VOL.NO.3 ISSUE NO.4 October 2001
Special Feature
Campus News
Sports
Campus Activities
Research
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We greet all our readers on the occasion of the silver Jubilee Celebrations of Pravara Medical Trust slated for 2001-2002. PMT was envisioned in 1972 and the first hospital was established in 1976 as a vehicle of health care service to the ru- ral people of Loni and the surrounding areas by Padmashri Vithairao Vikhe Patii. The Trust made rapid progress and has become a center of excel- lence and model for the rural upliftment and hu- man resource development. We salute all the founders, stalwarts and service providers of the trust for their invaluable contributions. This issue of the Newsletter contains selected topics chosen to include matters of current interest, relevant to the fields of medicine and medical education. With every passing day our understanding changes, new facts emerge and old ones are seen in new light. Medical Education and Medical Ethics are two such areas which are being debated and are considered to be in urgent need for review and remodelling. The articles "New Trends in Medical Education" and "New guidelines for Ethical Conduct of Doctors" are therefore timely and appropriate along with your popular pages of Campus News and Campus Activities.
Let the light of knowledge lead you while the lamps of "Diwaii" brighten up your homes.
Special Feature
Community Health Center, Pathare
The Center was inaugurated on 2nd October 2001 at the hands of Hon. Shri Vimlendra Sharan, District Collector, Ahmednagar presided by Shri Baburao Tatyaba Gholap Patil, President, Zilia Taleem Sangh , Ahmednagar , in the presence of Hon. Shri Radha Krishna Vikhe Patil , Ex. Minister for Agricul- ture & Irrigation, Govt. of Maharashtra and Dr. Ashok Patil , President of International Association of Agri- cultural Medicine & Rural Health and Chief Executive Officer of the Pravara Medical Trust, Loni.
Following are the facilities available at Community Health Center, Pathare.
Routine services
- Registration charges will be Rs. 5/ - (five only) for all the patients except children, senior citizen and those insured under Padmashree Vikhe Patil Gramin Arogya Vima Yojna.
- Free O P D consultation by Medical Officer and available specialists.
- Free medicines for minor ailments to all ( as per the list approved by the Medical Superintendent, PRH, Loni).
- Free medicines for diseases under National Health Programs. ( Tuberculosis, Leprosy, MCH y Malaria etc.).
- Free routine laboratory services ( 1-1b, Urine -albu- niin, sugar etc. slides for W, Sputwn, TLC, DLC will be, collected and send to PRR Loni
- Free procedures like minor suturing, 1 & D, first aid , dressing & bandage,injection facility, temporary splints before transfering to the Pravara Rural Hospital, Loni.
- Disposables like syringes, needles, 1 V sets etc. will be provided free to poor patients only.
- Monday - Department of Medicine
- Tuesday - Department of Surgery
- Wednesday - Reproductive and Child health services by OBS/Gyn & Pediatrics dept.
- Thursday - Department of Opthalmology
- Friday - Department of Orthopaedics
- Saturday - Department of Dentistry
- Emergency Patients will be provided free transport .as and when requirecl
- Patients referred by the R H C, Pathare will be trans- ported to PRH, Loni with the specialist teatn while re- turing from the center.
- Morning hours : 9.00 AM to 1.00 PM
- Specialist services : Morning From 9.30 AM to l2.30PM
- Emergencies: Roundtheclock - 24 hours.
- Patients referred from the RHC, Pathare , can avail the services at PRH, Loni as per the routine charges.
- Those patients who have Health Insurance Card will be treated free up to sum insured.
Campus Activities
MNGO-RCH Project Activities - July 2001 TO September 2001
Monitoring Visit by MNGO to approved FNGOs:
The MNGO had organized yearly evaluation visits to four Field NG0s supported with grant-in-aid, working in Aurangabad, Beed & Jalna districts during July 2001to, September 2001.The members of Technical Consultative Group of MNGO - Prof. K.V. Somasundaram, Dr. B.S. Payghan, Dr. R.C. Goyal and Mr. P.G.Dushing have carried out the visits to following NGOs.
