WELCOME CENTRAL LEPROSY TEACHING AND RESEARCH INSTITUTE, TIRUMANI,CHENGALPATTU 1 HISTORY 1924 Lady Wellington Leprosy Sanatorium at Tirumani 1924 to 1939 Managed by Church of Scotland. Dr. Paul Brand devoted his life for the reconstructive Surgery 1946 Before Independence, Mahatma Gandhi Father of our Nation visited the land of Tirumani. He gave written message of blessing to the patients of the Sanatorium and wished well to the staff. SIGNATURE AND GREETINGS OF MAHATMA GANDHIJI Significance of 30th January on 30.01.1946 – Father of the Nation visited CLTRI Coincidentally, he died on 30.01.1948. 30th January every year celebrated as Anti Leprosy Day. HISTORY 05-01-1955 CLTRI was established by Government of India under a Governing Body 1957- 1966 Dr. Dharmendra famous Leprologist was associated with CLTRI as Director from 1967 to 1971 he was Emeritus Medical Scientist of CLTRI. 1967- 1971 Significant Contribution :- Lepromin Test Standardization of DDS (Diamino Diphenyl Sulphone) a drug used for treating leprosy patients. 1974 CLTRI became a subordinate office of DGHS under MOH&FW 1978-1983 Standardization of MDT (Multi Drug Therapy ) done in this Institute. 1991 Nodal Centre for Thalidoamide drug therapy for ENL (Erythrosom Nodosum Leprosom) reaction Cases.3 OBJECTIVE To undertake research into basic problems relating to the occurrence and spread of leprosy and its control. To train manpower necessary to implement NLEP. To provide specialized services in the area of diagnosis, reaction, relapse and Reconstructive surgery in Leprosy. To monitor and evaluate National Leprosy Eradication Programme. Additional Responsibitiy given in 2005 after Elimination of Leprosy CBHI Training RNTCP Operational Research IDSP Training 5 AREA OF CLTRI Total Land of CLTRI - 560.83 Acres Institutional Buildings - 66.53 Acres Residential Buildings - 28.72 Acres Vacant Land - 190.58 Acres Land Given to HLL (for proposed Medipark on 20-03-2009 by MOHFW) - 275 Acres 6 BUILDING 1.HOSPITAL BLOCK : Out Patient Unit Main Hospital -124 Bedded Hospital Sick Room Medical Investigation Ward Surgical Ward with X-ray department & Operation theatre Physiotherapy Block MCR and Footwear Unit Centralised Kitchen Laundry Centralised Stores 7 BUILDING (Continued) 2. ADMINISTRATIVE BLOCK a. Administration b. Laboratory & Animal House c. Library d. Epidemiology 3. HOSTEL a. Scientist Hostel - 18 Rooms b. Students Hostel - 18 Rooms c. Canteen 8 STAFF STRENGTH – STATUS REPORT Sl. No. 1 Total Strength Filled Vacancy Vacancy Percentage A ( Medical) Specialist 15 3 12 87% GDMO 11 6 5 45% Group 2 A- Non Medical 3 0 3 3 B- Gazetted 5 2 3 4 B- NonGazetted 19 14 5 5 Group C 117 84 33 28% 6 MTS 80 56 24 30% 250 165 85 34% TOTAL 66 % 34 % 100% 60% 26% 9 Budget Estimate 2012-13 S.No. HEAD PLAN 10% Balance reduction in Budget Non-plan* NON-PLAN 1 Salaries 0 84150 0 84150 2 Wages 0 1400 0 1400 3 Overtime allowance 0 10 1 9 4 Medical Treatment 0 750 75 675 5 Domestic Travel Expenses 500 300 30 270 6 Office Expenses 2200 2020 202 1818 7 Publication 0 10 1 9 8 Other Administrative Expenses 250 0 0 0 9 Supplies and Materials 3500 2800 280 2520 10 Minor Works 1550 0 0 0 11 Scholarships /Stipend 0 300 30 270 12 Other charges 0 10 1 9 13 Motor Vehicles 0 450 45 405 14 Machinery and Equipment 1500 300 30 270 9500 92500 695 91805 TOTAL 11 Wards Nursing Section Medical Record Section Out Patient Department 12 • Expert Management of reactions with Thalidomide, Relapses/Drug Resistance etc. • Teaching activities in leprosy to Undergraduates, House Surgeons of Medical Colleges, NMS Supervisors and Nurses. • Collection and study of relapse/recurrence cases in leprosy. 