care institute of medical sciences outcomes2 what's inside n n board of directors n awards n...

134
Outcomes 2017 Care Institute of Medical Sciences A premier multi-super specialty hospital GREEN Green Hospital International Centers Of Excellence

Upload: others

Post on 25-Mar-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Care Institute of Medical Sciences Outcomes2 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

Outcomes2017

Care Institute of Medical Sciences

A premier multi-super specialty hospitalGREEN

Green Hospital

International Centers Of Excellence

Page 2: Care Institute of Medical Sciences Outcomes2 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

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

Page 3: Care Institute of Medical Sciences Outcomes2 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

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

Page 4: Care Institute of Medical Sciences Outcomes2 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

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

Page 5: Care Institute of Medical Sciences Outcomes2 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

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.

Page 6: Care Institute of Medical Sciences Outcomes2 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

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

Page 7: Care Institute of Medical Sciences Outcomes2 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

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

Page 8: Care Institute of Medical Sciences Outcomes2 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

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.

Page 9: Care Institute of Medical Sciences Outcomes2 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

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.

Page 10: Care Institute of Medical Sciences Outcomes2 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

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)

Page 11: Care Institute of Medical Sciences Outcomes2 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

11

Departmental Overview

+ Myxoma

Page 12: Care Institute of Medical Sciences Outcomes2 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

12

Departmental Overview

Page 13: Care Institute of Medical Sciences Outcomes2 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

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)

Page 14: Care Institute of Medical Sciences Outcomes2 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

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.

Page 15: Care Institute of Medical Sciences Outcomes2 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

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.

Page 16: Care Institute of Medical Sciences Outcomes2 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

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

Page 17: Care Institute of Medical Sciences Outcomes2 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

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

Page 18: Care Institute of Medical Sciences Outcomes2 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

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

Page 19: Care Institute of Medical Sciences Outcomes2 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

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)

Page 20: Care Institute of Medical Sciences Outcomes2 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

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.

Page 21: Care Institute of Medical Sciences Outcomes2 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

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

Page 22: Care Institute of Medical Sciences Outcomes2 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

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

Page 23: Care Institute of Medical Sciences Outcomes2 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

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

Page 24: Care Institute of Medical Sciences Outcomes2 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

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

Page 25: Care Institute of Medical Sciences Outcomes2 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

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

Page 26: Care Institute of Medical Sciences Outcomes2 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

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

Page 27: Care Institute of Medical Sciences Outcomes2 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

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

Page 28: Care Institute of Medical Sciences Outcomes2 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

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)

Page 29: Care Institute of Medical Sciences Outcomes2 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

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.

Page 30: Care Institute of Medical Sciences Outcomes2 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

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)

Page 31: Care Institute of Medical Sciences Outcomes2 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

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

Page 32: Care Institute of Medical Sciences Outcomes2 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

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

Page 33: Care Institute of Medical Sciences Outcomes2 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

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

Page 34: Care Institute of Medical Sciences Outcomes2 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

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

Page 35: Care Institute of Medical Sciences Outcomes2 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

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

Page 36: Care Institute of Medical Sciences Outcomes2 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

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

Page 37: Care Institute of Medical Sciences Outcomes2 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

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)

Page 38: Care Institute of Medical Sciences Outcomes2 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

38

Heart Failure

Stages, Phenotypes and Treatment of HF

Page 39: Care Institute of Medical Sciences Outcomes2 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

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

Page 40: Care Institute of Medical Sciences Outcomes2 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

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

Page 41: Care Institute of Medical Sciences Outcomes2 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

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.

Page 42: Care Institute of Medical Sciences Outcomes2 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

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

Page 43: Care Institute of Medical Sciences Outcomes2 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

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

Page 44: Care Institute of Medical Sciences Outcomes2 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

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)

Page 45: Care Institute of Medical Sciences Outcomes2 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

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

Page 46: Care Institute of Medical Sciences Outcomes2 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

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

Page 47: Care Institute of Medical Sciences Outcomes2 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

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

Page 48: Care Institute of Medical Sciences Outcomes2 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

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

Page 49: Care Institute of Medical Sciences Outcomes2 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

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

Page 50: Care Institute of Medical Sciences Outcomes2 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

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)

Page 51: Care Institute of Medical Sciences Outcomes2 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

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

Page 52: Care Institute of Medical Sciences Outcomes2 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

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

Page 53: Care Institute of Medical Sciences Outcomes2 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

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

Page 54: Care Institute of Medical Sciences Outcomes2 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

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

Page 55: Care Institute of Medical Sciences Outcomes2 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

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

Page 56: Care Institute of Medical Sciences Outcomes2 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

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

Page 57: Care Institute of Medical Sciences Outcomes2 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

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

Page 58: Care Institute of Medical Sciences Outcomes2 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

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

Page 59: Care Institute of Medical Sciences Outcomes2 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

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

Page 60: Care Institute of Medical Sciences Outcomes2 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

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

Page 61: Care Institute of Medical Sciences Outcomes2 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

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

Page 62: Care Institute of Medical Sciences Outcomes2 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

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

Page 63: Care Institute of Medical Sciences Outcomes2 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

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

Page 64: Care Institute of Medical Sciences Outcomes2 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

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

Page 65: Care Institute of Medical Sciences Outcomes2 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

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)

Page 66: Care Institute of Medical Sciences Outcomes2 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

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

Page 67: Care Institute of Medical Sciences Outcomes2 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

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

Page 68: Care Institute of Medical Sciences Outcomes2 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

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

Page 69: Care Institute of Medical Sciences Outcomes2 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

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

Page 70: Care Institute of Medical Sciences Outcomes2 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

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

Page 71: Care Institute of Medical Sciences Outcomes2 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

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

Page 72: Care Institute of Medical Sciences Outcomes2 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

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

Page 73: Care Institute of Medical Sciences Outcomes2 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

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

Page 74: Care Institute of Medical Sciences Outcomes2 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

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

Page 75: Care Institute of Medical Sciences Outcomes2 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

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)

Page 76: Care Institute of Medical Sciences Outcomes2 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

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

Page 77: Care Institute of Medical Sciences Outcomes2 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

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

Page 78: Care Institute of Medical Sciences Outcomes2 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

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.

