Meenakshi Mission Hospital and Research Centre Annual Report 08 - 09 by Meenakshi Mission Hospital and Research Centre

A NN UAL A NN UAL REPORT REPORT

08-09 09 08-

(Run by S.R. Trust) (Run by S.R. Trust)

Lake Area, Melur Road, Madurai - 625 107, Tamilnadu, INDIA. Lake Area, Melur Road,/ Madurai Phone: 0452-2588741 4263000- 625 107, Tamilnadu, INDIA. Phone: 0452-2588741 / 4263000 Fax: 0452-2586353 Fax: 0452-2586353 E-mail: mmhrc@sancharnet.i n E-mail: mmhrc@sancharnet.i n Web: www.meenakshimission.org Web: www.meenakshimission.org

WORLD- CLASS CARE WORLD- CLASS CARE WITHIN WITHIN EVERYBODY’’S REACH EVERYBODY S REACH

(Run by S.R. Trust) (Run by S.R. Trust)

Here’s how you can make a difference

S.R. TRUST S.R. Trust (Reg. No. 291/85 dated May 9, 1985) is a public

Programs You Can Support Your simple act of compassion could be somebody’s miracle….

Mission

DONATE NOW!!! • Rs. 600 for cataract surgery per patient World-class care within everybody’s•reach. Rs. 1, 000/- for Dialysis per person Your donations can be made as follows: • Rs. 2, 000/-for feeding 100 patients with free nutritious • Naming a block in the donor’s name – Rs. 20 Lakh meals per day • Naming a wing in the donor’s name – Rs 10 Lakh Vision • Rs. 3,600/-for treating a cancer child for every 6 months. • Naming a room in the donor’s name – Rs. 1 Lakh No man is too poor to afford first grade medical treatment. • Rs. 5,000/-to support a child’s investigation suffering from • Donation for specific equipment/facilities cardiac problems. (list available on request) • Rs. 7, 200/- for providing one-year treatment to a child suffering from cancer. Values • Rs. 15, 000/- for providing 5 cycles of Chemotherapy for a Care child suffering from cancer. Compassion • Rs. 20, 000/- life time donation to provide free nutritious Committment meals. Charity • Rs.50, 000/- to support a child’s Routine Drug Expenses, Empathy Surgery Expenses and Blood Transfusion Quality Service

charitable non-profit organization founded by Dr. N. Sethuraman, a socio-medical activist, who made a paradigm shift in rural health services. Thiru. Manikavasagam, his teacher, inspired Dr. N. Sethuraman and urged him not only to provide

Board of Trustees Dr. N. Sethuraman

Founder President/Chairman

Dr. Mrs. Rajam Sethuraman Executive Director

Dr. S. Gurushankar Vice Chairman

Ar. S. Ramesh Vice President

medical services, but also to work towards social upliftment.

Mr. S. Parthasarathy

Today, Thiru. Manikavasagam would be very proud of his

Mr. S. Manavalan

student who has made S.R.Trust a fully-fledged modern

Mrs. N. Chinnammal

facility with contemporary team-based care and cutting

Mr. A. Shanmugasundaram

edge technology.

Mr. S. Regunathan Mr. P.K. Amarnath Chartered Accountant

Editorial

Apart from these, donations of any value in cash or kind and volunteer services are welcome. All Cheques/drafts should be drawn in favour of “S.R. Trust” Quality Policy All donations are exempted under 80G of Income Tax Act. Meenakshi Mission Hospital and Research Centre, in pursuit of

Editor Prof. Dr. N. Krishnamurthy

excellence, is committed to comply with applicable requirements for

Compilation Ms. R. Padma Priya

developing and providing world-class healthcare at an affordable cost.

Academic Director

Associate Editor Mr. P. Sundarraj

Senior Manager – Projects

Resource and Development

We shall foster an environment in which every person is motivated to continually improve the efficiency and effectiveness in the management of healthcare services.

Concept & Co-ordination Ms. C. Yalini Sheeba Manager – R & D

Photography Mr. B. Shanmugam Mr. N. Shankar

S.R. TRUST

Board of Trustees

S.R. Trust (Reg. No. 291/85 dated May 9, 1985) is a public

Dr. N. Sethuraman

Founder President/Chairman

Dr. Mrs. Rajam Sethuraman Executive Director

Dr. S. Gurushankar Vice Chairman

Ar. S. Ramesh Vice President

medical services, but also to work towards social upliftment.

Mr. S. Parthasarathy

Today, Thiru. Manikavasagam would be very proud of his

Mr. S. Manavalan

student who has made S.R.Trust a fully-fledged modern

Mrs. N. Chinnammal

facility with contemporary team-based care and cutting

Mr. A. Shanmugasundaram

edge technology.

Mr. S. Regunathan Mr. P.K. Amarnath Chartered Accountant

Editorial Editor Prof. Dr. N. Krishnamurthy Academic Director

Associate Editor Mr. P. Sundarraj

Senior Manager â&#x20AC;&#x201C; Projects

Compilation Ms. R. Padma Priya

Resource and Development

Concept & Co-ordination Ms. C. Yalini Sheeba Manager â&#x20AC;&#x201C; R & D

Photography Mr. B. Shanmugam Mr. N. Shankar

Dr. S. Gurushankar, Vice Chairman, Meenakshi Mission Hospital & Research Centre, Madurai receives the National Award for Performance Excellence in Healthcare, from his Excellency Mr. S.C. Jamir, the Governor of Maharashtra.

At a grand function in Mumbai on 24th March 2009, His Excellency Mr. S.C. Jamir, the Governor of Maharashtra, handed over the National Award for Performance Excellence in the Healthcare category for 2008, to Dr. S. Gurushankar, Vice Chairman, Meenakshi Mission Hospital & Research Centre, Madurai. This National Award is instituted by the Indian Merchantâ&#x20AC;&#x2122;s Chamber â&#x20AC;&#x201C; Ramakrishna Bajaj National Quality Award Trust, Mumbai.

HEALTHCARE AWARD

From the Chairman’s Desk Continuing the odyssey of excellence The end of each year brings us closer to our vision. This presents an opportunity, not just to reminisce and celebrate past achievements, but a chance to look forward to what the future has in store for us. “The future belongs to those who believe in the beauty of their dreams”. The past year has once again been a splendid one for our hospital, in terms of excellent quality patient-care services. Once again, I am very proud to present the Annual Report 2008-2009 for our hospital. Even the most successful organizations, however outstanding, can be lulled into complacency. Yet, after 20 years of being on the forefront of providing medical care, Meenakshi Mission Hospital and Research Centre continues to exceed expectations. This requires constant innovation, insistence on excellence and an ever-increasing investment in the future.

In this Annual Report 2008-2009, you will read about many of our achievements as narrated by the family members of Meenakshi Mission Hospital - the patients, residents, families, donors, staff, doctors and volunteers. As we prepare to take on the changes and challenges that lie ahead, we will continue to rely on those who have taken us this far. As a first accolade for a charity hospital, The Credibility Alliance has conferred on Meenakshi Mission Hospital the accreditation for good governance of voluntary organizations. At present, we are one among twenty-seven NGOs to receive this honour. All credit for this goes to our supporters. The constant faith and solidarity reposed in us by the people who encourage us to strive hard, has helped us improve our capabilities for the benefit of society. Under the guidance of Smile Train, USA we’ve put back smiles on the faces of 4,500 cleft lip/palate patients. We have received continuous support from Direct Relief International, USA for donating medical supplies and for the execution of our Meenakshi Telecare project to the marginalized poor persons, with the vision of health to all. Vitamin Angels Alliance, USA has helped to bring about a blindness free society. A heartfelt thank you to each one of you for your marvellous support. This year’s annual report reflects the many ways in which we are building on our mission, which is to set the standard in patient care, research and community development. The report also talks about how we plan to extend those efforts to move steadily, flexibly, and in no way complacently, towards a future of immense potential. We are widening our horizons and progress beyond our boundaries to fulfill our vision that “No man is too poor to afford first grade medical treatment”. This we do by initiating a Hospice Centre, a new initiative towards our successful charity journey. My sincere thanks to Lions Club International, Lions Club of Madurai Vaigai and all the club members for executing this project. For the first time in India, we conducted Duck Race 2009 with more than 1000 bright yellow, red-lipped, attractive “adopted” rubber ducks, a sight to behold for hospice care! And a mega event which met with great success. Another step ahead - we have come out with a quarterly newsletter ‘Charity Journey’, which is a gallery of all our charity activities. Our commitment is to do everything possible in the interest of the recipients for our services and the community in general, to protect and enhance the work currently undertaken by our organization. Nevertheless, the potential for change gives rise to uncertainity, which inevitably causes anxiety amongst staff, and I therefore recognize the forbearance of our valued employees as these complicated matters are worked through. This year was indeed a very busy one, and this report to our community is an opportunity to celebrate our achievements and accomplishments of the past year. Once again we want to express our sincere thanks to our Board, our staff, our doctors, volunteers, well wishers and our supporters for all their encouragement and support. We look forward to your continued encouragement and support in the years ahead.

Together let us bring hope to life.

Dr. N. Sethuraman Founder Chairman

From the Vice Chairman’s Desk Expanding the frontiers of Healthcare With the Wall Street and the Dalal Street taking a toll, the healthcare industry is the only industry to have stayed out of the economical downturn. The Indian Healthcare delivery industry, which comprises of the pharmaceutical market and the healthcare delivery market, was estimated to grow at 23% for the year 2008 – 09 and this still holds good, in spite of the global recession. Meenakshi Mission Hospital & Research Centre (MMHRC) has performed exceptionally well in this time of crisis and has outperformed the industry with a growth of 31% for the year 2008 – 09, over the previous financial year. With this good note, I present to you the Hospital’s report for the financial year 2008 – 09. As you go through our report, you would realize that Meenakshi Mission Hospital & Research Centre (MMHRC) is quite unique in its nature of service. Our right proportion of men, machine, materials and money has made our products and services unique.

MMHRC, managed by the SR Trust, has always put people in the forefront, which has taken us to greater heights. Our full-time consultants are trained and experienced in their respective specialities. They are always encouraged to embrace new technology and update their knowledge through Continuous Medical Education (CME) Programmes and domestic & foreign conferences. Our support staff is deeply committed to deliver excellence and is trained to serve patients without bias. Our passion for technology has made us constantly upgrade our facilities with better machines just to provide a delighting service to the patients. MMHRC is known for its pioneering effort of implementing first-class technology in South Tamil Nadu and ensure that it reaches common man. I would like to take this opportunity to show my gratitude to our suppliers, big or small, for their immense cooperation in our day-to-day supplies. It is only because of their involvement and integrity that we were able to post this performance. In spite of the implementation of world-class technology and quality materials, we have always ensured that our services are affordable to all. No matter what, MMHRC has always been and is living its dream of proving the fact that “No man is too poor to afford first grade medical treatment”. The Board of SR Trust has always supported the administration of MMHRC through its timely appreciations and suggestions. The strong team of the Board, medical team and the supportive personnel are committed to provide outstanding clinical care, relying on new and proven technologies for advanced care, which has paved the way to massive patient flow. Our journey has really been thorny in spite of which we have ensured that all our services are of the utmost quality. The Ramakrishna Bajaj National Quality Award, instituted by the IMC Ramakrishna Bajaj National Quality Award Trust, Mumbai, which was handed over to us for Performance Excellence in the Healthcare category for 2008, has reassured us that MMHRC is still traveling in the right direction towards achieving “World-class care within everybody’s reach”. With this year’s colossal performance, we would like to start off the year 2009 – 10 and to put in our best efforts to record our best performance ever. This year we would be commissioning a new Fixed Cathlab, to handle the increasing number of cardiology patients and the Linear Accelerator, to improve the accuracy of our diagnosis of tumours. The expansion of our Dialysis wing would be dedicated to the escalating number of patients for dialysis sessions. We will also be ready with our new Canteen block to cater to the staff and the visitors with our sumptuous menu. With all these projects in the pipeline, we will never leave behind the purpose of our existence – to serve the needy and the poor. The past 19 years has made us more mature and strong in our approach and we have realized that all our achievements are just stepping stones in our expedition. We invite you to be a part of this endeavour to help post better successes in future.

Dr. S. Gurushankar Vice Chairman

Contents

Medical Excellence Accident and Emergency medicine

Anaesthesiology & Pain clinic

Andrology & Urology

Cardiac Anaesthesiology

Cardio Thoracic & Vascular surgery

Cardiology

Community Care centre

Dental & Oral Surgery

Dermatology & Venereology

Diabetology

General Medicine

Imaging Sciences & Interventional Radiology

Intensive Respiratory Care Unit (IRCU)

Laboratory Services

Medical Oncology

Nephrology

Neurology

Neuro Surgery

Nuclear Medicine

Obstetrics & Gynaecology

Ophthalmology

Orthopaedics and Traumatology

Otorhinolaryngology (ENT)

Paediatrics & Neonatology

Pharmacy

Physical Medicine & Rehabilitation

Plastic Surgery / Smile Train Project

Psychiatry & Counselling

Radiation Oncology

Reproductive Medicine

Surgery & Surgical Gastroenterology

Surgical Oncology

Academic Excellence Library

Meenakshi Mission Hospital College

Developmental Excellence Promotional Initiatives

Quality Service Deprtment

Resource & Development

Financial Performance

Leader in Health Information

Performance Highlights

Hereâ&#x20AC;&#x2122;s how you can make a difference

MEDICAL

EXCELLENCE

Accident and Emergency Medicine

Emergency medicine is an emerging and exciting specialty of medicine and is the front door of the hospital. It is the portal of entry for all kinds of emergencies, which range from minor injuries to life threatening conditions requiring immediate resuscitation and critical interventions. The Accident & Emergency Department of MMHRC has evolved from a mere referral point to a fully equipped department run by qualified emergency physicians. MMHRC is a tertiary referral centre and level one trauma centre which provides comprehensive emergency care to the sick and injured, 24 hours a day, 7 days a week. The department has six beds, which are mainly meant for initial resuscitation and stabilization of all sick patients. The practice of emergency medicine includes the initial evaluation, diagnosis, treatment, and disposition of any patient requiring expeditious medical or surgical care. One of the most amazing aspects of Accident & Emergency Department is the wide variety of cases that arrive on a daily basis (Medical, Surgical, Trauma, Cardiac etc). Caring for patients during the most unexpected and frightening times of their lives is undeniably a biggest challenge and a job with great responsibility. An effective, efficient and timely response to an emergency is the hallmark of an institute of quality. Our A & E department is run by 2 qualified emergency physicians, supported by 4 medical officers, 1 nursing supervisor, 8 nursing staff and 5 paramedical staff. The doctors and staff nurses are trained in BASIC LIFE SUPPORT and ADVANCED CARDIAC LIFE SUPPORT and can handle all kinds of emergencies effectively. Every staff in the ED knows their roles and responsibilities and we work together as a well coordinated team with a motto of “SAVING LIVES”. Everyone of us know the importance of each second during emergencies, and we know that “Time lost is life lost”.

The department is equipped with all life saving equipments like defibrillator, ventilator, cardiac monitors etc.All life saving procedures will be done at bedside in the emergency department under close monitoring. Every patient in our emergency department will receive appropriate and timely care with zero waiting time. The way the patient has been managed in the first hour determines the chance of his survival. Hence we treat all sick patients aggressively in the A & E department. We have backup from all the other specialties round the clock. The success rate in reviving a patient from cardiac arrest in our emergency department is as high as 71.73%, which is much higher than in the developed nations (44% - 54%). This speaks about the quality care given in the A & E department.

Regular department activities 1. Regular classes to the staff on Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and initial approach to trauma patients 2. Powerpoint presentation by nursing and paramedic staff on every Monday and Friday on topics related to emergency medicine. 3. Regular classes and training for overseas nursing students and trainees. 4. Lectures to interns and post graduate students. 5. Regular lectures on first aid in emergencies to police and NGOs. 6. Lectures on emergency medicine for the IMA doctors in and around Madurai. Statistical performance

The department also provides pre-hospital care service with its 3 ambulances. The goal of our pre-hospital care is to take the emergency room to the patient and provide appropriate care on the field during the GOLDEN

Total no. of patients seen in A & E department during the year 2008-09 is 8725, of which 2050 were medico-legal cases.

HOUR that can make the difference between life and death. Our paramedics are adequately trained in intubating and can handle any emergency during transportation of the patients. Our paramedics contact the emergency room consultants through mobile phone to get advice regarding patient management during transport so that the treatment errors are minimized.

Total no. of cardiac arrests revived during the year 2008-09 is 33 out of 46 (71.73% success)

The number of cases seen in our Accident & Emergency Department has drastically increased since last year and is expected to rise further in the following years.

Total no. of ambulance calls attended during 2008-09 is 380

Total no. of emergency procedures performed during 2008-09 1. Endotracheal intubations

Future plans • We aspire to be the No.1 emergency care provider in

- 420

2. Intercostal drainage tube placement-

Madurai and South Tamil Nadu

• To expand our department with in-patient facility to

3. Central venous access

- 33

admit patients who need observation in ED for short

4. Pericardiocentesis

period

• To start a Poison Control Center in MOU with Contributions to MMHRC’s medical journal -

Role of effective cardio pulmonary resuscitation and early defibrillation for in-hospital cardiac arrest (May’08)

Stimson’s method for anterior shoulder reduction (Oct’08)

Tension pneumopericardium- a rare case (Nov’08)

Bochdalek hernia presenting as Tension Pneumothorax (Dec’09)

Retrospective study on revival of cardiac arrests in ED (Feb’09)

Management of acute burns (Mar’09)

World Health Organization • To start a training programme in Trauma and Emergency Care specifically focused at primary care physicians and general practitioners in and around Madurai district. • To start a training program for Emergency Medical Technicians (EMT) to work efficiently in pre-hospital setup. Highlights • Dr. Narendra Nath Jena is selected as an Executive Member from South India for Indian Society for Trauma & Acute Care (ISTAC)

Conferences and training programmes attended this year Dr. Narendra Nath Jena -

Attended ISSPCON 2008 at CMC- Vellore

Attended international conference in Preventive Cardiology September 2008 at New Delhi

• Won 2nd prize in the Annual Clinical Society Meeting 2009, for presenting a retrospective study on revival of cardiac arrest in our emergency department. • We provide free consultation and treatment to poor patients for minor injuries and illness.

