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Scrub typhus

Posted by: Philip Alex | Posted on: September 2nd, 2013 | 0 Comments

From the last year, we have been seeing scrub typhus (presumably) in Manali. Patients present to us with fever, chills, respiratory difficulty, with or without jaundice. They may also have central nervous system symptoms, with confusion and headache. The characteristic eschar alerts us to the possibility of typhus. They invariably have a low platelet count and may also have leucopenia and anemia. The respiratory distress is usually progressive when diagnosed late or when they present to us late. They often need ventilation and are very sick. They may also go into renal failure. The presence of jaundice and altered liver enzymes often compounds the seriousness of the disease. Early initiation of doxycycline therapy, blood transfusion if appropriate and steroids with early ventilation saves lives. A four percent hospital mortality has been described.

Transmitted by the trombiculid mite, chigger bites transmit the Orientia tsutsugamushi. The disease can occur a week after being bitten and the eschar by this time is a characteristic central dark necrosed area often well circumscribed and circular in appearance.

Diagnosis is by the indirect fluorescent antibody test or PCR, or biopsy of the eschar. We have been informed that the Weil Felix test is available in the Kullu zonal hospital.

The clinical and laboratory picture is pretty characteristic to allow the early initiation of therapy.

Scrub typhus is becoming a problem both to diagnose and treat in time in Himachal and other areas of North India as these links to newspapers suggest.

http://articles.timesofindia.indiatimes.com/2013-09-03/india/41725012_1_test-facility-scrub-typhus-kangra

http://www.ibtimes.co.in/articles/503396/20130903/scrub-typhus-trombiculid-mites-leptotrombidium-deliense.htm

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Sugam service pack

Posted by: Philip Alex | Posted on: August 31st, 2013 | 0 Comments

Sugam service pack has been upgraded to version five, with more features, reports and integration in with our otrs ticketing system. This has made it more convenient for all, and has worked on fixing some bugs in the system. We thank our team of developers for this upgrade.

Digital CR X ray system

Posted by: Philip Alex | Posted on: August 28th, 2013 | 0 Comments

Lady Willingdon hospital now has a digital computed radiography (CR) system, which allows our x rays to be far clearer and sharper than they were with conventional film.

Here is a KUB and IVP (Intra venous pyelogram) to illustrate how clear the system is.

For us, it is now like daylight, while our earlier experience with x rays in comparison was like peering through a dark and gloomy tunnel.

Besides, these images can be viewed on consoles in the emergency department and in the outpatient clinic  and on computers in other areas in the hospital.

The images can also be manipulated to zoom and rotate, and focus on areas that we would like to magnify.

Amazing technology. We are so grateful to those who have made this possible.

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Stones anyone?

Posted by: Philip Alex | Posted on: August 28th, 2013 | 2 Comments

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A fifty year old patient had come to us with pain in the right flank. Investigations revealed a large staghorn calculus on the right side. A retrograde pyelogram showed some obstruction at the pelvi ureteric junction. He underwent a dismembered pyeloplasty here on the 28th of August. He is doing well.

The size and number of the stones is pretty impressive.

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Welcome Anish Christanand

Posted by: Philip Alex | Posted on: July 18th, 2013 | 0 Comments

We welcome Mr. Anish Christanand, a ct technician and radiographer who will man our ct scan machine. Anish trained in CMC Vellore and has a bachelors degree in medical imaging technology. He  also worked in Herbertpur Christian hospital prior to coming here. We are very glad to have him with us.

Jibhi health mela

Posted by: Philip Alex | Posted on: July 2nd, 2013 | 0 Comments

Jibhi mela is an annual event, conducted over a period of three days in villages which come under the purview of Jibhi CHAI (Community Health Action Initiative).  This year, though the early arrival of the monsoon seemed to dampen our preparatory efforts, the mela was a grand success.

Preparation began almost a month ahead with informing the primary schools and anganwadis in the villages of Hirab, Sajwar, Shoja and Ghyagi, and requesting permission from the educational authorities who are in-charge of these schools.  The rains slashed the Jibhi area in the early weeks of June, making the kachha roads difficult for commuting.  However, the week prior to the mela, the weather turned in our tide, with the mercury rising up.

The team from Manali arrived on 19th evening, and after unwinding and a brief rehearsal, we were all set for the show.  The full team consisted of doctors (Anu and Nishanth), a dentist (Riya), an optometrist (Jasmine), an OPD worker (Sonam), social work interns (Paul, Jackson, and Prasanjit), Jibhi staff (Kanta and Kuldeep), and healthcare workers from the villages in Banjar district (Tara, Nimu, Shakti, and Manorama).

All 3 days involved driving up rather treacherous roads (these roads are not for the uninitiated!), and trekking up beautiful paths through the villages, carrying medicines. Apart from enjoying the silence and beauty of these ancient mountains, we also had a good cardiovascular workout, which betrayed the abysmal levels of fitness in some of our team members!  The children received us with enthusiasm, while the teachers had the place organized for us to perform.  The theme this year was tuberculosis, since a significant portion of people from Banjar block are known to have succumbed to the illness.  We did a brief skit which covered the symptoms and diagnostic options for TB affecting the lungs, bones, abdomen, and brain.  The skit was well received with significant numbers of adults from the villages also attending the mela.  Paul and Jackson kept the children occupied with games and music, while we were checking them up.

On the first day (June 20th 2013), we saw a total of 169 patients from the villages of Hirab and Sajwar together, 80 from Shoja on the second day, and 65 from Ghyagi on the third day.  Due to local elections on the next day, we had to wrap up soon on the last day.   Patients who required further investigations or medicines were advised to follow-up in the Jibhi clinic.