13 On Going research activity Drug Resistance using Mouse foot Pad Surveillance 14 Out-Patients particulars for the Last 5 years 2008-09 2009-10 2010-11 2011-12 2012-13 (Till Oct ) 1 No. of new Cases attended OPD 64 104 74 90 48 2 No. of old Cases attended OPD 7155 7220 6192 6094 3353 3 No. of patients attended OPD from GLC block 2680 2074 1514 1694 776 4 No. of other Cases (NCL) Attended OPD 2224 1748 1441 1161 775 5 Total no. of patients seen in OPD 12123 11146 9221 9039 4952 GLC - Government Leprosy Centre NCL - Not a Case of Leprosy 15 Surgical Unit Physiotherapy Section Artificial Limbs & Footwear Section X-ray Section Micro-cellular Rubber 16 Surgical (cont.) The Basic functions: • Reconstructive Surgery • Patient care activities. • Teaching and Training Programs. • Research. 17 Physiotherapy Section Physiotherapy Services to PAL. Various Teaching and Training programs. Counselling & Health Education. Facilities Available Wax Bath, Electrical Muscle Stimulator, Inter Ferential Therapy, Ultra Sonic Therapy Traction Table. 18 Artificial Limbs & Footwear Section Footwear patients and Prosthetic to the Leprosy Micro-cellular Rubber Small Production unit - Micro-Cellular Rubber sheets (2000 sheets per annum) Providing MCR sheets to other states 19 Details of Major and Minor Surgery Done for the Last 5 years S. No Surgeries 2007-08 2008-09 2009-10 2010-11 2011-12 Major Surgeries –(Reconstructive Surgery) 1. Claw finger correction 7 7 14 6 8 2. Claw thumb correction 3 5 5 5 1 3. Wrist drop Correction - - 1 1 - 4. Drop Foot Correction 5 1 - 6 - 5. Lagapthalmos Correction - 1 2 - - 6. Surgical Decomposition of Nerves (Ulnar Nerve, Median Nerve, Posterior Nerve) 4 1 2 3 - 7. Amputation (Below Knee & Below Elbow Amputation) 4 2 - - - Minor Surgeries 8. Ulcer Surgery 53 16 20 5 - 9. Miscellaneous like Biopsy, MTH Resection, Calcaneal shaving, lagopthalmus, Skin Grafting, Cystectomy etc. 18 4 6 6 - Physiotherapy Activities for the last 5 year S.N Activities o 1. New Case 2. Assessments 3. 2007-08 2008-09 2009-10 2010-11 2011-12 70 55 77 51 195 973 895 708 530 789 Hand Exercises 1905 1823 1742 1755 1943 4. Foot Exercises 857 797 737 714 749 5. Wax Therapy 1845 1741 1698 1598 1740 6. Splints 460 416 778 309 407 7. General Cases 91 60 67 52 71 Footwear and Prosthetic Supplied for the last 5 year S. No 2007-08 2008-09 2009-10 201011 2011-12 1234 1119 1199 942 500 1. Simple and Modified Micro cellar Rubber Sandals (in pairs) 2. Orthotic and Prosthetic Appliances(in no’s) 23 21 25 28 5 3. Major repair of Orthosis and Prosthesis (in no’s) 8 4 13 12 1 4. Modifications Arch Support and Metatarsal Bars (in no’s) 144 115 171 93 54 Division of Epidemiology & Statistics Monitoring & Evaluation Unit Statistics Technical Training Library Electronic Data Processing Unit 23 Division of Epidemiology & Statistics CLTRI Website was created by our unit. Website for our institute was hosted in NIC server (http://cltri.gov.in/). Logo for our Institute was designed. Inventory Management Software was developed. Consultancy services to the BCGVL, Guindy, Chennai for creation of website and Inventory management system. 24 Monitoring & Evaluation of NLEP Activities Monitoring & Evaluation of NLEP Activities among Tamil Nadu, Karnataka, Kerala and Lakshawdeep states/UT was carried out. Visits Made for Monitoring Activities Lakshadweep Islands - 2000 population of school children were Examined on January 2012. Tamil Nadu, Karnataka, Pondicherry States/UT for planning M & E Activities. M & E conducted in Erode District, Tamil Nadu. Surveillance Activities Phase I of the Activity Study of the Household and Neighbourhood Contacts of newly Reported Leprosy cases in the CLTRI OPD from Thirukalukundram Taluk area work was carried out during October 2011. Phase II of the Activity is started on August 2012 and completed on September 2012 Analysis of the collected data is under process. PROPOSALS SFC proposal for Strengthening of CLTRI was Prepared and submitted in DGHS (17 Oct 2012). Operational Research Study to ascertain the reasons for High Endemicity in 24 districts of 3 states (Andhra Pradesh, Gujarat, Karnataka) was send to CLD(31 May 2012). Data Analysis OPD Data -New case attending CLTRI OPD for the past 2 year were entered and analysed. Spatial Distribution of (Geographical Information) of New cases attending CLTRI was prepared. Monthly