Presented a case of Bochdalek’s hernia misdiagnosed as tension pneumothorax at EMCON 2008 in Salem

TRAUMA 2008 in AIIMS, Delhi.

Dr. Shankar Hippargi -

Presented a case of pneumopericardium causing cardiac tamponade (tension pneumopericardium) at EMCON 2008 in Salem

TRAUMA 2008 in AIIMS, New Delhi.

I-GEL AIRWAY INSERTION

Anaesthesiology and Pain Clinic Modern Anaesthesia techniques play a vital role in the successful outcome of all surgical procedures. Proper pre-operative evaluation, optimization of co-morbidities, modern Anaesthesia techniques, vigilant monitoring with modern equipment and excellent post-operative care are the key to successful healthcare. Modern Anaesthesia includes â&#x20AC;&#x201C; newer drugs, monitors (EtCO2, IBP, ABG, Gas analyzer) airway equipments (Fibreoptic bronchoscope, proseal LMA, ILMA, I-gel) and ventilators. Our team includes 12 skilled Anaesthesiologists, well trained in modern Anaesthesia techniques and devices. The department provides Anaesthesia for all types of surgeries, which includes Cadaveric renal transplant, Joint replacements, Spine surgeries, Lip and Palate corrective surgeries, etc., under one umbrella.

A brief recap of the last year

Statistics General Anaesthesia

6707

1) CME Programme, April 2008 - Paediatric Anaesthe-

Spinal / Epidural

2557

sia update in April 2008 successfully attended with

Plexus Blocks

426

Nerve Blocks

103

more than one hundred delegates. 2) NEMAACON & EMCON - Dr. K.M. Senthilkumar,

Pain Clinic

Consultant presented a paper on Management of â&#x20AC;&#x153;REFRACTORY VENTRICULAR FIBRILLATIONâ&#x20AC;?, in

Various modalities of pain relief are being under taken to

October 2008, Mumbai & Management of Gloriosa

patients for immediate post-operative pain relief and

superba poisoning management in EMCON November

neurolytic block for those suffering with agony of

2008.

long-term pain.

4) SACP in Kolkata, Nov 2008 - Our senior consultant

Acute pain relief

Dr. N. Maharajan presented a paper on retrospective

IV Narcotics Infusion

1195

Continuous Epidural

788

Subcutaneous Narcotics

428

Labour Analgesia

analysis of cardiac patients for laparoscopic surgery. 5) ISA National Conference in Jodhpur, Dec 2008 a) Senior Consultant Dr. M. Krishnan presented a paper on Anaesthetic management of critically ill patients.

Chronic Pain Relief

b) Our PG Dr. Himanshu Sharma presented a paper

Gasserian Ganglion Block

Coeliac Plexus Block

Lumbar Sympathetic Block

6) Criticare in Agra, Feb 2009 - Our PG Dr. B. Manikan-

Posterior Nerve Root Block

dan presented a paper on the Incidence of Interme-

Epidural Steroid

on single dose epidural for Urologic procedure.

diate Syndrome in Organophosphrous Poisoning.

Academic Activities Our department had the chance to teach and train postgraduates in DNB, two post DA candidates and NBE recognized two primary candidates. Lectures, clinical case presentations and journal club discussions are undertaken twice a week. PGs are evaluated and guided properly regarding pre-operative assessments and given enough training in step wise manner in managing all types of risk cases. PGs are taking part in symposium and panel discussion. Clinical case presentations are being undertaken on Sundays, once a month moderated by the Head of the department. PGs are encouraged to take part actively in presenting papers at state & national conferences and 100% results are the highlights for this year.

Inauguration of “Laser Enucleation Prostate” - Workshop by Dr. Jens Rassweiler (Germany) in July 2008, using a new 50W Holmium Yag Laser. Right to left: Dr. S. Gurushankar, Vice Chairman, MMHRC, Mr. Vinod Ratra (LaserCompany), Mr. Jens Rassweiler (Faculty), Dr. V.N. Rajasekaran Medical Director, MMHRC, Dr. T. R. Murali – HOD Urology.

Andrology & Urology The Urology Department, one of the ‘pillars’ of the hospital, has been proudly watching other departments take their roots in the patient care of this magnificent Institution. Urology has trained young post graduate surgeons to become full fledged urologist, now practicing all over India and also abroad. Presently the department offers two seats for training and has been recognized as one of the best training centers for urology in this country. Laparoscopy in Urology has progressed to become the choice of harvest techniques of a “donor” kidney in Renal Transplantation Pyeloplasty, simple and radical nephrectomies, VVF repair, and marsupialization of cysts are routine now. Excellent techniques are employed in Paediatric and Reconstructive Urology. The Urology Department has emerged as a referral centre for complex problems and patients with severe co-morbidities like cardiac, CNS, renal disease and diabetes. It has also become a referral center for urologists in the Periphery encountering a difficult situation. The understanding and coordination with the Department of Nephrology is excellent in rendering the department capable of giving the best possible treatment to salvage patients with renal failure. Endourology and endoscopic Urology continue to flourish with PCNL being done more often for stones in the kidneys, bigger than 1 cm. Our goal has been complete stone clearance along with metabolic urine, blood screen and meticulous follow up. We are noticing a significant change in the pattern of our stone patients in the past decade. There has been a change in the nature of operation from routine to complex cases and urological problems with co-morbidities. MMHRC continues to enjoy its place as a top Andrology centre with all the investigative and diagnostic facilities in the management of all problems related to sexual health and fertility in men. In recent years, focus has been shifted to the Aging Men. Comprehensive care is given to the Aging Male not only with regard to restoration of sexual potency but, general health as a whole. Number of operations in Urology Department Jan 1990 - Mar 2009

We are now moving close to completing two decades of excellence in service in Urology at our centre.

Glimpse of the facts STATISTICS Ureteroscopy TURP TURBT Cystolitholopaxy Cystolithotomy Open Nephrectomy Lap. Nephrectomy Lap. Adrenalectomy Patial Nephrectomy Nephroureterectomy Lap. Nephroureterectomy Radical Prostatectomy Bladder Repair Pyeloplasty Urethroplasty Augmentation Cystoplasty Cystoplasty Pyelolithotomy Ureteric Reimplantation Open Prostatectomy VVF PCN PCNL Penectomy Penile biopsy EIU Hydrocelectomy Vasectomy Hypospadias Correction Endopyelotomy Chordee Correction Perineal Urethroplasty Lap. Orchidopexy Orchidopexy Orchidectomy Herniorrhaphy Mitrofanoff Renal Transplant Renal Donor Nephrectomy CAPD Catheter Insertion AV Fistula TOT

TOTAL 546 135 32 36 1 26 17 3 4 2 2 2 6 13 4 1 1 1 14 3 3 49 69 4 15 59 17 8 9 1 2 4 2 9 29 8 2 14 14 31 106 3

Trucut Biopsy DJS DJSR P SCOPY MASSAGE Cystoscopy CMG MCU AUG Circumcision Endoscopic Calibration Trocar SPC Bladder Biopsy Mass Excision SSG Laparascopic Deroofing of Cyst PU Fulguration PCCL Fistula Closure Epididydectomy Ilial Conduit

15 157 625 33 323 228 160 176 122 114 24 32 1 2 6 10 12 2 4 1

ANDROLOGY EEJ Testicular Biopsy Varicocelectomy Penile Prosthesis ICIVAD RIGISCAN OP - VSS

16 38 55 6 232 174 125

UROLOGY New Registrations Review Registrations In patients

2196 8214 2423

ANDROLOGY New Registrations Review Registrations In patients

1214 2459 329

The initial mission of cardiovascular anaesthesiology was to develop a body of knowledge that would enable anaesthesiologists to improve survival and decrease morbidity of cardiac surgical patients. From PA catheters and Transesophageal Echocardiography to Thoracic Epidurals enabling fast-track anaesthesia for beating heart surgery, anaesthesiologists have kept pace with all the advancements in cardiac surgery by constantly re-inventing themselves, learning new techniques and mastering new technology. In our hospital, Cardiac Anaesthesiology has evolved over the past thirteen years. Our vision is to innovate and deliver high quality, cost effective anaesthesia care and pain management, to create rewarding careers for our staff and to develop leadership in the field of cardio thoracic anesthesia and cardiac rehabilitation.

Cardiac Anaesthesiology Statistics The annual caseload comprises about 489 cardiac procedures of which 281 represent patients undergoing coronary bypass grafting, 68 valve repair or replacement and 113 congenital procedures. This covers the entire gamut of cardio thoracic anaesthesia, i.e., anaesthesia for Coronary artery bypass surgery, Valvular heart surgery, Congenital cardiac surgery and Thoracic & Vascular surgery. About 85% of our coronary revascularisation has been done on a beating heart, which requires quality care anaesthesia and immense haemodynamic monitoring. In line with the advancements in cardiac surgery, our department performs valve repairs on suitable patients, with outstanding results. Cardiac anaesthesiologists play a major role in performing Peri-operative Transesophageal Echocardiography (TEE), thereby, providing adequate assessment tailored to the pathology involved. Transesophageal Echocardiography (TEE) Few areas in cardiac anaesthesia have matured in the recent past as much as the use of intraoperative Transesophageal Echocardiography (TEE). It provides distinct real time images of the heart. An evaluation by TEE may be required to obtain the most precise information to guide surgical intervention (e.g., myocardial revascularization, valvular competence and repair of congenital heart defects) and to guide pharmacological support and/or fluid administration in the peri-operative period. TEE is the biggest leap in haemodynamic monitoring and is a useful tool in the hands of a cardiac anaesthesiologist. In our hospital, TEE is used by the cardiac anaesthesiologist during mitral valve repair and heart failure surgeries and has become imperative for the successful outcome of these surgeries.

Management of Diabetes

• Dedicated, well-trained staff are always in attendance, and each patient receives

Although, there is evidence to suggest new techniques like off-pump CABG and the use of arterial grafts for

comprehensive care by a single nursing personnel. • An anaesthesiologist is available round-the-clock,

improved outcomes in diabetic patients, the optimal

and nothing is left to chance. This assures adequate

treatment for multivessel CAD continues to evolve for

post-operative care of the cardiac patient.

the diabetic patient population, which despite improvements in revascularization, still suffers from

Accomplishments

significantly worse outcomes when compared to the general population.

Dr. S. Kumar was elected as a National Executive Council Member of the Indian Association of Cardiothoracic

Utmost care is taken to maintain tight glycemic

Anaesthesiologists (IACTA).

control during the peri-operative period in our department to reduce wound infection and other co-morbidities. We are also actively involved in the post-operative follow up of lifetime glycemic control of the cardiac surgery patients. Cardiac Rehabilitation Cardiac rehabilitation was given special and

Academic Activities A host of academic activities form a part of the calendar and ensures that the team is kept abreast of the latest developments in anaesthesia. Actively participated as Faculty in National Conference of Cardiac Anaesthesia in 2008 in Ahmedabad.

well-deserved attention this year. We have a dedicated Cardiac Rehabilitation team (includes a dietician and a

Actively participated and underwent training in

physiotherapist) which takes care of the rehabilitative

Transesophageal Echocardiography (TEE) course

needs of the patients. Cardiac rehabilitation includes all

conducted by the Indian Association of Cardiac

measures used to help people with heart disease, return

Anaesthesia (IACTA) at Bangalore in March 2008.

to an active and satisfying life and to prevent recurrence of cardiac events. These services include both in-patient and out patient cardiac rehabilitation. The aim of this program is to educate the patient and emphasize the need to apply the appropriate medical regimen in addition to the non-pharmacological treatment modalities of cardiac rehabilitation to achieve maximal benefit. Facilities

The way forward ‘We are here to add what we can to life, not to get what we can from life.’ - William Osler Looming large on the horizon are the prospects of: • Mitral valve repair • Minimally invasive cardiac surgery • Heart failure surgeries • Heart transplantation • Key-hole Robotic Cardiac surgeries

• A well-equipped theatre with an invasive multichannel monitor including monitoring of ETCO2

The past year has been a dynamic one. With the

and Cardiac Output.

same enthusiasm, dedication and commitment, we

• Nine-bed ICU with multi-channel monitors, latest Ventilators, and IABP machines.

are looking forward to meet all the challenges in the years ahead.

• Transesophageal Echocardiography.

The Department of Cardiothoracic Surgery provides national expertise in various cardiac procedures and also in various thoracic and vascular procedures. The year 2008-2009 has been a very satisfying year for our department. We continue to have to our credit a record number of cases done in a single year.

Cardiothoracic & Vascular Surgery

Statistics: The total number of cases done for the year 2008-2009 was 489 with an age range of 3 days to 82 years. This covers the entire gamut of cardiothoracic surgery including Coronary bypass surgery, Valvular heart surgery, Congenital cardiac surgery and Thoracic and Vascular surgery. In Coronary revascularisation surgery, the main emphasis is on Beating Heart CABG because this is a new and exciting development in the field with significant reduction in mortality, rate and cost. About 85% of our coronary revascularisation has been done on a beating heart. The exact number of cases in each field is given in the table. We emphasize on total arterial revascularisation to achieve better patency rate of the grafts. We undertake all high-risk cases like those with low ejection fraction, ventricular aneurysm, concomitant carotid stenosis and ischemic mitral regurgitation.

excellent results. Our results with valve repair have improved after attending various workshops on this aspect by International faculties at various centers by our surgical team. Transesophageal echocardiography performed routinely by our cardiac anaesthesiologists provides valuable support with encouraging results to the cardiac surgical team.

In Valvular heart disease, apart from routine valve replacement, valve repair and Atrial Fibrillation ablation (Maze Operation) are also being done. Valve repairs conducted by experienced surgeons have been found to offer substantial advantage over replacements in terms of lowering the valve related complications. In our department, we also offer valve repair to suitable patients and have witnessed

Our results have been very gratifying with internationally acceptable results. Our mortality for elective operations is less than 1%. Even in emergency operations performed on patients in Cardiogenic shock, the department has shown good results. We are one of the few hospitals in the country offering Endoscopic Vein Harvesting Technology to our patients at an affordable cost.

In Congenital heart surgery, the common operations like ASD, VSD and PDA are being carried out routinely. We have also performed high-risk complex operations like Total Correction of Tetrology of Fallot. In keeping with the latest trends in surgery, minimally invasive techniques are being applied increasingly. The number of thoracic and vascular surgeries done also contributes a great deal to the quality outcome of the department.

Facilities The Operation theatre dedicated to cardiothoracic surgery is a state-of-the-art facility with a seamless stainless steel cladding of the walls, Laminar airflow and a separate Air-handling unit for this theatre only. All these things will help to reduce the infection rate to zero. There is a ten bed ICU with all the latest gadgets, as available in the most developed centers in India. We have 3 Intra-aortic balloon pumps to salvage patients with Myocardial Infarction in Cardiogenic shock. An Endoscopic Tower has been procured for Endoscopic Vein harvesting. Endoscopic Vein Harvesting

were done in a stream of 36 hours to encourage the scheme of free cardiac surgery. The Future The future looks very encouraging. We, in the Department of Cardiothoracic Surgery share the dreams of our Founder Chairman to perform Heart Transplantation and Key-Hole Robotic Cardiac surgery in our Institution.

Statistics Total no. of Out-patients treated Total no. of In-patients treated Sl. No.

Academic Activities The department has not lagged behind in academic activities. We regularly attend conferences and workshops conducted at national and international levels, thereby pacing ourselves with the current trends in cardiac surgery. Free Heart Surgery True to our Institution’s Mission that “No man is too poor to afford first grade medical treatment”, we have strived to perform FREE HEART SURGERY on 66 persons hailing from the less fortunate economic strata. With the tremendous help from “KID AID FOUNDATION” and “ILHAM SIRAR IRUDHAYA PATHUGAPPU THITTAM” to mobilize funds, we achieved this enormous task. Among this, 11 cases

Name of the surgery

= =

5223 746 No. of cases

1 CORONARY ARTERY BYPASS GRAFT SURGERY BEATING HEART CABG ONPUMP CABG 2 OPCAB + CAROTID ENDARTECTOMY 3 CABG + MITRAL VALVE REPLACEMENT 4 CABG + MV REPAIR 5 CABG + AORTIC VALVE REPLACEMENT 6 CABG + DOR’S OPERATION 7 CABG + LV CLOT REMOVAL 8 CABG + VSD CLOSURE 9 MITRAL VALVE REPLACEMENT 10 MITRAL VALVE REPAIR 11 REMOVAL OF LA MYXOMA 12 AORTIC VALVE REPLACEMENT 13 AVR + OPEN MITRAL VALVOTOMY 14 BENTALL’S PROCEDURE 15 EXCISION OF SAM 16 DOUBLE VALVE REPLACEMENT 17 DVR + TRICUSPID VALVE REPAIR 18 ASD CLOSURE 19 VSD CLOSURE 20 VSD CLOSURE + ASD CLOSURE 21 VSD CLOSURE + PDA LIGATION 22 PDA LIGATION 23 INTRA CARDIAC REPAIR 24 THORACIC PROCEDURES 25 VASCULAR PROCEDURES 26 OTHERS TOTAL

242 26 1 1 2 5 3 3 1 22 4 1 16 1 3 1 6 3 80 10 1 1 12 9 18 15 2 489

Cardiology The Cardiology Department comprises of 24 hours emergency services to manage cases of acute myocardial infarction for thrombolysis (or) primary angioplasty and its subsequent management, and to manage cases of congestive cardiac failure for stabilization and various other acute cardiac cases. The department is well equipped with a critical care unit, with monitors and ventilators and also possesses computerized ECG, Treadmill test, colour Doppler and 24 hours holter monitoring.

