Outcomes2018

Care Institute of Medical Sciences

A premier multi-super specialty hospitalGREEN

Green Hospital

International Centers Of Excellence Certificate No. MC-3049

1

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

Vision, Mission and Values n Trauma Center

n Gastro-Intestinal and General Surgery

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

2

Vision, Mission and Values

2

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

3

Vision, Mission and Values

4

Board of Directors

Dr. Hemang Baxi

Director

Dr. Anish Chandarana

Executive Director

Dr. Milan Chag

Managing Director

Dr. Urmil Shah

Director

Dr. Ashit Jain

Director, USA

Dr. Dhiren Shah

Director

Dr.(Prof.) Dilip Mavlankar

Director, India

Dr. Satya Gupta

Director

Dr. Kamlesh Pandya

Director, USA

Dr. Ajay Naik

Director

Mr. Kirti Patel

Director, UK

Dr. Keyur Parikh

Chairman

5

Awards

International Healthcare

Awards, 2018

Global Healthcare Excellence

Awards, 2018

3rd Digital Health Innovation

Summit 2019

Gujarat Best Brand

Awards, 2018

International Healthcare

Awards, 2019

6

Abbreviations

2D 2 Dimensional

3D 3 Dimensional

4D 4 Dimensional

ACCF American College of Cardiology Foundation

ACE Angiotensin -Converting -Enzyme Inhibitor

ACLS Advanced Cardiac Life Support

ACR American College of Radiology

ACS Acute Coronary Syndrome

AHA American Heart Association

AIDS Acquired Immune Deficiency Syndrome

AMA American Medical Association

ARB Angiotensin II Receptor Blocker

ASD Atrial Septal defect

AV Aortic Valve

AVM Arteriovenous malformation

AVR Aortic valve replacement

BA/BE Bio Availability/ Bio Equivalent

BAS Ballon Artrial Septostomy

BAV Balloon Aortic Valvuloplasty

BLS Basic Life Support

BMI Body Mass Index

BMT Bone Marrow Transplant

BSI Blood Stream Infection

CABG Coronary Artery Bypass Grafting

CAD Coronary Artery Disease

CAE Carotid Artery Endarterectomy

CAS Carotid Artery Stenting

CBC Complete Blood Count

CCU Critical Care Unit

CHD Coronary Heart Disease

CIED Cardiovascular Implantable Electronic Devices

CLC CIMS Learning Center

COPD Chronic Obstractive Pulmonary disease

CPR Cardiac Pulmonary Resuscitation

CRRT Continuous Renal Replacement Therapy

CRT Conformal Radiotherapy

CRT-D Conformal Radiotherapy- Dimensional

CT Computed Tomography

CT-SCAN Computed Tomography

CV Cardiovascular

CVD Cardiovascular Disease

D TO B Door To Ballon

DAP Dose Area Product

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Abbreviations

DBP Diastolic Blood Pressure

DHS Dynamic Hip Screw

DLCO Diffusing Capacity of the Lungs for Carbon

Monoxide

DVR Double Valve Replacement

ECG Echocardiograms

ECHO Echocardiogram

ECMO Extracorporeal membrane oxygenation

ENT Ear, Nose, Throat

EP Electrophysiology

EPS Electrophysiology Study

ERCP Endoscopic Retrograde Cholangio

Pancreatography

FDA Food and Drug Administration

FESS Functional endoscopic sinus surgery

FISH Fluorescence In Situ Hybridization

FT Flurotime

GERD Gastroesophageal Reflux Disease

GI Gastrointestinal

GICU General Intensive Care Unit

GIST Gastrointestinal Stromal Tumor

H2F Hospital To Family

H2H Hospital To Home

HAI Hospital Acquired Infection

HDL High Density lipoprotein

HDU High Dependency Unit

HEPA High Frequency Particulate Air

HFOV High Frequency Oscillatory Ventilation

HIV Human Immunodeficiency Virus

HLA Human Leukocytic Antigen

HPV Human Papilloma Virus

ICCU Intensive Coronary Care Unit

ICD Implantable Cardioverter Defibrillator

ICH-GCP International Council of Harmonisation -

Good Clinical Practice

ICMR Indian Council of Medical Research

ICSI Intra Cytoplasmic Sperm Injection

ICU Intensive Care Unit

IITV Image Intensifier Television

IMRT Intensity Modulated Radiotherapy

IUI Intrauterine Insemination

IV Intravenous

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Abbreviations

IVF In vitro Fertilization

IVU Intravenous Pyelogram

JIC Joint International Conference

LDL Low Density Lipoprotein

LOS Length of Stay

LV Left Ventricular

LVEF Left Ventricular Ejection Fraction

LVRS Lung Volume Reduction Surgery

MDR Multi-Drug-Resistant

MICAS Minimally Invasive Cardiac Surgery

MLC Multileaf Collimator

MRA Magnetic Resonance Angiography

MRI Magnetic Resonance Imaging

MUFA Monounsaturated Fatty Acids

MV Repair Mitral Valve Repair

MVR Mitral Valve Replacement

NABH National Accreditation Board for Hospital &

Healthcare Providers

NABL National Accreditation Board for Testing and

Calibration Laboratories

NBP Noninvasive Blood Pressure

NCDR National Cardiovascular Drug Registry

NIBP Non-Invasive -Blood Pressure

NICU Neonatal Intensive Care Unit

NIEPS Non invasive EP Study

NO Nitric Oxide

OPD Out Patients Deparments

OT Operation Theatre

PAD Peripheral Arterial Disease

PAMI Primary Angioplasty in Acute Myocardial

Infraction

PCI Percutaneous Coronary Intervention

PCNL Percutaneous Nephrolithotomy Surgery

PDA Patent Ductus Arteriousus

PERM Programme Electronic Review Management

PFO Patent Foramen Ovale

PFT Pulmonary Function Test

PGD Preimplantation Genetic Diagnosis

PM10 Particulate Matter 10

PM2.5 Particulate Matter 2.5

PPPPP Prior Planning Prevents Poor Performance

PRP Platelet-rich Plasma

9

Abbreviations

PT Prothrombin Time

PT CA Percutaneous Transluminal Coronary

Angioplasty

PTSMA Percutaneous Transluminal Septal Myocardial

Ablation

PUFA Polyunsaturated Fatty Acids

PVL Periventricular Leukomalacia

QCI Quality Council of India

RCT Root Canal Treatment

RFA Radiofrequency ablation

RVG Radionuclide Ventriculogram

SBP Systolic Blood Pressure

SICU Surgical Intensiv Care Unit

SLE Systemic Lupus Erythematosus

SO2 Sulfur Dioxide

SPO2 Peripheral Capillary Oxygen Saturation

SSI Surgical Site Infection

STEMI ST-Elevation Myocardial Infarction

SVR System Vascular Resistance

TAVI Transcatheter aortic valve Implantation

TB Tuberculosis

TEVAR Thoracic Endovascular Airtic Repair

TFA Transfemoral approach

TIFFA Targeted Imaging for Fetal Anomalies

TMT Treadmeal Test

TOF Tetralogy of Fallot

TOT Transobturator Tape

TPN Total Parental Nutrition

TRA Tranradial Approach

TTI Transfusion Transmitted Infection

TURBT Transurethral Resection of Bladder Tumor

TURP Transurethral Resection of The Prostate

TV Tidal Volume

TVT Tension Frees Vaginal Tape

URS Ureteroscopic

US United States

USG Ultra Sonography

UTI Urinary Track Infection

VAD Ventricular Assist Device

VAP Ventilator-Associated Pneumonia

VATS Video Assisted Thoracic Surgery

VIU Visual Internal Urethrotomy

VMAT Volumetric Modulated Are Therapy

VSD Ventricular Septal Defect

VSG Vertical Sleeve Gastrectomy

WBC White Blood Cell

XDR Extensively Drug-Resistant

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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 has a vast pool of talented and experienced team of doctors, who are

further supported by a team of highly qualified, experienced & dedicated

support staff & cutting edge technology. More than 110 consultants and 940

employees work together to manage over 16393 inpatients per year. The

hospital has an infrastructure comprising of around 350 beds including about

128 ICU beds, 12 Operation Theatres, state-of-the-art digital flat panel Cath

lab, an ultra-modern dialysis unit besides a host of other world-class facilities.

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About CIMS

CIMS Hospital Scores High on Technology:

ŸGujarat’s first digitized operation theatres and ICUs.

ŸGujarat’s First ECMO facility

ŸLatest Cancer Radiation machines

ŸLatest Radiology- MRI and CT scan Machine

ŸGujarat’s first certified GREEN Operation Theaters: certified for safe

practices and environment friendly features such as low emission of carbon

dioxide, infra-red rays and radiation within permissible limits.

ŸOne of the most advanced ultra-modular and fully monitored emergency &

trauma facility

ŸAdding to its clinical triumphs, CIMS Hospital following first heart transplant

has further performed a total of 8 heart transplants - the only center in

Gujarat to perform heart transplant. Besides, CIMS has also recently

established Paediatric Bone Marrow Transplant programme and Blood

Bank within the premises of the hospital to facilitate smoother services for all

patients.

International Centers Of Excellence Certificate No. MC-3049

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About CIMS

CIMS Flagship

ŸJCI (Joint Commission International), NABH(National Accreditation Board

for Hospitals and Healthcare Providers) and NABL(National Accreditation

Board for Testing and Calibration Laboratories) accreditation

ŸNABH Emergency

ŸNABH Ethics committee (First in India)

ŸGreen OT

ŸFirst Heart Transplant Surgery of Gujarat

ŸPediatric Bone Marrow Transplant Unit - First in Gujarat

ŸRadial Lounge (One of the first in the country)

ŸTAVI (Transcatheter Aortic Valve Implantation ) - First in Gujarat

ŸDigitized OTs and ICUs for better patient care - First in Gujarat

ŸCertified Heart and Renal Transplant Center

ŸFirst ever ECMO (Extracorporeal Membrane Oxygenation) machine for

patients with cardio respiratory failure

ŸThe High level Isolation Unit (HLIU)

ŸFirst in Asia Pacific to set up Elekta Versa HD for cancer radiation treatment

ŸOne of the only private Hospital in Western India with 3 Cath labs

ŸOne of the only Indian Hospital Certified as International Center of

Excellence(ICOE) by American college of Cardiology (ACC)

ŸCare at Home : A branch of homecare for medical and nursing care at home

ŸHospital to Home visits to improve drug (medicine) adherence and patient

compliance

ŸA fleet of well-equipped ambulances with ECMO facility; pediatric

ambulance

ŸExclusive Trauma Center following ATLS (Advanced Trauma Life Support)

protocols Center

ŸRound-the-clock dialysis facility

ŸEthics Committee that provides assistance with ethical issues related to

patient’s safety and well-being.

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About CIMS

TECHNOLOGICAL EXCELLENCE

ŸState-of-the-Art Equipment

ŸHigh-end Cath Labs with DSA and stent boost facility

ŸCT Scan Revolution EVO 128 slice-First in India

ŸMRI Sigma Explorer Electrophysiology with 3D system

ŸEchocardiography machines with 3D-TEE, 3D adult and pediatric Echo

Ÿ24 x 7 x 365 'stroke' unit with latest CT scan with CT angiography and

perfusion scan facilities First in India

ŸPACS system to view various imaging in ICU and doctor's lounge

ŸCarto-3 system, state-of-the-art imaging system offers enhanced

visualization for treating arrhythmia patients

ŸState-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

ŸExtracorporeal membrane oxygenation (ECMO)

ŸDedicated Neutropenic Care

ŸGujarat’s First Carl Zeiss Pentero 900 Microscope (High - end path breaking

innovation for enhanced visualization during surgery)

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Department Overview :

15

Department Overview :

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In Vitro Fertilization Center

CIMS Hospitals is a state-of-the-art specialty hospital in India for all infertility

treatment and IVF.

CIMS hospital provides best quality, comprehensive and holistic care to

women in India at a reasonable cost. An interdisciplinary team of expert and

caring professionals is committed to meeting the physical as well as emotional

and spiritual needs for each woman and her family.

The Hospital has been designed and furnished to provide a high level of

Fertility care with comfort and privacy. Every room is spacious and private.

The architecture is soothing and dignified, with a clean, modern design.

Hospital is having India’s first 0.3 micron clean air IVF treatment lab.

