Vol. VII Issue II October 2015

LIGNITE LIFE LINEPROVEN VALUES. POWERFUL VISION.

Dr.Subash Chandra Parija, Director /JIPMER Puducherry releasing a booklet “Towards Better Living“,

when he visited the NLC GH Stall, on July 03, 2015, the inaugural day of Neyveli Book Fair – 2015.

Shri. B.Surender Mohan, our beloved CMD, received the first copy. The book was published by NLC GH

on the occasion of the Neyveli Book Fair.

High Blood Pressure, Diabetes, harmful effects of smoking, health risks associated with excessive usage

of mobile phones and health tips towards better health are the topics covered in this trilingual booklet.

Dignitaries visit to Hospital Stall at Book Fair

INSIDE

2 Yoga for Better Living 4 Mouth Ulcers 6 8 What’s New?Happenings...

1 5 Foot Care in Diabetics3 Diabetic Retinopathy 7 First Aid in Road Traffic Accidents...Patient-Friendly measure...

Dignitaries visit to Hospital Stall at Book Fair

International Yoga DayConstipation in ChildrenContinuing to learn...

2

Dr.V.Nagaraju Department of Ayurveda

Yoga for Better Living

At yoga Centre of AHCS, Block-8 dispensary, Yoga for

Better Living Programme is being organized uninterruptedly,

since April 1994. About 100 participants each day learn and

practice yoga for better living. On 21st June the centre has

completed 21 years of the service to the community. The

dedicated service being rendered by the team of voluntary

teachers of both genders, besides enthusiastic participation of

part icipants is the key to the success of the

programme.

The best cost effective tool to modify life style is adhering to

the “Yoga way of Life”. Life style modification is only way to

prevent prevalent non-communicable disease – a bane of

modern living.

Yoga literally means fusion, union which can be achieved by

allowing all the instruments in the symphony of life to play in

harmony.

Yoga way of life includes practicing yama (prescriptions)

and Niyama (restraints/proscriptions) which are the

cardinal principles of seeing ourselves in relation with

the environment & ourselves. These are the concept to be

contemplated, absorbed, executed on physical, emotional

and mental level and needs to be refined. This paves way to

lead our life to its fullest potential.

Asana and pranayama are primary preparations to establish

harmony with system. Bending and stretching being aware

of your breathing helps in focusing mind. Pratyahara-

withdrawing senses is practiced while relaxing in savasana.

Regular practice of all the above paves the way to further

maintain in focus for longer duration to attain Samadhi or

ultimate bliss. This is precisely “Raja Yoga”.

During the process the side benefit one encounters is a state

of well being, improved work efficiency, better flexibility,

ability to withstand physical strain, better coping strategies

with stress – besides transforming negative emotion like

anger, greed, fear into soften emotions like love, compassion,

contentment and confidence. Reduction in craving helps in

making oneself more sober and motivates to stay away from

undesirable habits like smoking and consumption of alcohol

and over eating.

But, the secret in achieving benefits is only in sustained practice.

Let us try to make practice of Yoga an inevitable component of

our living as regular as one brushes his or her teeth.

In connection with International Yoga Day, Yoga Centre of Ayurvedic Health Care Services, GH, NLC, has organized a mass yoga

practice on 21st June 2015 between 6.30 & 7.30 am. About 80 male and 50 female participants practiced Yoga in the event while

another 40-50 yoga enthusiasts looked on.

NLC management has provided a roof to the open terrace adjacent to Yoga hall in Block-8 dispensary, which was formally

inaugurated by CGM/TA, Shri N.S.Ramalingam, in the presence of General Superintendent/Medical, Dr.P.Ravi. Dr.V.Nagaraju,

GS/Medical welcomed the gathering and thanked the management for continued support. Dr.P.Ravi had focused upon the

importance of International Yoga Day in his presidential address and advised to practice regularly. CGM/TA Shri N.S. Ramalingam,

lauded the continued service being rendered by the Yoga Centre of AHCS.

International Yoga Day Celebrations at AHCS

3

Dr. C.D. Venmal Devi Department of Ophthalmology

Diabetic Retinopathy

Retinopathy is the medical term for disease of the retina.