CATH LAB The department has its unique two cardiac Cath labs from WIPRO GE OEC and SEIMENS medical system. The hospital is going to upgrade its Cath lab to GE-INNOVA 2001 flat panel and state-of-the-art technique Cath system. Facilities Available: 1. IABP: Used for patients with low Blood Pressure due to acute MI or other causes, for artificial maintenance of Blood Pressure in emergency situations. 2. ACT Machine: It can detect activated coagulation time, to monitor the dose of Heparin, particularly during PTCA and CABG. 3. TEE: Transesophageal Echocardiography is useful as a Diagnostic tool, to detect various cardio abnormalities particularly in the setting of any clot in Heart, ASD device closure and assessment of prosthetic valve function and also during operative procedure to assist the surgeon. 4. Stress ECHO: This modality is useful to Diagnose and Prognosticate Coronary Artery Disease patient. It is more sensitive and specific than routine Tread Mill test, performed as exercise stress echo (or) dobutamine stress echo.

5. Thallium (or) Technitum Study: We have a well equipped Nuclear Medicine department with SPECT camera for Thallium or Technetium 99 M Sesta MIBI Myocardial viability assessment study. Special Remarks To provide primary PTCA as a modality of Therapy in Acute Myocardial Infarction in Tamilnadu. In the recent past, we have done a large number of Primary PTCA in AMI including those with IABP assisted stenting. Facilities available in the Department of Cardiology • Two well equipped Hi-Tech Cath Labs - WIPRO GE & SIEMENS • Philips iE33 dedicated Colour Doppler Echocardiogram • Tread Mill Test - NASEN • Computerized Resting ECG • Holter Monitoring – DL 820-3/12 LCD Recorder • Well equipped Coronary Care Unit which comprises – NIBP Monitors, Hi-tech Cardiac Monitors and Ventilators with ICU trained cardiac nurses • Hi-tech Ambulance on call for 24 hours

Academic Activities

Intervention for Peripheral vascular disease

The National Board Examination has accredited MMHRC to conduct 3 years course in cardiology to award post-doctoral fellowship in DNB Cardiology. The cardiologists are updating their knowledge by regularly attending the National and International conferences and live workshops. Annual update of all the Interventional procedures in the National Interventional Council of India is done.

• • • •

Procedures in the department 2000 Angiograms annually and 600 Angioplasties every year. We perform 100 Balloon Mitral Valvotomies every year. Coronary Angioplasty • MMHRC performs the highest number of primary Angioplasty for Acute Myocardial infarction for entire Tamilnadu. • We also perform 2 vessel and 3 vessel angioplasty. • We also perform angioplasty in critically-ill patients with Intra Aortic Balloon Pump support. • We offer both bare metal and drug eluting stents of Angioplasties. INTERVENTION FOR HEART FAILURE MMHRC is equipped to provide biventricular pacing as a treatment for heart failure. PROCEDURE FOR CARDIAC ARRYTHMIAS • Electrophysiological study and radio frequency ablation for various cardiac arrythmias. • Implantable cardiovertor and defibrillator for prevention of sudden cardiac death. Intervention for Valvular Heart Disease • Balloon mitral valvuloplasty • Balloon aortic valvuloplasty • Balloon pulmonary valvuloplasty Intervention for Congenital Heart Disease • PDA coil closure / Device closure • ASD/VSD device closure • COA balloon angioplasty Correction of congenital heart defects in underprivileged children is done free of cost as a part of KID AID Foundation. Children started getting benefits under this scheme.

Renal angioplasty Carotid angioplasty Iliac and femoral angioplasty Below knee angioplasty

Pericardiocentesis Emergency pericardiocentesis is done to prevent death from cardiac tamponade. Angiograms • Coronary angiogram • Cerebral, Renal and Peripheral angiogram • Cardiac catheterization with oxymetry, pressure study and angiogram for congenital heart defects PACEMAKER IMPLANTATION • Temporary pacemaker implantation on emergency basis round the clock • Single and double chamber permanent pacemaker implantation Miscellaneous Alcoholic septal ablation for HOCM Cardiologists available in the hospital Dr. R. Siva Kumar, MD., DNB., (Cardio) Dr. S. Selvamani, DNB., (Gen Med.)., DNB., (Cardio) Dr. M. Sampath Kumar, MD., DM., (Cardio) Dr. N. Ganesan, MD., DM., (Cardio) Cardiac procedures in the Cath lab Coronary Angiogram Right heart catheterization Coronary angioplasty/stent implantation including primary PTCA Balloon mitral valvuloplasty Balloon aortic valvuloplasty Balloon pulmonary valvuloplasty Balloon tricuspid valvuloplasty PDA coil closure/Device closure Temporary and permanent pacemaker implantation ASD / VSD device closure COA balloon angioplasty Carotid and renal angioplasty 15

Conferences attended by Dr. R. Sivakumar, MD., DNB., (Cardio)

Non-cardiac Procedures Aortogram Cerebral Angiogram Renal Angiogram Peripheral Angiogram Mesenteric Angiogram Renal angioplasty / stent implantation Peripheral angioplasty / stent implantation Therapeutic vascular embolisation STATISTICS FROM APRIL 2008 to FEBRUARY 2009 CORONARY ANGIOGRAM PTCA BALLOON MITRAL VALVOTOMY PERMANENT PACEMAKER IMPLANTATION LOWER LIMB ANGIO CEREBRAL ANGIO RENAL ANGIOPLASTY IABP PERICARDIAL TAPPING TEMPORARY PACEMAKER IMPLANTATION CARDIAC CATHETERISATION PERIPHERAL ANGIOGRAM PERIPHERAL ANGIOPLASTY PDA COIL CLOSURE PTBD ASD DEVICE CLOSURE IVC FILTER RENAL ANGIOGRAM AORTOGRAM BALLOON PULMONARY VALVOTOMY BALLOON AORTIC VALVOTOMY AORTIC STENTING ICD CAROTID ANGIOPLASTY E.P. STUDY OTHERS Total Out patients Review cases New cases In patients

= 1544 = 542 = 126 = 16 = 12 = 03 = 09 = 32 = 05 = 40 = 25 = 04 = 01 = 29 = 16 = 11 = 02 = 10 = 02 = 03 = 04 = 01 = 01 = 01 = 14 = 23 2476 =8891 =6344 =2547 =1901

1. April 2008 participated as faculty at an interventional meet at Dubai. 2. July 2008 update on hypertension at Hong Kong. 3. June 2008 ESC at Munich, Germany. 4. September 2008 Indo-French meet at Nantes, France, participated as Faculty and chaired a live case session. 5. October 2008 TCT, Washington DC, U.S.A. 6. February 2009 ‘SINGLIVE’ at Singapore. Conferences attended by Dr. S. Selvamani, DNB (Gen. Med) DNB. (Cardio) 1. March 2008 – Greece - Intervention conference presented cases 2. May 2008 – EUROPCR conference at Barcelona, Spain 3. October 2008 - TCT-Intervention Cardiology Conference at Washington, U.S.A. 4. December 2008 - Indo European conference at London; U.K., Revascularisation – Presented cases and won the best case award 5. August 2008 - Meet at Chennai for aliskirinen trial investigation. Conferences attended by Dr. N. Ganesan, M.D., D.M., (Cardio) 1. July 2008 - ACT Conference, Chennai 2. August 2008 - World Cardiology Symposium, Singapore 3. September 2008 - Tamilnadu CSI Cardiology Conference, Kodaikanal 4. December 2008 - Annual CSI Cardiology Conference, Chennai 5. January 2008 -Trans Radial Interventional Workshop, Ahmedabad 6. February 2008 - Interventional Workshop, Delhi

Community Care Centre Mother Teresa Community Care Centre provides excellent care and support services to people living with HIV/AIDS under the eminent leadership of Dr. V. N. Rajasekeran, Medical Director and Dr. Senthil Prabakar, Dermatologist. Since 1998, Mother Teresa Ward serves the PLWHAs to lead a safe, long and peaceful life under the aegis of Tamilnadu State AIDS Control Society (TANSACS), Chennai. The Centre aims at providing comprehensive services in the area of Medical care, counselling, home care, nutritional training & support, hotline service, networking, recreation facilities, medication, referral services for ART adherence and intervention with other NGOs. This 10 bedded, free ward provides IP & OP consultation, drugs, food, counselling, yoga, psychological support, round the clock nursing care, ARV collaboration with Government Rajaji Hospital, HIV test, referral services and testing and treatment for tuberculosis totally free of cost.

FACILITIES AVAILABLE: 1. 10 spacious cubical rooms with centralized oxygen supply 2. 24 hours specialized nursing care 3. Counselling room 4. Video hall 5. Yoga Therapy 6. Library 7. Procedure room 8. ICTC lab

STATISTICS Apr â&#x20AC;&#x2122;08 to Mar â&#x20AC;&#x2122;09 IN PATIENTS OUT PATIENTS DELIVERY MINOR OPERATIONS

504 949 2 12

The department of Dental & Oromaxillo facial surgery offers efficient dental services to all people, which is equipped with modern sophisticated dental chairs and latest instruments for precision and provision of best dental aid to all. We provide uncompromising choice of quality dental materials, equipments and condition of asepsis.

Dental & Oral Surgery

Facilities Available: I Routine dental treatment procedure

9. Management of infections of dental and orofacial regions

1. Extraction

10. Management of TMJ related problems

2. Oral prophylaxis, scaling and polishing

11. Periodontal and gingival surgical procedure

3. Tooth coloured filling

12. Dental management for medically compromised

4. Removable orthodontic appliance

patients

5. Removable partial denture

13. Paediatric dentistry

6. Complete denture

14. Dental management in pregnancy

7. Porcelain / metal crowns & bridges 8. Root canal treatment

AWARENESS PROGRAM: Regular dental camps are conducted in schools and

II Specialized treatment procedure

colleges for screening and oral hygiene education in

1. Dental Implants

and around Madurai.

2. Correction of abnormal positioned tooth by

Dental camps for general public are being held

orthodontics (Fixed/Removable/Surgical)

every Wednesday in the dental OP in order to

3. Facial cosmetic surgery

create awareness.

4. Management of impacted teeth and related problems 5. Dento alveolar surgery

Statistics

6. Management of dento facial trauma

In patients

7. Surgical management and reconstruction for cysts

Out patients

2448

New

478

Review

1970

and tumors of the jaws 8. Endodontic surgery â&#x20AC;&#x201C; Apicectomy

The department of Dermatology, Cosmetology and Venereology is in touch with the latest development in the field. It deals with various dermatological procedures apart from accurate diagnosis for even troublesome, acute and chronic diseases. We have a good track record of recovery for many life threatening drug reactions like Toxic epidermo necrolysis, SJS and various vesiculo bullous diseases. The various routine daily procedures carried out in the Department of Skin and Cosmetic Laser clinic are as follows:

Dermatology & Venereology

Treatment

Disease

1. Melanocyte Transfer – Punch Grafting & Epidermal Grafting Tattooing

Leukoderma (Vitiligo)

2. PUVA treatment Psoriasis Chronic eczema with lichenification Acne and its scar Hyper pigmentation (Melasma) Facial Rejuvenation Keloids, wart and corn foot Excessive Hair (Hirsutism) Androgenetic alopecia Tattoo removal / Freckles Nevus of Oto & post inflammatory pigmentation Department Statistics Out patients New Reviews In patients

: : : :

PUVA Therapy & NB UVB Therapy Dermabrasion – (Micro Motor) 1. Co2 laser scar revision 2. Micro dermabrasion 3. Comedone Extraction Chemical peeling Microdermabrasion procedure Cryotherapy Diode Laser & Electroepilation Hair Transplantation Q-switched Nd – Yag Laser

6053 1500 4553 122

Diabetology It is obvious that in countries like India, the rising prevalence of Diabetes with its complications are likely to produce severe constraints on healthcare budget in future. WHO estimates that around 171 million individuals had diabetes in the year 2000 and would increase to 366 million by the year 2030. India has the dubious distinction of being called the â&#x20AC;&#x153;DIABETIC CAPTAL OF THE WORLDâ&#x20AC;? as more than 40 million adults are suffering from diabetes and the number is likely to go up to 80 million by the year 2030.

“PREVENTION IS BETTER THAN CURE”, is a well known proverb and only ‘Activation’ of this proverb provides the solution to achieve noble healthcare.

FUTURE PLAN • SOUND HEALTH EDUCATION (BY PROVIDING MATERIALS LIKE MONTHLY

Our department is a small one with big service hearted

- MAGAZINES & SCREENING CAMPS).

persons to serve the society. We have “Out patient and

• DIABETIC CLUB

In patient services”. The Department of Diabetology

• DIABETIC SHOPPE

takes immense pride in providing CONSULTATION

• DIABETIC FOOT CLINIC

LIAISON services to other departments of MMHRC.

• PODIATRIC CARE • PATIENT EDUCATION

Most of the Diabetes patients suffering today need

• OBESITY CLINIC

good care by a “DIABETOLOGIST” to keep their sugar under control to avoid further complications like Diabetic Neuropathy, Diabetic Retinopathy & Diabetic Nephropathy. We favour our patients by educating them about the above problems and make them ready for evaluating the same periodically.

STATISTICS APRIL 2008 – MARCH 2009 OUT PATIENTS (NEW)

418

OUT PATIENTS (REVIEW)

4054

IN PATIENTS

281

We carry out our ‘Primary care’ by education of the patients about the disease and make them ready for

AWARENESS CAMPS ON DIABETIS DAY:

further follow up. We conduct camps for the public and

The World Diabetes Day logo is a blue circle, the global

persons in need to control Diabetic complications in

symbol for diabetes developed by the United Nations as

the future. Our ‘Secondary care’ aims to control the

a part of Diabetes Awareness campaign. The logo was

individual patient’s sugar level and make referrals to the

adopted in the year 2007 and the circle symbolizes life

concerned departments for the evaluation of diabetes

and health. The blue colour reflects the sky that unites

related complications. A Dietician gives a free hand

all the nations. The blue colour signifies the unity of the

advice to our patients on how to restore their health by

global diabetes community in response to diabetic

Diet Advice.

pandemic. November 14th is World Diabetes Day and our department has arranged a camp for screening diabetic patients. Around 150 new patients were screened on World Diabetes Day and treatment was given to them. CONCLUSION We aim for the ‘Quality Care of patients we treat rather than Quantity of Patients’. We are aware that patience is needed to achieve our Mission and we are proud to say, “We are just a brick in the pillar of MMHRC”.

General Medicine The department of General Medicine is a core department of the hospital and has treated and admitted maximum number of patients. The department is manned by eminent consultants, senior medical officers and researchers under the able guidance of Dr. V. N. Rajasekaran, Medical Director.

The Specialities

Major and Minor Procedures

� Asthma and Allergy Clinic

� Bone Marrow Aspiration

� Diabetes & Foot Care

� Lumbar Puncture

� Geriatric Clinic

� Pleural Aspiration

� Respiratory Medicine

� Liver Aspiration

� Haematology

� I.C.D. Procedure

� Computerized Pulmonary Lung

� Diagnostic Tapping

Function Test � Comprehensive Asthma Care Clinic � Tuberculosis Clinic � Lung Biopsy � Pleural Biopsy by Abram’s and Cope’s pleural biopsy needles � FNAC lung and tube thoracostomy

� Liver Biopsy Procedure

The Recap • A one day CME Programme Medicine 2008 on September 14th 2008 (Sunday) at our Conference Hall – I. • National Conference of IMA CGP 2008, Practicon 2008 on 13th and 14th December 2008, at our Conference Hall – I. • TAPICON – 2008 State Level Conference at Tiruchirapalli.

