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Civil Hospital Karnal

Functioning of Health Institutions

The following main National Health activities are being looked after through these health institutions:-

Family Welfare

Sterilization facilities for Male & Female is available in General Hospital Karnal. On every Monday, Tuesday, Thursday & Friday. On a fixed day every week in every CHC.  Services are also available for Medical Termination of Pregnancy (M.T.P.)
Facility for Copper-T is available at Sub Centre, Primary Health Centre, Community Health Centre as well in the other Health Institutions. Other spacing methods such as Oral Pills and Condom are also available in same institution.
No Scalpel Vasectomy technique is being used for male sterilization. Which is going to the poplar in the district.

Immunization Services:-

Under this programme 0 to 5 years of children are being provided free immunization against Diphtheria, Pertusis, Tetanus, Polio, Tuberculosis and Measels. In the villages out reach sessions are organised for these services on every Wednesday. Through PPI three rounds of polio immunization were organised in the months of Nov.2001, Dec.2001, Jan.2002, during which 1,89,495, 246951 & 207110 were the beneficiaries. There is provision of Apni Beti Apana Dhan, Balika Smrdhi Yojana and National Maternity Scheme.  

Malaria Control Programme

All the patients suffering from fever are provided Chloroquine tablets free of costs and their blood is also examined for presence of Malaria parasite . In the villages 1326 Drug Distribution Centres are functioning through which person suffering from fever can get chloroquine tablets free of cost without getting his blood tested for Malarial parasite. In the urban area Anti Larval measures are adopted and also in selected areas focal spray programme is undertaken from the month of June 2005 in Block Gharaunda of high risk villages of Gharaunda block.

General Health Services

Regularly samples of eatables are taken for analysis and suitable action is taken against the person found guilty. The water samples from urban as well as rural areas are regularly taken, so that portable germs free water is made available to the public. Health education and  awareness regarding communicable diseases and HIV/AIDS is imparted to public.

T.B. Control Programme

All the patients suspected to be suffering from T.B. are examined for their blood, sputum and X-Ray chest and given free medicine if found suffering from Tuberculosis. There is one Distt. T.B. Centre along with 26 PHIs looking after this programme. The Distt. T.B.Officer is looking after the leprosy patients also. 

The growing tendency of Tuberculosis is a living evidence of some snags somewhere in NTCP(National Tuberculosis Control Programme) NTCP was launched in 1962 after 40 years of operation NTCP. It was observed that this has not made any significant epidemiological impact on problem of TB. However NTCP has created a large number of infrastructure through out the country like District TB  centre.

Based on the findings and recommendation of review committee Govt. of India involved a Revised Strategy (RNTCP) with the objective of curing at least 85% of the Smear Positive patients and Sputum Conversion, i.e. Sputum Positive to Sputum Negative to 90%

DOTS is (Directly Observed Treatment System in short-course chemotherapy areas) also known as RNTCP has been introduced as a proved intervention to combat the spead of this disease in Karnal district 

RNTCP focuses on sputum positive cases. It will help to lower/eliminate the reservoir of infection in the community. This will also help to curb the growing tendency and reduce the morbidity and mortality of the disease. Saving the life of the most productive group of individulas and thier working capacity will help to improve thier socioeconomic conditions and ultimately in the development of the country.

Under this therapy, during the intensive phase, the medicines are administered by the DOTS ( Directly Observed treatment  System) is providing  a service to a patient must be done by a person who is acceptable and accessible to the patient and accountable to the Health System. In this therapy, multiple worker form the health system like example MPW, ANM, Pharmacist, Doctor and etc.

During the continuation phase, the patient is issued medicines for 1 week in a multiblister of which the first dose is swallowed by the patient in the presence of the Health Worker or Volunteer or like other trained person to ensure the complete treatment, the consumption of medicines (in the continuation phase) is also checked by return of empty mulitibilster when the patient comes to collect medicines for the next week. Sputum microscopy is done at definite intervals during treatment to monitor the patient's progress toward cure.

District T.B. Societies have been formed in Karnal districts and Govt. Of India is likely to release funds to the District Societies . District T. B. Officer is the Incharge of District T.B. Control Programe. One T.B. Unite is established for a population of 5 lacs. One medical officer, one senior treatment supervisor and one senior L.T. are appointed there supervise the activities of DOTS provider and L.T. posted in the microscopy centre which is established for a population of one lacs. Anti T.B. drugs are provided free of cost to all the T.B. cases.  

