January 2011

The new year dawns and one hopes that the year ahead will prove beneficial to the farmers and daily wage workers

Total Outpatient: 1641
Below 15 years: Male - 122; Female - 101
Above 65 years: Male: 129; Female - 121
15 - 65 years: Male - 503; Female - 665

Income (per month)
INR less than 1000: 1103
1000 - 2000: 493
2000 - 3000: 30
3000 - 4000: 11
More than 4000: 08

Eye Care
Total patients: 88
Glasses: 21
Medicines: 61
Surgeries: 06

Antenatal Programme
New registrations: 06
Delivery: NIL
Abortion: NIL

Venkat - CHD VSD and Kypho Scoliosis

 Venkat is a 14 yr old boy. He has a large Ventricular Septal Defect and a Kypho Scoliosis
We are hoping to get him operated under the Arogyasri scheme. Till then his treatment is being supported by Heart and Hand for the Handicapped, USA

Geetha - Malnutrition

Geetha, 14 years, came to us because of excessive fatigue. When I was talking to her found that she was bit dull and her hair quite coarse. Suspected a hypothyroid state and the investigations proved it. She is now on Eltroxin and Nutritional supplements. Hope that she does well.
Her treatment is supported by Heart and Hand for the Handicapped USA.

December 2010

The last month of the year and the patient continue puring in. We have had to put restrictions on the number of patients being seen as we are unable to cope with the demands.

Total Outpatient: 1780
Below 15 years: Male - 128; Female - 122
Above 65 years: Male: 156; Female - 121
15 - 65 years: Male - 520; Female - 733

Income (per month)
INR less than 1000: 1172
1000 - 2000: 534
2000 - 3000: 55
3000 - 4000: 13
More than 4000: 06

Eye Care
Total patients: 93
Glasses: 20
Medicines: 71
Surgeries: 02

Antenatal Programme
New registrations: 04
Delivery: 01 (LSCS)
Abortion: NIL

Mohd Sameer - Inguinal Hernia

Post op With mother

Mohd Sameer - Post op

 Mohd Sameer all of 04 months of age - was operated at St Johns Medical College for a Congenital Hernia. he is doing well and the smile on his and his mothers face is worth it. By the way the mother is just 18!







 
Erappa came to us with a rapidly growing mass on the right side of the neck. An FNAC and subsequent Biopsy showed it be a Cancer, but the primary was not clear. Immunohistochemistry studies showed  that the Cancer was a melanoma. This led us for a search of the Primary and it is possible that it was in the floor of the mouth.
He is under treatment at SVIMS, Tirupati, under Arogyasri programme
All his investigations costs were supported by Village Development Council, London, under the Old Age Scheme

Erappa ? Melanoma floor of mouth

Erappa - Secondaries in the neck

November 2010

Back from a vacation and a good diwali, the RHC started off slowly.

Rishi Valley it self was busy hosting the annual Krishnamurti Gathering from 22 to 25 November. The children came back after their winter vacations on 26th and the valley was agog once again with all the noise and energy children bring.

Total Outpatient: 1323
Below 15 years: Male - 108; Female - 90
Above 65 years: Male: 117; Female - 89
15 - 65 years: Male - 418; Female - 501

Income (per month)
INR less than 1000: 867
1000 - 2000: 383
2000 - 3000: 57
3000 - 4000: 09
More than 4000: 08

Eye Care
Total patients: 68
Glasses: 16
Medicines: 47
Surgeries: 08

Antenatal Programme
New registrations: 02
Delivery: 02 (both LSCS)
Abortion: NIL

Keerthi - Nephrotic Syndrome

 

Anjamma - Pesticide Dermatitis

 Anjamma has typical dermatitis brought on by spraying / using pesticides (Endosulfan in particular) without safety precautions

Keerthi had come to us with facial swelling and a diagnosis of Nephrotic Syndrome was made. She was treated by Paediatric Nephrologist at St Johns Medical College and is now doing well.

Her treatment was supported by Sishukunj International,London

October 2010

With October the Valley starts cooling off. This is also the time for the festive vacation. The RHC was closed for 2 weeks from the end of October till the 1st week of November, and  reopened after Diwali.
It was a much needed break for all of us.


