A RARE CASE OF TUBERCULOSIS

Khadarvalli - 17 years presented to us with multiple sub cutaneous abscesses of 01 month duration. Mnay of these abscesses had been repeatedly drained at private nursing homes in Madanapalle - Guess what - none of the aspirates or fluid was ever sent for pathological examination.
We suspected Cutaneous Tuberculosis
and found AFB in the aspirate. St Johns Medical College further confirmed the Diagnosis and after surgery to drain all abscesses he was put on Cat I treatment.
Suffice to say that he is doing very well.

SIDDAMMA - Mitral Valve Replacement

Siddamma - Age 15 years - was suffering from Rheumatic Heart Disease, Mitral Regurgitation and Stenosis. She was under medical management for 5 years.
However she progressively developed Cardiac Failure and a superadded Fungal Infection of the Lungs.
She was admitted at NARAYANA HRUDAYALAYA in Bangalore where her condition was stabilised and successfully operated.
She is now doing well. We wish to thank all those donors who helped in her surgery.

List of Patients Treated at Secondary/Tertiary Centres

1
Chandrakala Bronchopneumonia Amrutha Hospital
2
Amrutha ANC - Delivery Usha Speciality
3
Redappa C TB Abdomen Popular Nursing Home
4
Adilakshmi Vaginal Hysterectomy Usha Speciality
5
Vanisree Parietal Wall abscess Popular Nursing Home
6
Vasantha PIH & Ecclampsia Usha Speciality
7
Varshita Congenital Cataract (optd) Satya Eye Hospital
8
Kanakamma ANC - LSCS Usha Speciality
9
Mehaboob Bee RHD, MS, SVTs Sri Venkateswara Institute Medical Sciences
10
Lakshmamma Dacryocystectomy Satya Eye Hospital
11
Jaithumbee Iridectomy Satya Eye Hospital
12
K Chandra Thyrotoxicosis St Johns Medical College Hospital
SJMCH
13
Masthan Bee TB Lymphadenitis Popular Nursing Home
14
Ademma Left Ovarian Mass + Hysterectomy
Usha Speciality
15
Ramanaiah Paraplegia,Bed Sores, Multi SustemFailure
Popular Nursing Home
16
Syamala Congenital heart Disease
SJMCH
17
Narasimhulu Multiple Perianal Abscess Popular Nursing Home
18
Varalakshmi Chorio Carcinoma SJMCH
19
Bhavani HIV + Lactic acidosis Baptist Hospital
20
E Subbi Reddy TB Lymphadenitis Popular Nursing Home
21
Amravathi Lumbar Canal Stenosis Saptagiri Scans
22
Savithramma Fever MLL
23
Shashikumar Appendicectomy Popular Nursing Home
24
Abilash Hyperactive Airway Disease Amrutha Hospital
SJMCH (2 times)
25
Deekshita Labial Lipoma & Ectopic Anus
SVRR (Tirupati)
26
Baby Hyperactive Airway Disease Amrutha Hospital
27
Jayamma Acoustic Schwanomma SVIMS
28
Anwar Basha TB Abdomen Popular Nursing Home
29
Anil HIV +ve AMC
30
Jabeena Sultana ANC - Delivery Usha Speciality
31
Nagamani HIV +ve SJMCH
32
Sudarshan TB Lymphadenitis Popular Nursing Home
33
Abilash Bronchopneumonia Amrutha Hospital
34
Tejashree Bronchopneumonia Amrutha Hospital
35
Beebeejan Oral Submucosal Fibrosi KMIO
36
Krishnappa Osteomyelitis SILOAM Orthopaedic
37
Manjunath Achondroplastic Dwarf SJMCH
38
Mangamma Bronchiectasis - Lobectomy SJMCH
39
Ganesh P Hyperactive Airway Disease + Bronchopneumonia
SJMCH
40
Anasuya Abdominal TB SJMCH
41
Lakshmaiah IHD + HTN + DM SJMCH
42
Nagamani PUO & HIV SJMCH
43
Jayachandra TB Meningitis SJMCH
44
Nagendra Global Development Decay & Left Eye Catatct (IOL)
SJMCH
45
Abilash Hyperactive Airway Disease + Bronchopneumonia
SJMCH
46
Venkataramana Bronchiectasis + Stevens Johnson
SJMCH
47
Dhanalakshmi Puerperal Sepsis & Peritonitis
SJMCH
48
Bhudevi SLE, Auto Immune Hepatitis
SJMCH
49
Gangabhavani HIV + Lactic acidosis Baptist Hospital
50
Thimmamma Seizure Disorder Apollo Aragonda
51
Ashrafunissa Mullerian Anomaly - Vaginal Agenesis
Sundaram Medical
52
Narsimha Reddy Thyroidectomy Popular Nursing Home
53
Siddamma RHD, MR, CCF - MVR (optd)
Narayana Hrudyalaya
54
Muniyamma PUO RVS
55
Deepak Kumar # Left arm SILOAM Orthopaedic
56
Krishnappa Viral Hepatitis RVS
57
Reddamma Ca Breast Cancer Institute, Chennai
58
Venkatappa Naidu PIVD Lv4 - Sv2 with Neuro deficit
Saptagiri Scans
59
Saroja Ca Ovary Cancer Institute, Chennai
60
B Narasimhulu CA Larynx KMIO
61
T Haritha Cerebral Palsy SJMCH
62
Khadarvalli Multiple TB Abscesses SJMCH
63
Narasamma Incisional Hernia Repair Popular Nursing Home
64
Chandrasekhara Sero -ve arthritis, DM (II) SJMCH
65
Thayaramma Idiopathic Thrombocytopenic Purpura
SJMCH
66
Abhilash Hyperactive Airway Disease SJMCH
67
Susheela ANC-LSCS Usha Speciality
68
Susheela AN C Usha Speciality
69
Raziya ANC Usha Speciality
70
K Basiri Severe Rheumatoid Arthritis SJMCH
71
G Abeda PIVD LV4-5 SJMCH
72
Subhan Basha Bronchiolitis with Hyperactive Airway Disease
Amrutha Hospital
73
S Nouzia DM(II) with Superadded infection
Popular Nursing Home
74
Bharati FB Oesophagus Satya Sai clinic

