B R Singh Hospital ,established in

1934 ,was named after Baba Ramrick

Singh, the first Indian Agent of the

Indian Railways and acting GM of the

then Eastern Bengal Railway in Pre-

Independence Era.

It was a Health Unit just besides the

Sealdah Railway Station then to serve

the employees mostly of the Traffic

Deptt. of Railways of Eastern Region

certifying their fitness. . Later it was

converted to a hospital with 36 beds.

Now it is one of the best equipped

Railway hospitals in India.

The East Indian Railway (EIR) Company was incorporated in 1845 to connect East

India with Delhi. The first train ran here

between Howrah and Hooghly on 15 August 1854. The management of the East

Indian Railway was taken over by the

British Indian government on 1 Jan 1925.

The Eastern Railway was formed on 14 April 1952 by amalgamating three lower

divisions of the East Indian Railway:

Howrah, Asansol and Danapur, the entire Bengal Nagpur Railway (BNR) and

the Sealdah division of the

erstwhile Bengal Assam Railway. On 1 Aug 1955, some portions of BNR were

separated from Eastern Railway and

became the South Eastern Railway. Three

more divisions: Dhanbad, Mughalsarai and Malda were formed later. Till 30

September 2002 ER consisted seven

divisions. On 1 October 2002 a new zone, the East Central Railway was carved out

by separating the Eastern Railway's Danapur, Dhanbad and Mughals

arai divisions from it. Presently, it

comprises four divisions.

B. R. Singh Hospital, E Rly, Sealdah.

I N S I D E T H I S

I S S U E :

Brief History of

the Medical

Department

4

Services and

Facilities in

B.R.Singh Hosp

10

Cardiac Bypass

Surgery in E

Railway

13

The Story of

Hyperbaric

Oxygen

16

It is only a Fish

Bone!

17

Dying mother

saved

19

Frequenty

Asked

Questions:

20

I N D I A N R A I L W A Y M E D I C A L

S E R V I C E A S S O C I A T I O N ,

E A S T E R N R A I L W A Y

S P E C I A L

P O I N T S O F

I N T E R E S T :

Message from

the General

Manager, E Rly

Forward by the

Chief Patron,

CMD/E Rly

Introductory

Editorial by

MD/BRSH

History of Eastern Railway

Focus on B. R Singh Hospital, Sealdah

Website: brsingh-irms.org.com

Medinews N O V E M B E R 2 0 1 2 V O L U M E 1 I S S U E 0 0 1

New Koilaghat, the present day

Headquarters of Medical Department,

Eastern Railway Eastern Railway

Special Mention: Pages from

History of East Indian

Railway…..

Dr.S.S. Rathaur,

Chief Medical Director &

Addl. Comm, SJAB,

Eastern Railway &

Chief Patron

14, Strand Road,!2th Floor,

New Koilaghat Building,

Kolkata 700001

MESSAGE

The idea of publishing a quarterly "Medinews" for railway beneficiaries of

Eastern Railways was in my mind for quite some time as I often noticed that most of our

clients are not aware of the kind of medical facilities available in different hospitals of

Eastern Railways. This quarterly publication will contain reports on various procedures

being done and the infrastructural up gradation taking place in the medical field over this

zone.

I am extremely happy to see this dream turning into a reality. The kind of moral

support by our General Manager and the technical help by Controller of Stores in getting

the issues printed in printing press of Eastern Railways are worth praise.

I hope the "Medinews" will find a place in the hearts of its readers and will fulfill

the purpose of its publication.

I wish the Editorial board a grand success.

.

(Dr.S.S. Rathaur)

Editorial:

At the outset, I would like to thank everyone

involved in initiating the concept of a

newsletter –"Medinews" and for their

unrelenting encouragement and support in

bringing out its inaugural issue.

New concepts and innovative techniques are

being discovered regularly. It is amazing how

the Medical Department of Eastern Railway

under the dynamic leadership of CMD-E Rly has

kept pace with the latest developments in the

field of Medicine. This Newsletter is an attempt

to highlight a few of the services the medical

profession has been providing to the Railway

beneficiaries relentlessly along with highlights

of some activities of the Medical department,

practical advice on some common diseases and

guidelines to healthy life etc.

The focus of the first issue of the Newsletter is

on the Eastern Railway's zonal hospital, B R

Singh Hospital

Dr.A.K.Singh,

Medical Director, BR Singh Hospital

Sealdah, Eastern Railway

Kolkata 700014

Adjudged as “Best Hospital" in Eastern Railway

for 2010-11 and also a "Baby Friendly hospital",

this hospital was also a major contributor in

winning of overall "Comprehensive Health care

Shield" of Railway Board 2010-11.

B R Singh Hospital with 465 beds continues to

provide high quality services- preventive,

promotive and curative to nearly 6.8 lakh

beneficiaries. This is one of the few tertiary

care hospitals where specialists are available

round the clock, something not seen in some of

the top corporate hospitals.

In order to update the medical knowledge,

Annual Scientific conferences and CME

Programmes are being held every year since

1971 starting with a symposium on 'Recent

advances in Myocardial infarction' as the first

topic delivered by Dr J C Banerjee of Kolkata.

Let us work together for the success of this

Newsletter to be published quarterly

(Dr.A.K.Singh)

Pages from History of East Indian Railways Compiled by Dr S.S.Rathaur

CMD-Eastern Railways

First Indian CMO of East India Railway:

Lt. Col. Dr. Hassan Suhrawardy, D.Sc.,

M.D., D.P.H., F.R.C.S. (1884 – 18 Sep 1946)

Life and family

Lt. Col. Dr. Hassan Suhrawardy was the

first Indian Chief Medical and Health

Officer (1932-37) of the East Indian

Railway & a noted Surgeon, politician

and public servant in India.