Dr. V.N. Rajasekaran, Medical Director & HOD of Medicine � APICON – 2009 – All India Physician Association Conference at Noida � Medicine Dept. Post Graduate Students present the Oral Paper Oral Paper Presentation – Use of Primaquine in SARS and HIV Infections by Dr. S. Sheela IMA State Level Conference at Kumili in May 2008

• Medicine Dept. Post Graduate Students presented the Oral Paper on Clinical Profile of Thrombocytopenia and Dr. Sabarinathan won the II prize. • Poster Presentation: A Comprehensive Study on Optitoxemia by Dr. S. Sheela • Poster Presentation: Clinical Profile of Extra Pulmonary Tuberculosis by Dr. S. Cardia

Paper Presentation - Dr. S. A. Rajarathnam Oration Award(IMA) Clinical Applications of Fibreoptic Bronchoscopy STATISTICS All types of Fever

4312

All types of Neoplasms

1459

Circulatory diseases

3760

Digestive Systems

1395

Metabolic diseases

2484

Physician & Haematologist

Genito Urinary diseases

769

Haematological diseases

1749

� August – 2008 – Indian Society of Blood Transfusion

Mental disorders

1208

Nervous systems

1199

Others

3283

Respiratory diseases

2851

Total

24469

• Poster Presentation: Audit on Bone Marrow Aspiration Studies by Dr. Santosh Hedau Dr. P. Krishnamoorthi, Senior Consultant,

Medicine Conference at Pune � October – 2008 State level IMA Conference at Chennai as a Faculty � November – 2008 Indian Society of Haematology

Endocrine, Nutrition and

Conference at Pondicherry � January – 2009 Indian Society of Haematology Conference at Mumbai

Imaging Sciences And Interventional Radiology The department of Imaging & Interventional Radiology has been showing a steady growth over the last decade with addition of latest equipments every year to offer the best to our patients. This year we have installed a high end 3D Rotational Angiography Unit, the first of its kind in this part of our country , which will help us deliver advanced interventional radiology procedures to treat complex vascular lesions of Brain and Spine and also to perform the routine interventional procedures with high precision. A 1.5 Tesla MRI unit will be installed shortly this year with latest softwares which will take our diagnostic abilities to higher level. Academic activities : This year we have planned to conduct training programme for DNB Radiodiagnosis postgraduates to help them face their exams with confidence. We have started a teleradiology programme in our dept through which we are planning to offer reporting and teleconferencing programmes. We are also conducting short term training programmes for radiologists in Ultrasound , CT, MR and Basic Interventrional Radiology techniques.

Diagnostic and therapeutic procedures

Ultrasound

• Diagnostic Angiographies. • Embolisation of Uterine, Bronchial , Hepatic, Renal and peripheral arteries. • Peripheral Angioplasty and stenting. • CT and ultrasound guided Biopsy and aspiration.

Color Doppler Echocardiography

1,253

Doppler procedures

2367

Doppler studies of various organs

19037

Routine U/S imaging

54, 627

3D ultrasonography

682

• Carotid and Renal Angiography and stenting. • Mammography Biopsy

• Hepato biliary interventions PTBD, Stenting

Routine CT scans

• Radiofrequency ablation of Tumours

CT guided procedures

532

• Real time 3D ultrasonography guided Biopsies.

Coronary angio.

340

5748

• Image guided neurolysis for chronic pain. EUS: 636

• Vertebroplasty. • Endosonography guided Biopsy and drainage.

CONFERENCES ATTENDED

• CT coronary angiography. Equipments

DR. T. MUKUNTHARAJAN 01. ISVIR NATIONAL MEET , MUMBAI

• X-ray machines –Ranging from 20 – 800 MA

INVITED FACULTY.

• Image Intensifier • Mammography

02. RAIN , CHENNAI.

• Voluson E8–high end 4D whole body colour Doppler

03. DVT INVESTIGATOR MEET, MALAYSIA.

• Logiq 5 -Colour Doppler • Logic E book portable colour Doppler ultrasound

DR. N.KARUNAKARAN

• INNOVA 2100 3D Cath Lab

01. HEAD AND NECK IMAGING – TARGET - CHENNAI.

• Seimens Axiom Artis U Cath Lab

02. PAEDIATRIC RADIOLOGY ANNUAL CONFERENCE – CHENNAI

• Computed radiography.

03. MRI UPDATE - MUMBAI

• Multi slice CT scanner • Open MR system.

DR. R. GANESH

• Endoscopic ultrasonography.

01. MUSCULOKELETAL RADIOLOGY REVIEW COURSE - MUMBAI

Glimpse of facts

02. DR. HARNAM SINGH MID TEM CME - CHENNAI 03. SPIRAL CT UPDATE – GOA.

Radiology Routine x-rays

52,326

Contrast studies like IVU and Barium etc,

3,128

MEETING CONDUCTED 01. MONTHLY RADIOLOGY CME.

Inverventional radiology: Angiographies,

307

Angioplasties and Stenting, Embolisations Drainage procedure and Biopsies

114 890

Intensive Respiratory Care Unit This critical unit operates with a strength of 11 cubicles, assures maximum isolation, barrier nursing, privacy and sterility, providing intensive care and high dependency care in the same unit with the aid of appropriate pharmaceutical, therapeutic and diagnostic interventions and modest technical backup. The new configuration Provision for Neonatal mechanical ventilation by dedicated team in Neonatal ICU. Our technical arsenal Sophisticated monitoring devices, drug delivery systems, and new generation of Mechanical Ventilators aided by smooth man-machine interactions.

We take pride in ... Vigilant and dynamic monitoring by a dedicated team, motivated and guided by a team of full time Anaesthesiologists, delivering excellent patient care with a humane touch. We indulge in • Enhancing practical skills in the handling of complex equipments, monitoring procedures and performance of Invasive techniques. • Enhancing clinical skills in recognizing, preventing and managing critical illness, infection control and organ support. Our Collaterals: • Trained physiotherapy unit • Dieticians • Biomedical backup • Family counseling / Psychiatric consultation for patients who attempted suicide Our key to success Patient centered comprehensive, multidisciplinary care with coordinated, collaborative and cost effective approach in a compassionate and healing environment.

We deliver

Our performance

• Advanced Mechanical ventilatory therapy

Total No. of Admissions

1,186

i) Adults

1,104

ii) Paediatrics

Total No. of patients on Ventilator

930

temporary cardiac pacing

Total No. of poisoning patients

172

Mechanical ventilatory support for post-

Total survival rate

84%

operative and polytrauma patients

Survival rates - ventilated patients

80%

• Management of complicated Organo-

Survival rates - poisoning patients

98%

including Non-Invasive ventilation • Neonatal ventilation in dedicated Neonatal ICU • Percutaneous dilational tracheostomies • Central venous and arterial cannulations and •

phosphorus poisonings with encouraging and successful outcomes • Orientation, teaching and training programmes for medics and paramedics

The year 2008-2009 saw the laboratory services excel in many ways. While there was further investment in newer technologies, there was also excellence in performance. The number of blood sample collections increased to 1,50,177 with an average of 14,000 collections per month. This is an increase from an average of 11,000 per month last year. A total of 3,48,385 tests on biochemical parameters were done and 16,229 hormone assays were performed. 2,74,255 tests were performed in haematology. 8,858 biopsies were reported and 293 special tests were done in histopathology. 18,936 cultures were performed and 66,466 serological tests carried out in microbiology. The blood bank collected a total of 6,668 units of blood. 32,247 blood groupings were done and 10,475 units of blood or blood components were issued. The number of apheresis procedures done was 57.

Laboratory Services

EQUIPMENT INSTALLATION In April 2008, the Vitros system from Ortho Clinical Diagnostics, a unit of Johnson and Johnson was installed in the blood bank, which uses the chemiluminiscence method for immunoassays (CLIA). This system is used for screening of blood for various diseases such as HIV, HBsAg and HCV, which are carried out on each unit of blood that is issued from the blood bank. By installing this system, the safety of the blood issued has increased tremendously. At the same time, a dry chemistry system also from Ortho Clinical Diagnostics was installed in Biochemistry. This system eliminates the usage of liquid reagents. In August 2008, the LH750 from Beckman Coulter was installed in Haematology. This was in view of the increase in workload. This machine has the added advantage over the previous AL in that we can now report nucleated RBCs, which was not possible previously. In addition, the turn-around time (TAT) for haematology tests has come down to one hour.

EXCELLENCE IN PERFORMANCE The Biochemistry department was ranked 10 out of a total of 121 laboratories participating in the national external quality assurance programme of BioRad (US). This list includes the most reputed hospitals and laboratories in the country. The laboratory started a quality circle called the Ruby Quality Circle. It won the Excellence Award at the 18th chapter convention on Quality Circles 2008, held at Kodaikanal for its project on reducing delay in reporting. CONFERENCE The Laboratory Services organized a National Conclave in Clinical Laboratory Management on the 14th and 15th of February 2009. It was followed by a workshop on NABL standards. It was well attended by delegates from all over South India.

Medical Oncology services can be broadly divided into curative, palliative and supportive care therapies based on the stage of disease and the performance status of the patient. Curative arm comprises of cancers that are curable with chemotherapy alone like ALL, AML, Testicular tumours, chorio carcinoma and lymphomas where irradiation may be added if required as consolidation. The other curative role of chemotherapy is either as neo-adjuvant given before surgery or as adjuvant after surgery like in cancer of breast. Chemoradiation has now been proven to be superior to radiation alone in cancer â&#x20AC;&#x201C; head & neck and cervix . With the help of the Department of Surgical and Radiation oncology and other department colleagues of our institution, Medical oncology department has been able to serve the patient suffering from cancer in a holistic manner with particular attention to the patientâ&#x20AC;&#x2122;s disease, financial status, his emotional status, and also that of his / herâ&#x20AC;&#x2122;s close relatives. If required, help of our counsellor is also utilized to help patients tide over the emotional crisis.

Medical Oncology

Financial help upto the extent of free stay and treatment charges are done for deserving patients especially children who are on treatment for Acute lymphoblastic leukemia / lymphomas. Patient compliance is improved with the use of Day care chemo where patients need not spend money and time for admission for the sake of chemotherapy. We plan to improve the facilities of day care room with better reclining chairs, Television programmes and magazines while the patient undergoes chemotherapy. Support from blood bank with the help of single donor platelets which increases the platelet count more rapidly with less risk of alloimmunisation in patients who need long term platelet support like AML on treatment is also utilized.

Targeted therapy is now widely used in our department as per international protocols like Rituximab for B-cell lymphomas, Bevacizumab for metastatic colorectal cancers etc. Various studies are being done in isolation and as part of larger multicenter trials which help to keep the academic interests alive and for the benefit of the patients with cancer. Procedures like Bone marrow aspiration & biopsy, intrathecal drugs and other intervention are routinely done in the department. We hope to establish a full fledged Bone marrow transplantation unit in the near future to cater to the needs of the people of South Tamilnadu which will help patients suffering from Leukemia, Lymphomas and Myeloma apart from curable haematological diseases like aplastic anaemia and Thalassemia.

Department of Nephrology took giant strides in the year 2008-09. The addition of Continuous Renal Replacement Therapy marks a new era in the treatment of acute renal failure. The march forward in providing the standard of care in haemodialysis, peritoneal dialysis and transplantation continued relentlessly. Academics were at the forefront with more than 10 publications and awards plenty. Continuous renal replacement therapy Acutely ill renal patients have multi system involvement with coagulation abnormalities and low blood pressure. Although dialysis is life saving, conventional haemodialysis is impossible due to its inherent limitations. State-of-the-art and first of its kind in South Tamil Nadu, PRISMA CRRT machine acquired by the department facilitates renal replacement therapy for all acutely illpatients in the form of CVVH and CVVHDF. The machine can take up all forms of ARF including post-operative, obstetric and DIC associated ARF as the system can support anticoagulation free dialysis in haemodynamically unstable patients. Additionally SCUF can be used to treat refractory heart failure with pulmonary edema and Plasmapharesis can be taken up where indicated.

Nephrology

We saw additional new haemodialysis machines in the past year and are eagerly awaiting the commissioning of the new dialysis unit in the adjacent building. This capacity upgradation has seen us stay ahead with workload of more than 1000 cases per month . The state of the art Osmonics Water Treatment system is installed and will improve the already high standards of care in haemodialysis. Peritoneal dialysis catheter insertion done percutaneous has seen a tremendous growth last year earning the Department the distinction of single largest number of CAPD initiations in a calendar year. Plasmapharesis and acute peritoneal dialysis including automated cycler exchanges is performed regularly. Transplantation Our centre has continued the excellent transplantation program where related donor renal transplantation is done with the latest immunological and imaging workup. The surgical team has done laparoscopic donor nephrectomy bringing advantages of shorter hospital stay and less painful surgery to the donor. In early February â&#x20AC;&#x2122;09, we carried out the first ever multiple organ procurement from a deceased donor from southern district of Tamil Nadu. Double renal transplantation was carried out in two renal failure patients.

Interventional nephrology The department has always been at the forefront of the evolving field of interventional nephrology. Routine tunneled haemodialysis catheter insertion and percutaneous peritoneal dialysis catheter were undertaken. Urology colleagues have been creating permanent vascular access with AV fistula while Radiologists have been of great help in performing sonographically guided renal biopsies and renal angioplasty. Academics New postgraduates have registered each successive year with National Board under the able guidance of Dr. K Sampathkumar for training as Diplomate of National Board in Nephrology. The ISN CON 2007 saw us achieve accolades with the first prize in both oral and poster papers. Dr. K Sampathkumar has successfully organized the ISN SC CON at Mysore in February 2008 and ISNSC CON 2009 at Kanyakumari. The first live interactive Interventional Nephrology workshop of India was organized at Kanyakumari under the southern chapter of Indian Society of Nephrology. Future developments 1. Collaboration with International Society of Nephrology for sister renal unit programmes. 2. Collaboration with International Society of Peritoneal dialysis for academic exchange programme. 3. Setting up a Renal Research cell for south Indian Kidney diseases. Publications: 1. Sampathkumar K, Sooraj YS, Ajeshkumar RP, Mahaldar AR, Muthiah R.The Case | Acute paraplegia with anuric ARF. Occlusive aortic thrombus with ischemia of spinal cord and kidneys.Kidney Int. 2007 Sep;72(5):657-9. 2. Sampathkumar K, Murali TR, Sooraj YS, Mahaldar AR. Emphysematous prostatitis in renal transplant. Indian J Urol 2007;23:476-8 3. Sampathkumar K, Sooraj YS, Ajeshkumar RP, Mahaldar AR, Muthiah R. Rhabdomyolysis due to hair dye poisoning: An emerging threat. Indian J Crit Care Med 2007;11:212-4 4. Sampathkumar K, Mahaldar AR, Sooraj YS, Ajeshkumar RP, Muthiah R:Milk Alkali Syndrome-Old Wine in a New Bottle. I journal of peritoneal dialysis April 2007,41-43

5. Sampathkumar K, Mahaldar AR, Sooraj YS, Ajeshkumar RP, Muthiah R: Percutaneous CAPD catheter insertion by nephrologist. I J Nephrology April 2008 6. Sampathkumar K, Sooraj YS, Ajeshkumar RP, Mahaldar AR, Muthiah R: Lathanum deposits in colon- a new phenomenon I J Nephrology April 2008 7. Sampathkumar K, Sooraj YS, Ajeshkumar RP, Mahaldar AR, Muthiah R -Jouberts syndrome with renal failureKidney International, 2008 8. Niacin for phosphate control â&#x20AC;&#x201C; perspective from a developing country.Krishnaswamy Sampathkumar, International urology and Nephrology journal, November,2008. 9. Hair dye poisoning â&#x20AC;&#x201C; An emerging threat in the developing country.Krishnaswamy Sampathkumar, Sooraj YS.Journal of emergencies and trauma. February,2009. 10. Granulomatous interstitial nephritis due to renal tuberculosis. Krishnaswamy Sampathkumar, SoorajYS, Amol Mahaldhar, Ramakrishnan, Ajesh Kumar. Saudi Journal of Kidney disease and transplantation, 2009 11. Is there an urban rural divide in the CAPD results-. Indian journal of Peritoneal dialysis.June 2009. Amol Mahaldar,Sampathkumar, AjeshKumar, Ramakrishnan. Total Number of Kidney Transplantations Total OP Patients Total Review Total Admission Total New Cases Total Haemodialysis Renal Transplantations CAPD PD Renal Biopsy CRRT Plasma Pharesis Permcath Insertions

= = = = = = = = = = = = =

355 20,862 19,641 1811 1,196 11,096 26 21 23 122 40 10 20

The Department of Neurology has come a long way since its inception stage to its present stage with enthusiasm and agility. We have got two consultant neurologists and 3 young medical officers full time. Neuro emergencies are managed with zero delay showing faithful precision and devoted care. Our stroke unit is one of the novel components of the hospital and is unique among a few of similar units, throughout India. We have all the facilities for the management of stroke, intervention to rehabilitation.

Neurology

All types of Neurological disorders are managed appropriately. Our Neuro physiology lab, not only has EEG, EMG and Evoked potentials, but also, a well renowned sleep laboratory. Neuro sciences department of MMHRC is recognized for its teamwork approach in stroke management. Our timely hemicraniectomy intervention for malignant MCA infarct cases has been recognized internationally. Statistics New

1,563

Review

3,931

Total (OP)

5,494

Admission (IP)

730

The department of neurosurgery continues in its effort to give comprehensive neurocare for the patients down south Tamilnadu. The year April 2008-March 2009 is another period of growth for our department. To add to our efforts ,our department has been recognized for DNB training in neurosurgery from this year. This year we shifted to the new OT complex with state-of-the-art facilities. The whole gamut of neurosurgery was done this year from the basic shunts and head injury to the most complicated procedures in brain and spine. Our department is now becoming the referral centre for complex brain tumours. One of the interesting and difficult tumours which we operated is a brain stem cavernoma which only a few neurosurgeons would operate even in best of centres in India. This year there has been an increase of number of aneurysms and endoscopic surgery performed in our department. We conducted our annual CME on the month of October and it was attended by over 100 doctors down south Tamilnadu. Our Senior Consultant neurosurgeon Dr. K. Selvamuthukumaran attended the Neuroendoscopic Workshop held at GHENT, Belgium. Todayâ&#x20AC;&#x2122;s dream is tomorrowâ&#x20AC;&#x2122;s reality and our dream next year is to have a full fledged neuroendoscopic system so as to expand our endoscopic neurosurgery from pituitary tumours and CSF rhinnorhea to other areas of brain.