CIMS IVF provides a wide range of infertility services including:

ŸOvulation Induction

ŸIUI-Intrauterine Insemination

ŸReproductive Surgery: Laparohysteroscopy for evaluation of infertility

ŸIVF – In Vitro Fertilization

ŸAssisted Hatching

ŸGenetic Counselling

ŸFrozen embryo Transfer

ŸCryopreservation

ŸICSI – Intra Cytoplasmic Sperm Injection

ŸAndrology Services

ŸSurgical Sperm Retrieval

ŸFamily-friendly labour and delivery suites

ŸExpert in high risk deliveries with continuous monitoring

ŸEpidural and pain management through in-house anesthesiologists

ŸNeonatal Intensive Care Unit (NICU)

IVF is Useful to Treat Patients With

ŸBlocked or damaged fallopian tubes

ŸMale factor infertility including decreased sperm count or motility

ŸWomen with ovulation disorders, premature ovarian failure, uterine fibroids

ŸWomen who have had their fallopian tubes removed

ŸIndividuals with a genetic disorder

ŸUnexplained infertility

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Heart Transplant

Because of awareness to organ donation in India, treatments for heart failure

and heart transplants are increasing across the country.

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 integrated approach focused on the patient makes CIMS

Hospital a leader in transplant outcomes

Heart Transplantation

CIMS Hospital Ahmedabad achieved one of the rare feats by doing the 1st

heart transplant surgery in Gujarat.

CIMS Heart Transplant Team has successfully completed 8 Heart Transplant

so far.

Heart transplants are performed when other treatments for heart problems

haven't worked, leading to heart failure. In adults, heart failure can be caused

by several conditions, including:

ŸA weakening of the heart muscle (cardiomyopathy).

ŸCoronary artery disease

ŸHeart valve disease.

ŸA heart problem you're born with (congenital heart defect).

ŸDangerous recurring abnormal heart rhythms (ventricular arrhythmias) not

controlled by other treatments.

ŸAmyloidosis.

ŸFailure of a previous heart transplant.

ŸIn children, heart failure is most often caused by either a congenital heart

defect or a cardiomyopathy.

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Heart Transplant

19

Bone Marrow Transplant

CIMS Centre for Bone Marrow Transplant is one of the best in India and

Gujarat. Centre for Bone Marrow Transplant is a stand alone dedicated facility,

equipped with ultra-modern infrastructure and internationally trained and

widely experienced faculty. The Centre is supported by state-of-the-art

laboratory services and transfusion services, along with a fully equipped

radiation oncology unit with facility for total body irradiation. The Centre offers

both allogenic and autologous stem cell transplant using bone marrow,

peripheral blood stem cells and cord blood stem cells for various benign and

malignant disorders like Thalassemia, Aplastic Anaemia, Leukemia,

Lymphomas, Multiple Myelomas and Advanced Paediatric Solid Tumors.

CIMS Bone Marrow Transplant Unit has Performed 73 BMT with 96% Disease

free Survival Success Ratio.

Key Department Highlights

ŸEach room is supported by separate HEPA filter with triple level air filtration

ŸTransplants are routinely performed for children as well as adults

ŸLeading bone marrow transplant and high end Hematology reference center

ŸBoth Allogenic and Autologus stem cell bone marrow transplantations are

done for various Hematological disorders, Auto immune disorders and

Genetic disorders

ŸRehab and Counselling – This supportive service is very essential for the

Haematology Department and is taken care of by a team of expert

Physiotherapists, Yoga specialists and Clinical psychologists

ŸVery active Hemet OPD – 15000/year and IPD 5000/year

ŸOne of the Tertiary Haematology referral unit in India

ŸVery busy Leukemia, Hemophilia/Lymphoma, Myeloma programme

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Bone Marrow Transplant

Support services from Haematology Lab

ŸRoutine investigations

ŸCoagulation studies

ŸHemolytic work up

ŸThrombophilic work up

ŸMolecular Genetics

ŸCytogenetics and FISH Lab

Ÿ24 hours Blood Bank

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22

Renal Transplant Center

With the blue print in place, CIMS poises for a comprehensive RENAL

TRANSPLANT program with stringent processes in place following

international guidelines and practices, maintaining its registry.

CIMS Renal Transplant Team has successfully completed 10 Renal

Transplant so far.

State-of-the-art procedures for kidney transplantation include:

ŸLiving donor kidney transplants

ŸCadaveric renal transplantation

Renal Transplant Team

ŸRenal transplant programme co-ordinator for counseling sessions for

patient and relatives

ŸRenal Transplant Committee constituted by subject matter experts and key

opinion leaders for transparent, non-objectionable ethical review

ŸBest infection control practices while harvesting kidney to be transplanted

and also throughout the procedure.

RENAL TRANSPLANT SALIENT FEATURES:

The center is functional under the able hands of experienced and

efficient urologists and transplant surgeons so as to perform minimally

invasive surgery, with minimum post-operative recovery time and

hospitalization.

The already existing state-of–the art-operation theaters offer a sterile,

post-operative environment, controlling infections and continuous patient

monitoring.

In house diagnostic services-pathology and radiology will make the procedure

ABO and Human Leukocytic Antigen (HLA) compatible and compliant.

The kidneys are well transplanted such that cold and warm ischemia times are

as short as possible.

The ethical/legal committee reviews and permissions are finally implemented.

The operating protocol are certified ethically and legally.

23

Blood Bank

Only a life lived for others is a life worth while.

In India, Heath System currently operates within an environment of rapid

social, economical and technical changes. Such changes raises the concern

for the quality of health care. Blood banks/ blood centers are an integral part of

health care system. Accreditation would be the single most important

approach for improving the quality of blood banks.

Blood transfusions are a critical part of everyday life and assist in saving

countless lives each year. The blood bank has a vast array of state of the art

equipment for its smooth functioning, which include: Deep Freezers which

maintain temperatures of -30 C and -80 C, heavy duty refrigerated centrifuge

for the separation of components at different speeds, Platelet agitators,

Cryobath, Tube Sealers and Blood Collection Monitors.

All the above equipment have automatic temperature monitors and digital

readout systems as well as automatic alarms, with continuous temperature

surveillance, which ensure the safety of the blood and components issued

from the Blood Bank.

At CIMS, the Blood Bank, equipped with modern medical apparatus, is

functional all through the year and has 24/7 Blood bank services; like

ŸBlood grouping and typing

ŸBlood cross matching

ŸCoombs test (updated method using gel technology now routinely done for

all blood cross matches)

ŸCoombs cross match

ŸTests for uncommon blood cell antigens and antibodies

ŸAntibody titre

ŸScreening for TTI (Transfusion Transmitted Infections) and essential testing

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Genetic Center

CIMS clinical 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.

The geneticist's advice is helpful in cases of

ŸAdvanced maternal age (age 35 or older)

ŸFirst trimester/nuchal screening pre-test education/ counseling

ŸAbnormal maternal serum screening

ŸConcerns about genetic disease because of ethnicity – Thalassemia, Sickle

Cell Disease

ŸAbnormal ultrasound findings

ŸPrevious child with a genetic condition, birth defect(s) and/or mental

retardation

ŸRecurrent miscarriages

ŸFamily/personal history of genetic condition

ŸFamily/personal history of birth defect(s)

ŸFamily/personal history of mental retardation

ŸMedication exposures during pregnancy

ŸConsidering Preimplantation Genetic Diagnosis (PGD)

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National Cardiovascular Data Registry (NCDR)

Knowledge Processing:

The National Cardiovascular Data Registry (NCDR) of the

American College of Cardiology Foundation (ACCF),

CathPCI Registry collects detailed clinical, process-of-care

and outcomes data for patients undergoing coronary

angiography and percutaneous coronary intervention (PCI)

in the USA. The registry contributes to quality of care by

providing data feedback on a wide range of performance

metrics to participating centers and by facilitating local and

national quality improvement efforts.

CIMS the only INDIAN center voluntarily submits complete,

consistent, and accurate data of both diagnostic

catheterization (angiography) and angioplasty procedures

to NCDR CATH PCI registry so as to identify and close

gaps in the quality of care; reduce wasteful and

inefficient care variations; and implement effective,

continuous quality improvement of clinical practice

improving patient outcomes and lowering health care

costs.

The earlier CathPCI version 4.4 has 252 data fields which is

replaced with current Version 5 which is effective from April

1, 2018 (Timeframes 2018Q2 and subsequent) changes

include 218 new elements and 131 retired elements

including selections. Elements encompassing patient

demographics, medical history and risk factors, hospital

presentation, initial cardiac status, procedural details,

medications, laboratory values, and in-hospital as well as 30

days outcomes to create and implement protocols that

improve care for patients nationwide.

In Comparison to US hospital CIMS hospital performed

55 percent higher radial procedure.

In Indian population prevalence of cardiac disease is

higher between age 55 to 65 years.

Data at CIMS reveals high burden of cardiac disease

between ages 55 to 65 years.

100%

80%

60%

40%

20%

0%

26

National Cardiovascular Data Registry (NCDR)

CIMS follows ACC/AHA guidelines drivenpractices

performed by a group of expert cardi ologists including

interventional cardiologist, electrophysiologists, cardiac

surgeons, cardiac anesthetists, experienced Cath lab

technicians and nurses.

Following diagnostic catheterization, based on ACC

guidelines CIMS has developed its own quality metrics for

treatment. Depending on severity of disease,

associated risk factors, patient characteristics the

treatment matrix is individualized for best outcomes.

ŸDoor to balloon time averages about 60 minutes shorter

than the protocol of 90 minutes

ŸData comparison of door-to-ballon 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 guidelines.

ŸIn comparison to ACC guidelines D2B at CIMS is shorter

depicting following of quality protocols and procedures.

27

National Cardiovascular Data Registry (NCDR)

As per ACC guidelines on hospital discharge, nearly all

patients without a contraindication were receiving aspirin

and a statin medication. CIMS care continues at home

through its Care at Homes department.

PCI associated bleeding rate is nearly half in comparison to

US data establishing reduce bleeding complications

following radial intervention.

RIGHT MEDICATION FOR BETTER OUTCOME

Doctor may recommend taking a daily aspirin or other blood

thinner. This can reduce the tendency of blood to clot, which

may help prevent obstruction of coronary arteries.

At CIMS, medications are discharged appropriately

according to ACC guidelines affecting long term patient care

and Quality of life.

28

Cardiology

CIMS has an ultra-modern 24×7 heart care facilities. The

department is handled by renowned Cardiologists,

Cardiothoracic Surgeons, Electro-physiologists,

Intensivists and Anesthesiologists who offer heart care

services across the spectrum of adult and pediatric heart

care.

CIMS Cardiology Unit

The group cardiology practice caters to

ŸCoronary Artery Disease, Non-Coronary & Peripheral

Vascular Diseases, Electro-physiology & Device

Therapies.

ŸOur Intensive Coronary Care Units (ICCUs) are managed

and monitored round-the-clock by critical care specialists

and intensivists, supported by highly trained paramedical

and nursing teams.

Department of Interventional Cardiology provides advanced

diagnostic tests and treatment for problems as common as a

bout of chest pain (Angina), as serious as heart attack

(Myocardial Infarction) and as rare as Tricuspid Atresia. The

Invasive Cardiology offers treatment for Coronary Artery

Disorders, using Angioplasty, Stents, Laser, Ultrasound

techniques etc.

29

Cardiology

CIMS Cath-Lab

Our sophisticated Cathlab and advance technology offers

unmatched outcome in various cardiac ailments. Team of

dedicated and highly skilled interventional cardiologists

perform coronary and peripheral angiographies, balloon

angioplasties, stenting, EP studies and ablation, pulmonary

and mitral valvuloplasties and other interventions.

Cardiology Department focuses on holistic approach to

Cardiac Care through invasive & non-invasive therapeutic &

diagnostic services, managed by dedicated team of doctors

and is one of the finest in the country. The department

consists of Interventional Cardiology and Cardio-Thoracic

Surgery.

Radial Lounge

30

Cardiology

Majority of patients who underwent cardiac catheterization

were within age group 51-70 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.

Prevalence of hypertension and diabetes was high among

patients undergoing cardiac catheterization. These statistics

show that when patients have both hypertension and diabetes,

which is a common combination, their risk for cardiovascular

disease doubles.

31

Cardiology

The best outcomes for patients with PAMI are achieved at

hospital like CIMS with 24*7 accesses to primary PCI.

Low Door to Balloon time reduces treatment delays and

establishes the adage that “time is muscle”. Data

comparison of door-to-ballon 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 guidelines

At CIMS, our well experienced interventional

cardiologists with technical expertise perform majority of

procedures through radial approach as compared to

femoral approach.

50% of people suffering from a heart attack do not survive

because they don’t get treated on time. At CIMS, our doctors

are trained and equipped to open blocked arteries in a

record time to save heart from further damage.