Suhrawardy was married to Sahibzada

Shahbanu Begum and had one son and

one daughter; Hassan Masud Suhrawardy

(1903–1963) and Shaista Suhrawardy

Ikramullah. He is the grandfather of Salma

Sobhan, Naz Ikramullah and Princess

Sarvath of Jordan.

Career

Suhrawardy was the First Muslim Vice-

Chancellor of Calcutta University (1930–

1934) and the second Muslim from the

sub-continent to become a Fellow of

the Royal College of Surgeons of

England.

In 1945 he was appointed Professor of

Islamic History and Culture in Calcutta

University while retaining the chair of

Public Health and Hygiene, which he had

held since 1931.

He served as an adviser to the Simon

Commission and was a member of the

Bengal Legislative Council of which he

was Deputy President from 1923 to 1925.

As Chief Medical and Health Officer

(1932-37) of the East Indian Railway he

founded the railway's ambulance and

nursing division.

Knighthood

It was while he was Vice-Chancellor and

Dean of the Faculty of Medicine that he

received his knighthood immediately after

he had saved the life of Sir Stanley

Jackson from an attempt by Bina Das, a

female student who attempted to shoot

Jackson in the Senate House of

the University of Calcutta in February,

1932.

His distinguished career in medicine and

in the public service was crowned in 1939

by his appointment to succeed Sir Abdul

Qadir as Adviser to the Secretary of State

for India. He retired from that post in 1944,

He was active in the Muslim League,

renouncing his knighthood a month before

his death in August 1946.

***************

First CMO-Bengal-Assam Railways Compiled by Dr.S.S. Rathaur

CMD-Eastern Railways

(From Wikipedia)

Dr.Pares Chandra Datta Born-1892

Died-1963

Background and education

He was born in Silchar in Assam.

His family owned substantial tracts

of land in Lakhai, presently in

Bangladesh, for several centuries.

His father was a Senior Government

Pleader who shifted to Silchar in the

latter half of the 19th. Century, and

eventually moved into Vakilpatty, a

locality in Silchar. After studying in

the Government High School,

Silchar, he joined Presidency

College, Calcutta. Later he joined

Calcutta Medical College, ranking

first class second in the University,

before proceeding to England for

higher studies.

Career

He became a Member of the Royal

College of Surgeons (MRCS),

London and in 1916 a Fellow of the

Royal College of Surgeons (FRCS),

London. He was also a Member of

the Royal College of Physicians

(MRCP), London. In 1917 he was

appointed as House Surgeon at the

Royal Infirmary in Oldham. Later in

the same year he was appointed as

the Second House Surgeon. He

joined the Royal Infirmary in 1918

and was appointed as an Assistant

Demonstrator of Anatomy at

University College, London for

three months. He became FRCS,

Edinburgh in 1920.

After the completion of his studies,

he was commissioned in the Indian

Medical Service as a Captain. After

returning to India following a long

gap, he went as the Surgeon to His

Britannic Majesty's Consul

General in Meshed (now Meshad) in

Persia. Later he was also a Honorary

Surgeon (Eye, Ear and Throat) at the

Campbell, Calcutta.

He joined the Eastern Bengal

Railways (EBR), in 1925 and was

appointed as District Medical

Officer of Kancharapara in

Bengal. In 1930 he travelled to

Edinburgh on a 13-month study

leave, where he completed his

Diploma in Public Health (DPH).

After returning to the same post in

Kancharapara, he was transferred to

Calcutta and appointed to the newly

created post of District Medical

Officer, Sealdah in 1933.

The EBR authorities had decided to

build their own self-contained

hospital for the treatment of their

officers and staff. On January 1,

1942 he was appointed as the First-

Chief Medical Officer of the newly

constituted Bengal Assam Railway

and was given the responsibility of

running the new B.R. Singh

Memorial Hospital in Sealdah. As

a member of the newly constituted

Bengal Assam Railway, he, like all

other officers and staff of the

railways, was embodied in the

Defence of India Corps which came

under army rules and regulations.

He retired from the railways on 14

August 1947. After retirement, in

1948 he joined the West Bengal

Government's Health Directorate as

Deputy Director (Supervision). He

finally retired in 1953 after holding

various posts including the Director

of Health Services WB.

*******************

**

LIST of CMOs and CMDs, New Koilaghat,

Eastern Railway, Kolkata.

CMO: CMD:

R.G. Griffith, 1893-1901 Dr.K.P.Pathak Nov 1991-Oct 1993

J Stewart Brooke 1901-1912 Dr.D.K.Das Oct 1993-Jan1999

E.W.N.Guinness 1912-1917 Dr. G. Hariharan Nov 1999-May 2000

Sir Harry Waters 1917-1924 Dr.N.Ghosh May 2000-Sep 2000

A.K.H.Pollock 1924-1931 Dr.A.Sen Oct 2000-Nov 2000

R.V.Clayton 1931-1932 Dr.G.Subramanium Nov 2000-Mar 2003

Sir H Suhrawardy 1932-1937 Dr.S.B.Sarkar Apr 2003-Apr 2003

Dr.S.E.R.Laborda 1937-1938 Dr.T.S.Wasnik Apr 2003-Mar 2004

Dr.S.C Chatterjee 1938-1940 Dr.S.B.Sarkar Apr 2004-Mar 2005

Dr.S.E.R.Laborda 1940-1946 Dr.S.C Das Apr 2005-Jan 2006

Dr.S.S.Kent 1946-1952 Dr. J Chattopadhyay Feb 06-Nov 06

Dr.P.N.Gokhale 1952-1954 Dr. A Buxy Nov 2006 ( one day)

