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Artemis Health Institute (AHI), at Gurgaon is a NABH Accredited, 300-bed tertiary care super-specialty flagship hospital established by Artemis Health Sciences (AHS) - a healthcare venture launched by the promoters of the Apollo Tyres Group. Artemis aims at creating an integrated world-class healthcare system by leveraging the best medical practices backed by cutting-edge technology. The super-specialties chosen by Artemis as its area of focus include Cardiovascular (Heart), Oncology (Cancer), Orthopedics & Joint Replacements, Neurosciences and Bariatric & Minimally Invasive Surgery in addition to host of other specialties.
The services offered by Artemis encompass comprehensive medical solutions including consulting, diagnostics and therapy. For the benefit of its patients, the Institute also runs specialised programmes like Artemis Restore, Well Woman Programmes, and specialised clinics like Breast Clinic, Pain Clinic, Artemis Heart Club, Asthma Care Clinic, Skin Clinic, Knee & Shoulder Clinic, Ayurveda Clinic and Epilepsy Clinic amongst others.
The facility at Gurgaon is designed and constructed in strict accordance with International guidelines. Spread across a total area of 525,000 square feet (when completely built), the facility focuses on offering patients technology-backed world-class healthcare delivered by leading medical professionals and certified by international medical bodies. Eventually, this state-of-the-art, multi-specialty, tertiary care hospital will accommodate 550 beds to fulfill the ever growing need for high quality patient care. Additionally, Artemis follows patient-centric processes conforming to International Patient Protocols, thereby establishing new standards of service and care.
The institution is equipped with the latest technology in preventive, diagnostic and therapeutic imaging, along with the highest levels of in-patient monitoring, and a paperless and film-less Hospital Information System.
Artemis already has many firsts to its credit, being the first installation in India to offer:
•Intelligent critical patient monitoring system with clinical decision support application backed by portal imaging technology
• Film-less and paperless environment (seamless integration with the Hospital Infor mation System)
•An endovascular suite inside an operating room, which will allow endovascular surgery and catheter-based procedures along with hybrid surgery in the composite unit
•Functional MRI Scanning using Non-Contrast Imaging for Cancers (DWIBS)
•MRI-PET fusion technology
•First Hospital in the country to install state of the art Image Guided Radiation Therapy for Cancer Treatment.
• 3D dynamic road mapping for reconstructive imaging
•First & the only centre in Haryana, which is licensed and government approved for conducting Renal Transplant Surgeries
•Fertility Preservation Services for Cancer Patients.
•First In Vitro Fertilisation & Assisted Reproductive Technique centre in India to start.
•A technology tie-up with Philips Medical Systems allows Artemis early and exclusive access to the latest global imaging and monitoring equipment
•The real time Image Guided Radiation Therapy (IGRT) is one of its kinds in North India. Allows for radiation to be delivered exactly where required, with minimal impact on healthy cells
•An Endovascular Suite equipped with the latest in 3D rotational imaging to perform neuro-interventional, cardiac catheterisation or peripheral endovascular procedures with precision
•An in-house bio-repository and a 24-hour blood bank with the facility to conduct Individual Donor NAT (Nucleic Acid Amplification Test)
•One of the very few operational Paediatric ICU and Neonatal ICU in North India
ACCREDITATIONS & AWARDS:
Most Promising Start-Up of the Year 2007 award by Express Healthcare magazine
Best IT Implementation for the Year 2008 from PC Quest magazine for Hospital Information System.
Artemis Super Specialities:
•Human Organ Transplant
•Blood Transfusion Services
•Obstetrics & Gynaecology
•Plastic & Reconstructive Surgery
•Artemis Artificial Limb Centre.
Department of Otolaryngology (Ear, Nose, Throat) Head and Neck Surgery
The ENT Department at Artemis offers a comprehensive list of diagnostic and therapeutic options, all under one roof. A detailed evaluation is first undertaken by a team comprising of ENT Surgeons and Audiologists.
Based on the diagnosis and extent of hearing loss, all options from simple prescription of medicines to hearing restoration devices to complex surgery such as cochlear implants are discussed where relevant. Where possible, patient is given a free trial of hearing aids or Baha implants to ensure patient satisfaction.
Patient makes the final choice based on individual profile and needs. Post treatment rehabilitation is undertaken to achieve maximum benefit.
