lala ram sarup institute of tuberculosis and respiratory
TRANSCRIPT
1
Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases
(Autonomous Institute under Ministry of Health and Family Welfare, Govt. of India)
Sri Aurobindo Marg, New Delhi-110 030
ANNUAL REPORT
2011-2012
2
CHANGE OF GUARD
Dr D.Behera handing over the charge of Institute to our new Director Dr Rohit Sarin
Dr Sarin and Dr Behera with the entire faculty of LRS Institute
3
PREFACE It is my proud privilege and honour to take over the reins of LRS Institute of
Tuberculosis and Respiratory Diseases as its Director on 23rd May 2012. I am thankful to
the Government of India and the Governing Body of the Institute for giving me a chance to
lead this Institute which has coveted history of past 60 years since its inception as Lala
Ram Sarup TB Hospital. Ever since the up gradation of the hospital into an autonomous
Institute in 1991 by Govt. of India, the Institute has grown from strength to strength. The
Institute has the prime objectives of patient care, support to National Tuberculosis Control
Programme in the country and to provide facilities for training, teaching and research
activities. In this journey of 60 years, LRSI has made significant contribution in the field of
quality patient care, medical education and research.
I am associated with this Institute for more than 25 years and assisted in its
development process. It is now an apex institute of the country in the field of tuberculosis
and respiratory diseases. The institute is well recognized for diagnosis, treatment, training
and research both within country and neighbouring countries.
LRSI has always been craving for more - Achieving goals and creating higher
targets. As a part of our next 20 year plan Institute is now ready with a Vision Document
where we all aspire not only to modernize the hospital but to also improve the patient care,
medical education and medical research.
We are aware that society has great expectations from our Institute and accordingly
we have tried and succeeded in providing affordable specialized medical care in the region.
What we have achieved till today is the result of hard work of our team comprising faculty
and more than 500 staff including nurses and technicians and the faith people have in us.
The Annual Report of the Institute aims to provide elaborate information, to present best
practices, to highlight events and to give different perspectives in addressing the challenges
related to the patient care and medical research in India while supporting the country's TB
control programme.
The Institute has been able to provide quality care through the untiring efforts put in
by the trained faculty and the staff of its departments and sections, which are being
continuously upgraded with the latest available technology. In addition to providing DOTS
services, Institute screens for MDR TB and gives DOTS-Plus treatment to those diagnosed
4
among 6 million population of Delhi. It also supervises the IRL activities over 8 states of
India that includes areas in the North East. The Dept of Microbiology is a National
Reference Laboratory and undergoes yearly proficiency testing for culture and drug
sensitivity for the first and second line drugs by all methods through Supranational
Mycobacteriology Reference Laboratory, Institute of Tropical Medicine, Antwerpen,
Belgium. A number of equipments like BSL-III laboratory, MGIT System, Line Probe Assay
and Gene Expert have been smoothly functioning to assist the clinicians in delivering a
quality patient care and research. The department has now been certified for providing LPA
based diagnostic services under PMDT. New MDR TB wards, having a negative pressure
system, a first of its kind facility in the country, have started functioning so as to enhance
the institutional care of MDR TB cases. A state of art Thoracic Operation Theatre has been
providing services to those requiring diagnostic or therapeutic surgical interventions. Their
post-operative care is facilitated by the availability of a well equipped intensive care unit.
Availability of emergency services and research block has further enhanced the capabilities
of the Institute to provide quality critical care and facilities for research. Commencement of
specialised chest clinics has ensured better service provision to patients having lung
cancer, sleep related breathing disorders, allergy and other non-TB respiratory diseases
over the time.
Amongst the many achievements of the Institute during the year, one was the
starting of the independent operations of two new departments of Molecular
Medicine/Genetics and Biochemistry following the joining by a Molecular Biologist and a
Biochemist with their supporting staff. This is likely to give a great boost to the patient care,
education and research within the Institute. A number of CMEs/ workshops like PG CME-
2011 North India, National Task Force Workshop, Respiratory Allergy and Immunotherapy
Update and many others were held for the benefit of the medical fraternity at large. The
Institute faculty participated in a number of trainings and national level meetings, whose
decisions will guide the TB control programme of our country in future. The faculty was on
the editorial boards of many reputed national and international journals. The Institute
admitted 10 students for DNB degree course that made the total number of students
undergoing the PG training to 27 considering their enrollment of last 3 years. An elaborate
teaching curriculum was followed for them. About 2000 trainees (including the nursing
students) underwent trainings in various departments and sections of the Institute. About 75
researches (including those involving DNB students) were pursed during the year. A large
number of publications took place in several reputed national and international journals and
5
books, in addition to the regular 3-monthly publication of the Institute’s newsletter. The
Institute continued to provide all routine and many other investigations including the Digital
X-ray, spirometry, ultrasound and others free of cost to all those patients requiring them.
Even the special investigations like CT Scan were provided free of cost in appropriate
cases. A large number of high end equipments were procured during the year to strengthen
the departments and sections in enhancing the patient care and research. A new 40-bed
private ward has been constructed and is ready for use. A new 30-flat doctors hostel has
been constructed and being allotted. The construction of an Effluent Treatment Plant
(including its testing) and that of a laundry has also been completed. Besides, the old toilet
block has been renovated and the construction work of a new kitchen is in the advanced
stage of progress.
Let me take the opportunity in this report to thank all our members, medical fraternity
and friends for their great interest and most generous support to continue our efforts in the
field. It was only with and because of them that we were able to create a number of
promising programmes and activities. We mourn the sudden demise of our founder director,
Dr R.C.Jain, who passed away on 4th August last year. We have started a new Dr R.C.
Jain Memorial Oration lecture in his honour. We shall continue to make our efforts to make
the Institute an institution of international repute in patient care, training and research in the
field of tuberculosis and respiratory diseases.
Dr.Rohit Sarin
Director
6
GOVERNING BODY MEMBERS
1. Shri P. K. Pradhan Chairman Secretary (Health & Family Welfare) Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
2. Dr. Jagdish Prasad Vice Chairman Director General Health Services & Directorate General of Health Services, Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
3. Shri K. Desiraju Alternative Vice Chairman Special Secretary Ministry of Health & Family Welfare Govt. of India Nirman Bhawan, New Delhi
4. Shri R. K. Jain Member Additional Secretary & FA Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
5. Dr. R.S. Shukla Member Joint Secretary Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
6. Dr. Ashok Kumar Member DDG (TB) Directorate General of Health Services Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
7. Dr. (Mrs.) S. Brindha Member
Director (CGHS) A-545, Nirman Bhawan, Ministry of Health & Family Welfare New Delhi
8. Sri Triupati Venkatsawmy Member Deputy Secretary(Finance) Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
9. Sri Rajender Kumar Member Secretary (Health & FW) Room No.A-907, Department of Health & Family Welfare Govt. of NCT Delhi, 9th Level, A-Wing, IP Estate Delhi Secretariat, New Delhi-110002
7
10. Prof. (Ms.) Upreet Dhaliwal Member
Dean, Faculty of Medical Sciences & Head, Department of Ophthalmology University College of Medical Sciences Shahadra, Delhi – 110095
11. The Secretary Member Medical Council of India Pocket- 14 , Sector - 8, Dwarka Phase -1 New Delhi – 110077
12. Dr. S. R. Chauhan Member
Medical Commissioner (ESIC) Employees State Insurance Corporation Kotla Road, New Delhi-110002
13. Dr. S. K. Sharma Member
Prof. & Head Department of Medicine All India Institute of Medical Sciences New Delhi – 110 029
14. Dr. S.K. Jindal Member
Prof. & Head Department of Medicine Department of Pulmonary Medicine PGIMER, Chandigarh - 160012
15. Dr. V.K. Arora Member Ex-Director (LRSI) C-151, Sector – 51 Kendriya Vihar, NOIDA Uttar Pradesh
16. Dr. G.R. Khatri Member President-World Lung Foundation-South Asia 60, Regal Building Parliament Street New Delhi-110001
17. Prof. Sushma Batra Member
Head, Department of Social Work, Delhi School of Social Work University of Delhi 3, University Road Delhi-110 007
18. Dr. C.A.K. Yesudian Member Prof. & Dean (School of Health Systems Studies) Tata Institute of Social Sciences V.N.Purav Marg, Deonar, MUMBAI – 400 088
8
19. Dr. D. Behera Member Secretary
Director LRS Institute of TB & Respiratory Diseases Sri Aurobindo Marg New Delhi
9
STANDING FINANCE COMMITTEE MEMBERS 1. Shri K. Desiraju Chairman
Special Secretary Ministry of Health & Family Welfare Govt. of India Nirman Bhawan, New Delhi
2. Shri R. K. Jain Member Additional Secretary & FA Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
3. Dr. R.S. Shukla Member Joint Secretary Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
4. Dr. Ashok Kumar Member DDG (TB) Directorate General of Health Services Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
5. Dr. (Mrs.) S. Brindha Member
Director (CGHS) A-545, Nirman Bhawan, Ministry of Health & Family Welfare New Delhi
6. Shri Triupati Venkatsawamy Member Deputy Secretary (Finance) Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
7. Dr. D. Behera Convenor Director LRS Institute of TB & Respiratory Diseases Sri Aurobindo Marg New Delhi
10
ESTATE COMMITTEE MEMBERS
1. Dr. R.S. Shukla Chairman Joint Secretary Ministry of Health & Family Welfare Govt. of India Nirman Bhawan, New Delhi
2. Dr. Ashok Kumar Member DDG (TB) Directorate General of Health Services Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
3. Sri Triupati Venkatsawmy Member
Director (Finance) Ministry of Health & Family Welfare Nirman Bhawan, New Delhi
4. Senior Architect Member
Directorate General of Health Services Nirman Bhawan, New Delhi
5. Chief Engineer (NDZ) 1, CPWD Member
New Delhi 6. Dr. D. Behera Convenor
Director LRS Institute of TB & Respiratory Diseases Sri Aurobindo Marg New Delhi
11
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
2.1 New Registrations 2.2 Distribution of Symptomatics 2.3 Distribution of TB Cases Registered under RNTCP 2.4 Age & Sex Distribution of New Smear Positive PTB Cases 2.5 Distribution of Sites of EPTB Cases 2.6 Respiratory Emergency 2.7 Total Cases in OPD (OPD load) 2.8 Paediatric OPD 2.9 Specialised Clinics (Non-TB Cases)
3. Indoor Patient Data
3.1 Total Indoor Admissions 3.2 Age & Sex Distribution of Admitted Patients 3.3 Outcome of Admitted cases 3.4 Observations on Indoor Cases
4. Departments and Sections of the Institute 4-A. Departments
4.1 Department of Anaesthesia 4.2 Department of Bio-Chemistry 4.3 Department of Epidemiology & Public Health 4.4 Department of Hospital Administration 4.5 Department of Internal Medicine 4.6 Department of Microbiology 4.7 Department of Molecular Medicine / Genetics 4.8 Department of Paediatrics 4.9 Department of Pathology 4.10 Department of Physiology 4.11 Department of Radiology 4.12 Department of TB & Respiratory Diseases 4.13 Department of TB Control & Training 4.14 Department of Thoracic Surgery and Surgical Anatomy
12
4-B. Sections
4.15 Air Pollution Related Diseases Diagnostic Centre 4.16 Anti-Retroviral Therapy Centre 4.17 Biostatistics Section 4.18 Computer Section 4.19 Fibre-Optic Bronchoscopy Unit 4.20 Health Education Section 4.21 Library 4.22 Nursing Section 4.23 Physiotherapy Section 4.24 Respiratory Intensive Care Unit 4.25 Sleep Laboratory 4.26 Integrated Counseling and Testing Centre 4.27 Yoga Therapy and Research Centre
5.0 Researches Other Than DNB Course 6.0 Awards and Achievements
7.0 Publications
8.0 Seminars/ Workshops/ CMEs/CMEs Organised
9.0 Presentations during Conferences/Seminars/CMEs/Workshops
9.1 Outside Country 9.2 Within Country
10.0 Conferences/Seminars/CMEs/Workshops Attended 10.1 Outside Country 10.2 Within Country
11.0 List of Committees
11.1 Technical Specifications Committee 11.2 Lower Purchase Committee 11.3 Higher Purchase Committee 11.4 Standing Purchase Committee 11.5 Tender Opening Committee 11.6 Quotation Opening Committee 11.7 Tender Evaluation Committee 11.8 Inspection Committee - Medical Store 11.9 Inspection Committee - General Store 11.10 Estate Committee 11.11 Condemnation Committee 11.12 Hospital Disposal Committee 11.13 Diet Committee 11.14 Hospital Infection Control Committee 11.15 Hospital Waste Management Committee 11.16 Transport Repair Committee 11.17 Equipment Repair Committee 11.18 Disaster Management Committee
13
11.19 Library Committee 11.20 Training Committee 11.21 Annual Report Committee 11.22 Research Committee 11.23 Ethical Committee 11.24 Canteen Committee 11.25 Committee to look into the complaints of sexual harassment 11.26 Official Language Implementation Committee 11.27 Public /Employees Grievance Committee 11.28 Cultural and Sports Committee 11.29 Employees Welfare Committee 11.30 Record Management Committee 11.31 Space Allotment Committee 11.32 House Allotment Committee 11.33 Medical Board 11.34 Medical Re-imbursement Board 11.35 Committee for Advance on Establishment Matters 11.36 College Council Committee 11.37 PG Committee
11.38 Medical Education Unit
12.0 Other Activities of Institute
14
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 Anaesthesia
2. Department of Bio-Chemistry
3. Department of Epidemiology & Public Health
4. Department of Hospital Administration
5. Department of Internal Medicine
6. Department of Microbiology
7. Department of Molecular Medicine / Genetics
8. Department of Paediatrics
9. Department of Pathology
10. Department of Physiology
11. Department of Radiology
12. Department of TB & Respiratory Diseases
13. Department of TB Control & Training
14. Department of Thoracic Surgery and Surgical Anatomy
15
1.2 Treatment
1.2.1 Outdoor The Institute runs a daily OPD and the registration is computerized. The
patients are registered as Area, Non area or Outsiders because the patients are not
only coming from the specified RNTCP 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 specialized clinics to focus on specific areas in Respiratory
Medicine.
1.2.2 Indoor treatment facility
The Institute provided indoor treatment to the serious patients for the
treatment of tuberculosis and respiratory diseases through the available 432 beds in
wards and ICU.
Distribution of total beds (Unit Wise) in the Institute
Type of Patient Unit-I Unit-II Unit-III Unit-IV Unit-V
Male Non-TB 13 13 13 07
Female Non-TB 4 4 4 3 2
Male TB 28 27 25 17 16
Female TB 18 18 18 07 10
MDR TB (Male + Female) 9 9 9 9 9
Empyema cases (Male) 14 14 14
Total 86 85 83 43 37
Total TB & Chest = 334 Paediatrics = 34 Surgery = 27 Emergency = 22 Sleep = 1 ICU = 14 ======================= Grand Total = 432 ----------------------------------------- In addition, a new private ward with 40 beds is ready which will enhance the
indoor bed capacity.
1.3 Teaching & Training The Institute provides teaching and guiding facilities for various post- graduate
16
(M.D. / PhD) courses of various Universities. 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 27 students undergoing training at
present after the increase of the DNB seat from 6 to 10 per year.
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 country, in implementation of strategies under Revised National
Tuberculosis Control Programme. The Institute is actively involved in organising
Continuing Medical Education (CME) programmes on different aspects of diagnosis
and management of tuberculosis and respiratory diseases.
1.4 Manpower
At present, the Institute has 51 Group-A, 189 Group-B and 249 Group-C Staff
in position. In addition, there are 23 senior residents, 27 DNB & 8 Non-DNB junior
residents working on tenure/adhoc basis.
Posts Group
A Group
B Group
C SR JR( DNB)
JR ( Non-
DNB) Total
No. of Sanctioned Staff
55 193 301 23 30 8 610
Present Staff strength 51 189 249 23 27 8 547
2.0 OUT PATIENT DEPARTMENT 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 that is functioning well within its
domiciliary area through DOT cum microscopy centers and only DOT centres.
2.1 New Registrations (Chest Symptomatics)
A total of 42162 chest symptomatics attended the LRS-OPD and 6885
attended the DOTS centres within the Institute specified area other than LRS OPD.
This constituted a total of 49047 chest symptomatics under LRS Institute.
Out of 49047 patients, 20997 came from the LRS specified area and included
17
14112 attending the LRS-OPD and 6885 coming to DOTS centres. Further, 16760
came from Non-Area, while 11290 came from outside Delhi as shown in Table-1.
This indicates that majority (67% or 2/3rd) of the patients who attend the LRS-OPD
are from Non Specified area from Delhi or from outside Delhi. About 2/3rd of the
patients belonged to 15-44 years of age group as shown in Table-1a.
Table-1 : Total Chest Symptomatics (NEW OPD registrations) under LRS Institute (April-2011 -March-2012)
LOCALITY Symptomatics RNTCP Specified area of the Instt.
Symtomatics visited at RNTCP DOTS centres directly.
6885
LRS OPD computerized registration counter
Patients from DOTS area visited LRS-OPD directly
14112 42162
Beyond specified area of the Instt.
NON AREA (within Delhi)
16760
Out Siders ( Outside from Delhi
11290
Total Symptomatics under LRS Institute 49047
Table 1a : Age and Sex Distribution of Symptomatics at LRS-OPD ( April-2011 -March-2012)
Age Groups Male Female TOTAL
>0 and <5 499 1.9% 358 2.3% 857 2.0%
>=5 and <10 775 2.9% 497 3.2% 1272 3.0%
>=10 and <=14 713 2.7% 730 4.8% 1443 3.4%
>=15 and.<=24 5881 21.9% 3855 25.1% 9736 23.1%
>=25 and..<=34 6124 22.8% 3780 24.6% 9904 23.5%
>=35 and.<=44 4836 18.0% 2711 17.7% 7547 17.9%
>=45 and.<=54 3640 13.6% 1659 10.8% 5299 12.6%
>=55and .<=64 2728 10.2% 1179 7.7% 3907 9.3%
>=65 1610 6.0% 587 3.8% 2197 5.2%
TOTAL 26806 100.0% 15356 100.0% 42162 100.0%
64% 36%
18
2.2 Distribution of Symptomatics
The patients who come to the Institute for seeking treatment are investigated
and after confirmed diagnoses are referred to their respective DOTS centres or chest
clinics for further treatment of tuberculosis.
Out of 42162 symptomatics at LRS OPD, record was available for 31933
patients. Of these, a total of 18251 (43%) were diagnosed as suffering from
tuberculosis either pulmonary or extra pulmonary and 13682 (33%) were diagnosed
as Non TB Cases (Table 2 and 2a).
Table 2: Diagnosis of Symptomatics (April-2011 -March-2012) Code
Diagnosis Final Diagnosis Provisional Diagnosis Male Female Total Male Female Total
1 URTI 342 179 521 863 499 1362 2 LRTI 398 162 560 721 572 1293 3 PNEUMONIA 26 13 39 76 24 100 4 PTB 4275 1635 5910 5971 4106 10077 5 TB- Pleural Effusion 679 298 977 724 563 1287 6 POST TB SEQUELAE 657 192 849 641 343 984 7 COPD 548 64 612 967 255 1222 8 ASTHMA 349 141 490 545 399 944 9 I.L.D. 30 16 46 46 16 62 10 SARCOIDOSIS 19 5 24 20 14 34 11 CARCINOMA 59 8 67 100 24 124 12 BRONCHIECTASIS 33 14 47 50 47 97 13 PUL.ESINOPHILIA 73 16 89 54 22 76 14 OCC.LUNG DIS 5 0 5 7 0 7 15 SLEEP DISORDER 3 0 3 8 0 8 16 LUNG ABSCESS 13 1 14 3 3 6 17 EMPYEMA 63 13 76 55 27 82 18 PNEUMOTHORAX 22 2 24 19 3 22 19 HYDROPNEUMOTHORAX 37 10 47 69 26 95 20 OTHER disease 726 515 1241 823 584 1407 21 Metastasis Lung 2 1 3 1 0 1 22 AIDS 6 1 7 31 4 35 23 Smoking 20 2 22 130 8 138 24 ABD LN Tubercular 30 28 58 78 71 149 25 TB LN Tubercular 77 79 156 153 176 329 26 Miliary TB 4 3 7 5 0 5 27 Skeletal TB 19 16 35 30 14 44 28 TBM 5 3 8 5 1 6 TOTAL 8520 3417 11937 12195 7801 19996
19
Table 2a : Diagnosis of OPD Symptomatics
Diagnosed Provisional
Diagnosis
TOTAL Percentage
TB cases (PT+EPT) 6887 11364 18251 43%
Non TB cases 5050 8632 13682 33%
Not diagnosed/ Not available 10225 4 10229 24%
Total 22162 20000 42162 100%
All area cases, who came to LRS OPD, were investigated and after diagnosis
referred back to LRS-DOTS centres for follow up treatment except seriously ill
patients, who needed hospitalisation.
Table-3 shows that after diagnosis 8747 TB cases were referred out from
LRS-OPD to LRS-DOTS centers or to Chest Clinics in Delhi or to neighboring states.
Among 8747 TB cases referred out, 2241 were referred out to LRS-DOTS centres,
2849 to non-area chest clinics in Delhi and remaining 3657 to outside Delhi Chest
Clinics.
Table-3 : Total TB cases Diagnosed and Referred Out ( April-2011 -March-2012)
Patients visited from
Symptomatics at LRS OPD only
TB cases diagnosed and referred out from LRS Institute to their respective chest clinics for DOTS treatment (Patients not registered in LRS TB registers)
Area (patients from specified area of the Instt.)
14112 2241
Non Area (Non specified area of the Instt.)
16760 2849
Outsider (from outside Delhi) 11290 3657
TOTAL
42162 8747
20
Table-4 shows TB patients referred to DOTS centres and neighbouring states
for further treatment after diagnosis at LRS. Of 8747 patients, 8219 were adults and
remaining 528 were children.
Table -4: Patients Referred to DOTS Centres and Neighbouring States
after Diagnosis at LRS (April-2011 -March-2012) Details Sex Adults Children
TOTAL Sp+
ve Sp-ve EPT Sp+
ve Sp-ve
EPT
a) DOTS patients guided and referred to the LRS-DOTS centres:
Those who came directly to LRS-OPD
M 656 359 378 9 24 39 1465 2241
25.6
% F
254 194 227 26 25 50 776
Those who were already registered at DOTS centres and referred to LRS-OPD
- - - - - - - -
b)DOTS patients guided and referred to the Other- DOTS centres in Delhi and neighbouring states: Referred to NON AREA DOTS centres
M
821 465 394 5 31 39 1755 2849
32.6
% F
424 290 279 30 24 47 1094
Referred to neighbouring states (OUT SIDE Delhi)
M
1035 452 417 19 32 48 2003 3657
41.8
% F
791 417 366 17 27 36 1654
Total patients referred from LRS:-
TOTAL (Percentage referred)
3981 (46)
2177 (25)
2061 (24)
106 (1)
163 (2)
259 (3)
8747
8219 528 8747
21
The flow chart shows the distribution of symptomatics and cases diagnosed
and referred after diagnosis from the Institute during the year.
22
2.3 Distribution of TB Cases Registered under RNTCP
Among the total 3272 TB cases, there were 939 (29%) new smear positive
pulmonary TB, 521 (16%) new smear negative, 1065 (33%) EPTB, 6 other new
cases, 209 relapses, 50 failures, 181 Treatment after Defaults and 301 other re-
treatment cases. Among 939 new smear positives, 594 were males and 345
females.
