Lala Ram Sarup Institute of
Tuberculosis and Respiratory
Diseases
( Ministry of Health and Family Welfare)
ANNUAL REPORT
2005-2006
Sri Aurobindo Marg, New Delhi-110 030.
1
PREFACE
LRS Institute of Tuberculosis and Respiratory Diseases has been treating ailing
patients of tuberculosis and respiratory diseases over the last 54 years since its inception in
1952. It has scaled great heights from providing a sanatorium treatment to the tuberculosis
(TB) patients in past to emerging as a powerful force engaged in the control of disease at
national level, especially after being taken over by the Ministry of Health and Family Welfare,
Govt. of India as an autonomous institute in 1991.
The Institute has been successful in achieving its main objective of supporting the
National Tuberculosis Control Programme through implementation of recommended DOTS
strategy within its area, through provision of training to various health personnel and through
carriage of world class research on private public collaboration in TB control, which had become
mandatory because a large section of country’s population approaches the private sector first for
relief of symptoms. Private practitioners of the Institute’s area and their staff were sensitised to
the principles of Revised National Tuberculosis Control Programme (RNTCP) and tools prepared
in this regard as a result of which the programme implementation has been effected in private
sector, in a manner, similar to that being carried in public sector. The Institute also played a key
role in the development of guidelines of pediatric TB case management with participation of
pediatricians, tuberculosis experts and TB control programme managers. These guidelines are
being adopted at the national level.
A new state-of-art Out Patient Department (OPD) complex became operational within
Institute, which has streamlined the registration process, provided the space for emergency case
management, simplified the consultation and diagnostic work-up of patients and facilitated the
implementation of RNTCP as well as the conduct of various teaching and training activities for
2
medical and para-medical students. The new OPD has assisted in the realisation of 15 new
specialised chest clinics that have provided varied treatment options to the patients suffering from
TB or respiratory diseases.
Availability of an indoor facility and a state-of-art Respiratory Intensive Care Unit (ICU)
ensures that all seriously ill patients suffering from TB or respiratory diseases get admitted for
management under the guidance of specialists and trained health staff. Similarly, existence of a
Thoracic Surgical Department facilitates the conduct of various operative interventions on patients
having persistent symptoms despite the best of conservative medical treatment. The proposal to
develop the unit into a National Thoracic Centre has been cleared by the Govt. of India and
earnest efforts have begun in the direction to create such centre at the earliest.
With aim to establish itself as an Institute of international repute, we continue to expand
our network of service provision. A new department of Polysomnography has become functional
within the Institute. It is diagnosing patients having sleep related respiratory disorders and
accordingly providing management options to them. In addition, newer diagnostic facilities like
Polymerase Chain Reaction and Gas Liquid Chromatography are likely to become operational
soon. Further efforts are on to strengthen every department of the Institute with most modern
technology available.
Over the years, numerous research projects have been carried out in the various sub
specialties of respiratory disease within the institute like the departments of RNTCP,
Microbiology, intensive care and so on . Other research assignments on the vital health issues of
current interest like air pollution, Multi drug resistant and HIV/AIDS are coming up within the
3
institute, whose results are likely to benefit the entire country in the times to come.
We record our grateful and sincere thanks to members of our Governing Body, Finance
Committee and other committees for their help and guidance in the Institute’s work. We are
particularly grateful to Sri Naresh Dayal , our Chairman, Governing Body for his continued
guidance, Dr. R.K.Srivastava, the Vice Chairman, for his support and guidance in the activities of
Institute and Shri Deepak Gupta , Chairman, Standing Finance Committee for his assistance
and advice in the management of our Institute. Our grateful thanks are due to Shri Raghubir
Singh, Additional Secretary & Financial Advisor and Smt. Rita Teaotia, Joint Secretary, for their
continued advice and support. We have great pleasure in recording our high appreciation for the
loyal and devoted work put in by every member of our Institute.
PROF (DR) D. BEHERA
DIRECTOR
4
ANNUAL REPORT CONTENTS
Page No
1. Background of Institute
1.1
Introduction
1.2
Treatment
1.3
Teaching & Training
1.4
Manpower
2. Out Patient Department (Domiciliary Clinic)
2.1.1 New Registration in OPD
2.1.2 Total TB cases diagnosed referred & registered.
2.1.3 Disease wise distribution of TB cases registered
2.1.4 Sputum status of adults & children
2.1.5 Distribution of EPT cases.
2.1.6 Various sites of EPT cases.
2.1.7 Age & Sex distribution of TB cases registered
2.1.8 Paediatric OPD
2.1.9 Specialised Chest Clinics (NON TB cases )
2.1.10 Total Patients in OPD (OPD load)
3. Indoor Patient Data
3.1
Total Indoor Admissions
3.2
Age & Sex distribution of admitted patients
3.3
Distribution of admitted patients as per outcome.
3.4
Observations
4. Departments of the Institute
4.1
Department of TB & Respiratory Diseases
4.2
Department of Tuberculosis Control
4.3
Department of Respiratory Intensive Care
4.4
Department of Microbiology
4.5
Department of Thoracic Surgery
4.6
Department of Paediatric Tuberculosis and Respiratory Diseases
4.7
Department of Radiology
5
4.7.1 X-rays
4.7.2 Ultrasound
4.7.3 CT Scan
4.8
Department of Pathology
4.9
Department of Anaesthesia
4.10
Department of Clinical Respiratory Physiology
4.11
Department of Epidemiology , IEC Centre & Biostatistics
4.12
Department of Medical Laser
4.13
Department of Training
4.14
Department of Medicine
4.15
Computer Section
4.16. Library
5.0
Research activities
5.1
On going research studies under DNB course.
5.2
Research studies being carried out other than DNB courses
6.0
Papers & Articles published
7.0
Presentations during Conferences/Seminars/CME/Workshop
8.0
Conferences/Seminars/CME/Workshop attended
9.0
Various Committees
9.1
Purchase Committee (General Store)
9.2
Purchase Committee (Medical Store)
9.3
Purchase Committee (Hospital DIET)
9.4
Estate Committee
9.5
Medical Board
9.6
Medical Re-imbursement Committee
9.7
Library Committee
9.8
Condemnation Committee
9.9
Training Committee
9.10
Hospital Infection Control Committee
9.11
Hospital Waste Management Committee
9.12
Hospital Disposal committee
6
9.13
Transport Repair Committee
9.14
Equipment Repair committee
9.15
Annual report Committee
9.16
Committee to look into the complaints of sexual harassment
9.17
Committee for betterment of the services to be taken from the canteen
contractor
9.18
Hindi Protsahan Committee
9.19
Welfare Committee
9.20
House Allotment Committee
9.21 Committee for Advance on Establishment matters
9.22
Public Grievance Committee
9.23
Research Committee
9.24
Ethical Committee
10.
Statistical Tables from 1 to 45
Table-1: Chest Symptomatics (NEW OPD registrations) at LRS-OPD-(Out patients-i)
Table-2:Total TB cases Diagnosed, Referred and Registered out of total new symptomatics
(Out patients data-ii)
Table-3 : Patients referred from LRS to DOTS centres and Neighbouring states after
diagnosis.
Table-4 : Health Education data
Table-5: Disease wise distribution of TB cases registered for treatment (Out patients data-iii)
Table-6: Sputum wise distribution of pulmonary tuberculosis cases registered (Out patients
data-iv)
Table-7: Distribution of extra pulmonary tuberculosis cases registered for treatment from
LRS-OPD (Out patients data-v)
Table-8 : Distribution of Sites of EPT cases (Out patients data-vi)
Table-9: Age & Sex distribution of registered TB cases (Out patients data-vii)
Table-10 : Non TB patients in chest clinics (Out patients data-viii)
Table-11: Total Patients in OPD (OPD Load)(Out patients data-ix)
Table-12: Age & Sex distribution of the Admitted & Discharged patients (Indoor data-i)
Table-13: Outcome of patients treated in the Hospital (Indoor data-ii)
Table-14: Categorywise distribution of Pulmonary Tuberculosis cases (Indoor data-iii)
7
Table-15: Sputum Status of discharged pulmonary tuberculosis cases (Indoor data-iv)
Table-16: Complications in Pulmonary Tuberculosis cases (Indoor data-v)
Table-17: Distribution of Extra Pulmonary Tuberculosis cases (Indoor data-vi)
Table-18: Distribution of Non Tubercular cases (Indoor data-vii)
Table-19: HIV suspected among admitted TB patients (Indoor data-viii)
Table-20: Distribution of Pulmonary Tuberculosis Cases as per treatment given (Indoor dataix)
Table-21:Details of I.C.U. Admissions
Table-22 (a): Thoracic Major Chest surgery
Table-22 (b): Thoracic Endoscopic procedures
Table-22(c): Thoracic Surgical Minor Procedures
Table-23 : Number of x-rays
Table-24 : Number of Ultrasounds
Table-25: Number of CT scans
Table-26: Smear microscopy (Sputum Examinations) Data (Microbiology data-I)
Table-27: Culture section (Pulmonary Specimen) Data (Microbiology data-ii)
Table-28: Culture section (Extra Pulmonary Specimens) Data (Microbiology data-iii)
Table-29: Bacteriology ( Pyogenic cultures) Data (Microbiology data -iv)
Table-30: Results of Pyogenic cultures (Microbiology data-v)
Table- 31: Data of Mycology Samples (Microbiology data-vii)
Table- 32: Data of Mycology tests (Microbiology data-viii)
Table-33: Data of Mycology test results (Microbiology data-ix)
Table 34.: Immunology Test data (Microbiology data-ix)
Table-35 Biochemistry Data
Table-36: Haematology Data
Table-37: Cytology Data
Table-38: Histopathology Data
Table-39: Data of Tuberculin tests
Table-40: Number of procedures done in Respiratory Laboratory (PFT Lab.)
Table-41: Training data
Table-42: Voluntary counselling and testing centre (VCTC) Data
Table-43 : Fibroptic bronchoscopy unit data
8
Table-44 : Physiotherapy Section
Table 45. Polysomnography data ( sleep lab. Study data)
9
ANNUAL REPORT 2005-2006
(1.4.2005-31.3.2006)
1. BACKGROUND OF INSTITUTE
1.1
Introduction
LRS TB hospital was established by TB Association of India in 1952. The
hospital was upgraded into an autonomous institute in 1991 by Govt. of India. The
institute was renamed as LRS Institute of Tuberculosis & Respiratory Diseases as an
autonomous institute under the Ministry of Health & Family Welfare, Government of
India.
It is now an apex institute of the country in the field of tuberculosis and
respiratory diseases. The institute is well recognised for diagnosis, treatment,
teaching, training and research in the field of tuberculosis and respiratory diseases.
