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Vol. IX Issue V April 2019
NLC INDIA
CREATING WEALTH
FOR WELLBEING
Sincere wishes for a speedy recovery
On the occasion of the 70th Republic Day on 26.01.2019, Smt. Kanchan Rakeshkumar, President,
Sneha Opportunity Services & Neyveli Ladies Club, Smt. Devahi Thangapandian and Smt. Shanthi Vikraman,
Patrons of Neyveli Ladies Club visited NLC India Hospital, distributed fruits and sweets to the
in-patients and wished them a speedy recovery.
LOWER BACK PAIN
Dr Ratanlal Rajesh Agarwala
Orthopaedic Department
Lower Back Pain: What could it be? carrying a bucket up the stairs. Some back injuries can be sudden and
Do you have lower back pain? You are not alone. Anyone can traumatic, and some happen slowly over time. You may think that
experience lower back pain at any time, even if you don’t have a prior athletes and active people get injured the most due to their active
injury or any of the risk factors. It is not always serious and can often lifestyle. “But this is not always the case. You are just as likely to tweak
get better on its own. But in some cases pain is your body’s way of your back while bending over to pick up a sock from under the bed.
telling you that something isn’t right. It’s the everyday tasks, like holding a child that may lead to back
injuries when done improperly.
Why is lower back pain such a common problem?
Herniated Discs
The bottom part of your back typically has just five vertebrae — fewer
than your neck and mid-back. And these vertebrae do a lot of heavy A herniated, or bulging, disc is a disc that has “spilled out” of its lining.
lifting! Your lower back is where your spine connects to your pelvis, This happens most frequently in the lower back. The injured disc may
bearing the weight of your upper body. This area experiences a lot of not always hurt. But even if it’s painless, its contents can press on or
movement and stress, which may lead to wear, tear and injuries. irritate nearby nerves, causing pain in the lower back and other areas.
What are some common causes of lower back pain? What does it mean if lower back pain is shooting into legs?
Lifestyle factors Lower back pain can radiate to other parts of the body: up or down
from its place of origin. Sometimes lower back
There are three major lifestyle factors that may
pain can be on one side of the back, which is
affect your chances of developing lower back
also normal. If the pain is shooting from the
pain : Multiple studies have established a link
lower back into one or both legs, it could be
between smoking and lower back pain.
sciatica (nerve pain), but it’s not always the
Smoking raises inflammation inside the body
case. There are many parts in the lower back
and hinders the body from healing itself.
that may cause the pain to radiate into the legs,
Obesity is also associated with several types of
such as facet joints, sacroiliac joints, muscles or
chronic pain, including lower back pain.
inflammation of the bursa.
In people with high body mass index (BMI), the
Can lower back pain be a sign of something
stress on the spine increases, contributing to
serious like cancer?
even more wear and tear.
Lower back pain can be related to cancer. In
Your level of physical activity can also play a
fact, it is one of the first symptoms of prostate
role in your lower back health. While a sedentary lifestyle could
cancer when it metastasis and creates lesions. Almost any cancer can
increase your risk of developing lower back pain, so can excessive
spread to the back and some, like sarcoma, can originate in the back.
or strenuous physical activity. Check with your doctor if you are
Be cautious, especially if you are experiencing other symptoms
unsure about your ideal level of physical activity.
besides lower back pain. Talk to your doctor if you have additional
Arthritis of the Spine
symptoms or concerns.
Arthritis of the spine — the slow degeneration of the spinal joints — is
What can I do for low back pain at home?
the most frequent cause of lower back pain. All of us experience
If your lower back pain has just started, the best thing you can do is
wear and tear as we age, and it is normal for your lower back to start
rest and record your symptoms, times, dates and which activities
acting up as you get older. As the cartilage breaks down between
trigger the pain or make it worse or better. Take this information to your
the spinal joints, surrounding tissues may become inflamed. The
doctor if the pain doesn’t resolve on its own. It will make diagnosing the
inflammation and the thinning of cartilage increase friction in the joints,
cause much easier.
which may cause pain in the lower back.