ANNUAL REPORT - RVRHC

RISHI VALLEY RURAL HEALTH CENTRE
KRISHNAMURTI FOUNDATION INDIA

ANNUAL REPORT 2005 - 06

This year past, saw an exponential growth in the number of patients seen at the Health Centre. From 7400 to 11400 was an unanticipated increase, which, stretched our resources, human, financial as well as psychological to almost breaking point.
It is never easy working day in and out with the poor. People pour into the centre seeking succour for their illnesses. More and more complex diseases, long standing conditions – crippling them, drive the poor into deeper debt. Most times we arrive at a working diagnosis- THEN WHAT? - The levels of poverty in our country are frightening, many cannot even afford a bus fare of Rs 50/- which will get them to Bangalore and a tertiary care centre, forget about meeting costs of investigations and treatment.
One wonders what will happen to the Rural Poor in this age of globalisation, privatisation and exploitation.

OUTPATIENT

Total 11532
Adults 10367
Children 1165




2003-04 6351
2004-05 7481
2005-06 11 532

The centre saw 11532 patients as compared to 7481 in the year 2004-05 and 6351 in the previous year. This increase in 4000 patients was unprecedented. We found that affordability and quality of service rendered were the two most important components in the decision amongst patients to come to the health centre.

The Manmohini Kaul Charitable Medical trust partly funds the subsidy on treatment for patients.