progressive Report from districts of Tamil Nadu, Andhra Pradesh and other states were received and entered into Computerised Simplified Information System (CSIS). Analysis of Reaction Case data is under process. Training Activities • State/District Leprosy Officer (SLO/DLO) (5 days) = 3 batches • Medical Officer Training Course (5 days) = 2 batches • Non-Medical Health Supervisor’s (2 months) = 2 batches • Skin smear Technician Training (5 days) = 1 batch • Laboratory orientation Training (BCG Staff) = 2 batches • Final MBBS students =125 students (one day visit) • CRRI Training (5 days ) =110 Trainees • Tertiary case management of Leprosy (10 days) = • Inplant training in Microbiology & Molecular Biology to Biotechnology students 1 batch = 1 batch 29 Library • Books - 3278 • Journal - 4409 • Periodicals Foreign journals - Indian Journals - 24 09 30 Workshop/Conference / Training Attended • Dr. V.C.Giri Assistant Director (Epid) attended HIVCONGRESS 2012, Held at Mumbai from 16th to 18th March 2012, Presented one Research paper and Two paper by Co-authors in scientific session. Attended RTI Act for Public Information Officer training at ISTM, New Delhi –August 2012 Published 2 paper in International Journals. • Dr. V.C.Giri, AD (Epid) & Dr. R. Veerkumaran, CMO delivered lectures in Leprosy CMC organised by Tirunelveli Medical College, Tirunelveli, Tamil Nadu. • Mr. U. Aravindan, Statistical Investigator Gr. II attended training in Statistical Analysis system (SAS) training held at Christian Medical College, Vellore, Tamil Nadu. Biochemistry Hematology & Microbiology & Animal Immunology & Molecular House Biology Clinical Sterilisation Pathology & Histopathology 32 Investigation for Leprosy related and other Routine Investigations Basic and Applied Research activities in Leprosy. Research in field of Diagnosis, Molecular Biology, Drug therapy, Animal studies in the field of Leprosy etc., 33 On going Research projects: Study on surveillance of Drugs [rifampicin and dapsone] resistance, among smear positive multibacillary leprosy cases Detection of fumonisin producing Fusarium species from rice seeds by polymerase chain reaction. Variable number tandem repeats VNTRs finger printing as an Epidemiological marker for Mycobacterium leprae haplotyping 34 Laboratory Investigations in the Last 5 years S. No DEPARTMENTS / SECTIONS 200809 200910 201011 201112 201213 1 Clinical Pathology & Skin Smear 1233 1010 831 1168 669 2 Hematology & Serology 2255 3316 3000 3767 1980 3 Microbiology 262 397 100 129 82 4 Histopathology & Molecular biology (Routine & Research activities) 483 4 71 331 5 Biochemistry 1705 1705 3130 3244 1463 6 Animal Position in the Animal House 1. Balb/C Mice Inbred Strain 2. Swiss Albino Mice Inbred Strain 3. Rabbit … … 4. Rat … … 5.Sheep 323 269 6 14 323 269 6 14 548 496 4 548 496 4 548 496 4 35 Scientific Publications in last 1 year Detection of mutations in folp1, rpoB and gyrA genes of M. leprae by PCR- direct sequencing--a rapid tool for screening drug resistance in leprosy. Lepr Rev. 2011 Mar;82(1):36-45. OXA beta-lactamase-mediated carbapenem resistance in Acinetobacter baumannii. Indian Journal of Medical Microbiology, Vol. 29, No. 3, July-September, 2011, pp. 269274 Detection of Amp C genes encoding for beta-lactamases in Escherichia coli and Klebsiella pneumoniae. Indian Journal of Medical Microbiology, Vol. 30, Issue 3, 2012, pp. 290-295 blaIMP AND blaVIM Mediated Carbapenem Resistance in Pseudomonas and Acinetobacter species in a Tertiary Care Hospital in India. The Journal of Infection in Developing Countries, October 2012. 36 37 38 Phase I: 9 cluster are surveyed out of 18 clusters 2531 population was Examined 13 Cases case were found. NCDR= 51.36 per 10000 Adult Child Total Paucibacillary (PB) 6 3 9 Multibacillary (MB) 4 0 4 Phase II: 9 cluster are surveyed out of 18 clusters 3702 population was Examined 13 Cases case were found. NCDR= 35.11 per 10000 Adult Child Total Paucibacillary (PB) 6 3 11 Multibacillary (MB) 2 0 2