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.

December 2008

As the year comes to an end the health centre continues to move on in providing health care for the rural poor.

Outpatient: Total 1865
Below 15 years
Male: 150; Female: 114
>65 years
Male: 101; Female 81
Adults
Male: 537; Female: 882

Income levels (INR per month)
Below 1000: 1006
1000 - 1500: 619
Above 1500: 240

Eye Programme: 108
Glasses: 26
Medicines: 28
Surgery: 07

Antenatal Programme:
New: 07
Deliveries: Home - 01, Hospital: 03 (02 LSCS)
Abortions: Nil

Subhadra, delivered a baby after 07 years of marriage. The look on her face says it all.

You could not have asked for a more proud set of parents.

Apuramu is 24 years and suffers from Epilepsy. The plaster cast on her left arm bears testimony to an injury sustained during an epileptic attack.

She is 04 months pregnant and is under our care. We are hoping that her epilepsy will be controlled so that she can have a normal conception and delivery.

Both Apuramu and Subhadra have been supported by funding from the Village Development Council, London, England