The aim of the Department of Otolaryngology Head and Neck Surgery is to:
Provide excellent state-of-the-art patient care in a supportive environment
Conduct educational programs that provide excellent training in research and clinical care
Enhance knowledge through relevant research of the highest quality and translate it rapidly into bedside care
- Pediatric otolaryngology
- Head and oncology
- Audiology and speech therapy
- Cochlear Implants
The Department of Nephrology and Urology was started in 2007 at Artemis Health Institute.
services were established under the able leadership of Dr. Sunil Prakash renowned Nephrologist a along with leading transplant surgeon Dr. Harsha jauhari. The department is always focused to provide high quality medical care with a human touch.
Range of Kidney Services Available:
•Continuous Renal Replacement Therapy (CRRT)
•Kidney Biopsy and other procedures
•Vascular Access for Hemodialysis
•Kidney Transplantation and post transplant follow up care
•Focus on preventive aspects of HD and slowing disease progression to dialysis by managing patients under dietary modification and medicines
A) Clinical Nephrology:
A leading centre for the management of all renal problems. State-of-the-art facilities for renal pathology, with complete biochemical, immunological, microbiological and histological (including immunoflorescence and immuno-histo-chemistry) - back up available under one roof.
B) Dialysis Unit
Round the Clock Dialysis services available.(24x7)
First dialysis unit in India to provide maintenance Hemodialysis in separate chambers with TV and separate staff for all patients.
1) We provide latest R.O. (Reverse Osmosis) water as per AAMI Standards for the dialysis, to ensure patient safety and prevent long term complications on Hemodialysis.
2) Latest generation, fully computerized bicarbonate Hemodialysis machines with volumetric ultra filtration and adjustable sodium facility, and provides better patient safety profile.
3) We have one of the best, state-of-the-art computerized automatic dialyzer re-use system in India which ensures safety & adequacy of dialysis and also economize dialysis for the patient.
4) Facility for continuous monitoring of sick patient on dialysis through highly sophisticated monitors throughout the dialysis procedure is available.
5) Separate and dedicated Machines available for HCV and Hbs Ag Positive patients.
6) Disinfection of Hemodialysis machines after every shift is practiced for patient safety.
7) We have highly trained technical and nursing staff under supervision of nephrologists.
8) Dialysis Medical officer available in the department to handle all types of complications.
9) Free Recreation and Refreshment available for patients during Dialysis
C) Chronic Peritoneal Dialysis/Automated Peritoneal Dialysis:
CAPD is also suitable for patients who are living in far and remote areas where facility of hemodialysis is not available
Dedicated Staff available to look after Peritoneal Dialysis
In-house training and counseling available for patients and their attendants on Peritoneal Dialysis
D) Continuous Renal Replacement Therapy (CRRT )
Artemis Renal Institute provides highly sophisticated dialysis for critically ill patients in ICU/ICCU with multi-organ failure, where peritoneal or routine Hemodialysis are not possible for various reasons.
Various procedures done with this technique are:-
SCUF (Slow Continuous Ultrafiltration)
CVVH (Continuous Veno-Venous hemofiltration)
CVVHD (Continuous Veno-Venous hemodialysis)
CVVHDF (Continuous Veno-Venous hemodiafiltration)
E) Renal Transplant services
Renal transplant services are available at AHI. Dr. Harsha Jauhari is the renowned transplant surgeon at our center. He is a leading transplant surgeon in India, He was trained in U.K. and is also head of transplant services at Sir Gangaram Hospital.
Dr. Sunil Prakash is the head of nephrologist and transplant services. He has been associated with more than 200 transplant during his earlier Stints Northern Railway Hospital New Delhi. He along with his team of nephrologists provide total support to the programme .
Kidney transplant is a surgical procedure in which a kidney from either a healthy living donor or deceased donor (cadaver) is implanted in to the renal failure patient. Kidney transplant has many limitations like-
Arranging for a kidney from relatives or close friends. This at times becomes a Herculean task.
Alternatively the patients can live on dialysis.
It is very important to understand that without dialysis or transplant, the end stage kidney patient cannot survive at all.
So although dialysis is expensive, at times painful and time consuming but it is the only way to live for many years in the face of ESRD
Nephrology and integrated department is regularly involved in CME. We are actively involved in regular public awareness camps that focus on DM, HT and detection of CKD in early stages.
