Extracorporeal
Life Support) System
When lungs no longer oxygenate and heart cannot perfuse the oxygen in spite of maximum efforts, the
consequences are multi organ failure and loss of life. ECMO is a ray of hope for such patients.
Indications for ECMO In Adults
n
severe mitral regurgitation and aortic regurgitation
n Viral myocarditis
n Bridge to Left Ventricular Assist Device (LVAD) and cardiac transplant
n Adults Respiratory Distress Syndrome (ARDS)
n Pneumonia
n Trauma
n Status asthmatics
n Chemical pneumonitis
n Inhalational pneumonitis
n Near drowning
n Bronchiolitis obliterans
n Autoimmune lung disease vasculitis, good pasture syndrome
n Air-leak syndrome
Cardiogenic shock secondary to acute coronary syndrome, acute
In Neonatal and Pediatric
n Adult respiratory distress syndrome (ARDS)
n Pneumonia
n Status asthmatics
n Chemical pneumonitis
n Inhalational pneumonitis
n Near drowning
n Acute chest syndrome (Sickle cell)
n Bronchiolitis
n Persistent air-leak syndrome
Infectious Disease
56
Treatment in cases of
Pulmonary and extra pulmonary tuberculosis, including
MDR and XDR- TB
HIV disease and infections in HIV patients
Infections in cancer patients and organ transplant
recipients
Hospital acquired infections and complicated infections
in ICU patients
Tropical infections like malaria, enteric fever, swine flu,
dengue, chikungunya, etc.
Advice regarding adult vaccinations and travel care
Adult Vaccination
Vaccination for prevention of infectious diseases is of
utmost importance in this era of globalization,
increasing life expectancy, and growing population of
immunocompromised patients, migration and
increasing international travel
Pulmonology
57
CIMS Pulmonary Medicine Department is managed by senior and eminent pulmonologists. They are well versed
with all modern techniques in their field including Fiber Optic Bronchoscopy, Pulmonary Function Testing
including DLCO, Sleep study, fiberoptic pleuroscopy and allergy testing.
Following diseases are diagnosed and treated at CIMS hospital:
n Bronchial asthma including difficult to treat asthma
n COPD and advanced COPD
n Interstitial lung diseases
n Respiratory allergic diseases
n Tuberculosis and drug resistant tuberculosis
n Lung tumors
n Snoring and sleep disorders (snoring is hazardous and should not be ignored)
n Non resolving and recurrent pleural effusion
n Critical care for critically ill pulmonary patients
Following facilities are available at CIMS hospital:
n Video fiber-optic bronchoscopy (diagnostic and
therapeutic procedure)
n Pulmonary Function Test (PFT) including Diffusing
n Capacity of Lung Carbon Monoxide (DLCO)
n Sleep laboratory (one of the best sleep lab with highly
trained sleep specialist and pulmonologist)
n Allergy Testing
n The Pulmonary & Sleep Center staff offer a full range of
services to assist the breathing impaired, and to help
diagnose and treat sleep related disorders.
n CIMS offers Home Sleep Testing (HST) for qualifying
patients. Patients appropriate for Home Sleep Testing
include Patients at risk for mild-to-moderate sleep apnea,
with snoring.
Air sacs(alveall)
Bronchiole
Normal Windpipe(trachea)
Lung
Bronchus
Fluid in air sacs
Pneumonia
58
Pulmonology
Pulmonary function tests are a group of procedures that measure the function of the lungs, revealing problems in
the way a patient breathes.
The tests can determine the cause of shortness of breath and may help confirm lung diseases, such as
asthma, bronchitis or emphysema.
The tests are also performed before any major lung surgery to make sure the person won't be disabled by
having a reduced lung capacity.
1208
1765
2183 2185
2783
29993306
0
500
1000
1500
2000
2500
3000
3500
2011 2012 2013 2014 2015 2016 2017
No
. o
f P
ati
en
ts
Total Number of Patients in PFT Study
2011
2012
2013
2014
2015
2016
2017
Sleep Lab
59
CIMS Sleep Laboratory fills the vacuum for a world class
sleep disorder lab in Gujarat. It is the latest and most
sophisticated Sleep Lab in Gujarat. The Sleep Lab is designed
to evaluate, diagnose and help patients to manage OSA.
A sleep study examines sleep patterns, body movements,
snoring, airflow, stages of sleep, heart rate, blood pressure,
ECG and others. It helps the experts in locating the exact
problem with the patient and dealing with it accordingly.
Equipment's: Our sleep lab is equipped with additional
sensors, hardware and software to carry out cardiovascular
studies. Our lab is equipped to diagnose cases of unexplained
impotence due to sleep apnea or other diseases.
Who needs a sleep study?
All individuals who snore at night and have one of the
following symptoms :
n Excessive loud snoring
n Disturbed night sleep
n Daytime sleepiness
n Choking in sleep
n Lack of concentration
n Loss of memory
n Irritability
n Depression
n Sexual dysfunction
n Breathlessness that wakes you from sleep
n Patient with uncontrolled hypertension, heart
diseases, CV stroke with loud snoring
11
60
Sleep Lab
18 1724
34
52
81
50
0
10
20
30
40
50
60
70
80
90
2011 2012 2013 2014 2015 2016 2017
No
. o
f P
ati
en
ts
Sleep Study
2011
2012
2013
2014
2015
2016
2017
4.64
5.42 5.45
4.244.56
3.89
4.68
0
1
2
3
4
5
6
2011 2012 2013 2014 2015 2016 2017
Da
ys
Pulmonology Average Length of Hospital Stay
Neuro and Spine Surgery
61
At CIMS, highly qualified and skilled team of neurosurgeons along with an efficient team of anesthesiologists,
nurses and medical staff perform different surgeries of neurology.
Most of the neurology patients need individualized and special care through a multi disciplinary comprehensive
approach. Besides evaluation and management of the disorder, prevention is also mainstay of neurology care. We
focus on risk factor identification and early treatment, across all neurological disorder spectrums.
n Headache and other pain syndromes (migraine)
n Epilepsy (convulsion/seizure)
n Stroke (paralysis)
n Giddiness (dizziness, vertigo)
n Movement disorders (such as Parkinson's disease, essential tremor and dystonia)
n Dementia (Alzheimer's and other)
n Infections of the brain (Meningitis, encephalitis)
n Cerebral palsy and spasticity
n Multiple sclerosis Spine disorders (backache, "slip-disc", radiculopathy, and spondylosis)
n Nerve and muscle diseases ( including amyotrophic lateral sclerosis, peripheral neuropathy, myasthenia gravis,
muscular dystrophy, myopathies)
n Sleep disorders
n Mental/behavioral health disorders
Facility at CIMS
n Dedicated Stroke Unit & Neuro ICU
n Epilepsy Clinic
n Brain & Spine Surgery
n Brain & Spine Tumors (Neuro-oncology)
n Brain & Spine Injury (Neuro-trauma)
n Paediatric Neurology
n Interventional Neuroradiology
n Neuro-critical Care
n Neuropathology
n Neurorehabilitation
n Neuro-anesthesia
62
Neuro and Spine Surgery
Treatment and procedures carried out at CIMS
include:
n Minimally Invasive Spine Surgery (MISS): micro
discectomy, decompression laminectomy,
laminoplasty and spine fusion
n Spinal tumor, vascular malformation excision
n Percutaneous Kyphoplasty and vertebroplasty
for spine fractures
n Cervical and lumbar artificial disc
replacement surgery
n Correction of scoliosis and other deformities
n Spine stabilization: spondylolisthesis, Koch's
spine, traumatic fractures
n Spasticity surgery (Baclofen pump)
n Spinal cord stimulator for chronic pain
27
150
121
162 161
119
146
0
20
40
60
80
100
120
140
160
180
2011 2012 2013 2014 2015 2016 2017
Neuro Surgeries
Nu
mb
er
of
Pro
ced
ure
s
21
4
2
1
8
6
3
2
25
11
4
3
15
5
3
4
17
3
6
7
111
0 20 40
V.P SHUNT
Trans Nasal TumourExcision
Dorsal
Aneuysm Clipping
2011 (N=46)
2012 (N=230)
2013 (N=264)
2014(N=348)
2015(N=365)
2016(N=241)
2017 (N=238)
Neuro and Spine Surgeries
Number of Surgeries
73
39
23
12
39
24
88
46
40
14
24
10
114
40
43
31
32
62
92
45
32
34
63
55
75
1
12
26
28
89
62
5
37
77
38
5
2
14
14
10
0 20 40 60 80 100 120
Craniotomy + EVD + Excisionof Tumor
Spine Stabilization
Microdisectomy
Cervical
Others
Lumber
2011 (N=46)
2012 (N=230)
2013 (N=264)
2014(N=348)
2015(N=365)
2016(N=241)
2017 (N=238)
Neuro and Spine Surgeries
Number of Surgeries
63
CIMS Trauma Center provides an organized and systemic approach to the care of the injured patients.
Optimal trauma care requires system oriented approach that integrates field and hospital element which
CIMS is already offering.
Goals achieved at CIMS Trauma Center:
To assist in improving the care of the injured patient by providing emergency consultation and
comprehensive trauma care under one roof according to resources for optimal care of the injured patient .
To assist in the ongoing assessment of trauma patients for optimal care of the injured patient for appropriateness,
timeliness, and efficient management.
Trauma Center
14
1 12
89
12
85
9
31
9
35
3 2
11
16
25
42
2
12 13
41
5 57
9
2
23
3 3
97
3 2
8
17
0 1
0
5
10
15
20
25
30
35
40
45
Trauma Cases
2011 (N=8) 53
2012 (N=35) 240
2013 (N=53) 365
2014 (N=116) 275
2015 (N=119) 217
2016(N=72) 183
2017(N=53) 214
Nu
mb
er o
f P
atie
nts
64
Facilities at CIMS
n BLS and ATLS trained doctors, nurses and technicians
n 24 X 7 services round the year
n 10-bed state-of-the-art emergency department with back up of Trauma ICU
n Triage area equipped with facilities of a world class emergency room
n Mobile unit with a defibrillator, multipara monitor and ventilator
n Excellent communication facilities backup
n Emergency team gets activated according to CODE YELLOW ,when called for
n All staff is trained in patient resuscitation so that they are helpful to save patients
n Highly experienced team of other super specialist surgeons
n All Medico legal cases are accepted
n About 85 Critical Care Units with pediatric and neonatal ICU and 8 well equipped state-of-the-art
operation theatres
n ICU-ON-WHEELS and other Ambulance services run forth to collect trauma and emergency
patients from the site
n Facilities of directly shifting patients with MI for PAMI to Cath lab.
Trauma Center
36
179
271
179
98
111
161
0
50
100
150
200
250
300
2011 2012 2013 2014 2015 2016 2017
Trauma due to RTA
2011
2012
2013
2014
2015
2016
2017
Nu
mb
er
of
Pati
en
ts
Gastro-Intestinal and General Surgery
65
CIMS General Surgery department offers evaluation and
treatment for a full range of general surgery conditions.
Surgeons consult and perform surgery on medical conditions
involving the breast, endocrine system, gastrointestinal tract,
colon, liver, pancreas and rectum. The surgeons at CIMS are
dedicated to continuing improvement and work closely
with other specialists involved in patient's care to diagnose
and provide timely surgical intervention for complex
conditions.
Surgeries carried out at CIMS are
n Fistulectomy
n Incision and drainage
n Biopsy
n Excision of Tumor
n Haemorrhoidectomy
n Cyst Excision
n Debridement
n Amputation
n Circumcision
n Cholecystectomy
516
718
30
10
62
86
49
95
153
50
85 84
27
48
73
2424
64
23
0
20
40
60
80
100
120
140
160
180
< 30 year 30-60 year > 60 year
Nu
mb
er
of
Pati
en
ts
Age in Years
Age Distribution of General Surgery Patients
2011 (N=28)
2012 (N=58)
2013 (N=197)
2014 (N=298)
2015 (N=196)
2016 (N=145)
2017 (N=111)
66
Gastro-Intestinal and General Surgery
Procedure Type Volumes
2013
Volumes
2014
Volumes
2015
Volumes
2016
Volumes
2017
Debridement
37
70
67
35
34
Fistulectomy
15
5
5
7
5
Cyst Excision
15
2
7
7
2
Hernioplasty
13
7
6
5
1
I & D
10
9
11
13
3
Fasciotomy/Pilonidal
sinus
10
4
5
3
1
Biopsy
9
26
18
7
8
Amputation
7
9
6
3
7
Excision of Tumor
6
0
0
0
0
Circumcision
4
3
5
0
0
Hemorrhoidectomy
4
8
3
4
2
Cholecystectomy
2
0
1
1
0
Other Procedures
65
155
62
60
48
Total
197
298
196
145
111
Endoscopy
67
CIMS Endoscopy is a state-of-the-art facility equipped with the latest
endoscopic, monitoring and infection control equipment.