The institute is registered as a society under the Societies Registration Act,
1960 (XXI) The Union Minister of Health & Family Welfare is the President of the
institute and the Union Secretary (Health) is the Chairman of the Governing Body.
Director General Health Services is the Vice-Chairman and the Additional Secretary
(Health) is the Alternative Vice-Chairman of the Governing Body of the institute. The
Director is the Chief Executive Officer.
The institute is spread over an area of 25 acres of land in South Delhi and has
various departments to carry out the activities in accordance with the objectives of the
institute. These departments are
1.
Department of TB & Respiratory Diseases
2.
Department of TB control
3.
Respiratory Intensive Care Unit
4.
Department of Microbiology
5.
Department of Pathology
6.
Department of Thoracic Surgery
7.
Department of Paediatrics Tuberculosis & Respiratory Diseases
8.
Department of Radiology
9.
10.
Department of Medicine
Department of Anaesthesia
10
11.
12.
13.
14.
1.2
Department of Clinical Respiratory Physiology
Department of Epidemiology, IEC centre and Biostatistics
Department of Medical Laser
Department of Training
Treatment
1.2.1 Outdoor
The institute runs a daily OPD and the registration of the patients is being done
on a computerized sheet. The patients are registered as area, Non area or Outsiders.
This is done so because the patients are not only coming from the specified area of
the institute but also from whole Delhi and adjoining states like Haryana , Rajasthan
,UP ,Bihar etc. Besides the routine OPD the institute runs specialised chest clinics in
the afternoon . The Institute has a well equipped TB detection mobile van for field
work in Slums, Villages etc. This van is equipped with X-ray, Microscopy and drug
distribution facility, which has been found to be very useful for the patients in remote
areas.
1.2.2 Indoor treatment facility
The institute provides indoor treatment to the serious patients for the treatment
of tuberculosis and respiratory diseases. The institute has 520 beds. These beds are
distributed in 16 wards and ICU.
Distribution of Total beds in the institute
1.3
TB
beds
MDR
292
20
Chest
ward
46
Surgical
beds
Child
ren
108
34
ICU Sleep Emerg
Lab
ency
14
2
2
For TOTAL
Staff
2
520
Teaching & Training
The institute provides teaching facilities for various post- graduate (M.D. /
Diploma in TB & Respiratory Diseases) courses of Delhi University . The institute has
been recognised for imparting training for the award of degree by Diplomate of
National Board in respiratory diseases since 1999. There are 18 students undergoing
training at present.
The training is also imparted in the management of tuberculosis to the nursing
students from Rajkumari Amrit Kaur College of Nursing and the trainee health visitors
from New Delhi TB Centre every year. The institute is actively involved in the training
of various medical and paramedical personnel who visit from other states of our
11
country, in implementation of strategies under Revised National Tuberculosis Control
Programme. The institute is actively involved in organising Continuing Medical
Education programme (CME) on different aspects of diagnosis and management of
tuberculosis and respiratory diseases.
1.4
Manpower
At present, the institute has 36 Group-A, 42 Group-B, 192 Group-C and 191
Group-D Staff in position. In addition, there are 13 senior residents & 21 junior
residents working on tenure basis.
Posts
Group
Group
Group
Group
SR
JR
Total
A
B
C
D
No.of Sanctioned Staff
40
47
223
226
13
21
570
Present Staff strength
36
42
192
191
13
21
495
2.0
OUT PATIENT DEPARTMENT (DOMICILIARY CLINIC)
2.1
The institute provides treatment for patients within the domiciliary area. Patients also
visit from non area within Delhi and neighbouring states (outsiders). Further the
institute has implemented RNTCP within domiciliary area through 19 DOTS cum
microscopy centres and 17 additional DOTS centres. Eighteen of these 36 centres are
with support of DTUS and remaining 18 are established with NGO and private
practitioners collaboration.
2.1.1 New Registration at LRS OPD (Chest Symptomatic)(Table-1)
A total of 34092 chest symptomatics attended the LRS-OPD and 10580
attended the DOTS centres OPD. This constituted a total of 44672 chest
symptomatics under LRS Institute. Out of 34092 patients, who came at the LRS-OPD,
16666(49%) came from the LRS specified area, 9491(28%) from Non-Area and
7935(23%) from outside Delhi as shown in Table-1.
This indicates that about 51% (28% + 23%) of the patients who attend the LRS-OPD
are from Non Specified area from Delhi or from out side Delhi as shown in figure 1.
2.1.2 Total TB Cases diagnosed, referred & registered at LRS-OPD (Table-2 & 3)
12
The patients who come to the institute for seeking treatment are investigated
and after confirmed diagnosis are referred to their respective DOTS centres or chest
clinics for further treatment of tuberculosis.
Out of 34092 symptomatics, a total of 6256(18%) were diagnosed as suffering
from tuberculosis in LRS –OPD. Out of these , 4824(77%) were referred out from
LRS OPD to LRS DOTS Centres or to Chest Clinics in Delhi and neighbouring states.
Remaining 1432(23%) were registered at LRS-OPD for further treatment and follow
up of their illness of a serious nature belonging to Non Area and Out Side Delhi.
Among 4824 TB cases who were referred out, about 2769(57%) were referred
to LRS-DOTS centres and 1313(27%) to non-area chest clinics in Delhi and remaining
742(15%) to outside Delhi Chest clinics.
Among the 1432 TB cases, who were registered at LRS-OPD for follow up and
treatment, 838(59%) were from outside Delhi and 594(41%) were from Non area in
Delhi. All area cases, who came to LRS OPD were investigated and after diagnosis
they
were referred back to LRS-DOTS centres for follow up treatment except
seriously ill patients, who needed hospitalisation.
2.1.3 Disease wise distribution of registered TB cases (Table-5)
Pulmonary TB was seen in 3112(67%) and Extra Pulmonary TB in 1507(33%)
in DOTS centres, Whereas in LRS, Pulmonary TB was seen in 1183(83%) and Extra
pulmonary in 249(17%) patients (table-5).
Regarding distribution of disease in adults and children, it was observed that in
adults pulmonary TB comprised of 2788(70%) patients in DOTS centres and
1143(84%) in LRS, whereas in children, pulmonary TB was seen in 324(50%) patients
in DOTS centre and 40(61%)) in LRS, the rest being of Extra Pulmonary type.
It is observed that among the total 4619 TB cases registered under DOTS
Centre, 3968(86%) were adults and 651(14%) were children. Whereas in LRS-OPD,
among the total 1432 TB cases registered, 1366(95%) were adults and 66(5%) were
children.
13
2.1.4 Sputum wise distribution of pulmonary tuberculosis (table-6)
Sputum Positive vs Sputum Negative:It has been observed that among the total 1183 pulmonary TB cases registered
in LRS, 803(68%) were sputum positive and 380(32%) were sputum negative,
whereas in DOTS Centre, out of 3112 pulmonary TB cases, 1946(63%) were sputum
positive and 1166(37%) were sputum negative.
2.1.5 Distribution of Extra pulmonary Tuberculosis (EPT) cases (Table-7)
For Extra Pulmonary cases, it is observed that the male to female ratio was more in
LRS-OPD then in the DOTS centres it is 2:1 as compared to 1:1 in DOTS.
It is observed that EPT cases are proportionately more in Females in DOTS Centres in
comparison to LRS (Non-DOTS) with 785(52%) females having EPT under DOTS Centre
in comparison to 82(33%) in LRS.
2.1.6 Distribution of various sites of Extra pulmonary Tuberculosis (EPT) cases
(Table-8)
It is observed that Lymphadenitis, Pleural Effusion, Pneumothorax,Empyema account
for majority of the EPT cases in LRS-OPD as well as DOTS Centres.
2.1.7 Age & Sex Distribution of registered TB patients (Table-9)
On analysis it is seen that about 55% of the paediatric patients are below 10 years in
DOTS Centres whereas the trend is reverse in the LRS-OPD. It is also observed that in
adults majority of the patients were in 15-24 years of age group in DOTS Centre and 2544 yrs of age group in LRS, the most economically productive age group.
2.1.8 Specialised chest Clinics (NON TB cases ) (Table-10)
The institute is carrying out various specialised chest clinics, which are held in the
afternoon from Monday to Friday. These clinics are as follows.
i).
Clinic for Sarcodosis, Interstitial Lung Disease and Disease of unknown origin
ii).
Lung Cancer Clinic
iii).
Thromboembolic diseases Clinic
14
iv).
Bronchial Asthma Clinic
v).
Chronic airway Disease Clinic
vi).
Desensitization of Asthma patients Clinic
vii).
Smoking cessation Clinic
viii).
Pulmonary Rehabilitation Clinic
ix).
Clinic for patients on Long term Oxygen therapy
x).
Laser Therapy Clinic
xi).
Clinic for HIV and Tuberculosis : The clinic is looking after HIV/AIDS cases, their
management,documentation
and
surveillance
reporting to the Delhi state AIDS control society and
NACO.
xii).
Clinic for Empyema Patients
xiii).
Pediatric Bronchial Asthma Clinic
xiv).
Clinic for Pain Management
xv).
Sleep Clinic
xvi).
Occupational Lung Disease Clinic
Majority of the Non-TB patients suffered from COPD and Bronchial Asthma. (Table-10
)
2.1.9 Paediatric OPD
Paediatric patients are seen in a special Paediatric OPD daily from Monday to
Saturday. The T.B. patients from specified area of the institute are referred to the
respective DOTS centres while the others are treated at LRS OPD.(Table-3 to Table11)
2.1.10 Total patients in the OPD (OPD Load)(Table-11)
The total number of patients who attend the OPD constitute mainly four groups (i) New
registration (ii) Subsequent visits for diagnosis (iii) Follow up visits of TB cases (iv) Follow
up Visits of Non-TB patients.
Out of the total 118667 patients in the OPD, 34092 (29%) are new symptomatics,
62761(53%) patients made subsequent visits for diagnosis, 1710(14%) patients for follow
up of TB and 4713(4%) came are follow up of Non-TB diseases.
During the year OPD worked for 301 working days and it is observed that on an
average, a total of 394 patients came to the OPD every day including 113 new
registrations.
3.0
INDOOR PATIENT DATA
Those patients requiring hospitalisation are admitted in the institute for the
15
treatment of tuberculosis and other respiratory diseases. These hospitalised patients
include cases of multi-drug resistant TB, emergencies such as Haemoptysis,
Pneumothorax etc., surgical and seriously ill patients of respiratory diseases, cases
with diagnostic problems and patients requiring Intensive Care management for
respiratory diseases.