Dr.A.S.Arora 1954-1955 Dr.S.Ghosal Nov 2006-Jul 2007

Dr. N N Goyel 1955-1956 Dr. Nagarathnam Jul 2007-Feb 2008

Dr. A.L.Laksminarayan 1956-58 Dr. D.P Singh Mar 2008-Sep 2008

Dr.M.M Suri 1958-1961 Dr.N.Parashivamurthy Sep 08-Oct 10

Dr.S S Verma 1961-1967 Dr.S.S.Rathaur Oct 2010-

Dr,J R Gaddeock 1967-1971

Dr.H S Chaudhuri May 71-Sep 71

Dr.J R Gaddeock Sep 1971-1973

Dr.S W Correa 1973-1977

Dr.J M Ghosh 1977-1986

Dr. M S Ghosh Feb 86-May 86

Dr. J.M.Ghosh May 86-May 86

Dr.M.S.Ghosh Jun 86-Aug 86

Dr.Y.P.Kohli Aug 86-Sep 91

Dr.D.K Das Oct 91-Nov 91

7

Eastern Railway

Medical Department

The Medical Department, in keeping with

pattern of Medical & Health services on Indian Railways provides comprehensive health care through a close-knit organization.

The beneficiaries numbering 6.2 lakh include serving & retired railway employees and their dependents and certain other categories of

staff such as contractor's labour, vendors, licensed porters etc.

The Indian Railway Medical Service

(IRMS) is an organized Group 'A' service

of the Government of India. The officers of

this service are responsible for providing

comprehensive health care to the railway

beneficiaries.

Organization

The cadre is headed by a Director General,

Railway Health Service (DG-RHS) of

the rank of Secretary to the Government of

India.

At the Railway board level, the DG-

RHS is assisted by Executive

Director Health (General),

Executive Director Health

(Planning), Director-Health &

Family welfare, Director-Industrial

Health and other officers.

At the Zonal level, the medical

services are headed by a Chief

Medical Director (CMD) who is the

administrative head of the entire

zone. The CMD is assisted by 4

Addl Chief Medical Directors

(ACMD). At the divisional level,

the department is headed by a

Medical Director (MD) in zonal

hospital & Chief Medical

Superintendent (CMS) or Medical

Superintendent (MS)-in-charge in

divisional, sub-divisional and

workshop hospitals.

IRMS Doctors in a Health Camp

Doctor-Patient

Ratio in Eastern

Railways

Total Beneficiaries = 681708

Total Doctors = 346

Doctor-patient ratio

India- 1: 2000

E.Rly- 1:1970

8

Distribution of Doctors and

beneficiaries

Hospital Statistics-

B. R. Singh Hospital-2011

Sanctioned Bed-Strength: 465

Average daily IPD admission: 43

Average daily OPD attendance: 1694

Total Indoor admissions: 15564

Bed Occupancy Ratio: 85%

Special Surgery: 599

Major Surgery: 3038

Minor Surgery: 3234

Total Surgery: 6871

Hospital deliveries: 640

Sterilizations: 390

OPD Wing, BRSH/SDAH

Operation in progress, OT-2, BRSH/SDAH

Division/ WS

Employee

Retired Employees

IRMS Doctors CMP Residents

Visiting Consultant G.Total

SDAH 29987 21911 71 3 49 12 135

HWH 29540 10184 43 2 3 2 50

LLH 9305 4196 16 0 0 3 19

KPA 11219 5846 21 2 2 3 28

JMP 12741 2818 21 8 0 0 29

MLDT 8993 1865 17 3 0 2 22

HQ 6125 3 7 0 0 0 7

ASN 12356 4109 28 7 2 4 41

UDL 5560 2354 7 3 0 0 10

Metro 3900 982 4 1 0 0 5

Total 129726 54268 235 29 56 26 346

No. of beneficiaries 129726x4 54268X3

G.Total =518904 =162804 681708

9

History of the

Stethoscope:

Dr. Subhashish Das,

ACHD/BRSH/SDAH

o The stethoscope was invented in

France in 1816 by René Laennec at

the Necker-Enfants Malades

Hospital, Paris. It consisted of a

wooden tube and was monaural. His

device was similar to the common

ear trumpet.

o In 1840, Golding Bird described it

with a single earpiece.

o In 1851, Irish physician Arthur

Leared invented a binaural

stethoscope.

o In 1852 George Cammann perfected

the design of the instrument for

commercial production, which has

become the standard ever since.

o Rappaport and Sprague designed a

new stethoscope in the 1940's

consisting of chest piece with two

sides, one of which is used for the

respiratory system, the other for the

cardiovascular system. The

Rappaport-Sprague was later made

by Hewlett-Packard. The

Rappaport-Sprague model

stethoscope was heavy and short

18-24" (46–61 cm) with an

antiquated appearance and was

finally abandoned.

o Several other minor refinements

were made to stethoscopes, until in

the early 1960's Dr. David

Littmann, a Harvard Medical

School professor, created a new

stethoscope that was lighter than

previous models and had improved

acoustics.

o In 1999, Richard Deslauriers

patented the first external noise

reducing stethoscope, the DRG

Puretone. It featured two parallel

lumens containing two steel coils

which dissipated infiltrating noise

as inaudible heat energy.