Table-5: RNTCP (Block 1 ) All New and Re-treatment cases (April-2011 -March-2012) Age Groups
New Cases Re-treatment cases Total
New Smear Pos. Pul.TB
New Smear Neg. Pul.TB
New EPTB
Others
Relapse Failure Treatment after Default
Others
0-14 51 58 194 1 4 0 5 28 341
>=15 888 463 871 5 205 50 176 273 2931
Total 939 521 1065 6 209 50 181 301 3272
Male 594 304 576 3 141 xx xx xx Xx
Female 345 227 489 1 68 xx xx xx Xx
Total 939 531 1065 4 209 xx xx xx xx
2.4 Age and Sex Distribution of New Smear Positive PTB Cases
Table 6 shows the age and sex distribution of new smear positive TB cases
registered under RNTCP. It can be seen that majority (74%) of the new smear positive
cases belonged to 15-44 year age group.
Table-6: RNTCP (Block 2 ) Age & Sex Distribution of New Smear Positive PTB cases
(April-2011 -March-2012) Sex Age Groups (Years) Total 0-14 15-24 25-34 35-44 45-54 55-64 >=65
Male 17 184 145 91 76 47 34 594
Female 34 162 83 33 14 13 6 345
Total 51 346 228 124 90 60 40 939
23
2.5 Distribution of Sites of Extra-pulmonary Tuberculosis Cases The distribution of sites of EPTB cases are shown in Table 7. It is seen that
majority of EPT cases had Lymphadenitis (650; 51%) followed by Pleural Effusion
(369; 29%).
Table-7 : Distribution of Sites of EPTB cases (April-2011-March-2012) Sites of EPTB
Nos.
Sites of EPTB
Nos.
a)
LYMPHADENITIS :-
d)
C.N.S (Brain)
Cervical (Neck gland)
497
Tuberculoma
7
Mediastinal (Hilar)
30
Meningeal
9
Axillary
47
e)
UROGENITAL
Cold Abscess
17
Endometrium
22
Abdominal
58
f)
Renal
13
Other
1
GIT
g)
ABDOMINAL Koch's
106
b)
PLEURA h)
Pericaridial
4 Effusion
359
i)
Milliary
8
Empyema
4 j)
Others
13 Pneumothorax
6
Pyopneumothorax
-
Hydropneumothorax
-
c)
SKELETAL
Rib
1
Spine
37
Bone/ joint
30
Total EPTB cases
1269
2.6 Respiratory Emergency
As seen from table 8(a), a total of 8454 patients attended the emergency ward. Of
these, 3414 (40.4%) required to be admitted in the hospital. Table 8(b) shows that
majority (69.1%) had tuberculosis.
24
Table 8(a): Respiratory Emergency Data (April-2011 -March-2012) Total Patients attended the emergency Male Female Total
6139 2315 8454
Admitted from emergency 3414
Patients came for Nebulization only 1347
Patients came only for Injection 1650
Number of Deaths in Emergency 237
Table 8(b) : Type of patients attended the emergency
(April-2011 -March-2012) S.No Type of Disease No. % i) Tuberculosis (TB) 5840 69.1%
ii) Pneumothorax 228 2.7%
iii) Bronchial Asthma 199 2.4%
iv) COPD with Exacerbation 919 10.9%
v) Haemoptysis 938 11.1%
vi) Non Respiratory /Miscellaneous Conditions 330 3.9%
TOTAL patients in emergency 8454 100.0%
2.7 Total Cases in OPD (OPD Load)
The total number of patients who attend the LRS OPD constitute mainly four
groups: (i) New registrations (ii) Subsequent visits for diagnosis (iii) Follow- up visits
by TB patients and (iv) Follow- up visits by Non-TB patients.
Table 9 : Total patients visited LRS OPD (OPD Load)
(April-2011 -March-2012) Patient visits in OPD ADULTS CHILDREN
TOTAL Mal
e Female
Male
Female
i New OPD Registration 24821
13766 1988 1586 42161
ii Subsequent visits by patients
39665
20827 3489 2603 66584
iii Follow up visits made 1016 4317 486 368 15336
25
by TB cases after diagnosis
5
iv Patients visited LRS -OPD
74651
38910 5963 4557 124081
v Non TB patients (New+ Follow ups ) in Special Clinics 5773
vi Patients attended the emergency ward 8454
vii Staff OPD number 9929
TOTAL patients visited the LRS Institute ( Special Clinics+Emergency+ OPD)
148237
Number of working days 298
Average Number of New Registrations (Symptomatics) per day 141
Average number of total patients visited LRS per day 497
Table-9 shows that a total of 148237 patients visited LRS during the year. Of these,
42161 were new symptomatics. 66584 patients made subsequent visits for diagnosis,
15336 patients made follow up visits as TB cases.
During the year, OPD worked for 298 days. It was observed that on average, a total
of 497 cases visited LRS per day including 141 new registrations.
2.8 Paediatric OPD
Paediatric patients are seen in a Paediatric OPD daily from Monday to
Saturday. The T.B. patients from specified area of the Institute are referred to the
respective DOT centres while the others are treated at LRS OPD. The data is shown
in tables 4, 5, 6 and 9. A total number of 4478 tuberculin tests were done during the
year. Out of these, 62.4% were found to be tuberculin positive as shown in table-10.
Table -10 : Number of Tuberculin tests done (April-2011 -March-2012) <1 yr 1-2 3-5 6-10 11-14 >14 Total
Total Treated 15 145 521 637 927 2233 4478
Total Read 9 133 475 597 844 2084 4142
Positive 4 72 229 327 500 1456 2588
Negative 5 61 246 270 344 628 1554
PPD not read 6 12 46 40 84 141 329
26
2.9 Specialized Clinics (Non-TB Cases )
The Institute runs various specialised clinics, which are held periodically. The
data is shown in table -11.
TABLE-11 :- SPECIALIZED CLINICS DATA (April-2011 -March-2012)
S. No Name of the Clinic In-charge New Follow up
Number of patients
i)
Sleep Clinic Dr. Rajnish Gupta 37 65 102
ii)
Lung Cancer Clinic Dr. D. Behera / Dr. A. Jaiswal
105 280 385
iii)
Surgery Clinic Dr. R.K Dewan 176 2081 2257
iv)
Allergy Clinic Dr. A.K. Jain 135 696 831
v)
Tobacco Cessation Clinic
Dr. S.B. Singh 843 443 1286
vi)
APRD ( Air Pollution Related Disease) Clinic
Dr. J.K. Saini 22 27 49
vii)
Laser Therapy Clinic Dr. M.M. Puri 15 464 479
TOTAL 1333 4056 5389 viii) Pain Management Clinic ( Dr. Ashwini ) 384
Grand Total 5773 3.0 Indoor Patient Data
Those patients requiring hospitalisation are admitted in the Institute for the
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 2011 to March 2012, a total of 5790 patients were
admitted and 5197 were discharged.
27
3.2 Age & Sex Distribution of Admitted Cases
Table-12 shows that among the total 5790 admissions, there were 5502
(95%) adults and 288 (5%) children. Among the hospitalised adults, the maximum
were in the productive age group of 25 to 54 years.
Table-12: Age & Sex Distribution of the patients Admitted & Discharged (April-2011 -March-2012 )
Age groups (Yrs.)
Admission Discharge
Male Female Total Admission
Male Female Total Dischar
ge Children 0-5 29 15 44 24 13 37
6-10 44 25 69 36 23 59
11-14 57 118 175 51 97 148
Total children 130 158 288 111 133 244
Adults 15-24 569 398 967 494 369 863
25-34 699 319 1018 636 293 929
35-44 763 256 1019 690 222 912
45-54 838 199 1037 770 186 956
55-64 690 177 867 616 164 780
>=65 457 137 594 389 124 513
Total Adults 4016 1486 5502 3595 1358 4953
TOTAL Patients 4146 1644 5790 3706 1491 5197
28
3.3 Outcome of Admitted Cases :
Out of total 5197 indoor treated cases, 2778 (53%) were suffering from pulmonary
tuberculosis, 364 (7%) had extra pulmonary tuberculosis and 2055 (40%) were suffering
from non-tubercular disease. The outcome of these patients is given in Table-13. It is
observed that 13% of the patients died, 7% Left Against Medical Advice (LAMA), 6% were
Discharged on Request (DOR), 2% absconded, 3% referred out and remaining 3539 (68%)
were discharged after satisfactory treatment.
Table-13 : Distribution of outcome of indoor patients treated in the hospital
(April-2011 -March-2012 ) Outcome Adults Children TOTAL Grand
Total %ag
e PT EP
T NTB PT EP
T NTB PT EPT NTB
i Discharge 1695 223 1442 77 40 62 1772 263 1504 3539 68%
ii L A M A 236 20 114 8 0 1 244 20 115 379 7%
iii D.O.R. 144 21 130 5 4 7 149 25 137 311 6%
iv Absconded 73 8 37 1 1 1 74 9 38 121 2%
v Referred 67 28 64 6 4 11 73 32 75 180 3%
vi Died 450 14 185 16 1 1 466 15 186 667 13%
TOTAL 2665 314 1972 113 50 83 2778 364 2055 5197 100%
54% 6% 40% 46% 20% 34% 53% 7% 40%
4951 246 5197
3.4 Observations on Indoor Cases: On analysing the data of the discharged cases, the following observations are made:
i It is observed from Table 14 that 67% (45% Cat-II and 22% Others) of the
hospitalised pulmonary TB cases 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.
ii. As soon as the treatment response was observed clinically, the cases were
discharged and referred to respective DOTS centres for further treatment.
Therefore, it is observed that 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), 1765
29
admitted patients with sputum positive results had still not converted to smear
negative status possibly due to a shorter duration of stay in the hospital (Table-
15).
iii Of the total TB cases, about 66.8% had no complications, while 14.3% had
complications like pneumothorax, pyoneumothorax, empyema, lung abscess etc.
(Table 16).
iv Among the 263 extra-pulmonary TB cases, majority had pleural involvement
(70%) followed by Abdominal (9.9%), Lymph Node TB (3.4%), Miliary TB (3.4%)
and Tubercular meningitis (3%) as given in table 17.
v. Among the admitted non-TB chest cases, COPD and lung cancer constituted
30% and 22% of the cases respectively (Table 18).
vi Detection of HIV-cases is also done in the Institute. Most of the cases detected
were adult males. HIV was suspected in 1543 admitted patients, of whom, 69
(4.5% ; 64 adults and 5 children) were found to be HIV positive (Table 19).
vii The patients of PTB put on treatment received 3% conventional treatment, 1%
SCC, 50% DOTS and nearly 12% reserve drugs (Table 20).
viii Among the total 622 cases admitted in ICU, there were 434 medical (including
paediatric cases) and 188 surgical cases. During the year, 131 deaths occurred
in ICU (Table 21). These are included in the total deaths of the Institute.
Table-14 : Categorywise Distribution of PTB cases (April-2011 - March-2012 )
Category Adults
Children
Total
No. Percent Cat -I 843 42 885 32%
Cat-II 1220 48 1268 45%
Cat-III 17 0 17 1%
Other than Cat-I,II,III) 585 23 608 22%
TOTAL 2665 113 2778 100%
30
Table-15 : Sputum Status of Discharged Pulmonary TB cases (Excluding LAMA/DOR/Absconded and Deaths) (April-2011 -March-2012 )
(a) Total discharged PT cases 2778
(b) Cases excluded from analysis (LAMA(244 ) +DOR(149 ) +Absconded(74 ) +Referred out(73 )+Deaths(466 ) =
1006
(c) Sputum report not available at discharge 7
(d) Data analysed for Sputum status at admission and discharge {(d) = (a) - (b+c) }
1765
Number of patients who were Positive at admission and remained Positive at Discharge
1765
Table-16 : Complications in DISCHARGED PTB Cases (April-2011 -March-2012 )
Complications Number of Patients TOTAL Percentage
Children Adult
Pneumothorax 2 54 56 3.2%
Pyopneumothorax 4 137 141 8.0%
Empyema 1 46 47 2.7%
Lung Abscess 1 6 7 0.4%
No Complications 69 1114 1183 66.8%
Not Mentioned 0 338 338 19.1%
Total 77 1695 1772 100.0%
Table-17: Distribution of Extra Pulmonary Tuberculosis cases (EPT) (April-2011 -March-2012 )
Type of cases Adults Children Total Number Percent
i Lymph Node 2 7 9 3.4%
ii Pleural effusion /Empyema 28 156 184 70.0%
iii Abdominal Koch's 3 23 26 9.9%
iv Miliary 2 7 9 3.4%
v Pericardial Effusion 0 2 2 0.8%
vi Skeletal (Bone & Joints) 1 1 2 0.8%
vii Tubercular Meningitis(CNS)
3 5 8 3.0%
viii Others 1 22 23 8.7%
TOTAL 40 223 263 100.0%
31
Table-18 : Distribution of Admitted Non TB Cases (April-2011 -March-2012)
Types of Non Tuberculosis Children Adults Total Number Percent I COPD 1 614 615 30%
II Lung Carcinoma 1 445 446 22%
III Interstitial Lung Disease 3 73 76 4%
IV Pneumonia 9 55 64 3%
V Empyema (Non Tubercular) 11 93 104 5%
VI Bronchiectasis 6 101 107 5%
VII Cor Pulmonale 0 12 12 1%
VIII Pneumothorax 1 58 59 3%
IX Bronchial Asthma 23 32 55 3%
X Lung Abscess 0 14 14 1%
XI Sarcoidosis 0 10 10 0.5%
XII Tropical Pulm Eosin (TPE) 1 1 2 0.1%
XIII Others 27 468 495 24%
TOTAL 83 1976 2059 100%
Table-19 : Detection of HIV Among Suspected Admitted Patients (April-2011 -March-2012)
HIV test Status
PTB EPTB Non TB Total
Male Female Male Female
Male Female
Male Female Total
Children
Positive
2 1 0 2 0 0 2 3 5
Negative
16 36 19 10 21 8 56 54 110
Adults Positive
41 6 6 0 7 4 54 10 64
Negative
583 208 83 49 344 97 1010 354 1364
TOTAL 642 251 108 61 372 109 1122 421 1543
893 169 481 1543 0 1543
32
Table-20 : Distribution of PTB Cases as per Treatment Given (April-2011 -March-2012)
Treatment Type Children Adult Total Number Percent Conventional 0 54 54 3%
SCC 1 11 12 1%
DOTS 58 1321 1379 50%
Reserve Drugs 18 309 327 12%
TOTAL PT cases Started treatment 77 1695 1772 66%
Trement not started due to early DISCHARGE,LAMA DOR,ABSCONDED, REEFERRED OUT,DIED Before Treatment started
36 970 1006 36%
Total PTB cases 113 2665 2778 100%
33
Table-21 : Details of I.C.U. Admissions (April-2011 - March-2012) Total Treated TOTAL Medical Patients (Adults) 427 622
Medical Patient (Paediatric) 7
Surgical Patients 188
Cumulative No. of patients treated in rooms for critical care 1847
Cumulative No. of patients treated for intermediary care in high dependency units (HDU)
2145
Patient with longest stay 3mths
Average bed occupancy in rooms for critical patients(total rooms =6) 5.0
Average bed occupancy in High dependency rooms (HDU) (total beds =8) 5.9
Average Bed Occupancy (Total beds =14) 10.9
No. of patients on Invasive Ventilator 187
Average No. of Ventilator Days / Month 67
No. of patients on Non Invasive Ventilator 304
Average No. of days / patient on NON invasive ventilator 3.8
No. of ECGs done 591
No. of ABGs done 5689
No. of Central Lines put 53
Miscellaneous procedures
ICD 71
Pleural Aspirations 33
Pleural Biopsy 7
Tru-cut Biopsy 1
Bronchoscopy 5
Ascitic Tap 13
Tracheostomy 1
FNAC 8
Outcome
Discharge 94
Transfer out 372
LAMA 15
Death 131
34
Annual Trends of LRS Institute’s Data Vs National / International Scenario
Over the years, it has been observed that amongst the symptomatics attending the LRS
OPD, more than 3/4th are aged between 15-54 years. Majority (>40%) of diagnosed cases
have TB of either pulmonary or extra-pulmonary type. About 30% of them are new smear
positive PTB cases, of whom, >80% belong to 15-54 year age-group. Even among the
hospital admissions, about 70% are aged between 15-54 years. These observations are in
line with the recent Annual Status Report of our country, which suggests that almost 70% of
TB patients are aged between 15 and 54 years of age. Since this is the most productive
period of their lives, TB causes enormous socio-economic consequences for their
households and the country at large.1
About 10% of all TB cases are in the pediatric age group, while the remaining are
adults. Globally, pediatric TB cases account for 10 to 15% of all TB cases. Similarly, the
burden of pediatric TB in our country is also assumed to be 10% of total TB load.1 Thus, the
Institute data matches with the national and international figures of pediatric TB case load.
It is seen that males constitute about 2/3rd of all symptomatics attending the LRS OPD.
They also make up about 2/3rd of all new smear positive PTB cases. The findings are
similar to those observed in the Recent Annual Status Report of our country mentioning
two-thirds of TB cases to be males.1
Over the years, proportion of EPTB case detection as compared to PTB has been
rising. However, over last 2 to 3 years, the proportion of New EPTB cases is stable i.e.
around 1/3rd of all TB cases. Since EPTB diagnosis is difficult and requires a number of
special tests including invasive techniques, there is a need to develop non-invasive tests
and incorporate them in RNTCP so that these could be utilized at the periphery itself.
1- TB India 2012
35
4.0 Departments and Sections of the Institute
LRS Institute of TB and Respiratory Diseases has several departments and sections
to carry out the activities of the Institute. Their staff (including the names of the heads / in-
charges) and activities performed by them during the year are mentioned under the
respective department and section.
4-A Departments Various departments functioning within the Institute and their heads are mentioned
below.
S. No. Name of Departments Name of the Head of Department
4.1 Department of Anaesthesia Dr. Ashvini Kumar 4.2 Department of Bio-Chemistry Dr. Devika Tayal 4.3 Department of Epidemiology & Public Health Dr. Khalid Umer Khayyam 4.4 Department of Hospital Administration Dr. Rohit Sarin 4.5 Department of Internal Medicine Dr. Upasana Agarwal 4.6 Department of Microbiology Dr. V.P. Myneedu 4.7 Department of Molecular Medicine / Genetics Dr. Paras Singh 4.8 Department of Paediatrics Dr. Sangeeta Sharma 4.9 Department of Pathology Dr. Kumud Gupta 4.10 Department of Physiology Dr. Rupak Singla 4.11 Department of Radiology Dr. Devesh Chauhan 4.12 Department of TB & Respiratory Diseases Dr. Rupak Singla 4.13 Department of TB Control & Training Dr. Rohit Sarin 4.14 Department of Thoracic Surgery and Surgical
Anatomy Dr. R. K. Dewan
Detail of each department is given below. 4.1 Department of Anesthesia Dr. Ashvini Kumar : Head of Department
Dr. Prakash Sharma : Anaesthetist
The department has a centrally air-conditioned, state of the art operation theater with
Laminar flow. The department provides services for pre anesthetic assessment, pre-
operative optimization and administration of anesthesia for various diagnostic and
therapeutic procedures. Acute pain management for patients undergoing procedures under
anesthesia is also undertaken. The department also runs a pain clinic for management of
chronic post thoracotomy pain. Other activities like providing sterilization services and
36
Oxygen supply to the entire Institute are also undertaken by the department.
4.2 Department of Bio-Chemistry Dr. Kumud Gupta : Head of Department (till 30th September 2011) Dr. Devika Tayal : Head of Department (Joined wef 1st October 2011) Dr. Amita Khiwani : Senior Resident (Joined on 5th October 2011) Department of Biochemistry is well equipped with fully automatic random access
biochemistry analyser and automatic analyser. It carries out various tests like Blood Sugar,
Urea, Creatinine, Total-Bilirubin, Direct Bilirubin, SGOT, SGPT, Alkaline Phosphatase, Total
protein, Albumin, Uric Acid, Cholesterol & Electrolytes (Sodium, Potassium and Chloride).
The procurement of other equipments like ELISA Plate Reader, Plate Washer and the
instrument for estimation of Glycated Haemoglobin is in process. The tests and data of
department is given in table 22.
Table-22 : BIOCHEMISTRY tests done (April-2011 -March-2012 )
S.No. Type of Tests Number % out of 192535
i Blood Sugar 14451 7.5%
ii Blood Urea 17912 9.3%
iii Creatinine 18388 9.6%
iv Total Bilirubin 19209 10.0%
v Direct Bilirubin 18474 9.6%
vi S.G.P.T. 19403 10.1%
vii S.G.O.T. 19403 10.1%
viii Alk PO4 19389 10.1%
ix Protein 12734 6.6%
x Albumin 11699 6.1%
xi Uric Acid 2593 1.3%
xii Cholesterol 2329 1.2%
xiii Electrolytes 16551 8.6%
Total Tests 192535 100.0%
Total Number of Samples = 45324
37
4.3 Department of Epidemiology & Public Health Dr. Khalid Umer Khayyam : Epidemiologist and HOD
Dr. Sujata Arya : Senior Research Officer (Epidemiology)
Dr. Neeta Singla : Research Officer
Department is running RNTCP with the help of staff provided by STO, Delhi. It is
coordinating with Department of TB & Respiratory Diseases in provision of DOTS to all categories
of TB patients and also establishing a linkage to the RNTCP staff for continuation of treatment at the
patient’s doorsteps.
Besides this, the department is involved in facilitating the RNTCP modular training of MOs,
MOTCs, DTOs and STOs from different parts of the country on a continuous basis. Department is
also involved in regular teaching activities of post graduate students both from within and outside the
Institute. Department is also involved in regular RNTCP teaching programme for nursing staff of
the Institute and for nursing students from other Institutes. The faculty of the department has
delivered guest lectures and has attended various conferences at both national and international level.
The department has also organized various workshops on involvement of NGO and PPs in DOTS
and DOTS-Plus. Department is also involved in developing teaching modules for nurses for DOT-
Plus.
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 covering a population about 1.00 million. 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 tuberculosis control services provided by the institute have
been decentralized through DOT-cum-Microscopy centres established under the RNTCP in
the area covered by the institute. At places, sub-centres (DOT-Centres) have also been
started with NGO assistance to further bring the services closer to the patients and
community. The list of the DOT-cum-Microscopy Centre is as under:-
38
Name of Centre Medical Officer Incharge Phone No.
DGD – Mehrauli Dr. Jain 29961371
MCD – Fatehpur Dr. Sarkar 26653393
DGD – Chhatterpur Dr. Qayyum 26801602
DGD – Jaunapur Dr. Sunil Thapriyal 266548444
DGD – Ber Sarai Dr. Archana 26526942
DGD – Khanpur Dr. Mamta Gupta 29960981
DGD – Tigri Dr. Mamta Gupta 29960981
DGD – K-II Block, Sangam Vihar Dr. J.C Malik 26046306
DMC – I Block, Sangam Vihar Dr. Sujata Arya (MO-TC) 26517826 (Extn. 531)
DMC – J Block, Sangam Vihar Dr. Sujata Arya (MO-TC) 26517826 (Extn. 531)
DMC – G Block, Sangam Vihar Dr. Sujata Arya (MO-TC) 26517826 (Extn. 531)
DMC – I Block, Sangam Vihar Dr. Sujata Arya (MO-TC) 26517826 (Extn. 531)
LRS Institute Dr. K.K. Mathuria 26517826 (Extn. 531)
In addition to the above centres, the department is collaborating with the following
NGOs and Private Practitioners.
Name of NGOs Contact Person Phone No.
St. Marry, Aaya Nagar Dr. Joseph 011-55653587, 20913530
Vyakti Vikas Kendra India Dr. Sunita Khera 9810594753
Asha Community Health &
Devlopment
Ms. Rani 011-26716409, 26179844
Rotary Club of Delhi South Dr. B.S Khurana 9868103028
Rotary Club of Delhi Sainik
Farm
Dr. P.C Bansal 9312212736
39
The RNTCP is implemented by the DTO who is assisted by Medical Officer -TB
Control (MOTC). There are two tuberculosis units each being under one MOTC who is
assisted by Senior Treatment Supervisor (STS), Senior TB Laboratory Supervisor (STLS),
five Laboratory Technicians and five TB Health Visitors. The department also has a Data
Entry Operator. Most of the staff working in the department is on contract basis.