Neuro Surgery

Elective

Emergency

Tumour : Supra tentorial

Trauma

101

EVD

Stroke

Spine : disc and stabilization procedures :

Chronic SDH

Infra tentorial Shunt Spinal tumour

Others

Intra Cranial aneurysm

Total

319

Tethered cord

Cranioplasty

Endoscopic procedures

Total number of New patients

941

CV junction

Total number of Review patients

3073

Osteomyelitis

Total number of Outpatients

4014

Abscess

Total number of Inpatients

923

Nuclear Medicine This is a relatively new branch of imaging science, concerned with the FUNCTIONAL EVALUATION of various organ systems of the body. The procedures are very simple, whereby, the appropriate radiopharmaceuticals are injected intravenously and the emitted gamma rays (similar to X-rays) are detected by means of a gamma camera. Some of the well known applications of Nuclear Medicine include Estimation of individual kidney GFR / split function, Differentiation of non-obstructive from obstructive hydronephrosis, screening for skeletal secondaries in patients with known malignancies which are prone to disseminate the skeletal system, e.g., CA Prostate, CA Breast, Assessment of inducible ischemia and viability, Detection of ectopic gastric mucosa, Function evaluation of thyroid gland, detection of ectopic thyroids. Therapeutic applications of nuclear medicine include treatment of hyperthyroidism and post-operative ablation of remnant thyroid tissue / differentiated secondaries in patients with differentiate carcinoma of thyroid. The performance ... No. of Out patients

1,143

No of In patients

Diagnosis scans

1,378

Low dose Iodine whole body scans

140

110

Low dose Iodine – 131 therapy for hyperthyroidism High dose Iodine – 131 therapy for differentiated carcinoma of thyroid (post-operative)

Conferences Attended: 1. GFR Estimation: Comparison between gamma camera method and various bedside prediction equations in voluntary renal donors (Oral Presentation) at the 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine, 1-6 May 2008, Gold Coast, Australia. 2. Caroli’s Disease – A rare case report (Poster Presentation) at the 55th Annual Meeting of the Society of Nuclear Medicine, 14 – 18 June 2008, New Orleans, USA.

Inauguration of Maternal and Fetal Medicine Unit at MMHRC

Obstetrics And Gynaecology The department of Obstetrics and Gynaecology is a well established tertiary referral centre for management of various high risk pregnancies . Teamwork is the hall mark of managing these high risk cases. Considering the special needs of pregnancy, we are in the process of establishing the “Maternal and Fetal Medicine Unit” the first of its kind in South Tamil Nadu. As an initial move, we conducted a CME programme in November 2008 and subsequently a 15days workshop in February 2008 on Fetal medicine under the guidance of Dr. Asha Righsinghani, Visiting Professor, Maternal and Fetal Medicine Division, Department of Obstetrics and Gynaecology , University of IOWA, USA. Dr. S. Padma , Senior consultant attended a 10 day workshop on Fetal Medicine at AIIMS in August 2008 .

We performed Intra Uterine Transfusion

with international standards for performing minimal

successfully twice for a patient with hydrops foetalis for

access surgeries, at an affordable cost. We have

the first time in South Tamil Nadu. Apart from that

performed more than 1000 major laparoscopic

various medical and surgical problems complicating

procedures in the past 4-5 yrs and propose to perform

pregnancies are managed in the most appropriate way

more number of endoscopic surgeries to keep up with

in liaison with various specialists available under one

the increasing patient demand for such surgeries .

roof. Other services offered include painfree labour –epidural labour analgesia, counseling and

The laparosocpic surgeries performed include Total

management of recurrent pregnancy loss.

Laparoscopic Hysterectomy, Salphingostomy/ Salphingectomy for Ectopic pregnancies , Ovarian cystectomy,

Gynaecology has various emerging sub-specialties

Myomectomy, Endometriosis ablation, Sterilisation etc.

oncology, urogynaecology, endoscopy etc. The hysteroscopic surgeries performed include Endoscopy:

Diagnostic procedures ,Polypectomy, Endometrial

We are backed with all state-of-the-art facilities at par

ablation and Septal resections

Urogynaecology

STATISTICS

Site specific repair of pelvic organ prolapse is performed –including mesh repair. All procedentia patients are treated by Sacrospinous vault fixation successfully to prevent recurrent vault prolapse. Similarly, patients with post hysterectomy vault prolapse are also successfully managed with colpopexy

LSCS

255

D’LAP & PROCEED

TAH WITH BSO

106

LAVH WITH BSO

TLH WITH BSO

WERTHEIMS HYSTERECTOMY

STAGING LAPAROTOMY

VAGINAL HYSTERECTOMY

OBSTETRIC HYSTERECTOMY

LAPAROTOMY & PROCEED

MYOMECTOMY

LAP ASSISTED MYOMECTOMY

D’HYSTEROSCOPY & PROCEED

D’ HYSTERO LAP

HYSTEROTOMY

LAP.CHOLE WITH TAH

CERVICAL ENCIRCLAGE

SELECTIVE FETAL REDUCTION

TCRE

EUA & PROCEED

LAP STERILISATION

EVACUATION OF HEMATOMETRA

MANUAL REMOVAL OF PLACENTA

COMPLETE PERINEAL TEAR REPAIR

LABIAL ADHESION RELEASE

CERVICAL DILATATION

D&C

COLPOSCOPY

TOTAL

863

Gynaec Oncology We hosted the prestigious XVI Annual Conference of the Gynaecological Oncologists of India AGOICON 2007 in Nov. 2007 . Dr.S.Padma, Senior Consultant, delivered a guest lecture on “ Role of nurses in cervical cancer prevention ” at AGOICON 2008, held at Hyderabad in Nov. 2008. Regular opportunistic screening by pap smear, VIA (visual inspection after acetic acid) is integral part of patient examination .We have done approximately 10,000 pap smears in the past 5yrs. Patients with abnormal pap smears and positive VIA are further evaluated and treated with the aid of colposcope. Appropriate radical surgeries are done for patients diagnosed to have malignancies of various parts of female genital tract Academics The department is recognized by the National Board of Examination, New Delhi, for the Diplomate of National Board degree in Obstetrics and Gynecology. The academic course starts in the month of June and we admit 4 candidates each year 2 primary and 2 post diploma Dr. G.Sujatha, Post DGO, DNB Resident delivered a presentation on Uterine artery embolization-series of cases in June 2008 at MOGS , Madurai . She also participated in Quiz programme conducted during DHAKSHIN 2008, SOUTH ZONE MEETING and received State Level 3rd Prize on infertility topics. Dr. Jayamala I, Post DGO,DNB Resident presented a paper on Primary amenorrhoea a case series in DHAKSHIN 2008, SOUTH ZONE MEETING. Dr. Vanitha Annaselvi DNB Resident presented a paper Jaundice complicating pregnancy in DHAKSHIN 2008 , SOUTH ZONE MEETING. 36

MINOR

Family planning : MTP

MTP WITH TAT

MTP WITH LAP. STERILISATION

LAP STERILISATION

PUERPERAL STERILISATION

300

Total

368

Full Term Normal delivery

LSCS

255

Forceps

Expulsion of fetus

Total

371

2. Hepatic disorders complicating pregnancy :

3. PIH

4. Pre eclampsia and eclampsia

5. Thyroid disease

6. Gestational diabetes mellitus

7. Renal disorders complicating pregnancy

8. Overt DM

9. Others

Medical disease complicating pregnancy 1. Heart disease complicating pregnancy

Obstetric complication 1. Multiple gestation

2. IUD

3. APH

4. IUGR

5. Anaemia

6. Preterm labour

7. Rh incompatibility

Gynaec

I.P Statistic

OP Statistic New Review

April

113

141

578

May

154

613

June

112

145

564

July

100

151

558

August

113

139

625

September

118

167

620

October

129

163

691

November

119

154

654

December

111

152

677

January

144

640

February

109

147

615

I.P. TOTAL

1213

OP. NEW TOTAL

1657

OP.REVIEW TOTAL

6835

Ophthalmology The department is an advanced tertiary care centre, providing sub-specialty level care to the patients. At the present time the latest evolution of cataract surgery, namely refractive cataract surgery is our forte. Our philosophy aims at providing vision exactly to suit patient needs, with greater accuracy. This service is further complemented by multifocal Intra Ocular Lenses (Multifocal IOLs) and Toric IOLs. The usual complement of services like cornea, glaucoma (field analyzer), squint, medical retina (angiography and retinal laser) is available to meet the needs of our patients. We offer emergency eye care round the clock making it a unique feature.

Our focus on community service remains unchanged.

During the year, we have collaborated with Kalasalingam

Eye camps are conducted for the poor and needy

University, Krishnan Koil, conducting basic research into the mechanisms of diabetic retinopathy resulting in the three abstract presentations in ARVO conference and publications in peer reviewed international journals.

persons in remote areas of the seven surrounding districts. The patients are provided free cataract surgery with IOL implantation along with other related care and support services. The department is gearing towards meeting the challenge of diabetic eye disease of epidemic proportions. Emphasis on screening diabetic patients, delivering counselling and treatment are the important components of this endeavour.

Out patients Out patients free cases In patients Paying cases (Phacoemulsification) In patients free cases In patients free cases (ECCE)

: : : : : :

6,659 3,800 380 320 964 720

Orthopaedics and Traumatology Centre for Joint Replacement, Arthroscopic and Spinal Surgery The Department of Orthopaedics and Traumatology has become one of the tertiary referral centre for management of musculoskeletal disorders, joint replacements, trauma, Arthroscopic and spine surgeries. The department has been recognized by the National Board of Examinations, New Delhi, for Post- Graduate training for the award of â&#x20AC;&#x2DC; Diplomate of National Boardâ&#x20AC;&#x2122; degree in Orthopaedics. The academic course starts in the month of June and we admit two candidates every year. We are backed with state-of-the-art facilities at par with international standards in the Management of Trauma and experienced to manage mass casuality cases and disaster management. Management of polytraumatised victims is a regular feature and multidisciplinary interaction under one roof is a boon for successful management of these patients. Round the clock Accident and Emergency services and readily available specialists provide the best possible treatment for patients. Teamwork has been a hallmark of functioning in this institution and availability of many teams has led to successful, simultaneous management of the accident victims, thereby, reducing the waiting time for surgery, earlier rehabilitation and also reduced hospital stay. High velocity trauma results in multiple injured patients with multisystem involvement as well as involvement of the skeletal system. We follow the latest modalities of fracture fixation which includes the AO principles and in most of the patients with long bone fractures, the patient is ambulated on the 2nd post-operative day. Intramedullary Interlocking nailing has reduced the morbidity of patients and help the patient get back to his work at the earliest. Locking Compression Plating has been a very good option in Condylar fractures, Periarticular fractures, fractures of the upper limb and in Osteoporotic fractures.

Apart from trauma, successful management of spine disorders and backache forms the mainstay of the functioning of this department. The patients are approached systematically, with the latest modalities of treatment. Patients are benefited by minimally Invasive surgeries and Endoscopic surgeries. Quite commonly we see cases who have recurrent problems and spinal deformities and the same are managed with good success to the utmost satisfaction of the patients. Lumbar and Cervical Disc surgeries with or without stabilization, decompression and stabilization for treatment of lumbar and cervical canal stenosis are a regular feature in the department. Elderly patients commonly sustain Osteoporotic vertebral compression fractures and early mobilisation of these patients is the order of the day to prevent long term recumbency of the patient. Simple, effective way of treating these fractures by Vertebroplasty has made these elderly patients come back to their day to day activities at the earliest. Kyphotic deformity (forward bending of the spine) is effectively corrected by Kyphoplasty in indicated patients. We have a comprehensive Spinal injury setup and all Spinal Cord injured patients are managed effectively along with appropriate rehabilitation measures. A totally crippled can be made either ambulatory or wheel chair bound so as to cater to his/her day to day activities.

to them and as the research and advancements in the

With the growing geriatric population, the incidence of arthritis is on the rise, which is again double folded due to Rheumatoid arthritis. Arthritis is managed according to the stage, and the cause, the management varying from conservative management with health education, diet management, physiotherapy, minimally invasive surgeries, Arthroscopic surgeries and in severe cases, Total Joint Replacement. The awareness of the patients about Total Joint Replacement has increased and patients would like to lead a normal life without pain or with assistance. There is a growing increase in the nuclear families and elderly patients would like to be independent. Total Joint Replacement has been a boon

morbidity and patients get back to their sporting

design of the Implants have improved, today we have Total Joints wherein patient can do all activities including sitting on the floor, sitting cross legged, squatting and also kneel while doing their prayers regularly. Younger patients with Avascular Necrosis of the femoral head and secondary arthritis are being benefited by Surface Replacement Arthroplasties. Even the International guests visiting our centre are impressed by our set up and the quality of Joint replacement work taking place in this centre. As there is a need for the patients and public to be benefited, we have come out on a package system in which the conventional knee replacement surgery with the imported implant costs only Rs.1,20,000/- while with an Indian Implant, it costs Rs.85,000/- only. Sports injuries are quite common these days as the number of people taking up sports for fitness as well as a profession is increasing everyday. Contact sports, Adventure sports are also increasing, so also the injuries associated with these sports. Ligament injuries, Meniscal injuries are best managed arthroscopically and arthroscopy has become a day care procedure for most of the diagnostic procedures including biopsies. Arthroscopy assisted ligament reconstructions, treatment of Meniscal injuries have reduced the activities at the earliest. Arthroscopic shoulder surgeries is gaining popularity nowadays Health education has also been an integral part of the department activities and recently, we have started pubic awareness and education programme about the musculoskeletal disorders. We have conducted awareness camps. We are planning to conduct more camps at different places and also about different disorders. We also conduct free camps, have meetings with Doctors and appraise them of the recent advancements in Orthopaedics.

SERVICES AVAILABLE: TOTAL JOINT REPLACEMENTSMINIMALLY INVASIVE

COMPOUND

• Total Hip

Primary stabilization with flap covers

• Total Knee • Total Shoulder

LIMB RECONSTRUCTION

• Total Elbow

Deformity correction

• Surface Replacement Arthroplasties

Lengthening

• High performance arthroplasties

LRS

• Metal on Metal

Ilizarov

• Ceramic on Ceramic HAND INJURIES SPINE SURGERIES

MANAGEMENT OF MUSCULOSKELETAL

• Spinal Injury Comprehensive Managerment

TUMOURS

• Minimal invasive spine surgery

Well qualified, experienced and dedicated faculty

• Decompression & Stabilization

available round the clock have treated many

• Scoliosis, Kyphosis and Adult Deformity Correction

polytraumatized patients and saved the lives and limbs

• Revision spinal surgeries

of these unfortunate victims. The faculty also gets

• Endoscopic spine surgeries

updated with the latest developments round the world

• Disc Replacement

by interaction.

• Vertebroplasty and Kyphoplasty STATISTICS FOR THE YEAR 2008 ARTHROSCOPY

Total In Patients

1,859

• Diagnostic

Total Out Patients

12,118

• Debridements

Total Number of Surgeries

1,974

• Meniscal repairs

Major Surgeries

1,060

• ACL, PCL reconstructions

Minor Surgeries

914

TRAUMA Closed interlocking Nailing-Femur and Tibia

No. Of Day care procedures

312

Proximal Femur Nailing

Number of Polytraumatized patients

164

Distal Femur Nailing,

Number of Joint Replacements

Locking Compression Plating

Number of Spinal Surgeries

196

DCS, DHS

Number of Arthroscopic Surgeries

Bridge Plating Closed reduction and Casting

Otorhinolaryngology (E.N.T) FACILITIES AVAILABLE IN OUR DEPARTMENT: 1) All otologic surgeries are done here with state-of-the-art Zeiss microscope. 2) Advanced endoscopic sinus surgeries such as - Trans sphenoidal approach to pituitary. - Endoscopic closure of CSF rhinorrhoea. - Endoscopic dacryo cysto rhinostomy. - Endoscopic excisions of tumors are being done as a routine. 3) We have started doing phonosurgery – surgery to improve voice. FUTURE PLAN: 1) Laser surgeries for cancer of the larynx & hypopharynx. 2) To start cochlear implant programme for profoundly hearing impaired patients. CONFERENCE ATTENDED IN RECENT DAYS: 1) National Conference in cochlear implant in Pune – Armed Forces Medical College. 2) National Conference on Phono Surgery & Sialology – AIIMS, New Delhi. 3) Workshop on head & neck surgery, KMC, Mangalore.

STATISTICS:

LARYNGOLOGY AND HEAD & NECK:

OTOLOGY:

Tonsillectomy & Adenoidectomy

FB Oesophagus

Stapedectomy

Tracheostomy

Granulation ear canal removal / biopsy

MLS

Ear lobe repair

Neck Node Biopsy

FB ear

DL Scopy & Examination / Biopsy

Pinna Reconstruction

EAC Stenosis Repair

Mastoidectomy with tympanoplasty

Auricular Cyst / Papilloma / Keratosis / Polyp / Excision

Intra Tympanic GM instillation

Osteoma Mastoid Excision

RHINOLOGY:

Oral Cavity Biopsy

Neck Abcess – I & D

Benign Tumors Neck Excision

Bullgore Injury

Cut Throat Injury

Total cases

386

Total no. of OP

5441

Total no. of IP

360

Endoscopic Polypectomy

Review

4045

FESS / FESS with Septoplasty

New

1396

Septoplasty / SMR DNE & Cautery

5 26

OP STATISTICS:

Nasal Bone Reduction

DNE

550

Nasal Endoscopic Biopsy

Video Laryngoscopy

Youngs Operation / Release

PSG

Septorhinoplasty

Ear Piercing

Endoscopic DCR

Miscellaneous

Benign Tumors – Endoscopic Excision

CSF Rhinorrhoea Endoscopic Repair

Endoscopic Pituitary Surgeries

Audiogram

698

Synechiae Release

BERA

Electric Burns Nose – Repair

SPEECH LANGUAGE THERAPY:

Cald Well Luc Surgery

ENT

365

Abcess Floor of Nose I & D

STP

1,118

Carcinoma Nose wide excision

Hearing Aids Sold

AUDIOLOGY STATISTICS:

Paediatrics And Neonatology The department of paediatrics is slowly but steadily growing. As a referral centre we are providing excellent service to many complicated and referred cases. Paediatric patients are round the clock covered by qualified paediatrician. Through our dedicated service we have acquired a very good reputation for diagnosing and treating all types of paediatric patients. The general paediatrics consists of a separate emergency cum procedure room which is equipped with critical care resuscitation trolley, suction apparatus, centralized oxygen supply, intubation sets, emergency drugs, nebulizers, cardiac monitor, pulse oximeter infusion pumps etc. The NICU is equipped with warmer and air conditioner in order to maintain a thermo neutral temperature. The NICU is equipped with mechanical ventilator (high frequency mode), neonatal trolleys, double sided photo therapy units, incubators, open care warmer system with radiant warmers, centralized oxygen supply, pulse oximeter, apnea monitor, CO2 monitor, NIBP monitor, cardiac monitor, CPAP and sufficient infusion pumps.