Progress Report of T.B. Cases of District Karnal Under RNTCP 

Tuberculosis is one of the oldest disease known to mankind. In 1500 B.C, the Rig Veda describe the illness of Rajayaksma the king of disease.   

• India accounts for nearly 30 percent of all Tuberculosis cases in the world.

• Tuberculosis kills more adult in India than any other infectious disease.  

• T.B. kills more women than all causes of maternal mortality.  

• T.B. creates more orphan than any other disease.  

• Every year more than 3 lakhs children leave school on account of their parents T.B. 

•  Nearly 5 lakhs people die from T.B. in India every year-more than 1000 every day one every minute.

• Most of these death would be prevented by effective Tuberculosis control.

• Economic burden of Tuberculosis in India is enormous –13000 Crores in a year. It infects most productive age group of people, 15-45 years of age. 

• Every year each untreated sputum positive patient can infect 10-15 persons there by increasing the pool of infection.  

• 40% of total population and 60% of adult population in India is infected with T.B.  

• 150 lakh people are suffering from Tuberculosis in our country-15 per 1000.  

• Tuberculosis in infectious disease.  

• Tuberculosis spread by droplet infection – a patient with pulmonary tuberculosis coughs or sneezes – he throes T.B. germs in form of tiny droplets. These tiny droplets when inhaled by healthy person may cause the disease.  

• 25% T.B. patients are highly infectious - - sputum positive – throwing T.B. germs in their surrounding during coughing and sneezing.  

• T.B. can effect any part of body­---- lungs, heart, brain, bone, intestine kidneys, genital system etc. but Tuberculosis is mostly of lungs - - pulmonary tuberculosis – 85%  

• The incidence of tuberculosis in Haryana is approximately 1.5% of the population.  

• There are about 3 lakhs T.B. patients in the state of which 60,000 are positive, the most potential source of infection. 

SYMPTOMS OF TUBERCULOSIS

• Cough with Expectoration for 3 weeks or more.

• Rise of temperature in the evening

• Weight loss

• Chest pain

• Haemoptysis 

NATIONAL TUBERCULOSIS PROGRAMME

Started in 1962—results are not encouraging due to adherence to treatment is irregular, regardless of age, sex, religion education, or severity of disease – only 30% patients are completing treatment due to 

Very long treatment – 12 to 18 months.

Short supply of anti T.B. drugs.

Long distance to cover to collect T.B. medicine by Patient 

• Faulty diagnosis – mainly depends upon chest X-ray – only 60% correct diagnosis is possible with X-ray

Poor follow up of defaulters under this programme the drop out rate was approximately 45.50%

• No proper monitoring – only by X-ray chest.

• No proper treatment regimes used – non-standard and incomplete treatment. 

REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME 

• Started in India in 1996 as pilot project.

• Very encouraging results.

• Whole of Haryana is Governed under R.N.T.C.P. Programme.

• Under this programme three treatment units are created at- Karnal, Nilokheri and Jalmana

• In each treatment unit-one designated Medical Officer, one senior treatment supervisor and one senior T.B. Laboratory supervisor are posted who look after the programme exclusively in their sub district.

• 13 microscopic centers are created – T.B. Hospital Karnal, CHC Nilokheri, CHC Gharounda, CHC Indri,  CHC Nissing,  CHC Ballah, PHC Nigdhu-sputum examination of patient having cough for three weeks and more will be done by specially trained laboratory technicians by binocular microscope which allow effective diagnosis in the periphery.

• 160 directly Observed Treatment Center are started where patients will be given T.B. medicine under direct observation of trained health worker thrice in a week.

• Number, place and time of these DOT’s centers are flexible in accordance to convenience of patients so patient will not travel more than 1 K.M. to take his medicine.

• A box of medicine for the entire treatment is earmarked for every patient registered – ensuring the availability of the full course of treatment.

• Very good quality drugs and standard regimens will be used – shortening the treatment period from 12-18 months to 6-8 months.

• Each and every patient will be monitored till he is cured

• RNTCP shifts the responsibility for cure from patient to health system.

• With effective diagnosis and treatment under RNTCP, T.B. cases will be decreased 10-15 % per year – eradicating the T.B. in our district in next 10—15 years. 

School Health Services

School Health Programme

School children are our future citizens on whom the progress and welfare of the country depends. Therefore it becomes imperative that school children are imparted education under healthy and sanitary conditions during their school going period. The children are constantly under going physical, mental, emotional and social changes Measures have to be taken to safeguard their health in every possible way. so that the future generation does not suffer from any avoidable physical and mental disorders later in the life.