The RNTCP has consistently achieved the National targets of cure rate of above 85%
and case detection above 70% for the past several years. The Institute is also implementing
the DOTS Plus strategy for programmatic drug resistant cases through this department.
The Department has been involved in many publications in international and national
journals and is regularly generating data of RNTCP for discussion in monthly statistical
meetings.
RNTCP
Dr. Khalid U Khayyam : District TB Officer
Dr. Neeta Singla : Medical Officer TB control
Dr K Mathuria : Medical Officer TB control
Revised National Tuberculosis Control Programme was implemented in a phased
manner and the full fledged programme began in 1997. The programme uses the DOTS
strategy with the objective to achieve and maintain at least 85% cure rate of new sputum
smear positive and detection of at least 70% of such cases. Entire country was covered
under RNTCP in March 2006.
From when LRS was part of it?
The south zone district of Delhi was offered to this institute to implement the
national programme.
Currently LRS-RNTCP is looking after the 1 million population of land area starting
from Ber Sarai to Jaunapur and from Khanpur to Sangam Vihar. This area was divided into
40
two tuberculosis units. There are 11 designated microscopy centers and 17 DOT Centers
including NGO’s and PP’s.
RNTCP ACTIVITIES: Eleven microscopy centers are being operationalised with the help
of qualified and trained Laboratory Technician in 1 million population of South Zone of
Delhi. All the chest symptomatics undergo screening for TB by smear microscopy.
A DOT provider is available in all 17 DOT centers of our area whose functions include:-
• Initial home verification of TB diagnosed patients and provision of IEC activities to
family members.
• Initiation of DOTS as per RNTCP guidelines.
• Establishing the linkage by visiting the Institute on every Friday for timely
enrolment of the diagnosed and referred patients to their respective DOT area.
• Continuation of DOTS to patients after discharge from the Institute.
• Sending case and contacts to LRS Institute for various ongoing research projects.
• Helping the trainees during the field visits at DOT/MC Centres during their RNTCP
modular trainings.
IEC activities are done at each DOT centre on quarterly basis by 1st level of supervision. A
collaboration has been done with Department of Community Medicine of St.Stephen hospital for
training of DOT-provider regarding IEC activities at DOT Centre.
A collaboration has been done with NGOs and PPs. Among the NGOs, the St. Marry’s Medical
Centre is one of the well known organization working in tuberculosis. The ESI at Tigri and Mehrauli
patients are benefiting from DOT at ESI Centers.
A collaboration has been done with other organizations like Jamia Hamdard (Hamdard
University) for research work of M.Sc and Ph.D students.
41
LRS-RNTCP achieved the cure rate of 89% and the sputum conversion rate of smear positive
patients of 90% during the year (table-23). This achievement resulted due to the joint efforts of LRS,
NGOs, PPs and STO Delhi.
Table-23: LRS-RNTCP Outcome Data (April- 2011 to March 2012)
Indicator Yearly expected
2nd quarter 2011
3rd quarter 2011
4th quarter 2011
1st quarter 2012
Actual Year
New smear positive
950 294 220 217 288 1019
New smear Negative
950 185 168 103 121 577
Retreatment 475 207 116 181 203 707
EPT 190 413 394 206 222 1235
Total 2565 1099 898 707 834 3538
Sputum Con.
>90% 88.4% 86.28% 88% 88% 87.67%
Cure Rate >85% 89.8% 91% 88.4% 92.12% 90.33%
Default Rate
<5% 5% 4.6% 3.8% 0.6% 3.50%
Failure Rate <4% 1.9% 2.6% 2.3% 3.6% 2.6%
Death Rate <4% 2.5% 0.6% 1.5% 3.6% 2.05%
DOTS was given to a total number of 3538 patients that included 2749 of Category-I and 789
of Category-II.
DOTS-PLUS Project :
LRS Institute has been promoting National Tuberculosis Control Programme through
implementation of DOTS in 1 million populations in South Delhi, through 11 microscopy and 17
DOT centres. It has been successful in achieving the goals of the National Tuberculosis Control
Programme. The Institute started DOTS-PLUS as a pilot project in Jan’02. The project had
approval of green light committee. A total of 160 patients were enrolled in the project. The seven
year experience has also been published. This Experience of DOTS Plus project contributed
42
significantly in formulation of national DOTS Plus guidelines. Faculty of LRS Institute are also
members of National DOTS Plus committee for framing and revising the National Guidelines. LRS
Institute is now a part of National DOTS-Plus Programme.
Currently Institute is implementing National DOTS-Plus programme since Jan’09. The
activities under the programme are as follows:
• LRS institute covers a population of 6 million for screening the MDR in its National Reference
Laboratory and a population of 6 million for providing DOTS-Plus treatment. Five chest clinics
namely Malviya Nagar, Moti Nagar, RTRM, DFIT, and LRS chest clinics come under DOTS-
Plus treatment.
• The suspects for MDR are the patients who fail on CAT-I, CAT-II (any month follow-up positive)
and CAT-II initial positive under DOTS. All such patients are subjected to culture and sensitivity
free of cost by the LRS Microbiology Lab which is the national reference laboratory for
tuberculosis. Patients with proven MDR are enrolled in the programme. These patients are
treated with daily supervised regimen for a period of 2 years with the second line drugs free of
cost.
• All the patients enrolled in the programme are evaluated by a DOTS-Plus committee. Members of
the committee are specialists of chest medicine, epidemiology, internal medicine, Obs & Gynae,
ENT, Nephrology, Endocrinology, Psychiatry and microbiologist. This committee meets on a
weekly basis to discuss the enrollment related and other issues like adverse drug effects.
• Approximately 1062 patients were screened during the period and 226 patients started on
treatment. Their record was maintained on regular basis.
4.4 Department of Hospital Administration Dr. Rohit Sarin : Assistant Medical Superintendent and HOD
Dr. R.K.Dewan : Chief Administrative Officer
Dr. Kamla Verma : Chief Medical Officer (NFSG)
The Department of Hospital Administration is headed by the Assistant Medical
Superintendent, Dr. Rohit Sarin. The Dept. assists the Director in running the Institute. Other
divisions of the administration include a Chief Administrative Officer (Dr. R. K. Dewan) and an
officiating Administrative Officer (Mr.G.V.Raju). Various administrative issues are dealt by this
division. Estate Branch looks after the maintenance works of the Institute and consists of an
43
Estate Committee and a Consultant Civil Engineer on contract basis. The Medical and
General Stores, Health Education Section, Social Welfare Section, Transport Section, Medical
Record Section, Telephone Exchange, Security division, Procurement Cell, and a full fledged
Accounts Section take care of various activities of the Institute. The Institute also has a Public
Information Officer(Mr.G.V.Raju) and an Appellate Officer (Dr. Anand Jaiswal).
4.5 Department of Internal Medicine Dr. Upasna Agarwal : Head of Department
The Department of Medicine runs a daily medicine OPD and gives internal Medicine
consults to patients of Respiratory Medicine attending the Institute’s OPD and admitted in
wards and intensive care unit.
The Department of Medicine also runs a free HIV clinic under the aegis of National
AIDS Control Organization as discussed later under the Section.
The Department of Medicine hopes to provide quality care to people availing its
services and to lead in teaching, training and research activities in the future.
4.6 Department of Microbiology
Dr. V.P. Myneedu : Microbiologist and HOD
Dr. Manpreet Bhalla : Senior Research Officer
Dr. Ajoy Kumar Verma : Microbiologist
Dr. Ritu Singhal : Microbiologist
Dr. Manish Mathur : Senior Resident
NRL Staff
Dr. Niti Singh : NRL – Microbiologist
Dr. Jyoti Arora : NRL-Microbiologist
FIND Staff
Dr. Gavish Kumar : FIND – Microbiologist
The department of Microbiology is equipped to provide diagnostic and research support
44
in the areas of Mycobacteriology, Bacteriology, Mycology, Serology and Molecular Biology.
The department plays a pivotal role in the diagnosis of tuberculosis and supports the
RNTCP by performing the following.
• Smear microscopy by ZN stain and fluorescent stain on binocular, fluorescence and
Trinocular microscopes for the purpose of diagnosis and training.
• Culture, identification and drug susceptibility testing (DST) for all anti-TB drugs of
mycobacterium by conventional and MGIT 960 TB System.
• The laboratory carries out approximately 25,000 cultures/annum and DST to both first
line and second Line anti tubercular drugs.
• The laboratory is the National Reference Laboratory under RNTCP related activities and is
involved in conducting quality assurance, accreditation and training related programmes.
The department supervises the Intermediate Reference Laboratory (IRL) activities and
quality control issues of 11 states.
• Line Probe Assay (LPA) has been established in new research block to diagnose and to
detect resistance to Rifampicin and INH in 48 hours after receiving the smear positive
samples. This will help in rapid diagnosis of MDR TB Patients. Training was conducted by
Foundation for Innovative New Diagnostics (FIND) in this regard, following which, both
internal and external proficiency testing has been completed and laboratory has been
accredited by Central TB Division to use LPA as a diagnostic test for MDR TB under
DOTS Plus programme for Delhi State and other states.
• Gene-Xpert equipment has been donated by Melinda & Bill Gates Foundation for the
rapid diagnosis of TB and MDR TB. The department has evaluated the Gene-Xpert
equipment with 120 sputum samples from suspected MDR patients and the results were
compared with the results of solid and liquid cultures and DST Methods. The report of the
results has been tabulated and sent for publication in index journal.
• The Department of Microbiology has established a conventional identification for Non-
tubercular Mycobacteria isolated from various respiratory and pulmonary specimens.
• With a view to provide holistic diagnostic support for routine bacteriology, facilities of
mycology and serology also exist. The laboratory does routine serological screening for
HIV, HBsAg, HCV, Widal and Aspergillosis.
During this period, the department carried out proficiency testing of IRLs of Delhi,
45
Haryana, TB lab of PGI, Chandigarh and TB labs of Dept. of Medicine and of Dept. of Lab
Medicine of AIIMS, New Delhi. Several on-sight evaluations (OSEs) of IRLs of Manipur,
Haryana, Delhi state, Dept. of Microbiology and Govt. Medical College and Hospital,
Chandigarh were carried out. IRL of Karnal, Haryana was accredited. Other laboratories are in
various stages of accredition. During the year, microbiologists and LTs of all IRLs Haryana, TB Lab of Dept. of
Microbiology PGI, Chandigarh and TB lab of Dept. of Medicine were trained in culture and
DST of M.Tuberculosis as per RNTCP guidelines. Trainings of Lab Supervisors and Lab
Technicians from high burden Designated Microscopy Centers (DMCs) of Medical Colleges
under the Project – LIGHT of IUATLD was carried out at LRSI from December 2011 to April
2012.
Data of Microbiology Department for the year is shown in tables from 24 to 34.
Table-24: Pulmonary Smear Microscopy (Sputum examinations) (April-2011 -March-2012)
SOURCE OF SAMPLE Sputum smears made for microscopy
Sputum smears
confirmed by
Microscopy
Sputum Positives
Percentage positivity
OPD
Diagnosis
LRS RNTCP (DOTS) Area Non Area and Outsiders
33628 26387 4985 14.8%
Follow up 3867 3112 716 18.5%
Total (a) 37495 29499 5701 15.2%
INDOOR (b) 10486 9977 3107 29.6%
Culture Section
Pulmonary
OPD 14452 14452 4869 33.7%
Ward 3376 3376 983 29.1%
Extra Pulmonary 1666 1666 140 8.4%
Subtotal (c) 19494 19494 5992 30.7%
TOTAL (a)+(b)+(c) 67475 58970 14800 21.9%
46
Table-26 : CULTURE SECTION (EXTRA PULMONARY SPECIMENS) (April-2011 -March-2012 )
S.No.
TYPE OF TESTS No.of Specimen
Smear Positive
Conventional Culture
MGIT
I Pleural Fluid 374 4 342 22
Ii Pleural Pus 258 42 242 0
Iii Pus 395 57 380 43
Iv Bronchial Washings 121 2 109 0
V Lymph Node aspirate 0 0 7 67
Vi FNA 423 25 378 33
Vii Ascitic fluid 46 0 45 2
Viii Urine 12 0 8 11
Ix CSF 13 0 13 1
X Tissue Lung Biopsy 6 0 4 1
X Others 19 0 14 55
TOTAL 1667 130 1542 235
Table-25 : CULTURE SECTION (PULMONARY SPECIMEN) (April-2011 -March-2012 )
Particulars Total Samples Received
Conventional Culture
MGIT Culture
OPD 14452 8623 1891
INDOOR 3376 1209 210
Project 0 0 47
DOTS plus project 0 0 0
TOTAL 17828 9832 2148
47
Table -27 : Drug Susceptibility Results for PRIMARY DRUGS (Drug Resistance ) (CONVENTIONAL METHOD )
a. All Sensitive 217
b. Any Resistance 706
Drug No. Drug No. Drug No.
SHRE 201 SR 17 R 8
SHR 183 HR 88 S 51
HRE 11 SH 54 H 78
SHE 8 HE 4 E 1
SRE SE 1
RE 1
c. Indeterminate (Repeats ) 122
d. Quality Control 33
Total Tests Performed = (a+b+c+d) = 1078
Table- 28 : Drug Susceptibility Results (Drug Resistance results) (MGIT METHOD)
a. All Sensitive 133
Any Resistance 939
b. Drug No. Drug No. Drug No.
SHRE 333 SR S 16
SHR 200 HR 152 H 95
HRE 56 SH 48 R 4
SRE 1 HE 5 E 1
SHE 19 RE 1 I 8
c. Indeterminate (Repeats) 0
d. Quality Control 19
Total Tests Performed = (a+b+c+d) = 1091
48
Table-29 : BACTERIOLOGY ( PYOGENIC CULTURES) (April-2011 -March-2012 )
TYPE OF SAMPLES NO. TYPE OF SAMPLES No. i) Sputum / Throat swabs 1040 viii) Ascitic Fluid (AF) 20
ii) Bronchial washings 55 ix) CSF 4
iii) Pleural fluid 172 x) ET 168
iv) Pus 932 xi) Stool 5
v) Urine 938 xii) Others 32
vi) Lymph node Aspirate 8
vii) Gastric Aspirate 2
TOTAL Samples 3376
Table-31 : MYCOLOLGY (April-2011 -March-2012 ) TYPE OF SAMPLES NO. TYPE OF SAMPLES No. i) Sputum 167 vi) Urine 6
ii) Bronchial washing 35 vii) CSF 2
iii) Pleural fluid 4 viii) ET Aspirate 12
iv) Pus 17 ix) Blood 5
v) Lymph node aspirate 4 x) Biopsy 1
TOTAL 253
Table-30 : RESULTS OF PYOGENIC CULTURES (April-2011 -March-2012 ) Total number of samples = 3376
RESULTS OF SAMPLES NO. RESULTS OF SAMPLES No. i) Total Organisms isolated 2280 vii) Normal FLORA 364
ii) Gram positive 233 viii) Insignificant GROWTH 48
iii) Gram negative 2057 ix) Double/ triple growth 693
iv) Candida 137
v) Sterile 792
vi) Contaminated 20
49
Table- 32 : NAME OF THE TEST FOR MYCOLOGY
(April-2011 -March-2012) NAME OF TESTS No. NAME OF TESTS NO.
i) KOH Mount 253 iv) Germ tube test 100
ii) LPCB mount 223 v) SDA agar 253
iii) Wet mount 219 vi) SDA cc Agar 253
Table- 33 : NAME OF FUNGUS ISOLATED IN MYCOLOGY TEST : (April-2011 -March-2012
RESULTS OF SAMPLES NO. RESULTS OF SAMPLES No. i) Candida Albicans 39 vii) Aspergillus Sp 14
ii) Candida Non Albicans 32 viii) Aspergillus Terreus 1
iii) Aspergillus Fumigatus 15 ix) Aspergillus Niger 2
iv) Candida Sp 16 x) Rhizopus 1
v) Gem tube test 28 xi) Others 22
vi) Aspergillus Flavus 12 Total fungus isolated 182
Table -34 : IMMUNOLOGICAL TESTS (April-2011 -March-2012 ) TOTAL(Ward+OPD)
TESTS Number Positives
HIV 1 & 2 4269 178
HbsAg 1564 63
Widal 692 183
HCV 1245 31
Aspergilosis 144 10
TOTAL Immunology tests done = 7914
50
4.7 Department of Molecular Medicine /Genetics Dr. V.P. Myneedu : Microbiologist and HOD (till 22nd August 2011)
Dr. Paras Singh : HOD (Joined wef 23rd August 2011)
Dr. Mradula Singh : Senior Resident (Joined wef 17th September 2011)
The institute has recently constructed a new division for the purpose of molecular research
activities in regard to tuberculosis, HIV, lung cancer, and other infectious diseases. Currently,
department of Molecular Medicine is providing diagnostic facility to patients through Multiplex PCR
for identification of M. tuberculosis in pulmonary as well as paucibacillary extra-pulmonary TB
cases. Department also facilitates Real Time PCR screening assays for M. tuberculosis in pulmonary
and extra-pulmonary cases and HIV-1 Viral load testing to AIDS patients. Effort has been made for
further molecular identification of NTM by conventional PCR for diagnosis and treatment of
patients. Laboratory diagnosis of pulmonary and extra-pulmonary TB has been streamlined and has
been communicated to clinicians.
The major focus of research activities in the division is towards disease susceptibility. Hence,
the research is being focused on the biomarkers like chemokine receptors and its ligands, CCR2,
MCP-1, TLR, etc. with regard to Tuberculosis and HIV-1 infection and Vascular Endothelial Growth
Factor gene variants, XRCC4 gene variants and SNPs with regard to lung cancer. Recruitment of
healthy volunteers and TB patients has recently started for the approved projects. Two research
proposals have been approved by the Institute Research Committee and Ethics Committee, entitled
“Role of PCR in Detection of Mycobacteria in Pulmonary and Extra Pulmonary cases” and “Innate
immunity Markers: Role of Toll –like receptors Association of TLR4 with tuberculosis: Indian
Scenario”, and the work has commenced.
The vision of the department for next two years is to introduce the latest molecular tools for
identification of the pathogen in subjects with tuberculosis and respiratory / infectious diseases. A
major area of focus is pediatric tuberculosis that requires an early diagnosis and treatment. Efforts
are on to introduce CD4 Count facility to the AIDS patients. Efforts will also be made for NTM
identification by restriction fragment length polymorphism (RFLP) or Innolipa in immune-
compromised patients and further MDR/XDR identification by real time PCR assays.
The department received Conventional PCR, Real Time PCR, Gel documentation and other
equipments from the dept. of Microbiology. Many other equipments like CD4 Cell Counter, Water
Purification System, Thermal Cycler, etc. are in the process of procurement. The data of Molecular
Medicine/ Genetics for the period is given below.
51
DNA Extraction from suspected TB cases
PCR for IS6110 Gene Target in Suspected TB Patients
S. No Samples Number 1 Pleural Fluid 110 2 Ascitic Fluid 16 3 Tissue 3 4 sputum 5 5 Blood 3 6 CSF 2 7 Lymph Node 14 8 Menstrual fluid 1 9 Pus 21 10 Urine 8
Total No. of samples 183
Specimens AFB PCR for IS6110 Type No. Pos /Neg No. Positive Negative
Ascitic fluid 16 Pos - - - Neg 16 10 6
Lymph node 14 Pos 3 3 - Neg 11 6 5
Urine 8 Pos - - - Neg 8 2 6
CSF 2 Pos - - - Neg 2 2 -
Pleural Fluid 110 Pos - - - Neg 110 69 41
Pus 21 Pos 2 2 - Neg 19 13 6
Tissue 3 Pos - - - Neg 3 - 3
Sputum 5 Pos - - - Neg 4 3 1 ND 1 - 1
Menstrual fluid 1 Pos - - - Neg 1 1 -
Blood 3 NA 3 - 3 Positive Control 105 105 - Negative control 105 - 105 Total No. (Samples + Controls)
288 (183+210)
216 (111+105)
177 (72+105)
52
PCR for MPB64 Gene Target in Suspected TB Patients
Real Time PCR (Taq-Man) in Suspected TB Patients
Specimens AFB PCR for MPB 64 Type No. Pos
/Neg No. Positive Negative
Ascitic fluid 15 Pos - - - Neg 15 3 12
Lymph node 13 Pos 2 1 1 Neg 11 5 6
Urine 8 Pos - - - Neg 8 - 8
CSF 2 Pos - - - Neg 2 - 2
Pleural Fluid 107 Pos - - - Neg 107 39 68
Pus 21 Pos 2 1 1 Neg 19 7 12
Tissue 2 Pos - - - Neg 2 - 2
Sputum 5 Pos - - Neg 4 1 3 ND 1 1
Menstrual fluid 1 Pos - - - Neg 1 - 1
Blood 3 NA 3 2 1 Positive control
24 24 -
Negative control
24 - 24
Total No. (Sample + Controls)
225 (177+48)
83 (59+24)
142 (118+24)
Samples PCR results
Type No. Pos Neg Invalid Pus 6 5 1 -
Tissue 1 - 1 -
Pleural Fluid 44 11 30 3 Lymph Node 6 5 1 -
Sputum 2 - 2 -
53
Multiplex PCR for M. tuberculosis Detection 4.8 Department of Paediatrics Dr. Sangeeta Sharma : Paediatrician & Head of Department The Institute has a 34 bed paediatric ward which is headed by a paediatrician. The
department provides both domiciliary as well as institutional care by running a daily OPD
for paediatric cases having TB & Respiratory Diseases and admitting those having serious
illnesses and complications like tuberculosis with empyema, haemoptysis, meningitis, drug
failure or drug resistant cases etc. in paediatric ward or in ICU.
The department is actively involved in teaching of DNB students, nurses and other
trainees from outside the Institute. Department in-charge is involved in RNTCP training
Ascitic fluid 7 2 4 1
Blood 4 1 2 1
CSF 1 1 - -
Menstrual fluid 1 - 1 -
Urine 2 - 2 -
Positive Control 10 10 -
Negative Control 10 - 10 Total Test (samples+controls)
84 (74+10)
35 (25+10)
54 (44+10)
4 (4+0)
Specimens PCR results Type No. Positive Negative
Ascitic fluid 2 1 1 Lymph node 3 3 - Urine 1 1 - Pleural Fluid 4 3 1 Pus 2 2 - Positive control 2 2 - Negative control 2 - 2 Total No. (Sample + Controls)
16 (12+4) 12 (10+2) 4 (2+2)
54
programmes and has delivered guest lectures and attended various conferences at both
international and national level during the year, details of which are mentioned under the
appropriate section. The department provided training on MDR Paediatric TB to 3 WHO-
sponsored doctors from Bhutan on 22nd March 2012.
The department is pursuing various research activities. Results of one of these
studies involving retrospective analysis of DOTS strategy for 1098 paediatric pulmonary TB
cases was published in International Journal of Tuberculosis and Lung Diseases in January
2008.
4.9 Department of Pathology Dr. Kumud Gupta : Head of Department
Dr. Shalini Mullick : Pathologist
Senior Resident : One
The Pathology department provides its services for the outdoor and the indoor patients
of the institute through the following laboratories.
a) Haematology Lab b) Histopathology Lab and c) Cytology Lab.
Haematology Lab is equipped with Automatic Haematology Analyser. It carries out
tests of Haemoglobin, TLC, DLC, ESR, BT, CT, MP, Platelet Count, AEC and P/S
examination.
Cytology Lab is equipped with Cystopin, Centrifuges etc. Various samples, received in
cytology lab, consist of FNA-surgical lumps and masses, ultrasound & CT guided FNA, BAL,
bronchial washings, pleural fluid, ascitic fluid, pericardial fluid, peritoneal fluid, sputum, CSF
etc.
