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Annual Report 2007 - 2008

MEENAKSHI MISSION HOSPITAL AND RESEARCH CENTRE (Run by S R Trust)

Mission

World class care within everybody's reach. Vision

No man is too poor to afford first grade medical treatment. Values Care Compassion Commitment Charity Empathy Quality Service Quality Policy Meenakshi Mission Hospital and Research Centre, in pursuit of excellence, is committed to comply with applicable requirements for developing and providing world class health care at an affordable cost. We shall foster an environment in which every person is motivated to continually improve the efficiency and effectiveness in the management of health care services.

Vice Chairman Dr. S. Gurushankar receiving Modern Medicare Award under Social Responsibility Initiative of the year 2007 from Frost & Sullivan

Discover the Passion & Compassion

MEENAKSHI MISSION HOSPITAL AND RESEARCH CENTRE (Run by S.R. Trust)

Annual Report 2007 - 2008

Lake Area, Melur Road Madurai - 625 107 INDIA Ph : +91 - 452 - 2588741 (10 Lines) 4263000 Fax : +91 - 452 - 2586353 E-mail : mmhrc@sancharnet.in We b : www.meenakshimission.org

S.R. Trust S.R. Trust (Reg No. 291/85 dated may 9, 1985), a public charitable non-profit organization founded by Dr. N. Sethuraman, a socio medical activist, who made a medical paradigm shift in rural health services, Thiru. Manikavasagam inspired Dr. N. Sethuraman and urged him not only to provide medical services but also to work for social uplifment. Today, Thiru. Manikavasagam would be proud of his student who has made S.R. Trust a full-fledged modern facility with contemporary team-based care and cutting edge technology.

Board of Trustees

Editorial

Dr. N. Sethuraman

Editor

Founder President / Chairman

Prof. Dr. N. Krishnamurthy

Dr. Mrs. Rajam Sethuraman Executive Director

Dr. S. Gurushankar

Academic Director Associate Editor

Mr. P. Sundarraj Senior Manager - Projects

Vice Chairman Compilation

Ar. S. Ramesh Vice President

Mr. S. Parthasarathy Mr. S. Manavalan Mrs. N. Chinnammal Mr. P. Dhandapani Mr. A. Shanmugasundaram Mr. S. Regunathan Trust Auditor Mr. P.K. Amarnath Chartered Accountant

Ms. M.P. Suganya Programme Associate

Ms. R. Padma Priya Resource and Development Concept & Co-ordination

Ms. C. Yalini Sheeba Manager - R&D Photography

Mr. B. Shanmugam Mr. N. Shankar Designed & Printed at Thee Classic Printers Madurai

Chairman’s Report Embarking on the path of significant growth… It is with great pleasure that I present Meenakshi Mission Hospital and Research Centre's 2007-2008 Annual Report, recapping a year of exemplary patient care services as we mark the 19th Anniversary of MMHRC listing it in the top Indian Hospital rankings. Our experience has provided us with a solid foundation to anticipate the needs of our patients and community and we have continued to deliver a range of services to meet the public demand. Quality care has always been and will always be our main focus. Yet we recognize there is no room for complacency if we are to meet the patient expectations in terms of clinical excellence, ambience, respect and dignity during treatment. This year, successful amalgamation of all our wings with advanced technology and expertise has produced a major presence in the health sector especially in management of patients. Plans to bolster long term sustainability by increase in beds, speciality care services, new technology, telemedicine, and community outreach activities would surely be the prudent steps in programme extension, generate significant efficiencies and assist our ability to offer more streamlined care. The year also marked the beginning of new achievements. Patients, staff and community at large have played a role in helping us shape our approach. While continuing the legacy of holistic care for our patients, we are obliged to deliver quality service, development of our information management systems to support medical, clinical and hospital management; to remain environmentally aware and to promote health and well being at community level. Due to the successful journey all through these years of service, over and above the excellence in medical care and clinical research, our commitment to achieve our mission - to serve the poor and needy through our innumerable charity services made our hospital receive Modern Medicare Award for “Social Responsibility Initiative of the year 2007” from GE for its comprehensive work in extending its exceptional service to the People Living with HIV/AIDS (PLWHAs). Still the journey by the Smile Train Regional Centre continues in treating persons with cleft lip/palate with over 3900 surgeries by an able team of medical professionals to facilitate a cleft free society. Medical grants and Mobile CT Ambulance from Direct Relief International, USA has paved way for successful working model of Telemedicine, which self propagates throughout India and into the developing world. It will provide a channel for continuous access to the most sophisticated medical support systems, at all times and shall improve patient care, enhance medical training, standardize Clinical practice, stabilize costs and invite clinicians worldwide. Throughout the year, the board was guided by Trust governance principles to ensure, that we meet our obligations while assessing our performance and our role in the community. Our position as a leading health care provider brings with it the responsibility to lay the foundation for the future to continue the same, by inviting expert surgeons in different disciplines from the Smile Train USA for its “ Medical Exchange Programme” to serve in our centre. We could not have achieved so much without the dedication of our board, medical specialists, nurses and other staff. I take this opportunity to acknowledge all our loyal donors, corporate partners, volunteers, officials, government institutions, and academic institutions in giving helping hands for our success. We pay tribute to their tireless efforts in the face of an ever-changing environment. They are the spirit of our organization and I am grateful for their dedication. I conclude with the personal word of appreciation to all- “The best of all is, God is with us!”

Dr. N. Sethuraman Founder Chairman

Vice Chairman’s Report Dear Friends, I am very pleased to report that 2007-2008 was another year of continued growth and strong performance for Meenakshi Mission Hospital and Research Centre. Our commitment to the hospital is the guarantee of quality and we are proud of the changes that have been brought about by MMHRC team. Along with the commitment of all of our medical colleagues and the great team of people, MMHRC will continue to meet and exceed standards required by the Health care providers and the Indian Council on Healthcare Standards to achieve our stated goal of making MMHRC the best. The patient occupancy rate was above 95% over the year. We have successfully completed 'D wing' project, which ensures more patient flow and bed occupancy with streamlined efficacy and still we are in expansion of our building. When we consider the strong fundamentals of Indian private hospital industry, MMHRC's pipeline of expansion projects and quality in patient care delivery systems at home and abroad has very well positioned it for future growth. Proudly we can say that our lab is on par with International standards. We strive hard to get 5 S certification for quality maintenance. This year is the tremendous year for MMHRC performance. The 21st National Convention on Quality Circles at Kolkata has awarded our hospital for QCFI – Canara Bank Award – 2007 for Service Sector Organization, Excellent Award for 'ROSE QC', Distinguished Award for 'GEM QC. It is my pleasure to say that MMHRC is under NGO accreditation from “The Credibility Alliance”. We are in the process of obtaining “NABH“ certification. In the fiscal year 2008, we expect new projects, services and specialists, equipments & technology, ambience and service quality and continue to prove well to deliver growth and earnings progressively toward the end of the year and beyond. The skilled nurses, technologists and administrators at MMHRC, aided by state-of-the-art equipment provide a congenial infrastructure for the medical professionals in providing health care of International Standards. Looking ahead, I am optimistic and excited about MMHRC's future. Our growth potential is underpinned by very strong industry fundamentals, led by growing private health insurance, an ageing population and high quality suite of assets. Over the coming year, the hospital will continue to invest in growth and additional acquisition opportunities in the private hospital sector, as well as actively explore ways to leverage our management expertise in related markets within wider health care environment. The success and eminence of MMHRC began as the dream of one man extended to be transformed into the dream of many. We strive to accomplish our dreams and goals to bring greater effulgence in the future. I would like to thank our doctors, our employees, bankers, suppliers and all our stakeholders for their hard work and commitment and their ongoing support to achieve our Vision : “ No man is too poor to afford first grade medical treatment”.

Dr. S. Gurushankar Vice Chairman

Medical Excellence Anaesthesiology & Pain clinic Andrology & Urology Cardiac Anaesthesiology Cardio Thoracic & Vascular Surgery Cardiology Community Care Centre Dental & Oral Surgery Dermatology & Venereology General medicine Imaging Sciences & Interventional Radiology Intensive Respiratory Care Unit (IRCU) Laboratory Services / Blood Bank Medical Oncology Nephrology Neurology Neuro Surgery Nuclear Medicine Obstetrics & Gynaecology Ophthalmology Orthopaedics, Traumatology and spine surgery Otorhinolaryngology (ENT) Paediatrics & Neonatology Pharmacy Physical Medicine & Rehabilitation Plastic Surgery / Smile Train Project Psychiatry & Counselling Radiation Oncology Reproductive Medicine Surgery & Surgical Gastroenterology Surgical Oncology

2 4 6 9 12 16 17 19 21 23 25 27 33 34 36 38 40 42 45 47 50 52 55 56 58 61 63 66 68 70

Academic Excellence Library

72

Meenakshi Mission Hospital College

73

Developmental Excellence Promotional Initiatives

78

Quality Service Department

80

Resource & Development

83

Honour Roll List of Contributors

90

Financial Performance

94

Publications

96

Performance Highlights

96

Medical Excellence

Anaesthesiology and Pain Clinic

TThis year, we are able to

conduct successful

balanced Anaesthesia to the maximum possible safetyness and comfort of the patient as well as the surgeon. Our department is having ten eminent and skilled Anaesthesiologists and we provide services to all

Introduction

surgical fields like general, speciality and super speciality surgeries as Neuro, Cardio – Thoracic, SGE, Urology and renal transplantation, Ortho and Traumotology; Hip and Knee replacement and Spine surgeri es are assi sted. So our department provides Anaesthetic management to all types of cases under one umbrella.

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Chronic pain relief

Statistics General Aneasthesia

6422

Spinal / Epidural

2579

Nerve Blocks

0043

Plexus Blocks

0357

Gasserian Ganglion Block

11

Coeliac plexus block

02

Lumbar sympathetic block

02

Posterior nerve root block

03

Superior hypo gastric plexus block

02

Epidural Steroid

41

Academic Activities

Pain Clinic Our department is running a pain clinic by which various modalities of pain relief are being given to patients for acute post operative pain relief and also chronic pain relief to the patients suffering with agony of long term pain.

Modalities of acute pain relief Continous Epidural local Analgesia (Bupivacaine pump) Continuous Epidural lacal Analgesia with Opioids (Pethidine / Fentanyl pump)

Our department has the opportunity of teaching and training Postgraduates in DNB – 2 post DA candidates (2 year course ) and 2 primary candidates (3 year course) recognized by NBE. Our PGs are given enough training in managing all types of ASA risk cases in stepwise manner after careful preoperative evaluation and preparation of the patient. We are conducting regular lecture programmes twice a week; PGs are taking active parts in symposium and panel discussions. Clinical case discussions are being undertaken on Sundays twice a month moderated by the HOD. Our PGs are encouraged to take active parts in presenting paper in State and National conferences.

Patient control Analgesia 1. Nelcon State Conference 2007 On demand IM opioid

(a) “A paper on Proseal LMA” presented by our PG Dr. P. Aarthi

Labour Analgesia with continous Epidural during second stage of labour

Statistics

2. AGOICON 2007 - MMHRC

Acute pain relief Continous Epidural

728

Subcutaneous Narcotic

617

IV Narcotic infusion

573

PCA

(b) “Problems and management of Anaesthesia in Laparoscopic procedures”.

Our PG Dr. V. Poornima presented a paper on “Superior Hypo Plexus Block for chronic pain due to cancer cervix” 3. ISA National Conference 2007 “Anaesthetic management of Pierre Robin Syndrome” presented by Dr. M. Krishnan.

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Introduction The Department continuous to be leading urology department in South Tamilnadu under the stewardship of Dr. T.R. Murali who has completed eighteen years of service. At MMHRC, we do all sub specialities of urology in this department including laparoscopic urology.

Laparoscopic Urology Laparoscopic Urology is the “standard of care” for several urological procedures at MMHRC, like adult pyeloplasties, simple and radical nephrectomies, vesicovaginal fistula and so on. Laparoscopic donor nephrectomy for the left kidney is standard practice with no difference in outcome as a early or late graft function is concerned. Laparoscopic adrenalectomy, now the “Standard of care” has included adreno cortical carcinomas as well, less than 6cm in size, both on the left and right sides.

Andrology Andrology is a popular service with an increasing patient-to-patient referra l thus sign ifying full satisfaction among patients. Counselling for patients with sexual myths and misconceptions and problem s continues to be the forte of the department. Andrology camps conducted once in three months are extremely popular and are used for public interaction.

Urology Camps Urology camps conducted once a month both in the hospital and chosen places outside. More than thousand patients were benefitted from such camps with subsidized costs in treatment.

Urolithiasis and Endourology PCNL for complex renal stones is standard practice with minimal morbidity and full clearance. More than fifty such procedures were done in the last year. The blood transfusion rate is less than 10%. Ureterorenoscopy both flexible and rigid are the most common endourological procedures for ureteric stones at all levels with laser lithotripsy able to tackle calyceal stones as well. Flexible outpatient check cystoscopy for bladder tumor surveillance is being introduced as day care surgery.

Andrology and Urology 4

Educational activities of the department flourish with four CME's called the “Uro spice” for general practitioners were held over the year. The strength of DNB postgraduates has gone up from one to two. The first lady postgraduate in Urology was taken in July 2007. Standardization of Laser enucleation of prostate is the goal of the department for 2008.

Statistics Ureteroscopy TURP TURBT Cystolitholapaxy Cystolithotomy Lap. Nephrectomy Lap. Adrenalectomy Nephroureterectomy Lap. Nephroureterectomy Radical Nephrectomy Radical Cystectomy Radical Prostatectomy Epispadias repair Bladder repair Pyeloplasty SIS Urethroplasty

528 145 42 52 2 13 4 1 1 31 3 1 5 13 25 1

Augmentation Cystoplasty Urethroplasty Pyelolithotomy Buccal Mucosal Urethroplasty Meatoplasty Ureteric reimplantation Open Prostatectomy VVF PCN PCNL PCN gram PCNR Penectomy Penile biopsy EIU Urocoil Hydrocelectomy Vasectomy Hypospadias correction Chordee correction Ureterostomy closure Ureteroneocystostomy Inguinal Bl. Dissection Orchidopexy Orchidectomy Herniorrhaphy Hernioplasty Mitrofanoff operation Renal Transplant Renal Donor Nephrectomy CAPD Catheter insertion CAPD catheter removal AV fistula TVT Trucut biopsy DJS RGC RGC gram RGC removal

Andrology EEJ Testicular Biopsy Varicocelectomy Penile prosthesis

4 9 9 1 17 11

DJSR P SCOPY MASSAGE Cystoscopy CMG MCU AUG FNAC Circumcision Endoscopic calibration Trocar SPC Urethral dilatation Macroplastique injection Dressing SPC tube change SPC removal Bladder Biopsy BNI I&D Sec. Suturing cyst excision Labial separation Epididymal cyst aspiration Slough excision Clot evacuation SSG USG guided aspiration Cystogram DIVU PCN change External sphintertomy Laparoscopic deroofing of cyst Wound Debridement PU Fulguration PCCL Fistula closure Epididymectomy Dorsal plication

1 75 44 56 66 2 1 69 9 5 11 1 1 1 5 21 24 9 5 3 14 14 40 11 139 5 35 282 74 26 74

Urology 13 37 27 10

ICIVAD RIGISCAN OP - VSS

185 155 85

New Registration Review Registration Inpatients

605 7 27 40 160 195 4 135 155 36 84 65 10 15 33 20 6 5 2 10 15 2 2 5 7 75 74 13 5 1 7 8 2 1 1

Andrology 2118 7655 2611

New Registration Review Registration Inpatients

1154 2340 310

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Cardiac Anaesthesiology CCardiac

surgery is a high risk and complex

field of medicine with significant morbidity and mortality. Quality anaesthetic care with special attention can greatly enhance patient safety. Cardiac anaesthesia is inextricably intertwined with cardiac surgery and has mainly evolved in the last 50 years. It has grown into a largest and most influential sub-speciality of Anaesthesiology.

Introduction

Remarkable progress has been made in Cardiac Surgery in the last eight years and paved way for innovations in Cardiac Anaesthesia. From PA catheters and Trans-esophageal Echocardiography to Th or acic Epi du rals ena bl ing fast-track anaesthesia for Beating heart surgery, anaesthesiologists have kept pace with all the advancements in cardiac surgery by constantly re-inventing themselves, learning new techniques and mastering new technology.

6

Statistics The Total Number of cases from April 2007 to March 2008 is 434. This covers the entire gamut of cardiothoracic anaesthesia including anaesthesia for Coronary Bypass surgery, Valvular heart surgery, Congenital cardiac surgery, Thoracic & Vascular surgery.

under Thoracic Epidural Anaesthesia (TEA) as the sole anaesthetic without general anaesthesia (GA). Coronary Artery Bypass Grafting (CABG) in an awake patient without endotracheal general anaesthesia was first performed in October 1998 with high thoracic epidural block at Ankara, Turkey.

Awake Cardiac Surgery Over the past several years, beating heart surgery has been accepted as one of the modes of surgical treatment in ischaemic heart disease. In an attempt to further simplify and decrease the “invasiveness” of this procedure, performing this operation without endotracheal general anesthesia is deemed feasible in certain subsets of patients. There are reports about an alternative anaesthetic technique by performing Conscious Off pump Coronary Artery Bypass (COPCAB) – Beating heart CABG operations

The technique of high thoracic epidural anaesthesia is a highly precision based methodology involving calculated doses of local anaesthetics in the epidural space which anaesthetizes only the chest region, while the patient is fully awake. This enables painless surgery for patients who are at risk for general anaesthesia.

7

Elimination of GA and attendant complication enab les the ver y ear ly and effect ive mobilization of the patients.

Activities A host of academic activities form part of the calendar and ensures that the team is kept abreast of the latest developments in anaesthesia.

Facilities A well-equipped theatre with an invasive multi - channel monitor including monitoring of ETCO and Cardiac Output. Nine -bed ICU with multichannel monitors, latest Ventilators, and IABP machines. A dedicated, well-trained staff offering individual care.

An anaesthesiologist is always available round-the-clock to assure adequate post operative care of the cardiac patient.

A dedicated Cardiac Rehabilitation team (includes a dietician and a physiotherapist) which takes care of the rehabilitative needs of the patient. The first successful Coronary Artery Bypass Surgery under Thoracic Epidural Anaesthesia (TEA) was performed in our hospital in August 2006. It also happens to be the first successful awake CABG in the state of Tamil Nadu.

8

Actively participated as Faculty in Cardiac Anaesthesia Update 2007 in December 2007 in Chennai. Actively participated and presented a paper on Ru ptured Sinus of Va lsalva-anaesthetic management in the National Conference of Indian Society of anesthesiologist in Mysore in December 2007. Actively participated in the National Conference of Indian Association of cardiac anesthesiology in Ahmedabad in February 2008.

The Future “The only way to discover the limits of the possible is to go beyond them into the impossible.� - Arthur C. Clarke

Looming large on the horizon are the prospects of Heart Transplantations and Key-hole Robotic Cardi ac surgeri es. As we march on, trying to set new standards in cardiac care, we seek your blessings and those of the Almighty in the realisation of our dreams.