32

Cardiology

Single Vessel Disease

Double Vessel Disease

Triple Vessel Disease

33

Cardiology

In general, drug-eluting stents are preferred over bare-

metal stents for most patients. The reduced risk of re-

blocked arteries from drug-eluting stents reduces the need

for repeat angioplasty procedures, which carry the risk of

complications such as heart attack and stroke. The choices

of intracoronary device were similar at CIMS and US

facilities relating similar patient treatment.

34

Cardiology

In the radial approach:

ŸEase of catheter passage even in overweight or

obese patients.

ŸThe patient does not require post-procedural

immobility up to 4 to 5 hours.

ŸEarly ambulation and PCI can be performed as a

day care procedure.

ŸAccording to AHA guidelines (2011) of PCI, compared to

femoral access, radial access decreases the rate of

access-related bleeding and local vascular

complications.

Cardiology Average Length of Hospital Stay

ŸThe (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.

ŸAverage Length of hospital stay after Cardiac Producers is

gradually reduced.

35

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.

The Cardiac Investigations Unit undertakes several

procedures including:

ŸECGs

ŸTransthoracic Echocardiograms

ŸDobutamine Stress Echocardiograms

ŸExercise Stress Echocardiograms

ŸTransoesphagel Echocardiograms

ŸExercise stress tests

ŸTilt table testing

Ÿ24 and 48-hour Holter monitoring

ŸCardiac Event Monitoring (seven days)

Ÿ24-hour Ambulatory Blood-Pressure Monitoring

ŸNon-invasive EP study (NIEPS)

36

Cardiac Investigations

37

Cardiac Rhythm Disorders

CIMS has established a unique Cardiac Arrhythmia

Management Centre which provides customized catheter

- based treatment that incorporates comprehensive

state-of-the-art technology to effectively cure arrthymias.

CIMS offers various treatments for cardiac rhythm disorders

ŸElectrophysiology studies (EPS) for diagnosis of cardiac

arrhythmia (conventional and 3 Dimensional Mapping

System)

ŸRadiofrequency Ablations (RFA) of complex cardiac

arrhythmias pacemaker Implantation

ŸBiventricular Pacing (Cardiac Resynchronization

Therapy) for heart failure

ŸAutomatic Implantable Cardioverter Defibrillator (AICD)

implantation

ŸComprehensive 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

With improved facilities and increased expertise for CIED

procedures, the average length of stay at CIMS has

reduced with progressing time.

CIMS electrophysiologists work closely with our

cardiothoracic surgeons and heart failure specialists

to treat patients who may require heart surgery or

whose heart rhythm disorder is related to heart

failure.

38

Cardiac Rhythm Disorders

39

Cardiac Surgeries

Today, our centre treats patients with the latest technologies

in Minimally Invasive Cardiac Surgery, Minimally Invasive

Hybrid Cardiac Surgery, Interventional Cardiology, Non-

Invasive Cardiology, Pediatric Cardiology and pediatric

Cardiac Surgery for Coronary Artery Bypass Graft Surgery,

Valve Replacement and Repair, Aneurysm and Aortic

Dissection Surgery.

Our Intensive Coronary Care Units (ICCUs) are managed

and monitored round-the-clock by critical care specialists

and intensivists, supported by highly trained paramedical

and nursing teams. Our hospital also offers an excellent

cardiac rehabilitation program that focuses on the post-

operative care of cardiac patients.

Services at CIMS:

ŸCongenital heart surgery

ŸMitral valve repair

ŸSingle and double valve replacement

ŸAortic root replacement

ŸOf f pump coronary artery bypass grafting (CABG) on

beating heart

ŸMinimally Invasive Cardiac Surgery (MICAS) CABG for

LV dysfunction

ŸPatent ductus arteriosus (PDA), Atrial septal

defect(ASD), Ventricular septal defect(VSD), Tetralogy

of Fallot (TOF )

ŸCombined carotid and bypass procedure

Facility:

Ÿ2 Class 100 laminas air flow modular operation theatres

only devoted to cardiac surgery

ŸPositive and Negative isolation chambers in the SICU

Ÿ20 bed surgical intensive care unit

40

Cardiac Surgeries

Our hospital also offers an excellent cardiac rehabilitation program that focuses on the post-operative care of cardiac

patients. Today, our centre provide patients with the latest technologies in Minimally Invasive Cardiac Surgery, Minimally

Invasive Hybrid Cardiac Surgery, Interventional Cardiology, Non-Invasive Cardiology, Paediatric Cardiology and Paediatric

Cardiac Surgery for Coronary Artery Bypass Graft Surgery, Valve Replacement and Repair, Aneurysm and Aortic Dissection

Surgery.

41

Cardiac Surgeries

ASD Closures can be performed by use of devices as well

through surgery depending upon the case, suitable

treatment option is selected.

We also offer comprehensive treatment for congestive heart

failure and end-stage lung disease, including:

ŸSurgical ventricular remodeling procedures

ŸHeart and lung transplantation

ŸVentricular assist devices

Surgeons at CIMS Hospital are committed to continually

studying and evaluating new methods of surgical treatment

and improving surgical outcomes through clinical and

laboratory research in such areas as protection of the brain

and neurological systems during bypass operations and the

future use of stem cells for concomitant procedures in

patients with congestive heart failure.

CIMS Cardiologist Team CIMS Cardio Vascular and Thorasic Surgeon Team

42

Heart Failure

In an effort to keep heart failure complications under check,

CIMS has been tirelessly striving to bring better heart care to

the country.

Along with performing path-breaking surgeries, our team of

experts at CIMS has also been constantly introducing world-

class heart management methods to India.

Today, we offer comprehensive solutions to advanced heart

failure conditions all under one roof. In addition to cutting-

edge Ventricular Assist Device (VAD) therapy, the CIMS

heart failure clinic for Heart Failure and Transplant has

changed the way heart patients are treated today.

The centre offers outpatient ambulatory therapy for

administration of inotropic medications which helps in

rapidly improving symptoms and restoring vital organs to

their normal conditions.

CIMS is one of the first hospital to offer LVAD

Left Ventricular Assist Device (LVAD)

Bridging to Transplantation. The device serves as a

temporary bridge so that a patient can recover some life-

sustaining degree of heart function prior to transplantation.

Heart Translplant

Heart Transplant is a surgical procedure performed to

remove the diseased heart from the brain dead patient and

replace it with a healthy one from the organ donor.

43

Cardiac Valve Disorders

CIMS Valvular Clinic is state-of-the-art center for the

diagnosis and treatment of heart valve disease.

Cardiovascular imaging specialists use best procedures to

determine the type and severity of heart valve disease and

plan treatment. The decision to prescribe medical treatment

or proceed with surgical repair or replacement is based on

the type of heart valve disease, the severity of damage the

age and medical history.

Surgeons in the Department of Thoracic and

Cardiovascular Surgery have perform over 250 heart valve

surgeries each year, including valve repair and replacement

of the mitral valve, aortic valve, pulmonic valve and tricuspid

valve.

In addition, via a process that begins with evaluation at The

CIMS Valvular Center, these heart valve specialists also

perform:

ŸVentricular Septal Defect (VSD) Closure (post-surgical or

post-infarction)

ŸAtrial Septal Defect (ASD) Closure

44

Cardiac Valve Disorders

ŸPatent Formen Ovale (PFO) Closure

ŸValvuloplasty (Aortic, Mitral, Pulmonic and Tricuspid)

ŸParavalvular Leak (PVL) Closure

ŸLeft Ventricular Pseudoaneurysm Closure

ŸValve-in-valve procedures for degenerated bioprosthetic

valves in inoperable/high-risk surgical patients

ŸTranscatheter Left Atrial Appendage Exclusion

ŸClinical Research Study Opportunities

MVR cases are always predominant as mitral valve is

commonly affected in rheumatic disease and degenerative

disease. Double valve replacement carries higher morbidity

and mortality risks.

Heart Valve Disease

45

Minimal Invasive Cardiac Surgery

CIMS is the first official center to launch a fully equipped

MICS program in Ahmedabad and Gujarat

As world has changed from 'big' to 'small', so has

cardiac surgery. It has evolved and changed from

routine midline sternotomy to Minimally Invasive Cardiac

Surgery (MICS). We have come across problems related

to big incisions like wound infection, keloid scars, pain,

delayed recovery and more over cosmetic problem in

young patients.

MICS resolves the challenges faced. MICS has undergone

numerous changes in technique and philosophy. With

innovations in perfusion techniques, refinement of

transthoracic echocardiography and the development of

specialized surgical instruments, necessary tools to

progress to less invasive approaches are available

today at CIMS.

MICS Surgeries at CIMS

(1) ASD

(2) Mitral valve repair / replacement

(3) Aortic valve replacement

(5) Selected cases of CABG

(6) Hybrid CAB

CIMS also offers an excellent cardiac rehabilitation program

that focuses on the post-operative care of cardiac patients.

With time, average length of hospital stay following cardiac surgery is reduced,

relating the established protocols followed and experienced expertise.

46

Pediatric Cardiac Sciences

The Pediatric Cardiac Sciences department at CIMS is one

of the most advanced in Western India with latest

equipment including inhaled Nitric Oxide, ECMO (Extra

Corporeal Membrane Oxygenation) and intra operative

Transesophageal Echocardiography.

Our team has produced tremendous impact on outcome

of several hundred small infants and children born with

heart disease since birth. This includes all varieties of

catheter interventions, device closure, closed and open

cardiac surgeries, neonatal and infant cardiac surgeries,

cardiac surgeries in adults (Grown up Congenital Heart

Disease), redo operations and hybrid cases.

The pediatric cardiac team at CIMS is one of the most

comprehensive team catering to all varieties of

congenital heart disease(CHD). Patients from one day /

premature neonate to adult with CHD are treated at

CIMS

47

Vascular and Endovascular Surgery

Carotid artery surgery is a procedure to restore proper blood

flow to the brain. There are two procedures to treat a carotid

artery that has plaque buildup in it. This can be treated by

endarterectomy (CAE) or by stent placement (CAS)

At CIMS, Duplex ultrasound or magnetic resonance

angiography (MRA) as well as other imaging and

pathological tests are used to suggest the diagnosis but the

gold standard is conventional renal angiography.

At CIMS, Vascular Surgery Includes:

ŸCarotid Endarterectomy for Stroke prevention

ŸOpen Repair of Aortic and Peripheral aneurysms

ŸAorto – Femoral – Popliteal Bypasses

ŸA – V Access (Fistula) surgery

ŸDiabetic Foot Care Clinic

Highly skilled Cardiothoracic surgeons of CIMS operate

various procedures such as Lobectomy, Pneumonectomy,

Thorectomy, Embolectomy, Pleuroscopy including Video-

assisted Thoracic Surgery (VATS). Expert thoracic

surgeons mainly focus on early diagnosis and prediction of

recurrent diseases in lung and esophageal cancer.

ŸEndovascular Interventions

ŸAngioplasties and stenting for Peripheral Vessels

Occlusive Diseases

48

ŸThoracic Endovascular Aortic Repair (TEVAR)

ŸAt CIMS the cardiologists, vascular and endovascular

surgeons treat thoracic and thoracoabdominal

aneurysms with a minimally invasive procedure called an

endovascular stent graft.

The skills necessary to perform TEVAR cannot be attained

through short “courses”. A dedicated team of vascular

surgeons, interventional radiologist/cardiologist,

cardiothoracic surgeons is necessary in order to obtain the

“wire skills” and to perform these endovascular procedures.

At CIMS the PPPPP (Prior Planning Prevents Poor

Performance) rule is followed. Preoperative imaging and its

accurate interpretation, vessel access, calcification or

tortuosity in the arteries are considered. Patient is closely

watched in the postoperative period and timely evaluated for

endoleak, migration, device structural deterioration, etc.

Our surgeons are uniquely trained and experienced to

weigh the various treatment options available, including

medical therapy, as well as surgical and endovascular

approaches.By offering the entire spectrum of therapeutic

options, our physicians can assure patients that they are

receiving the most appropriate therapy for their conditions.

Vascular and Endovascular Surgery

Endovascular Sugery

49

Vascular and Endovascular Surgery

Carotid Endarterectomy

50

Highly skilled Cardiothoracic surgeons of CIMS operate various procedures such as Lobectomy, Pneumonectomy, Lung

Decortication, Thorectomy, Embolectomy, Pleuroscopy including Video-assisted Thoracic Surgery (VATS).

We provide care for all diseases of the chest, including:

ŸEsophageal Cancer

ŸLung Cancer

ŸChronic Pleural Effusion

ŸOther Chest Tumors

ŸThe Range of such operations, routinely done include:

ŸLobectomy

ŸPneumonectomy

ŸThoracotomy

Thoracic Surgery

51

At CIMS, the Department of Orthopedic Surgery is

committed to deliver the highest quality of diagnostic and

therapeutic patient care to both adults and children for a

diverse spectrum of orthopedic disorders.

