India's first double hand transplant successful, says doctors

February 1, 2015

hand transplant

Thiruvananthapuram, Feb 1: With the first successful double hand transplant, Indian doctorshave registered a rare feat of carrying out the world's first hand transplant of a coloured skin and the first hand transplant in any developing country.

So far, only 110 successful hand transplants have been done, since the first one in France 13 years ago, in USA, European countries, China and Australia.

The honour for the rare feat goes to a team of surgeons at the Kochi-based Amrita Institute of Medical Sciences. The transplant was carried out on January 12 and 13 to a train accident victim - 30-year-old Manu, who received both the hands of a 24-year-old road accident victim.

"The operation lasted for 16 hours with more than 20 surgeons participating in the procedure. Each hand required connecting two bones, two arteries, four veins and about 14 tendons," saidDr. Subramania Iyer, Professor and Head of the Plastic Surgery Department.

"The immune suppressant drugs were started before the start of the surgery and continued after it. He was shifted to a transplant ICU. Careful monitoring of the blood supply to the hands was done and all precautions to prevent infections was instituted in the nursing. Another operation to replace an area of bad skin was done for his left hand on the second day," he added.

Dr. Iyer further said, "After14 days post-surgery, both the hands have been accepted by the recipient's body and he started regaining movements. He has been shifted out of the ICU and post-surgical rehabilitation process has started under supervision."

"Manu will be able to move his hands since his own muscles of the forearm are working to move the fingers. The sensations will return only slowly and is expected in three to four months. His immunosuppressant drugs (to prevent rejection of the transplanted hands) will have to be continued indefinitely, but at a reduced rate from three months," he added.

Dr. Iyer said, the current transplant is important, since follow up of the transplanted skin is done by the appearance of the skin and skin biopsies every month to see signs of rejection.

He said the details of the transplant have been added to the International Registry of Hand Transplants, which maintains stringent standards in the follow-up of these cases.

The entire expense for the transplant was borne by Mata Amritanandamayiu Math.

"This transplant has put the Indian scientific community among the league of a few developed nations in the field of composite tissue allotransplant," said Dr. Iyer.

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Agencies
June 24,2020

New Delhi, Jun 24: Expanding the testing criterion for coronavirus, the Indian Council of Medical Research has said it should be made widely available to all symptomatic individuals across the country.

"Since test, track and treat' is the only way to prevent spread of infection and save lives, it is imperative that testing should be made widely available to all symptomatic individuals in every part of the country and contact tracing mechanisms for containment of infection are further strengthened," it said in an advisory on 'Newer Additional Strategies for COVID-19 Testing' on Tuesday.

In its revised testing strategy for COVID-19 issued on May 18, the Indian Council of Medical Research (ICMR) had advised testing for all symptomatic Influenza-like illness (ILI) among returnees and migrants within seven days of illness.

All hospitalised patients who develop ILI symptoms, symptomatic individuals living within hotspots or containment zones and healthcare and frontline workers involved in containment and mitigation of coronavirus were also advised testing.

The apex health research body has also advised authorities to enable all government and private hospitals, offices and public sector units to perform antibody-based COVID-19 testing for surveillance to help allay fears and anxiety of healthcare workers and office employees.

The earlier advisories on rapid antibody testing advisories had focused on areas reporting clusters (containment zones), large migration gatherings/evacuees centers and testing of symptomatic ILI individuals at facility level.

Besides, the ICMR on Tuesday also recommended deployment of rapid antigen detection tests for COVID-19 in combination with RT-PCR tests in all containment zones, all central and state government medical colleges and government hospitals, all private hospitals approved by the National Accreditation Board for Hospitals and Healthcare (NABH), all NABL-accredited and ICMR approved private labs, for COVID-19 testing.

All hospitals, laboratories and state governments intending to perform the point-of-care antigen tests need to register with ICMR to obtain the login credentials for data entry.

"ICMR advises all state governments, public and private institutions concerned to take required steps to scale up testing for COVID-19 by deploying combination of various tests as advised," the advisory added.

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Agencies
May 2,2020

Clinician-scientists have found that Irish patients admitted to hospital with severe coronavirus (COVID-19) infection are experiencing abnormal blood clotting that contributes to death in some patients.

The research team from the Royal College of Surgeons in Ireland found that abnormal blood clotting occurs in Irish patients with severe COVID-19 infection, causing micro-clots within the lungs.

According to the study, they also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission.

"Our novel findings demonstrate that COVID-19 is associated with a unique type of blood clotting disorder that is primarily focussed within the lungs and which undoubtedly contributes to the high levels of mortality being seen in patients with COVID-19," said Professor James O'Donnell from St James's Hospital in Ireland.

In addition to pneumonia affecting the small air sacs within the lungs, the research team has also hundreds of small blood clots throughout the lungs.

This scenario is not seen with other types of lung infection and explains why blood oxygen levels fall dramatically in severe COVID-19 infection, the study, published in the British Journal of Haematology said.

"Understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high-risk groups," O'Donnell said.

"Further studies will be required to investigate whether different blood-thinning treatments may have a role in selected high-risk patients in order to reduce the risk of clot formation," Professor O'Donnell added.

According to the study, emerging evidence also shows that the abnormal blood-clotting problem in COVID-19 results in a significantly increased risk of heart attacks and strokes.

As of Friday morning, the cases increased to 20,612 cases in Ireland, with 1,232 deaths so far, according to the Johns Hopkins University.

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Agencies
April 15,2020

Dear parents, if you want your children to have proper sleep, read this carefully. Joining a growing list of studies that tell parents to shun devices at bed-time, researchers say that children who use devices and decide what time they go to sleep, achieve less sleep and feel more sleepier the following day than their peers.

The study of children in this age-group (aged 11 to 13 years), published in the New Zealand Medical Journal, found most (72 per cent) of the 163 students interviewed by University of Otago researchers achieved recommended guidelines of an average 9 to 11 hours sleep nightly over one week.

"But that also means that almost one in four students did not achieve sleep within these guidelines, which highlights an area for improvement," said study researcher Kate Ford.

However, consistent with previous research in 15 to 17-year-old New Zealanders, the study results show less sleep on the nights where devices are used in the hour before bed.

According to the researchers, students who used devices before going to sleep were also more likely to report that they felt sleepy the following morning. Watching television before bed had no significant effect on sleep length.

There were also some interesting observations over the weekends where students went to bed later but woke later achieving similar sleep length to the school days, the researchers said.

A small group of students (six per cent) who reported less than seven hours of sleep, including a small number reporting not sleeping at all, according to the study,

Therefore, while the average across the week of 72 per cent of students reporting adequate sleep is reassuring, it is far from the goal of every child achieving sleep within the recommended guidelines," Ford said.

Dr Paul Kelly, head of the Sleep Health Service at Canterbury District Health Board, supervised the study and explained that the foundations for good health are based on proper nutrition, regular exercise and good sleep quality.

Sleep quality is often overlooked as a contributory factor to poor health.

"The study findings suggest the need for parental guidance around bedtimings and moderation of the use and availability of electronic devices before bed," Kelly said.

"Respect and protect your sleep, as good daytime functioning is reliant on adequate sleep," Kelly added.

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