3.1
Total Indoor Admissions
During the period from April 2005 to March 2006, a total of 4319 patients were
admitted and 4263 were discharged.
3.2 Age & Sex Distribution of Admitted Patients (Table 12)
Among the total 4319 admissions, 4088 were adults and 231 were children.
Amongst the hospitalised adults, the maximum number of patients were in the
productive age group of 25 to 44 years.
3.3
Outcome of patients treated in the hospital (Table-13) :
Out of total 4263 discharged patients, 2255(53%) were suffering from
pulmonary tuberculosis, 526(12%) had extra pulmonary tuberculosis and 1482(35%)
were suffering from non-tubercular disease. The outcome of these patients is given in
Table-11. It is observed that 12% of the patients died, 9% LAMA, 6% DOR, 4%
absconded, 8% were referred out and remaining 61% (2600) were discharged after
satisfactory treatment.
3.4
Observations on Indoor patients:
On analysing the data of the discharged patients, the following observations are
made :
i
It is observed that 67% (50% Cat-II, 17% Others) of the hospitalised patients
were put on retreatment regimens including reserve drugs, thereby reflecting
that most of the patients admitted are those who are defaulters and failures and
having difficulties of treatment compliance(Table 14).
ii.
Among the Pulmonary TB cases, who were discharged after satisfactory treatment
from LRS (excluding LAMA, Absconded, DOR, Referred or Deaths), and for whom
the sputum report was available, it is observed that 240(30%) out of 807 sputum
positive cases converted into sputum negative and 70%(567) remained positive at
the time of discharge (Table-15).
iii
About 10% of the total TB patients had complications like pneumothorax,
empyema, lung abscess etc. (Table 16)
iv
Among the 526 extra-pulmonary TB cases, majority of them had pleural
involvement (60%), Abdominal(10%), Milliary TB (5%) , TBM (5%) etc(Table 17)
v.
Amongst the non-TB chest cases,who were admitted COPD was the major
16
contributor (33%). Lung cancer constituted 11% of the cases (Table 18)
vi
The HIV-cases in the Institute have also increased and are mostly adult males.
HIIV was suspected in 1066 admitted patients, out of whom, 83 (7.8%) were found to
be HIV positive. (Table 19)
vii
The patients put on treatment ,received 6% conventional treatment and 72%
SCC. Hospitalization of DOTS patients contributed 12% of TB cases. Nearly 9% of
the patients were on reserve drugs. (Table 20)
viii
Among the total 491 patients, who were treated in ICU ,234 were Medical
patients and 251 were surgical patients. During the year, 48 deaths occurred in the
ICU. (Table 21).These are included in the total deaths in the institute.
4.0 VARIOUS DEPARTMENTS OF THE INSTITUTE
4.1 Department of TB & Respiratory Diseases
This department has gradually developed into one of the major referral centres in the
entire northern India for patients suffering from tuberculosis (including drug resistant
tuberculosis) and other critical and chronic respiratory diseases. State of the art diagnostic
& treatment facilities are provided to these patients within the institute including reserve
anti tuberculous drugs, surgical treatment (where surgery is indicated) and intensive
respiratory care. The department is regularly engaged in various teaching, training and
research activities.
4.1.1 Organising the DNB degree course :
The institute has been recognised for imparting DNB training (TB & Respiratory
diseases) to postgraduate students since 1999.
4.1.2 Organising CME & Conferences:
The institute is actively involved in organising Continuing Medical Education (CME)
programmes on different aspects of diagnosis and management of tuberculosis.
During the year following CME ‘s and updates were organised in the institute.
(i)
CME on Respiratory Critical Care on 21.8.2005
(ii)
CME on Bronchoscopy on 28.8.2005
(iii)
CME on Sleep Disorders on 4.9.2005
(iv)
CME on "Pulmonary Function Test in Clinical Practice” on 11.9.2005
(v)
Respiratory update on 13.11.2005
All the doctors of the institute attended the above CME’s and updates.
4.2 Department of Tuberculosis Control
The LRS Institute of TB & Respiratory Diseases has been entrusted the responsibility
by the Delhi Govt. of undertaking Tuberculosis Control activity in a defined geographical
area in the southern part of Delhi. The domiciliary treatment services were earlier being
offered to these area patients from the OPD of the institute. With the introduction of the
Revised Strategy for Tuberculosis Control (RNTCP) by the Government of India the
17
tuberculosis control services provided by the institute have been decentralized.
Government
N.G.O.
Private practitioners
Total
4.3
DOT-cumMicroscopy
Centres
14
2
3
19
DOT
TOTAL
4
5
8
17
18
7
11
36
The data pertaining to these patients has been given in Table-1 to Table -9.
Department of Respiratory Intensive Care
The institute has established a 14 bed Respiratory Intensive Care Unit (I.C.U.) for
providing best possible chances of recovery and survival from critical respiratory illnesses.
The building was constructed under the auspices of Shri Adya Katyayini Shakti Peeth
Mandir Chattarpur, New Delhi, and has state of art equipment for managing acutely ill
respiratory patients. ICU has been functioning since Aug, 1996. During the period from
April-05 to March-06 ,a total of 491 patients were treated in the ICU (Table-21).
4.3.1 Polysomnography (Sleep Lab.) :
The Institute has a fully operational sleep lab, which is looked after by a Chest Physician.
Assistance in the work is provided by two trained staff members.Selection ,enrolment and
work up of the cases is done at the sleep clinic. The polysomnography study is conducted in
the sleep lab. Cases are followed up in the sleep clinic and given appropriate instructions.
Diagnosed cases of Obstructive sleep apnoea are selected for CPAPA titrations. The
department has also been sensitising the resident doctors of the institute in the diagnostic
and therapeutic evaluation of sleep related breathing disorders.
During the period from April-05 to March-06 , a total of 54 cases had undergone sleep
studies ,while a total of 13 cases underwent CPAP titration. (Table-45).
4.4 Department of Microbiology
The Department of Microbiology of LRS Institute is one of the three National Reference
laboratories for ELSA programme for smear and Drug Sensitivity Test (DST).
The Microbiology department is well equipped to carry out the routine diagnostic procedures
for
i)
Mycobacteriology – the smear, cultures, identification and drug sensitivity testing
for M.Tuberculosis.
ii)
Pyogenic bacteriology
iii)
Mycology and
iv)
Serology for HIV HbsAg widal and Aspergillosis.
The department has been using fluroscent microscopes and BACTEC 460 TB system for
rapid detection, identification and sensitivity of m.tuberculosis.
The Gas liquid
chromatography is soon to be operated. All the equipment for PCR system is available and
18
will start as soon as BSL-3 facility lab will be handed over.
The department is conducting training programmes for WHO fellows and paramedical
personnel (Lab. Technician, Sr.TB Lab. Supervisors, Treatment organisers, Sr.Treatment
supervisors ) who visit from other states of our country for implementation of strategies under
Revised National Tuberculosis Control Programme (RNTCP). The trainings done during the
year are given in table-41. The work done in the Microbiology Department during the year is
given in table- 26 to table-34
4.5 Department of Thoracic Surgery
The department of Thoracic Surgery is well known for its excellence and attracts
patients from far away places in India. It is a unique centre in the field of thoracic surgery
which is devoted exclusively to the care of patients suffering from TB and respiratory
disorders. This is so because most of the other centres have practically converted
themselves into cardiac surgical units. All types of major chest surgeries like resection of
lung, decortication, thoracoplasty etc. are being done. This unit is also attracting patients
suffering from common paediatric emergencies like foreign body inhalation and other
problems related to the field. The Dept. is also imparting training in fibre-optic
bronchoscopy and other surgical procedures to young doctors.
A total of 310 major thoracic surgeries, 120 Brochoscopies and 3974 other minor
procedures were done during the year(Table-22(a),(b),(c)).
4.6
Department of Paediatric Tuberculosis and Respiratory Diseases
The institute has a 34 beded paediatric ward which is headed by a paediatrician. The
department provides both domiciliary as well as institutional care. The institutional care is
provided to children with complicated tuberculosis e.g. tuberculosis disease with
Empyema, Haemoptysis, Meningitis, drug failure or drug resistant cases etc.
4.7 Department of Radiology
4.7.1 X-RAYS
The Radiology Department is equipped with a 500 mA X-ray machine, 3 Odelca
cameras ( 70 mm film ), 100 mm cut film and 100 x 45 meters roll film. The Department
has 2 portable x-ray machines (100mA) for taking x-rays of in bed patients in ICU &
wards. A total of 39417 X-rays were done in this year(table-23)
4.7.2 ULTRASOUND :
A 3.5 MHz ultrasound machine (Aloka SSD - 630), with 2 probes (linear & sector) is
used for performing chest & abdominal ultrasound of patients routinely. A total of 4756
ultrasounds were done during the year(table-24).
4.7.3 CT SCAN
A whole body spiral CT scan (GE prospeed CT scanner system, WIPRO ) is
functional in the institute since 18th Aug.1998. This costly diagnostic modality has now
come within the reach of poor TB patients. During the year a total of 747 CT scans have
been done . (Table 25).
19
4.8
Department of Pathology
The Pathology department provides its services through the following four labs.
a) Haematology, b) Histopathology, c) Cytology and d) Biochemistry.
All the four labs are well equipped with automatic Haematology Analyser, Fully
Automatic Biochemistry Analyser, Electrolyte Analyser,
Cytospin etc. Apart from
routine haematological and Biochemical tests, the labs provide complete profile of
pulmonary pathology tests for TB and respiratory diseases. It has been proposed to add
Blood bank to meet the emergency needs of Haemoptysis and Surgical patients. Round
the clock laboratory services for ICU and post operative cases are also proposed.The
various investigations done in the Pathology Department are detailed in Table-35 to
Table-38.
4.9
Department of Anaesthesia
The Department looks after the Anaesthesia management and preoperative care of all
routine and emergency surgical cases. The department is well equipped with modern
automatic machines and monitoring equipment like pulse oximeter, cardiac monitor,
ventilator, flexible & rigid bronchoscopes (Adult & Child) etc. The department has volume
cycle as well as pressure cycle ventilators. The central gas supply and central vacuum is
also being looked after by the Department.
4.10
Department of Clinical Respiratory Physiology (PFT Lab)
The department is equipped with a computerised complete pulmonary functions tests
machine for spirometry, lung volume and diffusion tests, a blood gas analyzer machine, a
portable spirometer, a respirometer, nebulizers etc. Patients of tuberculosis and
respiratory diseases are referred to PFT laboratory for the diagnostic evaluation. Patients
who are being considered for Thoracic surgery are also referred to PFT laboratory for pre
operative evaluation and post operative care In order to avoid contamination of spirometry
with M. Tuberculosis, the department is equipped with a separate spirometer hooked to
the computer/printer by a 2 way switch box. The department is also equipped with body
plethysmograph and oscilloscope. PFT Laboratory is also involved actively in various on
going research projects.