Staffed by experienced Gastroenterologists, Surgeons,
Respirologists, and Endoscopy nurses, CIMS is committed to
deliver expert endoscopic care in a timely, safe, and patient friendly
manner.
We provide acute care 24 hours a day, 7 days a week, to manage life
threatening illnesses as well as screening procedures for diagnostic
and preventive purposes.
Endoscopy Includes:
n Investigate causes of digestive pathologies like abdominal pain
and gastrointestinal bleeding
n Diagnose digestive diseases and conditions such as anemia,
bleeding, inflammation, diarrhea or cancers of the digestive
system
n Treat certain digestive system problems such as difficulty in
swallowing caused by a narrow esophagus, or to remove
polyps; to remove foreign objects, etc.
Endoscopy Services at CIMS:
n Olympus Colonoscopy is used to
examine Large Bowel i.e. Colon,
Rectum (large intestine).
n Ul t ramodern endoscopy f rom
Olympus–Gastro scope for Upper GI
tract i.e. esophagoscopy.
n Gastroscopy and Duodenoscopy
n Colonoscopy
n ERCP to evaluate bile duct and
pancreatic ducts
n Capsule Endoscopy for small intestinal
diseases
n Removal of tumors like polyps from
stomach, duodenum, large intestine
n Removal of stones from bile duct
n Stent placement in food pipe, bile duct
and pancreatic duct
n Management of acute upper and lower
GI hemorrhage (bleeding)
248342
575
939
1093
1318
1487
0
200
400
600
800
1000
1200
1400
1600
2011 2012 2013 2014 2015 2016 2017
Endoscopy Procedures
Nu
mb
er
of
Pro
ced
ure
s
Oncology
68
Cancer is one of the most feared diseases of recent times. A lot of medical progress has been undertaken in this field
and new findings have been brought to the forefront. This includes improved understanding for the biology of cancer,
precision in diagnosis and staging of cancer and optimizing the treatment of cancer. Expert surgical oncology team
offers optimum multimodality tailored treatment to the need of every patient.
Services provided at CIMS
n Early detection and prevention programs and cancer-related health check-up
n All types of surgery according to latest protocols
n Organ preserving surgery for different cancers (Mandible, voice-box in throat cancers, breast cancers, anal
valve in rectal & anal cancers, limb preservation in bone cancers)
n Chemotherapy for all solid cancers
n Reconstructive surgery and prosthesis for jaw, breast, limbs and other defects
n Well trained and efficient nurses for patient care
n Specially trained doctors and intensivists for the medical management of the patient
n Physiotherapy and functional rehabilitation
n Medical education for doctors
Facilities provided at CIMS
n Powerful surgical oncology team that offers optimum multimodality treatment tailored to the need of every patient
n State-of-the-art facilities for diagnosis and staging of all types of cancer
n Trained nurses to handle patients who are on aggressive chemotherapy and patients with aplastic anemia
n Experienced team of nursing staff , medical officers backed by high-end infrastructure, ICU set-up for high risk
and major operative procedures
n Round the clock availability of intensivists
n Back-up of an efficient pathology department.
n Modular, joint less operation theaters with anti-fungal paint application.
n LED OT lights
n Harmonic scalpel
n Enseal vessel sealing equipment
n Inbuilt OT cameras for direct relay and transmission of cases in auditorium
69
Oncology
Oncology Protocols offer:
n Early detection and prevention programs and cancer-related health check-up
n All types of surgery according to latest protocols
n Organ preserving surgery for different cancers (Mandible i.e. jaw, voice-box in throat cancers, breast cancers,
sphincter preserving rectal surgeries, pouch surgeries, limb preservation in bone cancers)
n Chemotherapy for all solid cancers
n Protocol based chemotherapy for hemato-oncology disorders
n Reconstructive surgery and prosthesis for jaw, breast, limbs and other defects and rehabilitation
n Specially trained doctors and intensivists for medical management of patients
n Nutrition plan guided by dietician before and after surgery
n Physiotherapy and functional rehabilitation
n Radiation therapy: Techniques of Radiotherapy:
1) 2D Radiotherapy: It is based on simple X-ray based planning, treats larger area of body
2) 3D CRT (3 Dimensional Conformal Radiotherapy):It is based on CT Scan based planning and uses
multiple beam & MLC (Multileaf Collimator) to form the shape of radiation beam according to tumor contour.
3) IMRT (Intensity Modulated Radiotherapy): It is conformal radiotherapy which allows higher radiation dose
to be focused to region within the tumor and minimizing the dose to surrounding normal critical structures.
4) VMAT (Volumetric Modulated Are Therapy): It is advanced form of IMRT
n The Medical oncology department is equipped with facilities like: Day care chemotherapy Center with specially
trained nursing staff, High dose chemotherapy, Targeted therapy & biological therapy.
n While the Surgical Oncology team at the CIMS hospital offers treatment for Head & Neck Cancer, Breast &
Thoracic cancer, GI & Hepato-Pancreato - Biliary services and Gynae Oncology.
6198 106 131 113
660
777
0
100
200
300
400
500
600
700
800
900
2011 2012 2013 2014 2015 2016 2017
Oncology Surgeries
2011
2012
2013
2014
2015
2016
2017
Num
ber
of P
roce
dure
s
70
Oncology
953 978
112
1548
1829
660
1934
765 777
0
500
1000
1500
2000
2500
Chemotherapy Radiation Therapy Surgery
2015
2016
2017
Total Oncology Volumes
Nu
mb
er
of
Pro
ce
du
res
37 246
6527
6
5941
4
87
404
703924
443
193
34
551
192
0
100
200
300
400
500
600
<30 year 30-60 year >60 year
2011 (N = 61)
2012 (N = 98)
2013 (N = 106)
2014 (N= 131)
2015 (N= 113)
2016 (N=660)
2017(N=777)
Age Distribution of Oncology Patients
Nu
mb
ero
f P
ati
en
ts
263543
55634356
7559 54
372
288
482
295
0
100
200
300
400
500
600
Males Females
2011 (N = 61)
2012 (N = 98)
2013 (N = 106)
2014 (N=131)
2015 (N=113)
2016 (N=660)
2017(N=777)
Gender Distribution of Oncology
Nu
mb
er
of
Pa
tie
nts
21 25
104
171
233
143
62
6
0
50
100
150
200
250
<20 21-30 31-40 41-50 51-60 61-70 71-80 >80
Age Distribution of Radiation Therapy Patients (N= 765)N
um
ber o
f P
ati
en
ts
71
Oncology
392
373
360
365
370
375
380
385
390
395
Male Female
Gender Distribution of Radiation Therapy Patients (N= 765)
Nu
mb
er
of
Pati
en
ts
36
110
179
556
622
358
70
30
100
200
300
400
500
600
700
<20 21-30 31-40 41-50 51-60 61-70 71-80 >80
Age Distribution of Chemo Therapy Patients (N= 1934)
Nu
mb
er
of
Pa
tie
nts
829
1104
0
200
400
600
800
1000
1200
Male Female
Gender Distribution of Chemo Therapy Patients (N= 765)
Nu
mb
er
of
Pati
en
ts
5.99
6.36
5.25 5.12
3.9
4.55
3.96
1
2
3
4
5
6
7
2011 2012 2013 2014 2015 2016 2017
Oncology Average Length of Hospital StayIn
Da
ys
Nephrology
72
Nephrology department at CIMS Hospital has four dialysis machines. The department functions round the clock. The
Department takes care of all types of nephrology cases, e.g. acute renal failure, chronic renal failure, acute and
chronic nephritis, nephrotic syndrome, Reno vascular hypertension, collagen disorders involving kidneys etc.
CIMS is well-equipped with all necessary resources for a successful renal transplantation which include, but not
limited to:
n Highly experienced and qualified team of doctors
n Appropriate counselling sessions for patient and relatives
n Transparent, non-objectionable ethical review by Renal Transplant Committee constituted by subject matter
experts and key opinion leaders
n Regulatory compliance as per State Govt. guidelines for organ transplantation
n Best infection control practices while harvesting kidney to be transplanted and also throughout the procedure.
The Nephrology unit at CIMS Hospital offers comprehensive nephrology services under one roof. It is known across
India for its expertise in the treatment of the most complex kidney related diseases. The institute has also facility of
renal transplantation in both live and cadaveric donor programs. The institute has some of the leading nephrologists
in India, who work closely with physical and occupational therapists to develop a comprehensive, individualized
treatment plan, keeping in mind the patient's diagnosis, lifestyle and professional requirements.
349
810
1214
1427
1693 1690 1672
0
200
400
600
800
1000
1200
1400
1600
1800
2011 2012 2013 2014 2015 2016 2017
In Patient Dialysis
Nu
mb
er
of
Pat
ien
ts
73
Patients with kidney disease need quality care,
guidance and hope. We provide a full spectrum of
services and take pride in our teamwork to achieve the
best possible outcomes in a range of disorders from
congenital to acquired and degenerative. Our
nephrologists direct all aspects of treatment, including
early intervention, transplant support and dialysis
services, like peritoneal dialysis (CAPD) and clinical
research.
Facility for CRRT (continuous renal replacement
therapy) for critically ill patients requiring dialysis is also
available.
The department provides all forms of dialysis including
hemodialysis and peritoneal dialysis.
Hemodialysis:
Hemodialysis for acute as well as chronic renal
failure patients
Hemodialysis is also done in cases of drug over
dosage
Plasmapheresis for renal as well as non-renal
cases
To reduce incidence of hepatitis B and C rigorous
precautions are taken and such patients are dialysed on
separate machines.CIMS has 6 dialysis workstations
and performed above 3100 hemodialysis procedures in
last year (2017) at the hospital.
n
n
n
Nephrology
1151
1571
1990
1895
1535
1197
1463
0
500
1000
1500
2000
2500
2011 2012 2013 2014 2015 2016 2017
Outdoor Patient Dialysis
Nu
mb
er
of
Pat
ien
ts
74
Urologic surgery focuses on the urinary tracts of males and females, and on reproductive system of males.
At CIMS, urologists perform minimally invasive surgical procedures to shorter the hospital stay with less discomfort
and bleeding issues.
Urologists at CIMS are dedicated to perform stone and prostate surgery also in high risk cardiac patients
Our team of surgeons, specialty nurses and other supporting staff are committed to the highest level of patient care
and their high level of skills will ensure a smooth management of urological disorders
Technological Excellence at CIMS:
n Storz HD Laparoscopy and urology instrument
n LED OT lights
n 4th generation Harmonic and tissue sealing system for precise advanced laparoscopic surgery with minimal
blood loss and tissue trauma
n Inbuilt OT Cameras for direct relay and transmission of cases in auditorium.
n Laser availability on request
n Round-the-clock availability of experienced surgeons to manage abdominal emergencies such as acute
abdominal pain, G.I. bleeding or trauma
n Experienced Nursing staff, Medical Officers and Infrastructure, high tech ICU set-ups for High risk and Major
operative procedures
n Reliable back-up of good surgical ICU facilities
Urology
88103 104
159
217
276 283
0
50
100
150
200
250
300
2011 2012 2013 2014 2015 2016 2017
Urology Surgery
Num
ber
of P
roce
dure
s
75
Urology
66
106
10
67
23
5
5
1
0
0
67
57
52
42
33
13
7
4
1
67
43
29
22
34
2
5
2
2
1
28
41
31
18
21
2
3
13
2
20
24
9
27
2
5
13
2
2
47
13
29
7
6
1
26
19
14
15
3
5
2
4
0 20 40 60 80 100 120
D.J. Stenting
Others
PCNL + URS (stone surgery)
Cystoscopy
TURP
Nephrectomy
Orchidectomy
PCN Tube Insertion
Lap. Redical Nephrectomy
Cysto Lithoplexy
Number of Surgeries
Urology Surgery
2011 (N = 88)
2012 (N=103)
2013 (N=104)
2014 (N=159)
2015 (N=217)
2016 (N=276)
2017 (N=283)
76
Urology
1422
52
14
36
53
13
35
56
10
80
69
29
9791
34
130
112
37
138
108
0
20
40
60
80
100
120
140
160
<30 year 30-60 year >60 year
2011 (N = 88)
2012 (N = 103)
2013 (N = 104)
2014 (N=159)
2015 (N=217)
2016 (N=276)
2017(N=283)
Age Distribution of Urology Surgery Patients
Nu
mb
er o
f P
ati
en
ts
75
13
87
16
91
13
124
35
167
50
218
58
215
68
0
50
100
150
200
250
Males Females
2011 (N = 88)
2012 (N = 103)
2013 (N = 104)
2014 (N=159)
2015 (N=217)
2016 (N=276)
2017(N=283)
Gender Distribution of Urology Surgery Patients
Nu
mb
er
of
Pati
en
ts
5.22 5.53
4.83
5.45
1.84
4.62
2.26
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
2011 2012 2013 2014 2015 2016 2017
Urology Average Length of Hospital Stay
In D
ays
77
Bariatric surgery is the most advanced and scientific method of losing weight and correcting all the
comorbidities associated with obesity.