We have transport incubator which serve to transport

economic children. Laboratory investigations are done

the babies from other hospitals where they are born.

at concessional rate during these camp days. By this economically deprived people also get treatment from

Our neonatal intensive care unit is well known for its

our hospital. It also provides free immunization (BCG

excellent service to term, preterm and sick new born

&OPV) on all working days.

babies. To avoid cross infection the unit is divided into septic and aseptic units. Most importance is given to

The department of paediatrics has treated 7476 out

aseptic techniques while dealing with neonates.

patients and 693 in patients from April 2008 to March 2009. The various types of cases treated as in patients

Being the only hospital in Madurai providing surfactant

in the department of paediatrics is as follows.

therapy and ventilatory care for premature babies and RDS, we have placed the initial steps in providing tertiary care for the very sick babies and extreme premature babies. The outcome of premature babies treated with

STATISTICS

surfactant, parenteral nutrition and hyper bilirubinemia

PAEDIATRICS :

treated by Exchange transfusion are well comparable

RESPIRATORY SYSTEM

with any other well-equipped tertiary care centre in our

Bronchopneumonia

country. Ventilator care and surfactant therapy

LRI

provided here has improved the survival rate of preterm

Pyothorax

babies with respiratory problems.

Status Asthmaticus

Aspiration pneumonitis

With the help of Blood bank and free availability of

Wheezing Bronchitis

blood component therapy, complicated and rare

Hyperactive air way disease

bleeding disorders, platelet disorders, thalassemia,

ALT B

septicemia and Haemophilia are managed successfully.

Hypoplasia of LT lung

Exchange transfusions have saved many newborn with

Cong left lobar empyema

Rh haemolytic disease.

Lung Abscess

Tuberculosis

Super specialities in surgery, urology and plastic surgery

Bronchiectasiss with disseminated

help us to provide best treatment to children with acute

tuberculosis

surgical and urological problems and also correction for

Cold Abscess

congenital anomalies. CARDIOVASCULAR SYSTEM During the above period several interesting and

Congenital heart disease

complicated cases and rare syndromes have been

Myocarditis

diagnosed and treated in our department successfully.

Dilated cardiomyopathy

Hypertrophic cardiomyopathy

As per our aim to serve poor people also, we are

Rheumatic heart disease

conducting free paediatric health camps on every

Pericardial effusion

Saturday by our department to cater to the lower socio-

Myocardial dysfunction

GASTRO INTESTINAL SYSTEM AGE

Hepatitis

Gastritis

Intussusception

Hyper acute liver failure

Ruptured liver abscess

Gastro – Esophageal reflux

Enterocolitis

DKA

Stricture esophagus (Peptic)

Cholelithiasis

Perforated peritonitis

Hiatus hernia

Diaphragmatic Hernia

Biliary Atresia

Cirrhosis

Chylus Ascites

Glycogen storage disorder

Meningo encephalitis

Seizure disorder

Neem oil Encephalopathy

Atypical febrile seizure

Febrile convulsion

Hepatic Encephalopathy

Tuberculous Meningitis

Mental retardation with autistic features

Leigh’s disease

Subdural haemorrhage

Torch infection

Migrane

Brain stem dysfunction

Neurocysticercosis

Extra pyramidal symptoms

Post infectious poly neuropathy

Brain stem dysfunction with glioma

Chicken pox with Encephalopathy

Post Chicken pox cerebellar demyelination :

Infantile hemiplegia

Moya moya Disease

CENTRAL NERVOUS SYSTEM

RENAL DISORDER Cystitis Nephrotic Syndrome Acute glomerular nephritis Acute renal failure Hydroureteronephrosis [VUR] Haematuria UTI Ectopic kidney Nephrocalcinosis Early Medullary Sponge Kidney Chronic Renal Failure Renal Tubular Acidosis Renal Tumour

: : : : : : : : : : : : :

10 8 6 5 5 3 3 1 1 1 1 1 1

BLEEDING DISORDER Anaemia Idiopathic thrombocytopenic purpura Gaucher’s disease Bleeding disorder Von – wilbran’s disease Haemolytic anaemia Post circumcision frenular Haematoma Epistaxis Thrombosthenia Haematochezia Haemophillia Henoch schonlein purpura Pancytopenia Aplastic anaemia

: : : : : : : : : : : : : :

7 6 3 3 2 3 1 1 1 1 1 1 1 2

DERMATOLOGY Staphylococcal skin scalded syndrome TEN Utricaria SLE Eczematous dermatitis GENERAL PAEDIATRICS Septicemia Abscess Foreign body Aspiration Scalds Enteric fever Acute febrile illness Parotitis KwashiorKar Drowning Cleft lip & cleft pallate Malarial Fever Chicken Pox Lymphocytic gastro intestinal infiltration with malnutrition Headache Myositis Acute otitis media Wound infection Tongue tie Chronic diarrhea [HIV +ve] Bilateral gynaecomastia Bilateral corneal opacity Cellulitis Constipation Contracture of left toe Acute exanthematous fever Ambiguous genitalia Recurrent abdominal pain Cervical lymphadenopathy Hypothyroidism Nuchal pain Unknown native seed ingestion Reactive arthritis

: : : : :

2 1 1 1 1

: : : : : : : : : : : :

15 13 9 7 5 5 5 3 3 2 2 2

: : : : : : : : : : : : : : : : : : : :

2 2 3 2 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1

POISONING Scorpion sting Camphor poisoning Snake bite Oleander poisoning

: : : :

3 3 3 1

ROAD TRAFFIC ACCIDENTS & TRAUMA RTA : Crush Injury : Facial Injury : Palate Injury : Soft tissue Injury with synovitis of hip :

1 1 1 1 1

MISCELLANEOUS Neuroblastoma Hodgkins lymphoma Non Hodgkins lymphoma Infected urachal cyst Cystic fibroma

3 2 2 1 1

: : : : :

NEONATOLOGY RESPIRATORY SYSTEM Preterm with RDS

Birth Asphyxia

MAS

Newborn with RDS

IUGR

Pneumonitis

Hypoplasia of left lung

Respiratory distress syndrome

CVS CHD

Cyanotic heart disease

Rhabdomyoma

Myocardial dysfunction

Hypertrophic myocardiopathy

of newborn

Coarctation of aorta

Persistent pulmonary hypertension

GASTRO INTESTINAL SYSTEM

Midgut volvulus

NEC

Perforation peritonitis

Gastrointestinal duplication cyst

Congenital hypertrophic pyloric stenosis

Neonatal hepatitis

Bleeding rectum

Inguinal hernia

Microvillus inclusion Disease

Hirschprung disease

ANOMALY Anorectal anomaly

Cleft lip and cleft palate

Laryngomalacia

Congenital diaphragmatic hernia

Dextrocardia

Pierre Robins syndrome

Hydrops fetalis

Tracheo – oesophagial fistula

Tracheo – oesophagial atresia

Developmental dysplasia of hip

Hydrocephalus

Neonatal seizure

Hypoxic Ischemic Encephalopathy

Meningo myelocele

IVH

Subarachroid Haemorrhage

Cerebral abscess

CNS

NEONATAL JAUNDICE Pathological - Jaundice

RH Incompatibility

Exchange transfusion

neonatal hypoglycemia

Hydronephrosis & Post urethral Valve

Inborn error of Metabolism

Haemorrhagic disease of Newborn

Neonatal varicella

MISCELLANEOUS Septicemia Infant of diabetic mother with

Pharmacy

Our hospital has an onsite pharmacy department, to ensure the right medicines are received at the right time, through a highly efficient and economical system. We adopt and apply the best pharmaceutical expertise to help in maximizing drug efficacy and minimize drug toxicity.

The core features of our department are: � Adhering to the guidelines as per Drugs & Cosmetics Act of 1948 for pharmacy management. � 24 hour round-the-clock quality patient care services. � Well trained and qualified pharmacists. � Deliverance of standard medicines to the customers. � Controlled temperature helps in maintaining quality of medicine & efficiency � Our entire system is computerised. The main goals of our department are: � To provide maximum patient care � To ensure quality patient service � To educate patients � To facilitate adverse drug monitoring 50

The Department of Physical Medicine & Rehabilitation works with the philosophy of â&#x20AC;&#x2DC;The patient comes firstâ&#x20AC;&#x2122;. The Physiotherapy Department is fitted with the latest equipment to work in all specialities of the hospital. We have a qualified and highly experienced team of physiotherapists providing OPD services (Direct and referrals) and IPD services (Inside wards and Intensive care units) that adhere to international standards. This helps to offer a multifaceted approach for the successful rehabilitation of every patient.

Physical Medicine And Rehabilitation

Our physiotherapists provide wide range of therapies after examination, tailored to suit individual needs of the patients. The aim is to restore proper functioning of the body, to reduce impact of dysfunction, disability and pain of the body from trauma and disease, hence, improving the mobility, health and reducing risk of any future injuries. Therapies include: Manual Therapy: Stretching, manual resistance training, joint mobilization and manipulation, manual lymphatic drainage (post lymphedema ) and chest physiotherapy. Electro Therapy Techniques: Short-wave-diathermy, ultra-sound therapy [1 MHz, 3 MHz], pelvic & cervical traction[continuous & intermittent], Interferential therapy, wax-bath, electrical muscle stimulator, T.E.N.S, slim-up and vacuum therapy. Exercises: Posture training, muscle strengthening, cardio vascular training and stretching. Other Services: Advice orthosis and prosthesis (post amputation) offering information regarding equipment aids (wheel chairs, walking aids), taping and splinting.

Facilities available

ICU post surgical care: Chest physio & general mobility ex, incentive spirometer, bronchial hygiene,

Electrotherapy - SWD/IFT/Ultrasonic/MS stimulator,

proper positioning of the operative side/part and

T.E.N.S, paraffin wax bath and cryotherapy.

ambulation. The Haemophilia Federation of India, Madurai chapter

Diagnostic – S D curve/MS testing/ADL assessment.

gives physiotherapy care and advice through our department.

Mechanical – Traction - Cervical/Lumbar/Pelvic/C.P.M. for lower extremity, Tiltable rowing, treadmill.

The core idea at the Department of Physical Medicine & Rehabilitation is to ensure rehabilitation is carried out in

Manual Mobilization Therapies - Mobilization couch

a short period, to return the patient back to normal life.

with specific features for mobilization. Exercise Therapy Active/Assisted/Passive/Resisted/Graded resisted

Academic Activities

exercises, PNF techniques, suspension therapy,

Various physiotherapy colleges affiliated to Tamil Nadu

Theraband/tubes exercises.

Dr. M.G.R Medical University have tied-up with our

Chest Physiotherapy - Assessment of pulmonary

hospital to get C.R.R.I. for their BPT students.

functions, therapeutic functions, postural Drainage, Therapeutic, Interventional physiotherapeutic procedures, nebulization breathing exercises, Incentive spirometer, humidification, home care and follow ups.

Conferences attended P. Ganesan, Senior Physiotherapist presented a paper on “Physiotherapeutic Prophylaxis for DVT”, in National

Gynae/Obstetric - Antenatal & postnatal ex., postural

Level conference at Meerut (UP).

correction & awareness, Fitness - Assessment & Improvement, etc. Post Operative Cardiac Surgeries - Following cardiac surgeries pre & post operative physiotherapeutic exercise for patients including - breathing exercises, chest manoeuvers, humidification, nebulization, incentive spirometers, limb physiotherapy and cardiac rehab- phase I –IV. For Neurological Disorders - Proper positioning of the limbs (anti synergic patterns) general mobility & strengthening exercises, PNF and Bobath.

Statistics In patients

22,535

Out patients

3,882

Total patients

26,417

Dr. N. Panchavarnam, HOD, Plastic Surgeon at Smile Train Office, New York, USA.

Plastic Surgery The Department of Plastic Surgery is recognized as a centre for excellence in plastic surgeries and correction of other allied deformities. Cosmetic, general plastic, reconstructive surgeries have also increased in fairly large numbers and so has the awareness of aesthetic surgeries increased.

Total number of cases operated • UNILATERAL LIP • BILATERAL LIP • PALATOPLASTY • FACIAL CLEFT • REVISION LIP • REVISION PALATE • FISTULA REPAIR • PHARYNGEAL FLAP • SECONDARY NOSE CORRECTION • ALVEOLAR BONE GRAFT • FACIAL SCAR REVISION • TRAUMATIC LESION IN HEAD & NECK • LIPECTOMY • TONGUE TIE RELEASE • LOBULOPLASTY • RHINOPLASTY • HAEMANGIOMAS

895 272 53 322 1 38 35 28 10 3 1 4 4 1 10 4 2 8

• BURN INJURIES

• GYNAECOMASTIA

• ABDOMINOPLASTICS

• THUMB RECONSTRUCTION

• PRESSURE SORE RECONSTRUCTION

• CHRONIC ULCER RECONSTRUCTION

• RECONSTRUCTION OF LOWER LIMB DEFECTS

• CLEFT NOSE REPAIR

• FAT FILLING

• LIP RECONSTRUCTION

• EAR RECONSTRUCTION

• TM JOINT RELEASE

• HAIR TRANSPLANT

• SYNDACTYLY RELEASE

• REIMPLANTATION

• CONTRACTURE RELEASE

SMILE TRAIN PROJECT Since inception of our Smile Train Project, we have made rapid progress and are now one of the leading regional cleft correction centres in the world. We ensure quality and safety for our patients in every aspect at our centre. And thus, we regularly receive patients from all over the state.

Unilateral Lip

Pre-Operative

Post-Operative Bilateral Lip

Post-Operative ACHIEVEMENTS:

Pre-Operative

1. Total number of surgeries done under the Smile Train Project – 763. 2. We have completed a total of 4,500 cases. 3. Pre-operative monitoring has improved after the introduction of state-of-the-art multi parameter monitors with an ETCO2 monitor. 4. With the newly acquired state-of-the-art fibre optic

5. The latest edition of the “Dr. Speech” software introduced for nasal measurements in patients helps give speech therapy at ease. 6. In recognition of our centre with world standards, many international medical professionals from

nasopharyngoscope, we are performing

various specialties like plastic surgery, orthodontist,

post-operative nasopharyngoscopy on patients

dentist, etc., choose our centre to get training in

who have undergone palatoplasty and for speech

cleft related and allied surgeries under the “Smile

diagnostic purposes.

Train Medical Exchange Program”.

PLASTIC SURGERY CASES Plastic surgery is one of our specialties, which has the ability to deal with problems from head to toe. Plastic surgeons are also known as Reconstructive Surgeons, because we are often called by other departments to fix tissue defects.

After Liposuction Gynaecomastia

After Liposuction Gynaecomastia with Obese abdomen After Fat Injection

Right Hemi facial Microsomia After Fat Injection Thin lower lip after surgery

1. A total number of 119 major plastic surgical procedures were done in the last one year. 2. In a case of microtia of the right ear, ear reconstruction was done in a single stage using carved costal cartilage and temper parietal facial flap. 3. A rare case of temperomandibular joint ankylosis was operated and TM joint release done by using temporo parietal facial flap. 4. A number of cosmetic surgeries like gynaecomastia and obese abdomen were treated successfully with excellent results.

ACADEMIC ACTIVITIES Last year, we laid a lot of emphasis on academic activities and actively took part in the monthly clinical society meetings and the CMEs. We presented 10 papers in 12 clinical society meetings that took place last year. Further more, we also regularly contribute articles for publication in the Madurai Medical Journal. PAPERS PRESENTED AT VARIOUS INTERNATIONAL / NATIONAL CONFERENCES. • “Workshop in Cleft Lip and Palate” at Chang Kang Memorial Hospital, Taipei. • “My experience in revision cleft lip to correct common pit falls in unilateral & bilateral cases” at Varanasi. • “Aesthetic result of Triple Wedge technique for wide cleft lips” at Pondicherry.

Psychiatry And Counselling The Department of Psychiatry’s guiding principle of evidence based medical therapeutics-the practice of clinical psychiatry based upon rigorous scientific standards and most recent empirical evidence for selection of therapeutic options has been enshrined as the defining feature of providing quality care to the psychiatrically ill population of Tamil Nadu. Although emphasis has been laid upon scientific psychopharmacological management, the department reinforces its faith in cost-effective treatment option of psychotherapeutic models of management like: • Crisis intervention counselling for suicide-attempters and suicide-contemplators. • Somatic reattribution model of counselling for medically unexplained physical symptoms. • Motivation enhancement and relapse prevention techniques for alcohol de-addiction and smoking cessation. • Marital counselling and cognitive behaviour therapy for psychiatric disorders.