At CIMS, complex orthopedic injuries are taken care by a

team of eminent experts that includes orthopedic surgeons,

anesthesiologist, physical and occupational therapist and

nurses, who are in constant touch with the patient's right

from pre-surgery assessment to post-operative hospital

stay.

Orthopedic surgeries and treatments carried out at

CIMS are:

ŸJoint Replacement, Knee, Hip, Shoulder and Elbow

Replacement

ŸRevision Knee and Hip Replacement Surgery

ŸComplicated Intraarticular and periarticular factures

ŸComplicated poly trauma and high risk orthopedic surgery

ŸArthroscopic surgery

ŸArthroscopic reconstruction

ŸSports surgery

CIMS Orthopedic surgery team includes experienced Joint

Replacement Surgeons, Plastic Surgeons, Intensivist,

Anaesthetologist which conduct complicated procedures

with excellent outcomes.

CIMS joint replacement team is backed by an ultramodern

high tech laminal airflow operation theatre with all

sophisticated and latest anesthesia equipment, power

Orthopedic Surgery

52

instruments, latest electro coagulation system, dual shadow

less imported lights and many more gadgets.

CIMS joint replacement department is supported for

complicated and high risk patient by ultramodern well

equipped incentive care units, round the clock critical care

support of efficient critical care department and renowned

experienced cardiology team.

Outcomes Measures of Total Knee Replacement:

ŸDecreased morbidity and mortality

ŸImproved functional status

Orthopedic Surgery

Knee Replacement Hip Replacement

Shoulder Replacement Elbow Replacement

53

Critical Care

CIMS CRITICAL CARE is supported by advanced in-house

radiology and pathology services, state-of-the-art

rehabilitation including physiotherapist, clinical nutritionist,

and occupational therapist. CIMS CRITICAL CARE

performs regular in-house teaching / training program for

supportive medical and nursing staff, medical students,

public seminars/awareness programs, etc.

Critical care Services include:

ŸManagement of all types of shock state

ŸManagement of cardiorespiratory arrest by dedicated

CPR team

ŸThrombolytic therapy for acute pulmonary thrombo-

embolism and acute ischemic stroke

ŸRenal and hepatic failure care

ŸAll kinds of sepsis including oncology, post-transplant,

immuno-compromised patients

ŸNeurological emergencies

ŸAll kinds of surgical and obstetrics emergencies

ŸPoly trauma & burns care

ŸCare for pre-operative high-risk patient, intra and post-

operative complicated patient (including care of

complicated GI, orthopaedic, neuro, onco, bariatric

surgeries, acute pancreatitis)ECMO Machine

Critical Care Unit

54

Core Principles of Safety Science at CIMS

ŸCreate a culture where mistakes are identified.

ŸFocus on systems rather then people.

ŸLeader controls the potential to change system.

At CIMS, core principles are achieved through:

ŸCommit no harm

ŸEncourage open communication

ŸCelebrate safety

CIMS ICU/GICU Design:

The ICU complex at CIMS is designed in such a way that

each ICU cubicle has adequate sunlight day long with

exposure to common green atrium area, making the ICU

really a green ICU with added advantage of making it least

prone for ICU related delirium or psychosis.

At CIMS Merging ICU/GICU and Emergency Room:

This is a major and novel concept to place ICU, next to

emergency room (ER) to complement ER to manage all

critical patients from the ER itself. This ensures treatment

from ER itself relating with golden hour management.

ŸTPN (total parental nutrition)

ŸCare of poisoning patient

ŸPalliative care (pain relief) for terminally ill

ŸIntermediate care at high dependency unit (HDU)

At CIMS, CCU Process Measures Include:

Ÿ Avoid excessive use of antibiotics

ŸJudicious monitoring of fluid and inotrope therapy

Ÿ Avoid excess sedation

Ÿ Avoid too liberal blood transfusion

Responsibilities of CIMS Critical Care Physician

ŸCreating guidance for granting of specific privilege in the

ICU

ŸDeveloping ICU programs, policies, rules and regulations

ŸDeveloping recommendations about the need for

continuous educational programs that are consistent with

the type of service offered by critical care and developing

performance improvement activities

ŸManaging physician staff members adherence to medical

laws and other hospital policies, sound principles of

clinical practice regulation that promote patient safety

Ÿ

Critical Care

55

Trauma Center

Goals achieved at CIMS Trauma Centre

ŸTo 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.

ŸTo assist in the ongoing assessment of trauma patients for

Optimal Care of the Injured Patient for appropriateness,

timeliness, and efficient management.

Emergency and Trauma care services and features

include

ŸSTEMI Cardiac Care Designation – state of the art care for

patients suffering heart attacks

ŸStabilization of life-threatening conditions

ŸLife-saving procedures

ŸImmediate treatment of medical and surgical

emergencies

ŸEmergency treatment for minor injury or illness

ŸEmergency care for minor or major trauma victims

Facilities at CIMS

ŸBLS and ACLS trained doctors, nurses and technicians

Ÿ24 X 7 services round the year

ŸTriage area equipped with facilities of a world class

emergency room

ŸFacilities of directly shifting patients with MI for PAMI to

We, at CIMS, are extremely committed to provide the best and the right care to all trauma patients.

At CIMS, trauma personnel are trained and re-trained using nationally available education tools such as the Advanced

Trauma Life Support and Advanced Burn Life Support courses.

The goal of our expert trauma center in Ahmedabad is to provide treatment to a child within 30 minutes (Platinum Hour) and

Treatment to an adult within 60 minutes (Golden Hour)".

56

Trauma Center

cathlab.

ŸICU-ON-WHEELS and other Ambulance services run

forth to collect trauma and emergency patients from the

site

ŸMobile unit with a defibrillator, multipara monitor and

ventilator

ŸExcellent communication facilities backup.

ŸEmergency team gets activated according to CODE

BLUE, when called for

ŸEntire staff is trained in patient resuscitation so that they

are helpful to save patients

ŸHighly experienced team of orthopedic surgeons, general

surgeons and anesthetists

CIMS Trauma Centre Principles:

ŸLife-threatening injuries are appropriately treated

promptly and in accordance with appropriate priorities, so

as to maximize the likelihood of survival.

ŸPotentially disabling injuries are treated appropriately, so

as to minimize functional impairment and to maximize the

return to independence and to participation in community

life.

Ÿ Pain and psychological suffering are minimized.

Cognizance Initiative

A unique program is undertaken by CIMS hospital to provide

early awareness to the general public regarding the

prevention and safety of traumatic incidents either roadside,

workplace or home by conducting seminars and

conferences and distributing pamphlets emphasizing safe

driving and sudden medical attention required to prevent

negative long term psychological reactions.

57

Infectious Disease

CIMS infectious disease unit with help of a full-time

dedicated Infectious Diseases consultant, provides in-

patient and out-patient care for:

HIV and AIDS (Acquired Immunodeficiency Syndrome)

Pulmonary and extra pulmonary tuberculosis, including

MDR (Multi-drug resistant) and XDR (Extensively drug-

resistant) TB

Community acquired infections like upper respiratory

infections, pneumonia, urinary tract infections, brain

infections, etc.

Tropical infections like malaria, dengue, typhoid fever,

chikungunya

Opportunistic fungal infections like candidiasis,

aspergillosis, and mucormycosis in immuno-compromised

patients

Hospital acquired infections, post-surgical infections

Infections in cancer patients

Infections in organ transplant recipients

Adult Vaccination:

Vaccination for prevention of infectious diseases is of

utmost importance in this era of globalization, increasing life

expectancy, and growing population of immuno-

compromised patients, migration and increasing

international travel.

58

Pulmonary Medicine

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, fiber optic pleuroscopy and allergy

testing.

Various procedural and surgical treatments offered at

CIMS include:

ŸAtypical mycobacterial infections

ŸPulmonary fibrosis

ŸBalloon dilation and stent placement to open windpipes

ŸLaser treatment for palliation

ŸBronchoscopy including interventional treatments with

lasers and stents

ŸMesothelioma

ŸLung volume reduction surgery (LVRS)

ŸNicotine dependence

ŸEmphysema

ŸChronic chough and bronchitis

ŸPulmonary embolism

ŸPulmonary vasculitis

ŸSleep apnea

ŸFlolan infusion

Pulmonary function tests:

Pulmonary function tests are a group of procedures that

measure the function of the lungs, revealing problems in the

way a patient breathes.

59

Pulmonary Medicine

The tests can determine the cause of shortness of breath

and help in differential diagnosis of lung diseases, such as

asthma, COPD or interstitial lung disease.

The tests are also performed before any major lung surgery

to make sure the person is not disabled by having a reduced

lung capacity.

CIMS PFT lab has facility to conduct DLCO, which is an

integral tool to measure extent of problem in interstitial lung

disease.

Sleep lab:

ŸCIMS hospital houses senior and renowned

pulmonologists. Besides, it is equipped with world class

instruments like Video bronchoscope and Advanced PFT

with DLCO apart from sleep laboratory at par to

international standards.

ŸCIMS Sleep Lab is like a private bedroom equipped with

cable television, queen bed, recliner and private

bathroom.

ŸThe sleep lab is equipped with additional sensors,

hardware and software to carryout cardiovascular studies

and other uncommon sleep disorders.

ŸHome sleep study with portable devices

60

Neuro and Spine Surgery

CIMS Neurosurgery department utilizes multi-disciplinary

approach to diagnose and treat neurological disorders in

patients.

Complex medical and surgical conditions including

malignant and benign brain tumors, skull based tumors,

epilepsy, movement disorders and vascular malformations

are treated.

CIMS neurosurgical team is focused on treating the most

complex medical and surgical conditions including

malignant and benign brain tumors, skull based tumors,

epilepsy, movement disorders and vascular malformations.

Skull Base Surgery Services:

ŸSkull base tumor excision: acoustic neuromas,

chordomas

ŸCerebro spinal fluid leaks

ŸCraniofacial deformities

ŸCranial base osteomyelitis

ŸMicro vascular decompression for trigeminal neuralgia,

hemifacial spasm.

61

Neuro and Spine Surgery

Pediatric Neurosurgery

ŸHydrocephalus: Endoscopic ventriculostomy, shunt

surgery

ŸPediatric brain and spine tumor surgery

ŸSpinal dysraphism and tethered cord surgery

ŸCraniosynostosis correction

ŸOccipito cervical decompression for chiari malformation.

Brain Surgery services

ŸBrain tumor surgery

ŸMicroscopic/ endoscopic transnasal pituitary tumor

excision

ŸNeuro Vascular lesions: Aneurysm, AVM

ŸStroke surgery: brain hemorrhage, carotid endartrectomy

ŸStereotactic surgery

ŸCranioplasty

ŸEpilepsy surgery

ŸCranial trauma

Stroke Surgery

ŸBrain hemorrhage, carotid endartrectomy

ŸStereotactic surgery

ŸCranioplasty

ŸEpilepsy surgery

62

Surgeries Performed and Diseases TreatedBasic Laparoscopic SurgeriesAppendectomyCholecystectomyAdvanced Laparoscopic SurgeriesŸInguinal and ventral hernia repairŸPeptic and enteric perforation repairŸFundoplicationŸHeller's cardiomyotomyŸCystogastrostomy /cystojejunostomyŸMinimally invasive surgery for acute necrotising

pancreatitisŸRectopexyŸColectomyŸThoracolaparoscopic esophagectomy

Esophagus and StomachŸCorrosive oesophageal and gastric strictureŸEsophagus and stomach malignancyŸGastric GISTŸEsophageal motility disordersŸAcid peptic diseasesŸGERDCIMS is certified and accredited for Liver TransplantBiliary and Liver DiseasesŸBiliary and hepatic malignancyŸBile duct injuries and post cholecystectomy billiary

structureŸHydatid liver diseaseŸLiver tumourŸShunt surgeries for portal hypertension

PancreasŸPancreatic malignancyŸChronic pancreatitisŸPancreatic neuroendocrine tumourŸAcute necrotising pancreatitis

Small and Large bowelŸCarcinoma of colon and rectumŸUlcerative colitisŸFecal fistulaŸRectal prolapse

GI Surgery and General Surgery:

CIMS division of GI surgery is dedicated to provide

comprehensive surgical care for patients with basic and

complex gastrointestinal diseases. Patients are referred to

CIMS surgeons from across the state and country for

management of a variety of benign and malignant GI

disorders. The surgeons provide complete evaluation,

diagnosis, best mortality treatment available as well as

surgery required for patient's alignment and surgical treatment

for a wide variety of GI disorders. We have pioneered some

of the most advanced, minimally invasive procedures while

achieving the fewest complications, highest survival rates

and best outcomes in the state.