CIMS is equipped with state-of-the-art technology to perform laparoscopic and bariatric surgeries of varied
complexities
At CIMS, outcomes of bariatric surgery are getting better all the time, as surgeons
gain experience in performing these technically demanding procedures laparoscopically.
The risks are not trivial, but they are acceptably low. The benefits: not only do patients
lose weight and keep it off, now there are convincing data that many patients are cured of
obesity-related diseases, notably type 2 diabetes. In fact, the procedure may pay for itself
within a few years by reducing medical costs due to obesity-related illness. Best of all, the
long term mortality rate seems to be lower for morbidly obese patients who undergo this
surgery than for those who do not.
INTRAGASTRIC AIR BALOON: An air balloon is implanted through the endoscopic route
in only around 30 minutes without the need to hospitalize the patient. This procedure of implanting is non-
Surgical and minimally invasive thus reducing post implantation nausea, vomiting and the feeling of pain.
SLEEVE GASTRECTOMY: The Vertical Sleeve Gastrectomy (VSG) generates weight loss solely through
gastric restriction (reduced stomach volume). In VSG approximately 2/3rd of the stomach is tapped off along
its greater curvature, leaving behind 1/3rd stomach along lesser curvature, which is roughly the size and
shape of a Banana or Sleeve. This operation does not involve any “rerouting ” or reconnecting of the
intestines. Hence it is technically a simpler operation than the gastric bypass.
GASTRIC BYPASS: Under this procedure, a small stomach pouch is created and section of the small intestine is
directly attached to the pouch. By creating a smaller stomach pouch, a Gastric Bypass limits the amount of
food that can be eaten at one time, so you feel full sooner and stay full longer . It also causes your body to
absorb fewer calories.
Bariatric and Metabolic Surgery
Bariatric and Metabolic Surgery
78
18
28 28
7
16
46
54
0
10
20
30
40
50
60
2011 2012 2013 2014 2015 2016 2017
Nu
mb
er
of
Pro
ced
ure
s
Bariatric Surgeries
Obesity Management at CIMS
CIMS provides a comprehensive, multidisciplinary
approach to care for the evaluation and treatment of
obesity. We offer a unique, integrated Patient-focused
team approach that meets patients' needs through every
step of the process.
At CIMS the highly skilled and committed team gives you
the best and the latest options for Bariatric surgery so you
can get back to your normal life with more self-
confidence.
Plastic Surgery
79
Criteria for hospitalization:
n
n Greater than 10% burns in a child
n Any burn in the very young, the elderly or the infirm
n Any full thickness burn
n Burns of special regions: face, hands, feet, perineum
n Circumferential burns
n Inhalation injury
n Associated trauma or significant pre-burn illness: e.g. diabetes
Plastic surgery at CIMS works with other surgical disciplines like oncosurgery, orthopedics, ENT, neurosurgery &
CVTS. The department under one roof offers state-of-the-art tertiary level care in all disciplines of Plastic Surgery
which include cosmetic surgery and various branches of reconstructive surgery like craniofacial surgery, maxillofacial
surgery, and surgical treatment of vascular anomalies, hand surgery, reconstructive microsurgery including brachial
plexus injuries, burns, reconstruction following ablative surgery for cancers and reconstruction following trauma.
Skin Grafting significantly improves the way a wound heals and prevents chances of infection or unsightly scars and
contractures that might develop if the wound is allowed to heal on its own without Skin Grafting.
Greater than 15% burns in an adult
2635
63 73
86 88
127
0
20
40
60
80
100
120
140
2011 2012 2013 2014 2015 2016 2017
Nu
mb
er
of
Pro
ced
ure
s
Plastic Surgeries
80
Services available at CIMS include:
n
n Reconstructive microsurgery including
brachial plexus injuries
n Craniofacial surgery
n Aesthetic plastic surgery
n Laser surgery
n Pediatric plastic surgery
n Hand surgery
n Skin grafting to treat wounds, trauma,
burns and infection
Plastic surgery at CIMS for cancer
patients include
n Mastectomy for breast cancer
n Head and neck cancer
n Surgery for skin cancer
n Surgery for colorectal cancer,
gynecological or peritoneal cancers
Reconstructive surgery
Plastic Surgery
179
28
7
48
15
62
11
69
17
60
28
104
23
0
20
40
60
80
100
120
Males Females
2011 (N = 26)
2012 (N = 35)
2013 (N = 63)
2014 (N=73)
2015 (N=86)
2016 (N=88)
2017(N=127)
Gender Distribution of Plastic Surgery Patients
Nu
mb
er
of
Pa
tie
nts
15 15
6 5
1820
8
24
3
13
20
8
20
2
1216
1916
5
66
27
33
16
5
12
2 3
16
1
12
70
1614
12
0
15
0
10
20
30
40
50
60
70
80
2011(N=26)
2012(N=35)
2013(N=36)
2014(N=86)
2015(N=86)
2016(N=88)
2017(N=127)
Nu
mb
er
of
Pro
ce
du
re
Types of Plastic Surgery
0
10
20
30
40
50
60
70
<30 year 30-60 year >60 year
2011 (N = 26)
2012 (N = 35)
2013 (N = 63)
2014 (N= 73)
2015 (N=86)
2016 (N=88)
2017(N=127)
Age Distribution of Plastic Surgery Patients
Nu
mb
er
of
Pati
en
ts
Gynecology
81
n
range of gynecological care for women from
adolescence through post-menopause. Our care
extends from preventive care to diagnostic,
operative and educational care.
n High Risk Pregnancy Unit with round-the-clock
expert team of obstetrician
n State-of-the-art NICU & Green ICU
n Round-the-clock intensivists
n In-house avai labi l i ty of Neonatologist ,
Cardiologist, Hematologist, Gastroenterologist
and Nephrologist
n Facilities of CT, MRI, Blood Bank & Dialysis
n Expert in management of medical disorders in
pregnancy, pre-pregnancy consultation
The Gynecology division at CIMS offers a wide
Fetal Medicine
n Facility for 3D/4D TIFFA/anomaly scan
n Colour doppler, foetal well-being scan, foetal echo
n Prenatal diagnostic and therapeutic procedures
like
F Amniocentesis
F Foetal reduction
F Cordocentesis
n Intra-uterine blood transfusion
n Aneuploidy screening
n First trimester combined screening (NT Scan +
S.BHCG + S.PAPP-a)
n Quadruple marker
n NIPT(Non-invasive prenatal diagnostic technique)
n Adolescent clinic and guidance
n Menorrhagia clinic for heavy periods (non-
invasive treatment like mirena and thermal
balloon ablation)
n Laparoscopic & hysteroscopic surgeries
n All types of gynaecological surgeries
n Urogynaecology
n Pelvic floor dysfunction surgeries (prolapse)
n Menopausal clinic
n HPV vaccine for prevention of cervical cancer
n Screening for cancer and treatment
n Contraception and family planning
n Treatment of white discharge (Leucorrhoea)
82
Gynecology
Infertility & IVF (Artificial Reproductive Technoogy)
Male & female infertility – evaluation and treatment
Laparo – hysteroscopy for evaluation of infertility
Intrauterine insemination (IUI)
In-Vitro Fertilization (IVF – Test Tube Baby)
Intracytoplasmic Sperm Injection (ICSI)
n
n
n
n
n
31 29 30
6984
115
165
0
50
100
150
200
2011 2012 2013 2014 2015 2016 2017
Nu
mb
er
of
Pro
ced
ure
s
Gynaecology Surgeries
83
Gynecology
104
84
14
103
93 1 32 3
12 11
1 1
23
9 10
21
4 2
32
1219
9 11
1
36
27 2623
2 1
21
34
44
52
6 8
0
10
20
30
40
50
60N
um
be
r o
f P
ati
en
ts
Gynaecology and Obstetrics Surgeries
2011 (N=27)
2012 (N=26)
2013 (N=19)
2014 (N=69)
2015 (N=84)
2016 (N=115)
2017 (N=165)
921
17
184
14 15
115
47
716
62
5
27
83
5
54
104
7
0
20
40
60
80
100
120
<30 year 30-60 year >60 year
Nu
mb
er
of
Pati
en
ts
Age Distribution of Gynaecology Patients
2011 (N=31)
2012 (N= 29)
2013 (N=30)
2014 (N=69)
2015 (N=84)
2016 (N=115)
2017 (N=165)
Neonatal Center
84
Pediatric and Neonatal Critical Care at CIMS Hospital (CIMS KIDS) is recognized as Gujarat's foremost pediatric
health-care institution and is geared with its mission statement and vision to be the most leading center dedicated to
advancing children's health through the integration of patient care, research and education.
Neonatal Critical Care Unit at CIMS is specially designed to treat ill or premature newborn infants.
n It is managed by a team of experts under the guidance of a highly experienced and expert neonatologist who on
requirement closely work with the hospital's obstetrics team and highly specialized (subspecialty) pediatric
services.
n Houses a special Neonatal Intensive Care Unit: level 3C (without ECMO)
n “Newborn critical transport van “…working 24x7 for kids provides comprehensive care for newly born weighing
800g (or 28 weeks or more in mother's womb ).
n Houses conventional and advanced life support systems including ventilators and ECMO (Artificial heart lung
machine).
n Well equipped to perform complex surgeries including- abdominal, respiration related and even cardiac
surgeries in the newborn.
n CIMS Perinatology wing promotes transfer of expecting mother's for care of mother and prematurely delivered
or sick babies identified through echo/sonography.
Pediatric Intensive Care Unit (PICU):
The PICU is well-equipped with recent and modern ventilators, infusion pumps; fiber optic and virtual bronchoscope
unit at bedside, nitric oxide delivery system, and sonography guided vascular access facility and bedside
echocardiography along with all expert personnel, intensivist, cardiologists, and general as well pediatric cardiac
surgeon in house. CIMS KIDS Foundation makes the unit self-sustainable.
First of its kind initiative with support of “Reeta Keyur Parikh Charitable Trust“, this Foundation supports families
undergoing huge financial trauma for treating their kids with long standing illness like neurological, trauma, cardiac
and neonatal disorders by adopting 1 NICU bed and 1 PICU bed. At least 20 families have been treated so far with the
help of this Foundation. All neonatal consultants waive off their professional charges to support this mission.
85
CIMS KIDS - Community and Social Activities brings awareness to children through school activities on theme of
1. Healthy diet for healthy children
2. Pediatric CPR (Cardio Pulmonary Resuscitation)
At CIMS, our neonatal experts provide a complete range of advanced care for the baby. This includes highly
specialized care for critically ill newborn or premature infants needing special medical treatment or surgery.We are
proud to be one of the top neonatal intensive care programs existing in India. At CIMS we believe every child deserves
the best neonatal intensive care.