Histopathology Lab is equipped with Microtone Knife Sharpner, Wax Bath etc. It
receives mainly resected lung specimens, pleural biopsy, lymph node, skin biopsy,
bronchial biopsy, TBLB and tru-cut lung biopsy etc. Various equipments were procured for
doing immuno-histo chemistry during the year. The test is likely to be started soon following
the receipt of the chemicals and equipments in the department.
55
Table-35: HAEMATOLOGY tests done ( Pathology Lab. data ) (April-2011 -March-2012 )
OPD Emergency
Type of Tests Number % out of 90452
Number % out of 15407
i) Total Haemoglobin 23230 25.7% 4460 28.9%
ii) Total T.L.C. 23093 25.5% 4460 28.9%
iii) Total D.L.C. 23100 25.5% 4460 28.9%
iv) Total E.S.R. 729 0.8% 1
v) Total B.T. 57 0.1% -
vi) Total C.T. 57 0.1% -
Vii Total M.P. 1035 1.1% 28 0.2%
viii) Total Platelet Count 14337 15.9% 1985 12.9%
ix) Total A.E. Count 3081 3.4% 8 0.1%
x) Total PS 342 0.4% 5 0.0%
xi) PCV 3 0.0% -
xii) PT 765 0.8% -
xiii) APTT 623 0.7% -
Total Tests 90452 100.0% 15407 100.0%
Total Number of samples = 24439 4494
56
Table-36 : CYTOLOGY test done ( Pathology Lab. data)
(April-2011 -March-2012 ) S.No. CYTOLOGY TESTS Number %age out of
4370 i) Fine Needle Aspiration Cytology (FNAC) 1909 43.7%
ii) Pleural Fluid 1246 28.5%
iii) Bronchial Washing 239 5.5%
iv) Sputum for Cytology 413 9.5%
v) C.S.F. 6 0.1%
vi) Pus 73 1.7%
Vii Ascitic Fluid 58 1.3%
viii) Bronchial brush washing (smear) 64 1.5%
ix) BAL 186 4.3%
x) TBNA 72 1.6%
xi) ET aspirate 9 0.2%
xi) PericardIal Fluid 9 0.2%
xii) Peritoneal fluid 36 0.8%
xiii) Bronchial Aspirate 42 1.0%
xiv) OTHERS 8
0.2%
TOTAL 4370 100%
57
Table-37 : HISTOPATHOLOGY tests done ( Pathology Lab. data) (April-2011 -March-2012 )
Type of Histopathology tests Number %age out of 746
i) Pneumonectomy 31 4%
ii) Lobectomy 32 4%
iii) Lymph node biopsy 9 1%
iv) Transbronchial Biopsy 148 20%
v) Pleural Biopsy 279 37%
vi) Cell Block 71 10%
Vii Lung Biopsy 29 4%
viii) True Cut Biopsy 53 7%
ix) Skin Biopsy 5 1%
x) TBLB 43 6%
xi) Others 46 6%
TOTAL 746 100%
During the year, the department in-charge took classes for various batches of B.Sc. Nursing
students on investigations carried out in Pathology Lab. Monthly classes / Pathology Conference was
also moderated for DNB students in the form of case presentation. The in-charge took lectures on
HIV and cytology for candidates of Fellowship in HIV medicine. Practical work of DNB students
was supervised during their lab visits and their posting in Path lab. Processing of various lab
specimens was also taught to the newly appointed technicians.
During the year, the Department of Biochemistry got segregated from the Department of
Pathology. 3staff personnel (2 technicians and 1 lab assistant) were transferred to Biochemistry
department.
A museum of ‘resected histological specimens’ was made by mounting the specimens in jars and
by photo album.
58
4.10 Department of Physiology (PFT Lab) Dr. Rupak Singla : Officer In-charge
Dr. Sanjay Gupta : Senior Medical Officer
Resident Doctors : Posted by Rotation
The Department of Physiology (PFT Lab) is equipped with computerised complete pulmonary
functions tests machine for spirometry, lung volume and diffusion tests, portable spirometer, respirometer,
respiratory pressure meter, nebulizers etc. In order to avoid contamination of spirometry with M.
Tuberculosis, the department is equipped with a separate spirometer for tuberculosis patients. The department
is also equipped with a body plethysmograph and an oscilloscope to carry out airway resistance and
conductance studies. Bronchial provocation tests can also be done in the laboratory.
The department assists surgical unit in a preoperative assessment of the patients. The patients from
OPD are evaluated for confirmation of diagnosis of respiratory diseases, assessment of severity and response
of treatment. The department is actively participating in the research activities of the Institute and has
contributed research papers for publications also. Since 2005 onwards, Dr Rupak Singla, In-charge, PFT
Laboratory, has been regularly participating as faculty in the pre-conference PFT Workshop in the National
Conference of TB and Chest diseases (NAPCON) held once a year.
The department has been teaching and training the doctors and the staff of the Institute in the
diagnostic and therapeutic evaluation of pulmonary function tests in various respiratory disorders.
They include the postgraduate DNB students, senior residents and the other doctors and staff of the
Institute. Lectures and journal clubs are organized for the residents as per their academic schedule to
cover the subject in the teaching curriculum.
The Department has also conducted hands on workshop for post graduate students of North
India and Delhi.
Equipments: The PFT Laboratory is equipped with following equipments:-
1. Computerized complete pulmonary Function test machine for spirometry, static lung volume and
diffusion capacity measurements.
2. Body Plethysmography
3. Portable spirometer for sputum positive patients
4. Equipment for measurement of MIP and MEP
5. ECG machine
6. Respirometer
7. Other minor equipments
59
The department has participated in the following Research Projects (year wise): S
No. Year Name of
Student Research Title
1 2002
Dr. Deven Juneja
To study the impact of rescetional surgery on lung functions in patients suffering from non-neoplastic pulmonary diseases
2 2003
Dr. Meenakshi Dingra
To study the effect of thoracoplasty on lung functions in empyema patients
3 2003 Dr. V. Sailendra
Evaluation of sleep disorders in chronic obstructive pulmonary disease
4 2004
Dr. Anupam Malik
Impact of pulmonary rehabilitation on morbidity due to chronic obstructive lung disease
5 2005 Dr. Angila Dorjee
To study the alterations in lung functions and respiratory mechanics in patients of tubercular pleural effusion
6 2005
Dr. Yogesh Gupta
To determine the pattern of sleep disordered breathing among obese Indian subjects
7 2006
Dr. Brahma Prakash
Impact of chronic obstructive lung disease on activities of daily living
8 2008
Dr. Uday A. Gupta
To assess the impact of endobronchial biopsy on the diagnosis of patients suspected with pulmonary sarcoidosis and its correction with clinical, radiological and spirometry variables
9 2008 Dr. Shweta Gupta
Differentiation of Chronic Obstructive Pulmonary Disease & Asthma using Symptom based Questionnaire
10 2008 Dr. Deepak Kumar
To determine the existence and pattern of Sleep Disordered breathing in non obese adult Indian snores
11 2008 Dr. Srinath Dhandapani
Profile of patients failing to Category I treatment under RNTCP
12 2009 Dr. Roseleen Kaur Bali
To study the effects of yoga on lung function tests and quality of life in patients with COPD
13 2010 Dr. M. Shaikh
To compare six minute walk test and sit to stand test in chronic obstructive pulmonary disease patients and in healthy individuals
15 2010 Dr. Shikha Jain
Effect of follow-up in unsupervised home-based pulmonary rehabilitation program for patients with COPD-A randomized controlled trial
16 2010 Dr. Manashree
Post TB sequelac in MDR TB patients at the end of 2 years of completion of treatment
17 2010 M Qasim Effect of early mobilization combined with conventional physiotherapy treatment after 4 Hrs of lobectomy on haemodynamics ABG and PFT
18 2010 Samana Sayed
To study the clinical balance a submaximal exercise task in Indian COPD patients and its correlation with quadriceps girth Body mass index and disease severity
19 2010 Asma Rehman
Effect of inspiratory muscles stretching on chest expansion dyspnea, 6 – minute walk distance and quality of life in COPD patients
20 2010 Rajneet Kaur
Study of effectiveness of exercise component of home based pulmonary rehabilitation program in patients with
60
post tubercular squelae 21 2010 Kauser
Kapadia Effect of acupuncture transcutaneous electrical stimulation on heart rate recovery after six minute walk test in chronic obstructive pulmonary disease patients
22 2011 Saif Ullah Khan
Study of effect of ambulation and chest expansion exercises on ABG and PFT in patient with post tubercular empyema
23
2011 Hina Vaish Validity of Enright and Sherrill’s reference equation for six minute walk test in healthy north Indian adult males.
24 2011 Sumanta Ghosh
Effects of high intensity interval based inspiratory muscle training in patients with COPD undergoing a 4 week pulmonary rehabilitation programme on PFT values (FEV1, FEV1/FVC), peak inspiratory pressure, functional capacity and HRQL.
25 2011 Akmal Aslam Kothawala
Comparison of effect of flow oriented versus volume oriented incentive spirometry on PFT, chest expansion, exercise tolerance, dyspnea and quality of life in post tuberculous empyema thoracis.
26 2011 Parijat Ghatak
Effectiveness of core and diaphgramatic strengthening as exercise component of home based pulmonary rehabilitation program in post tubercular patients with dyspnea.
27 2012 Dr. Sachin Sharma
Effect of yoga in post TB sequelae patients
28 2012 Dr. Nitika Rawal
Profile of poorly controlled asthma and various factors contributing to it.
The department has published following books: 1. “Pulmonary Function Tests in Clinical Practice” published in November 2010 for post
graduate students and for general practioners for NAPCON 2010 edited by Dr Rupak Singla.
2. “Pulmonary Function Tests in Clinical Practice” published in February, 2005 for CME for
NATCON 2005 edited by Dr Rupak Singla.
3. “Spirometry in Clinical Practice” published in September, 2005 for CME for General
Practitioners, 2005 edited by Dr Rupak Singla.
The department has organised following Workshops on PFT: 1. Organised “Live Workshop on Spirometry” in CME Programme for Post Graduate Students of
North India on 16th to 17th July 2011 at LRS Institute of TB & Respiratory Diseases
2. Organized a “Live Workshop on Spirometry, Lung Volume, Diffusion Capacity and Body
Plethysmography” on 24th October 2010 at LRS Institute of TB & Respiratory Diseases
61
Total number of PFTs done during the year 2011-12 is shown in table 38.
Table- 38 : Number of procedures done in Respiratory Laboratory (PFT Lab.)
(April-2011 – March 2012) i)
Spirometry
6026
ii)
Reversibility
137
iii)
Lung Volume
158
iv)
Diffusion test
143
Total No. of PFT's done
6464
i)
VTG
104
ii)
Airway Resistance with Body Box
104
Total number of Body Plethysmographies done
208
Total No. of ECG done
2164
4.11 Department of Radiology
Dr. Devesh Chauhan : Radiologist & HOD
Dr. Anita Yadav : Assistant Professor (Radiology)
Senior Resident (Radiology) : Vacant
The department is providing diagnostic imaging services to institute with state of art
diagnostic equipments. It is having following equipments –
• Spiral CT Scan (GE) prospered Sx
• Kodak DRY LASER CAMERA
• Automatic Film processor (AFP) – Konak – Japan
• Heavy duty Automatic Film processor (AFP) – Protec – Germany
• Ultrasound machine (Siemens, G-50)
• Computed Radiography System (AGFA)
• Heliophos-D, 500mA X-ray machine + Fluoroscopy unit –(SIEMENS)
62
• 500mA X-ray machine – Philips Medical System – Installed in January 2011
• Multimobile- 10 – Installed in December 2010
• Nanomobile 100mA Portable X-ray Machine (Siemens)
• 600mA X-ray Machine (Listem Corporation KOREA)
• Temp Controlled Manual X-ray Film Processor (MEX INDIA. New Delhi)
• Digital Radiography System (procured in February 2012)
The department is carrying out conventional radiological imaging as well as image
guided (Ultrasound & CT guided) diagnostic procedures such as FNACs, biopsies,
therapeutic & diagnostic aspirations etc. The department is also providing X-ray facility
round the clock. CT scans are being carried on subsidized rates.
CT Scan (Brain) - Rs 1000/- for OPD patients, Rs 500/- for IPD patients.
CT Scan (Other body parts) - Rs 2000/- for OPD patients, Rs 1000/- for IPD patients.
Non-ionic contrast media is also being provided by Institute and is included in above
mentioned rates. In case of poor patients, CT scan is being carried out free of cost.
The department is also involved in teaching activities to DNB students and the
trainees of HIV fellowship.
Radiology data is shown in tables 39 to 41. A total of 51512 X-rays, 5025
ultrasounds and 1472 CT Scans were done during the year.
Table-39 : Number of X-rays done (April-2011 -March-2012 )
Film Sizes Number
8x10 3583
10x12 43935
12x15 1959
11x14 1798
14x14 237
14x17 -
a) Total No. of X-rays done 51512
Special procedures:
i) Barium Swallow 6
ii) Barium follow through 3
b) Total Special procedures done 9
63
Table-40 : Number of Ultrasounds done (April-2011 -March-2012 ) a) Chest+Neck 2251
b) Abdomen+KUB 2604
c) Ultrasound guided FNAC 13
Colour Doppler 98
d) Aspiration 6
Subtotal 4972
e) Ultrasounds done in ICU 53
Total Number of Ultrasounds done 5025
Table-41 : Number of CT SCANS done (April-2011 -March-2012 ) a) Chest 1138
b) Head 190
c) Abdomen 129
d) CT Scan Guided 15
Total Number of C.T.SCANS done 1472 Free CT scan =544 (37%) Paid CT scan = 928 (67%)
4.12 Department of TB and Respiratory Diseases
The Department of TB and Respiratory Diseases is actively involved in teaching,
training and research in the field of TB & Respiratory Diseases. The faculty of the
department assists the government of India in developing strategies for TB control and
in implementation of the same. The faculty has contributed significantly to the
development of national guidelines in India for management of tuberculosis, MDR- TB
and pediatric tuberculosis under the national programme. Dr D. Behera, Dr Rupak
Singla and Dr Rohit Sarin are members of various technical committees in the Central
Tuberculosis Division at the national level.
The administrative constitution of the department is as follows:-
Head of Department: Dr Rupak Singla
1. Dr Rupak Singla, Chest Specialist (Gr.-I) (SAG) Incharge Unit-II
64
2. Dr Anand Jaiswal, Chest Specialist (Gr.-I) (SAG) Incharge Unit-I
3. Dr M.M. Puri, Chest Specialist (Gr.-I) (SAG) Incharge Unit-III
4. Dr Sushil Munjal, Chest Specialist (Gr.-I)
5. Dr S.B. Singh, Chest Specialist(Gr.-I)
6. Dr Rajnish Gupta, Chest Specialist (Gr.-I)
7. Dr Lokender, Chest Specialist (Gr.-I)
8. Dr J.K. Saini, Chest Specialist (Gr.-II)
9. Dr. Amit Sharma, Chest Specialist (Gr.-II)
10. Dr. Puneet Arora, Chest Specialist (Gr.-II)
11. Dr. Prabhpreet Sethi, Chest Specialist (Gr.-II)
12. Dr. Pushpendra Kumar Verma, Chest Specialist (Gr.-II)
13. Dr. Kamla Verma, Chief Medical Officer (SAG)
14. Dr M.P. Arora, Chief Medical Officer, (NFSG)
15. Dr Sanjay Singh, Chief Medical Officer
16. Dr Rakesh Aggarwal, Chief Medical Officer
17. Dr Anil Jain, Chief Medical Officer, (NFSG)
18. Dr Sanjay Gupta, Chief Medical Officer, (NFSG)
19. Dr Vikram Vohra, Chief Medical Officer, (NFSG)
20. Dr. Kapil Mathuria, Chief Medical Officer, (NFSG)
21. Dr Alok Yadav, Medical Officer
In addition, there are 15 Senior & 38 Junior Resident doctors working on tenure
basis for the care of the patients. There are 10 seats of DNB students each year.
Special Chest Clinics: For patients suffering from various non-tuberculous chest
diseases special clinics are also run by the department such as Cancer clinic, smoking
cessation clinic, Allergy clinic, Sleep clinic, Physiotherapy Clinic, Air Pollution related
diseases clinic.
Allergy Clinic : This clinic is for evaluation of patients with Asthma, Rhinitis, Eczema
and other diseases allergic in nature. Management of allergic disorders, respiratory
allergies (Bronchial asthma and Allergic Rhinitis) are primarily dealt with in this clinic.
Skin Allergy testing is free of cost. Immunotherapy (Desensitization) is done in
selected cases. Occupation related allergies are also evaluated. Skin test against
aspergillus and other fungal allergies are also done. Clinic runs on Tuesday and Friday
between 9:00AM to 1:00 PM.
65
Lung Cancer Clinic : Lung cancer clinic is running in the Institute since January 2007.
Dr. D. Behera is the in-charge of the clinic and other team members are Dr. A. Jaiswal,
Dr. J.K. Saini and Dr. P. Sethi. During the period 2011-2012, a total of 384 lung
cancer patients attended the clinic, out of whom 105 were newly diagnosed and 279
were follow up cases. Besides, the management of lung cancer patients, junior
residents and senior residents are also trained in lung cancer management.
Postgraduate students of V.P. Chest Institute were posted in lung cancer clinic for five
days, in three batches of five students each.
Tobacco Cessation Clinic : Dr. S.B. Singh is the Incharge of this Clinic. This special
clinic is run in OPD Room No. 119 from Monday to Friday. Patients who are using
Tobacco in any form are referred from OPD and given counseling to quit their habit of
smoking. During the year, a total of 1296 patients were given counseling of quitting
tobacco habit. 31st May 2011 was observed as World No Tobacco day.
Details of Sleep Clinic, Air Pollution related Disease and Physiotherapy Clinic
are mentioned in relevant sections.
Inpatient services: The Department has indoor wards for around 450 beds. Currently
some of them are under renovation. The department provides inpatient care to
tuberculosis, lung cancer and other non-TB respiratory diseases patients and free anti-
retrovirus treatment to patients suffering from TB-HIV co-infection. For acutely ill
patients the department is equipped with 14 bedded ICU.
Emergency Services: Since 1st April 2009 institute has started emergency ward of 20
beds for care of patients reporting in emergency. This provides emergency care to the
respiratory cases.
Out Patient Services: The Department has an out-patient department (OPD) with an
average daily attendance of 400 - 500 patients. In one year more than 42000 new
chest symptomatic patients attend the OPD with a total attendance of around 1.5 lakh
patients per year. A total of around 5000- 6000 Tuberculosis cases are diagnosed
every year. The OPD runs from 9 AM to 1 PM. The registration in OPD is done from
8.45 AM to 12 noon.
Trainings: The Department is actively involved in the training of various medical and
paramedical personnel in implementation of strategies under Revised National
Tuberculosis Control Programme (RNTCP). The institute also conducts training for
Bronchoscopy, Pulmonary Function Tests, Sleep Medicine and ICU. The department is
66
actively involved in organizing Continuing Medical Education programme (CME),
seminars, conferences on different aspects of diagnosis and management of
tuberculosis and respiratory diseases. Some of the CMEs conducted during 2011-12 at
LRS Institute were:
1. CME programme PG-CME-2011 (North India) on 16th & 17th July, 2011 for PG
students of North India .
2. Workshop on PFT on 16.07.2011 in PG CME-2011 (North India) for PG students of
North India.
3. Workshop on Sleep Studies on 16.07.2011 in PG CME-2011 (North India) for PG
students of North India.
4. Workshop on Bronchoscopy on 16.07.2011 in PG CME-2011 (North India) for PG
students of North India.
5. A “Patient Awareness Program” on 03.05.2011 on the occasion of World Asthma Day.
6. A lecture by the department on ”Update on Lung Cancer” on 06.08..2011.
7. CME on Respiratory Allergy and Immunotherapy on 3rd February 2012.
Research Activities: The faculty members of the department are involved in
several multi-centric trials at international level and other research projects within the
country. Besides this all DNB students submit research projects as a part of their DNB
course. The details of the various research activities have been mentioned under
research section.
Post graduate DNB (Respiratory Medicine) Course: The DNB course in
Respiratory Medicine was started at LRS Institute of TB & Respiratory Diseases from
July,1999. The Institute was further accredited in the year 2002, 2005, 2008 and
2010. The Diplomate qualifications awarded by the National Board of Examinations
have been equated with post graduate M.D. degree qualifications of Universities by the
Government of India, Ministry of Health and Family Welfare. At present, the number of
post graduate three year training course DNB candidates are ten per year in the
January session. They are chosen as per merit of the CET followed by Centralized
counselling by the NBE. The method of selection of the candidates is as per the
guidelines of National Board of Examinations issued from time to time.
67
Dr. Rupak Singla, Head, Department of TB & Respiratory Diseases is Incharge of
DNB Course. He is assisted by Dr. Sanjay Singh Kathait, CMO (Academic) in the
Department. Various academic activities such as Faculty Lectures, Seminars, Bed Side
Classes, Grand Case Presentations, Pathology Conferences, Radiology conferences,
Journal Clubs, Statistical Meetings, External Faculty Lectures, Lab. Visits and Mortality
Meetings are regularly held for the post graduate students. The detailed academic
schedule is available on the website of the Institute.
Academic Section and DNB Course:- The academic section was established in the
Institute to oversee and streamline the ongoing and develop academic activities of the
Institute. The Academic Section is represented by:
Dr. Rupak Singla, Incharge Academic Section
Dr. Sanjay Singh, CMO (Academic)
The academic section carries out the process for the admission of DNB students
each year. The academic section prepares an elaborates Academic Schedule for the
DNB students for the whole year. This covers all the activities required for complete
DNB training. This can be viewed on the website of the Institute. It has been widely
appreciated and taken by various Institutes for incorporating in their annual academic
schedule. Having all required departments for DNB training under one roof, our
students are exposed to all types of patients procedures and Thoracic Surgery for
composite DNB training.
MD (TB and Respiratory Diseases) and DM (Respiratory Medicine) students from
V.P. Chest Institute and WHO fellows from different countries are also posted to
Department of TB & Respiratory Diseases for clinical training.
The academic section has established collaboration with ISIC Institute of
Rehabilitation Sciences and Jamia Hamdard University to further strengthen the
department of Physiotherapy. Eight students from Jamia Hamdard University and 2
from ISIC per batch per year attended the Institute to impart Physiotherapy to our
Indoor patients and intern gain practical experience. They have chosen topics and Co-
guides from our Institute to do research in their chosen field of physiotherapy.
