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Gland with tumour removed

K.V. Prasad



ACTIVE AGAIN: Mandrachalam after the surgery. - Photo: K. Ananthan

COIMBATORE: At 38, Mandrachalam was tottering on the brink of abject poverty. Thymoma - a tumour in the thymus gland in the chest - had caused depletion of acetylcholine, a chemical facilitating muscle movement.

The muscles of his left eyelid had weakened and the eye remained shut. He experienced difficulty in swallowing: a symptom that warned of the spread of the debilitating problem. He was about to lose a daily wage of Rs. 50 at S. Kumarapalayam in Palladam, about 30 km east of the city, that helped him feed a family of five.

An ophthalmologist nearby referred him to the Coimbatore Medical College Hospital (CMCH). A computerised tomography scan revealed the tumour.

"This is a rare case of myasthenia gravis (ocular myasthenia if the eye is affected). It occurs in one out of a lakh people," the Dean of the CMCH, T.P. Kalaniti, said.

Acetylcholine depletion led to loss of muscle power as the day progressed. From normal muscle strength while waking up in the morning, the condition plunged to total weakness by evening. Eye and neck muscles were affected by this problem.

Cardio-thoracic surgeon B. Jayaraman removed the gland on October 18 in a two-hour surgery by opening the chest. Anaesthetists J. Hanumantha Rao and V. Pankajavalli had a tough time as the normal dose of muscle relaxant could not be given because the patient already had weak muscles.

"The eyelid function has been restored," said Dr. Jayaraman.

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