CIMS neonatal intensive care unit offers a complete range of advanced neonatal care for the babies. Our NICU
services range from ventilation and intravenous therapy to genetic and metabolic evaluation to surgery and post-
surgery care.
At CIMS, Neonatal & Pediatric Critical Care Program includes:
n Highly qualified intensive care team to treat critical neonates
n State-of-the-art 12 bedded advanced neonatology setup, well equipped with conventional as well as high
frequency oscillatory ventilation (HFOV-SLE 5000) with nitric oxide compatibility
n Special respiratory care of premature babies with non invasive ventilation (i.e. bubble CPAP)
n Well equipped designated PICU (4 bedded-pediatric ICU) & 5 bedded pediatric surgical ICU
n Special care for infection control with 0.3 micron Hepa filters in ICU
n Facilities for multi para invasive monitoring, Peritoneal dialysis, bedside Ultrasonography, Total Parenteral
Nutrition, Phototherapy
n Multi-disciplinary intervention program with facilities like in-house pediatric surgery, Bronchoscopy, Radiology
n State-of-the-art care for critical subset of disease i.e. HMD, PPHN, Prematurity
n 24 x 7 emergency support and transport team equipped with pediatric ventilators
n Perinatal high-risk pregnancy consultation
Neonatal Center
86
Neonatal Center
State-of-the-art treatment for complex critical patients:-
High Frequency Oscillator Nitric oxide therapy
for PPHN
Care of extremely premature & Low birth
weight babies
Fibre optic
Bronchoscopy
Bubble CPAP PediatricEchocardiography
All kind of CardiacSurgery
21
63
3732
4147
109
0
20
40
60
80
100
120
2011 2012 2013 2014 2015 2016 2017
Total Non-Cardiac Pediatric Surgeries
87
Neonatal Center
6 510
33
12 14
5
19
410
411 10
101
7
19
1146
18 20
22
22
70
15
0
10
20
30
40
50
60
70
80
< 1 month 2-12 month 2-10 yr > 10 yr
Age Distribution of Non Cardiac Pediatric Surgeries
2011 (N=21)
2012 (N=63)
2013 (N=37)
2014 (N=32)
2015 (N=41)
2016(N=46)
2017(N=109)Nu
mb
er
of
Pati
en
ts
12
4 42
37
1412
8
1416
1
1111
3
9 911
710 9
1315
8 98
4 5
25
0
5
10
15
20
25
30
35
40
GastroinstestinalGenito-Urinary Respiratory Other
2011(N=21)
2012(N=63)
2013(N=37
2014(N=32
2015(N=41)
2016(N=46)
2017(N=109)
Nu
mb
er
of
Pro
ced
ure
Types of Non Cardiac Pediatric Surgeries
88
At CIMS, Head and Neck Surgeries include:
n
n Nasal Endoscopy
n Stapedectomy (removal of all or part of a bone in the middle ear)
n Cochlear implants (implantation of a device to stimulate nerve ends within the ear to enable hearing)
n Myringotomy (insertion of ear tubes to drain fluid in persons with chronic ear infections)
n Correction of a deviated septum and various forms of endoscopies
n Tonsillectomy and Adenoidectomy of various grades were successfully performed
Advantages of Balloon Sinuplasty Technique
n Less invasive : No need of cutting and removing the normal tissue of nose
n Less trauma : The pressure needed to inflate the balloon can be monitored from out side
n Less pain : Minimum intra operative and post operative pain
n Less recovery time : Procedure is recommended as office procedure / day care procedure
n Less scarring : No need of putting any incision over face or nose Less follow up : No post operative endoscopic
nasal cleaning is required
CIMS ENT department is dedicated to make sure our patients have the most positive, comprehensive and
highest quality of care. The ENT experts at CIMS, diagnose and treat conditions of the ear, nose, sinuses,
larynx (voice box), mouth, throat, head, and neck.
Physicians at CIMS, treat patients through both medical and surgical means providing facial plastic and
reconstructive surgery, pediatric ENT, cochlear implants, and hearing aids as well as treatment for balance
disorders, inhalant allergies, sinus and snoring disorders, voice and swallowing problems, and cancer of the
head and neck.
Tympanoplasty (reconstruction of the ear drum)
Ear Nose and Throat
89
At CIMS, total 30 nasal endoscopy have been performed in 2017.
Diagnostic nasal endoscopy is a procedure performed to better characterize the anatomy of the nasal cavity
and/or paranasal sinuses and to identify sinonasal pathology not afforded by anterior rhinoscopy.
Common indications for diagnostic nasal endoscopy include but are not limited to:
n Evaluate for chronic sinonasal symptoms unexplained by anterior rhinoscopy.
n Assess interval response to medical or surgical therapy in patients with chronic sinusitis and recurrent acute
sinusitis
n Monitor for recurrence of nasal polyps
n Evaluate and manage epistaxis
n Perform endoscopically guided cultures
n Assess facial pain suggestive of rhinogenic origin
n Evaluate clear rhinorrhea suggestive of cerebrospinal fluid leak
n Perform initial diagnosis and interval surveillance for sinonasal neoplasms
Ear Nose and Throat
15
37
32
47
45
70
29
0
10
20
30
40
50
60
70
80
2011 2012 2013 2014 2015 2016 2017
ENT Surgeries
Nu
mb
er
of
Pro
ced
ure
s
90
Ear Nose and Throat
52 1
3 35
15
11 12
2 3 47
14
51
4
15
20
85 5
1921
14 3
3027
53 4
2
15
0
5
10
15
20
25
30
35
Nu
mb
er
of
Pro
ce
du
res
Different Surgical Procedures of ENT
8
15
6
0
2
4
6
8
10
12
14
16
<30 year 30-60 year >60 year
Nu
mb
er
of
Pati
en
ts
Age Distribution of ENT Patients for 2017
25
4
0
5
10
15
20
25
30
Male Female
Nu
mb
er
of
Pa
tie
nts
Gender Distribution of ENT Patients for 2017
91
Pain management is a challenging issue arising from either complicated medical, surgical or neurological
issues. CIMS Pain Management Center is a one-stop destination for patients with chronic pain disorder. At CIMS a
specialized team of doctors, anesthetist, neurologist, medical psychologist, and physiotherapist diagnose,
evaluate and treat acute or chronic pain.
We use latest and advanced IMAGE GUIDANCE techniques to control pain. This improves precision and results with
minimally invasive technique.
At CIMS, we do very high end procedures like:
n Nerve root blocks
n Facet joint blocks
n Median branch blocks / Radio frequency ablation
n Ozone nucleolysis
n Vertebroplasty / Kyphoplasty
n Sacroiliac joint injection
n Piriformis injection
n Caudal, lumbar, thoracic, cervical epidural injection
n Myofascial trigger injection
n Hypodermic needling
n Sympathetic blocks like Sphenopalatine block, stellate block, T2, T3 Block, Splanchnic block /RF ablation,
Celiac block, Superior hypo gastric plexus block, Ganglion impar block etc.
n Gasserian ganglion radiofrequency ablation / V2,V3 block
n Occipital, intercostal, suprascapular, Genicular nerve blocks etc.
n Spinal cord stimulator implantation and monitoring
n Intrathecal morphine pump implantation
n PRP therapy
n Joint injections
We use IMAGE GUIDANCE by
n Live fluoroscopy
n Live USG
n Live CT Scan guidance
Pain Management
92
Pain Management
9
25
35
3941
0
5
10
15
20
25
30
35
40
45
2011 2012 2013 2014-2015 2016-2017
Pain Management
Nu
mb
er
of
Pa
tie
nts
Ophthalmology
93
As eye problems and ophthalmology diseases significantly impact the quality of life, our ophthalmology services also
extend to psychological support, health education and advanced care planning. In some cases where intensive care
may be required, our medical practitioners recommend specific treatment procedures. These include conditions such
as:
Cataract: Depending on the extent of the disorder, vision is corrected with prescription glasses or lenses.
Glaucoma: Once this disorder is detected, steps such as prescription eye drops, laser surgery or even microsurgery
is recommended to prevent the problem from progressing and leading to blindness.
Squint: Oculoplastic corrective surgery is often recommended in most cases.
Cornea: Dry eye management is recommended to prevent the eye from drying out, thus ensuring that the eye is well
moisturized.
Neurophthalmology: Optic nerve disease evaluation and management is often recommended to prolong
functionality. The other form of treatment includes diplopia management and electrophysiology.
13
2
15
39
57
26
56
46
47
196
367
2
14
1
5
0 100 200 300 400
Indirect Opthalmoscopy
Scan Biometry
YAG Laser Capuslotomy
Perimetry
Shirmer Test
Dry Eyes Assessment
Goniscopy
Pachymetry
Fundus Photogarphy
Fundus Screening
Major Eye Procedure
Minor Eye Procedure
Total Dry Eye Evaluation
YAG Laser Iridectomy
NumberOf Surgery
Opthalmo Surgery 2017 (N=886)
Pathology
94
CIMS is a NABL accredited State of the Art Quality Laboratory which offers 24x7 operational supports to the medical
teams in the hospital.
CIMS Pathology strongly supports clinicians in diagnosing and treating their patients. Services are also available for
outdoor, walk in patients. Customer friendly ambience aids to their experience to a great extent.
CIMS Microbiology also provides services for complete TB work up from specimen to Diagnosis for all specimens
which include:
1. AFB Fluorescence study
2. GeneXpert
3. Line probe assay
4. AFB culture (on automated MGIT)
5. Differentiation between NTM and MOTT
6. Complete DST for MTB and NTM/ MOTT
Experienced microbiologists are available for regular patient interactions. With Services available round the clock,
CIMS Microbiology stands strong to support the clinician. CIMS Microbiology also offers state-of-the-art molecular
microbiology with the high end fully automated gene sequencer.
95
Pathology
Cardiac Marker
Test Name Year 2014 Year 2015 Year 2016 Year 2017
Troponin-T 1436 1242 1323 1556
CPK-T 243 229 295 280
CPK-MB 236 180 237 167
NT Pro BNP 181 167 205 247
LDH 272 263 221 241
Diabetic Markers
Test Name Year 2014 Year 2015 Year 2016 Year 2017
Sugar 37637 36273 38156 42897
HbA1c 5500 5297 5502 6469
Microalbuminuria 963 851 673 103
Serum Acetone 360 431 573 555
Insulin 29 27 15 24
Coagulation Marker
Test Name Year 2014 Year 2015 Year 2016 Year 2017
PT 6089 6173 6888 8099
APTT 1223 1832 2031 2824
FDP 19 09 09 14
Fibrinogen 154 151 237 403
D-Dimer 207 166 190 180
96
Collagen Markers Test Name Year 2014 Year 2015 Year 2016 Year 2017
ANA 197 185 214 259
ANA Profile 42 48 65 63
SepticemicMarkers1847
Procalcitonin 151 144 168
C-Reactive Protein 1862 1847 2260 2610
Tumor
Markers
Test Name Year 2014 Year 2015 Year 2016 Year 2017
PSA 1265 1191 1026 1201
CA 125 68 67 88 79
CA 15.3 0 0 0 03
CA 19.9 46 31 42 50
CEA 138 131 137 157
Bone Markers
Rheumatoid
Arthritis 273 284 309 471
Uric Acid 1821 1627 1453 2026
Vitamin D3 1066 956 884 1141
Calcium 1805 1791 1905 2323
Pathology
Liver Function Test
Test Name Year 2014 Year 2015 Year 2016 Year 2017
SGPT 18433 18319 20432 24023
SGOT 5273 5297 5629 6776
Alkaline
Phosphate 3118 3203 3423 3905
Bilirubin 4344 4283 4407 5454
Proteins 4317 4281 4418 5205
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Renal Function Test
Test Name Year 2014 Year 2015 Year 2016 Year 2017
Urea 15832 14738 14567 16703
Creatinine 30883 29772 32090 37777
Sodium 17826 17051 23061 23671
Potassium 37927 35143 41521 40098
Chloride 12346 12197 18214 14017
Pathology
Endocrine Investigations
Test Name Year 2014 Year 2015 Year 2016 Year 2017
T3
901 844 772 954
T4
903 850 782 959
TSH 6882 6395 6844 8272
Free T3
220 183 150 134
Free T4
272 213 223 193
PTH 204 187 221 296
Cortisol 94 68 67 81
Markers For Disease
Test Name Year 2014 Year 2015 Year 2016 Year 2017
HIV I and II 11046 10815 10861 12135
HbsAg 11029 10897 10958 12196
HCV 423 610 1101 2044
VDRL 551 491 424 377
Pneumoslide 19 09 12 07
Malaria 144 226 249
Dengue 175 448 694 369
AFB Stain 108 163 116
AFB Culture 170 114 264
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Anemia Profile
Test Name Year 2014 Year 2015 Year 2016 Year 2017
CBC 35713 3607 38788 44903
Vitamin B12 1815 1543 1403 1921
Iron 206 135 185 220
TIBC 189 117 173 178
Ferritin 200 166 232 380
Retic 133 118 107 120
G6PD 39 36 59 62
Hb
Electrophoresis 33 78 102 153
Allergy Profile
Test Name Year 2014 Year 2015 Year 2016 Year 2017
Absolute
Eosinophil
Count
97 120 93 118
Immunoglobulin
IgE 356 328 314 388
Test for
Allergens 17 40 13 51
Pathology
Radiology
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The Radiology Department at CIMS is equipped with the CT and MRI. The radiology department also has a computed
radiography and Picture Archiving & Communication System (PACS) facility which is networked to the entire hospital.