People who have had diabetes for many years can develop

damage to small blood vessels and organs throughout the

body. This is more likely to occur if the diabetes has not been

well controlled. One organ that can be affected is the retina,

the lining of the back of the eye that senses light and is

important for vision. The disease of the retina caused by

diabetes is called diabetic retinopathy.

Risk factors causing Diabetic Retinopathy

n Type 2 diabetes mellitus (T2DM) is one of the fastest

growing diseases in India and has become a major public

health challenge.

n The most common complication of T2DM is diabetic

retinopathy (DR), which is a leading cause of preventable

blindness in working-aged people.

n The diabetic individuals are 25 times more likely than their

nondiabetic counterparts to suffer severe, permanent

vision loss.

n The risk factors of disease is the onset and progression,

duration of diabetes, raised glycosylated hemoglobin

(HbA1c), raised systolic blood pressure (SBP) and urinary

albumin.

n Early Treatment Diabetic Retinopathy Study (ETDRS)

demonstrated that reducing elevated blood lipids and

treating anemia in T2DM patients could slow the

progression of retinopathy.

n Individuals with anemia were 1.80 times more likely to

develop diabetic retinopathy than individuals with no

anemia.

n Detection of anemia and its treatment is important in

the management of diabetic retinopathy in those

patients who had both anemia (Hb-10g/dl) and

diabetes mellitus.

n The improved hemoglobin concentration with therapy

of anemia improves tissue oxygenation and may

result in reduced VEGF production, which improves

the hyperpermeability and reduces the stimulus for

neovascularization.

n Individuals with duration of diabetes of more than 5

years have 1.56 times higher risk of developing

anemia than those with diabetes for less than 5

years.

n These observations suggest that anemia evaluation

should be considered in the routine management of

persons with diabetes and should be treated to

minimize the risk of microvascular complications such

as nephropathy and retinopathy.

Figure 1. Retinopathy in a patient with severeanemia. Note the retinal hemorrhages, cottonwool spots and venous tortuosity.

Ophthalmoscopic view

Optic discMacula of retina

Branches of retinal vessels(artericles and venules)

4

Dr.R.Nalini Department of Dentistry

Mouth Ulcers

Mouth ulcers are sores that appear in the mouth, often on the inside of the cheeks

Mouth ulcers also known as apthous ulcers can be painful when eating, drinking or brushing teeth

Occasional mouth ulcers are usually harmless and clear up on their own. Seek medical advice if they last longer than 3 weeks or keep coming back

Mouth ulcers cannot be caught from someone else

UP to 1 in 5 people get recurrent mouth ulcers

Type of mouth ulcer

The main types of mouth ulcer are

n Minor ulcer:- These are around 2-8mm in diameter and usually clear up in 10 days to 2 weeks

n Major ulcers:- These are bigger and deeper, often with a raised or irregular border. This type of ulcer can take several weeks to heal and may leave a scar in the mouth

n Herpetiform ulcers :- this type of ulcer is a cluster of dozens of smaller sores the size of pinheads

What causes mouth ulcers?

The exact cause of most mouth ulcers is unknown. Stress or tissue injury is thought to be the cause of simple mouth ulcers. Certain foods, including citrus or acidic fruits and vegetable (such as lemons, oranges, pineapples, apples, figs, tomatoes and strawberries), can trigger a mouth ulcer or make the problem worse. Sometimes a sharp tooth surface or dental appliance, such as braces or ill-fitting dentures, might also trigger mouth ulcers.

Some cases of complex mouth ulcers are caused by an underlying health condition, such as an impaired immune system, nutritional problems, such as vitamin B-1, zinc, folic acid, or iron deficiency and gastrointestinal tract disease, such as Coeliac disease and Crohn's disease.

When you first quit smoking, you may develop more mouth ulcers than normal, but this is temporary.

Some medications, including common pain killers, beta –blockers and some chest pain medicines may cause a reaction that leads to mouth ulcers

How are mouth ulcers treated?

Pain from a mouth ulcer generally lessens in a few days and the sores usually heal without treatment in about a week or two.

If sores are large, painful or persistent, your dentist may prescribe an antimicrobial mouth rinse, a corticosteroid ointment, or a prescription or non-prescription solution to reduce the pain and irritation.

Can mouth ulcers be prevented?

Although there is no cure for mouth ulcers and they often reoccur, you may be able to reduce their frequency with good dental hygiene and by

n Avoiding foods that irritate your mouth, including acidic or spicy foods

n Avoiding irritation from gum chewing

What is the treatment for mouth ulcers?

