February & March 2022

Edition
February - March 2022 | Page : 1
Successful Emergency Management
SUCCESS STORY
Relies Upon Experience And Expertise
Dr. Jyoti Goyal
HOD - Internal Medicine
Thirty year old female presented to us with
complaints of sudden onset of abdominal pain and
marked uneasiness followed by loss of consciousness
while going for the urina on. She was found in the
bathroom in semi conscious state by the rela ves. She
was taken to emergency of our hospital. In emergency
her GCS was e2m5 V2, l pupils were nsnr, blood
pressure was low 70/40 mm of hg ,she had marked
tachycardia HR160 per minute, tachypneaRR 36 per
minute and had rapid shallow breathing with very high
work of breathing. Her oxygen satura on was 70% on
room air.
Immediately ini al resuscita on started.
Airway was secured with endotracheal intuba on and
started on oxygen and ven latory support. Two large
bore cannula were put and fluid resuscita on started.
A er ini al stabiliza on she was shi ed to ICU for
further management and evalua on. In ICU her ABG
revealed marked lac c acidosis with pH of 6.9 and
lactates of 10 with haemoglobin of 3.5.
Along with ini al resuscita on,
simultaneously diagnos c evalua on was started to
look for the cause of her shock. Sudden onset
abdominal pain, very low Hb in ABG with shock
suggested possibility of hemorrhagic shock. There is
no history of fever, no history of chest pain or any
cardiac illness in past suggested a less likely possibility
of sep c and cardiogenic shock. There is no history of
trauma before the onset of illness. There is no history
of any over the counter medica on intake.
Urgent ultrasound was done to see for
evidence of hemoperitoneum. Ultrasound revealed
large amount of free fluid with thick echoes sugges ve
of blood with bulky adenexa. Point of care pregnancy
test was done and was found posi ve. Diagnosis of
ruptured ectopic pregnancy with hemoperitoneum
and hemerrhagic shock was made with in half an hour
of her arrival along with ini al stabiliza on. She was
immediately shi ed to opera on theater for further
defini ve management. She received mul ple blood
products. A er the surgery she was shi ed to ICU on
ven lator.
She was kept sedated and adequately
resuscitated overnight. Serial ABG’s were done to see
the declining trend of lactates. She improved
remarkably the very next day. In view of massive blood
transfusion a cau ous call of extuba on was taken. To
avoid the risk of TACO, she was given diure cs and she
responded posi vely.
Thirty six hours later a er the admission she
was off all vasopressors and ven latory support.
She was conscious and oriented, started accep ng
orally and mobillized. Next day she was shi ed to
room with suppor ve medical management along
with physiotherapy and mobiliza on.She was
discharged on the day six from the hospital. Take home
points Any shock state needs ini al resuscita on and
stabiliza on at the number one priority.
Along with ini al stabiliza on, a diagnos c
evalua on should be done simultaneously so as to
make a defini ve diagnosis. To establish the cause of
shock is of paramount importance to plan a defini ve
management. It was surgery in her case, earliest use of
broad spectrum an bio cs along with source control
in sep c shock and cardiac support in terms of
inotropes, IABP or angioplasty in case of cardiogenic
shock depending on the e ology. Point of care
ultrasound is extremely valuable tool to take mely
decisions in such life threatening emergencies.
A good team work and clear communica on
between all the speciali es is the key to successful
outcome in such emergencies.
Pushpanjali
Medicine Department
HAPPY PATIENT HAPPY US
February - March 2022 | Page : 2