The Department of Psychiatry takes immense pride in providing CONSULTATION â&#x20AC;&#x201C; LIAISON services to departments like Urology, Andrology, Nephrology, Cardiology, Cardio Thoracic Surgery, Neurology, Gastroenterology, HIV Care, Paediatrics, Medicine and Intensive Respiratory, Coronary and Medical Care Units. Therapeutic interventions like modified ECT for disorders such as suicidal depression, treatment resistant psychotic illness and acute catatonia are provided with utmost care. Deaddiction services such as Inpatient alcohol de-addiction, IV drug abuse prevention, smoking cessation services are provided. Focussed care is provided for children with illness such as ADHD (Attention Deficit Hyperactivity Disorder), MUPS (Medically Unexplained Physical Symptoms), conduct disorder and parent management training for proper child rearing practices.

The Department of Psychiatry further envisages expanding its various therapeutic modalities for providing psychiatric care of highest quality at best cost effective standards. Statistics New patients

404

Review patients

2,371

Out patients (total)

2,775

In patient (admission)

In patient opinions

656

Inauguration of the 13th Annual National Conference of the Breast Cancer Foundation - India BRECON 2009 on 7th March 2009 at MMHRC

Radiation Oncology Outstanding Radiation Oncology care is crucial for many of our patients with cancer. The department of Radiation Oncology sets standards by developing and incorporating the newest technologies and methods available to combat the progress of the disease. Since inception, we have been at the forefront of offering superior treatment and care for our patients with cancer. At MMHRC, our approach is patient-focused. Our multidisciplinary team works with each patient, applying decades of expertise to determine the right course of therapy. It is our priority to ensure that our patients and their families have full understanding of radiation therapy options and courses of treatment. MMHRC stays on the leading edge of technology through our involvement in clinical trails. We are constantly making strides in maximizing the effectiveness of radiation therapy while protecting healthy cells and minimizing discomfort and side effects. MMHRCâ&#x20AC;&#x2122;s innovation in radiation therapy includes the use of Intensity Modulated Radiation Therapy (IMRT) for some of our cancer patients. This advanced technique focuses hundreds of tiny beams of radiation with varied intensities directly at the tumor. IMRT allows us to combat tumors more specifically and intelligently than ever before. The effect is far less traumatic to our patients, with minimal damage to the bodyâ&#x20AC;&#x2122;s healthy tissues. The department is also equipped with state-of-the-art teletherapy and brachytherapy facilities.

Teletherapy The state-of-the-art mega voltage Cobalt 60 external

DR. K.S.KIRUSHNAKUMAR, MBBS., MD (RT) PAPERS PRESENTED:

radiation therapy unit Theratron Phoenix by AECL

International conferences

Canada has an unique feature of treating patients with

• UICC – Presented a paper titled “EVALUATION OF

rotational movements (360 dergees), thus enabling

GEMCITABINE VERSUS CISPLATINUM AS

doctors to handle complex treatment at various sites

RADIOSENSITIZER WITH RADIATIONTHERAPY IN

(superficial and deep seated).

LOCALLY ADVANCED CARCINOMA CERVIX” in UICC WORLD CANCER CONGRESS – 2008, held in

Brachytherapy

GENEVA, SWITZERLAND, during 27-31 August 2008. • UICC – presented a paper titled “BREAKTHROUGH

The Microselectron – HDR is a high dose rate

CANCER PAIN-AN ANALYSIS” in UICC WORLD

interstitial, intracavitary and intraluminal remote after

CANCER CONGRESS-2008, held in GENEVA,

loading system. It consists of a treatment unit in which

SWITZERLAND, during 27-31 August 2008

a single high intensity Iridium source, stored within a

• IGCS – presented a paper titled “A STUDY OF

shielded safe. This source can be remotely after loaded

LIPOSOMAL DOXORUBICIN IN REFRACTORY

into a small diameter catheter for treatment of

OVARIAN CARCINOMA” in INTERNATIONAL

cervical, vaginal endometrial, bronchial, oesophageal,

GYNAECOLOGICAL CANCER SOCIETY – 12, held in

breast, head and neck cancers, etc.

BANGKOK, THAILAND, during 25-28 October 2008.

The department is supported with SPIRAL CT SCAN,

CONFERENCE ATTENDED AS FACULTY

MRI and other facilities, which includes immobilizers

LECTURES DELIVERED

and equipments for meticulous planning and execution

• Panelist in the State AROI 2008 held in GKNM

of treatment, thereby ensuring high quality radiation

hospital, Coimbatore during November 2008 and

therapy for all patients.

the topic is Management of Lower GI tumors (Ano rectal Tumors)

Radiation Therapy causes ionization in the tissue,

• Delivered a Lecture on Meta Analysis of Radiation

which damages the DNA and leads to cell death,

therapy in Breast cancer in BRECON 2009-Annual

particularly in the cell’s mitotic process. The

Breast conference foundation Conference on

differential effect on normal and malignant tissues is

March 7 & 8 2009, Madurai

the result of a number of factors. DEMONSTRATIONS : For a particular dose of radiation, more damage may be inflicted on tumour cells than normal cells. The cell and tissue kinetics usually favour recovery and repopulation of the damaged normal tissue rather than tumour tissue.

• Performed and demonstrated the Insterstitial Brachytherapy procedure in Breast cancer in BRECON 2009 – Annual Breast Conference foundation Conference on March 7 & 8 2009, Madurai

The use of fractionated radiation therapy (administering the total dose in small daily amounts) further improves the therapeutic ratio. The decision to deliver curative or palliative radiation therapy to a patient is determined by staging and tumour sensitivity.

ONGOING RESEARCH ACTIVITES As a Principal Investigator in clinical trials Phase II –

Breast Cancer Cancer pain Metastatic Breast Cancer Endometrial Cancer Cancer Pain

Phase IIB -

Esophageal Cancer (Co-Investigator)

Phase III -

Cancer Pain Preventing DVT in cancer patients

Statistics (April 2008 – March 2009) Cervix Head and Neck ALL Oesophagus Breast Brain Bladder Bone Pituitary Rectum Lung Lymphoma Myeloma Vagina Pelvic Tumour Vulva Hodgkin’s Disease Prostate Sarcoma Stomach Spine Eye Kidney Endometrium Thyroid Penis Ovaries Others Tongue Total

145 106 3 17 89 36 13 13 1 27 35 3 14 3 3 2 9 12 8 6 11 15 3 14 4 4 1 9 32 638

Total number of patients treated during April 2008 to March 2009

6576

Out Patients

5730

New

445

In patients

846

Review

5285

638

308

radiation therapy under Ketamine anaesthesia -

Free OP

Paid OP

282

Free IP

Paid IP

318

Total Free

Total Paid

600

RADIATION THERAPY Total number of patients treated with external radiation therapy Total number of patients treated with brachytherapy Total number of patients treated with

Reproductive Medicine The Department of Reproductive Medicine is well equipped to deal with all kinds of problems of sub-fertile couples. Our department also concentrates and manages couples with BOH and High-risk pregnancy. This year, we started vitrification of embryo, apart from slow freezing of sperms and embryos. Next year, we plan to start vitrification of oocytes, mainly for young women with cancer before starting their oncotherapy. Couples from outside India have also recognized our centre and approached us for treatment.

SURGICAL LAPAROSCOPY 1. PCOD Puncturing

2. Adhesiolysis

3. Endometriosis

4. Salpingectomy

5. Ovarian Cystectomy

6. Ovarian Cyst Aspiration

7. Myomectomy

8. Fimbrial cyst excision

9. Oophorectomy

10. Excision of ovarian tumour

D. HYSTEROSCOPY

APRIL 2008 to MARCH 2009 NEW CASES

515

REVIEW

5,228

HSG

222

SURGICAL HYSTEROSCOPY

IUI

323

1. Septal Resection

ART (8 months)

2. Endometrial polypectomy

NORMAL DELIVERY

L.S.C.S

Take home Baby Rate of ART

24%

ECTOPIC

MULTIPLE PREGNANCY

Abortion after ART & IUI

Pre term Delivery

Adoption

LAPAROTOMY 1. Tubal Recanalisation

2. TAH with BSO

D. LAPAROSCOPY

We wish to improve our ART results better this year. Academic activities: 1. Visited Oregon Health Science University, Department of Reproductive Medicine – USA,as an observer. 2. Attended DIPSI - February 2009. 3. Reviewed an article – Menstrual Cycle Length in relative with AMH and FSH for British Journal of Obstetrics and Gynaecology.

Surgery & Surgical Gastroenterology The Department of Surgery and Gastroenterology is a high volume centre for therapeutic endoscopy, laparoscopy and surgical gastroenterology procedures. Our work in therapeutic ERCP and Laparoscopy has been appreciated at various forums both in India and abroad. This is achieved by teamwork headed by Dr. Ramesh Ardhanari. We have a fully equipped endoscopy suite including endoscopic ultrasound. We recently acquired a state-of-the-art full HD laparoscopic unit from STORZ. Apart form routine procedures, we have performed laparoscopic bariatric surgery on patients with morbid obesity. The results were encouraging, with good weight loss. The use of endoscopic ultrasound has become a routine modality of investigation in patients with Hepatico-biliary-pancreatic diseases. We have overcome the long learning curve, with greater diagnostic accuracy and excellent therapeutic results. On the academic front, we have a post graduate course and super specialty course accredited by the Diplomate National Board in General surgery and Surgical Gastroenterology. In 2008 our department was accredited for training in Fellowship in Minimal Access Surgery and first candidate is presently being trained.

OPERATION STATISTICS FROM APRIL 2008 TO MARCH 2009 Laparoscopic Cholecystectomy Laparoscopic appendicectomy Diagnostic laparoscopy Laparotomy resection anastomosis Laparoscopic Mesh hernioplasty Open Mesh Hernioplasty EUA + Open Haemorrhoidectomy Stapler Haemorrhoidectomy Choledochal cyst excision Whipple’s procedure PJ with Frey’s Splenectomy Total Gastrectomy Partial Gastrectomy DU perforation closure GJ vagotomy Thyroidectomy Obesity surgery LR shunt Anterior resection APER Colostomy Colostomy closure Hemicolectomy Laparoscopic rectopexy Radical Cholecystectomy Oesophagectomy Cystogastrostomy Wound debridement Amputation Excision biopsy Lap. fundoplication Hepatico jejunostomy Laparoscopic cardiomyotomy Anoplasty CBD exploration Kasai operation Total colectomy Liver resection

340 125 100 110 120 75 210 20 6 22 20 15 20 25 10 15 11 1 4 25 10 27 24 28 2 5 13 9 195 10 134 11 19 4 6 30 2 3 5

ENDOSCOPY STATISTICS FROM APRIL 2008 TO MARCH 2009 DIAGNOSTIC OGD

1734

SCLEROTHERAPY

ENDOSCOPIC VARICEAL LIGATION

175

OESOPHAGEAL STRICTURE DILATATION

OESOHAGEAL STENTING BLEEDING ULCER INJECTION

5 37

OGD & BRONCHOSCOPY FOREIGN BODY REMOVAL

FUNDAL GLUE INJECTION

SIGMOIDOSCOPY

145

COLONOSCOPY

195

DIAGNOSTIC & THERAPEUTIC ERCP

235

OGD COLONOSCOPY POLYPECTOMY

PILES BANDING

APC

ACHALASIA CARDIA BALLOON DILATATION

BILIARY SELF EXPANDABLE METAL STENTING

THROUGH PTBD-BILIARY SEMS

ENDO LOOP

PEG

FILTULA GLUE INJECTION

NASO JEJUNAL TUBE

ENDOSCOPIC ULTRASOUND (DIAGNOSTIC)

185

EUS GUIDED FNAC/BIOPSY

EUS GUIDED CELIAC BLOCK

EUS GUIDED CYSTO GASTROSTOMY (Pseudo cyst drainage)

Surgical Oncology The Department of Surgical Oncology routinely performs radical procedures on patients with head, neck, breast, gynaecological malignancies and soft tissue tumors. All cases are planned by tumor board, which is a multidisciplinary board including Radiation and Medical oncologists. We follow evidence based management protocols, which are accepted worldwide.

In the case of head and neck malignancies, radical resections are regularly performed for major subsites including oral cavity, larynx, etc., with a minimal mortality rate. In soft tissue tumors, radical chest wall resections were done with a minimal mortality. Reconstruction of post-resection defects was done with autologous tissues and allogenic implants, along with the plastic surgical services resulting in better function and minimal wound complications. In the management of breast cancer, emphasis has been

made on breast conservation procedures for early

Plan for the future:

cases of breast cancer. Reconstruction procedures have

With the advent of Neoadjuvant Chemotherapy, breast

been performed for locally advanced breast cancers.

conservation surgery will be made possible even in

The availability of digital mammogram and experienced

locally advanced breast cancers. Emphasis needs to be

radiologists has helped in the prompt identification and

laid on such cases in future. In Laryngeal malignancies,

management of benign breast diseases, which are a

the issue of voice preservation procedures

source of much anxiety to a majority of patients with

(Conservative Laryngectomy) needs to be addressed

complaints pertaining to breast.

for better quality of life.

Breast Cancer:

Mastectomy

Breast conservation surgery

Lumpectomy

Bilateral salpingo oophorectomy

Microdochectomy

Excision of Phyllodes tumor

Gynaecological Cancer:

Wertheimâ&#x20AC;&#x2122;s Hysterectomy

Pan hysterectomy

Staging laparotomy for CA Ovary

Interval Cytoreduction

Staging laparotomy for CA Endometrium

Excision of Vulval CA

Inguinal node dissection

Head and Neck Cancers:

Skin, Soft tissue tumors and others:

Thyroid

Hamartoma excision

Parotid

Wide excision + SSG

Composite resection

Chondrosarcoma rib wide excision

Neck dissection

Biopsy

Intra oral excision

SSG

Maxilla

Fasciotomy

Laryngectomy

Lipoma

Excision of Submandibular gland

PORT insertion

Thyroglossal cyst

Flap division

Scalp lesion

Soft tissue tumor neck

Minor Cases:

DL scopy

Biopsy

Tongue

Tracheostomy

104 66 4

Mandibulectomy

ICD

Para pharyngeal mass

I&D

Amputation

Wound Debridement

Urological Cancers: Urinary Bladder

1 Total No. of Cases

261

Major

143

Minor

118

ACADEMIC

EXCELLENCE

Library SHARING KNOWLEDGE IS WHAT WEâ&#x20AC;&#x2122;RE BEST AT Our library occupies a place of pride in the hospital and is an essential component of the hospital's outstanding research and education mission. It is a most lively place on the campus providing a safe, comfortable and friendly environment that enables learning and advancement of knowledge, and promotes discovery and scholarship. The mission of our library is to facilitate creation of new knowledge through acquisition, organization and dissemination of knowledge resources and providing for value added services. The library is open from 9.30 a.m. to 9.00 p.m. on working days and 10.00 a.m. to 1.00 p.m. on Sundays & Holidays. Our library has access to the digital library so as to ensure with all relevant information and resources that contain books, journals, website and research papers to suit the local conditions. DEPT. OF LIBRARY

Sl. No. I 1 2 3 4 5

DETAILS BOOKS MEDICAL BOOKS MANAGEMENT BOOKS HOSPITAL ADMINISTRATION BOOKS MISCELLANEOUS BOOKS SIDDHA BOOKS TOTAL

QUANTITY 2,911 3113 138 425 149 6,736

II 1 2 3

JOURNALS INTERNATIONAL JOURNALS INDIAN JOURNALS NEWSLETTERS & OTHER JOURNALS

57 TOPICS 41 TOPICS 87 TOPICS

III 1 2

AUDIO CASSETTES MEDICAL MANAGEMENT

CDs [MEDICAL & MANAGEMENT]

61 84 918

Meenakshi Mission Hospital College A Division of Meenakshi Mission Hospital & Research Centre

Meenakshi Mission Hospital College Centre for Education Our hospital is an emerging internationally renowned centre for education, offering unique job oriented fulltime courses affiliated to Madurai Kamaraj University, Madurai, and Mother Teresa Women’s University, Kodaikanal for the last 12 years besides being a recognized centre for research and training in medical, nursing, paramedical and management from the day of its inception. Most of the fulltime courses offered at MMHRC are first of its kind in Asia developed with the aim of imparting skill-based training to healthcare professionals for tomorrow’s needs. Education Objectives

National Board of Examinations MMHRC is recognized by the National Board of

Vision Developing Healthcare Professionals of Today’s Relevance with Insight into Tomorrow’s Need Mission Internationally Renowned Centre for Healthcare Education Courses Offered Doctoral Studies MMHRC is recognized by Madurai Kamaraj University and MGR Medical University for Ph.D. Programmes.

Examinations to conduct Diploma in National Board (D.N.B.) postgraduate courses in: 1. General Medicine 2. Family Medicine 3. General Surgery 4. Gynaecology 5. Anaesthesia 6. Orthopaedics 7. Radiology 8. Genitourinary Surgery 9. Surgical Gastroenterology 10. Nephrology 11. Cardiology

Royal College of Surgeons, Edinburgh The Royal College of Surgeons of Edinburgh, England has bestowed the recognition to MMHRC to train doctors seeking AFRCS Examinations.