Once you know which motion or position causes your lower back pain,
Back Injuries
try to avoid it and see if you get better. Icing the painful spot can also
A bad fall or a car accident can cause a lower back injury. But so can
2
UNDERSTANDING
A BASIC LABORATORY REPORT - III
(Continued from previous issue)
Dr Srinivas Suyam Prakash
HOD/Pathology
Blood Cell Counts Urine analysis
White Blood Cells (WBC) represent the body’s immune system and The urine is analyzed to determine a number of things including how
the various kinds of white cells have specialized functions. concentrated it is through Specific Gravity, which tells us how
Lymphocytes are mainly for defense against virus and cancer cells, “heavy” it is compared to water. The pH is very important because it is
while Polymorphs are primarily defending against bacteria. a good measure of how acidic or alkaline the tissues of the body are.
Monocytes are the second line of defense and finish the job started by WBC Esterase tells us whether there are white blood cells in the urine
the lymphocytes and polymorphs. High WBC count
and Occult Blood indicates the
Low WBC count
They are seen in higher numbers when presence of blood (may be due to
there is infection or inflammation. menstruation). Nitrite is a sign of
Basophils primarily function as clean infection, while Glucose in the urine may
up for allergy reactions and indicate diabetes. Ketones can also
Eosinophils perform a service when indicate diabetes, but may be due to a
toxins, allergens and parasites attack. low carbohydrate diet or fasting. Protein
Red Blood Cells are the oxygen may “leak” through the kidney and show
carrying cells using Hemoglobin to a possible weakness in that organ.
hold the oxygen until it is exchanged Bilirubin is normally eliminated through
for carbon dioxide. Hematocrit is a the bile and its presence in the urine
measure of the volume of whole blood may be an early sign of liver problems.
taken up by the red blood cells and Urobilinogen is a by-product of intestinal
expressed as a percent. MCV, MCH, MCV and RDW all reflect the activity and may suggest a lack of proper bowel flora.
size, shape and contents of red cells. A microscopic examination is used, if indicated, to confirm suspicious
Platelets are special cells in the blood that help form clots when repair findings of the basic urine analysis.
(Concluded)
is necessary.
Contd. from page 2...
help. And so can over-the-counter pain relievers the issue, you may get referred to a specialist.
that help reduce inflammation. Just remember that These specialists practice a comprehensive
pain killers treat only the symptom — pain — and approach to lower back pain, and can diagnose
not its cause. and treat a variety of conditions that have lower
When should I see a doctor if I have lower back back pain as a symptom.
pain? The good news is that surgery is rarely needed for
In many cases lower back pain stops on its own. lower back pain. “Only about one in ten patients
But if it doesn’t, here are some guidelines on when needs lower back surgery.”
you may want to start seeking professional help: Comprehensive approach to lower back pain
● If the pain lasts four weeks or longer ● Thorough History
● If the pain keeps getting worse as time goes by ● Physical Examination
● If you are experiencing other symptoms, such as fever, major ● X ray and Biochemistry Tests
weight loss or weight gain, loss of function or weakness in extremities, ● Refer to Orthopaedic & Spine Specialist
bladder problems, etc. ● Diagnosis specific exercises
Who should I see for lower back pain? ● Prescription for Physiotherapy
Your primary care physician knows you best and should be your first ● Surgery if needed
contact for lower back pain. If he or she is unable to diagnose or treat ● Get help at our Orthopaedic OPD.
3
OCULAR DIROFILARIASIS
Dr Rathnakumar
Ophthalmology Department
Abstract acuity was 6/6 in both eyes.
Ocular zoonotic infections by filarial worms are not uncommon. Most The haematological and biochemical test results were normal and
of them are caused by the genus Dirofilaria. The disease is zoonotic in no microfilaremia was seen in blood smears. When the worm was
nature; sporadic cases of human dirofilairsis have been reported from coiled the patient was asymptomatic and when it started moving it had
produced immense intolerable pain.
