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SRI LAKSHMI NARAYANA INSTITUTE OF MEDICAL SCIENCES, PUDUCHERRY

SLIMS Newsletter
Volume 1, Issue 3 Editorial Board:
Dr. R. Chidambaram
Chief Editor. Prof of Radiology & Director BU-MRC

Newsletter Date: 1st July 2012

VESICAL STONE
Page 3

MEDI-QUIZ WIN PRIZE


Page 6

WHY THIS KOLAVERI


Page 10

Dr. M. Balamurugan
Prof. of Pathology

Dr. P. Rajaram
Epidemiologist

Dr. Rathod, M.D.


Prof. of Forensic Medicine

First Ph.D. from our College who has done the public defence Viva-Voce examination from Biochemistry Department. Title of the Thesis: Role of minerals in Type I & Type II Diabetes Mellitus: A case study with special emphasis to Iron, Copper, Chromium, Selenium, Molybdenum and Vanadium

Dr. N. S. Pradeep Kumar


Prof. of Pathology

Dr. Vijaya. K, M.D.


Assoc. Prof. (OG)

Dr. R.S. Bharatwaj, M.D.


Asst. Prof. (P&SM)

Dr. Vinayak D. Kanade


SRF, Bioinformatics

Inside this issue:


CUTTING FOR THE STONE VESICAL CALCULUS PREVALENCE OF SUBCLINICAL NOISE INDUCED SENS ORI NE U R AL HE ARI NG LOSS AMONG COLLEGE STUDENTS DUE TO USAGE OF EAR PHONES A STUDY ON KNOWLEDGE, ATTITUDE, PRACTICE AND EXPERIENCES REGARDING VOLUNTARY BLOOD DONATION AMONG MEDICAL STUDENTS IN PUDUCHERRY MANAGEMENT OF PREGNANCY WITH CHRONIC HEPATITIS.B GENERAL ANAESTHESIA AND ENVIRONMENT NOISE-STRESS INDUCED OXIDATIVE STRESS AND NEURO- IMMUNOLOGICAL CHANGES IN ALBINO RATS EDUCATION ITS PURPOSE AND VALUE COMMUNITY PARTICIPATION MEDICON-2012 SPORTS

2 3

Mr. L. Siva
5 6 7

Research Scholar

8 9 11 12

FROM THE EDITORS DESK :


With all the encouragement and support given by you we are publishing the Third issue of Newsletter with lot of happenings in our Institution. I would like to thank the contributors for participating in the second issue. We are looking forward for more contributions from the faculties and students in the forth coming issue. - Dr. R. Chidambaram

Page 2

SLIMS NEWSLETTER

CUTTING FOR THE STONE VESICAL CALCULUS


Dr. G. D.Shivakumar1, Dr. Asayas Bosco Chandra Kumar2, Dr. Ajit Agarwal3, Dr. Maheswaran4. 1CRRI, 2,3Assistant Professor, 4 Professor & HOD, Department of Surgery, SLIMS, PONDICHERRY.

Abstract: "Cutting for the stone" is a phrase that has been used since the time of Hippocrates, Vesical stone also called as cystolith. It is one of the rare entities to see nowadays. Incidence is lower due to improved diet habits. And everything has gone minimally invasive. At times a large stone measuring 4X5 cm in the bladder requires an open suprapubic cystolithotomy. Here is such rare case operated in our hos- Conclusion: Vesical stone used to be very common in olden days but its incidence is pital with excellent recovery. lower due to food modifications like increased intake of protein and fiber rich diet. There are many condition causing inflammation of bladder, ureter and kidney, bladder diverticulum, Enlarged prostrate, Neurogenic bladder, UTI, bladder catheter. The complications of theses stones are acute bilateral obstructive uropathy, chronic bladder dysfunction, reflux nephropathy6, recurrent UTI, rarely malignancy and hence required to be removed. Bladder stone can be removed surgically without damaging the bladder. It is simple and cost effective to patient when compared to the transurethral procedure. But disadvantage is wound complications, post-operative pain and longer hospital stay. Hence for our rural population where accesses to sophisticated gadgets are not there time tested open surgical methods are the solution. Prevention: Drinking plenty of fluids and juices containing citrates, Prompt treatment of UTI and other urology conditions prevent bladder calculus.
References: 1. Schwartz BF, Stoller ML. The vesical calculus. Urol Clin North Am. May 2000;27(2):333-46. 2. Bhatia V, Biyani CS. Vesical lithiasis: open surgery versus cystolithotripsy versus extracorporeal shock wave therapy. J Urol. Mar 1994;151(3):660-2. 3. Lau S, Zammit P, Bikhchandani J, Buchholz NP. The unbreakable bladder stone--Munchhausen's tale. Urol Int. 2006;77(3):284-5. 4. Rub R, Madeb R, Morgenstern S, Ben-Chaim J, Avidor Y. Development of a large bladder calculus on sutures used for pubic bone closure following extrophy repair. World J Urol. Aug 2001;19(4):261-2. 5. Rafique M. Vesical calculus formation on permanent sutures. J Coll Physicians Surg Pak. Jun 2005;15(6):373-4. 6. Russinko PJ, Agarwal S, Choi MJ, Kelty PJ. Obstructive nephropathy secondary to sulfasalazine calculi. Urology. Oct 2003; 62 (4):748.