Two types of Stethoscope are used

nowadays, the common and widely

used Acoustic type and the

Electronic type.

10

Medical Services & facilities in B.R.Singh Hospital-Sealdah BR Singh hospital is 465 bedded tertiary care Super-Speciality hospital and zonal hospital of Eastern Railways established in 1934. It has specialist doctors in all the major disciplines to serve the Railway beneficiaries BR Singh hospital is the second such hospital to have advanced Cardiac centre in Indian Railways and the only hospital to have modern Burn unit with Hyperbaric Oxygen therapy in Eastern India & IR OPD and Special Clinics in various specialities, separate OPD facility for retired employees and their dependents are run daily on week days from 9 am to 4:30 pm. Regular classes, case discussions, journal clubs and CME programmes are held in each discipline for house surgeons & DNB students. A library with recent edition of books and journals along with high speed internet connection is available wherein live classes are conducted by IGNOU for DNB students via satellite in the library. Regular CME programme for all doctors are held once in a week

Health Fair,

Health Units under Sealdah

Division: 14

Ranaghat main, Ranaghat (CRE), Naihati, Krishnapur,

Bongaon, Barasat, Sonarpur,

Chitpur, Dakhindari,

Kamardanga, Narkeldanga, Gholsapur, Fairlie Place & Koilaghat.

Lock Up Dispensaries: 7

Beldanga, Krishnanagar,

Shantipur, Barrackpur, BudgeBudge, Judges Court & New Alipur.

The Emergency department runs 24X7. Well equipped casualty department run by efficient and senior medical professionals, is capable of handling all sorts of emergencies. Specialist doctors are available round the clock in all the major disciplines along with house surgeons and post graduate trainees of the respective departments.

11

SPECIAL CLINICS: At B R Singh Hospital

Cardiology Mon-Fri 2 PM

Diabetic Thurs 2 PM

Endocrinology Wed 2 PM

Neurology Mon Wed 2 PM

Hepatology Thurs 2 PM

Rheumatology Wed 2 PM

Nephrology Mon &Wed 2 PM

Pulmonology Tue &Thu 2 PM

Infertility Wed 2PM

Cancer Screening Mon 2 PM

Oncology Tues 2 PM

HRT Thu 2 PM

Urology Wed 9 AM

Pain clinic Mon 3 PM

Thoracic Surg. Wed 2 PM

Movem't Disorder Thur 11AM

ADMINISTRATIVE

MEETINGS &

INITIATIVES:

To maintain a high standard of

Medical Services the following

administrative initiatives have

been taken:

• Hospital Management Meeting:

once/month

• Internal Audit Meeting: once/week

• Hospital Visiting Committee Meeting:

twice/year

• Hosp Infection Control committee

meeting: once/month

• Review of Medicine expenditure:

once/week

• Review of Budget Expenditure:

once/month

• Review of PWP and M&P : once/month

• Coordination Meeting with DRM &

BO's: as & when required

• In-service Training of Group C &

Group D staff

Above: Centrally AC Ward, BRSH/SDAH

Baby Show, BRSH Auditorium.

Left: Executive Health Check-up for

PHODS, Belvedere Park Club, Feb 2012

12

RECENT

INNOVATIONS in

B R Singh Hospital

• 6 bedded Emergency Room with all

Modern emergency equipments

commissioned on 10th Aug 2011

• Multipurpose Health Drive Camps

Total of 64 Health camps held all

over the Sealdah Division & 2570

beneficiaries examined

• Executive Health Check-up for

Officers

• Total of 25 Blood Donation camps

organized & 925 units of blood

collected

• Healthy Baby shows once a year

• School Health Programmes

• Involvement of ERWWO and Scouts

and Guides in health activities

• AIDS Awareness Programme

• Hospital Cornea Retrieval

Programme (HCRP) with Disha Eye

hospital. >100 eye donations

performed by Railway patients to

Disha Eye Hospital

• Opening of Counseling Centre at

BRSH/SDAH on 09/5/12 for HIV

AIDS, De-addiction, Family Planning

& Adolescent Sexual Health

(Conducted by Family Planning

Association of India, a premier NGO)

• Modified Early Warning Scoring

(MEW Score) introduced in Casualty

and all critical care units for Serious

Indoor patients for better Triage and

treatment from Apr 2011

• Feed back form introduced for

Indoor Patients from 15th Aug 2011

• Diagnostic Centre at Panchanantala

started on 14th.Jan 2011 as desired

by the MR

FACILITIES COMING

UP SHORTLY IN BRSH:

G+5 Super Speciality Building with

Modern Seamless OT Complex

CT Scan and MRI

3rd Lift in the OPD

New 3 Storey Central Medical Stores

Provision of dormitory for patient's

attendants

Revamping of centralized Medical

gas Pipeline & Manifold System

Installation of Liquid Medical

Oxygen Plant

Indoor Patient Feedback Form

13

Cardiac Bypass

Surgery in B R Singh

Hospital

Dr.Munna Das

DMO/Card/BRSH/SDAH

An Advanced cardiac Seamless CTVS OT

in B.R.Singh Hospital was inaugurated by

then Honorable Minister of Railways Ms

Mamata Banerjee on 30th.Jan'2011. The

centre is headed by Dr Alok Mazumdar

with able assistance of team comprising of

Cardiothoracic Surgeon Dr

H.K.DasMahapatra & Dr Abhijit Santra,

Cardiologists Dr Basudeb Bhattacharya &

Dr Munna Das, Cardiac Anaesthesiologist

Dr Chayan Bhattacharya along with five

senior residents, House physicians and

dedicated forty nurses & other paramedics

for24 hrs manning of the ICCU, CTVS ITU

& Semi ICCU. The unit became fully

operational in April 2011.