Medicines Cure Diseases,

But Only Doctors Can Cure Patients
SUCCESS STORY 1 SUCCESS STORY

Dr. Mridul Sharma Dr. Rajnish Kumar Singh

HOD - Pushpanjali Institute of Neuro Sciences Senior Consultant Physician

One pa ent met with an accident and Pa ent Mrs. Salma Begum was admi ed
came to us with the injury of C5 vertebra, the with complain of uncontrolled Diabetes Melli s ,
person may be unable to breathe since the spinal she was treated at mul ple centres earlier but
cord nerves located between the third and fi h
pa ent RBS was overwhelmed, she has
cervical vertebrae controls respira on. Damage
to the spinal cord at the C5 vertebra also affects comorbidity of obesity and hyperthyroidism also.
the vocal cords, biceps, and deltoid muscles in She was counselled for dietary control, given
the upper arms. The pa ent was paralyzed, all insulin (long ac ng basal insulin) and accurate
four hands and feets were not working and was oral hyperglycemic agents. Gradually pa ent RBS
having difficulty in breathing, was properly controlled and she improved
By performing and emergency surgery by
clinically with disappearance of her symptoms.
Dr. Mridul Sharma and the pa ent got relief in
few days. Pushpanjali
Medicine Department
SUCCESS STORY 2
Pa ent Bhupendra Singh was admi ed at
Pushpanjali Hospital a er a road accident, his
condi on was very cri cal, many bones of his
head and jaw were broken.
A er that the pa ent's life was saved in
intensive care by successful brain surgery. The
opera on lasted for five hours.

Pushpanjali
Institute of Neuro Sciences

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People Pay The Doctor For His Trouble

For His Kindness They Still Remain In His Debt
SUCCESS STORY

their gra tude to Dr. Manish Sharma and

Pushpanjali Hospital for their coopera on.
Agra Development Forum's General
Secretary Sushil Jain, Spokesperson Minister
Sandesh Jain, Jairam Das, Mahendra Jain, CA
Arun Agarwal, Forum Treasurer CA Mridul
Pathak, Dr. Sunil Sharma, Dr. Ramesh Dhamija, Dr.
Dr. Manish Sharma BK Agarwal, Dr. Vijay Katyal, Dr. Ravi Sabharwal,
HOD - Pushpanjali Institute of Cardiac Sciences
Rakesh Agrawal also appreciated the good work
One such doctor from Agra, did not go done by Dr. Manish Sharma and Pushpanjali
home on Holi, saved the life of a heart a ack Hospital Agra.
pa ent. The pa ent was not even charged for the
treatment. He is senior cardiologist Dr. Manish
Sharma at Pushpanjali Hospital Agra.
Mahesh Chand Sharma, aged fi y years,
resident of Belanganj, works in a sari showroom
for ₹ 10000 per month, suffered a heart a ack on
the day of Holi fes val. They came to the hospital
and doctor advised for Angiography.
Their financial condi on was not good that
they can even afford Angiography cost. His
rela ves contacted Agra Vikas Manch for their
help. They contacted Pushpanjali Hospital and
established the connect with Dr. Manish Sharma.
The pa ent was immediately admi ed to
the Cardiology Department of Pushpanjali
Hospital. Angiography was done and it was found
that one artery was completely closed. There is
an obstacle in the second one as well.
Angioplasty was performed by inser ng stents in
both arteries.
The en re cost of angioplasty was jointly
borne by Dr. Manish Sharma of Agra Vikas Manch
and Pushpanjali Hospital.
Mahesh Sharma is completely healthy Pushpanjali
now. Institute of Cardiac Sciences
Agra Vikas Manch President Rajkumar Jain
and Convenor Sunil Kumar Jain have expressed
HAPPY PATIENT HAPPY US
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Each Body Is Different