G) Urology services
Under able guideline of Dr. Pradeep Bansal - M.C.H. Urology from (GPGI Lukhnow)
CASUALTY SERVICES :
24 hours casualty services are available. All patients concerning nephrology opinion are attended by a nephrologist in emergency room. Senior consultant supervises all these services round the clock
Artemis Neurosciences Institute:
Artemis Health Institute is a multispeciality hospital and considered to be as one of the best tertiary care hospital in India. It is located in Delhi national capital territory area in the Indian millennium city Gurgaon. The hospital is well known for the best possible equipment of international standards with best possible patient care. Although it serves a large section of population of India but a large number of international patients also come here for treatment. Due to its high standard of healthcare facility, it has been awarded the distinction of accreditation of NABH (National accreditation Board for Healthcare organizations and Hospitals) which is a rare distinction and a very few hospitals in India have earned it.
Since its inception in 2007, Institute of Neurosciences has been a leader in the diagnosis, treatment and rehabilitation of patients with neurological disorders or illnesses. The Institute’s professional staff members are experts in a variety of fields related to diseases of the nervous system. The Institute combines physicians and other healthcare providers in neurology, neurosurgery, neuroradiology and behavioral sciences who treat adult and pediatric patients with a variety of neurological disorders.
The Department of Clinical Neurosciences was established in 2007. By virtue of dedicated Neurosurgeons, Neurologists, paramedics and world class equipment and facilities. It is one of the busiest tertiary care department amongst the private set ups in India. It offers multidisciplinary comprehensive care with human touch. Artemis Neurosciences Institute is surrounded by pleasant ambience and is well connected with railway stations. Artemis Neuroscience Institute (ANI) is dedicated with its most advanced medical technology compatible with international standard. The department has a team of highly trained doctors with international background working for a better treatment result. The emergency services render a twenty four hour of service to the community.
The Neurosurgeons at Artemis healthcare use their vast experience in Neurosurgery/ Neurology to help diagnose and treat disorders of the nervous system affecting the whole body, the spine, brain, hands, legs, arms and face. The Neurosurgery department offers some of the most advanced surgical treatments along with a variety of non-surgical approaches to restore his patient's health and relieve their pain. Neurosurgeons at ANI perform minimally invasive surgeries of the spine and skull base.
•Comprehensive patient management- All modalities of treatment are available under one roof.
•Protocol based therapy
•Consultation at clinic and remote
•OPD Documentation, statistics
•Special nursing and rehabilitative services as required
•Comprehensive Diagnostic facilities Hematology
Neurosciences Institute is backed by
•State of art Laboratory services which offers a round the clock service
•Imaging Three texla MRI and ultra fast CT machine
•PET CT scan
•Neuro physiological laboratory - EEG, EMG, NCV, Visual evoke potential, Brain stem auditory evoke potential
What we treat at Artemis Neuro sciences Institute
•TIA- Transient Ischemic Attack
•Headaches including Chronic tension headache
•Motor neuron disease
Our Neurosurgeons are involved in the treatment of
Brain tumors, both benign and malignant . Awake craniotomy if the tumor is located in an eloquent area of the brain.
Traumatic head injuries: subdural, epidural, intracerebral hematomas, brain contusion, depressed fracture.
Complex vascular diseases like Aneurysm, Arterio-venous malformation (AVM)
Insertion of ventricular shunts for normal pressure hydrocephalus (NPH) or obstructive hydrocephalus or endoscopic third ventriculostomy .wherever applicable
Anterior Cervical Discectomy and Fusion with instrumentation. The cervical disc and/or spur are removed during this operation. After removal of the disc it is fused with instrumentation.
Insertion of artificial discs for cervical disc herniation and/or degeneration.
Treatment of Posterior Decompression of the cervical vertebrae.
Posterior Fusion of the cervical vertebrae.
Discectomy - A portion of the disc is removed from the spine to release the pressure on the nerve.
Kyphoplasty/Vertebroplasty for fracture - This is a minimally invasive treatment in which orthopaedic balloons are used to gently elevate the fractured vertebrae in an attempt to return it to the correct position.
Microdiscectomy (minimally invasive spine procedure) - This is an operation on the lumbar spine that is performed using a very small incision and removes only the portion of the ruptured disc that is pinching the spinal nerve causing pain.The surgery is performed under operating microscope.