CASE REPORT: A 65 year old male patient came to OPD with complaints of fever, lower abdominal pain, frequency of urination, burning micturition. On examination revealed no significant clinical findings. On urine routine pus cells were detected, X-Ray KUB revealed a bladder stone. Ultrasound prostrate normal, working diagnosis of UTI1 made and on IVU a solitary bladder stone confirmed. Patient urine culture sensitivity sent and started him on antibiotics. Planned for a suprapubic lithotomy due to stone being large. Other modalities are mechanical cystolithotripsy and extracorporeal shock wave therapy2.

Through suprapubic incision about 5 Cms, bladder opened and stone identified, solitary stone measuring 4x5cms hard, unbreakable3 stone removed in Toto, bladder closed with absorbable sutures and care taken to not leave any residual suture material4,5 which can cause a bladder stone later and a suprapubic drained was put removed post-op day four. And post operative day 14 Foleys catheter removed and his post operative stay was uneventful and patient was discharged and asked to review in surgery OPD after a week.

Volume 1, Issue 3 Page 3

PREVALENCE OF SUBCLINICAL NOISE INDUCED SENSORINEURAL HEARING LOSS AMONG COLLEGE STUDENTS DUE TO USAGE OF EAR PHONES
AUTHORS: Dr. M. Prakash, Asst. Professor, Dept of ENT, Sree Balaji Medical College and Hospital (SBMC&H), Chennai. Dr.R. Venkataramanan, Asso. Professor, Dept of ENT, Sri Lakshmi Narayana Institute of Medical Science (SLIMS), Puducherry. CO-AUTHORS: Gunavathy Krishnan, CRRI, SBMC&H, Pavithra Saikumar, CRRI , SBMC&H, M. Kaarthik Kumaar, CRRI, SLIMS.

Regular use of iPod and MP3 players can lead to irreversible hearing loss. In a study 28% of young college students using iPods were found to have irreversible subclinical sensorineural hearing loss Sensorineural hearing loss (SNHL) is due to defects either in the sensory end organ of the cochlea or in neural transmission to the central nervous system (CNS). A defect exists either in the conversion of acoustic energy by the sense organ of the inner ear or in the transmission of neural impulses centrally. Noise induced hearing loss is the second most common cause of SNHL after presbycusis. Both the intensity and the duration of noise exposure interact to influence potential damage to the hair cells of the inner ear. No currently known medical or surgical treatments can prevent or reverse noise induced hearing loss. The advancement in the technology might also be hazardous to the normal functions of the human body. Extensive usage of ear phones can cause irreversible sensorineural hearing loss among people within a decade. Usage of Personal Listening Devices (PLD) like iPods, mp3 Players have increased dramatically. Irrational use of ear phones would have an effect on hearing thresholds. Chronic noise exposure causes mechanic ultra structurally visible damage at the level of the organ of Corti, initially causing a loss of

outer hair cells, leading finally to neuronal degeneration. Typically, hearing loss initially occurs as a sensorineural high frequency notch, normally at 4kHz. The middle frequencies, e.g. the main speech frequencies, are affected considerably later. The extent and progress of the hearing loss depend on the intensity, duration of exposure and frequency composition of the sound and the individual noise susceptibility. We did a study involving 300 students using ear phones to listen to music using iPods, mp3 players. Questionnaire was designed to survey students about no. of years of ear phone usage, no. of hours per day, model of ear phone used, usage during travel (train, bus). Anyone with the following were excluded from the study. H/O of any ear symptoms, H/O of any otological surgeries, Family H/O of deafness, H/O of exposure to noisy environment, intake of Ototoxic drugs, abnormal Otoscopic finding or Tuning Fork Test (TFT). Out of 300 subjects, 51 were excluded from our study after obtaining the informed consent from the students the participants were selected based on the duration of ear phone usage, number of hours/day, model of ear phone, volume level etc. They were subjected to otoscopic examination to rule out the external ear pathology, tuning fork tests is done to assess the type of hearing loss and pure tone audiometry test for finding pure tone average. The data has