Mouth ulcers generally go away by themselves and in most cases you can ignore them. Over the counter gels or lozenges that protect the ulcer or anaesthetic effect to relieve the discomfort of a mouth ulcer are available antimicrobial mouthwash can help to kill micro-organisms causing infections

Mouth ulcers can be quite painful and depending on their specific location in the oral cavity, often interfere with your ability to eat and speak. Sometimes, such an ulcer indicates the deficiency of certain vital nutrients and therefore, taking multivitamin supplements can be useful: however, it can take a few days for the effects to start showing. There are many reasons as to why ulcers occur, here we give you 5 quick home remedies to treat them.

n If the mouth ulcer is causing a lot of pain, gently rub a small ice cube over the spot or rinse your mouth with ice-cold water.

n You could also chew on a clove bud (lavang) and direct the juice generated to the area where the ulcer is located. Clove buds are a great ingredient to cure sore throat too.

n To prevent the ulcerated area from getting infected, make it a point to rinse your mouth with a little salt water

Remember, this won't make the ulcer disappear, but it can help reduce the pain

While the above are short-term tips to give you relief from ulcer pain, the below- mentioned ingredients are remedies that will help you get rid of them.

Honey

Honey is a natural humectants – that is, it helps retain moisture and prevent dehydration. It also helps reduce scarring and hastens the process of new tissue growth. This, along with its anti-microbial effect ensures faster healing of the mouth ulcer.

Tip : Dab a little honey onto the mouth ulcer or mix in a little turmeric to make a paste that can be applied to the affected area.

Tulsi

The leaves of the tulsi plant have amazing medicinal properties and one of the important actions of tulsi is as an adaptogen – a substance that aids the body to adapt to stress.

Tip : Chew a few leaves of tulsi along with common water about three to four times every day. This is help in healing of ulcers faster and also have a preventive action against their recurrence.

Liquorice

Called Mulethi in hindi, Yashtimadhu in Sanskrit and Adhimadhuram in tamil, liquorice has several medicinal properties. Scientific studies have found that it contains ingredients with marked anti-inflammatory properties which are responsible for its action against painful mouth ulcers. Mulethi is available as stem pieces as well as in powder form.

Tip : Rub the stem with a little water on a grinding stone and apply the paste to the ulcerated area. Or, if you buy the liquorice powder, disperse it in some honey or medicinal quality glycerine and apply to the mouth ulcer. You can also mix a little liquorice powder with turmeric into a glass of warm milk and drink three or four times in a day for good results.

Other cooling Agents

Since mouth ulcers are due to excess body heat, other substances with cooling properties can help get rid of them. For example, you could apply a little ghee directly to the ulcerated area, or drink a glass of buttermilk two or three times every day. Castor oil also has wonderful cooling property; apply little oil to your scalp and the soles of the feet, allow the oil to soak in for a few hours and then wash with warm water.

Painless mouth ulcer is one of the earliest signs of oral cancer consult your doctor at the earliest if painless mouth ulcer is present.

5

Dr. J. Ilango Department of Medicine

Foot Care in Diabetics

Diabetes can damage the nerves and blood vessels in the feet leading to numbness and reduced feeling in the feet. Controlling blood sugar levels can reduce diabetic foot complications. Diabetes-related foot problems can worsen very quickly and are difficult to treat, so it is important to seek prompt medical attention.

Check your feet every day. Inspect the tops, sides, soles, heels, and between your toes looking for: Dry and cracked skin, blisters or sores, bruises or cuts, redness, warmth, or tenderness, firm or hard spots.

Wash your feet every day with lukewarm water and mild soap. Gently dry your feet, especially between the toes. Use lotion, petroleum jelly, or oil on dry skin. Soak your feet in lukewarm water to soften your toenails before trimming. Cut the nails straight across.

Protect your feet from heat and cold. Do not walk barefoot, especially on hot pavement. Wear shoes at all times to protect

your feet from injury. Check the inside of your shoes for stones, nails, or rough areas that may hurt your feet. Wear shoes that are comfortable and fit well. Blisters and sores can develop when your foot presses against your shoe. Wear clean, dry socks.