A total 5622 PFT's were done during the year. The number of other procedures done
in Respiratory Laboratory are detailed in Table-40.
4.11
Department of Epidemiology, IEC Centre & Biostatistics :
The institute has an epidemiological wing, which is involved in various research work
and statistical analysis of the patients data.
4.11.1 Health Education Section:
Health education about TB & RNTCP is being given to the patients, their relatives,
friends and companions. The Department has developed many leaflets & pamphlets which
are distributed to the OPD patients. The Department also has a public address system for
the OPD and a Health Education Exhibition display system for the patients & their relatives.
The number of patients on whom health education was imparted is mentioned in table-3 & 4.
20
4.11.2 Biostatistics Section
The Biostatistics section is concerned with the collection, collation and compilation of
data from the OPD, indoor patients and the various departments of the institute. The
reports are compiled on monthly, quarterly and annual basis. The section compiles a
monthly statistical report for the whole institute for internal circulation. A monthly statistical
meeting is being organised on every third Thursday of the month under the Chairmanship
of the Director .All the Doctors & Officers attend this meeting.
The department also imparts training to delegates at various levels for documentation,
monitoring and supervision under the RNTCP. Training to Trainee health visitors and
other paramedical staff is also imparted. Technical and statistical assistance is being
given for the research projects carried out in the institute. Statistical analysis is also done
for post-graduate students who seek help for their DNB thesis analysis work.
4.12
Department of Medical Laser
Use of Laser in Treatment of TB is a modality & requires lot of research. The
department is equipped with following Lasers:
1. Nitrogen Lasers
2. Helium Neon Laser
3. Semi Conductor Laser
4.12.1 Physiotherapy Section
The physiotherapy section in the institute is actively involved in patient care in ICU,
post surgical wards and in general wards. Physiotherapy treatment to patients helps them
early recovery from the disease.
The section is having various machines like short-wave diathermy (SWD), Ultrasound
therapy machine, Electric stimulation, TENS (Transcutaneous Electric Nerve Stimulation),
Shoulder Wheel, Static Cycle, Manual Traction Set etc.. At many stages urgent
physiotherapy is given to respiratory ICU patients and post surgical patients. Besides this,
physiotherapy treatment is being given to patients admitted in the wards suffering from
bronchiectasis, empyema, lung abscess, pleural thickening and joint contractures. The
patients who received Physiotherpy treatment are shown in table –44.
4.13
Department of Training
The institute is actively involved in the training of various medical and paramedical
personnel who visit from other states of our country, in implementation of strategies under
Revised National Tuberculosis Control Programme (RNTCP). Several training
programmes have already been conducted by the institute for doctors and paramedical
personnel (Lab Tech.,Sr. Lab Tech., Treatment organisers, Sr.Treatment supervisors and
programme officers, Administrators) of several states. Training is also imparted to the
nursing students from Rajkumari Amrit Kaur College of Nursing and the trainee health
visitors from New Delhi TB Centre every year. The trainings done during the year are
given in table-41.
21
4.14 Department of Medicine
The department of medicine is providing care to patients having general diseases such
as Diabetes, Hypertension, CHF, and chronic renal failure in medical patients with TB and
respiratory diseases. It is equipped with an Acuson Colour Doppler Machine and is
performing Echocardiography, Peripheral Doppler and Non Invasive Cardiac
investigations. It assists in performing specialised procedures like Pericadiocentasis and
handles cardiac complications in ICU. This unit is headed by a Physician (Medical
Specialist)
4.15. Computer Section
The institute has a computer section, which is actively involved in clinical data
processing, patient billing, and financial accounting. It has advanced software packages
to assist clinical and epidemiological research. This section is strengthened by E-mail and
fax facilities. As a part of patient care system OPD module started and other related
software package are under progress.
4.16. Library
It has latest editions of books on Tuberculosis and other Respiratory diseases. There
are about 400 books on various subjects along with a large number of national and
international scientific journals, magazines and important national newspapers.
4.17
Voluntary Counselling and Testing Centre (VCTC)
A centre for Voluntary counseling for HIV testing has been started in the institute.
During the period from April-05 to March-06 , a total of 1943 patients were imparted
pretest counseling and 1792 came for post test counseling. A total of 123 patients were
found positive for HIV (Table –42).
4.18 FIBROPTIC BRONCHOSCOPY UNIT :
The unit has diagnostic as well as therapeutic bronchoscopes. Since the beginning of the
unit, During the period from April-05 to March-06 , a total of 259 bronchoscopes have
been done. (Table-43). These bronchoscpies were done with 423 different procedures .
The unit has helped in diagnosing the difficult cases like Lung cancer, ILD, Occupational lung
disease etc. The residents of the institute are being trained in performing the procedures.
5.0 RESEARCH ACTIVITIES:
Research is one of the primary objective of the institute. The following research studies are in
progress.
22
5.1 On going Research research :
Studies being carried out under DNB courses :
Sno. Title of the study
Date of Student
Guides
start
1
Profile of Patients failing Category –
Dr.SriNath Dr.R.Singla
I, Anti-Tuberculosis treatment under
RNTCP
2
Clinico Radiological and pathological
Dr.Balaji N Dr.S.K.Munjal
profile of TB in HIV sero positive and
Gungewad Dr.R.Sarin
sero negative patients.
3
Criteria of hospital admission under
Dr.Ruchi
Dr.R.Sarin
DOTS strategy
Arora
Dr.V.Vohra
4
To determine the pattern of sleep
Dr.Yogesh Dr.A.Jaiswal
disordered breathing in obese Indian
Gupta
Dr.Anil Jain
Subjects.
5
Prevalence of Anxiety and
Dr.Anil
Dr.S.B.Singh
Depression in Patients of COPD.
Kush
Dr.Lokender
6
Study the extent of delay in
OctDr.Nitin
Dr. Rohit Sarin
diagnostic and treatment under
2005
Rathi
Dr.Sushil Munjal
DOTS
7
Effect of Pulmonary Rehabilitation
on Morbidity in patients of COPD.
5.2 RESEARCH OTHER THAN DNB COURSE :
1) “ Evaluation of a modified cold ZN With the regular Z N method for its feasibility at rural
Primary Health Centre” started in 2005 in Department of Microbiology of the Institute .
2) To study the efficacy and safety of Levofloxacin containing regimen in pulmonary MDR TB
cases.
3) Cross section study of the prevalence of HIV infection among pulmonary TB patients
admitted in a tertiary referral TB institute.
4) Efficacy and Safety of Immunomodulator in Mycobacterium (Mw Vaccine) as an adjunct
therapy in Pulmonary tuberculosis (Cat. I).
5) Efficacy and Safety of Immunomodulator in Mycobacterium (Mw Vaccine) as an
adjunct therapy in Pulmonary tuberculosis (Cat. II).
6) Efficacy and Safety of Immunomodulator (Mycobacterium Mw) as an adjunct therapy in
MDR Pulmonary tuberculosis.
7). A comparative study of various quality control assessment methods under RNTCP at
NODAL centers (LRS Institute ).
23
6.0 PUBLICATIONS :
6.1 PAPERS AND ARTICLES PUBLISHED :
S.No
Author’s Name
Title of the Paper Published
1
Rajnish Gupta, V.K. Arora Pneumonia In Elderly
Journals/Month/Volume/Page No.
Physician's Digest, June-July, 2005;
14(2) : 82-93.
2
Singla R, Nazeer Khan, Influence
of
diabetes
on IJTLD 2006; 10: 74-79.
Nasser
Al-Sharif, manifestations and treatment outcome
Mohammed O Al-Sayegh, of pulmonary TB patients.
M.A. Shaikh, M. M.
Osman
3
Singla R, Arora VK
“Is it worth treating category I failure Ind JTub 2006; 53(2); 113-116.
patients with category II regimen?”
4
Sagrika Holder,Manpreet “Detection of Acid Fast Bacilli in post Journal of clinical microbiology, JulyBhalla,Shuamasre
liysis Debris of clinical specimens 2005,Vol.43, No.7 pp 3580-3581.
Majumdon,J.S.Tyagi,V.K. improves the reliability of PCR “clinical
Arora
evaluation of PCR in the diagnosis of
tuberculosis.
Papers Accepted for Publication :
1
Singla R, Kumar A, Endobronchial tuberculosis Presenting Accepted for publication in Indian J of
Chauhan D, Juneja D, as tumorous mass.
Chest Dis and Allied Sci.
Tyagi VN, Arora VK.
2.
P. Vaisalakshi
A Simple drug susceptibility testing of Accepted for publication in IUATLD
M. Tuberculosis to Isoniazid and
Rifampicin by a NRA applied directly
on Microscopy positive sputum
sample
24
6.2 Chapters in the book” Practical Approach to Critical Respiratory Medicine, Sleep Disorders and Fibroptic
Bronchoscopy” edited by Editors: Arora VK, Arora R Published by Jayee Brothers, Medical Publishers (P) Ltd.
2006;
S.No
Name of the Chapter
Author’s Name
1
Management of Pneumonia in Elderly in ICU
Rajnish Gupta, V.K.Arora,
2
Pneumonia In Elderly
Rajnish Gupta, V.K. Arora
3
Anti-TB Drugs, Liver and Desensitization
V.K. Arora, Rajnish Gupta,
4.
Interpretation of Polysomnography and Management of Obstructive VK Arora, Rajnish Gupta, Arora R
Sleep Apnea Hypapnoea Syndrome
5.
Intermittant Short Course Chemotherapy and DOTS”
M.M.Puri
7.0 Presentations during Conferences/Seminars/Workshops :
Details of Presentations :
S.No. Title of the Paper Presented
1
Dr. V.K.Arora delivered a lecture on "Assessment of a Respiratory
Critically ill Patient".
2
Dr. V.K.Arora delivered a lecture on "Basics of Polysomonography"
3
4,
5.
Venue
"Respiratory Critical Care" CME
Organised at LRSI
"Pulmonary Sleep Medicines"
CME organised at LRSI
Dr. V.K.Arora and Dr.Rajnish delivered a lecture on "Sleep related "Respiratory Update" organised
Respiratory Disorders" in Clinical Practice
at LRSI
Dr. V.K.Arora delivered a lecture "Analysis and Interpretation of During Training Course in
Sleep Study"
Operation of Sleep Lab"
organised at LRSI (31/12/05 9/1/06)
Dr. R.Sarin delivered a Talk on “RNTCP and Childhood TB” during New Delhi
PEDICON 2006
25
Dates
21/8/2005
4/9/2005
13/11/2005
5/1/2006
5-8 January
2006
Contd. Details of Presentations
S.No
Title of the Paper Presented
6.