GI Surgery and General Surgery

63

Endoscopy

happy .A commitment to ethical medical practice plays a key

role and to ensure that the the patient receives the best

available treatment at an affordable cost

Staffed by experienced Gastroenterologists, Gastro

Surgeons, Pulmonologist and Endoscopy nurses, CIMS is

committed to deliver expert endoscopic procedures in a

timely, safe, and patient friendly manner. We provide acute

care 24 x 7 days, to manage life threatening illnesses as well

as screening procedures for diagnostic, preventive and

therapeutic purposes.

Endoscopy services at CIMS:

ŸOlympus Colonoscope is used to examine Large Bowel

i.e. Colon, Rectum (large intestine).

ŸUltramodern endoscopy from Olympus–Gastro scope for

Upper GI tract i.e. Oesophagoscopy - Gastroscopy and

Duodenoscopy

ŸColonoscopy

ŸERCP to evaluate bile duct and pancreatic ducts

ŸCapsule Endoscopy for small intestinal diseases

ŸRemoval of tumors like polyps from stomach, duodenum,

large intestine

ŸRemoval of stones from bile duct

ŸStent placement in food pipe, bile duct and pancreatic duct

ŸManagement of acute upper and lower GI hemorrhage

Designed for the privacy and comfort of our patients, The

Endoscopy Unit at CIMS Hospital is a dedicated, state-of-

the-art unit for therapeutic and diagnostic procedures.

CIMS has an expertise of nation's leading and good

specialists in gastrointestinal diseases. Our gastro-

enterologists are the best and nationally recognized for

providing breakthrough care of complex digestive diseases.

At CIMS, all efforts are made earnestly to make the patient

Upper Gastrointestinal Endoscopy

64

Bariatric Surgery

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.

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.

“LOOSE WEIGHT, GAIN HEALTH”. Any type of Obesity,

however mild, is a risk factor that can aggravate into life

threatening conditions. The CIMS is equipped with state-of-

the-art technology to perform laparoscopic and bariatric

surgeries of varied complexities.

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

CIMS has performed more then 200 Surgeries till date.

65

Oncology

Expert surgical oncology team offers optimum multimodality

tailored treatment to the need of every patient.

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.

Services

ŸEarly detection and prevention programs and cancer-

related health check-up

ŸAll types of surgery according to latest protocols

ŸOrgan 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)

ŸChemotherapy for all solid cancers

ŸProtocol based chemotherapy for hemato-oncology

disorders

ŸReconstructive surgery and prosthesis for jaw, breast,

limbs and other defects and rehabilitation

ŸSpecially trained doctors and intensivists for medical

management of patients

ŸNutrition plan guided by dietician before and after surgery

ŸPhysiotherapy and functional rehabilitation

Follow up is stratified according to disease risk. Patients are

given information regarding their personal follow up

programme (clinical and imaging).

High risk patients are followed up more closely with joint

care by surgeons and oncologists according to agreed local

protocols.

66

Oncology

Techniques of Radiotherapy:

Ÿ2D Radiotherapy: It is based on simple X-ray based

planning, treats larger area of body.

Ÿ3D CRT (3 Dimensional Conformal Radiotherapy):

Itisbased on CT Scan based planning and uses multiple

beam & MLC (Multileaf Collimator) to form the shape of

radiation beam according to tumor contour.

ŸIMRT (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.

ŸVMAT (Volumetric Modulated Are Therapy):It is advanced

form of IMRT.

CIMS Cancer Center has one of the largest surgical

oncologist team affiliations in India

Cancer Surgery

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Oncology

68

Nephrology

ŸManagement of difficult vascular access ( AV Fistula)

ŸSalvation of failing AV Fistula, fustulography and

fistuloplasty

ŸRenal biopsy

ŸPlasmapheresis

At CIMS, 7 renal transplants have been successfully

performed till date

ŸThe department consists of highly skilled committed

nephrologists, transplant surgeons and a large team of

registrars.

ŸIt is an academically well established, teaching /training

institute for the super specialty of Nephrology and has to

its credit to have trained more than ten nephrologists

serving in various prestigious institutes of India.

ŸThe paramedical staff including dialysis technicians,

nurses and housekeeping staff are well versed with their

technical skills. It provides a full range of renal services

including hospital hemodialysis, peritoneal dialysis and

care for transplant recipients.

We are well-equipped with all necessary resources for a

successful renal transplantation which include, but not

limited to:

ŸHighly experienced and qualified team of doctors

ŸAppropriate counseling sessions for patient and relatives

ŸTransparent, non-objectionable ethical review by Renal

Transplant Committee constituted by subject matter

experts and key opinion leaders

ŸRegulatory compliance as per State Govt. guidelines for

organ transplantation

ŸBest infection control practices while harvesting kidney to

be transplanted and also throughout the procedure.

ŸState-of-the-art department to provide all kidney related

care under one roof

Ÿ6 Hemodialysis HD machine and 1 CRRT machine for the

patients

ŸFacility for CRRT (Continuous Renal Replacement

Therapy) for critically ill patients

ŸAdherence to international standards for infection control

and quality in dialysis

ŸTo reduce incidence of hepatitis B and C, rigorous

precautions are taken and such patients are dialyzed on

separate machines.

Services

ŸManagement of acute renal failure, chronic renal failure,

acute and chronic nephritis, nephrotic syndrome, reno-

vascular hypertension, and collagen vascular disorders

involving kidneys etc.

Ÿ24 x 7 Dialysis

ŸCRRT for dialysis in critically ill patients.

ŸTunneled cuffed catheter insertion (PERM CATH) for

patients having difficulty in constructing-working-AV

Fistula

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Urosurgery

Within the urology specialty at CIMS there is a dedicated

treatment program for prostate cancer treatment and

facilities to carry out laparoscopic (keyhole) surgery

wherever possible.

At CIMS full range of services, available from the urology

team include the following Services:

(I) Surgical Procedures for Enlarged Prostate

ŸTrans-Urethral Resection of the Prostate (TURP) with

Holmium laser

ŸProstatic Biopsy

(II) Prostate Cancer Diagnosis and Treatment

ŸRadical Prostatectomy

ŸLaparoscopic Prostatectomy

(III) Bladder CanceruFlexible Cystoscopy

ŸTransurethral Resection of Bladder Tumor (TURBT)

ŸOpen Radical Cystectomy

ŸLaparoscopic Radical Cystectomy

ŸRadical Cystectomy and Neobladder Formation

Urosurgery

Age distribution of urosurgery patients

Gender distribution of urosurgery patients

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Urosurgery

(IV) Kidney Cancer

ŸPartial Nephrectomy

ŸLaparoscopic Radical Nephrectomy

ŸOpen Radical Nephrectomy

ŸPercutaneious Nephrolithotomy Surgery (PCNL)

/Ureteroscopic Lithotripsy (URS) / Flexible URS /

Cystolitholepexy for Urinary Stones.

ŸVisual Internal Urethrotomy (VIU) – for Stricture

Urethnal.

ŸPediatric Endoscopic Surgeries.

ŸTension-free Vaginal Tape (TVT) / Transobturator

Tape (TOT) for Stress Urinary Incontinence.

ŸPlastic Surgery for Hypospadias, Hernia,

Hydrocele Operations and Mesh Repairs.

Orchiopexy, Varicocelectomy, Vasectomy

CIMS Renal Transplant Team

has successfully completed

10 Renal Transplant so far.

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Plastic Surgery

The Plastic surgery procedures at CIMS Hospital include both

cosmetic enhancements as well as functionally reconstructive

operations using surgical and non-surgical techniques to

change the appearance and function of a person's body.

Plastic surgery at CIMS repairs and restores appearance and

function through wide range of reconstructive cosmetic surgery

services. CIMS plastic surgeons team with surgeons in

dermatology, otolaryngology (ENT) and oral/maxillofacial

surgery and physicians to offer a comprehensive restoration.

Services available at CIMS include

ŸReconstructive surgery

ŸReconstructive microsurgery including

ŸBrachial plexus injuries

ŸCraniofacial surgery

ŸAesthetic plastic surgery

ŸLaser surgery

ŸPediatric plastic surgery

ŸHand surgery

ŸSkin grafting to treat wounds, trauma, burns and infection.

ŸPlastic surgery at CIMS for cancer patients include

ŸMastectomy for breast cancer

ŸHead and neck cancer

ŸSurgery for skin cancer

ŸSurgery for colorectal cancer,

ŸGynecological or peritoneal cancers.

Total Volume of Plastic Surgery

Age Distribution of Plastic Surgeries

Gender Distribution of Plastic Surgeries

72

Obstetrics and Gynaecology

The Gynecology division at CIMS offers a wide range of

gynecological care for women from adolescence through

post-menopause. Our care extends from preventive care to

diagnostic, operative and educational care.

Department at CIMS is fully committed to deliver world class

health care services to women looking for gynecological

solutions. At CIMS we have a dedicated team of

obstetricians and gynecologists offering a wide range of

services. From pre-pregnancy care to childbearing and

post-menopausal care, there is a solution for all health

concerns a woman experiences during these stages.

Gynecological and pregnancy related services

provided at CIMS include

ŸPregnancy care and birth

ŸHigh risk pregnancy

ŸInfertility

ŸMenorrhagia Clinic (Heavy Periods)

ŸWhite discharge / Leucorrhoea

ŸMenopausal symptoms

ŸUrinary leakage

ŸCancer screening and treatment

ŸContraception and family planning

ŸAdolescent clinic and guidance

ŸOperative laparoscopy and hysteroscopy surgery

ŸAll types of gynec surgery

ŸFoetal USG and doppler and anomaly scan

ŸHPV vaccine (for prevention of cervical cancer)

Age Distribution of Gynaecology Surgeries

Types of Gynaecology and Obstetrics Surgeries

73

Obstetrics and Gynaecology

Obstetrics and Gynaecology

ŸHigh Risk Pregnancy Unit with round-the-clockexpert

team of obstetrician

ŸState-of-the-art NICU & Green ICU

ŸRound-the-clock intensivists

ŸIn-house availability of Neonatologist, Cardiologist,

HematoIogis t, Gastroenterologist and Nephrologist

ŸFacilities of CT, MRI, Blood Bank & Dialysis

ŸExpert in management of medical disorders in pregnancy,

pre-pregnancy consultation

Foetal Medicine

ŸFacility for 3D/4D TIFFA/anomaly scan

ŸColour doppler, foetal well-being scan, foetal echo

ŸPrenatal diagnostic and therapeutic procedures like

ŸAmniocentesis

ŸFoetal reduction

ŸCordocentesis

ŸIntra-uterine blood transfusion

ŸAneuploidy screening

ŸFirst trimester combined screening (NT Scan + S.BHCG +

S.PAPP-a)

ŸQuadruple marker

ŸNIPT(Non-invasive prenatal diagnostic technique)

Our team of experienced gynecologists along with round-

the-clock medical and paramedical staff provide tender

care to pregnant females and gynec patients.

At CIMS besides, pregnant and gynec patients

Comprehensive Woman Health checkup program are

arranged and conducted successfully.

74

Neonatal Center

Neonatal Department of CIMS Hospitals specializes in

treating babies with a wide range of congenital and acquired

conditions through state of the art technology and care.

Goal of CIMS Neonatal care unit.

ŸTo reduce the neonatal morbidity & mortality.

ŸTo provide continuing in- service training of medical &

nursing personnel in the care of newborn.

ŸTo improve clinical care of the critically ill.

ŸKey features of Neonatal and Pediatric Critical Care Unit.

ŸHighly qualified intensive care team to treat critical

neonates and children.

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.

Multi-disciplinary intervention program with facilities like in-

house pediatric surgery, pediatric cardiology and pediatric

cardiac surgery, fibreoptic bronchoscopy, post trauma care.

24x7 emergency support and pediatric transport team

equipped with pediatric ventilators.

Goal of CIMS Neonatal care unit

ŸTo improve clinical care of the critically ill neonate.

ŸTo reduce the neonatal morbidity &mortality

ŸTo provide continuing in- service training of medical &

nursing personnel in the care of newborn.

75

ENT

As medical advances in otolaryngology occur, CIMS are at

the forefront at offering new techniques and treatments.

CIMS ENT is dedicated to providing the highest quality, most

advanced non surgical and surgical ear, and nose and throat

care for patients of all ages. We provide patient with

complete ENT diagnosis, treatment and surgical services.

CIMS Goals: To discover new insights into the

pathophysiology of otalaryngological diseases.

