A 13-year-old tribal boy Manikandan, son of plantation workers in Parambikulam, Palakkad, was the butt of ridicule since birth because of a rare medical condition called encephalocele in which brain matter oozes out of gaps in the skull into a sac-like structure, giving the patient’s head a grotesque appearance.
A fist-sized ball of brain matter used to hang from Manikandan’s nose as a pendulum. It obstructed his vision and deformed his nose and face. His life changed radically for the better a few days ago when a 10-member team of surgeons at Amrita Institute of Medical Sciences removed the external deformity in a surgery that lasted 11 hours. The entire cost of the procedure was borne by Kerala Government agencies, as Manikandan’s parents, Selvan and Ramata, are from a poor socio-economic background.
Dr. Subramania Iyer, Professor and Head, Plastic & Reconstructive Surgery, Amrita Institute of Medical Sciences, said “It was a complex surgery. Manikandan’s encephalocele was very large which had pushed the bone of his right eye outwards. For surgery, his skull was opened and the normal brain isolated from the sac of non-functioning brain matter hanging from his face. The removal of the deformity left a defect in the skull, a portion of which had to be reconstructed. The patient’s eye sockets were repositioned to remove the deformity in the right eye, and the nose was also remodelled. All these were huge surgical challenges. Manikandan has now recovered fully from the surgery and is ready for discharge. He will now be able to attend school and participate in all social activities like any other child of his age. The surgery was carried out by the combined effort the paediatric craniofacial department consisting of more than 12 surgeons and anaesthetists.”
The surgical team that operated on Manikandan consisted of paediatric neurosurgeons, craniomaxillofacial surgeons and plastic surgeons, assisted by neuro anaesthetists and a paediatric neuro ICU nursing team. The surgical team was led by Dr. Suhas Udayakumaran, Dr. Pramod Subash and Dr. Subramania Iyer and helped by the anaesthetic team led by Dr. Gokuldas and Dr. Mathew.
Manikandan’s father, Selvan said, “We belong to the Marasar tribe and work in a plantation. I have five children, who are all normal and healthy, except Manikandan who was born with a swelling on the nose which kept growing. Because of the huge deformity on his face, he never went to school or mingled with others, as people used to make fun of his appearance. After surgery, he is eager to go back home, start school and make friends. I thank the doctors of Amrita Hospital from the bottom of my heart for enabling him to lead a normal life.”
The district administration of Palakkad and the tribal welfare department stepped in to fund Manikandan’s surgery. Mr. Suresh, District Tribal Welfare Officer, Palakkad, brought the plight of the boy to the attention of Dr. P. Pugazhenthi (IFS), Director, Scheduled Tribes Development Department, Kerala. He, in turn, escalated the issue to Mr. A.K. Balan, Hon. Minister for Welfare of Scheduled Castes, Scheduled Tribes and Backward Classes, Government of Kerala. The Minister took keen interest in the matter and sanctioned funds for Manikandan’s surgery. Ms. P. Marykutty (IAS), District Collector, Palakkad, provided logistical support to liaison between the various Government departments and visited Manikandan at Amrita Hospital to monitor his progress.
Encephalocele is a rare congenital disorder, found in 1 in 5,000 births, in which bones of a baby’s skull do not close completely in the mother’s uterus. This creates an opening through which brain tissue and cerebro-spinal fluid protrudes out of the head in a sac-like structure. The condition can be fatal if the encephalocele hampers development of the brain. Past infancy, patients usually live an isolated life, ashamed to show their face in public.
The number of people affected by Multiple Sclerosis (MS) is on the raise at an alarming rate. MS is a rare demyelinating neurological disorder which affects young individuals predominantly between the age 20 to 40. Many patients suffer in silence because of lack of awareness and high cost of treatment.
The department of Neurology at Amrita Institute of Medical Sciences conducted a seminar to create awareness about this disease on June 16, 2017. Patients affected with Multiple Sclerosis and their relatives were invited to this free seminar.
The Comprehensive Multiple Sclerosis Clinic at Amrita Hospital has treated over 200 patients and is among one of the largest MS clinics in the country. The multi disciplinary clinic also involves ophthalmologist, physiatrist and physiotherapists, psychiatrist, psychologist, speech therapist, urologist and social workers. The theme of this years World MS Day is “Tips to live with MS.”
For the first time in Kerala, patients who were unable to undergo angiograms previously have a source of respite now. Patients with diabetes, kidney related issues and the elderly can now avail the carbon dioxide insufflation procedure that has been made available at Amrita Institute of Medical Sciences, Kochi.
According to Dr Srikanth Moorthy, Head, Radiology, Amrita Hospital, “Digital Subtraction Angiography (DSA), CT scans and MRIs are available but it is difficult for doctors to make a prognosis by looking at the scans. He adds, “However, the CO2 insufflation procedure is an ideal solution for the patient population.” He adds, “It is a safe procedure as CO2 is non toxic and water soluble. The CO2 is injected to the lower body of the patient and it helps give a good picture of the arteries which helps doctors better treatment plans.” So far 10 patients have undergone this procedure at the hospital.
Amrita Institute of Medical Sciences signed an MoU with Dr. B. Borooah Cancer Institute (BBCI) for clinical, academic and research collaboration. The MoU was signed at a function held at BBCI auditorium in Guwahati by Dr. A.C. Katraki on behalf of BBCI and Dr. Debnarayan Dutta, Head, Radiation Oncology, Amrita Hospital, Kochi.
The function was attended by Dr. R. Bhuyan, Director, Health Services, who was also the chief guest. As part of the MoU, postgraduate students from both the institutes will participate in teaching and training programmes. Faculties representing Amrita Hospital, Kochi will participate in clinical and academic programmes at BBCI four to six months intervals while faculties from BBCI will also get an opportunity to train students at Amrita Hospital.
It is also expected that Amrita Hospital and BBCI can be mutually supportive for capacity development in various fields of oncology, clinical and academic collaboration and advancement of research projects for the benefit of the people of the country in general and the Northeast region in particular. BBCI is a recognized institute for cancer treatment, education and research and experts hope this MoU can act as a platform for broad based collaboration in oncology between Amrita Hospital and Dr. B. Borooah Cancer Institute.
In connection with the World Environment Day celebrations held at Amrita Hospital on June 05, 2017, Dr. (Col) Vishal Marwaha, Principal, Amrita School of Medicine, distributed saplings to the students of Amrita Health Sciences Campus.