been analyzed statistically. From PTA readings, average of 500 Hz, 1000 Hz & 4000 Hz was considered to evaluate the subjects hearing threshold. PTA values - 69 subject out of 249 studied (i.e., 28%) showed minimal subclinical sensorineural hearing loss (SNHL). In subjects with usage of ear phones 2 yrs significant SNHL was observed among 23% of subjects. In subjects with > 2yrs usage of ear phones the SNHL was found to be 40%.It was noticed that there is a marked increase in SNHL among ear phone users in noisy environment, since they increase the volume of the ear phones in noisy surroundings. Sensorineural hearing loss (SNHL) is rare in younger age. Sound stress caused by indiscriminate usage of earphones is the most likely cause of SNHL in this age group. This is an irreversible but preventable disability which can be avoided through safety measures. Informing people about the effects of ear phones on the hearing threshold may encourage them to proactively protect themselves. To conclude prevalence of hearing loss was found to be 28%. It was higher among subjects with, prolonged duration of ear phones usage and listening in noisy environment.

Page 4

SLIMS NEWSLETTER

A Study on Knowledge, Attitude, Practice and Experiences regarding Voluntary Blood Donation among Medical Students in Puducherry, India
R.Vijayakumar1, R. Chidambaram2, R. Srikumar2, E. Prabhakar Reddy3, S. Latha1, V. Kowsalya1, Gayathri Fathima1. 1 Dept. of Physiology, 2Medical Research Centre, SLIMS, 3Dept. of Biochemistry, SLIMS, Puducherry.

Background: Safe blood saves millions of lives. Role of youngsters in Voluntary Blood Donation (VBD) is crucial to meet the demand of safe blood. Therefore understanding the various factors contributing to knowledge, attitude and practice of VBD among youngsters is important. Objectives: The present study aims to assess the level of knowledge, attitude, practice and experiences regarding VBD among the medical students. Methods: The study was conducted among 371 medical students from Sri Lakshmi Narayana Institute of Medical Sciences and Research In-

stitute, Puducherry, India in the year 2012. Results: Result shown that overall knowledge on blood donation among respondents was 44.8% (1st year 36.7%; 2nd year 42.8%; and 3rd year 54.9%). In this study13.2% of students had donated blood, in which 2.7% of male students alone donating blood on regular basis. Among the voluntary blood donors male students (40) are more likely to donate blood than the female students (09). The majority of the participants (86.7%) never donated blood but showed positive attitude (62.6%) by expressing

their willingness to donate blood while few of the non-donors had negative attitude (22.8%). Conclusion: The present study recommends that even medical students needs to be educated about the importance and health benefits of blood donation on regular basis. Spreading the awareness and motivation about the blood donation on regular basis and addressing the problems faced during blood donation will strengthen the recruitment and retention of blood donors to donate blood on regular basis to achieve 100% VBD in India.

BIUC Prevails When All Else Fail As A Successful Haemostatic Method In Uncontrollable PPH In A Case Of Amniotic Fluid Embolism- A Case Report
1

Dr. K.Vijaya, 2 Dr. R.S Bharatwaj 2 Associate Professor, Dept. of Obstetrics and Gynaecology, Associate Professor, Dept. of Community Medicine, SLIMS, Pondicherry

ABSTRACT: Amniotic fluid embolism (AFE) was first reported by Richardo Meyer 1926. Amniotic fluid embolism (AFE) occurs in 1/8000 to 1/80,000 deliveries with a maternal mortality ranging from 26% in a recent report to 86% in earlier ones. Neonatal outcome is generally poor with a mortality rate of 20%25% and, of the survivors, only 50% may be neurologically intact. The presenting signs and symptoms of AFE involve many organ systems. Acute dyspnoea or sudden agitation and anxiety are common premonitory symptoms. It is estimated that approximately 10 50% of patients with AFE present

with seizures. Rapid decline in pulse oximetry values or sudden absence or decrease in end-tidal carbon dioxide may be apparent. Hemodynamic compromise quickly follows these prodromal signs. We present here a case of AFE with Disseminated Intravascular Coagulation (DIC) in a tertiary care setting but with a situational resource limitation. The ideal requirements for the case management were not met due to the patients rare blood group as well as unavailability of fresh frozen plasma or other sophisticated tools. The baby could not be saved, but with the simple and

effective technique of a persistent and sustained Bimanual Internal Uterine Compression (BIUC) over almost an hour the haemorrhage was controlled and the patient could be saved.