Dr. R.Sarin delivered a Guest Lecture on “DOTS PLUS” in the Lucknow
NATCON 2006
7.
Dr. R.Sarin presented Paper “DOTS-Plus – An Urban Experience” Lucknow
during NATCON 2006
8.
Dr. P. Vaisalakshi presented "A simple inexpensive, rapid method
of DST for M. Tuberculosis to Isoniazid and Rif. by NRA method
by Directly on sputum smear positive "
Dr.M.M.Puri presented :” Non Invasive ventilation in Respiratory
Disorders “
Dr.M.M.Puri presented “ Lung changes in Elderly and
Management of Common respiratory diseases in elderly”
Dr.M.M.Puri presented CPAP titration and Interpretation of
Polysomnography report “
Dr.M.M.Puri presented “ Pulmonary Rehabilitation in the
management of COPD “
9
10
11
12
13
14.
Venue
Sri Ram Chandra Medical
College and Research
Institute, Chennai
CME –“Respiratory Critical
Care” held at LRS Instt.
DGHS HQ. 23.11.2005
During Polysomnography
training at LRS Instt.
60Th National Conference of
TB and Chest Diseases,
Lucknow
HIV congress-2006
Dr.M.M.Puri presented “Disseminated Lymphadenopathy with
Intracranial spread in HIV seropositive patients”
Mr.P.P.Sharma, presented " Statistical modelling to assess the Conference of Indian Society for
trends on annual risk of tuberculosis infection "
Medical Statistics held at
Jawahar Lal Nehru Medical
college,Belgaum,.
26
Dates
23-26
February
2006
23-26
February
2006
22.10.06
21.8.2005
6.1.2006
23-26Feb
2006
10-12
March,2006
19-22nd
Jan.2006
8.0 Conference /Workshop/Seminar/Training attended :
Details of Conference/Workshop/Seminar/ Training attended:
S.No
Name of the
Name of Conference/Workshop/Seminar/
Participant
Training attended
1
Dr. R.Singla
Represented LRS Institute in meeting on
“PETTS” project at 36th UNION World
Conference on Lung Health.
2
Dr. R.Singla
Attended at 36th UNION World Conference on
Lung Health
3
Dr. R.Singla
Chaired a session on “Respiratory Update
4
Dr. R.Singla
5
Dr. R.Singla
6
Dr. R.Singla
7
Dr. R.Singla
8
Dr. R.Singla
9
Dr. R.Singla
Participated as Panelist in a Panel dicussion
on “DOTS programme – a critical review” at
NAPCON 2005
Chaired a session on “Respiratory Infections
in non-HIV immunocompromised host” at
NAPCON 2005.
Presented a paper on “ Pre-operative PFT
Criteria for Lung Resection Surgery : Indian
Perspective” at NAPCON 2005
Organized “Pulmonary Update” jointly with
Delhi Doctors association
Venue
Dates (From - to)
Paris, France
19th October 2005.
Paris, France.
18th to 22nd October 2005
LRS Institute of TB and
Res. Diseases, New Delhi
Kolkata.
13th November 2005.
Kolkata
17th November 2005
Kolkata.
19th November 2005
LRS Institute of TB and
Res. Diseases, New
Delhi.
Chaired a session on “RNTCP in context of
LRS Institute of TB and
Paediatrics and Radiology in Paediatric TB” in Res.Diseases, New Delhi.
PEDOCON 2006 in workshop.
Participated in Panel discussion “RNTCP in
LRS Institute of TB and
context of Paediatrics” in PEDOCON 2006
Res.Diseases, New Delhi.
27
19th November 2005
24th December 2005
4th January 2006 at
4th January 2006 at
Cotd. Name of Conference/Workshop/Seminar/ Training attended:
S.No
Name of the
Name of Conference/Workshop/Seminar/
Participant
Training attended
10
Dr. R.Singla
Delivered lecture on “TB control among
HCWs: what need to be done” in conference
“HIV/AIDS and TB: Past, Present and Future:
2006.”
11
Dr. R.Singla
Chaired a session on “Bronchoscopy in ICU:
early vs late” in “1st National Conference on
Current Perspective of Pulmonary infections”
12
Dr. R.Singla
Chaired a session on “Rigid Bronchoscopy” in
CME
13.
Dr. R.Singla
Attended National Level meeting for
Formulating treatment and management
guidelines for MDR-TB cases under RNTCP
14
Dr.R.Sarin
Attended National Level meeting for
Formulating treatment and management
guidelines for MDR-TB cases under RNTCP
15
Dr.R.Sarin
Attended workshop on Monitoring & Evaluation
for National TB Programme Managers
16
Dr.R.Sarin
attended conference NATCON – 2006
17
Dr.R.Sarin
18
Dr.Rajneesh
Gupta
Dr.Rajneesh
Gupta
19
Venue
Dates (From - to)
Organised by AIIMS Golden
Jubilee Celebrations in Delhi
13th January, 2006.
New Delhi
4th September 2005.
LRS Institute of TB and
Res.Diseases, New Delhi
28th August, 2005.
New Delhi
11th & 12th April, 2006
New Delhi
30th January to
02nd February 2006
23-26 Feb. 2006
Lucknow
Attended 2nd INDO-US CME on Antiretroviral AIIMS, New Delhi
Treatment in HIV / AIDS (AIIMS – UCLA
Collaborative Project)
Attended and acted as CME Coordinator of Organised by LRSI at LRSI
Respiratory Critical Care CME
Attended and acted as CME coordinator of Organised by LRSI at LRSI
Pulmonary Sleep Medicine CME
28
4-5 March 2006
21/8/2006
4/9/2006
Cotd. Name of Conference/Workshop/Seminar/ Training attended:
Sr
Name of the
Name of
Venue
No.
participant
Conference/Workshop/Seminar/
Training attended
20
Dr.Rajneesh Gupta
Attended "Respiratory Update" Organized jointly by LRSI and IMACME
SD
21
Dr.Rajneesh Gupta
Attended and Chaired a session in Vardhman
Mahavir
Medical
Sleepcon 2005 at National College and Safdar jang Hospital,
Conference cum workshop on New Delhi
sleep disorder on 11/12/05
22
Dr.Rajneesh Gupta
Attended and Chaired Session in Organised by LRSI and Delhi
"Pulmonology Update"
Doctors Association at LRSI
23
Dr.Rajneesh Gupta
Attened "Course cum Workshop" Organised
by
Indian
Sleep
on Polysomnography and Related Disorders Association in aboration
Procedures
with Tyco Health Care at New Delhi
24
Dr,P.Vishalakshi
Brain showing workshop on
International Centre for genetic.
Tuberculosis
Engineering, Boitech, New DelhiLRS Institute.
25
Dr,P.Vishalakshi
National Conference of Pediatric
Sri Ram Chandra Medical College
CME XXXIX Annual Conference
and Research Institute
of IAMM
26
Dr,P.Vishalakshi
CME . HIV Newer concept Delhi
Rockland Hospital
Chapters of IAMM
27
Dr,P.Vishalakshi
Training for external Quality
assurance
NTI , Banglore
29
Dates (From - to)
13/11/2005
7-11th Dec, 2005
24/12/05
10-11th Feb.,2006
May 19-21 2005
Oct.19-23 2005
Oct. 19th 2005
(5 days) Sept.