68
Studies carried out under DNB course during the year 2011-12:
S No. Year of start
Title of the study Student Guide/Co-guide
1. 2009 To study the actual direct observation treatment in a patient receiving intensive phase of DOTS therapy and its association with treatment outcome under programme condition
Dr. Sushil M. Kindo
Dr. M. M. Puri Dr. R. Sarin Dr. U.K.Khalid
2. 2009 To compare the response of chemotherapeutic regimens (a) Cisplatin and Docetaxel and (b) Cisplatin and Irinotecan in appropriately staged III B/ IV case of non small cell lung can cer
Dr. Akshay Dr. S. B. Singh Prof (Dr) D.Behera Dr. Anand Jaiswal
3. 2009 HIV knowledge, attitude, practice among new patients of tuberculosis attending a tertiary care TB Institute
Dr. Neeraj Dr. V. Vohra Dr. S. Munjal Dr. Upasana
4. 2009 Study of aspergilloma in post tubercular patients presenting with haemoptysis
Dr. Sandeep Katiyar
Dr. Anil K. Jain Dr. M.M. Puri Dr Anita Yadav Dr Manpreet Bhalla
5. 2009 To study the clinico-cytological and bacteriological correlation of cervical tubercular lymphadentis
Dr. N. Shashi Kumar
Dr. Rupak Singla Dr. S.B. Singh Dr. P. Visalakshi Dr. Kumud Gupta
6. 2009 To study the effects of yoga on lung function tests and quality of life in patients with COPD
Dr. Roseleen Kaur Bali
Dr. Sanjay Gupta Dr. R. Singla Dr. J. K. Saini Dr I.V.Basavaraddi
7. 2009 Study of risk behavior for HIV infection among tuberculosis patients
Dr. Ankur Gupta
Dr. S. K. Munjal Dr. R. Singla
8. 2009 To determine blood lactate levels in patients with sepsis admitted to a respiratory intensive care unit and to correlate with their hospital out comes
Dr. Amit Asati Prof(Dr) D.Behera Dr.Rajnish Gupta
9. 2010 To study prevalence of tobacco smoking among pulmonary tuberculosis patients and to find the impact of smoking cessation on treatment outcome
Dr.Prachi Saxena
Prof. (Dr) D.Behera Dr. Rupak Singla Dr. Neeta Singla
10. 2010 Comparative study of clinic-radiological profile of smokers and non smokers suffering from pulmonary tuberculosis
Dr.Deepti Rathee
Dr. Rohit Sarin Prof. (Dr) D. Behera Dr. U.K. Khalid
11. 2010 Sequel of Multi Drug Resistant Tuberculosis patients at the end of Treatment
Dr.Manashree Mallick
Dr. Rupak Singla Dr. Sushil Munjal Dr. Neeta Singla
69
12. 2010 To study clinical profile of extra-pulmonary tuberculosis among HIV infected patients and assess the utility of procedures performed
Dr.Sonam Spalgais
Dr. Anand Jaiswal Dr.Upasana Agarwal
13. 2010 Frequency and duration of treatment interruption in new sputum smear positive pulmonary tuberculosis patients and its effect on the treatment outcome
Dr. Priyanka Changmai
Dr. M.M. Puri Dr. Anand Jaiswal Dr. U.K. Khalid
14. 2010 To study and compare the efficacy of counselling Vs counselling plus NRT in the form of Nicotine Chewing Gum in quitting smoking in smokers attending the Tobacco Cessation Clinic
Dr.Meenu Kumari
Dr. S.B. Singh Dr. Rajnish Gupta
15. 2010 To study the clinical profile and outcome of patients of acute respiratory failure requiring invasive mechanical ventilator support
Dr.Kamanasish Das
Dr. Rajnish Gupta Dr Anil K. Jain
16. 2010 Evaluation of the actual technique of using inhalation device in adult patients of COPD and bronchial asthma
Dr.Piyush Arora
Dr.Lokender Kumar Dr.Vikram Vohra
17. 2010 To assess the quality of life in lung cancer patients at diagnosis and at the end of treatment
Dr.Sharon Fernandis
Dr. J.K. Saini Prof. (Dr) D. Behera Dr. Sanjay Gupta
18. 2011 To study the effect of yoga in patients with Pulmonary impariment after Tuberculosis
Dr. Sachin Sharma
Dr. Sanjay Gupta Dr. Rupak Singla Dr. U.K. Khalid
19. 2011 To study a clinical profile and treatment outcomes in patient of pyopneumothorax in tertiary care hospital
Dr. Vipin Kumar Yadav
Dr. Lokender Kumar Dr. M.M. Puri Dr. R.K. Dewan
20. 2011 To study the outcome of Directly Observed Treatment Short course-Anti-tubercular treatment in Tuberculosis patients co-infected with HIV and on concomitant anti-retroviral therapy
Dr. Ughade Deepika Prakash
Dr. D. Behera Dr. S.B. Singh Dr. Upasna Agarwal
21. 2011 Treatment outcome of multi drug resistant suspect patient of pulmonary Tuberculosis who are not multi drug resistant and to assess their clinico-radiological and bacteriological profile
Dr. Satya Ranjan Sahu
Dr. J.K. Saini Dr. Sushil Munjal Dr. Khalid U.K.
22. 2011 To determine and to compare the initial and final effective pressure levels in the Indian adult patients with obstructive sleep apnea
Dr. Pankaj Gulati
Dr. Rajnish Gupta Dr. Anand Jaiswal
23. 2011 To determine the extent and profile of Drug Resistant TB (Including XDR TB)’ patients amongst MDR suspect in LRS-RNTCP area
Dr. Ashish Ranjan
Dr. V. Vohra Dr. RohitSarin Dr. Khalid U.K. Dr. M. Bhalla
70
24. 2011 Profile of poorly controlled asthma and evaluating various factor contributing to go it
Dr. Nitika Rawal
Dr. Anil K. Jain Dr. D. Behera
25. 2011 To determine post tuberculosis squeal and one year after successful treatment completion amount new pulmonary TB patients and its correlation with extent of disease (cavitory, non-cavitory, extent of lung Zone involvement)., sputum status and degree of positinty at the initiation of treatment
Dr. Sheikh Tariq Sultan
Dr. Rohit Sarin Dr. Anil Jain
26. 2011 To study the profile of MDR TB patients and factors influencing their treatment outcome under DOTS plus in Delhi
Dr. Sagar Khade
Dr. VikramVohra Dr. R. Singla Dr. Neeta Singla Dr. Ashwini Khanna Dr. Anuj K. Bhatnagar
27. 2011 Impact of Thoracic Surgery on Pulmonary Function Test
Dr. Bhagwan Mantri
Dr. Anand Jaiswal Dr. Sanjay Gupta
4.13 Department of TB Control and Training Dr. Rohit Sarin : Head of Department
The department works in close contact with the LRS- RNTCP and Dr Sarin is the
Vice-Chairman of the Committee which oversees the RNTCP implementation. The
department is also responsible for conducting all training activities relating to the
RNTCP. One of the main objectives of the Institute is to impart training to the various
personnel on different aspects of tuberculosis as well as on the National TB Programme
and the Revised Strategy. In its efforts towards this objective, the Institute, over the years,
has been actively involved in training the key trainers from all over the country on the
Revised National Tuberculosis control Programme,. In addition, the Institute has also been
organising workshops, seminars, CME programmes and symposiums on the Revised
National Tuberculosis Control Programme. Some of the important decisions in the
formulation of the Revised Strategy in the country have emanated as a result of these
workshops and seminars. Specifically these include the areas of Management Information
System, RNTCP in tribal areas, drug doses in treatment regimen of RNTCP and seminars
with teachers and professors of medical colleges and various TB specialists to reach to a
consensus on the strategy. The National DOTS Plus strategy was pilot tested at the
Institute and subsequently, the National Guidelines were formulated. The department is
also assisting the Central TB Division for imparting training under DOTS Plus and
71
development of modules for different categories of staff involved in its implementation. The
training modules for Nurses and Private Medical Practitioners developed by the Department
have recently been approved by the Central TB Division and would now be used for training
the trainers in this Category.
The 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 training activities are carried out by the following :-
Training Committee:
Dr. Rohit Sarin Chairman Dr. Rupak Singla Member Dr. Anand Jaiswal Member Dr. Kumud Gupta Member Dr. Vikram Vohra Member Dr. Anil Jain Member Dr. Anita Yadav Member Shri M.B. Naidu Member Mrs. Anita Rani Kansal Member
Facilitators:
1. Dr. Rupak Singla Chest Physician 2. Dr. Anand Jaiswal Chest Physician 3. Dr. M. M. Puri Chest Physician 4. Dr. Sushil Munjal Chest Physician 5. Dr. S.B. Singh Chest Physician 6. Dr. Anil Kr. Jain C M O (NFSG) 7. Dr. Vikram Vohra C M O (NFSG)
8. Dr. Sanjay Gupta C M O (NFSG)
9. Dr. Kapil K. Mathuria C M O (NFSG)
10. Dr. Rakesh Aggarwal C M O
11. Dr. Lokender Kumar Chest Physician
12. Dr. J.K. Saini Chest Physician
13. Dr. Khalid U K Epidemiologist
14. Dr. Sujata Arya S R O
15. Dr. Neeta Singla R O
16. Dr. Alok Yadav MO
72
Other Resource Persons:
1 Sh. M. B. Naidu Nodal Officer In-charge 2 Mrs. Rita V. Lyall Dy. Nursing Superintendent 3 Mrs. T. Percy Dy. Nursing Superintendent
The different categories of personnel trained in the Institute during the year 2011-12
are as under:
Table-42: Training Activities done (April-2011 to March-2012)
Sr. No Name of the activity Date/Period Number of participants
1. RNTCP Modular Training 23rd May to 4th June 2011 30
2. Axshya Project(GFR-9) Managers training course in RNTCP
13th to 17th June 2011 27
3. Axshya Project(GFR-9) Managers training course in RNTCP
27th June to 1st July 2011 26
4. Axshya Project(GFR-9) Managers training course in RNTCP
01st July 2011 75
5. Workshop on TB diseases burden estimation for India
7th to 08th July 2011 20
6. RNTCP 7th Meeting of the National DOTS-Plus Committee
11th to 12th July 2011 23
7. 20th Meeting of the National laboratory committee
13th July 2011 24
8. P.G.C.M.E. Respiratory Medicine by LRSI
16th to 17th July 2011 80
9. Training Course on MDR –TB by UNION 25th to 29th July 2011 30
10. Training Course on MDR –TB by UNION 1st to 5thAugust 2011 28
11. WHO Fellows from Mynamar 8th to 12th August 2011 04
12. RNTCP Modular Training 5th to 17th Sept 2011 24
13. HIV Fellowship Medicine Students from M.A.M.C.
28th to 29th Sept 2011 12
14. State Accountants training in Financial 29th to 30th Sept 011 117
73
Management
15. Training Programme for MPhil/MPH/PHD Students from JNU
30th Sept 2011 35
16. DOTS Plus(PMDT) training in RNTCP 10th to 14th Oct 2011 26
17. DOTS Plus(PMDT) training in RNTCP 12th to 16th Dec 2011 23
18. WHO Fellows from DPR Korea 21st Nov to 15th Dec 2011 04
19. National Task-force Workshop December-2011
21st to 22nd Dec 2011 122
20. National Consultation on Diagnosis & Treatment of Paediatric TB
31st Jan to 1st Feb 2012 27
21. TB Health Visitors(Students from NDTB Centre
16th to 21st January 2012 6
22. 21,Meeting on National Standing Committee For ongoing Research under RNTCP
8th February 2012 27
23. National DOTS Plus Committee Meeting
10th February 2012 15
24. PMDT Trg. Under RNTCP 6th to 10th Feb 2012 30
25. PMDT Trg. (Bombay)Under RNTCP 27th Feb to 2nd Mar 2012 36
26. RNTCP Modular Training 12th to 24th Mar 2012 17
27. PMDT Trg. Under RNTCP(Bhutan) 19th to 27th Mar 2012 03
28. PMDT Trg. Under RNTCP (Nigeria) 26th to 30th Mar 2012 03
Total 904
4.14 Department of Thoracic Surgery and Surgical Anatomy Dr. R. K. Dewan : Head of Department
The department is well known for its excellence and attracts patients from far way
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
74
because most of the other centres have practically converted themselves into cardiac
surgical units. All types of major chest surgeries like resection of lung, de-cortication,
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 imparting training in fibre-optic bronchoscopy and other surgical
procedures to the doctors of the Institute, as well as, to those from outside the Institute.
Seven M.Ch. doctors (Cardio-thoracic surgeons) from AIIMS underwent training for one
month each between the months of April 2011 to March 2012. Surgeons from Armenia,
Afghanistan, South Africa and Egypt visited the department and worked as observers
from May 2011 to March 2012.
During the year, the department procured new equipments like thoracoscopes,
mediastinoscopes, pediatric fibre-bronchoscopes and rigid bronchoscopes with
accessories.
Data related to surgical department is shown in Table-43 (a) and (b).
Table-43 (a) : THORACIC MAJOR CHEST SURGERY (April-2011 -March-2012) i) Pneumonectomy 33 viii) Rib resection 14
ii) Lobectomy 27 ix) VATS 11
iii) Thoracoplasty 30 x) Others 10
iv) Thoracotomy 26
v) Decortication 43
vi) Open window Thoracotomy 178
vii) Bronchoscopy 57 TOTAL 429
TOTAL MAJOR PROCEDURES = 429
75
Table-43 (b) : THORACIC MINOR SURGERY PROCEDURES DONE (April-2011 -March-2012 )
PROCEDURES : Minor OT in OPD
In main OT
Total
i) Intercostal Tube drainage - 97 97
ii) FNAC 1879 1 1880
iii) Pleural Aspiration 1707 11 1718
iv) Change of I.C.D. - 27 27
vi) I & D GA - 21 21
I & D LA
vii) Dressing - 123 123
viii) Ascitic tap 3 0 3
ix) Others - 69 69
TOTAL MINOR PROCEDURES = 3589 349 3938
4.B Sections of the Institute Various sections of the Institute are given as under.
4.15 Air Pollution Related Diseases Diagnostic Centre 4.16 Anti-Retroviral Therapy Centre 4.17 Biostatistics Section 4.18 Computer Section 4.19 Fibre-Optic Bronchoscopy Unit 4.20 Health Education Section 4.21 Library 4.22 Nursing Section 4.23 Physiotherapy Section 4.24 Respiratory Intensive Care Unit 4.25 Sleep Laboratory 4.26 Integrated Counseling and Testing Centre 4.27 Yoga Therapy and Research Centre
Detail of each section is mentioned below. 4.15 Air Pollution Related Diseases Diagnostic Centre Dr J K Saini : In-Charge A total of 51 patients (25 new and 26 follow-up) were enrolled in APRD-DC during
the year 2011-12. A Chemistry Laboratory was established in the APRD-DC for analysis of
air pollutants. A Chemistry Laboratory Assistant was kept for air pollutants sampling and
analysis of air pollutants like suspended particulate matter (SPM), sulphur-di-oxide and
nitrogen oxides.
76
4.16 Anti-Retroviral Therapy Centre Dr Upasna Agarwal : In-Charge
Department of Medicine runs a free Antiretroviral Therapy Centre under the aegis of
National AIDS Control Organization. Dr. Upasna Agarwal, Specialist (Medicine) is the in-
charge of the centre. The centre is having one Senior Medical Officer (SMO), one
counselor, one peer educator, one data manager, one staff nurse, one lab technician and
one pharmacist.
Comprehensive HIV care facilities are provided at the ART Centre. These include
free of cost antiretroviral therapy, free CD 4 testing, treatment and prophylaxis of
opportunistic infections, patient and family counseling as well as pre-ART support and care
services. The centre follows stringent recording and reporting procedures and regularly
reports to the National AIDS Control Organization.
Data of ART Centre is shown in Table-44.
Table 44 : ART Centre data (April-2011 -March-2012 ) a: HIV care data: No Indicators Adults (>14 years) Children( <14
years) TOTAL
M F TG/TS M F
i) Number of persons in HIV care at the begining of this month
573 258 4 32 10 877
ii) Number of New Persons Registered in HIV care during this month
88 52 1 3 2 146
iii) Cumulative number of persons registered in HIV care at the end of the reporting month
661 310 5 35 12 1023
b: Pre ART Care: i) Cummulative number of patients
in Pre ART care 217 140 2 15 4 378
c: Patients on ART : i) Number of patients on ART at
the begining of the month 379 132 3 19 7 540
ii) New patients started ART during this month
65 28 0 1 1 95
iii) Cumulative number of patients on ART at the end of this month
444 160 3 20 8 635
77
4.17 Biostatistics Section Dr. P.P. Sharma : Statistician
The statistician is involved in research activities being carried out in the Institute. The
statistician helps the researchers in planning of the research studies, sample size
determination and critical data analysis utilizing the scientific statistical tools. Technical
and statistical assistance is also provided to the DNB students for their research thesis.
Lectures for the new DNB students are given on Basic Statistics, Sample Size
Determination, Sampling Methodologies, etc. for carrying the research during the DNB
course. The statistician is also involved as a co- investigator in the research studies.
The section collects the patient’s data from various departments of the Institute.
Reports are compiled on monthly, quarterly and annual basis. The section compiles a
monthly statistical report for internal circulation. A monthly statistical meeting is being
organized on every third Thursday of the month under the Chairmanship of the Director.
The Institute’s data is presented by the Statistician during the meeting. All the doctors &
officers attend this meeting and discuss the data of the Institute.
The statistician also imparts training to delegates at various levels like trainee health
visitors, and technicians for documentation, monitoring and preparation of various
statistical reports.
4.18 Computer Section
Mr. G.V. Raju : System Analyst (In-charge)
The computer section is actively involved in clinical data processing and dissemination
of information. To improve information transfer and access, the computer section provided
new infrastructure in terms of hardware, software and network equipments. Patient billing,
discharge summary, report, internet search and other data processing related works are
looked after by the computer section. Institute website contents are regularly updated. The
computer section also coordinates with outside agency for hardware maintenance and
internet facility on regular basis and provides technical support to various programs
78
including seminars and workshop within the Institute. There are four data entry operators
working in this section.
4.19 Fibre-Optic Bronchoscopy Unit
Dr.Anand Jaiswal : In-charge
Routine diagnostic bronchoscopies and all bronchoscopic procedures are carried in
the unit. Teaching and training in bronchoscopy is done for residents of Institute. Training of
doctors from other institutes is also done with payment of training fee.
The unit has various equipments as mentioned below.
• Fibre-optic bronchoscopes – Three (BF-3, PE- 2 series and BF-ITR)
• Video bronchoscope - One
• Pulse Oximeter
• CCD Camera with Video Output and facility for recording
• All accessories of bronchoscope, biopsy forceps, brush, TBNA etc
During the period from April 2011 to March 2012, a total of 357 bronchoscopies were
done with 641 different procedures like bronchial biopsy, trans-bronchial biopsy, bronchial
brushing, bronchial aspirate, trans bronchial needle aspiration, broncho-alveolar lavage etc.
as shown in Table-45.
The laboratory has helped in diagnosing difficult cases like lung cancer, ILD,
occupational lung disease etc. The doctors within and outside the Institute are also being
trained in performing the procedures.
Table 45 : FIBREOPTIC BRONCHOSCOPY UNIT (April-2011 -March-2012 ) Number of Scopy done : 357
Procedures carried during Bronchoscopies:- Number
i) Bronchial Aspiration 280
ii) Bronchial Brush 63
iii) Bronchial Biopsy 151
iv) Transbronchial biopsy 40
79
v) BAL 38
vi) Endo Bronchial needle Aspiration 0
vii) TBNA (Transbronchial Needed Aspiration) 69
TOTAL Procedures 641
4.20 Health Education Section
Mr. M. B. Naidu : Officer In-charge
Health education about TB & RNTCP is being given to the patients, their relatives,
friends and companions. Health Education plays a vital role in treatment of tuberculosis.
This section has developed many leaflets & pamphlets to educate patients. The health
education material is regularly distributed to the patients.
Short video films on TB, AIDS, No Smoking / Tobacco, Asthma etc. are being
screened regularly to create awareness among the patients and their relatives in OPD from
9.00 am to 1.00pm.
All doctors communicate through Public Address System (P.A. System) installed in
the OPD rooms to call patients. After diagnosis all patients attending in OPD are referred
for health education in Room no.107. After imparting health education patients are referred
to their nearby DOT Centres for further treatment.
Nursing Students from R.A.K. College of Nursing, New Delhi were posted for two
weeks in three batches for their group project in LRS Institute. During their posting, the
student nurses were trained in I.E.C. health education activities for group presentation and
they performed role play in OPD to create awareness among the patients and the relatives
on TB and its sign and symptoms, diagnosis, spread and treatment.
Our institute is celebrating every year the following days of special importance.
World TB Day - 24th March
World Asthma Day - 5th May
World No Tobacco day - 31st May
World AIDS Day - 1st December
80
On these special days, we conduct health education awareness programs for TB
patients and their companions. We organise drawing competitions, dance and song
competitions for children. We also distribute prizes for winners and children.
In our Photo Section, digital photography has been started to facilitate for I.E.C.,
Training and other Institute activities. The number of patients on whom health education
was imparted during the year is mentioned in Table-46 :
Table-46 : HEALTH EDUCATION DATA (April-2011 -March-2012) S. No Category of patients imparted Health Education TOTAL
i) Health Education to New & Follow up TB patients in the OPD 7528
ii) No. of patients imparted Health Education in the wards 3808
Total number of Patients imparted health education 11336
4.21 Library
Dr. R.K. Dewan : Chairman Mr. Jitendra Kumar : Assistant Librarian
(Joined wef 24th September 2011 ) Mr. Sachin Sharma : Library Information Assistant
( Joined wef 19th September 2011) Library has bought 80 new books, 19 National Journals and 49 International
Journals on Tuberculosis & Respiratory related diseases during the year 2011-12. Our
department provides services to resident doctors, DNB students and other staffs of the
hospital.
Along with books, we provide internet facilities through four desktop
computers to our users. There is a separate division for Hindi language in the library.
There are 1155 quality books available on Tuberculosis & Respiratory Diseases in the
library. Library functions between 8.00 AM to 10 PM on all Working days.
81
4.22 Nursing Section Nursing Superintendent : Mrs. Anita Rani Kansal
Deputy Nursing Superintendent : 02
Assistant Nursing Superintendent : 04
Nursing Sisters : 30
Staff Nurses : 145
The nursing personnel are providing quality nursing care to the critical ill, surgical,
paediatric and other patients with respiratory diseases. The section is responsible for pest control,
infection control and waste management in the Institute. Training programmes are organized for
student nurses and other nurses. More than 1000 nursing students (B.Sc. Nsg) visited our Institute for
their educational programmes as per table given below.
Nursing students who visited our Institute for their educational programmes (April – 2011 to March – 2012)
S.No Name of College / Institute Training Category
No. of Students
Dates
1. Ms. Ramaiah Institute of Nursing Education, Bangalore
4th year B.Sc(N) P.B. B. Sc
23
26
11/04/11
2. Athena College of Nursing, Mangalore, Karnataka
2nd year P.C. B. Sc. 4th Year B. Sc.
49
48
07/04/11
3. Government College of Nursing, Bangalore 4th year B.Sc 42 08/04/11 4. Ellen Thoburn Cowen Memorial Hospital,
Kolar 4th year B.Sc 30 06/04/11
5. K.V.S. College of Nursing, Bangalore 2nd & 3rd year B.Sc 4th Year B.Sc.
03
17
27/05/11
6. Smt. Narayani D. R. Karigowda College of Nurisng
B.Sc. 62 13/05/11
7. Faith Institutions, Bangalore B.Sc.(N) 41 31/05/11 8. Masood College of Nursing, Mangalore M.Sc (N) 24 11/06/11 9. Unity Academy of Education College of
Nursing, Mangalore B.Sc(N) 37 28/06/11
10. P. H. Hindui National Hospital & Medical Research Center Andheri (East) Mumbai-400059
B.Sc.-M.Sc 49 21/10/11
11. National Institute of Mental Health and Neuro Science Bangalore.
4th year B.Sc 24 14/10/11
12. Kempe Gawada College of Nursing Bangalore 4th year B.Sc 53 03/11/11 13. R.A.K. College of Nursing Lajpat Nagar Josip
Broz Marg, New Delhi-24 B.Sc.(N) 22 18/11/11
14. Canara College of Nursing Kundapur Karnataka
M.Sc(N) 81 24/11/11
82
15. City College of Nursing Mangalore B.Sc 60 02/12/11 16. Kailkese Rakmini Shelly Memorial College of
Nursing Mangalore -575016. 4th year B.Sc 29 08/12/11
17. Laxmi Memorial College of Nursing, A. J. Towers, Mangalore -575002
4th Year B.Sc. 37 10/01/12
18. Laxmi Memorial College of Nursing, A. J. Towers, Mangalore -575002
4th Year B.Sc. 87 11/01/12
19. M.M.M. College of Nursing No.-3 Sakltu Nagar, Nolambar Mangappair, West Chennai-60095
4th year B.Sc. 37 27/01/12
20. Jaslok, College of Nursing Mumbai 4th year B.Sc. 30 02/12/12 21. Althena College of Nursing Falnir Road
Mangalore 4th year B.Sc. 48 17/01/12
22. Masood College of Nursing M.Sc. 58 22/12/11 23. M.M. College of Nursing Mullana Ambaka M.Sc. 07 14/02/12 24. Bel-ani college of Nursing Panchgnai Satara 4th year B.Sc. 48 23/02/12 Total 1027
A research study related to the nurse’s knowledge regarding TB and RNTCP is also in
progress.