Surgical removal of the worm was carried out immediately under
Surgical removal under
topical anaesthesia topical anaesthesia. Symptoms resolved immediately following the
surgical removal of the worm.
Grossly the worm was intact on extraction, without damaging its
structures a whitish motile worm of 20 cms in length by 0.5 mm in
breadth was removed and preserved in 10% formalin for identification.
Patient was reviewed every week for a month. She was started on
Dirofilarial worm seen in tapering topical Antibiotic steroid eye drops to treat the allergic
conjunctiva (Pre op)
reactions produced by the dirofilarial worm.
various parts involving eyes, face, chest wall and lung parenchyma. Ocular Dirofilariasis may progress to serious consequences like
damaged vision, floaters, glaucoma, retinal detachment, vitreous
We report a case of subconjunctival dirofilariasis in a 47 year old
female who had foreign body sensation and severe pain in left eye.
Dirofilarial worm
Thus early diagnosis and treatment in this patient helped in preventing preserved in
various serious ophthalmic complications. 10% formalin container
CASE REPORT
A 47 year-old lady presented with complaints of severe pain over left
orbital region and irritation of left eye since last two hours on
3rd January 2019 around 3.30 pm to the EYE OPD, NLC India
Hospital. History of travel from her native place from Pollachi 10 days
back where she gave history of contact with pets like dogs and cats in
her farm. She also mentioned that she had injury of an insect (vellai E)
in her left eye which recently migrated after Kerala rains.
opacity, loss of visual acuity and even blindness.
Ocular examination by slitlamp revealed an undulating vermiform
mass by a live worm on the temporal quadrant of left eye under bulbar This case was diagnosed much earlier in the disease process even
conjunctiva at the fornix with localized congestion. Rest of the ocular before the complications occurred and was treated and relieved of
examination was with in normal limits and her uncorrected visual pain within one hour of diagnosis at our NLC India Hospital.
Condition of eye on 1st Post op day Condition of eye on 3rd Post op day Condition of eye on 7th Post op day
4
HOSPITAL DIARY - Q4/2018-19
New washing equipments commissioned
Shri R. Vikraman, Director/HR, NLCIL commissioned an automatic
and a semi automatic heavy duty washing machines at the laundry
unit of NLC India Hospital on 23.02.2019. These automated
equipments, with a capacity of 25 kg each, purchased at a cost of
Rs.12.50 lakh replaced the 15 years old manual washing machines.
The event was witnessed by Shri S.R. Sekar, CGM/TA, Dr. M.K. Jha,
CGS/Medical i/c, Dr. Venmal Devi, CMO/Medical and also incharge of
Laundry Unit, Doctors, Para Medical Staff and employees of Medical
Branch.
Electronic Token System introduced in NLC India Hospital Pharmacy
Shri R. Vikraman, Director/HR, NLCIL inaugurated the Electronic Token
System facility at the Pharmacy of NLC India Hospital on 23.02.2019.
The new facility, installed at a cost of Rs.1.50 lakh enabled to streamline
the crowd in the pharmacy and to speed up the drugs disbursement.
This facility also gives a great relief to both pharmacists and patients
as the waiting time is considerably reduced in the counters.
Dr. M.K. Jha, CGS/Medical i/c and Dr. J. Ilango, ACMO, Incharge of
Pharmacy, Pharmacists and employees of NLC India Hospital
witnessed the event. After commissioning the new facility, Director/HR
gave valuable suggestions to improve the drug issuing system.
Clean efforts brings commendation
While NLCIL observed Swachhta Pakhwada (Clean India Fortnight) NLCIL is encouraging the units / factories / offices that are
between 16.08.2018 and 31.08.2018, NLC India Hospital also well-maintained, by presenting awards and this time, significantly,
observed it in an effective manner. An exclusive Committee was the team NLC India Hospital won a special award and a certificate
constituted by Dr. M.K. Jha, CGS/Medical i/c, and the event was of appreciation in the offices category. Shri V. Thangapandian,
organised in a systematic way. Apart from cleaning activities in Director/Power and Smt. Devahi Thangapandian presented the
Hospital premises and school areas, the NLC India Hospital team special award and certificate to Dr. M.K. Jha, CGS/Medical i/c and
created awareness on cleanliness among general public, students of the team NLC India Hospital during the Republic Day Celebrations at
Neyveli Township and nearby villages in a planned manner. Neyveli on 26.01.2019.