Total Outpatient: 1327
Below 15 years: Male - 85; Female - 75
Above 65 years: Male: 97; Female - 85
15 - 65 years: Male - 466; Female - 519

Income (per month)
INR less than 1000: 834
1000 - 2000: 460
2000 - 3000: 18
3000 - 4000: 11
More than 4000: 04

Eye Care
Total patients: 102
Glasses: 19
Medicines: 79
Surgeries: 04

Antenatal Programme
New registrations: 03
Delivery: NIL
Abortion: NIL

Nandini was brought to us because of failure to thrive. We found a Mental Retardation, probably due to consanguinity. She is under investigation and assessment at St Johns Medical College

Nandini Mental Retardation and Bronchial Asthma

September 2010

The rains have stopped. This year though there has been a better rainfall, the tanks are not full and hence the problem of summer looms large.
Lindsey Adkisson, who has done her Masters in Rural Development, is a William J Clinton Fellow. She has been sponsored by the America India Foundation to work at the RHC for 10 months. She will be working on documenting Health Issues related to Pesticide use as well as doing a survey on land use, cropping patterns, economics of farming.
Its a pleasure to welcome her to this field.


Total Outpatient: 1971
Below 15 years: Male - 181; Female - 167
Above 65 years: Male: 143; Female - 111
15 - 65 years: Male - 556; Female - 813

Income (per month)
INR less than 1000: 1384
1000 - 2000: 542
2000 - 3000: 24
3000 - 4000: 18
More than 4000: 03

Eye Care
Total patients: 99
Glasses: 19
Medicines: 78
Surgeries: 02

Antenatal Programme
New registrations: 03
Delivery: 01 (Hospital)
Abortion: NIL

Narasamma and Child

 Narasamma had Pesticide (Endosulfan) induced dermatitis and infertility.
Following complete cessation of pesticide use, she conceived and delivered a healthy female baby.
Mom and kiddo are really happy.

August 2010

August is as busy as usual.


Total Outpatient: 1996
Below 15 years: Male - 184; Female - 155
Above 65 years: Male: 115; Female - 91
15 - 65 years: Male - 575; Female - 876

Income (per month)
INR less than 1000: 1387
1000 - 2000: 557
2000 - 3000: 33
3000 - 4000: 13
More than 4000: 06

Eye Care
Total patients: 102
Glasses: 19
Medicines: 79
Surgeries: 04

Antenatal Programme
New registrations: 03
Delivery: NIL
Abortion: NIL

July 2010

July continues to be busy as usual. The stats are below:

Total Outpatient: 1911
Below 15 years: Male - 166; Female - 153
Above 65 years: Male: 135; Female - 111
15 - 65 years: Male - 566; Female - 780

Income (per month)
INR less than 1000: 1298
1000 - 2000: 582
2000 - 3000: 23
3000 - 4000: 3
More than 4000: nil

Eye Care
Total patients: 95
Glasses: 15
Medicines: 70
Surgeries: 10

Antenatal Programme
New registrations: 02
Delivery: NIL
Abortion: NIL

June 2010

The new Outpatient block, which was made possible thanks to a generous donation by Mr Ahsan Hyadri, '59 Batch of Rishi Valley School was inaugurated on 01 June.

Staff getting ready for lamp lighting

Decorating the entrance

Krishnappa, oldest RVS employee lighting the lamp

Naidu Sir, RVS Staff from 1960 

The new block

The new block has proved to be a real blessing. There is now enough space for each of us,patient flow is better and the overcrowding has reduced immensely.

Many ,many thanks to Ahsan for his generous contribution.

Total Outpatient: 1741
Below 15 years: Male - 105; Female - 82
Above 65 years: Male: 129; Female - 97
15 - 65 years: Male - 628; Female - 700

Income (per month)
INR less than 1000: 1105
1000 - 2000: 571
2000 - 3000: 33
3000 - 4000: 20
More than 4000: 12

Eye Care
Total patients: 79
Glasses: 25
Medicines: 49
Surgeries: 05

Antenatal Programme
New registrations: 07
Delivery: NIL
Abortion: NIL

April 2010

April is a hot, the temperatures go up steadily hovering around the early 40's. This year has been unseasonably hot and there is hope that the rains in June would be good. A thunderstorm brought the temperatures down for a couple of days but in the process uprooted a number of trees.