Volume 1, Issue 3 Page 5

MANAGEMENT OF PREGNANCY WITH CHRONIC HEPATITIS.B


Dr. P. Rajaram, Epidemiologist , Department of Community Medicine, SLIMS, Puducherry

Infection with hepatitis B virus (HBV) is a Global Public Health Problem. In the pregnant lady perinatal transmission of HBV is the main cause of chronic hepatis, cirrhosis and Hepatocellular carcinoma. The rate of Perinatal transmission of hepatitis B to the foetus is 35% To 45% overall and up to 80% in HBV DNA Positive Mothers. Hence in a pregnant lady suffering from chronic hepatitis B, the approach is two fold treatment of mother and prevention of infection of foetus. Pregnancy in chronic hepatitis In general, Pregnancy is well tolerated by women who are chronic carriers of hepatitis B virus. Reactivation of the virus and exacerbation of the disease during or after gestation are uncommon. Treatment of the mother The approach to treatment of the pregnant lady suffering from chronic hepatitis B is on the same lines as in a non-pregnant patient with following modifications. The safety of the Antiviral therapy for hepatitis B during pregnancy and during breast feeding is not well defined. Interferon and Peg-interferon contraindicated during pregnancy largely because of their known antiproliferative effects. In the event of pregnancy peg-interferon to be discontinued. Currently lamivudine, telbivudine, emtricitabine and tenofovir are classified as category B, indicating that they demonstrate no evidence of teratogenicity in animal studies but have not been adequately evaluated in humans and ongoing registries include to few instances of pregnancy during thereby to provide reliable guidance. These agents could be used if the potential benefit of treating during pregnancy is believed to out weigh potential risks to mother or foetus.

Entecavir and adefovir are classified as category C and in the embryo and foetal toxicities have been observed in animals, but there reproduction studies are not always predictive of human response. A central issue regarding safety of therapy during pregnancy is whether Nucleoside analog therapy should be stopped in young women, who are attempting pregnancy or who become pregnant during treatment. Currently lamivudine and zidovudine are recommended for HIV -1 infected women during pregnancy. Thus in women who are being treated for hepatitis B, that become pregnant switching to lemivudine during of pregnancy period is a reasonable recommendation. Preventive transmission. The placenta forms an excellent barrier against the transmission of this large virus (HBV) and intrauterine infection with Hepatitis B is rare. However transplacement transmission due to leakage can occur such as during a threatened abortion. The major problem of women who are chromic carriers of hepatitis B is the risk of maternal to infant (vertical) transmission at delivery due to exposure to maternal blood in the birth canal. Perinatal transmission of hepatitis B is a major health problem in endemic areas. Transmission at birth is more likely if the mother is HBeAg positive or has high circulating levels if hepatitis B (HBV DNA) Immuno Prophylaxis of the Newborn with Hepatitis B with hyper immune globulin. (HBIG) Passive immunization given at birth to the infants has been shown a decrease in infection to 10 20% of infants. (Against 35% - 80% if no

prophylaxis given) Another approach is the passive method is to give HBIG to mothers every 4th weekly starting at 28 weeks of gestation. Results are comparable to those immunization given at birth. Vaccination of the New Born with Hepatitis B vaccine. Hepatitis B vaccine is given to infants at birth, 1 and 6 month has been documented to end the transmission of infection to only 10% of the newborns. (Over 90% of Newborns are interrupted) Most of the clinicians area combination of HBIG as well as Hepatitis B vaccine at birth to Newborn. The Advantage of using the combination has not been documented in literature. Vaccination and passive immuno prophylaxis is usually effective in preventing the transmission. (At least in those with lower viral loads) Short course of Lamivudine therapy 8 weeks before delivery. Used in mother with high HBV DNV in serum. There have been two small trials of Lamivudine therapy during pregnancy in women with chronic hepatitis B and high levels of HBV DNA that focused the prevention of transmission of hepatitis B to the infant HBV transmission was less in women who were treated with Lamivudine, but none of these studies were adequately powered or controlled to prove the efficacy or advisability of this approach. therapy appeared to be safe, at least to the infant. Caesarian section to prevent vertical transmission. Caesarian section delivery has been shown to end infection rate in a few trials, but is not recommended due to problems and complications of caesarian section deliveries.

Page 6

SLIMS NEWSLETTER

GENERAL ANAESTHESIA AND ENVIRONMENT


Dr. Vishwanath R1. Hiremath, Dr. Mahesh N2, Dr. Nagalingam N, Department of Anaesthesiology, SLIMS, Puducherry - 605 502 1 Professor, 2Assistant Professor.