- Satya Vishnu Charitable Trust, Aurangabad. 23.07,2001
- Society for Education in Values &Action Aurangabad. 24.07.2001
- Yuvagram Vikas Mandal, Dharur Road, Kaij, Beed 26.07.2001
- Bhumika Vishwasth Sanstha, Yelda, Beed. 27.07.2001
- Manushyabal Vikas Kehdra, Wahegaon 18.09.2001
- Satya Vishnu Charitable Trust, 18.09.2001 Aurangabad.
- Jeevan Vikas Sanstha, Paithan 19.09.2001
- Society for Education in Values & Action, Aurangabad. 19.09..2001
- Samarth Ramdas Swami Public Health, Education & Agricultural Development Sanstha, At : Ranjani (SCR) 26.09.2001
- Shri Gajanan Maharaj
Workshop for Field NGO
The Mother NGO had organized a tw.0-day workshop for all the nine Field NG0s implementing projects in their target areas for the year 2001-2002 on 12-13 July 2001. The main objective of the workishop was to share the experiences and solve the problems at the field level of the FNG0s Prof. Somasundaram, Project Director, welcomed the guests and participants. The workshop was inaugurated by Dr. Ashok Patil President, International Association of Agricultural Medicine and Rural Health. In his inaugural speech Dr. Ashok Patil has emphasized the importance of selfless and dedicated service of the field workers in successful implementation of any field level project Dr. R.C.Goyal, Prof. and Head, Dept. of PSM, gave the vote of thanks. All the teaching staff of Dept.of PSM. was actively involed in the work shop as resource persons. All the nine FNOGs representatives shared their experences and actively participated in the Workshop.
Release of First Installment of Grants-in-aid to approved FNG0s
The MNGO released the first installment of Grant- in-aid to the following five FNG0s for the year 2001 - 2002 :
"S.N. ***Name of the Field NGO *****Sanctioned First Amount Installment "
- Manushyabal Vikas Kendra, Wahegaon 1,49,200/- 44,700/-
- Jivan Vikas Sanstha, Paithan 1,50,880/- 45,200/-
- Jivandhara Sevabhavi Sanshta, Ambajogai 1,64,400/- 49,300/-
- Samarth Rar-ndas Swami Public Health Education & Agricultural Development Sanstha, At: Ranjani 1,02,100/- 30,800/-
- Shri Gajanan Maharaj Krishi & Shaik4hanik Sanstha, Umbarkhed, Tal: Dewalgaon Raja,Dist: Buldhana 1,50,350/- 45,100/-
Project Review & Sanction Committee Meeting
A Project Review and Sanction Committee meeting was held on 11.08.2001 under the Chairmanship of Dr. R.M.Barukha. Dr. G.S. Chinde, Asst. Director, Health Services, Pune, Dr. N.S. Mhaske, Trustee & Secretary, PMT attended the meeting. The meeting reviewed the performance of the Mother NGO and approved nine FNG0s activities from April 2000 to June 2001.The Committee has also approved the Project proposals of the following FNG0s for one year from August 2001.- Satya Vishnu Charitable Trust, Aurangabad
- Society for Education in Values & Action, Aurangabad
- Bhumika Vishwastha Sanstha, Yelda, Dist. Beed.
- Yuvagram Vikas Mandal, Kaij. Dist. Beed.
Pravara Medical Trust Organises Sant Gadge Baba Village Sanitation Drive
Department of Community Medicine (PSM) of Pravara Medical Trust, Loni, had organized various activities with the help Gram Panchayat Loni (BK) from 16th October to 20th October 2001. Following were the programs conducted.
1. 16/10/2001 Tuesday -Environmental Sanitation Education.
A team of 100 members consisted of staff & students from Medical (PSM Dept.), BSc. Nursing, General Nursing visited 450 houses covering a population of 2652 to explain about a) personal hygiene b) house hygiene c) surrounding sanitation d) waste disposal (solid & liquid) e) water purification & its importance f) village sanitation g) market sanitation . .
2. 17/10/2001 Wednesday - Environmental Sanitation Drive Rally (Prabhat Phery)
A total of 128 staff & students from Medical(PSM Dept.), BSc. Nursing, General Nursing and few village members took part in the procession. Procession started ftom Pravara Sahakari Bank through market to Balasahebnagar, Vithalnagar and concluded at Pravara Sahakari Bank. All the participants chanted various slogans on environmental and personal hygiene. Rangoli Competition was also organised during this event. It was inaugurated by Smt. Shalinitai Vikhe Patil.