2005
9.0
VARIOUS COMMITTEES:
In order to streamline the various activities of the institute the Director has constituted
different committees headed by Senior Officers of the institute. These Committees are as
under (as per circular No.Adm/2/2004/700, 22.05.2004)
9.1
PURCHASE COMMITTEE (GENERAL STORE)
Dr. M. M. Puri
Chairman
Dr. Ashwini Kumar
Member
Dr. Sanjay Singh
Member
Dr. Vikram Vohra
Member
Sh. B. B. P. Agarwal
Member
9.2
PURCHASE COMMITTEE (MEDICAL STORE)
Dr. Sanjay Gupta
Chairman
Dr. Anil Kumar Jain
Member
Dr. Kapil Kumar Mathuria Member
Sh. B.B.P. Agarwal
Member
9.3
PURCHASE COMMITTEE (HOSPITAL DIET)
Dr. Kamla Verma
Chairman
Dr. Anil Kumar Jain
Member
Mrs. T. Percy
Member
Sh. B.B.P. Agarwal
Member
9.4
ESTATE COMMITTEE
Dr. V. P. Myneedu
Dr. M.P. Arora
Dr. Sanjay Singh
Er. R.D. Madan
Sh. N. Singh
Chairman
Member
Member
Member-Secretary
Member
MEDICAL BOARD
Dr. Upasna Agarwal
Dr. Kapil Kumar Mathuria
Dr.Devesh Chauhan
Dr.Rajneesh Gupta
Chairman
Member
Member
Member
9.5
9.6
MEDICAL RE-IMBURSEMENT BOARD
Dr. Kamla Verma
Chairman
Dr. Rakesh Agarwal
Member
Dr. Lokender
Member
Dr. Ashwini Kumar
Member
30
9.7
LIBRARY COMMITTEE
Dr. S. K. Munjal
Dr. Sangeeta Sharma
Dr. S.B.Singh
Sh. G. V. Raju
Shri A.K. Srivastava
Chairman
Member
Member
Member
Member
9.8
CONDEMNATION COMMITTEE
Dr. S. K. Munjal
Chairman
Dr. S.B.Singh
Member
Mrs. T. Percy
Member
Sh. Vijay Khera
Member
9.9
TRAINING COMMITTEE
Dr. Rohit Sarin
Dr.Khalid
Dr. Sanjay Gupta
Dr. Visalakshi
Dr. Neeta Singla
Sh. M. B. Naidu
Chairman
Member
Member
Member
Member
Member
9.10
HOSPITAL INFECTION CONTROL COMMITTEE
Dr. V. P. Myneedu
Chairman
Dr. Rakesh Agarwal
Member
Dr. Upasna Agarwal
Chairman
Dr. Sanjay Gupta
Member
Mrs. Rita V. Lyall
Member
9.11
HOSPITAL WASTE MANAGEMENT COMMITTEE
Dr. Rohit Sarin
Chairman
Dr. Ashwini Kumar
Member
Dr. Lokender
Member
Dr. Vikram Vohra
Member
Mrs. T. Percy
Member
9.12
HOSPITAL DISPOSAL COMMITTEE
Dr. Ashwini Kumar
Chairman
Dr. Sanjay Singh
Member
Ms. Rita V. Lyall
Member
Sh. B.B.P. Agarwal
Member
9.13
TRANSPORT REPAIR COMMITTEE
Dr.Khalid
Chairman
Dr. Kapil Kumar Mathuria Member
Sh. G.V. Raju
Member
9.14
EQUIPMENT REPAIR COMMITTEE
Dr. Kumud Gupta
Chairperson
31
Dr. Anand Jaiswal
Dr. Visalakshi
Dr.Rajnish Gupta
Dr. Kapil Kumar Mathuria
Member
Member
Member
Member
9.15
ANNUAL REPORT COMMITTEE
Dr. Kamla Verma
Chairperson
Dr. Rajnish Gupta
Member
Dr. Vikram Vohra
Member
Sh. G.V. Raju
Member
Sh. P. P. Sharma
Member
Sh.B.R.Goomer
Member
9.16
COMMITTEE TO LOOK INTO THE COMPLAINTS OF SEXUAL HARASSMENT
Dr. Kamla Verma
Chairperson
Dr. Neeta Singla
Member
Dr. Pratibha Mishra
Member
Mr. G. V. Raju
Member
Ms. T. Percy
Member
9.17
COMMITTEE FOR BETTERMENT OF THE SERVICES TO BE TAKEN FROM THE
CANTEEN CONTRACTOR
Dr. Khalid U.Khayam
Chairman
Mr. M. B. Naidu
Member
Sh.B.R.Goomer
Member
9.18
HINDI PROTSAHAN COMMITTEE
Dr. Anand Jaiswal
Chairman
Sh. V. K. Jain
Member
Junior Hindi Translator
Member
Sh. Kuldeep Upadhyaya Member
9.19
WELFARE COMMITTEE
Sh.B.R.Goomer
Convenor
Dr. Pratibha Mishra
Member
Sh. N. Singh
Member
9.20
HOUSE ALLOTMENT COMMITTEE
Dr. Kamla Verma
Chairperson
Dr. Sanjay Gupta
Member
Sh.B.R.Goomer
Member
Sh. B.B.P. Agarwal
Member
9.21
COMMITTEE FOR ADVANCE ON ESTABLISHMENT MATTERS
Dr. R.K. Dewan
Chairman
Sh. V. K. Jain
Member
Sh. B.B.P. Agarwal
Member Secretary
Sh. Vijay Bhatt
Member
32
9.22
PUBLIC GRIEVANCE COMMITTEE
Dr. V. P. Myneedu
Chairman
Dr. Anand Jaiswal
Member
Dr. Khalid
Member
Sh.B.R.Goomer
Member
9.23
RESEARCH COMMITTEE
Dr. V. K. Arora
Chairman
Dr. Rohit Sarin
Member
Dr. R.K. Dewan
Member
Dr. M.M. Puri
Member
Dr. Ashwini Kumar
Member
Dr. Visalakshi
Member
Dr.Upasana Agarwal
Member
9.24
ETHICAL COMMITTEE
Dr. V. K. Arora
Dr. Rohit Sarin
Dr. Pratibha Mishra
Dr. Thangsing Chinkolal
Ms. Sudha Srivastava
Chairman
Member
Member
Member
Member
9.25 DISASTER MANAGEMENT COMMITTEE
Dr.Rohit Sarin
Dr. Rajnish Gupta
Sh.B.R.Goomer
Mrs. Rita V.Lyall
Sh.S.N.Punia
Chairman
Member
Member
Member
Member
9.26 TENDER OPENING COMMITTEE
Dr.M.P.Arora
Dr. Vikram Vohra
Nominee of Accounts Section
Nominee of Administrative Section
Chairman
Member
Member
Member
33
Table-1 :
Chest Symptomatics (NEW OPD registrations)at LRS-OPD- (Out patients data-i)
(April-2005- March-2006 )
LOCALITY
Specified area of the Instt.
Symptomatics
Symtomatics visited at RNTCP DOTS centres directly.
Patients from DOTS area visited
LRS-OPD directly.
Beyond specified area of
the Instt.
10580
16666
48.9%
NON AREA
9491
27.8%
OUT SIDE from Delhi
7935
23.3%
Total symptomatics
34
34092
44672
Table-2 :
Total TB cases Diagnosed, Referred and Registered out of total new symptomatics
(April-2005- March-2006 )
Patients visited from
Symptomatic
s only at LRS
OPD
TB
cases
diagnosed
at
LRS -OPD
(Out patients data-ii)
TB cases referred out TB cases registered in TB registers
from LRS Instittute after for follow up treatment at LRS-OPD
diagnosis
to their
respective chest clinics
for DOTS treatment
(Patients not registered in
LRS TB registers)
Area (patients from specified area
of the Instt.)
16666
2769
2769
None of the area cases were
registered for follow up, all are
referred to RNTCP for (DOTS or
Conventional treatment)
Non Area (Non specified area of
the Instt.)
9491
1907
1313
594
Outsider (outside from Delhi)
7935
1580
742
838
34092
6256
4824
1432
(100%)
(18.3%)
(77%)
(23%)
TOTAL
(100%)
35
Table-3 :
Patients referred to DOTS centres and Neighbouring states for further treatment after diagnosis at
LRS : HEALTH EDUCATION DATA (Contd.) (April-2005- March-2006 )
Details
Adults
Sp+ve
a)
Sp-ve
Children
Ept
Sp+ve
Sp-ve
TOTAL
Ept
DOTS patients guided and referred to the LRS-DOTS centres:
Those who came directly to LRS-OPD
1140
542
708
34
99
152
2675
Those who were already registered at
DOTS centres and referred to LRSOPD
31
22
29
0
3
9
94
b)
Patients guided and refered to the Other- DOTS centres in Delhi and neighbouring states:
Referred to NON AREA DOTS centres
600
320
283
16
38
56
1313
Referred to neighbouring states (OUT
SIDE Delhi)
419
134
121
9
32
27
742
2190
1018
1141
59
172
244
4824
45%
21%
24%
1%
4%
5%
100%
Total patients referred from LRS:TOTAL
36
Table-4 :
HEALTH EDUCATION DATA : (April-2005- March-2006 )
Sno
Category of patients imparted Health Education
TOTAL
i
Health Education to New & Follow up TB patients in the OPD
663
ii
No. of patients imparted Health Education in the wards
1676
iii
Patients who were referred to other chest clinics also imparted health education
3056
Total number of Patients imparted health education
Table-5 :
5395
Disease wise distribution of TB cases registered for treatment
(April-2005- March-2006 )
TB cases registered from (Locality)
PT
Adult
(Out patients data-iii)
EPT
Children Adult
Total TB Cases
Children
Adult
Children
Total
Non Area
435
21
125
13
560
34
594
Outsider
708
19
98
13
806
32
838
1143
40
223
26
1366
66
1432
(17%)
1432
327
3968
Sub Total (LRS OPD)
1183
DOTS(RNTCP)Centres Treatment
2788
(83%)
324
37
249
1180
(100%)
651
4619
(AREA cases)
3112
TOTAL (LRS+DOTS)
(67%)
1507
4295
(33%)
4619
1756
(100%)
6051
Table-6 : Sputum wise distribution of PULMONARY TUBERCULOSIS cases registered (Out patients data-iv
(April-2005- March-2006 )
Patients from
Adults
Male
Children
Female
Male
Female
Sputum+
ve
Sputum ve
Total
Pos.
Neg.
Pos.
Neg.
Pos.
Neg.
Pos.
Neg.
Non Area
202
108
71
54
2
6
10
3
285
171
456
Outsider
397
144
111
56
3
6
7
3
518
209
727
Sub Total
599
252
182
110
5
12
17
6
803
380
1183
DOTS(RNTCP)
1198
564
671
355
18
126
59
121
1946
1166
3112
TOTAL(LRS+DOTS
1797
816
853
465
23
138
76
127
2749
1546
4295
38
Table-7 : Distribution of EXTRA PULMONARY TUBERCULOSIS Cases registered for treatment from LRSOPD
(April-2005- March-2006 ) (Out patients data-v)
Patients visited from
ADULTS
CHILDREN
TOTAL
Male
Female
Mc
Fc
Male
Female
Total
NON-AREA
82
43
4
9
86
52
138
OUTSIDER
73
25
8
5
81
30
111
155
68
12
14
167
82
249
785
1507
TOTAL
223
DOTS (RNTCP)
TOTAL(LRS+DOTS)
586
26
594
136
191
1180
327
1403
353
39
249
722
1507
1756
Table-8 : Distribution of Sites of EPT cases from (April-2005- March-2006 )
(Out patients data-vi)
Sites of EPT cases
LRS OPD
DOTS centres
No.
%
No.
%
Lymphadenitis
32
13%
835
55%
Pleural Effusion
61
24%
374
25%
Empema
30
12%
6
0%
Pneumothorax
65
26%
5
0%
Pyopneumothorax
3
1%
0
0%
Abdominal TB
14
6%
113
7%
Skeletal (Bone/Joint) TB
19
8%
103
7%
Genital TB( Endometritis/Urogenital)
0
0%
20
1%
CNS( Tuberculoma/Menengitis)
2
1%
26
2%
Milliary
7
3%
11
1%
Others (Eye/Skin/etc)
16
6%
14
1%
TOTAL EPT cases
249
100%
1507
100%
40
TABLE-9 :AGE & SEX DISTRIBUTION OF TB CASES REGISTERED -(April-05 to March-06)(Out patients data-vii)
L.R.S. OPD cases
CHILD
REN
Age group
M
F
M
F
Sub
Total
(i)
5
1
4
4
14
51
27
30
39
147
161
6-10
3
3
6
2
14
51
52
54
63
220
234
11-14
9
19
2
8
38
42
101
52
89
284
322
17
23
12
14
66
144
180
136
191
651
717
15-24
168
85
54
27
334
526
465
242
255
1488
1822
25-34
203
105
37
20
365
464
293
176
193
1126
1491
35-44
205
51
32
9
297
352
129
96
81
658
955
45-54
147
30
18
6
201
229
66
41
40
376
577
55-64
83
11
8
4
106
126
42
21
19
208
314
>=65
45
10
6
2
63
65
31
10
6
112
175
Sub Total (b)
851
292
155
68
1366
1762
1026
586
594
3968
5334
868
315
167
82
1432
1906
1206
722
785
4619
6051
4619
6051
<= 5
Sub total(a)
ADUL
TS
TOTAL (a)+(b)
PT
DOTS Centres cases
1183
EPT
249
1432
41
PT
EPT
M
F
M
3112
1507
F
Sub
Total
(ii)
TOTAL
(i)+(ii)
TABLE-10 :- AFTERNOON SPECIAL CHEST CLINICS (NON TB ) :
(April-2005- March-2006 )
Sno
Name of the Clinic
15.