Cardio Thoracic and Vascular Surgery

TThe year 2007-2008 has been a very remarkable year for us. We have to our credit, a record number of cases done in an year apart from many firs ts not only in our institu tion but also in India.

Introduction

We have successfully conducted many cases which hav e bee n con ducted only by our institu tion which adds credits to us.

9

Statistics The total number of cases done for the year 2007-2008 is 434 aged from 2 months to 72 yrs. This covers the entire gamut of cardiothoracic surgeries including Coronary Bypass surgery, Valvular heart surgery, congenital cardiac surgery and Thoracic and vascular surgery. In Coronary Revascularisation surgery, the main emphasis is on Beating Heart CABG because this is a new and exciting development in the field with significant reduction in morbidity and cost. We emphasize on total arterial revascularisation to achieve better patency rate of the grafts. We undertake all high-risk cases like those with low ejection fraction, ventricular aneurysm, concomitant carotid stenosis and ischemic mitral regurgitation.

1.5% mortality has been achieved by our hospital in equal to the international results. Our mortality for elective operations is less than1%. Even in Emergency operations performed In patients in Cardiogenic shock, we have obtained good results. We are one of the few units in the country offering Endoscopic Vein Harvesting Technology to our patients at affordable cost.

Facilities An exclusive Operation theatre is dedicated to Cardiothoracic surgery with state-of- the- art facility, seam-less stainless steel cladding of the walls, Laminar airflow and a separate Air-handling Unit. All these things will help to reduce the infection rate to zero. There is a ten-bed ICU with all the latest gadgets available in the most developed centers in India. We have 3 Intra-aortic balloon Pum ps to salva ge pa tien ts with Myocardial Infarction in Cardiogenic shock. An Endoscopic Tower has been pr oc ur ed for End os cop ic Ve in harvesting.

Academic Activities The department has not lagged behind in Academic activities. Every year Continuing Medical Education Programme is being organized to educate our fraternity about the latest developments in this field. The fifth successive CME was conducted on 15th March 2008. 300 doctors attended. In Valvular heart disease, apart from routine valve replac ement, valve repair and Atri al Fibrillation ablation (Maze Operation) are also bei ng done. In Congeni tal hear t sur ger y, the common operations like ASD, VSD and PDA are being done routinely. We have also performed high-risk complex operations like Total Correction of Tetrology of Fallot. In keeping with the latest trends in surgery, minimally invasive techniques are bein g increa singly applied.

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We have published the following Midterm results of off-pump coronary artery bypass surgery in Indian patients. The internet journal of thoracic and cardiovascular surgery 2007 Vol 11; No: Early experience of endoscopic vein harvesting for CABG Indian journal of thoracic and cardiovascular surgery 2007; 23: 188-191 Complications in atrial septal defect device closure Interact cardiovasc thoracic surgery 2008; 7: 167-169

We have so far published 10 papers from our department. As a credit to the excellent results of the department. The National Board of Examinations for the super speciality DNB program in cardio thoracic surgery has approved “MMHRC-CTVS”.

Free Heart Surgery True to our Institution's Vision that “No Man is too poor to afford first grade medical treatment” we have strived to perform FREE HEART SURGERY to twenty unfortunate children in the lowest economic strata with the immense help from “Save The Little Hearts” to mobilize funds to achieve this enormous task

The Future The future looks very encouraging. The Department of Cardiothoracic Sugery shares the dreams of our Founder Chairman to perform Heart Transplantation and Key-Hole Robotic Cardiac surgery. Total no. of Out-patients - 4284

Total no. of In-patients - 612

Statistics S. No.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23.

Name of the Operation

No. of Cases

Coronary Artery Bypass Graft Surgery OPCAB + CAROTID ENDARTERECTOMY CABG + MITRAL VALVE REPLACEMENT CABG + AORTIC VALVE REPLACEMENT CABG + DOR'S OPERATION CABG + RSOV REPAIR CABG + ASD CLOSURE MITRAL VALVE REPLACEMENT MITRAL VALVE REPAIR AORTIC VALVE REPLACEMENT DOUBLE VALVE REPLACEMENT OPEN MITRAL VALVOTOMY ASD CLOSURE VSD CLOSURE VSD CLOSURE + PDA LIGATION VSD CLOSURE + RSOV REPAIR PDA LIGATION INTRA CARDIAC REPAIR FOR TOF COA REPAIR CENTRAL SHUNT THORACIC PROCEDURES VASCULAR PROCEDURES OTHERS

Beating Heat CABG OnPump CABG

Total

231 43 1 1 5 1 1 1 19 2 11 5 1 51 4 1 1 14 4 1 1 13 12 10 434

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Introduction T he T

Cardiology department of Meenakshi Mission Hospital and Research Centre comprises of 24 hours emergency services to manage cases of Acute myocardial infarction for thrombolysis (or) primary angioplasty and its subsequent management, and to manage cases of congestive cardiac failure for stabilization and various other acut e cardi ac cases for round the cloc k management. The department is well equipped with Critical Care Unit with the monitors and ventilators. The department also possess computerized ECG, Tread mill test, Colour Doppler and 24 hours Holter monitoring.

Cardiac Procedures in the Cath Lab Coronary Angiogram Right heart catheterisation Coronary angioplasty/stent implantation Ballon mitral valvuloplasty Balloon aortic valvuloplasty Balloon pulmonary valvuloplasty Balloon tricuspid valvuloplasty PDA coil closure Temporary and permanent pacemaker implantation ASD Device Closure CTC

Facilities Available

Cath Lab The department has its unique two cardiac cath labs from WIPRO GE OEC and SIEMENS medical system. The lab performs various diagnostic and interventional Cardiac procedures. A team of specialists and interventional Cardiologists are involved in performing the procedures.

1. IABP : Intra Aortic Balloon Pump, Which is a necessary equipment useful in patients who present with Low Blood Pressure due to Acute MI or Other causes, for artificial maintenance of Blood Pressure in emergency Situations.

Cardiac Procedures performed in Cath Lab The Cardiology department is effectively supported by Cardiothoracic surgical team which provides surgical standby during interventional procedures. They also perform closed and Open heart procedures including valve replacement and Coronary By-pass surgery. This Unique hospital which is located in Southern Tamilnadu has its pride in providing world class health care particularly to the rural population.

Cardiology 12

2. ACT Machine : It can detect activated coagulation time, to monitor the dose of Heparin, particularly during PTCA and CABG. 3. TEE : Trans Oesophageal Echo useful as a Diag nosti c tool, to detec t various cardio abnormalities particularly in the setting of any clot in Heart, ASD device closure and assessment of prosthetic valve function and also during operative procedure to assist the surgeon. 4. STRESS ECHO : This modality is useful to diagnose and prognosticate Coronary artery disease patient. It is more sensitive and specific than Routine Tread Mill test, performed as Exercise Stress Echo (or) Dobutamine Stress Echo. 5. Thallium (or) Technetium Study : We have well equipped Nuclear Medicine Department with spect camera for Thallium for Technetium 99 M Sesta MIBI Myocardial viability assessment study.

Special Remarks Our Institute is well equipped to provide primary PTCA as a modality of Therapy in Acute Myocardial Infarction, in this region of Tamilnadu. In recent past we have done reasonable number of Primary PTCA in AMI including those with IABP assisted Stenting.

Facilites available in the Department of Cardiology Two well equipped Hi-Tech Cath Labs a) WIPRO GE b) SIEMENS Philips iE 33 dedicated Colour Doppler Echo Cardiogram Tread Mill Test – NASEN Holter Monitoring – DL 820-3/12 LCD Recorder Computerized resting ECG Well equipped Coronary Care Unit which comprises – NIBP monitors, Hitech Cardiac monitors and ventilators with ICU trained cardiac nurses. Hitech Ambulance on call for 24 hours – Hitech Phone.No-98421-23232

Academic Activities The National Bo ard Examination has accredited MMHRC to conduct 3 years course in cardiology to award post – doctoral fellowship in DNB Cardiology.

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The cardiologists are updating their knowledge by attending regularly the Na tional and International conferences and live workshops Annual update of all the Interventional pr oce dur es in the Nat ional Int er ve nt ional council of India

Procedures In The Dept of Cardiology Car di ol og ists of MMHRC pe rfor m 150 0 Angiograms Annually and 400 Angioplasties every year. We perform 100 Balloon Mitral Valvotomies every year.

Coronary Angioplasty MMHRC performs highest number of primary Angioplasties for Acute Myocardial Infarction for the entire Tamilnadu. We also perform 2 vessel and 3 vessel angioplasty We also perform angioplasty in critically ill patients with Intra Aortic Balloon Pump support. We offer both bare metal and drug eluting stents for Angioplasties.

Intervention for heart failure MMHRC is equipped to provide biventricular pacing as a trea tment for heart failure.

Procedure For Cardiac Arrythmias Electrophysiological study and radiofrequency ablation for various cardiac arrythmias. Implantatable cardiovertor and defibrillator for prevention of sudden cardiac death.

Intevention for Valvular Heart Disease Balloon mitral valvuloplasty Balloon aortic valvuloplasty Balloon pulmonary valvuloplasty

Intervention For Congenital Heart Disease

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Co rrection of congenital heart defects in underprivileged children is done free of cost as a part of KID AID foundation. Children started getting benefits under this scheme.

Intervention for Peripheral Vascular Disease Renal angioplasty Carotid angioplasty Iliac and femoral angioplasty Below knee angioplasty

Pericardiocentesis Emergency pericardiocentesis to prevent death from cardiac tamponade

Angiograms Coronary angiogram Cerebral, Renal and Peripheral angiogram Cardiac catheterization with oxymetry, pressure study and angiogram for congenital heart defects.

Pacemaker Implantation Temporary pacemaker implantation on emergency basis round the clock Single and double chamber permanent pacemaker implantation

Miscellaneous Alcoholic septal ablation for HOCM

Cardiac procedures in the Cath lab Coronary angiogram Right heart catheterisation Coronary angioplasty/stent implantation including primary PTCA Balloon mitral valvuloplasty Balloon aortic valvuloplasty

PDA coil closure / Device closure

Balloon pulmonary valvuloplasty

ASD / VSD device closure

Balloon tricuspid valvuloplasty

COA balloon angioplasty

PDA coil closure/Device closure

Temporary and permanent pacemaker implantation ASD/VSD device closure COA Balloon Angioplasty A team of Interventional Cardiologist and specialist carrying out various cardiac procedures.

Non Cardiac Procedures

Conference Attended Dr. R. Sivakumar, MD., DNB., (Cardio) 1) May 2007 - Attended EURO PCR at Barcelona – Spain. 2) June 2007 - Attended live workshop on Carotid Interventions at New Delhi – Escorts Heart Institute 3) August 2007 - Attended a lecture on heart failure at Chennai.

Aortogram Cerebral Angiogram

4) September 2007 - Attended symposium on drug eluting stent at Chennai.

Renal Angiogram

Mesenteric Angiogram

5) December 2007 - Attended PTCA registry and annual CSI meet at Hyderabad and submitted interesting cases

Renal angioplasty/stent implantation

6) February 2008 attended “Singapore Live” at Singapore

Peripheral Angiogram

Peripheral angioplasty/stent implantation

7) Participated as faculty in March 2008 at Dubai in “ Live Demonstrations” course in interventional cardiology.

Therapeutic vascular embolisation

Statistics 1272

Coronary Angiogram PTCA

440

Balloon Mitral Valvotomy

105

Dr. S. Selvamani,

DNB.,(Gen. Med) DNB., (Cardio)

1) June 2007 - Conference at Indonesia on Cardiology 2) August 2007 - ESI Conference on cardiology Austria

Permanent Pacemaker Implantation

24

Lower Limb Angio

12

Cerebral Angio

03

Renal Angioplasty

04

LABP

26

Pericardial Tapping

13

Temporary Pacemaker Implantation

48

Cardiac Catheterisation

15

Peripheral Angiogram

04

PDA Coil Closure

11

PTBD

16

ASDDevice Closure

22

IVC Filter

06

Renal Angiogram

08

OUT PATIENTS

8377

E.P.Study

05

NEW CASES

2256

Others

40

REVIEW CASES

6121

IN-PATIENTS

1733

Total

2074

3) November 2007- Interventional exchange programme on Interventional Cardiology at Sydney Australia. 4) February 2008 -Vascular voyage conference at Grace Europe presented cases

Dr. N. Ganesan,

MD.,DM., (Cardio)

1) September 2007 – World Torrent symposium at Phukhet, Thailand 2) December 2007 CSI annual conference at Hyderabad. 3) February 2008 annual Echocardiography conference at New Delhi.

15

Introduction

“Service with compassion for needy people”

Community Care Centre Mother Teresa Special Ward for People Living with HIV / AIDS

AAs a Pioneer health care institution, Meenakshi Mission Hospital and Research Centre (MMHRC) initiated a Community Care Centre by name “Mother Teresa Special Ward for PLWHAs” in the year 1997. It was a critical time where the spread was extremely high, ignorance about the disease and lack of proper medical care and support. No health institutions or hospitals were coming forward to treat the HIV persons and there were no specific health care providers to medical intervene. We are proud to say that our hospital is the First Private Hospital to provide treatment, care and support for the PLWHAs totally free of cost. This care and support service began in 1998, and provides excellent services to PLWHAs under the eminent leadership of Dr.V.N. Rajasekaran and Dr. Senthil Prabakar. The comprehensive service for PLWHAs involves medical care, counselling, home care, nutritional training & support, hotline Service, networking, recreation facilities, medication, and referral services for ART adherence and intervention with other NGOs. Since 1998,our service reached to to more than 10,000 PLWHAs. Mother Teresa Ward is a 10 bed clinic provides free IP & OP service, drugs, food, counselling, yoga, psychological support round the clock

16

nursing care, treatment on opportunistic infections, referral services etc. As it is situated in the core area of hospital, it eliminates the social stigma and enable them to avail the free speciality consultant care as and when needed. The Centre prov ides exceptional facilities for PLWHAs as it has following area s: Separate cubical rooms (10 bed) Consultation Room Counselling Room Video Hall Yoga Hall Library Procedure room Kitchen Laboratory Our team consists of medical Profess ionals, counsellor, nurses, out reach workers, lab tech nicians, administrative and sup portive staff.

2007-2008 Performance IN PATIENTS OUT PATIENTS

385 1220

TThis

is ano ther fascinat ing success ful year

for the department of Dental Surgery. The department is fully loaded with its state of the art Dental equipments with hitech and classic environement and latest treatment modalities

Introduction

with professional & personal touch. This year we emphasized more towards the correction of malaligned Dentition and single visit complete Dentures.

Dental and Oral Surgery 17

Our Services ...

Scaling & bleaching for stained & yellowish tooth.

Oral & maxillo facial trauma management Cosmetic surgical correction of facial deformation. Maxillary and mandibular prognathism. Surgical management of orofacial cyst and tumour.

All types of restoration for carious tooth with first grade dental materials. Full mouth fixed porcelain crown & bridge prosthesis. Apicectomy Impaction

Orthodontic Correction of malaligned & proclined teeth.

Paedodontia

Dental obturators & expansion devices for cleft palate patients.

Awareness Programme

Single visit complete denture

Regular dental camps are conducted in schools and colleges for screening and oral hygiene education..

Implant dentures.

Dental camps for general public are being held every Saturday in the dental OPD.

Removable & fixed prosthesis. Conservative management by root canal therapy for severe carious tooth .

Statistics IN PATIENT

Light cure composite restoration for damaged & broken tooth.

18

47

OUT PATIENT

3439

NEW CASE

1523

REVIEW

1916

Dermatology & Venereology

TThe Department of Dermatology , cosmetology and venereology is in touch wi th latest developments in the field. It deals with various

Introduction

dermatological procedures apart from accurate diagnosis of even troublesome acute and chronic disease.

19

Th e variou s rou tine da ily pr oc edu res carried ou t in the de pa rtment of skin and cos metol og y are as fol lows .

Disease

Test / Treatment

Allergy Patch Testing Leukoderma (Vitiligo)

1. Melanocyte Transfer – Punch Grafting & Epidermal Grafting 2. Tattooing 3. PUVA Treatment

Psoriasis Chronic eczema with lichenification

PUVA Therapy & NB UVB Therapy Dermabrasion – (Micro Motor)

Acne and its scar

1. Co2 Laser Scar revision 2. Micro Dermabrasion 3. Comedone Extraction.

Hyper pigmentation (Melasma) Facial Rejuvenation MICRODERMABRASION PROCEDURE

Chemical peeling

Dermabrasion

Keloids , wart and corn foot Excessive Hair (Hirsutism) Androgenetic alopecia

Cryotherapy Diode Laser & Electroepilation Hair Transplantation

Tattoo removal / Freckles Nevus of Oto & Post Inflammatory pigmentation

Q – Switched Nd – Yag Laser

Statistics IN PATIENTS OUT PATIENTS NEW REGISTRATION REVIEW REGISTRATION

20

122 6346 1437 4909

General General Medicine Medicine

TThe General Medicine Department has admitted and treated maximum number of patients. This year many executives from corporate and banks have undergone Heal th Check- up pr ogr am mes . Many pr ivat e insurance (i.e.) The Third Party Administrators have recognized our department doctors in their Panel of doctors. The Intensive Medical Care Unit (IMCU) and Intensive Coronary Care Unit (ICCU) are equipped with state-of-the-art equipments and manned round the clock by medical personnel.

Introduction

Our hospital PG training is recognized by National Board of Examinations, New Delhi for General Medicine and Family Medicine. The PG training programme is quite popular for its depth of practical training. We are getting high quality aspirants for the PG post every year. In 2003 – 2006 batch and 2004 – 2007 batch, four DNB students have passed and joined for higher studies in various institutions this year.

21

Sub Specialities of General Medicine Asthma and Allergy Clinic

Computerised Pulmonary Lung Function Test

Diabetes & Foot Care Comprehensive Asthma Care Clinic

Geriatric Clinic

Tuberculosis Clinic

Respiratory Medicine

Lung Biopsy

Haematology Flexible Fiberoptic Bronchoscopy : Our hospital has an

unique privilege of

performing about 769, bronchoscopies from April 2007 till March 2008.

Various difficult

diseases have been diagnosed and managed on few occasions.

Bronchoscopy has been

used therapeutically also. In fact, our hospital is catering to the need of many patients in southern districts of Tamilnadu especially for

Pleural Biopsy by Abram's and Cope's pleural biopsy needles and FNAC lung and tube thoracostomy

Major and Minor procedures Bone Marrow aspiration Lumbar Puncture Pleural Aspiration Liver Aspiration

Bronchoscopy.