This helps in real time transmission of information and diagnostic results.
The Department of Radiology and Imaging is well equipped with all the latest equipment's. It has a GE Sigma 1.5
Tesla super conductive MRI unit that comes with a whole range of features. The CT scan has speed 128 slice high
resolution scan with facilities that enable routine CT to 3D reconstruction. The other diagnostic facilities provided at
CIMS include Colour doppler, digital subtraction angiography, mammography, X-rays with image intensifiers and
more.
Department of Radiology and Imaging at CIMS hospital offers services of:
n Digital X-ray
n IITV
n Various x-ray procedures
n Ultrasonography
n Colour doppler
n Mammography
n Computerized Tomography Scan (CT Scan)
n Magnetic Resonance Imaging (MRI)
Computerized Tomography Scan (128 slice CT scan)
For patients requiring a CT examination, and in particular for those
requiring cardiac, brain or peripheral vascular examination, the state-of-
the-art 128-slice CT scanner takes advantage of the latest advances in
CT imaging technology to provide increased speed and detailed
information, better diagnostic care, greater convenience and improved
patient comfort.
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Engineered for both speed and accuracy, the 128-slice CT scanner at CIMS Hospital is the only advanced CT
scanner of this type in the region. It represents our continued commitment to deliver the very best in diagnostic
imaging to patients.
At CIMS, 128-slice CT imaging has ushered in a new era of diagnostic imaging and new non-invasive procedures
such as Coronary Angiography (CTA). The high speed scanner provides our radiologists with the ability to see more
anatomical detail in a fraction of the time previously required with conventional CT while simplifying sophisticated
cardiovascular and brain examinations and making them non- invasive and virtually pain free.
For certain patients, angiography of the heart, brain and peripheral vascular system no longer require the use of
catheters threaded through arteries and veins to inject x-ray contrast to provide a diagnostic image. With the
128–slice scanner, the x-ray contrast is administered through an IV in a patient's arm and the tremendous speed and
computing power of the scanner automatically coordinates the injection of the contrast in concert with the scanner's
imaging hardware to produce exquisitely detailed images of even the smallest arteries and related structures.
Benefits for cardiac patients in particular, the benefits are significant:
n Acute chest pain can be evaluated quickly with a single scan.
n The test can take as little as 10 minutes from scan to diagnosis instead of hours, and can potentially avoid other
tests such as stress testing, ECG studies, and blood testing.
n The scanner's speed shortens the length of time patients must hold their breath - from 17 seconds to just 9.
n Images of the beating heart in real time permit the evaluation of heart valves and related structures.
n Since cardiac catheterization is no longer required, there are fewer risks and complications.
n Since there is no recovery time involved, patients can leave when their exam is completed.
n The procedure is less expensive than traditional angiography helping to control cost.
Radiology
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Radiology
Investigation 2011 2012 2013 2014 2015 2016 2017
CT 1177 2536 2323 3087 3194 3295 5049
X-RAY 10079 16062 18823 20260 19018 16527 17299
USG 1390 2561 5343 6291 7018 7930 9614
Doppler 1727 2382 3031 3035 2883 2616 2847
MAMMO 128 646 725 744 1162 907 1132
Total Number 14501 24187 30245 33417 33275 31275 35941
11
43
10
89
37
5
22
17
16
25
42
5
50
07
19
89
51
1
62
91
17
99
27
0
35
06
15
98
31
2
61
88
12
48
38
1
96
14
13
26
38
0
0
2000
4000
6000
8000
10000
12000
USG Abdomen Carotid Doppler Renal Doppler
Nu
mb
er
of
Pa
tie
nts
USG and Doppler Study
2011
2012
2013
2014
2015
2016
2017
Physiotherapy, Rehabilitation & Nutrition
102
After an accident or illness, returning home in optimal physical condition is a top priority for both patients and staff at
CIMS.
At CIMS we stay up-to-date, because treatment techniques are constantly improving. Our patients get the benefit of
the very latest in medical technology but we believe the greatest healing power lies in the gentle touch of a human
hand, the compassion in a human voice just knowing that someone cares.
The physicians, nurses, therapists and other disciplines create a team that understands health and healing and is
committed to enhancing the quality of life for those we serve.
Our hospital provides comprehensive medical rehabilitation services for adults and adolescents (over the age of 14).
Common diagnoses and conditions admitted include strokes, amputations, burns, brain injury, spinal cord injury and
multiple orthopedic traumas.
At CIMS Rehabilitation Services Include:
n Cardiac Rehabilitation
n Orthopedic/musculoskeletal Rehabilitation
n Neurological Rehabilitation
n Pulmonary Rehabilitation
n Post-Surgery Rehabilitation (including liver and
kidney transplant)
n Pain management
n Nutritional Counseling
n Yoga Sessions
n Manual Therapy and Electro Therap
Women Wellness Programs include:
n Obesity Management
n Pre-natal and Post-natal exercises
n Post-Menopausal Rehabilitation
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Physiotherapy, Rehabilitation & Nutrition
Code Blue
104
At CIMS, "Code Blue" is used to indicate a patient requiring resuscitation or otherwise in need of immediate
medical attention, most often as a result of a respiratory arrest or cardiac arrest.
CIMS hospital, as a part of a disaster plan, sets a policy to
determine which units provide personnel for code coverage. CIMS
hospital has rapid response team or “blue code team” to reduce
preventable in-hospital deaths.
A single telephone number '222' is used for all Code Blue events at
CIMS. The call will automatically be directed to the Emergency
Department who will dispatch a Code Blue Response Team.
Frequently, physicians from anesthesia, emergency medicine and
internal medicine are in charge of the team. A rapid response team leader or a physician is responsible for
directing the resuscitation effort and is said to “run the code”.
In-hospital cardiac arrests are common and delayed treatment is associated with a lower survival rate and
poor neurological outcomes. However, early recognition of “at-risk” situation is important for the safety of the
patients. But blue code alarms in response to the misused cases may demoralize the team, and the team could
not respond to the alarm. Hence it is possible to set up an intermediate step called “confirmation step”
between an initial blue code call and an activation of hospital-wide alert.
105
Code Blue
Quality Measure
106
Quality improvement is not just about standard-setting and benchmarking with the best: there are analytical,
counseling and self-improvement dimensions to the process. Through self-assessment at CIMS, we strive to
assess our level of performance in relation to established standards and implement ways to continuously
improve. At CIMS, quality measures are assessed by monitoring a wide range of parameters monthly and comparing
them to established certified benchmarks.
Appropriateness of Care:
Appropriateness in healthcare is a complex parameter with various dimensions and definitions which differ
with pathologies and regions. However, principally they address -A) Clinically effective evidence based care
B) Cost effective care
C) Consistent ethical care
The priorities of these dimensions vary in different populations.
Based on above principles Appropriateness of Care can be measured using below indicators which directly
and/or indirectly relate to patient wellbeing. These indicators include
I) Patient care indicators
II) Guideline driven indicators
III) Clinical outcome indicators
IV) System specific indicators
V) Cost-effective indicators
VI) Structural indicators.
At CIMS Appropriateness of Care is the followed ideology.
Quality improvement is not just about standard setting and benchmarking with the best: there are analytical,
counseling and self-improvement dimensions to the process. Through self-assessment at CIMS, we strive to
assess our level of performance in relation to established standards and implement ways to continuously
improve.
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Quality Measure
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Quality Measure
Ambulance and Transport Services
109
n We have 4 ambulances including one Trauma ambulance with fixed ventilator unit, one CIMS Kids
ambulance, and two general ambulances with two mobile Ventilator units.
n The demand for emergency ambulance services continues to increase each month, and as such, it becomes
even more of a challenge to maintain the standards we wish to provide.
Ambulances are equipped with international quality instruments for international standards of service & care. The
doctors on board are trained adequately experienced to handle all kinds of emergencies.
n 24 x 7 services are provided for all patient transport needs
n Transfers from home to hospital and from hospital to hospital
n Highly trained medical personnel
n Our ambulances carry oxygen therapy equipment with defibrillator to provide aid in the event of any
deterioration of patients whilst in our care.
Care At Homes
110
The prominence of health care services has evolved in India.
Today, health care services is undergoing a revolutionary change with changing medical innovations, newer
technology and understanding of receiving the right medical care.
Also, in today's fast paced world, it has become extremely important and difficult to receive a continuance of the right
medical care after discharge from the hospital.
When the health of a loved one is compromised, all treatment options can seem a bit overwhelming. Often, many
patients and their families choose to receive medical care in the comfort of home. It's a familiar alternative to the
hurried pace of a hospital, nursing home, or assisted living community.
111
Many a times, after discharge, the patient is in need for help and assistance at home. This is where Care at Homes
steps in a new branch of care giving service developed by us to ensure that each patient receives right care even after
going home. Care at Homes refers to medical services being provided to the patient at home, especially for those who
require exclusive attention and consistent assistance including a range of services such as doctor visit, nursing care,
physiotherapy, psychotherapy, dietary and nutrition, speech assistance and nursing.
Backed by an exceptional team of our care givers including nurses, attendants, physiotherapist, etc., we offer an
uncompromising level of service that doctors can trust. Our services range from 24-hour complex clinical care to
weekly patient visits. Regardless of the situation, we aim to give you peace of mind.
Care At Homes
Our Services
n Implementing clinical care plans
n Attending to disabilities, chronic illness, and/or
therapies
n Coordinating home medical equipment,
pharmacy and supplies
n Pharmacy (medications) at your doorstep e
Assisting with mobility and transfers
n Performing personal care
n Assisting with daily activities
24 x 7 Specialized Nursing Service
n Escort nurse for patients shifting
n Wound care and dressing
n Intravenous (IV) infusion therapy, Intra Muscular
(IM) and Sub Cutaneous (SC) injections
n Focus on continuous training and development
n Catheter (urinary) insertion and care e Vaccination
at home
Patient's Say
112
PR: Very good hospital and all the facilities are just awesome. Especially staff doctors are too good. I never saw this
kind of superb facility and cooperative staff ever.
MP: This is the best cancer treatment hospital, if you want to save your or your belonging's life from cancer, get admit
here and you are saved.Docters are so much cooperative they give you full time understanding your medical
conditions. Visits regularly and takes care of what treatment is going on they even make sure of your medicine and
diet every time they visit. Hospital is neat and clean, staff cleans hospital whole day. The staff is not only friendly but
they'll make you feel like family. No outside people are allowed it's strictly not allowed for unwanted people. And best
thing is that the doctors comes to visit patient at home, never heard of that before. We are 320km far from CIMS but
they came. Really they are amazing and too friendly.
JS: No words for services of Hospital. I feel almighty is there within every person. I really appreciate the work of
doctors team Staff, etc. My wife got a second life in CIMS. Thank you so much all of you.
VM: I have visited CIMS hospital for heart related problem to consult Dr. Ajay Naik sir. He had EP Study & successful
RF Ablation performed by transept route. Now I have gone after 15 days and I am feeling well my heart beat now
controlled. CIMS staff members are very friendly and helpful and co-operative. They provide nice facility.