Clinic for Sarcoidisis,Interstitial Lung Disease and Disease of unknown origin
16.
Lung Cancer Clinic
22
19
41
17.
Bronchial Asthma Clinic
23
485
508
18.
Clinic of Chronic airway Disease
30
686
716
19.
Clinic for HIV and Tuberculosis
55
154
209
20.
Clinic for Empyema and Surgical Patients
694
1462
2156
21.
Sleep Clinic
23
69
92
22.
Clinic Occupational Lung Disease/ Silicosis
8
15
23
ix
x
xi
xii
xiii
xiv
xv
Pain management clinic
Paed. Bronchial Asthama clinic
Clinics for laser therapy
LTOT Clinic
Pul. Rehablitation Clinic
Smoking Cessation clinic
Desensitization of Asthama Patients Clinic
TOTAL
21
48
32
10
13
4
4
994
9
307
489
27
51
7
3
3802
30
355
521
37
64
11
7
4796
42
New Follow
up
7
19
Number of
patients
26
Table-11: Total Patients in OPD (OPD Load) (April-2005- March-2006 )(Out patients data-ix)
No
Details of patients visited
Adults
Children
M
F
MC
FC
Total
% of
Patients
i
New OPD registration of patients
19632
10615
2176
1669
34092
28.7%
ii
Subsequent visits by patients for
diagnosis
34704
21780
3709
2568
62761
52.9%
iii
Follow up visits made by TB cases
after diagnosis
11304
5246
272
279
17101
14.4%
iv
Follow up visits made by Non-TB
patients after diagnosis
3196
1055
306
156
4713
4.0%
TOTAL Patients in the OPD
68836
38696
6463
4672
118667
100.0%
No. of Working OPD Days in the year
301
Average Number of New Patients per day
113
Average number of total patients in OPD per day (OPD load)
394
43
Table-12: Age & Sex distribution of the patients Admitted & Discharged during (April-2005- March-2006 )(Indoor data-i)
Age groups
(Yrs.)
Admission
Discharge
Male
Female
Total Admission
Male
Female
Total Discharge
0-5
29
29
58
29
24
53
6-10
33
20
53
33
25
58
11-14
53
67
120
42
66
108
115
116
231
104
115
219
15-24
422
318
740
433
309
742
25-34
547
343
890
526
347
873
35-44
674
207
881
682
207
889
45-54
569
170
739
574
163
737
55-64
401
102
503
388
99
487
>=65
263
72
335
246
70
316
Total Adults
2876
1212
4088
2849
1195
4044
TOTAL patients
2991
1328
4319
2953
1310
4263
CHILDREN
Total children
ADULTS
44
Table-13 : Distribution of outcome of indoor patients treated in the hospital
(April-2005- March-2006 ) (Indoor data-ii)
Outcome
Adults
PT
Children
TOTAL
EPT
NTB
PT
EPT
NTB
PT
EPT
NTB
Grand
Total
%age
i
Discharge
1213
309
914
54
51
59
1267
360
973
2600
61%
ii
LAMA
229
28
93
6
4
4
235
32
97
364
9%
iii
D.O.R.
175
18
78
2
2
0
177
20
78
275
6%
iv
Absconded
124
13
47
2
1
3
126
14
48
188
4%
v
Referred
70
48
183
5
5
12
75
53
195
323
8%
vi
Died
367
46
89
8
1
0
375
47
89
511
12%
2178
462
1404
77
64
78
2255
526
1482
4263
100%
54%
11%
35%
35%
29%
36%
53%
12%
35%
TOTAL
4044
219
45
4263
Table-14 : Categorywise distribution of Pulmonary Tuberculosis cases (April2005- March-2006 ) (Indoor data-iii)
Category
Adults
Children
Total
No.
Percent
Cat -I
682
33
715
32%
Cat-II
1096
37
1133
50%
Cat-III
28
1
29
1%
Other than CatI,II,III(Conventional/Reserve
Drugs etc.)
372
6
378
17%
2178
77
2255
100%
TOTAL
46
Table-15 :
Sputum Status of discharged Pulmonary TB cases (Excluding
LAMA/DOR/Absconded and Deaths)
(April-2005- March-2006 ) (Indoor data-iv)
(a)
Total discharged PT cases
2255
(b)
Cases excluded from analysis
(LAMA(235)+DOR(177)+Absconded(126)+Referred
out(75)+Deaths(375) =
988
(c)
Sputum report not available at discharge
208
(d)
Data analysed for Sputum status at admission and discharge
{(d)=(a)-(b+c)}
1059
Those who were Positive at Admission:
( 807)
Number of patients who were Positive at admission and remained
Positive at Discharge
Number of patients who were Positive at admission and converted to
Negative at Discharge
Those who were Negative at Admission:
567
(70%)
240
(30%)
(250)
Number of patients who were Negative at admission and remained
Negative at Discharge
Number of patients who were Negative at admission and became
Positve at Discharge
47
244
(98%)
6
(2%)
Table-16 : Complications in Pulmonary Tuberculosis cases (Indoor data-v)
(April-2005- March-2006 )
Complications
Number of Patients
TOTAL
Percentage
Children
Adult
Pneumothorax
1
34
35
1.6%
Pyopneumothorax
5
104
109
4.8%
Empyema
0
32
32
1.4%
Lung Abscess
1
28
29
1.3%
No Complications
70
1980
2050
90.9%
Total
77
2178
2255
100.0%
Table-17: Distribution of Extra Pulmonary Tuberculosis cases (EPT)
(Indoor data-vi) (April-2005- March-2006 )
Type of cases
Adults
Children
Total
Number
Percent
i
Lymph Node
34
4
38
7.2%
ii
Pleural effusion /Empyema
291
26
317
60.3%
iii
Abdominal Koch's
41
11
52
9.9%
iv
Milliary
19
6
25
4.8%
v
Pericardial Effusion
4
1
5
1.0%
vi
Skeletal (Bone & Joints)
11
5
16
3.0%
vii
Tubercular
Meningitis(CNS)
19
7
26
4.9%
viii
Others
43
4
47
8.9%
462
64
526
100.0%
TOTAL
48
Table-18 : Distribution of Admitted Non Tubercular cases (Indoor data-vii)
(April-2005- March-2006 )
Types of Non Tuberculosis
Adults
Children
Total
Number
Percent
COPD
494
0
494
33%
Lung Carcinoma
157
1
158
11%
Interstitial Lung Disease
19
1
20
1%
Pneumonia
55
8
63
4%
Empyema (Non Tubercular)
91
16
107
7%
Bronchiectasis
85
3
88
6%
Corpulmonale
16
2
18
1%
Pneumothorax
30
2
32
2%
Bronchial Asthma
33
12
45
3%
Lung Abscess
15
0
15
1%
Sarcoidosis
5
0
5
0.337%
Tropical Pulm Eosin (TPE)
7
4
11
0.742%
Others
397
29
426
29%
TOTAL
1404
78
1482
100%
49
Table-19 : Detection of HIV among the suspected admitted patients
(Indoor data-viii)
(April-2005- March-2006 )
HIV test Status
Adult
TOTAL
TOTAL
Male
Female
Male
Children
Female
Chidren
62
19
1
1
252
27
34
977
271
28
35
1060
Positive
Negative
Children
664
726
997
63
50
83
(7.8%)
Table-20 : Distribution of Pulmonary Tuberculosis Cases as per treatment
given (Indoor data-ix) (April-2005- March-2006 )
Treatment Type
Adult
Children
Total
Number
Percent
Conventional
141
0
141
6%
SCC
1515
58
1573
72%
DOTS
260
14
274
12%
Reserve Drugs
192
4
196
9%
TOTAL PT cases Started treatment
2108
76
2184
100%
Trement not started due to early
DISCHARGE(30),LAMA(5)
DOR(5),ABSCONDED(8),
REEFERRED OUT(3),DIED Before
Treatment started (20)
71
0
71
3%
2179
76
2255
100%
Total PT cases
Table-21 : Details of I.C.U. Admissions : (April-2005- March-2006 )
Medical patients admitted (ADULTS)
234
Medical patient admitted (Paediatrics)
6
Surgical patients admitted
491
251
No. of Deaths in I.C.U.(Already included in total deaths in the instt.)
48
Number of patients on Invasive ventilation
67
Number of patients on NON Invasive ventilation
67
Number of ECG done
269
Number of ABG done
2352
Central line input
8
Defibrilator
3
51
Table-22 (a) : THORACIC MAJOR CHEST SURGERY
(April-2005- March-2006 )
i
Pneumonectomy
9
ix
Rib resection
16
ii
Lobectomy
28
x
PC Window
133
iii
Thoracoplasty
21
xi
Buloectomy
3
iv
Thoracotomy
27
xii
Others
8
v
Decortication
33
xiii
Open Lung Surgery
1
vi
Gastrostrormy
1
vii
VATS / (VATS+Thorocotomy)
13
viii
VATS+Totacoscopy
17
TOTAL
310
TOTAL MAJOR PROCEDURES =
Table-22 (b): THORACIC ENDOSCOPIC PROCEDURES (April-2005- March-2006 )
i
Bronchoscopy  GA
30
ii
Bronchoscopy  LA
90
iii
Videoscopy  LA
TOTAL
120
52
Table-22 (c) : THORACIC MINOR PROCEDURES SURGERY STATISTICS
(April-2005- March-2006 )
PROCEDURES :
NO.
i
Intercostal Tube drainage
342
ii
FNAC
1111
iii
Pleural Aspiration
995
iv
Change of I.C.D.