I.C.D. procedure Diagnostic Tapping Liver Biopsy Procedure

Statistics Circulatory Diseases

2994

Endocrine, Nutrition and Metabolic Diseases

1750

Respiratory Diseases

1879

Nervous System

978

Digestive systems

1422

Haematological diseases

1343

Mental disorders

897

Genito Urinary diseases

378

All types of fevers

3989

All types of neoplasms

1249

Others

2553

Total Number of cases

22

19,432

Imaging Sciences and Interventional Radiology

TThe department made a humble start in the year 1990 with 300 MA X-ray machine, black and white basic ultra sound machine has today reached a stage of completion with the addition of a Multi slice Angio CT and an open MRI equipment. Today the department has all imaging

Introduction

solutions including therapeutic interventional procedures under one roof. The dept is equipped with state of the art equipments in all its sub specialities. The addition of an Endoscopic Ultra Sonography machine makes our department, an exclusive centre for imaging sciences.

23

Academic Activities The quality and the volume of work done by our department has got us the permission to train two DNB post graduates per year. This year we are planning to conduct training program mes for DNB Radiodiagn osi s post graduates to help them face their exams with confidence. We have started a teleradiology programme in our dept through which we are planning to offer reporting and teleconferencing programmes. We are also conducting short term training programmes for radiologists in Ultra sound, CT, MR and basic interventional radiology techniques.

Diagnostic and therapeutic procedures Diagnostic Angiographies Embolisation of Uterine, Brachial, Hepatic, Renal and peripheral arteries. Peripheral Angioplasty and stenting. CT and ultrasound guided Biopsy and aspiration. Carotid and Renal Angiography and stenting. Mammography Biopsy

Radiology Routine x-rays 49,864 Contrast studies like IVU and Barium etc, 2,218 Inverventional Radiology Angiographies, Angioplasties and Stenting, Embolisations, Drainage procedure and Biopsies Ultrasound Color Doppler Echocardiography Doppler procedures Doppler studies of various organs Routine U/S imaging 3D Ultrasonography

56

1743 849 13,687 28,027 473

CT Routine CT scans CT guided procedures Coronary angio Ct renal and other angio

5009 216 30 63

MRI Routine MRI scans

1512

EUS Diagnosis Therapeutic

195

Hepato biliary interventions PTBD, Stenting

Conferences Attended

Radiofrequency ablation of Tumours

Dr. T. Mukuntharajan Invited Faculty for the National Conference of Indian Society of Vascular and Interventional Radiology

Real time 3D ultrasonography guided Biopsies Image guided neuronolysis for Chronic pain Vertebroplasty Endosonography guided Biopsy and drainage CT coronary angiography

Equipments X-ray machines –Ranging from 20 – 800 MA Image Intensifier Mammography Logic 500 Colour Doppler ultrasound scanner Real time 3D Colour Doppler volusson 730 expert Logic book portable color Doppler ultrasound OEC 9800 mobile cath lab Computed radiography Multi slice CT scanner Open MR system Endoscopic ultrasonography

24

Glimpse of facts

Spiral CT Update - 2007 Dr. N. Karunakaran MRI - Teaching Course Sri Chitra Tirunal Institute of Medical Sciences, Trivandrum Dr. R. Ganesh Women’s Imaging, 21-22 July 2007 Target, Musculoskeletal Conference Chennai Aug. 2007 ISNR & ISMRM, Annual Meeting, Mumbai Nov. 11-14, 2007 Musculoskeletal Radiology Review Course Mar. 4-6, 2008, Mumbai

Meeting Conducted Monthly Raiology CME

Intensive Respiratory Care Unit

TThis Critical care unit operates with the strength of 11 cubicles, assures maximum isolation, barrier nursing, privacy and sterility, providing Intensive care and high dependency care in the

Introduction

same unit with the aid of appropriate pharmaceutical, therapeutic diagnostic interventions and modern technical backup.

25

The New Configuration Provision for Neonatal mechanical ventilation by dedicated team in Neonatal ICU.

Our Technical Arsenal Sophisticated monitoring devices, drug delivery systems, and new generation of Mechanical Ventilators aided by smooth man-machine interactions

We Pride In... Vigilant and dynamic monitoring by a dedicated team, motivated and guided by a team of full time Anaesthesiologists, delivering excellent patient care with human touch.

Central venous and arterial cannulations and temporary cardiac pacing. Mechanical ventilatory support for post-operative and polytrauma patients. Management of complicated Organo-phosphorus poisoning with encouraging and successful outcomes. Orientation, teaching and training programmes for medics and paramedics.

We Indulge In... Enhancing practical skills in the handling of complex equipments, monitoring procedures and performance of Invasive techniques. Enhancing clinical skills in recognizing, preventing and managing critical illness, infection control and organ support.

Our Collaterals Trained physiotherapy Unit Dieticians Biomedical Backup Family counselling / Psychiatric consultation for Patients with attempted suicide.

Our Key to Success Patient centred comprehensive, multi-disciplinary care with coordinated, collaborative and cost effective approach in a compassionate and healing environment

We Deliver

Total No of Admissions

1009

i) Adult

900

ii) Paediatric

109

Total No of patients on Ventilator

835

Total No of poisoning Patients

111

Total survival Rate

81%

Advanced Mechanical ventilatory therapy including Non-Invasive ventilation.

Survival Rates窶天entilated patients

77%

Neonatal ventilation in dedicated Neonatal ICU.

Survival Rates - Poisoning Patients

97%

Surfactant therapy. Diagnostic and therapeutic fiber-optic bronchoscopy. Percutaneous dilational tracheostomies.

26

Our Performance

Laboratory Services

TThe infrastructure of the laboratory services has improved and the departments of biochemistry and haematology were shifted into a more spacious and functional environment. New equipments were

Introduction

purchased and newer techniques introduced in collection of blood samples.

27

Collection The departm ent conducts around 200 OP collections and 250 IP collections per day. All collections are performed in Vacutainer (Becton Dickinson) sin ce November 2007. Collection of paediatric samples is conducted using butterfly needles. Training is provided on regular basis by Becton Dickinson to phlebotomists and staff nurses in collection procedures of blood samples as a certificate programme

Biochemistry The department of biochemistry is fully equipped with : Fully automated analyser – Beckman Coulter Synchron CX9 Pro with a throughput of 900 test / hour. Beckman Coulter Access 2 CLIA for immunochemistry. The department is manned by qualified biochemists. The department does a workload of more than 27,000 routine tests per month. The workload per month for hormone assays in the CLIA is more than 1500 tests. The total number of tests done in the 2007-2008 in 3,14,567 (3,10, 214 routine tests and 4,353 by the CLIA)

28

The following special tests of assay are preformed by the department for the following Cyclosporin Digoxin Fertility hormones Iron studies Parathyroid hormones Serum protein and haemoglobin electrophoresis Thyroid hormones Tumour markers (CEA, Ca125)

The department participates in the External Quality Assurance Scheme (EQAS) of both Biorad (US) and CMC Vellore.

Haematology & Blood Bank The blood bank is one of the important support services of the hospital. Blood is collected mainly from voluntary blood donors. During the year

of cost to the Government Rajaji Hospital. Blood units are issued to deserving patients in approximately 30 outside hospitals.

Special Procedures

2007-2008, a total of 6398 units of blood were

The blood bank promotes the rati onal use of

collected. Ou t of these, 1825 units of

blood by blood component therap y.

components were prepared. A total of 6014 units were issued, 4,806 inside hospital , 963 to other

Aphaeresis is done using the Cobe Spectra.

hospitals and 245 to Government Rajaji Hospital.

Aphaeresis is used for the collection of plasma as

totally 3276 units were issued. A total of 22,002

well as platelets. It is also used for therapeutic

grouping and Rh typing were done, out of which

procedures on patients, where it is used either as

7063 were free grouping.

primary therapy or secondary adjuvant therapy. The most commonly used procedure is therapeutic

20% of blood units are collected through

plasma exchange or plasmapheresis.

blood donation camps which are supplied free

Academic Courses In association with the Meenakshi Mission Hospital College and Mother Theresa University, Kodaikanal Diploma in Medical Laboratory Technology (DMLT) (In collaboration with Indian Medical Association) B.Sc. in Applied Microbiology B.Sc. in Applied Biochemistry B.Sc. MLT – Medical Laboratory Technology In association with the Meenakshi Mission Hospital College and Madurai Kamaraj University PG Diploma in Blood Banking Management

Training Programmes Post-qualification practical training for DMLT students from private colleges and institutions in and around Madurai. Training for nursing college students in phlebotomy and other collection procedures

29

Pathology

TThe department of pathology deals with processing and reporting of biopsy samples [small and large], FNAC, Cytology, Cervical pap smears. Reports of bone marrow aspirate, abnormal peripheral smear, LE cell

Introduction

test are done. We are also doing frozen sections for difficult intra operative cases. Immunohistochemistry is being carried for difficult and rare cases.

30

Special Features

The following speci al tests are bei ng done ERPR

We possess,

Immunohistochemical markers

Fully automated tissue processor for processing tissue.

CD 117

Automated knife sharpener for thin sections.

CD 45 (LCA)

Special stains for 1.AFB 2.FUNGI 3. OTHER STAINS

CEA

Cytochemical stains [e.g.,] PAS, Myeloperoxidase, LAP

Cytokeratin

Chromogranin

Desmin

Immunohistochemistry Frozen section

EMA HER 2

Clinical Pathology

S100

The department of haematology and clinical pathology is well equipped with the

Synapthopsin

Fully automated analyser – 5 part, Beckman Coulter ACT-T5 Diff AL with automatic loading of samples with a throughput of 100 tests/day Semi-automated urine analyser – Bayer Urilyser. The department does a workload of approximately 20,000 routine tests per month. The total number of tests done by the department in 2007-2008 is 2,20,017. The following special tests are being conducted D-dimer Factor VIII assay FDP Fibrinogen G6PD

VIA

Academic Activities Conducted theory classes in pathology and cytology for final year B.Sc. [MLT] students. Conducted practical training in pathology for final year B.Sc. [MLT] students. Conducted theory practical classes for final year B.Sc. [MLT] students, Fatima College and National institute students. Regularl y prov ide materi als for cli nical meetings and paper presentation by various departments students for study purpose.

Statistics Total Number of samples received :

Hb electrophoresis Malarial antigen and antibody Urine LH

1. Biopsy [small & Large]

3397

2. Cytology & FNAC [including camp pap smear]

2782

Urine myoglobin 3. Frozen section

Histopathology There is a workload of around 500 biopsies and cytology per month.

4. LE cells Abnormal Peripheral smear and bone marrow

3

547

31

Microbiology dissertations. This year , we have trained 64 students and guided 29 projects from outside colleges..

Microbiology Introduction

TThe

department includes microscopy, culture, identification, susceptibility testing of various clinical specimens, serology by Rapid tests and ELISA with an automated ELISA reader, Western blot assay for HIV confirmation, surveillance of operation theatre and hospital risk areas, mo nitoring hospital acquired infections, monitoring sterilization and disinfection activities. This year, the department has performed about 6981 cultures, 37,236 serology and 4024 Microscopy, 64 Western blots , 950 AFB staining for National TB control programme, 1055 HIV tests for ICTC. The department participated in the external quality assessment scheme organized by Indian As sociation of Medical Microbiology for Quality Control. We conduct theory and practical training classes for students of B.Sc. Applied Microbiology and DMLT. We also train students in the related subject from othercolleges and guide in projects and

32

The department does around 1300 culture and sensitivity tests, around 4000 serology tests and around 650 microscopic examinations per month. The total number of investigations performed by the department in 2007-2008 in 48,241 (6981 culture and sensitivity, 4024 microscopic examinations and 37, 236 serologic examinations) The department participates in the Revised National Tuberculosis Control Programme (RNTCP) and the National AIDS control programme. It is also a member of the Infection Control Committee It participates in the External Quality Assurance Scheme (EQAS) with Amala Institute, Trichur, Kerala. The following special tests are conducted by the department Acute hepatitis profile Anti-Ds DNA IgM C3, C4 CHIK IgG, IgM Chronic hepatitis profile Dengue IgG, IgM IgG, IgA, IgM Leptospira IgM Mycodot TORCH panel Western Blot for HIV

TThe

Departme nt of Me dical

Oncology caters to a wide range of tumors starting from Hematological cancers like lymphomas and leukemias to the commoner solid

Introduction

tumors like cancers of the breast, cervix, ovary, lung etc. Patients come to us from a very large radius due to the sustained efforts of our doctors and the paramedical team.

Medical Oncology Curative cancers are given utmost priority in the implementation of universally recommended protocols to achieve best results. Financially poor patients especially children with cancer who cannot afford curative treatment are given assistance through the Camilla Children's Cancer Fund supported by our hospital and other donors.

Procedures like Intra-thecal administration of drugs, Pleurodesis, Intra-peritoneal chemotherapy are all being carried out routinely in the department.

Monoclonal antibodies for cancers of breast, colon and lymphomas and the newer targeted molecules for example in CML, GIST and head & neck cancers are routinely used as indicated.

Palliative treatment for advanced cancers are also done which make up a good number of patients in India with late stages of disease due to various factors in a developing country. Pain control is achieved with morphine or equivalents along with other drugs as adjuvant.

We take up clinical trials with enthusiasm as they provide a window of hope for our poor patients who cannot afford those to newer drugs and gives a path for the identification of newer molecules against cancer. Clinical trials increase survival of cancer patients. We have an exclusive clinical trial room with a dedicated person for documenting purposes. The long pending need for a Bone Marrow Transplantation Unit in southern India may become a reality soon in our institution with the support of our administration. Chemosensitive tumors that have relapsed after primary treatment can be salvaged with the BMT regimens. This may also be the answer to benign hematological conditions like Aplastic anaemia, Thallasemia etc which can be cured by BMT.

Constant health education to prevent cancers is also taken up on a regular basis especially to the patient attenders.

Expert opinion from the team consisting of Surgical Oncologist, Radiation Oncologist and medical oncologist, along with Pathologist decide the treatment modality & protocol of international standards at affordable cost.

Statistics Bone marrow aspiration

200

Ascitic fluid

110

FNAC

80

Intrathecal injections

50

Trucut Biopsies

40

Pleurodesis Day care chemotherapy

7 600

33

Nephrology Dialysis We are one of the largest haemodialysis units in Tamil Nadu with most recent haemodialysis machines, which offer cutting edge technology at affordable cost. We have dedicated machines and separate chambers patients.

for HCV and HBV infected

The number of haemodialysis has

increased significantly as compared to the previous year and now we perform more than 600 dialysis per month. We also have facilities for continuous

Introduction

renal replacement therapies like CAVH and CVVH. We also perform specialized procedures like plasmapharesis for variety of renal as well as extra renal diseases. We also have an active Continuous

34

TThe year 2007 – 2008 was a glorious year for the

Ambulatory Peritoneal Dialysis (CAPD) program,

Department of Nephrology. Our department was

with more than 100 patients under our care.

recognized as a force to reckon within India and

A Baxter PD centre was established in our

abroad. Our patient flow has also steadily

department in collaboration with Baxter India Ltd,

expanded in these years.

which has enhanced our CAPD program.

K. Sampath Kumar, YS. Sooraj, RP. Ajesh Kumar :

Renal Transplantation With more than 275 renal transplantations with excellent success rates, we are one of premier healthcare

institutions performi ng renal

transplantations in South India. Latest protocols

Extended Release Nicotinic

acid is a

promising agent for phosphate control in haemodialysis KI 2006, 69: 1287.

for postop erative immuno suppression s are

Administrative Posts

followed with prompt drug level monitoring. We

Our senior consultant Dr. K. Sampth Kumar was

also

elected to the post of Honorary Secretary, Indian

have facilitie s

for performing Cadaver

Transplants.

society of Nephrology Southern chapter, which goes a long way in strengthening our department.

Interventional Nephrology We regularly perform

Percutaneous CAPD

insertions and Percath insertions in our unit. Active participation of urology and radiology

Statistics Total Number of Kidney Transplantations

332

colleagues help us in perform ing AV fistula and Renal Angioplasties.

In Patients

1666

Out Patients We also have an active critical care nephrology unit that takes care of life threatening medical

New Registration

and nephrological emergencies

Review

Our department is one of the few centres

Chronic Renal Failure

approved for postgraduate training in Nephrology.

Acute Renal Failure

We have emerged as one of the very few centres

1098 15096

Snake Bite

in India doing original research. Our research on Influence of nicotinic acid on phosphours levels in

Renal Calculi

CRF patients has received international acclaim.

Nephrotic Syndrome

We had 2 international publications in the

Diabetic Nephropathy

pioneering journals of nephrology during the past year. We also had 3-conference presentations and

UTI

we bagged the gold medal for the best poster

Obstructive Uropathy

presentation in the south zone conference in the

Heriditary Renal Disease

Indian society of Nephrology held at Trivandrum.

SLE

24

Publications

Renal Biopsy

84

K. Sampath Kumar, M. Selvam, Y.S Sooraj,

CAPD

34

S. Gowthaman, RP. Ajesh Kumar : Extended

Peritoneal Dialysis

35

Renal Transplantation

28

Release Nicotinic Acid a novel oral agent for phosphat

control. Int. urology Nephrology

Journal 2006, 38: 171-174.

Haemodialysis

7729

35

Neurology

NNeurology department has grown from its stage of infancy to the toddler stage with full of energy and

Introduction

36

enthusiasm.

We have got two consultant neurologists and 2 young Medical officers for 24x7 for 365 days. Neuro emergencies are managed with zero delay along with faithful precision and devoted care. Our stroke unit is one of the novel sections of the hospital and is one among a few of similar units, throughout India; we have all the facilities for the golden hour management of stroke of any type, instantaneously. All types of Neurological disorders are managed appropriately. Neurophysiology lab which has, not only EEG, EMG & Evoked potentials, but also, a well renowned sleep laboratory. Neuro sciences department of MMHRC is recognized for its team work approach in stroke management and our timely hemicraniectomy intervention for malignant MCA infarct cases has been recognized for inter national as well as in international meets. We have started carotid endarterectony for extra cranial carotid blocks, recently, where indicated. Our comprehensive plan for various disorders is a recognized feature, appreciated by most of the public; We are planning to start a memory clinic for dementia cases soon.

Electrophysiology Lab Statistics S. No. EEG EMG PSG FEMORAL BAED NCS VIDEO EEG VEP CARPAL FACIAL SCIATICS TARSAL BLINK DECREMENT BRACHIAL

April 2006 - March 2007

April 2007 - March 2008

503 7 47 2 34 133 5 8 6 10 4 0 1 3 7

564 16 37 0 28 182 10 1 9 6 1 3 0 3 6

7000 6000 5000 NEW REG REVIEW REG TOT.NO.OP ADMISSION

4000 3000 2000 1000 0 2005-2006 2006-2007 2007-2008

37

Neuro Surgery

NNeurosurgery

is a recognized centre to perform all

complex neurosurgical procedures.

In the past two

decade there has been rapid strides being made in Neurosurgery. At MMHRC, we do all subspecialties

Introduction

in neurosurgery namely endoscopic neurosurgery, skull base neurosurgery, complex spine fusions, vascular neurosurgery and functional neurosurgery.

38

This year has been a tremendous year neurosurgery wi th 350 surgical

for

cases.