The team enjoyed a brief trek to the waterfalls nearby and also playing the stream beside the Jibhi clinic.  This was followed by a campfire session of singing and dancing, and feasting on lip-smacking mughlai biryani.

Over all, apart from providing basic health-care to these villagers, the team enjoyed the entire trip, and we look forward to another mela next year.

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Smile train leaves smiles behind

Posted by: Philip Alex | Posted on: June 22nd, 2013 | 0 Comments

Dr. Sanjay Sheoran and his team left thirteen patients smiling, their smiles and their lives forever changed.  The Smile train is an international organisation that sends their doctors all over the world to operate on cleft lip and cleft palate patients. They do this at no cost to the patient. This is the third consecutive year that the Smile train has stopped at Manali and we hope for many more stops in the years to come. Thank you Dr. Sanjay and team!

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Heart matters

Posted by: Philip Alex | Posted on: June 4th, 2013 | 0 Comments

The cardiac health mela was a huge success. The populace were directed through booths that took their height weight, waist hip ration and made them aware of their Body Mass Index and risk of heart disease with the central obesity score. Random blood sugar testing was done, and their blood pressures taken. They were then directed to the excercise track, where their target heart rate was made known to them, and then they were put through paces to achieve it, highlighting the need to be consistent and effective in their pursuit of excercise. Dietary advice was offered on the types of foods to be eaten, and avoided. Stations offering information on the relationship with dental caries to heart disease, and the efffects of heart disease on the eye and the other organ systems educated them on wholistic care. Video presentations demonstrated the process of a heart attack, unveiling what happens within the body when a person experiences a heart attack. At the culmination, they were able to eat a health meal cooked by our staff proving that healthy food can also be tasty. A street play highlighted the importance of heart disease to the onlookers.

The staff did a wonderful job, and every thing came together well to finish a mela, well done. This was also covered in detail in all the local newspapers. Great job, LWH.

 

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A busy month

Posted by: Philip Alex | Posted on: May 10th, 2013 | 0 Comments

April was a busy month. It sped by on wings. We had a series of camps. The first was an ENT camp, with Drs Regi Thomas, Associate Professor of Ent in CMC Vellore, and Dr. Rajan seeing over two hundred patients in three days. They also performed ear surgeries here. This has become an annual event, thanks to CMC Vellore. The next camp is scheduled in October, when Dr. George Ani will conduct it with another ent surgeon. This allows the people here to access this specialised care and even get their  surgeries here. We are also thinking of making the provision for hearing aids available in the next year.

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Dr. Kenny David, orthopedic surgeon and spine specialist, also from CMC Vellore has just finished an orthopedic camp here, seeing a large number of patients and performing orthopedic surgery. Some of the surgeries he performed were a boon to patients who had been nursing orthopedic conditions for years and had been unable to go to any other centre to access the care they needed.

Suraj  (name changed) was a boy who had been suffering from tuberculosis of the hip for the past two years which had eaten away the head of the femur, shortened his left leg and left him with a leg that he could not straighten out. Dr. Kenny did an excision arthroplasty by which he straightened the leg allowing healing which will allow the boy to walk, albeit with a limp. Similar corrective surgeries were performed on patients with malunited fractures of the arm and forearm. He also saw a large number of patients with backache, and operated on a  young boy whose nerve was being compressed by a disc that had bulged out causing pain and altered sensation in one leg. The boy was discharged smiling yesterday.

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Dr. Judy, Kenny’s wife is a specialist in rehabilitative medicine. She provided much needed input to the community rehabilitative program conducted by our physiotherapy department headed by Ms. Johanah Kancherla. They visited homes where patients who had sustained strokes or were otherwise disabled were being cared for by home carers, and provided advice and assistance to make the lives of these people a little easier, both for patient and the care giver. This program is now into its second year.

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Students from CMC Vellore are also here on their “Secondary Hospital Program”. Six students have shadowed the doctors, travelled to village clinics, performed school health check ups, assisted surgery, and also gone trekking and rafting, which is a full schedule for just two weeks.

 

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Annual day and retirement function

Posted by: Philip Alex | Posted on: April 17th, 2013 | 0 Comments

The annual day and retirement function was held on the 13th of April in the Daystar School Hall. This was held in honor of three of our long serving staff who reached their milestone of retirement. The hall was packed, and nostalgia mingled with humour as these staff were honored and anecdotes shared. This was interspersed with a cultural feast from the staff, showcasing songs, dances, and the decibel breaking debut of the “Willingdon Wallas“, a complete band that came together for the first time, and hopefully not for the last time.

Mr. Thampy John joined the hospital in 1987 as radiographer, but performed many tasks, including anesthesia technician, maintainence man, electrician, sound engineer, general organiser, staff representative, housekeeping supervisor.

Ms. Prema Devi joined the hospital in 1981, first as community worker, then was posted to Jibhi centre where she worked for ten years before returning to the main hospital. She retired as OPD staff.

Ms. Tara Devi joined the hospital in 1980 as community worker, was trained as a Dai, and was involved in community work before joining the main hospital as a ward aide, in which capacity she has worked all these years.

We thank God for their lives and service.

Retirement gifts were given out to the staff who were retiring, and a fitting finale was a dinner feast featuring local Himachali food.

It was a wonderful evening, and all the staff came together to put together yet another amazing program.

The photographs are in the “Hospital” gallery, and when the video is made available, it will also feature on U tube, the link to which will be provided.

 

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