3.18/10/2001 Thursday-Healthy Baby Competition.
A team consisting of Pediatricians, taff,and stu dents of general nursing conducted a healthy baby com- petition between 1 0.00 Am to 1.00 PM. The event was organized by the Department of Community Medicine and Gram Panchayat at Gram Panchayat hall of Loni(BK) for the children below 5 years of age. A total of 190 children participated in the competition. Scoring system based on various parameters were applied to judge the first , second & third ranking. B.Se. Nursing staffs & students arranged for the role play on various themes.
4.20/10/2001 Prize Distribution Ceremony.
All the parents were informed to assemble on 20th October 2001 at 9.30 AM to receive the prizes. Nine children were selected, three each from 0-1 years, 1-3 years & 3 -5 age group. Prizes were arranged by the PMT and were distributed at the hand of Dr. N.S. Mhaske Trustee & Secretary, PMT, Loni, Dr. K. C. Jain, Professor & Head, Department of Pediatrics , PRH, Loni and Police Patil, Loni(BK).
Reproductive & Child Health Scheme
A training workshop on Integrated Skill Development for Medical Officer working at various Government Primary Health Centres was organized from 03/0912001 to 15/09/2001 by the department of the Community Medicine , Rural Medical College , Loni assisted by the District Training Center & District Health Office , Ahmednagar. A total of 15 Medical Officers -had participated in the workshop. A detailed discussion was held on Technical , administrative , Financial and Management issues . A team of resource persons included Faculty of the Community Medicine Paediatrics, Obstetrics & Gynecology of PMT , Loni Regional Health Training Center, Pune District Training Center & District Health Office , Ahmednagar. Dr. G. B. Dhumale , Professor , Department of Community Medicine (PSM) co-ordinated the programme.
Sports Roundup
CAMPUS News
VIGNAHARTA - 2001
With the resonating sound of "GANAPATI BAPPA MORYA" the students of Pravara Medical Trust celebrated the Ganesh festival "VIGNAHARTA 2001".
From the time immemorial Ganesh festival is celebrated by the people of this country keeping in tradition which marks one of the major social events of our society.
This year too, as always, the students celebrated the arrival of " SHRI GANESH " with great enthusiasm praying for the peace and well being of all. These 10 days were really memorable time for all a time for spiritual growth, personal in introspection and of course fun & frolic.
The Ganesh murti was brought to the venue in a huge procession and sthapna was done by Dr.K.J.Shinde followed by Aarti.
The cultural events started from the next day. The first and the most exciting event was "Antakshari" organised by Medicos in which many of the under graduates and postgraduate students participated with great enthusiasm. " Khul ja Sim Sim", "Housie", "Extempore", were the sizzling events organised by the Denticos with the support of Dr.Anil Ghom.
The main attraction of the entire event was Orchestra in which many hidden talents were brought to the forefront. The foot tapping number finally brought the entire crowd to the dance floor. Sports event was organised which comprised Cricket, Badminton, Table Tennis and Carrom continued simultaneously with other events. The event "Fun - n - Fair" was organised by Medicos and Physicos which gained tremendous response and in the night was followed by Dandia. The event came to an end by movie show which was organised by Medicos and finally those ten days of excitement and enthusiasm came to a halt with the imersion of Ganesh Idol .
New Code of Conduct For Doctors
The Medical Council of India (MCI) in its revised guidelines for ethical conduct of doctors .has directed, them not to conduct any sex-determination tests for aborting the female foetus. It has also asked doctors to clearly display the fees and other charges in their chambers.
These long-awaited revised guidelines cover various medical issues, which have come up since the last ethical code was issued in 1956. These include the following directions.- Every physician will maintain a medical record of his patients for a period of three years from the date of commencement of treatment.
- Every physician, as far as possible, will prescribe drugs using their generic names.
- Printing of one's own photograph, sketches and diagrams of human system on the letterhead or the consulting room will be regarded as self-advertisement and viewed as unethical conduct.
- Physicians will need to display their registration numbers in their consultation rooms, on letter heads and prescriptions.
- Clinical trails may be under taken if they are initiated by the Indian Council of Medical Research, provided all ethical considerations are adhered to.
