Comprehensive Evaluation for Diagnosis and Treatment of Chronic Diseases
Chronic diseases are one of the leading causes of death and disability in the U.S.
According to the Centers for Disease Control, as of 2012, approximately half of all adults in America–117 million people–had one or more chronic health conditions.
Chronic inflammation is the driving force behind most chronic diseases.
Inflammation gradually weakens the immune system, making it increasingly more vulnerable to the development of chronic illnesses. By decreasing risk factors and harnessing the power of the human immune system, inflammation can be decreased, new cells can be generated and the body can function better.
Critical to assessing a patient's health status is having all of the information available. At The Maharaj Institute we offer a comprehensive Wellness and Anti-Inflammatory Program which is specifically designed to address the issues mentioned above.
Diagnosis and Treatment of Malignant and Non-Malignant Blood Diseases
Dr. Maharaj is a leader in the diagnosis and treatment of blood diseases (malignant and non-malignant) with more than 30 years of experience in the field of Hematology/Oncology and Stem Cell Transplantation.
Patients with hematological malignancies are at a particularly higher risk of developing severe infections when compared to other patients with solid tumors and the population in general.
At the Maharaj Institute, our team has been treating blood cancers with evidence-based chemotherapy regimens on a totally outpatient basis; a shift in the care of these aggressive malignancies, which normally is done at the hospital. The outpatient approach has resulted in a decreased incidence of infections and avoided the development of severe sepsis associated with hospital-acquired infections, significantly improving survival and quality of care.
Our experienced and caring team has been treating patients for the following hematological malignancies on a fully outpatient basis:
- Acute Myeloid and Lymphoblastic Leukemias;
- Chronic Lymphocytic Leukemia;
- Chronic Myeloid Leukemia and other Myeloproliferative Disorders;
- Hodgkin’s and Non-Hodgkin’s Lymphoma (Low, Intermediate or High Grade);
- Mantle Cell Lymphoma;
- Multiple Myeloma;
- Waldenstrom Macroglobulinemia.
In addition, the Institute offers world class service and care for other non-malignant hematological conditions such as:
- Cytopenias, including anemia, leukopenia and thrombocytopenia;
- Bleeding disorders;
- Iron metabolism disorders;
- Platelet disorders;
- Immune hematological disorders;
- Thrombophilias, inherited and acquired.
Second Opinion Consultations
The Maharaj Institute provides second opinion consultations for those individuals interested in gaining a deeper understanding of their condition and available treatment options. In this highly specialized consultation, medical records are extensively reviewed prior to a comprehensive clinical evaluation. Usually this consultation can take up to 3 hours, depending on the case. It is very personalized and options, from traditional to investigational treatments, are carefully explained to the patient and family members, helping them in the decision making process of what is best for the patient.
It is important that medical records are provided in a timely-manner prior to the consultation.
Bone Marrow Aspiration and/or Biopsy under Conscious Sedation
A bone marrow aspiration and biopsy is a common procedure used for the diagnosis and follow up treatment of many blood diseases and other conditions that affect the bone marrow. A sample of the liquid and solid portion of the bone marrow is removed and then submitted to a pathologist and/or a laboratory for examination.
At the Maharaj Institute the bone marrow biopsy is done under conscious sedation. Patients are given pain relievers and sedatives prior to the monitored procedure with the goal of ensuring a pain-free experience. Patients are closely monitored to prevent complications and discharged with a caregiver after full recovery.
Immunotherapy and Targeted Therapies
Immunotherapy is a type of treatment designed to boost the body’s natural defenses to fight cancer. It uses cells and molecules, either manufactured naturally by the body or created in a laboratory, to improve and restore the immune system function.
Immunotherapy may work in the following ways:
- Stopping or slowing the growth of cancer cells;
- Stopping cancer from spreading to other parts of the body;
- Helping the immune system work better at destroying cancer cells.
Immunotherapy is a broad category of anti-cancer treatment which can be grouped into four different subcategories:
1 Nonspecific immune stimulation immunotherapies:
These therapies use non-specific molecules that do not affect the cancer directly, but send signals that stimulate other cells of the immune system to fight against cancer cells. These therapies may consist of:
- Interleukins, which control the growth and activity of T cells;
- Interferons, a group of proteins released by the T cells that increase the immune system’s reaction to cancer cells;
- Colony Stimulating Factors, molecules that strengthen the immune system by stimulating the production of cells of the immune system in the bone marrow.