Total Outpatient: 1489
Below 15 years: Male - 78; Female - 62
Above 65 years: Male: 109; Female - 77
15 - 65 years: Male - 451; Female - 712

Income (per month)
INR less than 1000: 929
1000 - 2000: 524
2000 - 3000: 19
3000 - 4000: 10
More than 4000: 7

Eye Care
Total patients: 46
Glasses: 08
Medicines: 29
Surgeries: 09

Antenatal Programme
New registrations: 01
Delivery: NIL
Abortion: NIL

Divya 3 years

Divya - Post Operative

Divya presented to the RHC with colicky pain abdomen, vomiting, abdominal distension. Clinically there was diffuse tenderness, guarding in the right hypochondrium and flank, gurgling and increased bowel sounds. A small mass was felt in the same region.
Initial diagnosis of Intestinal Obstruction ? Due to Intusseption/Volvulus was made. The child was referred to St Johns Medical College, where a surprise awaited all.


The baby had a retroperitoneal terratoma, which had stretched the Inferior Vena Cava and Right Renal artery and vein. She was operated, and the tumour removed.  

 The tumour weighed 1.8 kg and was confirmed to be a TERRATOMA with multiple levels of maturity.

Divya has made a full recovery and is now doing well.

March 2010

The end of the financial year means more work what with audit and other requirements. This does not make a difference to the patients who keep pouring in.





The new Outpatient block is nearing completion and we hope to move in in June 2010.













Total Outpatient: 1931
Below 15 years: Male - 133; Female - 115
Above 65 years: Male: 137; Female - 119
15 - 65 years: Male - 534; Female - 893

Income (per month)
INR less than 1000: 1303
1000 - 2000: 579
2000 - 3000: 43
3000 - 4000: 11
More than 4000: 13

Eye Care
Total patients: 64
Glasses: 09
Medicines: 49
Surgeries: 06

Antenatal Programme
New registrations: 01
Delivery: 05 (Hospital - 02, LSCS - 03)
Abortion: NIL

February 2010

February continues to be busy as the first hint of summer reaches us. It had been unseasonaly cold over the first two weeks of the month and then all of a sudden the temperatures shot up. Now it is warm and a foretaste of summer.


The RHC monthly statistics are given below.

Total Outpatient: 1736
Below 15 years: Male - 131; Female - 105
Above 65 years: Male: 104; Female - 106
15 - 65 years: Male - 593; Female - 657

Income (per month)
INR less than 1000: 1356
1000 - 2000: 325
2000 - 3000: 40
3000 - 4000: 10
More than 4000: 05

Eye CareTotal patients: 82
Glasses: 15
Medicines: 56
Surgeries: 11

Antenatal Programme 
New registrations: 02
Delivery: 01 (Hopsital - LSCS)
Abortion: NIL

January 2010

We welcome the new year and hope it brings sunshine and happiness to all people

We added a new semi automatic analyser to the laboratory. Made by Vital Diagnostics Australia, it was funded by friends, alumni of AFMC and some well wishers. This has helped us do many more biochemical tests in our laboratory itself and saves the trouble of patient samples being sent to Madanapalle or other laboratories.





The RHC monthly statistics are given below.


Total Outpatient: 1575
Below 15 years: Male - 136; Female - 93
Above 65 years: Male: 147; Female - 147
15 - 65 years: Male - 469; Female - 583

Income (per month)
INR less than 1000: 1045
1000 - 2000: 485
2000 - 3000: 28
3000 - 4000: 25
More than 4000: 17

Eye CareTotal patients: 74
Glasses: 15
Medicines: 52
Surgeries: 07

Antenatal ProgrammeNew registrations: 01
Delivery: 01 (Hospital - 01)
Abortion: NIL

Total patients: April 2009 - January 2010: 15063

December 2009

The last month of the year and yet another year goes past.
One wonders whether this wonderful country of ours will reap the benefits of liberalisation, will the fruits of economic reforms actually trickle down to those most needing it, will governmental systems actually deliver? These are eternal questions as one continues to deal with the mass of humanity needing medical care.
The RHC monthly statistics are given below.