EYE CARE

The programme went forward another step when we were designated a Vision Care Centre by LV Prasad Eye Institute of Hyderabad. A Humphrey’s Frequency Doubling Test Instrument to measure visual fields was installed in November 2005. It has proved a boon for the early diagnosis of field defects, particularly those caused due to Glaucoma.
Patients 960
Cataracts 142
Other surgeries 10
Glaucoma 28

142 cataracts, 6 Dacryocystectomies and 4 Iridectomies were done at subsidised rates to the poor. In addition 28 patients with incipient Glaucoma were picked up thanks to the FDT instrument. I am glad to report that all patients are doing well.

AGAMA India partly supports this programme.
SILOAM eye hospital, a branch of LV Prasad Eye Institute, in Madanapalle, has started doing Cataract Surgeries at a nominal cost for our patients. This is in addition to those surgeries being done at a subsidised rate in Satya Eye Hospital, Madanapalle by an ex-parent of the school.
But as with any of our programme, lack of adequate funding remains the biggest constraint.

TUBERCULOSIS PROGRAMME

Total 87
New 68
Old (contd) 19
Sputum + (new) 30
Extra Pulmonary 12
Completed 31
RNTCP 31
Ongoing 12
Died 2
Default 2

The programme continues to be partly funded by the SIDVIM trust. The linkage with the RNTCP has proved to be beneficial, with a number of patients benefiting from access to Government supplied free medicines. Our laboratory has been recognised as a DESIGNATED MICROSCOPY CENTRE under the RNTCP.
What is worrying, however, is the growing incidence of HIV positivity amongst our patients. SIX of our TB patients were found to be HIV positive, one dying within a month of starting treatment. Providing Anti retro viral agents remains a pipe dream. Most of our effort is directed at counselling, the affected person as well as the family members in accepting the disease.


ANTENATAL PROGRAMME
(2005)
Total 30
Home 11
Hospital normal 5
Hospital LSCS 3
Lost to follow up 11

The ante – natal programme continues doing well. There is a greater awareness amongst pregnant women on the need for regular ante natal 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, 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 (Usha Speciality Hospital) at Madanapalle.

The data for the 4 years of the programme is given below:

Home Hospital normal Hospital LSCS Lost to follow up


2002 4 4 1 5
2003 11 3 4 8
2004 6 6 3 4
2005 11 5 3 11
2006 1 1 -


COMMUNITY DIAGNOSTIC CENTRE

Laboratory 2620
Microbiology 81
X-Ray 438

The Community Diagnostic Centre has more than proved its usefulness to us. Not only does the centre cater to the constantly growing needs of the Health Centre, but it also provides diagnostic services to the children of the school. The charges are nominal, covering the cost of chemicals as well as salaries and maintenance. Hence, patients are able to afford the cost of investigations done here.


ULTRASOUND

On 16th Feb 2006, the 2nd anniversary of Dr V Ramamurthy’s demise, his family and friends presented the Health Centre with an Ultrasound. Both of us are feeling our way into this new area and will start using it once training and licensing procedures are completed. We are sure that this machine will prove to be of a great benefit to us.

CAMPS

On 16th Feb, 2006 MMKCMT conducted a Paediatric Camp at the RHC. About 40 children benefited from the services of the visiting paediatrician.
33 patients with eye ailments were seen and 10 of them operated for Cataracts.

Vascular Diseases Project

With an aim at finding out the incidence/prevalence of Hypertension, Diabetes and IHD amongst the rural poor, the Health centre in collaboration with Monash University of Australia, has just started a one year epidemiological survey, covering a population of 5000.

A Closing Message

We would like to take this opportunity to thank one and all for their support to the Rural Health Centre.
A full list of patients who have been treated at Tertiary Care Centres will be put up on the blogspot at the soonest.
We look forward to your continuing support in the years to come. Please look at www.rvrhc.blogspot.com for our funding requirements.

Kartik and Kamakshi
April 2006
rvsrhc@yahoo.co.in www.rvrhc.blogspot.com www.rishivalley.org
(08571) 280573/280850/280622/280582