Decompressive Laminectomy with or without fusion and/or instrumentation - This surgery is done to treat spinal stenosis and relieve pressure on the spinal cord or spinal nerves. Laminectomy removes bone and/or thickened tissue that is narrowing the spinal canal and squeezing the spinal cord and nerves. Sometime along with it foraminotomy is performed to relieve the pressure on exiting nerve root. This procedure is done by surgically cutting into the back.
Posterior and Anterior Lumbar Interbody Fusion - In this procedure, the surgeon joins (fuses) two lumbar vertebrae. This helps stabilize the vertebrae in this part of the spine.
Spinal Cord Stimulator - This a treatment used for chronic pain. A small stimulator sends signals to your spinal cord to keep the pain messages from being sent to your brain.
Carpal Tunnel Release - Carpal tunnel release is surgery to treat carpal tunnel syndrome, which is pain and weakness in the hand caused by pressure on the median nerve at the wrist.
Ulnar Nerve Transposition - Ulnar Nerve Transpositon moves the affected nerve to relieve pain and pressure. A new tunnel is created for the nerve during this procedure.
Peripheral nerve trauma surgery. With the help of nerve stimulator the pathological area is found out and treated accordingly sometimes with nerve grafting. The finest suture material which is even thinner than a hair is used.
Perpheral nerve sheath tumor. Removal of tumor from a peripheral nerve is sometimes challenging. Goal is total removal of the tumor without altering the normal function of the nerve. Tumors can be benign or malignant. Malignant tumor is managed with the helped of Experienced Oncologists.
Tumors – Common pediatric tumor like medulloblastoma, craniopharyngioma or Astrocytoma are always challenging. Surgical removal is followed by treatment by a multidisciplinary team.
Tethered Cord - In this surgery under microscope the tethering of the spinal cord is removed allowing normal growth of the spinal cord restoring function of the limbs.
The Department of Radiology at Artemis Health Institute is dedicated to high quality medical imaging and sub specialized interpretation of those images. The department provides imaging and interpretation services to all In- Patient and Out-Patient facilities. All forms of diagnostic and interventional radiological procedures including sophisticated vascular and neuro interventional procedures are performed.
Body Imaging (conventional x-ray, mammography, ultrasound, MRI and CT)
Interventional Radiology (biopsy, minimally invasive therapy, angiography)
Neuroradiology (CT and MRI studies of the neurologic system)
Nuclear Medicine (SPECT, PET/CT, radionuclide imaging)
Radiology Department is fully backed by Radiology Information system (RIS) - a repository of patient data and reports which contribute to electronic medical records RIS is a computerized database used by radiology departments to store, manipulate and distribute patient radiological data and imagery. Our RIS assists in patient tracking & scheduling, result reporting and image tracking. RIS complements our HIS (Hospital Information Systems).
Artemis is the first Paper - less hospital in India.
The department provides a full support of tertiary care radiologic services, including Neuro-radiology and Interventional- Neuro-radiology, Cardiovascular Interventional Radiology, specialized Musculoskeletal, Chest, and Abdomen Radiology, Women's Imaging, and Nuclear Medicine.
Diagnostic services in ultrasound, digital mammography, PET/CT, and nuclear medicine are additionally provided. All diagnostic modalities are linked to the PACS (Picture Archiving and communication system). PACS at AHI handle images from ultrasound, magnetic resonance, positron emission tomography, computed tomography, endoscopy, mammograms, digital radiography, and computed radiography. PACS have the advantage of hard copy replacement, remote access and electronic image integration platform.
These activities are conducted on state-of-the-art equipment. Currently, Radiology and Imaging Sciences are operating with A.3 Tesla MRI equipment
B.64 Slice CT scan
C.Digital Mammography with stereotactic Platform
D.4- D ultrasounds
E.Digital X- rays
F.Bone densitometer for femur, spine and whole body BMD
3 Tesla MRI equipment
Neuro-Imaging ; High end neuro-imaging packages such as Diffusion, Perfusion Scan, Spectroscopy ( CSI & SVS) white matter fibre tracking functional MRI. MR Venogram, MR Angiogram.
•Enables early lesion detection.
•Differentiates tumors from infections and recurrent tumors from post - radiotherapy change using highly sensitive metabolite ratios in the MR spectroscopy protocol.
