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PRAVARA INSTITUTE OF MEDICAL SCIENCES, DEEMED UNIVERSITY, LONI BK. MAHARASHTRA-INDIA & PRAVARA RURAL HOSPITAL WELCOMES YOU ALL in Presentation on OPHTHALMOLOGY DEPARTMENT VIEW OF PRAVARA RURAL HOSPITAL DEPARTMENT OF OPHTHALMOLOGY CONTENTS Introduction Mission Establishment of the Department Faculty position Functioning of the Department Departmental statistics regarding patient turnover UG & PG Teaching & Training Program UG & PG Results Research Activities and Publications Departmental Progress Introduction “The brave trades where the ordinary man is scared to step” is the spirit of Shri Padmashri Vitthalrao Vikhe Patil. He dreamed of providing basic medical and educational facility to this rural backward and remote area of Maharashtra. His dream came true in shape of Pravara Rural Hospital and bloomed into Rural Medical College and Pravara Institute of Medical Sciences. With all the state of an art treatment & training facilities, department of ophthalmology, in tune with the original idea is geared into providing comprehensive eye care to the local population mostly consisting of low socio-economic and education background. Our Mission To provide quality, comprehensive, multi-speciality, basic to advanced, institutional & community eye care service to the highest order. We are committed to provide state of an art teaching and training, didactic and practical, instructional and hands-on, associated with quality and more of community based research for undergraduates and postgraduates. In the future we would like to be known nationally and internationally as gold standard centre of excellence in pan-ophthalmic care and as a model teaching and research institution for all level of ophthalmic training. Mile Stones The College started in 1984 The department got established in 1986 PG courses started 1991 MS passed out 0036 DO passed out 0063 NAME Our FacultyDESIGNATION Dr. Kishor Badhe Prof. & HOD Dr. Surekha Bangal Professor Dr. Somen Misra Professor Dr. Shubhangi Sathe Professor Dr. R.N. Kothari Associate Professor Dr. Sanjay Shelke Associate Professor Dr. Jyoti Gojumgunde Associate Professor Dr. Shubhangi Nigwekar Assistant Professor Dr. Waman Chavan Assistant Professor Dr. Shobhana Jorvekar Assistant Professor Dr. Kedar Nemiwant Assistant Professor Dr. Vijay Lodha Assistant Professor Courses Conducted MBBS 125 per year MS 3 per year DO 1 per year Major Equipments/ Instruments SR INSTRUMENTS / Particulars Qty EQUIPMENTS 1 Phacoemulsification Machine Biomedics Company 01 2 Vitrectomy Machine Paed.Cateract & Trauma 01 cases 3 Operative microscope with ---- 01 camera 4 Operative microscope ---- 01 5 Anterior segment laser Post operative Iridectomy / 01 Capsulotomy PCO SR INSTRUMENTS / Particulars Qty EQUIPMENTS 6 Posterior segment laser For Focal / Pan-retinal 01 photocyulation in DM 7 Automated perimetry For Glucoma suspets 01 8 Anterior segment camera Digital photography of 01 Anterior segments 9 Posterior segment camera Digital photography of 01 posterior segment 10 Slit lamp Biomicroscope with --- 03 applanation tonometer 11 Schiotz tonometer Iop measurement 07 SR INSTRUMENTS Use Qty /EQUIPMENTS 12 Non contact tonometer Iop measurement 01 13 A Scan Biometer To measure axialength of eye ball 14 14 Keratometer To measure the corneal currature ( 01 diameter) Kx horizontal Kv vertical 15 Lensometer --- 01 16 Auto Refractometer To measure refrective errors 01 17 Wet field cautery Haemostasis 02 18 Lister’s Perimeter --- 01 19 Synoptophore 01 SR INSTRUMENTS /EQUIPMENTS Use Qty 20 Refraction chair unit --- 03 21 Trial Lense Box with retinoscope --- 06 mirror 22 Snellen’s Vision box --- 08 23 Color vision --- 05 24 Indirect Ophthalmoscope with 20 D Fundus examination 02 lens 25 78 D lense, 90 D lens --- 02+02 26 Gonniolens 3 mirror and Gonniolens