Total Outpatient: 1800
Below 15 years: Male - 192; Female - 173
Above 65 years: Male: 121; Female - 98
15 - 65 years: Male - 541; Female - 675

Income (per month)
INR less than 1000: 1216
1000 - 2000: 545
2000 - 3000: 20
3000 - 4000: 11
More than 4000: 06

Eye CareTotal patients: 57
Glasses: 12
Medicines: 44
Surgeries: 01

Antenatal ProgrammeNew registrations: 02
Delivery: 05 (Hospital - 04, LSCS: 03)
Abortion: NIL

November 2009

After the Vacations and the festive season, the whole staff is back, refreshed and rejuvenated.
Dr Kamakshi and Dr Kartik had gone to Mysore to attend "INDIA PACIFIC INTERNATIONAL PAEDIATRIC AIDS CONFERENCE. The conference was most instructive bringing to light the latest in thinking on this burning issue. we also learnt a lot about the need to look for HIV in pregnant women and prevent transmission for Positive Parent to Child (PPTCT).
The RHC monthly statistics are given below.


Total Outpatient: 1383
Below 15 years: Male - 138; Female - 138
Above 65 years: Male: 113; Female - 82
15 - 65 years: Male - 369; Female - 543

Income (per month)
INR less than 1000: 892
1000 - 2000: 446
2000 - 3000: 24
3000 - 4000: 16
More than 4000: 04

Eye Care
Total patients: 50
Glasses: 06
Medicines: 40
Surgeries: 04

Antenatal Programme
New registrations: 05
Delivery: 01 (Hospital - 01)
Abortion: NIL

October 2009

October is the month of festivals, with Dusshera and Deepavali. This year we kept the Health Centre running right through with the staff taking leave by rotation. This seems to have helped the local population who have benefited from this.

Total Outpatient: 1478
Below 15 years: Male - 122; Female - 96
Above 65 years: Male: 128; Female - 87
15 - 65 years: Male - 461; Female - 584

Income (per month)
INR less than 1000: 974
1000 - 2000: 478
2000 - 3000: 18
3000 - 4000: 04
More than 4000: 03

Eye Care
Total patients: 61
Glasses: 13
Medicines: 42
Surgeries: 06

Antenatal Programme
New registrations: 03
Delivery: 01 (Hospital - 01)
Abortion: NIL

September 2009

The rains continued through most of September and we were thankful since the water table has definitely benefited. A number of tube wells which were dry have come to life again. We now await the North East Monsoon in End October.

Total Outpatient: 1680
Below 15 years: Male - 156; Female - 147
Above 65 years: Male: 144; Female - 93
15 - 65 years: Male - 470; Female - 670

Income (per month)
INR less than 1000: 1070
1000 - 2000: 542
2000 - 3000: 64
3000 - 4000: 17
More than 4000: NIL

Eye Care
Total patients: 49
Glasses: 10
Medicines: 32
Surgeries: 7

Antenatal Programme
New registrations: 02
Delivery: 03 (Hospital - 03, LSCS - 01)
Abortion: NIL

August continues to be busy, however most importantly, the rains came. We got about 20 cm of rain, which has definitely helped the water table as well as the standing crops. The farmers are all smiles and in some farms there is hectic planting activity of short term crops like Jowar, Bajra etc.

Total Outpatient: 1738
Below 15 years: Male - 120; Female - 135
Above 65 years: Male: 133; Female - 101
15 - 65 years: Male - 551; Female - 698

Income (per month)
INR less than 1000: 1084
1000 - 2000: 588
2000 - 3000: 51
3000 - 4000: 12
More than 4000: NIL

Eye Care
Total patients: 93
Glasses: 15
Medicines: 68
Surgeries: 10

Antenatal Programme
New registrations: 05
Delivery: 02 (Hospital - 02)
Abortion: NIL

Some Patients



Rasool Bee, 85 years old, came to the RHC with an ulcerative swelling in the Left sub mandibular region. The swelling starts from the mouth as the picture on the right shows. This was most probably a Squamous Cell Carcinoma, brought about by years of betel nut chewing. She refused to go anywhere else and is being given palliative care here.