We have opened a new neurosurgical ICU

Elective Brain tumours - supratentorial

23

infratentorial

13

Spine

25

named Neuro Critical Care Unit with 7 beds and all beds with latest monitoring devices. Spinal cord tumours

3

Myelomeningocele

6

Endoscopic sugery

10

In stroke surgery we have made tremendous improvement this year. For malignant MCA infarct we do decom pres sive crani ect omy nearly reducing the mortality from 80% to

Aneurysm

2

30% . In anot her signi ficant achi evem ent ,

Cranioplasy

7

we ha ve ope rat ed a 7 mont hs pr eg na nt

V.P.Shunt

51

patient with TB spine which in the added

Abscess and osteomyelitis

16

achievement. The patient made a tremendous

CV junction

recovery to continue pregnancy after 7 hours surgery and

Total

1 157

delivered a healthy baby in others

31

Emergency: craniotomy for trauma

78

Depessed fracture

24

Craniectomy for stroke

25

Dr. K. Selvamuthukumaran presented a paper

Chronic subdural hematoma

26

on “Decompressive craniectomy in malignant

EVD

13

MCA infarct” in the annual NSI conference

Total

193

at Agra.

New patients

1048

Review patients

3003

Total Number of OP

4136

time. Only

10 such cases are reported in

world literature. “Neurocon” our annual CME programme was also conducted

on

October 2007. Our Sr. Consultant

Inpatients

974

39

Nuclear Medicine

TThis is a relatively new branch of imaging science, concerned with the FUNCTIONAL EVALUATION of various organ systems of the body. The procedure is very simple, whereby the appropriate

Introduction

radiopharmaceuticals are injected intravenously and the emitted gamma rays (similar to X-rays) are detected by means of a gamma camera.

40

Som e of the well kno wn app licat ions of Nuclear Medicine include: Estimation of individual kidney GFR/ split function, Differentiation of non-obstructive from obstructive hydronephrosis, screening for skeletal secondaries in patients with known malignancies prone to disseminate the skeletal system ( ex. CA Prostate, CA Breast). Assessment of inducible ischemia and viability, Detection of ectopic gastric mucosa, Function evaluation of thyroid gland, detection of ectopic thyroids.

Statistics No. of out Patients

1,162

No of Inpatients

38

Diagnosis scans

1,160

RIA No. of Assays

5334

Low dose Iodine Whole body scans Low dose Iodine

Therapeutic applications of nuclear medicine include treatment of hyperthyroidism and post-

Therapy for hyperthyroidism

operative ablation of remnant thyroid tissue /

High dose Iodine

different iated secon dari es in pat ient s with

Therapy for differentiated carcinoma of thyroid (post-operative)

differentiate carcinoma of thyroid.

131 79 131 64 131 38

Conferences Attended 8th International Conference of Nuclear Cardiology (ICNC8) 29 April – 02 May 2007, Prague, Czech Republic (Organised in Conjunction with American Society of Nuclear Cardiology, European Association of Nuclear Medicine and European Society of Cardiology). Authored the article titled 'Need for hybrid systems in evaluation of coronary artery disease: revisited', which won the travel grant at this conference.

13th Annual Conference of Society of Nuclear Medicine (Southern Chapter) 28-29 July 2007, Hyderabad, India. (Chaired 'Case Reports Session' at this conference.)

5th Annual Conference of Association of Nuclear Medicine Physicians of India, 28-30 September 2007, Udaipur, India.

41

Introduction

TThe

Department of Obstetrics and

Gynaecology is a well established tertiary referral centre for management of vario us high risk pregnancies. Teamwork is the hall mark of managing these high risk cases. Considering the special needs of pregnancy, various me dical and surgical problems complicating pregnancies are managed in the most appropriate way in liason with various speciali sts available under one roof.

Obstetrics and Gynaecology 42

The spectrum of services available is Regular antenatal services at an affordable cost Pain free labour- epidural labour analgesia Counselling and management of recurrent pregnancy loss Effective preterm labour management Management of all medical and surgical problems associated with Pregnancy Gynaecology has various emerging subspecialiltiesOncology, Urog ynaecology and Endosco py. Various clinical steps have been implemented and ap pr opr iat e ins trum en ts like hy ster os co pe , resectoscope, versapoint, colposcope etc are available for providing high quality world class gynaecological care to the patients at affordable cost. Emphasis has been given on reducing the hospital stay and maximizing patient comfort by offering more endoscopic surgeries. The leap in the number of laparoscopic and hysteroscopic surgeries in the past few years is a proof of it.

Endoscopy The Laparoscopic surgeries performed include Hysterectomy Surgical management of ectopic pregnancies Ovarian cystectomy Myomectomy Endometriosis Sterilization, etc

The Hysteroscopic procedures performed include Diagnosis, guided biopsies for irregular bleeding PV Polypectomies TCRE –Endometrial ablation etc

Gynaec - Oncology Regular opportunistic screening by Pap smears and VIA is integral part of patient examination. Patients with abnormal pap smears and positive VIA are further evaluated and treated with the aid of colposcope. Appropriate radical surgeries are done for patients diagnosed to have malignancies of various parts of female genital tract . A) Reproductive Endocrinology Clicnic Hormone Replacement therapy, evaluation and management of primary and secondary amenorrhoea and other menstrual cycle abnormalities are done. B) Uro gynaecology : Surgical management of post hysterectomy vault prolapse including colpopexy, surgery for pelvic organ prolapse including mesh repair. Health education has also been an integral part of the departm ent activities. We have been conducting regular CME's for the benefit of post graduates, general practitioners and referral doctors in the past . We hosted the prestigious XVI Annual Conference of the Gynaecol ogi cal Oncologists of India - AGOICON 2007 on 16th –18th November 2007 in which many international and National faculty participated and shared their views and experiences. Evidence based management guidelines of various gynaecological malignancies were also discussed. Nearly 350 delegates attended the conference. The Two day conference and pre conference workshop which include live demonstrations of radical surgeries for various gynaecological malignancies, colposcopic procedures, onco nursing and tumour registry was well attended and appreciated by all. The Department is recognized by the Nation al Boa rd of examina tion s, New Delhi for the “Diplomate of National Board” degree in Obstetrics and Gynaecology. The academic course starts in the month of June and we admit 4 candidates each year – 2 Primary and 2 Post diploma.

43

Major Surgeries 1. Caeserian section 167 2. Laparoscopic hysterectomy Total Laparoscopic Hysterectomy 34 Total Laparoscopic Hysterectomy with BSO 25 Total Laparoscopic Hysterectomy with Lap. Cholecystectomy 3 LAVH WITH BSO 39 3. Abdominal Hysterectomy Total abdominal Hysterectomy 26 Total abdominal Hysterectomy with BSO 43 4. Vaginal Hysterectomy 8 5. Obstetric Hysterectomy 2 6. Internal iliac Aligation 3 7. Werthiems Hysterectomy 8 8 Staging Laparotomy for CA 24 Endometrium /ovary 9. Hysteroscopy 57 10. Lap. Ovarian cystectomy 15 11. D. Lap and proceed 24 12. Laparotomy and proceed 6 13. Ectopic pregnancy Laparotomy 5 Laparoscopy 13 14. Laparoscopic sterilization 23 15. Vaginal cyst excision 2 16. Vaginoplasty 1 17. CPT Repair 2 18. Tubo Plasty 1 19. Cervical Encirclage 2 Total 533 Minor Procedures D&C 58 Colposcopy 42 Family Planning MTP with TAT 10 MTP with LAP. Sterilization 16 LAP Sterilization 29 PS 570 Total 625 Full Term Normal delivery 150 LSCS 167 Forceps 41 Expulsion of fetus 4 Assisted Breech delivery 4 Total 366

44

Medical disease complicating pregnancy 1.Heart disease complicating pregnancy 2. Hepatic disorders complicating pregnancy 3. PIH 4. Pre eclampsia and eclampsia 5. Thyroid disease 6. Gestational diabetes mellitus 7. Renal disorders complicating pregnancy 8. Overt DM 9. Others

10 11 28 8 5 12 1 3 10

Obstetric Complications 1. 2. 3. 4. 5. 6. 7. 8.

Multiple gestation IUD APH IUGR Anemia Preterm labour Rh incompatibility Rupture uterus

12 4 7 10 2 66 17 3

Associated Gynaec disorder 1. Complete septate uterus 2. Fibroid uterus 3. Bicornuate uterus Month I.P of Statistics Year

1 1 11 O.P Statistics

New

Review

2007 Apr

90

131

544

May

95

128

554

Jun

82

115

501

Jul

84

133

144

Aug

79

144

523

Sep

100

177

580

Oct

94

145

586

Nov

82

140

453

Dec

86

121

534

2008 Jan

67

106

378

Feb

91

135

484

Mar

91

127

562

Total

1041

1602

5843

Ophthalmology

TThe department functions with the provision of comprehensive Ophthalmology services of consultation and support services to the other

Introduction

departments of the hospital.

45

Comprehensive ophthalmology capability is enhanced now by state of the art equipments like Humphery field analyzer for glaucoma evaluation; Carl Zeiss 532 green laser for photocoagulation in retinal diseases. Both these facilities are further strengthened by state of the art Carl Zeiss digital fundus camera. The department is surgically active in anterior segment, the cataract surgery forming a bulk followed by glaucoma filtering surgery, lacrimal surgery and oculoplastic surgery All the latest developments in the cataract surgery like micro incision cataract surgery foldable Intra Ocular Lens (IOL), aberration free lenses are available here making this one of the most advanced centres practicing modern cataract surgery. Multifocal IOLs are being offered to patient, routinely now. Vitreoretinal surgery will be introduced in the current year making this one of handfull of centres with such services. Our commitment to the communities has been as strong as ever, with number of free eye camps throughout the region, scores of poor persons have been benefited from free cataract surgery performed by us. Out patient attendance registered overall growth at (25.5% growth) paying patients and (30.8% growth) free patients over the previous year. All the subcategories showed growth rates just as impressive. Surgical volume also recorded modest growth on paying patients as well as free patients.

46

Orthopaedics, Traumatology and Spine Surgery

Centre for Joint Replacement and Arthroscopic Surgery

We are backed with state-of-the-art facilities at par with international standards in the management of trauma. There is no stone unturned in providing the best and latest managament of Trauma. Being a tertiary referral centre, we get all the polytraumatised patients and neglected trauma patients. We are experienced in managing mass casualty cases and disaster management.

TThe Department of Orthopaedics has become one of the tertiary referral centres down south for the management of trauma, musculoskeletal disorders, Joint replaceme nts, Arthroscopic

Multidisciplinary interaction under one roof is a boon for successful management of these patients. Round the clock accident and emergency services and readily available teamwork has been a hallmark of functioning in this institution and availability of many teams had led to successful,

surgeries and Spine surgeries.

simultaneous management of the accident victims

The department has been recognized by

thereby, reducing the waiting time for surgery,

the National Board of Examinations,

earlier rehabilitation and also reduced hospital stay.

New Delhi for post-graduate training for

With the increase in the armamentarium of

the award of Diplomate of National

Instrumentation, multiply injured patients are

Board degree in Orthopaedics.

treated eff ectively with minimally invasive

The academic course starts in the month

procedures. “Life is Motion� is the theme and every

of June and we admit two candidates

effort is made to put the patient back to their

every year.

pre-injury status at the earliest.

47

Apart from trauma , successful management of

last year a real resurgence in the number of Joint

spine disorders and backache forms the mainstay

Replacement cases. We are doing High Flexion

of the functioning of the department. The patients

Knees to gain more flexion (bending) of the knees

are approached systematically with the latest

facilitating squatting and other ground activities

modalities of treatment. Patients are benefited by

Arthritis among young is on the rise and these

minimally invasive surgeries, microdiscectomy

patients do with Surface Replacement

and endoscopic surgeries. We see cases who have

Arthroplasty.

recurrent problems and spinal deformities and are managed with good success to the utmost

These patients have almost a normal physical

satisfaction of the patients. Lumbar, thoracic and

activity including sitting cross legged, squatting

cervical spine surgeries with or without

and could involve in sports also.

stabilization are done regularly. Adding a feather to the cap, we have started doing corrective surgeries for scoliosis and Kyphosis. Keeping abreast with the latest advancement, Disc Replacement surgery is the latest addition. Elderly patients with Osteoporosis sustain compression fractures of spine in the bedridden patient and we do Vertebroplasty, which pre-focused, gives immediate stabilization to the spine and very good pain relief to the patient. The ill effects of these patients being confined to bed for long duration is avoided through them.

Considering the number of people involved in sports are increa sing everyd ay, there is a proportionate increase in the number of sports injuries. Ligament injuries, meniscal injuries, rotator cuff injuries are best managed arthroscopically and arthroscopy has become a day care procedure for most of the diagnostic procedures including biopsies. Arthroscopy assistedn ligame nt reconstructions, treatment of meniscal injuries have reduced the morbidity and patients get back to their sporting activities

at the earliest. Arthroscopic

debridement in mild to moderate arthritis of the With the growing geriatric population, the incidence of arthritis is on the rise, which is again double folded due to rheumatoid arthritis. Arthritis

kn ee s ha ve salva ge d many pa tien ts from undergoing a Total Joint Replacement and in some, has delayed the procedure temporarily.

is managed according to the stage, and the cause, the management varying from conservative

There is so much interest in treating young children

management wi th health education, diet

with deformities, either congenital or acquired.

management, physiotherapy, minimally invasive

CTEV in different stages and ages is managed ably,

surgeries, Arthroscopic surgeries and total joint

may be conservatively or surgical which could be

replacement for serious cases. As there is a need

soft tissue procedure, bony procedure or Ilizarov

for the patients and public to be benefited, we have

fixation. Patients with Post-Polio residual paralysis,

come out on a package system in which the knee

Cerebral palsy with deformities are taken care.

replacement surgery with the imported implant costs only Rs. 1,10,000/- while with an India Implant, it costs Rs.75,000/-only. The awareness and acceptance of the patients for total Joint Replacement has increased significantly and the

48

Health education has also been an integral part of the department activities and recently we have

Trauma - Closed interlocking Nailing-Femur

started public awareness and education programme

and Tibia, Proximal Femur Nailing,

about the musculoskeltal disorders. We are

Distal Femur Nailing, DCS, DHS,

planning to conduct more camps at different places for different disorders.

Bridge plating, Reconstruction Nailing

Services Available Round the clock fracture clinic Total Joint replacements - Total Hip, Total Knee, Total Shoulder, Total Elbow Spine surgeries - Minimally invasive spine surgery,

Compound - Primary stabilization with flap covers Limb Reconstruction - Deformity correction, Lengthening Hand injuries Rehabilitation of spinal cord injured patients Management of musculoskeletal tumours.

Decompression, Stabilization, Deformity Correction,

Statistics

Endoscopic Spine Surgeries,

Total In Patients

Disc Replacements

Total Out Patients

1683 10369

Vertebroplasty & Kyphoplasty Arthroscopy - Diagnostic, Debridements, Biopsies, Meniscal repairs ACL, PCL

Major Surgeries

917

Minor Surgeries

752

reconstructions.

49

Otorhinolaryngology ( E. N. T )

No. of Surgeries

Highlights of the Year

50

390

OP

4861

IP

364

OP Procedures

618

New OP Cases

1287

Review cases

3574

Statistics Otology MASTOIDECTOMY WITH TYMPANOPLASTY STAPEDECTOMY GRANULATION EAR CANAL REMOVAL EAR LOBE REPAIR TEMPORAL BONE TUMOR BIOPSY PRE AURICULAR SKIN TAG / SINUS EXCISION EAC STENOSIS REPAIR AURICULAR CYST EXCISION

81 9 4 4 1 4 1 1

Rhinology ENDOSCOPIC POLYPECTOMY 29 FESS / FESS with SEPTOPLASTY 34 SEPTOPLASTY / SMR 10 D N E & CAUTERY 30 FRACTURE NASAL BONE REDUCTION 7 NASAL ENDOSCOPIC BIOPSY 7 YOUNGS OPERATION / RELEASE 4 SEPTORHINOPLASTY 3 ENDOSCOPIC D C R 2 ENDOSCOPIC EXCISION OF BENIGN TUMOUR 8 ENDOSCOPIC TURBINOPLASTY 1 ORO ANTRAL FISTULA CLOSURE 1 C S F RHINORRHOEA ENDOSCOPIC REPAIR 8 ENDOSCOPIC PITUITARY SURGERIES 2 RHINOPHYMA 1

OP Procedures PSG DNE V L SCOPY EAR PIERCING MISCELLANOUS

42

618

Laryngology and Head & Neck TONSILLECTOMY / ADENOIDECTOMY FOREIGN BODY OESOPHAGUS TRACHEOSTOMY TONGUE TIE RELEASE VALLECULAR CYST EXCISION MICRO LARYNGEAL EXCISION MAXILLECTOMY THYROPLASTY TOTAL LARYNGECTOMY with PRIMARY T E P PAPILLOMA TONGUE EXCISION BIOPSY NECK CODE D L SCOPY & EXAMINATION / BIOPSY ORAL CAVITY

45 7 10 10 1 8 2 1 1 1 6 23 13

Audiology and Speech Therapy NUMBER OF AUDIOGRAMS ORAL GLYCERAL TEST

835 6

SPEECH THERAPY (IP, OP, & STP)

961

HEARING AIDS SOLD

61

BERA

21

51

Paediatrics and Neonatology Introduction

TThe department of paediatrics is slowly but steadily growing. As a referral centre we are providing excellent services to many complicated and referred cases.

Paediatric patients are round the

clock covered by qualified paediatrician. By our dedicati on, we have acq uired a very good reputation for diagnosing and treating all types of paediatric patients.

52

The general paediatrics consists of a separate emergency cum procedure room which is equipped with critical care resuscitation trolley, suction apparatus, centralized oxygen supply, incubation sets, emergency drugs, nebulizers, cardiac monitor, pulse oxymeter infusion pumps etc. The NICU is equipped with warmer and air conditioner in order to maintain a thermo neutral temperat ure. The NICU is equ ipped with mechanical ventilator (high frequency mode) neonatal trolleys, double sided photo therapy units, incubators, open care warmer system with radiant warmers, centralized oxygen supply, pulse oximeter, apnea monitor, Co2 monitor, NIBP monitor, cardiac monitor. CPAP and sufficient infusio pumps. We have transport incubator which serves to transport the babies from other hospital also. Our neonatal intensive care unit is a well known for its excellent service to preterm and sick new born babies. To avoid cross infection the unit is divided into septic and aseptic units. Importance is given for neonates. Our hospital provides surfactant therapy and ventilatory care for premature babies and RDS has placed the initial steps in providing tertiary care for very sick babies and extreme premature babies.

The outcome of premature babies treated with surfactant therapy, parental nutrition and hyper bilirubinemia treated by Exchange transfusion are well comparable with any other well-equipped tertiary care centre in our country. Ventilator care and surfactant therapy provided here has improved the survival rate of preterm babies with respiratory problems. With the help of Blood bank and free availability of blood component therapy, complicated and rare bleeding disorders, platelet disorders, thalassemia, sept icemia and Hemop hi lia are mana ged successfully. Exchange transfusions have saved many newborn with Rh hemolytic disease. Super specialties in surgery, urology and plastic surgery help us to provide best treatment to children with acute surgical and urological problems and also correction for congenital anomalies. During this year, several interesting and complicated cases and rare syndromes have also been diagnosed and treated in our department successfully. Our aim is to serve poor people for conducting free paediatric health camps every Saturday to cater the lower socio economic children. Laboratory investigations are done at concessional rate during these camp days. It also provides free immunization (BCG & OPV) on all working days.