The School Health Programme focuses at :-

1. All the primary school children are medically examined at least thrice in their primary school period.
2. The health condition of school children has to be ascertained and presence of diseases and physical defects must be detected and remedial measures are to be suggested. All the tanks where water is stored are to be cleaned daily as in homes and chlorination must be done.
3. Health education in the form of lectures is imparted to school children and community members on common ailments like caries, water borne diseases, scabies and skin infections, diarrhoeas and respiratory diseases.
4. Every Saturday is fixed for medical examination of school children referred by M.O.'s and Health Workers from the schools and adequate treatment is given at PHC's and CHC's and District Hospitals on "Priority Basis".
5. The practice of hygiene and healthful living has to be inculcated so that it becomes a regular feature with them both at school and at home.

Following Points are to be checked while a visit is made by the team consisting of Medical Officer and Other Staff:-

1. Cleanliness and Sanitary conditions of all the schools and school hostels as well as the quality of food and water served to the children must be checked. Chlorination of water/water tanks must be done regularly.
2. Weighing machines, standard weight charts and measuring tape should be readily available while examining the children.
3. The Medical examination of school children should be carried out methodically and the following points should be take in to account during medical examination of each child.

1. Name, Ag, Sex and Address of child.
2. Name of the School visited.
3. Date of examination.
4. Measurement of height. weight, nutrition, cleanliness, clothing, foot war etc.
5. Special examination of skin, nose, throat, eyes, ears, hair, feet, mental & nervous disorders.
6. Immunization status
7. Physical deformity and any other disease.
8. Any investigation if required.
9. Proper referral of children for further special treatment to District Hospitals.
   Regular Monitoring of the School Health Programme is done by District School Medical Officer regularly under direct guidance of Civil Surgeon, Karnal. 

Drug Inspection Programme

One Senior Drug Inspector and one Distt. Drug Inspector is posted in Karnal through which the licensing of whole sellers and retailers chemist are issued and processed. The chemist shops and R.M.P. premises are regularly visited for the benefit of General Public.

National Blindness Control Programme.

National Programme for Control of Blindness

National Programme for Control of Blindness is being run by District Blindness Control Society (D.B.C.S.) in Karnal since 1994. Deputy Commissioner, Karnal is the Chairman of D.B.C.S. and Civil Surgeon is the Vice-Chairman. District School Medical Officer is the Member Secretary of D.B.C.S.
Conventional and intraocular lens (IOL) implantation cataract surgeries are being performed in the district by govt. hospital and private eye hospitals and by some charitable institutions including N.G.O.'s. A number of eye camps are organized in the district by N.G.O.'s and govt. agencies. These surgeries are done free of cost. Reimbursement of Rs. 750/- per cataract surgery is provided by Govt. of India under N.P.C.B.

Progress Report for Year 2004-2005

No of cataract operations done

No. of Eye Camps organized by N.G.O.'s & Govt. Agencies    23

District Karnal TOPS Haryana in Cataract Surgeries during this year.

IEC activities done under D.B.C.S.

• Wall Paintings, Hoardings, Tin Plates in General Hospital, Karnal, CHC's & PHC's of the district on General Eye Care.
• Wall Paintings, Cable TV Strips and Cinema Slides on "Netradan-Mahadan".
• Observance of Prevention of Blindness week from April 1-7, 2005 on the theme Diabetes Mellitus and Eyes.

Blood Transfusion Services

Regional Blood Bank Karnal is catering the need of General Public in and around Karnal for their demand of fresh tested and disease free blood to the needy person. Various blood donation camps are arranged from time to time where the R.B.T.O. and her staff arranges the collection of blood from healthy donors. The facilities for testing of blood for hepatitis and AIDS is also available. V.T.C. is also working in this hospital.

Public Health Laboratories Services.

State Public Health Laboratories Services :-

On State Level Public Health Laboratory is situated in the General Hospital Campus at Karnal, where clinical Pathological Investigations, epidemiological work and training programme under various National Programmes are conducted.
State I.D.D. Laboratory under National Iodine Deficiency Disorders Control Programme has been set up at State Public Health Laboratory, Karnal. Under this Programme testing of ruine samples for estimation of urinary iodine excretion in Pregnant Women & Children below 5 years, is done.