4.23 Physiotherapy Section Dr M. M. Puri : In-charge
Mr. Prabhu Lal Jat : Physiotherapist
The physiotherapy section of the Institute is actively involved in patient care in OPD,
ICU, post surgical wards and in general wards. Physiotherapy treatment to patients
helps them in early recovery from the disease.
The section has various machines like Ultrasound Therapy Machine, machines for
Electric Stimulation and TENS (Trans-cutaneous Electric Nerve Stimulation), Shoulder
Wheel, Static Cycle, Manual Traction Set, Traction Machine, Postural Drainage Table,
Incentive Spirometer, Wax Bath Machine etc. Physiotherapy is given to patients
suffering from COPD, bronchiectasis, empyema, lung abscess, pleural thickening, joint
contractures etc., as well as, to post-operative patients in ICU and wards. The patients
who received physiotherapy treatment during the year are shown in table –47(a) and
(b).
83
Table 47(a) : PHYSIOTHERAPY Data (April-2011 -March-2012 ) DETAILS New Follow UP
TOTAL MALE FEMALE MALE FEMALE
Number of patients attended OPD for physiotherapy
302 177 426 362 1267
Number of calls attended from the wards and ICU for physiotherapy
621 244 1587 704 3156
Total patients received physiotherapy
923 421 2013 1066 4423
1344 3079
Table 47 (b): Physiotherapy Data based on Modality (April-2011 -March-2012 ) Type of Electrotherapy and Therapeutic Exercises Number of
sittings Shortwave Diathermy 127
Ultrasound Therapy 276
Vibrator Therapy 842
Wax Bath 109
Lumbar and Cervical Traction 40
Postural Drainage 39
Therapeutic Exercises 1267
Total Modalities 2573
* Shortwave diathermy machine not working since Sept-2011.
4.24 Respiratory Intensive Care Unit
Dr. Rajnish Gupta : In-charge
Dr. P. Sethi : Chest Specialist (Posted for 3 months wef 1st June-11)
Dr. Pushpendra Verma : Chest Specialist (Posted for 3 months wef 1st Sept-11)
Dr. Amit Sharma : Chest Specialist (Posted for 3 months wef 1st Dec-11)
Dr. Puneet Arora : Chest Specialist (Posted for 3 months wef 1st March-12)
84
Dhanvantari Respiratory Intensive Care Unit (ICU), functional since August 1996, is
a 14-bed unit for providing critical care to patients with 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.
The ICU provides round the clock diagnostic and treatment facilities in the form of
invasive / non-invasive mechanical ventilatory support and appropriate intensive measures
to all those patients having critical medical illnesses of a pre-dominant respiratory nature
and to those who have undergone thoracic surgical interventions within the Institute as
mentioned in Table-21. The medical care is supervised by the In-charge ICU, the respective
Unit In-charges and other specialists. Trained senior and junior residents, nursing staff and
other supporting staff are available on round the clock basis. Availability of a
physiotherapist, a psychologist and a medical social worker facilitates early mobilisation
and psychological care of the patients. More than 500 seriously ill patients are being treated
in ICU every year. Delivery of intensive care is facilitated by the regular procurement and
maintenance of critical care equipments, medicines and other essential items from time to
time. Two portable monitors were procured for ICU during the year.
Regular teaching and training on critical care management is being imparted to the
senior residents, DNB students, junior residents, other doctors and nursing staff during their
ICU postings. Lectures, seminars, journal clubs and case presentations are organized for
the residents as per their academic schedule to cover the subject in the teaching
curriculum. Training is being given in endo-tracheal intubations, handling of invasive / non-
invasive mechanical ventilation, performing various procedures like insertions of central
venous catheterizations etc. and in taking critical clinical management decisions at crucial
times.
Research projects are carried out regularly in ICU. During the year, two DNB
research projects entitled “To determine blood lactate levels in patients with sepsis admitted
to a respiratory intensive care unit and to correlate with their hospital out comes” and “To
study the clinical profile and outcome of patients of acute respiratory failure requiring
invasive mechanical ventilator support” were carried out in ICU.
85
4.25 Sleep Laboratory
Dr. Rajnish Gupta : In-charge
A Sleep Lab has been fully operational within the Institute since May 2004. A Chest
specialist-in-charge looks after the various activities of the sleep lab and is assisted in the
work by trained staff.
Sleep Lab is diagnosing patients with sleep related breathing disorders. All
suspected cases of sleep disordered breathing (like obstructive sleep apnoea etc.), referred
from the out-patient department of the Institute or from the other hospitals, are enrolled in
the Sleep Clinic run every week on Tuesdays. Detailed findings of their history and the
general examination are recorded in a specially designed proforma. Relevant investigations
are carried out and necessary instructions given to them. In order that they get acquainted
with the Sleep Lab, they are made to visit the lab at least once before the conduct of the
study. On the scheduled date, an overnight polysomnography is conducted in the sleep lab
on the Compumedics E-Series software. Following the recording, it is analyzed both
automatically and manually, interpreted and reported with specific recommendations.
All diagnosed cases of sleep disordered breathing are taken up for the requisite
Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BIPAP)
titrations simultaneously with a polysomnography. Following the titration, the study is
analyzed both automatically and manually, interpreted and reported with specific
recommendations including advice to use the optimal pressure during sleep. Subsequently,
they are called for the follow-up sleep studies and given appropriate instructions. 71 sleep
studies including the CPAP/ BIPAP titrations were performed during the year as shown in
table-48.
The diagnostic and therapeutic evaluation of sleep related breathing disorders is being
taught to the doctors and the staff including the postgraduate DNB students, senior
residents and the other doctors and the staff of the Institute. The subject is also covered in
the teaching curriculum of residents as per their academic schedule through lectures,
journal clubs etc. Teaching and training on the subject is also carried out for the benefit of
the trainees from other Institutes as well. A Workshop on Sleep Studies was carried out on
16th July 2011 during the PG CME-2011 North India organised at the Institute. A
Polysomnography training of 15 days was also carried out for 3 doctors of Dr. M. L. Chest
Hospital, G.S.V.M. Medical College, Kanpur and 2 staff of the Institute from 30th January
86
12 to 13th February 12.
Research projects on the subject are carried out regularly. A DNB research study
entitled “To determine and to compare the initial and final effective pressure
levels in the adult patients with obstructive sleep apnoea” was pursued during the
year.
Table 48 : Polysomnography data ( sleep lab. Study Data) : (April-2011 -March-2012 )
Number of cases = 71
Cases with Apnoeas
Obstructive 21
Central 0
Mixed 0
Cases with Hypopnoeas 23
Cases with significant RDI /hr.
Mild 6
Moderate 4
Severe 18
Cases with Noctural Hypoxaemia 30
Other findings 1
Cases put on CPAP Trial 30
4.26 Integrated Counseling and Testing Centre (ICTC)
Dr. Sushil Munjal - In-charge
A centre for Integrated Counseling for HIV testing has been operational in the
Institute. During the period from April-11 to March-12, a total of 4198 patients were
imparted pretest counseling and 4028 came for post test counseling. A total of 170 patients
were found positive for HIV (Table –49).
87
Table-49 Voluntary Counselling and Testing Centre (ICTC)
(April-2011 -March-2012 ) Adults Children TOTAL
M F MC FC
Pretest counselling
From OPD & Wards 2282 1038 432 412 4164
Voluntarily and from NGO
5 19 8 2 34
Total Number of pretest counselling
2287 1057 440 414 4198
Number of post test counselling 2275 936 435 382 4028
Number of patients refused consent 6 12 0 22 40
Number of patients reported HIV Positive
112 48 6 4 170
Number of HIV+ve patients who did not collect the report
3 1 0 0 4
Referral Frrom VCTC to RNTCP 1 0 2 0 3
The L.R.S. Institute is running a Post Graduate Fellowship Training in HIV Medicine
in collaboration with Maulana Azad Medical College, New Delhi since 2006. The In-Charge
is the Course Coordinator at LRS institute for Post Graduate HIV Medicine Fellowship
Programme. Every year, 16-18 fellows come for training. During the year, 12 fellows were
trained in the fellowship programme. The Contact Course II conducted in month of July
2011 was of 2 days duration. The Contact Course III conducted in October 2011 was of 3
days duration.
4.27 Yoga Therapy and Research Centre A centre for collaborative therapy and research in Yoga was inaugurated in the
Institute on 24th May 2007 in partnership with Morarji Desai National Institute of Yoga, New
Delhi. The Centre comprises of 4 staff - a Yoga Physician, Dr Gita Sharma, a male and a
female Yoga Instructor and a general duty attendant. The Institute is offering yoga services
to both outdoor and indoor patients of COPD, bronchial asthma and those requiring
respiratory rehabilitation, as well as, to hospital staff. A DNB research study has also been
conducted on the subject in patients of COPD.
Data of the centre for the year is shown in Tables – 50 (a) , (b) & (c).
88
YOGA THERAPY AND RESEARCH CENTRE ( In Collaboration with Morarji Desai National Institute of Yoga ,New Delhi)
Table 50(a ) : Yoga Services for the month of (April-2011 -March-2012) Patients detail
New Enrollment Old Enrollment (Follow ups)
Total
M F M F i) Patients treated at OPD 545 130 300 54 1029
ii) Patients treated at IPD 215 147 151 125 638
iii) General participants in Foundation Course
15 14 40 57 126
TOTAL 775 291 491 236 1793 1066 727 1793
Table 50(b) : Type of Patients Received Yoga Services (April-2011 -March-2012)
Type of Patients OPD IPD i) General Well Being /Preventive 12 56
ii) Bronchial Asthma 151 16
iii) COPD 286 44
iv) Post TB Sequelae 261 63
v) Pleural Effusion 13 14
vi) PTB 0 24
vii) Hydro-pneumothorax/ Pneumothorax 6 92
viii) Empyema 11 72
ix) Post-operative Rehabilitation 16 185
x) Sarcoidosis 5 0
xi) Arthiritis 13 0
xii) Pl. Thickening 62 0
xiii) Obesity 4 0
xiv) Lumbar Spondylosis / Back Pain 23 0
xv) Bronchiectasis 18 3
xvi) Miscellaneous 45 21
TOTAL 926 590
89
Table 50( c ): Details of Yoga Classes
(April-2011 -March-2012 ) Class Details Number i) Total Number of attendance 13834
ii) Total Number of Working days 298
iii) Average number of participants per day 46
iv) Total Number of Yoga classes 5303
v) Average number of classes per day 18
vi) Average number of participants per class 3
vii) Average duration of the class 30 min.
5.0 Researches Other Than DNB Course The L.R.S. Institute has rich clinical resources and is actively involved in
research in the field of TB & Respiratory Diseases. In addition to indoor
facilities, the Institute has a well developed outreach system of treating patients
in the field conditions under supervision. The TB patients under the specified
area of the Institute are being treated in the peripheral health centers (DOTS
centers). At DOTS centers, details of each patient are properly recorded till the
full treatment. Sputum examinations are done at pre-defined intervals and
recorded. Patients are given supervised treatment. The outcome of each patient
is recorded. Home visits are done for patients who fail to turn up for treatment.
This forms a very strong cohort group for any prospective research study.
The Institute assists the Government of India in developing strategies for
TB control and in implementation of the same. Based on operational research
the faculty of the Institute has contributed significantly to the development of
national guidelines in India for management of tuberculosis, MDR-TB and
pediatric tuberculosis under national programme.
The Institute has a Research Committee and an Ethical Committee for the
evaluation of the research proposals. The Institute at present is having
International / National collaboration. Several rapid diagnostic tests for the
90
diagnosis of tuberculosis are already being field tested in collaboration with
international agencies such as FIND (Foundation for Innovative Diagnostics).
LRS Institute has already signed MOU with ICGEB (International Centre for
Genetic Engineering and Biotechnology).
The long-term goal of the Institute will be to develop a centre of
excellence providing a platform for clinical immunological work in the field of tuberculosis and other respiratory diseases. The research focus would be priority to work on the diagnosis, monitoring and evaluation of various newer therapeutic modalities like drugs and vaccines besides studying the immune pathogenesis and development of tuberculosis and other respiratory diseases. The institute will focus on the proteomics and genomics to achieve the above objectives. The facility will focus on discovering antigens, antibodies and immunological biomarkers for rapid and early diagnosis of tuberculosis, HIV-TB co-infection, MDR-TB and XDR-TB and on developing cost-effective devices for rapid detection of tuberculosis. This in a long run will help in the field evaluation and application of technology in tackling these diseases and will supplement the Revised National Tuberculosis Control Programme.
Researches Other Than DNB carried during the year 2011-2012
S.No. Title of the study Name of
Researcher 1. A randomised double blind, placebo-controlled study to evaluate
the long-term safety and efficacy of Darbepoetin Alfa administered at 500 µg once-every-3-weeks to a hemoglobin ceiling of 12.0 g/dl in anemic subjects with advanced stage non-small cell lung cancer receiving multicycle chemotherapy
Dr. D. Behera, Dr. A. Jaiswal, Dr. Rajnish Gupta, Dr. J.K.Saini
2. A phase 2, multicenter, open label, randomized trial of AMG 706 or Bevacizumab in combination with Paclitaxel and Carboplatin for advanced non squamous Non-small Cell lung Cancer
Dr. D. Behera, Dr. A. Jaiswal
3. Study A4021016 Randomized open label, Phase III Trial of CP-751,871 in combination with paclitaxel and carboplatin versus paclitaxel and carboplatin in patients with non- small cell lung cancer
Dr. D. Behera, Dr. A. Jaiswal, Dr. Lokender
4. Annual Risk of Tuberculosis Infection (ARTI) in the slum population covered under RNTCP by LRS Institute
Dr. Rohit Sarin, Dr. D. Behera, Dr. Vikram Vohra, Dr. Khalid U.K.
5. Efficacy and safety of Immunomodulator (Mw) in Cat.II Pulmonary TB patients (Collaboration with DBT)
Dr. Rohit Sarin, Dr Neeta Singla
91
6. Repeat zonal level tuberculin survey for estimating annual risk of tuberculosis infection in East Zone (collaboration with NTI Bangalore)
Dr. Rohit Sarin, Dr. V. Vohra, Dr. Khalid U.K.
7. Molecular characterization of mycobacterium tuberculosis isolates from seven states of North-East India using spoligotyping
Dr. V.P. Myneedu, Dr. D. Behera, Dr. M. Bhalla, Dr. Ritu Singhal, Dr. Niti Singh
8. Prevalence of multi-drug resistant mycobacterium tuberculosis in North-East states, Delhi and Punjab using Line-probe assay in various subsets of RNTCP patients.
Dr. V.P. Myneedu, , Dr. Ritu Singhal, Dr. D. Behera, Dr. Niti Singh, Dr. Jyoti Arora, Dr. M. Bhalla
9. Role of voltage gated calcium channels and Suppressors of Cytokine Signaling (SOCS) in regulating immune responses to Mycobacterium tuberculosis (collaboration with ICGEB).
Dr K. Natarajan, Dr R. Singla, Dr Khalid U.K.
10. Identification of biomarkers and pathogen regulated targets for tuberculosis infection (collaboration with ICGEB).
Prof. V.S. Chauhan, Dr. D. Behera, Dr. R. Singla, Dr Khalid U.K.
11. Functional analysis of IL – 12R mutation in tuberculosis. Dr. Anand Jaiswal, Dr. D. Behera, Dr. Sangeeta Sharma, Dr. J S Tyagi, Mr. Vikas Kumar Sharma, Dr. H. Krishna Prasad
12. To study interleukin – 12 and its receptor polymorphism in TB patient and controls.
Dr. Anand Jaiswal, Dr. D. Behera, Dr. Sangeeta Sharma, Dr. J S Tyagi, Dr. Rajiv Kr. Jha, Dr. H. Krishna Prasad
13. Profile of tuberculosis among house hold contacts of MDR tuberculosis registered under DOTS Plus (Central TB Division funded)
Dr. Neeta Singla, Dr. D. Behera, Dr. R. Singla, Dr. P. Visalakshi
14. Deciphering dendritic cell function during Mycobacterium tuberculosis infection by RNA interference (in collaboration with Dr. B R Ambedkar Centre for Biomedical Research, University of Delhi)
Dr. Rupak Singla, Dr. D. Behera, Dr. K. Natarajan, Dr. Neeta Singla
15. Delays and constraints in diagnosis and initiation of DOTS-Plus treatment in MDR-TB patients at a DOTS Plus site, Delhi
Dr. Neeta Singla, Dr. D. Behera, Dr. Rupak Singla, Dr. P. Visalakshi
16. A study on smoking behaviour, attributable risk of smoking to pulmonary tuberculosis and efficacy of smoking cessation among tuberculosis patients
Dr. Neeta Singla, Dr. D. Behera, Dr. Somdatta Patra,
92
Dr S.B.Singh, Dr. G. R. Khatri
17. Evaluation and diabetes as determinant of tuberculosis : A matched controlled study
Dr. Neeta Singla, Dr. Rajendra Tandon, Dr. D. Behera, Dr. Roopa S
18. Study of Adverse of Adverse Drug Reaction in MDR TB patients under DOTS plus program (2011)
Dr. Neeta Singla, Dr. Rupak Singla, Mr. Anurag Gautam, Dr. D. Behera
19. Radiological pattern in Pulmonary TB in Children Dr. Sangeeta Sharma, Dr. Anita Yadav
20. To study HIV status of pediatric Pulmonary & Extra Pulmonary patients
Dr. Sangeeta Sharma, Dr S.K. Munjal
21. To study the menstrual pattern of adolescent girls in pulmonary & extra-pulmonary TB
Dr. Sangeeta Sharma
22. To study the association of indoor environmental risk factors and childhood tuberculosis
Dr. D. Behera, Dr. Sangeeta Sharma Dr. Somdatta Patra
23. Surveillance of drug resistance at LSRI TB & RD New Delhi DOTS Area
Dr. V.P. Myneedu, Dr Ritu Singhal, Dr M. Bhalla, Dr Khalid U.K., Mr P.P.Sharma
24. Profile of Mycobacterium tuberculosis at LRSI – A retrospective study
Dr V.P.Myneedu
25. Evaluation of real time PCR for the diagnosis of pulmonary and extra-pulmonary specimens and its comparison with conventional IS6110 PCR, MGIT 960 TB system, conventional culture & Smear Microscopy
Dr D. Behera, Dr M. Bhalla, Dr Jyoti Arora, Dr Tamanna Sharma
26. Study the impact of TB on HIV activity in dually infected patients using RT-PCR Assay
Dr Tamanna Sharma, Dr. M. Bhalla, Dr. Upasana Agarwal
27. Utility of PCR for diagnosis of pulmonary and extra pulmonary TB in comparison with smear microscopy, conventional culture and MGIT 960 system
Dr. M. Bhalla, Dr Tamanna Sharma, Dr. D. Behera, Dr Jyoti Arora
28. Evaluation of performance and suitability of Light Emitting Diode (LED) fluorescence microscope for detection of Acid Fast Bacilli in sputum for tuberculosis diagnosis (Funded by OLMPUS Magnus analyticus)
Dr. M. Bhalla, Dr P.P.Sharma
29. Studies on Aspergillus fumigatus proteome for identification of novel unknown immunogens
Dr. D. Behera, Dr. J.K. Saini,
93
Dr. G.L. Sharma
30. Molecular analysis of MDR and XDR strains of Mycobacterium tuberculosis isolated from a tertiary care hospital (ICMR funded)
Dr Urvashi B.Singh, Dr. D. Behera, Dr Jyoti Arora, Dr. M. Bhalla
31. Validation and clinical studies for methods for diagnosis of tuberculosis by smear microscopy, culture and polymerase chain reaction using processed clinical samples and kit thereof (DBT funded)
Dr. M. Bhalla, Dr Jaya Tyagi
32. Study of the influence of stress and micro-nutrients deficiency on human immuno-competent cells and its implication to mycobacterium tuberculosis
Dr. H.K. Prasad, Ms Savita Singh, Dr. D. Behera, Dr Anand Jaiswal
33. Use of the BACTEC Mycobacteria Growth Indicator Tube 960 Automated System for recovery of mycobacteria from extrapulmonary specimens and typing of isolates using Spoligotyping
Dr. M. Bhalla, Dr. Jyoti Arora, Dr. D. Behera
34. Tobacco consumption in youth attending OPD in a tertiary care respiratory hospital in Delhi.
Dr. Sujata Arya, Dr. Khalid U. K., Dr. D. Behera
35. To study the feasibility and usefulness of multiple samples collected same day for smear microscopy in the diagnosis of pulmonary TB at LRSI
Dr. Ajoy Kumar Verma, Dr. V.P. Myneedu
36. Evaluation and justification of phenol-Ammonium sulphate precipitation / sedimentation smear microscopy method for diagnosis of pulmonary tuberculosis : an effective, safe and reliable alternative for direct smear microscopy in microscopy centers
Dr. Ritu Singhal, Dr. M. Bhalla, Dr. V. P. Myneedu, Dr. D. Behera
37. Molecular epidemiology and genetic characterization of M. tuberculosis from HIV seronegative and HIV seropositive patients
Dr. Niti Singh, Dr. D. Behera, Dr. Tamanna Sharma, Prof.Sarman Singh
38. Role of modifications in routine fine needle aspiration cytology for increasing the diagnostic yield in extra-pulmonary tuberculosis
Dr. Shalini Mullick, Dr. Nidhi Paliwal, Dr. Sapna Thakur, Dr. Kumud Gupta
39. Molecular epidemiology of Extensively Drug Resistant TB (XDR-TB) and development of a rapid diagnostic technique.
Chhavi Gupta, Dr. Rupak Singla
40. Identification & evaluation of Mycobacterium tuberculosis antigens as biomarkers in clinical samples from tuberculosis patients & comparative analysis with other diagnostic methods
Amit Kaushik, Dr. Rupak Singla
41. A study to assess the need for training of nurses regarding management of TB patients receiving DOTS and DOTS Plus under RNTCP in selected hospitals and outreach facilities in Delhi
Mrs. Anita Kansal, Dr. D. Behera, Dr. R. Mahal
42. What is time taken and reasons for delay in the diagnosis and treatment in patients with lung cancer attending a tertiary care hospital in Delhi?
Dr. J.K. Saini, Dr D. Behera, Dr. Anand Jaiswal
43. Synergistic drug medium of INH and Rifampicin for identification of MDR Mycobacterium tuberculosis
Manoj Kumar, Dr M. Bhalla, Dr. Ritu Singhal
44. Study of the modulation of cell surface receptors by mycobacterium and defined recombinant antigens in human immune-competent
Ms. Harshita Mittal, Dr. S.K. Munjal
94
cells and its functional significance
45. Effects of high intensity interval based inspiratory muscle training in patients with COPD undergoing a 4 weeks Pulmonary Rehabilitaion Programme on PFT values (FEV1/FVC), Peak inspiratory pressures, dyspnea score, functional capacity and HQRL
Mr. Sumanta Ghosh, Dr. S.K. Munjal
46. Comparative effects of chair sitting and forward lean with cross legged sitting position on Cardio Respiratory parameters during recovery after six minute walk test in COPD patients
Md. Mumtaz Uddin, Dr. S.K. Munjal
47. “Comparison of effect of flow oriented versus volume oriented incentive spirometry on PFT, chest expansion, exercise tolerance, Dyspnea and Quality of life in Post Tuberculous Empyema Thoracis”
Mr. Akmal Aslam Kothawala, Dr. S.K. Munjal
6. Awards and Achievements : S.No. Details of Awards and Achievements
1. Dr. D. Behera delivered Achanta Lakshmipathi Oration on “Drug Resistant Tuberculosis (MDR/XDR-TB) in India-issues and solutions” in 51st Annual Conference of Medical Sciences at SUM Hospital, Bhubaneswar from 14th to 16th October 2011. He also delivered Dr. P. C. Sen Gold Medal Oration and Presidential address in NATCON 2011 from 18th to 20th November 2011 at Dehradun.