B R Singh Hospital Sealdah is now the

second railway hospital in the country to

conduct cardiac surgeries after. It also

became the first hospital in Kolkata to

conduct cardiac surgery in a state-of-the-art

modular operation theatre. According to

doctors, there is only one other hospital

(private) in the city that has a modular OT,

but it is not used for cardiac surgeries.

"A modular OT has stainless steel walls

that have no sharp bends or joints. This

allows a bacteria-free atmosphere and the

risks of infection are reduced considerably.

There is laminar flow of air through a filter

and cameras are fitted on the lights above

the operating table to record the procedure.

It costs between Rs 60 to 75 lakh just to set

up the OT. The equipment cost is extra,"

said Dr S.S. Rathaur, Chief Medical

Director-Eastern Railway.

Cardiac surgery in railway hospitals first

started in the 1970s at Perambur. It took

nearly 40 years for the railways, which has

over 13 lakh employees, to set up such

facilities at another hospital. While plans

were made to conduct cardiac surgeries in

Mumbai (Western Railway) and Delhi

(Northern Railway), the hospital in Kolkata

took the lead.

SOME OF FIRSTS IN BR SINGH

HOSPITAL:

o First Cardiac Resynchronization

Therapy done on 30th May2011.

o First coronary angiography done on

1st June 2011.

o First Automated Implantable

Cardiac Defibrillator implanted on 23rd

June 2011

o First Balloon Mitral Valvuloplasty

done on 6th July 2011.

o First diagnostic & therapeutic

Electrophysiological study done on 30th

July 2011.

o First coronary angioplasty done on

21st November 2011

o First Coronary Bypass Surgery done

on 17th May, 2012.

o First Atrial Septal Defect (Hole in

the heart) repaired on 6th. Sept 2012

Coronary Angiography in progress

14

Number of procedures done till date from

inception of this centre:

Dr.H.K.Das Mahapatra, a reputed Cardio-

thoracic Surgeon of Kolkata and his team

of doctors along with Dr.Chayan

Bhattacharjee, DMO/Anaes /BRSH

conducted the first Coronary Bypass

Surgery on 17th.May'12 in a case of Triple

Vessel Disease of Shri Khudiram Maity, 56

yrs, male, Com Clk and he was discharged

subsequently in a stable condition.

Coronary Bypass Surgery in progress

In-house Non-Surgical

Treatment of Carpal

Tunnel Syndrome

Carpal tunnel syndrome (CTS) is an

entrapment median neuropathy, causing

paresthesia, pain, numbness, and other

symptoms in the distribution of the median

nerve due to its compression at the wrist in

the carpal tunnel. The main symptom of

CTS is intermittent numbness of the thumb,

index, middle and radial half of the ring

finger. The numbness often occurs at night;

with the hypothesis that the wrists are held

flexed during sleep Pain in carpal tunnel

syndrome is primarily so intense that it

wakes one from sleep. The only

scientifically established disease modifying

treatment is surgery to cut the transverse

carpal ligament.

At B R Singh Hospital, Dr Sarbani

Sengupta ACHD/ Physician and

Rheumatologist is injecting Long-acting

Triamcinolone in patients of Carpal Tunnel

Syndrome which is a unique recommended

treatment of the said condition instead of

surgery. She has treated 86 patients with

this non-surgical method with great

success. It is highly effective treatment but

very few centres have this expertise in

India. She is also doing regular therapeutic

and diagnostic joint aspiration. She has also

started a SLE (Systemic Lupus

Erythomatosus) clinic in BRSH for better

management of SLE patients which is

multisystem disorder

• Coronary Angiography : 340

• PTCA/STENTING : 119

• B M V : 11

• Pacemaker Implant : 368

• C R T Implant : 4

• I C D Implant : 3

• Peripherals : 14

• E P S/ R F A : 34

• C A B G : 11

15

BOTOX does MAGIC

In 1897, Emile van Ermengem found that

the producer of the botulin toxin was a

bacterium, which he named Clostridium

botulinum. In 1928, P. Tessmer Snipe and

Hermann Sommer for the first time purified

the toxin. In 1949, Arnold Burgen's group

discovered, through an elegant experiment,

that botulinum toxin blocks neuromuscular

transmission through decreased

acetylcholine release. In the late 1960s

Alan Scott, M.D., a San Francisco

ophthalmologist, and Edward Schantz were

the first to work on a standardized

botulinum toxin preparation for therapeutic

purposes for eye muscle disorders. Since

then BOTOX has been used for various

therapeutic purposes.

Dr Bhaskar Ghosh ACHD/Neurology

runs Botulinum Toxin injection clinic and

there are 173 patients who get Botulinum

Toxin injection at a regular interval. This

is a highly specialized technique. It is the

only treatment of many medical conditions

associated with over activity and abnormal

contractions of muscles and also stiffness in

cerebral palsy and after stroke. It is also

injected in drooling saliva, chronic

headache (Migraine). Only few Movement

Disorder specialists inject this drug in India

and this form of treatment is available only

in Super specialty teaching institutes.

BRSH is one of the only few centres in

India where this drug is injected in all

indications by a single neurologist and

BRSH is pioneer in India in this field. Dr

Ghosh has published several papers on use

of this drug in various disorders and trained

several neurologists how to inject the drug.