•Detects stroke in less than ten minutes of onset.
•Creates a navigation path for neurosurgeon by mapping functional areas. eg speech, motor, sensory etc in relation to the tumor. Also tracks the white matter association fibers in relation to the tumor for minimal or no deficit following neurosurgery.
•Can detect impending stroke through MRA and MR Venogram.
•Dedicated seizure protocol, tinnitus protocol, protocol for Trigeminal Neuralgia, Temporal arteritis and multiple sclerosis.
Body Imaging: Whole body imaging protocol for early detection of disease.
Cochlear transplant protocol
Whole body DWIBS imaging combined with whole body MRI for increasing the sensitivity of detecting early lesion.
MR Angiogram from Arch of Aorta to dorsalis pedis.
Breast Cancer : Dedicated breast coils with perfusion imaging and subtracted images to detected early cancer in dense breasts or in women who are at high risk
Prostate Cancer: High resolution images combined with DWIBS and prostate spectroscopy for early detecting and staging of prostate cancer. Also for monitoring cancer prostate patients post therapy.
Genito-Urinary & Pelvic malignancies :
MRI with MR Urography for early detection of Bladder, Ureteric and renal cancers.
Detection, staging of endometrial cervical and ovarian cancers.
Triple phase liver imaging for early detection of HCC in cirrhotic liver.
Dedicated phased array coils for the joints for high resolution imaging
64 slice CT scan
For Coronary Angiogram
Abdominal, Neck Angiogram, Renal Angiogram
Volumetric liver study for pre and post liver transplant patients.
Triple phase liver scans for early detection of liver lesion.
Dedicated pancreatic protocol.
Cochlear transplant protocol.
3 -D reconstruction.
Virtual Bronchoscopy and Colonoscopy.
CT protocols are designed as per patient age and built etc. We follow the ALARA principle (As Low As reasonably Achievable) for radiation to ensure minimal radiation experience.
Digital Mammography with a stereotactic platform; for stereotactic Biopsies, Stereotactic 'J' wire localization of micro-calcification. Digital Mammography is the latest advancement in X-ray Mammography. Digital mammography uses essentially the same mammography system as conventional mammography, but the system is equipped with a digital receptor and a computer instead of film cassette.
Digital spot mammography allows faster and more accurate stereotactic biopsy. This results in shorter examination times and significantly improved patient comfort and convenience because the patient has to remain still for a shorter period.. The system is also equipped with a stereo-tactic biopsy attachment, wherein very small non palpable masses in the breast can be accurately biopsied.
4D Ultrasound & Doppler:Four-dimensional (4D) ultrasound is 3D ultrasound in motion. Doppler ultra sound is a special ultrasound technique that evaluates blood as it flows through a blood vessel, including the body's major arteries and veins in abdomen, arms, legs and neck. Doppler ultrasound images help the physician to see and evaluate:
Blockages in blood flow ( such as clots)
Narrowing of vessels ( which may be caused by plaque)
Tumors and congenital malformations.
AHI has 5 high end colour Dopplers for following areas:
IU 22 radiology application
IE 33 for Non-invasive Cardiology application
3 Envisor for Mobile colour Doppler application.
Ultrasonographic examinations can be performed for virtually every part of the body; though are not very useful for evaluation of diseases of the brain and chest. They are most useful for diseases of the abdomen, during pregnancy and for evaluation of blood vessels (color Doppler).
In general all ultrasonographic examinations are painless; there is no contraindication in pregnancy or on pediatric population. It is radiation free.
Digital X- rays and contrast examination such as barium, IVPs, MCU's, small bowel enema, barium enema, and barium meal follow through are also conducted at our hospital.
IMAGE GUIDED INTERVENTION
Pigtail catheter insertion.
Diagnostic and therapeutic fluid drainage.
Radiation Safety Issues
At Artemis we have a radiation council that monitors all radiation issues in the hospital.
Pregnancy is ruled out before any radiation exposure.
The patient's identification is checked before subjecting exposure.
Additional shielding is provided to all vulnerable patients.
Corridors are monitored for radiation for any leakage or scatter by the Radiation safety Officer and the readings are tabulated.
Personal monitoring devices are used by the staff to monitor radiation.
The radiation council oversees all these activities.