To invent new technological application designed to

optimize therapy of challenging clinical problems as well as

to overcome disabilities brought on by illness.

ŸTo patients with complicated ear, nose, and throat

disorders

ŸTo discover new insights into the pathophysiology of

otolaryngological disease

ŸTo invent new technological applications designed to

optimize therapy of challenging clinical problems as

well as to overcome disabilities brought on by illness

At CIMS, Head and Neck Surgeries include:

ŸTympanoplasty (reconstruction of the ear drum)

ŸNasal endoscopy

ŸStapedectomy (removal of all or part of a bone in the

middle ear)

ŸCochlear implants (implantation of a device to stimulate

nerve ends within the ear to enable hearing)

ŸMyringotomy (insertion of ear tubes to drain fluid in

persons with chronic ear infections)

ŸCorrection of a deviated septum and various forms of

endoscopies

ŸTonsillectomy and Adenoidectomy of various grades were

successfully performed.

Advantages of Balloon Sinuplasty Technique:

ŸLess invasive: No need of cutting and removing the normal

tissue of nose

ŸLess trauma : The pressure needed to inflate the

balloon can be monitored from out side

ŸLess pain : Minimum intra operative and post-

operative pain

ŸLess recovery time: Procedure is recommended as office

procedure / day care procedure

ŸLess 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 making 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.

Balloon Sinuplasty

ŸBalloon Sinuplasty – A Novel Treatment for Chronic

Rhinosinusitis

ŸBalloon Sinuplasty is safe and minimally invasive

procedure that opens blocked sinus passages.

ŸSurgeon thread a soft tipped guide wire equipped with

a tiny balloon into the nostrils and up to the area of

blockage. They then inflate the balloon just enough to

open the passageway. Finally they spray fluid into the

infected sinus to flush out the pus and mucous.

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ENT

77

Pain Management

Conditions treated at CIMS Pain Center

ŸBack pain

ŸKnee pain

ŸJoint pain

ŸNeck and shoulder pain

ŸHeadache and migraine

ŸCancer pain

ŸFibromyalgia

ŸTrigeminal neuralgia

ŸSports injuries

At CIMS, we do very high end procedures like:

ŸNerve root blocks

ŸFacet joint blocks

ŸMedian branch blocks / Radio frequency ablation

ŸOzone nucleolysis

ŸVertebroplasty / Kyphoplasty

ŸSacroiliac joint injection

ŸPiriformis injection

ŸCaudal, lumbar, thoracic, cervical epidural injection

ŸMyofascial trigger injection

ŸHypodermic needling

ŸSympathetic blocks like Sphenopalatine block, stellate

block, T2, T3 Block, Splanchnic block /RF ablation, Celiac

block, Superior hypo gastric plexus block, Ganglion impar

block etc.

ŸGasserion ganglion Radiofrequency ablation / V2,V3 Block

ŸOccipital, intercostal, suprascpular, Genicular nerve blocks

etc.

ŸSpinal cord stimulator implantation and monitoring

ŸIntrathecal morphine pump implantation

ŸPRP therapy

ŸJoint injections

ŸLive fluoroscopy

ŸLive USG

ŸLive CT Scan guidance

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.

78

Dentistry

Other Services

ŸRoot Canal treatment

ŸFillings

ŸProsthodontics

ŸPreventive Dentistry

ŸPedodontics

ŸOrthodontics

ŸPeriodontics

ŸMaxillofacial Surgery

At CIMS, we improve the quality of life with DENTAL

IMPLANTS

ŸImproved aesthetic

ŸPreserved facial structure

ŸImproved chewing function and confidence

ŸImproved dental hygiene

ŸReplacement of a whole missing tooth (root)

ŸAvoiding the need to prepare adjacent teeth, since a

conventional bridge is not used.

CIMS State-of-the Art Dental area:

ŸMinimum Dental Sittings

ŸLess Operational time

ŸPainless Treatment

ŸNo Cross Infection

ŸDay care/indoorfacilities for medically compromised and

seriously ill patients

ŸFacility of generalanaesthesia on dental chair only

ŸTotal care for NRI and overseas patients by special

international patient's department.

CIMS Hospital provides the best dental care in Ahmedabad

and Western India for families in a comfortable, modern and

relaxed environment using the best and latest techniques

and modern dental instruments.

Our Area of Expertise

ŸCardiac Dentistry

ŸDentistry for Cancer Patients

ŸImplants

ŸFull mouth rehabilitation

ŸCosmetic & Esthetic Dentistry

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Dentistry

Ÿ3 Dental chair set up: separate area specially designed for

the extra comfort, care with high end facilities and privacy.

ŸWe follow strict sterilization protocols.

ŸWe ensure our patient’s safety first. We have central

sterile supply department which guarantees perfect

sterility.

ŸWe have two x-ray machines and 2 RVG.

ŸIntra oral cameras are used to show pictures of each and

every tooth which help our patient understand the

treatment plan with more clarity.

ŸWe are an NABH accreditated institute. We have best

implant kits, physio dispenser and total instrumentation for

sinus lift procedures.

ŸFor endodontic procedure (Root canal treatments) we

have very sophisticated rotary motors with Apex locator

which makes treatment painless more accurate and in

minimal sittings.

ŸFor teeth whitening procedures, we have a bleaching light

to enhance your whitening experience.

ŸUltrasonic scalers.

ŸBest software for patient data maintenance.

80

Pathology

Customer friendly ambience aids to their experience to a

great extent.

The Pathology Department at CIMS is well-equipped to

carry out the latest test on patients and assist clinicians in

evaluation and diagnosis of diseases.

CIMS is a NABL accredited State-of-the-Art Quality

Laboratory which offers 24x7 operational support 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.

81

Pathology

Pathology

82

Radiology

83

Department of Radiology and Imaging at CIMS offers :

ŸDigital X-ray

ŸIITV

ŸVarious X-ray procedures

ŸUltrasonography

ŸColour Doppler

ŸMammography

ŸComputerized Tomography Scan (CT Scan)

ŸInterventional procedures like tapping, biopsy,

aspirations.

Various CT scan services available at CIMS hospital are

ŸCT Brain

ŸCT Thorax, abdomen, pelvis, neck, etc.

ŸCT IVU (IntraVenous Urography)

ŸCT coronary calcium scoring

ŸCT carotid angiography

ŸCT cerebral angiography

ŸCT aortography

ŸCT subclavian angiography

ŸCT lower limb angiography

ŸCT renal angiography

ŸCT mesenteric angiography

ŸCT brain perfusion, etc.

Mammography is a specific type of imaging that uses low

dose X-ray for examination of breast. It plays central role of

early detection of breast cancer. Current guide lines of

American cancer society (ACS), American medical

association (AMA) and American college of radiology (ACR)

84

recommend screening mammography every year for

women above 40 years of age.

Benefits

For cardiac patients in particular, the benefits are significant:

Acute chest pain can be evaluated quickly with a single

scan.

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.

The scanner's speed shortens the length of time patients

must hold their breath - from 17 seconds to just 9.

Images of the beating heart in real time permit the evaluation

of heart valves and related structures.

Since cardiac catheterization is no longer required, there are

fewer risks and complications.

Since there is no recovery time involved, patients can leave

when their exam is completed.

The procedure is less expensive than traditional

angiography helping to control cost.

Various diagnostic and therapeutic radiological

procedures are conducted, including:•

ŸAbdominal imaging

ŸBiopsy, using CT, ultrasound and fluoroscopic procedures

ŸBreast imaging

ŸCardiac radiology

ŸComputed tomography :Coronary artery calcification

scoring

Ÿ Lung cancer screening

ŸDiagnostic imaging in oncology

ŸGastrointestinal radiology

ŸGeneral radiology, chest and skeletal

ŸGenitourinary radiology

ŸMammography

ŸMusculoskeletal imaging

ŸUltrasound, including duplex and color-flow imaging

ŸUroradiology

ŸThoracic radiology

ŸVascular radiology.

Radiology

Physiotherapy, Rehabilitation and Nutrition

85

Physiotherapy team handles patients of CABG, Valve

Replacement, PTCA, Congenital heart diseases etc. at pre

and post procedure.

At CIMS Physiotherapy Treatment Includes:

ŸManual Therapy (manipulations / mobilizations)

ŸElectrotherapy Modalities

ŸShort Wave Diathermy

ŸUltrasound

ŸTractionuInterferential Therapy

ŸTENS (Transcutaneous Electrical Nerve Stimulation)

ŸMuscle Stimulator

ŸWax Bath

ŸHydrocollater (Hot pack)

ŸSuspension Frame

ŸBiomechanical Assessment

ŸOrthotic and Prosthetic Exercises

ŸMuscle Imbalance Correction

Geriatric Rehabilitation provides rehabilitation and

treatment for older adults who are experiencing multiple,

complex medical and psycho-social problems, or a recent

unexplained breakdown in health and function.

Cardiac Rehabilitationis specially designed and

programmed to provide specific information and planned

exercise that helps a cardiac patient to get back to everyday

life as efficiently as possible after a heart attack, heart

surgery or procedure.

Orthopedic Rehabilitation and Physiotherapy-Individuals

who undergo joint replacement, musculoskeletal injury, Hip

replacement, trauma, amputation or degenerative joint

diseases are treated to rebuild strength, restore physical

function and enhance the skills needed to perform daily

activities.

Physiotherapy, Rehabilitation and Nutrition

86

CIMS Women Wellness Program CIMS provides total

women fitness program that includes obesity management,

pre-natal and post natal (before and after pregnancy)

exercises and post-menopausal rehabilitation.

Nutrition

Dietary intake of fats, cholesterol, fruits, vegetables, fish and

sodium are linked to cardiovascular risk.

A cardio protective diet should consist of a variety of foods

and aim to achieve four major goals.

–a healthy overall diet

–a healthy body weight

–a desirable lipid profile, blood sugar level

–a desirable blood pressure

There is strong evidence that reducing the intake of total,

saturated fat and salt and increasing fruits and vegetables

are beneficial.

There are 5 dietician at CIMS to take care of the patients by

preparing diet plans for the rehabilitation patients,

counseling patients and their relatives for their dietary intake

and advising them about the food-drug interactions.

Saturated Fat: SAFA Sources include : Palm Oil, Coconut

Oil, Butter, Dark Chocolate, Fish Oil, Cheese.

Polyunsaturated Fats: PUFASources include: Soyabean

Oil, Corn Oil, Walnut Seed, Sunflower seed Oil.

1. Protective against cardiac arrhythmias

2. Protective against insulin resistance

3. Decrease cholesterol and increase HDL levels Monoun-

saturated fats: MUFA

Sources include: Mustard oil, Macadamia nut oil, Olive oil,

Canola oil, Peanut oil.

Code Blue

87

Code Blue is the term for a medical emergency, meaning a

person is possibly in danger of immediate dying.

Calling criteria for our MET service are based on acute

changes in

1. Heart rate (<40 or >130 beats/min),

2. Systolic blood pressure (<90 mmHg),

3. Respiratory rate (<8 or >30 breaths/min),

4. Conscious state, urine output (<50 ml over 4 hours), and

5. Oxygen saturation derived from pulse oximetry (<90%,

despite oxygen administration).

CIMS, as a part of its disaster plans, has set a policy to

determine which units provide personnel for code coverage.

This team is staffed by physician, anesthetist, respiratory

therapist, pharmacist and nurses.

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.

push hard and push fast

4.5 cm

100 compressions per minute

Quality Measure

88

health care costs. Similar results have been achieved in

lowering the rate of VAP and in reducing blood transfusions.

Medication Error:

ŸA medication error is any preventable event that may cause

or lead to inappropriate medication use or harm to a patient

(US-FDA). Examples include, but are not limited to:

ŸErrors in the prescribing, transcribing, dispensing,

administering, and monitoring of medications; Wrong drug,

wrong strength, or wrong dose errors;

ŸWrong patient errors

ŸWrong route of administration errors

ŸCalculation or preparation errors.

Adverse Anesthesia Event: Is any untoward medical

occurrence that may present during treatment with an

anesthetic product but which does not necessarily have a

causal relationship with this treatment.

Re- Scheduling: Re-scheduling of patients includes

cancellation and postponement (beyond 4 hours) of the

surgery.

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.

Length of stay (LOS) is a term used to measure the duration of

a single episode of hospitalization. Inpatient days are

calculated by subtracting day of admission from day of

discharge.

The purpose of Quality Measures is to Ensure Proper Process

for Selection, Collection, Analysis of Measures and Validation

of Data.

Hospital-acquired infection rates at CIMS are very low.