In 1972 Joseph Pristley discovered Nitrous Oxide (N2O) subsequently it gained entrance in the field of anaesthesia. Nitrous oxide with 150 years of history is by far the oldest anaesthetic still in routine use but its continuous use is frequently subject of debate with lots of studies and debates questioned. Nitrous oxide is toxic with prolonged exposure, can damage the environment, being green house gas is also leading to ozone layer depletion and global warming. Nitrous oxide increases the incidence of post operative nausea and vomiting in the early and late post operative period. It is really a problem in patients where the side effect is increased. It can lead to myocardial infarction in the late postoperative period there by increasing the morbidity and mortality. One of the reason for the continued use of nitrous oxide is it reduces the incidence of recall of intra operative awareness. But this can be prevented by increasing the MAC of volatile anaesthetic agent by 0.25 and that is 0.25 x MAC. Nowadays it is possible to carry air inhalational anesthesia without N2O. Mixing analgesic effect can

be achieved with moderate increase in the dose of opiods, anxiloysis by benzodiazepines and hypnosis by 0.2 to 0.25 MAC of volatile anesthetic agents. In order to achieve the anesthetic effect, expired concentration of 1.2% of isoflurane is required, in case of sevoflurane 2.2% and with desflurane 5% is the one required. But the advantage of avoiding N2O is one can use low flow anaesthetic techniques. Patient will inhale only O2 and air with anaesthetic agents, hence total gas intake is reduced considerably. Techniques will no longer require washing out of nitrogen. Hence initial phase of low flow anaesthesia requiring high fresh gas flow can be kept as short as possible (initial 15-20 minutes) which is determined by wash-in of volatile anaesthesia. As there is no uptake of N2O a greater percentage of gas is circulating within the breathing system minimizing the occurrence of accidental gas volume deficiency. The carrier gas flow required will be just that amount of oxygen taken up by the patient which can be calculated by applying the brody's formula. Using fresh gas flow as

low as 0.25 l/min will result in a significant decrease of the input of conventional vaporizer outside the circuit. But it becomes nearly not possible to maintain expired isofluorane concentration of 1.2%, but newer low soluble volatile agents like sevoflurane and desfluorane are ideal agents for use with flows corresponding to the basal oxygen uptake. Overall cost of nitrous oxide free inhalational anaesthesia will be negligible when we consider the benefits provided to the patient. Teratogenicity and infertility and fetal loss (female members), in the persons working in operation theatre atmosphere is a threat with traces of N2O inhaled by the members in the operation theatre for a prolonged period of time. Hence conclusion is considering the various benefits of alternate techniques ecofriendly anaesthesia, oxygen-air-volatile anaesthetic agent with low fresh gas flow should be consider as ideal technique avoiding routine use of N2O.

MEDI-QUIZ!!! WIN PRIZE!

Attention UG students!!! Identify and get a prize! First come, first served! 34 year lady with recurrent bleeding per rectum. No constipation, no loss of weight , on examination per abdomen soft non tender no mass. Local examination no fissure or hemorrhoids. Colonocsopic picture at slims. What is the diagnosis? Send your answers to slimsnewsletter@gmail.com. Last time Quiz Winners: Mr. Praveen Kumar & Mr. Vigneshwaran sivaguru,. Answer: Kala azar (Leishmania donovani) diagnosed with a Wright's stain on a bone marrow aspirate

Volume 1, Issue 3 Page 7

NOISE-STRESS INDUCED OXIDATIVE STRESS AND NEURO- IMMUNOLOGICAL CHANGES IN ALBINO RATS
R. Sheeladevi1, R. Srikumar2 and R.Vijayakumar2 1 Department of Physiology, Immunology Laboratory, Dr. ALM. PG. Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai. 2Department of Physiology, SLIMS, Puducherry - 605 502

Stress is one of the basic factors in the etiology of number of diseases. Sound has an ever-increasing impact on human daily life and stressrelated illnesses are more frequently observed. The present study was aimed to investigate the effects of noise-stress on antioxidant status and immunomodulation in Wistar strain albino rats. Noisestress employed in this study was 100 dBA for 4h/d/15 days. Four different groups of rats namely, non-immunized control, noisestress and corresponding immunized groups were used. Sheep red blood cells (5 X 109cells/ml) were used to immunize the animals. Bio-

chemical estimation of oxidative stress namely superoxide dismutase, catalase, glutathione peroxidase, ascorbic acid and lipid peroxidation in tissues (hypothalamus, thymus and spleen) were analyzed. Stress hormone corticosterone level was estimated in plasma. Non -specific immune defense was assessed by testing the neutrophil functions, which includes adherence, phagocytosis (phagocytic index and avidity index) and killing ability. Specific immune response was performed by testing the antibody titer of humoral and foot pad thickness and leukocyte migration inhibition test of cell-

mediated immune responses. Result showed noise-stress significantly increases the lipid peroxidation and corticosterone level with concomitant depletion of antioxidants in the studied tissues. Nonspecific neutrophil functions and specific cell-mediated immune defense were significantly suppressed with abnormal humoral antibody titer against SRBC was observed. The present study concludes that noise-stress disrupt the homeostasis balance by accelerates the generation of free radicals with impaired immune function may leads to allostatic load.