5
CONTINUING MEDICAL
EDUCATION PROGRAMMES
One day Clinical Workshop on Arrhythmias
Date : 12.01.2019
Resource Person : Dr. Jaisankar,
Director & Mentor, Cardiology and Electrophysiology Study
MIOT Hospital, Chennai
Recent Advances in Programmatic
Management of Tuberculosis
Date : 09.03.2019
Resource Person : Dr. R. Pajanivel
Professor & HOD, Pulmonology Department,
Mahatma Gandhi Medical College &
Research Institute, Puducherry
Methods of Ventilation : Invasive & Non-Invasive
Date : 15.03.2019
Resource Person : Dr. Ali Hasan Faiz Karnam,
Incharge of Emergency Medicine,
PIMS, Puducherry
PARENTS COUNSELLING PROGRAMME
NLCIL Education Dept., has organised a ‘Parents Counselling Programme’ for the parents of +2 students at NLCIL Boys’ Higher
Secondary School, Block-10, Neyveli on 29.01.2019. Dr.S.Narmadha, an eminent counselling Psychologist from Neyveli addressed about
200 parents. Shri R.Mohan, CGM/HR (CSR, Education, Sports & Culture), Shri S.Vinayagamoorthy, DGM/Education and
Smt. M.Rajeswari, Headmistress of the School also spoke on the occasion.
6
CONTINUING EDUCATION PROGRAMMES
FOR PARAMEDICALS
In-house credit hours one day
workshop on Infection Control in
Health Care facilities for Nurses
Date : 04.01.2019
Resource Persons : Mrs. P. Vasanthi,
Mrs. G. Malarvizhi, Associate Professors
& Mrs. D. Vanitha, Asst. Professor,
OPR Nursing College, Vadalur
Work Culture pertaining to
Hospital Change Management
Date : 05.02.2019
Resource Person : Shri Harish Kumar,
Reputed Trainer from Erode
Special Training Programme on
Universal Precaution & Infection
Control for Clinical Lab Technicians
Date : 05.03.2019
Resource Person : Dr. Rachna Williams
Technical Expert, Technical Support Unit
TANSCAS, Chennai
Special Lecture on
Universal Precautions &
Infections Control for Nurses
Date : 13.03.2019
Resource Person : Dr. Rachna Williams,
Technical Expert, Technical Support Unit
TANSACS, Chennai
7
NLC INDIA HOSPITAL ORGANISES
COMPREHENSIVE MEDICAL CAMPS
During the last quarter of 2018-19 (January to March 2019), NLC India Hospital had organised 4 medical camps in the peripheral villages with the
approval of Dr. Kala, Joint Director, Health Services, Cuddalore, Government of Tamil Nadu. In all the four camps, Doctors of various
Departments of NLC India Hospital viz., General Medicine, Eye, ENT, Pediatric, Maternity, Chest Clinic, Skin and Dental screened the patients
and distributed medicines. In all the camps, hearing aids were presented to beneficiaries.
At Indira Nagar : About 300 people from the locality of B1 and B2
Block Rehabilitation Centres benefitted at the comprehensive medical
camp held at Government Higher Secondary School premises, Indira
Nagar on 20.01.2019. Dr. M.K. Jha, Chief General Superintendent/
Medical and Shri Sivakumar, ADGM, Land Acquisition Department
inaugurated the camp.
At Oomangalam : The 4th Comprehensive Medical Camp was
organised by Team NLC India Hospital at Government Higher
Secondary School premises, Oomangalam on 27.01.2019.
