Saturday, June 18, 2011

Report of Activities 2010 - 11

Rural Health Centre - Report
2010 - 2011

  1. The new Outpatient block inaugurated in June 2010 has helped in reducing the overcrowding, thereby ensuring a greater efficiency in patient management.
  2. More than 19000 patients have accessed the RHC this year.
  3. The rates for consultation and laboratory investigations have been upwardly revised by about 10 – 15% from June 2011.
  4. The diagnostic centre continues to be as busy as ever doing more than 23000 tests this year.
  5. Dental Centre: Dental chair and other dental equipment donated by Dr Ms Meena Desai was commissioned in November 2010. After initial teething troubles, the room was ready for use and from January, Dr Kalpana, Dental Surgeon from Madanapalle, visits once a week providing dental cover.
  6. Ultrasound Machine: A new Colour Doppler (Sonoscape SSI 5000) was purchased from donations received at a cost of approximately Rs 10,00,000/-. About 5 scans are done daily. Dr Vishnu Reddy, a sonologist, visits once a fortnight to do more complex scans.
  7. Conference: Dr Kartik presented a paper “Tensions in Livelihoods – A Rural Perspective” at the IAEVG (International Association for Educational and Vocational Guidance) – JIVA Conference in Bengaluru in October 2010
    This paper has been selected for publication as a chapter for the forthcoming book " Handbook of Career Development – International Perspectives” to be published by Wiley International.
    Dr Radha Gopal and Dr Kamakshi Kartik have agreed to be co authors for this chapter. Dr Radha will be adding a unit on Livelihoods, how to make it more attractive for youth to stay back in the villages and build a model for sustainability, incorporating common use of common resources, traditional wisdom etc. Dr Kamakshi will be adding a unit on adolescent girls and young women, their choices and tensions.
  8. Distance Fellowship in Diabetology from CMC Vellore: Dr Kartik is presently doing the course and is scheduled for completion in July 2011.
  9. America India Foundation: Ms Lindsey Adkisson, a Masters in Community Development from the USA, has been working on documenting Pesticide and Health issues at the RHC. She also works with RVSDA (Dr Radha Gopal) documenting farming practices in the valley. Her contribution to understanding the issues related to pesticides has been tremendous. The RHC and RVSDA have applied for a fellow for the coming year, to take this project forward. We intend looking at environment, health, sanitation, food security, resource management as an integrated whole and attempt to make suitable educational material for the same.
  10. The Pharmacy is being run by Usha Medicals, Madanpalle, wef Jan 2011. Only medicines from LOCOST and Generic medicines are being dispensed. The outsourcing was done to reduce administrative load on the RHC. This arrangement is working well.
  11. Vascular Diseases Project: Monash University, Melbourne, Australia (Drs Amanda Thrisft, Dr Roger Evans and Dr Srikanth as Principal Investigators from Monash and Drs Kartik and Kamakshi as PIs from RHC) has received a grant for a long term case control study on Hypertension in a rural population. The study envisages an in depth study of 400 hypertensives and and age and sex matched control group. We hope that the results will help in bettering our understanding of the cause factors in Hypertension and then suggest different interventions. The study is scheduled to commence in Sep 2011 running till September 2013.
    An existing building near the RHC will be used as an office and a new team consisting of one coordinator, one nurse and one lab technician will be recruited for the project.
    CMC, Vellore has expressed a keen interest in being part of this project. A formal application to the Institutional Review Board of CMC, Vellore is scheduled for July 2011. It is envisaged that this project will continue to run for 10 – 15 years to follow up both hypertensives as well as non hypertensives to understand the life course and natural history of the two groups.

April 2011

The month of April is always welcome, since the vacations are just around the corner. The RHC will be closed for 4 weeks in May so that we could all enjoy a much needed break
 Total Outpatient: 1838
 
Below 15 years: Male - 86; Female - 69
Above 65 years: Male: 97; Female - 90
15 - 65 years: Male - 697; Female - 799

Income (per month)
INR less than 1000: 1381
1000 - 2000: 420
2000 - 3000: 27
3000 - 4000: 09
More than 4000: 01

Eye Care

Total patients: 58
Glasses: 17
Medicines: 32
Surgeries: 09

Antenatal Programme

New registrations: 04
Delivery: 0

Abortion: NIL

Thursday, April 14, 2011

March 2011

The last month of the financial year and as usual it has been really busy. We crossed 2000 patients in a month after a long time and you can imagine how tiring it was. Dr Ramesh coming back on duty after a prolonged absence due to a broken leg was welcome to say the least.
 
 Total Outpatient: 2074
 
Below 15 years: Male - 128; Female - 95
Above 65 years: Male: 136; Female - 146
15 - 65 years: Male - 724; Female - 845

Income (per month)
INR less than 1000: 1474
1000 - 2000: 552
2000 - 3000: 35
3000 - 4000: 10
More than 4000: 03

Eye Care

Total patients: 106
Glasses: 38
Medicines: 62
Surgeries: 06

Antenatal Programme

New registrations: 02
Delivery: 01 (hospital)

Abortion: NIL

Tuesday, March 01, 2011

February 2011L


February zipped past as usual. How much difference three days makes!!!
 
 Total Outpatient: 1788
 
Below 15 years: Male - 135; Female - 121
Above 65 years: Male: 125; Female - 122
15 - 65 years: Male - 583; Female - 702

Income (per month)
INR less than 1000: 1281
1000 - 2000: 469
2000 - 3000: 27
3000 - 4000: 11
More than 4000: NIL

Eye Care

Total patients: 104
Glasses: 20
Medicines: 72
Surgeries: 12

Antenatal Programme

New registrations: 03
Delivery: 01 (hospital)

Abortion: NIL

Saturday, February 12, 2011

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

Thursday, February 10, 2011

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.

Saturday, November 13, 2010

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



Saturday, July 24, 2010

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.

Thursday, July 15, 2010

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

Tuesday, February 02, 2010

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

Saturday, December 05, 2009

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

Thursday, October 15, 2009

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

Friday, September 04, 2009

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.

Tuesday, September 01, 2009

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.