53

In this year the department of pediatrics has treated 7507 out patients and 693 in patients from April 2007. The varies types of cases treated as in patients in the department of pediatrics are given below

Statistics NICU Premature Septicemia Birth asphyxia CHD IUGR Hyaline membrane disease Neonatal convulsions Hemorrhagic disease of new born Pathological jaundice NEC Meconium aspiration Congenital anomalies Newborn with Respiratory Distress Surfactant therapy Exchange transfusion Miscellaneous

44 13 27 2 12 1 34 2 31 6 6 5 31 3 2 8

GENERAL PAEDIATRICS AGE Acute Febrile Illness Hepatitis Enteric fever Malaria Dengue Hemorrhagic fever Constipation

37 24 22 5 2 2 25 1

CENTRAL NERVOUS SYSTEM Meningitis Encephalitis Seizure disorder Febrile convulsion Cerebral palsy Head injury GBS Spastic diplegia Others

54

HAEMATOLOGICAL Haemophilia Thrombocytopenia Factor VIII deficiency Factor 1X deficiency Hemorrhagic disorder ALL AML Hemolytic Anemia Thalassemia Platelet disorder Epistaxis

19 44 18 7 2 3 1 2 3 4 2

1 4 1 2 4 3 1 19 2 1

PAEDIATRICS & NEONATAL ICU 10 9 25 17 1 3 2 3 12

CARDIO VASCULAR SYSTEM CHD Myocarditis Rheumatic PDA Others

RESPIRATORY SYSTEM Bronchitis Pneumonia LRI PUO Pneumothorax Aspiration pneumonia Bronchiolitis Lactic acidosis Metabolic acidosis FB aspiration Epiglotitis

17 2 2 5 2

Nephrotic syndrome Acute glamerulo nephritis UTI ARF CRF Cystitis Hematuria Hydronephrosis PUV Poisoning Insect bite Near drowning Scald Miscellaneous Surgical emergencies Surgical correction

5 3 2 3 3 1 2 2 2 4 5 4 3 42 5 7

Pharmacy We have an efficient material management system consisting of good hospital formulary, a Pharmacy Therapeutic System (PTC) and strict indigenous scientific procedures controlled by a Purchase Committee. The PTC monitors the procurement of We have a 24-hours centralized pharmacy situated W

drugs and pharmaceuticals through established

in the lobby level, which caters to inpatients and

and Time-tested systems. All medicines are stored

outpatients. The IP and 24 hours Pharmacy sale

in the correct environmental conditions so that the

counters provide patients with the medicines as per

efficiency and potency of the drugs do not

their requirements, and doctor's demands.

deteriorate. Pharmacy has three functional areas:

The pharmacy stores makes available all the

Dispensing area, administrative area & storage

requirement of medicines, surgical items and

area, which are well designed and located for

consumables of the entire hospital. This area acts

convenient access, staff control

as a distribution centre of the hospital and supplies

Pharmacy stocks and dispenses over a thousand

all requirements for the departments.

various drugs of reputed Indian and International

The pharmacy department offers well-experienced

Brands. The emerging competitive market makes

service to the patients visiting the hospital.

us alert towards the needs of the patients.

and

security.

55

Physical Medicine and Rehabilitation A boon to mankind in alleviating pain and leading a healthy life.

TThe

department of physical medicine

and rehabilitation works with the philosophy

Introduction

56

of ‘’The patient comes first under any circumstance”.

Physiotherapy department is equipped with latest equipments, working in all sub specialities in physiotherapy. We have a qualified and highly experienced team of physiotherapists providing OPD services (Direct and refferal) and IPD services (in wards and intensive care units) with treatment procedures of international stan dards, with multifaceted approach to patients rehabilitation. Physiotherapists provide wide range of therapies after examination, tailored to suit individual needs. Physiotherapist aims to restore functioning of the body, to reduce impact of dysfunction, disability, pain of the body, from trauma and disease as into improve mobility, health and reduce risk of injuries.

Therapies Includes Manual Therapy: Stretching, manual resistance training, joint mobilization and manipulation, Manual lymphatic drainage (Post lymphedema), chest physiotherapy. El ect ro Ther apy Techni ques : Shor t-wave diathermy,. Ultra-Sound therapy [1mhz,3mhz], pelvic & cervical traction[continuous & intermittent], Interferential therapy, Wax-Bath, Electrical muscle stim ulator, T.E.N.S, Slim-up Vaccum therapy Exercises : Posture training, muscle strengthening, cardio vascular training and stretching.

Facilities Electrotherapy - SWD/IFT/Ultrasonic/ MS Stimulator, T.E.N.S, Paraffin waxbath, Cryotherapy Diagnostic – S D curve/MS testing/ADL assessment Mechanical - Traction-Cervical/Lumbar/Pelvic/C.P.M. for lower extremity. Tiltable, rowing, treadmill. Manual Mobilisation Therapies - Mobilization couch with specific features for mobilization. Exercise Therapy - Active/Assisted/Passive/Resisted/ Graded resisted exer cises, PNF techni ques, suspension therapy, Theraband/tubes exercises. Chest Physiotherapy - Assessment of pulmonary functions, therapeutic functions, postural Drainage, Therapeutic, Interven tional physi otherapeutic procedures, Nebulization Breathing exercises, Incentive

spirometer, Humidification, home care and follow ups. Gynae/Obstertric - Antenatal & postnatal Ex., postural correction & awareness, Fitness Assessment & Improvement etc. Post Operative Cardiac Surgeries - Following cardiac surgeries Pre & Post operative Physiotherapeutic exercise for patients includingBreathing exercises, chest manoeuvers, humidification, nebulization, Incentive Spirometers, Limb Physiotherapy, cardiac rehab- phase I -IV. For Neurological Disorders - Proper positioning of the limbs (Anti synergic patterns) general mobility & strengthening exercises, PNF, Bobath. ICU post surgical care - Chest physio & general mobility ex, Intensive Spiro meter ex, Bronchial hygiene, Proper positioning of the operative side/ part, Ambulation. HAEMOPHILIA FEDERATION OF INDIA Madurai chapter gives physiotherapy care and advice through our department. The core idea at the department of physical medicine & rehabilitation is to ensure that rehabilitation is done in short period and make life normal.

Academic Activities Various physiotherapy colleges under affiliated to TAMIL NADU Dr MGR MEDICAL UNIVERSITY has tie- up with our hospital to get C.R.R.I for their BPT students.

Total No. of Patients Treated IN PATIENTS

-

18767

OUT PATIENTS

-

3726

TOTAL PATIENTS

-

22493

57

Milestones T h e d e p a r t me n t h e a d Dr. N.Panchavarnam was one of the 12 surgeons in the world and one of the five surgeons from India, selected and honored with the prestigious “ S MI L E T R A I N H E R O AWARD� at Baltimore, USA. We have received Leading Plastic surgeons fro m USA and Israel, and other parts of the world who visite d MMHRC under the Smile Train Medical E x c h a n g e P r o g r a mme .

Plastic Surgery

T he Department of Plastic Surgery has evolved T a world-class plastic surgical centre over the last one year. It has been recognized as a centre of excellence in cleft surgery. In the Department of plastic surgery we are doing all cases coming under the Smile Train Project and also the other plastic surgery cases. We have got a

Introduction

state of the art operation theatre dedicated for plastic surgical cases only. Last year, there is an increase in the number of cosmetic surgical cases in our department, reflect ing the increased awareness of aesthetic surgery in the society.

58

Total number of cases operated 986 (From 1/4/2007 to 31/3/2008) Unilateral lip repair Bilateral lip repair Palatoplasty

Smile Train Project 252 47 385

Facial cleft repair

11

Revision lip repair

46

Revision palatoplasty

60

Palatal fistula repair

45

Pharyngeal flaps

15

Secondary nose correction

8

Alveolar bone grafting

1

Head and neck reconstructions

5

Facial scar revisions

5

Traumatic lacerations in head and neck

11

Tongue-tie release

12

Lobuloplasties

6

Rhinoplasties

3

Fascio-maxillary injuries

2

Oral cavity hemangiomas

5

Vascular malformations

2

Electrical burns

5

Thermal/Chemical burns

10

Gynaecomastia

8

Lipoma excision

2

Abdominoplasty

3

Thumb reconstruction

1

Pressure sore reconstruction

3

Tubal recanalization

1

Vaginoplasty

1

Chronic ulcer reconstruction

12

Reconstruction of lower limb defects

20

Total out patients New patients Review patients

Since inception of our Smile Train Project we have made rapid progress and now we are one of the leading cleft centres in the wo rld. In recognition to our dedicated work and the quality of service, the Smile Train, USA. has upgraded our centre as “ The Smile Train Regional Centre - MMHRC There has been a significant rise in the quality of our surgical work since the inauguration of the new operation theatre in the Regional Centre and many patients come and avail their services from all parts of India.

Achievements 1. Total number of surgeries done under the Smile Train project – 869. 2. We completed 3333 cases and released Souvenir for Smile Stone 3333. 3. Pre-operative monitoring has improved after the introduction of the state of the art multi parameter monitors having ETCO2 monitor. 4. With the newly acquired state of the art fibre optic nasopharyngoscope, we are performing post-operative nasopharyngoscopy for patients who have undergone palatoplasty. 105 cases of nasopharyngoscopies have been benefitted

3460 898 2562

59

5. For assessing the middle ear function of patients having cleft palate, we have a digital middle ear analyzer. We routinely do impedance audiometry of the patients using the machine. 6. The latest edition of the “Dr. Speech” software introduced this year makes nasalence measurements in patients very easy and helps in giving speech therapy. 7. July 2007, a Maxillofacial surgeon from Cochin came for one month's training in cleft lip and palate surgery. 8. In recognition of our centre of excellence in cleft surgery, three International doctors choose our centre to get training in cleft surgery under the Smile Train Medical Exchange Programme. Dr. Lawrence, a dental surgeon from Hawaii visited us in the month of January 2008 and underwent training. Dr. Kalish and Dr. Ad El, both senior plastic surgeons from Israel, also visited our centre to get trained. Many more doctors have already expressed their desire to visit our centre.

Plastic Surgery Cases Last year, we saw an increase in the number of general plastic surgical cases in our department. Plastic surgery is one of the specialties which deals with problems from head to foot. Plastic surgeons are also called “reconstructive surgeons” as majority of the times we are called by other departments to fix tissue defects. 1. A total number of 117 major plastic surgical procedures were done in the last one year. 2. A total number of 28 minor plastic surgical procedures were done last year. 3. A rare case of vaginal agenesis was operated and vaginoplasty done using Singapore flap.

60

4. Tubal recanalization was done in a post tubectomy patient. 5. A total amputation of right thumb was reconstructed by an osteoplastic groin flap 6. A case of acid burns on face with deep burns involving the whole face and neck was managed successfully. 7. Two dura exposed raw areas of the scalp were covered using flap cover. 8. In a case of microtia of right ear, ear reconstruction was done in a single stage using carved costal cartilage and temperoparietal fascial flap. 9. A rare case of vascular malformation of finger was treated with very good cosmetic result.

Academic Activities Last year we gave lot of emphasis on academic activities and we took active participation in the monthly clinical society meetings and also in the CMEs also. We presented 10 papers in the 12 clinical society meetings last year. We have also been giving regular articles to be published in the Madurai Medical Journal.

Papers presented in various International/National conferences 1. “Primary repair of Bilateral Cleft Lip with Nose Correction in a Single Stage” at the ASIA PACIFIC CLEFT LIP AND PALATE CONGRESS, GOA. 2. “Triple Wedge Repair for Wide Cleft Lips” at the SMILE TRAIN SURGEONS CONFERENCE, GOA. 3. “Challenging single stage repair of bilateral cleft lip” in the APSICON 2007,PUNE. 4. “Singapore Flap Vaginoplasty” in TANPAPS 2008, Kanyakumari. 5. “Functional assessment after Palatoplasty” in TANPAPS 2008, Kanyakumari.

Psychiatry and Counselling

TThe department of psychiatry's guiding principle of evidence based medical therapeutics – the practice of clinical psychiatry based upon rigorous scientific standards and most recent empirical evidence for

Introduction

selection of therapeutic options – has been enshrined as the defining feature of providing quality care to the psychiatrically ill populace of Tamilnadu.

61

Although emphasis has been laid upon scientific

The department of psychiatry envisag es to

psychopharmacological management and

the

expand its horizon by increasing attention to

department reinforces its faith in cost-effective

clinical research and to exemplify this initiative,

treatment psychotherapeutic models of

the following studies have been completed.

management like An introspection into choice of antidepressants in clinical practice – a naturalistic observation study.

Crisis interverntion Counselling for suicide-attempters and suicidecontemplators Somatic reattribution model of Counselling for medically unexpected physical symptoms

A study of factors contributing to co morbidity of depression in medical inpatients with diabetes mellitus.

Motivation enhancement and relapse prevention techniques for alcohol deaddiction and smoking cessation.

A study of factors contributing to comorbidity of generalized anxiety disorder in medical inpatients with anemia.

Marital counselling and Cognitive behaviour therapy for psyciatric disorders.

A cross-sectional study to evaluate association between daytime sleepiness and alcohol consumption.

The department of

psychiatry takes immense

pride in providing CONSULTATION-LIASON services to departments like Urology, Andrology,

Statistics

Nephrology, Cardiology, Cardio Thoracic Surgery,

New patients

Neur ol ogy , Gas troent er ol ogy , HIV

Review patients

1730

Out patients(total)

2141

CARE,

Paediatrics, medicine and intensive respiratory, coronary and medical care units. The main thrust of specialized psychiatric care has been focused upon the domains of Deaddiction Psychiarty Neuropsychiatry Child Psychiarty

62

411

Inpatients(admission)

56

Inpatients opinions

575

Radiation Oncology The Radiation Oncology division offers a wide range of therapy modalities supported by a staff of noted Radiation Oncologists, physicists and technologists.

Introduction O utstanding O

Radiation Oncology care is crucial for many of our patients with cancer. Meenakshi Mission Hospital and Research Centre's (MMHRC) renowned Department of Radiation Oncology devoted to the practice of evidence-based medicine continually sets the standard by developing and incorporating the newest technologies and methods available to combat the progress of the disease thereby providing patients with the most classy radiation planning and delivery available anywhere in the world today. The attending Radiation Oncologist wants the patients relationship with MMHRC to be as proficient, cour teous , and succ es sful as pos sibl e. We support the patient to raise any questions and concerns they may have during the process of receiving Radiation treatment at MMHRC.

External Beam Radiation Therapy Used in the treatment of : Brain tumors, Gynecologic Cancers, Head & Neck, Lung, skin, Prostate, Bladder and Breast Cancer, etc., The state-of-the-art mega voltage Cobalt 60 external radiation therapy unit Theratron Phoenix by AECL. Canada has the unique feature of treating patients with rotational movements (360째) thus enabling doctors to handle complex treatment at various sites (superficial and deep seated). The dual energy Linear Accelerator (with provision for upgradability to Three-dimensional conformal radiation therapy (3D-CRT) and Intensity Modulated Radiation therapy) has the advantages of greater penetration with less amount of undesirable side effects because of higher beam energy and sharp beam characteristics.

63

Brachytherapy

Clinical Trials

Used in the trea tment of : Br ai n tum or s,

As a lead ing resear ch inst itution MMHRC

Gynecologic Cancers, Head & Neck, Brea st,

conducts numerous clinical trials in many areas

Oesophagus, Lung and Prostate Cancer, etc.,

at one time. From the central nervous system (CNS) to the Head and Neck, and breast and

Brachytherapy is a method of delivering radiation to tumors by placing radioactive sources either within or immediately adjacent to tumor tissue. Because the radiation source is very close to the tumor, radiation can go directly to the tumor wi thout traveling through normal tissue. Brachytherapy can be given by low dose rate or

pain control some of the most important clinical trials completed to date have been led by investigators from MMHRC Numerous trials have addressed issues related to patient can get is by participation in a clinical trial especially for a recurrent cancer where all modalities have been exhausted.

high dose rate techniques, depending on the length of time the radioactive sources remain in

Academics & Training Programmes

place.

We have conducted a National Workshop on HDR At MMHRC, the brachytherapy team includes a

Brachytherapy during the year 2007.

radiation oncologists, physicist, and Oncology trained nurse. Our excellent staff members work together to provide the best care possible. We offer

Statistics (Apr. 2007 - Mar. 2008)

High Dose Rate (HDR) Brachytherapy for a variety

Tot al num ber

of sites including head and neck, oesophagus,

Apr il 2007 to Mar ch 2008

breast, gynaecologic, and other soft tissue tumors.

Out Patient - 5467

New

In-patient

Review - 5002

High Dose Rate (HDR) Brachytherapy During HDR brachytherapy a radioactive source is placed in the tumor volume temporarily,

of pat ient s treat ed dur ing

- 875

- 6342 -

465

Radiation Therapy Total number of patients treated with external radiation therapy - 578

for just a few minutes at a time, and then removed.

The source is guided to the correct

position using

plastic catheters and a special

machine called a remote after loader. Since the source position can be precisely adjusted, we can

Total number of patients treated with brachytherapy

- 144

Total number of patients treated with radiation therapy under Ketamine anaesthesia - 5

create customized dose distributions to meet each The flexibility of HDR system

Free OP

-

20

allows us to use this technology for a wide range

Paid OP

-

of malignancies. We routinely use CT and MR

Free IP

-

patient's needs.

image guidance and inverse planning to create the optimal dose distribution.

64

Paid IP

-

278

246

Total Free -

54

34

Total Paid -

524

Site Wise Distribution Uterine cervix

- 160

Thyroid

- 3

Head and Neck - 123

Bone

- 7

Breast

- 78

Myeloma

- 7

Brain

- 12

Hodgkin's disease - 6

Lungs

- 21

Kidney

- 4

Oesophagus

- 23

Leukemia

- 5

Eye

- 11

Stomach

- 11

Rectum

- 22

Penis

- 1

Sarcoma

- 9

Pituitary

- 4

Bladder

- 9

Others

- 39

Prostate

- 11

Spine

Total

- 578

- 11

DEPT. OF RADIATION ONCOLOGY SITE WISE DISTRIBUTION FROM APRIL 2007 TO MARCH 2008

2% 2% 2% CERVIX

2%

H&N

8%

BREAST

2%

RECTUM

29%

2%

OESOPHAGUS LUNG BRAIN

2%

PROSTATE STOMACH

4%

SPINE EYE

4%

BLADDER SARCOMA

4%

OTHERS

14%

23% 65

Reproductive Medicine TThe Department of Reproductive Medicine got its special recognition this year, so that its services to people suffering from infertility and associated conditions will be more focused and research in

Introduction

Re pr od uc tive Medi cine will gear up at par with other renowned centres.