What you see in this photograph is a classical case of DERMATITIS due to Endosulfan use. The RHC has taken on a project to document diseases associated with pesticide use.

JULY 2009

The month of July saw us battling with drought like situation. The rains have failed us and we wonder whether we will last till November when the NE Monsoon makes its appearance.
The patient load remained the same:

Total Outpatient: 1862
Below 15 years: Male - 167; Female - 175
Above 65 years: Male: 107; Female - 71
15 - 65 years: Male - 513; Female - 829

Income (per month)
INR less than 1000: 954
1000 - 2000: 733
2000 - 3000: 141
3000 - 4000: 32
More than 4000: 02

Eye Care
Total patients: 121
Glasses: 15
Medicines: 95
Surgeries: 11

Antenatal Programme
New registrations: 03
Delivery: 02 (Hospital - 02)
Abortion: 01

Some Patients
Venkataramana has a Corneal dystrophy of the Right Eye. You can see the



haziness in the cornea. This was primarily due to Malnutrition. A course of Vitamin A resolved the Corneal Dystrophy.

Anjeppa, 47 year old male had been treated earlier for Pulmonary TB at a Primary Health Centre.In all probabilities he had not completed his full course of treatment. A recurrence was detected at the RHC., we suspect MDRTB, for which a TB Culture has been done. There is also a strong suspicion of Leprosy.



Leonine features, loss of eyebrow hair, hyperpigmentation and hypoaesthesia. A slit skin biopsy is awaited.

Reddy Kumar was brought to the RHC by his distraught parents. Clinically we suspected ? Downs Syndrome. His Thyroid levels were suggestive of Hypothyroidism (TSH > 150 micrograms, T3 06.57, T4 0.7). He was started on Eltroxin 50 microgram, and increased to 100 microgram a weeklater. However two weeks into the treatment, he developed a severe lower respiratory infection, wheeze etc. This proved fatal and he passed away at the Government Hospital.

JUNE 2009

The RHC was closed for three weeks in May, a much needed break for all of us. It was also a month for introspection and to see where we could improve. One of the suggestions was that the RHC will work through the year, with the staff taking breaks. We also designated Tuesdays and Thursdays for people coming in from more than 35 km. This will hopefully mean that the patient load is better distributed.

Total Outpatient: 1510
Below 15 years: Male - 119; Female - 116
Above 65 years: Male: 139; Female - 137
15 - 65 years: Male - 415; Female - 584

Income (per month)
INR less than 1000: 770
1000 - 1500: 440
1500 - 3000: 234
More than 3000: 63

Eye Care
Total patients: 69
Glasses: 23
Medicines: 38
Surgeries: 08

Antenatal Programme
New registrations: 04
Delivery: 05 (Hospital - 02; LSCS - 01)

Some Patients

Sharad delivered a healthyfemale baby after succesful Tubal Recanalisation. She had lost two young children to road accidents a year apart and the parents were understandably shattered. Luckily the recanalisation worked and both the baby and she are doing well.
Sarojamma, has a Squamous Cell Carcinoma of the lip, brought about by years of betel nut chewing. How does one break this ubiquitous habit? Especially when it is used to stave off hunger pangs?

April 2009

April is the start of the new financial year, so in the middle of all accounts work, the RHC has to contend with an increase in patient load.

Total Outpatient: 2037
Below 15 years: Male - 134; Female - 109
Above 65 years: Male: 190; Female - 190
15 - 65 years: Male - 633; Female - 781

Income (per month)
INR less than 1000: 1060
1000 - 1500: 651
More than 1500: 326

Eye Care
Total patients: 79
Glasses: 24
Medicines: 50
Surgeries: 05

Antenatal Programme
New registrations: 07
Delivery: 05 (03 in Hospital, 01 LSCS and 01 at home)

A Patient: Thejaswini was brought to the RHC with loss of weight, lassitude as well as recurrent fevers. A routine check revealed that she was Type I Diabetes Mellitus. She was put on Injection Insulin and has stabilised well with 22 units in the morning and 18 units at night. She is doing well.
Her management is supported by Heart and Hand for the Handicapped, USA

MARCH 2009

March is the last month of the financial year and that normally means more work in terms of stock taking, accounts etc.
However this does not make any difference to the patients. Disease and infirmity do not make a distinction between the months of the year.