Never attempt to remove corns, calluses, warts, or other foot lesions yourself. Even small sores or blisters can become big problems if infection develops or they do not heal.

Quit smoking. Smoking decreases blood flow to your feet.

Treatment of superficial ulcers usually includes cleaning the ulcer and removing dead skin and tissue. If part of the toes or foot become severely damaged, causing areas of dead tissue (gangrene), partial or complete amputation may be required

During a foot exam, a healthcare provider checks for poor circulation, nerve damage, skin changes, and deformities. Ask the healthcare provider for a foot check at least once a year.

6

Dr.V.Prakash Department of Paediatrics

Constipation in Children

Constipation is one of the commonest problems in children particularly during toilet training.

What is constipation?

Constipation in children or babies can mean any, or all, of the following:

n Difficulty or straining when passing stools.

n Pain when passing stools, sometimes with a tiny amount of blood in the nappy, due to a small tear in the skin of the back passage (anus).

n Stools that is hard, and perhaps very large, or pellet-like and small, like goat droppings.

n Passing stools less often than normal. Generally, this is less than three complete (proper) stools per week.

Why constipation develops?

Pain — when the child passes stool, it can be painful and lead them to withhold (avoid going) in an effort to avoid more pain.

Unfamiliar surroundings — A child may not pass stools, if they do not have a place where they feel comfortable for passing stool, or if they are busy and ignore the need to use the toilet. This can happen when the child starts going to school and avoids passing stools because of hygiene concerns or being embarrassed about using the toilet at school to pass stools

Medical problems — Medical problems cause constipation in less than 5 percent of all children.

Constipation and development

Constipation is particularly common at three times in a child's life:

n After starting complimentary foods

n During toilet training

n After starting school

Parents can help by being aware of these high-risk times, working to prevent constipation, recognizing the problem

if it develops, and acting quickly so that constipation does not become a bigger problem.

Home remedy for constipation

Exclusive breast feeding and avoidance of cow's milk and formula feeds helps to prevent constipation.

Fruit juice – Certain fruit juices can help to soften bowel movements. These include prune, apple, or pear (other juices are not as helpful).

Fluids – It is not necessary to drink large amounts of fluid to treat constipation, although it is reasonable to be sure that the child drinks enough fluid.

Food recommendations – Offer your child a well-balanced diet, including whole grain foods, fruits, and vegetables.

Proper toilet training is very important for prevention of development and avoiding recurrence of constipation.

When to seek help?

Report to hospital if any of the following occurs:

n Your child has not passed stools within 24 hours of starting constipation treatment

n Your infant (younger than four months) has not passed stools within 48 hours of their normal pattern (eg, if an infant who normally passes stools once in every two days goes three days without passing stools). You should call earlier if your infant has other symptoms such as vomiting or pain.

n Your infant (younger than four months) has hard (rather than soft or pasty) stools

n Your infant or child does not want to eat or loses weight

n You see blood in your child's stools or diaper

n Your child has repeated episodes of constipation

n Your child complains of pain while passing stools

n You have questions or concerns about your child's bowel habits

July 10, 2015 - Minimal Invasive Surgery in GI Cancer - Dr.Vaithiswaran, Head of Minimal Invasive Surgery &

Bariatric Surgery, Global Hospital, Chennai

July 6, 2015 – Child Sexual Abuse – Dr. S.Bharathi, MO, NLC GH

Continuing to learn...

7

Dr.P.Nisha Department of Surgery

First Aid in Road Traffic Accidents:

Do's and Dont's

If you are one of the victims or the bypasser follow these steps

in road traffic accidents.

1. Check yourself first: If you are injured, first check and

assess the extent of the injuries for yourself. Stabilize

yourself, make sure you are comfortable.

2. Check other persons:

a). Assess the extent of his/her injuries.

b). Treat the quietest person first than the screaming

persons.

c). Ask for name, if he responds it means he is conscious and

most likely not suffered severe head injury.

3. Look for signs of breathing; if he is not responding check

for breathing and pulse.

4. Call for help: immediately call for an ambulance or rush

the person to hospital.

5. Check for obstruction: if you do not hear any breath

sounds, check his/her mouth for any obstruction. If there

is something obstructing the airways, use your index and

middle finger to clear the airways.

6. Perform life saving techniques:

If there is no pulse start EAR (External air resuscitation)

and CPR (cardiopulmonary resuscitation). Keep the

person neck straight to start EAR and CPR.