- Prescribing steroids or any other drug for including puberty in a child without any medical indication would be a violation of human rights and viewed as professional misconduct.
- Invitro fertilisation or artificial insemination is not be done without taking informed consent.
- Medical practitioners will maintain a register of medical certificates issued by them.
- Treatment of patients by physicians with communicable diseases or deteriorating vision is not to be allowed
Research
Outcome of Head and Neck Cancer Patients Treated at Pravara Rural Hospital From 1996-2000.
Dr. B. Mahesh Kumar
Asst. Professor, Dept. of Radiation Oncology
Aim:
To assess the results of radiotherapy in patients undergoing radical radiotherapy for H & N malignancies, particularly patient compliance and the acute effects.
Materials and Method:
The case records of patient getting registered at Radiation Oncology outpatient department were reviewed and the cases were selected. The records were scrutinised for patient compliance, frequency of the types, radiotherapy protocols, acute side effects and the response to treatment.
Results:
A total of 1456 patients had registered in our outpatient department. Out of this 352 patients had malignancies of the head and the neck region. The minimum age of diagnosis was 20 years while the maximum was 83. The male to female ratio was 4:25: 1. Forty percent of the patients were older than 60 years. The most common site was Tongue followed by Larynx. Pyriform sinus and the Oropharynx. Almost all the patient had a biopsy from the primary site for establishing the diagnosis. Squamous cell carcinoma was the most common type. More than fifty percent of the patients had presented in an advanced stage of the disease. Al- most all the patients had addiction with Tobacco and /or Alcohol. About 18% of the patients had post-operative radiotherapy.
All patients were planned for a minimum dose of 6000cGy (rads) in 3 0 fractions over six weeks with a daily dose of 200cGy. All were treated with parallel-opposed portals on a Cobalt - 60 machine.
Out of 352 patients, about 80 did not complete the planned treatment. Also forty patient were lost to follow- up. Of the remaining, 28% patients developed grade three mucosities, 4.5% had candidiasis. Approximately 21% of the patients took breaks lasting more than two weeks. Xerostomia was seen in 12% of the patients, loss of taste in 4% and lymph odema of the skin of the neck in 3%. of the patients.
The response to radiation was 48% for carcinoma larynx and Pyrifonn sinus, 33% for tongue, 43% for buccal mucosa. A response rate of 75% and 60% was seen for orophaynx and hard palate.
Discussion:
The response rates for various tumours were less as compared to those available in the literature . The possible reason which can be attributed to this, can be, the advanced presentation, prolonged treatment duration, elderly patients, illiteracy and lack of awareness and the cost of treatment.
Current Status of Medical Education a Pilot Study At Rural Medical College, Loni"
Dept. of Community Medicine.
Aims
To find out the views and opinions of the students of undergraduate and postgraduate on "Current Medical Education in India and the need for its change" at Rural Medical College Loni so as to become an 'efficient doctor' as per the Medical Council of India (MCI) goals.
Objectives
To evaluate the current teaching & learning pattern in student's and teacher's perspective. To asses' the student teacher communication for effective learning.
Materials and Methods
A cross sectional study comprising of 200 students and 35 teachers were interviewed using a predesigned & pretested questionaire. The final year MBBS student carried out the study under guidance of the department of Community Medicine.
Observation
- The majority(93%) of students preferred student centered knowledge & skill oriented teaching over teacher centered & exam oriented teaching/learning.
- Majority of students i.e.94% opined that 'Problem based learning' along with self directed learning must be included in the present system.
- Nearty'one third of students learning should be evaluated quantitatively & qualitatively through both theory & practicals.
- More than 2/3rd students opnied that a clinical batch should comprise of 10-15 students for effective learning.
- Nearly 65% students felt that communication between teachers and students is the back bone for learning.
- It was observed that 80% of students wish to have more weightage for qualitative exams than quantitative.
- A total of 72% post graduates expressed that they did not have confidence to deal with patient during and even after their internship.
- 56% students were unable to perform bedside diagnostic test, 75% were unable to plan community health programmes & manage epidenics.
- Majority i.e. 94% preferred PROBLEM BASED LEARNING over the present pattern. It is observed that students and teachers are willing to adopt newer methods of learning and also to shoulder more responsibilities for their learning.
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