Gonioscopy 01 4 mirror Anterior angle structure 01 glucoma suspect 27 Jackson’s cross cylinder Astigmatism 01 SR INSTRUMENTS Use Qty /EQUIPMENTS 28 Direct Ophthalmoscope Fundus examination 05 29 Streak Retinoscope Refraction 01` 30 Hess Screen --- 01 31 Tangent Scale --- 01 32 Tangent Scale --- 01 33 Cambridge Card set --- 01 34 Prism set --- 01 Teaching Aids Overhead Projector 01 LCD projector 01 Personal Laptops 07 Educational CD’s 40 Clinical Material • Average daily OPD : 115.47 patients • Average daily IPD : 08 patients • Average daily bed Occupancy rate : 79.47 % • Average daily operations : Major – 4.5 Minor – 25.5 Year-wise available clinical materials (During previous three years) Category 2007 2008 2009 IPD 17769 16371 19449 OPD 28058 37930 38147 Speciality In Clinics Days Clinics Faculty Incharge Monday Retina clinic Dr.S.V.Bangal Tuesday Squint/ Paediatric Dr.S.Jorvekar ophthalm.clinic Wednesday Cornea clinic Dr.K.P.Badhe Thursday Glaucoma clinic Dr.R.N.Kothari Friday Oculoplasty clinic Dr.S.Misra CME & Workshop’s Organised Total No. Sr. Dates Event Topic Speakers Dr. N. Misra Diabetic retinopathy – Early Dr. Pradeep Damle 1. 10.7.2004 CME diagnosis Dr. Prasanna Khatanker 2. 04.12.2004 CME Medical Retina Dr. Kerstin Finnstron Diabetic Retinopathy and Dr. Neeta Misra 3. 18.12.2004 C.M.E. Glaucoma – Early Diagnosis Dr. (Mrs) S. Bangal Dr.Neeta Misra 4. 19.2.2005 CME Retinopathy of prematurity Dr.N.V.Ammal Dr.Manish Bapaye Dr.N.V.Ammal Diabetic Retinopathy and 5. 19.03.2005 C.M.E. Dr. Neeta Misra Glaucoma – Early Diagnosis Dr.S.Bangal 6. 14.12.2005 C.M.E. Early diagnosis of Glaucoma Dr. N.V.Ammal and management of diabetic Dr. Neeta Misra retinopathy 7. 12.2.2006 C.M.E. ROP Dr.N.V.Ammal Dr.Neeta Misra Dr.Manesh Bapaye 8. 19.08.2007 C.M.E. Retina Update Dr. Amol Wankhede Dr. Anup Shah 9. 22.08.2008 C.M.E. Symposium on Cataract Surgery Undergraduate students 10. 09.06.2008 Guest The EYE Over Time Dr. Chandrappa Lect. Reshmi 11. 29.05.2009 Lect. Anaesthesia in ophthalmology Dr. Pradeep Naik 12 09.10.2009 Lect. Retinopathy of Prematurity DR. Abhishek Kothari 13 27.12.2009 CME Childhood Dr. Millind Killedar . Blindness Dr. Jaganath Dixit Dr. Charutha Bapaye Dr. Vaishali Une Dr. Anand Vaijawade Dr. Shobhana Jorvekar 14. Early ISM 89 female Dr.Surekha Sight detection of department , health Bangal savers diabetes RMC, Loni volunteers internation and working as al project glaucoma peripheral cases field health workers under 15. Visual Department of Medical Dr.Surekha SIDA assessment Ophthalmolog officers of Bangal project in children y, Paediatrics SIDA project under 5 and Nursing & nursing years of college, RMC, staff of SIDA age Loni project & Improvement in Teaching & Training Of Undergraduates UG Improvement in class attendance. Syllabus is revised & teaching schedule. Planned before each semester. More emphasis is given on presentation of the cases by the students during bed side clinics Attending OPD and operation theatres. Post-Graduate Teaching & Training A log book is maintained by all PGs. Regular PG activities 4 days a week. Attend central activity on Thursdays. Encouraged to present interesting cases in central clinical meetings & Research committee meetings. Encouraged to attend Local , State level & national CME / workshop / Conferences and present scientific papers. Involved in UG teaching activities. Attending multidiagnostics and special health camps like school health camp, detection of diabetic retinopathycamps, industrial workers eye checkup. Trained for enucleation for eye donation and participate in eye banking related activities like lectures on awareness Weekly Post Graduate Training Sr. Day Activity 01 Monday Seminar Presentation 02 Tuesday Journal Club 03 Wednesday Tutorials 04 Thursday Central Activity 05 Friday Case Presentation Departmental Library Subject Old