Having a child in hospital can be one of the most difficult and upsetting periods for any parent. You are bound to be anxious and may not know what to expect. Our aim is to provide holistic care to the children in an environment which is sensitive to the needs of the child and the family. Our experts of various pediatric specialities function as a team to make sure that the child and the family get the care and support that they duly deserve.
As a team- We are committed to providing care and services that are guided by the needs of families and are perceived as flexible, accessible, responsive and sensitive. Therefore, we will develop systems that enable staff to respond to family preferences and priorities in a timely and creative manner.
We believe that care should be provided by an identifiable health care team that includes families as an integral part of developing a plan and caring for their children. The family-professional partnership is based on mutual respect for the understanding that each brings to the situation.
We strive to provide coordinated care and linkages between our services and the family's community, including schools, local physicians, services and agencies.
All types of Pediatric and Neonatal emergencies
Pediatric Intensive Care and Pulmonology
Tertiary level Neonatal Intensive Care
Pediatric Metabolic medicine including juvenile diabetes
Pediatric Cardiology and cardiovascular surgery
Pediatric Infectious diseases and immunology
Childhood Vaccination and Community health
Paediatric Intensive Care:
Our aim is to provide excellent care to critically ill children in an environment which is sensitive to the needs of the child and the family.
Our Intensive Care is one of the largest for children in north India. We admit approximately 700 patients per year to PICU. Apart from NCR Our patients come from remote areas of Haryana, Rajasthan, UP and other neighouring states. We also get significant number of overseas patients in the need of specialized care.
We admit children with respiratory distress, neurological disorders, sepsis and severe infections and other systemic disorders needing ventilatory or other form of life support. We also get children post operatively who have had specialized surgery like neurosurgery, cardiac surgery, abdominal or ENT surgery.
Our PICU has state of the art equipments which are needed for the survival of critically ill children. We have a number of ventilators to allow different ventilatory techniques appropriate to the care of the child. A full range of renal replacement therapies are also available should any child require it.
Our team of doctors at PICU is most dedicated and commited to their patients. Our consultants are traind in specialized pediatric intensive care from world’s best institutes and widely respected in their field in the country. A 24x7 coverage by trained pediatric intensivists is provided at sight to deal with any emergency.
Our staff on PICU is fully trained and most commited and aware of the stress suffered by parents and relatives of children who are admitted to the unit.
Neonatal Intensive Care:
We have a state of art tertiary level neonatal intensive care unit at Artemis. This is a 12 bedded NICU equipped with the most advanced and sophisticated equipments needed to treat your tiny tots.
We are a referral center to treat babies with extreme prematurity and have managed babies with birth weight being as low as 600 to 700 grams with excellent outcome. We also get newborns with surgical problems like tracheo-esophageal fistula, congenital lung defects, intestinal obstruction and others for the surgical correction as we have a team of specialized pediatric surgeons, expert in performing surgeries on these little ones.
NICU is managed by formally trained Neonatologists who are experts in their field and are respected at national scene. A fully trained doctor on duty is always available to deal with any emergency.
A great emphasis is given to the quality of nursing care in NICU as we understand that good nursing is the back bone of any Neonatal ICU. Our staff is extremely well trained to take care of all types of sick neonates. They are caring, dedicated and sensitive towards the family as well. The success of these staff is demonstrated by the excellent feedback we have received from families.
We take pride in stating that our results are amongst the best in the country.
Artemis Super Specialities:
Human Organ Transplant
Blood Transfusion Services
Obstetrics & Gynaecology
Plastic & Reconstructive Surgery
Artemis Artificial Limb Centre
SCO Complex-317, Sector 29
India, Zip - 122001
Phone - 0124 4210317/18
S.C.F- 21 , First Floor Above Lakme Salon, Sector 14, Bank Market, Old Delhi-Gurgaon Road
India, Zip - 122001
Phone - 0124 4233767/3191300
310 B, Sushant Tower, Sector 56, Sushant lok 2
India, Zip - 122001
Phone - 124 2571392
C-1 Sushant Lok- 1 Sector-43 Phase- I
India, Zip - 122002
Phone - 0124 4585555
Sector 21, Panchkula
India, Zip - 134102
Phone - 0172 4500000
Sheetla Hospital, New Railway Road
India, Zip - 122006
Phone - 0124 4555821/803