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Thursday, December 27, 2007

Venkataramana - A Wizened baby

A three month old baby, one of the surviving twins.
The birth weight of both the twins was 2.0 kg (4.4 lbs).
The elder twin was a girl and so the mother did not give her breast milk, leaving the baby to depend on cow's milk. Being born small, the girl had no chance and died within a month of birth.
The younger being a male had the "privilege" of mother's milk. Now, in spite of being three months of age, this one is also struggling for life. Weight at present is 2.1 kg, a scant 100 gms more than his birth weight. The baby also had cough and respiratory distress. The X Ray showed a patch in the left lung suspicious of a Bronchopneumonia. Also worrying us is the fact that the baby has not put on any weight since birth.
It may be maternal malnutrition or more likely that the mother has Tuberculosis (the mother has cough with sputum production for a month now) which has been passed onto the baby.
The baby has been admitted at St Johns Medical College, Bangalore.
Watch this space for updates

An Old Age Story

An old lady, bent at the waist, almost double, using a stick to support her feeble frame, one amongst the many you would pass by on the dusty village raods without a second glance.
She came to us saying that she was unwell and had very little energy. One look at her and Dr Kamakshi diagnosed Anaemia. Sure enough, her Haemoglobin was 3 gm% (normal 12 gm%). No wonder she was tired and fatigued.
We helped her children understand the need for proper nutrition, a roasted mixture of ragi, green gram dhal, rice and chickpeas was suggested as a gruel, with the addition of milk and jaggery. Of course B Complex and Iron tablets were added. Luckily for her, she has children to look after her.
Let us hope that her remaining years on this earth will be qualitatively better.

Thursday, December 20, 2007




The patient load is unremitting. Day in and out the outpatient is full of the poor seeking succour. During the year, 15,426 patients sought the services offered by the RURAL HEALTH CENTRE, up from 11532 of the previous year. We managed to streamline a few systems and also, we got used to the numbers pouring in. As ever, funding is a constraint and mobilising resources the key to the successful running of the Health Centre.


2004 – 05: 7461
2005 – 06: 11532
2006 – 07: 15426

The average daily workload of the tri weekly outpatient is about 120, with a maximum of 200, which we saw in January.
Since its inception in January 2001, the RHC has treated a total of 61,005 patients.
We are reporting an HIV +ve incidence of 2.94%. ASHA Foundation in Bangalore and the newly opened ART Centres at Cuddapah and Tirupati have helped in extending free Anti Retroviral treatment to our patients.


This programme continues to do well. Support from SILOAM Eye Centre, (a unit of LV Prasad Eye Institute) and Sathya Eye Hospital, helped us in operating on a number of poor patients.
This year, 187 Cataract surgeries and 5 Glaucoma surgeries were done at these hospitals.
Since its inception in 2001, the Eye Care Facility has examined 5798 patients and has facilitated 748 cataract surgeries in this time period.
But as with any of our programmes, lack of adequate funding remains the biggest constraint. AGAMA India, has been the prime supporter of this programme and we hope that they would continue supporting us in the future.
We are looking for funding for this programme at a cost of Rs 1550/- per cataract surgery.


This programme is funded by the SIDVIM trust. The RNTCP now accepts all cases referred to the PHC, without hesitation. The cases being treated by us are the ones, which do not fall under the purview of the RNTCP treatment protocols.
We started TB cultures in our Microbiology Centre in January of this year and this has proved to be a great boon in the diagnosis and treatment, particularly of Multi Drug Resistant TB.
HIV positives continue to be detected amongst our TB patients, with an incidence of 4 out of the 62.
221 patients have benefited from the TB programme with a cure rate of 92.76%, which compares with the best in the rest of the country.
The data for the calendar year 2006 is given below.
Cases Details

New Cases: 62
Sputum +ve: 19 (31%)
Extra Pulmonary TB: 8 (13%)
Treated at RHC: 34 (55%)
Number successfully completed treatment at RHC: 23 (68%)
Number carried over to 2007 by RHC: 11 (32%)

Treated by RNTCP: 28 (45%)
Old Cases

Number carried forward from 2005: 12
Number successfully completed treatment: 11 (92%)
Number defaulted: 01 (8%)


The antenatal programme is also doing well. There is a greater awareness amongst pregnant women on the need for regular antenatal checks. The ‘lost to follow up’ is probably because of a number of home deliveries, which do not get reported, in spite of our best efforts.
An increasing number of women with multiple pregnancy losses and Bad Obstetric History are accessing our Centre for the following reasons (i) comprehensive work up (ii) personalised guidance and counselling, (iii) close monitoring of the ongoing pregnancy (iv) liaison with Fetal Care Research Centre, Chennai and (v) support of a committed Obstetrician at Madanapalle.

Statistics: 2006
Registered: 40
Delivered: 22
Hospital Normal: 04
Caesarean Section: 02
Ongoing: 11
Lost to follow up: 07


A total of 9305 tests were done at the Community Diagnostic Centre. As in any clinical setting, haematology and biochemistry predominated.
The Microbiology Centre, which is the only one of its kind in a 120 km radius, has proved to be highly beneficial in early diagnosis of various infections. The Centre did 150 cultures this year and we hope that more clinicians will avail of this facility.

Haematology: 3274
Biochemistry: 2441
Serology: 313
Urine Analysis: 1802
Clinical Pathology: 87
Endocrinology: 388
Microbiology: 150
Sputum: 379
ECG: 243
X Ray: 227

HIV: We tested 170 patients using a rapid agglutination test (TRIDOT). Of these 5 were declared positive, giving us a rate of 2.94%, which is comparable to what is reported in the literature.
Endocrinology: This was of a greater surprise to us. 25 out of 110 patients tested (22.73%) showed evidence of Hypothyroidism. This raises the question as to why there is so much of hypothyroidism in these areas.


To all of you who have supported the health centre, emotionally, financially and in every way possible. The list is big and there is not enough space to thank one and all.

Every bit small bit helps in our endeavours and we welcome any contribution. Please look at for our funding requirements.

Wednesday, December 19, 2007


Dr Kartik was away from mid October to mid November, to Oak Grove School of the Krishnamurti Foundation of America, Ojai, California, USA as part of a teacher visit programme. October was also the month of Deepavalli and the health centre was closed for two weekd from the middle of October to the end of October.
Skeleton staff manned the health centre, by turns, providing basic first aid and emergent medications. The health centre resumed its functioning from 26th Novmeber and right from the first day we were up and running starting with a hundred patients, going up to 150 patients by the end of the week.

October 2007

Children: 55
Total Patients: 653

Ophthalmic Programme
Children: NIL
Total Patients: 08
Cataract Surgeries: NIL

Antenatal Programme:
Registered: 03

November 2007

Children: 20
Total Patients: 321

Ophthalmic Programme
Children: NIL
Total Patients: NIL
Cataract Surgeries: 03

Antenatal Programme:
Registered: 04

When we look back, we wonder where the vacation went!!!! Just kidding.


It has been a while since I updated this so here goes. August and Spetember were busy months as usual. In fact it seems that we have got inured to the deluge of patients.
Here are some statistics:
August 2007

Number of Children: 103
Total Patients: 1942

Ophthalmic Programme
Children: 01
Total Patients: 112
Cataract Surgeries: 15

Ante Natal Programme
Registered: 02

September 2007

Number of Children: 73
Total patients: 1858

Ophthalmic Programme
Children: 05
Total Patients: 70
Cataract Surgeries: 10

Ante Natal Programme:
Registered: 04

All in all not a bad couple of months work.