Books New Books Total Books Ophthalmology 78 41 119 Departmental Museum No.of Specimens 07 Charts & Diagrams 40 International Publications Sr Title Journal Inter- Vol.,Pag Indexed Name of national e year ( Yes/No) Faculty 1 Comparative E Journal of Internatio Vol.1, Indexed Dr.Som valuation of the Ophthalmol nal No.1, en Misra Anti Inflammatory ogy in Page 22- effect of Topical Developing 24, 2007 0.1% Countries Dexamethasone sodium Topical 0.1% Declofenac Sodium after Cataract Surgery 2 Reconstructive Pravara Regional 2007 Non Dr. Surgery in a case Medical Indexed Soman of advanced Review Misra sebaceous cell carcinoma of the eye lid – A case report Sr Title Journal Inter- Vol.,Pa Indexed Name of national ge year ( Yes/No) Faculty 3 Choroidal Pravara Regional March Non Dr.Som melanoma A rare Medical 2007 Indexed en Misra case report Review 4 A Comparative Journal of Regional Vol.4, Non Dr. study of Post Maharashtr May – Indexed Soman operative a August Misra astigmatism ophthalmol 2008 between the ogical different external society incisions used in MSICS 5 External Tropical April Indexed Dr. Ophthalmomyisis by Doctor 2008 Soman oestrius ovius: an Misra unknown endemic eye disease in rural parts of central India Sr Title Journal International Vol.,Page Indexed Name of year ( Yes/No) Faculty 6 Ophthalmomyi Pravara Regional V4(3), Non Dr. asisex terna – Medical 28-30 Indexed Shubhangi A rare case Review 2009 Nigwekar report 7 Molluscum Pravara Regional V.4(4), Non Dr. contagiosum Medical 2009 Indexed Shubhangi Review Nigwekar OPD Space OPD area : 938 sq.metre Departmental office space : 15 Sqm HOD office space : 28.80 Sqm Professor Cabin : 28.80 Sqm Associate professor Cabin : 19.84 Sqm Lecturer/ assistant professor : 19.84 Sqm Working Ward Side Lab Facilities – routine investigations which includes Hb% estimation by haemoglobinometer, Urine sugar estimation, Blood sugar estimation by glucometer. Residents perform routine investigation. Special investigations: like microscopic examination of corneal ulcer scraping and conjunctival swabs. Ophthalmology Under Graduate Examination Result Sr. Year % 1. 2004-05 100.00 2. 2005-06 099.05 3. 2006-07 095.79 4. 2007-08 098.00 5. 2008-09 085.77 UG Post Graduate Examination Results Year Appear Appear DO Result Percentage MS Pass(MS) Pass(DO) MS DO 2004 3 3 2 3 66.6 100 2005 5 1 5 1 100 100 2006 1 2 1 2 100 100 2007 5 1 4 1 80 100 2008 2 1 2 1 100 100 2009 2 1 2 1 100 100 List of Journals Subscribed International - American Academy of Ophthalmology - British Journal of Ophthalmology - Highlights of Ophthalmology National - Indian Journal of Ophthalmology - Ophthalmology today - Pravara Medical Review Completed Projects Sr. No Title Investigator Start date Completion Date 1 “Role of B-Scan In Dr. Sudhir Kisan July 2001 July 2004 Suspected Posterior Kamble Segment Disorders of The Eye “ 2 Study of trends in Dr. Ghorpade December December 2004 Antibiotic sensitivity Harshwardhan G. 2001 microorganisms (Bacteria) causing corneal ulcer. 3 Clinicopathogenesis of Dr.Shivprakash December December 2004 eyelid tumors Verma 2001 Sr. Title Investigator Start date Completion date 4 Comparative: Dr. Gaydhankar July 2002 July 2005 Evaluation of the S.S AntiInflammatroy effects of Topical 0.1%Dexomethosane sodium and topical 1 % prednisolone acetate after cataract surgery 5 Incidence, Dr. Sujatha. December December 2005 Etiopathogenesis & V.Ammal 2002 Investigations of dry eye 6 Ocular manifestations Dr. Ajitkumar December December 2005 of haematological Shiram Ugale 2002 disorders Sr. Title Investigator Start date Completion Date 7 Management of Diabetic Dr. Leena December December Retinopathy in reference Mhaske 2002 2005 to laser 8 Clinical Profile of Various Dr. Deepak June 2003 June 2006 Types and Subtypes of Patil Glaucoma in a Rural Area . 