Dr Ghosh also runs a Movement Disorders

Clinic in BRSH, which is the only clinic in

Indian Railways. Most of the patients

attending the clinic are difficult to control

Parkinson‟s disease and Essential Tremor.

Dr Ghosh also runs an Epilepsy clinic for

better management of Epilepsy Patients.

*********

Dr Sarbani Sengupta ACHD-Physician &

Rheumatologist injecting Long-acting

Triamcinolone in a patient of Carpal

Tunnel Syndrome

How a DEADLY TOXIN that

can kill a person is used to cure

symptoms….

16

The Story of

Hyperbaric Oxygen

in Indian Railways: A new approach to treat Non-

healing Ulcers.

Dr Chayan Bhattacharyya,

DMO-Anaesthesia (In charge HBOT) /-

Non Healing ulcers are very nagging

problems both for patients and the treating

doctors. Often they are associated with foul

smelling discharge, disfigurement leading

to mental depression of the sufferer and

care givers. Patients often get distanced

themselves from society and even from

their family members.

Common Causes: Non-healing ulcers are

most commonly associated with

Diabetes mellitus.

Venous /arterial insufficiency.

Pressure ulcers

Tubercular infections.

Infections of bone

Gas gangrene.

Infection of soft tissue of limb with

antibiotic resistant strains.

and many more

How Hyper baric Oxygen Helps?

In almost all the cases cause of non-healing

is reduced supply of blood and oxygen to

the tissue involved. In pressurized

chambers when we provide oxygen at high

pressure of 2 to 2 .5 atmospheres absolute

(ATA), the oxygen dissolved in plasma

reaches each & every cell in the body and

initiates neovascularization & healing.

BEFORE HBOT

AFTER 10 SITTING OF HBOT

A Four Bedded Modern Burn Unit was

announced in the Railway Budget for

year 2009-10 by the then Hon‟ble

Railway Minister, Ms.Mamata Banerjee

Railway Board had sanctioned the 4

bedded Modern Burn Unit with

provisions for Hyperbaric Oxygen

Therapy vide Pink Book 567 in the year

2009-10 with a cost of Rs.4,24,00,000

17

Is HBOT is associated with risk?

No, it is not associated with any major risk,

but sometimes patient may feel pain in the

ears & may have fear of closed

space(claustrophobia). For that we do pre

procedural ENT check up, Eye check up

and checking up of vital parameters.

What are other conditions in which

HBOT can be used ?

Acute Sensory Neural Hearing loss.

Carbon monoxide poisoning

Cyanide poisoning

Cerebral Palsy.

Radiation Necrosis.

Osteomyelitis (infection of bone)

Cerebral Stroke.

Soft tissue infections & Gas gangrene etc

Conclusion:

HBOT, a new therapy in railways will

benefit lots of patients without any

associated increased risk.

*******

Hoarseness of Voice:

An unusual case

Dr.Debasish Guha

Sr.DMO (SG)/ENT

B.R.Singh Hospital

A female aged around 52 years, and

housewife by Profession, presented with a

history of hoarseness of voice for last one

month. She was a known case of Diabetes

mellitus and Hypertension with

Hypothyroidism. She was on Oral

Hypoglycemic, Antihypertensive and

Thyroxin therapy.

She didn‟t give any definite history of

sudden onset of hoarseness of voice.

On Indirect Laryngoscopy,

Leukokeratosis was noted. Fibre optic

Laryngoscopy was done, and a nodular

swelling at the junction of anterior 1/3rd

and

Post 2/3rd

of both Vocal cords (Lt>Rt) with

Leukokeratosis Right cord was obtained.

Both cords were found mobile.

As the patient was initially reluctant to

undergo Microlaryngoscopy or any sort of

Surgery, she was at first treated with Oral

Prednisolone, with careful monitoring of

Blood Sugar level, along with advice for

Voice rest, etc. Repeat test for Serum TSH

was done to detect the latest level.

Since the symptoms didn‟t subside at all,

the patient and her husband were counseled

to give consent for Microlaryngoscopy

under GA.

Per operatively, when the Vocal cords

were visualized under Microscope using

400 mm lens, the Leukokeratotic lesion that

was diagnosed clinically and by Fibre optic

Laryngoscopy, was found to be nothing but

a partially impregnated “Fish Bone” in the

Right Vocal cord near the Anterior

Commissure which was removed.. No

Vocal cord nodules were seen.

18

Within a few days Post operatively,

the Voice of the Patient returned to normal.

Peroperative Pictures of removal of

the Fish Bone were shown to convince the

patient and her relatives regarding the cause

of hoarseness of voice in this particular

case.

Pre operative Fibre Optic Laryngoscopic

Pictures:

Per-operative Pictures (taken by Mobile

Phone from T.V.Monitor):

Though, in the literature, „ Fish Bone

Larynx‟ is an emergency, and it may

compromise the airway and the patient has

extreme discomfort, but fortunately, in this

case the patient had no such emergency,

and her only complaint was hoarseness of

voice.

Quinine at Rescue

Dr. B. Ghatak, ACMS/ASN

Quinine was the first effective treatment for

malaria caused by Plasmodium falciparum,

appearing in therapeutics in the 17th

century. It was first used to treat malaria in

Rome in 1631. The form of quinine most

effective in treating malaria was found by

Charles Marie de La Condamine in 1737.