Typically, the two leading causes of hospital-acquired

infections in the ICU are central line infections and ventilator-

associated pneumonia (VAP). A mindset of zero infection

tolerance at CIMS and the consistent following of protocols

have resulted in reduction in central line infections over past

years. This reduction in catheter-related bloodstream

infections has saved many lives and significantly reduced

Ambulance and Transport Service

89

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.

24 x 7 services are provided for all patient transport needs

Transfers from home to hospital and from hospital to

hospital

Highly trained medical personnel

Our ambulances carry oxygen therapy equipment with

defibrillator to provide aid in the event of any

deterioration of patients whilst in our care.

CIMS Hospital has a well organized strategically placed fleet

of ambulances in order to serve the increasing emergency

medical needs.

ACLS/BLS trained emergency technicians and nurses with

advanced life saving equipment like defibrillator, ventilator,

oxygen cylinder and other medicaments for an integral part

of our ambulance service.

Round the clock ambulance service is available which is

equipped with a mobile ICU- set-up to transport critical

patients. The department is geared to face challenges of the

Pediatrics age groups with in-house Pediatrics /

Neonatology Care,

Ambulance services are available in the hospital for

7x24x365 days.

CIMS Ambulance Services include

ŸDoctor

ŸTrained Nurse

ŸECG

ŸEmergency Medicines

ŸStretcher

ŸLaryngoscope with all size blades

ŸSilicon Ambu Bag

ŸAnatomical face mask (all sizes)

ŸVenti mask and nasal cannula and 2nasal catheter

ŸGuedel's Air way (all sizes)

ŸStylet Magill's forceps

ŸPortex Endotracheal tubes

ŸLaryngeal mask Air way

ŸCombitube

ŸWorking suction Machine

ŸCylinder with Regulator2

ŸIV Cannula

ŸI.V. Set and Microdrip Set

ŸDisposable Syringes and Needles

ŸDefibrillator

ŸMultipara monitor

ŸXylocaine Jelly 2%, spray.

Ambulance Number of Services

Patient Drop 502

Patient Pick up 501

MRI & Check up 83

Other 14

Care At Homes

90

CIMS care at home unit provides complete state-of-the

art medical care at home which includes:

24 x 7 Specialized Nursing Service

ŸEscort nurse for patients shifting

ŸWound care and dressing

ŸIntravenous (IV) infusion therapy, Intra Muscular (IM)

and Sub Cutaneous (SC) injections

ŸFocus on continuous training and development

ŸCatheter (urinary) insertion and care

ŸVaccination at home

Care At Homes

91

Skilled nursing in chronic illnesses like:

ŸDiabetic care

ŸNephro care

ŸNeuro care

ŸPost transplant care,

ŸParkinson’s disease

ŸMental illnesses

ŸPost discharge care

ŸCancer care

ŸGeriatric care

ŸPaediatric care

ŸMaternity care

Caregiver Services

ŸBathing, grooming and toiletry services

ŸEscorting patients for appointment

ŸMobilization and ambulation with walker and wheel chair

ŸNutrition assistance with eating

ŸPicking up prescription and medication reminder

Rehabilitation Services

ŸPhysiotherapy (Occupational Therapy & Rehabilitation

Centre)

ŸNutritional assessment (with qualified Dietician)

Ÿ

Medical Equipment For Rental

ŸIV stand

ŸVentilator machine

ŸBi-pap machine

ŸInfusion pump

ŸBlood pressure (BP) instrument

ŸNebulizer

ŸAir bed / Water bed

ŸNimbus air bed

ŸSuction machine

ŸOxygen (O2) cylinder B-type

ŸOxygen (O2) concentrator(05 LTR.)

ŸMulti-parameter monitor

ŸFully and Semi motorized bed

ŸSemi Fowler (1 function) bed

ŸWheel chair

ŸMedical Equipment For Sale

ŸBlood pressure (BP) instrument

ŸPulse oxymeter

ŸGlucometer

ŸNebulizer machine

ŸThermometer

ŸSuction machine

ŸAir bed / Water bed

ŸWalker

ŸWalking stick

ŸWeighing scale

ŸWheel chair

ŸPatient bed side table

Patient’s Say

92

S. L.

Great care from all. The staff is very attentive and caring to provide the best service. Very calming atmosphere and the

hospital itself is so clean and shiny! It has been the best hospital I have been to in my life."

S. S.

There is all facilities needed in this hospital. Give 5 stars all the way. There are so much reassuring staff and experienced

doctors here. The convenience of cleaning and canteen is alsonice.

Thank you everyone.

S. M.

Best Hospital in India . The Hospital with best team of doctors. And Dr Keyur Parikh is one of the best personality i have ever

met in my life. I stayed more than a week but didn't feel that i am in hospital, it felt like home to me. The Doctors and nurses

are so friendly that u dont feel like u are taking to doctors. The services provided here are better than service provided in a

5star Hotel. And not only services but the patients care taken by Hospital is unimaginable. They treat patients as a family

member.

N. D.

All over Security experience is wow.I appreciate overall the way hospital is operating. Every staff right from gaurd medical

officer nursing staff billing and insurance staff even canteen staff all are wonderful..attandant and housekping also done

their wonderful job. Patients guests team is best part of cims. Inshort each and every staff very caring.

THANK YOU CIMS

R. D.

Dr. Manish Gandhi, A top most gastroenterologist surgeon attended my father surgery last month in Feb at CIMS. The

operation lasts 6-8 hours long. Dr. Gandhi and his team done the job carefully and now my father is much better. He was

suffering from a critical disease of Hilar cholangiocarcinoma. After resection Dr. Gandhi shown me snaps taken during

resection. I am grateful to have the best response and familiar behaviour of Dr. Gandhi and his team. Entire staff and

attenders at CIMS were very helpful.

A REAL CARE INSTITUTE OF MEDICAL SCIENCE.

N. M.

Dr. Shri Shaunak Shah sir is the best pediatrician and cardiologist surgeon.

A lot of achievements he has done and

I pray to God for always success as well as achievements for him towards every patient in future.

Thanks a lot

Patient’s Say

93

N. R.

CIMS Ahmedabad is very professionally operated hospital. Recently I have undergone prostrate operation in CIMS by Dr.

Rupesh Shah. He has a great expertise and is a very caring doctor. It appears that they all have great mission.

A. L.

Cims hospital all staff are down to earth .specially patients care is very good. really appreciate all. Thank you CIMS.

All instuments are very latest. PGET concept is very good. I appreciate them also.

N. M.

Last week my mother was treated for TKR (Total knee replacement) surgery at CIMS. Nice experience with staff behavior

and their services. And specially thanks to dr. Keyur Buch and his team.

P. P.

Very good hospital with clean rooms. We have a very high regard for Dr. Dhiren Shah (cardiologist). He is calm and takes

time to discuss the case which justifies his busy schedule. Canteen facility is good too in case family members need lunch or

dinner. Don’t have much experience with other departments but Over all good hospital for heart treatment.

I.H

Dr. Pranav Shah has a fantastic attitude, both humorous and caring. His straight forward honesty was a breath of fresh air.

He told me what l needed what to expect and did it all with humor a great skill. I m delighted with my experience. Every single

person on your staff was terrific. A big thank you to Dr. Pranav Shah n his team for prompt and efficient service.

A.D

The hospital provides diagnostic medical, surgical, palliative care facilities and is Ahmedabad's first Green Hospital. The

hospital is accredited to Joint Commission International (JCI), National Accreditation Board for Hospitals & Healthcare

Providers and National Accreditation Board for Testing and Calibration Laboratories. CIMS Foundation provides financial

aid and affordable healthcare to needy patients.

Ethics

94

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.

Scope of committee

Issue policy on medical ethics

Review, evaluate and approve cases for, ethical dilemmas,

terminal care.

Any other potential conflict of ethical issues and medical

policy and practice

Review and approve clinical drug and device trials/studies

from Phase I to Phase IV as well as all Bioavailability / Bio-

equivalence (BA/BE) studies.

Review and approve observational and experimental:

A) Investigator initiated

B) Sponsored research

C) Academic Projects

D) Clinical Registry

E) Others (e.g. Bio-Banks, tissue research, nutraceuticals

and food products etc.)

Ethics Committee of Care Institute of Medical Sciences is

registered by Central Drugs Standard Control Organization,

Government of India with Registration number

ECR/206/ Inst /GJ/2013 and re-regis tered wi th

ECR/206/Inst/GJ/2013/RR-16 as per the provision of Rule

122DD of the Drugs and Cosmetics Rules, 1945 and

registration is sought for Institutional Ethics Committee.

Ethics Committee of Care Institute of Medical Sciences is

also accredited by National Accreditation Board for

Hospitals & Health care Providers (NABH), Constituent

Board of Quality Council of India (QCI) under clinical trial

program with certificate number EC-CT-2017-0001

accreditation till August 05, 2020 also EC NABH

surveillance assessment was done on 21st & 22nd

December 2018.

The underlying goals of CIMS ethics committee are:

To promote the rights of patients;

To promote decision making between patients and their

clinicians;

To promote fair policies and procedures that maximize the

likelihood of achieving good, patient-centered outcomes;

and To enhance the ethical environment for health care

professionals in health care institutions.

Research Projects

95

1) Health Outcome of Metabolic Parameters in

Hyperuricemic Population

Objective: Despite the modest antioxidant activity exerted

by uric acid (7.0 mg/dL), is a potentially harmful condition

leading to complications such as gout, nephrolithiasis and

chronic nephropathy. The present study evaluates the

health outcome of metabolic parameters in hyperuricemia

Subjects.

Methodology: This was an observational Study. Various

variables of 2784 subjects were collected (2017-2018) from

CIMS hospital. The subjects were divided into two groups

based on uric Acid Level (UA): Group A I- 2122 Subjects with

normal UA level; Group A II- 662 Subjects with

hyperuricemia. Group AII was further sub-grouped in two

groups based on Locality.Group B I- General population;

Group B II – A specific locality. After analysis correlation was

performed between Group A vs Group B & Group 1B vs

Group 2B.

Result: 2169 subjects were males & 615 were females aged

over 21 years. Males have higher prevalence of

hyperuricemia. These variables were significantly higher in

Group 2B than Group 1B. Diet & habits also influence UA

levels; high intake of non-veg diet and alcohol were

associated with prevalence of hyperuricemia. Group B have

higher prevalence of obesity, hypertension, dyslipidemia,

diabetes and metabolic syndrome as compared to Group A.

These risk factors were significantly higher in Group 2B than

Group 1B.

Conclusion: The occurrence of hyperuricemia was

observed in 662 subjects including both male &female aged

over 21. Study showed prevalence of hyperuricemia in A

Specific locality. Finding of study clearly indicates a positive

relationship of age, gender, BMI, Triglycerides, LDL, HDL, &

Cholesterol with UA Levels. Hyperuricemia can be

considered to be the common life-style disorder,

accompanied with risk factors that can be affected by

locality. Hyperuricemia can be considered as better

predictor of metabolic syndrome.

2) To Evaluate Outdoor Air Pollution and Wellness

Parameters in Ahmedabad

Objectives: The aim of this study was further understand

the correlation between air pollution and assess the effects

of air pollution on Hospital visit due to symptoms of

Cardiovascular, Respiratory disease.

Background: Ahmedabad is 7th largest metropolitan city of

India, situated on bank of Sabarmati river in state of Gujarat

India at Ahmedabad. AAP and PM have been closely

associated with adverse health effects such as respiratory

disease and cardiovascular diseases.

96

Study Method: This was an observational study wherein

Ahmedabad was divided in to 5 zones East, West, south,

North, Central. We further divide each zone in to different

wards for easiness of recording. We gathered air pollution

records from Gujarat pollution control board. Air pollution

parameters studied included SO2, NO2, PM2.5, PM10

concentration at different times of the year and correlated

cardiovascular and Respiratory disease patients at CIMS.

Result and Discussion: During winter period air pollution

parameters were-PM10 (Mean=176.9) , PM2.5

(Mean=54.2), NO2(Mean=31.7) while visit to CIMS due to

cardiovascular and respiratory disease were [159(26.4%)]

and [104(21.5%)] respect ively. Prevalence of

cardiovascular disease patients was predominant.PM10,

PM2.5, NO pollutants were associated with increase in

Hospital visit for HTN, Coronary artery disease.

Conclusion: Air pollution is an important risk factor for

cardiovascular disease in Ahmedabad region with the

highest heart disease incidence supported the evidence of

effects on CVD due mainly to outdoor particulate pollutants

during winter period.

3) To Evaluate Safety and Efficacy of Levosimendan in

Patients with Coronary Artery Bypass Grafting(CABG).

Aim & Objective: To compare the hemodynamic effects

and immediate postoperative outcomes with levosimendan

and control group in patients undergoing coronary artery

bypass grafting (CABG).