66

We have well calibrated & fit equipments. This year we got another new incubator.

Tailor made treatment for individual couples

The statistics shows the faith of the infertile couple

Ovulation induction

in us. Our ser vi ce focuses

Follicular maturation study

on pr ovi di ng mor al ,

emotional, ethical and most advanced technical Intra uterine insemination

support to the infertile patients.

Comprehensive Services

Assisted Reproductive Techniques

Complete and comprehensive investigations at one stop

In Vitro Fertilization - Embryo Transfer Intra Cyto Plasmic Sperm (ICSI), injection - Embryo Transfer

Endocrinological evaluation Ultra sonography both Doppler 3 D scan

Cryo Preservation Sperm

Imaging of General tract, by HSG under vision

Endoscopic and Laparoscopic Fertility enhancing procedures

Embryo

Vitrification Gamete Donation

Diagnostic and Surgical Laparoscopy

Ovum

Diagnostic and Surgical Hysteroscopy

Sperm

Treatment of Ectopic pregnancy, ovarian cyst.

Embryo Donation Surrogacy

Others Life style modification advice Physiotherapy, Diet counseling Counseling, evaluation and treatment for Recurrent pregnancy loss. Antenatal Postnatal check ups.

Statistics NEW CASES REVIEW CASES

523 5528 191

Prenatal genetic counseling

HSG

Management of Adolescent Gynaec Problems

LAPAROSCOPY

89

HYSTEROSCOPY

75

Umbilical cord blood collection A hi ghl y traine d and de di cated team of Gynecologists, Andrologist, Embryologist and Nursing staff help infertile couples in achieving

IUI

264

ART (IVF & ICSI)

101

their goal.

67

Surgery & Surgical Gastroenterology Diagnostic indication Staging of upper GI malignancies – Esophagus, stomach, pancreas, bile duct. Submucosal lesions of upper GI tract.

Introduction

Barret's oesophagus, fundal varices assessment. Detecting CBD stones missed by other modality. Non-small cell lung cancer staging.

Medical & Surgical O ur department acquired state of the art O

Fine Needle Aspiration – Pancreatic nodal mass sampling, mediastinal node FNA.

Endoscopy Ultrasound first of its kind in South India. EUS Combines endoscopy & high

Endoscopic mucosal resection for early gastric cancer, Barret's esophagus.

frequency ultrasound. Ultrasonic imaging by

Drainage of pseudocyst pancreas.

EUS is either linear or radial. Radial generates

Cyst fluid analysis & cytology of cystic neoplasm pancreas

3600 images, used in conventional echoendoscopes. Linear produces 1200 images commonly used for therapeutic purposes (FNS Drainage) and diagnostic purpose also.

68

Therapeutic indication

Botulinum toxin injection, posterior gastropexy for GERD, EUS guided billary drainage in failed ERCP. EUS guided hepatico gastrostomy.

We have taken advanced laparoscopic surge ry to the next level by which more and more complicated procedures are successfully performed and by use of innovative and newer devices / prosth eses improve patient rec overy and red uce pain. We have been pioneers in use of lightweight meshes in inguinal and ventral hernias. These patients have less pain and less sti ffness at operati ve sit e.

Routine general surgical and advanced Gastro intestin al surgical procedures are performed in large numbers with low morbidity and mortality. This year the department of GI surgery will introduce NOTES ( Natural orifice Trans Luminal Endoscopic Surgery ).

We have protocol in place for bariatric surge ry (surge ry for morbid obesit y). We have counselled number of patients, and made them aware about the disease.

Statistics Laparoscopic cholecystectomy Laparoscopic Appendicectomy Diagnostic Laparoscopy Choledochal cyst Whipples procedure PJ with Frey's Splenectomy Total Gastrectomy Partial Gastrectomy GJ with Vagotomy DU Perforator Closure Open Mesh Hernioplasty Laparoscopic Mesh Hernioplasty Thyroidectomy Obesity Surgery LR Shunt EUA + Haemorrhoids Stapler Haemorrhoidectomy Laparotomy Anterior Resection APER Colostomy Colostomy Closure Hemicolectomy Laparoscopic Rectopexy Oesophagectomy Radical Cholecystectomy Thoracoscopic Oesophagectomy Cystogastrostomy Varicose Vein Wound Debridement Amputation RFA Excision Biopsy I&D Fundoplication FJ Hepatico Jejunostomy Laparoscopic Cardiomyotomy Pancreatic Necrosectomy Kasai Operation Anoplasty Tracheostomy Laparoscopic CBD exploration Parotidectomy Total Colectomy Splenic Artery Ligation + Devascularisation Open Cholecystectomy Liver Resection

347 106 112 5 21 25 11 12 23 18 9 84 115 24 1 4 208 15 193 24 3 20 31 14 3 10 2 2 7 15 182 8 1 125 85 6 11 12 3 4 2 3 7 28 2 5 1 2 2

69

Introduction T he T

Department of Surgical Oncology is routinely performing radical procedures in patients with head, neck, breast, gynaecological malignancies and sarcomas. We keep in pace with the recent advances in this field. All cases are planned in tumour board, which is a multidisciplinary board including Radiation and Medical Oncologist.

Surgical Oncology Recently in management of breast cancer, emphasis has been laid on breast conservation in early stages and reconstruction of breast after mastectomies for locally advanced diseases. We have been doing pedicled flap reconstructions using TRAM (Rectus abdominis) or lattismus dorsi muscle. In Gynaecological malignancies, for bulky cancers in cervix, we follow initial Intra cavitary Radiation therapy (ICRT) followe d by Werthiem's hysterectomy, which gives excellent results. In head and neck malignancies, with the availability of high speed saw, skull based surgeries have become a reality. With better understanding of the anatomy and availability of equipments, major laryngopharyngeal and oral resections have been effectively done with minimal morbidity.

With the increasing demand for cosmetic implication, reconstruction of breast need to be further emphasized. Also craniofacial and temporal bones resection are to be planned for appropriate cases. With rapid advances made in laparoscopic technique, Werthiems Hysterectomy has to be addressed laparoscopically. Breast : 68

70

Mastectomy Breast conservation surgery Lumpectomy Microdochectomy

1. 2. 3. 4. 5.

Werthiems Hysterectomy Staging Laparotomy (for Ovarian Cancer) Staging Laparotomy(for Endometrial Cancer) Vulval Cancer Inguinal nodal dissection

: : : : :

6 15 4 3 1

: : : : : : : : : : : :

35 10 5 16 20 3 2 3 1 2 1 10

Head & Neck Cancer : 109

1. Thyroid 2. Parotid 3. Composite resection 4. Neck dissection 5. Intra oral excision (lip, cheek, palate) 6. Maxilla 7. Laryngectomy 8. Scalp Lesion 9. Eyelid lesion 10. Orbital resection 11. Soft tissue tumor – Neck 12. DL Scopy Skin & Soft Tissue Tumor :12 Minor cases

Plan for future

1. 2. 3. 4.

Gynaecological Cancer : 29

: 32 : 9 : 26 : 1

1. Biopsy 2. Tracheostomy 3. ICD 4. I & D 5. Feeding Jejunostomy 6. Wound debridement 7. Fractional curettage 8. Secondary suturing 9. SSG 10. Tarsorraphy 11. Venous access device –PORT Total Cases Major cases : 218 New patients :

: 105 : 4 : 7 : 3 : 1 : 4 : 2 : 2 : 2 : 1 : 3

Minor cases : 133 Review patients :

Academic Excellence

Library Details

S. No.

Quantity

Books

TThe library is open

from 9.30 am

to 9.00 p.m on working days and 10-00 a.m to 1-00 p.m. on holidays and sundays. Our library has an

1

Medical Books

2780

2

Management Books

2875

3

Hospital Administration Books

138

4

Miscellaneous Books

425

5

Siddha Books

149

Total

access to the digital library so as to

6367

Magazines

ensure with all relevant information resources that contains books,

1

International

52

journals website and research papers

2

Indian

42

to suit the local conditions.

3

News Letter and Other

71

Audio Cassettes 1

Medical

61

2

Management

84

CD’s

72

895

Meenakshi Mission Hospital College MMHRC, emerging as an internationally renowned centre for education, offers unique job oriented full time courses affiliated to Madurai Kamaraj University, Madurai and Mother Teresa Women's University,

Centre for Education

Kodaikanal for the last 11 years besides a recognized centre for research and training in medical, nursing, paramedical and management from the day of its inception. Most of the ful ltime courses offered at MMHRC are first of its kind in Asia developed with the aim of imparting skill-based training to healthcare professionals of tomorrow's need.

Education Objectives Vision

Developing Healthcare Professionals of Today's Relevance with Insight to Tomorrow's Need Mission

Internationally Renowned Centre for Healthcare Education

73

Courses Offered

Indian Medical Association

Doctoral Studies MMHRC is recognized by Madurai Kamaraj University and MGR Medical University for Ph.D. Programmes.

MMHRC is recognized by Indian Medical Association to conduct the following 2-years fulltime Diploma Courses and admission is open to +2 Science examination passed with 50% marks.

Royal College of Surgeons, Edinburgh The Royal College of Surgeons of Edinburgh, England has bestowed the recognition to MMHRC to train doctors seeking AFRCS Examinations. National Board of Examinations MMHRC is recognized by the National Board of Examinations to conduct Diploma in National Board (D.N.B.) post graduate courses in General Medicine Family Medicine General Surgery Gynaecology Anaesthesia Orthopaedics Radiology Genitourinary Surgery Surgical Gastroenterology Nephrology Cardiology

Diploma in X-ray Imaging Technology (DXIT) Diploma in Operation Theatre Technician (DOTT)

Madurai Kamaraj University MMHRC enjoys Approved Institu tion Status of Madurai Kamaraj University. Following Courses, offered by Madurai Kamaraj University, are open to all graduates interested to pursue a challenging and promising Management Career.

Cardio Throcic Surgery

M.B.A. Hospital Administration

Neurology

PG Diploma in Fundraising Management

Neuro Surgery

PG Diploma in Micro Credit Management

Minimal Access Surgery

PG Diploma in Medical Records Management

Medical Council of India MCI has recogn ized MMHRC for Compulsory Rotatory Residen t Internshi p and Seni or House Sur geon cy for medi cal gradu ates. Mother Teresa Women's University Following 3-years fulltime Bachelor Degree Courses are affiliated to Mother Teresa Women's University, Kodaikanal and admission is limited to females who have passed +2 Science examinations with minimum 50% marks. B.B.A. – Hospital Administration B.Sc. – Applied Microbiology B.Sc. – Applied Biochemistry

74

Diploma in Medical Lab Technology (DMLT)

PG Diploma in Total Quality Management in Hospitals

Also MMHRC is recognized as 'Training Centre' to offer the following one-year PG Diploma courses under Directorate of Distance Education, Madurai Kamaraj University. PG Diploma in Nutrition and Dietetics PG Diploma in Bio Statistics PG Diploma in Hospital Documentation Management PG Diploma in Health Information Management PG Diploma in Hospital Laboratory Technology PG Diploma in Radiography and Imaging Technology PG Diploma in Pharmaceutical Chemistry

Recognitions Recognized as Post Graduate Institution by University of Colombo to train students in Post Graduate Diploma in Family Medicine Recognized by Indian Medical Council to train students in the Diploma, Fellow of College of General Practitioners that will lead to Diploma in Family Medicine. Recognized by several Universities in India and Abroad for Research Projects. Recognized training centre for Physiotherapists

Academic Performance Students achieved 100% result in the University Examinations – April 2007 and 97.4% result in the University Examinations – Nov. 2007. In the academic year ending 2007 totally 78 students were graduated. Fifty percent of our undergraduates have opted for higher studies and almost all other graduates were placed in suitable jobs through campus placement. Course wise Rank Holders are PG Diploma Courses (Year 2006-2007) PG Diploma in Management

- Umesh Dawadi

Recognized by all the leading Nursing Colleges for Internship

UG Courses (Year 2004 – 2007)

Recognized for Management Internship

B.Sc. Lab Technology

- M. Deepa

Recognized training centre to train Health Care Providers (HCPs) by USAID

B.Sc. Applied Microbiology

- P. Priyadharsini

B.B.A. Hospital Administration

- P.S. Gowthame

Recognized training centre to train Nurses to USA

Recognising Parents as Main Stakeholders in Education In the Students' Day 2006 we introduced “Recognizing High Fliers”, of which the highlight is 'the Best Parent of the Year' Award. In this academic year Mrs. S. Muthulakshm i and Mr. K. Suthanthiraprakasam, Parents of S. Prasanna, the 2nd year student of the 3 years fulltime B.B.A. Hospital Administration course, were honoured with the Best Parent Award.

Endowment Fund Based on the Endowment Fund contributed by Dr. N. Sethuraman, Founder Chairman, MMHRC, Silver Medals were awarded to the University Toppers in UG courses initiated by MMHRC at Mother Teresa Women's University, Kodaikanal.

Diploma Courses (Year 2005 – 2007) Diploma in Medical Lab Technology- R. Hemalatha

Staff Composition Besides involving 24 in-house part time and visiting faculties we have increased the fulltime teaching faculty members to 9 thereby ensuring adequate fulltime teachers in the areas of Microbiology, Biochemistry, and Hospital Administration.

2nd Students Sports Meet The 2nd Students Sports Meet was organized on Friday, Sep 14, 2007. Dr. Nirmala, Director, Mother Teresa Women's University, Kodaikanal, declared the Sports Meet open. Among the three Houses, Saffron House won the highest score and also the Overall Championship was won by K. Yogeswari, B.B.A. Hospital Administration II year student, a Member of the Saffron House.

Admission and Students Strength This academic year we admitted 35 students in the UG courses, 76 students in the fulltime PG courses, and 68 students in the dista nt education courses. The total stre ngth in UG courses is 83 students, besides 7 students undergoing DMLT course, and 85 students undergoing fulltime PG courses.

Parents Teachers Meet We facilitated “Parents – Teachers” Meet on Dec 19, 2007 with 75% attendance from Parents side as well as ensuring healthy discussions on the progress of Student’s performance and career growth.

75

Medical Documentation Science Medical Documentation Management Computer Application Informatics in Health

National Science Day We celebrated National Science Day on Feb 28, 2008 in commemorating Legacy of Sir CV Raman, with the basic objective to spread the message of importance of science and its application among the people. Scientific Model Making and Poster Presentation competitions were organized on that auspicious day based on the theme of the year “Understanding Planet Earth”.

Women's Day Women's Day was celebrated on March 14, 2008 to highlight the 'Role and Importance of Women in the Society' among the Students community. A Poster Presentation competition focussing on “Women Empowerment” and Fancy Dress competition on the theme 'Women Achievers' were organised.

Students' Day Competitions Towards Students' Day we organized 20 different competitions for students.

Research and Publications Prof. G. Sharmil, HOD, presented a Research Paper on Biochemical Analysis of Salivary Gland Extracts of Vector Mosquitoes in the National Conference on Me dical Arthropodology, organized by Centre for Medical Entomology, Indian Council of Medical Research, Ministry of Health, Government of India on Sep 01, 2007. Prof. A.K. Sivakuma r, Prof. G. Sharmi l, Mrs. R. Sudha and Mr. M.P. Tolerance Samuel authored the following reading materials, published by the DDE, MK University, for PG Diploma in Hospital Documentation Management and PG Diploma in Health Information Management courses: Human Anatomy, Physiology and Medical Terminology Health Environment

76

Practical Training / Additional Courses / Seminars Students of Management Courses underwent management training in 20 areas of the Hospital in partial fulfilment of the requirement of the course. Students visited different types of health care organizations like private / government hospitals, single / multi-specialty hospitals, nursing homes, clinics, health centres, health projects, diagnostic centres, etc. to get an understanding about the different types of providers in health care. Field visits / training programmes were organized exclusively for Science Course Students thereby they under-went observation training at Centre for Research in Medical Entomology, Agricultural College & Research Institute, Coonoor Pasteur Institute, Food Processing Industry, Dairy Products Manufacturing Units, etc. Students were actively involved in all our community outreach programmes and health care projects. Students had ample opportunities to develop their skills in events management, as they were totally involved in all our continuing medical education / national as well international seminars and other training programmes. Students were encouraged to undergo the short courses offered at the campus in the areas of Medical Transcription, Spoken English, Mushroom Cultivation. Besides, students were encouraged to actively participate in the Seminars, Workshops, Rallies, etc. organized by MMHRC, as well other Educational Ins titut ion s and Healthc are Organi zation s.

Honour / Award to the College “SSTHREE – Federation of Women Activities” honoured our Institution as one of the Best Women Oriented Colleges, on March 23, 2008 towards offering Hospital Management courses.

Developmental Excellence

TThe Marketing department, an initiative of our Chairman Dr. N. Sethuraman who has been successful in accomplishing its mission of propagating to the world that, Meenaskhi Mission hospital & Research Centre was formed for the poor & needy.

Promotional Initiatives After 17 years of extensive service to the underprivileged, the marketing department boasts in contributing to more than 50% of the hospital's total revenue. Rural patients are often deprived of both medical professionals and facilities. Our team of 15 experienced executives take MMHRC to the corners of the state, to ensure our mission of “World Class Care within Everybody's Reach�. This division extends its support to all medical professionals in the state, so that they may utilize our services to ensure that their patients get best treatment. Total No.of CME's for this year is 43. Our team is always on the move in the 15 southern districts of tamilnadu, creating awareness about the medical facilities available to the public. We had been ensuring that all our 8800 referred patients receive first grade medical treatment. To show our appreciation, we honor our referral doctors for their contribution in our path to achieve our mission. Our Continuous Medi cal Edu cat ion (CME) programmes and medical conferences provide a healthy platform, for the medical professionals in the southern districts of Tamilnadu, to enrich themselves with the unbound knowledge in their respective fields.

Corporate Division Most organizations share their principles with MMHRC, by providing the best medical facilities to their employees. Under the Employees State Insurance Corporation Scheme, employees of most reputed corporate companies and public sector units are covered for their medical treatment and made eligible for a cashless treatment. The Exservicemen Contributory Health Scheme also provides the same facility to all its Ex-serviceman. MMHRC has joined hands with about 50 companies and more than 8000 have been benefited this year. Bharath Sanchar Nigam Ltd., Central Electro Chemical Research Institute, and Tuticorin Port Trust contribute to our major corporate business.

78

Insurance & TPA Division Medical Insurance, being the most promising business trend, help to provide cash less medical treatment to the employees of other organizations, who have not been covered under the Employees State Insurance Corporation. GIC, LIC and other Private Life Insurance Companies provide varied comprehensive health coverage packages, under which the employees and their dependents are eligible to receive MMHRC's first grade medical treatment. The third party Administrators (TPAs) have joined the show by tying-up with the private life insurance companies to help them validate the medical bills.

Mediassist TTK Healthcare, Paramount Healthcare Management and DHS are our major TPAs who contribute the most to our Insurance business.