Therefore Each Rehabilitation Must Be Different
SUCCESS STORY

new Minimal Invasive & Ceramic Hip, Mr Singh

knew it would be the best loca on for surgery. “I
had an experience like no other at Pushpanjali
Hospital. It’s a small, in mate unit where there’s
laughter, and the staff is upbeat and friendly. I
was highly confident in the very personalized
care I received.”Mr Sher Singh underwent staged
Dr. Arun Gupta bilateral total hip replacement surgery at
Arthroscopy & Joint Replacement Surgeon Pushpanjali Hospital by Dr Arun Gupta & his
team. He is quite sa sfied and happy to recover
Mr. S Singh, thirty five years says he’s fast, with the help of paramedical staff &
grateful to be living at a me when medicine and physiotherapist in the hospital.
science make it possible to replace the body’s
joints. “If it weren’t for my total hip joint
replacement surgery, I’d be spending my days in a
wheelchair,” he says. Instead, he will be resuming
his ac ve lifestyle that includes working as
manager in a hospital. Mr Singh was fortunate to
be a candidate for a newer total hip replacement
procedure known as the CERAMIC TOTAL HIP
REPLACEMENT, offered by DR ARUN GUPTA , at
PUSHPANJALI HOSPITAL & RESEARCH CENTER,
AGRA. Dr Gupta uses minimally invasive
t e c h n i q u e w h i c h s i g n i fi c a n t l y re d u c e s
postopera ve pain and recovery me, while
making it easier to move. “I was actually up and
walking the next day of my surgery,” recalls Mr
Singh.In April 2020, in the dreaded 1st wave of
Covid pandemic, Mr Singh, while working in the
hospital as 1 line worker, contracted Covid and
became sick. For which he was on steroids for
some me. A er about a year he felt pain in his
both hips. He consulted at places and then to Dr
Arun Gupta. Dr Gupta asked for a MRI, which
revealed the diagnosis of bone death, i.e.,
Avascular necrosis of hip of stage iii. For which a
Pushpanjali
total hip replacement surgery was needed. “I
Orthopedic Department
bonded right away with Dr. Arun,” says Mr Singh.
“I liked and trusted him. Since I had already
exhausted all other op ons, I decided to have the
right hip replaced.” A er learning more about the
HAPPY PATIENT HAPPY US
February - March 2022 | Page : 5
Pushpanjali Intensive Care Units
Teamwork Saved The Life !!!
SUCCESS STORY
Dr. Jyoti Goyal Dr. Vipul Mishra
HOD - Pushpanjali Intensive Care Units,
HOD - Internal Medicine Critical Care, Pulmonology & Sleep Medicine
The best sight for an intensivist is to see
his pa ent going out of ICU ‘Smiling and Alive’
The best credit is to see a near fatal pa ent being
revived successfully. This is about a pa ent
received by me at 2 am in ICU. Mrs Anguri devi
fi y two years female with history of bronchial
asthma, hypertensive and diabe c brought on
irregular medicines to ICU at 2 am in gasping
respira on,unconscious with severe
bronchospasm with bleeding oral and nasal
bleeding. Pa ent was in accelerated
hypertension with high blood sugar level.Urgent
Abg and ECG was advised. Pa ent was admi ed
in ICU and immediately intubated. Abg showed
severe respiratory acidosis. Paco2 level was 134
and ph -7.01. Pa ent was diagnosed as ‘Acute
N e a r Fata l A st h m a ’ w i t h u n co nt ro l l e d
accelerated hypertension.
Pa ent was put on Bain’s circuit manual
posi ve pressure ven la on with respiratory
rate of 24-26/ min. Con nuous nebulisa on was
carried on for one hour with duolin and budecort.
Inj deriphylline and Inj magnesium sulphate was
given to relieve refractory bronchospasm.A er
ven la ng manually for almost 3 hours and
washing out Co2 ,as per serial Abg, pa ent was
finally put on pressure control ven la on.
Arterial line and central line were inserted
immediately. Pa ent was also taken on NTG
infusion I/V/O uncontrolled hypertension. A er
managing the pa ent judiciously for 6 hours,
Pushpanjali
Hospital & Research Centre
NABH ACCREDITED - ENTRY LEVEL
Dr. Sushant Dhawan
MBBS, MD Anaesthesia
pa ent regained consciousness at 8am and
started following commands.Bronchospasm got
relieved.Abg came out to be almost normalPh-
7.43, Paco2-51 Ven lator se ngs were changed
and pa ent was put on Cpap mode. HRCT chest
and CT head was advised which showed a
pneumoni c patch and no abnormality in CT
head. Pa ent was weaned successfully and
extubated in fully conscious state a er
monitoring for 8-10 hours on cpap mode.Pa ent
was recieved and managed ini ally by Dr.
Sushant Dhawan (MD Anaesthesia) and Dr.
Karunesh Pa ent got admi ed under Dr.Jyo
Goyal and every significant step taken a er
informing the primary consultant. ICU head - Dr.
Vipul Mishra. Rela ves admired the efforts and
were very pleased with icu team and all doctors
who are working for the be erment of pa ent at
Pushpanjali hospital & Researh Centre.
Pushpanjali
Medicine Department
Pushpanjali
ICU’s & Critical Care Department
HAPPY PATIENT HAPPY US
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Out Reach OPD’s

