Ben and Kelly two nurses working at the local hospital. photo aaahhh-karo SONY DSC SONY DSC KONICA MINOLTA DIGITAL CAMERA

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Shp (secondary hospital program)

Posted by: Philip Alex | Posted on: May 7th, 2014 | 0 Comments

The students from CMC Vellore are here on their secondary hospital program, accompanied by faculty Dr. Jacob John, consultant in community medicine. The batch is an all male team this time, and they have been accompanying doctors on rounds, in the ot, and to the peripheries to conduct clinics and check ups.

We thank CMC Vellore for sending them every year to Manali.


Subdural hematoma evacuation

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

Mrs J is a sixty five year old lady who was brought to us with the history of altered sensorium and behavior for a day prior. She had already obtained a ct scan from outside which showed a large subdural hematoma (blood clot) in her brain compressing her brain to the other side. She needed a surgery. She was referred to IGMC Simla, but the family did not have the economic means to take her there. Manali was their last hope.

Having explained all the risks of performing this surgery in a relatively unsupported environment, we did a craniotomy and evacuation of the hematoma here. The lady made a dramatic recovery and is being discharged well. We thank God for the amazing recovery she made and for saving her life.



Farewell again

Posted by: Philip Alex | Posted on: November 13th, 2013 | 0 Comments

We bid a fond farewell to Drs Anu Yarky, Dr. Shefali and to our Staff nurse Nisha Kumari with samosa and gulab jamuns  in front of the mess. All are going for further studies, and we wish them well. We had a bit of an emotional farewell. Emotions are always at the fringes of these functions, but this time, it overflowed!





Lahaul Spiti camp

Posted by: Philip Alex | Posted on: September 29th, 2013 | 0 Comments


The access to this district is over the formidable Rohtang pass, and traversing the road into this region comes with its share of excitement. The land is a study in contrast from east to west. Cut off and remote, the people have learnt to survive in this harsh environment with an innate fortitude and strength. Every thing here is scarce. Water, electricity, health care, newspapers. Everything has to be brought in over the pass, and the outcome of every emergent situation is decided by whether the people can carry the patient out over the pass, or whether the patient is hardy enough to survive. Understandably, the average populace is hardy, and healthy, because only the healthy survive. Yet, they brave the inclement weather and circumstances with a cheerfulness and a smile that is humbling to the visitor. Medical care is provided by a chain of government health centres, which are usually staffed by a few doctors. Specialists and specialised care is scarce. Surgical services can usually be accessed only in Kullu, Manali or Simla. Recent reports of surgical care being a public health problem where people are unable to access surgery has been highlighted by reports from Sierra leone and Africa. The situation in Lahaul Spiti is not very different and indeed, one can understand why surgery will elbow a place for itself as a public health issue. To meet this need, we will need to plan and execute camps in the future. The provision of safe surgery in remote locations is an incredible challenge.


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.

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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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