EAR 3 ways: mouth to mouth, mouth to nose, mouth to

mask.

7. Ways to help him/her in grave situations:

If there is bleeding from mouth/nose or person vomits,

turn the victim to his/her side. This will prevent from

choking/aspirations.

8. Deal with open wounds: control bleeding by applying

pressure using cloth or palm.

9. Always suspect spinal injuries: don't move the victim

much.

10. Avoid feeding the victim; which may cause choking

/aspiration. Keep the person warm by using blankets.

TIPS TO REMEMBER WHILE SHIFTING A

PERSON TO HOSPITAL:

1) Should be transported on a stretcher or a stiff board.

Important to reduce the movements of the injured

person.

2) Neck and back should be straight. Should place a rolled

up towel or thick cotton under the neck for better support.

3) Ensure that the person is lying flat.

4) If there is only limb injury, patient can be transported in

sitting position.

5) In case of bleeding, lift the injured part above the body

level. Apply pressure until he/she reaches the hospital

6) Make sure that the person is breathing and has pulse.

If he/she stops breathing, be prepared to start EAR and

CPR.

As a step in improvement of quality of services, the process of getting disease specific drugs has been simplified. Instead of waiting in

the queue twice for the prescription and registration, the patient is now registered and the prescription sent online to the counter from

one location itself, after which they have to come again only to collect the medicines. The issue of medicines has also been increased

to 30 days so that the visits are halved. This has resulted in immense patient satisfaction and efficient crowd management. Feedback

from patients is very good.

Patient-Friendly measure...

LIGNITE LIFE LINENews Letter of NLC General Hospital

(for private circulation only)Published by Neyveli Lignite Corporation Limited, ‘Navratna’ - A Govt. of India Enterprise

Neyveli 607 801, Tamil Nadu. Website : www.nlcindia.com

What’s New?

In commemoration of Dr.B.C Roy, who donned multi faceted role as doctor, socialist, humanist and humble leader and transformed the socio-economic and health status of rural people mired in poverty, ignorance and illiteracy as a selfless political head of state, Doctors' Day was celebrated on 01.07.2015. Sports extravaganza and cultural blitzkrieg marked this annual celebration. Doctors' Day was a stress buster as doctors were given opportunity to unwind themselves as they are stressed out by the rigors of clinical routines. At the same the time major agenda of the programme was not lost as doctors reaffirmed their commitment to ethical standards which require them to put the interest of patients ahead of other factors. The meeting was chaired by Dr. K.Janardhan, CGS/Medical. Key note address was delivered by Dr. P.Ravi, GS/Medical and Dr.V.Nagaraju, GS/Medical, which called upon doctors to re-orient their commitment to patient care modeling after Dr.B.C. Roy. Dr. Jeyamohandhas, RMO and Dr.N.Premkumar, ACMO co-ordinated the various sports and cultural events that marked Doctors' Day celebration.

Doctors' Day Celebrations

World Breastfeeding Week (Aug 1-7) and Oral Rehydration Solution week (July 29-Aug 4) were celebrated by Paediatric Department NLC GH along with Indian Academy of Paediatrics Cuddalore district branch. Awareness programmes and quiz regarding benefits of ORS and breastfeeding and ill effects of bottle feeding were conducted at various schools in and around Neyveli.

All student nurses of OPR Nursing College were educated on scientific facts about breastfeeding. They were also trained on how to prepare ORS solution and how to use it .

Books, pamphlets, stickers, posters regarding benefits of ORS and breastfeeding were also released during the period.

World Breastfeeding Week (Aug 1-7) and ORS Week Celebration (July 29-Aug 4)

Computed Radiography (CR) uses very similar equipment to conventional radiography except that in place of a film to create the image, an imaging plate (IP) made of photostimulable phosphor is used. Hence, instead of taking an exposed film into a darkroom for developing in chemical tanks or an automatic film processor, the imaging plate is run through a special laser scanner, or CR reader, that reads and digitizes the image. The digital image can then be viewed and enhanced using software that has functions very similar to other conventional digital image-processing software.

Benefits of C.R

Doctors can visualise at their workplace. It can be connected with PACS and can also be visualised by consultants in referral hospitals through Telemedicine.

Computed Radiography

Happenings...