Page 79: Care Institute of Medical Sciences Outcomes2 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

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

Page 80: Care Institute of Medical Sciences Outcomes2 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

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

Page 81: Care Institute of Medical Sciences Outcomes2 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

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)

Page 82: Care Institute of Medical Sciences Outcomes2 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

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

Page 83: Care Institute of Medical Sciences Outcomes2 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

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)

Page 84: Care Institute of Medical Sciences Outcomes2 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

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.

Page 85: Care Institute of Medical Sciences Outcomes2 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

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

Page 86: Care Institute of Medical Sciences Outcomes2 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

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

Page 87: Care Institute of Medical Sciences Outcomes2 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

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

Page 88: Care Institute of Medical Sciences Outcomes2 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

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

Page 89: Care Institute of Medical Sciences Outcomes2 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

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

Page 90: Care Institute of Medical Sciences Outcomes2 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

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

Page 91: Care Institute of Medical Sciences Outcomes2 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

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

Page 92: Care Institute of Medical Sciences Outcomes2 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

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

Page 93: Care Institute of Medical Sciences Outcomes2 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

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)

Page 94: Care Institute of Medical Sciences Outcomes2 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

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.

Page 95: Care Institute of Medical Sciences Outcomes2 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

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

Page 96: Care Institute of Medical Sciences Outcomes2 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

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

Page 97: Care Institute of Medical Sciences Outcomes2 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

97

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

Page 98: Care Institute of Medical Sciences Outcomes2 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

98

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

Page 99: Care Institute of Medical Sciences Outcomes2 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

Radiology

99

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.

Page 100: Care Institute of Medical Sciences Outcomes2 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

100

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

Page 101: Care Institute of Medical Sciences Outcomes2 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

101

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

Page 102: Care Institute of Medical Sciences Outcomes2 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

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

Page 103: Care Institute of Medical Sciences Outcomes2 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

103

Physiotherapy, Rehabilitation & Nutrition

Page 104: Care Institute of Medical Sciences Outcomes2 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

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.

Page 105: Care Institute of Medical Sciences Outcomes2 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

105

Code Blue

Page 106: Care Institute of Medical Sciences Outcomes2 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

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.

Page 107: Care Institute of Medical Sciences Outcomes2 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

107

Quality Measure

Page 108: Care Institute of Medical Sciences Outcomes2 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

108

Quality Measure

Page 109: Care Institute of Medical Sciences Outcomes2 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

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.

Page 110: Care Institute of Medical Sciences Outcomes2 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

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.

Page 111: Care Institute of Medical Sciences Outcomes2 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

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

Page 112: Care Institute of Medical Sciences Outcomes2 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

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

Page 113: Care Institute of Medical Sciences Outcomes2 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

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

Page 114: Care Institute of Medical Sciences Outcomes2 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

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)

Page 115: Care Institute of Medical Sciences Outcomes2 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

Research Projects

115

Page 116: Care Institute of Medical Sciences Outcomes2 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

116

Research Projects

Page 117: Care Institute of Medical Sciences Outcomes2 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

117

Research Projects

Page 118: Care Institute of Medical Sciences Outcomes2 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

118

Research Projects

Page 119: Care Institute of Medical Sciences Outcomes2 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

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

Page 120: Care Institute of Medical Sciences Outcomes2 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

120

Research Projects

Figure 2: Door to Balloon Time

Figure 3: PCI in-hospital Risk Adjusted Mortality

Page 121: Care Institute of Medical Sciences Outcomes2 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

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

Page 122: Care Institute of Medical Sciences Outcomes2 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

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

Page 123: Care Institute of Medical Sciences Outcomes2 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

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

Page 124: Care Institute of Medical Sciences Outcomes2 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

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

Page 125: Care Institute of Medical Sciences Outcomes2 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

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

Page 126: Care Institute of Medical Sciences Outcomes2 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

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.

Page 127: Care Institute of Medical Sciences Outcomes2 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

127

CIMS Learning Center

Page 128: Care Institute of Medical Sciences Outcomes2 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

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.

Page 129: Care Institute of Medical Sciences Outcomes2 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

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)

Page 130: Care Institute of Medical Sciences Outcomes2 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

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.

Page 131: Care Institute of Medical Sciences Outcomes2 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

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)

Page 132: Care Institute of Medical Sciences Outcomes2 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

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:

Page 133: Care Institute of Medical Sciences Outcomes2 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

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

Page 134: Care Institute of Medical Sciences Outcomes2 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

CIMS Hospital :Regd Office: Plot No.67/1, Opp. Panchamrut Bunglows, Nr. Shukan Mall, Off Science City Road, Sola,

Ahmedabad-380060, Gujarat, INDIA. Ph. : +91-79-2771 2771-75 (5 lines) Fax: +91-79-2771 2770

For appointment call : +91-79-3010 1200, 3010 1008 (M) +91-98250 66661 or

email on : [email protected]

www.cims.me

Ambulance and Emergency : +91-98244 50000, 97234 50000, 90990 11234

CIMS Hospital Pvt. Ltd. | CIN : U85110GJ2001PTC039962 | [email protected] | www.cims.me

Care Institute of Medical SciencesCIMS

R

Earning Trust with World-Class Practices