Shri Samidoss, HM of the school and Dr. Packiya Mary Jerome,
DGS/Medical, NLC India Hospital inaugurated the camp, in which
around 450 people were benefitted.
At Perperiyan Kuppam : The 5th Comprehensive Medical Camp of
this financial year was organised at Government Higher Secondary
School Premises, Perperiyan Kuppam on 17.02.2019. Smt. Senthil
Nayagi, HM of the School and Dr. M.K. Jha, CGS/Medical i/c
inaugurated the camp. As many as 350 people benefitted through
this camp.
At Uluthoor : The 6th Comprehensive Medial Camp was organised
at the St. Anne’s Church premises, Uluthoor on 10.03.2019.
Shri R. Mohan, CGM/HR (CSR, Education, Sports & Culture),
Dr. M.K. Jha, CGS/Medical i/c, NLC India Hospital and Rev. Fr.
Sahaya Nathan, Parish Priest of the Church participated in the
inaugural function. About 350 people benefitted through this camp.
MEDICAL CAMPS ORGANISED
IN OUTSIDE PROJECTS
Medical Camps at Rajasthan
The Management of our Barsingsar Mine cum Thermal Project, Rajasthan had organised 3 medical camps during the fourth quarter of 2018-19
under Corporate Social Responsibility Activities. Doctors and paramedical staff of Occupational Health Centre, Barsingsar Project screened the
patients and distributed medicines. All the three camps were organised in the presence of Shri E. Esaikkimuthu, Project Head, Barsingsar &
Bithnok Project, Shri D. Sridharan, General Manager/Barsingsar Thermal Power Station and Senior Officials.
At Barsingsar Village : In the Medical At Swaroopdesar Village : The Free At Lalamdesar Village : The camp was
Camp conducted on 12.02.2019, about Medical Camp was organised on 25.02.2019 organised on 11.03.2019 in which 410
570 people of the village benefitted. in which free medical treatments/medicines people from in and around the village
Free medicines have been provided to have been provided to 570 people of the were benefitted. Doctors Screened the
them. locality. patients and provided free medicines.
NTPL organises Free Eye Camp at Thoothukudi :
NLC Tamilnadu Power Limited Power, NLCIL inaugurated the
(NTPL), one of our Subsidiary eye camp in the presence of
Company at Thoothukudi had Shri Shajee John, Chief Executive
conducted a Free Eye camp at Officer/NTPL. 181 persons were
NTPL Township for the general benefitted. Out of which, 11 persons
public, in Association with District were recommended and identified
Blindness Control Society (DBCS), for the Surgical Treatments and
Thoothukudi on 17.02.2019. 66 persons were recommended for
Shri V. Thangapandian, Director/ Spectacles with various vision
errors.
A SPECIAL PAGE FOR
THE SPECIAL CHILDREN
ANNUAL MEDICAL CHECKUP
Annual Medical Examination of medical examination and
programme for Special Children of recommendations of doctors for
Sneha School for the academic year compliance by parents in terms of
2018-19 was conducted on seeking early medical intervention in
26.02.2019 in SNEHA School. the case of children diagnosed with
A team of specialist doctors from problems.
NLC India Hospital, comprising of Smt. Kanchan Rakeshkumar,
Physicians, Paediatricians, President SNEHA Opportunity
Dermatologist, Ophthalmologist, ENT Services Society, graced the occasion
and Dental surgeons and inquired the
and Psychiatrist doctors about health
screened children to status of each child and
assess them for requested the doctors
health problems to treat the children in
pertaining to their NLC India Hospital
specialty domains. who are diagnosed with
Health records were chronic medical
updated with findings conditions.