9 Study of Mechanical Dr. Jadhav May 2004 May 2007 Ocular Trauma Leading Rajat to Traumatic Cataract 10 “ Correlation between Dr.Sachin May 2004 May 2007 posterior Capsular kumar .G opacification And Visual Suryawanshi Function before And After Nd:Yag Laser Posterior Capsulotomy” Sr. Title Investigator Start date Completion Date 11 Incidence of Dr. Tupe May 2004 Congenital Ocular Parag N. May 2007 Anomalies in Padiatric Age Group 12 “A Comparative Study Dr. Pallavi May 2004 May 2007 of Foldable Acrylic Iols Arora and Rigid PMMA IOLs by Phacoemulsification Techniques With Superior scleral Tunnel Incision 13 “A Clinical Study Of Dr. Amit May 2005 May 2008 Concomitant Juneja Strabismus” Sr. Title Investigator Start date Completion Date 14 “ A Comparative Study Dr.B. May 2005 May 2008 of post operative Venugopal between the different Reddy external incisions used in manual small incision cataract surgery . 15 “A Study Of Safety And Dr. Priya Patil May 2006 May 2009 Efficacy Of Manual Small Incision Cataract Surgery (MSICS) In Eyes With White Cataract” 16 Chronic Dacryocystitis: Dr. Vartika May 2006 May 2009 Clinical profile, Anand Histopathology & Microbiology Sr. Title Investigator Start date Completion Date 17 Clinical Profile Dr. Gayatri Jakkula May 2007 December of 2009 SecondaryGla ucoma in Rural Area 18 Clinical Profile Dr. Rupali May 2007 December & Visual Nandwani 2009 Outcome of Ocular Injuries in Rural Area Completed project by faculty • Ahmednagar PMT Teaching hospital diabetic retinopathy and glaucoma project. • Project partners Pravara Medical Trust, Loni and sight savers international. • Period-14th June 2003 to 31st Dec 2006. • Project co-ordinator and investigator – Dr. Surekha Bangal. On Going Research Work Ocular manifestations in diabetes mellitus patients in Rural population. A clinico-epidemiological study of suppurative keratitis in rural tertiary eye care centre. Study of epidemiology of ROP in rural settings in level 2 nursery. Study of prevalence of chronic dacryocystitis associated with nasal pathology. Prevalence of Pterygium in two Wheeler Riders Services offered by the department OPD Services- Routine and Advanced: Refraction and prescription of glasses, Auto-refractometer. Diagnostic procedure- Slit lamp examination Direct ophthalmoscopy Indirect Ophthalmoscopy, Gonioscopy, Non-contact, applanation and Schiotz tonometry Sac syringing,Synaptophore, Diplopia charting, Automated Perimetry. Ocular imaging-Anterior and posterior segment photography, Angiography. Laser Procedures- Anterior and posterior segment Laser procedures. Minor surgeries in minor OT and procedure room. Operation Theatre Routine & advanced surgical services Almost all types of eye surgeries including Cataract surgeries by conventional, Small Incision Cataract Surgery and Phaco-emulsification, Glaucoma, squint, lacrimal sac surgeries, lid and oculo plastic surgeries, Keratoplasty. Multidisciplinary Services Detection of Diabetic and Hypertensive retinopathy, with the help of department of Medicine. Detection of Retinopathy of Prematurity and Vit-A prophylaxis programme with the department of Paediatrics. Detection of Retinopathy in PET with Gynaecology and Obstetric department. Management of Polytrauma cases with OMFS, ENT and Surgery department. Community projects with Preventive and Social Medicine department. Distinguish Services Cataract surgery by phaco-emulsification Laser facilities for Diabetic retinopathy, glaucoma, PCO Fundus photography and fluorescein angiography Anterior segment photography Humphrey’s perimetry for glaucoma and Neuro ophthalmology cases Paediatric Ophthalmology Learning Resources: Library books, regional ,national and international Journals Internet facilities Educational CDs Students are encouraged to attend Postgraduate programmes CME’s Seminars ,workshops, conferences and to participate in quiz