Total Outpatient: 1460
Below 15 years: Male - 91; Female - 87
Above 65 years: Male: 142; Female - 112
15 - 65 years: Male - 576; Female - 453

Income (per month)
INR less than 1000: 787
1000 - 1500: 439
More than 1500: 234

Eye Care
Total patients: 68
Glasses: 11
Medicines: 50
Surgeries: 07

Antenatal Programme
New registrations: 05
Delivery: 03 (02 Hospital and 01 at home)

Some Patients: Sreenath 02 months, was brought to us by concerned parents because of the wheeze and stridor. He had LARYNGOMALACIA, for which there is no treatment. The baby grows out of it by the time he is a couple of years old. The video however is quite scary. A photo is also attached.



Mohith Naik, 2 year old male had repeated fevers and was diagnosed here as recurrent Urinary Tract Infections, most likely due to a Posterior Urethral Valve. He was operated at CMC Vellore and is doing well. You can see the bladder opening in the abdomen, which will be closed subsequently.

February 2009

Come February and the heat builds up both in terms of illnesses as well as the onset of summer.

Total Outpatient: 1504
Below 15 years: Male - 105; Female - 90
Above 65 years: Male - 100; Female - 113
Adults: Male - 496; Female - 600

Income (per month)
INR less than 1000: 784
1000 - 1500: 477
More than 1500: 241

Eye Care
Total patients: 66
Glasses: 18
Medicines: 42
Surgeries: 06

Antenatal Programme
New registrations: 04
Delivery: 01 (Hospital)

Charan Teja, 18 months was brought to the health centre with complaints of failure to thrive. Looking at him Dr Ramesh felt that it was MARASMUS (Protein Energy Malnutrition). However, since there was a history of Urinary Dribbling, we thought of Chronic Urinary Tract Infection, due to Postr Urethral Valves and Septicemia. Parentaeral antibiotics were given and he was referred to St Johns Medical College, where the latter diagnosis was confirmed. He is at present admitted at SJMCH and surgery has been planned once his Urinary Infection comes under control.
His treatment is being funded by SISHUKUNJ INTERNATIONAL

This young 19 year old girl came to us because of delayed as well as irregular cycles. Dr Kamakshi made the diagnosis of TURNERS SYNDROME since she is short statured as well as has neck webbing.

January 2009

January is traditionally a leaner month, because of the harvest season and the important festival of Sankranti. The statistics for this month are given below:

Outpatient Total: 1419
Below 15 years: Male 124, Female: 82
Above 65 years: Male: 70, Female: 55
Adults: Male 435, Females: 653

Income:
INR less than 1000: 683
1000 - 1500: 480
More than 1500: 252

Eye Programme
Total Patients: 96
Glasses: 29
Medicines: 61
Cataract Surgeries: 05

Antenatal Programme
New: 07
Delivery: 1 (Hospital)

Venkatalakshmi, is about 60 years. All but crippled because of her Osteoarthritis, she is dependent on two sticks to help her walk. She finds it impossible to go about her daily functions. NSAIDS (Painkillers) and Calcium tablets alleviate the pain to some extent. Her treatment is being funded by the Village Development Council, London.
Bavaji: July 2008 and January 2009. A patient of Severe Thyrotoxicosis, who with treatment has shown dramatic improvement. The two photos say it all.
Pavan Kalyan, 18 months, had a broncho pneumonia. Use of Nebuliser and additional oxygen, as an outpatient procedure ensured that he survived. Ideally he should have been have been hospitalised, but lack of money, meant that we had to treat him at the RHC. Thanks to Dr Ramesh for seeing him through.
His treatment was funded by Heart and Hand for the Handicapped, USA.