432
v
Excision Biopsys  LA
31
Excision Biopsys  GA
I & D  GA
vi
136
I & D  LA
vii
Pleural Biopsy
viii
Others
6
921
TOTAL MINOR PROCEDURES =
Table-23 : Number of X-ray done
3974
(April-2005- March-2006 )
Film Sizes
Number
70MM
3706
100x100MM in Mobile Van
1924
100x100 Cut film
644
8x10
2022
10x12
4288
12x15
23080
14x14
3753
a) Total No. of X-rays done
39417
b) Special procedures:
i) Barium Swallow
14
ii) Barium follow through
8
53
TOTAL Special procedures
22
54
Table-24 : Number of Ultrasound done
(April-2005- March-2006 )
a)
Chest
2311
b)
Abdomen
2349
c)
Ultrasound guided FNAC
96
Total Number of Ultrasound done
Table-25 : Number of CT SCAN done
4756
(April-2005- March-2006 )
a)
Chest
572
b)
Spine
8
c)
Head
141
d)
Abdomen
e)
CT Scan Guided
22
4
Total Number of C.T.SCAN Done
Free CT scan = (%)
747
Paid CT scan =(%)
55
Table-26: PULMONARYSMEAR MICROSCOPY (SPUTUM EXAMINATIONS)
(April-2005- March-2006 )
SOURCE OF SAMPLE
OPD
Diag
nosis
Sputum
smears made
for
microscopy
Sputum smears
confirmed by
Microscopy
LRS RNTCP
(DOTS) Area
20973
20973
2658
12.7%
Non Area and
Outsiders
28477
20901
3993
14.0%
3674
2769
696
18.9%
53124
44643
7347
13.8%
10600
7600
2840
26.8%
8430
7834
2803
33.3%
Extra Pulmonary
1369
1369
91
6.6%
subtotal
18229
17037
5697
31.3%
81953
69280
15884
19.4%
Follow up
Total (a)
INDOOR
Culture
Section
(b)
Pulmo
nary
TOTAL (a)+(b)+(c)
OPD
Sputum
Positives
Percentage
positivity
Ward
(c)
Table-27 : CULTURE SECTION (PULMONARY SPECIMEN)
(April-2005- March-2006 )
Particulars
Total
Samples
Received
Conventional
Bactec
OPD
5899
3919
365
INDOOR
2396
1686
97
TOTAL
8295
5605
462
56
Table-28 : CULTURE SECTION (EXTRA PULMONARY SPECIMENS):
(April-2005- March-2006 )
S.No
.
TYPE OF TESTS
No.of
Specimen
Smear
Positive
Conventional
Culture
BACTEC
i
Pleural fluid
759
8
713
4
ii
Bronchial Washings
225
8
209
5
iii
Pus
305
43
276
6
iv
FNA
354
52
326
15
v
Pleural Pus
68
13
61
0
vi
Lymph Node aspirate
0
0
0
4
vii
Ascitic fluid
53
0
49
0
viii
Urine
9
0
9
1
ix
CSF
10
0
10
0
x
Tissue Lung Biopsy
9
0
8
1
xi
Pericardial fluid
0
0
0
0
xii
Others
2
0
3
3
1794
124
1664
39
TOTAL
57
Table-29 : BACTERIOLOGY ( PYOGENIC CULTURES):
(April-2005- March-2006 )
TYPE OF SAMPLES
NO.
TYPE OF SAMPLES
i
Sputum / Throat swabs
770
vii
ii
Bronchial washings
iii
iv
No.
Gastric Aspirates
6
103
Ascitic Fluid (AF)
11
Pleural fluid
104
ET
78
Pus
338
Stool
7
v
Urine
565
Others
48
vi
Lymphnode Aspirate
13
TOTAL Samples
2043
Table-30 : RESULTS OF OF PYOGENIC CULTURES : (April-2005- March-2006 )
Total number of samples =
RESULTS OF SAMPLES
NO.
RESULTS OF SAMPLES
i
Total Organisms
isolated
1389
vii
Normal FLORA
ii
Gram positive
456
viii
Insignificant GROWTH
3
iii
Gram negative
1034
ix
Mixed flora
1
iv
Candida
128
x
Double/triple growth
v
Sterile
348
vi
Contaminated
32
58
No.
315
174
Table-31 : MYCOLOLGY :
(April-2005- March-2006 )
TYPE OF SAMPLES
NO.
TYPE OF SAMPLES
No.
i
Sputm
154
v
Lymph node aspirate
5
ii
Bronchial washing
34
vi
Urine CSF
1
iii
Pleural fluid
1
vii
Urine FNAC
0
iv
Pus
9
viii
OTHERS/Urine swab
2
Table- 32 : NAME OF THE TEST FOR MYCOLOGY : (April-2005- March-2006 )
NAME OF TESTS
No.
NAME OF TESTS
NO.
i
KOH Mount
74
iv
Germ tube test
80
ii
LPCB mount
63
v
SDA agar
204
iii
Wet mount
74
vi
SDA cc Agar
45
Table- 33 : NAME OF FUNGUS IN MYCOLOGY TEST : (April-2005- March-2006 )
RESULTS OF SAMPLES
NO.
RESULTS OF SAMPLES
No.
i
Candida Albicans
47
xi
Aspergillus Niger
10
ii
Candida species
23
xii
Mucor
2
iii
Aspergillus species
7
xiii
Fungi isolated
113
iv
Aspergillus Fumigates
24
xiv
Contaminates
34
v
Aspergillus Flavus
11
xv
Sterile
40
vi
Aspergillus Terreus
10
xvi
C.Tropicals
3
59
Table -34
: IMMUNOLOGICAL TESTS
(April-2005- March-2006 )
TOTAL(Ward+OPD)
TESTS
Number
Positives
HIV 1 & 2
1704
109
Hbsag
239
10
Widal
227
81
2170
not applicable
TOTAL Immunology tests done =
Table-35 : BIOCHEMISTRY tests done during (Pathology Lab. data)
(April-2005- March-2006 )
SrNo
Type of tests
i
Blood Sugar
17422
14.7%
ii
Blood Urea
8832
7.4%
iii
Creatinine
9963
8.4%
iv
Total Bilirubin
11678
9.8%
v
Direct Bilirubin
12572
10.6%
vi
S.G.P.T.
12570
10.6%
vii
S.G.O.T.
12563
10.6%
viii
Alk po4
9704
8.2%
ix
Protein
7675
6.5%
x
Albumin
6019
5.1%
xi
Uric Acid
1172
1.0%
xii
Cholesterol
979
0.8%
xiii
Electrolytes
7590
6.4%
118739
100.0%
Total Tests
Number
% out of 118739
Total Number of samples = 30294
60
Table-36: HAEMATOLOGY tests done
(Contd. Pathology Lab. data )
(April-2005- March-2006 )
Type of tests
Number
% out of 51508
i
Total Haemoglobin
15206
29.5%
ii
Total T.L.C.
14914
29.0%
iii
Total D.L.C.
14914
29.0%
iv
Total E.S.R.
1610
3.1%
v
Total B.T.
111
0.2%
vi
Total C.T.
111
0.2%
vii
Total M.P.
933
1.8%
viii
Total Platelet Count
1109
2.2%
ix
Total A.E. Count
2125
4.1%
x
Total PS
461
0.9%
14
0.0%
51508
100.0%
xi
Others/ L.E.CELL
Total Tests
Total Number of samples =
15446
61
Table-37 : - CYTOLOGY test done
(Contd. Pathology Lab. data)
(April-2005- March-2006 )
Sr.No
CYTOLOGY TESTS
Number
%age out of
3778
I
Fine Needle Aspiration Cytology(FNAC)
1617
42.8%
ii
Pleural Fluid
940
24.9%
iii
Bronchial Washing
274
7.3%
iv
Sputum for Cytology
514
13.6%
v
C.S.F.
18
0.5%
vi
Pus
81
2.1%
vii
Ascitic Fluid
105
2.8%
viii
Bronchial brush washing (smear)
60
1.6%
ix
BAL
109
2.9%
x
TBNA
7
0.2%
xi
OTHERS
9
0.2%
xii
Urine (24 hr. protein)
44
1.2%
3778
100%
TOTAL
62
Table-38 :
HISTOPATHOLOGY tests done (Contd. Pathology Lab. data)
(April-2005- March-2006 )
Type of Histopathology tests
Number
%age out of
392
i
Pneumonectomy
9
2%
ii
Lobectomy
32
8%
iii
Lymphnodes biopsy
33
8%
iv
Bronchial Biopsy
100
26%
v
Pleural Biopsy
118
30%
vi
Cell Block
39
10%
vii
Lung Biopsy
2
1%
viii
True Cut Biopsy
16
4%
ix
Skin Biopsy
2
1%
x
others
41
10%
392
100%
TOTAL
63
Table-39 :
Number of Tuberculin tests done during (April-2005- March-2006 )
<1 yr
1-2
3-5
6-10
11-14
>14
Total
Total Treated
22
191
723
710
615
1799
4060
Total Read
19
166
664
646
558
1683
3736
Positive
3
36
172
221
241
890
1563
Negative
16
130
492
425
317
793
2173
PPD not read
3
25
59
64
54
116
321
Table-40 : Number of procedures done in Respiratory Laboratory (PFT Lab.)
during the period
(April-2005- March-2006 )
i
Spirometry
5193
ii
Reversibility
104
iii
Lung Volume
170
iv
Diffusion test
155
Total No. of PFT's done
5622
i
VTG
106
ii
Airway resistance with body Box
106
iii
Conductance with Oscilloscope
106
Total number of body Plethysmography
318
i
Total No. of ECG done
1971
ii
Total ABG
1696
iii
Nebulization
104
64
Table-41 : The training done during the period
(April-2005- March-2006 )
Categories
Number
i
DOCTORS
87
ii
Lab Technicians
12
Total
99
Table 42
: Voluntary Counselling and Testing Centre (VCTC)
(April-2005- March-2006 )
Adults
Children
TOTAL
M
F
MC
FC
Number of pretest counselling
1335
518
48
42
1943
Number of post test counselling
1256
461
40
35
1792
Number of patients refused
consent
7
0
0
0
7
Number of patients reported HIV
Positive
82
40
1
0
123
Remark if any :Table 43 : FIBREOPTIC BRONCHOSCOPY UNIT
:
(April-2005- March-2006 )
Number of Scopy done :
PROCEDURE CARRIED during Bronchoscopies:-
Number 259
i
Bro. Aspiration
225
ii
Bro. Brush
55
iii
Bron. biopsy
85
iv
Transbronchial biopsy
26
v
BAL
21
vi
Endo Bronchial needle Aspiration
0
vii
TBNA (Transbronchial Needed Aspiration)
11
TOTAL Procedures
423
65
Table 44: PHYSIOTHERAPY TREATMENT GIVEN DURING
(April-2005- March-2006 )
MALE
FEMALE
TOTAL
Number of patients attended OPD for
physiotherapy
913
656
1569
Number of calls attended from the
wards and ICU for physiotherapy
1940
942
2882
Total patients received physiotherapy
2853
1598
4451
Table 45 : Polysomnography data ( sleep lab. Study Data) :
(April-2005- March-2006 )
Number of cases =
Cases with Apnoeas
54
Obstructive
11
Central
0
Mixed
0
Cases with Hypopnoeas
Cases with significant RDI /hr.
16
Mild
16
Moderate
5
Severe
4
Cases with Noctural Hypoxaemia
5
Other findings
4
Cases put on CPAP Trial
13
66