2. Dr. Rohit Sarin became Vice Chairman of Tuberculosis Association of India and Chairman of New Delhi TB Centre from August 2011. As Vice Chairman, he organized NATCON 2011 at Dehradun, Uttarakhand. He was the Editor of Indian Journal of Tuberculosis and Member on the Editorial Boards of Indian Medical Prescriber, Journal of Delhi TB Association and Indian Journal of Tuberculosis and Chest Diseases. He was a Member of the National Joint Monitoring Mission for reviewing the RNTCP at periodic intervals. He was a Technical Member of various National-level Committees including National DOTS Plus Committee and National Infection Control Committee under the Ministry of Health and Family Welfare, Govt. of India to frame & revise the national guidelines. He was also the Member of the National Operational Research Committee for RNTCP. He was expert member of National Committee for Paediatric TB Guidelines. He was a Member of National Writing Group for TB-HIV Collaborative Activities. He was a Member of National Committee for reviewing and revising the Training Modules for Medical Officers in National TB Control Programme. He was a Coordinator for development of training modules for Nurses under DOTS Plus Programme.
3. Dr. Rupak Singla was nominated by Central TB Division as Technical member of the working group on “Treatment of TB including Drug Resistant TB” for developing National Strategic Plan for India for the period 2012-17. He is a Technical member of various national committees including National DOTS Plus committee and National Airborne Infection Control committee under the Ministry of Health and Family Welfare, Govt. of India to frame & revise the national guidelines. He is a member of the Project Review Committee of ICMR involved in review of various research projects related to tuberculosis and leprosy. He published seven papers in indexed International Journals and two papers in indexed National Journals and Contributed “Atelectasis and Pulmonary Fibrosis” chapter for the 9th Edition of API Text Book of Medicine 2011.
4. Dr. R. K. Dewan was named as a member of the Editorial Board of the Indian Journal of Chest Diseases and Allied Sciences.
5. Dr. Sangeeta Sharma was Chief Editor “Pediatrics Today”. She was the Reviewer for the
95
International Journal of TB and Lung Diseases and Indian Journal of Tuberculosis. She was expert member and Member, Document Writing Committee for Revised Pediatric TB Guidelines from 31st January to 1st February 2012. She was also Expert Member of Techno-Commercial Evaluation Committee for Procurement of PPD, MOHFW, GOI on 11.05.2011. She was the member editorial board of the Journal Pediatrics and Obstetrics Gynecology.
6. Dr. Sushil Munjal was the Peer Reviewer for SAARC Journal of TB, Lung Diseases and HIV/AIDS.
7.0 Publications
S.No. Author’s Name Title of the paper/ chapter
published Journal/Month/Volume/ Page
No/ Impact Factor (if any)/ Book/ Chapter in Book
1. Myneedu VP, Visalakshi P, Verma AK, Behera D, Bhalla M.
Prevalence of XDR-TB cases - A retrospective fact finding from a tertiary care TB hospital.
Indian J Tuberc 2011;58(2):54-9.
2. Puri MM, Srivastava A, Jain AK, Behera D.
Pneumatocele formation in adult Escherichia coli pneumonia
Ann Thorac Med 2011;6:101-2. (IF:1.06)
3.
Kumar L, Gupta R, Puri M M, Jaiswal A, Srinath, Murar A, Behera D.
Unilateral and painless development of isoniazid induced gynecomastia during retreatment of pulmonary tuberculosis.
J Assoc Physicians India 2011; 59:733-5.
4.
Srivastava V, Vashishta M, Gupta S, Singla R, Singla N, Behera D, Natarajan K.
Suppressors of cytokine signaling inhibit effector T cell responses during Mycobacterium tuberculosis Infection.
Immunol Cell Biol 2011; 89(7):786-91.
5. Behera D, Sharma PP. A retrospective study of seasonal variation in the number of cases diagnosed at a tertiary care tuberculosis hospital.
Indian J Chest Dis Allied Sci 2011; 53(3):145-52.
6. Singla N, Singla R, Jain G, Habib L, Behera D.
Tuberculosis among household contacts of multidrug-resistant tuberculosis patients in Delhi, India.
Int J Tuberc Lung Dis 2011;15(10): 1326-30. (IF:2.557)
7. Shen G, Singh K, Chandra D, Serveau-Avesque C, Maurin D, Canaan S, Singla R, Behera D, Laal S.
LipC (Rv0220) is an immunogenic cell surface esterase of Mycobacterium tuberculosis.
Infect Immun 2012; 80(1): 243-53. (IF:4.098)
8. Singla R, Caminero JA, Jaiswal A, Singla N, Gupta S, Bali RK, Behera D.
Linezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India.
Eur Respir J 2011 Sep 29. (Epub ahead of print). (IF:5.922)
96
9. Arora J, Singhal R, Bhalla
M, Reza S, Visalakshi P, Behera D, Myneedu VP.
Diagnostic utility of Capilia TB assay for identification of mycobacterium tuberculosis complex.
Current Res Tuberc, 2011 ISSN 1819-3366/DOI:10.3923/crt.2011© 2011 Academic Journals Inc.
10. Behera D. TB and diabetes – the dual epidemic: is it a matter of concern? (Editorial)
Indian J Tuberc 2011;58(4):143-7.
11. Myneedu VP, Verma AK, Sharma PP, Behera D.
A pilot study of same day sputum smear examination, its feasibility and usefulness in diagnosis of pulmonary TB.
Indian J Tuberc 2011;58(4):160-7.
12. Siddiqi S, Ahmed A, Asif S, Behera D, Javaid M, Jani J, Jyoti A, Mahatre R, Mahto D, Richter E, Rodrigues C, Visalakshi P, Rüsch-Gerdes S.
Direct drug susceptibility testing of mycobacterium tuberculosis for rapid detection of multidrug resistance using the Bactec MGIT 960 system: a multicenter study.
J Clin Microbiol. 2012;50(2):435-40. Epub 2011 Dec 7 (IF:4.22)
13. Blumenschein GR Jr, Kabbinavar F, Menon H, Mok TS, Stephenson J, Beck JT, Lakshmaiah K, Reckamp K, Hei YJ, Kracht K, Sun YN, Sikorski R, Schwartzberg L; Motesanib NSCLC Phase II Study Investigators. Collaborators (56) Au AK, Cheng CK, Mok TS, Tung Y, Behera D, Chacko R, Lakshmaiah K, Menon H, Nirni S, Pathak A, Thirumulai R, Arena F, Beck JT, Belman N, Blumenschein GR, Boccia R, Chan D, Clowney B, Davidson S, Del Prete S, Dudek A, Fain J, Hagenstad C, Henry D, Hoang T, Holladay C, Hu E, Kabbinavar F, Kaywin P, MacLaughlin W, March R, Marsland T, Meza L, Mott F, Page R, Paschold E, Patel G, Patel R, Prow D, Reckamp K, Rosen P, Sabbath K, Samuels B, Schwartzberg L, Shah M, Shtivelband M, Singh J, Stephenson J,
A phase II, multicenter, open-label randomized study of motesanib or bevacizumab in combination with paclitaxel and carboplatin for advanced nonsquamous non-small-cell lung cancer
Ann Oncol 2011;22(9):2057-67.
97
Subramaniam D, Swanson P, Thomas M, Webb R, Hassan A, Quednau BD, Wake C, Melara R.
14. Mehta PK, Kalra M, Khuller GK, Behera D, Verma I.
Development of an ultrasensitive polymerase chain reaction-amplified immunoassay based on mycobacterial RD antigens: implications for the serodiagnosis of tuberculosis.
Diagn Microbiol Infect Dis 2012; 72(2):166-74.
15. Das S, Duggal P, Roy R, Myneedu VP, Behera D, Prasad HK, Bhattacharya A.
Identification of hot and cold spots in genome of mycobacterium tuberculosis using Shewhart Control Charts.
Sci Rep 2012;2:297. (Epub 2012 Mar 2)
16. Sarin R. Guidelines for programmatic management of drug-resistant tuberculosis 2011 Update.
Geneva: World Health Organization, 2011 (WHO/HTM/TB2011.6)
17. Dewan RK, Kesieme EB, Ramchandani R.
Surgical treatment for trachea-bronchial carcinoid tumours: A 16-year experience.
Asian Cardiovasc Thorac Ann 2012;20:53-7.
18. Dewan RK, Ramchandani RK, Sisodia A, Verma P.
Delayed presentation of traumatic bronchial tear and successful repair.
Indian J Thoracic Cardiovascular Surgery (14 December 2011), pp. 1-3, doi:10.1007/s12055-011-0122-4
19. Gupta S, Bali RK, Das K, Sisodia A, Dewan RK, Singla R.
Rare presentation of spontaneous acquired diaphragmatic hernia.
Indian J Chest Dis Allied Sci 2011; 53:117-9.
20. Banday KM, Pasikanti KK, Chan EC, Singla R, Rao KV, Chauhan VS, Nanda RK.
Use of urine volatile organic compounds to discriminate tuberculosis patients from healthy subjects.
Anal Chem. 2011; 83(14): 5526–5534.
21. Mukherjee A, Singla R, Saha I, Sarkar A and Bhattacharyya P.
Difference in the outcome of patients with different grades of initial sputum positivity under the Revised National Tuberculosis Control Programme.
Indian J Chest Dis Allied Sci 2011; 53(4): 241-2.
22. Paliwal N, Thakur S, Mullick S, Gupta K.
FNAC in tubercular lymphadenitis: Experience from a tertiary level referral centre.
Indian J Tuberc 2011; 58: 102-7.
23. Bisht D, Verma AK, Bhardwaj HHD.
Intestinal parasitic infestation among children in a semi-urban population.
Tropical Parasiotology 2011;1(2):104- 7.
98
24. Tayal D, Goswami B, Koner BC, Mallika V.
Role of homocysteine and lipoprotein (A) in atherosclerosis: An update.
Biomedical Research 2011;22(4): 391-405.
25. Tayal D, Goswami B, Tyagi S, Chaudhary M, Mallika V.
Interaction between dyslipidemia, oxidative stress and inflammatory response in patients with angiographically proven coronary artery disease.
Cardiovascular J Africa 2012; 23(1): 23-7.
26. Varma- Basil M, Kumar S, Arora J, Angrup A, Zozio T, Banavaliker JN, Singh UB, Rastogi N, Bose M.
Comparison of spoligotyping, mycobacterial interspersed repetitive units typing and IS6110-RFLP in a study of genotypic diversity of Mycobacterium tuberculosis in Delhi, North India.
Mem Inst Oswaldo Cruz 2011; 106(5):524-35.
27. Sharma Sangeeta MDR TB in Children – LRS Experience.
Chapter in Abstract Book PEDICON 2012.
9.0 Presentations during Conferences/ Seminars/Workshops : 9.1 Outside Country : S.No. Title of the paper presented/ Session
chaired
Name of Participant
Venue
Dates
1. Co-ordinated and attended an Indo-Swiss bilateral workshop on “Infectious Diseases” at EPFL.
Dr D. Behera Lausanne, Switzerland
2nd to 3rd May 2011
2. Attended 14th World Conference on Lung Cancer and presented a paper on “Cisplatin and irinotecan combination chemotherapy in non-small cell lung cancer patients attending a TB hospital in India”.
Dr D. Behera Amsterdam, Netherlands
3rd to 7th July 2011
3. Attended 42nd Union World Conference on Lung Health and presented a paper entitled “An analysis of causes of mortality in patients with tuberculosis in North Indian hospital”.
Dr D. Behera Lille, France 26th to 30th October 2011
4. Presented a paper on “Molecular diagnosis of non-tuberculosis mycobacteria”.
Dr. Ajoy Verma
New York, USA
28th November 2011
99
9.2 Within Country : S.No. Title of the paper presented/ Session
chaired
Name of Participant
Venue
Dates
1. Delivered lecture in “Dr. Rajendra Prasad Oration” on Foundation Day Celebration of Department of Pulmonary Medicine of CSMMU.
Dr D. Behera Lucknow 29th April 2011
2. Delivered a lecture on “Progress in Management of Lung Cancer” at Shere-Kashmir Institute of Medical Sciences Respiratory and Critical Care Update.
Dr D. Behera Srinagar 29th June 2011
3. Attended Zonal Task Force Workshops under RNTCP in different Zones as Resource Person and Chairperson, National Task Force.
Dr D. Behera August and September 2011
4. Delivered Achanta Lakshmipatahi Oration on the topic entitled “Drug Resistant Tuberculosis (MDR/XDR-TB) in India-issues and solutions” in 51st Annual Conference of Medical Sciences & SUM Hospital.
Dr D. Behera Bhubaneswar 14th to 16th October 2011
5. Delivered lecture on “RNTCP…. Recent Issues” in the State Conference of the Association of Physician of India, Tripura branch.
Dr D. Behera Agartala 13th November 2011
6. Delivered Dr. PC Sen Gold Medal oration by Tuberculosis Association of India and Presidential Address in NATCON 2011 and delivered lecture on “Status and Updates on RNTCP including Drug Resistance TB”.
Dr D. Behera Dehradun 18th to 20th November 2011
7. Attended HIV-TB performance review meeting at ART Centre SCB Medical College, Cuttack and delivered a talk on HIV-TB.
Dr D. Behera Cuttack 21st November 2011
8. Attended NAPCON 2011 and delivered lecture on “RNTCP-Targets and Achievements” at VPCI.
Dr D. Behera Delhi 28th to 30th November 2011
9. Attended “Pulmo Rehab 2012” and delivered a lecture on the topic ‘Chronic Lung Diseases Burden in India’.
Dr D. Behera Coimbatore 21st to 22nd January 2011
10. Delivered a lecture on the topic ‘Diagnosis work up of Lung Cancer’ in symposium on Lung CA organized at SMS Medical College under the auspices of Rajasthan Cancer Society.
Dr D. Behera Jaipur 4th February 2012
11. Delivered a talk on the topic ‘MDR- Dr D. Behera Cuttack 11th to 12th
100
TB’ as a Guest Speaker in the 8th CHESTCON ODISHA organized by the Department of Pulmonary Medicine, S.C.B. Medical College & Hospital.
February 2012
12. Attended CME cum workshop on Common Respiratory Disorders in Children at PGIMER and delivered a key-note-address in the inauguration of the RNTCP workshop.
Dr D. Behera Chandigarh 18th to 19th February 2012
13. Attended Workshop to formulate National Guidelines for Diagnosis and Management of Pneumonia in Adults organized by PGIMER.
Dr D. Behera Chandigarh 19th March 2012
14.
Delivered a guest lecture on MDR/XDR-TB at European Respiratory Society – 2011 Workshop.
Dr Rohit Sarin
Kolkatta 17th June 2011
15. Attended meeting on the proposal from Principal Secretary (Medical Education), Govt. of Karnataka for Upgrading its Autonomous SDS Tuberculosis Research Centre (SDSTRC) and Rajiv Gandhi Institute of Chest Diseases (RGICD), Bengaluru as “National Institute of Chest Diseases” in the line of NIMHANS.
Dr Rohit Sarin
Bangalore 03rd October 2011
16. Attended a Symposium on Improving Tuberculosis Care and Control at and delivered a lecture on “XDR TB – An Emerging Challenge at AIIMS.
Dr Rohit Sarin
New Delhi 4th November 2011
17. Organised inauguration of National TB Seal Campaign by Hon’ble Union Health Minister Sh. Gulam Nabi Azad.
Dr Rohit Sarin
New Delhi 5th October 2011
18.
Attended NATCON 2011 as Vice-Chairman and delivered Guest Lecture on “Airbone Infection Control in TB” and “XDR-TB” and Chairperson for various award sessions.
Dr Rohit Sarin
Dehradun 18th to 20th November 2011
19. Facilitated National DOTS Plus training
Dr Rohit Sarin
New Delhi 06th to 10th February 2012
20.
Facilitated the World TB Day and Dr. R.C. Jain Memorial Lecture at LRS Institute of TB R.D.
Dr Rohit Sarin
New Delhi 24th March 2012
21. Participated as Member in the National Task Force in relation to Medical College Involvement in RNTCP at LRS Institute of TB & R.D.
Dr Rohit Sarin
New Delhi 21st to 22nd December 2011
22. Participated in National Paediatric Consultation meeting as a Member at LRS Institute of TB & R.D.
Dr Rohit Sarin
New Delhi 31st January to 01st February 2012
101
23. Participated in National OR Committee meeting as a Member at LRS Institute of TB & R.D.
Dr Rohit Sarin
New Delhi 08th February 2012
24. Participated in National DOTS Plus meeting as a Member at LRS Institute of TB & R.D.
Dr Rohit Sarin
New Delhi 10th February 2012
25. Attended the 58th Annual Conference of Indian Association of Cardiovascular Thoracic Surgeons and Moderated a symposium on “Surgery for Pulmonary Tuberculosis”.
Dr. R. K. Dewan
Kolkata 9th to 12th February 2012
26. Attended the 4th Asia Pacific Conference on Bronchology and Chaired one session & delivered a Guest Lecture on “Bronchoscopy in TB Sequel.”
Dr. R. K. Dewan
Jaipur 19th to 21st January 2012
27. Attended CT-CME (Thoracic) and Delivered three Guest Lectures on “History of Thoracic Surgery”, “Empyema Management” and “Bronchoplasty and Sleeve Resections”.
Dr. R. K. Dewan
Hyderabad 10th to 11th December 2011
28. Attended NAPCON 2011 and delivered a talk on “Management of Chronic Empyema”
Dr. R. K. Dewan
New Delhi 27th November 2011
29. Chaired a session on Pediatric Chest in Pediatric Surgery Update 2011 held in Maulana Azad Medical College
Dr. R. K. Dewan
New Delhi 27th March 2011
30. Delivered an Extension Lecture on “Role of Surgery in Pulmonary Tuberculosis” in the department of Surgery, JNMCH, AMU
Dr. R. K. Dewan
Aligarh 30th March 2011
31. Participated as Panelist in Panel discussion on MDR/XDR TB and infection control issues in PG CME – 2011 (North India) on for PG students of North India at LRS Institute of TB & Respiratory Diseases.
Dr. Rupak Singla
New Delhi 16th to17th July 2011
32. Delivered a lecture on “MDR-TB Implementation in India and current status” in Training of trainers regarding DOTS Plus for doctors from Mynamar under WHO
Dr. Rupak Singla
New Delhi 08th to 12th August 2011
33. Presented a talk on “Management of XDR-TB: LRS Institute Experience” in North Zone Task Force Workshop at MAMC.
Dr. Rupak Singla
New Delhi 15th September 2011
34. Presented a talk on “Management of XDR-TB: LRS Institute Experience in a symposium on Improving Tuberculosis Care and Control at
Dr. Rupak Singla
New Delhi 04th November 2011
102
AIIMS. 35. Delivered a lecture on “Interpretation
of Spirometry in “Workshop on PFT” in “NAPCON-2011”
Dr. Rupak Singla
New Delhi 27th November 2011
36. Training of trainers under RNTCP held in LRS Institute.
Dr. Rupak Singla
New Delhi 23rd May to 4th June 2011
37. Acted as Facilitator in Comprehensive courses on Clinical Management of Drug Resistant Tuberculosis in India conducted by International Union against Tuberculosis and Lung Diseases (The Union) held at LRS Institute.
Dr. Rupak Singla
New Delhi 25th to 29th July 2011
38. Acted as Facilitator in Comprehensive courses on Clinical Management of Drug Resistant Tuberculosis in India conducted by International Union against Tuberculosis and Lung Diseases (The Union) held in LRS Institute.
Dr. Rupak Singla
New Delhi 01st to 05th August 2011
39. Acted as facilitator in Training of trainers regarding DOTS Plus for doctors from Mynamar under WHO.
Dr. Rupak Singla
New Delhi 08th to 12th August 2011
40. Facilitator for Training Programme for Trainees from DPR Korea doctors.
Dr. Rupak Singla
New Delhi 21st November to 16th December 2011
41. Facilitator for Training of Medical students of Sweden.
Dr. Rupak Singla
29th November to 02nd December 2011
42. National Facilitator for Training of trainers under Programmatic Management of Drug Resistant TB held at LRS Institute.
Dr. Rupak Singla
New Delhi 12th to 16th December 2011
43. Delivered a lecture entitled “COPD – Update on Management” on 19.11.2011 at 66th National Conference on TB & Chest Diseases 2011 organized by Tuberculosis Association of India.
Dr. M.M. Puri
Dehradun 18th to 20th November 2011
44. Delivered a lecture entitled “Allergic Rhinitis and Asthma” in CME on Respiratory Allergies and Immunotherapy at LRS Institute of Tuberculosis and Respiratory Diseases.
Dr. M.M. Puri
New Delhi 3rd February 2012
45. Presented poster entitled “ FNAC in Tuberculous Lymphedenitis: experience from a tertiary level referral centre” at 26th Annual Conference of
Dr. Nidhi Paliwal, Dr. Sapna Thakur, Dr.
New Delhi 17th April 2011
103
Delhi Chapter of IAPM. Shalini Mullick, Dr. Kumud Gupta
46. Presented poster entitled “Adeno Carcinoma in Mature Teratoma of Anterior Mediastinum” at 27th Annual Conference of Delhi Chapter of IAPM.
Dr. Nidhi Paliwal, Dr. Kumud Gupta, Dr. R.K.Dewan, Dr. Shalini Mullick
New Delhi 25th February 2012
47. Delivered a lecture entitled “Obstructive Sleep Apnoea Syndrome – A Step by Step approach to diagnosis” at NATCON 2011 organised by TB Association of Uttarakhand under auspices of TAI.
Dr. Rajnish Gupta
Dehradun 19th November 2011
48. Delivered a talk on “Role of National Reference Laboratory in Tuberculosis Care and Control” at the Symposium on Improving TB Care & Control at AIIMS
Dr. Manpreet Bhalla
New Delhi 4th November 2011
49. Poster Presentation on “Predominance of Beijing genotype in XDR M. Tuberculosis isolates from a tertiary care hospital” in IAMM Delhi Chapter Meeting organised by UCMS & GTB Hospital at India Habitat Center.
Dr. Manpreet Bhalla
New Delhi 3rd December 2011
50. Delivered a talk on “Fluorescent Microscopy usefulness and utility in diagnosis of TB” at LRS Institute of TB & R.D.
Dr. Ajoy Verma
New Delhi February and March 2012
51. Presented a paper on “Drug Susceptibility pattern of tuberculosis isolates in eight states of India – Data from a National Reference Laboratory” at 66th National Conference on TB & Chest Diseases (NATCON 2011).
Dr. Niti Singh, Dr Ritu Singhal
Dehradun 18th to 20th November 2011
52. Presented a paper on “Evaluation and justification of Phenolammonium sulfate precipitation / sedimentation smear microscopy method for diagnosis of pulmonary tuberculosis” at 66th National Conference on TB & Chest Diseases (NATCON 2011).
Dr. Niti Singh, Dr Ritu Singhal
Dehradun 18th to 20th November 2011
53. Trainer for the STLS and LTs from Medical Colleges of India conducted by International Union of Tuberculosis and Lung Disease (IUTALD) in LED fluorescent Microscopy at LRS Institute.