Special Concession Division Honoring the selfless service to the society, MMHRC salutes the teachers, defense and police personnel by providing them with a special discount of 10% on their bills for any medical treatment all through the year. This special concession is also extended to all students and pensioners. This special concession division caters to this part of the society by recognizing them and creating awareness of their eligibility.

Camp Division Camps are an extended arm of MMHRC, through which we provide free consultation, diagnosis and refer patients to the hospital with a 10% special discount. Having successfully organized around 350 camps this year that includes Speciality, Blood, Eye, Cleft Lip & Palate, First Aid and General, we propagate to the mass that MMHRC, is still determined with its mission of reaching every individual with its first class medical treatment.

diverse areas within the premises and across the society. Partnering with with varied media channels, we have made sure that the audience receives 'Healthy' information and we ensure that they are posted on all updates through advertisements and editorials.

Prime Minister / Chief Minister Relief Fund

Across the Borders Marketing Medical Tourism, as the trend setters name it is turning out to be the order of the day. India, known for its pictures que nature and as a low-cost tourist destination, has also attracted patients for their medical treatment. The citizens of developed countries, like US and UK, have been grumbling about their expensive medical insurance packages and have identified Asian Countries like India as destinations for their Medical treatment.

The Government of India and the Government of Tamil Nadu have always made sure that its citizens receive all kind of support with regards to any health problems. We too make sure that we support them. MMHRC is fully committed to support any Government related Health Programme through.

Prime Minister's relief fund for renal transplantation, cancer and heart ailments. Chief Minister's relief fund for renal transplantation, cancer and heart ailments. National Blindness Control Programme. Tamilnadu Health fund scheme for all major diseases and surgeries to pensioners.

MMHRC has bee n su pporting these medical tourists with its state-of-the-art medical facilities ensuring that they return back home in good health and after a pleasant stay in India. We have been supporting the citizens of Sri Lanka, and Maldives. MMHRC, with full consciousness, has plans of extending its services, through Information Centres, to the Citizens of ot her count ries like Oman, Dubai , Singapore and Malaysia. The facilities of MMHRC have also been extended to the down-trodden people of North-eastern states. We are planning for an information Centre in West Bengal through which we could cater to the medica l require ments of the North eastern states.

Master Health Check Up Our 'Master Health Check Up' packages are the most comprehensive and the most affordable ones. Our customized MHC packages cover all divisions of our society to suit all individual medical needs. These packages include assessment and expert consultation with a complimentary meal and a comprehensive medical summary.

Media Relations The Media Relati ons divisio n helps disseminate valuable information on the exceptional efforts made by MMHRC in

79

Quality hub in MMHRC… At MMHRC our reputation is built in our ability to provide the service of what the customer wants or needs resulting in excellent medical treatment, which they can rely on, and the personal care, which they will appreciate. Our Customers can be confident that their rights will be recognized and respected by all the staff involved in their care. We the staff of Quality Service Department are the “Consumer Advocates” whose primary mission is to meet and exceed our customer needs and expectations. The responsibility is to foster positive customer service and strives to continuously improve our level of customer service. We are working to develop and test measures of quality, identify the best ways to collect, compare and communicate data on quality and widely disseminate informations about effective strategies to improve the quality of care. Several departments have enacted changes and have improved customer and employee satisfaction through implementation of quality improvement initiatives. We are also challenging some traditional practices, seeking innovative ways of doing things.

Patient Satisfaction pays

Complaints / Suggestions

We realize that when people enter our hospital they have certain expectations and they judge their experience on the service they receive while they are here. We strive constantly to meet and exceed those expectations. Quality Services team analyses customer feedback data in order to understand how effectively care is being delivered. The department collects more than 80% of the feed back forms from the In-patients. Out patients and from the Master Health check up customers. The understanding of overall quality of care and services will create process improvement initiatives that seek to raise the standard of care and service at higher level. Quality Service Department analyzes and interprets customer satisfaction and amicably solves the customer complaints. Immediate actions are taken to rectify the complaints and also an abstract is being sent to all the concerned departments for taking preventive and corrective action. A follow up thanks letter is being sent to all the customers who had created an opportunity to correct and improve ourselves. Minimization of customer complaints and speedy remedial actions are the quality parameters set for this department.

1 2

Appreciation Suggestion

Apr.07 - Mar.08 Avg % 6 8

3

Complaints

2

Sl.No

80

Description

Sl.No 1 2 3 4 5 6 7 8 9 10 11 12 13

Category / Department Facility Cost Canteen Pharmacy Nursing HK & Maintenance Doctors QSD HPD Front office Marketing Security Others

Complaints (Nos.) 12 7 58 47 24 47 8 4 7 9 0 16 2

Suggestions (Nos.) 405 137 89 66 55 45 31 29 16 13 12 8 94

Category wise Complaints & Suggestions (in Nos.) March 2007 – April 2008 Category Advertisement Behaviour Cost Delay Facilities Information Others Service

Quality Service Department

Complaints Suggestions 34 20 78 17 16 33 64

16 40 146 67 454 101 92 142

Thank you Wall

improvement. Kaizen is a system that involves every employee – from top management to the cleaning crew. Quality service department takes all initiatives to organize the 'Kaizen day' once in four months. This year we have conducted twokaizen days. The main reason for the kaizen is to focus the quality failures through well-enacted role-plays, which is a powerful tool to change the attitude. Employees are encouraged to discuss the causes for failures in detail and to prevent such happenings in future. Various awards are given like Extra mile, Best Employee and Spark Master Award. Awards

The appreciation given by the patients are posted in a Wall named “Thank you Wall” which motivates our Meenakshi missionians. They feel extremely happy when their good work is expressed with a token of thanks and photographs.

No. of Staff

Extra mile Awards

3

Spark "Masters"

5

Lost and Found things

42

Listening to our employees Spark Suggestion Scheme Empowered employees who actively submit improvement suggestions, gives organization a competitive advantage. Suggestion scheme is one of the powerful participatory tools, which earns great recognition. The main purpose of this scheme is to motivate & encourage the internal customer's to give suggestions for the further improvement of the hospital. 'SPARK' scheme is made successful by regular meetings and timely feed back to the staff. Employees and the departments who have contributed the maximum number of suggestions are honored on Kaizen day as “Spark Masters”.

Quality circles

Kaizen Day …. A sys tem of cont inuo us impr ovem ent in quality, technology, processes, culture, pr odu ctivi ty, safet y and leader shi p. The word Kaizen means “continuous improvement”. It comes from the Japanese words “Kai” means change and “Zen” means better /

Quality Circle is a small group of people from the same work area coming together voluntarily to identify work-area problems, analyze them and find solutions. The circle presents the solutions to Management and implements them after approval. Quality service Department acts as a facilitator in bringing quality through “quality circles”. We have 25 quality circles from various departments of the hospital to make an in-depth and systematic study of the problem identified by the staff. The “ROSE” and “GEM “quality circle participated in the 17th

81

Chapter Convention at Madurai in Septem ber 2007 and also particip ated in the 21st National Convention on Quality Circles at Kolka ta in December 2007 and receive d awards. S.No.

1

Convention

Awards

th 17 chapter convention, Madurai

Excellent Award for ‘ ROSE QC & GEM QC’

§ QCFI – Canara Bank Award – 2007 for Service Sector Organization 2

st 21 National Convention, Kolkata

§ Excellent Award for ‘ROSE QC’ § Distinguished Award for ‘GEM QC’ § Poster consolation prize

Meenakshi Mission Hospital and Research Centre Madurai

Studies conducted for the year 2007-2008 As analytical studies and its results facilitate in Decision making, Quality service Department engages itself in taking up timely relevant studies in various areas and to list a few. Ward Secretaries work load analysis Mess Satisfaction Survey Department wise deficiency case sheet analysis District wise – Corporate & Insurance patients Analysis District wise patients analysis Implementation of separate program for reimbursement procedure Out patient – In patient conversion study Pharmacy waiting time analysis Survey on Doctor's satisfaction with lab services Survey on Referral Doctors Satisfaction with our Services

82

Resource and Development

Introduction

We value the partnership with all those people with a spirit of generosity and commitment who understand that, without this help, MMHRC could not support the continued upgrading in our facilities and technology. Each group has a contribution to make; each group and individual is greatly valued.

Coming together is a beginning… Keeping together is progress… Working together is success…

MMHRC relies on the generosity of the community in order to maintain its high standards.

T he Department of Resource and Development T

There are many ways to demonstrat e our activities….

is responsible for all internal and external fundraising for and by the Hospital.

Projec t Management and execution Resource Mobilizati on

The hospital relies on the generosity of patients (past and present), individual donors, community groups and corporate supporters to supplement government funding in order to ensure that vital capital improvements will

Publication of Annual Reports Networking and Event Management Consultancy serv ices Datab ase Management Documentati on and Record Keeping.

benefit patient care and ultimately save lives.

83

Direct Relief International - USA Since 2004, DRI has been providing medical material aid including medicines, medical supplies and equipments to help the poor victimized persons. In collaboration with District Health Society we have distributed free medicines to district collectorates, charity hospitals, government institutions and NGOs to treat the poor persons. In this reporting year, DRI has donated medicines and goods worth of Rs. 22,33,67,640 to MMHRC. In addition to their services, DRI has donated Mobile CT Ambulance to provide diagnostic services to the people in need and also for the successful management of telemedicine project with the goal of providing accessibility of medical practitioners to the remote places through state of the art technologies with optimal economical outcomes with the vision of health for all.

The Smile Train Education programme To build the blocks of the sufferers with cleft lip/ palate, the Smile Train USA has come with the education programme by giving them a chance to step forward and catch up their lives. With this unique feature, the entire children undergone first primary cleft lip or palate repair would obtain this education grant. At our centre, we provide Travelling Allowance (TA) for the patients and school bags to children. We have distributed 494 bags and 214 persons have received the TA.

Vitamin Angels alliance- USA

The Smile Train Regional Centre Our hospital is one of the regional cleft lip/palate centres in southern India. The centre has been doing meticulous services for the persons living with cleft lip/ palate with quality surgical intervention, free medicines, free accommodation, free food, free speech therapy, etc. The centre is equipped with modern technologies-exclusive operation theatre, centralized 20 bed ward, nursing station, unique speech therapy room, video conferencing room, infotech centre, class room, research wing, library etc. With the support of government officials, collectorates, media persons we were able to mobilize persons. So far, the centre has put back the smiles for 3900 persons with cleft lip/palate. We are planning to extend our service activities to other states also.

84

With the mission of eradicating Vitamin A deficiency among children by 2020, the Vitamin Angels Alliance has tied up with our hospital to supply multivitamin supplements to rural children in Madurai district. This mission has started in the year 2004 and 1.1 million children have been cover ed. Mr. How ar d Schi ffer , President of Vitamin Angels along with his team members distributed vitamin A tablets to children of panchayat union schools in Tirumohur and Karuppayoorani of Madurai District.

Magen David Adom (MDA), UK A volunteer's outstanding organ ization and supporting organization of Brit Olam Israel has been associated with us during the tsunami break up. They came out with the mission of helping us with volunteers, medical supports. 1,55,15,820 Medicodine Tablets worth have been provided this year.

awareness. Mr. Jawahar, Madurai collector inaugurated the programme. Our hospital received a meticulous award for its excellent services rendered. So far 1114 patients availed the services.

Community Care Centre As a Pioneer health care institution, our hospital organized a Community Care Centre by name “Mother Teresa Special Ward for PLWHAs� in

the year 1997. The centre is

provided with 10 beds with qualified medical officer and supportive staff to enhance comprehensive care and

Integrated Counselling and Testing Centre (ICTC) With the support of Tamilnadu State AIDS Control Society (TNSACS), our hospital provides voluntary counselling, free testing for high-risk

support services for the PLWHAs. In addition to the regular

groups, and partners of PLWHAs, antenatal

treatment to prolong the life of the PLWHAs, other

mothers, and general public to find out the

supportive services like counselling, health education,

infectious status and Prevention of Parent to

library, referral services for ART centre, free CD4 count test

Child Transmission (PPTCT) of HIV. The unique

etc are provided. The health workers make field visit and

feature of the centre is to provide counselling

meet the PLWHAs at their homes and integrate with the

and testing in a confidential environment. PPTCT

community. This year 1223 Outpatients, 385 Inpatients

programme emphasize on nutrition, breast-

and 395 new cases have been treated at our centre.

feeding, family planning, couple counselling,

Regularly we observe World AIDS day every 1st of

antenatal care and menstrual history. This year

December.

3418 persons were counselled and 3377 tested.

Microscopic Centre-Revised National Tuberculosis Control Programme (RNTCP) Our hospital is one of the microscopic centres and DOTS providers supported by the District TB SocietyMadurai. Under RNTCP, the TB patients are provided with free sputum test, free drugs, free counselling. This year we organized TB rally in collaboration with TB centre. More than 100 students participated propagating about TB

85

Gnanambal Palliative Care Centre It is the framework for all of the services provided by Care Center. We focus on enhancing quality of life for the patients and family. It's about living every step of the way. The goals of palliative care centre is: To establish an active support system to help individuals and their family through treatment and recovery. To treat pain and other distressing symptoms. To provide psychological and spiritual support. To promote relief from suffering. To enhance ability to function. 515 persons have availed these services for the year 2007-2008.

Children Living with HIV/AIDS (CLWHAs) - Catholic Relief Services Clinton Foundation Our hospital takes care of the children suffering with HIV/AIDS by providing treatment, nutritional support, care and support. Under this programme, 95 persons were benefited so far.

1. That every individual has the right to attain his or her full potential as a human being and to achieve personal fulfillment; 2. That the family unit as a social system has the greatest potential to contribute to the health and security of that unit, and to support each member in achieving personal fulfillment; 3. That every individual and every family has the right to service regardless of their system of beliefs and values; 4. That every client and client group has the right to excell in counselling services; 5. In the value, integrity, confidentiality and the right to privacy of the individual and family; 6. That collaboration with other community organizations is vital. 7. Work out to prevent family breaking up and promoting harmony So far 647 persons have availed the services this year.

Camilla Cancer Fund A unique programme to support the poor little children with cancer by providing comprehensive health care and psychological support needs to create a hale and healthy environment. Our services offer financial, educational, emotional and practical help needed to ease the burden of childhood cancer. The fund provides financial assistance to families whose finances have been stressed due to their child's treatment. So far more than 20 children have availed the services and currently 22 donors are supporting this programme.

Habitat for Humanity India Family Counselling Centre With the missio n to help stren gthen individ uals and their relati onships with others, FCC believes, 1. That every individual has the right to attain his or her full potential as a human being and to achieve personal fulfillment;

86

Our hospital has provided with 100 houses for the staff of the hospital under “ Millard Linda Habitat” at Kathapatti. The programme is successfully launched under “ India Builds “ programme of Habitat. In this programme, 100 new houses and 200 repairs and renovation is in progress. To say proudly, 1000 new houses were also launched with the mission of building lives… building hopes.

Consortium of Service Organizations of Tamilnadu (CONSORT) Our hospital networks with grass root level NGOs by name Consortium of Service Organizations in Tamil Nadu. This federation of 365 NGOs cooperates in organizing and conducting health camps and other socio-medical program. This year many NGOs from differen t states acti vely participated in the “ Cost Effective Fundraising Techniques” conference conducted by our hospital.

Creche It aims to ensure that child's day is filled with experiences that will encourage all aspects of their learning. All our programmes are designed with the children's age groups in mind; and we will work to develop a programme tailored for them Each child is different and we understand that every child has different routines. The main activities include… Individual attention is given to each child Our programmes are designed to ensure a u wide range of activities, including free play and rest Each programme is carefully designed to suit u the ability of the individual age group Daily diaries are completed to tell you about u your child's day u

36 children enrolled so far.

Save the Little hearts Since 2004, our hospital has been successfully providing free cardiac surgeries for the poor little children with heart disea se. With eminent personalities in the committee from various disciplines, the program is managed successfully. 7o children have benefited so far. Regular documentation and follow-ups for each and every child is carried out.

CONSORT aims towards… 1) Functioning as a research centre by conduction Training Programmes for the development of staff of service organizations. 2) Assisting Service Organization in Project Formulation, Implementation, Monitoring and Evaluation etc. 3) Acting as networking agency of grass root level NGOs.

Tamilnadu Network of NGOs Working on HIV/AIDS This network was facilitated during the 7th Nati onal Convention of Indian Network of NGO s wo rking on HI V/ AI DS . TNN (The Tam ilnadu Network of NGOs working on HIV/AIDS) forum is an outcome of INN, which helps in the sprea d of HIV/AIDS with the membership of more than 250 grass roo t level NGOs. Regular zonal level meetings would be conducted with its members about HIV/AIDS.

Free Meals Scheme Since 1991, our hospital is providing free food to poor and cancer patients and their family members. This unique charity was first initiated by our hospital staff to treat them with with care and compassion. This noble cause is supported by the generosity of donors. Daily about 100 inpatients are distributed three times free nutritious meals.

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Cost Effective Fundraising In our constant endeavor to spread the fundraising knowledge, our hospital reg ularl y conducts conferences on fundraising with the support of expert fundraising consultants from India and Abroad. This year, we conducted a conference “ Cost Effective Fundraising Techniques” in effort to motivate smaller NGOs to take up fundraising and

Events / Conferences / Trainings conducted by MMHRC…

for medium and big organizations an opportunity to add value by cutting upon the expenses. This brought all the NGOs with an opportunity to l

Smile Train 3333

earn and take steps to boost fundraising efforts.

A remarkable achievement by our hospital towards

Eminent consultants like Richard D. Pordes,

completing 3333 surgeries. It was a memorable day

CFRE-Director, LLC, ex. International Director,

in the annals of MMHRC when Mr. David

UNICEF, George F. Taylor, Member of Executive

T. Hopper, the Consul General, American Consulate

Comm ittee, Winterline Foundation, US A,

in presence of Mrs. Hannah Fuchs and Mr. Sathish

Surat Sandhu, Chairman, SAFRG shared their

Kalra, Regional Director of The Smile Train USA

experiences and made the conference a grand

formally inaugurated the Smile Train Regional

success. Around 150 members participated and

th

Centre on 24 January 2007. We are proud to complete 3333

surgeries successfully by our able

team and with the support of Smile Train USA and thus brought a revolution in the medical history. We thank the smile train partnership with us in bringing confidence in minds of each and every person. Our hospital is indebted to all the PO-ICDS, CEOs, DDROs, Distric t Collectorates, Local, National and International Donors, Well wishers, banks. Volunteers, NGOs, Media Persons, Government officials for actively helping us to achieve our mission. Still now the programme is successfully going on well with the vision of bringing “Cleft Free Society”.

88

gained experiences from it.

Conferences attended by our R & D staff… 1. Microbicides Conference 2008 conducted by ICMR, New Delhi from 24th to 27th February 2008. - Ms. C. Yalini Sheeba, Manager- R & D and Mrs. S. Dhilshad, Counsellor, ICTC.