DC: Dr. Rupesh Shah is the best doctor. To write something for him would always be short of words, an excellent
doctor as well as an excellent human being, perfect analysis and diagnosis, passionate towards his work. Good
doctors like him replace the Fear of Illness with Trust in Recovery. He is truly an asset for CIMS and the entire
Ahmedabad. May he scale great heights.
FS: The hospital was referred to me by my cousin, at first I thought how the doctors, nurses and staff be? But soon I
kept one step in the hospital got good impression and services. The doctors are superb. They treated me so nicely
and friendly the nurses were very good and polite as they knew I was in fear but they made my treatment smooth.
Thanks to CIMS HOSPITAL
113
DS: CIMS hospital Dr.Vineet Sankhla he is a very good doctor, such like a God. Very much helpful nature. We are
really thankful to hospital for giving us an intelligent team. Dr. Dhiren Shah and his team such a great support to me.
Thank u all.
SJ: Special thanks to CIMS. Dr. Dhiren Shah and Dr. Dhaval Naik I won't say they are just good doctors they are next
to God for us. Down to earth nature. Had Wonderful experience with CIMS 100% satisfaction of patient. Such a
humble, polite, smiling, positive and experienced team who care for the patient so effectively and Complementary
doctor home visit add extra stars in their service part. Again bigger thanks to Dr. Dhiren Shah sir, Dr. Dhaval Naik sir
and their team and CIMS hospital.
PS: Amazing nice work and staff behavior so good and nice polite by staff and ambience and nature very good and Dr.
Keyur Parikh sir behavior very good and family behavior Dr. Parikh sir.
AV: Well experienced doctor's team. Modern and highly equipped tools. Best care provided to patients. Supportive
and caring doctors, nurse, patient care boys, housekeeping, security and back office staff. Best Hospital.
BP: Excellent treatment and all staff nature and behavior are excellent, excellent administration and care even after
discharge we got excellent service, H2H service is also appreciated.
Thanks to Dhiren Sir and Parikh Sir and all staff.
Patient's Say
Ethics Committee
114
Institutional Ethics Committee of Care Institute of Medical Sciences
Ethics Committee of Care Institute of Medical Sciences (EC CIMS) is the first Ethics Committee in India accredited by
National Accreditation Board for Hospitals and Healthcare Providers (NABH).
Ethics Committee of Care Institute of Medical Sciences is registered by Central Drugs Standard Control
Organization, Government of India Registration number ECR/206/Inst/GJ/2013 as per the provision of Rule 122DD
of The Drugs and Cosmetics Rules, 1945 and registration is sought for Institutional Ethics Committee.
Code of Ethics
The management is fully aware of ethical management and ethical practices. Hospital has established the
Ethical committee. Committee follows code of ethics established by Medical Council of India, Indian Council of
Medical Research (ICMR) and ICH-GCP guide lines. CIMS EC has initially applied for the NABH
accreditation as per the current NABH-Accreditation standards for Ethics Committee, Investigator and Clinical
Trial Site.
Scope of Committee
Review and approve clinical trials/studies (drugs and devices) both observational, academic, Investigator Initiated,
and experimental studies from Phase I to Phase IV, Bioavailability / Bio-equivalence (BA/BE) studies, Clinical
Registry and Others (e.g. Bio-Banks, tissue research, nutraceuticals and food products)
Research Projects
115
116
Research Projects
117
Research Projects
118
Research Projects
119
Achieving Highest Benchmarks in Interventional Cardiology:
NCDR® Cath PCI a Critical Contributing Factor
Background: NCDR is a transparent public reporting system which serves as a potent repository of clinical data to
improve quality metrics and answer research questions. Care Institute of Medical Sciences (CIMS) is the only first
Indian Center to be part of National Cardiovascular Data Registry(NCDR®) based CathPCI registry®. Bleeding
complications after coronary intervention are associated with prolonged hospitalization, increased hospital costs,
patient dissatisfaction, morbidity and one year mortality. Analysis of NCDR Cath PCI data following participation and
comparison with US percentiles indicated scope of improvement.
Methods: Datasets of CIMS hospital after (Oct. 2014-June 2017) NCDR based CathPCI registry® participation were
analysed. PCI In-hospital Risk Adjusted Rate of Bleeding Events, PCI in-hospital Risk Adjusted Mortality and Door to
Balloon Time were analysed temporally post NCDR Cath PCI participation. Strategies were designed and
implemented to improve these outcomes.
Results: Following NCDR Cath PCI
part ic ipat ion and i ts data analysis,
concentrated efforts at tabulating and
evaluating bleeding events prospectively in
PCI patients was initiated to understand true
rates of bleeding complications. Use of GP
IIb/IIIa inhibitors and low molecular weight
heparin became judicious. Use of dual
antiplatelet therapy, radial access PCI,
vascular closure devices, and unfractionated
heparin instead of Low Molecular Weight
Heparin were the adopted strategies. Bleeding
events reduced from 1.5% in 2014 to 0.31% in 2017 (80% improvement p<0.05 Fig 1). Median door-to-balloon time
decreased from 64 minutes to 46 minutes following NCDR participation (Fig 2), reducing risk-adjusted in-hospital
mortality significantly(p<0.001,Fig 3). This was achieved through strong interdepartmental communication;
establishing predetermined time-based goals in the patient care process (i.e., door-to-ED of less than 5 minutes,
door-to-team activation of less than 15 minutes, door-to-ED departure of less than 20 minutes, and finally door-to-
balloon time of less than 50 minutes).
Research Projects
Figure 1: PCI in-hospital Risk Adjusted Rate of Bleeding Events
120
Research Projects
Figure 2: Door to Balloon Time
Figure 3: PCI in-hospital Risk Adjusted Mortality
121
Reduced Median Fluoro Time: An Outcome of NCDR® Participation
Background: Patient-level factors, including anatomic characteristics of coronary artery lesions, and physician and
hospital practices have the potential to increase radiation exposure in cardiac catheterization. Thus strategies to
reduce radiation exposure in the Cath-lab largely lie in the hands of physicians and hospitals (Cath-lab
Technicians).The challenge is to perform increasingly complex work with shorter fluoroscopy times with no
procedural complications. Care Institute of Medical Sciences (CIMS) is the only first Indian Center to be part of
National Cardiovascular Data Registry(NCDR®) based CathPCI registry®. The group cardiology practice performs
97% of its PCI’s through radial access. As compared to femoral intervention, radiation exposure is higher in radial
access PCI’s.
Method: Datasets of CIMS hospital after (Oct. 2014-June 2017) NCDR based CathPCI registry® participation were
analysed for variables determining radiation exposure in the Cath lab. Strategies were established in reducing
radiation exposure in the Cath lab.
Results: After data analysis changes were introduced
in the hospital practices which included intra procedure
radiation dose announcements; reporting of
procedures for which the air-kerma exceeded 6,000
mGy; recording procedure air-kerma in the Cath-lab
report/software; and establishing compulsory radiation
safety training for fellows. Technical changes included
establishing standard X-ray imaging protocols,
increased use of x-ray beam spectral filters, reducing
the detector target dose for fluoroscopy and
acquisition imaging, and reducing the fluoroscopy
frame rate to 7.5 s−1. Cath-lab technician and supporting staff received training every three months from hospital’s
Radiation Safety Officer (RSO). Also experimental use of radiation protection shields like Cardio-Trap was initiated.
With time at CIMS median fluoro time decreased from 8 minutes to 5 minutes (Fig 1).
Conclusion: NCDR participation helped to improve quality matrix in terms of reducing fluoroscopic time.
Research Projects
Figure 1: Median Fluoro Time
122
Reduced Percutaneous Coronary Intervention In-hospital Risk Adjusted Rate of
Mortality and Bleeding Events via Radial Access: NCDR® Findings
Background: In the hands of experienced operators and high-volume catheterization Centers, trans radial coronary
interventions offer improved patient comfort, decreased access-site complications, and decreased costs without
compromising procedural success or long-term outcomes. Patients with Body Mass Index (BMI) >25, with ST-
Elevation Myocardial Infarction (STEMI), in particular, benefit from a transradial approach coronary intervention.
Bleeding complications after coronary intervention are associated with prolonged hospitalization, increased hospital
costs, patient dissatisfaction, morbidity and one year mortality.
Methods: Although transradial percutaneous coronary intervention (PCI) was practiced since 2004 at Care Institute
of Medical Sciences (CIMS), data collection became a part of the quality improvement drive following participation in
National Cardiovascular Database Registry (NCDR®), CathPCI registry® in 2014. NCDR CathPCI® data collection
proforma v 4.4 of the only Indian Center with a well-established radial lounge was analyzed for radial PCI. A total of
12102 patients underwent cardiac coronary angiography/intervention from Oct. 2014 to Jun. 2017, of which 11788
(97.40%) were right radial angiography/intervention and 4093 PCI’s. Concentrated efforts at tabulating and
evaluating bleeding events prospectively in angioplasty patients was the first step in understanding true rates of
bleeding complications.
Research Projects
2014 Pre-CathPCI
2017 CathPCI Outcomes
US 90th Percentile
Figure 1: PCI in-hospital Risk Adjusted Rate of Bleeding Events
123
Results: Of these total patients 3370 (82.33%) were males and 723 (17.67%) were females. Prevalence of obesity
was as high as 62.07% (overweight, BMI>25:1732(43.35%); obese, BMI>30:693(17.35%); morbidly obese:
BMI>40:55 (1.37%); diabetes: 1382(33.76%); STEMI: 1165(28.46%); age>75 years: 238 (5.81%). Median fluoro
time: 7 min; radiation exposure for diagnostic catheterization: 500-1000milligray; for PCI: 2500-3000milligray. With
adequate anticoagulation (unfractionated heparin);
sheath size (5F and 6F); and proper removal of
hemostasis band and manual compression incidence of
radial artery occlusion was <8%; in-house bleeding less
than 0.31% (Fig 1) and patients with STEMI in-hospital
risk adjusted mortality rate 3.19% (Fig 2). Analysis of
NCDR Cath PCI data following participation and
comparison with US percentiles indicated area of
improvement (Figure 1 & 2). Use of diltiazem and nitrates
reduced incidence of artery spasm. With 76% patients
without insurance coverage, diagnostic angiography
length of hospital stay (LOS) averaged 6-7 hours, with an
average procedural total cost of USD $167. PCI LOS
averaged to 1.5-2.0 days with cost depending on stent
type which ranged between USD $1900-3500.
Conclusion: NCDR CathPCI registry® helped establish that at a high volume Center with an established radial
procedure lounge, trained staff; patient comfort, mobility and cost effectiveness has increased with radial artery
catheterization with reduced hospital stay and reducing mortality rate and bleeding events from 1.5% to 0.31 in 2014
to 0.31% and mortality rate in 2017 (80% improvement ,p<0.05).
Figure 2: PCI in-hospital Risk Adjusted Rate
of mortality (patients with STEMI)
Research Projects
124
NCDR® as a Resource Improvement in Hospital Quality Parameters
Background: India is a developing nation and implementation of national registries, guidelines and electronic
medical records is in progress. Documentation of history taking, risk factor assessment for primary care, insurance
details, prescription errors etc. at times are not critically implemented. Appropriate Use criteria (AUC) guidelines are
not assessed mandatorily for PCI’s. Progressive hospitals are reorganizing cardiovascular services into
multidisciplinary programs that involve specific care settings for specific procedures. Reliable dataset and
characterization of target population are its primary requirement. Care Institute of Medical Sciences (CIMS) is the
only first Indian Center to be part of National Cardiovascular Data Registry(NCDR®) based CathPCI registry ®.
Method: Datasets of CIMS hospital before (Jan 2011-October 2014) and after (Oct. 2014-June 2017) NCDR based
CathPCI registry® participation were analysed. Variables compared included patient history including risk factors,
smoking cessation education, AUC, and discharge prescription.
Results: A total of 3832 PCI’s were performed post NCDR Cath PCI participation as compared to 5786 pre NCDR
Cath PCI participation. Documentation of data has improved significantly by 50.39% (p <0.05) in areas of history
taking including risk factors; audit of discharge prescriptions showed a significant improvement of 36.5% (p<0.05).