Dr. Niti Singh
New Delhi 13th to 17th February and 27th to 29th March 2012
104
54. Presented a paper on “Newer diagnostic methods of diagnosis of drug resistant tuberculosis” at NATCON 2011
Dr Ritu Singhal
Dehradun 18th to 20th November 2011
55. Presented a paper on “Pattern of tobacco consumption among youth in a tertiary care respiratory hospital of Delhi” at NATCON 2011
Dr Sujata Arya
Dehradun 19th November 2011
56. Presented a POSTER on “Knowledge, attitude and practices of tobacco consumption among youth in a tertiary care respiratory hospital of Delhi” at NATCON 2011
Dr Sujata Arya
Dehradun 20th November 2011
57. Presented a paper on “Tobacco and alcohol consumption among youth attending OPD in a tertiary care respiratory hospital of Delhi” at IPHACON 2012
Dr Sujata Arya
Kochi 11th February 2012
58. Presented an interesting case of Haemoptysis in a Nepalese origin young male patient diagnosed on bronchoscopy at NATCON 2011
Dr Pushpender Verma
Dehradun 20th November 2011
59. Facilitator for LPA Training at New Delhi TB Center
Dr. Jyoti Arora
New Delhi 28th March to 2nd April 2011
60. Facilitator for LPA TOT at ICELT Dr. Jyoti Arora
Delhi 12th to 17th December 2011
61. Facilitator for Fluorescent Training at LRS Institute
Dr. Jyoti Arora
New Delhi 20th to 23rd March 2012
62. Attended Mid Term Summer CME by Infectious Diseases Chapter of IAP, Kolkata and delivered guest lecture on Conventional V/S Newer Diagnostic Methods of TB”
Dr. Sangeeta Sharma
Kolkata 24th April 2011
63. Delivered a Guest Lecture on “Diagnosis of Pediatric TB” in NATCON – 2011
Dr. Sangeeta Sharma
Dehradun 18th November 2011
64. Delivered a Lecture on “MDR TB in Children- LRS Experience” in PEDICON 2012 during 49th Annual Conference of Indian Academy of Pediatrics. Chaired an invited guest lecture “TB or Not TB” by Prof. Nigel Curtis. Also Judged two sessions on “Intercostal Tube V/S/ Video Assisted Thoracoscopy” and “DOTS V/S Non-DOTS – which is better”.
Dr. Sangeeta Sharma
Gurgaon 21st January 2012
65. Delivered a lecture on “Bronchial Asthma” in Nehru Homeopathy College for their faculty doctors.
Dr. S. K. Munjal
New Delhi 25th April 2011
66. Delivered a lecture on “Psychosocial Issues in HIV/AIDS” in Department
Dr. S. K. Munjal
New Delhi 26th July 2011
105
of Community Medicine at MAMC. 67. Chaired a session on Misc. Talks at
NAPCON-2011. Dr. S. K. Munjal
New Delhi 29th November2011
68. Delivered a lecture on “HIV/TB Co-infection” at Conference Hall, Delhi University
Dr. S. K. Munjal
New Delhi 14th May 2011
69. Delivered a lecture on “HIV/TB Co-infection” at Conference Hall, Delhi University , under Global Fund to AIDS Tuberculosis & Malaria R-7 Project (GFATM R-7)
Dr. S. K. Munjal
New Delhi 4th July 2011 and 11th February 2012
70. Delivered a lecture on “TB-HIV Collaboration” at LRS Institute of TB and Respiratory diseases , in Training Programme for Trainees from DPR Korea Doctors.
Dr. S. K. Munjal
New Delhi 15th December 2011
71. Delivered a talk on Sensitization of class IV employees of LRSI on HIV/AIDS for Sensitization programme from DSAC.
Dr. S. K. Munjal
New Delhi 28th to 29th March 2012
72. Chaired a session CME “Respiratory Allergy and Immunotherapy at LRSI.
Dr. S. K. Munjal
New Delhi 3rd February 2012
106
10. Conference / Workshop/ Seminar/Training Attended :-
10.1 Outside Country : S.No. Conference / Workshop/
Seminar/Training attended
Name of Participant
Venue
Dates
1. Attended Annual Board Retreat of International Union against Tuberculosis and Lung Disease (IUALTD).
Dr D. Behera Paris, France 15th to 17th April 2011
2. Participated in International WHO Training for Drug Resistant Tuberculosis Consultants.
Dr Rohit Sarin Lesotho, South Africa
07th to 11th November 2011
3. Attended AITRP training program on molecular diagnosis of NTM at NYU.
Dr. Ajay Kr. Verma
New York, USA 1st September to 30th November 2011
4. Attended Comprehensive Clinical TB Course at Southeaster National Tuberculosis Center, Lantana.
Dr. Ajay Kr. Verma
Florida, USA 12th to 15th September 2011
5. Attended Comprehensive Clinical TB Course at National Jewish Health Center, Denver.
Dr. Ajay Kr. Verma
Colorado, USA 12th to 15th October 2011
6. Attended Diagnosis of Non-tuberculous Mycobacteria by Molecular Methods (PCR, RTPCR, PRA) at Florida Department of Health, Bureau of Laboratories, Mycobacteriology Laboratory, Jackson Ville
Dr. Ajay Kr. Verma
Florida, USA 16th to 30th October 2011
7. Attended Molecular diagnostic methods for diagnosis of TB at Wordsworth Center, New York State Dept. of Health, Dandaxdord Inst. 120, New Scotland Avenue, Albany.
Dr. Ajay Kr. Verma
New York, USA 16th to 26th November 2011
107
10.2 Within Country : S.No. Conference / Workshop/
Seminar/Training attended Name of
Participant Venue Dates (From –
to) 1.
Attended 16th Annual Conference of Environment and Pulmonary Diseases (NESCON 2011)organized under the auspices of Environment and Medical Association ‘Our Environment, Our Responsibility’.
Dr. D. Behera Mumbai 23rd to 24th April 2011
2. Attended 25th Annual Pulmonary and Critical Care Update (The Chest) at PGIMER.
Dr. D. Behera Chandigarh 08th October 2011
3. Attended 67th Annual Conference of Association of Physicians of India 2012.
Dr. D. Behera Kolkata 12th to 15th January 2012
4. Attended Indo Swedish Conference ‘Post Genomic Opportunities in Tuberculosis and other mycobacterial diseases’ organized by School of Life Sciences & Computation & Integrative Sciences, JNU.
Dr. D. Behera New Delhi 29th to 31st January 2012
5. Attended OR Workshop-cum-CME organized by State Task Force, UP.
Dr. D. Behera SAIFAI, U.P.
28th February 2012
6. Attended “NAPCON-2011” at India Habitat Centre.
Dr. Rupak Singla
New Delhi 27th to 30th November 2011
7.
Attended 66th National Conference on Tuberculosis and Chest Diseases (NATCON 2011).
Dr. M. M. Puri Dehradun 18th to 20th November 2011
8. Attended 13th NAPCON 2011 organised by V.P.Chest Institute
Dr. Rajnish Gupta
New Delhi 27th to 30th November 2011
9. Attended 20th Meeting of National Lab Committee at LRS Institute
Dr. Manpreet Bhalla
New Delhi 13th July 2011
10. Attended TB Diagnostics in India – Conference / workshop From Importation & Initiation to Innovation at St. John’s Research Institute
Dr. Manpreet Bhalla
Bangalore 25th to 26th August 2011
11. Attended PMDT Training – DOTS Plus at LRS Institute
Dr. Manpreet Bhalla
New Delhi 10th to 14th October 2011
12. Attended seminar on Accreditation – Strive for Excellence, organised by UCMS & GTB Hospital at India Habitat Center
Dr. Manpreet Bhalla
New Delhi 3rd December 2011
13. Attended Seminar on ‘Improving Tuberculosis Care and Control’ at AIIMS
Dr. Manpreet Bhalla
New Delhi 4th November 2011
14. Attended IUATLD Training – Project Light at LRS Institute
Dr. Manpreet Bhalla
New Delhi January to March 2012
15. Attended MICRODCON, IAMM Delhi Chapter 2012 at AIIMS
Dr. Manpreet Bhalla
New Delhi March 2012
16. Attended practical course on cartridge Dr. Ajay Kr. New Delhi 21st to 23rd
108
based automated nucleic acid amplification test (CBANAAT) at LRS Institute
Verma March 2011
17. Attended training on Fluoroscope Microscopy at LRS Institute
Dr. Ajay Kr.Verma
New Delhi February to March 2012
18. Attended ICAAICON – 2011 Dr. Puneet Arora
Aurangabad 16th to 18th December 2011
19. Attended 26th Annual Conference of Delhi Chapter IAPM
Dr. Shalini Mullick
Delhi 17th April 2011
20. Attended 27th Annual Conference of Delhi Chapter IAPM
Dr. Shalini Mullick
Delhi 25th February 2012
21. Attended National Conference on advances in coagulation and Thrombosis
Dr. Shalini Mullick
New Delhi 2nd March 2012
22. Attended User Group Meeting on Flow Cytometer
Dr. Shalini Mullick
Gurgaon 12th August 2011
23. Attended IRL Microbiologist workshop at New Delhi organized by USAID, CTD and PATH for the microbiologists and State Head quarter Consultants of Selected IRLs.
Dr. Niti Singh New Delhi 30th June to 1st July 2011
24. Completed Training in Line Probe assay for MDRTB (LPA for MDRTB Plus) in Deptt. Of Microbiology at LRS Institute
Dr. Niti Singh New Delhi 23rd to 27th August 2011
25. Participated in RNTCP National DOTS Plus Training organized by STDC, Kerala , CTD and Trivandum, Kerala WHO
Dr. Niti Singh Kerala 26th to 30th September 2011
26. Attended MICRO-DCON 2012, IAMM at AIIMS.
Dr. Ritu Singhal
New Delhi March 2012
27. Attended NATCON 2011. Dr. Ritu Singhal
Dehradun 18th to 20th November 2011
28. Attended Tuberculosis Care and Control Symposium at AIIMS.
Dr. Ritu Singhal
New Delhi 4th November 2011
29. Attended PMDT training DOTS-Plus. Dr. Ritu Singhal
Hyderabad November 2011
30. Attended IUTALD training Project LIGHT at LRS Institute.
Dr. Ritu Singhal
New Delhi February to March 2012
31. Attended 66th NATCON 2011. Dr. Sujata Arya
Dehradun 18th to 20th November 2011
32. Attended 56th Annual National Conference of Indian Public Health Association (IPHA).
Dr. Sujata Arya
Kochi, Kerala
10th to 12th February 2012
33. Attended Pre-conference CME on “Impact Evaluation of Public Health Programme”.
Dr. Sujata Arya
Kochi, Kerala
9th February 2012
34. Attended National Oncology Congress on Lung Cancer.
Dr. Pushpendra Verma
Delhi 29th January 2012
35. Attended 1st Annual Conference-cum-Workshop on Research Methodology
Dr. Pushpendra
Delhi 9th October 2011
109
and Art of Scientific Paper Writing at MAMC.
Verma
36. Attended Medicine Update 2012 at AIIMS.
Dr. Pushpendra Verma
Delhi 12th February 2012
37. Attended 5th Conference Best of ACC, Cardio-vascular Medicine.
Dr. Pushpendra Verma
Delhi 14th to 15th May 2011
38. Attended New Horizons in Caner Research : Biology to Prevention to therapy.
Dr. Devika Tayal
Gurgaon 13th to 16th December 2011
39. Attended Opening New Horizons in Clinical Bio-Chemistry at Sir Ganga Ram Hospital.
Dr. Devika Tayal
New Delhi 21st January 2012
40. Attended DOTS-Plus Training. Dr. Jyoti Arora Ahmedabad 12th to 16th September 2011
41. Attended MRI Update Dr. Devesh Chauhan
Mumbai 16th to 18th December 2011
42. Attended National Conference of Radiology
Dr. Devesh Chauhan
Hyderabad 28th to 31st January 2012
In addition, the faculty members and residents also attended all CMEs/ Workshops organized within
the Institute like PG CME – 2011 North India from 16th to 17th July 2011, National Task Force
Workshop for involvement of Medical Colleges in RNTCP from 21st to 22nd December 2011, CME
on Respiratory Allergy and Immunotherapy on 3rd February 2012, Dr. R.C.Jain Memorial Lecture on
World TB Day on 24th March 2012, etc.
110
11.0 LIST OF COMMITTEES [2011 - 2012]
1. TECHNICAL SPECIFICATION COMMITTEE (For equipment(s) upto cost of Rs.10.00 Lacs)
Dr. V.P. Myneedu Chairman Dr. Rajnish Gupta Member Dr. Anil Jain Member Dr. Amit Kumar Sharma Member Dr. Prabhpreet Sethi Member HOD/Section Incharge concerned Member-Convener
(For equipment(s) costing more than Rs.10.00 Lacs, one outside expert to be invited.)
2. LOWER PURCHASE COMMITTEE Dr. Sangeeta Sharma Chairperson Dr. Lokender Member Dr. M.P. Arora Member Dr. Anita Yadav Member Shri Vijay Khera Member Incharge Procurement Cell Member-Convener
3. HIGHER PURCHASE COMMITTEE Dr. Rohit Sarin Chairman Dr. Kumud Gupta Member Dr. Anil Jain Member Dr. S.B. Singh Member Dr. Pushpendra Kr. Verma Member Dr. Ritu Singhal Member Shri Atul Kumar Srivastava Member Incharge Procurement Cell Member-Convener
4. STANDING PURCHASE COMMITTEE Dr. D. Behera Chairman Dr. Rohit Sarin Member Dr. Rupak Singla Member Dr. M.M. Puri Member Dr. S.K. Munjal Member Dr. Manpreet Bhalla Member Representative of IFD, M/o Health & FW Member Shri Atul Kumar Srivastava Member Incharge Procurement Cell Member-Convener
5. TENDER OPENING COMMITTEE Dr. Khalid Chairman Dr. M.P. Arora Member Dr. Alok Yadav Member Mrs. T. Percy Member A nominee of Account Section Member A nominee of Administrative Section Member
111
6. QUOTATION OPENING COMMITTEE (For Estate, Hospital & Others)
Dr. Puneet Arora Chairman Shri Vijay Khera, JAO Member Mrs Pawan Banga, Store Superintendent Member Shri Vijay Bhatt, Office Superintendent Member
7. TENDER EVALUATION COMMITTEE
Dr. Anand Jaiswal Chairman Dr. Rakesh Agarwal Member Dr. Prakash Sharma Member Dr. Devesh Chauhan Member Dr. Prabhpreet Sethi Member Dr. Shalini Mullick Member A nominee of user department Member
8. INSPECTION COMMITTEE (Medical Store)
Dr. Lokender Chairman Dr. K.K. Mathuria Member Dr. Amit Sharma Member Dr. Alok Yadav Member A nominee of user department Member
9. INSPECTION COMMITTEE (General Store)
Dr. Devesh Chauhan Chairman Dr. Ajoy Kumar Verma Member Dr. Shalini Mullick Member A nominee of user department Member
10. ESTATE COMMITTEE
Dr. K. Khalid Chairman Dr. M.P. Arora Member Dr. Ajoy Kumar Verma Member Dr. Amit Sharma Member Shri Atul Kumar Srivastava Member Consultant (Civil) Member-Convener Assistant Enginner (Civil)/Junior Engineer Electrical
Member
11. CONDEMNATION COMMITTEE
Dr. Prakash Sharma Chairperson Dr. Amit Sharma Member Mrs. Rita V. Lyall Member Shri Vijay Khera Member
112
12. HOSPITAL DISPOSAL COMMITTEE Dr. Lokender Chairman Dr. Rakesh Agarwal Member Mrs. T. Percy Member Shri Vijay Khera Member
13. DIET COMMITTEE Dr. Kamla Verma Chairperson Dr. Sanjay Gupta Member Mrs. Anita Kansal Member Shri Atul Kumar Srivastava Member Incharge Kitchen Member
14. HOSPITAL INFECTION CONTROL COMMITTEE
Dr. V.P. Myneedu Chairman Dr. S.K. Munjal Member Dr. Vikram Vohra Member Dr. Neeta Singla Member Mrs. Anita Rani Kansal Member
15. HOSPITAL WASTE MANAGEMENT COMMITTEE
Dr. Rohit Sarin Chairman Dr. S.K. Munjal Member Dr. Sangeeta Sharma Member Dr. Puneet Arora Member Dr. Sujata Arya Member Mrs. T. Percy Member
16. TRANSPORT REPAIR COMMITTEE
Dr. Rajnish Gupta Chairman Dr. Alok Yadav Member Administrative Officer Member
17. EQUIPMENT REPAIR COMMITTEE
Dr. S.K. Munjal Chairman Dr. Anil Jain Member Dr. Prakash Sharma Member Dr. Pushpendra Kr. Verma Member Nominee of user department Member-Convener Shri Vijay Khera Member
18. DISASTER MANAGEMENT COMMITTEE
Dr. Rupak Singla Chairman Dr. Kamla Verma Member Dr. Anil Jain Member-Convener Mrs. Anita Rani Kansal Member Administrative Officer Member
113
Shri Nandlal, Havaldar Member
19. LIBRARY COMMITTEE
Dr. R.K. Dewan Chairman Dr. Upasna Agarwal Member Dr. S.B. Singh Member Dr. Alok Yadav Member Shri Vijay Khera Member
20. TRAINING COMMITTEE
Dr. Rohit Sarin Chairman Dr. Rupak Singla Member Dr. Anand Jaiswal Member Dr. Kumud Gupta Member Dr. Vikram Vohra Member Dr. Anil Jain Member Dr. Anita Yadav Member Shri M.B. Naidu Member Mrs. Anita Rani Kansal Member
21. ANNUAL REPORT COMMITTEE
Dr. Rajnish Gupta Chairman Dr. Ajoy Kumar Verma Member Dr. Sujata Arya Member Shri G.V. Raju Member Shri P.P. Sharma Member-Convener Administrative Officer Member
22. RESEARCH COMMITTEE
Dr. D. Behera Chairman Dr. Rohit Sarin Member Dr. V.P. Myneedu Member Dr. Anand Jaiswal Member Dr. M.M. Puri Member Dr. Sushil Munjal Member Dr. Manpreet Bhalla Member Dr. Shalini Mullick Member Dr. Upasna Agarwal Member- Convener
23. ETHICAL COMMITTEE
Dr. V.K. Vijayan, Director, VPCI Chairman Dr. J.N. Banvalikar, Medical Superintendent, RB TB Hospital, Delhi
Member
Dr. Rohit Sarin Member-Convener Dr. Anand Jaiswal Member Dr. R.K. Dewan Member Dr. Rajnish Gupta Member Dr. Thangsing Chinkolal Member Director- NDTBC Member
114
Secretary General, TAI Member Dr. Pratibha Mishra Member Shri Ravi Sikri Member
24. CANTEEN COMMITTEE
25. COMMITTEE TO LOOK INTO THE COMPLAINTS OF SEXUAL HARASSMENT
26. OFFICIAL LANGUAGE IMPLEMENTATION COMMITTEE
Dr. R.K. Dewan Chairman Shri Atul Kumar Srivastava Member Junior Hindi Translator Member-Convener
27. PUBLIC/EMPLOYEES GRIEVANCE COMMITTEE
Dr. Rupak Singla Chairman Dr. Rakesh Agarwal Member Dr. Prabhpreet Sethi Member Dr. Pushpendra Kr. Verma Member Dr. Alok Yadav Member Administrative Officer Member
28. CULTURAL AND SPORT COMMITTEE Dr. Sangeeta Sharma Chairperson Dr. Neeta Singla Member Mrs. Anita Rani Kansal Member Administrative Officier Member Ms. Seema John Member Shri N. Singh Member-Convener
29. EMPLOYEES WELFARE COMMITTEE Dr. D. Behera Chairman Dr. Rohit Sarin, AMS Member Dr. R.K. Dewan, CAO Member Dr. Khalid, CEC Member Dr. Upasna Agarwal, Specialist Grade- I Member
Dr. R.K. Dewan Chairman Dr. Neeta Singla Member Shri G.V. Raju Member Shri P.P. Sharma Member Administrative Officer Member
Dr. Kamla Verma Chairperson Dr. Neeta Singla Member Dr. Anita Yadav Member Mrs. Anita Rani Kansal Member Dr. Pratibha Mishra Member
115
Mrs. Anita Rani Kansal, NS Member Shri Atul Srivastava, Account Officer Member Administrative Officer Member Mrs. Manju Rani Aggarwal, Staff Nurse Member Mrs. Valsalla Manoj, Staff Nurse Member Shri Yogender, DEO Member Shri Rajesh Belwal, UDC Member Shri S. D. Kaushik, LDC Member Shri Anand Singh, Ward Boy Member Shri Raj Singh, Safai Karamchari Member Shri Rakesh – II, Safai Karamchari Member
30. RECORD MANAGEMENT COMMITTEE
Dr. Kamla Verma Chairperson Dr. Sanjay Gupta Member Dr. Puneet Arora Member Dr. Ritu Singhal Member Administrative Officer Member
31. SPACE ALLOTTMENT COMMITTEE
Dr. Anand Jaiswal Chairman Dr. Sanjay Gupta Member Dr. Devesh Chauhan Member Administrative Officer Member
32. HOUSE ALLOTMENT COMMITTEE
Dr. Kamla Verma Chairman Dr. Rajnish Gupta Member Shri Vijay Khera Member Administrative Officer Member
33. MEDICAL BOARD
Dr. Upasna Aggarwal Chairperson Dr. Sanjay Gupta Member Dr. Anita Yadav Member Dr. Alok Yadav Member
34. MEDICAL REIMBURSEMENT BOARD Dr. Sanjay Singh Chairman Dr. Ritu Singhal Member Dr. Sujata Arya Member Dr. Alok Yadav Member Shri Vijay Khera Member
116
35. COMMITTEE FOR ADVANCE ON ESTABLISHMENT MATTERS Dr. R.K. Dewan Chairman Shri Atul Kumar Srivastava Member Administrative Officer Member Shri Vijay Bhatt Member
36. COLLEGE COUNCIL COMMITTEE
Dr. D. Behera Chairman All HODs and Specialists Members All Medical Officers Members Dr. Rupak Singla Member-Convenor
37. PG COMMITTEE
Dr. D. Behera Chairman Dr. Rupak Singla Member Dr. Anand Jaiswal Member Dr. M.M. Puri Member
38. MEDICAL EDUCATION UNIT Dr. Rupak Singla Chairman Dr. Anand Jaiswal Member All other specialists Members HOD Microbiology Member HOD Pathology Member HOD Radiology Member
117
12.0 Other Activities of Institute
Dr M.M.Puri, Senior Chest Specialist, giving a talk on the occasion of World Asthma Day on 3rd May 2011
The Director, Dr D.Behera, lighting the lamp on the occasion of Nurse’s Day on 12th May 2011
118
Prof. K. K. Talwar, Chairman, Board of Governors, Medical Council of India, inaugurated the PG CME-2011 for Post Graduate Students of North India held at LRSI on 16th and 17th July 2011. Workshops on PFT, Bronchoscopy and Sleep Studies were conducted on 16th July 2011.
Director General Health Services, Dr Jagdish Prasad, inaugurated the National Task Force Workshop of Involving Medical Colleges in RNTCP held on 21st and 22nd December 2011
119
Dr Anil Jain, Chief Medical Officer (NFSG), deliberating in CME on Respiratory Allergy and Immunotherapy on 3rd February 2012
Hindi Pakhwada was celebrated from 14th to 28th October 2011
120
The faculty and the staff with the nursing students on the occasion of World TB Day on 24th March 2012. A number of educative activities were organized on the day.
Dr. Rajan Santosham being awarded the Dr. R. C. Jain Memorial Oration Lecture on 24th March 2012, World TB Day to commemorate our Founder Director who passed away last year
121
122
123
124
125
The Director, Dr D. Behera, hoisting the National Flag on the occasion of Republic Day
126