KSHEMA SOUTH ZONE ENT UG QUIZ- 2011


Date:12th JUNE, 2011. Venue: KS Hegde Medical Academy, Deralakatte, Mangalore.
Winners (1st PRIZE):

& M.Mohamed Abubaker Siddick Attention UG students!!! Identify and get a prize! First come, first served!
from SRI LAKSHMI NARAYANA INSTITUTE OF

M.Kaarthik Kumaar MEDI-QUIZ!!! WIN PRIZE!

34 year lady with recurrent bleeding per rectum. No constipaMEDICAL COLLEGE, PUDUCHERRY. Total number examination per abdomen soft non tion, no loss of weight , onof Teams Participated: 28 Teams, from various Colleges of South India like Mysore Medical tender no mass. Local examination no fissure or haemarroids. College, Amrita Institute of Medical Science etc,. Colonocsopic picture at slims. What is the diagnosis? Send your answers to slimsnewsletter@gmail.com.

"You can avoid reality, but you cannot avoid the consequences of avoiding reality" - Ayn Rand

Page 8

SLIMS NEWSLETTER

EDUCATION ITS PURPOSE AND VALUE


Dr. R.S Bharatwaj, Assistant Professor, Department of Community Medicine, SLIMS, Puducherry

Education, what does this word imply? Right from the age of pre kg, continuing for another three decades as a rigorous process of information being pumped into individuals through a variety of institutions; the travails of getting into these so-called fortresses of knowledge, all the tutorials; such a lot of information fed into the individual brains that is reinforced by repetition, aided by the award & punishment psychological disciplining mechanism. The process seems to be just endless. Personally looking back, a large store of the mass of information gathered in the past is lying somewhere hidden in the network of memory. The individual hope is, that one fine day when it is re-

quired , it would crop up & reveal itself to consciousness & be of help in handling the situation appropriately. But whether it happens or not is anybodys guess ! We are inclined to think, at least the ones who explore life beyond its superficialities, what is the need for so much of overloading of information. The pressure that is imposed in the training process causes so much of strain on the students that many a times, we question whether we are going in the right direction in the educational process. What is the purpose of education then? If the purpose of educating is to, only feed appropriate information & give a certain skill training, so as to make the children grow into adults who will fit into the slots and per-

form the roles society has designed for itself, then what is the purpose of feeding all the excess information that the individual will hardly ever use in his life time. But if education is about nurturing the inherent talent in each individual & make it flower in a natural way, then we have to re-think the way the educational system is structured & delivered. The latter, seems to be a more realistic & genuine way to look at education & re-think how to prepare the ground for the potential seeds of inherent talent to flower, as well as inculcate a value system too, that will serve towards the building up of a healthy, flourishing & happy society.

MEDICAL HUMOR SECTION


BEWARE CRRIs: THIS WAS FOUND WRITTEN IN THE CASE SHEET OF PATIENTS. 1. While in ER, she was examined, x-rated and sent home. 2. The skin was moist and dry. 3. Occasional, constant infrequent headaches. 4. Patient was alert and unresponsive. 5. Rectal examination revealed a normal size thyroid. 6. She stated that she had been constipated for most of her life, until she got a divorce. 7. I saw your patient today, who is still under our car for physical therapy. 8. Both breasts are equal and reactive to light and accommodation. 9. The patient refused autopsy. 10. The lab test indicated abnormal lover function. 11. Skin: somewhat pale but present. 12. Large brown stool ambulating in the hall. 13. Patient has two teenage children, but no other abnormalities

Volume 1, Issue 3 Page 9

COMMUNITY PARTICIPATION
Dr. P. Rajaram, Epidemiologist , Department of Community Medicine, SLIMS, Puducherry

The word community has been derived from the French word COMMUNE means people, i.e. group of people in different agegroups and sub-groups living in a defined area sharing certain characteristics common in such as colour, Traditional habits and cultural practices through life inherited with a Local leadership towards their fulfillment of daily and regular needs. Health-care of the community is no longer the responsibility of an organization such as the government (Panchayat, Taluk, Dist, & Medical College) or private voluntary Agencies. (NGOs etc.)When Health-care becomes the Health fulfillment based on the actual demands with warm unity towards the Health needs then the subject becomes as Community Responsibility. The community is merely looked upon as the source of pathology by most of the medical faculties. Hence the Community becomes the TARGET for most of the organizations including government and private health Agencies. Even the District Authorities including the district Medical colleges/ private voluntary Health agencies view the community as the source of diseases. As a result of this these organizations fail to understand the Heath needs Assessment by them and their Aim do not reflect the felt need (Real need) and finally the whole issues becomes fully Medicalised, because of this attitude of the organizations, the community itself is not at all consulted. Due to the nonconsultation of the community the Agencies always feel the Resistance from the community.