Special emphasis was placed on smoking cessation in smokers. Temporal trends following NCDR participation
showed improvement in the percentage of appropriate non-ACS PCIs from 64.71% in 2014 to 100% in 2017
(p<0.05); appropriate PCIs in ACS patients improved to 95.41% ensuring that patients who undergo PCI at CIMS
have a high likelihood of clinical benefit, while minimizing the potential for procedural risk.
Conclusion: Based on registry database, the practice of interventional cardiology at CIMS has evolved towards
more appropriate selection of patients for non-acute PCI since the introduction of PCI AUC metrics from NCDR
report. NCDR data has helped to improve quality matrix in term of demographic details and clinical history. The
improvement was achieved due to NCDR participation resulting in documentation of correct data in smart devices
like I pads in real time; improvement in communication skills with patient’s; establishing importance and criticality of
data; revising processes and standard operating procedures. There is significant improvement in AUC establishing
ethical clinical practices of international standards in a developing country.
Research Projects
CIMS Foundation
125
CIMS Foundation (Regd. No. E19607) is a registered trust under Income Tax Act 19614, subject to the limits
prescribes therein and certified that donation made to the trust shall qualify for deduction u/s 80G(5) of the Income
Tax Act, subject to the limits prescribed therein.
CIMS Foundation is combination of financial and social activities; we organized camps and lectures to create
awareness across the cross section of the societies, schools & colleges. More than 4000 people took advantage of
this initiative of CIMS Foundation.
n We believe every human being has a fundamental right of access to medical treatment. With CIMS Foundation,
we have taken our first step towards helping such people & their family who are in need.
n CIMS Foundation is established to provide support in delivering remedial healthcare to the vulnerable sections of
the society. In India, 21 % percent of people die each year because they are unable to afford proper medical care.
n CIMS has commenced with the contributions by Founding Members and Trustees, the Foundation has been
born of a dream. To Make A Difference. To Care. To Give Life.
n CIMS Foundation is combination of financial and social activities; we organized camps and lectures to create
awareness across the cross section of the societies, schools & colleges. More than 4000 people took advantage
of this initiative of CIMS Foundation.
n To create awareness about organ donation presently we had conducted awareness lecture on “ORGAN
DONATION” by faculty- Dr. Dhiren Shah- Heart Transplant surgeon, cardiothoracic and Vascular surgeon at
Gujarat Vidhyapith. The Students and faculties were very attentive throughout the lecture and had a fruitful
interaction with the speaker, making the lecture a success.
n The Smallest of your contribution will make the
biggest of difference. To a Life , To a Family, To
Faith, To Survival, To Happiness.
n You can send your donation by cheque/ DD in
favour of “CIMS Foundation” payable at
Ahmedabad or transfer direct to our bank
account,
Bank Detail
CIMS Learning Center
126
Care Institute of Medical Sciences (CIMS) is pleased to present the CIMS Learning Center (CLC) Program for the
year 2018.
Growth is driven by curiosity; curiosity is assuaged by knowledge. And knowledge is gained by continuing education.
At CIMS CLC, we recognize that teaching and practice go hand in hand. CLC is founded on that premise. To share
what we learn and pursue bigger ideas.
In today’s constantly evolving field of medicine, there is always new to learn. Rapid advances, newer breakthroughs
and technological innovations require continuous updates to impact practices.
We do provide best medical facilities to our patients; but we also are driven by the need to learn and teach… to create
a vast body of professionals highly committed to the pursuit of world-class healthcare with knowledge at their
fingertips.
CLC is born of that need. A dream to create a Learning Center par excellence, setting the highest standards of
medical education.
CIMS Learning Center Program offers continuing medical education opportunities for a variety of faculty and medical
providers, including Physicians, Technologists, Researchers and Nurses.
From the last 21 years, we have been holding a continuous stream of workshops, CMEs, Fellowships and Annual
conference JIC (hosting more than 2000 delegates) to uphold our academic endeavors.
CIMS hospital has been approved as American College of Cardiology (ACC) Center of Excellence 2014-2015, the
first & only one in India.
127
CIMS Learning Center
CIMS Education
128
CIMS regularly organizes CMEs, workshops, etc. to acquaint its doctors with the latest technology and techniques in
the field of medicine and surgery.
At CIMS, critical care unit holds weekly scientific and educational meetings open to all physicians. These
discussions range from guidelines to patient management and latest medical updates with case studies supported
by interactive audio-visual discussions.
As a part and process of education, we are proud of our annual mega educational event JCI- 2017, an annual
conference targeted at physicians showcasing advances in medicine and surgery. Addressed by leading
international and national medical luminaries, the conference is a result of an unwavering passion to educate
all.
Publication List (2014-2017)
129
1. Parloop Bhatt, Urmil Shah, Milan Chag, Dhiren Shah, Ajay Naik, Hemang Baxi, Anish Chandarana, Satya Gupta, Vineet
Sankhla, Tejas Patel, Vipul Kapoor, Piyush Thakar, Aditi Nanavati, Keyur Parikh NCDR® as a Resource Improvement in
Hospital Quality Parameters Abstract Accepted at NCDR 2018
2. Parloop Bhatt, Urmil Shah, Milan Chag, Dhiren Shah, Ajay Naik, Hemang Baxi, Anish Chandarana, Satya Gupta, Vineet
Sankhla, Tejas Patel, Vipul Kapoor, Piyush Thakar, Aditi Nanavati, and Keyur Parikh Achieving Highest Benchmarks in
Interventional Cardiology: NCDR® Cath PCI a Critical Contributing Factor Abstract Accepted at NCDR 2018.
3. Parloop Bhatt, Urmil Shah, Milan Chag, Dhiren Shah, Ajay Naik, Hemang Baxi, Anish Chandarana, Satya Gupta, Vineet
Sankhla, Tejas Patel, Vipul Kapoor, Piyush Thakar, Aditi Nanavati, Keyur Parikh Reduced Median Fluoro Time: An Outcome
of NCDR® Participation Abstract Accepted at NCDR 2018
4. Parloop Bhatt, Urmil Shah, Milan Chag, Dhiren Shah, Ajay Naik, Hemang Baxi, Anish Chandarana, Satya Gupta, Vineet
Sankhla, Tejas Patel, Vipul Kapoor, Piyush Thakar, Aditi Nanavati, Keyur Parikh Reduced Percutaneous Coronary
Intervention In-hospital Risk Adjusted Rate of Mortality And Bleeding Events via Radial Access: NCDR® Findings Abstract
Accepted at NCDR 2018
5. Keyur H. Parikh, Sameer Dani, Ranjan Shetty, Prathap Kumar, J.S.Hiremath, Dinesh Shah : Sirolimus Coated Balloon For
the Treatment of Coronary Artery Stenosis: Long Term Outcome From a Real World Experience (Abstract Accepted in
American College of Cardiology ACC March -2018)
6. Keyur H. Parikh, Sameer Dani, Ranjan Shetty, Prathap Kumar, J.S.Hiremath, Dinesh Shah : Treatment of Coronary In-Stent
Restenosis With Sirolimus Coated Balloon Catheter: Sub-Analysis Results From Nanolute Study (Abstract Accepted in
American College of Cardiology ACC March -2018)
7. Keyur H. Parikh, Clinical efficacy and safety of Sirolimus coated balloon in a real world single Center registry of Indian
population (Abstract Accepted at EURO PCR May 2018)
8. Parloop Bhatt, Parth Parikh, Anish Chandarana, Milan Chag, Vipul Kapoor, Aditi Nanavati, Tejas Patel, Satya Gupta,
Hemang Baxi, Urmil Shah, Vineet Sankhla, Neil Jain, Keyur Parikh, CIMS Hospital, Ahmedabad, India, L. M. College of
Pharmacy, Ahmedabad, India: Impact of Drug Eluting Stent Price Reduction in India: Selection for Stent Type Placement and
Associated Outcomes (Accepted in American College of Cardiology ACC March -2018)
9. Keyur H. Parikh, Parth Parikh, Parloop Bhatt, Aenasha Chag, Hemang Baxi, Milan Chag, Urmil Shah, Satya Gupta, Anish
Chandarana, Manish Doshi, CIMS Hospital, Ahmedabad, India, Cleveland Clinic Foundation, Cleveland, OH, USA: Real
World Clinical Outcomes of Sirolimus Coated Balloon in Coronary Artery Lesions: Results from Single Center
Study(Accepted in American College of Cardiology ACC March -2018)
10. Keyur H. Parikh, Parth Parikh, Deepa Shah, Parloop Bhatt, Piyush Thakar, Ajay Naik, Hemang Baxi, Shmuel Banai, CIMS
Hospital, Ahmedabad, India, Cleveland Clinic Foundation, Cleveland, OH, USA: Coronary Sinus ReducerTM Retains
Patency and Efficacy at Twelve Years: A Prospective Cardiac CT Angiography Outcomes(Accepted in American College of
Cardiology ACC March -2018)
Publication List (2014-2017)
130
11. Patel B Krunal, Chag C Milan, Gupta B Satya, Bhatt A Parloop, Parikh K Parth, Patel Aditi, Patel K Apurva, Jain N Neil, Parikh
H Keyur, CIMS Hospital, Ahmedabad, India, Cleveland Clinic Foundation, Cleveland, OH, USA: First In Man Vascular Use Of
Axiostat®: A Novel Whole Chitosan Haemostatic Dressing For Transradial Coronary Intervention Accepted: At WEC,
Rajasthan, India, October, 2017
12. Dhiren Shah, Milan Chag, Deepa Shah, Dhaval Naik, Amit Chandan, Chintan Sheth, Niren Bhavsar, Hiren Dholakiya,
Parloop Bhatt Late Coronary Stent Infection: A Difficult to Diagnose Rare Complication after Percutaneous Coronary
Intervention Manuscript Accepted at Indian Journal of Thoracic and Cardiovascular Surgery (IJTC-D-18-00066R1) 2018
13. Parikh K Parth, Patel B Krunal, Chag C Milan, Gupta B Satya, Bhatt A Parloop, Parikh K Parth, Patel Aditi , Patel K Apurva,
Jain N Neil, Parikh H Keyur, CIMS Hospital, Ahmedabad, India, Cleveland Clinic Foundation, Cleveland, OH, USA:
Superiority Of Newer Oral P2y12 Inhibitors In Treatment In Coronary Artery Disease Patients Undergoing Percutaneous
Coronary Intervention At A High Volume Non-Us Center Abstract Accepted: at WEC, Rajasthan, India, October, 2017
14. Keyur H. Parikh, Parth Parikh, Parloop Bhatt, Satya Gupta, Hemang Baxi, Urmil Shah, Tejas Patel, Milan Chag, Sameer
Dani, Ranjan Shetty, Prathap Kumar, Jagdish Hiremath, Dinesh Shah, Manish Doshi, CIMS Hospital, Ahmedabad, India,
Cleveland Clinic Foundation, Cleveland Clinic, India: Prospective Real World Registry for the Use of Sirolimus Coated
Balloon in Small Vessel De Novo Lesions (Accepted in American College of Cardiology ACC March -2018)
15. Parth Parikh, Parloop Bhatt, Vipul Kapoor, HemangBaxi , Satya Gupta, Tejas Patel, Anish Chandarana, Roosha Parikh,
Apurva Patel, Keyur Parikh. Optimal P2Y12 Inhibitors for Primary Percutaneous Coronary Intervention Patients in ST
Segment Elevation Myocardial Infarction: Actual Care Trends and Outcomes. Accepted and presented in SCAI
2017, Orlando.
16. Parth Parikh, Apurva Patel, Parloop Bhatt, Milan Chag, Roosha Parikh, Anish Chandarana, HemangBaxi, Satya Gupta, Vipul
Kapoor, Vineet Sankhla, Keyur Parikh, Care Institute Medical Sciences, Ahmedabad, India, Cleveland Clinic Foundation,
Cleveland, OH, USA: Evaluation of a New Radiation Protection Technology (Cardio-TRAP®) in Transradial Percutaneous
Coronary Intervention Procedures. Abstract Accepted and presented at ACC 2017,Washington, DC. Published in
Journal of the American College of Cardiology 69(11):1365 • March 2017. DOI: 10.1016/S0735-1097(17)34754-X.