Volunteers Services Our hospital regularly receives volunteers from India as well as abroad. These volunteers support our hospital services by serving the poor and ill persons. Our hospital is proud to receive many volunteers especially during the time of tsunami many volunteer organizations like Brit Olam Israel, Magen David Adom in Israel, GV team from Habitat for Humanity, volunteer students from American College, actively participated in our programme and still they support our program mes. We are happy for rece iving Ms. Jennifer from USA, who served with us in the hospital services and actively participated in the women empowerment programmes.

The Highlights… Face to face

: Rs.

6,65,240

Pay roll giving

: Rs.

6,00,538

Donation Box

: Rs.

9,57,384

Direct mail

: Rs.

9,42,559

Online fundraising : Rs.

60,000

School fundraising : Rs.

63,164

Other donations

: Rs. 12,62,712

Total

: Rs. 45,51,597

The Smile Train Medical Exchange Programme Our hospital has been intimated by the Smile Trai n USA that more than 500 surgeo ns, nurses and other medical professionals have volunteered for the Smile Train USA over the past year alone. Our hospital being a partner with

Exchange Programme” with us. To say about

Stay and Study abroad programme

our Regional Centre, the Smile Train USA has

Our hospital collaborates with The University of

Smile Train USA, has ext end ed “Medi cal

recognized our hospital as the leading health care provider and best centres in cleft lip/palate management. This new approach was

Iowa which is the major national research university located on a 1,900-acre campus in Iowa City in southeast Iowa, on the Iowa River near the intersection of U.S. Interstate Highways

launched in the month of October 2007 and now

80 and 380. Iowa is composed of 11 colleges,

we are receiving medical experts from different

the largest of which is the college of Liberal Arts

expert ise. Very recently, our hospi tal has

and Sc ien ces , en rol ling mos t of Iow a's

been registered with more than 40 medical

undergraduates. Through Stay and Study

volunteers from various different departments.

Programme we received 5 volunteers,

This programm e is an ongoing me dical

Ms. Eri n Today, Ms. Alexa ndra Keen an,

programme and now we have received three sur geons from pl as tic sur ger y and dent al surgery.

Ms. Brianne Fischer, Ms. Amanda Irish and Mr. Coodie from University of IOWA under the leadership of Prof. R. Rajagopal. These volunteers donated medical books to us.

89

Honour Roll List of Contributors 2007 - 2008 From Abroad Mrs. Rahmath Ziauddin, USA Mr.Brad-Butcher, USA Dr.Nat Annamalai, USA Mrs. Rohini Palaniyappan, Singapore Mr.Om, USA Ms. Poonam, USA Mr. Prasanth, USA Mr. Rajesh Chauhan, USA Ms. Bharesh Chauhan, USA Ms. Meenakshi Chaulan, USA Mr. Jaikishan, Birmigham Mr. Kiranlal Chauhan, UK Ms. Vibha Chauhan, USA Mrs.Prathab Bhuvana, USA Mr.Wolfgang Deepen, Germany Ms.Linda Gilchrist, USA Mr.Swaresh Narine, Canada Mrs. Padmini Saravanabhavan, USA Ms. S. Bhavya, Canada University of IOWA, USA Pappa fund, USA Mrs. M. Indira, United Arab Emirates K.B.Chandran, IOWA Mr.V. Venkatraman, Singapore Mr. A. Sivakumar, Colombo Mr. Ganeshram, Srilanka

From Inland Dr. N.Sethuraman, Founder Chairman, MMHRC, Madurai Mr. M. Selvaraj, Madurai Mrs. D. Jothi Bai, Kanchipuram Mr.S. Maniyan, Madathukkulam Mrs. S.Muthusamy, Karaikudi Er.R.Kannan, Madurai Ms. M.S.D.R. Sasi Sumathi, Madurai Lion.R.Kanan, Chennai Dr.Meikandan, MMHRC, Madurai Mr.K. Muthu, Madurai Mrs. C.Kamini Gurushankar, MMHRC, Chennai Mr. Murali Krishna, Bangalooru

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Mr. P.Thevaraji, Madurai Mr.C.N. Maheswaran, Chennai Dr.C.G. Natarajan, Salem Dr.S. Ramesh Babu, MMHRC, Madurai Dr.M. Ganesh pandian, Madurai Mrs. Packeeral beevi, Tirunelveli Mr. Shajahan, Madurai Mr.Y.Subramaniam, Thana Mr.M. Mariappan, Madurai The Chairman, Tuticorin Port Trust, Tuticorin Mr.S. Manokaran, Chennai Mr. P. Velusamy, Madurai Dr.Rajiv Chelladurai, Madurai Dr.S.K. Packiaraj, Madurai Dr.P. Adham Sheik Ali, Kallakadu Mr.S. Deiva Swamy, Nagarkoil Mr.S.P. Siva Shanmugam, Madurai Dr. Deivanai, Paramakudi The Classic Printers, Madurai Mr.M.D.Venkatesan, Madurai Mr.S.Radhakrishnan, Trichy Mr.M.K.C.Maharaja Poomalai, E.Malampatti Mr.K.Sadasiva Rao & Kalpana Bai, Madurai Dr.G.Vijaya, MMHRC, Madurai MJF. Lion. Nagarajan, Chennai Dr.Selvaseetharaman, Tuticorin Mr.Venkatesan Sundaram, (Montego Bay), Jamaica Mr.K.P.Haran and Family, Chennai Mr.T.Kanagasabai Chettiyar, Madurai Mr.RM.Sundaram, Madurai Dr.D.Suresh Kumar, Madurai Mr. R.Ashok Kumar, Madurai Mr. Govindram D.Rawal, Madurai Mr.P.Saravanan, Othakadai Ms. Bhagavathidevi, Chennai Mr. Vikramdutt, New Delhi Mr. Philips M.Subramanian, Chennai Mrs. R.Gnanasoundary, Virudhunagar Mr. AN.AR.ST.Subramaniam Chettiar, Karaikudi

Dr. V.Lakshmi, Tirunelveli APAC & Resource Development, MMHRC, Madurai Mr. K.Baskaran, Paramakudi Dist. DMK Secretary, Madurai Mr. K.Rajendra Prabhu, Madurai Mr.R.MarimuthuJeyalakshmi, Cholavandan Mr. D.Soundrarajan, Chennai Mr.J.K. Ponnaiah, Usilampatti Dr. P.Thirumalai, Chennai Mr. R.Kanagavel, Virudhunagar Mr. T.R.Rangaswami, Madurai Mr.S.P.Rathinam,Teacher, Karungalakudi Mr. N.R.Alagaraja, Theni Dr.P. Rathinasamy, Aruppukkottai Mr. V.Thanasekaran (Sekar), Chennai Mr.M. Ramachandran Chettiyar, Madurai Mr.P.K. Sivaramaganesh, Aruppukkottai Mr.P.Chandira Sekaran, Aruppukkottai Mr.P.T.Mahalingam, Aruppukkottai Mrs.K.S.T.K.Thangavel Rani, Madurai Dr.A.R.Raghuram, MMHRC, Madurai. Mr.K.Sundaresan Sudha, Madurai Lt. Col.A.Sasikala, Krishnagiri Dr.Cebi Issac, MMHRC, Madurai Mr.K.S.S. Mani, Chennai Mr.P.S.A.Srinivasan, Punaloor Mr.A. Maharajan, Batlagundu Ms.Madhangi Enterprises, Madurai Mr. V.Balaji,(Jaisankar), Sankarankovil Mr.S. HirudayaRaj(Ex.Navy), Thanjavur Mr.KumaraVengatesan, Tanjore Mr.K.E.SermaDurai, Othakadai Mr.V.L.Ravi, Uthamapalayam Mr.K.Siluvai, Tuticorin Mr.Hukkam Singh Dhakiya, Madurai Mr.N.Madhava das, Madurai Mr.G.Krishnamoorthy, Sivakasi Mr.C.Ravishankar, Madurai Mr.K.Damotharan, Madurai Dr.Venugopal Konanki, MMHRC, Madurai Mr.K.Venu gopal, Madurai Ms.Krishnaveniammal, Salem Mr.B. Joseph Jeromias ( Pulse Trust), Rameswaram Mr.K.P.K. Paramaguru Ayyanan Ambalam Veerathai, Madurai

Mr.P. Kumarasamy & mrs. K.Kaliammal, Namakkal Mr.V.Mathuram, Usilampatti Mr.V.R. R.Ramalingam, Madurai Mr.T.V. Padmanaban, Chennai Mr.S. Ravichandran & Mrs. R.Karthika, Coimbatore Mr.M. Chandra Sekaran, Chennai Mr. Dhansukh Chauhan, Putaparthi Ms. Muthuselvi, Tuticorin Mr. B. Sriram, Chennai Mr. R. Boopathy, Chennai Smt.Price Rose Packia Raj, Kovilpatti Mr. Thirugnana Thevar Amirtham, Servaviduthi Mr. Kunal Verma, Madurai Mrs. Maragatham, Aruppukkottai Mrs. Methonishta, Madurai Dr. Marina Packiaraj, Madurai Dr.G. Pandiarajan, Madurai Mrs. L.Fathima, Dindigul Dr.M. Srinivasan, Madurai Mr.A. Johnbhai, Rameswaram Mr.M. Balasubramanian, Chennai Mrs. D.R. India, Madurai Dr.Ramesh Ardhanari, MMHRC, Madurai Mr.V.Baskaran, Madurai Mr.V.M.Sundaram, Madurai Mr. V.V.D.Nithyanandham, Tuticorin Mr. N.Chandran, Madurai Mrs. C.V.KalaimaniVeerapathiran, Madurai Ms. S.Jeyalakshmi, Madurai Dr. S.Muthukrishnan, Madurai Mr. G.John Devadasan, Tirunelveli Mr. J. Bhurmal Raj Prohit, Madurai Mr P. Thirunavukkarasu Chettiyar, Madurai Ms. K. Chittu Achi, Madurai Rtn. Krishna Kundu, Andhaman Ln.N. Karthikeyan Mjf, Andaman Mr. V. Thiagarajan, Andhaman. Mrs.Padmini Balagopal, Gandhigram Mr.K.S. Muthusingappa Raja, Rajapalayam Ms.T.V. Saraswathy, Trichy Mr. E. Singamma Reddy, Vadipatti Mr. A. Arumugam Palani, Chatrapatti Mr. P.R..Palanisamy, (PRP) Madurai

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Dr.V.Ravindranath, Madurai Mr.P. Patani Raman, Madurai Mr.P. Govindasami, Chennai Dr.Poungrace, Virudhunagar Mr.S. Abdul Maricar, Karaikal Mr. S. Saikumar, Chennai Mr. P.S.Abdul kadar, Madurai Mr. Rajamani Muthusamy, Aruppukkottai Mrs.ShanmugavalliKathiresan, Madurai V.S.P.Karmegamani, Madurai Madurai Vaigai Club, Madurai Mr.R.V.Duraisamy Chellammal, Madurai Mr.P.Vaideeswaran, Tirunelveli Mr.D. Boopathy Rao, Kanchipuram Ms. N.Chinammal, Varapur Mr.S.JeyaRaman, Madurai Mr.S.Ragunathan (Trustee), Madurai Mr.G.K.Vasan MP, Chennai Mr.K.P.Karthikeyan, Madurai Mr.Veera Maruthu Pandian, Paramakudi Mr.S.Srinivasan, Gandhigram Mr.K.P.Perumal(Ex.Navy, Ramnad Madukkur Thoheed Charitable Trust, Tanjore Dr.R.Ravichandran, MMHRC, Madurai Dr.R.Sivakumar, MMHRC, Madurai Dr.S.Selvamani, MMHRC, Madurai Mr. P. Murali Dharan , Chennai Rev. Fr. Hermena Gild, Tuticorin Mr. R. Ganesh, Kerala Marakatha Sundaram.S., Madurai Mr. G. Mayilanandham, Madurai Mr. N.A. Habeeb Thaj, Madurai Mr. P. Saravanan, Namakkal Mrs. Kala Karmegam, Madurai Mr. Vikranath Karmegam, Madurai MR. Karthikeyan karmegam, Madurai Solamalai Automobiles P.Ltd, Madurai Mr.K.R. Mayilswami, Madurai Mr.S. Baraneetharan, Namakkal Mrs. Mala Murugan, Theni Mr.L. Ramaseema, Madurai Ms.S.Chitra Devi, Bangalore Mr.W.Peter Ramesh Kumar, Madurai

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Mr.S.Vellai samy, Dindigul Mr. S.Subbarayalu, Nagercoil Er. R. Manavalan, Chennai Mr. V.V.P.M Sevaraj, Madurai Mr.R.Mohandass, Madurai Dr.K.Selva Muthu Kumaran, MMHRC, Madurai Mr.Senthil Kumar, Powerica Ltd, Madurai Mr.Mariappa Murali, Madurai Mr.M.Anbukani, Madurai Mr. K. Dhanraj, Madurai Mr. M.S.Karthikeya Balaji, Tiruppur Dr. S.Balasubramanian, MMHRC, Madurai Mr.C.Saravana Kumar, Namakkal Mr.Ramanadhaesan, Kanchipuram Dr. Agnela Therasa Josephine, Ramnad, Dr. N. Karunakaran, MMHRC, Madurai Dr. R.Ganesh, MMHRC, Madurai Mr.N.Sukumar, N.-Chennai Mr.Vaithiappan & Mr.Muthukrishnan, Rajapalayam Mr.A.S.P. Mahalinga Nadar Agency, Chennai Mr.S.G. Sivanesan, Palani Mr. K.V.K.Baskara Sethupathy, Madurai Mr. J.L. Packiaraj, Kovilpatti Mr.N.P.M.Nagarathinam, Dindigul Mrs.Prema Sethuraman, Trichy M/S.Karthijai Movies Pvt.Ltd, Tirupur Mr.K.Nagabhushana Urala, Bangalore R.Mahadevan, Theni Mr.KPN. Mayan, Kodaikanal Mr.Vijaya Kumar Pragash, Dindigul Mr.S.Deepakumar Subbian, Virudhunagar Mrs.Gokuleshwaran Nandhini, Chennai Mrs.Santhi Venugopal, Coimbatore Mr.R.V.Manoharan, Madurai Mr.K.Natarajan, Namakkal Mr.M. Babu, Madurai Mr.O.B Dwarakanath, Chennai Mr.P.Gopinath, Madurai Mr.Thirunach, Bangalooru Mr.A Alagappan, Madurai Mr.S.V.Natarajan, Madurai Ms.B.Subbulakmi, Salem R.M.Subramaniam, Coimbatore Padma Padmanatha, Bangalooru

Honour Roll List of “CAMILA’’ Children Cancer Fund” Contributors Dr. Jayabose, USA

Smt. Valli Annamalai, Indian Council for Child Welfare , Madurai

Children Cancer Fund New York, USA

Oxford Matriculation Hr.Sec.School students, Sivagangai

Mr. Ashan D'souza, Madurai Mr. & Mrs. Dhanuskh Chauhan, Puttaparthi

Ms. T.V.Saraswathy, Trichy Gold Quest International, Chennai

SRI Saravana Traders, Tuticorin Dr. S.K. Packiaraj, Madurai

Mr. G. Sakthi Saravanan, Madurai

Mr. S. Krishnasamy, Thirunagar, Madurai

Mr. Venkatesan Sundaram, Jamaica, South Africa

Visvas Promoters (P) Ltd, Madurai

Mr.T. Amirtham, Anantha Metal Company, Madurai

Mr. D.R. Kodeeswaran, Tuticorin

Mr. K. Siluvai, Tuticorin

Mr.D.Boopathy Rao-Kanchipuram Mr.Shenbapa Kutty, Sivakasi

Mr. D.R. Kodeeswaran, Tuticorin

Mr.K.R.Suresh Kumar, Trichy

Mr. & Mrs. Dhanuskh Chauhan, Puttaparthi

Ms.M.S.T.V.Saraswathi, Trichy

Corporate & Individual Donors, Tamilnadu

Mr.M.A Rajeev, Madurai

Shri.M. Ramanathan, Puduvayal

Mrs.Nalini, Chennai

Shri. P. Arunachalam , Puduvayal

Mr.V.T.R.T Baskaran, Dindigul Dr. P.Adham Sheik Ali, Kalakad

Mr. Sambasivan Senthil Kumar (Student)

Mr.Michael A Bookman MD,

Mr. Sahara Constructions, Bangalooru

Fox Chase Cancer Center, Philadelphia,USA Mr.M.S.P.M. Chandran Sons, Madurai

Mr. Boopathy Rao, Kanchipuram Mr. R.D. Bhaskaran, Hyderabad-81

Mr. Harris Jayaraj, Chennai

Dr.S.K.Packiaraj, Madurai Free Meals Total Plates-1,31,178

Mr.A.Thiyagaraja, Pondicherry Mr.S. Regunathan Trustee, MMHRC, Madurai

Honour Roll List of SAVE THE LITTLE HEARTS Contributors Prime Minster's National Relief Fund, New Delhi

Mr.Prasadarao Meka-Houston-Texas, USA

Sun Foundation, Chennai

Honour Roll List of EYE CARE Contributors

Om Sakthi Narayani Siddar Peedam Charitable Trust,

Mrs. Naseera Banu, Madurai

Chief Minister's Public Relief Fund, Chennai

Sripuram Mr. Raja Charity Trust, Rajapalayam

Mr. Boopathy Rao, Kanchipuram V.R.R.Ramalingam-Madurai

Ms. Lean Jeah Cohen, University of IOWA, USA M/S. Madras Cements Ltd, Virudhunagar Dinamalar Tamil Daily Dr.G. Vasudevan, Rotary Club of Madurai West M/s. Villa Shipping Co& Trading, Maldives

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Financial Performance

94

Financial Performance

95

Leader in

Health Information rg emmhrc.o www.smil Website :

2007 - 2008

Performance Highlights

Customer Satisfaction Index 2006 - 2007

88%

2007 - 2008

88%

Customer Complaints 2006 - 2007 2007 - 2008

3% 2%

Live Birth Rate Success Rate Total Birth

100% 432

Success in Treating Accident Victims

96

Total MLC

2132

Success Rate

97%

DETAILS OF CHARITABLE FUND RECEIVED FOR THE YEAR 2007-2008

96

97

How You Can

Help? Donate liberally and help the hospital to equip itself better to pursue its mission of service to humanity under any one of the projects of the hospital. Further, donations could be made as follows : Naming of a block in the donor's name - Rs. 20 lakhs: wing in the donor's name - Rs. 10 lakhs; and a room in the donor's name - Rs. 1 lakh. Paying for specific equipment / facilities (list available on request) Apart from these, donations of any value in cash or kind and Volunteer Services are welcome. All cheques / drafts should be drawn in favour of “S.R. Trust� All donations are exempted under 80 G of Income Tax Act.

(Run by S. R . Trust) Lake Area, Melur Road, Madurai - 625 107 INDIA Phone : 0452-2588741 (10 Lines) 0452-4263000 Fax : 0452-2586353 E-mail : mmhrc@sancharnet.in Web : www.meenakshimission.org

classic madurai phone 2323819

MEENAKSHI MISSION HOSPITAL AND RESEARCH CENTRE


Meenakshi Mission Hospital Annual Report 2008