SNEHA HOSTED THE DISTRICT LEVEL SPORTS MEET FOR SPECIAL CHILDREN
SNEHA School – the trail blazing institution sets benchmark in and Smt. Salma Philip, Principal of Sneha School. The event featured
rehabilitation programme for mentally challenged children (Special both athletic and team games as the children participated with flair and
Children) for similar schools in the Cuddalore District to adopt its flamboyance. Winners were encouraged with trophies and medals. But
best practices. In terms of promoting sports among special children the ultimate winner is the event itself as the children competed in right
which is gaining momentum in recent times, SNEHA took the spirit and were united in the goal of celebrating sports in true spirit and
initiative to conduct a District level sports meet jointly with the in appreciation of each other’s talents. The event offered a never before
Sports Development Centre of experience of enjoying camaraderie
NLCIL and the NLC India Hospital on with one another and show cased their
20.02.2019 at the Bharathi Stadium. skills in a perfect ambience which
Bharathi Stadium offered.
The mega event was a big draw as
it attracted a larger than expected Smt. Kanchan Rakeshkumar, the
participation of 177 children from President SNEHA Opportunity
12 schools across Cuddalore Services Society was behind holding
District. Smt. Shanti Vikraman, this mega event for the first time in
Patron of Neyveli Ladies Club Neyveli which contributed to
flagged off the event in the presence enhancing the image of NLCIL as a
of Shri R. Ramesh, DGM/Sports, corporate citizen committed to the
NLCIL, Shri Raghava Reddy, Secretary, Sneha Opportunity Services cause of holistic development of special children.NEWS IN BRIEF
Photo
News
1. Housemates of “Anandam Illam” celebrating New Year 2019 with on “Health & Hygiene in Adolescence stage” at the Young Student
CMD and Directors of NLCIL and Smt. Kanchan Rakesh Kumar Scientist Programme-2018 organised by Tamilnadu State Council for
(01.01.2019) Science & Technology, Dept. of Higher Education, Govt. of Tamilnadu at
2 Shri S.R. Sekhar, CGM/TA administering polio drops to a child during Jawahar Science College, Neyveli (05.01.2019).
the 25th National Intensified Pulse Polio Programme – 2019 at Block-20, 5. NLC India Pavilion which displayed the handicrafts made by
Health Centre, Neyveli. 4723 children were given Polio drops Sneha Children at the Udyam Samaagam Trade Fair organised by
(10.03.2019). MSME Technology Development Centre at Coimbatore (24.03.2019)
3. Smt. Kanchan Rakesh Kumar and the Members of Australian Team viewing 6 Dr. S. Vijayakumari, Psychiatrist & ACMO/NLC India Hospital
the Yogasanas demonstrated by the students of Sneha school (11.01.2019) addressing the students of Kendriya Vidyalaya, Neyveli at the one day
4. Dr. S. Vijayakumari, Psychiatrist, NLC India Hospital handling a session Workshop on ‘Substance Abuse’ (11.02.2019).RUN FOR HEALTH
NLCIL Sports Development Centre organised a Mini Marathon family members, school and college
“Run for Health” at Neyveli on 17.02.2019 for the cause of Good students, CISF personnel and
Health and Fitness. Shri Rakesh Kumar, CMD, NLCIL flagged off general public enthusiastically
the Marathon at Bharathi Stadium in the presence of participated in the event.
Shri V. Anbuchelvan, Collector, Cuddalore District, Shri Nadella Shri T.D. Rajendran, a veteran
Naga Maheswar Rao, Director (P&P) sports super senior citizen
and Shri Prabhakar Chowki, from Sivakasi gave an
Director (Mines) of NLCIL. encouraging speech before the
About 2400 Citizens from all start. After a circuitous route of
walks of life in all age groups 5 km, the marathon came to a finish
participated in the Marathon. at the starting place. NLC India Hospital
Along with CMD, Collector made all the precautionary measures and sent ambulance vehicles
and Directors, our Senior along with the participants. Earlier, homage was paid to the martyrs
O ff i c i a l s , v e t e r a n s p o r t s of the terror strike in Pulwama and the run was dedicated to the
personnel of NLCIL, employees, martyred CRPF Jawans.
LIGNITE LIFE LINE
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Published by NLC India Limited, ‘Navratna’ - A Govt. of India Enterprise, Neyveli 607 801, Tamil Nadu. Website : www.nlcindia.comYou can also read