What is the Basic Reasons for this community Resistance? (I) The community often thinks that the approaches by any Health/ Medical Agencies in the Midst of the community is going to benefit only the Agencies and not the community. (II) Since salary/ wages are to be earned by the staff of Agencies/ organization the community starts feeling that the objectives of the organization is the job priority and not the community. (III) The community often complains that the identity of the Members of the community is not recognized properly by the approaching agencies. As an example the Distribution of Iron and folic Acid (IFA Tablets) Satisfies, the Agency to achieve its target, but the overall objective of the a Distribution programme is to correct Anemia either by prophylaxis or Treatment which is not achieved since the community is not consulted before such distributions. (IV) As a result of the above situation the community becomes neither responsive nor reactive towards the steps taken by these organizations. Issues concerning the community participation (a) What is the relationship between the service recipients and service providers. (b) Do the Members of the community and the implementing organizations interact before the launching of such a community oriented projects. (c) What is working time of the

Implementing organization (Health Post). (d) Is the working pattern of the agency convenient to the community for the due to them. (e) Is there any committee/council formed on either side before starting the project so that obstacles could be viewed and are cleared. (f) Are there different groups in the community with different ideas, deviating form the common interest of the community. Elements of community participation 1.Community needs assessment 2.Formation of local committees such as Village healths committee, sub-centre health committee & health committee at primary health centre level. (people welfare committee) 3.Local professionals (informal and formal leaders) should be included in the committees to be formed. 4.Preliminary meeting to discuss about the mission/prefect to be carried out at all committee levels. 5. Field survey, inter-personal interview, small groups meeting (SWG OR SHGS) (Self working group self help group) 6.Identification of the priority. 7.Community diagnosis. 8.Decentralized participation in planning & formulation of a project. 9. Action plan & motivation. 10. Blue-print approved by the committees. 11. Specific activities, Like screening, field test medical councilling & Assessment 12. Sustaining the relationship between the members of the organization with the members of the community.

"Never interrupt your enemy when he is making a mistake." - Napoleon Bonaparte

Page 10

SLIMS NEWSLETTER

WHY THIS KOLAVERI


Dr. L. Ravivarman, Jr. Resident, Paediatrics, Department of Physiology, SLIMS, Puducherry - 605 502

In this globalised world, anything from the west, be it their culture, lifestyle, political power, economy or defence equipments, we Indians look up to them. While being attracted to the rich or western world, we tend to forget our indigenous healthy habits and culture. The concept that West is the Best, as propagated by the Europeans and Americans is widely accepted by us. Today our Mother India, the second most populated country and the largest democracy in the world is, also the diabetic capital of the world. Of late, obesity and related problems are also on the rise. These twin problem of diabetes and obesity have huge potential to rope in other diseases too. Though it is well known and established by different studies that healthy eating habits is essential for a quality life, most of us are obsessed with promodern lifestyle, where these are compromised at times. Telecommunications have largely contributed to this. Television and

high speed internet services have made the entire world,a global village. While there are so many benefits because of these, there are ill effects too. This innocent south asian country, which is just developing, is not able to filter the unwanted contents and therefore falls victim to it. Tinned foods, artificial drinks, food with preservatives and fast food are suited for the western temperate climate with large frozen winter and snowfall. We the tropical people with moderate climate all through the year, blessed with good monsoon and a large agricultural population why are we obsessed with these products? Is it because our cine-stars and sports heros advertise for them or is there any stigma attached with consuming our indigenous products? With due respects to the exceptional few, why not these popular ones use their charisma for being goodwill ambassadors for programmes on TB, HIV prevention, child and maternal health and

school education. While there are many etiological factors for these emerging diseases, a simple step, ie, life style modification can create a huge change to the better. As doctors, we are supposed to educate people on healthy life style patterns. We very well know the ill effects of junk foods, carbonated drinks and sedentary life style. Still we have a positive inclination towards them. When we preach others to avoid these, let us practice them too. Lets say NO to junk foods and carbonated drinks. Support indigenous products viz fresh fruits, vegetables, milk products and healthy drinks like barley, ragi drink, etc.. Lets excuse our gustatory receptors a little and think beyond them too. Have a healthy life [This author had never taken a single 200ml coke/pepsi,etc.. in his 25 years of life]

PAPER PUBLISHED (2012)

1 1

Osteoporosis: Pathogenesis, Prevention and therapy.

Vaithilingam, 2E. Prabhakar Reddy, 2G. Suryaprakash, 3T. Mohanalaxmi.

Associate Professor of Orthopedics, 2Associate Professor of Biochemistry, 2Professor of Biochemistry, 3 Assistant Professor of Microbiology, SLIMS, Puducherry. Published in Journal of global pharma technology, 2012;4(04):1-6.

1 1

Evaluation of trace elements in Hepatitis B

Nayakanti Raghu, 2Animireddy Kishore, 3A. Franklin, 4E. Prabhakar Reddy.