Quinine was isolated and named in 1820 by

French researchers Pierre Joseph Pelletier

and Joseph Bienaimé Caventou. The name

was derived from the original Quechua

(Inca) word for the cinchona tree bark. It

remained the antimalarial drug of choice

until the 1940s, when other drugs with less

unpleasant side effects replaced it. Since

then, many effective antimalarials have

been introduced, although quinine is still

used to treat the disease.

One elderly patient was admitted in June,

2011 in the Divisional Railway Hospital,

Asansol in unconscious state.

He had history of fever for 7 days for

which he took medicines from Private

doctors where it was provisionally

diagnosed as a case of ?? liver abscess,

Initially antibiotic ceftriaxone was started.

As patient‟s level of consciousness

deteriorated initially provisional diagnosis

of cerebrovascular disease / metabolic

encephalopathy was made. Further

investigations revealed .blood pressure of

120/90 mm of Hg.and peripheral blood

smear done showed MP P.falciparum.

Optimal test for malaria was positive, blood

urea was 118mg%, and serum creatinine

was 2.62 mg%. CT scan done shows

evidence of Gliotic area in left frontal

region, & Periventricular hypo density

suggestive of ischaemic demyelination..

Chloroquine and Artemether were started

& continued for 24 hours..

19

Artemether failed to reduce fever and

moreover the level of consciousness

deteriorated gradually.

Without delay injection Quinine

dihydrochloride I.V. was started and with

each doses of I.V. QUNINE the patient’s

level of consciousness improved rapidly,

without any side effects. Patient was also

getting IV Epsolin along with adequate IV

fluids and antibiotics. Other causes of coma

were excluded as renal function also

rapidly returned to normal.

Diagnosis –Cerebral malaria, acute renal

failure, anemia.

Cerebral malaria carries a mortality of

around 30 to 50 %.

However after 15 days of hospital stay

patient was discharged in a stable and

ambulatory condition. There was no

neurodeficit at the time of discharge.

Patient shortly after admission

After recovery

A Precious Life

Saved:

Dying Mother

united with her

newborn child Dr.C S Lee, ACHD/Gyn/BRSH/SDAH

Dr S Das ACHD/Rad/BRSH/SDAH

2 years post Caesarian section

patient was admitted on 23/7/12 at 2:30 am

with LUCS done on 22/07/12 at 11am. She

was referred from a private hospital in a

state of shock after a bout of vomiting. At

the time of admission she was having

tachycardia, low BP and was shifted to ICU

urgently and managed conservatively. Hb%

was 7 gm% Urgent bedside USG done

showed collection in peritoneal cavity and

in pelvis on right side with clots found just

anterior to uterus near midline (? Rectus

sheath hematoma). As gradually her

condition deteriorated, she was taken for

emergency laparotomy. On laparotomy,

huge amount of intra- peritoneal bleeding

and clots were found which were removed

from above and below the the rectus sheath.

There was no active bleeding. Intra

abdominal drain was inserted and a

corrugated drain was put under rectus

sheath.

Patient was managed for 3 days in

ICU with occasional INR, LFT and

routine blood tests during which she

was transfused 5 units of blood and 4

units of FFP. There was no PPH.

Patient was shifted to maternity ward

and was managed conservatively.

Patient‟s condition improved

gradually and drains were

removed after 10 days.

Patient was discharged with no

complaints in a healthy state on

07/08/12.

***********

20

From the Doctor’s

Desk:

Why do people cough?

Coughing has a purpose. It is the way our

body keeps away unwanted stuff from

getting into your lungs. Coughing helps

clear extra mucus from your airways (small

tubes in your lungs). It is therefore a

manifestation of various diseases.

What are the common causes for cough?

Any condition that causes extra mucus like

smoking, a cold, a lung infection or a lung

disease, like asthma or COPD can cause

cough.

Cough may also be caused by a condition

not related to your lungs, such as heartburn,

some medications, or throat irritants (for

example, dust, pollution, chemicals in your

workplace or home).

How do I know if my cough is normal or

not?

It is normal to cough occasionally.

Coughing with a cold, flu or allergies is

normal.

Coughing is not normal if there is

associated blood or thick mucus. If your

cough makes you very tired, or light-

headed, or causing chest or stomach pain,

or causing you to “wet” yourself, you

should talk to your doctor to find out the

cause.

What are the different types of cough?

Cough may be of three types, depending on

how long the cough has lasts: acute (cough

less than 3 weeks), sub-acute (cough 3-8

weeks), or chronic (cough longer than 8

weeks).

What is the most common cause of acute

cough?

The main cause of acute cough is common

cold. A cough following a common cold

may last as long as two or three weeks.

What are the causes for cough lasting 3-8

weeks?

A cough that lasts for 3-8 weeks is often

caused by a cold or other lung infection that

lasts longer than normal for example

tuberculosis. A cough that lasts 3-8 weeks

may go away by itself but it may also need

treatment.

When do I seek medical advice?

You should seek medical advice if 1) you

are coughing up blood 2) you are short of

breath 3) you are losing weight 4) you are

coughing up coloured mucus 5) your cough

has changed over time 6) you have a fever

7)you are a current or ex-smoker

What are the causes for a chronic (8

weeks or longer) cough?

A chronic cough is not a disease in itself. It

is usually a sign of an underlying disease.

Some of the most common causes of

chronic cough include: post-nasal drip

syndrome, (when mucus drips down your

throat from the back of your nose),

something at home or work that is irritating

your nose or airway, allergies, asthma,

smoking, for chronic obstructive

pulmonary disease or COPD, acid reflux

(sometimes called gastro-esophageal reflux

disease or GERD), some high blood

pressure medications or a combination of

these causes. Tuberculosis is a common

cause for chronic cough in our country.