Methodology: This was an Observational Study to

compare the hemodynamic effects and immediate

postoperative outcomes with levosimendan and control

group in patients undergoing CABG. Data was collected

from medical record files of patients undergoing CABG in

between 2017-2018 from CIMS Hospital. A total of 80

patients were included which were divided in to two equal

groups: Group I : Subjects treated with Levosimendan;

Group II : Subjects with no treatment of levosimendan.

Hemodynamic, cardiac function and cardiac biomarkers

parameters were collected and reviewed.

Results: Among patients with low ejection fraction who

underwent CABG, levosimendan compared with control

group did not result in a significant difference in the

composite end points: Conversion of off-pump into on-

pump, requirement of Inotropes and Vasopressors infusion,

use of Pre/Post-operative IABP (Intra-Aortic Ballon

Pacemaker), Post-operative renal replacement

therapy/dialysis, total hrs on ventilator, post-operative

adverse events and patient baseline demographic detail..

Conclusion:These finding do not either support or rule out

beneficial effect of use of levosimendan in patients with low

LVEF in perioperative period for CABG surgery.

Research Projects

Fig 1:Comparison of requirement of Inotropes and Vasopressors

97

4) Impact of Blood Transfusion on Outcomes in Patient

Undergoing Coronary Artery Bypass Grafting

Objective: To determine blood transfusion rate, factor

affecting blood transfusion and outcomes in patient

undergoing CABG.

Study Method: This was a retrospective study. A total of 200

patient’s data from medical record file was collected.

Factors affecting blood transfusion, major post-operative

clinical outcomes were analyzed .Also Subgroup analysis of

anemic and non-anemic groups were performed.

Result & Discussion: of the 200 CABG patients:

175(87.5%) were males while 25(12.5%) were female

patients. Of these 145 (72.5%) patients received blood

transfusion. Ventilator support time, LOS in ICU, LOS in

hospital were longer in blood transfusion patients.

Conclusion: Blood transfusion works as an independent

factor for complication. Also, interaction with other co-

morbidities, patient’s characteristics, demographic details,

types of procedure, duration of surgery and patient’s pre-

operative condition are other significant factors affecting

blood transfusion. Based on this study, it was found that

hospital mortality rate was unaffected by blood transfusion

although it serves as a predictor for clinical outcomes.

5) Transradial vs. Transfemoral Approach for

Diagnostic Percutaneous Coronary Intervention and

Coronary Angiography in Patients with Coronary Artery

Disease

Objective: To compare radiation exposure in invasive

cardiac procedures performed by transradial and

transfemoral approaches

Background: Several benefits have been described over

years for transradial (TRA) versus transfemoral approach

(TFA) in cardiac interventions. Both are main approaches

used as a diagnostic and therapeutic purpose in cardiac

catheterization.

Research Projects

Table 4.1:

Subgroup analysis of anemic and non-anemic groups

Graph 4.1 Post-Operative Outcomes

98

Methodology: This was an observational study to

determine TRA Vs. TFA radiation exposure in

catheterization for Coronary Artery Disease. Data was

collected from July 2014 to March 2018 of CIMS Hospital

patients. A total of 484 subjects aged over 18 years were

included in study. 330 subjects underwent Coronary

Angiography (CAG), 20 Subjects underwent Percutaneous

Coronary Intervention (PCI) and 134 subjects underwent

CAG and PCI. Fluoro dose (FD), Fluoroscope Time (FT) and

Contrast Volume (CV) & Dose Area Product (DAP) of TRA

and TFA were compared. Following Statistical analysis

correlation was done to compare TRA Vs. TFA.

Results: The results depict that in CAG FT (Min) and FD

(ml) for TRA was higher than TFA. In PCI DAP (GY.cm2) and

FT (Min) were higher for TRA than TFA whereas FD (ml) and

CV (ml) were higher in TFA.In CAG + PCI DAP (GY.cm2), FD

(ml) and FT (Min) for TRA were higher than TFA. Marked

difference was observed in Prior CABG (0.006).

Conclusion: Radiation dose and exposure was higher to

the interventional cardiologist in TRA compare to TFA.

However patient compliance and duration of hospital stay

was shorter in TRA as compared to TFA.

6) An Observational Study to determine Management

and Treatment Outcomes in Pulmonary Arterial

Hypertension Patients

Objective: To determine outcomes in terms of mortality and

morbidity in pulmonary arterial hypertension(PAH) disease

patients when managed with different therapeutic options.

Methodology: This is an observational study to find out the

outcomes of pulmonary arterial hypertension patients. A

total 547 patients were included in this study. The data was

collected from CIMS hospital from 2008 to 2018.The

treatment included use of Ambrisentan, Sildenafil,

Bosentan, Tadanafil, Treprostinil, Riociguat, Macitentan,

digitalis etc.

Result: Prevalence of PAH was observed in all age groups,

highest (49%) was observed between ages 19-55 years

(Age group :0-18(7.31%), 19-55(48.08%), >56 (8.04%).Of

the total 547 patients 293 (53.56%) were males while 254

(46.43%) were females. Average weight of the subjects was

63.44Kg (SD=57.70). The mean -body mass index was

24.12 Kg/m2 (SD=22.41), pulse rate was 58.54bpm

(SD=66.56), systolic blood pressure was 90.40mm

hg(SD=91.65),diastolic blood pressure was 56.53mm hg

(SD=58.23), pulse pressure was 33.69mm hg

(SD=33.41).Treatments varied amongst subjects

depending upon contributing risk factors and confounding

variables. Treatment options included teprostinil,

Ambrisentan, Sildenafil, Bosentan, Tadanafil, Treprostinil,

Riociguat, Macitentan, digitalis. Mortality at 10years was

high in these subjects .

Conclusion: At 10 years mortality rate of PAH patients was

as high.

Research Projects

99

7) A Prospective, Randomized Study to Assess the

Effects of Magnesium Sulfate Pre-treatment on

Analgesia and Prevention of Arrhythmias After Off-

Pump Coronary Artery Bypass Graft Surgery in First 24

Hours

Objective: The purpose of this study was to determine the

beneficial effect of magnesium sulfate as a supplement for

reducing pain and treating arrhythmias associated with

postoperative off-pump coronary artery bypass graft

surgery.

Methodology: This was a single centric, prospective and

randomized study. Written informed consent was obtained

from patients before performing any assessments. The

study was performed in the operation theatre hold and SICU

of CIMS Hospital. Patients were randomly allocated into two

groups: Group-A and Group-B, Group A – subjects received

50 mg/kg of magnesium sulfate intravenously over 15

minutes and 30 minutes before the anesthesia induction.

Group B subjects did not receive magnesium sulfate

infusion.Visual analog scale was used to determine pain

perception following CABG at 0,1,2,3,4,6,8,12,16,20 and 24

hours.

Results: A total of 40 subjects were included in this study.

20 Subjects in magnesium group and 20 subjects in

control group with mean age of 57.05±8.08, 58.95±9.58

respectively with maximum number of male subjects in both

the groups. 6 (20%) male subjects in magnesium group and

17 (85%) subjects in control group whereas 4 (80%)

female subjects in magnesium group and 3 (15%) subjects

in control group. No marked differences were observed in

subjects of both the groups with respect to post-operative

vitals (P < 0.05). Perception of pain was lower in group

treated with MgSO4 as compared to control group

significantly at 20 and 24 hours.

Conclusion: Using VAS it was observed that post-operative

pain intensity was higher in subjects of control group as

compared to subjects of magnesium groups at different

interval of times. The study shows significant decrease in

intensity of pain in subjects treated with MgSO4.none of the

subjects in either groups developed arrthymias following

CABG.

Research Projects

Fig 1: Visual Analogue Score between groups at

various timelines after CABG

CIMS Foundation

100

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.

CIMS FOUNDATION welcomes all contributions in the form

of cash/cheque/draft/NEFT/wire transfer in favour of “CIMS

FOUNDATION”, IDBI Bank A/c No: 0067102000026798,

IFSC Code IBKL0000067. All the Contributions to CIMS

FOUNDATION are exempted u/s 80G (5) of the Income-

Tax Act, Subject to the limits prescribed therein.

CIMS Foundation Focus Areas

To support patients and the family members who are

socially , emotionally and financially weak.

To assist people who cannot complete their medical

treatment / care due to financial constraints.

To establish regular camps for providing medical

assistance at doorsteps in the rural areas.

To promote the welfare of children in need, including

children with physical disabilities and/or life threatening

diseases.

To provide care, hope and dignity to all patients to fight

against the disease and maintain good quality of life.

Grant of subscriptions and donations to deserving

private and public institutions for administering medical

relief to the needy people.

To interact with patients and relatives on daily basis to collect

and maintain patient data required for philanthropy.

To collect donations from donors for contribution and

disburse the donation to under privileged patient.-Mahatma Gandhi

”

“

More than 700 patients are supported by CIMS Foundation /

CIMS CSR Programme / Trust every year which covers Heart

Patients, Paediatric, Cancer Patients, Trauma Patients,

Renal/Kidney Patients, Obstetrics & Gynecology Patients,

Geriatrics Patients, Neuro Patients and other needy patients,

from all over the world who are getting their treatment at

CIMS Hospital.

CIMS Learning Center

101

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.

CIMS Education

102

CIMS organizes various national and international

conferences like JIC, NATACON, AFPACON, NGPCON,

APGCON etc. at various places throughout Gujarat and

adjoining states of India.

As a continuos process of education and social

awareness, CIMS has organized more than 22 CMEs in

various places of Gujarat, Rajasthan and MP.

CIMS hospital also conducts in-house learning courses

like Echo f e l l ows hi p, ECG Learning (Basic and

Advance) and, CPR training for medical fraternity as well

as common man.

C P R training sessions were conducted.

Medical camps are also organized by CIMS doctors

wherein super specialist doctors impart free

consultation to general public in both rural and urban

areas.

CIMS Health care

Awareness

Programme Venue

Number of

Participants

Ahmedabad 4435

Mundra 1650

Neemuch 1540

Amreli 1050

Deesa 1020

Palanpur 1015

Dehgam 780

Ratlam 494

Bhuj 402

Idar 387

Balotra 363

CIMS Health care

Awareness

Programme

Venue

Number of

Participants

Navsari 335

Bilimora 280

Dwarka 280

Adipur 220

Surat 140

Jamnagar 133

Udaipur 132

Bidada 110

Mehsana 90

Gandhidham 78

Other 319

Publication List (2014 Onwards)

103

1. Keyur H. Parikh, Clinical efficacy and safety of Sirolimus coated balloon in a real world single center registry of Indian

population TCT-264 Journal of the American College of Cardology, Vol. 72, No. 13, Supply B, 2018.

2. Parth Parikh, Parloop Bhatt, Deepa Shah, Piyush Thakar, Ajay Naik, Hemang Baxi, Shmuel Banai, Keyur Parikh First-in-

Human Use of Coronary Sinus Reducer in Patients With Refractory Angina Journal of the American College of Cardiology

December 18, 2018, 72 (24) 3227-3228; DOI:10.1016/j.jacc.2018.09.061

3. Parth Parikh, Parloop Bhatt, Deepa Shah, Piyush Thakar, Ajay Naik, Hemang Baxi, Shmuel Banai, Keyur Parikh, "First-

in-Human Use of Coronary Sinus Reducer in Refractory Angina: 12 Years Anatomical and Clinical Outcomes" (Manuscript

Accepted at JACC 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 NCDR® as a Resource Improvement in

Hospital Quality Parameters Abstract Accepted at NCDR 2018

5. 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.

6. 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

7. 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

8. 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)

104

9. 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)

10. Keyur H. Parikh, Clinical efficacy and safety of Sirolimus coated balloon in a real world single Center registry of Indian

population

11. 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.

12.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.

13.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.

14.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

15.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

Publication List (2014 Onwards)

105

16.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

17. 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)

18.Parth Parikh, Parloop Bhatt, Vipul Kapoor, Hemang Baxi , 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.

19.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.

20.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

21.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.

Publication List (2014 Onwards)

106

22.Urmil Shah, Milan Chag, Dhiren Shah, Ajay Naik, Hemang Baxi, 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.

23.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.

24.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.

25.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.

26.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.

27.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.

28.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.

29.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.

Publication List (2014 Onwards)

107

30.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.

31.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

32.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)

33.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)

34.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.

35.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

Publication List (2014 Onwards)

108

36.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.

37.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.

38.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.

39.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.

40.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.

41.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:

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.

Publication List (2014 Onwards)

109

42.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

43.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

44.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

45.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

46.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

47.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

Publication List (2014 Onwards)

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