2 Targeted immunotherapies:
These are more specific therapies such as monoclonal antibodies and cancer vaccines, which target specific tumor antigens. Some of these monoclonal antibodies are already available for clinical use and cancer vaccines are still undergoing clinical trials.
3 Checkpoint inhibitors:
The immune cells in cancer patients have membrane receptors that block them from attacking normal cells. Scientists have found that removing some of these blockades makes the immune response stronger. These drugs are still under clinical investigation for its efficacy and toxicity.
4 Adoptive Cell Therapies (ACT):
ACTs are experimental medicine therapies that activate and multiply patient’s blood or tumor-derived immune cells in-vitro before giving them back to the patient.
Many of these therapies are still under laboratory investigation, some are already in clinical trials and others are approved for clinical use. Dr. Maharaj uses his expertise, knowledge and skills to educate patients and caregivers and help them through the decision making process.
Blood plasma may contain antibodies that attack the immune system and impair its ability to function properly. Removal of those antibodies from the plasma can be highly effective in the treatment of certain diseases.
Plasmapheresis is a process in which the plasma—the liquid part of the blood—is separated from the blood cells in a machine and replaced with a solution, such as saline or albumin, which is then infused back into the patient.
Plasmapheresis can be used to treat a variety of disorders including: myasthenia gravis, Guillan-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, Lamber-Eaton myasthenic syndrome, sickle cell disease, certain forms of neuropathies, Wilson’s disease, and thrombotic thrombocytopenic purpura.
Treatment frequency can vary widely depending on the patient’s overall clinical condition.
At the Maharaj Institute, a patient can receive intravenous infusions, safely, in one of our private rooms, without the inconvenience and risks associated of having to go to the hospital.
Patients can feel confident, knowing that their physician is always within easy access and that the nurse and pharmacist will carefully monitor the infusion and answer their questions. Our nurses are experienced in administering complex intravenous therapies and our pharmacy follows strict sterile compounding guidelines.
Our Infusion Services include:
- Hydration and electrolyte replacement;
- Antibiotic, antiviral and anti-fungal therapies;
- Anti-inflammatory and steroid therapies;
- Micronutrient infusions (e.g. Iron);
- Specialty infusions.
A blood transfusion is a routine medical procedure that can be lifesaving for many. During a blood transfusion, donated blood or blood products are given to the patient intravenously.
Common indications for blood transfusions are:
- Post chemotherapy and bone marrow transplantation;
- Bleeding disorders;
- Surgery and injuries.
At the Maharaj Institute, a patient can receive blood transfusions safely in one of our private rooms, without the inconvenience and risks associated with going to the hospital.
Our experienced clinical staff gives intravenous injections prior to the transfusion to avoid transfusion reactions, performs safety identification checks of the blood product and monitors the patient throughout the procedure. A physician is always within easy access in the event a patient develops any sign of transfusion reaction or has any issues, questions or concerns.
The Maharaj Institute has a State of Florida certified pharmacy that follows strict compounding standards issued by the United States Pharmacopeia (USP) Chapter 797 which ensures the preparation of sterile compounds.
Our pharmacy dispenses medications and infusions based on evidence-based guidelines for quality and efficacy in-patient care. The Institute strives to educate patients on the safety and efficacy of medications.
The Maharaj Institute has an FDA IND clinical trial protocol (08001-BMSCTI) for investigating a novel cancer therapy using transfusions of white blood cells from healthy donors to patient with advanced solid tumors.
This investigational new cancer therapy was developed from the exciting research done by Dr. Zheng Cui MD., Ph.D. who identified that a particular strain of lab mouse (SR/CR mice) was cancer resistant. Dr. Cui’s research concluded that the cancer resistance was mediated by a specific population of leukocytes (granulocytes and monocytes) and that these cells, when transfused to a mouse with cancer, would cure the cancer.
The aim of this clinical trial is to replicate in humans the same results observed in mice and, ultimately, lead to an effective, nontoxic treatment for newly diagnosed patients as well as patients who can no longer benefit from conventional treatments.