and debate competitions. UG and PG students distinguished academic achievements List of Awards in last 5 years Excellence in P.G. Examination (Ophthalmology) 1. Dr. Saudagar Vaishali Adinath “ Late Dr. B.S. Sirdesai DOMS Prize” Standing First in D.O.M.S Diploma 2002 2. Dr. Subodh Purohit First Prize in free paper session Oct – 2002 3. Dr.Purohit Subodh Gopal “ Late Dr. B.S. Sirdesai ophth. Prize”Standing First in M.S. Ophthalmology2003 4. Shri. Godbole Verendra Viswas A.D. Patwardhan gold medal awarded Rural Medical College, Loni. M.S (Ophthal) examination Dec 2003 5. Dr. Kamble Sudhir Kisan “Late Dr. D.S.Sardesai Ophthal Prize”for standing first in M.S(Ophth) examination May 2004. 6. Dr. Somen Misra “Pituitary tumour – an advanced case” at MOSCON Shirdi – Nov 2004 7. Dr. Siv Prakash Varma 1st in M.S ophthalmology examination of Pune University in August 2005. 8. Dr. Deepak Patil First Prize Interesting Case Presentation in the Clinical Meeting of the Scientific Society. 9. Dr. Pallavi Arora 1st in M.S Ophthalmology Examination in Pune University May 2007 10 .Dr. Priya Patil 1st in M.S Ophthalmology Examination PIMS in 2009 Pioneer of Nursing: Florence Nightingale was born on 12 May, 1820 at Florence. She was an English Nurse and a Writer. She is known for pioneering modern nursing. She died on 30 August, 1910, at the age of 90 years at London. Why Nursing Care? People are illiterate. They are unaware of proper hygiene and diet. There is no one to take care of old people in the family. Old people in the family are neglected in their own family. People are poor and not economically sound. People are unaware of the care to be taken for minor injuries of eyes and hesitate to consult a doctor. To provide mental and psychological support from other people Our Ophthalmic Ward Hospital : A total 770 bedded capacity with all department Optha.Ward Capacity : 90 Beds Wards : Two Separate Wards i.e. Male and Female. Capacity : Male Ward is 56 while Female Wards 34. Staffing Structure : Head of Department & Prof Dr. Surekha Bangal Three Units of Doctors Head of Unit –I : Dr. Surekha Bangal Head of Unit –II : Dr. Soman Mishra Head of Unit –III : Dr. R.N Kothari Two Doctors and Two Residents are provided to Each above Units Ward In Charge : 2 Ward In charges are allocated for Male Ward Incharge : Mrs Sarita B. Kulkarni Female Ward Incharge : Mrs. Kusum Shinde 5 Nursing Trained staffs are allocated for each ward and In additions to this students from G.N.M, B.Sc & P.B.B.S course are deployed in each ward for their practical training in ophthalmic. Facilities Provided : Indoor patients are given free services as follows: Routine lab investigations & ECGS, X-rays, Ascan Free Medicines, Free Operations, Medicines required for operation and Free Patient’s Diet. Hospitalization Expenses are not charged Hot Water, Beds, Hospital linen etc. Patients Admitted with all Ophthalmic Diseased Patients. On admission, all routine investigation e.g, Bsl fasting sugar, and post lunch sugar, Hb, TLC, DLC, LFT,RFT, ECG, Chest X-ray, and A-scan are done. If all report are within normal limit, then patient is posted for surgery. Such as cataract, glaucoma, Chronic Dacrocystitis, blepharitis, entropion, estropion, Ocular injuries, Chemical burns, ptosis, choroditis, acuteiritis, retinobnastoma, orbital cellulites, corneal tear, keratoplasty, ptrygium, penetrating injury due to anything e.g thorns, arrow, sharp toys, ball, etc. Diabetic retinopathy, Uvitivs and other ophthalmic problems. Children suffering from congenital cataract, squint, corneal tear are also treated in our ward. Equipments in the Wards All necessary equipments& special equipment like Funduscope Vision Box Tonometer Laryngescope Slitlamp Ambubag A-Scan machine Nebulizer Kerotometer Machine Glucometer Vision Drum Bouls lamp Clinical Material Average daily OPD- 115.47 patients. Average daily IPD- 6 to 8 patients. Average daily Bed Occupancy rate-79.47%. Average daily operations- a) major-4.5 b) minor-25.5 Pre-Operative Care Inform the patient and his relatives about the surgery. Written consent is taken from patient and relatives. 