FREQUENTLY

ASKED QUESTIONS

ABOUT COUGH

Dr Angira Dasgupta

Sr.DMO/BRSH/SDAH

21

I quit smoking; but why do I still have a

cough?

Smokers and former smokers are at risk of

developing COPD. COPD is short for

chronic obstructive pulmonary disease –

the new name for emphysema and chronic

bronchitis. A cough that has lasted a long

time is a symptom of COPD. A simple

breathing test called spirometry is used to

diagnose COPD.

I have asthma; why do I still cough?

If you are coughing a lot, it could be a sign

that your asthma is not as well controlled as

it could be.

Can I just take cough medicine to make

my cough go away?

Unless your doctor recommends it, don‟t

use over-the-counter cough medicine. They

won‟t treat your cough; they‟ll just hide the

symptoms. Once your doctor determines

what is causing the cough with the help of

tests such as (spirometry, chest X-ray,

sputum tests) he or she can treat the cause.

Can you have more than one cause of

cough?

Yes, you can have more than one cause of

cough. In fact you can have two or three

causes at the same time. This is why it is

important to work with your doctor to find

the causes

Medical Equipment

Watch: Roche MODULAR P800 ANALYTICS

SWA

BR Singh Hospital is proud to announce the launch of this system in our Pathology Laboratory bringing uncompromised quality and world-class diagnostic testing to the Eastern Railways fraternity. The Roche Modular P800 is the star of the modular analytics Serum Work Area family. P800 is a State-of –the -art equipment and offers unique features in terms of flexibility where the system can be tailored to suit the customer requirement, thereby reducing the sample volume requirements with the

What? Equipment Used for automated

Biochemistry analysis, Blood

Sugar, LFT, Lipid profile etc

Where? Pathology department, B R

Singh Hospital.

Since When? 6th.Dec, 2011

Output: 800 test/hour

22

possibility of combining the Clinical chemistry and Immunology testing onto a single system. The system has an exhaustive menu of more than 160 parameters providing comprehensive testing on a single platform. The enhanced Intelligent Process Management (e.IPM) prioritizes sample movement thereby optimizing sample turnaround time. The Super STAT mode on the modular ensures top priority for critically emergency samples thereby relieving lab personnel follow up on STAT sample processing. With a throughput of 800 tests per hour the system ensures a smooth workflow. Modularity ensures the flexibility of increasing the throughput by changing the setup on-site with up to 27 different system combinations. . Installed on Reagent Rental Basis System: Capacity: 800 analysis /hour, ie, 1600 tests in 2 hours, as compared to previously 200 tests/hour and even before that, semi automatic at 40 tests/hour.

Did You Know?

Hospital Waste

Management at

B R Singh Hospital.

A variety of waste material is produced

daily in the wards, OT and OPD which is

scientifically disposed. Each hospital

should develop a proper system for

collection, storage and disposal of hospital

waste (Railway Boards letter No.96/11/

2-2/1 dated 23.4.97) the segregation of

hospital waste at source in different

categories, hazardous and nonhazardous

and collection in readily identifiable colour

coded containers is meticulously followed.

At B R Singh Hospital, not only

the color code is followed for

waste disposal, colored baskets

(blue and yellow) are provided in

each ward instead of colored

plastics used in most of the Govt

and Corporate Hospitals.

23

Forth-coming

Programme ahead..

o 42

nd Annual Scientific Seminar &

CM E Programme & All India

Annal Conference of Indian

Railway Ophthalmic Association---

7th,8

th and 9

th December,2012,

BRSH/SDAH

IN the NEXT ISSUE: o Know your Hospital: Focus on

Divisional Hospital, Howrah

o Alternative Employment on

Medical Grounds

o From the Doctor‟s Desk:

Hyperacidity and Dyspepsia

o Diet Watch

o Interesting Orthopedic Cases

o Medical Equipment : DR

o And many more…

The Board of Editors,

Comprising of

Dr. Munna Das, DMO/BRSH

Dr.C. Bhattacharya, DMO/BRSH

Dr. A Dasgupta, Sr.DMO/BRSH

Dr. D Guha, Sr DMO/BRSH

Dr. Subhashish Das,

ACHD/BRSH

Sincerely thank:

Dr. Shyam Sunder, CS1/BRSH

Dr. Rupa Mitra, MS/SDAH

Dr.A Dutta,ACHD/Admn/BRSH

Dr. G Dasgupta, ACHD/BRSH

Dr. B.N Dhar, ACHD/BRSH

Dr. A Sett, Dy CMD/KKK

For their efforts in bringing out this

magazine

Colour

Coding

Type of Containers Waste

Category

Yellow Plastic bag 1,2,3,6 Human Anatomical Waste (human

tissues, organs, body parts) Animal Waste & tissues, organs, Body parts

carcasses, bleeding parts, fluid, blood

and experimental animals .Microbiology & Biotechnology waste

(wastes from laboratory cultures,

stocks)

Red Disinfected Container/ Plastic bag

3,6,7 Solid Waste (Items contaminated with blood and body fluids including

cotton, dressings, soiled plaster casts,

line beddings, other material

contaminated with blood)

Blue/ White

translucent

Plastic bag/puncture proof container

4,7 Solid Waste (waste generated from disposable items other than the waste

sharps such as tubing, catheters,

intravenous sets etc.)

Black Plastic bag 5,9,10 Discarded Medicines and Cytotoxic drugs (Solid) Incineration Ash

Chemical Waste

24