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