Dr. (Prof.) Santanu Chaudhury Dr. Vipul Mishra Dr. Jyoti Goyal Dr. Gaurav Dhakre
Cancer Specialist HOD - Pushpanjali Intensive Care Unit HOD - Internal Medicine Neurosurgeon

Dr. Mridul Sharma Dr. Neeraj Rajput Dr. Jyoti Goyal Dr. Vipul Mishra Dr. Surendra Baghel Dr. Bhuwanesh Sharma
HOD - Pushpanjali Institute of Neuro Sciences HOD - Pushpanjali Institute of Neuro Sciences HOD - Internal Medicine HOD - Pushpanjali Intensive Care Unit ENT Specialist Consultant - Gastro, Onco & Laproscopic Surgeon

Aligarh
Dr. Vibhanshu Gupta
HOD - Pushpanjali Institute of Renal Sciences

Dr. Vibhanshu Gupta

HOD - Pushpanjali Institute of Renal Sciences
February - March 2022 | Page : 7

Out Reach OPD’s

Dr. Mridul Sharma

HOD - Pushpanjali Institute of Neuro Sciences

Dr. Vineet Chauhan Dr. Dilip Kumar Mishra Dr. Rajnish Kumar Singh Dr. Rohit Mahesh Gupta
HOD - Pushpanjali Institute of Gastro Sciences HOD - Pushpanjali Institute of Uro Sciences Senior Consultant Physician Consultant - ENT

Dr. Navneet Agarwal Dr. Bhuwanesh Sharma Dr. Surendra Baghel

Neurologist & Neurophysician Consultant - Gastro, Onco & Laproscopic Surgeon ENT Specialist

HEALTH FOR ALL

Peoples Caring For People
February - March 2022 | Page : 8

Motivational Training Program

Class On VAP Bundle Care

February - March 2022 | Page : 9

BLS Training & Health Checkup Camp @

HEALTH FOR ALL

Peoples Caring For People
February - March 2022 | Page : 10

Public Awareness Program

#World Cancer Day

4th February 2022

CLICK THIS LINK TO WATCH FULL VIDEO

https://bit.ly/3uR9vHz

#International Women’s Day

8th March 2022

CLICK THIS LINK TO WATCH FULL VIDEO

https://bit.ly/3jM6JwX

#World Kidney Day

8th March 2022

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https://bit.ly/3JOc29z

#World Tuberculosis Day

24th March 2022

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https://bit.ly/3jODnOr
February - March 2022 | Page : 11

Big Achievement

With
World Class Facilities

COMING SOON
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February - March 2022 | Page : 12

Celebration

6th February 2022

February - March 2022 | Page : 13
February - March 2022 | Page : 14
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Patient’s Feedback

HAPPY PATIENT HAPPY US

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February - March 2022 | Page : 16

Patient’s Admiration

We are so proud to
have you as part of our HEALTH FOR ALL
Pushpanjali family. We hope that People caring for pepole
you keep up the good work fory
more years to come.
Gulshan Pandey
Hospital Staff