Handicapped Board

On every Wednesday of the week various handicapped persons are examined for assessment of their percentage of disability by the medical board. The Red Cross Society Karnal is helping to provide them necessary Aid through special camps where the specialist assess the disability and prescribed the desired services to be provided.
Civil Surgeon is working as Registrar  and District Health officer is working as Deputy Registrar for Births and Deaths incidents of  Karnal. 

PNDT Act 1994

                To check the declining population of females & to maintain the dignity & status of women. The pre-conception & Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act 1994 is implemented in the Distt.  So for 48 Ultrasound Centers have been regd. under the Act. & routine inspection of the Regd. Ultrasound Centres is being done. Main Objects of the Act :- 

1. Prohibition of the misuse of Pre-Natal diagnostic technique for determination of sex of foetus, leading to female foeticide.
2. Prohibition of advertisement of Pre-Natal diagnostic technique for detection or determination of sex.
3. Permission & regulation of the use for Pre-Natal diagnostic technique for the purpose of detection of specific genetic abnormalities or disorders.
4. Permitting the use of such techniques under certain conditions by the regd. Institutions.
5. Punishment for violation of the provision.

 Laboratory  Functions

1        Clinical Pathological Investigation

We are doing clinical pathological investigation of the out door and indoor patients of general hospital Karnal and others surrounding Districts. This Lab has facility for the following tests.

All type of Bacteriological test and culture, Biochemistry tests various Hematological tests, Cytological, Histopathological, Serological, urine examination, Protozoology & Helminthological tests. 

2    Epidemiological Work

Some of the staff of epidemiological unit of the state is attached to this laboratory. This staff helps in the epidemiological studies of various communicable disease. In case of an outbreak of an epidemic the samples are received from whole of the state to find the cause and to take measures for the curtailments of the epidemic. 

3     Water for Bacteriological Examination

Water samples for Bacteriological analysis is received from the various districts of Haryana from health department, Municipal Committee educational institute and public health department laboratory. 

4    Diploma in Medical Laboratory Training Course

One year diploma course per medical laboratory technicians is run in this laboratory. Thirty student are admitted every year for training. Minimum Qualification for admission for this course is 10+2 with Science. Beside this laboratory also imparts training  programme for the in services laboratory technicians of the Haryana State. 

5    State T.B Training and Demonstration Center under RNTCP

This laboratory is declared as Haryana State T.B. Traning and Demonstration Center under Revised National Tuberculosis Control Programme for imparting training to S.T.L.S and L.T’s 

6    Under National Surveillance for Communicable Disease  

       This laboratory declared as Regional lab.  

Ch. Devi Lal Rastriya Uthan Aivam Parivar Kalyan Yojna “Devi Rupak” 

Objective :  A scheme to provide monthly incentive to eligible couples under the scheme in order to stabilize the population of the state, to check the declining trend in the male to Female sex ration, adoption of our child norm & spacing of child birth.

Incentives : A monthly incentive at the rates given below upto 20 years from the date of adoption of terminal method of family planning by either of the partner of a couple, will be given under the scheme :- 

 ELIGIBILITY CONDITIONS 

1. None of the partners constituting the couple should be an income tax payee. 

2. To be eligible under the scheme a couple would have to get themselves registered with the local Gram Panchayat/Municipal Committee within whose jurisdiction the couple ordinary resides. 

3. Couples within the age group upto to 45 years for male & 40 years of females are covered under the scheme irrespective of their date of marriage.

4. The benefit will be available after terminal method is adopted before the youngest child attains the age of 5 years.

5. In case neither of the parents adopts a terminal method of family planning after the birth of the first girl child, then in order to be eligible for this scheme, he/she will planning before the youngest child attains the age of 5 years. 

ACTIVITIES DONE UNDER R.B.T.C 

1.                  Motivation of donors to increase voluntary blood donation.

2.                  Registration & Medical examination of donor.

3.                  Donor selection to exclude high risk group.

4.                  Donor Bleeding.

5.                  Serological Testing (Blood Grouping & cross matching).

6.                  Testing for Transfusion transmissible diseases (Hepatitis B, Hepatitis C, Syphiliz & H.I.V., Malaria)

7.                  Sterilization & auto claving.

8.                  Disposal of unaffected Blood as per bio-safety measures.

9.                  Issue of blood to Govt. Hospital & Private Hospital of District Karnal & adjoining Distt.

10.              HIV Testing & counseling of suspected HIV cases under V.C.T.C. 

  Civil Surgeon is working as Registrar and District Health Officer is working as Deputy Registrar for Births and Deaths incidents of Karnal. A list of staff working at General Hospital, Karnal is also enclosed herewith.

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