Assistant Professor of Microbiology, 2Associate Professor of Microbiology, 3Professor of Microbiology, 4 Associate Professor of Biochemistry, SLIMS, Puducherry. Published in Journal of Pharmaceutical and Biomedical Sciences (JPBMS), 2012;15(11).

Volume 1, Issue 3 Page 11

MEDICON-2012: 5th International Annual Students' Research Conference,


MGIMS, Sevagram, Wardha, Maharashtra.
IInd MBBS students of Sri Lakshmi Narayana Institute of Medical Sciences (SLIMS), attended the MEDICON-2012 at Mahathma Gandhi Institute of Medical Science (MGIMS), Wardha, Sevagram, Maharashtra in the month of July. I on behalf of them would like to share some of our experiences. MGIMS is Indias Ist rural medical college, nestled in the Karmaboomi of Mahatma Gandhi (Bapus kuti) managed by Kasthurba health society. It seeks to provide accessible and affordable healthcare primarily to the underprivileged rural communities. We reached MGIMS on 10th of July12 at 3pm. The campus with its greenery, pleasant weather and the organizing students with warm smiles made us feel comfortable. Our delegate ID contained our name, the full schedule of MEDICON-12 with different timings. There was a barcode at the back which was used as a food pass and it contained photographs of the speakers in columns for autograph. We attended our respective preconference workshops Evidence based medicine, Life saving methods, How to publish a paper and Laboratory medicine which was very absorbing and educative. In the Plenary session Dr.Abay Bang (Director, Research) shared his experiences in research. The famous pediatrician & activist Dr. Binayak Sen, yes the same Doctor whose detention created such a furore among the public, gave a talk on Hunger, equity & Justice in Health care. Dr.Roli Mathur (Scientist, ICMR) gave a lecture on STS-The journey to successes. Praveen, Kalaimani and Ilayaperumal put up their posters and was examined by Judges. On 13th Dr.Sudhir Bhave, a Psychiatrist discussed the issue of Managing post-MBBS stress. Then the star of event Dr.Vinay Kumar, editor of the famous Pathology book we all follow Robbins Pathological basis of diseases talked on Molecular biology of cancer and personalized medicine. After these talks we had ample time to interact with Dr.Vinay Kumar and Dr.Abay Bang. Arun and Aravindraj put up their posters. Evening we visited Bapus kuti ashram and in the night exciting cultural programs were on. Sumedha presented her poster and a group oral presentation was done by Subhashini, Sooryodhaya, Srivimalkumar, Dineshkrishnaraj and Sukumar. Then there was simple valedictory function and we got our certificates. We reached Chennai on 16th and took a bus to Pondy. Home sweet home! This conference was an eyeopener to us for self realization. Meeting giants like Dr.Vinay Kumar gave us real thrill. It is almost impossible to describe the feeling of attending a conference in words. I sincerely feel each and every Medico should attend a student conference at least once during their tenure as a UG student. My sincere thanks to the teachers who inspired us, guides who guided us and the Research team who supported us. By Savithri, IInd MBBS, SLIMS, Pondicherry.

SLIMS XSTATICA 2012 - SPORTS


Page 12

SLIMS NEWSLETTER

Boys Kho-Kho Match

Girls Kho-Kho Match

"Victory goes to the player who makes the next-to-last mistake" - Grigorievitch Tartakower

"Don't be so humble - you are not that great." - Golda Meir

UPCOMING EVENTS
1. Medsicon 2012 - is being held on 10th to 12th August, 2012, at Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi Supported by Indian Medical Students Association. SLIMS MEDI-QUIZ 2012 - date is to be announced. Clinico-Pathological Correlation (CPCs) - date is to be announced. National Workshop-cum-Seminar on Research Methodology and Publications (Sponsored by Indian Council of Medical Research) August 23rd to 25th, 2012, held at JIPMER, Puducherry.

2. 3. 4.

LIST OF EVENTS
SRI LAKSHMI NARAYANA INSTITUTE OF MEDICAL SCIENCES
1. 2. XSTATICA 2012 - Cultural festival was held in SLIMS Campus. Intra-University Sports meet was held among all the constituent colleges of Bharath University at Chennai and SLIMS Campus, Puducherry. CME by Department of General Surgery: Topics-1) Carcinoma Stomach, 2) All about Thyroid, held at Lecturer Hall-IV, SLIMS Campus, Puducherry.

BHARATH UNIVERSITY - MEDICAL RESEARCH CENTRE, SLIMS CAMPUS


Osudu, Agaram Village, Kudapakkam Post, Villianur Commune, Puducherry - 605 502.

3.

Phone: 0413 2661328 Email: slimsnewsletter@gmail.com Website: http://www.bharathuniversity-

medicalresearchcentre.org

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