12. Cardio Thoracic Surgery 13. Neurology 14. Neuro Surgery 15. Minimal Access Surgery 71

Medical Council of India MCI has recognized MMHRC for Compulsory

Directorate of Distance Education – Madurai Kamaraj University

Rotatory Resident Internship and Senior House

MMHRC is recognized as ‘Training Centre’ to offer the

Surgeoncy for medical graduates.

following one-year PG Diploma courses under Directorate of Distance Education, Madurai Kamaraj University:

Mother Teresa Women’s University The following 3-year fulltime Bachelor Degree Courses are affiliated to Mother Teresa Women’s University, Kodaikanal, and admission is limited to females who have passed +2 Science examinations. 1. B.B.A. – Hospital Administration 2. B.Sc. – Applied Microbiology 3. B.Sc. – Applied Biochemistry Indian Medical Association MMHRC is recognized by Indian Medical Association to conduct the following 2-year fulltime Diploma Courses

1. PG Diploma in Hospital Management 2. PG Diploma in Hospital Documentation Management 3. PG Diploma in Health Information Management 4. PG Diploma in Nutrition and Dietetics 5. PG Diploma in Biostatistics 6. PG Diploma in Hospital Laboratory Technology 7. PG Diploma in Radiography and Imaging Technology 8. PG Diploma in Pharmaceutical Chemistry Recognitions 1. Recognized as Post Graduate Institution by University

and admission is open to applicants who have passed +2

of Colombo to train students in Post Graduate

Science examinations with 50% marks.

Diploma in Family Medicine

1. Diploma in Medical Lab Technology (DMLT)

2. Recognized by Indian Medical Council to train

2. Diploma in X-ray Imaging Technology (DXIT)

students in the Diploma, Fellow of College of

3. Diploma in Operation Theatre Technician

General Practitioners that will lead to Diploma in

(DOTT)

Family Medicine 3. Recognized by several Universities in India and abroad

Madurai Kamaraj University MMHRC enjoys the Approved Institution Status of Madurai Kamaraj University. The following Courses, offered by Madurai Kamaraj University, are open to all graduates interested to pursue a Challenging and Promising Management Career: 1. M.B.A. Hospital Administration 2. PG Diploma in Fundraising Management 3. PG Diploma in Micro Credit Management 4. PG Diploma in Medical Records Management 5. PG Diploma in Total Quality Management in Hospitals

for Research Projects 4. Recognized training centre for Physiotherapists 5. Recognized by all the leading Nursing Colleges for Internship 6. Recognized for Management Internship 7. Recognized training centre to train Healthcare Providers (HCPs) by USAID 8. Recognized training centre to train Nurses to USA

Recognizing Parents as Main Stakeholder in Education In the Students’ Day 2006 we introduced “Recognising

Course wise Rank Holders are… PG Diploma Courses (Year 2007-2008) – Also University Toppers

High Fliers”, of which the highlight is ‘Parent of the Year’ Award. In this academic year Mrs. I. Jerina Begam and

PG Diploma in

Mr. Y. Mehaboob Basha, Parents of Y.M. Salma, 3rd year

Fundraising Management - Rashmi Verma

student of B.Sc. Applied Biochemistry course, were honoured with the ‘Parent of the Year’ Award.

UG Courses (Year 2005 – 2008) – Also University Toppers

Endowment Fund B.Sc. Applied Biochemistry - C. Sujeetha Based on the Endowment Fund contributed by

B.Sc. Applied Microbiology - R. Remuki

Dr. N. Sethuraman, the Founder Chairman, MMHRC,

B.B.A. Hospital Administration - T. Gowthami

Silver Medals were awarded to the University Toppers in UG courses initiated by MMHRC at Mother Teresa

Diploma Courses (Year 2006 – 2008)

Women’s University, Kodaikanal. Diploma in Medical Lab Technology - M. Koorik Kumar Admission and Students’ Strength This academic year, we have admitted 25 students in the

Staff Composition

UG courses, 51 students in the fulltime PG courses, and

Besides involving 24 in-house part time and visiting

92 students in the distant education courses. The total

faculties, we have increased the fulltime teaching faculty

strength in UG courses is 94 students, besides 4

members to 10, thereby ensuring adequate fulltime

students undergoing DMLT course, and 75 students

teachers in the areas of Microbiology, Biochemistry, and

undergoing fulltime PG courses.

Hospital Administration.

Academic Performance

Parents-Teachers Meet

Students achieved 98.4% result in the University

We facilitated “Parents – Teachers” Meet on a biannual

Examinations – April 2008 and 99% result in the

basis in April and December of this year with 90%

University Examinations – Nov 2008.

attendance from the Parents side, ensuring healthy discussions on the progress of Students’ performance

In the academic year ending 2008, 68 students

and career growth.

graduated. Fifty percent of our undergraduates have opted for higher studies and almost all other graduates were placed in suitable jobs through campus placement.

National Girl Child Day

Programmes, Researches and Publications

National Girl Child Day was celebrated on Jan 24, 2009 to create awareness of issues related to girls. The highlight of the Celebration was the Drawing Competition for Higher Secondary Students on the theme - “Empower Girl Child via Education”. K. Sindhu of Siddu Matriculation Girls Higher Secondary School, Madurai, won the first prize and N. Suganya of MRR MAVMM Matriculation Higher Secondary School won the second prize. National Science Day We celebrated National Science Day on Feb 28, 2009, commemorating the legacy of Sir CV Raman, with the basic objective to spread the message of importance of science and its application among the people. Scientific Model Making and Poster Presentation competitions were organised on that auspicious day based on the theme of the year “Expanding Horizons of Science”. Women’s Day

Prof. A.K. Sivakumar, the Principal, continued his service as Advisor to Hospital Accreditation Programme, WHO; Permanent Invitee Member,

Women’s Day was celebrated on March 9, 2009 to

Executive Board, Ramlal Golchha Eye Hospital

highlight the ‘Role and Importance of Women in the

Foundation, Biratnagar, Nepal; Member, Academic

Society’ among the Students community. Competitions

Council, Madurai Kamaraj University; Senator, Madurai

on Poster Presentation and Fancy Dress were organized

Kamaraj University; and as President, Federation of

on the theme ‘Women and Men Unite to end Violence

Hospital Administrators (Madurai Chapter).

against Women and Girls’. He served as Member, Expert Committee / Board of Students’ Day Competitions

Studies, as well as Visiting Faculty cum Chairman of Examinations for Management Studies and Health

On Students’ Day, we organized competitions to exhibit

Science Programmes at Madurai Kamaraj University,

the talents and skills of the students.

Mother Teresa Women’s University and Bharathidasan University.

He served as Member of the Advisory Committee Meeting of the NSS programmes of Mother Teresa Womenâ&#x20AC;&#x2122;s University, Kodaikanal, and Rukmini Shanmugam Polytechnic College, Varichiyur. He was invited as guest speaker on the topics - Medical

Practical Training / Additional Courses / Seminars

Psychiatry in Hospitals, Managing Time, Marketing of Services, and Organisation Development at Kodaikanal

Students of Management Courses underwent

Christian College, Ayya Nadar Janaki Ammal

management training in 20 areas of the Hospital in

(Autonomous) College, Sri Kaliswari College, and

partial fulfillment of the requirement of the course.

Standard Fire Works College, Sivakasi, respectively. Students visited different types of healthcare He was invited as a lead faculty on Quality and Marketing

organizations like private / government hospitals, single /

subjects in the Workshop on Faculty Development on

multi-specialty hospitals, nursing homes, clinics, health

Entrepreneurship organized by Centre for

centres, health projects, diagnostic centres, etc., to get

Entrepreneurship Development (TN), Madurai.

an understanding about the different types of providers in healthcare.

Prof. G. Sharmil, HOD, presented a Review Paper on The Impacts of Climatic Change in Human Health in

Field visits / training programmes were organized

the National Seminar on Climatic Change and Emerging

exclusively for Science Course Students wherein they

Diseases, organised by School of Earth and Atmospheric

underwent observation training at Centre for Research

Sciences, Madurai Kamaraj University on Dec 13, 2008.

in Medical Entomology, Agricultural College & Research

Prof. G. Sharmil, HOD, presented a Research Paper on Biochemical Spectrum of Chikungunya Patients in Tamil Nadu in the 2nd National Conference on Medical Arthropodology, organized by Centre for Medical Entomology, Indian Council of Medical Research, Ministry of Health, Government of India on Dec 16, 2008. She was invited for a guest lecture on Interactive Aspects of Biochemistry at Department of Biochemistry & Microbiology, Nadar Saraswati College of Arts & Science, Theni. Prof. G. Sharmil, Mrs. A. Jasmine, and Ms. P. Rohini,

Institute, Connor Pasteur Institute, Food Processing Industry, Dairy Products Manufacturing Units, etc. Students were actively involved in all our community outreach programmes and healthcare projects. Students had ample opportunities to develop their skills in events management, as they were totally involved in all our continuing medical education / national as well international seminars and other training programmes. Students were encouraged to undergo the short courses offered at the campus in the areas of Medical Transcription, Spoken English, Mushroom Cultivation, Vermi Composting, etc.

Lecturers, served as Members, Board of Studies for the

Besides, students were encouraged to actively

Management and Applied Science courses offered at

participate in the Seminars, Workshops, Rallies, etc.

Mother Teresa Womenâ&#x20AC;&#x2122;s University, Kodaikanal.

organized by MMHRC, as well as other Educational Institutions and Healthcare Organizations.

Ms. N. Chellapriya, Lecturer, participated in the Workshop on Faculty Development on Entrepreneurship, organized by Centre for Entrepreneurship Development (TN).

DEVELOPMENTAL

EXCELLENCE

Press meet on Cadaver Transplant

2-Day National Conference on Laboratory

MMHRC Humour Club’s 17th year celebrations

Blood Donor’s Day Celebration

Promotional Initiatives With today’s situation demanding competition, the focus of the Marketing department in any hospital has changed to bringing in more and more patients. The Marketing team of our hospital, under the able guidance of our Founder Chairman Dr. N. Sethuraman, has always been working, not to bring in patients, but to impart knowledge about preventive, corrective and palliative ways of treating diseases.

After 19 years of extensive involvement, the Marketing team has become an integral part of the daily activities of the hospital. The department ensures that their message not only reaches the urban, but also the rural population. The team, being the largest in Tamil Nadu, has always made sure that their goals are in line with the organization’s goals. For the convenience of all Central & State Government Employees, Meenakshi Mission Hospital & Research Centre has enrolled itself under the CS (MA) rules, thereby, providing free services to the employees and their dependants. Also, the hospital has been approved under Section 17(2) of the Income Tax Act of 1961, thereby, providing income tax exemption on the reimbursement amount for the medical services availed by an individual.

Referral Doctors: This team, which comprises of 15 executives, move across the state to continuously impart knowledge about the facilities available in the hospital, which would ultimately benefit the patients. The team always goes an extra mile in making sure that the doctors are affiliated to the hospital. Our Continuous Medical Education (CME) programs and specialized conferences are organized to provide a healthy platform for the medical professionals, to keep themselves at par with the fast-paced medical field. Every time we meet a doctor, we make sure that he/she is honoured for his/her overwhelming contribution towards our efforts to achieve “World class care within everybody’s reach”.

Corporate Division: The corporate team works towards providing specialized care to the employees of various organizations, who have their own employee benefit programmes, through formal agreements. The team cordially works with these organizations to provide medical facilities at a concessional rate and create an opportunity for cashless medical treatment. The hospital has been approved by all major corporate and government organizations. The past year, had witnessed new agreements with the Sethu Samudram Corporation Ltd. and the Nuclear Fuel Complex at

Camp Division:

Pazhayakayal, Tuticorin. We have some proposals in the

In today’s scenario, medical camps have become an

pipeline with the Nuclear Power Corporation of India

extended marketing tool to bring in patients, but at

Ltd., Koodankulam and the Airports Authority of India.

MMHRC, camps are organized in line with the department’s goal of imparting knowledge about

Insurance & TPA Division:

preventive, corrective and palliative ways of treating

Medical insurance, a sector which has registered an

diseases. Our camp team identifies rural areas, where

exponential growth in India, has become a big help to

the awareness ratio is extremely low, and creates

common man. Organizations, which have not been

awareness on various diseases, their symptoms and the

covered under the Employees State Insurance

immediate care required. All the participants of the

Corporation, have tied-up with public and private

camps are eligible to avail a special concession of 10%

insurance companies to help provide cashless medical

on further check-ups. This year, the team has

treatment to their employees. MMHRC has tied up with

successfully conducted about 400 camps which include

more than 30 insurance companies and Third Party

general, eye, specialty, blood donation, first aid, cleft and

Administrators (TPAs) to ensure that we provide

camps for students and pensioners.

hassle-free and cashless medical treatment. This year, the team has been successful in tying-up with Star

Special Concession Division:

Insurance, that caters to the government employees

Continuing to recognize the selfless service to the

and has successfully conducted Corporate Social

society, MMHRC still provides a special concession of

Responsible (CSR) camps at Ramco Group, Rajapalayam

10% on medical bills to a certain group of the

and EID-Parry Sugars, Pugalur.

community – teachers, defence and police personnel. This special concession is also extended to the students and pensioners. This team coordinates with the camp team to take the message across and ensure them of better health at all times.

Across the Borders Marketing Division: With the increase in insurance premiums and waiting time for consultation, the West has made it difficult for its citizens to undergo surgeries in their countries. The new trend of Medical tourism has evolved as a benefit to such foreign patients and they are content with the medical expertise and the cost of its availability in India. With all of India getting excited, Madurai is no exception to Medical tourism. We have been receiving patients from the US, UK, Maldives, Sri Lanka and other Asian countries. They have all returned home satisfied with their treatment at MMHRC. In order to cater to special needs, we will be launching a dedicated luxury wing for the visitors which will house all the modern facilities that they can wish for. Apart from this, we have authorized Information centres in West Bengal to cater to the increasing number of patients from North East India. Master Health Checkup Division: MMHRC has always believed in the saying, “Prevention is better than cure”. To spread that message, MMHRC has

Public Relations Division:

evolved with some of the industry’s most

The Public Relations Division is responsible for handling

comprehensive health check-up programmes. This team

all jobs that involve any external agency, both

continuously organizes programmes targeting various

government and private, and ensure its successful

groups of the community to reinforce the need of an

completion. This team handles jobs like licensing,

annual health check-up. During this year, several

renewals, approvals and also coordination with

organizations like the TVS Group of Companies

government offices.

(Madurai) and Bajaj Allianz, have agreed to let their employees undergo an annual health check-up. With all

Prime Minister / Chief Minister Relief Fund:

this excitement, a new fully air-conditioned hall has been

The Government of India and the Government of Tamil

inaugurated for the facility, to provide a better ambience

Nadu always announce programmes that directly

to the patients.

benefit common man. MMHRC has always supported all medical programmes announced by the government,

Advertising & Media Division:

such as the -

This division is not only involved in publicizing the special

• Prime Minister’s Relief Fund for renal

events of the hospital, but also working with the specialists to write articles on several medical issues. The division is also responsible for handling the advertising

• Tamil Nadu State Illness Society funded through Government of Tami Nadu.

needs of the hospital. The team also works on several

• National Blindness Control Programme.

campaigns, commemorating the international health

• Tamil Nadu Health Fund Scheme for all major

days/events, which involve the public.

transplantation, cancer and heart ailments.

diseases and surgeries to pensioners.

Quality Service Department.

Quality hub in MMHRC

Patient Satisfaction Pays:

At MMHRC, our reputation is built on our ability to provide

We realize that when people enter our hospital they have

the service what the customer wants or needs resulting in

certain expectations and they judge their experience on

excellent medical treatment, which they can rely on, and

the service they receive while they are here. We strive

the personal care, which they will appreciate. Our Customers can be confident that their rights will be recognized and respected by all staff involved in their care. We the staff of Quality Service Department are the

constantly to meet and exceed those expectations. Quality Services team analyses customer feedback data in order to more thoroughly understand how effectively care is being delivered. The department collects more than 80% of the feedback forms from the In-patients, Out patients and

â&#x20AC;&#x153;Consumer Advocatesâ&#x20AC;? whose primary mission is to meet

from the Master Health check up customers. The

and exceed our customer needs and expectations.

understanding of overall quality of care and services will create process improvement initiatives that seek to raise

The responsibility is to foster positive customer service

the standard of care and service to a higher level .

and strive to continuously improve our level of customer service. We are working to develop and test measures of quality, identify the best ways to collect, compare and communicate data on quality and widely disseminate information about effective strategies to improve the quality of care. Several departments have enacted changes

Quality Service Department analyzes and interprets customer satisfaction and amicably solves the customer complaints. Immediate actions are taken to rectify the complaints and also an abstract is being sent to all the concerned departments for taking preventive and corrective action. A follow up thanks letter is being sent to

and have improved customer and employee satisfaction

all the customers who had created an opportunity to

through implementation of quality improvement

correct and improve ourselves. Minimization of customer

initiatives. We are also challenging some traditional

complaints and speedy remedial actions are the quality

practices, seeking innovative ways of doing things.

parameters set for this department.

Sl.No

Description

Apr. 08 – Mar.09 Avg %

Appreciation

Suggestion

Complaints

Complaints / Suggestions Sl. No.

Category / Department

Apr. 08 – Mar. 09 Avg %

Facility

Cost

Others

Canteen

Pharmacy

Nursing

Doctors

Marketing

HK & Maintenance

Quality Service

Security

Laboratory Services

Scan

Thank you Wall The appreciation given by the patients are posted in a Wall named “Thank you Wall” which motivates our

Complaints & Suggestions (Avg. per Month) April 2008 – March 2009

Meenakshi missionians. They feel extremely happy when their good work is expressed with a token of