17. Poonam Chodvadiya, Keyur Parikh, Ranjan Shetty, Sameer Dani, N. Prathapkumar: Sirolimus Coated Balloon
in the Treatment of Acute Coronary Syndrome: Result from the Nanolute Registry Keyur H. Parikh Page 31 of 38 Abstract
Accepted: TCT 388 Journal of The American College of cardiology Vol 68. No 18 Suppl 8, 2016
18. Milan Chag, Parloop Bhatt, Urmil Shah, HemangBaxi, Anish Chandarana, Satya Gupta, Vineet Sankhla, Aditi
Nanavati, Piyush Thakar, Keyur Parikh. Hospital to Home Visit, an Effective Health Care Initiative to Reduce
Complications and Improve Drug Compliance and Adherence: NCDR® Participation Advantage. Accepted in NCDR 2016.
19. Urmil Shah, Milan Chag, Dhiren Shah, Ajay Naik, HemangBaxi, Anish Chandarana, Satya Gupta, Vineet
Sankhla, Keyur Parikh, Parloop Bhatt. NCDR® as a Resource to Develop Cardiac Disease Specific Clinical Care Clinics.
Accepted in NCDR 2016.
Publication List (2014-2017)
131
20. Urmil Shah, Milan Chag, HemangBaxi, Anish Chandarana, Satya Gupta, Vineet Sankhla, Keyur Parikh, Parloop
Bhatt. An Asian Indian Single Center Radial Access Percutaneous Coronary Intervention Experience: NCDR®
Findings. Accepted in NCDR 2016.
21. Satya Gupta, Parloop Bhatt, Milan Chag, Parth Parikh, ,Roosha Parikh, Apurva Patel, Aditi Nanavati, Piyush Thakar,
Jawahar Mehta, Keyur Parikh. Depression Adversely Affects Long Term Outcomes in Acute Coronary Syndrome Patients: A
Real World Scenario. Accepted in SCAI 2016.
22. Satya Gupta, Parloop Bhatt, Milan Chag, Parth Parikh, Aditi Patel, Vatsal Chhaya, Anish Chandarana, HemangBaxi,
Urmil Shah, Dhiren Shah, Ajay Naik, Keyur Parikh. Temporal Trends in Young Indian Heart Failure Patients: A Ray
of Hope. Accepted in SCAI 2016.
23. Satya Gupta, Parloop Bhatt, Milan Chag, Parth Parikh, Aditi Patel, Roosha Parikh, Apurva Patel, Apurva Patel, Aditi
Nanavati, Anish Chandarana, HemangBaxi, Effect of Mono-therapy versus Combinational Therapy on Exercise Capacity
of Pulmonary Arterial Hypertension Patients: Actual Care Data. Accepted in SCAI 2016.
24. Satya Gupta, Parloop Bhatt, Milan Chag, Nairuti Trivedi, Keyur Parikh, Apurva Patel, Roosha Parikh, Parth Parikh, Aditi
Patel, Jawahar Mehta, Dhiren Shah. Chest Pain in Acute Coronary Syndrome Patients with Depression after 179 Bypass
Surgeries. Accepted in SCAI 2016.
25. Keyur Parikh, Ranjan Shetty, Sameer Dani, Parloop Bhatt, Manish Doshi, Prakash Sojitra. Real-world Safety and Outcome
Measures of Novel Sirolimus Coated Balloon Catheter. Accepted in ACC 2016.
26. Keyur H. Parikh, Satya Gupta, Parth Parikh, Aditi Patel, Aporva Patel, Roosha Parikh, Anish Chandarana, Milan Chag,
HemangBaxi, Urmil Shah, Sustained Long Term Safety Out comes of “NEOVASC” Coronary Sinus Reducer in No Option
Patients of Refractory Angina: 10 Year Follow up. Accepted in SCAI 2016.
27. Parloop Bhatt, Parth Parikh, Aditi Patel, Roosha Parikh, Apurva Patel, Jawahar L. Mehta, Keyur Parikh: Unique Aspects of
Coronary Artery Disease in Indian Women Abstract Accepted; Cardiovascular Drug & Therapy, 26th May 2015, by
Springer.
28. Parloop Bhatt, Parth Parikh, Apurva Patel, Milan Chag, Anish Chandarana, Roosha Parikh, Keyur Parikh: Long-term
Safety and Performance of the Orbital Atherectomy System for Treating Calcified Coronary Artery Lesions: 5-Year
Follow-Up in the ORBIT I Trial Cardiovascular Revascularization Medicine. (Accepted as a publication
Cardiovascular Revascularization Medicine 2016, S1553-8389 (15) 00091-3
29. Parth Parikh, Aditi Patel, Apurva Patel, Roosha Parikh, Keyur Parikh. Novel First in man use of first ever Sirolimus Drug
Coated Balloon in carotid in stent restenosis. (Accepted as a Poster Presentation in American College of Cardiology
ACC March -2015)
30. Parloop Bhatt, Aditi Patel, Parth Parikh, Jawahar Mehta, Piyush Thakar, Aditi Nanavati, Roosha Parikh, Apurva Patel, Keyur
Parikh. Depression and Outcome of Patients with Acute Coronary Syndrome: A 3 Year Follow-up Study. (Accepted as a
Poster Presentation in American College of Cardiology ACC March -2015)
Publication List (2014-2017)
132
31. Apurva Patel, Roosha Parikh, Parth Parikh, Milan Chag, Urmil Shah, HemangBaxi, Anish Chandarana, Satya
Gupta, Vineet Sankhla, Chintan Mehta, Neil Mehta, Jawahar Mehta, Parloop Bhatt, Keyur Parikh: A Hospital to
Home Visit Model to Ensure Medical Compliance and Reduce Complications Following Percutaneous
Coronary Intervention: A Novel Global Concept. Accepted as a presented at the Society for cardiovascular
Angiography and Intervention(SCAI) May 28-31,2014 Las Vegas, USA.
32. Niren Bhavsar, Roosha Parikh, Apurva Patel, Parth Parikh, Satya Gupta, Dhaval Naik, Chintan Mehta, Parloop
Bhatt, Keyur Parikh, Dhiren Shah: Comparative Safety and Efficacy Evaluation of Ivabradine, Metoprolol and
its Combination in Management of Inappropriate Sinus Tachycardia in Coronary Artery Bypass Graft patients.
(Submitted in American College of Cardiology ACC March -2014) Volume 63, Issue 12, A1569 doi:
10.1016/S0735-1097(14)61572-2 Jam Col lCardiol . 2014; 63(12_S):.doi:10.1016/S0735-1097(14)61572-2
33. Roosha Parikh, Apurva Patel, Shmuel Banai, Parth Parikh, Milan Chag, Urmil Shah, HemangBaxi, Anish
Chandarana, Ajay Naik, Satya Gupta, Vineet Sankhla, Parloop Bhatt, Keyur Parikh: A Possible Alternative
Percutaneous Treatment for Patients with Disabling No-Option Angina: “Neovasc” Coronary Sinus Reducer
Assessment - 8 Year Follow Up. Presented at SCAI, May 28-31,2014 Las Vegas, USA.
34. Apurva Patel, Roosha Parikh, Parth Parikh, Milan Chag, Urmil Shah, HemangBaxi, Anish Chandarana, Satya
Gupta, Vineet Sankhla, Parloop Bhatt, Keyur Parikh: Orbital Atherectomy System in Treating Calcified
Coronary Lesions: First in Man Assessment- 5 Year Follow Up. Presented at SCAI, May 28-31, 2014 Las Vegas,
USA.
35. Apurva Patel, Roosha Parikh, Anish Chandarana, Parloop Bhatt, Milan Chag, Satya Gupta, HemangBaxi, Vineet
Sankhla, Mehul Dudhasia, Urmil Shah, Keyur Parikh: Short-term Outcomes In Coronary Artery Disease
Patients With Multi-Lesion Disease Implanted With Multiple Bio absorbable Vascular Scaffolds. Submitted in American
College of Cardiology ACC, March 29-31,2014 Washington DC, USA.
36. Roosha Parikh, Apurva Patel, Parth Parikh, Keyur Parikh, Dhaval Naik, Niren Bhavsar, Hiren Dholakia,
Chintan Mehta, Neil Mehta, Parloop Bhatt, Jawahar Mehta, Dhiren Shah: A Hospital to Home Health Care Initiative for
Early Follow-up, Post Discharge Management, Patient Self Care and Activation Following Coronary Artery Bypass
Graft Surgery - A First Indian Pilot Study Submitted in American College of Cardiology ACC, March 29-
31,2014 Washington DC, USA.
37. Roosha Parikh, Apurva Patel, Parth Parikh, Milan Chag, Urmil Shah, HemangBaxi, Anish Chandarana, Satya
Gupta, Piyush Thakar, Jawahar Mehta, Parloop Bhatt, Vineet Sankhla, Keyur Parikh: Increasing Penetration of Drug
Eluting Stents in Developing Countries - A Single Center 10 year Study Submitted in American College of Cardiology
ACC, March 29-31,2014 Washington DC, USA.
38. Parloop Bhatt, Apurva Patel, Roosha Parikh, Parth Parikh, Aditi Patel, Satya Gupta, Jawahar Mehta,
WafiaEteiba, Sharon Mulvagh, Giuseppe Ambrosio, Naranjan Dhalla, James Willerson, Keyur Parikh:
Publication List (2014-2017)
133
International Task Force for Prevention of Cardiovascular Disease: Determining Factors to Assess Primary
Prevention Outcomes in Western India Submitted in American College of Cardiology ACC, March 29-31,2014
Washington DC, USA.
39. Parloop Bhatt, Parth Parikh, Apurva Patel, Milan Chag, Anish Chandarana, Roosha Parikh, Keyur Parikh: Orbital
Atherectomy System in Treating Calcified Coronary Lesions: 3-Year Follow-Up in First Human Use Study
(ORBIT I Trial). Accepted as a publication Cardiovascular revascularization medicine: including molecular
interventions 06/2014; 15(4). DOI: 10.1016/j.carrev.2014.03.004
40. William Wijns, Ph. Gabriel Steg, Laura Mauri, Volkhard Kurowski, Keyur Parikh, Runlin Gao, Christoph Bode, John P.
Greenwood, Erik Lipsic, FarqadAlamgir, Tessa Rademaker-Havinga, Eric Boersma, Peter Radke, Frank van
Leeuwen, and EdoardoCamenzind for the PROTECT Steering Committee and Investigators- Endeavour
zotarolimus-eluting stent reduces stent thrombosis and improves clinical outcomes compared with cypher
sirolimus-eluting stent: 4 year results of the PROTECT randomized trial. Accepted and Published in
European Heart Journal Advance Access published 08/2014; 35(40). DOI:10.1093/eurheartj/ehu318 14.72
Impact Factor
41. Parloop A. Bhatt ,Advances in heart health-The need for developing Indian guidelines for cardiovascular disease in
women, CV Network-The official bulletin of the international academy of cardiovascular sciences, Vol. 13 No.
4 - November 2014. International 22 CV Network – Vol. 13 No. 4 – November 2014
42. Bhatt PA, Parikh PK and Parikh KH. Prevalence, Assessment and Clinical Outcome in Cardiovascular
Disease: Impact of Gender Disparities. Austin J PharmacolTher. 2014; 2 (8).4. Peer Reviewed.
International. Austin J PharmacolTher - Volume 2 Issue 8 - 2014
43. Parloop A. Bhatt, Akhita B. Bhatt, Coenzyme Q10 supplement in breast cancer: The nutrient on
horizon, Kadakia International Journal of Research in Multidiscipline, ISSN: 2349 – 4875, Volume 1, Issue 1,
June 2014, 150-158. Peer Reviewed. National. Volume 1, Issue 1, June 2014
44. Kama Raval, Reena Desai, and Parloop Bhatt, Comparative Evaluation of Safety Outcomes of Different Prosthetic Valves in
Indian Subjects, Research and Reviews: Journal of Pharmacology and Toxicological studies, Volume 2,Issue 3,July -
September, 2014, e-ISSN:2322-0139 , p-ISSN:2322-0120 ,RRJPTS | 19-24. Peer Reviewed. International.
RRJPTS | Volume 2 | Issue 3 | July - September, 2014 Page:19-24
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For appointment call : +91-79-3010 1200, 3010 1008 (M) +91-98250 66661 or
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