2% Xylocaine test is done of the patient. Prepare the eye as per the doctor’s advice by cutting the eyelashesh. KMnO4 gargles are given on the previous day and on the operation day. According to the patients condition sponge bath or bathroom bath is given to the patient. Advice to the patient and relatives to remove any ornaments. Give the hospital linen to patient and appropriate label is stick on the patients clothes. Pre operative medicines are given to the patient’s previous and on operation day. eg, 1. Tab. Ciplox-500mg (bd) 2. Tab Dimox -250 mg (hs & cm) 3. Tab Calmpose-5mg (hs &cm) 4. Tab Rantac-150mg(bd) 5. Tab M.V-(od) 6. Instilling of Two hourly Antibiotics eye drops to the Eye to be operated If patient is diseased with HPTN, Heart disease, Diabetic, along with antibiotic routine medicine are given to patient as advised by doctor. Before the surgery of cataract, antibiotic drops are instilled in eye. Dilatation is done after this which is two step process as follows: 1) Dialatin is done by instilling Tropico eyedrop and homatrophin eyedrop every 5 min. 2) Ocuflur eye drop and Tropico eyedrop are instilled in eye every 5 min. The patient is sent to OT with all documents and X-rays. Post Operative Care When patient is shifted from OT to the ward, vital signs of patient are checked. Give the instructions to the patient to sleep supine position. Then to sleep on opposite side of the operated eye. If the patient is operated under local anesthesia, the advice the patient to take soft diet. Check the post operative orders. The give he analgesic and antibiotic medicine to the patient. Day after tomorrow doctor see the operated eye and instill the steroid and antibiotic drops and patch the eye or put the dark goggle each 2 hours. Precaution for the Patient after Surgery Wash hands with soap before instilling drop in eye. Don’t rub the operated eye. Don’t play with small children. Don’t take head bath after one month of surgery. Don’t apply hair oil and don’t massage the head. Protect eye from dust, smoke, heat, etc. Avoid watching TV and reading for one month. Avoid lifting heavy weight. Use a black goggle every time. Health Education Eye is the very delicate and important organ of the body. Take the medicine as per doctor’s prescription. Don’t use the drops of other patients. Include green vegetables, carrot, and papaya in the diet. As soon as foreign bodies like dust, smoke, insects and chemicals enter into the eye, wash the eye with cold water immediately. Don’t rub eye. Consult doctor immediately. Read in sufficient light and in appropriate posture. Cataract patients should keep the continuous and regular check up. Glucoma treatment if taken regularly and on time the site remains safe and not destroyed. Diabetic patient should check the eyes after the every six months. Patient Examination at CAMP OPD Ophthalmic refraction chair unit ND – YAG – LASER (photoco-ogulation) Perimetry glaucoma automated Humphrey’s perimeter ND – YAG – LASER for Capsulotomy/Iridectomy Ant Segment slit Lamp camera Operation Theatre Carlzeiss Takayi Microscopes Synaptophore Keratometer & A-Scan For use Squint evaluation To measure the comeal/ immature (diameter) KH- Horizontal KV- Vertical A-scan –To measure the axial length of eye ball & IOL power calculation OUR WARD MULTI DISCIPLINARY CAMP Undergraduate Classroom CME-Childhood Blindness 2009 May God gives us an energy to serve more lives. THANK YOU Presented by: Mrs.S.B.Kulkarni, Ward Incharge, Pravara Rural Hospital, Loni-Bk Questions ???
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